cssi/SciSciGPT-SciSciNet huggingface dataset:
1343PCURRENT TREND OF PALLIATIVE CARE CLINIC (PCC) REFERRALS AND THEIR IMPACT ON SYMPTOM BURDEN IN PATIENTS (PTS) WHO ARE SEEN IN GENITOURINARY MEDICAL ONCOLOGY CLINIC (GUMOC): RETROSPECTIVE ANALYSIS AT AN AMERICAN COMPREHENSIVE CANCER INSTITUTE

ABSTRACT Aim: 1) To assess the frequency of specialist PCC referrals in our GUMOC. 2) To analyze the impact of PCC referrals on the symptomatology of patients. Methods: 239 consecutive pts were collected from a retrospective review of GUMOC records in Roswell Park Cancer Institute from 12/1/2013 to 2/28/2014. This group of pts was used to assess the frequency of PCC referral. Pts were divided into two arms- Arm A= GUMOC pts referred to PCC; Arm B: GUMOC pts not referred to PCC. To be able to detect a 15% between the two arms at 95% significance, 37 additional pts (who were already being seen at GUMOC) were collected from retrospective review of PCC records over 9/1/2013 to 2/28/2014. Total 276 patients were divided into Arm A (n = 49), Arm B (n = 227 patients). Arm B includes 12 pts from GUMOC records and 37 pts from PCC records. Data for baseline symptom score and 4-week follow up symptom scores were collected. A palliative care screening tool (retrieved from Center to Advance Palliative care [CAPC] website) was used to assign a palliative care screening score (PCSS) to all study patients. Chi square test and T-test used respectively for categorical variables and numerical variables. Results: Out of the 239 initially collected GUMOC patients, 5% were referred to PCC. 10% (n = 24) had PCSS score of ≥ 4, and 33% pts with PCSS ≥ 4 were referred to PCC. Baseline symptoms, ECOG status (2-3) and cancer stage (locally advanced or stage 4) were more advanced in the Arm A vs. Arm B (p = 0.02, p Conclusions: GU cancer patients who are referred to PCC from medical oncology clinic have significant decrease in distressing symptoms. Frequency of PCC consultation is still low in comprehensive cancer institutes, and not in congruence with the available palliative care screening tools criteria suggested by CAPC. Standardized tools should be developed to guide PCC referrals, and routine use of these tools may help selecting patients who will benefit the most from PCC referral. Disclosure: All authors have declared no conflicts of interest.
Abstract 357: Induction of galectin-1 decreases radiosensitivity of patient-generated primary cell lines through AKT activation

Glioblastoma, grade IV malignant glioma based on the WHO classification, is one of the most common brain tumors found in adults and has an average survival time of twelve to sixteen months. The dismal prognosis associated with these tumors is largely due to their ability to grow and proliferate despite radiotherapy, which along with resection and Temozolomide is the current standard of care. A better understanding of the molecular mechanisms that define this malignant phenotype may result in new therapeutic targets and lead to improvements in how patients are treated. Galectin 1(GAL1), a beta-galactosidase binding protein, is strongly expressed in a variety of human cancers and has been shown to be upregulated by irradiation. In this study, we investigated the role of GAL1 upregulation following irradiation in a variety of patient-generated primary cell lines and its role in cell survival. Patient-generated primary cell lines were characterized using a variety of assays such as MTS, Annexin V, and cell viability. Western Blot analysis was performed probing for a variety of proteins implicated in proliferation, motility, and apoptosis. Radiation sensitivities were established by performing Clonogenic Survival Assays comparing the surviving fraction of patient-derived cell lines with established stable cell lines. 6 Gy irradiation upregulated Galectin 1 protein levels in the majority of primary cells used in our study. Furthermore, cell lines which Gal1was upregulated also displayed induction of Phospho-AKT and were significantly less sensitive to irradiation. The combination of GAL1 upregulation and Phosho-AKT induction following irradiation was associated with a significant decrease in the radiosensitization of the patient-derived primary cell lines used in our study. Interestingly, the patient-derived cell lines which showed no upregulation of GAL1 or Phospho-AKT induction displayed markedly increased sensitivity to radiation elucidating an interesting association between GAL1, Phospho-AKT, and radiation-sensitivity. The underlying mechanism by which GAL1 may medicate radioresistence seems to be through AKT activation, a well-documented protein involved in cell survival. Additional studies are ongoing to validate Galectin 1 as a target for radiation sensitization. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 357.
Monitoring on vitality dynamics of tugai vegetation in the lower reaches of Tarim River by ecological water delivery

The Tarim River is about 1 320 km long and thus one of the longest continental inland waterways worldwide. The rising water consumption in the upper and middle reaches and massive hydrotechnical interventions during the development of uncultivated land use (cotton growing) in the past decades,led to the widespread destruction of the natural ecosystems,particularly in the lower reaches of the river where on 320 km the floodplain forests of Euphrat poplars (Populus euphratica Oliv.) are either highly degraded or dead. Since 2000 the Chinese government has made efforts to restore these ecosystems and conducted ecological water delivery. According to monitoring results after the ecological water delivery in the past five years,the paper analyses the vitality dynamics of the Tugai vegetation in the lower reaches of the Tarim River. The results show:Due to ecological water delivery,there are a lot of changes. The biological diversity in the lower reaches of theTarim River has increased,a lot of plants that disappeared for a long time have reappeared,and the P. euphratica community has regenerated naturally to different degrees. Within 50 metres from the river course,a few P. euphratica and Tamarix spp. seedlings appear. Within 150 metres from the river course,a considerable number of P. euphratica appeared. Within 400 metres from the river bank,approximately 25% of P. euphratica have formed new branches at the base after the ecological water delivery. With water levels gradually rising after the water delivery,non-zonal meadow vegetation has developed in the large areas of the low-level terraces on both sides of the river sparse Arid non-zonal riparian vegetation commu-nities composed of P. euphratica,shrubs and herbaceous plants (Tugai Vegetation) developed,showing that ecological emergency water delivery has had a positive impact on vegetation vitality restoration and natural recovery of desert riparian vegetation whose main species is P. euphratica.
Recombinant E. coli Prototype Strains for in Vivo Glycorandomization

In vitro glycorandomization is a powerful strategy to alter the glycosylation patterns of natural products and small molecule therapeutics. Yet, such in vitro methods are often difficult to scale and can be costly given the requirement to provide various nucleotides and cofactors. Here, we report the construction of several recombinant E. coli prototype strains that allow the facile production of a range of small molecule glycosides. This strategy relies on the engineered promiscuity of three key enzymes, an anomeric kinase, a sugar-1-phosphate nucleotidyltransferase, and a glycosyltransferase, as well as the ability of diverse small molecules to freely enter E. coli. Subsequently, this work is the first demonstration of “in vivo glycorandomization” and offers vast combinatorial potential by simple fermentation.
Compensatory Responses of Swine Following Protein Insufficiency in Grower Diets

Four trials involving 426 crossbred pigs were conducted to determine the effect of protein restriction during early growth on subsequent performance and carcass characteristics at 100 kg. The experimental animals averaged 25 to 27 kg initial weight in trials 1, 2 and 3, and 18.2, 22.7 and 27.3 kg in three weight groups in trial 4. Pigs were fed corn-soybean meal supplemented diets of 12, 14 or 16% protein. Protein restriction (12 or 14% protein diets), to 52 kg in trial 1 and during the initial 4-wk period in trials 2, 3 and 4, reduced rate and efficiency of growth; performance was reduced more on 12% protein diets. In the subsequent growth period, early protein restriction improved gain and feed to gain ratio. Performance for the total period was similar for pigs fed a 14% protein diet continuously to that of pigs fed a 16 to 14% protein sequence when pigs had an initial weight of 25 kg or more. However, lighter weight pigs did not completely compensate for decreased performance during the early 4-wk period. Carcass characteristics were similar for all protein sequences.
Graphene and liquid crystal mediated interactions

ABSTRACTThe two-dimensional graphene-honeycomb structure can interact with the liquid crystal’s (LC) benzene rings through π–π electron stacking. This LC–graphene interaction gives rise to a number of interesting physical and optical phenomena in the LC. In this paper, we present a combination of a review and original research of the exploration of novel themes of LC ordering at the nanoscale graphene surface and its macroscopic effects on the LC’s nematic and smectic phases. We show that monolayer graphene films impose planar alignment on the LC, creating pseudo-nematic domains (PNDs) at the surface of graphene. In a graphene-nematic suspension, these PNDs enhance the orientational order parameter, exhibiting a giant enhancement in the dielectric anisotropy of the LC. These anisotropic domains interact with the external electric field, resulting in a non-zero dielectric anisotropy in the isotropic phase as well. We also show that graphene flakes in an LC reduce the free ion concentration in the nematic m...
MODELLING CHEMICAL TRANSPORT IN TOPSOIL WITH A GAMMA DISTRIBUTION FUNCTION

In applying the linear systems theory to the mathematical simulation of chemical transport in topsoil, the impulse response function is used to describe the overall effects of hydrodynamic and kinetic mechanisms of the system. The general nature of the impulse response function of a soil transport system can be represented by a gamma distribution function. The multiple regression equations derived in this study can be used to correlate parameters of a gamma distribution function with basic soil and chemical properties. Techniques developed in this study are most suitable for assessing spatial variation of groundwater contamination potential in a large area.
Archaeological Signatures of Corn Preparation in the U.S. Southwest

ABSTRACTFood preparation techniques, while anthropologically significant, are often difficult to reconstruct from archaeological remains. However, two methods of corn preparation—alkali processing and tortillas—have archaeological signatures. Alkali processing with ashes may cause salt erosion on ceramic vessel interiors. Tortillas are prepared on comales made of pottery or stone. Alkali processing and tortilla preparation are described using ethnographic data and archaeological examples from the southwestern United States and northwestern Mexico. The distribution of comales in the Hohokam Classic Period (A.D. 1100–;1450) is also addressed.
Reflections on Serious Games

This chapter comments on the contributions in this edited volume and identifies some challenges for future research on serious games. The contributors used rigorous experimental methods to systematically assess the impact of many components of serious games on learning and motivation. The games are serious because there is alignment with relevant instructional content in educational curricula and there is an assessment of associated knowledge, skills, and strategies. The chapters report learning gains for the games compared to comparison conditions, as well as the added value of several game features, such as multimedia, realism, challenge, adaptivity, feedback, interactivity, modeling, collaboration, competition, reflection, fantasy, narrative, and so on. These features are highly correlated in most games so it is difficult to assign credit to particular features when they are implemented in conjunction with many other features. Additional challenges emerge when the games target deep learning of difficult material: (1) game features imposing extraneous cognitive load on working memory, (2) incompatibilities in the timing of feedback to optimize deep learning versus motivation, and (3) control struggles between the game agenda and students’ self-regulated learning. It is argued that researchers could be more involved in the building of games under the guidance of scientific principles even though there are difficulties in the design process and in attempts to scale up researcher-designed serious games. The chapter ends with a quandary in assessing psychological constructs in serious games that are adaptive to the learner.
Teaching Social Studies/History to Elementary School Students through a Discipline-Specific Approach:

This mixed methods study explored students’ learning following an intervention unit, which focused on discipline-specific practices in elementary social studies/history. The following questions guided the research: To what extent does students’ learning in social studies/history change following their participation in a unit emphasizing disciplinary-specific practices? and How does their learning compare to students who learn the same content without this approach? Two fifth-grade teachers in a low socioeconomic district taught a disciplinary unit to their students, and a third fifth-grade teacher in the same district taught the same content to her students using a transmission approach. All students performed similarly on the pre-assessment; following the intervention students in the experimental classrooms made greater gains and demonstrated disciplinary-specific practices. This study has implications for elementary school instruction in social studies/history and literacy.
AML Exosomes Regulate Stromal Bystander Cells and Provide a Novel RNA Biomarker Platform

Abstract Abstract 1378 Cell membrane-derived vesicles carrying protein and RNA cargo have recently emerged as potent mediators of cell-cell communication. These vesicles traffic from their tissue of origin into the blood stream, providing a serum-based and minimally invasive biomarker platform for cancer-specific RNA and protein signatures. We were interested in evaluating vesicle production by acute myeloid leukemia (AML) cells, with an emphasis on RNA content and cell-cell trafficking. Here we demonstrate for the first time that cell lines and primary cells from AML patients release exosome-sized vesicles (30–100nm) capable of transfer to bystander cells. Analysis of their non-protein content revealed the enrichment of many coding- and non-coding RNAs with relevance to AML biology, including prognostically important transcripts encoding FLT3, NPM-1, IGF-IR, CXCR4 and MMP9. In addition, we demonstrated the presence of a diverse group of transcription factor mRNAs (MYC, MEF2C, GATA1, SHIP1, ID1, E2F1, CEPBA CEPBB) in exosomes. PCR array studies also confirmed the broad representation of cellular miRNAs. Among the 234 miRNAs represented, the levels of several (miR −9, −155 and −223 and LET-7A) were enriched over the levels seen in donor cells (U6 RNA control). When examining cell-cell trafficking of AML exosomes, we noted rapid entry into co-cultured stromal cells, with maximum uptake occurring between 2 and 3 hours. AML-derived mRNA transcripts were transferred to bystander cells without direct cell-cell contact after Transwell co-culture or direct exposure to purified exosome preparations, or via vesicle-rich media. Results show that exosome trafficking induced changes in gene expression (OPN, ANGPT, SCF, SDF-1A) and altered the secretion of cytokines and angiopoietic growth factors by bone marrow stromal cells. Additional proof-of-concept studies provided evidence for the canonical function of transferred RNA. Specifically, we found that transfer of IGF-IR mRNA led to proliferative responses in co-cultured OP9 stromal cells that were abrogated by the IGF-IR specific inhibitor picropodophyllin. Further, exosomes derived from AML cell lines (HL60 and Molm14) altered c-FOS and VEGF expression in OP9 cells as well as improving viability and promoting migration toward SDF-1A by a hematopoietic progenitor cell line (Baf3), respectively. Our observations support the concept that AML exosomes exhibit regulatory potential in the leukemic bone marrow niche via direct cytoplasmic cell-cell transfer of transcripts encoding tyrosine kinase receptors and transcription factor as well as micro- RNAs. We propose that AML exosomes contribute to the extrinsic signaling cues in the microenvironment that promote disease resistance in AML and that they are rich in biomarkers to guide diagnosis and treatment. Disclosures: No relevant conflicts of interest to declare.
Cell Death in Alcohol-Induced Liver Injury

Alcoholic liver disease (ALD) is a major health problem worldwide, for which no successful treatments are available. The pathogenesis of ALD is characterized as steatosis, inflammation, fibrosis, cirrhosis, which eventually leads to hepatocellular carcinoma (HCC). Over the last few decades, research from many labs has demonstrated that cell death including apoptosis and necrosis contributes to the pathogenesis of ALD. More recent studies from our lab and others suggest that alcohol consumption can also induce cellular adaptive response such as autophagy as a protective mechanism against alcohol-induced liver injury. In this book chapter, we summarize recent progress on roles of apoptosis, necrosis, and autophagy in the development of ALD. Understanding the complex mutual regulation of apoptosis, necrosis, and autophagy may offer novel therapeutic avenues against ALD by targeting these pathways.
Designing a National Longitudinal Faculty Development Curriculum Focused on Educational Scholarship: Process, Outcomes, and Lessons Learned

ABSTRACTProblem: Clinical educators at U.S. academic health centers are frequently disadvantaged in the academic promotion system, lacking needed faculty development, mentoring, and networking support. Intervention: In 2006, we implemented the national Educational Scholars Program to offer faculty development in educational scholarship for early career educators in pediatrics. We aimed to provide them with skills, experience, and initial success in educational scholarship and dissemination. The 3-year curriculum is delivered in interactive sessions at the annual pediatric academic meetings and online intersession modules. Curriculum content progresses from educational scholarship and implementing scholarly projects to dissemination and professional networking. Intersession modules address project planning, building an educator portfolio, reviewing the literature, using technology, authorship, and peer review. Concurrently, all scholars must complete a mentored educational project and demonstrate national ...
The long reach of early adversity: Parenting, stress, and neural pathways to antisocial behavior in adulthood.

Abstract Background Early life adversities including harsh parenting, maternal depression, neighborhood deprivation, and low family economic resources are more prevalent in low-income urban environments and are potent predictors of psychopathology, including, for boys, antisocial behavior. However, little research has examined how these stressful experiences alter later neural function. Moreover, identifying genetic markers of greater susceptibility to adversity is critical to understanding biopsychosocial pathways from early adversity to later psychopathology. Methods Within a sample of 310 low-income boys followed from 1.5 to 20 years of age, multimethod assessments of adversities were examined at 2 and 12 years of age. At 20 years of age, amygdala reactivity to emotional facial expressions was assessed using functional magnetic resonance imaging, and symptoms of antisocial personality disorder were assessed via the Structured Clinical Interview for DSM. Genetic variability in cortisol signaling ( CRHR1 ) was examined as a moderator of pathways to amygdala reactivity. Results Observed parenting and neighborhood deprivation at 2 years of age each uniquely predicted amygdala reactivity to emotional faces at 20 years of age over and above other adversities measured at multiple developmental periods. Harsher parenting and greater neighborhood deprivation in toddlerhood predicted clinically significant symptoms of antisocial behavior via less amygdala reactivity to fearful facial expressions, and this pathway was moderated by genetic variation in CRHR1 . Conclusions These results elucidate a pathway linking early adversity to less amygdala reactivity to social signals of interpersonal distress 18 years later, which in turn increased risk for serious antisocial behavior. Moreover, these findings suggest a genetic marker of youth more susceptible to adversity.
IL-18 Drives ILC3 Proliferation and Promotes IL-22 Production via NF-κB

Group 3 innate lymphoid cells (ILC3s) are important regulators of the immune system, maintaining homeostasis in the presence of commensal bacteria, but activating immune defenses in response to microbial pathogens. ILC3s are a robust source of IL-22, a cytokine critical for stimulating the antimicrobial response. We sought to identify cytokines that can promote proliferation and induce or maintain IL-22 production by ILC3s and determine a molecular mechanism for this process. We identified IL-18 as a cytokine that cooperates with an ILC3 survival factor, IL-15, to induce proliferation of human ILC3s, as well as induce and maintain IL-22 production. To determine a mechanism of action, we examined the NF-κB pathway, which is activated by IL-18 signaling. We found that the NF-κB complex signaling component, p65, binds to the proximal region of the IL22 promoter and promotes transcriptional activity. Finally, we observed that CD11c+ dendritic cells expressing IL-18 are found in close proximity to ILC3s in human tonsils in situ. Therefore, we identify a new mechanism by which human ILC3s proliferate and produce IL-22, and identify NF-κB as a potential therapeutic target to be considered in pathologic states characterized by overproduction of IL-18 and/or IL-22.
Weighing the shopping benefits of a smarter refrigerator

An IOT smart fridge containing scales can increase the utility of the product. By adding scales to regular image sensing technologies, a fridge can be created that makes fewer mistakes when creating a shopping list. This, combined with the fact that having a shopping list when heading to the grocery store can improve health and save money, makes for a useful smart fridge.
Chemicals in the Air: The Atmospheric System and Dispersal of Chemicals

Field studies are required to validate any numerical model of pesticide dispersion. The various complications which may arise must be considered in the design of the validation study.
The Idea of Human Hunting

Paleontology in the broadest sense is the study of the history of life, and paleoanthropology is the part of this history that deals with man. Like all historical scientists, paleontologists and paleoanthropologists assume that this history consists of individual events joined together into the Great Chain of Events leading to the present. They believe that history is thus directional, continuous and composed of identifiable minor events eventually transformable into the major events such as mass extinctions, biotic crises, origins of hunting and origins of agriculture. These significant events are interpreted and become powerful concepts in the development of scientific thought.
Ultrasound-Guided Pulsed Radiofrequency of C2 Dorsal Root Ganglion as Adjuvant Treatment for Chronic Headache Disorders: A Case Report

Cluster headaches are characterized by unilateral sudden onset of intense, brief, sharp pain along the side of the face around the eye. Patients often can have symptoms that are resistant to medications, nerve blocks, and surgical treatments. There is increasing evidence of anatomical and functional connections between the trigeminal and occipital nerves. We present a patient with cluster headache presenting with chronic ipsilateral facial pain with nasal congestion and left eye pain who achieved sustained pain relief with an ultrasound-guided injection into the pterygopalatine fossa in conjunction with an ultrasound-guided pulsed radiofrequency ablation procedure involving the C2 dorsal root ganglion.
Topological data analysis reveals principles of chromosome structure throughout cellular differentiation

Three-dimensional chromosome structure has a significant influence in many diverse genomic processes and has recently been shown to relate to cellular differentiation. Many methods for describing the chromosomal architecture focus on specific substructures such as topologically-associating domains (TADs) or compartments, but we are still missing a global view of all geometric features of chromosomes. Topological data analysis (TDA) is a mathematically well-founded set of methods to derive robust information about the structure and topology of data sets, making it well-suited to better understand the key features of chromosome structure. By applying TDA to the study of chromosome structure through differentiation across three cell lines, we provide insight into principles of chromosome folding generally, and observe structural changes across lineages. We identify both global and local differences in chromosome topology through differentiation, identifying trends consistent across human cell lines.
Strategies for Detection of Correlated Data Streams

There is an increasing demand for real-time analysis of large volumes of data streams that are produced at high velocity. The most recent data needs to be processed within a specified delay target in order for the analysis to lead to actionable result. In this paper we present an effective solution for the analysis of such data streams that is based upon a 3-fold approach that combines (1) incremental sliding-window computation of aggregates, to avoid unnecessary recomputations, (2) intelligent scheduling of computation steps and operations, driven by a utility function within a micro-batch, and (3) an exploration strategy that tunes the utility function. Specifically, we propose eight strategies that explore correlated pairs of live data streams across consecutive micro-batches. Our experimental evaluation on a real dataset shows that some strategies are more suitable to identifying high numbers of correlated pairs of live data streams, already known from previous micro-batches, while others are more suitable to identifying previously unseen pairs of live data streams across consecutive micro-batches.
New high intensity fibreoptic phototherapy devices in healthy newborns: a single pad wrapped around the neonate body in comparison with a double pad device.

Fibreoptic Phototherapy (FPT) allows to lower total serum bilirubin (TSB) levels in healthy neonates maintained in rooming-in with their mothers. The 2004 Cochrane review showed that, differently from preterm neonates, FPT was not as effective as traditional phototherapy in term neonates (TN), unless the simultaneous utilization of two FPT devices. Aim of this study was to compare the efficacy of two FPT devices, both equipped with a single light-emitting diode (LED): the first one has a single large pad wrapped around the infant body (Bilisoft, GE Health Care) (device A), the second one is a double-pad phototherapy device (BiliCocoon, CremascolieIris) (device B). We studied 172 healthy neonates with non-hemolytic hyperbilirubinaemia: 57 TN and 57 late preterm neonates (LPN) treated with device A (Group 1); 47 TN and 11 LPN treated with device B (Group 2). We evaluated the differences between groups by the Student’s t-test for continuous variables and by chi square test for categorical data. A two tailed p < 0.05 was considered significant. There were no differences in term of duration of FPT, TSB hourly reduction, percentage of TSB reduction after FPT, TSB maximum rebound, percentage of TSB increase after FPT discontinuation and number of after-discharge checks. Two neonates treated with device B showed no decrease in TSB values during FPT. Seven infants treated with device B experienced hyperpyrexia. The two LED FPT devices were both effective in lowering TSB either in TN or LPN. Device A was effective in all treated neonates without negative side effects during treatment; device B was effective in all but 2 infants and 12% of the neonates in the same group experienced hyperpyrexia. According to our results, the single big pad wrapped around the infant body has the same efficacy as a double FPT device in TN and LPN.
The effect of rate of torque development on motor unit recruitment and firing rates during isometric voluntary trapezoidal contractions.

It is common practice to examine motor unit (MU) activity according to mean firing rate (MFR) and action potential amplitude (MUAPAMP) vs. recruitment threshold (RT) relationships during isometric trapezoidal contractions. However, it is unknown whether the rate of torque development during the linearly increasing torque phase affects the activity of MUs during such contractions. Sixteen healthy males and females performed two isometric trapezoidal muscle actions at 40% of maximum voluntary contraction (MVC), one at a rate of torque development of 5% MVC/s (SLOW40) and one at 20% MVC/s (FAST40) during the linearly increasing torque phase. Surface electromyography (EMG) was recorded from the vastus lateralis (VL) via a 5-pin surface array sensor and decomposed into action potential trains of individual MUs, yielding MFRs and MUAPAMP which were regressed against RT separately for each contraction. Surface EMG amplitude recorded from leg extensors and flexors was used to quantify muscle activation and coactivation. MFR vs. RT relationship slopes were more negative (P = 0.003) for the SLOW40 (− 0.491 ± 0.101 pps/%MVC) than FAST40 (− 0.322 ± 0.109 pps/%MVC) and the slopes of the MUAPAMP vs. RT relationships (P = 0.022, SLOW40 = 0.0057 ± 0.0021 mV/%MVC, FAST40 = 0.0041 ± 0.0023 mV/%MVC) and muscle activation of the extensors (P < 0.001, SLOW40 = 36.3 ± 7.82%, FAST40 = 34.0 ± 6.26%) were greater for SLOW40 than FAST40. MU firing rates were lower and action potential amplitudes were larger in relation to recruitment thresholds for a contraction performed at a slower rate compared to a faster rate of isometric torque development. Differences in MU activity can exist as a function of rate of torque development during commonly performed isometric trapezoidal contractions.
Exploration of Decisional Control Preferences in Adolescents and Young Adults with Cancer and Other Complex Medical Conditions

Purpose: Adolescent and young adults (AYA) with cancer encounter many medical treatment decisions but may have variable desires for involvement in decision-making. This study describes the degree of decisional control AYA patients preferred in complex medical decisions. Methods: A cross-sectional descriptive correlational design evaluated experienced AYA patients' decision-making role preferences using the Control Preference Scale and explored relationships in a proposed model of decision control. Results: Overall, most patients preferred an "active collaborative" role (39%), where the patient prefers to make the final decision with input from the provider, or a "shared decision-making" role (34%), wherein the decision is jointly made between patient and provider. Oncology AYA patients tended to prefer a more passive role than nononcology AYA patients. Time since diagnosis also positively correlated with control preference, with patients preferring a more active level of decisional control as the number of days from diagnosis increased. While no other statistically significant relationships were found between factors put forth in the exploratory model and decision control, there were strong associations between the factors themselves that warrant future study. Conclusion: The findings advance the knowledge of AYA preferences for decision-making involvement, enhancing our ability to identify patients at risk for low health care engagement and explore the consequences of limited or impaired decisional capacity. Future research might examine interventions to promote self-management skills and patient decisional role preferences, fulfilling the need to respect both the desire for decision-making involvement of some patients and the preference to defer to the expertise of providers for others.
Applying Stone in a Western Landscape: Ranchers, Conservationists, and Causal Stories in the “American Serengeti”

As the emergence of nongovernmental conservation efforts generates conflict among various stakeholders, the causal story that each party articulates regarding conservation and the causes of land degradation reflects their unique interests. This study uses existing literature to evaluate causal stories surrounding a contemporary conservation effort: Montana's American Prairie Reserve. Through qualitative review of web‐based documents and newspaper articles, it generates a preliminary account of key stakeholders' causal stories. The case study suggests that parties who might be disadvantaged by ascribing responsibility for environmental harms in an adversarial fashion may instead elect to articulate causal stories that are more neutral than existing approaches might forecast. The study concludes by suggesting that further development of causal story literature may enable it to better address contemporary conservation efforts. 鉴于非政府形式的自然保护区工作的出现导致了不同利益攸关方之间产生冲突，各方就自然保护区和土地退化的起因而发表的叙事反应了各自的独特利益。本研究使用现有文献，对围绕蒙大拿州的美国大草原自然保护区（Montana’s American Prairie Reserve）这一当代保护区工作的因果叙事进行了评价。通过对基于网页的文件和报纸文章进行定性审视，产生了有关利益攸关方因果叙事的初步记录。案例研究暗示，那些因以一种对立方式对环境危害的责任进行归因而可能处于劣势的党派，有可能反而选择表达比现有方法所预测的更为中立的因果叙事。本文结论建议，对因果叙事进行进一步研究，可能会更好地应对当代自然保护区工作。 A medida que el surgimiento de esfuerzos de conservacion no gubernamentales genera conflictos entre varias partes interesadas, la historia causal que cada parte articula sobre la conservacion y las causas de la degradacion de la tierra refleja sus intereses unicos. Este estudio utiliza literatura existente para evaluar historias causales que rodean un esfuerzo de conservacion contemporaneo: la Reserva de Praderas Estadounidense de Montana. A traves de la revision cualitativa de documentos basados ​​en la web y articulos periodisticos, genera una cuenta preliminar de las historias causales de los principales interesados El estudio de caso sugiere que las partes que podrian estar en desventaja al atribuir la responsabilidad de los danos ambientales de una manera adversaria pueden optar por articular historias causales que son mas neutrales de lo que podrian predecir los enfoques existentes. El estudio concluye sugiriendo que un mayor desarrollo de la literatura de historias causales puede permitirle abordar mejor los esfuerzos contemporaneos de conservacion.
Primary Care Artificial Intelligence: A Branch Hiding in Plain Sight.

In 1966, Ian McWhinney argued that general practice should be a discipline and predicted that its research would thrive in the twilight zones where branches of knowledge converge.[1][1] In a review in this issue of Annals , Kueper et al have uncovered one such zone at the interface between computer
Evaluation of the CARDY Potassium Meter as a point-of-care instrument for measurement of plasma and blood potassium concentrations in cattle

A point-of-care analyzer ( CARDY K + meter C-131, www.horiba.co.jp) for the measurement of potassium concentration ([K]) has recently become available. The objective of this study was to validate the CARDY meter for the measurement of [K] in bovine plasma and blood.
Subseasonal Prediction of the State and Evolution of the North Pacific Jet Stream

The state and evolution of the North Pacific jet (NPJ) stream strongly influences the character of the downstream synoptic-scale flow pattern over North America. This study employs data from nine m...
Transcatheter mitral valve-in-valve and valve-in-ring replacement: Lessons learned from bioprosthetic surgical valve failures

INTRODUCTION Limited data are available about the outcomes of transcatheter mitral valve replacement (TMVR) using transseptal approach in patients with prior mitral valve repair (valve-in-ring) or replacement (valve-in-valve) (TMViVR) and on modes of the prior surgical valve failures. We report our tertiary center TMVR experience in high surgical risk patients with prior mitral valve repair or replacement. METHODS From December 2016 to January 2020, patients with symptomatic severe mitral valve stenosis and/or insufficiency at increased redo surgical risk were included. TMViVR was performed off-label with Sapien S3 valve (Edwards Lifesciences). Patients were followed within 30-days and 1-year from the procedure. RESULTS Twenty-seven patients underwent transcatheter mitral valve-in-valve (n = 21) or valve-in-ring (n = 6) replacement. Mean ± SD age was 71.8 ± 11 years with Society of Thoracic Surgeons' calculated mortality 7.1 ± 4.6%. The etiology of valve failure was stenosis in 17 (63%) patients, insufficiency in 4 (14.8%) patients, and both in 6 (22.2%) patients. TMViVR technical success was 100% in all patients. Left ventricular outflow track (LVOT) obstruction was observed in only one (3.7%) patient. Zero patients had moderate or severe central mitral valve regurgitation or paravalvular leak. All patients had symptomatic improvement at 30 days. The mean transmitral diastolic pressure gradient decreased from 14.1 ± 4.6 to 6.9 ± 4.6 mm Hg (p < .001) at 30 days. The one patient with LOVT obstruction required readmission at 5-months. One-year survival was 95%. At 1-year mean gradients remained lower than the baseline (7.0 ± 3.0 vs. 12.4 ± 4.0, p = .002). CONCLUSIONS Transcatheter mitral valve-in-valve and valve-in-ring replacement is feasible and safe. The improvement in mitral valve hemodynamics appears to be durable.
The Value of Telehealth and a Team-Based Approach in Improving Developmental and Behavioral Care During the COVID-19 Pandemic.

CASE: Billy is a 2.6-year-old boy who presented for evaluation in the developmental-behavioral pediatrics (DBP) clinic 2 weeks before the onset of pandemic-related clinic restrictions. Billy had received early intervention for the past year because of speech and fine motor delays. Billy's parents requested the evaluation in the DBP clinic because his delayed speech and disruptive behaviors had raised concern that he may have autism spectrum disorder. Owing to the onset of the pandemic, subsequent visits were completed through telehealth with a developmental-behavioral pediatrician, psychologist, behavioral clinician, and social workers who developed a collaborative plan of care. Billy was diagnosed with global developmental delay, significant tantrums, and impulsivity but did not meet the criteria for autism spectrum disorder.Billy lives with his parents and 2 sisters in a rural area, 3 hours from the DBP clinic. Both of his parents have been treated for depression in the past and reported that school was difficult for them. His sisters, ages 5 and 6 years, receive speech/language therapy but have not required additional special education services. His family has endured recent stressors including a flooding event that caused significant damage to their home, financial difficulties, and the recent unexpected death of a close family member. Billy's disruptive behaviors have resulted in difficulty finding and maintaining child care, further contributing to parental stress and dysfunction in the home.Despite assistance from the social worker, additional developmental and behavioral support services near the family's home were not identified. Therefore, services were offered to Billy and his parents through telehealth. Billy's parents began behavioral parent training with a clinician embedded within the DBP clinic and, with direct support from his parents, Billy began receiving supplemental speech/language and occupational therapies through telehealth. Through recurrent engagement with Billy's parents and frequent communication among the behavioral clinician, developmental-behavioral pediatrician, psychologist, and social worker, Billy was able to make significant developmental progress, and his parents reported improved ability to manage his difficult behaviors.How can telehealth be used to help families navigate complex systems and obtain optimal care and support?
A 210 GHz Fully-Integrated OOK Transceiver for Short-Range Wireless Chip-to-Chip Communication in 40 nm CMOS Technology

This paper presents a fully-integrated 210 GHz transceiver (TRX) with non-coherent on–off-keying (OOK) modulation for short-range multi-Gb/s wireless chip-to-chip communication in 40 nm CMOS technology. The direct detection-based receiver (RX) part comprises an on-die ${-}{\hbox{0.1}}$ dBi gain modified dipole antenna, an 8-stage 210-GHz 21.7-dB peak gain low noise amplifier (LNA) along with differential-pair neutralization technique and a 2.83-kV/W peak responsivity simple demodulator (push detector) in order to operate efficiently in THz regime. The phased-locked transmitter (TX) consists of a 210 GHz ${-}{\hbox{1.3}}$ dBm output power 3.8% locking-range phased-locked loop (PLL), two modified cascode transistors as a simple OOK modulator, a 4-stage 210-GHz 19.4-dB peak power gain power amplifier (PA) with neutralization and especially layout enhancement techniques and a similar modified on-die dipole antenna. The implemented PLL employs a triple-push circular-geometry voltage-controlled oscillator (VCO) followed by a divider chain $({\div}{\hbox{1024}})$ . The proposed TRX achieved error-free operation $({\rm BER} with ${+}{\hbox{6.8}}$ dBm of EIRP at center frequency of 210 GHz with ${\hbox{2}}^{31}{\hbox{--}}1$ PRBS of 10.7 Gb/s data-rate over 1 cm distance while consuming 421 mW of DC power which results to energy efficiency of 39.3 pJ/bit.
Disputes Related to Healthcare Across National Boundaries: The Potential for Arbitration

Trade in international health services has the potential to play a leading role in the global economy, but its rapid growth is impeded by legal barriers. Advances in technology and cross-border movement of people and health services create legal ambiguities and uncertainties for businesses and consumers involved in transnational medical malpractice disputes. Existing legal protections and remedies afforded by traditional judicial frameworks are unable to resolve the following challenges: (1) assertion of personal jurisdiction; (2) choice of forum and law considerations; (3) appropriate theories of liability for injuries and damages arising from innovations in medical care and delivery of health services; and (4) enforcement of foreign judgments. Such legal uncertainties and ambiguities call for a uniform means of redress that is more flexible and predictable than litigation in a court room. Given such needs, arbitration offers a potential solution, as it is a private streamlined adjudication process that has been successfully utilized on an international level to resolve several of the above mentioned legal quandaries. The voluntary, flexible, and legally binding nature of arbitration agreements across jurisdictions makes this form of dispute resolution more efficient and adaptive to changes in the health services industry than litigation. With careful construction of an approach that accounts for arbitration costs, reasonable recovery amounts, and complementary mechanisms such as no-fault compensation, international arbitration of medical malpractice disputes will reallocate the legal risks borne by businesses and consumers more fairly and efficiently.
Cervicography: A new method for cervical cancer detection

A new diagnostic method, cervicography, provides permanent, objective documentation of normal and abnormal cervical patterns. The projected cervicogram is comparable to direct visual colposcopic magnification and resolution. The cervicogram can be obtained by a technician and sent to an expert for evaluation. A study of 700 women was undertaken to compare the diagnostic accuracy of colposcopic, cytologic, and cervicographic findings. In 296 women with abnormal cytologic findings, 136 cases of dysplasia or carcinoma were diagnosed by directed biopsy. In 91.1%, both colposcopic and cervicographic findings were suspicious; 2.9% of the cases were detected solely by cervicography, and 5.9% were detected solely by colposcopy. In 404 routinely screened patients with no previous abnormal cytologic findings, nine cases (2.2%) of dysplasia were detected solely as a result of cervicographic screening.
Medical Student Performance After a Vertically Integrated Radiology Clerkship.

Abstract Purpose Proper selection of imaging examinations and basic image interpretation skills are essential for all physicians, yet only approximately 25% of US medical schools require clerkships in radiology. Although there is limited time in most medical school curricula to allow the addition of a required radiology clerkship, the authors developed one that is vertically integrated over a two-year period. This clerkship includes one week of contact with radiologists distributed over the M2 and M3 years, podcasts, online modules, required readings, and presentations. A standard national examination is administered at the end of the clerkship period. This clerkship was designed to address the educational needs of students while occupying minimal time in the curriculum. The purpose of this study was to determine if students completing this clerkship perform as well on a national radiology examination as students from other medical schools, regardless of their curricula. Methods At the end of the M3 year, these students take a computer-based radiology examination developed by the Alliance of Medical Student Educators in Radiology and used by students at multiple medical schools nationally. The mean and median scores of these students were compared with those of students at these other institutions. Results The mean and median scores of the students were 74% and 74% (standard deviation, 7.5%) compared with 74% and 50% (standard deviation, 8.4%) at other institutions. Conclusions Students completing this vertically integrated radiology clerkship had test scores comparable with those of students at other medical schools.
A fast isomorphism test for groups whose Lie algebra has genus 2

Abstract Motivated by the desire for better isomorphism tests for finite groups, we present a polynomial-time algorithm for deciding isomorphism within a class of p -groups that is well-suited to studying local properties of general groups. We also report on the performance of an implementation of the algorithm in the computer algebra system magma .
Selectin blockade decreases postischemic recruitment of bone marrow stromal cells

Objectives/Hypothesis Investigate the localization mechanisms of bone marrow stromal cells following transient ischemia-reperfusion injury in a murine flap model. Study Design Controlled laboratory study. Methods A cutaneous flap based on the inferior epigastric artery was elevated, and transient ischemia of 3.5 hours using a microvascular clamp was achieved. Fucoidan was injected intravenously 24 hours before the ischemic period. Following the period of ischemia, radiolabeled bone marrow stromal cells were injected intravenously, and radioactivity was determined postoperatively. Results Attenuation of the uptake of bone marrow stromal cells into postischemic tissue was observed in those mice treated with fucoidan as indicated by gamma counts measured in the flaps when compared with controls (P < . 001). Conclusions Decreased uptake of radiolabeled bone marrow stromal cells into postischemic tissues pretreated with fucoidan indicates selectin-mediated bone-marrow stromal cell recruitment in a murine cutaneous flap model. Level of Evidence N/A. Laryngoscope, 123:2993–2995, 2013