cssi/SciSciGPT-SciSciNet huggingface dataset:
Prognosis in Patients With Left Ventricular Apical Aneurysm Diagnosed by Thallium-201 or Tc-99m Sestamibi SPECT Images

Abstract The prognosis of patients with left ventricular (LV) aneurysm diagnosed by thallium single-photon emission computed tomography (Tl-SPECT) or technetium-99m sestamibi SPECT (MIBI) has not previously been defined. Of 9,505 Tl or MIBI patients, 139 with apical infarct and probable LV aneurysm on tomographic images were identified. Patients were grouped by the presence of divergent versus parallel LV walls. Divergent walls show increasing separation of the walls as they approach the apex on vertical or horizontal long-axis slices. The degree of the deformation at the apex (divergent vs parallel walls), extent of impaired myocardium (total number of pixels in the defect/total number of pixels in the myocardium × 100%), percentage of reversibility, and segmental and total severity of standard deviations of perfusion defects were calculated. Seventy-six patients underwent contrast ventriculography. Patients with divergent walls (n = 57) were older (p = 0.05), had lower ejection fractions (p = 0.012), higher lung uptake (only Tl patients) (p = 0.06), and more frequent ST elevation on the resting electrocardiogram (p = 0.009) than patients with nondivergent (parallel) walls. For both groups, the percent impaired myocardium was comparably high (44 ± 9% vs 46 ± 10%). Analysis of asynergic segments in 76 patients who underwent contrast ventriculography showed more akinetic, paradoxical, or aneurysmal segments in the apical region of the left ventricle in the group with SPECT divergent walls. Cox model analysis showed divergence as the significant correlate of death. At 5 years, survival for the group with divergent walls was 52% compared with 75% for those with nondivergent walls (p = 0.008). Despite significant apical LV impairment in both groups, mortality was almost twice as high in the group with divergent walls compared with patients with parallel walls. Thus, patients with LV aneurysm diagnosed by radionuclide SPECT perfusion imaging have a higher mortality when displaying a divergent wall pattern than patients with lesser deformity. This study examines the prognostic significance of divergent left ventricular (LV) walls seen on tomographic scintigrams in 139 patients who had LV apical aneurysm diagnosed by thallium single-photon emission computed tomography (Tl-SPECT) or technetium-99m sestamibi SPECT (MIBI) scintigrams. Five-year survival in patients with divergent LV walls on Tl or MIBI scintigrams was 52% versus 75% in patients with a parallel wall pattern; of several variables assessed from Tl and MIBI, age and divergence of the walls were the only significant correlates of nonsurvival (p = 0.008) associated with mortality, which was almost double that of patients with parallel walls.
I'm Not There

ROSS POSNOCK, a Fellow of the American Academy since 2009, is the Anna Garbedian Professor of the Humanities at Columbia University. His books include The Trial of Curiosity: Henry James, William James and the Challenge of Modernity (1991), Color and Culture: Black Writers and the Making of the Modern Intellectual (1998), and Philip Roth’s Rude Truth: The Art of Immaturity (2006). Perhaps, like me, you have a propensity to collect books without quite knowing why. Over the years I have piled up books by and about, say, Ludwig Witt genstein, Hannah Arendt, George Santayana, Philip Roth, Ad Reinhardt, Philip Guston, Franz Rosenzweig, Penelope Fitzgerald, Thomas Bernhard–and not only not read them, but have no desire to do so. I have kept busy working on other things. And for a decade or two at a time, these texts simply gather dust on my shelves. But then, inevitably, I am drawn to these nearly forgotten volumes and, strangely, they prove pivotal to a new project: I recall, for instance, that Santayana ascended, literally, from the obscurity of a low shelf to earn a chapter in my book on William and Henry James. Wittgenstein made an analogous, if more circuitous, journey from the shadows, waiting untouched, until 1⁄2ve years ago when I kept a long-held inner vow to read an other languishing tome, one that had stared me down so often it had acquired an aura of intimidation: Stanley Cavell’s The Claim of Reason: Wittgenstein, Skepticism, Morality and Tragedy. It was indeed intimidating, but also inspiring: that experience opened the door to more Cavell–and to deeper engagements with Emerson–and to Wittgenstein, who has joined the sage of Concord as a central 1⁄2gure in my current project on writers, artists, and philosophers who renounce their careers. The peculiarities of this manner of book buying– the absence of full consciousness and the long gap between acquisition and reading–puts me in mind
Activated protein C protects against myocardial ischemic/reperfusion injury through AMP-activated protein kinase signaling

Summary. Background: Activated protein C (APC) is a vitamin K-dependent plasma serine protease that down-regulates clotting and inflammatory pathways. It is known that APC exerts a cardioprotective effect by decreasing apoptosis of cardiomyocytes and inhibiting expression of inflammatory mediators after myocardial ischemia. Objectives: The objective of this study was to understand the mechanism of the APC-mediated cardioprotection against ischemic injury. Methods: Cardioprotective activities of wild-type APC and two derivatives, having either dramatically reduced anticoagulant activity or lacking signaling activity, were monitored in an acute ischemia/reperfusion injury model in which the left anterior descending coronary artery (LAD) was occluded. Results: APC reduced the myocardial infarct size by a mechanism that was largely independent of its anticoagulant activity. Thus, the non-anticoagulant APC-2Cys mutant, but not the non-signaling APC-E170A mutant, attenuated myocardial infarct size by EPCR and PAR-1-dependent mechanisms. Further studies revealed that APC acts directly on cardiomyocytes to stimulate the AMP-activated protein kinase (AMPK) signaling pathway. The activation of AMPK by APC ameliorated the post-ischemic cardiac dysfunction in isolated perfused mouse hearts. Moreover, both APC and APC-2Cys inhibited production of TNFα and IL-6 in vivo by attenuating the ischemia/reperfusion-induced JNK and NF-κB signaling pathways. Conclusions: APC exerts a cardioprotective function in ischemic/reperfusion injury through modulation of AMPK, NF-κB and JNK signaling pathways.
On the theory of stepwise electrode processes

Summary The equations for d.c. polarographic waves of two-step electrode reaction are derived with the stationary plane, expanding plane model of diffusion, as well as with a steady-state approach. The equations for total current and currents due to individual steps are derived and the corresponding logarithmic diagrams are discussed. The procedures for characterization of individual steps are proposed and illustrated by the analysis of data for Cu 2+ ion reduction in perchlorate media. The results are compared with those of Jacq et al. who used the same data and the same model. The meaning of overall parameters of the stepwise electrode reaction is discussed and, using the Marcus theory of charge transfer, the relation between the overall standard heterogeneous rate constant and the corresponding rate constants of homogeneous exchange reactions is presented. The meaning of Vetter's “exchange currents of individual steps” is also discussed.
On multivariable stability in the gain space

Abstract General existence conditions under which the stability of the individual loops of a multivariable system in a given compact and bounded gain space imply the global asymptotic stability of the multivariable system in the same space are very useful in practice and essentially indicate when in principle it is possible to obtain stable closed-loop performance of a multivariable system by tuning every loop separately. Such conditions are particularly useful for fault tolerant control of multivariable systems. This paper gives the required necessary and sufficient conditions and effectively unifies all previous work on diagonal stabilizability which includes as special cases: the diagonal dominance, the H matrix, the GKK matrix and the decentralized integral controllability (DIC) conditions reported previously in the literature. Some application examples are included.
A Sawtooth Pattern of Cadherin 2 Stability Mechanically Regulates Somite Morphogenesis

Differential cadherin (Cdh) expression is a classical mechanism for in vitro cell sorting. Studies have explored the roles of differential Cdh levels in cell aggregates and during vertebrate gastrulation, but the role of differential Cdh activity in forming in vivo tissue boundaries and boundary extracellular matrix (ECM) is unclear. Here, we examine the interactions between cell-cell and cell-ECM adhesion during somitogenesis, the formation of the segmented embryonic precursors of the vertebral column and musculature. We identify a sawtooth pattern of stable Cdh2 adhesions in which there is a posterior-to-anterior gradient of stable Cdh2 within each somite, while there is a step-like drop in stable Cdh2 along the somite boundary. Moreover, we find that the posterior somite boundary cells with high levels of stable Cdh2 have the most columnar morphology. Cdh2 is required for maximal cell aspect ratio and thus full epithelialization of the posterior somite. Loss-of-function analysis also indicates that Cdh2 acts with the fibronectin (FN) receptor integrin α5 (Itgα5) to promote somite boundary formation. Using genetic mosaics, we demonstrate that differential Cdh2 levels are sufficient to induce boundary formation, Itgα5 activation, and FN matrix assembly in the paraxial mesoderm. Elevated cytoskeletal contractility is sufficient to replace differential Cdh2 levels in genetic mosaics, suggesting that Cdh2 promotes ECM assembly by increasing cytoskeletal and tissue stiffness along the posterior somite boundary. Throughout somitogenesis, Cdh2 promotes ECM assembly along tissue boundaries and inhibits ECM assembly in the tissue mesenchyme.
Aquaporin 5 (AQP5) is a novel signaling molecule triggering Ras/ERK/retinoblastoma (Rb) signaling pathway in colon cancer cell lines

B115 Overexpression of several aquaporins (AQPs) has been reported in different types of human cancer; however, the role of AQPs in human carcinogenesis has not yet been clearly defined. Here, we demonstrate that overexpression of human AQP5 (hAQP5) induced many phenotypic changes characteristic of transformation both in vitro and in vivo. Overexpression of wild-type (WT) hAQP5 increased cell proliferation and phosphorylation of ERK1/2 in colon cancer cell line HCT116. However, this phenomenon in AQP5 mutants (N185D and S156A) was diminished compared with WT AQP5, indicating the requirement of both membrane association and serine/threonine phosphorylation of AQP5. Overexpression of AQP1 and AQP3 showed no difference of ERK1/2 phosphorylation, suggesting that AQP5, unlike AQP1, might be a water channel involved in signaling transduction. Moreover, in the nucleus, hAQP5-overexpressing cells showed an increase of phosphorylation of retinoblastoma (Rb) protein through complex of cyclin D1 and CDK4. Small interfering RNA (siRNA) analysis showed that AQP5 activates the Ras signaling pathway in DLD1 and HCT116 cell lines. Furthermore, hAQP5-transfected NIH3T3 cells revealed tumorigencity in athymic mice in vivo as well as in vitro colony formation. Therefore, our findings for the first time suggest that hAQP5 plays an important role in human carcinogenesis through Ras/ERK/Rb signaling pathway.
Influence of Humeral Version and Deltoid Tension on Glenohumeral Kinematics After Reverse Total Shoulder Arthroplasty

Reverse total shoulder arthroplasty (rTSA) is used to improve pain and function in arthritic, rotator cuff deficient shoulders. Surgical intervention is considered successful if range of motion and stability of the joint is maximized and force to abduct the arm is minimized. Implant hardware positioning may affect these outcome measures.© 2011 ASME
Bioassay Rating System for Predicting Mortality of Moribund Corn Rootworm (Coleoptera: Chrysomelidae) Larvae Following Exposure to Insecticide-treated Soil

We developed a rating system to predict the mortality of Diabrotica undecimpunctata howardi Barber larvae used to bioassay soil insecticides. Larvae were categorized, following 48 h exposure to insecticide-treated soil, as living, dead, or in one of five intermediate categories based on movement when exposed to bright light. The eventual mortality of larvae within a rating category was determined by returning the larvae to the treated soil for an additional 5 days and establishing the probability of mortality corresponding to each category. Percentage of dead larvae in the five behavioral rating categories was independent of the insecticide used. Compared to the bioassay method in which the test organisms are considered either alive or dead, the rating system was more consistent and more precise with respect to the assumptions underlying conventional parametric statistics. The rating-system approach is a sensitive and rapid bioassay technique that might be adapted to other test organisms and situations where the subject is under continuous exposure to the toxin being tested.
Acute Tubular Necrosis: Diagnosis, Treatment, and Nursing Implications

Acute tubular necrosis (ATN) is the most common cause of acute renal failure. Early recognition of patients who are at risk for ATN can prevent or improve the course of ATN. Acute renal failure is classified as prerenal, intrinsic, or postrenal disease. ATN is classified as a type of intrinsic renal disease. The clinical course of ATN is divided into the renal failure phase, diuretic phase, and recovery phase, with each phase having distinct symptoms and laboratory findings. Diagnosis of ATN often is complicated and confusing; understanding of laboratory findings can facilitate the critical care nurse's ability to assess those at risk for ATN. The care and treatment of the patient with ATN is complicated, and specific treatments are discussed in detail. The critical care nurse can play a vital role in identifying the patient at risk, preventing the development of ATN in those at risk, and providing appropriate care for those who develop ATN.
Research of Multi-dams Data Integration Based on Isolation Device and Heterogeneous Systems

In this paper,a common multi-dams data integration program is proposed under the physical isolation devices and heterogeneous measuring systems.This program,in minimum execution time and bandwidth consumption,has advantages of good universal,high maintainability and robustness,customized synchronization strategy,and strict data consistency and integrity assurance.Then the implementation is given,which is feasible and achieves the design goal after practical engineering inspection
Retinal Neuroprotective Effects of Flibanserin, an FDA-Approved Dual Serotonin Receptor Agonist-Antagonist

Purpose To assess the neuroprotective effects of flibanserin (formerly BIMT-17), a dual 5-HT1A agonist and 5-HT2A antagonist, in a light-induced retinopathy model. Methods Albino BALB/c mice were injected intraperitoneally with either vehicle or increasing doses of flibanserin ranging from 0.75 to 15 mg/kg flibanserin. To assess 5-HT1A-mediated effects, BALB/c mice were injected with 10 mg/kg WAY 100635, a 5-HT1A antagonist, prior to 6 mg/kg flibanserin and 5-HT1A knockout mice were injected with 6 mg/kg flibanserin. Injections were administered once immediately prior to light exposure or over the course of five days. Light exposure lasted for one hour at an intensity of 10,000 lux. Retinal structure was assessed using spectral domain optical coherence tomography and retinal function was assessed using electroretinography. To investigate the mechanisms of flibanserin-mediated neuroprotection, gene expression, measured by RT-qPCR, was assessed following five days of daily 15 mg/kg flibanserin injections. Results A five-day treatment regimen of 3 to 15 mg/kg of flibanserin significantly preserved outer retinal structure and function in a dose-dependent manner. Additionally, a single-day treatment regimen of 6 to 15 mg/kg of flibanserin still provided significant protection. The action of flibanserin was hindered by the 5-HT1A antagonist, WAY 100635, and was not effective in 5-HT1A knockout mice. Creb, c-Jun, c-Fos, Bcl-2, Cast1, Nqo1, Sod1, and Cat were significantly increased in flibanserin-injected mice versus vehicle-injected mice. Conclusions Intraperitoneal delivery of flibanserin in a light-induced retinopathy mouse model provides retinal neuroprotection. Mechanistic data suggests that this effect is mediated through 5-HT1A receptors and that flibanserin augments the expression of genes capable of reducing mitochondrial dysfunction and oxidative stress. Since flibanserin is already FDA-approved for other indications, the potential to repurpose this drug for treating retinal degenerations merits further investigation.
A New World Record — Four Financial Crises in 25 Years

A run on a bank — at least in an advanced industrial country — seems like an event out of the Great Depression of the 1930s. Frenetic depositors line up waiting for the bank to open because they want to be among the first to get their money; they anticipate that the bank soon will close because its money holdings will be exhausted. In September 2007, Northern Rock, the largest mortgage lender in Britain, experienced two runs, one in the wholesale commercial paper market and the other in the retail market. Northern Rock borrowed more than 40 million pounds from the Bank of England to avoid bankruptcy and then was taken over by the British Government. About the same time Countrywide Financial, the largest US mortgage lender, also experienced a run in the wholesale money market and received a capital infusion from Bank of America. Subsequently the US Treasury made a large investment in Bank of America to ensure that it had adequate capital.
Early Education and Piagetian Theory

Preschool educators have struggled for a number of years with the question of the educational significance of Piaget’s research and his theory of knowledge. This question is difficult for at least two reasons. First, the theory is not a theory of teaching, and its educational significance is thus not obvious. Second, the theory is a dynamic one, and the significance of any part must be understood in relation to its role in Piaget’s continuing epistemological search for answers to the question of how knowledge develops. In preschool education, the first efforts to use Piaget’s work have been direct applications of a few isolated parts taken out of their epistemological context. Unfortunately, these applications have had the effect, in practice, of reducing Piaget’s theory to something less, and even to something different, than it is. Later efforts are only just beginning to shift the emphasis away from direct applications of isolated parts to broader implications of the theory as a whole. At this point in the history of early education, it seems useful to review the assimilations of Piaget’s theory in preschool education. The purpose of this chapter is to consider the applications in light of the theory as a whole, to outline aspects crucial to education that are unrecognized in these applications, and to consider the direction of future efforts.
Divergent extremes but convergent recovery of bacterial and archaeal soil communities to an ongoing subterranean coal mine fire

Press disturbances are stressors that are extended or ongoing relative to the generation times of community members, and, due to their longevity, have the potential to alter communities beyond the possibility of recovery. They also provide key opportunities to investigate ecological resilience and to probe biological limits in the face of prolonged stressors. The underground coal mine fire in Centralia, Pennsylvania has been burning since 1962 and severely alters the overlying surface soils by elevating temperatures and depositing coal combustion pollutants. As the fire burns along the coal seams to disturb new soils, previously disturbed soils return to ambient temperatures, resulting in a chronosequence of fire impact. We used 16S rRNA gene sequencing to examine bacterial and archaeal soil community responses along two active fire fronts in Centralia, and investigated the influences of assembly processes (selection, dispersal and drift) on community outcomes. The hottest soils harbored the most variable and divergent communities, despite their reduced diversity. Recovered soils converged toward similar community structures, demonstrating resilience within 10-20 years and exhibiting near-complete return to reference communities. Measured soil properties (selection), local dispersal, and neutral community assembly models could not explain the divergences of communities observed at temperature extremes, yet beta-null modeling suggested that communities at temperature extremes follow niche-based processes rather than null. We hypothesize that priority effects from responsive seed bank transitions may be key in explaining the multiple equilibria observed among communities at extreme temperatures. These results suggest that soils generally have an intrinsic capacity for robustness to varied disturbances, even to press disturbances considered to be 'extreme', compounded, or incongruent with natural conditions.
Human class I major histocompatibility complex alleles determine central nervous system injury versus repair.

We investigated the role of human HLA class I molecules in persistent central nervous system (CNS) injury versus repair following virus infection of the CNS. Human class I A11+ and B27+ transgenic human beta-2 microglobulin positive (Hβ2m+) mice of the H-2 b background were generated on a combined class I-deficient (mouse beta-2 microglobulin deficient, β2m0) and class II-deficient (mouse Aβ0) phenotype. Intracranial infection with Theiler’s murine encephalomyelitis virus (TMEV) in susceptible SJL mice results in acute encephalitis with prominent injury in the hippocampus, striatum, and cortex. Following infection with TMEV, a picornavirus, the Aβ0.β2m0 mice lacking active immune responses died within 18 to 21 days post-infection. These mice showed severe encephalomyelitis due to rapid replication of the viral genome. In contrast, transgenic Hβ2m mice with insertion of a single human class I MHC gene in the absence of human or mouse class II survived the acute infection. Both A11+ and B27+ mice significantly controlled virus RNA expression by 45 days and did not develop late-onset spinal cord demyelination. By 45 days post-infection (DPI), B27+ transgenic mice showed almost complete repair of the virus-induced brain injury, but A11+ mice conversely showed persistent severe hippocampal and cortical injury. The findings support the hypothesis that the expression of a single human class I MHC molecule, independent of persistent virus infection, influences the extent of sub frequent chronic neuronal injury or repair in the absence of a class II MHC immune response.
Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients

Importance Though anecdotally linked, few studies have investigated the impact of facial paralysis on depression and quality of life (QOL). Objective To measure the association between depression, ...
Diffuse skin hyperpigmentation associated with chronic minocycline use in a patient with prosthetic joint infection

Cutaneous hyperpigmentation is a recognized adverse effect of chronic minocycline use occurring in up to 50% of patients. In this report we present a rare case of extensive skin hyperpigmentation involving both lower extremities in a patient receiving long term minocycline. The patient was receiving minocycline as suppression for chronic prosthetic joint infection. Risk factors associated with minocycline-induced cutaneous pigmentation (MICH) will be reviewed.
CareNet: Building a Secure Software-defined Infrastructure for Home-based Healthcare

Healthcare network and computing infrastructure is rapidly changing from closed environments to open environments that incorporate new devices and new application scenarios. Home-based healthcare is such an example of leveraging pervasive sensors and analyzing sensor data (often in real-time) to guide therapy or intervene. In this paper, we address the challenges in regulatory compliance when designing and deploying healthcare applications on a heterogeneous cloud environment. We propose CareNet framework, consisting of a set of abstraction and APIs, to allow the specification of compliance requirements. This work is a collaboration among computer scientists, medical researchers, healthcare IT and healthcare providers, and its goal is to reduce the gap between the availability of software defined infrastructure and meeting regulatory compliance in healthcare applications.
Nipple sparing mastectomy techniques: a literature review and an inframammary technique

Nipple sparing mastectomy (NSM) has quickly become an accepted technique for patients with selected cancers and for risk reducing surgery. Much of its surgical acceptance over the last decade has been based on the low risk of nipple areolar complex (NAC) occurrence in breast cancer patients. Improved patient satisfaction due to improved cosmetic outcomes with reconstruction have also driven its popularity. We reviewed current English journals to determine the NSM techniques which achieve the lowest complications, best outcomes, and best patient satisfaction. We researched studies showing reductions in complications with improved surgical techniques and patient selection which have been implicated in improved results. In the studies reviewed, incision placement, away from the nipple, resulted in the lowest rates of ischemic nipple complications and the best cosmetic outcomes. The effect of other factors such as surgeon experience and thickness of skin flap development were more difficult to prove. Leaving a 2-3 mm rim of tissue around the nipple bundle was shown to help preserve the nipple vascularity. Lower complication rates with improved outcomes and patient satisfaction were reported in the literature in patients with B or smaller cup sizes, non-smokers, and patients with lower body mass index (BMI). Incision placement, away from the nipple, with preservation of a 2-3 mm rim of tissue around the nipple bundle along with careful patient selection were the most significant variables reviewed which helped to lower complications rates of NSM. Coordinated surgical planning with the breast and plastic surgeons to determine the best surgical approach for each individual patient is necessary to obtain the best results. Although short-term oncologic follow-up seems to be acceptable, longer follow-up will still be needed to define the best breast cancer surgical candidates for the nipple sparing approach.
Using germination prediction to inform seeding potential: I. Temperature range validation of germination prediction models for the Great Basin, USA

Abstract Wet thermal germination regression models predict when subpopulations of seeds will germinate based on the summation of thermal time when seedbed soil water potential > −1.5 MPa. Germination rates fit models well at temperatures greater than 5 °C and less than 25 °C, but may not fit as well outside of that range. To better determine accuracy of these models, we quantified and compared seasonal wet degree days (WDD – a measure of thermal time) of sagebrush (Artemisia L.) -steppe seedbeds at five temperature ranges for up to 9 yr across 24 sites. Estimated thermal effects of three pinon and juniper (Pinus spp. and Juniperus spp.) tree removal treatments and three woodland infilling phases at time of tree reduction were also compared. We found that seedbeds sum a majority of WDD between 5 °C and 25 °C. Exceptions amounted to a relatively small percentage (12–20%) of total WDD in a season. Tree infilling or removal added WDD at 0 to
Vitamin D, Vitamin D Receptor, and Adipose Tissue: Focus on Cellular Mechanisms

Abstract Adipose tissue is a known storage site for vitamin D steroids and is rapidly emerging as a clinically relevant target tissue for 1,25(OH)2D. Links between vitamin D, body weight, and obesity have been proposed based on clinical and population studies; however, mechanistic understanding of the relationship is limited. The vitamin D receptor (VDR) is expressed in adipocyte precursors and is regulated during the differentiation process, but the impact of 1,25(OH)2D on adipogenesis varies considerably with model systems. A lean phenotype associated with enhanced energy expenditure has been confirmed in mice with genetic deletions in VDR, but whether this phenotype reflects actions of the receptor and/or its ligand in adipose tissue remains to be resolved. This chapter will provide a brief update on the role of adipose tissue as a storage depot for vitamin D and will review the effects of 1,25(OH)2D and the VDR on adipogenesis in vitro and adiposity in animal models.
Evolving morphology automatically reformulates the problem of designing modular control

Modularity is a system property of many natural and artificial adaptive systems. Evolutionary algorithms designed to produce modular solutions have increased convergence rates and improved generalization ability; however, their performance can be impacted if the task is inherently nonmodular. Previously, we have shown that some design variables can influence whether the task on the remaining variables is inherently modular. We investigate the possibility of exploiting that dependence to simplify optimization and arrive at a general design pattern that we use to show that evolutionary search can seek such modularity-inducing design variable values, thus easing subsequent search for highly fit, modular organization within the remaining design variables. We investigate this approach with embodied agents in which evolutionary discovery of morphology enables subsequent discovery of highly fit, modular controllers and show that it benefits from biasing search toward modular controllers and setting the mutation ...
Weapons and Methods of Attack as a Tactical Advantage

This chapter analyzes the weapons and methods of attack of assassins on municipal police chiefs and top-commanders across all other Northern Tier states. The tactical superiority of organized crime elements is manifest in the similarity of weaponry employed in law-enforcement assassinations (mainly AK-47s, AR-15s). It is also illustrated by the two signature attack “styles”: convoy style armed vehicular assaults and strategic hits on officers in or near their homes largely engaged in off-duty, everyday social activities. Operationally, such assassinations occur in strategic towns along three distinctive North-bound drug-transit highways across a range of municipalities in the multiple states of Baja California Norte, Baja California Sur, Sonora, Coahuila, Nuevo Leon, Tamaulipas, Sinaloa, Durango, Zacatecas and San Luis Potosi. The enhanced weaponry of organized crime elements along with surprise attacks, often involving deception, intersects with the relatively poor equipment (lack of bullet-proof vehicles) and uneven security for officers characteristic of multiple Mexican municipal police departments. Taken together, the tactical superiority of organized crime elements combined with their efforts to clear routes to smuggle drugs (operational means) facilitate the use of law-enforcement assassination as a strategy for action against law-enforcement agents.
"Triple hit" lymphomas: A retrospective cytology case series of an uncommon high grade B-cell malignancy with C-MYC, BCL-2 and BCL-6 rearrangements

The Revised fourth Edition World Health Organization (WHO) Classification of Tumors of Hematopoietic and Lymphoid Tissues suggests novel categories, including "high grade B-cell lymphoma with MYC and BCL2 and BCL6 gene rearrangements." These diseases are known colloquially as "double hit" and "triple hit" lymphomas. The "first-hit" in these cases is the harboring of a MYC rearrangement. Concurrent derangements of BCL2 and BCL6 can be the "second-hit" or "third-hit." To our knowledge, this is the first report of "triple-hit" lymphomas in cytology specimens. The files of the Cleveland Clinic (January 2007 through December 2017) were searched for all "triple hit" lymphomas. Four cases met inclusion criteria (cytology slides in files and histologically confirmed "triple hit" lymphoma). All slides were reviewed. The mean age was 65 years, with a male predominance. All patients presented at advanced stage and showed progressive disease despite therapy. FISH studies (histologic sections) confirmed translocations of MYC (8q24), BCL2 (18q21) and BCL6 (3q27) in all patients. All cases were characterized by high cellularity, dispersed cells, presence of stripped nuclei, lymphoglandular bodies, apoptotic bodies, cytomegaly, nucleomegaly, nuclear envelope irregularities, macronucleoli (most often single), recognizable mitoses and presence of cytoplasmic vacuoles (variable). The WHO recommends that all large B-cell lymphomas be investigated using cytogenetic or molecular techniques. Concurrent inhibition of MYC and BCL2 is a potentially effective treatment strategy for triple hit lymphomas, and an expanding literature exists regarding predictive biomarkers and therapeutic regimens. It is our intention to raise awareness of this uncommon mature B-cell neoplasm within the cytodiagnostic community.
Should we instruct patients to rub topical agents into skin? The evidence

Background: At least 15 factors influence the ability of compounds to penetrate the skin. Massage (rubbing) may be another factor that has gone relatively unrecognized.Method: PubMed, Google Schola...
Biological Events and Barriers to Effective Delivery of Cancer Therapeutics

The development and progression of human cancer are multistage processes that involve a variety of genetic mutations, epigenetic alterations, and interactions between tumor cells and their microenvironment. The genetic and epigenetic abnormalities lead to the selective growth of tumor cells that are highly resistant to apoptotic cell death and capable of avoiding immune surveillance. Those aggressive biological characteristics contribute to intrinsic and acquired resistance to cancer therapeutics. Intrinsic drug resistance refers to a poor therapeutic response of tumors to the initial chemotherapy, while acquired resistance is developed during drug treatment through additional genetic changes and dysregulation of signal pathways in tumor cells. Cross talk between cancer cells and tumor-associated stromal cells promotes infiltration and proliferation of tumor-associated fibroblasts and macrophages, accumulation of extracellular matrix (the supporting framework around the tumor cells), and dysfunctional tumor vasculatures, which create physical barriers for efficient delivery of therapeutic and diagnostic agents into tumor cells. Additional biological barriers include the overexpression of drug efflux pumps, upregulation of signal pathways associated with resistance, and the presence of cancer stem cells within the tumor. Targeting proteins that are overexpressed in the tumors such as human epidermal growth factor 2 (HER-2) aids in enhancing the overall efficiency of therapeutic delivery. While early detection of cancer cells is critical to effective treatment, clinically validated biomarkers of presymptomatic and early-stage disease are typically limited to serum or urine biomarker detection. Although conventional contrast-enhanced imaging approaches have been used for cancer detection, it has been difficult to detect small tumors due to their lack of specificity and sensitivity. Moreover, extensive stromal response in early tumors creates a delivery barrier for targeted imaging contrasts to reach tumor cells for production of specific imaging signals. In this chapter, we will focus on the key biological events in tumor development that result in heterogeneous therapeutic responses in cancer patients.
Wilms tumor 1 expression: addressing the 'elephant' in MDS.

‘How long do I have doc?’After pleasantries have been exchanged, a comprehensive medical history and physical exam have been performed, and a treatment plan has been discussed, we get to the ‘eleph...
Biochemical basis for the adenine requirement of ad3 mutants of Saccharomyces

Abstract In Saccharomyces thirteen non-allelic adenine requiring mutants (ad1–ad13) have been reported (Microbial Genetics Bulletin 1966). The metabolic defects associated with these mutants are well characterized only for ad1 which accumulates 5-amino imidazole ribotide (AIR) (Friedman and Moat 1958), and ad12 and ad13 which lack adenylosuccinate synthetase and adenylosuccinase activity respectively (Dorfman 1966). The biosynthetic pathway for adenine in yeast seems to be identical with that described for other organisms (cf. Magasanik 1962). Mutations at the ad3 locus of Saccharomyces are of particular interest because they result in a requirement for histidine as well as adenine (Roman 1956). Although it has been suggested by Levinthal et al 1962 that ad3 mutants accumulate 5-amino 4-imidazole carboxamide ribotide (AICAR), no evidence supporting this contention has been offered. In the present paper experiments are described which establish the primary metabolic defect of ad3 leading to the adenine requirement.
Analytical Modeling of Survivable Anycast Communication in Optical Networks

Network resources are imperfect and vulnerable to failure from a wide variety of sources. Survivability is a well-researched field that focuses on strategies to prevent or reduce the harm inflicted when network elements fail. Solutions tend to either provision resources, such as backup paths, proactively so that traffic can be switched to the alternative route after a failure, or quickly find new resources to provision after failure event occurs. Current survivability solutions guarantee protection against these failures, but there is no mathematical model to calculate the network blocking probability for survivability solutions of anycast communication. In this paper, we developed new analytical models to calculate network-wide blocking performance for anycast survivability approaches. Performance results show that our models are accurate and are verified by extensive simulation results.
Leidenfrost behavior in drop-wall impacts at combustor-relevant ambient pressures

Abstract Liquid-fueled combustion systems demand optimal performance over a range of operating conditions—requiring predictable fuel injection events, spray breakup, and vaporization across a range of temperatures and pressures. In direct injection combustors, these sprays impinge directly on combustion chamber surfaces. Although the outcome of fuel droplets impacting a wall is primarily driven by the wall temperature and the Leidenfrost effect, the shifting liquid-vapor saturation point with pressure may influence the droplet-wall heat transfer rate and transition from nucleate to film boiling. In this paper, the role of ambient pressure on the droplet impact regimes, spreading rate, and droplet rebound velocity during impact are explored for representative low boiling point and high boiling point pure hydrocarbon liquids (n-heptane and n-decane). High-speed image sequences of the drop-wall impact were acquired for ambient pressures of 1–20 bar and wall temperatures ranging from 35–300 ∘C with a drop Weber number of ~ 50. Droplet impact sequences were recorded using a high-speed CMOS camera and were processed to measure the droplet spread, droplet rebound velocity and track the droplet centroid motion. The dynamics of the drop spreading and rebound show similar behavior across a range of ambient pressures with the largest differences observed for wetted versus non-wetted cases (above the Leidenfrost temperature). For both fluids, the onset of drop rebound remains bounded by the saturation temperature (shifting with ambient pressure) and the thermodynamic limit of liquid superheat. This leads to a decrease in the superheat temperature above the saturation point as the critical pressure is approached.
Automatic Landmark-guided Bijective Brain Image Registration by Composing Region-based Locally Diffeomorphic Warpings

As the size of the neuroimaging cohorts being increased to address key questions in the field of cognitive neuroscience, cognitive aging, and neurodegenerative diseases, the accuracy of the spatial normalization as an essential pre-processing step becomes extremely important in the neuroimaging processing pipeline. Existing spatial normalization methods have poor accuracy particularly when dealing with the highly convoluted human cerebral cortex and when brain morphology is severely altered (e.g. clinical and aging populations). To address this shortcoming, we propose to implement and evaluate a novel landmark-guided region-based spatial normalization technique that takes advantage of the existing surface-based human brain parcellation to automatically identify and match regional landmarks. To simplify the non-linear whole brain registration, the identified landmarks of each region and their counterparts are registered independently with large diffeomorphic (topology preserving) deformation via geodesic shooting. The regional diffeomorphic warping fields were combined by an inverse distance weighted interpolation technique to have a smooth global warping field for the whole brain. To ensure that the final warping field is diffeomorphic, we used simultaneously forward and reverse maps with certain symmetric constraints to yield bijectivity. We have evaluated our proposed method using both simulated and real (structural and functional) human brain images. Our evaluation shows that our method can enhance structural correspondence up to around 86%, a 67% improvement compared to the existing state-of-the-art method. Such improvement also increases the sensitivity and specificity of the functional imaging studies by about 17%, reducing the required number of subjects and subsequent costs. We conclude that our proposed method can effectively substitute existing substandard spatial normalization methods to deal with the demand of large cohorts and the need for investigating clinical and aging populations.
Psychological Aspects of Long-Term Survivorship

Childhood cancer survivors and their families can be surprised by the realization that cancer does not end when treatment ends and that life does not automatically return to normal. As families manage the many transitions that accompany the end of treatment, they find that cancer survivorship has its own set of medical and psychological issues. Medical visits and monitoring continue – initially for disease recurrence and then for the emergence of medical late effects – and longer-term psychological reactions emerge. For these reasons, it is more accurate to conceive of cancer survivorship as a stage in a life-long chronic illness, rather than as an acute illness that ends with “cure” or the attainment of “survivorship” status [74]. The goal of this chapter is to provide an overview of psychological late effects of childhood cancer and present guidance for managing these effects.
Developing A Definition Of Climate And Health Literacy

A new generation of activists is calling for bold responses to the climate crisis. Although young people are motivated to act on climate issues, existing educational frameworks do not adequately prepare them by addressing the scope and complexity of the human health risks associated with climate change. We adapted the US government's climate literacy principles to propose a definition and corresponding set of elements for a concept we term climate and health literacy. We conducted a scoping review to assess how the peer-reviewed literature addresses these elements. Our analysis reveals a focus on training health professionals; more international than US domestic content; and limited information about data and models, fossil fuels, and equity. We propose developing a framework that builds on the elements to support a broader educational agenda that prepares students and future leaders to recognize the complex health ramifications of a changing climate.
Women’s Health and Sex- and Gender-Based Medicine: Past, Present, and Future

Sex- and gender-based women’s health (SGBWH) is the integration of women’s health and the newer field of sex- and gender-based medicine. This chapter provides a foundation for primary care providers (PCPs) to understand the evolution and integration of these fields, the implications for research and clinical care, and the mandate to include SGBWH curricula in health-care education. SGBWH is concerned with eliminating gaps in the comprehensive care of women patients and improving the sex- and gender-informed care of all patients. Prior to 1990, women’s health was equated with reproductive health, sometimes referred to as “bikini medicine.” Since the 1990s, however, the definition has broadened. Changing terminology reflects the evolution of the field, and consensus and partnership among health-care providers and health educators will allow the field to advance. The optimal care of women, which is the focus of this book, includes the integration of primary care medicine, primary care psychiatry, primary care gynecology, and primary care breast health into the care of patients as individuals within the context of sex, gender, cultural, and societal factors. Continued research advances in the study of sex as a biological variable, the inclusion of findings into health-care education at all levels, and the fostering of comprehensive evidence-based primary and specialty care, will help ensure excellent primary care for women and the delivery of more personalized health care for all patients.
Does preoperative disease severity influence outcomes in reverse shoulder arthroplasty for cuff tear arthropathy

Abstract: Introduction The degree of symptomatic disease and functional burden has been demonstrated to influence patient results and satisfaction in total hip and knee arthroplasty. While the relationship between preoperative diagnosis and patient outcomes has been an area of study for reverse total shoulder arthroplasty (RTSA), the influence of the progression of cuff tear arthropathy (CTA) has not yet been examined. The purpose of this study is to evaluate whether preoperative radiographic disease burden and scapular geometry impacts patient outcomes and satisfaction in a cohort of patients with CTA treated with RTSA. Methods Eighty-six patients were treated for CTA with RTSA between September 2016 and September 2018 by the senior author (*.*.) and enrolled into an institutional registry. At the time of initial evaluation baseline ASES score, patient demographics, history of shoulder surgery, and presence of pseudoparalysis were collected. Radiographs were obtained to evaluate critical shoulder angle (CSA), acromial index (AI), and progression of CTA as assessed by the Hamada grading and Seebaeur classification. Patients were contacted in order to reassess their ASES score and their satisfaction with the improvement in their shoulder function. Results Seventy-nine (91.6%) patients were available for evaluation at a minimum of 24 months of follow-up. Multivariable logistic regression modeling revealed that scapular geometry measurements (CSA and AI) and the degree of CTA (Seebaeur and Hamada) were not associated with worse outcomes as assessed by ASES score. However, degenerative changes as assessed by the Hamada grade (0.13 (0.02-0.86), p=0.03) and preoperative ASES scores (1.04 (1.01, 1.07), p=0.008) were independently associated with higher satisfaction at 24 months of follow-up. Conclusion The results indicate that patients with greater CTA disease progression do not show differing outcomes after RTSA compared to those with milder disease. In contrast, both poorer preoperative function and degenerative changes as assessed by the Hamada classification were associated with greater satisfaction after RTSA for CTA. Given the broad spectrum of disease in CTA, there is likely a corresponding range in patient expectations that requires further study to maximize patient satisfaction.