cssi/SciSciGPT-SciSciNet huggingface dataset:
Data-driven segregation of trauma patients using principal component analysis yields novel, patient-specific insights into acute inflammation

Objectives: The human inflammatory response to trauma is a multidimensional, complex process that manifests in patient-topatient variability. We have attempted to elucidate aspects of this response using mathematical approaches, with the goal of improved diagnosis and treatment. Methods: Thirty-three trauma patients (20 males, 13 females; age, 44 ± 3; Injury Severity Score, 24 ± 3) were recruited after IRB approval. Serial blood samples were obtained from all 33 patients, with 3 samples within the first 24 hours. Twenty-five inflammatory cytokines in plasma were quantified using Luminex. The NO2/NO3 was measured using the nitrate reductase/Griess assay. Principal component analysis (PCA) followed by hierarchical clustering was used to suggest patient-specific principal inflammatory drivers. Results: Principal component analysis suggested that traumainduced inflammation was dominated by GM-CSF, TNF-α, IL-10, IL-15, and IL-β in this patient cohort. Individualized PCAwas carried out using cytokine and NO2/NO3 data obtained in the first 24 hours, to discern individual features of inflammation. We found that IL-1Ra (n = 16 patients), RANTES (n = 16 patients), MIP-1β (n = 14 patients), TNF-α (n = 12 patients), and IL-6 (n = 11 patients) dominate in the first component in these patients. This analysis delineated groups that differed significantly in their Marshall score (group A, 1.6 ± 0.25 vs group B, 4.33 ± 0.37) within the first 24 hours post injury. Patients in groups A and B, who were segregated based on patient-specific PCA based on inflammation biomarker data obtained within the first 24 hours, remained segregated (significantly lower Marshall score in group A vs group B) for up to 4 days. Conclusions: Although additional work is needed, these findings raise the potential for multiplexed cytokine analysis coupled with patient-specific PCA as a potential biomarker framework for outcome prediction in trauma.
Critical Limb Ischemia

Critical limb ischemia (CLI), defined as chronic ischemic rest pain, ulcers, or gangrene attributable to objectively proven arterial occlusive disease, is the most advanced form of peripheral arterial disease. Traditionally, open surgical bypass was the only effective treatment strategy for limb revascularization in this patient population. However, during the past decade, the introduction and evolution of endovascular procedures have significantly increased treatment options. In a certain subset of patients for whom either surgical or endovascular revascularization may not be appropriate, primary amputation remains a third treatment option. Definitive high-level evidence on which to base treatment decisions, with an emphasis on clinical and cost effectiveness, is still lacking. Treatment decisions in CLI are individualized, based on life expectancy, functional status, anatomy of the arterial occlusive disease, and surgical risk. For patients with aortoiliac disease, endovascular therapy has become first-line therapy for all but the most severe patterns of occlusion, and aortofemoral bypass surgery is a highly effective and durable treatment for the latter group. For infrainguinal disease, the available data suggest that surgical bypass with vein is the preferred therapy for CLI patients likely to survive 2 years or more, and for those with long segment occlusions or severe infrapopliteal disease who have an acceptable surgical risk. Endovascular therapy may be preferred in patients with reduced life expectancy, those who lack usable vein for bypass or who are at elevated risk for operation, and those with less severe arterial occlusions. Patients with unreconstructable disease, extensive necrosis involving weight-bearing areas, nonambulatory status, or other severe comorbidities may be considered for primary amputation or palliative measures.
Tunable narrow-linewidth photonic microwave generation using semiconductor laser dynamics

Generation of a broadly tunable narrow-linewidth microwave subcarrier on an optical wave by exploiting the nonlinear dynamics of a semiconductor laser through a proper combination of optical injection and optoelectronic feedback is experimentally demonstrated. The microwave frequency is generated by the period-one oscillation of an optically injected semiconductor laser. It is tuned in the range from 10 to 23 GHz by varying the optical injection strength, and its linewidth can be narrowed by optoelectronic feedback alone. The linewidth is reduced from the range of 40-120 MHz without stabilization by three orders of magnitude to the range of 10-160 kHz with stabilization through optoelectronic feedback alone. The effect of a small microwave modulation is also investigated. It reduces the linewidth to below the 1-kHz resolution limit of our instrument.
Prenatal Psychosocial Needs: Differences Between a TennCare Group and a Privately Insured Group in Appalachia

The purpose of this study was to determine the prenatal psychosocial needs of a group of women enrolled in TennCare, a Medicaid managed care program designed to cover all otherwise uninsured people in Tennessee, and compare them with privately insured women. Face-to-face interviews were conducted using standard and reliable questionnaires with a convenience sample of 120 pregnant women between 14 and 44 years of age and 16 to 28 weeks gestation at three prenatal clinics in East Tennessee. Chi-square analysis revealed that the TennCare enrollees in East Tennessee were significantly more likely to report higher psychosocial needs in pregnancy than the privately insured group. Women enrolled in TennCare had a significantly higher incidence of physical abuse, depressive symptoms, and smoking than the privately insured group. Pregnancy provides a window of opportunity for assessing and intervening with vulnerable women enrolled in Medicaid managed care who report psychosocial problems.
Effect of Film Thickness on the Validity of the Sauerbrey Equation for Hydrated Polyelectrolyte Films

The frequency and energy dissipation change of a quartz crystal microbalance during moisture absorption was measured for films with thickness ranging from 3 to 205 nm. Evidence of the viscoelastic nature of the films was observed for films thicker than 90 nm through the frequency and energy dissipation changes. For sufficiently thin films (t < 40 nm), the frequency change could be effectively modeled as a simple increase in mass, as predicted by the Sauerbrey equation. The viscosity of the swollen films was independent of initial polymer film thickness (93−205 nm). The equilibrium swelling ratio was independent of film thickness for all films examined (3−205 nm). The transition between the observation of a rigid film and a film showing viscoelastic character was found to be at β1D = 0.26 ± 0.10, where β1 = 2π/λs, λs is the shear wavelength, and D is the film thickness. This transition agrees with the predictions of White and Schrag (J. Chem. Phys. 1999, 111, 11192).
A Re-Examination of the Use of the Test of Standard Written English and Resulting Placement for Older Upper-Division and Master's Level Students

The Test of Standard Written English (TSWE) was developed to assess the ability of college students to use English. Most of the research has validated the use of the TSWE with freshman level students. The one study with older junior and master's degree level students was replicated with the one-year cumulative grade point average serving as the criterion variable. Confirmed was the finding that TSWE scores, resulting placement, and subsequent success in an English course (if required) was predictive of the academic success of older upper-division and master's level students.
A two-stage procedure for partially identified models

Abstract This paper studies a two-stage procedure for estimating partially identified models, based on Chernozhukov, Hong, and Tamer’s (2007) theory of set estimation and inference. We consider the case where a sub-vector of parameters or their identified set can be estimated separately from the rest, possibly subject to a priori restrictions. Our procedure constructs the second-stage set estimator and confidence set by taking appropriate level sets of a criterion function, using a first-stage estimator to impose restrictions on the parameter of interest. We give conditions under which the two-stage set estimator is a set-valued random element that is measurable in an appropriate sense. We also establish the consistency of the two-stage set estimator.
SOME DECISION QUESTIONS CONCERNING THE TIME COMPLEXITY OF LANGUAGE ACCEPTORS

Almost all the decision questions concerning the resource requirements of a computational device are undecidable. Here we want to understand the exact boundary that separates the undecidable from the decidable cases of such problems by considering the time complexity of very simple devices that include NFAs (1-way and 2-way), NPDAs and NPDAs augmented with counters - and their unambiguous restrictions. We consider several variations - based on whether the bound holds exactly or as an upper-bound and show decidability as well as undecidability results. We also introduce a stronger version of machine equivalence (known as run-time equivalence) and identify classes of machines for which run-time equivalence is decidable (undecidable). In the case of decidable problems, we also attempt to determine more precisely the complexity class to which the problem belongs.
Treatment for Insomnia in Depressed Adolescents

Objective: Sleep undergoes dramatic changes during the adolescent years due to biological, circadian, and psychosocial influences. It is now known that sleep loss, both acute and chronic, can affect emotion regulation and can increase the likelihood of developing depression and risky behaviors. Method: The authors carried out a systematic review utilizing the PubMed database by using the search terms including: “adolescence, depression, sleep, and insomnia.” The present review covers manuscripts accepted up to the year 2013. The following review discusses findings on the bidirectional relationship between insomnia and depression and will cover current evaluation and treatment options. Results: Depression can be present in up to 20 percent of adolescents and most of these children will have some form of sleep disturbance. The etiology of sleep disturbances may reflect insomnia, circadian rhythm sleep disorder, sleep apnea, or other factors. Pharmacological and cognitive behavioral therapy approaches are common, but may result in limited gains due to persistent insomnia. Antidepressant medications may be lessened and relapse may be higher in those with insomnia. Treatment monitoring may be helped by motivational interviewing techniques and examining the teen’s self-report over parental sleep reports. Conclusion: Sleep disturbances that are identified, addressed, and appropriately monitored may result in improved sleep and mood. Active involvement of the teen in the therapy process may improve outcomes. Further research is needed to develop non-pharmacological strategies that are acceptable and sustainable for adolescents
TUMOR NECROSIS FACTOR-α BINDING IN PORCINE PRIMARY STROMAL–VASCULAR CELL CULTURES

The binding characteristics of tumor necrosis factor-alpha receptors (TNFRs) in primary stromal-vascular cultures from fat tissue of 7-d-old pigs were analyzed. Cells were plated and maintained in 10% fetal bovine serum from day 0 to day 3 and then switched to serum-free medium from day 3 to day 6 to induce lipid filling. On days 3 and 6 of culture, some of the cells were lysed for ligand and immunoblotting and the remainder subjected to competitive and inhibitory-binding assays. Media from day 6 of culture were subjected to ligand and immunoblotting. Competitive binding analysis showed one-site bindings, with IC50s in the nanomolar and Kds in the picomolar ranges, that were not significantly different at both time-points of measurement. However, the Bmax decreased significantly with differentiation. Preincubation with antibody against TNF receptor type 1 (TNFR1) or TNF receptor type 2 reduced the specific binding by 95 and 15%, respectively, suggesting a dominating role of TNFR1 in 125I-labeled TNFalpha (125I-TNFalpha) binding. This was further supported by ligand blotting of cell lysates. Ligand and immunoblotting of cell lysates indicated that TNFalpha utilizes both types of surface receptors and their isoforms which were not modified during differentiation. Ligand blotting of media revealed soluble receptors with high Mr implying the formation of multimers. Immunoblotting suggested the presence of both types of TNFRs, but a greater abundance of soluble TNFR1. Also, it indicated the additional formation of smaller oligomers from both types of soluble receptors suggesting higher affinity of larger multimers for 125I-TNFalpha.
Optimal congestion pricing toll design for revenue maximization: comprehensive numerical results and implications

The purpose of this paper is to present bi-level optimization models and develop a genetic algorithm (GA) based method to solve the optimal congestion pricing toll design problem and to determine the second-best link-based optimal toll locations and toll levels simultaneously. The upper-level subprogram is to maximize the toll revenue collected while explicitly accounting for the toll booth setting up and operating cost, given certain toll level constraints. The lower-level subprogram is a traditional user equilibrium problem with elastic demand. The proposed GA model is applied to the Sioux Falls network, which has 76 links and 24 origin–destination pairs, assuming homogeneous users. Comprehensive numerical results including solutions achieved under continuous tolling and discrete tolling schemes, tolling on optimized links and tolling on heuristically selected most congested links are carefully presented and compared. The impact of value of time and the elastic demand sensitivity are also comprehensivel...
Tumor immunity in mice immunized with fibroblasts transfected with tumor DNA.

Accumulating evidence from multiple sources’ indicates that cancer cells form unique tumor associated antigens (TAAs). Under appropriate circumstances, they can become the targets of immune-mediated attack. Immunization of tumor-bearing animals, and patients, with tumor vaccines can stimulate anti tumor immune responses2’3leading to tumor rejection.
The Environmental Paradox of the City, Landscape, Urbanism, and New Urbanism

“The City Council, as you can well imagine, swallowed this line whole. Who wouldn’t? Landscape is good; building is landscape; therefore building is good. One hears this three-car train of logic constantly in architectural discourse today…Nothing sells like landscape. It’s our sex” (Heymann, 2011). “If you love nature, live in the city” (Glaeser, 2011). As the first quote above suggests, the proponents of Landscape Urbanism have been winning design competitions and commissions, as well as gaining professional and academic acclaim. Closely associated with hallowed ecological values, it has been given a wide berth in the media and public process. However, it has received limited analysis and criticism in the professional and academic worlds. New Urbanism, on the other hand, is an older and more organized movement whose agenda has been repeatedly dissected and critiqued. A critical comparison of the two is illuminating and timely in an era of increasing ecological degradation and climate disruption, as well as of rapid urbanization. Before comparing the two, the environmental merits and demerits of urbanism in general will be discussed.
Normal total plasma calcium in the newborn

The first week of human life is characterized by rapidly changing plasma calcium levels, as well as low concentrations in comparison with adults. Whereas the infant's cord blood has a higher concentration than the mother's blood, the level drops precipitously in the first 24 hr (first drop) after birth and reaches a minimum level (second drop) at about 48 hr. A third drop may follow between the fourth and seventh days, but is different from the other two in that it is generally preventable with proper milk feeding. The level is markedly influenced by starvation, diet, and age. During the first week, the full-term newborn may show calcium levels in the range of 1.75 to 3.00 mmol/1, whereas the premature newborn shows values of 1.50 to 2.50 mmol/1. The low birth weight infant displays intermediate values. The literature on diseases involving calcium in the newborn, particularly neonatal tetany, is especially helpful in establishing a concept of normal levels, providing clinically supported upper and lower values. Calcium studies on the new born have been notably advanced by use of sound ultramicrochemical analytical methods.
Robotic-assisted Laparoscopic Pyeloplasty: Analysis of Symptomatic Patients With Equivocal Renal Scans

Objectives To review the objective and subjective success rates of robotic-assisted laparoscopic pyeloplasty in symptomatic patients with radiographic findings suggestive of uretero-pelvic junction obstruction (UPJO), but equivocal renal scans (diuretic T1/2 Methods We reviewed 77 patients with symptomatic UPJO, who underwent robotic-assisted laparoscopic pyeloplasty between August 2006 and March 2013. We grouped patients by renal scan findings into 1 of 2 groups, obstructed (diuretic T1/2 ≥20 minutes) or equivocal (diuretic T1/2 Results Mean age was 40.7 years (range 17-80) with 70% female. UPJO occurred 44% left and 56% right, with 92% presenting with flank pain. Of 77 patients, 45 had obstruction on renal scan, with 41 (91%) having resolution of obstruction postoperatively and 44 of 45 (98%) having complete resolution of their initial symptoms. Thirty-two patients had equivocal findings with mean diuretic T1/2 of 12.6 minutes (range: 5.5-19.26) on renal scan. In this latter group, patients had significantly less of a decrease in their diuretic T1/2 postoperatively (4 vs 64 minutes, P = .018) and reported less pain resolution (53% vs 98%, P ≤.001) than group 1. Conclusion Many studies have demonstrated excellent success of pyeloplasty, with most series including patients meeting strict diagnostic criteria for obstruction. Our study examines outcomes in patients with clinically symptomatic UPJO and equivocal diuretic renography. In our cohort, equivocal patients were significantly less likely to have subjective resolution of symptoms than patients in the obstructed group.
The Elementary Transcendental Functions

(1954). The Elementary Transcendental Functions. The American Mathematical Monthly: Vol. 61, No. 6, pp. 386-392.
Does discipline fairness matter for the police code of silence? Answers from the US supervisors and line officers

Purpose – Following the theoretical model of reporting and disciplinary fairness developed by Kutnjak Ivkovic and Klockars (1998), the purpose of this paper is to use a survey of US police officers to explore empirically the contours of the code of silence and the potential relation between the code and perceptions of disciplinary fairness. Design/methodology/approach – In 2013-2014, a police integrity survey was used to measure the contours of police integrity among 604 police officers from 11 police agencies located in the Midwest and on the East Coast of the USA. The questionnaire contains descriptions of 11 scenarios describing various forms of police misconduct, followed by seven questions measuring officer views of scenario seriousness, the appropriate and expected discipline, and willingness to report misconduct. Findings – The results point out that the code of silence varies greatly across the scenarios, both for supervisors and line officers. While the supervisor code and the line officer code d...
EFFECT OF CHANNELING ON THE SCINTILLATION RESPONSE OF NaI(Tl) TO POSITIVE IONS

The scintillation response of NaI(T1) to ions has heen studied in the MeV region with the ion beam aligned along low index axes and planes and also along a random direction. The scintillation efficiency increases when the beam is channeled along a major symmetry direction. This effect is due to the lower electronic stopping power experienced by a channeled particle. The effect of channeling is observed along {100}, {110}, and {111} planes and along , and axes. These experiments also permit study of channeling phenomena in thick crystals, e.g. measurement of the channeling critical angle.
Feedback Passivation of Discrete-Time Systems Under Communication Constraints

Passivity is a desirable property of a dynamical system because it implies stability and is invariant under negative feedback and parallel interconnections. Feedback passivation is the process of making a nonpassive system passive through feedback control. In this technical note, we study the problem of feedback passivation when the controller has limited information about the state of the plant. Nonlinear plants that are linear in the control inputs are considered. The main result of the technical note is a certainty equivalence principle: any state feedback controller that ensures closed-loop input-strict passivity with index $\mu$ using the exact state of the plant will also ensure closed-loop stochastic quasi passivity using an estimate of the state, provided that the infinity norm of the estimation error process is bounded by some function of $\mu$ . A corollary is that for linear systems, although passivity is more strict than stability, feedback passivation does not place more constraints on the estimation error and hence does not demand more from the communication channel than mean square stabilization.
Lethal ischemia due to intracoronary endothelin in pigs.

Endothelin is a recently discovered endothelium-derived peptide with potent coronary constrictor properties in vitro. To evaluate endothelin9s cardiac actions in vivo, we measured coronary flow and regional myocardial shortening when intracoronary porcine endothelin was given to anesthetized open-chested pigs. Bolus adminstration into the left anterior descending (LAD) coronary artery of six pigs caused dose-related rapidly reversing depression of LAD flow and local shortening. Marked reductions in flow [-71 +/- 8 (SE) %] and shortening (-83 +/- 2%) after 30 pmol/kg demonstrated endothelin9s potency in cardiac tissues. Systemic hemodynamic values were unaltered except for transient rises in left ventricular end-diastolic pressure. Endothelin-induced decrement in LAD flow was accompanied by electrocardiographic signs of myocardial ischemia and net release of local myocardial lactate. Intracoronary infusion of endothelin, 15 pmol.kg-1.min-1, caused progressive decline in LAD flow and local shortening followed by severe persistent hypotension and terminal ventricular fibrillation in four of five pigs. Unlike intracoronary delivery of other potent coronary constrictors, intracoronary administration of endothelin did not lead to rapid escape from the peptide9s deleterious influence. Coronary exposure to endothelin under pathophysiological circumstances could result in uniquely persistent decrements in myocardial perfusion and contractile function.
Ultrastructural Morphology of the Hyphal Sheath of Wood Decay Fungi Modified by Preparation for Scanning Electron Microscopy

Our previous attempts to elucidate the structure and extent of the hyphal sheath of wood-decay fungi by scanning electron microscopy (SEM) showed that different preparative methodologies yield differing and frequently conflicting results. Foisner et al. (1985a and b), Highley and Murmanis (1985, 1987), and Green et al. (1989) provided substantial ultrastructural evidence for the presence of extracellular membranous structures that assume a variety of forms, including sheets, tubules, vesicles, and fibers. Evans et al. (1981) reported a fibrillar sheath surrounded by a tripartite pellicle on rapidly growing Bipolaris maydis. Day et al. (1986a and b) also provided evidence for extracellular fungal stuctures, called “fungal fimbriae”, which the authors described as primarily proteinaceous. Foisner et al. (1985a and b) analyzed isolated, extracellular membranous structures, which were reportedly composed of carbohydrate, protein, and lipid. These structures were better visualized by transmission electron microscopy (TEM) after treatment with osmium and/or ruthenium red.
The Scientific Meeting

There are many types of scientific meetings. The most familiar meetings are those sponsored and convened by a scientific organization. These organizations can be international, national, regional, or state. The primary organization for food science is IFT, Institute of Food Technologists. Other important organizations for food scientists are ASM (the American Society for Microbiology) and ACS (the American Chemical Society). A list of organizations of interest to food scientists can be found in Table 10.1. IFT is a unique organization in that it combines a scientific meeting with a trade show (see Fig. 10.1). Every food scientist needs to attend the IFT meeting at least once in a lifetime. It must be experienced to be appreciated. Every practicing scientist should become a member of a scientific organization. University food scientists usually belong to at least one additional organization that is more aligned with their disciplinary perspective such as ACS or ASM. For postharvest physiologists, ASHS (American Society for Horticultural Science) and ASPB (American Society of Plant Biologists) offer alternatives. Few alternatives to IFT have a major trade show at their meetings analogous to IFT. Industrial food scientists usually divide up responsibilities among relevant societies within the company to cover each of the important areas.
The Design For Testability Methodology

The synthesis algorithm described in Chapter 6 produces a circuit implementation that is guaranteed to be hazard-free if and only if a set of inequalities among path delays inside the circuit is satisfied. So using a suitable delay model during the synthesis process it is possible to guarantee hazard-freeness in the absence of delay faults. Now our goal is to test those path delays, and be sure that the above mentioned inequalities are satisfied in each manufactured circuit.
A Comprehensive Index for Predicting Risk of Anemia from Patients' Diagnoses.

Abstract This article demonstrates how time-dependent, interacting, and repeating risk factors can be used to create more accurate predictive medicine. In particular, we show how emergence of anemia can be predicted from medical history within electronic health records. We used the Veterans Affairs Informatics and Computing Infrastructure database to examine a retrospective cohort of 9,738,838 veterans over an 11-year period. Using International Clinical Diagnoses Version 9 codes organized into 25 major diagnostic categories, we measured progression of disease by examining changes in risk over time, interactions in risk of combination of diseases, and elevated risk associated with repeated hospitalization for the same diagnostic category. The maximum risk associated with each diagnostic category was used to predict anemia. The accuracy of the model was assessed using a validation cohort. Age and several diagnostic categories significantly contributed to the prediction of anemia. The largest contributors w...
Activation of Nuclear Factor−κB by Tumor Necrosis Factor in Intestinal Epithelial Cells and Mouse Intestinal Epithelia Reduces Expression of the Chloride Transporter SLC26A3

Background & Aims Diarrhea associated with inflammatory bowel diseases has been associated with increased levels of inflammatory cytokines, including tumor necrosis factor (TNF). The intestinal mucosa of patients with inflammatory bowel diseases has reduced expression of solute carrier family 26 member 3 (SLC26A3, also called DRA). We investigated whether TNF directly affects expression of DRA in human intestinal epithelial cells (IECs) and in the intestines of mice, and studied the mechanisms of these effects. Methods We performed quantitative reverse transcription polymerase chain reaction, immunofluorescence, and immunoblot analyses in Caco-2, HT-29, and T-84 cells human IECs cultured in 2 or 3 dimensions with or without TNF (50 ng/mL for 6–24 hours). We purified nuclear extracts and quantified nuclear factor−κB (NF-κB) activation and DNA binding. We isolated intestinal crypts from C57BL/6 mice, cultured enteroids, incubated these with TNF (50 ng/mL, 24 hours), and quantified messenger RNAs. DRA-mediated exchange of Cl − for HCO 3 − was measured by uptake of 125 I. Expression of the NF-κB inhibitor α (IkBa) was knocked down in Caco-2 cells with small interfering RNAs. Activation of NF-κB in response to TNF was measured by luciferase reporter assays; binding of the NF-κB subunit p65 in cells was analyzed in chromatin immunoprecipitation assays. DRA promoter activity was measured in a luciferase reporter assay. C57BL/6 mice were injected with TNF (5 μg/mouse for 3–6 hours) or vehicle (control); intestines were collected and analyzed by immunofluorescence, or RNA and protein were collected from the mucosa. Results Incubation of IECs with TNF reduced expression of DRA. Knockdown of NF-κB inhibitor α in IECs led to nuclear translocation of the NF-κB subunit p65 and reduced levels of DRA messenger RNA and protein. Expression of a transgene encoding p65 or p50 in IECs led to significant reductions in the promoter activity of DRA and its expression. In chromatin immunoprecipitation assays, p65 bound directly to the promoter of DRA , at the regions of −935 to −629 and −375 to −84. Injection of mice with TNF or incubation of crypt-derived enteroids with TNF reduced their expression of DRA messenger RNA and protein. Conclusions In human IECs and intestinal tissues from mice, we found TNF to activate NF-κB, which reduced expression of the Cl − / HCO 3 − exchanger DRA (SLC26A3), via direct binding to the promoter of DRA. This pathway is an important therapeutic target for inflammatory bowel disease−associated diarrhea.
Distribution of Medical Education Debt by Specialty, 2010-2016.

This survey study analyzes the trends in the distribution of medical education debt by focusing on the increase in graduates without such debt.
Oncology providers, patients, and caregivers reflect: Applying "big data" for better supportive outcomes.

59Background: The development of “big data” methods offers an opportunity to more precisely predict patient outcomes. We explored physicians, patients, and caregivers’ perspectives about the use of predictive models in oncology practice. Methods: We conducted 12 patient, 12 provider, and 12 caregiver interviews (N = 36) from Stanford University outpatient oncology clinics. We queried participants about patient and family-centered applications of predictive models for prognosis, cost, and novel patient and family-centered outcomes. Two trained coders iteratively examined transcripts for consistent topics and used the constant comparative methods to establish themes and sub-themes. Results: Several overlapping themes emerged: 1) Outcomes of Interest, [provider] “Predictive information about side effects or adverse effects of treatment would be helpful”: 2) Barriers to Using Predictions, [patient] “If it seems too sort of set in stone, without…you know, everything has grey areas”; 3) Benefits to Using Predic...
Teaching Low-Income Spanish-Speaking Caregivers to Implement EMT en Español With Their Young Children With Language Impairment: A Pilot Study

Purpose This study examined the effectiveness of teaching low-income Spanish-speaking caregivers of young children with language impairment a naturalistic language intervention, EMT en Espanol. Met...
When Physicians and Surrogates Disagree about Futility

Situations in which the patient's family seems not to be acting in good faith or the patient's suffering is uncontrollable are relatively rare and do not warrant giving physicians unilateral power to withhold or withdraw treatment in all cases of perceived medical futility.
External Snapping Hip

External snapping hip is caused by the iliotibial (IT) band moving over the greater trochanter. In contrast, internal snapping hip is typically caused by the iliopsoas tendon moving over either the femoral head or the iliopectineal eminence. These are both extra-articular causes of snapping hip; there are also intra-articular causes. The diagnosis of external snapping hip is typically clinical, with many patients able to demonstrate the snapping upon request. Treatment should consist of physical therapy and IT band stretching. Injections of corticosteroid may be helpful in the cases of painful snapping hip, typically caused by associated trochanteric bursitis. If these interventions fail, surgical windowing or lengthening of the IT band is the next option. Hip abduction weakness or a Trendelenburg gait are possible complications of this operation.
Alcohol in human history

The role of ethanol in the history of human development is here summarized under seven topics: I. Alcohol: the substitute for water as the major human beverage; II. Alcohol as a component of the diet and source of calories; III. Alcohol, concentration by distillation; IV. The Reformation, Temperance and Prohibition; V. Potable nonalcoholic beverages: Boiled water (coffee, tea); VI. Purification and sanitation of water; VII. The present and future.
Power problems in VLSI circuit testing

Controlling or reducing power consumption during test and reducing test time are conflicting goals. Weighted random patterns (WRP) and transition density patterns (TDP) can be effectively deployed to reduce test length with higher fault coverage in scan-BIST circuits. New test pattern generators (TPG) are proposed to generate weighted random patterns and controlled transition density patterns to facilitate efficient scan-BIST implementations. We achieve reduction in test application time without sacrificing fault coverage while maintaining any given test power constrain by dynamically adapting the scan clock, accomplished by a built-in hardware monitor of transition density in the scan register.
Extension of Twisted Pluricanonical Sections with Plurisubharmonic Weight and Invariance of Semipositively Twisted Plurigenera for Manifolds Not Necessarily of General Type

Let X be a holomorphic family of compact complex projective algebraic manifolds with fibers X t over the open unit 1-disk Δ. Let \( K_{x_t } \) and K X be respectively the canonical line bundles of X t and X. We prove that, if L is a holomorphic Une bundle over X with a (possibly singular) metric e −ϕ of semipositive curvature current on X such that e −ϕ|x 0 is locally integrable on X 0, then for any positive integer m, any s ∈ Γ(m \( K_{x_0 } \) + L) with |s|2 e −ϕ locally bounded on X 0 can be extended to an element of Γ (X, m K X + L). In particular, dim Γ (X t , m \( K_{x_t } \) + L) is independent of t for ϕ smooth. The case of trivial L gives the deformational invariance of the plurigenera. The method of proof uses an appropriately formulated effective version, with estimates, of the argument in the author’s earlier paper on the invariance of plurigenera for general type. A delicate point of the estimates involves the use of metrics as singular as possible for p \( K_{x_0 } \) + a p L on X 0 to make the dimension of the space of L 2 holomorphic sections over X 0 bounded independently of p, where a p is the smallest integer \( \geqslant \frac{{p - 1}} {m} \) . These metrics are constructed from s. More conventional metrics, independent of s, such as generalized Bergman kernels are not singular enough for the estimates.
Quantitative cytoplasmic TUNEL: the method to measure apoptosis and necrosis coexisting in a single liver or kidney cell

Apoptosis in solid organs often develops to and overlaps with necrosis, presenting so called “aponecrosis.” Methods for simultaneous quantification of apoptosis and necrosis in a single cell do not...
CMPK2 and BCL-G are associated with type 1 interferon–induced HIV restriction in humans

Type 1 interferons (IFN) are critical for host control of HIV and simian immunodeficiency virus. However, it is unknown which of the hundreds of interferon-stimulated genes (ISGs) restrict HIV in vivo. We sequenced RNA from cells that support HIV replication (activated CD4+ T cells) in 19 HIV-infected people before and after interferon-α2b (IFN-α2b) injection. IFN-α2b administration reduced plasma HIV RNA and induced mRNA expression in activated CD4+ T cells: The IFN-α2b-induced change of each mRNA was compared to the change in plasma HIV RNA. Of 99 ISGs, 13 were associated in magnitude with plasma HIV RNA decline. In addition to well-known restriction factors among the 13 ISGs, two novel genes, CMPK2 and BCL-G, were identified and confirmed for their ability to restrict HIV in vitro: The effect of IFN on HIV restriction in culture was attenuated with RNA interference to CMPK2, and overexpression of BCL-G diminished HIV replication. These studies reveal novel antiviral molecules that are linked with IFN-mediated restriction of HIV in humans.
Case Series: Management of Neurotrophic Keratitis from Familial Dysautonomia.

Significance Familial dysautonomia is a rare genetic disorder that affects the sensory and autonomic nervous systems. Affected individuals have decreased corneal sensation and can develop serious complications from neurotrophic keratitis. Scleral devices are an excellent option for the long-term management of patients with familial dysautonomia and neurotrophic keratitis. Purpose In this series, we describe three patients with familial dysautonomia and classic ocular complications fit with scleral devices. No identifiable health information is included in this case report. Case reports Case 1: A 35-year-old white male presented with blurred vision without complaint of pain or dryness. He had moderate punctate corneal staining and central stromal corneal scarring in both eyes despite use of artificial tears, punctal plugs, and therapeutic soft lenses. He was fit with 18.2-mm commercial scleral devices, which improved vision and protected the ocular surface. Case 2: A 20-year-old cognitively impaired white female presented with history of frequent eye rubbing and self-mutilation. She had recurrent corneal abrasions with corneal scarring in both eyes and was fit with 16-mm gas-permeable prosthetic replacement of the ocular surface ecosystem devices. Case 3: An 18-year-old white male with history of frequent corneal abrasions and blurred vision was referred by his medical doctor. He and his mother were trained in the safe handling of 16- and 16.5-mm gas-permeable prosthetic replacement of the ocular surface ecosystem devices in the right and left eyes. Corneal epithelial defects healed and vision improved with daily use. Conclusions Individuals with familial dysautonomia present unique clinical challenges owing to severe ocular surface disease and inability to perceive pain. Initial therapy for neurotrophic keratitis includes lubrication, punctal occlusion, and therapeutic lenses. Additional therapies include autologous serum tears, amniotic membrane treatment, scleral devices, and tarsorrhaphy. In this series, scleral devices are an excellent option to protect the ocular surface and prevent common ocular complications.
Revisional Paraesophageal Hernia: Tips and Tricks

Paraesophageal hernias have among the highest recurrence rates of all hernias and represent a technically challenging problem for the surgeon. There is broad heterogeneity in both the type of paraesophageal hernia as well as the options for repair. This chapter will review the evaluation of a patient with a recurrent paraesophageal hernia as well the factors involved in patient selection. We will detail our preferred operative technique in recurrent paraesophageal hernia repair as well as technical considerations. Finally the results of repair are reviewed.
Development of an Earth and Space Science-Focused Education Program at Howard University

We have developed a curriculum at Howard University that educates and prepares students, especially underrepresented minorities, for careers in Atmospheric, Earth and Space Sciences. One of the main objectives of the current initiative has been to provide introductory Earth & Space Science courses at the undergraduate level through the Department of Physics & Astronomy. These courses enhance student learning by including astronomical observing and laboratory demonstration opportunities at the Howard University Observatory. Intermediate-level courses in Atmospheric and Space Science have also been designed, and will serve as a bridge toward the graduate-level courses currently being offered by the M.S./Ph.D.-granting Howard University Program in Atmospheric Sciences (HUPAS). HUPAS is the first and only program at a Historically Black College or University (HBCU) that offers a terminal graduate degree (M.S. or Ph.D.) in Atmospheric Sciences. Currently, a total of 23 graduate students are enrolled in HUPAS, ...
ICT and Indigenous Education: Emerging Challenges and Potential Solutions

This chapter takes a broad look at the ways in which Information and Communication Technology (ICT) has been utilized to expand access to education for previously underserved populations. At the same time, the chapter raises new challenges to meet educational needs, particularly those of indigenous populations, by discussing ICT use for professional development and cultural preservation. The chapter describes the need for maintaining respect for diverse classroom communities, producing culturally appropriate web-based educational materials in multiple languages, and building upon a community’s unique cultural customs and strengths. The chapter concludes that further research, evaluation, and policies are needed in order to make technology a viable solution for promoting indigenous knowledge.
The Fight for a New England Turpentine Trade: Empire, Markets, and the Colonial Landscape at the Turn of the Eighteenth Century

Imperial wars and Atlantic markets drove a boom in turpentine production in turn-of-the-eighteenth-century New England. English Colonists used techniques learned from Huguenot refugees to exploit l...
Preconditioning of mesenchymal stromal cells with low-intensity ultrasound: influence on chondrogenesis and directed SOX9 signaling pathways

Continuous low-intensity ultrasound (cLIUS) facilitates the chondrogenic differentiation of human mesenchymal stromal cells (MSCs) in the absence of exogenously added transforming growth factor-beta (TGFβ) by upregulating the expression of transcription factor SOX9, a master regulator of chondrogenesis. The present study evaluated the molecular events associated with the signaling pathways impacting SOX9 gene and protein expression under cLIUS. Human bone marrow-derived MSCs were exposed to cLIUS stimulation at 14 kPa (5 MHz, 2.5 Vpp) for 5 min. The gene and protein expression of SOX9 was evaluated. The specificity of SOX9 upregulation under cLIUS was determined by treating the MSCs with small molecule inhibitors of select signaling molecules, followed by cLIUS treatment. Signaling events regulating SOX9 expression under cLIUS were analyzed by gene expression, immunofluorescence staining, and western blotting. cLIUS upregulated the gene expression of SOX9 and enhanced the nuclear localization of SOX9 protein when compared to non-cLIUS-stimulated control. cLIUS was noted to enhance the phosphorylation of the signaling molecule ERK1/2. Inhibition of MEK/ERK1/2 by PD98059 resulted in the effective abrogation of cLIUS-induced SOX9 expression, indicating that cLIUS-induced SOX9 upregulation was dependent on the phosphorylation of ERK1/2. Inhibition of integrin and TRPV4, the upstream cell-surface effectors of ERK1/2, did not inhibit the phosphorylation of ERK1/2 and therefore did not abrogate cLIUS-induced SOX9 expression, thereby suggesting the involvement of other mechanoreceptors. Consequently, the effect of cLIUS on the actin cytoskeleton, a mechanosensitive receptor regulating SOX9, was evaluated. Diffused and disrupted actin fibers observed in MSCs under cLIUS closely resembled actin disruption by treatment with cytoskeletal drug Y27632, which is known to increase the gene expression of SOX9. The upregulation of SOX9 under cLIUS was, therefore, related to cLIUS-induced actin reorganization. SOX9 upregulation induced by actin reorganization was also found to be dependent on the phosphorylation of ERK1/2. Collectively, preconditioning of MSCs by cLIUS resulted in the nuclear localization of SOX9, phosphorylation of ERK1/2 and disruption of actin filaments, and the expression of SOX9 was dependent on the phosphorylation of ERK1/2 under cLIUS.
Treatment burden following standard of care open versus robotic D2 gastrectomy plus neoadjuvant chemotherapy (NAC) for locally advanced gastric cancer (LAGC).

303Background: Phase III trials demonstrate improved short-term outcomes after laparoscopic gastrectomy for LAGC compared to open. We hypothesized that robotic D2 gastrectomy after NAC (NAC/RG) yie...
INDUSTRY AND PRACTICE: Another Look at On Time and Within Budget: An Agency Theory Explanation

Over the years, IT projects have gained the reputation for being completed late and beyond budget. Project managers, consultants, academic researchers, and others have suggested reasons. Perhaps IT projects grow uncontrollably beyond their initial scope. Maybe cost estimators simply underestimate their complexity. Weâ€™ve been thinking about cost and target overruns. We propose another explanation. It uses agency theory to account for the problems. Our argument is thus that IT researchers should test agency in the context of IT projects.
Writing the History of Human Rights: A world divided: the global struggle for human rights in the age of nation-states, by Eric D. Weitz, Princeton, Princeton University Press, 2019, 576 pp., USD$35.00 (hardcover), ISBN: 9780691145440

I would like first to express my gratitude to Dirk Moses for arranging this forum and to the four colleagues whose own scholarship is so important and from whom I have learned a great deal. It is i...
Pre-operative headaches and obstructive hydrocephalus predict an extended length of stay following suboccipital decompression for pediatric Chiari I malformation

For young children and adolescents with Chiari malformation type I (CM-I), the determinants of extended length of hospital stay (LOS) after neurosurgical suboccipital decompression are obscure. Here, we investigate the impact of patient- and hospital-level risk factors on extended LOS following surgical decompression for CM-I in young children to adolescents. The Kids’ Inpatient Database year 2012 was queried. Pediatric CM-I patients (6–18 years) undergoing surgical decompression were identified. Weighted patient demographics, comorbidities, complications, LOS, disposition, and total cost were recorded. A multivariate logistic regression was used to determine the odds ratio for risk-adjusted LOS. The primary outcome was the degree patient comorbidities or post-operative complications correlated with extended LOS. A total of 1592 pediatric CM-I patients were identified for which 328 (20.6%) patients had extended LOS (normal LOS, 1264; extended LOS, 328). Age, gender, race, median household income quartile, and healthcare coverage distributions were similar between the two cohorts. Patients with extended LOS had significantly greater admission comorbidities including headache symptoms, nausea and vomiting, obstructive hydrocephalus, lack of coordination, deficiency anemias, and fluid and electrolyte disorders. On multivariate logistic regression, several risk factors were associated with extended LOS, including headache symptoms, obstructive hydrocephalus, and fluid and electrolyte disorders. Our study using the Kids’ Inpatient Database demonstrates that presenting symptoms and signs, including headaches and obstructive hydrocephalus, respectively, are significantly associated with extended LOS following decompression for pediatric CM-I.
Forward: Presidential Power and Foreign Affairs

“Presidential Power and Foreign Affairs,” was funded by a grant from the Wolf Family Foundation, organized by Case Western Reserve’s Frederick K. Cox International Law Center, and co-sponsored by the International Association of Penal Law (American National Section), the American Society of International Law, the International Law Association (American Branch), and the Public International Law and Policy Group.