cssi/SciSciGPT-SciSciNet huggingface dataset:
Abstract C28: Platelet-derived growth factor receptor-β (PDGFRβ) in the breast metastatic tumor microenvironment

A role for the tumor microenvironment (TME) in cancer progression is irrefutable and our laboratory has been at the forefront of this field providing evidence for both tumor suppressive and oncogenic roles of the TME. The PDGF pathway is an exemplar for the study of tumor-stroma interaction as PDGF receptors (PDGFR) are frequently expressed in the fibroblasts and pericytes within the tumor-associated stroma of epithelial tumors including breast cancer. In contrast, PDGF ligands are expressed by the epithelial tumor cells themselves. However, beyond a few descriptive studies, the role of interactive PDGFRβ signaling in the TME during breast cancer initiation, progression and metastases is not understood. This can be attributed in part to limited in vivo models to study the complex TME, especially for breast cancer associated metastases. To overcome this limitation, we have established a transgenic knock-in mouse model that expresses constitutively active PDGFRβ in the stroma of the mammary gland as well in the lung and the brain, two common sites of metastatic breast cancer dissemination. We have found that these mice develop mammary gland hyperplasia highlighting the importance of PDGFRβ in the TME in driving mammary epithelial cell growth. To test whether activation of mutant PDGFRβ in either the lung or the brain increases metastatic growth at either site, two experimental metastases assays were performed: (1) tail vein and (2) intracranial injections to test for lung and brain metastatic outgrowth, respectively. Tail vein injection of the non-metastatic murine mammary cancer cell line DB7 cells led to pronounced lung metastases in PDGFRβ knock-in mice in less than 4 weeks. No macrometastases were seen in the control at this same time point. Similar to the surge in lung metastasis, intracranial injection of DB7 cells led to an increase in tumor growth in brains of the mutant versus wild type controls, revealing an important role for PDGFRβ signaling in the breast cancer metastatic microenvironment. In addition, knockdown of PDGF-B in mammary cancer cells represses intracranial growth in wild type animals. Combined these data support a role for PDGFRβ signaling in the breast cancer metastatic microenvironment. Ongoing investigation is aimed to delineate how activated PDGF-B to PDGFRβ signaling primes the metastatic niche. Citation Format: Gina Sizemore, Anisha Mathur, Katie Thies, Chelsea Bolyard, Steven Sizemore, Raleigh Kladney, Anthony Trimboli, Balveen Kaur, Gustavo Leone, Michael Ostrowski. Platelet-derived growth factor receptor-β (PDGFRβ) in the breast metastatic tumor microenvironment. [abstract]. In: Proceedings of the AACR Special Conference: Function of Tumor Microenvironment in Cancer Progression; 2016 Jan 7–10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2016;76(15 Suppl):Abstract nr C28.
Complement Enhances Foxp3+ T Regulatory Cell Induction by B Cell Lymphoma

Abstract Abstract 5176 The effect of complement on the immune system is complex and includes inhibition of aspects of the immune response. For example, we previously reported that C3b can inhibit the ability of mAb to activate NK cell-mediated antibody-dependent cellular cytotoxicity and that polymorphisms in C1q associated with lower C1q levels correlate with better therapeutic outcome. Polymorphisms in C5 and C9 complement components have also been shown to be associated with lymphoma risk. The current studies were designed to assess whether complement components may exert their inhibitory effects through the immune regulatory network, such as that mediated by T regulatory (Treg) cells. Peripheral Blood Mononuclear Cells (PBMCs) from healthy donors were co-cultured with Raji B cell lymphoma cells for 48 hours in the presence of unmodified autologous human serum or complement-depleted serum [heat-inactivated (HI) or cobra-venom factor (CVF)-treated serum]. Cells were stained with anti-CD3-APC-Cy7, CD4-PE-Cy7, CD25-PerCP-Cy5.5 and Foxp3-APC and the percent of CD4+ T-cells that were CD25highFoxp3+ (henceforth referred to as Tregs) determined. The ability of cells cultured in this manner to inhibit granzyme B expression in PHA-activated CD8+ autologous T cells was also determined. Tregs were not induced when PBMCs were cultured without Raji cells regardless of whether the cells were cultured in serum (data not shown). However, PBMCs co-cultured with Raji B lymphoma cells showed significantly higher percentages of Tregs in the presence of unmodified human serum (*p=0.0387) when compared to HI or CVF-treated human serum (**p=0.0370 and 0.0227, respectively) (Fig. 1). Tregs enriched from PBMCs cultured with unmodified human serum and Raji cells also showed an increase in immunosuppressive function, as determined by their inhibitory effect on PHA-induced GrzB expression by autologous CD8+ T cells (*p=0.0029) (Fig. 2). Download : Download high-res image (109KB) Download : Download full-size image Download : Download high-res image (93KB) Download : Download full-size image We conclude that complement enhances generation of Treg cells induced by B lymphoma cells as indicated by both phenotypic and functional studies. Ongoing studies are exploring the role of individual complement components in Treg induction, and the possibility of using complement depletion as a strategy to boost immune responses against lymphoma. Disclosures: No relevant conflicts of interest to declare.
Life, Death and Self-Deception

I have just learned that a friend of mine has died. In the confusion of my response, I feel his presence like I have not for many years. It quickens my field of vision, there is delighted relief in just turning my head to see things, because I think that he is inert and darkened. I saw him last by chance seven years ago on a subway. I recall feeling defensive about something he had said, and that he was growing bald. Probably I did not think of him focally at all in these intervening years, aside from vaguely expecting that something more would come of our relationship someday. But now that his life has been enclosed by time and ended, all that he was and is to me comes flooding back over me: driving together across the country to school long ago, sleeping out beside the road in sleeping bags and awakening to see him talking to himself and pointing at the sky, telling him the next phonograph records I wanted to buy and pleased that he noted what I wanted him to, that Berlioz was included. I remember getting his letters, and his handwriting. Without his knowing it, I suppose, he helped me disclose my possibilities in the world.
Polypharmacy and Delirium in Critically Ill Older Adults: Recognition and Prevention

Among older adults, polypharmacy is a sequelae of admission to the intensive care unit and is associated with increased medication-associated adverse events, drug interactions, and health care costs. Delirium is prevalent in critically ill geriatric patients and medications remain an underappreciated modifiable risk for delirium in this setting. This article reviews the literature on polypharmacy and delirium, with a focus on highlighting the relationships between polypharmacy and delirium in critically ill, older adults. Discussed are clinician strategies on how to recognize and reduce medication-associated delirium and recommendations that help prevent polypharmacy when interventions to reduce the burden of delirium in this vulnerable population are being formulated.
Long-term Potentiation at Neocortical Level

ABSTRACT A review of author's studies of long-term potentiation (LTP) in the neocortex is presented. Long-lasting (up to 3.5 hours) increase in the amplitude of the field potentials (FP) was found in vitro neocortical slices from adult mouse after short-term (seconds) high-frequency stimulation of the white matter. Similar increase was demonstrated in the sensorimotor cortex of the unanaesthetized rabbits. In addition, long-lasting changes in short-latency (less than 2 msec) single neuronal responses and “indirect” wave of pyramidal tract response (PTR) was described. The results of neuronal and PTR recordings suggest monosynaptic neocortical LTP and indicate an increase in the efficacy of the exitatory connections as a main mechanism of the LTP. The differences between hippocampal and neocortical LTP are discussed. The latter is considered to be a more convenient paradigm for future studies of the relationship between mechanisms of LTP and behavioral conditioned reflex (CR).
Alarm Management: A Systems Approach to Patient Safety

The purpose of a medical device alarm is to command the attention of the clinician for notification of an immediate or potential adverse patient condition. It should be actionable and requires a response. The frequency of false alarms has increased due to increased numbers of alarming devices, lack of standardization of alarms, and alarm settings with sensitivity over specificity. In some hospitals alarm signals can reach several hundred per patient, with most requiring no clinical intervention. Clinicians can become overwhelmed and desensitized by the frequency of these alarms. During the last six years, there have been patient deaths reported that were attributed to “alarm fatigue.” Clinical alarm hazards have been cited as being among the top ten health technology hazards for several years. As a result, a national initiative is underway in the United States focusing on safe use of alarms. Appropriate use of well-designed devices and an organized work environment can reduce risks and increase safety. Alarm customization, tailoring alarm parameters to individual patient needs, communication between clinicians, policies to empower clinicians and teamwork can help to create safer systems.
Scanning electron microscope metrology

During the manufacturing of present-day integrated circuits, certain measurements must be made of the submicrometer structures composing the device with a high degree of precision. Optical microscopy, scanning electron microscopy and the various forms of scanning probe microscopies are major microscopical techniques used for submicrometer metrology. New techniques applied to scanning electron microscopy have improved some of the limitations of this technique and time will permit even further improvements. This presentation will review the current state of scanning electron microscope (SEM) metrology in light of many of these recent improvements.
Craft Brewing Festivals

Recent growth of craft beer festivals in Pennsylvania created a rise in beer tourism. Cook examines three such beer festivals through statistical analysis of its attendees gathered during on-site visits. The chapter focuses on four key points about craft beer festivals and beer tourists: how far the patrons had to travel, how they heard about the event, their self-defined socioeconomic status, and their opinions on craft beer. Findings indicate that these affluent festivalgoers tend to be local, repeat attendees, and disdainful of ‘macro’ mainstream beer. Cook notes best practices of successful craft beer festivals. “Pennsylvania: Keystone of Craft Brewing Festivals” also examines gender and the way in which Pennsylvania’s beer laws allow beer festivals to play a special role in the growth of craft beer.
Regioselective Hydroamination Using a Directed Nucleopalladation/Protodepalladation Strategy

Alkene hydroamination is an attractive approach for converting alkenes into structurally complex amine products. Several different strategies have been pursued over the past few decades to achieve this historically challenging reaction. One of the key issues associated with this transformation is control of regioselectivity, which is particularly difficult for internal non-conjugated alkenes. Our group has recently found success using a removable bidentate auxiliary to control regioselectivity and stabilize the key nucleopalladated intermediate in a palladium(II)-catalyzed alkene hydroamination with N–H nucleophiles. This article describes the historical context for this work, the underlying conceptual logic, our results to date, and the future outlook.
Systems-Level Analysis of Energy and Greenhouse Gas Emissions for Coproducing Biobased Fuels and Chemicals: Implications for Sustainability

In light of advances in the simultaneous production of biobased fuels and chemicals, a prospective well-to-wheel lifecycle assessment (LCA) model of a two-step multistage torrefaction biorefinery is constructed to quantify both lifecycle greenhouse gas (GHG) emissions and energy return on primary fossil energy investment (EROIfossil) for a transportation-range biofuel product. Coproducts—including cyclopentanone (CPO), biochar, and a potential net electricity export—are handled via six coproduct scenarios, evaluated across both market-based allocation and displacement methods. Process-scale performance metrics and product distributions are compared across cases to evaluate trade-offs between process and environmental performance; carbon flows are visualized to better explain patterns of carbon yield and waste. LCA results include median GHG values spanning from −30.8 to +36.1 g CO2e/MJ-fuel and median EROIfossil values ranging from 1.6 to 12.8 MJ-fuel/MJ-PEfossil. Sensitivity results for the Market CPO ca...
Role of HNF1β in the differential diagnosis of yolk sac tumor from other germ cell tumors

Identification of the yolk sac tumor (YST) component in germ cell tumors (GCT) may prove challenging, and highly sensitive and specific immunohistochemical markers are still lacking. Preliminary data from the literature suggest that HNF1β may represent a sensitive marker of YST. The specificity of HNF1β has not been addressed in GCT. A cohort of 49 YST specimens from 45 patients was designed, occurring either as pure tumors, or as a component of a mixed GCT. Immunohistochemistry was conducted on whole tumor sections using HNF1β. SALL4, OCT4, CD30, CDX2, Cytokeratin 19, Glypican 3, and GATA3 were used for classification of the GCT components. Patients were mostly male (39/45), aged 14 months to 49 years, with primary testicular tumors (37/39), or primary mediastinal pure YSTs (2/39). All 6 primary tumors occurring in females (6/45) were pure ovarian YSTs; age range was 4 to 72 years. HNF1β nuclear reactivity was seen in the YST component in all 49 tumors, with a moderate to strong nuclear pattern of staining. Embryonal carcinoma (EC, 0/32) and seminoma (0/6) were negative. Choriocarcinoma (6/6) showed faint focal cytoplasmic reactivity to HNF1β but no nuclear staining. In teratomas, only enteric-type glands showed nuclear reactivity to HNF1β (11/16). Therefore, HNF1β sensitivity in YST component identification was 100% and specificity was 80%. Thus, in our experience, HNF1β is a sensitive and reliable marker of the YST component in GCT, and allows distinction of YST from intricately admixed EC, especially in the diffuse embryoma pattern.
Prostate cancer in the era of “Omic” medicine: recognizing the importance of DNA damage repair pathways

Data from recent high-throughput studies analyzing local and advanced prostate cancer have revealed an incredible amount of biological diversity, which has led to the classification of distinct molecular tumor subtypes. While integrating prostate cancer genomics with clinical medicine is still at its infancy, new approaches to treat prostate cancer are well underway and being studied. With the recognition that DNA damage repair (DDR) mutations play an important role in the pathogenesis of this disease, clinicians can begin to utilize genomic information in complex treatment decisions for prostate cancer patients. In this Review, we discuss the role of DDR mutations in prostate cancer, including deficiencies in homologous repair and mismatch repair (MMR), and how this information is revolutionizing the treatment landscape. In addition, we highlight the potential resistance mechanisms that may result as we begin to target these pathways in isolation and discuss potential combinatorial approaches that may delay or overcome resistance.
Factors Effecting Late Results After Meniscectomy

Meniscectomy has frequently been performed on the assumption that the absence of a meniscus has little effect on joint function. Statistical analysis of data obtained from the histories, physical examinations, and roentgenographic and electrogoniometric studies of ninety-nine patients with a mean follow-up of 17.5 years after meniscectomy revealed a high incidence of poor results, degenerative arthritis, ligamentous laxity, and decreased stance-phase flexion. A meniscus should be removed only when it is definitely abnormal.
High-power ion-cyclotron heating on the levitated octupole

Experiments are underway in the Wisconsin Levitated Toroidal Octupole to create hot, dense plasmas to facilitate the study of ..beta.. limits and related phenomena such as Pfirsch-Schlueter and bootstrap currents. The question of ballooning mode instability limits on ..beta.. = 8 ..pi..nk(T/sub i/+T/sub e/)/B/sup 2/ is of general importance for all toroidal systems, and ICRF heating should permit study of high ..beta.. plasmas with lower collisionality and smaller gyroradii than those of the high ..beta.. gun-injected plasmas currently under study in the Octupole. To these ends we are developing sources capable of delivering 4 MW to the plasma (1.5 MW coupled to the plasma to date, the rest under development).
Robust Adaptive Control for Constrained Dynamical Systems Following Unreliable Reference Signals

In this paper, we present robust model reference adaptive control laws that guarantee uniform ultimate boundedness of the trajectory tracking error for nonlinear dynamical systems subject to constraints on the state space and the measured output, and affected by matched, unmatched, and parametric uncertainties, as well as uncertainties in the initial conditions. A common assumption in the design of control laws for trajectory tracking is that the reference model or the reference signal verify the constraints imposed on the closed-loop system's trajectory. The control laws presented in this paper do not rely on this assumption and guarantee satisfactory results also in case the reference trajectory or the reference output signal do not verify the given constraints and hence, may draw the plant's trajectory or measured output outside their constraint sets. A numerical example illustrates the feasibility of the theoretical results presented.
An ENSO-induced aerosol dipole in the west-central Pacific and its potential feedback to ENSO evolution

We examine the impact of El Nino–Southern Oscillation (ENSO) on satellite observed aerosol optical depths (AODs) over the equatorial Pacific. AODs are found to decrease close to the International Dateline and increase in the vicinity of the Maritime Continent during the El Nino developing phase (and vice versa during La Nina) to form an AOD dipole. The positive AOD anomaly over the Maritime Continent is caused by increases in fire-induced fine smoke aerosols in Indonesia and coarse dust particles transported from Australia via the strengthening winds when El Nino develops and affects the Pacific walker circulation. The negative AOD anomaly around the International Dateline is caused by decreases in the emission of marine aerosols, as the developing El Nino is associated with weakening surface wind speeds in the region. This aerosol dipole is found particularly strong during the Central-Pacific type of ENSO, which has most of its sea surface temperature and wind variations around the International Dateline. The Eastern-Pacific type of ENSO produces positive AOD anomalies over the Maritime Continent but weaker negative AOD anomalies near the International Dateline. As a result, the AOD dipole is less obvious during the EP ENSO. The shortwave radiative forcing associated with the aerosol dipole is 29% (21%) as large as the ENSO-induced outgoing longwave radiation in the Maritime Continent (International Dateline) region and represents an important positive feedback to help sustain the ENSO development that may be potentially important in Central Pacific ENSO studies and predictions.
Management of Papillary Thyroid Microcarcinoma.

The worldwide incidence of thyroid cancer is increasing. A third of new thyroid cancer cases are papillary thyroid microcarcinoma (PTM), which are 1 cm or less. These tumors are mostly indolent with excellent prognosis. Although thyroid surgery is the most common management option for patients with PTM, new management options demand that treatment decisions must be individualized and based on patient’s preference, context, and biology. This article describes management options for PTM patients and shared decision-making as a novel method for individualizing care.
Use of Polarization Curves and Impedance Analyses to Optimize the “Triple-Phase Boundary” in K–O2 Batteries

K–O2 superoxide batteries have shown great potential for energy-storage applications due to the unique single-electron redox processes in the oxygen or gas-diffusion electrode. Optimization of the ‘triple-phase boundary’, the region of the cathode where the O2, electrolyte, and electrode surface are in immediate contact, is crucial for maximizing their power performance, but one that has not been explored. Herein, we demonstrate an efficient method for maximizing the power capabilities of the K–O2 battery system by optimizing the interface using polarization and impedance analyses. At the one extreme, an electrolyte volume-deficient state decreases access to the electrochemically active surface area resulting in a limitation of the maximum power output of the K–O2 battery, whereas an excess electrolyte volume state increases the diffusion path to the active surface area for the dissolved O2 inducing mass-transfer limitations sooner, which results in a decrease in the current and power output. Finally, we ...
In Vivo Layer-Specific Mechanical Characterization of Porcine Stomach Tissue Using a Customized Ultrasound Elastography System

This paper presents in vivo mechanical characterization of the muscularis, submucosa and mucosa of the porcine stomach wall under large deformation loading. This is important for the development of gastrointestinal pathology-specific surgical intervention techniques. The study is based on testing the cardiac and fundic glandular stomach regions using a custom-developed compression elastography setup. Particular attention has been paid to elucidate the heterogeneity and anisotropy of tissue response. A Fung hyperelastic material model has been used to model the mechanical response of each tissue layer. A univariate analysis comparing the initial shear moduli of the three layers indicates that the muscularis (5.69±4.06 kPa) is the stiffest followed by the submucosa (3.04±3.32 kPa) and the mucosa (0.56±0.28 kPa). The muscularis is found to be strongly distinguishable from the mucosa tissue in the cardiac and fundic region based on a multivariate discriminant analysis. The cardiac muscularis is observed to be stiffer than the fundic muscularis tissue (shear moduli of 7.96±3.82 kPa vs. 3.42±2.96 kPa), more anisotropic (anisotropic parameter of 2.21±0.77 vs. 1.41±0.38), and strongly distinguishable from its fundic counterpart. Finally, a univariate comparison of the in vivo and ex vivo initial shear moduli for each layer shows that the muscularis and submucosa tissues are softer while in vivo, but the mucosa tissue is stiffer while in vivo. The mechanical properties highlight the inhomogeneity and anisotropy of multilayer stomach tissue.
Selective Differential Electrocardiographic Leads

The method of localized transfer impedance vector cancellation was used to design specific differential leads that can focus on specific regions of the heart in exclusion to others. Linear combinations of two orthogonalized and normalized electrocardiographic lead systems will, under some favorable conditions, cancel out the impedance strength in most regions of the heart muscle, leaving significant residues for other regions. Results were inferred from isometric plots of the transfer impedance measurements on a torso model filled with potassium chloride solution of resistivity that approximately equals the average resistivity of the human thorax. Scanning equipotential lines on the surface of the torso model, in addition to evaluating the transfer impedance of some 20 known electrocardiographic leads, assisted in synthesizing the new differential leads. Unlike the proximity leads believed to result by applying precordial electrodes near the heart source, differential leads do not require a theoretically questionable central terminal system.
Polyhydroxybutyrate (PHB): A Model System for Biopolymer Engineering: II

PHB is the most common member of the polyhydroxyalkanoate family of polyester biopolymers produced intracellularly as energy reserve materials in a large number of diverse bacteria. The physical properties of these biodegradable thermoplastics have made them an attractive proposition for commercial development. Two aspects of PHB make it attractive for biopolymer engineering. First, unlike exopolysaccharides, the enzymology of the biosynthetic pathway is well documented for a number of different bacteria. Second, a number of co-polymers with altered structures have been produced by controlled fermentation (1–13, Table 1).
Non-negative constrained inverse eigenvalue problems - Application to damage identification

Abstract Damage identification using eigenvalue shifts is ill-posed because the number of identifiable eigenvalues is typically far less than the number of potential damage locations. This paper shows that if damage is defined by sparse and non-negative vectors, such as the case for local stiffness reductions, then the non-negative solution to the linearized inverse eigenvalue problem can be made unique with respect to a subset of eigenvalues significantly smaller than the number of potential damage locations. Theoretical evidence, numerical simulations, and performance comparisons to sparse vector recovery methods based on l 1 -norm optimization are used to validate the findings. These results are then extrapolated to the ill-posed nonlinear inverse eigenvalue problem in cases where damage is large, and linearization induces non-negligible truncation errors. In order to approximate the solution to the non-negative nonlinear least squares, a constrained finite element model updating approach is presented. The proposed method is verified using three simulated structures of increasing complexity: a one-dimensional shear beam, a planar truss, and a three-dimensional space structure. For multiple structures, this paper demonstrates that the proposed method finds sparse solutions in the presence of measurement noise.
Identifying and Enhancing Meaningful Relationships for Individuals with ASD: The Socially Playful Genogram

The socially constructed genogram allows clients to include individuals to whom they are emotionally close, which may include both biological relatives as well as others. While identifying importan...
Of Contractarians and Bankruptcy Reform: A Skeptical View

In response to Professor Barry Adler’s paper, Bankruptcy Primitives, where he argued that "[b]ankruptcy law could better serve its basic functions with greater freedom of contract both for individual and corporate debtors," this short essay argues that a non-waivable bankruptcy system, with a supervised bankruptcy process, and a non-waivable discharge right, are not only important, but are necessary and essential. In short, this essay seeks to support the proposition that bankruptcy should be a mandatory rule, rather than merely a default rule.
Un)Conscious Judging

Fact inferences made by the trial judge during the pretrial period are the lynchpin of civil litigation. If inferences were a matter of universally held logical deductions, this would not be troubling. Inferences, however, are deeply contestable conclusions that vary from judge to judge. Subconscious psychological phenomena can lead to flawed reasoning, implicit bias, and culturally influenced perceptions. Inferences differ significantly, and they matter. Given the homogeneous makeup of the judiciary, this is a significant concern. This article will demonstrate the ubiquity, importance, and variability of inferences by examining actual cases in which trial and appellate (or majority and dissenting) judges draw quite different inferences from the same record. It will then review the psychological literature to show ways in which judges are affected by subconscious forces. It concludes by suggesting reforms to judicial education, use of decision mechanisms that promote conscious deliberation, and civil procedure rule changes designed to increase information and decrease the impact of individual judges’ inferences.
Where to Go from Here? Toward a Model of 2-Year College Students' Postsecondary Pathway Selection.

Objective: Empirical work explaining student mobility, particularly postsecondary pathways among 2-year college students, remains limited. This study examines the underlying process that drives 2-y...
Excisional Hemorrhoidectomy: Safe in Patients With Crohn's Disease?

Introduction Due to concerns over wound healing, hemorrhoidectomy in patients with Crohn's disease (CD) remains controversial. We sought to ascertain safety and efficacy of excisional hemorrhoidectomy in CD. Methods A retrospective review of all adult CD patients undergoing excisional hemorrhoidectomy between January 1, 1995, and January 1, 2019, at 2 IBD referral centers was performed. Data collected included patient demographics, clinical characteristics of CD (anorectal symptoms; prior nonoperative hemorrhoidal therapy; presence of other perianal disease; and activity, duration, and anatomic location of CD), and postoperative complications including bleeding, wound healing, and need for further therapy or surgical intervention after surgery. Results A total of 36 adult patients with Crohn's disease with symptomatic hemorrhoidal disease were included. The study cohort included 16 males (44%), and median age was 49 (range, 21 to 77) years. Predominant symptoms included pain (n = 16; 44%), prolapse (n = 8; 22%), and bleeding (n = 12; 33%). Sixteen patients (44%) had nonoperative therapy before surgery. Twenty-four patients (67%) had other perianal disease. At the time of hemorrhoidectomy, 9 patients (25%) were exposed to corticosteroids, 8 patients (25%) to immunomodulators, and 9 patients (25%) to biologics. During a median follow-up time of 31.5 (range, 1 to 255) months after hemorrhoidectomy, 4 patients (11%) had complications (1 developed a stricture, 1 developed a perianal abscess/fistula, 1 had a nonhealing wound, and 1 had hemorrhoidal recurrence). Conclusion Our data suggest that excisional hemorrhoidectomy may be performed safely in CD patients who have failed nonoperative hemorrhoidal therapy without concern for de novo perianal disease or need for proctectomy.Hemorrhoidal disease is common in patients with Crohn's disease. This study sought to understand the outcomes of surgically treating hemorrhoids in patients with Crohn's disease.
Simulation of oxygen transport and estimation of tissue perfusion in extensive microvascular networks: Application to cerebral cortex.

Advanced imaging techniques have made available extensive three-dimensional microvascular network structures. Simulation of oxygen transport by such networks requires information on blood flow rate...
(Mis)educating the children of Mexican-origin people in the United States: the challenge of internal language borders

This article maintains that in spite of their seeming progress, Mexican-origin students in the US continue to face barriers that are typical of the complex challenges endured in public schools by m...
Pricing in Insurance 4.0

The business model canvas for insurance 4.0 also considers the economic factors: revenue and costs. There is a belief that insurance 4.0 acts mainly on the reduction of expenses and investments. It does have an impact on revenue. The significant result is primarily on pricing. Insurance 4.0 support risk pricing. It can support in the direction of the extreme customization of risk evaluation and related policy pricing. This chapter presents a model and analyzes its impact. Similarly, investments by insurance companies are a vital source of income and should be fully supported in insurance 4.0.
Bayesian Statistical Model Checking for Continuous Stochastic Logic

In this paper, we propose a Bayesian approach to statistical model-checking (SMC) of discrete-time Markov chains with respect to continuous stochastic logic (CSL) specifications. While Bayesian approaches for simpler logic without nested probabilistic operators and Frequentist approaches for nested logic have been previously explored, the Bayesian approach for CSL consisting of nested probabilistic operators has not been addressed. The challenge in the nested case arises from the fact that unlike in probabilistic model-checking (PMC), where we obtain a definitive answer for the model-checking problem for the sub-formulas, instead, we only obtain a correct answer with a certain confidence, which needs to be factored into the recursive SMC algorithm. Here, we propose a Bayesian test based algorithm for CSL that has nested probabilistic operators. We have implemented our algorithm in a Python Toolbox. Our experimental evaluation shows that our Bayesian SMC approach performs better than both the frequentist SMC approach and PMC algorithms.
ACE domains and depression: Investigating which specific domains are associated with depression in adulthood.

Abstract Background The study of adverse childhood experiences (ACEs) has shown deleterious effects throughout adulthood. Little attention, however, is given to specific ACE domains as they relate to mental health outcomes, as most studies use cumulative ACE score models. Objective The current study disaggregates ACEs domains to investigate their independent effect (while controlling for each other and other demographic covariates) on receiving a depression diagnosis as an adult. Participants and Setting Data were obtained from the Behavioral Risk Factor Surveillance Survey (BRFSS; N = 52,971). Methods To control and account for the numerical number of ACEs, separate models were run among each ACE score (e.g., those with an ACE score of exactly two, three, etc.). An aggregate model with all participants is also included. Results Across all ACE scores, those with a history of family mental illness had the highest likelihood of receiving a depression diagnosis. The second strongest association were those with sexual abuse. No other trends were found among the six other domains. Further, those with a combination of family mental illness and sexual abuse had the highest odds of depression. Conclusions Mental health providers should consider the numerical number of ACEs as well as the specific ACE domains (specifically, family mental illness and sexual abuse). Additionally, this provides evidence for a possible weighting schema for the ACEs scale.
Cost-Effectiveness of Preoperative Spinal Imaging Before Total Hip Arthroplasty.

Abstract Background The risk of instability, dislocation, and revision following total hip arthroplasty (THA) is increased in patients with abnormal spinopelvic mobility. Seated and standing lateral lumbar spine imaging can identify patients with stiff/hypermobile spine (SHS) to guide interventions such as changes in acetabular cup placement or use of a dual-mobility hip construct aimed at reducing dislocation risk. Methods A Markov decision model was created to compare routine preoperative spinal imaging (PSI) to no screening in patients with and without SHS. Screened patients with SHS were assumed to receive dual-mobility hardware while those without SHS and nonscreened patients were assumed to receive conventional THA. Cost-effectiveness was determined by estimating the incremental cost-effectiveness ratio. Effectiveness measured as quality-adjusted life years (QALYs), with $100,000 per additional QALY as the threshold for cost-effectiveness. Sensitivity analyses were performed to determine the robustness of the base-case result. Results The screening strategy with PSI had a lifetime cost of $12,515 and QALY gains of 16.91 compared with no-screening ($13,331 and 16.77). The PSI strategy reached cost-effectiveness at 5 years and was dominant (ie, less costly and more effective) at 11 years following THA. In sensitivity analyses, PSI remained the dominant strategy if prevalence of SHS was >1.9%, the cost of PSI was Conclusion Screening patients for SHS prior to THA with PSI is both less costly and more effective and should be considered as part of standard presurgical workup.
A Perspective from the Field: How Can We Empower the Next Generation of Physician to Heal the Opioid Epidemic?

Despite the continued emphasis on prescription opioids in the media and rise in substance use seen during the COVID-19 pandemic, medical school graduates today are unprepared to turn the tide on th...
Three fun assignments for an Artificial Intelligence class

Three creative assignments are discussed that are geared toward an undergraduate Artificial Intelligence curriculum. The modified Turing Test project has students conversing with online chat bots, as well as with other classmates. All conversations are posted on the web and classified as to who the "human" was speaking to, another human or a computer. The sixteen puzzle project requires students to compare the performance of two different heuristics used in solving the sixteen puzzle problem. The final assignment uses LEGO( handy-board based robots to teach the concepts of neural networks.
Mind wandering "Ahas" versus mindful reasoning: alternative routes to creative solutions.

Based on mixed results linking both mindfulness and its opposing construct mind wandering to enhanced creativity, we predicted that the relationship between mindfulness and creativity might depend on whether creative problems are approached through analytic strategy or through “insight” (i.e., sudden awareness of a solution). Study 1 investigated the relationship between trait mindfulness and compound remote associates problem solving as a function of participants’ self-reported approach to each problem. The results revealed a negative relationship between mindfulness and problem-solving overall. However, more detailed analysis revealed that mindfulness was associated with impaired problem solving when approaching problems with insight, but increased problem solving when using analysis. In Study 2, we manipulated participants’ problem-solving approach through instructions. We again found a negative relationship between mindfulness and creative performance in general, however, more mindful participants again performed better when instructed to approach problems analytically.
Epidemiology of medicare abuse : The example of power wheelchairs

OBJECTIVES: To determine the effect of neighborhood ethnic composition on power wheelchair prescriptions. DESIGN: The 5% noncancer sample of Medicare recipients in the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database, from 1994 to 2001. SETTING: SEER regions. PARTICIPANTS: Individuals covered by Medicare living in SEER regions without a cancer diagnosis. MEASUREMENTS: Individual characteristics (age, sex, ethnicity, justifying diagnosis, and comorbidity), primary diagnoses, neighborhood characteristics (percentage black, percentage Hispanic, percentage with <12 years education, and median income), and SEER region. RESULTS: The rate of power wheelchair prescriptions was 33 times greater in 2001 than in 1994, with a shift over time from justifying diagnoses more closely tied to mobility impairment, such as strokes, to less-specific medical diagnoses, such as osteoarthritis. In multilevel, multivariate analyses, individuals living in neighborhoods with higher percentages of blacks or Hispanics were more likely to receive power wheelchairs (odds ratios=1.09 for each 10% increase in black residents and 1.23 for each 10% increase in Hispanic residents) after controlling for ethnicity and other characteristics at the individual level. CONCLUSION: These results support allegations that marketers promoting power wheelchairs have specifically targeted minority neighborhoods.
“Single tail” and “twin tail” 3-(perfluoroalkylethanethia)alkylsuccinic anhydrides give RF segmented diacids, amic acids, imides, esters, and salts: Unusual 1H NMR of the succinamic acids

Abstract Free radical addition of RFCH2CH2SH (1; RF = n-C6F13; n-C8F17; n-C10F21; RSH) to 2-alken-1-ylsuccinic anhydrides (2–7; C3–C6, and C8) gives adducts 8–13 (RSCHR1CH2CHR2[ CHC  O ( O ) C  OCH 2 ]) in 90–100% conversion and yield. Thus, addition of thiol 1 to 2 (R1, R2 = H), or 3 (but-3-en-2-yl anhydride; R1 = H, R2 = Me), gives only terminal RS-substituted adducts 8 and 9 (respectively). However, the higher alkenyl anhydrides 4–7 (R1 = CH3(CH2)n, n=0–4) add 1 to give regioisomeric anhydrides 10a,b–13a,b with twin RF and alkyl tails of different sizes. Anhydrides 8–13a,b react quantitatively with nucleophiles. Amines give succinamic acids, and then imides; water and strong bases give diacids and salts; and, ethanol and diethylene glycol give half esters. Diethylamine and 8 give RS-substituted succinamic acid RS(CH2)3[CH(CO2H)CH2CONEt2] (24a,b). The NEt2 groups of 24a,b rotate slowly around the mesomeric CN sp2 bond of (−)OCN(+)Et2, and the two ethyl groups are non-equivalent in NMR spectra. Similarly, in succinamic acids 31a,b and 32a,b, derived from anhydride 3 and amine CH3NHR, the syn and anti methyls of the (−)OCN(+)(CH3)R amide function give two NMR signals. Likewise, the slowly rotating R[R(CH2)3N(CH3)2] groups of 31a,b and 32a,b give rise to syn and anti tautomers with non-equivalent N(CH3)2 groups. The imides from reaction of 3–7, or 8–13, with NH2(CH2)3N(CH3)2 are strongly basic and form water soluble salts with acids. These anionic, cationic, non-ionic or amphoteric RF-surfactants afford surface tensions in water below 18 dyn/cm and are similar to RF-surfactants used for fighting hydrocarbon fuel fires. The new RF-segmented compounds are analogous to RF–RH segmented amphiphiles that readily self-assemble into stable fluorinated vesicles, tubules and other organized molecular systems.
Why Stop Now? Predicting Worker Engagement in Online Crowdsourcing

We present studies of the attention and time, or engagement, invested by crowd workers on tasks. Consideration of worker engagement is especially important in volunteer settings such as online citizen science. Using data from Galaxy Zoo, a prominent citizen science project, we design and construct statistical models that provide predictions about the forthcoming engagement of volunteers. We characterize the accuracy of predictions with respect to different sets of features that describe user behavior and study the sensitivity of predictions to variations in the amount of data and retraining. We design our model for guiding system actions in real-time settings, and discuss the prospect for harnessing predictive models of engagement to enhance user attention and effort on volunteer tasks.
Направления Координации Административной Реформы в Народнохозяйственном и 'Силовом' Блоках Российской Власти (Areas of the Administrative Coordination Reforms in the National Economic and 'Power' Units of the Russian Authorities)

Исследованы отечественный и зарубежный опыт координации развития экономики и обеспечения традиционных функций государства в области внешней и внутренней безопасности, а также проанализированы основные проблемные области развития системы государственного управления народным хозяйством и «силовым» блоком в ходе комплекса реформ, инициированных российским правительством в 2003 г. Выявленные проблемы координации реформа в народнохозяйственном и силовом» блоке российской власти свидетельствуют о необходимости кардинальной модернизации имеющихся в России институтов обеспечения национальной безопасности, в том числе путем активного заимствования лучшего мирового опыты.Investigated domestic and foreign experience in coordinating economic development and provide the traditional functions of the state in the field of external and internal security, and also analyzed the main problem areas of the system of state management of the economy and the "power" unit in the complex reforms initiated Russian government in 2003. The problems identified in the coordination of national economic reform and "force" the block Russian authorities indicate the need for a radical modernization of existing in Russian institutes of national security, including through active Drawing the world's best experiences.
Health risk indicators in incoming freshmen at a public mid-western university (1031.11)

The purpose of this was study to explore the prevalence of health risk indicators in college students upon commencement of freshman year. Within three weeks of arriving on campus, freshmen (n=20 M,...
Ileal mucosal bile acid absorption is increased in Cftr knockout mice

Excessive loss of bile acids in stool has been reported in patients with cystic fibrosis. Some data suggest that a defect in mucosal bile acid transport may be the mechanism of bile acid malabsorption in these individuals. However, the molecular basis of this defect is unknown. This study examines the expression of the ileal bile acid transporter protein (IBAT) and rates of diffusional (sodium independent) and active (sodium dependent) uptake of the radiolabeled bile acid taurocholate in mice with targeted disruption of the cftr gene. Wild-type, heterozygous cftr (+/-) and homozygous cftr (-/-) mice were studied. Five one-cm segments of terminal ileum were excised, everted and mounted onto thin stainless steel rods and incubated in buffer containing tracer 3H-taurocholate. Simultaneously, adjacent segments of terminal ileum were taken and processed for immunohistochemistry and Western blots using an antibody against the IBAT protein. In all ileal segments, taurocholate uptake rates were fourfold higher in cftr (-/-) and two-fold higher in cftr (+/-) mice compared to wild-type mice. Passive uptake was not significantly higher in cftr (-/-) mice than in controls. IBAT protein was comparably increased. Immuno-staining revealed that the greatest increases occurred in the crypts of cftr (-/-) animals. In the ileum, IBAT protein densities and taurocholate uptake rates are elevated in cftr (-/-) mice > cftr (+/-) > wild-type mice. These findings indicate that bile acid malabsorption in cystic fibrosis is not caused by a decrease in IBAT activity at the brush border. Alternative mechanisms are proposed, such as impaired bile acid uptake caused by the thick mucus barrier in the distal small bowel, coupled with a direct negative regulatory role for cftr in IBAT function.