cssi/SciSciGPT-SciSciNet huggingface dataset:
Role of Human Factors Engineering in Improving Employment Outcomes among Cancer Survivors

What role will human factors engineers and return to work professionals play in addressing the needs of cancer survivors in return to work? The National Cancer Institute estimates that there are 10...
Homotransplantation of uterus and ovaries in dogs: A preliminary report

An experimental technique for homotransplantation of the uterus and ovary by vascular anastomosis, in dogs, is described. Of 14 such homotransplantations, 5 were in male recipients. There were 6 immediate postoperative deaths and 8 long-term survivors. Viable uteri were found in 5 of the 8 long-term survivors when they were killed on a scheduled date. Detailed discussion on the rejection pattern, the uniqueness of the uterus as a fetus-harboring organ, and review of the literature is included. To our knowledge, homotransplantation of the uterus by vascular anastomosis has not been previously reported.
Structure and Function of Natural Antibodies

The presence of immunoglobulins (Ig) in the circulation of normal humans and animals that bind a variety of foreign antigens, such as bacterial components and products, viruses, protozoa, fungi, as well as self antigens, such as nucleic acids, phospholipids, erythrocytes, serum proteins, cellular components, insulin and thy-roglobulin, has been recognized since the beginning of this century [1–9]. Because their emergence is independent of known and/or intentional immunization, these antibodies have been termed “natural antibodies”. In contrast to antigen-induced antibodies, which are mainly IgG and monoreactive, a considerable proportion of natural antibodies are IgM and polyreactive, that is they bind several unrelated antigens with different affinities. Natural polyreactive and monoreactive IgG and IgA antibodies also exist [7]. The vast majority of natural antibodies, whether IgM, IgG or IgA, are produced by CD5+ B cells, the predominant lymphocytes in the neonatal cell repertoire [10,11]. Because of their broad reactivity with a variety of microbial components, diese antibodies may play a major role in the primary line of defense against infections. Owing to their ability to bind self antigens, they may serve as templates for some of the high-affinity autoantibodies that emerge in patients with autoimmune disease, particularly those associated with a significant expansion of CD5+ B cells [12–14].
Distinct evolutionary paths to TKI resistance in NSCLC

Despite initially responding, EGFR-mutant non-small cell lung cancer (NSCLC) patients treated with EGFR tyrosine kinase inhibitors (TKIs) invariably acquire drug resistance. A better understanding ...
Rate limiting activity of charge transfer during lithiation from ionic liquids

Abstract Given the increased use of room temperature ionic liquid electrolytes in Li-ion batteries, due to their non-flammability and negligible volatility, this study evaluates the lithiation kinetics to understand and improve the rate performance of Li-ion batteries. Lithium titanate spinel is used as a model electrode and the electrolyte is composed of LiTFSI and TFSI-coordinated alkoxy-modified phosphonium ionic liquid. Based on the analysis of activation energies for each process, we report that the charge-transfer reaction at the electrode/electrolyte interface is the rate-limiting step for cell operation. This finding is further supported by the observation that a 50-fold decrease in charge-transfer resistance at higher temperatures leads to a significant performance improvement over that of a traditional organic electrolyte at room temperature. Charge-transfer resistance and electrolyte wetting on the electrode surface are critical processes for optimal battery performance, and such processes need to be included when designing new ionic liquids in order to exceed the power density obtained with the use of current carbonate-based electrolytes.
Identifying Markov Processes Up to Time Change

The intertwining of Markov processes and potential theory has been apparent at least since Hunt’s fundamental trilogy on these subjects and was certainly evident even before then. The relationships between these two subjects have been investigated vigorously and profitably since then, and we intend to add to this study here. The central object of interest in potential theory is the cone of excessive functions, a positive cone of functions satisfying various axioms or principles of potential theory (see for example [7] and the references). The best known is the cone of superharmonic functions in R3 consisting of positive constants together with functions of the form ∫ |x-y|-1 μ(dy), where µ is a positive measure: this arises in Newtonian potential theory, and today’s axiomatic approach owes a great deal to abstraction and generalization of properties of this particular cone of functions. Each reasonable Markov process (X(t), Px) on E has an associated cone of excessive functions S(X) which can be obtained in an analytic manner from the semigroup P(t): throw a positive function f(x) into the cone if P(t)f(x) ≤ f(x) for all positive t and if P(t)f(x) increases to f(x) as t decreases to zero. Such a cone may contain only constant functions. We restrict our detailed discussion to transient processes (see (1.1) for a definition) so that the excessive functions separate points in the state space E. Later in this section, we discuss the non-transient case briefly.
Spiral cracking pattern in asphalt materials

Abstract The present work for the first time reports observations and modeling to characterize three-dimensional spiral-shaped fracture patterns in a bi-axially stressed layer of asphalt material bonded to an aluminum substrate. Five different asphalt materials with different fracture characteristics are investigated. A logarithmic spiral model was found to mathematically represent the 3D helix-shaped cracks observed. A spiral tightness parameter is proposed for the characterization of spiral fracture patterns in asphalt. Results of acoustic emission and compact tension tests are also presented and employed in the evaluation of observed spiral cracks. The shape of spirals are found to be influenced by the fracture properties of the asphalt materials tested and appear to be independent of the thickness and shape of the test sample. The embrittlement temperature and fracture energy of tested asphalt materials were found to correspond to the characteristic parameters of spiral cracks.
Support and Sabotage: A Qualitative Study of Social Influences on Health Behaviors Among Rural Adults.

Purpose Social environments exert an important influence on health behaviors, yet evidence from rural-specific contexts is limited. This study explored how social relationships influence health-related behaviors among midlife and older rural adults at increased risk of chronic disease. Methods Seventeen focus groups were conducted with 125 sedentary, overweight/obese adults (aged 40-91 years) residing in “medically underserved” rural Montana towns in 2014. Groups were stratified by age (40-64 and ≥65) and gender. Transcripts were examined thematically using NVivo software according to social influences on diet, physical activity, and tobacco use. Analyses were conducted in 2015-2016. Results Attitudes and actions of family members and friends were key influences on health behaviors, in both health-promoting and health-damaging ways. In these small, isolated communities, support from and accountability to family and friends were common facilitators of behavior change and maintenance. However, expectations to conform to social norms and traditional gender roles (eg, caregiving duties) often hindered healthy lifestyle changes. Conclusions These findings suggest that health behavior interventions targeting adults in rural settings need to consider and, if possible, integrate strategies to address the impact of social relationships in both supporting and sabotaging behavior change and maintenance.
Postprandial Clearance of Oxidized Low-Density Lipoprotein in Patients with Stroke Due to Atherosclerosis

Background Oxidized low-density lipoprotein (OxLDL) is a contributor to atherosclerosis development. OxLDL formation increases in the postprandial state due to oxidative stress in subjects with coronary artery disease (CAD) and diabetes, but has not been studied in patients with atherosclerotic stroke. We aimed to determine differences in postprandial OxLDL in patients with atherosclerotic stroke compared to stroke from other causes. Methods Patients with ischemic stroke but no history of CAD (n = 42) were enrolled and categorized by stroke subtype as extracranial atherosclerosis (EC), n = 12; intracranial atherosclerosis (IC), n = 16; or other cause, n = 14. After fasting overnight, subjects consumed a standardized fat meal. OxLDL levels were measured at t = 0 and t = 4 hours postprandial using enzyme-linked immunosorbent assay. Comparisons between the mean changes in OxLDL between the groups were performed using the analysis of variance procedure. Results The IC group had the highest mean baseline level of OxLDL and the greatest decline during the postprandial period. There was a trend toward a difference in the mean change in OxLDL between the 3 groups (P = .0553). Subjects with atherosclerotic stroke (EC and IC groups) had higher fasting OxLDL and had a significant decline in OxLDL compared to those with stroke from other causes (P = .0164). Conclusions Subjects with stroke due to atherosclerosis, particularly intracranially, demonstrated high fasting OxLDL and a decline in OxLDL during the postprandial period. This decline in OxLDL may indicate an accelerated clearance of OxLDL resulting from meal-induced oxidative stress.
Adolescent Sleep Duration, Variability, and Peak Levels of Achievement and Mental Health.

To inform public health recommendations for adolescent sleep, the amounts of sleep associated with the highest levels of academic achievement and mental health were examined. The degree to which daily variability in sleep duration represents an underappreciated but functionally significant sleep behavior also was tested. A total of 421 adolescents (Mage = 15.03 years) with Mexican-American backgrounds reported nightly sleep times for 2 weeks; approximately 80% repeated the same protocol 1 year later. Multilevel modeling indicated that the amount of sleep associated with the lowest levels of internalizing and externalizing symptoms was more than 1 hr greater than the amount associated with the highest levels of academic performance. Greater daily variability in sleep duration predicted greater symptomatology and mixed academic outcomes.
The surprising upsides of worry

Worry is an aversive emotional experience that arises alongside repetitive unpleasant thoughts about the future. In this paper, we argue that although extreme levels of worry are associated with depressed mood, poor physical health, and even mental illness, worry has an upside. We focus on two empirically supported benefits of worry: its motivational benefits and its benefit as an emotional buffer. Regarding motivation, worry illuminates the importance of taking action to prevent an undesirable outcome and keeps the situation at the front of one's mind to ensure that appropriate action is taken. It also triggers efforts to mitigate the consequences of bad news, motivates productive behavior that in turn reduces worry, and enhances the effectiveness of goal-directed action by prompting people to focus on obstacles that might derail best-laid plans. Worry can also serve as an emotional buffer by providing a desirable contrast to subsequent affective reactions, particularly for people who are prone to high levels of worry.
Argentation gas chromatography revisited: Separation of light olefin/paraffin mixtures using silver-based ionic liquid stationary phases.

Abstract Silver ion or argentation chromatography utilizes stationary phases containing silver ions for the separation of unsaturated compounds. In this study, a mixed-ligand silver-based ionic liquid (IL) was evaluated for the first time as a gas chromatographic (GC) stationary phase for the separation of light olefin/paraffin mixtures. The selectivity of the stationary phase toward olefins can be tuned by adjusting the ratio of silver ion and the mixed ligands. The maximum allowable operating temperature of these stationary phases was determined to be between 125 °C and 150 °C. Nuclear magnetic resonance (NMR) spectroscopy was used to characterize the coordination behavior of the silver-based IL as well as provide an understanding into the retention mechanism of light olefins.
Coherent Noise Suppression using Interferometric Cross-Correlation

We introduce a single-shot coherent noise suppression technique based on interferometric spectral upshifting in conjuncture with computational image recovering. The efficiency is demonstrated and quantified in regimes of low signal-to-noise ratio.
Transmutation Approximations for the Application of Hybrid Monte Carlo/Deterministic Neutron Transport to Shutdown Dose Rate Analysis

AbstractIn fusion energy systems (FES) neutrons born from burning plasma activate system components. The photon dose rate after shutdown from resulting radionuclides must be quantified. This shutdown dose rate (SDR) is calculated by coupling neutron transport, activation analysis, and photon transport. The size, complexity, and attenuating configuration of FES motivate the use of hybrid Monte Carlo (MC)/deterministic neutron transport. The Multi-Step Consistent Adjoint Driven Importance Sampling (MS-CADIS) method can be used to optimize MC neutron transport for coupled multiphysics problems, including SDR analysis, using deterministic estimates of adjoint flux distributions. When used for SDR analysis, MS-CADIS requires the formulation of an adjoint neutron source that approximates the transmutation process. In this work, transmutation approximations are used to derive a solution for this adjoint neutron source. It is shown that these approximations are reasonably met for typical FES neutron spectra and m...
Are people willing to share their political opinions on Facebook? Exploring roles of self-presentational concern in spiral of silence

Social networking sites such as Facebook have become a major platform for American political discussion. However, publicly expressing opinions on Facebook can make individuals perceived negatively by their Facebook friends, contributing to the spiral of silence. The purpose of this study is to extend the spiral of silence framework by integrating the perspective of online self-presentation to investigate the psychological processes of Facebook users' political self-disclosure through commenting, sharing and posting behaviors. Survey data from 283 Facebook users confirmed the opinion-congruence based mechanism argued by the classic spiral of silence theory, and found that Facebook users willingness of online engagement in controversial issues is also related to self-presentational concern and approval-based contingency of self-worth. Psychological processes of SNS users' political self-disclosure are examined.An extended spiral of silence model with a self-presentation approach is proposed.The opinion-congruence based mechanism argued by spiral of silence is confirmed.Approval-based CSW and self-presentational concern explain online expression.Two opposing dialectics of opinion expression on SNSs are discussed.
Fibronectin Conformation and Assembly: Analysis of Fibronectin Deletion Mutants and Fibronectin Glomerulopathy (GFND) Mutants

To study fibronectin (FN) conformation and assembly, we generated several deletion mutants: FNΔI1–5, FNΔIII1–3, FNΔIII4–8, and FNΔIII11–14. A monomeric form, FNmono, which lacked the C-terminal dimerization region, was also created. FNtnA–D was generated by swapping FNIII domains 1–8 in FNΔIII11–14 with seven FNIII domains from tenascin-C. The conformations of these mutants were analyzed by glycerol gradient sedimentation under low-salt (20 mM NaCl) and high-salt (200 mM NaCl) conditions. Surprisingly, most of the mutants showed a compact conformation under low-salt conditions, except for FNtnA–D. When we tested these mutants in cell culture, FNΔI1–5, FNΔIII1–3, and FNtnA–D were unable to form a matrix. Interestingly, FNΔIII1–3 and FNtnA–D were capable of co-assembly with full-length FN, while FNΔI1–5 was not. This indicates that the segment I1–5 is crucial for matrix assembly and segment III1–3 is also important. Mutations in FN are associated with glomerulopathy, but when we studied mutant proteins, the...
Acrylic bone cements for joint replacement

Abstract The number of total joint arthroplasty procedures is projected to rise at an unexpected rate. As such, proper understanding of acrylic bone cement and application plays an important role in reducing the rate of implant failure. Polymethylmethacrylate (PMMA) is the primary component of modern day bone cement which was invented at the turn of the 20th century by a German chemist and eventually made its way into the healthcare field because of special characteristics that make it excellent for fixation between prosthesis and bone. PMMA is packaged in a powder and liquid form that is mixed to make a viscous moldable biomaterial. Centrifugation and vacuum mixing in the preparation of bone cement reduces the introduction of air and porosity which allows for increase in compressive strength and energy absorption capacity. The structural property depends on storage temperature, sterilization methods, molecular weight, proportion of liquid to powder, and use of other substances as copolymers. Viscosity level of the cement determines setting time, ability to deform under constant load, and amount of heat released during polymerization. The strength of cement–bone interface directly correlates with the degree of apposition, surgical technique, loading characteristics, as well as by the properties of each substance. However, moisture absorption by PMMA at body temperature and high humidity levels can negatively affect PMMA biomechanics. Studies show that cemented arthroplasty fixation achieves superior functional patient outcomes, less residual pain, and decreased revision rates. Bone cement can also help in the treatment of periprosthetic joint infection (PJI). Cement spacers are impregnated with antibiotics to remove organisms that may remain following I&D of a joint. There is some concern of arthroplasty failure due to micromovements of implants from cemented components, however, the risk of early revision due to fracture is much higher with uncemented prosthesis. Finally, when using bone cement in arthroplasty orthopaedic surgeons should be aware of a rare complication of bone cement implantation syndrome (BCIS) that may result in intraoperative cardiac death.
On the formal specification of sum-zero constrained intrinsic conditional autoregressive models

Abstract We propose a formal specification for sum-zero constrained intrinsic conditional autoregressive (ICAR) models. Our specification first projects a vector of proper conditional autoregressive spatial random effects onto a subspace where the projected vector is constrained to sum to zero, and after that takes the limit when the proper conditional autoregressive model approaches the ICAR model. As a result, we show that the sum-zero constrained ICAR model has a singular Gaussian distribution with zero mean vector and a unique covariance matrix. Previously, sum-zero constraints have typically been imposed on the vector of spatial random effects in ICAR models within a Markov chain Monte Carlo (MCMC) algorithm in what is known as centering-on-the-fly. This mathematically informal way to impose the sum-zero constraint obscures the actual joint density of the spatial random effects. By contrast, the present work elucidates a unique distribution for ICAR random effects. The explicit expressions for the resulting unique covariance matrix and density function are useful for the development of Bayesian methodology in spatial statistics which will be useful to practitioners. We illustrate the practical relevance of our results by using Bayesian model selection to jointly assess both spatial dependence and fixed effects.
Insight into Chemistry on Cloud/Aerosol Water Surfaces

ConspectusCloud/aerosol water surfaces exert significant influence over atmospheric chemical processes. Atmospheric processes at the water surface are observed to follow mechanisms that are quite different from those in the gas phase. This Account summarizes our recent findings of new reaction pathways on the water surface. We have studied these surface reactions using Born–Oppenheimer molecular dynamics simulations. These studies provide useful information on the reaction time scale, the underlying mechanism of surface reactions, and the dynamic behavior of the product formed on the aqueous surface.According to these studies, the aerosol water surfaces confine the atmospheric species into a specific orientation depending on the hydrophilicity of atmospheric species or the hydrogen-bonding interactions between atmospheric species and interfacial water. As a result, atmospheric species are activated toward a particular reaction on the aerosol water surface. For example, the simplest Criegee intermediate (C...
Thoracic Epidurals are Associated With Decreased Opioid Consumption Compared to Surgical Infiltration of Liposomal Bupivacaine Following Video-Assisted Thoracoscopic Surgery for Lobectomy: A Retrospective Cohort Analysis.

Objective Thoracic epidural analgesia (TEA) is considered the gold standard for postoperative pain control in thoracic surgery, however it is associated with the undesirable risks of hypotension urinary retention, and bleeding. Recently, surgical site infiltration with liposomal bupivicaine (LB) has been suggested as a comparable alternative to TEA. The authors compared total opioid consumption in patients who received either TEA or LB undergoing video-assisted thorascopic surgery (VATS) for lobectomy. Design Retrospective cohort study. Setting University hospital. Participants Patients undergoing VATS for lobectomy. Interventions TEA versus LB Measurements and Main Results The primary outcome was POD 0 to 2 total opioid requirements, measured in intravenous morphine equivalents (mg). Wilcoxon rank sum test was used to calculate the significant differences in the primary outcome. The 25 - 75% interquartile range (IQR) was reported with each median value. Forty-five patients were included in the analysis, in which 14 (31.1%) were in the LB group. Between the TEA and LB group, there were no differences in age, sex, or body mass. The median (25 - 75% IQR) total opioid consumption during POD 0 - 2 in the TEA and LB group were 28.0 mg (12.0 – 52.0 mg) and 49.5 mg (35.0 – 70.5 mg), respectively (p = 0.03), in which the median difference was 22.5 mg (95% CI 0.60 – 38.0 mg). Conclusions VATs lobectomy patients consumed 43.4% less opioids on POD 0-2 with TEA when compared to surgical site infiltration of LB. Further prospective randomized controlled trials are required to demonstrate superior analgesia of TEA in this surgical population.
Molecular Mechanisms of Endocrine Disorders

The completion of the draft sequence of the human genome (1) promises advances in many areas of medicine, and endocrinology is no exception. Molecular diagnostic testing for RET proto-oncogene mutations has already revolutionized the management of multiple endocrine neoplasia type 2 (MEN2) and familial medullary thyroid cancer (FMTC). Other tests for genetic variation are beginning to impact the diagnosis of diabetes. Understanding the molecular mechanisms of endocrine disorders is integral to refining these and other diagnostic tests.
From Cohort Data to Life Table Parameters Via Stochastic Modeling

We develop a new method through which parameters such as the duration of stages and the mortality rates within them can be deduced from data on abundance of the stages over time in one cohort of individuals. This method involves modeling of the development process, modeling of the sampling process with its inherent errors, a statistical approach based on the models, and a numerical algorithm designed to perform the statistical estimation on real (noisy) data. We discuss the meaning of development time in the face of mortality, and illustrate the use and the validity of the method with real data from cohorts where the development times were independently measured in situ.
Tracking the clinical experience of women with metastatic breast cancer at an academic cancer center.

93Background: Time-driven activity-based costing (TDABC) can be used by health systems to identify inefficiencies and improve the patient experience in clinical encounters. This quality improvement project utilized a Plan, Do, Study, Act (PDSA) cycle to evaluate routine clinic-based care for women with metastatic breast cancer (MBC). Methods: A project plan was developed to directly observe the time spent by MBC patients in clinic (Plan). Patient clinical encounters could include a physician visit along with scans, infusion, and/or labs. We then created process maps of typical patient clinical experiences (Do). Next, we tabulated times (mean, standard deviation [SD]) that patients spent in waiting areas and with each clinical team member (physician, fellow, nurse practitioner, registered nurse, medical assistant, chaplain, social worker, pharmacist, navigator) to identify care inefficiencies (Study). Lastly, we discussed results with providers and identified and implemented strategies for improving effici...
Isolated herpes simplex virus pneumonia in children

Disseminated herpes simplex virus (HSV) infection is a well recognized condition in infants and children. However, the diagnosis of isolated HSV pneumonia, without evidence of other organ involvement, in this population is rare. We present a case series of isolated HSV pneumonia in four patients, all of which survived this acute illness with normal neurological outcome. Clinical features, diagnostic approaches, intensive care management, and antiviral drug therapy are reviewed.
The Selective RhoA Inhibitor Rhosin Promotes Stress Resiliency Through Enhancing D1-Medium Spiny Neuron Plasticity and Reducing Hyperexcitability

Abstract Background Nucleus accumbens dopamine 1 receptor medium spiny neurons (D1-MSNs) play a critical role in the development of depression-like behavior in mice. Social defeat stress causes dendritic morphological changes on this MSN subtype through expression and activation of early growth response 3 (EGR3) and the Rho guanosine triphosphatase RhoA. However, it is unknown how RhoA inhibition affects electrophysiological properties underlying stress-induced susceptibility. Methods A novel RhoA-specific inhibitor, Rhosin, was used to inhibit RhoA activity following chronic social defeat stress. Whole-cell electrophysiological recordings of D1-MSNs were performed to assess synaptic and intrinsic consequences of Rhosin treatment on stressed mice. Additionally, recorded cells were filled and analyzed for their morphological properties. Results We found that RhoA inhibition prevents both D1-MSN hyperexcitability and reduced excitatory input to D1-MSNs caused by social defeat stress. Nucleus accumbens–specific RhoA inhibition is capable of blocking susceptibility caused by D1-MSN EGR3 expression. Lastly, we found that Rhosin enhances spine density, which correlates with D1-MSN excitability, without affecting overall dendritic branching. Conclusions These findings demonstrate that pharmacological inhibition of RhoA during stress drives an enhancement of total spine number in a subset of nucleus accumbens neurons that prevents stress-related electrophysiological deficits and promotes stress resiliency.
J M Keynes, Chapter 21 of the General Theory, and the Textbook AD-AS Model. Why Keynes's Suggested Simplifications to His Aggregate Supply Curve Approach in Chapter 21 of the General Theory Were Overlooked

J M Keynes discussed a number of simplifications of his D-Z model in chapter 21 of the General Theory that were comparable to the completely (infinitely) elastic range and synthesis ranges of the standard AD-AS model that is provided in Principles and Intermediate macroeconomics textbooks in (O,P) space, where P is the actual price level. Keynes was explicit that these represented simplifications from his AD-AS(D-Z) model as specified in chapter 20 of the General Theory and did not cover the range of analysis that his D-Z model was capable of covering, such as multiple equilibria, expectations, or the impact of uncertainty. The view that Keynes did not have any formal, mathematical models in the General Theory resulted in his simplified models of his Aggregate Supply Curve being overlooked for the last 82 years.
Chapter 5 – A Comparison Between Various Topological Indices, Particularly Between the Index J and Wiener's Index W

A review of various methods for comparing the numerous topological indices described until now is provided, based upon methods that use cluster analysis and the ordering of constitutional isomers of alkanes with 6 through 9 carbon atoms. The ordering induced by the average distance connectivity index J (which deserves to be called a sharpened Wiener index W) parallels the ordering induced by W, but reduces the degeneracy of the latter index and provides a much higher discriminating ability. These methods allow the detection of similarity and dissimilarity between topological indices, and it is hoped that this analysis will prove to be useful in QSAR/QSPR studies.
Adolescent and Young Adult IUD Delivery in Non-traditional Health Settings

Non-traditional health settings have the ability to respond to gaps in adolescent and young adult reproductive healthcare by addressing access barriers that patients may face in traditional health settings, particularly among highly vulnerable youth. While all of the sites discussed in this chapter have the ability to offer same-day IUD placements and meet adolescents and young adults in their communities, programs may not currently exist. For most non-traditional sites, a one-size-fits-all policy approach regarding IUD placement for adolescents and young adults is impractical. It is important to be thoughtful and tailored in planning and implementing IUD provision in non-traditional settings while following existing guidelines and building community partnerships. The Centers for Disease Control and Prevention’s Quality Family Planning Guidelines provide an evidence-based roadmap on how to implement these services. Lastly, maintaining patient confidentiality and preventing contraceptive coercion, especially with adolescents and young adults who are underserved or medically disenfranchised, is of utmost importance. This chapter will describe how to effectively provide IUDs in non-traditional clinic settings, review the nuances of several non-traditional healthcare settings that may be barriers or facilitators to IUD delivery, and discuss planning and implementation needs when initiating or expanding provision of IUDs in non-traditional clinic settings.
Amplitude Effects for the Oscillating Disk in Liquid Helium-Ii.

The amplitude variation of the logarithmic decrement $D$ of a disk (radius \ensuremath{\cong} 2.5 cm) performing torsional oscillations in liquid He II has been found to depend on the history of the helium bath. Two types of damping curves are observed: (i) The first (called "steep") occurs when the height $h$ of the bath above the disk is greater than some critical height ${h}^{\ensuremath{'}}$, ($15.8\ensuremath{\le}{h}^{\ensuremath{'}}\ensuremath{\le}16.8$ cm) and the time interval $\ensuremath{\Delta}t$ between reaching the $\ensuremath{\lambda}$ temperature ${T}_{\ensuremath{\lambda}}$ and the initial deflection of the disk is short ($\ensuremath{\Delta}tl60$ min); (ii) the second curve (called "flat") occurs when either $hl{h}^{\ensuremath{'}}$ or, if $hg{h}^{\ensuremath{'}}$, then $\ensuremath{\Delta}t$ must be long ($\ensuremath{\Delta}tg60$ min). There is a critical velocity ${v}_{c}$ associated with each type of curve. For the steep curves, ${v}_{c1}$ increases with temperature (from 1.33 to 2.15\ifmmode^\circ\else\textdegree\fi{} K) and varies with period as ${\ensuremath{\tau}}^{\ensuremath{-}\frac{1}{2}}$ for periods between 3.9 and 19.6 sec. For the flat curves, ${v}_{c2}$ is independent of temperature (from 1.4 to 2.156\ifmmode^\circ\else\textdegree\fi{} K), is larger than ${v}_{c1}$, and has a period dependence given by ${v}_{c2}{\ensuremath{\tau}}^{\frac{1}{2}}=1.4$ (cgs units) for periods between 3.9 and 45.0 sec. The difference between steep and flat curves is attributed to the presence of a long-lived motion of the superfluid (possibly an ordered array of quantized vortex lines) in the subcritical flow for the steep case and the absence of this motion for the flat case. The low-amplitude logarithmic decrement ${D}_{0}$ is found to be the same for the steep and flat curves. The relative change in ${D}_{0}$ from the calculated value [$\frac{({D}_{0}\ensuremath{-}{D}_{\mathrm{calc}})}{{D}_{0}}$] is found to increase as $\frac{h}{\ensuremath{\lambda}}$ decreases $\ensuremath{\lambda}$ is the penetration depth). The excess damping slightly above ${v}_{c}$ cannot be explained by the effect of mutual friction. The relative change in moment of inertia $\frac{({I}_{a}\ensuremath{-}{I}_{a0})}{{I}_{a0}}$ at high amplitudes (up to 2.5 rad) indicates that, for the steep curves, about 30% of the superfluid is entrained for a 4-sec period and 5% for a 12-sec period. No entrainment is indicated for the flat curves.
Organ Recitals: A Large Group Active Learning Technique

This approach is best suited to students who already are familiar with the basic content but need experience applying it to clinical cases or problems. After studying assigned podcasts or readings the students attend an interdisciplinary session focused on a specific clinical presentation.
Reconfigurable Many-Core Embedded Computing Platform with Geometrical Bus Interconnection

There is an increasing interest in many-core embedded system of the scale of hundreds designed specifically with high degree of parallelism. These systems require high performance interconnection with minimum cost. In this paper, we propose a reconfigurable architecture based on a Geometrical Reduced Bus System (GRBS) interconnection and present interconnect characterization in terms of cost, fault tolerance and effective memory bandwidth. GRBS has b number of reduced buses given by ${\text{b}} = \frac{{{\mathbf{min}}\left( {{\mathbf{n}},{\mathbf{m}}} \right)}}{{\mathbf{k}}}$ where n is the number of processor cores and m is number of memory modules and k is the bus reduction factor for number of buses. We present geometrical connections such as rhombic, trapezoidal, cyclic, balanced, staircase and pyramid to connect to either processor cores or memory modules. Our results show that by using reduced bus connections, we can achieve comparable memory bandwidth and 1.5x bandwidth per cost. GRBS provides sustainable memory bandwidth for single bus failure.
Docked vs. dockless equity: Comparing three micromobility service geographies

Abstract Docked bike-share programs have proliferated worldwide, but studies find that the distribution of docked stations is geographically unequal. New dockless systems offer more flexibility compared to docked systems, but it remains unclear if dockless systems can address existing geographic inequities. This study examines all 32 US cities with both docked and dockless micromobility (bikeshare and e-scooter) programs and develops three service geography indicators to compare the geographic equity of docked versus dockless systems. We first use Lorenz curves and Gini indices to examine the overall spatial distribution of micromobility; we then use logistic and Tobit regressions to investigate how service geography corresponds to neighborhood characteristics. Results show that the distribution of docked systems is extremely unequal, and that dockless systems greatly reduce geographical inequalities relative to docked. Low-density areas and neighborhoods with low median household incomes, smaller shares of young people, and fewer zero-car households have limited micromobility service. Docked services are less prevalent in communities of color, and the implementation of dockless systems yields mixed outcomes for racial equity. Importantly, designated service areas do not always translate into available micromobility vehicles. Policymakers should use program design and performance metrics to address the mismatch between designated and actual service geographies and to ensure that micromobility services benefit marginalized communities.
Ablation of Atrial Fibrillation: The Cleveland Clinic Experience

Atrial fibrillation (AF) is the most common arrhythmia in clinical practice, with an overall prevalence in the general population of 0.4% [1]. Initial therapy of AF is directed toward the return to and maintenance of sinus rhythm, usually with the addition of antiarrhythmic drug therapy. However, even the best antiarrhythmic therapy is associated with only a 50%–60% success rate of maintaining sinus rhythm after 1 year, and is associated with significant side effects including proarrhythmia, drug toxicity, and possibly an increase in mortality [2]. Catheter ablation of the atrioventricular node with subsequent pacemaker implantation can be useful to facilitate ventricular rate control, but atrial systole is not restored and the thromboembolic risk is unchanged.
Obstruction Following Anti-Incontinence Procedures: Diagnosis and Treatment with Transvaginal Urethrolysis

AbstractWe reviewed the charts of 41 patients who underwent transvaginal urethrolysis and resuspension of the bladder neck by the Raz technique for urethral obstruction with or without stress urinary incontinence following anti-incontinence surgery. We sought to evaluate the effectiveness of the procedure as well as to determine any factors that had an effect on the outcome of surgery. Patients were evaluated for obstruction and stress urinary incontinence by history, physical examination, video urodynamics (or multichannel urodynamics plus cystogram and voiding cystourethrography) and cystoscopy. All patients reported normal emptying before the procedure that caused obstruction. Several variables were evaluated for individual predictive values for outcome, including type of surgery causing obstruction, number of previous antiincontinence procedures, urodynamic evidence of obstruction (high pressure, low flow), instability, concomitant stress urinary incontinence and total urinary retention, which were ev...
Surveillance for recurrent endometrial carcinoma : development of a follow-up scheme

We examined the method of diagnosis for a group of women who developed recurrent endometrial carcinoma after being rendered clinically disease-free by primary therapy. We then used this information to develop a follow-up protocol that maximizes the chances for detecting recurrence while minimizing surveillance costs. In brief, we evaluated all women with clinical stage I endometrial carcinoma who were treated with curative intent during a 7-year period. Medical records were examined to identify patients who had tumor recurrence diagnosed during follow-up in our clinic. Clinical presentation, time to diagnosis, method of diagnosis, and subsequent outcome were analyzed. This information was used to design a surveillance protocol for further clinical testing. Ninety-six percent of 412 women treated between 1985 and 1992 were clinically disease-free after primary surgery with or without adjuvant treatment. Median follow-up is 64 months. Overall, 44 patients (11%) developed recurrent cancer after a median interval of 14.8 months. Complete follow-up data were available for the 39 patients who had their recurrence diagnosed in our clinic. The cumulative percentages of diagnosed recurrences were 51, 82, and 95% at 12, 24, and 36 months, respectively. Sixteen women (41%) had symptoms that led to the identification of recurrent disease. Recurrences in the 23 asymptomatic women (59%) were diagnosed by physical examination in 13, chest radiograph in 1, serum CA-125 level in 6, vaginal cytology in 1, and computed tomography in 2. Only 1 patient with a grade 1 adenocarcinoma had treatment failure. At the time of analysis, 30 patients with recurrent cancer had died of disease, 6 were alive with disease, and 3 were free of disease. A surveillance scheme consisting of an examination, vaginal cytology, and serum CA-125, combined with immediate evaluation of symptomatic women, could be expected to identify 95% of recurrences. Such an approach, performed at 6- to 12-month intervals for 3 years, could be limited to patients with grade 2-3 adenocarcinomas or variant cell types. However, given the high failure rate of salvage therapy, the prompt detection of recurrence may not convey a survival advantage.
Effect of Body Weight on Cefazolin and Vancomycin Trabecular Bone Concentrations in Patients Undergoing Total Joint Arthroplasty.

Abstract Background: Effective use of prophylactic antibiotics decreases the incidence of surgical site infections (SSIs) after total joint arthroplasty (TJA). The purpose of this prospective study was to determine the viability of weight-based dosing protocols for cefazolin and vancomycin to determine if appropriate minimum inhibitory concentrations (MIC) are met. Methods: Trabecular bone was harvested from discarded bone samples from 34 patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA). The cefazolin and vancomycin concentrations were determined in the trabecular bone using high-performance liquid chromatography. Results: No difference was noted in bone concentration with respect to patient weight for cefazolin. Regarding vancomycin, a substantial difference was noted in trabecular bone concentrations with respect to patient weight with lower body mass index (BMI) achieving greater concentrations. Using the current weight-based protocol of antibiotic prophylaxis, 84% and...
Inducible Macrophage Cytotoxins. I. Biokinetics of Activation and Release In Vitro

Peritoneal exudate macrophage monolayers (PEMM) from C57BL/6 and DBA/2 mice inoculated ip with tumor allografts were induced to release in vitro labile cell toxin(s), herein called "macrophage cytotoxin(s)" (MCT). Macrophages released MCT spontaneously for a short interval when initially established as monolayers, and they were reinduced to secrete MCT by exposure to allogeneic and syngeneic tumor cells (but not to normal cells) and by exposure to polyinosinic-polycytidylic acid (poly I . poly C) and lipopolysaccharide (LPS). PEMM from normal mice treated ip 3 days previously with thioglycollate were also induced to release toxins in vitro. These cells did not release MCT spontaneously before or after treatment with neoplastic cells but were induced to release MCT by exposure to poly I . poly C or LPS. Resident peritoneal macrophages did not release MCT either spontaneously or after treatment with tumor cells, poly I . poly C, or LPS. MCT released from alloimmune mice stimulated with syngeneic or allogeneic tumor cells were resolved by molecular sieving into a major peak at 140,000--160,000 daltons, called "alpha-MCT," and into a minor peak at 60,000 daltons, called "beta-MCT." However, supernatants from thioglycollate-induced PEMM, stimulated with poly I . poly C or LPS, appeared to be composed entirely of the alpha-class. alpha-MCT from poly I . poly C-stimulated PEMM caused 31--56% lysis of syngeneic EL-4 and allogeneic L-929, NS-1, and YAC-1 tumor cells in vitro but was not cytotoxic for normal cells. Secretion of the MCT by PEMM derived from thioglycollate-treated animals stimulated with poly I . poly C was inhibited by colchicine, emetine, iodoacetic acid, trypan blue, and cytochalasin B.
Keyword Management Costs and “Broad Match” in Sponsored Search Advertising

In sponsored search advertising, advertisers bid to be displayed in response to a keyword search. The operational activities associated with participating in an auction, i.e., submitting the bid and the ad copy, customizing bids and ad copies based on various factors (such as the geographical region from which the query originated, the time of day and the season, the characteristics of the searcher), and continuously measuring outcomes, involve considerable effort. We call the costs that arise from such activities keyword management costs. To reduce these costs and increase advertisers’ participation in keyword auctions, search engines offer an opt-in tool called broad match with automatic and flexible bidding, wherein the search engine automatically places bids on behalf of the advertisers and takes over the above activities as well. The bids are based on the search engine’s estimates of the advertisers’ valuations and, therefore, may be less accurate than the bids the advertisers would have turned in th...
Long-term seizure outcome in reoperation after failure of epilepsy surgery.

OBJECTIVE Treatment of patients who fail epilepsy surgery is problematic. Selected patients may be candidates for further surgery, potentially leading to a significant decrease in the frequency and severity of seizures. We present our long-term outcome series of highly investigated patients who failed resective epilepsy surgery and subsequently underwent reoperative resective procedures. METHODS We performed a retrospective consecutive analysis of patients who underwent reoperative procedures because of medically intractable epilepsy at our institution from 1990 to 2001. Seventy patients underwent reoperative epilepsy surgery, with 57 patients having a minimum follow-up period of 2 years. We assessed the relationship between seizure outcome and categorical variables using chi2 and Fisher's exact tests, and the relationship between outcome and continuous variables using a Wilcoxon rank-sum test. Statistical significance was set at a P value of 0.05. RESULTS Of the 57 patients (29 male and 28 female patients), the age of seizure onset ranged from 3 months to 39 years (mean, 10.7 +/- 10.3 yr; median, 7 yr). The mean age at reoperation was 24.7 +/- 12 years (range, 4-50 yr). The interval between first and second resection was 7 days to 16 years. The follow-up period ranged from 24 to 228 months (mean, 128 mo; mode, 132 mo). Seizure outcome was classified according to Engel's classification. Fifty-two percent of the patients had a favorable outcome (38.6% were Class I and 14.0% were Class II). Patients with tumors as their initial pathology had better outcome compared with patients with focal cortical dysplasia and mesial temporal sclerosis (P < 0.05). CONCLUSION Reoperation should be considered in selected patients failing epilepsy resective surgery because approximately 50% of patients may have benefit. Patients with cortical dysplasia and mesial temporal sclerosis are less likely to improve after reoperation.