cssi/SciSciGPT-SciSciNet huggingface dataset:
Cardiac responses to exercise distinguish postural orthostatic tachycardia syndrome variants

We previously showed that one‐third of adolescents with postural orthostatic tachycardia syndrome (POTS) have hyperkinetic circulation. In a subsequent cohort, we compare participants with POTS grouped according to cardiac output (![Formula][1] ) versus oxygen uptake (![Formula][2] ) function, whose circulatory response to exercise lay at the lower end of this distribution. We hypothesized that such grouping determines the circulatory response to incremental‐protocol, upright, cycle ergometry by whatever blend of flow and resistance adjustments best maintains normal blood pressure. We reviewed data on 209 POTS participants aged 10–19 years (73% female) grouped as follows: ![Formula][3] or hypokinetic variant ( N = 31); normal‐![Formula][5] had slopes between 3.21 and 7.97; hyperkinetic participants had ![Formula][6] slope >8 L·min−1 per L·min−1 ( N = 32). Heart rate response to exercise was virtually identical in each group. Mean stroke volume (SV) rose normally in the hyperkinetic group (51 ± 38%); less in the normal ![Formula][7] group (22 ± 27%); but was flat in the low ![Formula][8] group (−7 ± 16%). Mean arterial pressure was similar at rest while systemic vascular conductance was flat from rest to exercise in the hypokinetic group, and by comparison rose more steeply in the normal ![Formula][9] ( P < 0.001) and in the hyperkinetic ( P = 0.02) groups. In conclusion, we identified a variant of POTS with a hypokinetic circulation maintained by a vasoconstricted state. We speculate that they cannot muster preload to augment exercise SV due to profound thoracic hypovolemia, and must resort to vasoconstriction in order to maintain perfusion pressure within working muscle. [1]: /embed/mml-math-1.gif [2]: /embed/mml-math-2.gif [3]: /embed/mml-math-3.gif [4]: /embed/mml-math-4.gif [5]: /embed/mml-math-5.gif [6]: /embed/mml-math-6.gif [7]: /embed/mml-math-7.gif [8]: /embed/mml-math-8.gif [9]: /embed/mml-math-9.gif
Sensitivity and specificity of abstraction using gist reasoning measure in adults with traumatic brain injury

Abstraction, a unique aspect of human reasoning, is affected by TBI. Lack of sensitive metrics to characterize abstraction in TBI recovery may impede detection of cognitive deficits and impact daily function. Recent findings found lower performance in abstracting meaning from complex information, referred to as gist reasoning, in adults with TBI. This study extends those findings to (a) compare abstract thinking between adults with TBI and controls on gist reasoning, similarities, and proverbs and (b) examine and compare sensitivity and specificity of abstraction measures. Participants included adults with moderate to severe chronic TBI (n = 30) and controls (n = 40), all between 25 and 55 years. ANOVA examined group differences on abstract thinking performance. A 10-fold cross-validation analysis examined sensitivity and specificity of each measure, and all possible combinations of measures. The TBI group performed significantly lower on gist reasoning and similarities. Results demonstrated higher sensitivity of gist reasoning (84.7%) as compared to similarities and proverbs. Specificity of gist reasoning (71.1%) was second highest, with proverbs multiple choice being the highest (85.2%). Combination of measures did not yield significant gains in sensitivity beyond gist reasoning alone. Gist reasoning could provide an additional diagnostic tool to detect impaired abstraction deficits in adults with chronic TBI. Furthermore, gist reasoning performance has implications to guide cognitive training.
In vitro metabolism of new synthetic cannabinoid SDB-006 in human hepatocytes by high-resolution mass spectrometry

The drug abuse epidemic within the United States remains one of the nation’s most serious social challenges, especially among adolescents and young adults. Novel psychoactive substances continuously emerge into the illicit drugs-of-abuse market to evade legislation. In 2013, SDB-006 was detected as a novel synthetic cannabinoid (SC) with high binding affinity to CB1 (EC50 = 19 nM) and CB2 (EC50 = 134 nM). Unfortunately, no human metabolism data for SDB-006 are currently available, making it challenging to confirm intake, since all previously investigated SCs were extensively metabolized. The present study aims to recommend appropriate marker metabolites for documenting SDB-006 consumption by investigating its metabolism in human hepatocytes. For metabolite profiling, 10 µM of SDB-006 was incubated in human hepatocytes for 3 h. Metabolite identification in hepatocyte samples was accomplished with high-resolution mass spectrometry via information-dependent data acquisition. Results revealed that SDB-006 was highly metabolized in human hepatocytes. A total of 20 metabolites were characterized, generated mainly from hydroxylation and glucuronidation. Hydroxylation occurred primarily on several positions of the pentyl chain. N-Dealkylation was the other major pathway, including depentylation and debenzylation. Based on our data, we propose 4′-keto-SDB-006 (M19) and pentyl-OH-SDB-006 (M15) as optimal marker metabolites for documenting SDB-006 intake.
QCA: Intervention in Africa Since 1960

To test the role that pre-existing relationships play in intervention success, interventions by colonizers will be compared to each other, and to interventions by non-colonial states through a variety of conditions which measure structural and cultural inter-institutional legibility. The sources of military intervention success in African civil wars are deeply interrogated through the use of iterative qualitative comparative analyses (QCA) both crisp set and fuzzy set. Significantly, the analysis reveals the role of shared language in intervention dyads plays in intervention success.
Family Poverty, Family Processes and Children’s Preschool Achievement: Understanding the Unique Role of Fathers

Developmental research has highlighted the importance of fathers for children’s early academic success, and growing evidence suggests that children living in poverty may benefit the most from positive father involvement. Using a subsample of children from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), this study examined direct and mediated pathways from family poverty to children’s preschool achievement. Analyses revealed that poverty had a more consistent negative association with fathers’ parenting than mothers’ parenting and fathers’ parenting was a more consistent mediator of links between poverty and child achievement than mothers’ parenting. Specifically, fathers’ and mothers’ warmth as well as fathers’ home learning stimulation mediated the relation between poverty and children’s reading scores. Furthermore, fathers’ warmth and mothers’ home learning stimulation mediated the relation between poverty and children’s math scores. Results point to the unique contribution of fathers to children’s preschool achievement and imply that poverty is differentially associated with fathers’ and mothers’ parenting practices during the early childhood period.
Function of PU.1 (Spi-1), C/EBP, and AML1 in early myelopoiesis: regulation of multiple myeloid CSF receptor promoters.

Recent studies of the regulation of normal myeloid genes, as well as the study of leukemias, has suggested that transcription factors play a major role in hematopoietic differentiation as well as leukemogenesis.[l–3] In order to understand the process of normal myeloid differentiation, it is important to identify and characterize the transcription factors which specifically activate important genes in the myeloid lineage. In addition, these factors may play a role in acute myelogenous leukemia (AML), in which this normal differentiation program is blocked. Receptors for growth factors play an important role in myelopoiesis. [4–7] In order to further understand the mechanisms directing the expression of these key regulators of hematopoiesis, we have initiated studies investigating the transcription factors activating the expression of several important myeloid colony-stimulating factor (CSF) receptors.
THE ORGANIZATION OF IMMUNOGLOBULIN GENES

ABSTRACT In order to distinguish among various models which have been advanced to account for the diversity of antibody molecules, we must know how the constant and variable regions of immunoglobulins are represented in the somatic genome. For this purpose, we have purified mRNA corresponding to a mouse kappa immunoglobulin light chain from the myeloma tumor, MOPC-41. This mRNA directs the enzymatic synthesis of highly radioactive DNA (cDNA). This cDNA, which should correspond to the constant region of the kappa chain, was assessed for reiteration frequency using hybridization kinetic analysis and was found to be represented approximately three times per haploid genome . This result tends to rule out germ line hypotheses which require many copies of the constant region gene. It also requires the postulation of a recombinational mechanism to join constant and variable region sequences. Hybridization kinetic analyses designed to assess the entire light chain sequence (C and V regions) made use of 125I-MOPC-41 mRNA. These revealed a major component of relatively unique frequency and a minor (~ 20%) component with a reiteration frequency of approximately 30-50 copies per haploid genome. Careful analysis of the extent of hybridization of this mRNA to DNA prepared from several tumors and tissues, thermal profiles, and relevant competition studies, while sensitive, do not permit us to distinguish unambiguously between a germ line model and the type of somatic mutation model which permits germ line genes corresponding to each kappa subgroup. Our results do, however, clearly rule out the existence of thousands of variable region sequences so closely related to the MOPC-41 V-region as to permit extensive, stable cross hybridization.
THE CHALLENGES OF MANAGING TEST: STANDARDIZATION

Semiconductor ver t ica l in tegra ted bus iness flow that covers design to final test is gradually being replaced by vertical collaboration (as the figure shown blow). In vertical collaboration model, fab, tes t ing and assembly can be outsourced/foundried by special ized companies with bet ter cost , cycle t ime and/or performance. This trend has created complex mesh linking between each party. Foundries deal with different requirements/specs before (and after) their process whi le product companies deal wi th di f ferent foundries both vertically and horizontally (two or more foundries in the same process) . Standardizat ion, therefore, has become an even more important task in this industry and a challenge for testing management.
Pediatric Hip Disorders: Slipped Capital Femoral Epiphysis and Legg-Calvé-Perthes Disease.

1. Alexa J. Karkenny, MD* 2. Brandon M. Tauberg, MD* 3. Norman Y. Otsuka, MD* 1. *Montefiore Medical Center and the Children’s Hospital at Montefiore, Bronx, NY * Abbreviations: AP: : anteroposterior LCPD: : Legg-Calve-Perthes disease MRI: : magnetic resonance imaging SCFE: : slipped capital femoral epiphysis 1. The differential diagnosis for a limping child or adolescent with hip or knee pain is broad. Delayed or missed diagnoses of slipped capital femoral epiphysis and Legg-Calve-Perthes disease have significant morbidity. Clinicians should understand when to suspect these disorders based on history, examination, and early imaging findings to allow for timely referral to a specialist. 2. Clinicians should also have a basic understanding of the treatment options and prognosis of these disorders to counsel patients and their families before and during treatment by a specialist. After completing this article, readers should be able to: 1. Identify the general anatomy relevant to slipped capital femoral epiphysis (SCFE) and Legg-Calve-Perthes disease (LCPD) pathology. 2. Recognize the symptoms and physical examination findings of SCFE and LCPD. 3. Know the basic laboratory values and imaging to order to evaluate for SCFE and LCPD when referring to a specialist. 4. Differentiate straightforward presentations of SCFE and LCPD. 5. Understand broad treatment categories and the prognoses of SCFE and LCPD. 6. Realize the importance of timely referral to a specialist for SCFE and LCPD. Pediatric hip pathology can lead to devastating complications, such as hip instability, early arthritis, and growth abnormalities. Two of the most common pathologies in this age group include slipped capital femoral epiphysis (SCFE) and Legg-Calve-Perthes disease (LCPD). The importance of early diagnosis is paramount in both of these disorders, to allow for early treatment and attempt to limit the potentially morbid outcomes. Because many of these children will initially present to their pediatrician, recognition and early referral to an orthopedic …
Epoxy infiltrated 3D printed ceramics for composite tooling applications

Abstract The use of additive manufacturing (AM) provides an opportunity to fabricate composite tooling molds in a rapidly and cost effectively manner. This work has shown the use of a polymer based infiltrated ceramics produced via binder jetting for producing composite tooling molds. Here, molds based on silica sand as well as zircon sand have been printed on a S-Max 3D printer unit and subsequently impregnated with an epoxy system for yielding functional molds in the range of autoclave temperatures around 150–177 °C. The mechanical properties of the infiltrated 3D printed materials have been investigated and it was observed that the polymer-infiltrated systems resulted in a compressive and flexural strength one order of magnitude higher than the non-infiltrated printed ceramic material. A thermal analysis was also performed on both the infiltrated and non-infiltrated printed samples, and it was recorded that the incorporation of the polymer resulted in a larger coefficient of thermal expansion on the infiltrated systems. Here, a carbon fiber reinforced composite was manufactured with the infiltrated composite tooling molds printed in the S-Max unit, and it was observed that the assembled molds are capable of producing a successful composite material. The present work has demonstrated that a binder jetting process, is a feasible technology for producing thermostable low cost composite tooling molds.
Enabling User Driven Web Applications on Remote Computing Resource

While CI providers have continued success with the infrastructure-as-a-service model (IaaS), there are increasing demands to offer more user driven service models from domain scientists. We propose a user driven web application that empowers users to run their interactive analytic tasks using CI resources dynamically. Ad-hoc analysis routines can be described with multiple pre-defined task modules in a configuration file that can be shared and re-used. A user can run the web application on CI resource without alleviated privilege or additional service deployment by administrators. The functions and user interface of the web application are automatically initialized based on the configuration file. Therefore, the framework offers a new way for a user to access and utilize remote resources. This new model can effectively reduce the access barrier to remote computing resource offered by CI. In this paper, we describe the proposed architecture of this framework and give a use case example.
Afrofuturism, Critical Race Theory, and Policing in the Year 2044

In 2044, the United States is projected to become a “majority-minority” country, with people of color making up more than half of the population. And yet in the public imagination—from Robocop to Minority Report, from Star Trek to Star Wars, from A Clockwork Orange to 1984 to Brave New World—the future is usually envisioned as majority white. What might the future look like in year 2044, when people of color make up the majority in terms of numbers, or in the ensuing years, when they also wield the majority of political and economic power? And specifically, what might policing look like? This Article attempts to answer these questions by examining how artists, cybertheorists, and speculative scholars of color—Afrofuturists and Critical Race Theorists—have imagined the future. What can we learn from Afrofuturism, the term given to “speculative fiction that treats African-American themes and addresses African-American concerns [in the context of] techno culture?” And what can we learn from Critical Race Theory and its “father” Derrick Bell, who famously wrote of space explorers to examine issues of race and law? What do they imagine policing to be, and what can we imagine policing to be in a brown and black world?
Characterization of individual cell motion in human skin capillaries by noninvasive reflectance confocal video microscopy (Conference Presentation)

Leukocyte-endothelial interactions have been well-characterized by intravital microscopy in mice. Quantitative parameters descriptive of these dynamic processes, e.g. the level of leukocyte rolling, adhesion and extravasation, can detect and track inflammation. Despite technology available to study individual cell motion noninvasively in human skin, we are not aware of any published exploratory or clinical studies. In this preliminary study, we explore the feasibility to extract parameters characteristic of individual cell motion in the postcapillary vessels of healthy human skin from videos taken by a noninvasive clinical confocal microscope (Vivascope 1500). The microscope is capable of real-time imaging of individual cells at 9 frames per second. We took videos of ten cutaneous vessels per each of two body sites (volar forearm and upper anterior chest) of ten healthy subjects. We then characterized the dynamic motion of cells via subsequent video analysis by extracting the following parameters: blood flow velocity, number of adherent leukocytes (stationary <30 s), and number and diameter of vessels. We observed variation in blood flow velocity within 1 minute in the same vessel, between vessels within an 8x8 mm field of view, and within two different body sites. Leukocyte adhesion, more commonly associated with inflammatory conditions, can also be observed in healthy skin. Further studies are needed to test the potential of this approach to detect inflammation.
Design and Implementation of Adaptive Fuzzy PD Line Following Robot

Line following robot is a basic autonomous robot that detects line and follow it autonomously. Because of its simple design and low cost, line following robots play important role and these robots have been widely used in different areas like warehouse operations, self-driving cars, student competitions etc. The design of line following robots can be basic or sophisticated depending on mission requirements, hardware used and programming capabilities. There are a limited number of methods that are used to control the line following robots independent from sensor system structures. In this study, PID-based approaches and fuzzy-based control approaches which are widely used in the literature are compared and a hybrid control approach is discussed. To demonstrate the success of the hybrid control method, a line follower robot is designed and then PD and fuzzy-based control approach is implemented orderly. Finally, Adaptive Fuzzy PD Controller as a hybrid control methodology is implemented and success of the approach is discussed. It is demonstrated that Adaptive Fuzzy PD Controller as hybrid control approach has better results than the common control approaches in the literature especially by using the low power, cost effective processors.
Perception about prostate cancer among African-American men: Focus group analysis

4732 Focus groups are an effective strategy for obtaining information about the health beliefs and practices of African-American men. Fourteen (14) focus groups were conducted in three counties in the Baltimore Metropolitan Area (Baltimore City, Baltimore County, Harford County) to determine factors that impact the low participation rate of African American men in annual screening for prostate cancer. Focus group participants ranging in age from 19–81 years were recruited from churches, clinics, work sites, and social clubs. The discussions, which were audiotaped and subsequently transcribed, were moderated by African Americans who utilized a 13-item open-ended questionnaire. Themes identified using the cut-and-paste method included the following barri ers: lack of knowledge and awareness, fears, and misconceptions, limited access and availability of screening services, embarrassment, and distrust for medical professionals and government. Positive belief, hope and experience with prostate cancer were enabling factors for prostate cancer screening. Outcomes from the groups will be used in planning and developing a culturally sensitive health education program for African American men. Lack of education and awareness about prostate cancer among African-American men, necessitates increased funding for educational and screening programs within this hard to reach population.
Long-Term Complications of Osteocutaneous Free Flaps in Head and Neck Reconstruction:

ObjectiveTo determine the frequency at which patients with osteocutaneous free flap reconstruction of the head and neck develop long-term complications and identify predisposing perioperative facto...
Qualitative analysis of resilience characteristics of people with unilateral transtibial amputation.

Abstract Background Resilience characteristics are a significant factor in the highly variable rehabilitation outcomes for people in middle age or later with transtibial amputation. Objective The purpose of this study was to describe resilience characteristics meaningful to people with transtibial amputation in middle age or later, who use a prosthesis. Methods Semi-structured interviews were conducted, audio recorded, and transcribed with eighteen participants. Interview transcripts were coded and analyzed using a directed content analysis approach, guided by Charney’s theory of resilience and Connor-Davidson Resilience Scale scores. Results Five main resilience characteristics (themes) were identified: coping skills, cognitive flexibility, optimism, skill for facing fear, and social support. Participants with higher resilience scores generally described effective use of coping skills, cognitive flexibility, optimism, skills in facing fears, and social support to attain meaningful goals. In contrast, participants with lower resilience scores discussed passive coping strategies, cognitive rigidity, general pessimism, avoidance of activities due to fear, or social support limitations. Conclusion Coping skills, cognitive flexibility, optimism, skills for facing fear, and social support were identified as meaningful resilience characteristics for people with transtibial amputation in middle age or later. These characteristics can be targeted and enhanced using resilience interventions. Future research should consider these characteristics when designing and testing rehabilitation focused resilience interventions for people with TTA.
Hospitalized exacerbation of bronchial asthma in Chongqing, HEAT study

Objective Analysis of hospitalization in acute exacerbation of bronchial asthma (asthma).Methods Using retrospective analysis the reason for hospitalization in acute exacerbation of asthma in Chongqing several teaching hospitals and dimethyl above hospital during January-December 2007.Results In all 570 patients,470 people have different inducing factors,such as catching a cold,inhaled excitant gas (air fumes),weather and seasonal change,allergy source stimulation,etc.87.19％existing improper treatments,20 patients withdrawal during the no acute phase (3.51％),497 people don't use in rules,most patients only use aminophylline or LABA,although 93 patients used ICS+LABA treatment,but only 73 people adhere to rules (12.81 ％).Conclusions The main reason of asthma patients hospitalized with acute aggravate is treatment of acute period of non standard or withdrawal.The environments factors are also induce asthma acute exacerbation.At the same time,acute exacerbation significantly increased the cost of treatment of asthma.Therefore,strengthening asthma patient knowledge,treatment of management and guiding significance. Key words: Asthma; Acute exacerbation; Hospitalization; Inducing factors
Consistent Estimation of Generalized Linear Models with High Dimensional Predictors via Stepwise Regression

Predictive models play a central role in decision making. Penalized regression approaches, such as least absolute shrinkage and selection operator (LASSO), have been widely used to construct predictive models and explain the impacts of the selected predictors, but the estimates are typically biased. Moreover, when data are ultrahigh-dimensional, penalized regression is usable only after applying variable screening methods to downsize variables. We propose a stepwise procedure for fitting generalized linear models with ultrahigh dimensional predictors. Our procedure can provide a final model; control both false negatives and false positives; and yield consistent estimates, which are useful to gauge the actual effect size of risk factors. Simulations and applications to two clinical studies verify the utility of the method.
Utility of screening urinalysis to detect abdominal injuries in suspected victims of child physical abuse.

Abstract Background Urinalysis, liver enzymes (LE) and lipase are used to screen for abdominal injuries in children with suspected physical abuse (SPA). However, data on the utility of urinalysis is limited. Objectives Describe the prevalence of hematuria in evaluations for SPA. Determine test characteristics of hematuria, LE and lipase to identify kidney and other abdominal injuries among children with SPA. Participants and setting Children Methods Demographic, clinical, and laboratory data including presence of hematuria (blood on urine dipstick), elevated LE (> 80 U/L) and elevated lipase (> 100 U/L) were abstracted retrospectively. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the overall study population and for patients without abdominal symptoms. Results Ten percent of patients had hematuria (N = 237). Prevalence of abdominal and kidney injuries was 7 % and 1 % respectively. Of 3 patients with kidney injury, 2 had hematuria and all had elevated LE. Sensitivity (67 %) and NPV (99 %) of hematuria to detect kidney injuries were lower than LE and the same as lipase. Specificity (91 %) and PPV (8%) of hematuria to detect kidney injury were greater than LE and similar to lipase. Sensitivity of hematuria to detect any abdominal injury (50 %) was lower than LE (81 %). Sensitivity of hematuria to detect occult abdominal injury was 0 %. Conclusions Hematuria alone did not lead to detection of kidney injury. Test characteristics of hematuria were largely similar or inferior to LE and lipase.
Disruptions, distractions, and discoveries: Doctoral students’ reflections on a pandemic

This paper describes the reflections of two social work PhD students based on their personal and professional experiences with the COVID-19 pandemic. The students describe their positionality and use that to expound on the impact of the pandemic on their lives. They reflect on the disruptions to their social work education and research priorities including transitioning to online learning and modifications to research agendas. They then discuss ongoing distractions such as worries about getting sick, mental health concerns, and financial constraints. They share their discoveries about glaring disparities in coronavirus infection and death rates, the need to adjust research agendas in response to current events, and the urgency for qualitative research strategies to add meaning to the numbers being reported. In addition, the authors describe shared experiences and intersections they discovered while writing this essay. Finally, recommendations for practice include recommitting to social work values to help surmount the ongoing waves of this pandemic; reimagining social work education so that disparities and injustice intersect with every subject taught and graduates become experts at leading social change; and harnessing the untapped potential of qualitative research to drive real, systemic change.
An Evaluation of Caching in Nation Scale, Normally Isolated Mobile Ad Hoc Networks

Nation Scale Mobile Ad Hoc Network, or NSHoc, was developed to enable smartphone users to request and receive content via opportunistic encounters in nation scale topologies. It provides a novel solution for large scale delay tolerant communications when network infrastructure is down after natural disasters, inaccessible due to extreme censorship or nonexistent in remote areas. Prior work demonstrated that NSHoc can successfully deliver content, including unpopular content, with no existing knowledge of network members and in sparse topologies where individual nodes may remain isolated for minutes or even hours at a time. However, significant questions regarding the caching properties of NSHoc were left unanswered. In this paper we present an analysis of caching in NSHoc, the first analysis of caching in a nation scale MANET. Our results show that NSHoc can deliver content with only a small performance loss even when half of the users are immobile and that it is resilient against black hole attacks. However, NSHoc is vulnerable to content flooding attacks. We found that the percentage of requests fulfilled dropped from 97% to 78% when only 5% of users were flooding the network with unpopular content. We demonstrate the effectiveness of two defenses against content flooding attacks: friends first caching and statistical checking of content caches prior to exchanging content. Both of these defenses provide complete protection against least popular content flooding attacks, restoring the percentage of requests fulfilled to 97%.
Anesthesia for children with complete trisomy 18 (Edwards syndrome): A cohort review of 84 anesthesia encounters in nine patients

Background Trisomy 18 or Edwards syndrome is the second most common aneuploidy with a prevalence between 1/3000 and 1/10 000 live births. The syndrome encompasses malformations of the central nervous, cardiac, respiratory, gastrointestinal, and genitourinary systems. Trisomy 18 carries a poor prognosis with 90% of patients not surviving beyond 1 year of age; however, the current trend toward more aggressive supportive care may prolong survival. The limited anesthesia literature highlights the abnormal airway anatomy but generally describes uneventful airway management and perioperative course. Aim Our goal was to review all anesthesia encounters recorded for eleven trisomy 18 patients treated at Children's Wisconsin during the study period to explore the frequency of anesthesia encounters and to improve our understanding of the perioperative risks. Methods We performed a retrospective chart review of all patients with trisomy 18 who were treated at our institution between 2012 and 2017. Records were screened for anesthesia encounters, perioperative critical events and complications, enrollment in palliative care, code status, and time of death. Results Eleven children were identified. Children were born between 2001 and 2016. Two children never required anesthesia care. Nine patients had a total of 84 anesthesia encounters for 121 surgical or diagnostic procedures or emergent intubations. Critical events and perioperative complications included difficult mask ventilation (n = 7), difficult intubation (n = 15), and mechanical or pharmacological cardiopulmonary resuscitation (n = 6). Five patients presented with difficult peripheral intravenous access. One patient died in the immediate postoperative period. On five occasions, patients required emergent intubation outside of the operating room. Conclusion Difficult airway management and respiratory compromise were critical concerns during the perioperative period in our patient population, and the inability to ventilate could lead to cardiorespiratory arrest. This case series provides a comprehensive, longitudinal view of complete trisomy 18 patients in the perioperative period and adds information for counseling families and care providers.
High School Basketball Coach and Player Perspectives on Warm-Up Routines and Lower Extremity Injuries.

While participation in sports-related activities results in improved health outcomes, high school athletes are at risk for lower extremity injuries, especially ankle, knee, and thigh injuries. Efforts to promote the adoption and implementation of evidence-driven approaches to reduce injury risk among school-aged athletes are needed. However, there is limited research regarding the perceived barriers, facilitators, and adherence factors that may influence the successful implementation of effective warm-up routines among this population. We conducted a qualitative study using semi-structured interviews and focus groups to assess high school basketball coach and player current practices, knowledge, and perspectives about warm-ups and lower-extremity injuries (LEIs). We interviewed coaches (n = 12) and players (n = 30) from May to October 2019. Participants were recruited from public high schools in a joint school district in Southern California. Multiple coders employed thematic analysis of the data using validated methods. Coaches and players reported regular engagement (e.g., daily) in warm-up routines, but the time dedicated (range 5–45 min), types of exercises, and order varied substantially. Players often co-lead the warm-up practice with the coach or assistant coach. Despite regular engagement in warm-up, players and coaches report multiple challenges, including (1) limited time and space to warm-up effectively at games, (2) a perception that young players are not prone to injury, (3) competing demands for coaches’ time during practice, and (4) coaches’ lack of knowledge. Coaches and players perceive that warming up before practice will result in fewer injuries, and many players are motivated to warm up as a result of their personal injury experience; however, they desire guidance on the ideal exercises for preventing injury and training on the proper form for each exercise. Regular involvement in basketball warm-up routines is common among high school teams, but the methods and time dedicated to these practices varied. Players and coaches are eager for more information on warm-up programs shown to reduce LEIs.
Laparoscopic Trachelectomy for Cervix Yolk Sac Tumor in 11-Month-Old Girl: The Youngest Case.

ABSTRACT Background Yolk sac tumor (YST) is a malignant entity that often occurs in girls less than 3 years of age and is the most frequent type of primary extragonadal germ cell tumor. Case We describe the case of an 11-month-old girl who was referred to our center for vaginal bleeding with evidence of a uterine mass on ultrasonography. Preoperative investigations confirmed YST of the uterine cervix without metastasis. After 4 cycles of systemic chemotherapy, the patient was treated with laparoscopic trachelectomy (fertility-sparing surgery) without perioperative complications. Summary and Conclusion After 12 months of follow-up, no residual mass was seen. The laparoscopic technique for trachelectomy for uterine cervix YST seems to be feasible and safe in children under 1 year of age.
Perspectives on Constrained Forecasting.

This expository paper discusses Bayesian decision analysis perspectives on problems of constrained forecasting. Foundational and pedagogic discussion contrasts decision analytic approaches with the traditional, but typically inappropriate, inferential approach. Illustrative examples include development of novel constrained point forecasting and entropic tilting methodology to explore consistency of a predictive distribution with an imposed or hypothesized constraint. Linear, aggregate constraints define illuminating examples that relate to broadly important problems involving aggregate and hierarchical constraints in commercial and economic forecasting. Discussion explores the impact of different loss functions, questions of how constrained forecasting is impacted by dependencies among outcomes being predicted, and promotes the broader use of decision analysis including routine evaluation of predictive distributions of loss under chosen forecasts/decisions. Extensions to more general constrained forecasting problems, connections with broader interests in forecast reconciliation and other considerations are noted.
Cellphone Accessible Information Via Bluetooth Beaconing for the Visually Impaired

We describe a complete hardware/software system, dubbed Universal Real-Time Navigational Assistance (URNA), which enables communication of relevant location-aware information to a blind person carrying a Bluetooth-enabled cell phone. Although URNA can be used for a number of different applications (e.g., an information kiosk at a shopping mall or public transit information at a bus stop), we concentrate on the challenging case of an urban intersection. Information provided to the user as he or she approaches the intersection includes a description of the intersection topology and real-time notification of the state of the traffic lights.
Accommodation: how you see it, how you don't.

Accommodation refers to a condition in which a transplant sustains little or no injury and functions normally despite the presence of anti-donor antibodies in the circulation of the recipient. We first observed accommodation in the 1980’s in the setting of ABO-incompatible kidney transplantation. At that time, 75% of kidneys incompatible for blood group-A or -B were rejected within 3 months. However, Guy Alexandre and a few others found that rejection could be averted and enduring function achieved if the offending antibodies were depleted at the time of surgery. Probing the surprising success we found that in some recipients the anti-blood antibodies returned to the circulation and in all cases the kidneys continued to express the corresponding antigen. We figured then that the grafts might have acquired resistance to injury (1). After observing a similar phenomenon in cardiac xenografts, we applied the term ‘accommodation’ to denote the possibility that the graft and/or recipient had changed in such a way that what was once lethal was no longer so (2). Notwithstanding occasional reports on highly sensitized recipients (3), accommodation has been seen rarely in recipients presensitized to HLA (perhaps because anti-HLA antibodies include high affinity IgG, presumably reflecting somatic hypermutation characteristic of T cell-dependent and not T cell-independent responses that attack blood group and xenogeneic antigens) and de novo produced anti-HLA antibodies presage bad outcomes (4). Whether accommodation can be achieved reliably in presensitzed recipients, how it occurs and why it is not seen more often should compel interest.
Linear control of underactuated spacecraft with two reaction wheels made feasible by solar radiation pressure

This paper describes a method of recovering linear controllability of an underactuated spacecraft by accounting for the effects of solar radiation pressure (SRP) in the spacecraft attitude dynamics model. The developments are based on a spacecraft model with a four wheel reaction wheel array of which two wheels have failed and two wheels are functioning. The model for SRP torque as a function of spacecraft attitude is incorporated into the state-space description of the system. Under suitable assumptions, the linearization of the underacted spacecraft model (with SRP effects included) is shown to be linearly controllable. This conclusion is exploited to define a novel approach for handling reaction wheel failures based on conventional Linear Quadratic (LQ) controllers. The results of the linear and non-linear simulations illustrate the ability to recover pointing by controlling two functioning reaction wheels while two other wheels undergo subsequent failures.
Role of MAPK in the Regulation of Double-Stranded RNA- and Encephalomyocarditis Virus-Induced Cyclooxygenase-2 Expression by Macrophages

In response to virus infection or treatment with dsRNA, macrophages express the inducible form of cyclooxygenase-2 (COX-2) and produce proinflammatory prostaglandins. Recently, we have shown that NF-kappaB is required for encephalomyocarditis virus (EMCV)- and dsRNA-stimulated COX-2 expression in mouse macrophages. The dsRNA-dependent protein kinase R is not required for EMCV-stimulated COX-2 expression, suggesting the presence of protein kinase R-independent pathways in the regulation of this antiviral gene. In this study, the role of MAPK in the regulation of macrophage expression of cyclooxygenase-2 (COX)-2 in response to EMCV infection was examined. Treatment of mouse macrophages or RAW-264.7 cells with dsRNA or infection with EMCV stimulates the rapid activation of the MAPKs p38, JNK, and ERK. Inhibition of p38 and JNK activity results in attenuation while ERK inhibition does not modulate dsRNA- and EMCV-induced COX-2 expression and PGE2 production by macrophages. JNK and p38 appear to selectively regulate COX-2 expression, as inhibition of either kinase fails to prevent dsRNA- or EMCV-stimulated inducible NO synthase expression by macrophages. Using macrophages isolated from TLR3-deficient mice, we show that p38 and JNK activation and COX-2 expression in response to EMCV or poly(IC) does not require the presence the dsRNA receptor TLR3. These findings support a role for p38 and JNK in the selective regulation of COX-2 expression by macrophages in response to virus infection.
PLIF Measurements of Fuel Distribution in a PFI Engine Under Cold Start Conditions

This paper summarizes the first phase of an experimental effort focused on developing a comprehensive understanding of the in-cylinder air/fuel mixing and combustion processes in spark-ignition engines using laser-based fuel distribution and combustion measurements. As part of this first phase, a semi-quantitative, laser-induced fluorescence, fuel distribution measurement technique was developed and demonstrated. The calibration, correction, and image analysis processes associated with the technique were shown to be comparatively simple and effective (relative to other analytical and empirical methods). The error associated with the technique was shown to be 5 - 10 % under vapor phase conditions. This work was applied to a port fuel injected optical engine, which was designed for optical access through the piston and cylinder liner under firing conditions. The engine was operated under Coordinated Strategy for Starting with Reduced Emissions (CSSRE) operating conditions and characterized using the laser-induced fluorescence technique, as well as cylinder pressure analysis. Various ignition timings, Charge Motion Control Device (CMCD) positions, and fuel preparations were examined. Significant differences in fuel distributions were observed during the intake stroke for the various operating conditions, including differences in fuel droplet and vapor distribution. However, by the end of the compression stroke, it was difficult to discern between the fuel distributions for the various operating conditions, suggesting that all achieved approximately the same level of homogeneity. These results were supported by the cylinder pressure analysis which illustrated that the standard deviation in NMEP was explained completely by the effect of combustion phasing.
Diagnosis and treatment of biaxial keratomas in the left fore foot of a 15-year-old Clydesdale mare

Summary A 15-year-old Clydesdale mare presented for furtherdiagnostics and treatment of waxing and waning lamenessand recurrent subsolar abscesses. Radiographs andcomputed tomography revealed biaxial masses extendingfrom the hoof capsule, causing bone resorption of the distalphalanx. Surgery was performed to remove the masses andpost operative care included regional limb perfusions,systemic antibiotics and therapeutic shoeing. Histopathologywas consistent with the diagnosis of keratoma for each of themasses; this is the first case of confirmed biaxial keratomas.Two months after surgery the horse is sound at the walk and isexpected to return to full function within the next year. Introduction While not common, keratomas are a well known cause oflameness in horses. Keratomas are defined as hyperplasticproliferations of the stratum germinativum of the coronaryband or surrounding tissues (Reeves et al . 1989). Keratomasmost commonly affect the toe, although the quarters, heeland sole may be affected (Lloyd
Correlates of Psychomotor Symptoms In Autism

Publisher Summary As per American Psychiatric Association (APA), 2000, the current diagnostic criteria for autism reﬂect these general categories and include qualitative impairment in social interaction, communication, and a restricted repertoire and repetitive stereotyped pattern of behaviors, interests, or activities with a total of six symptoms needed to meet full criteria The chapter focuses on symptoms characteristic of the latter category, with an emphasis on the types of motor abnormalities manifested in children with autism, the function of these behaviors, and the underlying biological mechanisms to explain the occurrence of these behaviors. Symptoms—including restricted and stereotyped range of activities and interests—have typically been conceptualized as behaviors that are observable and atypical. The APA lists a cluster of symp-toms representative of this category in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition text revision (DSM-IV-TR; APA, 2000). Stereotypic behaviors and movement disorders are observed in individuals with autism and the DSM-IV recognizes this symptom as a diagnostic feature of autistic disorder. However, behavioral abnormalities of this nature are common early in development and among children with mental retardation, other pervasive developmental disorders (PDDs), and neurological conditions, thus, limiting its specificity to autism. Diagnosing children with autism should not be predicated on observations of stereotypic movements. Nevertheless, the occurrence of these behaviors and the interference they cause in the child's social and cognitive development has led to a body of research on the cause and treatment of stereotypic behaviors in individuals with autism. Etiological explanations for these abnormal movements are largely based on biological and neurochemical theories but may be reinforced, managed, and maintained by social and sensory consequences.
Assessment of prey vulnerability through analysis of wolf movements and kill sites.

Within predator–prey systems behavior can heavily influence spatial dynamics, and accordingly, the theoretical study of how spatial dynamics relate to stability within these systems has a rich history. However, our understanding of these behaviors in large mammalian systems is poorly developed. To address the relationship between predator selection patterns, prey density, and prey vulnerability, we quantified selection patterns for two fine-scale behaviors of a recovering wolf (Canis lupus) population in Yellowstone National Park, Wyoming, USA. Wolf spatial data were collected between November and May from 1998–1999 until 2001–2002. Over four winters, 244 aerial locations, 522 ground-based telemetry locations, 1287 km of movement data from snow tracking, and the locations of 279 wolf kill sites were recorded. There was evidence that elk (Cervus elaphus) and bison (Bison bison) densities had a weak effect on the sites where wolves traveled and made kills. Wolf movements showed a strong selection for geothermal areas, meadows, and areas near various types of habitat edges. Proximity to edge and habitat class also had a strong influence on the locations where elk were most vulnerable to predation. There was little evidence that wolf kill sites differed from the places where wolves traveled, indicating that elk vulnerability influenced where wolves selected to travel. Our results indicate that elk are more vulnerable to wolves under certain conditions and that wolves are capable of selecting for these conditions. As such, vulnerability plays a central role in predator–prey behavioral games and can potentially impact the systems to which they relate.