cssi/SciSciGPT-SciSciNet huggingface dataset:
An analysis of quality of life (QOL) in patients with epilepsy and comorbid psychogenic nonepileptic seizures (PNES) after vagus nerve stimulation (VNS).

Abstract Purpose Patients with epilepsy (PWE) may suffer from comorbid psychogenic nonepileptic seizures (PNES). The efficacy of vagus nerve stimulation (VNS) in the treatment of epilepsy and depression is established, however the impact on PNES is unknown. Since many patients with PNES have comorbid depression, we explored the impact on quality of life (QOL) that VNS has on PWE and PNES. Methods The video electroencephalogram (vEEG) of all patients who underwent VNS at our institution was reviewed. Patients diagnosed with both psychogenic seizures and epileptic seizures on their vEEG were included in this study. These patients were contacted, and given a QOLIE-31 survey to assess their quality of life after VNS. Patients also completed a separate survey created by our group to categorize the quartile of their improvement. Pre-operative psychiatric disease was retrospectively reviewed. Results From a period of 2001 to 2016, 518 patients underwent placement of VNS for drug resistant epilepsy (DRE) at our institution. In total, 16 patients were diagnosed with both epilepsy and PNES. 11/16 patients responded to our questionnaire and survey. 9 out of 11 patients felt that their epileptic seizures had improved after VNS, while 7 of the 11 patients felt that their psychogenic episodes had improved. 2(28.6%), 1 (14.3%), and 4 (57.1%) of participants said their PNES improved by 25–50%, 50–75%, and 75–100%, respectively. 3(27.3%), 3 (27.3%), 1 (9.1%), and 4 (36.4%) of the participants said their epileptic seizures improved by 0–25%, 25–50%, 50–75%, and 75–100%, respectively. The average overall score for quality of life for the study participants was found to be 51 (± 8) out of 100. Conclusion Patients with epilepsy and comorbid PNES may benefit from VNS. It is unclear whether the benefit is conferred strictly from decreased epileptic seizure burden. The possible effect on PNES may be related to the known effect of VNS on depression. Further studies are necessary to elucidate the role of VNS in the treatment of PNES and possibly other psychiatric disease.
The Effect on Somatic Growth of Surgical and Catheter Treatment of Secundum Atrial Septal Defects

Historical studies suggest an association between atrial septal defect (ASD) and impaired growth with inconsistent improvement following closure. Limited data exist regarding the impact on growth in the era of transcatheter therapy. To evaluate the effect of closure on growth, we conducted a retrospective review of patients undergoing surgical or transcatheter closure during two time periods. Four hundred patients with isolated secundum ASD were divided into three cohorts: early surgical, contemporary surgical, and transcatheter. Data collected included demographics; height, weight, and body mass index (BMI) percentiles; catheterization hemodynamics; and co-morbidities. For all cohorts, there was no significant change in height or weight percentiles during two years after ASD closure. Age at repair was later for contemporary surgical and transcatheter cohorts (p < 0.0001). In the transcatheter cohort, mean Qp:Qs was 1.65 ± 0.54, but there was no correlation between greater Qp:Qs and decreased somatic growth. Subgroup analysis for patients with any initial growth percentile <5th percentile demonstrated a significant change in weight and BMI percentiles in the first two years after closure (p < 0.0004). The advent of transcatheter therapy shifted institutional practice to later age at repair for both surgical and transcatheter closure. There was no significant change in weight and height percentiles during two years after closure. Only patients with initial weight and BMI <5th percentile had improved growth after treatment. Concern for impaired growth should not generally be an indication for early ASD repair. However, early repair may be indicated in children with existing significant growth failure.
Environmental analysis of perovskites and other relevant solar cell technologies in a tandem configuration

Future high performance PV devices are expected to be tandem cells consisting of a low bandgap bottom cell and a high bandgap top cell. In this study, we developed a cradle-to-end of use life cycle assessment model to evaluate the environmental impacts, primary energy demand (PED), and energy payback time (EPBT) of four integrated two-terminal tandem solar cells composed of either Si bottom and lead-based perovskite (PKPb) top cells (Si/PKPb), copper indium gallium selenide (CIGS) and PKPb (CIGS/PKPb), copper zinc tin selenide (CZTS) and PKPb (CZTS/PKPb), or tin-lead based perovskite (PKSn,Pb) and PKPb (PKSn,Pb/PKPb). Environmental impacts from single junction Si solar cells were used as a reference point to interpret the results. We found that the environmental impacts for a 1 m2 area of a cell were largely determined by the bottom cell impacts and ranged from 50% (CZTS/PKPb) to 120% of those of a Si cell. The ITO layer used in Si/PKPb, CZTS/PKPb, and PKSn,Pb/PKPb is the most impactful after the Si and CIGS absorbers, and contributed up to 70% (in PKSn,Pb/PKPb) of the total impacts for these tandem PVs. Manufacturing a single two-terminal device was found to be a more environmentally friendly option than manufacturing two constituent single-junction cells and can reduce the environmental impacts by 30% due to the exclusion of extra glass, encapsulation, front contact and back contact layers. PED analysis indicated that PKSn,Pb/PKPb manufacturing has the least energy-intensive processing, and the EPBTs of Si/PKPb, CIGS/PKPb, CZTS/PKPb, and PKSn,Pb/PKPb tandems were found to be ∼13, ∼7, ∼2, and ∼1 months, respectively. On an impacts per kW h of Si basis the environmental impacts of all the devices were much higher (up to ∼10 times). These results can be attributed to the low photoconversion efficiency (PCE) and short lifetime that were assumed. While PKSn,Pb/PKPb has higher impacts than Si based on current low PCE (21%) and short lifetime (5 years) assumptions, it can outperform Si if its lifetime and PCE reach 16 years and 30%, respectively. Among the configurations considered, the PKSn,Pb/PKPb structure has the potential to be the most environmentally friendly technology.
Financial Integration in East Asia: Past, Present and Possible Futures

This paper reviews the East Asian experience with financial integration, how economies in the region have responded to shocks, and what they may do to continue to thrive in the future. It discusses openness to capital flows as a key aspect of financial integration, briefly considering the theoretical underpinnings and empirical evidence for the benefits of openness. It then examines the East Asian experience with the two financial crises that have affected the region, and how the two episodes have differed. It concludes by considering policy options for the future, including regulatory reform and coordination, and various possible risk management policies and institutions. The analysis illustrates differences in patterns of financial development for the three largest economies of the region (China, Japan and South Korea) and discusses implications for financial integration efforts.
Grand challenges and great potential in foreign language teaching and learning

This article argues for the field of foreign languages to begin to identify and define our Grand Challenges, which are difficult yet solvable problems facing our field. Seeking answers to these challenges can provide new opportunities for collaboration and can spur new directions and innovation within language learning and teaching. Researchable questions that emerge from these Grand Challenges can form a research trajectory, build community support, and contribute to changing public opinion about the role of languages in greater society
Diabetes risk scores for Hispanics living in the United States: A systematic review.

Abstract Aim Undiagnosed diabetes is more prevalent among racial/ethnic minorities in the United States (U.S.). Despite the proliferation of risk scores, few have been validated in Hispanics populations. The aim of this study is to systematically review published studies that developed risk scores to identify undiagnosed Type 2 Diabetes Mellitus based on self-reported information that were validated for Hispanics in the U.S. Methods The search included PubMed, EMBASE, Cochrane and CINAHL from inception to 2016 without language restrictions. Risk scores whose main outcome was undiagnosed Type 2 diabetes reporting performance measures for Hispanics were included. Results We identified three studies that developed and validated risk scores for undiagnosed diabetes based on questionnaire data. Two studies were conducted in Latin America and one in the U.S. All three studies reported adequate performance (area under the receiving curve (AUC) range between 0.68 and 0.78). The study conducted in the U.S. reported a higher sensitivity of their risk score for Hispanics than whites. The limited number of studies, small size and heterogeneity of the combined cohorts provide limited evidence of the validity of risk scores for Hispanics. Conclusions Efforts to develop and validate risk prediction models in Hispanic populations in the U.S are needed, particularly given the diversity of this fast growing population. Healthcare professionals should be aware of the limitations of applying risk scores developed for the general population on Hispanics.
Managing a Secret Project

We consider the problem of scheduling a project when there is an adversary from whom you want to conceal the project’s progress. Interfering with the progress by the adversary is called interdiction. Interdiction may involve hiring away key employees, campaigning for a change in zoning laws, etc. In this paper we take the perspective of a project manager with an adversary. The project manager seeks to limit the adversary’s opportunity to interdict, and, therefore, tries to keep the adversary “in the dark” as long as possible while completing the project on time. In the context of a leader-follower game, we formulate and analyze a new form of project management problem for secret projects where the project manager uses a combination of deception, task scheduling, and crashing to minimize the time between the adversary’s awareness and reaction and the project’s completion. We formulate a novel mixed-integer linear program and determine characteristics of optimal schedules. Using a detailed example of nuclear weapons development we illustrate the interconnectedness of deception, task scheduling, and crashing and the resulting influence on adversary behavior.
ADSORPTION AND DESORPTION OF WATER FILMS ON GRAPHITE SURFACES

The presence of water as a film on the surfaces of graphite markedly affects the rate of oxidation of graphite. This observation has led to an attempt to evaluate the properties of these surface films by using a radioactive tracer technique. It has been found that water films on graphite will readily exchange with tritium gas (T2 or HT) and with tritiated water vapor. The absorptive properties of these films may then be studied using the radioactivity to detect the presence of a film. Such studies have been made using the surfaces of graphite single crystals and those of spectroscopic graphite. The films are strongly held but may be removed by heating to ˜900°C. This treatment is sufficient to remove all of the tritiated water from single crystals of graphite; however, water is still held in the deep pores of artificial graphite.
Geometry and bond lengths of chemisorbed atoms and molecules: NEXAFS and SEXAFS

A brief review is given of the near edge x-ray absorption fine structure (NEXAFS) and surface extended x-ray absorption fine structure (SEXAFS) techniques which have been developed in conjunction with the availability of high brightness monochromatic synchrotron radiation. Concepts and applications of the techniques are discussed using selected examples of chemisorption problems involving atoms and molecules on surfaces. Extensive references to related work are given.
"Not so fast!" the complexity of attempting to decrease door-to-floor time for emergency department admissions.

Article-at-a-Glance Background Successful quality improvement is fundamental to high-performing health care systems, but becomes increasingly difficult as systems become more complex. Previous attempts at the University of California, San Francisco (UCSF) Medical Center to reduce door-to-floor (D2F) time —the time required to move an ill patient through the emergency department (ED) to an appropriate inpatient bed—had not resulted in meaningful improvement. An analysis of why attempts at decreasing D2F times in the ED had failed, with attention to contextual factors, yields recommendations on how to decrease D2F time. Methods A team of 11 internal medicine residents, in partnership with the Patient Flow Executive Steering Committee, performed a literature review, process mapping, and analysis of the admissions process. The team conducted interviews with medical center staff across disciplines, members of high-performing patient care units, and leaders of peer institutions who had undertaken similar efforts. Findings and Recommendations Each of the following three domains—(1) Improving Work Flow, (2) Changing Culture, and (3) Understanding Incentives—is independently an important source of resistance and opportunity. However, the improvement work and understanding of complexity science suggest that all three domains must be addressed simultaneously to effect meaningful change. Recommendations include eliminating redundant and frustrating processes; encouraging multidisciplinary collaboration; fostering trust between departments; providing feedback on individual performance; enhancing provider buy-in; and, ultimately, uniting staff behind a common goal. Conclusion By conceptualizing the hospital as a complex adaptive system, multiple interrelated groups can be encouraged to work together and accomplish a common goal.
Detection of the 2012 Havre submarine eruption plume using Argo floats and its implications for ocean dynamics

Abstract More than 85% of the Earth's volcanism and geothermal heat release occurs underwater at mid-ocean ridges, intra-plate hotspots, and oceanic island arcs. However, we lack a clear understanding of how a submarine eruption interacts with the overlying water column, the structure of the submarine eruptive plume, and the transport of volcanic products in the ocean by these plumes. We describe here the detection of eruption-derived temperature increase and salinity decrease from the 2012 Havre submarine caldera eruption by an existing array of temperature/salinity profiling floats, known as Argo. The Argo floats observed the signal, significant at >3 sigma level with respect to the background ocean variability (noise), at ocean depths of ∼1750–2000 m deeper than the eruptive vent itself. In order to understand this signal, we develop a new conceptual submarine plume model which suggests that the sub-vent level temperature and salinity anomalies are caused by large-scale ocean mixing induced by the eruptive plume, rather than heating directly from the eruption. Using results from scaling analysis and a modified numerical plume-gravity current model, we show that submarine eruptions can efficiently advect water masses from the deep ocean closer to the surface and form multiple subsurface intrusions during the process. Consequently, the submarine eruptive plumes can initiate significant ocean mixing, a process with significant implications for both long- and short-term influence of submarine volcanism on ocean chemistry, dynamics, and ecology. Finally, our model confirms that a detectable anomaly would persist out to 100s of km from the eruption location, comparable to Argo's spatial sampling. Given the global ocean coverage and a decadal baseline, the Argo floats (and other similar datasets), in concert with hydrophone and seismic arrays, can provide significant new constraints on subaqueous volcanism, eruption dynamics, and the impact on Earth systems through enhanced ocean mixing and nutrient supply, e.g. during submarine Large Igneous Provinces.
Inverse-designed photonic fibers and metasurfaces for nonlinear frequency conversion [Invited]: publisher’s note

This publisher’s note corrects the funding section in Photon. Res.6, B822327-9125PRHEIZ10.1364/PRJ.6.000B82(2018).
Universal tumor screening for Lynch syndrome: Perceptions of Canadian pathologists and genetic counselors of barriers and facilitators

BACKGROUND People at risk of developing hereditary cancers associated with Lynch Syndrome (LS) can be identified through universal screening of colorectal tumors. However, tumor screening practices are variable across Canada and few studies explore the perspectives of genetic counselors and pathologists about tumor screening. This study was conducted to better understand the barriers and facilitators of implementing universal tumor screening in health centers across Canada. METHODS An online survey about tumor screening programs was administered to genetic counselors and pathologists across Canada through communication channels of professional organizations. It was hosted on SurveyMonkey and accessible from October 2016 to March 2017. RESULTS Barriers to tumor screening included a lack of sustainable resources, including funding and genetic counselors. Respondents strongly identified the need for a coordinated, interdisciplinary approach to program planning with the "right people at the table." Respondents currently with a screening program provided advice such as carefully designing the program structure, developing patient and family follow-up protocols, and ensuring adequate resources (funding, staff, training for providers) were available prior to program initiation. CONCLUSION There is no national approach to universal tumor screening in Canada. However, future efforts can be informed by the experiences of those centers that have already created a universal tumor screening program for LS. These data suggest the need for an interdisciplinary approach, initial and sustained funding, and careful advanced planning of program structures and policies.
Local to National and Back Again: Beer, Wisconsin & Scale

Brewing has been an important part industrialized in the latter portions of Wisconsin’s culture and economy since the first settlers arrived in the early 1800s. Like much of the country, Wisconsin brewers experienced a spatial shift in accordance with the industry’s technology. Starting with many brewers each serving local markets, developments in beer preservation, packaging and transport allowed certain Wisconsin brewers to seize opportunities for expanded market areas. The enlarged economies of scale achieved by these larger brewers provided a competitive advantage that slowly put smaller operations out of business. By the mid-twentieth century, brewing had largely become a national enterprise with fewer local or regional players. Though its market share remained limited, the craft brewing movement represented a reversal of this trend, both nationally and in Wisconsin. Like the early brewers who had settled the state, these new Wisconsin breweries were focused on achieving an economy of scale by developing a local market of consumers.
Bio-inspired passive base isolator with tuned mass damper inerter for structural control

Inspired by the energy-dissipating mechanism of abalone shell, a bio-inspired passive base isolation system combined with a tuned mass damper inerter (TMDI) is developed. This paper presents the numerical model consisting of bio-inspired tuned mass damper inerter isolation system, structural system model, and energy response equation as an integral system for structural control. The structural control performance of the present bio-inspired base isolation system is demonstrated with numerical simulations using both a single-degree-of-freedom model and a multi-degree-of-freedom model under six different samples of earthquake excitations. A comparative study with three other types of existing base isolators reveals that the present bio-inspired tuned mass damper inerter isolation system may be relatively more effective in reducing the displacement, acceleration, input energy ratio and base shear force for the illustrative cases. In addition, a parametric study is performed to explore the effectiveness of the parameters chosen for the structure. The results illustrate that satisfactory target responses can be achieved for the examples studied by optimizing the parameters such as maximum bio-inspired force, damping coefficient, stiffness, and inertance of inerter.
IFNγ-Stimulated Dendritic Cell Exosomes for Treatment of Migraine Modeled Using Spreading Depression

Migraine is a common headache disorder characterized by unilateral, intense headaches. In migraine with aura, the painful headache is preceded by focal neurological symptoms that can be visual, sensory, or motor in nature. Spreading depression (the most likely cause of migraine with aura and perhaps related headache pain) results in increased neuronal excitability and related increases in inflammation and production of reactive oxygen species. This in turn can promote the transformation of low-frequency, episodic migraine into higher-frequency and eventually chronic migraine. Though migraine affects 11% of adults worldwide, with 3% experiencing chronic headache, existing therapies offer only modest benefits. Here, we focus on the mechanisms by which environmental enrichment (i.e., volitionally increased intellectual, social, and physical activity) mitigates spreading depression. In prior work, we have shown that exposure to environmental enrichment reduces susceptibility to spreading depression in rats. This protective effect is at least in part due to environmental enrichment-mediated changes in the character of serum exosomes produced by circulating immune cells. We went on to show that environmental enrichment-mimetic exosomes can be produced by stimulating dendritic cells with low levels of interferon gamma (a cytokine that is phasically increased during environmental enrichment). Interferon gamma-stimulated dendritic cell exosomes (IFNγ-DC-Exos) significantly improve myelination and reduce oxidative stress when applied to hippocampal slice cultures. Here, we propose that they may also be effective against spreading depression. We found that administration of IFNγ-DC-Exos reduced susceptibility to spreading depression in vivo and in vitro, suggesting that IFNγ-DC-Exos may be a potential therapeutic for migraine.
PATH-52. ANAPLASTIC PILOMYXOID ASTROCYTOMA HARBORING BRAF FUSION, PTEN AND TERT MUTATIONS

Pilomyxoid astrocytomas (PMA) are focal neoplasms that are often cured with total resection. We present a case of a progressive PMA with histologic and molecular features suggestive of malignant transformation. A 13-year old boy presented with headaches, diplopia, and seizures. He had previously been followed for 7 years by serial imaging for a cystic/solid enhancing mass in the right temporal lobe without biopsy that had remained stable up to 6 months prior to his current illness. MRI of brain demonstrated significant progression of the solid component with extension into the subependymal portions of the lateral ventricles, leptomeningeal spread in brain and spine, and hydrocephalus. Patient underwent a partial resection of tumor and VP shunt placement. Pathology demonstrated a prominent myxoid matrix with angiocentric arrangement of monomorphous bipolar cells. PHH3 and Ki-67 stains confirmed multiple mitoses and elevated proliferation rate. Next Generation sequencing of tumor confirmed the presence of a KIAA1549-BRAF duplication/fusion, CDKN2A deletion, along with PTEN and TERT promoter mutations without BRAF V600E or ATRX mutations. The histology and molecular features was suggestive of a pilomyxoid astrocytoma (PMA) with anaplastic transformation. Patient is currently receiving carboplatin + vincristine plus a MEK inhibitor (TrametinibTM, Novartis Corporation, Cambridge, MA) for tumor control. We believe that the tumor was initiated by the oncogenic BRAF fusion and the dramatic progression and spread of disease after a long period of stability was probably related to recent acquisition of additional deleterious mutations that have been previously reported in anaplastic pilocytic astrocytoma.
Performance Study of the First 2-D Prototype of Vertically Integrated Pattern Recognition Associative Memory

Extremely fast pattern recognition capabilities are necessary to find and fit billions of tracks at the hardware trigger level produced every second anticipated at high-luminosity Large Hadron Collider (HL-LHC) running conditions. Associative memory (AM)-based approaches for fast pattern recognition have been proposed as a potential solution to the tracking trigger. However, at the HL-LHC, there is much less time available, and the speed performance must be improved over previous systems while maintaining a comparable number of patterns. The vertically integrated pattern recognition AM (VIPRAM) project aims to achieve the target pattern density and performance goal using 3DIC technology. The first step taken in the VIPRAM work was the development of a 2-D prototype ( protoVIPRAM00 ) in which the AM building blocks were designed to be compatible with the 3-D integration. In this article, we present the results from extensive performance studies of the protoVIPRAM00 chip in both realistic HL-LHC and extreme conditions. Results indicate that the chip operates at the design frequency of 100 MHz with perfect correctness in realistic conditions and conclude that the building blocks are ready for 3-D stacking. We also present performance boundary characterization of the chip under extreme conditions.
α-Synucleinopathy associated c-Abl activation causes p53-dependent autophagy impairment

Studies link c-Abl activation with the accumulation of pathogenic α-synuclein (αS) and neurodegeneration in Parkinson’s disease (PD). Currently, c-Abl, a tyrosine kinase activated by cellular stress, is thought to promote αS pathology by either directly phosphorylating αS or by causing autophagy deficits. αS overexpressing transgenic (Tg) mice were used in this study. A53T Tg mice that express high levels of human mutant A53TαS under the control of prion protein promoter. Two different approaches were used in this study. Natural aging and seeding model of synucleinopathy. In seeding model, intracortical/intrastriatal (IC/IS) stereotaxic injection of toxic lysates was done using tissue lysates from end-stage symptomatic mice. In this study, nilotinib and pifithrin-α was used as a c-Abl and p53 inhibitor, respectively. Both Tg and non-transgenic (nTg) mice from each group were subjected to nilotinib (10 mg/kg) or vehicle (DMSO) treatment. Frozen brain tissues from PD and control human cases were analyzed. In vitro cells study was implied for c-Abl/p53 genetic manipulation to uncover signal transduction. Herein, we show that the pathologic effects of c-Abl in PD also involve activation of p53, as c-Abl activation in a transgenic mouse model of α-synucleinopathy (TgA53T) and human PD cases are associated with the increased p53 activation. Significantly, active p53 in TgA53T neurons accumulates in the cytosol, which may lead to inhibition of autophagy. Thus, we hypothesized that c-Abl-dependent p53 activation contributes to autophagy impairment in α-synucleinopathy. In support of the hypothesis, we show that c-Abl activation is sufficient to inhibit autophagy in p53-dependent manner. Moreover, inhibition of either c-Abl, using nilotinib, or p53, using pifithrin-α, was sufficient to increase autophagic flux in neuronal cells by inducing phosphorylation of AMP-activated kinase (AMPK), ULK1 activation, and down-regulation of mTORC1 signaling. Finally, we show that pharmacological attenuation of c-Abl activity by nilotinib treatment in the TgA53T mouse model reduces activation of p53, stimulates autophagy, decreases accumulation αS pathology, and delays disease onset. Collectively, our data show that c-Abl activation by α-synucleinopathy causes p53 dependent autophagy deficits and both c-Abl and p53 represent therapeutic target for PD.
Analysis of monitoring results of drinking-water-borne endemic fluorosis in Liaoning Province from 2011 to 2016

Objective To master the prevalence of drinking-water-borne endemic fluorosis of children in the disease affected areas of Liaoning Province and to understand the effect of water improvement measures in prevention and control of fluorosis. Methods The data of 18 water improvement projects in drinking-water-borne endemic fluorosis areas of Liaoning Province from 2011 to 2016 were collected by retrospective method, and the data of dental fluorosis in children aged 8 to 12 years old were analyzed. The prevalence and detection rate of dental fluorosis in children aged 8 to 12 years old were analyzed. To compare the incidence of dental fluorosis among children from villages with qualified water fluoride and those from villages with unqualified water fluoride. Results From 2011 to 2016, in the annual survey of 18 water engineering projects in 18 monitored villages, normal operating rate was between 94.44% (17/18)-100.00% (18/18), water fluoride qualified rate was between 88.89% (16/18)-100.00% (18/18). In the monitored village, 4 941 children aged 8 to 12 were examined, and the detection rate of dental fluorosis was 9.8% (484/4 941). The dental fluorosis index was 0.19. The detection rate (14.0%, 10.7%, 10.7%, 8.7%, 6.6%, 8.1%) of dental fluorosis was decreasing year by year (χ2trend=24.3,P<0.05). The total detection rate of children's dental fluorosis in monitored villages (8.1%, 356/4 422) with normal operation of water improvement projects and qualified water fluoride was lower than that in monitored villages with excessive water fluoride (24.7%, 128/519, χ2= 145.1, P < 0.05). Conclusion After water improvement measures are implemented in drinking water fluorosis areas of Liaoning Province, the dental fluorosis of children in the affected areas is effectively controlled, but the problem of excessive fluoride in water improvement projects still exists, and the management of water improvement projects should be strengthened in the future. Key words: Drinking; Fluorosis, dental; Improvement of water engineering
Biomarkers of kidney injury among children in a high-risk region for chronic kidney disease of uncertain etiology.

Mesoamerican Nephropathy (MeN), a form of chronic kidney disease of uncertain etiology, is a leading cause of death in Central America. The disease often presents in young adult male agricultural workers and progresses rapidly. Given the young age at presentation, we hypothesized that children in Central America experience subclinical kidney injury prior to working life. We assessed specimens from a cross-sectional study of youth, aged 7–17 years, predominantly residing in a high-risk region of Nicaragua (n = 210). We evaluated urinary concentrations and risk factors for kidney injury biomarkers neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), monocyte chemoattractant protein 1 (MCP-1), and chitinase-3-like protein 1 (YKL-40). We evaluated the association between biomarkers and contemporaneous eGFR and compared biomarker concentrations with reference values from healthy children in other countries. Median uNGAL, uIL-18, and uKIM-1 concentrations exceeded healthy reference values. A one-year increase in age was associated with 40% increase in odds of being in the highest quartile of uNGAL (OR 1.4; (95%CI 1.2, 1.5); p < 0.0001). Youth who reported ever experiencing dysuria had 2.5 times the odds of having uNGAL concentrations in the top quartile (OR 2.5; (95%CI 1.4, 4.6); p = 0.003). Girls had significantly higher concentrations of all biomarkers than boys. Nine percent of children demonstrated low eGFR (≤ 100 ml/min/1.73 m2), while 29% showed evidence of hyperfiltration (eGFR ≥ 160 ml/min/1.73 m2), both potentially indicative of renal dysfunction. Children residing in regions of Nicaragua at high risk for MeN may experience subclinical kidney injury prior to occupational exposures.
Rhetoric and the Temporal Turn: Race, Gender, Temporalities

In September 2019, climate activist Greta Thunberg chastised members of the United Nations over their inaction on climate change. The sixteen-year-old Swedish student emphasized the generation gap ...
Revisiting Dinuclear Ruthenium Water Oxidation Catalysts: Effect of Bridging Ligand Architecture on Catalytic Activity.

An attractive catalytic pathway for the conversion of water to oxygen would involve two metal oxide centers combining in a constructive sense to make O═O. This prospect makes the study of certain d...
Is COVID-19 Keeping us Up at Night? Stress, Anxiety, and Sleep Among Adult Twins

In response to the COVID-19 pandemic, a variety of social distancing measures to mitigate the virus outbreak have been implemented. These measures may have unintended consequences on individuals' well-being, such as increased stress, anxiety, and sleep disruptions. We investigated the extent to which individuals' mental health status is associated with perceived changes in sleep amount and sleep quality among a sample of adult twin pairs (N = 909 pairs; 77% MZ, 23% DZ), less than a month after the outbreak was declared a pandemic by the World Health Organization. About half of participants reported no change in sleep amount (50.1%) or sleep quality (55.6%). Approximately one-third of the participants had increased amount of sleep (29.8%), and 32.9% reported a decrease in sleep quality. We found that stress and anxiety levels were associated with sleep reduction (ORs = 2.36 and 3.12 for stress and anxiety, respectively) and poorer sleep quality (ORs = 2.45 and 3.73 for stress and anxiety, respectively), even after taking into account between-family confounds. A much smaller association was observed between levels of stress and anxiety and increased sleep amount (ORs = 1.42 and 1.60 for stress and anxiety, respectively) and sleep quality (OR = 1.21 and 1.29 for stress and anxiety, respectively), which was no longer significant after controlling for between-family confounds. Our results demonstrate that stress and anxiety associated with the COVID-19 pandemic and social distancing measures may be linked to reduced sleep amount and quality.
Psychological Therapies for Women Who Experience Intimate Partner Violence.

Are psychological therapies safe and effective for women who experience intimate partner violence?
A pirate ship sailed into the yacht club: How we built a novel pediatric emergency medicine curriculum for an emergency medicine training program.

Background Pediatric emergency medicine (PEM) has seen little progression toward a standardized PEM educational framework. The 2018 Academic Emergency Medicine Consensus Conference on Advancing PEM Education addressed this gap in core EM education. Absent elements include a "broad needs assessment to identify and evaluate existing curricula and systems gaps in EM training" and a "clearly defined core PEM curriculum that unifies and drives the learning process." PEM education innovators were called to construct a "unified foundation in PEM education for all levels of emergency care" and to "promote innovation in teaching and learning strategies in curricula." We endeavored to meet this challenge at our institution. Methods The PEM curriculum design is based on the Kern model of curriculum development and included a needs assessment, development of goals and objectives, educational strategies, implementation, evaluation, and programmatic feedback. We committed to using effective learning strategies and active learning methods in developing our curriculum and conducted a 1-year pilot within our EM residency's didactic conference. We used exit surveys to collect feedback for each session as well as midyear focus groups to gauge the program's effectiveness. At the start and end of the pilot year residents completed the PEM survey regarding the effect of the PEM curriculum on their self-assessed knowledge, training, and comfort in managing PEM topics. Results Feedback regarding the PEM curriculum was positive. Following 1 year of the pilot curriculum, learners in the PGY-1 and PGY-3 classes demonstrated statistically significant improvement in their self-assessed knowledge, training, and comfort with PEM topics. The PGY-2 class had a similar statistically significant improvement in self-assessed knowledge in PEM topics. Conclusions Our novel PEM curriculum was well received and has shown early evidence of improving self-assessed knowledge and comfort among EM residents.
Thoracoscopic segmentectomy for a large previously undiagnosed CPAM presenting as a spontaneous pneumothorax: A case report.

Abstract Introduction Incidentally found congenital pulmonary airway malformations (CPAM) in older children are extremely rare and have traditionally been managed with minimally invasive versus open lobectomy of the affected lobe. Presentation of case In this report, we present a 11-year-old male who presented with a recurrent spontaneous pneumothorax and was found to have a large symptomatic CPAM confined to a single segment of the right lower lobe. The patient was successfully treated with thoracoscopic segmentectomy without any residual disease seen on follow up imaging. Discussion Minimally invasive thoracoscopic approach has many advantages over open approach including better pain control, reduced hospital length of stay, and decreased intraoperative blood loss. With increasing use of minimally invasive approaches, lung-sparing surgery has demonstrated to be a viable and an attractive option for definitive resection of CPAM, without compromising resection margins and/or future lung function. Conclusion This report demonstrates that minimally invasive lung-sparing surgical treatment of a large CPAM is feasible in older children.
Modulation of gene expression on a transcriptome-wide level following human neural stem cell transplantation in aged mouse stroke brains.

Introduction Neural stem cell (NSC) transplantation offers great potential for treating ischemic stroke. Clinically, ischemia followed by reperfusion results in robust cerebrovascular injury that upregulates proinflammatory factors, disrupts neurovascular units, and causes brain cell death. NSCs possess multiple actions that can be exploited for reducing the severity of neurovascular injury. Our previous studies in young adult mice showed that human NSC transplantation during the subacute stage diminishes stroke pathophysiology and improves behavioral outcome. Methods We employed a well-established and commonly used stroke model, middle cerebral artery occlusion with subsequent reperfusion (MCAO/R). Here, we assessed the outcomes of hNSC transplantation 48 h post-MCAO (24 h post-transplant) in aged mouse brains in response to stroke because aging is a crucial risk factor for cerebral ischemia. Next, we tested whether administration of the integrin α5β1 inhibitor, ATN-161, prior to hNSC transplantation further affects stoke outcome as compared with NSCs alone. RNA sequencing (RNA-seq) was used to assess the impact of hNSC transplantation on differentially expressed genes (DEGs) on a transcriptome-wide level. Results Here, we report that hNSC-engrafted brains with or without ATN-161 showed significantly reduced infarct size, and attenuated the induction of proinflammatory factors and matrix metalloproteases. RNA-seq analysis revealed DEGs and molecular pathways by which hNSCs induce a beneficial post-stroke outcome in aged stroke brains. 811 genes were differentially expressed (651 downregulated and 160 upregulated) in hNSC-engrafted stroke brains. Functional pathway analysis identified enriched and depleted pathways in hNSC-engrafted aged mouse stroke brains. Depletion of pathways following hNSC-engraftment included signaling involving neuroinflammation, acute phase response, leukocyte extravasation, and phagosome formation. On the other hand, enrichment of pathways in hNSC-engrafted brains was associated with PPAR signaling, LXR/RXR activation, and inhibition of matrix metalloproteases. Hierarchical cluster analysis of DEGs in hNSC-engrafted brains indicate decreased expression of genes encoding TNF receptors, proinflammatory factors, apoptosis factors, adhesion and leukocyte extravasation, and Toll-like receptors. Conclusions Our study is the first to show global transcripts differentially expressed following hNSC transplantation in the subacute phase of stroke in aged mice. The outcome of our transcriptome study would be useful to develop new therapies ameliorating early-stage stroke injury.
The Effect of Computerized Dietary Analysis Nutrition Education on Nutrition Knowledge, Nutrition Status, Dietary Compliance, and Quality of Life of Hemodialysis Patients

■ Objective: To assess the effect of nutrition education, using computerized dietary analysis, on nutrition knowledge, nutrition status, dietary compliance, and quality of life in hemodialysis patients. ■ Design: A 6-month nonrandomized control study including 3 months of prestudy data. ■ Setting: A free-standing dialysis center that treated approximately 50 hemodialysis patients. ■ Patients: Twenty chronic hemodialysis patients (treatment: n=12, control: n=8) who voluntarily agreed to participate. ■ Interventions: All study participants completed prestudy and poststudy quality-of-life assessments, a depression inventory, and a nutrition knowledge assessment. Patients in the treatment group completed monthly 3-day food records, which were analyzed by computer nutrient analysis software. Results were discussed with the patients during one-on-one education sessions. Control patients completed prestudy and poststudy 3-day food records. ■ Main outcome measures: Change in prestudy and poststudy assessment scores, nutritionrelated laboratory data, anthropometric data, and dietary data. ■ Results: The treatment group's nutrition knowledge test scores significantly improved. Nutrient intakes showed no significant changes except for calorie intake, which decreased in the treatment group. Serum albumin and total protein increased in both groups, and the protein catabolic rate (PCR) of the treatment group increased significantly. The treatment group showed improvement in the alertness behavior area of the Sickness Impact Profile (SIP), and the control group declined in the recreation and pastimes area of the SIP. ■ Conclusions: Computerized dietary analysis is an effective instruction tool, is helpful in improving dietary protein intake as measured by PCR, and may contribute to improved quality of life of hemodialysis patients.
Africa has unique and urgent barriers to cleft care: lessons from practitioners at the Pan-African Congress on Cleft Lip and Palate.

Background: The goals of this study were to delineate the protocols employed for managing patients with cleft lip and palate deformities, delineate the challenges facing practitioners and patients, and to determine the patient and physician barriers to cleft care delivery in the region. Methods: Survey questionnaires were administered to practitioners attending the second Pan-African Congress on Cleft Lip and Palate (PACCLIP), which took place in Ibadan, Nigeria, West Africa from February 4-7, 2007. The conference included 225 participants, representing 17 African countries. Results: Protocols for repair of cleft lip and palate deformities were varied, with Millard's and von Langenbeck's techniques being the preferred approach for the management of cleft lip and palate deformities, respectively. A large proportion of providers have limited access to core cleft care supporting teams, especially speech language pathologists, orthodontists, and audiologists. Several challenging barriers to cleft care were also identified at both the institutional and individual levels and are reported. Conclusion: Geographic separation in Africa presents a similar challenge due to isolationism as it does to surgeons in Europe. Specific to Africa are the increased barriers to care, and economic and financial hardship at various levels. A focus on funding, team building, infrastructural support, and patient education appear to be crucial in improving the care and lives of children with facial clefts in Africa. Pan African Medical Journal 2012; 12:15
Multibump Solutions of a Semilinear Elliptic PDE on R n

The purpose of this paper is to describe some recent joint work of V. Coti Zelati and the author on semilinear elliptic partial differential equations on R n [1]. This research is in part an outgrowth of earlier work on homoclinic solutions of Hamiltonian systems of ordinary differential equations [2].
What's Wrong with the Ontotheological Error?

In some circles, ‘the ontotheological error’ is a buzz-word, a dismissive pejorative hurled at philosophical theologians who say that God falls under the concept ‘being’. The accusation is that to say that God falls under the concept ‘being’ is to imply that God is a being, alongside others. Whatever good-making features may otherwise be ascribed, God is thereby brought down to the level of creatures. Perfect-being theology makes God differ from creatures only in degree and not in kind. To believers in such a God, critics of ontotheology charge: your God is too small! My questions are “what?” and “why?”: what exactly is the ontotheological error? and why is it an error? The label itself makes clear: ontotheology is a species of philosophical theology. My second question, therefore, breaks in two: what philosophical mistakes is ontotheology thought to make? and why are these taken to be theologically disastrous?
Activity-Based Modeling of Travel Demand

Since the beginning of civilization, the viability and economic success of communities have been, to a major extent, determined by the efficiency of the transportation infrastructure. To make informed transportation infrastructure planning decisions, planners and engineers have to be able to forecast the response of transportation demand to changes in the attributes of the transportation system and changes in the attributes of the people using the transportation system. Travel demand models are used for this purpose; specifically, travel demand models are used to predict travel characteristics and usage of transport services under alternative socio-economic scenarios, and for alternative transport service and land-use configurations.
Supreme Court Rules that ERISA Preempts State Law Claims Challenging Utilization Review by HMO

This article reports on Aetna Health Inc. v. Davila, the 2004 United States Supreme Court ruling that members of ERISA health plans cannot sue their plan administrators for consequential damages for injuries the members suffered allegedly due to the administrators’ coverage decisions. The Aetna ruling confirmed the historical view that ERISA plan participants and beneficiaries are limited to the civil remedies set forth in section 502(a) of ERISA. The Aetna decision squelched several theories advanced by lower courts that had found that such claims for consequential or punitive damages did not fall within ERISA section 502(a), and therefore were not preempted by ERISA. While the Aetna ruling limits potential liability of ERISA plans and thereby helps to conserve their assets, it also leaves members who allegedly suffer physical injury from negligent utilization review largely without a remedy.
Fine Structure in Solar Oscillation Spectra

I discuss here two aspects of helioseismology which rely on precise measurements of the relative frequencies of solar oscillation modes: rotational and magnetic mode splittings, and solar cycle changes in the mode frequencies. Recent data are presented, along with speculation into the future of the measurements.