cssi/SciSciGPT-SciSciNet huggingface dataset:
Acute ischaemia after subarachnoid haemorrhage, relationship with early brain injury and impact on outcome: a prospective quantitative MRI study

Objective To determine if ischaemia is a mechanism of early brain injury at the time of aneurysm rupture in subarachnoid haemorrhage (SAH) and if early MRI ischaemia correlates with admission clinical status and functional outcome. Methods In a prospective, hypothesis-driven study patients with SAH underwent MRI within 0–3 days of ictus (prior to vasospasm) and a repeat MRI (median 7 days). The volume and number of diffusion weighted imaging (DWI) positive/apparent diffusion coefficient (ADC) dark lesions on acute MRI were quantitatively assessed. The association of early ischaemia, admission clinical status, risk factors and 3-month outcome were analysed. Results In 61 patients with SAH, 131 MRI were performed. Early ischaemia occurred in 40 (66%) with a mean DWI/ADC volume 8.6 mL (0–198 mL) and lesion number 4.3 (0–25). The presence of any early DWI/ADC lesion and increasing lesion volume were associated with worse Hunt-Hess grade, Glasgow Coma Scale score and Acute Physiology and Chronic Health Evaluation II physiological subscores (all p Conclusions Early ischaemia is related to poor acute neurological status after SAH and predicts future ischaemia and worse functional outcomes. Treatments addressing acute ischaemia should be evaluated for their effect on outcome.
Effects of rituximab on lymphocytes in multiple sclerosis and neuromyelitis optica.

Abstract Objective To investigate the effect of rituximab, a B-cell targeted therapy that is used in the treatment of multiple sclerosis (MS) and neuromyelitis optica (NMO), on other immune cells such as CD4+ and CD8+ T-cells in patients with MS and NMO. Design, setting and patients This is a retrospective study of all patients with MS or NMO who received at least one rituximab infusion at the UCSF MS tertiary care center between May 2005 and July 2011. Main outcome measures Linear mixed models were used to assess (a) how post-infusion cell counts changed over time compared to pre-infusion levels and one another; (b) whether the cell counts were different over multiple courses of rituximab; and (c) what was the dosing effect on the cell counts over time. Results Rituximab initially reduced CD4+ (by 26%, p =0.0005) and CD8+ (by 22%, p =0.0006) T-cells, although these changes were only transient. Subsequent treatments with rituximab did not result in a significant drop in CD4+ or CD8+ T-cells. Changes in other cell types were also typically more marked after the first cycle of rituximab than after additional treatments. The total dose of rituximab received did not appear to have a significant effect. Conclusions Although transient, rituximab-induced decrease in CD4+ and CD8+ T-cells may increase the risk of infection in susceptible individuals.
Endocrine surgery specialty training: opportunities for growth.

THE PRACTICE OF GENERAL SURGERY has been undergoing a significant transformation. An increasing number of graduates from general surgery residency programs are pursuing specialty training in a growing number of fellowships. There are benefits to this trend as it has been well established that specialty focus, both with respect to training and practice, results in better outcomes for patients. However, the competing concern has been the fear that with the growing number of fellowships, the number of cases available to general surgery residents would decrease and adversely impact their training. The field of endocrine surgery has reflected these changing conditions and these concerns. Over the last 10 years the specialty of endocrine surgery has been maturing with a growing number of fellowships across the U.S. and abroad. The American Association of Endocrine Surgeons (AAES) has developed and published a standardized curriculum for the training of endocrine surgery fellows and has established a match for its participating fellowship programs. The Directors of these AAES-recognized fellowships meet biannually to discuss the issues surrounding training. This group has wrestled with the concern regarding the impact of fellowship training programs on the quality and the quantity of the endocrine surgery experience for general surgery residents. There is a paucity of data in the literature to provide clarity to this issue in an objective way. The paper by Goldfarb et al at the Massachusetts General Hospital appearing in this issue of Surgery seeks to address some of these concerns.
Bazedoxifene and conjugated estrogen prevent diet-induced obesity, hepatic steatosis, and type 2 diabetes in mice without impacting the reproductive tract

Despite the capacity of estrogens to favorably regulate body composition and glucose homeostasis, their use to combat obesity and type 2 diabetes is not feasible, because they promote sex steroid-r...
Efficient transmission power allocation for wireless video communications

This paper considers a situation where a video sequence is to be compressed and transmitted over a wireless channel. Our goal is to minimize the amount of distortion in the reconstructed video sequence under certain channel bandwidth and transmission power constraints, with transmission power allocated across packets. Two power allocation algorithms under more realistic assumptions than those used in previous work are proposed, allocating transmission power to packets according to their relative importance. Simulations are conducted for a time-correlated Rayleigh fading channel with multiple transmit antennas, and results demonstrate the performance improvement of the proposed methods over the conventional constant power method.
Environmental and economic impacts of reducing total phosphorous runoff in an agricultural watershed

Abstract The economy of northwest Arkansas relies greatly upon livestock and poultry production. The supply of production by-products is increasingly coming under scrutiny as an important source of water pollution in the region. This study uses stochastic dominance techniques to evaluate, environmentally and economically, a range of ten best management practice scenarios to lessen water pollution in the Lincoln Lake watershed. The goal is to generate rankings that could be useful for supporting producers’ and watershed managers’ selection of management practices to reduce total phosphorous losses in runoff. Specifically, this study compares scenarios in terms of net return risk reduction for bermudagrass hay producers. The results showed that environmental and economic rankings differ from each other. Although all scenarios analyzed were effective in reducing total phosphorous losses when compared to a baseline, six of them also decreased net returns. This suggests that including some best management practices may lead to increased net return risk. However, some scenarios were identified that may increase net returns, reduce total phosphorous losses and do not differ considerably from producers’ current management practices. The previous results suggested that the joint environmental-economic impact was important when considering scenarios and that producers’ risk attitudes and best management practices’ economic impacts should be accounted for when selecting scenarios. Producers and watershed managers can weigh trade-offs between total phosphorous losses reduction and net returns variability when making water conservation decisions.
Transepithelial and Endothelial Transport of Poly (Amidoamine) Dendrimers

This article summarizes our efforts to evaluate the potential of poly (amidoamine) (PAMAM) dendrimers as carriers for oral drug delivery. Specifically, the permeability of a series of cationic PAMAM–NH2 (G0–G4) dendrimers across Caco-2 cell monolayers was evaluated as a function of dendrimer generation, concentration, and incubation time. The influence of dendrimer surface charge on the integrity, paracellular permeability, and viability of Caco-2 cell monolayers was monitored by measuring the transepithelial electrical resistance (TEER), 14C-mannitol permeability, and leakage of lactate dehydrogenase (LDH) enzyme, respectively. Microvascular extravasation of PAMAM–NH2 dendrimers in relation to their size, molecular weight, and molecular geometry is also discussed. Results of these studies show that transepithelial transport and microvascular extravasation of PAMAM dendrimers are dependent on their structural features including molecular size, molecular geometry, and surface chemistry. These results suggest that by optimizing the size and surface charge of PAMAM dendrimers, it is possible to develop oral delivery systems based on these carriers for targeted drug delivery.
Identifying protein–protein interactions in somatic hypermutation

Somatic hypermutation (SHM) in immunoglobulin genes is required for high affinity antibody-antigen binding. Cultured cell systems, mouse model systems, and human genetic deficiencies have been the key players in identifying likely SHM pathways, whereas "pure" biochemical approaches have been far less prominent, but change appears imminent. Here we comment on how, when, and why biochemistry is likely to emerge from the shadows and into the spotlight to elucidate how the somatic mutation of antibody variable (V) regions is generated.
Sibling Interaction and Morale: The Effects of Family Relations on Older People

Previous research has found no relationship between the morale of the elderly and frequency of interaction with children. This is often explained in terms of cohort differences in attitudes, values, and interests between parents and children. This study examines the relationship between morale and interaction with siblings among the elderly and finds no relationship. The indicated conclusion is that, at least in terms of interaction frequency, relations with kin do not affect the morale of the elderly. Furthermore, age differences are not relevant to the explanation of this fact.
Features of Cutaneous Malignant Melanoma Metastatic to the Retina and Vitreous

Background/Aims: To report a case of cutaneous malignant melanoma with cerebral metastasis found to have vitreoretinal metastasis upon referral for neovascular gl
Sticky Feet - Evolution in a Multi-Creature Physical Simulation.

We demonstrate artificial evolution in a system that combines physical simulation with competition between creatures. The simulated creatures are constructed using point masses that are connected by oscillating springs. The creatures pull themselves across their 2D environment by varying the amount of friction at different point masses, giving them sticky feet. Creatures combat one another, and the victor of such an encounter earns the right to reproduce, possibly with mutation. Rather than testing one individual against another in pairs, as many as 100 creatures move and interact with each other in the same 2D environment. Over time, the initial creatures are replaced by new creatures that are more agile and better at combating others. The evolved creatures from such simulations exhibit a wide array of body plans, locomotion styles, and interaction behaviors.
Status of Assessing the Indirect Nuclear Propulsion Concept

Recently a study has been initiated by NASA 's Project Prometheus to assess an alternative nuclear propulsion system concept, know as the Indirect Nuclear Propulsion Concept, from a technical and utility feasibility standpoint. Features and potential of this in - space propulsion system concept are identified. The initial study effort is focused on development of a baseline INP system design model, which is the primary f ocus of this paper. Details pertaining to the approach, features and initial demonstration results associated with this on -going model development are presented. Proposed future plans to complete development of the concept design model and to assess its fe asibility are also discussed.
Demonstration of a Circulating Endotoxin Hapten in Burned Mice

SummaryA quantitative hemagglutination-inhibition test was developed for the determination of endotoxin (hapten) in serum of mice. When the blood sera of conventional mice given a minimal or severe burn were tested for circulating endotoxin, significantly elevated titers of E. coli endotoxin (or hapten) were found in the sera. There is as yet no conclusive evidence, however, that the circulating endotoxin is biologically active.
Gestational Changes in the Uterine Expression of an Inwardly Rectifying K+ Channel, ROMK

We have examined the repertoire and relative expression levels of voltage-gated K+ channels in timed-pregnant rat uteri. These studies have revealed the gestation-specific and abundant expression of mRNA encoding an inwardly rectifying K+ channel, ROMK (originally identified in renal outer medulla), within the gravid uterus. Steady-state levels of ROMK transcripts undergo dynamic gestational changes: they are undetectable in virgin uteri, reach a maximum level by Day 12 of gestation, decline thereafter until, by term, they are again undetectable. Kidney cells also express ROMK transcripts at high levels but do not undergo apparent changes during gestation. Molecular analyses (by "rapid amplification of cDNA ends", or "5'-RACE") of the ROMK mRNAs revealed the presence of two alternative-splicing variants which are likely to arise from distinct transcription-start sites within the same gene. Polymerase chain reaction-based assessments of gravid uteri from other species revealed the expression of ROMK transcripts in the myometrium as well. Uterine expression of ROMK therefore represents a generalized phenomenon, characterized by both gestation- and tissue-specific regulation, and the transcription-regulatory mechanisms of this channel protein are potentially complex. From the biophysical properties of this channel in vitro and the observed gestational profile, we hypothesize that this channel modulates both the resting membrane potential and cellular excitability of myometrial cells, and in turn contributes to the observed contractile quiescence of the gravid uterus.
Effect of iodide, thiouracil and thyroxine on the disappearance of thyroidal I131.

SummaryThe effect of thiouracil, iodide and thyroxine on thyroidal secretion was determined by an in vivo method utilizing I131. Thiouracil accelerated thyroidal secretion sixfold; thyroxine inhibited it, and sodium iodide induced either no change or a depression of secretory rate.
Diagnostic value of exercise induced ~18F-FDG myocardial metabolism scintigraphy in myocardial ischemia

Objective To evaluate the feasibility and diagnostic accuracy of exercise induced myo- cardial imaging with ~(18)F-fluorodeoxyglueose(FDG)in myocardial isehemia.Methods Twenty-six patients with known or suspected coronary artery disease(CAD)and with no prior myocardial infarction underwent simuhaneous myocardial perfusion and metabolism imaging following intravenous injection of ~(99)Tc~m-methoxy- isobutylisonitrile(~(99)Tc~m-sestarnibi)and ~(18)F-FDG at peak exercise.Subsequently rest perfusion imaging and coronary,angiography(CAG)were performed in all patients.Exercise ~(18)F-FDG myocardial imaging was compared with ~(99)Tc~m-sestamibi imaging and CAG.Results In 22 patients with ≥50% narrowing over 1 coronary artery,18 had perfusion abnormalities(sensitivity 82%),whereas 20 had abnormal myocardial ~(18)F-FDG uptake(sensitivity 91%,P0.05).Patients with reversible(12 cases)or partial reversible(3 cases)perfusion abnormalities had increased myocardial ~(18)F-FDG uptake in abnormal perfusion segments. Compared with CAG,perfusion defect was seen in myocardial segments corresponding to 25 vascular territo- ries of 51 vessels with ≥50% narrowing in 22 patients in ~(99)Tc~m-sestamibi imaging(sensitivity 49%), whereas increased ~(18)F-FDG uptake was seen in 34 vascular territories(sensitivity 67%,P=0.008).Con- clusions Exercise induced myocardial ischemia can be imaged directly with ~(18)F-FDG.Combined exercise ~(18)F-FDG and ~(99)Tc~m-sestamibi imaging provides a better assessment of exercise-induced myocardial ischemia as compared with exercise-rest perfusion imaging.
Discrimination of human leukemia subtypes by flow cytometric analysis of cellular DNA and RNA

A newly developed flow cytometry technique for simultaneous measurements of three features of individual cells--DNA, RNA, and nuclear diameter--using acridine orange as a fluorescent metachromatic dye, has been applied to cell-cycle analysis. DNA stemline determination, and to classification of 102 cases of human leukemias in adults. Acute lymphoblastic leukemia (L1-2) was characterized by moderately increased RNA of G0/1 cells as compared to normal lymphocytes; acute nonlymphoblastic leukemia (M 1-5) by very high RNA of G0/G1 cells. Both had either diploid or aneuploid DNA stemlines. Chronic lymphocytic leukemia showed diploid DNA, very low proliferation, and low RNA, similar to that found by use to be typical for normal B cells. In chronic myelogenous leukemia, two cell populations were distinguished, one with high RNA, the other with very low RNA and elongated nuclear diameter due to stripped, unfolded nuclei of polymorphonuclear leukocytes. The number of leukemic blast cells, identified by aneuploid DNA values, correlates well with conventional microscopy counts and could be followed during the course of treatment. Thus, acridine orange flow cytometry can be used to discriminate subtypes of human leukemias, to determine cell cycle stages, and to detect and monitor aneuploid leukemia stemlines.
Embracing the Messiness: Critical and Diverse Perspectives on Racial and Ethnic Identity Development

This chapter discusses the importance of applying diverse and critical perspectives to racial and ethnic identity in U.S. higher education contexts, no matter how messy the constructs may be.
Psychologic care of the older rehabilitation patient.

Rehabilitation of older persons must include adequately addressing psychological issues. These issues go beyond detection and treatment of mental health problems, and are necessary in understanding the patient's psychological needs and characteristics in preparation for discharge back to the community.
Electroporation of DNA into Physarum polycephalum Mitochondria: Effects on Transcription and RNA Editing in Isolated Organelles

Mitochondrial RNAs in the acellular slime mold Physarum polycephalum contain nucleotides that are not encoded in the mitochondrial genes from which they are transcribed. These site-specific changes are quite extensive, comprising ~4% of the residues within mRNAs and ~2% of rRNAs and tRNAs. These “extra” nucleotides are added co-transcriptionally, but the means by which this is accomplished have not been elucidated. The cox1 mRNA also contains four sites of C to U changes, which occur post-transcriptionally, most likely via targeted deamination. The currently available in vitro systems for studying P. polycephalum editing are limited in that the template is the entire ~63,000 bp mitochondrial genome. This presents a significant challenge when trying to define the signals that specify editing sites. In an attempt to overcome this issue, a method for introducing DNA into isolated P. polycephalum mitochondria via electroporation has been developed. Exogenous DNA is expressed, but the transcripts synthesized from these templates are not edited under the conditions tested. However, transcripts derived from the mitochondrial genome are accurately edited after electroporation, indicating that the editing machinery is still functional. These findings suggest that this method may ultimately provide a feasible approach to elucidating editing signals.
Neutron activation analysis: the determination of manganese.

Criteria pertaining to biochemical applications of neutron activation analysis were formulated and dealt with experimentally. An ultramicromethod was described which permits the determination of the essential microconstituent, manganese, in biological samples, including small pools with low concentrations. Samples containing, on the average, 0.261 m mu g of manganese were analyzed with a variance of plus or minus 3.4%. The mean concentration of manganese in human plasma was 2.69 mu g per liter. The plasma concentration remained constant in the rabbit after injections of manganous sulfate whereas that of whole blood increased. Manganese concentrations were determined in some tissues and in some reagents. (auth)
Balancing Act: Maintaining Amino Acid Levels in the Autistic Brain

The ever-expanding number of genes that are mutated in autism is showing us how imbalances in fundamental cellular processes can lead to disease. A recent study by Tarlungeanu et al. (2016) identifies a form of ASD resulting from a failure of the brain to properly import amino acids.
Selective incorporation of thymidine in the organelle DNA of Polytoma obtusum

Polytoma obtusum was found to selectively incorporate exogenous thymidine into its leukoplast DNA. The nuclear DNA was unable to incorporate [3H]thymidine, although both DNA species could be labeled with radioactive adenine with similar efficiencies. The mitochondrial DNA (mitDNA), which had a buoyant density of 1.714 g/ml and was banded slightly on the heavier side of the nuclear DNA peak, was also found to incorporate a small amount of [3H]thymidine. These observations suggest that P. obtusum lack cytoplasmic thymidine kinase, whereas the enzyme is present in both leukoplast and mitochondria.
Research Objectives, Methodology and Layout

The research project is undertaken to contribute to the comprehension of system change and its process. This field of analysis is wide in nature and a definition of the research project is achieved by aiming to investigate the economic system within a societal framework. This definition necessitates the analysis of the place of the economic system within the societal system as well as the derivation of elements and structures to classify economic systems. Economic transformation is conceived as the change of system structures and it is intended to establish a framework to provide a method of distinguishing its features. Any analysis of change, however, needs to go beyond the classification of structural changes and has to focus on the process of change. This process of change is described by the term “transformation” and is juxtaposed to the term “evolution”. Both forms of change are based on human action and a humanistic view is thereby accepted. The objective is to extend a system-theoretical static approach, focus on human action within a framework and establish some fundamental features about human behaviour. Questions are raised with regard to why system changes happen, how they materialise and why the term “adjustment” is factually relevant.
Clinical Trial Design and Regulatory Issues for Therapeutic Cancer Vaccines

What is the appropriate end point for a therapeutic vaccine? Althoughwe have begun to see objective tumor responses in some patients, response rates of 10 to 20% are not generally adequate to use as end points in phase 2 trials. In order to see reliable differences in survival in a phase 2 trial, a very striking treatment effect in a wellcontrolled setting is probably required. As a practical matter, to show benefit, most phase 3 studies of therapeutic vaccines have used overall survival in advanced disease or time to recurrence either in the adjuvant setting or following complete resection with a high risk of recurrence. It is important to understand some of the reasons phase 3 vaccine trials have consistently failed to meet expectations following promising phase 2 trials. Phase 2 trial results may be strongly influenced by patient selection and retrospective analysis of subgroups, which may contribute to inadequate phase 3 trials even when based on positive phase 2 data. However, even with well designed trials, rational vaccine development beyond the empiric evaluation of individual products will require a deeper understanding of human tumor immunobiology.
Competing Theories and Concepts on Politics, Governance, and Development

Multiple theories and concepts of governance, politics, and development have been employed in the study of African politics, with varying degrees of analytical potency and competing implications for African governance and development. Some of these theoretical and conceptual frameworks are rooted in the liberal perspective while others proceed from a critical paradigm; some are holistic while others are individualistic; some are dyadic while others are atomistic; some are unilinear in orientation while others are dialectical. The purpose of this chapter is to critically examine these theories and concepts with a view to evaluating their analytical rigor vis-a-vis African politics, as well as their practical implications for Africa’s governance and development. In doing this, the chapter will pay particular attention to the strengths and limitations of the theoretical and conceptual frameworks in terms of their descriptive, explanatory, and predictive potency.
Semiparametric regression analysis for alternating recurrent event data

Alternating recurrent event data arise frequently in clinical and epidemiologic studies, where 2 types of events such as hospital admission and discharge occur alternately over time. The 2 alternating states defined by these recurrent events could each carry important and distinct information about a patient's underlying health condition and/or the quality of care. In this paper, we propose a semiparametric method for evaluating covariate effects on the 2 alternating states jointly. The proposed methodology accounts for the dependence among the alternating states as well as the heterogeneity across patients via a frailty with unspecified distribution. Moreover, the estimation procedure, which is based on smooth estimating equations, not only properly addresses challenges such as induced dependent censoring and intercept sampling bias commonly confronted in serial event gap time data but also is more computationally tractable than the existing rank-based methods. The proposed methods are evaluated by simulation studies and illustrated by analyzing psychiatric contacts from the South Verona Psychiatric Case Register.
Going beyond Chu harrington limit: ULF radiation with a spinning magnet array

ULF antennas, if made portable within a diameter of 1m, will operate under an electrical length of the order of 10−4 to 10−6 wavelengths in free space. Like for any other electrically small antenna, Chu's limit kicks in and defines the lower bound of the radiation quality factor. In this paper we present our study on an electromechanical radiating system based on spinning permanent magnets which is not subject to Chu's limit. Based on our simulation study, a spinning magnet antenna array is proposed.
Security Requirement and Standards for 4G and 5G Wireless Systems

In this article, we give an overview on the security requirements and standards for the fourth generation (4G) long term evolution (LTE) and the fifth generation (5G) wireless systems. Compared with the third generation (3G) universal mobile telecommunication system (UMTS), the LTE system not only improves the network capacity and coverage but also provides better performance of data rate, access latency, energy efficiency (EE), and spectrum efficiency (SE) [1]. With the increasing data usage and the new multimedia applications, LTE technologies have been proposed by the 3rd generation partnership project (3GPP) as the broadband mobile wireless networks with packet switched, IP-based technology solely, fully inter-working with different access technologies, different types of base stations and relay nodes. To support more use cases with unique service requirements, 5G wireless systems are developed. There are eight advanced features for 5G wireless systems, 1-10 Gbps connections to end points in the field, 1 millisecond latency, 1000x bandwidth per unit area, 10-100x number of connected devices, 99.999% availability, 100% coverage, 90% reduction of network energy usage and up to ten years battery life for low power devices [2]. These advanced features make 5G wireless systems capable of supporting many new use cases, new industry applications, a multitude of devices and applications to connect society at large. Due to the introduction of new characteristics, there are many new security requirements in the design of the security architectures of the 4G LTE and 5G wireless systems.
Annotated checklist of Afrotropical Trogolaphysa Mills, 1938 (Hexapoda: Collembola: Paronellidae) and description of a new species from Madagascar

ABSTRACT The Paronellini Borner, 1906 of Africa and Madagascar are poorly known. Nineteen Paronella-like species have been reported from Africa, but it is unclear how they are distributed among genera as currently defined. Here we review all references containing descriptions and reports of Paronella-like species from Africa, Madagascar and the Seychelles. And based on that information we propose generic allocations for all forms. As a result, 11 species are referred to Trogolaphysa Mills, 1938; three to Paronella Schott, 1893; one to Troglopedetes Absolon, 1907; one may be assigned to either Trogolaphysa or Lepidonella Yosii, 1960; one could be placed in Trichorypha Schott, 1893 or Paronella, and two are nomina nuda. For all forms referred to as Trogolaphysa we provide a short list of synonymy, diagnosis, and an identification key. We also described a new species, Trogolaphysa judithnajtae n. sp., from Madagascar, which is distinguished from Trogolaphysa wahlgreni (Mitra, 2002) n. comb. by being blue ins...
Motor Retraining (MoRe) for Functional Movement Disorders: Outcomes From a 1-Week Multidisciplinary Rehabilitation Program.

Abstract Background Functional movement disorders (FMDs) are conditions of abnormal motor control thought to be caused by psychological factors. These disorders are commonly seen in neurologic practice, and prognosis is often poor. No consensus treatment guidelines have been established; however, the role of physical therapy in addition to psychotherapy has increasingly been recognized. This study reports patient outcomes from a multidisciplinary FMD treatment program using motor retraining (MoRe) strategies. Objective To assess outcomes of FMD patients undergoing a multidisciplinary treatment program and determine factors predictive of treatment success. Design Retrospective chart review. Setting University-affiliated rehabilitation institute. Patients Thirty-two consecutive FMD patients admitted to the MoRe program from July 2014–July 2016. Intervention Patients participated in a 1-week, multidisciplinary inpatient treatment program with daily physical, occupational, speech therapy, and psychotherapy interventions. Main Outcome Measurements Primary outcome measures were changes in the patient-rated Clinical Global Impression Scale (CGI) and the physician-rated Psychogenic Movement Disorder Rating Scale (PMDRS) based on review of standardized patient videos. Measurements were taken as part of the clinical evaluation of the program. Results Twenty-four of the 32 patients were female with a mean age of 49.1 (±14.2) years and mean symptom duration of 7.4 (±10.8) years. Most common movement phenomenologies were abnormal gait (31.2%), hyperkinetic movements (31.2%), and dystonia (31.2%). At discharge, 86.7% of patients reported symptom improvement on the CGI, and self-reported improvement was maintained in 69.2% at the 6-month follow-up. PMDRS scores improved by 59.1% from baseline to discharge. Longer duration of symptoms, history of abuse, and comorbid psychiatric disorders were not significant predictors of treatment outcomes. Conclusions The majority of FMD patients experienced improvement from a 1-week multidisciplinary inpatient rehabilitation program. Treatment outcomes were not negatively correlated with longer disease duration or psychiatric comorbidities. The results from our study are encouraging, although further long-term prospective randomized studies are needed. Level of Evidence III
Are all antidepressants alike

Antidepressants are indicated in about 40 different disorders, including mood disorders, anxiety disorders, and other disorders. We propose to call these disorders antidepressani-responsive disorders (ARDs). We describe the clinical and biological criteria that differentiate the antidepressants. Although antidepressants share the same clinical efficacy in most ARDs, the configuration of adverse drug reactions varies widely. The recent antidepressants should be preferred to the tricyclic antidepressants as first-line treatment because of their lesser risk of severe adverse drug reactions. However, several recent antidepressants have been associated with severe complications such as the serotonin syndrome and the withdrawal syndrome. Patient characteristics should be included as a criterion to predict both unwanted and favorable effects.
Training Evaluation in Virtual Worlds: Development of a Model

Many organizations have adopted virtual worlds (VWs) as a setting for training programs; however, research on appropriate evaluation of training in this new setting is incomplete. In this article, we address this gap by first exploring the unique issues relevant to evaluation faced by training designers working in VWs. At the macro-organizational level, the primary issue faced is an organizational culture unreceptive to or otherwise skeptical of VWs. At the micro-organizational level, two major issues are identified: individual trainees unreceptive to VWs and general lack of experience navigating VWs. All three of these challenges and their interrelationships may lead to poor reactions, learning, and transfer from VW-based training despite strong, pedagogically sound training design. Second, we survey the training evaluation research literature, identifying the most well-supported training evaluation models, discussing the suitability of each for evaluating VW-based training. Third, we propose a new integrative model based upon this literature, incorporating solutions to the unique issues faced in VWs with the most relevant portions of the models discussed earlier. Fourth, broad thematic implications of this model are identified and applied to prior VW literature. Finally, we provide specific recommendations to practitioners and researchers to evaluate their VW-based training fully.
Optimal sequencing of chemoradiotherapy for locally advanced laryngeal cancer.

OBJECTIVE To determine the optimal sequencing of chemoradiotherapy for locally advanced laryngeal cancer. The hypothesis was that concurrent chemoradiotherapy (CCRT) would be associated with improved overall survival (OS) compared to induction chemotherapy followed by radiotherapy (RT)/surgery (IC). METHODS The National Cancer Database identified 8,154 patients with American Joint Commission on Cancer stage III/IV (excluding T1) laryngeal cancer between 2004 and 2013 treated with one of the established organ preservation techniques: CCRT or IC. The association between OS and total radiation dose (< 66 gray [Gy] or ≥ 66 Gy) was analyzed using the Kaplan-Meier method, as was the association between OS and timing of IC (21-42, 43-100, or 101-120 days before RT). Hazard ratios (HR) adjusted for patient and clinical characteristics were computed using Cox regression modeling. RESULTS The median follow-up was 32.7 months. The estimated 5-year OS for CCRT and IC was 49.9% and 50.6%, respectively (P = 0.653). On multivariate analysis, no difference was observed between the two regimens (IC, adjusted HR 0.96, 95% confidence interval [CI] 0.88-1.04, P = 0.268). Radiation dose ≥66 Gy had improved OS overall in CCRT group but not in IC patients. When comparing CCRT and IC in patients receiving ≥66 Gy, there was no difference in OS (adjusted HR 0.97, 95% CI 0.89-1.06, P = 0.552). Patients starting chemotherapy 21 to 42 or 101 to 120 days prior to RT had inferior OS compared to patients starting between 43 to 100 days. CONCLUSION For locally advanced laryngeal cancer, there is no difference in OS between CCRT and IC. Factors associated with survival included radiation dose and timing of induction chemotherapy before RT. LEVEL OF EVIDENCE 3b Laryngoscope, 129:2313-2320, 2019.
Universal Design for Learning as a Curriculum Development Tool in Physical Education

The purpose of the article is to discuss the universal design for learning (UDL) framework as a curriculum development tool and illustrate how it can be implemented in the physical education settin...
The relationship of 25-hydroxyvitamin D concentrations and individual-level socioeconomic status.

Abstract Socioeconomic status (SES), defined as the ability to access desired resources, is associated with behaviors that may affect vitamin D status. Most studies of the effect of vitamin D status on outcomes do not account for individual-level SES. The ability to adjust for SES in epidemiologic studies, when data on conventional SES measures have not been obtained, would be advantageous. We identified all serum 25(OH)D measurements in adults age 18 years and older residing in Olmsted County, MN, a mixed urban-rural setting, between January 1, 2005 and December 31, 2011, through the Rochester Epidemiology Project. The first 25(OH)D measurement was considered the index measurement for each subject. SES was determined for each subject by the HOUsing-based SocioEconomic Status (HOUSES) index, derived from real property data. The HOUSES index is an aggregated z-score of assessed housing value, area of living space, number of bedrooms, and number of bathrooms, with higher scores indicating higher SES. Multivariable analyses were adjusted for age, BMI, sex, race, season of 25(OH)D measurement, and Charlson comorbidity index. HOUSES was matched for 10,378 of 11,002 subjects (94 %) with 25(OH)D measurements available. The mean (SD) age was 54.3 (17.1) years with 26.9 % ≥65 years; 77.3 % were women, and 12.1 % were non-white. The mean 25(OH)D concentration was 30.0 (12.9) ng/mL, and 598 (5.8 %) had a 25(OH)D value 50 ng/mL, respectively (P = 0.12 for trend). 25(OH)D increased by 0.43 (95 % CI 0.36-0.50) ng/mL for each unit increase in HOUSES in univariate analysis and by 0.28 (0.21-0.35; P
Ranking disease control strategies with stochastic outcomes

This paper explains how the methodologies of first and second order stochastic dominance, and expected utility using specific risk preferences, can be applied to epidemiology when choosing among control strategies that have stochastic outcomes. We provide a step-by-step guide on how epidemiologists can rank a number of control strategies based on their distribution of estimated benefits. We also explain how the expected utility model and decision maker's risk preferences can be used to select between outcomes when none stochastically dominates. To illustrate these techniques, we show the ranking of various control strategies for a dairy herd endemically infected with Mycobacterium avium subs. paratuberculosis (MAP) and mastitis, and explain how decision maker's risk preferences affect the ranking.
Determining absolute Seebeck coefficients from relative thermopower measurements of thin films and nanostructures

Measurements of thermoelectric effects such as the Seebeck effect, the generation of electric field in response to an applied thermal gradient, are important for a range of thin films and nanostructures used in nanoscale devices subject to heating. In many cases, a clear understanding of the fundamental physics of these devices requires knowledge of the intrinsic thermoelectric properties of the material, rather than the so-called “relative” quantity that comes directly from measurements and always includes contributions from the voltage leads. However, for a thin film or nanostructure, determining the absolute Seebeck coefficient, α abs, is challenging. Here, we first overview the challenges for measuring α abs and then present an approach for determining α abs for thin films from relative measurements made with a micromachined thermal isolation platform at temperatures between 77 and 350 K. This relies on a relatively simple theoretical description based on the Mott relation for a thin film sample as a function of thickness. We demonstrate this technique for a range of metal thin films, which show that α abs almost never matches expectations from tabulated bulk values, and that for some metals (most notably gold) even the sign of α abs can be reversed. We also comment on the role of phonon and magnon drag for some metal films.
Irradiance, photosynthesis and elevated pCO2 effects on net calcification in tropical reef macroalgae

Abstract Calcifying tropical macroalgae produce sediment, build three-dimensional habitats, and provide substrate for invertebrate larvae on reefs. Thus, lower calcification rates under declining pH and increasing ocean pCO2, or ocean acidification, is a concern. In the present study, calcification rates were examined experimentally under predicted end-of-the-century seawater pCO2 (1116 μatm) and pH (7.67) compared to ambient controls (pCO2 409 μatm; pH 8.04). Nine reef macroalgae with diverse calcification locations, calcium carbonate structure, photophysiology, and site-specific irradiance were examined under light and dark conditions. Species included five from a high light patch reef on the Florida Keys Reef Tract (FKRT) and four species from low light reef walls on Little Cayman Island (LCI). Experiments on FKRT and LCI species were conducted at 500 and 50 μmol photons m−2 s−1 in situ irradiance, respectively. Calcification rates independent of photosystem-II (PSII) were also investigated for FKRT species. The most consistent negative effect of elevated pCO2 on calcification rates in the tropical macroalgae examined occurred in the dark. Most species (89%) had net calcification rates of zero or net dissolution in the dark at low pH. Species from the FKRT that sustained positive net calcification rates in the light at low pH also maintained ~30% of their net calcification rates without PSII at ambient pH. However, calcification rates in the light independent of PSII were not sustained at low pH. Regardless of these low pH effects, most FKRT species daily net calcification rates, integrating light/dark rates over a 24h period, were not significantly different between low and ambient pH. This was due to a 10-fold lower dark, compared to light, calcification rate, and a strong correspondence between calcification and photosynthetic rates. Interestingly, low-light species sustained calcification rates on par with high-light species without high rates of photosynthesis. Low-light species' morphology and physiology that promote high calcification rates at ambient pH, may increase their vulnerability to low pH. Our data indicate that the negative effect of elevated pCO2 and low pH on tropical macroalgae at the organismal level is their impact on dark net calcification, probably enhanced dissolution. However, elevated pCO2 and low pH effects on macroalgae daily calcification rates are greatest in species with lower net calcification rates in the light. Thus, macroalgae able to maintain high calcification rates in the light (high and low irradiance) at low pH, and/or sustain strong biotic control with high [H+] in the bulk seawater, are expected to dominate under global change.
Comminuted Articular Distal Radius Fractures

Abstract Comminuted, intraarticular distal radial fractures present a substantial management challenge. Typically, the result of higher energy injuries they can also occur during fractures in osteopenic bone. While all injuries have the potential for ongoing disability and functional impairment, overall fracture severity of the distal radius has been shown to be correlated with inferior health-related quality of life and radiographic outcomes. In the setting of complex articular fracture pattern, a number of techniques have been described. Regardless of treatment modality, surgical goals remain the restoration of alignment, length and re-establishing articular congruency. Despite a variety of available surgical techniques to aid in the management of these complex intraarticular distal radius fractures, strong evidence to support the superiority of any one technique remains limited. Each technique brings with it specific advantages and complications. Despite a lack of scientific consensus, volar plating has become the mainstay of conventional treatment for distal radius fractures. However, highly comminuted articular fractures may present specific challenges for this technique. This is particularly the case when complex articular comminution, and shear patterns are present where higher rates of complications and poorer radiographic outcomes have been reports. Despite evidence to support improved radiological congruency using many of these techniques, inferior functional outcomes regardless of reduction are common in these complex injuries. This finding likely represents the inherent chondral injury present despite radiographic osseous reduction. Further complicating the issue is the lack of clear relationship between radiographic outcome and functional/clinical outcomes, particularly in the elderly.
Bespoken Spirits: Disrupting Distilling

On October 7, 2020, Bespoken Spirits publicly announced it had received $2.6 million of seed funding for its “sustainable maturation process,” a process that could produce award-winning whiskeys in just days rather than years using a novel technology and data science. The technology dramatically reduced the time, cost, and environmental impact of making whiskey (it required less energy, space, and wood). At the same time, the technology could also be used to enhance a whiskey’s taste profile (aroma, color, and taste) which could allow distillers to charge more for their products. To date, entrepreneurs Stu Aaron and Martin Janousek had proven they could produce whiskey at scale and with desired properties. Having validated the concept, they now had to decide whether to continue making whiskey themselves or use their technology to process whiskey for others. In short, they had to decide whether to be a product-based, B2C company or a technology-based, B2B company, or both? If they decided to be a technology business, should they emphasis the Maturation-as-a-Service (MaaS, faster and lower cost production) or the Customization-as-a-Service (CaaS, creation of customized/bespoken products with unique taste profiles) business in the short term? This short case has four objectives. First, it illustrates how new technologies can dramatically change industry economics. The production of whiskey, which can take from three to 30 years or more, has a particularly unattractive economic profile from a present value perspective. Second, it shows how a novel technology can create a competitive advantage by reducing input costs, or allowing distillers to increase quality and target specific market segments which should allow them to increase price (i.e., create a cost, price, and/or dual advantage). Third, it forces students to confront a common, yet difficult decision of whether to become a product-based or a technology-based company. As part of that assessment, students must consider both the nature and sustainability of the advantage as well as the investment cost, risk, and feasibility of each strategic option.