cssi/SciSciGPT-SciSciNet huggingface dataset:
Epitope Location in the Cryptococcus neoformans Capsule Is a Determinant of Antibody Efficacy

Monoclonal antibodies (mAbs) to the polysaccharide capsule of Cryptococcus neoformans can prolong survival in mice. However, the properties of antibodies that mediate protection are not fully understood. The IgM mAbs 12A1 and 13F1 originated from the same B cell and differ only by somatic mutations in their variable regions; yet mAb 12A1 protects against serotype D infection, while mAb 13F1 does not. Phage peptide display libraries were used to analyze the fine specificity of these two mAbs. The selection of distinct peptide motifs from identical libraries confirmed that mAbs 12A1 and 13F1 bound to two distinct epitopes. Immunofluorescence and immunoelectron microscopy studies revealed differences in antibody localization within the capsule of serotype D strain; mAb 12A1 bound to the outer rim of the capsule resulting in an annular pattern, whereas mAb 13F1 bound throughout the capsule and had a punctate appearance. The difference in the binding pattern of mAb 12A1 and 13F1 was not observed on serotype A organisms, where both mAbs bound to the capsule with an annular fluorescence pattern. The fluorescence pattern of binding correlated with protective efficacy; mAb 13F1 prolonged survival of mice infected with the J11 serotype A strain (annular fluorescence), but not serotype D strains (punctate pattern). Annular binding, but not punctate binding, was associated with increased opsonic efficacy for phagocytosis of C. neoformans by J774.16 macrophage-like cells. The correlation between capsular binding pattern, opsonic activity, and ability to prolong survival suggests that the efficacy of anticryptococcal antibodies is dependent upon where they bind in the polysaccharide capsule.
RNA structure‐dependent uncoupling of substrate recognition and cleavage by Escherichia coli ribonuclease III

Members of the ribonuclease III superfamily of double-strand-specific endoribonucleases participate in diverse RNA maturation and decay pathways. Ribonuclease III of the gram-negative bacterium Escherichia coli processes rRNA and mRNA precursors, and its catalytic action can regulate gene expression by controlling mRNA translation and stability. It has been proposed that E.coli RNase III can function in a non-catalytic manner, by binding RNA without cleaving phosphodiesters. However, there has been no direct evidence for this mode of action. We describe here an RNA, derived from the T7 phage R1.1 RNase III substrate, that is resistant to cleavage in vitro by E.coli RNase III but retains comparable binding affinity. R1.1[CL3B] RNA is recognized by RNase III in the same manner as R1.1 RNA, as revealed by the similar inhibitory effects of a specific mutation in both substrates. Structure-probing assays and Mfold analysis indicate that R1.1[CL3B] RNA possesses a bulge– helix–bulge motif in place of the R1.1 asymmetric internal loop. The presence of both bulges is required for uncoupling. The bulge–helix–bulge motif acts as a ‘catalytic’ antideterminant, which is distinct from recognition antideterminants, which inhibit RNase III binding.
Challenges and Opportunities for Next-Generation Intracortically Based Neural Prostheses

Neural prosthetic systems aim to help disabled patients by translating neural signals from the brain into control signals for guiding computer cursors, prosthetic arms, and other assistive devices. Intracortical electrode arrays measure action potentials and local field potentials from individual neurons, or small populations of neurons, in the motor cortices and can provide considerable information for controlling prostheses. Despite several compelling proof-of-concept laboratory animal experiments and an initial human clinical trial, at least three key challenges remain which, if left unaddressed, may hamper the translation of these systems into widespread clinical use. We review these challenges: achieving able-bodied levels of performance across tasks and across environments, achieving robustness across multiple decades, and restoring able-bodied quality proprioception and somatosensation. We also describe some emerging opportunities for meeting these challenges. If these challenges can be largely or fully met, intracortically based neural prostheses may achieve true clinical viability and help increasing numbers of disabled patients.
Estimating person--environment transactions on intention to change drug-using behaviors.

The community attachment model of addiction is an ecologically based social process model that suggests social context referents (peers, family, neighbors, etc.) will influence attachment to addiction or recovery communities, via cognitive, affective, and behavioral commitments. This study examined the influence of social context referents on intention to change drug using behavior, and examined moderating effects of three contextual indicators (labor market attachment, educational attainment, and family poverty status) on these relationships. The study sample consisted of 302 adults in inpatient and outpatient substance abuse treatment facilities, who completed a set of instruments that included the Ecological Assessment of Substance Abuse Experiences (EASE), a new instrument designed to measure the influence of social context referents on addiction and recovery attachment processes. Results showed that all three contextual indicators moderated relationships among social context referenced attitudes, dru...
HIV Testing, Staging, and Evaluation

HIV testing and incidence are stable, but trends for certain populations are concerning. Primary prevention must be reinvigorated and target vulnerable populations. Science and policy have progressed to improve the accuracy, speed, privacy, and affordability of HIV testing. More potent and much better tolerated HIV treatments and a multidisciplinary approach to care have increased adherence and viral suppression. Changes to health care law in the United States seek to expand the affordability and access of improved HIV diagnostics and treatment. Continued challenges include improving long-term outcomes in people on lifetime regimens, reducing comorbidities associated with those regimens, and preventing further transmission.
177 Determining the impact of By-O-Reg+ in diets with or without feed grade antibiotic on growth performance of nursery pigs.

Citation: Thomas, L. L., Woodworth, J. C., Goodband, R. D., DeRouchey, J. M., Tokach, M. D., & Dritz, S. S. (2016). Determining the impact of By-O-Reg plus in diets with or without feed grade antibiotic on growth performance of nursery pigs. Journal of Animal Science, 94, 83-83. Retrieved from ://WOS:000375783900177
The approach to the adolescent patient.

Success in working with adolescents depends largely upon the interest, sensitivity, and personality of the physician, and his willingness to invest time and effort in developing the skills and techniques necessary for effective communication. Interviewing is discussed, with attention to special problems such as the uncommunicative or depressed adolescent. Family, school, and peer group relationships should all be considered when eliciting the history. The importance of evaluating the physical findings in terms of the teenager's psychophysiologic development is stressed.
Maternal Intimate Partner Violence: Relationships with Language and Neurological Development of Infants and Toddlers

Objectives This longitudinal study examined the influence of Intimate Partner Violence (IPV) experience of pregnant women participating in the Domestic Violence Enhanced Home Visitation Program on the language and neurological development of infants and toddlers. Methods A total of 210 infants and toddlers born to women reporting low, moderate, and high levels of IPV were included in the analysis. Logistic regression analysis was used to determine the bivariate association between maternal IPV and risk of language and neurological delay of infants and toddlers and between covariates and language and neurological delay. Generalized estimating equation models with logit link was used to predict the risk of language and neurological delay of infants and toddlers as a result of maternal IPV. Results Infants and toddlers born to women exposed to moderate levels of IPV had increased odds of language delay compared to infants and toddlers of women who experienced low levels of violence (OR 5.31, 95 % CI 2.94, 9.50, p < 0.001). Infants and toddlers born to women who experienced moderate and high levels of IPV were at higher risk of neurological delay respectively, compared to infants and toddlers of women who experienced low levels of IPV (OR 5.42, 95 % CI 2.99, 9.82, p < 0.001 and OR 2.57, 95 % CI 1.11, 5.61, p = 0.026). Conclusions for Practice Maternal IPV is associated with increased risk of language and neurological delay of infants and toddlers. These findings have implications for health care for women and infants exposed to IPV. Clinicians including pediatricians working with pregnant women should screen for IPV throughout pregnancy to identify women and children at risk. Interventions to reduce maternal IPV and early intervention services for infants and toddlers exposed to IPV are necessary for optimal maternal and child health.
Stochastic Evaluation of Tunneling Performance Using Discrete-Event Simulation

Estimating tunneling time and cost performance is an extremely important and challenging task for all contractors during the construction planning and cost estimating phase of tunnel projects. The complexity of tunneling operations and the variety of associated uncertainties contribute to a significant amount of risk in the estimation of tunneling time and cost. Since conventional deterministic estimating cannot measure tunneling risks, particularly geologic uncertainty, in a systematic and quantitative manner, a stochastic approach is necessary for evaluating tunneling performance. This paper presents a stochastic methodology for evaluating tunneling performance by using discrete-event simulation. Different tunnel excavation and support methods when applied to different geologic conditions define different tunneling alternatives, which change the precedence logic of tunneling operations. Thus, the construction performance for each tunneling alternative in the project must be assessed separately. To organize tunneling costs, all work items in the project are categorized into divisions based on a work breakdown structure (WBS) designed specifically for tunnel projects. Cost items within each division are then classified into fixed costs and variable costs that depend on the selected excavation-support methods and the resulting tunnel advance rates. The tunnel advance rates for a particular alternative are determined by analyzing the probabilistic network of tunneling activities associated with that alternative. The duration of tunneling activities is expressed by time-estimating equations formulated by analyzing the work at the process level. Uncertainties associated with tunneling processes are evaluated by subjective assessment using the Perry & Greig method. The probabilistic scheduling networks for different tunneling alternatives are analyzed using discrete-event simulation performed in ProbSched, a graphical probabilistic scheduling program implemented as an add-in to the STROBOSCOPE simulation system. The simulation results provide probability distributions of tunnel advance rates and tunneling unit costs for all possible alternatives, which can be used to determine optimal excavation and support policies for the project. The stochastic evaluation of tunneling performance for the Hanging Lake Project in Colorado is presented as an example application.
Phototactic Response of Instars of the Armyworm (Lepidoptera: Noctuidae)

Behavioral response of first through sixth instars of the armyworm, Pseudaletia unipuncta (Haworth), to five light levels was measured during photophase and scotophase. The first two instars were generally photopositive, the third and fourth instars largely neutral, and the fifth and sixth instars were photonegative. Photopositive responses during the scotophase were similar to or weaker than those elicited during the photophase, given the same light intensity. Photonegative responses during the photophase were similar to or weaker than those elicited during the scotophase.
Human Connexin 26 (Cx26) N14K Mutant Alters Hemichannel Calcium and Voltage Sensitivity

Unpaired hemichannels, those not forming gap junction channels, play an autocrine/paracrine role by releasing transmitters, such as glutamate and ATP, to the extracellular medium. Hemichannels are gated by changes in extracellular Ca+2 concentration and membrane voltage. Several human connexin mutations that produce diseases increase hemichannel opening (e.g., gain of function due to decreased sensitivity to extracellular Ca+2). Using Xenopusoocytes and two-electrode voltage clamp techniques, we studied the voltage and calcium sensitivity of a connexin 26 (Cx26) mutation, N14K, located in the N-terminal domain (NT). The NT is thought to fold into the pore and form part of the pore lining; position N14 is approximately at the “hinge” region at which the NT bends toward the pore. We observe a significant leftward shift in the voltage-dependence N14K (midpoint at - 6.7 mV ± 0.7) mutants with respect to wild type channels (midpoint at + 9.6 mV ± 0.9). Rearrangements of the NT are associated with voltage dependent sub-conductances in wild type Cx26 hemichannels, however, N14K mutant channels did not display voltage dependent sub-conductances. The apparent calcium affinity was also significantly reduced in N14K (KD = 0.74 mM) compared to wild type channels (KD = 0.34 mM). Deactivation kinetics in wild type channels show single mono-exponential relaxations that are accelerated as a function of calcium concentration, but not voltage. The Cx26 mutant N14K displays two slower components. One of these components is both Ca+2 and voltage dependent but the other is not. Overall, our data indicate that under physiological conditions the N14K mutation stabilizes the open state relative to wild type channels by reducing both calcium and voltage sensitivity. R01GM099490/R01GM101950.
Wound Hygiene Practices After Total Knee Arthroplasty: Does It Matter?

Abstract Background Current literature is limited with regard to standardized postoperative surgical site hygiene after total knee arthroplasty (TKA). With little guidance from the literature, the timing of permissible postoperative cleaning is a decision made by the individual surgeon using anecdotal evidence. A standardized wound care regimen is of particular interest to minimize the risk of infection. Methods To examine what species of bacteria recolonize the surgical site postoperatively, a randomized controlled trial was performed of 16 TKA patients who were allowed to shower at 2 days postoperatively and of 16 patients who were asked to wait until 2 weeks postoperatively before showering after TKA. Culture swabs of skin adjacent to the incision were performed preoperatively, just after incision closure, at dressing removal, and at 2 weeks postoperatively. Bacteria were speciated and compared between groups. A swab of the contralateral knee was performed at 2 weeks as a control. A survey of patient's preference regarding early and late showering was also carried out. Results No difference was found between the groups in rate of colonization or bacterial type, and no patients developed infection. Patients overwhelmingly preferred early showering rather than late ( P = .28-.99). Conclusion There is no difference in surgical site bacterial recolonization between early and delayed showering after primary TKA.
Changes in heart rate associated with nebulized racemic albuterol and levalbuterol in intensive care patients

The effects of equipotent doses of racemic albuterol and levalbuterol on heart rate (HR) in intensive care patients with and without baseline tachycardia were studied. Patients were included if they were hemodynamically stable and required bronchodilator therapy every four hours; patients were excluded if they were maintained on a beta-blocker. Four hours after the most recent bronchodilator treatment, each patient was randomized to receive at least two consecutive doses of albuterol 2.5 mg or levalbuterol 1.25 mg four hours apart via nebulization. HR was recorded at the end of the second dose and 5, 10, 15, 30, 60, 90, 120, 180, and 240 minutes after treatment. Twenty intensive care patients, including 10 with baseline tachycardia and 10 without baseline tachycardia, were enrolled. In patients with baseline tachycardia, the mean largest HR increase was 1.4 beats/min (1.3%) with albuterol and 2.0 beats/min (2.1%) with levalbuterol (both increases were not significant). In patients without baseline tachycardia, the mean largest HR increase was 4.4 beats/min (6.7%) with albuterol (p = 0.04) and 3.6 beats/min (5.0%) with levalbuterol (p = 0.03). Short-term use of nebulized albuterol and levalbuterol was associated with similar changes in HR in intensive care patients with or without baseline tachycardia.
Diabetes Training for Community Health Workers.

Background: A 2.5-month diabetes education training for community health workers (CHWs) was developed, implemented, and evaluated. Methods: Training methods used included case studies, role-playing, and lectures. Exams were used throughout the training for its evaluation. Teaching was delivered by different ways: a one day American Diabetes Association (ADA) course; a five day Diabetes Self-Management Program (DSMP); Conversation Maps; and a series of seven National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) diabetes education booklets. Results: Qualitative and quantitative evaluative methods were used during and after the training. The CHWs' diabetes knowledge was evaluated by a pre- and post-test Diabetes Knowledge Questionnaire (DKQ). The post-test was conducted one week after completing the training. The findings showed that the diabetes knowledge of the CHWs increased. Conclusions: Diabetes competencies and evaluative tools need to be developed specific for CHWs as a way to standardize all CHW diabetes trainings.
Effect of Okam on Airway Inflammation in Asthmatic Mouse

Objective To explore the effect of Okam on airway inflammation in asthmatic mouse.Methods Thirty-two SPF grade Kunming Strain mice were randomly divided into positive control group,glucocorticoid inhalation group,Okam group and negative control group with 8 mice in each group.The mice were sensitized and repeatedly challenged with ovalbumin(OVA) to establish the models of chronic asthma.The glucocorticoid group were given Budesonide(200 μg) and saline everyday by inhalation,the Okam group were given 50 mg/kg Okam by gavage,and the positive group had saline at the same time,the negative control group received saline at all stages.The inflammation of the lung tissue were scored underwent HE staining.Bronchoalveolar lavage fluid(BALF) cell count and differential were studied,and interferon-γ(IFN-γ),interleukin-4(IL-4) in BALF were determined by enzyme-linked immunosorbent assay(ELISA).Results There were no inflammatory cell infiltrate of bronchiole in the negative control group.Inflammatory infiltration of lung tissue were obvious in the positive control group.Inflammatory infiltration of lung tissue lightened obviously in the Budesonide and Okam groups.The total cell number,Eosinophils(EOS) and IL-4 level in BALF,and the score of the lung tissue in Okam group were all markedly lower than those in positive control group(t=5.942,7.089,7.078 Pa0.01),and the IFN-γ increased greatly(t=6.171 P0.01),and the IFN-γ decreased(t=4.116 P0.01).Compared with the negative control group,the total cell number,EOS,and IL-4 level in BALF were all significantly increased(t=2.150,3.977,2.593 Pa0.05),and the IFN-γ significantly decreased (t=4.116 P0.01).Compared with the Bude-sonide group,the total cell number and EOS increased greatly(t=4.984,6.195 Pa0.01),IL-4 changed fewly(t=1.424 P0.05),IFN-γ lower(t=4.275 P0.01),and the score of the lung tissue increased(P0.01).Conclusions Okam may inhibit the airway inflammation of asthmatic mice,and might be an ancillary drug for asthma.
Association of Hepatitis C Virus With Alcohol Use Among U.S. Adults: NHANES 2003–2010

Introduction Excessive alcohol use exacerbates morbidity and mortality among hepatitis C virus (HCV)–infected people. The purpose of this study was to describe self-reported patterns of alcohol use and examine the association with HCV infection and other sociodemographic and health-related factors. Methods Data from 20,042 participants in the 2003–2010 National Health and Nutrition Examination Survey were analyzed in 2014. Estimates were derived for self-reported demographic characteristics, HCV-RNA (indicative of current HCV infection) status, and alcohol use at four levels: lifetime abstainers, former drinkers, non-excessive current drinkers, and excessive current drinkers. Results Former drinkers and excessive current drinkers had a higher prevalence of HCV infection (2.2% and 1.5%, respectively) than never or non-excessive current drinkers (0.4% and 0.9%, respectively). HCV-infected adults were estimated to ever drink five or more drinks/day almost every day at some time during their lifetime about 3.3 times more often (43.8% vs 13.7%, p Conclusions Chronic HCV infection is associated with both former and excessive current drinking. Public health HCV strategies should implement interventions with emphasis on alcohol abuse, which negatively impacts disease progression for HCV-infected individuals.
Real-time imaging of chromophore alignment in photorefractive polymer devices through multiphoton microscopy

A model with which to predict the effect of coplanar electrode geometry on diffraction uniformity in photorefractive polymer display devices was developed. Assumptions made in the standard use cases are no longer valid in the regions of extreme electric fields present in this type of device. Using electric-field induced second-harmonic generation through multiphoton microscopy, the physical response in regions of internal electric fields which fall outside the standard regimes of validity were probed. Adjustments to the standard model were made and the results of the new model corroborated through holographic four-wave mixing measurements.
Epidemic situation of AIDS in Deqing County of Guangdong from 2000-2011

[Objective]To analyze the epidemiological characteristics and trend of AIDS in Deqing County of Guangdong,provide scientific basis for making the prevention and control measures of AIDS.[Methods]The descriptive epidemiological method was used to analyze the epidemic data of AIDS in Deqing County from 2000-2011.[Results]During 2000-2011,a total of 168 HIV infection and AIDS patients were reported in Deqing County,which included 53 AIDS patients and 22 death cases.There were 127 male cases and 41 female cases,and the male-to-female ratio was 3.10∶ 1.Most o f cases were farmer,housekeeping and job-waiting,and retiree,which accounted for 51.19%(56 cases),11.90%(20 cases) and 5.95%(10 cases),respectively.52 cases were reported in Decheng Town,19 cases in Guanxu Town,19 cases in Yuecheng Town,17 cases in Xinxu Town,15 cases in Huilong Town and 14 cases in Gaoliang Town.The main transmission routes were heterosexual contact and drug injection,which accounted for 60.71% and 22.02% respectively.[Conclusion]The epidemic situation of AIDS shows a rising trend year by year in Deqing County,and it has spread from high-risk population to general population.It is necessary to carry out comprehensive and effective prevention measures to control AIDS.
Deterministically Factoring Sparse Polynomials into Multilinear Factors.

We present the first efficient deterministic algorithm for factoring sparse polynomials that split into multilinear factors. Our result makes partial progress towards the resolution of the classical question posed by von zur Gathen and Kaltofen in [GK85] to devise an efficient deterministic algorithm for factoring (general) sparse polynomials. We achieve our goal by introducing essential factorization schemes which can be thought of a relaxation of the regular factorization notion.
Landscape of Royalization: An English Military Outpost on Roatán Island, Honduras

During the seventeenth and eighteenth centuries, the British Crown competed with other European imperial powers for control over the land, labor, and materials of the Caribbean. The British Crown came to view the Caribbean as the geographical hub within which it would be able to obtain key resources and to challenge the rapidly growing power of the Spanish Empire. One of the most contentious ports in the western Caribbean was New Port Royal harbor on Roatan Island, Honduras, because of its strategic location across the Bay of Honduras from the Spanish settlement of Trujillo. In 1742, the settlement of Augusta was established as a British military outpost. “Royalization” refers to the strategies employed by monarchies to bring about loyalty to a state. While the royalization process was intended to instill a sense of loyalty and British identity among colonists, documentary and archaeological data suggest that multifaceted relationships emerged among British and indigenous populations at settlements such as Augusta.
Blood substitutes in surgery.

BACKGROUND Despite increasing safety of blood supplies, and blood conservation strategies, the need for blood transfusion is increasing. Due to storage characteristics, blood is not always available when it is needed. AIMS Review the necessity for an oxygen carrying blood substitute. Review the history of the compounds that may become blood substitutes, and briefly describe those in clinical trials. MATERIAL AND METHODS Review of literature in the area of blood substitutes. RESULTS AND CONCLUSIONS There is a need for oxygen carrying blood substitutes. Despite disappointments in recent clinical trials leading to withdraw of some compounds, there are several promising products nearing clinical approval.
Adolescent Medicine in Rural America

Although rural adolescents face many of the same tasks and problems as their urban counterparts, less readily available medical care and educational support for rural youth is a current issue.
B lymphocyte subpopulations in chronic lymphocytic leukemia

We have defined two subpopulations of B lymphocytes in chronic lymphocytic leukemia (CLL). The major variant (termed typical) was characterized by the presence of a relatively homogeneous population of small-to-medium-sized lymphocytes with low-density SmIgM and no evidence of intracellular Ig synthesis. A minor group (termed atypical) was identified by the presence of a pleomorphic cell population with few small lymphocytes. The predominant SmIg was IgG, which was detected intracellularly as well as in the serum. The atypical group appeared to be an arrest at a later stage of differentiation where a switch from IgM to IgG synthesis and secretion had occurred. Clinical correlation suggested several clear-cut differences in clinicopathologic characteristics, but the median survivals for both groups at 2 yr was nearly identical.
Duplication methods for replacement of broken orthoses

The methods presented for replacement of broken orthoses have proved very effective (Fig. 9). In more than 5 years of employing such duplication techniques, we have found patient satisfaction in the product to be commensurate with that for their originally prescribed devices. The techniques presented are not the only methods by which orthoses can be duplicated. We recognize that the clinician should refabricate the same orthosis only when the cause of breakage has been determined to be material fatigue or stress. Should the patient's weight, foot structure, or activities have changed, new orthoses should be fabricated with those factors in mind.
Synthesis of a funtionalized monomer of the rare M7O210+ double tetrahedron Zn cluster: [Zn7O2(O2C2H3)10(3-{CH2OH}C5H4N)2]

Abstract A heptanuclear zinc cluster has been synthesized based on the rarely seen M 7 O 2 10 + double tetrahedron. This new cluster is monomeric in nature and is the first of its kind to display the added functionality of uncoordinated hydroxyl groups. These reactive functional groups will allow it to be used to construct designed frameworks.
What clinicians miss about miscarriages: Clinical errors in the treatment of early term perinatal loss

In this article, clinical errors in the treatment of perinatal grief after a miscarriage are discussed, including (a) minimizing or avoiding painful affects related to the miscarriage, (b) assuming grief is resolved upon a subsequent healthy pregnancy, and (c) neglecting early unresolved losses that are reawakened by the loss of the pregnancy. It is argued that these unintentional errors, frequently committed by significant others in the patient's life, are similarly made by well-intentioned clinicians due to a lack of knowledge about the psychological impact of miscarriage and, moreover, an unconscious avoidance of such a common yet distressing loss. Background information relevant to each clinical error is briefly reviewed, followed by recommendations for a better approach to the situation and verbatim clinical exchanges. The author suggests that, in general, a better approach to treatment is based on the assumptions that: (a) miscarriage is often a traumatic loss in a woman's life, and (b) the traumatic affect associated with the event should be approached, rather than avoided, within a safe affect regulating relationship with the therapist. (PsycINFO Database Record
Clinical Decision Support and Alerting Mechanisms

More than 55 % of US hospitals have electronic health records (EHRs); frequently these contain computerized decision support (CDS) in the form of alerts. Alerts are a common form of CDS often implemented for medication ordering and decision support to improve patient care. EHRs implement rules supplied by third-party vendors to help guide the dosing process include weight-based dosing. Since many of these rules are conservative, they result in noisy alerting and are therefore overridden by users. Alert fatigue is commonly studied and reported by providers. EHR implementers customize these rules to reduce noise. Adverse drug events are a common occurrence, prevalent in both adult and pediatric populations. However, there are few automated ways to identify adverse drug events. Weight-based dosing guidance for medication orders has limited functionality if the patient’s body weight is entered incorrectly. Despite safeguards intended to prevent weight data-entry errors, erroneous weights exist in patients’ charts. These pose a safety threat to patients, especially inpatients, whose medication doses may be calculated from the last recorded weight. In this chapter we will give an overview of pediatric clinical decision support in EHRs, the different modes and forms of CDS, as well as diving into several related and specific areas of CDS – medication dosing alerts and the detection of weight data entry errors. We will review these common sources of error and frustration in the EHR, how errors can be identified, and changes implemented to mitigate the errors.
Do autologous blood and PRP injections effectively treat tennis elbow

Both approaches reduce pain, but the improvement with platelet-rich plasma (PRP) is not clinically meaningful. Autologous blood injections (ABIs) are more effective than corticosteroid injections for reducing pain and disability in patients with tennis elbow in both the short and long term.
Cones and Limits

We wish to continue our exploration of universality with some additional examples. For this, we need to define a few more categorical concepts.
CHAPTER 21 – Measures of Function and Health-Related Quality of Life

Publisher Summary This chapter discusses approaches and commonly used measures to assess health-related Quality of Life (QOL) and functional activity. There are many approaches to assess the health of a person. Most include measurements in several domains. The relationships among these domains provide many investigational opportunities. These may be causally connected or associated through complex societal and economic or other relationships not necessarily disease dependent. Much interest has been generated in evaluating what constitutes meaningful and valued daily activity to an individual. Two converging processes in U.S. health care have driven this interest: a strong consumer movement, in part fueled by easy access to information, which has spearheaded rising expectations for personal health, and a need for a more systematic and comprehensive approach to health status measurements. Instruments for measurement have improved significantly during the past decade. They have become more quantitative and reliable. They have been expanded to include measures of personally held beliefs and values to understand the impact of disease on behaviors such as coping, participation, and motivation. This has increased the variety of information obtained and raised confidence in data collected from QOL measures, both self-report and observer-administered instruments.
Transcriptome profiling of 3D co-cultured cardiomyocytes and endothelial cells under oxidative stress using a photocrosslinkable hydrogel system.

Abstract Myocardial infarction (MI) is one of the most common among cardiovascular diseases. Endothelial cells (ECs) are considered to have protective effects on cardiomyocytes (CMs) under stress conditions such as MI; however, the paracrine CM-EC crosstalk and the resulting endogenous cellular responses that could contribute to this protective effect are not thoroughly investigated. Here we created biomimetic synthetic tissues containing CMs and human induced pluripotent stem cell (hiPSC)-derived ECs (iECs), which showed improved cell survival compared to single cultures under conditions mimicking the aftermath of MI, and performed high-throughput RNA-sequencing to identify target pathways that could govern CM-iEC crosstalk and the resulting improvement in cell viability. Our results showed that single cultured CMs had different gene expression profiles compared to CMs co-cultured with iECs. More importantly, this gene expression profile was preserved in response to oxidative stress in co-cultured CMs while single cultured CMs showed a significantly different gene expression pattern under stress, suggesting a stabilizing effect of iECs on CMs under oxidative stress conditions. Furthermore, we have validated the in vivo relevance of our engineered model tissues by comparing the changes in the expression levels of several key genes of the encapsulated CMs and iECs with in vivo rat MI model data and clinical data, respectively. We conclude that iECs have protective effects on CMs under oxidative stress through stabilizing mitochondrial complexes, suppressing oxidative phosphorylation pathway and activating pathways such as the drug metabolism-cytochrome P450 pathway, Rap1 signaling pathway, and adrenergic signaling in cardiomyocytes pathway. Statement of Significance Heart diseases are the leading cause of death worldwide. Oxidative stress is a common unwanted outcome that especially occurs due to the reperfusion following heart attack or heart surgery. Standard methods of in vivo analysis do not allow dissecting various intermingled parameters, while regular 2D cell culture approaches often fail to provide a biomimetic environment for the physiologically relevant cellular phenotypes. In this research, a systematic genome-wide transcriptome profiling was performed on myocardial cells in a biomimetic 3D hydrogel-based synthetic model tissue, for identifying possible target genes and pathways as protecting regulators against oxidative stress. Identification of such pathways would be very valuable for new strategies during heart disease treatment by reducing the cellular damage due to reperfusion injury.
What Is Real Time Computing? A Personal View

This article makes the case for embracing temporal properties as an integral part of the modeling paradigm in cyber-physical systems design.
Empowerment of Women Between Law and Science

This paper examines the role of biomedical technology in reconstructing traditional gender roles in the Muslim world. It questions the neutrality of this technology and explores the extent to which various applications of genetic and reproductive technologies can be used either to enhance or diminish gender equality. It concentrates on Islamic normative discussions surrounding pre-marital genetic testing and sex selection and emphasizes the role of these discussions for the proper accommodation of these technologies within the Muslim context.
Changes in visually guided behavior of Royal College of Surgeons rats as a function of age: a histologic, morphometric, and functional study.

PURPOSE. To compare the changes in visually guided performance as a function of age between Royal College of Surgeons (RCS) dystrophic and congenic rats and to correlate photoreceptor cell number with visually guided performance in age-matched populations of RCS dystrophic rats. METHODS. The visually guided performances of RCS dystrophic (n = 6) and congenic (n = 7) rats were studied from 0.75 to 12 months of age using a water escape paradigm that tested their ability to find a submersed, randomly placed platform that used a light source as a clue. The time to find the platform (latency) was recorded. In age-matched dystrophic RCS rats, histopathologic changes were described and the number of photoreceptor cell nuclear profiles per midsagittal retinal section was counted. Changes with age in visually guided behavior and photoreceptor cell populations of RCS dystrophic rats then were compared. RESULTS. The latency of RCS dystrophic rats increased significantly beyond that of congenic rats after 6 months of age. Photoreceptor cell number in dystrophic rats precipitously decreased through 6 months of age, stabilized at 9 months, and decreased further at 12 months. Two unexpected results were seen in the dystrophic animals: At 6 months of age, as few as 22 ± 3 photoreceptor cell nuclei per midsagittal section provided similar latencies as at 2 months when there were as many as 400. Although the number of photoreceptor cells remained stable from 6 to 9 months of age, functional vision significantly deteriorated. CONCLUSIONS. Two important phenomena were observed. First, the RCS rats performed very well in the water escape test even while their photoreceptor cell population was being decimated. Second, once a low threshold was reached, a dramatic deterioration of visually guided behavior occurred without a further reduction in photoreceptor cell numbers.
Modeling and simulation of a microgrid using feedforward neural networks

Electric power grids and complex computer systems have many similar properties of the operation behavior and the structure. A microgrid can be treated as a small electric grid that contains consisted of numerous residential loads, energy storage units, and distributed energy. The goal of implementing microgrids is to supply power to homes even in the event of an electric grid outage. That is, the stored energy in the storage unit and distributed generation will supply energy to the load until the main grid return to the normal operation, and therefore, supply power to the load and store energy back to the storage unit. This method allows decentralization of the electric grid regarding control and energy supply. To deal with decentralized systems, one needs to construe the electric grid as a system of systems (SoS), and use models that can capture the dynamics of the microgrid. This paper presents a model of microgrid using feedforward neural networks. This model can be utilized in complex system modeling techniques such as agent-based approaches and system dynamics, or a combination of various methods to represent different electric elements. An example of modeling real microgrid is presented to demonstrate the emergent characteristics of the interconnected system. Simulation results and waveforms are discussed.
Reciprocal interactions between prostaglandin E2- and estradiol-dependent signaling pathways in the injured zebra finch brain

Astrocytic aromatization and consequent increases in estradiol are neuroprotective in the injured brain. In zebra finches, cyclooxygenase-activity is necessary for injury-induced aromatase expression, and increased central estradiol lowers neuroinflammation. The mechanisms underlying these influences are unknown. Here, we document injury-induced, cyclooxygenase-dependent increases in glial aromatase expression and replicate previous work in our lab showing increases in central prostaglandin E2 and estradiol following brain damage. Further, we describe injury-dependent changes in E-prostanoid and estrogen receptor expression and reveal the necessity of E-prostanoid and estrogen receptors in the injury-dependent, reciprocal interactions of neuroinflammatory and neurosteroidogenic pathways. Adult male and female birds were shams or received bilateral injections of the appropriate drug or vehicle into contralateral telencephalic lobes. Injuries sustained in the presence of indomethacin (a cyclooxygenase inhibitor) had fewer aromatase-expressing reactive astrocytes relative to injuries injected with vehicle suggesting that cyclooxygenase activity is necessary for the induction of glial aromatase around the site of damage. Injured hemispheres had higher prostaglandin E2 and estradiol content relative to shams. Importantly, injured hemispheres injected with E-prostanoid- or estrogen receptor-antagonists showed elevated prostaglandin E2 and estradiol, respectively, but lower prostaglandin E2 or estradiol-dependent downstream activity (protein kinase A or phosphoinositide-3-kinase mRNA) suggesting that receptor antagonism did not affect injury-induced prostaglandin E2 or estradiol, but inhibited the effects of these ligands. Antagonism of E-prostanoid receptors 3 or 4 prevented injury-induced increases in neural estradiol in males and females, respectively, albeit this apparent sex-difference needs to be tested more stringently. Further, estrogen receptor-α, but not estrogen receptor-β antagonism, exaggerated neural prostaglandin E2 levels relative to the contralateral lobe in both sexes. These data suggest injury-induced, sex-specific prostaglandin E2-dependent estradiol synthesis, and estrogen receptor-α dependent decreases in neuroinflammation in the vertebrate brain.
Do no-excuses disciplinary practices promote success?

The urban education reform landscape is being transformed by the rapid spread of charter schools. Leading the way is a group of high-performing, no-excuses charter schools, represented by networks ...
Cohabitation, Marijuana Use, and Heavy Alcohol Use in Young Adulthood

Background: Research on the association between cohabitation and substance use has been inconsistent, with some studies indicating an elevated risk among cohabiters and others finding either no dif...
Ground-Penetrating Radar Surveys to Investigate the Roman Colony of Libarna

The Libarna Urban Landscapes Project is using non-invasive techniques to identify buried structures in the Roman city of Libarna, Piedmont, Italy. Ground-penetrating radar (GPR) is being used to supplement areas where drone photography and electrical resistivity measurements are ineffective. GPR has imaged previously unidentified structures in several areas that are likely of Roman origin. These data will be used to develop an excavation plan for future field work.
The Historical and Ecumenical Value of Kenneth Kirk’s Anglican Moral Theology:

Anglican moralist Kenneth Kirk is an early twentieth-century forerunner of Catholic revisionism. Kirk critiques the moral manuals and defends a historicist, biblically grounded virtue ethic forty y...
Home food availability and child intake among rural families identified to be at-risk for health disparities.

Abstract Background Home food environments (HFE) of children impact dietary intake, though relatively few studies have focused on young children from backgrounds with socioeconomic and racial-ethnic diversity. The objective of the present study was to examine the relationship between the HFE and child dietary intake of preschool-aged children from rural and low-income, culturally diverse families. Methods Children (aged 2–5 years) and their primary caregivers (n = 164 parent-child dyads) participated in this study using a cross-sectional design. HFE, including home food availability, accessibility and purchasing, was measured by the Home-IDEA, a checklist instrument completed by parents. Parents also reported child dietary intake using the Block Kids Food Screener (BKFS). Results Home food availability of both healthful and unhealthful foods, including fruits, vegetables, meats, and sugar-sweetened beverages significantly predicted reported child intake of these foods after controlling for demographic, location and weight status. Overall dietary intake recommendations were not met for vegetables, whole grains, protein, and dairy. The accessibility and purchasing frequency of foods was not associated with reported child dietary intake. Conclusions The available HFE showed positive associations with dietary intake for a broad range of foods ranging from healthy and less healthy foods among preschool-aged children from a health disparate population. Recommendations to improve the quality of dietary intake for young children may be facilitated by modifying the HFE by focusing on increasing the availability of healthy foods and diminishing the presence of less healthful options.
Disease-Oriented Regionalization Approach: Quality of Care and Volume Above All

The growing complexity of modern medicine introduces the potential for increasing variation in the delivery of healthcare. For patients with the same disease process, outcomes of treatment may vary considerably due to this variation. For a system looking to optimize quality and consistently deliver high-quality care, developing strategies to minimize this variation is imperative. In this chapter regionalization of complex surgery as a policy measure to optimize postoperative outcomes is discussed as a prototype of this approach. The evidence base for regionalization is presented and analyzed, as well as the pros and cons of implementation of such a policy in the United States.
Dietary Differences Among Sympatric Callitrichinae in Northern Bolivia: Callimico goeldii, Saguinus fuscicollis and S. labiatus

Studies of sympatric species can provide important data to define how dietary and habitat requirements differ among them. I collected dietary data during a first yearlong comparative study of wild groups of Callimico goeldii, Saguinus labiatus and S. fuscicollis. Dietary overlap was highest between Saguinus fuscicollis and Saguinus labiatus throughout the year, and lowest between Saguinus labiatus and Callimico goeldii. All three species had high dietary overlap in February and March when a few abundant fruit species dominated their diets. Although all three species rely heavily on many of the same fruits and arthropods, there are several important distinctions among their diets. Surprisingly, Callimico goeldii consume large quantities of fungus throughout the year: 29% of annual feeding records. Mycophagy is more frequent in the dry season when fruits are scarce. In contrast, Saguinus labiatus rarely eat fungus during the period of fruit scarcity, and instead rely on nectar, a resource never exploited by Callimico goeldii. Saguinus fuscicollis also rely on nectar during periods of low fruit availability and increase their intake of arthropods and exudates. During April, a period of fruit scarcity, exudates comprise >50% of the feeding records of Saguinus fuscicollis. The use of different food resources during fruit scarcity, and differences in the heights at which each species feeds and forages appear to define a distinct ecological niche for each of them and allow them to maintain long-term associations throughout the year. Furthermore, I hypothesize that the limited distribution of Callimico goeldii may result from their restriction to forests that have high disturbance rates, where microhabitats appropriate for fungal growth are abundant, but which also contain abundant fruit and insects.