cssi/SciSciGPT-SciSciNet huggingface dataset:
The Effect of Short-Term Estradiol Therapy on Cognitive Function in Older Men Receiving Hormonal Suppression Therapy for Prostate Cancer

OBJECTIVES: To determine the effect of estrogen (E) alone (without the influence of testosterone (T)) on cognitive function in older men, using 17-b micronized estradiol versus placebo in older men rendered hypogonadal (low T and E) by treatment for prostate cancer. DESIGN: Short-term double-blind, randomized, controlled trial. SETTING: AnoutpatientGeneralClinicalResearchCenter. PARTICIPANTS: Twenty-seven community-dwelling men aged 65 and older receiving neoadjuvant or established therapy with luteinizing-hormone releasing-hormone agonists for treatment of prostate cancer enrolled in a shortterm randomized, controlled trial of 17-b micronized estradiol versus placebo on the effect on biochemical markers of bone turnover. MEASUREMENTS: Hormone levels, including E, T, and sex hormone‐binding globulin; standardized neurocognitive tests, including measures of sustained attention, executive function, and memory; and questionnaires to assess subjects’ perception of cognitive deficits and symptoms of depression. RESULTS: There were no significant differences between patients receiving E or placebo on 15 of 17 neurocognitive measures and no significant differences in self-reported cognitive deficits or number of depressive symptoms. CONCLUSION: Although studies have suggested that E replacement therapy may improve cognitive function, most notably memory performance in postmenopausal woman, there was no evidence in the present study that the addition of short-term E therapy was more beneficial than placebo in tests of cognitive performance in hypogonadal men. JA m Geriatr Soc 52:269–273, 2004.
DISCUSSION OF Experimental Evidence on the Role of Tax Complexity in Investment Decisions

INTRODUCTION Boylan and Frischmann (2006) (hereafter, BF) look at an interesting and relevant question: How does the complexity of a tax system affect investments in a market setting? With the recent issuance of a report by the President’s Advisory Panel on Tax Reform (2005) recommending a simplification of the tax code, tax complexity is clearly a timely issue that resonates with policy makers. The general result of the paper is also interesting—complexity leads to differential market outcomes and those differential outcomes diminish but do not disappear over time. Because I find the topic timely and interesting, I will focus my discussion on what we learn from the paper and how, if possible, we could learn more from this type of research.
Changing Channels: Progressive Insurance Drive Insurance

Sequel to Progressive Insurance: Not Your Standard Insurance Story. The company launches a new sub-brand, Drive Insurance, that will be only sold through independent agents, not through the Web or 1-800 numbers.
Taming rare variation with known biology in long QT syndrome.

The tools necessary for linking novel genes to Mendelian diseases are now at the fingertips of most clinical scientists, thanks to the plummeting cost of whole genome and whole exome sequencing (WES).1,2 Such easy access to sequence data would have been unimaginable 18 years ago, when HERG 3 and SCN5A 4 were first linked to long QT syndrome (LQTS) in 2 large families using time-consuming and expensive sequencing techniques. Since the completion of the human genome project5 and development of next-generation sequencing technologies, there have been a handful of spectacular success stories, in which WES has led to timely diagnoses and life-saving therapies for previously uncharacterized Mendelian disorders.6 Because WES became readily available, there was anticipation that the molecular nature of most Mendelian disease would be uncovered in very little time, and that a surge of publications would emerge with links between novel genes and Mendelian diseases that have for years remained mysteries. The 1000 Genomes Project7 and the Exome Sequencing Project8 showed us, however, that the number of rare variants in each individual’s genome is much higher than we had anticipated. Each person carries thousands of rare, potentially unique, possibly disease-causing variants. Wading through this sea of rare and novel genomic variation has proven a formidable challenge. Thus, further establishing the burden of proof that a given variant causes disease is complex. Functional, rare variation in a plausible gene cosegregating with disease and absent in controls represents a minimum bar, but each of these features exists as a continuous function. Furthermore, even when causality seems clear by these metrics, the proportion of variance in disease expression explained needs independent assessment (oligogenic contribution to disease is inevitable). In this issue of Circulation Cardiovascular Genetics , Boczek et al9 demonstrate, via WES and …
Optimal transfers with guidance to the earth-moon L1 and L3 libration points using invariant manifolds: A preliminary study

Two optimization methods are presented for designing fuel-optimal impulsive transfers from low earth orbit to the Earth-Moon libration points L1 and L3 using the stable manifolds found in the Circular Restricted Three Body Problem. The two methods used are a grid search and a genetic algorithm. All transfers require one maneuver to leave LEO and a second to transfer onto the stable manifold. The trajectories discussed have total changes in velocity between 3.48 km/s and 3.72 km/s. An LQR based guidance scheme is presented which maintains the spacecraft on the stable manifold in the presence of injection errors in burn magnitude and direction. Monte Carlo analyses are conducted to further demonstrate effectiveness of the guidance scheme. The total ∆V costs to use the guidance scheme average 12.34 m/s and 10.88 m/s for L1 and L3 libration point transfers, respectively, when a thrust magnitude Gaussian dispersion with 1σ = 1% error is combined with in-plane and out-of-plane thrust direction Gaussian dispersions with 1σ = 1 degree error.
A Case-control Study on Risk Factors of Type 2 Diabetes Mellitus among Mountain Residents

Objective To explore the risk factors of type 2 diabetes mellitus( T2DM) in mountainous countryside residents in order to provide relevant intervention measures. Methods 80 new cases of T2DM were selected from pingyuan community in Liandu District of Lishui City as case group,and 160 normal people were selected as control group at the same time and places,in which the 1 ∶ 2 matched design of case- control study method was used. Conditional Logistic regression analysis was applied in this study. Results The multiple conditional logistic regression analysis suggested that primary family history,history of hypertension,abdominal obesity were the risk factors of T2DM( OR = 2. 08,1. 55 and 2. 78 respectively); while education level,exercise and fish intake were the protective factors( OR = 0. 74,0. 59 and 0. 32 respectively). Conclusion T2DM is the result of both genetic factors and environmental factors. Moreover,health education,balanced diet and proper physical exercise should be encouraged among residents to prevent T2DM in mountainous countryside.
Ellis Semigroups and Ellis Actions

A semigroup S is a nonempty set with an associative (usually not commutative) multiplication map M: S ×S → S. For p, q ∈ S, we write $$pq = M\left( {p,q} \right) = {M^p}\left( q \right) = {M_q}\left( p \right)$$ (6.1) In terms of the translation maps, the associative law says $${M^p} \circ {M^q} = {M^{pq}}{M_p} \circ {M_q} = {M_{pq}}$$ (6.2) In general, for a function Φ: S × X → X where S is a semigroup, for p ∈ S and x ∈ X, we write $$px = \Phi \left( {p,x} \right) = {\Phi ^p}\left( x \right) = {\Phi _x}\left( p \right)$$ (6.3) The map Φ is called a semigroup action when for all p, q ∈ S: $${\Phi ^p} \circ {\Phi ^q} = {\Phi ^{pq}}$$ (6.4) Thus M defines an action of S on itself.
Zombie tapeworms in late capitalism: accelerating clinical and reproductive labour in Mira Grant's Parasitology Trilogy

Biomedicine is increasingly shaped by the speculative economical values of neoliberal capitalism. A key feature of this new bioeconomical regime is the patenting and circulation of organisms and tissue samples, allowing rapid commercialisation of bacterial, animal and human biomedical materials. When thinking about this trend towards commercialisation, we must consider the ways by which biomedicine has been shaped by economics to better address these exploitative relationships between medical researchers and subjects. These fraught questions of agency and exploitation can be addressed through the concept of clinical labour, a term Melinda Cooper and Catherine Waldby coined to discuss embodied forms of labour, including surrogacy, clinical trials and tissue economies, that dominate the post-Fordist biomedical economy. As a genre that extrapolates from contemporary technoscientific practices, science fiction is uniquely positioned to explore the ethics of biomedical research in this neoliberal speculative economy. Science fiction can give human-like agency and affect to microbial, animal and alien life, allowing modified organisms to speak and interact with their creators. Creating these dialogues between commercialised organisms and biomedical researchers makes clear the connections between contemporary clinical practice and exploitative labour relations, illuminating the more troubling aspects of the new bioeconomy and imagining alternatives to this system.
Pre-season motor performance relevant to knee injury control in an English adult netball club: a descriptive study

Noncontact knee injuries are common in netball and can result in major disability and socioeconomic burden. Different types of single-leg balance (SLB) and single-leg hop (SLH) test have been widely used in a variety of knee sports medicine contexts. Knowledge of SLB and SLH test performance can help inform the clinician regarding an athlete's risk of knee injury. There is, however, a gap in the scientific literature regarding SLB and SLH test performance in adult netball players. Therefore, the purpose of this study was to describe pre-season performance of a battery of SLB and SLH tests considered clinically important in knee injury control in an English adult netball club. The Illinois Agility Test (IAT) was also performed to represent netball-related agility. After university ethics approval was obtained and informed consent completed, 23 female netball players participated (mean±standard deviation (SD): age 29±6 y; height 171.6±7.0 cm; mass 68.2±9.8 kg; defence n=10; centre n=2; attack n=11). All reported being uninjured, available for selection and registered for pre-season training. Test order was: barefoot eyes closed balance (ECB; sec), shod triple hop for distance (THD; cm), single hop for distance (SHD; cm) and vertical hop (VH; cm). Leg order was right (R), left (L). The IAT was conducted last. Practice trials and then three measured trials were performed. Appropriate between-trial rest periods were ensured. All tests have previously reported reliability. The mean of measured trials was used for descriptive statistics. All players successfully completed all tests. Mean±SD values were: ECB, R 22.5±15.8 s, L 29.6±15.5 s; THD, R 463.1±53.2 cm, L 464.6±38.7 cm; SHD, R 167.0±18.0 cm, L 166.4±15.7 cm; VH, R 20.0±3.7 cm, L 19.5±3.1 cm; IAT, 19.5±1.3 sec. Across all tests, mean data were comparable to mean data published by other research groups for females of similar age playing in other agility-focused team sports at similar levels of competition. Because the present data were comparable to data from other research groups, the present data were accepted and corroborated as a representation of the motor performances contained within each of the tests. The present and new data can, therefore, be used at several points during the knee injury control decision-making process for adult female netball players.
Survival of Escherichia coli on Lettuce under Field Conditions Encountered in the Northeastern United States

Although wildlife intrusion and untreated manure have been associated with microbial contamination of produce, relatively few studies have examined the survival of Escherichia coli on produce under field conditions following contamination (e.g., via splash from wildlife feces). This experimental study was performed to estimate the die-off rate of E. coli on preharvest lettuce following contamination with a fecal slurry. During August 2015, field-grown lettuce was inoculated via pipette with a fecal slurry that was spiked with a three-strain cocktail of rifampin-resistant nonpathogenic E. coli. Ten lettuce heads were harvested at each of 13 time points following inoculation (0, 2.5, 5, and 24 h after inoculation and every 24 h thereafter until day 10). The most probable number (MPN) of E. coli on each lettuce head was determined, and die-off rates were estimated. The relationship between sample time and the log MPN of E. coli per head was modeled using a segmented linear model. This model had a breakpoint at 106 h (95% confidence interval = 69, 142 h) after inoculation, with a daily decrease of 0.70 and 0.19 log MPN for 0 to 106 h and 106 to 240 h following inoculation, respectively. These findings are consistent with die-off rates obtained in similar studies that assessed E. coli survival on produce following irrigation. Overall, these findings provide die-off rates for E. coli on lettuce that can be used in future quantitative risk assessments.
LEFM size requirements for the fracture testing of sea ice

The stress-separation curve obtained for the in-situ response of first-year sea ice is used to obtain specimen size requirements for sea ice fracture tests. Issues of notch sensitivity and minimum size requirements for the applicability of linear elastic fracture mechanics are addressed. The role of time dependent deformations in studying sea ice fracture is examined.
Thresholds of sea-level rise rate and sea-level rise acceleration rate in a vulnerable coastal wetland.

Feedbacks among inundation, sediment trapping, and vegetation productivity help maintain coastal wetlands facing sea-level rise (SLR). However, when the SLR rate exceeds a threshold, coastal wetlands can collapse. Understanding the threshold helps address key challenges in ecology-nonlinear response of ecosystems to environmental change, promotes communication between ecologists and resource managers, and facilitates decision-making in climate change policies. We studied the threshold of SLR rate and developed a new threshold of SLR acceleration rate on sustainability of coastal wetlands as SLR is likely to accelerate due to enhanced anthropogenic forces. Deriving these two thresholds depends on the temporal scale, the interaction of SLR with other environmental factors, and landscape metrics, which have not been fully accounted for before this study. We chose a representative marine-dominated estuary in the northern Gulf of Mexico, Grand Bay in Mississippi, to test the concept of SLR thresholds. We developed a mechanistic model to simulate wetland change and then derived the SLR thresholds for Grand Bay. The model results show that the threshold of SLR rate in Grand Bay is 11.9 mm/year for 2050, and it drops to 8.4 mm/year for 2100 using total wetland area as a landscape metric. The corresponding SLR acceleration rate thresholds are 3.02 × 10-4 m/year2 and 9.62 × 10-5 m/year2 for 2050 and 2100, respectively. The newly developed SLR acceleration rate threshold can help quantify the temporal lag before the rapid decline in wetland area becomes evident after the SLR rate threshold is exceeded, and cumulative SLR a wetland can adapt to under the SLR acceleration scenarios. Based on the thresholds, SLR that will adversely impact the coastal wetlands in Grand Bay by 2100 will fall within the likely range of SLR under a high warming scenario (RCP8.5), highlighting the need to avoid RCP8.5 to preserve these marshes.
Location-centric flow flux for improved indoor mobility models

Understanding the mobile user flow flux patterns is important for numerous applications relevant to crowd movement, from information sharing, networking, to security and public health. Particularly in instances of smart buildings and hospitals, among others, the flow between indoor locations, and mobility modeling within buildings is of a prime significance. Much of the mobility modeling studies have focused on a user-centric approach for outdoors movement. In this study, we take a location-centric approach for indoor mobility to analyze and characterize region relationships as pertains to user flow. Our study is trace-driven, as we use extensive measurements from wireless LANs, and mine them to quantify metrics for influx and outflux and show their stability for various buildings at university campus involving more than 108K anonymous mobile users and more than 3 million records. The flux degrees are shown to be temporally stable where their coefficient of variations do not exceed 0.42. However, the correlation between the degrees and dynamic spatial density is not always strongly positive and it varies between buildings. Finally, we outline several smart buildings applications of location-centric flow flux.
Results of a Coordinated Specialty Care Program for Early Psychosis and Predictors of Outcomes.

Objective:This study prospectively evaluated outcomes of OnTrackNY, a statewide coordinated specialty care (CSC) program for treatment of early psychosis in community settings, as well as predictor...
Non-Pharmacological Treatments for Chronic Pain

Precise estimates of the prevalence of chronic pain syndromes are difficult to ascertain. In the US, for example, there may be >30 million people with chronic or recurrent painful conditions. To date, there is still no one treatment that consistently and permanently alleviates chronic pain for all people. Since pain is likely to persist for a significant number of people, a disease management approach is highly desirable. In order to be both clinically effective and cost effective, a disease management algorithm should be developed based on the best available evidence. This article presents evidence relevant to clinical and cost effectiveness for different non-pharmacological strategies in treating chronic pain, including education, exercise, surgery, spinal cord stimulation, and interdisciplinary rehabilitation. Illustrative studies and comparative analyses of several outcomes (i.e. pain reduction, reduction in healthcare utilization, improvement in physical functioning, and closure of disability claims) are discussed. In addition, the costs of complications related to the more invasive treatments are highlighted. Given the wide diversity of syndromes that fit within chronic pain, no single algorithm can be provided that will be appropriate for all chronic pain diseases. The general steps in an algorithm for any chronic pain syndrome should include a thorough evaluation, the provision of information and reassurance to the patient, and the prescription of appropriate treatment that may eliminate the cause of palliate symptoms. Also, patients should be recommended for interdisciplinary rehabilitation when there is no treatable cause and symptoms are likely to persist. Routine monitoring and careful documentation of symptoms and both physical and emotional functioning are essential. Even when conventional medical and surgical modalities are provided, residual symptoms are likely to persist. Thus, self-management and functional restoration should be considered as adjunctive treatments for all chronic pain patients. Excessive diagnostic testing and futile efforts to eliminate all pain are discouraged as they are both costly and repeated failures may lead to patient passivity, emotional distress, and greater disability. In the absence of a specific treatment that has the potential to eliminate the cause of the symptoms (e.g. surgery), the available clinical and cost outcomes data suggest that if pain persists following the natural course of the disease and after the patient has been provided with reassurance and information, an interdisciplinary treatment approach that focuses on self-management and functional restoration is most effective. There is minimal research on the integration of such rehabilitation programs with other commonly used approaches such as medication or surgery.
Tumor Necrosis Factor Leads to the Internalization and Degradation of Thrombomodulin From the Surface of Bovine Aortic Endothelial Cells in Culture

Tumor necrosis factor (TNF), a mediator of the inflammatory response, induces tissue factor and decreases the expression of thrombomodulin (TM) on endothelial cells, thus shifting the hemostatic properties of the endothelium. To determine the mechanism of TM downregulation, bovine aortic endothelial cells in culture were treated with TNF (2 nmol/L) and the fate of TM followed. Both surface expressed TM (antigen and activity), and the total TM pool (measured by radioimmunoassay and activity in detergent extracts) dropped to less than or equal to 20% of control values within 12 hours of TNF treatment. TM was not found in an immunologically recognizable form in the supernatants of treated cultures. Chloroquine (greater than or equal to 100 mumol/L) was able to abrogate the TNF effect on the total TM pool but not the effect on surface-expressed TM activity. We conclude that TNF induces the internalization and subsequent degradation of the TM molecule. None of the components of the protein C anticoagulant pathway, either alone or in combination, prevented the TNF-dependent downregulation of TM antigen.
I-cell disease, mucolipidosis II. Pathological, histochemical, ultrastructural and biochemical observations in four cases.

Pathological, histochemical, ultrastructural and biochemical studies on 4 cases of I-cell disease are reported. These studies support a lysosomal defect with deficiency of many acid hydrolases and storage of both glycolipids and mucopolysaccharides within lysosomes. The clinical, pathological and biochemical spectra of I-cell disease in these 4 cases suggest three distinct nosologic entities: a prototype, a malignant infantile form and a more benign juvenile type. Consanguinity was present in one of the cases. An autosomal recessive mode of inheritance seems most likely.
Stress, Trauma, and Posttraumatic Growth : Social Context, Environment, and Identities

What happens in the trauma’s aftermath? How do its effects manifest differently on the individual, family, and community-wide levels? Stress, Trauma, and Posttraumatic Growth: Social Context, Environment, and Identities explores the way traumatic events are defined, classified, and understood throughout the life cycle, placing special emphasis on the complex intersections of diverse affiliations and characteristics such as age, class, culture, disability, race and ethnicity, gender identity and expression, immigration status, political ideology, religion, sex, and sexual orientation. The book gives its readers a solid basis for understanding traumatic events and treating their effects and also shows the varied ways that trauma is conceptualized across cultures. Both new and seasoned clinicians will come away from Stress, Trauma, and Posttraumatic Growth with a deep understanding of the principles that guide successful trauma treatment.
Cervical Alignment and Sagittal Balance

In patients with cervical spine pathologies, surgical consideration of alignment and balance is critical for obtaining optimal outcomes [1]. Preoperative evaluation of these patients must therefore take into account baseline deformity, as well as potential risk of progression. As such, reliable methods of describing cervical alignment and balance and awareness of their surgical implications are of the utmost importance. Here, we describe standard parameters utilized in classification of cervical spine alignment, deformity, and their key clinical associations.
Medication Histories in Critically Ill Patients Completed by Pharmacy Personnel

Background: Although critically ill adults often have extended hospital lengths of stay and are at high risk of having medication-related adverse events, the value of medication histories in these ...
Ocular Prophylaxis for Gonococcal Ophthalmia Neonatorum: US Preventive Services Task Force Reaffirmation Recommendation Statement

Importance:In the United States, the rate of gonococcal ophthalmia neonatorum was an estimated 0.4 cases per 100 000 live births per year from 2013 to 2017. Gonococcal ophthalmia neonatorum can cause corneal scarring, ocular perforation, and blindness as early as 24 hours after birth. In the absence of ocular prophylaxis, transmission rates of gonococcal infection from mother to newborn are 30% to 50%. Objective:To reaffirm the US Preventive Services Task Force (USPSTF) 2011 recommendation on ocular prophylaxis for gonococcal ophthalmia neonatorum. Evidence Review:The USPSTF commissioned a reaffirmation evidence update to identify new and substantial evidence sufficient enough to change its prior recommendation. Findings:Using a reaffirmation process, the USPSTF found no new data that would change its previous conclusion that topical ocular prophylaxis is effective in preventing gonococcal ophthalmia neonatorum and related ocular conditions. The USPSTF found no new data that would change its previous conclusion that there is convincing evidence that topical ocular prophylaxis of all newborns is not associated with serious harms. Therefore, the USPSTF reaffirms its previous conclusion that there is convincing evidence that topical ocular prophylaxis for all newborns provides substantial benefit. Conclusions and Recommendation:The USPSTF recommends prophylactic ocular topical medication for all newborns to prevent gonococcal ophthalmia neonatorum. (A recommendation).
Unusual manifestations of Langerhans cell histiocytosis of the head and neck. Case report with pseudoaneurysm of external carotid artery, tracheal, mandibular, and sphenoid involvement.

Langerhans cell histiocytosis of the head and neck is an uncommon histiocytic proliferative disorder that often clinically resembles an inflammatory process. A pseudoaneurysm of the external carotid artery was found by contrast-enhanced CT and confirmed by Dopper ultrasonography and angiography in a 9 year old girl with a lytic lesion of the mandible, a prior severe tracheal inflammatory process, and sclerotic lesions of the sphenoid wings. Biopsies of the mandibular lesion, pseudoaneurysm, and trachea demonstrated Langerhans cell histiocytosis. In cases of LCH with head and neck involvement, contrast-enhanced CT allows adequately detailed initial evaluation of the protean manifestations of this disorder.
An Unsupervised Domain Adaptation Approach to Classification of Stem Cell-Derived Cardiomyocytes

The use of human embryonic stem cell-derived cardiomyocytes (hESC-CMs) in applications such as cardiac regenerative medicine requires understanding them in the context of adult CMs. Their classification in terms of the major adult CM phenotypes is a crucial step to build this understanding. However, this is a challenging problem due to the lack of labels for hESC-CMs. Adult CM phenotypes are easily distinguishable based on the shape of their action potentials (APs), but it is still unclear how these phenotypes are expressed in the APs of hESC-CM populations. Recently, a metamorphosis distance was proposed to measure similarities between hESC-CM APs and adult CM APs, which led to state-of-the-art performance when used in a 1 nearest neighbor scheme. However, its computation is prohibitively expensive for large datasets. A recurrent neural network (RNN) classifier was recently shown to be computationally more efficient than the metamorphosis-based method, but at the expense of accuracy. In this paper we argue that the APs of adult CMs and hESC-CMs intrinsically belong to different domains, and propose an unsupervised domain adaptation approach to train the RNN classifier. The idea is to capture the domain shift between hESC-CMs and adult CMs by adding a term to the loss function that penalizes their maximum mean discrepancy (MMD) in feature space. Experimental results in an unlabeled 6940 hESC-CM dataset show that our approach outperforms the state of the art in terms of both clustering quality and computational efficiency. Moreover, it achieves state-of-the-art classification accuracy in a completely different dataset without retraining, which demonstrates the generalization capacity of the proposed method.
Sarcopenia is Predictive of Functional Outcomes in Older Trauma Patients

Introduction Older patients are more vulnerable to poor outcomes after trauma than younger patients. Sarcopenia, loss of skeletal mass, is prevalent in trauma patients admitted to the intensive care unit (ICU), and it has been shown to correlate with adverse outcomes, such as mortality and ICU days. Yet, little is known whether it predicts other outcomes. We hypothesized that sarcopenia independently predicts poor functional outcomes in older trauma patients admitted to the ICU. Methods We performed a retrospective review of patients aged >55 admitted to a surgical ICU in a Level I trauma center for two years. Sarcopenic status was determined by measuring total skeletal muscle cross-sectional area at the L3 level on admission computed tomography (CT), normalized for height with sex-specific cutoffs. Primary outcome measures were in-hospital mortality, functional outcomes measured by the Glasgow Outcome Scale (GOS) at discharge, and discharge disposition. Multivariable logistic regression was used to determine predictors of primary outcomes. Results Out of 230 patients, 32% were sarcopenic. The overall mortality was 20%, and 30% were discharged with poor functional outcomes. A higher proportion of sarcopenic patients among survivors had poor functional outcomes at discharge (55% vs. 30%, p=0.002). Sarcopenia was not predictive of in-hospital mortality but was an independent predictor of poor functional outcomes at discharge (OR 2.6; 95% confidence interval [CI] 1.3-5.5), adjusting for age, Glasgow Coma Scale (GCS) on admission, diagnosis of traumatic brain injury (TBI), Injury Severity Score (ISS), and the number of life-limiting illnesses. Conclusions Sarcopenia is prevalent in geriatric trauma ICU patients and is an independent predictor of poor functional outcomes. Assessing for sarcopenia has an important potential as a prognostic tool in older trauma patients.
A Meta-analysis on the Outcome of Sequential Glaucoma Drainage Implantation.

Precis A meta-analysis shows that second glaucoma drainage implantation can be effective after a failed drainage implant. There is a need for continued glaucoma medications and the risk of corneal decompensation. Purpose Studies on second glaucoma drainage implantation are small and exploratory. We performed a meta-analysis on the efficacy of second glaucoma drainage implantation. Materials and methods The intraocular pressure (IOP) and the number of glaucoma medications were compared preoperative to postoperative after second drainage implantation. Kaplan-Meier survival curves were aggregated and compared with the survival curve from the Tube versus Trabeculectomy study. Results Nine studies, all retrospective, were included in the meta-analysis. Our results showed that second drainage implantation significantly lowered the IOP and reduced the number of medications. Most patients still required medications for adequate IOP control. Second drainage implants tended to fail earlier than first drainage implants in the Tube versus Trabeculectomy study. The most common complication after second drainage implants was corneal decompensation. Conclusions Second glaucoma drainage implantation can be considered a viable approach after a failed drainage implant, but patients should be counseled on the need for continued medical therapy and the risk of corneal decompensation.
The effect of deep AR suppression with enzalutamide or apalutamide on endogenous glucocorticoids: Implications for adverse effects and development of combination therapies.

17Background: Metabolic consequences of potent AR suppression with enzalutamide and apalutamide are unresolved. Endocrine perturbations induced by potent AR antagonists may promote adverse effects ...
Contemporary College Students

The stereotypical image of the “college student” is an early 20s white middle-class individual whose parents have higher education and high enough income to pay for four years of said student’s tui...
Good Feature Matching: Toward Accurate, Robust VO/VSLAM With Low Latency

Analysis of state-of-the-art visual odometry/visual simultaneous localization and mapping (VSLAM) system exposes a gap in balancing performance (accuracy and robustness) and efficiency (latency). Feature-based systems exhibit good performance, yet have higher latency due to explicit data association; direct and semidirect systems have lower latency, but are inapplicable in some target scenarios or exhibit lower accuracy than feature-based ones. This article aims to fill the performance-efficiency gap with an enhancement applied to feature-based VSLAM. We present good feature matching, an active map-to-frame feature matching method. Feature matching effort is tied to submatrix selection, which has combinatorial time complexity and requires choosing a scoring metric. Via simulation, the Max-logDet matrix revealing metric is shown to perform best. For real-time applicability, the combination of deterministic selection and randomized acceleration is studied. The proposed algorithm is integrated into monocular and stereo feature-based VSLAM systems. Extensive evaluations on multiple benchmarks and compute hardware quantify the latency reduction and the accuracy and robustness preservation.
The burden they bear: A scoping review of physician empathy in the intensive care unit.

Abstract Purpose Research shows that physician empathy can improve patients' reporting of symptoms, participation in care, compliance, and satisfaction; however, success in harnessing these advantages in the ICU hinges on a myriad of contextual factors. This study describes the current state of knowledge about intensivists' empathy. Methods A scoping review was conducted across six databases and grey literature to clarify intensivists' experiences of empathy and identify directions of future inquiries. The search had no date limits and was specific to empathy, intensivists, and ICU environments. Results were blindly and independently reviewed by authors. Results The search yielded 628 manuscripts; 45 met inclusion criteria. Three overarching themes connected the manuscripts: (1) the risks and benefits of empathy, (2) the spectrum of connection and distance of intensivists from patients/families, and (3) the facilitators and barriers to empathy's development. Conclusion Empathy among intensivists is not a dichotomous phenomenon. It instead exists on continua. Four steps are recommended for optimizing empathy in the ICU: clearly defining empathy, addressing risks and benefits transparently, providing education regarding reflective practice, and developing supportive environments. Overall, this review revealed that the state of knowledge about empathy as experienced by intensivists still has room to grow and be further explored.
multi-scale validation of radomic features in triple negative breast cancer

1003 Introduction: The significance of radiomic features to the underlying tumor biology is not well understood. Quantitative image features are highly dependent on the accuracy of image segmentation, registration, modeling, and variation of image resolutions. Therefore, computational methods are needed to correlate image features with the underlying biology. Our objective was to correlate radiomic features of [18F] fluorodeoxyglucose (FDG) radioisotopic images with hematoxylin and eosin (H&E) histopathology across scales at both high resolution and at translationally-relevant FDG-PET images resolution using triple negative breast cancer (TNBC) patient-derived tumor xenograft (PDX). Methods: Following preclinical FDG-PET imaging, PDX tumors (N=5) were removed, flash frozen, and cut into thirty-six 10 μm slices with alternate 2D slices used for H&E histology or radioisotopic imaging using a GE Typhoon FLA9500. Multi-slice 2D autoradiographic images were segmented using a combination of level-set , and watershed method. A combination of image translation, rotation and registration was also used to compare between radioisotopic and H&E images. The segmented high-resolution images were degraded to low resolution using bicubic interpolation and gaussian blurring to achieve a full-width-half-max (FWHM) of 1.7mm corresponding to preclinical PET resolution. Then 129 radiomics were extracted as per IBSI guideline from PET (high and low resolution) and correlated against H&E images cytometric features. Linear regression was used to investigate correlations between the PET and H&E radiomics. Result: The proposed segmentation method was tested and compared with pathology images. The segmentation accuracy was > 95%, and relative area error was ≤ 5%. H&E and radiographic images and their co-registered image are shown in Figure 1 (A). The high-resolution radiographic images and corresponding low-resolution images are shown in Figure 1 (B). Thirty eight out of 129 radiomics features exhibited significant correlation (slope p-value 0.4) between H&E and high resolution radioisotopic imaging, but poor correlation with the corresponding low-resolution image is shown in Figure 1 (D). Conclusions: We developed a pipeline to correlate radiomic features between multi-scale PET images to H&E pathology that will be useful for classification and characterization of tumor features. Numerous features correlated significantly between H&E and radioisotopic images following image degradation, which is useful to identify clinically relevant radiomic features. These findings suggest that his pipeline can be used to validate PET (and potentially) MR features against underlying biology using H&E or other immune-histo pathology techniques. Our future vision is to develop stable and robust radiomics biomarkers linked to tumor biology for diagnostic purposes.
Non-ALJ Adjudicators in Federal Agencies: Status, Selection, Oversight, and Removal

This article republishes—in substantively similar form—our 2018 report to the Administrative Conference of the United States (ACUS) concerning federal agencies’ adjudicators who are not administrative law judges (ALJs). (We refer to these adjudicators as “non-ALJ Adjudicators” or “non-ALJs.”) As our data indicate, non-ALJs significantly outnumber ALJs. Yet non-ALJs are often overlooked and difficult to discuss as a class because of their disparate titles and characteristics. To obtain more information on non-ALJs, we surveyed agencies on non-ALJs’ hearings and, among other things, the characteristics concerning non-ALJs’ salaries, selection, oversight, and removal. We first present our reported data on these matters, which are the most comprehensive data to date on the non-ALJs’ indicia of impartiality. We then provide suggested practices for agencies to promote non-ALJs’ actual and apparent impartiality in presiding over agency hearings.
Robotic surgery training during general surgery residency: a survey comparing attitudes towards a robotic training curriculum within general surgery, urology, and OBGYN residents and attendings.

General surgery residents are increasingly exposed to robotic surgery during their training. However, there is no standardized robotic educational curriculum across United States residency programs. Prior to implementing a robotic surgery curriculum, we surveyed our residents and attendings to ascertain their attitude towards robotic surgery training in residency. An anonymous survey was distributed to all general surgery, obstetrics and gynecology (OBGYN), and urology residents, and their respective attending staff at our institution. Responses were compared between residents, attendings, and specialty. Twenty-six (72% response rate) general surgery residents and 18 (47%) subspecialty residents (OBGYN and urology) responded to the survey. Among attendings, 21 general surgery (32%) and 18 subspecialty staff (27%) responded. The majority of general surgery residents and attendings agreed that a robotic surgery curriculum should be implemented in the general surgery residency program (100 vs 86%, p = 0.04). Subspecialty residents also believed a formal curriculum should be implemented within their respective programs (100%). There was no statistically significant difference between general surgery and subspecialty resident responses. The majority of general surgery and subspecialty attendings responded that they would want a robotic surgery curriculum if they were currently residents (76 vs 94%, p = 0.12). The majority of general surgery residents and attendings at our institution believe a robotic surgery curriculum should be offered during residency. This attitude is similar to those of the subspecialty residents and attendings. A surgical education initiative should be developed to create a standardized training program to assure teaching of basic technical skills in robotic surgery before trainees enter clinical practice.
MR1-Restricted Vα19i Mucosal-Associated Invariant T Cells Are Innate T Cells in the Gut Lamina Propria That Provide a Rapid and Diverse Cytokine Response

Mucosal-associated invariant T (MAIT) cells reside primarily in the gut lamina propria and require commensal flora for selection/expansion. They are restricted by the highly conserved MHC class I-related molecule MR1 and, like most NK T cells, express an invariant TCRα chain. Although they probably contribute to gut immunity, MAIT cells have not been functionally characterized because they are so rare. To create a model in which they are more abundant, we generated transgenic mice expressing only the TCRα chain (Vα19i) that defines MAIT cells. By directly comparing Vα19i transgenic mice on MR1+/+ and MR1−/− backgrounds, we were able to distinguish and characterize a population of Vα19i T cells dependent on MR1 for development. MR1-restricted Vα19i transgenic T cells recapitulate what is known about MAIT cell development. Furthermore, a relatively high proportion of transgenic MAIT cells express NK1.1, and most have a cell surface phenotype similar to that of Vα14i NK T cells. Finally, MR1-restricted Vα19i T cells secrete IFN-γ, IL-4, IL-5, and IL-10 following TCR ligation, and we provide evidence for what may be two functionally distinct MAIT cell populations. These data strongly support the idea that MAIT cells contribute to the innate immune response in the gut mucosa.
A 165-base pair sequence between the dihydrofolate reductase gene and the divergently transcribed upstream gene is sufficient for bidirectional transcriptional activity.

Abstract The dihydrofolate reductase gene encodes a key enzyme of one-carbon metabolism and is constitutively expressed in all cells. Recently, transcripts initiated at 89 base pairs upstream from the transcriptional initiation site of the dihydrofolate reductase gene and transcribed from the opposite strand have been identified and shown to encode for a protein with homology to a bacterial DNA mismatch repair enzyme (Fujii, H., and Shimada, T. (1989) J. Biol. Chem. 264, 10057-10064). Therefore, the two genes are organized in a head-to-head configuration separated by an 89-base pair segment. The promoter activities of this short spacer sequence were studied in a transient assay using the chloramphenicol acetyltransferase and the guanine phosphoribosyltransferase genes as reporters. A 165-base pair fragment from -111 to +54 relative to the dihydrofolate reductase initiation site was shown to be sufficient for transcriptional activity in either direction, suggesting that expression of the two divergent genes is regulated by a bidirectional promoter that may use common regulatory elements.
Effects of urease inhibition in hyperammonemia: clinical and experimental studies with acetohydroxamic acid.

Summary Acetohydroxamic acid (AHA), an inhibitor of urease, was used in the treatment of coma and azotemia complicating hepatic failure on six occasions in 5 patients. Under the circumstances of the study, no consistent clinical effect was observed, but a significant reduction in blood am monia concentrations was produced. In dogs with Eck fistulas, AHA reduced fasting blood ammonia concentrations and prevented the hyperammonemia which otherwise occurred after intravenous administration of urea. In animals, the compound is rapidly absorbed from the gastrointestinal tract and excreted in the urine, and no toxic effects were observed. These preliminary data warrant further investigation of the compound as an adjunct to treatment in some instances of hepatic coma.
Zinc-Binding Protein ZnuA

ZnuA is a high-affinity, periplasmic zinc (Zn2+)-binding protein that is a component of a three-protein ABC transport system. The overall structure of ZnuA is very similar to the previously determined structures of the periplasmic domains of the ABC metal transporters PsaA and TroA. ZnuA has a ‘C clamp’ shape, which is composed of two (β/α)4 domains related by pseudo twofold symmetry. Also like the other metal transporters, the two domains are linked by a 33-residue α-helix. This likely keeps the two domains in a relatively fixed position as made evident by the lack of large domain movement upon binding and release of metal. Unlike PsaA and TroA, however, there is an extended loop near the metal-binding cleft, which is rich in histidines and acidic residues. Structural studies demonstrate that the removal of this loop does not affect the structure of ZnuA, and isothermal titration calorimetry (ITC) studies show that this loop contains low-affinity zinc-binding sites but does not directly affect the binding of zinc to the high-affinity site within the cleft. Together, these results suggest that this unusual loop region may play a role in the regulation of zinc uptake when the periplasmic concentration of zinc is high. 3D Structure Keywords: zinc; ABC transport; Synechocystis; regulation; solute-binding domain
Measuring graphene adhesion using atomic force microscopy with a microsphere tip

Van der Waals adhesion between graphene and various substrates has an important impact on the physical properties, device applications and nanomanufacturing processes of graphene. Here we report a general, high-throughput and reliable method that can measure adhesion energies between ultraflat graphene and a broad range of materials using atomic force microscopy with a microsphere tip. In our experiments, only van der Waals force between the tip and a graphene flake is measured. The Maugis–Dugdale theory is employed to convert the measured adhesion force using AFM to the adhesion energy. The ultraflatness of monolayer graphene on mica eliminates the effect of graphene surface roughness on the adhesion, while roughness of the microsphere tip is addressed by the modified Rumpf model. Adhesion energies of monolayer graphene to SiO2 and Cu are obtained as 0.46 and 0.75 J m−2, respectively. This work provides valuable insight into the mechanism of graphene adhesion and can readily extend to the adhesion measurement for other 2D nanomaterials.
QCD corrections to weak decays

Abstract Weak decays are significantly altered by effects of strong interaction. In the K system these corrections give rise to Δ I = 1 2 rule, and have measurable effects on rare weak process like K →π v v , K →π e + e − and ϵ′ ϵ . The situation in the K system is briefly reviewed. Strong interaction effects are also important in D and B system. A possible mechanism for D + -D 0 life-time difference is reviewed and then rare B processes are dealt with extensively. Electromagnetic penguin diagrams are enhanced by QCD corrections, giving rise to process like B → K ∗ γ and B → Ke + e − . Process mediated by gluon penguins are also discussed.