cssi/SciSciGPT-SciSciNet huggingface dataset:
Inclusion for toddlers with autism spectrum disorders: The first ten years of a community program

The present quasi-experimental study examines the outcomes for a group of 102 children diagnosed with an autism spectrum disorder at age 2 who attended an inclusive toddler program (described by Stahmer and Ingersoll, 2004) until age 3. Outcomes on standardized developmental assessments indicate significant improvement, with large effect sizes, in developmental level, adaptive behavior and communication. Thirty-one of the children (31%) were functioning in the typically developing range when they exited the program at age 3, after an average of 8 months of intervention. Predictors of positive outcomes included length of time in the program, level of words and gestures use at entry and higher externalizing and lower internalizing behavior CBCL scores at entry. Implications for serving toddlers with autism in inclusive settings and suggestions for future research directions are discussed.
Acute vincristine pretreatment protects adult mouse cardiac myocytes from oxidative stress

Vincristine is a chemotherapeutic agent that disrupts microtubules. We noted that paclitaxel (Taxol), which stabilizes microtubules, protected cultured adult mouse cardiac myocytes from oxidative stress induced by H(2)O(2). We hypothesized that vincristine, which disrupts microtubules, should have the opposite effect. To our surprise, we found that pretreatment with concentrations of vincristine ranging from 30 to 120 micromol/L for 60 min preserved myocyte viability and morphology after incubation with 30 micromol/L of H(2)O(2) for 35 min as measured by trypan blue exclusion. The cardioprotective effects of vincristine were also observed during prolonged hypoxia. With continuous exposure to vincristine, survival lasted for as long as 24 h, but longer periods of exposure up to 42 h resulted in extensive cell death. Despite microtubule disruption evidenced on deconvolution microscopy, vincristine activated a prosurvival pathway resulting in increased phosphorylation of Akt, ERK and GSK-3beta and in reduced cytochrome C release into the cytosol. Pharmacological inhibitors of Akt and Erk attenuated the cardioprotective effect of vincristine. We conclude that short-term pretreatment with vincristine exerts dramatic protective effects in cultured adult mouse myocytes subjected to acute oxidative stress. Despite causing microtubule disruption, vincristine initiates a prosurvival signaling pathway. As vincristine and doxorubicin are often used in conjunction to treat patients, it is possible that vincristine could be used to modify the cardiotoxicity of doxorubicin.
Words in the brain are not just labelled concepts

Pulvermuller assumes that words are represented as associations of two cell assemblies formed according to Hebb's coincidence rule. This seems to correspond to the linguistic notion that words consist of lexemes connected to lemmas. Standard examples from theoretical linguistics, however, show that lemmas and lexemes have properties that go beyond coincidence-based assemblies. In particular, they are inherently disposed toward combinatorial operations; push-down storage, modelled by decreasing reverberation in cell assemblies, cannot capture this. Hence, even if the language capacity has an associationist characterization at some level, it cannot just be co-occurrence-based assembly formation.
Tropomyosin 4 regulates adhesion structures and resorptive capacity in osteoclasts.

Tropomyosins (Tms) are α-helical dimers that bind and stabilize actin microfilaments while regulating their accessibility to other actin-associated proteins. Four genes encode expression of over forty Tms, most of which are expressed in nonmuscle cells. In recent years, it has become clear that individual Tm isoforms may regulate specific actin pools within cells. In this study, we examined how osteoclast function may be regulated by the tropomyosin isoform Tm-4, which we previously showed to be highly localized to podosomes and sealing zones of osteoclasts. RNAi-mediated knockdown of Tm-4, both in RAW264.7- and mouse marrow-derived osteoclasts, resulted in thinning of the actin ring of the sealing zone. Knockdown of Tm-4 also resulted in diminished bone resorptive capacity and altered resorption pit shape. In contrast, osteoclasts overexpressing Tm-4 demonstrated thickened podosomes on glass as well as thickened, aberrant actin structures on bone, and diminished motility and resorptive capacity. These results indicate that Tm-4 plays a role in regulating adhesion structures of osteoclasts, most likely by stabilizing the actin microfilaments present in podosomes and the sealing zone.
Amplitude Distribution of Calcium Sparks in Confocal Images: Theory and Studies with an Automatic Detection Method

Determination of the calcium spark amplitude distribution is of critical importance for understanding the nature of elementary calcium release events in striated muscle. In the present study we show, on general theoretical grounds, that calcium sparks, as observed in confocal line scan images, should have a nonmodal, monotonic decreasing amplitude distribution, regardless of whether the underlying events are stereotyped. To test this prediction we developed, implemented, and verified an automated computer algorithm for objective detection and measurement of calcium sparks in raw image data. When the sensitivity and reliability of the algorithm were set appropriately, we observed highly left-skewed or monotonic decreasing amplitude distributions in skeletal muscle cells and cardiomyocytes, confirming the theoretical predictions. The previously reported modal or Gaussian distributions of sparks detected by eye must therefore be the result of subjective detection bias against small amplitude events. In addition, we discuss possible situations when a modal distribution might be observed.
Randomized Controlled Trial of Intensive Versus Conservative Glucose Control in Patients Undergoing Coronary Artery Bypass Graft Surgery: GLUCO-CABG Trial

OBJECTIVE The optimal level of glycemic control needed to improve outcomes in cardiac surgery patients remains controversial. RESEARCH DESIGN AND METHODS We randomized patients with diabetes ( n = 152) and without diabetes with hyperglycemia ( n = 150) to an intensive glucose target of 100–140 mg/dL ( n = 151) or to a conservative target of 141–180 mg/dL ( n = 151) after coronary artery bypass surgery (CABG) surgery. After the intensive care unit (ICU), patients received a single treatment regimen in the hospital and 90 days postdischarge. Primary outcome was differences in a composite of complications, including mortality, wound infection, pneumonia, bacteremia, respiratory failure, acute kidney injury, and major cardiovascular events. RESULTS Mean glucose in the ICU was 132 ± 14 mg/dL (interquartile range [IQR] 124–139) in the intensive and 154 ± 17 mg/dL (IQR 142–164) in the conservative group ( P < 0.001). There were no significant differences in the composite of complications between intensive and conservative groups (42 vs. 52%, P = 0.08). We observed heterogeneity in treatment effect according to diabetes status, with no differences in complications among patients with diabetes treated with intensive or conservative regimens (49 vs. 48%, P = 0.87), but a significant lower rate of complications in patients without diabetes treated with intensive compared with conservative treatment regimen (34 vs. 55%, P = 0.008). CONCLUSIONS Intensive insulin therapy to target glucose of 100 and 140 mg/dL in the ICU did not significantly reduce perioperative complications compared with target glucose of 141 and 180 mg/dL after CABG surgery. Subgroup analysis showed a lower number of complications in patients without diabetes, but not in patients with diabetes treated with the intensive regimen. Large prospective randomized studies are needed to confirm these findings.
Bayes least squares linear estimation of densities

Linear, least squares statistical methods in which the "parameters" are interpreted as random variables were introduced by Whittle, and further developed by Hartigan and others. They are applied here to the problem of estimating the coefficients in an orthogonal expansion of a multivariate density, given a simple random sample.
On some aggregation operators for numerical information

In this chapter we review some of the aggregation operators that are appropriate for fusing numerical information. We focus on the ones that belong to Choquet and Sugeno integral families. This is, the ones that these integrals generalize. In particular, the review includes, among others, the following operators: arithmetic mean, weighted mean, OWA and WOWA operators, weighted minimum and weighted maximum, Sugeno and Choquet integral.
Ovarian carcinoma spheroids disaggregate on type I collagen and invade live human mesothelial cell monolayers

Ovarian carcinoma patients frequently develop malignant ascites containing single and aggregated tumor cells, or spheroids. Spheroids have been shown to be resistant to many therapies, but their contribution to ovarian cancer dissemination remains undetermined. We have previously shown that ascites spheroids adhere to extracellular matrix (ECM) proteins and live human mesothelial cells via β1 integrin subunits. Here, we assessed the ability of spheroids that were generated from the human ovarian carcinoma cell line NIH: OVCAR5 to disseminate and invade in vitro. Spheroids were seeded on ECM proteins for 24 h. While laminin and type IV collagen stimulated some cell migration, spheroids completely disaggregated on type I collagen substrates. A monoclonal antibody against the β1 integrin subunit significantly inhibited disaggregation on all proteins tested. To test their invasive ability, spheroids were added to monolayers of live human LP9 mesothelial cells. Within 24 h, the spheroids adhered and disaggregated on top of the monolayers, and within a week had established foci of invasion encompassing a 200-fold larger surface area. Addition of a monoclonal antibody against the β1 integrin subunit drastically reduced spheroid invasion into the mesothelial cell monolayers. GM 6001, a broad-scale matrix metalloproteinase inhibitor, also significantly blocked spheroid invasion into the mesothelial cell monolayers. ɛ-amino-N-caproic acid, a serine protease inhibitor, partially inhibited spheroid invasion. Based on their ability to attach to, disaggregate on, and invade into live human mesothelial cell monolayers, spheroids should thus be regarded as potential contributors to the dissemination of ovarian cancer.
Nursing intervention to increase the duration of breastfeeding.

T HE U.S. DEPARTMENT OF HEALTH and Human Services (1994) published the Healthy People 2000 guidelines as a statement of national concerns regarding health in the U.S. One Healthy People 2000 objective is to increase the percentage of women who continue to breastfeed for the first 6 months of their infant's life. The American Academy of Pediatrics recommends that women breastfeed their infant's for the first year of life (Gartner, 1997). An intervention that increases the duration of breastfeeding in low-income women offers health benefits to mothers and babies (Krebs & Murtaugh, 1997). The benefits of breastfeeding are well established. Women who breastfeed are less likely to develop osteoporosis and some forms of cancer (Cummings, Kelsey, & Nevitt, 1985; Michels et al., 1996; Schneider, 1987). Furthermore, breastfeeding is empowering for low-income minority women (Locklin & Naber, 1993). Infants who are breastfed for at least 4 months are less likely to die of sudden
Institutionalizing Neutrally Competent Policy Analysis: Resources for Promoting Objectivity and Balance in Consolidating Democracies

Creating institutions that foster the production of objective and balanced policy analysis is a challenging task for all types of regimes. The value of neutral competence often suffers in tradeoffs with the value of responsiveness, especially in the exercise of executive authority. Institutional designers, however, are not without resources for structuring arrangements to promote the production of objective and balanced policy analysis: organizations can be created with an incentive to achieve “reputations” for neutral competence; organizations can be isolated from being too politically responsive through forms of “independence”; for promoting interaction based on “professional norms” can be created to resolve conflicts about prediction; “participation in international organizations” can be leveraged to counteract domestic biases; and “transparency” can be employed to facilitate balancing of views or to shame severe abuses. This essay sets out the logic underlying design with these sorts of institutional resources, illustrates their use primarily in the U.S. context, and speculates on their application in consolidating democracies.
A preliminary study of the baboon prostate pathophysiology.

BACKGROUND Prostate cancer, benign prostatic hyperplasia, and prostatitis frequently affect men worldwide. At present there are no suitable animal models for these diseases. This study explores the potential use of the baboon as a model for prostatic diseases. METHODS Prostates of 48 baboons of different ages were studied. Prostate specific antigen (PSA) and alpha-methyl-acyl-CoA racemase (AMACR) were localized in the different lobes of the prostate by Western blotting and immunohistochemistry. PSA in baboon serum was demonstrated by radioimmunoassay and western blotting. Baboon AMACR cDNA was cloned and its expression assayed in baboon tissues. RESULTS The baboon prostate is anatomically and histologically similar to its human counterpart, with cranial and caudal lobes corresponding to central and peripheral zones of the human prostate. We found lymphocytic infiltration (91%), and sclerosing/atrophic lesions (34%). PSA tissue immunostaining intensity and alpha-methyl-acyl-CoA racemase (AMACR) gene expression levels differed between the cranial and caudal lobes of the prostate. The cloned baboon AMACR cDNA showed 96% homology with its human counterpart. Anti-human AMACR, PSA and basal keratin antibodies stained intracellular and basement membrane structures in the baboon prostate. The sclerosing/atrophic lesions were comparable to their human counterparts. CONCLUSIONS The similarity of baboon prostate to its human counterpart and the fact that human antibodies (AMACR, PSA, basal keratin) are reactive to baboon prostatic proteins indicates that the baboon is a promising model for human prostatic diseases. Prostate 67: 1421–1431, 2007. © 2007 Wiley-Liss, Inc.
Stochastic Dynamics of Plant-Water Interactions

Describing water flow from soil through plants to the atmosphere remains a formidable scientific challenge despite years of research. This challenge is not surprising given the high dimensionality and degree of nonlinearity of the soil-plant system, which evolves in space and time according to complex internal physical, chemical, and biological laws forced by external hydroclimatic variability. Although rigorous microscopic laws for this system still await development, some progress can be made on the formulation of macroscopic laws that upscale known submacroscopic processes and use surrogate stochasticity to preserve the probabilistic and spectral information content of the high dimensional system. The external hydroclimatic forcing is inherently intermittent with variability across all scales, thereby precluding the use of standard approximations employed in analysis of stochastic processes (e.g., small noise perturbations). Examples are provided to show how superposition of stochasticity at multiple s...
Rapid ventricular response.

Scenario: A 72-year-old female who had quadruple coronary artery bypass surgery 1 year earlier suddenly awoke at home with nausea and felt her heart racing. She took a nitroglycerine tablet because she thought she was having “heart problems,” then suddenly she felt faint. She called 911. Following is the 12-lead ECG obtained in the ambulance. The patient’s blood pressure was 70/40 mm Hg. A regular feature of the American Journal of Critical Care, the ECG Puzzler addresses electrocardiogram (ECG) interpretation for clinical practice. To send an eLetter or to contribute to an online discussion about this article, visit www.ajcconline.org and click “Respond to This Article” on either the full-text or PDF view of the article. We welcome letters regarding this feature.
Gender-Based Differences Of Partners In CPA Firms: Evidence From Kentucky

This paper investigates whether a relationship exists between situation-centered factors and the holding of partner status in a public accounting firm, and to determine if gender differences exist in the relationship between these variables. From a sample of 1227 Kentucky public accountants, it was found that the population of a county, number of other partners and associates in a firm, and years of experience are significantly related to the holding of partner status. However, women are less likely to be a partner in a firm with a larger number of associates and population does not appear to influence a womans chances of being a partner. The authors discuss the implications of these findings for practicing public accountants and provide suggestions for future research.
Retroactive Recognition of Same-Sex Marriage for the Purposes of the Confidential Marital Communication Privilege

The Supreme Court's decision in Obergefell v. Hodges opened the door to same-sex couples to receive recognition of their marriages going forward. But the question remains: what of the couples that would have been married Pre-Obergefell but for now-unconstitutional laws? This Note focuses on one right that cannot be remedied by prospective marriage recognition: the confidential marital communication privilege in evidentiary law. Arguing by analogy to common-law marriage, this Note argues that same-sex marriages should be retroactively recognized so that the promise of liberty enshrined in Obergefell is fully realized.
What Would You Do if It Were Your Kid

When patients or family members ask us what we'd do if the patient were our relative, how do we balance our professional judgment with personal judgments? And what if what we're recommending is different from what we would do for our own child or spouse?
Barriers to Asthma Management as Identified by School Nurses

Asthma rates are increasing in children. School nurses have opportunities to care for children with asthma but need to overcome barriers impacting their ability to manage asthma in the school setting. This study (a) assessed barriers present in the school setting, (b) determined the impact of barriers on performance of asthma management behaviors, and (c) determined the impact of barriers on importance ratings of asthma management behaviors, asthma self-efficacy, and asthma attitudes (N = 537). Results revealed 72% of the nurses reported at least one barrier. As numbers of barriers increased, performance of asthma management behaviors decreased. Significant relationships were found between specific asthma management behaviors and specific barriers. No significant relationships were found between barriers and asthma self-efficacy, asthma attitude, or importance ratings of asthma management behaviors. Removing barriers may allow the nurse to perform at greatest effectiveness, enhancing the positive outcomes that result from appropriate asthma management.
Isolating Enteropathogenic E.coli from Clinical Pneumonia in Dead Tree Shrews

Objective To isolate,culture and identify the pathogenic bacterium from 6 cases of bacterial pneumonia within 1 month in tree shrews.Methods We Dissected the dead tree shrew,cut open the lung tissue with sterile blade to insert focus of infection in the lung with inoculating loop to get samples for inoculating on nutrient agar and another two samples for bacterial smear with Gram staining and acid-fast staining.The bacterium obtained was isolated and cultivated for bacterial growth observation,then the pathogenic bacterium of tree shrew and its antibiotic susceptibilities was initially identified by Gram staining,acid-fast staining,oxidase test,biochemistrical encoding identification system and 9-kind antibiotic susceptibility test.Results A amount of negative bacteria were observed from samples with Gram staining.Acid-fast staining appears it was nontuberculous mycobacterium about size 0.2 μm×2~6 μm.Only 1 strain strong bacterium was observed in every 6 case on nutrient agar plate,it was verified as Gram-negative bacterium and nontuberculous mycobacterium,its size and staining results were the same as samples.It was identified as enteropathogenic E.coli.Antibiotic susceptibility test shows it is highly susceptibility to cefoperazone,furantoin,ampicillin,amikacin,ofloxacin,norfloxacin,sulfonamide methoxybenzyldine and low susceptibility to gentamicin and penicilin.Conclusion We conclude that Bacterial pneumonia is the cause of these 6 tree shrew death cases,the enteropathogenic E.coli.was initially identified as the reason.Drugs selected by antibiotic susceptibility could instruct clinical treatment like these cases in tree shrews.
Effects of Highly Active Antiretroviral Therapy for Children infected with AIDS

Objective To identify and analyze treatment effect of the highly active antiretroviral therapy(HARRT) for children through following-up AIDS children observation so as to provide evidence for standardized treatment and management of AIDS children.Methods Needed AIDS children were provided HAART therapy with regular clinical and laboratory follow-ups.Results Among the 40 AIDS children with HAART in Anhui province,the rate of medical compliance was more than 95% during the first 9 months.Child growth indicators-height and weight were better at the 6th month than the 3rd month after HAART(P0.05);both were better at the 3rd and 6th month than the baseline(P0.05).There were 5 cases (17.9%) with persistent and intermittent fever at 6th month and the rates of having other symptoms and signs were all less than 10%.There was 1 case of cerebropathia(5%) and there were no other serious opportunistic infections.CD4 lymphocyte count increased from 103.73 103.89pc/ul at baseline to 536.60 344.63 pc/ul at the 12th month(F=8.137,P0.05).CD4 count increased about 100 every 3 months of HAART.The rate of HIV virus load suppressed(VL10000 Copies/ml) was 50%~80% after 6 months treatment.Conclusion The medical compliance rate was high among AIDS children with HAART in Anhui and the treatment effectiveness was obvious in terms of child growth,clinical,immunological and virological indicators.
Evolving health services administration education: keeping pace with change.

Virginia Commonwealth University (VCU) celebrated its golden anniversary in 1999. It was an occasion for faculty and alumni to renew memories of their experiences together and marvel at the dramatic changes they have seen in the health care industry. This qualitative study was undertaken to reflect on the department's immediate future course, and to learn how to reposition the education program and curricula to respond to evolving industry needs and demands. Results and conclusions are based on interviews conducted with several stake-holder groups, including VCU alumni, who are executives in the health sector; human resources recruitment officers; and selected program directors from leading health administration (HA) education programs in the U.S. Trends are identified in the health care industry environment, and strategies are proposed for the HA education programs to strategically adapt for the future.
Billing and Coding for Procedures

Procedures are a mainstay of critical care physician assistant and nurse practitioner duties. Despite this, billing and coding for procedures remains poorly understood by both providers and administration. The key to accurate billing is proper CPT code selection and adequate documentation.
A Low Cost Structurally Optimized Design for Diverse Filter Types

A wide range of image processing applications deploys two dimensional (2D)-filters for performing diversified tasks such as image enhancement, edge detection, noise suppression, multi scale decomposition and compression etc. All of these tasks require multiple type of 2D-filters simultaneously to acquire the desired results. The resource hungry conventional approach is not a viable option for implementing these computationally intensive 2D-filters especially in a resource constraint environment. Thus it calls for optimized solutions. Mostly the optimization of these filters are based on exploiting structural properties. A common shortcoming of all previously reported optimized approaches is their restricted applicability only for a specific filter type. These narrow scoped solutions completely disregard the versatility attribute of advanced image processing applications and in turn offset their effectiveness while implementing a complete application. This paper presents an efficient framework which exploits the structural properties of 2D-filters for effectually reducing its computational cost along with an added advantage of versatility for supporting diverse filter types. A composite symmetric filter structure is introduced which exploits the identities of quadrant and circular T-symmetries in two distinct filter regions simultaneously. These T-symmetries effectually reduce the number of filter coefficients and consequently its multipliers count. The proposed framework at the same time empowers this composite filter structure with additional capabilities of realizing all of its Ψ-symmetry based subtypes and also its special asymmetric filters case. The two-fold optimized framework thus reduces filter computational cost up to 75% as compared to the conventional approach as well as its versatility attribute not only supports diverse filter types but also offers further cost reduction via resource sharing for sequential implementation of diversified image processing applications especially in a constraint environment.
Immune Reconstitution after Allogeneic Hematopoietic Stem Cell Transplantation: Time To T Up the Thymus

The success of allogeneic hematopoietic stem cell transplantation, a key treatment for many disorders, is intertwined with T cell immune reconstitution. The thymus plays a key role post allogeneic hematopoietic stem cell transplantation in the generation of a broad but self-tolerant T cell repertoire, but it is exquisitely sensitive to a range of insults during the transplant period, including conditioning regimens, corticosteroids, infections, and graft-versus-host disease. Although endogenous thymic repair is possible it is often suboptimal, and there is a need to develop exogenous strategies to help regenerate the thymus. Therapies currently in clinical trials in the transplant setting include keratinocyte growth factor, cytokines (IL-7 and IL-22), and hormonal modulation including sex steroid inhibition and growth hormone administration. Such regenerative strategies may ultimately enable the thymus to play as prominent a role after transplant as it once did in early childhood, allowing a more complete restoration of the T cell compartment.
Oxidative dissolution under the channel leads geomorphological evolution at the Shale Hills catchment

The hydrologic connectivity between hillslopes and streams impacts the geomorphological evolution of catchments. Here, we propose a conceptual model for hydrogeomorphological evolution of the Susquehanna Shale Hills Critical Zone Observatory (SSHCZO), a first-order catchment developed on shale in central Pennsylvania, U.S.A. At SSHCZO, the majority of available water (the difference between incoming meteoric water and outgoing evapotranspiration) flows laterally to the catchment outlet as interflow, while the rest is transported by regional groundwater flow. Interflow, shallow hillslope flow, is limited to the upper 5 to 8 m of highly fractured bedrock, thought to have formed during periglacial conditions in the late Pleistocene. In contrast, groundwater flowpaths are influenced by the primary permeability of the varying stratigraphic units. Both flowpaths respond to weathering-related secondary permeability. O2-rich interflow mixes with deep O2-poor groundwater under the catchment outlet at depths of 5–8 m. Penetration of this oxygenated interflow under the valley results in pyrite oxidation, release of sulfuric acid, dissolution of minerals, and weakening of bedrock. This is hypothesized to enhance channel incision and, in turn, to promote drainage of deep groundwater from the ridges. Drainage subsequently lowers the catchment water table, advancing the cascade of reactions that produce regolith. Weathering in the catchment is characterized by both sharp and diffuse reaction fronts. Relatively sharp fronts (pyrite, carbonate) mark where vertical, unsaturated flow changes to horizontal, saturated flow, while diffuse fronts (illite, chlorite, feldspar) mark where flow is largely vertical and unsaturated. According to this model, catchment morphology reflects subsurface pyrite reactions due to mixing of interflow and groundwater flow under the valley floor that ultimately results in clay weathering and regolith production nearer the land surface.
VIRAL ETIOLOGY OF LEUKEMIA AND LYMPHOMAS.

CONSIDERABLE PROGRESS has been accomplished during the past 15 years in the study of the nature of leukemia. It seems more and more apparent that the various forms of leukemia and lymphomas, not only in chickens, mice, rats, and other animal species, but also in humans, are caused by filterable and transmissible viruses.
Short-term and family-reported long-term outcomes of simple versus complicated gastroschisis.

Abstract Background Our goal is to determine short- and long-term outcomes of simple gastroschisis (SG) and complicated gastroschisis (CG) patients including quality of life (QoL) measures, surgical reoperation rates, and residual gastrointestinal symptom burden. Materials and methods Retrospective chart review of patients who underwent surgical repair of gastroschisis between January 1, 2009, and December 31, 2012, was performed at a quaternary children's hospital. Parent telephone surveys were conducted to collect information on subsequent operations and current health status as well as to assess QoL using two validated tools. Results Of 143 patients identified, 45 (31.5%) were reached and agreed to participate with a median follow-up age of 4.7 y. Although CG was associated with short-term outcomes such as longer length of stay, longer days to feeds, and higher complication rates, there were no major differences in long-term QoL outcomes when comparing SG and CG. Children with CG experienced abdominal pain/gas/diarrhea more often than those with SG and required more major abdominal procedures than those with SG (15% versus 0%, P = 0.009). Conclusions Despite worse short-term outcomes, presence of certain gastrointestinal symptoms, and need for more surgical interventions for patients with CG, and overall QoL scores were reassuringly similar to those with SG.
Rapid Urine Dilution to Improve Pelvic Imaging in Bone Scanning

A significant reduction in the contribution of bladder radioactivity to total counts seen on the anterior pelvic view of a bone scintiscan can be effected by the administration of 16 to 32 oz of water given immediately after the initial series of bone images (3 hr delayed) with a repeat pelvic spot view immediately thereafter. A mean reduction of bladder radioactivity from 29% of total pelvic counts to 7.5% was facilitated using this modification of our routine bone imaging protocol. This simple, rapid dilution technique improved image quality in each of a total of 11 arbitrarily selected patients evaluated by bone scintigraphy, without increasing total scan time or resulting in any adverse or untoward effects.
Visual Target Acquisition

The process of searching the display of an electro-optical imaging system for a target consists of four interrelated processes: detection, classification, recognition, and identification. Detection is the discrimination of an object from its background and its assignment to the class of potentially interesting objects. Classification is the assignment of the detected object to a gross class of objects such as vehicles or combatant vessels. Recognition is the assignment of the classified object to a specific subclass such as tanks or destroyers. Identification is the assignment of the recognized object to an even more specific category such as M-60 tanks or Spruance class destroyers.
Optical Coherence Tomography as a Biomarker in Clinical Trials for Ophthalmology and Neurology

In the past, clinical trials in neuro-ophthalmology have focused upon functional endpoints including Snellen visual acuity and visual field testing, both of which may have significant test/retest variability because of their dependence upon subject alertness and cognitive function. The introduction of optical coherence tomography (OCT) into the practice of clinical ophthalmology has now extended into clinical trials in both ophthalmology and neurology. Recent advances in the resolution and reproducibility of spectral-domain OCT have now produced algorithms that measure the structural integrity of the optic nerve and retina. OCT is in vivo histopathology and the qualitative and quantitative metrics of this painless, noninvasive, non-contact technology can now be correlated with traditional functional measurements to provide a complete longitudinal profile of the afferent visual system for clinical trials.
Subtypes of constipation: sorting out the confusion.

Abstract In patients with chronic constipation, identifying subtypes based on underlying physiology guides subsequent therapeutic choices. Chronic constipation subtypes include slow-transit constipation, pelvic floor dyssynergia, functional constipation, and irritable bowel syndrome with constipation. Chronic constipation subtypes are defined by the result of colonic transit, pelvic floor function, and the presence or absence of significant abdominal pain. Although a variety of tests are available, the most straightforward approach uses the 5-day colonic marker test of transit and anorectal manometry with balloon expulsion testing to evaluate for pelvic floor dysfunction. Patients with normal physiologic tests have either irritable bowel syndrome with constipation or normal-transit constipation. Significant overlap exists between subtypes and a clear distinction is not always possible, with up to a 50% overlap between patients with slow-transit constipation and irritable bowel syndrome, approximately 10% of patients evaluated exhibiting both slow transit and pelvic floor dyssynergia, and 50% of patients with pelvic floor dyssynergia also found to have slow transit. Symptom severity assessment provides the rationale for pursuing further testing and directing the aggressiveness of treatment as patients with greater symptom severity have reduced quality of life and poor physical functioning scores. Few constipation-specific validated measures exist for measuring symptom severity in chronic constipation. In clinical practice severity may be defined as mild symptoms having minimal impact upon daily activities or moderate to severe symptoms that increasingly interfere with daily life.
Lesbian, Gay, And Bisexual Adults Report Continued Problems Affording Care Despite Coverage Gains

The uninsurance rate among lesbian, gay, and bisexual (LGB) adults has dropped since the Affordable Care Act (ACA) and legalization of same-sex marriage. Less is known about whether disparities in ...
Off the grid but on the radar: disconnected celebrity in Alaskan subsistence television

Alaska-based reality shows have constituted a sizeable presence of late, with dozens of unscripted series debuting since 2010. Set against the bulk of this programming, The Last Alaskans promises a...
Modeling and sensitivity analysis methodology for hybrid dynamical system

Abstract This paper provides a complete mathematical framework to compute the sensitivities with respect to system parameters for any second order hybrid Ordinary Differential Equation (ODE) and ranked 1 and 3 Differential Algebraic Equation (DAE) system. The hybrid system is characterized by discontinuities in the velocity state variables due to an impulsive forces at the time of event. Such system may also exhibit at the time of event a change in the equation of motions, or in the kinematic constraints. The methodology and the tools developed in this study compute the sensitivities of the states of the model and of the general cost functionals with respect to model parameters for both, unconstrained and constrained, hybrid mechanical systems. The analytical methodology that solves this problem is structured based on jumping conditions for both, the velocity state variables and the sensitivities matrix. The proposed analytical approach is then benchmarked against a known numerical method. Finally, this study emphasizes the penalty formulation for modeling constrained mechanical systems since this formalism has the advantage that it incorporates the kinematic constraints inside the equation of motion, thus easing the numerical integration, works well with redundant constraints, and avoids kinematic bifurcations.
Paramagnetic Fluorinated Nanoemulsions for in vivo F-19 MRI

We aim to develop perfluorocarbon-based nanoemulsions with improved sensitivity for detection of inflammatory macrophages in situ using F-19 MRI. Towards this goal, we evaluate the feasibility of nanoemulsion formulation incorporating a metal chelate in the fluorous phase which shortens the F-19 longitudinal relaxation rate and image acquisition time. Perfluorinated linear polymers were conjugated to metal-binding tris-diketonate, blended with unconjugated polymers, and emulsified in water. Phospholipid-based surfactant was used to stabilize nanoemulsion and provide biocompatibility. Nanoemulsions were metalated with the addition of ferric salt to the buffer. Physical stability of surfactant and nanoemulsion was evaluated by mass spectrometry and dynamic light scattering measurements. Nanoemulsions were injected intravenously into a murine granuloma inflammation model, and in vivo19F/1H MRI at 11.7 T was performed. We demonstrated stability and biocompatibility of lipid-based paramagnetic nanoemulsions. We investigated potential oxidation of lipid in the presence of metal chelate. As a proof of concept, we performed non-invasive monitoring of macrophage burden in a murine inflammation model following intravenous injection of nanoemulsion using in vivo F-19 MRI. Lipid-based nanoemulsion probes of perfluorocarbon synthesized with iron-binding fluorinated β-diketones can be formulated for intravenous delivery and inflammation detection in vivo.
Pediatric hematology and oncology fellow education in sexual and reproductive health: A survey of fellowship program directors in the United States.

PURPOSE Pediatric oncology clinicians identify a need for increased sexual and reproductive health (SRH) education with adolescent and young adult (AYA) cancer patients. By surveying pediatric oncology fellowship directors, this study clarifies the state of current fellowship education about SRH for the AYA patient. METHODS A survey was sent to all pediatric oncology fellowship program directors (PDs) in the United States consisting of 13 questions pertaining to three primary SRH domains: sexual health, fertility, and safe sex practices. Descriptive statistics and χ2 were used in data analyses. RESULTS Sixty-three PDs responded to the survey (91% response rate). Of these, 88% reported having formal instruction regarding fertility, 41% reported curriculum regarding contraception and 30% reported some education regarding sexual health. The curriculum "being too full" was identified as a barrier to education on fertility (29%), sexual health (40%), and safe sex practices (38%). Not being a required or expected part of the program was more likely to be endorsed as a barrier for sexual health (26%) and safe sex practices (30%) compared with fertility (8%) (P < 0.005). Lack of experts to teach was a more frequently endorsed barrier to education on sexual health (47%) compared with either fertility (23%) or safe sex practices (25%) (P < 0.005). CONCLUSIONS This study identifies important gaps in oncology fellow education about SRH. Future research must explore optimal education strategies that are feasible and acceptable by PDs and fellow learners, and effective in optimizing AYA SRH care.
Competitive Enrollment Policies in Computing Departments Negatively Predict First-Year Students' Sense of Belonging, Self-Efficacy, and Perception of Department

Enrollment in computing at the college level has skyrocketed, and many institutions have responded by enacting competitive enrollment processes. However, little is known about the effects of enrollment policies on students' experiences. To identify relationships between those policies and students' experiences, we linked survey data from 1245 first-year students in 80 CS departments to a dataset of department policies. We found that competitive enrollment negatively predicts first-year students' perception of the computing department as welcoming, their sense of belonging, and their self-efficacy in computing. Both belonging and self-efficacy are known predictors of student retention in CS. In addition, these relationships are stronger for students without pre-college computing experience. Our classification of institutions as competitive is conservative, and false positives are likely. This biases our results and suggests that the negative relationships we found are an underestimation of the effects of competitive enrollment.
The use of group text messaging to enhance social support of social work students

The use of technology in higher education, including that related to social work, has received considerable attention in the literature in recent years. Much of this focus has been on enhancing lea...
CLINICAL PRACTICE. Polycystic Ovary Syndrome.

A 22-year-old woman reports having hirsutism and irregular menses. She describes unpredictable and infrequent menses (five or six per year) since menarche at 11 years of age. Dark, coarse facial hair began to develop at 13 years of age. The symptoms worsened after she gained weight in college. The physical examination includes a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 29, blood pressure of 135/85 mm Hg, and moderate hirsutism without virilization. Laboratory tests reveal a total testosterone level of 65 ng per deciliter (2.3 nmol per liter) (assay reference range, 14 to 53 ng per deciliter [0.5 to 1.8 nmol per liter]), calculated free testosterone level of 15.3 pg per milliliter (53.1 pmol per liter) (assay reference range, 0.6 to 6.8 pg per milliliter [2.1 to 23.6 pmol per liter]), and glycated hemoglobin level of 5.7% (normal value, ≤5.6%). How should this case be evaluated and managed?
Brown watersnakes (Nerodia taxispilota) as bioindicators of mercury contamination in a riverine system.

Mercury (Hg) is a contaminant that enters the environment through natural or anthropogenic means. Ecological risk assessments have examined Hg bioaccumulation and effects in many taxa, but little is known about Hg dynamics in reptiles, or their potential use as bioindicator species for monitoring Hg in aquatic systems. Numerous snake species, like North American watersnakes (Nerodia spp.), are piscivorous and are exposed to Hg through their diet. The purpose of this study was to identify factors associated with Hg accumulation in a common watersnake species and compare Hg concentrations of the snakes to those in fish occupying the same habitats. To this end, we sampled brown watersnakes (Nerodia taxispilota) from the Savannah River, a major river system in the southeastern U.S., and compared N. taxispilota Hg accumulation trends to those of bass (Micropterus salmoides), catfish (Ictalurus and Ameiurus spp.), and panfish (Lepomis and Pomoxis spp.) collected from the same reach. Total Hg (THg) in N. taxispilota tail tips ranged from 0.020 to 0.431 mg/kg (wet weight; mean: 0.104 ± 0.008). Snake tail THg was significantly correlated with blood THg, which ranged from 0.003 to 1.140 mg/kg (0.154 ± 0.019). Snake size and site of capture were significantly associated with tail THg. Snake tail THg increased at sites along and downstream of the area of historic Hg pollution, consistent with fish THg. Snake muscle THg was predicted based on tail THg and ranged from 0.095 to 1.160 (0.352 ± 0.022). To gauge Hg biomagnification in N. taxispilota, we compared predicted snake muscle THg concentrations to THg in fish of consumable size. Average biomagnification factors for THg in N. taxispilota were 3.1 (panfish) and 5.4 (catfish), demonstrating N. taxispilota likely biomagnify Hg through their diet. These results reveal N. taxispilota to be an effective bioindicator species for monitoring Hg in aquatic environments.
An explainable machine learning platform for pyrazinamide resistance prediction and genetic feature identification of Mycobacterium tuberculosis.

Objective Tuberculosis is the leading cause of death from a single infectious agent. The emergence of antimicrobial resistant Mycobacterium tuberculosis strains makes the problem more severe. Pyrazinamide (PZA) is an important component for short-course treatment regimens and first- and second-line treatment regimens. This research aims for fast diagnosis of M. tuberculosis resistance to PZA and identification of genetic features causing resistance. Materials and methods We use clinically collected genomic data of M. tuberculosis that are resistant or susceptible to PZA. A machine learning platform is built to diagnose PZA resistance using the whole genome sequence data, and to identify resistance genes and mutations. The platform consists of a deep convolutional neural network (DCNN) model for resistance diagnosis and a support vector machine (SVM) model as a surrogate to identify resistance genes and mutations. Results The DCNN model achieves a PZA resistance diagnosis accuracy of 93%. Each prediction takes less than a second. The SVM has revealed 2 novel genes, embB and gyrA, besides the well-known pncA gene, and 9 mutations that harbor PZA resistance. Discussion The DCNN and SVM machine learning platform, if used together with the real-time genome sequencing machines, could allow for rapid PZA diagnosis, allowing for critical time to ensure good patient outcomes, and preventing outbreaks of deadly infections. Furthermore, identifying pertinent resistance genes and mutations will help researchers better understand the biological mechanisms behind resistance. Conclusions Machine learning can be used to achieve high-accuracy resistance prediction, and identify genes and mutations causing the resistance.
Symptoms of bipolar disorder are associated with lower bariatric surgery completion rates and higher food addiction.

Abstract Background Bipolar disorder (BP) is highly comorbid with obesity, however, little is known about how BP might be associated with bariatric surgery outcomes. Methods In this retrospective clinical cohort study, 1034 patients completed a psychological evaluation, and screening positive for possible BP was defined as a score ≥7 and moderate disability on the Mood Disorders Questionnaire. Food addiction (FA), subthreshold binge eating disorder (BED), and illegal drug use were also assessed using standardized questionnaires. Results The 54 (5.2%) patients screening positive for BP were less likely to have bariatric surgery compared to 980 (94.8%) patients who screened negative for BP (5 patients or 9.3% vs 273 patients, or 27.9%). Patients with possible BP also had significantly higher prevalence of FA (37% vs 13.2%), subthreshold BED (29.6% vs 8.3%) and illegal drug use (7.4% vs 2.1%). Conclusions In this retrospective clinical cohort study, patients who screened positive for BP had a higher prevalence of food addiction, subthreshold binge eating disorder and recent illegal drug use. They also demonstrated lower completion rates for having bariatric surgery. Clearly, more needs to be learned about how to help patients with symptoms of bipolar disorder manage their obesity and behavioral challenges.