cssi/SciSciGPT-SciSciNet huggingface dataset:
The Response Regulator BfmR Is a Potential Drug Target for Acinetobacter baumannii

ABSTRACT Identification and validation is the first phase of target-based antimicrobial development. BfmR (RstA), a response regulator in a two-component signal transduction system (TCS) in Acinetobacter baumannii, is an intriguing potential antimicrobial target. A unique characteristic of BfmR is that its inhibition would have the dual benefit of significantly decreasing in vivo survival and increasing sensitivity to selected antimicrobials. Studies on the clinically relevant strain AB307-0294 have shown BfmR to be essential in vivo. Here, we demonstrate that this phenotype in strains AB307-0294 and AB908 is mediated, in part, by enabling growth in human ascites fluid and serum. Further, BfmR conferred resistance to complement-mediated bactericidal activity that was independent of capsular polysaccharide. Importantly, BfmR also increased resistance to the clinically important antimicrobials meropenem and colistin. BfmR was highly conserved among A. baumannii strains. The crystal structure of the receiver domain of BfmR was determined, lending insight into putative ligand binding sites. This enabled an in silico ligand binding analysis and a blind docking strategy to assess use as a potential druggable target. Predicted binding hot spots exist at the homodimer interface and the phosphorylation site. These data support pursuing the next step in the development process, which includes determining the degree of inhibition needed to impact growth/survival and the development a BfmR activity assay amenable to high-throughput screening for the identification of inhibitors. Such agents would represent a new class of antimicrobials active against A. baumannii which could be active against other Gram-negative bacilli that possess a TCS with shared homology. IMPORTANCE Increasing antibiotic resistance in bacteria, particularly Gram-negative bacilli, has significantly affected the ability of physicians to treat infections, with resultant increased morbidity, mortality, and health care costs. In fact, some strains of bacteria are resistant to all available antibiotics, such as Acinetobacter baumannii, which is the focus of this report. Therefore, the development of new antibiotics active against these resistant strains is urgently needed. In this study, BfmR is further validated as an intriguing target for a novel class of antibiotics. Successful inactivation of BfmR would confer the multiple benefits of a decreased ability of A. baumannii to survive in human body fluids, increased sensitivity to complement-mediated bactericidal activity and, importantly, increased sensitivity to other antibiotics. Structural studies support the potential for this “druggable” target, as they identify the potential for small-molecule binding at functionally relevant sites. Next-phase high-throughput screening studies utilizing BfmR are warranted.
Athens QRS Score as a Predictor of Coronary Artery Disease in Patients With Chest Pain and Normal Exercise Stress Test

Background The diagnostic value of the Athens QRS score to detect obstructive coronary artery disease CAD in patients with otherwise normal exercise stress test remains unclear. Methods and Results We analyzed 458 patients who underwent exercise stress test with or without myocardial perfusion imaging within 2 months of coronary angiography from 2008 to 2011. Patients (n=173) with abnormal stress test based on ST segment criteria were excluded. The Athens QRS score ≤5 was defined as abnormal. In our study cohort, 285 patients met the inclusion criteria and were divided into 2 groups: low Athens QRS score (LQRS, n=56), with QRS score ≤5 and normal Athens QRS score normal Athens QRS score, n=229), with QRS score >5. The presence of single‐vessel and multivessel obstructive CAD was higher in LQRS than in normal Athens QRS score patients (47% versus 7.5% and 30% versus 3.8%, respectively, all P <0.001). Logistic regression analysis showed that the likelihood of CAD was strongly and independently associated with LQRS (odds ratio=36.81, 95% CI: 10.77–120.47), diabetes (odds ratio=6.49, 95% CI: 2.41–17.49), lower maximum heart rate (odds ratio=0.92, 95% CI: 0.88–0.95, all P <0.001), and older age (odds ratio=1.93, CI: 1.88–1.97, P =0.002). Conclusions In a clinical cohort of patients with chest pain and normal exercise stress test, LQRS score is a strong independent predictor of presence of CAD. LQRS patients have a 6‐fold higher prevalence of CAD and may warrant further evaluation even with reassuring exercise stress test.
Rethinking the theatre of the absurd: ecology, the environment and the greening of the modern stage

A little over half a century ago, in his seminal work The Theatre of the Absurd Martin Esslin both demarcated a genre of theatre and also defined the philosophical and aesthetic contours by and thr...
Monoclonal Antibodies OKT3 in Resistant Acute Allograft Rejections Treatment

The usefulness of orthoclone OKT3. for the treatment of steroid resistant acute allograft rejection in 12 patients was investigated. The patients were treated with OKT3 in 5 mg daily dosage regimen during 8–12 days. Improved function of the transplanted kidney was registered in all patients. Cummulative survival rate during 18 months period of patients and renal transplants was 92 %. Early side effect was mainly fever, we have one pulmonary edema. Looking long term complications, CMV infection was registered in 4 patients, one of them died due to sepsis.
Accommodations and Support Services for Students with Autism Spectrum Disorder (ASD): A National Survey of Disability Resource Providers.

Students with Autism Spectrum Disorder (ASD) are participating in postsecondary education at an increasing rate. Yet, we know little about what types of accommodations or services disability resource providers employ to support students with ASD. The purpose of this study was to examine how postsecondary institutions are fostering the academic success of students with ASD. Using a randomly selected, nationally representative sample of postsecondary institutions (n =1,245 response rate 38.8%; return rate 41.9%), this study explored enrollment trends of students with ASD and the types of reasonable accommodations and support services offered to those students. This study used predictive modeling to isolate factors that are strong indicators of whether or not and institution provided ASD-specific programs. Findings indicate that although students with ASD are more likely to attend two-year public institutions, there are no differences in accommodations or student support services by institution type. Over 90% of institutions use academically focused accommodations (e.g., extended exam time), but only 44.7% of institutions provided sensory accommodations and 28.3% of institutions offered ASDspecific services. The existence of peer mentoring programs was the strongest predictor of whether or not an institution had ASD-specific services. Implications for practitioners working in postsecondary environments and future research are discussed. 26
Prevention of pressure ulcers in the acute care setting: New innovations and technologies

Background:Pressure ulcers (PUs) challenge many in the healthcare field requiring costly and complex care. PUs result from prolonged ischemia and subsequent soft-tissue injury caused by unrelieved pressure over a bony prominence. Proper risk assessment and implementation of prevention strategies for
Risk of ionizing radiation exposure from CT scans in the Neuro ICU - a patient safety blind spot?

Introduction : The exposure to ionizing radiation has increased significantly with the wide availability of computed tomography (CT) scans and portable imaging technology. We examine the pattern of use of inpatient diagnostic imaging and radiation exposure in the neuro-intensive care unit (Neuro ICU, N-ICU) patient population at a large academic medical center. Methods : We retrospectively evaluated all patients admitted to the Neuro ICU at our academic medical center from January 1 to December 31, 2013. The number and type of CT studies was collected, and the corresponding estimated radiation dose was calculated. We limited the evaluation to CT scans, which accounts for the majority of radiation exposure. Data were electronically collected and cross-referenced to the patients’ electronic medical records (EMR) and radiology records. Radiation dose estimates were calculated based on published reference values and conversion factors (CT head (2mSv)), CT angiography of the head and neck (7-10 mSv), Ct Chest /Abd/pelvis ( 10 mSv), CT cerebral perfusion analysis (3.3 mSv). Results: In the calendar year 2013, we had a total of 2353 admission encounters (F=1078). The mean age on admission was 56.55Y ± 16.7. The mean length of ICU stay was 6.3 days. Mechanical ventilation was initiated on 420 patients with a mean length on mechanical ventilation 5.09 days. 2028 CT scans were completed of which approximately 60% were head CT without contrast (n=1209). 379 patients had multiple CT studies. The mean number of studies was 3.8 ± 2. The number of patients with more thanthree3 studies during their ICU stay was 159. The maximum number of studies on a single patient was 21. Conclusion: Patients in the Neuro ICU are at a risk for significant exposure to ionizing radiation. Radiation exposure must be factored into the culture of quality and patient safety in the ICU.
Novel mutation in PLA2G6 gene in a patient with infantile neuroaxonal dystrophy.

Infantile neuroaxonal dystrophy (INAD) is an autosomal recessive disorder that causes psychomotor regression. Clinicopathological features include truncal hypotonia followed by spastic quadriparesis, strabismus, nystagmus, cerebellar ataxia, bulbar dysfunction, and cerebellar atrophy. INAD is associated with a variety of mutations in the PLA2G6 gene that encodes the group VI calcium-independent phospholipase A2 protein which is important in cell membrane homeostasis. Defects in this protein cause axonal dystrophy. We report a 2-year-old boy with INAD who was found to have a novel deletion c.1019_1025del7 leading to a frame shift in the PLA2G6 gene. We suggest that this change may be an addition to the array of mutations causing INAD.
The complete mitochondrial genome of the Cape honey bee, Apis mellifera capensis Esch. (Insecta: hymenoptera: apidae).

We characterized the complete mitogenome sequence of the Cape honey bee, Apis mellifera capensis, from South Africa. The circle genome is 16,470 bp in length, with the base composition of 43.2% A, 9.6% C, 5.6% G, and 41.5% T. The assembled mitogenome has 13 protein-coding genes (PCGs), 22 transfer RNAs, two ribosomal RNA genes, and one control region. All protein-coding genes are initiated by ATT, ATC, ATG or ATA codons and are terminated by the typical stop codon TAA. The heavy strand encodes four protein-coding genes, eight tRNAs, and two rRNAs. The light strand encodes nine protein-coding genes and 14 tRNAs. The complete mitogenome sequence of A.m. capensis is identical to the gene arrangement found in other A. mellifera mitogenomes and it provides essential and important DNA molecular data for further phylogenetic and evolutionary analysis of members of the genus Apis.
Medicaid Meets Its Equal Access Requirement For Dental Care, But Oral Health Disparities Remain

Most US children today have public or private dental health insurance, yet oral health among publicly insured children remains a policy concern. We analyzed data for 2011–12 from the National Survey of Children’s Health to compare oral health status and the use of dental care among publicly and privately insured children. After we adjusted for demographic and parent characteristics, we found no differences between the two groups in parent-reported use of dental care or unmet need for dental care. However, compared to parents of privately insured children, parents of publicly insured children were less likely to report that the condition of their child’s teeth was excellent or very good and more likely to report that the child had had a dental problem in the past twelve months. Family income differences between the groups accounted for much of this disparity. Our findings suggest that Medicaid is meeting its mandate to ensure that dental care is as available for children in the program as it is for private...
Advantages and pitfalls of pocket ultrasound vs daily chest radiography in the coronary care unit: A single-user experience.

Background Pocket ultrasonography may enhance patient diagnosis and care. We sought to assess pocket ultrasound in detecting common conditions in the coronary care unit (CCU) compared to portable daily chest radiography (CXR) and conventional transthoracic echocardiography (TTE). Methods An experienced pocket ultrasound user performed a pocket ultrasound examination for interstitial edema, pneumonia, central line seen in the right ventricle, pleural and pericardial effusions, left atrial enlargement, and cardiomegaly. Data were blindly compared to the radiologist CXR interpretation and cardiologist TTE interpretation. Results A total of 102 CXR and pocket ultrasound examinations were performed in 66 patients. The most common CXR indication was “interval change” (37%) and finding central line (65%). Pocket ultrasound demonstrated overall good concordance with CXR ranging from 77% for pleural effusion to 92% for pneumonia. Additionally, the pocket ultrasound examination appeared to anticipate resolution of pulmonary edema prior to the CXR. Compared to TTE, pocket ultrasound had excellent sensitivity for cardiac findings with values ranging from 85% for left atrial enlargement to 100% for cardiomegaly, but limited specificity of cardiomegaly at just 51%. Conclusion In the CCU, bedside pocket ultrasound reliably diagnoses common conditions identified by CXR with the advantage of lack of ionizing radiation and the suggestion of detecting the resolution of pulmonary edema prior to CXR. Pitfalls include only modest concordance for pleural effusions and limited specificity for cardiomegaly. Larger, multicenter studies are needed to determine whether pocket ultrasound can reduce routine daily CXR in the CCU and other intensive care settings.
Representations of Real-World Phenomena: Modeling as a Transdisciplinary Formative Skill and Practice

Late in the summer of 2013, Elon Musk set the Internet ablaze with a “napkin sketch” of the Hyperloop Alpha, his futuristic vision for mass transit (Christensen, 2013). Musk backed his rudimentary doodle with a 57-page memo where he aimed to keep “numbers to a minimum and avoid formulas and jargon” and apologized, “in advance for [his] loose use of the language and imperfect analogies” (Musk, 2013). The memo is a thorough, visually stunning and inspiring proposal for a high-speed mass transit line between Los Angeles and San Francisco wherein passengers travel at speeds up to 800 miles per hour above already existing highways. As The New Yorker magazine noted, “Musk has put forth a plausible idea that doesn’t require yet-to-be-developed technologies” (Friend, 2013). The memo and it’s 25+ visual sketches, drawings, and figures is, however, the blueprint for something much more impressive than a regional transit line. Instead, the memo presents a promising, innovative, and potentially transformative model that may completely redefine mass transit in the twenty-first century (Figs. 7.1 and 7.2).
Seeking a dialogue: a targeted technology for sustainable agricultural systems in the American Corn Belt

This Community Essay aims to start a dialogue on the role of targeted environmental technologies in “sustainable agriculture.” Using the new water-quality technology of denitrification bioreactors ...
"For Heart, Patriotism, and National Dignity": The Italian Language Press in New York City and Constructions of Africa, Race, and Civilization

“For Heart, Patriotism, and National Dignity”: The Italian Language Press in New York City and Constructions of Africa, Race, and Civilization” examines how mainstream and radical newspapers employed Africa as a trope for savage behavior by analyzing their discussion of wage slavery, imperialism, lynching, and colonialism, in particular Italian imperialist ventures into northern Africa in the 1890s and Libya in 1911-1912. The Italian language press constructed Africa as a sinister , dark , continent, representing the lowest rung of the racial hierarchy. In expressing moral outrage over American violence and discrimination against Italians, the press utilized this image of Africa to emphatically convey its shock and disgust. In particular, Italian prominenti newspapers capitalized on this racial imagery to construct a narrative of Italianness and Italian superiority in order to combat unflattering depictions of Italian immigrants arriving in the United States.
Sarcomatoid Carcinoma of the Lung: The Mayo Clinic Experience in 127 Patients.

Abstract Background Pulmonary sarcomatoid carcinoma (PSC) is an unusual form of non–small-cell lung cancer (NSCLC). Because of its rarity and heterogeneity, the treatment and prognosis of PSC have not been clearly described. Methods and Materials We retrospectively evaluated all patients with a diagnosis of PSC from 1997 to 2015 at the Mayo Clinic (Rochester, MN). The clinical characteristics, treatment details, and outcomes were collected. The survival rates of the PSC patients were compared with those for other subtypes of NSCLC. We used propensity score matching to minimize the bias resulting from to imbalanced comparison groups. Results The study included 127 PSC patients. The median age at diagnosis was 68 years (range, 32-89 years), most of whom were men (61%) and smokers (82%). The clinical stage was I, II, III, and IV in 15.9%, 20.6%, 22.2%, and 41.3%, respectively. The median survival time was 9.9 months (95% confidence interval [CI], 7.6-12.6 months). The 1-, 2-, and 5-year survival rates were 42%, 23%, and 15%, respectively. Most patients received multimodality treatment. Of the 3 patients who received neoadjuvant chemotherapy, a partial response was demonstrated in 2. Twenty-five patients who underwent palliative chemotherapy were evaluated for tumor response: 52% experienced progression, 40% stable disease, 8.0% a partial response, and 0% a complete response. Multivariate analysis showed T stage, M stage, and treatment with surgery plus neoadjuvant chemotherapy or surgery plus adjuvant therapy were independent prognostic factors (P Conclusion We found the outcome of PSC to be significantly worse than that of adenocarcinoma and squamous cell carcinoma. Neoadjuvant or adjuvant chemotherapy, in addition to surgical resection, should be considered.
A Test of The Risk Perception Attitude Framework as a Message Tailoring Strategy to Promote Diabetes Screening

The risk perception attitude (RPA) framework was tested as a message tailoring strategy to encourage diabetes screening. Participants (N = 602) were first categorized into one of four RPA g...
Effects of laser polarization and linear surface features on nanoparticle synthesis during laser ablation in liquids

We elucidate non-isotropic interactions present during laser ablation of ridged surface features under linearly-polarized light and their effect on nanoparticle synthesis via the laser ablation in liquid method. A relationship between the relative polarization/ridge orientation and ablation processes was established by measuring cavitation bubble kinetics, examining the morphology of the ablated surface, and evaluating nanoparticle size distribution. Anisotropic behavior was observed, and this is attributed to selective heating of linear surface structures as confirmed with rigorous coupled-wave analysis. When the incident electric field is aligned parallel to the linear ridges on the target surface, the resulting nanoparticle distributions are much more monodisperse. This phenomenon has a strong influence in the polydispersity and batch-to-batch reproducibility in laser ablation in liquid.
Real-Time Observation of G-Quadruplex Dynamics Using Single-Molecule FRET Microscopy

The potential importance of G-quadruplex structures was implied by the recent findings that the human POT1 disrupts G-quadruplex and stimulates the telomerase activity. A solid understanding of the range of conformations that can be adopted by guanine-rich sequences can potentially shed much light on the molecular mechanisms underlying certain human diseases related to telomeres. Furthermore, structure-based design of chemotherapeutic drugs for cancer might be realized by addressing different types of G-quadruplex structures. Using the unique capabilities of single-molecule spectroscopy, we have recently reported on the intricate dynamic structural properties of a minimal form of human telomeric DNA. Here, we present the detailed step-by-step methods for the real-time observation of G-rich DNA sequences by means of single-molecule FRET microscopy and provide the protocols for vesicle encapsulation and surface immobilization assays. Such assays provide a firm basis for future studies aimed at elucidating the interaction between telomeric DNA and telomere-associated proteins as well as the synthetic therapeutic agents that specifically stabilize certain G-quadruplex topologies.
Identification and Reduction of Model Structure for Modeling Distributed Parameter Systems

In this paper, the problem of how to determine the model structure for modeling a distributed parameter system is considered. The model structure error of using model M A to replace model M B is defined as a weighted sum of their distances in both observation and prediction spaces. The value of so defined structure error can be obtained by solving a max-min problem. In order to select an appropriate complexity of model structure, the concept of extended identifiabilities is further extended to the case that model structure error is involved. A stepwise regression procedure is then presented for simultaneously determining the model structure and model parameters. Numerical examples are given to explain the presented concepts and methodology.
Imaging Modalities for Studying Disc Pathology

Low back pain is the second most frequent reason for a physician visit and permanently disables more than 5 million Americans with annual costs of $100 billion in the USA (Sheehan 2010; Chou et al. 2007). While not well understood, it is widely accepted that degenerative disc disease of the intervertebral disc contributes directly to axial back pain (Deyo 2002). With degeneration, alterations in matrix composition, structure, and mechanical loading occur in a progressive cascade that leads to tissue breakdown and pain. It would not be unreasonable to surmise that (1) aging alone does not account for degenerative disc disease since that would imply that all older people have painful discs and (2) success of treatment strategies aimed at halting the progression of degenerative disc disease-related chronic back pain will benefit from noninvasive methods to detect early changes in discs undergoing transition down the cascade.
Integration of a hyphenated HPIC-ICPMS protocol for the measurement of transplutonium isotopic mass distributions for 252Cf campaigns at Oak Ridge National Laboratory

Rapid measurement of transplutonium isotopic mass distributions during 252Cf production campaigns at Oak Ridge National Laboratory is a critical need. Mass measurements for the isotopes of plutonium, americium, curium, and californium are routinely requested to support the α-hydroxy-isobutyrate runs for the purification and recovery of the heavy curium target material and final 249Bk, 252Cf, and 254Es enriched isotope products. This paper presents the integration of an online high-pressure ion chromatography inductively coupled plasma mass spectrometry technique together with the protocol and chemistry that allows for rapid baseline separation and direct quantification of the transplutonium elemental concentrations and isotopic compositions.
Walking droplets in a circular corral: Quantisation and chaos

A millimetric liquid droplet may walk across the surface of a vibrating liquid bath through a resonant interaction with its self-generated wavefield. Such walking droplets, or “walkers,” have attracted considerable recent interest because they exhibit certain features previously believed to be exclusive to the microscopic, quantum realm. In particular, the intricate motion of a walker confined to a closed geometry is known to give rise to a coherent wave-like statistical behavior similar to that of electrons confined to quantum corrals. Here, we examine experimentally the dynamics of a walker inside a circular corral. We first illustrate the emergence of a variety of stable dynamical states for relatively low vibrational accelerations, which lead to a double quantisation in angular momentum and orbital radius. We then characterise the system’s transition to chaos for increasing vibrational acceleration and illustrate the resulting breakdown of the double quantisation. Finally, we discuss the similarities and differences between the dynamics and statistics of a walker inside a circular corral and that of a walker subject to a simple harmonic potential.A millimetric liquid droplet may walk across the surface of a vibrating liquid bath through a resonant interaction with its self-generated wavefield. Such walking droplets, or “walkers,” have attracted considerable recent interest because they exhibit certain features previously believed to be exclusive to the microscopic, quantum realm. In particular, the intricate motion of a walker confined to a closed geometry is known to give rise to a coherent wave-like statistical behavior similar to that of electrons confined to quantum corrals. Here, we examine experimentally the dynamics of a walker inside a circular corral. We first illustrate the emergence of a variety of stable dynamical states for relatively low vibrational accelerations, which lead to a double quantisation in angular momentum and orbital radius. We then characterise the system’s transition to chaos for increasing vibrational acceleration and illustrate the resulting breakdown of the double quantisation. Finally, we discuss the similarities ...
Fabrication of Glass-Insulated Ultramicrometer to Submicrometer Carbon Fiber Electrodes to Support a Single Nanoparticle and Nanoparticle Ensembles in Electrocatalytic Investigations.

We report a procedure to fabricate glass-insulated carbon fiber ultramicroelectrodes (CF UMEs) with sizes of 10 and 1 μm in diameter. CF UMEs of theses sizes are commonly insulated with polymer or ...
The motion of a buoyant vortex filament

Author(s): Chang, Ching; Smith, Stefan G Llewellyn | Abstract: We investigate the motion of a thin vortex filament in the presence of buoyancy. The asymptotic model of Moore a Saffman (Phil. Trans. R. Soc. Lond.A, vol. 272, 1972, pp. 403–429) is extended to take account of buoyancy forces in the force balance on a vortex element. The motion of a buoyant vortex is given by the transverse component of force balance, while the tangential component governs the dynamics of the structure in the core. We show that the local acceleration of axial flow is generated by the external pressure gradient due to gravity. The equations are then solved for vortex rings. An analytic solution for a buoyant vortex ring at a small initial inclination is obtained and asymptotically agrees with the literature.
Mixed-integer programming models for optimal constellation scheduling given cloud cover uncertainty

Abstract We consider the problem of scheduling observations on a constellation of remote sensors, to maximize the aggregate quality of the collections obtained. While automated tools exist to schedule remote sensors, they are often based on heuristic scheduling techniques, which typically fail to provide bounds on the quality of the resultant schedules. To address this issue, we first introduce a novel deterministic mixed-integer programming (MIP) model for scheduling a constellation of one to n satellites, which relies on extensive pre-computations associated with orbital propagators and sensor collection simulators to mitigate model size and complexity. Our MIP model captures realistic and complex constellation-target geometries, with solutions providing optimality guarantees. We then extend our base deterministic MIP model to obtain two-stage and three-stage stochastic MIP models that proactively schedule to maximize expected collection quality across a set of scenarios representing cloud cover uncertainty. Our experimental results on instances of one and two satellites demonstrate that our stochastic MIP models yield significantly improved collection quality relative to our base deterministic MIP model. We further demonstrate that commercial off-the-shelf MIP solvers can produce provably optimal or near-optimal schedules from these models in time frames suitable for sensor operations.
Saline Load Test for Detecting Traumatic Arthrotomy in the Wrist.

Background Open injuries communicating with the wrist joint are essential to detect to facilitate timely, appropriate treatment. While the saline load test to detect traumatic arthrotomy has been well studied in the knee and ankle, it has not been studied in the wrist, and therefore the appropriate volume of saline infusion to detect traumatic arthrotomy is not known. Purpose The purpose of this study was to utilize wrist arthroscopy to determine the saline infusion volume necessary to achieve 99% sensitivity in detecting traumatic arthrotomy. Methods Twenty consecutive patients undergoing elective wrist arthroscopy were prospectively enrolled. A 5-mm arthrotomy was established between the third and fourth dorsal extensor compartments. An 18-gauge needle was inserted into the 6R portal on the radial side of the extensor carpi ulnaris. Sterile normal saline was injected into the wrist joint through the needle at a rate of 0.1 mL per second until extravasation from the 3–4 portal was visualized. Saline volumes required for extravasation were analyzed. Results The mean saline volume required for extravasation was 0.8 mL. The volume of saline needed to achieve sensitivities of 50, 90, 95, and 99% were 0.4, 2.2, 2.3, and 2.5 mL respectively. Conclusions The saline infusion volume required to detect a dorsal radiocarpal arthrotomy with 99% sensitivity was 2.5 mL. We recommend using at least 2.5 mL when performing the saline load test to rule out a potential arthrotomy to the wrist in the traumatic setting. Level of Evidence: This is a Level II, diagnostic study.
E- and Z-, di- and tri-substituted alkenyl nitriles through catalytic cross-metathesis

Nitriles are found in many bioactive compounds, and are among the most versatile functional groups in organic chemistry. Despite many notable recent advances, however, there are no approaches that may be used for the preparation of di- or tri-substituted alkenyl nitriles. Related approaches that are broad in scope and can deliver the desired products in high stereoisomeric purity are especially scarce. Here, we describe the development of several efficient catalytic cross-metathesis strategies, which provide direct access to a considerable range of Z- or E-di-substituted cyano-substituted alkenes or their corresponding tri-substituted variants. Depending on the reaction type, a molybdenum-based monoaryloxide pyrrolide or chloride (MAC) complex may be the optimal choice. The utility of the approach, enhanced by an easy to apply protocol for utilization of substrates bearing an alcohol or a carboxylic acid moiety, is highlighted in the context of applications to the synthesis of biologically active compounds.
Metaphenomic Responses of a Native Prairie Soil Microbiome to Moisture Perturbations.

ABSTRACT Climate change is causing shifts in precipitation patterns in the central grasslands of the United States, with largely unknown consequences on the collective physiological responses of the soil microbial community, i.e., the metaphenome. Here, we used an untargeted omics approach to determine the soil microbial community’s metaphenomic response to soil moisture and to define specific metabolic signatures of the response. Specifically, we aimed to develop the technical approaches and metabolic mapping framework necessary for future systematic ecological studies. We collected soil from three locations at the Konza Long-Term Ecological Research (LTER) field station in Kansas, and the soils were incubated for 15 days under dry or wet conditions and compared to field-moist controls. The microbiome response to wetting or drying was determined by 16S rRNA amplicon sequencing, metatranscriptomics, and metabolomics, and the resulting shifts in taxa, gene expression, and metabolites were assessed. Soil drying resulted in significant shifts in both the composition and function of the soil microbiome. In contrast, there were few changes following wetting. The combined metabolic and metatranscriptomic data were used to generate reaction networks to determine the metaphenomic response to soil moisture transitions. Site location was a strong determinant of the response of the soil microbiome to moisture perturbations. However, some specific metabolic pathways changed consistently across sites, including an increase in pathways and metabolites for production of sugars and other osmolytes as a response to drying. Using this approach, we demonstrate that despite the high complexity of the soil habitat, it is possible to generate insight into the effect of environmental change on the soil microbiome and its physiology and functions, thus laying the groundwork for future, targeted studies. IMPORTANCE Climate change is predicted to result in increased drought extent and intensity in the highly productive, former tallgrass prairie region of the continental United States. These soils store large reserves of carbon. The decrease in soil moisture due to drought has largely unknown consequences on soil carbon cycling and other key biogeochemical cycles carried out by soil microbiomes. In this study, we found that soil drying had a significant impact on the structure and function of soil microbial communities, including shifts in expression of specific metabolic pathways, such as those leading toward production of osmoprotectant compounds. This study demonstrates the application of an untargeted multi-omics approach to decipher details of the soil microbial community’s metaphenotypic response to environmental perturbations and should be applicable to studies of other complex microbial systems as well.
Growing Pains: An Employment Compliance Primer for Small Employers

Small employers often have an advantage over their larger counterparts in that they are not subject to certain regulatory compliance requirements. However, as small employers' workforces expand, the organizations become subject to various federal employment statutes. This paper reviews the primary federal employment laws that are likely to impact small firms as they grow. It also provides suggestions for dealing with these mandates.
Using exercise to facilitate arousal reappraisal and reduce stress reactivity: A randomized controlled trial

Abstract Background Maladaptive stress reactivity is a vulnerability factor for the recurrence of mood and anxiety episodes. Since appraisals of situational demand and available resources to cope with a stressor drive stress reactivity, they are meaningful targets for intervention. In the present study, we test whether exercise (EX) can facilitate learning arousal reappraisal (AR) techniques among individuals vulnerable to depressive episodes and thereby improve reactivity to stressful events. Methods Participants (N = 167) with mild-to-moderate symptoms of depression were randomly assigned to inactive control (CTRL), EX (three 5-min bouts at varying intensity), AR instruction, or their combination (EX+AR) prior to undergoing a stressor. Stress appraisal (pre- and post-stressor) and perceived stress (pre-, post-, 5-, 10-, and 15-min post-stressor) were assessed. Results The EX+AR condition reported a more adaptive appraisal of the stressor and exhibited a greater decline in perceived stress immediately and 15-min post the stressor compared to EX and CTRL conditions. The AR condition also reported a more adaptive appraisal of the stressor and exhibited a greater decline in perceived stress but only 15-min after the stressor and only in comparison to the CTRL condition. There were no significant differences between the EX+AR and AR conditions nor between the EX and CTRL conditions. Conclusions Results provide no clear evidence for a synergistic effect for EX+AR and highlights that AR instruction aids adaptive reappraisal of stress. Studies with longitudinal designs are needed. These observations add to the body of literature exploring mechanisms for improving stress reactivity and the role exercise may play.
3.2 A 0.0088mm 2 Resistor-Based Temperature Sensor Achieving 92fJ·K 2 FoM in 65nm CMOS

Resistor-based temperature sensors can achieve superior performance in terms of energy efficiency and resolution compared to their BJT counterparts. Among them, Wien-(WB)[1]- and Wheatstone-Bridge (WhB)[2] -based architectures are the most popular. They employ an integrated resistor as a sensor and read out the temperature-dependent voltage/current/phase-shift using a high-resolution ΔΣ analog-to-digital converter (ADC). The high gain of the sensor combined with small quantization error of the ΔΣ ADC make these architectures the best in terms of resolution FoM (20 to 100fJ.K2)[1], [2]. However, high-resolution ΔΣ ADCs occupy large area :0.1mm2. Using a polyphase filter as a sensor, [3] proposed a frequency-locked-loop FLL-based readout scheme to solve both the area problem and the high-frequency clock requirement see Fig. 3.2.1. While it significantly reduced the area <0.01mm2, the FLL front-end circuits, specifically the zero-crossing detector (ZCD) and the charge-pump (CP), significantly limited the noise and accuracy performance, resulting in a resolution FoM of 430fJ.K2. In [4] the ZCD flicker noise and offset are cancelled using a dual-edge phase-frequency detector. However, the resulting performance is still limited by the CP noise resulting in an FoM of 260fJ.K2, which is 2.4x worse than that of the WB sensor in [1].
Evaluation of Susceptibility Patterns in Uropathogens and Empiric Antibiotic Therapy in the Emergency Department.

Objectives: Urinary Tract Infections (UTIs) are the most common bacterial infections encountered in the Emergency Department (ED). Objectives of this study are to describe the urological pathogens ...
A Comparison of Acute Pain Management Strategies After Cesarean Delivery

BACKGROUND There are approximately 1.2 million cesarean deliveries performed each year in the United States alone. While traditional postoperative pain management strategies previously relied heavily on opioids, practitioners are now moving toward opioid-sparing protocols using multiple classes of nonnarcotic analgesics. Multimodal pain management systems have been adopted by other surgical specialties including gynecology, although the data regarding their use for postoperative cesarean delivery pain management remain limited. OBJECTIVE To determine if a multimodal pain management regimen after cesarean delivery reduces the required number of morphine milligram equivalents (a unit of measurement for opioids) compared with traditional morphine patient-controlled analgesia while adequately controlling postoperative pain. STUDY DESIGN This was a prospective cohort study of postoperative pain management for women undergoing cesarean delivery at a large county hospital. It was conducted during a transition from a traditional morphine patient-controlled analgesia regimen to a multimodal regimen that included scheduled nonsteroidal anti-inflammatory drugs and acetaminophen, with opioids used as needed. The data were collected for a 6-week period before and after the transition. The primary outcome was postoperative opioid use defined as morphine milligram equivalents in the first 48 hours. The secondary outcomes included serial pain scores, time to discharge, and exclusive breastfeeding rates. Women who required general anesthesia or had a history of substance abuse disorder were excluded. The statistical analyses included the Student t test, Wilcoxon rank-sum, and Hodges-Lehman shift, with a P value <.05 being considered significant. RESULTS During the study period, 877 women underwent cesarean delivery and 778 met the inclusion criteria-378 received the traditional morphine patient-controlled analgesia and 400 received the multimodal regimen. The implementation of a multimodal regimen resulted in a significant reduction in the morphine milligram equivalent use in the first 48 hours (28 [14-41] morphine milligram equivalents vs 128 [86-174] morphine milligram equivalents; P<.001). Compared with the traditional group, more women in the multimodal group reported a pain score ≤4 by 48 hours (88% vs 77%; P<.001). There was no difference in the time to discharge (P=.32). Of the women who exclusively planned to breastfeed, fewer used formula before discharge in the multimodal group than in the traditional group (9% vs 12%; P<.001). CONCLUSION Transition to a multimodal pain management regimen for women undergoing cesarean delivery resulted in a decrease in opioid use while adequately controlling postoperative pain. A multimodal regimen was associated with early successful exclusive breastfeeding.
An Innovative Method for the Evaluation of LAGs and Rural Development: ‘A Mirror for LAGs’

The Leader initiative delivers a variety of innovative activities. It is a tool for rural development that is used to bring people, communities, and regions together. Experience in the European countries, including the Czech Republic, has shown that the Leader initiative has delivered visible enhancements to rural areas. This paper is based on an internal project of the Institute of Agricultural Economics and Information (IAEI) elaborated in the period from 2014 to 2016. The internal project dealt with the creation of a methodology with a special focus on the self-evaluation of the Local Action Groups (LAG), titled “A Mirror for LAGs”. The aim was to develop and validate a self-evaluation tool for LAGs. Cooperation with fourteen LAGs was used as the methodology of creation. The proposed procedure was tested on two LAGs. The method has two parts; an evaluation of the LAG’s strategy is undertaken as Part A, and an evaluation of the Leader principles as Part B. The evaluation of strategy (Part A) is based on the analysis of LAG activities concerning strategy. In Part A, the following elements are analyzed: the basic characteristics of the LAG, the financial budget, and the way the strategy’s objectives were met. Part A is mostly based on a quantitative approach. The evaluation of the principles (Part B) is mainly based on a qualitative analysis. Part B assesses the most individual way that evaluators (LAG) conduct their work and requires a significant amount of subjective assessment. For example, very often questionnaire surveys, interviews and focus groups are needed to generate data. The evaluation of the Leader principles depends on the evaluator’s skills too.
The Legacies of Atrocities and Who Fights

How do the legacies of atrocities shape who fights? We argue that past atrocities shape local grievances and economic incentives. Increasing grievances make individuals more likely to rebel, and less likely to fight for the perpetrator. When organizations use material incentives to recruit, worsening economic conditions increase the incentives to fight. We study how the atrocity of the 1845–1849 Great Famine affected whether Irishmen fought for or against Britain. Leveraging data on over 150,000 Irish combatants, we show that individuals in places more severely affected by the Famine fought in the pro-British Irish Militia and the WWI British military at lower rates. However, they rebelled against Britain at higher rates. Additional quantitative evidence suggests that historical grievances shaped the choice to fight for both sides, while increasing opportunity costs only mattered when organizations paid combatants. We demonstrate how the memories of the past, and economic conditions in the present, shape who fights.
A Framework for Predictive Control of Sampled-Data Systems Using Sporadic Model Approximation

This paper studies stability of sampled-data systems controlled by discrete-time model predictive control (MPC) algorithms. We consider a general framework for the codesign of discrete-time MPC law and the associated scheduling schemes, where the discrete-time model used in MPC approximates the behavior of the plant with state-dependent sampling periods. Sufficient conditions are derived to guarantee uniform ultimate boundedness of the resulting closed-loop system. The results can be applied to most existing model approximation methods with either fixed or time-varying sampling rates. It is shown that to stabilize the system, the model used in the FHOCP does not have to be very accurate as long as the associated scheduling scheme matches the model and the approximation error is below a threshold related to the running cost function.
Molecular and Clinical Characterization of Patients With Metastatic Castration Resistant Prostate Cancer Achieving Deep Responses to Bipolar Androgen Therapy.

Abstract Background Bipolar androgen therapy (BAT) is an emerging treatment strategy for men with metastatic castration resistant prostate cancer (mCRPC) whereby serum testosterone is cycled from supraphysiologic to near-castrate levels each month. BAT has been shown to induce clinical responses in a significant proportion of patients, some of which are extreme. We explored the clinical and molecular characteristics of patients with mCRPC who achieved deep responses to BAT. Methods We conducted a retrospective analysis of patients with mCRPC treated with BAT at Johns Hopkins. We identified 22 of 114 (19%) patients with mCRPC who achieved ≥70% PSA reductions upon treatment with BAT. All patients were treated using 400 mg testosterone cypionate intramuscularly every 28 days, together with continuous LHRH agonist therapy. Clinical-grade DNA sequencing was obtained using commercially available assays. Results Somatic next-generation sequencing was obtained for 15 of 22 (68%) patients. Of these 15 extreme PSA responders with sequencing data available, All 15 of 15 (100%) harbored a pathogenic mutation in TP53 and/or a homologous recombination DNA repair (HRD) gene. Among the subset of patients with measureable disease (N = 15), 10 patients (67%) achieved an objective response including one patient with a complete response. The median radiographic progression-free survival of these deep PSA responders was 11.3 months (95% CI, 7.9-25.0 months). Conclusions We observed an enrichment of TP53 and HRD mutations in mCRPC patients with extreme PSA responses to BAT, with durability lasting about a year. These data support the hypothesis that BAT may most benefit patients with DNA repair-deficient mCRPC. Further studies of BAT in biomarker-selected mCRPC populations (ie, TP53/HRD-mutated) are warranted.
In Vivo Dynamics of the Latent Reservoir for HIV-1: New Insights and Implications for Cure

Although antiretroviral therapy (ART) can reduce viremia to below the limit of detection and allow persons living with HIV-1 (PLWH) to lead relatively normal lives, viremia rebounds when treatment is interrupted. Rebound reflects viral persistence in a stable latent reservoir in resting CD4+ T cells. This reservoir is now recognized as the major barrier to cure and is the focus of intense international research efforts. Strategies to cure HIV-1 infection include interventions to eliminate this reservoir, to prevent viral rebound from the reservoir, or to enhance immune responses such that viral replication is effectively controlled. Here we consider recent developments in understanding the composition of the reservoir and how it can be measured in clinical studies. We also discuss exciting new insights into the in vivo dynamics of the reservoir and the reasons for its remarkable stability. Finally we discuss recent discoveries on the complex processes that govern viral rebound. Expected final online publication date for the Annual Review of Pathology: Mechanisms of Disease, Volume 17 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.