cssi/SciSciGPT-SciSciNet huggingface dataset:
Incidence of knee sepsis after ACL reconstruction at one institution: the impact of a clinical pathway.

Background: After experiencing an unusually high incidence of knee sepsis after anterior cruciate ligament (ACL) reconstruction, we sought to (1) describe how we resolved this problem through temporary discontinuation of the procedure, formation of a multidisciplinary ACL Task Force, systematic investigation of clinical data and institutional care practices, and development and implementation of an evidence-based ACL Clinical Pathway (the Pathway); and (2) report our findings and results. Methods: From 1999 through 2008, thirty-seven cases of knee sepsis after ACL reconstruction were recorded at our institution. In 2008 (yearly incidence, 4.4%), ACL reconstructions were temporarily suspended and a Task Force was assembled to (1) identify infection risk factors or epidemiological links among cases, (2) inspect environment and processes for possible infection sources, and (3) update existing perioperative practices according to current evidence-based guidelines to reduce surgical site infection risk. These actions led to the development of the Pathway for patients and providers. The rates of knee sepsis before and after the Pathway was implemented were compared. Results: There was no consistent risk factor or epidemiologic link among the cases of knee sepsis other than the time and place of the ACL reconstruction. Process review identified shortfalls in decontamination and sterilization of some surgical equipment. Perioperative care practices review revealed wide interprovider variation. Pathway implementation reduced the rate of knee sepsis after ACL reconstruction from 1.96% (twenty-four cases after 1226 ACL reconstructions performed from 2002 to 2008) to 0% (zero cases after 500 ACL reconstructions performed from 2008 to 2011); the difference was significant (p = 0.003). Conclusions: When a Task Force investigation suggested that knee sepsis after ACL reconstruction was a multifactorial problem, we implemented and standardized evidence-based perioperative care practices via the institution-wide Pathway, which significantly improved the quality and consistency of care for patients undergoing ACL reconstruction, as well evidenced by the elimination of knee sepsis. Clinical Relevance: For the care of surgical patients in many settings, there remains disparity between the best available evidence and actual clinical practices. This study shows how a hospital community implemented and standardized a bundle of evidence-based practices to significantly improve the quality of clinical outcomes for patients undergoing an orthopaedic procedure.
Heteroepitaxy and the performance of CIGS solar cells

The preferred orientation of CIGS is related to the crystal structure of the bottom MoSe2 layer. The lattice mismatch of chalcopyrite (220) CIGS to hexagonal (102) MoSe2 is lower than other orientations. The lattice mismatch depends on the Ga composition x, reaching a minimum at x=0.35. 2D dislocation and trap densities were calculated as a function of lattice mismatch for various compositions. In good agreement with experiment, the best performance CIGS solar cell was obtained at x=0.35 in this numerical device simulation. The lattice mismatch between CIGS and hexagonal CdS can also lead to 2D dislocations in CdS at the top CIGS interface. Interface traps saturate the open circuit voltage at high Ga composition by a thermionic emission transport mechanism. These models well explain observed CIGS solar cell performance over the full range of Ga compositions.
ESTIMATING A POSSIBLY RATIONAL MEAN

Publisher Summary This chapter discusses the estimation of a possibly rational mean with squared error loss. The results indicate that the Bayes procedure is approximately one that adjusts the sample mean (or possibly the Bayes estimate from a highly smoothed prior) to include the special contribution of a salient specific candidate for the true value of θ. It seems very likely that such a procedure will be robust. One may ask whether there should be some component of the loss function to favor the estimate being a rational number. An additive component will do this even if the sample is so large that this is strongly contraindicated by the data. In many situations this is appropriate.
Transforming Consultants’ Recommendations into Business Improvements: A Model and Action Agenda

The use of consultants is a way for small businesses to gain quick access to management expertise. Unfortunately, too often, both the owner and the consultant feel frustration at the conclusion of the consulting engagement. The owner feels the consultant's recommendations are too general. The consultant is disappointed with the owner's follow-up on key recommendations. No one is willing to take responsibility for implementation. This article explores how to deal with the follow-up challenge. It includes an eight-part model for organized improvement and an action agenda for improved follow-up.
Bandpass Attenuating-Counter-Propagating Phase Modulator

Attenuating-counter-propagating (ACP) phase modulators enable wideband optical phase-locked loop (OPLL) phase demodulator for high dynamic range RF/photonic links. However, existing ACP modulators have low-pass response that limits the OPLL operating frequency. In this letter, we present the first bandpass ACP phase modulator realized on an LiNbO3 substrate employing a novel periodically bended optical waveguide structure. The device demonstrated latency free phase modulation centered at 7 GHz.
Wulff clusters inR 2

We give the first existence and regularity results on the cheapest way to enclose and separate planar regions of prescribed areas, where cost is given by a general norm ϕ, thus generalizing the Wulff shape for enclosing a single region. As an example, we classify the cheapest way to enclose and separate two planar regions of prescribed areas for the l1 norm (“Manhattan metric”) into three distinct types, according to the relative size of the prescribed areas.
A semiotic theory of institutionalization

In management theory scholars emphasize that what actors do is often not what they say, but they tend to assume that what actors do is what they mean or that what they mean is what they say. These assumptions are problematic when studying the institutionalization process, where doing, saying, and meaning move from the micro level to the macro level. I argue that the three are distinct correlates of social reality corresponding to the semiotic triangle composed of referent, signifier, and signified, which is key to understanding institutionalization. I combine the semiotic triangle and the chain of signification to conceptualize the process of institutionalization as the coevolution of the three correlates of the sign. Specifically, I identify two kinds of institutionalization: denotational and connotational. Whereas denotational institutionalization entails the coupling of the referent, signifier, and signified, connotational institutionalization involves decoupling among the three. Furthermore, decouplin...
Yield response of Fenghua Zhan and Yuexiang Zhan to water management and fertilizer and fertilization as well as their interaction

Rice grain yield (RGY) response of Fenghua Zhan and Yuexiang Zhan to upland cultivation with rice straw mulching (M),normal lowland cultivation (P),fertilizers (two types of CRF of BT and AgroBB, urea), dosages (high amount ,HD, 225 kg N per hm2 and low amount,LD,150 kg N per hm2 and their interaction had been studied by field experiments in both 1st rice and 2nd rice in Guangzhou. Results showed that fertilizers and their dosage had no significant influence on RGY of both 1st and 2nd rice under either M or P condition. RGY of HT and AgroBB with once basal application was the same as that of urea with 3 splitting application. For the 1st rice, RGY of M was more than that of P in urea plots, whereas RGY of P more than of M in both BT and AgroBB treatments. For the 2nd rice,RGY of P was bigger than that of M for all fertilizer treatments. The yield decreased by 17. 6%,21. 5% and 12.1% for urea,BT,AgroBB respectively. Yield of BT and AgroBB treatments in P was higher than that in M for both 1st and 2nd rice. Between two CRFs, AgroBB was favorable to stabilize RGY compared to BT. RGY in LD treatment (150 kg N per hm2) was significantly higher than that of HD (225 kg N per hm2). RGY of LD treatments was 4. 6% to 7. 2% higher than that of HD for 1st rice and the.corresponding date was 7. 1% to 9. 7 % for 2nd one. Increase rate of RGY in urea plots at LD was the maximum among the three fertilizers and no statistic difference between BT and AgroBB existed,neither did RGY for every treatment between two varieties. There was no significant interaction effect of fertilizers,dosage and varieties and water managements on RGY expect for a few treatments. Among the interaction effect, AgroBB was better than urea and BT. Therefore,less irrigation with rice straw mulching and urea application of 150 kg N per hnr splitting as 40 % of basal,30 % of topdressing at tillering stage and the other 30 % at the end of tillering stage was suggested for 1st rice production in pearl river delta. For the 2nd rice,one could use the same fertilization program except normal paddy water management system at both tillering stage and booting stage.
Progressive congestive heart failure: Ways to approach office management

Treatment of congestive heart failure depends on the cause, precipitating factors, and symptoms of the disease in each patient. Dr Kahn outlines the use of the three main types of pharmacologic agents given for heart failure--diuretics, vasodilators, and digoxin. He describes a stepwise regimen, whereby agents are added as needed to improve symptoms and prolong life.
Implantation of a New Semiautomatic Artificial Genitourinary Sphincter: Experience With Primary Activation and Deactivation in 47 Patients

AbstractAS 742 is a new semiautomatic artificial genitourinary sphincter that has been used at the clinic for the last 2½ years in the management of urinary incontinence. Compared to the previous model the simplified design provides for much easier implantation, more reliable function related to cuff pressures and to cuff configuration, and more flexibility in the selection of the site for cuff placement. In addition, this new device has enabled the development and use of a new concept of primary and secondary activation. A total of 47 patients (41 male and 6 female subjects) has undergone implantation of the AS 742. Of the 42 patients who had primary activation 34 experienced continence without further surgical revision. The remaining 5 patients who primarily had deactivated devices subsequently had the devices activated and the patients are dry. Of the 8 patients with initial failures 2 had infection and 6 had primary cuff erosion of the urethra. In 4 of the 8 patients the cuff was replaced, and the dev...
Big Data Analytic Paradigms: From Principle Component Analysis to Deep Learning

Large sets of data (numerical, textural and image) have been accumulating in all aspects of our lives for a long time. Advances in sensor technology, the Internet, social networks, wireless communication, and inexpensive memory have all contributed to an explosion of “Big Data,” as part of thrust in robust intelligence. Big data is created in many ways in today’s highly inter-connected world. Social networks, system of systems (SoS: complex interoperable) systems and wireless systems are only some of the platforms creating big data. Recent efforts have developed a promising approach, called “Data Analytics”, which uses statistical and computational intelligence (CI) tools such as principal component analysis (PCA), clustering, fuzzy logic, neuro-computing, evolutionary computation, Regression analysis, Bayesian networks, etc. to reduce the size of “Big Data” to a manageable size and apply these tools to (a) extract information, (b) build a knowledge base using the derived data, and (c) eventually develop a non-parametric model for the “Big Data”. This chapter attempts to construct a bridge between SoS and Data Analytics to develop reliable models for such systems. One of the recent most promising data analytic too is “Deep Learning”. Deep learning is the broad term for the recent development and extensions of neural networks in the machine learning community, which has allowed for state of the art results in speech, image, and natural language processing tasks. Hierarchical learning is an area of research which focuses on learning high order representations from low level data. Learning to recognize objects from images, recognizing words or syllables from audio, or recognizing poses and movement from video are all good examples of modern hierarchical learning research, which is a central focus of the “deep learning” movement in the machine learning and computational statistics community. This chapter will give a rather comprehensive look at all the BIG data analytic tools—old and new. Data bases of photovoltaic and wind energy (from US National Renewable Energy Laboratory) as well as transportation data will all be used here.
Power and Politics: Speech Acts and Freedom of Expression

Thus far, I have argued that there is conceptual space within egalitarian liberalism to accommodate an activist state in the service of regulating culturally oppressive speech. In Chapters 2 and 3, I argued that the criticisms of the traditional liberal justifications for unregulated freedom of expression brought by feminists and critical race theorists in the silencing and subordination arguments demonstrated the lack of attention paid to power relations by egalitarian liberal theory. The discussion in this chapter will show — using the framework of speech act theory developed by J. L. Austin — that while there are significant problems with the silencing and subordination arguments as they stand, in particular their conclusion that the speech of pornographers and hate speakers is powerful enough to silence and subordinate, they nevertheless make what I think is a fundamental point — that liberal thinking about the allocation and delineation of rights leaves something crucial about power undiscussed, and that speech act theory provides a very helpful framework for finally discussing the relationship between language and power that the silencing and subordination arguments have only gestured at.
The Northern Ireland Peace Process

This chapter looks at the Northern Ireland Peace Process beginning with the turning point in the Troubles in 1988, when there was an apparent reversal of policy under British Prime Minister John Major. The chapter analyzes the administration of British Prime Minister Tony Blair and the process that led to peace.
What a Difference a Day Makes: Differences in Initial Abstinence Response During a Smoking Cessation Attempt.

Aims To (1) identify distinct classes of smokers based on quit day withdrawal symptoms and (2) explore the relations between withdrawal classes and demographics, tobacco dependence, treatment and smoking outcomes. Design Secondary data analysis of participants (n = 1504) in a randomized double-blind placebo-controlled multi-site smoking cessation trial who provided ecological momentary assessments of withdrawal symptoms on their quit day. Participants received smoking cessation counseling and were randomized to receive placebo or one of five active pharmacotherapies. Setting Research offices in Madison and Milwaukee, Wisconsin, USA. Participants Adult smokers (n = 1236; 58% female, 86% white), recruited from the community via advertisements, who abstained on their quit day. Measurements Demographics and tobacco dependence were assessed at baseline and participants carried palmtop computers to record withdrawal symptoms (craving, negative affect, difficulty concentrating, hunger and anhedonia) on their quit day. Point-prevalence abstinence and latency to relapse were assessed at 8 weeks and 6 months post-quit. Findings Latent class analysis identified four withdrawal classes [Akaike information criterion (AIC) = 70.09]: Moderate withdrawal (64% of sample), high craving–anhedonia (8% of sample), affective withdrawal (13% of sample) and hunger (15% of sample). The high craving–anhedonia class reported significantly higher dependence (P < 0.01), were less likely to have received combination nicotine replacement, reported lower week 8 abstinence rates and relapsed sooner than those in the moderate withdrawal class (P < 0.05). The affective withdrawal class reported higher levels of baseline negative affect and life-time psychopathology (P < 0.05) and relapsed more quickly than the moderate withdrawal class (P < 0.01). Conclusions While the majority of smokers report typical levels of withdrawal symptoms on their quit day, more than one-third report extreme craving or extreme negative affective or extreme hunger responses to initial abstinence. These distinct quit-day withdrawal symptom patterns are related to baseline characteristics, treatment and cessation success.
Brief Mental Training Reorganizes Large-Scale Brain Networks.

Emerging evidences have shown that one form of mental training - mindfulness meditation, can improve attention, emotion Emerging evidences have shown that one form of mental training - mindfulness meditation, can improve attention, emotion regulation and cognitive performance through changing brain activity and structural connectivity. However, whether and how the short-term mindfulness meditation alters large-scale brain networks are not well understood. Here, we applied a novel data-driven technique, the multivariate pattern analysis (MVPA) to resting-state fMRI data to identify changes in brain activity patterns and assess the neural mechanisms induced by a brief mindfulness training - integrative body–mind training (IBMT), which was previously reported in our series of randomized studies. Whole brain resting-state fMRI was performed on an undergraduate group who received 2 weeks of IBMT with 30 min per session (5 h training in total). Classifiers were trained on measures of functional connectivity in this fMRI data, and they were able to reliably differentiate (with 72% accuracy) patterns of connectivity from before vs. after the IBMT training. After training, an increase in positive functional connections (60 connections) were detected, primarily involving bilateral superior/middle occipital gyrus, bilateral frontale operculum, bilateral superior temporal gyrus, right superior temporal pole, bilateral insula, caudate and cerebellum. These results suggest that brief mental training alters the functional connectivity of large-scale brain networks at rest that may involve a portion of the neural circuitry supporting attention, cognitive and affective processing, awareness and sensory integration, and reward processing.
Matter - a current picture.

A century ago, a two-part review by W.C. McC. Lewis entitled “The Structure of Matter” appeared in this journal, surveying the achievements that had been made to date in that field. Topics included...
Correcting errors by natural redundancy

For the storage of big data, there are significant challenges with its long-term reliability. This paper studies how to use the natural redundancy in data for error correction, and how to combine it with error-correcting codes to effectively improve data reliability. It explores several aspects of natural redundancy, including the discovery of natural redundancy in compressed data, the efficient decoding of codes with random structures, the capacity of error-correcting codes that contain natural redundancy, and the time-complexity tradeoff between source coding and channel coding.
The identity development of urban minority boys in single mother households

This phenomenological study explored the gender and career identity development of 13 urban minority young men, with an emphasis on the potential impact of father absence and single-mother parenting. Six themes were identified: (a) emotional intelligence and maternal appreciation and internalization, (b) consequent assumption of a parentified role, (c) nontraditional perception of masculinity, (d) experienced paternal void, (e) resilience, and (f) the limitations and aspirations in career pathways. Implications for practice and research are discussed.
Resistenz schizophrener Patienten gegen eine soziale und berufliche Rehabilitation

Eine Untersuchung des sozialen und beruflichen Verhaltens schizophrener Patienten fuhrt zu folgenden Beobachtungen: 1. Resistenz gegen eine Rehabilitation charakterisiert die Mehrzahl der schizophrenen Patienten auf allen Stufen des therapeutischen Ansprechens; 2. zwischenzeitliche Ruckfalle storen weiterhin die andauernde und erfolgreiche Rehabilitation trotz neuer psycho-sozialer Therapieprogramme, die einen fruhen Ruckfall hinauszogern, aber einen spateren nicht verhindern; 3. Verhaltensweisen aus der Zeit vor der Berufstatigkeit, die gegen eine vollstandigere Rehabilitation wirken, spiegeln moglicherweise Elemente des Typ II-Syndroms und die diesen zugrunde liegenden psychobiologischen Anomalien wider; 4. die funktionelle Bedeutung dieser psychobiologischen Defizite wird wahrscheinlich durch entwicklungsbedingte Geschlechtsunterschiede beeinflust, die fur die Spezialisten beruflicher Rehabilitation noch genauer ermittelt und formuliert werden mussen; 5. die vorlaufigen Bestandteile eines diagnose- und geschlechtsspezifischen Rehabilitationsprogramms, aufbauend auf der schizophrenen Pathophysiologie, konnen zwar formuliert werden, bedurfen aber einer extensiven Entwicklung.
Clays of Contention: An Ethnoarchaeological Study of Factionalism and Clay Composition

This ethnoarchaeological study examines sociopolitical constraints on traditional pottery production in Paradijon, southern Luzon, the Philippines. Factionalism divided the potting community as it became involved in elite competition and dictated that the two potting factions acquire clays from sources controlled by elite alliance partners. This study examines patterning in instrumental neutron activation analysis (INAA) data in relationship to the involvement of independent craft specialists in elite competition. Patterning of INAA data at community and regional levels is found, illustrating the middle-range links between sociopolitical behavior of potters and patterns in clay composition. INAA patterning among clay preparation areas appears dependent on whether a preparation area is in public or private space. Regionally, primary markets express INAA signals from both factions, whereas secondary markets reflect potter participation of a particular faction.
The Na+/I− Symporter (NIS) and Thyroid Hormone Biosynthesis

The thyroid hormones are essential for the development and maturation of the central nervous system, lungs, and skeletal system, and for intermediary metabolism in virtually all tissues throughout life. Iodine is an essential constituent of these hormones, the only ones that contain it. The first step in thyroid hormone biosynthesis is the active accumulation of iodide by the thyroid follicular cells, a process mediated by the Na+/I− symporter (NIS), an integral plasma membrane glycoprotein located at the basolateral surface of these cells. In this chapter, we discuss the most recent findings on the highly complex thyroid hormone biosynthesis pathway, with an emphasis on NIS. Thyroid hormones are the only hormones whose biosynthesis takes place both intracellularly and extracellularly – in the thyroid follicular cells and at the cell/colloid interface, respectively. NIS, for its part, has emerged as a key transporter that plays a critical role not only in thyroid physiology and in the treatment of thyroid cancer with radioiodide administered after thyroidectomy, but also as the mediator of active iodide uptake in other tissues, such as lactating breast. Since the isolation of the cDNA that encodes NIS, a great deal of progress has been made in the investigation of the protein’s structure/function and regulation, and it is clear that a deeper mechanistic understanding of NIS is likely to lead to novel medical applications.
The velocity of large scale jets in Quasars

We present an analysis of the je t /counterje t ratios measured from the very deep VLA images of quasars made by Bridle and his collaborators. A technique is developed for including ' largest linear size' information as a statistical indicator of source orientation. Nine of these sources form a complete and well defined sample. If the difference in jet and counter jet brightness are a t t r ibuted to Doppler beaming, then jet velocities less than 0.8c are rejected at the 99% confidence level, and the da ta are most consistent with values of v/c very close to 1. Addi t ional new evidence that the velocities of large scale jets are relativistic also comes from total intensity and polarized images of the extended structure surrounding core-dominated quasars. R e f e r e n c e Wardle et al., in preparation.
Tumor Suppressor Gene 101: A Virus’ Multifunctional Conduit to the ESCRT Trafficking Machinery

Abstract Eukaryotic cells transport proteins and lipids between the exterior and interior environments using membrane-bounded vesicles that travel by two major pathways: the outward, exocytic pathway, and the inward, endocytic pathway. The product of the tumor suppressor gene 101 (Tsg101) is a highly conserved protein and component of the endosomal sorting complex required for transport (ESCRT) machinery whose function is exploited by viruses that utilize both pathways. Tsg101's critical function is to recognize and sort the ESCRT cargo. While the ESCRT machinery is best known for its role in trafficking of cellular cargo from the plasma membrane to degradative compartments in the cell interior, viruses use it to facilitate egress from the cell periphery. This chapter focuses on the unique molecular properties of Tsg101 that enable it to be exploited by pathogens to gain access to the machinery's membrane remodeling apparatus necessary for their separation from the host. Particular emphasis is placed on how the structure of Tsg101 contributes to its unique role as an assembly chaperone to the retrovirus HIV-1, permitting the virus to influence ESCRT machinery interaction with other cellular machineries, including phosphatidylinositol lipid and calcium signaling systems. The role of Tsg101 in the egress of viruses outside the Retroviridae and its potential as a target for broadly effective antiviral drug development also is discussed. Although many questions remain, our understanding is growing of the Tsg101 protein and the complex mechanism by which it facilitates the virus budding process, just one of its many functions.
CHAPTER 18 – A Perspective on Pathogens as Biological Control Agents for Insect Pests

Pathogens that cause disease in insects fall into four main groups—viruses, bacteria, fungi, and protozoa. This chapter describes each of these groups in terms of the biological properties that determine their utility as agents for controlling insects. It provides a brief historical review and a preliminary description of strategies for using pathogens in control programs. One of the viruses used for such purpose are iridoviruses that are nonoccluded viruses with a linear double-stranded DNA genome that produce large icosahedral virions replicating in the cytoplasm of a wide range of tissues in infected hosts, causing disease that is generally fatal. Virions can form paracrystalline arrays in infected tissues, imparting an iridescent hue to the infected hosts. The bacteria are relatively simple unicellular microorganisms that lack internal organelles such as a nucleus and mitochondria and reproduce by binary fission. With a few exceptions, most of those used as microbial insecticides grow readily on a wide variety of inexpensive substrates, a characteristic that greatly facilitates their mass production. The majority of bacteria currently being used or under development as the microbial control agents for insects are spore-forming members of the bacterial family Bacillaceae and belong to the genus Bacillus . These insect-pathogenic bacilli occur in healthy and diseased insects, but also occur in, and can be isolated from, many other habitats including insect frass, soil, plants, granaries, and aquatic environments.
Reversible Binding of Ethylene and Propylene by Germylenes

The diarylgermylenes Ge(ArMe6)2 and Ge(AriPr4)2 (ArMe6 = C6H3-2,6-(C6H3-2,4,6-Me3)2), AriPr4 = C6H3-2,6-(C6H3-2,6-iPr2)2) are shown to react reversibly with ethylene. It is demonstrated that the more sterically crowded Ge(AriPr4)2 also reversibly binds propylene. The germirane products Ar2GeCH2CHR (Ar, R = ArMe6, H (1a), AriPr4, H (1b), and AriPr4, Me (1c)) were characterized via 1H and 13C NMR spectroscopy and by X-ray crystallography in the case of 1b. Thermolysis of Ge(AriPr4)2 under ethylene resulted in Ge–C bond homolysis and the formation of the digermene [(AriPr4)Ge(Et)]2 (1d). The thermodynamic parameters of the reactions were determined by variable-temperature 1H NMR spectroscopy.
Artificial RNA Polymerase II Elongation Complexes for Dissecting Co-transcriptional RNA Processing Events.

Eukaryotic mRNA synthesis is a complex biochemical process requiring transcription of a DNA template into a precursor RNA by the multi-subunit enzyme RNA polymerase II and co-transcriptional capping and splicing of the precursor RNA to form the mature mRNA. During mRNA synthesis, the RNA polymerase II elongation complex is a target for regulation by a large collection of transcription factors that control its catalytic activity, as well as the capping, splicing, and 3’-processing enzymes that create the mature mRNA. Because of the inherent complexity of mRNA synthesis, simpler experimental systems enabling isolation and investigation of its various co-transcriptional stages have great utility. In this article, we describe one such simple experimental system suitable for investigating co-transcriptional RNA capping. This system relies on defined RNA polymerase II elongation complexes assembled from purified polymerase and artificial transcription bubbles. When immobilized via biotinylated DNA, these RNA polymerase II elongation complexes provide an easily manipulable tool for dissecting co-transcriptional RNA capping and mechanisms by which the elongation complex recruits and regulates capping enzyme during co-transcriptional RNA capping. We anticipate this system could be adapted for studying recruitment and/or assembly of proteins or protein complexes with roles in other stages of mRNA maturation coupled to the RNA polymerase II elongation complex.
Abstract 15: Targeting vismodegib-resistant medulloblastoma using novel hedgehog pathway inhibitor and miR-29b mimic

The purpose of this study to develop targeted liposomes of MDB5 and miR-29b combination for medulloblastoma (MB) treatment. Due to high heterogeneity and diverse genetic make-up, MB treatment is a challenge. Aberrant activation of hedgehog (Hh) pathway regulates cell growth, cancer stem cell (CSC) proliferation, and tumorigenicity in sonic Hh subgroup of MB. Further, Hh signaling regulates yes-associated protein 1 (YAP1) and glutaminolysis for energy need of tumor cells. GDC-0449 a smoothened receptors (SMO) antagonist treats (SHH)-MB initially, but resistance develops after repeated administration. Cholesterol potentiates Hh pathway independent of SHH by binding directly to the SMO. On the other hand, our RNA-seq and miRNA profiling confirmed downregulation of tumor suppressor miR-29b-3p in human MB samples. miR-29b control genes of apoptosis; p53, MDM2, AKT2, and cholesterol biosynthesis including HMGCR and SREBP1. We recently synthesized a potent GDC-0449 analog MDB5 (SMO inhibitors), which binds strongly to various Smo-mutants compared to GDC-0449. We found that a combination of MDB5 and miR-29b can treat MB synergistically. When we modified miR-29b backbone with 2-O’-methoxyethyl phosphorothioate (OMe-PS-miR-29b-3p), it showed enhanced stability in 50% serum. We designed a cationic lipid MDC2 for liposomal delivery of MDB5 and miR-29b1 simultaneously. Liposomes were prepared using film hydration technique and characterized for particle size and zeta potential, drug loading and release profile, miRNA complexation, stability, and transfection efficiency. These liposomes incorporated 88% MDB5 when the drug to phospholipid molar ratio was kept at 5%. Complete complexation was observed at N/P ratio of 3:1. These liposomes when loaded with green fluorescent protein (GFP) siRNA, resulted in 70% of signal silencing into DAOY MB cells (Shh driven). Liposomal MDB5 had higher cytotoxicity in DAOY cells compared to GDC-0449. Further, MDB5 and OMe-PS-miR-29b loaded liposomes resulted in higher, cytotoxicity and % of apoptosis, G0-G1 phase arrest, and decreased target gene expression in DAOY cells. Combination of drugs to simultaneously target multiple pathways related to Hh, glutaminolysis, cholesterol biosynthesis, and apoptosis has the potential to treat MB. Successful completion of this study will provide a nanomedicine for treating SHH-MB and other brain tumors. Citation Format: Virender Kumar, Bharti Sethi, Vinod Kumar, Timothy R. Mcguire, Don W. Coulter, Ram I. Mahato. Targeting vismodegib-resistant medulloblastoma using novel hedgehog pathway inhibitor and miR-29b mimic [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 15.
A Groupwise Approach for Inferring Heterogeneous Treatment Effects in Causal Inference

Recently, there has been great interest in estimating the conditional average treatment effect using flexible machine learning methods. However, this estimate is often difficult to interpret if covariates are high dimensional. The paper propose a groupwise approach to study effect heterogeneity where the conditional average treatment effect is partitioned into interpretable subgroups. Our method is simple, only based on linear regression and sample splitting, and is semiparametrically efficient under assumptions. We also discuss ways to conduct multiple testing across different subgroups. We conclude by reanalyzing a get-out-the-vote experiment during the 2014 U.S. midterm elections.
Epithelial cell infection by Epstein-Barr virus

Epstein-Barr Virus (EBV) is etiologically associated with multiple human malignancies including Burkitt lymphoma and Hodgkin disease as well as nasopharyngeal and gastric carcinoma. Entry of EBV into target cells is essential for virus to cause disease and is mediated by multiple viral envelope glycoproteins and cell surface associated receptors. The target cells of EBV include B cells and epithelial cells. The nature and mechanism of EBV entry into these cell types are different, requiring different glycoprotein complexes to bind to specific receptors on the target cells. Compared to the B cell entry mechanism, the overall mechanism of EBV entry into epithelial cells is less well known. Numerous receptors have been implicated in this process and may also be involved in additional processes of EBV entry, transport, and replication. This review summarizes EBV glycoproteins, host receptors, signal molecules and transport machinery that are being used in the epithelial cell entry process and also provides a broad view for related herpesvirus entry mechanisms.
Interface Failure Analysis of Triangular Rollable and Collapsible (TRAC) Booms

Characterizing the interface bond of thin-ply composites is important for assessing the overall structural integrity. Due to the flexibility of thin composite laminates, it is not feasible to carry out mode I double cantilever beam (DCB) and mode II end notch flexure (ENF) tests, due to the large geometric changes undergone during testing. To reduce the compliance during testing, thick aluminum substrates are bonded to the two free-surfaces of the test laminates. DCB and ENF tests are specifically carried out in this configuration. A specific glass fiber plain weave interface of a 7-ply composite structure is tested. µCT imaging shows the presence of periodic voids of size scales of 200 µm, and local delaminated regions of 0 . 7 − 5 . 6 mm. The former is attributed to capillary effects from the glass tows, while the latter is due to insufficient resin flow during the two-cure manufacturing process.
Chronic Non-Malignant Pain in Patients with Cancer Seen at a Timely Outpatient Palliative Care Clinic

Palliative care is seeing cancer patients earlier in the disease trajectory with a multitude of chronic issues. Chronic non-malignant pain (CNMP) in cancer patients is under-studied. In this prospective study, we examined the prevalence and management of CNMP in cancer patients seen at our supportive care clinic for consultation. We systematically characterized each pain type with the Brief Pain Inventory (BPI) and documented current treatments. The attending physician made the pain diagnoses according to the International Association for the Study of Pain (IASP) task force classification. Among 200 patients (mean age 60 years, 69% metastatic disease, 1-year survival of 77%), the median number of pain diagnosis was 2 (IQR 1-2); 67 (34%, 95% CI 28-41%) had a diagnosis of CNMP; 133 (67%) had cancer-related pain; and 52 (26%) had treatment-related pain. In total, 12/31 (39%) patients with only CNMP and 21/36 (58%) patients with CNMP and other pain diagnoses were on opioids. There was a total of 94 CNMP diagnoses among 67 patients, including 37 (39%) osteoarthritis and 20 (21%) lower back pain; 30 (32%) were treated with opioids. In summary, CNMP was common in the timely palliative care setting and many patients were on opioids. Our findings highlight the need to develop clinical guidelines for CNMP in cancer patients to standardize its management.
Surface Pleasures: Bicycling and the Limits of Infrastructural Thinking

There has been a resurgence of recreational cycling in Mumbai, as elsewhere in India, since the early 2010s. A significant reason for the new popularity of cycling has to do with the immersion in t...
Bronchoalveolar lavage-based COVID-19 testing in patients with cancer.

Abstract Objective/Background A few case reports in the setting of coronavirus disease 2019 (COVID-19) and multiplex polymerase chain reaction (PCR)-based assays for common respiratory pathogens have shown a higher yield of bronchoalveolar lavage (BAL) samples than upper airway specimens in immunocompromised patients. Methods A retrospective study was conducted reviewing patients diagnosed with COVID-19 at the Medical College of Wisconsin (Milwaukee, WI, USA) between March 13, 2020 and June 11, 2020. All patients tested positive for SARS-CoV-2 via real-time reverse transcriptase PCR (RT-PCR), through a nasopharyngeal or a bronchoscopy specimen. Results During the study period, 53 bronchoscopy procedures were performed at the institution, of which five patients tested positive for COVID-19. Of the five patients, three underwent BAL testing based on high clinical suspicion for COVID-19 after the nasopharyngeal (NP) swab(s) was negative. All three patients had underlying cancers and had lymphopenia for a considerable duration prior to being diagnosed with COVID-19. Two patients had better outcomes that could be attributed to earlier BAL specimen testing resulting in timely medical intervention. Conclusion This study underscores the need for early lower respiratory tract sampling, whenever possible, in patients with cancer and prolonged lymphopenia. High clinical suspicion ought to supersede false-negative NP reverse transcriptase–PCR as early bronchoscopic evaluation in cancer patients, who are either receiving active treatment or are immunosuppressed, can allow timely institution of efficacious treatment, enrollment into clinical trials, as well as effective infection control. In the apt clinical setting in patients with cancer, presumptive treatment may also be considered to minimize exposure to healthcare providers and proceduralists.
Preliminary experiences in acute occupational therapy for in-patients with coronavirus-19 (COVID-19): leveraging assistive technology in three case studies of male veterans.

Coronavirus 2019 (COVID-19) was first identified in December 2019 with millions of cases reported globally in the succeeding months. Initial hospitalisation strives to minimise multisystem organ fa...
Dynamics of resilience–equity interactions in resource-based communities

Despite the growing focus on understanding how to build resilience, the interaction between resilience and equity, particularly in the context of power asymmetries like those in communities reliant on resource-based industries, or resource-based communities, is not well understood. Here we present a stylized dynamical systems model of asymmetric resource access and control in resource-based communities that links industrial resource degradation, community well-being, and migration in response to economic and resource conditions. The model reveals a mechanism of collapse due to these dynamics in which over-extraction and resource degradation trigger irreversible population decline. Regulating resource extraction can increase resilience (in the sense of persistence) while also shifting the sustainable equilibrium and the implications for equity. Resilience does not guarantee equity at equilibrium, and this misalignment is more pronounced in the transient interactions between short term equity and long term resilience. The misalignment between resilience and equity demonstrates how equity considerations change the policy design process in important ways. Regulation improves resilience in resource-based communities but resilience does not guarantee community wellbeing, according to mathematical modeling of resource exploiting industries-community interactions.
Outcomes of Laparoscopic Versus Open Resection of Meckel's Diverticulum.

Abstract Background Meckel's Diverticulum (MD) is a common congenital anomaly accounting for half of pediatric gastrointestinal bleeds. No large-scale studies exist comparing open and laparoscopic surgery and conversion rates remain high. We sought to compare postoperative outcomes associated with each approach and to determine risk factors for conversion. Materials and Methods NSQIP-Pediatric was used to identify patients who underwent a MD resection from 2012 to 2018. Outcomes between patients treated with a laparoscopic versus open versus laparoscopic converted to open (LCO) surgery were compared. Chi-square tests and adjusted logistic regression analysis were used to determine significance and factors associated with conversion. Results Six hundred eighty-one patients were identified, 295 (43.3%) underwent open, 267 (39.2%) laparoscopic, and 119 (17.5%) LCO resection. Patients undergoing laparoscopic compared to open procedures had shorter length of stay (LOS; 3 versus 4, P= 0.009), and similar morbidities (10.5% versus 16.6%, P = 0.164) and operative times (71.6 versus 76.6 mins, P= 0.449) on adjusted analysis. Patients with LCO compared to open procedures had similar LOS (4 versus 4, P= 0.334) and morbidities (14.3% versus 16.6%, P= 0.358), but longer operative times (90.1 versus 76.6 mins, P= 0.002) on adjusted analysis. Patients with laparoscopic and LCO procedures had fewer unplanned intubations compared to open procedures (0.0% versus 0.0% versus 2.4%, P= 0.011) and lower mortality (0.0% versus 0.0% versus 1.7%, P= 0.046) on univariate analysis. Conclusions Laparoscopic MD resection has shorter LOS and similar complications and operative time compared to an open approach while LCO resection increases operative time but not LOS or morbidities.
Of the Philosophy of Religion and Its Methodology

“Of the Philosophy of Religion and its Methodology” In this chapter, Lorkowski first introduces and clarifies terminology for types of belief regarding higher powers. After this, the author argues that we should form our beliefs based on evidence, and that faith-based belief is often irresponsible because our beliefs have consequences to others. As such, our ideal goal should be to proportion all beliefs according to evidential support, evaluating them objectively and dispassionately.
Evaluation of a Quality Improvement Experience for Family Medicine Clerkship Students.

Background and objectives There is emphasis on systems-based practice competencies and quality improvement (QI) training in postgraduate medical education. However, we lack effective approaches to provide experiences in these areas during undergraduate medical education. To address this, we developed a novel approach to providing didactic and experiential learning experiences in QI during a third-year family medicine clerkship. Methods We implemented and evaluated a QI curriculum combining self-directed learning with real-world experience to increase knowledge and confidence in the plan-do-study-act (PDSA) process for family medicine clerkship students. Students collaborated and presented their change ideas in a "Shark Tank" format for practice leaders at the end of their rotation. We used pre- and postcurriculum surveys to assess knowledge of and comfort with completing QI projects. Results Three hundred eighty-nine students completed precurriculum surveys and 242 completed postcurriculum surveys. Pre- and postlearning evaluations revealed an increase in agreement or strong agreement with self-reported understanding of specific QI topic areas of 50%. Almost all (91.3%) reported feeling confident or reasonably confident in their ability to create change in health care after exposure to the curriculum, compared with 66.3% in the precurriculum survey. One-third of students (34%) reported intent to complete the Institute for Healthcare Improvement Open School curriculum in QI. Conclusions Self-directed learning about QI, combined with practice observation, small-group discussion and presentation in a Shark Tank format was effective and engaging for learners. Students had limited preexisting knowledge of QI principles, suggesting a need for preclinical exposure to this topic. The family medicine clerkship provides an ideal environment for teaching QI.
Genomic Testing: a Genetic Counselor’s Personal Reflection on Three Years of Consenting and Testing

Whole exome sequencing (WES) is increasingly used in research and clinical genetics as the cost of sequencing decreases and the interpretation improves. Genetic counselors need to be prepared to counsel a diverse patient population for this complex test. This commentary is a reflection of one genetic counselor's experiences in counseling, consenting, and returning results for clinical and research WES for over 120 participants and patients. She reflects on how she overcame the initial challenges and concerns of counseling for WES and how her counseling evolved from a teaching based counseling model to an interactive patient-center counseling model. Her insights are offered to prepare other genetic counselors for the growing use of genomic testing.
Neighborhood Racial Transition and Housing Returns: A Portfolio Approach

A portfolio test was used to determine whether neighborhood racial transition impacts the risk/return of housing. We conclude that the diversification advantages of residential real estate were adversely affected by racial transition and that hedge efficiency was positively related to neighborhood income and the proportion of owner occupancy. This result applied only to neighborhoods with a high rate of racial transition and was independent of neighborhood racial composition.
FAT METABOLISM IN HIGHER PLANTS. XXI. BIOSYNTHESIS OF FATTY ACIDS BY AVOCADO MESOCARP ENZYME SYSTEMS.

Abstract 1. 1. In the avocado mesocarp, both the particulate and the supernatant fractions readily synthesize long-chain fatty acid from suitable substrates. The particulate fraction can utilize effectively acetate, acetyl-CoA and malonyl-CoA but malonic acid is inactive. The supernatant fraction can only utilize malonyl-CoA or malonic acid. Data indicate that acetyl-CoA carboxylase (acetyl-CoA: CO 2 ligase (ADP), EC 6.4.1.2) is present in the particulate fraction but absent in the supernatant while the convere is true for malonyl-CoA synthetase (malonate: CoA ligase (AMP)). 2. 2. The supernatant fraction synthesizes only palmitic and stearic acids, mainly in the form of glycerides. Unsaturated fatty acid synthesis is associated with the particulate fraction. Possible factors controlling the extent of C 16 and C 18 fatty acids in these systems are discussed.