cssi/SciSciGPT-SciSciNet huggingface dataset:
A Rebuttable Presumption Against Nondemocratic Consensual Intervention

Since the development of the U.N. Charter, the international legal order has sought to strictly control use of force between states. But voluntaristic conceptions of international law have protected a state’s right to invite other states to use force in its territory. This law of invitation to intervention simply lacks the requisite rigor to ensure that states using such force do not otherwise violate international law, like human rights or treaty obligations. Imposing some sort of democratic requirement on the law can provide that rigor. That said, international law cannot prejudice those peoples which have not chosen Western-style democracy as their form of government. So, a rebuttable presumption against intervention in non-democratic states would then serve to discourage use of force, but respect a people’s non-democratic expression of sovereign government. In other words, non-democratic states must affirmatively prove that use of force will not otherwise violate international law. Considering the spectrum of alternatives, no rule offers a similarly strong incentive to comply with international law while still remaining flexible enough for use in international politics. This is demonstrated most clearly through Russian intervention in Syria, whereby a rebuttable presumption could have prevented this additional military force or induced Syria to better comply with its international responsibilities.
Characterization of Respirable Aerosols Generated during Routine Laboratory Procedures

Biosafety Level 2 (BSL-2) and Biosafety Level 3 (BSL-3) facility lab personnel routinely perform procedures that are capable of producing respirable aerosols. While these procedures are considered ...
Impact of Human Mutant TGFβ1/Fc Protein on Memory and Regulatory T Cell Homeostasis Following Lymphodepletion in Nonhuman Primates

Transforming growth factor β1 (TGFβ1) plays a key role in T cell homeostasis and peripheral tolerance. We evaluated the influence of a novel human mutant TGFβ1/Fc (human IgG4 Fc) fusion protein on memory CD4+ and CD8+ T cell (Tmem) responses in vitro and their recovery following antithymocyte globulin (ATG)-mediated lymphodepletion in monkeys. TGFβ1/Fc induced Smad2/3 protein phosphorylation in rhesus and human peripheral blood mononuclear cells and augmented the suppressive effect of rapamycin on rhesus Tmem proliferation after either alloactivation or anti-CD3/CD28 stimulation. In combination with IL-2, the incidence of CD4+ CD25hi Foxp3hi regulatory T cells (Treg) and Treg:Th17 ratios were increased. In lymphodepleted monkeys, whole blood trough levels of infused TGFβ1/Fc were maintained between 2 and 7 μg/mL for 35 days. Following ATG administration, total T cell numbers were reduced markedly. In those given TGFβ1/Fc infusion, CD8+ T cell recovery to predepletion levels was delayed compared to controls. Additionally, numbers of CD4+ CD25hi CD127lo Treg increased at 4-6 weeks after depletion but subsequently declined to predepletion levels by 12 weeks. In all monkeys, CD4+ CD25hi Foxp3hi Treg/CD4+ IL-17+ cell ratios were reduced, particularly after stopping TGFβ1/Fc infusion. Thus, human TGFβ1/Fc infusion may delay Tmem recovery following lymphodepletion in nonhuman primates. Combined (low-dose) IL-2 infusion may be required to improve the Treg:Th17 ratio following lymphodepletion.
Pseudorabies virus as a transneuronal tract tracing tool: specificity and applications to the sympathetic nervous system.

Because of technical shortcomings, neuroanatomical tract tracing methods have been limited in their ability to examine functional pathways. This has been particularly true of the study of the sympathetic nervous system. Peripheral targets of the sympathetic nervous system are innervated by sympathetic ganglion cells which are located in various, discreet ganglia, primarily in the abdomen and thoracic cavity. Each ganglion contains neurons innervating multiple targets. In turn, each ganglion is innervated by preganglionic motor neurons located in the thoracic and lumbar spinal cord. Preganglionic neurons are innervated by neurons from the brainstem and hypothalamus, as well as probably by spinal interneurons. At each of these sites, the ganglia, the preganglionic nuclei of the spinal cord, and the brainstem and hypothalamus, functionally different neurons are intermingled. Therefore, placement of a traditional retrograde marker (i.e. HRP) in any of those sites would generate retrogradely labeled neurons that represent multiple functional pathways, making the study of one functional pathway impossible. A transneuronal retrograde tracer could obviate this problem by passing the original tracer from the first neuron labeled transsynaptically to neurons which synapse on to it. After injection of the transneuronal tracer into a peripheral target, the tracer would be transported, first to the ganglion cell, then to the preganglionic neurons that innervate the ganglion cell, and then to the neurons in the brain that innervate the preganglionic neurons. All the neurons labeled would belong to one functional pathway, specifically involved in control of that target which was injected. There have been attempts to develop such tracers. WGA-HRP, tetanus toxin, and the tetanus toxin C-fragment have been used with limited success (1,2,3,4,5).(ABSTRACT TRUNCATED AT 250 WORDS)
The invisible vulnerable: the economically and educationally disadvantaged subjects of clinical research.

U.S. Department of Health and Human Services (HHS) federal regulations pertaining to the protection of human subjects at Title 45 of the Code of Federal Regulations, Part 46, Subpart A (“the Common Rule”), refer to the need for special precautions when persons characterized as vulnerable are used as human research subjects. Under the Common Rule, persons considered “vulnerablae” are those who are likely to be susceptible to coercive or undue influence; the term “vulnerable” includes “children, prisoners, pregnant women, mentally disabled persons,” or those who are “economically or educationally disadvantaged.” The need for special precautions with some of these vulnerable persons in the context of research has long been addressed by both mandatory additional protections found in Subparts B through D of 45 C.F.R. pt. 46 (that are not, coincidentally, part of the Common Rule) and additional detailed guidance documents provided by HHS or its components to investigators and their respective institutions.
AAV capsid CD8+ T-cell epitopes are highly conserved across AAV serotypes

Adeno-associated virus (AAV) has become one of the most promising vectors in gene transfer in the last 10 years with successful translation to clinical trials in humans and even market approval for a first gene therapy product in Europe. Administration to humans, however, revealed that adaptive immune responses against the vector capsid can present an obstacle to sustained transgene expression due to the activation and expansion of capsid-specific T cells. The limited number of peripheral blood mononuclear cells (PBMCs) obtained from samples within clinical trials allows for little more than monitoring of T-cell responses. We were able to identify immunodominant major histocompatibility complex (MHC) class I epitopes for common human leukocyte antigen (HLA) types by using spleens isolated from subjects undergoing splenectomy for non-malignant indications as a source of large numbers of lymphocytes and restimulating them with single AAV capsid peptides in vitro. Further experiments confirmed that these epitopes are naturally processed and functionally relevant. The design of more effective and less immunogenic AAV vectors, and precise immune monitoring of vector-infused subjects, are facilitated by these findings.
Clinical pharmacology of new antiepileptic drugs.

Article abstract-Advances in neurobiology, molecular biology, and pharmaceutical science have led to the development of a number of new antiepileptic drugs (AEDs). The investigational AEDs described in this review include ganaxolone, levetiracetam, losigamone, pregabalin, remacemide, rufinamide, stiripentol, and zonisamide. They have shown efficacy in a variety of seizure types and offer hope for improved therapeutic efficacy, beneficial pharmacokinetics, and a decrease in the incidence of drug interactions and adverse events. As the results of ongoing clinical trials of these drugs become available, these medications may be considered for rational drug therapy of epilepsy, either singly or in combination with currently available AEDs.
A general gridding, discretization, and coarsening methodology for modeling flow in porous formations with discrete geological features

Abstract A comprehensive framework for modeling flow in porous media containing thin, discrete features, which could be high-permeability fractures or low-permeability deformation bands, is presented. The key steps of the methodology are mesh generation, fine-grid discretization, upscaling, and coarse-grid discretization. Our specialized gridding technique combines a set of intersecting triangulated surfaces by constructing approximate intersections using existing edges. This procedure creates a conforming mesh of all surfaces, which defines the internal boundaries for the volumetric mesh. The flow equations are discretized on this conforming fine mesh using an optimized two-point flux finite-volume approximation. The resulting discrete model is represented by a list of control-volumes with associated positions and pore-volumes, and a list of cell-to-cell connections with associated transmissibilities. Coarse models are then constructed by the aggregation of fine-grid cells, and the transmissibilities between adjacent coarse cells are obtained using flow-based upscaling procedures. Through appropriate computation of fracture-matrix transmissibilities, a dual-continuum representation is obtained on the coarse scale in regions with connected fracture networks. The fine and coarse discrete models generated within the framework are compatible with any connectivity-based simulator. The applicability of the methodology is illustrated for several two- and three-dimensional examples. In particular, we consider gas production from naturally fractured low-permeability formations, and transport through complex fracture networks. In all cases, highly accurate solutions are obtained with significant model reduction.
Disentangling Topic Models: A Cross-cultural Analysis of Personal Values through Words

We present a methodology based on topic modeling that can be used to identify and quantify sociolinguistic differences between groups of people, and describe a regression method that can disentangle the influences of different attributes of the people in the group (e.g., culture, gender, age). As an example, we explore the concept of personal values, and present a cross-cultural analysis of value-behavior relationships spanning writers from the United States and India.
Love in Latin America

Through a number of anthropologic and ethnographic studies, this study explores modern romantic love in Latin America. It highlights the influences of historical cultures native to the regions discussed as well as Western cultural influences. This chapter shows the cultural mix of not only the people that call the countries of Latin America home, but also the conceptions of romantic love. In this analysis, this chapter highlights research from Mexico, Argentina, Brazil, and Nicaragua.
On the decay properties of the Franklin analyzing wavelet

Abstract We study the behaviour of the Frankin analysing wavelet ψ, which is piecewise linear with nodes in ℤ/2, by giving the size and sign of ψ( n /2).
Acute Ischemic Stroke of Undetermined Etiology in a University Hospital

P8 Objectives: Ischemic stroke is classified as of undetermined etiology in approximately 30% of cohorts in many clinical studies of stroke, including the Trial of ORG 10172 in Acute Stroke Treatment (TOAST). We investigated this undetermined etiology classification in our own in-hospital ischemic stroke population, and sought to determine clinical features of acute ischemic stroke which may be more or less predictive of an undetermined etiology. Methods: The medical records of patients admitted to the University Hospital with ischemic stroke between 1990 and 1998 were reviewed. Etiologic classification was determined based on imaging and other studies according to the TOAST criteria as atherothrombotic, embolic, lacunar, of other determined etiology, and of undetermined etiology (UND). The last category was then subdivided into negative evaluation (UND-1), more than one cause identified (UND-2), and incomplete evaluation (UND-3). Clinical features that might predict undetermined etiology were assessed, including severity, age, gender, and previously known ischemic stroke risk factors. Results: Of 690 patients with ischemic stroke, 163 (23.6%) had undetermined etiology. Men and women had a similar rate of UND. In the categories UND-1, UND-2, and UND-3 there were 39 (5.7%), 52 (7.5%), and 72 (10.4%) patients respectively. Stroke with severe paresis and diminished sensorium had a low frequency of undetermined etiology (13%, p Conclusions: In clinical studies of ischemic stroke a determination of undetermined etiology may be due to an incomplete evaluation, or more than one likely cause, rather than a negative evaluation. There are clinical features on presentation of ischemic stroke that are predictive of a classification of undetermined etiology.
Comparison of open surgical techniques for repair of types III and IV thoracoabdominal aortic aneurysms

Abstract Objective The objective of this study was to compare outcomes after repair of type III and type IV thoracoabdominal aortic aneurysms (TAAAs) by three different open surgical techniques at a tertiary care institution. Methods Consecutive patients who underwent elective repair of type III and type IV TAAAs at our institution between 1999 and 2011 were retrospectively reviewed. Patients were divided into three groups according to surgical technique: clamp and sew (CS), left-sided heart bypass (LHB), and visceral branching (VB) followed by aortic reconstruction. Primary end points were early mortality and complications; secondary end points were need for blood transfusion, duration of operation, and long-term survival. Results Between 1999 and 2011, there were 121 consecutive patients (83 men, 38 women) with 52 type III and 69 type IV TAAAs who underwent elective repair (CS, 65 patients; LHB, 31 patients; VB, 25 patients). Perioperative spinal drainage was used in 84%. Procedure duration was longest in the VB group (mean, 9.1 hours vs 7.7 hours and 5.7 hours for CS and LHB; P P = .015). Mean duration of mesenteric ischemia was significantly shorter in the VB group vs CS and LHB (18 minutes vs 35 minutes for CS and 30 minutes for LHB; P P = .82]; 18, 20, and 18 days [ P = .76]). Overall 30-day mortality was 6.6%, not different between groups (6%, 10%, and 4%; P = .68). Mean follow-up was 45 ± 42 months, and actuarial overall survival at 3 and 5 years was 70% and 64%, with no difference between groups ( P = .36). Conclusions For repair of type III and type IV TAAAs, the sequential VB technique has the longest duration, but it has the advantage of the shortest mesenteric and visceral ischemia times without improvement in early outcomes. Irrespective of the techniques used, complications, early mortality, risk of spinal cord injury, and survival were the same.
Zapping the food supply

The idea of exposing food to gamma radiation is over 30 years old, and in 1963 the Food and Drug Administration (FDA) began to permit the irradiation of wheat. Over the years, a few more foodstuffs such as spices and tea were added, but in 1984 the FDA started to approve irradiation of a much broader list of products which now includes meat, poultry, and fresh fruits and vegetables. Simultaneously the FDA has increased the levels of radiation that may be used. The FDA's recent willingness to allow most of the food supply to be irradiated - and at high doses - has triggered an acrimonious debate. The amount of radiation involved is substantial, with intensities millions of times greater than that of an ordinary chest X-ray. The announced goal of promoters of food irradiation is to obtain general approval for the use of up to one million rad. Irradiation does not make food radioactive, nor has alleged radioactivity been at issue in the debate. But there is concern that foods processed by irradiation may contain radiolytic products that could have toxic effects. 12 refs.
Diagnosis and Pathological Analysis of Patient Cancers by Detection of Proliferating Cells in Gelfoam ® Histoculture

Patient tumors grew in Gelfoam® histoculture with maintenance of tissue architecture, tumor-stromal interaction, and differentiated functions. In this chapter, we review the use of Gelfoam® histoculture to demonstrate proliferation indices of major solid cancer types explanted directly from surgery. Cell proliferation was visualized by histological autoradiography within the cultured tissues after [3H]thymidine incorporation by the proliferating cells. Epilumination polarization microscopy enables high-resolution imaging of the autoradiography of each cell. The histological status of the cultured tissues can be assessed simultaneously with the proliferation status. Carcinomas were observed to have areas of high epithelial proliferation with quiescent stromal cells. Sarcomas have high proliferation of the cancer cells of mesenchymal organ. Normal tissues can also proliferate at high rates. Mean growth fraction index (GFI) was highest for patient tumors with the pure subtype of small-cell lung cancer than other types of lung cancer.
Structural Evidence for Rifampicin Monooxygenase Inactivating Rifampicin by Cleaving Its Ansa-Bridge.

Rifampicin monooxygenase (RIFMO) decreases the potency of rifampicin (RIF) by converting it to oxidative products. Further decomposition of RIF has been observed in bacteria producing RIFMO and contributes to RIFMO-mediated drug resistance. Here we report the first crystal structure of RIFMO in complex with the hydroxylated RIF product. The 2.10 A resolution structure reveals a breach of the ansa aliphatic chain of RIF between naphthoquinone C2 and amide N1. Our data suggest that RIFMO catalyzes the hydroxylation of RIF at the C2 atom followed by cleavage of the ansa linkage, which leads to inactivation of the antibiotic by preventing key contacts with the RNA polymerase target.
Ordinary differential equations and Easter Island: a survey of recent research developments on the relationship between humans, trees, and rats

A survey of ordinary differential equation models investigating environmental and sustainability issues in the history of Easter Island appeared in 2011. One of the results discussed was a model by Basener et al. which investigated the relationship between humans, the forest stock, and the non-native Polynesian rat that was introduced by early settlers. This paper surveys recent developments in research using differential equation models to understand the interactions between people, rats, and forest stock.
Introduction to the Clinical Forum: Working Memory in School-Age Children

Purpose The purpose of this article is to introduce the LSHSS Clinical Forum: Working Memory in School-Age Children. All the articles in this clinical forum concern the nature of working memory and...
Introducing Geo-Cultural Landscapes in Iran

The concept of “Cultural landscapes” reflects a relatively steady state of the interaction between humans and natural environment that occurred through centuries. There are significant cultural landscapes of high values were originated in Persian Empire more than 25 centuries ago through Silk Road and worship complexes. Takht-e Soleyman, as a typical civilizing cultural landscape site is an explicitly highlighted ground for the reasons of its initiation and persistence.
Development of Appropriate Imaging Methods to Trace Cell Fate, Engraftment, and Cell Survival

Abstract In the field of regenerative medicine, one of the key areas is stem cell therapy, which involves introducing new cells into damaged tissue to improve function. Various cell types may be used, including mesenchymal stem cells, embryonic stem cells, induced pluripotent stem cells, and adipose-derived stem cells. Imaging is important for answering questions about stem cell viability, location, engraftment with host tissue, and differentiation, as well as for studying the basic biology of these cells in vitro. Common approaches to cell imaging are magnetic resonance imaging, optical methods, ultrasound, single photon emission computed tomography, and positron emission tomography. It is important to recognize that in direct imaging, contrast agents, and in indirect imaging, reporter genes that are used to track delivered cells can influence the biology and behavior of these cells. Some of the side effects associated with labeling can be avoided by labeling only a fraction of the cells. Before the data can be interpreted, however, the imaging signal must be carefully validated.
Helicobacter pylori strains from Duodenal Ulcer Patients Differ at the Genomic Level from Those Patients with simple Gastritis

The frequent presence of Helicobacter pylori in healthy individuals without peptic ulcer disease suggests that as yet unidentified specific microbe-host interactions are important in determining whether an infected individual does or does not develop ulcer disease. Development of a peptic ulcer following H. pylori infection may require the genetic predisposition of the infected individual, infection with an “ulcer-virulent” H. pylori strain, or both.
Incidence of pregnancy events among women with a malignant disease diagnosis.

e18262Background: Pregnancy concurrent with cancer is rare, but adds additional complexity to cancer management and treatment. Little information is available about incidence of pregnancy events am...
Book Review:Spirituality, Religion and Aging: Illuminations for Therapeutic Practice

Holly Nelson-Becker. Spirituality, Religion, and Aging: Illuminations for Therapeutic Practice . Sage: Los Angeles. 2018
A Synthesis of Computational and Experimental Approaches of Evaluating Chemical, Physical, and Mechanistic Properties of Asphalt Binders

Asphalt binder is a very complex chemical compound. Much work has been done to understand and model its chemical, morphological, rheological, and mechanical features. This paper synthesizes and presents findings from pertinent studies available in the public domain. Understanding of asphalt characteristics at the very finite level is the first critical step to develop a better macroscopic- or pavement-level performance model. This paper showcases a summary of current knowledge gained on (a) how chemical elemental compositions and molecular groups play critical roles in asphalt binder’s performance in pavement composites; (b) morphological properties and their relationships with the asphalt’s structural performance; and (c) mechanistic characteristics of asphalt binder’s at nanoscopic, mesoscopic, and microscopic levels, and how they are related to macroscopic- or pavement-level performance.
Dance Trends: Choreographic Plagiarism: When Does Borrowing Become Stealing?

What makes a piece of choreography your own creation? How much borrowing or inspiration from others is acceptable or expected in a work of choreography? This is a dilemma that we all need to grappl...
Native kidney BK virus nephropathy, a systematic review

Background There is a growing base of literature describing BK nephropathy (BKVN) in patients outside of the setting of kidney transplant. Previous systematic reviews of the literature have been limited by methodology or by the scope of patients included. Study design and methods Systematic Review (Prospero # CRD42018088524). Setting & population Patients without kidney transplant who had biopsy-proven BKVN. Selection criteria for studies Full-text articles that describe native BKVN patient cases. Analytical approach Descriptive synthesis. Results The search identified 630 unique articles of which 51 were included in the final review. Sixty-five cases (including two new cases presented in this review) were identified, all but one occurred in the setting of known immunosuppression. Limitations The primary limitation was the exclusion of studies that did not fulfill the stringent review criteria. We excluded reports with only a clinical diagnosis of BKVN, such as those with viruria and/or viremia without biopsy. Conclusions As of May 2018, there are 65 reported cases of BKVN in native kidneys. This represents the most comprehensive description of biopsy-proven BKVN in native kidneys to date. Evaluation for BK nephropathy should be considered in immunocompromised patients who exhibit unexplained renal failure.
Diamond photochemistry with visible light

Abstract This project demonstrates diamond-based photochemistry using visible light. Diamond has the unique property of having a widely tunable electrochemical surface, with hydrogen terminated diamond known to have a negative electron affinity. This property enables the emission of electrons from the surface of the diamond. In this work, electrons are emitted into an aqueous solution, creating a reservoir of free, solvated electrons, that can be used to initiate energy intensive chemical reactions. We demonstrate that visible light incident on thin films of diamond on molybdenum substrates can be used to reduce nitrogen gas to ammonia via the photogenerated electrons.
Cue specificity of predator-induced phenotype in a marine snail: is a crab just a crab?

A wide range of taxa have been shown to display inducible, phenotypically plastic responses to known predators. Most studies of inducible defenses include only known predators but not non-predatory species in experimental designs, precluding tests of specificity for these responses. We tested the specificity of predator-induced defenses in the marine snail Nucella lamellosa, when exposed to chemical cues from potential crab predators as well as more distantly related non-predatory crabs that co-occur with this snail. Surprisingly, all crabs tested, even those that are not predators, triggered the common induced response of a reduction of soft-tissue mass relative to control animals, likely reflecting a reduction in snail feeding activity. In contrast, only N. lamellosa’s major predator, Cancer productus, triggered the production of a thicker apertural lip. Increased thickening of the apertural lip may be an adaptive response specific to C. productus, which uses shell-breaking at the apertural lip (i.e., shell-peeling) as their main form of attack. Apertural lip thickening appeared to be due to reallocation of shell material (i.e., a change in shell shape) rather than an increase in shell deposition. Our findings demonstrate the importance of determining the specificity of cues triggering inducible responses in prey, and the mechanisms that underlie these plastic responses, as the responses to general versus specific cues may limit the adaptive value of an inducible defense.
Impact of length of stay on HCAHPS scores following lumbar spine surgery

Objective Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys, completed by patients following an inpatient stay, are utilized to assess patient satisfaction and quality of the patient experience. HCAHPS results directly impact hospital and provider reimbursements. While recent work has demonstrated that pre- and postoperative factors can affect HCAHPS results following lumbar spine surgery, little is known about how these results are influenced by hospital length of stay (LOS). Here, the authors examined HCAHPS results in patients with LOSs greater or less than expected following lumbar spine surgery to determine whether LOS influences survey scores after these procedures. Methods The authors conducted a retrospective review of HCAHPS surveys, patient demographics, and outcomes following lumbar spine surgery at a single institution. A total of 391 patients who had undergone lumbar spine surgery and had completed an HCAHPS survey in the period between 2013 and 2015 were included in this analysis. Patients were divided into those with a hospital LOS equal to or less than the expected (LTE-LOS) and those with a hospital LOS longer than expected (GTE-LOS). Expected LOS was based on the University HealthSystem Consortium benchmarks. Nineteen questions from the HCAHPS survey were examined in relation to patient LOS. The primary outcome measure was a comparison of "top-box" ("9-10" or "always or usually") versus "low-box" ("1-8" and "somewhat or never") scores on the HCAHPS questions. Secondary outcomes of interest were whether the comorbid conditions of cancer, chronic renal failure, diabetes, coronary artery disease, hypertension, stroke, or depression occurred differently with respect to LOS. Statistical analysis was performed using Fisher's exact test for the 2 × 2 contingency tables and the chi-square test for categorical variables. Results Two hundred fifty-seven patients had an LTE-LOS, whereas 134 patients had a GTE-LOS. The only statistically significant difference in preoperative characteristics between the patient groups was hypertension, which correlated to a shorter LOS. A GTE-LOS was associated with a decreased likelihood of a top-box score for the HCAHPS survey items on doctor listening and pain control. Conclusions Here, the authors report a decreased likelihood of top-box responses for some HCAHPS questions following lumbar spine surgery if LOS is prolonged. This study highlights the need to further examine the factors impacting LOS, identify patients at risk for long hospital stays, and improve mechanisms to increase the quality and efficiency of care delivered to this patient population.
What May Be Wrong with the “End” in the End-of-Revolution Thesis?

That revolution has ended in, or is about to vanish from, our contemporary world has become a common sense of published opinion. Although there are still some dissenting voices, this chapter focuses exclusively on the argument structure undergirding the end-of-revolution thesis, as it has been elaborated recently, in the context of the global domination of neoliberal capitalism. The purpose of the chapter is to reconstruct the architecture of the argument structure of the end-of-revolution thesis and to probe the validity of each of its six central elements. Without refuting the end-of-revolution thesis as such, the chapter seeks to demonstrate that its substantiations, in their present form, are either banal and unspecific or theoretically underdeveloped and inconsequential, or both.
Trends In Hospitals And Skilled Nursing Facilities Sharing Medical Providers, 2008-16.

Hospitals and skilled nursing facilities (SNFs) face increasing pressure to improve care coordination and reduce unnecessary readmissions. One strategy to accomplish this is to share physicians and...
Toxic Shock Syndrome

A previously healthy 14-year-old female presents to the primary care office with a one day history of profound weakness associated with high fever and rash. She needs assistance walking to the examination room. On further questioning, she also reports rigors, night sweats, and loose watery diarrhea in the last 24 hours. She appears acutely ill. Her temperature is 40.3°C, pulse 128 beats per minute, respiratory rate 24 per minute, and blood pressure of 78/50. You note generalized erythroderma with the appearance of a sunburn, bilateral bulbar conjunctivitis, and a strawberry tongue. Her precordium is hyperdynamic. She has bounding pulses. Arrangements are made for immediate emergency transportation to the nearest hospital. You explain to the patient and her mother that you suspect that she has developed toxic shock syndrome. When you ask if she is currently menstruating, the patient nods yes. When asked if she currently has a tampon in place, the patient again nods yes. You explain that it is urgent that she remove the tampon immediately, and she does so. A moment later, emergency medical technicians appear. As they prepare to transfer the patient to the hospital via ambulance, two large bore intravenous catheters are placed, and isotonic fluid is administered. On arrival to the hospital, the patient’s vital signs are unchanged. She remains hypotensive. Additional fluid resuscitation is given, blood and urine are collected for various diagnostic tests, and empiric antibiotic therapy is initiated with oxacillin, clindamycin, and vancomycin. Laboratory results reveal leukopenia, thrombocytopenia, elevated hepatic transaminases, elevated serum creatinine, and prolonged prothrombin time. She is admitted to the intensive care unit. Despite treatment with antibiotics and continuous, aggressive cardiovascular support, later the same night, she develops acute respiratory distress syndrome with respiratory failure requiring endotracheal intubation and mechanical ventilation. One day later, she appears quite edematous, but her rash has noticeably faded, and she is requiring much less cardiovascular support to maintain an acceptable blood pressure. On day 4 of hospitalization, she no longer requires additional cardiovascular support. The generalized edema is less evident, and her rash is gone. Laboratory test results are all improved. She is successfully extubated later in the day. Blood and urine cultures results are negative. She remains hospitalized to complete 10 days of treatment with oxacillin and vancomycin. The clindamycin is discontinued after 5 days. At hospital discharge, the patient notes her own lack of stamina for activities of daily living. When seen in follow-up 1 week later in the primary care provider’s office, her energy level had returned to normal.
Hurst-Exponent-Based Detection of High-Impedance DC Arc Events for 48-V Systems in Vehicles

Expanding dc electrical distribution systems require improved detection and mitigation of dc arc events. The high heat resulting from dc arcing raises concerns on equipment and personnel safety. In this article, a new adaptive detection method for series dc arc faults is presented. The proposed detection method utilizes Hurst exponent estimation of the system current to detect arcing events with a high detection rate and strong immunity against sudden load changes, chaotic load profiles, and switching harmonics. To verify the proposed detection method, a test setup to generate dc arcs was built, and over one thousand tests were performed under various conditions. The tests were conducted under different environment temperatures, air gap lengths, loads, and electrode diameters. The effectiveness of the proposed method is demonstrated by the test results and validated with an arc detector prototype.
Active hexose correlated compound restores the gene expression and protein secretion of protective cytokines of immune cells in a murine stress model during Chlamydia muridarum genital infection

Chlamydia trachomatis genital infection is the most common bacterial sexually transmitted disease worldwide. Previously we reported that cold-induced stress results in immune suppression of mice that subsequently leads to increased intensity of Chlamydia muridarum genital infection. Furthermore, we demonstrated that stressed mice orally fed with active hexose correlated compound (AHCC) have reduced shedding of C. muridarum from the genital tract. However, the mechanism of AHCC on reducing the organ load and changes in the immune response in the stress model is not well known. This study evaluated infection and changes in immunological parameters of stressed AHCC-fed mice with or without C. muridarum genital infection. We hypothesized that AHCC feeding to stressed mice restores the protective immune function and reduces susceptibility to C. muridarum genital infection. Results show that oral feeding of stressed mice with AHCC resulted in decreased shedding of C. muridarum from the genital tract, reduced production of plasma catecholamines, increased expression of T-bet and reduced GATA-3 in CD4+ T cells, increased production of IL-12 and IFN-γ, and reduced production of IL-4 in CD4+ T cells, and enhanced expression of surface markers and co-stimulatory molecules of CD4+ T cells, bone marrow-derived dendritic cells (BMDCs), and natural killer cells. Co-culturing of mature BMDCs with splenic CD4+ T cells led to the increased and decreased production of T-helper 1 and T-helper2 cytokines, respectively. Overall, our results show that AHCC fosters the restoration of Th1 cytokine production while reducing Th2 cytokine production, which would promote C. muridarum clearance in the murine stress model.
Hypermetabolic Thoracic Pathologies that Mimic Malignancy.

1119 Objectives: To present interesting clinical cases that illustrate 18F fluorodeoxyglucose (FDG) uptake in benign pathologies or physiologic conditions that can be commonly confused as malignancy on FDG PET /CT. The knowledge of these cases will help improve the ability of molecular imaging and radiology trainees and physicians to provide a more accurate interpretation and guide appropriate management of the patient. Methods: A total of 12 cases of FDG PET /CT performed at our institution are included that showed interesting FDG avid lesions within the thorax. The lesions were diagnosed to be either benign pathologies or termed physiologic. A chart review of the 12 patients was performed to follow-up on the clinical course of the pathologies and to ensure pathological diagnosis or other imaging modalities concurred with the FDG-PET/CT findings where ever applicable . All the patients underwent whole body (vertex to mid thighs) FDG-PET/CT scans using standard technique one-hour post injection. Results: FDG is taken up in cells undergoing any glucose metabolic process and therefore it is non-specific for a malignant process. Hence, knowledge of common differential diagnosis of FDG avid lesions and their imaging appearance is important to avoid false positive findings and unnecessary additional work-up. Our experience of hypermetabolic abnormalities in the thorax included findings within the lung parenchyma, pleura, mediastinum, axilla, pulmonary and mediastinal vasculature, cardiac, and breast. The findings were classified in eight categories as follows: acute pulmonary infection, granulomatous diseases, inhalation diseases, vascular pathology, post-surgical, post-oncologic therapies, breast pathologies, and physiologic. Selected interesting cases within each category are summarized in the table provided below with a representative example in a figure. Chart review demonstrated resolution of some benign pathologies with appropriate medical or surgical management in some cases. In some cases, the multimodality follow-up imaging demonstrated concordance. For example, a case of a hypermetabolic axillary deep vein thrombosis was confirmed with subsequent ultrasound imaging. Furthermore, in other cases laboratory/ pathology reports were in keeping with benign PET/CT findings. Conclusions: Non-specific FDG uptake in the glycolytic pathway presents a challenge to correctly decipher a benign versus malignant thoracic metabolic process. In order to arrive at an accurate diagnosis for benign hypermetabolic thoracic processes, understanding of the imaging appearance, anatomic location, and clinical history all play an important role.
Associations between social network characteristics and alcohol use alone or in combination with cannabis use in first-year college students.

Objective Simultaneous use of alcohol and cannabis is common among young adults, but little research has examined social ties and their relation to simultaneous use. This study investigated the social network characteristics of college students at two time points in the first year of college. Participants were categorized into those who used alcohol and cannabis, such that their effects overlap (simultaneous users), those who used both substances without overlapping effects (concurrent users), and those who used alcohol only. Method First-year college students (N = 1,294) completed online questionnaires during the fall and spring semester. At both assessments, participants nominated up to 10 important peers in their class, reported on peers' alcohol and cannabis use, and reported their own use of alcohol or cannabis with each peer. Results Concurrent and simultaneous users reported a greater proportion of drinking buddies than those who used alcohol only. A greater proportion of friends who used alcohol or cannabis, but not the proportion who were "drinking buddies" or "cannabis buddies," was associated with increased odds of simultaneous use relative to concurrent use. Participants nominated network ties that paralleled their own substance use (e.g., the majority of simultaneous users' networks ties were also simultaneous users). Conclusion Having a larger percentage of friends who use cannabis and alcohol is associated with increased odds of using both substances at the same time, perhaps because it gives access to both substances at the same time. Interventions should account for amount of exposure to alcohol and cannabis use from network members. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Short-term PM2.5 and cardiovascular admissions in NY State: assessing sensitivity to exposure model choice

Air pollution health studies have been increasingly using prediction models for exposure assessment even in areas without monitoring stations. To date, most studies have assumed that a single exposure model is correct, but estimated effects may be sensitive to the choice of exposure model. We obtained county-level daily cardiovascular (CVD) admissions from the New York (NY) Statewide Planning and Resources Cooperative System (SPARCS) and four sets of fine particulate matter (PM2.5) spatio-temporal predictions (2002–2012). We employed overdispersed Poisson models to investigate the relationship between daily PM2.5 and CVD, adjusting for potential confounders, separately for each state-wide PM2.5 dataset. For all PM2.5 datasets, we observed positive associations between PM2.5 and CVD. Across the modeled exposure estimates, effect estimates ranged from 0.23% (95%CI: -0.06, 0.53%) to 0.88% (95%CI: 0.68, 1.08%) per 10 µg/m3 increase in daily PM2.5. We observed the highest estimates using monitored concentrations 0.96% (95%CI: 0.62, 1.30%) for the subset of counties where these data were available. Effect estimates varied by a factor of almost four across methods to model exposures, likely due to varying degrees of exposure measurement error. Nonetheless, we observed a consistently harmful association between PM2.5 and CVD admissions, regardless of model choice.
Fermi Gamma-Ray Observatory-Science Highlights for the First 8 Months

This viewgraph presentation reviews the science highlights for the first 8 months of the Fermi Gamma-Ray Observatory. Results from pulsars, flaring AGN, gamma ray bursts, diffuse radiation, LMC and electron spectrum are also presented.
An Experiment with a Relational Data Base System in Environmental Research

The use of computers in environmental research presents a number of problems both to the ecologist and the systems analyst. An analysis of some of these problems led in the reported project to the development of a prototype data base system, founded on the relational concept. In this paper we discuss certain characteristics of environmental data and their use, we show how these characteristics were mapped onto requirements on the software tools, and we describe how the final system attempts to meet these requirements.
Ecosystemic Issues and Approaches

Kenneth Hardy’s tongue-in-cheek diagnostic category reflects postmodern and feminist concerns about labeling people for problems caused by socioeconomic forces or by the oppression of marginalized groups. It reflects a dialectic of individual or family vs. societal processes as explanations for psychopathology. Ecosystemic models examine the hierarchy of social forces that affect opportunities available for individuals and families. Uri Bronfenbrenner (1979) suggested a hierarchy of macrosystems to microsystems that mediate these influences, privileging White Anglo-Saxon Protestant (WASP) men, but oppressing less powerful groups. Bronfenbrenner’s model described the environment’s influence on children’s development. He recognized that individuals affect the environment as well and that these mutual effects continue throughout a person’s lifespan, the chronosystem.
A general continuous state task network formulation for short term scheduling of multipurpose batch plants with due dates

Abstract A new continuous-time MILP model for the short term scheduling of multipurpose batch plants with due dates is presented. The proposed model is a general State Task Network (STN) formulation that accounts for variable batch sizes and processing times, various storage policies (UIS/FIS/NIS/ZW), utility constraints (other than units), and allows for batch mixing and splitting. Its key features are: (a) a continuous, common for all units time partitioning, (b) assignment constraints are expressed using only the binary variables defined for tasks, (c) start times of tasks are eliminated, (d) a new class of tightening valid inequalities is added to the MILP formulation, and (e) a new disjunctive programming formulation is used for the matching of due dates with time points. The proposed model is more general than the previously reported models and is computationally efficient.
Panostotic Expansile Bone Disease With Massive Jaw Tumor Formation and a Novel Mutation in the Signal Peptide of RANK

Precise regulation of bone resorption is critical for skeletal homeostasis. We report a 32-year-old man with a panostotic expansile bone disease and a massive hemorrhagic mandibular tumor. Originally from Mexico, he was deaf at birth and became bow-legged during childhood. There was no family history of skeletal disease. Puberty occurred normally, but during adolescence he experienced difficulty straightening his limbs, sustained multiple fractures, and developed a bony tumor on his chin. By age 18 years, all limbs were misshapen. The mandibular mass grew and protruded from the oral cavity, extending to the level of the lower ribs. Other bony defects included a similar maxillary mass and serpentine limbs. Upon referral at age 27 years, biochemical studies showed serum alkaline phosphatase of 1760 U/L (Nl: 29-111) and other elevated bone turnover markers. Radiography of the limbs showed medullary expansion and cortical thinning with severe bowing. Although the jaw tumors were initially deemed inoperable, mandibular mass excision and staged partial maxillectomy were eventually performed. Tumor histopathology showed curvilinear trabeculae of woven bone on a background of hypocellular fibrous tissue. Fibrous dysplasia of bone was suspected, but there was no mutation in codon 201 of GNAS in samples from blood or tumor. His clinical and radiographic findings, elevated serum markers, and disorganized bone morphology suggested amplified receptor activator of NF-κB (RANK) signaling, even though his disorder differed from conditions with known constitutive activation of RANK signaling (eg, familial expansile osteolysis). We found a unique 12-base pair duplication in the signal peptide of TNFRSF11A, the gene that encodes RANK. No exon or splice site mutations were found in the genes encoding RANK ligand or osteoprotegerin. Alendronate followed by pamidronate therapies substantially decreased his serum alkaline phosphatase activity. This unique patient expands the phenotypes and genetic basis of the mendelian disorders of RANK signaling activation. © 2014 American Society for Bone and Mineral Research.