cssi/SciSciGPT-SciSciNet huggingface dataset:
The Reliability of Quantitative Electroencephalography as an Indicator of Cerebral Ischemia

The electroencephalogram (EEG) has been used to detect episodes of cerebral ischemia during various surgical procedures. Recently, computerized systems for recording and interpreting the quantitative EEG (QEEG) have been used by anesthesiologists because of their ease of application, clarity of display, and reported ability to identify ischemic EEG changes. However, the extent to which automated techniques of QEEG interpretation reliably differentiate cerebral ischemia from the confounding effects of anesthetics and other sources of "artifact" is not completely established. In this study, EEGs were recorded before and after defibrillator testing in patients undergoing implantable cardioverter defibrillator (ICD) placement and during analogous time periods in control patients undergoing abdominal surgery. EEGs were subjected to standard visual inspection by an experienced electroencephalographer and QEEG analysis with a commercially available system was used for automated EEG interpretation in order to evaluate the reliability of this quantitative technique. The CIMON technique identified episodes which met previously defined criteria for QEEG cerebral dysfunction and ischemic pattern in both groups, despite the presumed absence of cerebral ischemia in the control patients. Since there was no evidence of cerebral ischemia in the raw EEGs of either the ICD patients or the controls, these QEEG changes were not confirmed by conventional techniques of EEG interpretation. Our results suggest that caution is warranted when using automated systems for intraoperative interpretation of EEG.
Effects of in Vivo Exposure to Glucocorticoids on Pituitary, Serum, and Messenger Ribonucleic Acid Levels of the Gonadotropin Hormones FSH and LH in Male

Publisher Summary Glucocorticoids (both corticosterone, the native glucocorticoid in the rat, and cortisol) have different effects on the two anterior pituitary hormones, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which regulate reproductive processes. Sustained exposure to high levels of glucocorticoids, such as those present in a stress response, suppresses serum levels of LH, while not affecting or only minimally affecting pituitary content of LH in both sexes. This suggests that glucocorticoids inhibit the release of LH from the gonadotropes. In contrast, high levels of circulating glucocorticoids do not affect or only slightly affect serum levels of FSH, but increase pituitary content of FSH in both sexes. This indicates that glucocorticoids either increase synthesis or block the degradation of FSH in the gonadotropes. Treatment of male rats with elevated levels of cortisol caused a decrease in serum LH, but pituitary content of LH was not affected; immunoreactive serum FSH was not affected in males treated with cortisol; pituitary content of FSH was increased in male rats treated with cortisol; and cortisol treatment completely reversed the effects of a gonadotropin-releasing hormone (GnRH) antagonist on pituitary FSH in female rats.
‘But You Looked Smart’: Participant Observations of HIV Testing and Counseling for Young Adults

In recent years, a consistent increase of new HIV infections in young adult populations has been reported. One argument is that this population does not receive adequate information or support to promote healthy behavior choices. The current study provides direct evaluation of services and communication about prevention provided to young adults by trained counselors to identify critical issues that could illuminate ongoing barriers. Six clinic sites surrounding a large Midwest university were evaluated. Through participant observations and interviews, this analysis demonstrates that while the rapid HIV test has increased the opportunity for counseling to take place, numerous areas of concern still exist including access to testing, the use of judgmental language, as well as the presence of both halo and horn effect.
Health Reform and the Plight of the Uninsured Pregnant Woman

America’s health and prosperity will depend on the health and prosperity of the future generation — a generation comprised of children. To ensure the health of America’s tiniest citizens and the future leaders of tomorrow, the United States must take an interest in providing adequate prenatal, natal, and postnatal care to its mothers. Part I of this article seeks to explain the barriers preventing pregnant women from obtaining adequate and affordable health insurance coverage. I examine the three health insurance options currently available to pregnant women — employer-sponsored health insurance, individually purchased insurance, and government-funded insurance — and provide an overview of the legal history regarding the pregnant woman’s access to health care coverage. Part II provides a discussion of the Patient Protection and Affordable Care Act (ACA) and analyzes whether Obama’s 2010 health care reform made any significant progress towards improving the pregnant woman’s ability to access affordable health care coverage. Part III concludes the article with further recommendations for reforming the new health insurance system, which include (i) updating the Federal Poverty Level (FPL) standard or adopting a new measurement to more accurately reflect the poverty level and economic need of families and individuals; (ii) adopting a “fallback provision,” which extends affordable health insurance coverage to all pregnant women who do not otherwise have access to any means of affordable health insurance; and (iii) instituting more outreach, transparency, and accountability within the state health insurance systems.
Quantifying and Comparing Surrogate Fold Motions in Thick Sheet Materials

Origami-based design is increasing in popularity as its benefits and advantages become better understood and explored. Surrogate folds are a means of achieving fold-like behavior, offering solutions for origami-based products in new materials. A surrogate fold is a localized reduction in stiffness in a given direction allowing the material to function like a fold. A family of surrogate folds is reviewed and the respective behaviors of the folds discussed. For a given fold configuration, the material thickness is varied to yield different sizes of surrogate folds. Constraint assumptions drive the design, and the resultant configurations are compared for bending motions. Finite element and analytical models for the folds are also compared. Prototypes are made from different materials. This work creates a base for creating design guidelines for using surrogate folds in thick sheet materials.Copyright © 2015 by ASME
Conflict, Democratization, and the Kurds in the Middle East: Turkey, Iran, Iraq, and Syria

Few moments in the history of the last half century have witnessed the level of media coverage of the Kurds as has been the case in the late months of 2014 and the spring of 2015. Central to the ub...
Predictors of mortality in patients with chronic kidney disease and an implantable defibrillator: an EPGEN substudy

Aims Chronic kidney disease (CKD) is increasingly prevalent, and is an independent risk factor for cardiovascular mortality. Clinical trials of the implantable cardioverter–defibrillator (ICD) have demonstrated a survival benefit over medical therapy for the prevention of sudden cardiac death, but its benefit in patients with concomitant CKD is unclear. Methods and results We studied 199 subjects with CKD, defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, who underwent ICD implantation in the Duke Electrophysiology Genetic and Genomic Studies (EPGEN) biorepository. The mean age of the cohort was 67.8 ± 9.3 years, and the mean eGFR was 41.1 ± 13.2 mL/min/1.73 m2. There were 63 deaths over a mean follow-up of 31.1 ± 18.8 months, corresponding to an annual mortality rate of 12.2%. Additionally, there was a 7% annual rate of appropriate ICD therapy. Using Cox regression analysis, older age, lower ejection fraction, and lower eGFR were found to be significant predictors of mortality. There was a gradient of risk associated with lower renal function: a 10 mL/min reduction in eGFR conferred a 48% increase in the risk of death ( P < 0.001). Further adjustment for appropriate ICD therapy did not modify these associations. Conclusion In patients with CKD treated with a defibrillator, more advanced renal dysfunction is associated with reduced survival despite appropriate defibrillator therapy. This may be due to competing mortality risks in this population that attenuate the benefit of the ICD in reducing arrhythmic death. Age, ejection fraction, and kidney disease severity can be used to risk stratify patients before device implantation.
The relationship between passibility, agency and social interaction and its relevance for research and pedagogy

The interaction analysis presented by Kim and Roth examines nine students, their teachers, the learning task and materials in a mixed second and third grade science classroom during the school day. In the research narrative readers are introduced to two resourceful and creative groups of students as they work on a task assigned by their teacher—to cantilever a pizza box over the edge of a student desk. Readers are given glimpses (through images and transcripts) of the inventive ways each group solved the cantilever problem. Sometimes the children disregarded the design constraints, but even after compliance they managed to successfully solve the problem. The point of the learning task was not clearly stated, but readers are told the unit focused on investigating forces, forces in equilibrium, and structures as well as different forces (push, pull, etc.), properties of materials, and the relations between weight and balance while building structures. Kim and Roth were specifically interested in using this session to investigate and resolve the problem of learning as described by socio-cultural theorists as, how does a learner orient toward a learning outcome when they cannot do that until they have learned it? To answer this question Kim and Roth argued that learners (in engineering design) learn when and because: (1) they are open to be affected by the responses of materials to student action (i.e. student and material agency and physical touch) (2) their bodies are endowed with the capacity to be affected (i.e. passibility), and (3) knowledge and understanding emerge as and in social relations first. In their analysis, Kim and Roth argued that knowledge and knowing-how depend on these three universal processes. The authors further theorized the concept of passibility. Included in their theory of passibility was the claim that passibility is necessary for agency. After reading this paper we found we had many questions about Kim and Roth’s analysis, context, and assertions, but we decided to focus this forum response on the problem of the learner and the solutions posed by Kim and Roth as well as the proposed relationship between passibility and agency.
Biosynthesis of squalene by rat preputial gland.

SummaryPreputial glands from rats, when incubated with C14 acetate show a marked incorporation of C14 into squalene, a sterol precursor, and little into sterols. In this regard, the preputial glands differ from many other mammalian tissues which show incorporation of C14 mainly into sterols and little into squalene. Human dermis, which contains sebaceous glands, is another mammalian tissue which shows preferential accumulation of the C14 into squalene. The mechanism of the difference is unknown, though it seems likely that factors necessary for conversion of squalene to sterols are missing in these tissues, or that an inhibitor of this reaction is present.
Determination of 12 pesticides residues in tea by gas chromatography

Objective:To establish gas chromatographic method for the determination of organochlorine and organophosphorous pesticide residues in tea.Methods:The analytes were extracted with acetone and petroleum ether,purified with graphite carbon column and detected by ECD.Results:The average recoveries and relative standard deviations(RSDs)for the analysis were in the range of 79.0%～102.1% and 1.87%～3.34%%(n=5),respectively.The limits of detection were 0.008 mg/L～0.051 mg/L.Good linearities were obtained in the concentration ranging from 0.1 mg/L～15.0 mg/L,the correlation coefficients were higher than 0.9923.Conclusion:The method is simple,rapid,sensitive which can meet the needs for organochlorine and organophosphorous pesticide residues in tea.
A Functional-Differential System of Neutral Type Arising in a Two-Body Problem of Classical Electrodynamics

Publisher Summary This chapter discusses functional-differential system of neutral type arising in a two-body problem of classical electrodynamics. The functional-differential system is referred as neutral system because of its resemblance to the equation y′(t) = f(t,y(t), y(g(t)),y′(g(t)))for t>t0. The term apparently arose because in certain simple cases, the equation is equally considered as having a retarded argument or an advanced argument. The equations of motion for the two-body problem of classical electrodynamics have certain singularities. Thus, it is important to assume restricted domains of definition for the functions f and g. As the solution does not have any more than a piecewise continuous derivative, nothing is gained by imposing more than piecewise continuity conditions on φ′(t) The chapter is restricted to the two-body problem partly for simplicity and partly to emphasize that the existence theorems are studied at present for functional-differential system.
The Minority Report: The Concerns of Staff Opposed to Schoolwide Positive Behavior Interventions and Supports in their Schools

ABSTRACTLow staff support for schoolwide positive behavior interventions and supports (SWPBIS) is a barrier to implementation and sustainability. In this qualitative study, we identify staff opposed to SWPBIS among staff in 36 schools across 9 districts in western Washington. Nonsupportive staff (n = 44) are compared to supportive staff (n = 1,166) on demographic variables. Then, open-ended statements provided by nonsupportive staff are coded and analyzed to identify themes and develop an understanding of concerns about the SWPBIS initiative in their schools. Nonsupportive staff were concerned for the commitment and participation of all stakeholders, including staff, administrators, and students. Some sources of opposition were attributable to misunderstandings of SWPBIS and outright philosophical disagreements. Other sources of staff opposition were attributable not to the SWPBIS framework, but to school-level factors such as negative climate. We provide consultants with suggestions for engaging nonsuppo...
New Technology for Red Blood Cell Preservation.

A method for freeze-drying red blood cells (RBCs) while maintaining a high degree of viability, has important implications in blood transfusion and clinical medicine. The disaccharide trehalose, found in animals capable of surviving dehydration can aid in this process. We are reporting a method for loading RBCs with trehalose followed by subsequent freeze-drying and rehydration. The loading of erythrocytes is based on the thermal properties of the RBC plasma membranes and provides efficient uptake of the sugar at 37°C in a time span of 7 hours. The data show that RBCs can be loaded with trehalose from the extracellular medium through a combination of osmotic imbalance and the phospholipid phase transition, producing an intracellular trehalose concentration of about 40 mM. Freeze-drying of trehalose loaded RBCs results in water contents in the range between 2 and 4 % and a level of survival of around 37 %, as measured by the extent of hemolysis. Surprisingly, freeze-dried and rehydrated RBCs showed high levels of ATP and 2,3-DPG and low methemoglobin. Biochemical analysis demonstrated that the activities of superoxide dismutase, catalase and acetylcholine esterase in freeze-dried RBCs are similar to those in fresh RBCs. These data provide an important step toward a stable erythrocyte product, which will be invaluable for transfusion and clinical applications. Supported by DARPA grant N66001-03-1-9827
Effects of pH on Metals Precipitation and Sorption: Field Bioremediation and Geochemical Modeling Approaches

At the Sanders Lead car-battery recycling plant, near Troy, AL, groundwater is highly acidic (pH varies from 3 to 3.5) and carries high concentrations of Pb, Cd, Zn, Cu, and Fe. Pilot field experiments conducted at the site show that in situ metabolism of sulfate reducing bacteria (SRB) can produce desired geochemical effects to remove heavy metal Pb, Cd, Zn, and Cu from groundwater. A reaction path model of sulfate reduction shows the redox potential (Eh) effects on mineral precipitation and pH controls on the sorption of different metals. Lead strongly adsorbs to hydrous ferric oxide (HFO) present in the aquifer over a wide pH range. Both sorption (due to pH increase) and solid sulfide formation are important for removing Pb. Although theoretical modeling shows that the sorption of most cations is promoted as pH increases, HFO can only scavenge Zn, Cd, Co, and Ni at relatively neutral pH conditions. Thus concentrations of our primary contaminants Zn and Cd attenuate in acidic conditions primarily via precipitation or coprecipitation of solid sulfide phase as Eh drops. The modeling result explains why the Pb plume is retarded in migration with respect to the Cd plume under the low-pH conditions at the site. For As, arsenate sorbs strongly onto the protonated weak sites of ferric hydroxide for the pH range of calculation. Arsenite sorption is also favored by increasing pH, however, arsenite desorbs and becomes mobilized at very low oxidation state as it reacts with dissolved sulfide to form AsS complexes. In addition, intermittent rainfall events could cause short-term Eh increases, potentially leading to oxidation of sulfide solids and subsequent pH decrease, and the remobilization of metals. This study argues for the importance of accounting for pH changes when evaluating the fate, transport, and long-term stability of metals at shallow contaminated sites.
No deal: An inquiry into new deal era archaeology in Kansas

The impact of the New Deal has been a topic of ongoing historical investigation, with, in the past few decades, substantive research in New Deal relief programs on Americanist archaeology by discip...
Sleep duration in the United States 2003-2016: first signs of success in the fight against sleep deficiency?

Study Objectives The high prevalence of chronic insufficient sleep in the population has been a concern due to the associated health and safety risks. We evaluated secular trends in sleep duration over the most recent 14-year period. Methods The American Time Use Survey, representative of US residents ≥15 years, was used to investigate trends in self-reported sleep duration and waking activities for the period 2003-2016 (N = 181335 respondents). Results Sleep duration increased across survey years both on weekdays (+1.40 min/year) and weekends (+0.83 min/year, both p 7-9 hr), and long (>9 hr) sleep changed by -0.44% per year (p < .0001), -0.03% per year (p = .5515), and +0.48% per year (p < .0001), respectively. The change in sleep duration was predominantly explained by respondents retiring earlier in the evening. The percentage of respondents who watched TV or read before bed-two prominent waking activities competing with sleep-decreased over the same time period, suggesting that portions of the population are increasingly willing to trade time in leisure activities for more sleep. The results also suggest that increasing online opportunities to work, learn, bank, shop, and perform administrative tasks from home freed up time that likely contributed to increased sleep duration. Conclusions The findings indicate first successes in the fight against sleep deficiency. Public health consequences of the observed increase in the prevalence of long sleep remain unclear and warrant further investigation.
Caliceal Obstruction Owing to a Large Parapelvic Cyst: Excretory Urography, Ultrasound and Computerized Tomography Findings

AbstractBenign parapelvic cysts are a common finding on radiology studies. Rarely, a parapelvic cyst may enlarge enough to obstruct the renal calices. We report a case in which computerized tomography following an excretory urogram and ultrasound proved to be especially helpful in the noninvasive evaluation of an obstructing parapelvic cyst.
Resilience, Life Events, and Well-Being During Midlife: Examining Resilience Subgroups

Developmental midlife processes involve resilience, changing challenges, and perceptions of getting older. In Study I and II, the Managing Life Survey resulted in growth, managing uncertainty, objectivity, adversity, and strategy use subscales. In Study II, resilience subgroups were identified. High and non-religious resilience groups had significantly higher averages for MLS subscales, time orientations, grit, life satisfaction; and significantly lower averages for adversity and negative event scores, compared to other groups. Noteworthy findings herein consist of (1) differences across resilience groups, with spiritual strategies emerging as an important discriminator; (2) the role of future perspectives on well-being characterizing early midlife; (3) the influence of growth and purpose on well-being characterizing late midlife; and (4) the cumulative effect of education on life satisfaction in late midlife. The results herein are consistent with the psychological benefits of moderate levels of challenge; with developmental differences across early and late midlife, and with Socioemotional Selectivity Theory.
Targeting Homologous Recombination Repair in Cancer

Publisher Summary This chapter discusses the homologous recombination repair (HRR) in cancer. The process of HRR can be roughly divided into four phases: resection of DNA ends; formation of RAD51 filament; strand invasion and Holliday junction (HJ) formation; and dissolution of HJs. The defects in HRR regulatory and mediator proteins may be much more common in human cancers than previously appreciated, but even though they are associated with genomic instability they do not necessarily confer sensitivity to DNA damaging agents due to compensatory increases in HRR. Therefore, testing for the status of a single HHR gene, such as BRCA1, may not provide an appropriate measure of HRR activity in a given tumor without also assessing for the presence of compensatory mechanisms such as RAD51 overexpression, p53 mutation, 53BP1 loss, or other yet uncharacterized alterations.
Aspects of Scalar Brane-World Cosmological Perturbations

We summarize an approach to deal with scalar brane-world cosmological perturbations based on Mukohyama's master equation. We also give its relation to one based on perturbing the effective Einstein's equations on the brane (involving the Weyl fluid).
Rapid technic for preparation of hemoglobin solutions for electrophoresis.

In order to shorten and simplify the procedures for preparation of hemoglobin solutions for electrophoresis, a technic requiring only a single short centrifugation of blood has been developed. The method involves a centrifugation of diluted whole blood overlying a dense layer which excludes plasma but not erythrocytes. The dense layer consists of 30% (w/v) sucrose containing 0.5% Triton X-100 and 0.01 M Tris, pH 9.0. As the red cells traverse the dense sucrose solution they are lysed by the detergent. The resulting lysate is ready for electrophoresis. The procedure can be carried out using ordinary centrifuge tubes or capillary tubes. The lysates are uncontaminated with plasma protein and electrophoresis results are indistinguishable from those with lysates prepared by more time-consuming procedures.
Occupational Therapist-Delivered Cognitive-Behavioral Therapy for Knee Osteoarthritis: A Randomized Pilot Study.

Objective This study assessed the feasibility and preliminary efficacy of an online-assisted, occupational therapist-delivered, cognitive-behavioral therapy intervention to promote physical function in patients with knee osteoarthritis (KOA). Method Fifty-seven participants with KOA were randomized 2:1 to the Engage program (eight clinic-based sessions supported by online modules) or usual care. Using analysis of covariance, we estimated Engage's effect on physical function (Western Ontario and McMaster Universities Osteoarthritis Index's Physical Function subscale [WOMAC-PF]) at 6 mo. Results Data were analyzed on 46 completers. Engage was associated with a small effect (η² = 0.01) on the WOMAC-PF. More Engage participants than controls reported much or very much improvement (45% vs. 13%; p = .03). Satisfaction was high, and 30 of 31 participants attended six sessions or more. Conclusion An online-supported cognitive-behavioral program for people with KOA delivered by occupational therapists is feasible and may contribute to improved physical function.
FROM BIRTH TO ADULTHOOD: ANTHROPOMETRIC TRAJECTORIES AND THEIR IMPLICATIONS FOR CHRONIC DISEASES IN GUATEMALA

The objective of this paper was to study nutritional status and growth, as measured by height and weight, over the life course and their connection with chronic diseases in Guatemala, a country with high levels of child undernutrition and adult overnutrition, using data from the Institute of Nutrition of Central America and Panama (INCAP) Nutrition Trial Cohort study. The study sample comprised a birth cohort of 1570 individuals who had data in the original 1969-1977 survey as well as the 2002-2004 follow-up, allowing for an analysis of the nutritional transition from childhood to adulthood. The associations between childhood and adulthood anthropometrics were analysed, and the links of these with chronic disease indicators were assessed using multiple regression analysis and structural equation modelling. Moving upwards in nutritional status from childhood to adulthood was observed frequently in the study population. Unlike sex and place of residence, early anthropometrics were not generally found to be associated with adult body mass index (BMI). However, direct relationships were found between childhood nutritional status and growth and adulthood high-density lipoprotein (HDL) cholesterol, triglycerides and fasting blood glucose. Furthermore, these relationships were not mediated by BMI. The findings were not sensitive to the metric of childhood anthropometrics, as the use of length-for-age, weight-for-age and weight-for-length all resulted in similar conclusions. These relationships demonstrate the importance of early childhood conditions for later-life outcomes. However, the lack of such relationships for blood pressure suggests that the biological links between childhood anthropometrics and various chronic diseases might vary.
The regulation of oxidative metabolism by nitric oxide protects β-cells from DNA damage-induced cell death

Nitric oxide, generated in β-cells in response to cytokines, induces DNA damage that activates DNA damage response (DDR) and eventually leads to apoptosis if damage is too extensive. We have shown that nitric oxide, while inducing double-strand DNA breaks (DSBs), also inhibits DDR signaling and protects β-cells from DNA damage-induced apoptosis.The ability of nitric oxide to inhibit the DDR signaling is selective to β-cells and correlates with a loss in ATP levels, while non-β-cells are able to maintain both ATP levels and DDR signaling when treated with nitric oxide. However, the mechanism that regulates this cell type selectiveness is not known. β-cell metabolism is characterized by the coupling of glycolysis to mitochondrial oxidative metabolism, where 90% of the carbons of glucose are oxidized to CO2 in a concentration-dependent manner. Nitric oxide is known to inhibit mitochondrial oxidative metabolism (e.g. aconitase in the TCA cycle and complex IV of electron transport chain (ETC)). In response to nitric oxide, β-cells are not able to compensate the inhibition of mitochondrial oxidation by increasing glycolytic metabolism. In contrast, non-β-cells compensate for the mitochondrial inhibition by increasing glycolytic metabolism to maintain their ATP pool. Consistent with the action of nitric oxide, we showed that rotenone, an inhibitor of complex I of ETC, also inhibit DDR signaling and decrease ATP levels in β-cells but not in non-β-cells. Importantly, when non-β-cells are forced to generate ATP via mitochondrial oxidation, nitric oxide inhibits DDR signaling, decrease ATP levels, and protects cells from DNA damage-induced apoptosis. These findings suggest that the coupling of glycolysis to mitochondrial oxidative metabolism in β-cells allows nitric oxide to decrease ATP levels and subsequently inhibit DDR signaling and protect β-cells from DNA damage-induced apoptosis.
Plant Resistance in Sorghums to the Sugarcane Aphid (Hemiptera: Aphididae)

Abstract Ten sorghum, Sorghum bicolor (L.) Moench, lines near or in commercial release were evaluated with the intent of identifying the phenotypic expression of host-plant resistance to the sugarcane aphid Melanaphis sacchari (Zehnter) (Hemiptera: Aphididae). Two of the 10 entries (OL2042 and SP7715) expressed a high degree of resistance to the sugarcane aphid, with damage ratings 4.0 and were statistically lower than the susceptible check Tx7000. Chlorophyll loss and damage ratings exhibited a linear relationship (R2 = 0.87), followed by a slight improvement (R2 = 0.89) in the regression models when the difference in plant height was added as a second independent variable. The relationship helps e...
Prognostic Significance of Holter Monitor Findings in Patients With Light Chain Amyloidosis.

Abstract Objective To evaluate the prognostic impact of Holter findings in patients with light chain amyloidosis. Patients and Methods We evaluated 239 patients in whom light chain amyloidosis was diagnosed from January 1, 2010, through December 31, 2015, who underwent 24-hour Holter monitoring. Results Holter testing was done before stem cell transplant evaluation in 183 of the 239 patients (76.6%) and at diagnosis in 50 (20.9%). Holter findings were nonsustained ventricular tachycardia (NSVT) in 60 patients (25.1%), ventricular couplets in 103 (43.1)%, accelerated idioventricular rhythm in 32 (13.4%), and atrial fibrillation (AF) in 18 (7.5%). Overall survival (OS) at 3 and 6 months after Holter monitoring in patients with AF vs without AF was 78% (95% CI, 54%-91%) vs 96% (95% CI, 92%-98%) (P=.002) and 61% (95% CI, 38%-80%) vs 92% (95% CI, 87%-95%), (P Conclusion Atrial fibrillation and NSVT on 24-hour Holter monitoring are associated with inferior short-term OS outcomes but do not impact peritransplant mortality.
A mixed methods study of perceived barriers to physical activity, geriatric syndromes, and physical activity levels among older adults with peripheral artery disease and diabetes.

Previous studies suggest a myriad of factors prevent individuals from engaging in physical activity; however, less is known about barriers faced by individuals with multiple chronic conditions, such as peripheral artery disease (PAD) and type 2 diabetes, and how these barriers may impact engagement in physical activity. To date, there are no studies that integrate simultaneous assessment of perceived barriers to physical activity and engagement in physical activity in older adults with PAD and diabetes. This integration is key to understanding the implications of barriers to physical activity and to developing strategies to address those barriers. Therefore, this study investigated the unique physical activity experiences of older adults with PAD and diabetes. This study used a concurrent mixed methods design. Ten adults aged 65 years and older with PAD and diabetes completed semistructured interviews about experiences with physical activity, self-reported questionnaires assessing quality of life and fear of falling, and measures of physical function (eg, 6-minute walk test, chair stand, gait speed). Physical activity was measured objectively with accelerometry. Inductive content analysis was used to identify themes, and integrated analysis was performed to evaluate patterns among qualitative and quantitative variables. On average, participants were 74 years old and spent 10% of their time in moderate or vigorous physical activity (range: 3%–18%); 80% of participants were men. Barriers to physical activity identified through qualitative interviews included lack of accessibility, lack of enjoyment of activity, lack of motivation, and pain and physical health. Facilitators to physical activity were social support, accessibility and convenience, and enjoyment of the activity. Participants with more sedentary time and less moderate or vigorous physical activity tended to report greater fear of falling and greater barriers to physical activity and achieved lower distances in 6-minute walk tests. This research provides insight into both the nature of perceived barriers to physical activity and engagement in physical activity among older adults with PAD and diabetes. The integration of self-reported measures and objective measures facilitates our understanding of the lived experiences of individuals with these conditions. Study findings can be used to support further investigation into factors that influence engagement in physical activity in individuals with PAD and diabetes and to assist in the development of strategies to address identified barriers.
Exploring Teachers’ Evaluation Perceptions: A Snapshot:

Teacher perceptions after 5 years of implementing evaluation protocols that were initiated under Race to the Top revealed attitudes about the evaluation instrument used and the nature of their rela...
Labor Market Conditions and Racial/Ethnic Differences in College Enrollment

The racial/ethnic differences in college enrollment are pervasive and persistent. In this article, I provide evidence of a business cycle-driven component to the college enrollment gaps among racial/ethnic groups in the USA. Using a nationally representative sample from the National Longitudinal Survey of Youths 1997 (NLSY97) and fixed-effects enrollment probability models, I find that Hispanics are more likely than non-Black-non-Hispanics to enroll in 2-year college during high unemployment periods. Similarly, I find that individuals who are Black are more likely than non-Black-non-Hispanic individuals to enroll in 2-year colleges but are less likely to enroll in 4-year colleges during periods of high unemployment. The positive effect of high unemployment rate on 2-year college enrollment for Blacks is almost entirely offset by negative effects on 4-year college enrollment. Non-Black-non-Hispanics are least sensitive to labor market conditions. The cyclicality of college enrollment rates of Blacks and Hispanics and the relatively smooth enrollment rates of non-Black-non-Hispanic individuals may be able to explain a part of the persistent gap in college enrollment.
Texture Analysis in Cerebral Gliomas: A Review of the Literature

Texture analysis is a continuously evolving, noninvasive radiomics technique to quantify macroscopic tissue heterogeneity indirectly linked to microscopic tissue heterogeneity beyond human visual perception. In recent years, systemic oncologic applications of texture analysis have been increasingly explored. Here we discuss the basic concepts and methodologies of texture analysis, along with a review of various MR imaging texture analysis applications in glioma imaging. We also discuss MR imaging texture analysis limitations and the technical challenges that impede its widespread clinical implementation. With continued advancement in computational processing, MR imaging texture analysis could potentially develop into a valuable clinical tool in routine oncologic imaging.
The Major Histocompatibility Complex

New classes of immunotherapeutics are being developed based on understanding of the molecular interactions that initiate immune activation. One such class involves novel therapeutics directed at specific sites on major histocompatibility complex (MHC) molecules; in another class, the MHC molecules themselves act as therapeutic agents to regulate and block immune responses. The use of small peptides that bind MHC molecules forms the basis for modulating antigen-specific interactions and provides a rational approach to disease-specific and antigen-specific intervention.
Does perfusion matter? Preoperative prediction of incisional hernia development.

Incisional hernias complicate 12–15% of general surgery cases with higher rates reported after laparotomy for aortoiliac occlusive disease (10–17%) and aneurysmal disease (17–38%). We hypothesize that inadequate perfusion of the abdominal wall promotes future hernia development. Thirty-eight patients undergoing midline laparotomy or thoracoabdominal approach for aortic disease with at least 2 years of follow-up were included in the study. Preoperative imaging was reviewed to assess vessel patency, contributing to the abdominal wall perfusion. Patency of the superior epigastric artery was determined at the T10 level, the inferior epigastric artery at the L4 level, and the deep circumflex iliac artery at the anterior superior iliac spine. Lumbar arteries were considered patent if they were seen branching from the aorta. Clinic notes and hospital medical records were reviewed to evaluate the hernia development post-procedure. Thirteen patients (34%) developed an incisional hernia. Absent flow from bilateral superior epigastric arteries or absent flow from ipsilateral superior and inferior epigastric arteries was found to be predictive of hernia development (P = 0.013, 0.011, respectively). There was no association identified with perfusion from the lumbar or deep circumflex iliac arteries. Absent patency of the abdominal wall vasculature is a novel risk factor for incisional hernia development in the setting of aortic disease. Preoperative assessment of perfusion may convey the risk of hernia development and may be a tool to guide measures such as prophylactic mesh placement to reduce the future risk of incisional hernia.
Acute myocardial injury in mdx hearts ameliorated by ARB but not ACE inhibitor treatment

Abstract Duchenne muscular dystrophy (DMD) is a devastating muscle disease that afflicts males due to the loss of the protein dystrophin, resulting in muscle deterioration and cardiomyopathy. Dystrophin’s absence causes increased membrane fragility, myocyte death, and tissue remodeling. Inhibition of angiotensin signaling with ACE inhibitors or angiotensin receptor blockers (ARBs) is a mainstay of DMD therapy, with clinical guidelines recommending starting one of these therapies by the age of 10 to address cardiomyopathy. Using the mdx mouse model of DMD, we previously showed that isoproterenol causes extensive damage in dystrophic hearts, and treatment with the ARB losartan starting only 1 hour before isoproterenol dramatically reduced this myocardial injury. In the present study, we probed whether ACE inhibitors, which are more frequently prescribed, can deliver similar protection. Surprisingly, lisinopril treatment initiated 1 hour before isoproterenol failed to demonstrate any effect on injury in mdx hearts. Further, with a 2-week pretreatment, only losartan significantly lowered mdx cardiac injury, without any benefit associated with lisinopril treatment. These results confirm the ability of ARBs, but not ACE inhibitors, to prevent acute injury in mouse hearts, and prompt the question whether ARBs should be more frequently used for DMD cardiomyopathy because of these potential protective actions.
1686 The Effect of 24-hour Call on Laparoscopic Skills of ObGyn Residents

Study Objective To assess the effect of 24-hour call on the simulated laparoscopic skills of Ob/Gyn residents from a large, tertiary-care hospital in a metropolitan city. Design A standard peg transfer drill module on the Laparoscopy VR Trainer (CAE Healthcare) was used as a surrogate for surgical skills. Participants performed the simulation module three times at the start of their call and later at the completion of call. Participants also completed a short survey of basic demographics, caffeine intake and sleep over the call shift, and prior experience on the simulator. All sessions on the simulator were logged and data, including total time, average right and left path lengths, and number of dropped pegs, was extracted. Setting n/a Patients or Participants Residents of a university-based Ob/Gyn program Interventions n/a Measurements and Main Results 22 residents were recruited for the study. A total of 35 trials were performed. Participants showed improvement in all outcomes over their call shift with a significant decrease in total time required to complete the task, a significant decrease in left and right path lengths, and significantly less pegs dropped from pre to post call sessions (p .05) for any of the outcomes. Conclusion Data revealed a statistically significant improvement in post call performances across all measured variables. This was true regardless of year in residency and was not affected by amount of sleep obtained, amount of caffeine consumed, or time since last caffeine consumption. This is one of the first studies to show an improvement after a call shift. Further studies are needed to investigate the potential impact of sleep deprivation on more complex medical procedures as well as the impact of sleep deprivation on a physician's ability to diagnose, educate, and obtain informed consent.
Rectal indomethacin reduces the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis in low-risk patients

Background Evidence shows that rectal indomethacin (RI) reduces the risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in high-risk patients. The prophylactic role of RI in low-risk patients has not yet been identified. The objective of our study was to evaluate the impact of RI in preventing PEP in low-risk patients. Methods A retrospective cohort study was conducted to evaluate the impact of RI in preventing PEP. RI was available starting November 2012. Patient characteristics and procedure details were collected. Results The study population included 2238 patients who underwent ERCP (1055 in the RI group and 1183 in the control group). PEP was diagnosed in 107 patients (4.8%). In a multivariate model of consecutive patients, RI reduced the incidence of PEP by 55% (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.36-0.94; P=0.03). In a multivariate model that included 1874 (84%) low-risk patients, RI reduced the incidence of PEP by 62% (OR 0.38, 95%CI 0.19-0.74; P=0.004). Propensity-matched group analysis was performed for low-risk native papilla patients. RI reduced the incidence of PEP by 61% (OR 0.39, 95%CI 0.18-0.8; P=0.009). Conclusion RI reduced PEP in consecutive as well as low-risk patients. RI should be administrated in consecutive patients unless contraindicated. Larger prospective studies are needed to confirm our results.
An Ethnobotanical Study of the Genus Elymus1

Grains of domesticated grasses (Poaceae) have long been a global food source and constitute the bulk of calories in the human diet. While most contemporary grass domesticates consumed by humans are annual plants, there are over 7000 perennial grass species that remain largely unexplored for domestication purposes. Documenting ethnobotanical uses of wild perennial grasses could aid in the evaluation of candidate species for de novo crop development. In this study, we 1) provide an ethnobotanical survey of the perennial grass genus Elymus; and 2) investigate floret size variation in Elymus species used by people. We identified at least 21 taxa with recorded nutritional, medicinal, and/or material uses and at least 25 different indigenous communities associated with a use. The most common ethnobotanical use of Elymus in this survey is as forage, though at least 12 species are consumed by humans. Elymus species used for food warrant pre-breeding and future analyses to assess potential utility in perennial agricultural systems. We found average floret area does not differ significantly across geographic regions and among documented ethnobotanical uses, with the exception of species used for medicine in North America. A variety of Elymus species show promise for continued human use, and standing morphological variation in the genus should be further explored.
Do Preschoolers' Neuropsychological Functioning and Hyperactivity/Inattention Predict Social Functioning Trajectories Through Childhood?

Objective This longitudinal study examined whether preschool attention deficit hyperactivity disorder (ADHD) symptoms and neuropsychological functioning predicted trajectories of children's social functioning from age 3 to 4 through 12 years. Methods Three- and four-year-old children (N = 208; 72.6% boys) were evaluated annually through age 12. Parent and teacher Attention Deficit/Hyperactivity Disorder Rating Scale, Fourth Edition responses during the initial evaluation were used to categorize preschoolers as "High" or "Low" risk for ADHD. Children's neuropsychological functioning was assessed using the NEPSY. Teachers' reports of children's social functioning were obtained annually from preschool through age 12 years using the Adaptability, Functional Communication, and Social Skills subscales of the Behavioral Assessment System for Children, Second Edition. Hierarchical linear modeling was used to assess the trajectories of social functioning and determine whether preschoolers' neuropsychological functioning and ADHD risk status predicted social functioning at age 12 years, and/or change in social functioning throughout childhood. All models controlled for baseline socioeconomic status. Results High Risk children had significantly lower teacher-rated Adaptability and Social Skills at age 12 years. High Risk children and those with lower Verbal neuropsychological functioning in preschool had lower teacher-rated Functional Communication at 12 years old. Lower preschool Verbal neuropsychological functioning predicted greater positive change in teacher-rated Functional Communication across childhood. Conclusions Early identification of and intervention for children exhibiting ADHD behaviors is critical given the enduring negative impact of these behaviors on social functioning. Screening preschoolers for verbal difficulties is encouraged given their long-term impact on children's ability to clearly express thoughts and feelings and obtain and provide information.
Implementation of a Centralized Telepsychiatry Consult Service in a Multi-Hospital Metropolitan Health Care System: Challenges and Opportunities.

Background Providing adequate psychiatry consultation capacity on a 24/7 basis is an intrinsic challenge throughout many multihospital health care systems. At present, implementation research has not adequately defined the effectiveness and feasibility of a centralized telepsychiatry consultation service within a multihospital health care system. Objective To demonstrate feasibility of a hub and spoke model for provision of inpatient consult telepsychiatry service from an academic medical center to 2 affiliated regional hospital sites, to reduce patient wait time, and to develop best practice guidelines for telepsychiatry consultations to the acutely medically ill. Methods The implementation, interprofessional workflow, process of triage, and provider satisfaction were described from the first 13 months of the service. Results This pilot study resulted in 557 completed telepsychiatry consults over the course of 13 months from 2018 to 2019. A range of psychiatric conditions commonly encountered by consultation-liaison services were diagnosed and treated through the teleconferencing modality. The most common barriers to successful use of telepsychiatry were defined for the 20% of consult requests that were retriaged to face-to-face evaluation. The average patient wait time from consult request to initial consultation was reduced from >24 hours to 92 minutes. Conclusions This study demonstrated the feasibility of a centralized telepsychiatry hub to improve delivery of psychiatry consultation within a multihospital system with an overall reduction in patient wait time. This work may serve as a model for further design innovation across many health care settings and new patient subpopulations.