cssi/SciSciGPT-SciSciNet huggingface dataset:
Plasma LH concentrations for prepubertal, postpubertal, anestrous and cyclic ewes of varying fecundity.

Plasma concentrations of luteinizing hormone (LH) and ovulation rates were studied in various breeds of prepubertal postpubertal anestrous and cyclic ewes. Pulsatile releases of LH which significantly (p less than .01) decreased in magnitude with age were observed in prepubertal females. Yearling ewes showed significantly higher concentrations of LH than mature ewes (p less than .01). Midanestrous LH concentrations were significantly higher than late anestrous values in yearlings (p less than .05). The ovulation rate for Finnsheep ewes was significantly higher than that for other breeds (lambs p less than .05; yearlings p less than .01) but did not correlate with plasma LH concentrations within or between breeds. It is concluded that the relationship between plasma LH concentrations and ovulation rates is highly variable and age-dependent.
Optimizing interconnection complexity for realizing fixed permutation in data and signal processing algorithms

In hardware implementation of several widely used data and signal processing algorithms, data permutations need to be performed between the consecutive computation stages consisting of parallel computational units. Recently, some highly data parallel streaming architectures for data permutation have been proposed to achieve high throughput. However, the interconnection complexity of these designs increases dramatically with the problem size and data parallelism. In this paper, we develop a hardware structure to perform data permutation with optimized interconnection complexity, denned as the interconnection area per throughput. We propose a novel design technique such that the required interconnection logic is highly reduced for realizing a fixed permutation on streaming data. Our experimental results show that the proposed design technique reduces interconnection complexity by 27.3% to 75.8%, and improves the throughput by 5.3%∼129% and the energy efficiency by 1.2×∼3.5× compared with the state-of-the-art.
Dorsal Tunica Albuginea Plication for Hypospadias Curvature

A systematic approach is described to correct congenital penile curvature using intraoperative artificial erection, preservation of the urethral plate when possible, tunica albuginea plication to straighten the penis and island flap urethroplasty (onlay and tube) when needed. After many years of experience we recognize that curvature correction is not necessarily enhanced by division of a healthy urethral plate. To correct inherent congenital curvature or corporeal disproportion we use a modification of the Nesbit dorsal tunica albuginea plication.
Toward Early, Personalized, Rational Polypharmacy In Psychiatry: A Tri-Dimensional Approach

Psychiatry is a complex field of medicine in which a growing understanding of the underlying disease biology is not fully integrated into clinical practice.Diagnosis is based on subjective personal history and clinical criteria. The latter are chosen through a consensus process by committees of experts in the field, and encoded in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and its international homologue, the International Classification of Diseases. These criteria are re-evaluated and updated periodically, on average every two decades, although the pace is likely to accelerate. The lack of objective diagnostic tests and empirical data-based approaches to psychiatric classification are possible reasons for the relative lack of reproducibility in psychiatric clinical trials. After participating in this activity, the psychiatrist should be better able to:
Proteomes and Biomarkers of the Neurovascular Unit

Brain vessels display a distinct phenotype that includes tight junctions and barrier properties of brain endothelial cells, as well as their close association with glial cells and neurons that enable tight coupling of blood flow with brain tissue energy demand. Brain vessels undergo profound molecular, physiological, and anatomical changes and reorganization in response to injury or disease. These changes can be analyzed using integrated system biology approaches. Screening and analyses of protein expression and modifications and their association with pathophysiological vascular responses are an important research approach to identify translational vascular targets and biomarkers useful for modifying or monitoring cerebrovascular disease. This is accomplished by deploying highly sensitive mass spectrometry–based techniques, ranging from whole-proteome screening to targeted quantitative proteomics. This chapter will summarize recent advances in applying these methods to build a neurovascular unit (NVU) “Carta,” an integrated collection of dynamic proteomes of cellular and subcellular compartments of the NVU and brain vessels isolated by various techniques from animal and human brains.
Do premedical students know what they are getting into

The number of medical school applications continues to rise despite recent reports of decreased physician job satisfaction. To better understand this paradoxical trend, I surveyed 84 premedical students about their expectations of a medical career. Almost all respondents anticipated that as physicians they would be able to cure, heal, and help their patients (98%) and that their work would be intellectually satisfying (95%). Most anticipated that their jobs would be prestigious (83%) and even fun (73%). Far fewer than half the respondents would be discouraged from pursuing a medical career by the fear of being sued (38%), business worries (22%), or administrative duties (20%). Comparison of the student responses with results of a physician job satisfaction survey carried out the same year showed that the students, as a group, were modestly idealistic with respect to the daily work of being a physician and somewhat naive about the problems caused by various business and administrative issues. I conclude that premedical students could be better informed about the current reality of being a physician and that practicing physicians are responsible for providing this education.
Changes in Legal Education and Legal Ethics: Article: Getting Past Legal Analysis...Or How I Learned to Stop Worrying and Love Teaching Rape

Long after the rape chapter was over, when we had moved on to inchoate crimes and cases involving "call girls" and conniving defendants who took messages for them in an era before voicemail - protagonists with whom my students, it seemed safe to wager, were unacquainted - the thoughtful young man from the third row stopped in to ask, "What was the take away from the classes on rape?" My hope is that, in explaining my approach to teaching rape, I will also address the deeper themes afoot in contemporary critiques of legal education: whether and how law schools are training students for the practice of law, and what practical use, if any, is served by scholarship among legal academics. These interviews, combined with years of teaching the edited appellate opinion in my casebook, convinced me that I could use the case to surface themes and teach skills often left out of the first-year classroom. Before class, I divided the students into small groups, assigning each group a distinct rape statute, and required them to apply their statutes to the police statements in order to advise the state's attorney about the merits of prosecuting the case. In a class on rape, the search for "bad facts" forces students to retell two stories - the victim's and the defendant's - in legally relevant ways. The state charged both boys with rape, and at first blush, the facts underlying Juan G. Either way, rape victim advocates felt certain that civil remedies could have offered Laura more than criminal law did. Has sexual contact or sexual intercourse with another person without consent of that person and causes injury, illness, disease or impairment of a sexual or reproductive organ, or mental anguish requiring psychiatric care for the victim.
Examining Youth’s Mathematics Practices in an After-School Robotics Team

Sixteen-year-old Joseph and his teammate, Kim, were in the process of determining a diagonal length on the robot competition field. After consulting the competition manual and measuring several side lengths, Joseph realized that he might need to use some geometric principles to calculate the missing diagonal length. It was at this point that he called across the room to Ms. Miller, the team advisor, who was also a math teacher in the high school, indicating that, “We need geometry!”
Improvements in Colorectal Cancer Incidence Not Experienced by Nonmetropolitan Women: A Population-Based Study From Utah.

Purpose Little is known about disparities in colorectal cancer (CRC) incidence and mortality by community-level factors such as metropolitan status. Methods This analysis utilized data from the Surveillance, Epidemiology, and End Results (SEER) program from Utah. We included patients diagnosed with CRC from 1991 to 2010. To determine whether associations existed between metropolitan/nonmetropolitan county of residence and CRC incidence, Poisson regression models were used. CRC mortality was assessed using multivariable Cox regression models. Findings CRC incidence rates did not differ between metropolitan and nonmetropolitan counties by gender (males: 46.2 per 100,000 vs 45.1 per 100,000, P = .87; females: 34.4 per 100,000 vs 36.1 per 100,000, P = .70). However, CRC incidence between the years of 2006 and 2010 in nonmetropolitan counties was significantly higher in females (metropolitan: 30.4 vs nonmetropolitan: 37.0 per 100,000, P = .002). As compared to metropolitan counties, the incidence of unstaged CRC in nonmetropolitan counties was significantly higher in both males (1.7 vs 2.8 per 100,000, P = .003) and females (1.4 vs 1.6 per 100,000, P = .002). Among patients who were diagnosed between 2006 and 2010, metropolitan counties were found to have significantly increased survival among males and females, but nonmetropolitan counties showed increased survival only for males. Conclusions While we observed a decreasing incidence of CRC among men and women in Utah, this effect was not seen in women in nonmetropolitan areas nor among those with unstaged disease. Further studies should evaluate factors that may account for these differences. This analysis can inform interventions with a focus on women in nonmetropolitan areas.
A Debt Against the Living: An Introduction to Originalism

Thomas Jefferson famously wrote that the earth belongs to the living. His letter to James Madison is often quoted for the proposition that we should not be bound to the 'dead hand of the past', suggesting that the Constitution should instead be interpreted as a living, breathing document. Less well-known is Madison's response, in which he said the improvements made by the dead - including the US Constitution - form a debt against the living, who benefit from them. In this illuminating book, Ilan Wurman introduces Madison's concept of originalism to a new generation and shows how it has shaped the US Supreme Court in ways that are expected to continue following the death of Justice Antonin Scalia, one of the theory's leading proponents. It should be read by anyone seeking a better understanding of originalism and its ongoing influence on the constitutional jurisprudence of the Supreme Court.
Transonic Panel Flutter Predictions Using a Linearized Stability Formulation

A methodology is presented for prediction of dynamic instabilities arising from fluid–structure coupling. The inviscid compressible Euler equations are linearized about a steady-state solution and ...
Neonatal immune response to rhinovirus A16 has diminished dendritic cell function and increased B cell activation.

BACKGROUND Rhinovirus infections during infancy account for the majority of respiratory illness health care utilization and are an associated risk factor for subsequent development of allergic asthma. Neonatal type I interferon production is diminished compared to adults after stimulation with TLR agonists. However, broad profiling of immune cell responses to infectious rhinovirus has not been undertaken and we hypothesized that additional immune differences can be identified in neonates. In this study, we undertook a comparative analysis of neonatal and adult blood immune cell responses after in vitro incubation with infectious RV-A16 for 6 and 24 hours. METHODS Intracellular proinflammatory and type I interferon cytokines along with expression of surface co-stimulatory and maturation markers were measured using multi-parameter flow cytometry. RESULTS Both circulating myeloid dendritic cell (mDC) and plasmacytoid dendritic cell (pDC) frequency were lower in cord blood. Qualitative and quantitative plasmacytoid dendritic cell IFN-alpha + TNF- alpha responses to rhinovirus were significantly lower in cord pDCs. In cord blood samples, the majority of responsive pDCs were single-positive TNF-alpha producing cells, whereas in adult samples rhinovirus increased double-positive TNF-alpha+IFN-alpha+ pDCs. Rhinovirus upregulated activation and maturation markers on monocytes, mDCs, pDCs, and B cells, but CD40+CD86+ monocytes, mDCs, and pDCs cells were significantly higher in adult samples compared to cord samples. Surprisingly, rhinovirus increased CD40+CD86+ B cells to a significantly greater extent in cord samples compared to adults. CONCLUSIONS These findings define a number of cell-specific differences in neonatal responses to rhinovirus. This differential age-related immune response to RV may have implications for the immune correlates of protection to viral respiratory illness burden and determination of potential biomarkers for asthma risk.
Early Disseminated Lyme Disease Masquerading as Mononucleosis: A Case Report

Abstract Background Disseminated Lyme disease can be difficult to diagnose, as it begins with nonspecific signs and symptoms, which, if not treated correctly, can lead to atrioventricular conduction blocks and meningitis. In addition, the diagnosis can be further complicated by potentially false-positive test results. Case Report We report a case of early-disseminated Lyme disease presenting with Borrelia meningitis and concomitant Lyme carditis, which was misdiagnosed as mononucleosis. A young, previously healthy patient had been hiking in the woods of upstate New York and 4 weeks later developed fever, night sweats, and myalgias. He was diagnosed with mononucleosis via a positive rapid heterophile agglutination antibody test to the Epstein-Barr virus at a walk-in clinic and was started on medications, but then subsequently developed left hip pain, a facial droop, and a very long first-degree atrioventricular conduction block. He went to the Emergency Department, where he had testing that confirmed disseminated Lyme disease. Why Should an Emergency Physician Be Aware of This? This case highlights the difficulty in early diagnosis of disseminated Lyme disease and how a potentially false-positive laboratory test can lead to the complications of Borrelia meningitis and Lyme carditis in untreated young healthy patients. Emergency physicians need to consider Lyme disease in patients with nonspecific signs and symptoms, especially if they have been outdoors for prolonged periods of time in Lyme-endemic areas.
Continuing Bonds and Psychosocial Functioning in a Recently Bereaved Pet Loss Sample

Research has shown that pet loss can be a devastating and complex experience for some human survivors, yet this loss may not be fully recognized by friends, partners, or acquaintances as a signific...
Water Column Ammonium Concentration and Salinity Influence Nitrogen Uptake and Growth of Spartina Alterniflora

Abstract Salt marsh macrophytes, such as Spartina alterniflora, play a critical role in uptake and transformation of inorganic nitrogen before it reaches coastal waters, but it may be possible to exceed S. alterniflora nitrogen uptake capacity, particularly when salinity is elevated. While it is well known how inorganic nitrogen availability or salinity influences S. alterniflora nitrogen uptake individually, investigating the combined effects of both factors is essential because changes in inorganic nitrogen supply often occur simultaneously with altered freshwater flow. Nitrogen uptake and growth responses of Spartina alterniflora to inorganic nitrogen (0, 10, or 100 μM ammonium, NH4+) and salinity (20, 30, or 40) treatments were measured in greenhouse microcosms with tidal simulation. Water column NH4+ uptake decreased as salinity increased with the addition of 10 μM NH4+ after 48 h. In contrast, with 100 μM NH4+ addition uptake rates were twice as high in the lowest (20) and highest (40) salinity compared to the mid-level (30) salinity treatment. After 6 months, above and belowground S. alterniflora plant tissue NH4+ uptake (δ15N) decreased by 50% with increasing salinity across all NH4+ addition treatments. Furthermore, at the highest salinity, above and belowground biomass, stem density and culm height were greater in the 10 μM NH4+ addition compared to the 0 and 100 μM NH4+ addition, indicating potential for low-level NH4+ additions to mitigate salinity-induced stress. Overall the effects of salinity on S. alterniflora nitrogen uptake and biomass generally outweighed those of water column N concentration, suggesting the interaction of salinity and nutrient loading should be considered when developing predictive models for the fate of coastal ecosystems under changing environmental conditions.
Emergency Kidney Transplantation in Recipients With Iliocaval Thrombosis Using Splenic Vessel Anastomosis After Splenectomy: A Case Series.

Abstract Background The external iliac vein is the standard site used for venous anastomosis in kidney transplantation. When a pre-transplantation diagnosis of iliocaval thrombosis is established, a different and suitable venous drainage for the renal outflow must be identified for successful transplant. Methods We report 4 cases of kidney transplantation, performed from 2004 to 2016, in recipients presenting with thrombosis of the inferior vena cava and iliac system needing, because of the lack of access for dialysis, urgent kidney transplantations. The splenic vessels were used in all cases for the graft’s vascular anastomosis after splenectomy. Results Kidney transplantation after splenectomy, with anastomosis of the renal vessels to the splenic ones, was completed in all 4 patients. All of the cases were technically successful with good renal function on discharge. During the follow-up, no graft losses were registered as due to thrombotic event or inadequate renal venous outflow. A normal vascular inflow and outflow was confirmed by means of follow-up ultrasound. Two grafts were lost at 31 months and 91 months, both to noncompliance with immunosuppressive therapy. The other 2 are currently functioning well. Notably, the kidney’s position in the left upper quadrant has not caused technical difficulties in urologic reconstruction. Conclusions In our experience, kidney transplantation using splenic vessels for vascular anastomosis is technically feasible and very useful in the setting of complete iliocaval thrombosis.
Improving Quality in the Care of Patients with Inflammatory Bowel Diseases

Efforts to improve healthcare quality were firmly established before the Institute of Medicine (IOM) historic 2000 and 2001 reports, To Err is Human Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century Despite the long-standing healthcare quality improvement (QI) efforts that date back to the turn of the 20th century, the IOM reports significantly advanced the awareness of healthcare quality deficits and the resulting risk to patients from those gaps in care. Studies immediately following the IOM reports emphasized and verified the presence of detrimental care gaps and highlighted a myriad of contributing factors. Studies focused specifically on the inflammatory bowel diseases (IBD), Crohn's disease and ulcerative colitis , demonstrated suboptimal patient outcomes stemming from, in part, system and provider variation. In the years that have followed, research studies have shown the persistence of suboptimal outcomes in IBD despite an awareness of key drivers for poor care quality and concerted efforts in advancing QI initiatives. In 2017, IBD advocacy groups and provider networks have demonstrated progress in furthering both pediatric and adult IBD outcomes through the use of QI methods and tools including collaborative learning networks. A significant amount of work lies ahead, however, to build upon these advances and improve IBD outcomes further. This article reviews the history of quality initiatives in healthcare, identifies ongoing gaps in IBD care with a review of current IBD improvement efforts taking place, and identifies several targets for improving IBD care quality moving forward into the 21st century.
Juno's science planning process: Development and evolution since launch

NASA's Juno spacecraft arrived at Jupiter on July 4, 2016 after a 5-year interplanetary cruise. In initial concept, Juno's science planning and operations process was extremely simple, with instruments operating in a very repetitive (from orbit to orbit) and non-interactive fashion. That initially simple, non-interactive, planning process has undergone significant changes and enhancements over the course of the project's lifetime, with the most significant changes occurring after launch. Since Juno's launch in August 2011, a new science investigation has been added (the Radiation Monitoring Investigation, which uses Juno's Stellar Reference Units (SRUs) and Jovian Infrared Auroral Mapper (JIRAM) instrument to monitor the Jovian radiation environment), as has a power modeling process that takes into account the details of instrument operation on any given orbit. Additionally, the planned capture orbit was changed from 107 days to two 53.5-day orbits, and the planned science orbit was changed from an 11-day period to a 14-day period. Lastly, a tactical science planning process was developed in order to allow Juno's science teams to make changes to their observation plans from one orbit to the next, a capability that did not exist in the original baseline. Since arrival at Jupiter, the science planning process and timeline has undergone further changes, as the project chose to remain in the 53-day period capture orbit for the entirety of the science mission. In this paper, I will discuss the drivers that led to the significant changes to Juno's initial baseline science planning process that were implemented during cruise, how these new processes were developed, and how they were to be implemented for the instrument teams and the Juno mission system as a whole. Budgetary and human-factor impacts, such as workload considerations, will also be discussed, when applicable. We will discuss the post-Jupiter Orbit Insertion (JOI) change to Juno's science orbit through the lens of science planning and operations, and discuss how the process Juno currently uses was finally settled on.
SunRISE status: Concept development update

The authors present an update on the Sun Radio Interferometer Space Experiment (SunRISE) mission concept. SunRISE is space-based sparse array, composed of formation flying SmallSats designed to localize the radio emission associated with coronal mass ejections (CMEs) from the Sun. Radio emission from CMEs is a direct tracer of the particle acceleration in the inner heliosphere and potential magnetic connections from the lower solar corona to the larger heliosphere. Furthermore, CME radio emission is quite strong such that only a relatively small number of antennas is required, and a small mission would make a fundamental advancement. Indeed, the state-of-the-art for tracking CME radio emission is defined by single antennas (Wind/WAVES, Stereo/SWAVES) in which the tracking is accomplished by assuming a frequency-to-density mapping. The paper presents the most recent updates on this mission concept, starting with an overview of the science requirements. It then focuses on the SunRISE concept of operations, which consists of six SmallSats placed in a geostationary graveyard orbit for 6 months to achieve the aforementioned science goals. Each of the mission phases are discussed in detail. Finally, the paper dives into SunRISE's science data processing process, including simulation results, demonstrating how the data will produce sufficient to achieve the science goals.
Say’s Law, Marxian Crisis Theory and the Interconnectedness of the Capitalist Economy

Scholars have long debated exactly why Marx felt that general gluts were not just possible, but inevitable. This article argues that Theories of Surplus Value anchored that necessity in the complex...
Crossed Products of Hopf Algebras and Enveloping Algebras

The notion of crossed products for Hopf algebras acting (weakly) on non-commutative algebras is discussed together with the “splitting theorem” of Blattner-Cohen-Montgomery that a Hopf algebra H may be written as a crossed product over a homomorphic image \( \bar H \) provided the map H —→ \( \bar H \) is split as a coalgebra map.
Using Literature as an Aid to Practice

Literature, both fiction and autobiography, can be used by practitioners to understand clients' moral imperatives, constructions of meaning, and subjective dimensions of caregiving. Clients' storie...
P032 Edta elucidates unexpected crossmatch results

Introduction Pretreatment of serum with ethylenediaminetetraacetic acid (EDTA) eliminates interfering components and provides a clearer, more accurate antibody (Ab) profile in luminex single antigen (SA) antibody detection assays. Some patient sera do not show obvious signs of interference but have high background (i.e. binding to NC bead devoid of HLA antigen). We report the case of a highly sensitized patient with hidden reactivity to class I antigens revealed by EDTA, but confounded by treatment to reduce high background. Methods DC is a 64 yo Asian male who received a deceased donor (DD) kidney transplant (Tx) in 1984, but since 2005 has had MPGN and is currently listed for a second kidney Tx. His antibody profile has remained stable the past few years (cPRA 49–57%). His serum has been historically treated with Adsorb Out™ (AO) to remove high background. The strongest Ab reactivity in AO treated sera has been against class I: A3, A11, A25, A26, A29, A43. However, recent flow crossmatches (XMs) against two DD cells were strong B and T cell positive in the absence of any strong or discernible DSA, with delta channel shifts (DCS) of 350–400. One DD typed for A1, the other A11 so we suspected an epitope/CREG reactivity since the actual DSA levels to A1 and A11 were low to moderate (MFI = 616–3,155), which did not correlate with the strong positive flow XMs. We decided to treat the patient’s sera with EDTA, instead of the routine AO treatment, for the SA assay and discovered a significant increase in A1 Ab (MFI = 23,274) and A11 (MFI = 20,622). In fact, all Abs previously detected by AO treatment, displayed significantly higher MFI levels after EDTA treatment. Although the background reactivity to the NC bead was higher in EDTA treated compared to AO treated sera, it was within acceptable limits of the assay. We then EDTA and AO treated this patient’s serum and found no significant difference compared to the EDTA alone treated sample (A1 MFI = 23,226, A11 MFI = 21,672). Conclusion Despite what may appear as clear, consistent patient Ab data over the course of months to years, it is imperative to continually monitor Ab profiles carefully, to reveal possible epitopes and changing trends. Ab testing by SA assays must also be interpreted in concert with XM data to ensure proper unacceptable antigens are in UNET and to ultimately provide an optimal Tx outcome.
The role of heart binding antibodies in rheumatic fever.

It is obvious to any student of cardiology that the heart may be injured in a number of ways only some of which are immunologically mediated. However as our knowledge of cardiac pathologic mechanisms increases, it is this author’s opinion that immunological mechanisms will play a much greater role in cardiac pathology than has hitherto been suspected. On this note I would like to review with you at least one example where a microbial-host immunological interaction appears to play a dominant role in causing cardiac damage. Hopefully further knowledge of this disease state may provide information concerning a number of myocardial diseases the etiology of which is still unknown.
Adopting an Activity-Based Cost Management Model at A Community College: A Case Study

This paper discusses the key findings from a qualitative case study examining the implementation of an activity-based cost management model (ABC model) at a large community college. In a climate of...
NeuADC: Neural Network-Inspired RRAM-Based Synthesizable Analog-to-Digital Conversion with Reconfigurable Quantization Support

Traditional analog-to-digital converters (ADCs) employ dedicated analog and mixed-signal (AMS) circuits and require time-consuming manual design process. They also exhibit limited reconfigurability and are unable to support diverse quantization schemes using the same circuitry. In this paper, we propose NeuADC — an automated design approach to synthesizing an analog-to-digital (A/D) interface that can approximate the desired quantization function using a neural network (NN) with a single hidden layer. Our design leverages the mixed-signal resistive random-access memory (RRAM) crossbar architecture in a novel dual-path configuration to realize basic NN operations at the circuit level and exploits smooth bit-encoding scheme to improve the training accuracy. Results obtained from SPICE simulations based on 130nm technology suggest that not only can NeuADC deliver promising performance compared to the state-of-art ADC designs across comprehensive design metrics, but also it can intrinsically support multiple reconfigurable quantization schemes using the same hardware substrate, paving the ways for future adaptable application-driven signal conversion. The robustness of NeuADC’s quantization quality under moderate RRAM resistance precision is also evaluated using SPICE simulations.
An exploration of the socio-cultural context in immigrant-concentrated neighborhoods with unusual rates of child maltreatment

Despite the field’s understanding of individual and family level predictors of child maltreatment, research on neighborhood indicators of child abuse and neglect, especially in immigrant communitie...
On the molecular etiology of decreased arachidonic (20:4n-6), docosapentaenoic (22:5n-6) and docosahexaenoic (22:6n-3) acids in Zellweger syndrome and other peroxisomal disorders

Alterations in the metabolism of arachidonic (20:4n-6), docosapentaenoic (22:5n-6), and docosahexaenoic (22:6n-3) acids and other polyunsaturated fatty acids in Zellweger syndrome and other peroxisomal disorders are reviewed. Previous proposals that peroxisomes are necessary for the synthesis of 22:6n-3 and 22:5n-6 are critically examined. The data suggest that 22:6n-3 is biosynthesized in mitochondria via a channelled carnitine-dependent pathway involving an n-3-specific delta-4 desaturase, while 20:4n-6, 20:5n-3 and 22:5n-6 are synthesized by both mitochondrial and microsomal systems; these pathways are postulated to be interregulated as compensatory-redundant systems. Present evidence suggests that 22:6n-3-containing phospholipids may be required for the biochemical events involved in successful neuronal migration and developmental morphogenesis, and as structural cofactors for the functional assembly and integration of a variety of membrane enzymes, receptors, and other proteins in peroxisomes and other subcellular organelles. A defect in the mitochondrial desaturation pathway is proposed to be a primary etiologic factor in the clinicopathology of Zellweger syndrome and other related disorders. Several implications of this proposal are examined relating to effects of pharmacological agents which appear to inhibit steps in this pathway, such as some hypolipidemics (fibrates), neuroleptics (phenothiazines and phenytoin) and prenatal alcohol exposure.
On Roughness — Induced Transition: Facts, Views, and Speculations

The mechanisms whereby small distributed roughness promote transition to turbulence are unknown and represent bypasses to known instability scenarios, including the e N design method. Mechanisms associated with single-roughness elements are partially understood (at least at low speeds) but probably not quantifiable. Yet, when favorable-pressure gradient laminar-flow airfoils were designed, roughness was the primary agent which rendered them nonlaminar in practice. Nearly blind correlation from a limited bases of experimental data still governs roughness sensitive designs. The topic was put on the agenda of the workshop first because of its obvious practical importance. Secondly, it is hoped that our vastly improved instrumentation and computer capabilities in the 1990’s may lead to research into the mechanisms themselves and thereby establish a more rational basis for design correlations.
Myopathies presenting with head drop: Clinical spectrum and treatment outcomes.

Abstract Dropped head syndrome can be the presenting feature of a wide spectrum of neurological conditions. In this study, we aimed to define the clinical characteristics and treatment outcomes of 107 patients, where head drop was the presenting or predominant clinical feature of a myopathy. Median age at presentation was 68 years (range 42–88). A specific diagnosis was reached in 53% of patients: Inflammatory myopathy (n = 16), myopathy with rimmed vacuoles (n = 10), radiation-induced myopathy (n = 8), sporadic late-onset nemaline myopathy (n = 7), myofibrillar myopathy (n = 4), facioscapulohumeral dystrophy (n = 3), inclusion body myositis (n = 2), mitochondrial myopathy (n = 2), scleroderma-associated myopathy (n = 2), and single cases of necrotizing autoimmune myopathy, drug-induced myopathy, and B-cell chronic lymphocytic leukemia-myopathy. Splenius capitis had the highest diagnostic yield for a muscle biopsy (67%). When tested, 31/35 (89%) of patients had abnormal pulmonary function tests, 15/30 (50%) abnormal swallow evaluation, 24/65 (37%) abnormal electrocardiogram and 5/38 (13%) abnormal transthoracic echocardiogram. 23/43 (53%) treated patients responded to treatment. Patient-reported limb weakness and neck flexion weakness on physical examination were associated with good response to treatment. A wide spectrum of acquired and hereditary myopathies can present with head drop, some of which are potentially treatable. Establishing a diagnosis is crucial for timely treatment administration, screening for swallowing and cardiorespiratory involvement, and counseling regarding prognosis.
Trends in the use of neoadjuvant chemotherapy for bladder cancer with nonurothelial variant histology: An analysis of the National Cancer Database

Introduction: The aim of this study is to evaluate the trends in the use of neoadjuvant chemotherapy (NAC) over time (2006–2014) for patients diagnosed with muscle-invasive bladder cancer (MIBC) with nonurothelial variant histology (NUVH) in the National Cancer Database. Materials and Methods: We queried the NCDB for patients with muscle-invasive (i.e. cT2-4N0-3M0/X) urothelial carcinoma (UC) of the bladder. We examined demographic, clinical, and pathologic features associated with NAC, also substratifying into pure UC and NUVH. Tests of association were performed using Chi-square/Fisher's exact test for categorical variables and t-tests, ANOVA, or Kruskal–Wallis test for continuous variables. Outcomes were examined with Cox proportional hazards and 90-day mortality with the Kaplan–Meier method. Results: Totally 22,320 patients met our inclusion criteria, of whom 22.6% received NAC. The proportion of NAC increased significantly over time in the neuroendocrine and urothelial cell categories with 57.1% and 34.1% of patients in 2014 receiving NAC vs. 44% and 10.6% in 2006. No other variant histology showed a significant increase across the time sampled. Patients receiving NAC were more likely to have downstaging to pT0 (13.4% vs. 2.7%), negative surgical margin (89.1% vs. 86%), and pN0 (63.2% vs. 60.5%) and were less likely to have 30-day (1.4% vs. 3%) or 90-day (5% vs. 8.3%) mortality. Rates of downstaging to pT0 after NAC were similar among histologies. Conclusion: Neoadjuvant chemotherapy utilization continues to slowly increase in patients with MIBC. Patients with variant histology lag behind in terms of receiving NAC but appear to derive as much benefit as patients with pure urothelial cell bladder cancer.
Reconsidering the Innovation and Ambiguity in Idle Talk under the Bean Arbor (Doupeng xianhua 豆棚閒話)

Scholars have pointed out the originality in the narrative structure and content in the early Qing story collection Doupeng xianhua 豆棚閒話 (Idle Talk under the Bean Arbor; literally, “leisurely chat ...
Pretreatment prognostic factors associated with outcomes for first-line FCR-based treatments in previously untreated CLL.

6517 Background: First-line chemoimmunotherapy with fludarabine, cyclophosphamide, and rituximab (FCR) demonstrated improved outcomes, including survival, for fit patients (pts) with CLL. Modificat...
The Paradox of the Tribal Equalitarian

As Clark and Winegard (this issue) comprehensively demonstrate, tribal psychology is universal. It knows no ideological boundaries. Yes, tribalism-based epistemological group biases occur for conse...
Racial disparities in immune-related adverse events (irAE) of immune checkpoint inhibitors (ICPi) and association with survival based on clinical and biochemical responses.

7025Background: ICPi cause various irAE with thyroid dysfunction as a commonly reported abnormality. There is increasing evidence showing positive association with development of irAE and survival....
How toddlers new to child care become members of a classroom community

Transitioning into child care can bring complex emotional tensions and have a lasting and powerful impact on future separations and caregiving encounters. Despite the increasing number of children ...
Real-Time Automatic Seizure Detection Using Ordinary Kriging Method in an Edge-IoMT Computing Paradigm

Epilepsy is one of the leading neurological diseases in the world, affecting approximately 70 million of the world’s population and often results in early mortality if not properly managed. The primary purpose of seizure detection is to reduce threat to life in the event of a seizure crisis. Previous efforts in the literature concentrate mostly on performance based on accuracy and other similar metrics. However, there is a short time lapse between the onset of a seizure attack and a potential injury that could claim the life of the patient. Therefore, there is the need for a more time-sensitive seizure detection model. We hereby propose a real-time seizure detection model in an edge computing paradigm using the ordinary kriging method, relying on the premise that the brain can be modeled as a three-dimensional spatial object, similar to a geographical panorama where kriging excels. Fractal dimensional features were extracted from patients’ electroencephalogram (EEG) signals and then classified using the proposed ordinary kriging model. The proposed model achieves a training accuracy of 99.4% and a perfect sensitivity, specificity, precision and testing accuracy. Hardware implementation in an edge computing environment results in a mean detection latency of 0.85 s. To the best of the authors’ knowledge, this is the first work that uses the kriging method for early detection of seizure.
Polyethylene glycol-fusion repair of sciatic allografts in female rats achieves immunotolerance via attenuated innate and adaptive responses.

Ablation/segmental loss peripheral nerve injuries (PNIs) exhibit poor functional recovery due to slow and inaccurate outgrowth of regenerating axons. Viable peripheral nerve allografts (PNAs) as growth-guide conduits are immunologically rejected and all anucleated donor/host axonal segments undergo Wallerian degeneration. In contrast, we report that ablation-type sciatic PNIs repaired by neurorrhaphy of viable sciatic PNAs and a polyethylene glycol (PEG)-fusion protocol using PEG immediately restored axonal continuity for many axons, reinnervated/maintained their neuromuscular junctions, and prevented much Wallerian degeneration. PEG-fused PNAs permanently restored many sciatic-mediated behaviors within 2-6 weeks. PEG-fused PNAs were not rejected even though host/donors were neither immunosuppressed nor tissue-matched in outbred female Sprague Dawley rats. Innate and adaptive immune responses to PEG-fused sciatic PNAs were analyzed using electron microscopy, immunohistochemistry, and quantitative reverse transcription polymerase chain reaction for morphological features, T cell and macrophage infiltration, major histocompatibility complex (MHC) expression, apoptosis, expression of cytokines, chemokines, and cytotoxic effectors. PEG-fused PNAs exhibited attenuated innate and adaptive immune responses by 14-21 days postoperatively, as evidenced by (a) many axons and cells remaining viable, (b) significantly reduced infiltration of cytotoxic and total T cells and macrophages, (c) significantly reduced expression of inflammatory cytokines, chemokines, and MHC proteins, (d) consistently low apoptotic response. Morphologically and/or biochemically, PEG-fused sciatic PNAs often resembled sciatic autografts or intact sciatic nerves. In brief, PEG-fused PNAs are an unstudied, perhaps unique, example of immune tolerance of viable allograft tissue in a nonimmune-privileged environment and could greatly improve the clinical outcomes for PNIs relative to current protocols.
Over-voltage Study of AC System at Converter Station of A Multi-terminal UHVDC Project

The over-voltage level directly affects the selection and insulation design of the main equipment in power station. This paper calculates the over-voltage condition of AC lines and equipment in the converter station of Yunnan-Guangxi-Guangdong UHVDC (ultra-high voltage direct current) project. The suppression method and equipment insulation parameters are proposed. The calculation shows that the shunt reactor has obvious effect on limiting the power frequency over-voltage (PFO) of long-distance line. In order to suppress the resonant over-voltage and the secondary arc current, the installation of the neutral point reactor is recommended. The maximum switching over-voltage (SO) can be limited by installing a $400\Omega$ closing resistor to a AC line breaker. The switching over-voltage can be very large during bi-pole blocking at converter station when DC system passively enters into isolated mode. Multiple measures, such as installing metallic oxide arrester (MOA), control and protection optimization, are taken to reduce the overvoltage. The SO is limited below 1.64 p.u. afterwards. The maximum power frequency transient overvoltage level during bi-pole blocking at converter station is calculated as 1.49 p.u., which does not meet the requirements of the over-voltage regulations and should be specified when selecting equipment. The maximum absorption energy of A type arrester is 4245kJ, which is lower than its rated capacity. This paper studies the over-voltage and its suppression method of AC system and provides the basis for the insulation design of transmission line and the selection of main equipment in converter station.
Trade linkages, balance sheets, and spillovers: The Germany-Central European Supply Chain☆

Abstract Germany and the Czech Republic, Hungary, Poland, and Slovakia (the CE4) have been in a process of deepening economic integration which has lead to the development of a dynamic supply chain within Europe—the Germany-Central European Supply Chain (GCESC). Model-based simulations suggest two key policy implications: first, as a reflection of strengthening trade linkages, German fiscal spillovers (stemming from higher public consumption) to the CE4 and more broadly to the rest of the euro area, have increased over time, but are still relatively small. This is explained by the supply chain nature of trade integration: final demand in Germany is not necessarily the main determinant of CE4 exports to Germany. Second, increased trade openness in both Germany and the CE4 implies a greater exposure of the GCESC to global shocks. However, owing to its strong fundamentals—including sound balance sheets and its safe haven status—Germany plays the role of a regional anchor of stability by better absorbing shocks from other trading partners instead of amplifying their transmission across the GCESC.
Incident Strokes Among American Indian Individuals With Atrial Fibrillation.

BACKGROUND American Indian individuals experience a relatively high risk for cardiovascular disease and have exhibited a higher risk of stroke compared with other racial and ethnic minorities. Although this population has the highest incidence of atrial fibrillation (AF) compared with other groups, the relationship between AF and nonhemorrhagic stroke among American Indian individuals compared with other groups has not been thoroughly studied. METHODS and RESULTS We used the Healthcare Cost and Utilization Project to evaluate risk of nonhemorrhagic stroke among American Indian individuals, with comparisons to White, Black, Hispanic, and Asian individuals, among all adult California residents receiving care in an emergency department, inpatient hospital unit, or ambulatory surgery setting from 2005 to 2011. Of 16 951 579 patients followed for a median 4.1 years, 105 822 (0.6%) were American Indian. After adjusting for age, sex, income level, insurance payer, hypertension, diabetes mellitus, coronary artery disease, congestive heart failure, cardiac surgery, valvular heart disease, chronic kidney disease, smoking, obstructive sleep apnea, pulmonary disease, and alcohol use, American Indian individuals with AF exhibited the highest risk of nonhemorrhagic stroke when compared with either non-American Indian individuals with AF (hazard ratio, 1.38; 95% CI, 1.23-1.55; P<0.0001) or to each race and ethnicity with AF. American Indian individuals also experienced the highest overall risk for stroke, with no evidence that AF disproportionately heightened that risk in interaction analyses. CONCLUSIONS American Indian individuals experienced the highest risk of nonhemorrhagic stroke, whether in the presence or absence of AF. Our findings likely suggest an opportunity to further study, if not immediately address, guideline-adherent anticoagulation prescribing patterns among American Indian individuals with AF.
Membrane properties of trisulfonated hydrophilic and partially fluorinated hydrophobic multiblock copolymer

Abstract A multiblock copolymer with increased charge density in the hydrophilic phase was synthesized by utilizing a trisulfonated poly(arylene ether sulfone) backbone (SHQS100). To achieve a balance of membrane properties a partially fluorinated poly(arylene ether benzonitrile) hydrophobic phase (6FPAEB) was used in uneven block lengths to form the hydrophilic-hydrophobic multiblock copolymer. Multiblock copolymers were synthesized via nucleophilic aromatic substitution to achieve high molecular weight copolymers and corresponding ductile membranes. Combination of the shorter increased charge density hydrophilic phase and longer partially fluorinated hydrophobic phase resulted in superior proton conductivity and mechanical properties while limiting water uptake and swelling, despite high ion-exchange capacity. The trifunctional SHQSH hydrophilic phase is proposed to produce a more concentrated charge region in the hydrophilic phase, while swelling of the membrane was limited by a longer partially fluorinated hydrophobic phase.