cssi/SciSciGPT-SciSciNet huggingface dataset:
Detection of strabismus by the Spot Vision Screener

Background The Spot Vision Screener, a new automated screener designed for use in schools and pediatric offices, refers children for strabismus based on the device's measurement of “gaze.” We sought to evaluate its ability to detect manifest strabismus of ≥8 Δ in primary position, which criteria is specified by the 2013 guidelines of the American Association for Pediatric Ophthalmology and Strabismus for detection of amblyopia risk factors by automated vision screeners. Methods In this prospective study, new and returning patients seen in the pediatric ophthalmology clinic underwent screening with the Spot Vision Screener (version 1.1.51) prior to a complete examination by a pediatric ophthalmologist. A Research Electronic Data Capture database was created for results of Spot referral status and examination. Patients who were referred by the Spot for gaze were included as test positives. Patients found to have constant strabismus of ≥8 Δ in primary position by the physician were considered referral positive. Results A total of 444 children (average age, 72 months; range, 11-221 months) were included. Of these, 93 (20.9%) met the referral-positive threshold for strabismus criteria on examination by the pediatric ophthalmologist. The sensitivity of the Spot to detect AAPOS-threshold strabismus was 77.17%; the specificity, 93.73%. Positive predictive value was 76.34%; negative predictive value, 94.0%. Conclusions The Spot demonstrates good sensitivity and excellent specificity for detecting AAPOS-threshold strabismus.
On the isotropy of randomly generated representative volume elements for fiber-reinforced elastomers

Abstract The isotropy of different numerical simulations of fiber reinforced elastomers has been explored by explicitly applying stretch in different loading directions, in models with representative volume elements (RVEs) spanning a wide range of fiber volume fractions and system sizes. The results show that the homogenized response is not the same for all loading directions, and that the corresponding dependance takes the form of a sine. The anisotropy decreases with the RVE size, and so it can be used to asses if the scales can be separated in a given model. Considering the average response over all loading directions greatly reduces the variation between different RVEs, which can be used to improve the accuracy of the simulations in a way that is significantly more efficient than increasing the size of the RVE. The simulations have also shown a good correlation between the isotropy of each representative volume element at low and high values of the applied stretch. The result of linear simulations can therefore be used as an efficient indication of the anisotropy expected at high deformations.
Broadcasting Truth to Power:The American Friends Service Committee and the Early Southern Civil Rights Movement

This article addresses two gaps in the historical literature on the modern civil rights movement. First, it highlights the contributions of the American Friends Service Committee (AFSC) to the struggle for racial justice in the South. Second, it reveals the importance of radio broadcasting in helping to create a climate in which southern white racial attitudes and discriminatory practices were challenged. It demonstrates how AFSC-sponsored broadcasts reflected Quaker principles, but also how debates over appropriate programme content exposed the tensions between principled and pragmatic considerations, morality and expediency, that shaped the Movement and detem1ined the AFSC's role in it.
Tailoring the Composition of Bio‐oil by Vapor‐Phase Removal of Organic Acids

Selective removal of organic acids from biomass pyrolysis vapors was demonstrated. A broad adsorbent range was tested with CaCO3 showing the best selectivity. Extensive material characterization demonstrated that the acid removal occurred through monolayer adsorption on CaCO3. Adsorbent regeneration was achieved by in situ heat treatment of the postreaction adsorbent where the adsorbed acid was converted into a ketone. The mitigation of the loss of other products was achieved by using surface modified CaCO3 materials, resulting in a significant improvement in the selectivity toward organic acid removal. The surface modification appeared to lead to formation of a metal-carboxylate intermediate consisting of both acetate and carbonate groups. Acetate group on the CaCO3 surface resulted in the suppression of side reactions. Generally, a higher acid removal was accompanied with a greater loss of other compounds, which could be tuned by using CaCO3 with different surface modification.
Beads on a Chain (BoC) Polymers with Model Dendronized Beads. Copolymerization of [(4-NH2C6H4SiO1.5)6(IPhSiO1.5)2] and [(4-CH3OC6H4SiO1.5)6(IPhSiO1.5)2] with 1,4-Diethynylbenzene (DEB) Gives Through-Chain, Extended 3-D Conjugation in the Excited State That Is an Average of the Corresponding Homopolymers

The general objectives of the work reported here and in accompanying papers are to identify optimal tools for the synthesis of silsesquioxane (SQ)-based BoC oligomers and polymers, especially those that show 3-D, through-chain (cage) conjugation in the excited state. Here we first examine the utility of polymerizing (p-IPhSiO1.5)8 with divinylbenzene (DVB) using Heck catalytic cross-coupling as baseline systems for BoCs with model dendrons. Thereafter, we functionalize the remaining IPh groups by cross-coupling with 4-MeOC6H4CH═CH2 or 4-NH2C6H4CH═CH2. As an alternate approach, we first functionalize (p-IPhSiO1.5)8 with 4-MeOC6H4CH═CH2 or 4-NH2C6H4CH═CH2 by catalytic cross-coupling such that only an average of two iodophenyls remain and then polymerized with DVB or 1,4-diethynylbenzne (DEB). This latter approach permits synthesis of copolymers as demonstrated using 1:1 mixtures of the two SQs with R = NH2 or OMe. Here we assess the utility of two different routes to conjugated BoC polymers. Investigation o...
A Case of Susac Syndrome

A 32-year-woman presented with mild encephalopathy, unsteady gait and instability, history of bilateral deafness, and bilateral visual changes. Magnetic resonance imaging of the brain demonstrated multiple hyperintensities involving the corpus callosum (Figure 1). There was no cord signal abnormality on imaging studies of the spinal cord. Imaging studies of the cervical and intracranial vasculature showed no evidence of vasculitis. Cerebrospinal fluid markers for inflammation and demyelination were negative, including oligoclonal bands. Visual evoked potentials were within normal limits. Extensive laboratory testing including Lyme antibody titers was unremarkable. Ophthalmology referral confirmed bilateral branch retinal artery occlusions. The patient was also referred for audiography evaluation, which confirmed bilateral hearing loss. These symptoms, retinal and audiographic examination, and imaging study findings were consistent with a diagnosis of Susac syndrome. Susac syndrome is an immune-mediated endotheliopathy characterized by the triad of encephalopathy, cochlear hearing loss, and retinal artery occlusions diagnosed by clinical examination supported by pathognomonic corpus callosum involvement on magnetic resonance imaging.1 The patient was initially treated with corticosteroids, but these were discontinued following resolution of symptoms, as Susac syndrome is a self-limiting condition. Should she experience recurrence of symptoms, options for therapy include a combination of immunosuppressive agents such as corticosteroids, intravenous immunoglobulin, methotrexate, mycophenolate, and cyclosphosphamide.2 Figure 1. Magnetic resonance imaging (MRI) of brain T2 fluid-attenuated inverted recovery (FLAIR) demonstrating multiple hyperintensities involving the corpus callosum.
Intestinal myoelectric alterations in rats chronically infected with the tapeworm Hymenolepis diminuta

This study determined that intestinal myoelectric activity was profoundly altered during a strictly luminal, chronic, tapeworm infection. Chronically implanted bipolar electrodes were attached to five sites on the serosal surface of the rat small intestine. One was placed on the duodenum, three on the jejunum, and the fifth on the ileum. Electromyographic recording in nonfasted unanesthetized animals was begun at day 5 postsurgery. All electromyographic recordings were analyzed for slow wave (SW) frequency, phase III frequency, duration of phase III, and percentage of SW with spike potentials. Three initial control recordings prior to infection confirmed the presence of normal interdigestive motility characterized by the three phases (I, II, III) of the migrating myoelectric complex (MMC). Two nonpropulsive myoelectric alterations were observed in infected animals: the repetitive bursts of action potentials (RBAP) and periods of sustained spike potentials (SSP). Myoelectric activity from infected animals indicated decreased cycling of the interdigestive MMC. RBAP and SSP were more prevalent in the distal small intestine corresponding to tapeworm location. The percent of spike potential activity indicated that there was a reversal in the spike potential gradient on the small intestine. The number of spike potentials was maximal in caudal and minimal in oral intestine. We propose that overall localized increases in myoelectric spike potential activity represent increased contractility and decreased propulsion triggered by the presence of the tapeworm. These motility changes were surprising, since the tapeworm Hymenolepis diminuta does not penetrate the intestinal mucosa. This interaction between parasite and host may prevent expulsion of the tapeworm from the small intestine.
Purification and Chemical Sensitization of Photographic Gelatin

AbstractA photographic method for the evaluation of methods of producing inert gelatins is described. Of the several methods studied, treatment with peroxyacetic acid was most effective. A gelatin treated in this way was partially restored to its original photographic characteristics by the addition of both sodium thiosulphate and sodium sulphite.
Hypoxia-induced let-7d has a role in pericyte differentiation

The microvascular pericyte is an important regulatory cell that maintains tissue homeostasis. One of the mechanisms by which pericytes maintain tissue homeostasis is through the induction of endogenous adaptative changes to stress signals. These adaptations include migration, differentiation and induction of angiogenesis. We have investigated pericyte responses to hypoxic stress (1 % O2) and have reported that pericytes adapt to hypoxia, in part, through changes in endogenous and released microRNAs (miRNAs). Of those miRNAs, Let-7d plays an important role. We exposed pericytes to hypoxia with and without basic fibroblast growth factor (bFGF) in stem cell medium. The expression of Let-7d in pericyte-derived neurospheres was determined. Evidence of differentiation was determined by immunocytochemistry. Hypoxia enhanced pericyte spheres were positive for Let-7d. The transcription factor Sox2, a marker of cell differentiation, was also induced in pericytic spheres. Taken together, our results suggest that pericyte expression of Let-7d in response to hypoxia and bFGF is involved in pericyte differentiation. Thus, for the first time, we propose a pathway for induction of pericyte differentiation. Modulation of this pathway in pericytes may be an important target in tissue repair.
Positron Decay of Y 88

The weak positron spectrum in the decay of Y/sup 88/ has been investigated using a 4 pi -positron-scintillation spectrometer. Two measurements of the spectrum yield experimental shape factors which are consistent above 250 kev with that expected for a unique once-forbidden transition. The average end- point energy obtained in these two measurements is 761 plus or minus 9 kev. The positron branching was measured and found to be 0.20 plus or minus 0.01%. The log ft is 9.4, and log f/sub 1/t is 8.7. On the basis of recent measurements of the gammaray intensities in the Y/sup 88/ decay the electron capture branching to the 1840-kev level is determined to be 5.8 plus or minus 0.7%, which yields an electron capture to positron ratio of 29 plus or minus 4 for this transition. (auth)
Exploiting Drosophila genetics to understand microRNA function and regulation

Although a great deal is known about the identity, biogenesis, and targeting capacity of microRNAs (miRNAs) in animal cells, far less is known about their functional requirements at the organismal level. Much remains to be understood about the necessity of miRNAs for overt phenotypes, the identity of critical miRNA targets, and the control of miRNA transcription. In this review, we provide an overview of genetic strategies to study miRNAs in the Drosophila system, including loss- and gain-of-function techniques, genetic interaction strategies, and transgenic reporters of miRNA expression and activity. As we illustrate the usage of these techniques in intact Drosophila, we see certain recurrent themes for miRNA functions, including energy homeostasis, apoptosis suppression, growth control, and regulation of core cell signaling pathways. Overall, we hope that this exposition of Drosophila genetic techniques, well known to the legions of fly geneticists and used to study all genes, can inform the general miRNA community that focuses on other biochemical, molecular, computational, and structural avenues. Clearly, it is the combination of these myriad techniques that has accelerated miRNA research to its extraordinary pace.
Structured regularization for barrier NLP solvers

Barrier methods have led to several nonlinear programming (NLP) solvers (e.g. IPOPT, KNITRO, LOQO). However, certain regularity conditions are required for convergence of these methods. These conditions are violated for optimization models with dependent constraints, thus leading to method failure. These shortcomings can be identified by checking the inertia of the KKT matrix, and current solvers either add regularizing terms to correct the inertia of the KKT matrix or revert to more expensive trust region methods to solve the barrier problem. This study improves on these approaches with a new structured regularization strategy; within the Newton step it identifies an independent subset of equality constraints and removes the remaining constraints without modifying the KKT matrix structure. This approach leads to more accurate Newton steps and faster convergence, while maintaining global convergence properties. Implemented in IPOPT with linear solvers HSL_MA57, HSL_MA97 and MUMPS, we present numerical experiments on hundreds of examples from the CUTEr test set, modified for dependency. These results show an average reduction in iterations of more than 50 % over the current version of IPOPT. In addition, several nonlinear blending problems are solved with the proposed algorithm, and improvements over existing regularization strategies are further demonstrated.
Modeling the within-host dynamics of cholera: bacterial–viral interaction

ABSTRACTNovel deterministic and stochastic models are proposed in this paper for the within-host dynamics of cholera, with a focus on the bacterial–viral interaction. The deterministic model is a system of differential equations describing the interaction among the two types of vibrios and the viruses. The stochastic model is a system of Markov jump processes that is derived based on the dynamics of the deterministic model. The multitype branching process approximation is applied to estimate the extinction probability of bacteria and viruses within a human host during the early stage of the bacterial–viral infection. Accordingly, a closed-form expression is derived for the disease extinction probability, and analytic estimates are validated with numerical simulations. The local and global dynamics of the bacterial–viral interaction are analysed using the deterministic model, and the result indicates that there is a sharp disease threshold characterized by the basic reproduction number R0: if R0<1, vibrios...
Life-Cycle Approach to Collecting, Managing, and Sharing Transportation Infrastructure Asset Data

AbstractTransportation asset management (TAM) demands a data-driven decision-making process to proactively maintain, preserve, and extend the long-term service life of transportation assets. State ...
Clinical Significance of Free Circulating CD4 and CD8 in Patients with Acute Myeloid Leukemia and Myelodysplastic Syndrome.

CD33, a 67-kDa sialoglycoprotein expressed on the cell surface of monocytic/myeloid lineage and early hematopoietic progenitor cells, is frequently expressed in patients with acute myeloid leukemia (AML). Gemtuzumab ozogamicin (GO), an immunoconjugate consisting of a humanized anti-CD33 antibody and a cytotoxic compound (N-acetyl-γ-calicheamicin dimethylhydrazine), targets CD33 and has shown promising results in patients with AML. No evidence of a relationship between the levels of CD33-positive leukemic cells and clinical response has been found. We investigated the possibility that cell-free circulating CD33 (cCD33) might be useful as a marker of clinical behavior. We used a newly developed bead-based immunoassay to measure cCD33 in the plasma of patients with AML (n = 97) or myelodysplastic syndrome (MDS; n = 44). All patients were treated with standard therapy including idarubicin and ara-C. cCD33 levels were significantly higher in patients with MDS (median, 1600 U/μL; range, 102–791,350 U/μL) than in those with AML (median, 2709 U/μL; range: 62–263,349 U/μL) (P = 0.004). High-risk cytogenetic abnormalities were associated with higher cCD33 levels in patients with MDS (P = 0.04) but not in patients with AML (P = 0.72). cCD33 levels correlated with WBC count and % monocytes in patients with AML (R >0.35) but not in patients with MDS. cCD33 levels correlated with clinical behavior only among AML patients with intermediate-risk cytogenetic abnormalities (n = 56); those with cCD33 levels above the median had longer survival (P = 0.04). These data confirm the presence of cCD33 in AML and MDS and also suggest that cCD33 can be used as a tumor marker in patients with AML. Although further study is needed for confirmation, cCD33 appears to result from turnover of leukemic cells, may play a role in patients being treated with GO, and should be considered in the pharmacokinetic and pharmacodynamic studies of such therapy.
An Approach to Quantify the Factors That Affect Performance Measurement System Implementation

AbstractAlthough there have been many important academic advancements in the area of performance measurement systems, many practitioners and researchers still report encountering significant challenges during practical applications. This has led to the development of research to identify factors that affect the success of performance measurement systems. Previous studies attempt to identify and evaluate these factors, but there is little evidence of the inter-relationships and overall effects of various factors on the successful implementation of performance measurement systems. This article describes an exploratory study that applies an existing approach, originally proposed to design performance measurement systems, to investigate the effectiveness of the approach in quantifying the systemic effects of success factors on the implementation of a performance measurement system. The results of this study suggest that applying this approach provides quantitative assessments of the systemic effects of the su...
Urinary diversions in low-resource settings

Obstetric fistula is a devastating consequence of poorly attended childbirth which occurs almost exclusively in low resource settings. Most women with fistula can be cured or significantly improved by one or more vaginal surgeries. The last resort for women with otherwise incurable obstetric fistula is urinary diversion. The ileal conduit urinary diversion was the procedure considered by the authors of the accompanying article (Walker et al BJOG). Under optimal conditions, any urinary diversion is fraught with numerous potential risks. These include anastomotic leak, surgical site infection, sepsis, metabolic abnormalities, ureteral obstruction, uremia and death. In low resource settings, the magnitude of these complications is magnified exponentially by pervasive shortages of staff, supplies, training and high level care. Patients must be counseled on these risks when undergoing urinary diversion procedures: Risks which extend beyond the peri-operative period and involve more than just physical sequelae. This article is protected by copyright. All rights reserved.
Association between statin use, the vaginal microbiome, and Gardnerella vaginalis vaginolysin-mediated cytotoxicity.

Background Bacterial vaginosis (BV) is the leading dysbiosis of the vaginal microbiome. The pathways leading towards the development of BV are not well understood. Gardnerella vaginalis is frequently associated with BV. G. vaginalis produces the cholesterol-dependent cytolysin (CDC), vaginolysin, which can lyse a variety of human cells and is thought to play a role in pathogenesis. Because membrane cholesterol is required for vaginolysin to function, and because HMG-CoA reductase inhibitors (statins) affect not only serum levels of cholesterol but membrane levels as well, we hypothesized that statins might affect the vaginal microbiome. Methods To investigate the relationship between use of the statins and the vaginal microbiome, we analyzed 16S rRNA gene taxonomic surveys performed on vaginal samples from 133 women who participated in the Vaginal Human Microbiome Project and who were taking statins at the time of sampling, 152 women who reported high cholesterol levels but were not taking statins, and 316 women who did not report high cholesterol. To examine the effect of statins on the cytolytic effect of vaginolysin, the cholesterol-dependent cytolysin (CDC) produced by Gardnerella vaginalis, we assessed the effect of simvastatin pretreatment of VK2E6/E7 vaginal epithelial cells on vaginolysin-mediated cytotoxicity. Results The mean proportion of G. vaginalis among women taking statins was significantly lower relative to women not using statins. Women using statins had higher mean proportions of Lactobacillus crispatus relative to women with normal cholesterol levels, and higher levels of Lactobacillus jensenii relative to women with high cholesterol but not taking statins. In vitro, vaginal epithelial cells pretreated with simvastatin were relatively resistant to vaginolysin and this effect was inhibited by cholesterol. Conclusions In this cross-sectional study, statin use was associated with reduced proportions of G. vaginalis and greater proportions of beneficial lactobacilli within the vaginal microbiome. The negative association between statin use and G. vaginalis may be related to inhibition of vaginolysin function.
A Rhodium-Cyanine Fluorescent Probe: Detection and Signaling of Mismatches in DNA

We report a bifunctional fluorescent probe that combines a rhodium metalloinsertor with a cyanine dye as the fluorescent reporter. The conjugate shows weak luminescence when free in solution or with well matched DNA but exhibits a significant luminescence increase in the presence of a 27-mer DNA duplex containing a central CC mismatch. DNA photocleavage experiments demonstrate that, upon photoactivation, the conjugate cleaves the DNA backbone specifically near the mismatch site on a 27-mer fragment, consistent with mismatch targeting. Fluorescence titrations with the 27-mer duplex containing the CC mismatch reveal a DNA binding affinity of 3.1 × 106 M–1, similar to that of other rhodium metalloinsertors. Fluorescence titrations using genomic DNA extracted from various cell lines demonstrate a clear discrimination in fluorescence between those cell lines that are proficient or deficient in mismatch repair. This differential luminescence reflects the sensitive detection of the mismatchrepair-deficient pheno...
Study of the upper airway of obstructive sleep apnea patient using fluid structure interaction.

Abstract Up to 14% of the U.S. population is estimated to have obstructive sleep apnea (OSA), while the outcomes of the treatments have variable results. In the current study, a three-dimensional fluid-structure interaction modeling was applied to simulate the upper airway to identify the precise location, severity, and characteristic of airway collapse. This was accomplished using Simpleware® and ANSYS® software applied to a 3-D rendering of the airway in a real patient with severe OSA. During this simulation, areas which are prone to collapse and precipitate apneic episodes were identified at the tip of the soft palate and the base of the tongue, with intrathoracic pressure as low as −1370 Pa. These results are consistent with anatomical structures currently indicated and targeted in the treatment of OSA. This improved FSI modeling simulation, which is the first to completely model the whole upper airway without consideration of the nasal cavity in OSA, and can allow virtual modification of the airway prior to actual treatment by doctors.
Factors affecting annual compensation and professional development support for infection preventionists: Implications for recruitment and retention.

Background Factors affecting annual compensation and professional development support have been studied for various healthcare professions. However, there is little understanding of these factors for infection preventionists (IPs). Methods Using secondary data from the Association for Professionals in Infection Control and Epidemiology 2015 MegaSurvey, we designed a descriptive, correlational study to describe IP annual compensation and professional development support. We tested for associations between demographic variables and annual compensation and investigated for predictors of higher annual compensation. Results Median salary for IPs was $75,000. IPs who indicated that their compensation was based on industry benchmarks reported a median salary of $85,000 (P Conclusion This study can be used to develop recruitment and retention guidelines that lead to a well-educated, well-compensated, and competent IP workforce.
Interactions with Temporal Adverbials

Our main concern in this chapter are the questions of what functions temporal adverbials can have in simple tense clauses and in perfect clauses, and how temporal adverbials can interact with each other. We will identify possible functions of temporal adverbials and provide evidence that temporal adverbials can indeed take over these functions. Of course this general working strategy does not imply any claims about any particular adverbials, nor does it take into account idiosyncratic properties of adverbials in much detail. We will take it for granted that the classification of temporal adverbials as sketched in chapter 4, and as supplemented by more subtle distinctions in the literature, is well-motivated; that the internal semantic composition of particular temporal adverbials can be captured adequately, and we will assume plausible definitions of the semantic contribution of particular adverbials without arguing for them in detail.
Modularity-In-Design: An Analysis Based On the Theory Of Real Options

This paper investigates the economic role of modularity in the design of new products and processes. We construct a formal model of the design process based on the financial theory of options, and analyze the benefits and costs of breaking apart a complex design into independent modules linked by pre-established interfaces. The model provides a rigorous framework for dealing with the effects of uncertainty, and shows how modular designs, independent experiments and testing technologies interact to create economic value. The model also shows how modularity rests on and contributes to the knowledge and organizational structure of a company.
Photochemical synthesis of oligothiophene thin films and nano-patterns in condensed multilayer films of 2,5-diiodothiophene—Effects of surface chemistry of substrates

Abstract This paper reviews photochemical reactions of 2,5-diiodothiophene multilayers on various solid substrates that lead to production of oligothiophene thin films and micro-patterns with a thickness relevant to nanotechnology applications. Upon UV absorption, the C I bond of 2,5-diiodothiophene dissociates generating a thienyl radical and iodine atom. The radicals generated in multilayers can react with other radicals or intact monomers to form dimers. Since the C I bonds are present at the ends of the coupling reaction product, further photodissociation and coupling reactions can take place forming oligomeric species. On inert substrates, the average conjugation length of the product is about 3–4 thienyl units. Various pattern generation schemes can be incorporated with this photochemical reaction. Examples of masked irradiation, wettability pre-patterning, and controlled clustering of thermal desorption process are demonstrated. On copper surfaces, the average conjugation length of the produced oligothiophene is increased to 6–7 units, which is long enough for technical applications. This increase is due to Ullmann coupling reactions at the buried interface between the copper and adsorbed film. The mechanism for this buried surface reaction is elucidated from the thickness dependence of the conjugation length and Ullmann coupling side product.
Immune Checkpoint Inhibitors in Small Cell Lung Cancer: A Partially Realized Potential

Small cell lung cancer (SCLC) is a highly lethal subtype of lung cancer that has seen few therapeutic advances, despite ongoing concerted efforts. Immunotherapy has been an effective option in other carcinogen-related cancers and has shown modest activity in SCLC. Monotherapy with the anti-PD-1 antibody nivolumab in patients with at least two prior lines of therapy was associated with a response rate of 11.9% and a median duration of response of 17.9 months, leading to accelerated approval by the Food and Drug Administration (FDA) as third-line therapy for SCLC. Second-line checkpoint inhibitors have not performed well enough to change the standard of care, and maintenance immunotherapy has not shown significant benefit. However, the incorporation of concurrent immunotherapy in the first-line treatment of SCLC has improved outcomes. The addition of the anti-PD-L1 antibody atezolizumab to standard carboplatin plus etoposide led to an improvement in progression free survival (PFS) and overall survival, the first such improvement in over 30 years leading to the approval of atezolizumab as part of first-line therapy for advanced SCLC. While these landmark approvals offer promising novel treatment options for this recalcitrant disease, more work is needed to optimize their delivery and to build upon these important advances.
Severe Trauma Leads to a Fall in Intracellular Triphosphates and a Rise in cAMP in Platelets

Background: Severe trauma and hemorrhage leads to an acute coagulopathy as exemplified by a rise in prothrombin time, and a fall in clotting firmness and platelet aggregation. Because platelets contribute 70-80% of the clot strength, evaluating the intracellular mechanisms that regulate aggregation may lead to strategies to mitigate the development of coagulopathy. Platelet aggregation requires energy, and energy stores may be depleted after hemorrhagic shock and tissue trauma. Also, aggregation is initiated by elevations in inositol trisphosphate and calcium, and inhibited by elevations in cyclic adenosine and guanosine monophosphates. Platelet dysfunction after trauma may involve one or more of these intracellular intermediates. Objective: To measure intracellular levels of mono- and tri-phosphates in platelets from rats subjected to polytrauma and hemorrhagic shock. Methods: Polytrauma was induced in isoflurane anesthetized Sprague-Dawley rats (n=10 per group) by damage to the small intestines, right and medial lobes of the liver, the right leg skeletal muscle, and by fracturing the right femur. 40% hemorrhage was then performed immediately after trauma. Blood samples were taken before, immediately after trauma, and at 2 and 4hrs. Platelet rich plasma PRP was generated by centrifugation of whole blood at 200g for 10min, no brakes. Cyclic AMP and cGMP were extracted from 100μl of PRP after adding to 1ml of EtOH, 10mM ammonium formate, with 10μg/ml cGMP-Br as an internal control. Triphosphates were extracted from another 100μl PRP by addition of 50% EtOH, 500mM Formic Acid with 10μg/ml ATP-C10 as an internal control. Samples were centrifuged at 20K g for 10min, and supernatant dried. All Samples were brought up in 200ul of 0.1% formic acid for analysis by LC-MS/MS. Results: In platelets, the intracellular levels of Adenosine Triphosphate (ATP), Guanosine Triphosphate (GTP) and Inositol Trisphosphate (IP3) all fell significantly by 4hrs after polytrauma and hemorrhage (ATP: 5.8±0.9 vs. 0.9±0.7μg/ml, GTP: 1.23±0.22 vs 0.01±0.01 μg/ml and IP3: 625±310 vs 125±36 ng/ml). Cyclic AMP was significantly elevated over baseline (10.4±0.7 vs 15.1±1.63ng/ml), however cGMP was down (1.17±0.39 vs 0.10±0.12 ng/ml). Conclusion: The platelet dysfunction that accompanies polytrauma and hemorrhagic shock may be a result of falling energy stores (ATP, GTP), a loss of IP3 mediation of Ca dependent aggregation, and a rise in the inhibitory mediator cAMP. These results suggest that the addition of metabolic substrates to standard resuscitation fluids may help restore platelet function after trauma and hemorrhage. Disclosures No relevant conflicts of interest to declare.
Clinical Decision Support Tools for Microbiology Laboratory Testing

Abstract Microbiology clinical laboratory testing has a vital impact on diagnostic and treatment decisions for patients with infectious diseases, but poor utilization can lead to diagnostic errors, overuse of antibiotics, and increased hospital stays for unnecessary treatment. Traditional efforts to improve test utilization, such as education and one-on-one engagement with clinicians, are not always effective at achieving widespread and long-lasting benefits. Clinical decision support (CDS), the use of computer and communication technology to improve clinical decision making, is one option to improve test utilization at an institutional level with minimal day-to-day effort. In this article, examples of CDS are introduced to demonstrate both the potential of CDS to improve microbiology test utilization and the challenges involved in its implementation and maintenance.
Remembering Dr. James H. Cone

In this essay, I reflect on Dr. James H. Cone’s legacy as a teacher and mentor who generously invested in multiple generations of students – including white students like me. This is one of several short essays presented by recent students at a public forum at Union Theological Seminary after his death in 2018.
Policing a Pandemic: Stay-at-Home Orders and What they Mean for the Police.

The COVID-19 pandemic has dramatically altered life globally during the first 4 months of 2020. Many countries, including the United States, responded to the pandemic by issuing stay-at-home orders/shelter-in-place orders (SaHOs/SiPOs) to their citizens. By April 2020, more than 90% of the U.S. population was subject to an order. SaHOs/SiPOs raise a number of complex issues for the police, ranging from concerns about infringement of constitutional rights to potential sanctions for violations of an order. This article delves into the issues surrounding SaHOs/SiPOs and highlights their complexity for the police. First, we examine the "why the police?" question, and point to key features of their role which make enforcement of SaHOs/SiPOs the proper business of the police. Second, we examine the relevant legal doctrines that can serve as the basis for police actions against violators of orders, most notably the special needs doctrine. Last, we offer police legitimacy as a lens for viewing the appropriateness of police responses to violators of SaHOs/SiPOs.
What dimensions of career expos have the most impact on student satisfaction

Abstract Even though the career expo is an important career engagement initiative for hospitality management programs, it has been under-researched in hospitality education. Hence, this study investigated the underlying quality dimensions of hospitality career expos and their impact on student satisfaction. A total of 319 useable student responses were collected from 11 hospitality programs. Five quality dimensions of hospitality career expos were identified through exploratory factor analysis. The results of multiple regression analysis indicated that four out of five career expo factors (exhibitor performance, pre-event service, event organization, and job information) have a significant impact on student satisfaction with career expos. Detailed implications for event organizers and hospitality management programs are discussed.
News Frames and News Exposure Predicting Flu Vaccination Uptake: Evidence from U.S. Newspapers, 2011-2018 Using Computational Methods.

Flu remains a prevalent public health issue and the flu vaccine uptake remains low. This study examined the behavioral consequences of first- and second-level agenda setting by testing the effects ...
Optimizing Bag Selection: An Overview of Laparoscopic Specimen Retrieval Bags

Study Objective The objective of this video is to provide an overview of the variety of different specimen retrieval bags available in the United States, offer practice guidelines for bag selection, and review bag terminology to highlight important concepts for bag selection. Design Although a number of companies manufacture laparoscopic bags to assist in removal of specimens from the body cavity, differences in size, shape, and labeling of the bags lead to confusion when attempting to choose the best laparoscopic bag for one's needs. Setting Laparoscopic Surgery Requiring Specimen Removal. Patients or Participants N/A Interventions N/A Measurements and Main Results To assist viewers, we include a review table comparing various specifications of the most common laparoscopic bags in the United States. We talk viewers through steps on how to choose a bag during laparoscopic surgery. These steps include first determining the specimen size, type and shape. These specimen characteristics will dictate the required bag size and type of bag, and which ultimately will influence laparoscopic trocar size. Finally, we demonstrate the bagging of various tissue specimens with different sizes and shapes of laparoscopic bags. Conclusion To maximize operating room efficiency, we recommend starting off by thinking about the characteristics of the pathology, which will dictate bag size and bag type, which finally will influence trocar size. Starting off with an appropriate laparoscopic bag will reduce operating room efficiency and allow for safe laparoscopic removal of specimens from the body cavity.
A clinical focus on the use of extended-duration thromboprophylaxis in medically ill patients

Purpose This review describes and analyzes literature to provide recommendations for use of extended-duration thromboprophylaxis (EDT) in medically ill patients. Summary Guidelines recommend pharmacologic thromboprophylaxis for patients at increased thrombosis risk during hospitalization and recommend against extending thromboprophylaxis beyond hospitalization. Despite these recommendations, observational data demonstrate that venous thromboembolism (VTE) risk persists following hospital discharge. A MEDLINE literature search was performed to identify original research evaluating the safety and efficacy of EDT. Eight meta-analyses and 5 randomized controlled trials-each varying in the agents studied (enoxaparin, rivaroxaban, apixaban, and betrixaban)-were selected for inclusion. Collectively, the evaluated data demonstrates that EDT reduces the incidence of VTE at the expense of increasing the risk of major bleeding and without providing mortality reduction. Variations in enrollment criteria, differences in EDT strategies, and uncertainty regarding proper patient selection limit the applicability of EDT in practice. Rivaroxaban and betrixaban gained Food and Drug Administration (FDA) approval on the basis of results of the APEX and MARINER trials and a post hoc analysis of the MAGELLEN trial results. Although a number of agents are FDA approved for use in EDT, clinicians must carefully weigh the risks vs benefits of EDT with these agents until studies demonstrate a more favorable risk-benefit profile. Conclusion Evidence to support EDT in medically ill patients is inconclusive and has highlighted the need for an individualized approach. The reviewed evidence supports guideline recommendations from both the American College of Chest Physicians and the American Society of Hematology that recommend against routine use of EDT in the majority of medically ill patients. Future studies are needed to optimize the risk-benefit profile of EDT and to ensure proper patient selection.
Anticipatory human subthalamic area beta-band power responses to dissociable tastes correlate with weight gain

Abstract The availability of enticing sweet, fatty tastes is prevalent in the modern diet and contribute to overeating and obesity. In animal models, the subthalamic area plays a role in mediating appetitive and consummatory feeding behaviors, however, its role in human feeding is unknown. We used intraoperative, subthalamic field potential recordings while participants (n = 5) engaged in a task designed to provoke responses of taste anticipation and receipt. Decreased subthalamic beta-band (15–30 Hz) power responses were observed for both sweet-fat and neutral tastes. Anticipatory responses to taste-neutral cues started with an immediate decrease in beta-band power from baseline followed by an early beta-band rebound above baseline. On the contrary, anticipatory responses to sweet-fat were characterized by a greater and sustained decrease in beta-band power. These activity patterns were topographically specific to the subthalamic nucleus and substantia nigra. Further, a neural network trained on this beta-band power signal accurately predicted (AUC ≥ 74%) single trials corresponding to either taste. Finally, the magnitude of the beta-band rebound for a neutral taste was associated with increased body mass index after starting deep brain stimulation therapy. We provide preliminary evidence of discriminatory taste encoding within the subthalamic area associated with control mechanisms that mediate appetitive and consummatory behaviors.
Using Repetitive Control to Enhance Force Control During Human-Robot Interaction in Quasi-Periodic Tasks

We investigated the use of repetitive control (RC) to enhance force control during human-robot interaction in quasi-periodic tasks. We first developed a two-mass spring damper model and formulated three different RCs under force control: a 1st order RC (RC-1), a 3rd order RC designed for random period error, and a 3rd order RC designed for constant period error. Then, we quantified the performance of these three RCs through simulations and experiments conducted on a bench top linear platform, subject to nominal cyclical inputs (input signal and fundamental frequency: 0.5 Hz), and subject to inputs with random and constant period errors. Moreover, we compared the performance achieved with the RCs with those achievable with a passive proportional controller (PPC), subject to known theoretical limits for passivity and coupled stability. In both simulated and real-world experiments, the root mean square force error under nominal conditions was reduced most effectively by the RC-1 to 0.7% and 12.9%, respectively, of the error achieved with the PPC. Subject to inputs with constant period errors, RCs performed better than PPC for period error values below 0.05 Hz, with the RC-1 performing significantly better than both 3rd order RCs. Subject to inputs with random period errors, all RCs performed better than PPC up to 0.11 Hz of frequency error. Our results indicate that RC can successfully integrated in force control schemes to improve performance beyond the one achievable with a PPC, in the range of period variability expected in applications such as walking assistance and rehabilitation.
Reassigning the CaH+ 11Σ → 21Σ vibronic transition with CaD.

We observe vibronic transitions in CaD+ between the 11Σ and 21Σ electronic states by resonance enhanced multiphoton photodissociation spectroscopy in a Coulomb crystal. The vibronic transitions are compared with previous measurements on CaH+. The result is a revised assignment of the CaH+ vibronic levels and a disagreement with multi-state-complete-active-space second-order perturbation theory theoretical calculations by approximately 700 cm−1. Updated high-level coupled-cluster calculations that include core-valence correlations reduce the disagreement between theory and experiment to 300 cm−1.
Fulminant Colitis

Fulminant colitis is an important clinical challenge despite great progress in its management over the decades. Corticosteroids greatly reduced mortality and colectomy rates, however, case fatality rates remain at roughly 2%. The goal of medical therapy is to prevent colectomy while avoiding complications that may lead to death or worsen the outcome of colectomy, if this cannot be avoided. In addition to corticosteroids, cyclosporine and infliximab have been used in the setting of severe colitis. Rescue therapy with cyclosporine must be followed by maintenance therapy with a thiopurine agent if successful remission is to be maintained durably. Rescue therapy with infliximab may be followed by maintenance therapy with the same agent, or in some cases, by a thiopurine agent. Both cyclosporine and infliximab may be associated with increased risks, such as neurotoxicity in the case of cyclosporine, or opportunistic or serious infection in the setting of immune suppression from either agent. In either case, it is critical to avoid excessive prolongation of unsuccessful medical therapy if optimal surgical outcomes are to be achieved. A great deal of judgment is needed to guide the timing of colectomy, but it is clear that mortality increases as the time to colectomy is prolonged.
Occupational Rhinitis

Work-related rhinitis, which includes work-exacerbated rhinitis and occupational rhinitis, may be two to three times more common than occupational asthma. Both high molecular weight proteins and low molecular weight chemicals have been implicated as causes of occupational rhinitis. A diagnosis is established based on occupational history and, if appropriate, documentation of IgE-mediated sensitization to the causative agent. Management of work-related rhinitis is similar to that of non-work-related rhinitis and includes elimination or reduction of exposure to offending agents combined with pharmacotherapy. If treatment allergens are commercially available, allergen immunotherapy may also be considered if appropriate.
Co-Curriculum and ESL Student Success: A Case Study in an Intensive English Language Program

ABSTRACT This project examines the relationship between co-curricular activities and ESL student success in an intensive English language program. Extracurricular and co-curricular activities have been linked to the improvement of several factors, such as self-esteem, retention, and grade point average (Astin, 1984, 1999; Bergen-Cico & Viscomi, 2013). Research in second language acquisition has suggested that meaningful interaction between individuals in the target language (L2) will increase a student’s proficiency. Therefore, a ESL student’s further involvement in an intensive English program could have a major impact on not only their academic success (operationalized in this study by the amount of classes that received a passing mark), but also their proficiency. Documented are the lived experiences of four, advanced-level ESL students who are currently enrolled in an intensive English language program on the west coast of the United States. The information gathered through face-to-face interviews and an analysis of each student’s academic transcript is used to see if there is a relationship between the students’ academic involvement in co-curricular activities and their perception of their success.