cssi/SciSciGPT-SciSciNet huggingface dataset:
Socioeconomic and Racial Disparities in Parental Perception and Experience of Having a Medical Home, 2007 to 2011–2012

Abstract Objective To evaluate whether socioeconomic (SES) and racial disparities in the parental perception and experience of having a medical home decreased from 2007 to 2011–2012. Methods We used nationally representative samples of children aged 1 to 17 from the 2007 (n = 83,293) and 2011–2012 (n = 87,774) National Surveys of Children's Health. Multivariable logistic regression was used to test associations between SES (income, employment, and education) and race/ethnicity to the medical home and its subcomponents (personal doctor or nurse, usual source of care, family-centered care, referrals, care coordination), controlling for a priori identified covariates. Results From 2007 to 2011–2012, fewer children overall had access to a medical home (56.9% vs 54.0%, aOR = 0.91, 95% confidence interval 0.86–0.96). There were no significant changes in SES and racial trends in access to the medical home during this time period. For example, parents of children Conclusions Despite widespread efforts to promote the medical home for all children, large SES and racial disparities in the parental perception and experience of having a medical home persisted from 2007 to 2011–2012.
PICROTOXININ BINDING SITES IN BRAIN

Publisher Summary One of the classical substances that antagonize the synaptic transmission mediated by the inhibitory neurotransmitter γ-aminobutyric acid (GABA) is picrotoxin. Picrotoxin is a non-nitrogen-containing molecule, found in the plants of the Menispermaceae family. Picrotoxin is made up of two compounds, picrotoxinin and picrotin (50:50), which differ only in the hydration of the isopropenyl group. The biological activity of picrotoxin is contained primarily in picrotoxinin. Picrotoxinin differs from another GABA antagonist, bicuculline, in its lack of structural similarity to GABA and in its inability to displace [3H]GABA binding from its receptor sites. Nonetheless, picrotoxinin blocks postsynaptic GABA-mediated responses that involve an increase in the conductance to chloride ions. This chapter presents an experiment conducted to learn about the possible site of action of picrotoxinin at the GABA postsynaptic receptor-ionophore complex, where a radioactive analog of picrotoxinin, α-[3H]dihydropicrotoxinin ([ 3H]DHP) is synthesized. It also discusses the properties of picrotoxinin binding.
Towards Defeating DDoS Attacks

Distributed Denial of Service (DDoS) attacks are attacks where a host of compromised systems are used to target a single system. This single system can be either an actual machine or a network resource. What makes these attacks so prevalent and hard to deal with is the fact that they are distributed. They come from a wide variety of machines, making them hard to trace and even harder to counter. This, in conjunction with the fact that many tools are becoming available on the market that make DDoS attacks easier, makes preventing DDoS attacks a very imperative issue. This paper proposes a mechanism, DDDoS, or Triple Dos, which will deal with DDoS attacks on the Internet layer. There are registration and authentication protocols used to connect clients and servers, so that an unregistered client cannot access the network and thus flood it with traffic. The Triple Dos service will only be activated when a DDoS attack is detected (using clustering), and it will ensure that registered clients and servers can always communicate.
Introduction: The Tincture of Time

Acknowledging and accepting mindfulness into clinical social work compels us to think about the implications for our understanding of human behavior, our social systems, our educational structures, our understanding of health and mental health, and our approach to clinical research. Time and care is needed to examine mindfulness with critical optimism and its implications for practice now, and in the near future.
Melanoma Chemoprevention: Current Status and Future Prospects†

The incidence of skin cancers, both nonmelanoma and melanoma, is increasing in the United States. The ultraviolet radiation, mainly from sun, is considered the major cause for these neoplasms. While nonmelanoma skin cancers are far more numerous, melanoma remains the most challenging. This is because melanoma can become extremely aggressive and its incidence is increasing worldwide due to lack of effective early detection, as well as disease recurrence, following both surgery and chemotherapy. Therefore, in addition to better treatment options, newer means are required to prevent melanomas from developing. Chemoprevention is a reasonable cost-effective approach to prevent carcinogenesis by inhibiting the processes of tumor initiation, promotion and progression. Melanoma is a progressive disease, which makes it very suitable for chemopreventive interventions, by targeting the processes and molecular pathways involved in the progression of melanoma. This review discusses the roles of various chemopreventive agents such as NSAIDs, statins, vitamins and dietary agents in melanoma and highlights current advancements and our perspective on future of melanoma chemoprevention. Although considerable preclinical data suggest that melanoma may be prevented or delayed by a numerous chemopreventive agents, we realize there are insufficient clinical studies evaluating their efficacy and long-term safety for human use.
Controlled Delivery of Single or Multiple Antigens in Tolerogenic Nanoparticles Using Peptide-Polymer Bioconjugates.

Polymeric nanoparticles (NPs) have demonstrated their potential to induce antigen (Ag)-specific immunological tolerance in multiple immune models and are at various stages of commercial development. Association of Ag with NPs is typically achieved through surface coupling or encapsulation methods. However, these methods have limitations that include high polydispersity, uncontrollable Ag loading and release, and possible immunogenicity. Here, using antigenic peptides conjugated to poly(lactide-co-glycolide), we developed Ag-polymer conjugate NPs (acNPs) with modular loading of single or multiple Ags, negligible burst release, and minimally exposed surface Ag. Tolerogenic responses of acNPs were studied in vitro to decouple the role of NP size, concentration, and Ag loading on regulatory T cell (Treg) induction. CD4+CD25+Foxp3+ Treg induction was dependent on NP size, but CD25 expression of CD4+ T cells was not. NP concentration and Ag loading could be modulated to achieve maximal levels of Treg induction. In relapsing-remitting experimental autoimmune encephalomyelitis (R-EAE), a murine model of multiple sclerosis, acNPs were effective in inhibiting disease induced by a single peptide or multiple peptides. The acNPs provide a simple, modular, and well-defined platform, and the NP physicochemical properties offer potential to design and answer complex mechanistic questions surrounding NP-induced tolerance.
Abstract P50: IV Alteplase Use Predicts Favorable Discharge Disposition in Patients With Acute Ischemic Stroke: Insights From the UTHSC Houston Stroke Registry

Introduction: Acute ischemic stroke patients receiving IV alteplase (t-PA) within 4.5 hours of symptom onset are 30% more likely to have minimal or no disability at 3 months. During hospitalization, short-term disability is subjectively measured by discharge disposition, whether to home or Inpatient Rehabilitation (IR), Skilled Nursing Facility (SNF) or Sub-acute Care (Sub). There are no studies assessing the role of IV t-PA as a predictor of short-term disability, evidenced by post-stroke disposition. Hypothesis: Low NIHSS is a predictor of high functional status. We assessed the hypothesis that similar to low NIHSS, t-PA predicts post-stroke disposition to a level of care suggestive of high functional status. Methods: All patients with acute ischemic stroke admitted to the UT Service between January 2004 and October 2009 were included. Stratification occurred for age>65, NIHSS and stroke risk factors. Using multivariate logistic regression, the data was analyzed to determine whether there were differences in post-stroke disposition among patients who received t-PA. Results: Patients with mild (NIHSS Home vs. Other Level of Care Of 2261 patients, 1032 were discharged home, 1229 to another level of care. Patients who received t-PA were 1.7 times more likely to be discharged home (P = IR vs. SNF Of 1111 patients, 731 patients were discharged to acute IR, 380 to SNF. There were no statistically significant differences in disposition between patients who received t-PA. (P = .0638, OR 1.338, 95% CI 0.983 to 1.822). SNF vs. Sub Of 498 patients, 380 were discharged to SNF, 118 to Sub. There were no significant differences in disposition between patients who received t-PA. Conclusion: Acute stroke patients who receive IV t-PA are more 1.7 times more likely to be discharged home. If post-stroke care is necessary, there is a trend toward rehabilitation at a level reflective of improved functional status (IR vs. SNF). This study is limited by its retrospective nature and the undetermined role of psychosocial factors related to discharge. Prospective studies of time to t-PA therapy in relation to post-stroke disposition are warranted.
On limiting temperatures in chemical reactors

The heat flow in a chemical reactor of flat plate or cylindrical shape is analyzed on the basis of the Arrhenius reaction rate expression. The analysis yields a critical design parameter which allows dimensioning of the reactor in order to maintain the reactor temperatures within narrowly prescribed limits.
Identification of key business and management skills needed for pharmacy graduates

Objective. To identify key business, management, and human resources skills needed by pharmacy graduates. Methods. Pharmacy preceptors were recruited for inclusion in one of four focus groups. At each focus group, participants were asked to complete a demographic questionnaire and to identify key skills that new graduates need but do not have. Each focus group was audio-recorded, transcribed, de-identified, and categorized using a data dictionary. Results. Twenty-seven preceptors participated in the focus groups. Fourteen participants had a Doctor of Pharmacy degree. Participants were involved in management positions for a median of 10.5 years (range 5-21 years) and 50% (median) of their time was devoted to management responsibilities (range 20%-80%). Seven themes were identified as being most critical: communication, business skills, decision-making and time management, conflict resolution, leadership and professionalism, personnel management, and computer software techniques. Conclusion. Communication was the most prominent skill identified, followed by decision-making and business knowledge. These skills should be addressed in pharmacy curricula. Future research should focus on how to best teach these skills.
Macro Reference Library

In this chapter, the usage of macros (user-defined commands) included in the add-on software is explained, along with descriptions of each individual parameter. A menu item named “Packaging” is added in the preprocessor, solution, and postprocessor menus within the ANSYS®-GUI environment, as shown in Fig. 4.1.
Incentivized Information Fusion with Social Sensors

This paper deals with the problem of incentivized information fusion, where a controller seeks to infer an unknown parameter by incentivizing a network of social sensors to reveal the information. The social sensors gather information on the parameter after interacting with other social sensors, to optimize a local utility function. We are interested in finding incentive rules that are easy to compute and implement. In particular, we give sufficient conditions on the model parameters under which the optimal rule for the controller is provably a threshold decision rule, i.e, don't incentivize when the estimate (of the parameter) is below a certain level and incentivize otherwise. We will further provide a complete sample path characterization of the optimal incentive rule, i.e, the nature (average trend) of the optimal incentive sequence resulting from the controller employing the optimal threshold rule. We show that the optimal incentive sequence is a sub-martingale, i.e, the optimal incentives increase on average over time.
System modeling of demand responsive transportation services: Evaluating cost efficiency of service and coordinated taxi usage

Abstract This paper presents a continuum approximation model for the operating cost of demand responsive transit (DRT) systems in large urban networks. Applications of the proposed model shed light on ways demand and characteristics of the DRT system affect major components of cost: fleet, vehicle hours, and vehicle miles traveled. Verifying the relationship with empirical data, results show an accurate approximation of the operating cost for the paratransit system in New Jersey. Furthermore, we develop a systematic approach for evaluating the efficiency of policy implementations for DRTs. Finally, the circumstances where coordinated taxis could be a cost reduction strategy are identified.
Focus on the facts: A news and information literacy instructional program

This article provides an overview of the “fake news” issue and places it in the context of information literacy instruction for college students. In 2017, the faculty librarians at a large state co...
Tissue engineered nigrostriatal pathway for treatment of Parkinson's disease.

The classic motor deficits of Parkinson's disease are caused by degeneration of dopaminergic neurons in the substantia nigra pars compacta, resulting in the loss of their long-distance axonal projections that modulate the striatum. Current treatments only minimize the symptoms of this disconnection as there is no approach capable of replacing the nigrostriatal pathway. We are applying microtissue engineering techniques to create living, implantable constructs that mimic the architecture and function of the nigrostriatal pathway. These constructs consist of dopaminergic neurons with long axonal tracts encased within hydrogel microcolumns. Microcolumns were seeded with dopaminergic neuronal aggregates, while lumen extracellular matrix, growth factors, and end targets were varied to optimize cytoarchitecture. We found a 10-fold increase in axonal outgrowth from aggregates versus dissociated neurons, resulting in remarkable axonal lengths of over 6 mm by 14 days and 9 mm by 28 days in vitro. Axonal extension was also dependent upon lumen extracellular matrix, but did not depend on growth factor enrichment or neuronal end target presence. Evoked dopamine release was measured via fast scan cyclic voltammetry and synapse formation with striatal neurons was observed in vitro. Constructs were microinjected to span the nigrostriatal pathway in rats, revealing survival of implanted neurons while maintaining their axonal projections within the microcolumn. Lastly, these constructs were generated with dopaminergic neurons differentiated from human embryonic stem cells. This strategy may improve Parkinson's disease treatment by simultaneously replacing lost dopaminergic neurons in the substantia nigra and reconstructing their long-projecting axonal tracts to the striatum.
Mitochondrial fatty acid oxidation disorders and cyclic vomiting syndrome

Inherited fatty acid oxidation (FAO) disorders represent a relatively new group of inborn errors of metabolism. Although our understanding of the biochemical and molecular bases of these disorders has improved dramatically in recent years, many patients remain undetected or are given other diagnoses, cyclic vomiting syndrome (CVS) being one of them in a few known cases. Medium chain acyl-CoA dehydrogenase deficiency and the late-onset form of glutaric acidemia type II have been anecdotally misdiagnosed as CVS. In addition, short chain acyl-CoA dehydrogenase deficiency (either true defects or polymorphism-related phenotypes) and particularly short-chain 3-hydroxy acyl-CoA dehydrogenase deficiency may present with clinical and biochemical features that closely resemble CVS. However, the collective role played by FAO and probably other metabolic disorders among the causes of CVS in unknown. Guidelines for a diagnostic approach to FAO disorders at the biochemical level are being presented and discussed. Hopefully, a better understanding and an awareness of FAO disorders could improve the diagnostic evaluation of patients with CVS.
Nuclearity effects in supported, single-site Fe(ii) hydrogenation pre-catalysts.

Dimeric and monomeric supported single-site Fe(II) pre-catalysts on SiO2 have been prepared via organometallic grafting and characterized with advanced spectroscopic techniques. Manipulation of the surface hydroxyl concentration on the support influences monomer/dimer formation. While both pre-catalysts are highly active in liquid-phase hydrogenation, the dimeric pre-catalyst is ∼3× faster than the monomer. Preliminary XAS experiments on the H2-activated samples suggest the active species are isolated Fe(II) sites.
Effects of Computer-Assisted Instruction on the Mathematics Performance of Students with Learning Disabilities: A Synthesis of the Research.

Over the past decades, there has been a significant increase in the use of computers and mobile devices in schools as part of mathematics instruction for students with learning disabilities (LD). T...
Decisions to Withdraw Extracorporeal Membrane Oxygenation Support: Patient Characteristics and Ethical Considerations.

Abstract Objective To describe the prevalence and context of decisions to withdraw extracorporeal membrane oxygenation (ECMO), with an ethical analysis of issues raised by this technology. Patients and Methods We retrospectively reviewed medical records of adults treated with ECMO at Mayo Clinic in Rochester, Minnesota, from January 1, 2010, through December 31, 2014, from whom ECMO was withdrawn and who died within 24 hours of ECMO separation. Results Of 235 ECMO-supported patients, we identified 62 (26%) for whom withdrawal of ECMO was requested. Of these 62 patients, the indication for ECMO initiation was bridge to transplant for 8 patients (13%), bridge to mechanical circulatory support for 3 (5%), and bridge to decision for 51 (82%). All the patients were supported with other life-sustaining treatments. No patient had decisional capacity; for all the patients, consensus to withdraw ECMO was jointly reached by clinicians and surrogates. Eighteen patients (29%) had a do-not-resuscitate order at the time of death. Conclusion For most patients who underwent treatment withdrawal eventually, ECMO had been initiated as a bridge to decision rather than having an established liberation strategy, such as transplant or mechanical circulatory support. It is argued that ethically, withdrawal of treatment is sometimes better after the prognosis becomes clear, rather than withholding treatment under conditions of uncertainty. This rationale provides the best explanation for the behavior observed among clinicians and surrogates of ECMO-supported patients. The role of do-not-resuscitate orders requires clarification for patients receiving continuous resuscitative therapy.
Characterization of cyclical spatial heterodyne spectrometers for astrophysical and planetary studies

High-resolution spectroscopy can make key science measurements for a variety of astrophysics and planetary targets, including solar system planetary atmospheres, comets, solar wind charge exchange emission, and interstellar and interplanetary medium. With the ability to record adjacent spectral lines simultaneously key isotopic ratios such as D/H, C12/C13, O16/O18, etc., can be measured precisely. Traditional high spectral resolution spectrometers usually must couple to large optics to compensate for their low throughput, which prohibits achieving compactness, in particular in space and remote field applications. Also, the high cost of construction and maintenance limit their quantity and usage for the long duration temporal measurement of the sources. Spatial heterodyne spectrometers (SHS) are increasingly used in scientific observations and industry. To date, SHS instruments come in two major architectures: Michelson design and cyclical design. Cyclical SHS, also known as reflective SHS, can offer significant advantages over traditional spectrometers in obtaining high-resolution spectra in shorter wavelengths. Although cyclical SHSs have been introduced before, there has been no mathematical or performance characterization of their technique. This paper presents a comprehensive mathematical design and performance expectations of the cyclical tunable SHS technique to enable and expand its usage in a variety of platforms and applications, in the industry and astronomical observations from ground and space telescopes.
Benefits of Peer Review on Students' Writing.

Writing has long been recognized as both an outcome and method of successful pedagogy in psychology. Accordingly, there are a number of methods that successful instructors have employed to teach ps...
Characterizing hyperspectral signatures of human faces in the shortwave infrared spectrum

Hyperspectral imaging provides extensive spectral reflectance information useful for material classification and discrimination not available with conventional broadband imaging. In this work, we first seek to characterize the hyperspectral signature of human faces in the shortwave infrared (SWIR) band. A hyperspectral SWIR face dataset of 100 subjects was collected as part of this study. Regions of interest (ROI) were defined for each subject and the mean and variance of each ROI were computed. The results show that hyperspectral signatures are similar between male and female subjects for the cheek, forehead, and hair ROIs. Furthermore, this study investigated whether the hyperspectral face signatures from the ROIs contained discriminative information for gender classification. We implemented and trained five different classifiers for gender classification. Results from the machine learning experiments indicate that hyperspectral facial signatures in the SWIR band is only weakly discriminative with respect to gender.
Fuzzy Deep Stack of Autoencoders for Dealing with Data Uncertainty

This paper addresses the problem of dealing with uncertainty on neural networks for the specific case of Autoencoders. The recently introduced concepts of ‘Autoencoders’ and ‘Deep Stacks of Autoencoders’ (DSAE) and their use for dimensionality reduction and data compression problems have gained considerable attention and reached very promising results. However, similarly to the traditional neural networks, Autoencoders are deterministic structures that are not very suitable for dealing with data uncertainty, a very important aspect of the real-world applications. In this paper, we propose a fuzzy approach to reduce uncertainty on stacks of Autoencoders by automatically adding qualitative fuzzy information about the data to the input layer. This can be accomplished by adding a fuzzy layer-0 to the stack of Autoencoders that extracts fuzzy knowledge from the crisp data set and includes that knowledge as extra information to the network input. The approach is completely transparent to the network and to the user and, theoretically, can be generalized to any architecture of neural network, including convolutional neural networks. The results presented here are very encouraging and present substantial improvement, especially when dealing with noisy data.
Single-cell analysis to understand the diversity of immune cell types that drive disease pathogenesis

Single-cell next-generation sequencing assays are powerful tools to understand the nature of the immune cells that drive disease pathogenesis. In this brief review we explain the value of performing assays at single-cell resolution to better understand the pathogenesis of allergy, asthma, and other lung diseases. We explain the challenges in performing single-cell studies of airways and lung samples from patients with lung diseases. A major limitation comes from the amount of diseased tissue that can be used for research purposes. Finally, we discuss which sequencing strategies can be used to successfully investigate airway and lung diseases at single-cell resolution.
Halal Food: A History

Zabihah.com, a website created in 1998 to compile reviews of halal-compliant restaurants across the globe, claims to have over 20 000 annual users (p. 242). The popularity of this site alone indica...
An Exploration of Contributor-Created Description Field in Participatory Archives

Participatory archive initiatives are an emerging phenomenon in the archives field. These initiatives are defined by the participation of the individuals that archival materials are created by or about. This often includes the description of materials by their creators. However, participatory archival description brings forth several questions: What knowledge and insights can be gained about items in a digital collection when they are described by their record creators and contributors? And what risks are there when the data values for are not created in a standardized format? To answer these questions, this paper examined the outcome of participatory archival description – i.e., free-text description metadata field created by participatory archives’ contributors. Using the Boston Harbor Islands Mass. Memories Collection Dublin Core-based description metadata records, contributor-created Description field length and attributes were analyzed through a combination of quantitative and qualitative content analysis methods. Study results show that data value of contributor-created description metadata was dominated by utterances that provide contextual information regarding archival objects, particularly about the individuals and physical environment that contributors associate with the items, while item content itself can be under-described.
E-044 Packing density, recurrence and complication rates between various endovascular aneurysm treatment modalities: analyses from the SMART registry

Background Over the past decade, coil embolization of intracranial aneurysm has proved to be both safe and effective. A major concern coil embolization is the recurrence of aneurysm requiring re-treatment. Low coil packing leading to coil compaction has been associated with a higher risk of aneurysm recurrence. In this study, we evaluate packing density, aneurysm recurrence and complication rates associated with different endovascular techniques. Methods The prospectively collected data from the SMART registry was interrogated. Only patients with unruptured aneurysms were included in these analyses. Patients were divided into four groups according on the endovascular treatment modality used: group 1 (primary coiling), group 2 (balloon assisted coiling), group 3 (stent assisted coiling), and group 4 (balloon and stent assisted coiling). Baseline characteristics, aneurysm features, packing density, complication and recurrence rates were compared between the groups. Results Total of 607 patients were included in this study. Of those, 240 were in group 1, 68 in group 2, 287 in group 3, and 22 in group 4. Median age was 61 (IQR, 53–69), and 75% were females (table 1). There was no difference in aneurysm size, or duration of coil deployment. Wide neck aneurysms were more prevalent in groups 3 and 4 compared to groups 1 and 2 (group 3; 72.8%, group 4; 81.8%, group 1; 57.9%, and group 2; 61.8%, P=0.008). While there was no difference in packing density between the groups at initial treatment, at 1-year, complete occlusion (RR class 1) was achieved at a higher rate in groups 3 and 4 (75%) compared to 1 (62.6%) and group 2 (42.6%) P Conclusions In patients with unruptured intracranial aneurysms, the use of primary coiling and balloon assisted coiling was associated with similar packing density to stent or stent plus balloon assisted coiling, though with lower rates of aneurysm obliteration at 1 year. Combined stent and balloon assisted coiling was associated with higher rates of immediate complications. Further prospective studies are warranted to confirm our findings. Disclosures S. Al Kasab: None. E. Almallouhi: None. M. Anadani: None. M. Sattur: None. A. Spiotta: None.
Many-body localization near the critical point

The authors study the phase transition between thermal and many-body localized phases in one-dimensional systems with quenched randomness and short-range interactions. The approach uses a renormalization group model, very similar to those of previous works, that puts the avalanche instability of the many-body localized phase at center stage. Within that model, the universal critical behavior is determined analytically, and the phase transition is found to belong to a new universality class that differs from the previously found Kosterlitz-Thouless result in important ways.
Factorial Invariance in Preventive Intervention: Modeling the Development of Intelligence in Low Birth Weight, Preterm Infants

The paper addresses the issue of measurement invariance in the analysis of preventive intervention data. Procedures for testing the invariance of covariance matrices, measurement models, and structural growth models are illustrated using data from an early intervention program for low birth weight, preterm infants. Intelligence Quotient (IQ) measured at 5 time points was modeled using piecewise growth curve analysis. Change over time in children's cognitive development was modeled separately for the pre- and postintervention periods. The first period was during the intervention, which lasted from birth through age 3 years. The second was during the postintervention period, which included follow-up assessments at ages 5 and 8 years. The analytical approach is illustrated with findings indicating that the development of IQ was different for higher low birth weight (HLBW: 2001–2500 g) and lower low birth weight (LLBW: <2001 g) infants. Examination of the effects of covariates on the IQ trajectories associated with the two birth weight groups indicated differential effects on IQ depending on the period of development and birth weight. Neonatal health and maternal age were predictors of IQ change in the LLBW group whereas maternal education was related to change in the HLBW group. During the posttreatment period, only Hispanic ethnicity and treatment group status were related to change. Hispanic participants exhibited an accelerated trajectory between program end and age 8 years. Intervention recipients exhibited a flatter trajectory during the same time period whereas participants in the control group exhibited an accelerated development, essentially catching up with their counterparts in the treatment group. Results clearly illustrate the utility of invariance testing in modeling developmental trajectories in response to preventive intervention.
Brief History of Gender Affirmation Medicine and Surgery

Gender dysphoria is the inner conflict and distress caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth. The earliest reports of gender identity alteration can be traced back to 1500 BC in ancient Egypt and during the Roman Empire (509 to 27 BC). During the modern era, Magnus Hirschfeld was considered the father of transgender healthcare and established the Institute for Sexual Science in Berlin. This was the world’s first institute devoted to sexology and was the site of the first documented gender affirmation surgery: orchiectomy, penectomy, and vaginoplasty in a transgender female patient. Dr. Harry Benjamin was a close friend of Hirschfeld who also had a keen interest in transgender healthcare and advocacy. Dr. Benjamin assisted hundreds of transgender individuals by prescribing hormones and suggested they visit surgeons abroad for gender affirmation surgeries. He later founded the Harry Benjamin International Gender Dysphoria Association (HBIGDA), which outlined standards of care for transgender individuals who desired medical and surgical treatment. In 2007, HBIGDA became known as the World Professional Association for Transgender Health (WPATH), which is a professional organization dedicated to the care and treatment of individuals with gender dysphoria today.
Cytotoxic T-lymphocyte infiltration and chemokine predict long-term patient survival independently of tumor mutational burden in triple-negative breast cancer:

Background:Cytotoxic T-lymphocyte (CTL) infiltration into tumor is a positive prognostic factor in breast cancer. High tumor mutational burden (TMB) is also considered as a predictor of tumor immun...
Detection of hydrogen isotopes in Zircaloy-4 via femtosecond LIBS

The analysis of hydrogen isotopes (1H, 2H, and 3H) is crucial to several applications, including nuclear forensics and safeguards, characterization of nuclear fission and fusion reactor materials, geochemistry, and space exploration. Laser-induced breakdown spectroscopy (LIBS) is a promising tool for the real-time analysis of hydrogen isotopes. However, the accurate, quantitative analysis via LIBS can be challenging due to 1H contamination on sample surfaces, residual 1H in the analysis environment, minor amounts of solute 1H, and spectral line broadening. Here, we characterize femtosecond laser induced plasmas from Zircaloy-4 targets with varying 1H and 2H concentrations in a He gas environment via spatially and temporally resolved optical emission spectroscopy. The impact of varying ambient gas pressure, the spatial distribution, and temporal histories of species viz., 1Hα, 2Hα, and Zr I on Zircaloy-4 plasma spectral features are reported. 1Hα and Zr I emission features are found to have different ambient pressure dependencies and are separated in both space and time in the laser induced plasmas. Lastly, the measured 2Hα emission intensities via femtosecond LIBS for a wide range of 2H concentrations in Zircaloy-4 samples showed a linear trend when plotted versus known 2H concentration.
Vaccine Considerations for Multiple Sclerosis in the COVID-19 Era.

People with multiple sclerosis (MS) are at risk for infections that can result in amplification of baseline symptoms and possibly trigger clinical relapses. Vaccination can prevent infection through the activation of humoral and cellular immune responses. This is particularly pertinent in the era of emerging novel vaccines against severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). MS disease-modifying therapies (DMTs), which affect the immune system, may impact immune responses to COVID-19 vaccines in people with MS. The objective of this article is to provide information on immune system responses to vaccinations and review previous studies of vaccine responses in people with MS to support the safety and importance of receiving currently available and emerging COVID-19 vaccines. Immunological studies have shown that coordinated interactions between T and B lymphocytes of the adaptive immune system are key to successful generation of immunological memory and production of neutralizing antibodies following recognition of vaccine antigens by innate immune cells. CD4+ T cells are essential to facilitate CD8+ T cell and B cell activation, while B cells drive and sustain T cell memory. Data suggest that some classes of DMT, including type 1 interferons and glatiramer acetate, may not significantly impair the response to vaccination. DMTs—such as sphingosine-1-phosphate receptor modulators, which sequester lymphocytes from circulation; alemtuzumab; and anti-CD20 therapies, which rely on depleting populations of immune cells—have been shown to attenuate responses to conventional vaccines. Currently, three COVID-19 vaccines have been granted emergency use authorization in the USA on the basis of promising interim findings of ongoing trials. Because analyses of these vaccines in people with MS are not available, decisions regarding COVID-19 vaccination and DMT choice should be informed by data and expert consensus, and personalized with considerations for disease burden, risk of infection, and other factors.
Emergency Department Visits, Related Hospitalizations, and Reasons for Emergency Department Utilization After Traumatic Spinal Cord Injury.

Abstract Objective To identify the self-reported frequency of emergency department (ED) visits, ED-related hospitalizations, and reasons for ED visits among people with traumatic spinal cord injury (SCI) and compare them with general population data from the same geographic area. Design Cross-sectional. Setting A specialty hospital in the Southeastern United States. Participants The participants (N=648) were community-dwelling adults (18 years and older) with a traumatic SCI, who were at least 1 year postinjury. A comparison group of 9728 individuals from the general population was retrieved from the 2017 National Health Interview Survey (NHIS). Interventions Not applicable. Main Outcome Measures Participants completed self-report assessments on ED visits, ED hospitalizations, and reasons for ED visits in the past 12 months using items from the NHIS. Results A total of 37% of participants with SCI reported at least 1 ED visit, and 18% reported at least 1 ED hospitalization in the past 12 months. Among those having at least 1 ED visit, 49% were admitted to hospitals. After controlling for sex, age, and race/ethnicity, participants with SCI were 151% more likely to visit the ED (odds ratio [OR], 2.51) and 249% more likely to have at least 1 ED hospitalization than the NHIS sample (OR, 3.49). Persons with SCI had a higher percentage of ED visits because of severe health conditions, reported an ED was the closest provider, and were more likely to arrive by ambulance. NHIS participants were more likely to visit the ED because no other option was available. Conclusions Compared with those in the general population, individuals with SCI have substantially higher rates of ED visits, yet ED visits are not regularly assessed within the SCI Model Systems. ED visits may indicate the need for intervention beyond the acute condition leading directly to the ED visits and an opportunity to link individuals with resources needed to maintain function in the community.
Exploring the foci and depth of coach-teacher interactions during modeled lessons

Abstract While modeling teaching is a potentially productive coaching pedagogy, little is known about how coaches and teachers interact during modeled lessons to support teacher learning. This study explored the foci and depth of coach-teacher interactions during modeled lessons. Drawing on six coach-teacher dyads’ interactions (n = 295) across 25 lessons, qualitative analyses revealed six distinct types of interactions during modeling. Furthermore, we forward a new conceptualization of depth of coach-teacher interactions during modeling based on the extent to which the coach or teacher made their reasoning evident during interactions about content, pedagogy, and students. Implications for practice and future research are discussed.
Insect Resistance Management Plans: The Farmers' Perspective

Farmers are required to implement insect resistance management (IRM) plans for all Bt crops in order to reduce the probability that insects susceptible to Bt will develop resistance. These IRM plans require farmers to plant at least 20% of the corn acreage to a non-Bt hybrid, and in specific configurations. In order for IRM plans to be effective, farmers must correctly implement these refuge requirements both in terms of acreage and configuration. This article reports survey results which show that farmers believe refuges will be effective in managing resistance, but that they would not implement them if they were not required. The article also reports survey and focus group data on farmers’ perceptions of each refuge configuration. These data show that farmers who have experience with implementing refuges report less time and effort associated with refuges, which is partly due to having learned how to implement refuges more efficiently.
Self comes to mind : constructing the conscious brain

This title is winner of the CORINE International Book Award 2011. It is from one of the most important neuroscientists at work today, a path-breaking investigation of a question that has confounded neurologists, philosophers, cognitive scientists and psychologists for centuries: how is consciousness created? Antonio Damasio has spent the past thirty years studying and writing about how the brain operates, and his work has garnered acclaim for its singular melding of the scientific and the humanistic. In "Self Comes to Mind", he goes against the long-standing idea that consciousness is somehow separate from the body, presenting compelling new scientific evidence that consciousness - what we think of as a mind with a self - is in fact a biological process created by a living organism. The result is a groundbreaking investigative journey into the neurobiological foundations of mind and self.
Preliminary microRNA analysis in lung tissue to identify potential therapeutic targets against H5N1 infection.

Abstract Within the past decade, human infections with the highly pathogenic avian influenza H5N1 have resulted in approximately 60% mortality and increased the need for vaccines and therapeutics. Understanding the molecular events associated with pathology can aid this effort; therefore, this study was conducted to assess microRNA (miRNA) expression in mouse lungs infected with H5N1 A/Vietnam/1203/04. Intranasal administration of 1500 median tissue culture infectious dose of H5N1 promoted differences in the number and expression pattern of miRNA from lung tissue collected at 2, 4, 6, 24, and 96 h post-exposure that mapped to common biological functions. Informatics analysis identified miRNA-specific predicted genes known to be therapeutic drug targets in which Furin was common to all time periods. This study provides insight into the differential miRNA expression with respect to the host-pathogen relationship and identification of potential therapeutic drug targets.
Role of the histone amino termini in facilitated binding of a transcription factor, GAL4-AH, to nucleosome cores

Facilitated, "cooperative" binding of GAL4-AH to nucleosomal DNA occurred in response to inhibition from the core histone amino termini. The binding of GAL4-AH (which contains the DNA-binding and dimerization domains of GAL4) to nucleosome cores containing multiple binding sites initiated at the end of a nucleosome core and proceeded in a cooperative manner until all sites were occupied. However, following tryptic removal of the core histone amino termini, GAL4-AH binding appeared to be noncooperative, similar to binding naked DNA. Binding of GAL4-AH to nucleosomes bearing a single GAL4 site at different positions indicated that inhibition of GAL4 binding was largely mediated by the histone amino termini and primarily occurred at sites well within the core and not near the end. When the histone amino termini were intact, binding of GAL4-AH to sites near the center of a nucleosome core was greatly enhanced by the presence of additional GAL4 dimers bound to more-accessible positions. These data illustrate that the binding of a factor to more-accessible sites, near the end of a nucleosome, allows facilitated binding of additional factors to the center of the nucleosome, thereby overcoming repression from the core histone amino termini. This mechanism may contribute to the binding of multiple factors to complex promoter and enhancer elements in cellular chromatin.
A Spiraling Case of Persistent Dysphagia

Question: A 77-year-old woman with gastroesophageal reflux disease, hypertension, and recurrent aspiration pneumonias presented as a referral for evaluation and management of persistent dysphagia. She reported having dysphagia to liquids more than solids for last 8-9 years with associated heartburn, regurgitation, and chest pain. She had 25-lb weight loss over the last 6 months and had 4 hospitalizations over the last 4 years for volume depletion and 2 hospitalizations for aspiration pneumonia. She underwent multiple empiric esophageal dilatations (Maloney 49-50 Fr dilators) over last several years without any improvement. Barium swallow study (Figure A) showed a corkscrew esophagus with patent gastroesophageal junction. High resolution manometry (Figure B) revealed 6 simultaneous contractions and 40% peristaltic contractions with high lower esophageal sphincter pressure, but normal relaxation in 80% of swallows. Esophagogastroduodenoscopy images are also shown (Figure C). She was referred for further management after no improvement in symptoms despite empiric dilatations and medical management with high-dose proton pump inhibitor therapy and nifedipine. What is the most likely diagnosis? What is the next step in management for this patient? Look on page 299 for the answer and see the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI.
Repeated cocaine augments excitatory amino acid transmission in the nucleus accumbens only in rats having developed behavioral sensitization

Rats were pretreated with daily cocaine or saline injections for 1 week. The rats treated with daily cocaine were separated into two groups: a sensitized group of animals demonstrating > 20% increase in motor activity on the last injection compared with the first injection of daily cocaine, and a nonsensitized group showing
THERMAL ACCELERATION OF PORTLAND CEMENT MORTARS WITH MICROWAVE ENERGY

Abstract The use of microwave energy as a source of heat to accelerate curing of ordinary Portland Cement mortar was investigated. Shortly after casting, specimens were treated with different levels of microwave power. Microwave heating produced an increase in temperature that shortened the induction period and increased the rate of hydration for the first 24 h compared to specimens cured at 20°C. The microwave treatment did not alter significantly the compressive strength of the samples compared to samples cured at 20 degrees Celsius.
MC1R and the response of melanocytes to ultraviolet radiation

The constitutive color of our skin plays a dramatic role in our photoprotection from solar ultraviolet radiation (UVR) that reaches the Earth and in minimizing DNA damage that gives rise to skin cancer. More than 120 genes have been identified and shown to regulate pigmentation, one of the key genes being melanocortin 1 receptor (MC1R) that encodes the melanocortin 1 receptor (MC1R), a seven-transmembrane G protein-coupled receptor expressed on the surface of melanocytes. Modulation of MC1R function regulates melanin synthesis by melanocytes qualitatively and quantitatively. The MC1R is regulated by the physiological agonists alpha-melanocyte-stimulating hormone (alphaMSH) and adrenocorticotropic hormone (ACTH), and antagonist agouti signaling protein (ASP). Activation of the MC1R by binding of an agonist stimulates the synthesis of eumelanin primarily via activation of adenylate cyclase. The significance of cutaneous pigmentation lies in the photoprotective effect of melanin, particularly eumelanin, against sun-induced carcinogenesis. Epidermal melanocytes and keratinocytes respond to UVR by increasing their expression of alphaMSH and ACTH, which up-regulate the expression of MC1R, and consequently enhance the response of melanocytes to melanocortins. Constitutive skin pigmentation dramatically affects the incidence of skin cancer. The pigmentary phenotype characterized by red hair, fair complexion, inability to tan and tendency to freckle is an independent risk factor for all skin cancers, including melanoma. The MC1R gene is highly polymorphic in human populations, and allelic variation at this locus accounts, to a large extent, for the variation in pigmentary phenotypes and skin phototypes (SPT) in humans. Several allelic variants of the MC1R gene are associated with the red hair and fair skin (RHC) phenotype, and carrying one of these variants is thought to diminish the ability of the epidermis to respond to DNA damage elicited by UVR. The MC1R gene is considered a melanoma susceptibility gene, and its significance in determining the risk for skin cancer is of tremendous interest.