cssi/SciSciGPT-SciSciNet huggingface dataset:
Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest

Background Antiarrhythmic drugs are used commonly in out-of-hospital cardiac arrest for shock-refractory ventricular fibrillation or pulseless ventricular tachycardia, but without proven survival benefit. Methods In this randomized, double-blind trial, we compared parenteral amiodarone, lidocaine, and saline placebo, along with standard care, in adults who had nontraumatic out-of-hospital cardiac arrest, shock-refractory ventricular fibrillation or pulseless ventricular tachycardia after at least one shock, and vascular access. Paramedics enrolled patients at 10 North American sites. The primary outcome was survival to hospital discharge; the secondary outcome was favorable neurologic function at discharge. The per-protocol (primary analysis) population included all randomly assigned participants who met eligibility criteria and received any dose of a trial drug and whose initial cardiac-arrest rhythm of ventricular fibrillation or pulseless ventricular tachycardia was refractory to shock. Results In the per-protocol population, 3026 patients were randomly assigned to amiodarone (974), lidocaine (993), or placebo (1059); of those, 24.4%, 23.7%, and 21.0%, respectively, survived to hospital discharge. The difference in survival rate for amiodarone versus placebo was 3.2 percentage points (95% confidence interval [CI], -0.4 to 7.0; P=0.08); for lidocaine versus placebo, 2.6 percentage points (95% CI, -1.0 to 6.3; P=0.16); and for amiodarone versus lidocaine, 0.7 percentage points (95% CI, -3.2 to 4.7; P=0.70). Neurologic outcome at discharge was similar in the three groups. There was heterogeneity of treatment effect with respect to whether the arrest was witnessed (P=0.05); active drugs were associated with a survival rate that was significantly higher than the rate with placebo among patients with bystander-witnessed arrest but not among those with unwitnessed arrest. More amiodarone recipients required temporary cardiac pacing than did recipients of lidocaine or placebo. Conclusions Overall, neither amiodarone nor lidocaine resulted in a significantly higher rate of survival or favorable neurologic outcome than the rate with placebo among patients with out-of-hospital cardiac arrest due to initial shock-refractory ventricular fibrillation or pulseless ventricular tachycardia. (Funded by the National Heart, Lung, and Blood Institute and others; ClinicalTrials.gov number, NCT01401647.).
Automatic word-level abstraction of datapath

Abstracting word information from gate-level designs is essential for formal verification, technology mapping and hardware security applications. In this paper, we present a novel method to abstract the word-level information from arithmetic gate-level circuits using a computer algebraic approach. The proposed technique translates the gate-level circuit into algebraic domain and applies algebraic rewriting to extract the arithmetic function. During the iterative rewriting, intermediate Pseudo-Boolean expressions are examined to identify word-level candidates. The proposed algorithm is able to abstract the word components from candidates and to reason about the word operation from the internal expressions. Successful experiments were performed on gate-level datapaths, including multipliers of up to 128-bit widths.
An Individual Tree-Based Automated Registration of Aerial Images to Lidar Data in a Forested Area

Abstract In this paper, we demonstrate an approach to align aerial images to airborne lidar data by using common object features (tree tops) from both data sets under the condition that conventional correlation-based approaches are challenging due to the fact that the spatial pattern of pixel gray-scale values in aerial images hardly exist in lidar data. We extracted tree tops by using an image processing technique called extended-maxima transformation from both aerial images and lidar data. Our approach was tested at the Angelo Coast Range Reserve on the South Fork Eel River forests in Mendocino County, California. Although the aerial images were acquired simultaneously with the lidar data, the images had only approximate exposure point locations and average flight elevation information, which mimicked the condition of limited information availability about the aerial images. Our results showed that this approach enabled us to align aerial images to airborne lidar data at the single-tree level with reasonable accuracy. With a local transformation model (piecewise linear model), the rmse and the median absolute deviation ( mad ) of the registration were 9.2 pixels (2.3 meters) and 6.8 pixels (1.41 meters), respectively. We expect our approach to be applicable to fine scale change detection for forest ecosystems and may serve to extract detailed forest biophysical parameters.
Parental indulgence, self-regulation, and young adults’ behavioral and emotional problems

ABSTRACTBecause emotional and behavioral problems during young adulthood are an evolving public health concern, it is important to identify parenting behavior in the family of origin that prevents ...
Eye movements in software traceability link recovery

Information Retrieval (IR) approaches, such as Latent Semantic Indexing (LSI) and Vector Space Model (VSM), are commonly applied to recover software traceability links. Recently, an approach based on developers' eye gazes was proposed to retrieve traceability links. This paper presents a comparative study on IR and eye-gaze based approaches. In addition, it reports on the possibility of using eye gaze links as an alternative benchmark in comparison to commits. The study conducted asked developers to perform bug-localization tasks on the open source subject system JabRef. The iTrace environment, which is an eye tracking enabled Eclipse plugin, was used to collect eye gaze data. During the data collection phase, an eye tracker was used to gather the source code entities (SCE's), developers looked at while solving these tasks. We present an algorithm that uses the collected gaze dataset to produce candidate traceability links related to the tasks. In the evaluation phase, we compared the results of our algorithm with the results of an IR technique, in two different contexts. In the first context, precision and recall metric values are reported for both IR and eye gaze approaches based on commits. In the second context, another set of developers were asked to rate the candidate links from each of the two techniques in terms of how useful they were in fixing the bugs. The eye gaze approach outperforms standard LSI and VSM approaches and reports a 55 % precision and 67 % recall on average for all tasks when compared to how the developers actually fixed the bug. In the second context, the usefulness results show that links generated by our algorithm were considered to be significantly more useful (to fix the bug) than those of the IR technique in a majority of tasks. We discuss the implications of this radically different method of deriving traceability links. Techniques for feature location/bug localization are commonly evaluated on benchmarks formed from commits as is done in the evaluation phase of this study. Although, commits are a reasonable source, they only capture entities that were eventually changed to fix a bug or resolve a feature. We investigate another type of benchmark based on eye tracking data, namely links generated from the bug-localization tasks given to the developers in the data collection phase. The source code entities relevant to subjected bugs recommended from IR methods are evaluated on both commits and links generated from eye gaze. The results of the benchmarking phase show that the use of eye tracking could form an effective (complementary) benchmark and add another interesting perspective in the evaluation of bug-localization techniques.
Utility of prospective pathologic evaluation to inform clinical genetic testing for hereditary leiomyomatosis and renal cell carcinoma

BACKGROUND Patients with hereditary leiomyomatosis and renal cell carcinoma (HLRCC) resulting from fumarate hydratase (FH) mutations may present with skin, uterine, and renal tumors, with each having unique pathologic features. This study investigated the association between prospectively identified suspicious pathology (SP) and FH mutations when patients were referred for genetic testing. METHODS This was an institutional review board–approved cohort study of patients receiving FH testing from 2008 to 2013. SP was defined as a report of HLRCC histologic features identified during a prospective pathologic assessment. The association between SP and FH mutations was analyzed. RESULTS FH testing was performed in 29 patients with a median age of 37 years; 15 (52%) were female, and 18 (62%) were white. Pathologists reported SP from kidney tumors (11 of 18), leiomyomas (9 of 15: uterus [n = 8] and bladder [n = 1]), and metastatic tumors (3 of 6) in 23 of 39 associated specimens (59%) from 21 of the 29 patients (72%). Patients with SP were younger (35 vs 51 years; P = .010), and those with kidney tumors more often had stage pT3 or higher renal cell carcinoma than those without SP (100% vs 33%; P = .006). FH mutations were present in 8 patients with SP (38%) and in 1 patient without SP (13%; P = .37); 7 of these patients had kidney cancer (n for SP = 7), all with N1 disease. Analyzing SP by tissue type identified only SP from renal tumors as being significantly associated with positive testing for an FH mutation (P = .013). CONCLUSIONS SP from kidney tumors was statistically associated with FH mutations. An expert pathologic assessment of renal tumors will facilitate the clinical identification of HLRCC cases, and this will result in genetic testing and targeted cancer screening for patients and at-risk family members. Cancer 2017;123:2452–58. © 2017 American Cancer Society.
Spatial Pattern Formation and Morphogenesis in Development: Recent Progress for Two Model Systems

The rapid growth in the number of identified molecular components that comprise signal transduction and gene control networks has focused attention on the difficult problem of understanding how networks of such components function and how they are controlled. In the context of developmental biology. the problem is to understand how the inherited genetic information in a fertilized egg is translated into a normal adult that may comprise several hundred different cell types arranged into numerous specialized tissues and organs. The complexity of the problem stems in part from one of the central facts of developmental biology, which is that the developmental fate of a cell in a multicellular system is determined not only by its genome, but also by its spatial position relative to other cells and the signals it receives from them. Intercellular communication, either through cell-cell contact or through release or presentation of signaling molecules, plays a significant role in determining what part of the genetic code is transcribed at a particular point in space and time in a multicellular system. While gene-sequencing has provided enormous detail concerning which genes are present in the genome of various organisms, much less is understood about the complex networks of regulatory interactions that control how genes are turned on or off at the appropriate time and place in a developing organism.
Influences on the performance of hospital clinical event monitoring.

Abstract The implementation of real-time clinical monitors in large hospital information systems places large performance demands on these systems. Meeting these demands not only requires methodologies to augment the performance of individual monitors but an understanding of how patient population and monitor characteristics might influence overall system performance. We have built a multimonitor simulator to study these influences on performance. In doing so, we have focused on the impact of a variety of techniques to cache a subset of a large number of monitors in primary memory.
Comparisons of respiratory muscle strength and chest expansions between obese class I and normal weight females

Background: Obesity is a medical condition which increases body fat and a negative effect on respiratory system. Objectives: To compare the respiratory muscle strength and chest wall expansions between obese class I and normal weight females. Materials and methods: Ninety female participants aged 18-30 years old were equally divided into normal weight (BMI 19.28±0.57 kg/m2) and obese class I (BMI 26.32±0.64 kg/m2) groups. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured in both groups by respiratory muscle meter. Chest expansions at the upper, middle and lower part of thorax were assessed using a tape measurement. Results: MIP and MEP were significantly different between groups ( p <0.05). Additionally, respiratory muscle strength of obese class I group was higher than those in the normal weight group. The upper, middle, and lower chest expansions in obese class I group were higher than those in normal weight group ( p <0.05). Conclusions: Respiratory muscle strength and chest wall expansions in obese class I female participants were higher than those in normal weight females.
Integration and organizational change towards sustainability

This interdisciplinary study examines why and how corporate leaders operationalize sustainability in organizational strategy, systems and activities. Through interviews with sustainability professionals using a cross-industry sample of multinational organizations recognized as top performers by multiple sources (Dow Jones Sustainability Index, Newsweek Green Rankings, GRI, and KLD), the research identified drivers, enablers, evaluation methods and change management practices for corporate social, environmental and financial initiatives. Using multiple coders, and an analysis of responses to structured interview questions, we determine how sustainability professionals influence the alignment of sustainability goals, mission and values at leading organizations. Scholarly contributions include insight into how top performing companies manage change involving social and environmental responsibility. Insights come from primary research with the individuals who anchor those corporate sustainability initiatives providing a foundation for further theory development and testing of propositions. The key findings include integration as a systems-based approach to sustainability, change management, innovation, and corporate strategy. Integration takes place through the alignment of performance metrics within and across business units and functions with a call for Integrated Bottom Line performance measurement throughout organizations and value chains to inform management decision-making, transparency, and external reporting. Predictions are that integration and change management are critical success factor for the advancement of strategic sustainability initiatives.
Reconfigurable Linear/Circular Polarization Rectangular Waveguide Filtenna

We introduce a new reconfigurable linear polarization and circular polarization (CP) antenna, based on a rectangular waveguide (RWG) and a novel reconfigurable polarizer. The polarizer consists of two orthogonal apertures. The apertures transform the linear polarization of the dominant mode of the RWG antenna to CP. Each of these apertures is loaded by a p-i-n diode to alter its electrical length. This length difference provides the phase rotation needed to obtain CP. The signal polarization of the antenna can be selected by changing the applied bias voltage of p-i-n diodes as right-handed (RH)/left-handed (LH) CP. We can also achieve linear polarization if both diodes are ON or OFF. The reconfigurable polarizer acts as a bandpass filter, since the apertures can be considered as complementary electrically small resonators. This self-filtering capability is useful for reduction out of band noise in a communication system such as satellite links. The proposed antenna is designed to operate at 2.65 GHz, but the same approach can be applied to other frequency bands. The measurement results show a very good RH/LHCP and they are in good agreement with simulations.
Broadband 19F TOCSY using BURBOP-based spin lock

Abstract A train of BURBOP universal rotation pulses has been used to generate a spin lock sufficient to observe TOCSY correlations over a 46 kHz 19F spectral window (i.e. 122 ppm on a 9.4 T spectrometer). This spin lock requires lower RF field (γB1 = 15 kHz), and was employed over a wider spectral window, than previously reported DIPSI-2 spin locks. The BURBOP-based spin lock was effected for 80–160 ms periods with a 2% duty cycle without evidence of harm to the RF coil of the probehead. Spectral separation and full set of correlations were obtained for a mixture of perfluorocarbons.
Mass Shootings Backfire: The Boomerang Effects of Death Concerns on Policy Attitudes

ABSTRACTFear-inducing communication is commonly adopted in the public domain. For example, advocates of gun control have believed that the tragic cases of mass shooting would be an effective persuasive tool to draw favorable public opinion about gun control policies. However, this assumption does not meet reality. Despite a rash of mass shootings over the past 2 decades, public support for gun regulation has continued to decline. To resolve this dilemma, this article conducted 3 experiments and provided compelling explanations of how threatening shooting stories generated the unintended effects. In line with the terror management theory, the moderated mediation model showed that shooting stories produced partisan polarization on gun policies. Theoretical and practical implications of fear-inducing messages are discussed.
Field of View Normalization in Multi-Site Brain MRI.

Multi-site brain MRI analysis is needed in big data neuroimaging studies, but challenging. The challenges lie in almost every analysis step including skull stripping. The diversities in multi-site brain MR images make it difficult to tune parameters specific to subjects or imaging protocols. Alternatively, using constant parameter settings often leads to inaccurate, inconsistent and even failed skull stripping results. One reason is that images scanned at different sites, under different scanners or protocols, and/or by different technicians often have very different fields of view (FOVs). Normalizing FOV is currently done manually or using ad hoc pre-processing steps, which do not always generalize well to multi-site diverse images. In this paper, we show that (a) a generic FOV normalization approach is possible in multi-site diverse images; we show experiments on images acquired from Philips, GE, Siemens scanners, from 1.0T, 1.5T, 3.0T field of strengths, and from subjects 0–90 years of ages; and (b) generic FOV normalization improves skull stripping accuracy and consistency for multiple skull stripping algorithms; we show this effect for 5 skull stripping algorithms including FSL’s BET, AFNI’s 3dSkullStrip, FreeSurfer’s HWA, BrainSuite’s BSE, and MASS. We have released our FOV normalization software at http://www.nitrc.org/projects/normalizefov .
The Interaction Between Mindfulness, Emotion Regulation, and Social Anxiety and Its Association with Emotional Eating in Bariatric Surgery Candidates

Previous research has shown that emotional eating is common in bariatric surgery candidates, and may be related to poorer surgical outcomes. Emotional eating may be particularly common in surgery candidates reporting social anxiety symptoms, but less is known about the possible mechanisms that may link social anxiety and emotional eating. The aim of the current study was to examine the interaction between mindfulness/emotion regulation and social anxiety and the association of this interaction with emotional eating in bariatric surgery candidates. Bariatric surgery candidates (n = 1088) were referred by their surgeons for a comprehensive psychiatric presurgical evaluation, including a semistructured diagnostic interview and self-report questionnaires. The relationship between emotional eating and the interaction of mindfulness facets/emotion regulation skills and social anxiety was examined using hierarchical linear regressions. The interaction between social anxiety and the mindfulness facets of observing, describing, and acting with awareness was significantly associated with emotional eating after controlling for covariates. However, only the observing by social anxiety interaction was significant relative to the other facets in a final regression model. The interaction between social anxiety and emotional regulation deficits related to goals, strategies, impulse control, and clarity was significantly associated with emotional eating, but only the nonacceptance by social anxiety interaction was significant relative to the other emotion regulation subscales. Findings continue to suggest a potential link between social anxiety and emotional eating in bariatric surgery candidates, and indicate that deficits in certain mindfulness facets and emotion regulation skills may be particularly relevant in this sample.
Contact Equilibrium Processes

Several operations involved in the processing of foods involve the separation of selected components from the food product. Often these operations must be conducted on a large scale to meet the demands of a large manufacturing plant. Mass transfer is the basic process involved in one group of these separation operations, which are normally referred to as contact equilibrium separations. These equilibrium processes normally include (a) gas absorption such as hydrogenation of oil or carbonation of beverages; (b) liquid-solid extraction as involved in the removal of edible oil from soy beans; (c) liquid extraction, commonly used in removing sucrose from cane or beets; and (d) distillation, used in removal of oil from solvents or in manufacturing of alcoholic beverages. All these processes are similar in that the separation of absorption process involves the transfer of mass from a component or phase of the product to a secondary phase or component. Due to the many factors which influence this transfer of mass, a fundamental understanding of the process is required.
UNIFORMLY MOST POWERFUL UNBIASED TESTS FOR THE PARAMETERS OF THE GAMMA DISTRIBUTION

Abstract. Uniformly most powerful unbiased tests for the parameters of the gamma distribution are constructed for each parameter with the other parameter considered as an unknown nuisance parameter. Convenient approximations for the sampling distributions of the respective test statistics are provided.
Guild play in MMOGs: rethinking common group dynamics models

Humans form groups and congregate into groups for a variety of reasons and in a variety of contexts e.g., corporations in offline space and guilds in Massively Multiplayer Online Games (MMOGs). In recent years a number of models of group formation have been proposed. One such model is Johnson et al's [10] model of group evolution. The model is motivated by commonalities observed in evolution of street gangs in Los Angeles and guilds in an MMOG (World of Warcraft). In this paper we first apply their model to guilds in another MMOG (EQ2)1 and found results inconsistent from the model's predictions, additionally we found support for the role of homophily in guild formation, which was ruled out in previous results, Alternatively, we explore alternative models for guild formation and evolution in MMOGs by modifying earlier models to account for the existence of previous relationships between people.
The Spectral Calibration of Swept-Source Optical Coherence Tomography Systems Using Unscented Kalman Filter

The ever-increasing demand for acquiring images at a faster rate and consequently of deeper layers of tissue in swept-source optical coherence tomography (SS-OCT), has motivated researchers to investigate techniques capable of performing fast acquisition without compromising sensitivity. Non-linear spectral sweeps, phase instability, and increased noise levels of swept lasers can cause the image quality to deteriorate, especially if a lower quality light source is used. This work leverages the unscented Kalman filter aiming to alleviate these shortcomings. Using this filter, both the non-idealities of the non-linear sweep and the increased noise levels are accounted for. Simulations show promising performance results in terms of extracting the non-linear spectral sweep as a function of time. The UKF also shows better metrics compared to other versions of the Kalman filter when it comes to tracking non-linearities and hardware implementation complexity giving the method significant advantages in real-time applications of hand-held, portable optical coherence tomography devices.
Three Important Findings From a Study on HPV “Real World” Effectiveness

* Abbreviation: HPV — : human papillomavirus Early clinical trials of the human papillomavirus (HPV) vaccine demonstrated high vaccine efficacy against persistent infection with the vaccine-specific HPV subtypes, indicating that there will be significant reductions in the prevalence of HPV-related cancers and diseases with widespread vaccination.1 Now that the vaccine has been available for public consumption for more than a decade, researchers are shifting their focus to the vaccine’s effectiveness, that is, how the vaccine performs in real-world situations rather than in the highly controlled clinical trial environment. Several studies have been done in this regard in a variety of countries, indicating that the vaccine is performing well, as expected.2 However, given the range of factors that can affect vaccine uptake and effectiveness, many more studies with this focus are needed to truly understand the vaccine’s expected public health potential. The study by Spinner et al3 in this issue of Pediatrics adds significantly to this growing body of literature. In this study, researchers recruited 4 cross-sectional cohorts (ie, study “waves”) of adolescent and young adult women (ages 13–26 years) from 2 clinical sites over a period of 11 years. The primary outcome assessed was HPV infection status, and analyses were stratified by whether the women had been vaccinated against HPV. HPV infection outcomes were divided into a group corresponding to the 4 types covered by the quadrivalent vaccine (HPV-6, HPV-11, HPV-16, and HPV-18) and an additional 5 HPV types covered in the 9-valent … Address correspondence to Amanda F. Dempsey, MD, Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Denver, Anschutz Medical Campus, 13199 E. Montview Blvd, Suite 300, Aurora, CO 80045. E-mail: amanda.dempsey{at}ucdenver.edu
Exploring Size-Speed Trade-Offs in Static Index Pruning

Static index pruning techniques remove postings from inverted index structures in order to decrease index size and query processing cost, while minimizing the resulting loss in result quality. A number of authors have proposed pruning techniques that use basic properties of postings as well as results of past queries to decide what postings should be kept. However, many open questions remain, and our goal is to address some of them using a machine learning based approach that tries to predict the usefulness of a posting. In this paper, we explore the following questions: (1) How much does an approach that learns from a rich set of features outperform previous work that uses heuristic approaches or just a few features? (2) What is the relationship between index size and query processing speed in static index pruning? We show that an approach that prunes postings using a rich set of features including post-hits and doc-hits can significantly outperform previous approaches, and that there is a very pronounced trade-off between index size and query processing speed for static index pruning that has not been previously explored.
Differences in GluN2B-containing NMDA receptors result in opposite long-term plasticity and dopaminergic modulation at ipsilateral vs. contralateral cortico-striatal synapses

Abstract Excitatory neurons in the primary motor cortex project bilaterally to the striatum. However, whether synaptic structure and function in ipsilateral and contralateral cortico-striatal pathways is identical or different remains largely unknown. Here, we describe that excitatory synapses in the contralateral pathway have higher levels of NMDA-type of glutamate receptors (NMDARs) than those in the ipsilateral pathway, although both synapses utilize the same presynaptic vesicular glutamate transporter. We also show that NMDARs containing the GluN2B subunit, but not GluN2A, contribute to this difference. The altered NMDAR subunit composition in these two pathways results in opposite synaptic plasticity: long-term depression in the ipsilateral pathway and long-term potentiation in the contralateral pathway. Furthermore, we demonstrate that activation of D1 and D2 dopamine (DA) receptors by either selective pharmacological agonists or light-induced release of endogenous DA have no effect on NMDAR-mediated neurotransmission in either pathway. However, blocking basal DAergic tone with either D1 or D2 with selective antagonists revealed that GluN2B-containing NMDARs are modulated by D1 receptors in the contralateral pathway and by D2 receptors in the ipsilateral pathway. Such distinct modulatory actions seem to be permissive rather than sufficient for the induction of long-term synaptic plasticity. Altogether, our results provide novel and unexpected evidence for the lack of bilaterality of NMDAR-mediated synaptic transmission at cortico-striatal pathways due to differences in the expression of GluN2B subunits, which results in differences in bidirectional synaptic plasticity and modulation by dopaminergic inputs.
Clinical counseling on sun protection and indoor tanning avoidance: A survey of current practices among U.S. health care providers.

Abstract Clinicians can play a role in skin cancer prevention by counseling their patients on use of sun protection and indoor tanning avoidance. We used data from the 2016 DocStyles, a web-based survey of U.S. primary care providers, to examine skin cancer prevention counseling practices among 1506 providers. In 2018, we conducted logistic regression analyses to examine factors associated with regularly providing counseling. Almost half (48.5%) of all providers reported regularly counseling on sun protection, and 27.4% reported regularly counseling on indoor tanning. Provider characteristics associated with regular counseling included having practiced medicine for at least 16 years (sun protection: adjusted prevalence ratio [aPR] = 1.27, 95% confidence interval [CI] = 1.15, 1.41; indoor tanning: aPR = 1.38, 95% CI = 1.17, 1.63), having treated sunburn in the past year (sun protection: aPR = 1.78, 95% CI = 1.46, 2.17; indoor tanning: aPR = 2.42, 95% CI = 1.73, 3.39), and awareness of U.S. Preventive Services Task Force recommendations (sun protection: aPR = 1.73, 95% CI = 1.51, 2.00; indoor tanning: aPR = 2.70, 95% CI = 2.09, 3.48). Reporting barriers to counseling was associated with a lower likelihood of regularly counseling on sun protection (1–3 barriers: aPR = 0.82, 95% CI = 0.71, 0.94; 4+ barriers: aPR = 0.80, 95% CI = 0.69, 0.93) and indoor tanning (1–3 barriers: aPR = 0.72, 95% CI = 0.57, 0.91; 4+ barriers: aPR = 0.61, 95% CI = 0.47, 0.78). Barriers to counseling included lack of time (58.1%), more urgent health concerns (49.1%), and patient disinterest (46.3%). Although many providers report regularly counseling patients on skin cancer prevention, most report serious barriers to providing such counseling. Additional research could explore strategies to integrate compelling and informative skin cancer prevention counseling into current provider practices.
Imaging or Fiber Probe-Based Approach? Assessing Different Methods to Detect Near Infrared Autofluorescence for Intraoperative Parathyroid Identification.

Background Near infrared autofluorescence (NIRAF) can guide intraoperative parathyroid gland (PG) identification. NIRAF detection devices typically rely on imaging and fiber probe-based approaches. Imaging modalities provide NIRAF pictures on adjacent display monitors, and fiber probe-based systems measure tissue NIRAF and provide real-time quantitative information to objectively aid PG identification. Both device types recently gained FDA approval for PG identification but have never been compared directly. Study Design Patients undergoing thyroidectomy and/or parathyroidectomy were recruited prospectively. Target tissues were intraoperatively visualized with PDE-Neo II (imaging-based) and concurrently assessed with PTeye (fiber probe-based). For PDE-Neo II, NIRAF images were collected from in situ or excised tissues, alongside the surgeon's interpretation of visualized tissues, and retrospectively analyzed in a blinded fashion. The PTeye was concomitantly used to record NIRAF intensities and ratios from the same tissues in real time. Results Twenty patients were enrolled for concurrent evaluation with both systems, which included 33 PGs and 19 nonparathyroid sites. NIRAF imaging demonstrated 90.9% sensitivity, 73.7% specificity, and 84.6% accuracy for PG identification when interpreted in real time by the surgeon compared with 81.8% sensitivity, 73.7% specificity, and 78.8% accuracy where images were quantitatively analyzed post hoc by an independent observer. In parallel, NIRAF detection with PTeye yielded 97.0% sensitivity, 84.2% specificity, and 92.3% accuracy in real time for the same specimens. Conclusions Both NIRAF-based systems were beneficial for identifying PGs intraoperatively. Although NIRAF imaging provides valuable spatial information to localize PGs, NIRAF detection with fiber probe provides real-time quantitative information to identify PGs in presence of ambient room lights.
Female toads engaging in adaptive hybridization prefer high-quality heterospecifics as mates

Hybridization-interbreeding between species-is generally thought to occur randomly between members of two species. Contrary to expectation, female plains spadefoot toads (Spea bombifrons) can increase their evolutionary fitness by preferentially mating with high-quality males of another species, the Mexican spadefoot toad (Spea multiplicata). Aspects of Mexican spadefoot males' mating calls predict their hybrid offspring's fitness, and plains spadefoot females prefer Mexican spadefoot males on the basis of these attributes, but only in populations and ecological conditions where hybridization is adaptive. By selecting fitness-enhancing mates of another species, females increase hybridization's benefits and exert sexual selection across species. Nonrandom mating between species can thereby increase the potential for adaptive gene flow between species so that adaptive introgression is not simply happenstance.
Tumor necrosis factor-α, TNF receptor, and soluble TNF receptor responses to aerobic exercise in the heat.

Abstract The purpose of this study was to evaluate the effects of aerobic exercise in the heat on circulating concentrations of tumor necrosis factor (TNF)-α, soluble TNF receptors (STNFR1&2), and surface expression of TNFR1&2 on monocyte subpopulations. Twelve recreationally active Caucasian men (24.4 ± 3.4 yrs.; 180.0 ± 6.8 cm; 81.5 ± 8.0 kg; 47.2 ± 4.8 mL·kg−1·min−1) completed an exercise protocol in three environmental conditions: high temperature/low humidity [HTLH; 35 °C, 20% relative humidity (RH)]; high temperature/moderate humidity (HTMH; 35 °C, 45%RH); and moderate temperature/moderate humidity (MTMH; 22 °C, 45%RH). Each protocol consisted of a 60-minute cycling trial at 60% VO2max, a 15-minute rest, and a time-to-exhaustion trial at 90% VO2max (TTE). Blood was sampled before (PRE), immediately after (POST) the 60-minute trial, immediately post-TTE (PTTE), and one-hour post-TTE (REC). Circulating TNF-α and STNFR1&2 were assayed. TNFR1&2 expression on monocyte subsets was measured by flow cytometry on a subset of participants (n = 8). TNF-α area under the curve with respect to increase (AUCi) was greater during HTMH compared to MTMH and HTLH. STNFR1 concentration was greater during HTMH compared to MTMH. With all trials combined, STNFR1 concentration increased from PRE to POST, PTTE, and REC. TNFR1 expression on non-classical monocytes was greater during HTMH compared to HTLH while TNFR2 expression was lower during HTLH compared to both MTMH and HTMH. Data suggest that exercise in the heat increases circulating TNF-α and STNFR1 concentration concomitantly. Furthermore, non-classical monocyte expression of TNFRs are impacted by temperature and humidity during exercise.
Implementation of an Interdisciplinary AACN Early Mobility Protocol.

BACKGROUND Increasing mobility in the intensive care unit is an important part of the ABCDEF bundle. Objective To examine the impact of an interdisciplinary mobility protocol in 7 specialty intensive care units that previously implemented other bundle components. METHODS A staggered quality improvement project using the American Association of Critical-Care Nurses mobility protocol was conducted. In phase 1, data were collected on patients with intensive care unit stays of 24 hours or more for 2 months before and 2 months after protocol implementation. In phase 2, data were collected on a random sample of 20% of patients with an intensive care unit stay of 3 days or more for 2 months before and 12 months after protocol implementation. RESULTS The study population consisted of 1266 patients before and 1420 patients after implementation in phase 1 and 258 patients before and 1681 patients after implementation in phase 2. In phase 1, the mean (SD) mobility level increased in all intensive care units, from 1.45 (1.03) before to 1.64 (1.03) after implementation (P < .001). Mean (SD) ICU Mobility Scale scores increased on initial evaluation from 4.4 (2.8) to 5.0 (2.8) (P = .01) and at intensive care unit discharge from 6.4 (2.5) to 6.8 (2.3) (P = .04). Complications occurred in 0.2% of patients mobilized. In phase 2, 84% of patients had out-of-bed activity after implementation. The time to achieve mobility levels 2 to 4 decreased (P = .05). Intensive care unit length of stay decreased significantly in both phases. CONCLUSIONS Implementing the American Association of Critical-Care early mobility protocol in intensive care units with ABCDEF components in place can increase mobility levels, decrease length of stay, and decrease delirium with minimal complications.
Evaluation of the Modified Pulmonary Index Score to Evaluate Pediatric Asthma Severity in the Pediatric Intensive Care Unit

Background: Scoring systems are frequently used to assess the severity of pediatric asthma exacerbations. The modified pulmonary index score (MPIS) is used in our institution as part of our pediatric asthma pathway. Total MPIS has been found to be highly correlated with pediatric intensive care unit (PICU) length of stay (LOS); however, this was a single center study with a relatively small sample size. We sought to evaluate the use of the MPIS to predict hospital LOS for patients admitted to our PICU. Methods: Following IRB approval, the medical records of all pediatric asthma subjects aged 2 to 17 years of age admitted to our PICU between June 2014 and November 2017 were retrospectively reviewed. Subjects were identified via ICD9 and ICD10 codes. We a priori divided subjects into three groups based upon each subject’s first MPIS documented in PICU, low (MPIS 0-5) medium (MPIS 6-9) and high (MPIS ≥10). Hospital LOS, PICU LOS, time on continuous albuterol, and need for increased respiratory support were compared between groups. Data were analyzed with SPSS v24 with nonparametric, chi-squared, and one-way ANOVA performed. Poisson regression analysis was performed to identify PICU admission factors associated with hospital length of stay. Results: A total of 143 subjects were included. There were no differences for age, gender, weight, home medications, medical history, cause of exacerbations, noninvasive ventilation use, or need for intubation between groups. There were significant differences between groups for mean heart rate (P 10 when compared to an MPIS ≤6. Conclusions: The MPIS thresholds used in our pathway appear to differentiate exacerbation severity. A higher MPIS is associated with increased hospital LOS, PICU LOS, time on continuous albuterol, need for high-flow nasal cannula and need for heliox.
Henry Wheaton and Richard Peters: “Owning” the Law

A freshly-imagined re-telling of the factual backstory of the early Reporters of Decisions of the U.S. Supreme Court, and particularly of Wheaton v. Peters, 33 U.S. 591 (1834), compacted for popular reading. The piece was solicited for inclusion in One Hundred Americans Making Constitutional as a dual biography of Henry Wheaton and Richard Peters, Jr., the third and fourth Reporters of Decisions of the U.S. Supreme Court. Why are they (and the case that bears their names) important enough to include as Americans who “made constitutional history”? In early America, reporters of courts were entrepreneurs who privately published selected opinions of judges, for purchase by interested members of the bar, to the extent that summaries or fragments of the opinions as delivered orally could be gleaned from the notes of attorneys in attendance. The first two Reporters of Decisions, Alexander Dallas and William Cranch, at a minimum helped to preserve the Supreme Court’s earliest decisions. But their reports were inaccurate, incomplete, slow to appear, expensive for purchasers, and unprofitable to the Reporters. Enter Henry Wheaton, Justice Story’s fellow New Englander, maritime scholar, and friend. Prodded by Wheaton (and Story), the Justices, for their part, furnished to Wheaton any written opinions they might prepare or notes they might make in connection with their oral opinions. Wheaton, in turn, promised and delivered reports that were accurate, full, annotated, and prompt, but also more handsome and expensive than his predecessors’. When Wheaton stepped down in 1827 to turn to diplomacy and literature, Richard Peters, Jr., succeeded him. Peters, no scholar (as his own reports soon proved) was, instead, a capable businessperson. In 1830, he published his Condensed Reports, which reduced all 25 volumes by Dallas, Cranch, and Wheaton to six--cutting type size, omitting arguments of counsel, emasculating concurring and dissenting opinions—and lowered the cost per set from $130 to $36. Wheaton sued. The Supreme Court’s decision in the case favored Peters, based on doubts concerning Wheaton’s compliance with certain statutory formalities, and ordered a remand. The outcome conspicuously failed to endorse Wheaton’s contention that the underlying opinions of the Court contained protectible matter, which either the Reporter or the Justices owned. Ultimately, a jury ruled for Wheaton and, in 1850, the case settled for $400. But by then both Wheaton and Peters were dead. So who actually won the case? The only true winner was the fledgling Republic itself. Thanks to Wheaton v. Peters, judges do not own the opinions by which they interpret and establish the law of the land. Nor do members of Congress own the statutes they enact, or presidents and their cabinets the executive orders and administrative regulations they promulgate. Who owns the law in America? The people do.
Development and evaluation of a simulation-based mastery learning maintenance of certification course.

Background/Objectives: To develop and evaluate a post-acute care simulation-based mastery learning (SBML) continuing medical education (CME)/maintenance of certification (MOC) procedure course.Desi...
Factors of Recidivism among Individuals with Co-occurring Conditions in Rural Mental Health Jail Interventions:

Estimates indicate that nearly half of rural jail detainees meet the criteria for co-occurring disorders (COD). It is critical to examine factors of recidivism among detainees with COD in rural com...
Standardized skill pass-offs and nursing student confidence: A qualitative study

Abstract The use of standardized skill pass-offs or skills check-offs and the ability to critically think are vital in the development of confident and competent nurses. At a university in the Intermountain West, basic psychomotor skill training begins the first semester of the associate nursing program and is typically done through the use of demonstration and return demonstration. This qualitative cross-sectional survey was conducted to identify the nursing students’ perception of the relationship between a skill pass-off and their confidence in the clinical setting. Twenty-five students completed a four question survey related to skill pass-off and student confidence. The results of this study indicated that while skill pass-offs did provide students with repetition and knowledge of the supplies needed to complete the skill, the feeling of confidence did not occur until the student practiced in the clinical environment. The outcome of this study emphasizes the importance of students’ experiences in the clinical setting.
Plant growth and biocrust-fire interactions across five North American deserts

Abstract Biological soil crusts (biocrusts) are communities predominately comprised of lichens, bryophytes, fungi, algae, and cyanobacteria that form at the soil surface in dryland ecosystems worldwide. Biocrusts can influence the vascular plant community by altering surface hydrology, nutrient cycling, and the availability of microsites suitable for germination. Fire frequency has increased in many dryland systems, but the potential impacts of fire on biocrust-plant interactions remains unclear. Our study explores how biocrusts and the heating associated with fire affect plant growth across five North American desert sites: the Chihuahuan, Colorado Plateau, Great Basin, Mojave, and Sonoran. Using field-collected biocrusts and mineral soil samples from each of these five deserts, we investigated soil biogeochemical differences and the implications of soil heating and biocrust cover on greenhouse grown Elymus elymoides plants. Results showed plant biomass and leaf production were largely determined by the desert where soils originated, and that the soils collected from the Great Basin site, whether heated or not, were generally higher in nutrients and distinct from the other North American desert sites. In contrast, the Chihuahuan site was lower in nutrients and plant biomass growth compared with the other desert sites. In the short term, biocrusts and heating did not significantly affect the biogeochemical profile of individual desert site soils. However, biocrusts and soil heating positively influenced plant growth, and the combination of these factors influenced plants more strongly than either factor considered separately. These findings highlight the importance of biocrusts in mediating resources and suggest additional mechanisms through which fire may alter or accentuate dynamics between biocrusts and vascular plants.
Neural network method for solving parabolic two-temperature microscale heat conduction in double-layered thin films exposed to ultrashort-pulsed lasers

Abstract Simulation of the micro/nanoscale heat conduction induced by ultrashort-pulsed laser heating has been attracting great attention. Additionally, machine and deep learning techniques are becoming an important tool in engineering and science research. This article presents an artificial neural network (ANN) method for solving the parabolic two-temperature heat conduction equations in double-layered thin films exposed to ultrashort-pulsed lasers. Convergence of the ANN solution to the analytical solution is theoretically analyzed. Finally, the ANN method is used to predict the electron and lattice temperatures in a gold film padding on a chromium film when exposed to ultrashort-pulsed lasers, which is based on the parabolic two-temperature heat conduction model.