cssi/SciSciGPT-SciSciNet huggingface dataset:
Protective effect of propranolol on the hypertrophied heart during cardiopulmonary bypass.

In order to evaluate a possible protective effect of propranolol on the hypertrophied left ventricle, 76 patients who underwent aortic valve replacement were studied because of elevated left ventricular end-diastolic pressures (LVEDP), large aortic valve gradients, and evidence of cardiac hypertrophy preoperatively. A single intravenous bolus of propranolol (6 mcg. per kilogram) was given to 60 patients prior to anoxic cardiac arrest. Sixteen patients who did not receive propranolol served as control subjects. Whereas anoxic arrest times remained the same in both groups, ventricular fibrillation time during anoxic arrest was significantly decreased in the propranolol-treated group (control 46.8 ± 7.8 minutes, propranolol 19.8 ± 15.8 minutes [p
What's it worth?

Patients without effective coverage frequently must pay charges for medical services that are higher than the hospital's contracted rates. A national survey of hospitals shows great variation in how charges are set and accommodations made for patients with low income. The government is taking a more active role in examining charging practices. Hospitals can take several steps to help stave off government intervention.
Transforming growth factor-beta and prostate cancer.

This review focuses on the possible role of transforming growth factor-β isoforms 1–3 (TGFβ) in prostate cancer. TGFβ1 appears to inhibit the cellular proliferation of normal prostate cells. Surprisingly, TGFβ1 is overexpressed in prostate cancer. To help explain this apparent paradox, it has been revealed that with tumor progression, prostate cancer cells acquire reduced sensitivity to the growth-inhibitory effects of TGFβ1. Aberrations of the TGFβ1 signaling pathway at the prereceptor, receptor, or postreceptor level may lead to prostate cancer cell resistance to TGFβ1 growth inhibition. Indirectly, elevated levels of TGFβ1 may induce host effects that may be beneficial to prostate tumor growth by suppressing the immune system, promoting angiogenesis and extracellular matrix formation, and enhancing metastatic potential. Consequently, TGFβ1 appears to be important in prostate carcinogenesis and tumorigenicity. TGFβ2 and TGFβ3 are only briefly presented as very little is known about their role in prostate cancer.
Frequency analysis of temperature-dependent interferometric signal for the measurement of the temperature coefficient of refractive index

A method of frequency analysis for the measurement of the temperature coefficient of refractive index (dn/dT) using a Fabry–Perot interferometer was developed and tested against ethanol and water. The temperature-dependent interferometric signal described by Airy’s formula was analyzed in both the temperature and frequency domains. By fast Fourier transform, a low-pass filter was designed and employed to eliminate the noise superimposed on the signal. dn/dT was determined accurately from the noise-removed signal by peak analysis. Furthermore, the signal frequency parameters may be utilized for the material thermophysical property characterization. This method lays the foundation for an online dn/dT instrument for monitoring chemical processes.
Exposure to Atmospheric Science in Courses at Minority-Serving Institutions

ABSTRACTOne remedy proposed for the shortage of underrepresented minorities (URMs) in atmospheric science is greater collaboration between graduate programs in atmospheric science and minority-serving institutions (MSIs). However, if URMs have few opportunities to take relevant coursework at MSIs, then they are unlikely to pursue graduate study in atmospheric science and other science, technology, engineering, and mathematics (STEM) disciplines. An earlier perusal of MSIs indicated that such opportunities were limited, but in the present study, a content analysis of courses offered at 180 MSIs found that 91% offered at least one course including content on atmospheric science, and that 4-yr institutions typically offered nearly four such courses. URMs who gravitate to atmospheric science careers also are influenced by courses that are inquiry based, relevant to their experiences, and emphasize discussion of implications for climate change and public policy. Half of the MSI courses related to atmospheric s...
Defining Glomerular Disease in Mechanistic Terms: Implementing an Integrative Biology Approach in Nephrology

Advances in biomedical research allow for the capture of an unprecedented level of genetic, molecular, and clinical information from large patient cohorts, where the quest for precision medicine can be pursued. An overarching goal of precision medicine is to integrate the large–scale genetic and molecular data with deep phenotypic information to identify a new mechanistic disease classification. This classification can ideally be used to meet the clinical goal of the right medication for the right patient at the right time. Glomerular disease presents a formidable challenge for precision medicine. Patients present with similar signs and symptoms, which cross the current disease categories. The diseases are grouped by shared histopathologic features, but individual patients have dramatic variability in presentation, progression, and response to therapy, reflecting the underlying biologic heterogeneity within each glomerular disease category. Despite the clinical challenge, glomerular disease has several unique advantages to building multilayered datasets connecting genetic, molecular, and structural information needed to address the goals of precision medicine in this population. Kidney biopsy tissue, obtained during routine clinical care, provides a direct window into the molecular mechanisms active in the affected organ. In addition, urine is a biofluid ideally suited for repeated measurement from the diseased organ as a liquid biopsy with potential to reflect the dynamic state of renal tissue. In our review, current approaches for large–scale data generation and integration along the genotype-phenotype continuum in glomerular disease will be summarized. Several successful examples of this integrative biology approach within glomerular disease will be highlighted along with an outlook on how achieving a mechanistic disease classification could help to shape glomerular disease research and care in the future.
‘Tell Me the Landscapes in Which You Live and I Will Tell You Who You Are’ – Online Theology Students Crossing Thresholds in Religious Education and Spirituality Against an Australian Desert Context

This article proposes that in the crossing of learning thresholds, it is possible to identify a number of significant intersections between three key areas – (1) stories about teaching challenges provided by an initial survey of 60 selected online adults studying religious education (RE), spirituality and theology; (2) the crossing of the Australian bush, frontier, or desert landscape; and (3) threshold concept (TC) theory. This survey of online teacher views revealed five specific teacher learning challenges that could be compared with five selected features of the Australian bush or desert landscape. Narratives of teacher learning challenges were extracted from a range of online discussion scripts, while certain features of the Australian landscape emerged from a later, unplanned literature analysis of that topic. This article examines two of these thematic clusters, related to liminality and to ‘stretching’ of teachers, in relation to desert literature and TC theory. The article closes with a series of...
A mathematical model of mechanotransduction reveals how mechanical memory regulates mesenchymal stem cell fate decisions

Mechanical and biophysical properties of the cellular microenvironment regulate cell fate decisions. Mesenchymal stem cell (MSC) fate is influenced by past mechanical dosing (memory), but the mechanisms underlying this process have not yet been well defined. We have yet to understand how memory affects specific cell fate decisions, such as the differentiation of MSCs into neurons, adipocytes, myocytes, and osteoblasts. We study a minimal gene regulatory network permissive of multi-lineage MSC differentiation into four cell fates. We present a continuous model that is able to describe the cell fate transitions that occur during differentiation, and analyze its dynamics with tools from multistability, bifurcation, and cell fate landscape analysis, and via stochastic simulation. Whereas experimentally, memory has only been observed during osteogenic differentiation, this model predicts that memory regions can exist for each of the four MSC-derived cell lineages. We can predict the substrate stiffness ranges over which memory drives differentiation; these are directly testable in an experimental setting. Furthermore, we quantitatively predict how substrate stiffness and culture duration co-regulate the fate of a stem cell, and we find that the feedbacks from the differentiating MSC onto its substrate are critical to preserve mechanical memory. Strikingly, we show that re-seeding MSCs onto a sufficiently soft substrate increases the number of cell fates accessible. Control of MSC differentiation is crucial for the success of much-lauded regenerative therapies based on MSCs. We have predicted new memory regions that will directly impact this control, and have quantified the size of the memory region for osteoblasts, as well as the co-regulatory effects on cell fates of substrate stiffness and culture duration. Taken together, these results can be used to develop novel strategies to better control the fates of MSCs in vitro and following transplantation.
Comment on “The challenge of energy-efficient transportation” J. Hermans

It’s hard to beat the energy density and convenience of liquid hydrocarbons. The product of energy used and journey time is another way to compare transportation systems. It is more practical to power electric cars from batteries than photovoltaics. Solar can be used to supply some of the energy needed to recharge the batteries. The primary energy used to make food, the fuel for the human cyclist, can be many times the calorific energy derived from the food. Transportation is a major source of carbon dioxide emissions. Hermans makes some excellent points in his article “The challenge of energyefficient transportation.” However primary energy to produce fuel should also be considered. The embodied energy of liquid hydrocarbon fuels is much less than their energy content. For a cyclist the fuel is food, and, depending on diet, the primary energy can be many times the food’s calorific energy. The article is over optimistic on the prospect of cars directly powered by solar photovoltaics. It’s more realistic to use batteries in electric cars and generate the electricity from a number of sources. For anything other than trains that run on fixed tracks it’s hard to beat the energy density and convenience of liquid hydrocarbons.
Targeted Delivery of Doxorubicin by PLGA Nanoparticles Increases Drug Uptake in Cancer Cell Lines.

Doxorubicin (DOX) is an anthracycline drug widely used in the treatment of a large spectrum of solid tumors. Its application is limited by its efflux through the multidrug resistance (MDR) protein. In this study, we explored the potential of DOX - PLGA nanoparticles (DNPs) and antibody decorated nanoparticles (ADNPs) to overcome MDR in cancer cells. DNPs were prepared by the O/W emulsion solvent evaporation method. The surface decoration of nanoparticles with antibody was performed via carbodiimide reaction. The particles were characterized for their size and zeta potential, and their in vitro uptake was compared with their unconjugated counterparts. Entrapment efficiency of DNPs and ADNPs was measured by fluorescence using the DMSO burst release procedure. Cytotoxicity was measured using the SRB assay. The DNP and ADNP nanoparticles had average diameter of 162.6 ± 2.0 nm and 213.0 ± 3.5 nm respectively. Their corresponding surface charges were -13.2 ± 2.3 mV and -1.3 ± 3.8 mV respectively. Our results showed that cellular uptake of DOX from DNPs in DOX-resistant MES-SA/Dx5 cancer cell was higher compared to free DOX. However, the uptake of DOX from DNPs in MES-SA and SKOV-3 cancer cell lines was comparable to free DOX treatment. Next, we conjugated the DNPs with HER-2 antibody to specifically target to SKOV-3 cancer cell line and MES-SA and MES-SA/Dx5 were used as negative controls. Results showed higher uptake of DOX from ADNPs compared to free DOX and DNPs in SKOV-3. However, the cellular uptake of DOX from ADNPs was comparable to DNPs in MES-SA and MES-SA/Dx5. Cytotoxicity results were consistent with the cellular uptake data. Our study concludes that the targeted DNPs may enhance the cellular uptake and cytotoxicity in SKOV-3.
Bioerosion by pit-forming, temperate-reef sea urchins: History, rates and broader implications.

Sea urchins are dominant members of rocky temperate reefs around the world. They often occur in cavities within the rock, and fit so tightly, it is natural to assume they sculpted these “pits.” However, there are no experimental data demonstrating they bore pits. If they do, what are the rates and consequences of bioerosion to nearshore systems? We sampled purple sea urchins, Strongylocentrotus purpuratus, from sites with four rock types, three sedimentary (two sandstones and one mudstone) and one metamorphic (granite). A year-long experiment showed urchins excavated depressions on sedimentary rocks in just months. The rate of pit formation varied with rock type and ranged from 100 yr for granite. In the field, there were differences in pit size and shapes of the urchins (height:diameter ratio). The pits were shallow and urchins flatter at the granite site, and the pits were deeper and urchins taller at the sedimentary sites. Although overall pit sizes were larger on mudstone than on sandstone, urchin size accounted for this difference. A second, short-term experiment, showed the primary mechanism for bioerosion was ingestion of the substratum. This experiment eliminated potential confounding factors of the year-long experiment and yielded higher bioerosion rates. Given the high densities of urchins, large amounts of rock can be converted to sediment over short time periods. Urchins on sandstone can excavate as much as 11.4 kg m-2 yr-1. On a broader geographic scale, sediment production can exceed 100 t ha-1 yr-1, and across their range, their combined bioerosion is comparable to the sediment load of many rivers. The phase shift between urchin barrens and kelp bed habitats in the North Pacific is controlled by the trophic cascade of sea otters. By limiting urchin populations, these apex predators also may indirectly control a substantial component of coastal rates of bioerosion.
Disorders of Consciousness, Agency, and Health Care Decision Making: Lessons From a Developmental Model

The health care decision-making framework applied to adolescents, a process that gives minors an increasing role in decision making as they mature, should be applied to patients recovering from dis...
FAST: Rapid determinations of antibiotic susceptibility phenotypes using label‐free cytometry

Sepsis, a life-threatening immune response to blood infections (bacteremia), has a ∼30% mortality rate and is the 10th leading cause of US hospital deaths. The typical bacterial loads in adult septic patients are ≤100 bacterial cells (colony forming units, CFU) per ml blood, while pediatric patients exhibit only ∼1000 CFU/ml. Due to the low numbers, bacteria must be propagated through ∼24-hours blood cultures to generate sufficient CFUs for diagnosis and further analyses. Herein, we demonstrate that, unlike other rapid post-blood culture antibiotic susceptibility tests (ASTs), our phenotypic approach can drastically accelerate ASTs for the most common sepsis-causing gram-negative pathogens by circumventing long blood culture-based amplification. For all blood isolates of multi-drug resistant pathogens investigated (Escherichia coli, Klebsiella pneumoniae, and Acinetobacter nosocomialis), effective antibiotic(s) were readily identified within the equivalent of 8 hours from initial blood draw using <0.5 mL of adult blood per antibiotic. These methods should drastically improve patient outcomes by significantly reducing time to actionable treatment information and reduce the incidence of antibiotic resistance. © 2018 International Society for Advancement of Cytometry.
Some Max-Min examples

This chapter illustrates the application of the directional derivative to problems ranging from trivial to quite difficult.
Splenosis: Report of two cases and review of the literature

Summary Splenosis is the autotransplantation of splenic tissue after splenic injury. Only seventy-five cases have previously been reported. Two additional cases found at laparotomy are described. The etiologic, pathologic, and clinical features of splenosis are discussed. Although usually asymptomatic, splenosis may cause intestinal obstruction, simulate a mass lesion, cause recurrence of hematologic disease, or perhaps be responsible for abdominal pain.
Wayfinding Training for the Severely Mentally Ill

Compliance with outpatient community mental health treatment is problematic for seriously mentally ill adults. One way to facilitate clients' compliance is through training in public bus riding and...
Hormonal, Metabolic and Hemodynamic Adaptations to Glycosuria in Type 2 Diabetes Patients Treated with Sodium-Glucose Co-Transporter Inhibitors.

Background & introduction The advent of the sodium-glucose cotransporter-2 inhibitors [SGLT-2i] provides an additional tool to combat diabetes and complications. The use of SGLT-2i leads to effective and durable glycemic control with important reductions in body weight/fat and blood pressure. These agents may delay beta-cell deterioration and improve tissue insulin sensitivity, which might slow the progression of the disease. Methods & results In response to glycosuria, a compensatory rise in endogenous glucose production, sustained by a decrease in plasma insulin with an increase in glucagon has been described. Other possible mediators have been implicated and preliminary findings suggest that a sympathoadrenal discharge and/or rapid elevation in circulating substrates (i.e., fatty acids) or some yet unidentified humoral factors may have a role in a renal-hepatic inter-organ relationship. A possible contribution of enhanced renal gluconeogenesis to glucose entry into the systemic circulation has not yet been ruled out. Additionally, tissue glucose utilization decreases, whereas adipose tissue lipolysis is stimulated and, there is a switch to lipid oxidation with the formation of ketone bodies; the risk for keto-acidosis may limit the use of SGLT-2i. These metabolic adaptations are part of a counter-regulatory response to avoid hypoglycemia and, as a result, limit the SGLT-2i therapeutic efficacy. Recent trials revealed important cardiovascular [CV] beneficial effects of SGLT-2i drugs when used in T2DM patients with CV disease. Although the underlying mechanisms are not fully understood, there appears to be "class effect". Changes in hemodynamics and electrolyte/body fluid distribution are likely involved, but there is no evidence for anti-atherosclerotic effects. Conclusion It is anticipated that, by providing durable diabetes control and reducing CV morbidity and mortality, the SGLT-2i class of drugs is destined to become a priority choice in diabetes management.
Dual Dopaminergic Regulation of Corticostriatal Plasticity by Cholinergic Interneurons and Indirect Pathway Medium Spiny Neurons

Endocannabinoid (eCB)-mediated long-term depression (LTD) requires dopamine (DA) D2 receptors (D2Rs) for eCB mobilization. The cellular locus of the D2Rs involved in LTD induction remains highly debated. We directly examined the role in LTD induction of D2Rs expressed by striatal cholinergic interneurons (Chls) and indirect pathway medium spiny neurons (iMSNs) using neuron-specific targeted deletion of D2Rs. Deletion of Chl-D2Rs (Chl-Drd2KO) impaired LTD induction in both subtypes of MSNs. LTD induction was restored in the Chl-Drd2KO mice by an M1-selective muscarinic acetylcholine receptor antagonist. In contrast, after the deletion of iMSN-D2Rs (iMSN-Drd2KO), LTD induction was intact in MSNs. Separate interrogation of direct pathway and iMSNs revealed a deficit in LTD induction only at synapses onto iMSNs that lack D2Rs. LTD induction in iMSNs was restored by D2R agonist application. Our findings suggest that Chl D2Rs strongly modulate LTD induction in MSNs, with iMSN-D2Rs having a weaker, iMSN-specific, modulatory effect.
Resistance training induced changes in strength and specific force at the fiber and whole muscle level: a meta-analysis

Considerable debate exists as to whether increases in strength that occur with resistance exercise are the result of increases in muscle size. Most studies have attempted to answer this question using assessments of whole muscle size and voluntary muscle strength, but examining changes at the individual muscle fiber level may also provide some insight. The purpose of this meta-analysis was to compare adaptations at the whole muscle and individual fiber level. A meta-analysis was conducted in February, 2018 including all previously published papers and was analyzed using a random effects model. There were no differences (p = 0.88) when comparing hypertrophy at the whole muscle (4.6%) and individual fiber level (7.0%), but significantly larger (p < 0.001) strength gains were observed at the whole muscle level (43.3%) relative to the individual fiber (19.5%). Additionally, there was an increase in the specific tension of type 1 muscle fibers (p = 0.013), but not type 2 muscle fibers (p = 0.23) which was driven by similar increases in strength (type 1: 17.5%, type 2A: 17.7%), despite differences in muscle size (type 1: 6.7%, type 2A: 12.1%). These results support the hypothesis that the neural adaptations play a large role in increasing isotonic whole muscle strength, but also demonstrate that an improvement in specific tension of type 1 muscle fibers is present. These results would suggest that some mechanism intrinsic to the muscle fiber, and independent of muscle growth, may also be contributing to strength increases in response to resistance exercise providing an avenue for future research.
The First Bilateral Investment Treaties: U.S. Postwar Friendship, Commerce and Navigation Treaties

This book provides a history of the twenty-two post-World War II Friendship, Commerce and Navigation Treaties (FCNs) negotiated bilaterally by the United States with a variety of countries. While t...
Machine Learning-Based Blending of Satellite and Reanalysis Precipitation Datasets: A Multiregional Tropical Complex Terrain Evaluation

AbstractThis study evaluates a machine learning–based precipitation ensemble technique (MLPET) over three mountainous tropical regions. The technique, based on quantile regression forests, integrat...
Self-Transcendent Awe as a Moral Grounding of Wisdom

Since humans have been thinking about the human condition, “What is wisdom?” and “How might we attain it?” have been central questions we ask about our lives. The target article of Grossman and col...
Polymer of intrinsic microporosity (PIM) based fibrous mat: combining particle filtration and rapid catalytic hydrolysis of chemical warfare agent simulants into a highly sorptive, breathable, and mechanically robust fiber matrix

Abstract Highly selective and lightweight protective suits featuring excellent breathability, mechanical robustness, and catalytic degradation performance toward chemical warfare agents (CWAs) are highly desirable for first responders and the military. However, current multilayered state-of-the-art chemical/biological (CB) protective textiles containing activated carbon and separate aerosol-protective layers exhibit several drawbacks including high thermal burden and secondary contamination. Herein, we present for the first time, a highly sorptive, breathable, and mechanically strong aerosol-protective layered fabric with prominent catalytic degradation capability of CWA simulant, through novel material selection and engineering design. The electrospun polymer of intrinsic microporosity (PIM-1) fiber web with hierarchical porosity is used as a matrix material, preventing toxic gas penetration while providing pathways for air and water vapor molecules. Polyacrylonitrile (PAN) nanofibers assembled with PIM-1 fibers via a layer-by-layer electrospun-deposition approach are shown to achieve significantly enhanced mechanical integrity and filtration efficiency, due to the high polar chemical structure and small fiber diameter of PAN. The subsequent incorporation of UiO-66-NH2 particles, a Zr-based metal-organic framework (MOF), further enhances the sorption capacity while maintaining excellent filtration efficiency, mechanical strength, and breathability, and also endows the fiber web with remarkable catalytic degradation towards CWA simulants. The resulting PIM/PAN/MOF composite fiber mat demonstrates unprecedented integrated properties with water vapor transmission rate of 1,013 g/m2·24 h, surface area of 574 m2/g, increased tensile strength (more than 70 times compared to neat PIM-1 fiber web), and PM2.5 and PM10 filtration efficiency of 99.88% and 99.94%, respectively, comparable to commercial polypropylene (PP) non-woven textile. This facile and effective fabrication of such a multifunctional composite fiber mat is valuable for the design of protective garments in health care, personal protective gear, and law enforcement and military uniforms.
499. Infection with Coronavirus Disease 19 (COVID-19) in Healthcare Personnel with Exposure to COVID-19

Background: As of June 2, 2020, 67,113 cases and 321 deaths due to Coronavirus Disease 19 (COVID-19) have been reported in healthcare personnel (HCP) in the United States Given the close contact of HCP with individuals with COVID-19, it is important to quantify the risk of acquiring COVID-19 in the healthcare setting Methods: We conducted a retrospective cohort study of HCP exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at our academic medical center from March 15, 2020 to May 16, 2020 Exposure during the study period was defined as having contact with patients or other HCP with COVID-19 within 6 feet of distance for at least 90 seconds when HCP's eyes, nose, or mouth were not covered HCP with exposures were monitored for symptoms consistent with COVID-19 for 14 days from last exposure and those who developed symptoms were tested for SARSCoV- 2 using RT-PCR Results: We identified 33 exposure events;19 of which were patient-to-HCP exposures and 14 of which were HCP-to-HCP exposures These 33 events resulted in 959 exposed HCP among whom 238 (25%) developed one or more symptoms of COVID-19 and required SARS-CoV-2 RT-PCR testing Testing was performed at 7 1 ± 5 0 (mean ± SD) days from exposure Of the 238 HCP who were tested, 82% were female and 49% were registered nurses (Table 1) Five HCP tested positive for SARSCoV- 2 by RT-PCR, but one was presumed to have acquired the disease from a household member with confirmed COVID-19 Among the four HCP who were infected due to occupational exposure, three were nurses while one was an environmental service worker (Table 1) Conclusion: Despite exposures among HCP, the risk of acquiring symptomatic COVID-19 in the healthcare setting was low with less than 1% of HCP with occupational exposure subsequently diagnosed with COVID-19 With the definition of exposure now changed to at least 15 minutes of close contact without personal protective equipment, we anticipate fewer exposures at our healthcare facility and that much of COVID-19 transmission affecting HCP are due to community exposures
Complex Regional Pain Syndrome and Post-herpetic Neuralgia

Complex regional pain syndrome and post-herpetic neuralgia are presented apart from the general neuropathy chapter due to their unique presentations and treatment algorithms and underlying mechanisms. Questions in this chapter will attempt to help hone both diagnostic and treatment plans for these entities through both conservative and interventional means.
Supporting Student Science Writing: Beyond Unreflective Macroscaffolds

Literacy practices in science classrooms have been traditionally limited to the provision of macroscaffolds (writing templates like Question-Hypothesis-Methodology-Results). This paper explores the allowances and shortcomings of such practice by means of a systematic examination of a corpus of lab reports written by two small groups of college students taught to write scientifically through a macroscaffold-based approach. Despite reporting the same experience and being supported by the same macroscaffold, students’ science writing differed in important ways. Group A’s impersonal inferences expressed social detachment and objectivity (students positioned themselves as distant and objective knowledge producers), whereas Group B adopted a position of social closeness and subjectivity more typical of personal genres (e.g., personal diaries). Atypical of what is expected of science writers, Group B’s personal inferences was taken as indicative of an alternative conception of what it meant to scientifically infer from one’s empirical observations. Such a different style pointed to the possibility of some students holding alternative conceptions about what it means to scientifically infer from one’s empirical observations. It is argued that, although macroscaffolding may be a helpful starting point, students need additional guidance on specific linguistic aspects of science writing, and possibly engage in genre-based literacy activities.
A Challenging Diagnosis of Primary Hyperparathyroidism in an Adolescent Female

Background: Hypercalcemia secondary to primary hyperparathyroidism (PHPT) is less common in children than adults. Single parathyroid adenoma is commonly the cause of primary hyperparathyroidism in children. Clinical Case: We present a 15-year-old female with one-week history of abdominal pain despite taking over the counter antacids. Her initial work up by her primary care provider revealed serum calcium of 11.8 mg/dL (9.0–11.5) and creatinine of 0.8 mg/dL (0.4–1.2). A week later, she presented to the emergency department with same complaint. In ED, she was found to have hypercalcemia (12.8 mg/dl) with elevated parathyroid hormone (PTH) at 78.5 pg/mL (15–65). Her random urine calcium creatinine ratio was high at 2.1. Her 25OHD was 25 ng/mL (30–100). She had negative urine pregnancy test but had trace ketones, leukocyte esterase, blood and bacteria. CBC and CMP were otherwise unremarkable. She continued to complain abdominal pain with nausea, decrease appetite, fatigue, and general muscle weakness. There was no known family history of calcium or metabolic bone disorders. Her vital signs and physical exam were normal. Subsequent labs showed mild improvement of calcium between (11–12.3 mg/dL), PTH between 54.5 and 77 pg/mL, normal thyroid function. Ionized calcium was mildly elevated 6.0 mg/dL (4.5–5.3) but her repeat 25OHD was low at18 ng/mL. Serum phosphorus levels were relatively normal with lowest level of 2.5 mg/dL (2.7–4.5). Gliadin Deamidated IgA was detectable 15 U/mL (< 15.0 U/). Ultrasound of abdomen was significant for nonspecific mild hepatomegaly; kidneys were normal in size and appearance. Ultrasound of thyroid was significant for probably intrathyroid parathyroid, measuring 6 x 8 x 8 mm. Tc-Sestamibi scan did not confirm a parathyroid adenoma. Genetic testing for MEN-1 was negative. FHH- related genes (i.e. CASR) was positive for p.R990G variant resulting in a mild gain of function of the calcium-sensing receptor. Although previous Tc-Sestamibi scan was unremarkable, an over read of it raised a concern for questionable uptake in the left superior lobe. SPEC-CT demonstrated possible abnormal parathyroid tissue in the upper pole of the left thyroid. FNA of the left thyroid nodule confirmed likely intrathyroidal parathyroid adenoma. Subsequent follow up and treatment, including parathyroidectomy, was done by another institution. She underwent a left parathyroidectomy with normalization of serum calcium and PTH levels post operatively (10.1 mg/dl and 8 pg/mL, respectively) and has complete resolution of her previous abdominal and gastrointestinal symptoms. Conclusion: PHPT is uncommon in children and adolescents and is typically associated with a single parathyroid adenoma. High index of suspicion is key for early diagnosis of PHPT despite a negative Tc-Sestamibi initially.
Effect of testosterone treatment on the trabecular bone score in older men with low serum testosterone

The trabecular bone score (TBS) is an indirect measure of vertebral bone microarchitecture. Our objective was to examine the effect of testosterone treatment on TBS. One hundred and ninety-seven hypogonadal men were randomized to testosterone or placebo. After 12 months, there was no difference in the changes in TBS by randomized group. In the Bone Trial of the Testosterone Trials, testosterone treatment increased trabecular volumetric bone mineral density (vBMD) and increased estimated bone strength as determined by finite element analysis. The trabecular bone score (TBS) is an indirect measure of vertebral bone microarchitecture. TBS predicts fracture independent of lumbar spine areal (a) BMD. The objective of this study was to examine the effect of testosterone treatment on TBS compared to its effects on vBMD and aBMD. Two hundred and eleven men were enrolled in the Bone Trial of the Testosterone Trials. Of these, 197 men had 2 repeat TBS and vBMD measurements; 105 men were allocated to receive testosterone, and 92 men to placebo for 1 year. TBS, aBMD, and vBMD were assessed at baseline and month 12. There was no difference in the percent change in TBS by randomized group: 1.6% (95% confidence intervals (CI) 0.2–3.9) in the testosterone group and 1.4% (95% CI −0.2, 3.1) in the placebo group. In contrast, vBMD increased by 6% (95% CI 4.5–7.5) in the testosterone group compared to 0.4% (95% CI −1.65–0.88) in the placebo groups. TBS is not clinically useful in monitoring the 1-year effect of testosterone treatment on bone structure in older hypogonadal men.
Acute Airway Compromise After Isolated Mandibular Subcondyle Fracture in a Patient With a Hemi-Mandible: A Case Report:

Evaluation of the airway is the first step in any trauma protocol, and this is particularly important in instances of facial trauma. While airway compromise is not uncommon in blunt or penetrating ...
Modeling and analysis of switched-mode hybrid systems driven by threshold events

We consider a class of continuous-time hybrid systems in which the interface between the continuous-state dynamics and discrete-state dynamics is defined by threshold-crossing events. Discrete-state transitions are forced by events that occur when continuous signals cross specified thresholds. The discrete states, in turn, influence the continuous system dynamics through condition signals that are inputs to the continuous state equations. To apply discrete-state methods to analysis and synthesis of such systems, it is necessary to create a discrete-state model that accepts the event language generated by the hybrid system. This is not possible in general, however, because the threshold event language can be nonregular. We present an algorithm for computing a sequence of finite-state automata which accept regular languages that are increasingly refined outer approximations to the threshold event language. The definitions and algorithm are developed and illustrated for a simple two-integrator continuous system with arbitrary rates and 0–1 thresholds. The paper concludes with a discussion of several open problems for future research.
Photoproduction of top quarks in peripheral heavy ion collisions

In relativistic heavy ion collisions, top quarks can be produced by photon-gluon fusion when a photon from the Weizsacker-Williams virtual photon field of one nucleus interacts with a gluon in the other nucleus. Photoproduction with heavy ions at the Large Hadron Collider (LHC) will be the first accessible non-hadronic top production channel. We calculate the $t \overline t$ photoproduction cross sections, pair mass and top quark rapidity distributions in peripheral lead-lead and oxygen-oxygen collisions. The cross sections are sensitive to the top quark charge and the large- $Q^2$ gluon distribution in the nucleus. We find a cross section of 15 pb in oxygen-oxygen collisions, leading to 210 pairs in a one month ( $10^6$ s) LHC run. In pA collisions, the rate is higher, 1100 pairs per month for pO. A comparison of the AA and pA data might allow for a study of gluon shadowing at high Q $^2$ .
Lymph node involvement as a prognostic factor in pancreatic cancer.

The finding of metastatic disease in lymph nodes predicts a poor outcome for patients with adenocarcinoma of the head of the pancreas. Nodal metastases occur in as many as one-half of the patients who currently undergo resection with small tumors (<2 cm in diameter). There is some evidence that a more extensive lymphatic and soft tissue resection than is commonly done could prolong survival. This possibility should be tested in a prospectively designed study.
Diophantine approximation by algebraic hypersurfaces and varieties

Questions on rational approximations to a real number can be generalized in two directions. On the one hand, we may ask about "approximation" to a point in R" by hyperplanes defined over the rationals. That is, we seek hyperplanes with small distance from the given point. On the other hand, following Wirsing, we may ask about approximation to a real number by real algebraic numbers of degree at most d. The present paper deals with a common generalization of both directions, namely with approximation to a point in R n by algebraic hypersurfaces, or more generally algebraic varieties defined over the rationals.
Insertion Devices at the National Synchrotron Light Source-II

The NSLS-II storage ring completed commissioning in 2014 and all project-beamline IDs have also been commissioned. As of February 2015, six beamlines are about to finish commissioning. By the end of 2015, the ring is expected to store 300 mA with top-up injection capability and 500 mA with a second superconducting RF cavity installed in the following year. The design principle of the NSLS-II ring is to employ low-field BMs and simultaneously install high-field wigglers in non-dispersive straights to reduce the horizontal emittance. The more wigglers are installed, the smaller the horizontal electron beam emittance becomes. At this stage, six 3.4-m-long wigglers with 1.8 T effective field and 100 mm period length have been installed in three straight sections, which could reduce emittance in a bare lattice from 2.1 nm.rad to approximately 1.0 nm. rad. Two 2.0-m-long EPU49s are installed for the coherent soft X-ray (CSX) beamline in a short straight (SS) section also known as the low-βx straight section. Th...
Effects of different data base formats on information retrieval

This research examined the effects of three different data base formats on the information retrieval performance of users. Spatial, tabular, and verbal forms of two data base domains (airline and thesaurus) were constructed, along with questions that required users to search through the data base to determine the correct response. Three types of questions, compatible with the forms of the data bases, were designed--spatial, tabular, and verbal. The data indicate that users' responses to the questions are faster and more accurate when the format of the information in the data base matches the type of information needed to answer the question. Although the importance of matching data base format to query type may seem obvious, it would appear that the designers of most current data base systems have not taken this into account. Language: en
The Theory of Quaternality

It is well-known that every involution in a logical or mathematical system gives rise to a theory of duality; for example, negation in the sentential calculus and predicate calculus, complementation in the calculus of classes, complementation and conversion in the calculus of relations, etc. The purpose of this note is to call attention to the fact that every involution in a logical or mathematical system gives rise to a theory of quaternality and that the square of quaternality, of which the classical squares of opposition are special cases, provides a diagrammatic representation for much of the theory of quaternality. For the sake of definiteness we expose the theory of quaternality in the context of the lower predicate calculus.Let ϕ and ψ be formulas of the lower predicate calculus. The constants {T and F} {∧ and ∨} {→ and ⇷} {← and ⇸}{↔ and ⇹} {↑ and ↓} {∧ (all) and ∨ (some)} are dual. The constant ~ is self-dual. The negational of ϕ, denoted ϕN, is the formula obtained from ϕ by interchanging negated and unnegated variables (that is, sentence variables and predicate variables) and by interchanging dual constants. The contradual of ϕ, denoted ϕC, is the formula obtained from ϕ by interchanging negated and unnegated variables. The dual of ϕ, denoted ϕD, is the formula obtained from ϕ by interchanging dual constants. The four formulas ϕ, ϕN, ϕC, ϕD, are quaternals of each other.
High-temperature operation of THz quantum-cascade lasers

We have developed THz quantum-cascade lasers based on resonant-phonon-assisted depopulation and using metal-metal waveguides for mode confinement. The band diagram of the QCL structure is illustrated. Based on the combination of these two unique features, many THz QCLs with record performance, including a maximum pulsed operating temperature at 147 K, a maximum cw operating temperature at 97 K were developed.
A Systems Approach for the Evolving Nature of Part Costs

A web-based, enterprise-wide system management tool integrating a hierarchical product structure with purchasing, engineering and accounting databases can significantly improve the organization's ability to adapt to change and ultimately, attain project financial goals. This paper describes the fundamental elements of the PCS WEBTRACK tool developed at PACCAR for a systems approach to managing the evolving nature of part costs.
Teaching students to use genetic algorithms to solve optimization problems

Genetic Algorithms have been used to solve a wide variety of problems. They have proven to be of notable usefulness in solving optimization problems of all kinds. Because of this, I believe that Genetic Algorithms should be taught routinely in Algorithms and Algorithm Analysis classes. My experience has shown that adding instruction about the implementation of Genetic Algorithms enhances student understanding of approximation algorithms and does not take an unreasonable amount of time away from the other topics. SUN workstations supplied by National Science Foundation DUE-ILI grant #9651290 provided the computing environment used for the work reported here.
When Women in Statistics Come to Know Their Power

The inaugural Women in Statistics Conference was held May 15–17, 2014, in Cary, North Carolina. This conference targeted women in career stages from undergraduate through tenured professor and seni...
Using Visual Analytics to Determine the Utilization of Preoperative Anesthesia Assessments

Background: Preoperative assessments are a required and essential element of anesthetic care, yet little is known about the utilization of these documents by clinicians who are not part of the anesthesia care team. As part of perioperative workflow restructuring, we implemented a data visualization technique of electronic medical record audit log data to understand the utilization of preoperative anesthesia assessments by non-anesthesia personnel. Methods: An audit log cache containing 140 days of data was queried for all accesses of preoperative anesthesia assessment documents for any patient who had a preoperative anesthesia assessment that was accessed during that period. User roles were aggregated into categories. Descriptive statistics and data visualization were generated using R (R Software Foundation, Vienna, Austria). Comparisons were performed with the Wilcoxon signed rank test with continuity correction. Results: During the study period, 73 802 (0.015%) of the 485 062 902 audit log accesses were preoperative anesthesia assessments representing 412 departments, 302 user roles, and 3 916 distinct users who accessed preoperative anesthesia assessments from 14 235 surgical cases. Each assessment was accessed 2.9 times on average. Assessments performed in the preoperative anesthesia assessment clinic were accessed more frequently than those created on the day of surgery in the preoperative holding room (3.58 ± 5.18 v. 1.98 ± 1.76 average views; p<0.0001). We observed accesses of these documents by pathology and general surgery researchers, as well as orthopedics attending physicians accessing documents that were two years old. Conclusions: This approach revealed patterns of utilization that had not been previously identified, including usage by surgical residents, surgical faculty, and pathology researchers both before and after the surgical event for which the documents are generated. Knowledge of these dependencies directly informed perioperative workflow restructuring efforts. This visual analytic approach could be broadly utilized to understand documentation dependencies in a variety of clinical contexts.
Clear-air Seeding: Opportunities and Strategies

Clear-air seeding is the artificial creation or enhancement of cloud cover in clear air which is between saturation with respect to ice and saturation with respect to liquid water. Previous work has demonstrated that clear-air seeding is possible, and may be economically worthwhile through its effects on the radiation balance near the ground. Order-of-magnitude arguments, contrail observations and direct measurements are used to assess the frequency and horizontal extent of opportunities for clear-air seeding in the upper troposphere. Clear, ice-supersaturated air is a common occurrence in the mid-latitude upper troposphere at all times of year, typically appearing over 100 km-wide regions downstream of cyclonic or convective storm systems. The frequency of opportunities was also estimated for a particular application of clear-air seeding-cloud cover enhancement during winter nights to reduce space heating costs. Opportunities were studied for the middle and lower troposphere through a careful analysis of radiosonde humidity data, and for the upper troposphere through observalions of natural cirrus. Under suitable cloud cover and wind conditions, five to ten opportunities each season are estimated for locations in the northeastern United States, a frequency sufficient for economic advanlage based on a previous analysis. Two methods are discussed for seeding clear, ice-superssLurated air to create clouds. Seeding with ice crystals is studied using a numerical simulation of ice crystal cloud growth, which includes both ice physics and radiative transfer. Ice crystal seeding is most effective when the seeding rate is greatest and the moist layer seeded is deepest. Aircraft contrails generally utilize only a small fraction of the available water vapor in excess of ice saturation, before they settle out of the moist layer in which they were created. The development of clouds seeded with ice-nucleating aerosols, rather than ice crystals, depends greatly on the rate at which the seed material nucleates ice crystals. This type of seeding would produce a longer lasting, lower density cloud than would seeding with ice crystals.
The statistics of tragedy

On the Western Front during the First World War, 237 British soldiers were executed for desertion. Was the punishment an effective deterrent, or were lives needlessly wasted? Eric S. Brent investigates