cssi/SciSciGPT-SciSciNet huggingface dataset:
Metal Catalyzed Electrochemical Synthesis of Hydrocarbons from Epitaxial Graphene

Pt/Au transition metal catalysts are shown to significantly improve the electrochemical hydrogenation of low defect density epitaxial graphene (EG) layers ~2ML thick on Si-face 6H-SiC Initial experiments using Pt nanoparticles deposited from aqueous solution showed large increases in hydrogenation, however, this method demonstrated large variability, attributed to the aqueous nature of the catalyst deposition, known to change the conductivity and reactivity of graphene, as well as clustering of Pt nanoparticles. To reduce process variability, 20 nm thick evaporated metals were used. From Raman, the average observed hydrogen cluster density ~1011 cm−2 was similar to the average densities of intrinsic defects (1010,11 cm−2) and charge impurities (1011 cm−2) consistent with recent reports that these sites play a crucial role in the hydrogenation of EG. Au catalysts (3.23 ± 0.22%wt) showed slightly better H-incorporation than Pt (2.81 ± 0.03%wt), an observation we attribute to the fact that H2 dissociation is no longer the rate-limiting step, as H+ is readily available in the aqueous state. The electrochemical enablement of these hydrogenation pathways using catalysts offers new routes to carbon chemistries for hydrogen storage, bandgap engineered hydrocarbons as well as EG-based battery electrodes.
Helmholtz Resonance Based Micro Electrostatic Actuators for Compressible Gas Control: A Microjet Generator and a Gas Micro Pump

This paper reports Helmholtz-resonance based micro electrostatic actuators to control compressible gaseous fluids in the micro scale. Particularly, it discusses design, fabrication, and testing results of two electrostatic actuators: a micro jet generator and an integrated peristaltic multistage micro pump. These electrostatic actuators vibrate a micro membrane in a micro chamber at a high frequency (>10 kHz), and easily induce the resonant behavior of compressible gases in the chamber. Such resonant behavior, often called the Helmholtz resonance, can repeatedly create instantaneous pressure in equilibrium between the inside and outside of the chamber and cause gas to rapidly exit the chamber, forming a collimated jet. The developed micro jet generator consists of multiple acoustic chambers in parallel; produces directional gas momentum from each chamber by utilizing the Helmholtz resonance; and collectively entrains nearby gas molecules to form a gas stream. The fabricated micro jet generator has a footp...
Hamlet's "Cruelty" in the Nunnery Scene: The Actors' Views

CCORDING to Herbert Beerbohm Tree, the nunnery scene between Hamlet and Ophelia, which has "vexed the minds of the analytical" more than any other scene in Hamlet, takes on "all the clearness of a blue sky" when it receives "imaginative stage treatment".1 A similar view was held by Henry Irving, who considered this scene the crux of the play and who felt that only a great actor (not an armchair critic) could make clear what Shakespeare intended it to mean.2 Although both of these actors emphasized stage interpretation as the best means of elucidating the scene in question, both of them also wrote and published their own explications, apparently with the idea that since they had "lived" through the scene as Hamlet they were better prepared than most critics to explain the thoughts and motives which lie behind his words. A number of other actors have put their interpretations of the nunnery scene into writing; this scene, in fact, has received more critical comment from actors than has any other in Shakespeare's plays. Actors' discussions of the nunnery scene have dealt with a wide range of problems, from technical considerations involving staging and "business" to matters of more general concern and farther-reaching significance bearing on the interpretation of Hamlet's character and the nature of his relationship with Ophelia.3 This paper will focus on one of the most interesting problems of the latter sort, evidently the most basic question for actors and perhaps for literary critics as well: How can Hamlet's apparent cruelty in the nunnery scene be explained (or explained away)? The emphasis will be less on what the actors have done to illustrate Hamlet's cruelty, or lack of it, than on the reasoning behind their acting-in other words, on the actors' critical theories. But, since these theories will be more meaningful if their theatrical practicability is kept in mind, there will be occasional references to the ways in which reasoning has been translated into action. The problem of Hamlet's "cruelty" to Ophelia-whatever its source in Shakespeare's text-seems to have been intensified in the late eighteenth century by tendencies both theatrical and critical. Hamlet's part in the nunnery scene had always been theatrically effective, and an actor like Garrick doubtless made the most of it. As long as audiences
The use of SPHARM-PDM and mean latitude axis to evaluate airway changes

ABSTRACT Objective: To introduce new 3-D imaging techniques to characterize shape and volume changes of the oropharyngeal space after bilateral sagittal split osteotomy (BSSO) advancement. Materials and Methods: Longitudinal cone-beam computed tomography (CBCT) scans were obtained for 20 patients undergoing BSSO advancement at three time points (T1 = presurgery, T2 = splint removal, and T3 = 1 year after surgery). Segmentation of the airway was performed using the following boundaries: hard palate/posterior nasal spine superiorly and lower border of C3 to the base of the epiglottis inferiorly. For shape measurements, point-based correspondent models and mean latitude axis were obtained for all the data using SPHARM-PDM software. All 3-D correspondent models were rigidly registered using Procrustes alignment. Absolute distance maps and corresponding vector maps were calculated to show shape and vector differences between each correspondent point. Mean latitude axis is a new imaging method to calculate mini...
Relationship between iodine intake and thyroid cancer

Universal salt iodization(USI) to prevent iodine deficiency disorders(IDD) has made great success,but in recent years, thyroid disease incidence increased again, along with the increase in iodine intake, and thyroid cancer also increased, and have been closely watched. For a comprehensive understanding and further analysis about the relationship between iodine intake and thyroid cancer, improving the strategy of the universal salt iodization, this article reviewed the research progress in the relationship between iodine intake and thyroid cancer at home and abroad.
Efficacy analysis of micro-card combined with 23-valent pneumococcal polysaccharide vaccine in the prevention of children with lower respiratory tract infection

Objective To study the clinical effect and adverse reactions of micro-card combined with 23-valent pneumococcal polysaccharide vaccine in the prevention of children with lower respiratory tract infection. Methods 220 children were randomly divided into the vaccine group and the control group,110 children in each group.The vaccine group was followed up for 2 weeks to monitor adverse drug reactions,and at the same time,all children were tracked for 1 year. Antibiotics usage,duration of hospital stay,medical expense,immune and hemoglobin were compared. Results After the micro-card joint 23 pneumococcal polysaccharide vaccine,the incidence of children's lower respiratory infection and degree decreased significantly,the usage of antibiotics also decreased obviously,the duration of hospital stay was shortened,and the economic burden of their parents reduced. At the same time,the level of immunoglobulin and hemoglobin was significantly higher in the vaccine group than in the control group( P 0. 05). There were local reactions,which could be treated by hot fomentation or rest for 12 to 36 hours. Conclusion The micro-card joint 23 pneumococcal polysaccharide vaccine for 2-5 years old children has very good prevention and protection effect,with good economic efficiency and high safety.
Organization of the Tgm family of transposable elements in soybean

We have compared the organization of six Tgm elements that were selected from a genomic library of soybean DNA on the basis of hybridization with subcloned regions of Tgm 1 (transposon, Glycine max) from the seed lectin gene. These elements ranged in size from 1.6 kbp to greater than 12 kbp. Tgm2, Tgm3, Tgm4 and Tgm5 represent partial isolates in which the genomic clone contained a 3' but not a 5' terminus of the element; while Tgm6 and Tgm7, like Tgm1, were small isolates flanked by both 5' and 3' nonelement sequences. Cross-hybridization studies between subcloned portions of these seven elements identified regions of homology which suggest that the Tgm transposable elements of soybean form a family of deletion derivatives. In addition to internal deletion events, numerous deletions and base substitutions are also present within the borders of these elements which are comprised of the same tandemly repeated sequence. The 39% amino acid homology between a 1 kb portion of an open reading frame in Tgm4 and Tgm5 and ORF1, an open frame from the first intron of the maize Enhancer (Suppressor-mutator) transposable element, suggests that both elements encode a common function that requires a high degree of protein conservation.
The Hippocratic Oath

pollo the physician, the sun god, drove the chariot of sun. He was the son of Zeus and Leto and the ,brother of Artemis, goddess of the moon. Apollo’s son was Asclepius, who was taught healing by the centaur Chauron; so skilled in medicine was he that he could restore the dead to life. This talent angered Pluto, god of the underworld, who persuaded Zeus to destroy Asclepius with a thunderbolt.’ The staff of Asclepius, always pictured with one serpent, is the symbol of the American Medical Association. The caduceus, the staff of Hermes, has two snakes and is surmounted by two wings; it also is sometimes used as a medical insignia. The daughters of Asclepius were Hygiea and Panaceia, whose names have been immortalized in the English language. By the 5th century BC, when Hippocrates was born on the Isle of Cos off the southwest coast of Asia Minor, the followers of Asclepius had for generations been the sole possessors of the knowledge of healing, using both diet and drugs.? I t seems likely that Hippocrates belonged to the school founded a century earlier by Pythagoras in Crotona, on the Italian peninsula. This philosophical school held that the human soul was immortal, that reincarnation existed, and that the works one did in this life determined his destination in the life to come. To Pythagoreans, medical skill was the greatest wisdom attainable, and medical standards could not be set too high. In addition to the wisdom of his oath, Pythagoras also left medicine many other familiar passages: “Life is short and
Parents of Children with Attention Deficit/Hyperactivity Disorder: A Meta-Synthesis, Part I

In 2011 6.4 million children in the United States ages four to 17 years had a diagnosis of Attention-deficit/hyperactivity disorder (ADHD). Quantitative studies have indicated that parenting stress for parents of children diagnosed with ADHD is high. This meta-synthesis compiled and analyzed a systematic review of the qualitative studies of parents’ lived experience of having a child with ADHD. Searches in online scholarly databases yielded an initial 1217 hits, which were narrowed down to seventy-three studies that met the criteria. A “meta-ethnography” framework was used for the synthesis. One major finding involved the emotional burden of caring for a child with ADHD. Parents struggled with a variety of intense and painful emotions as they attempted to manage family routines. Disciplining children only worked in a limited way and took constant effort throughout the day. The challenges of parenting spilled into other areas of the parents’ lives, such as their health, psychological, marital, and occupational functioning. Implications for practitioners are discussed, including the need to validate parental stress and the difficulty of applying behavioral management strategies with their children, the need for increased support of partner relationships, and the need to connect parents with support to prevent poorer outcomes for the child.
Scaling Human Cancer Risks from Low LET to High LET when Dose-Effect Relationships are Complex.

Health risks from space radiations, particularly from densely ionizing radiations, represent an important challenge for long-ranged manned space missions. Reliable methods are needed for scaling low-LET to high-LET radiation risks for humans, based on animal or in vitro studies comparing these radiations. The current standard metric, relative biological effectiveness (RBE) compares iso-effect doses of two radiations. By contrast, a proposed new metric, radiation effects ratio (RER), compares effects of two radiations at the same dose. This definition of RER allows direct scaling of low-LET to high-LET radiation risks in humans at the dose or doses of interest. By contrast to RBE, RER can be used without need for detailed information about dose response shapes for compared radiations. This property of RER allows animal carcinogenesis experiments to be simplified by reducing the number of tested radiation doses. For simple linear dose-effect relationships, RBE = RER. However, for more complex dose-effect re...
Outcomes of Restrictive and Hypertrophic Cardiomyopathies After LVAD: An INTERMACS Analysis

Abstract Background Patients with restrictive (RCM) and hypertrophic (HCM) cardiomyopathies are felt to be a difficult population to treat with left ventricular assist device (LVAD) therapy. Scarce data exist on outcomes of continuous-flow (CF) LVAD support in these challenging patient cohorts. Methods The Interagency Registry for Mechanically Assisted Circulatory Support Registry was queried for all patients with RCM (n = 94) and HCM (n = 104) who underwent CF LVAD implantation between March 2008 and March 2014. Survival, adverse event rates, baseline demographics, echocardiography parameters, and competing outcomes were compared with patients with dilated cardiomyopathy (DCM) (n = 8749). Results Left ventricular size was smaller and baseline EF was higher in RCM and HCM compared with DCM patients. Nonetheless, these parameters were not completely normal in the RCM and HCM groups, suggesting that most of these patients exhibited features of a DCM and represented a mixed phenotype. In these specific patient populations, survival up to 4 years was not different among the 3 groups (log rank 0.25) and competing outcomes at 1 year were similar. In the subgroup of patients with very small ventricles (ie, Conclusion Relatively few patients with HCM and RCM undergo CF LVAD implantation, and most that do display some features of a DCM. Overall survival and adverse event profiles of these patients were similar to traditional DCM patients; however, in those with very small ventricles, survival was inferior.
Unilateral Quadriceps Strengthening With Disinhibitory Cryotherapy and Quadriceps Symmetry After Anterior Cruciate Ligament Reconstruction

Context: The effect of unilateral cryotherapy-facilitated rehabilitation exercise on involved-limb quadriceps function and limb symmetry in individuals with quadriceps dysfunction after anterior cruciate ligament reconstruction (ACLR) remains unclear. Objective: To measure the effect of a 2-week unilateral cryotherapy-facilitated quadriceps-strengthening program on knee-extension strength and quadriceps central activation ratio (CAR) in participants with ACLR. Design: Controlled laboratory study. Setting: Laboratory. Patients or Other Participants: A total of 10 volunteers with unilateral ACLR (1 man, 9 women; age = 21.0 ± 2.8 years, height = 164.6 ± 5.0 cm, mass = 64.0 ± 6.1 kg, body mass index = 23.7 ± 2.7 kg/m2) and 10 healthy volunteers serving as control participants (1 man, 9 women; age = 20.8 ± 2.5 years, height = 169.1 ± 6.2 cm, mass = 61.1 ± 6.4 kg, body mass index = 21.4 ± 2.3 kg/m2) participated. Intervention(s): Participants with ACLR completed a 2-week unilateral cryotherapy-facilitated...
Parent ratings of working memory are uniquely related to performance-based measures of secondary memory but not primary memory.

Introduction: Existing evidence suggests that performance- and rating-based measures of working memory (WM) correlate poorly. Although some researchers have interpreted this evidence as suggesting ...
A Complex Cardiac Mass Originating from Interatrial Septum in a Patient with History of Kidney Cancer: A Case Report and Literature Review

Cardiac tumors are a rare phenomenon, and most cases are secondary to metastatic cancers rather than primary tumors. Renal cell carcinoma (RCC) is notorious for metastasis to cardiac tissue. Tumor thrombus migration to the renal vein and inferior vena cava happens in up to 10% of patients with RCC. Transitional cell carcinomas are another form of renal cancer, which may metastasize to the heart and are associated with widespread metastasis. Here, we report a patient with a past medical history of metastatic transitional cell cancer of renal pelvis under treatment with checkpoint inhibitor therapy presenting with shortness of breath. He had disseminated metastasis to bones, pleural space, lungs, and muscles. A large mass was found in the interatrial septum with invasion to the right and left atrium. The mass had a cystic component protruding into the left atrium. He passed away a few days after presentation.
Sociodemographic Correlates of Visual Acuity Impairment in Hispanic Children and Adolescents

Sociodemographic correlates of visual impairment were examined in 6- to 19-year-old Hispanic children and adolescents using data from the Hispanic Health and Nutrition Examination Survey. Mexican American and Puerto Rican children whose parents had 0 to 6 years of education were more likely to remain visually impaired even when tested with their glasses or contact lenses, if any (i.e., with usual correction) than children whose parents reported 12 to 17 years of education. Mexican Americans residing below versus at or above the poverty line were more likely to remain visually impaired even with the usual correction. Mexican Americans enrolled in the Medicaid program or who were without health insurance were more likely to remain visually impaired than Mexican Americans with private health insurance. When tested without glasses or contact lenses, Cuban Americans and Mexican Americans born outside of the mainland United States had lower rates of visual impairment compared to those born in the United States; however, children in this latter group were more likely to remain visually impaired with usual correction than U.S.-born Mexican Americans. These findings suggest that Hispanic children from economically disadvantaged households and those born outside the United States may not be receiving optimal eye care that could improve visual function.
The Role of Routine Followup Bone Scans After Definitive Therapy of Localized Prostatic Cancer

AbstractThe records of 100 patients with localized prostatic cancer were examined retrospectively in an effort to determine the usefulness of routine 99mtechnetium bone scans following definitive therapy with 125iodine implantation or external beam irradiation. With a mean followup of 47 months per patient 19 per cent of these patients had positive scans and an additional 15 per cent had scans that were considered equivocal. Of the 100 patients none had a positive scan in the absence of either an elevated serum acid phosphatase or bone pain. In our series the low incidence of positive scans as the sole evidence of disease progression does not support its routine use after definitive therapy for localized carcinoma of the prostate.
Intersection Systems and Families of Large Oscillation

Several key concepts of set-theoretic and topological type are introduced in this section. A combinatorial theorem of Erdős-Rado on intersection systems based on Dedekind’s pigeon-hole principle characterizes those pairs of cardinals α, κ (with a regular and ω ≤ κ < α) for which every family of a sets, each with fewer than κ elements, has a subfamily with a elements every two of which have the same intersection (Theorem 3.2). This result gives estimates for the Souslin number of certain product spaces with various topologies (3.8–3.11). The Erdős-Tarski theorem on the regularity of the Souslin number is Theorem 3.5. Some basic results of the Erdős-Rado partition calculus, developed below in § 8, are applied here (Theorems 3.13 and 3.14) to estimate the Souslin number of certain spaces.
Analysis of signaling pathways controlling flagellar movements in mammalian spermatozoa.

Abstract The mammalian sperm flagellum is an example of organelles where sensory and signaling functions are integrated with motility. Structurally related to other ciliary appendages, it has unique cytoskeletal structures that serve to assemble signaling complexes as well as components of metabolic pathways. Flagellar motility is regulated by signaling events that control sperm ion milieu, energy production, and classical second messenger-dependent phosphorylation cascades. Here, we will concentrate on the cAMP signaling pathway associated with flagellar motility. We will describe methods to analyze the properties of a unique adenylyl cyclase termed sAC (gene name Sacy , Adcy10 ), which plays an essential function in cAMP accumulation in spermatozoa. This soluble adenylyl cyclase (sAC) is a sensor for bicarbonate, pH, and Ca 2 + and is likely involved in coupling energy homeostasis with signaling events. We will also describe methods to investigate the macromolecular complexes that bring together sAC and other signaling molecules.
Moving Horizons Estimation for Wheelchair Trajectory Repeatability in the Home

An advantage of Moving Horizons Estimation in contrast with the previously tested Extended Kalman Filter is presented in the context of achieving a useful form of teach/repeat for wheelchairs of severely disabled veterans within their homes. The ability to combine numerical integrals of the measured wheel rotations of the chair with chair-mounted cameras and camera-based observations of wall-mounted fiducials within a trailing, selected “window” based on the “taught” trajectory, in order to precisely and reliably repeat that trajectory, is presented. The importance and real-time feasibility of the observation-batch-selection protocol—which is applied both to the teaching data and, in real time, to the tracking data—is discussed. Experimental illustration uses the trajectory shown in https://youtu.be/7Yrc3IuXBus.
Comparing two maximum likelihood algorithms for mixture Rasch models

The mixture Rasch model is gaining popularity as it allows items to perform differently across subpopulations and hence addresses the violation of the unidimensionality assumption with traditional Rasch models. This study focuses on comparing two common maximum likelihood methods for estimating such models using Monte Carlo simulations. The conditional maximum likelihood (CML) and joint maximum likelihood (JML) estimations, as implemented in three popular R packages are compared by evaluating parameter recovery and class accuracy. The results suggest that in general, CML is preferred in parameter recovery and JML is preferred in identifying the correct number of classes. A set of guidelines is also provided regarding how sample sizes, test lengths or actual class probabilities affect the accuracy of estimation and number of classes, as well as how different information criteria compare in achieving class accuracy. Specific issues regarding the performance of particular R packages are highlighted in the study as well.
Exercise in Individuals With CKD: A Focus Group Study Exploring Patient Attitudes, Motivations, and Barriers to Exercise

Rationale & Objective Data suggest that exercise is beneficial for patients with chronic kidney disease (CKD) to reduce cardiovascular disease and the progression of CKD. Despite these benefits, the majority of patients with CKD remain sedentary. The purpose of this study was to identify attitudes, motivators, and barriers to exercise among individuals with CKD. Study Design Qualitative study. Setting & Participants 10 focus groups (41 adult participants with CKD stages 3-4 who were not currently exercising) from the Denver Metro Area. Analytical Approach Thematic analysis. Clinics were purposively sampled. Focus groups were recorded and transcribed. Results We identified 7 themes reflecting perceptions of exercise of patients with CKD: improvement in health and quality of life; motivation from family, friends, or peers; limitations due to comorbid conditions; challenges due to environmental factors (safety, weather, and cost concerns); lack of time; family as a barrier; and lack of provider counseling on type of exercise and the benefits. Participants recognized the benefits of exercise on health, but exercise was not viewed to have a significant impact on CKD. Having a friend, family member, or group to exercise with was viewed as a significant motivator. However, particularly in Spanish-speaking participants, family was often seen as a barrier if they were not willing to exercise with the patients. Most participants expressed receiving limited information from their kidney provider regarding how exercise affected their kidney health. Spanish-speaking participants in particular expressed frustration with their nephrologist's lack of advice regarding exercise. Limitations Potential selection bias and inclusion of only sedentary patients with CKD. Conclusions Barriers and motivators to exercise were similar among participating men and women with CKD. Lack of advice from kidney providers regarding exercise was a significant barrier. Exercise interventions in patients with CKD should include not only increased patient self-efficacy and social support, but also counseling and prescribing of exercise by nephrologists.
Cartilage 3D Printing

Cartilage is a tissue designed to provide near frictionless joint movement while withstanding load during locomotion. Clinically relevant repair or regeneration of damaged or degenerated cartilage remains a challenge. Recapitulation of the matrix structure and cellular organization in repair tissues is key to generating long-term functional repair tissue. 3D bioprinting is a promising technique that can address many of the challenges facing successful tissue engineering of articular cartilage. This chapter introduces the structure and function of articular cartilage, provides a brief overview of the cartilage injury and degeneration, and lists the challenges of cell-based repair. The state-of-the-art in 3D bioprinting technologies is discussed with a focus on 3D printing of cartilage and recent advances in the concept of direct in situ 3D printing. Finally, the challenges of using this technology are presented, as well as a perspective on the future of 3D bioprinting for cartilage tissue engineering and regenerative medicine.
Comprehensive Next-Generation Sequencing Unambiguously Distinguishes Separate Primary Lung Carcinomas From Intrapulmonary Metastases: Comparison with Standard Histopathologic Approach.

Purpose: In patients with >1 non–small cell lung carcinoma (NSCLC), the distinction between separate primary lung carcinomas (SPLCs) and intrapulmonary metastases (IPMs) is a common diagnostic dilemma with critical staging implications. Here, we compared the performance of comprehensive next-generation sequencing (NGS) with standard histopathologic approaches for distinguishing NSCLC clonal relationships in clinical practice. Experimental Design: We queried 4,119 NSCLCs analyzed by 341–468 gene MSK-IMPACT NGS assay for patients with >1 surgically resected tumor profiled by NGS. Tumor relatedness predicted by prospective histopathologic assessment was contrasted with comparative genomic profiling by subsequent NGS. Results: Sixty patients with NGS performed on >1 NSCLCs were identified, yielding 76 tumor pairs. NGS classified tumor pairs into 51 definite SPLCs (median, 14; up to 72 unique somatic mutations per pair), and 25 IPMs (24 definite, one high probability; median, 5; up to 16 shared somatic mutations per pair). Prospective histologic prediction was discordant with NGS in 17 cases (22%), particularly in the prediction of IPMs (44% discordant). Retrospective review highlighted several histologic challenges, including morphologic progression in some IPMs. We subsampled MSK-IMPACT data to model the performance of less comprehensive assays, and identified several clinicopathologic differences between NGS-defined tumor pairs, including increased risk of subsequent recurrence for IPMs. Conclusions: Comprehensive NGS allows unambiguous delineation of clonal relationship among NSCLCs. In comparison, standard histopathologic approach is adequate in most cases, but has notable limitations in the recognition of IPMs. Our results support the adoption of broad panel NGS to supplement histology for robust discrimination of NSCLC clonal relationships in clinical practice.
Chapter 13 – Barrier Penetration

The phenomenon known as barrier penetration or tunneling involves a particle moving from one side of a barrier to the other, even though the particle does not have sufficient energy to get over the barrier. This is the result of the wave function for the particle not going to zero at the boundaries of the barrier. The solution of this quantum mechanical model is illustrated. The barrier penetration model has application to alpha decay, scanning electron microscopy, superconductivity, and molecular inversion. These applications are discussed in this chapter.
Skin-cleaning among hospitalized people who inject drugs: a randomized controlled trial.

Aims To test the hypothesis that among hospitalized people who inject drugs (PWID), a brief intervention in skin-cleaning would result in greater reductions in follow-up emergency department (ED) or hospitalization rates compared with a usual care condition. Design Randomized, two-group (intervention, n = 128; usual care, n = 124), single-site clinical trial with12-month follow-up. Setting Hospital inpatient services in Boston, Massachusetts, United States. Participants People who injected drugs on at least 3 days each week prior to hospital admission (n = 252). Participants averaged 37.9 (± 10.7) years of age; 58.5% were male, 59.3% were white and 61.1% had a diagnosis related to skin infection at enrollment. Intervention and comparator Intervention was a skin hygiene education and skills-training behavioral intervention [short-term efficacy data on a behavioral intervention (SKIN)] consisting of two education- and skills-based skin-cleaning sessions, one during hospitalization and another 4 weeks later. The comparator was treatment as usual: an informational brochure about substance use treatment options and needle exchange programs in the area and follow-up clinical appointments as arranged by the inpatient medical staff. Measurements Electronic medical records were reviewed and discharge diagnoses for each ED visit and hospital admission were categorized into injection-related bacterial events (e.g. cellulitis) and non-injection-related events. Negative binomial regression was used to test the intervention effects for the primary outcome and total ED visits, as well as the secondary outcomes, total number of hospitalizations, injection drug use-related (IDU-related) ED visits and IDU-related hospitalizations. We also tested whether the outcomes were moderated by whether the initial hospitalization was IDU-related. Findings Of people assigned to SKIN, 66 completed two sessions, 55 completed one session and seven completed zero sessions. Adjusting for baseline covariates, the mean rate of total ED visits in the next 12 months was non-significantly higher [incidence rate ratio (IRR) = 1.13, 95% confidence interval (CI) = 0.96, 1.33, P = 0.152] compared with usual treatment. The intervention did not significantly reduce total hospitalizations or IDU-related hospitalizations. Adjusting for baseline covariates, the mean rate of injection drug use-related ED visits in the next 12 months was lower (IRR = 0.57, 95% CI = 0.35, 0.91, P = 0.019) compared with treatment as usual. Conclusions A skin-cleaning intervention for people who inject drugs delivered during a hospitalization did not significantly reduce either overall emergency department use or hospitalization. There was some evidence that it may have reduced injection drug use-related emergency department visits.
Evaluating spiny mice (Acomys) as a model for cardiac research

Abstract Complex tissue regeneration is extremely rare among adult mammals. An exception, however, is the superior tissue healing of multiple organs in spiny mice (Acomys). While Acomys species exhibit the remarkable ability to heal complex tissue with minimal scarring, little is known about their cardiac structure and function. In this study, we characterized cardiac structure, anatomy, and in vivo function, as well as cardiomyocyte characteristics in Acomys compared to the most commonly used cardiac mouse model, the C57BL6 mouse strain (Mus). Our results demonstrate comparable cardiac anatomy, structure and function between the two rodent species, but reveal significant differences in their cardiomyocyte characteristics. These findings establish Acomys as a new mammalian model for cardiac research.
A tribute to the late Professor Donald Simpson, Australian neurosurgeon and namesake of the Simpson grading system for meningioma extent of resection

Donald Simpson (1927-2018) was a neurosurgeon from Adelaide, Australia, who is often cited for the 1957 publication he wrote as a trainee on the relationship between extent of resection and outcomes for meningiomas. That paper summarized a series of over 300 patients operated on in England by well-known neurosurgeons Sir Hugh Cairns and Joseph Buford Pennybacker. Simpson was also known later in his career, when he was at the University of Adelaide in South Australia, for his contributions to the areas of hydrocephalus, spina bifida, craniofacial anomalies, head injury, brain abscesses, and neurosurgical history, and he published extensively on these topics. In addition to his work in clinical neurosurgery, Simpson made humanitarian contributions studying kuru in New Guinea and aiding refugees during the Vietnam War. Simpson was an active member and leader of many Australian surgical organizations and was an officer of the Order of Australia. Donald Simpson's legacy as an adult and pediatric neurosurgeon, an academician, a leader, and a humanitarian is extensive and will prove long lasting. Professor Simpson's life serves as an example from which all neurosurgeons may learn.
The application of current diagnostic criteria for left ventricular noncompaction in patients undergoing cardiac MRI

Background: Isolated noncompaction of the left ventricular myocardium (INVM) is a cardiomyopathy characterized by an excessive number of prominent trabeculations with deep intertrabecular recesses in the left ventricular apex. IVNM is commonly diagnosed by echocardiography utilizing the Chin, Jenni, and Stollberger criteria. Cardiac magnetic resonance imaging (CMR) represents an additional modality which can diagnose IVNM. As with echocardiography, multiple diagnostic criteria have been proposed, including maximum end-diastolic non-compacted to compacted myocardial thickness ratio of >2.3, trabeculated LV mass >20% global LV mass, and increased fractal dimension. Furthermore, studies …
Age differences in utilization and outcomes of tissue-plasminogen activator and mechanical thrombectomy in acute ischemic stroke

Abstract Background and purpose U.S. demographics is shifting towards older population. Older stroke patients likely receive less tissue-plasminogen activator (t-PA) and mechanical thrombectomy (MT) compared to younger patients. The objective of this study is to evaluate extent of difference in utilization of t-PA and MT and outcomes of stroke between three age groups −18–45 (young adults), 46–80 (middle/old), and > 80 (oldest old) years. Methods It is a retrospective cross-sectional observational study. Primary outcomes were rates of stroke intervention and effect of age on stroke intervention. Secondary outcomes were in-hospital mortality, discharge to home, and prolonged length of stay. Multivariate survey-logistic regression was performed to evaluate outcomes. Results Among 487,105 patients in the study 4.8% were young adults, 66.6% middle/old, and 28.6% oldest old. Compared to young adults, middle/old received 19% (OR = 0.81; 95%CI = 0.72–0.91) less t-PA alone; and 33% (OR = 0.67; 95%CI = 0.53–0.83) less MT alone; oldest old received 25% less t-PA alone (OR = 0.75; 95%CI = 0.66–0.86) and 51% (OR = 0.49; 95%CI = 0.38–0.63) less MT alone. Compared to young adults, in-hospital mortality was three-fold higher among middle/old (OR = 3.5; 95%CI = 1.3–9.6), and seven-fold higher among oldest old (OR = 7.5; 95%CI = 2.8–20.5) for t-PA alone; discharge to home reduced by 40% in middle/old (OR = 0.6; 95%CI = 0.4–0.7) and by 80% in oldest old (OR = 0.2; 95%CI = 0.1–0.2) for t-PA alone and similarly for MT alone. Conclusions Oldest old receive one-fourth less t-PA and half less MT compared to young adults. Oldest old patients who received t-PA alone or MT alone had remarkably worse outcomes for in-hospital mortality and discharge to home than young adults did.
A Smaller Window to the University: The Impact of Athletic De-Escalation on Status and Reputation

Given the changing landscape of Division I athletic competition, determining the most advantageous commitment to athletic programs is an important issue in sport and university policy. With the recent autonomy granted to select Division I Football Bowl Subdivision conferences and pending antitrust litigation vying for college athlete compensation, many universities are considering alternative courses of action in reducing their existing commitment to Division I athletics. Accordingly, this study sought to examine the impact of de-escalating Division I commitment — specifically discontinuing a Division I football program — on the status and reputation of the university and athletic department. In considering the entire population of universities which have discontinued their Division I football program from 1981 to 2010 (N = 21), the results revealed that football program discontinuation had little positive or negative impact on academic status and reputation, and a slight negative impact on athletic status. The implications of this research contributes important information on assessing previous decisions to discontinue a Division I football program and what became of those decisions.
Information Elicitation from Rowdy Crowds

We initiate the study of information elicitation mechanisms for a crowd containing both self-interested agents, who respond to incentives, and adversarial agents, who may collude to disrupt the system. Our mechanisms work in the peer prediction setting where ground truth need not be accessible to the mechanism or even exist. We provide a meta-mechanism that reduces the design of peer prediction mechanisms to a related robust learning problem. The resulting mechanisms are ϵ-informed truthful, which means truth-telling is the highest paid ϵ-Bayesian Nash equilibrium (up to ϵ-error) and pays strictly more than uninformative equilibria. The value of ϵ depends on the properties of robust learning algorithm, and typically limits to 0 as the number of tasks and agents increase. We show how to use our meta-mechanism to design mechanisms with provable guarantees in two important crowdsourcing settings even when some agents are self-interested and others are adversarial.
Extracellular vesicles regulate gap junction-mediated intercellular communication and HIV-1 infection of human neural progenitor cells.

Abstract Human immunodeficiency virus-1 (HIV-1) has been shown to cross the blood-brain barrier and cause HIV-associated neurocognitive disorders (HAND) through a process that may involve direct or indirect interactions with the central nervous system (CNS) cells and alterations of amyloid β (Aβ) homeostasis. The present study focused on the mechanisms of HIV-1 infecting human neural progenitor cells (hNPCs) and affecting NPC intercellular communications with human brain endothelial cells (HBMEC). Despite the lack of the CD4 receptor, hNPCs were effectively infected by HIV-1 via a mechanism involving the chemokine receptors, CXCR4 and CCR5. HIV-1 infection increased expression of connexin-43 (Cx43), phosphorylated Cx43 (pCx43), and pannexin 2 (Panx2) protein levels in hNPCs, suggesting alterations in gap-junction (GJ) and pannexin channel communication. Indeed, a functional GJ assay indicated an increase in communication between HIV-infected hNPCs and non-infected HBMEC. We next analyzed the impact of HBMEC-derived extracellular vesicles (EVs) and EVs carrying Aβ (EV-Aβ) on the expression of Cx43, pCx43, and Panx2 in HIV-1 infected and non-infected hNPCs. Exposure to EV-Aβ resulted in significant reduction of Cx43 and pCx43 protein expression in non-infected hNPCs when compared to EV controls. Interestingly, EV-Aβ treatment significantly increased levels of Cx43, pCx43, and Panx2 in HIV-1-infected hNPCs when compared to non-infected controls. These results were confirmed in a GJ functional assay and an ATP release assay, which is an indicator of connexin hemichannel and/or pannexin channel functions. Overall, the current study demonstrates the importance of hNPCs in HIV-1 infection and indicates that intercellular communications between infected hNPCs and HBMEC can be effectively modulated by EVs carrying Aβ as their cargo.
Analysis of conflict of interest policies among organizations producing clinical practice guidelines.

BACKGROUND Conflicts of interest (COI) jeopardize the validity of Clinical Practice Guidelines (CPGs). When the Institute of Medicine promulgated COI policies in 2011, few organizations met these requirements, but it is unknown if organizations have improved their policies since that time. We sought to evaluate current adherence to IOM standards of COI policies. METHODS AND FINDINGS We conducted a retrospective document review of COI policies and CPGs from organizations that published five or more CPGs between January 1, 2018 and December 31, 2019. Organizations were identified via CPG databases. COI policies were obtained from an internet search. We collected data on i) the number of organizations that have COI policies specific to CPG development, ii) the number of policies meeting each IOM standard and iii) the number of IOM standards met by each policy. COI disclosures from five CPGs of each organization were assessed for adherence to IOM standards. Among the 46 organizations that published 5 or more CPGs, 36 (78%) had a COI policy. Standard 2.2b (requiring divestment of financial COI) was met least frequently, by 2 of 36 (6%) organizations. Standard 2.1 (requiring disclosure of COI) was met most frequently, by 33 of 36 (92%) organizations. A total of 31 of 36 (86%) organizations met 4 or fewer of the 7 IOM standards. Among the 16 organizations limiting COI to a minority of the CPG panel (standard 2.4c) and the 15 organizations prohibiting COI among chairs or co-chairs (standard 2.4d), 12 (75%) and 10 (67%) organizations violated the respective standard in at least one CPG. The main limitations of our study are the exclusion of organizations producing fewer CPGs and ability to assess only publicly available policies. CONCLUSION Among organizations producing CPGs, COI policies frequently do not meet IOM standards, and organizations often violate their own policies. These shortcomings may undermine the public trust in and thus the utility of CPGs. CPG-producing organizations should improve their COI policies and their strategies to manage COI to increase the trustworthiness of CPGs.
Mathematical models of the steps involved in the systemic delivery of a chemotherapeutic to a solid tumor: From circulation to survival

The efficacy of an intravenously administered chemotherapeutic for treatment of a solid tumor is dependent on a sequence of steps, including circulation, extravasation by the enhanced permeability and retention effect, transport in the tumor microenvironment, the mechanism of cellular uptake and trafficking, and the mechanism of drug action. These steps are coupled since the time dependent concentration in circulation determines the concentration and distribution in the tumor microenvironment, and hence the amount taken up by individual cells within the tumor. Models have been developed for each of the steps in the delivery process although their predictive power remains limited. Advances in our understanding of the steps in the delivery process will result in refined models with improvements in predictive power and ultimately allow the development of integrated models that link systemic administration of a drug to the probability of survival. Integrated models that predict outcomes based on patient specific data could be used to select the optimum therapeutic regimens. Here we present an overview of current models for the steps in the delivery process and highlight knowledge gaps that are key to developing integrated models.
Protein phosphorylation in T-cell signaling: effect of age

Abstract Aging is a natural biological phenomenon, which is the inevitable fate of all living organisms and is characterized by functional decline of different vital parts of the body including the immune system. Different arms of the immune system are modulated due to aging in humans as well as animal model systems; among these the changes of the T-cell functions have been studied most extensively. In recent years, the biochemical events implicated with the signal transduction cascade responsible for transmission of signal from the cell surface to the nucleus have been studied in detail in a wide variety of cellular systems, including lymphocytes. It is now evident that multiple steps of the signal transduction cascade, including protein phosphorylation and activities of different enzymes, are adversely affected due to aging. This chapter summarizes our current knowledge on two major effector pathways involved in intracellular transmission of T-cell receptor (TCR) signals, one of which is initiated by phospholipase C gamma-1 (PLCγ-1) that leads to the activation of calcium-dependent kinases and phosphatases, and the other one is initiated by Ras-GTP-binding protein that leads to the activation of mitogen-activated protein kinase (MAPK) cascade involving several dual specificity kinases and phosphatases. Age-associated modulation of these effector systems will be discussed in the context of the immune deficiency of T-cells. Such knowledge can provide useful information in designing intervention strategies to improve the immune function of the elderly.
Unsound Theorem Proving

We discuss the benefits of complete unsound inference procedures for efficient methods of disproof. We give a framework for converting a sound and complete saturation-based inference procedure into successive unsound and complete procedures, that serve as successive approximations to the theory. The idea is to successively add new statements in such a way that the inference procedure will halt. Then the satisfiability is evaluated over a stronger theory. This gives an over-approximation to the given theory. We show how to successively compute better over-approximations. Similarly, a sound an incomplete theorem prover will give an under-approximation. In our framework, we succesively compute better over and under-approximations in this way.
Conflict vs. Cohesion

Abstract The languages spoken in the context of family and work life transmit ethnicity from one generation to the next, presenting each with cohesive cultural identity as well as strain and conflict. Yet conflict appears to be prevailing over cohesion all too often in work organizations. Today's Employee Assistance Program professionals should take on ethnic-sensitive practice because no workforce can afford to ignore systemic problems such as racism, poverty and discrimination. Applying group-work and psychodynamic theory to a non-clinical environment, this article describes and analyzes an EAP-based model of cross-cultural training. This type of program goes far in developing the sensitivity and awareness so necessary to genuine multi-culturalism.