cssi/SciSciGPT-SciSciNet huggingface dataset:
Regulation of hepatic stellate cell activation and growth by transcription factor myocyte enhancer factor 2

Background & Aims: Hepatic stellate cells (HSCs) undergo activation during the development of liver fibrosis. Transcriptional regulation plays a key role in this process. We studied the role of transcription factor myocyte enhancer factor 2 (MEF2) during HSC activation. Methods: Culture of HSCs isolated from rat liver on plastic dishes and HSC-T6 on a basement membrane–like matrix were used as models of HSC activation and deactivation, respectively. The expression and activity of MEF2 were correlated with HSC activation. The roles of MEF2 during HSC activation were assessed in vitro and in vivo by animal models of fibrosis. Results: Early induction of MEF2 messenger RNA and protein accompanied culture-induced HSC activation. This was associated with enhanced MEF2 DNA binding and transactivation activity. p38 mitogen-activated protein kinase but not extracellular signal–regulated kinase pathway was required for increased MEF2 activity during HSC activation. Increased MEF2 protein also correlated with fibrosis in vivo. Reversal of HSC activation was paralleled by a marked decrease in MEF2 protein and activity. Functionally, enhancing MEF2 significantly increased the expression of α–smooth muscle actin (α-SMA), activated collagen I promoter activity, and stimulated HSC proliferation. MEF2 interference RNA significantly inhibited expression of α-SMA, collagen α1(I), and proliferating cell nuclear antigen. Conclusions: The studies provide the first evidence for the presence of MEF2 in the liver and show that MEF2 regulates multiple aspects of HSC activation. These studies show a novel role of MEF2 as a key nuclear mediator that may participate in the pathologic process of liver fibrogenesis in vivo.
Insulator-metal transition on the triangular lattice

Mott insulators with a half-filled band of electrons on the triangular lattice have been recently studied in a variety of organic compounds. All of these compounds undergo transitions to metallic and/or superconducting states under moderate hydrostatic pressure. We describe the Mott insulator using its hypothetical proximity to a ${Z}_{2}$ spin liquid of bosonic spinons. This spin liquid has quantum phase transitions to descendant confining states with N\'eel or valence bond solid order, and the insulator can be on either side of one of these transitions. We present a theory of fermionic charged excitations in these states and describe the route to metallic states with Fermi surfaces. We argue that an excitonic condensate can form near this insulator-metal transition due to the formation of charge neutral pairs of charge $+e$ and charge $\ensuremath{-}e$ fermions. This condensate breaks the lattice space group symmetry, and we propose its onset as an explanation of a low temperature anomaly in $\ensuremath{\kappa}\text{\ensuremath{-}}{(\mathrm{ET})}_{2}{\mathrm{Cu}}_{2}{(\mathrm{C}\mathrm{N})}_{3}$. We also describe the separate BCS instability of the metallic states to the pairing of like-charge fermions and the onset of superconductivity.
Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage.

The goal of this study was to determine the causes of mortality and morbidity after subarachnoid hemorrhage. We identified all first-ever spontaneous subarachnoid hemorrhages that occurred in the nearly 1.3 million population of greater Cincinnati during 1988. Thirty-day mortality for subarachnoid hemorrhage was 45% (36 of 80 cases). Of the 36 deaths, 22 (61%) died within 2 days of onset; 21 of these deaths were due to the initial hemorrhage, and one death was due to rebleeding documented by computer tomography. Nine of the remaining 14 deaths after day 2 were caused by the initial hemorrhage (2 cases) or rebleeding (7 cases). Volume of subarachnoid hemorrhage was a powerful predictor of 30-day morality (P = .0001). Only 3 of the 29 patients with a volume of subarachnoid hemorrhage of 15 cm3 or less died before 30 days. Two of these 3 patients died from documented rebleeding; the third had 87 cm3 of additional intraventricular hemorrhage. Delayed arterial vasospasm contributed to only 2 of all 36 deaths. Most deaths after subarachnoid hemorrhage occur very rapidly and are due to the initial hemorrhage. Rebleeding is the most important preventable cause of death in hospitalized patients. In a large representative metropolitan population, delayed arterial vasospasm plays a very minor role in mortality caused by subarachnoid hemorrhage.
Activation of ATF6 and an ATF6 DNA Binding Site by the Endoplasmic Reticulum Stress Response

ATF6 is a member of the basic-leucine zipper family of transcription factors. It contains a transmembrane domain and is located in membranes of the endoplasmic reticulum. ATF6 has been implicated in the endoplasmic reticulum (ER) stress response pathway since it can activate expression of GRP78 and other genes induced by the ER stress response. ER stress appears to activate ATF6 by cleavage from the ER membrane and translocation to the nucleus. However, direct DNA binding by ATF6 had not been demonstrated. In this report, we have identified a consensus DNA binding sequence for ATF6. This site is related to but distinct from ATF1/CREB binding sites. The site was placed in a reporter gene and was specifically activated by ATF6 overexpression and was strongly induced by the ER stress response. A dominant negative form of ATF6 blocked ER stress induction of both ATF6 site and GRP78 reporter genes. We further found that GAL4-ATF6 could be activated by ER stress. These results demonstrate that ATF6 is a direct target of the ER stress response. A proximal sensor of the ER stress response, human IRE1 (hIRE1), was sufficient to activate the ATF6 reporter gene, while a dominant negative form of hIRE1 blocked ER stress activation, suggesting that hIRE1 is upstream of ATF6 in the ER stress signaling pathway.
Coresidence With Parents, Women's Economic Resources, and the Transition to Marriage in Japan

Integrating three theoretical explanations for declining rates of marriage in Japan, the authors develop hypotheses in which linkages between benefits of coresidence with parents and marriage timing are moderated by women's own socioeconomic characteristics. To evaluate these hypothesized interactive relationships, data from a panel survey of Japanese women is used to estimate hazard models for the transition from the parental home to first marriage. Results are consistent with the hypothesis that limited domestic responsibilities contribute to later marriage among coresident women with higher levels of human capital. Less evidence is found for the hypothesis that limited living expenses are associated with later marriage among women whose potential husbands are likely to have more tenuous economic prospects. The authors conclude that coresidence with parents plays a potentially important role in the marriage behavior of economically independent women in societies where family formation is relatively inco...
Equilibria and Efficiency Loss in Games on Networks

Social networks are the substrate upon which we make and evaluate many of our daily decisions: our costs and benefits depend on whether---or how many of, or which of---our friends are willing to go to that restaurant, choose that cellular provider, already own that gaming platform. Much of the research on the ``diffusion of innovation,'' for example, takes a game-theoretic perspective on strategic decisions made by people embedded in a social context. Indeed, multiplayer games played on social networks, where the network's nodes correspond to the game's players, have proven to be fruitful models of many natural scenarios involving strategic interaction. In this paper, we embark on a mathematical and general exploration of the relationship between 2-person strategic interactions (a ``base game'') and a ``networked'' version of that same game. We formulate a generic mechanism for superimposing a symmetric 2-player base game $M$ on a social network $G$: each node of $G$ chooses a single strategy from $M$ and simultaneously plays that strategy against each of its neighbors in $G$, receiving as its payoff the sum of the payoffs from playing~$M$ against each neighbor. We denote the \emph{networked game} that results by~$\gamenet{M}{G}$. We are broadly interested in the relationship between properties of~$M$ and of~$\gamenet{M}{G}$: how does the character of strategic interaction change when it is embedded in a social network? We focus on two particular properties: the (pure) price of anarchy and the existence of pure Nash equilibria. We show tight results on the relationship between the price of anarchy in~$M$ and $\gamenet{M}{G}$ in coordination games. We also show that, with some exceptions when $G$ is bipartite, the existence or absence of pure Nash equilibria (and even the guaranteed convergence of best-response dynamics) in $M$ and $\gamenet{M}{G}$ are not entailed in either direction. Taken together, these results suggest that the process of superimposing $M$ on a graph is a nontrivial operation that can have rich, but bounded, effects on the strategic environment.
What drives variation in the corticosterone stress response between subspecies? A common garden experiment of Swamp sparrows (Melospiza georgiana)

Although differences in the corticosterone stress response have frequently been reported between populations or closely related subspecies, their origin remains unclear. These differences may appear because individuals adjust their corticosterone stress response to the environmental conditions they are experiencing. However, they may also result from selection that has favoured individuals with specific corticosterone stress response or from environmental factors that have affected the development of the corticosterone stress response during early life. We investigated these hypotheses by studying the corticosterone stress response of two closely related subspecies of swamp sparrows (Melospiza sp.). We showed for the first time that two closely related subspecies can differ in their corticosterone stress response when raised at the laboratory and held in similar conditions for a year. Thus, we demonstrated that selection, developmental processes or a conjunction of both of these processes can account for variation in the stress response between closely related subspecies.
Specific Molecular Chaperone Interactions and an ATP-dependent Conformational Change Are Required during Posttranslational Protein Translocation into the Yeast ER

The posttranslational translocation of proteins across the endoplasmic reticulum (ER) membrane in yeast requires ATP hydrolysis and the action of hsc70s (DnaK homologues) and DnaJ homologues in both the cytosol and ER lumen. Although the cytosolic hsc70 (Ssa1p) and the ER lumenal hsc70 (BiP) are homologous, they cannot substitute for one another, possibly because they interact with specific DnaJ homologues on each side of the ER membrane. To investigate this possibility, we purified Ssa1p, BiP, Ydj1p (a cytosolic DnaJ homologue), and a GST-63Jp fusion protein containing the lumenal DnaJ region of Sec63p. We observed that BiP, but not Ssa1p, is able to associate with GST-63Jp and that Ydj1p stimulates the ATPase activity of Ssa1p up to 10-fold but increases the ATPase activity of BiP by <2-fold. In addition, Ydj1p and ATP trigger the release of an unfolded polypeptide from Ssa1p but not from BiP. To understand further how BiP drives protein translocation, we purified four dominant lethal mutants of BiP. We discovered that each mutant is defective for ATP hydrolysis, fails to undergo an ATP-dependent conformational change, and cannot interact with GST-63Jp. Measurements of protein translocation into reconstituted proteoliposomes indicate that the mutants inhibit translocation even in the presence of wild-type BiP. We conclude that a conformation- and ATP-dependent interaction of BiP with the J domain of Sec63p is essential for protein translocation and that the specificity of hsc70 action is dictated by their DnaJ partners.
Bootstrap trellis decoding

A new hybrid coding scheme is introduced that bears the same relation to Viterbi decoding as bootstrap hybrid decoding [3] bears to sequential decoding. Bounds on the probability of error are developed and evaluated for some examples. In high-rate regions of interest, the computed exponents are more than three times as large as those for Viterbi decoding. Results of simulations are also presented.
Chlorine Spray Washing to Reduce Bacterial Contamination of Poultry Processing Equipment

Abstract About 100 cells of Salmonella/cm2 were inoculated in a thin layer of chicken fat on stainless steel plates. When plates were sprayed at 30 psi for 3.5 sec Salmonella counts were reduced about 50% with tap water alone, 90% with 20 ppm chlorine, and 96% with 40 ppm chlorine. In a commercial plant, the built-in water sprays, which rinse surfaces of the automatic eviscerating machines that come in contact with carcasses, were adjusted to different chlorine levels. When chlorine was not used for 4 hr the total plate count (TPC) of three different sample locations on each of four machines averaged 40,000 bacteria/cm2; when chlorine was not used for only 2 hr TPC averaged 4,000/cm2; when chlorine was supplied at 20 ppm, TPC averaged 400/cm2, when supplied at 40 ppm, TPC averaged 20/cm2, and when supplied at 70 ppm, TPC averaged 3/cm2. Surfaces that came in direct contact with carcasses showed higher TPC than surfaces exposed only to runoff of carcasses with wash water.
Optical Square-Wave Clock Generation Based on an All-Optical Flip-Flop

We demonstrate optical square-wave clock generation based on an all-optical flip-flop. The bistable output power from a resonant-type semiconductor optical amplifier (SOA) is switched on and off by modulating its input with its output via cross-gain modulation in a traveling-wave SOA. All active components are driven by dc currents, and the wavelength and clock frequency are selectable. A clock frequency of 3.5 MHz is demonstrated, limited by the time of flight between bulk optical components. Optical square-wave clock signals are promising for applications in photonic integrated circuits and all-optical signal processing.
An Initial evaluation of law enforcement overdose training in Rhode Island

Abstract Objectives To assess initial change in knowledge, self-efficacy, and anticipated behaviors among Rhode Island law enforcement officers on drug overdose response and prevention. Methods Law enforcement officers (N = 316) voluntarily completed a pre-post evaluation immediately before and after taking part in overdose prevention and response trainings. Assessment items included measures of knowledge (Brief Overdose Recognition and Response Assessment (BORRA)), self-efficacy, attitudes toward drugs and overdose prevention, awareness of the Good Samaritan Law, and open-ended items pertaining to overdose knowledge and response behaviors. Non-parametric tests measured within-group and between-group differences. Wilcoxon Signed Rank tests and Kruskal-Wallis tests evaluated changes in BORRA scores and self-efficacy items. McNemar’s tests assessed changes regarding the Good Samaritan law and open-ended items. Wilcoxon Signed Rank tests measured post-training change in attitudes. Results Law enforcement officers demonstrated statistically significant improvements in self-efficacy (identifying signs of opioid overdose, naloxone indication, counseling witnesses in overdose prevention, and referring witnesses for more information), overdose identification knowledge (BORRA mean increased from 7.00 to 10.39), naloxone administration knowledge (BORRA mean increased from 10.15 to 12.59), Good Samaritan Law awareness (17.9% increase after training), and anticipated behaviors in response to future observed overdose (65.7% changed from passive to active response post training). Conclusions Harm reduction programs can provide law enforcement officers with the knowledge and skills necessary to intervene and reduce overdose mortality. Given the statistically significant improvements in self-efficacy, attitudinal changes, and Good Samaritan law awareness, law enforcement officers are more prepared to actively interact with drug users during a drug-involved emergency.
Noise Coupling Models in Heterogeneous 3-D ICs

Models of coupling noise from an aggressor module to a victim module by way of through silicon vias (TSVs) within heterogeneous 3-D integrated circuits (ICs) are presented in this paper. Existing TSV models are enhanced for different substrate materials within heterogeneous 3-D ICs. Each model is adapted to each substrate material according to the local noise coupling characteristics. The 3-D noise coupling system is evaluated for isolation efficiency over frequencies of up to 100 GHz. Isolation improvement techniques, such as reducing the ground network inductance and increasing the distance between the aggressor and victim modules, are quantified in terms of noise improvements. A maximum improvement of 73.5 dB for different ground network impedances and a difference of 38.5 dB in isolation efficiency for greater separation between the aggressor and victim modules are demonstrated. Compact, accurate, and computationally efficient models are extracted from the transfer function for each of the heterogeneous substrate materials. The reduced transfer functions are used to explore different manufacturing and design parameters to evaluate coupling noise across multiple 3-D planes.
Duration of Stay and other Aspects of Nursing Home Use

In 1965, the Human Population Laboratory (California State Department of Health Services) conducted a survey of the non-institutionalized population of Alameda County. Subsequent checking of death records disclosed that 521 survey participants aged fifty-five years or over in 1965 had died by January, 1975. A follow-up in 1977-78 of nursing home experience among these decedents revealed that about two-fifths of those for whom information could be obtained (N = 455) had entered a nursing home at least once in the nine-year follow-up period. Further inquiry located 158 cases whose experience of institutionalization before their death could be reconstructed. Among these cases, only 22 per cent ever returned home or transferred to a residential facility after being institutionalized. Most persons died after the first admission, at the nursing home itself or at an acute care hospital to which they had been transferred shortly before death. Among the cases whose experience of institutionalization could be reconstructed, five out of ten spent less than three months, and six out of ten spent less than six months, as patients in nursing home(s). However, nearly 30 per cent of the 158 cases with reconstructed histories accumulated patient-days exceeding a year.
A Hox Transcription Factor Collective Binds a Highly Conserved Distal-less cis-Regulatory Module to Generate Robust Transcriptional Outcomes

cis-regulatory modules (CRMs) generate precise expression patterns by integrating numerous transcription factors (TFs). Surprisingly, CRMs that control essential gene patterns can differ greatly in conservation, suggesting distinct constraints on TF binding sites. Here, we show that a highly conserved Distal-less regulatory element (DCRE) that controls gene expression in leg precursor cells recruits multiple Hox, Extradenticle (Exd) and Homothorax (Hth) complexes to mediate dual outputs: thoracic activation and abdominal repression. Using reporter assays, we found that abdominal repression is particularly robust, as neither individual binding site mutations nor a DNA binding deficient Hth protein abolished cooperative DNA binding and in vivo repression. Moreover, a re-engineered DCRE containing a distinct configuration of Hox, Exd, and Hth sites also mediated abdominal Hox repression. However, the re-engineered DCRE failed to perform additional segment-specific functions such as thoracic activation. These findings are consistent with two emerging concepts in gene regulation: First, the abdominal Hox/Exd/Hth factors utilize protein-protein and protein-DNA interactions to form repression complexes on flexible combinations of sites, consistent with the TF collective model of CRM organization. Second, the conserved DCRE mediates multiple cell-type specific outputs, consistent with recent findings that pleiotropic CRMs are associated with conserved TF binding and added evolutionary constraints.
Convention hotel food and beverage operating efficiency profile

ABSTRACTHotel food and beverage operations require both revenue generating activities and expense margin controls in order to generate and sustain profits. This mixed methods study deployed a multi-factor polygon analysis and linear regression to evaluate convention hotel food and beverage margins within an urban, full-service convention hotel. Multiple hotel food and beverage expense margins were evaluated and compared across multiple outlets using a multi-factor polygon analysis. Linear regression analysis indicated the transient guestroom segment average rate had a significant impact on outlet labor cost margins and the group occupied room segment had a significant impact on in-room dining revenue and labor costs.
Burgeoning Ungulate Populations in National Parks: is Intervention Warranted?

The issues pertaining to ungulates and vegetation in national parks embody the essence of a broad debate about the purposes of and approaches to park management. Parks have always been thought of as preserves of natural environments, but valued primarily for their recreational and cultural attributes. Manipulation of natural resources to enhance these values was unquestioned. Today parks are increasingly valued for biological attributes, providing remnants of natural ecosystems, reservations for species diversity, and reservoirs of genetic variety. Burgeoning ungulate populations are impinging on some of these values. There is increasing debate about the need for intervention to control native ungulate populations. The principal issues in this debate involve concepts of herbivore-vegetation interaction, natural regulation, and ecosystem stability. I argue that attempts to resolve these issues in science have not been successful. Specifically, I argue that we cannot reject the hypothesis that natural regulation is functioning to control ungulate populations. Neither can we reject the hypothesis that burgeoning ungulate populations are fluctuating within bounds that allow continued ecosystem stability. Thus, it is inappropriate to base a decision to intervene on scientific understanding. Intervention may be warranted but, at present, the basis of such a decision must be largely political.
Differential Seasonal Steroid and Gonadotropin Expression in Full-Sibling Female Channel Catfish Maturing at Two or Three Years of Age under Normal and Accelerated Thermoperiods

AbstractThe present study was designed to determine whether female Channel Catfish Ictalurus punctatus exhibiting accelerated maturation display similar steroid (estradiol and testosterone) and gonadotropin (luteinizing hormone and follicle-stimulating hormone [FSH] messenger RNA) profiles within the first reproductive period compared with full-sibling females that reached maturity 1 year later. The accelerated maturation (AM) fish were maintained under a shortened annual temperature cycle, consisting of 4 months in 26°C water followed by 2 months at 13–14°C, repeated for three cycles. In 2007, 2-year-old AM fish were 12 times more likely to spawn on any given day than the normal maturation (NM) fish. The 2-year-old NM group was 21 times more likely to spawn as 3-year-old fish in 2008 than in the previous year, 2007. In 2007, NM fish had higher body mass in January, March, and May and maintained higher gonadosomatic index (GSI). Two-year-old AM fish never had significantly higher levels of any measured va...
Radiological Impact on Man and the Environment from the Oil and Gas Industry: Risk Assessment for the Critical Group

Radiation exposure of workers in the oil-gas industry can occur by inhalation of high-levels of radon gas; increased gamma dose rates; increased gamma dose rate due to 226Ra, 210Pb, 228Ra, and 228Th. The waste also has elevated contents of long-lived radionuclides. Finally, the recycling of waste originating within the oil-gas industry can pose a contamination problem. The various exposure pathways and a regulatory framework are discussed with regard to their applicability to the conditions in the Caspian Region.
An overview of simulation-based hydrodynamic design of ship hull forms

This review paper presents an overview of simulation-based hydrodynamic design optimization of ship hull forms. A computational tool that is aimed to accomplishing early-stage simulation-based design in terms of hydrodynamic performance is discussed in detail. The main components of this computational tool consist of a hydrodynamic module, a hull surface modeling module, and an optimization module. The hydrodynamic module includes both design-oriented simple CFD tools and high-fidelity CFD tools. These integrated CFD tools are used for evaluating hydrodynamic performances at different design stages. The hull surface modeling module includes various techniques for ship hull surface representation and modification. This module is used to automatically produce hull forms or modify existing hull forms in terms of hydrodynamic performance and design constraints. The optimization module includes various optimization algorithms and surrogate models, which are used to determine optimal designs in terms of given hydrodynamic performance. As an illustration of the computational tool, a Series 60 hull is optimized for reduced drag using three different modification strategies to outline the specific procedure for conducting simulation-based hydrodynamic design of ship hull forms using the present tool. Numerical results show that the present tool is well suited for the hull form design optimization at early design stage because it can produce effective optimal designs within a short period of time.
Impact of Sickle Cell Disease on Parents.

Abstract Background: Caregivers of patients with chronic illness experience a heavy burden leading to their own negative health outcomes and decreased quality of life. Parents may experience a similar burden caring for children with sickle cell disease, a chronic illness characterized by intermittent hospitalizations, recurrent painful crises, and reduced life expectancy. There are little data evaluating how caring for a child with sickle cell disease affects family functioning and parental health-related quality of life (HRQL). Purpose: To examine family functioning and HRQL of parents of children with sickle cell disease. Methods: During a routine clinic visit, parents completed the PedsQL Family Impact Module, which measures the HRQL of parents who are caring for a child with chronic disease by assessing parental fatigue, stress and difficulty concentrating, etc. In addition, the PedsQL Family Impact Module measures family functioning by assessing family relationships and daily activities. Scores range from 0, representing poor family functioning or HRQL, to 100, representing better family functioning or HRQL. To highlight the impact of caring for a chronically ill child living at home, we compared mean family functioning and HRQL scores of parents of children with sickle cell disease to parents of children with a complex chronic health condition who lived in a long-term Children's Convalescent Hospital (Varni et al.) using a one-sample t-test. Results: Forty-three parents (41 female and 2 male) of children with sickle cell disease completed the PedsQL Family Impact Module. The mean age (standard deviation) of the children was 9.9 yrs (4.9). Parents of children with sickle cell disease had a significantly lower HRQL summary score than the comparison population (71.99 versus 83.75; p≤.001). In addition, parents of children with sickle cell disease had a significantly lower family functioning summary score than the comparison population (73.91 versus 84.27; p=.002) Table 1 shows the mean HRQL and family functioning scores for each scale in both groups of parents. Conclusions: Caring for a child with sickle cell disease has a significant impact on the parent's HRQL and family functioning. Parents of children with sickle cell disease are more fatigued, have more trouble concentrating and remembering things, and struggle with stress within their families. Future research in sickle cell disease needs to examine the impact of the child's treatment and care on family functioning and parental HRQL to improve the burden on these parents. Additionally, greater parent education, family-centered support, and social support may be needed to lessen this burden. Health Related Quality of Life and Family Functioning of Parents of Children With Sickle Cell Disease Scale Sickle Cell Disease (n=43) Comparison Group (n=12)(Varni et al.) HRQL Physical Functioning 59.07* 82.99 Emotional Functioning 74.63 78.33 Social Functioning 79.07 85.42 Cognitive Functioning 76.17* 88.75 Family Functioning Family Daily Activities 67.46* 85.14 Family Relationships 78.02 83.75 *p
Clinical Neurogenetics: Recent Advances in the Genetics of Epilepsy

Abstract Epilepsy represents a diverse group of disorders with primary and secondary genetic etiologies, as well as non-genetic causes. As more causative genes are identified, genetic testing is becoming increasingly important in the evaluation and management of epilepsy. This article outlines the clinical approach to epilepsy patients, with emphasis on genetic testing. Specific targeted tests are available for numerous individual genetic causes of epilepsy. Broader screening tests, such as chromosome microarray analysis and whole exome sequencing, have also been developed. As a standardized protocol for genetic testing has not been established, individualized diagnostic approaches to epilepsy patients should be used.
Octreotide Is Ineffective in Treating Tumor-Induced Osteomalacia: Results of a Short-Term Therapy.

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome in which unregulated hypersecretion of fibroblast growth factor 23 (FGF23) by phosphaturic mesenchymal tumors (PMT) causes renal phosphate wasting, hypophosphatemia, and osteomalacia. The resulting mineral homeostasis abnormalities and skeletal manifestations can be reversed with surgical resection of the tumor. Unfortunately, PMTs are often difficult to locate, and medical treatment with oral phosphate and vitamin D analogues is either insufficient to manage the disease or not tolerated. Octreotide has been proposed as a potential treatment for TIO due to the presence of somatostatin receptors (SSTR) on PMTs, however the role of somatostatin signaling in PMTs and the efficacy of treatment of TIOs with somatostatin analogues is not clear. In an effort to evaluate the efficacy of octreotide therapy in TIO, 5 subjects with TIO were treated with octreotide for 3 days. Blood intact FGF23, phosphate and 1,25(OH)2D3, and tubular reabsorption of phosphate (TRP) were measured at frequent time points during treatment. Octreotide's effects were assessed by comparing group means of the biochemical parameters at each time point to mean baseline values. There were no significant changes in blood phosphate, FGF23, 1,25(OH)2D3, or TRP during octreotide treatment, consistent with a lack of efficacy of octreotide in treating TIO. This article is protected by copyright. All rights reserved
How the internal environment impacts information systems project success: An investigation of exploitative and explorative firms.

Problems impacting information systems (IS) projects are well recognized. However, there has been limited research on how a positive internal environment impacts successful IS planning implementati...
Modest alcohol consumption decreased total mortality

Source Citation Doll R, Peto R, Hall E, Wheatley K, Gray R. Mortality in relation to consumption of alcohol: 13 years' observations on male British doctors. BMJ. 1994 Oct 8;309:911-8
U.S. Maize Yield Growth and Countervailing Climate Change Impacts

Over the past several decades, maize yields in the US Midwest have risen at about 17% per decade as a result of steady technological progress. Although the trend is expected to remain positive, climate change is expected to have an increasing countervailing effect. In this chapter, I compute the yield growth rates necessary to fully offset the potential negative effects of a warming climate. Relying on a statistical model allowing for nonlinear effects of temperature on yield, I find that maize yields would decrease by −4.2, −21.8 and −46.1% around the trend, under uniform warming scenarios of 1 °C, 3 °C and 5 °C, respectively. I find that an increase of 6.6%/decade in maize yields is required to fully offset the detrimental effects of a severe but still plausible 3 °C warming in the next three decades. This indicates that future maize yield trends could – all else equal – be substantially curtailed due to the climate change. This case study illustrates how agricultural policy analysts can assess the magnitude of potential climate change impacts relative to historical yield trends to help identify targets for agricultural research.
Radiographic Evaluation of Immunotherapy

For many radiologists, the assessment of oncology patients’ response to treatment represents a significant portion of their practice. It has been shown that radiologic responses to immunotherapy can differ from traditional cytotoxic therapy, as do the complications of treatment. Inflammatory response to immunotherapy may mimic actual progression radiologically, an entity known as pseudoprogression. As advances in immunotherapy continue, radiologists need to evolve their practice in order to be able to discern between pseudoprogression and progression. They also need to become familiar with the imaging appearance of specific immune-related adverse events, in order to accurately diagnose these complications so appropriate interventions may be expedited. This chapter will review the standardized methods of radiologically assessing tumor response to traditional cytotoxic chemotherapy as opposed to immunotherapy. It will review the entity and imaging findings of pseudoprogression, and it will also depict the radiologic findings of immune-related pneumonitis and colitis.
Physical activity in individuals with lower extremity amputations: a narrative review

The beneficial effects of physical activity (PA) on the health and well-being of individuals are well established. Physical therapists are often involved in promoting optimal levels of PA in variou...
Norepinephrine levels predicts the improvement in orthostatic symptoms after atomoxetine in patients with neurogenic orthostatic hypotension (P5.320)

Objective: The purpose of this study was to determine the predictors of the improvement in orthostatic symptoms with atomoxetine. Background: We previously reported that the norepinephrine transporter inhibitor, atomoxetine, improves upright blood pressure and pre-syncopal symptoms as measured by the orthostatic hypotension symptom assessment (OHSA) in patients with neurogenic orthostatic hypotension (nOH). Design/Methods: Our sample size consisted of 101 autonomic failure patients with nOH who participated in clinical trials (NCT00223691, NCT1316666) conducted in two national referral centers for autonomic disorders (Vanderbilt Autonomic Dysfunction Center and NYU Langone Medical Center Dysautonomia Center). The analyses was performed in patients with symptomatic nOH defined as item-1 OHSA (lightheadedness) equal or more than four points. Seated blood pressure was measured in three occasions before and 60 minutes after receiving 18 mg of atomoxetine. Standing blood pressure at 1, 3, 5 and 10 minutes and OHSA questionnaire was collected before and after the atomoxetine dose. Multiple linear regression was used to test for overall linear relations between the dependent variable (OHSA score after atomoxetine) and independent variables (baseline OHSA score, age, diagnosis, baseline supine norepinephrine levels) and to assess the significance of these relations after adjustments for each covariate. Results: 47 patients (47%) met criteria for symptomatic nOH. The average age at the time of evaluation was 67±9 years, 47 % were males. 55% were diagnosed as pure autonomic failure, 30% as multiple system atrophy, 11% as Parkinson disease and 4% were patients with nOH of unknown etiology. Adjusted R2 for this model was 0.3, only supine norepinephrine levels (P=0.047) accurately predicted orthostatic symptoms following atomoxetine after adjusting for baseline OHSA, age and specific diagnosis. Conclusions: Supine baseline norepinephrine levels predict the improvement in symptoms produced by atomoxetine in patients with symptomatic nOH. Disclosure: Dr. Shibao has received personal compensation for activities with Lundbeck Pharmaceuticals and Thearavance Biopharma as a consultant. Dr. Martinez has nothing to disclose. Dr. Palma has received personal compensation for activities with Lunbeck as a speaker and advisor. Dr. Kaufmann received personal compensation from Lundbeck and Astra Zeneca for his membership on Scientific Advisory Board.. Dr. Kaufmann received personal compensation from Springer for serving as editor in Chief of Clinical Autonomic Research.. Dr. Kaufmann received support for conducting clinical trials of Droxidopa for Chelsea Therapeutics.. Dr. Biagioni has received personal compensation for activities with Lundbeck LLC and Thearavance Biopharma. Dr. Biaggioni has received research support from Astra Zeneca.
A model-theoretic analysis of monotonic knowledge

We present a semantic model for knowledge with the following properties: (1) Knowledge is necessarily correct, (2) agents are logically omniscient, i.e., they know all the consequences of their knowledge, and (3) agents are positively introspective, i.e., they are aware of their knowledge, but not negatively introspective, i.e., they may not be aware of their ignorance. We argue that this is the appropriate model for implicit knowledge. We investigate the properties of the model, and use it to formalize the notion of circumscribed knowledge.
Distribution of Ti3+ Surface Sites in Reduced TiO2

We describe a DFT + U study of the (110) rutile surface with oxygen vacancies (Ov's). Oxygen vacancies leave behind two excess unpaired electrons per Ov, leading formally to the formation of two Ti3+ ions. We investigate the location of the Ti3+ ions within the first three surface layers. In total, we obtained 49 unique solutions of possible Ti3+ pairs, to examine the stability of all Ti types (e.g., five-coordinated surface Ti, six-coordinated surface Ti, subsurface sites, etc.). Our results show that subsurface sites are preferred but that many configurations are close in energy, within up to 0.3−0.4 eV of each other. In contrast to findings in previous work, we show that sites directly adjacent to the Ov's are unstable. Analysis of our results shows that the two Ti3+ ions within a pair behave independently of each other, as there are little electronic interactions between the excess electrons associated with these sites. We also examined the migration of Ti3+ sites from the surface into the bulk and fi...
Non-lethal Sepsis and Nitric Oxide Inhibition in the Guinea Pig

Nitric oxide (NO) is synthesized from arginine by three distinct isoforms of nitric oxide synthase (NOS). Two of these isoforms, endothelial NOS (eNOS, type III NOS) and neuronal NOS (nNOS, type I NOS) are expressed in a constitutive manner and are responsible for regulating physiological functions. The induction of the third isoform of nitric oxide synthase (iNOS) by inflammatory processes and the subsequent overproduction of NO is thought to contribute to the tissue damage that occurs in a number of diseases having an inflammatory component, such as sepsis. As a model of sepsis, non-lethal endotoxemia in Hartley guinea pigs was induced using three serotypes of lipopolysaccharide (LPS, 30 mg/kg, i.p.). Each stimulated an increase in total plasma nitrites 6 h following their administration. Treatment orally with two inhibitors of NOS, L-nitroarginine methyl ester (L-NAME), a non-selective inhibitor and N-iminoethyl-L-lysine (L-NIL), a selective iNOS inhibitor, 30 min after the induction of sepsis, inhibited (p < 0.05) the increase in plasma nitrites with ED50 values of 7 ± 1 and 0.4 ± 0.03 mg/kg, respectively, suggesting that NOS inhibitors may be useful in the treatment of human sepsis, or other diseases where excess NO levels have been implicated, such as asthma, arthritis and inflammatory bowel disease.
Resident Experience and Education in Academic and Community Pediatric Primary Care Sites: Lessons for a Changing Healthcare Landscape

Efforts to improve pediatric primary care training in residency are important both for the residents and for the patients cared for in residency clinics. Pediatric residents typically get their primary care training at primary care centers affiliated with an academic center or at community-based locations. We aimed to compare residents’ experience of continuity clinic in academic centers and community settings, and to identify relative strengths and weaknesses of each. Survey data was evaluated for residents at one large pediatric residency program. Community sites had relative strengths in patient flow, population management, and perception of overall quality of care. Academic sites had relative strengths in continuity of care and ease of follow-up of results. Community and academic pediatric primary care training sites have varied strengths that could inform efforts to improve residency training to better meet the needs of residents and patients.
The impact of health literacy on shared decision making before elective surgery: a propensity matched case control analysis

Poor health literacy affects over 90 million Americans. The primary aim of the study was to evaluate a possible association between health literacy and decision conflict in surgical patients. Patients undergoing a diverse number of elective surgeries were enrolled in the study. Health literacy was measured using the Newest Vital Sign instrument and decision conflict using the low literacy version of the Decision Conflict Scale. 200 patients undergoing elective surgeries were included in the study. Patients who had greater health literacy scores had lower decision conflict scores, Spearman’s rho = − 0.43, P < 0.001. Following propensity-score matching to account for potential covariates, the median (IQR) decision conflict score was 20 (0 to 40) for patients with poor health literacy compared to 0 (0 to 5) for patients with adequate literacy, P < 0.001. Poor health literacy is associated with greater decision conflict in patients undergoing elective surgical procedures. Strategies should be implemented to minimize decision conflict in poor health literacy patients undergoing elective surgical procedures.
Gasping for a Diagnosis

Gasping for a Diagnosis A 42-year-old man presented with progressive nonproductive cough, shortness of breath, and unintentional weight loss. He reported no fevers, chills, night sweats, hemoptysis...
Sources of errors in coagulation testing

Abstract In this chapter, errors in coagulation testing that are known to significantly affect test results have been addressed. The sources of these errors can be found in both pre-analytical and analytical phases of testing. Knowing the sources of errors is essential for trouble-shooting unexpected laboratory results that are not correlated with clinical information. There are also pre-analytical artifacts present in patient samples that cause rejection of samples by the laboratory. Similarly, interferences in analytical testing may produce unexpected results in coagulation testing. Knowing these artifacts and interferences should help clinicians to work with laboratory personnel to prevent future incidences or to pursue alternative methods of testing.
Tocqueville’s Critique of the U.S. Constitution

Few studies of Democracy in America give substantial weight to Tocqueville’s analysis of the United States Constitution in volume 1, part 1, chapter 8. In this article, I argue that Tocqueville’s a...
Protocol for a Cluster Randomized Trial Comparing Team-Based to Clinician-Focused Implementation of Advance Care Planning in Primary Care.

Introduction: For many patients, primary care is an appropriate setting for advance care planning (ACP). ACP focuses on what matters most to patients and ensuring health care supports patient-defined goals. ACP may involve interactions between a clinician and a patient, but for seriously ill patients ACP could be managed by a team. Methods: We are conducting a cluster randomized trial comparing team-based to clinician-focused ACP using the Serious Illness Care Program (SICP) in 42 practices recruited from 7 practice-based research networks (PBRNs). Practices were randomized to one of the two models. Patients are referred to the study after engaging in ACP in primary care. Our target enrollment is 1260 subjects. Patient data are collected at enrollment, six months and one year. Primary outcomes are patient-reported goal-concordant care and days at home. Secondary outcomes include additional patient measures, clinician/team experience, and practice-level measures of SICP implementation. Study Implementation: This trial was designed and is conducted by the Meta-network Learning and Research Center (Meta-LARC), a consortium of PBRNs focused on integrating engagement with patients, families, and other stakeholders into primary care research and practice. The trial pairs a comparative effectiveness study with implementation of a new program and is designed to balance fidelity to the assigned model with flexibility to allow each practice to adapt implementation to their environment and priorities. Our dissemination will report the results of comparing the two models and the implementation experience of the practices to create guidance for the spread of ACP in primary care.
Investigation of Read Disturb and Bipolar Read Scheme on Multilevel RRAM-Based Deep Learning Inference Engine

The multilevel resistive random access memory (RRAM)-based synaptic array can enable parallel computations of vector–matrix multiplication for machine learning inference acceleration; however, any conductance drift of the cell may induce an inference accuracy drop because the analog current is summed up along the column. In this article, the read disturb-induced conductance drift characteristic is statistically measured on a test vehicle based on 2-bit HfO2 RRAM array. The drift behavior of four states is empirically modeled by a vertical and lateral filament growth mechanism. Furthermore, a bipolar read scheme is proposed and tested to enhance the resilience against the read disturb. The modeled read disturb and proposed compensation scheme are incorporated into a VGG-like convolutional neural network for CIFAR-10 data set inference.
A Critical Review of Extraction and Identification Methods of Microplastics in Wastewater and Drinking Water

This critical review analyzes methodologies used to collect, quantify, and characterize microplastics in both wastewater and drinking water. Researchers used different techniques at all stages, from collection to characterization, for quantifying microplastics in urban water systems. This represents a barrier to comprehensively assess the current loads of microplastic and to compare the results obtained by such assessments. The compiled studies address microplastic contamination using four types of sample collection techniques, four methods for processing samples, and four techniques for characterizing microplastics. This results in significant discrepancies in each of the following: (1) reported concentrations in both wastewater effluents and drinking water, (2) microplastic characteristics (i.e., size, color, shape, and composition), and (3) quality control and assurance procedures. Finally, this review qualitatively evaluated the reports by the completeness of their data based on a ranking system using five criteria: sample collection, sample processing, quality control, identification technique, and results. The results of this ranking system clarify disparities between the studies.