cssi/SciSciGPT-SciSciNet huggingface dataset:
Race/Ethnicity differences in the inpatient management of acute asthma in the United States.

Background The only published US study on racial/ethnic disparities in inpatient asthma management was performed in 1989–1990 at a single center. The authors reported that black and Hispanic children were provided substandard care at hospital discharge compared to white children. The purpose of the present analysis was to reexamine this important issue in a large multicenter study. Methods A cohort study of 1,232 children and adults hospitalized with a physician diagnosis of acute asthma at 30 hospitals in 22 US states was used. Results The cohort included 562 children and 670 adults. There were no significant racial/ethnic differences in the choice of inpatient medications or length of stay among either children or adults. At hospital discharge, Hispanic children were less likely to receive an asthma action plan compared to white children (60%) or black children (63%; p Conclusions We did not identify racial/ethnic disparities in the inpatient treatment and outcomes for children or adults with acute asthma. At hospital discharge, Hispanic children were less likely to receive an asthma action plan compared to white or black children, possibly due to language or socioeconomic differences.
High-mobility ambipolar transistors and high-gain inverters from a donor-acceptor copolymer semiconductor.

Ambipolar organic field-effect transistors (OFETs), which are capable of both p- and n-channel operations, are gaining attention as an alternative approach to mimicking complementary metal-oxide semiconductor (CMOS) digital integrated circuits for achieving high-performance and cost-effective circuits in organic electronics. [1‐13] Low power dissipation and high performance are some of the major advantages of CMOS technology over non-complementary ones. [14] Power consumption is minimized in CMOS circuits because the component transistors are selectively turned on only when the circuit is switching, otherwise they are off at the steady state. The better performance of a CMOS circuit in terms of sharp switching and high noise immunity arises because every elemental transistor actively contributes to the function of the circuit. [14] Most efforts towards CMOS-like circuits in organic electronics have focused on utilizing distinct p- and n-type semiconductors. [1,15] However, the necessity of lateral patterning of semiconductors in CMOS circuits makes device fabrication on a common substrate a very complex process. Ambipolar OFETs represent an approach to high-performance CMOS-like circuits that minimize patterning and complex fabrication processes. [1] Ambipolar transistors are also of interest in fundamental studies of charge transport in organic semiconductors [1,6,16] as well as the development of efficient light-emitting transistors. [8,17‐21]
Vision-based control of mobile robots

This paper presents an approach for direct control of a mobile robot to keep it on a pre-taught path based solely on the perception from a monocular CCD camera. In particular, we present a novel vision-based control algorithm for mobile systems equipped with a conventional camera and a pan-tilt head or with an omnidirection camera. This algorithm avoids numerical instabilities of previously reported approaches. The experimental performance of the method as well as its practical limitations are discussed.
Change in CpG Context is a Leading Cause of Correlation between the Rates of Non-Synonymous and Synonymous Substitutions in Rodents

Correlation between the rates of synonymous (silent) and non-synonymous (amino acid-changing) nucleotide substitutions in genes is a widespread and yet unexplained genome-level phenomenon, which is in disagreement with the neutral theory of molecular evolution (Kimura, 1983). Comparison of 7732 orthologous genes of mouse and rat confirms the previously observed correlation between the rates of substitutions in non-synonymous and synonymous nucleotide sites. In rodents, this correlation is primarily caused by tandem substitutions and, in particular, by CpG mutation bias leading to doublet nucleotide substitutions. The nature of correlation between the rates of synonymous and non-synonymous substitutions in seven pairs of prokaryotic genomes is unclear.
Physical Activity and Dietary Determinants of Weight Loss Success in the US General Population.

Objectives. I studied lifestyle behaviors of long-term weight losers in a nationally representative sample.Methods. I categorized the dietary and physical activity data of 8012 adults from the 2009–2012 National Health and Nutrition Examination Surveys into (1) long-term weight losers (≥ 10% loss for ≥ 1 year), (2) recent weight losers (≥ 10% loss within past year), and (3) overweight or obese individuals who never lost 10% or more of their weight.Results. Long-term weight losers consumed fewer calories (2072; 95% confidence interval [CI] = 2011, 2134 kcal vs 2211; 95% CI = 2173, 2249 kcal; P < .001) and were more likely to report any vigorous leisure activity (24.5% vs 20.3%; P = .027) than did overweight or obese individuals. Among those engaging in vigorous leisure activity, long-term weight losers reported a greater quantity (188; 95% CI = 159, 223 min × wk–1 vs 156; 95% CI = 142, 172 min × wk–1; P = .047). Recent weight losers did not differ from overweight or obese individuals on absolute calorie in...
Phenomenology, Religious Studies, and Theology

The possibility and prospect of a phenomenological theology is a difficult but recurrent question. Recent works by Anna-Teresa Tymieniecka and Steven Laycock, however, provide considerable help with respect to clarifying the parameters of the problem— especially with respect to the questions of God and creativity.*
Simple hydroelastic impact models for water-borne debris:

Debris driven by tsunamis pose a significant threat to structures, and yet most building codes that include debris impact are based on rigid-body dynamics. However, the debris will most likely not be rigid compared to the structural components, such as walls and columns, that they impact. Impact by flexible, water-borne wood poles and shipping containers is considered in this paper. A relatively simple one-dimensional model for acoustic wave propagation, for which an analytical solution is obtained, is shown to provide a good estimate for the initial impact force and duration. This model is validated with small-scale, in-air tests. The simple model is also validated with two-dimensional fluid–structure interaction using a finite element code. The acoustic model works well for initial impact as long as the debris rebounds from the impact target. When the water prevents separation, then the acoustic model significantly overestimates the asymptotic force. The effect of the gravitational waves resulting from ...
Disseminated Aspergillus ustus infection following cardiac surgery.

Aspergillus ustus is a soil residing fungus that rarely has been implicated in human infections. A 72-year-old man who had undergone surgery for mitral valve replacement and triple coronary artery bypass developed progressive pneumonia with A. ustus . The infection had spread to other organs and finally was diagnosed at postmortem examination.
Understanding Health Disparities: The Relevance of the Stress Process Model

Race and socioeconomic status (SES) health disparities imply massive impact in terms of unequal suffering and dramatic social and economic costs. It is clear that status differences in the availability, use, and effectiveness of medical care and in a variety of health behaviors are implicated in these disparities. However, it is equally clear that adjustments for these differences leave the majority of race and SES health disparities unexplained. Despite wide acceptance of the idea that differences in stress exposure may contribute importantly to such disparities, it is contended that the stress hypothesis has never been effectively tested because of misclassification in the distinction between the disordered and the well and the inadequate estimation of differences in exposure to social stressors. This article reviews the empirical basis for this contention and describes an ongoing community study designed to more effectively evaluate the hypothesis that lifetime stress exposure represents a fundamental ...
Marital Conventionalization: Definition and Measurement

This article is a report of a preliminary study in the definition and measurement of marital conventionalization. Marital conventionalization is defined as the extent to which a person distorts the appraisal of his marriage in the direction of social desirability. Since the measurement of the variable is direct, the major focus is upon establishing content validity for a short scale of marital conventionalization. Since the results indicate that marital conventionalization is both extensive and intensive, it is necessary to control for its effect in any study of highly egoinvolved areas, particularly the area of marital adjustment.
Diagnosis of Acquired Uterine Arteriovenous Malformation by Doppler Ultrasound.

Abstract Background Acquired uterine arteriovenous malformation (AVM) is a rare cause of postpartum vaginal bleeding and can often be confused with retained products of conception (RPOC). Certain findings on ultrasound (US) increase the likelihood for AVM, such as hypoechoic areas in the myometrium and high velocity, multidirectional blood flow. Recognizing these changes on bedside US can cue the physician to send the patient for further studying and lead to the correct diagnosis. Case Report A 31-year-old, multigravida, multiparous female presented 5 weeks post–cesarean section with heavy, intermittent vaginal bleeding. Patient had multiple previous visits for similar bleeding, including an evaluation for RPOC. Upon current presentation, the patient underwent an US in the emergency department with color and pulse wave Doppler. US revealed a hypoechoic area within the myometrium, with high velocity, bidirectional blood flow, raising the clinical suspicion for uterine AVM. Following confirmatory studies, the patient underwent successful embolization of the AVM. Why Should an Emergency Physician Be Aware of This? The proper diagnosis of AVM is crucial, because the primary treatment modality for the alternative diagnosis of RPOC (i.e., dilation and curettage) can worsen vaginal bleeding and lead to shock or death, and is therefore contraindicated for uterine AVM. US is a quick bedside tool that can be used for rapid diagnosis of uterine AVM.
The Evolution of 'Competition': Lessons for 21st Century Telecommunications Policy

Assessments of competition or the lack thereof have been central to the evolution of public policy toward the telecommunications industry for over a century. This centrality continues today. Even so, numerous basic and profound questions persist regarding the definition and measurement of competition, as well as appropriate institutional oversight mechanisms for competition policy. In this paper, we chronicle the evolution of the “competition” concept in economics and also examine how “competition” has been defined in the communications policy arena. We find that the academic literature on competition hits an important inflection point in the mid-twentieth century with the development of the concept of “workable competition,” a term later equated to “effective competition.” Through careful examination and analysis of historical FCC regulations, we find that while the concept of “effective competition” is central to policy formation at the FCC, the Commission’s own applications of “effective competition” are inconsistently applied. Given the centrality of this concept, and its inconsistent applications to date, we draw upon the seminal contributions to the development of the notion of “effective competition” to proffer a straightforward and robust modern definition that we believe is suitable for application in twenty-first century communications markets.
A critical review of videoconferencing software to support school consultation

With recent advances in technology, several viable options now exist for school consultants to communicate with teachers via synchronous online videoconferencing (VC) without the need for specialized equipment. Unfortunately, few studies have evaluated the effectiveness of school consultation through VC, so practitioners are provided little guidance when determining if VC is suited to these specific needs. In this article, we identify the VC software packages most commonly used in the growing telehealth literature and discuss how features common to these programs might support effective school teleconsultation. We focus our attention on six specific capabilities: (a) onscreen document sharing; (b) group VC; (c) instant messaging; (d) recording capabilities; (e) integrated cloud storage; and (f) ethical compliance in regard to client confidentiality. Potential applications of these features are discussed, as well as practical and ethical considerations for trainers and school practitioners.
Testing proportionality between the first-order intensity functions of spatial point processes

This article proposes a Kolmogorov-Smirnov type test for proportionality between the first-order intensity functions of two independent spatial point processes. After appropriate scaling, the test statistic is constructed by maximizing the absolute difference between their point densities over a π -system. By treating non-stationary point processes as transformed from stationary point processes such that all questions of asymptotics related to the tightness can be answered, the article shows that the resulting test statistic converges weakly to the absolute maximum of a pinned Brownian sheet. This may be reduced to the standard Brownian bridge in a special case. A simulation study shows that the type I error probability of the test is close to the significance level and the power function increases to 1 as the magnitude of non-proportionality increases. In applications to two typical natural hazard data, the article concludes that the first-order intensity functions might be proportional in one case and not in the other.
Latex Sphere Retention by Microporous Membranes in Liquid Filtration

An experimental study of particulate matter retention by microporous membranes during liquid filtration has been conducted using 0.1, 0.22, 0.45, and 0.65-μm-rated hydrophilic and hydrophobic membrane filters. Retention measurements have been made with polystyrene latex spheres using an automated filter test system and a laser particle counter to measure the upstream and downstream particle concentration.Particle filtration during loading tests was found to begin with a sieving dominant regime followed by a transition regime and a cake filtration regime as particles accumulate inside the filter pores and on the filter surface. For latex sphere sizes equal to the nominal pore size of the filter, the initial filter efficiencies ranged from 97 to 99.9 percent. Complete retention (>99.9999999 percent) was achieved for a range of particle sizes two to three times the rated pore sizes of the filter. With the addition of a surfactant to the liquid, the retention was found to be lowered as a result of enhanced pa...
Design of liquid–liquid separation hydrocyclones using parabolic and hyperbolic swirl chambers for efficiency enhancement

Abstract The wall profile of the swirl chamber greatly impacts the internal flow structures and separation efficiency of a liquid–liquid separation hydrocyclone. The objective of this study is to examine the effects of parabolic and hyperbolic wall profiles of hydrocyclone swirl chamber on the internal flow structures and separation efficiency based on the numerical simulations. The internal flow structures observed for the different wall profiles of swirl chamber motivates the redesign of hydrocyclone geometry to achieve enhanced separation efficiency. Results show that, for a dilute system (oil concentration less than 1%), the hyperbolic and parabolic swirl chambers without a tail pipe yield, respectively, 16.5% and 25% higher separation efficiency for a droplet size of 30 μm when compared with a conical swirl chamber without tail pipe. However, the hyperbolic swirl chamber has a greater potential for the reduction of effective length of hydrocyclone with maintaining high separation efficiency. In addition, a hydrocyclone with truncated hyperbolic swirl chamber and tail pipe provides very long reverse flow core and yields 17% and 33% higher efficiency than that of full hyperbolic and conical swirl chambers without tail pipe, respectively.
Poring over furrows

Cryo-electron microscopy reveals the structure of a chloride channel that is closely related to a protein that transports lipids.
Mesencephalic astrocyte-derived neurotrophic factor (MANF), a new player in endoplasmic reticulum diseases: structure, biology, and therapeutic roles

Mesencephalic astrocyte-derived neurotrophic factor (MANF), a newly identified 18-kDa soluble protein, localizes to the luminal endoplasmic reticulum (ER), whose stress can stimulate MANF expression and secretion. In Drosophila and zebrafish, MANF regulates dopaminergic neuron development. In contrast, in mice, MANF deficiency leads to diabetes and activation of the unfolded protein response. Recent studies in rodent models have demonstrated that MANF mitigates diabetes, exerts neurotrophic function in neurodegenerative disease, protects cardiomyocytes and neurons in myocardial infarction and cerebral ischemia, respectively, and promotes immune cell phenotype switch from proinflammatory macrophages to prorepair anti-inflammatory macrophages. The cytoprotective mechanisms of MANF on ER stress are currently under active investigation. In addition, for the first time, we have discovered that MANF can potentially serve as a urinary ER stress biomarker in ER stress-mediated kidney disease. These studies have underscored the diagnostic and therapeutic importance of MANF in ER diseases.
Computational Investigation on Hydrodeoxygenation (HDO) of Acetone to Propylene on α-MoO3 (010) Surface

Density functional theory (DFT) calculations were performed on the multistep hydrodeoxygenation (HDO) of acetone (CH3COCH3) to propylene (CH3CHCH2) on a molybdenum oxide (α-MoO3) catalyst following an oxygen vacancy-driven pathway. First, a perfect O-terminated α-MoO3 (010) surface based on a 4 × 2 × 4 supercell is reduced by molecular hydrogen (H2) to generate a terminal oxygen (Ot) defect site. This process occurs via a dissociative chemisorption of H2 on adjacent surface oxygen atoms, followed by an H transfer to form a water molecule (H2O). Next, adsorption of CH3COCH3 on the oxygen-deficient Mo site forms an O–Mo bond and then the chemisorbed CH3COCH3 forms CH3COCH2 by transfer of an H atom to an adjacent Ot site. The surface bound hydroxyl (OH) then transfers the H atom to the immobilized O atom to form surface-bound enol, CH3CHOCH2. The next step releases CH3CHCH2 into the gas phase, while simultaneously oxidizes the surface back to a perfect O-terminated α-MoO3 (010) surface. The adsorption of H2,...
E-cigarette Use Among US Adults: Population Assessment of Tobacco and Health (PATH) Study.

Introduction In 2011 the US Food and Drug Administration launched the Population Assessment of Tobacco and Health (PATH) Study to gather information for regulatory activities authorized by the Family Smoking Prevention and Tobacco Control Act (TCA). Methods Data were drawn from the first wave of the PATH survey, involving interviews of 32 320 civilian and non-institutionalized adults. In addition to conventional classifications for current, former and never smoking and e-cigarette use, we used PATH questions to classify former and current triers of these products. Descriptive statistics were used to describe the prevalence, patterns of, and reasons for e-cigarette use, and the perceptions of nicotine and e-cigarettes among user groups, according to smoking status. Results The prevalence of current smoking was 18%; an additional 3.1% of participants were current triers. The prevalence of current e-cigarette use was 2.4% (1.0% every day, 1.4% some days), with another 3.2% as current triers. The majority of nonsmokers who were current e-cigarette users were already current (56%) or former (34%) cigarette triers. Reasons for e-cigarette use were similar across subgroups, but patterns of use were different. Majorities of participants believed that nicotine is the main substance driving tobacco use, that nicotine causes most cancers, and that e-cigarettes were less harmful than cigarettes. Conclusions E-cigarettes were used primarily by current smokers and recent former smokers. The main reasons for use center around perceptions that e-cigarettes are less harmful than cigarettes to users and others. Implications This study reports detailed information about the prevalence, patterns of, and reasons for e-cigarette use in the first (baseline) wave of the PATH Study in 2014. In addition to conventional categories for current, former and never smoking and e-cigarette use, the PATH questionnaire facilitated classification of new usage groups consisting of current and former triers of these products, which may impact prevalence estimates.
Perspectives on Adaptive Capacity to Climate Change in Hazardous Environments: Insights from Broward County, Florida

AbstractParticular social factors can limit or promote adaptive capacity and resilience in hazardous environments. Understanding these factors is essential for developing planning tools for risk re...
Design of hydrogels to stabilize and enhance bone morphogenetic protein activity by heparin mimetics.

Abstract Although bone morphogenetic protein-2 (BMP-2) is known to be the most potent stimulator available for bone formation, a major barrier to widespread clinical use is its inherent instability and absence of an adequate delivery system. Heparin is being widely used in controlled release systems due to its strong binding ability and protective effect for many growth factor proteins. In this work, we developed a hydrogel surface that can mimic heparin to stabilize BMP-2 and to enhance osteogenesis by introducing heparin-mimicking sulfonated molecules such as poly-vinylsulfonic acid (PVSA) or poly-4-styrenesulfonic acid (PSS), into photo-crosslinkable hydrogel. Bioactivity of BMP-2 was well preserved in the presence of polysulfonates during exposure to various therapeutically relevant stressors. The heparin-mimicking sulfonated hydrogels were effective to bind BMP-2 compared to unmodified MeGC hydrogel and significantly enhanced osteogenic differentiation of encapsulated bone marrow stromal cells (BMSCs) without the addition of exogenous BMP-2. The sulfonated hydrogels were effective in delivering exogenous BMP-2 with reduced initial burst and increased BMSCs osteogenesis induced by BMP-2. These findings suggest a novel hydrogel platform for sequestering and stabilizing BMP-2 to enhance osteoinductive activity in bone tissue engineering. Statement of Significance Although bone morphogenetic protein-2 (BMP-2) is believed to be the most potent cytokine for bone regeneration, its clinical applications require supraphysiological BMP dosage due to its intrinsic instability and fast enzymatic degradation, leading to worrisome side effects. This study demonstrates a novel hydrogel platform that mimics a natural protector of BMPs, heparin, to sequester and stabilize BMP-2 for increased osteoinductive signaling. This study will achieve the stabilization of BMPs with prolonged bioactivity by a synthetic heparin mimic that has not been examined previously. Moreover, the heparin mimetic hydrogel surface can augment endogenous BMP activity by sequestering and localizing the cell-produced BMPs. The additional knowledge gained from this study may suggest basis for future development of material-based therapeutics for tissue engineering.
User experience design to enhance the effectiveness of mobile technologies for the treatment of mental health

In America, half of the population experiences mental health issues in their lifetime. Less than one third, however, will receive treatment. The National Institute of Mental Health calls for research on new, scalable methods for treating mental illness. Cognitive Bias Modification (CBM) is used to alter responses to situations that make participants feel anxious or upset. In this paper, we analyze data from an online, session-based, CBM training program for anxiety in order to make recommendations to improve the user experience increasing engagement and adherence to the program. Our objectives include maximizing user value, decreasing attrition, and minimizing user burden. To meet our objectives, we are analyzing data related to attrition and user engagement and implementing principles of user experience design such as improved visuals and typography and elements of gamification. Preliminary analyses indicate that the highest number of dropouts were less educated participants leaving the program and the highest rates of attrition were shown towards the beginning of the sessions. Additionally, a redesigned interface will be deployed and future data will be collected to determine its effect on attrition.
Intravenous iron therapy in chronic kidney disease and peritoneal dialysis patients.

Identical National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) hematologic and iron targets apply to chronic kidney disease (CKD), peritoneal dialysis (PD), and hemodialysis (HD) patients, yet intravenous (i.v.) nondextran iron therapy is FDA approved only in HD patients. This is because oral iron has been considered adequate in CKD and PD patients, and delivering a parenteral therapy on a frequent basis to an outpatient population with notoriously poor vascular access presents logistical complexities. However, recognition of the need for more aggressive treatment of anemia in the CKD and PD population is growing. This awareness, along with the improved safety profiles of the new, nondextran irons, is tipping the risk-benefit ratio toward more widespread use of i.v. iron in these patients. This article provides a summary of the literature and of our own experience using i.v. iron therapy in CKD and PD patients. Our protocol relies on early monitoring and intervention with i.v. ferric gluconate before severe iron deficiency develops. The proactive approach allows for relatively infrequent treatments at only moderately "high" doses (250 mg) of ferric gluconate. The convergence of convenience and safety may expedite more energetic anemia prevention and treatment in PD and CKD patients.
Disinterment from paving materials: Use of heavy equipment for exhumation and examination of bodies

Common paving materials—concrete and asphalt—pose an unusual and complex barrier to disinterment and examination of human remains. Although not commonly encountered, these materials are seen with sufficient frequency to justify consideration of the procedures and equipment necessary for disinterment. Over a seven year period we have encountered paving materials seven times. In each of these cases, the material was slightly different in quality, and different tools—including heavy construction equipment—were necessary. Sometimes the paving material could be managed without heavy power tools, but occasionally specialized construction tools have proven very useful.
Vancomycin-associated drug-induced hypersensitivity syndrome.

Background Although hypersensitivity reactions are well characterized for certain medications, vancomycin-associated drug-induced hypersensitivity syndrome (DIHS), or drug reaction with eosinophilia and systemic symptoms (DRESS), has yet to be defined. Objective To better define the clinical phenotype of vancomycin-associated DIHS. Methods A retrospective case series was conducted over an 8-year period at a single, academic institution. A total of 29 cases of DIHS/DRESS were identified, of which 4 were attributed to vancomycin. A literature review was performed; it identified 28 additional cases of vancomycin-induced DIHS. Vancomycin-associated acute interstitial nephritis was also reviewed to detect additional, previously uncharacterized cases of systemic hypersensitivity. The review yielded 11 additional cases. Results In this literature review and retrospective series, the incidence of renal dysfunction among vancomycin-induced cases (75% and 68% of cases in the series and literature, respectively) was notably higher than the overall reported incidence in DIHS (10%-40%). The degree of renal impairment was also significantly increased in the retrospective series (a median 4.98-fold change in baseline creatinine level vs a 2.25-fold increase in non–vancomycin-associated cases [P = .011]). Limitations The principal limitation of this study is the small sample size. Other notable limitations include the retrospective nature of the study and absence of confirmatory renal biopsies. Conclusion Although the current understanding of DIHS/DRESS is imperfect, our findings suggest that vancomycin-induced cases present with a unique phenotype characterized by a higher burden of renal involvement.
Review of Have Dog Will Travel

A book review of Have Dog Will Travel, a memoir about a poet’s relationship with his Guide Dog.
A tabletop adaptive optics demonstrator for STEM outreach activities

The Air Force Research Laboratory’s Laser Division faces the unique challenge of explaining the intricate technical problems in its research portfolio to a varied audience that includes upper military leadership who control program funding all the way to students of all levels as part of STEM outreach activities. An innovative solution to this challenge was developed by a team of junior scientists and engineers in the form of a series of table top demos used to visually illustrate some of the key technical challenges and fundamental science the lab is working on. One of the most challenging problems facing our team is the degrading optical effect caused by turbulence. Modern laser weapons systems utilize Adaptive Optics (AO) to correct for many of these effects and thus our team set out to showcase an AO system approachable to the public. This paper highlights how we use a commercial product as the center of our demo, lessons we have learned while showcasing this demo and a few expansion possibilities. This system boasts a unique ability to speak to all ages and thus has been used to explain key concepts to military leadership at the Pentagon as well as expose elementary students across the USA to STEM challenges. This system is one of a two-part set. The other, focusing on Line-of-Sight Stabilization, is discussed in a sister paper.
A RARE COMPLICATION OF A RARE DISEASE: PERICARDITIS RELATED TO RUPTURED PERICARDIAL CYST

Pericardial cysts are rare. Although generally asymptomatic and detected incidentally, patients may represent with chest discomfort, dyspnea or palpitations. Pericarditis related to a ruptured pericardial cyst has not been previously reported 62 year-old male presented with NYHA class III dyspnea.
Imagination, Non-existence, Impossibility

Imagination is one of the most important human abilities. It is deployed in the most mundane parts of human life, such as deciding what to have for breakfast. But it is also at the core of all creative acts, of the kind performed by scientists, mathematicians, philosophers, novelists, musicians, political reformers, visionaries. And it does not take long to see that it is puzzling. I can clearly imagine things that do not exist, and never will exist, such as Anna Karenina, and the Taj Mahal in London. But if I kick something, it has to be there to be kicked. How can I imagine something if it is not there to be imagined? Even worse, the things I imagine may even be impossible. A mathematician imagines that a certain equation has a solution, and then proves that there can be no such thing: it is a mathematical impossibility. How can I imagine something when it is impossible for it to exist?
Cannabis Use in Inpatients With Schizophrenia Spectrum Disorders at a Community Hospital

Background: Cannabis is the second most used recreational drug in the United States and one of the most used substances in patients with schizophrenia spectrum disorder (SSD). Unfortunately, the increased use is likely to continue as more states legalize recreational use of cannabis. Although the association between cannabis and schizophrenia has been studied extensively, the understanding of the relationship is still evolving. In this study, we sought to determine the prevalence and potential factors associated with cannabis use (CU) among inpatients with SSD at a community teaching hospital. Methods: We performed a retrospective review of the electronic medical charts of patients discharged from the psychiatric unit of our hospital from July 1, 2017 through October 31, 2017. Patients were included in this study if: 1) They were â‰¥ 18 years old; 2) They had discharge diagnosis of SSD; and 3) They had urine drug testing performed. Pertinent sociodemographic and clinical variables, including substance use status and hospital length of stay (LOS), were abstracted. Univariate frequencies and summary statistics were performed. Odds ratios (ORs) were determined by logistic regression analysis of bivariate and multivariate analyses. Results: Three hundred sixty-five (52.2%) patients had a discharge diagnosis of SSD, and only 322 had urine toxicology result for cannabinoids and were included in analysis. Of the 322 patients, 41.5% (n = 133) screened positive for cannabinoids. Of the 133 patients, 78% were African American, 15% were Hispanic and 5% were White; 77% were male and the median age was 36 years. Bivariate analyses showed tobacco use (OR: 2.8, 95% confidence interval (CI): 1.7 - 4.6), alcohol use (OR: 3.4, 95% CI: 2.9 - 7.0), younger age (OR: 2.8, 95% CI: 1.8 - 4.5), male gender (OR: 2.9, 95% CI: 2.2 - 3.2), unemployment (OR: 3.91, 95% CI: 3.49 - 7.35), homelessness (OR: 3.18, 95% CI: 2.76 - 3.84) and LOS (OR: 3.46, 95% CI: 2.93 - 4.31) were significantly associated with CU. Result of multivariate analysis was similar to that found in bivariate analysis. Conclusions: CU appears to be prevalent among patients with SSD. Clinicians and public health professionals are encouraged to understand the health implications of its use in patients with mental illness especially against the backdrop of current marijuana laws. J Clin Med Res. 2020;12(4):243-250 doi: https://doi.org/10.14740/jocmr4110
3PC-038 Physicochemical stability of the bevacizumab biosimilar, ABP 215, in intravenous bags after preparation and storage

Background and importance ABP 215 (MVASI) is the first approved biosimilar to Avastin (bevacizumab reference product, RP). ABP 215 presents an alternative and effective treatment option. ABP 215 is administered intravenously after dilution in an infusion bag and confers its action by binding vascular endothelial growth factor (VEGF)-A and preventing its interaction with VEGF receptors on endothelial cells, resulting in angiogenesis inhibition. Extended physicochemical stability under in use conditions is valuable to enable administration flexibility by ensuring efficacy during handling conditions not covered by standard stability studies. Aim and objectives The aim of the study was to evaluate the physicochemical stability of ABP 215 after dilution, storage and infusion during potentially worst case handling conditions. Material and methods Low and high dose ABP 215 solutions were prepared in polyvinyl chloride and polyolefin intravenous (IV) bags. Prepared bags were stored at 2–8°C for 35 days and then stored at 30°C for 2 days, followed by IV infusion simulation. Stability indicating assays were selected to assess product quality on initial dilution into the IV bags, at prespecified time points during the 2–8°C refrigerated storage, 30°C storage, and prior and following the infusion. Stability indicating assays were selected to assess drug product quality. Size variants were assessed via size exclusion chromatography. Fragmentation was assessed via reduced capillary electrophoresis. Charge heterogeneity was assessed via cation exchange chromatography. Subvisible particle formation trends were assessed via subvisible particle testing and potential visible proteinaceous particle formation trends were assessed via visual inspection. Protein concentration was monitored for changes. Product quality consistency was evaluated via potency measurements. Results After dilution, storage and infusion, ABP 215 solutions showed no changes outside of product acceptance criteria in molecular size or charge variants, fragmentation, particulate formation, protein concentration or potency. Conclusion and relevance Across the evaluated worst case handling conditions, a robust set of stability indicating assays showed that ABP 215 product quality and activity remained within the product acceptance ranges over the examined extended storage. References and/or acknowledgements Conflict of interest Corporate sponsored research or other substantive relationships: All authors are employees and stockholders of Amgen Inc.
Classification of gastrointestinal symptom patterns in young adults.

The purpose of this study was to identify common gastrointestinal (GI) symptom groups using the Patient-Reported Outcomes Measurement Information System - GI symptom scales (PROMIS-GI) within a large sample of young adults. An attempt was made to relate the emergent groups to the Rome IV disorders of gut-brain interaction symptom domains. The PROMIS-GI is a freely available, adaptable, normatively referenced symptom measurement system that is applicable to many health assessment situations. Participants were 956 introductory psychology students between the ages of 18 and 25 who completed the PROMIS-GI as part of ongoing research monitoring physical and psychological health of students at a major southeastern university. GI symptom groups were determined using a latent class analysis (LCA) approach. These GI symptom groups were then compared on key psychosocial factors including self-reported mood, anxiety, and health related quality of life (HRQoL) using MANOVA. Three groups were identified based on GI symptom elevations: Normal (n = 649), Mild (n = 257), and Moderate (n = 50). Self-reported anxiety, depression, and bodily pain levels were significantly higher in the Mild and Moderate GI symptom groups, and they indicated significantly lower work functioning, and general health ratings compared to participants in the normal group. Approximately a third of young adults surveyed were experiencing at least one GI symptom of a severity greater than normative levels. Both the Mild and Moderate GI groups demonstrated a similar configuration of symptoms with significantly the higher levels of pain, gas/bloating, and nausea/vomiting compared to the Normal group. The configuration of symptoms did not map discretely onto the Rome IV diagnostic categories for Bowel Disorders, such as IBS with predominant Diarrhea or Functional Constipation as might be expected. Rather, the emergent groups suggest that Bowel Disorders occur on a continuum of severity across multiple symptom areas. Mild to moderate GI symptoms appear to emerge at much earlier ages and are more frequent than previously documented. It is recommended that health service providers evaluate individual patterns of “GI health” when young adults present with anxiety and depression, and conversely, they should assess anxiety and depression when they present with GI complaints.
Characterization and Systemic Delivery of Dibenzoylmethane via the Intranasal Route

Intranasal (IN) administration is known to be noninvasive with the potential to carry a drug or vaccine directly to the blood, bypassing first-pass metabolism in the liver and the harsh environment of the gastrointestinal system. Orally administered dibenzoylmethane (DBM) has been shown experimentally to be neuroprotective in animal models of tauopathy and prion disease and effective in the treatment of certain forms of cancers. The purpose of this study was to prepare, characterize, and test formulations of DBM designed for IN administration. DBM was formulated in brain homogenate (BH) and hypromellose and as nanoparticles (NPs). These formulations were detected using UPLC and characterized in solid and suspension states; NPs were also characterized by in vitro cell culture–based studies. Particle size for DBM NP was 163.8 ± 3.2 nm, and in vitro release studies showed 95.80% of DBM was released from the NPs within 8 days. In vitro cell, culture studies suggested no drug uptake until 6 h. A histological analysis of nasal cavity (NC) sections and blood detection studies were carried out 30 min after inhalation. DBM amounting to 40.77 ± 4.93 and 44.45 ± 5.36 ng/mL was detected in the blood of animals administered DBM in polymeric and NP formulation, respectively. Histological studies on NCs confirmed the presence of BH within lymphatic vessels in the lamina propria of each animal; BH was identified traversing the mucosa in 2 animals. Thus, formulations for DBM administered via IN route were successfully designed and characterized and able to cross the nasal mucosa following inhalation.
Transoral robotic submandibular gland transposition to reconstruct radical tonsillar resection defects

Significant dysphagia, pain, and risk of bleeding occur after transoral robotic surgery (TORS) radical tonsillectomy. We present a novel surgical technique utilizing robotically assisted submandibular gland transposition (SMGT) to reconstruct the radical tonsillar defect. A 48-year-old male with p16+ tonsillar squamous cell carcinoma underwent deep TORS radical tonsillectomy, contralateral tonsillectomy, ipsilateral neck dissection, and TORS-assisted reconstruction of the radical defect with ipsilateral SMGT. Postoperatively, the patient experienced minimal pain and was discharged on postoperative day (POD) 3 tolerating a soft diet. There were no episodes of postoperative bleeding. This procedure was performed in five other cases as well. Transoral robotic SMGT can be used successfully to repair deep TORS radical tonsillectomy defects and may theoretically reduce dysphagia, pain, and the risk of hemorrhage.
Cerebral Amyloid Angiopathy Burden and Cerebral Microbleeds: Pathological Evidence for Distinct Phenotypes.

Background The relationship between cerebral microbleeds (CMBs) on hemosiderin-sensitive MRI sequences and cerebral amyloid angiopathy (CAA) remains unclear in population-based participants or in individuals with dementia. Objective To determine whether CMBs on antemortem MRI correlate with CAA. Methods We reviewed 54 consecutive participants with antemortem T2 *GRE-MRI sequences and subsequent autopsy. CMBs were quantified on MRIs closest to death. Autopsy CAA burden was quantified in each region including leptomeningeal/cortical and capillary CAA. By clustering approach, we examined the relationship among CAA variables and performed principal component analysis (PCA) for dimension reduction to produce two scores from these 15 interrelated predictors. Hurdle models assessed relationships between principal components and lobar CMBs. Results MRI-based CMBs appeared in 20/54 (37%). 10 participants had ≥2 lobar-only CMBs. The first two components of the PCA analysis of the CAA variables explained 74% variability. The first rotated component (RPC1) consisted of leptomeningeal and cortical CAA and the second rotated component of capillary CAA (RPC2). Both the leptomeningeal and cortical component and the capillary component correlated with lobar-only CMBs. The capillary CAA component outperformed the leptomeningeal and cortical CAA component in predicting lobar CMBs. Both capillary and the leptomeningeal and cortical components correlated with number of lobar CMBs. Conclusion Capillary and leptomeningeal/cortical scores correlated with lobar CMBs on MRI but lobar CMBs were more closely associated with the capillary component. The capillary component correlated with APOEɛ4, highlighting lobar CMBs as one aspect of CAA phenotypic diversity. More CMBs also increase the probability of underlying CAA.
Parents' willingness to pay for a COVID-19 vaccine for themselves and their children in the United States

Differences in obtaining a vaccine vary based on a multitude of factors including perceptions of vaccine safety, efficacy and willingness to pay (WTP). This study focuses on parent perceptions towa...
FIFA 11+ Kids program effects on jump kinetics in soccer players - A randomized controlled clinical trial.

This study aimed to analyse the effects of the FIFA 11+ Kids programme on jump kinetics in soccer players. Twenty-four athletes (aged 9-11 years) were randomly allocated to the following groups: 1) the FIFA 11+ Kids programme (FT, n = 12), and 2) control training (CT, n = 12). Kinetic assessments of vertical jump (VJ), drop landing (DL), and anterior jump + maximum vertical jump (AJ) were performed on a force platform before and after eight weeks of training. Post-intervention impulse peak force and maximum impulse force (VJ) were significantly greater than the baseline values in the FT group (P < 0.001). Post-intervention landing peak force values for the first and second landings (DL) were significantly greater than the baseline values in the FT group (P = 0.01 and P = 0.05, respectively). Post-intervention landing peak force in the first landing (AJ) was significantly greater than the baseline values in the FT group (P = 0.005). The FT was effective in improving the impulsion performance during VJ. However, it increased the landing forces during DL and VJ.
Pulmonary Hypertension in Critically Ill Patients

Pulmonary hypertension (PH) in critically ill patients requiring the intensive care unit (ICU) is a complex and challenging disorder. Whether the elevations of pulmonary arterial pressures are acute or preexisting, significant PH in the setting of acute illness can lead to rapid deterioration of right ventricular (RV) function, precipitating hemodynamic collapse and death. Outcomes of patients with PH who require the ICU are quite poor. In patients with underlying pulmonary arterial hypertension (PAH) or inoperable chronic thromboembolic PH (CTEPH) who are admitted to the ICU, mortality rates between 30 and 41 % have been reported. Given their fragile hemodynamic status, understanding the pathogenesis of RV failure secondary to PH is critical for RV rescue and successful treatment of these patients. In this chapter, we will discuss the pathophysiology of RV failure and management of PH and RV failure in the ICU.
Congenital hypertrophy of the lower extremity associated with elephantiasis

Abstract A case of a patient with both congenital hypertrophy of a limb and elephantiasis due to a congenital malformation of the subcutaneous tissues with diffuse hemangioma, connective tissue proliferation, and lymphatic insufficiency is reported. The successful operative treatment is discussed.