cssi/SciSciGPT-SciSciNet huggingface dataset:
Biomarkers of chronic inflammation in disease development and prevention: challenges and opportunities

The US National Institutes of Health convened a workshop on disease-promoting chronic inflammation to identify the challenges and needs in the development of clinically feasible strategies for monitoring a person's inflammation status before, during and after disease occurrence.
Modification of constrained LQR for control of walking in-pipe robots

In this paper, a new control method for walking in-pipe robots is discussed. The method is based on a combination of a linear quadratic regulator for systems with explicit mechanical constraints and a proportional-derivative controller formulated in terms of end effector coordinates (Cartesian coordinates of the robot's foot that takes the step). The performance of the proposed method is measured using a quality criteria discussed in the paper. A nine-link walking in-pipe robot is used as an example in simulations. The simulation show that the proposed method improves the performance of the control system. Also, simulations demonstrated that the control system using the proposed controller is not sensitive to torque saturation and the changes in the initial conditions.
Tutorial: Teaching Verbal Behavior to Children with ASD.

Early and intensive behavioral intervention has been shown to result in favorable outcomes for children with autism spectrum disorder. Procedures and practices based on and influenced by B. F. Skinner’s Verbal Behavior (VB) have been increasingly integrated into EIBI curricula in recent years. In this article, I give an overview of some basic tenets of VB as they pertain to behavioral interventions for children with ASD, with a special emphasis on the relevance of basic behavioral principles to verbal operants. Additionally, I provide a few examples of practical recommendations derived from VB.
Glassy dynamics of landscape evolution

Soil creeps imperceptibly downhill, but also fails catastrophically to create landslides. Despite the importance of these processes as hazards and in sculpting landscapes, there is no agreed-upon model that captures the full range of behavior. Here we examine the granular origins of hillslope soil transport by discrete element method simulations and reanalysis of measurements in natural landscapes. We find creep for slopes below a critical gradient, where average particle velocity (sediment flux) increases exponentially with friction coefficient (gradient). At critical gradient there is a continuous transition to a dense-granular flow rheology. Slow earthflows and landslides thus exhibit glassy dynamics characteristic of a wide range of disordered materials; they are described by a two-phase flux equation that emerges from grain-scale friction alone. This glassy model reproduces topographic profiles of natural hillslopes, showing its promise for predicting hillslope evolution over geologic timescales.
Maps of Korea

As compared with some other countries of the world, Korea is a well mapped land. This brief review lists some of the major maps and sets of maps of the peninsula which are useful to those interested in Korea.Old Korean maps. Korean scholars for their use in studies of Chinese and Korean literature and for their administrative work if they were chosen for government posts prepared small hand atlases. Some of these atlases have been collected by Western scholars and copies are found in the Library of Congress, American Geographical Society Library, New York Public Library and a number of other map collections. These atlases are usually made up of maps of the world, China, Korea, the eight provinces of Korea, Japan and the Loo Choo Islands.They are hand drawn and copied from some prototype. On their margins or on the reverse side of each map are brief gazetteers or comments. A description of the China-centered world map was given by Homer B. Hulburt, “An ancient map of the world,” Bulletin of the American geographical society, 36 (1904), 600–05. The atlas was described and reproduced in part by H. Cordier in Description d'un atlas Sino-Coreen. Manuscript du British Museum (Paris: Ernest Leroux, 1896). A Japanese, Otani, prepared a 37 page catalogue of old Korean maps which was published by the Keijo Imperial University, Seoul, in 1933, but a copy of this has not been found in American libraries.
Interscale Predictive Wavelet Coding with Huber Markov Random Field

An interscale predictive wavelet coding (IPWC) scheme is proposed in this paper. The image is encoded top-down, from the coarsest scale to the finest scale. At each scale, the current scale coefficients are predicted from the coded coefficients at the coarser scale and the prediction residue is encoded. The interscale prediction is based on MAP estimation with Huber Markov random field statistical image model. The efficiency of IPWC is supported by experimental results.
The effect of polyploidy on embryo cleavage after in vitro fertilization in humans

The effect of polyploidy on the early development of human embryos is unknown. This study compares the early development of 90 polyploid and 275 diploid human embryos conceived in vitro. Between May 1983 and January 1986, 3081 oocytes were recovered during 631 cycles of laparoscopy for in vitro fertilization (4.9 oocytes/cycle); 1924 oocytes (62.4%) fertilized. There were 90 oocytes with more than two pronuclei (4.7% of fertilized oocytes), identified in 72 cycles (11.4% of cycles). In these cycles, the proportion of diploid oocytes (n = 275) that cleaved (cleavage rate) (92.7%) was significantly greater than the proportion of polyploid oocytes (n = 90) that cleaved (65.5%) ( P P
Economic Inequality, Poverty, and Park and Recreation Delivery

This paper explores the nature of economic inequality in the United States and its implications for the delivery of park and recreation resources to poorer Americans. The first part of this paper shows that economic wealth and poverty are increasingly concentrated, resulting in persistent poverty among segments of the U.S. population. Growing economic inequality over the last 35 years is linked to the weakening of trade unions, the loss of high paying manufacturing jobs, declining tax rates levied on wealthy Americans, the erosion of unemployment benefits and public spending on social services, the loss of public sector jobs, and a scaling back of progressive government policies that have historically benefited poorer Americans. Growing economic inequality has led to the rise of an underclass, primarily minority, which is stuck in poverty. In the second part of the paper, six ideas are presented about how to better serve poorer Americans. Public parks and recreation leaders are encouraged first to develop positive relationships with influential allies when advocating for improved leisure service delivery. A related strategy is to work with allies to improve accessibility of park and recreation resources. Redressing access inequities may be couched as environmental justice and civil rights issues. A third strategy is to offer leisure education programs that include basic instruction associated with different recreation activities. The key here is provide poorer Americans formative experience in leisure activities; many of these experiences are taken for granted by more affluent Americans. Another tactic is to increase safety so that poorer Americans are more likely to access parks and community facilities. A fifth course of action is to ensure poorer Americans are made to feel welcome when visiting recreation areas. Principles of inclusion must permeate all levels of the organization so that every citizen feels welcome. A final and obvious consideration in these economically challenging times is to make services affordable. Professionals associated with recreation and parks and their allies must proactively work to change how agencies currently operate and implement inclusive systems and strategies to ensure that leisure services are available to all Americans regardless of their socioeconomic status.
Grade classification model tandem BpNN method with multi-metal sensor for rice eating quality evaluation

Abstract Evaluation of rice eating quality is increasingly important to researchers and consumers. In this paper, a novel tandem evaluation approach, which is grade classification model tandem back propagationartion neural network (BpNN) method, was developed for multi-metal sensor to predict rice eating quality. Characteristic current and potential arrays were extracted and properly processed, resulting in potential phasor plane values and current phasor plane values. The current phasor plane values were used as the input variables of grade classification model, and consequently, the classification value and grade value of sample output as well as potential phasor plane values were used in the following BpNN for score prediction. It was found that the performance of developed grade classification model tandem BpNN method was better than that of direct neural network method. The scores predicted by developed method were compared to sensory scores obtained by traditional sensory evaluation. A correlation coefficient of 0.9964, a RMSE of 0.69, a slop of 0.98 and an intercept of 1.45 were obtained. The accuracy of developed method for score prediction was 90%. Results indicated that the developed tandem evaluation approach was an efficient method for rice score prediction in electronic tongue system.
An Inward-Rectifier Potassium Channel Coordinates the Properties of Biologically Derived Membranes

Abstract KirBac1.1 is a prokaryotic inward-rectifier K+ channel from Burkholderia pseudomallei. It shares the common inward-rectifier K+ channel fold with eukaryotic channels, including conserved lipid-binding pockets. Here, we show that KirBac1.1 changes the phase properties and dynamics of the surrounding bilayer. KirBac1.1 was reconstituted into vesicles composed of 13C-enriched biological lipids. Two-dimensional liquid-state and solid-state NMR experiments were used to assign lipid 1H and 13C chemical shifts as a function of lipid identity and conformational degrees of freedom. A solid-state NMR temperature series reveals that KirBac1.1 lowers the primary thermotropic phase transition of Escherichia coli lipid membranes while introducing both fluidity and internal lipid order into the fluid phases. In B. thailandensis liposomes, the bacteriohopanetetrol hopanoid, and potentially ornithine lipids, introduce a similar primary lipid-phase transition and liquid-ordered properties. Adding KirBac1.1 to B. thailandensis lipids increases B. thailandensis lipid fluidity while preserving internal lipid order. This synergistic effect of KirBac1.1 in bacteriohopanetetrol-rich membranes has implications for bilayer dynamic structure. If membrane proteins can anneal lipid translational degrees of freedom while preserving internal order, it could offer an explanation to the nature of liquid-ordered protein-lipid organization in vivo.
Neuronal responses in posterior parietal cortex during learning of implied serial order

Monkeys are able to learn the implied ordering of pairs of images drawn from an ordered set, without ever seeing all of the images simultaneously and without explicit spatial or temporal cues. The learning of implied order differs from learning of explicit visual or motor sequences. We recorded the activity of parietal neurons in rhesus macaques while they learned 7-item TI lists when only 2 items were presented on each trial. Behavior and ensemble neuronal activity were significantly influenced by the ordinal relationship of the stimulus pairs, specifically symbolic distance (the difference in rank) and joint ranks (the sum of the ranks). Symbolic distance strongly predicted decision accuracy, and learning was consistently faster as symbolic distance increased. An effect of joint rank on performance was also found nested within the symbolic distance effect. Across the population of neurons, there was significant modulation of firing correlated with the relative ranks of the two stimuli presented on each trial. Neurons exhibited selectivity for stimulus rank during learning, but not before or after. The observed behavior during learning is best explained by a virtual workspace model, not by associative or reward mechanisms. The neural data support a role for posterior parietal cortex in representing several variables that contribute to serial learning, particularly information about the ordinal ranks of the stimuli presented during a given trial. Thus, parietal cortex appears to belong to a neural substrate for learning and representing abstract relationships in a virtual workspace.
Feasibility of Self-administered Neuromodulation for Neurogenic Bladder in Spinal Cord Injury

Purpose To determine if self-administered transcutaneous tibial nerve stimulation (TTNS) is a feasible treatment option for neurogenic bladder among people with spinal cord injury (SCI) who utilize intermittent catheterization for bladder management. Methods Four-week observational trial in chronic SCI subjects performing intermittent catheterization with incontinence episodes using TTNS at home daily for 30 minutes. Those using anticholinergic bladder medications were given a weaning schedule to begin at week 2. Primary outcomes were compliance and satisfaction. Secondary outcomes included change in bladder medications, efficacy based on bladder diary, adverse events, and incontinence quality of life (I-QoL) survey. Results All 16 subjects who started the study completed the 4-week trial rating TTNS with high satisfaction and easy to use, without discomfort. Twelve of 14 patients (86%) using anticholinergic bladder medications reduced their dosage and maintained similar frequency and volumes of bladder catheterization and incontinence episodes. Bladder medication reduced by approximately 3.2 mg weekly (95% confidence interval, -5.9 to -0.4) and anticholinergic side effects of dry mouth and drowsiness decreased more than 1 level of severity from baseline (P=0.027, P=0.015, respectively). At 4 weeks, total I-QoL score improved by an average of 3.2 points compared to baseline in all domains. Conclusion This pilot trial suggests TTNS is feasible to be performed at home in people with chronic SCI. Participants were able to reduce anticholinergic medication dosage and anticholinergic side effects while maintaining continence, subsequently improving QoL scores. These results advocate for further randomized, controlled trials with longer duration and urodynamic evaluation to assess long-term efficacy.
Teaching Writing in the Midst of Fragile Alliances: Insights from Literacy Teacher Educators

The purpose of this phenomenological narrative study was to describe what it means to be Literacy Teacher Educators (LTEs) who supported writing in the context of a research–practice partnership (R...
Bipolar radiofrequency ablation creates different lesion characteristics compared to simultaneous unipolar ablation.

Introduction Both bipolar and simultaneous radiofrequency ablation (bRFA, simRFA) have been used to treat thick midmyocardial substrate as well as during circular, multipolar ablation between shorter distances. Objectives We sought to evaluate the biophysical parameters of simRFA, sequential unipolar RFA (seqRFA), and bRFA. Methods Bovine myocardium was placed in a circulating saline bath. To simulate thick substrate conditions, two open irrigated ablation catheters were oriented across from each other, with myocardium in between. Thermocouples were placed in the center, ±2 mm, of the myocardium. Unipolar ablations were performed sequentially or simultaneously at 50 W for 60 seconds and compared to bRFA using the same settings. In addition, to simulate multipolar ablation, two open irrigated ablation catheters were oriented on the same side and perpendicular to myocardium at 1, 2, and 4 mm spacing. SimRFA were performed at 15 and 25 W for 60 seconds and compared to bRFA. Results For thicker tissue, simRFA produced similar lesion volume and depth compared to bRFA but with a lesion geometry similar to seqRFA. Unlike seqRFA and simRFA, bRFA had a necrotic core spanning the myocardium. Core depths, volumes, and temperatures were significantly greater for bRFA lesions compared to simRFA or seqRFA (Figure, P Conclusions BRFA has greater core lesion temperatures, corresponding to a denser and larger necrotic core, than either simRFA or seqRFA. This may have implications for considering the optimal strategy for deep midmyocardial substrates or during multipolar ablation.
Differential adoption of opioid agonist treatments in detoxification and outpatient settings

Abstract Background Opioid use disorder (OUD) is a significant public health problem for which a substantial amount of treatment exists. The degree to which methadone and buprenorphine are administered in different treatment modalities is not clear but critical to understanding treatment success rates and service development strategies. Methods Data from the national Treatment Episode Dataset for Admissions and Discharges (TEDS-A [N = 4,070,264] and TEDS-D [832,731], respectively) were used to determine the likelihood patients initiating detoxification and outpatient OUD treatment between 2006 and 2015 were expected to receive opioid agonist treatment. Joinpoint regression evaluated significant trends and a generalized linear model with logit link function identified characteristics associated with receiving an agonist during detoxification. TEDS-D informed the percent of patients leaving detoxification against medical advice who did/did not receive an opioid agonist. Results Though agonist use in outpatient settings increased by 60% during 2012–2015, agonist use in detoxification was lower than outpatient treatment, decreased significantly by 26% from 2009 to 2015, and never exceeded 16% of detoxification admissions during 2006–2015. In 2015, persons who were under 25, homeless, had co-occurring psychiatric problems, utilized Medicare, Medicaid, or had no insurance, and had no prior OUD treatment or were high treatment utilizers were the least likely to receive an agonist during detoxification. Conclusions Efforts to expand opioid agonist access has been successful for outpatient but not detoxification settings. Improving detoxification outcomes is a potentially high impact way for the US to expand efficacious OUD treatment access in the US.
Recent Advances in Severe Asthma: From Phenotypes to Personalized Medicine

This review focuses on recent clinical and translational discoveries in severe and uncontrolled asthma that now enable phenotyping and personalized therapies in these patients. Although asthma is common in both children and adults and typically responds to standard therapies, a subset of individuals with asthma experience severe and/or persistent symptoms despite appropriate therapies. Airflow obstruction leading to frequent symptoms requiring higher levels of controller therapy is the cardinal feature of severe asthma, but the underlying molecular mechanisms, or endotypes, are diverse and variable between individuals. Two major risk factors that contribute to severe asthma are genetics and environmental exposures that modulate immune responses, and although these often interact in complex manners that are not fully understood, certain endotypes converge in severe asthma. A number of studies have evaluated various features of patients with severe asthma and classified patients into phenotypes with clinical relevance. This phenotyping is now incorporated into clinical practice and can be used to guide advanced biological therapies that target specific molecules and inflammatory pathways that contribute to asthma pathogenesis.
The Role of Neoadjuvant Chemotherapy in Patients With Resectable Malignant Pleural Mesothelioma-An Institutional and National Analysis.

Background There is no standard of care with respect to the use of neoadjuvant chemotherapy (NAC) in resectable malignant pleural mesothelioma (MPM). We performed an intention-to-treat analysis with data from a single institution and the National Cancer Database (NCDB) to identify whether the use of NAC impacts survival in resectable MPM. Methods Patients with MPM who had surgery with curative intent at Duke University from 1995 to 2017 were selected, and the 2004-2015 NCDB was used to identify MPM patients with clinical stage I-IIIB who underwent definitive surgery. For both cohorts, patients were stratified by receipt of NAC. Primary outcomes were overall survival and postresection survival (RS), which were estimated using Kaplan-Meier and multivariable Cox proportional hazards models. Results A total of 257 patients met inclusion criteria in the Duke cohort. Compared with immediate resection (IR), NAC was associated with similar overall survival but an increased risk for postresection mortality in both unmatched (adjusted hazard ratio [HR] = 1.85, 95% confidence interval [CI] = 1.21 to 2.83) and propensity-matched (HR = 1.62, 95% CI = 1.03 to 2.55) cohorts. A total of 1949 NCDB patients were included: 1597 (81.9%) IR and 352 (18.1%) NAC. RS was worse for patients undergoing NAC in both unmatched (HR = 1.85, 95% CI = 1.21 to 2.83) and propensity-matched (HR = 1.29, 95% CI = 1.06 to 1.57) analyses compared with patients receiving IR. Conclusions In this intention-to-treat study, NAC was associated with worse RS compared with IR in patients with MPM. The risks and benefits of induction therapy should be weighed before offering it to patients with resectable MPM.
Assessment of Expected Out-of-Pocket Spending for Rheumatoid Arthritis Biologics Among Patients Enrolled in Medicare Part D, 2010-2019

Importance The closure of the Medicare Part D coverage gap from 2010 to 2019 was intended to help decrease out-of-pocket costs for beneficiaries, especially those taking high-cost drugs. However, yearly increases in list prices and the introduction of newer and more expensive drugs may have limited savings for beneficiaries. Objective To assess the association of closure in the Medicare Part D coverage gap with projected annual out-of-pocket costs from 2010 through 2019 for rheumatoid arthritis (RA) biologics. Design, Setting, and Participants This cross-sectional analysis used data from the Medicare Formulary and Pricing Files for the first quarter (January 1 to March 31) in each calendar year from 2010 to 2019 for 17 RA biologic drug and strength combinations. Exposures Medicare Part D plan design and drug price by year. Main Outcomes and Measures Expected annual out-of-pocket costs for 1 year of treatment. Results Among the 17 drug and strength combinations assessed, list prices increased each year for every product, with a mean increase of 160% for the 6 drugs available during the entire study period. For the 6 products available during the entire study period, projected mean (SD) annual out-of-pocket costs were 34% (2%) lower in 2011 than in 2010 ($6108 in 2010 to $4026 in 2011) but only 21% (8%) lower in 2019 ($4801) because of yearly increases in list price. All 4 products with higher out-of-pocket costs in 2019 than in the first year available entered the market between 2011 and 2015. For all products studied, the percentage of money spent in the catastrophic phase increased each year and was a mean (SD) of 22% (14%) higher in 2019 than in 2010 or the year first available. Conclusions and Relevance Although beneficiaries experienced large reductions in out-of-pocket spending from 2010 to 2011, more than half of those savings were lost by 2019 because of annual increases in list prices, even as the coverage gap continued to close in subsequent years.
List Of Illinois Crustacea: With Descriptions Of New Species

A first contribution to the knowledge of Illinois crustacea, comprising 22 species accounts, with some described as new.
97 – Borrelia burgdorferi

Publisher Summary Borrelia burgdorferi causes Lyme borreliosis (LB) or Lyme disease. It possesses some genetic and phenotypic features that are unique among prokaryotes, such as a linear chromosome and multiple linear and circular plasmids in a single cell. B. burgdorferi is maintained in nature mainly by means of a rodent/bird-tick cycle and is occasionally transmitted to humans by the bite of an infected Ixodes tick. Clinical manifestations of Lyme borreliosis depend upon the stage of the infection and may affect dermatological, neurological, cardiac and musculoskeletal systems. This chapter presents the general aspects regarding B. burgdorferi sensu lato with a focus on its genome and molecular characteristics. Strategies for prevention and control of Lyme borreliosis include the reduction of tick host populations, ecological and chemical control of tick vectors, and personal protection of individuals who have a high risk for Lyme borreliosis. Practical and environmental approaches for reservoir and tick control have not, however, been well developed. Personal protection includes wearing light colored clothes to make crawling ticks visible, tucking trousers into socks to prevent ticks from gaining access to exposed skin, and using tick or insect repellents and vaccination.
Anti-Escherichia coli Functionalized Silver-Doped Carbon Nanofibers for Capture of E. coli in Microfluidic Systems.

Silver-doped carbon nanofibers (SDCNF) are used as the base material for the selective capture of Escherichia coli in microfluidic systems. Fibers were spun in a glovebox with dry atmosphere maintained by forced dry air pumped through the closed environment. This affected the evaporation rate of the solvent during the electrospinning process and the distribution of silver particles within the fiber. Antibodies are immobilized on the surface of the silver-doped polyacrylonitrile (PAN) based carbon nanofibers via a three-step process. The negatively charged silver particles present on the surface of the nanofibers provide suitable sites for positively charged biotinylated poly-(L)-lysine-graft-poly-ethylene-glycol (PLL-g-PEG biotin) conjugate attachment. Streptavidin and a biotinylated anti-E. coli antibody were then added to create anti-E. coli surface functionalized (AESF) nanofibers. Functionalized fibers were able to immobilize up to 130 times the amount of E. coli on the fiber surface compared to neat silver doped fibers. Confocal images show E. coli remains immobilized on fiber mat surface after extensive rinsing showing the bacteria is not simply a result of non-specific binding. To demonstrate selectivity and functionalization with both gram negative and gram-positive antibodies, anti-Staphylococcus aureus surface functionalized (ASSF) nanofibers were also prepared. Experiments with AESF performed with Staphylococcus aureus (S. aureus) and ASSF with E. coli show negligible binding to the fiber surface showing the selectivity of the functionalized membranes. This surface functionalization can be done with a variety of antibodies for tunable selective pathogen capture.
Burn patient decontamination outside of mass casualties.

Objective Decontamination protocols for victims of mass casualty events are well documented and emphasized to protect physicians, nurses and facilities. Decontamination practices outside of mass casualty events are unknown. This pilot study was undertaken to assess the current practices of burn patient decontamination outside of mass casualty events within level I and II trauma center emergency departments in the state of Michigan. Methods Using the Michigan Trauma Quality Improvement Project membership, a 10-question online survey was sent to trauma program managers at all level I and II trauma centers in Michigan. Survey questions focused on institutional decontamination protocols and consistency of use. Results Survey response was 50%. Of the responding facilities, 31% did not decontaminate burn patients. Of the centers who indicated that they did decontaminate burn patients, 31% did not follow a standardized protocol. Our survey revealed that 69% of facilities used a protocol for decontamination: 45% used the protocol consistently on all burns, and 55% at physician discretion. Products used most frequently to decontaminate burn patients included water (100%) followed by soap (44%). Conclusion This pilot survey of level I and II trauma centers in the state of Michigan revealed variability in the use of burn patient decontamination protocols and consistency of use. Additional research is warranted to determine if our results are reflective of trauma centers nationally.
Endorectal advancement flap: are there predictors of failure?

PURPOSE: The management of complex perianal fistulas with endorectal advancement flap is aimed at avoiding the risk of sphincter injury associated with traditional surgical methods. Long-term follow-up is required to assess the recurrence and continence outcomes of this procedure. The aim of this study was to review our experience with endorectal advancement flap in the treatment of complex perianal fistulas and to define the predictors of successful healing. METHODS: A retrospective chart review of all patients who underwent endorectal advancement flap for complex perianal fistulas between 1988 and 2000 was performed. Follow-up was established by telephone interview. RESULTS: One hundred six consecutive endorectal advancement flap procedures were performed on 94 patients (94.4 percent). There were 56 females (59.6 percent). Mean age was 41.6 (range, 18-76) years. Cryptoglandular disease was the most common cause of fistula (n = 41, 43.6 percent), followed by Crohn's disease (n = 28, 29.8 percent). At a mean follow-up of 40.3 (range, 1-149) months, the procedure was successful in 56 (59.6 percent) of 94 patients. Twelve patients underwent repeat surgery with the same technique because of initial failure, 8 of whom eventually healed. Crohn's disease was associated with a significantly higher recurrence rate (57.1 percent) when compared with fistulas in patients without Crohn's disease (33.3 percent, P< 0.04). Prior attempts at repair of the fistula were not associated with less favorable outcome of the procedure (P = 0.5). Recurrence was not associated with the type of fistula, origin, preoperative steroid use, postoperative bowel confinement, use of postoperative antibiotics, or creation of a diverting stoma. The median time to recurrence was 8 (range, 1-156) weeks; there was no postoperative mortality. Two patients had postoperative bleeding, one requiring resuture of the flap on the first postoperative day. Recurrences were observed in 15.7 percent of the patients 3 or more years after the repair. In 8 patients (9 percent), continence deteriorated after the endorectal advancement flap, a more common finding in patients who had undergone previous surgical repairs (P < 0.02). CONCLUSION: The success rate of endorectal advancement flap for complex perianal fistulas is modest. Failure is mainly correlated with the presence of Crohn's disease.
An outpatient antimicrobial stewardship initiative for urinary tract infections in primary care pediatrics

Background Studies have showed that 30% of antibiotics prescribed in the outpatient setting are unnecessary Acute UTI constitutes a significant health burden in outpatient pediatrics affecting ∼2 8% of children every year Antibiotics are often started empirically when diagnosing UTI making pediatric UTIs an ideal target for outpatient stewardship The primary objective was to reduce the use of broad-spectrum empiric antibiotics with a secondary objective to study antibiotic discontinuation in culture negative cases Methods The electronic medical records of two pediatric practices were screened for patients aged 2 months to 18 years diagnosed with uncomplicated UTI using ICD-10 codes N39, R30 and R35 The definition of a positive urine culture was > 50,000 CFU/ml if catheterized and > 100,000 CFU/ml if clean-catch specimen A two-year pre-intervention period began in January 2018 An audit and review of urine culture processes were studied at each site with a subsequent educational intervention, a direct, one-hour session focused on the use of cephalexin as first-line empiric therapy based on the local antibiogram The post-intervention period began at each site after the intervention A COVID-19 sub-analysis was performed for the post-intervention period Results During the study, 515 encounters and 113 encounters were included during the pre- and post-intervention periods, respectively 74 4% (383/515) of pre-intervention encounters had empirically prescribed antibiotics;higher-generationcephalosporins (i e cefdinir, cefprozil) most frequently Antibiotics were empirically prescribed in 75 2% (85/113) of post-intervention encounters with a statistically significant increase in cephalexin use (32/85, 37 6%, p < 0 01) and reduction in higher- generation cephalosporin use (p < 0 01), Figure 1 In the COVID-19 analysis, empiric antibiotic prescribing Conclusion: The educational intervention was effective in changing antibiotic prescribing with an increased use of narrow spectrum antibiotics This change waned without reinforcement and reliance on telemedicine during COVID-19 Antibiotic discontinuation in culture-negative cases remains an important area for improvement
What fosters environmental engagement in China? Exploring the underlying pathways using the O-S-R-O-R model

Building on the O-S-R-O-R framework, this study proposes the environmental communication mediation model and examines the formations of environmental engagement behavior in China. Analyzing data fr...
A conserved role for arrow in posterior axis patterning across Arthropoda

Abstract Segmentation is a key characteristic of Arthropoda that is linked to the evolutionary success of this lineage. It has previously been shown in both vertebrates and short germ insects that posterior segmentation requires canonical Wnt (cWnt) signaling, which maintains the expression of Caudal and the posterior growth zone; disruption of cWnt signaling incurs posterior truncations in these lineages due to the loss of the tail bud. However, comparable datasets for Wnt signaling are limited outside of holometabolous insects, due to incomparable phenotypic spectra and inefficacy of gene misexpression methods in certain model species. We applied RNA interference (RNAi) against the Wnt co-receptor arrow (arr), a key member of the cWnt signaling pathway in holometabolous insects and vertebrates, to examine posterior axis elongation of the cobweb spider Parasteatoda tepidariorum (short germ embryogenesis; one Wnt8 homolog), the cricket Gryllus bimaculatus (intermediate germ; one Wnt8 homolog), and the milkweed bug Oncopeltus fasciatus (short germ; two Wnt8 homologs). Knockdown of arr in insects resulted in posterior truncations affecting the gnathos through the abdomen in O. fasciatus, whereas posterior truncations only affected the T3 segment through the abdomen in G. bimaculatus. Spider embryos with disrupted arr expression exhibited defects along the entire axis, including segmentation defects throughout the germband. RNA-Seq-based differential gene expression analysis of severe Ptep-arr loss-of-function phenotypes at two developmental stages was used to confirm that knockdown of Ptep-arr results in systemic disruption of the Wnt pathway. Intriguingly, we found that knockdown of arr did not abrogate Wnt8 expression in any of the three species, with cad expression additionally retained in severe loss-of-function phenotypes in the cricket and the spider. Together with data from a holometabolous insect, our results suggest that cWnt signaling is not required for maintenance of Wnt8 expression across Arthropoda. These outcomes underscore the diagnostic power of differential gene expression analyses in characterizing catastrophic phenotypes in emerging model species.
NMDAR-mediated transcriptional control of gene expression during the development of medial ganglionic eminence-derived interneurons

Medial ganglionic eminence (MGE)-derived parvalbumin (PV)+, somatostatin (SST)+, and Neurogliaform (NGFC)-type cortical and hippocampal interneurons, have distinct molecular, anatomical and physiological properties. However, the molecular mechanisms regulating their diversity remain poorly understood. Here, via single-cell transcriptomics, we show that the obligate NMDA-type glutamate receptor (NMDAR) subunit gene Grin1 mediates subtype-specific transcriptional regulation of gene expression in MGE-derived interneurons, leading to altered subtype identities. Notably, MGE-specific conditional Grin1 loss results in a systemic downregulation of diverse transcriptional, synaptogenic, and membrane excitability regulatory programs. These widespread gene expression abnormalities mirror aberrations that are typically associated with neurodevelopmental disorders, particularly schizophrenia. Our study hence provides a roadmap for the systematic examination of NMDAR signaling in interneuron subtypes, revealing potential MGE-specific genetic targets that could instruct future therapies of psychiatric disorders.
Rox index predicts intubation in patients with COVID-19 pneumonia and moderate to severe hypoxemic respiratory failure receiving high flow nasal therapy

Introduction Use of high flow nasal therapy (HFNT) to treat COVID-19 pneumonia has been greatly debated around the world due to concern for increased healthcare worker transmission and delays in invasive mechanical Ventilation (IMV). Herein we analyze the utility of the ROX index to predict the need and timing for IMV in a retrospective analysis of patients with COVID-19 with moderate to severe hypoxemic respiratory failure treated with HFNT. Methods This was a retrospective analysis of 129 consecutive patients with COVID-19 admitted to Temple University Hospital in Philadelphia, Pennsylvania, from March 10, 2020, to May 17, 2020 with moderate to severe hypoxemic respiratory failure treated with High Flow nasal therapy (HFNT). HFNT patients were divided into two groups: HFNT only and HFNT progressed to IMV. The primary outcome was the ability of the ROX index to predict the need of IMV. Secondary outcomes were mortality, rates of intubation, length of stay (LOS) and rates of nosocomial infections in our cohort treated with HFNT were also reported. Results 837 patients with COVID-19 were screened, 129 met inclusion criteria. The mean age was 60.8(+13.6) years, BMI 32.6(+8), 58(45 %) were female, 72(55.8%) were African American, 40 (31%) Hispanic. 48 (37.2%) were smokers. Of the 129, 89 were HFNT only group whereas 40 in the HFNT progressed to IMV group. Mean time to intubation was 2.5 days(+ 3.3). The 89 HFNT only patients had a significant improvement in ROX from initiation of HFNT at all recorded time points. In contrast, the ROX in HFNT progressed to IMV patients remained unchanged or decreased over time. ROX index of less than 5 at HFNT initiation was predictive of progression to IMV (OR = 2.137, p = 0,052). Any decrease in ROX index after HFNT initiation was predictive of intubation (OR= 14.67, p 0), peak D-dimer >4000 and admission GFR < 60 ml/min were very strongly predictive of need for IMV (ROC = 0.86, p=0.001). Mortality was 11.2% in HFNT only group versus 47.5% in the HFNT progressed to IMV group (p = 0.0001). Mortality and need for pulmonary vasodilators were higher in the HNFT progressed to IMV group. Conclusion ROX index is a valuable, noninvasive tool to evaluate patients with moderate to severe hypoxemic respiratory failure in COVID-19 treated with HFNT. ROX helps predicts need for IMV and thus limiting morbidity and mortality associated with IMV.
Telling Our Story Part I: Positioning African Studies to Thrive within Changing Research and Political Landscapes

At a time when multiple pressures challenge teaching and research in area studies, it has become more difficult to promote African Studies at the local, national, and international levels. These pressures include increased emphasis on enrollment-based evaluation and assessment, global security concerns, and the move toward international and global studies - sometimes to the detriment of deep context-based area specialization. As libraries try to provide services, collections, and spaces tailored to the needs of their users, they face the challenge to cater to these diverse approaches which often compete for the same resources. What knowledge, understanding, experiences, and data can we bring to the table to promote and advocate for African Studies scholarship, teaching, learning, archives and libraries? This roundtable intends to open a dialogue among ASA members (e.g., faculty, graduate students, Title VI center directors, outreach directors, et al.) and a wide range of other stakeholders who benefit from or contribute to the ASA mission -- to share ideas and arguments on how to identify and implement strategies for securing a sustained commitment to African and area studies within the academy. Given the variety of environments in which African Studies scholars work, and the many challenges to scholarly paths for supporting a liberal higher education, we hope this roundtable will stimulate dialogue and ideas to better position African Studies and area studies to thrive.
Sodium Transport by Epithelial Cells

The Koefoed-Johnsen and Ussing model for Na transport by the frog skin is now more than 35 years old. One of the purposes of this chapter is to pay homage to this simple but brilliant insight into how epithelial cells work. In addition, the model will be updated in terms of the transporters involved in the Na reabsorption process. As we shall see, this is not really a refinement of the model, since most of these transporters are precisely those postulated in the original paper.1 We do have, however, a great deal more information on their functional and molecular properties. Another goal of this chapter will be to review the regulation of the individual components of the system, and of the system as a whole. A final topic is the question of which ions are transported along with Na or in exchange for Na to preserve electroneutrality, and what mechanisms are involved in this transport.
Factors That Impact Pseudomonas aeruginosa Biofilm Structure and Function

This chapter focuses on the relationships among biofilm development, the environment, and antimicrobial tolerance for the paradigm organism Pseudomonas aeruginosa. While a specific strain of P. aeruginosa consistently produces the same biofilm structure under one laboratory culturing condition, the same strain produces a very different biofilm structure under different culturing conditions. Investigators have discovered that biofilms grown in vitro reproducibly form specific structures that are affected by a plethora of conditions. For P. aeruginosa, two general biofilm shapes have been observed using the flow cell system: structured biofilms and flat biofilms. While the environmental sensing mechanisms and the regulatory pathways leading to the formation of specific biofilm structures have not been fully elucidated, it is clear that many factors are important for this process. A focus of recent work has been on identifying the signal transduction and regulatory pathways that control biofilm formation and that integrate different environmental signals during biofilm development. The chapter provides an outline about the regulation of biofilm formation by cyclic-di-GMP (c-di-GMP) and two-component systems (TCSs). Researchers are currently trying to determine the nature of these environmental signals, and as they do, our understanding of which environments promote or impair biofilm formation will grow. Microbial fuel cells and wastewater treatment communities are a few examples of engineered, structured communities that could benefit from such an approach.
The association of serum uric acid levels with outcomes following percutaneous coronary intervention.

Background: Serum uric acid may serve as a marker for the activation of oxidative stress and may therefore be a marker for subsequent cardiovascular events. Our goal was to assess the association of serum uric acid levels and the outcomes of patients who have undergone percutaneous coronary intervention (PCI). Methods: We performed a retrospective cohort study of patients who underwent PCI between 1/1/2000 and 12/31/2007. Data were retrieved from the Cardiac Lab Interventional Clinical Database as well as the medical records. Outcomes of mortality as well as major adverse cardiac events (MACE) that include death, myocardial infarction (MI), and target vessel revascularization were obtained. There were 10,632 unique patients who had a PCI at the Mayo Clinic in Rochester and allowed use of their records for research. During this time, 1,916 had a uric acid measure within 2 years prior to the day of PCI. Results: Of the 1,916 patients in our cohort, 1,353 had normal uric acid levels and 563 had elevated uric acid. After multivariable analysis, there was a strong trend in association with follow-up mortality in patients with elevated uric acid (HR = 1.25, 95% CI 0.98–1.59, P = 0.07). The association with mortality or MI (HR = 1.15, 95% CI 0.93–1.43, P = 0.20) and the association with MACE (HR = 1.04, CI 0.86– 1.25, P = 0.71) were not significant. Conclusions: In a large single-center database with complete follow-up, elevated serum uric acid was associated with increased mortality in PCI patients. These data show a trend for uric acid in the pathophysiology of atherosclerotic coronary artery disease and highlight the need for further research. (J Interven Cardiol 2010;23:277–283)
Ethnic diversity, distrust and corruption in Afghanistan: Reflections on the creation of an inclusive culture

Purpose – Afghanistan is an ethnically diverse country which has suffered from many negative consequences caused by mismanagement of diversity, low levels of education, and political acrimony among different groups. The paper seeks to discuss how cultural and ethnic diversity can lead to civil unrest and make management of a country more complex. When diversity is not managed well, its consequences can be high levels of conflict, animosity, discrimination, corruption, and distrust among different ethnic groups.Design/methodology – This is a conceptual paper. It covers the realities of ethnic, religious and language diversity in Afghanistan based on first hand observations and experience along with findings from the literature.Findings – The paper suggests that diversity education along with an ethical climate is especially crucial for Afghanistan if the aim is to create an inclusive culture where everyone's voice is heard, understood and integrated for implementation. A diversity continuum model for inclu...
Automated classification of Pap smear tests using neural networks

The preliminary results of a project that automates the classification of Pap smear samples are given. In the preprocessing stage, first a set of ten features is extracted from a Pap smear image and is used to form the feature space. Then, the standard "The Bethesda System" (TBS) rules are translated into fuzzy rules that are used to classify the Pap smear test into normal and abnormal classes based on the extracted features. A feedforward neural network is applied for the sample for which fuzzy logic based classification is unclear. The high accuracy of classification of neural network on the preliminary results indicates the successful performance of the system.
Possibility of high temperature superconductivity in C[sub 36] and C[sub 24]N[sub 12] solids

Some preliminary discussion is presented concerning predicting superconductivity in general and the properties of existing fullerene superconductors. This is followed by a consideration of the likelihood of superconductivity in C36 solids. Our present knowledge about C36 and the similar molecule C24N12 is reviewed along with the relevant arguments used as a basis for suggesting that these systems are good candidates for superconductivity at relatively high temperatures.