cssi/SciSciGPT-SciSciNet huggingface dataset:
Eicosapentaenoic acid regulates brown adipose tissue metabolism in high-fat-fed mice and in clonal brown adipocytes

Brown adipose tissue (BAT) plays a key role in energy expenditure through its specialized thermogenic function. Therefore, BAT activation may help prevent and/or treat obesity. Interestingly, subcutaneous white adipose tissue (WAT) also has the ability to differentiate into brown-like adipocytes and may potentially contribute to increased thermogenesis. We have previously reported that eicosapentaenoic acid (EPA) reduces high-fat (HF)-diet-induced obesity and insulin resistance in mice. Whether BAT mediates some of these beneficial effects of EPA has not been determined. We hypothesized that EPA activates BAT thermogenic program, contributing to its antiobesity effects. BAT and WAT were harvested from B6 male mice fed HF diets supplemented with or without EPA. HIB 1B clonal brown adipocytes treated with or without EPA were also used. Gene and protein expressions were measured in adipose tissues and H1B 1B cells by quantitative polymerase chain reaction and immunoblotting, respectively. Our results show that BAT from EPA-supplemented mice expressed significantly higher levels of thermogenic genes such as PRDM16 and PGC1α and higher levels of uncoupling protein 1 compared to HF-fed mice. By contrast, both WATs (subcutaneous and visceral) had undetectable levels of these markers with no up regulation by EPA. HIB 1B cells treated with EPA showed significantly higher mRNA expression of PGC1α and SIRT2. EPA treatment significantly increased maximum oxidative and peak glycolytic metabolism in H1B 1B cells. Our results demonstrate a novel and promising role for EPA in preventing obesity via activation of BAT, adding to its known beneficial anti-inflammatory effects.
Galactorrhea and Acute Lymphoblastic T-Cell Leukemia: A Case Presentation and Evaluation of the Role of Prolactin

Abstract 4828 Acute lymphoblastic T-cell leukemia (T-ALL) accounts for nearly 15% of newly diagnosed cases of childhood acute lymphoblastic leukemia (ALL). Historically, T-ALL has conferred a worse prognosis than other forms of ALL. Although multi-agent pulse chemotherapy has improved EFS over the past several decades, the lack of clinical or laboratory based prognosticators as well as high rate of relapse have remained barriers in management. Described is a case of acute lymphoblastic T-cell leukemia in a previously healthy sixteen-year-old girl initially presenting with galactorrhea and hyperprolactinemia without evidence of CNS infiltrate. Although galactorrhea has been described in a few adults as an initial presentation of acute myeloginous leukemia (AML) and a single adult case of T-cell lymphoma, to date there has been no association with childhood cancers or T-ALL in particular. Hypothesized in AML cases as a rare paraneoplastic phenomenon, this case explores this theory and employs direct prolactin staining of tumor cell cytoplasm, serial prolactin monitoring throughout treatment, and investigation into underlying causes for hyperprolactinemia in the context of T-ALL. The possibilities for prolactin as a novel tumor marker are explored. Disclosures: No relevant conflicts of interest to declare.
A two dimensional accuracy-based measure for classification performance

Abstract Accuracy has been used traditionally to evaluate the performance of classifiers. However, it is well known that accuracy is not able to capture all the different factors that characterize the performance of a multiclass classifier. In this manuscript, accuracy is studied and analyzed as a weighted average of the classification rate of each class. This perspective allows us to propose the dispersion of the classification rate of each class as its complementary measure. In this sense, a graphical performance metric, which is defined in a two dimensional space composed by accuracy and dispersion, is proposed to evaluate the performance of classifiers. We show that the combined values of accuracy and dispersion must fall within a clearly bounded two dimensional region, different for each problem. The nature of this region depends only on the a priori probability of each class, and not on the classifier used. Thus, the performance of multiclassifiers is represented in a two dimensional space where the models can be compared in a more fair manner, providing greater awareness of the strategies that are more accurate when trying to improve the performance of a classifier. Furthermore we experimentally analyze the behavior of seven different performance metrics based on the computation of the confusion matrix values in several scenarios, identifying clusters and relationships between measures. As shown in the experimentation, the graphical metric proposed is specially suitable in challenging, highly imbalanced and with a high number of classes datasets. The approach proposed is a novel point of view to address the evaluation of multiclassifiers and it is an alternative to other evaluation measures used in machine learning.
Friends, Lovers, and Rivals: Katharina Lescailje, Cornelia van der Veer, and Katherine Philips

This chapter considers how women in England and the Low Countries used friendship poems to construct a new language of private emotion and to intervene in civic, and thus public, discourse hitherto reserved for men. The poetry of Cornelia van der Veer and Katharina Lescailje addressed to each other and the famous friendship poems of Katherine Philips are at the heart of this chapter. These three writers reveal a desire to elevate the female friend to an absolutist position of power. They also depict a corrupting male-dominated public sphere and treat retirement from public life not as a withdrawal into a private sphere, but as another way to present oneself to a larger public. These shared aspects of female friendship poetry in royalist and non-royalist poetry from different countries suggest that they are not (or not only) the product of the specific political environment in England after the Civil Wars, but instead a genre through which women could imagine a place in the public eye in countries with different political structures. They also suggest that women were not yet able to forge a new type of public presence for themselves, but instead relied on older, absolutist forms of publicity to imagine female agency.
VEGFR2 Signaling Driven by Cellular Redox Status

Angiogenesis (a process of new vessel formation) is triggered by tissue ischemia. Paradoxically, angiogenesis is diminished in cardiovascular diseases (CVDs) due to a decrease in cellular glutathione (GSH) and increase in reactive oxygen species (ROS). Interestingly, our laboratory has demonstrated that a small decrease in cellular GSH promotes vascular endothelial growth factor (VEGF)-driven ischemic angiogenesis while a larger decrease in cellular GSH does not. Thus, we hypothesize VEGF receptor2 (VEGFR2) activation is regulated by intracellular GSH redox state. To specifically study the role of altered GSH redox state on angiogenesis, we used diamide to oxidize GSH to GSSG in human aortic endothelial cells. GSSG can react with protein cysteine thiols to form S-glutathionylated proteins that in turn affect protein function and stability. Our preliminary experiments show that drastic changes in GSH/GSSG activate VEGFR2 independent of VEGF while a moderate change does not activate the receptor. Interestingly, the addition of H2O2 alone did not activate VEGFR2 suggesting a role for GSH/GSSG in regulating VEGFR2. To understand the mechanism of S-glutathionylation in VEGFR2 activation, we used dimedone, a sulfenic acid trap. Pretreatment with dimedone abolished VEGFR2 activation after diamide treatment suggesting that cysteine sulfenic acid formation precedes S-glutathionylation. Local ROS production in the vicinity of proteins can effectively mediate cellular signaling. On that note, O2●– derived from endothelial nitric oxide synthase (eNOS) could activate VEGFR2 in altered GSH/GSSG. S-glutathionylation of eNOS leads to its uncoupling and drives O2●– generation. To test the role of O2●– in VEGFR2 activation in altered GSH redox state, we inhibited eNOS using L-NAME or siRNA and then treated with diamide. VEGFR2 activation decreased after eNOS inhibition suggesting a potential role for eNOS in VEGFR2 activation under altered GSH redox state. We believe a small decrease in GSH/GSSG would result in priming of VEGFR2 signaling pathway while a larger decrease in GSH/GSSG will result in dysfunctional signaling. In conclusion, the GSH/GSSH ratio is important in triggering and promoting VEGFR2 signaling.
Evaluation of Rint1 as a modifier of intestinal tumorigenesis and cancer risk

The Rad50 Interacting Protein 1 (Rint1) influences cellular homeostasis through maintenance of endoplasmic reticulum, Golgi and centrosome integrity and regulation of vesicle transport, autophagy and the G2/M checkpoint. Rint1 has been postulated to function as a tumor suppressor as well as an oncogene, with its role depending perhaps upon the precise cellular and/or experimental context. In humans, heterozygosity for germline missense variants in RINT1 have, in some studies, been associated with increased risk of both breast and Lynch syndrome type cancers. However, it is not known if these germline variants represent loss of function alleles or gain of function alleles. Based upon these findings, as well as our initial consideration of Rint1 as a potential candidate for Mom5, a genetic modifier of intestinal tumorigenesis in ApcMin/+ mice, we sought to explicitly examine the impact of Rint1 on tumorigenesis in ApcMin/+ mice. However, heterozygosity for a knockout of Rint1 had no impact on tumorigenesis in Rint1+/-; ApcMin/+ mice. Likewise, we found no evidence to suggest that the remaining Rint1 allele was lost somatically in intestinal tumors in ApcMin/+ mice. Interestingly, in contrast to what has been observed in Rint1+/- mice on a mixed genetic background, Rint1+/- mice on a pure C57BL/6J background did not show spontaneous tumor development. We also evaluated colorectal cancer data available in the COSMIC and ONCOMINE databases and found that RINT1 overexpression, as well as the presence of somatic missense mutations in RINT1 were associated with colorectal cancer development. In vitro evaluation of two missense variants in RINT1 suggested that such variants do have the potential to impact RINT1 function.
Human-machine analytics for closed-loop sense-making in time-dominant cyber defense problems

Many defense problems are time-dominant: attacks progress at speeds that outpace human-centric systems designed for monitoring and response. Despite this shortcoming, these well-honed and ostensibly reliable systems pervade most domains, including cyberspace. The argument that often prevails when considering the automation of defense is that while technological systems are suitable for simple, well-defined tasks, only humans possess sufficiently nuanced understanding of problems to act appropriately under complicated circumstances. While this perspective is founded in verifiable truths, it does not account for a middle ground in which human-managed technological capabilities extend well into the territory of complex reasoning, thereby automating more nuanced sense-making and dramatically increasing the speed at which it can be applied. Snort1 and platforms like it enable humans to build, refine, and deploy sense-making tools for network defense. Shortcomings of these platforms include a reliance on rule-based logic, which confounds analyst knowledge of how bad actors behave with the means by which bad behaviors can be detected, and a lack of feedback-informed automation of sensor deployment. We propose an approach in which human-specified computational models hypothesize bad behaviors independent of indicators and then allocate sensors to estimate and forecast the state of an intrusion. State estimates and forecasts inform the proactive deployment of additional sensors and detection logic, thereby closing the sense-making loop. All the while, humans are on the loop, rather than in it, permitting nuanced management of fast-acting automated measurement, detection, and inference engines. This paper motivates and conceptualizes analytics to facilitate this human-machine partnership.
Initially intact neural responses to pain in autism are diminished during sustained pain.

Pain assessments typically depend on self-report of the pain experience. Yet, in individuals with autism spectrum disorders, this can be an unreliable due to communication difficulties. Importantly, observations of behavioral hypo- and hyperresponsivity to pain suggest altered pain sensitivity in autism spectrum disorder. Neuroimaging may provide insight into mechanisms underlying pain behaviors. The neural pain signature reliably responds to painful stimulation and is modulated by other outside regions, affecting the pain experience. In this first functional magnetic resonance imaging study of pain in autism spectrum disorder, we investigated neural responses to pain in 15 adults with autism spectrum disorder relative to a typical comparison group (n = 16). We explored temporal and spatial properties of the neural pain signature and its modulators during sustained heat pain. The two groups had indistinguishable pain ratings and neural pain signature responses during acute pain; yet, we observed strikingl...
Impact of histopathology, tumor-infiltrating lymphocytes, and adjuvant chemotherapy on prognosis of triple-negative breast cancer

Given its high recurrence risk, guidelines recommend systemic therapy for most patients with early-stage triple-negative breast cancer (TNBC). While some clinicopathologic factors and tumor-infiltrating lymphocytes (TILs) are known to be prognostic in patients receiving chemotherapy, their prognostic implications in systemically untreated patients remain unknown. From a cohort of 9982 women with surgically treated non-metastatic breast cancer, all patients with clinically reported ER-negative/borderline (≤10%) disease were selected for central assessment of ER/PR/HER2, histopathology, Ki-67, and TILs. The impact of these parameters on invasive disease-free survival (IDFS) and overall survival (OS) was assessed using Cox proportional hazards models. Six hundred five patients met the criteria for TNBC (ER/PR 15% (75%). Histologically, 70% were invasive carcinoma of no special type, 16% medullary, 8% metaplastic, and 6% apocrine. The median stromal TIL content was 20%. Four hundred twenty-three (70%) patients received adjuvant chemotherapy. Median OS follow-up was 10.6 years. On multivariate analysis, only higher nodal stage, lower TILs, and the absence of adjuvant chemotherapy were associated with worse IDFS and OS. Among systemically untreated patients (n = 182), the 5-year IDFS was 69.9% (95% CI 60.7–80.5) [T1a: 82.5% (95% CI 62.8–100), T1b: 67.5% (95% CI 51.9–87.8) and T1c: 67.3% (95% CI 54.9–82.6)], compared to 77.8% (95% CI 68.3–83.6) for systemically treated T1N0. Nodal stage and TILs remained strongly associated with outcomes. In early-stage TNBC, nodal involvement, TILs, and receipt of adjuvant chemotherapy were independently associated with IDFS and OS. In systemically untreated TNBC, TILs remained prognostic and the risk of recurrence or death was substantial, even for T1N0 disease.
Value of routine stool testing for pathogenic bacteria in the evaluation of symptomatic patients with ileal pouches.

Background In symptomatic patients with an ileal pouch, stool studies are often sent to diagnose enteric pathogens. Aim of this study is to find the value of routine stool studies in the evaluation of symptomatic patients and the clinical implications of such pathogens in patients with ileal pouches. Methods Consecutive ileal pouch-anal anastomosis (IPAA) patients who had stool tests out of a 2283-case registry from 2002 to 2015 were included in the study. Patients with positive stool cultures were compared with controls (symptomatic without positive stool culture) in a 1:4 ratio. Response to antibiotic therapy, recurrence rate and rate of hospitalization at 1 and 3 months were assessed. Results A total of 643 (28%) had stool cultures done and only 1.7% (11/643) were found to be positive for stool cultures. Campylobacter spp. (45%) was the most common pathogen followed by Aeromonas spp. (36%). Non-smokers and patients without any antibiotic use in the last 3 months were found to have higher prevalence of positive stool cultures than controls (p < 0.001 and p = 0.023). Patients with pathogenic bacteria were found to have a higher risk of acute kidney injury (27.3% vs 4.5%, p = 0.049), hospitalization within 3 months of initial stool testing (36.4% vs 6.8%, p = 0.009) and mortality (18.2% vs 0%, p = 0.040). However, there were no statistically significant differences in the clinical outcomes in patients with positive stool cultures who received pathogen-directed therapy. Conclusions We found that the yield of stool tests for bacterial pathogens in symptomatic pouch patients was extremely low and the treatment of detected pathogens had a minimum impact on the disease course of pouchitis. The clinical utility of routine stool culture in those patients warrants further study.
Vollmachtskundgaben und Fortbestehen der Vollmacht

Die rechtstheoretische Beurteilung der in den §§170 ff. BGB getroffenen Regelung ist seit jeher umstritten. Im wesentlichen1 stehen sich zwei Theorien gegenuber.
High-Q silicon fin bulk acoustic resonators for signal processing beyond the UHF

This paper reports, for the first time, on the silicon Fin Bulk Acoustic Resonator (FinBAR) technology that enables extreme scaling of integrated signal processing beyond the ultra-high-frequency (UHF) regime. High-aspect-ratio fins are etched in silicon substrate and covered by aluminum nitride films to enable efficient electromechanical transduction of bulk acoustic resonance modes with large coupling coefficient (k t 2). The low phononic dissipation of single crystal silicon, along with suppression of piezoelectric charge redistribution loss in the sidewall transduction result in unprecedentedly high quality-factors (Q) in ultra-and super-high-frequency (SHF) regimes. A prototype FinBAR is presented operating in 3rd and 9th width-extensional modes at 2 GHz and 6 GHz, with Q of 4,800 and 2,300, and k2 of %1.2 and %0.5, respectively. The resulting record f×Q of 1.4×1013, the large kt2×Q of 58, and lithographical frequency scalability demonstrate the potential of FinBARs to realize SHF acoustic processors for emerging 5G multi-frequency systems.
Rituximab for treatment of refractory fulminant acute disseminated encephalomyelitis (ADEM) (P4.314)

Objective: NA Background: ADEM is a rapidly progressing, thought to be autoimmune, demyelinating condition that is usually triggered by environmental factors including viral illness. Treatment is generally with pulse high dose steroids, IVIG and plasmapheresis. We report a case of fulminant ADEM refractory to standard treatment, successfully treated with Rituximab. Design/Methods: A 24-year-old male presented with altered mental status progressing to weakness. Family reported a viral infection roughly 2 months prior to admission. Brain MRI showed bilateral hyperintense FLAIR lesions suggestive of ADEM; cervical spine MRI was normal. He was started on empiric treatment with intravenous methylprednisolone followed by plasmapheresis with progressive worsening of his symptoms, eventually requiring intubation, tracheostomy and PEG tube. Repeat MRI one month later showed progression of numerous T2/FLAIR hyperintense lesions. He then received IVIG also with no improvement prompting a brain biopsy which was consistent with demyelination. He was trialed with one dose of rituximab with significant decrease in lesion enhancement on follow up imaging. He was eventually treated with a total of 4 doses of weekly rituximab with slow improvement in his symptoms and transition to long term care facility. Results: NA Conclusions: We present a case of atypical ADEM which was resistant to steroids, plasmapheresis and IVIG that eventually responded to rituximab. Rituximab is not traditionally used in this setting but this response could represent a basis for further investigation into the safety and efficacy of rituximab for refractory fulminant ADEM. Disclosure: Dr. Khalife has nothing to disclose. Dr. Liang has nothing to disclose. Dr. Shah has nothing to disclose.
The International Epidemiology of HIV-1 Infections

The acquired immunodeficiency syndrome (AIDS) epidemic has spread to almost all countries in the world. This disease is responsible for and will be the cause of enormous morbidity and morality in all countries but particularly in the third world countries. Even with widespread underreporting of human immunodeficiency virus type 1 (HIV-1) infections in many developed and underdeveloped countries, 266,000 AIDS cases have been reported in 156 countries. Between 1981 and 1990, the World Health Organization (WHO) conservatively estimates that more than 500,000 cases have occurred worldwide and 300,000 have died (Chin and Mann, 1989; Mann and Chin, 1988a). When HIV-1 was isolated as the cause of AIDS (Barre-Sinoussi, 1983; Gallo et al. 1984), epidemiologists noted that the large number of HIV-1 infected patients with the clinical syndrome of AIDS was only a small segment of the total number of persons infected with HIV-1. These asymptomatic patients are the most prevalent group of infected persons and are the vector by which the disease continues to spread even in the face of control and prevention programs. The WHO recently estimated that by the year 2000 there will be 14 million asymptomatic HIV-1 infected persons (Chin and Mann, 1989; Piot et al. 1990; World Health Organization, 1989b), and at least 6,000,000 of these infected persons will die of AIDS within the 10 years.
Biotin: Physiology, Dietary Sources, and Requirements

This article discusses the molecular, biochemical, and physiological roles of biotin (vitamin B 7 ). Biotin serves as an essential cofactor for five enzymes that fix carbon dioxide (use free bicarbonate) in order to synthesize intermediates that are crucial to intermediary metabolism. The clinical findings of frank biotin deficiency include a scaly red skin rash distributed around the eyes, nose, mouth, and perineal orifices. In adults, depression, lethargy, hallucinations, and paresthesia of the extremities are prominent neurologic symptoms; in infants, the most striking neurologic findings are hypotonia and developmental delay. Frank deficiency is rare; marginal deficiency is much more common.
Introduction: Why the Church Should Pay Attention to Transhumanism

Technology is becoming increasingly powerful in its ability to transform humanity by enhancing our physical and mental capacities. Transhumanists endorse this process, and their arguments provide a convenient perspective on contemporary society. Many Christians reject transhumanism, but not all. The Christian Transhumanist Association, for example, endorses a version of transhumanism that sees technology as a means by which God continues to fashion humanity in the divine image. Christians disagree on how to view transhumanism, but there can be no disagreement on the growing power of technology to modify humanity. Central to Christianity is the claim that God’s grace brings about our transformation. Our challenge is to understand how grace can be proclaimed in an age when technology is exalted.
Compensation or Recovery? Altered Kinetics and Neuromuscular Synergies Following High-Intensity Stepping Training Poststroke.

Background. High-intensity, variable stepping training can improve walking speed in individuals poststroke, although neuromuscular strategies used to achieve faster speeds are unclear. We evaluated...
3241 Using infant exertion to tailor treadmill intervention

OBJECTIVES/SPECIFIC AIMS: This research examined 3 aims to address the need to understand and quantify exertion in infants. Aim 1: Develop a schema to identify and code exertional behaviors in infants during treadmill stepping. Aim 2: Establish feasibility for the schema’s use with clinical populations. Aim 3: Pilot the schema in a study designed to induce infant exertion. METHODS/STUDY POPULATION: Aims 1 and 2 were achieved using existing treadmill stepping data. The data used in Aim 1 included eight typically-developing infants (age 7-10 months) who were able to sit independently, but not walk. The data used in Aim 2 came from two separate data sets from infants who took more than 10 steps in a 30-second trial: Data set A included six typically-developing infants (age 2-5 months) who were unable to sit independently (developmentally comparable to atypical populations who might receive treadmill interventions). Data set B included six infants with Spina Bifida (age 3-10 months). Aim 3 was addressed with a prospective study using an exertion model. Pre-walking, typically developing infants (age 8-10 months) underwent five total stepping trials. Trial 1 determined the infant’s individualized maximum stepping speed; trials 2-5 were each 60 seconds and alternated between a baseline stepping speed of.20 m/s and the infant’s maximum stepping speed determined in trial 1. All video data were coded for step type, step frequency, and exertional behavior. RESULTS/ANTICIPATED RESULTS: Aim 1: Two behaviors were identified and determined to capture infant exertion: foot dragging and leg crossing. Aim 2: The feasibility of capturing exertion with these two behaviors was established for young infants and infants with neuromotor delays, with exertional behaviors increasing with stepping exposure (p< 0.05). Aim 3: Total exertion (foot dragging + leg crossing) was higher in the maximum speed trials compared to baseline trials (p = 0.005). DISCUSSION/SIGNIFICANCE OF IMPACT: Exertion in infants can be quantified. The exertion schema developed with this study will support the development of dosing guidelines for infant treadmill intervention. The next step in this line of research is to examine the correlation between infant exertion and heart rate, in effort to move from behaviorally-informed protocols to more precise, individualized protocols based on the physiological response of the infant.
Clinical Process Modeling: An Approach for Enhancing the Assessment of Physicians' Clinical Reasoning

To ensure the validity of test interpretation and use, educators must be able to connect the dots between the tasks examinees perform on a test and the decisions educators make based on the results of that test. Toward that end, in this article, the authors introduce an approach called clinical process modeling, which combines clinical reasoning and principled assessment design. The goal of this approach is to better align test item development with the assessment of physicians' application of knowledge. Clinical process modeling involves creating complex decision trees that can mirror clinical reasoning illness scripts and include the steps and pathways a physician could take to address a specific patient presentation from initial presentation to correct diagnosis and therapy. Once created, these decision trees can be used to inform the assessment development process.To illustrate this approach, the authors describe how they developed one such clinical process model for a common presentation of low back pain from the field of internal medicine. They explain the steps they took to develop their model and the corresponding test item. They conclude by discussing potential future directions and additional implications for this work, emphasizing how clinical process models can be used to inform other educational processes and clinical practice.
Pharmaceutical uses of Blockchain Technology

This research identifies a conceptual e-Prescription system based on blockchain technology. The system utilizes cryptocurrency principles applied to the electronic prescription processes to achieve its goals. This e-Prescription system can be utilized as a combatant to the nationwide opioid crisis as a potential Prescription Drug Monitoring System (PDMP). While not a fully evaluated system, the proof of concept results presented have significant demonstrated potential. Moreover, the concepts can be used to create a system that can serve as an inspiration to use blockchain technology in healthcare applications.
Laparoscopic and Robotic Urology

In the field of pediatric urology, an interest in laparoscopic surgery and robot-assisted laparoscopic surgery (RALS) has been growing since the initial description of diagnostic laparoscopy for the evaluation of nonpalpable testes in 1976. These minimally invasive techniques have been adopted more slowly in children than in adults, but recent improvements in instrumentation and the widespread acceptance of RALS have led to rapid expansion of their application in pediatric urology.
Strategies for Reducing Final Surgical Defect Sizes in the Treatment of Lentigo Maligna.

BACKGROUND Lentigo maligna (LM) is associated with disproportionately high surgical morbidity. OBJECTIVE The authors report on 2 strategies to reduce the surgical morbidity associated with LM. METHODS Forty LM lesions were removed with excisional biopsies without margins and closed with purse-string sutures. Invasive cases underwent staged excisions with 10-mm margins. Cases without invasion were treated with neoadjuvant topical imiquimod 5% cream (5 d/wk × 8 weeks) followed by conservative staged excisions with 2-mm margins using radial sections stained with hematoxylin and eosin and immunostaining with Mart-1, with or without SOX10. RESULTS Invasion was detected in 12/40 (30%) of the excisional biopsy specimens (average depth 0.45 mm). No invasion was detected in 28/40 (70%). All 24 patients who completed neoadjuvant topical imiquimod 5% cream before staged excisions had negative first-stage margins at 2 mm. Compared with average published margins for LM, this represents a 71.4% reduction in the required margin and an average reduction in the final surgical defect by 74%. CONCLUSION LM treatment by excisional biopsies with a purse-string closure enables accurate tumor staging and contracts the tumor footprint to its minimal size. Subsequent neoadjuvant imiquimod followed by a conservative staged excision with 2-mm margins allows for removal of LM with decreased surgical morbidity.
Education Policy and Black Teachers: Perspectives on Race, Policy, and Teacher Diversity:

This article examines interview responses from prominent education researchers who were asked to consider the role of major educational policies in the underrepresentation of Black teachers in publ...
STRATEGY FOR COLLECTION OF DRINKING WATER CONCENTRATES

In the first chapter of a recent book on water analysis, Aaron Rosen reviewed the state of water analysis in 1950 and pointed out the need for a new and entirely different approach to sampling (1). Thus in 1950, Braus, Middleton, and Walton (2), using a column of activated carbon to filter 5000 gallons or more of water, were able to recover from 2 to 4 g of organic pollutants by extracting the carbon with ethyl ether and an additional 2 to 10 g by a second elution with ethanol. The process was subsequently scaled up eighty-fold (3); the ether was replaced with chloroform and water-free extracts of 150–1700 g were obtained. As recently as 1974, this same procedure was used to prepare the starting material for a detailed analysis of the organic pollutants in New Orleans drinking water (4).
Factors associated with extended length of stay in patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis

Cross-sectional study. To investigate whether certain patient, surgical, and recovery-related factors may be associated with extended LOS following posterior spinal fusion for Adolescent Idiopathic Scoliosis (AIS). Understanding determinants of hospital length of stay (LOS) following surgical procedures is important for perioperative planning and improvements in quality of care. Using a private insurance claims database, AIS patients ages 10–21 that underwent posterior spinal fusion from 2010 to 2016 in the United States were identified. Extended LOS was defined as > 7.2 days (+ 1 standard deviation from the mean). Univariate and multivariate analyses were performed to identify factors associated with extended LOS. Significance was set at p < 0.05. 5864 patients met the inclusion criteria (mean age 14.4 ± 2.2 years; 75% girls). Mean LOS was 4.7 ± 2.5 days (median 4 days). 69% patients had 7–12 levels fused, and 25% had 13+ levels fused. On multivariate analysis, factors associated with extended LOS were: longer fusion construct (13+ levels fused) (OR 2.1, p = 0.020), thoracoplasty (OR 3.8, p < 0.001), and postoperative complications: wound problems (OR 13, p < 0.001), respiratory problems (OR 7.9, p < 0.001), urinary tract infection (OR 6.0, p < 0.001), and constipation (OR 2.4, p < 0.001). Postoperative ICU admission, female gender, and surgery performed on Wednesday were significant on univariate analysis but not on multivariate analysis. Extended LOS was associated with an increase of $50,494 in net hospital payments (p < 0.001). Patient, surgical and recovery factors are associated with extended LOS in AIS patients who undergo posterior spinal fusion surgery. Extended LOS significantly increases healthcare spending. Level III.
Negative Police Encounters and Police Avoidance as Pathways to Depressive Symptoms Among US Black Men, 2015-2016.

Objectives. To examine negative police encounters and police avoidance as mediators of incarceration history and depressive symptoms among US Black men and to assess the role of unemployment as a m...
Spontaneous dichorionic-diamniotic twins in a noncommunicating uterine horn: A case report.

Abstract Background We present a rare case of a dichorionic-diamniotic twin pregnancy in a noncommunicating rudimentary uterine horn diagnosed prior to rupture at 12 weeks of gestation. Case A 33-year-old woman with history of two prior spontaneous abortions presented with a spontaneously conceived dichorionic-diamniotic twin pregnancy. Routine first-trimester screening ultrasound detected an extrauterine twin pregnancy. The patient was admitted for observation and treatment planning. Magnetic resonance imaging (MRI) of the pelvis led to the radiologic diagnosis of suspected abdominal ectopic pregnancy. Exploratory laparotomy led to an intraoperative diagnosis of twin pregnancy within a rudimentary uterine horn, which was removed without incident. Conclusion This is a rare case of a twin pregnancy contained in a noncommunicating rudimentary uterine horn. The presence of this horn was not detected on ultrasonography or MRI.
Chapter 6 – Carbon nanotubes

Publisher Summary This chapter reviews the preparation and application of carbon nanotubes. Carbon nanotubes have caught the fancy of chemists, physicists, and material scientists. Interest, in this material has overshadowed that of fullerenes in recent years, although nanotubes still are not as readily available as fullerenes. The market price of nanotubes is still too high, and new synthesis methods based on a continuous process need to appear for this scenario to change. It should be noted that the laser method for producing SWNTs reported in 1996 provided a boost by making adequate quantities of pure SWNTs available. Many theoretical predictions were based on modeling SWNTs, and this availability of good quality SWNTs carried the possibility, for the first time, that some of these predictions could be tested. The most promising and fascinating developments have taken place in exploring the potential of nanotube electronics. Important concepts based on nanotube molecular devices have been demonstrated, but the biggest challenge still remains in building nanotube-based architectures to suit existing or future electronic fabrication technology. Nanotubes can be considered to be the ultimate carbon fiber, and it will be surprising if applications for nanotube are not developed in areas where traditional carbon fibers are abundantly used. One of the problems for nanotube-based composite is the lack of understanding of how the mechanics work around a nanosized inclusion or filler. With extremely small dimensions and mechanical strength, as well as elasticity, one area where nanotubes ultimately may become indispensable is their use as nanoprobes.
A multi-model approach toward understanding iron fouling at rock-fill drainage sites along roadways in New Hampshire, USA

Factors affecting iron fouling in wet areas adjacent to roadways were investigated by collecting field rock cut and aqueous physicochemical data; developing exploratory predictive models; and developing geochemical models. Basic data included the identification of iron fouling from aerial imagery and field visits at 374 New Hampshire rock cut locations, and their associated rock-fill sites. Based on field water quality measurements from wet areas at 36 of the rock-fill sites, the occurrence of iron fouling was associated with higher values of specific conductance, lower concentrations of dissolved oxygen and lower pH compared to areas without iron fouling. A statistical model, using boosted regression trees, was developed to predict the occurrence of iron fouling in wet areas adjacent to roadways where rock-fill from nearby rock cuts was used in roadway construction. The model was used to develop a continuous iron fouling probability map for the state of New Hampshire that can be used to better understand the occurrence of iron fouling. Geochemical models illustrate how iron fouling of waters increases along roadways built with fill from sulfidic rock cuts as a result of acid generation from pyrite dissolution and ferrous iron (Fe2+) oxidation and increases in areas with greater specific conductance from deicing runoff caused by cation exchange. More iron is precipitated as goethite in simulations that include pyrite, and in simulations with deicing salts added, indicating that rock-fill sites with rocks that contain pyrite and water with greater salt content could have enhanced iron fouling.
New York’s War on Drugs and the Impact on Female Incarceration Rates:

Prior literature suggests that drug legislation in the late 1970s and 1980s caused the rapid increase in the female incarceration rate. Empirical investigations focused on the female incarceration ...
A Trusted Authentication Scheme for IoT-based Smart Grid Applications

Advanced metering infrastructure (AMI) network, which is an example of the benefits of IoT technology in the power grid system, offers two-way communication between various power smart grid nodes (i.e., smart meters, aggregator, and the utility company) to enable efficient and reliable power delivery. This type of communication within a smart grid, however, brings several challenges in protecting these nodes from various types of cyber attacks. An efficient and dynamic hardware-oriented authentication and key management scheme for AMI networks is proposed in this paper as a proof of concept, to demonstrate the potential benefits of IoT technology in smart cities. The proposed scheme is based on a dynamic physical unclonable function (PUF) architecture that extracts a large set of reliable secret keys to authenticate AMI nodes over their corresponding lifetimes provided by the manufacturer. For a secure exchange of the secret keys while preserving privacy, a lightweight encryption scheme is utilized to authenticate AMI smart meters without disclosing the the keys that are exchanged and/or the identity of the meter. Furthermore, the proposed framework will enable different security levels defined by the standards of the National Institute of Science and Technology (NIST) to ensure a secure communication between AMI constituents. The proposed scheme is implemented on 10 FPGA boards (Nexys4 DDR Artix-7 with 28 nm). The experimental results demonstrate that the proposed scheme is highly secure and efficient in terms of authentication time and data storage requirements.
American Needle Ruling May Have Impact in Other Areas of Sports Business

This legal commentary discusses the implications of the United States Supreme Court's ruling in the case American Needle v. National Football League on both sports leagues and players unions.
Inhibition of Cytochrome Oxidase Impairs Learning and Hippocampal Plasticity: A Novel Animal Model of Alzheimer's Disease

Patients suffering from Alzheimer’s disease (AD), as well as other dementing disorders, show global decreases in markers of cerebral metabolism such as blood flow, oxygen uptake and glucose utilization (Phelps, Mazziotta, and Huang, 1982). The question arises, however, as to whether these changes are of etiological significance. Blass, Sheu and Cedarbaum (1988) have distinguished between primary, secondary and tertiary disorders of energy metabolism. A primary disorder is a defect of the cellular machinery of energy metabolism. These defects are inborn errors and primarily affect the CNS. The CNS is more sensitive to a decline in energy metabolism than other organs are, and is therefore a major target of damage when this function is impaired. A secondary disorder of energy metabolism is not metabolic in origin, but rather a consequence of a triggering pathology which damages mitochondrial function. Sequelae from the subsequent dysfunction of energy metabolism, then, produce cellular pathology and contribute to the overall disease process. A tertiary disorder of energy metabolism is one in which the abnormal markers of energy metabolism are purely a consequence of neuronal degeneration. In the latter class, the decline in energy metabolism occurs late in the disease and is trivial as a pathophysiological process in the disease. The classification of AD within this schema is unknown.
Small reactor power systems for manned planetary surface bases

A preliminary feasibility study of the potential application of small nuclear reactor space power systems to manned planetary surface base missions was conducted. The purpose of the study was to identify and assess the technology, performance, and safety issues associated with integration of reactor power systems with an evolutionary manned planetary surface exploration scenario. The requirements and characteristics of a variety of human-rated modular reactor power system configurations selected for a range of power levels from 25 kWe to hundreds of kilowatts is described. Trade-off analyses for reactor power systems utilizing both man-made and indigenous shielding materials are provided to examine performance, installation and operational safety feasibility issues. The results of this study have confirmed the preliminary feasibility of a wide variety of small reactor power plant configurations for growth oriented manned planetary surface exploration missions. The capability for power level growth with increasing manned presence, while maintaining safe radiation levels, was favorably assessed for nominal 25 to 100 kWe modular configurations. No feasibility limitations or technical barriers were identified and the use of both distance and indigenous planetary soil material for human rated radiation shielding were shown to be viable and attractive options.
The solution to the Lyapunov equation in constant gain filtering and some of its applications

Presented in this paper is a solution to the Lyapunov equation in constant gain filtering. A specific method for deriving the noise reduction ratios for the alpha-beta and alpha-beta-gamma filters are explored using the Lyapunov equation. This enables us to simplify the computation drastically. For a 2 /spl times/ 2 matrix, one has to solve for one unknown instead of two. For a 3 /spl times/ 3 matrix, one has to solve for three unknowns instead of six and so on. Thus reduction in the number of variables has considerable advantage for higher dimensional filters such as the alpha-beta-gamma filter.
Ingredient composition and pasta:water cooking ratio affect cooking properties of nontraditional spaghetti

Summary An experiment was conducted to determine the effect of different pasta:water ratios and nontraditional ingredients on the cooking properties of spaghetti. Spaghetti was made using semolina and semolina containing 20% (w/w) nontraditional (NT) ingredients (corn, flaxseed, lentil, oat, pinto bean and soybean flours). Pasta:water ratios evaluated were 13 g:400 mL, 27 g:400 mL and 48 g:400 mL. Addition of pasta caused a decline in cooking water temperature. The water temperature drop and recovery time to boiling (100 °C) varied with pasta:water ratio and with nontraditional ingredient in the spaghetti. These results were attributed to the calculated specific heat capacity of the ingredients incorporated in the spaghetti. Cooking time was reduced for all NT spaghetti with respect to the control sample and was longest when 48 g of pasta was cooked. Pasta:water ratio affected cooking loss but not cooked weight or cooked firmness. Cooking losses were greater with 13 g:400 mL compared to 48 g:400 mL.
File servers for network-based distributed systems

Le «file server» est un service assurant l'interface entre l'utilisateur et le fichier qu'il interroge, dans le cadre d'un reseau d'information. Diverses caracteristiques des «file servers» sont decrites a partir d'une etude de quelques serveurs experimentaux
Effect of intranasal histamine challenge on Eustachian tube function.

Abstract Objective: To show a relationship between intranasal histamine challenge, the development of middle ear effusion and Eustachian tube (ET) dysfunction in a rat model. Methods: Non-allergic Sprague–Dawley rats weighing between 450–600 g were randomly assigned to receive an intranasal infusion of 16 μl of 10% histamine or normal saline. ET function was assessed by using the forced-response test to measure passive and active opening and closing pressures at time intervals of 6, 10, 14, 18, 22, and 26 min and 24 h post-infusion. Mucociliary clearance times (MCCTs) of the tubotympanum at 18 min post-infusion were measured by timing the transit of dye from the middle ear to the nasopharynx. Outcome measures were ET dysfunction and evidence of clinical effusion. Results: Intranasal histamine caused acute ET dysfunction when introduced into the nasopharynx demonstrated by significant elevations in passive and active opening and closing pressures ( P ⩽0.001) compared to controls. The largest difference was seen at 26 min post-infusion. Furthermore, MCCTs were 2.4 times longer after infusing intranasal histamine than after saline infusion. No clinically significant effusions were evident in either group at any time interval. Conclusion: These data demonstrate a successful development of an intranasal histamine rat model, in addition to a relationship between intranasal histamine challenge and development of acute ET dysfunction.
The effect of specific antibodies on oxygen uptake and H+ pumping by cytochrome c oxidase vesicles

Antibodies to solubilized cytochrome c oxidase and to subunit III were incubated with liposomal oxidase. In oxygen uptake experiments, the inhibiting effects on RCI of anti-oxidase (primarily anti- subunits II and IV) and anti-III were by different mechanisms: the former, by inhibiting the uncoupled rate; the later, by stimulating the coupled rate. In experiments with H+ translocation, anti-oxidase was without effect, while anti-III was a potent inhibitor of proton pumping. These results are conclusive evidence for redox-linked proton extrusion from the vesicles by the oxidase (and its subunit III).