cssi/SciSciGPT-SciSciNet huggingface dataset:
Expanding the Role of Endovenous Laser Therapy: Results in Large Diameter Saphenous, Small Saphenous, and Anterior Accessory Veins

Background Endovenous laser therapy (EVLT) is an accepted form of axial vein ablation for symptomatic venous reflux but there is debate regarding its efficacy and complication rates in large veins (≥1 cm). In addition, its role in the treatment of small saphenous veins (SSVs) and anterior accessory veins (AAVs) has not been well characterized either. Methods A retrospective review of patients undergoing EVLT on the great saphenous vein (GSV), SSV, or AAV between August 2007 and May 2009 was conducted. A total of 885 limbs were reviewed. In all, 153 patients were excluded because of incomplete information. Gender, age, vein size, operative details, ultrasound, and clinical follow-up results were recorded. Veins that measured Results A total of 732 ablations were reviewed, involving 175 men and 557 women (76.1%). Average follow-up with duplex ultrasound was 3 weeks, and all patients underwent at least one postprocedural ultrasound. In all, 565 (77.3%) GSVs, 113 (15.5%) SSVs, and 53 (7.3%) AAVs were treated. A total of 88 ablations were performed on veins measuring ≥1 cm, 12% of all treated veins. In all, 82 GSVs, three SSVs, and three AAVs measured >1 cm, and GSVs comprised 93.2% of treated large veins ( p ≤ 0.001 vs. entire cohort). For active ulceration, 4.9% of small vein and 9.1% of large vein treatments were performed ( p = 0.11). An average of 2,983 J (range: 250-7,922) was used for each ablation, with veins measuring ≥1 cm being treated with significantly more energy (3,733 vs. 2,876 J, p p = 0.91). This included failure in 3.4% of small vein and 4.5% of large vein ablations ( p = 0.59). In addition, two deep vein thromboses (0.4%) occurred, both in GSVs. The most common complication was failure of closure, occurring in 1.6% of GSVs, 8.8% SSVs, and 13.2% AAVs ( p p ≤ 0.001) and fewer complications ( p = 0.005) than SSV or AAV. Conclusions Complication rates and closure rates are not significantly different for veins of diameter ≥1 cm and smaller veins. Although more energy is used, this has not translated into higher complication rates, thus making EVLT safe and effective for large vein closure. Significantly higher failure and complication rates were seen in SSV and AAV treatment as compared with GSV treatment.
Selective Hypoaldosteronism Despite Prolonged Pre- and Postoperative Hyperreninemia in Primary Aldosteronism

In a prospective study of 7 patients with aldosterone-producing adenoma (APA), long-term (6-72 months) preoperative stimulation of plasma renin activity (PRA) by diuretic therapy (spironolactone plus hydrochlorothiazide) did not prevent selective aldosterone deficiency postoperatively. In all patients aldosterone excretion rate (AER) fell to subnormal values (from a mean of 97 to 2.6 mug/24 h) following removal of APA, although PRA remained elevated. Generalized adrenocortical insufficiency was excluded by the demonstration of normal baseline plasma cortisol and urinary 17-OHCS and the appropriate response to ACTH stimulation. In 6 of 7 patients studied 1-3 months postoperatively, short-term (4 days) sodium deprivation evoked normal increases in PRA, but AER response was blunted (except in 1). Restudy of 3 of 6 patients after 6-12 months revealed that aldosterone production had returned to normal. These results indicate that renin deficiency is not the principal cause of postoperative selective hypoaldosteronism in these patients. On the other hand, they appear to substantiate the possibility raised by in vitro and in vivo studies that spironolactone can directly inhibit aldosterone biosynthesis.
Growth hormone exacerbates diabetic renal damage in male but not female rats

Background Human and animal studies support the idea that there are sex differences in the development of diabetic renal disease. Our lab and others have determined that in addition to Ang II (through the AT1R), growth hormone (GH) contributes to renal damage in models of renal failure; however, the impact of sex and GH on the mechanisms initiating diabetic renal disease is not known. This study examined the effect of sex and GH on parameters of renal damage in early, uncontrolled streptozotocin (STZ)-induced diabetes.
Ethnographic Interviewing: Asking the Right Questions to the Right People in the Right Ways.

Current philosophy in early childhood education advocates family-centered intervention goals for handicapped children. To develop appropriate gaals for children from diverse cultures, professionals must understand parents' beliefs and values regarding the family's and child's resources and needs; and they must adopt an ecological framework that considers children's functioning within the broader aspects of their environment. Interviewing provides a means of obtaining the information necessary to develop culturally appropriate, family-centered intervention goals. This paper describes the influence of culture on the interview process and describes an approach to ethnographic interviewing of families of handicapped children that enables professionals to ask the right questions to the right people in the right ways so they can assist families in meeting the needs of their children.
Control of the welding process using infrared sensors

Integration of sensors in a welding system enhances the quality of the welds produced. Variations in three welding process parameters-weld bead width, penetration depth, and torch position-were monitored using an infrared sensor. Intentionally induced variations in each of these welding parameters were found to affect uniquely the plate surface temperature distributions measured by the infrared sensor. The effects of weld bead width and torch position perturbations on the temperature distribution were separated so as to identify and control these two weld process parameters simultaneously. Preliminary results suggest that simultaneous penetration depth, bead width, and torch position control is possible. >
Weight loss and improved fitness slow down the decline in mobility in obese adults with type 2 diabetes.

Commentary on: Rejeski WJ, Ip EH, Bertoni AG, et al. Look AHEAD Research Group. Lifestyle change and mobility in obese adults with type 2 diabetes. N Engl J Med 2012; 366: 1209– 17.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] The increasing prevalence of type 2 diabetes (T2D) and its complications challenge our healthcare delivery systems. Indeed, the healthcare industry is vulnerable to the rising costs and faces challenges with respect to increased life expectancy and prevalence of chronic diseases. Adults with T2D often have limitations in mobility and experience increased risk of physical disability.1 Furthermore, the number of obese older adults with T2D has substantially increased in the last 20 years.2 Obesity among older adults is problematic because it not only increases the risk of medical complications but also causes physical dysfunction.3 Functional limitations associated with obesity and T2D exacerbate the age-related decline … [1]: {openurl}?query=rft.jtitle%253DNew%2BEngland%2BJournal%2Bof%2BMedicine%26rft.stitle%253DNEJM%26rft.issn%253D0028-4793%26rft.aulast%253DRejeski%26rft.auinit1%253DW.%2BJ.%26rft.volume%253D366%26rft.issue%253D13%26rft.spage%253D1209%26rft.epage%253D1217%26rft.atitle%253DLifestyle%2Bchange%2Band%2Bmobility%2Bin%2Bobese%2Badults%2Bwith%2Btype%2B2%2Bdiabetes.%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJMoa1110294%26rft_id%253Dinfo%253Apmid%252F22455415%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1056/NEJMoa1110294&link_type=DOI [3]: /lookup/external-ref?access_num=22455415&link_type=MED&atom=%2Febmed%2F18%2F2%2Fe18.atom [4]: /lookup/external-ref?access_num=000302005100009&link_type=ISI
ETHANOL AND ACETALDEHYDE METABOLISM DURING ETHANOL CONSUMPTION

Following acute administration of ethanol, both blood and brain acetaldehyde levels were higher in DAB/2 mice than in C57B1/6 mice. Chronic administration of ethanol resulted in significantly higher levels of brain acetaldehyde following a challenge dose of ethanol to C57B1/6 mice. Brain acetaldehyde levels were lower than those found in blood. Based upon kinetic analyses of acetaldehyde metabolism by brain tissue in vitro , the concentration gradient existing between blood and brain can be explained on the basis of a metabolic barrier.
Validation of self-rated overall diet quality by Healthy Eating Index-2010 score among New York City adults, 2013.

Objective: Chronic conditions such as cardiovascular disease and cancer can result from a number of diet-related environmental and behavioral factors. Screening for poor diet is helpful in developing interventions to prevent chronic disease, but measuring dietary behavior can be costly and time-consuming. The purpose of this study was to test the ability of a self-rated, single-item measure for evaluating diet quality among individuals and populations. Methods: A 24-h dietary recall and single-item self-rated diet quality measure were collected for 485 adults. From dietary recalls, Healthy Eating Index-2010 (HEI) scores were computed and compared with self-rated diet quality. Data were collected in 2013 among adult (18 years and older) New York City residents. Results: The study sample was 57% female, 47% white, 56% college educated, and 45% in the highest income tertile. The mean HEI score was 56.5 out of a possible 100. Women averaged higher HEI scores compared to men (58.1 vs 54.3, p = .01). There was a modest yet significant correlation between HEI scores and self-rated diet quality (ρ = 0.29, p < .01). Overall, mean HEI score increased as self-rated diet quality improved (from 48.2 for “poor” to 63.0 for “excellent”). Conclusions: The single-item measure of self-rated diet quality may provide a simple method of identifying those with the worst diet quality. Further investigation of this measure's validity is needed with alternative measures of dietary intake and with health outcomes.
Where do experts look while doing 3D image segmentation

3D image segmentation is a fundamental process in many scientific and medical applications. Automatic algorithms do exist, but there are many use cases where these algorithms fail. The gold standard is still manual segmentation or review. Unfortunately, even for an expert this is laborious, time consuming, and prone to errors. Existing 3D segmentation tools do not currently take into account human mental models and low-level perception tasks. Our goal is to improve the quality and efficiency of manual segmentation and review by analyzing how experts perform segmentation. As a preliminary step we conducted a field study with 8 segmentation experts, recording video and eye tracking data. We developed a novel coding scheme to analyze this data and verified that it successfully covers and quantifies the low-level actions, tasks and behaviors of experts during 3D image segmentation.
Ship Compliance in Emission Control Areas: Technology Costs and Policy Instruments

This paper explores whether a Panama Canal Authority pollution tax could be an effective economic instrument to achieve Emission Control Area (ECA)-like reductions in emissions from ships transiting the Panama Canal. This tariff-based policy action, whereby vessels in compliance with International Maritime Organisation (IMO) ECA standards pay a lower transit tariff than noncompliant vessels, could be a feasible alternative to petitioning for a Panamanian ECA through the IMO. A $4.06/container fuel tax could incentivize ECA-compliant emissions reductions for nearly two-thirds of Panama Canal container vessels, mainly through fuel switching; if the vessel(s) also operate in IMO-defined ECAs, exhaust-gas treatment technologies may be cost-effective. The RATES model presented here compares current abatement technologies based on hours of operation within an ECA, computing costs for a container vessel to comply with ECA standards in addition to computing the Canal tax that would reduce emissions in Panama. Retrofitted open-loop scrubbers are cost-effective only for vessels operating within an ECA for more than 4500 h annually. Fuel switching is the least-cost option to industry for vessels that operate mostly outside of ECA regions, whereas vessels operating entirely within an ECA region could reduce compliance cost with exhaust-gas treatment technology (scrubbers).
The Syndrome of Inappropriate Antidiuretic Hormone Secretion in a Patient with Adenocarcinoma of the Prostate

AbstractWe report the syndrome of inappropriate antidiuretic hormone secretion in a 59-year-old man with stage C adenocarcinoma of the prostate. Serum antidiuretic hormone levels returned to normal following treatment with a gonadotropin-releasing hormone analogue. To our knowledge this case represents the first in which resolution of this syndrome occurred with treatment of the carcinoma.
Waste heat rejection methods in geothermal power generation

This chapter focuses on the theoretical and practical considerations of the methods of heat rejection to the environment from geothermal power plants. The influence of heat exchanger effectiveness of the condenser and the heat rejection equipment on the thermodynamic efficiency of the power station is discussed. Generalities are made to compactly review the numerous methods of heat rejection from geothermal power plants. Condenser configurations, heat transfer characteristics, and operating and maintenance issues of each method are discussed. Condensers used in geothermal power plants are mainly of the direct-contact or surface type, with methods of heat dissipation to the environment generally consisting of wet cooling towers, air-cooled condensers, or a combination of wet-dry (or evaporative) condensers. The actual choice depends on designer preference and what the geothermal site characteristics dictate.
Dominance of the Asymptotic Field

The basis of the method of photoelasticity is stress-induced birefringence exhibited by many polymers—for example, polymethylmethacrylate, Homalite-100, and polycarbonate are commonly used in dynamic fracture investigations because of their birefringent properties. Thus, a stressed specimen becomes a phase retarder (with spatially varying retardation induced by the spatial variation of the stress field)—the fast and slow principal optical directions coincide with the principal stress directions. The index of refraction at a point on a stressed specimen depends on the stress state at that point; hence a polarized light beam travelling through a stressed specimen will experience a relative phase retardation in the components of the light resolved along the local principal stress directions. This stress-induced birefringence can be exploited to reveal the stress field in the specimen. In this chapter, the phenomenon of temporary birefringence, the Jones matrix for a stressed specimen, and the circular polariscope that is commonly used for revealing the shear stress distribution in the specimen is described.
Epigenetic Approaches to Cancer Therapy

The dysregulation of genes is in many instances responsible for the initiation and development of cancers of various origins. However advanced analysis of cancerous cell genomes provides insights to possibilities other than mutations that favor a tumorigenic phenotype. Epigenomic studies have shown that gene expression can be regulated independently of the DNA sequence by modifying specific bases or chromatin residues and the changes are central to tumorigenesis. The epigenetic marks are heritable and reversible and consequently enzymes that regulate these changes are potential targets for cancer therapy. Inhibitors of epigenetic enzymes can restore the gene expression imbalances set by the epigenetic marks, restoring pathways that initiate cellular differentiation and apoptosis necessary for tumor inhibition. Here we review current approaches to targeting enzymes such as the DNA methyltransferases (DNMTs), histone acetyltransferases (HATs), histone deacetylases (HDACs), histone methyltransferases (HMTs), and histone demethylases (HDMTs) that regulate epigenetic pathways through drug-based inhibitors.
Production of Shoots from Dormant Species of Acer as Influenced by Length and Caliper of Stem Sections

Abstract Stem sections removed from selected, dormant species of Acer L. (maples) were forced to produce softwood shoots under greenhouse conditions. Species and clones varied widely in the percentage of stem sections forming shoots, and in the number of shoots that were generated per section. Both length and diameter of sections influenced the number of shoots that were generated. With respect to length, it was best to use stem sections of 30 to 40 cm (11.8 to 15.7 in) since longer sections failed to produce additional shoots and occupied considerably more production space. Effect of increased stem diameter varied across species. For A. rubrum, the number of shoots produced was greatest on ‘large’ diameter (5.2 to 7.6 cm; 2.0 to 3.0 in) stem sections; shoot production was greatest on ‘medium’ diameter (3.3 to 5.1 cm; 1.3 to 2.0 in) stem sections of A. palmatum. Data indicate that an optimum diameter will have to be determined for each species that is propagated when using this method.
Music Special Collections, L. Tom Perry Special Collections, Harold B. Lee Library, Brigham Young University

Brigham Young University (BYU) Music Special Collections include rare editions, manuscript scores, and music archives. Strengths are focused in harp music, viola music, popular American music of th...
Exploring the uses and importance of avatar dress in a multiplayer online game: A qualitative study of women gamers

The purpose of this study was to explore the uses of dress in the gaming activities of female MMO players. Women were chosen as the focus of this study in response to a call from scholars who noted the relative dearth of qualitative research about female gamers (Lewis & Griffiths, 2011). Three main research questions were developed: (1) Which gaming activities are most associated with dress for study participants?; (2) How is dress incorporated into these activities?; and (3) Is dress utilized to explore questions of identity or to develop and maintain social relationships?
Psychosis and Schizencephaly – A case report and systematic review

Psychotic symptoms have been reported in association with a wide array of brain abnormalities. Few published reports have examined the association between schizencephaly and psychiatric illness. Originally defined by Wilmarth and later by Yakolev and Wadsworth – Schizencephaly is an uncommon congenital disorder of cerebral cortical development, defined as a grey matter-lined cleft extending from the pial surface to the ventricle. The nosology is based on neuroradiologic findings and confirmed by neuropathology when available. The Clinical presentation and neurodevelopmental outcomes of the disorder vary and are usually related to the extent/areas of the brain involved. In this article we review the medical literature around Schizencephaly paying particular attention to the pathophysiology, etiology and diagnosis of such patients. We then present a case of Schizencephaly and first episode psychosis in a 16-year-old adolescent who was admitted to our inpatient psychiatric service. Lastly, we present the findings of a systematic review from PubMed whereby we summarize 10 cases of Schizencephaly with associated psychiatric symptoms.
Management Options for Patients with GERD and Persistent Symptoms on Proton Pump Inhibitors: Recommendations from an Expert Panel

The aim of this study was to assess expert gastroenterologists’ opinion on treatment for distinct gastroesophageal reflux disease (GERD) profiles characterized by proton pump inhibitor (PPI) unresponsive symptoms. Fourteen esophagologists applied the RAND/UCLA Appropriateness Method to hypothetical scenarios with previously demonstrated GERD (positive pH-metry or endoscopy) and persistent symptoms despite double-dose PPI therapy undergoing pH-impedance monitoring on therapy. A priori thresholds included: esophageal acid exposure (EAE) time >6.0%; symptom-reflux association: symptom index >50% and symptom association probability >95%; >80 reflux events; large hiatal hernia: >3 cm. Primary outcomes were appropriateness of four invasive procedures (laparoscopic fundoplication, magnetic sphincter augmentation, transoral incisionless fundoplication, radiofrequency energy delivery) and preference for pharmacologic/behavioral therapy. Laparoscopic fundoplication was deemed appropriate for elevated EAE, and moderately appropriate for positive symptom-reflux association for regurgitation and a large hiatal hernia with normal EAE. Magnetic sphincter augmentation was deemed moderately appropriate for elevated EAE without a large hiatal hernia. Transoral incisionless fundoplication and radiofrequency energy delivery were not judged appropriate in any scenario. Preference for non-invasive options was as follows: H2RA for elevated EAE, transient lower esophageal sphincter relaxation inhibitors for elevated reflux episodes, and neuromodulation/behavioral therapy for positive symptom-reflux association. For treatment of PPI unresponsive symptoms in proven GERD, expert esophagologists recommend invasive therapy only in the presence of abnormal reflux burden, with or without hiatal hernia, or regurgitation with positive symptom-reflux association and a large hiatus hernia. Non-invasive pharmacologic or behavioral therapies are preferred for all other scenarios.
Application of FT-IR and NMR to epoxy resins

The application of FT-IR and high resolution solid state NMR to the structural characterization of epoxies is described. Theoretical and experimental background is given and progress to date in these two fields summarized.
Abdominal complications from peritoneal shunts

Abstract Abdominal complications of peritoneal shunts for hydrocephalus occur infrequently. Pseudocysts, peritonitis, ascites, pseudotumor, and volvulus have been reported. We are presenting a patient who developed an acute abdomen from a pseudocyst to stress: (a) that abdominal symptoms usually precede the neurologic symptoms; and (b) that the abdominal symptoms can develop from days to years after the shunting procedure.
Factors Associated With Emergency Department Use by Patients With and Without Mental Health Diagnoses.

Importance An association between frequent use of the emergency department (ED) and mental health diagnoses is frequently documented in the literature, but little has been done to more thoroughly understand why mental illness is associated with increased ED use. Objective To determine which factors were associated with higher ED use in the near future among patients with and without mental health diagnoses. Design, Setting, and Participants A retrospective case-control study of all patients presenting to the ED in California in 2013 using past ED data to predict future ED use. Data from January 1, 2012, through December 31, 2014, from California’s Office of Statewide Health Planning and Development were analyzed. Main Outcomes and Measures Factors associated with higher ED use in the year following an index visit for patients with vs without a mental health diagnosis. Results Among the 3 446 338 individuals in the study (accounting for 7 678 706 ED visits), 44.6% (1 537 067) were male; 31.6% (1 089 043) were between the ages of 18 and 30 years, 40.3% (1 338 874) were between the ages of 31 and 50 years, and 28.1% (968 421) were between the ages of 51 and 64 years. The mean (SD) number of ED visits per patient per year was 1.69 (2.56), and 29.1% of patients (1 002 884) had at least 1 mental health diagnosis. Previous hospitalization and high rates of lagged ED visits were associated with higher future ED use. The severity of the mental health diagnosis (mild, moderate, or severe) was associated with increased ED visits (incidence rate ratio [IRR], 1.029; 95% CI, 1.02-1.04 for mild; IRR, 1.121; 95% CI, 1.11-1.13 for moderate; and IRR, 1.226; 95% CI, 1.22-1.24 for severe). Little evidence was found for interaction effects between mental health diagnoses and other diagnoses in predicting increased future ED use. Conclusions and Relevance Certain classes of mental health diagnoses were associated with higher ED use. The presence of a mental illness diagnosis did not appear to interact with other patient-level factors in a way that meaningfully altered associations with future ED use.
Towards an Affective Video Recommendation System

Video streaming services are prominent in people’s lives and there is a need for improved video recommendation systems that adapt to their users in a personalized way. This project uses affective computing and non-invasive sensing to address this issue. Our objective is to develop an approach that uses the viewer’s emotional reactions as the basis for recommending new content. To achieve this goal, we must first understand how viewers react to videos. We conducted a study where subjects’ facial expressions and skin-estimated pulse were monitored while watching videos. Results showed that our approach can estimate dominant emotions 70% of the time. We found no correlation between the number of emotional reactions people have and how they rate the videos they watch. The pulse estimation is reliable to measure important changes in pulse, however it can still be improved.
Far Field Plume Distribution and Divergence for NEXT: DART Mission

In support of the Double Asteroid Redirection Test (DART) mission, laboratory measurements were made on the NEXT ion engine, which will be used for the spacecraft's in-space propulsion [1]. This study revisits a small range of mission-specific 2.7A throttle levels to understand the effect of in-flight flow rate variability, investigate intermediate throttle conditions, and improve measurement methodology. This paper specifically examines the far-field plume divergence and backflow ion flux distribution of the NEXT, while a companion paper examines the charge state distributions.
The influence of molecular structure on the adsorption of PFAS to fluid-fluid interfaces: Using QSPR to predict interfacial adsorption coefficients

Per- and poly-fluoroalkyl substances (PFAS) are emerging contaminants of critical concern for human health risk. Assessing exposure risk requires a thorough understanding of the transport and fate behavior of PFAS in the environment. Adsorption to fluid-fluid interfaces, which include air-water, OIL-water, and air-OIL interfaces (where OIL represents organic immiscible liquid), is a potentially significant retention process for PFAS transport. Fluid-fluid interfacial adsorption coefficients (Ki) are required for use in transport modeling and risk characterization, yet these data are currently not available for the vast majority of PFAS. Surface-tension and interfacial-tension data sets collected from the literature were used to determine interfacial adsorption coefficients for 42 individual PFAS. The PFAS evaluated comprise homologous series of perfluorocarboxylates and perfluorosulfonates, branched perfluoroalkyls, polyfluoroalkyls, alcohol PFAS, and nonionic PFAS. The Ki values vary across eight orders of magnitude, and are a function of molecular structure. The results of quantitative-structure/property-relationship (QSPR) analysis demonstrate that a model employing molar volume (Vm) as a descriptor provides robust predictions of log Ki values for air-water interfacial adsorption of the wide range of PFAS. The model also produced good predictions for a limited set of data for OIL-water interfacial adsorption. The predictive capability of the QSPR model for a wide range of PFAS with greatly varying structures reflects the fact that molar volume provides a reasonable representation of the influence of molecular size on cavity formation/destruction in solution, and thus the hydrophobic-interaction driving force for interfacial adsorption. The QSPR model presented herein provides a means to incorporate the fluid-fluid interfacial adsorption process into transport characterization and risk assessment of PFAS in the environment. This will be particularly relevant for determining PFAS mass flux in the atmosphere, in the vadose zone, in source zones containing organic immiscible liquids, and in water/wastewater treatment systems.
Surpassing the physical Nyquist limit to produce super-resolution cryo-EM reconstructions

Abstract Recent advances in single-particle cryo-electron microscopy (cryo-EM) methods have led to the determination of hundreds of high-resolution (
Development and growth of corrosion features on protected silver mirrors during accelerated environmental exposure

Various layer schemes have been developed to protect thin film silver mirrors from tarnish and corrosion. However, the mechanisms by which these additional layers improve mirror durability are not fully understood. Accelerated environmental exposure testing of protected silver mirrors was used to investigate the effects of layer composition on the mechanisms of corrosion feature development and growth. Two model mirror coatings were analyzed in which the composition of the base layer below the silver and the adhesion layer above the silver were varied. Large circular corrosion features formed preferentially along the silver–chromium interfaces, regardless of where this interface was located within the layered structure of the mirror. The corrosion features originated at coating defects in the dielectric protection layer, and their growth was likely driven by the oxidation and chloridation of both silver and chromium at the Ag–Cr interfaces.
Rapid online buffer exchange for screening of proteins, protein complexes and cell lysates by native mass spectrometry

It is important to assess the identity and purity of proteins and protein complexes during and after protein purification to ensure that samples are of sufficient quality for further biochemical and structural characterization, as well as for use in consumer products, chemical processes and therapeutics. Native mass spectrometry (nMS) has become an important tool in protein analysis due to its ability to retain non-covalent interactions during measurements, making it possible to obtain protein structural information with high sensitivity and at high speed. Interferences from the presence of non-volatiles are typically alleviated by offline buffer exchange, which is time-consuming and difficult to automate. We provide a protocol for rapid online buffer exchange (OBE) nMS to directly screen structural features of pre-purified proteins, protein complexes or clarified cell lysates. In the liquid chromatography coupled to mass spectrometry (LC-MS) approach described in this protocol, samples in MS-incompatible conditions are injected onto a short size-exclusion chromatography column. Proteins and protein complexes are separated from small molecule non-volatile buffer components using an aqueous, non-denaturing mobile phase. Eluted proteins and protein complexes are detected by the mass spectrometer after electrospray ionization. Mass spectra can inform regarding protein sample purity and oligomerization, and additional tandem mass spectra can help to further obtain information on protein complex subunits. Information obtained by OBE nMS can be used for fast (<5 min) quality control and can further guide protein expression and purification optimization.
MLKL-dependent signaling regulates autophagic flux in a murine model of non-alcohol-associated fatty liver and steatohepatitis.

Background & Aims Autophagy maintains cellular homeostasis and plays a critical role in the development of non-alcoholic fatty liver and steatohepatitis. The pseudokinase mixed lineage kinase domain-like (MLKL) is a key downstream effector of receptor interacting protein kinase 3 (RIP3) in the necroptotic pathway of programmed cell death. However, recent data reveal that MLKL also regulates autophagy. Herein, we tested the hypothesis that MLKL contributes to the progression of Western diet-induced liver injury in mice by regulating autophagy. Methods Rip3+/+, Rip3−/−, Mlkl+/+ and Mlkl−/− mice were fed a Western diet (FFC diet, high in fat, fructose and cholesterol) or chow for 12 weeks. AML12 and primary mouse hepatocytes were exposed to palmitic acid (PA). Results The FFC diet increased expression, phosphorylation and oligomerization of MLKL in the liver. Mlkl, but not Rip3, deficiency protected mice from FFC diet-induced liver injury. The FFC diet also induced accumulation of p62 and LC3-II, as well as markers of endoplasmic reticulum stress, in Mlkl+/+ but not Mlkl−/− mice. Mlkl deficiency in mice also prevented the inhibition of autophagy by a protease inhibitor, leupeptin. Using an mRFP-GFP-LC3 reporter in cultured hepatocytes revealed that PA blocked the fusion of autophagosomes with lysosomes. PA triggered MLKL expression and translocation, first to autophagosomes and then to the plasma membrane, independently of Rip3. Mlkl, but not Rip3, deficiency prevented inhibition of autophagy in PA-treated hepatocytes. Overexpression of Mlkl blocked autophagy independently of PA. Additionally, pharmacologic inhibition of autophagy induced MLKL expression and translocation to the plasma membrane in hepatocytes. Conclusions Taken together, these data indicate that MLKL-dependent, but RIP3-independent, signaling contributes to FFC diet-induced liver injury by inhibiting autophagy. Lay summary Autophagy is a regulated process that maintains cellular homeostasis. Impaired autophagy contributes to cell injury and death, thus playing a critical role in the pathogenesis of a number of diseases, including non-alcohol-associated fatty liver and steatohepatitis. Herein, we show that Mlkl-dependent, but Rip3-independent, signaling contributed to diet-induced liver injury and inflammatory responses by inhibiting autophagy. These data identify a novel co-regulatory mechanism between necroptotic and autophagic signaling pathways in non-alcoholic fatty liver disease.
NKX3.1 Identifies Prostatic Origin of Dural Metastasis in the Setting of Negative Prostate-Specific Antigen Stain:

No clear guidelines exist for the appropriate diagnostic workup of an intracranial mass suspected to be a metastasis from unknown primary origin. Dural metastasis from prostatic origin is very rare. Patients with a known history of metastatic prostate cancer who present with a newly discovered lesion on brain imaging require neurosurgical biopsy to confirm diagnosis prior to initiating treatment. Intracranial metastasis from prostate cancer is rare, and dural metastasis is rarer than intraparenchymal metastasis. Current consensus guidelines support immunohistochemical staining with classic markers such as prostate-specific antigen (PSA) to identify prostatic origin. However, PSA detection of prostate metastases declines with higher Gleason scores and in patients undergoing androgen deprivation therapy. NKX3.1 is another stain that is highly sensitive and specific for prostate. Our patient was a 54-year-old man with a history of metastatic prostate cancer who presented with new-onset seizures. Brain imaging revealed a dural-based lesion with surrounding vasogenic edema and midline shift. The patient underwent resection of the lesion, which was stained with multiple cancer markers. Prostate-specific antigen was negative, but NKX3.1 was positive indicating a prostatic origin for the mass. He underwent a craniectomy to remove the lesion and was given steroids. However, he succumbed to his illness several months later. Here, we document the first report to our knowledge of a patient with prostate metastasis to the dura that is PSA negative, but NKX3.1 positive.
Public–Private Partnerships in the Preservation of Presidential Records:

The National Archives and Records Administration, in partnership with private support foundations, administers 13 individual presidential libraries comprising the Presidential Library System. These...
An Individualized, Alert-based Heartlogic Management Strategy Can Identify Patients At Risk For Impending Heart Failure Events

Background HeartLogic is a diagnostic tool that uses multiple sensors (heart sounds, thoracic impedance, respiration, heart rate, patient activity) to track physiologic trends and combine them into one composite index designed to alert clinicians of patients at risk for impending heart failure events (HFE). While prior studies have shown an alert threshold of 16 to be predictive of HFE, there is currently no standard treatment protocol to manage these alerts. Objective To design a management algorithm and assess the utility of HeartLogic alerts in predicting HFE among patients with chronic systolic heart failure. Methods All patients with activated HeartLogic devices at a large academic center were followed prospectively for three months and monitored for elevated HeartLogic index defined as 16 or greater. All alerts were managed by the heart failure clinical team who assessed each patient via telephone call. Diuretic changes were made at the discretion of the clinical team. HFE, defined as unscheduled visits or heart failure hospitalizations occurring within 6 weeks after the initial alert were recorded. Results We identified a total of 80 patients with activated HeartLogic devices. A total of 38 patients (48%) had at least one HeartLogic alert during the study period. Of these, 26 patients (68%) appeared to have false positive alerts and did not require diuretic change nor had HFE, while 12 (32%) had heart failure symptoms requiring diuretic adjustment or urgent follow-up. Three of these 12 patients failed outpatient diuretic augmentation and were admitted for decompensated heart failure. Among the 42 patients (52%) who did not have an alert, only one patient had a HFE. Overall, HeartLogic demonstrated a sensitivity of 92%, specificity of 61%, positive predictive value of 32% and negative predictive value of 98%. Increasing HeartLogic alert threshold to >20 in this cohort would improve specificity to 90% and positive predictive value to 56%, thereby reducing staff burden, with an acceptable sensitivity (69%) and negative predictive value (94%). Conclusion This is the first study to evaluate the effects of an individualized HeartLogic threshold in an alert-based follow-up management strategy. This strategy identified actionable alerts leading to change in diuretic management. We do not recommend a standardized diuretic change algorithm for alerts given the heterogeneity of the index value and high false positive rate of alerts. Future studies are needed to determine if this management strategy leads to decrease in heart failure admissions.
Value of Information on Resilience Decision-Making in Repeated Disaster Environments

AbstractThis paper reports on a series of controlled experiments with human subjects on the decision of firms to invest in resilience to mitigate supply-chain disruptions and their willingness to p...
A Novel Approach to Assessing and Treating Musculoskeletal-Mediated Atypical Abdominal Pain: A Case Study.

Abdominal pain is a common and functionally limiting complaint within the healthcare system linked to impaired quality of life and increased health care utilization. This chief complaint is associated with an extensive differential diagnosis leading to high utilization of diagnostic testing, increased healthcare cost, and delayed access to care. In patients presenting with acute or chronic abdominal pain, musculoskeletal pain often requires expensive testing, thereby delaying definitive care. An improved triage process is warranted. Performing a musculoskeletal examination to determine if pain patterns can be mechanically reproduced at the site of origin, or remote to the site of pain, warrants referral to a musculoskeletal specialist. In our young and healthy population, once the musculoskeletal mediated abdominal pain origin is determined, we see significant success in the application of a treatment approach consisting of manipulative therapy, exercise, and instrument-assisted soft tissue mobilization. A multimodal treatment approach for musculoskeletal-mediated abdominal pain has not been previously described. This case study outlines a novel management approach for musculoskeletal-mediated abdominal pain and provides an alternative diagnostic technique, when implemented early in the evaluation and management process of atypical abdominal pain, that improves the quality of life.
Evaluation of the Abbott ARCHITECT HIV Ag/ Ab combo assay for determining recent HIV-1 infection

Background Given the challenges and costs associated with implementing HIV-1 incidence assay testing, there is great interest in evaluating the use of commercial HIV diagnostic tests for determining recent HIV infection. A diagnostic test with the capability of providing reliable data for the determination of recent HIV infection without substantial modifications to the test protocol would have a significant impact on HIV surveillance. The Abbott ARCHITECT HIV Ag/Ab Combo Assay is an antigen/antibody immunoassay, which meets the criteria as the first screening test in the recommended HIV laboratory diagnostic algorithm for the United States. Methods In this study, we evaluated the performance characteristics of the ARCHITECT HIV Ag/Ab Combo signal-to-cutoff ratio (S/Co) for determining recent infection, including estimation of the mean duration of recent infection (MDRI) and false recent rate (FRR), and selection of recency cutoffs. Results The MDRI estimates for the S/Co recency cutoff of 400 is within the 4 to 12 months range recommended for HIV incidence assays, and the FRR rate for this cutoff was 1.5%. Additionally, ARCHITECT Combo S/Co values were compared relative to diagnostic test results from two prior prospective HIV-1 diagnostic studies in order to validate the use of the S/Co for both diagnostic and recency determination. Conclusion Dual-use of the ARCHITECT Combo assay data for diagnostic and incidence purposes would reduce the need for separate HIV incidence testing and allow for monitoring of recent infection for incidence estimation and other public health applications.
Patient feedback surveys among pregnant women in Eswatini to improve antenatal care retention.

Background Uptake and retention in antenatal care (ANC) is critical for preventing adverse pregnancy outcomes for both mothers and infants. Methods We implemented a rapid quality improvement project to improve ANC retention at seven health facilities in Eswatini (October-December 2017). All pregnant women attending ANC visits were eligible to participate in anonymous tablet-based audio assisted computer self-interview (ACASI) surveys. The 24-question survey asked about women’s interactions with health facility staff (HFS) (nurses, mentor mothers, receptionists and lab workers) with a three-level symbolic response options (agree/happy, neutral, disagree/sad). Women were asked to self-report HIV status. Survey results were shared with HFS at monthly quality improvement sessions. Chi-square tests were used to assess differences in responses between months one and three, and between HIV-positive and negative women. Routine medical record data were used to compare retention among pregnant women newly enrolled in ANC two periods, January-February 2017 (‘pre-period’) and January-February 2018 (‘post-period’) at two of the participating health facilities. Proportions of women retained at 3 and 6 months were compared using Cochran-Mantel-Haenszel and Wilcoxon tests. Results A total of 1,483 surveys were completed by pregnant women attending ANC, of whom 508 (34.3%) self-reported to be HIV-positive. The only significant change in responses from month one to three was whether nurses listened with agreement increasing from 88.3% to 94.8% (p<0.01). Overall, WLHIV had significantly higher proportions of reported satisfaction with HFS interactions compared to HIV-negative women. A total of 680 pregnant women were included in the retention analysis; 454 (66.8%) HIV-negative and 226 (33.2%) WLHIV. In the pre- and post-periods, 59.4% and 64.6%, respectively, attended at least four ANC visits (p = 0.16). The proportion of women retained at six months increased from 60.9% in the pre-period to 72.7% in the post-period (p = 0.03). For HIV-negative women, pre- and post-period six-month retention significantly increased from 56.6% to 71.6% (p = 0.02); however, the increase in WLHIV retained at six months from 70.7% (pre-period) to 75.0% (post-period) was not statistically significant (p = 0.64). Conclusion The type of rapid quality improvement intervention we implemented may be useful in improving patient-provider relationships although whether it can improve retention remains unclear.
Ruth Bader Ginsburg: Litigating Against Gender Discrimination...and Remembering One Such New York Case

This tribute to Justice Ginsburg, published by the Historical Society of the New York Courts, focuses on her New York State ties and activities. Ruth Bader Ginsburg was born and raised in Brooklyn and graduated from Cornell University and, later, Columbia Law School. She became a New York lawyer and, in time, a law professor at Columbia and, in 1972, co-director of the American Civil Liberties Union’s Women’s Rights Project. From her ACLU base in New York City, Professor Ginsburg litigated pathmaking cases regarding the equal rights of women and men. She participated in thirty-four cases before the Supreme Court of the United States, including presenting oral arguments to the Justices in six cases. This article describes that history, and also Ginsburg’s participation in one New York City gender discrimination case that went up to the New York Court of Appeals, the State’s high court, but not, ultimately, to the U.S. Supreme Court. The New York Civil Liberties Union (NYCLU), the national ACLU’s New York City affiliate, brought this case, Sontag v. Bronstein. It concerned a dumbbell-lifting test that New York City’s civil service commission imposed as a job qualification on two women who were school audio-visual aides; because they failed the weight-lifting test, the City moved to dismiss them from their jobs. They sued, claiming gender discrimination. Their lead attorney was NYCLU lawyer Eve Cary. Joining her on the brief in the New York Court of Appeals was then-Professor Ginsburg. They won—the dumbbell test was sexist government harassment of women, not a bona fide job test. Justice Ginsburg always remembered the Sontag case, its striking facts, and Eve Cary’s powerful brief. Justice Ginsburg kept that brief close at hand, including as she wrote the Supreme Court’s 1996 landmark gender equality decision, United States v. Virginia. In many senses, that decision was a culmination of the constitutional lawyering that Cary, Ginsburg, and their NYCLU and ACLU colleagues had done, including in Sontag, two decades earlier.
Cirrus Cloud Optical and Morphological Variations within a Mesoscale Volume

Cirrus cloud optical and structural properties were measured above southern Wisconsin in two time segments between 18:07 and 21:20 GMT on December 1, 1989 by the volume imaging lidar (VIL) and the High Spectral Resolution Lidar (HSRL) and the visible infrared spin scan radiometer (VISSR) atmospheric sounder (VAS) on GOES. A new technique was used to calculate the cirrus cloud visible aerosol backscatter cross sections for a single channel elastic backscatter lidar. Cirrus clouds were viewed simultaneously by the VIL and the HSRL. This allowed the HSRL aerosol backscatter cross sections to be directly compared to the VIL single channel backscattered signal. This first attempt resulted in an adequate calibration. The calibration was extended to all the cirrus clouds in the mesoscale volume imaged by the VIL.