cssi/SciSciGPT-SciSciNet huggingface dataset:
Zebrafish Motor Neuron Subtypes Differ Electrically Prior to Axonal Outgrowth

Different muscle targets and transcription factor expression patterns reveal the presence of motor neuron subtypes. However, it is not known whether these subtypes also differ with respect to elect...
Learning to learn – Intrinsic plasticity as a metaplasticity mechanism for memory formation

“Use it or lose it” is a popular adage often associated with use-dependent enhancement of cognitive abilities. Much research has focused on understanding exactly how the brain changes as a function of experience. Such experience-dependent plasticity involves both structural and functional alterations that contribute to adaptive behaviors, such as learning and memory, as well as maladaptive behaviors, including anxiety disorders, phobias, and posttraumatic stress disorder. With the advancing age of our population, understanding how use-dependent plasticity changes across the lifespan may also help to promote healthy brain aging. A common misconception is that such experience-dependent plasticity (e.g., associative learning) is synonymous with synaptic plasticity. Other forms of plasticity also play a critical role in shaping adaptive changes within the nervous system, including intrinsic plasticity – a change in the intrinsic excitability of a neuron. Intrinsic plasticity can result from a change in the number, distribution or activity of various ion channels located throughout the neuron. Here, we review evidence that intrinsic plasticity is an important and evolutionarily conserved neural correlate of learning. Intrinsic plasticity acts as a metaplasticity mechanism by lowering the threshold for synaptic changes. Thus, learning-related intrinsic changes can facilitate future synaptic plasticity and learning. Such intrinsic changes can impact the allocation of a memory trace within a brain structure, and when compromised, can contribute to cognitive decline during the aging process. This unique role of intrinsic excitability can provide insight into how memories are formed and, more interestingly, how neurons that participate in a memory trace are selected. Most importantly, modulation of intrinsic excitability can allow for regulation of learning ability – this can prevent or provide treatment for cognitive decline not only in patients with clinical disorders but also in the aging population.
Proposed Guidelines for International Clinical Education in US-Based Physical Therapist Education Programs: Results of a Focus Group and Delphi Study

Background Physical therapist students are increasingly engaging in international clinical education (ICE). The growth of international engagement has been accompanied by appeals to ensure that these experiences are conducted in an ethical manner. Although detailed guidelines have been developed to guide global health training in general, they do not specifically address all aspects relevant to ICE in physical therapist education. Objective The purpose of this study was to systematically develop recommendations for the implementation of ICE in physical therapist education to promote ethical practice. Methods An initial virtual focus group of 5 physical therapist faculty with expertise in ICE provided input to review and revise global health training guidelines previously developed by non–physical therapists. The revised guidelines were distributed to a pool of 19 physical therapist faculty with ICE experience for additional review and revision through 3 online Delphi survey rounds. Results The participants accepted 31 of the original guidelines with or without revisions, rejected 2 guidelines, and developed 10 new guidelines or subguidelines. Most notably, they rejected a guideline related to students pursuing training outside of a structured program, stressing that ICE should never be done outside of a formal program. Limitations The primary limitation is that the study included only faculty from sending institutions and thus lacked the voices of the host institutions, students, partner organizations, or funders. Conclusions This study systematically produced guidelines for ICE in physical therapist education using a range of ICE experts from sending institutions. The recommendations may be used by educators and other decision makers to optimally design new ICE opportunities or to improve existing ones. Additional validation should be done to ensure relevance for all stakeholders.
Estimation of Fiber-Matrix Interfacial Shear Strengths in Lignocellulosic-Thermoplastic Composites

The interaction and adhesion between fibers and the matrix in composite materials have a significant influence on the properties of the fiber composite. It is, therefore, of utmost importance to be able to evaluate the properties of the interface/ interphase of the fiber-matrix for optimization of the properties of the composites. Techniques that are currently used to evaluate the properties of this region will be discussed with special attention to lignocellulosic­ thermoplastic composites. Sample preparation, applicability, problems and advantages of each technique will be highlighted. Results obtained at our laboratory for wood-low molecular weight polyethylene systems using the pull-out test will be discussed.
Republication: In That Case

For the past several months there has been sustained human-to-human transmission of a novel strain ofavian influenza A with genetic components of human influenza in several countries around the world. Your community was first affected three weeks ago and since then there have been over 500 cases and 50 deaths. Oseltamivir phosphate is the only drug that may effectively reduce mortality of ill patients and limit infection of exposed persons. However, supplies of oseltamivir are limited, and hospitals across the country are independently making decisions to govern allocation of antivirals within their institutions. In your community, the five major academic medical centers have recently established five different protocols regarding prioritization of access to care:
Coordinate control of anchorage independence, actin cytoskeleton, and angiogenesis by human chromosome 1 in hamster-human hybrids

Abstract A panel of hybrids previously derived from fusions between a chemically transformed hamster cell line and normal human fibroblasts (A. Stoler and N. Bouck, Proc. Natl. Acad. Sci. USA, 82: 570–574, 1985) has been used to test whether or not anchorage independence, lack of actin cables, and angiogenic activity, three characteristics of transformed cells considered necessary but not sufficient for neoplasia, are coordinately regulated. In these hybrids anchorage independence is initially suppressed and those hybrids where it remains suppressed have been shown to retain human chromosome 1. Here we show that suppressed hybrids also display actin microfilament cables characteristic of normal cells and are unable to elicit an angiogenic response in the rat cornea assay. In contrast, those hybrids in which anchorage independence is expressed and which have lost human chromosome 1 have an actin cytoskeleton resembling that of the transformed parent and are potently angiogenic.
Heat Shock Protein 84 Forms a Complex with Mutant p53 Protein Predominantly within a Cytoplasmic Compartment of the Cell

Abstract Cellular DNA damage results in the increased expression and accumulation of the p53 tumor suppressor protein within the nucleus which leads to cell cycle arrest or apoptosis. In some cases, however, wild-type p53 and some mutant forms of p53 reside in the cytoplasm of cancer cells. To understand the mechanism responsible for its cytoplasmic retention, studies were undertaken to determine if unique proteins form a complex with mutant p53 within the cytoplasm of transformed cells. One protein, with an apparent molecular mass of 92 kDa (p92), was observed to form a complex with a temperature-sensitive mutant p53 (TSp53Val-135) in the cytoplasm of transformed rat embryo fibroblasts at the non-permissive temperature. p92 copurified with TSp53Val-135 on a p53-specific immunoaffinity column and a gel filtration column. The protein was purified to homogeneity and identified as hsp84 by partial amino acid sequence analysis. hsp84 is a member of the hsp90 class of proteins. At the non-permissive temperature, TSp53Val-135 and hsp84 colocalized in the cytoplasm near the nuclear envelope. At the permissive temperature, TSp53Val-135 resides in the nucleus and expresses a “wild-type like” conformation. Under these conditions hsp84 continued to reside in the cytoplasm and little or no hsp84 formed a complex with p53. The results suggest that hsp84 binds mutant p53 in a spatial and/or conformation dependent manner.
Sex difference in fluid exchange during food deprivation in the rabbit.

Daily measurements of body weight, water and food intakes and urinary Na+, K+, Cl-, osmolarity and volume were made during 7 days of ad lib. feeding, followed by 7 days of food deprivation in normal male, and normal and ovariectomized female rabbits. Male rabbits deprived of food show a marked increase in fluid intake and urine output which is associated with an enhanced Na+ excretion. In contrast, female rabbits display a diminished or even depressed fluid exchange during food withdrawal; the onset of the increased Na+ excretion, although present as in the male, is delayed. Ovariectomy converts the female type of response to that of the male, i.e., a polyuria and polydipsia. Diethylstilbestrol (100 μg/day) or estradiol (100 μg/ day) given to the male on the 3rd and 4th days of food deprivation results in a significantly reduced water intake and urine output and increased urinary osmolar concentration; similar results are obtained in estradioltreated ovariectomized rabbits. Possible mechanisms of this est...
Wavelets in computer graphics

One of the perennial goals in computer graphics (CC) is realism in real time. Handling geometrically complex scenes and physically faithful descriptions of their appearance and behavior clashes with the requirement of multiple frame per second update rates. It is no surprise then that hierarchical modeling and simulation have already enjoyed a long history in CG. Most recently these ideas have received a significant boost as wavelet based algorithms have entered many areas in CG. We give an overview of some of the areas in which wavelets have already had an impact on the state of the art.
Is fluorescence polarization reliable and cost efficient in a fetal lung maturity cascade

Abstract OBJECTIVE: The objective of the study was to compare the accuracy of the TDxFLM test (Abbott Laboratories) with the fetal lung maturity cascade (shake, foam stability index, lecithin/sphingomyelin tests) and to determine whether the TDxFLM test could increase the efficiency and reduce the cost without decreasing the reliability of a cascade. STUDY DESIGN: A prospective, single-blinded study was conducted. Uncontaminated amniotic fluid obtained by transabdominal amniocentesis for fetal lung maturity assessment was evaluated with use of the fetal lung maturity cascade and the TDxFLM test. At study completion the results of the TDxFLM test were compared with those of the maturity cascade with regard to hyaline membrane disease, which was defined by strict clinical and radiographic parameters. A power analysis was performed requiring a sample size of 100 infants delivered within 72 hours of amniocentesis with use of the 95% confidence interval. RESULTS: A total of 115 cases had a full maturity cascade performed, of which 40 (35%) had a positive shake or foam stability index and 75 cases required progression to a lecithin/sphingomyelin ratio because of negative results. The TDxFLM test result was ≥70 mg/gm in 42 (37%) of these 115. One hundred eight newborns were delivered within 72 hours of the amniocentesis; 65% (71) of these were between 30 and 37 weeks of estimated gestational age. There were 7 cases of hyaline membrane disease in the 108 newborns. Of these 108, 87 had a mature original cascade versus 85 mature tests with use of a proposed TDxFLM test–lecithin/sphingomyelin ratio cascade with one case of respiratory distress syndrome and hyaline membrane disease. The sensitivity, specificity, and positive and negative predictive values for the original cascade were 86%, 84%, 27%, and 99%, respectively; for the proposed TDxFLM test–lecithin/sphingomyelin ratio cascade the values were 86%, 83%, 26%, and 99%, respectively. The TDxFLM test–lecithin/sphingomyelin ratio cascade would have resulted in a cost reduction of 24% with no significant delay in turnaround time. CONCLUSION: The TDxFLM test appears to be a reliable and accurate assessment of fetal lung maturity. Furthermore, by replacing the shake and foam stability index portion of the cascade with the TDxFLM test, a cost savings of 24% would occur without a decrease in safety. These results also reveal that it could enhance patient care and be cost efficient for institutions not currently doing fetal pulmonary maturity testing to undertake use of the TDxFLM test and to only send out specimens for a lecithin/sphingomyelin ratio that have an initial immature TDxFLM test result (
Reduction and Mastopexy of the Reconstructed Breast: Special Considerations in Free Flap Reconstruction

Autologous breast reconstruction is capable of creating a breast that closely resembles a natural breast. Reduction and mastopexy in this type of reconstruction yields several challenges to the reconstructive surgeon. Revision surgery is common to achieve symmetry; however, reduction, mastopexy, and other revision techniques are sparse in the current literature. Often, these techniques are passed from mentor to student during plastic surgery training or are learned with experience in managing one's own patients. Reviewing anatomical principles unique to this subset of patients is essential. We must also consider factors unique to this group including the effects of delayed reconstruction, radiation, skin paddle size, and flap volume. In this article, the authors describe some of the common principles used by experienced reconstructive surgeons to perform reduction and mastopexy in autologous breast reconstruction to achieve a natural, aesthetically pleasing breast reconstruction. In addition, they have included several case examples to further illustrate these principles.
Conceptualization and Description of HRD in Ghana

The conceptualization and description of HRD have not been consistent across countries. The purpose of this paper is to examine the conceptualization and description of HRD in Ghana as a way of addressing aspects of HRD, which are ignored or orphaned. We present a critical analysis of current literature and bring to light HRD practices in Ghana. We also focus on role of culture in HRD practices, as well as Ghana’s national policy and strategies. It is our contention that contemporary HRD theory is constricted by a fractured epistemology, which delineates areas such as capacity building and capacity development out of the realm of HRD. This paper is therefore situated in a theory that accounts for dynamic aspect of systems theory, capacity development and HRD. Our typology integrates and extends the conceptualization and definition of HRD into the realm of capacity development based on comprehensive sets of shared fundamental assumptions in HRD and systems theory.
Mentoring for online teachers

The purpose of this chapter is twofold. First, we provide a synthesis of what is known about mentoring in general, mentoring for K-12 brick and mortar teachers, and mentoring for K-12 online teachers. In order to synthesize this literature we have divided it into the broad categories of (1) the benefits and challenges of mentoring, (2) characteristics of effective mentors, (3) characteristics of effective mentees, (4) characteristics of effective mentoring programs, and (5) strategies to support mentoring. Second, we use this knowledge as a springboard to suggest policy and research implications for the mentoring of K-12 online teachers.
Implementation of Age-Specific Services for Transition-Age Youths in California.

Objectives:This study examined the implementation of age-specific services for transition-age youths in California under the Mental Health Services Act (MHSA).Methods:This study employed a sequenti...
Models for predicting enteric methane emissions from dairy cows in North America, Europe, and Australia and New Zealand

There are several models in the literature for predicting enteric methane (CH4 ) emissions. These models were often developed on region or country-specific data and may not be able to predict the emissions successfully in every region. The majority of extant models require dry matter intake (DMI) of individual animals, which is not routinely measured. The objectives of this study were to (i) evaluate performance of extant models in predicting enteric CH4 emissions from dairy cows in North America (NA), Europe (EU), and Australia and New Zealand (AUNZ) and (ii) explore the performance using estimated DMI. Forty extant models were challenged on 55, 105, and 52 enteric CH4 measurements (g per lactating cow per day) from NA, EU, and AUNZ, respectively. The models were ranked using root mean square prediction error as a percentage of the average observed value (RMSPE) and concordance correlation coefficient (CCC). A modified model of Nielsen et al. (Acta Agriculturae Scand Section A, 63, 2013 and 126) using DMI, and dietary digestible neutral detergent fiber and fatty acid contents as predictor variables, were ranked highest in NA (RMSPE = 13.1% and CCC = 0.78). The gross energy intake-based model of Yan et al. (Livestock Production Science, 64, 2000 and 253) and the updated IPCC Tier 2 model were ranked highest in EU (RMSPE = 11.0% and CCC = 0.66) and AUNZ (RMSPE = 15.6% and CCC = 0.75), respectively. DMI of cows in NA and EU was estimated satisfactorily with body weight and fat-corrected milk yield data (RMSPE 0.60). Using estimated DMI, the Nielsen et al. (2013) (RMSPE = 12.7 and CCC = 0.79) and Yan et al. (2000) (RMSPE = 13.7 and CCC = 0.50) models still predicted emissions in respective regions well. Enteric CH4 emissions from dairy cows can be predicted successfully (i.e., RMSPE < 15%), if DMI can be estimated with reasonable accuracy (i.e., RMSPE < 10%).
Adaptive resilient routing via preorders in SDN

In this paper, we propose and advocate a new routing paradigm -- dubbed routing via preorders -- which circumvents the limitations of conventional path-based routing schemes to effectively take advantage of topological diversity inherent in a network with rich topology for adaptive resilient routing, while at the same time meeting the quality-of-service requirements (e.g., latency) of applications or flows. We show how routing via preorders can be realized in SDN networks using the "match-action" data plane abstraction, with a preliminary implementation and evaluation of it in Mininet.
Propagation and Immortalization of Human Lens Epithelial Cells in Culture

Results. The primary cells from infant eyes proliferated for three passages before senescence was observed. However, the immortalized cells remained proliferative and retained the morphology of the primary cells. Immunohistochemical analysis demonstrated that these immortalized cells were SV40 large T antigen-positive and ceased to produce infectious virus after a few passages. Immortalized cells passaged to population doubling levels of 76 continued to form confluent cultures within 7 days of subculture. Analysis of proteins by SDS-PAGE and immunoblotting showed that immortalized cells produce a protein with molecular weight of about 25 kD, which reacted with an antibody to /3H-crystallin. Conclusions. This report constitutes the first successful immortalization of human lens epithelial cells. Currently, two cell lines have been created (B-3 and B-4) and passaged to population doubling levels of 76 and 52, respectively. These cells may provide an important human cell line specific to in vivo human lens epithelial cell physiology and would be of interest in establishing a human model to study lens cell differentiation and the etiology of cataract. These cells may also provide a constant and reproducible source of lens epithelial cells for eye-related toxicology studies and to assay inhibitory drugs for the prevention of cataracts and posterior capsular opacification observed after cataract extraction. Invest Ophthalmol Vis Sci. 1994;35:3094-3102.
Diet-induced weight loss leads to a switch in gene regulatory network control in the rectal mucosa

Abstract Background Weight loss may decrease risk of colorectal cancer in obese individuals, yet its effect in the colorectum is not well understood. We used integrative network modeling, Passing Attributes between Networks for Data Assimilation, to estimate transcriptional regulatory network models from mRNA expression levels from rectal mucosa biopsies measured pre- and post-weight loss in 10 obese, pre-menopausal women. Results We identified significantly greater regulatory targeting of glucose transport pathways in the post-weight loss regulatory network, including “regulation of glucose transport” (FDR = 0.02), “hexose transport” (FDR = 0.06), “glucose transport” (FDR = 0.06) and “monosaccharide transport” (FDR = 0.08). These findings were not evident by gene expression analysis alone. Network analysis also suggested a regulatory switch from NFΚB1 to MAX control of MYC post-weight loss. Conclusions These network-based results expand upon standard gene expression analysis by providing evidence for a potential mechanistic alteration caused by weight loss.
Labeling hypergraph-structured data using markov network

The goal of this dissertation is to label datapoints into two groups utilizing higher order information among them. More specifically, given likelihood (or error) measures that subsets of data are generated by a pattern (or belong to a class), we wish to label the individual datapoints into two classes. Several computer vision problems deal with data in this format. In model estimation, small subsets of data are randomly sampled to produce an error measure. Groups of object parts are often used to provide useful geometrical information for object recognition/ localization. We propose a novel labeling algorithm by modeling the datapoints as nodes of a higher order Markov Network. A new higher order clique function plays the central role in our method. The behavior of this clique function is analyzed to explain how it affects the inference and to predict when it is theoretically guaranteed to produce an optimal solution. We also describe how a parametric form of the proposed clique function can be learned from labeled data. Results on several different computer vision problems will be presented to demonstrate the effectiveness of the proposed algorithm .
Cautions on the treatment of non-detect results for environmental forensics

ABSTRACTWhile censored data (i.e., containing non-detect [ND] results) may provide useful information in the context of risk assessment, their utility in chemical forensics is less clear. Substitution of NDs can create invasive patterns and may obscure the true forensic features in the underlying chemistry and sample compositions. The effect of substituting numeric values for NDs on the results of common chemical forensics multivariate analyses is illustrated using synthetic simulated data and laboratory measurements of soil samples from Colorado. The analyses of simulated and laboratory data demonstrate the impact of substituting values for NDs on multivariate analyses and indicate the potential for incorrect conclusions about the true forensic features within the data. Recommendations are provided for how to investigate and visualize the impact of NDs on chemical forensic multivariate analyses.
Intrinsic difficulties in using the doubly-infinite time axis for input-output systems theory

We point out that the natural definitions of stability and causality in input-output control theory lead to certain inconsistencies when inputs and outputs are allowed to have support on the doubly-infinite time-axis. In particular, systems with right half plane poles cannot be considered to be both causal and stabilizable. In contrast, there is no such conflict when the semi-infinite time axis is used. >
Incomplete Circle of Willis: A risk factor for mesial temporal sclerosis?

Abstract Objective The aim of this study was to investigate whether there may be a correlation between the anatomical variants of Circle of Willis (CoW) and presence/laterality of mesial temporal sclerosis (MTS). Methods We retrospectively identified the CoW variants on Wada angiograms in 71 patients with pathologically proven MTS. Angiograms were interpreted by two radiologists independently and blinded to clinical data. We divided the anterior and posterior components of the CoW into functionally complete and functionally incomplete groups. We then sought its correlation with the presence and laterality of MTS. Results No statistically significant relationship was found between the functional status of the anterior circulation and the laterality of the MTS (p = 0.657). Relationship of the posterior incomplete circle to MTS was statistically significant on both sides (p = 0.023 for the left, p = 0.04 for the right), with an effect size moderate to large for the left side and moderate for the right side. Although the fetal variant appeared to be related to the ipsilateral MTS, it did not reach to a level of statistical significance (p = 0.15). Significance The study demonstrates a statistically significant association of the incomplete posterior circulation of the CoW to the presence of ipsilateral MTS. Further studies in larger patient populations may be needed to seek whether an incomplete circulation may facilitate development of MTS, especially affecting the watershed zones.
Patient, public, and oncologists’ attitudes toward rationing medical care.

6518 Background: Lowering health care costs is critical. Patients with cancer (PT) and oncologists (MD) regularly make decisions regarding interventions with potentially marginal benefit but substa...
Criticality Safety Study for the Disposal of Damaged Fuels from Fukushima Daiichi Reactors

This paper summarizes our previous works on neutronics analysis for the disposal of damaged fuels from Fukushima Daiichi reactors. Three major stages have been identified for the criticality safety assessment after disposal. In order to evaluate the criticality safety for certain repository conditions and engineered barriers designs, neutronics models have been defined for different stages, and numerical results have been calculated by a Monte-Carlo code MCNP. For stages when fissile nuclides in the damaged fuels remains in the vicinity of the engineered barriers, the neutron multiplicity (keff) for a canister containing fuel debris surrounded by buffer was calculated over the leaching time. For the stage when fissile nuclides originated from multiple packages deposit in far-field host rocks, the critical masses for uranium depositions were studied for various rock types and geometries. The methodology presented in the present paper could be further improved and utilized to assist the repository system design and criticality safety assessment in the future.
Special considerations in management of jugular paraganglioma

Paragangliomas are neuroendocrine neoplasms that arise from chief cells in extra-adrenal paraganglia of the peripheral nervous system. While previous chapters have expanded upon historical, diagnostic, and management issues pertaining to paragangliomas, this chapter will discuss the management and prognosis regarding multicentric paragangliomas, malignant tumors, catecholamine-secreting paragangliomas, high-risk anesthetic patients, and future directions. Due to the paucity of literature on these particular topics, studies analyzing other head and neck paragangliomas, as well as non-head and neck paragangliomas and pheochromocytomas, are reviewed when relevant to highlight special considerations in management.
Has inpatient hospital treatment before and after age 65 changed as the difference between private and Medicare payment rates has widened

The past decade witnessed a dramatic increase in inpatient hospital payment rates for patients with private insurance relative to payment rates for those covered by Medicare. A natural question is whether the widening private-Medicare payment rate difference had implications for the hospital care received by patients just before and after turning 65—the age at which there is a substantial shift from private to Medicare coverage. Using a large discharge dataset covering the period 2001–2011, we tracked changes at age 65 in the following dimensions of hospital care: overall hospitalization rates, case mix, referral-sensitive surgeries, length of stay, full established charges, number of procedures, mortality, and composite measures of inpatient quality and patient safety. In all cases we found either no change or a change that was small and inconsistent with payment rate changes during the study period.
Consistency Requirements for Integral Representations of Green’s Functions—Part I

Rigorous consistency checks are presented for verifying the correctness of integral representations of Green’s functions. We focus here on the Green’s functions in open regions of the Helmholtz equation. The two consistency checks are: 1) the completeness relation of the Green’s function and 2) the field behavior at infinity. The completeness relation is required so that the solution for arbitrary excitation and at arbitrary location for the problem at hand can be constructed exactly. The behavior at infinity must be such that the fields satisfy Sommerfeld’s radiation condition even though the constituent spectra in the integral representation are comprised of incoming and outgoing waves. The application of these two requirements is demonstrated for some existing Green’s functions of varying complexity-free-space Green’s function, Green’s function in the exterior region of a perfectly conducting wedge, and Sommerfeld integral representation of the Green’s function for a material half-space.
Sciatic nerve stimulation and its effects on upper airway resistance in the anesthetized rabbit model relevant to sleep apnea

Previously, sciatic nerve stimulation has been shown to activate upper airway and chest wall muscles. The supposition that resistance through the upper airway would be reduced with this afferent re...
Association of Physical Activity With Income, Race/Ethnicity, and Sex Among Adolescents and Young Adults in the United States: Findings From the National Health and Nutrition Examination Survey, 2007-2016.

Importance Physical activity in youth is associated with adult health. Understanding the prevalence and factors of moderate to vigorous physical activity among adolescents and young adults will guide public health and policy efforts. Objectives To describe the current patterns of physical activity and duration among adolescents and young adults and to identify the direction and magnitude of associations between physical activity and income, race/ethnicity, and sex. Design, Setting, and Participants This cross-sectional secondary data analysis used the self-reported physical activity data of adolescents and young adults from the National Health and Nutrition Examination Survey from 2007 through 2016. This data set is a multistage probability sample of the noninstitutionalized US population and allows estimates that represent the US population. The years 2007 through 2016 were selected because of the consistent physical activity questions during this period. Adolescents and young adults aged 12 to 29 years who responded to the survey were included. Individuals who were underweight were excluded. Data analysis was performed from October 17, 2017, to April 27, 2018. Main Outcomes and Measures Self-reported physical activity duration and intensity. Results Of the 9472 participants, 4771 (50.4%) were males, and the weighted mean age (range) was 20.6 (12-19) years. Across all demographic categories, females reported less physical activity than did their male counterparts. White adolescent males were most likely (89.3%; 95% CI, 86.5%-92.1%) and black females aged 18 to 24 years were least likely (45%; 95% CI, 39.0%-51.0%) to report any physical activity. Among those who were active, black males aged 18 to 24 years reported the longest duration of activity (77.9 minutes per day; 95% CI, 66.4-89.3 minutes per day), and black females aged 25 to 29 years reported the shortest duration of activity (33.2 minutes per day; 95% CI, 28.1-38.2 minutes per day). In adjusted models, younger age, white race, and higher income were associated with greater physical activity. Conclusions and Relevance Female adolescents and young adults were not meeting the recommended guidelines for physical activity, and substantial disparities by race and income levels were noted. These data highlight opportunities for targeted physical activity programming and policy efforts.
Predatory Kidnapping–Child Victim

This chapter defines the meaning, characteristics, and implications for the prevention and investigation of a predatory child kidnapping. The predatory kidnapping of a child victim involves the sexually motivated abduction of individuals under 18 years of age. In the cases reviewed in the chapter, most victims are girls abducted by men. The approaches used by these abductors to subdue their victims are through the use of force, verbal threats, and persuasions or deceptions. The majority of victims of child predatory kidnappings survived their abduction. It reveals that victim age and gender have been shown to be critical variables in child victimization cases. Neonates, infants, toddlers, and preschoolers are found to be equally likely to be abducted by males or females for emotionally based reasons or with the intent of keeping the child. Predatory kidnappers use persuasion or deception as a means to approach their victims. Advising parents and guardians to carefully attend to the content of the child's discussions about the new “heroes” and “friends” in her world can serve as an important tool in preventing harm. Lack of success in developing assertiveness has been implicated in the development of depression, anxiety, social phobias, and increased risk of victimization for a child between 11 and 13 years old. Internet use poses potential challenges to a child between 14 and 17 years of age. Children should be taught the responsible use of the Internet to mitigate the risk of victimization. On investigation, law enforcement personnel must immediately determine the type of case being reported and the resources needed to investigate must also be determined.
Setting Up a “Lab”(Clinical or Basic Science Research Program) and Managing a Research Team

As a brand new faculty member, the surgeon-scientist is generally excited about starting a new position and eager about the possibilities for building their very own research program. However, there is perhaps no greater source of anxiety for the young surgeon-scientist than setting up and staffing a new research program (either in basic bench research or patient-oriented translational research). In this chapter, we provide very broad guidelines and advice to help the new faculty member avoid those pitfalls and build a successful research program. We also admit that there are numerous approaches to each of these elements and the recommended approaches delineated here, represent a small fraction of available options. Although many of the references described in this chapter relate to bench research, the concepts can be applied broadly to any research program including clinical research programs. This chapter is deliberately written in a broad, informal and somewhat humorous style. The suggestions and recommendations are based on information distilled from multiple sources, while trying to be as practical as possible. As much as possible, there are no references to specific techniques, research designs etc. At the end of the Chapter, there is a suggested reading list which contains useful material from which we have obtained some of this material. It is our hope that the new surgeon-scientist starting their scientific career will find this information useful in avoiding the most common pitfalls in setting up their research programs. We hope you enjoy it.
Dynamic optimization of some forward-looking stochastic models

A dynamic decision model is said to be forward-looking if the evolution of the underlying system depends explicitly on the expectations the agents form on the future evolution itself. Such models lead to nonstandard stochastic dynamic optimization problems where one has to take into account the fact that there is a circular (closed) relationship between future forecasts and future system behavior. In this paper we study a class of such problems where there is an additional control input designed to make the system track a given trajectory. This leads to a game-theoretic formulation in which context we consider both finite and infinite horizon formulations. It is shown that for the finite horizon problem the unique Nash equilibrium solution requires (fixed size) memory for both agents because of spillover across stages, whereas for the infinite horizon version no memory is needed.
Glutamine Supplementation in Glutamine Synthetase Deficiency

An inherited defect of glutamine synthetase (GS), the only known enzyme catalysing the endogenous synthesis of glutamine in the mammalian organism, has been described in only three patients so far. GS deficiency can therefore be regarded as an ultra-rare disorder. All three patients presented immediately after birth or early in the neonatal period and were affected by severe chronic encephalopathy with severe developmental delay and seizures. Diagnosis of GS deficiency depends on the cognition of decreased levels of glutamine in plasma, urine or cerebrospinal fluid (CSF) posing a particular challenge to the physician since most metabolic disorders present on the contrary with elevated levels of a single or several amino acid(s). This chapter mainly describes the therapeutic intervention in a patient with an inherited defect of GS who well tolerated a four week trial with enteral or parenteral l-glutamine. During the trial, increasing doses of glutamine were given (maximum and final dose of 1,020 mg/kg on and after day 21 of the trial) resulting in a complete correction of the systemic glutamine deficiency and in a partial correction of the lack of glutamine in the brain. Importantly, preexisting chronic moderate hyperammonemia was not aggravated nor were toxic CSF ammonia or glutamate levels provoked by the high-dose glutamine treatment. In future patients, glutamine supplementation should begin as early as possible in order to completely avoid the consequences of systemic glutamine deficiency in the milder cases and to alleviate the consequences by replenishing glutamine pools in those patients already affected by severe glutamine deficiency due to insufficient compensation during pregnancy. It remains however to be established whether an earlier intervention can prevent the devastating natural course of chronic encephalopathy in GS deficiency.
Readmission after surgery for oropharyngeal cancer: An analysis of rates, causes, and risk factors.

Author(s): Goel, Alexander N; Badran, Karam W; Mendelsohn, Abie H; Chhetri, Dinesh K; Sercarz, Joel A; Blackwell, Keith E; John, Maie A St; Long, Jennifer L | Abstract: Objectives/hypothesisDetermine the rate, diagnoses, and risk factors associated with 30-day nonelective readmissions for patients undergoing surgery for oropharyngeal cancer.Study designRetrospective cohort study.MethodsWe analyzed the Nationwide Readmissions Database for patients who underwent oropharyngeal cancer surgery between 2010 and 2014. Rates and causes of 30-day readmissions were determined. Multivariate logistic regression was used to identify risk factors for readmission.ResultsAmong 16,902 identified cases, the 30-day, nonelective readmission rate was 10.2%, with an average cost per readmission of $14,170. The most common readmission diagnoses were postoperative bleeding (14.1%) and wound complications (12.6%) (surgical site infection [8.6%], dehiscence [2.3%], and fistula [1.7%]). On multivariate regression, significant risk factors for readmission were major ablative surgery (which included total glossectomy, pharyngectomy, and mandibulectomy) (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.06-1.60), advanced Charlson/Deyo comorbidity (OR: 2.00, 95% CI: 1.43-2.79), history of radiation (OR: 1.58, 95% CI: 1.15-2.17), Medicare (OR: 1.34, 95% CI: 1.06-1.69) or Medicaid (OR: 1.82, 95% CI: 1.32-2.50) payer status, index admission from the emergency department (OR: 1.19, 95% CI: 1.02-1.40), and length of stay ≥6 days (OR: 1.57, 95% CI: 1.19-2.08).ConclusionsIn this large database analysis, we found that approximately one in 10 patients undergoing surgery for oropharyngeal cancer is readmitted within 30 days. Procedural complexity, insurance status, and advanced comorbidity are independent risk factors, whereas postoperative bleeding and wound complications are the most common reasons for readmission.Level of evidence4. Laryngoscope, 129:910-918, 2019.
Photopolymerizable Injectable Cartilage Mimetic Hydrogel for the Treatment of Focal Chondral Lesions: A Proof of Concept Study in a Rabbit Animal Model.

Background:In this study, we investigate the in vitro and in vivo chondrogenic capacity of a novel photopolymerizable cartilage mimetic hydrogel, enhanced with extracellular matrix analogs, for car...
Prevalence and Characteristics of Caregiver Distress One-Year after Allogeneic Hematopoietic Cell Transplant in an Older Cohort of Patients - a Single Institution Experience

Introduction Older patients with hematologic malignancies are increasingly considered for allogeneic hematopoietic cell transplant (allo-HCT). However, older patients may require increased level of post-transplant care than younger allo-HCT patients given their comorbidities. Moreover, older patients commonly have older caregivers and together, these factors contribute to increased caregiver distress, which has been shown to be associated with worsened health outcomes. Objectives To identify predictors of caregiver distress and examine the prevalence of caregiver distress in the older allo-HCT patient population. Methods We examined caregiver distress retrospectively for all patients aged 60 years and older who underwent first allo-HCT at our institution from 2015 to 2016. We systemically identified the incidence and characterized caregiver distress and attendance in a caregiver support group from the start of conditioning up to 1-year post allo-HCT. Caregiver distress was defined in this setting as any social work documentation of evidence of caregiver distress, including burnout, fatigue, burden, or difficulty coping. No standardized instruments were used given the nature of this study. Results 144 patients were included. Table 1 depicts the baseline caregiver characteristics, prevalence of caregiver distress, and attendance at the caregiver groups within one-year post allo-HCT. Caregivers of 15 patients (10%) had developed distress at a median of 14 days post-transplant (range day -5 to day +335). Caregivers of 29 patients (20%) had attended a caregiver support group meeting at least once. Caregiver distress was reported in multiple settings including early in hospitalization, during worsening of patient symptoms (pain, GVHD, pre-engraftment syndrome), critical illness, disease relapse, and readmission for complications. Caregiver distress was also noted when caregivers had documented health issues, difficulty coping with patient illness, or lack of social support. We examined independent association of pre-transplant variables with caregiver distress and caregiver support group participation and did not identify any significant association by univariate logistic regression. Conclusions While limited by the retrospective nature and likely underreporting, this study reveals areas of caregiver distress following allo-HCT for older patients. Future studies will attempt to better identify caregivers experiencing caregiver distress through a larger sample size and through inclusion of standardized assessments of caregiver distress, such as the caregiver reaction assessment, in social work meetings with caregivers. We will continue to examine patient records and to extend follow-ups to identify predictors of caregiver distress to improve outcomes for at-risk older patients and their caregivers.
Robot-assisted repair of a urogenital sinus with an anorectal malformation in a patient with McKusick-Kaufman syndrome.

Summary Introduction A urogenital sinus (US) and an anorectal malformation (ARM) are a rare constellation of anomalies, and the optimal surgical approach is unclear. Open and laparoscopic approaches have been described for US and ARM, but no data exist to support robotic assistance in children. Case A 20-month-old Amish female presented to the study center with fever and abdominal pain. Abdominal ultrasound showed a large fluid-filled vagina, urinalysis was positive, and she was admitted for antibiotic therapy. Magnetic resonance imaging (MRI) confirmed hydrocolpos. An examination under anesthesia including cystoscopy demonstrated a short perineal body, an anteriorly displaced anus by muscle stimulation, and no vaginal opening. An ultrasound-guided, percutaneous vaginostomy tube was placed, and 650 cc of pus was drained. Vaginal and urine cultures grew similar strains of Escherichias coli. After a course of antibiotics, she underwent a robot-assisted mobilization of the intra-abdominal vagina and uterus, posterior sagittal anorectoplasty, vaginal pull-through, and a diverting colostomy. There were no intra-operative complications. Her Foley catheter was removed on post-operative day #3, and she voided spontaneously and was discharged in good condition. She remained in the hospital for ostomy teaching, but pain control and diet were not barriers to discharge after 12 h. Conclusion Robotic mobilization of the intra-abdominal vagina in a pediatric patient with US and ARM is technically feasible and can be accomplished safely. Further comparative studies to other approaches are lacking. In this case, the robot allowed for good visualization, intra-operative collaboration between multiple specialties for complex patients with aberrant anatomy, and easy dissection in a narrow pre-pubertal pelvis and would be an approach that the study group uses in future cases.