cssi/SciSciGPT-SciSciNet huggingface dataset:
Suppression by sodium, potassium or nucleotides of binding between cardiac steroid (digoxigenin) and sodium- and potassium-dependent adenosine triphosphatase formed in the presence of magnesium and phosphate.

The cardiotonic steroid binding to (Na+ + K+)-ATPase formed in the presence of the Mg2+ and Pi (type II binding) is suppressed by the Na+, K+, or nucleotides in different ways. In the ouabain binding at real equilibrium, such effects were difficult to detect because of the high affinity of its sugar moiety to the enzyme. The apparent number of binding sites according to Scatchard plots of digoxigenin binding and the association rate of digoxigenin were reduced by the Na+ at pH 6.5 and 8.5. This Na+-effect was delayed in the initial phase at pH 6.5, when the Na+ was added after the phosphorylation of the enzyme was accomplished by the Mg2+ and Pi. Therefore, the Na+ seems to bind with the nonphosphorylated form of the enzyme, and to reduce level of the phosphorylated enzyme, the active form for digoxigenin binding. In contrast to the Na+, the K+ increased the apparent binding constant according to Scatchard plot of digoxigenin binding at pH 6.5 and 8.5; the K+ seems to bind with the phosphorylated form of enzyme, causing the insensitive complex not to bind with digoxigenin. Unlike either the Na+ or K+, triphosphonucleotides suppressed the type II digoxigenin binding only partially. The potencies of ATP and β,γ-methylene ATP were similar; both were most potent among the triphosphonucleotides (its half-maximum concentration [unknown] 0.2 mM). GTP and ITP were less potent while AMP was almost ineffective. ADP was as effective as ATP in less than 0.8 mM, but in higher concentrations, ADP increased the inhibition of digoxigenin binding, reducing the increment of the increase, while ATP showed saturation. According to Scatchard plots, ATP decreased only the apparent number of binding sites below pH 8.0, but it increased only the apparent binding constant above pH 8.0. β,γ-Methylene ATP reduced the association rate of digoxigenin at pH 7.0 and 8.3, but did not seem to change the level of phosphorylated protein by the Mg2+ and Pi and the dissociation rate of digoxigenin-enzyme complex at both pHs. Therefore, such nucleotide-effect seems to be one of the low-affinity effects of ATP, and seems to include some conformational changes of phosphorylated active form produced by the Mg2+ and Pi, reducing its affinity to cardiotonic steroids.
Exponential Decay Rate Conditions for Uncertain Linear Systems Using Integral Quadratic Constraints

This technical note develops linear matrix inequality (LMI) conditions to test whether an uncertain linear system is exponentially stable with a given decay rate $\alpha$ . These new $\alpha$ - exponential stability tests are derived for an uncertain system described by an interconnection of a nominal linear time-invariant system and a “troublesome” perturbation. The perturbation can contain uncertain parameters, time delays, or nonlinearities. This technical note presents two key contributions. First, $\alpha$ - exponential stability of the uncertain LTI system is shown to be equivalent to (internal) linear stability of a related scaled system. This enables derivation of $\alpha$ - exponential stability tests from linear stability tests using integral quadratic constraints (IQCs). This connection requires IQCs to be constructed for a scaled perturbation operator. The second contribution is a list of IQCs derived for the scaled perturbation using the detailed structure of the original perturbation. Finally, connections between the proposed approach and related work are discussed.
Trauma of the spleen and liver in children.

Splenic and hepatic trauma are discussed in terms of diagnosis, management, and surgical treatment. Rupture of the spleen should seldom be fatal when there are no other multiple injuries present which jeopardize life. Rupture of the liver, in contrast, can result in death before surgical intervention can be accomplished, and mortality remains significant despite immediate surgical intervention.
Environment-driven somatic mosaicism in brain disorders

The identification of somatic mosaicism in the brain lends a new perspective to our understanding of the role of gene and environment interactions in psychiatric disease risk. Somatic mutations, such as retrotransposon insertions, that are precipitated by modern environmental factors may alter neuronal function and neurological traits, increasing the societal prevalence of mental disorders.
The nurse response to abnormal vital sign recording in the emergency department

Aims and objectives To examine what occurs after a recorded observation of at least one abnormal vital sign in the emergency department. The aims were to determine how often abnormal vital signs were recorded, what interventions were documented, and what factors were associated with documented follow-up for abnormal vital signs. Background Monitoring quality of care, and preventing or intervening before harm occurs to patients are central to nurses’ roles. Abnormal vital signs have been associated with poor patient outcomes and require follow-up after the observation of abnormal readings to prevent patient harm related to a deteriorating status. This documentation is important to quality and safety of care. Design Observational, retrospective chart review. Methods Modified Early Warning Score was calculated for all recorded vital signs for 195 charts. Comparisons were made between groups: (1) no abnormal vital signs, (2) abnormal vital sign present, but normal Modified Early Warning Score and (3) critically abnormal Modified Early Warning Score. Results About 62·1% of charts had an abnormal vital sign documented. Critically abnormal values were present in 14·9%. No documentation was present in 44·6% of abnormal cases. When interventions were documented, it was usually to notify the physician. The timing within the emergency department visit when the abnormalities were observed and the degree of abnormality had significant relationships to the presence of documentation. Conclusions It is doubtful that nurses do not recognise abnormalities because more severely abnormal vital signs were more likely to have documented follow-up. Perhaps the interruptive nature of the emergency department or the prioritised actions of the nurse impacted documentation within this study. Further research is required to determine why follow-up is not being documented. Relevance to clinical practice To ensure safety and quality of patient care, accurate documentation of responses to abnormal vital signs is required.
A pilot goal-directed perfusion initiative is associated with less acute kidney injury after cardiac surgery

Background We sought to determine whether a pilot goal-directed perfusion initiative could reduce the incidence of acute kidney injury after cardiac surgery.
Policies for promotion of physical activity and prevention of obesity in adolescence

Obesity rates among children and adolescents in developed countries have increased dramatically since the 1970s. During that same period, numerous secular changes have combined to reduce the demand for physical activity in day-to-day life, and many barriers to physical activity are now evident. As a consequence, most children and adolescents do not meet the accepted public health guidelines for physical activity. Accordingly, public health interventions are needed to increase physical activity in adolescence. Such interventions, if successfully implemented, can be expected to improve fitness and health as well as reduce the prevalence of overweight and obesity in young people. Promotion of physical activity in populations of children and adolescents will require comprehensive strategic planning and adoption of new policies in multiple societal sectors. This paper highlights nine initiatives that can address the problem of physical activity in children. The initiatives are to: establish comprehensive school physical activity programming; demand high quality physical education; require physical activity in early child care and education; require physical activity in afterschool programs; create equity in community resources; activate youth sports programs; re-normalize active transport to school; institutionalize clinic-based physical activity assessment and counseling; and build activity-friendly homes. A case will be made for comprehensive national and international strategic planning aimed at effective and large-scale implementation of these initiatives and tactics.
Phenomenal consciousness, collective mentality, and collective moral responsibility

Are corporations and other complex groups ever morally responsible in ways that do not reduce to the moral responsibility of their members? Christian List, Phillip Pettit, Kendy Hess, and David Copp have recently defended the idea that they can be. For them, complex groups (sometimes called collectives) can be irreducibly morally responsible because they satisfy the conditions for morally responsible agency; and this view is made more plausible by the claim (made by Theiner) that collectives can have minds. In this paper I give a new argument that they are wrong. Drawing on recent work in the philosophy of mind (what Uriah Kriegel calls “the phenomenal intentionality research program”) and moral theory (David Shoemaker’s tripartite theory of moral responsibility), I argue that for something to have a mind, it must be phenomenally conscious, and that the fact that collectives lack phenomenal consciousness implies that they are incapable of accountability, an important form of moral responsibility.
Creativity and Identity in the Construction of Professional Portfolios

In this qualitative study, we explore acts of creative identity construction by focusing on the digital portfolios of engineering graduate students as they integrate research, teaching, and service with personal beliefs and experiences. We employ theoretical lenses of identity construction as performative and fluid, and self-authorship as intentional meaning making in that process. Our findings indicate two types of creative identity construction. First, the participants construct professional identities by drawing together and commenting on various experiences, values, and passions they select to represent their professional selves. Second, and equally important, the students use portfolios to construct an identity for the profession of engineering itself, not only through explicit engineering philosophies, but also through the ways in which they describe their work and their values. Both sets of constructions represent creative acts of engineering identity work. We conclude that the discursive acts that students undertake when they pair evidence of their achievements with narrative reflections serve as sites of identity construction that allow students the time and the framework to intentionally construct their career trajectories, their personal development, and the various facets of their professional roles. Constructing a portfolio is creative act of self-authorship that allows students to integrate their many intersecting identities and craft wholly new and unique ways of being an engineer.
Quercetin, Morin, Luteolin, and Phloretin Are Dietary Flavonoid Inhibitors of Monocarboxylate Transporter 6.

Monocarboxylate transporter 6 (MCT6; SLC16A5) has been recognized for its role as a xenobiotic transporter, with characterized substrates probenecid, bumetanide, and nateglinide. To date, the impact of commonly ingested dietary compounds on MCT6 function has not been investigated, and therefore, the objective of this study was to evaluate a variety of flavonoids for their potential MCT6-specific interactions. Flavonoids are a large group of polyphenolic phytochemicals found in commonly consumed plant-based products that have been recognized for their dietary health benefits. The uptake of bumetanide in human MCT6 gene-transfected Xenopus laevis oocytes was significantly decreased in the presence of a variety of flavonoids (e.g., quercetin, luteolin, phloretin, and morin), but was not significantly affected by flavonoid glycosides (e.g., naringin, rutin, phlorizin). The IC50 values of quercetin, phloretin, and morin were determined to be 25.3 ± 3.36, 17.3 ± 2.37, and 33.1 ± 3.29 μM, respectively. The mecha...
Strain Measurement at Temperatures Up to 800°C Utilizing Digital Image Correlation

An experimental technique is introduced to measure full field strains using three dimensional digital image correlation at temperatures up to 800°C. Challenges include: thermal air gradients, speckle pattern adhesion, image distortion due to viewing window deformation, camera calibration, and infrared light pollution of the camera sensor. Elements of the test setup are designed to address all of these challenges. The technique is used to measure full-field strains on Ti-6Al-4V specimens as they are loaded to failure in tension. The technique provides substantially more data than traditional elevated temperature strain measurement methods.
Inductive Reasoning and Problem Solving: The Early Grades

Publisher Summary This chapter considers where reasoning “fits” within the context of higher-order thinking skills with references to reviews of curriculum programs that have been developed to promote thinking, reasoning, and problem-solving skills in the United States and Europe. It discusses cognitive intervention and academic achievement, where teaching may involve individual students, small groups of students, or entire classrooms. It also introduces a cognitive training program for children from ages 6 to 10 that teaches inductive reasoning and problem-solving skills. Attitude is defined as “a state of mind or feeling.” Most of a teacher's day is spent providing students with domain-specific information. Formal reasoning is typically thought of as having two distinct forms. One is inductive reasoning; the other is deductive. Cognitive training program, a highly practical training program helps children in the primary or elementary grades (ages 6 to 10) achieve greater competence in problem solving and inductive reasoning. Generalization (GE) is the process whereby the common attribute that can be used to group a number of objects. Identification of the common attribute between objects provides the basis for forming a common group, class, category, or concept.
Non-Mydriatic Ultra-Widefield Imaging Compared With Single-Field Imaging in the Evaluation of Peripheral Retinal Pathology.

Background and objective To report clinical feasibility of non-mydriatic ultra-widefield (NMUWF) imaging and determine the prevalence of peripheral retinal pathology in comparison to standard single-field imaging in a primary care setting. Patients and methods Six hundred and thirty-two subjects (1,260 eyes) who underwent NMUWF imaging during annual health screening from October 2015 through March 2016 were retrospectively identified. An automated algorithm processed the raw images into: (1) NMUWF image with mask/grid outline that delineates the center 45° field simulating standard single-field photograph and (2) single-field image comprising 45° posterior pole extracted from the corresponding NMUWF image. Results Mean age of patients was 59.6 years ± 7.5 years. Of the 1,260 eyes, 1,238 eyes (98.3%) were considered optimum for grading. NMUWF images detected peripheral retinal pathology in 228 eyes (18.4%) that were not visible on corresponding single-field images. Conclusions NMUWF imaging is feasible in a primary care setting, allows improved visualization of peripheral retinal pathology, and may therefore be useful for telemedicine screening. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:962-968.].
An Integration of Statistics and Christianity

The Christian world-view has implications for statistics at the philosophical level as well as at the theoretical and applied levels. At the philosophical level statistics can be regarded as reflec...
The Association between Potential Exposure to Magazine Ads with Voluntary Health Warnings and the Perceived Harmfulness of Electronic Nicotine Delivery Systems (ENDS)

(1) Background: Several brands of electronic nicotine delivery systems (ENDS) carry voluntary health warning messages. This study examined how potential exposure to ENDS magazine ads with these voluntary health warnings were associated with the perceived harmfulness of ENDS. (2) Methods: Risk perception measures and self-reported exposure to ENDS ads were obtained from the 2014 Georgia State University (GSU) Tobacco Products and Risk Perceptions Survey of a nationally representative sample of U.S. adults. We examined the association between potential exposure to magazine ads with warnings and the perceived harms of ENDS relative to cigarettes, using binary logistic regressions and controlling for general ENDS ad exposure and socio-demographic characteristics. (3) Results: Potential exposure to ENDS magazine ads with warnings was associated with a lower probability of considering ENDS to be more or equally harmful compared to cigarettes, particularly among non-smokers (OR = 0.16; 95% CI: 0.04–0.77). In addition, ad exposure, ENDS use history, race/ethnicity, gender, education, and income were also associated with harm perceptions. (4) Conclusions: This study did not find evidence that magazine ads with warnings increased misperceptions that ENDS are equally or more harmful than cigarettes. With more ENDS advertisements carrying warnings, more research is needed to determine how the warnings in advertisements convey relative harm information to consumers and the public.
the relevance of a university degree in meteorology for the broadcast meteorologist

The increasing descriptive knowledge of the atmosphere's behavior plus the increased physical understanding of meteorological events necessitates basic training in meteorology and oceanography if one is to continue to comment meaningfully upon the weather scene. This training should enable the broadcast meteorologist to get the maximum utility and interesting commentary out of information supplied to him from public sources. It also should prepare him to operate his own meteorological set-up including the use of data from sophisticated tools such as radar and weather satellites. These objectives can be attained through the curriculum for the B.S. degree in Meteorology which is supplemented by special elective courses.
Focusing on the Future of Cardiovascular Outcomes Research: Highlights From the American Heart Association/American Stroke Association Quality of Care and Outcomes Research 2018 Scientific Sessions.

The American Heart Association/American Stroke Association Quality of Care and Outcomes Research (QCOR) 2018 Scientific Sessions was recently held in Arlington, VA, from April 6 to 7. The 2-day conference featured >50 oral presentations and 170 poster presentations across an array of topics, including the use of big data science in clinical practice, the shifting policy landscape in cardiovascular care, and the expanding role of social media in science. One key theme throughout the conference was the future of cardiovascular outcomes research, which was highlighted by the 2018 QCOR Outstanding Achievement Award recipient and keynote speaker Eric D. Peterson, MD, MPH. Dr Peterson reflected on the progress of cardiovascular outcomes research as a field and the QCOR community in general. What was once a small group of geeks running simple regression models on manually chart-reviewed data has grown into a much larger group of wonks applying machine learning techniques to hundreds of thousands of electronic medical records, he reflected. He also forecasted the future of cardiovascular outcomes research, which included the potential of big data science to improve outcomes, the importance of fostering partnerships with patients who actively participate in research, and the development and use of living clinical registries. Above all, he stressed the importance of mentorship and investing in the future generation of cardiovascular outcomes researchers. Within the context of this theme, we offer several directions of cardiovascular outcomes research that were presented at QCOR 2018 Scientific Sessions. In addition, we present updates on the current and future state of Get With The Guidelines (GWTG) registries and highlight the career development opportunities that QCOR 2018 provided to young investigators. ### Translating Big Data to Clinical Practice The opening plenary session of QCOR 2018 highlighted opportunities that big data science offers, including machine learning, artificial intelligence, and natural language processing. In addition, the challenges to implementing …
1 – Interactive Effects of Water Stress and Elevated CO2 on Growth, Photosynthesis, and Water Use Efficiency

Publisher Summary This chapter focuses on three critical aspects of crop productivity as affected by water deficit and elevated CO2. Water deficit is probably the most important to determine plant growth and productivity worldwide. At the same time, climatic conditions and CO2 concentration in the atmosphere strongly influence plant water use and growth. Interestingly, as the level of CO2 rises above the present ambient level, photosynthesis enhances and transpiration often reduces, resulting in a higher efficiency of water use, while plant growth and productivity generally increase. Limited data also show that elevated levels of CO2 may facilitate plants' adjustment to drought. How water deficits and elevated CO2 interact to impact plant productivity and water use efficiency (WUE) is a pivotal question in terms of future changes of natural and managed terrestrial ecosystems. For natural communities, differences in WUE under elevated CO2 may determine the success in adaptation and competition of plant species, and ultimately in community succession, and in generally warmer temperature and more frequent drought.
CONTROLLING RACES IN ASYNCHRONOUS SEQUENTIAL MACHINES

Abstract State feedback controllers can be used to restore predictable behavior of asynchronous sequential machines that are afflicted by a critical race. The present note presents necessary and sufficient conditions for the existence of such controllers. The controllers also assign a specified behavior to the controlled machine. Copyright © IFAC 2002
RECENT RESEARCH IN THE PHYSIOLOGY OF MEDITATION

Publisher Summary This chapter discusses the recent research in the physiology of meditation. The practice of meditation can produce rather unusual physiological effects in the areas of metabolism, hemispheric specialization, and habituation. The concept of deautomatization to meditation results in the alteration in consciousness experienced during meditation stemmed from a reorganization of habituated perceptual and cognitive functions, presumably by reinvestment of actions and percepts with attention. The deautomatized state of consciousness experienced during meditation becomes a generalized trait and with continued practice, the meditator shifts his or her dominant mode of attention from one that is verbal and analytical to one predominantly intuitive and holistic. The goal of meditation has been traditionally described in terms of such a change in normal attentional processes to create a healthier, unitive awareness of experience. The attentional alteration resulting from meditation reflects a relative shift in the brain's underlying dominant mode of information processing.
Transcatheter Aortic Valve Replacement: What the Near-Term Future Holds and What Evidence Is Needed?

Transcatheter aortic valve replacement (TAVR) is a rapidly evolving therapy that already has a strong evidence base in both inoperable and high-risk patients with severe calcific aortic stenosis. Its ongoing growth as a treatment modality in the near future demands a rigorous approach to clinical research to provide evidence to support its long-term safety and efficacy. This evidence will come in several important areas: (1) refining the indications for TAVR, (2) improving its safety, and (3) building on the success of the first-generation devices with novel designs and concepts. The indications for this technology are being refined, and although the primary focus is on aortic stenosis, exciting new applications are emerging that will require rigorous evaluation and present new challenges. Improving the safety and efficacy of TAVR is of paramount importance, and there is a growing evidence base that concurrent advances in imaging techniques are helping to reduce complications that can arise with TAVR. Several new TAVR devices are emerging, which are each being evaluated in clinical studies.
Models for evaluating the performability of degradable computing systems

Recent advances in multiprocessor technology established the need for unified methods to evaluate computing systems performance and reliability. In response to this modeling need, a general modeling framework that permits the modeling, analysis and evaluation of degradable computing systems is considered. Within this framework, several user oriented performance variables are identified and shown to be proper generalizations of the traditional notions of system performance and reliability. Furthermore, a time varying version of the model is developed to generalize the traditional fault tree reliability evaluation methods of phased missions.
On Barbier's ‘étoiles M, C et à émission nouvelles’

More than half of the new M, C and emission-line stars discovered on objective-prism plates by Barbier (1975) are shown to be objects with previously published spectral classifications.
Disruption of prepulse inhibition is associated with severity of compulsive behavior and nucleus accumbens dopamine system changes in Sapap3 knockout mice

Obsessive compulsive disorder (OCD) is associated with disruption of sensorimotor gating, which may contribute to difficulties inhibiting intrusive thoughts and compulsive rituals. Neural mechanisms underlying these disturbances are unclear; however, striatal dopamine signalling is implicated in both OCD pathophysiology and the neural regulation of sensorimotor gating. The goal of this study was to examine the relationships between sensorimotor gating, compulsive behavior, and dopamine system functioning in Sapap3 knockout mice (KOs), a widely used preclinical model system for OCD research. Using prepulse inhibition (PPI), a translational measure of sensorimotor gating, we found no differences between Sapap3-KOs and controls when comparing group means. However, there was significant heterogeneity in PPI levels across Sapap3-KOs, which was negatively correlated with severity of compulsive grooming. Disruption of PPI and compulsive grooming were associated with reduced dopamine D1 and D2/3 receptor density in the nucleus accumbens core (NAcC) measured via autoradiography. Finally, chronic treatment with a first-line pharmacotherapy for OCD, the selective serotonin reuptake inhibitor (SSRI) fluoxetine, normalized PPI; these therapeutic effects were associated with reduced density of dopamine transporter in NAcC. This is the first detailed characterization of heterogeneity across different OCD-relevant behavioral and neurochemical measures in a transgenic model system, highlighting associations between severity of compulsive behavior and sensorimotor gating disturbances. Our findings also suggest that changes in NAcC dopamine functioning may be critical for the pathology and treatment of OCD-relevant sensorimotor gating impairments.
Theories of Emotional Development: Where Have We Been and Where Are We Now?

In this chapter, we review several theories of emotional development. For each, we address definitions and basic tenets, we ask what “develops” and how emotions change with age. What is particularly noteworthy is that although there are several emotional development theories, none ascribes to a single emotion theory. Moreover, no single emotional development theory guides contemporary research. In the second half of the chapter, we review other conceptual frameworks and theories that are not emotion theories per se but are widely used to guide research on emotional development. Throughout this chapter, we provide illustrative empirical examples for aspects of each theory. In many ways, this chapter is a primer on emotion development theory rather than an exhaustive review of each theory. We end with a recommendation calling for empirical evidence to guide theory development.
Fosmidomycin biosynthesis diverges from related phosphonate natural products

Fosmidomycin and related molecules comprise a family of phosphonate natural products with potent antibacterial, antimalarial and herbicidal activities. To understand the biosynthesis of these compounds, we characterized the fosmidomycin producer, Streptomyces lavendulae, using biochemical and genetic approaches. We were unable to elicit production of fosmidomycin, instead observing the unsaturated derivative dehydrofosmidomycin, which we showed potently inhibits 1-deoxy-D-xylulose-5-phosphate reductoisomerase and has bioactivity against a number of bacteria. The genes required for dehydrofosmidomycin biosynthesis were established by heterologous expression experiments. Bioinformatics analyses, characterization of intermediates and in vitro biochemistry show that the biosynthetic pathway involves conversion of a two-carbon phosphonate precursor into the unsaturated three-carbon product via a highly unusual rearrangement reaction, catalyzed by the 2-oxoglutarate dependent dioxygenase DfmD. The required genes and biosynthetic pathway for dehydrofosmidomycin differ substantially from that of the related natural product FR-900098, suggesting that the ability to produce these bioactive molecules arose via convergent evolution.
Special Places, Sacred Spaces: Two Traditional Buddhist Temples in Nihonmachi Los Angeles:

This article explores two significant Buddhist temples in Los Angeles’s Little Tokyo, the Nishi Hongwanji, and the Higashi Honganji Buddhist Churches. The study’s methodology is inspired by Yi-Fu T...
Postoperative Neurocognitive Disorders in the Geriatric Patient

Postoperative neurocognitive disorders including delirium and cognitive dysfunction are among the most common postoperative complications experienced by older adults. Risk factors for postoperative neurocognitive disorders include pre-existing cognitive impairment, advanced age, and lower educational attainment. It is important to discuss the potential for these common postoperative sequelae with at-risk patients.
Reconstructive and prosthodontic outcomes after multiple palatomaxillary reconstructions.

Objective A subset of patients who undergo major palatomaxillary reconstruction do not initially achieve their intended oncologic and/or reconstructive goals and require additional surgery. We aim to detail the unique management considerations in this patient population. Methods We performed a retrospective review of patients who underwent palatomaxillary reconstruction by the senior author (m.l.u.) between 1998 and 2016. Results Twenty-one patients required multiple reconstructions. The median time to second reconstruction was 17 months. The most common reason for a second reconstruction was for recurrent disease (10 of 21), followed by functional/aesthetic reasons (7 of 21) and osteoradionecrosis (4 of 21). Four patients went on to have a third reconstruction, and two underwent a fourth. A total of 27 reconstructions were performed, consisting of 20 soft tissue free flaps, four vascularized bone free flaps, and three locoregional flaps. Conclusion This patient cohort represents unique oncologic and reconstructive challenges. With long-term follow-up, multiple reconstructions may be required to optimize oncologic and functional/aesthetic outcomes. This is the first series of its kind that details the reasons for, as well as the outcomes of, patients who required multiple reconstructive procedures following initial palatomaxillary reconstruction. Level of evidence 2B Laryngoscope, 130:2349-2353, 2020.
Reseña de Pedro Calderón de la Barca, «La aurora en Copacabana (una comedia sobre el Perú)», edición crítica de José Elías Gutiérrez Meza, Madrid / Frankfurt am Main, Iberoamericana / Vervuert, 2018, 338 pp. ISBN: 978-84-16922-66-6

Resena de Pedro Calderon de la Barca, La aurora en Copacabana (una comedia sobre el Peru), edicion critica de Jose Elias Gutierrez Meza , Madrid / Frankfurt am Main, Iberoamericana / Vervuert, 2018, 338 pp. ISBN: 978-84-16922-66-6 (Iberoamericana), 978-3-95487-689-1 (Vervuert), 978-3-95487-690-7 (e-Book)
Reduction of Central-Line–Associated Bloodstream Infections in a Spinal Cord Injury Unit

Background: Central-line–associated bloodstream infections (CLABSIs) are a complication of indwelling central venous catheters, which increase morbidity, mortality, and cost to patients. Objective: Due to increased rates in a spinal cord injury unit (SCIU), a performance improvement project was started to reduce CLABSI in the patient population. Methods: To reduce the incidence of CLABSI, a prevention bundle was adopted, and a peer-surveillance tool was developed to monitor compliance with the bundle. Staff were trained to monitor their peers and submit weekly surveillance. Audits were conducted by the clinical nurse leader with accuracy feedback. Bundle peer-surveillance was implemented in February of 2018 with data being fed back to leadership, peer monitors, and stakeholders. Gaps in compliance were addressed with peer-to-peer education, changes in documentation requirements, and meetings to improve communication and reduce line days. In addition, the use of an antiseptic-impregnated disc for vascular accesses was implemented for dressing changes. Further quality improvement cycles during the first 2 quarters of fiscal year 2019 included service-wide education reinforcement, identification in variance of practice, and reporting to staff and stakeholders. Results: CLABSI bundle compliance increased from 67% to 98% between February and October 2018. The weekly audit reporting accuracy improved from 33% to 100% during the same period. Bundle compliance was sustained through the fourth quarter of 2019 at 98%, and audit accuracy was 99%. The initial CLABSI rates the quarter prior to the intervention were 6.10 infections per 1,000 line days for 1 of the 3 SCIUs and 2.68 infections per 1,000 line days for the service overall. After the action plan was initiated, no CLABSIs occurred for the next 3 quarters in all SCIUs despite unchanged use of central lines (5,726 line days in 2018). The improvement was sustained, and the line days decreased slightly for 2019, with a fiscal year rate of 0.61 per 1,000 line days (ie, 3 CLABSIs in 4,927 central-line days). Conclusions: The incidence of CLABSI in the SCIU was reduced by an intensive surveillance intervention to perform accurate peer monitoring of bundle compliance with weekly feedback, communication, and education strategies, improvement of the documentation, and the use of antiseptic-impregnated discs for dressings. Despite the complexity of the patient population requiring long-term central lines, the CLABSI rate was greatly impacted by evidence-based interventions coupled with reinforcement of adherence to the bundle. Funding: None Disclosures: None
CD40 stimulation as a molecular adjuvant for cancer vaccines and other immunotherapies

The substantial advances attained by checkpoint blockade immunotherapies have driven an expansion in the approaches used to promote T cell access to the tumor microenvironment to provide targets for checkpoint immunotherapy. Inherent in any T cell response to a tumor antigen is the capacity of dendritic cells to initiate and support such responses. Here, the rationale and early immunobiology of CD40 as a master regulator of dendritic cell activation is reviewed, with further contextualization and appreciation for the role of CD40 stimulation not only in cancer vaccines but also in other contemporary immune-oncology approaches.
The DNA-binding protein CST associates with the cohesin complex and promotes chromosome cohesion

Sister chromatid cohesion (SCC), the pairing of sister chromatids after DNA replication until mitosis, is established by loading of the cohesin complex on newly replicated chromatids. Cohesin must then be maintained until mitosis to prevent segregation defects and aneuploidy. However, how SCC is established and maintained until mitosis remains incompletely understood, and emerging evidence suggests that replication stress may lead to premature SCC loss. Here, we report that the ssDNA-binding protein CTC1-STN1-TEN1 (CST) aids in SCC. CST primarily functions in telomere length regulation but also has known roles in replication restart and DNA repair. After depletion of CST subunits, we observed an increase in the complete loss of SCC. In addition, we determined that CST associates with the cohesin complex. Unexpectedly, we did not find evidence of altered cohesin loading or mitotic progression in the absence of CST; however, we did find that treatment with various replication inhibitors increased the association between CST and cohesin. Because replication stress was recently shown to induce SCC loss, we hypothesized that CST may be required to maintain or remodel SCC after DNA replication fork stalling. In agreement with this idea, SCC loss was greatly increased in CST-depleted cells after exogenous replication stress. Based on our findings, we propose that CST aids in the maintenance of SCC at stalled replication forks to prevent premature cohesion loss.
Im/migrant children’s stories in elementary school: caring and making space in the classroom

Family separation policies’ impacts on children’s education are one of the critical issues of our time. In this article, I draw on ethnographic data collected over two years in one Northeastern tow...
Deadlock Avoidance for Sequential Resource Allocation Systems: Hard and Easy Cases

Deadlock is a major problem for systems that allocate resources in real time. The key issue in deadlock avoidance is whether or not a given resource allocation state is safe: that is, whether or not there exists a sequence of resource allocations that completes all processes. Although safety is established as NP-complete for certain broad resource allocation classes, newly emerging resource allocation scenarios often exhibit unique features not considered in previous work. In these cases, establishing the underlying complexity of the safety problem is essential for developing the best deadlock avoidance approach. This work investigates the complexity of safe resource allocation for a class of systems relevant in automated manufacturing. For this class, the resource needs of each process are expressed as a well-defined sequence. Each request is for a single unit of a single resource and is accompanied by a promise to release the previously allocated resource. Manufacturing researchers have generally accepted that safety is computationally hard, and numerous suboptimal deadlock avoidance solutions have been proposed for this class. Recent results, however, indicate that safety is often computationally easy. The objective of this article is to settle this question by formally establishing the NP-completeness of safety for this class and investigating the boundary between the hard and easy cases. We discuss several special structures that lead to computationally tractable safety characteristics.
Early experience with scientific applications on the blue gene/l supercomputer

Blue Gene/L uses a large number of low power processors, together with multiple integrated interconnection networks, to build a supercomputer with low cost, space and power consumption. It uses a novel system software architecture designed with application scalability in mind. However, whether real applications will scale to tens of thousands of processors has been an open question. In this paper, we describe early experience with several applications on a 16,384 node Blue Gene/L system. This study establishes that applications from a broad variety of scientific disciplines can effectively scale to thousands of processors. The results reported in this study represent the highest performance ever demonstrated for most of these applications, and in fact, show effective scaling for the first time ever on thousands of processors.
Peripheral CD4(+) T-cell tolerance is induced in vivo by rare antigen-bearing B cells in follicular, marginal zone, and B-1 subsets.

B cells are efficient APCs when they internalize antigen via BCR-mediated uptake. Adoptively transferred antigen-presenting B cells can induce T-cell tolerance to foreign and self antigens; however, it is unknown whether endogenous B cells presenting self-peptides interact with naive T cells and contribute to peripheral T-cell self-tolerance. Moreover, the relative abilities of mature B-cell subsets to induce T-cell tolerance have not been examined. To address these questions, we created a new mouse model wherein a very small fraction of B cells expresses an antigen transgene that cannot be transferred to other APCs. We limited antigen expression to follicular, marginal zone, or B-1 B-cell subsets and found that small numbers of each subset interacted with naive antigen-specific T cells. Although antigen expressed by B-1 B cells induced the most T-cell division, divided T cells subsequently disappeared from secondary lymphoid tissues. Independent of which B-cell subset presented antigen, the remaining T cells were rendered hypo-responsive, and this effect was not associated with Foxp3 expression. Our data show that physiologically relevant proportions of B cells can mediate peripheral T-cell tolerance, and suggest that the mechanisms of tolerance induction might differ among follicular, marginal zone, and B-1 B-cell subsets.
Identification of model structure for aquatic ecosystems using regionalized sensitivity analysis.

The Regionalized Sensitivity Analysis (RSA) was developed in 1978, for identifying critical unknown processes in poorly defined systems, thus directing the focus of further scientific investigations. Here, we demonstrate its application to model structure identification, by ranking the constituent hypotheses and identifying the critical elements for progressive revision of the model. Our case study is Lake Oglethorpe - a small monomictic impoundment in South-eastern Georgia, USA. Recent studies indicate that the warm temperate regional climate affords an extended growing season - typically from March to October - which promotes bacterial productivity in the lake. The result is a summer food web dominated by microbial processes, in contrast to the conventional phytoplankton-dominated food chains typically observed in the cold temperate lakes of Europe and North America. Starting with a simple phytoplankton-based food web model and a qualitative definition of system behaviour, we use the RSA procedure to establish the critical role of bacteria-mediated decomposition in Lake Oglethorpe, thus justifying the inclusion of microbial processes. Further analysis reveals the importance of size-dependent selective consumption of phytoplankton and bacteria. Finally, we discuss important practical implications of this novel application of the RSA regarding sampling efficiency and statistical robustness.
Crowded Trades, Short Covering, and Momentum Crashes

Despite momentum's strong historical performance, its returns have large negative skewness and occasionally experiences persistent strings of sharp negative returns, referred as "momentum crashes" in the recent literature. I argue that momentum crashes are due to crowded trades which push prices away from fundamentals leading to strong reversals, and exacerbated by limits of arbitrage being more severe in the short-leg due to impediments to short selling. Using short interest and institutional ownership data together to measure the "crowdedness" of momentum, I show that momentum crashes can be avoided in the cross section by shorting only non-crowded losers. There is considerably more short-covering during times when momentum fails. I show using high frequency short sale transactions data that short covering is especially severe in the crowded loser portfolio. A placebo test using a set of 63 futures contracts show that momentum crashes do not exist in futures market after market exposure is correctly hedged, which is consistent with my hypothesis.
Segregated Regulatory CD39+CD4+ T Cell Function: TGF-β–Producing Foxp3− and IL-10–Producing Foxp3+ Cells Are Interdependent for Protection against Collagen-Induced Arthritis

Oral immunization with a Salmonella vaccine vector expressing enterotoxigenic Escherichia coli colonization factor Ag I (CFA/I) can protect against collagen-induced arthritis (CIA) by dampening IL-17 and IFN-γ via enhanced IL-4, IL-10, and TGF-β. To identify the responsible regulatory CD4(+) T cells making the host refractory to CIA, Salmonella-CFA/I induced CD39(+)CD4(+) T cells with enhanced apyrase activity relative to Salmonella vector-immunized mice. Adoptive transfer of vaccine-induced CD39(+)CD4(+) T cells into CIA mice conferred complete protection, whereas CD39(-)CD4(+) T cells did not. Subsequent analysis of vaccinated Foxp3-GFP mice revealed the CD39(+) T cells were composed of Foxp3-GFP(-) and Foxp3-GFP(+) subpopulations. Although each adoptively transferred Salmonella-CFA/I-induced Foxp3(-) and Foxp3(+)CD39(+)CD4(+) T cells could protect against CIA, each subset was not as efficacious as total CD39(+)CD4(+) T cells, suggesting their interdependence for optimal protection. Cytokine analysis revealed Foxp3(-) CD39(+)CD4(+) T cells produced TGF-β, and Foxp3(+)CD39(+)CD4(+) T cells produced IL-10, showing a segregation of function. Moreover, donor Foxp3-GFP(-) CD4(+) T cells converted to Foxp3-GFP(+) CD39(+)CD4(+) T cells in the recipients, showing plasticity of these regulatory T cells. TGF-β was found to be essential for protection because in vivo TGF-β neutralization reversed activation of CREB and reduced the development of CD39(+)CD4(+) T cells. Thus, CD39 apyrase-expressing CD4(+) T cells stimulated by Salmonella-CFA/I are composed of TGF-β-producing Foxp3(-) CD39(+)CD4(+) T cells and support the stimulation of IL-10-producing Foxp3(+) CD39(+)CD4(+) T cells.
Maintaining Data Consistency in Structured P2P Systems

A fundamental challenge of supporting mutable data replication in a Peer-to-Peer (P2P) system is to efficiently maintain consistency. This paper presents a framework for Balanced Consistency Maintenance (BCoM) in structured P2P systems with heterogeneous node capabilities and various workload patterns. Replica nodes of each object are organized into a tree structure for disseminating updates, and a sliding window update protocol is developed for consistency maintenance. We present an analytical model to optimize the window size according to the dynamic network conditions, workload patterns and resource limits. In this way, BCoM balances the consistency strictness, object availability for updates, and update propagation performance for various application requirements. On top of the dissemination tree, two enhancements are proposed: (1) a fast recovery scheme to strengthen the robustness against node and link failures, and (2) a node migration policy to remove and prevent bottlenecks allowing more efficient update delivery. Simulations are conducted using P2PSim to evaluate BCoM in comparison to SCOPE [1]. The experimental results demonstrate that BCoM outperforms SCOPE with lower discard rates. BCoM achieves a discard rate as low as 5 percent in most cases while SCOPE has almost 100 percent discard rate.