cssi/SciSciGPT-SciSciNet huggingface dataset:
Colorectal liver metastases: disappearing lesions in the era of Eovist hepatobiliary magnetic resonance imaging

Abstract Background Hepatobiliary contrast enhanced MRI is known to be the most sensitive imaging modality for detection of colorectal hepatic metastasis. To date no study has investigated the rate of disappearing lesions with gadoxetic acid MR (Eovist/Primovist), or characterized the pathologic response of lesions which disappear on gadoxetic acid MR. Methods Retrospective review of hepatic resections for colorectal metastases between 01/2008 and 01/2014 was performed to evaluated the rate of disappearance of lesions on gadoxetic acid MR and the rate of complete pathologic response in the lesions that disappear. “Disappearing lesions” were lesions on baseline imaging that were not identifiable on pre-operative Eovist MRI. Complete pathologic response was defined as no viable tumor on pathology or by lack of recurrence within 1 year. Results In 23 patients, 200 colorectal metastases were identified on baseline imaging. On pre-operative Eovist MR 77 of the 200 lesions (38.5%) were “disappearing” lesions. At surgical pathology or 1 year follow-up imaging, 42 of 77 lesions (55%) demonstrated viable tumor (21) or recurrence (21). Thirty of 77 lesions (39%) were nonviable at pathology (10) or without evidence of recurrence at 1 year (20). 5 lesions were indeterminate. Discussion Despite disappearance on Eovist MR imaging (the most sensitive available imaging modality), 38.5% of all colorectal metastases disappeared and of those, 55% were viable.
Abstract 3672: Adrenocortical carcinoma cell lines are sensitive to compounds targeting the G2/M transition

Adrenocortical carcinoma (ACC) is an aggressive tumor of the adrenal cortex. It affects 1-2 per million and has a 5 year survival rate of 25-30% due to late detection and a lack of effective systemic therapy. Mitotane, an isomer of the insecticide DDT, is the only compound approved for the treatment of patients with ACC. It has a poor response rate (22% as a single agent) and a toxicity profile that often results in dose reduction or cessation of therapy altogether. New therapies are desperately needed. Expression profiling of ACC by ourselves and others highlights the importance of the G2/M transition, the p53 pathway, and signaling of IGF2 through IGF1R. Using this knowledge, we profiled the in vitro chemosensitivity of the two ACC cell lines, H295R and SW-13, to compounds that target aspects of these pathways. Cells were plated, and drug added 24 hours later in a 3-fold serial dilution, with the exception of mitotane which was done as a 1.5-fold serial dilution. Viability was assessed by CellTiter Glo at 3 different time points. The cell lines show sensitivity to compounds that target the G2/M transition (VX-680 and BI-2536) and EGFR (erlotinib). The difference in response between H295R and SW-13 to LY294002 suggests the cell lines harbor a difference in the relative contributions of PI3K signaling versus Ras-Raf-MEK signaling downstream of IGF1R. Additionally, the response of both cell lines to erlotinib suggests that EGFR signaling may play a role in ACC. Neither cell line was particularly sensitive to MDM2 inhibition, indicating that this is not a good target to restore p53 pathway function. Finally, our results suggest that further testing of compounds that target G2/M is warranted, particularly PLK-1 inhibitors. 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 3672.
High-Intensity Interval Training and Moderate-Intensity Continuous Training in Ambulatory Chronic Stroke: Feasibility Study.

Background Poststroke guidelines recommend moderate-intensity, continuous aerobic training (MCT) to improve aerobic capacity and mobility after stroke. High-intensity interval training (HIT) has been shown to be more effective than MCT among healthy adults and people with heart disease. However, HIT and MCT have not been compared previously among people with stroke. Objective The purpose of this study was to assess the feasibility and justification for a definitive randomized controlled trial (RCT) comparing HIT and MCT in people with chronic stroke. Design A preliminary RCT was conducted. Setting The study was conducted in a cardiovascular stress laboratory and a rehabilitation research laboratory. Patients Ambulatory people at least 6 months poststroke participated. Intervention Both groups trained 25 minutes, 3 times per week, for 4 weeks. The HIT strategy involved 30-second bursts at maximum-tolerated treadmill speed alternated with 30- to 60-second rest periods. The MCT strategy involved continuous treadmill walking at 45% to 50% of heart rate reserve. Measurements Measurements included recruitment and attendance statistics, qualitative HIT acceptability, adverse events, and the following blinded outcome variables: peak oxygen uptake, ventilatory threshold, metabolic cost of gait, fractional utilization, fastest treadmill speed, 10-Meter Walk Test, and Six-Minute Walk Test. Results During the 8-month recruitment period, 26 participants consented to participate. Eighteen participants were enrolled and randomly assigned to either the HIT group (n=13) or the MCT group (n=5). Eleven out of the 13 HIT group participants attended all sessions. Participants reported that HIT was acceptable and no serious adverse events occurred. Standardized effect size estimates between groups were moderate to very large for most outcome measures. Only 30% of treadmill speed gains in the HIT group translated into overground gait speed improvement. Limitations The study was not designed to definitively test safety or efficacy. Conclusions Although further protocol optimization is needed to improve overground translation of treadmill gains, a definitive RCT comparing HIT and MCT appears to be feasible and warranted.
Mutual Connectivity Analysis (MCA) for Nonlinear Functional Connectivity Network Recovery in the Human Brain Using Convergent Cross-Mapping and Non-metric Clustering

We explore a computational framework for functional connectivity analysis in resting-state functional MRI (fMRI) data acquired from the human brain for recovering the underlying network structure and understanding causality between network components. Termed mutual connectivity analysis (MCA), this framework involves two steps, the first of which is to evaluate the pair-wise cross-prediction performance between fMRI pixel time series within the brain. Here, we use a Generalized Radial Basis Functions (GRBF) neural network as a nonlinear time series predictor. In a second step, the underlying network structure is subsequently recovered from the affinity matrix using non-metric network clustering approaches, such as the so-called Louvain method. Finally, we use convergent cross-mapping (CCM) to study causality between different network components. We demonstrate our MCA framework in the problem of recovering the motor cortex network associated with hand movement from resting state fMRI data. Results are compared with a ground truth of active motor cortex regions as identified by a task-based fMRI sequence involving a finger-tapping stimulation experiment. Our results on whole-slice fMRI analysis demonstrate that MCA-based model-free recovery of regions associated with the primary motor cortex and supplementary motor area are in close agreement with localization of similar regions achieved with a task-based fMRI acquisition.
Control between coexistent attractors for optimal performance of a bistable piezoelectric vibration energy harvester

Research in broadband nonlinear piezoelectric energy harvesting has gained traction in recent years as resonant, linear harvesters do not operate optimally in dynamic environments. By placing a linear harvester in a symmetric magnetic field, a nonlinear restoring force allows the system to realize motion across two potential wells. Different levels of excitation enable the system to oscillate solely in one potential well, periodically across both potential wells, or aperiodically across both potential wells. Periodic interwell motion is considered desirable for nonlinear energy harvesting systems, however, coexistent attractors inhibit uniqueness of such a solution. The authors have previously shown that chaotic, aperiodic motion between potential wells can be optimized for improved energy harvesting. The technique applied a chaotic controller to stabilize a large amplitude periodic orbit within the chaotic attractor. This work considers the basins of attraction of the two concurrent attractors and applies an intermittent control law in which the system is perturbed from a chaotic, aperiodic interwell response into the desirable large amplitude, periodic, interwell response.
Interpretable Probabilistic Latent Variable Models for Automatic Annotation of Clinical Text.

We propose Latent Class Allocation (LCA) and Discriminative Labeled Latent Dirichlet Allocation (DL-LDA), two novel interpretable probabilistic latent variable models for automatic annotation of clinical text. Both models separate the terms that are highly characteristic of textual fragments annotated with a given set of labels from other non-discriminative terms, but rely on generative processes with different structure of latent variables. LCA directly learns class-specific multinomials, while DL-LDA breaks them down into topics (clusters of semantically related words). Extensive experimental evaluation indicates that the proposed models outperform Naive Bayes, a standard probabilistic classifier, and Labeled LDA, a state-of-the-art topic model for labeled corpora, on the task of automatic annotation of transcripts of motivational interviews, while the output of the proposed models can be easily interpreted by clinical practitioners.
Vegetable Output, Cost Savings, and Nutritional Value of Low-Income Families’ Home Gardens in San Jose, CA

ABSTRACTParticipation in home food gardening in the United States has been growing. From 2008 to 2013, the number of home gardens increased by 4 million, and the number of households with annual incomes of less than $35 000 that are food gardening rose by 38%. The purpose of this study was to measure crop output, cost savings, and nutritional value of low-income home gardeners in San Jose, California. This pilot study included administering a background survey to a convenience sample of low-income home gardeners with a subset of gardeners weighing vegetable output of plots during the 2104 spring–summer growing season. Participants included an ethnically diverse group of 50 low-income families who completed the survey and 8 gardeners who weighed vegetable output of their garden. The gardeners produced an average of 1.23 lb vegetables/ft2 and saved an average of $339 by growing their own vegetables. Cost savings were greatest when vertical high-value crops such as tomatoes and cucumbers were grown. All weig...
Reduced Chemical Kinetics for the Modeling of TiO2 Nanoparticle Synthesis in Flame Reactors

Flame synthesis represents a viable technique for large-scale production of titanium dioxide (TiO2) nanoparticles. A key ingredient in the modeling of this process is the description of the chemical kinetics, which include Ti oxidation, hydrocarbon fuel combustion, and chlorination. While detailed chemical mechanisms have been developed for predicting TiO2 nanoparticle properties by West et al. (e.g., Combust. Flame 2009, 156, 1764), their use in turbulent reacting flow simulations is limited to very simple configurations or requires significant modeling assumptions to bring their computational cost down to an acceptable level. In this work, a reduced kinetic scheme describing the oxidation of TiCl4 in a methane flame is derived from and validated against the predictions of a detailed mechanism from the literature. The reduction procedure uses graph-based methods for unimportant kinetic pathways elimination and quasi-steady-state species selection. Reduction targets are chosen in accordance with previous ...
Diversity-Multiplexing Tradeoff of GMD/UCD with Antenna Selection

Assuming both the channel state information at the transmitter (CSIT) and receiver (CSIR), we can design a transceiver to readily approach the performance limit of MIMO systems, e.g., the geometric mean decomposition (GMD) and uniform channel decomposition (UCD) schemes. The high performance of the MIMO systems comes with increased hardware complexity. To reduce the system complexity, we consider selecting Lt transmit and Lr receive antennas in a MIMO system with Mt transmit and Mr receive antennas (Lt les Mt and Lr les Mr). We analyze the D-M tradeoff of GMD/UCD combined with optimal antenna selection. Approximating the error probability with the Q-function, we show that UCD can achieve the optimal diversity-multiplexing (D-M) tradeoff using uncoded quadrature amplitude modulation (QAM). In contrast, the GMD scheme is D-M tradeoff suboptimal in general but is optimal if min{Lt, Lr} les Mr + Mt-l/MrMt.
Parabolic reflection high intensity ultrasound based device with mechanically-variable focusing

The goal of our investigation is to develop a high intensity focused ultrasound (HIFU) device with mechanically-variable focal lengths, achieved by parabolic reflection mechanism. Several configurations of parabolic reflector were simulated using Wave2000 Pro and a custom-developed geometric ray tracing method (MatLab). A cylindrical ultrasound transducer (height 5 cm, diameter 3.7 cm, frequency 2 MHz) was used as the source. Translational and rotational movements of single parabolic reflectors, multiple parabolic reflectors, and segmented parabolic reflectors were considered for their effectiveness in focusing the beam in the range of 5-10 cm. The simulations showed that focusing using a single parabola was achieved with a translation of 14 cm, and a rotation of 25 /spl deg/. Multiple parabola provided optimal focusing with a minimum number of 4 segments. Parabolic reflection mechanism may provide an effective method of a variable-focus HIFU transducer.
Pneumosinus Dilatans: Over 100 Years Without an Etiology.

Purpose Pneumosinus dilatans (PD) is a rare pathologic hyperaeration of the paranasal sinuses that causes serious deformation of the overlying bone and soft tissue. The condition occurs most commonly in the frontal sinus of young men who present with different complaints, including cosmetic. More than 100 cases have been reported in the literature since it was first described in 1898; however, the etiology of this condition remains unclear. Materials and Methods A systematic review of all available clinical publications on the subject of PD was conducted in the PubMed electronic database. The resultant articles were grouped based on evidence supporting or refuting various theoretical etiologies to further characterize the condition. Results In total, 134 known cases were reported in 117 articles. Most affected patients were young men in the third decade of life. Only 19 (16.2%) articles offered some form of evidence in support of a particular etiology. The most substantiated etiologies of PD included a “ball-valve” mechanism of sinus outflow obstruction leading to air trapping or a primary fibro-osseous pathologic process that disrupts the cellular milieu. Less substantiated theories included hormonal dysregulation or a spontaneously draining mucocele. No data exist to support causation by gas-forming bacteria. A bimodal distribution of incidence, a younger population (16 to 25 yr), and an older population (36 to 40 yr) might suggest multiple possible etiologies. Conclusions Several theories on the etiology of PD exist, but none have been substantiated by reliable scientific evidence. Standardizing the clinical evaluation, classification, management, and pathologic analysis of patients with PD could aid in elucidating its true etiology.
Biolayer interferometry of lipid nanodisc-reconstituted yeast vacuolar H+ -ATPase.

Vacuolar H+-ATPase (V-ATPase) is a large, multisubunit membrane protein complex responsible for the acidification of subcellular compartments and the extracellular space. V-ATPase activity is regulated by reversible disassembly, resulting in cytosolic V1-ATPase and membrane-integral V0 proton channel sectors. Reversible disassembly is accompanied by transient interaction with cellular factors and assembly chaperones. Quantifying protein-protein interactions involving membrane proteins, however, is challenging. Here we present a novel method to determine kinetic constants of membrane protein–protein interactions using biolayer interferometry (BLI). Yeast vacuoles are solubilized, vacuolar proteins are reconstituted into lipid nanodiscs with native vacuolar lipids and biotinylated membrane scaffold protein (MSP) followed by affinity purification of nanodisc-reconstituted V-ATPase (V1V0ND). We show that V1V0ND can be immobilized on streptavidin-coated BLI sensors to quantitate binding of a pathogen derived inhibitor and to measure the kinetics of nucleotide dependent enzyme dissociation.
Notes: Testing Hypotheses

Abstract A survey of the literature on the development of physical education tests reveals little of value to the researcher confronted with the problem of assessing the gross motor ability of manpower pools and predicting success in related tasks. Flexible instructions, subjective scoring, limited concepts of validity, and other factors involving a disregard or misinterpretation of principles of test construction have greatly reduced the usefulness of research in this field (1, p. 1).
Conceptual design problem

Design or problem solving is a natural human activity. We have been designing and acting as designers (sometimes unconsciously) throughout our lives. Design begins with the acknowledgment of needs and dissatisfaction with the current state of affairs and realization that some action must take place in order to correct the problem. When a small child moves a stool to an appropriate location so that she can use it to get to her toy, she has acted as a designer — of a rudimentary design — by positioning the stool so that she can satisfy her need of playing with the toy.
Surface vs. Air Shipment of Humanitarian Goods under Demand Uncertainty

The combination of insufficient funds and limited information regarding the demand in regions of desperate need presents a great challenge to many humanitarian organizations. This study examines how a humanitarian organization can minimize the expected shortage in delivering relief aid to regions of need, either though surface or air transportation, in the presence of demand uncertainty with a budget constraint. The study makes four contributions. First, we show that when there is reserved supply for air transportation, it is optimal to provide a higher service level through surface shipment to regions with greater demand uncertainty. Second, we show that the demand variation plays a significant role in the allocation of funds between surface and air shipments. The reaction of the humanitarian organization to higher degrees of demand uncertainty can be determined by the optimal level of inventory purchased for surface shipment. If the optimal inventory for surface shipment is less than the mean demand, then we show that increasing degrees of demand uncertainty leads to increasing reliance on the air shipment option with greater levels of inventory reserved for air transportation and decreasing levels of inventory reserved for surface shipment. Third, when there are opportunities to invest in better forecasting, we find that a humanitarian organization should focus its resources on improving the demand forecast in one region as opposed to evenly allocating resources to all regions. Fourth, we show that the expected amount of shortages reduces with a higher number of regions to serve due to a riskâ€ pooling effect.
TRICUSPID REGURGITATION INDUCED BY PERMANENT PACEMAKER

Over 2 million people in the United States have permanent cardiac devices with rates of implantation increasing annually. Device leads may cause iatrogenic complications such as tricuspid regurgitation which can lead to serious morbidity if unrecognized. A 79 year old woman presented to her primary
Studying Plus-End Tracking at Single Molecule Resolution Using TIRF Microscopy

The highly dynamic microtubule plus-ends are key sites of regulation that impact the organization and function of the microtubule cytoskeleton. Much of this regulation is performed by the microtubule plus-end tracking (+TIP) family of proteins. +TIPs are a structurally diverse group of proteins that bind to and track with growing microtubule plus-ends in cells. +TIPs regulate microtubule dynamics as well as mediate interactions between microtubule tips and other cellular structures. Most +TIPs can directly bind to microtubules in vitro; however, the mechanisms for their plus-end specificity are not fully understood. Cellular studies of +TIP activity are complicated by the fact that members of the +TIP family of proteins interact with each other to form higher-order protein assemblies. Development of an in vitro system, using minimal components, to study +TIP activity is therefore critical to unequivocally understand the behavior of individual +TIP proteins. Coupled with single molecule imaging, this system provides a powerful tool to study the molecular properties that are important for +TIP function. In this chapter, we describe a detailed protocol for in vitro reconstitution of +TIP activity at single molecule resolution using total internal reflection fluorescence microscopy.
Disrupted Brain Connectivity in Alzheimer’s Disease: Effects of Network Thresholding

Diffusion imaging is accelerating our understanding of the human brain. As brain connectivity analyses become more popular, it is vital to develop reliable metrics of the brain’s connections, and their network properties, to allow statistical study of factors that influence brain ‘wiring’. Here we chart differences in brain structural networks between normal aging and Alzheimer’s disease (AD) using 3-T whole-brain diffusion-weighted images (DWI) from 66 subjects (22 AD/44 normal elderly). We performed whole-brain tractography based on the orientation distribution functions. Connectivity matrices were compiled, representing the proportion of detected fibers interconnecting 68 cortical regions. We found clear disease effects on anatomical network topology in the structural backbone – the so-called ‘k-core’ – of the anatomical network, defined by varying the nodal degree threshold, k. However, the thresholding of the structural networks – based on their nodal degree – affected the pattern and interpretation of network differences discovered between patients and controls.
She Looks like She’d Be an Animal in Bed: Dehumanization of Drinking Women in Social Contexts

The purpose of the present research was to examine the perceptions of women who drink in social contexts through the lens of dehumanization (Haslam 2006). Across three experiments, we manipulated the presence of alcohol by depicting a woman at a bar with a bottle of beer or a bottle of water and measured dehumanization. As hypothesized, women were dehumanized more in the alcohol condition than in the water condition by men (Experiments 1–3) and women (Experiments 2 and 3). Notably, the presence of alcohol compared to water had no impact on dehumanization of men (Experiment 2). Also, as hypothesized, perceived intoxication emerged as a significant mediator of the link between alcohol condition and dehumanization in Experiments 1 and 2, and alcohol quantity predicted greater dehumanization in Experiment 3. Extending the present work to prior work in this area, Experiment 3 also examined the links among alcohol, perceived sexual availability, and dehumanization, revealing that perceived sexual availability mediated the link between alcohol and dehumanization. Implications for theories of dehumanization, alcohol, and social perception as well as practical implications of these findings are discussed.
Campaign Rhetoric and the Incumbency Advantage

The congressional incumbency advantage reflects an inequity in competition—candidates receive an electoral edge simply because they hold office. Scholars have identified an array of factors that co...
A case report of vanishing bile duct syndrome after exposure to pexidartinib (PLX3397) and paclitaxel

Pexidartinib (PLX3397) is a small molecule tyrosine kinase and colony-stimulating factor-1 inhibitor with FDA breakthrough therapy designation for tenosynovial giant-cell tumor, and currently under study in several other tumor types, including breast cancer, non-Hodgkin's lymphoma, and glioblastoma. Here, we report a case of severe drug-induced liver injury requiring liver transplantation due to vanishing bile duct syndrome (VBDS) after exposure to pexidartinib in the I-SPY 2 Trial, a phase 2 multicenter randomized neoadjuvant chemotherapy trial in patients with Stage II-III breast cancer. We also review the current literature on this rare, idiosyncratic, and potentially life-threatening entity.
Measuring Mobility in Low Functioning Hospital Patients: An AM-PAC Replenishment Project.

Abstract Objective To expand an existing validated measure of basic mobility (Activity Measure for Post-Acute Care [AM-PAC]) for patients at the lowest levels of function. Design Item replenishment for existing item response theory (IRT) derived measure via (1) idea generation and creation of potential new items, (2) item calibration and field testing, and (3) longitudinal pilot test. Setting Two tertiary acute care hospitals. Participants Consecutive inpatients (N=502) ≥18 years old, with an AM-PAC Inpatient Mobility Short Form (IMSF) raw score ≤15. For the longitudinal pilot test, 8 inpatients were evaluated. Results Fifteen new AM-PAC items were developed, 2 of which improved mobility measurement at the lower levels of functioning. Specifically, with the 2 new items, the floor effect of the AM-PAC IMSF was reduced by 19%, statistical power and measurement breadth were greater, and there was greater measurement sensitivity in longitudinal pilot testing. Conclusion Adding 2 new items to the AM-PAC IMSF lowered the floor and increased statistical power, measurement breadth, and sensitivity.
Effect of Concomitant Coronary Artery Bypass Grafting on Outcomes of Ascending Aorta Replacement

Background Ascending aorta replacement can be performed safely in high-volume centers. What remains unknown is whether concomitant coronary revascularization with bypass grafting affects postoperative outcomes. Methods This study retrospectively reviewed a prospectively maintained institutional database for patients who underwent ascending aorta replacement (AAR) during the period from 1997 to 2018. Patients were stratified into AAR alone (AAR) vs AAR and coronary artery bypass graft (AAR with CABG), further categorized as 1 or more than 1 CABG. Aortic dissection and root replacement cases were excluded. The primary end point consisted of major adverse events (MAE), including operative mortality, perioperative myocardial infarction, stroke, need for tracheostomy, and need for dialysis. Secondary end points were operative mortality, each MAE component, and late survival. Results A total of 951 patients were included in the analysis; 725 (76.2%) underwent isolated AAR, and 226 (23.8%) underwent AAR with CABG. Operative mortality was similar across the 2 groups (1.8% for AAR with CABG and 0.8% for AAR; P = .40). The unadjusted incidence of MAE was higher in the AAR with CABG group (5.8% vs 1.9%; P = .005).). On multivariable analysis, the performance of 1 CABG (odds ratio [OR], 1.90; 95% confidence interval [CI], 0.67 to 5.33; P = .23) and more than 1 CABG (OR, 2.65; 95% CI, 0.93 to 7.53; P = .07) was not associated with higher rates of MAE. Preoperative pulmonary dysfunction (OR, 2.51; 95% CI, 1.07 to 5.85; P = .03) was the only independent predictor of MAE. Conclusions In patients undergoing concomitant CABG with AAR, the performance of concomitant CABG is not associated with an increased risk of MAE.
Regional Variation in Billed Advance Care Planning Visits.

Background/objective Advance care planning (ACP) is associated with improved patient and caregiver outcomes, but is underutilized. To encourage ACP, the Centers for Medicare & Medicaid Services implemented specific ACP visit reimbursement codes in 2016. To better understand the utilization of these ACP reimbursement codes, we explored regional variation in billed ACP visits. Design We performed a retrospective cross-sectional analysis using a randomly sampled 5% cohort of Medicare fee-for-service (FFS) beneficiaries' claims files from 2017. Region was defined by hospital referral region. Setting National Medicare FFS. Participants A total of 1.3 million Medicare beneficiaries aged 65 years and older. Measurement Receipt of billed ACP service, identified through Current Procedural Terminology code 99497 or 99498. Proportion of beneficiaries who received billed ACP service(s) by region was calculated. We fit a multilevel logistic regression model with a random regional intercept to determine the variation in billed ACP visits attributable to the region after accounting for patient (demographics, comorbidities, and medical care utilization) and regional factors (hospital size, emergency department visits, hospice utilization, and costs). Results The study population included about 1.3 million beneficiaries, of which 32,137 (2.4%) had at least one billed ACP visit in 2017. There was substantial regional variation in the percentage of beneficiaries with billed ACP visits: lowest quintile region, less than 0.83%; subsequent regions, less than 1.6%, less than 2.4%, less than 3.3% to less than 8.4% in the highest quintile regions. A total of 15.4% of the variance in whether an older adult had a billed ACP visit was explained by the region. Although numerous regional factors were associated with billed ACP visits, none were strong predictors. Conclusion In 2017, we found wide regional variation in the use of billed ACP visits, although use overall was low in all regions. Increasing the understanding of the drivers and the effects of billed ACP visits could inform strategies for increasing ACP.
Effects of Solvent Molecular Structure on Diffusion through Plasticized Poly(vinyl chloride) Films

Diffusion of organic solvents in plasticized poly(vinyl chloride) (PVC) films is industrially significant for inkjet-printed PVC graphic displays, but comprehensive research on the mechanism of sol...
The Intersection of Faculty Success and Student Success

When institutions put student success at the forefront, what does this mean for faculty? While faculty may feel as if a focus on student success is in opposition to faculty success, the two are intertwined. An understanding of the relationship between faculty and student success can assuage faculty concern regarding competition for attention and resources when faculty success and student success are juxtaposed.
Eastern Equine Encephalitis Virus Rapidly Infects and Disseminates in the Brain and Spinal Cord of Infected Cynomolgus Macaques Following Aerosol Challenge

Eastern equine encephalitis virus (EEEV) is mosquito-borne virus that produces fatal encephalitis in humans. We recently conducted a first of its kind study to investigate EEEV clinical disease course following aerosol challenge in a cynomolgus macaque model utilizing the state of the art telemetry to measure critical physiological parameters. Following challenge, all parameters were rapidly and profoundly altered, and all nonhuman primates (NHPs) met the euthanasia criteria. In this study, we performed the first comprehensive pathology investigation of tissues collected at euthanasia to gain insights into EEEV pathogenesis. Viral RNA and proteins as well as microscopic lesions were absent in the visceral organs. In contrast, viral RNA and proteins were readily detected throughout the brain including autonomic nervous system (ANS) control centers and spinal cord. However, despite presence of viral RNA and proteins, majority of the brain and spinal cord tissues exhibited minimal or no microscopic lesions. The virus tropism was restricted primarily to neurons, and virus particles (~61-68 nm) were present within axons of neurons and throughout the extracellular spaces. However, active virus replication was absent or minimal in majority of the brain and was limited to regions proximal to the olfactory tract. These data suggest that EEEV initially replicates in/near the olfactory bulb following aerosol challenge and is rapidly transported to distal regions of the brain by exploiting the neuronal axonal transport system to facilitate neuron-to-neuron spread. Once within the brain, the virus gains access to the ANS control centers likely leading to disruption and/or dysregulation of critical physiological parameters to produce severe disease. Moreover, the absence of microscopic lesions strongly suggests that the underlying mechanism of EEEV pathogenesis is due to neuronal dysfunction rather than neuronal death. This study is the first comprehensive investigation of EEEV clinical disease course and pathogenesis in a NHP model and will provide significant insights into the evaluation of countermeasure.
Dexamethasone decreases postoperative opioid and antiemetic use in shoulder arthroplasty patients: a prospective, randomized controlled trial.

Background Multimodal pain control can be beneficial in relieving postoperative pain and limiting narcotic use following orthopedic procedures. Additionally, with increasing interest in outpatient arthroplasty procedures, providers have interest in adequate early postoperative pain control and complications. The purpose of this study was to investigate the effect of dexamethasone on pain, postoperative nausea and vomiting, and length of stay following total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA). Methods One hundred twelve patients undergoing TSA or RTSA by a single surgeon were assessed for inclusion in this investigation. We performed a prospective randomized controlled trial to investigate the effect of 10 mg of dexamethasone administered within 90 minutes of surgery. Primary outcome assessed was the average morphine equivalent use over the first 24 hours postsurgery. Secondary outcomes included postoperative visual analog scale (VAS) scores, antiemetic use, postoperative nausea and vomiting, and complications. Results A total of 75 patients were included in the final analysis, with 32 patients (42.7%) randomized to the control group and 43 (57.3%) randomized to the dexamethasone group. Body mass index was significantly greater in the control group (33.8 vs. 30.3, P = .014); otherwise, there were no significant demographic differences between groups. Average ondansetron use was significantly lower in the dexamethasone group compared with controls for the 0- to 4-hour interval (0.1 vs. 0.9 mg, respectively, P = .006) and was lower overall for the first 24 hours (0.3 vs. 1.0 mg, P = .025). Differences in VAS scores were significantly lower in the dexamethasone group at all time points (P Conclusion Dexamethasone decreases opioid requirements in the first 24 hours following surgery, provides improved pain control, and decreases antiemetic use following shoulder arthroplasty. Dexamethasone is an important multimodal adjunct for controlling pain and postoperative nausea and vomiting following primary TSA.
Mind-Body Activity Program for Chronic Pain: Exploring Mechanisms of Improvement in Patient-Reported, Performance-Based and Ambulatory Physical Function.

Background Improving physical function among patients with chronic pain is critical for reducing disability and healthcare costs. However, mechanisms underlying improvement in patient-reported, performance-based, and ambulatory physical function in chronic pain remain poorly understood. Purpose To explore psychosocial mediators of improvement in patient-reported, performance-based, and objective/accelerometer-measured physical function among participants in a mind-body activity program. Methods Individuals with chronic pain were randomized to one of two identical 10-week mind-body activity interventions aimed at improving physical function with (GetActive-Fitbit; N=41) or without (GetActive; N=41) a Fitbit device. They completed self-reported (WHODAS 2.0), performance-based (6-minute walk test), and objective (accelerometer-measured step-count) measures of physical function, as well as measures of kinesiophobia (Tampa Kinesiophobia Scale), mindfulness (CAMS-R), and pain resilience (Pain Resilience Scale) before and after the intervention. We conducted secondary data analyses to test mediation via mixed-effects modeline. Results Improvements in patient-reported physical function were fully and uniquely mediated by kinesiophobia (Completely Standardized Indirect Effect (CSIE)=.18; CI=0.08, 0.30; medium-large effect size), mindfulness (CSIE=−.14; CI=−25, −.05; medium effect size) and pain resilience (CSIE=−.07; CI=−.16, −.005; small-medium effect size). Improvements in performance-based physical function were mediated only by kinesiophobia (CSIE=−.11; CI=−23, −.008; medium effect size). No measures mediated improvements in objective (accelerometer measured) physical function. Conclusion Interventions aiming to improve patient-reported physical function in patients with chronic pain may benefit from skills that target kinesiophobia, mindfulness, and pain resilience, while those focused on improving performance-based physical function should target primarily kinesiophobia. More research is needed to understand mechanisms of improvement in objective, accelerometer-measured physical function. Trial Registration ClinicalTrials.gov NCT03412916.
Agency, Pluricorporality, and Respondeat Superior

Initial disclaimer: This is a thought piece regarding the origins of respondeat superior liability. It is intentionally lightly sourced because while my thoughts on this issue were almost certainly influenced by other scholars, I attempted to construct this model solely from my own thoughts and reflections. In other words, I did not look at any other work while I was constructing it, so any similarities to other scholarship is the result of the impact that scholarship had on my thinking, over time, not that I used that scholarship to craft this. In the [likely] event that I expand on this in the future, I will (of course) provide proper attribution for those prior works, once I have identified them. This short essay attempts to provide an economic rationale for the law of agency and, by so doing, an economic and moral justification for respondeat superior liability. Smithian principles of specialization and trade require some legal doctrines for allowing productive individuals to be in more than one place at a time, through agents, a principle I refer to as pluricorporality. Obtaining the benefits of pluricorporality requires accepting the costs, including tort liability, when the principal acts through the medium of an agent.
Cone Theorems and Cyclic Covers

This note is a continuation of [Kollar91b]. The aim is again to prove various forms of the Cone Theorem using methods similar to the original geometric arguments of [Mori79;82]. The basic idea is the same as in [Kollar91b]. Instead of deforming a curve C ⊂ X directly, we construct a covering Y → X and deform another morphism D → Y whereD is a suitable covering of C. In [ibid], Y was a bug-eyed cover of X, therefore a nonseparated algebraic space. The method of this article is to replace X by its formal completion along C and then find a suitable cyclic covering Y of this formal scheme.
Depression in Asian American children.

Competing interests: H Chung is Medical Director, Depression andAnxiety Management Team, Pfizer, Inc.
Structure-property relationships in Waspaloy via small angle scattering and electrical resistivity measurements

The mechanical properties in superalloys are controlled by the distribution of the {gamma}{prime} precipitate phase. Electrical measurements have been shown to be sensitive to certain aspects of the precipitation process and show promise for predicting the evolving microstructural state in superalloys. Aging experiments were conducted on Waspaloy samples for temperatures between 600 and 950 C for times ranging from 2min to 500h. Particle size distributions were obtained by modeling of small angle scattering (SAS) data, whereas, small precipitate size information, strain, and lattice mismatch data were obtained from X-ray diffraction. The microstructural information was then used to create a figure of merit of electron scattering intended to correlate electrical properties to the precipitate microstructure. The proposed figure of merit shows an empirical correlation with the electrical resistivity data, demonstrating the sensitivity of the resistivity measurements to the precipitation process and coarsening behavior.
Survival of grasshopper sparrows (Ammodramus savannarum ) during two important life stages in grassland managed with fire and grazing

Patch-burn grazing is a management framework that promotes heterogeneity in grasslands, similar to the structure grasslands birds evolved inhabiting. Published studies on patch-burn grazing have been conducted on large, contiguous grasslands and only one of these studies has investigated the reproductive success of grassland birds. We assessed the effects of patch-burn grazing (grazing, one third of the pasture burned annually) compared with a more traditional graze-and-burn treatment (grazing, entire pasture burned every third year) on nests of grasshopper sparrows (Ammodramus savannarum) in fragmented grasslands. We modeled grasshopper sparrow nest survival as a function of multiple biological and ecological factors. Constant daily survival rates were greater in patch-burn grazing pastures than in graze-and-burn pastures (patch-burn grazing rate = 0.930, burnand-graze rate = 0.907). Multiple factors were significant in survival models including year, stage of nest, a negative effect of nest age, and a negative effect of cool-season grass abundance within five meters of the nest. Our findings represent grassland bird survival in small-scale, fragmented grassland similar to many found throughout the corn-belt region of the United States. Results showed that survival rates were the highest in pastures managed with patch-burn grazing, but multiple factors influenced grasshopper sparrow survival. Results emphasize the importance of researchers using multiple covariates when examining
A Study of Design That Understands the Influences on the Changes of Information Processing Ability of Users

The main goal of this study is to research new design approaches for creating interactive products by designers that take into consideration the positive long-term influence a product has on users. In recent years, users are more and more interested in products that can have a good influence on them, for example, how much of a positive change can occur to their emotional or physical health through using a product. With the further advancement of technology, a wide range of effects frequently occur between new devices and users. These effects can be considered a new experience by users. In the future, users will take into consideration the positive influences a product has on them, and the long-term experience of using a technology device. Because of these compelling reasons, research is necessary to study the factors and characteristics of influences that products have on users through objective and utility methods.
Brill-Zinsser Disease

Brill-Zinsser disease is an exacerbation of epidemic louse-borne typhus fever caused by Rickettsia prowazekii . The organisms are not eradicated from the original infections and reappear, sometimes several years distant, as a mild form of the disease. The disease is passed by the body louse and in rare instances by lice and fleas from flying squirrels.
Epitope Mapping of Recombinant Human Procathepsin D

Procathepsin D is the proform of the aspartic proteinase, cathepsin D. The mature form, cathepsin D, is a low specificity proteinase found in the lysosome where the intracellular protein catabolism carried out by it is well understood. The proform, procathepsin D is also expressed in secretory and membrane-associated forms.1,2 These non-lysosomal forms of procathepsin D are associated with a wide variety of physiological and pathophysiological functions including metastasis of breast cancer,3 tissue remodeling, antigen presentation in the MHC class II pathway,4 and general role in the immune system.5 The structural bases whereby this proteinase can perform these varied and specific functions are unknown. Several possibilities for membrane-association have been proposed, none has been conclusively demonstrated. The propeptide has no hydrophobic regions or C-terminal membrane anchor sequences that may be responsible for membrane association. Membrane association may be due to surface exposed residues of the propeptide. It seems likely that most of the non-lysosomal functions involve interactions of the cellular machinery with the surface features of the folded propeptide region such as propeptide specific receptors.6 Therefore there is interest in the conformation of procathepsin D. A demonstration of a difference in the conformations of the various forms of this proteinase will add to the limited knowledge about the structural bases of the functions of the non-lysosomal forms of this proteinase.
Following unenhanced MRI assessment for local recurrence after surgical resection of mesenchymal soft tissue tumors, do additional gadolinium-enhanced images change reader confidence or diagnosis?

Abstract Purpose Evaluate if gadolinium enhanced MR imaging (GeMRI) improves confidence, changes the final diagnosis, or improves accuracy in the assessment of musculoskeletal (MSK) tumor residual or recurrence following surgical resection. We also assess if different experience levels change the above results. Methods and materials Initially, pre-contrast images were independently reviewed by two radiologists, one with 25 years of experience (R1) and one undergoing MSK specialty training (R2). Two questions were answered: (1) Mass present? and (2) Likelihood of malignancy? Subsequently, both pre-contrast and post-contrast images were independently reviewed. The same questions were again answered plus four others including if GeMRI changed mass characterization, better defined cystic versus solid, better defined tumor extent, or improved conspicuity. Lastly, the readers answered whether GeMRI changed confidence, and changed their final diagnosis. Histologic diagnoses were available in 43 cases, with the remaining 44 cases based upon clinical and/or imaging follow-up. Results GeMRI definitely improved confidence in 8/7 cases, and slightly improved confidence in 20/29 cases and changed the final diagnosis in 11/8 cases for R1 and R2 respectively. Positive and negative predictive values statistically improved for R2 (positive predictive value 36.4% versus 50%, p = 0.02; negative predictive value 75.4% versus 79.1%, p = 0.04) but not for R1. Reader concordance for malignancy improved with GeMRI ( κ = 0.44 pre-contrast and κ = 0.71 post-contrast). Conclusion GeMRI improved reader confidence, improved reader concordance and modestly improved accuracy for the less experienced reader. Where possible, GeMRI should be used in the assessment of MSK tumor residual or recurrence.
PolyADP-ribose polymerase-1 (PARP-1) and the Evolution of Learning and Memory

PARP-1 is a multifunctional enzyme that can modulate gene expression. Cohen-Armon et al.1 found that a homologue of PARP-1 is activated in the Aplysia nervous system as the animal responds to an aversive stimulus, which leads to sensitization, and during a more complex form of learning that involves feeding behavior. Significantly, inhibiting PARP-1 activation blocked the learning. Several key pathways in Aplysia neurons are activated both during learning and after injury, suggesting that mechanisms of learning evolved from primitive responses to injury. Since PARP-1 is evolutionarily conserved as a responder to various forms of stress, the finding that PARP-1 is activated during learning supports this idea. BioEssays 26:1268–1271, 2004. © 2004 Wiley Periodicals, Inc.