cssi/SciSciGPT-SciSciNet huggingface dataset:
Psychiatric Comorbidities and Mortality among Hospitalized Parkinson Disease Patients (P06.068)

Objective: We hypothesized that Parkinson disease (PD) patients diagnosed with depression or anxiety would have higher in-hospital mortality compared to PD patients with no psychiatric comorbidities. Alcohol or drug use would further increase mortality. Background Community-based and clinical studies estimate 20-40% PD patients suffer from anxiety, 25-95% have depressive symptoms, and at least 8% meet major depression criteria. About 75% of PD patients develop depression within 10 years of PD onset, with almost a two-fold risk of depression than others. Psychiatric comorbidities seem to negatively affect PD patients9 quality of life and survival. Design/Methods: We used 1998-2009 Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) to test our hypotheses. We identified PD, depression, anxiety, alcohol and drug use through International Classification of Diseases, 9th Revision (ICD-9) codes. Descriptive statistics summarized patient differences before data analyses. Logistic regressions used SAS survey procedures and HCUP-NIS sampling weights to account for complex survey design. All models considered patients9 age, gender, race/ethnicity, and insurance type. Results: 3,599,901 discharges met inclusion criteria, with age 77.8 (SD 9.2), 52.9% male; 65.1% White; 8.1% private/HMO insurance. Depression was identified in 11.2%, anxiety in 5.3%, underestimates to population predicted prevalence of those disorders in same settings. Statistically lower mortality was found for PD patients with known depression (OR=0.65; p Conclusions: We postulate that depression and anxiety are under diagnosed in hospitalized PD patients but associated with lower in-hospital PD mortality when recognized. Alcohol and illicit substance use did not impact outcome for PD patients with psychiatric co-morbidities, but these seemed to be under recognized. Asian race as well as Medicaid and uninsurance were associated with higher odds of inpatient death. Supported by: Dr. Mejia is a 2010-2012 AAN Foundation Clinical Research Training Fellowship recipient and a 2011 Rappaport Foundation Research Scholar in Neuroscience. Disclosure: Dr. Mejia has nothing to disclose. Dr. El-Chemali has nothing to disclose.
β-Cyclodextrin tetradecasulfate/tetrahydrocortisol±minocycline as modulators of cancer therapies in vitro and in vivo against primary and metastatic lewis lung carcinoma

Tetrahydrocortisol, β-cyclodextrin tetradecasulfate, and minocycline used alone or in combination are not very cytotoxic toward EMT-6 mouse mammary tumor cells growing in monolayer. Tetrahydrocortisol (100 μM, 24 h) and β-cyclodextrin tetradecasulfate (100 μM, 24 h) protected EMT-6 cells from the cytotoxicity of CDDP, melphalan, 4-hydroperoxycyclophosphamide, BCNU, and X-rays under various conditions of oxygenation and pH. Minocycline (100 μM, 24 h) either had no effect upon or was additive with the antitumor alkylating agents or X-rays in cytotoxic activity toward the EMT-6 cells in culture. The combination of the three modulators either had no effect upon or was to a small degree protective against the cytotoxicity of the antitumor alkylating agents or X-rays. The Lewis lung carcinoma was chosen for primary tumor growth-delay studies and tumor lung-metastases studies. Tetrahydrocortisol and β-cyclodextrin tetradecasulfate were given in a 1:1 molar ratio by continuous infusion over 14 days, and minocycline was given i.p. over 14 days, from day 4 to day 18 post tumor implantation. The combination of tetrahydrocortisol/β-cyclodextrin tetradecasulfate diminished the tumor growth delay induced by CDDP and melphalan and produced modest increases in the tumor growth delay produced by cyclophosphamide and radiation. Minocycline co-treatment increased the tumor growth delay produced by CDDP, melphalan, radiation, bleomycin, and, especially cyclophosphamide, where 4 of 12 animals receiving minocycline (14×5mg/kg, days 4–18) and cyclophosphamide (3×150 mg/kg, days, 7, 9, 11) were long-term survivors. The 3 modulators given in combination produced further increases in tumor growth delay with all of the cytotoxic therapies, and 5 of 12 of the animals treated with the 3-modulator combination and cyclophosphamide were long-term survivors. Although neither tetrahydrocortisol/β-cyclodextrin tetradecasulfate, minocycline, nor the three modulator combination impacted the number of lung metastases, there was a decrease in the number of large lung metastases. Treatment with the cytotoxic therapies alone reduced the number of lung metastases. Addition of the modulators to treatment with the cytotoxic therapies resulted in a further reduction in the number of lung metastases. These results indicate that agents that inhibit the breakdown of the extracellular matrix can be useful additions to the treatment of solid tumors.
Applications of the Reserve Midget machine in obstetrical anesthesia: Preliminary report

Abstract A series of 63 consecutive obstetrical patients managed with the Hingson Reserve Midget machine is presented. The study is too small to arrive at any definitive conclusion. It appears, however, that this compact unit may merit a place in the field of obstetrical anesthesia. The machine is easy to handle and explosion hazards are markedly reduced. Despite these advantages the dangers inherent in the administration of any and every anesthetic agent remain.
The Lost Continent of Atlantis

A legend is usually defined as a nonhistorical or unverifiable story handed down by tradition from earlier times and popularly accepted as historical. It is generally agreed that many legends have some fragments of truth in them. However, the greater the span of time over which such a story is handed down, the greater the opportunity for exaggeration, distortion, and embellishment. This would be especially true in times prior to the invention of the printing press.
Diet, Food, Nutrition, and Exercise in Cystic Fibrosis

Abstract In cystic fibrosis (CF), a decline in nutrition status has been linked to a reduction in activity levels and exercise capacity. Despite this, research in the field of nutrition for the exercising CF patient has been limited, and evidence-based recommendations are not yet available. With careful consideration, many aspects of sports nutrition can be applied to the pediatric and adult evidence-based CF nutrition guidelines. This chapter summarizes the available nutrition and dietary management literature for CF and the healthy population when participating in exercise or sport. Where specific evidence was not available, considerations for the CF population were identified. Topics covered include energy and protein requirements, substrate utilization, macro- and micronutrient requirements, dietary supplements, and children in sport. Hydration was also examined in terms of electrolyte losses, fluid and electrolyte replacement, thirst drive, and the use of sports drinks.
Magnetotail Phenomena during Magnetospheric Substorms

The purpose of this chapter is to examine first of all whether satellite observations in the magnetotail can be interpreted in terms of the formation of a new magnetic neutral line and the subsequent enhancement of reconnection along the scheme outlined in Section 4.4.1. For this purpose it may be worthwhile to describe briefly the most widely conjectured model of magnetotail phenomena during the magnetospheric substorm. The model is well illustrated in Figure 6.1, but similar models have been proposed by a number of other workers (cf. Hones, 1973, 1975; McPherron et al., 1973b). These workers suggest: A southward turning of the interplanetary magnetic field is accompanied by erosion of the dayside magnetosphere, flux transport to the geomagnetic tail, and a gradual thinning and inward motion of the plasma sheet. As a result, at about T = −30 min, “The plasma sheet has become very thin over its whole length beyond X ≃ −10 to −15 R E. At T = 0, a neutral line forms at X ≃ −10 to 15 R E. Reconnection of oppositely directed field lines starts there and produces rapid flow of plasma both earthward and anti-earthward from its location” (Hones, 1973). Thus, “The expansion phase of substorms can originate near the inner edge of the plasma sheet as a consequence of rapid plasma sheet thinning. At this time a portion of the inner edge of the tail current is ‘short circuited’ through the ionosphere. This process is consistent with the formation of a neutral point in the near-tail region” (McPherron et al., 1973).
Immunodeficiency and Sinus Disease

The hallmark of immune deficiency is recurrent, unusual, or persistent infection. Immune deficiency can be present as either a primary or secondary medical disorder. There are more than 120 genes that have been implicated in PRIMARY IMMUNE DEFICIENCY (PID) which account for more than 180 primary immunodeficiency diseases described and the number keeps expanding. The infrequency of PID suggests that screening for PID is unnecessary for recurrent acute sinusitis. The probabilities of a positive screening study for PID increase in patients with chronic rhinosinusitis refractory to medical therapy requiring surgical management and reported to be present in as many as 12 % of such patients in limited studies.
The response of the inner magnetosphere to the trailing edges of high‐speed solar‐wind streams

The effects of the leading edge stream interface of high-speed solar-wind streams (HSSs) upon the Earth's magnetosphere have been extensively documented. The arrival of HSSs leads to significant changes in the plasmasphere, plasma sheet, ring current, and radiation belts, during the evolution from slow solar wind to persistent fast solar wind. Studies have also documented effects in the lower ionosphere and the neutral atmosphere. However, only cursory attention has been paid to the trailing-edge stream interface during the transition back from fast solar wind to slow solar wind. Here we report on the statistical changes that occur in the plasmasphere, plasma sheet, ring current, and electron radiation belt during the passage of the trailing-edge stream interface of HSSs, when the magnetosphere is in most respects in an extremely quiescent state. Counterintuitively, the peak flux of ~1 MeV electrons is observed to occur at this interface. In contrast, other regions of the magnetosphere demonstrate extremely quiet conditions. As with the leading-edge stream interface, the occurrence of the trailing-edge stream interface has a periodicity of 27 days, and hence, understanding the changes that occur in the magnetosphere during the passage of trailing edges of HSSs can lead to improved forecasting and predictability of the magnetosphere as a system.
Digital Technology: A Double-Edged Sword for a School Principal in Rural Pennsylvania:

This case study was inspired by visits to several different rural high schools in Pennsylvania. The case illuminates the challenges faced by rural principals and superintendents who want to integra...
Route of Delivery in Women With Stillbirth: Results From the Stillbirth Collaborative Research Network.

OBJECTIVE:To describe delivery management of singleton stillbirths in a population-based, multicenter case series.METHODS:We conducted a retrospective chart review of 611 women with singleton stillbirths at 20 weeks of gestation or greater from March 2006 to September 2008. Medical and delivery info
Impact of Radiation Therapy in Surgically Resected Limited-Stage Small Cell Lung Carcinoma.

To elucidate the role of radiation therapy (RT) in the treatment of surgically resected limited-stage small cell lung carcinoma (LSCLC). We queried the SEER database from 1998 to 2012 to identify patients who were diagnosed with LSCLC as their only primary tumor. Kaplan–Meier analysis was utilized to determine disease-specific survival (DSS) and overall survival (OS), while multivariate analysis was used to compare survival in terms of patients and treatment characteristics. Eight hundred twenty-three LSCLC patients were identified for inclusion within the study. 12-month DSS for patients who did not receive surgery or RT was 31.9% (95% CI 27.7–36.3), 93.3% (95% CI 71.6–90.5) for surgery alone, and 81.0% (95% CI 69.3–88.6) for surgery + RT. 12-month OS was 27.2% (95% CI 23.4–31.1), 74.7% (95% CI 62.6–83.4), and 78.3% (95% CI 66.4–86.4) for no surgery or RT, for surgery alone, and for surgery + RT, respectively. In terms of multivariate analysis, patients receiving surgery alone and patients receiving surgery + RT had a better DSS and OS than those who received neither treatment. However, OS (HR 1.60; 95% CI 0.93–2.75, p = 0.09) and DSS (HR 1.34; 95% CI 0.72–2.51, p = 0.37) were not significantly associated with patients receiving surgery alone compared to surgery + RT. Surgery alone and surgery + RT were positively associated with DSS and OS compared to patients who did not receive surgery or RT. However, the addition of RT to surgery did not significantly predict DSS or OS compared to surgery alone.
School mental health – a multi-layered and complex field

This issue of Advances in School Mental Health Promotion touches on different levels of school mental health implementation, from district and school considerations for the installation of evidence...
Effects of Food Deprivation on Fixed Ratio Barpressing in the Presence of Free Food

Deprived and nondeprived rats barpressed on a series of fixed ratio (FR) schedules in the presence of free food, and the percentage of pellets consumed which were earned was determined. When the schedules were presented in an initial ascending order (CRF, FR 3, FR 7, FR 3, CRF), there was a significant interaction between deprivation level and test order (first vs. second testing) for both the CRF and the FR 3 schedules. In each case, deprived rats earned a higher percentage of food consumed on the first testing of the schedule, and nondeprived rats earned the higher percentage on the second testing. In a second experiment, no interaction was found when the schedules were presented in an initial descending sequence (FR 7, FR 3, CRF, FR 3, CRF).
Association Between Opioid Prescribing Patterns and Abuse in Ophthalmology.

Importance Drug overdoses have become the number 1 cause of mortality in American adults 50 years and younger. Prescription opioid abuse is a growing concern that has garnered widespread attention among policymakers and the general public. Objective To determine the opioid prescribing patterns among ophthalmologists and elucidate their role in the prescription opioid abuse epidemic. Design, Setting, and Participants In this observational cohort study, beneficiaries and their physicians were analyzed using 2013 to 2015 Medicare Part D Prescriber Data. The Centers for Medicare and Medicaid Services Medicare Part D Prescriber Public Use Files for 2013, 2014, and 2015 were accessed. Analysis began in June 2017. Data were collected and analyzed regarding the prescribing patterns for opioid drugs (eg, number of prescriptions written including refills, number of days’ supply, and prescriber rates) for all participating ophthalmologists. Main Outcomes and Measures The mean number of opioid prescriptions written annually by ophthalmologists; prescriber rates compared with all prescriptions written; and geographic distribution of opioid prescriptions written per ophthalmologist. Results In 2013, 4167 of 19 615 ophthalmologists were women (21.2%). Consistently, most ophthalmologists (88%-89%) wrote 10 opioid prescriptions or fewer annually. Approximately 1% (0.94%-1.03%) of ophthalmologists wrote more than 100 prescriptions per year. On average, ophthalmologists wrote 7 opioid prescriptions per year (134 290 written annually by 19 638 physicians, on average) with a mean supply of 5 days. The 6 states with the highest volume of opioid prescriptions written annually per ophthalmologist were located in the southern United States. Conclusions and Relevance In general, ophthalmologists show discretion in their opioid prescribing patterns. The present opioid abuse epidemic should prompt physicians to consider revisiting their prescribing protocols given the high risk for dependency.
The Current State of Epicutaneous Immunotherapy for Food Allergy: a Comprehensive Review.

The food allergy epidemic of recent years has led to the search for safe and effective methods of immunotherapy for foods. Studies of epicutaneous immunotherapy (EPIT) in mice have shown promising safety and efficacy data. Murine models have also identified probable mechanisms for the development of tolerance to food allergens, including the induction of regulatory T cells. Clinical data is lacking, but relatively small and early studies among peanut and cow’s milk allergic subjects suggest that EPIT has an excellent safety profile, particularly compared to other methods of specific allergen immunotherapy. Efficacy data are also promising for peanut allergy, among younger patients (ages 4–11 years of age), suggesting that a majority of young patients will experience an increase in reaction threshold with therapy. The goal of this therapy is the protection from accidental exposures to a known food allergen. Additional clinical data is needed to prove efficacy and further demonstrate the safety profile of EPIT for food allergy, prior to approval by the Food and Drug Administration.
How do interactive graphing tools help students interpret virtual experiments about car collisions

This study examines how experimentation using a visualization featuring coordinated animated and graphical representations of motion can help students reach sophisticated insights about car collisions. Airbags: Too Fast, Too Furious? is a one-week high school physics investigation about airbag safety that addresses students' understanding of motion graphs. The design of Airbags builds on research that recommends using visual representations to scaffold inquiry-based learning (Quintana et al, 2004), particularly investigations concerning motion (White, 1993). Airbags incorporates dynamic visualizations that aim to help students understand events in a car collision that occur too quickly to be observed in real time. The visualizations present coordinated animated and graphical representations that are each designed to help support students' understanding of the other (Ainsworth, 1999; Kozma, 2003).
Primary and secondary immune deficiencies of domestic animals.

Publisher Summary This chapter discusses the primary and secondary immune deficiencies of domestic animals. Domestic animals interact with an environment teeming with pathogenic microorganisms. Resistance to and recovery from infection by these organisms is dependent upon normal host defense systems. Immune responses are mediated by two major classes of lymphocytes. Both classes are derived from a common pluripotent stem cell precursor, the location of which varies with the developmental age of the animal. Abnormalities of lymphocytes, phagocytic cells, and complement system components increase susceptibility to infection and often lead to death. Classification as a primary or secondary disorder implies a mechanistic basis in the characterization of the disease. A primary disorder is one in which a genetic basis is proven or suspected. A secondary disorder is one in which the animal is initially capable of producing normal defense responses. However, because of a mechanical problem, disease, or treatment, the response capacity of the animal is suppressed or depleted. Examples of secondary deficiencies include malnutrition, irradiation, failure of newborn to absorb colostral immunoglobulin, treatment with corticosteroids, neoplasia, and infection by immunosuppressive agents.
Pharmacological and Pharmacodynamic Alterations in the Elderly

Except for drugs eliminated predominantly by renal excretion, it is not possible to generalize on the type, magnitude, or importance of age-related differences in pharmacokinetics. Conflicting data in the literature for various drugs may be attributed to small numbers of subjects studied, differences in selection criteria for subjects, and variation in protocol design. Apparent age-related differences in drug disposition are multifactorial and influenced by environmental, genetic, physiological, and pathological factors.
Treatment and Palliation of Symptoms in Patients With Advanced Pulmonary Arterial Hypertension

Pulmonary arterial hypertension (PAH) is a complex disease in which the illness as well as the associated treatment can be particularly burdensome. Previously considered to be uniformly fatal, PAH treatment and management has improved with an extended survival. However, this can come with symptom burden. Burden can be associated with the disease itself in addition to the treatment aimed at ameliorating these symptoms. This article explores both the use of PAH-directed therapy as well as traditionally supportive treatment strategies for palliation of symptoms in those with PAH. As highlighted in the patient case described throughout this issue, patients are constantly weighing the benefits and burdens of treatment during each step of their journey.
Patient Education: A Change in Review

Hospital patient education committees play a critical role in providing appropriate and easy-to-read patient education materials. As previous literature has noted, health literacy impacts individua...
University and Government Uniting to Address Homeland CyberSecurity Issues

The purpose of this paper is to share the ideas and experiences that California Polytechnic University (Cal Poly) has created to address high priority technology and cybersecurity gaps identified by the current work shortage of cyber professionals, as well as preparing the public sector to defend itself against critical infrastructure attacks as identified by the Department of Homeland Security (DHS).
Selling Renewable Generation with a Penalty for Shortfall

We consider the problem of selling renewable electricity in a two-stage market to a number of load serving entities (LSEs). Since the generation is random, the renewable generator promises to pay a penalty, which is linear in the shortfall, to each LSE. We derive allocation and pricing rules that induce all load serving entities to truthfully bid their willingness to pay per unit of electricity in dominant strategies.
Recent advances in mobile edge computing and content caching

Abstract The demand for digital media services is increasing as the number of wireless subscriptions is growing exponentially. In order to meet this growing need, mobile wireless networks have been advanced at a tremendous pace over recent days. However, the centralized architecture of existing mobile networks, with limited capacity and range of bandwidth of the radio access network and low bandwidth back-haul network, can not handle the exponentially increasing mobile traffic. Recently, we have seen the growth of new mechanisms of data caching and delivery methods through intermediate caching servers. In this paper, we present a survey on recent advances in mobile edge computing and content caching, including caching insertion and expulsion policies, the behavior of the caching system, and caching optimization based on wireless networks. Some of the important open challenges in mobile edge computing with content caching are identified and discussed. We have also compared edge, fog and cloud computing in terms of delay. Readers of this paper will get a thorough understanding of recent advances in mobile edge computing and content caching in mobile wireless networks.
Monitoring Outcomes in Nursing: Quality Improvement

This chapter explores quality assessment and its importance in the Cardiac Intensive Care Unit (CICU). Patient outcomes are dependent upon the care provided and experience of healthcare providers. There are hospital wide and population specific care standards to monitor and improve outcomes. Healthcare providers need to collaborate both within and outside of their organization to aide in identifying problems and improving processes.
Early information needs of adolescents and young adults about late effects of cancer treatment

BACKGROUND Adolescent and young adult (AYA) cancer survivors have high risks of late effects. Little is known about the late-effect information needs of AYAs early in treatment or their role in treatment decision making. This study evaluated the importance, quality, and implications of information about late effects in AYAs recently diagnosed with cancer. METHODS This study surveyed 201 AYAs with cancer who were 15 to 29 years old and were treated at the Dana-Farber Cancer Institute (Boston, Massachusetts). Patients were approached within 6 weeks of their diagnosis and were asked about their late-effect and infertility information needs, treatment decision making, and communication outcomes. RESULTS Forty-five percent of the participants were female; 88% were white. Most AYAs (87% [173 of 200]) considered information about the risks of late effects to be extremely or very important; 80% (159 of 200) valued information about infertility. Many were distressed by information about late effects (53% [105 of 200]) and infertility (45% [89 of 200]); those who considered late-effect information distressing were more likely to value this information (P < .0001). Consideration of late effects (41% [82 of 201]) and infertility (36% [72 of 201]) greatly influenced many patients' treatment decision making. Although 92% of the patients (184 of 199) reported receiving high-quality information about the diagnosis, 57% (113 of 199; P < .0001) and 65% (130 of 199; P < .0001) felt that they had received high-quality information about late effects and infertility, respectively. CONCLUSIONS Most AYAs with cancer value early information about the risks of late effects and infertility, yet many patients felt that they had not received high-quality information about these topics. The development of age-appropriate late-effect communication strategies that recognize high AYA distress may help to address the gap between desired information and perceived information quality.
Advance on synthesis, pharmacokinetics, and pharmacodynamics of the anti-epileptic drug: Levetiracetam

Over the past few decades, many patients around the world have suffered from epilepsy, and epilepsy treatment is a long-term process. Thus, the safety and efficacy of medication for epilepsy are of equal importance. Levetiracetam is a second-generation anti-epileptic drug with a unique mechanism of action, good anti-epileptic efficacy, and safety. The therapeutic field has broad application prospects because levetiracetam offers several advantages over other anti-epileptic drugs. In this review, the synthesis, pharmacokinetics, pharmacodynamics, and reverse reaction of levetiracetam were summarized and discussed. This paper will be helpful for the development and application of levetiracetam.
Evolving Approaches to Treatment of Allosensitization and Antibody-Mediated Rejection

The therapeutic benefits of immune modulatory agents in autoimmunity revealed the pathologic relevance of B cells, plasma cells, and autoantibodies to these diseases. They have also rejuvenated interest in how B cells mediate multiple effector functions including antibody production, antigen presentation to T cells, costimulation, and the production of immune modulatory cytokines. Considerable experience in repurposing these drugs from autoimmunity and cancer immunotherapy, as well as new drug development in transplantation, has yielded important advances in the treatment of antibody-mediated rejection episodes and novel drug development aimed at desensitization to human leukocyte antigens (HLA). After years of slow progress, we now stand on an important threshold that promises many advances in the care of allosensitized patients. Critical to this are efforts to encourage basic scientists, clinical investigators, industry, National Institutes of Health (NIH), our academic societies, and the U.S. Food and Drug Administration (FDA) to continue support of these important objectives. Modification of alloimmunity and alloantibodies will also have relevance to xenotransplantation where the xenoantibodies present a formidable obstacle to advancement of this important therapy. Working together, we can advance transplant therapeutics where biologic agents are likely to play novel and important roles. Here we discuss current and emerging drugs in this area.
Focused Ultrasound-Mediated Blood-Brain Barrier Opening Increases Delivery and Efficacy of Etoposide for Glioblastoma Treatment.

Purpose Glioblastoma (GBM) is a devastating disease. With the current treatment of surgery followed by chemoradiation, outcomes remain poor, with median survival of only 15 months and a 5-year survival rate of 6.8%. A challenge in treating GBM is the heterogeneous integrity of the blood-brain barrier (BBB), which limits the bioavailability of systemic therapies to the brain. There is a growing interest in enhancing drug delivery by opening the BBB with the use of focused ultrasound (FUS). We hypothesize that an FUS-mediated BBB opening can enhance the delivery of etoposide for a therapeutic benefit in GBM. Methods and Materials A murine glioma cell line (Pdgf+, Pten-/-, P53-/-) was orthotopically injected into B6(Cg)-Tyrc-2J/J mice to establish the syngeneic GBM model for this study. Animals were treated with FUS and microbubbles to open the BBB to enhance the delivery of systemic etoposide. Magnetic resonance (MR) imaging was used to evaluate the BBB opening and tumor progression. Liquid chromatography tandem mass spectrometry was used to measure etoposide concentrations in the intracranial tumors. Results The murine glioma cell line is sensitive to etoposide in vitro. MR imaging and passive cavitation detection demonstrate the safe and successful BBB opening with FUS. The combined treatment of an FUS-mediated BBB opening and etoposide decreased tumor growth by 45% and prolonged median overall survival by 6 days: an approximately 30% increase. The FUS-mediated BBB opening increased the brain tumor-to-serum ratio of etoposide by 3.5-fold and increased the etoposide concentration in brain tumor tissue by 8-fold compared with treatment without ultrasound. Conclusions The current study demonstrates that BBB opening with FUS increases intratumoral delivery of etoposide in the brain, resulting in local control and overall survival benefits.
Mental health history and social barriers impacting caregivers of infants with cystic fibrosis

OBJECTIVES Caregivers of infants with cystic fibrosis (CF) carry a heavy treatment burden for their child along with the inherent difficulties of raising an infant. This study investigated the impact of self-reported caregiver mental health diagnoses and social barriers during the 1st year of life on clinical outcomes. METHODS A retrospective chart review was conducted for infants seen in a large tertiary hospital CF clinic over a 5-year period. Baseline characteristics were collected, and documentation from physician and social work notes were reviewed. Demographics and clinical characteristics were compared by the presence or absence of self-reported mental health diagnoses, social barriers, and "emotional concern." RESULTS Analyses were conducted on 71 patients. Thirty-five percent of caregivers disclosed mental health diagnoses, 52% identified social barriers to care, and 55% reported feeling upset or fatigued. Having a caregiver with a self-reported mental health diagnosis was associated with tobacco smoke exposure (p < .001) and increased odds of hospitalizations (odds ratio [OR], 3.01; 95% confidence interval [CI], 1.49-6.06), emergency department/urgent care visits (OR, 3.17; 95% CI, 1.32-7.64), and longer lengths of stay (OR, 1.93; 95% CI, 1.69-2.20). Caregivers who expressed emotional concern had infants with significantly lower weight-for-length percentiles (p = .012). DISCUSSION Caregiver mental health and social barriers to care are important determinants to address as they may impact clinical outcomes in infants with CF. Identifying barriers and struggles early increases the likelihood that clinical teams can intervene and provide support. Further research into mental health and socioeconomic barriers faced by caregivers of infants with CF is crucial.
Universal entropy and hawking radiation of near-extremal AdS4 black holes

We compute the Bekenstein-Hawking entropy of near-extremal asymptotically AdS4 electrically charged rotating black holes using three different methods: (i) from the gravity solution, (ii) from the near-horizon Kerr/CFT correspondence and (iii) from the boundary conformal field theory. The results from these three different approaches match exactly, giving us a unique and universal expression for the entropy and the microstate counting of near-extremal AdS black holes via the AdS/CFT correspondence. In the second method, we extend the Kerr/CFT correspondence to the near-extremal case to compute the left and right central charges. We also use hidden conformal symmetry of the near-horizon geometry to compute the Frolov-Thorne temperatures. From the results of the near-extremal AdS4 black hole entropy, we provide a microscopic foundation for Hawking radiation.
Allied Command Operations/Supreme Headquarters Allied Powers Europe (ACO/SHAPE)

This is the most senior headquarters at the strategic level, and it traces its lineage to the Allied Powers of World War II. Here, political end states are translated into military objectives and milestones, and accordingly, military planners conduct high-level reviews to develop plans to put into execution its strategy. Likewise, SHAPE/ACO coordinates force generation conferences to convince nations to contribute to NATO Response Force standby operations, and looks to help garner support for NATO member nations (and others) to contribute forces to future operations like they have in recent times in Afghanistan and Kosovo. It is at this level that ACO will designate one of the operational level headquarters to oversee the day-to-day execution of operations. Through Allied Command Transformation (ACT), it looks to conduct exercises designed to help prepare the two operational commands: Allied Joint Force Command Brunssum, and Allied Joint Force Command Naples to take over the standby mission for the NATO Response Force (NRF).
Comparative Synthesis: Learning Optimal Programs with Indeterminate Objectives.

Quantitative program synthesis aims to generate a program that satisfies not only boolean specifications but also quantitative objectives. Nonetheless, obtaining precise quantitative objectives per se can be a challenging task. In this paper, we propose comparative synthesis, a bootstrapping quantitative synthesis framework in which an indeterminate objective and a satisfying program are synthesized in tandem. The key idea is to make comparative queries to learn the user's preference over candidate programs, with which objectives can be conjectured. These objectives, which are indeterminate as they can be refined along the course of user interaction, guide the search of satisfying programs. Within the comparative synthesis framework, we developed two novel comparative synthesis procedures (CLPs) with the aim of minimizing the number of queries to the user. We prove that both CLPs converge and use them in two case studies: generating bandwidth allocations for network design and solving SyGuS benchmarks with syntactic objectives. Experiments show that our framework can successfully synthesize satisfying/optimal solutions by making queries only, without a priori knowledge about the quantitative objective.
Testicular sperm extraction vs. ejaculated sperm use for nonazoospermic male factor infertility.

Objective To study the potential benefit of testicular sperm compared with ejaculated sperm for men with oligospermia. Design After exemption from institutional review board approval, we performed a retrospective cohort study using the Mayo Clinic Assisted Reproductive Technology database. Setting Single academic center. Patient(s) Couples with nonazoospermic male factor infertility (total motile sperm Intervention(s) In vitro fertilization, Intracytoplasmic sperm injection, TESE. Main Outcome Measure(s) The primary outcome was live birth rate. The secondary outcomes were fertilization rate, blastulation rate, pregnancy rate, and miscarriage rate. Result(s) Subjects in the two groups were similar in age, body mass index, and ovarian reserve. Baseline sperm parameters were similar in the two groups: total motile sperm (5.4 in the ejaculate sperm group vs. 3.6 million motile per ejaculate), except that baseline motility was higher in the group that used ejaculated sperm (40% vs. 29%). The total number of mature oocytes retrieved was similar in the two groups, but the use of TESE was associated with a 20% decrease in fertilization (60.0% vs. 80.6%) and half the number of blastocyst embryos (two vs. four) compared with ejaculated sperm. Compared with ejaculated sperm, use of TESE did not improve the miscarriage rate (11% vs. 9%) or the live birth rate (50.0% vs. 31.3%). Conclusion(s) Patients with male factor infertility and oligozoospermia did not have improved ICSI outcomes with the use of TESE samples compared with ejaculated sperm.
Is There a Transcript?: Mapping Access in the Multimodal Designs of Popular Podcasts

Podcasting has grown into an established mode of cultural production, knowledge making, and community building. Though podcasts are commonly designed within multimodal content systems, transcript availability for many podcast series remains uneven. I survey the webpages of 94 English-language podcasts (two each sampled from 47 podcast production networks) in order to measure the availability and findability of official transcripts. With this research, I begin to both investigate the limits of podcasting's practical attention to access and question some of the values, priorities, and assumptions that underly the conventions of podcasting. Transcript availability matters for purposes of inclusion and for the empowerment of audiences who hope to engage with podcasting conversations for scholarship, activism, or coalition-building. This small study forms a foundation from which we can continue building the infrastructure needed to make transcripts more expected and more widely available.
Continuous Random Variables and Probability Distributions

As mentioned at the beginning of Chap. 2, the two important types of random variables are discrete and continuous. In this chapter, we study the second general type of random variable that arises in many applied problems. Sections 3.2 and 3.3 present the basic definitions and properties of continuous random variables, their probability distributions, and their various expected values. The normal distribution, arguably the most important and useful model in all of probability and statistics, is introduced in Sect. 3.4. Sections 3.5 and 3.6 discuss some other continuous distributions that are often used in applied work. In Sect. 3.7, we introduce a method for assessing whether given sample data is consistent with a specified distribution. Section 3.8 presents methods for obtaining the distribution of a rv Y from the distribution of X when the two are related by some equation Y = h(X). The last section of this chapter is dedicated to the simulation of continuous rvs.
Medical treatment for the terminally ill: the 'risk of unacceptable badness'

When patients or their families rarely request inappropriate end of life care in the ICU for capricious reasons. End of life treatment decisions that only prolong discomfort and death are usually emotional and based on unrealistic expectations. I explore some of those reasons in this paper.
DNA polymerase III accessory proteins. I. holA and holB encoding delta and delta

The genes encoding the delta and delta' subunits of the 10-subunit Escherichia coli replicase, DNA polymerase III holoenzyme, have been identified and sequenced. The holA gene encoding delta is located downstream of rlpB at 15.2 min and predicts a 38.7 kda protein. The holB gene encoding delta' is located at 24.3 min and predicts a 36.9-kDa protein. Hence the delta and delta' subunits are unrelated proteins encoded by separate genes. The genes have been used to express and purify delta and delta' in quantity. The predicted amino acid sequence of delta' is homologous to the sequences of the tau and gamma subunits revealing a large amount of structural redundancy within the holoenzyme.
Intrinsic Religiosity and Volunteering During Emerging Adulthood: A Comparison of Mormons with Catholics and Non‐Catholic Christians

Emerging adulthood is a period when religious beliefs are likely to be shaped. Studying the influence of religious culture on prosocial behavior among emerging adults aids our understanding of the process and effects of religious socialization. Mormon religious culture places a particularly strong emphasis on caring for family and fellow Mormons. Because intrinsically religious individuals internalize their religious community's values, we hypothesized that the relationship between intrinsic religiosity and volunteering would be stronger among Mormons than among Catholics or non-Catholic Christians. We tested this hypothesis using a sample of Mormon (N = 118), Catholic (N = 304), and non-Catholic Christian (N = 542) emerging adults (18–29 year olds) across three volunteering contexts (religious, family, and secular). Controlling for extrinsic religiosity and worship attendance, the relationship between intrinsic religiosity and frequency of volunteering was greater among Mormons than Catholics and non-Catholic Christians in the context of religious and family volunteering. However, intrinsic religiosity was not a significant predictor of secular volunteering. Our findings suggest that Mormon culture influences the frequency and type of volunteering engaged in by young Mormon adults.
Managerial Performance Evaluation and Real Options

ABSTRACT: In a dynamic setting with demand following a random process, we ask how investment and operating decisions can be delegated to a manager with unknown time preferences. Only the manager observes the demand realization in each period and, therefore, has private information when choosing whether to acquire the productive asset and, subsequently, how to utilize it. We derive accrual accounting-based performance measures under which the manager will make the efficient decisions provided the investment date is exogenously given. We show that in an environment where demand follows a martingale process, the corresponding accounting rules are more decelerated if the firm has the option to idle capacity in case of negative demand shocks. We then describe the limitations of accounting-based performance measures in a scenario where the investment date is endogenously determined, i.e., the firm has an option to wait.
Charge balancing fill rate monitor

A fill rate monitor has been developed for the NSLS storage rings to allow machine tuning over a very large dynamic range of beam current. Synchrotron light, focused on a photodiode, produces a signal proportional to the beam current. A charge balancing circuit processes the diode current, creating an output signal proportional to the current injected into the ring. The unit operates linearly over a dynamic range of 120 dB and can resolve pulses of injected beam as small as 1 /spl mu/A.
Use of plastic films for aeration in soil incubation experiments

Abstract Gas Chromatographie studies showed that various plastic films tested are not sufficiently permeable to carbon dioxide and oxygen to permit their use for aeration in soil incubation experiments. When films having a thickness of 1 mil were compared under conditions commonly used in soil incubation experiments, their permeabilities to oxygen and carbon dioxide decreased in the order: polyethylene > Teflon > polypropylene > cellulose acetate > nylon, Saran, or Mylar. Polyethylene film having a thickness of 0.5 mil (1 mil = 10−3 in) is considerably more permeable to oxygen and carbon dioxide than is the 1-mil film commonly used for aeration in soil incubation experiments, but its advantage in this respect is offset by its higher permeability to water vapor.
Scanning laser ophthalmoscopic analysis of the pattern of visual loss in age-related geographic atrophy of the macula

Purpose We explored the clinical impression that geographic atrophy of the retinal pigment epithelium, a form of advanced age-related macular degeneration, is perceived by the patient as progressing gradually, even when fixation switches from foveal to extrafoveal. Methods We analyzed the responses of 60 patients with geographic atrophy to a questionnaire administered as part of a five-year study of the natural course of geographic atrophy, funded by the National Eye Institute. We performed scanning laser ophthalmoscope perimetry on all patients. We examined two additional patients with geographic atrophy who reported abrupt visual loss. Results No eye with geographic atrophy was reported by any patient to have had sudden visual loss. Although most patients with geographic atrophy show foveal fixation until the fovea is atrophic and then show extrafoveal fixation, scanning laser ophthalmoscope perimetry in three patients with geographic atrophy showed alternation between a foveal and an extrafoveal retinal locus for fixation. Two patients with geographic atrophy who complained of abrupt visual loss were found to have occult choroidal neovascularization, which evolved in one patient to classic choroidal neovascularization. The neovascularization was difficult to detect because of the presence of geographic atrophy and its associated ophthalmoscopic and fluorescein angiographic features. Conclusions Visual loss in geographic atrophy is nearly always perceived by the patient as being gradual, even when considerable decreases in visual acuity occur and when foveal vision and fixation are lost. A possible explanation for this perception is that there is a transitional period during which a patient uses both a foveal and extrafoveal site for fixation. The complaint of abrupt visual loss in a patient with geographic atrophy should raise the suspicion of choroidal neovascularization, which may be occult and difficult to detect.
Physical modeling of RF source generation based on electro-optic modulation and laser injection locking

In this paper we present a frequency domain method to model the physical behavior of widely tunable (1-100GHz) and spectrally pure (1Hz linewidth) RF source, generated by down-mixing of two coherent DFB lasers with a desired RF frequency offset. Rate equations that govern master and injection locking laser behavior are used, and linearization process is followed to derive phase and intensity noise responses by carefully examining the components in the system. Various noise sources are incorporated into the model to explore their significance to final system performance. The phase noise, and RF linewidth are simulated to evaluate the system performance of the generated RF sources.