cssi/SciSciGPT-SciSciNet huggingface dataset:
Characterization of lesions of the talus and description of tram-track lesions.

Background The ankle joint, although not prone to primary osteoarthritis (OA), is known to be susceptible to secondary OA as a result of sports injuries and other trauma. Unlike the knee joint, a thorough investigation of talar cartilage lesions has not been previously reported. Methods One hundred and five human tali from 67 donors were used to determine the type and location of the most common lesions through gross examination, radiography, diffraction enhanced imaging, and histology. "tram-track lesions" also are described. Results The most anterior and posterior regions of the talar dome, along with the medial and lateral borders of the dome were most affected by cartilage degeneration. These are regions that appear to be most subjected to frictional forces from their articulating counterparts during high stress activities that move articulating surfaces slightly out of congruence with each other. One particularly striking cartilage degeneration pattern that, to our knowledge, has not been described histologically, is the tram-track lesion. These lesions displayed a longitudinally oriented groove in the cartilage, running from anterior to posterior, in which the deepest portion of the groove was located in the middle of the anterior-posterior axis of the talus. Several of these cartilage grooves had a bony ridge beneath, mirroring the cartilage groove whereas others did not. This suggests that the cartilage groove develops before the interruption of the tidemark (border between the calcified and uncalcified cartilage). In specimens for which the articulating tibial articular surface was available, (17) it was found that the tibia displayed small osteophytes on the anterior articular margin that exactly corresponded to their articulation with the talar cartilage grooves as the ankle articulated through plantar flexion and dorsiflexion. Conclusion This study provides an in-depth histologic and gross anatomic look at the most common lesions of the talus of the ankle joint. In particular, the "tram-track" lesion was shown to be a consequence of its tibial articulation and to include both subchondral bone and articular cartilage changes.
Bayesian approaches for monitoring clinical trials with an application to toxoplasmic encephalitis prophylaxis

Bayesian methods have been a subject of increasing interest among researchers engaged in the interim monitoring and final analysis of clinical trials data. In particular, Chaloner et al. (1992) have shown how prior distributions may be elicited relatively easily from a panel of experts using computer-assisted interactive graphical methods. Significant stumbling blocks remain, however, to routine implementation of Bayesian methods by practitioners. For example, heavy computational burdens have historically precluded real-time evaluation of stopping rules. In addition, the resulting statistics may not be amenable to simple monitoring displays, since the resulting posterior distributions for important model parameters need not be symmetric, unimodal or based on a low-dimensional sufficient statistic. In this paper we investigate these computational issues by comparing the posterior distributions of model parameters obtained assuming approximate posterior normality with more precise results obtained via numerical integration. We also investigate the impact of approximations on the performance of Bayesian stopping rules. Where the normal approximation is inappropriate, the Bayesian methodology still allows for inference and simple monitoring displays based on posterior probabilities. We illustrate the methodol- ogy with a numerical example featuring prior distributions elicited from five AIDS experts and data from a recently completed toxoplasmic encephalitis prophylaxis trial (Jacobson et al., 1992).
Epilepsy in Pregnancy

Epilepsy is a common neurological condition in women. It is associated with lowered fertility rates that may be due to hormonal and social factors. Women with epilepsy (WWE) who choose to get pregnant must also consider the risk to their developing fetus of exposure to anticonvulsant therapy as birth defects occur more often in children born to WWE exposed to these agents. However, seizures in pregnant women can also increase the risk of adverse outcomes for the pregnancy, so due consideration must be given to identifying the seizure medication that is most likely to work for a given patient and associated with the lowest rate of teratogenicity, optimizing the use to monotherapy at the lowest concentration required for efficacy, and maintaining the serum concentration at an effective level throughout the pregnancy. Folic acid should be prescribed as for all women of childbearing age. Careful counseling for and monitoring of WWE can increase the chances of a successful pregnancy resulting in normal and healthy babies.
DKK-1 Is a Widely Expressed, Potent Tumor-Associated Antigen in Multiple Myeloma Recognized by Cytotoxic T Lymphocytes.

Idiotype proteins have been used for immunotherapy in multiple myeloma (MM); and the results thus far have been disappointing. Therefore, the identification and use of novel and more potent tumor-associated antigens are urgently needed to improve the efficacy of the treatment. Dickkopf-1 (DKK1), a secreted protein and Wnt signaling pathway inhibitor, is highly expressed by the tumor cells of most myeloma patients and may be responsible for suppressed osteoblast formation. Based on these data and the fact that DKK1 is not expressed in normal tissues except placenta, prostate, and mesenchymal stem cells, we hypothesized that DKK1 is a novel tumor-associated antigen in MM. In this study we examined the capacity of DKK1 to trigger the induction of antimyeloma cytotoxic T lymphocyte (CTL) responses. Using DKK-1 peptide-pulsed dendritic cells (DCs), we successfully generated DKK-1 peptide (DKK1 20-29 and DKK1 66-74V )-specific CTL lines and clones from HLA-A2 + MM patients and healthy individuals. In our experiments, mature DCs obtained from cultures of blood monocytes were pulsed with HLA-A2-restricted DKK1 peptides. Autologous T cells were then stimulated weekly with these DCs, and cytotoxicity was examined against DKK1 peptide-pulsed T2 cells, myeloma cell lines, and primary myeloma cells isolated from patients. After 4 cycles of in vitro stimulation and subsequent T cell cloning and expansion, specific CD8 + CTL lines and clones were obtained. These CTLs not only had cytolytic activity against DKK1 peptide-pulsed T2 cells, but also significantly lysed HLA-A2 + MM cell line U266 and primary tumor cells in vitro. No killing was observed against HLA-A2 + normal lymphocytes including B cells or HLA-A2 − myeloma cell lines or primary myeloma cells from patients. The CTL response could be inhibited by anti-HLA-A2 antibody indicating that the response was indeed restricted by HLA-A2 molecules. IFN-γ, but not IL-4, was secreted by the T cells indicating that the effector cells were type-1 CD8 + T cells. Further functional studies are underway. Thus, these results demonstrate that DKK1-specific CTLs are able to lyse myeloma tumor cells including primary myeloma cells from patients, and identify DKK1 as a potentially important antigenic target for antimyeloma immunotherapeutic strategies
Is There an Increased Risk of Intracranial Hemorrhage When Treating Patients Who Are Currently on Dual Anti-Platelets with IV tPA? (P01.233)

OBJECTIVE: To study risk of hemorrhagic complications in patients on anti-platelets receiving IV Tissue Plasminogen Activator (tPA). BACKGROUND: IVtPA is the standard of care for treatment of acute ischemic stroke within 4.5 hours of stroke symptoms. Previous studies have shown an increased risk of hemorrhagic complications in patients on dual anti-platelet therapy who receive IVtPA. DESIGN/METHODS: We performed a retrospective review of 73 patients who were admitted to the Stroke service at University of Toledo Medical Center (UTMC) after receiving IVtPA between October 2009 and September 2012. Medical records were reviewed to identify demographics, stroke risk factors, baseline NIHSS, time to treatment and radiographic and clinical outcomes. RESULTS: 73 patients were treated with IVtPA within 4.5 hours from the onset of symptoms and were admitted to our center. The mean age was 65.7 years old and the mean NIH stroke scale was 10.5. Seventeen patients were only on aspirin, 2 only on clopidogrel, 1 only on prasugrel, 1 on aspirin and aspirin-dipyridamole, 1 on aspirin and ticlodipine, 1 on aspirin and warfarin, and 4 on aspirin and clopidogrel. Six patients (8.2%) had a symptomatic parenchymal hemorrhage (PH) and 1(1.4%) had asymptomatic hemorrhagic transformation (HT). Among those on aspirin, only 1 patient (5.9%) suffered a symptomatic PH and 1(5.9%) had an asymptomatic HT. Among those on both aspirin and clopidogrel, 1 patient (25%) suffered an asymptomatic HT. There was no PH in the aspirin and clopidogrel group. No significant difference in PH/HT was noted when aspirin vs. clopidogrel vs. aspirin + clopidogrel groups were compared (χ 2 =3.68, p=0.159). CONCLUSIONS: In our cohort, there was no additional risk of hemorrhagic complications in patients on dual antiplatelet therapy who received IVtPA, prospective studies are needed to confirm this finding. Disclosure: Dr. Kung has nothing to disclose. Dr. Korsnack has nothing to disclose. Dr. Zaidi has nothing to disclose. Dr. Jumaa has nothing to disclose.
Right ventricular function mirrors clinical improvement with use of prostacyclin analogues in pediatric pulmonary hypertension.

Pulmonary hypertension (PH) causes significant morbidity and mortality in children due to right ventricular (RV) failure. We sought to determine the effect of prostacyclin analogues on RV function ...
Premature hippocampus-dependent memory decline in middle-aged females of a genetic rat model of depression.

Abstract Aging and major depressive disorder are risk factors for dementia , including Alzheimer’s Disease (AD), but the mechanism(s) linking depression and dementia are not known. Both AD and depression show greater prevalence in women. We began to investigate this connection using females of the genetic model of depression, the inbred Wistar Kyoto More Immobile (WMI) rat. These rats consistently display depression-like behavior compared to the genetically close control, the Wistar Kyoto Less Immobile (WLI) strain. Hippocampus-dependent contextual fear memory did not differ between young WLI and WMI females, but, by middle-age, female WMIs showed memory deficits compared to same age WLIs. This deficit, measured as duration of freezing in the fear provoking-context was not related to activity differences between the strains prior to fear conditioning. Hippocampal expression of AD-related genes, such as amyloid precursor protein , amyloid beta 42, beta secretase , synucleins , total and dephosphorylated tau, and synaptophysin , did not differ between WLIs and WMIs in either age group. However, hippocampal transcript levels of catalase ( Cat ) and hippocampal and frontal cortex expression of insulin-like growth factor 2 ( Igf2) and Igf2 receptor (Igf2r) paralleled fear memory differences between middle-aged WLIs and WMIs. This data suggests that chronic depression-like behavior that is present in this genetic model is a risk factor for early spatial memory decline in females. The molecular mechanisms of this early memory decline likely involve the interaction of aging processes with the genetic components responsible for the depression-like behavior in this model.
Effect of copolymer sequence on structure and relaxation times near a nanoparticle surface

We simulate a simple nanocomposite consisting of a single spherical nanoparticle surrounded by coarse-grained polymer chains. The polymers are composed of two different monomer types that differ only in their interaction strengths with the nanoparticle. We examine the effect of adjusting copolymer sequence on the structure as well as the end-to-end vector autocorrelation, bond vector autocorrelation, and self-intermediate scattering function relaxation times as a function of distance from the nanoparticle surface. We show how the range and magnitude of the interphase of slowed dynamics surrounding the nanoparticle depend strongly on sequence blockiness. We find that, depending on block length, blocky copolymers can have faster or slower dynamics than a random copolymer. Certain blocky copolymer sequences lead to relaxation times near the nanoparticle surface that are slower than those of either homopolymer system. Thus, tuning copolymer sequence could allow for significant control over the nanocomposite behavior.
The patient care component: patient-centered horizontal integration in a vertical world.

Abstract This paper describes the structure and operational properties of the Patient Care Component, a patient care data system developed by the Indian Health Service to support primary care in a multi-site, decentralized, health care organization. Sharing the same technology base as the Department of Veterans Affairs Distributed Hospital Computer Program, the system requires a minimal level of investment in technology compared to alternative approaches and is in operation at 140 sites. The Indian Health Service and historical aspects of the system are described briefly; the paper focuses on the design objectives for the system and lessons learned from development and several years of operational experience.
Correction of chordee. The Nesbit procedure.

SUMMARY In select patients the Nesbit operation is a useful procedure for the correction of congenital or acquired chordee. This operation results in a deliberate shortening of the convex surface of the corpora cavernosa to counterbalance congenital or acquired shortening on the opposite side. Precise placement of the corrective tuck allows complete correction of the chordee with minimal disturbance of normal tissue. An artificial erection should be created to permit precise identification of the point of maximal curvature on the longer (convex) side of the penis. The transverse elliptical segment to be removed should be placed precisely at this point and should be of sufficient width to result in complete correction of the chordee. Care should be taken to remove only a segment of the tunica albuginea without damaging the underlying erectile tissue. In cases of ventral chordee, the corrective procedure will require elevation of the neurovascular bundle. In cases of dorsal chordee, the procedure will require elevation of the urethra and corpus spongiosum. A repeat artificial erection insures that an adequate correction has been obtained.
Simpler, Faster, and Sensitive Zika Virus Assay Using Smartphone Detection of Loop-mediated Isothermal Amplification on Paper Microfluidic Chips

The recent Zika virus (ZIKV) outbreak has prompted the need for field-ready diagnostics that are rapid, easy-to-use, handheld, and disposable while providing extreme sensitivity and specificity. To meet this demand, we developed a wax-printed paper microfluidic chip utilizing reverse transcription loop-mediated isothermal amplification (RT-LAMP). The developed simple and sensitive ZIKV assay was demonstrated using undiluted tap water, human urine, and diluted (10%) human blood plasma. Paper type, pore size, and channel dimension of various paper microfluidic chips were investigated and optimized to ensure proper filtration of direct-use biological samples (tap water, urine, and plasma) during capillary action-driven flow. Once ZIKV RNA has flowed and reached to a detection area of the paper microfluidic chip, it was excised for the addition of an RT-LAMP mixture with a pH indicator, then placed on a hot plate at 68 °C. Visible color changes from successful amplification were observed in 15 minutes and quantified by smartphone imaging. The limit of detection was as low as 1 copy/μL. The developed platform can also be used for identifying other flaviviruses, such as Chikungunya virus (CHIKV) and Dengue virus (DENV), and potentially other quickly transmitted virus pathogens, towards field-based diagnostics.
Lung Transplant Outcomes in Patients With Pulmonary Fibrosis With Telomere-Related Gene Variants

Background Pulmonary fibrosis (PF) is the most common disease indication for lung transplantation. Our recent work implicated an excess of rare genetic variants in the telomere-related genes TERT, RTEL1, and PARN in PF disease risk. The impact of such variants on posttransplant outcomes is uncertain. The objective of this study was to determine if patients with these PF-associated variants have altered rates of posttransplant acute rejection (AR), chronic lung allograft dysfunction (CLAD), and survival. Methods The study cohort consisted of 262 PF lung transplant recipients previously genetically characterized by whole exome sequencing. Thirty-one patients (11.8%) had variants in TERT, RTEL1, or PARN, whereas 231 (88.2%) did not. Multivariate Cox proportional hazards models adjusted for relevant clinical variables were used to assess the outcomes of death and CLAD. The AR burden was quantified and compared over the first posttransplant year. Results Patients with PF with disease-associated variants in TERT, RTEL1, or PARN had a significantly higher risk of death (adjusted hazard ratio [HR], 1.82; 95% CI, 1.07-3.08; P = .03) and CLAD (adjusted HR, 2.88; 95% CI, 1.42-5.87; P = .004) than patients without these variants. There was no difference in AR burden or rates of grade 3 primary graft dysfunction between the two groups. Conclusions Rare variants in the telomere-related genes TERT, RTEL1, or PARN are associated with poor posttransplant outcomes among PF lung transplant recipients. Further research is needed to understand the biological mechanisms by which telomere-related variants increase the risk for death and CLAD.
Laparoscopic Cholecystectomy with Single Port Access System in 15 Dogs

Objective To evaluate the outcome of laparoscopic cholecystectomy performed with a single port access system (SPAS) in dogs. Study design Retrospective study. Animals Fifteen client-owned dogs with nonobstructive gallbladder disease. Methods Medical records were reviewed for signalment, clinical signs, diagnostic imaging, surgical findings, and outcome until suture removal. Results The SPAS was placed 1 cm caudal to the umbilicus. The procedure was completed with the SPAS alone in two cases. An additional cannula was added in 12 cases. In the last 10 cases, the additional cannula was placed at the beginning of the procedure. Dissection began at the cystic duct in 11 dogs (73%). In three cases (20%), the SPAS procedure was converted to a laparotomy; two of these conversions were elective, and one was emergent. The risk of conversion was affected by the experience of the surgeon (odds ratio = 0.53; P = .0105), and the rate of conversion was reduced when a cannula was added at the beginning of the procedure (P = .022). Fourteen dogs were discharged from the hospital. One dog died after being discharged due to severe cholangiohepatitis, and another dog died due to leakage of a gastrostomy tube. Conclusions The use of SPAS for cholecystectomy in dogs has an acceptable outcome. The experience gained by the surgeon and the addition of a cannula reduced the risk of conversion. Clinical relevance/impact Laparoscopic cholecystectomy can be performed with a SPAS. The placement of an additional cannula at the beginning of the procedure is highly recommended.
Restaging [18F] fludeoxyglucose positron emission tomography/computed tomography scan in recurrent cutaneous squamous cell carcinoma: Diagnostic performance and prognostic significance

Background There are no specific recommendations for [18F] fludeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in assessing recurrent cutaneous squamous cell carcinoma (cSCC). Objective To evaluate FDG-PET/CT in recurrent cSCC. Methods FDG-PET/CT scans were retrospectively reviewed. Sites of abnormal uptake were noted and correlated with biopsy/histopathology studies, where available, and with follow-up imaging or clinical data in others. Comparison with available CT/magnetic resonance imaging was performed. The prognostic significance of PET/CT parameters was evaluated, and PET/CT-based change in management was recorded. Results A total of 115 FDG-PET/CT scans were analyzed in 100 consecutive patients with cSCC. Of these, 96 (84%) scans were positive for recurrence, and 25 showed distant metastases. PET/CT detected unsuspected disease sites in 39 of 115 scans (34%), locoregional disease in 14, distant metastases in 11, both locoregional disease and distant metastases in 8, additional local cutaneous disease in 5, and second malignancy in 1. Comparison of 78 PET/CT scans with available CT/magnetic resonance imaging showed 37 additional abnormalities on 23 PET/CT scans, predominantly including skin/subcutaneous lesions and nodes. PET/CT led to change in management in 28% of patients. On univariate/multivariate analysis, increased number of FDG-positive lesions and lung metastases on PET/CT was associated with increased risk of death/disease progression. Limitations Retrospective study. Conclusions FDG-PET/CT was sensitive in detecting recurrent disease in cSCC, led to change in management for 28% of patients, and proved to be of prognostic value.
Revalidation of Surgeons in Practice

Revalidation of surgeons in practice continues to evolve rapidly. Articulating the overall aim of revalidation as adherence to safe standards of practice, this chapter explores common goals and nuanced differences in approaches to revalidation in various countries. The different approaches are a result of disparate regulatory systems and roles of professional organizations. After describing contemporary factors affecting revalidation as an important professional consideration, its relationship to continuing professional development is explored. The author describes two types of revalidation: “Global” and “Focused.” The latter relates to changes in the practices of individual surgeons and is illustrated through three case studies. Finally, strategies to support revalidation efforts are proposed.
Optimizing solar cooling systems

Abstract This papers discusses solar powered absorption cycle performance by simulating different component temperatures. The main components that were investigated included a generator, condenser, absorber and evaporator. The COP was optimized against the generator temperature while varying the other temperatures one at a time. The considered range for the generator temperature was 55–85 °C (131–185 F). The optimum value for the evaporator temperature was 10 °C (50 F), while that for the condenser and absorber was 30 °C (86 F). The optimized COP was around 0.776 with the above selected components' temperatures and for generator temperatures higher than 70 °C (158 F). A simulation for the proposed optimized system was run for a 250 m2 (2691 ft2) house located in Indiana, USA and it was found that 13 solar collectors, having a 2 m2 (21.5 ft2) surface area each, were needed to run the generator along with a storage tank ranging in size from 1300 to 1700 L (343–450 gallons). The initial cost for such systems is much higher than that for conventional cooling systems, but the savings from the sustainable running cost offsets such higher initial costs over the long time. With the significant drop in collector prices and available incentives from the government and state agencies to use such sustainable systems, the payback period could be significantly improved.
A low dose heparinized saline protocol is associated with improved duration of arterial line patency in critically ill COVID-19 patients.

Abstract Purpose Critically ill patients with Coronavirus Disease 2019 (COVID-19) have high rates of line thrombosis. Our objective was to examine the safety and efficacy of a low dose heparinized saline (LDHS) arterial line (a-line) patency protocol in this population. Materials and Methods In this observational cohort study, patients ≥18 years with COVID-19 admitted to an ICU at one institution from March 20–May 25, 2020 were divided into two cohorts. Pre-LDHS patients had an episode of a-line thrombosis between March 20–April 19. Post-LDHS patients had an episode of a-line thrombosis between April 20–May 25 and received an LDHS solution (10 units/h) through their a-line pressure bag. Results Forty-one patients (pre-LDHS) and 30 patients (post-LDHS) were identified. Baseline characteristics were similar between groups, including age (61 versus 54 years; p = 0.24), median Sequential Organ Failure Assessment score (6 versus 7; p = 0.67) and systemic anticoagulation (47% versus 32%; p = 0.32). Median duration of a-line patency was significantly longer in post-LDHS versus pre-LDHS patients (8.5 versus 2.9 days; p Conclusions A LDHS protocol was associated with a clinically significant improvement in a-line patency duration in COVID-19 patients, without increased bleeding risk.
The Human Tongue: Normal Structure and Function and Associated Pathologies

Publisher Summary This chapter discusses the normal structure and function and associated pathologies of the human tongue. The mammalian tongue is very well developed, extremely mobile, and a multipurpose structure. The mammalian tongue was evolved out of the reptilian tongue by an increase in musculature and papillary structure. A median elevation in the floor of arch I, the tuberculum impar, is seen but appears to make little contribution to the developing tongue. Two lateral lingual swellings of the first arch form the anterior two-thirds of the tongue. This part of the tongue is interlaced with intrinsic muscles that add to the increased thickness and mobility of the tongue As in the other classes, the mammals also witness diversity within the species. Bats and honey possum have extremely long tongues that aid in obtaining the nectar upon which they feed. Mammals that feed on ants, insects, and termites, such as the anteater, have long vermiculae-shaped tongues. The nectar and insect feeders may have tongues as long as their entire body. The dog has a tongue that functions as a thermoregulator because of poorly developed sweat glands. In general, the carnivores have a mobile and well-formed lingual structure but the herbivores evidence the best developed tongue for grabbing herbage. The mammalian tongue is a major bearer of taste buds and highly developed salivary glands
Association of serum levels of antioxidant micronutrients with mortality in US adults: National Health and Nutrition Examination Survey 1999-2002.

Objective To examine associations between serum antioxidant levels and mortality (all-cause, cancer and CVD) among US adults. Design We examined the risk of death from all-cause and cause-specific mortality associated with serum antioxidant (vitamin E and carotenoids) and vitamin A levels using Cox regression models to estimate hazards ratios (HR) and 95 % CI. Setting The National Health and Nutrition Examination Survey (NHANES) 1999-2002 was followed up through 31 December 2015. Participants The NHANES 1999-2002 cohort included 8758 participants aged ≥ 20 years. Serum carotenoid levels were only assessed for the 1999-2000 cycle. Therefore, sample size for each assessed antioxidant ranged from 4633 to 8758. Results Serum vitamin E level was positively associated with all-cause mortality (HR = 1·22, 95 % CI 1·04, 1·43, highest v. lowest quartile). No other antioxidants were associated with mortality in overall analysis. In race/ethnicity-specific analyses, high vitamin E and α-tocopherol levels were associated with increased risk of all-cause mortality among non-Hispanic Whites. Among non-Hispanic Blacks, serum α-tocopherol level was associated with decreased risk of cancer mortality (HR = 0·30, 95 % CI 0·12, 0·75, third v. first quartile) and total carotenoid levels with reduced risk of CVD mortality (HR = 0·26; 95 % CI 0·07, 0·97, second v. lowest quartile). Hispanics with high β-carotene levels had reduced risk of CVD mortality. Conclusions Serum antioxidant levels may be related to mortality; these associations may differ by race/ethnicity and appeared to be non-linear for all-cause and cause-specific mortality. Further studies are needed to confirm our results.
Low Health Literacy Exists in the Inflammatory Bowel Disease (IBD) Population and Is Disproportionately Prevalent in Older African Americans.

Background Low health literacy is common in general populations, but its prevalence in the inflammatory bowel disease (IBD) population is unclear. The objective of this study was to assess the prevalence of low health literacy in a diverse IBD population and to identify risk factors for low health literacy. Methods Adult patients with IBD at a single institution from November 2017 to May 2018 were assessed for health literacy using the Newest Vital Sign (NVS). Demographic and socioeconomic data were also collected. Primary outcome was the prevalence of low health literacy. Secondary outcomes were length-of-stay (LOS) and 30-day readmissions after surgical encounters. Bivariate comparisons and multivariable regression were used for analyses. Results Of 175 IBD patients, 59% were women, 23% were African Americans, 91% had Crohn disease, and mean age was 46 years (SD = 16.7). The overall prevalence of low health literacy was 24%. Compared to white IBD patients, African Americans had significantly higher prevalence of low health literacy (47.5% vs 17.0%, P < 0.05). On multivariable analysis, low health literacy was associated with older age and African American race (P < 0.05). Of 83 IBD patients undergoing abdominal surgery, mean postoperative LOS was 5.5 days and readmission rate was 28.9%. There was no significant difference between LOS and readmissions rates by health literacy levels. Conclusions Low health literacy is present in IBD populations and more common among older African Americans. Opportunities exist for providing more health literacy-sensitive care in IBD to address disparities and to benefit those with low health literacy.
Centric Fusion (CF) Translocations in North American Cattle

Cytogenetic investigations were made concerning the presence of the 1/29 and 14/20 Robertsonian translocations in the Charolais and Simmental cattle breeds in the United States and Canada. The results indicated that positive cases were present in some of these beef cattle populations. Of the 659 Charolais cattle tested, 142 (22%) were 1/29 CF translocation positive. Of the 353 Simmental cattle tested, 138 (39%) were 14/20 CF translocation positive. For both breeds these results are not representative of the prevalence of the chromosomal aberration in the entire population.
Premalignant Oligodendrocyte Precursor Cells Stall in a Heterogeneous State of Replication Stress Prior to Gliomagenesis

Cancer evolves from premalignant clones that adopt unusual cell states to achieve transformation. We previously pinpointed the oligodendrocyte precursor cell (OPC) as a cell of origin for glioma, but the early changes of mutant OPCs during premalignancy remained unknown. Using mice engineered for inducible Nf1-Trp53 loss in OPCs, we acutely isolated labeled mutant OPCs by laser-capture microdissection, determined global gene-expression changes by bulk RNA sequencing, and compared with cell-state fluctuations at the single-cell level by stochastic profiling, which uses RNA-sequencing measurements from random pools of 10 mutant cells. At 12 days after Nf1-Trp53 deletion, bulk differences were mostly limited to mitotic hallmarks and genes for ribosome biosynthesis, and stochastic profiling revealed a spectrum of stem-progenitor (Axl, Aldh1a1), proneural, and mesenchymal states as potential starting points for gliomagenesis. At 90 days, bulk sequencing detected few differentially expressed transcripts, whereas stochastic profiling revealed cell states for neurons and mural cells that do not give rise to glial tumors, suggesting cellular dead-ends for gliomagenesis. Importantly, mutant OPCs that strongly expressed key effectors of nonsense-mediated decay (Upf3b) and homology-dependent DNA repair (Rad51c, Slx1b, Ercc4) were identified along with DNA-damage markers, suggesting transcription-associated replication stress. Analysis of 10-cell transcriptomes at 90 days identified a locus of elevated gene expression containing an additional repair endonuclease (Mus81) and Rin1, a Ras-Raf antagonist and possible counterbalance to Nf1 loss, which was microdeleted or downregulated in gliomas at 150 days. These hidden cell-state variations uncover replication stress as a potential bottleneck that must be resolved for glioma initiation. SIGNIFICANCE: Profiling premalignant cell states in a mouse model of glioma uncovers regulatory heterogeneity in glioma cells-of-origin and defines a state of replication stress that precedes tumor initiation.See related articles by Singh and colleagues, p. 1840 and Schaff and colleagues, p. 1853.
Divergence of House Prices in the United States: 2000 to 2015

Housing is the largest component of most American households’ wealth. Divergence of house prices directly affects wealth inequality. Using 5.9 million repeat sales of single-family houses, we find strong evidence that pricier houses had higher price appreciation rates from 2000 to 2015. Across houses, when the log house price increased by one standard deviation, the price appreciation rate increased by 70 to 100 basis points per annum. The superior performance of pricier houses was more pronounced in periods when the housing market performed poorly. We also use a variety of specifications to document detailed temporal variation and non-linearity of the relationship between houses’ price appreciation and their prices.
Picturing Political Power: Images in the Women’s Suffrage Movement

Allison Lange’s recent book, Picturing Political Power: Images in the Women’s Suffrage Movement, a study of the women’s movement through its images, makes it clear that new and innovative perspecti...
Foams: Theory: Measurements: Applications

Thin liquid film physics structure, drainage and coalescence of foams and concentrated emulsions foam rheology - the theory and role of interfacial rheological properties experimental results on foam rheology experimental techniques for the characterization of foams fundamental methods for measuring foam stability nonaqueous foams additives for foams foam wet processing in the textile industry foams in personal care products foams in enhanced oil recovery foams for firefighting foams in mineral flotation and separation processes science and technology of silicone antifoams.
Radical‐initiated curing of unsaturated polyesters with styrene. role of polymer‐bound versus free tertiary amine accelerators

Polyester prepolymers, prepared from maleic anhydride and diethylene glycol were cured with styrene using benzoyl peroxide as the catalyst and tertiary amines as accelerators. The effect of the accelerators on curing rates and efficiencies and resin properties was studied when the accelerators were chemically incorporated into the polyester prepolymer versus when the same accelerators were free. The accelerators employed were diethylaniline (1); N,N-bis-(2-hydroxyethyl)aniline (2); N,N-bis(2-hydroxyethyl)propylamine (3); N,N-bis(2-hydroxyethyl)-isopropylamine (4); N,N-bis(2-hydroxyethyl)butylamine (5); and dimethylaniline. The efficiency of the free accelerators decreased in the order dimethylaniline > 1 > 2 > 4 > 3 > 5. Each of the accelerators, 2–5, were significantly more efficient when incorporated into the polymer chain than when they were used free according to measured curing times, pot life, and gel times. Furthermore, the initiation energies for polymer-bound accelerators 3, 4, and 5 are significantly lower than those obtained when these same accelerators are added free. Polymerbound accelerators 2, 3, 4, and 5 gave resins with higher Brinell's hardness, higher tensile strengths, higher softening points, and lower extractable fractions than were obtained for resins prepared with identical amounts of the corresponding free accelerators. Mechanisms to account for these results are suggested.
A model for the social system for the multiman extended duration space ship.

Model for social system for extended-duration spaceship crews subject to isolation, confinement and/or stress
Face detection from color images by iterative thresholding on skin probability maps

In this paper, we present a technique for face detection from color images, which utilizes facial geometry and iterative thresholding of skin probability maps to determine candidate face regions in an image. The actual face regions are determined by a fast and efficient eye locator technique that employs symmetry analysis along with luminance, chrominance and curvature information. Iterative thresholding makes the technique tolerant to variations in illumination and background. The facial geometry analysis and eye locator techniques are tolerant to scale variations of faces. Experimental results demonstrate the superiority of the proposed technique to a standard PCA (principal components analysis)-based technique, in the presence of scale and illumination variations.
Assessment of the reporting of quality and outcome measures in hepatic resections: a call for 90-day reporting in all hepatectomy series.

Background The aim of this paper is to assess the current state of quality and outcomes measures being reported for hepatic resections in the recent literature.
Wood to Metal: The Structural Origins of the Modern Airplane

The transition from the wood-and-fabric airplane to the all-metal airplane was essentially complete by World War II. The late 1920s and early 1930s are said to have witnessed a structural revolution in aeronautics with the appearance of streamlined metal aircraft with such features as tightly cowled multiple engines, variable-pitch propellers, retracting landing gear, and stressed-skin aluminum construction. A prevalent assumption regarding this transition is that the building material acted as a primary driver of change, that engineering advance was guided by an inevitable move toward metal structures. Metal did indeed allow engineers to extend performance parameters afforded by innovative structural designs, but, interestingly, many of these key innovations were not developed to takeadvantageof metal. They emerged independent of theconstruction material, and often weree rst used in wooden airplanes. The cluster of original ideas that coalesced in the 1930s constituted one of the major watershedperiodsin aerospacetechnology.Metalcarriedthisbasicdesign revolutiontothelimitsofitsengineering andtechnicalfeasibility,butonlyafteranewfoundationwasinplace.Metaldidnotspawnthestructuralrevolution. An exploration of therootsof the structural revolution in aeronautics and thecomplexity oftechnological progress is presented.
Analysis of the kinetic and redox properties of the NADH peroxidase R303M mutant: correlation with the crystal structure.

The crystal structure of the flavoprotein NADH peroxidase shows that the Arg303 side chain forms a hydrogen bond with the active-site His10 imidazole and is therefore likely to influence the catalytic mechanism. Dithionite titration of an R303M mutant [E(FAD, Cys42-sulfenic acid)] yields a two-electron reduced intermediate (EH(2)) with enhanced flavin fluorescence and almost no charge-transfer absorbance at pH 7.0; the pK(a) for the nascent Cys42-SH is increased by over 3.5 units in comparison with the wild-type EH(2) pK(a) of Cys42-SOH. The crystal structure of the R303M peroxidase has been refined at 2.45 A resolution. In addition to eliminating the Arg303 interactions with His10 and Glu14, the mutant exhibits a significant change in the conformation of the Cys42-SOH side chain relative to FAD and His10 in particular. These and other results provide a detailed understanding of Arg303 and its role in the structure and mechanism of this unique flavoprotein peroxidase.
Modeling of piezoelectric multilayer structures

A method to study electromechanical behavior in piezoelectric laminated structures is presented. An accurate electromechanical description is mathematically involved, requiring quite often the adoption of ad hoc and unrealistic assumptions. An alternate approach to existing techniques is proposed in this paper. Emphasis is placed in a two-dimensional formulation to describe the behavior of electroelastic layered media. The methodology consists of rewriting the field equations of piezoelectricity in terms of a combination of certain electrical and mechanical variables collected into a state vector. Integral transformations are used to produce an ordinary differential equation for the state vector, whose solution is given in terms of a transfer matrix. The virtue of this approach is that the transfer matrix allows us to furnish information on local as well as global electromechanical behavior with equal ease. The resulting consequences of the methodology are the prediction of changes of geometry that will occur in a structure in response to a controlled command, and a more efficient means of structural actuation.
Non-axisymmetric local magnetostatic equilibrium

In this work we outline an approach to the problem of local equilibrium in nonaxisymmetric configurations that adheres closely to Miller’s original method for axisymmetric plasmas (Miller et al. 1998 Phys. Plasmas 5, 973). Importantly, this method is novel in that it allows not only specification of 3D shape, but also explicit specification of the shear in the 3D shape. A spectrally-accurate method for solution of the resulting nonlinear partial differential equations is also developed. We verify the correctness of the spectral method, in the axisymmetric limit, through comparisons with an independent numerical solution. Some analytic results for the two-dimensional case are given, and the connection to Boozer coordinates is clarified.
Extended release naltrexone for alcohol use disorders: quasi-experimental effects on mortality and subsequent detoxification episodes.

Background Utilization of extended release naltrexone (XRN) for alcohol use disorders (AUDs) in the U.S. Veterans Health Administration (VHA) has been limited, perhaps due to high cost, lack of established superiority over less expensive alternatives including oral naltrexone, and related formulary restrictions. Despite these barriers, pockets of higher utilization exist in VHA, allowing for the quasi-experimental examination of the effects of XRN on 1-year mortality and number of subsequent detoxification episodes among patients with high rates of psychiatric comorbidities and previous psychosocial and pharmacological addiction treatment. Methods Using propensity score-weighted mixed-effects logistic regression, 1-year mortality was compared between patients with AUDs who received XRN in fiscal year 2010 (n = 387) and a random sample of patients with AUDs who did not receive XRN (n = 3,759). Among the subgroup of patients who had at least 1 detoxification episode in the previous year, 1-year mortality and number of subsequent detoxification episodes were compared between those who did and did not receive XRN. Results Overall, 1-year mortality for the patients receiving XRN was significantly lower than for the comparison group who did not receive XRN (odds ratio [OR] = 0.30; p < 0.001). Among patients with a detoxification episode in the previous year, those receiving XRN had, on average, 0.80 fewer subsequent detoxification episodes (p < 0.001) and significantly lower mortality (OR = 0.78, p < 0.001) in the postindex year. Conclusions Among patients with AUDs, those receiving XRN had lower 1-year mortality and fewer detoxifications compared to similar patients not receiving XRN. These results, although observational, support the use of XRN, especially among patients with high rates of psychiatric comorbidities and previous addiction treatment who are still struggling with AUDs and/or facing a period of vulnerability to relapse.
Another Innovation at Journal of Clinical Oncology

It has been an exciting first year as Editor-in-Chief, during which many changes have been made to Journal of Clinical Oncology (JCO). These include launching the rapid-review effort, along with a substantial increase in articles published on a high-priority, free-access basis (ie, Rapid Communications). Readers have also noticed the frequent appearance of a new section entitled Understanding the Pathway, in which we provide a snapshot of the relevant biology that underlies an accompanying original report. The podcast effort has also been very successful and has become a popular venue for keeping up with selected JCO articles, especially for readers who have not yet had a chance to view the accompanying articles in print. As some of you have noticed, we have begun to post videos on our JCO Web site (www.jco.org), illustrating important procedures (eg, laparoscopy) relevant to an original report (eg, jco.ascopubs.org/content/ 30/7/681/suppl/DC1). The launch of user-friendly applications for commonly used mobile devices represents our commitment to provide readers with easy access to the timely and practice-changing information that they have come to expect from JCO. We continue to develop a robust menu of new Special Series reviews, including the recently published Care of the Whole Patient With Cancer and new topics to be published soon regarding adult survivorship, comparativeeffectiveness research, genomics-driven cancer medicine, non–small-cell lung cancer, and pain management. I would like to call your attention to yet another innovation that is being introduced in JCO, which we call Oncology Grand Rounds. This section is designed with the practitioner in mind and will be case based, discussing management approaches to commonly encountered oncologic problems in a data-driven fashion, using an original report published in the same issue of JCO as the focal point for discussion. I have often felt that it is difficult for busy practitioners to fully know how to integrate the findings of original research into their own clinical practice, and my hope is that this new section will help to accomplish this goal. Indeed, we still envision the original report as being the center of attraction in this choreographed production, surrounded by contributions from other sections such as Oncology Grand Rounds, Understanding the Pathway, Editorials, Comments and Controversies, and podcasts, all providing a thematic thread designed to enhance the readership experience (Fig 1). As you might imagine, we work hard behind the scenes to coordinate this, but it is a labor of love fueled by the positive reinforcement that we receive from our valued readers and the knowledge that ultimately, these efforts will lead to better patient care. I would like to thank the many readers, my great editors, and our wonderful staff at JCO who have been supportive of my efforts during this first year. We are off to a great start, but there is more to come, so please stay tuned.
Life‐Table Analysis of Abstinence in a Study Evaluating the Efficacy of Disulfiram

Data from a study evaluating the efficacy of disulfiram for the treatment of alcoholism were analyzed by life-table methods. Previous analysis by more commonly used statistical tests showed a trend favoring disulfiram treatment, but the results were not statistically significant. Life-table methods are the appropriate techniques for analyzing longitudinal studies because they evaluate response to treatment over time rather than at one point in time. Analysis of our data using these methods revealed that disulfiram, combined with medical care and counseling, was superior to medical care and counseling alone in 128 men followed for 1 yr. This report demonstrates: (A) the advantage of life-table methods for evaluating treatment outcome data in alcoholism studies; and (B) the importance of disulfiram treatment in alcoholic patients similar to those we studied.