cssi/SciSciGPT-SciSciNet huggingface dataset:
Microglia Initiate Central Nervous System Innate and Adaptive Immune Responses through Multiple TLRs

Microglia are the resident macrophage-like population in the CNS. Microglia remain quiescent until injury or infection activates the cells to perform effector inflammatory and APC functions. Our previous studies have shown that microglia infected with a neurotropic strain of Theiler's murine encephalomyelitis virus secreted innate immune cytokines and up-regulated costimulatory molecules and MHC class II, enabling the cells to present viral and myelin Ags to CD4+ T cells. Recently, TLRs have been shown to recognize pathogen-associated molecular patterns and initiate innate immune responses upon interaction with infectious agents. We examined TLR expression on brain microglia and their functional responses upon stimulation with various TLR agonists. We report that mouse microglia express mRNA for all of the recently identified TLRs, TLR1-9, used for recognition of bacterial and viral molecular patterns. Furthermore, stimulation of quiescent microglia with various TLR agonists, including LPS (TLR4), peptidoglycan (TLR2), polyinosinic-polycytidylic acid (TLR3), CpG DNA (TLR9), and infection with viable Theiler's murine encephalomyelitis virus, activated the cells to up-regulate unique patterns of innate and effector immune cytokines and chemokines at the mRNA and protein levels. In addition, TLR stimulation activated up-regulation of MHC class II and costimulatory molecules, enabling the microglia to efficiently present myelin Ags to CD4+ T cells. Thus, microglia appear to be a unique and important component of both the innate and adaptive immune response, providing the CNS with a means to rapidly and efficiently respond to a wide variety of pathogens.
Hierarchical fault tolerance for nanoscale memories

This paper considers dynamic fault tolerance techniques applicable to ultradense memories based on nanoscale crossbar architectures. It describes how they can be integrated, in a hierarchical fashion, to provide runtime protection against device failures. Simulation is employed to estimate the effectiveness of a number of configurations, and the results show that there are synergistic combinations that allow for substantial reliability improvements over conventional techniques. For example, a memory with a bit-level failure rate of 2times10-4 FIT and a failure distribution of 10% arrays and 30% each for bits, rows, and columns shows three orders of magnitude reduction in uncorrectable errors at 100 000 hours when a given amount of redundancy is allocated to a combination of error correction coding and spare rows, columns, and arrays versus other configurations
Shared Stabilization Functions of Pyrimidine-Rich Determinants in the Erythroid 15-lipoxygenase and α-globin mRNAs

The poly(C)-binding proteins, alphaCPs, comprise a set of highly conserved KH-domain factors that participate in mRNA stabilization and translational controls in developmental and viral systems. Two prominent models of alphaCP function link these controls to late stages of erythroid differentiation: translational silencing of 15-lipoxygenase (Lox) mRNA and stabilization of alpha-globin mRNA. These two controls are mediated via association of alphaCPs with structurally related C-rich 3'-untranslated region elements: the differentiation control elements (DICE) in Lox mRNA and the pyrimidine-rich motifs in alpha-globin mRNA. In the present report a set of mRNA translation and stability assays are used to determine how these two alphaCP-containing complexes, related in structure and position, mediate distinct posttranscriptional controls. While the previously reported translational silencing by the DICE is not evident in our studies, we find that the two determinants mediate similar levels of mRNA stabilization in erythroid cells. In both cases this stabilization is sensitive to interference by a nuclear-restricted alphaCP decoy but not by the same decoy restricted to the cytoplasm. These data support a general role for alphaCPs in stabilizing a subset of erythroid mRNAs. The findings also suggest that initial binding of alphaCP to target mRNAs occurs in the nucleus. Assembly of stabilizing mRNP complexes in the nucleus prior to export may maximize their impact on cytoplasmic events.
A MR Brain Classification Method Based on Multiscale and Multiblock Fuzzy C-Means

A fully automatic, multiscale and multiblock fuzzy C-means (MsbFCM) classification method with intensity correction for MR images is presented in this paper. We use a bilateral filter to process MR images and to build a multiscale image series by increasing the standard deviation of spatial function and reducing the standard deviation of range function. We separate every scale image into multiple blocks and for every block a multiscale fuzzy C-means classification method is applied along the scales from the coarse to fine levels to overcome the effect of intensity inhomogeneity. The method is robust for noise MR images with intensity inhomogeneity because of its multiscale and multiblock bilateral filtering scheme. Our method was compared with the conventional FCM, a modified FCM (MFCM) and multiscale FCM (MsFCM) method on synthesized images, simulated brain MR images, and real MR images. The MsbFCM method achieved an overlap ratio of greater than 91% as validated by the ground truth even if original images have 9% noise and 40% intensity inhomogeneity. Experimental results using real MR images demonstrate the effectiveness of the proposed method. Our MsbFCM classification method is accurate and robust for various MR images.
Standardized versus open-ended assessment of psychosocial and medical concerns among African American breast cancer patients.

Standardized quality of life measures have been developed and used primarily with Caucasian and middle-class cancer patients. This study assessed the ability of several widely used standardized measures to capture the concerns and problems of 89 African American breast cancer patients. Concerns and problems were assessed using both an open-ended format and standardized measures. The degree of overlap in responses from these two formats was examined. The most frequently reported problems in the open-ended format included physical (43%), financial (40%), and worry about others (30%). Overall, standardized measures had significant overlap with open-ended concerns and problems. The Cancer Rehabilitation Evaluation System-Short Form subscales/items were associated with corresponding open-ended physical, financial, and social problems (R2 change=0.07–0.16, p's⩽0.02), the Interpersonal Support Evaluation List-Short Form was associated with open-ended social problems (R2 change=0.11, p=0.004), and the Mental Health Inventory was associated with open-ended psychological distress problems (R2 change=0.08, p=0.01). One category of open-ended problems, worry about others, was not captured by standardized measures. With the exception of associations between open-ended physical problems and psychological distress measures, there were few significant correlations between standardized measures and dissimilar problem categories. These findings suggest that the standardized measures in this study reflected the concerns and problems of African American breast cancer patients. Additional studies are needed to evaluate the utility of other widely used standardized measures that have not been developed or standardized among non-white samples. Copyright © 2005 John Wiley & Sons, Ltd.
A Nurse Leadership Project to Improve Health Literacy on a Maternal-Infant Unit

ABSTRACT Objective To describe how participation in the Sigma Theta Tau International Maternal-Child Health Nurse Leadership Academy positioned the authors to lead an interdisciplinary team through implementation and evaluation of a change project related to patient education based upon national health literacy standards. The project goal was to improve patient satisfaction with nurse communication and preparation for hospital discharge. Design Quality improvement. Setting/Participants Mother/-baby unit of an academic medical center serving a high percentage of patients of a minority population and underserved clients. Intervention The five- step intervention included (a) review of current health literacy standards, (b) formation of an infrastructure for development and evaluation of existing patient education materials, (c) assessment of patient education materials currently in use, (d) assessment of literacy level and learning styles of new mothers, and (e) provision of continuing education to increase knowledge of nurses as patient teachers and of health literacy. Measurement Mean scores of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) in the domains of patient satisfaction with nurse communication and discharge information were used to measure patient satisfaction with health communication. Results Patient satisfaction with nurse communication increased from 75.9% to 84.6%. Satisfaction with discharge information increased from 84.6% to 98.6%. Conclusion The leadership academy successfully positioned the authors to guide an interdisciplinary team through development of a process to meet the education and communication needs of patients and improve their health literacy As a result, a positive effect was noted on patient satisfaction with health communication.
Time-periodic transport in heterogeneous porous media

Analytical solutions for the one-dimensional convection-diffusion equation in a semi-infinite, heterogeneous domain are obtained for periodic boundary conditions. The kinematic dispersion of the porous medium is taken to be either a linear function of distance, or an exponential function of distance that asymptotically becomes constant. The analytic solutions are given in terms of Kelvin functions and hypergeometric functions, respectively, which are computed using Mathematica. The solutions are compared with each other and with the constant dispersivity case, and the amplitudes and phase shifts are studied with respect to the frequency of the input wave at the boundary. All three models respond differently to different single frequency inputs, showing different decay rates at lower frequencies and more pronounced phase shifts at higher frequencies. The use of single frequency, periodic inputs appears to give more distinguishable solutions than traditional pulse-type data which contains multiple spectral frequencies, and the resulting solutions can be used as a verification for numerical schemes for convection-diffusion equations.
Correlation properties of ocean altimeter returns

The correlation properties of altimeter returns are useful in the optimal design of altimeter systems. They are also necessary for implementing maximum likelihood estimation algorithms for altimeter waveform parameter estimation. The authors derive a simple expression for the bin-to-bin and pulse-to-pulse correlation of altimeter waveforms. This expression is a triple convolution of the specular point probability density function, a product of altimeter point target responses, and a generalized surface impulse response. This result is analogous to the usual expression for the mean altimeter waveform. The authors compare these theoretical predictions against real data, using measurements from the Skylab and Geosat altimeters. Finally, they present a simple application of the results to altimeter system design. >
Advocating Self-Advocacy: Board Membership in a Statewide Mental Health Consumer Organization

Until 2008 Ohio Advocates for Mental Health was a statewide mental health advocacy organization run by mental health consumers and supportive of consumer-run organizations around the state. The author's tenure on the board entailed repeated engagement with questions of identity - self-identity, peer support through personal identification, and negotiation of public identities with provider groups and the state agency. These are fundamental to defining and legitimating the claims of mentally ill people not just for health care resources but for full participation as citizens in the public sphere.
Hepatic MR Elastography: Clinical Performance in a Series of 1377 Consecutive Examinations

With a technical failure rate of less than 5.6%, the use of hepatic MR elastography to assess changes in liver tissue mechanics, which are associated with many pathophysiologic factors, may yield important information regarding staging of liver disease without invasive biopsy.
Self-Interest Assumption and Relational Trust in University-Industry Knowledge Transfers

Since knowledge is a critical resource for ensuring firm growth and survival, firms are increasingly going outside their boundaries and collaborating with other organizations to obtain new knowledge. This study focuses on two distinct self-enforcing safeguards important for interorganizational knowledge transfer. Using survey questionnaire data from senior executives in 180 small to large-sized industrial firms working with university research centers, we focus on the self-enforcing safeguards of self-interest assumption and relational trust and examine the role of each in university-industry knowledge transfer. Results from multiple linear regression show both self-interest assumption and relational trust are positively associated with greater knowledge transfer, however, relational trust is more strongly associated to knowledge transfer than self-interest assumption. We also found that as knowledge becomes more tacit, self-interest assumption becomes negatively associated with knowledge transfer while relational trust becomes more strongly positive. We conclude by discussing implications for future research and management practice
Simultaneous flow cytometric measurements of cytoplasmic Ca++ and membrane potential changes upon FMLP exposure as HL-60 cells mature into granulocytes : using [Ca++]in as an indicator of granulocyte maturity

Treatment of human leukemic HL-60 cells with N,N-dimethylformamide (DMF) induces them to mature until they reach granulocytoid morphology 3-6 d later. We have reported a maturation-dependent ability of these cells to respond to phorbol myristate acetate (PMA), as evaluated by membrane depolarization and by oxidative burst product formation (Newburger et al.: J. Biol. Chem. 259,3771, 1984). More recently we have attempted to develop techniques for simultaneous evaluation of these parameters during HL-60 cell maturation. Here, we compare the cytoplasmic [Ca++] and membrane potential changes elicited by the chemotactic peptide fMLP via simultaneous measurement of individual cells in a fluorescence-activated cell sorter (FACS), as done previously for mature granulocytes (Lazzari et al.: J. Biol. Chem. 261,9710, 1986). The stimulus-induced [Ca++]in changes are detected with the fluorescent probe Indo-1 and reproducibly increase in magnitude for a subpopulation of cells as the cells mature into granulocytes. Ca++ responsiveness to formyl peptide is restricted to a subpopulation of HL-60 granulocytes which expresses receptors for chemotactic peptide and consistently increases in magnitude (in response to the same concentration of agonist) with maturation. In contrast, there is less consistency in the direction or magnitude of membrane potential changes elicited under the same circumstances from the same maturing HL-60 cells.
Neural antagonists modulate pulmonary vascular pressure-flow plots in conscious dogs.

Multipoint pulmonary vascular pressure-cardiac index (P/Q) plots were constructed in conscious dogs during normoxia by graded constriction of the thoracic inferior vena cava to reduce Q. P/Q plots ...
Photonic Crystal Emitters for Thermophotovoltaic Energy Conversion

This paper reports the design, fabrication, and characterization of 2D photonic crystal (PhC) thermal emitters for a millimeter-scale hydrocarbon TPV microgenerator as a possible replacement for batteries in portable microelectronics, robotics, etc. In our TPV system, combustion heats a PhC emitter to incandescence and the resulting radiation is converted by a low-bandgap TPV cell. The PhC tailors the photonic density of states to produce spectrally confined thermal emission that matches the bandgap of the TPV cell, enabling high heat-to-electricity conversion efficiency. The work builds on a previously developed fabrication process to produce a square array of cylindrical cavities in a metal substrate. We will present ongoing incremental improvements in the optical and thermo-mechanical properties, the fabrication process, and the system integration, as recently combined with fabrication using novel materials, such as sputtered coatings, to enable a monolithic system.
A unique patient with epilepsy with cinematographic visual hallucinations

Purpose The purpose of this case report is to document a patient with cinematographic hallucinations, with corresponding right temporal lobe seizures on electroencephalogram (EEG).
Algorithmic Feasibility of Observing Artificial Life Evolution

An observation process is a fundamental implicit component of the simulation based studies on artificial-evolutionary systems (AES) by which time-varying entities are identified and their behavior is observed to uncover higher-level “emergent” phenomena. In this paper, we analyze algorithmic feasibility of implementing an observation process and consequent automated discovery of the entities and the evolutionary processes in arbitrary AES models. We characterize the bounds for the worst case computational complexity for the process of discovery of possible presence of entity and population level reproduction with epigenetic development in the child entities involving mutations and heredity in presence of natural selection. In particular, we prove that if entities in an AES simulation are structurally distinguishable, the problem of observability of evolutionary processes is only polynomially harder w.r.t. the entity recognition. The complexity bounds are presented in parameterized form so that for any given AES model, if parameter estimates are known, corresponding bounds can be derived.
An audible alarm system to facilitate the intraoperative identification of cardiac conduction tissue

The incidence of complete heart block after intracardiac operations has decreased as familiarity with the usual location of the conduction tissue has increased. In certain complex anomalies the exact location of the conduction tissue cannot be accurately predicted. Precise intraoperative identification of conduction tissue is possible from surface electrograms. This technique has received only limited clinical interest because the available method requires visual analysis of multiple high-speed wave forms and therefore results in considerable delay of information feedback to the surgeon. The current method has been modified to reduce the wave-form analysis to a single summated signal which is monitored electronically. An audible alarm is generated when a wave form arising from conduction tissue is recognized. The instrument makes this identification by analyzing the wave form's amplitude, frequency and temporal relationship to the isoelectric portion of the P-R interval. This innovation should increase the applicability of the technique by obviating the complexity of visual wave-form analysis.
Einfluß von cyclischem AMP auf den Glucosestoffwechsel in menschlichen Blutplättchen

Menschlichen Blutplattchen kommt eine Schlusselfunktion im Hamostase- und Thrombosemechanismus zu. Zu den wichtigsten Funktionen hierbei gehoren Aggregation und Freisetzungsreaktion. Sie scheinen durch den intracellularen Gehalt an cyclischem AMP beeinflust zu werden: Eine Erhohung der intracellularen cyclischen AMP-Spiegel geht mit einer Hemmung der Thrombocytenfunktion einher. Die Erhohung des cAMP-Spiegels kann dabei entweder durch eine Aktivitatssteigerung der Adenylcyclase oder Hemmung der Phosphodiesterase erfolgen. Uber die Stoffwechselmechanismen, die uber eine Erhohung des cyclischen AMP-Gehaltes zu einer Hemmung der Thrombocytenfunktion fuhren, ist nichts Genaues bekannt. Da Blutplattchen kein Kreatinphosphat enthalten, kommt ihrem hohen Glykogengehalt grose Bedeutung als cytoplasmatischem Energiespeicher zu. Auf diese Zusammenhange wurde bereits von Weber u. Mitarb. [1] sowie von Scott [2] hingewiesen. Die im Glykogen gespeicherte Energie wird durch das Enzym Phosphorylase [3, 4, 5, 6] verfugbar gemacht. Uber die Aktivitat dieses Enzyms unter dem Einflus von cyclischem AMP liegen bisher nur zwei sich widersprechende Untersuchungen vor [7, 8]. Es erschien uns daher angebracht, diesen Zusammenhangen weiter nachzugehen.
Contribution of Variable-Speed Wind Generators to Frequency Regulation and Oscillation Damping in the United States Eastern Interconnection

The United States Eastern Interconnection (EI) has been going through some profound changes due to the increasing penetration of wind power in this bulk grid, including the worsening of the frequency response and inter-area oscillation. However, the fast response speed of electronics devices makes it possible that the kinetic energy stored and/or wind power reserve (if it exists) in variable-speed wind generators could be injected into the power grid in a fast manner. This portion of fast-injected active power could contribute to frequency regulation or oscillation damping of the EI significantly if implemented with appropriate control schemes. In this chapter, a user-defined wind electrical control model with fast active power controllers is built in PSS®E. Then, based on the 16,000-bus EI system dynamic model, the potential contributions of variable-speed wind generators to the EI frequency regulation and oscillation damping are evaluated respectively. Simulation results have demonstrated that current and future penetrations of wind generation are promising in providing frequency regulation and oscillation damping in the EI.
Echovirus Infection and Basal Ganglia Edema

The case of a 4-year-old girl with bilateral edema of the basal ganglia in association with echo type 21 viral infection is reported from the University Hospitals of Munster and Hamburg, Germany.
A review of orientation characterization in short fibre–reinforced mould filling processes

The existing models for the characterization and prediction of orientation field in short fibre–reinforced mould filling processes are investigated. First, the basics of flow kinematics during the filling stage of injection moulding are reviewed. In particular, commonly used Hele–Shaw flow equations and the effects of advancing fluid front are described. Second, techniques to characterize orientation state and models for solving fibre orientation are presented. The three distinct concentration regimes of fibre suspensions and the necessity of using anisotropic constitutive models during mould filling simulations are discussed. Finally, a few recent examples are included which depict the numerically predicted orientation field during mould filling.
Lawfulness as Mind-Dependent

Scientific explanations are subsumption arguments: they place special cases within a framework of regularity represented by laws. Our concept of explanation — causal explanation preeminently included — is such as to require that the generalizations used for explanatory purposes must be lawful.
Genetic screening enters the single-cell era.

Four studies overcome the limitations of pooled and arrayed genetic screens by integrating single-cell transcriptomics.
Silica-on-silicon waveguides with MgF 2 cladding layers

we report on the choice of MgF 2 as cladding layers on silica-on-silicon optical waveguides fabricated by electron beam irradiation. The deposition methods need to be chosen carefully with low temperature as not to damage the low refractive index change during fabrication process. The main consideration is that the refractive index of the cladding layer should be very close to that of silica and it have good transparency, as well as be capable of being deposited at low temperature. The thickness profile then examined using DEKTAK II surface profiler.
Abstract A06: Regulation of homologous recombination by the SUMO ligase NSMCE2

Introduction : The purpose of this study is to determine the role of the E3 SUMO ligase NSMCE2 in BLM regulation and homologous recombination (HR). Background : DNA damage generated during replication is a major source of mutations and failure to repair this damage can cause genomic instability. HR is a high-fidelity DNA repair pathway activated primarily by replication-associated DNA damage. Numerous HR proteins are regulated by sumoylation, but the mechanisms that control sumoylation and their roles in HR are poorly understood. Cells deficient in the SUMO E3 ligase NSMCE2 are sensitive to DNA damaging agents and have defects in HR. Our preliminary data indicated that BLM sumoylation is dependent on NSMCE2. Because BLM sumolyation is required to recruit RAD51 to stalled forks, we hypothesized that NSMCE2-deficient cells are deficient in HR due to a defect in BLM-dependent RAD51 recruitment. Results : To test this hypothesis, we transfected HeLa cells with siRNAs specific to NSMCE2 and tested whether cells could recruit RAD51 to replication forks stalled with hydroxyurea (HU). Contrary to our hypothesis, we found that the amount of RAD51 protein that accumulated at stalled forks was greater in HU-treated NSMCE2-deficient cells compared to HU-treated control cells. To our surprise, the amount of single-stranded DNA binding protein RPA was diminished by half in HU-treated NSMCE2-deficient cells and DNA damage signaling was similarly diminished as evidenced by the lower levels of γ-H2AX. Consistent with the low levels of γ-H2AX, the double-strand breaks (DSB) that normally form after extended treatment with HU were also greatly diminished in NSMCE2-deficient cells. Consistent with previous reports, we found that the levels of HU-induced sister chromatid exchange were also low. These data indicated that despite the over-accumulation of RAD51 to sites of stalled replication forks, cells are unable to perform HR repair efficiently, indicating that RAD51 is unable to complete its function there. Conclusions : The hyper-accumulation of RAD51 at stalled forks we observed in NSMCE2-deficient cells suggests the sumoylation of one or more substrates by NSMCE2 is required for the remodeling of stalled forks that normally leads to unloading of RAD51 at the fork, strand breakage, and repair by HR. We suggest that the RAD51 accumulation that is observed in a substantial fraction of cancers may not be sufficient to demonstrate that the cells are HR proficient. Based on our data, RPA staining combined with RAD51 may be able to distinguish HR-proficient and deficient cells. Citation Format: Kelvin W. Pond, Christelle DeRenty, Mary Yagle, Nathan Ellis. Regulation of homologous recombination by the SUMO ligase NSMCE2 [abstract]. In: Proceedings of the AACR Special Conference on DNA Repair: Tumor Development and Therapeutic Response; 2016 Nov 2-5; Montreal, QC, Canada. Philadelphia (PA): AACR; Mol Cancer Res 2017;15(4_Suppl):Abstract nr A06.
Marfan syndrome diagnosis and management

Marfan syndrome is the most common inherited multisystem disorder of connective tissue. This autosomal dominant condition has an incidence of 2-3 per 10,000 individuals. Although genetic diagnostic techniques are available, the diagnosis is primarily made using the Ghent diagnostic criteria. Early identification and appropriate management improves the prognosis of patients with Marfan syndrome who are prone to the life-threatening cardiovascular complications of aortic dissection and rupture. Beta-blockers have been demonstrated to slow aortic growth and thus delay the time to aortic surgery. Operative intervention has markedly changed the prognosis of patients with Marfan syndrome and can be safely performed on an elective basis. The advance in the understanding of the cause of Marfan syndrome, as well as early recognition of the disorder and subsequent institution of medical and surgical therapy has resulted in dramatic improvement.
How personal costs influence customer citizenship behaviors

Abstract Many customers engage in customer citizenship behaviors, such as restocking unwanted items, helping other customers, or putting shopping carts back. Although previous research has investigated a variety of antecedents of customer citizenship behaviors, it has not yet considered the personal costs that might inhibit the decision to engage in those behaviors. Using social exchange theory and tested with three experimental studies, this research demonstrates that customers consider their personal cost/benefit trade-off prior to engaging in customer citizenship behaviors. Specifically, perceived self-sacrifice reduces intention to engage in customer citizenship behaviors while awareness of public self-image increases intention. Furthermore, this cost/benefit trade-off between self-sacrifice and public self-image is influenced by peer norms and perceived consequence to the firm.
Physical and Metaphysical Counterfactuals: Evaluating Disjunctive Actions

The structural interpretation of counterfactuals as formulated in Balke and Pearl (1994a,b) [1, 2] excludes disjunctive conditionals, such as “had X$X$ been x1 or x2$x_1~\mbox{or}~x_2$,” as well as disjunctive actions such as do(X=x1 or X=x2)$do(X=x_1~\mbox{or}~X=x_2)$. In contrast, the closest-world interpretation of counterfactuals (e.g. Lewis (1973a) [3]) assigns truth values to all counterfactual sentences, regardless of the logical form of the antecedent. This paper leverages “imaging” – a process of “mass-shifting” among possible worlds, to define disjunction in structural counterfactuals. We show that every imaging operation can be given an interpretation in terms of a stochastic policy in which agents choose actions with certain probabilities. This mapping, from the metaphysical to the physical, allows us to assess whether metaphysically-inspired extensions of interventional theories are warranted in a given decision making situation.
Disseminated histoplasmosis in a patient with common variable immunodeficiency: A coincidence or the result of T cell defects?

Abstract Background In endemic regions, histoplasmosis is often seen in hosts with defective cell mediated immunity. We report a case of disseminated histoplasmosis in a patient with common variable immunodeficiency (CVID), a disorder mainly characterized by B cell defects. Case A 35 year old male with CVID developed fever, headache, dyspnea and pancytopenia within few weeks of swimming in the Tennessee River. After a non-revealing initial evaluation he was transferred to a tertiary facility for fever of unknown origin, where massive splenomegaly was noted. Clinical course was complicated by hypoxia from extensive bilateral lung infiltrates requiring non-invasive ventilation. Urine and serum Histoplasma antigens were positive. He was treated with liposomal amphotericin B followed by itraconazole after clinical improvement within 48 h and discharged home by day 6. Fungal blood cultures sent on day 1 grew Histoplasma capsulatum on day 19. After 5 months splenomegaly completely resolved and he successfully completed one year of treatment with itraconazole. Conclusions Our case highlights the significance of T cell defects in CVID. More research focusing on T cell defects in CVID is required to understand the extent of vulnerability to such intracellular pathogens in CVID.
A Modal Argument

The following is a version of a familiar type of modal argument for God’s existence: (a) Since the concept of God is the concept of a being than which no greater being is logically possible, the concept of God is such that it is true in each possible world that if God exists in that world, then it is logically impossible for him to fail to exist there, i.e., his existence in that world is logically necessary. (b) There is a possible world, W, in which God exists.
Data Analysis and the Design of Experiments in Ornithology

One familiar statement one hears about data analysis in ornithology is that traditional ornithologists accumulated facts, but did not make generalizations or formulate causal hypotheses (Emlen, 1981; Wiens, 1980). The approach of modern ornithologists, on the other hand, is said to be more theoretical. Modern ornithologists formulate hypotheses, make predictions, check the predictions with new data sets, perform experiments, and do statistical tests. Proponents of the modern approach frequently state their position in a condescending tone, and this is guaranteed to arouse the ire of those more committed to empirical research (Olson, 1981). In this essay, we hope to lessen the differences of opinion on this subject as they were recently expressed in the commentary section of The Auk (Austin et al., 1981). We agree with Popper (1959, 1972, 1983) that the goal of science is to develop better explanatory theories about processes in nature, but it does not follow that advances are made only by hypothesis testing.
Patient Perceptions of Chaperones during Intimate Examinations and Procedures in Urology Clinic

AbstractIntroduction:We surveyed patients on their expectations and preferences regarding chaperones during intimate examinations and procedures in urology clinic.Methods:Patients identified in the...
The Strengths of Servant Leadership

Servant leadership has several components, and these components combine to create some unique strengths to this model of leadership. At its core, servant leadership is driven by virtues or deeply held values in the leader. In this way, servant leadership addresses the issues of ontology in the leader. The leader becomes a servant; the leader does not just attach serving behaviors. It is an issue of the soul or the person and even of their worldview or of their sense of reality. It is deeply embedded in the person. Then, since this way of leading is very person oriented for the leader and focus oriented on the other person, it is very personal. Yet, it can be applied in large group settings as well as small ones. Since this model is driven by virtues or deeply held values in the leader the strength of this form of leadership is that it is foundational in the soul of the person. It is not just what a leader does; it is more of a process of becoming more and then as a by-product of these particular virtues giving of self in service to others.
Second Language Assessment

Second language (L2) testing addresses measurement and ethical issues in assessing individuals’ proficiency in a second or foreign language and in assessing academic and professional knowledge and skills through a language that is not their mother tongue. The primary measurement issue is understanding the construct to be assessed, while ethical issues that arise include the consequences of and responsibility for assessment use. L2 assessment faces two challenges: linking issues of validity and use, and meeting the growing need for language testers engaged in developing practical language assessments for real-world uses. L2 testing as a field has made advances in understanding the nature of language ability, and will continue to advance in understanding the ethical issues of using language assessments in the real world.
Patient Engagement and Consumerism

Over the last decade, there have been important changes in how patients participate in the research process. Historically, patients have been passive participants in the research process, with engagement at most meaning that a patient would respond to an advertisement to participate in a research study. As health and clinical trial information has become electronic and more easily distributed, patients are able to engage in research in different ways. This has affected all stages of the research process, from recruitment and consent, to participation and finally understanding the results of studies. These recent changes have helped overcome initial barriers to patient participation in trials. As research participation becomes even more driven by patient engagement, even more changes are expected with both potential benefits and risks to the research process.
Thrombozytopenie bei Autoimmunhämolyse: Verbrauch oder Myelodysplasie?

Anamnese: Bei einem 77-jahrigen Patienten lag eine uber mehrere Jahre bekannte und Coombs-positive Autoimmunhamolyse vor. Er war bereits mit Steroiden, Rituximab, Cyclophosphamid, Cyclosporin A sowie bei Auftreten einer Thrombozytopenie mit Eltrombopag und einer Splenektomie ohne nachhaltigen Erfolg behandelt worden. Nach 3 Jahren wurden eine Leukozytopenie sowie eine Verschlimmerung der Thrombozytopenie festgestellt. Klinischer Befund und Diagnostik: Es bestanden eine deutliche Panzytopenie ohne Linksverschiebung oder Blastenausschwemmung sowie positive Hamolyseparameter. Die Knochenmarkpunktion zeigte den Befund eines myelodysplastischen Syndroms mit Blastenvermehrung. Die zytogenetische Analyse ergab eine partielle Trisomie 18q. Therapie und Verlauf: Bei Vorliegen eines myelodysplastischen Syndroms mit hohem Risiko einer Transformation in eine akute myeloische Leukamie wurde eine Therapie mit 5-Azacytidin begonnen. Hierunter besserte sich die Thrombozytopenie rasch, jedoch wurde die Therapie nach einer infektiologischen Komplikation auf Patientenwunsch unterbrochen und erst nach 11 Monaten bei erneut zunehmender Thrombozytopenie wieder begonnen. Folgerung: Bei Auftreten von Blutbildveranderungen, die nicht mit der Grunderkrankung vereinbar sind, sollte immer die Neudiagnose eines myelodysplastischen Syndroms in Erwagung gezogen werden.
Permanent and transitory earnings, accounting recording lag, and the earnings coefficient

In this paper, (1) wedefine precisely the terms permanent and transitory earnings;(2) we delineate the effects of the degree of permanence andof accounting recording lag on estimates of the slope coefficientfrom a returns-earnings regression and (3) we examine the relationbetween the estimates of the earnings coefficient and observablevariables that may indicate (i) the extent to which earningsare more or less permanent, and (ii) the extent to which valuerelevant events are recorded in accounting earnings in a timelyfashion. Our main point is that attributing differences in thereturns-earnings relation to one of these effects without controllingfor the other may lead to erroneous conclusions.
Genetic Alzheimer’s Disease

Alzheimer’s disease (AD) is a progressive neurodegenerative disease and the most common cause of dementia in the United States. AD generally presents with memory difficulties and eventually manifests with behavioral changes, language difficulties, and physical signs such as rigidity and parkinsonism. Neuropathological analysis of brain tissue from AD patients shows amyloid plaques and neurofibrillary tangles, which to date have provided important clues to the investigation of AD pathogenesis. AD families following both a Mendelian and a complex inheritance pattern have been identified. Thus far, there are three genes – APP, PSEN1 , and PSEN2 – associated with autosomal dominant AD. Recent genome-wide association study (GWAS) and candidate gene studies have revealed putative modifier genes in the development of late-onset AD.
Defective DNA repair in hereditary ovarian cancers: Implications for therapy.

Purpose The role of mutated DNA repair pathways in hereditary ovarian cancer (OC) and the clinical basis for the use of poly(ADP-ribose) polymerase (PARP) enzyme inhibitors and an immune checkpoint inhibitor as novel targeted therapies in the treatment of certain OC subtypes are reviewed. Summary OC is the most lethal of all gynecologic malignancies and encompasses a highly diverse collection of cancers. Hereditary OCs are a unique subtype of OC encompassing up to 24% of all OCs, including cancers driven by germline mutations of the BRCA1 or BRCA2 genes, mutations associated with Fanconi anemia (FA), BRCAness germline mutations, and Lynch syndrome. With an increasing wealth of genomic data available in cancer research, a common thread of defective DNA repair pathways as a primary driver of hereditary OCs has emerged. OCs driven by BRCA1/2 , FA-associated, and BRCAness germline mutations have a demonstrated sensitivity to PARP inhibitors due to underlying deficiencies in DNA homologous recombination; however, clinical responses are often partial and highly dependent on platinum sensitivity. Additionally, the immune checkpoint inhibitor pembrolizumab is indicated for certain metastatic solid tumors characterized by microsatellite instability, a distinguishing feature highly associated with DNA mismatch repair deficiency in Lynch syndrome–associated cancers, including some OCs. Conclusion In hereditary OC syndromes, mutations in DNA repair pathways form the clinical basis for the use of PARP inhibitors and an immune checkpoint inhibitor as novel targeted therapies.
Passive and active electric methods: New frontiers of application

Abstract Geophysical methods enable the identification of buried structures related to several human activities and also by nature. The basis for their use is the rules and the laws of physics that allow to differentiate the physical properties of the investigated medium. These methods can be used comprehensively to solve several thematic issues such as the detection of archaeological features, the recognition of geologic subsurface, and the study of monumental heritage conservation state. From the whole range of geophysical methods, taking into account the accuracy and the ability to use a variety of field conditions, the geoelectric active and passive imaging are increasingly being used. In this chapter, the instrumentation development and basic principles of geoelectric surveying techniques are presented. The ongoing developments in the survey designs and field procedures in two-dimensional (2D) and three-dimensional (3D) geoelectric active and passive surveys are discussed. Particularly, the acquisition geometry for 3D geoelectric imaging data development was emphasized.
TotShots: An Innovative Pediatric Free Clinic Providing High Patient Satisfaction to the Underserved.

BACKGROUND AND OBJECTIVES The University of Arizona College of Medicine-Tucson TotShots clinic is a student-developed, student-directed free clinic that provides sports physicals and vaccines to uninsured pediatric patients in Tucson, Arizona. TotShots runs under the greater umbrella of the Commitment to Underserved People Program, which aims to teach medical students how socioeconomic and cultural factors impact health and access to health care. Our objective was to study cost savings and patient satisfaction of this clinic. METHODS Value of care provided through sports physicals and vaccine administration was calculated using the Centers for Medicare and Medicaid Services Physician Fee Schedule and Centers for Disease Control Vaccines for Children Decisions Analysis Model. In addition, patient satisfaction was measured through the utilization of an optional three-question survey completed by patients in their preferred language at the resolution of their visit. Vaccines and sports physicals were administered from April 2017 to November 2017. RESULTS TotShots administered 51 vaccines and completed 115 sports physicals resulting in a value of $415.65 of administration fees and $5,878.80 of sports physical examinations. Sixty-three of 66 total patients completed patient satisfaction surveys. Of those patients, 57 (90.5%) were highly satisfied with their provider's communication, 58 (92%) rated their perception of the quality of medical care they received as excellent, and 54 (85.7%) of patients were highly satisfied with their overall TotShots experience. CONCLUSIONS TotShots fills a valuable role in increasing access to vaccines and sports physicals while maintaining high patient satisfaction and high value of cost savings.
Commentary on Gronau and Wagenmakers

The three examples Gronau and Wagenmakers (Computational Brain and Behavior, 2018; hereafter denoted GW the smaller, simpler model is a point hypothesis that in fact generates the data; the larger class contains the smaller. As GW Bayesian model selection (BMS) as reported by Kass and Raftery (Journal of the American Statistical Association, 90, 773–795, 1995); and LOOCV as reported by Browne (Journal of Mathematical Psychology, 44, 108–132, 2000) and Gelman et al. (Statistics and Computing, 24, 997–1016, 2014). In this commentary, we shall restrict the focus to forms of BMS and LOOCV. In addition, in these days of “Big Data,” one wants inference procedures that will give reasonable answers as the amount of data grows large, one focus of the article by G&W. We discuss how the various inference procedures fare when the data grow large.
Applied compositional data analysis: with worked examples in R

This well written book illustrates the concepts and methodologies needed to analyse compositional data and interpret the results using R languages. What is compositional data? The constrained multi...
CORR Insights(®): Anterior and Anterolateral Approaches for THA Are Associated With Lower Dislocation Risk Without Higher Revision Risk.

T he direct anterior approach for THA has garnered substantial interest among total joint surgeons. A Google search for ‘‘anterior approach hip’’ returned 1,190,000 matches. The most common claims of superiority of direct anterior approach include: Decreased length of hospital stay, quicker rehabilitation, less blood loss, shorter surgery, less postoperative pain, lower risk of dislocation, more natural return to function and activity, and shorter incisions. In fact, one manufacturer’s website (http://www. aboutstryker.com/hip/procedures/procedures-daa.php) emphasizes that the new approach can be done through a three or four inch incision, compared to eight to 12 inches for a moretraditional approach, which the manufacturer also says ‘‘requires a significant disturbance of the joint and connecting tissues.’’ Ironically, direct anterior is considered a new approach even though the anterior approach (which is the lower limb of a classic Smith-Peterson approach) was described in 1949 and was used during my residency training and musculoskeletal oncology training (1979–1986). The approach was recommended for patients with higher risk of dislocation (dementia, neuromuscular disorders) and was used for treatment of benign and malignant disease of the hip. In practice, I have also used it in cases of simultaneous bilateral THA.
Virtual coaching for child welfare workers – a tool to promote learning

This pilot study considers the effects of a virtual coaching intervention on learning outcomes of an online training for child welfare workers. A two-group pretest–posttest design was used to asses...
GH and Catabolic States

Accelerated weight loss, associated with a decrease in body fat and skeletal muscle mass characterizes the metabolic response to catabolic illness. While these events are commonly observed in patients who have sustained extensive injury or severe infection, similar responses have been described in individuals with other disorders such as multiple organ systems failure, patients with chronic obstructive lung disease, those with AIDS and individuals undergoing extensive chemotherapy and radiation treatment for cancer.1