cssi/SciSciGPT-SciSciNet huggingface dataset:
Parental preference for one-stage versus two-stage surgical repair for children with congenital heart disease.

Background: Little is known regarding parental preference for a one-stage complete repair versus a two-staged approach with initial palliation, followed by repair, of the congenital cardiac malformation. Methods: We interviewed 103 parents of healthy children referred to a clinic for pediatric cardiology. Participants were presented with a hypothetical scenario in which their children had a cardiac lesion requiring surgery. The surgery could be performed either by means of one-stage complete repair, or using a two-stage approach, with palliation first followed by complete repair a year later. The mortality rate for the one-stage repair was set at 5%. Participants were asked to choose between the one- and two-stage approaches, with differing mortality rates for the two-stage approach. The scenarios included options when the two-stage combined mortality rate was lower than the one-stage mortality, and the first stage mortality rate was at 1% and 3%, and when the two-stage combined mortality rate was the same as that for one-stage mortality, these being set at 1% and 3%. Results: When the two-stage combined mortality rate was lower than that of the one-stage repair, participants were more likely to choose the two-stage approach if the first stage mortality rate was 1% as compared to 3% (57% and 44%, respectively, p = 0.04). When the two-stage combined mortality rate was the same as the one-stage approach, participants choosing the two-stage approach when the mortality rate was set at 1%, and when it was raised to 3%, were not significantly different (42% and 34%, respectively, p = 0.24). When the combined two-stage mortality was the same as that set for one-stage repair, participants with no insurance were less likely to choose the two-stage approach than those covered by insurance (p = 0.03). Conclusions: In the chosen scenarios, when the mortality for a two-stage combined approach is the same as that for one-staged repair, more parents choose the one-staged repair. If the two-stage combined mortality is lower than that for one-staged repair, parents are more likely to choose the two-stage repair if the mortality for the first stage is lower. When the mortality rates for the one-stage and two-stage approaches are the same, people without insurance are more likely to choose one-staged repair.
Global information systems and human resource management: a research agenda

A socio-technical approach to information systems requires recognition of the inextricable link between information technologies and humans as designers and users. This essay explores five areas in which information technology and human computer designers/users interact within the context of global organizations. These five areas are: using information technology to support the human resource strategy of global organizations, using information technology to support the generation and distribution of organizational learning, using human resource management techniques and programs to support the work of information systems professionals, using human resource management techniques and programs to support the work of global â€œend-usersâ€ or knowledge workers, and, finally, national and regional policies to support technical and human resource infrastructures.
Three-dimensional secondary instability of a spatially developing von Kármán vortex street in a far wake

This paper presents studies of a three-dimensional secondary instability of a spatially developing von Karman vortex street. It develops owing to the nonlinear interaction between a two-dimensional mean far-wake flow and its most unstable disturbances. This forms a nonlinear primary wake flow. Sections of this flow are selected to perform a temporal secondary stability study under the assumption of parallel flow. The eigenvalue characteristics of the secondary instability are compared with the results from the use of a linear primary flow comprising unmodified mean wake flow coexisting with a linear primary fundamental disturbance with an empirical amplitude as a parameter, resulting in a simpler Floquet analysis. The maximum amplification rates occur at about the same spanwise wavenumber for both the nonlinear and linear primary flows, in qualitative agreement. But the amplification rate versus the spanwise wavenumber spectrum are both qualitatively and quantitatively different, the nonlinear primary flow results in a lower magnitude of the amplification rates. Some interpretations of controlled experiments are made, and it is concluded that the two- and three-dimensional disturbances so obtained appeared to be from the primary instability, where the amplification mechanisms come from the unmodified mean flow. A general discussion of the nonlinear interaction between the primary two-dimensional flow and the three-dimensional secondary instability is given, which may well form the basis for further nonlinear studies.
Development of a CFD Analysis Plan for the First VHTR Standard Problem

Data from a scaled model of a portion of the lower plenum of the helium-cooled very high temperature reactor (VHTR) are under consideration for acceptance as a computational fluid dynamics (CFD) validation data set or standard problem. A CFD analysis will help determine if the scaled model is a suitable geometry for validation data. The present article describes the development of an analysis plan for the CFD model. The plan examines the boundary conditions that should be used, the extent of the computational domain that should be included and which turbulence models need not be examined against the data. Calculations are made for a closely related 2D geometry to address these issues. It was found that a CFD model that includes only the inside of the scaled model in its computational domain is adequate for CFD calculations. The realizable k~e model was found not to be suitable for this problem because it did not predict vortex-shedding.
Breast cancer risk by extent and type of atypical hyperplasia: An update from the Nurses' Health Studies.

BACKGROUND Women with atypical hyperplasia (AH) on a benign breast biopsy specimen are at increased risk for the development of breast cancer. However, the relation between the type and extent of AH (atypical ductal hyperplasia [ADH] vs atypical lobular hyperplasia [ALH]) and the magnitude of the breast cancer risk is not well defined. METHODS A nested case-control study of benign breast disease and breast cancer risk was conducted. Women with breast cancer and prior benign breast biopsy findings (488 cases) were matched to women with prior benign breast biopsy findings who were free from breast cancer (1907 controls). Benign breast biopsy slides were reviewed and categorized as nonproliferative, proliferative without atypia, or AH (ADH or ALH). The number of foci of AH was also recorded. RESULTS Among women with ADH, the interrelation between the extent of atypia and breast cancer risk was not significant (odds ratio [OR] for 1 or 2 foci, 3.5; 95% confidence interval [CI], 2.2-5.6; OR for ≥3 foci, 2.7; 95% CI, 1.4-5.1; P = .41). Similarly, although the risk with ALH was higher for those with ≥3 foci than for those with <3 foci, the difference was not statistically significant (OR for 1 or 2 foci, 5.2; 95% CI, 2.7-10.0; OR for ≥3 foci, 8.0; 95% CI, 4.5-14.2; P = .19). CONCLUSIONS This analysis demonstrates that the extent of ADH or ALH does not significantly contribute to breast cancer risk. The lack of a significant dose-response relation between the extent and type of atypia and breast cancer risk suggests that it would be premature to use the extent of atypia to influence management decisions for women with ADH or ALH. Cancer 2016;122:515–520. © 2015 American Cancer Society.
Stakeholder Influence Strategies and Value Creation by New Ventures

New ventures bring the founders' visions to fruition, creating positive benefits for entrepreneurs and stakeholder groups. Simultaneously, these efforts may disrupt and destroy existing means of production, distribution, and consumption thus imposing- costs, or even creating negative values for stakeholders. This paper describes the types of value that are likely to be created and destroyed, and examines the value-related interactions between stakeholders and new ventures. We draw upon entrepreneurship literature, stakeholder theory, and the resource dependence perspective to develop a framework illustrating these interactions, then we explore the effects of stakeholder salience and dependence on influence strategies that new ventures may employ under conditions of low agreement of value goals, and suggest propositions for different influence strategies and value outcomes.
Psychosis, Lack of Job Skills, and Criminal History: Associations With Employment in Two Samples of Homeless Men

Objective:This study examined factors associated with employment among homeless men with mental illness, particularly history of criminal justice involvement.Methods:Data from 569 homeless men in the 11-site Collaborative Initiative to Help End Chronic Homelessness (2004–2009) and 1,101 homeless male veterans in the U.S. Department of Housing and Urban Development—Veterans Affairs Supportive Housing program at 19 sites (1992–2003) were analyzed.Results:In neither sample was criminal or incarceration history significantly associated with job attainment or earnings for either black or white participants. In contrast, psychotic disorders and public-support income were negatively associated with job attainment and earnings. The majority of homeless veterans reported lifetime occupations as skilled or unskilled manual workers.Conclusions:These findings highlight the high rate of nonemployment among homeless men and suggest that employment among homeless men is not significantly impeded by a criminal record but...
Solidarity and Particularity: E Pluribus Unum? Group Rights and the Politics of Fear and Trust

Even ethnically plural societies require a unum in order to have a state able to keep the peace, allow and protect freedom, encourage participation and belonging, and extract and redistribute resources. That redistribution is needed to improve the chances for fairness and justice for individuals. Group rights and federalist devolution are dangerous paths on which to embark as they threaten to preclude toleration, trust, and solidarity among compatriots. But no one will embrace a unum from which s/he is excluded. In societies with too much history and too much memory, the creation of a unum may be unsuccessful, leaving separation as the alternative to federalism.
Approaches for characterizing threshold dose–response relationships for DNA-damage pathways involved in carcinogenicity in vivo and micronuclei formation in vitro

Assessing the shape of dose-response curves for DNA-damage in cellular systems and for the consequences of DNA damage in intact animals remains a controversial topic. This overview looks at aspects of the pharmacokinetics (PK) and pharmacodynamics (PD) of cellular DNA-damage/repair and their role in defining the shape of dose-response curves using an in vivo example with formaldehyde and in vitro examples for micronuclei (MN) formation with several test compounds. Formaldehyde is both strongly mutagenic and an endogenous metabolite in cells. With increasing inhaled concentrations, there were transitions in gene changes, from activation of selective stress pathway genes at low concentrations, to activation of pathways for cell-cycle control, p53-DNA damage, and stem cell niche pathways at higher exposures. These gene expression changes were more consistent with dose-dependent transitions in the PD responses to formaldehyde in epithelial cells in the intact rat rather than the low-dose linear extrapolation methods currently used for carcinogens. However, more complete PD explanations of non-linear dose response for creation of fixed damage in cells require detailed examination of cellular responses in vitro using measures of DNA damage and repair that are not easily accessible in the intact animal. In the second section of the article, we illustrate an approach from our laboratory that develops fit-for-purpose, in vitro assays and evaluates the PD of DNA damage and repair through studies using prototypical DNA-damaging agents. Examination of a broad range of responses in these cells showed that transcriptional upregulation of cell cycle control and DNA repair pathways only occurred at doses higher than those causing overt damage fixed damage-measured as MN formation. Lower levels of damage appear to be handled by post-translational repair process using pre-existing proteins. In depth evaluation of the PD properties of one such post-translational process (formation of DNA repair centers; DRCs) has indicated that the formation of DRCs and their ability to complete repair before replication are consistent with threshold behaviours for mutagenesis and, by extension, with chemical carcinogenesis.
Femtosecond response of metal – oxide hybrid nanosystems.

By designing and fabricating metal-oxide hybrid nanosystems with ultra-high field enhancements we demonstrate femtosecond dynamics of Kerr-type nonlinear optical response.
Abstract 2702: Renal cell carcinomas lack arginosuccinate synthetase expression and respond to pegylated arginine deiminase treatment

Proceedings: AACR 101st Annual Meeting 2010‐‐ Apr 17‐21, 2010; Washington, DC Biomarkers may be predictive of benefit from therapy. As a result, there is increasing interest in determining new biomarkers and new agents that may target specific pathways that are abnormal in a certain cancer. Normal cells produce arginine internally via the urea cycle. However, certain cancer cells lack one of the urea cycle enzymes, argininosuccinate synthetase (ASS) and become dependent upon an exogenous supply of arginine for growth and survival. For these ASS-deficient cancers, preferential killing of tumor cells induced by arginine deprivation may be effective and safe. ADI-PEG20 is a microbial enzyme, arginine deiminase conjugated with polyethylene gycol. The primary mechanism of action of ADI-PEG20 is arginine deprivation. Thus cancers that are deficient in ASS expression and require arginine could benefit from ADI-PEG20. ADI-PEG20 has been in phase 2 clinical trials for the treatment of hepatocellular carcinoma and metastatic melanoma. Patients whose cancers were deficient in ASS expression have demonstrated medical benefit from ADI-PEG20. Thus at least in these cancers, lack of ASS expression could serve as a biomarker to predict clinical benefit from ADI-PEG20. Other investigators have noted that human renal cell carcinoma (RCC) tissue specimens lack expression of ASS. To confirm these observations and investigate the extent of ASS deficiency in RCC, we analyzed biopsy samples obtained from 31 patients for ASS expression by immunohistochemistry and found all to be ASS negative. We also established three primary RCC cell lines and tested them for response to ADI-PEG20 treatment. Dose dependent growth inhibition was observed after 48 hours for all three cell lines using the MTS proliferation assay. We further tested three ATCC RCC cell lines, 786-O, ACHN and Caki-1 using the MTS assay and observed similar growth inhibition after 48 hours. Cell cycle analysis using the three primary RCC lines revealed that G1 arrest was apparent in samples treated with ADI-PEG20. After 48 hours of ADI-PEG20 treatment, the percentage of cells in G1 increased from 33% to 62%. These results suggest that ADI-PEG20 can potentially be an effective therapeutic agent for the treatment of RCC. They also suggest the potential utility of ASS expression as a biomarker in identifying patients that are most likely to benefit from the ADI-PEG20 treatment. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2702.
Right sided heart failure and pulmonary hypertension: New insights into disease mechanisms and treatment modalities ☆

Abstract Pulmonary hypertension (PH), a rare chronic progressive disorder, is a well-established cause of right heart failure. Given that right heart function is the most important determinant of PH patient longevity Sandoval et al. (1994), D'Alonzo et al. (1991), Benza et al. (2010) [1–3], right heart pressure overload and failure secondary to PH is a critical aspect of the disease to review. In this article, we will highlight new research on the mechanisms of PH induced right heart failure, as well as review the latest PH treatments aimed at improving or sustaining right heart function.
A Method of Behavior Inheritance Based on the Indirect Restraint

The research on inherited behavior has gained widespread attention.Most of existing methods are based on direct behavior relation,and less involved in behavior and effective inheritance methods.In this paper,a kind of methods of effective behavior inherited based on indirect behavior relationship of Petri net,first to distinguish the relationship between the indirect behavior and direct behavior relationship,then to propose indirect behavior hierarchy analysis method based on Petri nets,on this basis to put forward a method of looking for effective inheritance behavior region.Finally the Specific example shows that the method is very effective.
Prevalence of hypertension andits influence on inhabitants in Wuhan

Objective To understand the prevalence of hypertension and its influence factors on inhabitants in Wuhan, and provide evidence for developing intervention strategy. Methods Multi-stage cluster random sampling method was applied in Jianghan and Huangpi districts of Wuhan city. Questionnaire survey,body height,body weight,and blood pressure were conducted among 1632 inhabitants aged over 18 years. Multivariate unconditional logistic regression model was employed to analyze the influence factors of hypertension. All the data were put into the database with Epi-Data version 3. 1 software and analyzed with SPSS version17. 0 software. Result The prevalence rate of hypertension in the population was 33. 3%( male 36. 92%,female 30. 7%). Multivariate logistic regression analysis showed that age,BMI and high-salt diet were identified as the major risk factors of hypertension,with the odds ratio( OR) values: 3. 20,1. 52 and 1. 43 respectively. Conclusion The prevalence of hypertension in Wuhan inhabitants aged over 18 years was basically consistent with the national average level,and it has become one of the major harmful factors for the health of the inhabitants in Wuhan.
First beryllium capsule implosions on the National Ignition Facility

The first indirect drive implosion experiments using Beryllium (Be) capsules at the National Ignition Facility confirm the superior ablation properties and elucidate possible Be-ablator issues such as hohlraum filling by ablator material. Since the 1990s, Be has been the preferred Inertial Confinement Fusion (ICF) ablator because of its higher mass ablation rate compared to that of carbon-based ablators. This enables ICF target designs with higher implosion velocities at lower radiation temperatures and improved hydrodynamic stability through greater ablative stabilization. Recent experiments to demonstrate the viability of Be ablator target designs measured the backscattered laser energy, capsule implosion velocity, core implosion shape from self-emission, and in-flight capsule shape from backlit imaging. The laser backscatter is similar to that from comparable plastic (CH) targets under the same hohlraum conditions. Implosion velocity measurements from backlit streaked radiography show that laser energy coupling to the hohlraum wall is comparable to plastic ablators. The measured implosion shape indicates no significant reduction of laser energy from the inner laser cone beams reaching the hohlraum wall as compared with plastic and high-density carbon ablators. These results indicate that the high mass ablation rate for beryllium capsules does not significantly alter hohlraum energetics. In addition, these data, together with data for low fill-density hohlraum performance, indicate that laser power multipliers, required to reconcile simulations with experimental observations, are likely due to our limited understanding of the hohlraum rather than the capsule physics since similar multipliers are needed for both Be and CH capsules as seen in experiments.
Evaluation of Erectile Dysfunction in Patients with Peyronie’s Disease

AbstractOf 62 hospitalized patients with Peyronie’s disease 18 (29 per cent) had abnormal nocturnal penile tumescence studies that were characterized as indicating organic impotence. However, the majority of these patients had some underlying disease or factor other than the plaque itself to explain the altered nocturnal penile tumescence. In only 5 per cent of these patients could the abnormal nocturnal penile tumescence be attributable to the plaque itself. Primary excision of the plaque and dermal grafting improved erectile function in all except a minority of patients who required insertion of a penile prosthesis to alleviate continued erectile impotence. For this reason we do not recommend insertion of a penile prosthesis during plaque excision. The plaque of Peyronie’s disease does not appear to impede vascular flow distal to the plaque. However, previous excision may result in altered hemodynamics that can result in erectile impotence.
Early Signs of Autism

A blinded comparison of parental and clinical observations of the behavior of 26 autistic children (23 boys and 3 girls) younger than age 48 months is reported from the Vanderbilt University School of Medicine, Nashville, TN, and The Children’s Mercy Hospital, Kansas City.
Incorporating ToxCast and Tox21 datasets to rank biological activity of chemicals at Superfund sites in North Carolina.

Background The Superfund program of the Environmental Protection Agency (EPA) was established in 1980 to address public health concerns posed by toxic substances released into the environment in the United States. Forty-two of the 1328 hazardous waste sites that remain on the Superfund National Priority List are located in the state of North Carolina.
Application of learner-based teaching innovations to enhance education in wildlife conservation

Wildlife conservation professionals will be confronted with increasingly complex problems in the twenty-first century. This professional milieu will require lifelong learning, greatly developed critical thinking ability, and well-honed communications skills, attributes already considered by employers to be deficient in new employees. To enhance the education of wildlife professionals, we review teaching applications that promote learner-based mastery and retention of content knowledge and the development of higher order thinking and process skills (e.g., interpersonal communication). These applications include active learning strategies that create relevancy and better engage students with course material, writing-to-learn to enhance communication skills and promote an active learning atmosphere in classrooms, and case studies and controversies to demonstrate to students how ecological concepts and management principles can be applied to solve complex problems with multiple stakeholders. Drawing on basic premises from cognitive psychology, learner-based education relies on active learning experiences to assist students in building on prior knowledge. New information and problem-solving scenarios are made available to students in relevant contexts to enhance learning. We recommend using learner-based pedagogies in teaching wildlife conservation to better prepare students for careers as natural resource problem-solvers. As educators experiment with learnerbased applications within higher education classrooms, professional workshops, or public education venues, their results should be shared through professional publications.
Interaction and Substitution between Capital, Labor, and Energy in the US Economy

Estimates of price substitution among capital, labor, and energy are critical to numerous policy issues. Estimating factor share equations of the translog production function requires constant returns to scale and competitive factor markets. The present estimates find mixed evidence on these assumptions starting with log linear production and parsimoniously adding interaction terms. Data cover US output from 1949 to 2013 with inputs of fixed capital assets, the labor force, and Btu energy input. Energy interaction and proves critical revealing declining productivity of overpaid labor. Underpaid capital and energy are weak substitutes if at all. Labor has the strongest own price substitution.
Chemical Contributions to Neurodevelopmental Disorders

Children increasingly receive diagnoses of neurodevelopmental disorders (NDDs). Causes are multifactorial, but growing consensus identifies environmental factors, especially chemical exposures, as ...
Consequences of Retained Defibrillator and Pacemaker Leads After Heart Transplantation-An Underrecognized Problem.

Abstract Background Cardiovascular implantable electronic devices (CIEDs) are common in patients undergoing heart transplantation (HT), and complete removal is not always possible at the time of transplantation. Methods We retrospectively assessed the frequency of retained CIED leads and clinical consequences in consecutive HT patients from 2013 to 2016. Clinical outcomes included bacteremia, upper-extremity deep venous thrombosis (UEDVT), lead migration, and inability to perform magnetic resonance imaging (MRI). Results A total of 138 patients (55 ± 11 years of age, 76% male) were identified; 37 (27%) had retained lead fragments (RLFs) at discharge. Patients with RLFs were older, had longer lead implantation time before HT, and a higher prevalence of dual-coil CIED leads compared with those without RLFs (P Conclusion RLFs after HT occur commonly and are associated with a higher rate of UEDVT and limit the use of MRI. Although no significant difference was found in the rates of bacteremia between the groups, this finding might be explained by the overall low incidence. Patients with risk factors for RLFs should be identified before transplantation, and complete lead removal should be considered with a multidisciplinary approach.
Plant-based diets and cardiovascular health.

Abstract Plant-based diets, defined in terms of low frequency of animal food consumption, have been increasingly recommended for their health benefits. Numerous studies have found plant-based diets, especially when rich in high quality plant foods such as whole grains, fruits, vegetables, and nuts, to be associated with lower risk of cardiovascular outcomes and intermediate risk factors. This review summarizes the current evidence base examining the associations of plant-based diets with cardiovascular endpoints, and discusses the potential biological mechanisms underlying their health effects, practical recommendations and applications of this research, and directions for future research. Healthful plant-based diets should be recommended as an environmentally sustainable dietary option for improved cardiovascular health.
Group theoretic approaches to nuclear and hadronic colective motion

Three approaches to nuclear and hadronic collective motion are reviewed, compared and contrasted: the standard symmetry approach as typified by the Interacting Boson Model, the kinematic symmetry group approach of Gell-Mann and Tomonaga, and the recent direct construction by Buck. 50 references.
Georg Simmel’s group expansion:

Georg Simmel triggers off much more interest among sociological scholars today than he previously did. Therefore I believe an interesting question to ask is: why does Simmel re-earn an academic legitimacy in the current social context? I will here assume that Simmel’s analysis of “group expansion” and “enlarged social circles” can be put together with the notion of “globalization” as a topical explanation of today’s social world. To the purpose of analyzing potential connections, I will mainly focus on the article entitled “Group expansion and the development of Individuality” (Simmel 1971, 251-293) and I will indulge myself in a comparative study between concepts developed by Simmel such as “the transformation of social bonds”, the “collective individuality”, the “individuation of the economic sphere”, and empiric observations on globalization in the 21st century.
Improvement of the aerodynamic performance of vertical axis wind turbines with leading-edge serrations and helical blades using CFD and Taguchi method

Abstract The flow performance of vertical-axis wind turbines (VAWTs) is significantly deteriorated by dynamic stall at low tip-speed-ratios (TSR). Dynamic stall occurs periodically during the rotation of turbine blades and generates flow separations formed at leading-edges, which results in tremendous fluctuations in torque and essential reduction in power outputs. The target of this study is to apply a combination of CFD and Taguchi method to optimize the aerodynamic performance of a typical three-bladed VAWT at a low TSR of 2. Leading-edge wavy serrations and helical blade structures are implemented as the design parameters and the performance of these designs are compared with a corresponding baseline straight blade design of a traditional H-type VAWT. A comprehensive simulation study is carried out to obtain detailed flow characteristics. The Taguchi method is applied to find out the optimal combination of the selected factors such as amplitude and wave length of the serrations and twist angle of helical blade. A modified additive model is used to include the interaction effects among the selected factors. The optimal combination is found to appear in the case with an amplitude of 2.5%cb (cb is the blade chord length) and a wavelength of cb/6 for leading-edge serration as well as a blade twist angle of 60°. The simulation results show that the flow separations and torque fluctuations are significantly suppressed due to the passive flow control strategies implemented in the optimized VAWT model. The power output of the optimized wind turbine is found to increase by 18.3% in comparison to the baseline model. In addition, the force fluctuations are observed to be significantly reduced by employing the helical design, which is beneficial for improving the lifespan of turbines. The results derived from this study indicate a better VAWT design for the rural and built environments with relatively insufficient wind energy.
The Cleveland Classification of Ileal Pouch Disorders

Abstract While restorative proctocolectomy with ileal pouch-anal anastomosis, the standard of surgical treatment for patients with ulcerative colitis or familial adenomatous polyposis who require proctocolectomy. However, various adverse mechanical, inflammatory, functional, neoplastic, and metabolic conditions can occur postoperatively. Each category consists of multiple phenotypes. Commonly used diagnostic tools including clinical assessment, endoscopy, histology, imaging, and manometry. Accurate diagnosis and differential diagnosis are crucial for the prevention of disease progression and associated complications and guidance of proper treatment.
Nursing Care in the Neurointensive Care Unit

Neurocritical care specialty units (neurointensive care units) have emerged as a distinct medical subspecialty and discipline, integrating complex critical care medicine, neurosurgical care, and neurological care with the goal of interdisciplinary and multidisciplinary care of complex life-threatening central and peripheral nervous system disorders. As the field continues to evolve, a multidisciplinary team approach and management are paramount for the key role patient care optimization. In turn, a well-run neurocritical care unit is ideally staffed by trained neurointensivist physicians, which may hail from different disciplines such as neurology, neurosurgery anesthesia, or critical care medicine. Tantamount to this, nurse staff trained in critical care with a major emphasis on neurological and neurosurgical patients care management is essential for a safe and optimal care of such patients.
Abstract 4001: Unraveling the molecular mechanism of racial disparity in hepatocellular carcinoma (HCC): A link between type I interferon (IFN-I) signaling and HCC disparity

Among HCC patients, there is a statistically significant increase in incidence and mortality as well as a decrease in 5-year survival rates in African-American (hereafter referred to as black) patients compared to non-Hispanic white (hereafter referred to as white) patients. Currently, there is a gap in our understanding of the molecular mechanism underlying this racial disparity. The purpose of this study is to unravel this molecular mechanism. Gene expression profiles were analyzed by RNA-sequencing (RNA-Seq). Canonical pathway analysis of the differentially expressed genes was performed by Ingenuity Pathway Analysis (IPA). Differential expression of the genes was validated by qRT-PCR and immunohistochemistry. The role of the identified genes in regulating proliferation was determined by transient knockdown by siRNA in a patient-derived xenograft (PDX) cell line established from a black HCC patient followed by MTT assay. In TCGA database, RNA-Seq data from 377 HCC patients were available, of which 17 were black and 184 were white. 279 genes were identified, with a p-value Persistent activation of the IFN-I signaling pathway might be a key determinant of racial disparity in black HCC patients. This pathway might be exploited to develop targeted treatment that work best for black HCC patients. Citation Format: Saranya Chidambaranathan-Reghupaty, Mikhail Dozmorov, Rachel Mendoza, Zhao Lai, Paul B. Fisher, Trevor Reichman, Devanand Sarkar. Unraveling the molecular mechanism of racial disparity in hepatocellular carcinoma (HCC): A link between type I interferon (IFN-I) signaling and HCC disparity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4001.
Leaf ruptures: Acoustic impulse events in wildland fires

Quantifying wildland fires is of interest to both the fires science and land management communities. Remote sensing of these events has exclusively focused on electromagnetic spectra emissions. However, wildland fires also produce sound. Unraveling their acoustic profile will likely reveal new information unrealized through traditional remote sensing techniques. We start with the “crackling” sounds often associated with burning live vegetation. The data in these acoustic impulse events are rich, yielding information about the specific plants involved. In work presented here, acoustic impulse events are used to tease apart the influences of species, age, and plant moisture during combustion of live conifer needles. Needles were collected and burned onsite for six species within the Priest River Experimental Forest. Replicate measurements were carried out in order to reduce the influence of individual branches or trees. Moisture of the needles was ascertained just prior to the experiment through both predawn leaf water potential as well as gravimetric fuel moisture. The burning material was recorded at 50 kHz with a ½ in. measurement microphone. The acoustic impulse events were isolated and analyzed to determine likelihood of unique character traits. We present results of investigating the potential differences in acoustic signature based on species and age.
Embedding Naturalistic Communication Teaching Strategies during Shared Interactive Book Reading for Preschoolers with Developmental Delays: A Guide for Caregivers.

Shared interactive book reading (SIBR) is a broad term used to describe the act of adults reading aloud to children, while encouraging interaction by asking questions and engaging in a discussion about the book. SIBR can be used to embed naturalistic communication teaching strategies, creating learning opportunities to promote a child’s language and communication skills. This article presents practical information on how caregivers can use naturalistic communication teaching strategies during SIBR with their child with developmental delays or disabilities (DD). The intended audiences are caregivers (e.g., parents, grandparents) and practitioners (e.g., classroom teachers, speech-language pathologists, reading specialists) who work with caregivers of children with DD. We explain the importance of early communication skills, naturalistic communication teaching strategies, and SIBR, and describe how to embed naturalistic communication teaching strategies within SIBR. Through a vignette we illustrate how caregivers can implement the techniques and strategies and how practitioners can support caregivers’ implementation.
Spectral broadening of optical transitions at tunneling resonances in InAs/GaAs coupled quantum dot pairs

We report on linewidth analysis of optical transitions in InAs/GaAs coupled quantum dots as a function of bias voltage, temperature, and tunnel coupling strength. A significant line broadening up to 100 $\mu$eV is observed at hole tunneling resonances where the coherent tunnel coupling between spatially direct and indirect exciton states is maximized, corresponding to a phonon-assisted transition rate of 150 ns${}^{-1}$ at 20 K. With increasing temperature, the linewidth shows broadening characteristic of single-phonon transitions. The linewidth as a function of tunnel coupling strength tracks the theoretical prediction of linewidth broadening due to phonon-assisted transitions, and is maximized with an energy splitting between the two exciton branches of 0.8$-$0.9 meV. This report highlights the linewidth broadening mechanisms and fundamental aspects of the interaction between these systems and the local environment.
Learner Driver Experience and Teenagers' Crash Risk During the First Year of Independent Driving.

Importance One mechanism for teenagers’ elevated crash risk during independent driving may be inadequate learner driving experience. Objective To determine how learner driver experience was associated with crash risk during the first year of independent driving. Design, Setting, and Participants Youth aged 15.5 to 16.1 years at recruitment were eligible to participate. Participants’ vehicles were instrumented with sensors, and driving was recorded during the learner period through 1 year of independent driving. Data were collected from January 2011 through August 2014 in southwestern Virginia. Exposures The amount, consistency and variety of practice, driving errors, and kinematic risky driving (KRD) rates during the learner period were recorded. Surveys, including one on sensation-seeking personality traits, were assessed at baseline. Main Outcomes and Measures Cox proportional hazard regressions examined associations between individual characteristics and learner driving experience with driving time to first crash and all crashes in the first year of independent driving. So that hazard ratios (HRs) can be directly comparable, units of measurement were standardized to the interquartile range. Results Of 298 individuals who responded to recruitment, 90 fulfilled the criteria and 82 completed the study (of whom 75 were white [91%] and 44 were girls [54%]). Teenage participants drove a mean (SD) of 1259.2 (939.7) miles over 89 days during the learner period. There were 49 property-damage crashes and/or police-reportable crashes during independent driving. Factors associated with driving time to first crash included higher sensation-seeking personality scale scores (HR, 1.67 [95% CI, 1.08-2.57] per 0.75-unit increase), learner driving KRD rates (HR, 1.27 [95% CI, 1.12-1.43] per 9.24-unit increase), and learner driving errors (HR, 0.44 [95% CI, 0.22-0.86] per increase of 6.48 errors). Similar results were obtained for all crashes in the first year, with the addition of consistency of learner driving practice (HR, 0.61 [95% CI, 0.38-0.99] per 0.23-unit increase). Conclusions and Relevance Individual characteristics and learner driving experiences were associated with crash risk during independent driving. As expected, there was an association between sensation seeking and crashes. Elevated KRD rates during the learner period may reflect risky driving behavior among novices or tolerance to abrupt maneuvers by parents who supervise driving. Consistent practice throughout the learner period could reduce teenage crash risk, which is supported by learning theories indicating distributed practice is effective for developing expertise. Errors during practice may constitute learning events that reinforce safer driving. Physicians could encourage parents to provide opportunities for regular practice driving and monitor their teenager’s KRD rates during the learner period using in-vehicle or smartphone-based technology.
Pathophysiology of SARS-CoV-2: targeting of endothelial cells renders a complex disease with thrombotic microangiopathy and aberrant immune response. The Mount Sinai COVID-19 autopsy experience

Abstract BACKGROUND Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and its associated clinical syndrome COVID-19 are causing overwhelming morbidity and mortality around the globe, disproportionately affecting New York City. A comprehensive, integrative autopsy series that advances the mechanistic discussion surrounding this disease process is still lacking. METHODS Autopsies were performed at the Mount Sinai Hospital on 67 COVID-19 positive patients and data from the clinical records were obtained from the Mount Sinai Data Warehouse. The experimental design included a comprehensive microscopic examination carried out by a team of expert pathologists, along with transmission electron microscopy, immunohistochemistry, RNA in situ hybridization, as well as immunology and serology assays. RESULTS Laboratory results of our COVID-19 cohort show elevated inflammatory markers, abnormal coagulation values, and elevated cytokines IL-6, IL-8 and TNFα. Autopsies revealed large pulmonary emboli in four cases. We report microthrombi in multiple organ systems including the brain, as well as conspicuous hemophagocytosis and a secondary hemophagocytic lymphohistiocytosis-like syndrome in many of our patients. We provide electron microscopic, immunofluorescent and immunohistochemical evidence of the presence of the virus and the ACE2 receptor in our samples. CONCLUSIONS We report a comprehensive autopsy series of 67 COVID-19 positive patients revealing that this disease, so far conceptualized as a primarily respiratory viral illness, also causes endothelial dysfunction, a hypercoagulable state, and an imbalance of both the innate and adaptive immune responses. Novel findings reported here include an endothelial phenotype of ACE2 in selected organs, which correlates with clotting abnormalities and thrombotic microangiopathy, addressing the prominent coagulopathy and neuropsychiatric symptoms. Another original observation is that of macrophage activation syndrome, with hemophagocytosis and a hemophagocytic lymphohistiocytosis-like disorder, underlying the microangiopathy and excessive cytokine release. We discuss the involvement of critical regulatory pathways.
Abstract PO-010: Elucidating intratumoral heterogeneity and predicting effective combination regimens in PDAC PDOs using scRNA-seq and snATAC-seq

Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-related death in the United States. The overwhelming majority of patients (up to 85%) present with unresectable disease, and the 5-year survival rate stands at a dire 9%. Current chemotherapeutic regimens extend survival by only a few months, and the molecular underpinnings of treatment failure in advanced disease remain largely unknown. Recently, single-cell sequencing techniques have emerged as highly effective methods to uncover intratumoral heterogeneity across many cancer types, including PDAC. These studies, and our own unpublished data, have reiterated profound transcriptomic subclonal diversity in PDAC, which likely underlies the divergent therapeutic responses and eventual treatment failure. Using a patient-derived organoid (PDO) platform, we have characterized, on the single cell level, gene expression and regulation profiles to understand the heterogeneity and clinical utility of this model. We applied predictive RNA-seq-based algorithms (CMap) to our initial PDO profiling data to design “custom” PDO combinatorial regimens as a true precision medicine-based approach. We are in the process of validating these predictions in vitro; however, preliminary single-cell RNA (scRNA-seq) data shows treatment PDOs with CMap-predicted compounds induced dramatic transcriptomic shifts in subclones reflective of an efficacious treatment strategy. Additionally, we conducted single-nuclei ATAC sequencing (snATAC-seq) of PDOs pre- and post-treatment with CMap-predicted compounds. This data, coupled to our scRNA-seq, allowed for construction of chromatin regulatory maps, and determined alterations in chromatin accessibility and gene regulation induced by targeted combinatorial therapeutics. These findings provide meaningful insight to biological processes driven by treatment-induced chromatin accessibility, and its relationship to heterogeneous transcriptional architecture. Our data suggests that differential regulation across PDO subclones may drive responses to therapy and acquired resistance mechanisms observed in the clinic, which could be predicted and therapeutically targeted with scRNA sequencing. Thus, this work represents the importance of leveraging subclonal architecture in the preclinical space to ensure both treatment efficacy and the consideration of novel therapeutic combinations in PDAC patients. Citation Format: Paola A. Guerrero, Anirban Maitra, Maria E. Monberg, Jaewon J Lee, Vincent Bernard-Pagan, Senthil Muthuswamy. Elucidating intratumoral heterogeneity and predicting effective combination regimens in PDAC PDOs using scRNA-seq and snATAC-seq [abstract]. In: Proceedings of the AACR Virtual Special Conference on Pancreatic Cancer; 2020 Sep 29-30. Philadelphia (PA): AACR; Cancer Res 2020;80(22 Suppl):Abstract nr PO-010.
Queer identity and theory intersections in mathematics education: a theoretical literature review

Researchers have become aware of a need to focus on the continued development of gender and sexuality research in mathematics education, as frameworks and conceptual perspectives have been difficult to operationalize, particularly outside of the heteronormative categories of cis-male and cis-female studies. Early pioneers of this work have proposed intersectionality theory (e.g., Leyva, 2017) and queer theories (e.g., Dubbs 2016; Esmonde 2011; Sheldon and Rands 2013) as promising lenses for conceptualizing such research, as they allow for critical postmodern engagement by avoiding many of the structuralist gender commitments that have previously prevented it. In this paper, I build on this work by employing the notion of mathematical identity. I perform a systematic, theoretical review of the literature to articulate a basis for the intersection of mathematical identity and queer identity. I articulate the theoretical basis for this intersection of identities by building a framework that illustrates the intersectional nature of mathematical and queer identities and gives scholars a tool for conceptualizing future work in this area. This paper issues a call to the field to embrace the uncertainty of this new research borderland, because it is only through a radical vision of identity research in mathematics education—such as is offered here—that researchers can begin to situate students’ participation in mathematics within larger social and economic systems that have yet to be analyzed in depth with respect to queer identity.