cssi/SciSciGPT-SciSciNet huggingface dataset:
Management of Bile Duct Injuries Within the First Forty-Eight Hours

Within the first 48 h of bile duct injury (BDI), patients often show only mild nonspecific symptoms of nausea and abdominal discomfort. High clinical suspicion of these patient symptoms is necessary to achieve early diagnosis. Work-up should include imaging to assess for intra-abdominal fluid collections, and complete cholangiography should be performed to define biliary anatomy and classify the injury. Successful management requires drainage of intra-abdominal fluid collections, treatment of infection, and early referral to a hepatobiliary specialist. While the timing of BDI repair is controversial, patients with appropriate physiologic status that do not require drainage procedures may be considered for immediate repair. BDI repair should be delayed up to 6 weeks in patients that require drainage procedures, treatment for infections, or where inflammation is excessive.
Monocyte Binding to Endothelial Cells Induced by Oxidized Phospholipids Present in Minimally Oxidized Low Density Lipoprotein Is Inhibited by a Platelet Activating Factor Receptor Antagonist

Our group has previously demonstrated that oxidized phospholipids derived from mildly oxidized low density lipoprotein (MM-LDL) or oxidized 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphorylcholine (oxPAPC) increase monocyte-endothelial interactions. There are indications that the effects of these phospholipids are receptor mediated. Oxidized phospholipids have previously been shown to activate cells via the platelet activating factor (PAF) receptor, therefore, we pretreated human aortic endothelial cells (HAECs) with a PAF-receptor antagonist (WEB 2086) prior to treatment with oxPAPC. WEB 2086 inhibited monocyte binding to endothelial cells induced by oxPAPC (200 μg/ml) at concentrations from 1 nM to 10 μM, but had no effect on the induction of monocyte binding induced by lipopolysaccharide (LPS). We were able to isolate and identify several active oxidized phospholipids by combined normal phase high performance liquid chromatography (HPLC) and electrospray mass spectrometry (LC/MS). The induction of monocyte binding to HAECs by two of these partially purified phospholipids was totally abolished by the pretreatment of HAECs with WEB2086 (100 nM). PAF itself, however, when tested at concentrations from 10 nM to 10 μM had no effect on monocyte binding. These results suggest that several of the oxidized phospholipids present in MM-LDL and oxPAPC induce monocyte binding through a receptor which is perhaps distinct from the PAF-receptor, but can be blocked by the PAF-receptor antagonist WEB 2086.
Teacher Education in Deep Focus

In May of 1941, Orson Welles’s now-iconic film Citizen Kane premiered in New York City. A thinly veiled depiction of publishing magnate William Randolph Hearst, Citizen Kane was a sort of twentieth-century morality play about the ethical hazards of greed and excess. Storying the rise and fall of poor-boy-turned-famous, Charles Foster Kane, the film dutifully adhered to the elements of a solid Greek tragedy: hubris, ultimately, is the hero’s downfall. Citizen Kane has been lauded for its non linear storyline and for the mystery—sweet and sad in the end—of “Rosebud.” But the movie was also famous for its use of a cinematic breakthrough, “deep focus.”
Burden of systolic and diastolic left ventricular dysfunction among hispanics in the United States

Background— Population-based estimates of cardiac dysfunction and clinical heart failure (HF) remain undefined among Hispanics/Latino adults. Methods and Results— Participants of Hispanic/Latino origin across the United States aged 45 to 74 years were enrolled into the Echocardiographic Study of Latinos (ECHO-SOL) and underwent a comprehensive echocardiography examination to define left ventricular systolic dysfunction (LVSD) and left ventricular diastolic dysfunction (LVDD). Clinical HF was defined according to self-report, and those with cardiac dysfunction but without clinical HF were characterized as having subclinical or unrecognized cardiac dysfunction. Of 1818 ECHO-SOL participants (mean age 56.4 years; 42.6% male), 49.7% had LVSD or LVDD or both. LVSD prevalence was 3.6%, whereas LVDD was detected in 50.3%. Participants with LVSD were more likely to be males and current smokers (all P <0.05). Female sex, hypertension, diabetes mellitus, higher body mass index, and renal dysfunction were more common among those with LVDD (all P <0.05). In age–sex adjusted models, individuals of Central American and Cuban backgrounds were almost 2-fold more likely to have LVDD compared with those of Mexican backgrounds. Prevalence of clinical HF with LVSD (HF with reduced EF) was 7.3%; prevalence of clinical HF with LVDD (HF with preserved EF) was 3.6%. 96.1% of the cardiac dysfunction seen was subclinical or unrecognized. Compared with those with clinical cardiac dysfunction, prevalent coronary heart disease was the only factor independently associated with subclinical or unrecognized cardiac dysfunction (odds ratio: 0.1; 95% confidence interval: 0.1–0.4). Conclusions— Among Hispanics/Latinos, most cardiac dysfunction is subclinical or unrecognized, with a high prevalence of diastolic dysfunction. This identifies a high-risk population for the development of clinical HF.
Wiring the Drosophila Brain with Individually Tailored Neural Lineages

A complex brain consists of multiple intricate neural networks assembled from distinct sets of input and output neurons as well as region-specific local interneurons. Within a given anatomical set, there exist diverse neuronal types that can vary in morphology, neural physiology, and modes of neurotransmission. The genetic programs that guide specification of neuronal types during neurogenesis preconfigure the brain. This is best demonstrated in the Drosophila central brain, which is composed of ∼100 pairs of individually tailored neuronal lineages. Each neuronal lineage (the neurons/glia produced from a single stem cell) can contain multiple morphological classes of neurons that can consist of many analogous neuronal types. The detailed patterns of neuronal diversification are lineage-specific and can differ drastically even among neighboring neuronal lineages. Furthermore, the interrelationships between neuronal lineages and neural networks are complex. These phenomena underscore the importance of tracking all neuronal lineages in understanding brain development and evolution.
Contraception and reproductive counseling in women with peripartum cardiomyopathy.

Abstract Objectives Pregnancies following a diagnosis of peripartum cardiomyopathy (PPCM) are associated with increased risk for maternal morbidity and mortality. Yet patterns of contraceptive use and reproductive counseling have received little attention. This nationwide registry-based study sought to evaluate patterns and clinical characteristics associated with contraceptive use, and examine the prevalence of contraceptive counseling in women with PPCM. Methods From December 2015 to June 2016, 177 PPCM patients (mean age of 34.8±5.7 years, median time since diagnosis of 3.0±4.3 years) completed questionnaires about contraceptive use and counseling at registry enrollment. T Tests, chi-square and logistic regression were used to compare demographic and clinical characteristics among women who reported contraceptive use vs. nonuse. Results Tubal ligation (24.3%), condoms (22.0%) and intrauterine devices (IUDs; 16.4%) were the most common forms of contraception. Among sexually active women, 28.9% reported contraceptive nonuse. Contraceptive users had a lower body mass index higher education, and were less likely to be in a dating relationship, have hypertension, wear an external cardioverter–defibrillator, and use antihypertensive medications compared with nonusers (all p Conclusions This preliminary study indicates that 1 in 4 PPCM patients are sexually active and are not using contraception to prevent PPCM reoccurrence. Although a majority of women did receive reproductive counseling, as many as 25% of patients reported no discussion of contraceptive strategies to prevent unintended pregnancy and heart failure relapse.
SoundSifter: Mitigating Overhearing of Continuous Listening Devices

In this paper, we study the overhearing problem of continuous acoustic sensing devices such as Amazon Echo, Google Home, or such voice-enabled home hubs, and develop a system called SoundSifter that mitigates personal or contextual information leakage due to the presence of unwanted sound sources in the acoustic environment. Instead of proposing modifications to existing home hubs, we build an independent embedded system that connects to a home hub via its audio input. Considering the aesthetics of home hubs, we envision SoundSifter as a smart sleeve or a cover for these devices. SoundSifter has hardware and software to capture the audio, isolate signals from distinct sound sources, filter out signals that are from unwanted sources, and process the signals to enforce policies such as personalization before the signals enter into an untrusted system like Amazon Echo or Google Home. We conduct empirical and real-world experiments to demonstrate that SoundSifter runs in real-time, is noise resilient, and supports selective and personalized voice commands that commercial voice-enabled home hubs do not.
Expression of the Wilms’ Tumor Supressor Gene (WT1) in Renal Cell Carcinoma

Wilms’ tumor represents the most common pediatric solid abdominal tumor, with an incidence of 1 in 10,000 live births (1). Histologically, these tumors classically show a triphasic appearance consisting of a mixture of stromal, tubular, and mesenchymal elements in a dysplastic pattem.The tumor is thought to originate from transformed elements of nephrogenic rests which represent embryonic mesenchymal elements in the developing kidney (2, 3). Similar to retinoblastoma, Wilms’ tumors occur in unilaterally and bilaterally, as well as inherited and sporadic forms, with earlier occurrence in bilateral and inherited tumors (1).
Security for minimum storage regenerating codes and locally repairable codes

We consider the problem of designing repair efficient distributed storage systems, which are information-theoretically secure against a passive eavesdropper that can gain access to a limited number of storage nodes. We present a framework that enables design of a broad range of secure storage codes through a joint construction of inner and outer codes. As case studies, we focus on two specific families of storage codes: (i) minimum storage regenerating (MSR) codes, and (ii) maximally recoverable (MR) codes, which are a class of locally repairable codes (LRCs). The main idea of this framework is to utilize the existing constructions of storage codes to jointly design an outer coset code and inner storage code. Finally, we present a construction of an outer coset code over small field size to secure locally repairable codes presented by Tamo and Barg for the special case of an eavesdropper that can observe any subset of nodes of maximum possible size.
Addressing the Minimum Environmental Impacts of Algal Renewable Diesel Production from a Consequential Perspective

Abstract Microalgae are among the most promising biomass resources to address global energy and environmental issues. Compared with their fossil-based counterparts, fuels from microalgae have demonstrated mitigated environmental impacts. However, there is no quantitative analysis on their environmental consequences in response to dynamic market interactions. In this paper, we focus on producing renewable diesel from microalgae and substituting the biofuel product for fossil-based diesel. To quantify their life cycle environmental impacts, we develop a novel systems analysis framework based on consequential life cycle optimization. Optimization results show that with the highest overall profitability, the minimum 100-year global warming potential and ReCiPe endpoint score via a consequential approach correspond to − 121.53 g CO2 -e/MJ and − 13.28 Pt./MJ, respectively. The optimal results are 5 times and 6 times lower than those obtained via an attributional approach.
Low Levels of Allochthony in Consumers Across Three High-Elevation Lake Types

The integration of lakes into watershed-scale energy budgets remains a major goal of aquatic ecosystem ecology. However, this enterprise has focused almost exclusively on temperate and boreal systems and on zooplankton as representatives of system-wide energy flow. We investigated the proportion of consumer biomass derived from terrestrial sources, allochthony, in three classes of high-elevation lakes—alpine, large and small montane—of varying geometry and watershed ecosystem development, and across five taxa, including macrobenthic invertebrates and fish. We used stable isotopes of carbon (13C:12C), nitrogen (15N:14N), and hydrogen (2H:1H) to fit a modular Bayesian mixing model, which estimated proportional assimilation of phytoplankton, algal periphyton, and terrestrial organic matter by each consumer. The stable isotope analysis was supplemented with a comparison of fatty acid profiles between consumers and producers, and with a Daphnia magna rearing study involving aquatic and terrestrial nutrient sources. The most probable estimate of allochthony across consumer taxa was 41% in small montane lakes (< 0.1 ha) with high terrestrial C loading. For large montane (3–11 ha) and alpine lakes (0.8–3 ha), with substantially less terrestrial influence, allochthony was just 4 and 3%, respectively. Allochthony was also lower on average for benthic grazers than for pelagic consumers. Our results corroborate previous findings that lake size, depth, and light penetration are dominant physical controls on allochthony, but add that it sharply declines at high elevation due to changes in terrestrial primary production near or above tree line.
Integrating agent-based simulation into emergency operations center training command and control systems

This paper discusses agent-based simulation with respect to Emergency Response command and control systems. These systems often are referred to as Crisis Information Management Systems (CIMS). The paper begins with a brief discussion of the background of CIMS, and the authors present a training simulator for Emergency Managers, called SimEOC. Next, the authors present challenges faced with respect to integrating agent-based simulation into CIMS for training. Finally, the authors conclude by suggesting the solution of using Geographic Information Systems (GIS) as the integrating artefact for agent-based modeling and CIMS.
Rapid Progression of Knee Pain and Osteoarthritis Biomarkers Greatest for Patients with Combined Obesity and Depression: Data from the Osteoarthritis Initiative:

ObjectiveTo compare the progression of biochemical biomarkers of osteoarthritis (OA), knee pain, and function between nonobese patients (NON), obese patients without depression (OBESE), and obese p...
Large Draining Focal Fibrous Hyperplasia Secondary to Periapical Granuloma

Periapical granuloma is a pathological diagnosis associated clinically and radiographically with a nonvital tooth and a periapical radiolucency, respectively. It is frequently seen as a sequela of long-standing pulpal necrosis. Often times, a draining fistula is observed near the nonvital tooth. We report an unusual case of a large draining focal fibrous hyperplasia in association with a large periapical granuloma treated at our clinic. The diagnosis was made by the clinical presentation, radiologic and histopathologic findings.
Variance Estimation in Monte Carlo Eigenvalue Simulations Using Spectral Analysis Method

AbstractMonte Carlo (MC) simulation is widely used to solve the eigenvalue form of the Boltzmann transport equation that mathematically represents the neutron transport process through complex mult...
Theoretical Relationship among Myocardial Tissue and Cavity Pressures, Contractility, and Vascular Volume Change

The intramyocardial pump model introduced by Spaan et al. [1] to explain the reduction of coronary inflow during cardiac contraction has been recently questioned by Krams et al. [2–4]. The latter authors demonstrated that the systolic coronary inflow impediment is only weakly dependent on left ventricular cavity pressure, but is affected more by cardiac contractility and perfusion pressure. Since the pump model, in its simplest form, assumes a direct proportionality between intramyocardial tissue pressure (IMP) and left ventricular cavity pressure (with one zero if the other is zero) it would appear that the pump model fails to explain the results of Krams et al. A recent letter by Kresh [5] discusses the controversy further. In view of the interest and importance of this subject, it seemed helpful to develop a relatively simple model from which various factors affecting IMP can studied. In particular, the relationship between IMP and left ventricular pressure is clarified, and simple formulas are given that can be used in conjunction with a pump model.
FIELD TRIALS WITH ISOTOPICALLY LABELED NITROGEN FERTILIZER

ABSTRACT Field trials utilizing 15 N-depleted ammonium sulfate fertilizer were established at two locations, one on Yolo fine sandy loam at U.C. Davis, and the other on Hanford sandy loam at the Kearney Field Station, with corn as the test crop. At Davis 3 irrigation regimes and 4 fertilizer rates were used, while at Kearney 6 fertilizer rates were used with uniform irrigation. Plant tissue, soil solution and soil samples were analyzed to determine the fate of the applied N. Efficiency of N uptake by crops ranged from 30 to 67% at Davis and from 35 to 68% at the Kearney site, with maximum values occurring at fertilizer levels which produced maximum grain yield. Soil solution analyses showed that very little nitrate derived from fertilizer escaped from the root zone unless fertilizer rates were in excess of crop needs. The experiments demonstrate the potential for use of 15 N-depleted materials in field trials, which makes it possible to obtain very useful information not available with conventional techniques. Costs for labeled fertilizer for field-scale experiments are relatively modest.
Calcineurin Inhibitor Toxicity, Polyomavirus, and Recurrent Disease

Cyclosporin A (CsA) and tacrolimus have greatly improved graft survival since their introduction in the 1980 and 1990s, respectively. While the drugs are structurally unrelated, their mechanism of immunosuppression is remarkably similar. The dramatic immunosuppressive and nephrotoxic effects of CsA and tacrolimus are largely explained by their calcineurin inhibition. The pathology of CsA and tacrolimus toxicity is pathologically indistinguishable.
Disaster Planning for Community-Dwelling Older Adults: Strengths, Weaknesses, and Interventions

Older adults with diminished physical, cognitive, and economic resources are more vulnerable to adverse consequences than others during and after disasters. Disaster preparedness is a matter of critical concern as the population of older adults grows at the same time that hazardous events are occurring with greater frequency and severity across the country. Disaster planners must implement procedures for identifying the most vulnerable older adults so they can provide adequate and appropriate assistance. Several states and communities have developed promising models, such as recruiting active, involved older adults to identify and assist their less able older neighbors. This chapter reviews the existing literature and provides an overview of new and developing practices designed to strengthen existing systems and protect the well-being of elders.
Numerical Study on MRI RF Heating for Circular External Fixators under 1.5T MRI

Tissue heating due to radio frequency (RF) energy absorption in human body for patients in a Magnetic Resonance Imaging (MRI) environment is one of the primary concerns about MRI related safety issues for patients, especially with the presence of sizable metal implants such as circular external fixation devices. This paper proposes a novel method to evaluate the MRI RF induced heating effects of circular external fixation devices utilizing an innovative leg phantom. A number of essential geometrical parameters, i.e. number of screws and wires, ring frame diameter, strut length, and insertion angle were numerically investigated to study the RF induced heating mechanism and behaviors of circular external fixation devices. Numerical results suggest that non-wire configuration with fewer screws, large ring frame size, relatively large strut length and the maximum insertion angle pointing outwards may lead to the worst case MRI RF coil induced heating. The peak spatial average specific absorption rate (SAR) over 1 gram can approach 341.3 W/kg with a 2 W/kg whole body SAR.
Protecting Neighborhoods or Priming Them for Gentrification? Historic Preservation, Housing, and Neighborhood Change

Preservation advocates and city officials have a diverse set of policies for protecting historic neighborhoods and restoring historic buildings. Although the primary goal of these tools is to prese...
Causes of Hypertension in the Young

This discussion deals with the most common causes of persistent hypertension in children in two kinds of patient populations. In one group, the patients are usually symptomatic and severely hypertensive with blood pressures well above 150/100 mm Hg regardless of age. They have been observed either in hypertension clinics or as hospital inpatients. The other group has incidental hypertension, usually of a mild degree, discovered during routine physical examination in general pediatric office practice.
Representations of Attachment to Father in the Narratives of Preschool Girls in Post-Divorce Families: Implications for Family Relationships and Social Development

This study used the Attachment Story Completion Task-Revised (ASCT-R) (Bretherton, Ridgeway, & Cassidy, 1990), a representational measure of attachment security, to examine characteristics of preschool-aged girls' narratives associated with portrayals of attachment to the father. The children's (n = 27) parents had been divorced or legally separated for at least 2 years, and they lived in the primary custody of their mothers. We had previously discovered that girls' responses to the ASCT-R differed from those of boys in unexpected ways. Whereas boys' representations of child-father attachment varied positively with teacher ratings of social behavior in child-care settings, the opposite was the case for girls. Girls who portrayed children's attachment to the father more frequently were rated lower in social competence, contrary to expectations. A more detailed analysis of responses to the ASCT-R suggests that girls' representational attachment behavior toward the father was associated with narrative representations of both parents as unavailable, family instability, and concerns for the father's well-being.
An Empirical Test of Image Restoration Theory and Best Practice Suggestions Within the Context of Social Mediated Crisis Communication

Crises are inevitable for any company, and the fate of a company’s image rests in how well they are responded to. Few studies have experimentally tested the impact that common types of company responses can have on consumers’ perceptions when a negative complaint has been made online. This research sought to expand the strategies put forth for crisis management by image restoration theory (IRT) using best practice research within the context of social mediated crisis communication. An online experiment examined the effect of a company’s response to an online complaint (i.e., professional apology, personal apology, deleting the comment, ignoring the comment, control group) on participants’ perceptions of the company (i.e., perceptions of company caring, attitude). The potential for perceptions of company caring to mediate the relationship between these expanded strategies and IRT’s ultimate aim of attitude change was also tested. An apology, whether professional or personal, improved participants’ perceptions compared to deleting or ignoring the complaint. Caring significantly mediated the relationship between response strategy and participant attitude. Compared to a control group, which had no transgression, ignoring or deleting the complaint led to negative attitudes about the company, while responding to the complaint with a personal or professional apology led to positive attitudes about the company via perceptions of company caring. Results indicate that online complaints could also be seen as opportunities to improve a company’s image, as attitudes toward the company were highest when a transgression occurred and was responded to positively, compared to not having the transgression take place at all (i.e., control condition). Potential extensions to current image repair strategies in the social media environment are discussed.
The effect of acute stress on salivary markers of inflammation: a systematic review protocol

There is an increasing interest in the ability to non-invasively assess biological markers of stress. Measures of inflammation following exposure to acute stress have been assessed in saliva, but a systematic review and meta-analysis of the reliability of changes in response to stress has not been conducted. The proposed review aims to update and extend a prior review of this literature by performing a systematic review and meta-analysis, conducting moderator analyses, summarizing and reviewing best practices, and providing recommendations for future research. The adopted search strategy will involve the electronic databases PubMed, PsycINFO, and Embase. We will include the articles identified by a 2015 narrative review on a similar topic, as well as use reference treeing to identify additional potentially relevant articles. Identified articles will be independently screened by title and abstract. The full text of potentially relevant articles will then be retrieved and read for full inclusion criteria. Data will be extracted, and random-effects meta-analyses will be conducted in R for articles determined to meet all inclusion criteria. The primary outcome will be the magnitude of changes in inflammatory biomarkers following acute stress exposure, as indicated by Cohen’s d. Participant psychosocial or demographic (e.g., age, gender/sex, race/ethnicity, salivary flow rate, oral health status, health status) and methodological (e.g., stressor type, sample timing, assay technique, sample collection method, study quality) moderators of this response also will be examined using meta-regression. This systematic review will synthesize the evidence regarding salivary markers of inflammation in response to acute stress. We anticipate variation across studies but hypothesize that salivary markers of inflammation will increase in response to acute stress. The evidence obtained for this study will help guide future research by providing guidelines for the design and measurement of studies assessing salivary inflammation in response to acute stress. Findings will be disseminated with a peer-reviewed manuscript and an international conference presentation.
Coordination between an Aggregator and Distribution Operator to Achieve Network-Aware Load Control

Operational issues could arise on a distribution network if a third-party aggregator controls a large number of the network’s loads without visibility of network states or topology. This paper investigates mechanisms by which an aggregator could coordinate with a distribution network operator such that aggregate load actions do not negatively impact the network. We propose two possible frameworks for coordination and develop a specific coordination scheme in which the operator can partially block the aggregator’s control inputs to loads. We design a control strategy for the aggregator assuming it has little to no information about how the operator is blocking its control. The proposed controller estimates the number of loads that are not receiving the aggregator’s commands and compensates accordingly. In a simulation study, the proposed controller consistently outperforms a benchmark controller in terms of average tracking error.
Laparoscopic Distal Gastrectomy with Billroth II Anastomosis

This chapter discusses technical aspects of laparoscopic distal gastrectomy with Billroth II anastomosis including instrumentation and equipment, patient positioning, trocar placement, and surgical steps. The authors also offer pearls and pitfalls.
Multimodal Imaging for the Diagnosis of Isolated Cardiac Sarcoidosis

Abstract We report a case of isolated cardiac sarcoidosis (CS) diagnosed using a multimodality imaging approach. A patient presented after an out-of-hospital, ventricular fibrillation–mediated card...
Counting the Weighs: Growth Velocity Tables for Preterm Infants

Consistent methods are needed to calculate and report postnatal growth of the preterm infant. Growth charts are valuable resources to visually monitor growth trends over time. This article includes growth velocity tables, with numerical data, intended to complement existing resources and provide clinicians with a quantitative method to assess and report weekly changes in growth. Tables were constructed using the 50th percentile dataset for the Fenton 2013 Growth Charts to estimate fetal growth rates. This dataset is based on preterm infant birth measures rather than postnatal growth; therefore, the intended use of these resources is to promote a consistent method for reporting how a preterm infant is growing. Consistent methods to calculate and report current growth can contribute more reliable data for research and further insight to postnatal growth associated with the best possible health outcomes for future preterm infants.
Autophagy compensates for Lkb1 loss to maintain adult mice homeostasis and survival

Liver Kinase B1 (LKB1), also known as serine/threonine kinase 11 (STK11) is the major energy sensor for cells to respond to metabolic stress. Autophagy degrades and recycles proteins, macromolecules, and organelles for cells to survive starvation. To access the role and cross-talk between autophagy and Lkb1 in normal tissue homeostasis, we generated genetically engineered mouse models where we can conditionally delete Stk11 and autophagy essential gene, Atg7, respectively or simultaneously, throughout the adult mice. We found that Lkb1 was essential for the survival of adult mice, and autophagy activation could temporarily compensate for the acute loss of Lkb1 and extend mouse life span. We further found that acute deletion of Lkb1 in adult mice led to impaired intestinal barrier function, hypoglycemia, and abnormal serum metabolism, which was partly rescued by the Lkb1 loss-induced autophagy upregulation via inhibiting p53 induction. Taken together, we demonstrated that autophagy and Lkb1 work synergistically to maintain adult mouse homeostasis and survival.
Buccal vs vaginal misoprostol combined with Foley catheter for cervical ripening at term (the BEGIN trial): a randomized controlled trial.

Background Combining pharmacologic agents with mechanical ripening achieves the shortest time to labor; however, there is no clear evidence on route of drug administration. Buccal administration of misoprostol has shown greater patient acceptance but remains understudied. Objective This study aimed to evaluate the difference in time to delivery between buccal and vaginal administration of misoprostol along with a Foley catheter for induction of labor. Study Design The BEGIN trial (buccal vs vaginal misoprostol combined with Foley catheter for cervical ripening at term) was an institutional review board–approved, randomized clinical trial conducted from June 2019 to January 2020 comparing identical doses (25 μg) of buccal misoprostol and vaginal misoprostol along with a Foley catheter for induction of labor. Randomization was stratified by parity. Labor management was standardized among participants. Individuals undergoing induction of labor at ≥37 weeks with a singleton gestation and needing cervical ripening were included. Our primary outcome was time to delivery. Kruskal-Wallis, Pearson chi-squared, and Cox survival analyses with intent-to-treat principles were performed. A sample size of 216 was planned to detect a 4-hour reduction in delivery time. Results A total of 215 women (108 in the buccal drug administration group and 107 in the vaginal drug administration group) were randomized. The vaginal route of drug administration achieved a faster median time to delivery than the buccal route of drug administration (19.7 hours in the vaginal route vs 24.1 hours in the buccal route; P Conclusion We found that vaginal administration of misoprostol was superior to buccal administration of misoprostol along with a Foley catheter for induction of labor. Furthermore, vaginal administration of misoprostol resulted in twice the chance of delivering earlier compared with buccal administration of misoprostol with no difference in cesarean delivery rates. Therefore, the vaginal route of administration of misoprostol should be preferred among individuals undergoing a combined pharmacologic and mechanical induction.
Detection of antibiotics in the urine of children and pregnant women in Jiangsu, China.

Abstract Exposure to low concentrations of antibiotics links to multiple health hazards, such as drug resistance of bacteria, and childhood obesity. In this study, seven antibiotics were measured in the urine of 107 children and 126 pregnant women in Jiangsu Province by ultra-performance liquid chromatography and tandem mass spectrometry (UPLC-MS/MS). The overall urinary antibiotics detection rate was 38.6%. Most (98.3%) of the participants’ antibiotics concentrations were no more than 10 ng/mL. Children had a significantly higher detection rate than pregnant women (47.7% vs. 31.0%, P = 0.009), as well as the concentration (95th percentile: 6.49 vs. 4.08 ng/mL, P = 0.002). The detection rates of individual antibiotics ranged from 0.4% to 15.0%, and the concentrations ranged from lower than the limit of detection (LOD) through up to 31.96 ng/mL individually. Two or more antibiotics were detected in 11.2% of the urines. Tetracyclines were more frequently detected than phenicols (30.9% vs.12.4%). Oxytetracycline was the most frequently detected (15.0%). Multivariate logistic regression showed that consuming puffed food every day was associated with a significantly increased likelihood of detection, and higher concentration of overall antibiotics, and of doxycycline. Children were more likely to be detected of doxycycline and florfenicol, and to have elevated concentration of doxycycline, compared with pregnant women. This study highlights the relatively heavier antibiotics exposure in children, and a possible impact of puffed food on it, which needs to be warranted in future studies.
Cost to Medicare of Delayed Adalimumab Biosimilar Availability

Launched in 2002, originator adalimumab (Humira) is the top revenue-generating drug in the United States. Between 2016 and 2019, the US Food and Drug Administration approved 5 adalimumab biosimilars, yet none have been marketed owing to patent dispute settlements. We sought to calculate the cost of this delayed entry to Medicare over this period by estimating the difference between reported spending on originator adalimumab and estimated spending on originator and biosimilar adalimumab products assuming timely biosimilar market entry. Estimates of potential biosimilar spending were calculated based on the following evidence-based projections: (i) market capture of 15% for the first biosimilar and 5.5% for successive biosimilars in their first year on the market, and 5% annually thereafter; (ii) price reductions of 3.5% per year and 2.4% per additional biosimilar entry for originator adalimumab; and (iii) price discounts of 25% at launch, 3.4% per year, and 1.7% per additional biosimilar entry for biosimilar adalimumab. Based on these assumptions, had adalimumab biosimilars launched upon approval, estimated non-rebate spending on them would have been $18.3 million in 2016, $225.7 million in 2017, $436.2 million in 2018, and $727.7 million in 2019, whereas estimated non-rebate spending on originator adalimumab would have been $2.33 billion, $2.04 billion, $1.78 billion, and $1.42 billion. Cumulative spending on adalimumab would have thus been $8.98 billion instead of an observed $12.11 billion. Accounting for estimated rebates, total predicted savings would have been $2.19 billion. Reforms for timely biosimilar availability will be critical in ensuring optimal savings for Medicare after biosimilar approval.
Innovation within Real Sectors, and Sequence for Arrival of Innovations within Stock Markets: Quandary or Conformance?

Whereas a high quality innovation ought always to be preferred, in relation to a lower quality innovation, this study provides formal theoretical evidence for presence of alternate preferences within stock markets. Sequence of arrival of IPOs that is preferred by investors and issuers - an 'increasing cascade' of IPO quality that is induced by forces of demand - is shown to be preferred, precisely because it is susceptible to systemic overvaluations that are induced by political connectedness of lower quality IPOs. Given systemic overvaluations always, in eventuality, transform into busts, and given arrival at busts implies a chasing after previously attained valuation highs, in addition to cycle of boom and bust, there is arrival at valuations that chase their very own overvalued tails. We arrive then at a correlated, equivalently, self fulfilling equilibrium for stock prices that does not coincide with a rational expectations equilibrium (REE). The evidence demonstrates that assessments of healthiness of stock markets on basis of increases to price levels is inconsistent with rational expectations equilibriums. The formal theoretical antidote that is arrived at calls for adoption of each of `top-down' innovation systems (innovation systems in context of which IPOs list in order of decreasing average quality); 'Market Incompleteness Metrics (MIM)' that signal levels of returns of which investors ought to be expectant; and rubrics for pricing of `Innovation Futures' characteristics for each of newly listing and incumbent firms within stock markets. Absent introduction of the three proposed measures, the optimal innovation system within real sectors - the top-down innovation system - conflicts with preferences of investors, as such conflicts with the most desirable sequence for arrival of innovations within stock markets.
Basal ganglia shape features differentiate schizoaffective disorder from schizophrenia

Abstract There is growing evidence that schizophrenia and schizoaffective disorder represent closely related syndromes that vary in severity along a neurobiological continuum. In the present study, volume and shape of the basal ganglia was examined in people with schizophrenia and schizoaffective disorder relative to healthy controls and hypothesized that unique neuroanatomical differences would be observed in each patient group. Magnetic resonance 1.5T images were obtained from schizophrenia (n = 47), schizoaffective disorder (n = 15), and from healthy control (n = 42) participants, matched for age, gender, parental socioeconomic status, and race. The caudate, putamen, and globus pallidus were characterized using high-dimensional brain mapping procedures (Csernansky et al., 2004b). Results revealed significant shape deformations between schizophrenia and schizoaffective disorder that also differed from control subjects. Relative to schizophrenia, schizoaffective subjects showed exaggerated inward deformations indicative of localized volume loss in subregions of the caudate, putamen, and globus pallidus (all p
Tumor-Associated Exosomes: A Potential Therapeutic Target for Restoring Anti-Tumor T Cell Responses in Human Tumor Microenvironments

Exosomes are a subset of extracellular vesicles (EVs) that are released by cells and play a variety of physiological roles including regulation of the immune system. Exosomes are heterogeneous and present in vast numbers in tumor microenvironments. A large subset of these vesicles has been demonstrated to be immunosuppressive. In this review, we focus on the suppression of T cell function by exosomes in human tumor microenvironments. We start with a brief introduction to exosomes, with emphasis on their biogenesis, isolation and characterization. Next, we discuss the immunosuppressive effect of exosomes on T cells, reviewing in vitro studies demonstrating the role of different proteins, nucleic acids and lipids known to be associated with exosome-mediated suppression of T cell function. Here, we also discuss initial proof-of-principle studies that established the potential for rescuing T cell function by blocking or targeting exosomes. In the final section, we review different in vivo models that were utilized to study as well as target exosome-mediated immunosuppression, highlighting the Xenomimetic mouse (X-mouse) model and the Omental Tumor Xenograft (OTX) model that were featured in a recent study to evaluate the efficacy of a novel phosphatidylserine-binding molecule for targeting immunosuppressive tumor-associated exosomes.
Evaluation of [18F]NCFHEB and its sensitivity to increases in endogenous acetylcholine in non-human primates

412 Objectives The cholinergic system plays an important role in medical and psychiatric disorders. Here, we evaluate the suitability of the recently developed PET ligand [18F](-)-norchloro-fluorohomoepibatidine ([18F]NCFHEB) to image α4β2 nicotinic acetylcholine (ACh) receptors in rhesus monkeys, and assess its sensitivity to physostigmine-induced increases in endogenous ACh. Methods PET data were acquired for 2 h. The arterial input function and plasma free fraction fP were measured. Rhesus monkeys underwent test and retest scans, a blocking scan with nicotine (0.24 mg/kg, iv) and two scans after physostigmine (0.06-0.28 mg/kg, iv). Regional normalized distribution volumes (VT/fP) were quantified using the multilinear analysis MA1 method. Results [18F]NCFHEB radiochemical purity was >98% and specific activity at the end of synthesis was 2.5±0.6 mCi/nmol (n=5). [18F]NCFHEB had high plasma free fraction (0.89±0.04, n=10) and rapid metabolism, with a parent fraction of 43±7 and 14±2% at 30 and 90 min postinjection. Baseline [18F]NCFHEB VT/fP values were 7.4±1.0 (cerebellum), 13±1.0 (hippocampus), 15±1.8 (frontal cortex), 13±1.6 (putamen), and 33±5.3 (thalamus) mL/cm3 (n=4). Test-retest variability of VT/fP ranged from 9% (thalamus) to 15% (cerebellum) (11% average for all regions). From blockade studies with nicotine, [18F]NCFHEB normalized nondisplaceable distribution volume (VND/fP) was 6.7±1.2 mL/cm3 (n=2) for all brain regions. Physostigmine-induced increases in ACh reduced [18F]NCFHEB VT/fP by 17±10% (cerebellum), 20±7% (hippocampus), 22±7% (frontal cortex), 30±6% (putamen) and 31±7% (thalamus) (n=4). Conclusions This first-time evaluation of [18F]NCFHEB in rhesus monkeys confirmed several favorable properties including high free fraction in plasma and specific binding in brain, good test-retest reproducibility and sensitivity to increases in endogenous ACh. These results support the use of this tracer in human studies of the cholinergic system in healthy and diseased brain. Research Support VA PTSD Center and NIH (K01 MH092681, K02 DA031750)
A Uniform Theory of Federal Court Jurisdiction Under the Federal Arbitration Act

The Federal Arbitration Act (FAA) is considered an anomaly among federal statutes. The protections of the FAA are substantive law, yet citing to the FAA is insufficient to invoke the federal courts’ jurisdiction. Instead, parties seeking federal court assistance on arbitration matters must have independent jurisdictional grounds, usually federal question or diversity jurisdiction. This requirement stems from FAA Section 4, which states that jurisdiction lies in any district court which, “save for the agreement, would have jurisdiction under title 28 . . . of the controversy” Courts across the country are encountering serious difficulty interpreting this language and have created upwards of a dozen different legal tests for jurisdiction. These tests turn largely on a handful of non-salient factors, notably the presence or absence of underlying state court litigation. Some courts interpreted the “controversy” language as requiring courts to “look through” the federal court motion to the substance of the arbitral controversy. Other courts “look through” only to the subject of underlying state litigation. Still other courts refuse to “look through” to anything at all, relying solely on the pleadings before them. In 2009, the Supreme Court’s Vaden v. Discover Bank, determined that FAA Section 4 required the district courts to “look through” the federal court documents and consider the merits of underlying state-court litigation and to apply the well-pleaded complaint rule. The Vaden decision, however, is both incorrect and imprudent. The decision was incorrect on its merits under both a textual and policy analysis. The Court was imprudent because it only addressed a small portion of cases falling under the FAA’s jurisdiction. Significant questions and circuit splits still plague the courts. A simplified, uniform test would greatly alleviate all of this confusion. Specifically, a test interpreting Section 4 to allow a “look through” to the arbitral controversy in all instances would best serve the intent of the FAA, the courts, and the litigants. While this change could be accomplished statutorily or through the common law, a common law change is proposed to shortcut congressional inaction on arbitration issues.
Abstract MP77: Will the World Health Organization’s “25 x 25” Goal Be Achieved? An Ecologic Time Trend Analysis of Relative and Absolute Premature Mortality Risk Due to Non-Communicable, Chronic Diseases

Objectives: To evaluate country-level time trends (1994-2011) in premature (30-69 years) mortality from non-communicable, chronic diseases (NCDs), including cardiovascular diseases, and to create forward projections to 2025 to evaluate the WHO’s goal of reducing the risk of premature mortality from NCDs by 25% by 2025. Methods: Using publicly available data from the WHO Mortality Database, we created annual estimates of risk of premature (30-69 years) NCD mortality (1994-2011). The sample included data from all countries reporting NCD mortality data from ≥2 years (n=116) and all countries reporting population estimates over the same years (n=135). We matched these datasets by country, year, division, administrative grouping and sex to reach a final sample of 60 countries (193 WHO Member States, 2011). We used ordinary least squares and log-linear Poisson regression models stratified by sex to evaluate the annual change in risk of premature mortality. We then created forward projections through 2025 using log-linear models. We used extrapolated premature mortality risk at 2025 and compared risk to 2010, with projected United Nations age- and sex-specific population estimates, to evaluate trends. Results: Among all included countries, the average (SD) risk of premature mortality from NCDs based on log-linear models in 1994 was 6.8 (4.2) and 3.9 (2.1) per 1,000 persons in men and women, respectively (Table 1). In 2010, men in lower-middle income countries had the highest rates of premature NCD mortality (7.2 [1.8] per 1,000), and women from high-income OECD countries had the lowest rates (2.0 [0.5] per 1,000). If recent trends continue, the median risk of premature mortality from NCDs will decrease by 25.1% (IQR 16.4, 37.0) by 2025. Conclusions: Among included countries, if recent trends in risk of premature death from NCDs continue to 2025, 50% of countries will achieve the WHO’s 25 x 25 goal. However, data are disproportionately missing from low- and middle-income countries, which appear less likely overall to achieve this goal. ![][1] [1]: /embed/graphic-1.gif