cssi/SciSciGPT-SciSciNet huggingface dataset:
The Column Procedure: A Limited Lateral Approach for Extrinsic Contracture of the Elbow*

Thirty-eight elbows (thirty-seven patients) with an extrinsic contracture were treated operatively with a limited lateral approach to the anterior and posterior aspects of the capsule. Because the procedure elevates muscles from the anterior and posterior aspects of the lateral supracondylar osseous ridge, we called it the column procedure. The mean preoperative arc of flexion was 49 degrees (from 52 to 101 degrees). At a mean of forty-three months (range, twenty-four to seventy-four months) postoperatively, the mean arc of flexion was 94 degrees (from 27 to 121 degrees). The mean total gain in the arc of flexion-extension was 45 degrees; thirty-four elbows (89 percent) had an improved range of motion at the latest follow-up examination. Overall, thirty-one elbows (82 percent) had a satisfactory result. Greater improvement was obtained in elbows that had had severe stiffness (a total arc of 31 to 60 degrees) or very severe stiffness (a total arc of 30 degrees or less) or that had had a combined flexion and extension contracture. A complication occurred in four elbows (11 percent). A hematoma developed in two elbows and impaired the final outcome in one of them. Two elbows had transient ulnar paresthesia, which resolved spontaneously. The arc of flexion obtained at the time of the operation was lost in ten elbows (26 percent) after an initial period of improvement; at the latest follow-up evaluation, four of these elbows had a mean decrease in the arc of flexion of 24 degrees compared with preoperatively. The column procedure is associated with a low rate of complications and is safe and effective for the treatment of a limitation in flexion or extension resulting from an extrinsic contracture of the elbow.
FREQUENT BICLONALITY AND Ig GENE ALTERATIONS AMONG B CELL LYMPHOMAS THAT SHOW MULTIPLE HISTOLOGIC FORMS

Configurations of Ig gene DNA were examined in multiple biopsy specimens from seven cases of human B cell lymphoma that showed histologic differences among the specimens within each case. Analysis by Southern blot hybridizations with DNA probes for each of the three Ig loci revealed that the configurations of DNA within these loci were identical among the specimens in two of the cases. This result indicated the monoclonality of these lymphomas, despite differences in histology between biopsy specimens. In contrast, no common nongermline configurations of Ig gene DNA were detected among multiple biopsies in each of three other cases. Therefore, different histologies correlated with separate clones of proliferating B cells in these cases. In the last two cases, the configurations of light chain gene DNA were the same among biopsies in each case, consistent with a monoclonal origin in both lymphomas. However, differences were detected in the configuration of the heavy chain gene DNA. Analysis with a series of DNA probes of the mu heavy chain region indicated that the differences in the DNA configurations of the heavy chain genes from the biopsies probably arose from postrearrangement deletions of either the switch or constant regions of the mu gene. These studies indicate that, contrary to the conventional belief, individual tumors that contain different histologic types of lymphoma within the same patient frequently arise from separate clones of neoplastic cells. Furthermore, the heavy chain genes of monoclonal tumors may show postrearrangement deletions, often resulting from instability of DNA sequences within or around the mu switch region.
Biogenic, Psychogenic, and Sociogenic Models of Adjustment to Chronic Pain: An Exploratory Study

Objective:Based upon three models of etiology and adjustment in CLBP, predictions were made about the variables that were expected to differentiate organic and nonorganic patients, including: psychological distress (anxiety, depression, stress, alienation), pain condition and treatment, and general health.Method:Patients from a medical school orthopedic clinic with an organic (N = 58) or a nonorganic (N = 33) diagnosis for chronic low back pain (CLBP) were compared on medical, psychological and sociodemographic variables.Results:Nonorganic patients exhibited greater emotional distress, contrary to the biogenic model, and nonorganic patients did not exhibit more somatic complaints, contrary to the psychogenic model. Both patterns were consistent with the sociogenic model; nonorganic patients were more distressed, but not because of a greater tendency to somatize. Moreover, modeling was not supported as an explanation of the pain and distress among these patients.Conclusions:Social anomie may explain why pa...
Aβ deposition is associated with enhanced cortical α-synuclein lesions in Lewy body diseases

In order to understand better the neuropathological substrate of dementia in Parkinson's disease (PD) and to examine its interactions with Alzheimer's disease (AD), we examined autopsy brains from 21 cases of PD and Lewy body disease (LBD) with dementia. We separated brains in two groups according to the presence of Abeta deposits. In brains without Abeta, we found few or no Lewy bodies (LB) in the cerebral cortex. By contrast, in brains with Abeta, we observed significant increases in LB in the cerebral cortex (p < 0.01) and alpha-synuclein immunoreactive lesions in the cingulate cortex (p < 0.01). Immunoblots of alpha-synuclein from cingulate cortex in brains with Abeta showed significantly higher levels of insoluble alpha-synuclein compared to brains without Abeta. Our observations indicate that in cases of PD with dementia, the neocortex is not necessarily involved by LB. Furthermore, the presence of Abeta deposits in the cerebral cortex was associated with extensive alpha-synuclein lesions and higher levels of insoluble alpha-synuclein. This suggests that Abeta enhances the development of cortical alpha-synuclein lesions in cases of PD.
Epithelial Ovarian Tumors of Borderline Malignancy: Long-Term Follow-Up

Abstract Thirty-nine patients underwent primary surgery for epithelial ovarian tumors of low malignant potential at the Massachusetts General Hospital between 1970 and 1980. Eighty-five percent of patients were found to have Stage I disease and 15% were found to have Stage III disease. Fifty-four percent of patients had a tumor with serous histology, 39% had a tumor with muccinous histology, and the remainder of patients had tumors with an endometrioid or mixed-cell type. Second malignancies and benign ovarian tumors were frequently found concomitantly with the borderline tumors or in follow-up. Gastrointestinal and endometrial adenocarcinomas were the most common second malignancies and were frequently found associated with a borderline tumor of serous histology. Follow-up was available in all 39 patients (100%). Mean time of follow-up was 11.8 years. Sixty-nine percent of patients are clinically without evidence of disease with a mean follow-up of 14.7 years, 23% died of other causes, 5% died of disease, and 3% died with disease and sepsis. All patients dying with disease did so within 7.3 years of their primary surgery. Seven patients underwent conservative surgery, defined as preservation of stone ovarian tissue. Six of 7 patients are clinically free of disease with a mean follow-up of 14.6 years; 1 patient died of other causes. No patients treated conservatively had a recurrence of their disease.
Arts Involvement and Spirituality as Sources of Well-Being in Older People

Spirituality and involvement with the arts have been individually studied as contributors to late-life well-being. This study explored relationships among arts involvement, as measured by a six-item scale constructed for this research, experiences of the transcendent in everyday life, as measured by the Daily Spiritual Experiences Scale (DSES), and morale, as measured by the Philadelphia Geriatric Center Morale Scale (PGCMS). Participants were adults over age 40 (N = 90). Only arts scores significantly predicted PGCMS scores (B = 0.17, t = 2.26, p < 0.05). In addition, DSES scores and arts scores were significantly correlated (r = 0.50, p < 0.01). These results are discussed in terms of growing interest in congregational programs that promote dialogue between the arts and religion.
Simplifying video editing using metadata

Digital video is becoming increasingly ubiquitous. However, editing video remains difficult for several reasons: it is a time-based medium, it has dual tracks of audio and video, and current tools force users to work at the smallest level of detail. Based on interviews with professional video editors, we developed a video editor, called Silver, that uses metadata to make digital video editing more accessible to novices. To help users visualize video, Silver provides multiple views with different semantic content and at different levels of abstraction, including storyboard, editable transcript, and timeline views. Silver offers smart editing operations that help users resolve the inconsistencies that arise because of the different boundaries in audio and video. We conducted a preliminary user study to investigate the effectiveness of the Silver smart editing. Participants successfully edited video after only a short tutorial, both with and without smart editing assistance. Our research suggests several ways in which video editing tools could use metadata to assist users in the reuse and composition of video.
Development as a dynamic system

Development is about creating something more from something less, for example, a walking and talking toddler from a helpless infant. One current theoretical framework views the developmental process as a change within a complex dynamic system. Development is seen as the emergent product of many decentralized and local interactions that occur in real time. We examine how studying the multicausality of real-time processes could be the key to understanding change over developmental time. We specifically consider recent research and theory on perseverative reaching by infants as a case study that demonstrates this approach.
Hu protein R-mediated posttranscriptional regulation of VEGF expression in rat gastrocnemius muscle.

Hypoxic exercise increases VEGF expression and the formation of new capillaries. In addition to hypoxia-inducible factor regulation at the transcriptional level, VEGF message stabilization is also ...
How many cigarettes did you smoke? Assessing cigarette consumption by global report, time-line follow-back, and ecological momentary assessment.

Objective: This study evaluated and compared several methods of assessing daily cigarette consumption. Design: Comparison of measures of daily cigarette consumption from several sources, from 232 smokers entering a smoking cessation program. Main Outcome Measures: Global reports of average smoking, Time-Line Follow-Back (TLFB) recall for the week preceding the study (premonitoring TLFB), 2 weeks’ cigarette recordings using electronic diaries and ecological momentary assessment (EMA), and TLFB recall of smoking during EMA (monitored TLFB). Results: Global reports and premonitoring TLFB showed severe digit bias: six times as many values as expected were rounded at 10. Monitored TLFB also showed substantial digit bias (four times). EMA data showed none. EMA averaged 2.6 cigarettes lower than monitored TLFB, but exceeded TLFB on 32% of days. Across days, EMA and TLFB only correlated 0.29. Daily variations in TLFB did not correlate with variations in carbon monoxide (CO) measures taken on 3 days, but EMA measures did; among participants whose CO varied, r .69. CO correlated with EMA cigarettes recorded in the preceding 2 hours, suggesting timely recording of cigarettes. Conclusion: TLFB measures are limited for precise assessment of cigarette consumption. EMA measures appear to be useful for tracking smoking, and likely other health-relevant events.
Emerging Threats to Human Health from Global Environmental Change

Large-scale anthropogenic changes to the natural environment, including land-use change, climate change, and the deterioration of ecosystem services, are all accelerating. These changes are interacting to generate five major emerging public health threats that endanger the health and well-being of hundreds of millions of people. These threats include increasing exposure to infectious disease, water scarcity, food scarcity, natural disasters, and population displacement. Taken together, they may represent the greatest public health challenge humanity has faced. There is an urgent need to improve our understanding of the dynamics of each of these threats: the complex interplay of factors that generate them, the characteristics of populations that make them particularly vulnerable, and the identification of which populations are at greatest risk from each of these threats. Such improved understanding would be the basis for stepped-up efforts at modeling and mapping global vulnerability to each of these threa...
Machine cell formation for production management in cellular manufacturing systems

The formation of machine-part families is an important task in the design of cellular manufacturing systems. Manufacturing cell grouping has the effect of reducing material handing cost and work in process. Among the many methods utilized in machine cells formation, the similarity coefficient method is most widely used. Production sequence and product volumes, if incorporated properly in determining the machine cells, can enhance the quality of solutions and reduce the number of intercellular movements. Measures for cell formation based on operations sequence utilizing ordinal production data are few and have many limitations, such as counting the number of the trips for each individual part instead of counting the weights of the batches. A new ordinal production data similarity coefficient based on the sequence of operations and the batch size of the parts is introduced. Furthermore, a new clustering algorithm for machine cell formation is proposed. The new similarity measure showed more sensitivity to t...
Reversible cerebral vasoconstriction syndrome with reversible renal artery stenosis

A 41-year-old woman presented with thunderclap headaches, cortical blindness, generalized seizures, and severe hypertension. Brain imaging (figure) showed features of reversible cerebral vasoconstriction syndrome (RCVS) and posterior reversible encephalopathy syndrome.1 Her neurologic examination improved, but severe hypertension persisted. Abdomen CT angiography showed right renal artery narrowing with possible dissection, initially attributed to fibromuscular dysplasia (FMD). Renal angioplasty was considered; however, she was discharged on multiple antihypertensive agents. Her blood pressure normalized, and parenchymal lesions and vertebral/renal artery abnormalities showed complete resolution on follow-up at 7 months. This case emphasizes that RCVS can affect the extracerebral systemic arteries,2 and can be misinterpreted as FMD.
Paraphrastic Sentence Compression with a Character-based Metric: Tightening without Deletion

We present a substitution-only approach to sentence compression which "tightens" a sentence by reducing its character length. Replacing phrases with shorter paraphrases yields paraphrastic compressions as short as 60% of the original length. In support of this task, we introduce a novel technique for re-ranking paraphrases extracted from bilingual corpora. At high compression rates paraphrastic compressions outperform a state-of-the-art deletion model in an oracle experiment. For further compression, deleting from oracle paraphrastic compressions preserves more meaning than deletion alone. In either setting, paraphrastic compression shows promise for surpassing deletion-only methods.
Green food through time

Leaves are the fundamental photosynthetic unit of a plant, and yet they suffer more tissue loss to herbivory than any other plant organ (Schowalter, 2000). Traces of insect folivory, or feeding on leaves, are clearly visible on the leaf surface. For example, after an insect consumes part of a leaf, the surrounding tissue becomes thickened to prevent further damage or desiccation (Fig. 1A). Galls and mines (Figs. 1B–D) are evidence that the leaf provided shelter and food for insect eggs and larvae. Some leaves even have scars showing where they were pierced by an insect stylet to obtain food or by an ovipositor to place eggs inside the leaf. Today, angiosperms and insects dominate terrestrial biodiversity and biomass (Price, 2002) and insect folivory plays a critical role in terrestrial trophic webs and nutrient cycling. Thus, studies of plant-insect interactions through time have important implications for evolutionary biology and paleoecology. Ellen Currano earned a B.S. in Geophysical Sciences and an A.B in Biological Sciences from the University of Chicago. While in college, she first visited the two places that would shape her scientific interests: the Bighorn Basin, Wyoming, and East Africa. Ellen's Ph.D. in Geosciences from Pennsylvania State University, supervised by Peter Wilf (PSU) and Scott Wing (Smithsonian Institution), included four summers collecting fossil leaves in the Bighorn Basin. After completing her Ph.D., Ellen returned to East Africa as an NSF Earth Sciences Postdoctoral Fellow. She spent a year studying the late Oligocene Chilga floras of northwestern Ethiopia, under the guidance of Bonnie Jacobs at Southern Methodist University. In fall 2009, Ellen began a tenure-track position in the Department of Geology …
New Design Procedure for Wind Uplift Resistance of Architectural Metal Roofing Systems

Currently, there are no Canadian national guidelines for the wind uplift resistance of architectural metal roof systems. Thus, it is difficult to judge their suitability and performance based on a common standard. Given the increasing use of metal roofs, it has been determined that there is a need for the development of a design guide, that would be applicable to all regions of Canada. Metal roofs can be classified into two groups: Structural and architectural. This paper focuses on the wind uplift performance of architectural metal roof systems. Several parameters influence the wind uplift performance of the architectural metal roofs. This study finds that air leakage of the structural deck is one of the significant factors that influences the wind uplift performance. This is based on experimental investigations carried out at the Dynamic Roofing Facility of the National Research Council of Canada, using the Special Interest Group on Dynamic Evaluation of Roofing System dynamic wind test protocol. Architectural roofing panels with three different types of commonly used, seam-interlocking mechanisms (joint details) were investigated. It has been noted that the resistance to wind uplift pressure increases dramatically as the air leakage ratio decreases. A modeling method is also described which quantifies system response by simulating the wind gusts over roof specimens with different leakage ratios that can represent field assemblies. The 1995 National Building Code of Canada was utilized for the estimation of the wind-induced loads and the present study provided extensive experimental data for various systems with each type of seam detail. Based on this analysis, a simplified design procedure was developed. The simplified procedure is presented through case studies of metal roof assemblies located in the Canadian provinces of British Columbia, Ontario, and Quebec.
Graphics-to-haptics: a tool for developing haptic virtual environments

Current haptic application development tools typically require considerable programming efforts in order to make an existing surface-based graphical virtual environment (G-VE) touchable. In this paper we describe a graphics-to-haptics (G/sub 2/H) tool that provides a framework for developing the largest possible haptic virtual environments (H-VE) for stable haptic applications. G/sub 2/H automatically converts a G-VE into a haptic application with no additional programming via a real-time visual software development process of 1) importing G-VEs, 2) setting haptic and visual properties for models, 3) selecting graphics and haptic rendering algorithms, 4) representing the haptic device position in the virtual space, 5) interfacing different haptic devices to the virtual environment, and 6) testing and modify the virtual environment to ensure real-time stability of the created haptic application. The tested H-VE can be used as the foundation for other applications such as surgical simulators [Acosta, E et al., (2004), (2002)].
The Garden Place

This is a revised version of UVA-C-0736. Mary Jane Bowers has recently moved to Lynchburg, Virginia and plans to open a retail garden store. She compiles financial projections for the initial startup of her business and its first year of operation. This case is designed for use during the introductory module of a financial accounting course and intended to give students exposure to the analysis of business transactions and the preparation of financial statements.
A front-tracking shock-capturing method for two fluids

We present a new high-order front-tracking method for hyperbolic systems of conservation laws for two gases separated by a tracked contact discontinuity, using a combination of a high-order Godunov algorithm and level set methods. Our approach discretizes the moving front and gas domains on a Cartesian grid, with control volumes determined by the intersection of the grid with the front. In cut cells, a combination of conservative and non-conservative finite volume quadratures provide small-cell stability. Global conservation is maintained using redistribution. We demonstrate second-order convergence in smooth flow and firstorder convergence in the presence of shocks.
Bit interleaved coded modulation to enable fractional bits-per-cell storage at NAND flash memory

Abstract In this paper, a practically implementable bit interleaved coded modulation (BICM) scheme is introduced to enable fractional bits-per-cell storage at NAND flash cells. The proposed system utilizes a near-systematic modulation scheme as well as a demodulation algorithm that generates reliability information for the use of soft-input error correction code (ECC) decoders. Both modulation and demodulation algorithms have simple structures and they are implemented in hardware efficiently with small area/power cost. Via software simulations and actual flash data experiments, we showed the benefits of the proposed BICM scheme using a low density parity check (LDPC) code.
The diverse vocational experiences of five individuals returning to work after severe brain injury: A qualitative inquiry.

AbstractObjective: The researchers explored the return-to-work experiences of five adults with severe traumatic brain injuries (TBIs) and those associated with them by performing a qualitative, multiple case study investigation involving in-depth, semi-structured interviews. Selection of this qualitative methodology allowed for personal, individualized accounts of adults with TBI returning to work. Specifically, this methodology promoted accurate representation of the idiosyncratic nature of each participant’s experiences.Methods: The researchers asked individuals to participate based on the diversity of their vocational experiences following TBI.Results: Four of the five participants had returned to their pre-injury jobs. Two were subsequently fired and, at the time of research participation, were unemployed. One participant never returned to paid employment; however, he had held two volunteer positions for several years post-injury. Salient content from interview transcripts allowed for the identificati...
The Working Family: A Researcher's View of Health in the Household

The author characterizes the underlying assumptions, convictions, and beliefs that each family holds about its environment as the family paradigm, citing the evidence for the family paradigm gleaned from the laboratory study of how families solve problems. He suggests that a family's health depends on the conservation of its paradigm; pattern regulators and ceremonials are two types of family routine that conserve the paradigm. When the paradigm is threatened with collapse, three stages can be delineated: the emergence of rules, the explicit family, and rebellion and action. Each last stage can propel the family toward dissolution or self-healing.
Is Intergenerational Solidarity a Unidimensional Construct? A Second Test of a Formal Model

Results from a second empirical test of a theory of intergenerational family relations, as an example of empirically driven theory construction in social gerontology, are presented. The theory we tested reflects an attempt to explain later-life patterns of affection, association, and consensus between parents and children as interdependent components of a meta-construct--family intergenerational solidarity. The theoretical model also identifies variables that are expected to predict variations in levels of solidarity. A recent empirical test (Atkinson, Kivett, and Campbell, 1986) offered little support for the central proposition of the model: that solidarity can be indexed by a linear-additive composite of affection, association, and consensus. The replication analysis reported here is based on a different sample, as well as alternate measures and statistical methods. The convergent results suggest that (a) later-life intergenerational solidarity is not a unidimensional construct, and (b) different variables predict each component. This exercise of theory statement, testing, and retesting leads us to suggest several refinements to the theory acknowledging a more complex relationship between dimensions of intergenerational relations in old age.
Alternative Multidimensional Scaling Methods for Large Stimulus Sets

Seven data collection methods available for scaling large stimulus sets are evaluated via simulation under three scaling approaches, using data from a known configuration. Pick or order methods pro...
A Comparison of the Biology of the Sugarcane Borer on Artificial and Natural Diets

A wheat germ medium, slightly modified, for rearing the pink bollworm, Pectinophora gossypiella (Saunders), was used to rear the sugarcane borer, Diatraea saccharalis (Fabricius) under laboratory conditions. Wheat germ was the principal constituent of the diet and the medium also contained vitamin-free casein, sucrose, Wesson’s salts, choline chloride, agar, sodium alginate, ascorbic acid and water. Ascorbic acid in the diet was found to be essential to normal growth and development of the larva. A vitamin mixture and an inhibitor also were included in the diet. The life cycle of the sugarcane borer on wheat germ medium and on sections of grain sorghum plants was compared.
Optimal first-line treatment of chronic myeloid leukemia: How to use imatinib and what role for newer drugs?

The development of imatinib mesylate (Gleevec), a tyrosine kinase inhibitor targeted against the causative Bcr-Abl protein in chronic myeloid leukemia (CML), has resulted in hematologic and cytogenetic remissions in all phases of CML. Following imatinib treatment, more than 90% of patients obtain complete hematologic response, and 70% to 80% achieve a complete cytogenetic response. With 5 years of follow-up, the data are very encouraging, exhibiting a major change in the natural history of the disease. The understanding of at least some of the mechanisms of resistance to imatinib has led to a rapid development of new agents that may overcome this resistance. Combination strategies are currently being investigated in preliminary clinical studies and may prove to be useful. Overall, there are an increasing number of treatment options now available for patients with CML.
Trajectories of marijuana use from late childhood to late adolescence: Can Temperament × Experience interactions discriminate different trajectories of marijuana use?

Informed by developmental ecological and epigenetic theory, the current study examined three aims concerning adolescent marijuana use with a large community sample (N = 755; gender = 53% female) and six annual assessments that spanned 11-18 years of age. First, the natural history of adolescent marijuana use was modeled using a two-part latent growth curve analysis. Second, the validity of the mixtures was examined with a broad array of known correlates of adolescent marijuana use. Third, temperament (e.g., surgency, effortful control, and negative affect) was tested as individual differences that would enter into statistical interactions with peer substance use and prior alcohol and cigarette use to distinguish trajectories of marijuana use. The results suggested that escalations in marijuana use were observed for some youth who initiated marijuana use early in adolescence. Youth whose marijuana use did escalate substantially (10%) were distinguished on temperament, conduct disorder, peer delinquency, and pubertal development at baseline. Furthermore, hypothesized interactions between surgency and both peer substance use and prior substance use discriminated different patterns of marijuana use. The findings are discussed with respect to strategies for timing and content of preventive interventions. Language: en
Ultrafast postprocessing of yttrium aluminum garnet ceramics via femtosecond pulse laser irradiation

We studied rapid densification and homogenization of sintered yttrium aluminum garnet (YAG) ceramics via sintering followed by femtosecond pulse laser (800 nm) irradiation. We formed localized, high-density microstructures within a YAG ceramic matrix. The laser irradiated regions were characterized using scanning electron microscopy, elemental mapping, and x-ray diffraction. Our results show that phase separation of YAG into YAlO3 and Al2O3 can be obtained in situ within stoichiometric YAG. With an optimum laser power and processing conditions, this process can be used for producing dense YAG ceramics.
Doing Philosophy With Children

A globalizing reality manifests the intersection of cultures in all aspects of public life. As educators then, it is our responsibility to prepare students not only for negotiating the complexity of civic life, but also for managing it in such a way that self and other, and the environment, are imbued with deeper meaning and respect. For, if our goal is a more humane culture within the context of this globalization, it must be established on the solid ground of a realistic appreciation of all perspectives and it must also be achieved within the overarching principle of “least harm done.”
Giant Ring Mitochondria in a Patient With Heart Failure and Cerebral White Matter Disease Resulting From an MT-TL1 Mitochondrial Gene Mutation.

Abstract Background The presence of giant ring mitochondria on endomyocardial biopsy is rarely reported and does not have a well-defined differential diagnosis. Methods We report the case of a 54-year-old man with heart failure and preserved ejection fraction and left ventricular hypertrophy, initially thought to have an infiltrative cardiomyopathy. Results The patient was found to have extensive vacuolization caused by giant ring mitochondria on endomyocardial biopsy. Mitochondrial genetic testing revealed an A3243G mutation in the MT-TL1 gene, which is a mitochondrial encoded transfer RNA-leucine molecule. Conclusions Mitochondrial disease should be considered in patients presenting with unexplained cardiomyopathy and skeletal muscle, cerebral, or metabolic abnormalities. In this case, the presence of unexpected extensive cardiomyocyte vacuolization and giant, ring-shaped mitochondria on endomyocardial biopsy prompted mitochondrial genetic testing, which ultimately resulted in the correct diagnosis and treatment.
A hybrid phantom system for patient skin and organ dosimetry in fluoroscopically guided interventions.

Purpose To investigate calibrations for improved estimates of skin dose and to develop software for computing absorbed organ doses for fluoroscopically guided interventions (FGIs) with the use of radiation dose structured reports (RDSR) and the UF/NCI family of hybrid computational phantoms Methods and Materials Institutional review board approval was obtained for this retrospective study in which ten RDSRs were selected for their high cumulative reference air kerma values. Skin doses were computed using the University of Florida's rapid in-clinic peak skin dose algorithm (or UF-RIPSA). Kerma area product (KAP) meter calibrations and attenuation of the tabletop with pad were incorporated into the UF-RIPSA. To compute absorbed organ doses the RDSR were coupled with software to develop Monte Carlo input decks for each irradiation event. The effects of spectrum matching were explored by modeling 1) a polychromatic x-ray energy beam made to match measured first half value layers of aluminum, 2) an unmatched spectrum, 3) and a mono-energetic beam equivalent to the effective x-ray energy. The authors also considered the practicality of computing organ doses for each irradiation event within a RDSR Results The KAP meter is highly dependent on the quality of the x-ray spectra. Monte Carlo based attenuation coefficients for configurations in which the beam is transmitted through the tabletop with pad reduced the amount by which the software overestimated skin doses. For absorbed organ dose computations the average ratio of computed organ doses for a non-fitted to fitted spectrum and effective energy to fitted spectrum is 0.45 and 0.03 respectively. Monte Carlo simulations on average took 38 minutes per patient. All in-field organ tallies converged with a relative error of less than 1% and out-of-field organs tallies within 10% relative error Conclusions This work details changes to the UF-RIPSA software that include an expanded library of computational phantoms, attenuation coefficients for tabletop with pad, and calibration curves for the KAP meter. For the computation of absorbed organ dose it is possible to model each irradiation event separately on a patient-dependent model that best morphometrically matches the patient, thus providing a full report of internal organ doses for FGI patients. This article is protected by copyright. All rights reserved.
Should Potential Risk of Chronic Traumatic Encephalopathy Be Discussed with Young Athletes

As participation in youth sports has risen over the past two decades, so has the incidence of youth sports injuries. A common topic of concern is concussion, or mild traumatic brain injury, in young athletes and whether concussions sustained at a young age could lead to lifelong impairment such as chronic traumatic encephalopathy (CTE). While the pathway from a concussed young athlete to an adult with CTE remains unknown, current research is attempting to provide more clarity. This article discusses how health care professionals can help foster an informed, balanced decision-making process regarding participation in contact sports that involves the parents as well as the children.
Race-to-sleep + content caching + display caching: a recipe for energy-efficient video streaming on handhelds

Video streaming has become the most common application in handhelds and this trend is expected to grow in future to account for about 75% of all mobile data traffic by 2021. Thus, optimizing the performance and energy consumption of video processing in mobile devices is critical for sustaining the handheld market growth. In this paper, we propose three complementary techniques, race-to-sleep, content caching and display caching, to minimize the energy consumption of the video processing flows. Unlike the state-of-the-art frame-by-frame processing of a video decoder, the first scheme, race-to-sleep, uses two approaches, called batching of frames and frequency boosting to prolong its sleep state for saving energy, while avoiding any frame drops. The second scheme, content caching, exploits the content similarity of smaller video blocks, called macroblocks, to design a novel cache organization for reducing the memory pressure. The third scheme, in turn, takes advantage of content similarity at the display controller to facilitate display caching further improving energy efficiency. We integrate these three schemes for developing an end-to-end video processing framework and evaluate our design on a comprehensive mobile system design platform with a variety of video processing workloads. Our evaluations show that the proposed three techniques complement each other in improving performance by avoiding frame drops and reducing the energy consumption of video streaming applications by 21%, on average, compared to the current baseline design.CCS CONCEPTS• Human-centered computing $ \rightarrow$ Mobile computing;• Computer systems organization $ \rightarrow$ Architectures; Embedded hardware;
Children's Literature and Family Diversity

The representation of diversity in children's literature has expanded from a focus on individual identities to representation of increasingly complex and diversified family structures. Children's ability to see themselves and their families mirrored in the stories they read impacts their development of a healthy identity. In addition, seeing families that are different may increase sensitivity and the ability to interact cross-culturally. Research and theoretical work since the early 2000s have focused on barriers that prevent existing literature from being more widely distributed, thereby limiting and narrowing children's exposure to diverse family structures, particularly in representations of gay- and lesbian-headed households. Keywords: children; diversity; family structure; identity; multiculturalism
Spatial and Seasonal Distributions of Current Use Pesticides (CUPs) in the Atmospheric Particulate Phase in the Great Lakes Region

The authors analyzed spatial and seasonal variations of current use pesticides (CUPs) levels in the atmospheric particulate phase in the Great Lakes basin. Twenty-four hour air samples were collected at six sites (two urban, two rural, and two remote) in 2015. The concentrations of 15 CUPs, including nine pyrethroid insecticides, four herbicides, one organophosphate insecticide, and one fungicide, were measured. The total CUPs concentrations were higher at the urban sites (0.38–1760 pg/m3) than at the rural and remote sites (0.07–530 pg/m3). The most abundant CUPs were pyrethroid insecticides at the urban sites. The levels of the other CUPs did not vary much among the six sites, except at the most remote site at Eagle Harbor, where the levels were significantly lower. Chlorothalonil was the most frequently detected CUP, which was detected in more than 76% of the samples. The atmospheric concentrations of total pyrethroid insecticides and total herbicides were correlated with local human population and dev...
Late and Congenital Syphilis

This article describes syphilis after the fourth or fifth year following infection by Treponema pallidum, beyond the infectious stages and early latency. Late manifestations of the disease, including late benign syphilis, cardiovascular syphilis, neurosyphilis, and congenital syphilis, are discussed and amply illustrated.
Decoupling District from Circuit Judge Nominations: A Proposal to Put Trial Bench Confirmations on Track

The nomination process for federal judges is broken. The problem is acute in the trial courts: At the recent pace of new appointments, the federal district bench will be almost half empty within a decade. Given where this is headed, how can we get back on track?This article proposes to address the failing district judge nomination process by breaking it apart from the process for circuit judges. To date, the Senate has procedurally treated the 861 Article III judgeships on lower courts (all judgeships other than those on the Supreme Court) as a block. For most of the last century, that worked fine while neither circuit nor district judgeships attracted much public interest or partisan debate. But, as the 179 circuit judgeships have received greater political attention — witness the failed circuit nominations of John Roberts (1992), Elena Kagan (1999), Miguel Estrada (2001), and Goodwin Liu (2010) — the historic norms that allowed a smooth flow of confirmations have changed to keep many judgeships empty for prolonged periods. Because the machinery of confirmation is shared for circuit and district judges, those new norms also have been applied to the process for filling 673 district judgeships. The result has been needless and harmful delay. Lawyers and political leaders alike understand that the jobs of district judges — and the stakes for those who depend on the courts — are different. I therefore propose to treat their nomination process differently.This article explores the failing state of the district judge nomination process (Part I) and synthesizes the history of its development (Part II). With that background, the article proposes a package for reform of the district judge process (Part III) consisting of: (1) public listing by the administration of the status of Senators’ recommendations to discourage delay as a bargaining tool in selections; (2) a distinct public questionnaire for district judges limited to questions on legal experience; (3) elimination of the routine Senate committee hearing on nominations; and (4) a mechanism for expedited consideration on the Senate floor.
Towards Better Discoverability and Use of Open Content

Availability and open access to resources is an important factor in educational development, but not a sufficient solution by itself. Open educational practices need to be fostered by an appropriate supportive environment including discoverable and shareable content, combined with tools for adaptation and redistribution. Although a number of open content resources have been created, the accessibility for end users remains low because resources are spread across different OER repositories. This paper is an attempt to respond to OER challenges by proposing an innovative architecture extending the set of features typical for portal OER repositories with resource discoverability, social networking features and (re)publishing functionality.
Man: The Advantages of Specialization

Being multicellular has definite advantages. The earliest colonies of cells reaped the immediate profit: multicellular organisms can be built in larger and larger sizes. Large organisms tend to eat smaller organisms, not the reverse. Over the course of evolution, the meek have generally not inherited the earth, giving multicellular organisms a competitive edge.
Importance of endoscopic and histological evaluation in the management of immune checkpoint inhibitor-induced colitis

Immune checkpoint inhibitors (ICPI) are efficacious treatments for advanced malignancies but can result in immune mediated diarrhea and colitis (IDC). Currently, the guidelines for the treatment of IDC depend only on clinical symptoms. Endoscopic and histologic features of such adverse events are not well studied in a manner that can help to gauge treatment plans. We aimed to characterize endoscopic and histologic features of IDC and to assess their association with clinical outcomes. Our study included patients who had undergone endoscopy for IDC (1/2010 to 3/2018). Patients with GI infection at time of onset were excluded. High-risk endoscopic features were ulcers deeper than 2 mm, larger than 1 cm, and extensive colonic involvement. Univariate and multivariate logistic regression were performed to assess the association of endoscopic and histological features with clinical outcomes. A total of 182 patients was included; most were white (92%), males (65%) with a mean age of 60 years. Median time from ICPI initiation to IDC was 7 weeks. Fifty-three percent had grade 3–4 diarrhea, and 32% grade 3–4 colitis. Forty-nine patients had mucosal ulcerations, 66 non-ulcerative inflammation and 67 normal endoscopy. Calprotectin was higher in patients with ulceration (P = 0.04). The sensitivity of lactoferrin to detect histologic and endoscopic inflammation was 90% and 70% respectively. Patients who underwent endoscopy earlier than 7 days after IDC onset had shorter duration of IDC symptoms and duration of steroid treatment than those who underwent endoscopy after 7 days of IDC onset (P = 0.026 and P = 0.053, respectively). Patients who underwent endoscopy > 30 days of symptom onset required longer duration of steroids (P = 0.02), had more recurrent symptoms (P < 0.01) and received later infliximab/vedolizumab add-on therapy than did those who underwent endoscopy ≤30 days (P = 0.03). High-risk features were associated with more frequent (P = 0.03) and longer duration (P = 0.02) hospitalization and infliximab/vedolizumab requirement (P < 0.01). Patients with active histological inflammation had more recurrence (P < 0.01) and repeat endoscopy (P < 0.01). Repeat endoscopy was required in 47 patients. A multivariate logistic regression revealed that longer ICPI treatment was associated with more frequent hospitalizations (OR 1.00; 95%CI 1.00–1.01; P < 0.01) and high-risk endoscopic features were associated with the requirement of infliximab/vedolizumab (OR 3.89; 95%CI 1.68–9.01; P < 0.01). High risk endoscopic features and active histologic inflammation represent important markers of disease severity with clinical implications and should be used in a timely manner to devise IDC-focused treatment algorithms.
Abstract 243: ICD-10, DRG and ACTION: Poor Agreement Between Diagnoses of Acute Myocardial Infarction Results in Significant Differences in Process and Outcome Measures

Background: In the Unites States, there are three major approaches to identify patients diagnosed with Acute Myocardial Infarction (AMI). The Center for Medicare and Medicaid Services uses ICD-10 c...
From Geometric Nature to Natural Geometry: Bodies We Create for Ourselves

One of the fundamental questions, which most of us have throughout childhood and until adulthood â€“ and of course is usually forgotten or sometimes passes our mind very quickly â€“, is: "where do I end?" or "where does the world begin?" Perhaps you have never asked such questions explicitly; perhaps this question seems eccentric to you. Nevertheless, in the following discussion, you will surely remember that you have some relevant experiences.
Silk-Based Therapeutics Targeting Pseudomonas aeruginosa .

Pseudomonas aeruginosa (P. aeruginosa) infections may lead to severe damage of the cornea, mucosa, and skin. The highly aggressive nature of P. aeruginosa and the rise in multi-drug resistance, particularly in nosocomial settings, lead to an increased risk for permanent tissue damage and potentially death. Thus, a growing need exists to develop alternative treatments to reduce both the occurrence of bacterial infection and biofilm development, as well as pathological progression post-infection. Silk derived from Bombyx mori silkworms serves as a unique biomaterial that is biocompatible with low immunogenicity and high versatility, and thereby ideal for stabilizing therapeutics. In this study, we assessed the cytotoxicity of P. aeruginosa on human corneal stromal stem cells and two mucosal cell lines (Caco-2 and HT29-MTX). To determine whether antibiotic-immobilized scaffolds can serve as alternative therapeutics to free, diffuse forms, we developed novel gentamicin-conjugated silk films as functional scaffolds and compared antimicrobial effects and free gentamicin. The advantages of generating a surface coating with a covalently-bound antibiotic may reduce potential side-effects associated with free gentamicin, as well as limit the diffusion of the drug. Our results suggest that gentamicin conjugated to native silk and carboxyl-enriched silk inhibits P. aeruginosa growth. Development of stabilized antibiotic treatments with surface toxicity selective against bacteria may serve as an alternative approach to treat active infections, as well as potential prophylactic use as coatings in high-risk cases, such as post-surgical complications or prolonged hospitalization.