cssi/SciSciGPT-SciSciNet huggingface dataset:
Adult Brainstem Glioblastoma Multiforme: Long-term Survivor

Adult, malignant brainstem gliomas are rare entities that often cause treatment conundrums due to the difficulty of surgical resection and, therefore, the absence of pathological diagnosis. This leads to a reliance on radiological imaging for diagnosis, which can often be unreliable. These shortcomings have made the treatment of brainstem gliomas challenging with unpredictable outcomes. The mainstay of treatment consists of chemotherapy and radiation; however, recurrence is inevitable. Predicting outcomes has been the major difficulty in treating these patients as adult malignant brainstem gliomas Grade II have a median survival between five to seven years while Grades III and IV are between 10-17 months (with some studies showing significantly longer survival in Grade III). Here, we present the case of a patient with the pathologic diagnosis of a right brachium pontis glioblastoma who had a remarkable survival of 73 months, whereas the expected median survival for these patients is 10-17 months.
Regulation of MONOCYTE NADPH OXIDASE:Role of Pattern Recognition Receptors

Dectin-1 belongs to the family of pattern recognition receptors and has recently been identified as the leukocyte β-glucan receptor. This study shows that both Dectin-1 and Complement Receptor 3 are essential for regulating NADPH oxidase activity in Zymosan-activated human monocytes. In addition, we show that TLR2 and TLR4 are not required for NADPH oxidase activation by Zymosan. Activation of NADPH oxidase results in the production of the oxygen free radical, superoxide anion (O2). Superoxide anion is critical for host defense against fungal and bacterial pathogens and efficient immune responses; however, uncontrolled monocyte-derived O2 may contribute to chronic inflammation and tissue injury. We have previously identified several proteins that regulate the activity of NADPH oxidase in primary human monocytes. In this study we focus on Dectin-1 downstream signaling and complex formation with intracellular signaling proteins. Our findings in human monocytes are supportive of the prior
The Attitude of the College Students to Entrepreneurial Skills Development in the Subject E-commerce

One of the main goals of many educational courses at various colleges, especially those which focus on applied economics and management, is the development of students' entrepreneur- ship skills. It is usually accomplished through various project-oriented tasks. The development of the students' entrepreneurship skills is also the primary objective of the E-commerce course offered by our Faculty of Economics. This course combines theoretical knowledge and practical skills. Students work on a number of practical exercises with the aim to create a functional e-shop. They have to look for business opportunities, understand economic processes, work within a team, and be able to promote their ideas, strategies, and procedures. Finally, yet most importantly, they must not be afraid to present and defend their solutions. This study examines whether and to what extent this approach contributes to the development of skills which are usually associated with entrepreneurship. The exploration was performed based on students' evaluation. Means-end chain model and hierarchical value map approach were chosen as a research method. The results of this research show that entrepreneurship skills are being developed except for a motivation of students to accept a risky business competitive environment. However, the propensity to take risk is one of the basic traits of successful entrepreneurs. Our future effort will aim therefore at modifying our educational content. Greater emphasis will be placed on how to teach students to accept competi- tive environment which is risky and mostly unpredictable.
Nurse Staffing in Acute Care Settings: Research Perspectives and Practice Implications

Article-at-a-Glance Background The research literature linking nurse staffing and outcomes has expanded radically at a time of profound changes in human resources and financial management in hospitals and health care systems. Findings Reviews of more than 100 peer-reviewed studies as of mid-2007 support an association between lower nurse staffing levels and poorer patient outcomes in acute care settings. Research efforts are increasingly aimed at understanding which outcomes are affected and under what circumstances and at evaluating the impact of staffing from an economic point of view. Minimal staffing levels appear to be a necessary but insufficient condition for safety in acute care hospitals. Conclusions and Implications In the face of a deepening nursing shortage, many facilities are likely to find that various aspects of staffing, such as coverage, licensure levels, and experience, are lower than those historically in place. Advance planning by staff and supervisors and careful monitoring of outcomes are needed to ensure patient safety. Health care managers and executives need to benchmark staffing levels and nursing-sensitive outcomes in their facilities, carefully analyze recruitment and retention issues, and develop short- and long-term strategies for averting and dealing with the shortfalls in numbers and skill mix of nursing personnel that they will likely face increasingly in the coming decades.
New Federalism and Environmental Policy

This article examines the degree of correspondence between the conceptual underpinnings of President Reagan's New Federalism and the willingness and capacity of states to assume a larger share of environmental responsibilities. The findings indicate that many of the states have not replaced federal aid reductions with own-source revenues. Replacements that did occur were limited to a single year and primarily in the area of hazardous waste management grants. The implications of these findings are that "decentralization and defunding" offederal programs in the environmental area may have had an adverse effect on the states' ability to provide solutions to pressing environmental problems in the first half of the 1980s.
Historical Investigation and the Practice of Marketing

Considerable similarities can be found between some of the problems that arise in the practice of marketing and those encountered in the study of history. The author describes the four stages of th...
A randomized comparison of long-and short-axis imaging for in-plane ultrasound-guided femoral perineural catheter insertion.

OBJECTIVES Continuous femoral nerve blocks provide effective analgesia after knee arthroplasty, and infusion effects depend on reliable catheter location. Ultrasound-guided perineural catheter insertion using a short-axis in-plane technique has been validated, but the optimal catheter location relative to target nerve and placement orientation remain unknown. We hypothesized that a long-axis in-plane technique for femoral perineural catheter insertion results in faster onset of sensory anesthesia compared to a short-axis in-plane technique. METHODS Preoperatively, patients receiving an ultrasound-guided nonstimulating femoral perineural catheter for knee surgery were randomly assigned to either the long-axis in-plane or short-axis in-plane technique. A local anesthetic was administered via the catheter after successful insertion. The primary outcome was the time to achieve complete sensory anesthesia. Secondary outcomes included the procedural time, the onset time of the motor block, pain and muscle weakness reported on postoperative day 1, and procedure-related complications. RESULTS The short-axis group (n = 23) took a median (10th-90th percentiles) of 9.0 (6.0-20.4) minutes compared to 6.0 (3.0-14.4) minutes for the long-axis group (n = 23; P = .044) to achieve complete sensory anesthesia. Short-axis procedures took 5.0 (4.0-7.8) minutes to perform compared to 9.0 (7.0-14.8) minutes for long-axis procedures (P < .001). In the short-axis group, 19 of 23 (83%) achieved a complete motor block within the testing period compared to 18 of 23 (78%) in the long-axis group (P = .813); short-axis procedures took 12.0 (6.0-15.0) minutes versus 15.0 (5.1-27.9) minutes for long-axis procedures (P = .048). There were no statistically significant differences in other secondary outcomes. CONCLUSIONS Long-axis in-plane femoral perineural catheters result in a slightly faster onset of sensory anesthesia, but placement takes longer to perform without other clinical advantages.
Conflicting prescriptions for ‘ethical’ leadership in complex institutions: Perspectives from US collegiate athletic administrators

This research sought to demonstrate how institutional complexity within the field of college athletics in the United States offers conflicting prescriptions for ethical leadership. With college athletics serving as the context for this investigation, data were collected from 14 athletic administrators at four universities. Participants suggested that ethical leadership in college athletics consisted of prioritizing the institution while integrating servant leadership. We discussed how these two logics are conceptually incompatible, thereby creating conflicting perspectives as to what it meant to be an ethical leader. By incorporating an institutional logic perspective, we demonstrated that conceptions of ethical leadership are subjected to engrained ideals that may not always be compatible as they lend themselves to differing ethical frameworks. The contextual implications as well as the broader discipline implications of this research are discussed.
SPECIAL REHABILITATION CONSIDERATIONS IN THE MANAGEMENT OF OBSTETRICAL BRACHIAL PLEXUS INJURIES

This article outlines important aspects in the rehabilitation of infants and children with brachial plexus injuries.
Highly compliant active clinging mechanism

A mechanism is currently designed and analyzed with the goal of providing controlled adhesion to objects with surfaces with little known surface finish, of varying curvature, and different materials. The main purpose of the mechanism is that of ensuring a soft docking, controlled in closed loop, for attachment to large pieces of orbital debris. Other envisaged purposes for the mechanism are sample collection and manipulation in free fall or at small bodies and in-situ analysis of cohesive forces in regolith. The electroadhesion forces are generated by the electric fields and polarization present when applying a voltage gradient across the adhesion mechanism. The current design consists of Pyralux®composite clad material on which macro fiber composites (MFCs) are attached. Once the proof of concept of the actuation with MFCs is completed, sensors will be added in order to provide capabilities for proprioception. The copper side of the Pyralux®layer is chemically etched in order to form an electrostatic adhesion device (EAD). Three EAD electrode configurations were investigated by analyzing, fabricating, and testing. Two configurations have the shape of multiple interlocking fine combs and one configuration has multiple spiral electrodes arranged similarly to the suckers of a cephalopod limb. The three designs were tested in order to compare the shear adhesion forces created. The interlocking comb or spiral pairs are envisaged to be individually actuated to control the force of adhesion during the clinging process. A MFC is embedded to the exposed non-adhering side of the Pyralux®composite so that the curvature of the mechanism can be controlled prior and post-contact with the object of interest. Strain gages are to be interspersed with the MFCs to determine the local curvature and possibly the curvature rate of the mechanism during clinging. The mechanism will have two feedback control loops one that controls the EAD electrodes and thus the clinging force and the other for the EAP patches which controls the curvature of the mechanism. It is planned that the loops are operated inside the attitude determination and control loop of the nanosatellite that docks with the piece of orbital debris or retrieves a sample from the surface of a small body. Out of the three pad designs investigated, the spiral design resulted in highest adhesion forces when adhering to a conductive and also an insulator surface. Tests were also completed comparing the adhesion force generated when activating the MFC to the adhesion without it's use. Results indicate an increase in adhesion when actuating the MFC on a surface with curvature.
Treatment outcomes in pediatric melanoma—Are there benefits to specialized care?

Abstract Purpose The purpose of this study was to evaluate the impact of hospital specialization on survival in pediatric melanoma. Methods We reviewed all patients under 18years old with cutaneous melanoma evaluated at MD Anderson Cancer Center, a National Cancer Institute (NCI)-designated center, from 2000 to 2014. We compared overall survival (OS) and disease-free survival (DFS) between patients who underwent all treatments at MDACC (Group A, n =146) and those who underwent initial surgical treatment at a non-NCI center (Group B, n =58). Kaplan–Meier survival curves were compared using the log-rank test. Results Group A patients had significantly better OS and DFS (both p Conclusion Surgical treatment at a comprehensive cancer center may improve outcomes for pediatric melanoma especially for patients presenting with later stage disease. Level of evidence Case-control study: Level III.
Green tea: clean-energy conservatism as a countermovement

Environmental politics in advanced industrialized countries have been characterized as a dynamic interaction of two opposing movements: an original movement of progressive environmentalism and a countermovement of conservative opposition to environmental and energy-transition policies. This study analyzes an additional dynamic based on the emergence of clean-energy conservatism in the United States. We develop an explanation of the emergence of this additional dynamic and examine the reasons conservatives give for supporting clean energy, the variety of their frames, differences from comparison organizations and policy outcomes. Clean-energy conservatism has emerged, in part, as a dissenting response to the alignment of conservatism with support for fossil fuels. Although clean-energy conservatives seek to redefine clean energy policy according to conservative ideology, they differ from comparison conservative organizations over climate change and air quality. Clean-energy conservatives can claim some pol...
Mechanisms by Which Manganese Porphyrins Affect Signaling in Cancer Cells

This chapter explores the role that metalloporphyrins (MnTE-2-PyP, MnTnBuOE-2-PyP, and MnTnHex-2-PyP) play in cancer growth and progression. This review focuses on the effect that metalloporphyrins have on signaling events in cancer cells. The first section reviews published data demonstrating that the redox environment influences cancer growth and progression by regulating cell cycle progression, angiogenesis, invasion, and metastasis. The next section reviews studies performed both in vitro and in vivo demonstrating that the addition of superoxide dismutase (SOD) enzymes reduces cancer growth. Then published data is presented showing that manganese porphyrins, which mimic SOD activity, also inhibit cancer growth. Finally, we review all of the mechanisms that have been published thus far on how manganese porphyrins inhibit cancer growth. Specifically, manganese porphyrins have been shown to alter tumor immunology, metabolism, transcription, and post-translational modifications of target signaling proteins. We hypothesize that by scavenging superoxide and enhancing hydrogen peroxide levels, the manganese porphyrins directly affect redox signaling pathways resulting in reduced tumor growth.
A nomogram to predict pathologic lymph node positivity in clinical stage I-II pancreatic adenocarcinoma.

382Background: Clinical nodal staging in PDAC is inaccurate. Most pts are cN0, but > 70% are pN+. We hypothesize that preoperative variables are associated with pN+ and could be used to create a predictive nomogram. Methods: The NCDB was reviewed from 2010-13 for pts with clinical stage I-II PDAC. Exclusions were neoadjuvant therapy, < 12 nodes examined, and missing data for clinical/pathologic stage, size, and number of nodes examined/positive. Logistic regression assessed factors associated with pN+ and an interaction was included for extrapancreatic extension and cN stage. A logistic regression based nomogram was constructed and 10-fold cross validation evaluated model discrimination. Results: Of 7,475 pts, 28% were cN+ but 74% were pN+ (P < 0.001). Associations of preoperative factors with pN+ are shown. Size was pathology based. We recommend multiplying imaging based size estimates by 1.33 for use in the nomogram based on studies showing that imaging underestimates size by 25%. Interestingly, extrapa...
A Place at the General Education Table for Health

This article explains how the transition to a common core curriculum across City University of New York schools created space for the introduction of health education courses, and the process by which the one college was successful in advocating for the approval of health courses into its curriculum.
Body temperature regulation in the dragonfly, Arigomphus villosipes (Odonata: Anisoptera: Gomphidae)

Regulation of thoracic muscle temperature has been investigated in a number of dragonfly species but is poorly known in the large and diverse family, Gomphidae. Moreover, temperatures of other body...
Technology-Mediated Sight: A Case Study of Early Adopters of a Low Vision Assistive Technology

A case study of early adopters of a head-mounted assistive device for low vision provides the basis for a sociotechnical analysis of technology-mediated sight. Our research complements recent work in HCI focused on designing, building, and evaluating the performance of assistive devices for low vision by highlighting psychosocial and adaptive aspects of digitally enhanced vision. Through a series of semi-structured interviews with users of the eSight 2.0 device and customer-facing employees of the eSight company, we sought to better understand the social and emotional impacts associated with adoption of this type of low-vision assistive technology. Four analytic themes emerged from our interviews: 1) assessing the value of assistive technology in real life, 2) negotiating social engagement, 3) boundaries of sight, and 4) attitudes toward and expectations of technology. We introduce the concept of multiplicities of vision to describe technology-mediated sight as being a form of skilled vision and neither fully-human nor fully-digital, but rather, assembled through a combination of social and technical affordances. We propose that instead of seeing low-vision users through a deficit model of sight, HCI designers have more to gain by viewing people with low vision as individuals with a distinct type of skilled vision that is both socially and technologically mediated.
Ultrawideband power amplifier for radar sounding and imaging of ice sheets

Airborne ultrawideband radars operating at VHF/UHF frequencies can be used to sound and image polar ice sheets with fine-resolution. The sensitivity of the radar depends upon the power-aperture product. High peak power coupled with a large aperture is required to sound more than 4-km thick ice. In this paper, we present the design of a 400-W power amplifier for operation over the frequency range of 150–550 MHz. The amplifier uses gallium-nitride (GaN) high-electron-mobility transistors (HEMTs) manufactured by Cree. The primary design goals are to maximize the output power and gain while minimizing the harmonic levels. To achieve these, a push-pull configuration with quadrature combining is implemented.
IRF8 Regulates Transcription of Naips for NLRC4 Inflammasome Activation.

Inflammasome activation is critical for host defenses against various microbial infections. Activation of the NLRC4 inflammasome requires detection of flagellin or type III secretion system (T3SS) components by NLR family apoptosis inhibitory proteins (NAIPs); yet how this pathway is regulated is unknown. Here, we found that interferon regulatory factor 8 (IRF8) is required for optimal activation of the NLRC4 inflammasome in bone-marrow-derived macrophages infected with Salmonella Typhimurium, Burkholderia thailandensis, or Pseudomonas aeruginosa but is dispensable for activation of the canonical and non-canonical NLRP3, AIM2, and Pyrin inflammasomes. IRF8 governs the transcription of Naips to allow detection of flagellin or T3SS proteins to mediate NLRC4 inflammasome activation. Furthermore, we found that IRF8 confers protection against bacterial infection in vivo, owing to its role in inflammasome-dependent cytokine production and pyroptosis. Altogether, our findings suggest that IRF8 is a critical regulator of NAIPs and NLRC4 inflammasome activation for defense against bacterial infection.
Out of sight, out of mind: managing religious diversity in Qatar

The small Gulf state of Qatar is today home to as many Christians, and as many Hindus, as it is Qatari citizens, making it one of the most religiously diverse states in the Middle East. A somewhat ...
Pelvic Floor Muscle Pain and Dysfunction

The pelvic floor provides anatomic support and coordinates the essential functions of defecation, micturition, and reproduction. The nerves and muscles of the pelvic floor act as an integrated unit, and when a component is compromised, dysfunction and pain can result. One type of dysfunction is the development of hypertonic muscles. The increased tone can lead to multiple problems seen by physicians including bladder or bowel pain, elimination disorders, vaginismus, vulvodynia, as well as chronic pelvic pain.
Introducing Göbekli Tepe to Psychology

Gobekli Tepe is the name of a remarkable archaeological site that challenges long held assumptions about the Neolithic Revolution, that is, our first transition from hunters and gatherers into sett...
Insulin-like growth factors in central nervous system tumors

Insulin-like growth factors (IGFs) appear to play arole in the development of tumors in generaland brain tumors in particular. Specific receptors forIGFs have been identified in normal human andrat brain, and evidence suggests that components ofthe IGF signal transduction system may play arole in the transformation process. Secretion of IGFsby a variety of human brain tumors hasbeen confirmed, and these growth factors appear tohave an autocrine stimulatory effect on these tumors.IGFs circulate in the blood stream bound toat least six distinct binding proteins which maymodulate the effects of these growth factors ontarget tissues. Sex steroids may also regulate thebehavior of certain brain tumors such as meningiomasat least in part through their effects onthe expression of IGFs and their binding proteins.Recently, antisense gene technology against certain IGFs ortheir receptors have resulted in potent antitumor effectsin the case of several gliomas, although themechanism for this remains unclear.
Pressure and stress transients in autoinjector devices

Spring-actuated autoinjectors delivering viscous drug solutions resulting from large drug concentrations require large spring forces which can create high peak pressures and stresses within syringes. The high peak pressures and stresses can lead to device failure. Measurements with a suite of novel instrumentation and analysis using numerical simulation explain the peak pressures and peak stresses as originating from mechanical impacts between moving components, the large acceleration of the components, and surprisingly, the production of tension waves in the liquid resulting in cavitation. The presence and intensity of cavitation depend on relative timing between the pressurization and the acceleration of the syringe, which, in turn, depend on the size and location of an air gap inside the syringe. We show that production of localized but very high pressures can result from shock wave focusing in the conical section of the syringe.
Global Vision, Technological Skills, and Systems Thinking Are Essential Qualities for Peace Engineering. Compassion too?

What capacities must an engineer possess for peace engineering? In addressing that question, this paper highlights two initiatives of the National Academy of Engineering (NAE): a roundtable jointly sponsored with the United States Institute of Peace (USIP) and a workshop on Engineering, Social Justice, and Sustainable Community Development, a project of the NAE Center for Engineering Ethics and Society. Then-NAE president Charles (Chuck) Vest opened the workshop by emphasizing the "intricate connections between science and engineering and larger social, political, and economic systems," stressing that "as the complexity of these interactions increases, they can geometrically increase the difficulties of determining the right thing to do, and determining the pathways for achieving sought after solutions" [1]. He called on engineers to adopt a global vision. Assuming that global vision can be taught (or at least fostered by engineering education), what other qualities are needed for peace engineering? The paper considers the perspectives of three peacebuilders whose insights seem to suggest that peace engineering programs must strive to prepare engineers with technical skills and systems thinking. But what about compassion or empathy? Are these essential as well? Possibly not empathy, given its associated emotional risks. But cultivating compassion may be important.
The role of alpha oscillations in spatial attention: limited evidence for a suppression account.

Covert spatial attention allows us to prioritize visual processing at relevant locations. A fast growing literature suggests that alpha-band (8-12 Hz) oscillations play a key role in this core cognitive process. It is clear that alpha-band activity tracks both the locus and timing of covert spatial orienting. There is limited evidence, however, for the widely embraced view that alpha oscillations suppress irrelevant visual information during spatial selection. Extant evidence is equally compatible with an account in which alpha activity enables spatial selection through signal enhancement rather than distractor suppression. Thus, more work is needed to characterize the computational role of alpha activity in spatial attention.
Public support for global warming policies: solution framing matters

One of the biggest challenges to sustainability is lack of public support for policies needed to reduce greenhouse gas emissions. Across three studies, we explored how solution framing impacts public support for financially costly policies designed to reduce greenhouse gas emissions. Study 1 analyzed data from a statewide public opinion poll (N = 771), while studies 2 (N = 100) and 3 (N = 163) were laboratory-based experiments. Specifically, we found that polling questions that asked about a financially costly climate change policy received more support when the goal of the policy was to create efficient technologies than when the goal was to curtail behavior. In addition, we replicate previous research showing that there is a partisan gap for beliefs about global warming and extend this research to show that the partisan gap is not found when looking at support for solutions. The implications of these results for promoting needed climate change policies is discussed.
Sun Shines on Hank Williams: 2019, Various Artists, CD, Bear Family BCD 17504

Rockabilly music emerged, thrived, and declined in the US between 1951 and 1960. Its history is bookended by Bill Haley’s cover recording of Jackie Brenston’s rollicking “Rocket 88” and the tragic ...
Diffusion tensor cardiovascular magnetic resonance in hypertrophic cardiomyopathy: a comparison of motion-compensated spin echo and stimulated echo techniques

Diffusion tensor cardiovascular magnetic resonance (DT-CMR) interrogates myocardial microstructure. Two frequently used in vivo DT-CMR techniques are motion-compensated spin echo (M2-SE) and stimulated echo acquisition mode (STEAM). Whilst M2-SE is strain-insensitive and signal to noise ratio efficient, STEAM has a longer diffusion time and motion compensation is unnecessary. Here we compare STEAM and M2-SE DT-CMR in patients. Biphasic DT-CMR using STEAM and M2-SE, late gadolinium imaging and pre/post gadolinium T1-mapping were performed in a mid-ventricular short-axis slice, in ten hypertrophic cardiomyopathy (HCM) patients at 3 T. Adequate quality data were obtained from all STEAM, but only 7/10 (systole) and 4/10 (diastole) M2-SE acquisitions. Compared with STEAM, M2-SE yielded higher systolic mean diffusivity (MD) (p = 0.02) and lower fractional anisotropy (FA) (p = 0.02, systole). Compared with segments with neither hypertrophy nor late gadolinium, segments with both had lower systolic FA using M2-SE (p = 0.02) and trend toward higher MD (p = 0.1). The negative correlation between FA and extracellular volume fraction was stronger with STEAM than M2-SE (r2 = 0.29, p < 0.001 STEAM vs. r2 = 0.10, p = 0.003 M2-SE). In HCM, only STEAM reliably assesses biphasic myocardial microstructure. Higher MD and lower FA from M2-SE reflect the shorter diffusion times. Further work will relate DT-CMR parameters and microstructural changes in disease.
Cyber Risks: Three Basic Structural Issues to Resolve

The incidence of cyber liability and cyber losses, collectively cyber risks, have increased greatly over the last several years. To add to the problem, cyber risks also expose insureds to statutory liability.
Flying with a net, and without: Preventative devices and self-control

Abstract Excessive consumption of many vice goods (e.g., alcohol) has both possible immediate (e.g., a drunk-driving crash) and delayed (e.g., liver disease) negative consequences. This research models the consumption choices of a consumer population with heterogeneous impatience and varying degrees of sophistication in conjunction with both immediate and delayed consequences of excessive vice good consumption. We show that even when a preventative device (e.g., a designated driver) that could eliminate the immediate dangers is available for (almost) free, some consumers forgo it in order to try to use the immediate danger as a soft tool to regulate excessive consumption (e.g., “If I know I don't have a designated driver, then I won't drink too much.”). Surprisingly, this “flying without a net” is a successful strategy for some consumers, and we quantify when it is likely to be successful versus harmful. This counterintuitive result has many consequences; e.g., public policies that make the provision of preventative devices compulsory could increase consumer welfare under certain conditions but overall are not Pareto-improving. Likewise, advertising campaigns that exaggerate the likelihood of immediate dangers may be welfare decreasing despite their good intentions. In exploring the effect of our model on pricing of preventative device, we find that pricing is not monotonic in the probability of danger. We also show that consumer pessimism about self-regulation can induce consumers to experience a “boomerang effect” of overconsumption in the presence of a preventative device. Overall our research shows that the relationship between prevention and risk is not as simple as might be assumed in standard analyses and that marketers and public policymakers often need to consider the short-term and the long-term risks as well how prone the consumers are to temptation and how sophisticated they are in judging their temptation.
IDENTIFICATION OF NOVEL PROTEIN BIOMARKERS PREDICTING VENTRICULAR DYSFUNCTION IN DUCHENNE MUSCULAR DYSTROPHY

Cardiomyopathy with associated ventricular dysfunction is the primary cause of death in Duchenne muscular dystrophy (DMD). Standard biomarkers of heart failure are only elevated in late disease. We aimed to identify novel biomarkers that correlate with ventricular dysfunction in boys with DMD.
Smoking, Implications of

Abstract Tobacco smoking is associated with several benign and malignant disorders of the gastrointestinal system. Smoking increases the risk of gastroesophageal reflux disease, peptic ulcer disease, Crohn's disease, and cancers of the oropharynx, esophagus, stomach, colorectum, liver, and pancreas. Smoking cessation attenuates the risk for many of these outcomes. Smoking results in substantially higher rates of flare and need for surgery in patients with Crohn's disease. While the risk of ulcerative colitis is lower in smokers and particularly former smokers compared to never-smokers, smoking does not improve natural course of the disease. Given its overall health effects, smoking is not recommended for anyone.
Is the relative value of surgeon effort equal across surgical specialties

Abstract Background Although relative value units are used to measure physician productivity, research has demonstrated incongruencies between relative value units and actual surgeon work effort. We sought to determine whether this variation extends across surgical specialties. Methods A retrospective review of surgical cases was conducted using the 2017 American College of Surgeons National Surgical Quality Improvement Program database. For each case, we identified the primary Current Procedural Terminology, surgical specialty, total relative value units, and 5 alternative measures of work effort. We then examined the correlation between a Current Procedural Terminology’s mean total relative value unit and work effort. Finally, we constructed a multivariable linear regression model to evaluate the association between surgical specialty and the expected mean total relative value unit adjusting for work effort and patient characteristics. Results A total of 876,515 cases met the inclusion criteria. Overall, median operative time correlated well with mean total relative value unit (R = 0.85), though it was lowest for cardiac surgery (R = 0.51) and highest for otolaryngology (R = 0.97). Neurosurgery had the greatest increase in mean total relative value unit per hour of operative time (12.9/h). Mean total relative value unit correlated modestly with length of stay (R = 0.58) and serious adverse events (R = 0.61) and weakly with readmission (R = 0.42) and mortality (R = 0.29). When holding these metrics constant, the multivariable model showed mean total relative value units differed according to surgical specialty alone. Compared with general surgery, neurosurgery and cardiac surgery earned 3.41 to 3.61 additional mean total relative value units (P Conclusion Surgeon productivity is increasingly measured using relative value units. While mean total relative value units correlate well with operative time, they may not reflect other aspects of work effort. Differences in mean total relative value units by surgical specialty demonstrate potential inequities in the determination of physician productivity.
Reliability and Validity of Two Surgical Prioritization Systems for Non-Emergent Gynecologic Surgery during the COVID Pandemic

Study Objective Scientifically evaluate the validity and reproducibility of two novel surgical triaging systems, as well as offer modifications to the MeNTS criteria for improved application in gynecologic surgeries Design Retrospective cohort study Setting Academic university hospital Patients or Participants 97 patients with delayed benign gynecologic procedures due to the COVID pandemic Interventions Surgical prioritization was assessed using two novel scoring systems, the Gyn-MenTS and mESAS systems for all 93 patients included Measurements and Main Results The inter-rater reliability and validity of 2 novel surgical prioritization systems (Gyn-MeNTS and mESAS) were assessed Gyn-MeNTS scores were calculated by 3 raters and analyzed as continuous variables, with a lower score indicating more urgency/priority The mESAS score was calculated by 2 raters and analyzed as a 3-level ordinal variable with a higher score indicating more urgency/priority All 5 raters were blinded to reduce bias Gyn-MeNTS inter-rater reliability was tested using Spearman r and paired t-tests were used to detect systematic differences between raters Weighted kappa indicated mESAS reliability Concurrent validity with mESAS and surgeon self-prioritization (SSP) was examined with Spearman r and logistic regression Spearman r's for all Gyn-MeNTS rater pairs were above 0 80 (0 84 for 1 vs 2, 0 82 for 1 vs 3, 0 82 for 2 vs 3, all p< 0001) indicating strong agreement The weighted kappa for the 2 mESAS raters was 0 57 (95% CI 0 40-0 73) indicating moderate agreement When used together, both scores were significantly independently associated with SSP, with strong discrimination (AUC 0 89) Conclusion Inter-rater reliability is acceptable for both scoring systems, and concurrent validity of each is moderate for predicting SSP, but discrimination improves to a high level when they are used together
Primary myelofibrosis: 2021 update on diagnosis, risk-stratification and management.

Disease overview Primary myelofibrosis (PMF) is a myeloproliferative neoplasm (MPN) characterized by stem cell-derived clonal myeloproliferation that is often but not always accompanied by JAK2, CALR, or MPL mutations. Additional disease features include bone marrow reticulin/collagen fibrosis, aberrant inflammatory cytokine expression, anemia, hepatosplenomegaly, extramedullary hematopoiesis (EMH), constitutional symptoms, cachexia, leukemic progression, and shortened survival. Diagnosis Bone marrow morphology is the primary basis for diagnosis. Presence of JAK2, CALR, or MPL mutation, expected in around 90% of the patients, is supportive but not essential for diagnosis; these mutations are also prevalent in the closely related MPNs, namely polycythemia vera (PV) and essential thrombocythemia (ET). The 2016 World Health Organization classification system distinguishes "prefibrotic" from "overtly fibrotic" PMF; the former might mimic ET in its presentation. Furthermore, approximately 15% of patients with ET or PV might progress into a PMF-like phenotype (post-ET/PV MF) during their clinical course. Adverse mutations SRSF2, ASXL1, and U2AF1-Q157 mutations predict inferior survival in PMF, independent of each other and other risk factors. RAS/CBL mutations predicted resistance to ruxolitinib therapy. Adverse karyotype Very high risk abnormalities include -7, inv (3), i(17q), +21, +19, 12p-, and 11q-. Risk stratification Two new prognostic systems for PMF have recently been introduced: GIPSS (genetically-inspired prognostic scoring system) and MIPSS70+ version 2.0 (MIPSSv2; mutation- and karyotype-enhanced international prognostic scoring system). GIPSS is based exclusively on mutations and karyotype. MIPSSv2 includes, in addition, clinical risk factors. GIPSS features four and MIPSSv2 five risk categories. Risk-adapted therapy Observation alone is advised for MIPSSv2 "low" and "very low" risk disease (estimated 10-year survival 56%-92%); allogeneic hematopoietic stem cell transplant (AHSCT) is the preferred treatment for "very high" and "high" risk disease (estimated 10-year survival 0%-13%); treatment-requiring patients with intermediate-risk disease (estimated 10-year survival 30%) are best served by participating in clinical trials. In non-transplant candidates, conventional treatment for anemia includes androgens, prednisone, thalidomide, and danazol; for symptomatic splenomegaly, hydroxyurea and ruxolitinib; and for constitutional symptoms, ruxolitinib. Fedratinib, another JAK2 inhibitor, has now been FDA-approved for use in ruxolitinib failures. Splenectomy is considered for drug-refractory splenomegaly and involved field radiotherapy for non-hepatosplenic EMH and extremity bone pain. New directions A number of new agents, alone or in combination with ruxolitinib, are currently under investigation for MF treatment (ClinicalTrials.gov); preliminary results from some of these clinical trials were presented at the 2020 ASH annual meeting and highlighted in the current document.
Relationship of physical function with quality of life in older patients with acute heart failure

BACKGROUND Older patients with acute decompensated heart failure (ADHF) have severely impaired physical function (PF) and quality of life (QOL). However, relationships between impairments in PF and QOL are unknown but are relevant to clinical practice and trial design. METHODS We assessed 202 consecutive patients hospitalized with ADHF in the multicenter Rehabilitation Therapy in Older Acute HF Patients (REHAB-HF) Trial. PF measures included Short Physical Performance Battery (SPPB) and 6-min walk distance (6MWD). Disease-specific QOL was assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ). General QOL was assessed by the Short Form-12 (SF-12) and EuroQol-5D-5L. PF was evaluated as a predictor of QOL using stepwise regression adjusted for age, sex, race, and New York Heart Association class. RESULTS Participants were 72 ± 8 years, 54% women, 55% minority race, 52% with reduced ejection fraction, and body mass index 33 ± 9 kg/m2 . Participants had severe impairments in PF (6MWD 185 ± 99 m, SPPB 6.0 ± 2.5 units) and disease-specific QOL (KCCQ Overall Score 41 ± 21 and Physical Score 47 ± 24) and general QOL (SF-12 Physical Score 28 ± 9 and EuroQol Visual Analog Scale 57 ± 23). There were modest, statistically significant correlations between 6MWD and KCCQ Overall, KCCQ Physical Limitation, and SF-12 Physical Scores (r = 0.23, p < 0.001; r = 0.30, p < 0.001; and r = 0.24, p = 0.001, respectively); and between SPPB and KCCQ Physical and SF-12 Physical Scores (r = 0.20, p = 0.004, and r = 0.19, p = 0.007, respectively). Both 6MWD and SPPB were correlated with multiple components of the EuroQol-5D-5L. 6MWD was a significant, weak predictor of KCCQ Overall Score and SF-12 Physical Score (estimate = 0.05 ± 0.01, p < 0.001 and estimate = 0.05 ± 0.02, p = 0.012, respectively). SPPB was a significant, weak predictor of KCCQ Physical Score and SF-12 Physical Score (estimate = 1.37 ± 0.66, p = 0.040 and estimate = 0.54 ± 0.25, p = 0.030, respectively). CONCLUSION In older, hospitalized ADHF patients, PF and QOL are both severely impaired but are only modestly related, suggesting that PF and QOL provide complementary information and assessment of both should be considered to fully assess clinically meaningful patient-oriented outcomes.
Supplier Diversity: A Mechanism for Supporting Minority Entrepreneurship

The Supplier Diversity (SD) movement developed as an outgrowth of the modern Civil Rights Movement that began in the late 1950s. American corporations had traditionally bought very little from minority firms prior to the late 1960s when the United States federal government began a series of programmes designed to assist and develop minority businesses. The early days of SD were characterized by compliance with the laws requiring government agencies and large federal contractors to utilize minority firms. By the late 1980s, the private sector-led initiatives to establish private certification agencies that performed this critical task, while also working to develop minority business enterprises. Today, the movement has grown to thousands of for-profit and not-for-profit buying organisations, contracting with thousands of diverse businesses across all industries.
How Corporate Political Spending Strains the Limits of the Business Judgment Rule

A number of agency issues arise when a corporation chooses to exercise its freedom of speech by making donations to a super PAC or other political organization. This article draws a distinction between contributions designed to influence legislation and regulation of the corporation and political donations that corporations justify as goodwill or community outreach. Analyzing the issue with an emphasis on the duty of loyalty, the article argues that much corporate political spending cannot really be understood as a business decision that should enjoy the protection of the business judgment rule. It also reflects on the Supreme Court’s recent decision in Hobby Lobby to illuminate the nature of much corporate political spending. The article concludes that greater scrutiny of corporate political donations under the law of fiduciary duties will have two positive benefits: 1. it will prevent spending that is designed to enrich the corporate decision makers themselves; and 2. it will shine more light on spending that helps advance a corporation’s own interests at the expense of the public good.
Molecular Masks" for ACE2 to Effectively and Safely Block SARS-CoV-2 Virus Entry."

Coronavirus Disease 2019 (COVID-19) remains a global health crisis, despite the development and success of vaccines in certain countries. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, uses its spike protein to bind to the human cell surface receptor angiotensin-converting enzyme 2 (ACE2), which allows the virus to enter the human body. Using our unique cell screening technology, we identified two ACE2-binding peptoid compounds and developed dimeric derivatives (ACE2P1D1 and ACE2P2D1) that effectively blocked spike protein-ACE2 interaction, resulting in the inhibition of SARS-CoV-2 pseudovirus entry into human cells. ACE2P1D1 and ACE2P2D1 also blocked infection by a D614G mutant pseudovirus. More importantly, these compounds do not decrease ACE2 expression nor its enzyme activity (which is important in normal blood pressure regulation), suggesting safe applicability in humans.
Do medical student mental stress and burnout vary with virtual versus in-person residency interviews

Aim: This study aimed to identify medical student stressors and mitigation methodologies based on interview modality. Materials & methods: A survey was administered to obstetrics and gynecology app...
Segment method for the control of systems in the presence of uncertainty

Abstract : The paper develops the segment method for the problem of control with uncertainty. It is shown that due to disturbances a segment of values of the performance functional is associated with each admissible control. It is proposed that the optimal control for the problem with uncertainty be defined on the basis of an ordering of associated segments. The ordering is achieved by introducing a segment index. Two particular segments, the pessimistic and the optimistic segment, are shown to be important in the analysis of the problem while minimization of the introduced segment index is the basic synthesis problem. The approach is applied to a linear control problem where uncertainty is caused by external disturbances and specific results are presented. They show the optimal control to retain the advantages of the usual, minimax type designs and ensure better system performance for disturbances other than the worst. (Author)
Gestational age-dependent maternal-fetal glyburide disposition in pregnant mice (1141.5)

Glyburide (Gly) is routinely used to treat hyperglycemia during pregnancy. Our objective was to determine if maternal-fetal disposition of Gly and metabolites is dependent on gestational age in pregnant mice because similar studies cannot be done in humans. Following retro-orbital injection of Gly, maternal plasma and fetuses were collected at 0.5-240 min after dosing. Pharmacokinetic parameters were determined using a pseudo-profile based bootstrap approach and compartmental/noncompartmental analyses. Maternal Gly clearance increased 2-fold on gestation day (gd) 15 and 19 versus gd 0. Gly depletion analysis using mouse liver microsomes confirmed that gestational age-dependent changes in Gly clearance is caused by increases in hepatic metabolism. Maternal metabolite/Gly area under the curve (AUC) ratios were low throughout gestation (~0.004), indicating an increase in both metabolite formation and clearance. Fetal/maternal Gly AUC ratios doubled from gd 15 to 19 (0.02 to 0.04), which is likely due to decr...
Liquid Alloys — New Perspectives and Challenges

The opening address of S. C. Moss was effective in summarizing topics where progress has been achieved in the study of alloy phase stability; the long-term goals seemed to be within reasonable reach, e.g., calculation of phase diagrams from first principles, relations between structure and physicochemical properties. The purpose of this contribution is to add another dimension, and perhaps a challenge to theoreticians in this field, by showing complexities in the liquid state which must be included in the modeling of phase equilibria, such as liquid-solid coexistence and the influence of the liquid properties on the solidus curve.