cssi/SciSciGPT-SciSciNet huggingface dataset:
Handheld Reflectance Confocal Microscopy for the Detection of Recurrent Extramammary Paget Disease.

Importance Extramammary Paget disease (EMPD) is commonly refractory to surgical and nonsurgical therapies. Identifying recurrent or persistent EMPD is challenging because the disease is multifocal, and multiple blind scouting biopsies are usually performed in this setting. Handheld reflectance confocal microscopy (HRCM) has been used to diagnose and map primary EMPD and therefore may be used to identify EMPD recurrences. Objective To evaluate HRCM’s diagnostic accuracy in the setting of recurrent or persistent EMPD as well as its potential diagnostic pitfalls. Design, Setting, and Participants This prospective case series study included patients referred to the Dermatology Service at Memorial Sloan Kettering Cancer Center between January 1, 2014, and December 31, 2016, with biopsy-proven EMPD in whom HRCM was used to monitor treatment response. Five patients were included, and 22 sites clinically concerning for recurrent or persistent disease were evaluated using HRCM and histopathologic examination. In 2 patients, video mosaics were created to evaluate large areas. Main Outcomes and Measures Sensitivity and specificity of HRCM in identifying recurrent or persistent EMPD; causes for false-negative results according to their location, histopathologic findings, and previous treatments. Results Of the 22 clinically suspicious sites evaluated in 5 patients (4 men, 1 woman; median [range] age, 70 [56-77] years), 9 (40.9%) were positive for recurrent disease on HRCM and histopathologically confirmed, and 13 (59.1%) sites were negative on HRCM, but 3 of the 13 were positive for EMPD on histopathological examination. In general, HRCM had a sensitivity of 75% and a specificity of 100% in identifying recurrent or persistent EMPD. False-negative results were found in 2 patients and occurred at the margins of EMPD, close to previous biopsy sites. Creating video mosaics (or video mosaicking) seemed to improve the detection of EMPD. Conclusions and Relevance Handheld reflectance confocal microscopy is a useful auxiliary tool for diagnosing EMPD recurrences and can be used to guide scouting biopsies, thus reducing the number of biopsies needed to render a correct diagnosis.
Probing the conformation of hemoglobin Presbyterian in the R-state

The influence of allosteric effectors on the R-state (liganded) conformation of Tg-HbP (human hemoglobin Presbyterian expressed in transgenic pig) has been probed using a number of biophysical techniques, and the results have been compared with that of liganded of HbA (human normal adult hemoglobin) to gain insight into the molecular basis of Asn-108(β)->Lys mutation–induced low-oxygen affinity of Hb. The nuclear magnetic resonance studies of Tg-HbP revealed that the conformation of the α1β1 and α1β2 interfaces of the protein in the deoxy state are indistinguishable from that of deoxy HbA, whereas the conformation of the microenvironment of His-103(α) of Tg-HbP, a residue of the α1β1 interface, is distinct from that of HbA in the R-state. In addition, the Presbyterian mutation also influences the structure of oxy Hb in other regions of the molecule. First, it facilitates the generation of deoxy (T)-state marker at 14.2 ppm (from 2,2-dimethyl-s-silapentane-5-sulfonate) on the interaction of oxy Hb with inositol hexa-phosphate without changing the ligation state. Second, it increases the geminate yield of the 10 ns photoproduct of CO-Hb. Third, it enhances the propensity of phosphate to increase the geminate yield. Fourth, it potentiates the ability of phosphate to induce deoxy-like features at the heme environment in the R-state. Fifth, it induces T-state-like signatures at the switch and hinge regions of the α1β2 interface. Finally, molecular modeling studies have indicated an increased affinity for the four anion binding sites mapped in the midcentral cavity of Hb caused by the presence of Lys-108(β). In short, Lys-108(β) in HbP induces a propensity for oxy Hb to access T-like conformational features in different regions of the oxy Hb molecule and also enhances the T-like signatures in the oxy state on interaction with allosteric effectors without changing its ligation. Interestingly, the intrinsic T-like conformational features of the R-state of HbP, in addition to those induced by the addition of allosteric effectors to liganded HbP, appear to be reminiscent of features of the B-state conformation of Hb found in rHb 1.1 (recombinant hemoglobin). We propose that the lowered oxygen affinity of Tg-HbP in the presence of allosteric effectors is a consequence of an altered R-state conformation of Hb, which reflects the facilitation of switching the R-state of HbP to the T-state compared with the normal R-state of HbA, thereby reducing HbA's affinity to oxygen.
HIV-antibody complexes enhance production of type I interferon by plasmacytoid dendritic cells

Type I IFN production is essential for innate control of acute viral infection; however, prolonged high-level IFN production is associated with chronic immune activation in HIV-infected individuals. Although plasmacytoid DCs (pDCs) are a primary source of IFN, the mechanisms that regulate IFN levels following the acute phase are unknown. We hypothesized that HIV-specific Ab responses regulate late IFN production. We evaluated the mechanism through which HIV-activated pDCs produce IFN as well as how both monoclonal HIV-specific Abs and Abs produced in natural HIV infection modulated normal pDC sensing of HIV. We found that HIV-induced IFN production required TLR7 signaling, receptor-mediated entry, fusion, and viral uncoating, but not endocytosis or HIV life cycle stages after uncoating. Abs directed against the HIV envelope that do not interfere with CD4 binding markedly enhanced the IFN response, irrespective of their ability to neutralize CD4+ T cell infection. Ab-mediated enhancement of IFN production required Fc γ receptor engagement, bypassed fusion, and initiated signaling through both TLR7 and TLR9, which was not utilized in the absence of Ab. Polyclonal Abs isolated from HIV-infected subjects also enhanced pDC production of IFN in response to HIV. Our data provide an explanation for high levels of IFN production and immune activation in chronic HIV infection.
Quality and safety improvement initiatives in complex spine surgery

Abstract The global health policy landscape is shifting. Health care is moving toward a value-based system with emphasis on reduced adverse events, improved patient outcomes, and increased cost efficiency. Studies have demonstrated that complex adult lumbar scoliosis surgery is accompanied by high variability in complication rates, which may be prevented with improved delivery of evidence-based care. In particular, standardized, systematic, multidisciplinary perioperative care protocols have been shown to significantly reduce the likelihood of a spectrum of negative outcomes associated with complex adult lumbar scoliosis surgery. This paper presents a review and analysis of multiple quality and safety improvement initiatives and methodologies in adult complex spine surgery. Achieving maximal quality and safety improvements in this field appears to require clinicians to go beyond focusing on specific elements of clinical practice and pay attention to optimizing the perioperative system. Two novel conceptual models were developed: the SpineSIM-D and the SpineSIM-C. They synthesize key success factors operating at the individual, team, and organizational levels to guide future quality and safety improvement initiatives. Comprehensive, systematic perioperative protocols that are multidisciplinary in nature appear to be rare in the field of complex spine surgery and have the potential to further improve quality and safety thereby meeting the requirements of health care’s value-driven future.
Refractory airway type 2 inflammation in a large subgroup of asthmatic patients treated with inhaled corticosteroids

Background Airway type 2 inflammation is usually corticosteroid sensitive, but the role of type 2 inflammation as a mechanism of asthma in patients receiving high-dose inhaled corticosteroids (ICSs) is uncertain. Objective We sought to determine whether airway type 2 inflammation persists in patients treated with ICSs and to evaluate the clinical features of patients with steroid-resistant airway type 2 inflammation. Methods We used quantitative PCR to generate a composite metric of type 2 cytokine gene expression (type 2 gene mean [T2GM]) in induced sputum cells from healthy control subjects, patients with severe asthma receiving ICSs (n = 174), and patients with nonsevere asthma receiving ICSs (n = 85). We explored relationships between asthma outcomes and T2GM values and the utility of noninvasive biomarkers of airway T2GM. Results Sputum cell T2GM values in asthmatic patients were significantly increased and remained high after treatment with intramuscular triamcinolone. We used the median T2GM value as a cutoff to classify steroid-treated type 2–low and steroid-resistant type 2–high (srT2-high) subgroups. Compared with patients with steroid-treated type 2–low asthma, those with srT2-high asthma were older and had more severe asthma. Blood eosinophil cell counts predicted srT2-high asthma when body mass index was less than 40 kg/m 2 but not when it was 40 kg/m 2 or greater, whereas blood IgE levels strongly predicted srT2-high asthma when age was less than 34 years but not when it was 34 years or greater. Conclusion Despite ICS therapy, many asthmatic patients have persistent airway type 2 inflammation (srT2-high asthma), and these patients are older and have more severe disease. Body weight and age modify the performance of blood-based biomarkers of airway type 2 inflammation.
Paddle-Wheel BODIPY–Hexaoxatriphenylene Conjugates: Participation of Redox-Active Hexaoxatriphenylene in Excited-State Charge Separation to Yield High-Energy Charge-Separated States

Hexaoxatriphenylene, a scaffold linker often utilized in building covalent organic frameworks, is shown to be electroactive and a useful entity to build light energy-harvesting donor–acceptor systems. To demonstrate this, new donor–acceptor conjugates have been synthesized by employing BODIPY as a sensitizer. Excited-state electron transfer leading to high-energy charge-separated states, useful to drive energy-demanding photocatalytic reactions, from the electron-rich hexaoxatriphenylene to 1BODIPY*, in the synthesized tri-BODIPY–hexaoxatriphenylene “paddle-wheel” conjugates, has been successfully demonstrated using femtosecond transient absorption spectroscopy. The measured rate of charge separation was in the range of ∼3–10 × 1011 s–1, revealing ultrafast charge separation.
E.2.III - Elevated Pressure CO 2 -Based Fluids Containing Polar Co-Solvents for Cleaning in Microelectronic Device Fabrication

Feature size reduction introduces significant challenges for surface wafer preparation, control of microcontamination in general, and introduction of reliable methodology to qualify and verify surface cleaning processes. Contaminants at levels that have been acceptable for larger device geometries may become “killer” (that is, yield-reducing) defects in sub-micron devices. Thus, the contaminant concentrations present on device surfaces at the end of each step in the integrated circuit (IC) fabrication process must be minimized. Sources of particle contamination are ubiquitous, and include process equipment, chemicals, personnel, and production processes. Subcritical and supercritical CO 2 cleaning demonstrated attractive results in efficient residue removal. The properties of CO 2 -based fluids allow the use of these mixtures in various applications of IC manufacturing from drying to low-K deposition. Although the initial cost of an elevated pressure CO 2 system is higher than traditional cleaning systems, when the environmental benefits and energy savings overall are considered, the return on investment becomes more attractive. The use of gas-expanded liquids (GXLs) in cleaning applications may further decrease the cost of initial investment without losing the unique properties of elevated pressure fluids.
Phylogeny reconciliation under gene tree parsimony

The growing genomic and phylogenetic data sets represent a unique opportunity to analytically and computationally study the relationship among diversifying species. Unfortunately, such data often result in contradictory gene phylogenies due to common yet unobserved evolutionary events, e.g., gene duplication or deep coalescence. Gene tree parsimony (GTP) methods address such issue by reconciling gene phylogenies into one consistent species evolutionary history as well as identifying the underlying events. In this study, we solve not only the GTP problem but also propose a new method to select gene trees in order to assist biologists in gaining insight from phylogenetic analysis. First, we introduce exact solutions for the intrinsically complex GTP problem. Exact solutions for NP-hard problems, like GTP, have a long and extensive history of improvements for classic problems such as traveling salesman and knapsack. Our solutions presented here are designed via integer linear programming (ILP) and dynamic programming (DP), which are techniques widely used in solving problems of similar complexity. We also demonstrate the effectiveness of our solutions through simulation analysis and empirical datasets. To ensure input data coherence for GTP analysis, as a method to strengthen species represented in a gene tree, we introduce the quasi-biclique (QBC) approach to analyze and condense input datasets. In order to take advantage of emerging techniques that further describe the sequence-host and gene-taxon relations, quasi-bicliques are optimized via weighted edge connectivities and distribution of missing information. Our study showed these QBC mining problems are NP-hard. We describe an ILP formulation that is capable of finding optimal QBCs in an effort to support GTP analysis. We also investigate the applicability of QBC to other applications such as mining genetic interaction networks to encouraging results.
Iron-deficient erythropoiesis in blood donors and red blood cell recovery after transfusion: initial studies with a mouse model.

BACKGROUND Most frequent red cell (RBC) donors and many first-time donors are iron deficient, but meet haemoglobin standards. However, the effects of donation-induced iron deficiency on RBC storage quality are unknown. Thus, we used a mouse model to determine if donor iron deficiency reduced post-transfusion RBC recovery. METHODS Weanling mice received a control diet or an iron-deficient diet. A third group receiving the iron-deficient diet was also phlebotomised weekly. This provided 3 groups of mice with different iron status: (1) iron replete, (2) mild iron deficiency with iron-deficient erythropoiesis, and (3) iron-deficiency anaemia. At ten weeks of age, blood was collected, leucoreduced, and stored at 4 oC. After 12 days of storage, 24-hour (h) post-transfusion RBC recovery was quantified in recipients by flow cytometry. RESULTS Before blood collection, mean haemoglobin concentrations in the iron-replete, iron-deficient, and iron-deficiency anaemia donor mice were 16.5±0.4, 11.5±0.4, and 7.0±1.4 [g/dL± 1 standard deviation (SD)], respectively (p<0.01 for all comparisons between groups). The 24-h post-transfusion RBC recoveries in recipients receiving transfusions from these three cohorts were 77.1±13.2, 66.5±10.9, and 46.7±15.9 (% ±1 SD), respectively (p<0.05 for all comparisons between groups). DISCUSSION In summary, donor iron deficiency significantly reduced 24-h post-transfusion RBC recovery in recipient mice. RBCs from mice with mild iron deficiency and iron-deficient erythropoiesis, with haemoglobin levels similar to those used for human autologous blood donation, had intermediate post-transfusion RBC recovery, as compared to iron-replete donors and those with iron-deficiency anaemia. This suggests that, in addition to the effects of iron deficiency on donor health, frequent blood donation, leading to iron-deficient erythropoiesis, may also have adverse effects for transfusion recipients.
Learning Empathy from My '97 Camry.

Learning Empathy from My ’97 Camry Sooner than the medical student had expected, a certain cynicism began to creep into his thoughts. Why didn’t patients simply follow their doctors’ orders and avoid complications? And then the aging car he’d inherited from his mother started acting up.
Trends Observed in Ten Years of the BDS Thin Film Laser Damage Competition (Conference Presentation)

The thin film damage competition series at the Boulder Damage Symposium provides an opportunity to observe general trends in laser damage behavior between different coating types (high reflector, anti-reflector, Polarizer, and Fabry-Perot filter), wavelength ranges (193 – 1064 nm), and pulse length ranges (40 fs – 18 ns). Additionally, the impact of deposition process, coating material, cleaning process, and layer count can be studied within a single year or more broadly across the history of this competition. Although there are instances where participants attempted to isolate a single variable to better understand it’s impact on laser resistance, this series of competitions isolates the variable of the damage testing service and protocol for a wide variety of participants. In total 275 samples from 58 different participants have been tested at four different laser damage testing facilities over the last ten years. Hafnia was clearly the best high refractive index material except for UV applications; although a wide range of high refractive index materials performed well. The best deposition process varied significantly between the different competitions, so it was much more strongly dependent on the coating type, wavelength, and pulse duration. For 1064 nm coatings with nanosecond scale pulse lengths, e-beam coatings tended to be the best performers. For short pulse length NIR mirrors and nanosecond pulse length UV mirrors, densified coating processes which all involved sputtering of the target material were the best performers. For UV AR coatings and excimer mirrors, both tested at nanosecond pulse lengths, they tended to favor very low energetic deposition methods yielding soft coatings such as sol gel dip coating for the AR and resistive heating of fluorides for the excimer mirrors. Finally cleaning method and layer count have had a less obvious correlation with laser resistance over the history of this thin film damage competition.
IMPLEMENTING A STANDARDIZED INTERVENTIONAL EXERCISE REGIMEN TO IMPROVE FUNCTIONAL MOVEMENTS IN FEMALE COLLEGIATE ATHLETES.

Background Interventional exercises have been developed to help athletes improve scores on the Functional Movement Screen™ (FMS™). However, there is a paucity of research on the effects of a similar program in female athletes, as well as the effects of a standardized corrective exercise regimen. The purpose of this study was to assess whether an in-season, standardized interventional exercise program improves FMS™ score asymmetry and the composite score of female collegiate athletes. Study design Prospective, quasi-experimental, cohort study. Methods Forty-one (mean age 19.5 ± 1.2 years; body mass, 70.6 ± 11.5 kg ; height, 1.70 ± 0.083 m) NCAA Division III female soccer (n=10), softball (n=17), and basketball (n=14) players participated in this study. The athletes completed the FMS™ screens prior to their season, regularly participated in four in-season standardized corrective exercises throughout three to four month athletic seasons, and completed the FMS™ screens in the postseason. Results The average score of all athletes before the season was 15.52 ± 0.63 and 16.04 ± 0.72 after the season. While the mean score of soccer players increased from 14.80 ± 0.92 to 16.1 ± 1.52 and the mean score of softball players increased from 15.83 ± 1.89 to 16.72 ± 1.41 at the end of the season, the mean score of basketball players dropped from 15.93 ± 1.49 to 15.29 ± 1.59. Women's basketball players experienced a decrease in their composite FMS™ score ( x ¯ = -0.571, p x ¯ =+1.30, p x ¯ =+1.12, p 0.05). Conclusions Standardized interventional programs during athletic teams' seasons may be used to help increase FMS™ scores and reduce asymmetry. Though more studies are warranted to address the negative effects of this standardized program in women's basketball players, this study demonstrated that the number of asymmetries significantly decreased from pre- to postseason among soccer and softball players, which may have implications for a higher resistance to injury. Levels of evidence 3.
Addicts and Admits: Metonymy in Medical Students’ Reflective Writing

Phenomenon: Metonymy refers to the substitution of the name of an attribute or adjunct for the name of the object or person being described. In medical contexts, this may involve referring to a per...
The Importance of Baselining Division 1 Football Athlete Jumping Movements for Performance, Injury Mitigation, and Return to Play

Data collection and analysis have become a critical component for decision-making and workout regimen design in athletic competition. The more data sports performance personnel have for individual athletes from a time in which the athlete was injury free, the more the coaching staff can utilize the movement data to baseline the athlete’s movement before an injury occurs and then train the athlete back to that baseline if an injury does occur. In this paper, we discuss the benefits and roadblocks of baselining. We present a case of baselining jumping performance for 22 division 1 football athletes, including a presentation of the methods used to measure jumping performance. Descriptive summaries of selected variables are presented, with a single participant highlighted to demonstrate a standard baselined jumping profile. Finally, ways in which an athlete’s jumping baseline can be used for future training and conditioning decisions are discussed.
Voluntary exercise improves voiding function and bladder hyperalgesia in an animal model of stress‐induced visceral hypersensitivity: A multidisciplinary approach to the study of urologic chronic pelvic pain syndrome research network study

Objective The underlying mechanism of interstitial cystitis/bladder pain syndrome (IC/BPS) is not well understood and evaluation of current therapeutic interventions has not identified any generally effective treatments. Physical activity has shown beneficial effects on individuals suffering from chronic pain. Anxiety-prone rats exposed to water avoidance stress (WAS) develop urinary frequency and lower bladder sensory thresholds with high face and construct validity for the study of IC/BPS. The aim of this study was to evaluate the role of chronic voluntary exercise on urinary frequency, voiding function, and hyperalgesia in animals exposed to WAS. Materials and methods Twenty-six female Wistar-Kyoto rats were exposed to WAS and thereafter randomized to either voluntary exercise for 3 weeks or sedentary groups. Voiding parameters were assessed at baseline, post-WAS, and weekly for 3 weeks. Before euthanasia, the animals underwent cystometrogram (CMG), external urinary sphincter electromyography, and assessment of visceromotor response (VMR) to isotonic bladder distension (IBD). Results WAS exposure resulted in adverse changes in voiding parameters. Compared with sedentary animals, animals in the voluntary exercise group had improved voiding parameters during metabolic cage and CMG testing, as well as improved bladder sensory thresholds as determined by VMR during IBD. Conclusion Voluntary exercise in an animal model of chronic stress leads to improvement in voiding function and visceral bladder hyperalgesia.
Female Collegiate Dancers Body Composition, Macronutrient and Micronutrient Intake Over Two Academic Years: A Longitudinal Analysis.

Collegiate dancers face unique challenges to maintain a lean aesthetic, optimal diet, and a high-performance level due to the various stressors in college. The purpose of this study was to examine changes in body composition (BC) and diet over two years. Participants (N = 17, 19.6 ± 1.6 years) completed two laboratory sessions per semester. Sessions included height and weight, BC, dietary intake, and a health history questionnaire. Regardless of rigorous dance training and variations in the academic calendar, no significant changes in BC or diet were observed within semesters of over two years. BMI was normal (24.9 ± 4.1 kg/m2) with fat mass exceeding 30% at all timepoints. Fat mass was negatively correlated with carbohydrate, fat, and protein intake (g/kg/day; r = −0.291, p = 0.004; r = −0.372, p < 0.0001; r = −0.398, p < 0.0001; respectively). Energy intake was within the recommended daily allowance (2040 ± 710 kcal/day), however may be insufficient for an active dance population. Protein (1.1 ± 0.5 g/kg), carbohydrate (3.7 ± 1.6 g/kg), calcium (835 ± 405 mg/day), iron (17 ± 15 mg/day), and potassium (1628 ± 1736 mg/day) intake fell below recommendations for an active population. Alterations in dance training and the demands of the academic calendar may be contributing to suboptimal dietary intake and BC in female collegiate dancers.
Clinical risk factors for the development of late-onset circulatory collapse in premature infants.

BACKGROUND Very low birth weight (VLBW) infants may be at risk for late-onset circulatory collapse (LCC) where otherwise stable infants develop hypotension resistant to vasoactive agents. The risk factors for LCC development are poorly defined, and it has been theorized that it may be in part due to withdrawal from exogenous prenatal steroids. The goal of this study was to define the clinical characteristics of LCC and investigate its association with antenatal steroid administration. METHODS This is a retrospective cohort study of infants born ≤1500 g. LCC was retrospectively diagnosed in infants requiring glucocorticoids for circulatory instability at >1 week of life. Demographic and clinical characteristics were compared between groups using Mann-Whitney test. RESULTS Three hundred and ten infants were included; 19 (6.1%) developed LCC. Infants with LCC were born at a median 4.6 weeks' lower gestation, 509 g lower birth weight than those without LCC. There was no difference in antenatal steroid delivery between the groups. CONCLUSIONS LCC occurs in a distinct subset of VLBW infants, suggesting the need for monitoring in this high-risk population. Antenatal steroids did not significantly increase the risk of LCC development in this study. IMPACT Late-onset circulatory collapse (LCC) is a life-threatening clinical entity occurring in around 6% in VLBW infants and is likely underdiagnosed in the United States. Targeting specific demographic characteristics such as birth weight (<1000 g) and gestational age at birth (<26 weeks) may allow for early identification of high-risk infants, allowing close monitoring and prompt treatment of LCC. No significant association was found between antenatal steroid administration and LCC development, suggesting that the theoretical risks of antenatal steroids on the fetal HPA axis does not outweigh the benefits of antenatal steroids in fetal lung maturity. To date, no studies characterizing LCC have originated outside of Asia. Therefore, providing a description of LCC in a U.S.-based cohort will provide insight into both its prevalence and presentation to inform clinicians about this potentially devastating disorder and foster early diagnosis and treatment. This study validates LCC characteristics and prevalence previously outlined by Asian studies in a single-center U.S.-based cohort while also identifying potential risk factors for LCC development. This manuscript will provide education for U.S. physicians about the risk factors and clinical presentation of LCC to facilitate early diagnosis and treatment, potentially decreasing neonatal mortality. With prompt recognition and treatment of LCC, infants may have decreased exposure to vasoactive medications that have significant systemic effects.
Tracheal Resection in the Management of Thyroid Cancer: An Evidence-Based Approach.

OBJECTIVE Determine the effect of patient demographics and surgical approach on patient outcomes after tracheal resection in the management of thyroid cancer. STUDY DESIGN Systematic review and meta-analysis. METHODS Systematic review of literature was performed using PubMed, Embase, and Cochrane Library to identify patients with thyroid carcinoma who underwent tracheal resection. Pooled estimates for patient demographics, presenting findings, complications, and outcomes are determined using random-effects meta-analyses. RESULTS Ninety-six relevant studies encompassing 1,179 patients met inclusion criteria. Meta-analysis pooled rates of complications: 1.7% (confidence interval [CI] 0.8-2.5; P < .001; I2 = 1.85%) airway complications, 2.8% (CI 1.6-3.9; P < .001; I2 = 13.34%) bilateral recurrent laryngeal nerve paralysis, 2.2% (CI 1.2-3.1; P < .001; I2 = 6.72%) anastomotic dehiscence. Circumferential resection pooled estimates major complications, locoregional recurrence, distal recurrence, overall survival: 14.1% (CI 8.3-19.9; P < .001; I2 = 35.26%), 15% (CI 9.6-20.3; P < .001; I2 = 38.2%), 19.7% (CI 13.7-25.8; P < .001; I2 = 28.83%), 74.5% (CI 64.4-84.6; P < .001; I2 = 85.07%). Window resection estimates: 19.8% (CI 6.9-32.8; P < .001; I2 = 18.83%) major complications, 25.6% (CI 5.1-46.1; P < .014; I2 = 84.68%) locoregional recurrence, 15.6% (CI 9.7-21.5; P < .001; I2 = 0%) distal recurrence, 77.1% (CI 58-96.2; P < .001; I2 = 78.77%) overall survival. CONCLUSION Management of invasive thyroid carcinoma may require tracheal resection to achieve locoregional control. Nevertheless, postoperative complications are not insignificant, and therefore this risk cannot be overlooked when counseling patients perioperatively. Laryngoscope, 131:932-946, 2021.
Who Should Implement Force When It's Needed and How Should It Be Done Compassionately?

ESP | 中文 This case questions the comparative moral permissibility of 2 different uses of force—actions done against a patient’s will—in the course of that patient’s care: covert medication administration and use of physical or chemical restraint. The commentary considers what constitutes the most compassionate use of force for this patient and how it should be implemented.
Assessing the impact of terrorism and counter-terrorism on public perceptions among ethnic minorities in Kenya

Since the Kenya Defense Forces (KDF) launched their military offensive against al-Shabaab in 2011, the country has experienced an unprecedented number of retaliatory attacks mounted by the jihadist...
The (lack of) relationship between secondary science teachers’ self-efficacy for culturally responsive instruction and their observed practices

There has long existed the argument that science teachers' self-efficacy directly correlates with instruction. Regarding self-efficacy for culturally responsive instruction (CRI), a promising equit...
Valuing stakeholder preferences for environmental benefits of stormwater ponds: Evidence from choice experiment.

Abstract With population growth driving urban expansion in many cities in the United States, there is a need for a sustainable way to manage stormwater. Green stormwater infrastructure (GSI) is considered an innovative way to handle stormwater because of its potential to provide multiple ecosystem services (ES) beyond flooding reduction. However, there is limited research regarding the society's perceived value for GSI practices' co-benefits. This study utilized stated-preference data obtained from a choice experiment in an online survey of 1159 South Carolina (SC) residents to estimate a monetary value for the ES provided by wet detention ponds— the most widely adopted stormwater practice in coastal counties of SC. The benefits examined are flooding reduction, water quality, wildlife habitat, recreation, and scenic beauty. The data were analyzed using a Mixed logit formulation. Considering the differences across the state, the model was estimated separately for five counties. Findings indicate that residents are willing to pay $13.8 to $37.8 annually for a 50% improvement in pollutant removal efficiency of ponds in addition to their current stormwater fee. Also, they are willing to pay $12.5 to $42.9 per year for the nearest pond to have buffer vegetation and wildlife. They are also likely to pay $5 to $22.5 for ponds to contribute to their neighborhood's scenic beauty. Furthermore, the results indicate that respondents from three counties are willing to pay $5.4 to $13.2 for a 50% improvement in flooding reduction, while those from two counties are likely to pay $3.9 to $4.9 for ponds to have recreational benefits. The findings of the study could help stormwater managers in designing their stormwater management programs, especially for better evaluation of stormwater utility fees.
A comparison of total shoulder arthroplasty relative value unit rates for osteoarthritis and proximal humerus fracture

Abstract Background Total shoulder arthroplasty (TSA) procedures performed for proximal humerus fractures are considered to have higher complications rates and longer operative time than TSA performed for osteoarthritis (OA). However, there exists only one current procedural terminology (CPT) code for TSA, which may not accurately capture the increased work and complexity required for fracture cases. The purpose of this study was to compare TSA work relative value unit (RVU) rates per operative time performed for osteoarthritis and fracture care. Methods Data were collected through the National Surgical Quality Improvement Program (NSQIP) database for the years 2006 to 2018 to identify all patients who underwent primary TSA for either OA or fractures. Work RVU, operation time (skin incision to closure), work RVU per minute, and payment per minute were compared between the osteoarthritis and fracture TSA cohorts. Bivariate and multivariate analyses controlling for patient demographics and comorbidity were utilized to determine whether there existed a reimbursement differential between the two groups. Results The mean operation times for primary TSA for osteoarthritis and fracture were 109 minutes and 122 minutes, respectively (P Conclusion On average, TSA performed for fracture care is associated with longer operative times and may require more work compared to elective TSA for OA. These results highlight the need for more precise procedural coding to accurately capture the added effort and operative time required for TSA in the setting of fracture care. Level of Evidence Level III
The Role of Parental Involvement in Cigarette Smoking among Adolescents in Nepal.

Limited studies have examined the role of a parent’s involvement in their child’s daily life as it relates to cigarette smoking among adolescents in low- and middle-income countries (LMICs). We exa...
Depression and socioeconomic stressors in expectant parents with fetal congenital anomalies.

Congenital anomalies are increasingly diagnosed before birth, which may lead to psychological distress in expectant parents. While the presence of significant symptoms of depression and stress in t...
Global Identification of Protein Prenyltransferase Substrates: Defining the Prenylated Proteome

Publisher Summary This chapter discusses the multiple approaches currently used to identify and define protein farnesyltransferase (FTase) and protein geranylgeranyltransferase-I (GGTase-I) substrates. The protein prenyltransferases, FTase and GGTase-I, catalyze the attachment of a 15-carbon farnesyl or 20-carbon geranylgeranyl moiety, respectively, to a cysteine near the C-terminus of a substrate protein targeting it to the membrane. Substrates of the prenyltransferases are involved in a myriad of signaling pathways and processes within the cell; therefore, inhibitors targeting FTase and GGTase-I are being developed as therapeutics for the treatment of diseases such as cancer, parasitic infection, asthma, and progeria. Direct identification approaches involve identifying FTase and GGTase-I substrates one by one or by using lipid donor analogs. A complementary approach to identify the prenylated proteome is to define the modes of FTase and GGTase-I substrate recognition using structure–function studies, peptide library studies, and computational methods. Identification of the entire prenylated proteome appears to be a realistic goal in the next decade, if not sooner. Definition of the prenylated proteome will be essential to better understand the roles of prenylation in cellular signaling, disease processes, and the complex array of posttranslational modifications within the cell.
Optimizing OpenMP programs on software distributed shared memory systems

This paper describes compiler techniques that can translate standard OpenMP applications into code for distributed computer systems. OpenMP has emerged as an important model and language extension for shared-memory parallel programming. However, despite OpenMP's success on these platforms, it is not currently being used on distributed system. The long-term goal of our project is to quantify the degree to which such a use is possible and develop supporting compiler techniques. Our present compiler techniques translate OpenMP programs into a form suitable for execution on a Software DSM system. We have implemented a compiler that performs this basic translation, and we have studied a number of hand optimizations that improve the baseline performance. Our approach complements related efforts that have proposed language extensions for efficient execution of OpenMP programs on distributed systems. Our results show that, while kernel benchmarks can show high efficiency of OpenMP programs on distributed systems, full applications need careful consideration of shared data access patterns. A naive translation (similar to OpenMP compilers for SMPs) leads to acceptable performance in very few applications only. However, additional optimizations, including access privatization, selective touch, and dynamic scheduling, resulting in 31% average improvement on our benchmarks.
Pneumoconioses, Mineral and Vegetable

The term pneumoconiosis, originally coined by Zenker,1 literally means dust in the lung. Because various types of dust can be found in the lungs of virtually all adults, this term has come to mean the accumulation of abnormal amounts of dust in the lungs and the pathologic response to this dust. A great variety of dust particles have been identified which, when inhaled in sufficient amounts, are capable of producing disease in man. The sources of these particles are diverse, ranging from occupational to environmental exposures. Factors important in determining the pathologic response to a given dust exposure include the number, size, and physiochemical properties of the inhaled particles; the route and efficiency of clearance of the particles from the respiratory tract; the nature and intensity of the host’s inflammatory response to the particles deposited in the lung; the duration of the exposure and interval since initial exposure; and interactions between the inhaled particles from multiple sources and other environmental pollutants, such as cigarette smoke.
Einige Erweiterungen disjunktiver Merkmalsbeschreibungen

In der vorliegenden Arbeit werden einige Erweiterungen disjunktiver Merkmalsbeschreibungen diskutiert, die im Rahmen von STUF (Stuttgart Type Unification Formalism) im Projekt LILOG entwickelt wurden. Gegenuber den bisherigen Ansatzen sind dies insbesondere Konzepte zur Behandlung von Termen mit fester und variabler Stelligkeit in einem Formalismus und zur Strukturierung von Wissensbasen durch die Verwendung von Wissensdomanen.
A new method for sealing containers with liquid samples for radioactivity measurements

It is imperative to use a leak-proof container for counting liquid sample to prevent contamination of costly gamma detectors. We report in this technical note a sealant that ensures no leak. It is a vinyl adhesive sealant used for household purposes, marketed by Gloucester Co., Inc, Franklin, MA under the trade name of Phenoseal (translucent variety). This sealant was superior to other sealants studied because it cures quickly, peels off easily after counting, and contains no detectable radioactivity. We have thoroughly tested this sealant in our laboratory and successfully employed it in the routine analysis of environmental liquid samples.
Full Paper Sheet Control Using Hybrid Automata

Some high speed color printers require that the sheets be accurately controlled in order to achieve a precise alignment of colors. To accomplish this goal a steerable nips mechanism has been proposed as the actuator. This steerable nips mechanism allows the sheet to be precisely controlled in longitudinal, lateral and skew directions. In this paper we develop a control strategy based on hybrid automata that precisely controls the position of the sheet. This hybrid control law has four finite states among which the system switches during the trajectories tracking process. Switching from one state to another is necessary since the normal control mode cannot be used when the trajectory being tracked requires the wheels to have zero angular velocity. The proposed controller is able to move the sheet from an initial position at rest to an arbitrary final position also at rest. The system model is nonlinear and subject to four nonholonomic constraints. Two of these constraints come from the fact that the velocities perpendicular to the wheels must be zero, and the other two constraints are due to the no-slip condition.
Recommendations for the Design and Analysis of Treatment Trials for Alcohol Use Disorders.

Background Over the past 60 years, the view that “alcoholism” is a disease for which the only acceptable goal of treatment is abstinence has given way to the recognition that alcohol use disorders (AUDs) occur on a continuum of severity, for which a variety of treatment options are appropriate. However, because the available treatments for AUDs are not effective for everyone, more research is needed to develop novel and more efficacious treatments to address the range of AUD severity in diverse populations. Here we offer recommendations for the design and analysis of alcohol treatment trials, with a specific focus on the careful conduct of randomized clinical trials of medications and nonpharmacological interventions for AUDs. Methods This paper provides a narrative review of the quality of published clinical trials and recommendations for the optimal design and analysis of treatment trials for AUDs. Results Despite considerable improvements in the design of alcohol clinical trials over the past 2 decades, many studies of AUD treatments have used faulty design features and statistical methods that are known to produce biased estimates of treatment efficacy. Conclusions The published statistical and methodological literatures provide clear guidance on methods to improve clinical trial design and analysis. Consistent use of state-of-the-art design features and analytic approaches will enhance the internal and external validity of treatment trials for AUDs across the spectrum of severity. The ultimate result of this attention to methodological rigor is that better treatment options will be identified for patients with an AUD.
GABAA receptors modulate axonal conduction in dorsal columns of neonatal rat spinal cord.

Abstract γ-Aminobutyric acid (GABA) can influence conduction in a number of axonal preparations from the peripheral and central nervous system. In the spinal cord, the excitability of primary afferent terminals has long been known to be affected by GABA. Whether conduction in the long fiber tracts of the spinal cord can be similarly modulated is unknown. Since GABA causes a pronounced depression of excitability in preparations of unmyelinated axons, and myelination is incomplete in the neonatal rat, we tested whether GABA can modulate conduction in the dorsal columns of 10–17-day-old rats. Experiments were performed in vitro, on isolated dorsal column segments (n = 18). The extracellular compound action potential evoked by submaximal stimuli was recorded with a glass micropipette positioned 0.5–2.0 mm from a stimulating electrode. At concentrations of 10−4−10−3 M, GABA decreased excitability, reversibly depressing the compound action potential amplitude, and increasing the latency by47 ± 11%and22 ± 9% (mean±S.E.M., n = 5, 10−3M), respectively. These effects were blocked by picrotoxin and mimicked by isoguvacine (10−4 M), which decreased the compound action potential amplitude by44 ± 10% and increased the latency by9 ± 4% (n = 5). Lower concentrations of these agents caused a modest increase in excitability. At 10−5 M, GABA increased the compound action potential amplitude by14 ± 2% and decreased the latency by3 ± 2% (n = 5). Our results demonstrate that functional GABAA receptors are present in neonatal dorsal columns. While the physiologic role of these receptors is not yet clear, these data suggest that axonal conduction in long tracts of the spinal cord may be subject to modulation by extrasynaptic mechanisms.
Individual health discount rate in patients with ulcerative colitis

Methods: We surveyed patients with UC and patients who were postcolectomy for UC to measure their valuations of UC and colectomy health states. We used Standard Gamble (SG) and TimeTrade-Off (TTO) methods to assess current and future health state valuations and calculated the discount rate. Results: Participants included 150 subjects with UC and 150 subjects who were postcolectomy for UC. Adjusted discount rates varied widely (0%–100%), with an overall median rate of 55.0% (interquartile range [IQR] 20.6–100), which was significantly higher than the standard rate of 5%. Within the normal range of discount rates, patients’ expected discount rate increased by 0.80% for each additional year of age, and female patients had discount rates that averaged � 8% less than their age-matched counterparts and approached statistical significance. Conclusions: The accepted discount rate of 5% grossly underestimates UC patients’ preference for long-term over short-term risk. This might explain UC patients’ frequent choice of the longterm risks of immunosuppressive medical therapy over the shortterm risks of colectomy. (Inflamm Bowel Dis 2011;17:1328–1332)
MITOSTATIN, A NOVEL MITOCHONDRIAL PROTEIN, THAT ACTS AS A TUMOR SUPPRESSOR IN PROSTATE CANCER CELLS

1793 Mitostatin is a novel putative tumor suppressor gene at chromosome 12q24.1. The 62-kD Mitostatin protein is expressed in most normal human tissues and its immunohistochemical staining is reduced in advanced stages primary breast and bladder tumors. Mitostatin expression negatively affects cell growth, induces cell death and regulates the expression and activation levels of Hsp27. To determine the role of Mitostatin in prostate cancer we transfected LNCaP, PC3, and DU145 prostate cancer cells with an expression vector encoding Mitostatin -V5 fusion protein or expressing the antisense cDNA of the coding sequence of Mitostatin. In addition, we silenced endogenous Mitostatin by siRNA strategies. Mitostatin expression in primary human prostate tumors was analyzed by immunohistochemistry using three tissue arrays (AccuMax Array - A222, A223 and A302) consisted of 293 0.6-mm cores. Our results demonstrate that ectopic expression of Mitostatin in PC3, DU145, and LNCaP prostate cancer cells in addition to induce a reduction in cell growth, significantly inhibits migration and invasion. Moreover, Mitostatin inhibits colony formation in soft-agar in PC3 and LNCaP cells and LNCaP tumorigenicity in nude mice. Conversely, targeting endogenous Mitostatin with siRNA and anti-sense strategies in PC3 and DU145 prostate cancer cells promotes transformation in both cell lines. Mitostatin immunohistochemical staining was absent in 35.5% of prostate tumor samples and its overall reduction was significantly associated with advanced stage disease. Our findings support the hypothesis that Mitostatin acts as a bona fide tumor suppressor and suggest that further investigations of Mitostatin as a useful clinical marker for diagnosis and prognosisin prostate tumors are warranted.