cssi/SciSciGPT-SciSciNet huggingface dataset:
Reassessing the boundaries of liver transplantation for hepatocellular carcinoma: Where do we stand with tumor down-staging?

Down-staging of hepatocellular carcinoma prior to liver transplantation (LT) has generated a lot of interest in recent years and has been identified in two recent national conferences on hepatocellular carcinoma as one of the priorities for research. Down-staging is defined as reduction in the tumor burden using local regional therapy specifically to meet acceptable criteria for LT. The rationale behind down-staging of tumors initially exceeding conventional criteria for LT is to select a subgroup of tumors with favorable biology and prognosis for LT as assessed by their response to local regional therapy. The expectation is to achieve comparable posttransplant survival between patients who achieve successful tumor down-staging before LT and those whose tumors meet LT criteria at the outset without needing down-staging. The application of tumor down-staging requires a highly structured approach using a treatment protocol that includes five essential components: eligibility criteria, down-staging endpoints, selection of the type of local regional therapy, minimal observation period from successful tumor down-staging to LT, and criteria for treatment failure and exclusion from LT. This review article summarizes published data on down-staging and addresses key questions related to each of the components of the down-staging protocol as well as treatment efficacy. Conclusion: Based on a review of published data and recommendations from recent national and international conferences on hepatocellular carcinoma and LT, a standardized down-staging protocol is proposed to further evaluate the feasibility and efficacy of applying tumor down-staging on a broader scale. (Hepatology 2016;63:1014–1025)
Letters of Denunciation in the Lyon Region, 1940-1944

While the historiography concerning practices of denunciation in central and eastern Europe has advanced rapidly in the last decade, this has not been the case in terms of western Europe. Scholars have devoted impressive amounts of energy to the study of collaboration, but few have touched upon denunciation - except perhaps in pass ing with an oblique reference to a letter of denunciation. In trigued by such references and strongly influenced by Alltagsgeschichte, this essay offers an introduction to the culture of denunciation in the departements of Isere and Rhone, of the Lyon region of France, during World War II. Organized around four specific cases, this essay explores a spectrum of denunciatory experiences found in a sampling of letters and judicial records from French local and na tional archives. Reports and correspondence of the prefects, gendarmerie, and police forces provide greater context and help to flesh out these examples.1
UAV Scheduling via the Vehicle Routing Problem with Time Windows

In an urban environment, multiple small unmanned aerial vehicles (UAVs) may be utilized to locate, surveil, or attack various targets. Whatever the task, the air vehicles must cooperate by efficiently communicating with each other and optimally assigning each UAV to the appropriate task at the appropriate target and at the appropriate time. In this paper, a vehicle assignment algorithm is developed using a mixed integer linear program (MILP) to find the global optimal scheduling solution. The MILP can accommodate both binary and continuous decision variables as well as a variety of constraints and objective functions; however, the NP-hard nature of the problem implies a dramatic increase in the computing complexity as the number of variables and constraints increase. This formulation accounts for an assortment of scenarios focused on the military necessity for precise intelligence, surveillance, and reconnaissance (ISR) by modifying the vehicle routing problem with time windows (VRPTW) formulation. The VRPTW is a type of capacitated vehicle routing problem which optimally assigns a designated number of delivery vehicles originating at a single depot to a known number of customers. Specifically, the VRPTW and network flow techniques account for various scenarios as well as operator imposed timing constraints such as precedence constraints. For example, certain targets may take precedence or require simultaneous arrival times where the targets are first hierarchically clustered according to their proximity to each other. Thus, this paper also focuses on methods of clustering targets and implements this information into the MILP to optimally assign UAVs to targets. Clustering targets that are near enough to alert each other of an attack will allow UAVs to recognize this potential and hence surveil these targets simultaneously to avoid early detection. This technique will also prevent targets from being further camouflaged or moved once alerted to a nearby attack. Finally, this paper will directly compare the computation times and solutions for the min makespan objective, the minimum total time objective, and the total distance minimization.
Epigenetics, Enhancers, and Cancer

The first molecular studies of cancer revealed DNA mutations resulting in activation of proto-oncogenes or loss of function of tumor suppressors. These studies formed the basis for the canonical model of the molecular etiology of cancer: DNA mutations in a small number of protein-coding genes lead to increased rates of cellular proliferation. Subsequent to these landmark studies, technological advances have allowed for more thorough characterization of the molecular changes that occur during malignant transformation. Among these advances has been the discovery that gene enhancer elements are key drivers of gene expression in eukaryotic cells and that enhancer elements can be identified through epigenomic profiling of specific chemical modifications on chromatin. In the past several years, epigenomic profiling studies have revealed that enhancer activity is broadly reprogrammed in cancer cells as they transform from their normal precursors during carcinogenesis. Moreover, this enhancer reprogramming results in activation and suppression of specific transcriptional programs and drives many of the characteristic behaviors of tumor cells. In light of these findings, the classic model of malignant transformation has been broadened to include epigenetic changes in enhancer activity as well as DNA mutations to coding genes. In this chapter, we summarize what is known about normal enhancer function in cellular development and differentiation. Next, we outline the most widely utilized technologies for interrogating enhancer activity across epigenomes. We then describe how these approaches have yielded new insights into tumor biology both through enhancer profiling alone and integration of this information with DNA mutations to the genes that regulate enhancer activity and to enhancers themselves. Finally, we describe how these insights have begun to be translated into novel approaches for the diagnosis and treatment of cancer. The goal of this chapter is to give a broad background on both the foundation and the current state of the art of this field to familiarize the reader with the progress that has been made and the exciting new potentials for improved patient care resulting from the study of epigenetic enhancer dysregulation in cancer.
Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia.

Abstract Introduction Clinical features of dementia (cognition, function, and behavioral and psychological symptoms) may differentially affect out-of-pocket medical and nursing home (NH) expenditures and informal care received (outcomes). Methods We used cross-sectional data (Aging, Demographics, and Memory Study) to estimate probabilities of experiencing outcomes by clinical features. For those experiencing an outcome, we estimated effects of clinical features on the amount of the outcome. Results No clinical feature predicted the probability of having out-of-pocket medical expenditures. For those with medical expenditures, higher cognition and poorer function were associated with more spending. Poorer function predicted having out-of-pocket NH expenditures. For those with NH expenditures, no clinical feature predicted the amount. Poorer function and a greater number of behavioral and psychological symptoms predicted the probability of receiving caregiving. For those receiving care, poorer function was associated with more caregiving. Conclusions Clinical features differentially impact outcomes with poorer function associated with all types of costs and caregiving received.
Isolation of a Membrane Protein Complex for Type VII Secretion in Staphylococcus aureus.

The ESAT6-like secretion system (ESS) of Staphylococcus aureus promotes effector protein transport across the bacterial envelope. Genes in the ESS cluster are required for S. aureus establishment of persistent abscess lesions and the modulation of immune responses during bloodstream infections. However, the biochemical functions of most of the ESS gene products, specifically the identity of secretion machine components, are unknown. Earlier work demonstrated that deletion of essB, which encodes a membrane protein, abolishes S. aureus ESS secretion. Loss-of-function mutations truncating the essB gene product cause dominant-negative phenotypes on ESS secretion, suggesting that EssB is a central component of the secretion machinery. To test this prediction, we purified native and affinity-tagged EssB from staphylococcal membranes via dodecyl-maltoside extraction, identifying a complex assembled from five proteins, EsaA, EssA, EssB, EssD, and EsxA. All five proteins are essential for secretion, as knockout mutations in the corresponding genes abolish ESS transport. Biochemical and bacterial two-hybrid analyses revealed a direct interaction between EssB and EsaA that, by engaging a mobile machine component, EsxA, may also recruit EssA and EssD. IMPORTANCE Type VII secretion systems support the lifestyle of Gram-positive bacteria, including important human pathogens such as Bacillus anthracis, Mycobacterium tuberculosis, and Staphylococcus aureus. Genes encoding SpoIIIE-FtsK-like ATPases and WXG100-secreted products are conserved features of type VII secretion pathways; however, most of the genes in T7SS clusters are not conserved between different bacterial species. Here, we isolate a complex of proteins from the membranes of S. aureus that appears to represent the core secretion machinery, designated ESS. These results suggest that three membrane proteins, EsaA, EssB, and EssA, form a secretion complex that associates with EssC, the SpoIIIE-FtsK-like ATPase, and with EsxA, a mobile machine component and member of the WXG100 protein family.
Development and Function of Inhibitory Circuitry in the Avian Auditory Brainstem

The avian auditory system has provided an excellent model circuit to explore important features of acoustic processing. For example, in the chicken (Gallus gallus) system, in 1975 Parks and Rubel first confirmed the coincidence detection based delay line model of sound localization in vertebrates that was originally proposed by Jeffress in 1948. Further, the system provides an unmatched experimental substrate to investigate cellular physiology and morphology in light of computational function. Many anatomical and physiologically specialized features of auditory neurons have been identified first in birds, and often complementary properties are observed in mammals. These discoveries have contributed substantially to our general understanding of processing of acoustic signals, and the function of inhibition specifically. However, many mechanistic features of inhibitory physiology in the avian system contrast sharply with those of mammals, while achieving similar computational outcomes. This chapter reviews the major progress made toward understanding inhibitory roles in auditory function with a focus on three areas: (1) development of inhibitory circuitry, (2) functional organization of the inhibitory network, and (3) synaptic physiology of inhibition in birds. Although many specific mechanisms of inhibition in birds differ from those of mammals, these circuits exhibit remarkable convergence when viewed from a functional perspective.
Differences in Post-Operative Outcome Between Conversion and Primary Total Hip Arthroplasty

Abstract Background The demand for conversion of prior hip surgery to total hip arthroplasty (conversion THA) is likely to increase as a function of increasing US hip fracture burden in addition to its application in managing other conditions. Thus, outcome analysis is warranted to better inform value-based reimbursement schemes in the era of bundled payments. Methods Via Current Procedural Terminology codes, the National Surgical Quality Improvement Project data files were queried for all patients who underwent primary THA and conversion of previous hip surgery to THA from 2005 to 2014. To better understand the isolated effect of procedure type on adverse outcomes, primary and conversion cohorts were then propensity-score matched via logistic regression modeling. Comparisons of the study's primary outcomes were drawn between matched cohorts. Statistical significance was defined by a P-value less than or equal to .05. Results Relative to the primary THA group, the conversion THA group had statistically greater rates of Center Medicare and Medicaid Services (CMS) complications (7.5% vs 4.5%), non-home bound discharge (19.6% vs 14.7%), and longer length of hospital stay. Conversion THA was associated with increased likelihood of CMS complications (odds ratio 1.68, confidence interval 1.39-2.02) and non-home bound discharge (odds ratio 1.41, confidence interval 1.25-1.58). No statistically significant differences in mortality and readmission were detected. Conclusion The elevated risk for CMS-reported complications, increased length of hospital stay, and non-home bound discharge seen in our study of conversion THA indicates that it is dissimilar to elective primary THA and likely warrants consideration for modified treatment within the Comprehensive Care for Joint Replacement structure in a manner similar to THA for fracture.
Introduction: Basilar Artery Aneurysms

Abstract Basilar artery aneurysms represent a diverse group of lesions with regard to anatomical location, regional anatomy, pathogenesis, and treatment options. The following sections introduces you to a section of chapters detailing basilar terminus, posterior cerebral artery/superior cerebellar artery, and basilar trunk aneurysms. These aneurysms have always posed a treatment challenge to neurosurgeons, and still require a thoughtful approach despite a rapidly increasing armamentarium of tools. This expansion and evolution of treatment options means that patients and neurosurgeons now have the ability to tailor the treatment to the individual aneurysm to achieve the safest and most effective outcome.
Chapter 8 Strategic analysis of auctions

Publisher Summary This chapter describes several forms of auctions, presents the formulations used in the main models, reviews some of the general results and empirical findings, and indicates a few applications. Auctions have been used for millennia, and remain the simplest and most familiar means of price determination for multilateral trading without intermediary market makers such as brokers and specialists. Their trading procedures, which simply process bids and offers, are direct extensions of the usual forms of bilateral bargaining. Auctions also implement directly the demand submission procedures used in Walrasian models of markets. They therefore have prominent roles in the theory of exchange and in studies of the effects of economic institutions on the volume and terms of trade. Their allocative efficiency in many contexts ensures their continued prominence in economic theory. They are also favored in experimental designs investigating the predictive power of economic theories. Auctions are apt subjects for applications of game theory because they present explicit trading rules that largely fix the rules of the game. They present substantive problems of strategic behavior of practical importance. They are particularly valuable as illustrations of games of incomplete information because bidders' private information is the main factor affecting strategic behavior. The simpler forms of auctions induce normal-form games that are essentially solved by applying directly the basic equilibrium concepts of noncooperative game theory, such as the Nash equilibrium, without recourse to criteria for selecting among multiple equilibria. The common-knowledge assumption on which game theory relies is often tenable or innocuous applied to an auction.
Full correlation matrix analysis (FCMA): An unbiased method for task-related functional connectivity.

Abstract Background The analysis of brain imaging data often requires simplifying assumptions because exhaustive analyses are computationally intractable. Standard univariate and multivariate analyses of brain activity ignore interactions between regions and analyses of interactions (functional connectivity) reduce the computational challenge by using seed regions of interest or brain parcellations. New method To meet this challenge, we developed full correlation matrix analysis (FCMA), which leverages and optimizes algorithms from parallel computing and machine learning to efficiently analyze the pairwise correlations of all voxels in the brain during different cognitive tasks, with the goal of identifying task-related interactions in an unbiased manner. Results When applied to a localizer dataset on a small compute cluster, FCMA accelerated a naive, serial approach by four orders of magnitude, reducing running time from two years to one hour. In addition to this performance gain, FCMA emphasized different brain areas than existing methods. In particular, beyond replicating known category selectivity in visual cortex, FCMA also revealed a region of medial prefrontal cortex whose selectivity derived from differential patterns of functional connectivity across categories. Comparison with existing method(s) For benchmarking, we started with a naive approach and progressively built up to the complete FCMA procedure by adding optimized classifier algorithms, multi-threaded parallelism, and multi-node parallelism. To evaluate what can be learned with FCMA, we compared it against multivariate pattern analysis of activity and seed-based analysis of functional connectivity. Conclusions FCMA demonstrates how advances in computer science can alleviate computational bottlenecks in neuroscience. We have released a software toolbox to help others evaluate FCMA.
Kinesin-5 Regulation and Function in Mitosis

Chromosome segregation during cell division requires a bipolar mitotic spindle. Therefore, how the spindle is formed, maintained, and functions is of fundamental importance for all eukaryotic cells. Members of the evolutionarily conserved kinesin-5 family of motor proteins have been shown to play an essential role in spindle formation by generating forces that establish and maintain spindle bipolarity and contribute to spindle elongation. Recent work demonstrates that accessory proteins and post-translational modifications regulate the localization and activity of kinesin-5 motors in cells. In addition, some kinesin-5 motors can move toward the microtubule plus-or-minus end. This new information provides insight into how these motors function during mitosis.
Occurrence of Discussion about Lung Cancer Screening Between Patients and Healthcare Providers in the USA, 2017

Computed tomography lung cancer screening reduces lung cancer mortality. However, screening is underutilized. This study assesses the extent to which providers discuss lung cancer screening with their patients, as a lack of discussion and counseling may serve as a potential cause of low utilization rates. Data from 1667 adults aged 55–80 years sampled in the 2017 Health Information National Trends Survey was utilized. A weighted multivariable logistic regression model was fit with past-year discussion about lung cancer screening with a provider as the outcome. The adjusted odds of discussion were higher for current cigarette smokers compared to non-cigarette smokers (adjusted odds ratio = 3.91; 95% confidence interval [CI], 1.75 to 8.74). Despite higher odds, the absolute prevalence was low with only 18% (95% CI, 11.8 to 24.2%) of current adult smokers reporting a past-year discussion. Knowledge of screening from trusted sources of medical information, such as doctors, can increase screening rates and may ultimately reduce lung cancer mortality.
Cigarette smoke reduces short chain fatty acid production by a Porphyromonas gingivalis clinical isolate

Objectives We hypothesized that short chain fatty acid (SCFA) production by oral pathogens is suppressed by exposure to cigarette smoke extract (CSE). Background Tobacco smoking is a major risk factor for plaque-induced periodontal diseases. Despite increased disease susceptibility, overt oral inflammation is suppressed in smokers, presenting a diagnostic conundrum. Bacterial-derived SCFAs can penetrate into oral tissues where they influence multiple components of immune and healing responses. Indeed, the SCFA burden has been correlated with the inflammatory condition of the gingiva. However, the influence of cigarette consumption on SCFA production is unknown. Methods GC/MS was employed to monitor the production of several SCFAs (propionic acid, isobutyric acid, butyric acid, and isovaleric acid) by representative anaerobic oral pathogens (Filifactor alocis 35896, Fusobacterium nucleatum 25586, Porphyromonas gingivalis 33277) that were exposed, or not, to a physiologically relevant dose of CSE (2000 ng/ml nicotine equivalents) generated from 3R4F reference cigarettes. Results The growth of all three bacterial species was unaffected by CSE. The capacity to produce SCFAs by these bacteria was highly varied. F alocis produced the highest concentration of a specific SCFA (butyrate); P gingivalis provided the most robust overall SCFA signal, while F alocis and F nucleatum did not release detectable levels of isobutyrate or isovalerate. As P gingivalis 33277 was the broadest SCFA producer, three low-passage clinical isolates (10208C, 5607, and 10512) were also examined. Compared to unconditioned microbes, reduced SCFA release was apparent in CSE-exposed low-passage clinical isolates of P gingivalis which reached significance for one of the three isolates (propionic, isobutyric, butyric, and isovaleric acids, all P Conclusions There is high disparity in the SCFA profiles of variant chronic periodontitis-associated bacteria, while CSE exposure reduces SCFA production by a specific clinical strain of P gingivalis. If the latter phenomenon occurs in vivo, a reduced SCFA burden may help explain the reduced vascular response to dental plaque in tobacco smokers.
Predictors and outcomes of jejunostomy tube placement at the time of pancreatoduodenectomy.

Abstract Background Clinically relevant postoperative pancreatic fistula and delayed gastric emptying cause substantial morbidity after pancreatoduodenectomy. Per international guidelines, the placement of jejunostomy tubes may be considered for patients at risk for malnutrition, such as those with a high risk for clinically relevant postoperative pancreatic fistula and related complications. This study determined predictors and postoperative outcomes of jejunostomy tube placement. Methods Patients undergoing pancreatoduodenectomy in 2014 to 2015 were identified using the American College of Surgeons National Surgical Quality Improvement Program and Procedure-Targeted Pancreatectomy Participant Use Files. Multivariable logistic regressions were used to identify factors associated with concurrent jejunostomy tube placement and postoperative outcomes. Results Of 3,600 patients, 8.9% underwent jejunostomy tube placement. Patients given a jejunostomy tube were more likely white (odds ratio 1.46, P = .016), to have low preoperative serum albumin levels (odds ratio 2.13, P Conclusion Jejunostomy tube placement during pancreatoduodenectomy was not driven by risk factors for clinically relevant postoperative pancreatic fistula or delayed gastric emptying, suggesting that practice patterns play a role. Among patients with at-risk preoperative albumin or who developed these complications, jejunostomy tube placement was not associated with worse outcomes, supporting selective utilization per guideline recommendations.
Adapting to Space Limitations During Prone Real-Time Magnetic Resonance Imaging-Guided Stereotaxic Laser Ablation: Technical Pearls.

Background New techniques of intraoperative magnetic resonance imaging (MRI)-guided stereotaxy enable minimally invasive approaches to intracranial pathology. Laser interstitial thermal therapy (LITT), convection-enhanced drug delivery, and stereotactic biopsy can be performed with a real-time confirmation of location and the ability to adjust for intracranial shift during the procedure. However, these procedures are constrained by patient positioning and the need for trajectories that avoid collision between stereotactic elements and the small MRI bore. To our knowledge, this is the first report to outline the technical details of safe intraoperative MRI (iMRI)-guided stereotaxy, performed with prone positioning. Objective To present technical pearls to guide the safe conduction of iMRI-guided stereotaxy and LITT while in the prone position. Methods The details of the positioning and trajectories for a series of patients who underwent Clearpoint® (MRI Interventions Inc) frameless real-time MRI-guided stereotaxis using a posterior approach were reviewed. Results In this series, 5 patients underwent selective amygdalohippocampectomy, and 2 underwent tumor biopsy/ablation while in the prone position without any complications. Conclusion Prone iMRI procedures can be performed safely even in a 60-cm MRI bore.
Consideration of Anticoagulation: Surgical Care for the Elderly in Current Geriatrics Reports

The geriatric population in the USA is growing at a dramatic rate. As this segment of the population increases in number, surgical providers will increasingly treat and evaluate patients with age-specific needs that affect surgical or trauma management. Consequently, surgeons should be familiar with trends in prescribing oral anticoagulants (OACs), their association with outcomes, and the guidelines for reversing and prescribing these medications. Warfarin was the only oral anticoagulant available in the USA until 2010 when non-vitamin K antagonist oral anticoagulants (NOACs) were introduced to the market. Since then, they have rapidly gained a majority of the US market share. The implications of NOAC use on bleeding complications such as in traumatic brain injury (TBI) are unclear, but evidence suggests that NOACs may be safer than warfarin. Guidelines for anticoagulation reversal in life-threatening bleeding associated with warfarin are well established, but optimal utilization is evolving for most NOAC agents. The use of anticoagulation therapy has changed dramatically over the last decade. These changes are multifactorial and include the increasing prevalence of OAC use, and the introduction of NOACs. Consequently, challenges associated with managing OAC in the elderly will only become more complicated over time. Surgical providers need to be aware of these changes and update their practice on the shifting epidemiology of this population, evolving guidelines, and new reversal agents.
A Wirelessly Powered Implantable CMOS Neural Recording Sensor Array using Pulse-based Neural Amplifier

Abstract The most important organ in the human body is unquestionably the brain. Yet, despite its importance, it is one of the least well understood organs. One reason for this lack of understanding of the brain is the lack of data available to researchers from in vivo studies. Historically, collecting measurements from the brain has been difficult due to the high risk to the patient. Recently technology has been developed to allow electrical measurements to be taken from the brain directly, however most systems involve non-permanent sensors because of the requirement for transcranial wiring for power and data. Developments in the field of CMOS circuit design, wireless power transmission, and wireless data transmission have enabled the creation of implantable neural recording devices as a combination of these technologies. The implant designed in this paper is ∼15 mm in diameter and 2 mm at its thickest point on a flexible polyamide PCB. The flexible nature of the implant allows for the implant to conform to the surface of the brain. The implant requires no transcranial orifice since it is powered wirelessly and transmits data wirelessly via Bluetooth low energy. The CMOS neural amplifier chip on the implant utilizes an enhanced form of delta modulation to remove the requirement for large ADCs to be present on the die, saving space and enabling 1024 amplifiers and electrodes to be present on the chip. The implant is capable of measuring, modulating, and wirelessly transmitting a millivolt order signal to a PC for demodulation and analysis.
Adaptive Auditory Alerts for Smart In-Vehicle Interfaces:

Missing a message from an in-vehicle device can range in severity from annoying at best to dangerous at worst. The in-cab auditory environment can vary spontaneously, making some volume levels too ...
Placement of Students with Extensive Support Needs in California School Districts: The State of Inclusion and Exclusion.

Access to general education settings for students with disabilities varies greatly among and within states across the United States and worldwide. The variability in placement and lack of access to general education for students with disabilities, particularly students with extensive support needs, are reasons to identify factors associated with placement and then address the role of current policy. Explored in this study were the placement of students with extensive support needs in 938 school districts across the State of California in the United States and therelationship between placement and economic and demographic factors. Results suggest alarmingly low access to general education classrooms for students with extensive support needs, significant variability in placement, and relationships between placement and factors, such as total enrollment, race, and expenditure.
Tuning T Helper Cell Differentiation by ITK

CD4+ effector T cells effectuate T cell immune responses, producing cytokines to orchestrate the nature and type of immune responses. The non-receptor tyrosine kinase IL-2 inducible T cell kinase (ITK), a mediator of T cell Receptor signaling, plays a critical role in tuning the development of these effector cells. In this review we discussed the role that signals downstream of ITK, including the Ras/MAPK pathway, play in differentially controlling the differentiation of TH17, Foxp3+ T regulatory (Treg) cells, and Type 1 regulatory T (Tr1) cells, supporting a model of ITK signals controlling a decision point in the effector T cell differentiation process.
Preoperative testing for urethroplasty is not associated with outcomes - A NSQIP study

Abstract Objective To assess the current practice of routine preoperative testing before urethroplasty and to determine if the results are clinically significant. Methods Data was obtained from the National Surgical Quality Improvement Program (NSQIP) database. We identified 1527 patients who underwent urethroplasty from 2010 to 2017. Chi-square and one-way ANOVA tests were used to compare categorical and continuous variables, respectively. Multivariable logistic regression analyses were utilized to assess the rate of complications between testing groups. Results A total of 8455 individual laboratory tests were performed on 1156 patients (average of 7 tests per patient), with only 959 labs (11.3%) showing abnormal results. Of the 1156 patients, 629 (54.4%) patients had at least one abnormal lab. Patients who had at least one abnormal preoperative lab were found to be significantly older (51.49 ± 16.57 years vs 48.14 ± 16.32 years; P Conclusion Obtaining routine preoperative labs, especially in patients with ASA ≤2, does not affect postoperative outcomes in patients undergoing urethroplasty.
The Diagnostic Utility and Clinical Implications of Bronchoalveolar Lavage in Cancer Patients With Febrile Neutropenia and Lung Infiltrates

Introduction Febrile neutropenia (FN) is a dreaded complication of cancer chemotherapy and frequently associated with respiratory infections. Flexible bronchoscopy (FB) serves as a useful diagnostic tool in this regard. Objective To determine the diagnostic yield, safety and clinical implications of bronchoalveolar lavage (BAL) in cancer patients with FN, having lung infiltrates on radiographic chest imaging. Methods We reviewed medical records of FN patients who underwent FB at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from July 2015 till July 2018. The culture yield of BAL, resultant change of management and outcome over the subsequent 30 days were retrospectively analysed. Statistical Package for Social Sciences (SPSS) version 20 (IBM Corp., Armonk, NY) was used for data analysis. Results Ninety FN patients, with mean age 26 ± 18 years and predominantly males (65.6%, n = 59) were included in the study. Seventy-seven (85.6%) had hematological and 13 (14.4%) solid organ malignancy. The mean absolute neutrophil count was 0.20 +/- 0.36/ µL. BAL cultures were diagnostic in 40 (44%) patients; the etiology was bacterial, fungal and mixed in 25 (62.5%), 14 (35%) and one (2.5%) patient, respectively. All patients were on empirical antibiotics prior to bronchoscopy: 32 (35.6%) on antibacterial alone and 58 (64.4%) on antibacterial plus antifungal therapy. Change of management occurred in 51 (56.7%) patients after BAL results, including de-escalation from dual antibiotics in 28 (55%) and initiation of new culture sensitive antibiotic in 23 (45%). FB-associated complications developed in three (5.6%) non-intensive care patients (ICU), including transient hypoxia in two and minor hemoptysis in one patient, while five (14.8%) mechanically ventilated patients in ICU experienced worsening of oxygenation parameters within 48 hours. Overall, 24 (26.7%) patients died. Mortality was 3.7% in non-ICU and 69% in ICU setting and significantly higher in patients with fungal pneumonias (p-value 0.01) and with prolonged neutropenia (p-value 0.001). Conclusions BAL is a safe diagnostic tool for FN patients with lung infiltrates, with minimal complications and sufficient diagnostic yield to improve diagnosis and management of such patients.
Regulation of tumor immune suppression and cancer cell survival by CXCL1/2 elevation in glioblastoma multiforme

The invasiveness and high immune suppression of glioblastoma multiforme (GBM) produce poor survival of afflicted patients. Unfortunately, in the past decades, no therapeutic approach has remarkably improved the survival time of patients with GBM. Our analysis of the TCGA database and brain tumor tissue arrays indicated that CXCL1 and CXCL2 overexpression is closely associated with GBM’s aggressiveness. Our results showed that elevation of CXCL1 or CXCL2 facilitated myeloid cell migration and simultaneously disrupted CD8+ T cell accumulation at tumor sites, causing accelerated tumor progression. Yet, blockade of CXCL1/2 significantly prevented myeloid-derived suppressor cell migration and thereby increased CD8+ T cell accumulation in vitro and in vivo. CXCL1/2 also promoted the paracrine factor S100A9 and further activated Erk1/2 and p70S60k, whereas blocking CXCL1/2 down-regulated these prosurvival factors. The combination of targeting CXCL1/2 and standard temozolomide chemotherapy improved upon the antitumor efficacy of chemotherapy alone, extending the overall survival time in GBM.
It's Not What You Get but When You Get It: The Effect of Gift Sequence on Deposit Balances and Customer Sentiment in a Commercial Bank

Abstract The authors examine the impact of gifts on deposit balances and customer satisfaction in a longitudinal field experiment conducted at a commercial bank. They find that gifts increased deposit balances, survey response rates, and customer satisfaction compared with the no-gift control. They manipulated several factors within the gift treatment: gift type, the accompanying message, and the sequence of gift value, which improved ($35 then $100 gift), worsened ($100 then $35 gift), or was a single gift. A highly detrimental effect of decreasing gift value occurred on deposit balances. This “deterioration aversion” persisted in a long-term follow-up analysis of deposit balances. A vignette experiment replicates deterioration aversion and extends the results, demonstrating increased effectiveness of improving gifts over constant gift sequences and indicating that the mechanism underlying deterioration aversion involves the violation of expectations.
Endometritis of dairy cattle

An important cause of infertility in dairy cattle is uterine contamination, infection and inflammation that occur at the time of calving and persist until the time when the cow should be bred. Most cows have some post-partum uterine contamination and, under normal circumstances, the natural resistance of the uterus eliminates the contamination and inflammation and the uterus recovers. However, if infection remains, it is a cause of inflammation and infertility. The standard treatment for uterine infection is infusion of antibiotics into the uterus. This treatment is widely used in California. The purpose of this research was to determine the incidence of this condition and determine the efficacy of the treatment. In addition, observations were made on the identity of the bacterial contaminants of the uterus, their susceptibility to commonly used antibiotics and the absorption and excretion of antibiotics, including determination of antibiotic residues in milk following infusion.
Modeling the pyrolysis of preceramic polymers: A kinetic study of the polycarbosilane SMP-10

Abstract A material model was developed to predict changes in mass, density and thus volume of cured preceramic polymers for CMC matrices as they pyrolyze into ceramics. Because part warpage and delaminations are most likely to occur when matrix strain rates and strain rate gradients are the highest, the ability to accurately predict changes in a matrix material’s volume is essential to determining the processing conditions that will efficiently minimize composite scrap rates. Experimental and model analysis of the SiC forming polycarbosilane, SMP-10, revealed that volume shrinkage is initially driven by mass loss, is quickly dominated by density’s contribution, and has both temperature and time at temperature dependencies, where density is not a simple function of mass yield. While material density is rarely reported in the open literature, the ability to predict changes in density is essential to accurately predicting the volume yield of preceramic polymers used in ceramic matrix composites.
Active Cancer Patients Presenting to the Emergency Department with Acute Venous Thromboembolism: A Retrospective Cohort Study on Risks and Outcomes.

Abstract Background There is no prior study that has documented emergency department (ED) outcomes or stratified mortality risks of cancer patients presenting with an acute venous thromboembolism (VTE). Objective To evaluate ED treatment of these patients, to document their outcomes, and to identify risk factors associated with death. Methods A retrospective cohort study was performed on active cancer patients presenting with deep venous thrombosis or pulmonary embolism to two academic EDs between July 2012 and June 2016. Key outcomes included mortality, ED revisit, and admission within 30 days. The patient cohort was characterized; crosstabs and regression analysis were performed to assess relative risks (RRs) and mitigating factors associated with 30-day mortality. Results Of 355 patients, 9% died and 38% had one or more ED revisits or admissions. Recent immobility (RR 2.341, 95% CI 1.227–4.465), poor functional status (RR 2.090, 95% CI 1.028–4.248), recent admission (RR 2.441, 95% CI 1.276–4.669), and metastatic cancer (RR 4.669, 95% CI 1.456–14.979) were major risk factors for mortality. ED-provided anticoagulation reduced the overall mortality risk (RR 0.274, 95% CI 0.146–0.515) and mitigated the risk from recent immobility (RR 1.250, 95% CI 0.462–3.381), especially among patients with good or fair functional status. Conclusion Immobility and cancer morbidity are key risk factors for mortality after an acute VTE, but ED-provided anticoagulation mitigates the risk of immobility among healthier patients. Eastern Cooperative Oncology Group performance status can help clinicians risk stratify these patients at presentation.
Zero-Based Transportation Policy: Recommendations for 2021 Transportation Reauthorization

The devastating effects of the COVID-19 pandemic and associated lockdowns on various forms of transportation create an opportunity to review the successes and failures of federal transport policies before Congress reauthorizes federal highway and transit programs. After a one‐​year extension approved by Congress in September 2020, authorization for these programs will expire on September 30, 2021. A close look at federal transportation programs reveals that user‐​fee‐​funded systems work far better than projects funded by subsidies or deficit spending. User‐​fee‐​funded infrastructure tends to be much better maintained than infrastructure funded by subsidies. Subsidies, meanwhile, take away the incentive for transportation managers to innovate or improve productivity. Worker productivity in urban transit, for example, has declined by more than 55 percent since Congress began funding transit in the 1960s. The Interstate Highway System is the most successful megaproject in history, partly because it was built on a pay‐​as‐​you‐​go basis, being funded out of highway user fees only as those revenues were collected. This ensured that the roads were not built before they were needed (the way federally subsidized transcontinental railroads were) and so immediately produced enormous benefits as they were opened. Another important lesson is that efforts to save energy, reduce pollution, and improve highway safety by getting people to drive less have failed miserably. Instead, we saved energy, reduced pollution, and improved safety by building more energy efficient, cleaner, and safer automobiles and safer roads. Efforts to reduce greenhouse gas emissions should similarly focus on building cleaner cars, not trying to reduce driving. The COVID-19 pandemic highlights the need for a resilient transportation system, and motor vehicles and roads have proven far more resilient than any form of mass transportation. Unlike mass transportation, which requires continuing inputs of labor and funds, roads are available when they are needed even if a recession or other economic shock reduces revenues to highway agencies. Roads have also proven to be the best way to evacuate people and deliver rescue and recovery services in the event of natural disasters. “Road diets” and other programs that reduce roadway capacities are reducing the resiliency of our transportation system. After elaborating on the data and arguments above, this paper concludes with specific recommendations for the 2021 surface transportation reauthorization.
Performance, carcass, cartilage calcium, sensory and collagen traits of longissimus muscles of open versus 30-month-old heifers that produced one calf

One hundred eleven Simmental x Hereford (3/8 to 5/8 Simmental) heifers were used to determine the effects of age, parturition and implantation on performance, carcass and meat-sensory traits, muscle-collagen characteristics and thoracic-button calcification. Eighty-five heifers that calved at about 2 yr of age, designated as single-calf heifers (SCH), were either implanted (I-SCH) with Synovex-H or not implanted (NI-SCH). The remaining 26, 2-yr-old non-pregnant heifers (2-OH) served as controls. Additionally, 24, 1-yr-old open heifers (1-OH) from the same genetic source were utilized as the standard heifer-production system. The 1-OH and 2-OH were slaughtered after being fed a high-grain diet for 137 and 112 d, respectively. The SCH were fed the same high-grain diet beginning about 1 mo after calving and were fed 137 d before slaughter. The 33 I-SCH were implanted when started on the high-grain diet. Calves were weaned about 5 wk before the SCH were slaughtered. The 2-OH had the highest (P less than .05) feedlot ADG, whereas no differences (P greater than .05) occurred among other treatments. Dressing percentages were higher (P less than .01) for I-SCH than for NI-SCH. Carcass weights were lowest (P less than .05) and percentage kidney, pelvic and heart fat was highest (P less than .01) for 1-OH. Fat thickness, yield grades, marbling scores and quality grades were similar (P greater than .05) and desirable for all treatments.(ABSTRACT TRUNCATED AT 250 WORDS)
Audit Quality Examined One Large CPA Firm at a Time: Empirical Evidence of a Precursor of Arthur Andersen's Collapse

The largest CPA firms have been regarded as quality-differentiated auditors. This has been a prominent assumption of empirical research in accounting and auditing. Yet, prior research has only tested whether the largest CPA firms, in the aggregate, are quality-differentiated auditors. This paper contributes to the audit quality literature by individually examining each of the largest CPA firms. This new approach is timely, given the questions that have been raised concerning Arthur Andersen. Each Big Six CPA firm was compared to the non-Big Six CPA firms, using post-Private Securities Litigation Reform Act of 1995 data. The outcomes of auditors in civil and criminal litigation and administrative proceedings were analyzed using a taxonomy based on the corporate misconduct and economic analysis of legal process literatures. With the exception of Arthur Andersen, each of the Big Six CPA firms was individually found to be a higher quality auditor than the non-Big Six. The null hypothesis of no difference between the outcomes of each of the Big Six firms (except Arthur Andersen) and the non-Big Six was rejected at p
Graded reduction of Pafah1b1 (Lis1) activity results in neuronal migration defects and early embryonic lethality

Graded reduction of Pafah1b1 (Lis1) activity results in neuronal migration defects and early embryonic lethality
A theory of data type representation independence

It is widely recognized that one of the advantages of strong data type facilities is a guarantee that, within certain limits, the representation of primitive data types may be altered without affecting the meanings of programs--a property that may be called "representation independence". It is important to make this notion precise and provide a methodology for assuring that a language maintains representation independence. This is of particular value in the design of languages with highly general data type facilities, including such features as polymorphic functions and recursive types, for which representation independence is not at all obvious. To this end an extended lambda calculus language, called TypeL, is defined that includes syntactic type checking, an equality predicate, type abstraction and mutually recursive normal and type expressions. Based on a denotational semantics of TypeL, two characterizations of representation independence are defined and shown to hold in TypeL given appropriate restrictions on the environments. This result may be applied to high level language expressions if the semantics of these expressions can be defined by transformations into TypeL expressions. Examples of such transformation from the Russell language to TypeL are given.