cssi/SciSciGPT-SciSciNet huggingface dataset:
Guanine nucleotide binding properties of rap1 purified from human neutrophils

The guanine nucleotide binding properties of rap1 protein purified from human neutrophils were examined using both the protein kinase A-phosphorylated and the non-phosphorylated forms of the protein. Binding of GTP[S] (guanosine 5'-[gamma-thio]triphosphate) or GDP was found to be slow in the presence of free Mg2+, but very rapid in the absence of Mg2+. The binding of guanine nucleotides was found to correlate with the loss of endogenous nucleotide from the rap1 protein, which was rapid in the absence of Mg2+. The relative affinities of GTP and GDP for the binding site on rap1 were modulated by the presence of Mg2+, with a preferential affinity (approx. 15-fold) for GTP observed only in the absence of this bivalent cation. The dissociation of GDP from rap1 was not affected by the G-protein beta/gamma-subunit complex. Phosphorylation of rap1 in vitro by protein kinase A did not modify any of the observed nucleotide-binding parameters. Furthermore, the ability of a cytosolic rap1 GTPase-activating protein to stimulate neutrophil rap1 GTP hydrolysis was not modified by phosphorylation. These data suggest that the activation of rap in vivo may be regulated by the release of endogenous GDP, but that phosphorylation by protein kinase A does not affect guanine nucleotide binding or hydrolysis.
Kinetics of the Sn(3P0) Reactions with CO2 and O2 over Wide Temperature Ranges

Rate coefficients for the title reactions have been measured by the high-temperature fast-flow reactor (HTFFR) technique. The relative concentrations of Sn ground-state atoms were monitored by laser-induced fluorescence (LIF) for Sn + CO2 → SnO + CO and by either LIF or atomic resonance absorption for the Sn + O2 → SnO + O reaction. Results from these two diagnostic methods agree very well. We obtained, in units of cm3 molecule-1 s-1, k1(690−1600 K) = 2.3 × 10-10 exp(−9100 K/T) and k2(380−1840 K) = (5.1 × 10-13)(T/K)0.79 exp(−437 K/T), with 2σ accuracy limits of about ±25%. The results are compared to other metal atom reactions with these oxidants. All have similarly large preexponentials. The magnitudes of the exponential terms are shown to be typical for a spin-forbidden and a spin-allowed reaction, respectively.
New Technologies, Citizen Empowerment, and Civic Life

Information literacy and civic literacy intersect in ways that are important to society and that demonstrate the value of librarians and publishers. Librarians and publishers play an important role in cultivating information literacy in the populace so that citizens can carry out their civic responsibilities in an informed and responsible way. The spread of the Internet and the challenges it poses to traditional information providers creates new challenges for publishers and librarians.
Recovering refractive index correlation function from measurement of tissue scattering phase function(Conference Presentation)

Numerous methods have been developed to quantify the light scattering properties of tissue. These properties are of interest in diagnostic and screening applications due to sensitivity to changes in tissue ultrastructure and changes associated with disease such as cancer. Tissue is considered a weak scatterer because that the mean free path is much larger than the correlation length. When this is the case, all scattering properties can be calculated from the refractive index correlation function Bn(r). Direct measurement of Bn(r) is challenging because it requires refractive index measurement at high resolution over a large tissue volume. Instead, a model is usually assumed. One particularly useful model, the Whittle-Matern function includes several realistic function types such as mass fractal and exponential. Optical scattering properties for weakly scattering media can be determined analytically from Bn(r) by applying the Rayleigh-Gans-Debye (RGD) or Born Approximation, and so measured scattering properties are used to fit parameters of the model function. Direct measurement of Bn(r) would provide confirmation that the function is a good representation of tissue or help in identifying the length scale at which changes occur. The RGD approximation relates the scattering phase function to the refractive index correlation function through a Fourier transform. This can be inverted without approximation, so goniometric measurement of the scattering can be converted to Bn(r). However, geometric constraints of the measurement of the phase function, angular resolution, and wavelength result in a band limited measurement of Bn(r). These limits are discussed and example measurements are described.
Richard Pearce Replies

How great to receive your letter out of the blue, arguing, informing, opening up new perspectives on physics and on Pynchon.
Laparoscopic Management of Gallbladder Cancer: A Stepwise Approach

Background In the era of laparoscopic cholecystectomy, incidentally discovered gallbladder cancer (IGBC) has become a common clinical presentation.1 A consensus exists that radical resection should be performed for IGBC patients with T1b or more advanced tumors.2 Although the oncologic safety of laparoscopic treatment for selected patients with gallbladder cancer (GBC) has been demonstrated, a laparoscopic approach for IGBC remains uncommonly practiced due to the technical challenge of the frequently reoperative cases.3
Engineered Mesenchymal Stem/Stromal Cells for Cellular Therapies

The therapeutic potential of mesenchymal stem/stromal cells (MSCs) offers enormous hope for treating tissue defects and numerous diseases, including cancer. MSCs can self-renew, differentiate into multiple lineages, and exhibit proangiogenic and immunomodulatory effects. Along with these intrinsic properties, MSCs exhibit natural tropism toward inflamed tissue, which has led to the clinical application of these cells in different therapies. However, a significant barrier is the inability to localize the cells to the tissue of interest due to low homing efficiency, poor engraftment, and low cell retention. To circumvent these challenges, it is critical to develop engineering strategies that can improve tissue engraftment as well as enhance the therapeutic potential of these cells. In this chapter, we discuss the various nonviral chemical and biochemical cellular engineering approaches to modifying MSCs for improved cell targeting and their utility as delivery vehicles.
Parenting as Discipleship: A Contextual Motif for Christian Parent Education:

Many parents attend seminars and workshops to learn how to deal with problems of behavioral discipline. One goal of Christian parent education, however, should be to help parents understand a broad...
Behavior of Listeria monocytogenes when Incubated Together with Pseudomonas Species in Tryptose Broth at 7 and 13°C.

Tryptose broth (TB) was inoculated with Listeria monocytogenes (strain Scott A or California), Pseudomonas aeruginosa, Pseudomonas flourescens, or a combination of L. monocytogenes plus Pseudomonas species, and incubated at 7 or 13 degrees C for 8 weeks. McBride Listeria Agar was used to determine numbers of L. monocytogenes and Pseudomonas Isolation Agar to enumerate Pseudomonas species at 0, 7, 14, 28, 42, or 56 d. At 13 degrees C, presence of P. fluorescens had a slight negative effect on growth of L. monocytogenes strain Scott A, and was somewhat detrimental to its survival during the extended incubation. Growth of L. monocytogenes strain California was retarded by presence of P. fluorescens although the maximum population achieved by the pathogen was greater in the presence rather than absence of the pseudomonad; the pseudomonad did have a negative effect on survival of the pathogen. At the same temperature, P. aeruginosa had a negative effect on survival of L. monocytogenes strain California, but had essentially no effect on the other strain of the pathogen. Neither strain of L. monocytogenes affected growth of P. fluorescens nor P. aeruginosa. At 13 degees C the pH of TB generally decreased when L. monocytogenes grew by itself but increased when either pseudomonad grew by itself or together with the pathogen. At 7 degrees C, growth of both pseudomonads was minimal. Presence of non-growing cells of P. fluorescens retarded somewhat growth of both L. monocytogenes strains early during the incubation. P. aeruginosa had no detectable effect on either strain of L. monocytogenes. The pH of TB decreased when L. monocytogenes grew by itself or together with either pseudomonad, and remained unchanged in TB inoculated with either pseudomonad.
Experiment 3: Treatment Rules

Action rules should help in choosing treatment actions in the course of Tinnitus Retraining Therapy in subsequent visits. In order to understand the process of treatment and formulate appropriate data mining tasks in LISp-Miner, it is necessary to identify treatments actions taken by the doctor to improve tinnitus/hyperacusis patient’s condition.
Recent Trends in Baccalaureate-Prepared Registered Nurses in U.S. Acute Care Hospital Units, 2004–2013: A Longitudinal Study

Purpose To examine the trends in baccalaureate (bachelor of science in nursing)–prepared registered nurses (BSN RNs) in U.S. acute care hospital units and to project the growth in the number of BSN RNs by 2020. Design This is a longitudinal study using the Registered Nurse Education Indicators data (2004–2013) from the National Database of Nursing Quality Indicators. Methods The level of BSN RNs in each unit was operationalized as the proportion of nurses holding a baccalaureate degree or higher among all the nurses in a unit. Our sample included 12,194 unit-years from 2,126 units of six cohorts in 377 U.S. acute care hospitals. A hierarchical linear regression model was used to examine the trends in BSN RNs and to project future growth in the number of BSN RNs when controlling for hospital and unit characteristics and considering repeated measures in units over time and clustering of units within hospitals. Results The proportion of BSN RNs in U.S. acute care hospital units increased from 44% in 2004 to 57% in 2013 (a 30% increase); when combining all cohorts, this rate increased from 44% in 2009 to 51% in 2013. On average, the proportion of BSN RNs in a unit increased by 1.3% annually before 2010 and by 1.9% each year from 2010 on. The percentage of units having at least 80% of their nurses with a baccalaureate degree or higher increased from 3% in 2009 to 7% in 2013. Based on the current trends, 64% of the nurses working in a hospital unit will have a baccalaureate degree by 2020, and 22% of the units will reach the 80% goal by 2020. Conclusions There was a significant increase in the proportion of BSN RNs in U.S. acute care hospital units over the past decade, particularly after 2010. However, given the current trends, it is unlikely that the goal of 80% nurses with a baccalaureate degree will be achieved by 2020. Clinical Relevance The U.S. nursing workforce is under educational transformation in order to meet the increasing healthcare needs. To help accelerate this transformation, further advocacy, commitment, and investment are needed from all healthcare stakeholders (e.g., policymakers, executives and managers of healthcare facilities, nursing schools, etc.).
The Earth’s Magnetosphere: A Secondary Collisionless Magnetohydrodynamic Generator

That the earth and its atmosphere are rotating is communicated along magnetic field lines by electric fields. These electric fields put the plasma in motion so, to first order, the entire inner magnetosphere also rotates with the earth. In the sun’s frame of reference, this is the largest electric field source at latitudes less than about 60°, whereas in the rotating frame, this field vanishes and the processes in Chapter 3 dominate. At higher latitudes corresponding to magnetic field-line crossings at higher altitudes in the equatorial plane (but still below the polar cap), the electric field is determined by the flow field inside the magnetosphere. The flow slows down as it approaches the earth and the mechanical energy is converted to electric energy. This is accompanied by the so-called region 2 field-aligned currents and a variety of electric field generation effects. As particles approach the earth, they become energized and form the outer Van Allen radiation belts. Large ∂ B /∂ t electric fields can occasionally be generated at the earth’s surface where they endanger electric power systems. Large polarization fields occur in many situations and strong parallel electric fields generate the primary auroral particles. As these energetic particles penetrate deeper into the magnetosphere, they cross electric potential lines, reach 300,000,000 K, and fill the outer Van Allen radiation belts. The combination of varying flow fields and plasma gradients creates many localized electric field structures.
Memory in the Fly, Genetics of

The molecular processes that mediate learning and memory have been studied effectively by using genetics in the fruit fly. Mutant flies that show deficiencies in learning or memory have been isolated and used to identify some of the relevant genes and their protein products. Many of the proteins are involved in intracellular signaling through the small molecule, cyclic AMP. Neurons in the adult brain known as mushroom body neurons have been shown to be neurons that mediate odor learning.
Toxicity and outcomes associated with high-dose rate brachytherapy for medically inoperable endometrial cancer

Abstract Purpose To evaluate toxicity in inoperable endometrial cancer (EC) treated with definitive radiation therapy (RT). Materials and Methods Patients treated with definitive RT for EC were retrospectively reviewed. EQD2 values were calculated for bladder, rectum, and sigmoid. Acute and late toxicities were retrospectively graded. Descriptive statistical analysis was performed. Results Fifty-one patients were included. The majority of patients had endometrioid histology (N = 46, 90.2%) and Grade 1 disease (N = 32, 62.75%). Thirty-seven patients (72.5%) were treated with image-guided BT (IGBT) and 14 (27.5%) with two-dimensional BT. Forty patients (78.4%) received EBRT + BT and 11 (21.57%) received BT alone. No grade 2 (G2) or higher toxicities were reported with BT alone. G2 or higher acute toxicities with EBRT + BT were G2 proctitis (N = 2, 5.0%) and G3 proctitis (N = 1, 2.5%). Late toxicities included G3 vaginal stenosis (N = 1, 2.5%), proctitis (N = 1, 2.5%), enteritis (N = 1, 2.5%), and one G4 gastrointestinal bleed. One- and 2-year local control were 100% with BT alone and 93% and 89%, respectively, with EBRT + BT. One- and 2-year locoregional control were 100% with BT and 97% and 93%, respectively, with EBRT + BT. Recurrence-free survival was 89% at 1 and 2 years with BT alone compared to 87% and 80% with EBRT + BT. One- and 2-year overall survival were 88% and 72% with BT alone compared to 94% and 84% with EBRT + BT. There were no statistically significant differences in cancer control between the two groups. Conclusions Women with inoperable EC treated with definitive RT have low toxicity rates and durable local control.
Vitamin D3 supplementation of cull cows: effects on longissimus and semitendinosus muscle tenderness.

Previous studies have shown that supplementation of vitamin D3 to cow diets for 4 to 10 d before slaughter lowers Warner-Bratzler shear force (WBSF) values and increases sensory tenderness scores in beef cuts. The present study was conducted to evaluate the effects of vitamin D3 supplementation on muscle calcium concentration, WBSF values, and sensory tenderness ratings of LM and semitendinosus (ST) muscles from cull, predominately Angus, cows (eight cows per treatment). Treatments included 0 (control), 5 million IU, or 7.5 million IU of vitamin D3 supplemented daily for 7 d preslaughter. Twenty-four hours after slaughter, 2.54-cm-thick LM and ST muscle steaks were cut; aged for either 0, 7, 14, or 21 d (ST steaks aged for 7 d only); and frozen at -20 degrees C for WBFS and sensory analysis. Mean values for LM calcium concentration tended to increase (P = 0.14) with vitamin D3 supplementation (154, 176, and 183 microig/g, fresh basis, for 0, 5, and 7.5 million IU/d, respectively). After 7 d of aging, LM steaks from cows fed 7.5 million IU had lower (P 0.05) effect on WBSF values of ST steaks aged 7 d. Vitamin D3 supplementation did not (P > 0.05) affect sensory tenderness ratings for either LM or ST steaks at any aging period. Aging, however, had a linear (P < 0.001) effect on tenderness, with an increase in tenderness as aging time increased from 0 to 21 d. Thus, results from the present study indicate that vitamin D3 supplementation, at these levels and duration before slaughter, provided little benefit to muscle tenderness of beef from cull cows.
Metabolic Syndrome and Early-Onset Coronary Artery Disease: Is the Whole Greater Than Its Parts?

Objectives We sought to examine the association between the metabolic syndrome (MetS) (defined both by the 2001 National Cholesterol Educational Program Adult Treatment Panel III [ATP-III] definition and the American Heart Association/National Heart, Lung and Blood Institute [AHA/NHLBI] revision incorporating the lower threshold for impaired fasting glucose [IFG]) and early-onset coronary artery disease (CAD). Background The impact of MetS on premature CAD has not been studied extensively. Lowering the threshold to define the IFG component (from 110 to 100 mg/dl) and the value of the syndrome as a whole versus its individual components are subjects of intense debate. Methods We performed a case-control study with 393 early-onset CAD subjects (acute myocardial infarction, angina with ≥50% stenosis, or coronary revascularization) in men under age 46 years or women under age 56 years and 393 control subjects individually matched for gender, age, and race/ethnicity. Results By conditional logistic regression, presence of ATP-III MetS without diabetes (adjusted odds ratio [adj-OR] 4.9; 95% confidence interval [CI] 3.4 to 8.0) and with diabetes (adj-OR 8.0, 95% CI 4.39 to 14.6) was a strong independent determinant of early-onset CAD. Using the AHA/NHLBI revision, these ORs became slightly stronger. However, neither definition of MetS remained significantly associated with early-onset CAD in multivariate models adjusting for individual components. Conclusions The presence of MetS imparts a high risk of early-onset clinical CAD, but the prognostic information associated with the syndrome is not greater than the sum of its parts.
Coverage of Novel Therapeutic Agents by Medicare Prescription Drug Plans Following FDA Approval.

BACKGROUND: Regulatory approval of novel therapies by the FDA does not guarantee insurance coverage requisite for most clinical use. In the United States, the largest health insurance payer is the ...
Incomplete neutralization in African American English: The case of final consonant voicing

In many varieties of African American English (AAE), glottal stop replacement and deletion of word-final /t/ and /d/ results in consonant neutralization, while the underlying voicing distinction may be maintained by other cues, such as vowel duration. Here, I examine the relationship between vowel duration, final glottal stop replacement, and deletion of word-final /t, d/ to determine whether the phonological contrast of consonant voicing is maintained through duration of the preceding vowel. Data come from conversational interviews of AAE speakers in North Carolina, Tennessee, and Washington, DC. Results indicate that glottalization and deletion of word-final /t/ and /d/ are widespread across the speakers in the analysis. Additionally, the duration of vowels is significantly longer before underlying /d/ than /t/ for consonant neutralized contexts, thus showing that duration, normally a secondary cue to final voicing, may be becoming a primary cue in AAE.
Regional differences in the expression of tetrodotoxin-sensitive inward Ca2+ and outward Cs+/K+ currents in mouse and human ventricles

Tetrodotoxin (TTX) sensitive inward Ca2+ currents, ICa(TTX), have been identified in cardiac myocytes from several species, although it is unclear if ICa(TTX) is expressed in all cardiac cell types...
LOW FLOW ALARM IN A PATIENT WITH LEFT VENTRICULAR ASSIST DEVICE: WHAT WENT WRONG?

Pump thrombosis is a relatively common complication of Left Ventricular Assist Device (LVAD), but complete inflow cannula obstruction due to thrombosis is rare. A 56-year-old male presented after a sudden onset of low flow LVAD alarms and dyspnea. His respiratory rate was 28, his mean blood
Unrecognized Cardiac Amyloidosis at the Time of Mitral Valve Surgery: Incidence and Outcomes.

Objective It is increasingly recognized that cardiac amyloidosis can occur in patients with severe aortic stenosis undergoing both surgical and transcatheter valve replacements. We aimed to investigate whether unrecognized cardiac amyloidosis may also occur in patients with severe mitral valve disease undergoing surgery. Methods The pathology department database at our center was retrospectively analyzed over a 10-year period for cases in which the mitral valve or another type of cardiac tissue removed at the time of mitral surgery demonstrated incidental amyloidosis. Clinical and echocardiographic variables were collected from the electronic medical record and the echocardiographic database. Results Between 2007 and 2016, a total of 7,733 mitral valve surgical specimens were received. Of these, there were 15 cases in which the mitral valve, or another type of cardiac tissue removed at surgery, demonstrated incidentally detected amyloidosis. The most frequent comorbidities were hypertension (87%) and atrial fibrillation (80%); 13 patients (87%) underwent bioprosthetic mitral valve replacement, and 2 patients (13%) underwent mitral valve repair. Sites of amyloid deposition were the mitral valve (80%), left atrial appendage (33%), and subaortic tissue (7%); 14 patients (93%) had wild-type transthyretin amyloid. The mean duration of follow-up was 1,023 days (range: 29-2,811 days). There were no surgical complications in the follow-up period. Conclusions Over a 10-year period, incidentally detected cardiac amyloidosis occurred in 0.2% of the mitral valve surgical cases. The outcomes for these patients undergoing mitral valve surgery were excellent, with no complications or deaths attributable to surgery at a mean follow-up of 1,023 days.
Effect of metal–dielectric substrates on chemiluminescence kinetics

We studied chemiluminescence of rhodamine 6G (R6G) dye in a series of R6G:DNPO:PMMA films deposited onto a variety of metallic, metal–dielectric, and dielectric substrates. We found that chemiluminescence kinetics on top of Ag and Au films covered by an insulating MgF2 layer had longer decay times than those on top of purely dielectric substrates, MgF2 films on glass. We infer that Ag- and Au-based substrates with an insulating MgF2 layer on top affected the reaction rates by influencing polarization energies of reactants and surrounding molecular dipoles. At the same time, the chemiluminescence kinetics on top of Ag and Au surfaces (without an insulating MgF2 spacer) were substantially shorter than those on top of dielectric substrates, probably because of conventional chemical catalysis. The peak emission intensities on top of metallic substrates (with and without the MgF2 layer on top) were lower than those on top of purely dielectric substrates, likely due to inhibition of the energy transfer to acceptors (R6G dye molecules) known in the vicinity of metals. The further reduction of chemiluminescence intensity on top of lamellar metal–dielectric stacks could be due to preferential emission of light inside the volume of the metamaterial rather than outside.
Links between adolescent bullying and neural activation to viewing social exclusion

Neuroscientists who have studied bullying have primarily focused on the psychopathology of diagnosable offenders or the resulting symptomatology of victimization. Less attention has been given to theories that suggest that bullying may be an interpersonal strategy. In an exploratory study, we recruited a sample of adolescents (N = 24) who engaged in high rates of delinquent behavior and collected self-report ratings of bullying behaviors. During an fMRI scan, adolescents observed instances of social exclusion and social inclusion. The adolescents’ self-reported bullying was associated with greater ventral striatum, amygdala, medial prefrontal cortex, and insula activation when viewing social exclusion > social inclusion. Activation in these regions is commonly associated with reward-learning, salience monitoring, and motivational processes, suggesting that bullies show altered processing of interpersonal cues and social dynamic experiences in their environment. Our findings highlight the need for developmental neuroscientists to further explore the role of social motivation in processing socio-affective information, with a particular focus on goal-directed antisocial behavior.
Antibodies to Nucleic Acids

Publisher Summary Systemic lupus erythematosus (SLE) is an acute and chronic inflammatory disease in which circulating immune complexes deposit in the fine capillaries of the kidney, choroid plexus, and other tissue sites. The LE cell is a polymorphonuclear leukocyte that contains a homogeneous cytoplasmic inclusion of nuclear debris. It is present in the peripheral blood of patients with SLE but is not necessarily diagnostic of SLE. The formation of the LE cell depends upon the presence of antinuclear factor in the serum of lupus patients. Antinuclear factor is actually a heterogeneous group of antinuclear antibodies with varying specificity for DNA, nucleoprotein, histones, and other nuclear contents. Only the antinucleoprotein antibody is capable of inducing the LE cell phenomenon. The addition of serum containing antinuclear factor to normal peripheral blood leukocytes results in the formation of the LE cell. Complement is fixed in this reaction. Antinuclear factor can be absorbed from serum with isolated cell nuclei but not with intact cells. The mechanism of LE cell formation depends upon the interaction of the antinuclear factor with the nuclear contents of degenerating leukocytes.
Molecule Identification with Rotational Spectroscopy and Probabilistic Deep Learning.

A proof-of-concept framework for identifying molecules of unknown elemental composition and structure using experimental rotational data and probabilistic deep learning is presented. Using a minima...
Examining Gender Dimensions of Leadership in International Nonprofits

Do male and female executives approach leadership in similar ways? What do their approaches reveal about their potentials for addressing contemporary leadership challenges and promoting leadership ...
Trends in Incidence and Mortality by Hospital Teaching Status and Location in Aneurysmal Subarachnoid Hemorrhage.

Objectives Few studies have examined the impact of teaching status and location on outcomes in subarachnoid hemorrhage (SAH). The objective of the present study was to compare mortality and functional outcomes among urban teaching, urban nonteaching, and rural centers for hospitalizations with SAH. Methods The National Inpatient Sample for years 2003–2016 was queried for hospitalizations with aneurysmal SAH from 2003 to 2017. Cohorts treated at urban teaching, urban nonteaching, and rural centers were compared with the urban teaching center cohort acting as the reference. The National Inpatient Sample Subarachnoid Hemorrhage Outcome Measure, a validated measure of SAH functional outcome, was used as a coprimary outcome with mortality. Multivariable models adjusted for age, sex, NIH-SSS score, hypertension, and hospital bed size. Trends in SAH mortality rates were calculated. Results There were 379,716 SAH hospitalizations at urban teaching centers, 105,638 at urban nonteaching centers, and 17,165 at rural centers. Adjusted mortality rates for urban teaching centers were lower than urban nonteaching (21.90% vs. 25.00%, P Conclusions Rural and urban nonteaching centers have higher rates of mortality from SAH than urban teaching centers. Further study is necessary to understand drivers of these differences.
Predictors and prescribing patterns of opioid medications surrounding reverse shoulder arthroplasty.

Background Opioid analgesics play an essential role in postoperative pain management; however, they are also associated with high rates of abuse and decreased patient outcomes. With the declaration of the recent opioid crisis, more scrutiny has been placed on physicians and their prescribing habits, and orthopedic surgeons have been shown to be the third-largest providers of opioids. Many patients undergoing reverse shoulder arthroplasty (RSA) have acute and chronic pain and may be prescribed opioids. The purpose of this study was to understand opioid-prescribing patterns across all specialties for patients undergoing RSA. Methods A retrospective review of preoperative and postoperative opioid use in 407 patients who underwent RSA from 2012 to 2015 was performed. Demographic data including age, sex, race, ethnicity, body mass index, American Society of Anesthesiologists class, and smoking status were recorded. Opioid prescriptions within 90 days before and after surgery were collected using state-mandated prescription drug–monitoring databases. Prescriber specialty was recorded, and prescriptions were categorized as follows: orthopedic surgery, primary care or internal medicine, pain management and anesthesia, dentistry, and emergency medicine. Results The cohort was composed of 236 women (58.0%) and 171 men (42.0%). The average age was 71 years. Forty-six percent of patients received preoperative prescriptions, of which 24.7% were written by orthopedic surgeons and 60.0% were written by internal medicine specialists. Preoperatively, 20% of patients received >3 prescriptions for opioids, and postoperatively, 36.4% of patients received >3 opioid prescriptions. Fifty-nine percent of all postoperative prescriptions were written by orthopedists, and 35.2% were written by internal medicine specialists. Conclusion Not surprisingly, orthopedic surgeons prescribed the majority of postoperative prescriptions. Increased awareness, however, of preoperative prescribing habits by other specialty providers may be needed, with communication of their prescriptions to orthopedists, as preoperative use is the strongest predictor of postoperative dependence on opioids. Physicians should be aware of the number of patients receiving multiple prescriptions and their contribution to dependence with continued refills postoperatively. Therefore, surgeons must be more meticulous in assessing opioid consumption before surgery, as well as which providers are writing prescriptions after surgery, to limit opioid dispensation.
Surface proteins of SARS-CoV-2 drive airway epithelial cells to induce interferon-dependent inflammation

Abstract SARS-CoV-2, the virus that has caused the COVID-19 pandemic, robustly activates the host immune system in critically ill patients. Understanding how the virus engages the immune system will facilitate the development of needed therapeutic strategies. Here we demonstrate both in vitro and in vivo that the SARS-CoV-2 surface proteins Spike (S) and Envelope (E) activate the key immune signaling interferon (IFN) pathway in both immune and epithelial cells independent of viral infection and replication. These proteins induce reactive oxidative species generation and increases in human and murine specific IFN-responsive cytokines and chemokines, similar to their upregulation in critically ill COVID-19 patients. Induction of IFN signaling is dependent on canonical but discrepant inflammatory signaling mediators as the activation induced by S is dependent on IRF3, TBK1, and MYD88 while that of E is largely MYD88 independent. Furthermore, these viral surface proteins, specifically E, induced peribronchial inflammation and pulmonary vasculitis in a mouse model. Finally we show that the organized inflammatory infiltrates are dependent on type I IFN signaling, specifically in lung epithelial cells. These findings underscore the role of SARS-CoV-2 surface proteins, particularly the understudied E protein, in driving cell specific inflammation and their potential for therapeutic intervention. Author Summary SARS-CoV-2 robustly activates widespread inflammation, but we do not understand mechanistically how the virus engages the immune system. This knowledge will facilitate the development of critically needed therapeutic strategies to promote beneficial immune responses will dampening harmful inflammation. Here we demonstrate that SARS-CoV-2 surface proteins spike and envelope alone activated innate cell function and the interferon signaling pathway. This activation occurred in both immune and epithelial cells, and mechanistic studies demonstrated dependence on known key inflammatory signaling mediators, IRF3, TBK1, and MYD88. In animal studies, we showed that these viral surface proteins induce epithelial cell IFN-dependent lung pathology, reminiscent to acute COVID-19 pulmonary infection. These findings underscore the need for further investigation into the role of SARS-CoV-2 surface proteins, particularly the understudied E protein, in driving cell specific inflammation.
A tumor-specific mechanism of Treg enrichment mediated by the integrin αvβ8

Regulatory T cells (Tregs) that promote tumor immune evasion are enriched in certain tumors and correlate with poor prognosis. However, mechanisms for Treg enrichment remain incompletely understood. We described a mechanism for Treg enrichment in mouse and human tumors mediated by the αvβ8 integrin. Tumor cell αvβ8 bound to latent transforming growth factor–β (L–TGF-β) presented on the surface of T cells, resulting in TGF-β activation and immunosuppressive Treg differentiation in vitro. In vivo, tumor cell αvβ8 expression correlated with Treg enrichment, immunosuppressive Treg gene expression, and increased tumor growth, which was reduced in mice by αvβ8 inhibition or Treg depletion. Structural modeling and cell-based studies suggested a highly geometrically constrained complex forming between αvβ8-expressing tumor cells and L–TGF-β–expressing T cells, facilitating TGF-β activation, independent of release and diffusion, and providing limited access to TGF-β inhibitors. These findings suggest a highly localized tumor-specific mechanism for Treg enrichment.
The asymmetric Pitx2 regulates intestinal muscular-lacteal development and protects against fatty liver disease

Intestinal lacteals are the essential lymphatic channels for absorption and transport of dietary lipids and drive pathogenesis of debilitating metabolic diseases. Yet, organ-specific mechanisms linking lymphatic dysfunction to disease etiology remain largely unknown. In this study, we uncover a novel intestinal lymphatic program that is linked to the left-right (LR) asymmetric transcription factor Pitx2. We show that deletion of the asymmetric Pitx2 enhancer, ASE, alters normal lacteal development through the lacteal-associated contractile smooth muscle lineage. ASE deletion leads to abnormal muscle morphogenesis induced by oxidative stress, resulting in impaired lacteal extension and defective lymphatic-dependent lipid transport. Surprisingly, activation of lymphatic-independent trafficking directs dietary lipids from the gut directly to the liver, causing diet-induced fatty liver disease. In summary, our studies reveal the molecular mechanism linking gut lymphatic development to the earliest symmetry-breaking Pitx2 and highlight the important relationship between intestinal lymphangiogenesis and gut-liver axis. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=200 SRC="FIGDIR/small/447753v1_ufig1.gif" ALT="Figure 1"> View larger version (41K): org.highwire.dtl.DTLVardef@1a7e81corg.highwire.dtl.DTLVardef@77915forg.highwire.dtl.DTLVardef@1e91610org.highwire.dtl.DTLVardef@1a7911d_HPS_FORMAT_FIGEXP M_FIG GRAPHICAL ABSTRACT C_FIG HIGHLIGHTS[~] Gut lymphangiogenesis is linked to Pitx2-driven LR asymmetry [~]Lacteal-associated smooth muscle requires ASE [~]ASE deletion leads to redox imbalance in intestinal smooth muscle lineage [~]ASE is required for the normal route of dietary lipid transport [~]Pitx2ASE/ASE neonates develop diet-induced fatty liver disease
Does a Behavioral Parent Training Program for Parents of ADHD Children Improve Outcomes? A Pilot Project

Attention Deficit Hyperactivity Disorder (ADHD) is the most common chronic neurobehavioral disorder of childhood. Research suggests increased parent-child conflict exists in families with an ADHD child. The evidence indicates links between child behavior problems and parenting practices. Behavioral Parent Training (BPT) is an evidence-based intervention recommended for the treatment of ADHD. BPT is recommended as first-line treatment in ADHD children under age six and as a combination treatment approach for children older than the age six. BPT programs have demonstrated significant improvement in frequency of the problem behaviors of inattention, hyperactivity, and impulsivity associated with ADHD. Pre- and Post-BPT Parenting Scales and Vanderbilt ADHD Diagnostic Rating Scales for Parents and Teachers were used to evaluate the efficacy of the BPT program. Percent changes for each participant pre- and post-BPT were calculated. The Parenting Scale overall score and overreactivity factor score showed significant improvement post-BPT (p = .05). Participation in a BPT program can affect parenting practices and improve outcomes for ADHD children. BPT programs are effective in reducing negative parenting practices and improving outcomes for this population.
Heat and learning in elementary and middle school

Changing weather patterns and extreme events are not the only outcomes of global climatic change. We investigate the impact of changing weather conditions on human capital development by studying a...
Evaluation of standardized performance test methods for biomedical Raman spectroscopy.

Significance: Raman spectroscopy has emerged as a promising technique for a variety of biomedical applications. The unique ability to provide molecular specific information offers insight to the underlying biochemical changes that result in disease states such as cancer. However, one of the hurdles to successful clinical translation is a lack of international standards for calibration and performance assessment of modern Raman systems used to interrogate biological tissue. Aim: To facilitate progress in the clinical translation of Raman-based devices and assist the scientific community in reaching a consensus regarding best practices for performance testing. Approach: We reviewed the current literature and available standards documents to identify methods commonly used for bench testing of Raman devices (e.g., relative intensity correction, wavenumber calibration, noise, resolution, and sensitivity). Additionally, a novel 3D-printed turbid phantom was used to assess depth sensitivity. These approaches were implemented on three fiberoptic-probe-based Raman systems with different technical specifications. Results: While traditional approaches demonstrated fundamental differences due to detectors, spectrometers, and data processing routines, results from the turbid phantom illustrated the impact of illumination-collection geometry on measurement quality. Conclusions: Specifications alone are necessary but not sufficient to predict in vivo performance, highlighting the need for phantom-based test methods in the standardized evaluation of Raman devices.
Blues and the Rule of Law

Blues music emerged from African American communities during the Jim Crow era, inspired at least in part by society’s failure to afford them access to justice or the rule of law. The First Amendment, however, provided sufficient protection to speech to allow the art form of the Blues–lamenting the general disenfranchisement of Blacks in America–to develop, and ultimately to reach white audiences. At the same time, because reform came through extra-legal means (the speech and music of protest), the Blues also glorified the character of the outlaw, who flouts corrupt and unresponsive legal authority. In the end, the Blues, by lamenting the failure of legal institutions and lionizing the outlaw who defies them, raised awareness and played a role in bringing U.S. society closer to the rule of law, helping to resolve the rule of law failures that inspired its emergence.
The “Life Cycle” of Bacterial Ribosomes

Publisher Summary Bacterial ribosomes are ribonucleoprotein particles, essential for protein synthesis and are involved in the control of RNA synthesis. This chapter focuses on “life cycle” of bacterial ribosomes. The chapter defines “life cycle” as the events of inception, maturation, and repeated functioning of a ribosome. It essentially divides it into a series of biochemical reactions and considers each reaction as a separate event. The reactions discussed include: (1) synthesis of ribosomal (r-) RNA, (2) synthesis of ribosomal proteins, (3) formation of ribonucleoprotein particles that are precursors of complete ribosomes, (4) assembly of these precursor particles into completed ribosomes, (5) participation of ribosomes in protein synthesis, and (6) release of ribosomes from messenger (m-) RNA into a pool of free particles. Three general conclusions can be derived about the “life cycle” of ribosomes. This includes (1) the assembly of 30S and 50S ribosome subunits proceeds in steps, by a series of poorly characterized intermediates containing r- RNA and various amounts of ribosomal proteins; (2) the process of aggregation of these particles into completed ribosomes seems to be related to the process of polysome formation; and (3) after polysomes have completed their function in the synthesis of proteins, the ribosomes and m- RNA part company, the ribosomes to be reutilized for the formation of other polysomes and the messenger to be degraded and metabolized by the cell.
Through the Physician's Eyes: The Racist Parent.

An attending physician in an urban teaching hospital faces an ethical dilemma when a mother refused to allow an African American medical student to examine her child. Virtual Mentor is a monthly bioethics journal published by the American Medical Association.
Structured topic models: jointly modeling words and their accompanying modalities

The abundance of data in the information age poses an immense challenge for us: how to perform large-scale inference to understand and utilize this overwhelming amount of information. Such techniques are of tremendous intellectual significance and practical impact. As part of this grand challenge, the goal of my Ph.D. thesis is to develop effective and efficient statistical topic models for massive text collections by incorporating extra information from other modalities in addition to the text itself. Text documents are not just text, and different kinds of additional information are naturally interleaved with text. Most previous work, however, pays attention to only one modality at a time, and ignore the others. In my thesis, I will present a series of probabilistic topic models to show how we can bridge multiple modalities of information, in a united fashion, for various tasks. Interestingly, joint inference over multiple modalities leads to many findings that can not be discovered from just one modality alone, as briefly illustrated below: Email is pervasive nowadays. Much previous work in natural language processing modeled text using latent topics ignoring the social networks. On the other hand, social network research mainly dealt with the existence of links between entities without taking into consideration the language content or topics on those links. The author-recipient-topic (ART) model, by contrast, steers the discovery of topics according to the relationships between people, and learns topic distributions based on the direction-sensitive messages sent between entities. However, the ART model does not explicitly identify groups formed by entities in the network. Previous work in social network analysis ignores the fact that different groupings arise for different topics. The group-topic (GT) model, a probabilistic generative model of entity relationships and textual attributes, simultaneously discovers groups among the entities and topics among the corresponding text. Many of the large datasets do not have static latent structures; they are instead dynamic. The topics over time (TOT) model explicitly models time as an observed continuous variable. This allows TOT to see long-range dependencies in time and also helps avoid a Markov model's risk of inappropriately dividing a topic in two when there is a brief gap in its appearance. By treating time as a continuous variable, we also avoid the difficulties of discretization. Most topic models, including all of the above, rely on the bag of words assumption. However, word order and phrases are often critical to capturing the meaning of text. The topical n-grams (TNG) model discovers topics as well as meaningful, topical phrases simultaneously. In summary, we believe that these models are clear evidence that we can better understand and utilize massive text collections when additional modalities are considered and modeled jointly with text.
Project CALC: Calculus as a Laboratory Course

Calculus is the study of change. The concepts of calculus enable us to model processes that change and to describe properties of these processes that remain constant in the midst of change. Now change has come to the learning of calculus -change driven by the need to respond to the revolution in technology and fueled by funds from the United States National Science Foundation. What should be changed? How and how fast? What should remain constant? In this paper we describe one answer to these questions: Project CALC, a new calculus course developed at Duke University. The key features of our approach are real-world problems, hands-on activities, discovery learning, writing and revision of writing, teamwork, and intelligent use of available tools.
The Relative Influence of Nature and Nurture Upon Mental Development; A Comparative Study of Foster Parent-Foster Child Resemblance and True Parent-True Child Resemblance

The investigation in hand approaches the aspect of the problem which concerns heredity and home environment through a comparison of mental test resemblances obtaining between parents and their children on the one hand, with those obtaining between foster parents and their foster children on the other. Thus, it seeks to evaluate the effects of nature and of home nurture through a study of two kinds of familial resemblance, one of which is dependent upon nurture influence alone, and the other upon a combination of both nature and nurture influences. Through its use of foster parents and their foster children as subjects, it applies to its purpose the end results of the social experimentation which is going on in many homes all about us.