cssi/SciSciGPT-SciSciNet huggingface dataset:
ON HETEROZYGOSITY AND THE EFFECTIVE SIZE OF POPULATIONS SUBJECT TO SIZE CHANGES.

When a population is subject to fluctuations in size, the effective population number during any time interval is usually approximated by the harmonic mean of the successive generation sizes (Wright, 1938, 1939). If there are no mutations, the population will eventually reach complete homozygosity. The rate at which such a population approaches homozygosity was investigated by Karlin (1968), for stochastic, and also by Chia (1968), for cyclic, deterministic changes in population size. The analysis of homozygosity levels in populations subject to stochastic size changes was extended by Chia and Pollak (1974), who included the possible existence of mutations. For a population recovering from a great reduction in size, Nei et al. (1975) have concluded, using numerical computations and considering the existence of mutations, that the harmonic mean approximation to the effective population number is quite robust. It is our purpose in this note to extend the analyses of Nei et al. (1975) and of Chakraborty and Nei (1977) concerning the robustness of the harmonic mean approximation in situations which take into account the existence of mutations. We propose to do this by investigating cases where a population is subject to cyclic, deterministic changes in size. In such a situation, because the mutation rate is not zero, the expected level of heterozygosity, and hence the effective population number, will change in value throughout the cycle. The harmonic mean approximation, on the other hand, will have, in the steady state, a constant value. However, it will be shown that the harmonic mean is a good approximation in many such cases. Large discrepancies between the expected degree of heterozygosity and the value obtained using the harmonic mean approximation are found in those cases which combine a bottleneck of a very small population size together with a long cycle period. Also demonstrated here is the effect of repeated bottlenecks on greatly reducing the expected level of heterozygosity of the population.
Topology of a Trailing Vortex Flow Field with Steady Circulation Control Blowing

Trailing vortices adversely affect many applications and are robust to control efforts. In this study, a 1 mm slot placed along the suction-side of the airfoil tip spans 70% of the chord that blows pressurized air in the spanwise direction in an attempt to oppose the vortex motion via the Coanda effect. First, this experimental study uses stereo particle image velocimetry to observe the effects of different control levels along surface of the wing. These results show that the control jet appears to behave more akin to a jet in crossflow, bending backwards and rolling up with the vortex rather than oppose the vortex motion. The vortex separates from the surface further upstream (relative to the baseline case) with increased turbulent kinetic energy within the core. Investigation into the intermediate field shows a larger, more diffuse vortex relative to the baseline case. This diffuse vortex reduces the wake-hazard by as much as 40% in the first 5 chords downstream, potentially improving aircraft safety.
Lateral safety limits during a facial transclival approach to the craniovertebral junction.

AbstractBackground : Transclival procedures are infrequently performed and carry some dangerous complications. The carotid arteries and the hypoglossal nerves are the most important structures at risk during the subperiostal lateral dissection of the posterior wall of the oropharynx. These lateral landmarks are, however, not easily identified during the surgical dissection.Methods : We measured the location of the foramen lacerum externum and the hypoglossal canal with respect to the midline. These measurements were performed on 76 non-pathological CT-scanned skulls that were converted into accurate three-dimensional digital reconstruction models by the use of 3D image-processing. The same measurements were also taken on 15 non-pathological skulls by the use of a slide calliper.Results : For the foramen lacerum, the distance to the midline was 11 mm ± 1 mm SD (range 8–14 mm) on the right-hand side and 11 mm ± 1 mm SD (range 9–14 mm) on the left-hand side. For the right hypoglossal canal this distance was ...
Hypertensive cerebral hemorrhage. Demonstration of the source of bleeding

There have been many studies of hypertensive cerebral hemorrhage and the associated microvascular abnormalities. The actual primary site of bleeding has probably never been identified. In the present study, a 2- × l-cm hypertensive thalamic hemorrhage was studied in its entirety using continuous 8-μm-thick serial sections and stained with Mallory's phosphotungstic acid hematoxylin stain. The site of bleeding was focal rupture of a thin-walled elongated aneurysmal dilatation of a small artery normally 180 μm in diameter. The dilatation was 5-mm long and 600 μm in diameter. At the proximal end of the dilatation, the feeding artery showed a typical hypertensive lipohyalinotic lesion. There was only 1 site of bleeding. It was concluded that the aneurysmal dilatation was a preformed intracerebral saccular aneurysm of unusual shape and size. Rupture occurred during the period of hypertension induced by the infusion of pitressin. The presence of the lipohyalinotic lesion is considered a coincidence. This is probably the first demonstration of the primary site of arterial rupture in a hypertensive hemorrhage. The source of bleeding in hypertensive intracerebral hemorrhage has been studied over the years by many pathologists beginning with Charcot and Bouchard in 1868 (1). The most thorough investigations were by Matuoka in 1939 and 1952 (2, 3). It is probably correct to say, however, that despite the many studies of hypertensive brain hemorrhage, the actual primary site of bleeding has never been demonstrated. One of the main obstacles is the blood clot itself, which when fixed in formalin preparatory to making microscopic studies, becomes hardened to a degree that precludes a methodical microscopic study of the artery or arteries suspected of harboring the bleeding site. Another complicating factor is the development of secondary hemorrhages, “bleeding globes,” as a result of the mass effect of the main hemorrhage stretching and disrupting the surrounding …
Iron Supplementation for Chemotherapy-Induced Anemia in Patients Receiving Erythropoiesis-Stimulating Agents.

Clinical Question What are the benefits and harms of iron supplementation alone and as an adjunct to erythropoiesis-stimulating agents (ESAs) compared with ESA alone in the treatment of chemotherapy-induced anemia? Bottom Line Addition of iron to ESAs improves hematopoietic response, reduces the need for red blood cell transfusions, increases hemoglobin levels, and seems to be well tolerated. The subgroup analyses suggest the superiority of parenteral iron over oral iron supplementation in the treatment of chemotherapy-induced anemia.
Abstract 70: Participation in Cardiac Rehabilitation Is Associated with Reduced Rehospitalization Following Acute Myocardial Infarction

Background: Participation in cardiac rehabilitation (CR) has been shown to decrease mortality following acute myocardial infarction (MI), but its impact on rehospitalizations requires examination. Methods: We included patients who were hospitalized with first-ever MI in Olmsted County Minnesota from 1987-2010 and survived to hospital discharge. Participation in CR within the first 30 days following MI was determined using billing data and was analyzed as a time-dependent covariate. The association between CR participation and all-cause rehospitalization was analyzed using Andersen-Gill models to account for repeated events. As CR participation is a non-randomized intervention, we adjusted for propensity to participate after fitting a logistic regression model using 13 factors significantly associated with participation on univariate analysis. Patients were censored at the time of death or last follow-up. Results: Among 2991 patients (mean age 67 years, 59% male, 31% ST elevation MI), 1480 (49%) participated in CR following acute MI hospital discharge (first session occurred at a mean of 9 days post-discharge). Most patients (75%) were rehospitalized at least once during a mean follow-up of 7.6 years, and CR participation was associated with reduced risk of rehospitalization. The rehospitalization rates were 39% and 59% at one year for participants and non-participants, respectively. In unadjusted analysis, CR participation was associated with a markedly decreased risk of rehospitalization (HR 0.51, 95% CI 0.49-0.53, p<0.001). After adjusting for propensity to participate, the association between CR participation and all-cause rehospitalization persisted (HR 0.70, 95% CI 0.67-0.73, p<0.001). Conclusions: CR participation is associated with a markedly reduced risk of rehospitalization after incident MI. In addition to reducing mortality, improving CR participation rates may have a large impact post-MI healthcare resource use.
A qualitative approach to understanding Hawaiian apparel manufacturers' exports: strategic marketing resources, dynamic capabilities and export barriers

Hawaii is highly dependent on imported consumer goods which include apparel products. Even aloha wear (i.e., Hawaiian shirts and dresses) is often imported from other countries (e.g., China, India) because of the low cost advantages. The purpose of this study is to understand how Hawaii apparel manufacturers' (HAM) export businesses are performing in globalised circumstances. Understanding HAM's export business performance based on their marketing resources and export barriers can make important contributions to the academic literature and the apparel manufacturing industry in Hawaii. The results of the study revealed that a global market partnership is one of the most important factors that can boost exports. Collaborating with trustworthy international trade agencies turned out to be another key to success in exports. Government support (e.g., subsidy, tax benefit) and practical educational training (e.g., export seminars) may be necessary, and legal protection of designs should be adopted internationally.
The Value of Things in the Imaginative Life: Microeconomics in the Bloomsbury Group

(2001). The Value of Things in the Imaginative Life: Microeconomics in the Bloomsbury Group. History of Economics Review: Vol. 34, No. 1, pp. 56-73.
ELECTRIC GENERATORS FOR SMALL SOLAR-THERMAL SYSTEMS

ABSTRACT Induction machines are suitable electric generators for small solar-thermal systems using a Rankine-cycle turbine. The turbine shaft is coupled to a 2-pole induction machine which feeds into an alternating current public utility. Remote solar installations are often serviced by only single-phase public utilities. Three-phase machines, however, are more efficient than single-phase machines, cost less, and have less vibration. A three-phase induction generator coupled to a turbine can be operated at balanced voltages and currents, and feed single-phase power into a single-phase line using this new winding connection with capacitors.
Application comparison of Rogowski-type and optical-type electronic current transformer

This paper aims at analysis and comparison of the features of Rogowski-type and optical-type electronic current transformers(ECT). Referring the application results of digital substation in operation, it analyses engineering application, theory and reality combined, their advantages and disadvantages and summarizes experience in the application, providing reference for the application and research of ECT.
Some ways cognitive science might inform design

Design is fast and specific; cognitive science is slow and general. Can cognitive science be of use to design? Two projects are suggestive. In one, we turn users into designers, and extract cognitive design principles from their graphic and verbal productions for the design of visual explanations and graphic displays. In the other, we study the origins of designers' innovations, finding that both reconfiguration and reinterpretation are key to a process of constructive perception.
A transnational networked public sphere of air pollution: analysis of a Twitter network of PM2.5 from the risk society perspective

Drawing on digitaltrace data, publicly accessible government documents, and journalistic reports, this research integrates Beck’s risk society theory with digital media theories to examine the medi...
Pyridalthiadiazole acceptor-functionalized triarylboranes with multi-responsive optoelectronic characteristics

A new class of Ar2B–π–A dyads and A–π–B(Ar)–π–A triads that feature strong organic acceptor moieties (A = pyridalthiadiazole, PT) attached to a central triarylborane were synthesized via Stille cross-coupling of ArB(Th–SnMe3)2 (Th = thiophenediyl, Ar = 2,4,6-tri-tert-butylphenyl (Mes*) or 2,4,6-tris(trifluoromethylphenyl) (FMes)) with one or two equivalents of dibromopyridalthiadiazole. Single-crystal X-ray crystallography data for the triad Mes*B(Th–PT–Br)2 indicate a highly coplanar conformation, which is ideal for extended π-conjugation and favors intermolecular π-stacking. Despite the presence of Br substituents, these compounds exhibit strong photoluminescence in THF solution with quantum yields reaching up to 52%. Further extension of conjugation by coupling with 2-hexylthiophene leads to additional bathochromic shifts to give a highly soluble and strongly red-emissive material. All these compounds undergo facile reduction, first of the PT substituents and then at more negative potentials for the borane moiety. Upon chemical reduction with in THF, an intramolecular charge transfer (ICT) pathway from the reduced PT moieties to boron is enabled and this results in a change of the color to blue. Theoretical calculations reveal that, due to the electron-withdrawing effect of the PT moieties, not only the PT-centered LUMOs themselves but also the LUMO+1 or LUMO+2, which show contributions from the p orbital of boron, experience a significant decrease in energy; they are much lower in energy than those of typical conjugated triarylboranes. The relatively low energy of both the PT-centered LUMOs and boron-centered LUMO+1 or LUMO+2 opens up multiple pathways for reaction with highly nucleophilic fluoride anions. Evidence for very strong F− binding to boron is obtained in the case of the more sterically accessible FMes derivatives. Fluoride anion binding leads to an electron-rich borate moiety and as such generates an ICT pathway to the electron-deficient PT moieties; the direction of this ICT is opposite to that observed upon chemical reduction. For the Mes* derivatives, F− binding is hindered, resulting in competing reduction of the PT acceptors. Finally, the electron acceptor character of the hexylthiophene derivative is exploited in electron-only diodes that show an average electron mobility of 6.4 ± 1.6 × 10−5 cm2 V−1 s−1.
High strain actuation liquid crystal elastomers via modulation of mesophase structure

Control of the mesophase in liquid crystalline elastomers (LCEs) is a critical aspect in harnessing their unique stimuli-responsive properties. Few studies have compared nematic and smectic main-chain LCEs in a direct way. Traditionally, it is believed that the mesogen core and synthetic route determines the phase behavior. In this study, we hypothesized that tuning the LC phases in main-chain LCE systems can be achieved by varying the spacer length while maintaining the same mesogen (RM257). By increasing the length of dithiol alkyl spacers containing two to eleven carbons along the spacer backbone (C2 to C11), we can modulate the mesophase from nematic to smectic, tailor the nematic to isotropic transition temperature between 90 and 140 °C, and increase the average work capacity from 128 to 262 kJ m−3. Phase nano-segregation resulting in the smectic C phase is achieved at room temperature for the C6, C9, and C11 spacers. In a shape switching system, this manifests in impressive actuation stroke of 700%. Upon heating from room temperature, these samples transition into the nematic and later, the isotropic phase. Furthermore, this segregation occurs along with polymer chain crystallinity, which increases the modulus of the networks by an order of magnitude; however, the crystallization rate is highly time dependent on the spacer length and can vary between 5 minutes for the C11 spacer and 24 hours for shorter spacers. This study presents several possibilities of a thiol–acrylate reaction in modulation of the thermomechanical and liquid-crystalline properties of LCEs and discusses their potential use for biomedical applications.
Ventricular Performance is Associated with Need for Extracorporeal Membrane Oxygenation in Newborns with Congenital Diaphragmatic Hernia.

Objective To compare echocardiography (ECHO) findings of patients with congenital diaphragmatic hernia (CDH) who required extracorporeal membrane oxygenation (ECMO) to non-ECMO treated patients. Study design We reviewed clinical and ECHO data of newborns with CDH born between 2009 and 2016. Exclusions included major anomalies, genetic syndromes, or no ECHO prior to ECMO. Pulmonary hypertension was assessed by ductal shunting and tricuspid regurgitant jet. Speckle tracking echocardiography (STE) assessed function by quantifying deformation. Results Patients with CDH (15 ECMO and 29 with no ECMO) were analyzed. Most patients had a left CDH (88.6%). Age at ECHO was similar between groups. Outborn status ( P = .009) and liver position ( P = .009) were associated with need for ECMO. Compared with non-ECMO patients, patients who required ECMO had significantly decreased left and right ventricular function by both conventional and STE measures, as well as decreased right and left ventricular output. The right ventricular eccentricity index was higher in ECMO vs non-ECMO patients (2.2 vs 1.8, P = .02). There was no difference in pulmonary hypertension between CDH groups. Conclusions Need for ECMO was associated with decreased left and right ventricular function, as assessed by standard and STE measures. There was no difference in pulmonary hypertension between non ECMO and ECMO patients. Abnormal cardiac function may explain nonresponse to pulmonary vasodilators in patients with CDH. Management strategies to improve cardiac function may reduce the need for ECMO in newborns with CDH.
Community Conversations to Increase Employment Opportunities for Young Adults With Developmental Disabilities in California

In 2013, California enacted an Employment First policy that prioritized competitive integrated employment as the first option and preferred outcome for adults with developmental disabilities. State...
Myoediting: Toward prevention of muscular dystrophy by therapeutic genome editing

Muscular dystrophies represent a large group of genetic disorders that significantly impair quality of life and often progress to premature death. There is no effective treatment for these debilitating diseases. Most therapies, developed to date, focus on alleviating the symptoms or targeting the secondary effects, while the underlying gene mutation is still present in the human genome. The discovery and application of programmable nucleases for site-specific DNA double-stranded breaks provides a powerful tool for precise genome engineering. In particular, the CRISPR/Cas system has revolutionized the genome editing field and is providing a new path for disease treatment by targeting the disease-causing genetic mutations. In this review, we provide a historical overview of genome-editing technologies, summarize the most recent advances, and discuss potential strategies and challenges for permanently correcting genetic mutations that cause muscular dystrophies.
Repeal the Dickey Amendment to Address Polarization Surrounding Firearms in the United States.

An editorial is presented which addresses the author's views about the potential repeal of America's Dickey Amendment from 1996 in order to facilitate epidemiological research on firearm injuries and deaths in the U.S. Mistrust and political polarization are examined, along with public health research, America's gun policies, and the concept of guns as symbols of White authority in the U.S. American gun ownership and the prevention of school shootings are assessed.
Responsibilities of the Mentor

Mentorship is a relationship in which a more experienced person helps to guide a less experienced or knowledgeable person. The mentor in surgery is typically a qualified surgeon assigned to a more junior trainee. The trainee can be a medical student, a resident, a fellow, or a junior faculty. In surgery the mentor himself is defined by unique and personal traits of a nonhierarchical quality relationship. The mentor will trigger motivation (interests), inspiration (internal energy), and resilience in the mentee. This chapter will define the active (interventional) and passive (behavioral) responsibilities of the mentor. The mentor himself expands the horizons of the mentee and opens new doors. He transmits himself and projects qualities that will energize the mentee in his/her academic pursuit.
Nearly complete genome sequence of one GII.17 Norovirus identified by direct sequencing from HuZhou, China.

Background Human norovirus is the leading cause of acute gastroenteritis worldwide. However, in vitro culture system is complicated for human norovirus. Sequence analysis became more useful for norovirus research, particularly when using complete genomic sequences. Methods Real-time RT-PCR (qPCR) was performed for norovirus detection. Three modified paris of PCR primes were designed based on the alignment of the novel GII.17 norovirus complete sequence available in Genbank., which could amplify three overlapping fragments cover the whole genome. The PCR fragments were sequencing by Sanger sequence with Primer walking methods. Genogroup and genotype were assigned using the Norovirus Noronet typing tool and the strains were named according to the time of isolation. The phylogenetic analysis was conducted using MEGA software (ver. 6.06). Results One nearly complete genome sequence were obtained from sample collected from Huzhou, China. The partial genome sequence of the HuzhouNS2014603 strain is composed of 7556 nucleotides (nt).The strain was classified as GII.17 genotype both in ORF1 and ORF2, and was most closely related to the LC037415.1/Hu/GII.17/Kawasaki308 strain. Within the GII.17 cluster, the 2013/14 season strains were grouped separately from the GII.17 strains detected in 2014/15. HuzhouNS2014603 was clustered with the 2014/15 season strains. Compared with other strains selected, there are 98 variable residues across the VP1 domain. Among the 98 variable amino acids, 13 (13.3%) were observed in the shell domain and 22 (22.4%) in the P1domain; most of the substitutions and insertions were located in the P2 domain, account for 63 (64.3%). Conclusions This is the first report of the nearly complete genome of the novel GII.17 by direct sequencing method in the Huzhou area. The results of this study could be helpful for the study of the genetic evolution of the virus, the development of rapid diagnostic reagents and the design of vaccine.
Network Meta-Analysis of Percutaneous Intervention-Based Revascularization Strategies for ST-Elevation Myocardial Infarction and Concomitant Multi-Vessel Disease.

Abstract Background In patients with ST elevation myocardial infarction (STEMI) and concomitant multi-vessel disease (MVD), primary percutaneous coronary intervention (PCI) of the culprit vessel is the preferred reperfusion strategy. However, optimum timing of revascularization for non-culprit artery is unclear. In this Bayesian network meta-analysis (NMA), we compared different PCI-based revascularization strategies in STEMI patients with MVD. Methods 11 randomized controlled trials (RCTs) were selected using MEDLINE, EMBASE and CENTRAL (Inception to September 2017). For all outcomes, median estimate of odds ratio from posterior distribution with corresponding 95% credible interval was calculated. The Surface under the Cumulative Ranking Curve (SUCRA) metric was used to estimate the relative ranking probability of each intervention. Sensitivity analysis was conducted by excluding the RCTs in which the staged intervention was performed after two weeks of the index procedure or post discharge. Results In this NMA of 3172 patients, CR-I (instant complete revascularization) was associated with 40% relative risk reduction in all-cause mortality compared with IRA (infarct related artery) [0.60 (0.31–0.89)]. CR-I was superior to CR-S (staged complete revascularization) [0.42 (0.22–0.70)] and IRA [0.50(0.29–0.72)] in reducing the risk of re- infarction. Both CR-I and CR-S significantly reduced the risk of repeat revascularization compared to IRA, whereas the risk of CIN (contrast induced nephropathy) and major bleeding was similar across all interventions. Sensitivity analysis showed, that CR-I was a better strategy compared with CR-S [0.34 (0.12–0.74)] and IRA (0.60 [0.36–0.97]) in reducing all-cause mortality. Conclusions In this NMA, CR-I was associated with reduction in all-cause mortality and re- infarction compared with IRA.
High-accuracy HPV testing versus p16 IHC using multiple clinically relevant outcomes: The University of Chicago Experience.

6020Background: The current most widely used standard for HPV status testing in head & neck cancer is p16 IHC. However, p16 IHC is a surrogate method which does not test directly for HPV genetic ma...
The Global Beauty Industry: Colorism, Racism, and the National Body

The Global Beauty Industry is an interdisciplinary text that uses beauty to explore topics of gender, race, class, colorism, nation, bodies, multiculturalism, transnationalism, and intersectionality. Integrating materials from a wide range of cultural and geo-political contexts, it coalesces with initiatives to produce more internationally relevant curricula in fields such as sociology, as well as cultural, women's/gender, media, and globalization studies.
Author's view: epithelial plasticity metabolically reprograms normal cells towards a neoplastic-prone state.

We have uncovered that epithelial plasticity programs metabolically reprogram epithelial lung cells by increasing expression of genes (e.g., glutamine-fructose-6-phosphate transaminase 2 - GFPT2 and UDP-N-acetylglucosamine pyrophosphorylase 1 - UAP1) critical for the hexosamine biosynthetic pathway (HBP) and elevating global protein O-GlcNAcylation - a specific type of glycosylation. We found that increased O-GlcNAcylation could suppress oncogene-induced senescence tumor suppressor pathways that ultimately led to accelerated KrasG12D -driven lung tumorigenesis.
Safety of Outpatient Shoulder Surgery at a Freestanding Ambulatory Surgery Center in Patients Aged 65 Years and Older: A Review of 640 Cases.

Introduction With increasing utilization of surgery centers, it is important to demonstrate the safety of outpatient shoulder surgery in freestanding ambulatory surgery centers. No studies have specifically looked at the Medicare-age population and the rate of outpatient shoulder procedure complications in these patients at an ambulatory surgery center. Methods Six hundred forty patients were included in our study between 2000 and 2015. The incidence of major complications was identified, including acute infection requiring intravenous antibiotics or irrigation and debridement, postoperative transfer to a hospital, wrong-site surgical procedures, retention of a foreign object, postoperative symptomatic thromboembolism, medication errors, and bleeding/wound complications. Results There was a total of seven occurrence reports in seven patients, for a reported adverse event rate of 1.01%. Conclusions Our findings are consistent with currently reported outpatient hospital-based data and illustrate the safety of outpatient shoulder procedures at a freestanding ambulatory surgery center in Medicare-age patients.
Boundary of content ecology: chatbots, user experience, heuristics, and pedagogy

The increasing use of AI-powered chatbots has been transforming how technical communicators interact with users, content, and technologies. Menu-based, rule-based, or AI-powered, chatbots help automate customer service and technical support while moving away from more traditional web- or app-based frameworks. This panel explores how technical communicators design, teach, and evaluate chatbots before discussing lessons about user research, usability testing, information architecture, and new competencies that have to be introduced to prepare technical communication students to work toward/with useful and usable automated content.
COVID-19: Reduced Lung Function and Increased Psycho-emotional Stress

The COVID-19 outbreak causing reduced lung function and increased psycho-emotional stress in the community worldwide. Therefore, it is of interest to document such viral outbreak related emotional stress data in the community with known molecular and patho-physiological parameters of the affected individuals. We provide a concise, coherent, critical, precise, specific and direct narration of such events from a community research viewpoint using known molecular data in this editorial.
“Will the judge of all the earth not do justice?” A note on Genesis, Protagoras, and theodicy

This article argues that the introduction of the Hebrew words for judge and justice, which occurs only late in the text of Genesis is not fortuitous. Abraham introduces these terms in the context of his argument with God that He spare Sodom and Gomorrah if a number of righteous men can be found there. This happens long after the invention of human arts and institutions including the city and the execution by God of several notable and severe judgments against individuals and indeed all the living world. The words shopheṭ and mishpaṭ, one proposes, adumbrates a new and different kind of justice than what existed before one based on equality under law and on a procedure of advocacy and argument rather than mere Divine fiat. Since God accepts unquestioningly Abraham’s unprecedented definition of Him as “Judge of the world,” one might further suggest that the Master of the Universe in the course of the evolving covenantal relationship with mankind is allowing His creatures to discover aspects of Him that were hitherto unknown to them and unknowabletill they developed further. In both its character and the sequence of the events that unfold, the Biblical narrative is in some respects closely parallel to themyth of human genesis and cultural development, followed by the introduction of justice, in the Protagoras of Plato. Since the latter myth is connected to the progeny of Iapetos, who may be identical with Biblical Japheth, it is possible that the two narratives, Hebrew and Hellenic, may share common, possibly Semitic, roots.
Managing Hypertension in the elderly: What's new?

Hypertension is the leading modifiable risk factor for cardiovascular events and mortality in the world. Hypertension is a major risk factor for cardiovascular events and mortality in the elderly. The 2017 American College of Cardiology/American Heart Association hypertension guidelines recommend treatment of noninstitutionalized ambulatory community-dwelling persons aged 65 years and older with an average systolic blood pressure of 130 ​mm Hg or higher or a diastolic blood pressure of 80 ​mm Hg or higher with lifestyle measures plus antihypertensive drug to lower the blood pressure to less than 130/80 ​mm Hg For elderly adults with hypertension and a high burden of comorbidities and limited life expectancy, clinical judgment, patient preference, and a team-based approach to assess risk/benefit is reasonable for decisions about the intensity of SBP lowering and the choice of antihypertensive drugs to use for treatment. Randomized clinical trials need to be performed in frail elderly patients with hypertension living in nursing homes. Elderly frail persons with prevalent and frequent falls, marked cognitive impairment, and multiple comorbidities requiring multiple antihypertensive drugs also need to be included in randomized clinical trials. Data on patients older than 85 years treated for hypertension are also sparse. These patients need clinical trial data. Finally, the effect of different antihypertensive drugs on clinical outcomes including serious adverse events needs to be investigated in elderly frail patients with hypertension and different comorbidities.
The Association of Radiation Dose-Fractionation and Immunotherapy Use With Overall Survival in Metastatic Melanoma Patients

Objective Metastatic melanoma patients often receive palliative radiotherapy (RT) and immunotherapy (IT). However, the immunological interplay between RT dose-fractionation and IT is uncertain, and the optimal treatment strategy using RT and IT in metastatic melanoma remains unclear. Our main objective was to examine the effect of RT dose-fractionation on overall survival (OS). Methods Using the National Cancer Database (NCDB), we classified metastatic melanoma patients who received palliative RT into two dose-fractionation groups - conventionally fractionated RT (CFRT; <5 Gy/fraction) and hypofractionated RT (HFRT: ≥5 Gy/fraction) - with or without IT. Survival analysis was performed using the Cox regression model, Kaplan-Meier method, and propensity-score matching (PSM). Results A total of 5,281 metastatic melanoma patients were included, with a median follow-up of 5.9 months. The three-year OS was highest in patients who received HFRT+IT [37.3% (95% CI: 31.1-43.5)] compared to those who received HFRT alone [19.0% (95% CI: 16.2-21.9)], CFRT+IT [17.6 (95%CI: 13.9-21.6)], or CFRT alone [8.6% (95%CI: 7.6-9.7); p<0.0001]. The magnitude of OS benefit with the use of IT was greater in those who received HFRT (18.3%) compared with those who received CFRT (9.0%) (p<0.0001). The addition of IT to HFRT, compared to CFRT, was associated with greater OS benefit in patients treated with RT to the brain and soft tissue/visceral (STV) sites. On PSM analysis, HFRT+IT was associated with improved three-year OS compared to other treatments. Conclusion Metastatic melanoma patients who received HFRT+IT was associated with the greatest OS benefit. Our findings warrant further prospective evaluation as to whether higher RT dose-per-fraction improves clinical outcomes in metastatic melanoma patients receiving IT.
Sex Differences in the Repair of Retinal Detachments in the United States.

Purpose To investigate differences between women and men in the repair of rhegmatogenous retinal detachments (RRDs) in the United States. Design Retrospective cohort study. Methods Setting : A large insurance claims database. Participants : Subjects with an incident RRD between 2007 and 2015. Data: Demographic data, comorbid ocular conditions associated with RRD, systemic comorbidities, and surgical intervention (pneumatic retinopexy [PR], pars plana vitrectomy [PPV], laser barricade, or scleral buckle [SB]) were collected. Main outcome measures : Odds of receipt of surgical intervention for incident RRD, time to repair, type of intervention, and the rate of reoperation by sex. Results The study period included 133 million eligible records with 61,071 cases of incident RRD among which 43% (n = 26,289) were women. The primary outcome model had 23,933 confirmed RRD cases with a 93% retinal detachment repair rate. Women had 34% reduced odds of receipt of surgical repair of an RRD (odds ratio [OR] 0.66, 95% confidence interval [CI] 0.59, 0.73; P Conclusions Insured women are less likely than insured men to receive surgical intervention for an RRD. Based on the results of this study, if the odds of repair were equal between women and men in the United States, then 781 more women would receive surgery each year, or 7,029 more during the study period. Women are more likely to have the repair performed with scleral buckle, laser barricade, and pneumatic retinopexy. The reason for these sex differences in RRD repair remains unknown and requires further investigation.
PTEN activation contributes to tumor inhibition by trastuzumab and loss of PTEN predicts trastuzumab resistance in patients.

2460 The ErbB2-targeting antibody, trastuzumab (Herceptin) has remarkable therapeutic efficacy in certain patients with ErbB2-overexpressing tumors. The overall trastuzumab response rate, however, is limited and the cause of trastuzumab resistance is poorly understood. Here we report that PTEN activation contributes to trastuzumab’s anti-tumor activity. Trastuzumab treatment quickly reduced PTEN tyrosine phosphorylation, increased PTEN membrane localization and its phosphatase activity in cancer cells. Reducing PTEN expression in breast cancer cells by antisense oligonucleotides conferred trastuzumab resistance in vitro and in vivo. Patients with PTEN-deficient breast cancers had significantly poorer responses to trastuzumab-based therapy than those with normal PTEN. Thus, PTEN deficiency is a powerful predictor of trastuzumab resistance. Additionally, PI3K inhibitors rescued PTEN loss-induced trastuzumab resistance, suggesting PI3K-targeting therapies combined with trastuzumab could overcome the resistance. Trastuzumab is an excellent model of rationally designed targeted cancer treatment. However, mechanisms underlying trastuzumab anti-tumor function and causes of trastuzumab resistance are poorly understood. Here our data introduces the new concept that a rapid PTEN activation, before downregulation of ErbB2, is a novel mechanism underlying the anti-tumor activity of trastuzumab. This indicates a functional cross talk between ErbB2 receptor tyrosine kinase signaling and PTEN tumor suppressor activity. PTEN deficiencies were reported in ∼50% of breast cancers. Our finding that PTEN deficiency is significantly associated with trastuzumab resistance in patients can directly impact the treatment of these patients. PTEN-deficiencies in patients’ tumors can predict trastuzumab resistance and serve as an indicator for requiring PI3K-targeting combination treatment targeting PI3K to overcome the trastuzumab resistance.
Neurology and COVID-19.

In this Viewpoint, JAMA Neurology editors review the journal’s more important articles advancing scientific understanding of COVID-19 in the first 6 months of t
Distributed Aerodynamic Control using Active Trailing-Edge Flaps for Large Wind Turbines

This work presents a numerical framework to investigate distributed aerodynamic control devices for application in large wind turbines. Tool capabilities were extended to facilitate multiple aerodynamic polar tables. The airfoil aerodynamics characteristics were automatically determined, and blade-pitch, generator-torque, and trailing-edge-flap controllers were tuned in-the-loop according to a specific blade design. This automated workflow allows analysis and optimization of trailing-edge flaps, enabling codesign studies. Results targeted reductions of root-flap-bending moment derivatives. The applied trailing-edge-flap control reduced the standard deviation of root-flap-bending moments by more than 6% and benefit related parameters, e.g., reduce blade-tip deflections, by up to 8%. Because of varying thrust distributions along the blade span, different flap designs have nonlinear characteristics in terms of the control objective and show best performance when located at the radial position with maximum thrust. In general, larger flaps provide a greater influence to reduce the target control objective.
Thoracic vertebral morphology in normal and scoliosis deformity in skeletally immature rabbits: A Longitudinal study.

Objective To measure age-related changes in thoracic vertebral body heights (VBH) in skeletally immature normative and scoliotic rabbits to assess how VBH change during growth. To examine the potential link between the moment-arm of the rib tether and vertebral wedging as well as the sum of the curvature angles at the apical level (T7). To assess the correlation between the magnitude of initial spine curve and final spine curve in the scoliotic group. Methods Eight healthy, skeletally immature normative New Zealand rabbits and ten skeletally immature scoliotic rabbits which underwent unilateral rib tethering were included retrospectively. Each rabbit was scanned at two to four time points (at 7, 11, 14 and 28 weeks). Three dimensional bone models of thoracic vertebrae (T1-T12) were digitally segmented and reconstructed. VBH were calculated using surface landmark points from each thoracic vertebra. Apical level (T7) ± 2 levels in scoliotic rabbits were compared to their corresponding levels and time points in the normative group. The moment-arms between the centroids of 2D projections of T3-T9 vertebral bodies and the line which connects the centroids of the end levels were calculated. Results Bilateral left-right (L-R) symmetry and anterior-posterior (A-P) asymmetry were observed in normative VBH. Bilateral concave-convex (CC-CX) asymmetry and (A-P) asymmetry were observed in scoliotic VBH. No significant differences in growth rates were found between the normative and scoliotic groups. Vertebral wedging as well as curvature magnitude were positively correlated with the moment-arms. Conclusion Unilateral rib tether applies compressive forces on both concave and convex sides, whereas compressive forces are lower on the latter. Knowing the amount of vertebral wedging or curve magnitude would enable us to predict the applied force (moment-arms), which is important for planning a corrective surgery.
Digital Ethnicity: Social Belonging in the Internet Age

The Digital Ethnicity Scale (DES) was developed to describe the impact human interaction with digital communication technologies is having on cultural development. Longstreet’s (1978) sociobiological definition of ethnicity, used as a basis for the construct of digital ethnicity, focuses on cultural development during the earliest stages of human development, prior to the onset of children’s abstract thinking. The ultimate goal for the development of the digital ethnicity construct and Digital Ethnicity Scale is to describe those aspects of digital ethnicity and collect these descriptions along with demographic data to achieve profiles of various digital ethnicities. Digital profiles have emerged by demographic variables. These digital ethnic profiles are intended to provide insight into the social and educational needs of rapidly changing societal groupings by providing guidance for educational leaders, teachers, and teacher education programs to prepare candidates who will be able to address the biological, social, and cognitive changes brought about by pervasive use of digital communication technologies. A 5-phase development process, including the development and validation of both Likert-type items and semantic differentials, was conducted with more than 2000 respondents. Both theoretical and practical results of this inquiry are presented.
Abstract WMP77: SUMO1 Plays an Important Role in Cardiac Dysfunction After Intracerebral Hemorrhage in Aged Mice

Background: The conjugation of the small ubiquitin-like modifier1 (SUMO1) plays an important role in numerous biological processes, including DNA repair and signal transduction. SUMO1 also reduces ...
Increased speech contrast induced by sensorimotor adaptation to a nonuniform auditory perturbation

When auditory feedback is perturbed in a consistent way, speakers learn to adjust their speech to compensate, a process known as sensorimotor adaptation. Although this paradigm has been highly informative for our understanding of the role of sensory feedback in speech motor control, its ability to induce behaviorally relevant changes in speech that affect communication effectiveness remains unclear. Because reduced vowel contrast contributes to intelligibility deficits in many neurogenic speech disorders, we examine human speakers' ability to adapt to a nonuniform perturbation field that was designed to affect vowel distinctiveness, applying a shift that depended on the vowel being produced. Twenty-five participants were exposed to this "vowel centralization" feedback perturbation in which the first two formant frequencies were shifted toward the center of each participant's vowel space, making vowels less distinct from one another. Speakers adapted to this nonuniform shift, learning to produce corner vowels with increased vowel space area and vowel contrast to partially overcome the perceived centralization. The increase in vowel contrast occurred without a concomitant increase in duration and persisted after the feedback shift was removed, including after a 10-min silent period. These findings establish the validity of a sensorimotor adaptation paradigm to increase vowel contrast, showing that complex, nonuniform alterations to sensory feedback can successfully drive changes relevant to intelligible communication.NEW & NOTEWORTHY To date, the speech motor learning evoked in sensorimotor adaptation studies has had little ecological consequences for communication. By inducing complex, nonuniform acoustic errors, we show that adaptation can be leveraged to cause an increase in speech sound contrast, a change that has the capacity to improve intelligibility. This study is relevant for models of sensorimotor integration across motor domains, showing that complex alterations to sensory feedback can successfully drive changes relevant to ecological behavior.
Care of the Critically Ill Pediatric Hematopoietic Cell Transplant Patient

Although potentially curative therapy, hematopoietic cell transplantation (HCT) is fraught with many unique and life-threatening complications. Pulmonary complications, both infectious and noninfectious, are common and a significant source of nonrelapse mortality. Noninfectious pulmonary complications include a variety of etiologies difficult to diagnose and treat. Cardiac complications are less common and include primarily arrhythmias and cardiomyopathy. Sinusoidal obstruction syndrome/hepatic veno-occlusive disease is a potentially life-threatening complication occurring in up to 30% of pediatric HCT patients. Transplant associated thrombotic microangiopathy is characterized by de novo Coombs negative anemia, thrombocytopenia, elevated lactate dehydrogenase levels, proteinuria, hypertension, and schistocytes. It is associated with high rates of morbidity and mortality. Infections are common post-HCT and the stage of immune reconstitution affects which pathogens are most likely. Immunosuppression may obscure the typical signs/symptoms of infection. Engraftment syndrome is characterized by fever, vascular leak, dyspnea, organ dysfunction, rash, and diarrhea typically occurring within 4 days of granulocyte recovery. Acute graft versus host disease (GVHD) primarily affects the skin, liver, and intestinal tract; management is based on severity grade. Neurological complications are also common in HCT patients and may portend poor outcomes. Posterior reversible encephalopathy syndrome (PRES) occurs frequently in the first 100 days post-transplant, characterized by headache, seizures, mental status changes, visual changes, and hypertension. Although medications, metabolic aberrations and infections may all cause neurological symptoms post-HCT, it is important to consider CNS recurrence of malignancy as a source of the pathology. Post-transplant lymphoproliferative disease occurs and treatments continue to evolve. Chimeric antigen receptor (CAR) autologous T-cell immunotherapy is used to treat B-cell precursor acute lymphoblastic leukemia that is refractory or in relapse. It is associated with high remission rates, but also unique toxicities including cytokine release syndrome and CAR T-cell related encephalopathy syndrome (CRES)/immune effector cell associated neurotoxicity syndrome (ICANS).