cssi/SciSciGPT-SciSciNet huggingface dataset:
Repeat Rapid Response Events in Children: Characteristics and Outcomes.

OBJECTIVE We describe the characteristics and outcomes of pediatric repeat rapid response events within a single hospitalization. We hypothesized that triggers for repeat rapid response and initial rapid response events are similar, and repeat rapid response events are associated with high prevalence of medical complexity and worse outcomes. DESIGN A 3-year retrospective study. SETTING High-volume tertiary academic pediatric hospital. PATIENTS All rapid response events were reviewed to identify repeat rapid response events. INTERVENTION None. MEASUREMENTS AND MAIN RESULTS Patient demographics, rapid response triggers, primary clinical diagnoses, illness acuity scores, medical interventions, transfers to ICU, occurrence of critical deterioration, and mortality were reviewed. We reviewed 146 patients with 309 rapid response events (146 initial rapid response and 163 repeat rapid response: 36% 7 d after initial rapid response). Median age was 3 years, and 60% were males. Eighty-five percentage of repeat rapid response occurred in medical complexity patients. The triggers for 71% of all repeat rapid response matched with those of initial rapid response. Transfer to ICU occurred in 69 (47%) of initial rapid response and 124 (76%) of repeat rapid response (p < 0.01). The median hospital stay was 11 and 30 days for previously healthy and medical complexity patients, respectively (p = 0.16). ICU readmission at repeat rapid response was associated with longer hospital stay (p < 0.01). Mortality during hospitalization occurred in 14% (all medically complex) of patients after repeat rapid response. Hospital mortality after rapid response is 4.4% per our center's administrative data and 6.7% according to published multicenter data. CONCLUSIONS Prevalence of medical complexity was high in patients with repeat rapid response compared with that reported for pediatric hospitalizations. Triggers between initial and repeat rapid response events correlated. Transfer to ICU was more likely after repeat rapid response and among repeat rapid response, events with ICU readmissions had a longer length of ICU and hospital stay. Mortality for the repeat rapid response cohort was higher than that for overall rapid responses in our center and per published reports from other centers.
Abstract 16655: Bone Marrow Cell Therapy in Patients With Ischemic Heart Disease: A Meta-analysis of Randomized Controlled Trials Using Cardiac MRI

Introduction: The results from clinical trials of bone marrow cell (BMC) therapy in ischemic heart disease (IHD) have been discordant with regard to left ventricular (LV) functional improvement. This discrepancy has been attributed, in part, to the use of dissimilar cardiac imaging modalities. MRI is the gold standard for assessment of cardiac structure/function. Hypothesis: We hypothesized that BMC therapy will improve LV parameters in patients with IHD when assessed by cardiac MRI. Methods: We performed a systematic review and meta-analysis of data from randomized controlled trials (RCTs) of BMC therapy in patients with IHD that used cardiac MRI. Database searches through May 30, 2015 identified 27 eligible RCTs (enrolling 1826 patients). The MRI data on LV ejection fraction (EF), infarct size, LV end-systolic volume (LVESV), and LV end-diastolic volume (LVEDV) were analyzed with random-effects meta-analysis. Clinical outcomes were analyzed using Peto odds ratio (OR). Results: Compared with standard therapy, BMC therapy improved LVEF (1.62%; 95% confidence interval [CI]: 0.49 to 2.75; P=0.005) and reduced LVESV (-2.00 ml; 95% CI: -3.19 to -0.82; P=0.0009). The improvement in LVEF was similar in patients with acute myocardial infarction (MI) and chronic IHD. Perhaps more importantly, BMC therapy was associated with reduced incidence of recurrent MI (OR: 0.39; 95% CI: 0.20 to 0.78; P=0.007) along with substantial improvement in other outcome parameters, including mortality (Table). However, these changes did not reach statistical significance perhaps due to smaller patient numbers. Conclusions: These results from meta-analysis of RCTs using cardiac MRI indicate that BMC therapy improves LV function and outcomes in patients with IHD. These data may help resolve the controversy regarding whether the reported benefits of BMC therapy are dependent on the selection of imaging modalities.
A Framework for Research on Problem-Solving Instruction

Research on mathematical problem solving has provided little specific information about problem-solving instruction. There appear to be four reasons for this unfortunate state of affairs: (1) relatively little attention has been given to the role of the teacher in instruction; (2) there has been little concern for what happens in real classrooms; (3) there has been a focus on individuals rather than small groups or whole classes; and (4) much of the research has been largely atheoretical in nature. This paper discusses each of these reasons and presents a framework for designing research on mathematics problem-solving instruction. Four major components of the framework are discussed: extra-instruction considerations, teacher planning, classroom processes, and instructional outcomes. Special attention is given to factors that may be particularly fruitful as the focal points of future research.
A conceptual framework for understanding multiple tobacco product use and the impact of regulatory action

INTRODUCTION Over 35% of the adult tobacco-using population regularly use more than one tobacco product. Although rates of tobacco use in the United States have declined over the last decade, rates of multiple tobacco product (MTP) have either remained stable (among adults) or increased (among youth). METHODS In this paper, we review the literature and propose a framework for understanding both MTP use and how regulatory actions on any single tobacco product (STP) may influence the use of other tobacco products. RESULTS AND CONCLUSIONS Within the framework, Product, Person, and Context/Situational factors (and their interactions) influence product cross-substitution and thus patterns of use of MTPs. In addition, we propose that Context/Situation effects specifically increase the complexity of MTP-use patterns resulting in "dynamic complementarity" in addition to substitution-like relationships between tobacco products. Experimentation with, and use of, various tobacco products results in reinforcement histories that affect which products are used, in what contexts, and by whom, which in turn has downstream impacts on toxicant exposure and health. We conclude our analysis with an examination of how regulation of STPs can have impacts on the use of other STP and MTP use and provide research questions for further examining MTP use. IMPLICATIONS Though rates of tobacco use have declined in the United States, over 35% of the adult tobacco-using population regularly uses more than one tobacco product. This paper provides a framework for understanding MTP use and how regulatory actions on any STP may influence the use of other tobacco products. We conclude our analysis by providing research questions for further examining MTP use.
The Role of Inflammation in Colon Cancer

Colorectal cancer (CRC) is the one of the leading causes of cancer-related deaths in the world. CRC is responsible for more than 600,000 deaths annually and incidence rates are increasing in most of the developing countries. Epidemiological and laboratory investigations suggest that environmental factors such as western style dietary habits, tobacco-smoking, and lack of physical activities are considered as risks for CRC. Molecular pathobiology of CRC implicates pro-inflammatory conditions to promote the tumor malignant progression, invasion, and metastasis. It is well known that patients with inflammatory bowel disease are at higher risk of CRC. Many evidences exist reiterating the link between Inflammation and CRC. Inflammation involves interaction between various immune cells, inflammatory cells, chemokines, cytokines, and pro-inflammatory mediators, such as cyclooxygenase (COX) and lipoxygenase (LOX) pathways, which may lead to signaling towards, tumor cell proliferation, growth, and invasion. Thus, this review will focus on mechanisms by which pro-inflammatory mediators and reactive oxygen/nitrogen species play a role in promoting CRC. Based on these mechanisms, various preventive strategies, involving anti-inflammatory agents, such as COX inhibitors, COX-LOX inhibitors, iNOS inhibitors, natural supplements/agents, and synthetic agents, that blocks the inflammatory pathways and suppress CRC are discussed in this review.
Apriori Association Rules Learning

HTTP cookies are used to monitor web-traffic and track users surfing the Internet. We often notice that promotions (ads) on websites tend to match our needs, reveal our prior browsing history, or reflect our interests. That is not an accident. Nowadays, recommendation systems are highly based on machine learning methods that can learn the behavior, e.g., purchasing patterns, of individual consumers. In this chapter, we will uncover some of the mystery behind recommendation systems based on transactional records. Specifically, we will (1) discuss association rules and their support and confidence; (2) the Apriori algorithm for association rule learning; and (3) cover step-by-step a set of case-studies, including a toy example, Head and Neck Cancer Medications, and Grocery purchases.
Deploying Predictive Models In A Healthcare Environment - An Open Source Approach

Despite dramatic progress in the application of predictive modeling and data mining techniques to problems in modern medicine, a major challenge facing technical practitioners is that of delivering models to clinicians. We have developed an easily implementable framework for publishing predictive models written in R or Python in a way that allows them to be consumed by practically any downstream clinical application, as well as allowing them to be reused in a wide variety of environments without modification. The approach makes models available as web services embedded in containers and uses only open source technology. We provide a template, practical explanation and discussion of involved technologies for a model production framework. We currently use this framework to deliver a model for predicting readmission to hospital following discharge to skilled nursing facilities. The flexibility and simplicity of this methodology will allow it to be readily adopted at a wide variety of institutions. We also provide source code for an example model.
Self-sustainable Sensor Networks with Multi-source Energy Harvesting and Wireless Charging

Energy supply remains to be a major bottleneck in Wireless Sensor Networks (WSNs). A self-sustainable network operates without battery replacement. Recent efforts employ multi-source energy harvesting to power sensors with ambient energy. Meanwhile, wireless charging is considered in WSNs as a reliable energy source. It motivates us to integrate both fields of research to build a self-sustainable network and guarantee operation under any weather condition. We propose a three-step solution to optimize this new framework. We first solve the Sensor Composition Problem (SCP) to derive the percentage of different types of sensors. Then we enable self-sustainability by bringing energy harvesting storage to the field for charging the Mobile Charger (MC). Next, we propose a 3-factor approximation algorithm to schedule sensor charging and energy replenishment of MC. Our extensive simulation results demonstrate significant improvement of network lifetime and reduction of network cost. The network lifetime can be extended at least three times compared with traditional approaches and the charging capability of MC increases at least 100%.
Selective reductions. 53. Asymmetric reduction of α-fluoromethyl ketones with B-chlorodiisopinocampheylborane and B-isopinocampheyl-9-borabicyclo[3.3.1]nonane. Combined electronic and steric contributions to the enantiocontrol process

Abstract A systematic study of the asymmetric reduction of aryl and alkyl α-fluoroalkyl ketones with (−)-diisopinocampheylchloroborane ((−)-DIP-Chloride, 1 ), and (−)- B -isopinocampheyl-9-borabicyclo[3.3.1]nonane ( R -Alpine-Borane, 2 ) has been made. In the case of reagent 1 , the direction of asymmetric induction in the chiral reduction of aryl trifluoromethyl ketones differs from that of the corresponding mono- and difluoromethyl ketones. For example, while 2-fluoro, and 2,2-difluoroacetophenones are reduced with 1 to the R -alcohols in 95% and 85% ee, respectively, 2,2,2-trifluoroacetophenone is reduced, under neat conditions at room temperature, to the S -alcohol in 90% ee. Though DIP-Chloride reduces unhindered prochiral dialkyl ketones in poor ee, alkyl α-fluoroalkyl ketones are reduced in improved ee depending on the number of α-fluorine atoms present in the ketone. While monofluoromethyl ketones provide moderate ee in the R -isomer, the di- and trifluoromethyl ketones are reduced in moderate to excellent ee in the opposite isomer. For example, 1-fluoro-2-octanone is reduced in 40% ee ( R ), whereas 1,1-difluoro- and 1,1,1-trifluoro-2-octanone are reduced in 32% ( S ), and 91% ee ( S ), respectively. In the case of the asymmetric reduction of the above series of ketones with 2 , the results are different. There is no change in the direction of chiral induction in the reduction of α-fluoroacetophenones with 2 . 2-Fluoroacetophenone and 2,2-difluoroacetophenone are reduced with 2 to the R -alcohol in 89% and 97% ee, respectively. The reaction of 2,2,2-trifluoroacetophenone is very slow, only 90% complete in 45 d, and provides the R -alcohol in 32% ee. In contrast, while 1-fluoro- and 1,1-difluoro-2-octanone are reduced by 2 in 65% ( R ) and 50% ee ( R ), respectively, 1,1,1-trifluoro-2-octanone is reduced in 60% ee ( S ), raising the question of which factors other than the steric size of the trifluoromethyl group, control the enantioselectivity of these reductions. The effect of steric versus electronic influence in such chiral reductions is discussed.
Trend towards Improved Day 100 and 2-Year Survival After SCT for AL Amyloidosis: Outcomes Before and After 2006

Abstract 3554 Introduction: The role of SCT in the management of Ig light chain (AL) amyloidosis remains undefined. Patients: We report 422 patients ([Table 1][1]) who received SCT for AL amyloidosis to compare outcomes of patients treated before January 2006 with those of patients treated from January 2006 until December 1, 2009. View this table: Table 1. Patient Characteristics Results: Day 100 all-cause mortality decreased over this time period from 12% to 7% ( P =.09) [figure 1][2]. Survival at 2 years increased from 78% to 82%. [Figure 2][3] The major determinants of early mortality (before day 100) were the presence of cardiac involvement with amyloid and increased levels of cardiac biomarkers, lower serum albumin, higher serum creatinine, and a higher number of organs involved. ([Table 2][4]) On multivariate survival analysis, higher levels of serum troponin T and N-terminal pro–brain natriuretic peptide were the only predictors of early mortality after SCT. ![Fig 1][5] Fig 1 Survival through d 100 in patients with AL who underwent SCT before and after 2006 ( P =.09). ![Fig 2][5] Fig 2 Survival through 24 mo. in patients with AL who underwent SCT before and after 2006 ( P =.09). View this table: Table 2. Group Differences by Survival Duration Conclusion: Improved supportive care and refined patient selection has improved the safety margin for patients undergoing SCT; short-term mortality showed a more than 40% decrease after 2005. Recognition of this decrease in mortality is important for physicians caring for these patients as they weigh the pros and cons of SCT vs novel agent-based treatment in management of amyloidosis. Disclosures: Gertz: Celgene: Honoraria; Millenium: Honoraria, Membership on an entity's Board of Directors or advisory committees. Lacy: Celgene: Research Funding. Dispenzieri: Celgene: Honoraria, Research Funding; Binding Site: Honoraria. Kumar: Celgene: Consultancy, Research Funding; Millennium: Research Funding; Merck: Consultancy, Research Funding; Novartis: Research Funding; Genzyme: Consultancy, Research Funding; Cephalon: Research Funding. [1]: #T1 [2]: #F1 [3]: #F2 [4]: #T2 [5]: pending:yes
A brief introduction to production of titanium dioxide and titanium tetrachloride

Abstract This chapter provides a brief overview of titanium production from ore to purified titanium dioxide and titanium tetrachloride. Titanium dioxide is used as pigment material in the production of paints, paper, and many other products as well as a precursor material that is subsequently processed to produce titanium metal. Titanium tetrachloride is used as a precursor to titanium metal production via the Kroll process. The titanium is first processed at the ore site to separate titanium minerals from gangue or unwanted metals. This step is followed by chemical processing to separate titanium chemically from the mineral constituents with which it is associated in the mineral form. The final steps in producing the titanium dioxide and titanium tetrachloride depend on the chemistry used for separating titanium from the other elements found in the source mineral.
High-complexity extracellular barcoding using a viral hemagglutinin

While single-cell sequencing technologies have revealed tissue heterogeneity, resolving mixed cellular libraries into cellular clones is essential for many pooled screens and clonal lineage tracing. Fluorescent proteins are limited in number, while DNA barcodes can only be read after cell lysis. To overcome these limitations, we used influenza virus hemagglutinins to engineer a genetically encoded cell-surface protein barcoding system. Using antibodies paired to hemagglutinins carrying combinations of escape mutations, we developed an exponential protein barcoding system which can label 128 clones using seven antibodies. This study provides a proof of principle for a strategy to create protein-level cell barcodes that can be used in vivo in mice to track clonal populations.
Use of a bipolar sealing device to seal partial cystectomy with and without augmentation with a single-layer simple continuous suture pattern in an ex vivo canine model.

Objective To evaluate the ability of a bipolar sealing device (BSD) to seal canine bladder tissue and to determine the influence of suture augmentation on resistance to leakage of sealed partial cystectomies. Study design Ex vivo, simple randomized study. Sample population Urinary bladders harvested from canine cadavers (n = 23). Methods Partial cystectomy of the cranial third of each bladder was performed with a BSD. This seal was augmented with a simple continuous pattern of 4-0 polydioxanone in half of the specimens. A pressure transducer inserted through the ureter measured intraluminal pressure at initial leakage and catastrophic failure as dyed saline was infused via a catheter inserted through the urethra. Initial leakage pressure and pressure at catastrophic failure were compared between sutured and nonsutured sealed partial cystectomies. Results Sutured sealed cystectomies showed initial leakage at lower pressures compared to non-sutured cystectomies (8.6 vs. 17.7 mm Hg; P = .0365) but were able to sustain greater pressures at catastrophic failure (34.3 vs. 21.8 mm Hg; P = .007). Catastrophic failure occurred along the seam of all nonsutured sealed cystectomies and at the suture holes in 10 of the 12 sutured bladders. Conclusion Partial cystectomies were effectively sealed with a BSD in this canine cadaveric bladder model. Augmentation with a simple continuous suture pattern increased the pressure at which catastrophic leakage occurred but lowered initial leak pressure. Clinical significance This study provides evidence supporting the evaluation of BSD use for partial cystectomy in live animals.
Sacral nerve stimulation ameliorates colonic barrier functions in a rodent model of colitis.

Background The mucosal barrier damage is recognized as one of the key factors in the pathogenesis of colitis. While sacral nerve stimulation (SNS) was reported to have therapeutic potential for colitis, its mechanisms of actions on colonic permeability remained largely unknown. Methods In this study, colitis was induced by intrarectal administration of TNBS in rats. Five days later, they were treated with SNS or sham-SNS for 10 days. The effects of SNS on colonic permeability were assessed by measuring the expression of tight-junction proteins involved in regulating permeability and the FITC-dextran test. The mechanism of actions of SNS was investigated by studying the function of the enteric nervous system (ENS) cells and analyzing the autonomic nervous system. Key results SNS decreased the disease activity index, microscopic and macroscopic scores, myeloperoxidase activity, and pro-inflammatory cytokines (TNF-α, IL-6). SNS increased the expression of Zonula Occludens-1, Occludin, Claudin-1, and Junctional adhesion molecule-A in the colon tissue. The FITC-dextran test showed that the colonic permeability was lower with SCS than sham-SNS. SNS increased ChAT, pancreatic polypeptide, and GDNF and reduced norepinephrine NGF, sub-P, and mast cell overactivation in the colon tissue. Concurrently, SNS increased acetylcholine in colon tissues and elevated vagal efferent activity. Conclusions & inferences SNS ameliorates colonic inflammation and enhances colonic barrier function with the proposed mechanisms involving the increase in parasympathetic activity and modulation of the activity of the ENS and immune system, including mast cells.
Hofstadter Topology: Non-crystalline Topological Materials in the Moiré Era

The Hofstadter problem is the lattice analog of the quantum Hall effect and is the paradigmatic example of topology induced by an applied magnetic field. Conventionally, the Hofstadter problem involves adding $\sim 10^4$ T magnetic fields to a trivial band structure. In this work, we show that when a magnetic field is added to an initially topological band structure, a wealth of remarkable possible phases emerges. We prove that threading magnetic flux through a Hamiltonian with nonzero Chern number enforces a phase transition at fixed filling and that a 2D Hamiltonian with nontrivial Kane-Mele invariant produces a 3D TI or 3D weak TI phase in periodic flux. We then study fragile topology protected by the product of two-fold rotation and time-reversal and show that there exists a 3D higher order TI phase where corner modes are pumped by flux. We show that a model of twisted bilayer graphene realizes this phase. Our results rely primarily on the magnetic translation group which exists at rational values of the flux. The advent of Moir\'e lattices also renders our work relevant experimentally. In Moir\'e lattices, it is possible for fields of order $1-30$ T to reach one flux per plaquette and allow access to our proposed Hofstadter topological phase.
THE EFFECT OF LIMITED SPATIAL RESOLUTION OF STELLAR SURFACE MAGNETIC FIELD MAPS ON MAGNETOHYDRODYNAMIC WIND AND CORONAL X-RAY EMISSION MODELS

We study the influence of the spatial resolution on scales of 5° and smaller of solar surface magnetic field maps on global magnetohydrodynamic solar wind models, and on a model of coronal heating and X-ray emission. We compare the solutions driven by a low-resolution Wilcox Solar Observatory magnetic map, the same map with spatial resolution artificially increased by a refinement algorithm, and a high-resolution Solar and Heliospheric Observatory Michelson Doppler Imager map. We find that both the wind structure and the X-ray morphology are affected by the fine-scale surface magnetic structure. Moreover, the X-ray morphology is dominated by the closed loop structure between mixed polarities on smaller scales and shows significant changes between high- and low-resolution maps. We conclude that three-dimensional modeling of coronal X-ray emission has greater surface magnetic field spatial resolution requirements than wind modeling, and can be unreliable unless the dominant mixed polarity magnetic flux is properly resolved.
Ethical Concerns in Telemedicine

Interest in telehealth applications for orthopedic surgeons is growing; however, one of the largest concerns of orthopedic surgeons is over the “ethical implications” of telemedicine. There are four basic principles of medical ethics which include Autonomy, Justice, Beneficence, and Nonmaleficence. Autonomy is considered the coercion-free decision-making patients have regarding their healthcare. Justice is defined as healthcare equity distributed among all groups in society. Beneficence underlies that the healthcare service provided should be for the good of the patient and not for anyone else’s primary benefit. And, finally Nonmaleficence dictates that the service does not harm the patient or others in society.
Bio-inspired bistable piezoelectric energy harvester for powering animal telemetry tags: concept design and preliminary experimental validation

This paper presents the concept design, preliminary experimental validation, and performance evaluation of a novel bio-inspired bi-stable piezoelectric energy harvester for self-powered fish telemetry tags. The self-powered fish tag is designed to externally deploy on fish (dorsal fin) to track and monitor fish habitats, population, and underwater environment, meanwhile, harvests energy from fish motion and surrounding fluid flow for a sustainable power supply. Inspired by the rapid shape transition of the Venus flytrap, a bi-stable piezoelectric energy harvester is developed to generate electricity from broadband excitation of fish maneuvering and fluid. A bluff body is integrated to the free end of the bistable piezoelectric energy harvester to enhance the structure-fluid interaction for the large-amplitude snap-through vibrations and higher voltage output. Controlled laboratory experiments are conducted in a water tank on the bio-inspired bi-stable piezoelectric energy harvester using a servo motor system to simulate fish swing motion at various conditions to evaluate the power generation performance. The preliminary underwater experimental results demonstrated that the proposed bio-inspired bi-stable piezoelectric effectively converters fish swing motions into electricity. The average power output of 1.5 mW was achieved at the swing angle of 30° and frequency of 1.6 Hz.
Intrathecal baclofen, selective dorsal rhizotomy, and extracorporeal shockwave therapy for the treatment of spasticity in cerebral palsy: a systematic review

Cerebral palsy (CP) is a chronic congenital disorder as the result of abnormal brain development. Children suffering from CP often battle debilitating chronic spasticity, which has been the focus of recent academic literature. In this systematic review, the authors aim to update the current neuromodulation procedures for the treatment of spasticity associated with CP in all age groups. A systematic review following was conducted using PubMed from inception to 2020. After initial title and abstract screening, 489 articles were identified, and 48 studies met the inclusion criteria for this review. In total, a majority of the published articles of treatments for CP were reporting the use of selective dorsal rhizotomy (SDR) (54%), and the remainder were of intrathecal baclofen (ITB) pumps (29%) and extracorporeal shockwave therapy (ESWT) (17%). Each method was found to have improvement of spasticity at a rate that achieved statistical significance. ITB pump therapy is an all-encompassing method of treating spasticity in children from CP, as it allows for a less invasive treatment that can be titrated to individual patient needs; however, its disadvantages include its long-term maintenance requirements. SDR appears to be an effective method for permanent spasticity relief in young patients. ESWT is a more recent and innovative technique for offering relief of spasticity while being minimally invasiveness. Further studies are needed to establish optimal frequencies and sites of application for ESWT.
Advisory groups

Technology transfer to local governments has often been accompanied by the formation of advisory groups of expert scientists and engineers. This paper argues that such groups are difficult to manage and that overcoming their weaknesses is more than a question of the good intentions, public dedication, and managerial competence found in the Mayor's Science and Technology Advisory Council of Philadelphia. The necessary management requires tough negotiation in focusing on a limited agenda of issues, formal preparation of experts by city staff, and follow-through on non-technical aspects of the innovation process. Such managerial requisites can seem contrary to the very notion of an expert panel of scientists and engineers.
Comparative analysis of human immune responses following SARS-CoV-2 vaccination with BNT162b2, mRNA-1273, or Ad26.COV2.S

Abstract Background Three SARS-CoV-2 vaccines, two based on mRNA, BNT162b2 and mRNA-1273, and one based on an adenovirus platform, Ad26.COV2.S, received emergency use authorization by the U.S. Food and Drug Administration in 2020/2021. These vaccines displayed clinical efficacy in initial studies against confirmed COVID-19 of 95.0%, 94.1%, and 66.9%, respectively. Methods Individuals receiving one of these vaccines were invited to participate in a prospective longitudinal comparative study of immune responses elicited by the three vaccines. In this observational cohort study, humoral responses were evaluated using a SARS-CoV-2 receptor-binding domain (RBD) ELISA and a SARS-CoV-2 virus neutralization assay at mean of 21-31 days and 45-63 days following each initial vaccination. IFN-γ ELISPOT assays were conducted with peripheral blood mononuclear cells obtained at a median of 45-63 days after each initial vaccination. Results The two mRNA-based platforms elicited similar RBD ELISA responses and neutralizing antibody responses. The adenovirus-based vaccine elicited significantly lower RBD ELISA and SARS-CoV-2 virus neutralization activity. The mRNA-1273 vaccine elicited significantly higher spike glycoprotein-specific T cell responses than either the BNT162b2 or the Ad26.COV2.S vaccines. Conclusions Both mRNA based vaccines elicited higher magnitude humoral responses than Ad26.COV2.S and mRNA1273 elicited the highest magnitude of T cell response. Neutralizing antibody titers correlated with reported estimates of vaccine efficacy. Summary of key points We compared antigen specific humoral and T cell responses following vaccination with BNT162b2, mRNA-1273, or Ad26.COV2.S. Both mRNA based vaccines elicited higher magnitude humoral responses than Ad26.COV2.S and mRNA1273 elicited the highest magnitude of T cell response.
Feeding jejunostomy tube placement during resection of gastric cancers.

Abstract Background Feeding tube placement is common among patients undergoing gastrectomy, and national guidelines currently recommend consideration of a feeding jejunostomy tube (FJT) for all patients undergoing resection for gastric cancer. However, data are limited regarding the safety of FJT placement at the time of gastrectomy for gastric cancer. Methods The 2005–2011 American College of Surgeons National Surgical Quality Improvement Program Participant User Files were queried to identify patients who underwent gastrectomy for gastric cancer. Subjects were classified by the concomitant placement of an FJT. Groups were then propensity matched using a 1:1 nearest neighbor algorithm, and outcomes were compared between groups. The primary outcomes of interest were overall 30-d overall complications and mortality. Secondary end points included major complications, surgical site infection, and early reoperation. Results In total, 2980 subjects underwent gastrectomy for gastric cancer, among whom 715 (24%) also had an FJT placed. Patients who had an FJT placed were more likely to be male (61.6% versus 56.6%, P = 0.02), have recent weight loss (21.0% versus 14.8%, P versus 4.2%, P versus 1.3%, P versus 28.6%, P versus 24.1%, P versus 36.1%, P = 0.32) or mortality (5.8 versus 3.7%, P = 0.08). There were also no differences in major complications, surgical site infection, or early reoperation. Operative time was slightly longer among patients with feeding tubes placed (median, 248 versus 233 min, P = 0.01), but otherwise there were no significant differences in any outcomes between groups. Conclusions Concomitant placement of FJT at the time of gastrectomy may result in slightly increased operative times but does not appear to lead to increased perioperative morbidity or mortality. Further investigation is needed to identify the patients most likely to benefit from FJT placement.
Macroscopic Symmetry and Properties of Crystals

Publisher Summary The chapter is written with the point of view and the needs of the modern solid-state physicist in mind. There is a tendency to neglect a systematic presentation of the macroscopic symmetry properties of crystals in current curricula. The chapter may serve to bridge the gap in part. However, most of the readers will possess a rudimentary knowledge of the structures of the simpler crystals and of the language of crystal geometry—for example, Miller indices. Such knowledge is assumed. General familiarity with tensor language and matrix algebra is assumed. However, the mathematical argument leading to the reduction of property representation by means of crystal symmetry is supplemented throughout by equivalent physical argument. Most crystalline materials that are found in nature or are produced by man are polycrystalline—that is, they are composed of many minute crystals. If the orientation of the single crystals is random, the typical polycrystalline specimen behaves isotropically with respect to its physical properties.
LEEM Investigation of Refractory Metals Grown on Insulating Substrates: Nb (110) on Sapphire $(11\bar{2}0)$

We summarize LEEM studies of Nb (110) single crystals grown by MBE on Al2O3. At temperatures between 1300 K and 1600 K the structure relaxes to create flat terraces several μm wide, and stable subgrain boundaries, by clearly visible interfacial and surface processes. The Nb surface exhibits two mirror-equivalent variants of a reconstruction, one of which prevails at low temperatures. Upon approaching Tc at ~1480 K, the two variants alternate in extended stripes along , with stripe widths that decrease smoothly as T approaches Tc. Both at low T and above Tc, variants are trapped at dislocation strain fields.
Structure of a conserved hypothetical protein SA1388 from S. aureus reveals a capped hexameric toroid with two PII domain lids and a dinuclear metal center

The protein encoded by the SA1388 gene from Staphylococcus aureus was chosen for structure determination to elucidate its domain organization and confirm our earlier remote homology based prediction that it housed a nitrogen regulatory PII protein-like domain. SA1388 was predicted to contain a central PII-like domain and two flanking regions, which together belong to the NIF3-like protein family. Proteins like SA1388 remain a poorly studied group and their structural characterization could guide future investigations aimed at understanding their function. The structure of SA1388 has been solved to 2.0A resolution by single wavelength anomalous dispersion phasing method using selenium anomalous signals. It reveals a canonical NIF3-like fold containing two domains with a PII-like domain inserted in the middle of the polypeptide. The N and C terminal halves of the NIF3-like domains are involved in dimerization, while the PII domain forms trimeric contacts with symmetry related monomers. Overall, the NIF3-like domains of SA1388 are organized as a hexameric toroid similar to its homologs, E. coli ybgI and the hypothetical protein SP1609 from Streptococcus pneumoniae. The openings on either side of the toroid are partially covered by trimeric "lids" formed by the PII domains. The junction of the two NIF3 domains has two zinc ions bound at what appears to be a histidine rich active site. A well-defined electron density corresponding to an endogenously bound ligand of unknown identity is observed in close proximity to the metal site. SA1388 is the third member of the NIF3-like family of proteins to be structurally characterized, the other two also being hypothetical proteins of unknown function. The structure of SA1388 confirms our earlier prediction that the inserted domain that separates the two NIF3 domains adopts a PII-like fold and reveals an overall capped toroidal arrangement for the protein hexamer. The six PII-like domains form two trimeric "lids" that cap the central cavity of the toroid on either side and provide only small openings to allow regulated entry of small molecules into the occluded chamber. The presence of the electron density of the bound ligand may provide important clues on the likely function of NIF3-like proteins.
Re-analysis of the antidromic cortical response. II. On the contribution of cell discharge and PSPs to the evoked potentials.

Simultaneous recordings were obtained from single pyramidal tract (PT) neurons and from the surface of the motor cortex following stimulation of the surgically isolated PT of barbiturate-anesthetized cats. In agreement with previous suggestions (Humphrey 1968), the discharge of the PT cell population was found to contribute negligibly to a cortical surface record, whereas recurrent IPSPs gave rise to a comparatively large amplitude (0.4–0.7 mV) surface negativity. The results appeared to provide particularly clea evidence in favor of the hypotheses advanced by Eccles (1951) and by Purpura (1959) (i.e., that cortical gross waves derive largely from PSPs), because in this instance cell discharge and PSPs were separable in time, allowing the contributions of each to be independently assessed. However, the usual explanations advanced to account for such differential contribution (temporal and spatial dispersion of unit responses, cancellation of potential fields generated by responses of opposite polarity, etc.) appeared inadequate, suggesting that an additional, perhaps more fundamental mechanism was involved. To pursue this possibility, mathematical theories of electrotonic and volume conduction were used to calculate the extracellular potentials generated by a spike and a long duration IPSP in a pyramidally shaped model neuron. The results indicated that in generating a potential at a distant extracellular point (more than 150–200 μ from the active membrane regions), a pyramidally shaped neuron may behave essentially as a “low-pass filter”; i.e., long duration intracellular potentials may give rise to a greater external voltage than do short duration transients of even larger amplitude. The biophysical properties of the cell that might be responsible for this result were discussed. A population of model cells was then constructed, on the basis of experimental data concerning the distribution of evoked PT unit activity over time and cortical depth. The theoretical potentials distributions generated by the model population agreed well with those experimentally observed during the discharge of, and IPSPs within, the PT cell population. Possible implications of the model for interpretations of cortical gross potential data were discussed.
A superiority‐equivalence approach to one‐sided tests on multiple endpoints in clinical trials

This paper considers the problem of comparing a new treatment with a control based on multiple endpoints. The hypotheses are formulated with the goal of showing that the treatment is equivalent, i.e. not inferior, on all endpoints and superior on at least one endpoint compared to the control, where thresholds for equivalence and superiority are specified for each endpoint. Roy’s (1953) union-intersection and Berger’s (1982) intersection-union principles are employed to derive the basic test. It is shown that the critical constants required for the union-intersection test of superiority can be sharpened by a careful analysis of its type I error rate. The composite - test is illustrated by an example and compared in a simulation study to alternative tests proposed by Bloch et al. (2001) and Perlman & Wu (2004). The Bloch et al. test does not control the type I error rate because of its nonmonotone nature, and is hence not recommended. The - and the Perlman & Wu tests both control the type I error rate, but the latter test generally has a slightly higher power.
Value of Drug-Eluting Stents in Cardiac Transplant Recipients

Transplant allograft vasculopathy (TAV) was a leading cause of death in cardiac transplant recipients after the first year of transplantation. Whether drug-eluting stents (DESs) performed better than bare-metal stents (BMSs) for the treatment of patients with discrete epicardial stenosis was unknown. The aim was to determine the safety and efficacy of DESs compared with BMSs in the treatment of patients with TAV. Outcomes of 32 patients sequentially treated using DESs for TAV were retrospectively reviewed and compared with a historic cohort of 35 patients treated sequentially with BMSs for TAV. Patients treated with DESs were also compared with age- and gender-matched cardiac transplant controls to determine differences in survival. After adjustment for baseline risk factors, there was no difference in 1-year survival between patients treated with DESs or BMSs for TAV. Restenosis rates at 1 year were 49% in lesions treated using BMSs and 19% in those treated using DESs. Compared with an age- and gender-matched control group of cardiac transplant patients who did not have discrete obstructive epicardial TAV, patients who required treatment with DESs for epicardial obstructive disease had significantly worse survival. In conclusion, treatment of patients with TAV with DESs did not seem to alter the natural deleterious history of this disease process.
Identification of Two Regions from the Drosophila decapentaplegic Gene Required for Embryonic Midgut Development and Larval Viability

The Drosophila decapentaplegic (dpp) gene, a member of the transforming growth factor-beta family, is required for dorsal/ventral pattern formation and midgut and imaginal disk development. We have identified a 3-kb upstream regulatory region necessary for dpp expression in the visceral mesoderm of the gastric caeca primordia and a second 2.5-kb upstream regulatory region necessary for dpp expression in the midgut visceral mesoderm corresponding to a portion of abdominal segments 1 and 2 (parasegment 7). These regulatory regions act over a distance of up to 10-kb on all four of the dpp promoters examined. Absence of dpp expression in the gastric caeca primordia caused defective development of the gastric caeca and a concomitant partial reduction in larval and pupal viability. Absence of dpp expression in the visceral mesoderm of parasegment 7 caused a reduction in the length of the central portion of the larval gut and a change in the morphology of the midgut cells in this region but had little effect on the survival of the animals to the adult stage. However, a larval lethal phenotype was observed when both the central portion of the larval midgut and the gastric caeca were defective.
Artiodactyl nuclear DNA study.

Recently (News Focus, 25 June, p. [2081][1]), a short article by Elizabeth Pennisi appeared discussing the 1999 meeting of the American Genetic Association. Pennisi reports on an artiodactyl nuclear DNA study that we have recently completed at Texas A&M University. In short, a well-supported
Isolation of Human and Murine Homologues of the Drosophila Minibrain Gene: Human Homologue Maps to 21q22.2 in the Down Syndrome “Critical Region”

Abstract The presence of an extra copy of human chromosome 21 (trisomy 21), especially region 21q22.2, causes many phenotypes in Down syndrome, including mental retardation. To study genes potentially responsible for some of these phenotypes, we cloned a human candidate gene (DYRK) from 21q22.2 and its murine counterpart (Dyrk) that are homologous to theDrosophilaminibrain (mnb) gene required for neurogenesis and to the rat Dyrk gene (dual specificity tyrosine phosphorylation regulated kinase). The three mammalian genes are highly conserved, >99% identical at the protein level over their 763-amino-acid (aa) open reading frame; in addition, the mammalian genes are 83% identical over 414 aa to the smaller 542-aamnbprotein. The predicted human DYRK and murineDyrkproteins both contain a nuclear targeting signal sequence, a protein kinase domain, a putative leucine zipper motif, and a highly conserved 13-consecutive-histidine repeat. Fluorescencein situhybridization and regional mapping data localize DYRK between markers D21S336 and D21S337 in the 21q22.2 region. Northern blot analysis indicated that both human and murine genes encode approximately 6-kb transcripts. PCR screening of cDNA libraries derived from various human and murine tissues indicated that DYRK andDyrkare expressed both during development and in the adult.In situhybridization ofDyrkto mouse embryos (13, 15, and 17 days postcoitus) indicates a differential spatial and temporal pattern of expression, with the most abundant signal localized in brain gray matter, spinal cord, and retina. The observed expression pattern is coincident with many of the clinical findings in trisomy 21. Its chromosomal locus (21q22.2), its homology to themnbgene, and thein situhybridization expression patterns of the murineDyrkcombined with the fact that transgenic mice for a YAC to which DYRK maps are mentally deficient suggest that DYRK may be involved in the abnormal neurogenesis found in Down syndrome.
Prediction of critical conditions for thermal explosion problems by a series method

Owing to the high degree of nonlinearity of thermal explosion problems, a variety of procedures has evolved for the prediction of the critical conditions for ignition. In this communication, a series solution method is applied to the general one-dimensional, steady-state thermal explosion problem. The method has as advantages: (1) conceptual simplicity; (2) application to Cartesian, cylindrical and spherical geometry; (3) simple expression when flexibility, but not accuracy is required; and (4) direct extension to higher order series when accuracy is required.
Aldosterone, deoxycorticosterone and corticosterone differences between arteriosclerotic breeder vs nonarteriosclerotic virgin rats.

The circulating levels of the major adrenal steroids, corticosterone (Cmpd. B), deoxycorticosterone (DOC), and aldosterone were compared in male and female, arteriosclerotic, breeder and non-arteriosclerotic virgin, Sprague--Dawley rats under resting conditions, i.e., quiescence, and after exposure to a mild stress, i.e., movement from one room to another just prior to autopsy. Under resting conditions, the arteriosclerotic animals had significantly greater circulating levels of Cmpd. B, DOC and aldosterone than the non-arteriosclerotic animals. Both the arteriosclerotic and non-arteriosclerotic animals were able to respond adequately to the mild stress stimulus. However, the female breeder rats which manifest the most severe aortic sclerosis, showed the greatest increase in Cmpd. B and aldosterone in response to the mild stress. Although no statistically significant differences could be found between female breeders with grossly visible aortic sclerosis of clear, minimal, moderate, or severe degree, it was apparent that adrenal steroid responsiveness becomes progressively compromised with increasing severity of arteriosclerosis, e.g., unusually high or low levels of Cmpd. B and aldosterone under both quiescent and mild stress conditions. It is suggested that there may be some connection between abnormal hypothalamic-pituitary-adrenal-gonadal function in repeatedly-bred and the pathogenesis of their naturally-occurring ateriosclerosis.