cssi/SciSciGPT-SciSciNet huggingface dataset:
Perineural Dexamethasone to Improve Postoperative Analgesia with Peripheral Nerve Blocks: A Meta-Analysis of Randomized Controlled Trials

Background. The overall effect of perineural dexamethasone on postoperative analgesia outcomes has yet to be quantified. The main objective of this quantitative review was to evaluate the effect of perineural dexamethasone as a nerve block adjunct on postoperative analgesia outcomes. Methods. A systematic search was performed to identify randomized controlled trials that evaluated the effects of perineural dexamethasone as a block adjunct on postoperative pain outcomes in patients receiving regional anesthesia. Meta-analysis was performed using a random-effect model. Results. Nine randomized trials with 760 subjects were included. The weighted mean difference (99% CI) of the combined effects favored perineural dexamethasone over control for analgesia duration, 473 (264 to 682) minutes, and motor block duration, 500 (154 to 846) minutes. Postoperative opioid consumption was also reduced in the perineural dexamethasone group compared to control, −8.5 (−12.3 to −4.6) mg of IV morphine equivalents. No significant neurological symptoms could have been attributed to the use of perineural dexamethasone. Conclusions. Perineural dexamethasone improves postoperative pain outcomes when given as an adjunct to brachial plexus blocks. There were no reports of persistent nerve injury attributed to perineural administration of the drug.
Ligand modifications to reduce the relative resistance of multi-drug resistant HIV-1 protease.

Proper proteolytic processing of the HIV-1 Gag/Pol polyprotein is required for HIV infection and viral replication. This feature has made HIV-1 protease an attractive target for antiretroviral drug design for the treatment of HIV-1 infected patients. To examine the role of the P1 and P1 0 positions of the substrate in inhibitory efficacy of multi-drug resistant HIV-1 protease 769 (MDR 769), we performed a series of structure–function studies. Using the original CA/p2 cleavage site sequence, we generated heptapeptides containing one reduced peptide bond with an L to F and A to F double mutation at P1 and P1 0 (F-r-F), and an A to F at P1 0 (L-r-F) resulting in P1/P1 0 modified ligands. Here, we present an analysis of co-crystal structures of CA/p2 F-r-F, and CA/p2 L-r-F in complex with MDR 769. To examine conformational changes in the complex structure, molecular dynamic (MD) simulations were performed with MDR769–ligand complexes. MD trajectories show the isobutyl group of both the lopinavir analog and the CA/p2 L-r-F substrate cause a conformational change of in the active site of MDR 769. IC50 measurements suggest the non identical P1/P1 0 ligands (CA/p2 L-r-F and lopinavir analog) are more effective against MDR proteases as opposed to identical P1/P1 0ligands. Our results suggest that a non identical P1/P10composition may be more favorable for the inhibition of MDR 769 as they induce conformational changes in the active site of the enzyme resulting in disruption of the two-fold symmetry of the protease, thus, stabilizing the inhibitor in the active site.
Efficacy and safety of a popular thermogenic drink after 28 days of ingestion

We have recently demonstrated that consuming a thermogenic drink (TD) acutely increases energy expenditure and serum markers of lipolysis in healthy, college-aged individuals. The purpose of this study was to determine if consuming TD over 28 days affects its acute thermogenic and lipolytic effects as well as body composition and clinical chemistry safety markers. Sixty healthy, males (mean ± SE; 23 ± 1 years, 177 ± 2 cm, 81.7 ± 2.1 kg, 22.8 ± 1.4% body fat; n = 30) and females (23 ± 1 years, 166 ± 2 cm, 62.1 ± 1.8 kg, 28.3 ± 1.4% body fat; n = 30) reported to the laboratory on day 0 (T1) for determination of body composition, resting energy expenditure (REE) as well as glycerol and free fatty acid (FFA) levels before and after ingesting either 336 ml of TD or a non-caloric, non-caffeinated placebo (PLA) drink. Following day 0, participants supplemented daily with 336 ml·day-1 of either TD or PLA and repeated identical testing procedures on day 28 (T2). Day 28 area under the curve (AUC) values were calculated for REE, FFA, and glycerol. Day 28 acute data and prolonged AUC comparisons between groups were analyzed using ANOVAs with repeated measures. Percent body fat (p = 0.02) and fat mass (p = 0.01) decreased in the TD group compared to the PLA group after 28 days. Day 28 FFA AUC values (p = 0.048) were greater in the TD group compared to the PLA group. There was no significant difference in day 28 REE AUC values (p = 0.30) or glycerol AUC values (p = 0.21), although a significant increase in REE values in the PLA group may have confounded these findings. There were no differences between groups concerning blood and clinical safety markers. Within-group elevations in FFA and REE values in the TD group were still evident following a 28-day supplementation period which may contribute to the observed decrements in %BF. Further, prolonged TD supplementation did not alter the assessed clinical safety markers. Future studies should examine the synergistic and independent effects of the active ingredients in addition to effects of longer ingestion periods of TD ingestion with or without exercise at promoting and sustaining changes in body composition.
An inhibitor of K+ channels modulates human endometrial tumor-initiating cells

Background Many potassium ion (K+) channels function as oncogenes to sustain growth of solid tumors, but their role in cancer progression is not well understood. Emerging evidence suggests that the early progenitor cancer cell subpopulation, termed tumor initiating cells (TIC), are critical to cancer progression.
Metabolic and genomic analysis elucidates strain-level variation in Microbacterium spp. isolated from chromate contaminated sediment

Hexavalent chromium [Cr(VI)] is a soluble carcinogen that has caused widespread contamination of soil and water in many industrial nations. Bacteria have the potential to aid remediation as certain strains can catalyze the reduction of Cr(VI) to insoluble and less toxic Cr(III). Here, we examine Cr(VI) reducing Microbacterium spp. (Cr-K1W, Cr-K20, Cr-K29, and Cr-K32) isolated from contaminated sediment (Seymore, Indiana) and show varying chromate responses despite the isolates' phylogenetic similarity (i.e., identical 16S rRNA gene sequences). Detailed analysis identified differences based on genomic metabolic potential, growth and general metabolic capabilities, and capacity to resist and reduce Cr(VI). Taken together, the discrepancies between the isolates demonstrate the complexity inter-strain variation can have on microbial physiology and related biogeochemical processes.
Foreword: Hand Management in Physical Therapy

In recent years, physical therapists have recognized that with their background in basic science and exercise, they can contribute to the management of hand problems. This awareness has led to an effort both by occupational therapists and by physical therapists to form a combined specialty area in hand rehabilitation. Subsequently, hand centers have been created for the specialized care of patients with hand and upper extremity problems. Physical therapists who do not specialize in hand care, however, continue to treat hand problems. This issue of Physical Therapy provides current information from experts in hand management. The intent of this special issue is not to cover all the aspects of hand management, but to emphasize the areas most commonly dealt with by therapists outside of hand clinics. The first three articles, by Moran, Hardy, and Bear-Lehman and Abreu, are reviews of the anatomy, wound healing, and evaluation of the hand.…
The Role Of Managerial Demand and Ownership In the Determination Of Divided and Debt Policies Of Mature Corporations

In this study a theoretical and empirical investigation is undertaken to see how financial policies are set in a mature corporation with widely diffused ownership and risk averse management. Of particular interest is how differences in ownership structure, managerial compensation and investment policy influence dividends and leverage. A model is constructed in which risk averse managers, with HARA class utility functions, derive utility from pecuniary and non- pecuniary benefits and operate under constraints imposed by the sources and uses of funds identity, bankruptcy threat, and by exogenously specified compensation and shareholdings. The model in general predicts that both dividends and debt depend negatively on the proportion of insider equity and compensation and positively on investment income. The model is tested on a sample of 455 firms. Empirical results support all the basic predictions. Interestingly, the relationship of dividend, debt with both insider equity and compensation is convex as expected for nonlinear demand functions.
Electrophysiological gap detection thresholds: effects of age and comparison with a behavioral measure.

Background Temporal processing ability has been linked to speech understanding ability and older adults often complain of difficulty understanding speech in difficult listening situations. Temporal processing can be evaluated using gap detection procedures. There is some research showing that gap detection can be evaluated using an electrophysiological procedure. However, there is currently no research establishing gap detection threshold using the N1-P2 response. Purpose The purposes of the current study were to 1) determine gap detection thresholds in younger and older normal-hearing adults using an electrophysiological measure, 2) compare the electrophysiological gap detection threshold and behavioral gap detection threshold within each group, and 3) investigate the effect of age on each gap detection measure. Design This study utilized an older adult group and younger adult group to compare performance on an electrophysiological and behavioral gap detection procedure. Study sample The subjects in this study were 11 younger, normal-hearing adults (mean = 22 yrs) and 11 older, normal-hearing adults (mean = 64.36 yrs). Data collection All subjects completed an adaptive behavioral gap detection procedure in order to determine their behavioral gap detection threshold (BGDT). Subjects also completed an electrophysiologic gap detection procedure to determine their electrophysiologic gap detection threshold (EGDT). Results Older adults demonstrated significantly larger gap detection thresholds than the younger adults. However, EGDT and BGDT were not significantly different in either group. The mean difference between EGDT and BGDT for all subjects was 0.43 msec. Conclusions Older adults show poorer gap detection ability when compared to younger adults. However, this study shows that gap detection thresholds can be measured using evoked potential recordings and yield results similar to a behavioral measure.
1605 Nodular Fasciitis in the Pediatrics Population: A Single Center Experience

Background and Aims We aim to describe our experience with nodular fasciitis in the pediatric population, in an attempt to contribute additional information concerning clinical outcomes and management recommendations. Methods We performed a twenty-year retrospective chart review of patients ≤ 18 years diagnosed with nodular fasciitis at a single, large, academic institution. Results Five patients were treated for nodular fasciitis during the study period. The majority 3 (60%) were male. All presented with rapidly enlarging masses that were excised surgically and 4 (80%) of them had no signs of recurrence (one patient was lost to follow-up). The median age at presentation was 14 years. Most 3 (60%) lesions were located in the upper extremities and 4 (80%) had no related symptomatology or disability. All lesions were less than 3-centimeters in greatest dimension- Table 1 for Tumor Characteristics. Pathologic and immunohistochemical data was lacking in our cohort. Conclusion The characteristics of nodular fasciitis in children at our institution are slightly different than that which has been reported thus far. Due to variability in clinical presentation and histologic findings, additional studies are necessary to provide more practical, consistent and effective management strategies.
Factors Affecting Induction of Embryogenic Callus of Larix principis-rupprechtii

Taking mature zygotic embryos of Larix principis-rupprechtii as explants to induce embryogenic callus.Several factors influencing the induction were assayed by using completely random design,orthogonal design together with tissue culture technology in order to explore embryogenic callus induction in the early stage in larch and optimize its somatic embryogenesis system.The results show that the best way of disinfection during the induction of embryogenic callus is peeling,removing endosperm after disinfection of 30 minutes with 2% NaClO.The contamination rate and disinfection time are negatively correlated: the longer the sterilization time,the lower the contamination rate.The optimal agar concentration of embryogenic callus induction is 4 g.L-1,and the higher or lower of the agar concentration will not only reduce the induction rate,increase the level of callus browning,but also affect the development of explants.The results of orthogonal design for plant growth exogenous hormone show that the 2,4-D is the key factor and has a significant influence,followed is KT and 6-BA.The best combination of plant growth exogenous hormone is 2,4-D 1.8 mg.L-1 + 6-BA 0.3 mg.L-1 + KT 0.3 mg.L-1.
Microeological Modulator in Preventing Neonatal Antibiotic Associated Diarrhea:A Clinical Research

OBJECTIVE To understand the clinical effect of microeclogical modulator Bifid Triple Viable(BTV) in preventing neonatal antibiotic associated diarrhea(AAD).METHODS A prospective controlled study was undertaken on the antibiotic treated group and control group from Jan,2004 to Dec 2007.RESULTS Among the 996 neonatal patients in treated group,71 patients occurred AAD,with the morbidity of 7.13%.Among the 1012 neonatal patients in control group,235 patients occurred AAD(morbidity 23.22%).There was significant difference between the two groups(P0.01).CONCLUSIONS It shows obvious clinical effect of microecological moducator BTV on neonatal AAD to reduce the morbility.
Hypothalamic action of phoenixin to control reproductive hormone secretion in females: importance of the orphan G protein-coupled receptor Gpr173

Sexual maturation and maintenance of reproductive function are regulated by neurohormonal communication between the hypothalamus, pituitary, and gonads (referred to as the HPG axis). Phoenixin (PNX...
Knowledge Adoption in Online Communities of Practice (initially published in 2004)

In this study we investigate how members of text-based, asynchronous online Communities of Practice (COPs) adopt knowledge contributed by other COP members. Previous studies of knowledge adoption in computer-mediated settings have drawn on dual-process theories of information processing to understand the role of heuristic cues and elaboration likelihood in this process. Here we extend this research stream, exploring two potential new heuristic cues: genre conformity and information consistency. In addition, we examine the factors focused search and disconfirming information to understand how they may induce non-heuristic cognitive processes. Survey data were collected from an online COP and findings support the hypotheses generated from our research model. This study advances our understanding of knowledge sharing in online COPs. Findings suggest that the context of an online COP can play a dynamic role in how members process the content component of that COP. Focusing on the pull technology of online COPs, it offers another theoretical link between Computer-Mediated Communications and knowledge management. Practically, it also provides us with insights into online COPs as a potential means for improving organizational knowledge management.
BEHAVIOR OF SALMONELLA TYPHIMURIUM IN SKIMMILK DURING FERMENTATION BY LACTIC ACID BACTERIA1

Skimmilk was inoculated with Salmonella typltimurium (approximately 103/ml) and with Streptococcus cremoris, Streptococcus lactis, mixtures of S. cremoris and S. lactis, Streptococcus diacetilactis, Streptococcus thermophilus, Lactobacillus bulgaricus, mixtures of S. thermophilus and L. bulgaricus, a mixture of L. helveticus and S. thermophilus, and Leuconostoc citrovorum. Inocula of lactic acid bacteria ranged from 0.25 to 5.0% and incubation temperatures from 21 to 42 C. Streptococcus cremoris, S. lactis, and mixtures of the two repressed growth but did not inactivate S. typhimurium during 18 hr of incubation at 21 or 30 C when the lactic inoculum was 0.25%. An increase in inoculum to 1% resulted in inactivation of S. typhimurium at 30 C by some of the mixed cultures. Both S. diacetilactis and L. citrovorum were less inhibitory to S. typhimurium than were S. cremoris or S. lactis. When added at the 1% level, Streptococcus thermophilus was more detrimental to S. typhimurium at 42 C than was L. bulgaricus...
Lateral Neck Lesions with Vision Changes.

A man with a history of skin changes presented with sudden onset of bilateral blurry vision.
“Dreadful Harmony”: The Poetics of Evil in Sidney, Tasso, and Spenser

This chapter explores the tensions between Renaissance literary theories that downplay the appeal of evil and the widespread exploitation of that appeal in literary practice. It analyzes the literary philosophy and epic poetry of Philip Sidney, Torquato Tasso, and Edmund Spenser in the context of the religious writings of Saint Augustine. Drawing on Augustine’s aestheticization of evil as analogous to the shadows in a chiaroscuro painting, writers like Tasso find a pleasurable “dreadful harmony” in representations of the monstrous and infernal. Lastly, the chapter analyzes Spenser’s aesthetics of filth in The Faerie Queene book 1 and of cruelty and deception in book 2. In the process, it explores the powers and limits of sinister aesthetics to encourage engagement with things that ought to be repugnant.
Theory and Design of Frequency-Tunable Absorptive Bandstop Filters

Absorptive bandstop filters are a relatively new class of bandstop filter, which are able to achieve very high levels of stopband rejection with relatively low-quality-factor resonators, in contrast to typical reflective bandstop filters, whose stopband rejections are limited by the quality factors of their resonators. This paper performs an in-depth theoretical and practical analysis of this class of filter, presenting design principles for reducing the sensitivity to process variation, increasing the tuning range over which the filters can operate with good performance, and addressing the practical non-ideal effects of implementation, such as frequency variation of couplings and quality factor. Four varactor-tuned microstrip bandstop filters are presented to verify the presented theory. They illustrate the design tradeoffs between selectivity and tuning range, choice of coupling topology and tuning range, and show the benefits and drawbacks of cascading stages to create higher-order filters.
The Eighth Wonder of the World: The Life of Houston's Iconic Astrodome, by Robert C. Trumpbour and Kenneth Womack: (2016). Lincoln: University of Nebraska Press. 272 pages. $27.95 (hardcover).

As I reflect back on my career, I know now that I pursued graduate study in urban planning in part because of my love of two things: sports and cities. As a lifelong fan of sports teams that do lit...
Quantitative survival impact of composite treatment delays in head and neck cancer.

BACKGROUND Multidisciplinary management of head and neck cancer (HNC) must reconcile increasingly sophisticated subspecialty care with timeliness of care. Prior studies examined the individual effects of delays in diagnosis-to-treatment interval, postoperative interval, and radiation interval but did not consider them collectively. The objective of the current study was to investigate the combined impact of these interwoven intervals on patients with HNC. METHODS Patients with HNC who underwent curative-intent surgery with radiation were identified in the National Cancer Database between 2004 and 2013. Multivariable models were constructed using restricted cubic splines to determine nonlinear relations with overall survival. RESULTS Overall, 15,064 patients were evaluated. After adjustment for covariates, only prolonged postoperative interval (P < .001) and radiation interval (P < .001) independently predicted for worse outcomes, whereas the association of diagnosis-to-treatment interval with survival disappeared. By using multivariable restricted cubic spline functions, increasing postoperative interval did not affect mortality until 40 days after surgery, and each day of delay beyond this increased the risk of mortality until 70 days after surgery (hazard ratio, 1.14; 95% confidence interval, 1.01-1.28; P = .029). For radiation interval, mortality escalated continuously with each additional day of delay, plateauing at 55 days (hazard ratio, 1.25; 95% confidence interval, 1.11-1.41; P < .001). Delays beyond these change points were not associated with further survival decrements. CONCLUSIONS Increasing delays in postoperative and radiation intervals are associated independently with an escalating risk of mortality that plateaus beyond certain thresholds. Delays in initiating therapy, conversely, are eclipsed in importance when appraised in conjunction with the entire treatment course. Such findings may redirect focus to streamlining those intervals that are most sensitive to delays when considering survival burden. Cancer 2018. © 2018 American Cancer Society.
The variable gene activity theory of cell differentiation

This chapter presents the variable gene activity theory of cell differentiation. Several premises are required in arriving at the proposition that differentiation is a function of variable gene activity. First among these is the now well-understood molecular relationship between the genetic DNA and the structure of the various proteins found in the cell. The second premise of the argument for the variable gene activity theory is the proposition that every living cell nucleus in a metazoan organism contains the same complete [A1]
Enriching the customer experience: Implications for E-marketers

The significance of ‘customer experience’ on the Internet has been increasingly emphasized by both practitioners and academicians. However, they have used the term ‘customer experience’ in many different ways with little consensus about what experience really means and what its full implications are. Based on Pine and Gilmore’s experiential framework (1999), this paper attempts to sort out online customer experiences into four broad categories: entertainment, education, estheticism, and escape. Each of the four dimensions is reviewed and applied to the context of e-marketing. The authors conclude the discussion by stating that not all goods and services should be marketed as experiences in order to be successful on the Internet.
Light-dependant intraretinal ion regulation by melanopsin in young awake and free moving mice evaluated with manganese-enhanced MRI.

Purpose To test the hypothesis that in young, functionally blind mice, light-dependent intraretinal ion regulation occurs via melanopsin.
The Future of Locke v. Davey

The Supreme Court’s decision, in Zelman v. Simmons-Harris, to uphold a voucher program allowing state funds to be diverted to sectarian schools, did not address the question whether such programs are constitutionally required to include religious institutions. Locke v. Davey had the potential to resolve this question, but a surprisingly lopsided 7-2 majority decided the case without squarely addressing it. Davey upheld Washington’s refusal to allow a student to apply a state scholarship towards a degree in “devotional theology,” and it appeared, on its face, to be limited to “the State’s interest in not funding the religious training of clergy.” Yet the Court’s asserted principle of “play in the joints” between the Establishment and Free Exercise Clauses suggested a rationale with much broader implications: A mere denial of funding does not by itself create a cognizable burden on religious practice. Davey did not make clear which line of reasoning should control, and the first two federal appellate court decisions addressing the case are in fundamental disagreement about its meaning and scope. This Note responds to these developments for the first time, and concludes that a circumscribed version of the no-burden rationale should control Davey’s future application. The opinion’s discussion of the clergy is a red herring, because ultimately the Court found no violation of any constitutional right, meaning that the exclusion required no more than a merely “legitimate” justification. And while the Court suggested that there was no neutrality problem, it did so in such a way as to highlight the fact that neutrality is an incoherent concept unsuited to a sound understanding of the religion clauses. Furthermore, the no-burden rationale is founded on a theory – free exercise as an autonomy right – that is of a piece with our understanding of other similar rights. Of course, the state’s power is not unlimited, and the paper concludes by offering four important restrictions. This reading of Davey harmonizes the case with other Religion Clause doctrine, and protects religious liberty while allowing local governments the freedom to adapt policy to local conditions.
Preventing Cognitive Decline in Black Individuals With Mild Cognitive Impairment: A Randomized Clinical Trial.

Importance Mild cognitive impairment (MCI) is a transition state between normal cognitive aging and dementia that increases the risk for progressive cognitive decline. Preventing cognitive decline is a public health priority. Objective To determine whether behavioral activation prevents cognitive and functional decline over 2 years in black individuals with MCI. Design, Setting, and Participants Single-center, single-masked, attention-controlled randomized clinical trial. Participants were enrolled from June 21, 2011, to October 3, 2014, and follow-up ended December 13, 2016. Community-based recruitment and treatment of black individuals older than 65 years with amnestic MCI. Volunteer sample of 1390 persons with memory complaints were screened. Overall, 536 individuals had baseline assessment, and 315 (58.8%) were ineligible, most often owing to normal cognition (205 of 315 [65%]) or dementia (59 of 315 [18.7%]); 221 fully eligible participants were randomized. Analyses were intention to treat. Interventions Participants were randomized to behavioral activation, which aimed to increase cognitive, physical, and social activity (111 [50.2%]), or supportive therapy, an attention control treatment (110 [49.8%]). Main Outcomes and Measures The prespecified primary outcome was a decline of 6 or more recalled words on the total recall score of the Hopkins Verbal Learning Test–Revised assessed at 6, 12, 18, and 24 months. The secondary outcome was functional decline. Results Of 221 randomized participants (mean [SD] age, 75.8 [7.0] years, 175 women [79%]), 77 behavioral activation participants (69.4%) and 87 supportive therapy participants (79.1%) had 2-year outcome assessments. After baseline, behavioral activation participants engaged in significantly more cognitive activities than supportive therapy participants. The 2-year incidence of memory decline was 1.2% (95% CI, 0.2-6.4) for behavioral activation vs 9.3% (95% CI, 5.30-16.4) for supportive therapy (relative risk, 0.12; 95% CI, 0.02-0.74;P = .02). Behavioral activation was associated with stable everyday function, whereas supportive therapy was associated with decline (difference in slopes, 2.71; 95% CI, 0.12-5.30;P = .04). Rates of serious adverse events for behavioral activation and supportive therapy, respectively, were: falls (14 [13%] vs 28 [25%]), emergency department visits (24 [22%] vs 24 [22%]), hospitalizations (36 [32%] vs 31 [28%]), and deaths (7 [5%] vs 3 [4%]). Conclusions and Relevance Behavioral activation prevented cognitive and functional decline, but this finding requires further investigation. Black individuals have almost twice the rate of dementia as white individuals; behavioral activation may reduce this health disparity. Trial Registration ClinicalTrials.gov Identifier:NCT01299766
Primary Cardiac Sarcoma: A Rare, Aggressive Malignancy with a High Propensity for Brain Metastases.

Introduction. Primary cardiac sarcoma (PCS) has a poor prognosis compared to other sarcomas due to late presentation, challenging resection, incidence of metastases, and limited efficacy of systemic therapies. Methods. A medical record search engine was queried to identify patients diagnosed with PCS from 1992 to 2017 at the University of Michigan. Results. Thirty-nine patients with PCS had a median age of 41 years (range 2–77). Common histologies were angiosarcoma (AS, 14), high-grade undifferentiated pleomorphic sarcoma (UPS, 10), and leiomyosarcoma (LMS, 5). Sites of origin were left atrium (18), right atrium (16), and pericardium (5). AS was the most common right-sided tumor; UPS was more common on the left. Eighteen patients presented with metastases involving lung (10), bone (7), liver (5), and brain (4). Twenty-five patients underwent resection, achieving 3 R0 resections. Patients received a median of 2 (1–6) systemic therapies. Median overall survival (OS) was 12.1 months (range 0–79). Median OS was 14.0 months and 8.2 months in patients who did or did not undergo resection, respectively ( ). Brain metastases occurred in 12 (31%) patients, 9 (75%) of whom had left heart tumors, at a median of 8.5 months (range 0–75) from diagnosis. Median OS was 5.6 months (range 0–30) after the diagnosis of brain metastases. Conclusions. PCS portends a poor prognosis, because of difficulty in obtaining complete resection of sarcoma, advanced stage at diagnosis, and high risk of brain metastases. Providers should be aware of the increased risk of brain metastases and consider brain imaging at diagnosis and follow-up.
Ambulatory cancer care electronic symptom self-reporting (ACCESS) for surgical patients: a randomised controlled trial protocol.

Introduction An increasing proportion of cancer surgeries are ambulatory procedures requiring a stay of 1 day or less in the hospital. Providing patients and their caregivers with ongoing, real-time support after discharge aids delivery of high-quality postoperative care in this new healthcare environment. Despite abundant evidence that patient self-reporting of symptoms improves quality of care, the most effective way to monitor and manage this self-reported information is not known. Methods and analysis This is a two-armed randomised, controlled trial evaluating two approaches to the management of patient-reported data: (1) team monitoring, symptom monitoring by the clinical team, with nursing outreach if symptoms exceed normal limits, and (2) enhanced feedback, real-time feedback to patients about expected symptom severity, with patient-activated care as needed. Patients with breast, gynaecologic, urologic, and head and neck cancer undergoing ambulatory cancer surgery (n=2750) complete an electronic survey for up to 30 days after surgery that includes items from a validated instrument developed by the National Cancer Institute, the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). Information provided to patients in the Enhanced Feedback group is procedure-specific and based on updated PRO-CTCAE data from previous patients. Qualitative interviews are also performed. The primary study outcomes assess unplanned emergency department visits and symptom-triggered interventions (eg, nursing calls and pain management referrals) within 30 days, and secondary outcomes assess the patient and caregiver experience (ie, patient engagement, patient anxiety and caregiver burden). Ethics and dissemination This study is approved by the Institutional Review Board at Memorial Sloan Kettering Cancer Center. The relationships between the study team and stakeholders will be leveraged to disseminate study findings. Findings will be relevant in designing future coordinated care models targeting improved healthcare quality and patient experience. Trial registration number NCT03178045
Cognitive-Behavioral Therapy for Chronic Headache Disorders in Children and Adolescents

Headache is the most prevalent chronic pain complaint in pediatrics. Chronic headache, including migraine and tension-type headache, affects 3–5% of the population, and can be particularly detrimental to child and adolescent development due to the negative impact on school functioning. Standard medication treatment for chronic pediatric headache is limited, and results are no better than placebo. CBT, alone or combined with medication, is effective at substantially reducing headache days and improving the functioning of children and adolescents with chronic headache. CBT for pediatric headache involves pain coping skills, biofeedback, cognitive restructuring, and addressing psychosocial stressors that maintain the headache cycle.
Chronic Obstructive Pulmonary Disease in Women: A Biologically Focused Review with a Systematic Search Strategy

Purpose Evidence suggests that chronic obstructive pulmonary disease (COPD) symptoms and progression may differ between men and women. However, limited information is currently available on the pathophysiological and biological factors that may underlie these sex-related differences. The objective of this review is to systematically evaluate reports of potential sex-related differences, including genetic, pathophysiological, structural, and other biological factors, that may influence COPD development, manifestation, and progression in women. Patients and methods A PubMed literature search was conducted from inception until January 2020. Original reports of genetic, hormonal, and physiological differences, and biological influences that could contribute to COPD development, manifestation, and progression in women were included. Results Overall, 491 articles were screened; 29 articles met the inclusion criteria. Results from this analysis demonstrated between-sex differences in inflammatory, immune, genetic, structural, and physiological factors in patients with COPD. Conclusion Various biological differences are observed between men and women with COPD including differences in inflammatory and metabolic pathways related to obesity and fat distribution, immune cell function and autophagy, extent and distribution of emphysema and airway wall remodeling. An enhanced understanding of these differences has the potential to broaden our understanding of how COPD develops and progresses, thereby providing an opportunity to ultimately improve diagnosis, treatment, and monitoring of COPD in both men and women.
Measurements of Time-Resolved Air Freestream Nitric Oxide Rotational, Vibrational Temperature and Concentration in the T5 Reflected Shock Tunnel

We report on measurements of freestream temperature and nitric oxide (NO) collected in the Caltech T5 reflected shock tunnel facility. Quantum cascade lasers (QCL), emitting mid-infrared light resonant with fundamental rovibrational NO transitions, were directed through the supersonic (Mach ~5) flow immediately downstream of the nozzle exit plane. Tunable diode laser absorption spectroscopy (TDLAS) was used to measure the path-averaged rotational and vibrational temperature of NO in the flow, in addition to the NO partial pressure. The temperature measurements demonstrate strong evidence of NO rotational and vibrational equilibrium during the test-period (from 1 to 2 ms after shock reflection). Agreement between vibrational and rotational temperature was observed in all experiments, including one lower-enthalpy (h₀,∞ ≈ 8 MJ/kg) and four higher-enthalpy (h₀,∞ ≈ 18 MJ/kg) shots, during and after the nominal test time. Slight disagreement between the rotational and vibrational temperatures was observed during the start-up period preceding the test time. Unexpected absorption from CO and H₂O was also observed in the TDLAS measurements, yielding estimates of their partial pressures in the flow. The goal of these and future experiments is to help to inform improvements of existing models and solvers used for prediction of freestream conditions. Future efforts will include a more quantitative evaluation of freestream conditions, including core flow velocity and uniformity, and TDLAS measurements near relevant flow models.
The surprising sensitivity of index scale to delta-model assumptions: Recommendations for model-based index standardization

Abstract Delta-models (a.k.a. hurdle models) are widely used to fit biomass samples that include zeros and a skewed response for positive catches, and spatio-temporal extensions of these models are increasingly used to quantify trends in abundance (i.e., estimate abundance indices). Previous research has shown estimated indices are proportional to changes in abundance. However, little research has tested the performance of delta-models for estimating “scale”; that is, whether abundance indices are not just proportional to population changes but also have the correct absolute value. We use data for twenty species in the eastern Bering Sea and Gulf of Alaska as well as a factorial experiment conditioned on data for Gulf of Alaska Pacific cod to support five conclusions related to scale in spatio-temporal delta-models. First, we show that conventional (nonspatial) delta-models are surprisingly sensitive to the a priori choice of probability distribution for positive catches, where gamma and Tweedie models give similar scale estimates but other distributions generally differ. Second, these same distributions also estimate widely different scales when using spatio-temporal delta-models, and the delta-gamma and Tweedie models provide similar scale to design-based indices. Third, model selection using marginal AIC often identifies the lognormal distribution as most parsimonious, despite it resulting in systematically higher abundance than design-based indices for many species. Fourth, scale is sensitive to the spatial resolution (i.e., number of knots) used in fitting the spatio-temporal model when using a naive “empirical Bayes” estimator, but less sensitive when applying an epsilon bias-correction estimator. Fifth, the factorial simulation experiment suggests that the Tweedie and delta-gamma distributions perform well even when applied to data simulated from an inverse-Gaussian or lognormal distribution, whereas the opposite is not true. We conclude that index scale is sensitive to delta-model specification, and we make five recommendations when using spatio-temporal delta-models for index standardization: (1) apply the epsilon or other bias-correction methods to reduce sensitivity of index scale on spatio-temporal model resolution; either (2) compare the scale of delta-model indices with that of design-based indices when design-based indices are available or (3) use the delta-gamma or Tweedie distribution by default when design-based indices are not available; (4) do not assume that AIC will identify the model specification that results in the most appropriate scale; and (5) consider apparent mismatches in index scale depending upon whether an assessment model specifies or estimates the associated catchability coefficient and whether the design-based index is believed to measure total abundance for a fully-selected age or length-class.
5 GHz A1 Mode Lateral Overtone Bulk Acoustic Resonators in Thin-Film Lithium Niobate

This work presents the first demonstration of the first-order antisymmetric (A1) mode lateral overtone bulk acoustic resonators (LOBAR) in thin-film lithium niobate $(\mathrm{LiNbO}_{3})$ . Thanks to the fast phase velocity, large coupling, and low loss of A1 in $\mathrm{LiNbO}_{3}$ , equally spaced tones around 5 GHz are achieved using a large feature size of 500 nm. Electromechanical coupling $(k^{2})$ around 0.4 % and high $Q$ over 1000 are observed in more than 20 tones, surpassing the reported overtone resonators at 5 GHz. Meanwhile, the highest $Q$ of 2725, and the highest $fQ$ product of $1.4\cdot 10^{13}$ are measured at 5.16 GHz. Upon further optimizations, A1 LOBARs can facilitate novel 5G signal processing functions.
Mastermind Like Transcriptional Coactivator 3 (MAML3) drives neuroendocrine tumor progression

Metastatic disease in pheochromocytomas and paragangliomas (PCC/PGL) is not well-understood. The Cancer Genome Atlas discovered recurrent MAML3 fusion genes in a subset of tumors that lacked known germline or somatic driver mutations and were associated with aggressive disease. Here, we aimed to investigate the role of MAML3 in tumorigenesis. Human PCC/PGLs were used for IHC and genetic analysis. Three neuroendocrine tumor cell lines, SK-N-SH, QGP-1, and BON-1, were transiently transfected with MAML3 (FL) or exon 1 deleted MAML3 (dEx1; mimicking the fusion), and biologic effects of overexpression were examined in vitro. We found 7% (4/55) of human PCC/PGL have UBTF∼MAML3 fusions and all were sporadic cases with metastatic disease. Fusion-positive tumors had intense MAML3 nuclear staining and increased β-catenin by IHC and showed increased WNT4 expression. In vitro, overexpression of FL and dEx1 MAML3 increased invasion in SK-N-SH, QGP-1, and BON-1 (all P Implications: MAML3 increases tumorigenicity and invasion in neuroendocrine tumor cells and may be a prognostic marker for aggressive disease.
Neurocritical Care of the Pregnant Patient.

To summarize recent changes in management and emerging therapies for pregnant neurocritical care patients. Diagnostic and treatment options for managing neurologic emergencies in pregnant patients have expanded with both greater understanding of the effects of imaging modalities and medications on pregnancy and application of standard treatments for non-pregnant patients to pregnant populations. Specifically, this includes cerebrovascular diseases (pregnancy-associated ischemic stroke, pregnancy-associated intracerebral hemorrhage, cerebral venous sinus thrombosis), post-maternal cardiac arrest care, seizures and status epilepticus, myasthenia gravis, and fetal somatic support in maternal death by neurologic criteria. With the exception of direct abdominal computed tomography (CT), most imaging studies are reasonably safe in pregnancy. When emergent imaging is needed to prevent maternal morbidity or mortality, any CT sequence with or without contrast is appropriate to pursue. Though new safety data on antiplatelets, antihypertensives, thrombolytics, and antiepileptic drugs have increased options for disease management in pregnancy, unfractionated and low-molecular weight heparin remain the safest options for anticoagulation. Early studies on hypothermia, ketamine, and immunomodulating therapies in pregnancy are promising. In myasthenia gravis, new data on adjunct devices may allow more patients to undergo safe vaginal delivery, avoiding cesarean section and the associated risk of crisis. When difficult decisions regarding preterm delivery arise, recent outcome studies can help inform discussion. Lastly, when the feared complication of maternal death by neurologic criteria occurs, fetal somatic support may help to save at least one life.
Machine learning for design and optimization challenges in multi/many-core network-on-chip

Due to the advancement of transistor technology, a single chip processor can now have hundreds of cores. Network-on-Chip (NoC) has been the superior interconnect fabric for multi/many-core on-chip systems because of its scalability and parallelism. Due to the rise of dark silicon with the end of Dennard Scaling, it becomes essential to design energy-efficient, high performance, and reliable heterogeneous many-core NoC based systems. Because of the large and complex design space, multi/many-core NoC design space becomes difficult to explore for optimal trade-offs of energy-performance-reliability at both design-time and run-time. Furthermore, reactive resource management is not effective in preventing problems, such as creating thermal hotspots and exceeding power budget, from happening in adaptive system. Therefore, in this work, we explore machine learning techniques to design and configure the NoC resources in many-core systems based on the learning of the system and applications workloads. Machine learning can automatically learn from past experiences and guide the many-core system intelligently to achieve its objective on performance, power, and reliability. We have presented many-core NoC based systems design and resource management challenges, and explore and propose machine learning models to uncover near-optimal solutions quickly. Simulation results have been demonstrated to show the effectiveness of a machine learning technique.
A revision of Leopoldinia (Arecaceae)

A taxonomic revision of the Neotropical palm genus Leopoldinia based on morphological data and morphometric methods was carried out. One hundred and sixteen herbarium specimens were scored for seven qualitative and 24 quantitative variables. Qualitative variables were divided into six characters and one trait. Using the Phylogenetic Species Concept, the six characters were used to recognize three species. These are widely distributed in the central Amazon region of Brazil and adjacent Venezuela and Colombia. Nomenclature, descriptions, illustrations, and distribution maps are provided for each taxon.
Cancer class discovery using non-negative matrix factorization based on alternating non-negativity-constrained least squares

Many bioinformatics problems deal with chemical concentrations that should be non-negative. Non-negative matrix factorization (NMF) is an approach to take advantage of non-negativity in data. We have recently developed sparse NMF algorithms via alternating nonnegativity-constrained least squares in order to obtain sparser basis vectors or sparser mixing coefficients for each sample, which lead to easier interpretation. However, the additional sparsity constraints are not always required. In this paper, we conduct cancer class discovery using NMF based on alternating non-negativity-constrained least squares (NMF/ANLS) without any additional sparsity constraints after introducing a rigorous convergence criterion for biological data analysis.
Familial adenomatous polyposis: a review of gastrointestinal manifestations

Abstract Familial adenomatous polyposis (FAP) is an autosomal dominant cancer predisposition syndrome. Although colonic manifestations including multiple adenomas and subsequent adenocarcinomas are characteristic of this syndrome, benign and malignant involvement of the extracolonic gastrointestinal tract is also seen. The aim of this article is to review the clinical, pathologic and molecular genetics features of familial adenomatous polyposis syndrome in the entire gastrointestinal tract. Detailed characterization of these findings can facilitate appropriate surveillance strategies, treatment and preventative measures by collective efforts between the clinicians, genetic counsellors, and pathologists.
Dialogue at work? What it is and isn't

Purpose – The purpose of this paper is to distinguish productive and unproductive understandings of the dialogue concept for employment in organizational practice.Design/methodology/approach – A decade of theoretical/philosophical literature about “dialogue” in organizations both trivializes the concept and makes its accomplishment seem routine. This manuscript synthesizes that literature and separates unproductive or inauthentic understandings from those indicative of how dialogue is conceived and intended.Findings – The paper finds that if it is to accomplish what it has the potential to accomplish in organizational life, dialogue must be understood as interpersonally tough and unfamiliar, politically challenging and psychologically disconcerting.Originality/value – The manuscript should be of value to all those interested in employing dialogue at work, but who currently understand it in unclear ways due to the way it is talked about in the popular business press.