cssi/SciSciGPT-SciSciNet huggingface dataset:
Spontaneous Membrane Translocating Peptides: The Role of Leucine-Arginine Consensus Motifs

We previously used an orthogonal high-throughput screen to select peptides that spontaneously cross synthetic lipid bilayers without bilayer disruption. Many of the 12-residue spontaneous membrane translocating peptides (SMTPs) selected from the library contained a 5-residue consensus motif, LRLLR in positions 5-9. We hypothesized that the conserved motif could be a necessary and sufficient minimal motif for translocation. To test this and to explore the mechanism of spontaneous membrane translocation, we synthesized seven arginine placement variants of LRLLRWC and compared their membrane partitioning, translocation, and perturbation to one of the parent SMTPs, called "TP2". Several motif variant peptides translocate into synthetic vesicles with rates that are similar to TP2. However, the peptide containing the selected motif, LRLLRWC, was not the fastest; sequence context is also important for translocation efficiency. Although none of these peptides permeabilize bilayers, the motif peptides translocate faster at higher peptide to lipid ratios, suggesting that bilayer perturbation and/or cooperative interactions are important for their translocation. On the other hand, TP2 translocates slower as its concentration is increased, suggesting that TP2 translocates as a monomer and is inhibited by lateral interactions in the membrane. TP2 and the LRLLR motif peptide induce lipid translocation, suggesting that lipids chaperone them across the bilayer. The other motif peptides do not induce lipid flip-flop, suggesting an alternate mechanism. Concatenated motifs translocate slower than the motifs alone. Variants of TP2 with shorter and longer arginine side-chain analogs translocate slower than TP2. In summary, these results suggest that multiple patterns of leucine and arginine can support spontaneous membrane translocation, and that sequence context is important for the contribution of the motifs. Because motifs do not make simple, additive contributions to spontaneous translocation, rational engineering of novel SMTPs will remain difficult, providing even more reason to pursue SMTP discovery with synthetic molecular evolution.
Are Home Prices the Next Bubble

The strong rise in home prices since the mid-1990s has raised concerns over a possible bubble in the housing market and the effect of a sharp price decline on the U.S. economy. This article assesses two measures frequently cited to support a bubble - the rising price-to-income ratio and the declining rent-to-price ratio - and finds the measures to be flawed and the conclusions drawn from them unpersuasive. In particular, the measures do not fully account for the effects of declining nominal mortgage interest rates and fail to use appropriate home price indexes. The authors also estimate a structural model of the housing market and find that aggregate prices are not inconsistent with long-run demand fundamentals. Accordingly, they conclude that market fundamentals are strong enough to explain the recent path of home prices and that no bubble exists. Nevertheless, weakening fundamentals could have an impact on home values on the east and west coasts, where the new housing supply appears to be relatively inelastic. However, prices in these regions have typically been volatile, and previous declines have not had a sizable negative effect on the overall economy.
Primary Transfer Step in the Light-Driven Ion Pump Bacteriorhodopsin: An Irreversible U-Turn Revealed by Dynamic Nuclear Polarization-Enhanced Magic Angle Spinning NMR.

Despite much attention, the path of the highly consequential primary proton transfer in the light-driven ion pump bacteriorhodopsin (bR) remains mysterious. Here we use DNP-enhanced magic angle spinning (MAS) NMR to study critical elements of the active site just before the Schiff base (SB) deprotonates (in the L intermediate), immediately after the SB has deprotonated and Asp85 has become protonated (in the Mo intermediate), and just after the SB has reprotonated and Asp96 has deprotonated (in the N intermediate). An essential feature that made these experiments possible is the 75-fold signal enhancement through DNP. 15N(SB)–1H correlations reveal that the newly deprotonated SB is accepting a hydrogen bond from an alcohol and 13C–13C correlations show that Asp85 draws close to Thr89 before the primary proton transfer. Concurrently, 15N–13C correlations between the SB and Asp85 show that helices C and G draw closer together just prior to the proton transfer and relax thereafter. Together, these results in...
The Association between Cervical Exam after Ripening with Foley Balloon Catheter and Outcomes of Nulliparous Labor Induction.

Objective Evaluate the association between cervical examination after ripening with Foley catheter and labor induction outcomes. Materials and Methods In this retrospective cohort, nulliparous women with singleton, viable gestation undergoing cervical ripening with Foley catheter were compared based on cervical status after catheter removal or expulsion: favorable (modified Bishop score ≥ 5) or unfavorable (score Results A total of 774 women were eligible. Women with favorable examination postripening had lower body mass index (BMI) and more favorable admission cervical examination. The frequency of vaginal delivery was higher in women with favorable cervical examination postripening (57.9% versus 46.8%, p Conclusion A favorable modified Bishop score after cervical ripening with Foley balloon catheter is associated with higher chance of vaginal delivery and shorter labor duration.
Sound-induced monoaminergic turnover in the auditory forebrain depends on endocrine state in a seasonally-breeding songbird

Sensory responses to courtship signals can be altered by reproductive hormones. In seasonally-breeding female songbirds, for example, sound-induced immediate early gene expression in the auditory pathway is selective for male song over behaviourally irrelevant sounds only when plasma estradiol reaches breeding-like levels. This selectivity has been hypothesized to be mediated by release of monoaminergic neuromodulators in the auditory pathway. We previously showed that in oestrogen-primed female white-throated sparrows, exposure to male song induced dopamine and serotonin release in auditory regions. In order to mediate hormone-dependent selectivity, this release must be (1) selective for song and (2) modulated by endocrine state. Therefore, in the current study we addressed both questions by conducting playbacks of song or a control sound to females in a breeding-like or non-breeding endocrine state. We then used high performance liquid chromatography to measure turnover of dopamine, norepinephrine, and serotonin in the auditory midbrain and forebrain. We found that sound-induced turnover of dopamine and serotonin did in fact depend on endocrine state; hearing sound increased turnover in the auditory forebrain only in the birds in a breeding-like endocrine state. Contrary to our expectations, these increases occurred in response to either song or artificial tones; in other words, they were not selective for song. The selectivity of sound-induced monoamine release was thus strikingly different from that of immediate early gene responses described in previous studies. We did, however, find that constitutive monoamine release was altered by endocrine state; whether the birds heard sound or not, turnover of serotonin in the auditory forebrain was higher in a breeding-like state than in a non-breeding endocrine state. Our results suggest that dopaminergic and serotonergic responses to song and other sounds, as well as serotonergic tone in auditory areas, could be seasonally modulated. This article is protected by copyright. All rights reserved.
High Spin Phenomena

In this paper, we wish to discuss various aspects of high-spin phenomena. In particular, evidence for bands of states built on two quasiparticle states which are rotation aligned with respect to the rotating core is found in new regions at both ends of the periodic table for 68Ge, 76-80Kr, and 248Cm. The use of massive transfer reactions to populate high spin states is considered in the final section.
Nuclear Design of the Blanket/Shield System for a Tokamak Experimental Power Reactor

The various options and trade-offs in the nuclear design of the blanket/ shield for a Tokamak Experimental Power Reactor (TEPR) are investigated. The TEPR size and cost are particularly sensitive to the blanket/shield thickness, $delta$/sub BS/, on the inner side of the torus. Radition damage to the components of the superconducting magnet and refrigeration power requirements set lower limits on $delta$/sub BS/. These limits are developed in terms of TEPR design parameters such as the wall loading, duty cycle, and frequency of magnet anneals. The study of the nuclear performance of various material compositions shows that mixtures of tungsten, or tantalum, or stainless-steel alloys and boron carbide require the smallest $delta$/sub BS/ for a given attenuation. This $delta$/sub BS/ has to be doubled if the low induced activation materials graphite and aluminum are used. The space problems are greatly eased in the Argonne National Laboratory ANL-TEPR reference design by using two separate segments of the blanket/shield. The inner segment occupies the region of the high magnetic field, uses very efficient attenuators (tungsten- or tantalum- or stainless-steel-boron carbide mixtures), and is only 1 m thick. The outer more » blanket/shield is 131 cm and consists of an optimized composition of stainless steel and boron carbide. For the design parameters of 0.2 MW/m$sup 2$ neutron wall loading and 50 percent duty cycle, the reactor components can operate satisfactorily up to (a) 10 yr for the stainless-steel first wall, (b) 10 yr for the superconductor composite after which magnet warmup becomes necessary, and (c) 30 yr for the Mylar insulation. Nuclear heat generation rates in the blanket/ shield and magnet are well within the practical limits for heat removal. « less
Pole Placement Self-Tuning Control of Manipulators

Abstract The pole placement self-tuning (PPST) methods developed by Wellstead and his colleagues [1-3] are modified for application to a six degree of freedom robotic manipulator. The manipulator selected is the JPL-Stanford arm with five revolute joints and one prismatic joint. The results of two example applications demonstrate the clear superiority of the pole placement approach over previous minimum variance self-tuning attempts [4].
Enhancement in median nerve mobility during radioulnar wrist compression in carpal tunnel syndrome patients.

Abstract Background Carpal tunnel syndrome is a compression neuropathy at the wrist associated with compromised median nerve mobility. The purpose of this study was to investigate the effects of radioulnar wrist compression on median nerve longitudinal mobility within the carpal tunnel in carpal tunnel syndrome patients as well as healthy subjects. Methods Dynamic ultrasound images captured longitudinal median nerve motion in the carpal tunnel during radioulnar wrist compression force application in 11 healthy subjects and 11 carpal tunnel syndrome patients. Findings We found that median nerve mobility was not significantly affected by radioulnar wrist compression in healthy subjects (P = 0.34), but improved by 10 N radioulnar wrist compression in carpal tunnel syndrome patients (P Interpretation Moderate radioulnar wrist compression force application helps restore impaired median nerve mobility and may be effective in improve nerve function and symptoms associated with carpal tunnel syndrome.
A Multi-Stage Micro-Tangential Flow Filtration Device for µ TAS Applications

The design, fabrication, and testing of a micromachined tangential flow filtration device is presented. The filter design incorporates three stages of size-based filtration on a 1cm × 1 cm silicon substrate, which provides a band-pass filtration scheme and flexibility for flow control in filtering and unclogging operations at different filtration stages. 3-D flow simulations suggest means to determine the optimal flow control conditions. Fluorescent microscopy results show the proof of concepts of the filter design, with particle retentant ratio over 95% in all three filtration stages.
Current trends in non–HDL cholesterol and LDL cholesterol levels in adults with atherosclerotic cardiovascular disease

Background Low-density lipoprotein cholesterol (LDL-C) and non–high-density lipoprotein cholesterol (non–HDL-C) are targets for prevention of atherosclerotic cardiovascular disease (ASCVD). The American Heart Association and American College of Cardiology recently modified recommendations for clinical management of cholesterol in secondary and primary prevention. Accordingly, the present article examines the need for cholesterol-lowering drugs in the U.S. population with ASCVD. Objective This study examines trends in non–HDL-C and LDL-C levels in a free living population of ASCVD subjects between 1999 and 2016. Methods National Health and Nutrition Examination Surveys database included 4920 adults with ASCVD aged 40 to 85 years. Complete data were available for 4226. Trend analysis of changes in lipids is shown in box plots. Results Mean age was 67 years with 57% males. Over 17 years, LDL-C decreased significantly by 24% and non–HDL-C by 21%. Over the period of study, reported intake of cholesterol-lowering drugs rose from 37% in 1999-2000 to 69% in 2015 to 2016. Over this same period, serum triglycerides decreased by 29% (P Conclusions The changes in LDL-C and non–HDL-C in patients with ASCVD over a 17-year period probably are related to increased treatment with statins. However, the changes are too small to be explained by widespread use of high-intensity statins, which is the current recommendation for patients with ASCVD. These findings pose a challenge for professional education to support implementation of current guidelines for cholesterol-lowering therapies.
1800 Spontaneous Pyomyoma in A Premenopausal Nulliparous Woman without Risk Factors: A Case Report

Study Objective Pyomyoma is a rare complication of leiomyomata that can result in significant morbidity when not diagnosed and treated in timely manner. While most cases occur peripartum, post-uterine instrumentation or following embolization, we report a case of spontaneous pyomyoma with no inciting event necessitating urgent surgical management. Design Case report Setting Academic tertiary care center in Chicago, IL Patients or Participants NA Interventions NA Measurements and Main Results A 49-year-old healthy G0 with known symptomatic myomas presented to the ED with worsening abdominal pain and a blistering, erythematous rash of the right mid abdomen. Her CT demonstrated an enlarged fibroid uterus with an exophytic myoma measuring 28 × 20 × 16cm with focal areas of uterine wall rupture and surrounding fluid and extension into the abdominal wall. Intravenous antibiotics were begun, and she was taken to the operating room. Intraoperatively, she was found to have an enlarged myomatous uterus with a necrotic pedunculated myoma densely adherent to the anterior abdominal wall, gallbladder, liver, omentum, and porta hepatis. The necrotic portion fractured during uterine mobilization and drained more than one liter of purulent fluid. Frozen section was negative for malignancy. An additional suprafascial abscess in the right upper quadrant was drained for an additional 1L of purulent fluid and confirmed infection into the subcutaneous tissue. She underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy and debulking with residual fibroid capsule seen at the level of the porta hepatis. The patient was discharged home on POD#9; final pathology showed benign degenerated leiomyoma with focal areas of necrosis and inflammation weighing 3538g. Conclusion This is the second case in the literature when a pyomyoma was described in an immunocompetent, premenopausal woman without recent uterine instrumentation. This case highlights how benign myomas may lead to significant morbidity. Although rare, in patients presenting with fever, worsening pain and fibroids, pyomyoma should be considered in the differential.
Choquet–Iyengar Advanced Inequalities

Here we extend advanced known Iyengar type inequalities to Choquet integrals setting with respect to distorted Lebesgue measures and for monotone functions. See also [2].
Oil price regimes and their role in price diversions from market fundamentals

Speculative bubbles, market governance and property rights are thought to affect oil prices, but their timing and magnitude are uncertain. Here, we quantify these effects using econometric techniques that identify periods between 1938:1 and 2018:3 (denoting year:quarter) when prices strayed from the levels implied by market fundamentals. We identify nine price regimes that are associated with the Organization of the Petroleum Exporting Countries gaining control over the marginal supply of crude oil, US energy legislation, a precautionary demand shock, the Arab Spring and speculative bubbles. These bubbles raised real oil prices by US$14.31 and US$4.65 per barrel in 2007:4–2008:3 and 2010:1–2011:1, respectively, which transferred US$42.8 billion from US consumers to US oil producers and US$87.4 billion from the US economy to oil exporting nations. Conversely, some sharp changes, such as the price decline associated with the Asian financial crisis, can be explained by market fundamentals. Oil prices are thought to be affected by speculation but the exact impact of speculation on price is not known. Kaufmann and Connelly quantify this effect and identify its beneficiaries by building a price model based on supply and demand, market fundamentals and associating deviations with historical geopolitical events.
Toward a Black media philosophy

Marshall McLuhan is often considered a media philosopher, not a race theorist. Yet, his work is full of racial implications that often go unexamined. For McLuhan, media were ‘any extensions of man’...
Cloud People: Identities and Paradoxes

This chapter identifies three main categories of identities in contemporary air travel: the Airworld employee, the fluid passenger, and the vulnerable traveler. The first refers to air transport professionals who, in the aerial environment, suspend their identities and adopt those dictated by their uniform and occupation. The second is composed of ordinary individuals who, while crossing the threshold of the Airworld, experience a transformation of their everyday identity into that of passengers, operating within a regime of fluidity, barcodes, and security procedures. The last category consists of vulnerable passengers, discriminated because of racial and national prejudices; travelers who are condemned to prolonged isolation, detention, deportation, and authoritarian acts that transform the Airworld into a sordid infrastructure of human ignominy.
Validation of a High-Order Large Eddy Simulation Solver for Acoustic Prediction of Supersonic Jet Flow

A high-order large eddy simulation (LES) code based on the flux reconstruction (FR) scheme is further developed for supersonic jet simulation. The FR scheme provides an efficient and easy-to-implem...
Effects of sagebrush restoration on plant and bird communities in Grand Teton National Park

Approximately half of sagebrush steppe range-wide has been converted to non-native grasslands, which has contributed to population declines of sagebrush-associated songbirds. Removal of non-native grasses and restoration treatments are time-, resource- and energy-intensive, but could lead to the return of functional habitat for sagebrush wildlife. The extent to which restoration efforts repair the structure and functionality of sagebrush steppe for different types of wildlife, however, remains largely untested. To determine breeding songbird community responses to sagebrush restoration treatments, we are conducting a longitudinal study with sampling every 5 years within restoration units at different stages of restoration in the Kelly Hayfields restoration area in Grand Teton National Park, Wyoming. Thus far, in 2013 and 2018 we compared bird and plant communities in unrestored (largely smooth brome [Bromus inermis]) units to those in various stages of restoration treatments, and to areas of native sagebrush. The sagebrush plots will serve as desired comparators for the endpoints of restoration efforts. The in-progress and recently replanted units were either dominated by bare ground (following herbicidal application) or native forbs with very little shrub cover (< 0.1%). Native sagebrush units were dominated by shrubs and native bunchgrasses. Bird community composition was distinct among the different unit types. Abundance of grassland birds was highest in unrestored units, whereas the abundance of shrubland birds was highest in native sagebrush and positively associated with shrub cover. There were very few detections of birds in recently re-seeded units. Restored areas may initially provide little breeding bird habitat, especially prior to the establishment of native bunch grasses and a mature shrub layer. Plant and bird sampling efforts will continue every five years to document how plant and bird assemblages shift over time in response to restoration efforts. Featured photo by Matt Lavin on Flickr. https://flic.kr/p/fh7UJz
Economic Sanctions and Human Security: The Public Health Impact of Economic Sanctions

Despite the abundance of country-specific evidence and policy debate on the humanitarian effects of sanctions, there has not been any cross-national empirical research that examines the human cost of sanctions. In this study, I offer a quantitative analysis of the effect that economic sanctions have on public health conditions in target countries. I use the child mortality rate among under five-year olds as a proxy for health status and utilize time-series cross-nation data for the 1970-2000 period. According to the results, the public health effect of sanctions is largely conditional on the extent to which economic coercion is costly on the target economy. The US as a sender is also likely to increase the negative impact of sanctions on public health conditions. The economic wealth of target countries is unlikely to play any significant interactive role in mitigating the effect of economic coercion on public health. Similarly, the involvement of an intergovernmental organization (IGO) in sanction imposition has no discernable impact on child mortality.
Boosting or Hindering: AoI and Throughput Interrelation in Routing-Aware Multi-Hop Wireless Networks

While considerable work has addressed the optimal AoI under different circumstances in single-hop networks, the exploration of AoI in multi-hop wireless networks is rarely attempted. More importantly, the inherent relationships between AoI and throughput are yet to be explored, especially in multi-hop networks. This paper studies AoI in multi-hop wireless networks and explores its potential relationships with throughput for the very first time, particularly focusing on the impacts of flexible routes on the two metrics, i.e., AoI and throughput. By developing a rigorous mathematical model with interference, channel allocation, link scheduling, and routing path selection taken into consideration, we build the interrelation between AoI and throughput in multi-hop networks. A multi-criteria optimization problem is formulated with the goal of simultaneously minimizing AoI and maximizing network throughput. By qualitatively analyzing their relationships, we exhibit that the two metrics may conflict with each other, implying the optimal solutions for the multi-criteria problem will include a set of Pareto-optimal points rather than a single point existing in the traditional optimization problem. We resort to a novel approach by transforming the multi-criteria problem into a single objective one so as to find the weakly Pareto-optimal points iteratively, thereby allowing us to screen all Pareto-optimal points for the solution. Through formal proof, our solution is demonstrated to be able to identify all Pareto-optimal points and terminate in a finite number of iterations. We conduct the simulation evaluation to identify the optimal tradeoff points of AoI and throughput, demonstrating that one performance metric may improve at the expense of degrading the other, with the routing path found as one of the key factors in determining such a tradeoff.
Global Chromatin Profiling Fingerprints Reveal Therapeutic Efficacy in Breast Cancer

Regulatory abnormalities caused by epigenetic changes due to chromatin modifications are being increasingly recognized as contributors to cancer. While many molecularly targeted drugs have the potential to revert these modifications, their precise mechanism of action in cellular reprogramming is yet to be deciphered. We generated “network-based global chromatin profiling fingerprints” by integrating proteomic/phosphoproteomic, transcriptomic and regulatory genomic data to understand how unique chromatin alterations by post-translational histone modifications regulate cell state changes when treated with drugs in breast cancer. We find H3K27me3K36me3 as a key fingerprint, mediated by chromatin remodelers BRD4, NSD3, EZH2, and a proto-oncogene MYC. We show CDK inhibitors flavopiridol and dinaciclib display selective inhibitory potential toward BRD4/MYC, implicating them as potential therapeutic targets to restitute H3K27me3K36me3 status in breast cancer.
Predisposing factors and health-care utilization in liver transplant recipients with takotsubo cardiomyopathy: A national analysis

Aims and Objectives: Takotsubo cardiomyopathy (TCMP) is an acquired cardiomyopathy associated with physical, emotional, and surgical stress. Current literature on TCMP in liver transplant recipients (LTRs) is limited to case reports and case series. Methods: The Nationwide Readmission Database was utilized to identify all adults with an index admission for LT between 2010 and 2014 who developed TCMP. The prevalence of TCMP at the LT admission or readmission within the calendar year was examined. Predictors of development and health-care utilization of patients with and without TCMP in LTR were compared. Multivariable regression analysis was performed. Results: The prevalence of TCMP in LTRs was found to be 0.5% (141/28,067). Most of these patients developed early TCMP on the index admission for LT (n = 115; 82%). Older (57.5 ± 1.3 vs. 55.1 ± 0.3 years, P
Prevalence and Significance of Patient Prosthesis Mismatch Following Edwards SAPIEN XT and SAPIEN 3 Transcatheter Aortic Valve Replacement.

Background Severe patient prosthesis mismatch (sPPM) after surgical aortic valve replacement is associated with worse outcomes. Limited data exists on the impact of sPPM on outcomes after transcatheter aortic valve replacement (TAVR), especially regarding the newer generation valves. The aim of this study was to evaluate the incidence, determinants, and outcomes of sPPM in patients undergoing TAVR with Edwards SAPIEN XT (ES XT) and Edwards SAPIEN 3 (ES3) valves (Edwards Lifesciences, Irvine, CA, USA). Methods We retrospectively reviewed 366 patients who underwent TAVR with ES XT (n = 114) or ES3 (n = 252) valves between July 2012 and June 2018. sPPM was defined as indexed effective orifice area (iEOA) <0.65 cm2/m2. Kaplan-Meier survival estimates were used to determine outcomes. Results Multivariate linear regression analysis was utilized to determine potential independent effects of PPM on outcomes. sPPM was present in 40 (11%) of the patients [8 (7%) ES XT and 32 (13%) ES3] and was associated with female sex, smaller left ventricular outflow tract (LVOT) diameter and aortic valve annular area, absence of prior coronary artery bypass graft (CABG) surgery, shorter height, higher body mass index, and smaller pre-TAVR valve area (all p < 0.05). Among those with ES3 valves, the incidence of sPPM was inversely proportional to the valve size (50%, 25%, 5% and 3% for 20-, 23-, 26- and 29-mm valve sizes, respectively; p < 0.001). At a mean follow-up period of 3.5 ± 1.5 years, there was no difference in all-cause mortality (22.5% vs. 25.6%, p = 0.89) or a composite endpoint of heart failure, arrhythmias, stroke, and myocardial infarction (30% vs. 34%, p = 0.24) in those with or without sPPM. Conclusion ES3 was associated with a higher incidence of sPPM, particularly with smaller valve sizes. However, the presence of sPPM as defined by iEOA was not an independent predictor of adverse outcomes in patients undergoing TAVR within an intermediate follow-up period.
Elucidating the context for implementing nonpharmacologic care for neonatal opioid withdrawal syndrome: a qualitative study of perinatal nurses.

Up to 95% of neonates exposed to opioids in utero experience neonatal opioid withdrawal syndrome at birth. Nonpharmacologic approaches (e.g., breastfeeding; rooming-in; skin-to-skin care) are evidence-based and should be implemented. These approaches, especially breastfeeding, rely on engagement of the neonates’ mothers to help deliver them. However, little is known about the structural and social dynamic context barriers and facilitators to implementing maternal-delivered nonpharmacologic care. Using a qualitative descriptive design, perinatal nurses from a Midwest United States hospital family birthing center, neonatal intensive care unit, and inpatient pediatric unit were interviewed. These units were involved in caring for mothers and neonates affected by opioid use. Telephone interviews followed a semi-structured interview guide developed for this study, were audio-recorded, and lasted about 30–60 min. Interviews were transcribed verbatim and independently analyzed by five investigators using the constant comparative method. Themes were discussed until reaching consensus and subsequently mapped to a conceptual model adapted for this study. Twenty-one nurses participated in this study (family birth center, n = 9; neonatal intensive care, n = 6; pediatrics, n = 6). Analysis resulted in four major themes: 1) Lack of education and resources provided to staff and mothers; 2) Importance of interdisciplinary and intradisciplinary care coordination; 3) Flexibility in nurse staffing models for neonatal opioid withdrawal syndrome; and 4) Unit architecture and layout affects maternal involvement. Minor themes supported each of the four major themes. All themes mapped to the conceptual model. This study provides a more comprehensive understanding of the barriers and facilitators affecting implementation of maternal involvement in nonpharmacologic care of newborns with neonatal opioid withdrawal syndrome. Future efforts implementing nonpharmacologic approaches must consider the context factors affecting implementation, including structural and social factors within the units, hospital, and broader community.
Treatment and Follow-up Care Associated With Patient-Scheduled Primary Care Telemedicine and In-Person Visits in a Large Integrated Health System

Importance Telemedicine visits can offer patients convenient access to a clinician, but it is unclear whether treatment differs from that with in-person visits or how often patients require in-person follow-up. Objective To examine whether physician prescribing and orders differ between telemedicine and office visits, whether physicians conducting telemedicine visits are more likely to require in-person follow-up, and whether telemedicine visits are associated with more health events. Design, setting, and participants This cohort study included all patients who scheduled primary care appointments through the patient portal of a large integrated health care delivery system newly implementing patient-scheduled video telemedicine visits from January 2016 to May 2018. Main outcomes and measures Adjusted rates of any medication prescribed or laboratory tests or imaging ordered and rates of follow-up health care utilization (in-person visits, emergency department visits, and hospitalizations) within 7 days after the index visit, stratified by index primary care visit type, were generated using multivariable adjustment for patient, access, and clinical characteristics. Results This study included 1 131 722 patients (611 821 [54%] female; mean [SD] age, 43 [22] years) with 2 178 440 total appointments (307 888 [14%] telemedicine), of which 13.5% were for patients younger than 18 years, 22.2% were for patients 65 years or older, and 54.9% were for female patients. After adjustment, 38.6% (95% CI, 38.0%-39.3%) of video visits, 34.7% (95% CI, 34.5%-34.9%) of telephone visits, and 51.9% (95% CI, 51.8%-52.0%) of office visits had any medication prescribed; laboratory tests or imaging were ordered for 29.2% (95% CI, 28.5%-29.8%) of video visits, 27.3% (95% CI, 27.1%-27.5%) of telephone visits, and 59.3% (95% CI, 59.3%-59.4%) of clinic visits. After adjustment, follow-up visits within 7 days occurred after 25.4% (95% CI, 24.7%-26.0%) of video visits, 26.0% (95% CI, 25.9%-26.2%) of telephone visits, and 24.5% (95% CI, 24.5%-24.6%) of office visits. Adjusted emergency department visits and rates of hospitalizations were not statistically significantly different by primary care index visit type. Conclusions and relevance In this cohort study of patient self-scheduled primary care telemedicine visits within ongoing patient-physician relationships, prescribing and orders were significantly lower for telemedicine visits than for clinic visits, with slightly higher follow-up office visits for telemedicine but no difference in health events (emergency department visits or hospitalizations). Video or telephone visits may be a convenient and efficient way to access primary care and address patient needs.
Evaluation of reciprocal differences in Bos indicus x Bos taurus backcross calves produced through embryo transfer: I. Birth and weaning traits.

Angus (A) and Bos indicus (B; Brahman or Nellore) reciprocal backcross, embryo transfer calves, belonging to 28 full-sib families, were evaluated for differences in birth weight, gestation length, and weaning weight. Two methods were investigated; method I made no distinction between how the F(1) parents were produced, whereas method II distinguished between the 2 types of F(1) parents (AB vs. BA corresponding to A x B vs. B x A, respectively). Bos indicus backcross calves had a 4.3 d longer (P 0.10) in birth weight between males and females (1.5 and 1.1 kg, respectively). Further examination within each sex showed a difference between male reciprocals that was generally much larger than that between female reciprocals. Calves with a greater percentage of B in the sire compared with the proportion in the dam ranked heavier for weaning weight as for birth weight, though these differences were not significant. In breeding systems involving B x Bos taurus crosses, even when using embryo transfer, not only does the breed composition of the calves affect their preweaning performance, but the particular cross that produces the calves also should be considered in making breeding decisions.
Scaling properties of the Anderson model in the Kondo regime studied by σGσW formalism

The symmetric Anderson model for a single impurity coupled to two leads is studied at strong interaction using the GW approximation within the $\ensuremath{\sigma}G\ensuremath{\sigma}W$ formalism. We find that the low-energy properties show universal scaling behavior in the asymptotic regime. While the GW scaling functions are similar in form to the scaling functions known from the numerically exact solution, they are characterized by a different parameter value indicating that GW fails to describe correctly spin correlations between the impurity and lead electrons. We also compare the GW and exact Kondo scales for a broad range of the interaction strength. In contrast to the exponential behavior shown by the exact solution, the GW Kondo scale depends algebraically on the interaction strength.
Body, Medicine and the

This entry deals with changing interrelations between ideas and practices of medicine and ideas regarding the body. Its major purpose is to highlight the cultural and linguistic linkages that tie together medicine and the body in specific cross-cultural case studies. It presents first a discussion of the assumptions made about the body in classic biomedical thinking, and proceeds to contrast these assumptions with other cases, where notions of healing the whole person rather than an autonomous body are in play. This topic is pursued by means of the theoretical approach of embodiment. Materials from Chinese culture, from the Navaho people, from Turkey, and from the Temiar people are considered, in order to illustrate different ways in which embodiment theory illuminates the relationship between medicine, the body, and the total environment in which people live. Keywords: body; health; medicine
Limit Theorems for Markov Renewal Processes

This chapter defines Markov renewal type equations, introduces the key Markov renewal theorem, which is used in solving Markov renewal-type equations in the limit, and demonstrates how the theorem can be used over an example. Keywords: Markov renewal; limiting behavior; regenerative process; semi-Markov process; Key Markov Renewal Theorem
Structure and Function of the Vibrio cholerae Master Virulence Regulator ToxT

The epidemic diarrheal disease cholera is caused by the ingestion of food or water contaminated with the gram-negative bacterium Vibrio cholerae. Cholera toxin (CT) and the toxin-coregulated pilus ...
The Whole Is Greater than the Sum of the Parts: Analyzing Legal Problems in an Endogenous World

INTRODUCTION 385 I. THE ART OF ECONOMIC ANALYSIS 387 II. PROFESSOR AHDIEH’S ARTISTRY 388 CONCLUSION 390
Vapor phase nucleation: Molecular mechanisms for embryo development

The special features that distinguish the present theory from previous ones are (1) its molecular formulation such that the physical clusters upon which it is based can be used to accurately evaluate the partition function of the full supersaturated vapor, and (2) the characterization of clusters by more parameters than molecular content i alone. Only one additional parameter is used, namely v but this is enough to allow a natural distinction (the valley and the evaporation boundary) between clusters that serve as embryos and those that do not. Furthermore the v parameter reveals the existence of an important additional mode of cluster variation, i.e., the collective relaxation of its radial density distribution toward the evaporation boundary. If the valley existed on both sides of the ridge this mode would be unimportant since the entire nucleation process, on both sides of the ridge, would be channeled along the axis of the valley, and a characterization of the cluster by i alone would be almost sufficient
Management of Choledocholithiasis

Choledocholithiasis refers to gallstones within the biliary tree, most commonly from the gallbladder. Most cases of choledocholithiasis are asymptomatic, and are diagnosed during the course of the workup of cholelithiasis by a combination of laboratory and imaging derangements. A minority of cases of choledocholithiasis present as either ascending cholangitis or acute gallstone pancreatitis (or both). Regardless of symptoms, our approach is one of routine clearance of the biliary tree if choledocholithiasis has been found. There are many accepted means to achieve stone clearance. In this chapter, we will discuss these methods and our preferred method, the “single-stage” approach, which involves totally laparoscopic cholecystectomy, interrogation of the biliary tree (by both ultrasound and cholangiography), and, if necessary, common bile duct exploration. Endoscopic techniques, such as retrograde cholangiopancreatography, remain an important adjunct to each approach, and are used as first-line therapy in patients believed to be at higher risk for immediate surgical intervention (e.g., cholangitis and pancreatitis) or who have impacted common bile duct stones with anticipated difficult removal. Finally, there remains a role for open surgical management of choledocholithiasis, primarily when larger (>10 mm) stones are present. In this case, surgeons must be proficient in the techniques of common bile duct exploration, choledochoenterostomy, and transduodenal sphincterotomy.
The Hilbert Space Axiom in Quantum Mechanics

The Hilbert space axiom is the basic postulate of conventional quantum mechanics. In essence it maintains that the observables for an isolated quantum mechanical system S can be represented by self-adjoint operators on a complex Hilbert space H; the states for S can be represented by density operators on H; and the dynamics can be represented by a one-parameter unitary group on H. The power of this axiom is indisputable, but what is its justification? Where does the Hilbert space come from? And if it is necessary to use Hilbert spaces, why must they be complex?
Effect of Clinical Pharmacy Services on Prescribing on an Orthopedic Unit

Prescribing patterns of physicians on a university-hospital orthopedic unit before, during, and after a clinical pharmacist's intervention were monitored and compared with patterns on a similar unit without clinical pharmacy services at another university hospital. The experimental and control groups consisted of 10% random samples of all patients on the study wards. Mean drug cost, number of doses, and number of courses of therapy for all drugs and for antibiotics were calculated. The data collection period consisted of 9 months (phase 1) before, 12 months (phase 2) during, and 6 months (phase 3) after clinical pharmacy services. Prescribing of postoperative prophylactic antibiotics was evaluated for compliance with guidelines of the experimental hospital's pharmacy and therapeutics committee. In the experimental group there was a consistent reduction from phase 1 to phase 2 in overall and antibiotic drug costs, number of doses, and number of courses of therapy per patient-day, but the differences were not significant. Length of stay decreased from phase 1 to phase 2, but the patterns were not significant over time or between experimental and control groups. For the experimental group, there was a significant reduction during phase 2 in the number of hours of antibiotic prophylaxis after removal of surgical drains, but prescribers' overall compliance with guidelines for postoperative antibiotic prophylaxis did not change significantly over time. In a subgroup receiving antibiotics, drug costs per patient-day at the experimental site were reduced from phase 1 to phase 2 for all drugs and for antibiotics. Of 1196 consultations, 76% were unsolicited; 83% of antibiotic-related problems were identified by the pharmacist.(ABSTRACT TRUNCATED AT 250 WORDS)
Finite Reasons Without Foundations

In this paper I develop a theory of reasons that has strong similarities to Peter Klein’s innitism. The view I develop, Framework Reasons, upholds Klein’s principles of avoiding arbitrariness (PAA) and avoiding circularity (PAC) without requiring an innite regress of reasons. A view of reasons that holds that the ‘reason for’ relation is constrained by PAA and PAC can avoid an innite regress if the ‘reason for’ relation is contextual. Moreover, such a view of reasons can maintain that skepticism is false by the maintaining that there is more to epistemic justication than what can be expressed in any reasoning session. One crucial argument for Framework Reasons is that justication depends on a background of plausibility considerations. In the nal section, I apply this view of reasons to Michael Bergmann’s argument any non-skeptical epistemology must embrace epistemic circularity.
LIFE-STYLE RISK FACTORS FOR PANCREATIC CANCER IN LOUISIANA: A CASE-CONTROL STUDY

A hospital-based, incident case-control study of pancreatic cancer was conducted between 1979 and 1983 in parallel with similarly designed studies of lung and stomach cancers in high-risk areas of Louisiana. To evaluate life-style practices, including diet, the authors pooled controls from the three studies, and then excluded subjects with diet-altering chronic diseases. When the 363 cases were compared with the 1,234 identified controls, significantly elevated risks were found among persons with Cajun ancestry, especially in rural areas. Among current smokers, a significant twofold risk was associated with moderate (16-25 cigarettes per day) and heavy (greater than or equal to 26 cigarettes per day) consumption, while ex-smokers showed no consistent pattern of risk. After adjustment for potential confounding by smoking, diet, and demographic factors, the risk of pancreatic cancer was unrelated to use of alcoholic beverages or coffee. Pork products and rice were conspicuous as dietary risk factors, each showing a positive dose-response effect, whereas fruit consumption exerted a protective influence.
Analytical modeling of an autonomous vehicle storage/retrieval system.

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Relation among spin operators and magnons

We present an exact expression of spin operators in terms of magnons and quasielectrons in ferromagnetism. Its relation to the Holstein-Primakoff expression is discussed. The result shows that the spin rotation of electrons is induced by a transformation of magnons and quasielectrons which is different from rotation.
Sexual Abuse in Childhood and Interpersonal Violence in Adulthood: A Cumulative Impact on Depressive Symptoms in Women

This study investigates the cumulative impact of sexual abuse in childhood and adult interpersonal violence in the past year on depressive symptoms in a nonclinical sample of 265 primarily African American (74%) women. The frequency of depressive symptoms, measured by the Center for Epidemiologic Studies Depression Scale (CES-D), was highest for women who experienced both forms of victimization. Women who reported greater stress over life's daily hassles reported more depressive symptoms. Women with higher levels of family support and a sense of personal mastery reported fewer depressive symptoms. The final model explained 42% of the variance in CES-D scores. Implications for practitioners are discussed.
The insulation performance of reactive parylene films in implantable electronic devices.

Abstract Parylene-C (poly-chloro-p-xylylene) is an appropriate material for use in an implantable, microfabricated device. It is hydrophobic, conformally deposited, has a low dielectric constant, and superb biocompatibility. Yet for many bioelectrical applications, its poor wet adhesion may be an impassable shortcoming. This research contrasts parylene-C and poly(p-xylylene) functionalized with reactive group X (PPX-X) layers using long-term electrical soak and adhesion tests. The reactive parylene was made of complementary derivatives having aldehyde and aminomethyl side groups (PPX-CHO and PPX-CH2NH2 respectively). These functional groups have previously been shown to covalently react together after heating. Electrical testing was conducted in saline at 37 °C on interdigitated electrodes with either parylene-C or reactive parylene as the metal layer interface. Results showed that reactive parylene devices maintained the highest impedance. Heat-treated PPX-X device impedance was 800% greater at 10 kHz and 70% greater at 1 Hz relative to heated parylene-C controls after 60 days. Heat treatment proved to be critical for maintaining high impedance of both parylene-C and the reactive parylene. Adhesion measurements showed improved wet metal adhesion for PPX-X, which corresponds well with its excellent high frequency performance.