cssi/SciSciGPT-SciSciNet huggingface dataset:
Is cardiovascular screening in athletes justified? Inconsistent messages from the American Heart Association

Recent reports from the American Heart Association (AHA) and by lead authors of the 2014 AHA guidelines for cardiovascular screening in athletes present many inconsistencies that need to be critically examined. In three different AHA statements (1996, 2007, 2014), the AHA has endorsed cardiovascular screening: “Both AHA and ESC consensus panels have agreed previously that screening to detect cardiovascular abnormalities in asymptomatic young competitive athletes is justifiable in principle on ethical, legal, and medical grounds.”1 Furthermore, the AHA has not endorsed cardiovascular screening for young non-athletes: “Consideration for large-scale, general population, and universal cardiovascular screening in the age group 12 to 25 years with history-taking and physical examination alone is not recommended (including on a national basis in the United States) (Class III, no evidence of benefit; Level of Evidence C).”1 However, <1 year from publication, the AHA and leaders of the 2014 guidelines have called into question the very ethics of screening only young athletes, and recommended that all young persons be screened, with a cardiac history and physical examination as part of an …
A Monocyte Conditioned Medium Is More Effective Than Defined Cytokines in Mediating the Terminal Maturation of Human Dendritic Cells

Mature human dendritic cells can be generated in substantial numbers from nonproliferating progenitors in human blood using a two-step protocol. T cell-depleted mononuclear cells are first cultured with granulocyte-macrophage colony-stimulating factor and interleukin-4 (IL-4) and then exposed to monocyte conditioned medium (MCM). The dendritic cells generated using this approach are rendered terminally mature and are the most potent antigen presenting cells identified to date in humans. We sought to characterize factors in MCM that induce the terminal differentiation of dendritic cells. MCM contained substantial, although varying, quantities of several factors including tumor necrosis factor-alpha, IL-1beta, IL-6, and interferon-alpha. However, none of the four factors, individually or in various combinations, could fully substitute for the MCM to generate irreversibly differentiated dendritic cells. The yields, percentage of cells expressing the mature phase marker CD83, and mixed leukocyte reaction-stimulatory function were lower when defined cytokines were used in the place of MCM. Therefore, the full maturation of dendritic cells, because it entails changes in many known cell and molecular properties, requires a number of different cytokines that are released in tandem from appropriately stimulated monocytes. We propose that MCM-matured dendritic cells will be the most effective adjuvants for immunotherapy in vivo.
The 1935 Census—An Appraisal from the Viewpoint of Crop Estimates

The Crop Reporting Board of the United States Department of Agriculture is specifically charged by law with the function and duty of recording the production of agricultural products in the United States. This function and duty involves also the determination of the components of production, such as acreage planted, acreage harvested, yield per acre, numbers of livestock on hand, birth rates and gain in weight of livestock, milk per cow, and eggs per hen. From the beginning the board and its predecessors had a mandate to report the progress of crops dur, ing the growing season. These were the genesis and forerunner of the present crop production forecasts. The predecessors of the board also felt the need of an evaluation of production and for this purpose at an early date began to report prices as of December 1 of each year. Later, the need of a more adequate evaluation led Mr. Nat C. Murray to initiate in 1909 the series of monthly price reports. Still later we find the need for a measure of return on income from farming, expressing itself in the Gross Farm Value reports begun in 1912 under the direction of Mr. George K. Holmes. As developed to date in the Income Reports of the Department, there is entailed the determination of the utilization of agricultural commodities. To round out the picture of information needed by farmers in making production and marketing plans, timely reports are issued on intentions to plant, pig surveys, upon stocks on hand, wage rates, farm employment, and other miscellaneous subjects. 'Thus, the field of the Crop Reporting Board begins with farmers' seeding and breeding plans and follows through to record the net results as cash in their pockets. In pursuing this quest on far-flung fronts for some 79 crops and 13 livestock items, the board has available some half million of federal funds and the cooperative contributions by state agencies of some $140,000.00. Naturally, its facilities for establishing absolute measures are limited. Many such measures, as railroad shipments, come second hand. Primary counts are limited to those secured from cooperative state agencies through assessors and to summations of processed commodities centralized in a few hands, such as sugar cane, sugar beets, and rice.
Effect of Nitrogen and Oxygen Impurities on Tantalum Silicide Formation

Tantalum, being a refractory metal, is sensitive to ambient impurities when forming a silicide. By introducing nitrogen and oxygen impurities into a tantalum-silicon system, interesting chemical and physical effects are observed in their subsequent reactions. Nitrogen and oxygen behave similarly in such a system. If initially present in Ta, they segregate into the still unreacted Ta as the silicide layer grows at a somewhat retarded rate. The same impurities, initially present in Si, are immobile in the form of stable compounds and suppress TaSi2 growth. The rare isotopes 15N and 18O are introduced by implantation and Profiled by 15N(P,α) 12C and 18O(P,α) 15N nuclear reaction analyses, respectively. In addition, unintentionally incorporated 18O is checked by the 16O(d,α) 14N nuclear reaction. The results are explained in terms of the moving species Si, and of the chemical affinity, solubility and diffusivity of the impurities in their host lattice.
Effects of simulated removal activities on movements and space use of feral swine

Abundance and distribution of feral swine (Sus scrofa) in the USA have increased dramatically during the last 30 years. Effective measures are needed to control and eradicate feral swine populations without displacing animals over wider areas. Our objective was to investigate effects of repeated simulated removal activities on feral swine movements and space use. We analyzed location data from 21 feral swine that we fitted with Global Positioning System harnesses in southern MO, USA. Various removal activities were applied over time to eight feral swine before lethal removal, including trapped-and-released, chased with dogs, chased with hunter, and chased with helicopter. We found that core space-use areas were reduced following the first removal activity, whereas overall space-use areas and diurnal movement distances increased following the second removal activity. Mean geographic centroid shifts did not differ between pre- and post-periods for either the first or second removal activities. Our information on feral swine movements and space use precipitated by human removal activities, such as hunting, trapping, and chasing with dogs, helps fill a knowledge void and will aid wildlife managers. Strategies to optimize management are needed to reduce feral swine populations while preventing enlarged home ranges and displacing individuals, which could lead to increased disease transmission risk and human-feral swine conflict in adjacent areas.
High-speed, 3D SCAPE Microscopy of Fresh Tissues for in situ Histopathology

Freshly excised tissues were imaged with SCAPE microscopy, allowing rapid 3D visualization. Results suggest in situ imaging using SCAPE could be used to diagnose and monitor diseased tissue, and guide targeted biopsies and surgical resection.
Evaluation of Breast Cancer Stem Cells With Coexpression of Multiple Stem Cell Biomarkers

The presence of breast cancer stem cells (CSCs) is thought to be associated with breast cancer recurrence and metastasis. Cancer stem cell biomarkers include ALDH1a, CD24low/CD44high, CD133, SOX2, OCT4, and Nanog. ALDH1a and CD24low/CD44high have been often used as markers for sorting breast cancer stem cells. The prognostic value of the above mentioned stem …
Physical and self-reported response and the pharmacokinetics of e-cigarettes compared to cigarettes in substance-abusing participants

control training including relevant 12-Step content (AC). Posttraining and 6-mo follow-up observations of 12-Step groups were audiotaped and coded for adherence to 12-Step content and skillfulness. 12-Step engagement and self-reported substance use was assessed among clients (N=307) for six months following toolkit exposure. Results: TK counselors demonstrated very large Preto PostTraining adherence improvements in core curriculum techniques (F=55.49, p< .0001; d=2.07) and moderate improvements in 12Step content (F=4.66, p= .011; d= .55) relative to counselors in the AC condition. These effects were consistent and durable at 6months. Therewerenomaineffects of TKexposureon self-reported 12-stepattendanceandsubstanceuse.Amongclients activelyusing at baseline (35%), TK clients reported significantly fewer drinking days (p= .024; d= .52) and a trend towards fewer drug use days (p= .076; d= .49) relative to AC clients at 3 months. These differences were attenuated and no longer significant at 6 months. Conclusions: Multimedia toolkits are an easily disseminated approach to durably improve group counseling outcomes in community treatment for key client subgroups with minimal training and supervision. Financial support: NIAAA R01 AA017867.
A Survey of Network Security Situation Awareness

In order to improve the defense ability of information security in power grid,power enterprises put more and more attentions on the information network security situation awareness technology in order to realize the prediction and prevention of security events. This paper analyzes the necessity of studying the network security situation awareness technology. The architecture,methods and key algorithms in the existing domestic and overseas research works in this field are described in detail. Finally this paper summarizes the network security situation awareness technology and looks forward to its development trend.
Field Measuring Techniques Development of Grounding Grid Resistance and Measurement Error Analysis

Grounding grid resistance is an important technical index in grounding system of power plant and substation.The new field measuring techniques and apparatus used in domestic gounding grid site measurement has been amply discussed.And measurement error under different circumstance is minutely analyzed.
Evidence for alternative pathways of methionine catabolism.

The catabolism of methionine has been reviewed most recently by Greenberg (1975b), Mudd and Levy (1978), and Finkelstein (1975). These reviews propose that the major route of methionine degradation is via the transsulfuration pathway (Fig. 1). Following activation of methionine to S-adenosylmethionine, the methionine methyl group is transferred to methyl acceptors such as glycine and phosphatidylethanolamine. The sulfur atom of methionine is recovered in homocysteine, cystathionine, and cysteine. Carbon atoms 1 through 4 are recovered in homocysteine, cystathionine, and α-ketobutyrate.
Transcription factors and pattern formation in the developing lung

During development of the respiratory tract embryonic cells are instructed to organize themselves along an axis and differentiate, such that proximal structures (trachea) greatly differ from those in distal alveoli. Pattern formation relates to this process of organization, and it is believed to be transcriptionally regulated in many developmental systems. Although the lung is the site of expression of many transcription factors, such as Hox, retinoid receptors, hepatocyte nuclear factors, and myc, among others, little information is available on how they influence lung pattern. Functional studies so far have directly implicated the product of the protooncogene N-myc and the retinoic acid receptors as transcriptional regulators of lung patterning, and it is likely that tissue-specific homeobox genes, such as the thyroid transcription factor-1, play an important role in distal lung formation. This review describes several aspects of transcription factors possibly involved in lung patterning, including structure, spatial distribution, and their putative functions.
Drug information services in an oncology institution

Information requests received over a 14-month period in the drug information service of an oncology hospital were reviewed. Requests were classified as to the nature of the question, category of requestor and geographical distribution of both questions and requestors. Inquiries were tabulated as either oncology-related or nononcology and further divided into one of 12 information categoreis. Those questions concerning investigational chemotherapy and unproven cancer remedies were tabulated. An average of 104 requests monthly were received. Prescribing practitioners accounted for 47.7% of all inquirers. Overall, 39.4% of total requests were oncology-related. The majority (72%) of total requests originated within the institution. The greatest number of requests (17.7%) were of a general review nature. The second greatest number (14.3%) were efficacy-related questions which solicited an opinion as to the appropriateness of drug use. Methods need to be developed for measuring the impact of drug information services on prescribing habits.
Towards the analysis of high molecular weight proteins and protein complexes using TIMS-MS

In the present work, we demonstrate the potential and versatility of TIMS for the analysis of proteins, DNA-protein complexes and protein-protein complexes in their native and denatured states. In addition, we show that accurate CCS measurement are possible using internal and external mobility calibration and in good agreement with previously reported CCS values using other IMS analyzers (<5 % difference). The main challenges for the TIMS-MS analysis of high mass proteins and protein complexes in the mobility and m/z domain are described. That is, the analysis of high molecular weight systems in their native state may require the use of higher electric fields or a small compromise in the TIMS mobility resolution by reducing the bath gas velocity in order to effectively trap at lower electric fields. This is the first report of CCS measurements of high molecular weight biomolecules and biomolecular complexes (~150 kDa) using TIMS-MS.
Utility of endometrial sampling prior to risk-reducing hysterectomy in a patient with Lynch syndrome

Occult endometrial cancer is occasionally discovered in women with Lynch syndrome undergoing risk-reducing hysterectomy. The case presented here demonstrates that preoperative endometrial sampling can help detect these occult cancers; however, there are currently no recommendations for this preoperative intervention. A 50-year-old woman with Lynch syndrome underwent endometrial sampling prior to planned risk-reducing hysterectomy and bilateral salpingo-oophorectomy. The endometrial biopsy demonstrated a serous endometrial cancer. The patient was counselled regarding the diagnosis and revised operative plan, which now included staging, prior to surgery. Although the prevalence of occult endometrial cancer at the time of risk-reducing surgery in women with Lynch syndrome remains unknown, preoperative endometrial sampling may allow for improved patient counselling and surgical planning in this population, and can help avoid a subsequent surgery for staging.
Review: SubUrbanisms: Casino Urbanization, Chinatowns, and the Contested American Landscape and Chinese Style: Rediscovering the Architecture of Poy Gum Lee, 1923–1968

SubUrbanisms: Casino Urbanization, Chinatowns, and the Contested American Landscape Museum of Chinese in America, New York 24 September 2015–27 March 2016 Chinese Style: Rediscovering the Architecture of Poy Gum Lee, 1923–1968 Museum of Chinese in America, New York 24 September 2015–27 March 2016 If the United States, sprawling and diverse, can be difficult to see, the milieu of new immigrants, especially poor ones, is even less visible. A pair of exhibitions at the Museum of Chinese in America helped bring that world into focus: SubUrbanisms , which explored the lives of Chinese immigrants in twenty-first-century Norwich, Connecticut; and Chinese Style , which documented the mid-twentieth-century career of Chinatown-born architect Poy Gum Lee. SubUrbanisms , curated by Stephen Fan, a young Chinese American architect who grew up, in part, in Norwich, told the fascinating story of Chinese workers lured from New York City beginning around 2001 to work at Mohegan Sun, the massive casino complex developed by the Mohegan Tribe in the late 1990s on the site of a shuttered plant that made components for nuclear reactors. Norwich, like much of southeastern New England, industrialized early. A century ago, its bustling mills attracted thousands of new immigrants from the Lower East Side, mostly Italians and Jews (including several of my great-grandparents). As industry waned, however, downtown faded, and those who remained, like Americans coast to coast, spread out to a new ring of tract houses and commercial strips. It is here, rather than …
Biphasic Effects of Statins on Angiogenesis-Mediated Processes.

Background: Statins inhibit HMG-CoA reductase, resulting in the reduction of cholesterol synthesis as well as isoprenoids that modulate various cell functions. Methods: The present study was undertaken to determine the effects of different statins (lovastatin, fluvastatin, simvastatin, and pravastatin) on endothelial cell functions and angiogenesis. The effect of statins on endothelial cell migration toward matrix proteins and stimulated with tissue factor (TF)/factor VIIa was examined using modified Boyden chamber technique. Additionally, the effect of statins on endothelial differentiation and tube formation was determined in unstimulated and basic fibroblast growth factor (FGF-2) -stimulated endothelial cell tube formation. Furthermore, the effect of statins on the modulation of new blood vessel generation in the chick chorioallantoic membrane (CAM) model was determined under unstimulated and stimulated angiogenesis by FGF-2 or insulin. Results: Endothelial cell migration toward vitronectin and stimulated by TF/VIIa was shown to be inhibited by the various statins in a concentration (0.001–10 μM) -dependent manner. Endothelial cell differentiation and tube formation were enhanced by statins at low concentrations (0.01–0.001 μM) but inhibited at relatively high concentrations (0.1–10 μM) either in unstimulated or FGF-2-stimulated conditions, with different IC50s depending on the statin. In FGF-2- or insulin-stimulated angiogenesis in the CAM model, lovastatin demonstrated significant inhibition (40-75%) at 1–5 μg. In contrast, in unstimulated state lovastatin enhanced angiogenesis in the CAM model by 20–40% at 1–5 μg. Statins have proangiogenesis effects at low concentration in unstimulated or stimulated states but angiostatic effects at high concentrations in stimulated state. Similar biphasic effects on angiogenesis-mediated processes were determined with pravastatin, fluvastatin, or simvastatin, but with different potency. The antiangiogenesis efficacy was significantly ( P Conclusion: Statins have a biphasic dose-dependent effect on angiogenesis-mediated processes that depend on the microenvironment and status of the proangiogenesis stimuli. At clinically relevant doses, statins may modulate angiogenesis depending on the proangiogenesis/antiangiogenesis hemostasis. Table 1. Modulation of Angiogenesis by Statins in the Chick Chorioallantoic Membrane Model Table 2. Statins and Angiogenesis Modulation in the Chick Chorioallantoic Membrane Model
Spinal manipulation is appropriate for low back pain: fact or fiction?

Keywords: Spinal manipulation; Chiropractic manipulation; Osteopathic manipulation; Low back pain; Randomised clinical trial; Systematic review
K-Cl Cotransport and MCHC in HbE Transgenic Mice and Human HbE.

In HbE, HbC, and HbOArab a glutamic acid is mutated to a lysine resulting in a cumulative increase in positive charge of +4 units per tetramer when compared to HbA. These mutations occur at β−26, β−6, and β−121, respectively. We have reported an increase in both K-Cl cotransport and in red cell density (that is directly proportional to MCHC) for HbC and HbOArab. In the case of HbC, we demonstrated that transgenic mice expressing HbC also have these properties. We also previously reported that human homozyous HbE red blood cells (hRBC) have normal red cell density; that is, they have the same MCHC as HbA hRBC. We now report that RBC from mice (mRBC) expressing HbE have elevated K-Cl cotransport and normal MCHC and that these properties have been found in HbE hRBC as well. In mice expressing exclusively human α and βE, K-Cl cotransport in mRBC with HbE versus C57Bl was 10±0.9 versus 2.0±0.9 mmol/L cells x hr (FU), respectively. Mice expressing exclusively HbE have mRBC that are microcytic vs C57 (MCV=32.9±1.5 vs 47.5±2.0 fl, N=5, p<0.0003), have low MCH vs C57 (MCH=9.8±0.1 vs 14.7±0.8 pg, N=5, p<0.0004), but have normal MCHC vs C57 (CHCM=29.7±1.1 vs 30.9±1.9 g/dl, p=NS). In a human patient with HbE β thalassemia, we found elevated K-Cl cotransport (10±0.9 versus 2.0±0.9 FU) and red cell indices vs HbA that were analogous to those seen in HbE transgenic mice: (MCV=63.8 vs 88.1±2.3 fl), (MCH=20.9 vs 30.9±1.0 pg), but a normal MCHC vs HbA (CHCM=33.0 vs 34.9±1.2 g/dl). Because this patient suffers from severe thalassemia and hence has an elevated reticulocyte count (17%), the elevation in K-Cl cotransport may be due, in part or totally, to the presence of reticulocytes. However, reticulocytes have a lower MCHC than mature RBC, and blood with a high percent of reticulocytes generally has a low average MCHC; however, we observed a normal MCHC for this patient and others in whom K-Cl was not measured. We attribute the normal MCHC observed in both human patients with HbE and in our transgenic mouse model to the effect of K-Cl cotransport on a red cell with a thalassemic background. In conclusion, the low MCHC anticipated from the well-known thalassemic nature of the HbE mutation is not realized due to enhanced K-Cl cotransport. This demonstrates that the mouse model reproduces the hematologic features of the human disease and will provide a suitable model for gene therapy and other therapeutic approaches for HbE hemoglobinopathies.
A Prospective Comparison of How the Level of Response to Alcohol and Impulsivity Relate to Future DSM-IV Alcohol Problems in the COGA Youth Panel.

Author(s): Schuckit, Marc A; Smith, Tom L; Danko, George; Anthenelli, Robert; Schoen, Lara; Kawamura, Mari; Kramer, John; Dick, Danielle M; Neale, Zoe; Kuperman, Samuel; McCutcheon, Vivia; Anokhin, Andrey P; Hesselbrock, Victor; Hesselbrock, Michie; Bucholz, Kathleen | Abstract: BackgroundAlcohol problems reflect both environmental and genetic characteristics that often operate through endophenotypes like low levels of response (low LRs) to alcohol and higher impulsivity. Relationships of these preexisting characteristics to alcohol problems have been studied, but few analyses have included both low LR and impulsivity in the same model.MethodsWe extracted prospective data from 1,028 participants in the Prospective Youth Sample of the Collaborative Study on the Genetics of Alcoholism (COGA). At Time 1 (age 18), these drinking but non-alcohol-dependent males and females completed the Barratt Impulsivity Scale and the Self-Report of the Effects of Alcohol questionnaire regarding drinks required for effects the first 5 times of drinking (SRE5-LR). Two years later, they reported perceived drinking patterns of peers (PEER), their own alcohol expectancies (EXPECT), and their drinking to cope with stress (COPE). Subsequently, at Time 3, participants reported numbers of up to 11 DSM-IV alcohol criterion items experienced in the 2nyears since Time 2 (ALC PROBS). Data were analyzed using structural equationnmodeling (SEM).ResultsIn the SEM, Baseline SRE5-LR and impulsivity were weakly related and did not interact in predicting later ALC PROBS. LR was directly linked to Time 3 ALC PROBS and to PEER, but had no direct path to EXPECT, with partial mediation to ALC PROBS through PEER to EXPECT and via COPE. Impulsivity did not relate directly to ALC PROBS or PEER, but was directly related to EXPECT and COPE, with effects on ALC PROBS also operating through EXPECT and COPE.ConclusionsLow LRs and impulsivity related to Time 3 ALC PROBS through somewhat different paths. Education- and counseling-based approaches to mitigate future alcohol problems may benefit from emphasizing different potential mediators of adverse alcohol outcomes for youth with low LRs versus those with high impulsivity or both characteristics.
Considering the "public" in public health: popular resistance to the Smallpox Eradication Programme in India

Public health initiatives, including large-scale vaccination and disease eradication programmes, regularly pit the rights of the individual against broader benefits to society. At times, the public resists such initiatives, with the World Health Organisation's Smallpox Eradication Programme (SEP) in India being a case in point. Here, we critically investigate resistance to smallpox vaccines in India and argue that while the SEP successfully eradicated a global killer; individuals were stripped of human rights through coercion, forcible vaccination and quarantine. In many cases, resistance to vaccination was linked to deep-rooted social, cultural and religious beliefs. Critical points made in this paper are applicable to contemporary discussions on required vaccinations, quarantine during the outbreak of diseases and the current campaign to eradicate polio.
Current themes in myocardial and coronary vascular aging

Advancing age will affect every individual and its impact on cardiac health deserves significant attention. The age-related physiological changes occurring in the coronary vasculature, myocardium, and valves set the stage upon which cardiovascular disease can escalate in the elderly population. The overall focus of this review is to highlight new and noteworthy studies and to incorporate reviews related to cardiac senescence in the context of the current state of the field. Lastly, future directions in the field of cardiac aging and the development of novel therapeutics to treat pathophysiological conditions typically associated with advancing age will be discussed.
Big data on a big new market: Insights from Washington State's legal cannabis market.

Abstract Introduction Voters in eight U.S. states have passed initiatives to legalize large-scale commercial production of cannabis for non-medical use. All plan or require some form of “seed-to-sale” tracking systems, which provide a view of cannabis market activity at a heretofore unimagined level of detail. Legal markets also create a range of new matters for policy makers to address. Data Publicly available data were obtained on approximately 45 million individually priced items purchased in the 35 million retail transactions that took place during the first two and a half years of Washington State’s legal cannabis market. Records include product type (flower, extract, lotion, liquid edible, etc.), product name, price, and potency with respect to multiple cannabinoids, notably THC and CBD. Items sold can be traced back up the supply chain through the store to the processor and producer, to the level of identifying the specific production batch and mother plant, the firm that tested the product, and test results. Method Data visualization methods are employed to describe spatial-temporal patterns of multiple correlated attributes (e.g., price and potency) broken down by product. Text-analytic methods are used to subdivide the broad category of “extracts for inhalation” into more homogeneous sub-categories. To understand the competitiveness of the legal cannabis market in Washington we calculate the Herfindahl-Hirschman index (HHI) for processors and retailers. Results Cannabis prices fell steadily and proportionally at the processor and retailer levels. Retail and wholesale price maintained a roughly 3:1 ratio for multiple product types after some initial fluctuations. Although a wide range of edibles are sold, they account for a modest share of consumer spending; extracts for inhalation are a larger and heterogeneous market segment. The HHI indicates the cannabis market is highly competitive at the processor level, but less so for retail markets at the county level. Conclusions Washington’s state-legal cannabis market is diverse and rapidly evolving in terms of pricing, products, and organization. Post-legalization, researchers and policy makers may need to think in terms of a family of cannabis products, akin to how we think of new psychoactive substances and amphetamine-type stimulants, not a single drug “cannabis.”
To T or not to T: Differences in Testosterone Use and Discontinuation by HIV Serostatus among Men who Have Sex with Men.

OBJECTIVES The aim of the study was to characterize contemporary patterns and correlates of testosterone therapy (TTh) use and discontinuation by HIV serostatus among men in the Multicenter AIDS Cohort Study (MACS). METHODS Self-reported testosterone use data were collected semiannually from 2400 (1286 HIV-infected and 1114 HIV-uninfected) men who have sex with men. Multivariable Poisson regression was used to estimate prevalence ratios for TTh use and predictors of TTh discontinuation (2012-2015). RESULTS Use was higher among HIV-infected compared with HIV-uninfected men in all age strata, with an age-adjusted prevalence of 17% vs. 5%, respectively (adjusted prevalence ratio 3.7; P < 0.001). Correlates of use in the multivariable model were similar by HIV serostatus: white race, the Los Angeles (LA) site, more than one recent sexual partner, non-smoking status, and higher American Heart Association/American College of Cardiology (AHA/ACC) cardiovascular disease (CVD) risk score category (approximately 70% of testosterone users were in the high-risk category). Compared with HIV-uninfected men, HIV-infected men more frequently reported building muscle mass as a motivation for testosterone use. The TTh discontinuation rate was 20.9/100 person-years [95% confidence interval (CI) 17.3, 25.0/100 person-years]. Relative to HIV-uninfected men, HIV-infected men were half as likely to discontinue (adjusted incidence rate ratio 0.4; P < 0.001). Discontinuation was 40% higher in the period after the US Food and Drug Administration (FDA) safety communication for testosterone in 2014, independent of co-factors (P = 0.06). CONCLUSIONS Given the high prevalence of both TTh use and CVD risk among HIV-infected men, the benefits and risks of TTh should be examined in future studies of aging HIV-infected men and monitored routinely in clinical practice.
Primary care physicians and specialists as personal physicians: health care expenditures and mortality experience

Background The advent of managed care has resulted in considerable debate regarding the relative effects of specialist and primary care on patient outcomes and costs. Studies on these subjects have been limited to a disease-focused orientation rather than a patient-focused orientation inherent in primary care management. We examined whether persons using a primary care physician have lower expenditures and mortality than those using a specialist as their personal physician. Methods Using data on a nationally representative sample of 13,270 adult respondents tot he 1987 National Medical Expenditure Survey reporting as their personal physician either a primary care physician (general practitioner, family physician, internist, or obstetrician-gynecologist) or a specialist, we examined total annual health care expenditures and 5-year mortality experience. Results Respondents with a primary care physician, rather than a specialist, as a personal physician were more likely to be women, white, live in rural areas, report fewer medical diagnoses and higher health perceptions and have lower annual healthcare expenditures (mean: $2029 vs $3100) and lower mortality (hazard ratio = 0.76, 95% confidence interval [CI], 0.64-0.90). After adjustment for demographics, health insurance status, reported diagnoses, health perceptions, and smoking status, respondents reporting using a primary care physician compared with those using a specialist had 33% lower annual adjusted health care expenditures and lower adjusted mortality (hazard ratio = 0.81; 95% CI, 0.66-0.98). Conclusions These findings provide evidence for the cost-effective role of primary care physicians in the health care system. More research is needed on how to optimally integrate primary and specialty care.
Unusual dysprosium ceramic nano-fiber growth in a supercritical aqueous solution

The formation of nano-size ceramic fibers having diameters as small as 20 nm is described. This material was obtained by a simple precipitation reaction from a supercritical aqueous dysprosium bromide solution at high temperatures (450°C). The nano-structures have unusually high structural stability for extended time periods in this extreme solvent environment. The experimental procedures are described and analysis of the materials by scanning and transition electron microscopy, and x-ray diffraction is presented. The new materials may have useful applications as high-strength, corrosion resistant materials or as stable catalyst supports for extreme conditions.
Studies of desflurane in outpatient anesthesia.

The low solubility of desflurane contributes to rapid emergence after outpatient anesthesia. Compared with isoflurane, recovery times to eye opening, response to verbal commands, and orientation to person, place, and time have been significantly shorter. Even when compared with the rapid, short-acting intravenous anesthetic propofol for induction and maintenance of outpatient anesthesia, desflurane displayed more favorable early recovery characteristics. Although patients receiving desflurane are less sedated in the early postoperative period than those receiving propofol, times to ambulation and discharge were similar. The direct "antiemetic" activity of propofol may have contributed to a lower incidence of postoperative nausea and emesis versus desflurane. Finally, the effects of desflurane, isoflurane, and propofol on postoperative psychomotor (e.g., Trieger test, choice reaction time) and cognitive (e.g., digit-symbol substitution test, critical flicker fusion test) function are remarkably similar. Given its favorable early recovery profile, desflurane would appear to be a useful alternative to both isoflurane and propofol for maintenance of outpatient anesthesia. As desflurane is pungent and possesses respiratory irritant properties, propofol will likely remain the induction agent of choice in the outpatient setting. In conclusion, desflurane appears to have few adverse effects on recovery after ambulatory surgery, but nausea and emesis were lower with propofol. Desflurane's relative ease of administration versus propofol may be an important determinant of its future role in outpatient anesthesia.
Genetic variants including microsatellite instability in metastatic Hürthle cell carcinoma of the thyroid.

e18110Background: Hurthle cell carcinoma is a rare type of thyroid cancer. We report the results of tumor profiling from patients seen at Yale Cancer Center / Smilow Cancer Hospital including a tum...
Model Evaluation, Model Selection, and Algorithm Selection in Machine Learning

The correct use of model evaluation, model selection, and algorithm selection techniques is vital in academic machine learning research as well as in many industrial settings. This article reviews different techniques that can be used for each of these three subtasks and discusses the main advantages and disadvantages of each technique with references to theoretical and empirical studies. Further, recommendations are given to encourage best yet feasible practices in research and applications of machine learning. Common methods such as the holdout method for model evaluation and selection are covered, which are not recommended when working with small datasets. Different flavors of the bootstrap technique are introduced for estimating the uncertainty of performance estimates, as an alternative to confidence intervals via normal approximation if bootstrapping is computationally feasible. Common cross-validation techniques such as leave-one-out cross-validation and k-fold cross-validation are reviewed, the bias-variance trade-off for choosing k is discussed, and practical tips for the optimal choice of k are given based on empirical evidence. Different statistical tests for algorithm comparisons are presented, and strategies for dealing with multiple comparisons such as omnibus tests and multiple-comparison corrections are discussed. Finally, alternative methods for algorithm selection, such as the combined F-test 5x2 cross-validation and nested cross-validation, are recommended for comparing machine learning algorithms when datasets are small.
Stiffness triggers non-coding RNA pathology

The stiffness associated with cardiac fibrosis activates the expression of a common genetic polymorphism associated with cardiac pathology.
A New Laser Beam Pointing Method Using Laser Arrays

A new method is described for optical data transmissions from satellites using laser arrays for laser beam pointing. It combines a lens system and a vertical-cavity surface-emitting laser (VCSEL)/Photodetector Array, both mature technologies, in a novel way. This system is applied to satellites in low-Earth orbit, (LEO). It can replace current architectures which use dynamical systems, (i.e., moving parts) to point the laser, and which may use vibration isolation platforms. Results of computer simulations show diffraction limited beam propagation. Possible additional applications are to planetary distances (deep space optical communications, (DSOC)), to optical multiple access, (OMA), to communication between a constellation of close satellites, and to satellites that use modulating retro-reflectors. Keywords: laser beam pointing, free-space optical communication, low-Earth orbit (LEO) data communications, integrated VCSEL/ photodetector arrays, deep space optical communications (DSOC), optical multiple access (OMA), constellation of close satellites, modulating retro-reflectors.
Toward practical measures of complexity in real-time modeling methods

Systems development methods have become more complex, concurrently with many of today’s systems. UML has been criticized for its complexity. Using Rossi and Brinkkemper’s (1996) complexity metrics, Siau and Cao, (2001) completed a complexity analysis of UML and other modeling techniques, finding that UML is more complex than other techniques. Siau, Erickson and Lee (2002) proposed that Rossi and Brinkkemper’s metrics present the theoretical maximum complexity, as opposed to a practitioner-based complexity, that must be less than the theoretical maximum. Erickson and Siau (2004) proposed that a subset of UML (a kernel) composed of the most commonly used constructs, could be equated with the complexity that practitioners face when using UML. The current research extends Erickson and Siau’s (2004) work by analyzing UML complexity in the specific genre of real time systems. A Delphi study was conducted using expert practitioners, in an attempt to identify a use-based real-time UML kernel.
Lone Pair Effect, Structural Distortions, and Potential for Superconductivity in Tl Perovskites.

Potential new superconductors of the type MTlX3 (M: Rb, Cs; X: F, Cl, Br) are characterized by DFT band structure calculations.
Photo Quiz: A Multifocal Rash in a 16-Year-Old Aspiring Veterinarian

A previously healthy 16-year-old female presented to a dermatology clinic for evaluation of a pruritic, multifocal rash on her left arm that had begun 2 months ago. The rash first appeared on her forearm and then spread to her wrist and upper arm ([Fig. 1A][1]). The patient had a history of eczema
Rationale and design of a navigator-driven remote optimization of guideline-directed medical therapy in patients with heart failure with reduced ejection fraction

Although optimal pharmacological therapy for heart failure with reduced ejection fraction (HFrEF) is carefully scripted by treatment guidelines, many eligible patients are not treated with guideline-directed medical therapy (GDMT) in clinical practice. We designed a strategy for remote optimization of GDMT on a population scale in patients with HFrEF leveraging nonphysician providers. An electronic health record-based algorithm was used to identify a cohort of patients with a diagnosis of heart failure (HF) and ejection fraction (EF) ≤ 40% receiving longitudinal follow-up at our center. Those with end-stage HF requiring inotropic support, mechanical circulatory support, or transplantation and those enrolled in hospice or palliative care were excluded. Treating providers were approached for consent to adjust medical therapy according to a sequential, stepped titration algorithm modeled on the current American College of Cardiology (ACC)/American Heart Association (AHA) HF Guidelines within a collaborative care agreement. The program was approved by the institutional review board at Brigham and Women's Hospital with a waiver of written informed consent. All patients provided verbal consent to participate. A navigator then facilitated medication adjustments by telephone and conducted longitudinal surveillance of laboratories, blood pressure, and symptoms. Each titration step was reviewed by a pharmacist with supervision as needed from a nurse practitioner and HF cardiologist. Patients were discharged from the program to their primary cardiologist after achievement of an optimal or maximally tolerated regimen. A navigator-led remote management strategy for optimization of GDMT may represent a scalable population-level strategy for closing the gap between guidelines and clinical practice in patients with HFrEF.
Theorizing vernacular discourse in Sinophone transnational space: on Namewee’s YouTube music videos

This article expands Ono and Sloop’s conceptualization of vernacular discourse in a transnational social media space; namely, YouTube. This article showcases how the YouTube music videos of Namewee...
Machine Learning Methods for Connection RTT and Loss Rate Estimation Using MPI Measurements Under Random Losses

Scientific computations are expected to be increasingly distributed across wide-area networks, and Message Passing Interface (MPI) has been shown to scale to support their communications over long distances. Application-level measurements of MPI operations reflect the connection Round-Trip Time (RTT) and loss rate, and machine learning methods have been previously developed to estimate them under deterministic periodic losses. In this paper, we consider more complex, random losses with uniform, Poisson and Gaussian distributions. We study five disparate machine leaning methods, with linear and non-linear, and smooth and non-smooth properties, to estimate RTT and loss rate over 10 Gbps connections with 0–366 ms RTT. The diversity and complexity of these estimators combined with the randomness of losses and TCP’s non-linear response together rule out the selection of a single best among them; instead, we fuse them to retain their design diversity. Overall, the results show that accurate estimates can be generated at low loss rates but become inaccurate at loss rates 10% and higher, thereby illustrating both their strengths and limitations.
Quantification of wake shape modulation and deflection for tilt and yaw misaligned wind turbines

Misaligned wind turbine rotors redirect the wake, and manipulate the wake shape by introducing a counter-rotating vortex pair. This mechanism is of great interest for improving wind farm power output through static or dynamic misalignment. In this study, cross-plane stereo-particle image velocimetry measurements are used to characterize the wake evolution for tilt misalignment and verify differences with yaw misalignment. Blockage from the ground, shear in the velocity profile, turbulence levels, hub-vortices and tip-vortices are found to strongly affect wake evolution for a tilted wind turbine resulting in a non-symmetric behaviour for upwards deflecting or downwards deflecting tilt. The downwards deflection of a negatively tilted wind turbine is found to result in the most benefits for wake recovery and power availability downstream through increased wake-curling, faster wake-recovery, and downdraft of high-momentum flow.
Fibrosis of the diabetic heart: Clinical significance, molecular mechanisms, and therapeutic opportunities

In patients with diabetes, myocardial fibrosis may contribute to the pathogenesis of heart failure and arrhythmogenesis, increasing ventricular stiffness and delaying conduction. Diabetic myocardial fibrosis involves effects of hyperglycemia, lipotoxicity and insulin resistance on cardiac fibroblasts, directly resulting in increased matrix secretion, and activation of paracrine signaling in cardiomyocytes, immune and vascular cells, that release fibroblast-activating mediators. Neurohumoral pathways, cytokines, growth factors, oxidative stress, advanced glycation end-products (AGEs), and matricellular proteins have been implicated in diabetic fibrosis; however, the molecular links between the metabolic perturbations and activation of a fibrogenic program remain poorly understood. Although existing therapies using glucose- and lipid-lowering agents and neurohumoral inhibition may act in part by attenuating myocardial collagen deposition, specific therapies targeting the fibrotic response are lacking. This review manuscript discusses the clinical significance, molecular mechanisms and cell biology of diabetic cardiac fibrosis and proposes therapeutic targets that may attenuate the fibrotic response, preventing heart failure progression.
Erector Spinae Plane Block versus Continuous Perineural Local Anesthetic Infusion for Postoperative Pain Control After Supraclavicular Decompression for Neurogenic Thoracic Outlet Syndrome: A Matched Case-Control Comparison.

Objective The purpose of this study was to determine if single injection erector spinae plane blocks are associated with improved pain control, opioid use, numbness, length of stay, or patient satisfaction compared to intraoperatively placed continuous perineural infusion of local anesthetic after decompression of neurogenic thoracic outlet syndrome. Methods This is a retrospective cohort study at a tertiary academic center of eighty patients that underwent supraclavicular decompression for thoracic outlet syndrome between May 2019 and January 2020. Forty consecutive patients treated with single-injection preoperative erector spinae plane blocks were retrospectively compared to 40 age- and gender-matched controls treated with continuous perineural infusion. Results The primary outcome of mean pain scores was not significantly different between the erector spinae and perineural infusion groups over the three-day study period (4.2-5.3 vs 3.0-5.1 P=0.08). On post-operative day 0, mean pain scores were significantly higher in the erector spinae group (4.2 vs 3.0, P=0.02). While statistically significant, the score was still lower in the erector spinae group on day 0 than on day 1,2, or 3 in either group. Opioid use, nausea, length of stay and patient satisfaction were also similar. Upper extremity numbness was significantly less severe in the erector spinae group (36% vs 73% moderate-extreme, P=0.03) at 6-month follow-up. Conclusions Seventy-two-hour perineural local anesthetic infusion did not provide superior analgesia compared to preoperative single-injection erector spinae blocks. Furthermore, there was significantly less long-term postoperative numbness associated with erector spinae blocks compared to perineural local anesthetic infusion.