cssi/SciSciGPT-SciSciNet huggingface dataset:
Do varus or valgus outliers have higher forces in the medial or lateral compartments than those which are in-range after a kinematically aligned total knee arthroplasty? limb and joint line alignment after kinematically aligned total knee arthroplasty.

Aims The aims of this study were to determine the proportion of patients with outlier varus or valgus alignment in kinematically aligned total knee arthroplasty (TKA), whether those with outlier varus or valgus alignment have higher forces in the medial or lateral compartments of the knee than those with in-range alignment and whether measurements of the alignment of the limb, knee and components predict compartment forces. Patients and Methods The intra-operative forces in the medial and lateral compartments were measured with an instrumented tibial insert in 67 patients who underwent a kinematically aligned TKA during passive movement. The mean of the forces at full extension, 45° and 90° of flexion determined the force in the medial and lateral compartments. Measurements of the alignment of the limb and the components included the hip-knee-ankle (HKA) angle, proximal medial tibial angle (PMTA), and distal lateral femoral angle (DLFA). Measurements of the alignment of the knee and the components included the tibiofemoral angle (TFA), tibial component angle (TCA) and femoral component angle (FCA). Alignment was measured on post-operative, non-weight-bearing anteroposterior (AP) scanograms and categorised as varus or valgus outlier or in-range in relation to mechanically aligned criteria. Results The proportion of patients with outlier varus or valgus alignment was 16%/24% for the HKA angle, 55%/0% for the PMTA, 0%/57% for the DLFA, 25%/12% for the TFA, 100%/0% for the TCA, and 0%/64% for the FCA. In general, the forces in the medial and lateral compartments of those with outlier alignment were not different from those with in-range alignment except for the TFA, in which patients with outlier varus alignment had a mean paradoxical force which was 6 lb higher in the lateral compartment than those with in-range alignment. None of the measurements of alignment of the limb, knee and components predicted the force in the medial or lateral compartment. Conclusion Although kinematically aligned TKA has a high proportion of varus or valgus outliers using mechanically aligned criteria, the intra-operative forces in the medial and lateral compartments of patients with outlier alignment were comparable with those with in-range alignment, with no evidence of overload of the medial or lateral compartment of the knee. Cite this article: Bone Joint J 2017;99-B:1319–28.
Euthanasia and physician-assisted suicide not meeting due care criteria in the Netherlands: a qualitative review of review committee judgements.

Abstract Objectives To assess how Dutch regional euthanasia review committees (RTE) apply the euthanasia and physician-assisted suicide (EAS) due care criteria in cases where the criteria are judged not to have been met (‘due care not met’ (DCNM)) and to evaluate how the criteria function to set limits in Dutch EAS practice. Design A qualitative review using directed content analysis of DCNM cases in the Netherlands from 2012 to 2016 published on the RTE website (https://www.euthanasiecommissie.nl/) as of 31 January 2017. Results Of 33 DCNM cases identified (occurring 2012–2016), 32 cases (97%) were published online and included in the analysis. 22 cases (69%) violated only procedural criteria, relating to improper medication administration or inadequate physician consultation. 10 cases (31%) failed to meet substantive criteria, with the most common violation involving the no reasonable alternative (to EAS) criterion (seven cases). Most substantive cases involved controversial elements, such as EAS for psychiatric disorders or ‘tired of life’, in incapacitated patients or by physicians from advocacy organisations. Even in substantive criteria cases, the RTE’s focus was procedural. The cases were more about unorthodox, unprofessional or overconfident physician behaviours and not whether patients should have received EAS. However, in some cases, physicians knowingly pushed the limits of EAS law. Physicians from euthanasia advocacy organisations were over-represented in substantive criteria cases. Trained EAS consultants tended to agree with or facilitate EAS in DCNM cases. Physicians and families had difficulty applying ambiguous advance directives of incapacitated patients. Conclusion As a retrospective review of physician self-reported data, the Dutch RTEs do not focus on whether patients should have received EAS, but instead primarily gauge whether doctors conducted EAS in a thorough, professional manner. To what extent this constitutes enforcement of strict safeguards, especially when cases contain controversial features, is not clear.
Locally advanced pancreas cancer: Staging and goals of therapy.

Abstract Background Patients with locally advanced pancreatic cancer have historically been considered inoperable. The purpose of this report was to determine resectability rates for patients with locally advanced pancreatic cancer based on our recently described definitions of type A and type B locally advanced pancreatic cancer. Methods An institutional prospective pancreas cancer database was queried for consecutive patients with locally advanced pancreatic cancer treated between January 2009 and June 2017. All pretreatment imaging was re-reviewed and patients were categorized as locally advanced pancreatic cancer type A or type B. Demographics, induction therapy, resection type, and outcomes were reviewed. Results We identified 108 consecutive patients; 12 were excluded from analysis due to the absence of available pretreatment imaging or they had not yet completed all intended neoadjuvant therapy. Of the remaining 96 patients (45 type A, 51 type B), disease progression occurred in 19 (20%) during induction therapy and 30 (31%) were deemed inoperable at final preoperative restaging. Therefore, 47 (49%) of 96 patients were taken to surgery and 40 (42%) underwent successful resection (28 [62%] of 45 type A and 12 [24%] of 51 type B); an RO resection was achieved in 32 (80%). Metastatic disease was found intraoperatively (6 at laparoscopy, 1 at laparotomy) in 7 (15%) of 47 patients. There were no mortalities; 6 (15%) patients experienced major postoperative complications. Resected patients had a median overall survival of 38.9 months. Conclusion Locally advanced pancreatic cancer can be dichotomized into type A and B with distinctly different probabilities of completing all therapy to include surgery; thereby allowing goals of therapy to be established at the time of diagnosis. Multimodality therapy that includes surgery can be accomplished in selected patients with locally advanced pancreatic cancer and is associated with a median overall survival that approximates earlier stages of disease. (Surgery 2017;160:XXX-XXX.)
Light Therapy Improves Behavioral Disturbances, Sleep, Depression in Older Patients with Cognitive Impairment.

In this meta-analysis, older patients with cognitive impairment who were exposed to light therapy had moderate improvements in behavioral disturbances, small improvements in sleep quality, and moderate improvements in depression. The authors did not report data on responders vs. nonresponders or on the potential adverse effects of treatment.
The nutritional status of Latin American adults.

The high prevalence of infant and preschool child undernutrition in Latin America and its important impact on morbidity and mortality have been factors in the neglect of nutritional status in adult populations. This is an oversight that should be corrected, because the efficient working capacity of adults is a principal asset in combating national underdevelopment, which is the basis for most of the undernutrition in less developed countries.
Sex Roles and Psychopathology

Psychopathology and deviance cannot be understood in the abstract. Rather, definitions of deviance and mental illness depend on cultural norms, societal expectations and values, individual differences, professional biases, and the social-political climate of the time. Sex Roles and Psychopathology analyzes the extent to which cultural norms about the sexes, societal expectations and values about sex-typed behavior, sex differences, and professional biases influence the development, manifestation, and maintenance of abnormal behavior among men and women.
Mouse class 3 aldehyde dehydrogenases.

The Class 3 aldehyde dehydrogenases include the 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin, TCDD)-inducible cytosolic form (ALDH3c) and the constitutive microsomal form (ALDH3m), which is also TCDD-inducible. Table 1 summarizes the ALDH nomenclature used in this chapter. It might be noted that the Committee on Standardized Genetic Nomenclature for Mice is adamant about keeping the mouse gene designations the same as they have been for several decades.
Lithographically directed assembly of one-dimensional DNA nanostructures via bivalent binding interactions

In order to exploit the outstanding physical properties of one-dimensional (1D) nanostructures such as carbon nanotubes and semiconducting nanowires and nanorods in future technological applications, it will be necessary to organize them on surfaces with precise control over both position and orientation. Here, we use a 1D rigid DNA motif as a model for studying directed assembly at the molecular scale to lithographically patterned nanodot anchors. By matching the inter-nanodot spacing to the length of the DNA nanostructure, we are able to achieve nearly 100% placement yield. By varying the length of single-stranded DNA linkers bound covalently to the nanodots, we are able to study the binding selectivity as a function of the strength of the binding interactions. We analyze the binding in terms of a thermodynamic model which provides insight into the bivalent nature of the binding, a scheme that has general applicability for the controlled assembly of a broad range of functional nanostructures.
Swim bladder inflation failure affects energy allocation, growth, and feed conversion of California Yellowtail (Seriola dorsalis) in aquaculture

Abstract This study examines the effects of swim bladder inflation failure, a common developmental abnormality in finfish aquaculture, on the energy allocation, growth, and development of California Yellowtail (Seriola dorsalis). Health and fitness metrics including oxygen consumption, aerobic scope, critical swimming speed, feed conversion ratio, and growth rate, were monitored over a 32-week growout period in three groups of S. dorsalis: aquaculture-reared fish that failed to inflate their swim bladders (uninflated), aquaculture-reared fish with properly inflated swim bladders (inflated), and wild-caught individuals (wild). After the growout period, the uninflated fish had significantly lower body mass (636.1 ± 80.4 g vs. 758.6 ± 92.7 g inflated), shorter body length (36.5 ± 1.9 cm vs. 39.6 ± 2.0 cm inflated), and smaller girth (21.5 ± 1.2 cm vs. 23.2 ± 1.1 cm inflated) than the inflated fish. In addition, the uninflated fish had the least efficient feed conversion ratio (2.08 uninflated vs. 1.49 inflated, 1.41 wild), needing 39.8% more feed than the inflated fish, and 47.8% more feed than the wild fish to gain equivalent mass. These differences in growth and feed conversion appear to be primarily attributed to differences in energy allocation. Measures of oxygen consumption using a swim tunnel respirometer at two time points during the growout period showed that uninflated fish had significantly higher metabolic costs than both the inflated and wild groups over a large range of the swimming speeds tested. In addition, the uninflated fish were often observed swimming faster in their growout tank, likely to generate enough lift to compensate for the lack of a buoyant swim bladder. The wild-caught fish had the lowest feed conversion ratios and had significantly lower metabolic costs than both the inflated and uninflated aquaculture-reared fish at the beginning of the growout period (shortly after capture from the wild). The results of this study show that rearing S. dorsalis without a functional swim bladder is not economically feasible based on their poor growth and feed conversion ratios, and suggest that there is room for improvement in the metabolic efficiency of cultured S. dorsalis with properly inflated swim bladders.
Long-term efficacy of 1-1.2 kHz subthreshold spinal cord stimulation following failed traditional spinal cord stimulation: a retrospective case series.

Background and objective We investigated whether an effective long-term pain relief could be achieved using subthreshold 1–1.2 kHz spinal cord stimulation (SCS) among patients who were initially implanted with traditional paresthesia-based SCS but who failed to maintain an adequate pain relief. Methods Retrospective chart review was conducted of patients’ electronic records who underwent a trial of subthreshold 1–1.2 kHz SCS. One hundred and nine patients implanted and programmed at traditional paresthesia-based frequencies 40–90 Hz (low-frequency SCS) with unsatisfactory pain relief or unpleasant paresthesias were identified. Patients’ settings were switched to 1–1.2 kHz and 60–210 µs, and variable amplitude adjusted to subthreshold. Pain scores and medication usage were collected. Complete data are presented on 95 patients. Results Data were collected from 36 men and 59 women who were converted from above-threshold 40–90 Hz SCS to 1–1.2 kHz SCS, with a minimum follow-up of 12 months. Nearly a third (63/95 or 66.3%) of the subjects deemed 1–1.2 kHz SCS ineffective and returned to low-frequency SCS within 1 week after switch, and one-sixth (16/95 or 16.8%) of the subjects returned to low-frequency SCS within 1 month. Only 13 (13.7%) subjects continued using 1–1.2 kHz subthreshold SCS for 3 months or longer and 2.1% (2/95) of subjects continued using it at 12 months. A comparison of their pain scores and opioid use before and during the time we used 1–1.2 kHz SCS revealed no significant difference. Conclusion The results from our single center failed to show additional long-term clinical benefit of 1–1.2 kHz subthreshold SCS in patients with chronic pain failing traditional low-frequency SCS.
Waitlist Mortality and Extracorporeal Membrane Oxygenation as a Bridge to Lung Transplantation

Purpose Extracorporeal membrane oxygenation (ECMO) is increasingly used as a bridging strategy to lung transplantation (LT). This trend has been largely influenced by increasing acuity among recipients. The purpose of this study was to examine factors related to death prior to LT for patients on ECMO at the time of registration. Methods Patients included those who were on ECMO when registered in the United Network for Organ Sharing (UNOS) Organ Procurement and Transplantation Network Database between 2005-2017. At registration for LT, 402 adult patients were on ECMO as a bridge, 324 of whom were transplanted or died prior to LT. Multivariable logistic regression was used to examine factors associated with mortality prior to LT. Results Mean age was 44.7±15.4 years and 38% were female. In this sample, 21% died before LT (n =68) with 44% for pulmonary reasons, 15% for graft failure , 9% for cardiac arrest, 7% for infection, and 24% for other reasons. Most common indication for LT was interstitial-restrictive disease (49%) whereas pulmonary hypertension patients had highest mortality (39%) although not significant. In multivariable analysis, female gender was associated with more than double risk for mortality prior to LT (OR=2.40, P=0.005; TABLE). However, female patients were younger (39 vs 48 years, P creatinine (0.6 vs 0.8, P Conclusion Female gender and elevated serum creatinine were independently associated with higher risk for mortality in patients with ECMO as a bridge to LT.
Organizations Behaving Badly: Antecedents and Consequences of Uncivil Workplace Environments

The present study investigated the relationship between employees’ perceptions of five characteristics emphasized in their work organization (i.e., individualism, hostile interaction styles, compet...
The Ecology of Medical Care Before and After the Affordable Care Act: Trends From 2002 to 2016

BACKGROUND The initial ecology of medical care study was published in 1961, offering a framework by which to investigate individuals’ contact with the medical system. We studied changes in the framework around the implementation of the Patient Protection and Affordable Care Act (ACA) within longer-term trends. METHODS The 2002-2016 Medical Expenditure Panel Survey was used to determine rates of visit/contact per 1,000 individuals per month for physicians, primary care physicians, specialty physicians, emergency departments, inpatient hospitalizations, dental visits, and home health visits for the overall population and by age group, poverty category, health status, and race/ethnicity. Adjusted Wald tests were used to investigate differences between the pre-ACA (2012-2013) and post-ACA (2014-2015) periods. Multivariable linear regression was used to determine trends over the study period (2002-2016). RESULTS The survey included 525,804 person-years. The uninsured rate decreased from 12.8% (95% CI, 12.0%-13.7%) in 2013 to 7.6% (95% CI, 7.0%-8.3%) in 2016. From 2002 to 2016, the numbers of individuals in a month who had contact with primary care physicians, dental care, and inpatient hospitalizations decreased. Primary care physician contact decreased most among the elderly and those reporting fair/poor health. After ACA implementation, few significant changes were identified in the overall population or by age, poverty category, race/ethnicity, or health status. CONCLUSIONS The medical ecology framework was not notably altered 2 years after implementation of the ACA. The long-term decrease in primary care contact does not appear to have been interrupted after implementation of the ACA, was observed across income and age categories, and was most evident among the elderly and individuals reporting fair/poor health.
The emotional dimensions of reason-giving in deliberative forums

This study investigates the role of emotions in the context of a controversial debate surrounding criminal legislation in Brazil. While several thinkers have criticized deliberation for requiring purely rational discourse, we argue that emotion is a central component in the reasoning process. Whereas existing research on the link between justification and emotion has been theoretical, this article offers a novel analytical framework, based on correlational and content analyses, to examine how anger, indignation, fear and compassion underlay reasoned claims. This study is based on data from a morally charged debate in Brazil’s National Congress about setting the criminal responsibility age. Findings reveal that (i) emotions are not randomly distributed, but strongly correlate with the direction of argumentation; (ii) intentional objects, while not involving straightforward cognition, inform perspectives of reasoning; and (iii) these relationships appear unaffected by forum designs. This study helps to understand both personal and social levels of emotional concerns; has methodological implications for surveying emotional dynamics as a socially driven phenomenon; and offers general insights about how the imbrication of reason-giving and emotions is effectively achieved, further away from simplistic notions of rationality.
Tests in short supply? Try group testing

Christopher R. Bilder, Peter C. Iwen, Baha Abdalhamid, Joshua M. Tebbs and Christopher S. McMahan explain how, by pooling specimens, testing capacity for SARS-CoV-2 can be increased.
Livedo racemosa secondary to hyaluronic acid injection

Iatrogenic vascular occlusion secondary to filler injection, such as with hyaluronic acid, is a known but rare, entity. It typically occurs in the setting of facial cosmetic procedures but has also been described in the setting of osteoarthritis. We present a patient with ankle osteoarthritis who developed an asymmetric, reticular, livedoid eruption after intraarticular injection with hyaluronic acid. She was diagnosed with livedo racemosa secondary to vascular occlusion and placed on low molecular weight heparin. Later, a transition to low-dose daily aspirin maintained the improvement.
Sleep Quality Among Older Women and Men in the United States by Sexual Orientation

Sleep problems may increase the risk for, and result from, other health problems and negatively impact quality of life. Lesbian, gay, and bisexual older adults report more sleep problems compared to their straight counterparts when such problems are measured in the aggregate (e.g. “one or more of four specific sleep problems”). However, scant national research has examined if specific types of sleep problems vary by sexual orientation among older adults. Using 2015-2018 National Health Interview Survey (NHIS) data, we used logistic regression to separately model five sleep problems among women 50+ and men 50+ (lesbian/gay women: n=377, bisexual women: n=142, straight women: n=33,216; gay men: n=508, bisexual men: n=115, straight men: n=25,998) as functions of sexual orientation, controlling for age, race, education, and income. Sexual minority older adults were more likely than their straight counterparts to have taken sleep medication in the past week (women AOR=2.04, 95% CI:1.55, 2.67; men AOR=1.81, 95% CI:1.36, 2.40). The only other difference by sexual orientation found for men was bisexual older men’s greater likelihood, compared to straight men, of having difficulty falling asleep (AOR=2.02, 95% CI: 1.08, 3.79). Older women did not differ by sexual orientation in difficulty falling asleep, difficulty staying asleep, or waking up not feeling rested for four or more days in the past week, or meeting National Sleep Foundation recommendations for hours of sleep per night, whether lesbian/gay and bisexual women were examined together or disaggregated. Future research may examine why sleep quality only sometimes varies by sexual orientation.
Association of US state policy orientation with adverse birth outcomes: a longitudinal analysis.

Background The current US context is marked by extreme right–left partisanship, which means that state policies tend to bundle together and are not experienced in isolation. While prior work has leveraged abrupt shifts in single policies to examine the effects of state policy on birth outcomes, we examined a holistic measure that captures political polarisation. Methods Data were drawn from national birth certificates for 2003–2017 (N=56 770 470). Outcomes included preterm birth, low birth weight, small-for-gestational age and other perinatal health measures. The primary exposure was a composite index of right–left state policy orientation, generated from historical data on 135 state policies. Multivariable regressions were used to estimate the association between state policy orientation and each outcome, adjusting for relevant covariates. Results Compared with infants born in states with right-leaning policy orientations, those born in left-leaning states had lower odds of adverse birth outcomes (eg, low birth weight: OR 0.95 (0.93, 0.97), preterm birth: OR 0.94 (0.92, 0.95)). Subgroup analyses revealed stronger associations for US-born and White mothers. With the inclusion of state fixed effects, left-leaning policy orientation was no longer associated with lower odds of adverse birth outcomes. Models were otherwise robust to alternative specifications. Conclusion While left-leaning state policy orientation has protective associations with a range of birth outcomes, the associations may be explained by stable characteristics of states, at least during the study period. Future studies should examine state policy orientation in association with other health outcomes and study periods.
Cell fate dynamics and genomic programming of plasma cell precursors

This review is focused on the cellular dynamics and genomic programming of plasma cell (PC) precursors that arise during germinal center (GC) B cell responses in secondary lymphoid organs (SLOs) and give rise to PCs in the bone marrow. Considerable progress has been made in the phenotypic characterization of circulating and bone marrow PC precursors as well as their differentiated short-lived (SLPC) and long-lived (LLPC) counterparts, in the context of model antigen and vaccine responses. Importantly, it has been possible to infer the temporal dynamics of generation of PC precursors during a GC response. However, the nature of the PC precursors at their site of generation in SLOs, and their signaling and genomic states, remain to be elucidated. Our synthesis draws upon experimental studies conducted in murine models as well as in humans, the latter complemented with cell culture manipulations of PCs and their precursors. By integration of the studies in murine and human systems, which are being accelerated by new genomic methodologies, we highlight insights and hypotheses concerning the generation of PCs. This framework can be extended and explored from both fundamental and translational standpoints.
Knowledge-based dose prediction models to inform gynecologic brachytherapy needle supplementation for locally advanced cervical cancer.

Abstract PURPOSE The use of interstitial needles, combined with intracavitary applicators, enables customized dose distributions and is beneficial for complex cases, but increases procedure time. Overall, applicator selection is not standardized and depends on physician expertise and preference. The purpose of this study is to determine whether dose prediction models can guide needle supplementation decision-making for cervical cancer. MATERIALS AND METHODS Intracavitary knowledge-based models for organ-at-risk (OAR) dose estimation were trained and validated for tandem-and-ring/ovoids (T&R/T&O) implants. Models were applied to hybrid cases with 1–3 implanted needles to predict OAR dose without needles. As a reference, 70/67 hybrid T&R/T&O cases were replanned without needles, following a standardized procedure guided by dose predictions. If a replanned dose exceeded the dose objective, the case was categorized as requiring needles. Receiver operating characteristic (ROC) curves of needle classification accuracy were generated. Optimal classification thresholds were determined from the Youden Index. RESULTS Needle supplementation reduced dose to OARs. However, 67%/39% of replans for T&R/T&O met all dose constraints without needles. The ROC for T&R/T&O models had an area-under-curve of 0.89/0.86, proving high classification accuracy. The optimal threshold of 99%/101% of the dose limit for T&R/T&O resulted in classification sensitivity and specificity of 78%/86% and 85%/78%. CONCLUSIONS Needle supplementation reduced OAR dose for most cases but was not always required to meet standard dose objectives, particularly for T&R cases. Our knowledge-based dose prediction model accurately identified cases that could have met constraints without needle supplementation, suggesting that such models may be beneficial for applicator selection.
Hankel Type Convolution and Boundedness of Product of Pseudo Differential Type Operators

Two symbols are defined in this study utilising the Hankel type transform, as well aspseudo-differential type operators M(x,D) and N(x,D) associated with the Bessel type operator \(\Delta\)\(\alpha\),\(\beta\) defined by equation (2.1) in terms of these symbols.. Further product of M(x,D) and N(x,D) is defined. Sobolev type space is also defined. It is demonstrated that the pseudo-differential type operators M(x,D) , N(x,D) and the product of pseudo-differential type operators are bounded in a certain Sobolev type space associated with the Hankel type transform. Finally, certain unique cases are investigated.
Thromboembolism in Patients with Metastatic Renal Cell Carcinoma Treated with Immunotherapy.

Metastatic renal cell carcinoma (mRCC) is associated with a high risk of thromboembolism (TE). We investigated whether immunotherapy (IO) increases the hypercoagulable state in this high-risk population. Patients with mRCC treated with IO between 1 January 2015 and 31 December 2019 at the Cleveland Clinic were identified. Cumulative incidence analysis calculated TE rates over time and Gray’s test determined differences in TE rates among groups. The Kaplan–Meier method estimated survival, while Cox proportional hazard regression evaluated the impact of TE on OS. Of 351 patients, 75% were men with clear cell mRCC (81%) and International Metastatic Renal Cell Carcinoma (IMDC) intermediate- to poor-risk disease (77%). Patients received single-agent IO (52%), doublet IO (31%), or IO with non-IO therapy (17%). The median number of IO doses was 8 (range 1–81). At a median follow-up of 12.8 months, 12% of patients (n = 43) had a TE event (venous n = 37 [11%], arterial n = 6 [2%]). The cumulative TE incidence at 6 months was 4.4% (95% confidence interval [CI] 2.6–6.9) and 9.8% (95% CI 6.8–13.4) at 12 months. No factors, including IMDC or Khorana score, were identified to predict TE development. Seventy-two percent of TE resulted in hospitalization (9% TE-related mortality and 21% TE-related dose delay). TE (p < 0.0001), poor IMDC score (p < 0.0001), and Khorana score ≥ 2 (p < 0.0001) were associated with worse OS. Patients with mRCC treated with IO had a high incidence of TE. TE was associated with risk of treatment delay, hospitalization, and mortality, while TE, IMDC poor risk, and Khorana score ≥ 2 were associated with worse survival. Further investigations into IO-associated TE are needed to identify benefit from primary thromboprophylaxis. Patients with advanced renal cell carcinoma carry an increased risk of clotting, both in their arteries and veins. Historically, risk scores such as the Khorana score were used to assess which patients with solid tumors would benefit from preventative blood thinning medications as they undergo chemotherapy. Whether the Khorana score can be applied to use with immunotherapy is not known. Currently, limited knowledge exists of the impact of immunotherapy on additional clotting in patients with renal cell carcinoma. This study shows an increased incidence of clotting under immunotherapy treatment in patients with advanced renal cancer compared with rates seen in the literature. This study highlights an associated risk of hospitalization, need to stop cancer therapy, as well as risk of death from clotting. Additionally, we determine that clotting, poor disease pathology (as assessed by the International Metastatic Renal Cell Carcinoma Database Consortium), and a Khorana score of ≥2 are predictors of a worse overall survival. This information will be useful in future studies that will address the usefulness of preventative blood thinner medications in this high-risk population.
Brain Stimulation in Psychiatry: ECT, DBS, TMS and Other Modalities

The field of brain stimulation is advancing at rapid pace with a growing number of techniques now approved for the treatment of psychiatric illness. This text acts both as a concise, quick reference for experienced practitioners and a guidebook for residents learning about clinical brain stimulation techniques. The techniques covered include: Electroconvulsive therapy (ECT)Deep brain stimulation (DBS)Transcranial magnetic stimulation (TMS) Vagus nerve stimulation (VNS) Magnetic seizure therapy (MST) Transcranial direct current stimulation (TDCS)All aspects of these treatments are covered, from patient selection, through the implementation of the technique, to patient aftercare. Potential future applications are discussed and select, up-to-date reference lists guide practitioners to the most important further reading around each technique. Portable, concise and easy to navigate, covering all the need-to-know information, Brain Stimulation in Psychiatry is essential reading for practitioners, residents and medical students in psychiatry and neurology.
Antiestrogens: Mechanism of Action and Effects in Breast Cancer

Several of the nonsteroidal antiestrogens are in experimental use for the treatment of breast cancer. The treatment goal is to obtain, with minimal toxicity, specific control over cell growth by chemical means, thereby avoiding, on the one hand, pharmacologic doses of hormones and, on the other, major surgical ablative procedures.(1) One rationale for use of estrogen antagonists is an outgrowth of our current awareness of the role of estrogen receptors (ERs) and estrogen in breast cancer. Recent reports show that hormone dependence can be predicted by use of ER measurements. If estrogen antagonists block the action of estrogen at its receptor, it would be possible to obtain, by noninvasive means, the same therapeutic end as ablative hormonal procedures. Despite considerable research to that end, however, our knowledge of the mechanism of antiestrogen action remains unclear. The purpose of this review is to summarize this research. We will review first some of the biological activities of antiestrogens in normal tissues, and the mechanisms that have been proposed for their effects, then the role of antiestrogens in experimental animal breast cancer, and the data currently available on use of antiestrogens in humans and human breast cancer.
Using Set Covering and Uncertain Reasoning to Determine Treatments

Abstract Reggia's generalized set covering model is for determining the diseases which are present in a patient from his symptoms. In the current paper, several shortcomings in the basic model are described, and it is shown how these shortcomings can be overcome by employing a method for reasoning under uncertainty. Secondly, the model is used to determine treatments for a stroke patient from the diseases present, showing that set covering is appropriate for determining treatments from diseases as well as diseases from symptoms.
Migration of brine inclusions in salt

Theories of the migration of brine inclusions in salt are interpreted as simple physical processes, and theories by Russian and U.S. workers are shown to yield the same results. The migration theory is used to predict threshold temperature gradients below which migration of brine inclusions should not occur. The predicted threshold gradients are compared with the temperature gradients expected at the Waste Isolation Pilot Plant in New Mexico. The theory of a threshold gradient helps explain the existence of brine inclusions in natural salt deposits.
Heroes, Monsters, Freedom and Bondage: Inclusion, Exclusion and Autonomy in Une tempête, Jane Eyre and Wide Sargasso Sea

In the same decade that Martinican poet Aime Cesaire resurrected the dark, misshapen Caliban from Shakespeare’s The Tempest as the hero of his provocative adaptation for a black theater Une tempete (1969), Dominican writer Jean Rhys resuscitated the raving madwoman from Bronte’s Jane Eyre as the heroine of her haunting novel Wide Sargasso Sea (1966). Concomitantly, as did slave narratives and female gothic novels, they demonized the European patriarch as they “dramatiz[ed] the evils that result from human beings whose passion for power is focused not on power over self but on power over others,” to reiterate Kari J. Winter’s observation.... Charlotte Bronte, who also explores the nature of the patriarchal relationship, does so through the ordering of her narrative in Jane Eyre around a figurative slavery. We will find that whereas the European patriarch is a necessary component of her heroine’s attainment of sexual equality in Victorian England, he remains eccentric to the Caribbean worlds that Cesaire and Rhys present. Despite the difference in the role that they represent European man as playing in the more equitable worlds that they propose, the three texts come to the tacit understanding that his inclusion is contingent upon his willingness to relinquish his traditional role as master of his own destiny and that of others.
Kinematic analysis of maximal movement initiation in Greyhounds

Background Sprinting, jumping, stopping, turning and movement initiation produce the highest forces and largest ranges of motion in the canine gait, yet very little is known about them. Objective The purpose of this study was to develop a general kinematic sequencing of maximal movement initiation of Greyhounds using joint angles and a segmental diagram. Design Seven Greyhounds conducted maximal movement initiation trials on a vegetated surface by chasing a lure. A high-speed kinematic analysis was conducted to evaluate joint angles (cervical, shoulder, elbow, carpus, hip, stifle and tarsus). Results A sequence of the movement was developed and included a kinematic description at seven events: (1) standing, (2) set position, (3) front paw touch down, (4) rear paw take-off, (5) front paw take-off, (6) rear paw touchdown and (7) second front paw touchdown. In addition, canine segmental figures were generated for each of the seven events for a visual reference of segmental alignment. Conclusions Sequencing provides an understanding of movement initiation in Greyhounds. The kinematic data helps fill the void in the scientific literature with regard to movement initiation in a naturalistic environment. Clinical relevance These values will help the veterinary community understand the kinematics of maximal movement initiation so that training, conditioning, diagnosis, treatment and rehabilitation can be precisely directed to achieve the goal of optimal performance and properly returning dogs to athletic, recreational or working activities.
Involuntary Servitude, Public Accommodations Laws, and the Legacy of Heart of Atlanta Motel, Inc. v. United States

In Heart of Atlanta Motel v. United States (1964), the U.S. Supreme Court unanimously affirmed Congress’s power under the Commerce Clause to pass Title II, the public accommodations component of the Civil Rights Act of 1964 (CRA). The Johnson Administration expressed hope that this unanimous decision would aid the “reasonable and responsible acceptance” of the CRA. A less familiar legacy of this case is the role played by the Thirteenth Amendment and its declaration that “neither slavery and involuntary servitude . . . shall exist within the United States.” The owner of the Heart of Atlanta Motel unsuccessfully invoked this amendment to challenge Title II, drawing on a particular conception of private property. The Court rejected this argument briskly. Looking at this case in isolation would leave a modern reader ignorant of the role played by the Thirteenth Amendment in the debate over the enactment of Title II. This article revisits the Heart of Atlanta Motel case, drawing on contemporaneous press coverage and legal commentary about it and related legal challenges. It then shows how, when Congress considered Title II, proponents and opponents both appealed to the Thirteenth Amendment. The Administration and Congressional supporters emphasized the Commerce power as the constitutional hook for Title II, mindful of the Court’s invalidation, in the Civil Rights Cases (1883), of the Reconstruction-era public accommodations law of 1875 and of the fate of Thirteenth and Fourteenth Amendment arguments there. However, they appealed to the Thirteenth Amendment, in conjunction with the Fourteenth Amendment, and to the unfinished business of Reconstruction. The Thirteenth Amendment, they argued, sought to abolish all the incidents of slavery and to secure full citizenship; racial discrimination in public accommodations was a continuing badge of servitude. By contrast, opponents of Title II (e.g., Senator Strom Thurmond) argued that the Thirteenth Amendment forbade Title II; they equated “involuntary servitude” with “rendering involuntary service” and with violating private property rights. This claim returns in the Heart of Atlanta challenge and the rhetoric of fellow Atlanta restaurant owner (and, later, governor) Lester Maddox. The article concludes by examining the legacy of Heart of Atlanta Motel for later antidiscrimination laws and their critics, focusing on analogies between race discrimination and other forms of discrimination, such as sex and sexual orientation.
Hierarchical self-organization in genetic programming

This paper presents an approach to automatic discovery of functions in Genetic Programming. The approach is based on discovery of useful building blocks by analyzing the evolution trace, generalizing blocks to define new functions, and finally adapting the problem representation on-the-fly. Adaptating the representation determines a hierarchical organization of the extended function set which enables a restructuring of the search space so that solutions can be found more easily. Measures of complexity of solution trees are defined for an adaptive representation framework. The minimum description length principle is applied to justify the feasibility of approaches based on a hierarchy of discovered functions and to suggest alternative ways of defining a problem's fitness function. Preliminary empirical results are presented.
Self-Similar Mining of Time Association Rules

Although the task of mining association rules has received considerable attention in the literature, algorithms to find time association rules are often inadequate, by either missing rules when the time interval is arbitrarily partitioned in equal intervals or by clustering the data before the search for high-support itemsets is undertaken. We present an e.cient solution to this problem that uses the fractal dimension as an indicator of when the interval needs to be partitioned. The partitions are done with respect to every itemset in consideration, and therefore the algorithm is in a better position to find frequent itemsets that would have been missed otherwise. We present experimental evidence of the e.ciency of our algorithm both in terms of rules that would have been missed by other techniques and also in terms of its scalability with respect to the number of transactions and the number of items in the data set.
A reverse DNA strand exchange mediated by recA protein and exonuclease I. The generation of apparent DNA strand breaks by recA protein is explained.

Abstract The combined action of exonuclease I and recA protein leads to a kind of reverse DNA strand exchange in which joint molecules formed on the "wrong" or distal end of a linear duplex in the presence of ATP are stabilized by exonuclease I degradation of the displaced (+) strand. Continued pairing and degradation of the displaced strand leads to strand exchange that appears to progress with a polarity opposite that of the normal recA protein promoted reaction (i.e. 3'-5' with respect to the (+) strand). However, in contrast to the normal 5'-3' strand exchange, the displaced strand is completely degraded in the process. When the linear duplex DNA substrate has a heterologous region at the 5' (proximal) end, the major product (described in a previous study (Bedale, W. A., Inman, R. B., and Cox, M. M. (1991) J. Biol. Chem. 266, 6499-6510)) is a circular duplex DNA molecule with a double-stranded tail whose length corresponds closely to the heterologous segment of the substrate. The origin of this product is here shown to be the result of the exonuclease activity of exonuclease I (either added exogenously or present as a trace contaminant of recA protein or SSB protein preparations), as opposed to endonucleolytic or mechanical breakage. The levels of exonuclease I required to generate these products are sufficiently low that they are undetected by assays for exonuclease contamination in recA protein preparations. These results demonstrate that the interplay of recA protein with other enzymes can have a profound effect on both the mechanism and outcome of recA protein-promoted DNA strand exchange. They also demonstrate that the (+) strand of the duplex DNA substrate is at least transiently displaced in recA protein-mediated pairing even when joint molecules are limited to the distal end.
Seroagglutination Test for Identification of Mycobacterium paratuberculosis

Twenty-nine of 30 strains of Mycobacterium paratuberculosis isolated from clinical specimens were serologically identified. No cross-reactions were observed with Mycobacterium avium serotypes 1, 2, 4, and 8.
Exploring the potential contribution of irrigation to global agricultural primary productivity

[1] The potential contribution of irrigation to global agricultural net primary productivity (NPP) was explored using the Carnegie Stanford Ames Approach (CASA) model, modified for irrigation inputs. Excluding the effects from cultivar choice, fertilizer application, and water availability, removing climatic constraints to productivity through irrigation has the potential to increase carbon uptake by global cropland areas (which already have an average carbon uptake rate in excess of 175 gC/m2/yr) by an average of 25 gC/m2/yr with a maximum of 627 gC/m2/yr, especially in heavily irrigated semiarid areas such as northern India, the Indus River Valley, northeast China, the western United States, and the Nile River Valley. When accumulated across all irrigated areas and years, the total contribution of irrigation could exceed 0.40 Pg C per year, a value equivalent to the total NPP of U.S. croplands (0.41 PgC). The results also reveal that the relationship between cropland productivity affected by irrigation and climatic moisture availability is nonlinear: in locations that receive less than 1500 mm/yr rainfall, cropland productivity has a strong response to moisture; as humidity increases, additional moisture has very little impact on the productivity of crop areas. Moreover, the relationship between irrigation amount and productivity increase is also nonlinear: in humid locations, NPP response to irrigation is small but persistent; as aridity increases, irrigation has a substantial impact but its effect quickly saturates for irrigation input above 800 mm/yr, which may point to the efficiency of irrigation for different precipitation regions.
Barriers to Robust and Effective Human-Agent Teamwork

Abstract : Building a robust and effective human-agent team is difficult as teams can fail for many reasons. In this study, we investigated the performance of human-agent teams with divisional and functional team structure under different level of task load uncertainty. Divisional teams show robustness against uncertainly but can lead to poorer performance. Three reasons related to team coordination were identified for the poor performance, namely duplicate work, underutilization of resources and infrequent communication. We proposed a conceptual model to explain the mechanism of team coordination. In future studies, we hope to quantify this team coordination model, connect it with team performance and test the effect of different solutions using the model.
Teaching Scientific Reasoning through Attribution Theory

A teaching activity improves students' scientific reasoning by focusing attention on the causal, explanatory nature of psychological theories, The instructor's initial lecture emphasizes the argument form called Inference to the Best Explanation (IBE). Students construct IBE arguments by sorting a series of premises and conclusions based on correspondent inference theory (Jones & Davis, 1965), Discussion of argument strength follows, using the concepts presented in the lecture. Fifty-two introductory social psychology students evaluated the activity favorably, and results of a nonequivalent control group experiment showed that participation improved their reasoning ability. Suggestions for modifying the activity for other psychology courses are provided.