cssi/SciSciGPT-SciSciNet huggingface dataset:
Symptom incidence, distress, cancer-related distress, and adherence to chemotherapy among African American women with breast cancer.

Background There is a persistent racial survival disparity between African American (AA) and white women with breast cancer. There is evidence that symptom incidence, associated distress, and overall cancer-related distress may be unexplored, important contributing factors. The purpose of the current study was to: 1) describe and compare the number of chemotherapy-related symptoms and associated distress among AA women with breast cancer over the course of chemotherapy at 3 time points (at baseline before initiating chemotherapy, midpoint, and at the completion of chemotherapy); and 2) to describe the relationship between the number of chemotherapy-related symptoms and overall cancer distress compared with the ability to receive at least 85% of the prescribed chemotherapy within the prescribed timeframe. Methods Descriptive, comparative, and correlational analyses of symptom incidence, symptom distress, cancer-related distress, and prescribed chemotherapy dose received among a cohort of AA women receiving chemotherapy for breast cancer were performed. Results AA women (121 women) experienced worsening symptoms from baseline to midpoint in chemotherapy and then stabilized for the duration of therapy. The inability to receive 85% of the prescribed chemotherapy within a prescribed time point was found to be significantly correlated with midpoint symptom distress. Conclusions The main findings of the current study were that AA women experience a deterioration in symptom distress over the course of chemotherapy from baseline (before chemotherapy) to the midpoint, which was found to be associated with less adherence to chemotherapy overall. Thus, the incidence and management of physical and emotional symptoms, as measured through a multidimensional symptom measurement tool, may be contributing to breast cancer dose disparity and should be explored further. Cancer 2017;123:2061-2069. © 2017 American Cancer Society.
Power Analyses for Moderator Effects in Three-Level Cluster Randomized Trials

ABSTRACTResearchers are often interested in whether the effects of an intervention differ conditional on individual- or group-moderator variables such as children's characteristics (e.g., gender), teacher's background (e.g., years of teaching), and school's characteristics (e.g., urbanity); that is, the researchers seek to examine for whom and under what circumstances an intervention works. Furthermore, the researchers are interested in understanding and interpreting variability in treatment effects through moderation analysis as an approach to exploring the sources of the treatment effect variability. This study develops formulas for power analyses to detect the moderator effects in designing three-level cluster randomized trials (CRTs). We develop the statistical formulas for calculating statistical power, minimum detectable effect size difference, and 95% confidence intervals for cluster or cross-level moderation, nonrandomly varying or random slopes, binary or continuous moderators, and designs with o...
Three Ways That Data Can Misinform: Inappropriate Partialling, Small Samples, and Anyway, They're Not Playing Our Song.

Gangestad, Haselton, and Buss (this issue) have contributed a provocative analysis of cultural variation in mate preferences. We applaud their advocacy of an interactionist perspective on mate selection that takes nature and nurture into account simultaneously. We, like they, reject artificial dichotomies between evolved dispositions and environmental influences. As they ac knowledge, our debates with them center on the details of our respective interactionist theories, especially the ways in which evolutionary processes calibrated the human psychological dispositions that are manifest in mate preferences among modem humans. To advance this debate, we begin by briefly reviewing our theory and critiquing Gangestad et al.'s evolutionary psychol ogy theory. Our comment then addresses three flaws in Gangestad et al.'s (this issue) empirical demonstrations that lead them to conclude support for their own evolu tionary psychology theory over a biosocial account (Wood & Eagly, 2002). The first is the partialling fal lacy, whereby Gangestad et al. control the status of women for its socioeconomic and ecological determi nants in their attempt to show that this variable is not relevant to mate choice. The second is the small sample shortcoming, whereby their analyses are compromised by too many variables given the small number of cases. The third is their use of obsolete predictors, whereby they represent pathogen prevalence with old data in their attempt to show the relevance of this variable to mate choice.
Childhood severe asthma: New insights on remodelling and biomarkers

Severe asthma in children is characterised by severe and multiple aeroallergen sensitisation, food allergy, eosinophilic airway inflammation and airway remodelling. However, it is a heterogeneous disease with considerable variability in the manifestation of each of these characteristics between patients. Recent data from mechanistic studies that have used translational approaches including neonatal mouse models and airway bronchoscopic samples, have shown specific molecular mediators that drive remodelling and steroid resistance in paediatric severe asthma will be discussed. The importance of undertaking studies using age appropriate models and primary cells from children to identify novel therapeutic targets will be highlighted.
Tutorial: Optimization and analysis techniques for the deep submicron regime

Scaling in the deep submicron (DSM) regime has fundamentally altered the primary issues affecting VLSI design. The emergence of DSM-related problems has resulted in a proliferation of design techniques that attempt to alleviate these newer effects in current flows. However, future design methodologies would be required to undergo a paradigm shift to comprehensively address these problems. A few of these newer problems are listed below:
"How do I say that?": Using communication principles to enhance medication therapy management instruction.

Abstract Background and purpose Medication therapy management (MTM) is a comprehensive, patient-centered approach to improving medication use, reducing the risk of adverse events and improving medication adherence. Given the service delivery model and required outputs of MTM services, communication skills are of utmost importance. The objectives of this study were to identify and describe communication principles and instructional practices to enhance MTM training. Educational activity and setting Drawing on formative assessment data from interviews of both pharmacy educators and alumni, this article identifies and describes communication principles and instructional practices that pharmacy educators can use to enhance MTM training initiatives to develop student communication strategies. Findings Analysis revealed five key communication challenges of MTM service delivery, two communication principles that pharmacy teachers and learners can use to address those challenges, and a range of specific strategies, derived from communication principles, that students can use when challenges emerge. Implications of the analysis for pharmacy educators and researchers are described. Summary Proactive communication training provided during MTM advanced pharmacy practice experiences enabled students to apply the principles and instructional strategies to specific patient interactions during the advanced pharmacy practice experiences and in their post-graduation practice settings.
Estimating county-level tobacco use and exposure in South Carolina: a spatial model-based small area estimation approach.

Abstract Purpose Local health statistics are increasingly requested for policy-making and programmatic purposes; however, population-based surveys are often inadequate to support direct estimation for small areas. Model-based estimation techniques can be used to create local estimates for public health outcomes. Using the 2014–2015 South Carolina (SC) Adult Tobacco Survey, we examined tobacco-related outcomes at the county level using a spatial multilevel, poststratification approach. Methods To create county-level tobacco estimates, we used a two-level model with a spatially intrinsic conditional autoregressive random intercept. Stratum-specific (race, age, and sex) estimates for each county were then created and averaged based on population data obtained from the U.S. Census. Results The estimated prevalence of current smoking in SC counties among adults ranged from 7.4% to 35.1%, and the percentage reporting ever trying an e-cigarette ranged from 4.2% to 30.2%. Model validation showed considerable agreement between direct and indirect estimates (Pearson and Spearman correlations all >0.75) that varied by the sample size of the outcome, as hypothesized. Conclusions Data from the SC Adult Tobacco Survey were used to develop county-level estimates of multiple tobacco-related outcomes using a spatial multilevel, poststratification approach. The results showed heterogeneity in smoking behaviors across the state along with marked spatial correlation.
Psychosocial Functioning of Adolescents in Foster Care

Foster parents of seventy-one older adolescents were asked to provide information about their foster child's psychosocial functioning on eight conceptual dimensions. The practice implications of th...
Neurosurgical considerations in headaches.

The anatomic pathways for headaches are reviewed. Headaches from increased intracranial pressure, brain tumors, empty sella syndrome, spinal tap, injections of the brain and its coverings, collagen vascular disease, subarachnoid hemorrhage, trauma, and cervical spine disease are discussed.
Science teacher attitudes towards English learners

Abstract Access to science education is important given scientific understanding is foundational for individuals to deal with demands of increasingly technological societies. Unfortunately, English Learners (ELs) often struggle with achievement in science education. For teachers, implementing effective pedagogy for ELs is not easy, and teacher educators and researchers would benefit from understanding teacher attitudes related to practice in this field. We analyzed 553 PreK-12 teachers' attitudes toward ELs in the context of science education accounting for demographic, contextual, and educational variables. Results indicated above average attitudinal scores for the sample with specific variables showing statistically significant effects on participants’ scores.
A geometric reasoning approach for additive manufacturing print quality assessment and automated model correction

Abstract The onset of affordable AM printers has democratized digital manufacturing and enabled rapid growth of the AM industry. The recent advancement of AM technology has allowed for fabrication of highly complex parts that were difficult to produce using traditional manufacturing techniques. However, designers and novice users of additive technologies often lack the awareness of manufacturing considerations leading to lower quality parts and print failures. Therefore, it is crucial to develop an automated system that can analyze and correct designs before they are sent for fabrication so that wasteful iterations of build–test–redesign can be minimized. This paper outlines fundamental geometric reasoning algorithms to enable 3D print quality assessment. The developed algorithms computationally recognize potential printing problems in a given 3D model and suggest automatic local geometric changes to the 3D model to rectify the identified printing problems. The potential problems are identified using variations of shape diameter function and morphological operations. Also, a physics-based mesh deformation scheme is developed to make localized corrections to slices for improving printability. The utility of the developed approach has been demonstrated on both 2D slice and 3D model level corrections.
Sexual Abuse and Exploitation of PreK-12 Students by School Personnel.

The abuse of students by PreK-12 school personnel continues to be a multifaceted issue that affects students, staff, parents, and communities at an alarming rate. This two-part special issue builds...
(144) The Xm2 Pain Management Profile for Systematically Assessing Use of Pain Management Strategies from Multiple Domains: Example Profiles for Individuals with Chronic Pain

Management of chronic pain can require the use of many strategies from multiple domains. When so many strategies from multiple domains are being used, conducting a systematic assessment is difficult. This study describes the development of a pain management profile and illustrates its use with example profiles representing patients using a variety of strategies. The pain management profile was developed by modifying the framework used by Widerstrom-Noga and Turk1 and the universal scoring procedure (i.e. scores are on a single numeric scale regardless of original scale) developed by Robinson-Papp et al.2 Example profiles were developed using data collected from an online survey of the types of multi-domain strategies used by pharmacists who had chronic pain. Xm2 profiles organize management strategies into five domains: medications, medical, physical, psychological, and self-initiated strategies. Specific strategies (e.g. naproxen, rest) used are listed for each domain with a score indicating their associated level of use. The number of strategies reported ranged from two to 24 and the level of use score ranged from two to 72. Example profiles were developed for an individual with average scores who used opioids and an individual who did not use opioids, and for individuals in the lowest and highest 25% level of use. The use of a framework and universal score for level of use resulted in a profile that clearly identified the types of pain management strategies being used from all five domains with level of use. Such a profile could be developed for any individual with pain and may be helpful clinically to identify the most appropriate types and level of use of pain management strategies. (1. Widerstrom-Noga, Spinal Cord, 2003; 2. Robinson-Papp, J Pain Sym Man, 2005).
Influence of montmorillonite on the formation of biomass and metabolic products by some microorganisms

Die Zugabe von Montmorillonit zu Kulturlosungen verschiedener Mikroorganismen ergab bei Schuttel- oder Standkulturen meist eine Steigerung der Biomasse und einen erhohten Nahrstoffverbaruch. Diese Steigerung wurde besonders unter aeroben Verhaltnissen und in den ersten Wachstumsphasen beobachtet. Die Bildung von Athanol durch S. cerevisiae bzw. Citronensaure durch A. niger war beschleunigt, aber nicht wesentlich erhoht. Manometrische Messungen mit S. cerevisiae ergaben in Abhangigkeit von der Montmorillonit-Konzentration einen hoheren RQ. Die Relation der Biomasse zu verbrauchter Glucose deutet auf eine bessere Ausnutzung der Energiequelle fur synthetische Prozesse hin.
Malnutrition Diagnosis in Critically Ill Patients Using 2012 Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Standardized Diagnostic Characteristics Is Associated With Longer Hospital and Intensive Care Unit Length of Stay and Increased In-Hospital Mortality.

Background Standardized diagnostic criteria for malnutrition were developed by the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (AND/ASPEN) in 2012. The criteria as a whole has had little validation, and the effect of underlying condition on the impact of malnutrition has not been well studied. We measured the association between severe malnutrition and hospital length of stay (LOS), intensive care unit (ICU) LOS, and mortality among critically ill inpatients. Methods We analyzed hospital records from 5606 patients whose admission included an ICU stay. Associations between severe malnutrition and LOS and mortality were examined by multivariable linear and logistic regression. Results Thirteen percent were diagnosed with severe malnutrition. These had significantly longer hospital LOS (18 [interquartile range 10-35] days vs 8 [5-14] days), total ICU LOS (7 [3-15] days vs 3 [1-6] days) and in-hospital mortality (odds ratio [OR] 2.78, 95% confidence interval [CI] 2.33-3.31), compared with those without severe malnutrition. After adjusting for demographics, we found significant interactions between severe malnutrition and ICU location. Patients with malnutrition in the cardiothoracic surgery ICU experienced the largest increases in hospital LOS (21.10 days, 95% CI 18.58-23.61), ICU LOS (12.14 days, 95% CI 10.41-13.87), and in-hospital mortality (OR 8.78, 95% CI 5.11-15.07). Conclusion Critically ill patients diagnosed with severe malnutrition based on the AND/ASPEN diagnostic characteristics experienced longer hospital and ICU LOS and increased mortality. The magnitude of effect of malnutrition was modified by ICU location, underscoring the need to identify the major comorbidities associated with malnutrition.
Exploring Perceptions of Palliative Care Among Rural Dwelling Veterans

Aim. To explore the palliative care perceptions of rural dwelling veterans in a completely rural area of the United States. Background. As a whole, rural dwelling people have reduced access to health care, including palliative care. Palliative care can effectively address the distressing physical, emotional, psychological and spiritual suffering related to either serious acute or chronic conditions; additionally, it can be delivered at the same time with usual treatment at any point in the disease trajectory to improve the quality of life for rural dwelling veterans living with serious chronic conditions. However, a significant gap exists in the research pertaining to the perceptions of palliative care among rural dwelling veterans. Method. A qualitative study using a descriptive phenomenological approach was conducted as part of a larger mixed methods study. The setting was a geographically defined rural area encompassing over 8,500 square miles. Rural nursing theory served as the conceptual lens for this study. Audio-recorded, semi-structured, face-to-face interviews were conducted with a purposive sample of six male rural dwelling veterans using an interview guide. Subsequently, data were analyzed using a thematic analysis process. Findings. Four themes were identified: uncertainty about palliative care; where and when; palliative care is not hospice care; and opportunities. Rural veterans were found to be unaware of the meaning of palliative care. Five of the six veterans did not perceive palliative care to be end-of-life. A unique finding, none of the rural dwelling veterans perceived palliative care to be hospice care. Conclusions. In this study, rural veterans perceived hospice care and palliative care to be different. Veterans in this sample were unable to define palliative care and did not associate it with an improved quality of life. Therefore, broad-based palliative care education is needed for rural dwelling veterans and for healthcare professionals providing their care. Keywords: rural veterans, palliative care, aging in place, rural nursing theory, hospice DOI: http://dx.doi.org/10.14574/ojrnhc.v19i1.528
Church Support among African American and Black Caribbean Adolescents.

Church members are a significant but under-researched source of informal support particularly among adolescents. Church-based support networks are a long-standing and significant feature of religious involvement for Black Americans that provides tangible and psychosocial resources helpful for navigating life challenges. However, questions concerning the role of church support for Black adolescents in the United States are under-researched, especially potential ethnic group differences. This study examines church-based support among Black adolescents, focusing on ethnic variation in receiving and providing church support among African American and Black Caribbean adolescents (13–17 years). We use data from the National Survey of American Life-Adolescent (NSAL-A) Supplement study. Both African American and Black Caribbean adolescents report receiving church support, with approximately half of both groups providing overall assistance to others on a frequent basis. There were no significant ethnic differences for receipt or provision of church support. In separate regression models for African American and Black Caribbean adolescents, significant differences emerged across age, family income, geographic region, frequency of service attendance and congregational activity. For Black Caribbeans, girls provide help during illness more frequently than boys. For both African American and Black Caribbean adolescents, religious engagement (i.e., frequency of service attendance and congregational activity) was associated with both receiving and providing church support. Information about sociodemographic and religious differences in involvement with church support exchanges can be used to align Black adolescents’ participation in ways that are developmentally appropriate and consistent with their life experiences.
Positive in Public Service: Government Personnel, Constrained Incentives, and Positive Work Attitudes

ABSTRACT:Surveys of government personnel have shown that they are much more likely than their counterparts in business firms to say that it is hard to fire a poor performer, to raise the pay of a g...
Salt Marsh Migration into Lawns Revealed by a Novel Sediment-Based Approach

Upslope migration will be critical to the future survival and stability of tidal salt marshes in an age of accelerated sea-level rise, yet only a small number of studies have measured historic migration rates. We developed a new approach for reconstructing salt marsh migration that can be used even in situations where that migration would be undetectable by aerial photograph analysis, such as the growth of marsh plants under trees or the movement of marsh ecosystems into mowed lawns. Our approach involves identifying a wedge of salt marsh peat (overlying the pre-existing upland soil) through the presence of foraminifera and then dating that wedge using 137Cs. We demonstrate our approach by calculating migration rates (1963–2016) for two lawn-adjacent salt marshes along the Connecticut coast of Long Island Sound. Both marshes showed substantial migration over this time period, although vertical migration rates differed dramatically between the two sites, perhaps because of the differential influence of large storms. Further, we demonstrate that the presence of foraminifera (an unequivocal signal of tidal inundation) constitutes a more accurate indicator of the migration wedge than high organic content. Our relatively inexpensive approach could be used to assess migration rates at multiple sites in order to better understand the factors controlling marsh migration.
P76 Innovations in Dietetics Education: An Educational Case Study

Objective To demonstrate the benefit and innovation of the Marshall University (MU) Department of Dietetics’ relocation from campus to downtown. Use of Theory or Research Moving downtown allows Universities to develop state-of-the-art teaching facilities, productive group learning spaces, and active community-research agendas. Additional benefits include program growth, moving students closer to potential employers, preserving city history, and developing a “downtown footprint”. Target Audience Dietetics faculty/students, dietetic interns, SNAP-Ed administrators/educators Program Description Marshall Dietetics integrated with the department's SNAP-Ed Nutrition Education Program (NEP) when both programs moved to a downtown location in 2016. The downtown location provided for student and intern professional growth through the use of the shared teaching/community-outreach Kitchen, Huntington's Kitchen. Undergraduate students are immersed in nutrition education through coursework, while dietetic interns provide NEP lesson delivery, providing new mentorship and networking experiences. Evaluation Methods Qualitative - case study evaluation. Results Benefits of the move include incorporation of the SNAP-Ed NEP in all curricula. A distance dietetic internship and online graduate program were developed, addressing the profession's internship shortage. Program integration meets competency-based accreditation standards and provides for opportunities like community outreach classes, school garden development, and promotion of the Smarter Lunchroom/Pantry Movement; allowing students, NEP dietitians, the community, and SNAP-Ed recipients to benefit from evidence-based initiatives. Marshall Dietetics demonstrates how to connect students and dietitians with mentorship and networking experiences. Conclusions Innovative and integrative teaching strategies should be the norm in dietetics education. Marshall Dietetics is on the cutting edge with integrated programs, a contemporary foods laboratory, and technology-enhanced classrooms. Having both Dietetics and NEP in the new downtown location has allowed for the development of a distance dietetic internship and online graduate program, providing for program growth and meeting the needs of the profession. Using the Future Education Model as a benchmark, we have expanded outreach and enhanced partnerships creating unique opportunities for many stakeholders. Funding Marshall University.
Embarking on a Rhetorical Exploration: Accommodating Science (or Not) in Leisure Research

An ongoing debate points to a possible gap between the published research about and the delivery of leisure services. For example, two of the major research journals in the field of leisure studies...
Factors Associated With DNR Status After Nontraumatic Intracranial Hemorrhage.

Background We explored factors associated with admission and discharge code status after nontraumatic intracranial hemorrhage. Methods We extracted data from patients admitted to our institution between January 1, 2013, and March 1, 2016 with nontraumatic intracerebral hemorrhage or subarachnoid hemorrhage who had a discharge modified Rankin Scale (mRS) of 4 to 6. We reviewed data based on admission and discharge code status. Results Of 88 patients who met inclusion criteria, 6 (7%) were do not resuscitate (DNR) on admission (aDNR). Do not resuscitate on admission patients were significantly older than those who were full code on admission (P = 0.04). There was no significant difference between admission code status and sex, marital status, active cancer, premorbid mRS, admission Glasgow Coma scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, or bleed severity. At discharge, 66 (75%) patients were full code (dFULL), 11 (13%) were DNR (dDNR), and 11 (13%) were comfort care. African American and Hispanic patients were significantly more likely to be dFULL than Asian or white patients (P = .01) and less likely to be seen by palliative care (P = .004). Patients with less aggressive code status had higher median APACHE II scores (P = .008) and were more likely to have active cancer (P = .06). There was no significant difference between discharge code status and sex, age, marital status, premorbid mRS, discharge GCS, or bleed severity. Conclusions Limitation of code status after nontraumatic intracranial hemorrhage appears to be associated with older age, white race, worse APACHE II score, and active cancer. The role of palliative care after intracranial hemorrhage and the racial disparity in limitation and de-escalation of treatment deserves further exploration.
Stereotactic radiosurgery for head and neck paragangliomas: a systematic review and meta-analysis

Head and neck paragangliomas (HNPs) are rare, usually benign hyper vascularized neuroendocrine tumors that traditionally have been treated by surgery, with or without endovascular embolization, or, more recently stereotactic radiosurgery (SRS). The aim of our study is to determine the clinical and radiographic effectiveness of SRS for treatment of HNPs. A systematic search of electronic databases was performed, and 37 articles reporting 11,174 patients (1144 tumors) with glomus jugulare (GJT: 993, 86.9%), glomus tympanicum (GTT: 94, 8.2%), carotid body tumors (CBTs: 28, 2.4%), and glomus vagale (GVT: 16, 1.4%) treated with SRS definitively or adjuvantly were included. The local control (LC) was estimated from the pooled analysis of the series, and its association with SRS technique as well as demographic and clinical factors was analyzed. The median age was 56 years (44–69 years). With a median clinical and radiological follow-up of 44 months (9–161 months), LC was 94.2%. Majority of the patients (61.0%) underwent Gamma Knife Radiosurgery (GKS), but there was no statistically significant difference in LC depending upon the SRS technique (p = 0.9). Spearmen’s correlation showed that LC was strongly and negatively correlated with multiple parameters, which included female gender (r = − 0.4, p = 0.001), right-sided tumor (r = − 0.3, p = 0.03), primary SRS (r = − 0.5, p ≤ 0.001), and initial clinical presentation of hearing loss (r = − 0.4, p = 0.001). To achieve a LC ≥ 90%, a median marginal dose (Gy) of 15 (range, 12–30 Gy) was required. The results corroborate that SRS in HNPs is associated with good clinical and radiological outcome.
Advances in Diagnostic Procedures and Their Applications in the Era of Cancer Immunotherapy

Diagnostic procedures play critical roles in cancer immunotherapy. In this chapter, we briefly discuss three major diagnostic procedures widely used in immunotherapy: immunohistochemistry, next-generation sequencing, and flow cytometry. We also describe the uses of other diagnostic procedures and preclinical animal models in cancer immunotherapy translational research.
Minimal models for precipitating turbulent convection

Simulations of precipitating convection would typically use a non-Boussinesq dynamical core such as the anelastic equations, and would incorporate water substance in all of its phases: vapour, liquid and ice. Furthermore, the liquid water phase would be separated into cloud water (small droplets suspended in air) and rain water (larger droplets that fall). Depending on environmental conditions, the moist convection may organize itself on multiple length and time scales. Here we investigate the question, what is the minimal representation of water substance and dynamics that still reproduces the basic regimes of turbulent convective organization? The simplified models investigated here use a Boussinesq atmosphere with bulk cloud physics involving equations for water vapour and rain water only. As a first test of the minimal models, we investigate organization or lack thereof on relatively small length scales of approximately 100 km and time scales of a few days. It is demonstrated that the minimal models produce either unorganized (‘scattered’) or organized convection in appropriate environmental conditions, depending on the environmental wind shear. For the case of organized convection, the models qualitatively capture features of propagating squall lines that are observed in nature and in more comprehensive cloud resolving models, such as tilted rain water profiles, low-altitude cold pools and propagation speed corresponding to the maximum of the horizontally averaged, horizontal velocity.
Accelerated transsulfuration metabolically defines a discrete subclass of amyotrophic lateral sclerosis patients

Amyotrophic lateral sclerosis is a disease characterized by progressive paralysis and death. Most ALS-cases are sporadic (sALS) and patient heterogeneity poses challenges for effective therapies. Applying metabolite profiling on 77-sALS patient-derived-fibroblasts and 43-controls, we found ~25% of sALS cases (termed sALS-1) are characterized by transsulfuration pathway upregulation, where methionine-derived-homocysteine is channeled into cysteine for glutathione synthesis. sALS-1 fibroblasts selectively exhibited a growth defect under oxidative conditions, fully-rescued by N-acetylcysteine (NAC). [U13C]-glucose tracing showed transsulfuration pathway activation with accelerated glucose flux into the Krebs cycle. We established a four-metabolite support vector machine model predicting sALS-1 metabotype with 97.5% accuracy. Both sALS-1 metabotype and growth phenotype were validated in an independent cohort of sALS cases. Importantly, plasma metabolite profiling identified a system-wide cysteine metabolism perturbation as a hallmark of sALS-1. Findings reveal that sALS patients can be stratified into distinct metabotypes with differential sensitivity to metabolic stress, providing novel insights for personalized therapy.
Exocrine Pancreas Dysfunction in Type 1 Diabetes.

ABSTRACT Objective: Type 1 diabetes (T1D) is characterized by autoimmune β-cell destruction, but exocrine pancreas abnormalities may also play a role in the disease pathophysiology. Herein, we review the current evidence of exocrine damage in T1D and discuss its underlying pathophysiology, clinical evaluation, and treatment. Method: Extensive literature search was performed for "type 1 diabetes" and "exocrine dysfunction" on PubMed and Google Scholar databases. Results: T1D pancreata are significantly smaller than controls, both in weight and volume. T cells, dendritic cells, neutrophils, and products of complement activation are seen in T1D exocrine tissues. Exocrine pancreas fibrosis, arteriosclerosis, fatty infiltration, and acinar atrophy are also observed on histology. Pancreatic exocrine insufficiency (PEI) can be assessed through direct exocrine testing, fecal elastase concentration, and measurement of serum exocrine enzymes. The prevalence of PEI in T1D varies by modality and study but is consistently greater than controls. The clinical relevance of PEI in T1D is debatable, as many patients with laboratory evidence of PEI are asymptomatic. However, in PEI-symptomatic patients reported benefits of pancreatic enzyme replacement therapy (PERT) include relief of gastrointestinal symptoms, improved quality of life, better glycemic control, and optimal nutrition. Conclusion: Exocrine pancreas abnormalities often occur in T1D. Whether exocrine dysfunction occurs simultaneously with β-cell destruction, as a result of β-cell loss, or as a combination of both remains to be definitively answered. In T1D with gastrointestinal complaints, PEI should be evaluated, usually via fecal elastase measurements. PERT is recommended for T1D patients with symptoms and laboratory evidence of PEI. Abbreviations: AAb+ = autoantibody positive; AAb- = autoantibody negative; FEC = fecal elastase concentration; PEI = pancreatic exocrine insufficiency; PERT = pancreatic enzyme replacement therapy; PP = pancreatic polypep-tide; T1D = type 1 diabetes
A Personal Reflection on the 2008 ISSOTL Conference

Excerpt: The 5th International Society for the Scholarship of Teaching and Learning (ISSOTL) Conference was held in Edmonton, Alberta, Canada in October 2008. The theme of the conference was “Celebrating Connections: Learning, Teaching, Scholarship". The conference offered a myriad of opportunities for learning, growing and making connections with four days of keynote speakers, concurrent sessions and poster presentations.
Baryonic and leptonic GeV dark matter

Abstract We perform a systematic analysis of models with GeV-scale dark matter coupled to baryons and leptons. Such theories provide a natural framework to explain the matter-antimatter asymmetry of the universe. We find that only a few baryonic dark matter models are free from tree-level proton decay without explicitly imposing baryon number conservation, provided that the dark matter particle is sufficiently heavy. We enumerate those cases and present a brief overview of their phenomenology. We then focus on a leptonic dark matter model for a more detailed discussion of the baryon asymmetry generation via leptogenesis, the symmetry restoration in the dark sector and the expected dark matter annihilation signals in indirect detection experiments.
Cardiac pathology after valve replacement by disc prosthesis. A study of 61 necropsy patients.

Abstract Clinical and necropsy observations are described in 61 patients who had one or more cardiac valves replaced with a discoid prosthesis of the Hufnagel type. The most common (31 percent) cause of death among the 45 patients who died early (less than 65 days after operation) appeared to be prosthetic disproportion; that is, the prosthesis was too big for the aorta or ventricular cavity into which it was inserted so that inadequate space was present between the margins of the disc and the endocardium of ventricle or intima of aorta. Prosthetic thrombosis occurred in only 3 of the 45 patients who died early, but poppet movement appeared considerably altered in each. In contrast, thrombi were observed on a prosthesis in 14 of the 16 patients who died late (4 to 47 months [average 21] postoperatively), but in none did the thrombi appear of sufficient size to alter poppet function. Excessive bleeding occurred in 11 (24 percent) of the 45 early deaths and was primarily related to the insertion of a patch in the root of the aorta. Uncorrected valvular disease either by itself or by its ability to alter function of the prosthesis appeared responsible for death in 6 (13 percent) of the 45 patients who died early and in 2 (6 percent) of the 16 who died late. Insertion of a mitral poppet disc in a patient with uncorrected aortic regurgitation, even of mild degree, may be hazardous because the aortic regurgitant jet stream may interfere with proper function of the mitral disc. Likewise, insertion of a poppet disc only in the aortic valve position in a patient with combined aortic and mitral regurgitation may considerably increase the degree of mitral incompetence because the aortic prosthesis is intrinsically obstructive. Disc wear or variance was observed in all but one prosthesis in place for more than 1 year. Although hemolytic anemia of significant degree was not observed in any of the 16 patients who died late, the occurrence of renal hemosiderosis in 13 of the 16 patients indicates that the poppet disc prosthesis is considerably traumatic to erythrocytes. Thus, this type of prosthesis is not an ideal substitute cardiac valve. It clots, despite anticoagulant therapy, it is intrinsically stenotic, portions of it, that is, the disc, degenerate, and it causes hemolysis to erythrocytes.
Mechanisms of gender-specific TCDD-induced toxicity in guinea pig adipose tissue

After treatment with TCDD, the activities of cytosolic AhR-associated c-Src kinase, microsomal protein kinase C (nPKC epsilon), microsomal c-Src kinase, nuclear p44/42 MAPK, c-Jun N terminus kinase, and the amount of microsomal pan-Ras protein were different in males and females. TCDD did not decrease body or adipose tissue weights in transgenic src-deficient male mice as compared to their wild-type littermates, and the activity of AhR-associated c-Src kinase was not increased by TCDD in src-deficient male mice. Similar results were obtained when TCDD was given to male guinea pigs treated with the Src-kinase inhibitor, geldanamycin. Treatment with estradiol protected male guinea pigs from TCDD-induced wasting. TCDD induced similar changes in protein tyrosine kinase activity in adipose tissues of castrated male and intact female guinea pigs. The gender-specific mechanisms of TCDD-induced toxicity appear to involve c-Src kinase, nPKC epsilon, and pan-Ras, as well as overlap in the cytosolic signal transduction pathways of TCDD and sex steroids.
Sporadic-E Propagation with 3 μsec Pulses

Abstract Pulse broadening of 3 μsec pulses transmitted at 41 Mc/s via Es over the 1300 km Long Branch to Boulder path are examined and interpreted.
κ-Opioid Regulation of Thymocyte IL-7 Receptor and C-C Chemokine Receptor 2 Expression

Endogenous and exogenous kappa-opioid agonists have been widely reported to modulate the immune response. We have published results that show that the superantigen-induced proliferative response of thymocytes is inhibited by the selective kappa-opioid agonist trans-3, 4-dichloro-N-methyl-N-[2-(1-pyrolidinyl)cyclohexyl] benzeneaceamide methanesulfonate (U50,488H). Previous work has established that the kappa-opioid receptor is widely expressed within the thymus; however, little is known about the role of the kappa-opioid receptor in the function of thymocytes. In the present report, we have examined the impact of U50,488H administration on the expression of cytokines in superantigen-stimulated thymocytes by RNase protection analysis. We have measured detectable levels of the cytokines IL-2, IL-4, IL-5, IL-13, and IFN-gamma, and the chemokines lymphotactin and RANTES, in stimulated thymocyte cultures; however, addition of U50,488H did not alter the expression of these cytokines. Examination of cytokine receptor expression by these thymocytes revealed a significant inhibition in the expression of the transcript for the IL-7 receptor alpha-chain (IL-7Ralpha), and these results were confirmed by flow cytometry. Surprisingly, the expression of several other cytokine receptor chains including the common gamma-chain, IL-2Rbeta, or the IL-2Ralpha, IL-4Ralpha, and IL-15Ralpha chains, was not altered. In contrast to these results, a significant elevation in the expression of the chemokine receptor CCR2 was observed in U50,488H-treated cultures. These results suggest that the kappa-opioid receptor may function to promote cellular migration at the expense of the sensitivity to the growth-promoting/maturation activity of IL-7.
Stability of relative weight category and cardiometabolic risk factors among moderately and severely obese middle school youth

Objective To examine the stability of severe pediatric obesity relative to moderate obesity and associated changes in cardiometabolic risk from the beginning of 6th to the end of 8th grade. Methods Participants in HEALTHY, a multi-site, cluster randomized school-based study designed to mitigate risk for type 2 diabetes, completed standardized assessments of height, weight, glucose, insulin, lipids, and blood pressure at the beginning of 6th grade and the end of 8th grade. Youth were classified as moderately obese (100-119% of the 95th percentile of BMI for age and gender) or severely obese (≥120% of the 95th percentile of BMI for age and gender). Generalized linear mixed models (GLMM) that controlled for relevant covariables were used to examine the relation between baseline demographic and cardiometabolic risk factors and BMI status, as well as changes in relative weight category and risk factors during middle school. Results Severe obesity was more likely to endure over the course of middle school than was moderate obesity, and was associated with significantly higher levels of cardiometabolic risk. Conclusions Research with a specific focus on understanding, preventing, and treating severe obesity in children is warranted.
Editorial: Our Professional Image

Abstract : This article describes the management system of Dickinson College Library. By treating this particular library as case study, the article describes the history, rationales, and relative merits of the library’s innovative management structure in light of that structure’s possible wider application in other contexts. (Much of the substance of this article was presented as a paper at the University of Arizona's Living the Future II Conference, in Tucson, Arizona, April 21-24, 1998) Organizationally, libraries have changed little in recent years. Even though librarians and library managers have talked a great deal about developing teams, empowering staff, and implementing innovative management strategies (TQM having emerged as the currently most popular), the actual organizational framework of academic libraries has remained largely static. College and university libraries today are openly hierarchal, just as they were decades ago, reflecting a managerial pattern that owes more to the corridors of the business community than to the halls of the academic world. In an attempt to challenge this traditional structure, the library at Dickinson College developed more than two decades ago an altogether different model, a model that involved revolving leadership, collegiality and something of a holistic vision of librarianship. This article is a summary of that model and a frank assessment of its strengths and weaknesses. It is a case study of a single library’s management structure, a candid look at how one library combined both collegiality and high-standards of professional quality. It is, in short, an example of one way of managing a library in a particular context -- an example that, despite of its particularity, might well serve as a model for other institutions.
The Use of Acceptance to Promote Positive Change by Decreasing Shame and Guilt: A Practice Exemplar

The use of acceptance by mental health clinicians in the clinical setting is an effective method for providing a safe environment for clients to make positive changes. Acceptance means that mental health clinicians are non-judgmental and acknowledge the clients' situations as they are. When actively used by clinicians, acceptance decreases clients' anxiety and the intensity of their feelings of guilt and shame. Clients are then able to begin to accept themselves as they are. The purpose of this article is to discuss the ways in which mental health clinicians promote clients' acceptance of themselves using the tools of acceptance and commitment therapy and dialectical behavioral therapy.
Piriformis Syndrome With Variant Sciatic Nerve Anatomy: A Case Report

A 68-year-old male long distance runner presented with low back and left buttock pain, which eventually progressed to severe and debilitating pain, intermittently radiating to the posterior thigh and foot. A comprehensive workup ruled out possible spine or hip causes of his symptoms. A pelvic magnetic resonance imaging neurogram with complex oblique planes through the piriformis demonstrated variant anatomy of the left sciatic nerve consistent with the clinical diagnosis of piriformis syndrome. The patient ultimately underwent neurolysis with release of the sciatic nerve and partial resection of the piriformis muscle. After surgery the patient reported significant pain reduction and resumed running 3 months later. Piriformis syndrome is uncommon but should be considered in the differential diagnosis for buttock pain. Advanced imaging was essential to guide management.
Progress for Transgender Athletes: Analysis of the School Success and Opportunity Act

A small but growing number of high school students who identify themselves as transgender are demanding access to the same school activities that other students have the opportunity to participate in, including sports. This article describes how the School Success and Opportunity Act, which allows students to remain consistent with their gender choice throughout the school day, is increasing these students' access to sports.
Microwave heterodyne receiver based on AlGaAs/GaAs 2DEG bolometer

A hot-electron bolometric mixer (heterodyne detector), which employs the nonlinearities of a heated two-dimensional electron gas (2DEG) medium in a AlGaAs/GaAs heterostructure, was designed and characterized in the 60 GHz to 2.5 THz frequency range. Mixing experiments were performed at frequencies of ∼ 100 GHz and at a temperature of 77K which resulted in a measured gain bandwidth to be no less than 8.1 GHz, an internal conversion loss of 21 dB, and an optimal local oscillator power of 0.25 µW/µm2. We argue that such hot electron bolometers are promising for the future of THz detection technologies.