cssi/SciSciGPT-SciSciNet huggingface dataset:
Open-angle glaucoma and ocular hypertension: the Long Island Glaucoma Case-control Study

This case-control study evaluated risk factors for open-angle glaucoma (OAG) and high intraocular pressure (IOP), including systemic hypertension and its treatment, other systemic factors, familial, and demographic variables. The three study groups were based on masked ophthalmologic gradings of visual fields and fundus photographs, as well as tonometry. The OAG group (n=122) had OAG field defects, IOP > 21 mmHg, and cup-disc ratios > 0.5 and/or evidence of glaucoma disc damage. The ocular hypertensives (n= 108) had no field defects, IOP > 21 mmHg and normal discs. The controls (n= 190) had no field defects, IOP < 21 mmHg and normal discs. The data collection protocol included a standardized interview and measurements. Medical history was confirmed by contacting the primary care physicians (89% response from physicians).Study groups were compared by polychotomous logistic regression analyses. Men were more likely to have OAG and less likely to have ocular hypertension. Systemic hypertension was more frequ...
Focal Adhesion Kinase Is Critical for Entry of Kaposi's Sarcoma-Associated Herpesvirus into Target Cells

Kaposi's sarcoma-associated herpesvirus/human herpesvirus 8 (KSHV/HHV-8) interacts with cell surface alpha3beta1 integrin early during in vitro infection of human endothelial cells and fibroblasts and activates the focal adhesion kinase (FAK) that is immediately downstream in the outside-in signaling pathway by integrins, leading to the activation of several downstream signaling molecules. In this study, using real-time DNA and reverse transcription-PCR assays to measure total internalized viral DNA, viral DNA associated with infected nuclei, and viral gene expression, we examined the stage of infection at which FAK plays the most significant role. Early during KSHV infection, FAK was phosphorylated in FAK-positive Du17 mouse embryonic fibroblasts. The absence of FAK in Du3 (FAK(-/-)) cells resulted in about 70% reduction in the internalization of viral DNA, suggesting that FAK plays a role in KSHV entry. Expression of FAK in Du3 (FAK(-/-)) cells via an adenovirus vector augmented the internalization of viral DNA. Expression of the FAK dominant-negative mutant FAK-related nonkinase (FRNK) in Du17 cells significantly reduced the entry of virus. Virus entry in Du3 cells, albeit in reduced quantity, delivery of viral DNA to the infected cell nuclei, and expression of KSHV genes suggested that in the absence of FAK, another molecule(s) may be partially compensating for FAK function. Infection of Du3 cells induced the phosphorylation of the FAK-related proline-rich tyrosine kinase (Pyk2) molecule, which has been shown to complement some of the functions of FAK. Expression of an autophosphorylation site mutant of Pyk2 in which Y402 is mutated to F (F402 Pyk2) reduced viral entry in Du3 cells, suggesting that Pyk2 facilitates viral entry moderately in the absence of FAK. These results suggest a critical role for KSHV infection-induced FAK in the internalization of viral DNA into target cells.
The Effect of the Northeast Dairy Compact on Producers and Consumers, with Implications of Compact Contagion

We model and measure the effects of the Northeast Dairy Compact on prices, quantities, and producer and consumer welfare, underscoring the distribution of these effects across regions and among producer and buyers. Using 1999 as a base year, simulations show that the Compact raised the farm price of milk in the Northeast by $0.45/cwt., lowered the farm price of milk in the rest of the country by $0.02/cwt., and transferred income from producers outside the Compact region and buyers in the Compact region to producers in the Compact region. Non-Compact producer losses exceeded Compact producer gains. Similar results are found for a scenario of Compact contagion— extension of the Compact to include additional states. In both cases, the Compact changed the distribution of the costs and benefits of price discrimination as practiced by milk marketing orders. The implication is that the regional distribution of the Compact's welfare effects raises again the question of the organization of a government-sponsored milk marketing plan such as the federal milk marketing order system.
Evolution of the ENSO Signal over the Indo–Pacific Domain*

Abstract The evolution of the El Nino–Southern Oscillation (ENSO) in the Indian and western Pacific Oceans is investigated. Observations of sea surface temperature (SST), heat storage in the upper 400 m (HS), zonal surface wind stress (ZSWS), and meridional surface wind stress (MSWS) are mapped monthly onto a 2° latitude–longitude grid over as much of the Indian and western Pacific Oceans (i.e., 40°S–50°N, 40°E–180°) as possible for a 13-year period (1979–91). This grid resolution allows upper-ocean temperature variability to be resolved in the eastern Indian Ocean (i.e., Timor Sea) and the western Pacific Ocean (i.e., Philippine Sea). Time sequences of these variables at each grid node are band-passed filtered to yield the ENSO period scales of 3 to 6 years. Extended empirical orthogonal functions analysis is applied to the filtered time sequences, yielding an animation of the ENSO development in Indian and western Pacific Oceans. For the first modes of the four variables (SST, HS, ZSWS, and MSWS) peak a...
Obesity, Cardiometabolic Risk and Chronic Kidney Disease

Overweight and obesity have been defined by body mass index. Cardiometabolic health is perhaps a more physiologic way of understanding obesity and its complications, which may enable a more comprehensive definition of obesity. The focus of this chapter will be the relationship between metabolically abnormal obese (MAO) patients and the development of chronic kidney disease (CKD) through metaflammation, which is thought to be the consequence of the proposed mechanisms a–f described in Fig. 14.1. These mechanisms include: (a) nutritional free fatty acids (FFA) in chronic excess of nutritional needs, (b) toll-like receptor-4 (TLR-4) activation through Fetuin-A ligand, (c) fatty liver accumulation through a two-hit hypothesis, (d) maladaptation of the gastrointestinal (GI) microbiome, (e) perirenal sinus fat accumulation, and (f) overstimulation of the renin-angiotensin aldosterone system (RAAS) through various mechanisms (Fig. 14.1). Obesity itself, metaflammation, and insulin resistance all have been implicated in the development of proteinuria and eventual CKD. Weight loss is by far the most effective treatment, however, other areas of possible treatments are being investigated including those affecting PPAR-γ receptors, Fetuin-A receptors, and altering the composition of the gastrointestinal microbiome, among others.
Dinaciclib, a Cyclin-Dependent Kinase Inhibitor Promotes Proteasomal Degradation of Mcl-1 and Enhances ABT-737–Mediated Cell Death in Malignant Human Glioma Cell Lines

The prognosis for malignant glioma, the most common brain tumor, is still poor, underscoring the need to develop novel treatment strategies. Because glioma cells commonly exhibit genomic alterations involving genes that regulate cell-cycle control, there is a strong rationale for examining the potential efficacy of strategies to counteract this process. In this study, we examined the antiproliferative effects of the cyclin-dependent kinase inhibitor dinaciclib in malignant human glioma cell lines, with intact, deleted, or mutated p53 or phosphatase and tensin homolog on chromosome 10; intact or deleted or p14ARF or wild-type or amplified epidermal growth factor receptor. Dinaciclib inhibited cell proliferation and induced cell-cycle arrest at the G2/M checkpoint, independent of p53 mutational status. In a standard 72-hour 3-[4,5-dimethylthiazol- 2yl]-5-[3-carboxymethoxyphenyl]-2-[4-sulfophenyl]-2H, tetrazolium (MTS) assay, at clinically relevant concentrations, dose-dependent antiproliferative effects were observed, but cell death was not induced. Moreover, the combination of conventional chemotherapeutic agents and various growth-signaling inhibitors with dinaciclib did not yield synergistic cytotoxicity. In contrast, combination of the Bcl-2/Bcl-xL inhibitors ABT-263 (4-[4-[[2-(4-chlorophenyl)-5,5-dimethylcyclohexen-1-yl]methyl]piperazin-1-yl]-N-[4-[[(2R)-4-morpholin-4-yl-1-phenylsulfanylbutan-2-yl]amino]-3-(trifluoromethylsulfonyl)phenyl]sulfonylbenzamide) or ABT-737 (4-[4-[[2-(4-chlorophenyl)phenyl]methyl]piperazin-1-yl]-N-[4-[[(2R)-4-(dimethylamino)-1-phenylsulfanylbutan-2-yl]amino]-3-nitrophenyl]sulfonylbenzamide) with dinaciclib potentiated the apoptotic response induced by each single drug. The synergistic killing by ABT-737 with dinaciclib led to cell death accompanied by the hallmarks of apoptosis, including an early loss of the mitochondrial transmembrane potential; the release of cytochrome c, smac/DIABLO, and apoptosis-inducing factor; phosphatidylserine exposure on the plasma membrane surface and activation of caspases and poly ADP-ribose polymerase. Mechanistic studies revealed that dinaciclib promoted proteasomal degradation of Mcl-1. These observations may have important clinical implications for the design of experimental treatment protocols for malignant human glioma.
Report from the Certiorari Clinic: Impressions of Routine Capital Cases

The Certiorari Clinic at Northeastern University School of Law provides students the opportunity to do useful work in death penalty cases in an abbreviated time frame (an academic quarter) by focusing on a single step present in virtually every case- the petition to the United States Supreme Court for a grant of certiorari. Over the past decade, students have prepared petitions in more than one hundred capital cases from a dozen different states. This Commentary explains how this enterprise is organized and why it is worthwhile. I also report upon what a decade of wide but shallow exposure to capital cases reveals in terms of the evidence and advocacy necessary to secure a conviction and death sentences. Death cases are consistently, if infrequently, pursued and won on the basis of evidence that should, but apparently does not, create more than a lingering doubt about guilt. When it comes to the evidence necessary for conviction and sentence, death is not different.
New Junction Capacitance Methods for the Study of Defect Distributions and Carrier Properties in the Copper Indium Diselenide Alloys

We have recently been successful utilizing two methods which are new to the study of CIGS thin film samples: drive-level capacitance profiling, and transient photocapacitance spectroscopy. In this paper we review several of the key results that we have obtained by applying these methods to the study of the CIGS alloys over the past 2 years. This has resulted not only in new information concerning the deep defects and their spatial distributions in these materials, but also to more accurate determinations of free carrier densities, and of minority carrier trapping dynamics within the junction region. Light-induced metastable changes in the deep defect properties of these alloys are also documented through the use of these techniques.
Transforming growth factor beta 1 can induce estrogen-independent tumorigenicity of human breast cancer cells in athymic mice.

We have examined the effect of transforming growth factor beta 1 (TGF-beta 1) overexpression in human breast cancer cell tumorigenicity in athymic mice. Estrogen-dependent MCF-7 cells were stably transfected with pSVTGF beta 1. A clone was isolated which overexpressed TGF-beta 1 mRNA and secreted > 10-fold more TGF-beta activity into the tissue culture medium. Similar to the parent line, the MCF-7/TGF-beta 1 cells were relatively insensitive to exogenous TGF-beta 1 and exhibited low levels of TGF-beta receptors. Clonogenicity in soft agarose, doubling time, morphology, and sensitivity to 17 beta-estradiol and the antiestrogen tamoxifen were not altered in the transfected cells. Inoculation s.c. of MCF-7/TGF-beta 1 cells in ovariectomized nude mice resulted in 100% tumor formation which was totally abrogated by i.p. administration of the neutralizing anti-TGF-beta 2G7 IgG2B. The parent cells formed tumors only after estrogen supplementation. By immunohistochemistry, higher levels of TGF-beta 1 protein were detected in MCF-7/TGF-beta 1 tumors than in estrogen-induced parent MCF-7 tumors. Administration of 1 microgram TGF-beta 1 i.p. daily for 3 weeks after tumor cell inoculation transiently supported estrogen-independent growth of parent MCF-7 tumors in castrated nude mice. These data indicate that overexpression of TGF-beta 1 in human breast cancer cells can contribute to their escape from hormone dependence.
Respiratory modulation of sympathetic activity in neonatal swine.

Spontaneous efferent sympathetic activity (cervical sympathetic and splanchnic nerves) was recorded simultaneously with efferent phrenic discharge, with aortic pressure, and with the electrocardiogram in less than 1- to 51-day-old neonatal swine anesthetized with Saffan (alfaxalone). Power spectral analyses of sympathetic discharge revealed a frequency range of 4-36 Hz, with peaks distributed in four regions of the spectrum (4-6 Hz, 8-15 Hz, 16-22 Hz, and 28-36 Hz). Inspiratory modulation was readily apparent since sympathetic power spectral energy was greatest during the time of phrenic activity. Alterations in pulmonary afferent inputs (e.g., lung inflation tests and/or vagotomy) altered both phrenic and sympathetic activity. Use of the respiratory-cardiac modulation ratio indicated that respiratory modulation of sympathetic activity was greater than cardiac modulation. Complex afferent inputs, i.e., fictive Valsalva maneuver, indicated an immaturity of integration within the cardiovascular regulatory system. The adult patterns of blood pressure changes and heart rate responses were delayed until approximately 1 mo of age. Calculations of Valsalva ratios (ratio of maximal R-R interval to minimal R-R interval) indicated delayed onset of heart rate responses, reflecting the maturation of cardiovascular reflexes during the neonatal period.
Abstract W P111: Early At1 Blockade Ameliorates Ischemia/reperfusion Injury By Pi3k/akt And Enos Pathways: In Vivo And In Vitro Evidence

Background & Objective: We have recently shown a robust protection with Angiotensin (Ang) II type 1 receptor blockers (ARBs) against cerebral ischemia/reperfusion (I/R) injury. However, the mechanisms by which ARBs protect against I/R injury are still unclear. We tested the hypothesis that the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) pathway mediates some of the protective effects of ARBs after I/R injury. Methods: Male Wistar rats (280-300 g) underwent transient middle cerebral artery occlusion (MCAO) for 90min followed by reperfusion and received intravenous injection of candesartan (1 mg/kg) or vehicle at the time of reperfusion. Additional four groups of candesartan were injected intracerebroventricularly with PI3K/Akt, MEK and p38MAPK inhibitors at 15 min before MCAO. Rats were sacrificed at 24h post-MCAO and brains perfused for evaluation of neurological deficits, infarct size, and protein expression. Oxygen and glucose deprivation/reoxygenation (OGD/R) was used to mimic ischemic insult in hippocampal neuronal cells (HT22). Results (Table): Candesartan reduced infarct size and improved neurobehavioral outcomes in rats subjected to I/R. Candesartan alone increased phosphorylated eNOS, Akt and VEGF expression after I/R injury. Moreover, blockade of PI3K but not MEK or p28MAPK activity, compromised candesartan-induced protection. These findings provided the first evidence that candesartan improves eNOS phosphorylation in response to the activated PI3K/Akt signaling. In vitro studies further confirmed that candesartan protects against OGD/R-induced neuronal death through PI3K/Akt signaling stimulation in HT-22 cells. Conclusions: Our findings lead us to suggest that the PI3K/Akt pathway can play a role in mediating the protective effects of candesartan and provide therapeutic avenues for the treatment of stroke.
Vaccinations in asplenic adults

Purpose The recommended immunizations for adult asplenic patients are reviewed. Summary Patients without a spleen are at risk of developing overwhelming postsplenectomy infections due to encapsulated organisms, mainly pneumococcal, meningococcal, and Haemophilus influenzae type b (Hib). Due to the high mortality rates associated with these infections, vaccinations are recommended as a preventive measure. It is challenging to ensure optimal immunizations in these high-risk patients due to the number of recommended vaccines, the availability of multiple formulations, and the inability to administer specific formulations at the same time, as well as differences in subsequent vaccine administration schedules. Pharmacists play a key role in recommending specific vaccines and timing for these patients in order to achieve the most robust immune response. This article reviews the specific recommendations for pneumococcal, meningococcal, Hib, and influenza vaccinations in asplenic patients. Conclusion In order to prevent potentially life-threatening infections, asplenic individuals should be vaccinated against S. pneumoniae , N. meningitidis , Hib, and influenza. The optimal timing of vaccination in relation to splenectomy depends on the nature of the splenectomy.
Administration of estrogen by different delivery routes in frozen-thawed embryo transfer

Objective:To compare the influence of different delivery routes of estrogen therapy in the frozenthawed embryo transfer(FET).Methods:A total of 244 patients underwent hormone replacement treatment for FET were divided to two groups:120 patients used 17beta-estrogen(Estradiol gel)by transdermal route in the transdermal group and 124 patients used oral route of estrogen(Estradiol valerate tablet,Progynova)in the oral group.Results:There was no statistical difference in the mean endometrial thickness(P=0.63)between the two groups.Comparing with oral group,the estradiol levels were significantly higher(P=0.04)and drug consumption was significantly lower(P=0.03)in transdermal group.The period cancellation rate of the transdermal group was significantly lower(P=0.02).The biochemical pregnancy rate and clinical pregnancy rate were higher,abortion rate was lower in transdermal group,but there were no statistical difference(P=0.90,0.54,0.16 respectively).Conclusions:The transdermal route is an effective method for the patients using hormone replace treatment in FET.
Targeting Trauma-Induced Blood Brain Barrier Disruption: an Innovative Approach for Treating Concussion

1.7 million concussions occur each year in the United States. Repetitive concussions have been linked to chronic neurodegenerative changes in athletes and soldiers several years after injury. How t...
Hunting Behavior, Prey Selection, and Energetics of Snail Kites in Guyana: Consumer Choice by a Specialist

The hunting behavior, snail size selection, and time-activity patterns of non- breeding Snail Kites (Rostrhamus sociabilis sociabilis) were studied in Guyana rice fields. Kites spent 62% of the photoperiod perching, 19% foraging, 13% in maintenance activities, and 6% flying. As the day progressed, the percentage of daylight hours spent perching increased significantly, while foraging decreased significantly. Kites successfully captured and in- gested Pomaeea snails in 78% of the foraging bouts observed. The mode of hunting was evenly split between coursing (50.7%) and still-hunting (49.3%). Searching and returning times were related to time of day, as significantly more coursing hunts and still-hunts occurred in mornings and late afternoons, respectively. Prey handling time was the most time-consuming component of a foraging bout. Time spent searching for prey, returning, or handling prey was not related to snail size. The size distribution of captured snails differed significantly from that of available snails; kites selected more medium snails and fewer small snails and took large snails in equal frequency to that at which large snails were available. Kites captured the same-sized snails when coursing as when still-hunting. As rice grew, kite utilization of rice fields declined, and the frequency of still-hunting decreased while course-hunting attempts increased. The daily caloric intake of kites was estimated to be 104.2 kcal, the daily energy expenditure 85.7 kcal. Results are discussed in relation to consumer choices of specialists. The most important decision a foraging Snail Kite may make is what patch to search in and how long to search before abandoning patches. Received 14 January 1982, accepted 28 June 1982. LITTLE is known about the hunting behavior and foraging ecology of the Snail Kite (Rost- rhamus sociabilis). Long recognized as an ex- treme diet specialist, the Snail Kite feeds almost exclusively on Pomacea snails (Haver- schmidt 1962, Snyder and Snyder 1969, Voous and van Dijk 1973; for exceptions see Sykes and Kale 1974, Beissinger in prep.). A kite captures a snail by flying over a marsh, extending a foot, and grabbing the mollusc with long toes near the water surface. It then perches in order to extract the body from the shell with its thin, sharply hooked bill. Two modes of hunting have been observed (Snyder and Snyder 1969, Haverschmidt 1970): "still-hunting" kites vi- sually search from a perch and capture a snail near that perch after a short flight; "course- hunting" kites fly 3-5 m above a marsh, usu- ally facing into the wind, visually searching until a capture occurs. Snyder and Snyder (1969) and Voous and van Dijk (1973) described in
Role of ryanodine receptor channels in Ca2+ oscillations of porcine tracheal smooth muscle

Acetylcholine (ACh) induces repetitive, propagating intracellular Ca2+ concentration ([Ca2+]i) oscillations in porcine tracheal smooth muscle (TSM) cells. Using real-time confocal microscopy, we examined the role of sarcoplasmic reticulum (SR) Ca2+ release through inositol 1,4,5-trisphosphate (IP3) receptor and ryanodine receptor (RyR) channels in ACh-induced [Ca2+]i oscillations. In beta-escin permeabilized TSM cells, exposure to ACh in the presence of GTP also resulted in [Ca2+]i oscillations. [Ca2+]i oscillations could not be initiated by IP3 alone; however, an elevation of [Ca2+]i was observed. During ongoing [Ca2+]i oscillations, exposure to heparin, an IP3 receptor antagonist, caused a slowing of oscillation frequency but not complete inhibition. In contrast, ruthenium red, a RyR antagonist, completely abolished ACh-induced [Ca2+]i oscillations. Reverse transcriptase-polymerase chain reaction of TSM mRNA demonstrated the expression of RyR-2 and RyR-3 isoforms of the RyR. These results indicate that SR Ca2+ release through RyR channels is critical for ACh-induced [Ca2+]i oscillations in porcine TSM cells.
Beyond bedside manner.

Intuitive bedside manner is not always enough in dealing with physically ill patients who also present behavioral problems. These patients are better managed by organized, objective appraisal of the behavior and factors influencing it, such as the patient's personality pattern and characteristic reaction to crisis, the physician's approach, and the influence of social systems. Behavior that appears antitherapeutic can have an entirely different significance when seen as part of a relationship.
Outcomes of Bowel Resection in Patients With Crohn's Disease

There is limited data regarding outcomes of bowel resection in patients with Crohn's disease. We sought to investigate complications of such patients after bowel resection. The Nationwide Inpatient Sample databases were used to examine the clinical data of Crohn's patients who underwent bowel resection during 2002 to 2012. Multivariate regression analysis was performed to investigate outcomes of such patients. We sampled a total of 443,950 patients admitted with the diagnosis of Crohn's disease. Of these, 20.5 per cent had bowel resection. Among patients who had bowel resection, 51 per cent had small bowel Crohn's disease, 19.4 per cent had large bowel Crohn's disease, and 29.6 per cent had both large and small bowel Crohn's disease. Patients with large bowel disease had higher mortality risk compared with small bowel disease [1.8% vs 1%, adjusted odds ratio (AOR): 2.42, P < 0.01]. Risks of postoperative renal failure (AOR: 1.56, P < 0.01) and respiratory failure (AOR: 1.77, P < 0.01) were higher in colonic disease compared with small bowel disease but postoperative enteric fistula was significantly higher in patients with small bowel Crohn's disease (AOR: 1.90, P < 0.01). Of the patients admitted with the diagnosis of Crohn's disease, 20.5 per cent underwent bowel resection during 2002 to 2012. Although colonic disease has a higher mortality risk, small bowel disease has a higher risk of postoperative fistula.
Prenatal PCB Exposure and Cognitive Dysfunction

The neuropsychological effects of in utero exposure to PCBs and their related compounds were evaluated in 27 ‘Yu-Cheng’ (‘oil disease’) children (ages 7 to 12 years) at the Departments of Pediatrics and Psychiatry, National Cheng Kung University, Tainan, Taiwan.
The Constitutionality of Russia's 'Undesirable' NGO Law

In recent years, Russian lawmakers have expressed heightened concern about the activities of foreign non-governmental organizations (“NGOs”) operating within their country. Russian officials view these NGOs as a potential source of foreign interference in Russian internal affairs. They have responded to this perceived threat with a series of laws that increasingly hinder the work of international NGOs. The most recent anti-NGO law, passed in May 2015, takes the most aggressive steps yet. This law (the “Undesirable NGO Law”) allows Russia’s Prosecutor General to declare certain organizations “undesirable.” Such a label can be issued with minimal process and effectively constitutes a death sentence for foreign NGOs — many of which seek to protect human rights in Russia. Affected organizations include the National Endowment for Democracy, the MacArthur Foundation, and the Committee Against Torture.The Undesirable NGO Law provoked immediate criticism from both Russian civil society dissidents and international observers. Critics were quick to question the law’s constitutionality but failed to construct a thorough legal argument. This Article attempts to fill that gap with the first comprehensive constitutional analysis of the Undesirable NGO Law.The Article addresses threshold considerations related to constitutional supremacy and the authority of the Constitutional Court in Russia — both of which are relevant to resolving conflicts between the Undesirable NGO Law and the Russian Constitution. Next, the Article identifies and discusses key issues raised by the Undesirable NGO Law, including tension with Russian constitutional provisions for separation of powers, protection of civil rights, and the right to judicial appeal. The Article also assesses conflicts with Russian treaties and incorporated international law.Notwithstanding the multiplicity of constitutional questions raised by the Undesirable NGO Law, the Article concludes that the law will likely withstand legal scrutiny. Ingrained cultural and institutional challenges to comprehensive protection of civil rights in Russia operate as seemingly insurmountable barriers to realistic opposition. Nonetheless, the Article posits that simply considering the constitutional problems with the Undesirable NGO Law is a crucial way to continue the conversation and appeal to the sympathy and reason of the Russian people.
Maxillomandibular Advancement Surgery for Patients Who Are Refractory to Continuous Positive Airway Pressure: Are There Predictors of Success?

Purpose This pilot study was conducted to determine the effectiveness of maxillomandibular advancement (MMA) in the treatment of patients with moderate to severe obstructive sleep apnea (OSA). The predictive value of clinical, radiographic, and treatment-related variables also was investigated in relation to the success or failure of MMA as treatment for OSA. Materials and Methods A retrospective study design was used to assess the outcomes of MMA in patients with moderate to severe OSA (apnea hypopnea index [AHI] >15 events per hour) at the University of Michigan (Ann Arbor, MI). Data collected included clinical, radiographic, and polysomnographic findings. Primary outcomes of interest included the AHI, minimal oxygen saturation, and percentage of time spent with oxygen saturation lower than 88% as measured by polysomnography. Results Twenty patients met the inclusion criteria for the study (mean age, 48.8 ± 12.3 yr). Mean body mass index decreased from 32.03 ± 5.13 kg/m2 at baseline to 29.75 ± 5.23 kg/m2 at follow-up (P = .001). Mean advancements were 13.5 ± 2.7 mm at point B and 16.1 ± 4.5 mm at the pogonion. A 4.5-fold increase in minimal cross-sectional area and a 2.2-fold increase in airway volume were achieved on average. Patients showed a 68.5% decrease in mean AHI from 49.4 to 15.6 events per hour (P Conclusions These preliminary results indicate that MMA surgery might be highly effective for select patients with moderate to severe OSA. Despite large increases in airway dimensions, a surgical success rate of 55% was achieved in the overall sample. Assessment of predictive variables for success and failure are discussed.
An evaluation of the reconstructed coefficient of determination and potential adjustments

Previously, a method was proposed for calculating a reconstructed coefficient of determination in the case of right-censored regression using the expectation–maximization (EM) algorithm. This measu...
Side-necked Versus Hidden-necked: A Comparison of Shell Morphology Between Pleurodiran and Cryptodiran Turtles

Abstract: This study explores the potential morphological differences between pleurodiran and cryptodiran turtle shells. Pleurodires (Suborder Pleurodira), as suggested by their name, retract their heads into the shell by bending the neck to the side; this is different from cryptodires (Suborder Cryptodira), which withdraw their necks along a sagittal plane. Pleurodires also have evolved a unique pelvic morphology typified by two columnar pelvic elements sutured to both the carapace and plastron; in contrast, the pelvic girdle in cryptodires is loosely connected to the shell. These differences might put very different selective pressures on shell shape in these animals: The different head retraction strategies in the two groups could lead pleurodires to evolve wider and flatter anterior apertures while the differences in pelvic structure might permit the evolution of flatter carapaces (particularly in the posterior carapace) and narrower bridges as compared to cryptodires. We used 3D landmark data to char...
Clinical Stroke Diagnosis

Abstract Clinicians must first decide on the key questions to be asked. Answers are difficult unless the questions are clearly framed. In neurology, two diagnostic questions always require an answer: (1) what is the disease mechanism—the pathology and pathophysiology? and (2) where is the lesion(s)—the anatomy of the disorder? In stroke patients, the “what” question concerns which of the five stroke mechanisms (hemorrhage—subarachnoid or intracerebral; ischemia—thrombotic, embolic, or decreased global perfusion) is present. Before distinguishing among stroke mechanisms, clinicians should first ask whether the findings could be caused by a nonvascular process, such as a brain tumor, metabolic abnormality, infection, intoxication, seizure disorder, or traumatic injury that mimics stroke. The where question concerns the anatomic location of the condition, in the brain and in the vascular system that supplies and drains the brain.
Does paid sick leave affect the unmeasured costs of colorectal cancer treatment

6590 Background: For working patients, the financial impact of colorectal cancer (CRC) diagnosis and treatment can be substantial. Unmeasured costs can include unpaid time away from work and job lo...
The Effect of Temperature on Cyclic Fatigue of Nickel-titanium Rotary Endodontic Instruments.

Abstract Introduction This study examined the effect of different temperatures on the cyclic fatigue of nickel-titanium rotary files. Methods Three groups of nickel-titanium rotary files (EF group [EdgeFile; EdgeEndo, Albuquerque, NM], VB group [Vortex Blue; Dentsply Tulsa Dental Specialties, Tulsa, OK], and ESX group [ESX; Brasseler USA, Savannah, GA]) of size 25 with a .04 taper and 25-mm length were tested in a metal block that simulated a canal curvature of 60° and a 5-mm radius curvature. The block was submerged in a water bath filled with water at 3°C, 22°C, 37°C, and 60°C. At each temperature, 30 files from each group were rotated at 500 rpm in the block. The number of cycles to fracture (NCF) was calculated. Statistical analysis was completed using a 1-way analysis of variance with significance at P Results VB group showed a significant decrease in NCF as the temperature increased from 3°C to 60°C. The ESX group showed a significant decrease in NCF as the temperature increased from 3°C to 37°C. The EF group showed a significant increase in NCF from 3°C to 22°C and a significant decrease in NCF from 22°C to 37°C. For each temperature, the EF group showed higher NCF than the VB group, which showed higher NCF than the ESX group. Conclusions In this in vitro study, temperature was found to significantly affect the cyclic fatigue of nickel-titanium rotary files. At each tested temperature, NCF was the highest for the EF group followed by the VB group and lowest for the ESX group. Future cyclic fatigue studies should be conducted at body temperature.
Nationalism among Christian Palestinians

Prominent among the nationalist movements of this century is that of the Palestinians. Long denied their own state, the Palestinians continue their quest for independence. The state of Israel, in an effort to thwart the creation of a Palestinian state, has consistently sought to divide the Palestinian people along religious lines. This, along with a general misunderstanding of what constitutes a Palestinian means, that Christian Arabs from Palestine are often perceived as not being Palestinian. The focus of this paper is to place Christian Palestinians within the Palestinian nation by identifying common characteristics of language, culture, love of land, and identity; and then to place Christian Palestinians within the nationalist movement through examples of their participation in such activities as press editorship, protest, and even martyrdom during the intifada, and their assumption of leadership roles in nationalist organizations and government. Finally, it will illustrate how Christian Palestinians,...
Effects of early postpartum sodium salicylate treatment on long-term milk, intake, and blood parameters of dairy cows

Previous research has shown that cows who receive treatment with nonsteroidal anti-inflammatory drugs after calving may have increased milk yield beginning near peak lactation, resulting in greater 305-d milk production. It has not been demonstrated whether this response is associated with greater feed intake following the first 3 wk of lactation. Dry matter intake (DMI) and milk yield were measured daily for 56 cows over the first 120 d in milk. Cows in their second parity and greater were blocked by parity and alternately enrolled 12 to 36 h after calving into 1 of 2 treatments: either 3 daily drenches of water or 3 daily drenches of a similar volume of water containing 125 g of sodium salicylate (SAL) beginning 12 to 36 h after calving. Cows were housed in individual stalls to monitor DMI. Blood samples were collected before calving and on the last day of treatment, as well as at 7, 11, 14, 18, 21, 35, 49, 63, 77, 91, 105, and 120 d in milk. The SAL treatment did not affect estimated 305-d milk, fat, or protein yields (from monthly test days), daily milk yield or components, energy-corrected milk, fat-corrected milk, or DMI; however, an interaction between parity and treatment was observed for DMI, where second-parity SAL cows had decreased intake with no differences observed in older cows. This resulted in a parity by treatment interaction for the ratio of energy-corrected milk to DMI. Similarly, no main effects of treatment were observed for plasma glucose, β-hydroxybutyrate (BHB), or fatty acid concentrations, but we noted interactions between treatment and parity for glucose, BHB, and insulin. Older cows had greater plasma glucose and insulin concentrations and decreased plasma BHB following SAL but no differences were observed in second parity animals. Alterations in glucose and insulin resulted in a tendency for a treatment by time interaction for the revised quantitative insulin sensitivity check index. Feeding behavior was also altered following SAL administration, resulting in fewer but longer meals, as well as a tendency for greater meal weight. A tendency for a treatment by week interaction for inter-meal interval was observed, as well as a parity by treatment interaction for meal weight. Despite the lack of a milk yield response, SAL had a prolonged programming effect on feeding behavior and blood variables over the first 120 DIM, with responses largely dependent on parity.
Sources of Power and Agency

This chapter pays attention to the factors that contribute to a sense of power and agency among Muslim women in Chandhara. While describing the sources of power and agency, most of the informants, took the authority of men as granted. Women described their sources of power and agency within the sphere of men’s authority, to which they remain obedient because they believe that it is their moral obligation to uphold the traditions of their community. According to the informants, women’s source of power and agency differs from that of men’s. There are some moral virtues that are particularly applicable to women, such as patience (sabr), shyness (sharam), and modesty (haya). This chapter also analyzes how the narratives of the informants vary due to their age, education, class, social standing, marital status, and gender.
Adherence to Endotracheal Tube Depth Guidelines and Incidence of Malposition in Infants and Children.

BACKGROUND: Adherence to guidelines for endotracheal tube (ETT) insertion depth may not be sufficient to prevent malposition or harm to the patient. To obtain an estimate of ETT malpositioning, we evaluated initial postintubation chest radiographs and hypothesized that many ETTs in multiple intubation settings would be malpositioned despite adherence to Pediatric Advanced Life Support and Neonatal Resuscitation Program guidelines. METHODS: In a random subset (randomization table) of 2,000 initial chest radiographs obtained from January 1, 2009, to May 5, 2012, we recorded height, weight, age, sex, ETT inner diameter, and cm marking at the lip from the electronic health record. Chest radiographs of poor quality and with spinal or skeletal deformities were excluded. We defined adherence to Pediatric Advanced Life Support or Neonatal Resuscitation Program guidelines as the difference between predicted and actual ETT markings at the lip as ± 0.25, ± 0.50, or ± 1.0 cm for ETTs of 2.5–4, 4.5–6.0, or >6.5 mm inner diameter, respectively. We defined the proper position as the ETT tip being below the thoracic inlet (superior border of the clavicular heads) and ≥1 cm above the carina. Descriptive statistics reported demographics, guideline adherence, and malposition incidence. The chi-square test was used to assess relationships among intubation setting, malposition, and depth guideline adherence (P RESULTS: We reviewed 507 records, 477 of which met inclusion criteria and had sufficient data for analysis. Fifty-six percent of the subjects were male, with median (interquartile range) age 15.2 (3.4–59.4) months, and 330 ETTs (69%) were malpositioned: 39 above the thoracic inlet, and 291 CONCLUSIONS: In infants and children, a high proportion of ETTs were malpositioned on the first postintubation chest radiograph, with little influence of guideline adherence.
Efficient CO2 Electroreduction by Highly Dense and Active Pyridinic Nitrogen on Holey Carbon Layers with Fluorine Engineering

Electrocatalytic CO2 reduction by metal-free nitrogen-doped carbon (N-C) catalysts provides a solution for CO2 reuse; however, it suffers a large overpotential and poor selectivity due to the low intrinsic reactivity of N dopants. Herein, we report the promotion of CO2 reduction on N-C through the integration of increasing the numbers and inherent catalytic reactivity and selectivity of pyridinic N dopants. A novel sacrificial soft-templating approach was developed to construct a two-dimensional holey carbon nanostructure to preferentially host dense edge-located pyridinic N, and electron-rich fluorine (F) was simultaneously incorporated to activate pyridinic N sites by engineering their electronic properties. Consequently, the resultant N,F-codoped holey carbon layers achieve a CO Faradaic efficiency of 90% at a low overpotential of 490 mV for 40 h without decay, significantly surpassing the F-free N-C counterpart. Density functional theory (DFT) calculations reveal that the electron donation from a near...
5-Year Results of a Prospective Phase 2 Trial Evaluating 3-Week Hypofractionated Whole Breast Radiation Therapy Inclusive of a Sequential Boost.

Purpose To report 5-year outcomes of a phase 2 trial of hypofractionated whole breast irradiation (HF-WBI) completed in 3 weeks, inclusive of a sequential boost. Methods and Materials Women with stage 0-IIIA breast cancer (ductal carcinoma in situ through T2N2a) were enrolled on a prospective, phase 2 trial of accelerated HF-WBI. We delivered a whole breast dose of 36.63 Gy in 11 fractions of 3.33 Gy, with an equivalent dose to the regional nodes when indicated, followed by a tumor bed boost of 13.32 Gy in 4 fractions of 3.33 Gy over a total of 15 treatment days. The primary endpoint was locoregional control; secondary endpoints included acute/late toxicity and physician-assessed and patient-reported breast cosmesis. Results Between 2009 and 2017, we enrolled 150 patients, of whom 146 received the protocol treatment. Median age was 54 years (range, 33-82) and median follow-up was 62 months. Patients with higher-risk disease comprised 59% of the cohort, including features such as young age (33% ≤50 years), positive nodes (13%), triple-negative disease (11%), and treatment with regional nodal irradiation (11%) and/or neoadjuvant/adjuvant chemotherapy (36%). Five-year estimated locoregional and distant control were 97.7% (95% confidence interval [CI], 93.0%-99.3%) and 97.9% (95% CI, 93.6%-99.3%), respectively. Five-year breast cancer–specific and overall survival were 99.2% (95% CI, 94.6%-99.9%) and 97.3% (95% CI, 91.9%-99.1%), respectively. Acute/late grade 2 and 3 toxicities were observed in 30%/10% and 1%/3% of patients, respectively. There were no grade 4 or 5 toxicities. Physicians assessed breast cosmesis as good or excellent in 95% of patients; 85% of patients self-reported slight to no difference between the treated and untreated breast. Conclusions Our phase 2 trial offers one of the shortest courses of HF-WBI; at 5 years of follow-up there continues to be excellent locoregional control and low toxicity with favorable cosmetic outcomes in a heterogeneous cohort of patients.
Investigating Ammonium By-product Removal for Ureolytic Bio-cementation Using Meter-scale Experiments.

Microbially Induced Calcite Precipitation (MICP), or bio-cementation, is a promising bio-mediated technology that can improve the engineering properties of soils through the precipitation of calcium carbonate. Despite significant advances in the technology, concerns regarding the fate of produced NH4+ by-products have remained largely unaddressed. In this study, five 3.7-meter long soil columns each containing one of three different soils were improved using ureolytic bio-cementation, and post-treatment NH4+ by-product removal was investigated during the application of 525 L of a high pH and high ionic strength rinse solution. During rinsing, reductions in aqueous NH4+ were observed in all columns from initial concentrations between ≈100 mM to 500 mM to final values between ≈0.3 mM and 20 mM with higher NH4+ concentrations observed at distances furthest from the injection well. In addition, soil Vs measurements completed during rinse injections suggested that no significant changes in cementation integrity occurred during NH4+ removal. After rinsing and a 12 hour stop flow period, all column solutions achieved cumulative NH4+ removals exceeding 97.9%. Soil samples collected following rinsing, however, contained significant sorbed NH4+ masses that appeared to have a near linear relationship with surrounding aqueous NH4+ concentrations. While these results suggest that NH4+ can be successfully removed from bio-cemented soils, acceptable limits for NH4+ aqueous concentrations and sorbed NH4+ masses will likely be governed by site-specific requirements and may require further investigation and refinement of the developed techniques.
Carfilzomib for Heart Transplant Desensitization

Purpose Allosensitization in heart transplant (HT) candidates is associated with longer transplant wait times and post-transplant complications. We summarize our experience with desensitization using carfilzomib (CFZ), an irreversible proteasome inhibitor that causes plasma cell apoptosis. Methods One cycle of desensitization consisted of plasmapheresis and CFZ 20mg/m2 on days 1, 2, 8, 9, 15, and 16 with intravenous immune globulin 2g/kg after CFZ on day 16. Patients underwent repeat cycles as indicated. We summarize treatment impact by depicting calculated PRA (cPRA) for neat combined Class I and II IgG and C1q pre- and post-treatment using a cutoff for cPRA entry of ≥ 4000 and 500 MFI, respectively. We fit a linear mixed model to evaluate treatment effect. Results From June 2013 to October 2019, 9 patients underwent 20 cycles of CFZ with 6 requiring multiple cycles. Each cycle of CFZ resulted in an average cPRA decrease of 33% (95% CI: 16-50) for combined IgG and 36% (95% CI: 17-55) for C1q. An example is shown in Figure 1. From treatment start to finish, mean cPRA fell from 76% to 35% (p=0.005) for combined IgG and 56% to 4% (p=0.017) for C1q (Table 1). Six of 9 patients have been transplanted with 5 of the transplanted hearts crossing historical antibodies. HT survival at 1 year was 100%. Patient 6 has not been transplanted due to obesity. Patients 3 and 4 only received 4 doses of CFZ due to acute kidney injury, which resolved. Neutropenia, thrombocytopenia, neuropathy, and hepatotoxicity did not occur. Conclusion CFZ, as part of a desensitization regimen, appears to be safe and effective in sensitized patients awaiting HT. The number of cycles may depend on the HLA antibody titer prior to treatment.