cssi/SciSciGPT-SciSciNet huggingface dataset:
Post-Stroke Walking Behaviors Consistent with Altered Ground Reaction Force Direction Control Advise New Approaches to Research and Therapy

Recovery of walking after stroke requires an understanding of how motor control deficits lead to gait impairment. Traditional therapy focuses on removing specific observable gait behaviors that deviate from unimpaired walking; however, those behaviors may be effective compensations for underlying problematic motor control deficits rather than direct effects of the stroke. Neurological deficits caused by stroke are not well understood, and thus, efficient interventions for gait rehabilitation likely remain unrealized. Our laboratory has previously characterized a post-stroke control deficit that yields a specific difference in direction of the ground reaction force (F, limb endpoint force) exerted with the hemiplegic limb of study participants pushing on both stationary and moving pedals while seated. That task was not dependent on F to retain upright posture, and thus, the task did not constrain F direction. Rather, the F direction was the product of neural preference. It is not known if this specific muscle coordination deficit causes the observed walking deviations, but if present during walking, the deficit would prevent upright posture unless counteracted by compensatory behaviors. Compensations are presented that mechanically counteract the F misdirection to allow upright posture. Those compensations are similar to behaviors observed in stroke patients. Based on that alignment between predictions of this theory and clinical observations, we theorize that post-stroke gait results from the attempt to compensate for the underlying F misdirection deficit. Limb endpoint force direction has been shown to be trainable in the paretic upper limb, making it a feasible goal in the lower limb. If this F misdirection theory is valid, these ideas have tremendous promise for advancing the field of post-stroke gait rehabilitation.
Abstract 319: Vascular Oxidative Stress Promotes Aortic Stiffening

Clinical studies have shown a relationship between markers of oxidative stress and parameters of arterial stiffness. We have previously found that vascular reactive oxygen species (ROS) contribute to aortic hypertrophy in hypertension. In the present study, we hypothesize that vascular oxidative stress induces aortic stiffening by causing oxidative injury to the vessels. To test this hypothesis, we first studied isolated aortas from tg sm/p22phox mice, which have a constitutive increase in vascular ROS production. Six month old tg sm/p22phox mice were normotensive at baseline (118±6 systolic, 89±5 diastolic, mean±S.E.M. mmHg), but had increased aortic stiffness as indicated by the leftward shift on stress-strain curves (p sm/p22phox mice. In order to understand the nature of ROS involved in aortic stiffening, we deleted extracellular superoxide dismutase (ecSOD) in vascular smooth muscle using cre-loxp technology. Deletion of ecSOD would increase O 2 ·- , but not H 2 O 2 . Surprisingly, we found no difference in aortic stiffness or blood pressure in these mice compared to wild-type mice, either at baseline or in response to angiotensin II. These data indicate that O 2 ·- is unlikely involved in increasing aortic stiffness. It is therefore likely that other ROS, such as H 2 O 2 , modulate this response. In this regard, we have performed additional studies in which mice were treated with salicylamine, a scavenger of isoketals, which are oxidized products of arachidonic acid. These are known to cross-link lysines and could promote cross-linking of cellular components leading to vascular stiffening. Amazingly, this drug markedly reduced blood pressure (133±8 vs. 168±9 systolic; 95±6 vs. 125±7 diastolic, salicylamine vs. angiotensin II alone, p
Centrifuge Testing of Unsaturated Hydraulic Properties of Municipal Solid Waste

Soil water characteristic curve (SWCC) and unsaturated hydraulic conductivities of a municipal solid waste sample collected from a relatively shallow depth (~9 m) of a landfill cell located near Detroit were measured using the centrifuge method. Conventional tests typically take up to several weeks to months while the centrifuge experiments were completed in about two days which results in little degradation of the sample affecting its pore size distribution and gas generation during testing. The waste was about two and half years old. The sample tested in the centrifuge had: diameter – 30 cm; and height – 24 cm. The sample was conditioned for the stress level in the field before the SWCCs were measured. The unsaturated hydraulic conductivities of the waste were estimated using the instantaneous profile method. The estimated conductivities were orders of magnitude greater than those predicted by van Genuchten-Mualem prediction function when the pore interaction parameter of 0.5 was used.
Study of Glass Transition of a Poly(Imide Siloxane) Copolymer Using Thermal Analysis

Films of a poly(imidc siloxane) thermoplastic copolymer with a thickness of 0.5 mm have been characterized using thermal analytic techniques including DSC, TMA, and DMA. It was found that the glass transition temperature depends not only on heating rates but also on loading conditions. The mechanism of the glass transition in this copolymer is shown to involve two interconnected steps, namely volume change and phase ordering.
Effect of flotation reagents on direct reverse flotation of carbonate-containing iron ores

The effects of pulp pH values,dispersants and auxiliary collectors on direct reverse flotation of carbonate-containing iron ores were explored. Floatation experiment results show a sharp increase in iron grade as the pH value raises from 11. 0 to 11. 8, and the maximum grade can be obtained at pH 11. 8,after which the iron grade has almost no change. When the pH value is 12. 0, sodium tripolyphosphate is a kind of effective dispersant and sodium dodecyl sulfate is an effective auxiliary collector of KS-Ⅲ,both the iron recovery and grade increase with the action of sodium dodecyl sulfate or sodium tripolyphosphate. Theoretical calculations indicate that the floatation results are related to the solution chemistry of siderite and interactions between particles. Structure-activity calculations of collectors show that sodium dodecyl sulfate has perfect selectivity,emulsion and solubility.
Analysis of flashover on 220-kilovolt lines composite insulator

Flashover caused by hydrophobic composite insulators reducing transmission lines is analyzed,and the corresponding preventive measures focusing on the prevention and reduction of composite insulators hydrophobic lines tripping has been taken.
Varied anatomical types of ovarian adenofibroma

Ovarian adenofibroma is redefined to indicate a compound benign tumor composed of epithelial and fibromatous elements. The varied anatomical forms and geographic sites afford a classification herein enclosed. Gross identification of adenofibroma is not difficult. Solid types generally show small cysts (smooth or papillary) which contain clear fluid. Conversely, cystic forms, unlike serous cystadenoma, retain bands or islands of fibrous tissue. A double primary “cystoma and fibroma” are identified by the “apartheid” of the epithelial and stromatogenous components which in adenofibromata are intermingled. Cancerous changes are rare in adenofibroma and generally confined to the solid zones. Malignancy is focal and requires numerous blocks for its detection. The prognosis of fibroadenocarcinoma or cystadenofibrocarcinoma appears relatively favorable because of circumscription by the fibrogenous benign component of the compound tumor.
Carbohydrate sources for gestational diabetes mellitus screening: A comparison

One hundred eight patients were prospectively randomized to receive 50 g of a glucose polymer, d-glucose or a candy bar during a one-hour gestational diabetes mellitus (GDM) screening. The polymer had a mean serum glucose similar to that of d-glucose, with significantly fewer side effects, allowing an increased rate of examination completion. The candy bar produced a significantly lower mean serum glucose but had the highest rating for flavor. The polymer was an inexpensive and well-tolerated alternative for GDM screening, while the use of a candy bar needs more study.
Why Is It Important to Culturally Adapt Therapy for Asian Heritage Populations

This chapter focuses on helping the reader understand why cultural adaptations may be beneficial for Asian heritage populations. In doing so, it describes what groups are included under the Asian heritage rubric and provides numeric information about population sizes across the world and within the United States (US). Moreover, the chapter discusses how and why the mind–body split diverged between the East and West. Finally, the chapter includes some basic information about the development of psychotherapy and provides an overview of the options that we have for providing culturally competent and adapted care for diverse populations.
Numerical Simulation of a Laminar Vortex Flow

Neither theory or field measurements are available to completely describe the motion in a tornado flow. This has prompted numerous attempts at modeling vortex flows in the laboratory and numerically (Davies-Jones, 1976; Lewellen, 1976). While qualitative features of the outer flow (region I) are known, the complex interaction of the boundary layer (region II), corner (region III) and axial core region is not. In this study a numerical model is used to investigate the boundary layer dynamics of an axisymmetric laminar vortex.
Job Satisfaction and Expected Turnover Among Federal, State, and Local Public Health Practitioners

Objectives. To use data on the governmental public health workforce to examine demographics and elucidate drivers of job satisfaction and intent to leave one’s organization.Methods. Using microdata from the 2014 Federal Employee Viewpoint Survey and 2014 Public Health Workforce Interests and Needs Survey, we drew comparisons between federal, state, and local public health staff. We fitted logistic regressions to examine correlates of both job satisfaction and intent to leave one’s organization within the coming year.Results. Correlates of job satisfaction included pay satisfaction, organizational support, and employee involvement. Approximately 40% of federal, state, and local staff said they were either considering leaving their organization in the next year or were planning to retire by 2020.Conclusions. Public health practitioners largely like their jobs, but many are dissatisfied with their pay and are considering working elsewhere. More should be done to understand the determinants of job satisfactio...
SAR reduction of smart watch antenna using meander loop structure

A meander loop type antenna is proposed for reducing SAR values. SAR test is conducted on the wrist and mouth scene. The measured SAR of the meander loop antenna is compared with that of the monopole antenna and the loop antenna. Because the middle point of the meander loop antenna is located toward watch body and away from a human wrist, SAR and TRP of that can be improved.
Knee Problems in Children and Adolescents

It is important to recognize that there are differences in the spectrum of knee injuries that occur in childhood and adolescence and to always keep these in mind when examining the younger athlete. Constant vigilance for hip pathology presenting as knee pain is also necessary in this age group. As the tendency becomes greater for practitioners to become more specialized in treatment modalities (for example, arthroscopic surgeons, knee surgeons, and so forth), the likelihood of making preventable errors in the case of young athletes increases. The comprehensive care of the athlete and his or her injury is paramount, and one should be wary of the pressure to treat the youngster as one might the college or professional athlete in order to return him or her to sports more quickly. Serious injuries require time to heal and even more time for the patient to convalesce and undergo rehabilitation.
Atvis: A New Transit Visualization System

This chapter presents Atvis, a system to visualize transit data. Atvis is capable of representing bus route and traffic information at an abstract level. Compared with the traditional map-based geographical information system, Atvis focuses more on ridership, visualizing traffic data at or between stops, and interstop relationships, disregarding information that may not be essential to a user. This chapter describes the design and implementation of the Atvis visualization system and discusses how it can be used to observe transit patterns.
Pelvic Reirradiation for the Treatment of Locally Recurrent Rectal Cancer

This study aims to summarize the literature on pelvic reirradiation for the treatment of locally recurrent rectal cancer. Symptom palliation, rates of local progression after reirradiation with or without surgery, overall survival, and toxicity outcomes are discussed. The majority of patients received total doses of 30–40 Gy given in 1.2 or 1.5 Gy twice-daily fractions. Treatment evolved over time to include more conformal fields. The overall rates of local control generally range from 25 to 70% and surgical salvage after reirradiation was performed in 20–79% of patients. Some studies suggest that patients treated with reirradiation may have a higher rate of a complete R0 resection, which is an important predictor of overall survival. Survival outcomes have improved over time along with increased use of reirradiation. Pelvic reirradiation can offer effective symptom palliation and be part of a curative salvage treatment strategy for locally recurrent rectal cancer.
Messages from Above: Conflict and Convergence of Messages to the Catholic Voter from the Catholic Church Hierarchy

The Catholic Church often plays a policy and mobilization role in American politics. We assess the degree to which the Catholic Church hierarchy — including national and state conferences of bishops — can provide uniform information to parishioners about political participation. Using a textual analysis of information distributed to parishioners in Florida in the 2012 election, we evaluate how much political information is conveyed to parishioners, the sources of this information, and the factors associated with higher or lower levels of information. While we find that most parishes provided information related to the election, there is wide diversity in the types and sources of information. And, while the Catholic hierarchy attempted to provide messaging about the importance of political participation, not all parishes complied with these efforts. Our findings are consistent with the ideas that the local community and hierarchical structure combine to shape the behavior of the parishes.
65-P: MONITORING RENAL ALLOGRAFT RECIPIENTS BY LUMINEX C1q TESTING: ASSOCIATION WITH CLINICAL AND PATHOLOGICAL RESULTS

Aim HLA antibody identification testing has become increasingly sensitive, especially solid-phase assays using fluorescent detection. Recently, a new Luminex single antigen bead (SAB) based assay has been developed that detects HLA antibodies binding C1q, the initial complement protein. This test may help differentiate HLA antibodies with more clinical relevance than others, but the significance of C1q antibodies post-transplant (Tx) is still being determined. We have introduced C1q testing into our renal allograft antibody monitoring. Patients with donor specific antibody (DSA) also undergo C1q testing to determine DSA complement binding ability. To understand the clinical significance of C1q DSA, we determined the associations between C1q binding DSA and serum creatinine (Cr) and pathological C4d staining in a cohort of renal allograft patients. Methods DSA was detected in 72 sera by conventional Luminex SAB and C1q testing in 41 recipients (31 adult, 10 pediatric). Cr was recorded at the time of DSA testing and at the time of last follow-up. 19 adult patients had 24 biopsies at the time of C1q testing and were scored for peritubular capillary C4d immunostaining. Results At the time of DSA testing (mean 1364 days; range 7-8579), Cr did not differ between patients with or without C1q-binding DSA (1.9 ± 1.3 vs 2.1 ± 1.4; p = 0.41). Patients with DSA testing 1 year post-Tx (p = 0.29). At the time of last follow-up (mean 225d after C1q testing), Cr was significantly greater in patients with C1q DSA (2.8 ± 2.8 vs 1.4 ± 0.6; p = 0.05). In 79% of patients with C1q DSA had C4d focal or diffuse on renal biopsy compared to 60% in those without C1q DSA (Chi-Square = 9.35 p = 0.025). However, some patients with C1q DSA had minimal/no C4d, and patients without C1q DSA displayed focal or diffuse C4d. Conclusions In our renal allograft cohort, serum Cr did not different at the time of C1q DSA testing, but patients with C1q DSA had increased incidence of renal biopsy C4d and higher Cr at the time of last follow-up.
Fueling the culture of distrust in physicians.

I was happy to see Dr. Dutton and colleagues add Canadian data to the literature supporting prioritization and investment in social care.[1][1] I agree that social determinants of health can have as important an impact as health care on life expectancy — sometimes more. I also agree that using
THE IMPACT OF VALVULOARTERIAL IMPEDANCE ON THE LEFT VENTRICULAR MYOCARDIAL REGRESSION AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT: A COMPARISON WITH TRANSVALVULAR MEAN PRESSURE GRADIENT

Left ventricular hypertrophy is associated with poor prognosis in aortic stenosis. Left ventricular mass regression observed after transcatheter aortic valve replacement (TAVR) is presumed to result in reduction of left ventricular stress. Valvuloarterial impedance (Zva) is a surrogate marker of
Lady of the Lake

Lady of the Lake is an artistic appreciation for the beauty of Lake Michigan and Hamlin lake, which is located near Ludington, Michigan. The design process began when artist Dick Bourgault of Ludington, Michigan, took photos around Hamlin lake while taking an early spring walk with his wife. These pictures were posted on social media and the author of this endeavor found them fascinating. After obtaining permission from the artist, the photos were used to create a two-piece womenswear ensemble. Hamlin lake is a man-made lake that was once used for holding logs during for a sawmill built by Charles Mears. Charles named the artificial lake after Hannibal Hamlin who was Abraham Lincoln's vice president choice. The silhouette was inspired by a classic Balenciaga dramatic A-line shape that emphasizes volume. The upper front and back bodice pieces were then digitized and uploaded to Lectra's Modaris software.
Music Listening Habits and Music Behaviors of Middle and High School Musicians.

The purpose of this study was to explore music listening and performance characteristics of middle and high school students. The questions under investigation addressed reasons for liking a favorit...
Nonfat milk attenuates acute hyperglycemia in individuals with android obesity: A randomized control trial.

Background Elevated android body fat increases the risk of developing cardiometabolic diseases. Postprandial hyperglycemia contributes to the proatherogenic metabolic state evident in android adiposity. Due to the insulinotropic effect of milk-derived proteins, postprandial hyperglycemia has been shown to be reduced with the addition of dairy products. The purpose of this study was to determine whether one serving of nonfat milk added to an oral glucose tolerance test (OGTT) could attenuate postprandial hyperglycemia in individuals with elevated android adiposity and whether these improvements would be associated with metabolic and/or peripheral hemodynamic effects. Methods In this placebo-controlled, randomized, crossover experimental study, 29 overweight/obese adults (26 ± 1 year) consumed an OGTT beverage (75 g glucose) combined with either nonfat milk (227 g) or a placebo control (12 g lactose + 8 g protein + 207 g water) that was matched for both carbohydrate and protein quantities. Results In the whole sample, blood glucose and insulin concentrations increased over time in both trials with no significant differences between trials. Relative increases in peak blood glucose response were significantly related to android body fat (p < 0.05). The subjects in the highest tertiles of android body fat displayed attenuated hyperglycemic responses as well as improvements in flow-mediated dilation (FMD) after milk intake. Conclusions A single serving of nonfat milk may attenuate acute hyperglycemia in individuals with elevated android body fat offering a simple and convenient option for managing elevations in blood glucose.
Cation exchange effects on methanol oxidation and dehydration by supported polyoxometalates

Abstract A series of catalysts with Keggin-structure polyoxometalates (POMs) based on H3PMo12O40 dispersed on silica were used to investigate the role of counter-cation replacement during methanol oxidation and dehydration. The rates and turnover frequencies for both methanol selective oxidation to formaldehyde and methanol dehydration to dimethyl ether were decreased by the addition of sodium as the POM counter-cation. The decrease in turnover frequencies for the oxidation and dehydration pathways were highly correlated, suggesting a role of POM acidity in creating an intermediate common to both pathways. NH3 TPD was demonstrated to be a reasonable probe of the proton-methanol interaction and was used to correlate acid site strength changes during cation exchange with dehydration and oxidation activity. The usefulness of cation addition as a tool to tune POM properties is limited by the adverse impact on POM acidity and consequent destabilization of relevant reaction intermediates.
Comparison of the technical potential for hydrogen, battery electric, and conventional light-duty vehicles to reduce greenhouse gas emissions and petroleum consumption in the United States

Abstract Light-duty vehicles (LDV) are responsible for a large fraction of petroleum use and are a significant source of greenhouse gas (GHG) emissions in the United States. Improving conventional gasoline-powered vehicle efficiency can reduce petroleum demand, however efficiency alone cannot reach deep GHG reduction targets, such as 80% below the 1990 LDV GHG emissions level. Because the cost and availability of low-GHG fuels will impose limits on their use, significant reductions in GHG emissions will require combinations of fuel and vehicle technologies that both increase efficiency and reduce the emissions from fuel production and use. This paper examines bounding cases for the adoption of individual technologies and then explores combinations of advanced vehicle and fuel technologies. Limits on domestic biofuel production—even combined with significant conventional combustion engine vehicle improvements—mean that hydrogen fuel cell electric or battery electric vehicles fueled by low-GHG sources will be necessary. Complete electrification of the LDV fleet is not required to achieve significant GHG reduction, as replacing 40% of the LDV fleet with zero-emission hydrogen vehicles while achieving optimistic biofuel production and conventional vehicle improvements can allow attainment of a low GHG emission target. Our results show that the long time scale for vehicle turnover will ensure significant emissions from the LDV sector, even when lower emission vehicles and fuels are widely available within 15 years. Reducing petroleum consumption is comparatively less difficult, and significant savings can be achieved using efficient conventional gasoline-powered vehicles.
Agent-based models of inflammation in translational systems biology: A decade later

Agent-based modeling is a rule-based, discrete-event, and spatially explicit computational modeling method that employs computational objects that instantiate the rules and interactions among the individual components ("agents") of system. Agent-based modeling is well suited to translating into a computational model the knowledge generated from basic science research, particularly with respect to translating across scales the mechanisms of cellular behavior into aggregated cell population dynamics manifesting at the tissue and organ level. This capacity has made agent-based modeling an integral method in translational systems biology (TSB), an approach that uses multiscale dynamic computational modeling to explicitly represent disease processes in a clinically relevant fashion. The initial work in the early 2000s using agent-based models (ABMs) in TSB focused on examining acute inflammation and its intersection with wound healing; the decade since has seen vast growth in both the application of agent-based modeling to a wide array of disease processes as well as methodological advancements in the use and analysis of ABM. This report presents an update on an earlier review of ABMs in TSB and presents examples of exciting progress in the modeling of various organs and diseases that involve inflammation. This review also describes developments that integrate the use of ABMs with cutting-edge technologies such as high-performance computing, machine learning, and artificial intelligence, with a view toward the future integration of these methodologies. This article is categorized under: Translational, Genomic, and Systems Medicine > Translational Medicine Models of Systems Properties and Processes > Mechanistic Models Models of Systems Properties and Processes > Organ, Tissue, and Physiological Models Models of Systems Properties and Processes > Organismal Models.
The emergence of splinter factions in intrastate conflict

ABSTRACTWhy do some rebel groups fractionalize during intrastate conflict? The focus of this article is on understanding a particular phenomenon within fragmentation during civil war: the emergence...
העדפת ערכי בריאות וסביבה על פני ערכי כלכלה בחוק אוויר נקי

על רקע בעיות איכות האוויר במדינת ישראל, וחקיקת חוק אוויר נקי בשנת 2008 נבחנו ההסדרים שנקבעו בחוק זה. שאלה מרכזית במאמר הייתה מהו האיזון הנכון בין הרצון והצורך למנוע ככל האפשר את זיהום האוויר ובין הרצון לקיים אורח חיים מודרני הכולל בהכרח פליטות של מזהמים לאוויר. במאמר נסקרו שתי גישות אפשריות לאופן ההכרעה בנקודת האיזון הנכונה. הראשונה היא החלופה הכלכלית, המצדיקה ביצוע ניתוח עלות-תועלת שיצביע על נקודת איזון הנמצאת במינימום העלות המצרפית המשקית. החלופה השנייה היא החלופה הסביבתית-דמוקרטית, אשר מותחת ביקורת על הראייה הכלכלית בתחומי הסביבה. חלופה זו גורסת כי יש צורך לקיים דיון ציבורי דמוקרטי שבו תיבחר נקודת האיזון. זו עשויה להיות נקודה סביבתית יותר, שאותה יש ליישם גם במחיר כלכלי גבוה יותר. ההסדרים בחוק נותחו תוך שימוש בגישת הפרשנות התכליתית. מניתוח זה מסיק המאמר כי המחוקק הישראלי הכריע להעדיף את החלופה הסביבתית-דמוקרטית על פני הגישה הכלכלית.
First the Process, Then the Art of Medicine? The Gruyère Theory

I would like to start with a small anecdote to underline the value of the process. During a visit to the American Academy of Orthopedic Surgeons meeting in Washington, myself and my wife brought our 10-year-old son to the hospital due to a terrible pain he was suffering in his left heel. The pain had commenced on the plane journey from France to the USA. And, such was his discomfort that he was unable to sleep the night after our arrival despite medication. In the first 6 hours in the hospital, he was attended by four doctors. He had had an MRI, but it had not provided a definitive diagnosis of a tumour, infection or stress fracture, so a biopsy was planned. We were admitted in preparation for the procedure. As part of the admission process, we were asked all of the same questions again, for a fifth time: name, medical history—every piece of information that had already been recorded on file—date of birth, height, weight… Suddenly, a deep discussion between several doctors ensued. The prescribed doses of medication were totally wrong. The dose of the medication did not correlate with the weight of our son. According to the medical staff, this was a near-miss event, but a severe mistake had thankfully been avoided.
Development of Global Identity in the Social Studies Classroom

Global citizenship is a citizenship model that draws growing attention of practitioners and education theorists. Global identity is an important prerequisite for the development of global citizenship. This empirical study conducted in three social studies classrooms investigated whether social studies classroom discourse contributes to the emergence and development of students’ global identities and what linguistic elements of discourse impact the development of students’ global identities. Using the framework suggested by Bucholtz and Hall (2010), which analyzes identity as constituted in linguistic interaction, the study demonstrated how teacher mediated discourses are pertinent to the construction and development of global identity among students. By applying the indexicality principle, it was determined which linguistic symbols students identified as indexes of global identity. The study concluded that the use of words and phrases that relate indexically to global identity in the teacher’s narrative or a textbook affects the development of students’ global identities.
Conditional mixture models for precipitation data quality control

Rainfall is a very important weather variable, especially for agriculture. Unfortunately, rain gauges fail frequently. This paper describes a conditional mixture model for predicting the presence and amount of rain at a weather station based on measurements at nearby stations. The model is evaluated on simulated faults (blocked rain gauges) inserted into observations from the Oklahoma Mesonet. Using the negative log-likelihood as an anomaly score, we evaluate the area under the ROC and precision-recall curves for detecting these faults. The results show very good performance.
Traumatic thoracolumbar projectile with concomitant vertebral body and aortic injury

Abstract Penetrating subdiaphragmatic aortic trauma is associated with high morbidity and mortality with studies having reported a 50%-70% associated mortality. We describe a case of a patient with a subdiaphragmatic aortic injury caused by a 7.4-cm common nail that traversed through his L1 vertebral body into the aorta. His aortic injury was managed jointly with vascular surgery and neurosurgery teams.
Liberatory Media Literacy as Protective Against Posttraumatic Stress for Emerging Adults of Color.

Emerging adults (i.e., age 18-25 years) of color in the United States are exposed to race/ethnicity-related traumatic events in online settings. Although an emerging literature documents the mental health consequences of such online exposures among adolescents, the association between these exposures and symptoms of posttraumatic stress disorder (PTSD) remains understudied in emerging adults. Furthermore, little is known about strengths-based factors that may be protective for emerging adults of color faced with such exposures. The current study aimed to fill these gaps by examining the potential of liberatory media literacy (i.e., the ability to critically read, evaluate, support, and create media and technology that represents people of color in their full humanity) to ameliorate the association between exposure to traumatic events online and PTSD symptoms. Emerging adults of color (N = 325, Mage = 22.24, 56.0% male) were recruited to complete a self-report online survey that assessed exposure to race/ethnicity-related traumatic events in online settings, liberatory media literacy, and PTSD symptoms. The results of moderation analysis indicated that increased exposure to traumatic events online was associated with higher PTSD symptoms, β = .22, and that the inclusive media and technology component of liberatory media literacy was protective in this association, β = .19. However, these effects were small, f2 = .22-.23. The potential of liberatory media literacy as a strengths-based asset for emerging adults of color are discussed. Increasing inclusive media and technology skills may be an important target for intervention.
Relationship Between Financial Toxicity and Surgical Treatment for Early-Stage Breast Cancer: A Propensity Score-Matched Comparison of Breast-Conserving Therapy and Mastectomy.

Background Financial toxicity (FT) can lead to decreased quality of life and poor treatment outcomes. However, there is limited published data on the extent to which the various surgical treatment approaches for early-stage breast cancer are determinants for FT. Study Design We performed a single-institution cross-sectional survey of adult female patients with stage 0 to II breast cancer undergoing unilateral breast-conserving therapy or unilateral mastectomy. FT was measured using the Comprehensive Score for Financial Toxicity (COST) survey. Propensity matching was performed to optimize comparability of study groups. A multivariate regression model was used to identify factors associated with worsening FT as a robustness check. Our secondary end point was prevalence of coping strategies associated with cost of cancer care. Results Among 294 patients who met inclusion criteria, 203 underwent breast-conserving therapy and 91 received mastectomy. We generated 72 total matched pairs and noted no differences in demographic and socioeconomic characteristics. Of these, 55 pairs had complete COST information, which was comparable on adjusted analysis (26.6 vs 24.7; p = 0.481). High annual income (β = 4.83; p Conclusions Choice of BCT or mastectomy was not associated with a differential risk for FT in early-stage cancer. Decisions on ablative approach should be made based on patient preferences and disease-specific criteria. Transparent counseling on FT for high-risk populations promotes patient-centricity.
Improving admission medication reconciliation at a tertiary cancer center.

e18686Background: Accurate medication reconciliation (MedRec) is a pivotal step ensuring patient safety during transition of care, yet one of the most challenging aspects in healthcare quality and ...
Bipartisan Federal Legislation to Address Insulin Access and Affordability

Insulin access and affordability affect the well-being of millions of Americans. In the 116th Congress (2019–2020), seven bipartisan bills were introduced to address this issue. In this article, the authors group the seven bills into five categories (enhancing price transparency, limiting cost-sharing, changing biosimilar regulations, certifying prices, and permitting importation), summarize the main content of these bills, and discuss their implications. Understanding the bipartisan insulin pricing policy proposals can facilitate the development of a feasible legislative agenda to improve insulin access and affordability.
Chapter 4 High-Performance Liquid Chromatography of Free Nucleotides, Nucleosides, and Their Bases in Biological Samples

Publisher Summary The analysis of nucleic acid components in biological matrices by high performance liquid chromatography (HPLC) is important in genetic, biomedical, and biochemical research areas. The ideal HPLC methods offer high resolution and sensitivity, good reproducibility, and short analysis time. However, because of the complex nature of biological samples, it is difficult to balance all these factors. In the leukemic patients, lower Ino levels were found to correspond to a prognosis of remission and very high levels corresponded to a prognosis of relapse; thus, these results suggest that Ino can be used to predict the prognosis of the disease. Micellar liquid chromatography with a polyvinyl alcohol (PVA) column was recently used for the analysis of nucleosides and bases in biological samples. An example is the iso-serum by micellar liquid chromatography. Although HPLC is the method of choice for the separation and quantitation of nucleotides, nucleosides and bases in biological samples, increased resolution, selectivity, sensitivity, and speed of analysis will be required in the future for biomedical studies, biotechnology and the clinical laboratory.
Detection and characterization of cyanobacterial nifH genes.

Abstract The DNA sequence of a 359-bp fragment of nifH was determined for the heterocystous strains Anabaena sp. strain CA (ATCC 33047), Nostoc muscorum UTEX 1933, a Nostoc sp., Gloeothece sp. strain ATCC 27152, Lyngbya lagerheimii UTEX 1930, and Plectonema boryanum IU 594. Results confirmed that the DNA sequence of the 359-bp segment is sufficiently variable to distinguish cyanobacterial nifH genes from other eubacterial and arachaeobacterial nifH genes, as well as to distinguish heterocystous from nonheterocystous nifH genes. Nonheterocystous cyanobacterial nifH sequences were greater than 70 and 82% identical on the DNA and amino acid levels, respectively, whereas corresponding values for heterocystous cyanobacterial nifH sequences were 84 and 91%. The amplified nifH fragments can be used as DNA probes to differentiate between species, although there was substantial cross-reactivity between the nifH amplification products of some strains. However, an oligonucleotide designed from a sequence conserved within the heterocystous cyanobacteria hybridized primarily with the amplification product from heterocystous strains. The use of oligonucleotides designed from amplified nifH sequences shows great promise for characterizing assemblages of diazotrophs.
Sampling optimization for high-speed weigh-in-motion measurements using in-pavement strain-based sensors

Weigh-in-motion (WIM) measurement has been widely used for weight enforcement, pavement design, freight management, and intelligent transportation systems to monitor traffic in real-time. However, to use such sensors effectively, vehicles must exit the traffic stream and slow down to match their current capabilities. Hence, agencies need devices with higher vehicle passing speed capabilities to enable continuous weight measurements at mainline speeds. The current practices for data acquisition at such high speeds are fragmented. Deployment configurations and settings depend mainly on the experiences of operation engineers. To assure adequate data, most practitioners use very high frequency measurements that result in redundant samples, thereby diminishing the potential for real-time processing. The larger data memory requirements from higher sample rates also increase storage and processing costs. The field lacks a sampling design or standard to guide appropriate data acquisition of high-speed WIM measurements. This study develops the appropriate sample rate requirements as a function of the vehicle speed. Simulations and field experiments validate the methods developed. The results will serve as guidelines for future high-speed WIM measurements using in-pavement strain-based sensors.
The effect of challenge and threat appraisals under evaluative presence.

Four studies were conducted to examine whether cognitive appraisals, manipulated through task instructions, would moderate social-facilitation effects. In Study 1, participants in the challenge condition performed better on a mental arithmetic task when the experimenter was present. Conversely, participants in the threat condition performed worse when the experimenter was present. Study 2 extended these findings across 2 math tasks that varied in degree of difficulty. The pattern of performance data failed to support prior drive theories and provided support for a unique contribution of cognitive appraisals in explaining social-facilitation effects. Study 3 validated the appraisal manipulations by using multiple measures of cognitive appraisals. Finally, Study 4 offered increased validity by replicating the performance data using an anagram task.
A Model to Predict Cell-Mediated Immune Regulatory Mechanisms During Human Infection with Mycobacterium tuberculosis

A key issue for the study of tuberculosis infection (TB) is to understand why individuals infected with Mycobacterium tuberculosis experience different clinical outcomes. Elaborating the immune mechanisms that determine whether an infected individual will suffer active TB or latent infection can aid in developing treatment and prevention strategies. To better understand the dynamics of M. tuberculosis infection and immunity, we have developed a virtual human model that qualitatively and quantitatively characterizes the cellular and cytokine control network operational during TB infection. Using this model, we identify key regulatory elements in the host response. In particular, factors affecting cell functions, such as macrophage activation and bactericidal capabilities, and effector T cell functions such as cytotoxicity and cytokine production can each be determinative. The model indicates, however, that even if latency is achieved, it may come at the expense of tissue damage if the response is not properly regulated. A balance in Th1 and Th2 immune responses governed by IFN-γ, IL-10, and IL-4 facilitate this down-regulation. These results are further explored through virtual deletion and depletion experiments.
Curcumin enhances the effects of 5-fluorouracil and oxaliplatin in mediating growth inhibition of colon cancer cells by modulating EGFR and IGF-1R

Curcumin (diferuloylmethane), which has been shown to inhibit growth of transformed cells, has no discernible toxicity and achieves high levels in colonic mucosa. 5-fluorouracil (5-FU) or 5-FU plus oxaliplatin (FOLFOX) remains the backbone of colorectal cancer chemotherapeutics, but with limited success. The present investigation was, therefore, undertaken to examine whether curcumin in combination with conventional chemotherapeutic agent(s)/regimen will be a superior therapeutic strategy for colorectal cancer. Indeed, results of our in vitro studies demonstrated that curcumin together with FOLFOX produced a significantly greater inhibition (p < 0.01) of growth and stimulated apoptosis (p < 0.001) of colon cancer HCT-116 and HT-29 cells than that caused by curcumin, 5-FU, curcumin + 5-FU or FOLFOX. These changes were associated with decreased expression and activation (tyrosine phosphorylation) of EGFR, HER-2, HER-3 (72-100%) and IGF-1R (67%) as well as their downstream effectors such as Akt and cycloxygenase-2 (51-97%). Furthermore, while these agents produced a 2-3-fold increase in the expression of IGF-binding protein-3 (IGFBP-3), curcumin together with FOLFOX caused a 5-fold increase in the same, when compared to controls. This in turn led to increased sequestration of IGF by IGFBP-3 rendering IGF-1 unavailable for binding to and activation of IGF-1R. We conclude that the superior effects of the combination therapy of curcumin and FOLFOX are due to attenuation of EGFRs and IGF-1R signaling pathways. We also suggest that inclusion of curcumin to the conventional chemotherapeutic agent(s)/regimen could be an effective therapeutic strategy for colorectal cancer.
Nb and Ta layer doping effects on the interfacial energetics and electronic properties of LaAlO3/SrTiO3 heterostructure: first-principles analysis

The two-dimensional electron gas (2DEG) formed at the n-type (LaO)+1/(TiO2)0 interface in the polar/nonpolar LaAlO3/SrTiO3 (LAO/STO) heterostructure (HS) has emerged as a prominent research area because of its great potential for nanoelectronic applications. Due to its practical implementation in devices, desired physical properties such as high charge carrier density and mobility are vital. In this respect, 4d and 5d transition metal doping near the interfacial region is expected to tailor electronic properties of the LAO/STO HS system effectively. Herein, we studied Nb and Ta-doping effects on the energetics, electronic structure, interfacial charge carrier density, magnetic moment, and the charge confinements of the 2DEG at the n-type (LaO)+1/(TiO2)0 interface of LAO/STO HS using first-principles density functional theory calculations. We found that the substitutional doping of Nb(Ta) at Ti [Nb(Ta)@Ti] and Al [Nb(Ta)@Al] sites is energetically more favorable than that at La [Nb(Ta)@La] and Sr [Nb(Ta)@Sr] sites, and under appropriate thermodynamic conditions, the changes in the interfacial energy of HS systems upon Nb(Ta)@Ti and Nb(Ta)@Al doping are negative, implying that the formation of these structures is energetically favored. Our calculations also showed that Nb(Ta)@Ti and Nb(Ta)@Al doping significantly improve the interfacial charge carrier density with respect to that of the undoped system, which is because the Nb(Ta) dopant introduces excess free electrons into the system, and these free electrons reside mainly on the Nb(Ta) ions and interfacial Ti ions. Hence, along with the Ti 3d orbitals, the Nb 4d and Ta 5d orbitals also contribute to the interfacial metallic states; accordingly, the magnetic moments on the interfacial Ti ions increase significantly. As expected, the Nb@Al and Ta@Al doped LAO/STO HS systems show higher interfacial charge carrier density than the undoped and other doped systems. In contrast, Nb@Ti and Ta@Ti doped systems may show higher charge carrier mobility because of the lower electron effective mass.
Surgical outcomes in the elderly patient after osteocutaneous free flap transfer.

Objectives/Hypothesis Morbidity of free tissue transfer in the elderly patient is controversial. Recent studies have shown no significant difference in elderly fasciocutaneous free-flap donor site morbidity. The purpose of this study is to assess surgical outcomes in elderly patients receiving osteocutaneous free-tissue transfer. Study Design Retrospective chart review of patients 70 years and older undergoing osteocutaneous free flaps from 2000 to 2013. Methods Fibular, radial forearm, and scapular flaps were reviewed. Younger patients randomly selected from the same time period served as controls. Data collected included donor site morbidity, flap complications, feeding tube and tracheostomy dependence, and hospital stay. Results Forty-four osteocutaneous free flaps were performed in elderly patients. Overall, there was no significant difference in donor site morbidity between older and younger patients (P = 0.50) (tendon exposure, P = 1.00; split-thickness skin graft loss, P = 0.36; infections, P = 0.52; dehiscence, P = 1.00; and seroma, P = 1.00). There was no significant difference between older and younger patients being decannulated (P = 0.61) or the time to decannulation (P = 0.24). There was no difference in those who returned to baseline diet (P = 0.67). All patients returned to baseline ambulatory and shoulder status. Length of postoperative hospitalization (P = 0.78) and intensive care unit stay (P = 0.94) were also equal. The only significant difference was that more elderly patients were discharged to skilled nursing facilities (SNF) (40.9% vs. 15.9%, P < 0.01). Conclusion Elderly patients undergoing free tissue transfer have similar flap and donor site outcomes, feeding tube and tracheostomy outcomes, ambulatory status, and hospital stays compared to younger patients. They are, however, more likely to require SNF care posthospitalization. Level of Evidence 4. Laryngoscope, 124:2484–2488, 2014
The Poverty Deconcentration Imperative and Public Housing Transformation

Public housing has been on the chopping block for almost two decades now in an effort to deconcentrate poverty. In 1992 the federal government created the Housing Opportunities for People Everywhere (HOPE) VI program. HOPE VI is driven by the assumption that deconcentrating neighborhood-level poverty will yield better access to upward mobility opportunities for former public housing residents. To accomplish this, existing public housing is demolished and replaced with mixed-income developments. Public housing residents are relocated, many with Housing Choice Voucher subsidies to private-market rental housing. However, by its very definition mixed income means that only a small percentage of former residents get the opportunity to return. Do voucher relocated residents end up in lower poverty neighborhoods with greater upward mobility opportunities? We examine the spatial organization of relocation within the critical discourse on the deconcentration imperative. We highlight Atlanta because it recently became the first city in the nation to eliminate all of its public housing. Findings reveal that voucher relocatees end up in neighborhoods with modestly less poverty than the public housing neighborhoods they left. Questions remain about what poverty deconcentration means vis-a`-vis policy goals. We provide recommendations for future research.