cssi/SciSciGPT-SciSciNet huggingface dataset:
A nationwide analysis of antibiotic use in hospice care in the final week of life.

Context Antibiotic prescription in hospice patients is complicated by the focus on palliative rather than curative care and concerns regarding increasing antibiotic resistance. Objectives To estimate the antibiotic use in a national sample of hospice patients and identify facility and patient characteristics associated with antibiotic use in this population. Methods This was an analysis of data from the 2007 National Home and Hospice Care Survey, a nationally representative sample of U.S. hospice agencies. We included data from 3884 patients who died in hospice care. The primary outcome measure was prevalence of antibiotic use in the last seven days of life. Diagnoses, including potential infectious indications for antibiotic use, were defined using International Classification of Diseases, Ninth Revision (ICD-9) codes. Chi-squared tests and t-tests were used to quantify associations of patient and facility characteristics with antibiotic use. Results During the last seven days of life, 27% (95% CI: 24%-30%) of patients received at least one antibiotic and 1.3% (95% CI: 0.7%-2.0%) received three or more antibiotics. Among patients who received at least one antibiotic, 15% (95% CI: 10%-20%) had a documented infectious diagnosis compared with 9% (95% CI: 7%-11%), who had an infectious diagnosis but received no antibiotics. Conclusion In this nationally representative sample, 27% of hospice patients received an antibiotic during the last seven days of life, most without a documented infectious diagnosis. Further research is needed to elucidate the role of antibiotics in this patient population to maintain palliative care goals while reducing unnecessary antibiotic use.
Expectations and Undesired Inventory

Both economists and businessmen are interested in knowing whether inventories are higher or lower than firms desire: Economists because it would provide a clue to the structure of business expectations, businessmen because it would give some indication of the future trend of business. In this paper a model is presented with the aid of which an estimate, however crude, of the amount of undesired inventory in the economy is made from market data.
Approach to the Older Adult Patient

Upon completion of the chapter, the student will be able to: 1. Identify the different components of the history and physical examination and how these differ in older adults compared to younger adults. 2. Identify and understand the potential challenges in caring for older adults and ways to overcome them. 3. Enumerate the changes that occur with normal aging and contrast them with changes that occur secondary to disease.
Strategy and Decision Processes: What is the Linkage?

Despite all of the attention that strategic decision making has received, there has been surprisingly little work that has explicitly examined the link between the processes by which strategic decisions are made and their influence on strategy. The purpose of this commentary is to discuss some important aspects of the decision process, content, outcome linkage.
Hip proprioceptive feedback influences the control of mediolateral stability during human walking

Active control of the mediolateral location of the feet is an important component of a stable bipedal walking pattern, although the roles of sensory feedback in this process are unclear. In the present experiments, we tested whether hip abductor proprioception influenced the control of mediolateral gait motion. Participants performed a series of quiet standing and treadmill walking trials. In some trials, 80-Hz vibration was applied intermittently over the right gluteus medius (GM) to evoke artificial proprioceptive feedback. During walking, the GM was vibrated during either right leg stance (to elicit a perception that the pelvis was closer mediolaterally to the stance foot) or swing (to elicit a perception that the swing leg was more adducted). Vibration during quiet standing evoked leftward sway in most participants (13 of 16), as expected from its predicted perceptual effects. Across the 13 participants sensitive to vibration, stance phase vibration caused the contralateral leg to be placed significantly closer to the midline (by ∼2 mm) at the end of the ongoing step. In contrast, swing phase vibration caused the vibrated leg to be placed significantly farther mediolaterally from the midline (by ∼2 mm), whereas the pelvis was held closer to the stance foot (by ∼1 mm). The estimated mediolateral margin of stability was thus decreased by stance phase vibration but increased by swing phase vibration. Although the observed effects of vibration were small, they were consistent with humans monitoring hip proprioceptive feedback while walking to maintain stable mediolateral gait motion.
Set-Related Neurocognitive Networks

The term “set” refers to the anticipatory neurocognitive processes that prepare an individual to engage in a particular behavior. Set entails a specific configuration of anticipatory perceptual, motor, or cognitive brain processes that is initiated by task context and actively maintained for subsequent task performance. Set is made possible by prior perceptual, motor, or cognitive experience with the same or a similar task. Set-related processes are thought to establish conditions that guide and channel the fast communications between areas of the cerebral cortex that underlie perception, action, or cognition. It is proposed that set-related processes change the functional connectivity of cortical areas within and between large-scale networks of cognition, or neurocognitive networks. The operation of set has been implicated from the analysis of neuroimaging data recorded in a study of human subjects performing a demanding cued visuospatial attention task. From analysis of long-range directed (top-down) functional connectivity, a neurocognitive network of frontal and parietal cortical areas, called the Dorsal Attention Network, was inferred to modulate activity in retinotopic areas of Visual Occipital Cortex (VOC): top-down influences were larger to VOC subregions representing the attended visual hemifield than to subregions representing the unattended hemifield. This difference was maintained over seconds to minutes throughout the entire task. Bottom-up influences from the two subregions did not differ. The maintenance of task-specific top-down modulation of VOC throughout a recording session suggests that it reflects visuospatial attentional set.
A New Species of Quernaspis (Homoptera: Diaspididae)

A new species of scale insect, Quernaspis quercicola , from Quercus laurifolia Michx., collected on Cumberland Island, Georgia, is described. The new species resembles Q. quercus (Comstock) but differs in that the median lobes are not completely fused and in the lack of dorsal submedian and submarginal macroducts.
The Influence of Pre-surgical Orthodontic Treatment upon the Surgery of Cleft Lip and Palate:

Pre-surgical orthodontics has certain minor undesirable influences upon the surgery. These are the slight delay in the primary lip operation and the need for anterior palate repair in the bilateral case. When balanced against the very considerable advantages however there can be few surgeons who would not willingly accept the drawbacks in the interests of achieving a relatively easy definitive lip repair at the primary operation. One wonders whether there is significance in the fact that most of the criticism of pre-surgical orthodontics has come not from surgeons but from orthodontists who are either unable or unwilling to provide this service for their surgical colleagues and through them for their patients.
Role of Sirtuins in Regulating Pathophysiology of the Heart

Cardiovascular diseases (CVDs) are expanding at an alarming rate and people's propensity to develop them increases with age. Growing evidence indicates that sirtuins play a pivotal role in regulating a multitude of age-related diseases. Sirtuins are versatile molecules conserved from archaea to mammals. They are regulated by various metabolic and environmental stimuli. Seven sirtuin homologs (SIRT1-7) are present in mammals, with diverse cellular locations. Recent studies have delineated roles of sirtuins in regulating cardiac pathophysiological conditions under various stressors. SIRT1 is the most extensively studied sirtuin, while the role of other sirtuins in maintaining cardiac growth and function is still emerging. In this review we discuss the present understanding of the role of sirtuins in regulating pathophysiological conditions of the heart.
Lymphomas of the Large Airways

Lymphoproliferative disorders can involve the lungs in 3 ways: (1) by hematogenous spread of non-Hodgkin’s lymphoma (NHL) or Hodgkin’s disease (HD), (2) by contiguous invasion from a hilar or mediastinal site of nodal lymphoma, or (3) by primary pulmonary/airway involvement. Lymphomas occurring primary to the lung are rare and account for <1 % of all primary pulmonary neoplasms and all extranodal non-Hodgkin’s lymphomas (NHLs). The clinical presentation and radiologic findings vary according to the location of the main lesion, which can occur mostly in the lung parenchyma or, as reported in rare cases, in the large airways. The diagnosis relies on the histologic evaluation of tissue samples and the confirmation of the presence of a lymphoid clonal proliferation by ancillary studies. The vast majority of primary pulmonary lymphomas are marginal zone B cell lymphomas of mucosa-associated lymphoid tissue (MALT). Other less common types of lymphoma occurring primary to the lung include diffuse large B cell lymphoma, lymphomatoid granulomatosis, anaplastic large cell lymphoma, and lymphoproliferative disorders associated with immunosuppressed states.
Electric field enhancement and light transmission in cylindrical nanoholes.

The properties of electric fields in subwavelength cylindrical apertures are examined upon excitation by a far-field source. We find that the largest enhancements are localized at the edge of the aperture, close to its rim. Both the entrance and exit rims of the hole can produce intense fields, although at long wavelengths thick slabs lead to smaller fields at the exit rim. The fields display a two lobe angular pattern characteristic of a radiating dipole in the near field. The influence of aperture size and slab thickness on field enhancement is presented. Although there is often a connection between peak transmission and peak field, the two rarely occur at the same wavelength. Enhancements in the electric field intensity can be increased by an order of magnitude by adding a grooved structure around the aperture, which acts as a grating and permits coupling to surface plasmon polaritons. Our results indicate that nanohole systems can be optimized to yield large electric field enhancements, making them an attractive medium for surface enhanced spectroscopies.
Goal-Directed Behavior and Instrumental Devaluation: A Neural System-Level Computational Model.

Devaluation is the key experimental paradigm used to demonstrate the presence of instrumental behaviours guided by goals in mammals. We propose a neural system-level computational model to address the question of which brain mechanisms allow the current value of rewards to control instrumental actions. The model pivots on and shows the computational soundness of the hypothesis for which the internal representation of instrumental manipulanda (e.g., levers) activate the representation of rewards (or `action-outcomes', e.g. foods) while attributing to them a value which depends on the current internal state of the animal (e.g., satiation for some but not all foods). The model also proposes an initial hypothesis of the integrated system of key brain components supporting this process and allowing the recalled outcomes to bias action selection: (a) the sub-system formed by the basolateral amygdala and insular cortex acquiring the manipulanda-outcomes associations and attributing the current value to the outcomes; (b) the three basal ganglia-cortical loops selecting respectively goals, associative sensory representations, and actions; (c) the cortico-cortical and striato-nigro-striatal neural pathways supporting the selection, and selection learning, of actions based on habits and goals. The model reproduces and integrates the results of different devaluation experiments carried out with control rats and rats with pre- and post-training lesions of the basolateral amygdala, the nucleus accumbens core, the prelimbic cortex, and the dorso-medial striatum. The results support the soundness of the hypotheses of the model and show its capacity to integrate, at the system-level, the operations of the key brain structures underlying devaluation. Based on its hypotheses and predictions, the model also represents an operational framework to support the design and analysis of new experiments on the motivational aspects of goal-directed behaviour.
An Architectural Comparison of Reed-Solomon Soft-Decoding Algorithms

Reed-Solomon codes are used as error-correcting codes in diverse communication system applications. The decoding ing performance of traditional hard-decision Reed-Solomon decoders can be improved via the use of soft-decoding algorithms such as generalized minimum distance decoding, algebraic soft-decision decoding, and ordered statistics decoding. While it is relatively straight-forward to compare the decoding performance of these algorithms, it is harder to compare their hardware complexity. This is because an efficient architecture has a dramatic effect on the final implementation complexity. In this paper, we present efficient hardware architectures for each of the soft-decoding algorithms and compare their implementation complexity.
Prosthetic ecologies: vulnerable bodies and the dismodern subject in Sir Gawain and the Green Knight

ABSTRACTThis essay reads Sir Gawain and the Green Knight through the lens of Disability Studies. Specifically, it explores how the technologies of chivalry (a knight’s armour, his shield, and even ...
Complete Esophageal Obstruction after Endoscopic Variceal Band Ligation in a Patient with a Sliding Hiatal Hernia

Complete esophageal obstruction is a rare complication of endoscopic variceal banding, with only 6 cases in the English literature since the introduction of endoscopic variceal banding in 1986. We report a case of complete esophageal obstruction following esophageal banding due to entrapment of part of a sliding hiatal hernia. To our knowledge, our case is one of few with esophageal obstruction post-banding, and the first associated with a hiatal hernia. We recommend caution when performing esophageal banding on patients with a hiatal hernia.
A Retrospective Cohort Study of Acute Kidney Injury Risk Associated with Antipsychotics.

A recent large database analysis raised concerns of potential acute kidney injury (AKI) risk associated with antipsychotics. However, whether individual atypical and typical antipsychotics are associated with differential AKI risks has not been investigated. The current study compared the risks of AKI and known causes of AKI associated with a broad range of atypical and typical antipsychotics. This retrospective cohort analysis used January 2007–June 2013 US nationwide Humana claims data to define episodes of antipsychotic drug therapy for patients with schizophrenia and bipolar disorder. Study drugs were aripiprazole, fluphenazine, haloperidol, olanzapine, quetiapine, risperidone, and ziprasidone. Study outcomes were hospitalizations with AKI, and known causes of AKI, i.e., hypotension, acute urinary retention, neuroleptic malignant syndrome/rhabdomyolysis, and pneumonia. AKI was the primary outcome of the study. Cox regressions using haloperidol as the baseline comparator were used to estimate the impact of alternative antipsychotics on the risks of study adverse events following the initiation of treatment. The Cox models controlled for treatment history, comorbidities, and concomitant drug use in the prior 6 months. They also controlled for patient demographics and dose of current treatment. The overall incidence of AKI was 25.0 per 1000 person-years. According to our multivariate regression results, the risk of AKI was significantly increased in patients taking olanzapine [hazard ratio (HR) 1.344, 95% confidence interval (CI) 1.057–1.708], quetiapine (HR 1.350, 95% CI 1.082–1.685), and ziprasidone (HR 1.338, 95% CI 1.035–1.729) relative to haloperidol. Aripiprazole (HR 1.152, 95% CI 0.908–1.462) and risperidone (HR 1.147, 95% CI 0.923–1.426) had insignificantly higher risks of AKI compared with haloperidol, whereas fluphenazine (HR 0.729, 95% CI 0.483–1.102) had an insignificantly lower risk of AKI. When compared between drug classes, atypical antipsychotics had a significantly higher risk of AKI (HR 1.313, 95% CI 1.083–1.591) than typical antipsychotics. Antipsychotics are associated with differential AKI risks, with several atypical antipsychotics having higher risks than haloperidol. However, the overall incidence of AKI was moderate, and AKI risk should only raise concern for clinicians with elderly patients or patients who are vulnerable to kidney disease.
A potential role for neuronal connexin 36 in the pathogenesis of amyotrophic lateral sclerosis.

Abstract Neuronal gap junctional protein connexin 36 (Cx36) contributes to neuronal death following a range of acute brain insults such as ischemia, traumatic brain injury and epilepsy. Whether Cx36 contributes to neuronal death and pathological outcomes in chronic neurodegenerative diseases, such as amyotrophic lateral sclerosis (ALS), is not known. We show here that the expression of Cx36 is significantly decreased in lumbar segments of the spinal cord of both human ALS subjects and SOD1G93A mice as compared to healthy human and wild-type mouse controls, respectively. In purified neuronal cultures prepared from the spinal cord of wild-type mice, knockdown of Cx36 reduces neuronal death caused by overexpression of the mutant human SOD1-G93A protein. Taken together, these data suggest a possible contribution of Cx36 to ALS pathogenesis. A perspective for the use of blockers of Cx36 gap junction channels for ALS therapy is discussed.
Visualizing and Describing Foster Care Placement Pathways

This paper introduces a flowchart-based methodology for describing the movement of foster youth in and out of placements of differing types and durations. This longitudinal methodology is designed to be sufficiently simple to appeal to policymakers and administrators seeking to chart the movement of groups of youth over time and the sequencing of their placements, and sufficiently descriptive to be of use to researchers seeking to predict the placement trajectories of subgroups of foster youth. The paper provides an example of the use of the method drawing upon state administrative data from a large study of preadolescent and adolescent youth in foster care situated in Oregon. Implications for the application of the methodology to different issues of interest to researchers, policymakers, and administrators are discussed.
Distributed query-aware quantization for high-dimensional similarity searches

The concept of similarity is used as the basis for many data exploration and data mining tasks. Nearest Neighbor (NN) queries identify the most similar items, or in terms of distance the closest points to a query point. Similarity is traditionally characterized using a distance function between multi-dimensional feature vectors. However, when the data is high-dimensional, traditional distance functions fail to significantly distinguish between the closest and furthest points, as few dissimilar dimensions dominate the distance function. Localized similarity functions, i.e. functions that only consider dimensions close to the query, quantize each dimension independently and only compute similarity for the dimensions where the query and the points fall into the same bin. These quantizations are query-agnostic. There is potential to improve accuracy when a query-dependent quantization is used. In this paper we propose a Query dependent Equi-Depth (QED) on-the-fly quantization method to improve high-dimensional similarity searches. The quantization is done for each dimension at query time and localized scores are generated for the closest p fraction of the points while a constant penalty is applied for the rest of the points. QED not only improves the quality of the distance metric, but also improves query time performance by filtering out non relevant data. We propose a distributed indexing and query algorithm to efficiently compute QED. Our experimental results show improvements in classification accuracy as well as query performance up to one order of magnitude faster than Manhattan-based sequential scan NN queries over datasets with hundreds of dimensions.
Thinking about Thinking: Beyond Decision-Making Rationalism and the Emergence of Behavioral Ethics

This article examines behavioral ethics propositions, cognitive distortions, and bias reduction techniques. This is followed by the practitioner and academician response of the public administratio...
Taurine Reduces tPA (Tissue-Type Plasminogen Activator)-Induced Hemorrhage and Microvascular Thrombosis After Embolic Stroke in Rat

Background and Purpose— Taurine (2-aminoethansulfolic amino acid) exerts neuroprotective actions in experimental stroke. Here, we investigated the effect of taurine in combination with delayed tPA (tissue-type plasminogen activator) on embolic stroke. Methods— Rats subjected to embolic middle cerebral artery occlusion were treated with taurine (50 mg/kg) at 4 hours in combination with tPA (10 mg/kg) at 6 hours. Control groups consisted of ischemic rats treated with either taurine (50 mg/kg) or saline at 4 hours or tPA (10 mg/kg) alone at 2 or 6 hours after middle cerebral artery occlusion. Results— We found that combination treatment with taurine and tPA robustly reduced infarct volume and neurological deficits 3 days after stroke, whereas treatment with taurine alone had a less-significant protective effect. tPA alone at 6 hours had no effects on infarct volume but instead induced intracerebral hemorrhage. The combination treatment with taurine prevented tPA-associated hemorrhage and reduced intravascular deposition of fibrin/fibrinogen and platelets in downstream microvessels and hence improved microvascular patency. These protective effects are associated with profound inhibition of CD147 (cluster of differentiation 147)-dependent MMP-9 (matrix metalloproteinase-9) pathway in ischemic brain endothelium by taurine. Notably, targeted inhibition of CD147 by intracerebroventricular injection of the rat CD147 siRNA profoundly inhibited ischemia-induced and tPA-enhanced MMP-9 activity in ischemic brain endothelium and blocked tPA-induced cerebral hemorrhage. Finally, the combination treatment with taurine and tPA improved long-term outcome at least 45 days after stroke compared with saline-treated group. Conclusions— Our results suggest that taurine in combination with tPA may be a clinically feasible approach toward future attempts at combination stroke therapy.
Culturally responsive approaches to health promotion for Native Hawaiians and Pacific Islanders

Context: Obesity, diabetes and cardiovascular disease (CVD) have reached epidemic proportions among Native Hawaiians/Pacific Islanders (NHPI). Culturally responsive interventions that account for t...
Arthroscopic reconstruction of the posterior cruciate ligament: a comparison of quadriceps tendon autograft and quadruple hamstring tendon graft.

Abstract Purpose: Considerable controversies remain on the graft choice and fixation methods in the posterior cruciate ligament (PCL) reconstruction. The purpose of this study was to compare, at minimal 2-year follow-up, the outcomes of PCL reconstruction between using quadriceps tendon autograft and using quadruple hamstring tendon autograft. Type of Study: Case series. Methods: All patients received only PCL reconstruction without combined severe associated posterolateral instability. From 1996 to 1998, there were 24 patients who had a quadriceps tendon autograft, and 30 patients with hamstring tendon autograft. Twenty-two of the quadriceps tendon group and 27 of the hamstring tendon autograft group with 2 more years of complete follow-up were included for final analyses. Clinical assessments consisted of Lysholm knee scores, International Knee Documentation Committee (IKDC) scores, thigh muscle girth and strength, and radiographic evaluation. Results: On the Lysholm knee rating, 86% of patients showed good or excellent results in the quadriceps tendon group and so did 89% of patients in the hamstring tendon group. Fifty-nine percent of the quadriceps tendon group and 56% of the hamstring tendon group revealed a 3- to 5-mm ligament laxity. Two patients with quadriceps tendon grafts and 4 patients with hamstring tendon grafts revealed grade II laxity. The IKDC rating showed no significant difference between the 2 groups in terms of activity level, ligament laxity, and final rating. In the thigh girth side-to-side difference, 82% of the quadriceps tendon group and 78% of the hamstring tendon group had less than a 10-mm difference. Conclusions: Comparable satisfactory results between the 2 surgical groups were shown at a minimal 2 years follow-up. We suggested that both grafts could afford good ligament reconstruction likelihood and that they are reasonably acceptable graft choices for PCL reconstruction. Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 18, No 6 (July-August), 2002: pp 603–612
Race: a starting place.

Many challenges await those who wish to consider the role of race in health outcomes critically.
Improving Governance: Lessons Learnt

Governance first became a commonly used concept in the early 1990s when the international donor community adopted it to connote its support of economic, managerial, and political reforms in countries of the global South. Like development, it cuts across sectors and thus is a concept that lends itself to many definitions. Similarly, it is being used for different purposes: for academic analysis, for policy prescriptions, and for civic engagement.
The quieting response (QR): a modality for reduction of psychophysiologic stress in nursing students.

The purpose of this study was to investigate the effects of a 5-week stress management program for 40 junior baccalaureate nursing students. A quasi-experimental pretest-posttest control group design was used. The stress management group included training sessions using cognitive modification techniques and Stroebel's Quieting Response (QR) augmented with biofeedback techniques for self-relaxation. A significant reduction of state anxiety (P < .001) was reported on the State-Trait Anxiety Inventory (STAI) by the experimental groups, while the state anxiety of the control groups remained relatively unchanged. There were no significant changes in trait anxiety scores. Urinary potassium excretion was measured as an index of the adrenal stress response. Findings revealed no statistically significant correlation between potassium excretion and scores on the STAI. These results support the benefits of integrating a stress management program into curricula for nursing students.
Insulin-like growth factor I is a dual effector of multiple myeloma cell growth.

Multiple myeloma (MM) is an invariably fatal disease that accounts for approximately 1% to 2% of all human cancers. Surprisingly little is known about the cellular pathways contributing to growth of these tumors. Although the cytokine interleukin-6 has been suggested to be the major stimulus for myeloma cell growth, the role of a second potential growth factor, insulin-like growth factor I (IGF-I), has been less clearly defined. The IGF-I signaling cascade in 8 MM cell lines was examined. In 7 of these, the IGF-I receptor (IGF-IR) was expressed and autophosphorylated in response to ligand. Downstream of IGF-IR, insulin receptor substrate 1 was phosphorylated, leading to the activation of phosphatidylinositol-3′-kinase (PI-3K). PI-3K, in turn, regulated 2 distinct pathways. The first included Akt and Bad, leading to an inhibition of apoptosis; the second included the mitogen-activated protein kinase (MAPK), resulting in proliferation. Biologic relevance of this pathway was demonstrated because in vitro IGF-I induced both an antiapoptotic and a proliferative effect. Importantly, in vivo administration of IGF-I in SCID mice inoculated with the OPM-2 line led to approximately twice the growth rate of tumor cells as in controls. These results suggest that IGF-I activates at least 2 pathways effecting myeloma cell growth and contributes significantly to expansion of these cells in vivo.
Precious Metals And Retirement Portfolio Survival Rates

Recent gains in the value of gold bullion in the presence of declines in the stock and corporate bond markets suggest that retired investors may benefit from holdings of precious metals. Because of the comparative liquidity and economy of holding mutual fund shares, we examine the effect of an optimal allocation of precious metals funds shares on portfolio survival rates through payout periods of 15, 20, 25, 30, and 35 years using returns data from September 1988 through December 2008. Since most of the higher withdrawal rates that are supported by precious metals funds are ill-advised, adding precious metals fund shares to a conventional stocks and bonds portfolio does not appear to benefit most retired investors. The findings do support greater allocations to bonds rather than stocks.
Electronic Factors Influencing the Decarboxylation of beta-Keto Acids. A Model Enzyme Study.

A theoretical study of the mechanism of decarboxylation of β-keto acids is described. A cyclic transition structure was found with essentially complete proton transfer from the carboxylic acid to the β-carbonyl group. The activation barrier for decarboxylation of formylacetic acid is predicted to be 28.6 kcal/mol (MP4SDTQ/6-31G*//MP2/6-31G*) while loss of CO2 from its anion exhibits a barrier of only 20.6 kcal/mol (MP4SDTQ/6-31+G*//MP2/6-31+G*). Barrier heights of decarboxylation of malonic acid and α,α-dimethylacetoacetic acid are predicted to be 33.2 and 26.7 kcal/mol, respectively. Model enzyme studies using a thio methyl ester of malonate anion suggests that the role of malonyl-CoA is to afford a polarizable sulfur atom to stabilize the developing enolate anion in the transition structure for decarboxylation. Adjacent positively charged ammonium ions are also observed to stabilize the loss of CO2 from a carboxylate anion by through-bond Coulombic stabilization of the transition structure.
Post-Transplant Positron Emission Tomography Using Fluorine 18-Fluoro-Deoxyglucose ([18F]FDG-PET) Correlates with Outcome in Patients with Aggressive Non-Hodgkin’s Lymphoma Undergoing High Dose Chemotherapy Followed by Autologous Stem-Cell Transplantation (HDC/ASCT).

Abstract INTRODUCTION: Compared with standard chemotherapy, treatment of patients with relapsed aggressive lymphoma with high-dose chemotherapy and stem cell transplantation (HDC/ASCT) increases progression-free survival (PFS) and overall survival (OS). [18F]FDG-PET (PET) has been demonstrated to be more precise than conventional radiologic imaging techniques for restaging after chemotherapy [Kostakogu et. al. Euro J Nucl Med. 2000]. However, the value of PET, particularly posttransplant PET to predict clinical outcome after HDC/ASCT has yet to be established. METHODS: We analyzed 44 patients who had histologically proven non-Hodgkin's lymphoma (NHL), in first and subsequent relapse, sensitive to conventional-dose salvage chemotherapy, and had HDC/ASCT between April 1999 to June 2004 and PET as part of there disease evaluation, pre (6–8 weeks before) and/or post [early-30 days (D30) and late-100 days (D100)] HDC/ASCT. Thirty (68%) had DLBCL (diffuse large B-cell lymphoma), four (9%) FCCL (follicular center cell lymphoma), four (9%) T-cell lymphoma, three (7%) MCL (mantle cell lymphoma) and three (7%) TCR-BCL (T-cell-rich-B-cell-lymphoma). Log-rank analyses were done to compare PFS of PET positive and negative cases in (a) patients with DLBCL and (b) all histology combined. RESULTS: Thirty patients (68%) had pretransplant PET and thirty-nine (89%) had posttransplant PET. Fourteen (32%) patients had positive pretransplant scans, while 21 (48%) had positive post-transplant PET-scans. Three patients died and one patient had progressive disease before day 30 and were excluded. Mean observation time of remission cases were 691 days (range 129-1916 days). Among DLBCL patients pre-transplant PET scan did not correlate with PFS (p= 0.1332, figure 1), while posttransplant PET correlated with PFS (D30-PET p=0.0019; D100-PET p=0.007, combined p Download : Download high-res image (155KB) Download : Download full-size image Download : Download high-res image (154KB) Download : Download full-size image CONCLUSION: PET has an important prognostic role in evaluating response of patients following HDC/ASCT. In our analysis, posttransplant PET-scan showed positive correlation with PFS, and may be useful in detecting patients who need additional treatments as early as 30 days post-transplant. This finding however will need to be confirmed in a prospective study.
Early Palliative Care Consultation in the Medical ICU: A Cluster Randomized Crossover Trial

Objectives:To assess the impact of early triggered palliative care consultation on the outcomes of high-risk ICU patients.Design:Single-center cluster randomized crossover trial.Setting:Two medical ICUs at Barnes Jewish Hospital.Patients:Patients (n = 199) admitted to the medical ICUs from August 20
Jehovah’s Witnesses

Patients may decline blood product transfusions for many reasons. The most common reason for declining transfusion is a religious objection among Jehovah’s Witnesses. Caring for Jehovah’s Witnesses may present a unique challenge to providers around the time of surgery when blood loss can be expected. However, with proper planning and management, most surgeries can be performed safely with outcomes comparable to patients who accept transfusions.
Incorporating multi-physics deterioration analysis in building information modeling for life-cycle management of durability performance

Abstract Extending the application of Building Information Modeling (BIM) tools into the operation and management phases of a building's life cycle is a significant advance in recent years. However, few studies have investigated or developed tools for the life-cycle management of durability performance of built structures leveraging BIM. This gap is partly due to (i) the lack of an accessible interface that connects BIM software with durability models of built structures, and (ii) no available durability models that are fundamental in nature and thus can integrate with other tools. To begin addressing this gap, this paper presents a framework that uses the Application Programming Interface (API) within BIM to integrate physics-based durability performance models, which extends the application of BIM into the post-construction phases by enabling more accurate predictions of life cycle performance. An application of the framework is presented for analysis and management of a reinforced concrete structure.
Interferon in Polycythemia Vera (PV) Yields Improved Myelofibrosis-Free and Overall Survival

Introduction: Polycythemia vera (PV) progression to myelofibrosis (MF) is associated with significant morbidity and mortality. Recombinant interferon alfa (rIFN-α) is the only disease-modifying treatment shown to reverse marrow fibrosis, but the myelofibrosis-free survival (MFS) and overall survival (OS) benefit associated with rIFN-α treatment is yet to be determined. In our preliminary analysis of 306 PV patients (pts) (Abu-Zeinah et al. ASH 2019), those treated with rIFN-α had a longer MFS and OS compared to those treated with hydroxyurea (HU) or phlebotomy-only (PHL-O). Herein, we present the final analysis comparing MFS and OS of 470 PV pts treated with rIFN-α, HU, or PHL-O. Methods: This single-center retrospective study at Weill Cornell Medicine (WCM) was approved by the WCM institutional review board. Pts were identified by an automated query of the electronic medical record system for the diagnosis of PV and were included if they met the PVSG criteria (1974-2007), WCM criteria (2008-2016) (Silver et al. Blood 2013), and the WHO 2016 criteria (2016-2020). Post-PV MF (PPVMF) diagnosis was made according to IWG-MRT criteria. Both intention-to-treat (ITT) and on-treatment analyses compared the MFS and OS by treatment group and duration, respectively. In the ITT analysis, pts were grouped to rIFNa or HU according to the first treatment they received for at least one year or to PHL-O if no cytoreductive treatment was given. MFS and OS were estimated using Kaplan-Meier methods and the log-rank test compared survival between treatment arms in ITT analysis. Multivariable analysis of PPVMF risk and mortality was performed using a Cox proportional hazards model. Results: The 470 PV pts identified had a median age of 54 years (range 20-94) at diagnosis; 229 (49%) were women. The median follow-up was 10 years (range 0-45). The primary treatment was rIFN-a in 94 (20%), HU in 188 (40%), other drugs or combinations in 55 (12%), and PHL-O in 133 (28%). The median age at diagnosis for rIFN-a, HU and PHL-O groups was 49, 58 and 54 years respectively (p Discussion: This is the largest single center study in PV using universal diagnostic criteria showing the MFS and OS advantage with rIFN-a over HU or PHL-O, and its similar rates of toxicity to HU. The evidence suggests that early cytoreductive treatment rather than PHL-O is advantageous. Treatment with PHL-O was associated with a higher risk of MF than either rIFN-a or HU. Conclusion: Our results support early use of rIFN-a as a safe, disease-modifying treatment of rigorously defined PV to delay and potentially prevent PPVMF, and prolong overall survival of PV pts. Download : Download high-res image (812KB) Download : Download full-size image Disclosures Ritchie: Jazz pharmaceuticals: Honoraria, Research Funding; Pfizer: Honoraria, Research Funding; Abbvie: Honoraria; Sierra Oncology: Honoraria; Incyte: Speakers Bureau; Novartis: Honoraria. Silver: PharmaEssentia: Speakers Bureau. OffLabel Disclosure: Interferon alfa has been used off label in the treatment of MPN for decades
Changing texture of childhood: Palestinian children as new leisure consumers in mandatory Haifa

ABSTRACTDuring the British Mandate, the city of Haifa in Northern Palestine undergone profound cultural transformation which was manifested in the flourishing of a new range of public and commercia...
Public Sector Compensation: An Application of Robust and Quantile Regression:

This study assesses whether the theoretical compensation framework used to explain differences in public sector pay among full-time federal and state employees may also explain differences in pay a...
Broadcasting Regional Call Dialects Has Little Influence on the Effectiveness of Call-Broadcast Surveys for Marsh Birds

Emergent wetlands have declined in North America and, in response, many wetland-dependent animals have declined in abundance. For example, many species of secretive marsh birds in North America have declined during the last century. However, estimates of population decline and efforts to assess the effects of management actions are hampered because marsh birds are difficult to detect using conventional survey techniques. Call-broadcast surveys can improve detection probability of marsh birds; however, the effectiveness of call-broadcast varies regionally for some marsh birds, which might reflect differential responsiveness to call dialects. Here, we evaluated differential responses by least bitterns (Ixobrychus exilis) and clapper rails (Rallus crepitans) to different call dialects by using 679 paired call-broadcast surveys in Florida and South Carolina. We detected similar numbers of least bitterns and clapper rails responding to the different call dialects, except in Florida, where least bitterns responded more frequently to a more-distant (Louisiana) dialect than a more-local (Florida) dialect. Our results suggest that, at least for clapper rails and least bitterns, it may not be necessary to incorporate regional call dialects into standardized surveys. However, additional research is needed in more regions of North America and with other species.
AX-5 space suit reliability model

The AX-5 is an all metal Extra-vehicular (EVA) space suit currently under consideration for use on Space Station Freedom. A reliability model was developed based on the suit's unique design and on projected joint cycle requirements. Three AX-5 space suit component joints were cycled under simulated load conditions in accordance with NASA's advanced space suit evaluation plan. This paper will describe the reliability model developed, the results of the cycle testing, and an interpretation of the model and test results in terms of projected Mean Time Between Failure for the AX-5. A discussion of the maintenance implications and life cycle for the AX-5 based on this projection is also included.
Non-cell autonomous inhibition of the Shh pathway due to impaired cholesterol biosynthesis requires Ptch1/2

Birth defects due to congenital errors in enzymes involved cholesterol synthesis like Smith-Lemli-Opitz syndrome (SLOS) and Lathosterolosis cause an accumulation of cholesterol precursors and a deficit in cholesterol. The phenotype of both SLOS and Lathosterolosis have similarities to syndromes associated with abnormal Sonic hedgehog (Shh) signaling, consistent with the notion that impaired cholesterol signaling can cause reduced Shh signaling. Two multipass membrane proteins play central roles in Shh signal transduction, the putative Resistance, Nodulation and Division (RND) antiporters Ptch1 and Ptch2, and the G-protein coupled receptor Smoothened (Smo). Sterols have been suggested as cargo for Ptch1, while Smo activity can affected both positively and negatively by steroidal molecules. We demonstrate that mESCs mutant for 7-dehydroxycholesterol reductase (7dhcr) or sterol-C5-desaturase (sc5d) reduce the Hh response in nearby wildtype cells when grown in mosaic organoids. This non-cell autonomous inhibitory activity of the mutant cells required the presence of both Ptch1 and Ptch2. These observations support a model in which late cholesterol precursors that accumulate in cells lacking 7DHCR are the cargo for Ptch1 and Ptch2 activity that mediates the non-cell autonomous inhibition of Smo.
Worm Sign: A possible first‐trimester sonographic marker for intracranial haemorrhage resulting in significant cortical disruption

Fetal intracranial haemorrhage (ICH) is a pathophysiological process involving haemorrhagic and hypoxic-ischaemic insults resulting in antenatal brain damage. Insults to the central nervous system are usually not detected until the second or third trimester. In this case presentation, we present a possible prenatal ultrasound marker, 'worm sign', representing cortical disruption secondary to suspected ICH at 13 weeks' gestation. According to current literature review, this is one of the first cases of ICH, diagnosed in the first-trimester and highlights the importance of early neurovascular and structural evaluation of the fetal brain at the time of first-trimester ultrasound screening.
Humans judge, algorithms nudge: The psychology of behavior tracking acceptance

Abstract This article examines employees’ acceptance of behavior tracking in the workplace. We theorize that people more willingly accept behavior tracking when it is conducted solely by technology (i.e., computer algorithms) rather than by humans. We posit that this is driven by the expectation that human-free tracking feels less judgmental and will, therefore, allow for a greater subjective sense of autonomy. The results of five experiments supported these predictions, revealing that participants were more likely to accept technology-operated than human-operated tracking (Experiments 1–5), an effect driven by reduced concerns about potential negative judgment, which, in turn, increased subjective sense of autonomy (Experiment 2). The stated purpose for tracking (Experiment 3), relation to the human tracker (Experiment 4), and type of behaviors tracked (Experiment 5) did not eliminate the effect. Technology-operated tracking also led to higher anticipation of intrinsic motivation (Experiments 3–4). Implications for research on the future of work are discussed.
A New Strategy for Korea's Fiscal Policy in a Low Growth Environment

Adverse demographics and other structural weaknesses impinge on Korea's long-term fiscal outlook and potential growth. Moreover, inadequate social protection is creating poverty and dampening consumption. The paper presents projections of Korea's fiscal outlook, using new estimates of potential growth obtained with a novel multivariate filter. It shows that keeping fiscal revenues-to-GDP constant would result in an explosive public debt dynamic in the long term. Then, through simulations of the Flexible System of Global Models, the paper analyzes policies to preserve fiscal sustainability, while boosting potential growth and social protection. It concludes that with greater revenue mobilization, Korea can stabilize debt-to-GDP well below 'dangerous' levels. Policies to address Korea's challenges include higher targeted transfers to the most vulnerable and fiscal measures to support female labor force participation and employment, accompanied by product and labor market reforms.
Extraction of tissue optical property and blood flow from speckle contrast diffuse correlation tomography (scDCT) measurements

Measurement of blood flow in tissue provides vital information for the diagnosis and therapeutic monitoring of various vascular diseases. A noncontact, camera-based, near-infrared speckle contrast diffuse correlation tomography (scDCT) technique has been recently developed for 3D imaging of blood flow index (αDB) distributions in deep tissues up to a centimeter. A limitation with the continuous-wave scDCT measurement of blood flow is the assumption of constant and homogenous tissue absorption coefficient (μa). The present study took the advantage of rapid, high-density, noncontact scDCT measurements of both light intensities and diffuse speckle contrast at multiple source-detector distances and developed two-step fitting algorithms for extracting both μa and αDB. The new algorithms were tested in tissue-simulating phantoms with known optical properties and human forearms. Measurement results were compared against established near-infrared spectroscopy (NIRS) and diffuse correlation spectroscopy (DCS) techniques. The accuracies of our new fitting algorithms with scDCT measurements in phantoms (up to 16% errors) and forearms (up to 23% errors) are comparable to relevant study results (up to 25% errors). Knowledge of μa not only improved the accuracy in calculating αDB but also provided the potential for quantifying tissue blood oxygenation via spectral measurements. A multiple-wavelength scDCT system with new algorithms is currently developing to fit multi-wavelength and multi-distance data for 3D imaging of both blood flow and oxygenation distributions in deep tissues.