cssi/SciSciGPT-SciSciNet huggingface dataset:
Childhood family living arrangements and blood pressure in black men: the Howard University Family Study.

Black men have higher blood pressure (BP) levels and consequently higher prevalence of hypertension compared with men from other ethnic groups in the United States. Socio-familial factors in childhood have been found to play an important role in hypertension, but few studies have examined this relationship among black men. We investigated whether childhood family living arrangements are independently associated with mean BP and hypertension in a cross-sectional sample of 515 unrelated black male participants aged ≥20 years enrolled in the Howard University Family Study between 2001 and 2008. Black men who lived with both parents compared with the reference group of men who never lived with both parents during their lifetime had lower systolic BP (−4.4 mm Hg [95% confidence interval {CI}, −7.84 to −0.96]), pulse pressure (−3.9 mm Hg [95% CI, −6.28 to −1.51]), and mean arterial BP (−2.0 mm Hg [95% CI, −4.44 to 0.51]). This protective effect was more pronounced among men who lived with both parents for 1 to 12 years of their lives; they had decreased systolic BP (−6.5 mm Hg [95% CI, −10.99 to −1.95]), pulse pressure (−5.4 mm Hg [95% CI, −8.48 to −2.28]), mean arterial pressure (−3.3 mm Hg [95% CI, −6.56 to 0.00]), and a 46% decreased odds of developing hypertension (odds ratio=0.54; 95% CI, 0.30 to 0.99). No statistically significant associations were found for diastolic BP. These results provide preliminary evidence that childhood family structure exerts a long-term influence on BP among black men.
The Effects of Coupling it and Work Process Strategies in Redesign Projects

Organizational adaptation to competition often means inventing or adopting a process innovation and the daunting challenge of implementing it. Increasingly, process innovations rely on the capabilities embedded in an organization's IT infrastructure. Successfully implementing an IT-enabled process innovation depends largely on how a project's IT and work process designs fit and evolve with this IT infrastructure. However, little empirical research guides the formulation of IT and work process strategies. This study addresses the question: How does the degree of coupling between a redesign project's IT strategy and work process strategy affect project performance? Data collection utilized a multistage research design employing comprehensive phone interviews and matched surveys among three sets of respondents (project managers, IT managers, and process users) across 43 process redesign projects in the health care industry. Our findings indicate project performance improves with tightly coupled IT and work process strategies when implementing process inventions, and with loosely coupled strategies when implementing imitations.
The Effect of Vapor Depletion on Ice Nucleus Measurements with Membrane Filters

Abstract The depletion of water vapor during humidification of filter samples, which introduces complications in the determination of ice nucleus concentrations, is considered in detail. A complete solution of the problem appears beyond reach because of the dependence of the depletion effect on the activation spectrum of nuclei; these spectra cannot be determined independently. Measurements showed that depletion by activated nuclei is more important than by hygroscopic particles. A simple “area-of-effect” model was found to fit the observations relatively well. A generalized correction factor was derived with which the true concentrations of nuclei can be found from measured concentrations.
Learning to trick cost-based planners into cooperative behavior

In this paper we consider the problem of routing autonomously guided robots by manipulating the cost space to induce safe trajectories in the work space. Specifically, we examine the domain of UAV traffic management in urban airspaces. Each robot does not explicitly coordinate with other vehicles in the airspace. Instead, the robots execute their own individual internal cost-based planner to travel between locations. Given this structure, our goal is to develop a high-level UAV traffic management (UTM) system that can dynamically adapt the cost space to reduce the number of conflict incidents in the airspace without knowing the internal planners of each robot. We propose a decentralized and distributed system of high-level traffic controllers that each learn appropriate costing strategies via a neuro-evolutionary algorithm. The policies learned by our algorithm demonstrated a 16.4% reduction in the total number of conflict incidents experienced in the airspace while maintaining throughput performance.
Chapter II Linear programming

Publisher Summary This chapter discusses the linear programming. The linear programming problems involve the optimization of a linear function, called the “objective function,” subject to linear constraints, which may be either equalities or inequalities. The chapter discusses the new methods for solving linear programs problems and providing a development of the simplex method and the basic theory of linear programming. The geometry of linear programming models is presented and relevant geometrical concepts are algebraically characterized. The simplex method from a geometric point of view is developed. This development produces, as a by-product, various basic theorems concerning conditions for optimality and unboundedness, and leads in a natural way to the revised version of the simplex method. Duality theory and sensitivity analysis are also covered in the book. The chapter discusses the complexity of linear programming and two new methods—the ellipsoid method and Karmarkar's projective method. These are distinguished from the simplex method and have the desirable theoretical property of polynomial-time boundedness.
Complex-Order Distributions

This paper develops the concept of the complex order-distribution. This is a continuum of fractional differintegrals whose order is complex. Two types of complex order-distributions are considered, uniformly distributed and Gaussian distributed. It is shown that these basis distributions can be summed to approximate other complex order-distributions. Conjugated differintegrals are an essential analytical tool applied in this development due to their associated real time-responses. An example is presented to demonstrate the complex order-distribution concept. This work enables the generalization of fractional system identification to allow the search for complex order-derivatives that may better describe real time behaviors.Copyright © 2005 by ASME
Advances in Research on Nonprofit Advocacy and Civic Engagement

Nonprofits are collective endeavors that supply a bewildering range of products and services, including some of value to their immediate members only. Many also advocate policy positions on issues of direct interest to themselves, their clients and beneficiaries, and/or the broader community. There is substantial variation in their advocacy strategies, the scope of policy goals they embrace, and the types of individuals they engage in such activities. Consequently, there are also differences in whether and how nonprofit advocacy activities reduce inequalities, enhance civic participation, and promote deliberative democracy. This symposium interprets and theorizes about emerging nonprofit challenges by showcasing research of nonprofit advocacy and civic engagement scholars. Collectively, the papers demonstrate the vibrancy of the field of nonprofit civic engagement and advocacy and identify important areas for future research to capture the complexity of nonprofits as actors guided by both instrumental and normative goals, serving organizational and social missions, and reducing some types of inequalities but creating new ones.
Mass Transfer in Artificial Kidney with Different Blood Cycle Modes

Based on the one-dimensional and unsteady-state Krogh model, this paper investigates mass transfer of artificial kidney with three blood cycle modes during the course of hemodialysis. The variations of the permeable solute clearance with increasing time and the dialysis time with increasing blood flux are simulated in detail,and then one optimal blood cycle mode is acquired. The results are very important to improve the clinical efficiency of artificial kidney.
A complex origin for the Kelso Dunes, Mojave National Preserve, California, USA: A case study using a simple geochemical method with global applications

Abstract The Kelso Dune field in southern California is intriguing because although it is of limited areal extent (~ 100 km2), it has a wide variety of dune forms and contains many active dunes (~ 40 km2), which is unusual in the Mojave Desert. Studies over the past eight decades have concluded that the dunes are derived primarily from a single source, Mojave River alluvium, under a dominant, westerly-to-northwesterly wind regime. The majority of these studies did not, however, present data to support the Mojave River as the only source. We conducted mineralogical and geochemical studies of most of the 14 geomorphically defined dune groups of the Kelso Dune field as well as potential sand sources, alluvial sediments from the surrounding mountain ranges. Results indicate that sands in the nine western dune groups have K/Rb and K/Ba (primarily from K-feldspar) compositions that are indistinguishable from Mojave River alluvium (westerly/northwesterly winds) and Budweiser Wash alluvium (southwesterly winds), permitting an interpretation of two sources. In contrast, sands from the five eastern dune groups have K/Rb and K/Ba values that indicate significant inputs from alluvial fan deposits of the Providence Mountains. This requires either rare winds from the east or southeast or, more likely, aeolian reworking of distal Providence Mountain fan sediments by winds from the west, at a rate greater than input from the Mojave River or other western sources. The results indicate that even a small dune field can have a complex origin, either from seasonally varying winds or complex alluvial-fan-dune interaction. Application of K/Rb and K/Ba in K-feldspar as a provenance indicator could be used in many of the world's ergs or sand seas, where dune origins are still not well understood or are controversial. Four examples are given from Africa and the Middle East where such an approach could yield useful new information about dune sand provenance.
Acquisition, retention, and generalization of rhotics with and without ultrasound visual feedback.

Abstract Purpose The purpose was to provide a preliminary within-participant comparison of speech therapy with and without exposure to ultrasound visual feedback for postvocalic rhotics (/r/- colored vowels). Effects of the two treatments on acquisition, retention, and generalization were explored. It was hypothesized that treatment with ultrasound would facilitate acquisition but hinder retention and generalization. Methods A single subject randomized block design was replicated across four American English-speaking participants ages 7–9 years. Each participant was trained on postvocalic /r/. Each week for seven weeks, one session with ultrasound visual feedback and one session with no ultrasound were randomly ordered. A Training Probe and Generalization Probe were used to measure acquisition within each session as well as retention and generalization between two consecutive sessions. Graphical displays of the data, effect size calculation, and statistical results from a randomization test were used to analyze the results. Results Two participants showed essentially no evidence of acquisition, retention or generalization of rhotics ( Conclusion For some children, acquisition may be facilitated by ultrasound visual feedback. Ultrasound visual feedback neither inhibited nor facilitated retention or generalization of rhotics. As a whole, the 14 treatment sessions (7 with ultrasound and 7 without) were effective for 2 of the 4 participants when comparing pre/post generalization scores. Future studies should evaluate the effectiveness of ultrasound visual feedback given a larger dose and differing age groups.
Predicting Student Success in a Major’s Introductory Biology Course via Logistic Regression Analysis of Scientific Reasoning Ability and Mathematics Scores

Studies over the last 30 years have considered various factors related to student success in introductory biology courses. While much of the available literature suggests that the best predictors of success in a college course are prior college grade point average (GPA) and class attendance, faculty often require a valuable predictor of success in those courses wherein the majority of students are in the first semester and have no previous record of college GPA or attendance. In this study, we evaluated the efficacy of the ACT Mathematics subject exam and Lawson’s Classroom Test of Scientific Reasoning in predicting success in a major’s introductory biology course. A logistic regression was utilized to determine the effectiveness of a combination of scientific reasoning (SR) scores and ACT math (ACT-M) scores to predict student success. In summary, we found that the model—with both SR and ACT-M as significant predictors—could be an effective predictor of student success and thus could potentially be useful in practical decision making for the course, such as directing students to support services at an early point in the semester.
Taiwan, the South China Sea Dispute, and the 2016 Arbitration Decision

The South China Sea (SCS) has been an area of contention among strong powers and weak states since the release of the 1968 UN geological survey indicating this region’s rich resource potential. The disputes among China, Taiwan, Vietnam, and the Philippines have made the US concerned about regional peace and stability, though the US has no territorial claims there. At the center of this drama has been China’s assertive pose and the counter-moves of the US. Taiwan has also played a crucial role; nevertheless, most studies pay little attention to the crucial role it has played in the SCS disputes. This study explores what role Taiwan has played in the game of the SCS maritime dispute. After a brief introduction to the SCS dispute, this study examines Taiwan’s consideration and explores its policy variation between the former Ma Ying-jeou government and the new Tsai Ing-wen government after May 2016.
Chapter 13 – Intel Corporation—Intel IXP2400 Network Processor: A Second-Generation Intel NPU

Publisher Summary Next generation access and edge equipment requires flexible programming, high performance, low power consumption, and small real estate. In context to this, Intel has developed a next-generation network processor, the IXP2400, which is optimized to meet these requirements. The Intel IXP2400 network processor delivers a new level of intelligence and performance for access and edge applications, enabling the realization of quality of service (QoS), enforcement of service-level agreements (SLAs), and traffic engineering at OC-48/2 .5 Gbps and 4 Gbps data rates. The flexible media interface allows a variety of media devices, ranging from OC3 to OC48 speeds to be connected without logic to the IXP2400 for easier design and lower system cost. These capabilities essentially allow OEMs and service providers to offer differentiated and tiered services to their customers while efficiently managing their network resources and bandwidth. The performance and flexibility of the IXP2400 makes it desirable for a wide variety of high-performance applications such as multiservice switches, DSLAMs (DSL access multiplexers), CMTS (cable modem termination system) equipment, 2.5G and 3G wireless infrastructure, and layer 4-7 switches.
Moroccan Jews and the Spanish colonial imaginary, 1903–1951

This article explores the relationship between Spanish colonialism and Moroccan Jews. Throughout the first half of the twentieth century, Spanish writers and politicians revived Spain’s Jewish heritage and used it to fortify cultural and political ties with Sephardic Jewish communities across the Mediterranean, and especially in Morocco. This revival of Spain’s Jewish identity has often been associated with the liberal ‘Philo-Sephardic’ movement of the early twentieth century, but, as I argue in this article, Philo-Sephardism survived until the end of the colonial period and implicated, along the way, Spaniards of all ideological stripes, from liberals to fascists. In both its liberal and fascist iterations, Philo-Sephardism was a platform for challenging France’s cultural influence among Moroccan Jews and for asserting Spain’s legitimacy as a colonial power. Philo-Sephardism was also strengthened and shaped by the extensive participation of Moroccan Jews, who contributed to the movement by collab...
Physical Characterization of Frozen Saltwater Solutions Using Raman Microscopy

Ice is an important but poorly understood atmospheric reaction medium. Reactions in ice and at air–ice interfaces are often modeled using rate constants measured in liquid aqueous solution, despite evidence that reactivity in these two media can be very different. This approach may be valid at high ionic strengths (e.g., in sea ice) as a result of the formation of liquid brine. However, recent experiments indicate uneven solute distribution at ice surfaces, suggesting that liquid water does not completely wet ice surfaces at environmentally relevant solute concentrations. We have investigated the distribution of liquid solution, solid ice, and solid salt (NaCl·2H2O, “hydrohalite”) at the surface of frozen aqueous sodium chloride (NaCl) solutions and frozen seawater using Raman microscopy. At temperatures above the eutectic temperature (−21.1 °C), the ice surfaces were incompletely wetted, except occasionally at the highest temperatures (approximately −5 °C). Liquid water at the surface took the form of ei...
Bayesian design of a survival trial with a cured fraction using historical data

In this paper, we develop a general Bayesian clinical trial design methodology, tailored for time-to-event trials with a cured fraction in scenarios where a previously completed clinical trial is available to inform the design and analysis of the new trial. Our methodology provides a conceptually appealing and computationally feasible framework that allows one to construct a fixed, maximally informative prior a priori while simultaneously identifying the minimum sample size required for the new trial so that the design has high power and reasonable type I error control from a Bayesian perspective. This strategy is particularly well suited for scenarios where adaptive borrowing approaches are not practical due to the nature of the trial, complexity of the model, or the source of the prior information. Control of a Bayesian type I error rate offers a sensible balance between wanting to use high-quality information in the design and analysis of future trials while still controlling type I errors in an equitable way. Moreover, sample size determination based on our Bayesian view of power can lead to a more adequately sized trial by virtue of taking into account all the uncertainty in the treatment effect. We demonstrate our methodology by designing a cancer clinical trial in high-risk melanoma.
Pathogenese, Klinik und Therapie des septischen Schocks in der Schwangerschaft

Der Zusammenhang zwischen gramnegativen Infektionen und Schock wurde erst vor wenigen Jahren erkannt. Zwar hat schon Laennec im Jahre 1831 den Zusammenbruch des Kreislaufes als Folge von Infektionen beschrieben. Die Bedeutung gramnegativer Infektionen als Ursache von Schockzustanden geht jedoch erst auf die funfziger Jahre zuruck (Waibren, 1951; Broden und Hall, 1951). Im geburtshilflich gynakologischen Schrifttum waren es Studdiford und Douglas (1956), die in klassischer Weise den Zusammenhang zwischen septischem Abort und Schock aufgezeigt haben. Seitdem nimmt die Literatur standig zu. Es ist offensichtlich, das es sich um ein Krankheitsbild handelt, das im Augenblick die hochste Mortalitat aller Erkrankungen in der Schwangerschaft aufweist.
The Effects of Acidic Lipids and Heat-Stable Factor on the Physical-Chemical and Kinetic Properties of Glucocerebrosidase

Glucocerebrosidase (glucocerebroside:s-glucosidase, E.C.3.2.1.45) is a lysosomal enzyme whose deficiency is responsible for the sphingolipidosis, Gaucher’s disease1,2; it catalyzes the following reaction: $$\text{glucocerebroside}\,\text{+}\,{{\text{H}}_{2}}O\,\to \,glucose\,+\,ceramide$$ This membrane-bound enzyme can be solubilized by extraction of lysosomal membranes with detergents (e.g., sodium cholate, Triton X-100) and 1-butano13,4. However, such procedures disrupt the natural association of the enzyme with endogenous membrane lipids, thereby rendering glucocerebrosidase inactive. Reconstitution of s-glucosidase activity can be achieved two ways. The first one requires incorporating a strong ionic detergent such as sodium taurocholate or taurodeoxycholate in the assay medium5’6. Unfortunately, while members of the bile salt family are generally effective activators of glucocerebrosidase, they present two problems: (1) they are not components of the lysosomal membrane, and as such are nonphysiologic, and (2) they obscure differences in the kinetic properties of the residual (5–20% of control) spleen glucocerebrosidase of patients with the nonneurologic form (type 1) and the more severe neurologic (types 2 and 3) forms of Gaucher’s disease4. The second way to reconstitute s-glucosidase activity (determined using the water-soluble aryl glucoside substrate, 4-methylumbelliferyl-s-D-glucopyranoside (MUG1c)) is to add acidic natural lipids, alone or in combination with a heat-stable activator protein (isolated from Gaucher spleen7), to the s-glucosidase assay medium8–12. The present report describes the effects of acidic lipids and the heat-stable factor (HSF) on the physical-chemical and kinetic properties of glucocerebrosidase.
Robust Estimation in the Presence of Outliers

Publisher Summary This chapter discusses the bias and mean square error of various estimators of location and scale in the presence of an unidentified outlier. Publications on robust estimation sometimes convey the impression that tests for outliers are irrelevant. The argument seems to be that robust estimators are constructed to perform reasonably well as long as the number of outliers is not too large. The more extreme observations in the sample are typically given little or no weight in the robust estimator. Moreover, the argument proceeds, those observations that are rejected by some standard test for outliers may not be outliers at all; rather, the case may be of a long-tailed distribution. It is important, therefore, to reiterate another aim of outlier tests, crucial in the proper treatment of data, namely, the identification of observations deserving closer scrutiny. It is sometimes suggested that outlier tests be performed at the 10% or even 20% level. Raising the significance level will certainly improve the robustness of estimators based on the surviving observations.
How and why studies disagree about the effects of education on health: A systematic review and meta-analysis of studies of compulsory schooling laws

Rich literatures across multiple disciplines document the association between increased educational attainment and improved health. While quasi-experimental studies have exploited variation in educational policies to more rigorously estimate the health effects of education, there remains disagreement about whether education and health are causally linked. The aim of this study was to conduct a systematic review and meta-analysis to characterize this literature, with a focus on quasi-experimental studies of compulsory schooling laws (CSLs). Articles from 1990 to 2015 were obtained through electronic searches and manual searches of reference lists. We searched for English-language studies and included manuscripts if: (1) they involved original data analysis; (2) outcomes were health-related; and (3) the primary predictor utilized variation in CSLs. We identified 89 articles in 25 countries examining over 25 health outcomes, with over 600 individual point estimates. We systematically characterized heterogeneity on key study design features and conducted a meta-analysis of studies with comparable health outcome and exposure variables. Within countries, studies differed in terms of birth cohorts included, the measurement of health outcomes within a given category, and the type of CSL variation examined. Over 90% of manuscripts included multiple analytic techniques, such as econometric and standard regression methods, with as many as 31 "primary" models in a single study. A qualitative synthesis of study findings indicated that educational attainment has an effect on the majority of health outcomes-most beneficial, some negative-while the meta-analysis demonstrated small beneficial effects for mortality, smoking, and obesity. Future work could focus on inconsistent findings identified by this study, or review the health effects of other types of educational policies.
LGBT Medical Education: First-Year Medical Students’ Self-Assessed Knowledge and Comfort with Transgender and LGB Populations

Medical education lags with respect to care for lesbian, gay, bisexual, and transgender populations, all of which experience disparities around access to care and health outcomes. (1) To evaluate M1 students’ perceived preparedness to care for transgender patients compared to LGB populations, (2) to identify knowledge and skills gaps, and (3) to recommend curricular developments. An online survey was administered to M1 students (N = 137) and assessed knowledge of and comfort levels with special populations. Responses were compared regarding transgender and nonbinary populations to those regarding LGB ones. Analyses consisted of t tests of response means and natural language processing of a free-text field querying for knowledge and skills needed to work with these subpopulations. With a 100% response rate, students expressed significantly lower levels of knowledge and comfort regarding transgender and nonbinary populations compared to LGB ones. Natural language processing of the sentiment of the free-text field revealed greater magnitude for transgender populations (83.7 vs. 62.1) and equal average sentiment scores (0.2). Content also revealed a greater emphasis on direct interaction with trans and nonbinary persons in order to develop gender-affirming language and skills whereas LGB content focused on acquiring knowledge of LGB health issues. M1 students feel less knowledgeable about and comfort with transgender persons compared to LGB ones; they want more exposure to and interaction with trans-patient experiences in order to develop gender-affirming language and clinical practices that address the range of healthcare needs.
Tissue Models for Neurogenesis and Repair in 3D

Development and maturation of vascular and neuronal tissues occurs simultaneously in utero, and are regulated by significant crosstalk. We report on the development of a 3D tissue system to model neurogenesis and recapitulate developmental signaling conditions. Human umbilical vein endothelial cells (HUVECs) were seeded inside channels within collagen gels to represent nascent vascular networks. Axons extending from chicken dorsal root ganglia (DRGs) grew significantly longer and preferentially towards the HUVEC seeded channels with respect to unloaded channels. To replicate these findings without the vascular component, channels were loaded with brain-derived neurotrophic factor (BDNF), the principle signaling molecule in HUVEC-stimulated axonal growth, and axons likewise were significantly longer and grew preferentially towards the BDNF-loaded channels with respect to controls. This 3D tissue system was then used as an in vitro replicate for peripheral nerve injury, with neural repair observed within 2 weeks. These results demonstrate that our 3D tissue system can model neural network formation, repair after laceration injuries, and can be utilized to further study how these networks form and interact with other tissues, such as skin or skeletal muscle.
Placental CO2 Exchange

This chapter discusses carbon dioxide transfer of the placenta. It outlines the role of the Haldane effect.
Mathematical Modeling of a Brain-on-a-Chip: A Study of the Neuronal Nitric Oxide Role in Cerebral Microaneurysms

Brain tissue is a complex material made of interconnected neural, glial, and vascular networks. While the physics and biochemistry of brain’s cell types and their interactions within their networks have been studied extensively, only recently the interactions of and feedback among the networks have started to capture the attention of the research community. Thus, a good understanding of the coupled mechano-electrochemical processes that either provide or diminish brain’s functions is still lacking. One way to increase the knowledge on how the brain yields its functions is by developing a robust controlled feedback engineering system that uses fundamental science concepts to guide and interpret experiments investigating brain’s response to various stimuli, aging, trauma, diseases, treatment and recovery processes. Recently, a mathematical model for an implantable neuro-glial-vascular unit, named brain-on-a-chip, was proposed that can be optimized to perform some fundamental cellular processes that could facilitate monitoring and supporting brain’s functions, and highlight basic brain mechanisms. In this paper we use coupled elastic, viscoelastic and mass elements to model a brain-on-a-chip made of a neuron and its membrane, and astrocyte’s endfeet connected to an arteriole’s wall. We propose two constrained Lagrangian formulations that link the Hodgkin-Huxley model of the neuronal membrane, and the mechanics of the neuron, neuronal membrane, and the glia’s endfeet. The effects of the nitric oxide produced by neurons and endothelial cells on the proposed brain-on-a-chip are investigated through numerical simulations. Our numerical simulations suggest that a non-decaying synthesis of nitric oxide may contribute to the onset of a cerebral microaneurysm.
Ambiguous genitalia: An overview of 7 years experience at the Children’s Hospital & Institute of Child Health, Lahore, Pakistan

Objective: To determine the classification and etiological diagnosis of children presented with ambiguous genitalia/atypical genitalia according to the newer classification system of Disorder of Sex Development (DSD). Methods: This observational, cross-sectional study was conducted at the Department of Pediatric Endocrinology and Diabetes at The Children’s Hospital I 2014. Files of all the children with ambiguous genitalia were retrospectively analyzed and relevant data was retrieved. All the information was recorded on predesigned proforma and analyzed accordingly. Results: A total of 300 cases of ambiguous genitalia classified according to the new DSD classification. 46, XX DSD were 54.3% (n=163), 46, XY DSD were 43.7% (n=131), sex chromosome DSD were 2% (n=6). Among 46, XX DSD cases, the most common cause was congenital adrenal hyperplasia (97%, n=158). However, in 46, XY DSD partial androgen insensitivity/5α-reductase deficiency (62%. n=81) constituted the most commonest disorder. Other causes of 46XY DSD include testosterone synthesis defect(23%), congenital adrenal hyperplasia (CAH,12%), testis regression syndrome (1.5%) and persistent mullerian duct syndrome (PMDS,1.5%). Sex chromosome disorder constituted one case of iso-chromosome X turner syndrome, mixed gonadal dysgenesis (n=3), ovotesticular DSD/chimerism (n=2). Conclusion: Ambiguous genitalia have varied etiologies, 46; XXDSD found being the commonest of all, showing predominance of CAH especially salt loosing type. The early detection and prompt treatment of cases of ambiguous genitalia plays a pivotal role in the management of acute life threatening condition and gender assignment. How to cite this:Manzoor J, Aftab S, Yaqoob M. Ambiguous genitalia: An overview of 7 years experience at the Children’s Hospital & Institute of Child Health, Lahore, Pakistan. Pak J Med Sci. 2019;35(1):151-155. doi: https://doi.org/10.12669/pjms.35.1.289 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Risk and Protective Factors for Secondary Traumatic Stress and Burnout Among Home Visitors

The overarching goal of this study was to understand the context of home visitor secondary traumatic stress and burnout, and how this might affect intention to quit among home visitors, particularl...
Total Synthesis of trans-Resorcylide via Macrocyclic Stille Carbonylation

The resorcylic macrolides are important natural products with a wide range of remarkable biological activities. So far, most of the reported resorcylic macrolide syntheses use either macrolactonization or ring closing metathesis to build the corresponding macrocycle. In continuation of our efforts in developing novel carbonylation reactions to facilitate natural product total synthesis, we report herein a total synthesis of trans-resorcylide (1) featuring a palladium-catalyzed macrocyclic Stille carbonylation to build its 12-membered macrocycle.
Direct and indirect effects of temperature on arctic plants

Most physiological processes of arctic plants are less temperature sensitive than those of temperate counterparts and consequently are most strongly limited by factors other than temperature. Annual carbon gains is limited primarily by length of growing season and secondarily by light, temperature, and nitrogen. Nutrient absorption is limited much more strongly by nutrient availability than by temperature. Nutrient availability in turn is restricted by a variety of factors stemming indirectly from low temperature. The in situ growth rate of arctic plants is comparable to or higher than that of temperate plants despite a 15–20°C difference in average air temperature. I conclude that temperature limits in several ways the rate at which resources become available to arctic plants and thereby the rates of resource acquisition and growth that can be maintained in an arctic environment, but that temperature is not a strong direct limitation to plant growth in the Arctic.
WISSENSCHAFTLICHER BEITRAG: Anatomical double bundle anterior cruciate ligament reconstruction using tibialis anterior tendon allografts: Reconstruction through two femoral and two tibial tunnels

Zusammenfassung Durch die Verbesserung der VKB-Rekonstruktion mit der Einzelbundel-(1-Kanal)-Technik konnten gute klinische Resultate erreicht werden. Trotzdem kann eine abnormale Rotationsinstabilitat nach Einzelbundel-VKB-Rekonstruktion bei guter antero-posteriorer Stabilitat auftreten und sollte vermieden werden, da eine fehlende Wiederherstellung der Rotationsstabilitat nach VKB-Rekonstruktion zu einer schlechten Kniefunktion und zur Unzufriedenheit der Patienten fuhren kann. In-vitro-biomechanische Studien zeigten, dass die anatomische 2-Bundel-(2-Kanal)- Technik zu signifikant weniger anteriorer Translation der Tibia und weniger Rotationsinstabilitat als die Einzelbundeltechnik fuhrt. Ebenfalls sind die Resultate der ersten klinischen Kurzzeitnachuntersuchungen positiv. Aufgrund dieser Tatsachen empfehlen wir eine anatomische 2-Bundel-Technik mit 2 tibialen und 2 femoralen Bohrkanalen und einem Allograft (Tibialis-anterior- oder Tibialis-posterior-Sehnen). Diese Technik stellt sowohl das anteromediale als auch das postero-laterale Bundel des Kreuzbandes wieder her. Trotzdem sind klinische Langzeituntersuchungen mit Messungen der Rotationsstabilitat und Erfassung von arthrotischen Veranderungen notwendig, um die Resultate der biomechanischen und ersten klinischen Untersuchungen zu bestatigen.
Career Interest and Psychomotor Aptitude Among Medical Students.

OBJECTIVE The primary objective is to assess psychomotor aptitude of medical students interested in pursuing a procedural career. Secondary objectives include exploring the relationship between actual and perceived aptitude, and identifying predictors of superior aptitude. DESIGN This is a cross-sectional, multisite study in which participants completed a paper survey, four visuospatial aptitude assessments, and a laparoscopic simulation modeled after the Fundamentals of Laparoscopic Surgery (FLS) peg transfer test (used as a proxy for psychomotor aptitude). SETTING Johns Hopkins University School of Medicine and Mayo Clinic School of Medicine. PARTICIPANTS All second-year medical students who had not yet initiated clinical rotations were eligible. Sixty-four students participated. RESULTS Students interested in a procedural career exhibited superior psychomotor aptitude (faster FLS task completion time), and a majority of these students correctly identified themselves as having above-average aptitude compared with peers. However, over one quarter of all students, regardless of career interest, incorrectly over- or under-rated their psychomotor aptitude. Upon completing their preclinical curriculum, a minority of students felt prepared to participate or assist in their surgical clinical rotations. CONCLUSIONS Prior to embarking on their clinical rotations, over one quarter of medical students lack awareness of their psychomotor aptitude and many do not feel prepared to participate in the next phase of their training. Early aptitude testing and introduction to laparoscopic training may assist in career selection, preparedness, and success.
Injuries among Amish children: opportunities for prevention.

The purpose of this study was to examine the injury risk patterns among Amish children, many of whom may be exposed to uncommon injuries and limited access to care due to their agrarian lifestyle and remote communities. Retrospective Chart Review. With IRB approval, we performed a retrospective review of Amish patients age ≤ 12 years presenting to a level I pediatric trauma center between January 1, 2005, and December 31, 2015. Data abstracted from the institutional trauma registry and electronic medical record were analyzed using descriptive statistics and univariate/multivariate analysis. One hundred eighty-three Amish children were admitted, and 2 died from injuries. Patients were 72.1% male; the median age was 5 (IQR 3–8); median injury severity score (ISS) was 9 (IQR 4–14), Most injuries were the result of blunt force trauma (91.8%). The most frequent mechanisms were falls (42.6%), followed by animal-related (15.3%), and buggy (12.5%). Most injuries occurred at home (44.4%) or on a farm (33.9%). Hay hole falls were a unique source of injury with a high ISS (12; IQR 6–17). The overall median length of stay (LOS) was 2 days (IQR 1–3), with animal-related injuries associated with the longest LOS (3 days; IQR 1–4.75). The majority of injuries among Amish children are due to falls. Hay hole falls and animal-related injuries result in the highest ISS and longest LOS. These findings identify the farm as a potential target for culturally appropriate interventions for risk modification.
The role of digitally-enabled employee voice in fostering positive change and affective commitment in centralized organizations

This study investigated the extent to which organizational structure and communication climate influence employee voice and concomitant outcomes. Given the prevalent use of digital technologies, we...
Chapter 5 – Medicinal Chemistry

Identifying a compound or class of compounds that has biological activity at a particular biomolecular target is a necessary first step toward an eventual clinical candidate. In the vast majority of programs, however, many additional related compounds, possibly hundreds or even thousands, will need to be prepared and tested before a suitable molecule is selected for in vivo assessment. The various “warts” of early compounds, such as low target potency, limited solubility, poor selectivity, or low membrane permeability, are addressed as each successive round of analogs is prepared. Medicinal chemistry principles are applied and structure–activity relationships are developed in order to identify and understand how changes in chemical structure impact the physicochemical and biochemical properties of candidate compounds. The manipulation of chemical structures to improve the characteristics of lead compounds is often a major aspect of a drug discovery program.
Creating and Implementing an Undergraduate Research Lab in Political Science

Faculty members are increasingly recognizing the value of integrating high impact practices, such as undergraduate research, into the college experience. In this paper, I argue that one way of gett...
Adaptive Dynamic Inversion Control with Actuator Saturation Constraints Applied to Tracking Spacecraft Maneuvers

This paper presents an adaptive control methodology for nonlinear plants that prevents the adaptive parameters from drifting due to trajectory errors arising from control saturation. The reference trajectory is modified upon saturation, so that the modified trajectory approximates the original reference closely and can be tracked within saturation limits. The adaptive parameters are updated by the error between the plant trajectory and this modified reference. Asymptotic tracking of the modified reference is guaranteed with the assumption that the modified reference remains bounded and asymptotic convergence of the modified reference to the original reference is guaranteed whenever the control becomes unsaturated. Also, bounded learning of the adaptive parameters is guaranteed. A numerical example of attitude tracking for a rigid spacecraft is presented which shows that, in the presence of persistent excitation, the adaptive parameters converge to the true parameters, even when the actuator saturates.
Novel BAG3 Variants in African American Patients With Cardiomyopathy: Reduced β-Adrenergic Responsiveness in Excitation-Contraction.

Abstract Background We reported 3 novel nonsynonymous single nucleotide variants of Bcl2-associated athanogene 3 (BAG3) in African Americans with heart failure (HF) that are associated with a 2-fold increase in cardiac events (HF hospitalization, heart transplantation, or death). Methods and Results We expressed BAG3 variants (P63A, P380S, and A479V) via adenovirus-mediated gene transfer in adult left ventricular myocytes isolated from either wild-type (WT) or cardiac-specific BAG3 haploinsufficient (cBAG3+/−) mice: the latter to simulate the clinical situation in which BAG3 variants are only found on 1 allele. Compared with WT myocytes, cBAG3+/− myocytes expressed approximately 50% of endogenous BAG3 levels and exhibited decreased [Ca2+]i and contraction amplitudes after isoproterenol owing to decreased L-type Ca2+ current. BAG3 repletion with WT BAG3 but not P380S, A479V, or P63A/P380S variants restored contraction amplitudes in cBAG3+/− myocytes to those measured in WT myocytes, suggesting excitation–contraction abnormalities partly account for HF in patients harboring these mutants. Because P63A is near the WW domain (residues 21–55) and A479V is in the BAG domain (residues 420–499), we expressed BAG3 deletion mutants (Δ1–61 and Δ421–575) in WT myocytes and demonstrated that the BAG but not the WW domain was involved in enhancement of excitation–contraction by isoproterenol. Conclusions The BAG3 variants contribute to HF in African American patients partly by decreasing myocyte excitation–contraction under stress, and that both the BAG and PXXP domains are involved in mediating β-adrenergic responsiveness in myocytes.
General Electric and Suez: Deal or No Deal?

On Wednesday, March 1, 2017, Jean-Louis Chaussade, the chief executive officer (CEO) of Suez SA (Suez), a French utility company that primarily operated in water and waste management, had to decide whether or not to acquire General Electric Water & Process Technologies. During the negotiations between Chaussade and the CEO of General Electric Company (GE), there had been many drastic changes, including the January 2017 inauguration of a US president with no political experience and an agenda that did not favour international co-operation. The deal represented a significant investment of US$2–$3 billion, and Suez would have to rely on an external partner to have even a chance of winning the bid GE had launched only a few weeks earlier. The complex negotiations were also fraught with risks due to increasing political interference from the new US president. What should Chaussade do?
The effect of individual learning on collective foraging in honey bees in differently structured landscapes

The trade-off between exploiting known resources and exploring for new ones is a complex decision-making challenge, particularly when resource patches are variable in quality and heterogeneously distributed in the landscape. Social insect colonies navigate this challenge, in the absence of centralized control, by allocating different individuals to exploration or exploitation based on variation in individual behaviour. To investigate how heritable differences in individual learning affect a colony's collective ability to locate and choose among different quality food resources, we develop an agent-based model and test its predictions empirically using two genetic lines of honey bees (Apis mellifera), selected for differences in their learning behaviour. We show that colonies containing individuals that are better at learning to ignore unrewarding stimuli are worse at collectively choosing the highest-quality resource. This work highlights how differences in individual behaviour may have unexpected consequences for the emergence of collective behaviour.
Psychosocial Stress and Age Influence Depression and Anxiety-Related Behavior, Drive Tumor Inflammatory Cytokines and Accelerate Prostate Cancer Growth in Mice.

Prostate cancer (PCa) prevalence is higher in older men and poorer coping with psychosocial stressors effect prognosis. Yet, interactions between age, stress and PCa progression are underexplored. Therefore, we characterized the effects of age and isolation combined with restraint (2 h/day) for 14 days post-tumor inoculation on behavior, tumor growth and host defense in the immunocompetent, orthotopic RM-9 murine PCa model. All mice were tumor inoculated. Isolation/restraint increased sympathetic and hypothalamic-pituitary-adrenal cortical activation, based on elevated serum 3-methoxy-4-hydroxyphenylglycol/norepinephrine ratios and corticosterone levels, respectively. Elevated zero maze testing revealed age-related differences in naive C57Bl/6 mice, and increased anxiety-like behavior in tumor-bearing mice. In open field testing, old stressed mice were less active throughout the 30-min test than young non-stressed and stressed, and old non-stressed mice, suggesting greater anxiety in old stressed mice. Old (18 month) mice demonstrated more depression-like behavior than young mice with tail suspension testing, without effects of isolation/restraint stress. Old mice developed larger tumors, despite similar tumor expression of tumor vascular endothelial growth factor or transforming growth factor-beta1 across age. Tumor chemokine/cytokine expression, commonly prognostic for poorer outcomes, were uniquely age- and stress-dependent, underscoring the need for PCa research in old animals. Macrophages predominated in RM-9 tumors. Macrophages, and CD4+ and CD4+FoxP3+ T-cell tumor infiltration were greater in young mice than in old mice. Stress increased macrophage infiltration in old mice. Conversely, stress reduced intratumoral CD4+ and CD4+FoxP3+ T-cell numbers in young mice. CD8+ T-cell infiltration was similar across treatment groups. Our findings support that age- and psychological stress interacts to affect PCa outcomes by interfering with neural-immune mechanisms and affecting behavioral responses.