cssi/SciSciGPT-SciSciNet huggingface dataset:
Leucopenia resulting from a drug interaction between azathioprine or 6-mercaptopurine and mesalamine, sulphasalazine, or balsalazide

AIM We evaluated the effect of coadministration of sulphasalazine, mesalamine, and balsalazide on the pharmacokinetics and pharmacodynamics of azathioprine and 6-mercaptopurine. METHODS Thirty four patients with Crohn9s disease receiving azathioprine or 6-mercaptopurine were enrolled in an eight week non-randomised parallel group drug interaction study and treated with mesalamine 4 g/day, sulphasalazine 4 g/day, or balsalazide 6.75 g/day. The primary outcome measure was the occurrence of clinically important leucopenia during the study, defined separately as total leucocyte counts 9 /l and ⩽3.5×10 9 /l. Whole blood 6-thioguanine nucleotide concentrations were determined. RESULTS Three patients could not be evaluated for the primary outcome measure. In the remaining 31 patients, the frequency of total leucocyte counts CONCLUSIONS In patients with Crohn9s disease receiving azathioprine or 6-mercaptopurine, coadministration of mesalamine, sulphasalazine, and possibly balsalazide results in an increase in whole blood 6-thioguanine nucleotide concentrations and a high frequency of leucopenia.
Processor architectures for fault tolerant avionic systems

The authors consider the application of modern processor architectures to avionics systems requiring fault masking during critical flight dynamic phases such as ascent or entry. Fault masking implies uninterrupted control during the period of fault detection, identification and recovery (FDIR). To provide this uninterrupted control requires tight coordination between redundant processors. The impact of the requirement for fault masking capability through tightly coupled processors on modern processor architectures is discussed. >
Quantum theory of a second-order soliton based on a linearization approximation

A linearized perturbation quantum theory of second-order soliton propagation is developed. The theory shows that the quantum fluctuations of photon number, phase, momentum, and position at an arbitrary propagation distance are linear combinations of these fluctuations at zero distance. The evolutions of second-order soliton quantum fluctuations are evaluated and compared with the quantum-fluctuation evolutions of a fundamental soliton. Based on this theory, the squeezing effect of a second-order soliton is studied. It is shown that, like a fundamental soliton, a second-order soliton also exhibits squeezing along propagation when a proper combination of the number and phase operators is detected.
Cross-Layer Modeling for QoS-Driven Multimedia Multicast/Broadcast over Fading Channels in [Advances in Mobile Multimedia]

In this article we propose a cross-layer design model for multimedia multicast/broadcast services to efficiently support the diverse quality of service requirements over mobile wireless networks. Specifically, we aim at achieving high system throughput for multimedia multicast/broadcast while satisfying QoS requirements from different protocol layers. First, at the physical layer, we propose a dynamic rate adaptation scheme to optimize the average throughput subject to the loss rate QoS constraint specified from the upper-layer protocol users. We investigate scenarios with either independent and identically distributed (i.i.d.) or non-i.i.d. fading channels connecting to different multicast receivers. Then, applying the effective capacity theory at the data link layer, we study the impact of the delay QoS requirement (i.e., QoS exponent) on the multimedia data rate of mobile multicast/broadcast that our proposed scheme can support. Also presented are simulation results which show the trade-off among different QoS metrics and the performance superiority of our proposed scheme as compared to the other existing schemes.
Tissue Acquisition in Patients with Suspected Lung Cancer: Techniques Available to the Pulmonologist

The method of diagnosis and staging of lung cancer for the most part depends on the type of lung cancer, small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC), the size and location of the primary tumor, the stage, and the overall clinical status of the patient. Although it is reassuring that the accuracy of differentiating between SCLC and NSCLC generated by various diagnostic techniques is excellent (Rivera et al. Chest 143(5 Suppl):e142S, 2013), treatment of NSCLC now relies on accurate histopathologic diagnosis and molecular characterization of the tumor. In recent years, we have witnessed a revolution in our understanding of the molecular genotype of lung cancer, and certain molecular determinants not only guide treatment decision-making but also have a prognostic and predictive function. Clinicians who perform diagnostic procedures in lung cancer need to be familiar with the array of options for tissue acquisition as well as the importance of judicious handling of specimens in order to derive the most information from each procedure.
Afro-Peruvian Spanish: Spanish slavery and the legacy of Spanish Creoles

The present work not only contributes to shedding light on the linguistic and socio-historical origins of Afro-Peruvian Spanish, it also helps clarify the controversial puzzle concerning the genesis of Spanish creoles in the Americas in a broader sense. In order to provide a more concrete answer to the questions raised by McWhorter’s book on The Missing Spanish Creoles, the current study has focused on an aspect of the European colonial enterprise in the Americas that has never been closely analyzed in relation to the evolution of Afro-European contact varieties, the legal regulations of black slavery. This book proposes the 'Legal Hypothesis of Creole Genesis', which ascribes a prime importance in the development of Afro-European languages in the Americas to the historical evolution of slavery, from the legal rules contained in the Roman Corpus Juris Civilis to the codes and regulations implemented in the different European colonies overseas. This research was carried out with the belief that creole studies will benefit greatly from a more interdisciplinary approach, capable of combining linguistic, socio-historical, legal, and anthropological insights. This study is meant to represent an eclectic step in such a direction.
“Transforming” the Conversation: Rethinking Fair Use in Academic Course Reserves

The Association of Research Libraries' 2012 publication, Code of Best Practices in Fair Use for Academic and Research Libraries, focuses heavily on the concept of transformative use within the fair use analysis. In some cases, the Association of Research Libraries advocates for using the entire work in an electronic format for course reserves. However, current approaches to electronic course reserves and fair use/transformative use arguments are not conducive to utilizing the Association of Research Libraries' recommendations. This article attempts to reframe the conversation by examining fair use in a broad context and the role of the class in the fair use analysis.
Evidence for an Involvement of the Renal Papilla in Hypertension

Several classic experiments support the view that the kidney exerts a nonexcretory antihypertensive function. Bilateral nephrectomy plus a sodium–volume load causes hypertension (Braun–Menendez and Von Euler, 1947; Grollman et al., 1949), while ureterovenous anastomosis (Grollman et al., 1949; Floyer, 1955; Muirhead, 1962) under similar circumstances prevents hypertension. Destruction of the renal papilla is attended by hypertension induced by sodium and volume (Muirhead et al., 1950, 1960a) on the one hand, and by aggravation of existing hypertension, on the other (Heptinstall et al., 1975). Unclipping of a one-kidney, one-clip hypertensive rat is followed by normalization of the arterial pressure within 24 hr or less (Byrom and Dodson, 1949; Floyer, 1955; Muirhead et al., 1976). Ureterovenous anastomosis plus unclipping is also attended by normalization of the arterial pressure (Floyer, 1955; Muirhead et al.., 1976), even though a longer time interval may be required. Indeed, ureterovenous anastomosis plus a saline load given intravenously (1.25-2.5% of the body weight) followed by unclipping is also attened by normalization of the arterial pressure, but additional time is needed (Muirhead and Brooks, 1980). Unclipping while an intravenous saline infusion equal to or greater than the urine loss is maintained is also attended by a normal pressure within 20 hr (Muirhead et al., 1976; Neubig and Hoobler, 1975). Thus, the recession of the arterial pressure in the ureterovenous experiment is not caused by substances entering the circulation via the ureter. Paired sham-operated controls for these manipulations had no change of the arterial pressure over the same time
Probability of atrial fibrillation after ablation: Using a parametric nonlinear temporal decomposition mixed effects model:

Atrial fibrillation is an arrhythmic disorder where the electrical signals of the heart become irregular. The probability of atrial fibrillation (binary response) is often time varying in a structured fashion, as is the influence of associated risk factors. A generalized nonlinear mixed effects model is presented to estimate the time-related probability of atrial fibrillation using a temporal decomposition approach to reveal the pattern of the probability of atrial fibrillation and their determinants. This methodology generalizes to patient-specific analysis of longitudinal binary data with possibly time-varying effects of covariates and with different patient-specific random effects influencing different temporal phases. The motivation and application of this model is illustrated using longitudinally measured atrial fibrillation data obtained through weekly trans-telephonic monitoring from an NIH sponsored clinical trial being conducted by the Cardiothoracic Surgery Clinical Trials Network.
Comenius and Savitribai Phule

Two extraordinary leaders, Jan Comenius (1592-1670) and Savitribai Phule (1831-1897), widely designated as father of modern education and mother of modern India education, are presented as worldvoice, worldview, and worldvenue colleagues. Informed by historians Arend van Leeuwen and David Freedman, philosopher Stephen Pepper, and economist Samir Amin, the cultural matrix of Comenius and Savitribai is delineated through their “Wv3”: their common worldvoice (individual virtuous, prototype person), who elicited their common worldview (holistic intellectual mindset), which informed their resultant worldvenue (social and behavioral mazeway) in education. It is noted that though separated by centuries and cultures, Comenius and Savitribai both chose Jesus as their prototype person, their worldvoice. It is then argued that Comenius’ mature educational worldview replaced monastic education for the privileged that neglected peasant classes with “universal education,” one school system for all children; and that Phule rejected Brahmin education of only pure males which forbade education of polluted castes, radicalized by her fresh worldview of “universal rights” for all, all children created equal by the Creator of all. Thus, both leaders, Comenius and Savitribai, independently yet similarly, forged an uncommon educational worldvenue where education is universally available, child sensitive, intellectually critical, and socially reforming.
Comparison of weigh-suckle-weigh and machine milking for measuring ewe milk production.

Thirteen crossbred ewes were used to compare weigh-suckle-weigh (WSW) and machine milking (MM) methods for determining milk production of ewes that were rearing single or twin lambs. At parturition, ewes were 13 mo of age and produced six single lambs and seven pairs of twin lambs. Milk production estimates were initiated on d 6 of lactation and a 3-d rotation of the two techniques was implemented. On d 6, milk production was measured using WSW; on d 7, MM was used. No measurement was made on d 8. The 3-d rotation was repeated 20 times throughout a 63-d lactation, resulting in 20 point estimates of milk production for each method of measurement for each ewe. The WSW procedure consisted of a 3-h period in which lambs were withheld from suckling their dams. This was followed by a suckling period, a second 3-h withholding period, and a second suckling period. Differences in pre- and postsuckling lamb weights of the second suckling period were defined as milk consumption and, indirectly, 3-h milk production. The MM procedure included an administration of 10 IU of oxytocin (i.v.), followed by evacuation of the udder with a machine using commercially available sheep milking equipment, and the milk was discarded. Lambs were withheld from suckling the ewes for a 3-h period, followed by a repetition of the oxytocin and machine milking procedures. Milk from the second milking was weighed. Milk production estimates determined using the WSW and MM techniques were similar ( P =.42). Average 3-h milk production was 340 and 351 g for WSW and MM, respectively. Machine milking provides a reliable tool in evaluating the milk-producing ability of ewes that are rearing single or twin lambs.
CD1b-autoreactive T cells recognize phospholipid antigens and contribute to antitumor immunity against a CD1b+ T cell lymphoma

Adoptive immunotherapy for cancer treatment is an emerging field of study. Till now, several tumor-derived, peptide-specific T cell responses have been harnessed for treating cancers. However, the contribution of lipid-specific T cells in tumor immunity has been understudied. CD1 molecules, which present self- and foreign lipid antigens to T cells, are divided into group 1 (CD1a, CD1b, and CD1c) and group 2 (CD1d). Although the role of CD1d-restricted natural killer T cells (NKT) in several tumor models has been well established, the contribution of group 1 CD1-restricted T cells in tumor immunity remains obscure due to the lack of group 1 CD1 expression in mice. In this study, we used a double transgenic mouse model expressing human group 1 CD1 molecules (hCD1Tg) and a CD1b-restricted, self-lipid reactive T cell receptor (HJ1Tg) to study the potential role of group 1 CD1-restricted autoreactive T cells in antitumor response. We found that HJ1 T cells recognized phospholipids and responded more potently to lipid extracted from tumor cells than the equivalent amount of lipids extracted from normal cells. Additionally, the autoreactivity of HJ1 T cells was enhanced upon treatment with various intracellular toll-like receptor (TLR) agonists, including CpG oligodeoxynucleotides (ODN), R848, and poly (I:C). Interestingly, the adoptive transfer of HJ1 T cells conferred protection against the CD1b-transfected murine T cell lymphoma (RMA-S/CD1b) and CpG ODN enhanced the antitumor effect. Thus, this study, for the first time, demonstrates the antitumor potential of CD1b-autoreactive T cells and their potential use in adoptive immunotherapy.
Development and Structure/Property Relationship of New Electron Accepting Polymers Based on Thieno[2′,3′:4,5]pyrido[2,3-g]thieno[3,2-c]quinoline-4,10-dione for All-Polymer Solar Cells

Several electron accepting polymers having weak accepting–strong accepting (WA-SA) and strong accepting–strong accepting (SA-SA) monomer alternation were synthesized for studies of structure/property relationship in all-polymer solar cells. Two kinds of cyclic amide monomers, 4,10-bis(2-butyloctyl)-thieno[2′,3′:5,6]pyrido[3,4-g]thieno-[3,2-c]isoquinoline-5,11-dione (TPTI) and 5,11-bis(2-butyloctyl)-thieno[2′,3′:4,5]pyrido[2,3-g]thieno[3,2-c]quinoline-4,10-dione (TPTQ), were synthesized as weak accepting monomers (WA). Difluorinated TPTQ (FTPTQ) and well-known perylene diimide (PDI) monomers were synthesized as strong electron accepting monomers (SA). By using 1-chloronaphthalene (CN) as a cosolvent, the morphology of the polymer blended films can be finely tuned to achieve better ordering toward face-on mode and favorable phase separation between electron donor and acceptor, resulting in significant enhancement of short circuit current (Jsc) and fill factor (FF). The fluorination in the TPTQ unit reduced ...
Comparing the Utilization of Health Care Resources in Children with ALL and AML Based on Geographic Location: A Retrospective Analysis Utilizing the PHIS Database

Introduction : Geographic barriers play a major role in access to health care and can increase health care utilization, especially in the Pediatric cancer patients where leukemia and treatment related complications are life threatening if not promptly managed. Objective : To assess health care utilization and costs in the pediatric ALL and AML population based on geographic distance from their primary cancer center based on the hypothesis that those living further away would incur greater cost due to delays in seeking and/or receiving care. Methods : To study this, we analyzed data from the Pediatric Health Information System (PHIS) database, which collects information for inpatient resource utilization at 45 children9s hospitals in the USA. Data from patient9s ≤ 21 years of age with the diagnosis of ALL or AML by ICD-9 code between the first quarter 2010 and the third quarter 2013 were used. The total number of hospitalizations and resources utilized and billed were measured 1 year following the index visit for ALL and 6 months for AML. Data collected were total cost / day, length of stay (LOS), and prevalence of ICU, TPN, and ventilator use. Stratified data depending on chemotherapy vs. non-chemotherapy stays were compared between children living 60 miles from the PHIS hospital using chi-square and Wilcoxon rank-sum statistics (Tables A & B). Results : Hospital admissions for chemotherapy (12,884) and non-chemotherapy (13,842) were recorded in the ALL group. Among chemotherapy admissions, no statistical significance in ICU, TPN or ventilator days in those 60 miles from the hospital admitted for non-chemo purposes. In children with AML, 2,855 chemo- and 1,414 non-chemo-related admissions were recorded. Those admitted for chemo living >60 miles away, had longer LOS, and more ICU use (4.1% vs. 6.7%, p=0.09), yet had lower cost per day. Those admitted for non-chemo purposes living ≥60 miles away had more prevalent ICU (8.3% vs. 14.5%, p=0.03) and TPN use (9.7% vs. 15.7%, p=0.06), and greater hospitalization cost and cost per day. Conclusion : Geographic distance from cancer centers increases health care resource consumption and cost especially in the unplanned admissions for complications in children with ALL and AML. Prospective studies are needed to confirm the resource utilization and costs associated with geographic distance from cancer center resources and should be considered in pediatric cancer center outreach planning. Disclosures No relevant conflicts of interest to declare.
Principios básicos de la anestesia neonatal

Resumen Introduccion En los neonatos existen diferencias significativas de desarrollo en la fisiologia y la farmacologia que hacen que sea mucho mas dificil llevar a cabo una anestesia segura. Objetivos Completar una revision focalizada del conocimiento actual sobre las diferencias fisiologicas y farmacologicas observadas en recien nacidos que tienen un impacto en la administracion segura de la anestesia. Metodos Se llevo a cabo una revision selectiva de la literatura sobre cambios en el desarrollo fisiologico y farmacologico. Resultados El conocimiento adquirido en esta revision fue usado para establecer principios comunes para la administracion segura de la anestesia en pacientes recien nacidos. Conclusion A pesar de la persistencia de grandes lagunas en nuestro conocimiento en esta fisiologia y farmacologia, los principios modernos y comunes del manejo de la anestesia en cirugia neonatal han mejorado significativamente los resultados clinicos.
A hemodialysis cohort study of protocol-based anticoagulation management.

Abstract Background Chronic hemodialysis patients frequently require anticoagulation treatment with warfarin for a variety of co-morbidities. The optimal method for monitoring and dose adjustment of warfarin-based anticoagulation in this population, however, remains unclear. To examine this more closely, we reviewed all hemodialysis patients at a single institution on chronic warfarin therapy for a 10-month period prior to and after the institution of a standardized protocol for warfarin dose adjustment and monitoring. Anticoagulation efficacy was assessed by time within the therapeutic INR range (TTR), and resource utilization was assessed by the number of weekly INR measurements required for monitoring. Results We retrospectively analyzed 4481 patient-days of warfarin therapy data (from 25 hemodialysis patients) in the pre-protocol timeframe, and 3308 patient-days of warfarin therapy data (from 21 hemodialysis patients) in the on-protocol timeframe. Time within the therapeutic INR range (TTR) did not improve with institution of the dosing protocol—51.18% using non protocol-based management, and 51.57% using protocol-based management (p 0.73). However, overall resource utilization was reduced with institution of protocolized warfarin monitoring—from 1.71 INR measurements per patient-week pre-protocol, to 1.20 INR measurements per patient-week (p Conclusions In this single-center study, institution of a standardized dosing protocol in a hemodialysis population on chronic warfarin therapy did not improve the rate of on-target anticoagulation, but did result in significantly lower resource utilization. We support protocol-based warfarin management in the hemodialysis population, but future work should examine the rate of on-target anticoagulation typically achieved in this group.
Population genetic structure and comparative diversity of smallmouth bass Micropterus dolomieu: congruent patterns from two genomes

Genetic diversity and divergence patterns of smallmouth bass Micropterus dolomieu spawning groups are analysed across its northern native range with mtDNA cytochrome b gene sequences and eight unlinked nuclear DNA microsatellite loci. Results reveal high levels of genetic variability and significant differences in allelic representation among populations (mtDNA: mean ± s.e., HD = 0·50 ± 0·06, mean ± s.e., θST = 0·41 ± 0·02 and microsatellites: mean ± s.e. HO = 0·46 ± 0·03, mean ± s.e. θST = 0·25 ± 0·01). The distributions of 28 variant mtDNA haplotypes, which differ by an average of 3·94 nucleotides (range = 1-8), denote divergent representation among geographic areas. Microsatellite data support nine primary population groups, whose high self-assignment probabilities likewise display marked divergence. Genetic patterns demonstrate: (1) high genetic diversity in both genomes, (2) significant divergence among populations, probably resulting from natal site homing and low lifetime migration, (3) support for three post-glacial refugia that variously contributed to the current northern populations, which remain evident today despite waterway connectivity and (4) a weak yet significant genetic isolation by geographic distance pattern, indicating that other processes affect the differences among populations, such as territoriality and site fidelity.
Indicators of Engagement

As institutions of higher education reshape their organizational and administrative structures and functions in alignment with community-based education and civic renewal, there has emerged a framework for the “engaged campus.” This essay traces the emergence of the engaged campus in the late 20th century as the developments in service-learning converged with widespread recognition of a national crisis defined by civic disintegration. Working from the conceptual framework of an engaged campus, the authors identify and provide current examples of ten critical “indicators” of community and civic engagement that indicate that an institution is establishing the essential foundations for engagement.
Metal Gate Electrodes

Metal gate electrodes are a vital enabler for the use of high-k gate dielectrics in advanced complimentary metal oxide semiconductor (CMOS) technology. This chapter will detail how metal gate electrodes were selected over poly-Si electrodes to be used in conjunction with high-k gate dielectrics, how metal gate electrodes are an important component of device scaling, and how the of the metal gate can be tuned to optimize the device performance. In this chapter you will see how the properties of the metal gate are inseparable from those of the high-k gate dielectric and how the metal gate can be manipulated to intentionally influence the properties of the dielectric material to produce a desired device response. This chapter will discuss the different ways in which metal gates can be used to change the effective work function of a MOS transistor, including the vacuum work function, dielectric/metal capping layers, and oxygen vacancy manipulation. In each of these cases there is a clear interplay between the metal gate and the gate dielectric and it is important to understand both materials systems in order to understand the device response. Finally, this chapter will detail the common approaches of integrating metal gate electrodes in a complimentary metal oxide semiconductor. Because there are various methods of modulating the effective work functions by using metal gate electrodes, there are multiple integration schemes that have been devised in order to produce optimized nMOS and pMOS transistors.
Testing by Competitors in Enforcement of Product Standards

Firms have an incentive to test competitors’ products to reveal violations of safety and environmental standards, in order to have competitors’ products blocked from sale. This paper shows that tes...
Breast carcinoma presenting as mammographic microcalcifications in axillary lymph nodes

While pleomorphic microcalcifications are commonly noted in the breast during mammography, the presence of such microcalcifications within axillary lymph nodes on mammography is rare. As there are no recent reported cases in the literature, this case report documents occult, metastatic papillary adenocarcinoma involving 5 of 16 lymph nodes in a patient presenting with microcalcifications in axillary nodes on mammography. More common causes of calcifications seen in axillary nodes on mammography are reviewed and include intranodal deposition of gold rather than calcium in patients treated for rheumatoid arthritis and as a sequelae in children following BCG vaccination. The technical approach for needle-directed biopsy of these microcalcifications is also discussed
MESSAGES FROM SYSTEMS TO USERS: A PROPOSAL FOR STANDARDIZATION

There is universal agreement among users that messages from computer systems are unnecessarily complicated. This is, of course, because the messages are created by and for system designers and not for users. Here, I suggest a standard for messages. The basic proposal is that the user, at entry to the system, be permitted to declare levels of expertise in computing and in the subject matter of the system, as well as levels of interest in these areas. The messages would then be restricted both in form and content to those particular levels. The proposal will be illustrated by a model of a statistical package.
The Non-Thermal Exhaust System II. MagneticWinds and Jets

Launching of the MHD wind is only the beginning of the nonthermal exhaust outflow. Just as the thermal exhaust is accelerated away from the injection region by pressure gradients, so the MHD wind also is significantly accelerated, and collimated into a jet, beyond the launching region. Furthermore, just as the thermal wind becomes causally disconnected from the engine beyond a critical (sonic) surface, and subsequently expands away freely and supersonically, so the nonthermal exhaust is accelerated through a series of MHD critical and separatrix surfaces, eventually becoming a freely propagating jet flow beyond the final separatrix surface.
Margaret of Anjou and the Rhetoric of Sovereign Vengeance

Critics discussing Queen Margaret of Anjou in Shakespeare’s Henry VI tetralogy have frequently described her as “masculine” or “androgynous” in her revenging anger. However, Margaret’s agency is explicitly marked as feminine, linked to her identification as queen, mother, and wife, as well as Stoic discourses of the passions that label excess of any emotion as unmasculine. I contend that Margaret’s wrath is a dangerously degenerative force that estranges the one-sex Galenic body from masculine fixity. She uses this feminine rage to rhetorically assert a sovereign identity that she never legally possesses and, moreover, trains other women in this revenging rhetoric. While revenge is a deranging force for the men in the play, it provides Margaret with a rhetoric to construct a position of sovereignty.
Nondestructive evaluation of thermal aging of adhesive joints by using a nonlinear wave mixing technique

Abstract This paper describes the use of a wave mixing technique to monitor thermal aging of adhesive joints. This newly developed technique measures the acoustic nonlinearity parameter of the adhesive in the joint. One of the significant features of this technique is that it requires only one-side access to the adhesive joint being measured, which significantly increases the technique's utility in field applications. To demonstrate the effectiveness of the new technique, measurements are conducted on adhesively joined samples that are thermally aged under different heating conditions, i.e., different temperature profiles and aging times. The results show that the measured acoustic nonlinearity parameter of the adhesive is very sensitive to thermal aging. On the other hand, linear reflection from the adhesive layer remains almost a constant among all the aging conditions investigated in this study. It is therefore concluded that the acoustic nonlinearity parameter is a much more sensitive measure of thermal aging of adhesive joints.
Tyrosine kinase inhibitor discontinuation in patients with chronic myeloid leukemia: A single-institution experience

Patients with CML treated with TKI can have a life expectancy comparable to that of the general population. Due to the extended duration of TKI administration, treatment discontinuation has been increasingly sought. Medical records of 100 patients with CML who were in MR4.5 and discontinued their TKI outside clinical trials were reviewed. After a median follow-up of 30 months (range, 5–112 months) after discontinuation, 35% and 17% lost MR4.5 and major molecular response (MMR), respectively. Only six patients lost MMR 12 months or more after discontinuation. Loss of MR4.5 was observed in 29% and 7% of patients with sustained MR4.5 duration of more than 2 and 6 years before discontinuation, respectively. By univariate analysis, there was a higher risk of loss of MR4.5 for patients who were treated for less than 87 months, received second or subsequent line TKI, never received interferon, or those with sustained MR4.5 for less than 6 years. By multivariate analysis, sustained MR4.5 for 6 years or more was the only significant predictor for durable response. Overall, 30% of patients who discontinued while in MR4.5 were retreated with 93% regaining MR4.5 at a median of 5 months. These results demonstrate that under proper conditions, treatment discontinuation is feasible outside of clinical trial setting. MR4.5 duration of 6 years or more before discontinuation is associated with very low risk of loss of MR4.5.
Trace Elements, Nutrition and Cancer: Perspectives of Prevention

A number of inorganic compounds and elements are known to have significant effects on tumor development. Certain metals or compounds of metals induce tumorigenesis directly and thus are genuine carcinogens. Others promote the growth of tumors, and hence, must be regarded as inorganic cocarcinogens. A few elements of compounds have benign or anticarcinogenic properties. Selenium, iodine, and possibly arsenic and manganese fall into this group, not to speak of the complexes of platinum and other metals that are about to gain acceptance as cancer chemotherapeutic agents. In the present account, the anticarcinogenic properties, particularly of selenium, or possess carcinogenic, cocarcinogenic, or anticarcinogenic propmally present in foods that may either act as selenium antagonists or possess carcinogenic, cocarcinogenic, or anticarcinogenic properties of their own. The emphasis on selenium appears justified in view of a growing body of direct and indirect evidence that suggests that this trace element will have to be considered in future cancer prevention programs.
Adaptive immune cells in calcific aortic valve disease

Calcific aortic valve disease (CAVD) is highly prevalent and has no pharmaceutical treatment. Surgical replacement of the aortic valve has proved effective in advanced disease but is costly, time l...
A Unified Characterization of Completeness and Triviality for Secure Function Evaluation

We present unified combinatorial characterizations of completeness for 2-party secure function evaluation (SFE) against passive and active corruptions in the information-theoretic setting, so that all known characterizations appear as special cases.
Mobile Social Commerce: Current State and Future Directions

With the sustained growth of the newly emerged market on mobile social applications such as Facebook, Snapchat, Instagram, WeChat, WhatsApp, and Line, mobile social commerce is the subject of incre...
An Australian Indigenous Diaspora: Warlpiri Matriarchs and the Refashioning of Tradition

Is movement about people or places? To be clear, this is not a question that Burke identifies in this book. However, it is one that, since I finished reading, continues to preoccupy my assessment o...
Learning with multimedia: The effects of gender, type of multimedia learning resources, and spatial ability

Abstract The purpose of this study was to examine the effect of gender and type of multimedia resource on learning outcomes while controlling for the effect of spatial ability. This study also aimed to investigate the differences in learning outcomes between retention and transfer questions. The independent variables for the study were gender and type of multimedia resources (static versus animated), and the covariate was spatial ability. The dependent variables for the first study goal were learning outcomes measured by performance scores in two procedural learning tasks (functioning of a toilet cistern and a car brake system). The dependent variables for the second study goal were learning outcomes measured by retention and transfer performance scores in the two procedural learning tasks. A total of 245 undergraduate students completed participation online. As anticipated, spatial ability had the most significant overall influence on learning outcomes. Gender differences were also found, even after controlling for spatial ability. The study, however, failed to identify effects of multimedia type in learning outcomes. Male participants consistently outperformed female participants in all learning tasks, regardless of the multimedia type. While the scores from the transfer questions were lower than the scores from retention questions, as expected, this decline was significantly less for males in the car brakes task. This was not the case in the toilet cistern task however, implying a potential subject domain effect. Overall, this study is significant in that it offers empirical evidence of gender effects, separate from spatial ability, when learning with multimedia resources.
Granulocyte Transfusions Are Safe and Feasible in High-Risk Pediatric Allogeneic Transplant Patients

Introduction Patients undergoing stem cell transplantation (SCT) are at high risk of bacterial and fungal infections prior to engraftment. Those with a significant infectious history are especially high-risk. Granulocyte transfusion (GT) may help prevent infectious complications during the pre-engraftment period, but feasibility and safety data on GT are limited in pediatric SCT patients. Objective We evaluated the safety and feasibility of volunteer-donor GT for pediatric SCT patients. Methods We retrospectively reviewed records of allogeneic SCT patients at UPMC Children's Hospital of Pittsburgh (Pittsburgh, PA) who received pre-engraftment GT from unrelated volunteers between August 2012 and October 2016. Granulocyte donors were ABO-matched and stimulated with oral corticosteroids. Patients received pretreatment with acetaminophen, diphenhydramine, and methylprednisolone before each infusion. Results Eleven patients (3 female) of median age 7.5 years (0.7 – 40.3) received a total of 53 GT (median 4 per patient). All patients had a history of bacterial and/or fungal infection (Table 1); 4 patients (36%) had received at least 1 prior allogeneic SCT. Mean cell dose per GT was 1.7 ± 0.7 × 1010. Mean rise in white blood cell (WBC) count after GT was 1 ± 1.6 × 109, which significantly correlated with cell dose (Figure 1). Fever occurred during 4 GT (7.6%), and transient dyspnea occurred during 3 GT (5.7%). No severe reactions were reported. During the course of GT, blood cultures from 3 patients (27%) grew coagulase-negative Staphylococcus, and 1 of these patients developed acute-on-chronic bacterial pneumonia. Overall survival was 82% at 100 days and 64% at 365 days post-SCT. Infection-related mortality was only 9% (1 patient died of disseminated cytomegalovirus). Conclusions In a high-risk group of pediatric allogeneic SCT patients with prior infections, GT did not cause any serious complications, and infection-related mortality was low. Corticosteroid-stimulated volunteer donors provided adequate cell doses. GT appears safe and feasible in high-risk pediatric SCT patients, and it may be underutilized as adjunctive treatment for those with a history of serious infections. The efficacy of GT deserves further study.
Primary Central Nervous System Lymphoma Presenting as Parkinsonism with Atypical MRI Findings and Elevated 14-3-3 Protein

Primary central nervous system lymphoma (PCNSL) is a rare neoplasm with an incidence of 2 to 3% of all CNS malignancies. The diagnosis can be challenging, especially with atypical presentations. Movement disorders can be one of the rare presentations of PCNSL. Here, we present an unusual case of gradually progressing Parkinsonism with an elevation of cerebrospinal fluid (CSF) 14–3-3 protein and atypical imaging findings found to have PCNSL. A 76-year-old female patient presented with gait and intermittent speech difficulty. Initial workup revealed a contrast-enhancing lesion in the bilateral putamen and head of caudate without any mass effect. Her symptoms were rapidly progressed over 6 months and presented with mild dysarthria, bradykinesia, mild rigidity, and reduced left arm swinging. These features were consistent with Parkinsonism. The repeat imaging showed the progression of hyperintensities in the bilateral putamen. The patient underwent a stereotypic biopsy of the right caudate nucleus, which revealed PCNSL. She was treated with high-dose methotrexate and is currently in remission. Diagnosis of movement disorders remains clinical and rapid progression of symptoms, and atypical presentation must warrant further imaging and workup.
Evaluation of Predictive Models for Complications following Spinal Surgery

Background Complications rates vary across spinal surgery procedures and are difficult to predict due to heterogeneity in patient characteristics, surgical methods, and hospital volume. Incorporation of predictive models for complications may guide surgeon decision making and improve outcomes. Methods We evaluate current independently validated predictive models for complications in spinal surgery with respect to study design and model generation, accuracy, reliability, and utility. We conducted our search using Preferred Reporting Items for Systematic Review and Meta-analysis guidelines and the Participants, Intervention, Comparison, Outcomes, Study Design model through the PubMed and Ovid Medline databases. Results A total of 18 articles met inclusion criteria including 30 validated predictive models of complications after adult spinal surgery. National registry databases were used in 12 studies. Validation cohorts were used in seven studies for verification; three studies used other methods including random sample bootstrapping techniques or cross-validation. Reported area under the curve (AUC) values ranged from 0.37 to 1.0. Studies described treatment for deformity, degenerative conditions, inclusive spinal surgery (neoplasm, trauma, infection, deformity, degenerative), and miscellaneous (disk herniation, spinal epidural abscess). The most commonly cited risk factors for complications included in predictive models included age, body mass index, diabetes, sex, and smoking. Those models in the deformity subset that included radiographic and anatomical grading features reported higher AUC values than those that included patient demographics or medical comorbidities alone. Conclusions We identified a cohort of 30 validated predictive models of complications following spinal surgery for degenerative conditions, deformity, infection, and trauma. Accurate evidence-based predictive models may enhance shared decision making, improve rehabilitation, reduce adverse events, and inform best practices.
Vein of Galen Malformation.

* Abbreviations: CPAP: : continuous positive airway pressure Fio2: : fraction of inspired oxygen MFCC: : Maternal Fetal Care Clinic MRA: : magnetic resonance angiography MRI: : magnetic resonance imaging MRV: : magnetic resonance venography PGE1: : prostaglandin E1 VOGM: : vein of Galen malformation A 37-year-old gravida 3, para 1 pregnant woman was referred to the Maternal Fetal Care Center (MFCC) at Boston Children’s Hospital at 36 weeks’ gestation for the finding of vein of Galen malformation (VOGM). The patient’s pregnancy was complicated by gestational diabetes. Her surgical history was notable for adenoidectomy, a previous cesarean section, and dilation and curettage following a spontaneous abortion. Maternal medications included prenatal vitamins and glyburide. Family history was noncontributory. This pregnancy was planned and naturally conceived. The woman received appropriate prenatal care. Noninvasive prenatal screening showed her to be at low risk and cell-free fetal DNA screening was negative. She had a normal anatomy scan at 20 weeks’ gestation. Fetal ultrasonography performed at 36 weeks' gestation for evaluation of fetal growth demonstrated a prominent rounded vascular structure in the quadrigeminal cistern with turbulent flow consistent with a VOGM. Fetal echocardiography at that time revealed dilation of the right atrium and right ventricle with normal biventricular function. There was no evidence of hydrops. Imaging at 37 weeks’ gestation in the Boston Children’s Hospital MFCC included repeat comprehensive fetal echocardiography, fetal ultrasonography, and fetal brain magnetic resonance imaging (MRI). Echocardiography revealed a markedly enlarged right atrium and right ventricle with mild right ventricular dysfunction. Moderate tricuspid regurgitation was noted, the innominate vein was markedly dilated, and the superior vena cava had increased flow. The interventricular septum was dyskinetic, suggesting increased pressure within the right ventricle. There was a patent foramen ovale and a patent ductus arteriosus with right-to-left shunting throughout the cardiac cycle. No evidence of pericardial effusion or hydrops fetalis was seen. Fetal ultrasonography showed a singleton male fetus with biometry measurements, including head circumference, corresponding to estimated gestational age. Amniotic fluid volume was normal. The fetal survey demonstrated a large midline intracranial vascular structure in the expected …
Cultivating normative authority: The biden administration, migration, and the international legal order

President Biden faces many hurdles to constructing an effective international legal order on migration, not least of which is the absence of any such structure even prior to the dual challenges of the nationalist fallout of the Trump administration's rhetoric and policies and the COVID-19 pandemic. Yet the excesses of cruelty under Trump and the social instability resulting from the pandemic may have created political space for the Biden administration to lay the groundwork for a more comprehensive international structure that governs migration of all kinds. To that end, President Biden should cultivate normative authority in the migration arena by shifting the national discourse, shoring up international agreements and institutions, and building regional cooperation.
Assessment of COVID-19 impacts on U.S. counties using the immediate impact model of local agricultural production (IMLAP)

Abstract CONTEXT The COVID-19 pandemic has resulted in immediate and wide impacts on human and agricultural systems. While some of the positive and negative impacts of COVID-19 on the environment and economies are emerging, there is not a comprehensive understanding of the potential impacts of COVID-19 on the most vulnerable farmers. OBJECTIVE The purpose of this study is to evaluate the immediate impacts of COVID-19 on agricultural and food systems in the United States. Our aim is to quantify the impacts on labor productivity in crops and livestock production considering the heterogenous vulnerability of different farmworkers. We are interested in measuring the production that is not realized due to COVID-19. METHODS In this paper, we introduce IMLAP, Immediate impact Model of Local Agricultural Production. This model is an economic framework considering short-term agricultural production responses to economic, environmental, and policy changes. We investigate the potential impacts of COVID-19 on the farmers in the U.S. for each county with a special focus on female, Hispanic, black and African American, and small-scale producers. RESULTS AND CONCLUSIONS Considering the impacts of COVID-19 on labor, the findings of this study suggest a decline in agricultural output in all the U.S. counties ranging from 1.18% to 7.14% of total production. Our simulation results show that counties with a higher number of small-scale farms, non-white farmers, and female-operated farms are the most vulnerable to COVID-19. Also, we argue that the stimulus policies and support packages must target these communities of producers to ensure that their livelihood is protected. The findings suggest that productivity growth (technological improvements) and international trade can eliminate the negative impacts of pandemics. SIGNIFICANCE The proposed quantitative framework of this study is a simple yet novel model that empowers diverse research communities to provide a quick analysis of the impacts of unprecedented events. It offers a holistic framework to evaluate the response of agricultural production to changes in availability and productivity of labor, machinery & equipment, land, fertilizer, seeds, and other inputs. This study presents new foundations for agricultural research communities to provide solutions to agricultural resilience challenges and highlights the significance of demand drivers, technological growth, and international trade in strengthening the food system.