cssi/SciSciGPT-SciSciNet huggingface dataset:
SLEEP AND ATTACHMENT IN PRETERM INFANTS

Infants born preterm are at elevated risk for socioemotional difficulties; however, factors contributing to this risk are largely understudied. Within the present study, we explored infant sleep as a biosocial factor that may play a role in infant socioemotional development. Within a prospective longitudinal design, we examined parent-reported sleep patterns and observed parenting quality as predictors of infant-mother attachment in 171 infants born preterm. Using structural equation modeling, we examined main effect and moderator models linking infant sleep patterns and parenting with attachment security. Sleep patterns characterized by more daytime sleep and positive/responsive parenting predicted infant attachment security. Parent-reported nighttime sleep patterns were unrelated to attachment in this sample of infants born preterm. These results indicate that daytime sleep and parenting quality may be important for emerging attachment relationships in infants born preterm. Abstracts translated in Spanish, French, German, and Japanese can be found on the abstract page of each article on Wiley Online Library at
H2O2 production and cytochrome c peroxidase activity in mitochondria isolated from the trypanosomatid hemoflagellate Crithidia fasciculata

Abstract H 2 O 2 production by coupled mitochondrial fractions from the protozoan, Crithidia fasciculata , has been measured spectrophotometrically by the formation of the stable enzyme-substrate complex with yeast cytochrome c peroxidase. H 2 O 2 formation was observed with succinate, l -α-glycerophosphate, l -proline, α-ketoglutarate, and with endogenous substrate. The maximum rate of H 2 O 2 generation obtained with each substrate in the presence of antimycin A was about 10% of the state 4 rate of O 2 respiration, and only 1–2% of the carbonylcyanide m -fluorophenylhydrazone-uncoupled respiratory rate. Therefore, excess O 2 uptake due to the formation of H 2 O 2 cannot satisfactorily account for the low ADP:O ratios previously reported. Cytochrome c peroxidase activity was measured in mitochondrial preparations by recording the decrease in absorbance at 550 nm during the oxidation of horse heart ferrocytochrome c which was observed after addition of H 2 O 2 . The distribution of activity after sonic disruption of mitochondrial preparations was that expected for a soluble enzyme. The activity was proportional to the amount of enzyme protein added, and was abolished by heating at 100 °C for 3 min. Total cytochrome c peroxidase activity in mitochondrial fractions isolated from C. fasciculata was calculated to be 0.3% that of isolated yeast mitochondria, but it is suggested that the in vivo activity may be considerably higher than this estimate.
Cabac Based Bit Estimation for Fast H.264 RD Optimization Decision

Rate distortion (RD) optimization, which is used to decide the best coding mode of a macroblock (MB) in H.264/AVC video coding standard, is a very efficient technique to improve coding performance. On the other hand, this RD optimization process also incurs a considerable complexity increase of the encoder. To reduce computational cost of RD optimization, fast bit estimation method can be adopted to avoid entropy coding computation during the mode decision process of H.264/AVC encoding [1] [2]. However, previous works [1][2] are all for CAVLC (Context Based Adaptive Variable Length Coding) based RD optimization process and are not accurate for CABAC (Context Based Adaptive Binary Arithmetic Coding) based RD optimization process. As known, compared with CAVLC, CABAC entropy coding provides higher coding efficiency at average bit rate saving of 9%-14% [3]. Hence, it is desirable to find a fast bit estimation method that is suitable for RD optimization with CABAC entropy coding. In this paper, we present such kind of fast bit estimation method. The experiments show that the proposed method can reduce around 30% of the RD optimization time averagely while maintaining the similar coding performance comparing to that of original H.264/AVC with RD optimization enabled.
Fractures and fracture-dislocations of the tarsometatarsal joint

We are reporting the results in a consecutive series of forty adults in whom, between 1978 and 1984, forty-one tarsometatarsal fracture-dislocations were treated with open reduction followed by temporary internal fixation with AO screws. Ninety per cent of the patients had an intra-articular or a periarticular fracture. An anatomical or nearly anatomical reduction was achieved in all but a few patients, and there was no loss of fixation or displacement. For thirty-four patients (thirty-five injuries), the length of follow-up averaged 3.4 years, and a good or excellent functional result was obtained in all but two of the thirty in whom an anatomical reduction had been achieved. Of the six patients who had a fair or a poor result, five had an associated grade-II or grade-III open injury. The development of post-traumatic arthritis was directly related to damage to the articular surfaces or to inadequate reduction, or to both.
Utilization of nitrogen in cows consuming wet distillers grains with solubles in alfalfa and corn silage-based dairy rations

The objectives of this experiment were to determine the effects of forage type on nutrient digestibility, purine derivative excretion, nitrogen utilization, and milk production in dairy cattle consuming rations containing high levels of wet distillers grains with solubles (WDGS). Primiparous (n = 8) and multiparous (n = 20) Holstein cows were used in a replicated 4 × 4 Latin square. Animals were fed 1 of 4 treatments during each 21-d period: 1) CONT-CS, 0% WDGS and high corn silage; 2) CONT-AS, 0% WDGS and high alfalfa silage; 3) WDGS-CS, 25% WDGS and high corn silage; and 4) WDGS-AS, 25% WDGS and high alfalfa silage (dry matter basis). Intake and milk data were collected daily and averaged for d 15 to 21 of each period. Dry matter intake was lower for CONT-CS than for CONT-AS, WDGS-CS, and WDGS-AS (22.5, 24.6, 24.6, and 24.8 kg/d, respectively). Digestibility of dry matter, organic matter, neutral detergent fiber, and N were not affected by treatment, averaging 59.6, 62.3, 40.1, and 58.6%, respectively. Excretion of urinary purine derivatives was greatest for WDGS-AS, followed by WDGS-CS, and then CONT-CS and CONT-AS. Thus, by calculation, estimated microbial protein flow was highest for WDGS-AS (2,189.9 g/d) followed by WDGS-CS (1,996.2 g/d), CONT-AS (1,640.0 g/d), and CONT-CS (1,627.0 g/d). Mass of fecal N was not different among treatments (averaging 287.1 ± 14.8 g/d), but urinary and manure N were reduced for rations with WDGS compared with those not including WDGS. Observed 4% fat-corrected milk was greatest for WDGS-AS, followed by WDGS-CS, and then CONT-CS and CONTAS (30.7, 29.7, 28.3, and 27.2 kg/d, respectively). Milk protein yield was greatest for WDGS-AS (1.00 kg/d), followed by WDGS-CS, and then CONT-AS and CONT-CS (0.96, 0.91, 0.86 kg/d, respectively). This research demonstrated that rations can be balanced for dairy cattle to include up to 25% WDGS and result in
Population Growth of Yellowstone Grizzly Bears: Uncertainty and Future Monitoring

Abstract Grizzly bears (Ursus arctos) in the Greater Yellowstone Ecosystem of the US Rocky Mountains have recently increased in numbers, but remain vulnerable due to isolation from other populations and predicted reductions in favored food resources. Harris et al. (2006) projected how this population might fare in the future under alternative survival rates, and in doing so estimated the rate of population growth, 1983–2002. We address issues that remain from that earlier work: (1) the degree of uncertainty surrounding our estimates of the rate of population change (λ); (2) the effect of correlation among demographic parameters on these estimates; and (3) how a future monitoring system using counts of females accompanied by cubs might usefully differentiate between short-term, expected, and inconsequential fluctuations versus a true change in system state. We used Monte Carlo re-sampling of beta distributions derived from the demographic parameters used by Harris et al. (2006) to derive distributions of λ...
Evaporation and Humidity Profiles for Neutral Conditions over Rugged Hilly Terrain

Abstract An analysis was made of vertical profiles of mean specific humidity in the hilly pre-Alpine region in Switzerland under conditions of new neutral atmospheric stability. The profile data were derived from radiosonde observations during the summer season of 1982. A logarithmic layer was found to extend from approximately 2h to 6h [where h(=95 m) is the mean height of the hills]. The zero-plane displacement height for water vapor d0ν appeared to be close to that for momentum, i.e., about 50 m; on the other hand, the water vapor roughness height z0ν for those ascents with a wet surface was found to be around 10 to 15 times smaller than the momentum roughness z0(=3.8 m). The values of evaporation, deduced from the humidity profiles with the friction velocity of the corresponding velocity profiles, were very close to those measured with a lysimeter.
Chronic Wound Biofilms: Pathogenesis and Potential Therapies

Chronic wounds are a growing medical problem that cause high rates of morbidity and mortality, costing the healthcare industry in the United States millions of dollars annually. Chronic wound healing is hampered by the presence of bacterial infections that form biofilms, in which the bacteria are encased in exopolysaccharide (EPS) and are less metabolically active than their free-living counterparts. Bacterial biofilms make chronic wounds more refractory to treatment and slow tissue repair by stimulating chronic inflammation at the wound site. Bacterial species communicate through a mechanism known as quorum sensing (QS) to regulate and coordinate the gene expression that is important for virulence-factor production, including biofilm formation. This review focuses on the relationships between chronic wounds, biofilms, and QS in the virulence of chronic-wound pathogens.
Regional climate change and national responsibilities

Global warming over the past several decades is now large enough that regional climate change is emerging above the noise of natural variability, especially in the summer at middle latitudes and year-round at low latitudes. Despite the small magnitude of warming relative to weather fluctuations, effects of the warming already have notable social and economic impacts. Global warming of 2 °C relative to preindustrial would shift the 'bell curve' defining temperature anomalies a factor of three larger than observed changes since the middle of the 20th century, with highly deleterious consequences. There is striking incongruity between the global distribution of nations principally responsible for fossil fuel CO2 emissions, known to be the main cause of climate change, and the regions suffering the greatest consequences from the warming, a fact with substantial implications for global energy and climate policies.
A review of methods for determining pesticide residues, contaminants and adulterants in fats and oils

Sensitive chromatographic methods are available for determining chlorinated pesticide residues and chick edema factor contaminants in fats and oils. Determination of chlorinated pesticide residues in fats and oils generally involves acetonitrile extraction, Florisil column cleanup, and analysis by electron capture gasliquid chromatography (ECGLC). However, other procedures are available including dimethyl sulfoxide extraction and sweep codistillation. Sensitive screening tests for chick edema factor involve alumina column fractionation of isolated unsaponifiable matter, sulfuric acid cleanup, and examination by ECGLC. Admixtures of animal and vegetable fats are detected by the gasliquid chromatography (GLC) of isolated sterols, and individual vegetable oils can be characterized by GLC analysis of the sterols as well as of the other unsaponiflable constituents.
Convergent Validity: The Relationship Between Perceived Pain and the Manual Ability Measure–20 (MAM–20)

Date Presented 4/18/2015Hand pain is common, but how much does pain contribute to deficits in manual ability? In this study, we examined the relationship between perceived pain and the Manual Ability Measure—20 (MAM–20). The results suggest that occupational therapists (OTs) should assess pain and m
Classification of the ECG Signal Using Artificial Neural Network

Recording of electrocardiogram (ECG) signals and the correlation to cardiovascular diseases are a major problem in today’s society. A common abnormality is arrhythmia, which is unexpected variation in cardiac rhythm. The goal of this study is to analyze these types of signals and find a more efficient way to classify these signals. Currently, medical devices for detecting ECG signals are at least 85 % accurate in analyzing the data. Neural networks have progressed quickly over the past few years, and have the capability of recognizing many types of variation in these signals. The pattern recognition power of Artificial Neural Networks (ANNs) is a valuable tool when classifying ECG signals in cardiac patients. Data obtained from the PhysioBank ATM was used to analyze the structure of an ANN and the effect that it has on pattern recognition. The results show that only one misclassification occurred resulting in an accuracy of 96 %.
Initial Trauma Assessment

Initial management of trauma begins with the primary survey before orthopedic intervention is performed. All trauma patients are assumed to have cervical spine injury until proven otherwise. The decision between early definitive surgical treatment and initial damage control orthopedics hinges on the physiologic state of unstable or polytrauma patients.
Rationality of longevity expectations: Evidence from the Korean Longitudinal Study of Aging

Abstract This study utilizes data from the Korean Longitudinal Study of Aging to test the rational expectations hypothesis regarding longevity expectations. The rationality of longevity expectations is tested on two grounds: belief formation and its association with consumption and savings outcomes. Although individuals seem to have little knowledge of lifespan, they revise their survival forecast rationally and systematically in response to new information. The updating process follows a random walk as predicted by a Bayesian learning model. We also show that consumption and savings behaviors vary with this rationally formed expectations as if individuals make deliberate long-range plans. Overall, these findings lend further support to the rational expectations hypothesis and individuals as forward-looking decision makers.
Genetic Architecture of Phenomic-Enabled Canopy Coverage in Glycine max.

Digital imagery can help to quantify seasonal changes in desirable crop phenotypes that can be treated as quantitative traits. Because limitations in precise and functional phenotyping restrain genetic improvement in the postgenomic era, imagery-based phenomics could become the next breakthrough to accelerate genetic gains in field crops. Whereas many phenomic studies focus on exploratory analysis of spectral data without obvious interpretative value, we used field images to directly measure soybean canopy development from phenological stage V2 to R5. Over 3 years, we collected imagery using ground and aerial platforms of a large and diverse nested association panel comprising 5555 lines. Genome-wide association analysis of canopy coverage across sampling dates detected a large quantitative trait locus (QTL) on soybean (Glycine max, L. Merr.) chromosome 19. This QTL provided an increase in yield of 47.3 kg ha−1. Variance component analysis indicated that a parameter, described as average canopy coverage, is a highly heritable trait (h2 = 0.77) with a promising genetic correlation with grain yield (0.87), enabling indirect selection of yield via canopy development parameters. Our findings indicate that fast canopy coverage is an early season trait that is inexpensive to measure and has great potential for application in breeding programs focused on yield improvement. We recommend using the average canopy coverage in multiple trait schemes, especially for the early stages of the breeding pipeline (including progeny rows and preliminary yield trials), in which the large number of field plots makes collection of grain yield data challenging.
Patients' Experiences With Extramammary Paget Disease: An Online Pilot Study Querying a Patient Support Group.

Objective To illustrate the heterogeneous care delivered to patients with extramammary Paget disease (EMPD), a rare and lethal malignancy with poorly described treatment methodologies, by characterizing the clinical and pathologic characteristics of an international patient support group. Materials and Methods Institutional review board approval was obtained to develop and distribute a nonvalidated survey to patients from an international, online EMPD support group. The survey was developed to capture patient clinical and pathologic details and was distributed between January 2017 and February 2017. Results Forty-two patients completed the survey. At a mean age of 64 years, patients most commonly developed rash, pruritus, or erythema in the genital and perianal regions. Patients presented to their primary care physician, gynecologist, or dermatologist and were initially treated with topical agents for benign diagnoses. After failing conservative treatments, patients underwent biopsy by a dermatologist or gynecologist and were diagnosed with EMPD on average 21 months after the onset of symptoms. Wide local and Mohs excisions were the most frequently administered treatments with positive margins reported in 43% of patients. Fewer patients underwent noninvasive treatment with imiquimod cream and radiation. In total, 29% of patients developed regional recurrence and distant disease. There was wide variation regarding medical specialties involved, diagnostic evaluation, treatment, and clinical follow-up. Conclusion This study provides a novel view of the varied clinical and pathologic details from patients treated across varying institutions and medical specialties. This study will hopefully educate providers of the overall disease process of EMPD and encourage the development of standardized treatment recommendations.
Missing data — mechanisms and possible solutions / Datos ausentes: mecanismos y posibles soluciones

One of the most common problems facing empirical researchers is when a portion of the data is missing. We will review three different types of ‘missingness’, namely missing completely at random, missing at random and missing not at random, and we will discuss how missing data can affect data analysis. We review methods to deal with missing data, including the simple ‘complete-case analysis’ approach, in which we only use the observations in the data set for which all the data is available, and the more sophisticated ‘multiple imputation’ approach, in which we repeat the analysis using multiple (completed) copies of the data set, and obtain the estimates of interest by averaging across all analyses. We will demonstrate how to implement solutions to missing data and review the limitations of the methods.
Disparities and eHealth: Achieving the Promise and the Potential

Over the last two decades, research from several distinct lines of investigation have coalesced to underscore the relationship between medical care, biophysiologic processes, and sociocultural and other environmental influences on healthcare outcomes generally and healthcare disparities specifically (see Chaps. 1–5). In the early 1980s, researchers examining variability in clinical practice patterns found nonrandom distributions in care across geographic locations. In the mid-1980s, the report of the Secretary’s Task Forces on Black and Minority Health highlighted the fact that the health of Blacks and minorities significantly lagged behind that of Whites in the US (Department of Health and Human Services, 1985). By the early 1990s, large scale epidemiologic studies confirmed earlier findings of nonrandom distribution of clinical practice patterns and the association between substandard care with low income and minority patients. These early findings encouraged a focus on healthcare quality problems with the US healthcare system, which revealed that problems associated with quality and healthcare disparities were in fact linked and should be considered together. In the case of healthcare disparities, the more recent attempts to address disparities have in most cases yielded disappointing results. As such, efforts were undertaken to clarify better the impact of “nonmedical” communications and social factors on healthcare disparities and healthcare outcomes. These investigations highlighted the need to integrate better the biomedical and sociobehavioral disciplines in current health care and clinical practice to improve quality and address disparities among an increasingly diverse population. They also highlighted the fact that communication barriers, literacy, as well as cultural and behavioral influences likely play a far more significant role in healthcare disparities than previously appreciated by the broader medical community.
Adult Spinal Deformity Knowledge in Orthopedic Spine Surgeons: Impact of Fellowship Training, Experience, and Practice Characteristics.

Abstract Study Design Survey study. Objective The purpose of this paper was to assess the level of adult spine deformity (ASD) knowledge among orthopedic spine surgeons and identify areas for improvement in spine surgery training. Summary of Background Data ASD is increasingly encountered in spine surgery practice. While ASD knowledge among neurosurgeons has been evaluated, ASD knowledge among orthopedic spine surgeons has not previously been reported. Methods A survey of orthopedic spine surgeon members of North American Spine Society (NASS) was conducted to assess level of spine surgery training, practice experience, and spinal deformity knowledge base. The survey used was previously completed by a group of neurologic surgeons with published results. The survey used 11 questions developed and agreed upon by experienced spinal deformity surgeons. Results Complete responses were received from 413 orthopedic spine surgeons. The overall correct-answer rate was 69.0%. Surgeons in practice for less than 10 years had a higher correct-answer rate compared to those who have practiced for 10 years or more (74% vs. 67%; p = .000003). Surgeons with 75% or more of their practice dedicated to spine had a higher overall correct rate compared to surgeons whose practice is less than 75% spine (71% vs. 63%; p = .000029). Completion of spine fellowship was associated with a higher overall correct-answer rate compared to respondents who did not complete a spine fellowship (71% vs. 59%; p Conclusions Completion of spine fellowship and having a dedicated spine surgery practice were significantly associated with improved performance on this ASD knowledge survey. Unlike neurosurgeons, orthopedic spine surgeons who have practiced for less than 10 years performed better than those who have practiced for more than 10 years. Ongoing emphasis on spine deformity education should be emphasized to improve adult spinal deformity knowledge base.
Hearing Screening in the Community

Adults typically wait 7–10 yr after noticing hearing problems before seeking help, possibly because they are unaware of the extent of their impairment. Hearing screenings, frequently conducted at health fairs, community events, and retirement centers can increase this awareness. To our knowledge, there are no published studies in which testing conditions and outcomes have been examined for multiple “typical screening events.” The purpose of this article is to report hearing screening outcomes for pure tones and self-report screening tests and to examine their relationship with ambient noise levels in various screening environments. One thousand nine hundred fifty-four individuals who completed a hearing screening at one of 191 community-based screening events that took place in the Portland, OR, and Tampa, FL, metro areas. The data were collected during the recruitment phase of a large multisite study. All participants received a hearing screening that consisted of otoscopy, pure-tone screening, and completion of the Hearing Handicap Inventory–Screening Version (HHI-S). In addition, ambient sound pressure levels were measured just before pure-tone testing. Many more individuals failed the pure-tone screening (n = 1,238) and then failed the HHI-S (n = 796). The percentage of individuals who failed the pure-tone screening increased linearly with age from It is important to select screening locations with a quiet space for pure-tone screening, use headphones with good passive attenuation, measure sound levels regularly during hearing screening events, halt testing if ambient noise levels are high, and/or alert individuals to the possibility of a false-positive screening failure. The data substantiate prior findings that the relationship between pure-tone sensitivity and reported hearing loss changes with age. Although it might be possible to develop age-specific HHI-S failure criteria to adjust for this, such an endeavor is not recommended because perceived difficulties are the best predictor of hearing health behaviors. Instead, it is proposed that a public health focus on education about hearing and hearing loss would be more effective.
Valve Prosthesis–Patient Mismatch (VP–PM): A Long-Term Perspective

The concept/phenomenon of valve prosthesis/patient mismatch (VP–PM), described in 1978, has stood the test of time. From that time to 2011, VP–PM has received a great deal of attention but studies have come to varying conclusions. This is largely because of the determination of prosthetic heart valve area [called effective orifice area index (EOAi)] by projection rather than by actual measurement, variable criteria to assess severity of EOAi and the timing of determination of EOAi. All prosthetic heart valves have some degree of VP–PM which must be placed in a proper clinical perspective. This can be done by determining its effects on function and outcomes. For mortality one needs to focus especially on severe/critical degree of VP–PM and determine the cause of death was due to VP–PM. For the period “beyond 2011” a road map is suggested that will have uniformity of assessment of VP–PM and a focusing on the important goals of VP–PM.
Behavioral Aspects of Motivation and Reward

History makes it clear that the concept of motivation has great heuristic value, for it brings a diverse range of behaviors into one theoretical framework. We begin with the fact that motivation is inferred from behavior, particularly to account for the many shifts in the arousal and direction of behavior throughout the day and the seasons of the year (as well as in intermediate-range rhythms such as the 4–5-day estrous cycle of the rat). Stimuli that are not particularly arousing at one point in time become so at another point in time when the internal environment or the state of the animal’s brain is changed. The arousal may have a general component, especially evident in the searching behavior that occurs when appropriate stimuli are not encountered in the environment. But arousal is not only a general response. It is very specific and selective in both the pattern of stimuli (e.g., sign stimuli or releasing stimuli) that do the arousing and in the patterns of appetitive and consummatory responses that follow. Arousal leads to specific consummatory behaviors such as eating or mating that lead to satiation or refractoriness, which itself may be quite specific. All motivated behaviors obey this general rule of specific arousal, appetitive and consummatory responses, quiescence (Craig, 1918).
The Craniofacial Evidence for Anthropoid and Tarsier Relationships

Monkeys and apes have long been observed to resemble humans in the external appearance of the head, having a globular braincase, a short snout, and forward-facing eyes. In 1864, Mivart grouped them in the suborder, Anthro-poidea, distinct from the Lemuroidea, to which he assigned lemurs, lorises, galagos, aye-ayes, and tarsiers (Mivart, 1864, p. 635). Although Mivart later (1873) identified a lengthy list of features distinguishing anthropoids from lemuroids, he maintained that New and Old World anthropoids had evolved in parallel from separate nonprimate ancestors. Mivart’s conception of An-thropoidea—a polyphyletic taxon united by numerous distinctive features of the skull—thrived in the intellectual milieu of the “classical primatological synthesis” in which parallelism was seen as a widespread phenomenon (e.g., Le Gros Glark, 1934, 1959; Simpson, 1945, 196D. However, with the adoption by primate systematists of the principles of phylogenetic systematics (Hennig, 1966) and, later, of the parsimony criterion for choosing between competing hypotheses of evolutionary relationships, the assumption of widespread parallelism fell out of vogue. Anthropoids have come to be interpreted as a closed descent community (sensu Ax, 1985), and their distinctive features have been reinterpreted as synapomorphies inherited from an ancestral stem species.
Subglottic hemangioma: Understanding the association with facial segmental hemangioma in a beard distribution

Abstract Objective A subglottic hemangioma (SGH) is a benign tumor of infancy that can cause severe obstruction of the airway. Infantile hemangiomas, in general, are the most common head and neck tumor in children, affecting 4–5% of the pediatric population. This retrospective cohort study characterizes subglottic infantile hemangiomas at a single vascular anomaly center over a 5-year period (2013–2017) during the era of propranolol treatment. Methods Queried the Vascular Anomaly Database at Children's Hospital of Pittsburgh for all infantile hemangioma(s) and then identified case of subglottic hemangiomas. Characterized key features of presentation, natural history and management for subglottic hemangiomas. A secondary differentiation focused on differences between subglottic hemangiomas associated with Beard Distribution (BD) vs not (NBD). Results Analysis of 761 cases of infantile hemangiomas demonstrated only 13 patients with subglottic hemangiomas (1.7%). Of those 13 patients, only 4 patients (30%) had BD while 2 patients (15%) had other cutaneous hemangiomas and 7 patients (55%) had no cutaneous hemangiomas. Secondarily, a total of 31 case of beard distribution cutaneous hemangiomas with 11 patients having oropharyngeal involvement (35%) but only 4 patients with subglottic hemangiomas (13%). Interestingly, 2 of the 4 BD patients had treatment failure on propranolol and required second line treatment with steroids or surgical excision while only 1 of 9 NBD patients failed propranolol treatment. As well the same 2 BD patients which failed propranolol also had PHACES syndrome. Conclusion Subglottic hemangiomas are a rare presentation of infantile hemangiomas but with significant morbidity. While the classic teaching that a segmental beard distribution hemangioma raises concern for a subglottic hemangioma, this cohort indicates subglottic hemangiomas occur in a NBD presentation (1.3%), and demonstrated only an approximate 10% incidence rate with a beard distribution. But more importantly, this study raises the question that beard distribution in setting of PHACES syndrome may herald a more recalcitrant and complicated natural history for a subglottic hemangioma. This is of significant concern as risk for CVA in setting of PHACES is highest with use of steroid treatment. None of our patients had high risk extra or intra cranial vascular arterial anomalies and no CVA were noted.
Dopaminergic amacrine cell number, plexus density, and dopamine content in the mouse retina: Strain differences and effects of Bax gene disruption

Many types of retinal neuron modulate the distribution of their processes to ensure a uniform coverage of the retinal surface. Dendritic field area, for instance, is inversely related to the variation in cellular density for many cell types, observed either across retinal eccentricity or between different strains of mice that differ in cell number. Dopaminergic amacrine (DA) cells, by contrast, have dendritic arbors that bear no spatial relationship to the presence of their immediate homotypic neighbors, yet it remains to be determined whether their coverage upon the retina, as a population, is conserved across variation in their total number. The present study assessed the overall density of the dopaminergic plexus in the inner plexiform layer in the presence of large variation in the total number of DA cells, as well as their retinal dopamine content, to determine whether either of these features is conserved. We first compared these traits between two strains of mice (C57BL/6J and A/J) that exhibit a two-fold difference in DA cell number. We subsequently examined these same traits in littermate mice for which the pro-apoptotic Bax gene was either intact or knocked out, yielding a five-fold difference in DA cell number. In both comparisons, we found greater plexus density and DA content in the strain or condition with the greater number of DA cells. The population of DA cells, therefore, does not appear to self-regulate its process coverage to achieve a constant density as the DA mosaic is established during development, nor its functional dopamine content in maturity.
Evaluating treatment protocols for rectal squamous cell carcinomas: the Duke experience and literature.

Background: Colorectal cancer is the third most common cancer in the United States and associated with significant morbidity and mortality. Within colorectal cancer histologies, squamous cell carcinomas (SCC) are rare compared to adenocarcinomas, with only about 200 cases reported to date. Because rectal SCC is rarely encountered, there is a lack of literature and clinical consensus surrounding its optimal treatment approach. Staging and management of SCC can be partly analogous to both rectal adenocarcinoma and anal canal SCC, which leads to a dilemma in how to best approach these patients. As large randomized prospective trials are unrealistic in the setting of this rare malignancy, this study evaluates an institutional experience and reviews the existing literature to help guide future management approaches. Methods: This retrospective study compared various treatment regimens for rectal SCC patients treated at Duke University Medical Center from January 1, 1980 through December 31, 2016. Patients ≥18 years old with histologically confirmed, nonmetastatic rectal SCC were included. Due to small sample size, all statistical analyses were descriptive. For our systematic review, a comprehensive search of PubMed from 1933 to March 2018 was performed, with selected articles referenced to ensure all relevant publications were included. A qualitative analysis was performed to examine patient diagnoses, treatments, and disease- and treatment-related outcomes. Results: Eight patients were included. Three patients underwent initial, curative attempt surgery and two of these patients required colostomy. With follow-up ranging from 7.1 to 31.5 months, one patient was alive with no evidence of disease while two developed local/regional recurrences. Five patients received definitive chemoradiation. Of these, three patients developed local/regional and/or metastatic recurrence. Two patients achieved complete response on imaging and currently remain disease-free (follow-up of 31.5 and 33.6 months). Conclusions: Although the review of our institutional experience is limited by small numbers, our analysis suggests that definitive chemoradiation therapy is the preferred treatment approach to rectal SCC based on improved disease-related outcomes, sphincter preservation and morbidity profiles. This conclusion is supported by a systematic literature review.
Acute necrotizing myopathy associated with bronchiolitis obliterans with organizing pneumonia (BOOP) responding to treatment with rituximab and steroids. (P3.462)

Objective: We report a case of acute nectrotizing myopathy associated with BOOP, a type of diffuse interstitial lung disease, that responded to treatment with rituximab and corticosteroids. Background: An optimal treatment plan for myopathy associated with BOOP is not available because of paucity of cases, complex clinical phenotypes and limited clinical trials. Design/Methods Case Report Results: A 42 year old male presented with progressive proximal weakness of upper and lower extremities for 1 month. He was treated for BOOP with high dose corticosteroids for 6 months prior to the onset of muscle weakness. The onset of myopathy coincided with steroid taper. On admission, creatine kinase was 19,245 IU/L, and myoglobin was 10,153 ng/ml. Anti Jo-1 antibody was present (265 AU/mL). Left vastus lateralis muscle biopsy demonstrated acute necrotizing myopathy. Azathioprine or methotrexate was considered, but deferred due to elevated liver-related enzymes, and intravenous immunoglobulins (IVIG) was deferred due to renal dysfunction secondary to myoglobinuria. A decision was made to treat the patient with 2 doses of rituximab (1000 mg) at a 2 week interval followed by oral corticosteroid taper. The patient experienced a remarkable improvement in strength and improvement in creatine kinase levels within weeks of treatment. Conclusions: Rituximab targets CD20-positive cells, leading to depletion of B cells in the blood within several weeks of administration. There is limited data from case series and case reports regarding use of rituximab in patients with myopathy associated with intersititial lung disease. Larger clinical trial experience is needed before definitive conclusions are drawn regarding the use of rituximab. Study Supported by: NA Disclosure: Dr. Ramaiah has nothing to disclose. Dr. Koffman has nothing to disclose.
Exploring the Relationship Between Foster Care Experiences and HIV Risk Behaviors Among a Sample of Homeless Former Foster Youth

Recent research shows high rates of poor behavioral health outcomes among homeless former foster youth, including increased risk for HIV-risk behaviors. In the current study, data were collected from 184 youth at drop-in centers in Los Angeles using behavioral health questionnaires to explore the relationships between specific aspects of foster care experiences and engagement in HIV-risk behaviors. Results indicated that youth whose first homelessness experience occurred before leaving foster care were significantly more likely to engage in drug use with sex and exchange sex than those whose first homelessness experience occurred after leaving foster care. Intervention services targeting HIV-risk behaviors should consider the aspects of foster care placements that may increase the risk of these behaviors, such as long periods of placement or experiencing homelessness before exiting foster care, as well as those that may decrease the risk of these behaviors, such as exiting placement at an older age.
Using Valid and Reliable Tools for Pain and Sedation Assessment in Pediatric Patients

Pain management and sedation strategies have become more complex in recent years, with accompanying documented increases in morbidity and mortality. Consequently, various government agencies and professional associations have issued requirements or recommendations designed to ensure optimal and safe pain management in different populations. The pediatric nurse must understand the rationale behind these guidelines, which pain and sedation assessment tools are valid and reliable, how and when to use these tools, and the purpose and limitations of each tool. This article summarizes the recent recommendations, identifies valid and reliable pediatric pain and sedation assessment tools, and describes the appropriate use of these tools to provide safe and high-quality patient care.
Periodic outgassing as a result of unsteady convection in Ray Lava Lake, Mount Erebus, Antarctica

Abstract Persistently active lava lakes show continuous outgassing and open convection over years to decades. Ray Lake, the lava lake at Mount Erebus, Ross Island, Antarctica, maintains long-term, near steady-state behavior in temperature, heat flux, gas flux, lake level, and composition. This activity is superposed by periodic small pulses of gas and hot magma every 5-18 min and disrupted by sporadic Strombolian eruptions. The periodic pulses have been attributed to a variety of potential processes including unstable bidirectional flow in the conduit feeding the lake. In contrast to hypotheses invoking a conduit source for the observed periodicity, we test the hypothesis that the behavior could be the result of dynamics within the lake itself, independent of periodic influx from the conduit. We perform numerical simulations of convection in Ray Lake driven by both constant and periodic inflow of gas-rich magma from the conduit to identify whether the two cases have different observational signatures at the surface. Our simulations show dripping diapirs or pulsing plumes leading to observable surface behavior with periodicities in the range of 5-20 min. We conclude that a convective speed faster than the inflow speed can result in periodic behavior without requiring periodicity in conduit dynamics. This finding suggests that the surface behavior of lava lakes might be less indicative of volcanic conduit processes in persistently outgassing volcanoes than previously thought, and that dynamics within the lava lake itself may modify or overprint patterns emerging from the conduit. Beyond its importance for Erebus, this result highlights the need to understand periodic processes emerging at all levels of the volcanic plumbing system in order to interpret surface observations.
Rationality of Fano Threefolds of Degree 18 over Non-closed Fields

We study unirationality and rationality of Fano threefolds of degree 18 over nonclosed fields.
Re-examining causes of surgical site infections following elective surgery in the era of asepsis

The currently accepted assumption that most surgical site infections (SSIs) occurring after elective surgery under standard methods of antisepsis are due to an intraoperative contamination event, remains unproven. We examined the available evidence in which microbial cultures of surgical wounds were taken at the conclusion of an operation and determined that such studies provide more evidence to refute that an SSI is due to intraoperative contamination than support it. We propose that alternative mechanisms of SSI development should be considered, such as when a sterile postoperative wound becomes infected by a pathogen originating from a site remote from the operative wound-eg, from the gums or intestinal tract (ie, the Trojan Horse mechanism). We offer a path forward to reduce SSI rates after elective surgery that includes undertaking genomic-based microbial tracking from the built environment (ie, the operating room and hospital bed), to the patient's own microbiome, and then to the surgical site. Finally, we posit that only by generating this dynamic microbial map can the true pathogenesis of SSIs be understood enough to inform novel preventive strategies against infection following elective surgery in the current era of asepsis.
Impacts of High-Strength Boat Waste on Activated Sludge Processes

AbstractDecisions to accept side-stream wastes at municipal wastewater treatment facilities require knowledge about potential impacts on plant operations. Among potential waste streams, coastal com...
Obtención de jarabes glucosados a partir de cáscaras de plátano (Musa paradisiaca L.) mediante hidrólisis enzimática de celulasas

The objective was to determine the effect of the application of the fungal cellulase enzyme on the silk banana peels (Musa paradisiaca) to obtain glucosed syrup. The enzymatic hydrolysis of banana shells at 30% (w / v) was studied at a constant temperature of 50 ° C. The independent variables to be controlled were the concentration of the fungal cellulase enzyme (0.5%, 1% and 1.5% w / v) and the hydrolysis time (18, 24 and 30 hours). The dependent variables were the percentage of Reducer Sugar and the percentage of Dextrose Equivalent (D.E.) of the enzymatically hydrolysed samples. The experimental design was completely randomized with factorial model 32. Glucosed syrups were obtained from silk plantain hulls by the enzymatic hydrolysis of the fungal cellulase. The highest percentages of Reducer Sugar and Dextrose Equivalent were presented in the Cellulase Concentration at 1.5% (w / v) during a hydrolysis time of 30 hours with average values ​​of 15.5% of reducing sugar percentage and 30.9% of percentage of Dextrose Equivalent. In the enzymatic hydrolysis with fungal cellulase at 1.5% (w / v) and 30 hours a higher value-added product was obtained, the operating conditions and the process steps were defined that should be adapted for the production of glucosed syrup from of banana peels (Musa paradisiaca).
Vitamin D in Children: Can We Do Better?

* Abbreviation: AAP — : American Academy of Pediatrics Severe vitamin D deficiency in children can result in nutritional rickets, which causes softening and weakening of the bones and is associated with impaired growth, developmental delays, and hypocalcemic seizures.1 Nutritional rickets, a largely preventable condition, can result in limb deformity, scoliosis, dental abnormalities, and fractures.1 In 2008, in an effort to prevent vitamin D deficiency and rickets in children in the United States, the American Academy of Pediatrics (AAP) increased the recommended daily intake of vitamin D for infants from 200 to 400 IU.1 In the current issue of Pediatrics , investigators Simon and Ahrens2 report that since 2009, the percentage of US infants who meet the AAP’s guidelines for vitamin D intake has not increased.1 The guidelines were met by only 27% of infants overall and by <40% of infants in nearly all demographic subgroups.2 Probable impediments to meeting the AAP guidelines include a combination of inconsistent prescribing by clinicians and poor adherence to the use of a supplement by parents of infants, and this is further complicated by a lack of awareness of the consequences … Address correspondence to Jaspreet Loyal, MD, MS, Department of Pediatrics, School of Medicine, Yale University, 333 Cedar St, New Haven, CT 06510. E-mail: jaspreet.loyal{at}yale.edu
Initial outcomes of an augmented competing stimulus assessment

Competing stimulus assessments (CSAs) are designed to identify stimuli that, when made freely available, reduce problem behavior. Although CSAs have demonstrated utility, identifying competing stimuli can be difficult for some individuals. The current study describes outcomes from an augmented CSA (A-CSA) for 6 consecutively encountered cases with treatment-resistant subtypes of automatically maintained problem behavior. When test stimuli were made freely available, only between 0 and 1 effective competing stimuli were identified for each case. Prompting and response blocking were temporarily employed in succession to promote engagement with stimuli and disrupt problem behavior. When those procedures were withdrawn and stimuli made freely available, the number of effective competing stimuli increased in all 6 cases. Findings suggest that procedures designed to promote engagement and disrupt problem behavior may allow the A-CSA to be a platform not only for identifying competing stimuli, but also for actively establishing competing stimuli.