cssi/SciSciGPT-SciSciNet huggingface dataset:
Naproxen With Cyclobenzaprine, Oxycodone/Acetaminophen, or Placebo for Treating Acute Low Back Pain: A Randomized Clinical Trial

Importance Low back pain (LBP) is responsible for more than 2.5 million visits to US emergency departments (EDs) annually. These patients are usually treated with nonsteroidal anti-inflammatory drugs, acetaminophen, opioids, or skeletal muscle relaxants, often in combination. Objective To compare functional outcomes and pain at 1 week and 3 months after an ED visit for acute LBP among patients randomized to a 10-day course of (1) naproxen + placebo; (2) naproxen + cyclobenzaprine; or (3) naproxen + oxycodone/acetaminophen. Design, Setting, and Participants This randomized, double-blind, 3-group study was conducted at one urban ED in the Bronx, New York City. Patients who presented with nontraumatic, nonradicular LBP of 2 weeks’ duration or less were eligible for enrollment upon ED discharge if they had a score greater than 5 on the Roland-Morris Disability Questionnaire (RMDQ). The RMDQ is a 24-item questionnaire commonly used to measure LBP and related functional impairment on which 0 indicates no functional impairment and 24 indicates maximum impairment. Beginning in April 2012, a total of 2588 patients were approached for enrollment. Of the 323 deemed eligible for participation, 107 were randomized to receive placebo and 108 each to cyclobenzaprine and to oxycodone/acetaminophen. Follow-up was completed in December 2014. Interventions All participants were given 20 tablets of naproxen, 500 mg, to be taken twice a day. They were randomized to receive either 60 tablets of placebo; cyclobenzaprine, 5 mg; or oxycodone, 5 mg/acetaminophen, 325 mg. Participants were instructed to take 1 or 2 of these tablets every 8 hours, as needed for LBP. They also received a standardized 10-minute LBP educational session prior to discharge. Main Outcomes and Measures The primary outcome was improvement in RMDQ between ED discharge and 1 week later. Results Demographic characteristics were comparable among the 3 groups. At baseline, median RMDQ score in the placebo group was 20 (interquartile range [IQR],17-21), in the cyclobenzaprine group 19 (IQR,17-21), and in the oxycodone/acetaminophen group 20 (IQR,17-22). At 1-week follow-up, the mean RMDQ improvement was 9.8 in the placebo group, 10.1 in the cyclobenzaprine group, and 11.1 in the oxycodone/acetaminophen group. Between-group difference in mean RMDQ improvement for cyclobenzaprine vs placebo was 0.3 (98.3% CI, −2.6 to 3.2; P = .77), for oxycodone/acetaminophen vs placebo, 1.3 (98.3% CI, −1.5 to 4.1; P = .28), and for oxycodone/acetaminophen vs cyclobenzaprine, 0.9 (98.3% CI, −2.1 to 3.9; P = .45). Conclusions and Relevance Among patients with acute, nontraumatic, nonradicular LBP presenting to the ED, adding cyclobenzaprine or oxycodone/acetaminophen to naproxen alone did not improve functional outcomes or pain at 1-week follow-up. These findings do not support use of these additional medications in this setting. Trial Registration clinicaltrials.gov Identifier:NCT01587274
Laser-Induced Photon-Branched Chain Reactionin a Chemically-Active Gas-Dispersed Medium

A promising avenue in the development of high-energy pulsed chemical HF/DF lasers and amplifiers is the utilization of a photon-branched chain reaction initiated in a two-phase active medium, that is, a medium containing a laser working gas and ultradispersed passivated metal particles. These particles are evaporated under the action of IR laser radiation which results in the appearance of free atoms, their diffusion into the gas, and the development of a photon-branching chain process, which involves photons as both reactants and products. The key obstacle here is the formation of a relatively large volume (in excess of 10 3 cm 3 ) of the stable active medium and filling this volume homogeneously for a short time with a submicron monodisperse metal aerosol, which has specified properties. In this paper, results are presented for an extensive study of laser initiation of a photon-branched chain reaction in a gas-dispersed H 2 – F 2 medium.
Systematic review of the validity and reliability of consumer-wearable activity trackers

Consumer-wearable activity trackers are electronic devices used for monitoring fitness- and other health-related metrics. The purpose of this systematic review was to summarize the evidence for validity and reliability of popular consumer-wearable activity trackers (Fitbit and Jawbone) and their ability to estimate steps, distance, physical activity, energy expenditure, and sleep. Searches included only full-length English language studies published in PubMed, Embase, SPORTDiscus, and Google Scholar through July 31, 2015. Two people reviewed and abstracted each included study. In total, 22 studies were included in the review (20 on adults, 2 on youth). For laboratory-based studies using step counting or accelerometer steps, the correlation with tracker-assessed steps was high for both Fitbit and Jawbone (Pearson or intraclass correlation coefficients (CC) > =0.80). Only one study assessed distance for the Fitbit, finding an over-estimate at slower speeds and under-estimate at faster speeds. Two field-based studies compared accelerometry-assessed physical activity to the trackers, with one study finding higher correlation (Spearman CC 0.86, Fitbit) while another study found a wide range in correlation (intraclass CC 0.36–0.70, Fitbit and Jawbone). Using several different comparison measures (indirect and direct calorimetry, accelerometry, self-report), energy expenditure was more often under-estimated by either tracker. Total sleep time and sleep efficiency were over-estimated and wake after sleep onset was under-estimated comparing metrics from polysomnography to either tracker using a normal mode setting. No studies of intradevice reliability were found. Interdevice reliability was reported on seven studies using the Fitbit, but none for the Jawbone. Walking- and running-based Fitbit trials indicated consistently high interdevice reliability for steps (Pearson and intraclass CC 0.76–1.00), distance (intraclass CC 0.90–0.99), and energy expenditure (Pearson and intraclass CC 0.71–0.97). When wearing two Fitbits while sleeping, consistency between the devices was high. This systematic review indicated higher validity of steps, few studies on distance and physical activity, and lower validity for energy expenditure and sleep. The evidence reviewed indicated high interdevice reliability for steps, distance, energy expenditure, and sleep for certain Fitbit models. As new activity trackers and features are introduced to the market, documentation of the measurement properties can guide their use in research settings.
M-bias, Butterfly Bias, and Butterfly Bias with Correlated Causes – A Comment on Ding and Miratrix (2015)

Ding and Miratrix [1] recently concluded that adjustment on a pre-treatment covariate is almost always preferable to reduce bias. I extend the examined parameter space of the models considered by Ding and Miratrix, and consider slight extensions of their models as well. Similar to the conclusion by Pearl [7], I identify constellations in which bias due to adjustment, or failing to adjust is symmetrical, but also confirm some findings of Ding and Miratrix.
The kinetic analysis of simultaneous calcium exchange and sorbitol washout in the rat heart.

SummaryIn isolated working rat hearts, the washout of 3H sorbitol as well as the exchange of 45Ca2+ could be described as the sum of three processes, two of which were found to be exponential in nature. The volume of distribution of 45Ca2+ was greater than that of the sorbitol. This greater volume of distribution was clearest for the compartment with the longest time constant. Addition of quinidine in doses which produced a 32% decline in maximum dP/dt had no effect on the rate constants for the washout of sorbitol or the exchange of 45Ca2+. The difference between the volume of distribution of calcium and sorbitol was also not measurably changed by the negative inotropic intervention.The results suggest that the kinetics of 45Ca2+ exchange are determined by those processes which limit the washout of the extracellular space. The studies with quinidine further suggest that if this agent displaces Ca2+ from binding or storage sites, the amount affected is too small to be detected by kinetic analysis of calci...
The Many Facets of Brown: Integration in a Multiracial Society

In writing the opinion in Brown v. Board of Education, Earl Warren was very conscious of constructing, not just a legal document, but a paradigm-shifting political statement. Against the entrenched customs, practices, and hierarchies of white supremacist rule, the Brown decision established liberal universalism as the guiding concept governing American race relations. Warren's own career, however, was marked by contradictory, rather than universal, stances on racialized political issues. On the one hand, the Brown decision, as Warren later wrote, manifested the belief held by Warren and countless millions of others that the fight against fascism had transformed humanity by creating an unprecedented unity in defense of "equal rights for all." On the other hand, Warren's articulation of the lessons of World War II promoted a false universalism, for he conveniently glossed over his own demagogic actions as California attorney general and governor during the war. In the months following Japan's attack on Pearl Harbor, Warren had argued that ordinary Japanese American farmers had "infiltrated themselves" into "strategic" military sites in California; he had even asserted that the absence of sabotage committed by any Japanese American indicated "a studied effort not to have any until the zero hour arrives." While it was in his eyes feasible to distinguish loyal from disloyal members of "the Caucasian race," Warren championed the mass internment of Japanese Americans, whose inscrutable character, he contended, made it impossible for authorities to "form any opinion that we believe to be sound."'
Evaluating Programs That Address Ideological Issues: Ethical and Practical Considerations for Practitioners and Evaluators

There are important practical and ethical considerations for organizations in conducting their own, or commissioning external, evaluations and for both practitioners and evaluators, when assessing programs built on strongly held ideological or philosophical approaches. Assessing whether programs “work” has strong political, financial, and/or moral implications, particularly when expending public dollars, and may challenge objectivity about a particular program or approach. Using a case study of the evaluation of a school-based abstinence-until-marriage program, this article discusses the challenges, lessons learned, and ethical responsibilities regarding decisions about evaluation, specifically associated with ideologically driven programs. Organizations should consider various stakeholders and views associated with their program to help identify potential pitfalls in evaluation. Once identified, the program or agency needs to carefully consider its answers to two key questions: Do they want the answer an...
The Trimethylamine–Formic Acid Complex: Microwave Characterization of a Prototype for Potential Precursors to Atmospheric Aerosol

The reactions of amines and carboxylic acids have recently received attention for their possible role in the formation of atmospheric aerosol. Here, we report a microwave study of the trimethylamine–formic acid hydrogen-bonded complex, a simple prototype in which to study amine–carboxylic acid interactions. Spectra of three isotopologues of the system have been observed using a tandem cavity and chirped-pulse Fourier transform microwave spectrometer. The complex has a plane of symmetry, with the acidic proton of the formic acid directed toward the lone pair of the nitrogen. The zero-point-averaged hydrogen bond length is 1.702 A, and the O–H···N angle is 177°. 14N nuclear quadrupole hyperfine structure has been used to assess the degree of proton transfer from the formic acid to the trimethylamine. Experimental results are supplemented with density functional theory calculations. M06-2X/6-311++G(3df,3pd) calculations indicate a binding energy of 16.8 kcal/mol with counterpoise correction (17.4 kcal/mol wi...
Bioavailability of Orally Delivered Alpha- tocopherol by Poly(Lactic-Co-Glycolic) Acid (PLGA) Nanoparticles and Chitosan Covered PLGA Nanoparticles in F344 Rats

It is hypothesized that the bioavailability of αT (alpha-tocopherol), an antioxidant, can be improved when delivered by poly(lactic-co-glycolic) acid (PLGA) nanoparticles (NPs) and chitosan covered PLGA nanoparticles (PLGA-Chi NPs), and that the mucoadhesive properties of chitosan may enhance absorption of αT. PLGA and PLGA-Chi NPs were characterized by measuring entrapment efficiency, size, polydispersity, and zeta potential. Nanoparticle physical stability, chemical stability of entrapped αT, and release kinetics were also measured. Pharmacokinetic studies were conducted by administering PLGA (αT) NPs, PLGA-Chi (αT) NPs, and free αT via oral gavage in rats. The size and zeta potential of the two particle systems were 97.87 ± 2.63 nm and −36.2 ± 1.31 mV for PLGA(αT) NPs, and 134 ± 2.05 nm and 38.0 ± 2.90 mV for PLGA-Chi (αT) nanoparticles in DI water. The particle systems showed to be stable during various in vitro assays. Bioavailability of nanodelivered αT was improved compared to the free αT, by 170% ...
Gaze, Posture and Gesture Recognition to Minimize Focus Shifts for Intelligent Operating Rooms in a Collaborative Support System

This paper describes the design of intelligent, collaborative operating rooms based on highly intuitive, natural and multimodal interaction. Intelligent operating rooms minimize surgeon’s focus shifts by minimizing both the focus spatial offset (distance moved by surgeon’s head or gaze to the new target) and the movement spatial offset (distance surgeon covers physically). These spatio-temporal measures have an impact on the surgeon’s performance in the operating room. I describe how machine vision techniques are used to extract spatio-temporal measures and to interact with the system, and how computer graphics techniques can be used to display visual medical information effectively and rapidly. Design considerations are discussed and examples showing the feasibility of the different approaches are presented.
Disaster Medicine: Lessons Learned from the Crash of Asiana Airlines Flight 214

Asiana Airlines Flight 214 crashed at San Francisco International Airport in July of 2013. There were 291 passengers and 16 crew members that became potential patients causing a Mass Casualty event (MASCAL). There are about 90 aircraft crashes in the USA monthly. Most of them are single-engine planes with few passengers and major airline crashes with large numbers of surviving passengers are rare. There is little data on the injury patterns of survivors of such crashes Historically such patients will have extremity fractures and traumatic brain injuries. The survivors of Asiana Flight 214 also sustained a significant number of sternal and spinal fractures. Some survivors displayed a toxic picture potentially related to the flame retardants manifested by severe hypocalcemia. The use of good MASCAL treatment principles helped to treat many patients without overwhelming the system.
Study on the Evaluation Index System of Website Construction in Agricultural Science Research Institutes

In the essay,based on the general idea of the evaluation index system of website construction and the principle of the evaluation index selection in agricultural science research institutes,by using the current website evaluation index system in domestic and the achievement of other researchers for reference,and aimed at the current development situation and the industry characteristics of agricultural science research institutes,the objective and the purpose of constructing the evaluation index were discussed,then the websites of agricultural science research institutes from six aspects were analyzed,such as website construction,website function,website designing,website technology and website influence.A relatively complete evaluation index system of website construction for agricultural science research institutes had been constructed.
In-Situ Experimental Investigations on the Dewatering of Fine Particle Impurities Using Hydrocyclones

Based on the practical conditions of Daqing Oil Field and the researches in room, an experimental investigation on the separation treatment of fine particle impurities was conducted using hydrocyclones. The result shows that the dewaterring rate might rise up to 90% with the increase of flow, and it was not that the more the flow was, the better. When the split ratio was below 8.75%, the result was ideal. Blockage would evidently occur inside the under flow tubes of the hydrocyclones if the split ratio was too small. The separation result of 5° cone angle hydrocyclones was better than that of 8° cone angle hydrocyclones,and their pressure loss was comparatively low.The primary test shows that it was possible to treat the fine particle impurities in the oil field wastewater using hydrocyclones.ydroc
Snapshots of a viral RNA polymerase switching gears from transcription initiation to elongation

During transcription initiation, RNA polymerase binds tightly to the promoter DNA defining the start of transcription, transcribes comparatively slowly, and frequently releases short transcripts (3-8 nucleotides) in a process called abortive cycling. Transitioning to elongation, the second phase of transcription, the polymerase dissociates from the promoter while RNA synthesis continues. Elongation is characterized by higher rates of transcription and tight binding to the RNA transcript. The RNA polymerase from enterophage T7 (T7 RNAP) has been used as a model to understand the mechanism of transcription in general, and the transition from initiation to elongation specifically. This single-subunit enzyme undergoes dramatic conformational changes during this transition to support the changing requirements of nucleic acid interactions while continuously maintaining polymerase function. Crystal structures, available of multiple stages of the initiation complex and of the elongation complex, combined with biochemical and biophysical data, offer molecular detail of the transition. Some of the crystal structures contain a variant of T7 RNAP where proline 266 is substituted by leucine. This variant shows less abortive products and altered timing of transition, and is a valuable tool to study these processes. The structural transitions from early to late initiation are well understood and are consistent with solution data. The timing of events and the structural intermediates in the transition from late initiation to elongation are less well understood, but the available data allows one to formulate testable models of the transition to guide further research.
Contractile Proteins in Relation to Transmitter Release

Actomyosin, the protein system responsible for muscle contraction, has been most studied, and is best understood, in terms of its composition, structural relationship, and function, in striated muscle. It has become increasingly evident, however, that this protein complex is not limited to muscle; studies indicate its presence in a variety of other cells some of rather primitive origin. For a recent review of actomyosin-like protein in nonmuscle cells see Pollard and Weihing (1974).
Oral Sequelae of Cancer Therapy

Patients undergoing cancer therapy are at risk of developing a wide range of acute and late treatment-related toxicities and complications. Depending on the type and location of cancer as well as the treatment modality, the oral cavity may be at significant risk for development of complications. Acute oral toxicities, when severe, may contribute to the need for treatment breaks and/or dose reductions, which can negatively impact clinical outcomes. Late complications contribute to morbidity and reduced quality of life, and in some cases may be life-threatening. Management of an individual patient requires an understanding of risks specific to the cancer and planned therapy, the epidemiology and clinical features of potential complications, and the principles of diagnosis and management.
Lead underpotential deposition for the surface characterization of silver ad-atom modified gold electrocatalysts for glucose oxidation

Abstract The surface composition of Ag–Au electrocatalysts plays an important role in enhancing their activity for glucose oxidation. In this work, the surface of a polycrystalline Au electrode was modified through underpotential deposition of Ag (Ag upd ) and the surface composition of the resulting Ag upd -modified Au catalysts was characterized using an ex situ electrochemical technique involving underpotentially deposited lead (Pb upd ). Recognizing that Ag and Au surfaces exhibit distinct Pb upd charge densities, the Pb upd charge density associated with a Ag ad-atom modified Au electrode surface is a representation of its surface composition. This enables quantification of the Ag and Au fractional surface coverages, which are in good agreement with those predicted based on the Ag upd charge density passed during Ag upd –Au surface preparation. The dependence of the glucose oxidation kinetics on the surface composition of the Ag upd –Au catalyst was investigated using voltammetry. Optimal catalytic activity was provided by catalysts with 56% Ag upd coverage. Our investigation, while providing a reliable analytical technique (using Pb upd ) for compositional characterization of heterogeneous catalyst surfaces, supports the surface composition dependence of the activity of Ag upd –Au catalysts toward glucose oxidation.
Does life stress moderate/mediate the relationship between finger length ratio (2D4D), depression and physical health?

Abstract Diseases with sex-dependent expressions may have an etiology in prenatal sex hormone exposure, specifically prenatal androgens. This study examined the relationship between prenatal hormone exposure (as evidenced by the 2D4D ratio), with life stress as a potential moderator/mediator, and adult depressive and/or physical health symptoms. Participants were n = 137 undergraduates from diverse backgrounds. Results indicated a more masculine 2D4D ratio was associated with poorer health in males, but the 2D4D ratio seemed to have little explanatory power for female physical/mental health. In males, a lower ratio (i.e., more masculine) ratio was linked to clinical cutoff scores for depression, higher levels of life stress, and greater depression scores. In addition, the relationship was mediated by life stress, indicating the link between a more masculine ratio and depression was dependent on levels of life stress. The 2D4D ratio was also moderated by life stress, such that at high levels of stress a more masculine ratio was associated with more physical symptoms. Overall, while life stress seemed to have the largest impact on physical and mental health for female participants, a more masculine ratio emerged as a risk factor for men, but was strongly governed by the context of reported stress levels.
Power-efficient terahertz communication circuits

Recent advances in CMOS/BiCMOS technologies have an enormous impact on the demonstration of mm-wave and terahertz integrated circuits. The higher frequency of operation at these ranges compared to RF frequencies, is specifically important for design of high speed communication systems. In this paper, we review the design challenges and recent demonstrations of communication circuits at the terahertz band. In order to achieve an efficient power generation in terahertz oscillators, a return-path gap coupler structure is introduced. Based on this structure, a 220 GHz spatial-orthogonal ASK transmitter is designed in 130 nm SiGe BiCMOS technology. This transmitter achieves an EIRP of 21 dBm and DC-to-THz-radiation efficiency of 0.7%. Compared with the state-of-the-art terahertz communication circuits, this circuit achieves a higher output power and higher DC-to-RF efficiency1.
Detection of Abrin Holotoxin Using Novel Monoclonal Antibodies

Abrin, a member of the ribosome-inactivating protein family, is produced by the Abrus precatorius plant. Having the potential to pose a severe threat to both human and animal health, abrin is classified as a Select Agent by the U.S. Department of Health and Human Services. However, an immunoassay that is specific for intact abrin holotoxin has not yet been reported. In this study, seven new monoclonal antibodies (mAbs), designated as Abrin-1 through Abrin-7 have been developed. Isotyping analyses indicate these mAbs have IgG1, IgG2a, or IgG2b heavy-chains and kappa light-chains. Western blot analyses identified two abrin A-chain specific mAbs, Abrin-1 and Abrin-2, and four B-chain specific mAbs (Abrin-3, -5, -6, and -7). A sandwich enzyme-linked immunosorbent assay (ELISA), capable of detecting a mixture of abrin isoforms and agglutinins was developed using B-chain specific Abrin-3 for capture and A-chain specific Abrin-2 as detector. The ELISA is highly sensitive and detects 1 ng/mL of the abrin holotoxin in phosphate-buffered saline, nonfat milk, and whole milk, significantly below concentrations that would pose a health concern for consumers. This ELISA also detects native abrin in plant extracts with a very low background signal. The new abrin mAbs and ELISA should be useful for detecting this potent toxin in the milk supply chain and other complex matrices.
Kierkegaard’s “Ugly Feelings”

Reconsidering contemporary affect theory through the lens of Soren Kierkegaard’s writings, this chapter extrapolates from Kierkegaard’s thought a more secular phenomenology of affects that stresses the pivotal role of experiences of overwhelmed and disproportionate cognition. The chapter argues that reimagining Kierkegaard as a theorist of affectively driven thinking helps us discern a conceptual gap in the way contemporary academic scholarship tends to analyze affects in our day and age. This gap consists in affect theory’s simultaneous insistence that an affect theorist is moved, and even possessed, by her affects, and that she can quasi-objectively evaluate their broader import. Kierkegaard’s writing enables us to see that this theoretical position is partly misguided. It constitutes a hitherto﻿ missed (but not irretrievable) opportunity for deeper engagement with affects as experiences of losing critical scale and distance.
Abstract 15748: Resting Myocardial Computed Tomography Perfusion Provides Incremental Value Beyond Coronary Stenosis and Atherosclerotic Plaque Characteristics for Predicting Lesion Ischemia: A Machine Learning Approach

Introduction: Atherosclerotic plaque characteristics (APCs) including stenosis severity, positive arterial remodeling, low attenuation plaque, and spotty calcification by coronary CT angiography (CCTA) are associated with lesion-specific ischemia. Typically-acquired CCTA enables evaluation of first-pass contrast-enhanced myocardial attenuation patterns. Whether resting CCTA perfusion (CTP) augments identification of ischemia-causing coronary lesions is unknown. Hypothesis: To evaluate the incremental value of resting CTP beyond APCs for determining lesion ischemia by fractional flow reserve (FFR). Methods: 252 patients (mean age: 62.9±8.7 years, 70.6% men) with suspected CAD were examined. Coronary lesion ischemia was defined as ≤0.80 by invasive FFR, and CT stenosis ≥50% defined obstructive CAD. The number of APCs was classified as 0, 1, and ≥2 present. Resting CTP was ascertained using a gradient boosting classifier for supervised machine learning, and expressed as the percent likelihood (%) of ischemia. An optimal binary cut-point for percent likelihood (53.4%) was determined. Multivariable odds ratios (OR), area under the receiver operating characteristic curves (AUC), and category-free net reclassification improvement (cNRI) were estimated for predicting ischemia. Results: Coronary lesion ischemia was identified among 129 (51.2%) patients. An increased likelihood of ischemia was observed for presence of obstructive CT stenosis (OR: 2.4, 95% CI: 1.2-4.5), increasing numbers of APCs (e.g., OR for ≥2 present: 9.1, 95% CI: 4.4-18.7), and abnormal resting CTP (OR: 2.9, 95% CI: 1.6-5.2). Resting CTP displayed improved discrimination (AUC: 0.82 vs. 0.79, P=0.034) and reclassification (cNRI: 0.49, P Conclusions: The addition of resting CTP improves incremental utility for predicting coronary lesions that cause ischemia over and above CT stenosis and APCs.
Proof Without Words: ¼+(¼)2+(¼)3+…=⅓.

(1999). Proof Without Words: ¼+(¼)2+(¼)3+…=⅓. Mathematics Magazine: Vol. 72, No. 1, pp. 63-63.
Rapid-Onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD)

Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) is a rare disorder, which can result in cardiorespiratory arrest if not diagnosed and managed in a timely manner. There is no genetic test for ROHHAD at present, but a CCHS-related PHOX2B mutation excludes the diagnosis of ROHHAD. Any previously healthy and non-obese child who rapidly gains 20–30 pounds over 3–6 months, between the ages of 2–7 years, followed by evidence of sequential endocrine abnormalities, should be evaluated for evidence of ROHHAD. It is important to evaluate the child for any evidence of hypoventilation during wakefulness and sleep at presentation and then at 2–3 month intervals, as the hypoventilation component of the phenotype unfolds rapidly. If unrecognized, and artificial ventilation during sleep (and in a subset during wakefulness and sleep) is not provided promptly, the child will be at risk for morbidity and/or cardiorespiratory arrest. Echocardiography should be performed every 6 months to evaluate for cor pulmonale and/or right ventricular hypertrophy due to anticipated intermittent hypoxia. 72-h Holter monitoring should be performed every 6 months to evaluate for severe bradycardia. Screening for neural crest tumors should also be done every 3–6 months, especially early in the ROHHAD phenotype. The patient with ROHHAD will need to have close physiologic monitoring of ventilatory status, artificial ventilation with continuous oximetry and capnography in the home with a highly trained registered nurse at the bedside, serial evaluation for endocrine abnormalities, and aggressive management of weight. At present there is currently no cure for ROHHAD; however, with optimal management, disease burden can be reduced for children with ROHHAD.
Cholera Toxin B Subunit as an Immunomodulator for Mucosal Vaccine Delivery

This chapter discusses cholera toxin B subunit as an immunomodulator for mucosal vaccine delivery. Efforts to exploit oral immunization for the development of vaccines against the great majority of infections, which directly afflict or invade through the mucosal surfaces, were formerly limited by the modest responses usually generated by the mucosal immune system. In part, this is probably because its functions include the maintenance of homeostasis despite being continuously challenged by large quantities of mainly harmless environmental antigens and commensal microorganisms. In addition, most nonviable immunogens have no affinity for the M cells overlying mucosal inductive sites, such as the intestinal Peyer's patches, and are readily digested within the gut lumen. Thus, oral immunization with conventional nonviable immunogens typically requires the repeated administration of large doses, and yields modest responses that do not persist. However, numerous developments during the past decade have addressed these problems. Notably, the exceptionally potent mucosal immunogenic and adjuvant properties of cholera toxin (CT) and related enterotoxins have been exploited by coupling other antigens to the nontoxic B subunit of CT, or by seeking to detoxify the heat-labile toxin (LT) of Escherichia coli while preserving its adjuvanticity.
Coronary Risk Factors and Prevention

The concept of coronary risk and the practical application of this concept among those men at excess risk is important for a number of reasons.
The Becker-Döring Equations

This chapter deals with the modified Becker-Doring equations, which provide perhaps the simplest kinetic model to describe a number of issues in the dynamics of phase transitions, e.g. metastability, nucleation, corsening. The important analogies between the Becker-Doring equations and the Boltzmann equation are emphasized. Moreover, the following topics are reviewed: the trend to equilibrium based on a non-increasing Lyapunov function similar to the Boltzmann H-function; the formal existence of a scaling limit (the Lifschitz-Slyozov-Wagner equations) which are a continuous theory of cluster evolution similar in spirit to the hydrodynamic limit of the Boltzmann equation.
Treating Pain and Inflammation in Hypertension

In recent years, there has been a substantial evaluation of the cardiovascular (CV) effects of nonsteroidal anti-inflammatory drugs (NSAIDs) and selective cyclooxygenase-2 (COX-2) inhibitors, including in patients with and without hypertension. In this chapter, the focus is on the effects of both NSAIDs and COX-2 inhibitors on blood pressure. Clinical trials and observational studies reviewing the relationships among NSAIDs, blood pressure, and blood pressure destabilization are discussed. The results of clinical trial for NSAIDs and COX-2 inhibitors have shown varying levels of destabilization of blood pressure control in treated hypertensive patients as well as variable incident rates in the development of arrhythmias, congestive heart failure, myocardial infarction, and stroke. Nonselective and COX-2-selective NSAIDs can be used with caution in selected arthritis patients with hypertension and very stable CV disorders (excluding congestive heart failure and moderate-to-severe kidney dysfunction) when the individual clinical benefit of anti-inflammatory therapy outweighs the CV and gastrointestinal risk. Consensus from various specialty groups suggests using NSAIDs at the lowest doses and for the shortest periods of time for the relief of pain and inflammation when patients are older and are at an increased risk for gastrointestinal or cardiovascular risk.
Characteristics of Chiropractic Patients Being Treated for Chronic Low Back and Neck Pain.

Abstract Objectives Chronic low back pain (CLBP) and chronic neck pain (CNP) are the most common types of chronic pain, and chiropractic spinal manipulation is a common nonpharmacologic treatment. This study presents the characteristics of a large United States sample of chiropractic patients with CLBP and CNP. Methods Data were collected from chiropractic patients using multistage systematic stratified sampling with 4 sampling levels: regions and states, sites (ie, metropolitan areas), providers and clinics, and patients. The sites and regions were San Diego, California; Tampa, Florida; Minneapolis, Minnesota; Seneca Falls and Upstate New York; Portland, Oregon; and Dallas, Texas. Data were collected from patients through an iPad-based prescreening questionnaire in the clinic and emailed links to full screening and baseline online questionnaires. The goal was 20 providers or clinics and 7 patients with CLBP and 7 with CNP from each clinic. Results We had 6342 patients at 125 clinics complete the prescreening questionnaire, 3333 patients start the full screening questionnaire, and 2024 eligible patients completed the baseline questionnaire: 518 with CLBP only, 347 with CNP only, and 1159 with both. In general, most of this sample were highly-educated, non-Hispanic, white females with at least partial insurance coverage for chiropractic care who have been in pain and using chiropractic care for years. Over 90% reported high satisfaction with their care, few used narcotics, and avoiding surgery was the most important reason they chose chiropractic care. Conclusions Given the prevalence of CLBP and CNP, the need to find effective nonpharmacologic alternatives for chronic pain, and the satisfaction these patients found with their care, further study of these patients is worthwhile.
The immersed discontinuous semi-discrete finite element method: A comparison of surface-immersed stiffened and body-immersed stiffened sandwich plate

Abstract Two types of stiffened sandwich plate structures are analyzed and compared. The first is surface-immersed stiffened sandwich plate, in which the stiffener’s top surface is bonded to the bottom surface of the sandwich plate. The second is body-immersed stiffened sandwich plate, in which the stiffener is immersed into the 3-D space of core soft layer. The immersed discontinuous semi-discrete finite element method is developed and applied to study the stiffened plates. The results are compared with ANSYS to verify the accuracy of the method. The convergence study is also given: an exponential convergence is observed. The stiffening efficiency is compared between the two types of stiffened sandwich plates. It is observed that the body-immersed stiffened plate has better strength and stability. The motivation to develop this method is to use a much smaller number of degree-of-freedom to analyze those stiffened plates, for which traditional finite element methods may not be convenient because of the difficulty in the generation of high-quality compatible mesh.
Abstract P329: Neighborhood Social Cohesion Partially Mediates the Association Between Seeing People Walk and Leisure-Time Walking in Latino Adults

Introduction: Higher frequency of seeing others exercise is associated with higher leisure-time (LT) physical activity. However, few studies have examined the association between frequency of seein...
Working Safely with Vaccinia Virus: Laboratory Technique and Review of Published Cases of Accidental Laboratory Infections with Poxviruses

Vaccinia virus, the prototype Orthopoxvirus, is widely used in the laboratory as a model system to study various aspects of viral biology and virus-host interactions, as a protein expression system, as a vaccine vector, and as an oncolytic agent. The ubiquitous use of vaccinia viruses in laboratories around the world raises certain safety concerns because the virus can be a pathogen in individuals with immunological and dermatological abnormalities, and on occasion can cause serious problems in normal hosts. This chapter reviews standard operating procedures when working with vaccinia virus and reviews published cases of accidental laboratory infections with poxviruses.
State Clean Energy Policies Analysis (SCEPA): State Policy and the Pursuit of Renewable Energy Manufacturing

Future manufacturing of renewable energy equipment in the United States provides economic development opportunities for state and local communities. However, demand for the equipment is finite, and opportunities are limited. U.S. demand is estimated to drive total annual investments in renewable energy equipment to $14-$20 billion by 2030. Evidence from leading states in renewable energy manufacturing suggests that economic development strategies that target renewable energy sector needs by adapting existing policies attract renewable energy manufacturing more than strategies that create new policies. Literature suggests that the states that are most able to attract direct investment and promote sustained economic development can leverage diverse sets of durable assets—like human capital and modern infrastructure–as well as low barriers to market entry. State marketing strategies for acquiring renewable energy manufacturers are likely best served by an approach that: (1) is multi-faceted and long-term, (2) fits within existing broad-based economic development strategies, (3) includes specific components such as support for renewable energy markets and low barriers to renewable energy deployment, and (4) involves increased differentiation by leveraging existing assets when applicable.
Preoperative Radiotherapy Trials to Facilitate Immediate Breast Reconstruction after Mastectomy

Postmastectomy radiotherapy (PMRT) is often a component of treatment algorithms for locally advanced or node-positive breast cancer. Breast reconstruction may be delayed or not performed due to negative effects of PMRT on the reconstruction. Administering radiotherapy in the preoperative setting allows for immediate breast reconstruction (IBR) to be performed in patients who have indications for PMRT and desire IBR. This review summarizes the current literature on this new concept. Most prospective treatment protocols included neoadjuvant systemic therapy followed by radiotherapy (RT) dose of 50–50.4 Gy conventionally fractionated and mastectomy with immediate autologous reconstruction after 6–8 weeks. There were no cases of IBR being aborted due to technical complications and overall postoperative complications ranged from 3 to 36%. These were typically non-operatively managed, and cosmetic results when evaluated were favorable. Initial oncologic outcomes indicate low locoregional recurrence rates (≤ 10%) and high 5-year overall survival rates of 87–98%. Although published studies are heterogeneous in nature, they suggest that preoperative RT followed by mastectomy with IBR is technically feasible and safe. Larger prospective studies with longer follow-up times may establish this as a new standard in the multidisciplinary treatment of high-risk breast cancer.
Final evaluation of health education on prevention and control of schistosomiasis in Hubei Province from 2004 to 2015

OBJECTIVE To evaluate the health education effect of schistosomiasis in Hubei Province after implementing of the Outline of National Mid-Long-Term Plan for Schistosomiasis Prevention and Control (2004-2015). METHODS Based on questionnaires and datum review, the data of health education for integrated prevention and control of schistosomiasis in Hubei Province from 2004 to 2015 were collected to evaluate the effect of health education. RESULTS A total of 16 662 499 schistosomiasis health education publicity materials were distributed, 28 712 times of media propaganda were conducted, 174 506 warning signs were established, 185 985 promotional slogans were issued, 1 212 810 pieces of personal protective equipment were distributed, 9 248 village officer training courses were organized, and 5 569 school teacher training courses in primary and secondary schools were conducted in 63 counties (cities, districts) of 13 cities in Hubei Province from 2004 to 2015. A total of 4 815 people were surveyed in 3 counties in 2015. The awareness rate of schistosomiasis control knowledge was 91.62%, and the correct rates of beliefs and attitudes were 89.54% and 96.91% respectively. The overall rate of correct behavior of the population was 91.91%. The related indicators, such as schistosomiasis infection rate, acute infection cases, and others, declined year by year over the same period. CONCLUSIONS The schistosomiasis health education in Hubei Province has obvious effects on enhancing the knowledge and attitudes of schistosomiasis control in populations and promoting the formation of correct schistosomiasis control behavior among residents. It has played an active role and is an important mean in comprehensive prevention and control of schistosomiasis.
Effectively combining temporal projection noise suppression methods in magnetoencephalography.

Abstract Background Magnetoencephalography (MEG) is an excellent non-invasive tool to study the brain. However, measurements often suffer from the contribution of external interference, including noise from the sensors. Suppression of noise from the data is critical for an accurate representation of brain signals. Due to MEG’s limited spatial resolution and superior temporal resolution, noise suppression methods that operate in the temporal domain can be favorable. New Method We examined the independent and joint effects of two temporal projection noise suppression algorithms for MEG measurements: One commonly used algorithm which suppresses correlated noise; temporal signal space separation (tSSS) and one new method which suppresses uncorrelated sensor noise; oversampled temporal projection (OTP). Results We found that both OTP and tSSS effectively suppress noise in raw MEG data and have the greatest effect of joint operation in cases where SNR is low, or when detecting higher SNR single-trial responses from raw data. We additionally demonstrate how the combination of OTP and tSSS is useful for the detectability of high-frequency brain oscillations (HFO). Comparison with existing Methods Although the mathematical description of OTP has been described before ( Larson and Taulu, 2017 ), OTP’s effect on HFOs in MEG data is novel. Additionally, the combination of OTP and commonly used temporal noise suppression algorithms (i.e., tSSS) has not been shown. Conclusions This finding is applicable to clinical populations such as epilepsy, where HFO signals are thought to be important markers for areas of seizure onset and are typically difficult to detect with non-invasive neuroimaging methods.
One hundred years of infection with three global pathogens in frog populations of Florida, USA

Abstract Batrachochytrium dendrobatidis (Bd), Perkinsea (Pr), and Ranavirus (Rv) are three leading pathogens linked to amphibian declines, but much remains unknown about their origins and spread. Museum specimens are a critical resource for resolving epidemiological patterns because they can elucidate infection dynamics and their relationship with disease outbreaks. Here, we established a timeline of Bd, Pr, and Rv presence in anurans in Florida, USA, a region of high amphibian diversity. We measured pathogen prevalence and pathogen intensity in museum specimens of the genus Rana, a widely infected host lineage. We also sequenced barcoding regions to determine whether genetic lineages varied over time. Before this study, the first documented cases of Bd, Pr, and Rv in Florida were in 2009, 2002, and 2002, respectively. We detected all three pathogens nearly a century earlier, with the earliest Bd and Pr detections in 1928 and the earliest Rv detection in 1922. Prevalence and intensity varied across host species, geographic regions, life stages, and decades, with unique patterns for each pathogen. While we were unable to recover robust sequence data for Rv, the Bd and Pr sequence data showed no genetic variation over time. We found significantly more co-detection of Pr and Rv compared to any other pathogen combination, and to our knowledge, we also detected the first simultaneous tri-detection of Bd, Pr, and Rv. Overall, this study represents considerable extension of the timing and understanding of amphibian pathogens in the southeastern USA.