cssi/SciSciGPT-SciSciNet huggingface dataset:
Depositional and Structural Histories of Richmond and Taylorsville Triassic Rift Basins: ABSTRACT

The Richmond and Taylorsville basins of Virginia display similar structural and sedimentological histories, which differ somewhat from those of other eastern North American rift basins. Both basins formed during the middle Carnian in response to the initial opening of the North Atlantic Ocean. Both are westward tilted half grabens whose border faults share a reactivated Paleozoic basement thrust (the Hylas zone). A dipmeter log from the Bailey 1 well (Richmond basin) shows that bedding dips toward the border fault and increases with depth. These relationships are interpreted to reflect syndepositional rotation and tilting of the basin above a listric normal fault. Unlike the red beds typical of other eastern North American rift basins, sediments of the Richmond and Taylorsville basins are mostly unoxidized gray sandstones and siltstones. The sediments of both basins can be divided into three facies associations. The lowest is a poorly sorted, coarse-grained, lithic arkose rapidly deposited in alluvial fans and braided streams. This was succeeded by sand, silt, and mud of a lower End_Page 1449------------------------------ gradient, fluvial-paludal setting. Organic-rich black shales accumulated in lakes (oxbows?) and overbank deposits. An influx of cross-bedded fluvial sands, possibly triggered by renewed border faulting on the west, characterizes the final stage of basin fill. These sediments represent fan-delta systems that prograded northeastward across the lacustrine-paludal lowlands. End_of_Article - Last_Page 1450------------
A Multipurpose Consider Covariance Analysis for Square-Root Information Filters

A new form of consider covariance analysis suitable for application to square-root information lters with a wide variety of model errors is presented and demonstrated. A special system formulation is employed, and the analysis draws on the algorithms of square-root information ltering to provide generality and compactness. This analysis enables one to investigate the estimation errors that arise when the lter’s dynamics model, measurement model, assumed statistics, or some combination of these is incorrect. Such an investigation can improve lter design or characterize an existing lter’s true accuracy. Areas of application include incorrect initial state covariance; incorrect, colored, or correlated noise statistics; unestimated states; and erroneous system matrices. Several simple, yet practical, examples are developed, and the consider analysis results for these examples are shown to agree closely with Monte Carlo simulations.
The influence of a sensitive period for auditory-visual integration in children with cochlear implants

Purpose: Children who experience long periods of auditory deprivation are susceptible to large-scale reorganization of auditory cortical areas responsible for the perception of speech and language. One consequence of this reorganization is that integration of combined auditory and visual information may be altered after hearing is restored with a cochlear implant. Our goal was to investigate the effects of reorganization in a task that examines performance during multisensory integration. Methods: Reaction times to the detection of basic auditory (A), visual (V), and combined auditory-visual (AV) stimuli were examined in a group of normally hearing children, and in two groups of cochlear implanted children: (1) early implanted children in whom cortical auditory evoked potentials (CAEPs) fell within normal developmental limits, and (2) late implanted children in whom CAEPs were outside of normal developmental limits. Miller's test of the race model inequality was performed for each group in order to examine the effects of auditory deprivation on multisensory integration abilities after implantation. Results: Results revealed a significant violation of the race model inequality in the normally hearing and early implanted children, but not in the group of late implanted children. Conclusion: These results suggest that coactivation to multi-modal sensory input cannot explain the decreased reaction times to multi-modal input in late implanted children. These results are discussed in regards to current models for coactivation to redundant sensory information.
Accountability and public health policies impacting proper Ebola response: time for a bioethics oversight board.

In November, 2014, at the time of the American Society of Tropical Medicine and Hygiene (ASTMH) and the American Public Health Association (APHA) annual conferences in New Orleans, LA, the Louisian...
Implication of a theorem for a class of quasigeostrophic flows

Large-scale atmospheric flows are often analyzed in the context of a quasigeostrophic (QG) model, which is characterized by conservation of quasigeostrophic potential vorticity (PV). Some of the subtle properties and limitations of a system may be best appreciated in terms of its intrinsic symmetry properties. For example, Nakamura (1993) points out that if the zonal mean flow and potential vorticity gradient in a QG system are vertically antisymmetric at one time, they remain antisymmetric for all time. It follows that the important barotropic governor mechanism (James 1987) cannot take place in such a situation, albeit a rather unrealistic one. Other symmetry properties have been noted and will be commented on shortly. Here we report yet another more general symmetry property of a QG system that has an implication for the constraint to baroclinic wave life cycle.
Finitary incidence algebras and idealizations

Let F be a field and P a poset. Then FI(P) denotes the finitary incidence algebra of P over F and I(P) is the corresponding incidence space. Moreover, let be the idealization of I(P) over FI(P). We determine the F-algebra automorphisms of D(P) and investigate when FI(P) is a zero product determined algebra.
AIDS-Related Lymphomas

Individuals who are immunodeficient, including those who are HIV infected, have an increased risk of developing lymphoproliferative disorders (LPDs). These lesions in the HIV-infected patient population are somewhat heterogeneous, but are more often clearly benign or malignant than the LPD lesions that arise in other immunodeficient states. Like those occurring in the setting of posttransplantation (also see Chap. 28, methotrexate therapy, primary immune disorders and advanced age, the AIDS-related LPDs are often associated with herpesvirus infection, particularly Epstein–Barr virus (EBV; HHV-4) and Kaposi sarcoma herpesvirus (KSHV; HHV-8). Also similar to the other immunodeficiency-related lymphoproliferations, if the HIV positive patient’s immune status can be restored, such as by highly active antiretroviral therapy (HAART), the lesions may regress. However, in many instances, a secondary genetic alteration, not all of which have been characterized, has occurred resulting in transformation to an irreversible neoplastic process.
Food Colors as Intrinsic Luminescent Sensors in Edible Products

Limited use of luminescence spectroscopy in food and pharmaceutical applications can be related to two main causes: a)the inherent properties of most useful fluorophores (low availability, toxicity, high price and restricted solubility), and b)incomplete photophysical characterization of edible and safe-to-ingest fluorophores.To expand the use of luminescence spectroscopy to monitor quality and safety of edible goods, photophysical properties of five generally-recognized-as-safe(GRAS) food colors that are routinely added to foods or pharmaceuticals were assessed. The sensitivity of the food dyes’ fluorescence emission intensity to the surrounding medium's rigidity and polarity were also determined.Environmental polarity moderately impacted the location of the fluorescence intensity peaks and bathochromic shifts were observed for all dyes as the polarity of the solvents increased. The Stokes shifts,(λem-λexc), were estimated to be 45-90nm depending on the medium and molecular structure of the synthetic color.All these food dyes were practically non emissive in common fluid solvents, which can explain the limited information on their photophysical properties. Excited state tautomerization and/or internal twisting, already reported in synthetic non-edible dyes in low viscosity solutions, can also constitute the predominant non- radiative relaxation pathway of the studied food colors in fluid environments. The medium's rigidity was altered by changing temperature and composition. As the viscosity and consistency index of the surrounding medium increased, the dyes’ fluorescent emission intensity also increased, which suggests the molecular rotor character of these dyes. The maximum fluorescence intensity of each dye vs. viscosity relationship was characterized by a power law model and the sensitivity of each dye to changes in viscosity was evaluated in terms of its parameters.In principle, the large Stokes shift and sensitivity to viscosity supports the potential use of these food colors as probes of microviscosity or molecular crowding in edible goods.
Images in clinical medicine. Digitalis purpurea (foxglove).

Figure 1. Digitalis purpurea (Foxglove). In 1775 William Withering demonstrated that the leaves of the foxglove plant alleviated certain forms of dropsy (edema), and in 1799 John Ferriar ascribed their beneficial effects to a primary action on the heart. All physicians have learned about digitalis, but few recognize its plant source. Digoxin, the preparation most commonly used in the United States, is derived from related plants, Digitalis lanata and D. orientalis.
Interpeduncular fossa lipoma: A novel cause of oculomotor nerve palsy in childhood

Oculomotor nerve palsy is a rare finding in children and, when reported, is most frequently either congenital or acquired from postnatal trauma, infection, aneurysm, or migraine. Intracranial lipomas also represent an uncommon finding in children, and although their development is not completely understood, they are now thought to be congenital in nature. Here, we describe the case of a 23-month-old boy presenting to the emergency department with left-sided, complete, pupil-involving oculomotor nerve palsy. On magnetic resonance imaging, he was found to have an intracranial lipoma of the left interpeduncular fossa. The patient had gradual and spontaneous improvement of symptoms, with complete resolution reported at the 4-month follow-up visit. However, a second magnetic resonance image at 6 months revealed that the lipoma did not change in size. To our knowledge, intracranial lipomas have been previously reported as a possible cause of partial oculomotor nerve palsy in only one adult and have never been reported in a child. In addition, we did not find any reports of intracranial lipomas as a cause of complete, pupil-involving oculomotor palsy, although they are known to cause other cranial nerve pathology. We conclude that intracranial lipomas, although rare, should be considered in the differential diagnosis for oculomotor nerve palsy in children. Further investigation is needed to determine the true incidence of this association.
Endoscopic biopsy pathology of Helicobacter pylori gastritis. Comparison of bacterial detection by immunohistochemistry and Genta stain.

c Objectives.—To describe the endoscopic biopsy pathology of Helicobacter pylori gastritis, compare bacterial detection by immunohistochemistry using a specific antibody with the Genta stain, and to compare the relative costs of the 2 techniques. Design.—One hundred cases of gastritis identified as positive for H pylori by Genta stain and 100 cases considered negative by the same technique were stained using an anti-H pylori‐specific polyclonal antibody. Laboratory reagent and labor costs for the 2 methods were compared. Results.—Chronic active gastritis with lymphoid follicles was significantly associated with H pylori infection (P , .0001). The immunohistochemical method had a sensitivity of 97% and a specificity of 98% compared with the Genta stain, with strong agreement for grading density of organisms ( k5 0.85; P , .001). Reagent costs were similar for both methods, but immunohistochemistry using an autoimmunostainer required less dedicated technical time and hence was less expensive than the Genta stain. Conclusions.—Immunohistochemistry using a specific antibody is an accurate and cost-effective method for H pylori detection in gastric biopsies. (Arch Pathol Lab Med. 1999;123:778‐781)
Influenza infection in neutropenic adults.

While lymphopenia is a well-defined risk factor for severe influenza, the effect of neutropenia is unknown. This was a retrospective single centre study of adult patients with documented neutropenia and influenza between 2005 and 2013. Forty patients were included with a median follow-up of 2 years (IQR 0.8-4.0). Median ANC at influenza diagnosis was 0.3 × 109/L (IQR 0.1-0.4 × 109/L). Outcomes included hospitalization (N = 28, 70%), pneumonia (N = 9, 23%), ICU admission (N = 9, 23%) and mechanical ventilation (N = 7, 18%). Three deaths (7.5%) were attributed to influenza, all of whom had lower respiratory tract infection (LRTI). Patients with LRTI (N = 18, 45%) also had a higher 30-day mortality (37 versus 0%) and 90-day mortality (42 versus 0%) than those with upper respiratory tract infection. In summary, neutropenic patients have high rates of influenza complications. Our study highlights the need for early diagnosis and aggressive management of influenza in this population.
Neurologic Complications of Enterovirus 71 Infection

The neurologic complications associated with the 1998 Taiwan enterovirus 71 epidemic are reported from National Cheng Kung University, Tainan; Chang Gung Children’s Hospital, Kaohsiung; and National Defense Medical Center, Taipei, Taiwan.
Microbial alteration of the hydrogen and carbon isotopic composition of n -alkanes in sediments

Abstract The hydrogen (δD) and carbon (δ13C) isotope compositions of long-chain n-alkanes provide a record of paleoenvironmental conditions. At present, the role bacteria play in altering the stable isotope composition of n-alkanes during storage of sediments is unclear. We collected four sediment samples at precise depth intervals from an archaeological site and stored these samples at room temperature for three years. Then, we collected sediment from identical locations (measured to the cm level) three years later and froze these immediately. Samples stored at room temperature showed high amounts of medium-chain n-alkanes (n-C18–n-C26), which were absent from samples that were immediately frozen, and a decrease in the abundance of long-chain n-alkanes (n-C27–n-C33). Measured δD values of n-C29 and n-C31 n-alkanes increased in stored samples by up to 25‰. δ13C values in stored samples are more negative than non-stored samples by up to 4.2‰. DNA analysis of the soil microorganisms showed bacteria containing genes coding for n-alkane degrading enzymes proliferated in samples during their three year storage. In particular, Rhodococcus and Aeromicrobium, genera which contain multiple coding regions for the n-alkane degrading enzymes CYP153 and AlkB, increased by an order of magnitude (from 0.7% to 7.5% of bacteria present). These data suggest that bacteria may play a larger role than previously expected in altering measured n-alkane stable isotope values during storage. We recommend that sediment samples that are exposed to significant changes in oxygen or ambient moisture after collection are extracted as soon as possible or stored refrigerated or frozen.
Aerobic oxidative esterification of primary alcohols over Pd-Au bimetallic catalysts supported on mesoporous silica nanoparticles

Abstract We have prepared a series of mesoporous silica nanoparticle (MSN) supported Pd-Au bimetallic catalysts using a newly developed sequential impregnation method. These catalysts were fully characterized by various techniques including nitrogen sorption, powder X-ray diffraction, inductively coupled plasma mass spectrometry (ICP-MS), transmission electron microscopy (TEM) and high angle annular dark-field scanning transmission electron microscopy (HADDF-STEM). By using this synthetic approach, we observed metal nanoparticles (NP) with diameters of 1–2 nm homogeneously supported on the MSN. The catalytic performance of these MSN supported metal NPs was tested by aerobic oxidative esterification in a tandem reaction where primary alcohols are oxidized to their corresponding aldehydes and to esters in a subsequent reaction. We determined that Pd NPs are very efficient in the first step of oxidation; however, stagnant in the subsequent oxidation. On the contrary, Au NPs show slow reactivity in converting alcohols to aldehydes, but extraordinarily efficient in the oxidation of aldehydes to esters. By fine tuning the metal ratio, the bimetallic catalyst exhibits better reactivity and selectivity toward a variety of primary alcohols than the corresponding monometallic catalysts. In addition, we also found that the bimetallic Pd-Au@MSN catalysts can be recycled three times without a significant loss in activity.
The 10 Conditions That Increased Vermont's Readiness to Implement Statewide Health System Transformation

Abstract Following an arduous, 6-year policy-making process, Vermont is the first state implementing a unified, statewide all-payer integrated delivery system with value-based payment, along with aligned medical and social service reforms, for almost all residents and providers in a state. Commercial, Medicare, and Medicaid value-based payment for most Vermonters will be administered through a new statewide accountable care organization in 2018–2022. The purpose of this article is to describe the 10 conditions that increased Vermont's readiness to implement statewide system transformation. The authors reviewed documents, conducted internet searches of public information, interviewed key informants annually in 2014–2016, cross-validated factual and narrative interpretation, and performed content analyses to derive conditions that increased readiness and their implications for policy and practice. Four social conditions (leadership champions; a common vision; collaborative culture; social capital and collec...
Impact of race and payer status on the outcome of chronic myeloid leukemia (CML) in the era of tyrosine kinase inhibitors.

e17568 Background: Race and payer status have been shown to impact the outcome of several hematological malignancies including multiple myeloma and acute leukemia. There is, however, limited inform...
Hotspot-aware task-resource co-allocation for heterogeneous many-core networks-on-chip

Abstract To fully exploit the massive parallelism of many-core on a chip, this work tackles the problem of mapping large-scale applications onto heterogeneous networks-on-chip (NoCs) while minimizing hotspots. A task-resource co-optimization framework is proposed which configures the on-chip communication infrastructure and maps the applications simultaneously and coherently, aiming to minimize the peak energy under the constraints of computation power, communication capacity, and total cost budget of on-chip resources. The problem is first formulated into a linear programming model to search for optimal solution. A heuristic is further developed for fast design space exploration at design-time and run-time in large-scale NoCs. Extensive simulations are carried out under real-world benchmarks and randomly generated task graphs to demonstrate the effectiveness and efficiency of the proposed schemes. Real system simulations show the significant improvement (30–200%) in NoCs latency and throughput compared to the state-of-the-art minimum-path approach because of the diminishing hotspots and balanced load distribution.
Aspects and Investigation of Photochemical Dynamics

This chapter starts by reviewing concepts that form a versatile means of describing nuclear motion and electronic structure changes during a photochemical reaction. This is followed by an introduction of a framework capable of describing how such ultrafast photodynamics can be probed experimentally. Rather than extensively reproducing formulas [1], the intention is to highlight and qualitatively discuss selected issues relevant to this project. As such, this chapter serves as a reference for the rest of the thesis.
Resting state connectivity in neocortical epilepsy: The epilepsy network as a patient-specific biomarker.

Abstract Objective Localization related epilepsy (LRE) is increasingly accepted as a network disorder. To better understand the network specific characteristics of LRE, we defined individual epilepsy networks and compared them across patients. Methods The epilepsy network was defined in the slow cortical potential frequency band in 10 patients using intracranial EEG data obtained during interictal periods. Cortical regions were included in the epilepsy network if their connectivity pattern was similar to the connectivity pattern of the seizure onset electrode contact. Patients were subdivided into frontal, temporal, and posterior quadrant cohorts according to the anatomic location of seizure onset. Jaccard similarity was calculated within each cohort to assess for similarity of the epilepsy network between patients within each cohort. Results All patients exhibited an epilepsy network in the slow cortical potential frequency band. The topographic distribution of this correlated network activity was found to be unique at the single subject level. Conclusions The epilepsy network was unique at the single patient level, even between patients with similar seizure onset locations. Significance We demonstrated that the epilepsy network is patient-specific. This is in keeping with our current understanding of brain networks and identifies the patient-specific epilepsy network as a possible biomarker in LRE.
Finding Critical Links for Closeness Centrality

Closeness centrality is a class of distance-based measures in the network analysis literature to quantify reachability of a given vertex (or a group of vertices) by other network agents. In this pa...
Diverse Misfolded Conformational Strains and Cross-seeding of Misfolded Proteins Implicated in Neurodegenerative Diseases.

Numerous neurodegenerative diseases including prion, Alzheimer’s and Parkinson’s diseases are characterized by accumulation of protein aggregates in brain. Prion disease is unique in that the natively folded prion protein forms diverse misfolded aggregates with distinct molecular conformations (strains), which underlie different disease phenotypes. In addition, the conformational strains are able to self-propagate their unique conformations by recruiting normal protein monomers and converting their conformations to misfolded conformers. There is an increasing body of evidence that suggests other aggregation-prone proteins including tau and alpha-synuclein associated with Alzheimer’s and Parkinson’s diseases, respectively, also behave like a prion that has conformational strains with self-propagation (seeding) property. Moreover, misfolded protein aggregates can promote misfolding and aggregation of different proteins through cross-seeding, which might be associated with co-occurrence of multiple neurodegenerative diseases in the same patient. Elucidation of diverse conformational strains with self-propagation capability and of molecular basis for the cross-talk between misfolded proteins is essential to the development of effective therapeutic intervention.
Self-Perceptions of Social Class and Career Success: A Bi-directional Analysis

This research examines the relationship between self-perceptions of social class with objective and subjective aspects of career success. A bi-directional relationship with a positive feedback loop...
A novel sub-epidemic modeling framework for short-term forecasting epidemic waves

Simple phenomenological growth models can be useful for estimating transmission parameters and forecasting epidemic trajectories. However, most existing phenomenological growth models only support single-peak outbreak dynamics whereas real epidemics often display more complex transmission trajectories. We develop and apply a novel sub-epidemic modeling framework that supports a diversity of epidemic trajectories including stable incidence patterns with sustained or damped oscillations to better understand and forecast epidemic outbreaks. We describe how to forecast an epidemic based on the premise that the observed coarse-scale incidence can be decomposed into overlapping sub-epidemics at finer scales. We evaluate our modeling framework using three outbreak datasets: Severe Acute Respiratory Syndrome (SARS) in Singapore, plague in Madagascar, and the ongoing Ebola outbreak in the Democratic Republic of Congo (DRC) and four performance metrics. The sub-epidemic wave model outperforms simpler growth models in short-term forecasts based on performance metrics that account for the uncertainty of the predictions namely the mean interval score (MIS) and the coverage of the 95% prediction interval. For example, we demonstrate how the sub-epidemic wave model successfully captures the 2-peak pattern of the SARS outbreak in Singapore. Moreover, in short-term sequential forecasts, the sub-epidemic model was able to forecast the second surge in case incidence for this outbreak, which was not possible using the simple growth models. Furthermore, our findings support the view that the national incidence curve of the Ebola epidemic in DRC follows a stable incidence pattern with periodic behavior that can be decomposed into overlapping sub-epidemics. Our findings highlight how overlapping sub-epidemics can capture complex epidemic dynamics, including oscillatory behavior in the trajectory of the epidemic wave. This observation has significant implications for interpreting apparent noise in incidence data where the oscillations could be dismissed as a result of overdispersion, rather than an intrinsic part of the epidemic dynamics. Unless the oscillations are appropriately modeled, they could also give a false positive, or negative, impression of the impact from public health interventions. These preliminary results using sub-epidemic models can help guide future efforts to better understand the heterogenous spatial and social factors shaping sub-epidemic patterns for other infectious diseases.
Teams of Rivals: China, the U.S., and the Race to Develop Technologies for a Sustainable Energy Future

Despite sharing a common interest in addressing climate change, when it comes to commercializing technologies for sustainable energy use, China and the United States are locked in rancor. The prevailing American view is that Chinese firms, rather than innovating, compete on the basis of mimicry, technology theft, and government subsidization. This paper, while not denying the evidence for technology duplication, illuminates three additional aspects of empirical reality: Chinese industrial innovation; multidirectional learning between Chinese and non-Chinese technology firms; and complementary, tiered development across Chinese and advanced industrial commercial innovators. The existence of these cross-border collaborative phenomena, while not invalidating the additional reality of inter-state commercial rivalry, suggests that such rivalry is neither structurally determined nor all pervasive. Extensive evidence of firm-level collaboration challenges the idea that climate remediation is necessarily impeded by a structurally-determined, geopolitically-driven “tragedy of the commons.”
SYSTEMIC HYPERTENSION IN PATIENTS EXPOSED TO ANTHRACYCLINE CHEMOTHERAPY IS ASSOCIATED WITH LONG TERM MORTALITY

Systemic hypertension (HTN) is a major cause of morbidity in the general population and is an important risk factor for mortality. Pediatric cancer survivors with exposure to anthracycline chemotherapeutic agents (ACA) have an increased risk of cardiovascular disease compare to their peers. We
Policy Responses to Climigration

The experience of climigration to date has illustrated the need for policies at all levels that anticipate the need for displacement and address the needs of both those who are being displaced and those who willingly or not will be expected to host displaced people. However, despite the numerous policies that have been proposed, relatively few have actually been implemented. Development of effective and sustainable policies requires research evidence, financial support, allocation of resources, and coordination of different social, economic, and administrative sectors. Above all, it requires public demand for a policy response to climate change displacement and the political will to implement that response.In this chapter, we focus on three types of policies: 1) policies designed to prevent the need for displacement; 2) policies that regulate and manage the process of displacement; and 3) policies that address the health-care needs of climigrants. The operationalization of each of these three types of policies at international, regional, national, and local levels is examined, along with a consideration of the challenges faced in developing and implementing them. We then conclude with a discussion of the lessons learned from this evaluation and recommendations for policy development.
Expenditure, Utilization, and Cost of Specialty Drugs for Multiple Sclerosis in the US Medicaid Population, 2008-2018.

Background Multiple sclerosis (MS) is a rare, long-standing, and disabling disease that affects the central nervous system and causes several clinical manifestations. As a result, this disease is associated with a high societal economic burden.
Splenic volvulus of a wandering spleen.

Abstract Background Wandering spleen is a rare condition in which the spleen is not anchored properly, due to congenital or acquired weakness of the splenic ligaments. This allows the spleen to migrate to any portion of the abdomen or pelvis, and can cause complications, including a splenic volvulus. The presentation of splenic volvulus of a wandering spleen ranges from mild pain to a surgical emergency. Splenic volvulus of a wandering spleen can cause significant morbidity and mortality, and often warrants surgical intervention. Cases of splenic volvulus of a wandering spleen have been reported in radiology and surgery literature, however there are no reports in emergency medicine literature in North America. Case report A 37-year-old female presented to the ED with seven days of mild left upper quadrant abdominal pain that acutely worsened. She underwent laboratory studies which were near her baseline values. A CT abdomen pelvis demonstrated findings consistent with splenic volvulus of a wandering spleen. She was taken emergently to the operating room for exploratory laparotomy, detorsion of spleen, and splenectomy. Her postoperative course was uneventful and she was discharged on hospital day six. Splenic volvulus of a wandering spleen is rare, though carries significant morbidity and mortality, especially if unrecognized. The presentation of splenic volvulus is variable, ranging from minor symptoms to an acute abdomen. Early diagnosis can prevent downstream complications, including development of vascular congestion, ischemia or infarcted intra-abdominal organs. Emergency Physicians should consider splenic volvulus in the differential diagnosis as an etiology of left-sided abdominal pain.
Akratic (epistemic) modesty

Theories of epistemic rationality that take disagreement (or other higher-order evidence) seriously tend to be “modest” in a certain sense: they say that there are circumstances in which it is rational to doubt their correctness. Modest views have been criticized on the grounds that they undermine themselves—they’re self-defeating. The standard Self-Defeat Objections depend on principles forbidding epistemically akratic beliefs; but there are good reasons to doubt these principles—even New Rational Reflection, which was designed to allow for certain special cases that are intuitively akratic. On the other hand, if we construct a Self-Defeat Objection without relying on anti-akratic principles, modest principles turn out not to undermine themselves. In the end, modesty should not be seen as a defect in a theory of rational belief.
Reluctant to Share: How Third Person Perceptions of Fake News Discourage News Readers From Sharing “Real News” on Social Media

Rampant fake news on social media has drawn significant attention. Yet, much remains unknown as to how such imbalanced evaluations of self versus others could shape social media users’ perceptions ...
Does Major Pancreatic Surgery Have Utility in Nonagenarians with Pancreas Cancer

This study aims to define the role of surgery and assess different therapies for nonagenarians with localized, nonmetastatic pancreatic adenocarcinoma (PDAC). The National Cancer Database (NCDB) was queried for patients ≥ 90 years of age with nonmetastatic, localized PDAC from 2004–2016. Postoperative mortality was assessed at 30 and 90 days in patients receiving pancreatoduodenectomy or total pancreatectomy. Overall survival (OS) was compared between three treatment groups: surgery alone, chemotherapy alone, and chemoradiation (chemoRT) alone. Of 380,524 patients with PDAC, 98 patients ≥ 90 years of age underwent curative-intent resection; 55% were female and 75% had a Charlson–Deyo comorbidity score of 0. A total of 17% received postoperative chemotherapy, 51.1% had poorly differentiated tumors with a median tumor size of 3 cm, 55.1% had positive lymph nodes, and 19.4% had positive resection margins. Postoperative median length of stay was 11 days. Postoperative 30- and 90-day mortality was 10.0% and 18.9%, respectively. Median OS for the surgery alone group was 11.6 months compared with 20.4 months in those receiving adjuvant therapy (p = 0.01). Among nonoperative PDAC patients, median OS in patients receiving chemotherapy only (n = 207) was 7.2 months, while chemoRT only (n = 100) was similar to surgery only (11 versus 11.6 months, p = 0.97). Even in well-selected nonagenarians, pancreatoduodenectomy or total pancreatectomy carries a high mortality rate. While adjuvant therapy after resection provides the best survival, it is seldom achieved, and chemoRT alone affords identical survival statistics as surgery alone. These data suggest it is reasonable to consider chemoRT as initial therapy, then reassess candidacy for resection if performance status allows.
71 Neoadjuvant chemotherapy in epithelial ovarian cancer: a case-control study in a Lebanese tertiary care center

Objectives We aim to compare the outcomes of patients with epithelial ovarian carcinoma treated with neoadjuvant chemotherapy to those with primary debulking surgery. Methods A retrospective case-control study was conducted at a Hotel-Dieu de France University Hospital. We reviewed the clinipathological data of 184 patients who were operated on for an epithelial ovarian cancer and we compared the outcomes of patients who received a neoadjuvant chemotherapy (n=94) with those treated with primary surgery(n=90). Results Patients in both groups had comparable age, menopausal status and comorbidities (p>0.05). Patients receiving neoadjuvant chemotherapy had more serous histology and high-grade lesions (58,1% vs. 41,9% (p=0.003), 58,8% vs. 41,2% (p=0.005), respectively). Bilateral adnexal involvement was more seen in the neoadjuvant group (57,4% vs. 42,6%, p=0.19). Patients receiving neoadjuvant chemotherapy were more likely to present lymph node involvement (61,1% vs. 38,9%, p=0.006). More bowel resection was done in the neoadjuvant group (62,4% vs. 37,6%, p=0.005). Postoperative complications were comparable between the two groups (p=0.441). Interval surgery group received more blood transfusion as primary surgery group (55,7% vs. 44,3%, p=0.004). Survival rate was 41,8% in the interval surgery group vs. 58,2% in the primary surgery group (p=0.000). Recurrence rate 60% in the interval surgery group vs. 40% in the primary surgery group (p=0.025). No difference in the recurrence interval was seen in both groups (p=0.272). Conclusion Patients with ovarian cancer receiving neoadjuvant chemotherapy seem to have more aggressive disease and do not have better outcomes in terms of survival and recurrence in comparison to primary surgery group.
Synthesis, Characterization, and Metal Adsorption Properties of Formaldehyde-Based Terpolymeric Resins Derived from Anthranilic Acid, Salicylic Acid, and Catechol

Two formaldehyde-based terpolymeric resins (anthranilic acid-catechol-formaldehyde (ACF) and salicylic acid-catechol-formaldehyde (SCF)) have been synthesized by condensing anthranilic acid with catechol and salicylic acid with catechol at 80 ± 5°C using dimethylformamide as a solvent. The resins were characterized by spectral analysis using Fourier-transform infrared (FTIR) spectroscopy. The physical-chemical properties of the resins have been studied. The exchange behavior of various metal ions, namely, Cd2+, Cr3+, Ca2+, and Mg2+, towards the synthesized resins has been studied depending on contact time and pH. Chelating properties of two resins were pH dependent, and with an increase in pH value from 1 to 5, the exchange capacity of metal ions was increased. The increasing rate of ion-exchange capacity was greater in ACF than that in SCF. Cd2+ showed higher rate of exchange at different time intervals in both cases, ACF and SCF. Cr3+ had higher exchange capacity with pH variation in both resins.
Measuring Discriminatory Social Norms Against Children With Disabilities to Improve Communication-Based Programs

In the Europe and Central Asia region, there are at least five million children diagnosed with some type of disability. These children are likely to be subjected to stigmatization and marginalization, which can lead to discrimination and reduction in access to services. A pilot study was developed to examine factors affecting the treatment of children with disabilities from a holistic, systematic perspective. Stratified by the social ecological model, 450 respondents participated in a structured interview designed to measure knowledge, attitudes, norms, marginalization, and stigma. The results yielded four conclusions. First, it showed that professionals did not rate differently on the constructs of the conceptual model when compared to nonprofessionals. Second, norms are likely affecting the treatment of children with disabilities. Third, the study shows that there is not enough emphasis on educating and involving community members to improve the treatment and protect the rights of children with disabilities. Finally, the results emphasize the importance of approaching disability from a comprehensive social ecological perspective.
Who Should See the Patient? On Deviations from Preferred Patient-Provider Assignments in Hospitals

In various organizations including hospitals, individuals are not forced to follow specific assignments, and thus, deviations from preferred task assignments are common. This is due to the conventional wisdom that professionals should be given the flexibility to deviate from preferred assignments as needed. It is unclear, however, whether and when this conventional wisdom is true. We use evidence on the assignments of generalist and specialists to patients in our partner hospital (a children's hospital), and generate insights into whether and when hospital administrators should disallow such flexibility. We do so by identifying 73 top medical diagnoses and using detailed patient-level electronic medical record (EMR) data of more than 4,700 hospitalizations. In parallel, we conduct a survey of medical experts and utilize it to identify the preferred provider type that should have been assigned to each patient. Using these two sources of data, we examine the consequence of deviations from preferred provider assignments on three sets of performance measures: operational efficiency (measured by length of stay), quality of care (measured by 30-day readmissions and adverse events), and cost (measured by total charges). We find that deviating from preferred assignments is beneficial for task types (patients' diagnosis in our setting) that are either (a) well-defined (improving operational efficiency and costs), or (b) require high contact (improving costs and adverse events, though at the expense of lower operational efficiency). For other task types (e.g., highly complex or resource-intensive tasks), we observe that deviations are either detrimental or yield no tangible benefits, and thus, hospitals should try to eliminate them (e.g., by developing and enforcing assignment guidelines). To understand the causal mechanism behind our results, we make use of mediation analysis and find that utilizing advanced imaging (e.g., MRIs, CT scans, or nuclear radiology) plays an important role in how deviations impact performance outcomes. Our findings also provide evidence for a “no free lunch” theorem: while for some task types deviations are beneficial regarding some performance measures, they can simultaneously degrade performance in terms of other dimensions. To provide clear recommendations for hospital administrators, we also consider counterfactual scenarios corresponding to imposing the preferred assignments fully or partially, and perform cost-effectiveness analyses. Our results indicate that enforcing the preferred assignments either for all tasks or only for resource-intensive tasks is cost-effective, with the latter being the superior policy. Finally, by comparing deviations during weekdays and weekends, early shifts and late shifts, and high congestion and low congestion periods, our results shed light on some environmental conditions under which deviations occur more in practice.
A comprehensive investigation of surface ozone pollution in China, 2015–2019: Separating the contributions from meteorology and precursor emissions

Abstract Despite the considerable reductions in primary and secondary air pollutants in China, surface ozone levels have increased in recent years. We report a trend of 3.3 ± 4.7 μg.m−3 year−1 in the annual mean maximum daily average ozone over an 8-h period (MDA8 ozone) across China between 2015 and 2019. Leveraging the Kolmogorov–Zurbenko filter method, we find that meteorology enhanced the ozone levels in Beijing–Tianjin–Hebei (BTH), the Yangtze River Delta (YRD), and the Pearl River Delta (PRD) while the reduction of solar radiation and the planetary boundary layer height accelerated ozone decreases in the Sichuan Basin (SCB) after 2017. Solar radiation and temperature increases, together with the reduction in sea level pressure, were the main contributors to enhance ozone in the YRD. They also contributed to 32% of ozone increases in BTH. Weaker meridional wind, lower relative humidity, and higher temperature escalated ozone enhancement in the PRD between 2016 and 2018. Regarding precursor emissions, NO2 long-term components showed a noticeable decline in all regions after 2017, partially due to the introduction of the most current action plan to reduce air pollutants over China in 2018. In contrast, the satellite-retrieved data suggest that VOC concentrations did not change substantially in target regions during the study period. After 2017, however, VOCs slightly increased in BTH, the YRD, and the PRD, which might be driven by temperature enhancements. Overall, the impact of meteorology on ozone variations was dominant in the YRD, the PRD, and the SCB from 2015 to 2019. Precursor emissions, however, played a leading role in ozone enhancement over the BTH. We also found that BTH and the YRD were in a transitional ozone formation regime while the PRD and the SCB tended to be more NOx-sensitive.
What Both Hart and Fuller Got Wrong

In the famous debate between H.L.A. Hart and Lon Fuller on the pages of the Harvard Law Review, Nazi law served as a litmus test against which each side measured how his, and the other’s, position stacked up. For Hart, law was law regardless of its possible immoral nature. However, if too evil, it could be disobeyed. For Fuller, morally repugnant laws were simply not laws at all. While disagreeing on this fundamental point, both Hart and Fuller shared, uncritically, a basic factual premise with respect to the legal situation that existed in the Weimar Republic and later on in the Third Reich. In “Positivism and Fidelity to Law” Fuller argued that “in the seventy-five years before the Nazi regime the positivistic philosophy had achieved in Germany a standing such as it enjoyed in no other country.” For his part, Hart accepts comments made by Gustav Radbruch including Radbruch’s statement that legal positivism has been virtually “unopposed by German lawyers for many decades” prior to the rise of National Socialism. This article argues that while Hart’s and Fuller’s shared view of the legal experience in both the Weimar Republic and the Nazi state may not have impacted greatly their jurisprudential stances, it is significant to point out the historical distortions inherent in their understanding of the legal reality leading up to, and pertaining during, the Nazi regime. In fact, it is argued, while National Socialism employed its particular—perverted to be sure—vision of “natural law,” it was the opponents of that regime that argued from the perspective of legal positivism.
Evolution-inspired redesign of the LPS receptor caspase-4 into an interleukin-1β–converting enzyme

Innate immune signaling pathways comprise multiple proteins that promote inflammation. This multistep means of information transfer suggests that complexity is a prerequisite for pathway design. Here, we test this hypothesis by studying caspases that regulate inflammasome-dependent inflammation. Several caspases differ in their ability to recognize bacterial lipopolysaccharide (LPS) and cleave interleukin-1β (IL-1β). No caspase is known to contain both activities, yet distinct caspases with complementary activities bookend an LPS-induced pathway to IL-1β cleavage. Using caspase-1/4 hybrid proteins present in canines as a guide, we identified molecular determinants of IL-1β cleavage specificity within human and murine caspase-1. This knowledge enabled the redesign of human caspase-4 to operate as a one-protein signaling pathway, which intrinsically links LPS detection to IL-1β cleavage and release, independent of inflammasomes. We identified caspase-4 homologs in multiple carnivorans that display the activities of redesigned human caspase-4. These findings illustrate natural signaling pathway diversity and highlight how multistep innate immune pathways can be condensed into a single protein.
Synthesis and analysis of elastic high-speed cam-operated mechanisms

A cam driving a lumped inertia through a massless, elastic, slider-crank fol­ lower linkage with two concentrated masses located at the pin joints is considered. An iterative procedure taking the elasticity, damping, and changing geometry of the linkage into account is developed for synthesizing the cam profile to produce a desired output motion at a given design speed. The steady state solutions for the inhomogeneous, periodic, linear, ordinary differential equations are solved numerically by Hsu's method.
Plenary Session: The Lindbergh Kidnapping Revisited: Forensic Sciences Then and Now

The kidnapping and death of the Lindbergh baby in 1932 were called “The Crime of the Century.” The subsequent investigation and trial proved a watershed for scientific crime detection in this country and for courtroom presentation of scientific and demonstrative evidence. Review of the evidence 50 years later—particularly the questioned document, physical. and psychiatric evidence—shows that the conclusions reached then are valid even by today's standards and that they were arrived at in a highly professional manner. Only the autopsy findings are found wanting.
Endovascular management of fusiform aneurysm of anterior temporal artery: Technical report.

Background: The treatment of a rare, nontraumatic, fusiform aneurysm of the anterior temporal artery (ATA) via endovascular techniques is presented, and procedural nuances are highlighted.