cssi/SciSciGPT-SciSciNet huggingface dataset:
Too high for transplantation? Single-center analysis of the lung allocation score.

Background Recent studies using United Network for Organ Sharing data suggest that lung transplantation in patients with high lung allocation scores (LAS) may lead to organ and resource wastage. Therefore, to determine whether a LAS cutoff value should be considered, we evaluated the relation of LAS to waitlist and posttransplant mortality in our center to determine if it could identify patients for whom listing for transplantation may be futile. Methods From May 1, 2005 to July 1, 2010, 537 adults were listed and 426 underwent primary lung transplantation at our institution. Endpoints were mortality before and after lung transplantation. The relationships of LAS at listing to waitlist mortality and of pretransplant LAS to posttransplant mortality were both analyzed by multiphase hazard function methodology. Results Higher LAS was strongly associated with waitlist mortality ( p p = 0.05), but not late ( p = 0.4), posttransplant survival was associated with higher LAS at transplantation, once other clinical characteristics predictive of early mortality were accounted for, neither waitlist nor pretransplant LAS was independently related to posttransplant mortality ( p = 0.12). Conclusions Higher LAS strongly predicts higher mortality on the lung transplantation waitlist, underscoring the value of LAS in prioritizing patients with the highest scores for transplantation. Early posttransplant mortality is modestly higher with higher pretransplant LAS, but the data of our center do not suggest a value above which transplantation should be denied as futile. This suggests that donor organs and resources are not being wasted.
Bringing non-human primate research into the post-genomic era: how monkeys are teaching us about elite controllers of HIV/AIDS

Whole-genome sequencing of Mauritian cynomolgus macaques reveals novel candidate loci for controlling simian immunodeficiency virus replication.
Postnatal methyl mercury exposure: effects on ontogeny of renal and hepatic ornithine decarboxylase responses to trophic stimuli.

Abstract The effects of postnatal methyl mercury exposure on the ontogeny of renal and hepatic responsiveness to trophic stimuli were examined. Increased ornithine decarboxylase (ODC) activity was used as an index of tissue stimulation. In the rat, renal ODC responsiveness to growth hormone, angiotensin, vasopressin, isoproterenol, and serotonin was absent at birth and matured 3 to 4 weeks later. However, pups exposed to methyl mercury showed marked ODC responses to these same agents as early as 10 to 19 days of postnatal age, accompanied by a significant renal hypertrophy. In contrast to the kidney, the liver of normally developing rats was responsive to trophic factors even in the neonate. In this tissue, there was no consistent effect of neonatal methyl mercury treatment on ODC responses at any developmental stage tested; although absolute liver weights were reduced, liver/body weight ratic was not affected. These results demonstrate that postnatal methyl mercury exposure causes a precocious onset of ODC responses to trophic agents specifically in the kidney. Altered responsiveness may mediate some of the effects of this organomercurial on overall renal development and function.
Cognitive/Behavioural Therapy and Pharmacotherapy with Chronic, Drug-Refractory Depressed Inpatients: A Note of Optimism

Several previous studies have reported that cognitive/behavioural treatments have been relatively ineffective for chronic, drug-resistant depressed patients. In the present report, six chronic, drug-resistant depressed patients were treated with an integrated program consisting of cognitive/behavioural treatment, pharmacotherapy, and short term hospitalization. The obtained improvement rates were substantially better than previous studies. Potential explanations for these findings are discussed.
The Impact of State Anxiety on Fear Inhibition

State anxiety was investigated as a moderator of learning to discriminate between safe and danger cues and transfer of fear inhibition within a conditioning paradigm. Participants were induced into...
Characterization of the activity of the spore cortex lytic enzyme CwlJ1

The germination enzyme CwlJ1 plays an important role in degrading the cortex during the germination of Bacillus anthracis spores. However, the specific function and catalytic activity of CwlJ1 remain elusive. Here we report for the first time a detailed in vitro mechanistic study of CwlJ1 expressed in Escherichia coli and its activity against the spore cortical fragments of B. anthracis when added exogenously. CwlJ1 was active on both decoated spores and spore cortical fragments. Through liquid chromatography-mass spectrometry analysis of the digested cortical fragments, we determined that CwlJ1 was a thermostable N-acetylmuramoyl-L-alanine amidase. CwlJ1 mainly recognized large segments of glycan chains in the cortex instead of the minimal structural unit tetrasaccharide, with specificity for muramic acid-δ-lactam-containing glycan chains and preference for the tetrapeptide side chain. Unlike most amidases, CwlJ1 did not appear to contain a divalent cation, as it retained its activity in the presence of EDTA. This study shines some light on the mechanism of spore germination, and provides increased insight into the development of sporicidal enzyme systems for decontamination of B. anthracis and other related bacteria.
A Herpes Simplex Virus 1 (McKrae) Mutant Lacking the Glycoprotein K Gene Is Unable To Infect via Neuronal Axons and Egress from Neuronal Cell Bodies

ABSTRACT We have shown that the herpes simplex virus 1 (HSV-1) gK gene is essential for efficient replication and spread in the corneal epithelium and trigeminal ganglion neuroinvasion in mice (A. T. David, A. Baghian, T. P. Foster, V. N. Chouljenko, and K. G. Kousoulas, Curr. Eye Res. 33:455–467, 2008). To further investigate the role of gK in neuronal infection, we utilized a microfluidic chamber system separating neuronal cell bodies and axonal termini. HSV-1 (McKrae) engineered virus constitutively expressing enhanced green fluorescence protein (GFP) was efficiently transmitted in both a retrograde and an anterograde manner. These results were corroborated by expression of virion structural proteins in either chamber, as well as detection of viral genomes and infectious viruses. In contrast, efficient infection of either chamber with a gK-null virus did not result in infection of the apposed chamber. These results show that gK is an important determinant in virion axonal infection. Moreover, the inability of the gK-null virus to be transmitted in an anterograde manner suggests that virions acquire cytoplasmic envelopes prior to entering axons. IMPORTANCE Herpes simplex virus 1 (HSV-1) enters mucosal epithelial cells and neurons via fusion of the viral envelope with cellular membranes, mediated by viral glycoprotein B (gB) in cooperation with other viral glycoproteins. Retrograde transport of virions to neuronal cell bodies (somata) establishes lifelong latent infection in ganglionic neurons. We have previously reported that gK binds gB and is required for gB-mediated membrane fusion (Jambunatathan et al., J. Virol. 85:12910–12918, 2011; V. N. Chouljenko, A. V. Iyer, S. Chowdhury, J. Kim, and K. G. Kousoulas, J. Virol. 84:8596–8606, 2010). In the current study, we constructed a recombinant virus with the gK gene deleted in the highly virulent ocular HSV-1 strain McKrae. This recombinant virus failed to infect rat ganglionic neuronal axons alone or cocultured with Vero cells in microfluidic chambers. In addition, lack of gK expression prevented anterograde transmission of virions. These results suggest that gK is a critical determinant for neuronal infection and transmission.
What Risk Assessments of Genetically Modified Organisms Can Learn from Institutional Analyses of Public Health Risks

The risks of genetically modified organisms (GMOs) are evaluated traditionally by combining hazard identification and exposure estimates to provide decision support for regulatory agencies. We question the utility of the classical risk paradigm and discuss its evolution in GMO risk assessment. First, we consider the problem of uncertainty, by comparing risk assessment for environmental toxins in the public health domain with genetically modified organisms in the environment; we use the specific comparison of an insecticide to a transgenic, insecticidal food crop. Next, we examine normal accident theory (NAT) as a heuristic to consider runaway effects of GMOs, such as negative community level consequences of gene flow from transgenic, insecticidal crops. These examples illustrate how risk assessments are made more complex and contentious by both their inherent uncertainty and the inevitability of failure beyond expectation in complex systems. We emphasize the value of conducting decision-support research, embracing uncertainty, increasing transparency, and building interdisciplinary institutions that can address the complex interactions between ecosystems and society. In particular, we argue against black boxing risk analysis, and for a program to educate policy makers about uncertainty and complexity, so that eventually, decision making is not the burden that falls upon scientists but is assumed by the public at large.
Toward Anticipatory Governance: The Experience with Nanotechnology

This volume argues that the emergence and institutionalization of nanotechnologies can only be fully grasped with respect to the ways contemporary reflections and deliberations contextualize them as future technologies. Because nanotechnologies are currently inchoate, even those stakeholders who recognize an interest in them often operate with only loosely formed and sometimes ill-conceived expectations of them. Even so, such projections are essential resources in legitimating and authorizing decision-making. In debates on nanotechnology, the future is “an active arena, one both pregnant and populated with agendas, interests and contestations” (Selin 2007: 214).
Assessing the Sociological Study of Asian American Christianity

In the following I review the extant literature on the sociology of Asian American Christianity which has grown exponentially since the 1980s. While some studies continue to offer complications to linear assimilation theories in explaining the role of religion among first and second generation Asian Americans, more recent research has employed other theoretical frames including supply-side religious economies, symbolic boundary formation, organizational fields, and contemporary racialization. Methodologically, the vast majority of these studies consist of regional comparisons of congregations, most of which are Chinese and Korean Protestant. In addition to a call for greater inclusion of non-Protestant Asian American Christians as well as South and Southeast Asian American Christians, I suggest substantive and methodological considerations for further research in the sociological study of Asian American Christianity.
Trace NO2 Detection Using Frequency Modulated Off-Axis Cavity Ring-Down Spectroscopy

Trace detection of NO2 at ppb-level is demonstrated using a vibration-insensitive variation of cavity ring-down spectroscopy. Modulating the laser frequency and off-axis alignment simplify the detector making it more suitable for in-situ monitoring.
La hibridación en las Cartas de Luis de Carvajal, el Mozo

En 1595, Luis de Carvajal el Mozo fue encarcelado por la Inquisicion en la Nueva Espana por segunda y ultima vez, junto con su madre Francisca y sus hermanas Ysabel, Leonor, Catalina y Ana. Durante su encarcelacion, Carvajal compuso cartas dirigidas a sus familiares. Sus epistolas tambien tienen como interlocutores implicitos a sus inquisidores, quienes, como Carvajal bien sabia, interceptaban sus misivas secretas. De este modo las cartas funcionan como una polemica oculta en la que Luis lucha de manera discursiva para reivindicar una subjetividad marginada. Su apropiacion consciente de elementos del discurso dominante demuestra que la nocion de sincretismo religioso como una amalgama inconsciente, en este caso, de elementos judios y catolicos, no esta lo suficientemente matizada. Por tanto, como marco teorico para aproxi-marse a los textos cripto-judios, propongo el empleo de las teorias de la hibridacion formuladas por Mijail M. Bajtin. In 1595, Luis de Carvajal, the Younger, along with his mother Francisca and sisters Isabel, Leonor, Catalina, and Ana, was jailed by the Inquisition in New Spain for the second and final time. During their incarceration, Carvajal composed letters that were addressed to his family members. If Carvajal’s explicit addressees were his family members, his epistles also figure his inquisitors as implicit interlocutors, who, as Carvajal well knew, were intercepting his secret missives. In this way, the letters function as a hidden polemic in which Carvajal struggles to defend a marginalized subjectivity. Carvajal’s deliberate appropriation of elements from the master discourse indicates that the notion of religious syncretism as an unconscious amalgam of, in this case, Jewish and Catholic components, is not a sufficiently nuanced critical model with which to analyze Crypto-Jewish writing, religiosity, and subjectivity. Therefore, I propose applying the theories of hybridity formulated by Mikhail M. Bakhtin.
Measuring the Congruence of Market Areas

Methods are proposed for assessing the boundary coincidence of two market areas that share the same distribution point. These methods may be used to test whether market areas vary in different dime...
Maternofetal Trauma in Craniosynostosis.

BACKGROUND Premature cranial suture fusion may prevent neonatal skull malleability during birth, increasing the risk of unplanned cesarean delivery and neonatal birth trauma caused by cephalopelvic disproportion. We sought to determine the incidence of perinatal maternofetal complications in cases of craniosynostosis. METHODS Records of children presenting with nonsyndromic craniosynostosis to a tertiary pediatric hospital from 1996 to 2012 were reviewed retrospectively with focus on birth history and birth-related complications. RESULTS Six hundred eighteen births were reviewed. Rates of cesarean delivery among mothers of children with craniosynostosis [n = 201 (32.5 percent)] exceeded the overall regional rate of 24.5 percent (OR, 1.50; p < 0.0001). Unplanned cesarean delivery occurred in 19.7 percent of births, and were most associated with nulliparous mothers, breech fetal presentations, and lambdoid or multisuture synostosis patterns. Eleven neonates (1.8 percent) exhibited cranial birth trauma, including cephalohematoma and subgaleal hematoma. Neonates with sagittal or multisuture synostosis patterns were more likely to suffer birth trauma and had a higher mean head circumference than those who did not (81st versus 66th percentile, p < 0.05). CONCLUSIONS In the setting of craniosynostosis, birth trauma is increased-for mothers in the form of increased cesarean delivery risk, and for fetuses in the form of subgaleal and subperiosteal perinatal bleeding. Difficult maternal labor may be mediated especially by multisuture or lambdoid synostosis, whereas fetal birth trauma may be mediated to a greater extent by large head size. Prenatal diagnosis of craniosynostosis could influence decision-making in the management of labor. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, IV.
Both midluteal serum progesterone levels and late luteal endometrial histology should be assessed in all infertile women

Criteria for diagnosis of luteal phase deficiency vary among specialists. Adequacy of corpus luteum function usually is based on a midluteal serum progesterone (P) concentration or a late luteal biopsy. To compare these two methods of determining luteal phase adequacy, 42 midluteal P levels were compared with late luteal endometrial biopsies from the same cycles in 34 women undergoing evaluation for infertility. Eleven cycles contained both hormonal and histologic evidence of luteal phase inadequacy; 12 contained only hormonal evidence of inadequacy; 9 contained only histologic evidence of inadequacy; and 10 contained both hormonal and histologic evidence of adequate luteal function. These data suggest that both midluteal phase P levels and late luteal endometrial biopsies should be assessed in infertile women, because neither can be used to predict the other.
The Nature of Faith

WE COME now to our main problem. What manner of cognition is the religious man’s awareness of God, and how is it related to his other cognitions?
Alternity, Acquisition, Invariance

I wonder if that aphasic moment when a word evades me is not suggestive of how a nonverbal animal engages the universe. But then when the word ‘comes to mind’, it has already reconstructed and particularized consciousness. It has the power to revise reality or even to generate alternate realities: fantasies, myths, lies. With the word forgotten or never learned, the universe must be taken nakedly, without the shaping gloss. For man the aphasic moment is a moment of irritation and dislocation, perhaps even panic or mental evacuation, or perhaps — if experienced religiously — of Buddhistic enlightenment.
Patterning the Embryonic Endoderm into Presumptive Organ Domains

The definitive endoderm germ layer in the late gastrula embryo (E7.5 in the mouse, HH4–5 in the chick) is a single layer of cells that are unspecified. Within two days of development (E9.5 mouse, HH18 chick), the definitive endoderm has formed a primitive gut tube with budding organ primordia. The late gastrula definitive endoderm is regionalized into axial and lateral domains along the anterior-posterior axis that give rise to the foregut, midgut and hindgut. By the early somite stage (E8.5 mouse, HH10 chick) the developing gut tube has become highly patterned at the molecular level. Genes are expressed in overlapping and distinct domains that indicate where organ buds will form. Several signaling pathways are involved in these early patterning mechanisms, including the fibroblast growth factors (FGFs), hedgehog, bone morphogenetic proteins (BMPs), retinoic acid (RA) and Wnt pathways. Disruption of these early patterning mechanisms can directly lead to defects in the development of endodermic organs including the thymus, parathyroid, lungs, liver, pancreas, and intestines. Genomics strategies are currently being used to identify molecular pathways involved in endoderm organogenesis. Information from endoderm organ development is being used to differentiate human embryonic stem cells into endoderm organ cell types, ultimately to treat degenerative diseases such as diabetes.
Capacity and absorption rate of tertiary and hindered amines blended with piperazine for CO2 capture

Abstract Aqueous piperazine (PZ) blended with a tertiary or hindered amine combines the high CO 2 capacity of the tertiary or hindered amine with the fast rate of PZ. For flue gas CO 2 capture, the optimum pK a (that which offers the highest CO 2 cyclic capacity) of a mono-tertiary amine blended with PZ is 9.1. A generic Aspen Plus® model for PZ/tertiary amine was developed to predict the CO 2 vapor-liquid-equilibrium (VLE) from the pK a of the tertiary amine. The polarity of the tertiary amine also affects the CO 2 solubility of the PZ/tertiary amine. Hindered amines that form little carbamate show similar CO 2 VLE to tertiary amines with the same pK a , when blended with PZ. The CO 2 absorption rate of most 2.5 m PZ/2.5 m tertiary amines was slightly slower than 2.5 m PZ, probably due to the higher viscosity of the blends.
Active Learning and Flipped Classroom, Hand in Hand Approach to Improve Students Learning in Human Anatomy and Physiology.

Because Human Anatomy and Physiology (A&P), a gateway course for allied health majors, has high dropout rates nationally, it is challenging to find a successful pedagogical intervention. Reports on the effect of integration of flipped classrooms and whether it improves learning are contradictory for different disciplines. Thus many educators are reluctant to explore the value of flipped classrooms. Therefore, in the present study we compare incorporating flipped classroom and minimal class discussion (control group) with flipped classroom and active learning activities (experimental group) in A&P and their impacts on both students’ exam performance and their satisfaction with the course. Assessments consisted of a survey of students’ attitudes and a comparison of exam performance in experimental and control groups. Exam performance among the students in flipped-classroom and active learning activities improved significantly relative to the control group [Mean ± SD: (76.93±18.33 vs 67.8±18.81), p<0.001. Student attitude, in which students rated the efficiency of pedagogical learning on a five-point Likert scale, was positive: the majority of students strongly preferred active-learning activities that were incorporated in the flipped-classroom. Students indicated that these activities helped them learn better and to connect the materials to the goals of their future careers (73.88% and 79.77% respectively). Therefore, we conclude that flipped classroom coupled with active learning strategies can improve students’ performance and attitude in the introductory A&P course.
Myelopathy due to Fibrocartilaginous Spinal Cord Embolism

Fibrocartilaginous embolism (FCE) is a condition in which a fragment of the nucleus pulposa migrating to block spinal cord arterial supply, resulting in ischemic infarction.
Incidence of Thrombosis in Serotonin Release Assay Negative Patients and Correlation with Pretest Heparin-Induced Thrombocytopenia Scoring System.

Introduction: Heparin-induced thrombocytopenia (HIT) is an immune mediated, adverse effect related to both unfractionated heparin (UFH) and low-molecular weight heparin (LMWH). HIT may result in significant morbidity and mortality. The serotonin release assay (SRA) is utilized in conjunction with clinical information to diagnosis HIT. Employment of the pretest clinical scoring system, known as the “4Ts”, classifies patients as having a low, intermediate or high probability for developing HIT. Previous investigators have reported clinically diagnosed HIT in patients with a negative SRA. However, there is no systematic study evaluating such a group of patients. We determined the frequency of thromboses in SRA negative patients and determined the correlation between the 4T score in patients with and without thromboses. Methods: We report a descriptive, single institution, retrospective study of 181 consecutive samples over the course of one year sent to the Coagulation Laboratory of St. Louis University for the work up of suspected HIT. A total of 142 patients were eligible. Patients with SRA negative samples were evaluated for evidence of thrombosis. Diagnosis of a thrombotic event was made by computed tomography (CT), venous Doppler ultrasonography (US), and ventilation-perfusion scanning (V/Q). Defined patient study groups were: all evalulable patients (PALL), patients with thromboses (TPOS) and patients without thromboses (TNEG). Analyses, between each patient group, the 4T score, mean platelet count prior to heparin therapy, and mean platelet nadirs were performed. Results: The overall incidence of proven thromboses in evaluable SRA negative patients was 14.8% (n=21). Of the 21 thromboses, 17(81.0%) were deep venous thromboses (DVT), 3(14.3%) were DVT and pulmonary embolus (PE), and 1(0.7%) was an isolated PE. A significant difference in 4T score was observed between TPOS vs PALL (p Conclusions: A higher incidence of thrombotic events in SRA negative patients was seen compared to historical data. A strong positive and negative correlation exists between high and low 4T scores, respectively, and the probability of thromboses from HIT. Prospective data are needed to address the incidence of thrombosis for patients in whom the pretest probability of HIT is high and in whom the SRA is negative. Studies evaluating the utility of serial SRA testing in such patients may lead to earlier identification of those at high risk for thromboses. Limitations of this study were the retrospective design, single institution, and the lack of serial SRA testing.
Flexible, Fine Grained Access Control for Internet of Things: Poster Abstract

Existing access control strategies for Internet of Things cannot provide good flexibility, robustness or quick response. We propose an access control approach of finer granularity and techniques supporting bulk operation to make interaction in IoT more flexible. Also, a decentralized strategy and data centric network techniques are used to enhance the system robustness and swiftness. We implement our design and conduct evaluation on security and performance.
Postfire soil water repellency in piñon–juniper woodlands: Extent, severity, and thickness relative to ecological site characteristics and climate

Wildfires can create or intensify water repellency in soil, limiting the soil's capacity to wet and retain water. The objective of this research was to quantify soil water repellency characteristics within burned pinon–juniper woodlands and relate this information to ecological site characteristics. We sampled soil water repellency across forty-one 1,000 m2 study plots within three major wildfires that burned in pinon–juniper woodlands. Water repellency was found to be extensive—present at 37% of the total points sampled—and strongly related to pinon–juniper canopy cover. Models developed for predicting SWR extent and severity had R2adj values of 0.67 and 0.61, respectively; both models included pinon–juniper canopy cover and relative humidity the month before the fire as coefficient terms. These results are important as they suggest that postfire water repellency will increase in the coming years as infilling processes enhance pinon–juniper canopy cover. Furthermore, reductions in relative humidity brought about by a changing climate have the potential to link additively with infilling processes to increase the frequency and intensity of wildfires and produce stronger water repellency over a greater spatial extent. In working through these challenges, land managers can apply the predictive models developed in this study to prioritize fuel control and postfire restoration treatments.
Randomized placebo-controlled pilot trial of omega 3 fatty acids for prevention of aromatase inhibitor-induced musculoskeletal pain

Aromatase inhibitor (AI)-induced joint symptoms negatively impact drug adherence and quality of life in breast cancer survivors. Mechanisms underlying symptoms may include inflammation. It is hypothesized that n − 3 polyunsaturated fatty acids (PUFAs) have anti-inflammatory properties and may reduce symptoms. We conducted a randomized, double-blind, placebo-controlled study comparing 4.3 g/day n − 3 PUFA supplements vs placebo for 24 weeks in postmenopausal breast cancer patients starting adjuvant AIs. Primary endpoints were adherence and tolerability; secondary outcomes included inflammatory cytokines and symptoms assessed by the Brief Pain Inventory short form (BPI-SF) and Functional Assessment of Cancer Treatment-Endocrine Symptoms (FACT-ES) at 0, 12, and 24 weeks. Forty-four women were randomized, of which 35 completed the study. Adherence was ≥ 88% based on these 35 patients with pill counts as well as change in red blood cell (RBC) n − 3 PUFAs. Common toxicities included grade 1 flatulence (55% of both groups) and belching (45% of n − 3 group). Mean pain severity scores (BPI-SF) did not change significantly by time or treatment arm. Quality of life, based on FACT-ES scores, significantly decreased within placebo (p = 0.04), but not the n − 3 group (p = 0.58), with a trend toward between-group differences (p = 0.06) at 12 weeks, but no significant differences at 24 weeks. RBC n − 3 levels were strongly positively correlated with FACT-ES at 12 weeks, but attenuated at 24 weeks. High-dose n − 3 PUFA supplementation is feasible and well tolerated when administered with AIs. Additional studies are needed to evaluate efficacy in prevention of joint symptoms.
Kinematic motion studies of an OmniDirectional mobile robot

Actuator failure may severely affect the performance of mobile robots and vehicles. This study serves to evaluate how a mobile system responds under various actuator failure modes to determine appropriate methods to satisfy performance objectives. We evaluate a kinematically symmetric holonomic mobile robot while fully actuable (with no motor/wheel failures), as well as under actuator failure conditions. Closed-loop state feedback is applied to the system to observe performance and self-correction under both nominal and failure mode conditions, and resulting performance is evaluated. Observations of these conditions motivate the need to address failure modes within the controller architecture.
Management of the Pregnant Asthmatic

Asthma occurs in approx 1% of pregnant women (1,2). This is comparable to the frequency of cardiac disease in pregnancy, making asthma one of the most common medical disorders complicating pregnancy. It is also comparable to the frequency of twin pregnancy. The frequency of asthma is known to be increasing, so we can anticipate an increased prevalence of asthma complicating pregnancy in coming years. Both the impact of asthma and asthma medication on the pregnancy and its outcome, as well as the impact of pregnancy on the severity of the patient’s asthma need to be considered. For these reasons there is a need for good communication between the obstetrician, the physician caring for the patient’s asthma, and any other physician involved in the care of the patient. It is also of vital importance that the patient be kept “in the loop.” In a climate of heightened awareness of the potential hazards of taking medication in pregnancy, many asthmatic women are understandably anxious about the possibility of birth defects resulting from their medication.
Barium Studies of the Upper GI Tract

Barium sulfate is commonly employed for radiographic visualization of the ­gastrointestinal (GI) tract. For the upper GI (UGI), the barium sulfate mixture is swallowed and traced radiographically as it passes through the oropharynx, hypopharynx, esophagus, and more distal GI tract. When there is a concern of perforation or obstruction, water soluble contrast should be used.
Food Safety: Mycotoxins – Occurrence and Toxic Effects

Mycotoxins are a diverse array of toxins produced by fungi that contaminate foods that induce a spectrum of biological effects in humans and animals. Initial recognition of the adverse effects of mycotoxins was determined from associations of acute toxicities to exposure. With the advent of biomarker strategies, chronic effects in humans and animals are now being elucidated. Regulatory concerns about mycotoxins have focused on these toxic effects. As we continue to study this class of contaminants, and explore the consequences of multiple mycotoxin interactions, we will refine our understanding of the toxicological effects of this vast number of chemicals.
A Lemma of Borel and Some Applications

Definition. A set E of real numbers has length ≤ l, written |E|≤ l, means that there is a countable union of intervals [a n ,b n ], a n ⩽ b n , that contains Eand such that $$ \sum {({{b}_{n}} - {{a}_{n}}) \leqslant \ell .} $$
a real-time performance analysis system for computers

ABSTRACT Computer systems are generally organized to provide adequate performance for a wide variety of applications. Rarely is a particular computer optimal for specific requirements of the customer. Consequently, the user is left with the task of determining how well the computer performs under various workloads, and, if possible, how to improve this performance. This paper describes a new tool, a Logic Analysis system, and how the performance of a computer system can potentially be improved by a very large factor - even after the system has been designed and implemented. The concept of performance is defined and discussed relative to the most common user requirements. Typical performance indices such as throughput rate, response time, instruction mix, and component overlap are introduced and followed by examples of how these indices are measured and displayed. Finally, the analysis system is discussed from the viewpoint of measurement accuracy, and a methodology is presented for assuring user-defined confidence levels and intervals.
Re-Examining the Development of Hirschman’s Linkage Analysis with Detection of Smithian Flavor

ABSTRACTHirschman’s production linkage (PL) framework has enjoyed a revival of interest since the 1980s, but its complexity and richness have been continually underappreciated. This paper clarifies...
Direct solid-phase peptide synthesis on chitosan microparticles for targeting tumor cells

Abstract An EGFR-targeting peptide with Ala-Glu-Tyr-Leu-Arg sequence was assembled directly onto the surface of spray-dried chitosan microparticles using solid-phase peptide synthesis with Fmoc chemistry. Both targeted and scrambled peptides were cleaved from chitosan with enzymatic digestion, isolated using reversed-phase HPLC, then identified with LC/MS/MS and amino acid analysis. Particles with conjugated peptides and fluorescent-labeled were characterized for binding with A549 (cancer) and WI-26 VA4 (normal) lung cells using flow cytometry and confocal microscopy. The purity of peptide synthesis was in the range of 74–77%. The cell binding studies revealed that particles modified with the peptide bind to lung cancer cells 8.3 times higher than the normal lung cells. The binding potential of surface-modified targeted particles to the tumor cells was compared with scrambled and unmodified ones and was found to be significantly different. The binding was 7.3–7.5-fold higher than the scrambled and unmodified particles, respectively. Modification of chitosan particles with direct assembly of Ala-Glu-Tyr-Leu-Arg peptide on their surface enhanced their targeting potential to lung cancer cells and could be used as a potential carrier for delivery and therapy. This approach can further be utilized for assembly of other short peptide ligands on micro- or nanoparticulate systems for tumor targeting.
Where Do Nonprofit and Civil Society Researchers Publish? Perceptions of Nonprofit Journal Quality

The field of nonprofit and civil society studies has grown tremendously in the past few decades, and scholarly journals have played a central role in this growth by facilitating circulation of research in the academic community. To date, only three nonprofit journals are indexed in the Social Science Citation Index (SSCI) and, as such, have an impact factor. There are, however, far more journals serving the nonprofit and civil society academic community. Thus, focusing solely on impact factors is not necessarily suitable for creating rankings or assessing journal quality in this field. Indeed, doing so fails to capture most scholarly publication outlets that focus on nonprofits and civil society. Seeking to overcome shortcomings of relying merely on impact factors, this exploratory study uses survey data collected from nonprofit and civil society researchers in the United States and Europe to provide insight into which journals they perceive to be quality outlets for nonprofit and civil society scholars. Our findings reveal that, while the impact factor can be one indicator of journal quality, newer outlets without an impact factor are also perceived to be viable outlets for publication by scholars in the field.
The Planning Process in Public and Private Blind Service Agencies

A nationwide survey of 25 administrators of public and private blind service agencies gathered overview information on the administrator's organizational planning processes. Statistically significa...
Chapter 3 – Predicting Agonist Effect

This chapter discusses the use of the Black–Leff operational model to quantify agonist affinity and efficacy. The operational model allows ascription of molecular properties (affinity in the form of KA and efficacy in the form of τ) for the prediction of agonist effect in different tissues from ratios of KA and τ obtained for agonists. This allows data obtained in test systems to predict what will be seen in therapeutic ones.
Endovascular Versus Open Repair for Ruptured Complex Abdominal Aortic Aneurysms: A Propensity Weighted Analysis.

Background This study evaluates 30-day mortality after endovascular aneurysm repair (EVAR) versus open repair for ruptured complex abdominal aortic aneurysms (cAAAs), including juxtarenal, pararenal, suprarenal, and extent IV thoracoabdominal aortic aneurysms (TAAA) in a real-world setting. Methods The Targeted Vascular Module from the American College of Surgeons National Surgical Quality Improvement Program was queried to identify patients undergoing repair for ruptured cAAA from 2011 to 2017. Primary endpoint was 30-day mortality. Secondary endpoints included renal failure, pulmonary complications, ischemic colitis, cardiac complications, lower extremity ischemia, post-operative rupture, and intensive care unit (ICU) length of stay (LOS). EVAR and open repair were compared using inverse probability weights. Results Four hundred forty-six patients had a ruptured cAAA repair during the study years; 105 (23.7%) were repaired via EVAR and 338 (76.3%) received open repair. The distribution by aneurysm type was as follows: 253 juxtarenal (57.1%), 59 pararenal (13.3%), and 100 suprarenal (22.6%) AAA with 31 type IV TAAA (7.0%). Juxtarenal aneurysms were more likely to be performed open than EVAR (P Conclusions Mortality after repair for ruptured cAAA is high; and treatment with EVAR may trend toward early survival advantage. Rates of renal failure were similar between each cohort. Open repair is associated with higher rates of pulmonary complications, ischemic colitis, and longer ICU stays.
Developing a Computer Graphics Course with a Game Development Engine

This paper reports on an intervention in introductory Computer Graphics courses, where practical coursework is transitioned from standard OpenGL Graphics APIs to the Unity Game Development Engine. Game Development Engines (GDEs) provide powerful programming tools and computing components. Software development in GDEs is facilitated by full-fledged IDEs. Complex scene modeling and image rendering are managed through a rich catalogue of rendering assets. Graphics APIs are evolving towards a lower level of hardware abstraction, reduced overhead, and multithreading capabilities. Such changes in APIs benefit software developers who build graphics engines; how much they benefit Computer Graphics education is yet to be determined. New graphics APIs represent a shift in graphics programming practices, nearly as big as programmable GPUs and shader-based APIs over a decade ago. As then, Computer Graphics instructors have to decide: either use outdated models, or again change how Computer Graphics is taught. This paper describes an educational approach that acknowledges the increasing divide between the ease of use and development speed of GDEs, and the complexity and vastness of new graphics APIs. We show the use of a GDE as software development framework, to support programming assignments covering core Computer Graphics concepts. Relying on a GDE, such graphics assignments don't have to shy away from shader-based graphics programming, while non-graphics low-level tasks are managed by the engine itself. With our approach, we hope to contribute to the discussion about evolving best practices in teaching Computer Graphics.
Neural Networks Based Feature Selection Approaches for Prognostics of Aircraft Engines

The majority of the Prognostics and Health Management (PHM) models proposed during the past few years have shown a significant increase in the amount of data-driven deployments. While more complex data-driven models are often associated with higher accuracy, there is a corresponding need to reduce model complexity. One possible way to reduce the complexity of the model is to use the feature (attribute or variable) selection and dimensionality reduction methods prior to the model training process. In this work, the effectiveness of multiple filter and wrapper feature selection methods (correlation analysis, relief forward/backward selection and etc.), along with Principal Component Analysis (PCA) as a dimensionality reduction method, was investigated. A basis algorithm of deep learning, Feedforward Artificial Neural Network (FFNN), was used as a benchmark modeling algorithm. As a case study, the prognostics of aircraft engine data from NASA Ames prognostics data repository was used to test the effectiveness of the filter and wrapper feature selection methods. The findings show that applying feature selection methods helps to improve model accuracy and significantly reduced the complexity of the models. This study hopes to be a baseline assumption for future complexity reduction solutions that can help in improving the deep learning approaches employed in the PHM domain.
Addressing Patient Bias and Discrimination Against Clinicians of Diverse Backgrounds

The duty to care for all patients is central to the health professions, but what happens when clinicians encounter patients who exhibit biased or discriminatory behaviors? While significant attention has focused on addressing clinician bias toward patients, incidents of patient bias toward clinicians also occur and are difficult to navigate.Clinicians anecdotally describe their experiences with patient bias, prejudice, and discrimination as profoundly painful and degrading. Though this phenomenon has not been rigorously studied, it is not unreasonable to postulate that the moral distress caused by patient bias may ultimately contribute to clinician burnout. Because women and minority clinicians are more likely to be targets of patient bias, this may worsen existing disparities for these groups and increase their risk for burnout. Biased behavior may also affect patient outcomes.Although some degree of ignoring derogatory comments is necessary to maintain professionalism and workflow, clinicians also have the right to a workplace free of mistreatment and abuse. How should clinicians reconcile the expectation to always "put patients first" with their basic right to be treated with dignity and respect? And how can health care organizations develop policies and training to mitigate the effects of these experiences?The authors discuss the ethical dilemmas associated with responding to prejudiced patients and then present a framework for clinicians to use when directly facing or witnessing biased behavior from patients. Finally, they describe strategies to address patient bias at the institutional level.
146. Structural allograft vs polyetheretherketone (PEEK) implants in patients undergoing spinal fusion surgery: a systematic review and meta-analysis

BACKGROUND CONTEXT Interbody spacers have been successfully used in spinal fusion procedures with the aim to restore disc height, provide stability and promote the bone fusion. PURPOSE The authors aimed to evaluate the efficacy of structural body allograft vs polyetheretherketone (PEEK) implants in patients undergoing spinal fusion surgery. STUDY DESIGN/SETTING We conducted a systematic review of the electronic databases using different MeSH terms from January 1970 to August 2019. PATIENT SAMPLE A total of 6,640 patients (structural allograft: 64% and PEEK cage: 36%) from 7 comparative studies were included in our analysis. OUTCOME MEASURES Outcome parameters included subsidence rate, mean change in lordotic angle, pseudarthrosis, reoperation, fusion rates and patient reported outcome measures. METHODS Pooled and sub-group analysis were performed using the random and fixed effect model based upon the I2 heterogeneity. RESULTS There was no statistically significant difference in terms of age (p=0.27), gender (p=0.31), body mass index (p=0.82) and smoking status (p=0.27) between the two groups. Overall, the mean follow-up was 12.9 ±1.5 months. Pooled meta-analysis revealed that patients with structural allograft had a 2.59-fold higher likelihood of fusion rates compared to patients with PEEK cages (OR: 2.59, 95% CI:1.02-6.57, p=0.05) at the last follow-up evaluation. Furthermore, patients with structural allograft had 61% less likelihood of pseudarthroses (OR: 0.39, 95%CI: 0.15-0.98, p=0.05) and 74% lower incidence of reoperation compared to patients with PEEK implants (OR:0.26, 95% CI:0.09-0.79, p=0.02). Although our results suggest that patients with structural allografts had a higher subsidence rate compared to PEEK implants, but it was statistically insignificant (OR:1.07, 95% CI: 0.45-2.53, p=0.89). CONCLUSIONS Our results corroborate that structural allografts are highly effective in promoting bony fusion compared to PEEK implants in patients undergoing spinal fusion surgery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
Misalignment of selection, plasticity, and among-individual variation: A test of theoretical predictions with Peromyscus maniculatus

Abstract Genetic variation and phenotypic plasticity are predicted to align with selection surfaces, a prediction that has rarely been empirically tested. Understanding the relationship between sources of phenotypic variation, i.e. genetic variation and plasticity, with selection surfaces improves our ability to predict a population’s ability to adapt to a changing environment and our understanding of how selection has shaped phenotypes. Here, we estimated the (co)variances among three different behaviors (activity, aggression, and anti-predator response) in a natural population of deer mice (Peromyscus maniculatus). Using multi-response generalized mixed effects models, we divided the phenotypic covariance matrix into among- and within-individual matrices. The among-individual covariances includes genetic and permanent environmental covariances (e.g. developmental plasticity) and is predicted to align with selection. Simultaneously, we estimated the within-individual (co)variances, which include reversible phenotypic plasticity. To determine whether genetic variation, plasticity and selection align in multivariate space we calculated the dimensions containing the greatest among-individual variation and the dimension in which most plasticity was expressed (i.e. the dominant eigenvector for the among- and within-individual covariance matrices respectively). We estimated selection coefficients based on survival estimates from a mark-recapture model. Alignment between the dominant eigenvectors of behavioural variation and the selection gradient was estimated by calculating the angle between them, with an angle of 0 indicating perfect alignment. The angle between vectors ranged from 68° to 89°, indicating that genetic variation, phenotypic plasticity, and selection are misaligned in this population. This misalignment could be due to the behaviors being close to their fitness optima, which is supported by low evolvabilities, or because of low selection pressure on these behaviors.
Laparoscopic Morgagni hernia repair on an infant using percutaneous suturing technique

Abstract Morgagni Hernias (MH) are anterior retrosternal diaphragmatic defects that necessitate surgical repair due to risk of incarceration. Historically, all repairs were performed through open surgery, but minimally invasive repair via abdominal or thoracic approach is becoming more commonly practiced. Closure of the diaphragmatic defect with the minimally invasive surgical technique is often completed using interrupted intracorporeal sutures. We present a case report of a 12-month-old male with asymptomatic MH, who underwent a novel laparoscopic approach to repair. The procedure began using three trocars to resect the hernia sac in a traditional fashion. Subsequently, the diaphragmatic defect was repaired using the subcutaneous endoscopically assisted suturing (SEAS) technique along the abdominal wall, similar to what was described by Harrison et al. for endoscopically-assisted inguinal hernia repair. The procedure was completed in 54 minutes. The patient tolerated the operation well, was discharged home post-operative day one and had no evidence of recurrence after five months. Laparoscopic repair of MH with percutaneous suturing is a novel approach that allows for safe, expeditious, and precise repair of a traditionally challenging procedure in small children with improved cosmetic outcomes.