cssi/SciSciGPT-SciSciNet huggingface dataset:
Altered cortical glutamatergic and GABAergic signal transmission with glial involvement in depression

Abnormalities in l-glutamic acid (glutamate) and GABA signal transmission have been postulated to play a role in depression, but little is known about the underlying molecular determinants and neural mechanisms. Microarray analysis of specific areas of cerebral cortex from individuals who had suffered from major depressive disorder demonstrated significant down-regulation of SLC1A2 and SLC1A3, two key members of the glutamate/neutral amino acid transporter protein family, SLC1. Similarly, expression of l-glutamate-ammonia ligase, the enzyme that converts glutamate to nontoxic glutamine was significantly decreased. Together, these changes could elevate levels of extracellular glutamate considerably, which is potentially neurotoxic and can affect the efficiency of glutamate signaling. The astroglial distribution of the two glutamate transporters and l-glutamate-ammonia ligase strongly links glia to the pathophysiology of depression and challenges the conventional notion that depression is solely a neuronal disorder. The same cortical areas displayed concomitant up-regulation of several glutamate and GABAA receptor subunits, of which GABAAα1 and GABAAβ3 showed selectivity for individuals who had died by suicide, indicating their potential utility as biomarkers of suicidality. These findings point to previously undiscovered molecular underpinnings of the pathophysiology of major depression and offer potentially new pharmacological targets for treating depression.
Escrow Encryption Systems Visited: Attacks, Analysis and Designs

The Escrow Encryption Standard and its realization - the Clipper chips - suggest a new type of encryption scheme. We present a few basic and somewhat subtle issues concerning escrow encryption systems. We identify and perform attacks on the actual Clipper and other recent designs (fair cryptosystems, TIS software escrow, etc.). We review requirements and concerns and suggest design approaches to systems with desired properties of key escrow.
WHO'S YOUR DADDY?: THE INHERENT UNFAIRNESS OF THE MARITAL PRESUMPTION FOR CHILDREN OF UNMARRIED PARENTS*

Many states have marital presumptions of legitimacy, which provide children born to married parents with protection against paternity lawsuits questioning their legitimacy. However, most states do not have legitimacy presumption statutes for unmarried couples. This lack of equality between married and unmarried couples makes it so that children born to unmarried parents, who have developed a psychological bond with a man they have always thought to be their father, are not afforded the same protection as other children in similar situations, simply because their parents were not married at the time of their birth. Therefore, this Note advocates for states to amend their paternity statutes to provide protection against nonpaternity lawsuits to psychological fathers and their psychological children. State statutes should provide a psychological father with the right to be declared the legal parent of his psychological child in cases where the child's legal father has been substantially absent from the child's life.
Development of Evaluation Procedures for Local Exhaust Ventilation for United States Postal Service Mail-Processing Equipment

Researchers from the National Institute for Occupational Safety and Health (NIOSH) have conducted several evaluations of local exhaust ventilation (LEV) systems for the United States Postal Service (USPS) since autumn 2001 when (a) terrorist(s) employed the mail system for acts of bioterrorism. As a part of the USPS 2002 Emergency Preparedness Plan, the development and installation of LEV onto USPS mail-processing equipment can reduce future exposures to operators from potentially hazardous contaminants, such as anthrax, which might be emitted during the processing of mail. This article describes how NIOSH field testing led to the development of recommended testing procedures for evaluations of LEV capture efficiency for mail-processing equipment, including tracer gas measurements, smoke release observations, air velocity measurements, and decay-rate testing under access hoods.
Sources of variation in false discovery rate estimation include sample size, correlation, and inherent differences between groups

High-throughtput technologies enable the testing of tens of thousands of measurements simultaneously. Identification of genes that are differentially expressed or associated with clinical outcomes invokes the multiple testing problem. False Discovery Rate (FDR) control is a statistical method used to correct for multiple comparisons for independent or weakly dependent test statistics. Although FDR control is frequently applied to microarray data analysis, gene expression is usually correlated, which might lead to inaccurate estimates. In this paper, we evaluate the accuracy of FDR estimation. Using two real data sets, we resampled subgroups of patients and recalculated statistics of interest to illustrate the imprecision of FDR estimation. Next, we generated many simulated data sets with block correlation structures and realistic noise parameters, using the Ultimate Microarray Prediction, Inference, and Reality Engine (UMPIRE) R package. We estimated FDR using a beta-uniform mixture (BUM) model, and examined the variation in FDR estimation. The three major sources of variation in FDR estimation are the sample size, correlations among genes, and the true proportion of differentially expressed genes (DEGs). The sample size and proportion of DEGs affect both magnitude and precision of FDR estimation, while the correlation structure mainly affects the variation of the estimated parameters. We have decomposed various factors that affect FDR estimation, and illustrated the direction and extent of the impact. We found that the proportion of DEGs has a significant impact on FDR; this factor might have been overlooked in previous studies and deserves more thought when controlling FDR.
The Euro Zone Economic Crisis and Sub-Saharan Africa’s Real Economy: Analysis and the Way Forward

The purpose of the paper was to investigate if there were some negative impact of the euro zone economic crisis on sub-Saharan Africa’s (SSA) real economy. The evidence revealed that the euro zone crisis had affected sub-Saharan Africa economy in terms of trade, development assistance, and remittance. The conclusion derived from the evidence is that SSA’s economic growth was negatively affected slightly. This was due to prudential policies implemented by SSA policy-makers. The article begins with the historical background of the euro zone economic crisis and its root causes. It then provides an analysis of the transmission channels of the crisis and its impact on SSA’s economies. This is followed by a discussion of the policy responses to the crisis by SSA’s policy-makers. The paper concludes with an analysis of SSA’s recent economic performance and the way forward for long term growth and sustainable development.
ILO Supervision and the Self-Executing Nature of Convention Provisions

Whether a particular provision of a treaty is self-executing or not is, in general, a question of municipal law. The courts of a particular jurisdiction decide under their constitutional system whether or not they will apply a provision without implementing legislation.1 Nevertheless, ILO supervisory organs, charged with the responsibility of ascertaining whether ratifying states have taken action necessary “to make effective” the provisions of conventions have themselves examined the question of whether a particular provision of an ILO convention is or is not self-executing within a specific legal system when there has not been a determination by the courts of the state concerned.
Safety: First, Do No Harm

If you plan on having anything to do with MRI, you had better care about safety. Whereas MRI is a powerful diagnostic tool that has become indispensable in health care delivery, it is potentially a double-edged sword. Patients have literally lost their lives due to errors in the use of clinical MRI scanners, and others have been seriously injured. Although the safety issues surrounding MRI have been know since its inception, renewed interest and serious attention to MRI safety dates from summer 2001. In July of that year, a 6-year-old boy who had just recovered from curative surgery for a brain tumor was killed during a follow-up MRI scan. During the scan, a ferromagnetic oxygen tank was brought into the scanner room and it launched into the bore crushing the little boy’s head. This event received international media attention and instigated the American College of Radiology (ACR) to convene a Blue Ribbon Commission to assess the state of MR Safety and the scope of safe MRI practice. The commission published a White Paper on MRI Safety, which has been updated since its initial release (see Appendix 4 for the complete citations), delineating, in considerable detail, the parameters of safe MRI practice. The ACR White Papers are required reading for anyone involved in MRI and especially for physicians responsible for the safe operation of an MRI facility. If the urge to do good by patients does not suffice to encourage compliance and attention to detail, the fact that such policy papers are likely to form de facto standards used in litigation should help us all wake up and pay attention.
Pure arterial CABG using BIMA: the response

The Authors’ reply The question posed by Al-Attar et al 1 in response to our analysis of bilateral internal mammary artery (BIMA) use in the USA using the Nationwide Inpatient Sample2 cannot be answered by this or other national databases as, …
A scalable quasi-Bayesian framework for Gaussian graphical models

This paper deals with the Bayesian estimation of high dimensional Gaussian graphical models. We develop a quasi-Bayesian implementation of the neighborhood selection method of Meinshausen and Buhlmann (2006) for the estimation of Gaussian graphical models. The method produces a product-form quasi-posterior distribution that can be efficiently explored by parallel computing. We derive a non-asymptotic bound on the contraction rate of the quasi-posterior distribution. The result shows that the proposed quasi-posterior distribution contracts towards the true precision matrix at a rate given by the worst contraction rate of the linear regressions that are involved in the neighborhood selection. We develop a Markov Chain Monte Carlo algorithm for approximate computations, following an approach from Atchade (2015). We illustrate the methodology with a simulation study. The results show that the proposed method can fit Gaussian graphical models at a scale unmatched by other Bayesian methods for graphical models.
Repatriated Earnings: A Carrot, Stick, and Cabbage Approach

Political and economic forces are creating pressure to make it much more costly for businesses to defer federal income taxes on overseas profits and to provide cash in the United States by encouraging a repatriation of those profits. Accordingly, our approach combines:• a penalty for not repatriating funds (an interest charge, or stick) with• a basic reward for repatriating funds that meet an economic trigger (a dividends received deduction, or carrot) and• an enhanced reward for repatriating funds that meet an enhanced economic trigger (a dividends received deduction that is twice the rate of the basic reward, or cabbage).
FreedomCAR and Casting

Expanding world economic prosperity, probable peaking of conventional petroleum production in the coming decades and environmental concerns require efforts to increase the efficiency of, and the development of alternatives to, petroleum-based fuels used in automotive transportation. In January 2002, the U.S. Department of Energy (USDOE) and the U.S. Council for Automotive Research (USCAR) of the “Big Three” traditionally-USA-based automakers, DaimlerChrysler (now Chrysler), Ford and General Motors, formed the Freedom Cooperative Automotive Research (FreedomCAR) Partnership to fund high-risk, high-payoff research into advanced automotive technologies with the potential for eventually lowering the USA’s nearly complete (95%) dependence on petroleum, 55% imported, for its transportation fuels. FreedomCAR replaced the Partnership for a New Generation of Vehicles (PNGV) which existed from 1993 to 2001.
Creating a Culture of Possibility A Case for Engaged Pedagogy

How to teach young people about the grave ecological and social crises of our times without crushing their sense of possibility? The author has come to believe that the nature of these crises, together with a widespread weakening of civic and democratic culture, makes it irresponsible to teach young people about “the world as it is” without simultaneously giving them opportunities to develop capacities for collective agency. As increasing numbers of school districts cut civics courses out of the high school curriculum altogether, students bring to their college studies little formal schooling about social change, and almost no practical experience of what it might mean to participate in the cocreation of the world. In short, they come to the overwhelming crises we would teach them about with a very shaky faith that social change is possible. There is an acute need for colleges and universities to innovate engaged pedagogies, creating a culture that cultivates, as one student put it, “the knowledge of wher...
Association between chlamydia pneumoniae and serum c-reactive protein levels in ischemic cerebrovascular disease

Objective:This study was conducted to evaluate a possible role of infection with chlamydia pneumoniae for inflammation in acute ischemic cerebrovascular disease.Mehods:Specific antibodies to chlamydia pneumoniae(IgG and IgM)and c-reactive protein levels were measured in both ischemic cerebrovascular disease group(n=30)and the control group(n=30).Results:Serum c-reactive protein levels were higher in patiens with acute ischemic cerebrovascular disease than in controls(P0.01).Serum chlamydia pneumoniae IgG positive patients had an elevated c-reactive protein levels(0.57±0.56 mg/dl),relative to IgG negtive patients(0.42±0.21 mg/dl)(P0.05).Serum chlamydia pneumoniae IgM positive patients had an elevated c-reactive protein levels(0.67±0.73 mg/dl),compared with IgM negtive patients(0.47±0.35 mg/dl)(P0.05).Conclusion:Acute and chronic infection with chlamydia pneumoniae,which both play a role in inflammation of acute ischemic cerebrovascular disease,increase levels of serum c-reactive protein complicated with other stroke factors.
STUDY ON STRUCTURAL CONTROL OF ORE IN THE CONTACT-DEPRESSION BELT OF LAOKA GRANITIC BODY

The contact-depression belt of Laoka granitic body is the most important Sn-Cu-polymetal ore-host structural.Sn-Cu ore bodies in the belt are genetically related to the belt and controlled by combination of structure,lithology and magmatism.Morphology,occurrence and size of ore bodies are directly influenced by the morphology,occurrence and size of the belt.The depression,a favorite orehost structure,together with other ore-control factors led to formation of thick and rich ore bodies under influence of late Yanshanian magmatic vapor-fluid.
Multiple Infection of Wolbachia in Synergus Japonicus

The wsp gene fragment of Wolbachia in Synergus japonicus associated with the plant galls of Andricus mukaigawae and Andricus mairei in Changsha,Hunan province,was amplified by using polymerase chain reaction with Wolbachia wsp-specific primers.Phylogenetic relationship of wsp gene sequences of Wolbachia in S.japonicus and other gall wasps was constructed with neighbor-joining method.The study showed that the identity of wsp gene sequences in S.japonicus from A.mukaigawae and A.mairei was only 77%,and the two strains belong to different strains.Thus,the results demonstrated multiple infection of Wolbachia in S.japonicus.
Primary epithelioid sarcoma of the hand and forearm. A review of thirteen cases.

Of eighty-five primary soft-tissue and sixteen primary bone sarcomas involving the hand and forearm, thirteen were epithelioid sarcomas, making this lesion third in frequency after fibrosarcoma and rhabdomyosarcoma in the whole series and first in frequency in the hand. In all thirteen patients the initial diagnosis was misleading; and recurrence, metastasis, or both occurred in all but the one patient who had primary forearm amputation. Primary en bloc excision and midforearm amputation are recommended if the lesion recurs.
Producing and Detecting Polarization

John Tyndall (1820–1893) was born into a protestant family in Leighlinbridge in southern Ireland. During his career, he published dozens of scientific articles and several books; he was well-known for his pioneering work on the scattering of light by atmospheric particles such as air pollutants. But Tyndall was perhaps best known for his popular scientific lectures which drew large audiences both in England and abroad. As a member of a group of intellectuals called the “X-Club”—along with biologist T.H. Huxley and philosopher Herbert Spencer—he argued for a philosophy of strict scientific naturalism subsidized by generous public funding. He forcefully opposed the natural theology of leading scientists such as James Clerk Maxwell and even Isaac Newton. In his famous 1874 Belfast Address before the British Association for the Advancement of Science, he exalted the work of Charles Darwin and argued that science “shall wrest from theology, the entire domain of cosmological theory.” Tyndall travelled to the United States in the 1870’s where he delivered popular lectures to packed houses in Boston, Philadelphia, Baltimore, Washington and New York. The readings included in the following chapters are drawn from a published version of these lectures in which Tyndall “sought to raise the Wave-theory of Light to adequate clearness in the reader’s mind, and to show its power as an organizer of optical phenomena.” His first lecture covers geometrical optics and philosophical topics such as the “Sterility of the Middle Ages.” The second lecture covers wave optics and contains a critical review of Newton’s particle theory of light. The third lecture begins with a discussion of the relationship between the architecture of crystals and how their structure might influence the polarization of light passing through them. We start our reading of Tyndall at this point (§4) in his third lecture.
Bathymetric Structure-from-Motion: extracting shallow stream bathymetry from multi-view stereo photogrammetry

Stream bathymetry is a critical variable in a number of river science applications. In larger rivers, bathymetry can be measured with instruments such as sonar (single or multi-beam), bathymetric airborne LiDAR (light detection and ranging), or acoustic Doppler current profilers. However, in smaller streams with depths less than 2 m, bathymetry is one of the more difficult variables to map at high-resolution. Optical remote sensing techniques offer several potential solutions for collecting high-resolution bathymetry. In this research, I focus on direct photogrammetric measurements of bathymetry using multi-view stereo photogrammetry, specifically Structure-from-Motion (SfM). The main barrier to accurate bathymetric mapping with any photogrammetric technique is correcting for the refraction of light as it passes between the two different media (air and water), which causes water depths to appear shallower than they are. I propose and test an iterative approach that calculates a series of refraction correction equations for every point/camera combination in a SfM point cloud. This new method is meant to address shortcomings of other correction techniques and works within the current preferred method for SfM data collection, oblique and highly convergent photographs. The multi-camera refraction correction presented here produces bathymetric datasets with accuracies of ~0.02% of the flying height and precisions of ~0.1% of the flying height. This methodology, like many fluvial remote sensing methods, will only work under ideal conditions (e.g. clear water), but it provides an additional tool for collecting high-resolution bathymetric datasets for a variety of river, coastal, and estuary systems. Copyright © 2016 John Wiley & Sons, Ltd.
Biosensor-Enabled Directed Evolution to Improve Muconic Acid Production in Saccharomyces cerevisiae

Muconic acid is a valuable platform chemical with potential applications in the production of polymers such as nylon and polyethylene terephthalate (PET). The conjugate base, muconate, has been previously biosynthesized in the bacterial host Escherichia coli. Likewise, previous significant pathway engineering lead to the first reported instance of rationally engineered production of muconic acid in the yeast Saccharomyces cerevisiae. To further increase muconic acid production in this host, a combined adaptive laboratory evolution (ALE) strategy and rational metabolic engineering is employed. To this end, a biosensor module that responds to the endogenous aromatic amino acid (AAA) as a surrogate for pathway flux is adapted. Following two rounds of ALE coupled with an anti-metabolite feeding strategy, the strains with improved AAA pathway flux is isolated. Next, it is demonstrated that this increased flux can be redirected into the composite muconic acid pathway with a threefold increase in the total titer of the composite pathway compared to our previously engineered strain. Finally, a truncation of the penta-functional ARO1 protein is complemented and overexpress an endogenous aromatic decarboxylase to establish a final strain capable of producing 0.5 g L−1 muconic acid in shake flasks and 2.1 g L−1 in a fed-batch bioreactor with a yield of 12.9 mg muconic acid/g glucose at the rate of 9.0 mg h−1. This value represents the highest titer of muconic acid reported to date in S. cerevisiae, in addition to the highest reported titer of a shikimate pathway derivative in this host.
Cerebral Palsy Among Term and Postterm Births

The relation of risk of cerebral palsy (CP) with gestational age among term and postterm births was investigated by researchers at the University of Bergen, Norway, and the Epidemiology Branch, NIH, Durham, NC, using Norway’s national health and insurance registries.
Laboratory diagnosis of biotinidase deficiency, 2017 update: a technical standard and guideline of the American College of Medical Genetics and Genomics

Disclaimer: These ACMG Standards and Guidelines are intended as an educational resource for clinical laboratory geneticists to help them provide quality clinical laboratory genetic services. Adherence to these Standards and Guidelines is voluntary and does not necessarily assure a successful medical outcome. These Standards and Guidelines should not be considered inclusive of all proper procedures and tests or exclusive of others that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test, clinical laboratory geneticists should apply their professional judgment to the specific circumstances presented by the patient or specimen. Clinical laboratory scientists and geneticists are encouraged to document in the patient's record the rationale for the use of a particular procedure or test, whether or not it is in conformance with these Standards and Guidelines. They also are advised to take notice of the date any particular guideline was adopted, and to consider other relevant medical and scientific information that becomes available after that date. It also would be prudent to consider whether intellectual property interests may restrict the performance of certain tests and other procedures.Biotinidase deficiency is an autosomal recessively inherited disorder of biotin recycling that is associated with neurologic and cutaneous consequences if untreated. Fortunately, the clinical features of the disorder can be ameliorated or prevented by administering pharmacological doses of the vitamin biotin. Newborn screening and confirmatory diagnosis of biotinidase deficiency encompasses both enzymatic and molecular testing approaches. These guidelines were developed to define and standardize laboratory procedures for enzymatic biotinidase testing, to delineate situations for which follow-up molecular testing is warranted, and to characterize variables that can influence test performance and interpretation of results.
Parental Substance Use and Foster Care Reentry

Foster care involvement due to parental substance use is a common problem with many challenges associated with service delivery. Using administrative data from a Midwestern state between the years 2009 and 2015 (N = 17,420), this study examines characteristics of substance-abusing families at the time of entry into the foster care system and estimates the risk of reentry subsequent to reunification. Bivariate findings and survival analysis for reentry suggests substance-using parents are more likely to be involved in additional allegations associated with foster care involvement. These results highlight the need for improved services integration and coordinated delivery among service systems.
The Čḯxwicən Project of Northwest Washington State, U.S.A.: Opportunity Lost, Opportunity Found

Abstract Cḯxwicən (pronounced ch-WHEET-son) is a 2700 year-old ancestral village of the Lower Elwha Klallam Tribe (LEKT), located on the northwest coast of Washington State, U.S.A. The Cḯxwicən project has scientific values that broadly contribute to research in human ecodynamics and maritime foragers, given the scale of the project, excavation methods, and enormous quantities of faunal materials recovered. The village holds great significance to the LEKT as their traditional village, which includes a sacred burial ground. The project began under challenging circumstances, when the village was inadvertently encountered during a construction project, incurring huge political, social and financial costs. Commitment by the LEKT and Cḯxwicən scholars and other partners turned an “opportunity lost” into an “opportunity found.” This paper provides background to this remarkable site and project goals that guided the Cḯxwicən research project. The Special Issue papers showcase project results, including reflections by tribal members. Overall, the project shows the potential for archaeology and heritage to support reconciliation between tribes and archaeologists and broader society.
ARCTIC OCEAN NOISE GENERATION DUE TO PACK ICE KINEMATICS AND HEAT FLUXES

Noise, ice motion, and a heat flux model are used to study the generation of arctic ambient noise under pack ice. During the summer, observations indicate that most under-ice noise is generated by the ice rushing through the water. Differential ice motion appears to be insignificant in producing ambient noise. This situation changes by fall when the total deformation of the pack ice becomes important in producing lower frequency noise (10 and 32 Hz). Correlations indicate that differential motions of other forms (primarily ice convergence) become important only during winter. As for higher frequency noise (1000 Hz) during fall and winter, correlations with ice motion are low and ambiguous. The generation of higher frequency noise by the combination of ice motion and thermal microfracturing is the likely cause of the seemingly sporadic nature of this frequency band. Anomalous observations are presented which are investigated using a variety of environmental data sets. A model of thermal heat flux within a slab of ice is used to demonstrate the character of one set of observations. However, there are distinct deficiencies in that the model fails to reproduce the phase of the thermal microfracturing and certain periods during which microfracturing is absent.
Treatment Planning: Prediction Tracings and Model Surgery

Once a treatment plan has been reached based on the physical examination of the patient, prediction tracings are helpful in determining the final position of soft tissue pogonion in both the sagittal and vertical dimensions. Accordingly, they help dictate the aesthetic desirability of simultaneous jaw repositioning and osseous genioplasty. Situations in which this is most clinically applicable are those involving mandibular rotational changes in the sagittal plane with the point of rotation being the mandibular condyle and/or the ramus osteotomy. Regardless of the point of rotation, the aesthetic consequences of mandibular rotation are profound. With counterclockwise mandibular rotation, as is most frequently seen in anterior open-bite and/or long-face correction, soft tissue pogonion is displaced superiorly and anteriorly. Another way of conceptualizing this is that one loses vertical dimension in the lower face but gains sagittal projection at soft tissue pogonion. In addition, the mandibular plane is flattened, and as a result, the gonial angle visually appears to be less obtuse, although it is really unchanged. Lastly, the mandibular incisors are uprighted, although this is a very subtle effect. The aesthetic changes accompanying mandibular clockwise rotation, regardless of the point of rotation, are just the opposite.
Predictors of gastrointestinal bleeding in older persons taking nonsteroidal anti-inflammatory drugs: Results from the FDA adverse events reporting system

ABSTRACTBackground and purpose:Older adults continue to take nonsteroidal anti-inflammatory drugs (NSAIDs) to manage chronic pain. The study's purpose was to identify predictors of gastrointestinal (GI) bleeding in older adults taking NSAIDs.Methods:A secondary analysis of the 2016 Food and Drug Adm
Preoperative patient expectations of elective reverse shoulder arthroplasty.

Background The purpose of this study was to determine patients’ preoperative expectations before primary elective reverse shoulder arthroplasty (RSA). We hypothesized that younger patients, patients with better preoperative function, patients with shoulder osteoarthritis (OA), and patients with no prior joint replacements would have higher expectations of RSA. Methods We prospectively studied 333 primary RSAs performed for cuff tear arthropathy (n = 242), OA (n = 68), or post-traumatic arthritis (n = 23). Expectations were assessed preoperatively using the Hospital for Special Surgery’s shoulder surgery expectations survey. Preoperative patient-reported measures were assessed with the American Shoulder and Elbow Surgeons shoulder score; Shoulder Activity Scale score; Short Form 12 mental component and physical component scores; and visual analog scale scores for pain, fatigue, and general health. A Poisson regression model was performed to control for potential confounding variables. Results Relief of night-time pain, relief of daytime pain, improvement in self-care, improvement in the ability to drive or put on a seat belt, and improvement in the ability to perform daily activities were reported as “very important” by approximately half of patients. No association was found between age and overall expectations. Multivariate analysis showed that better preoperative Shoulder Activity Scale and Short Form 12 physical component scores were associated with greater expectations (P Conclusion Patients have the highest expectations for pain relief and the performance of simple tasks after RSA. Patients with higher preoperative function, OA, and no previous joint replacements have greater expectations of RSA.
Chronic Fatigue Syndrome & Other Difficulties: Introducing a Modern Scientific Controversy to a Biology Classroom

One of the most perplexing dilemmas in modern science is chronic fatigue syndrome (CFS). Even though the illness was recognized at the beginning of the 20th century, the pathogenicity and etiology of the disease remain unknown. We describe an open-inquiry case study on CFS that we have used in our biology classrooms to increase students' critical-thinking skills and understanding of scientific method. Three general categories of potential pathogens – virus, vaccine, and microbiome – are discussed during multiple classroom sessions. We found that our students were more proactive than expected. They researched credible references from the most recent publications and formulated arguments on the medical issue. They applied knowledge of human body systems to explain the complexity of the disease. Students were capable of distinguishing “correlation” and “cause” relations between the disease and pathogens. We observed a high level of student participation and involvement, which not only increased their knowledge of scientific approaches but also strengthened their interaction and communication skills. The case study is suitable for biology courses in both high school and college.
Cracking of Cr-coated accident-tolerant fuel during normal operation and under power-ramping conditions

Abstract In this paper, an analysis is presented for the cracking of Cr-coated Zircaloy claddings proposed for use in accident-tolerant fuels (ATF). Tensile hoop stresses are induced in the coating by pellet-cladding interaction (PCI), which results from the fuel swelling under normal operation, or from additional thermal expansion of the fuel after power ramping. The hoop stress is limited by the stress relaxation associated with dislocation glide that dominates the thermal creep in the coating. The energy-release rate for crack channeling has also been calculated, and it increases almost linearly with the thickness of the coating. By comparing this energy-release rate with the toughness of Cr, we can develop a design map for the maximum coating thickness required to avoid fracture at different levels of ramped power. We also propose a design protocol for coatings based on a simplified fracture analysis, which allows existing PCI codes to be leveraged.
Complications of Jejunostomy Feeding Tubes: A Single Center Experience of 546 Cases.

Adequate perioperative nutrition is critical for the success of surgical outcomes. Jejunostomy feeding tube placement may ensure enteral feeding access; however, these types of tubes have had variable reported rates of dysfunction/morbidity. The aim of our study was to report our experience with jejunostomy feeding tube placement and the long-term outcomes following complex foregut surgery. We performed a review of all of our jejunostomy feeding tube placement patients from 1/1/2010 until 7/1/2018. The indication for surgery and primary operation were recorded. All adverse events related to the jejunostomy were recorded during the entire duration of tube access. Social “hassle-factor” issues were also reported, including the number of “jejunostomy-related” phone calls, reinsertion and related placement studies, and readmissions pertaining to jejunostomy-associated complications. During the study period, 542 primary procedures were performed with secondary jejunostomy placement. Jejunostomy-related adverse events occurred in 22.0% of patients (n = 119/542); 12.0% (n = 65/542) were dislodged tubes, 6.0% (n = 30/542) clogged tubes; 5% (n = 25/542) leaking tubes, and 2.8% (n = 15/542) site infections. Tube dysfunctions initiated 244 reinsertion/placement studies in 107 patients, 20 jejunostomy tube-related readmissions, and 78 phone calls to providers for tube dysfunction. Adverse event rates differed significantly between groups (p < 0.001), with esophagogastric resection adverse event rates of 42.3% versus 19.2% for pancreatic ablations. Jejunostomy feeding tubes resulted in adverse events in less than a third of patients. Patient-related hassle must be communicated preoperatively in order to prevent jejunostomy tube-related morbidity. Optimal early and late jejunostomy feeding optimization varies based on preoperative patient comorbidities, type of operation, and the need for adjuvant oncology therapy.
Dynamic pulmonary CT perfusion using first-pass analysis technique with only two volume scans: Validation in a swine model

Author(s): Zhao, Yixiao; Hubbard, Logan; Malkasian, Shant; Abbona, Pablo; Molloi, Sabee | Abstract: PURPOSE:To evaluate the accuracy of a low-dose first-pass analysis (FPA) CT pulmonary perfusion technique in comparison to fluorescent microsphere measurement as the reference standard. METHOD:The first-pass analysis CT perfusion technique was validated in six swine (41.7 ± 10.2 kg) for a total of 39 successful perfusion measurements. Different perfusion conditions were generated in each animal using serial balloon occlusions in the pulmonary artery. For each occlusion, over 20 contrast-enhanced CT images were acquired within one breath (320 x 0.5mm collimation, 100kVp, 200mA or 400mA, 350ms gantry rotation time). All volume scans were used for maximum slope model (MSM) perfusion measurement, but only two volume scans were used for the FPA measurement. Both MSM and FPA perfusion measurements were then compared to the reference fluorescent microsphere measurements. RESULTS:The mean lung perfusion of MSM, FPA, and microsphere measurements were 6.21 ± 3.08 (p = 0.008), 6.59 ± 3.41 (p = 0.44) and 6.68 ± 3.89 ml/min/g, respectively. The MSM (PMSM) and FPA (PFPA) perfusion measurements were related to the corresponding reference microsphere measurement (PMIC) by PMSM = 0.51PMIC + 2.78 (r = 0.64) and PFPA = 0.79PMIC + 1.32 (r = 0.90). The root-mean-square-error for the MSM and FPA techniques were 3.09 and 1.72 ml/min/g, respectively. The root-mean-square-deviation for the MSM and FPA techniques were 2.38 and 1.50 ml/min/g, respectively. The CT dose index for MSM and FPA techniques were 138.7 and 8.4mGy, respectively. CONCLUSIONS:The first-pass analysis technique can accurately measure regional pulmonary perfusion and has the potential to reduce the radiation dose associated with dynamic CT perfusion for assessment of pulmonary disease.
Detecting changes in postural sway.

Abstract Postural sway has been identified as a valid marker for assessing the presence of a concussion and monitoring return to activity progression. Instrumented balance assessments have shown to be more reliable in detecting postural sway. However, many sports medicine programs cannot afford to purchase a force plate system to objectively assess postural sway and changes, which may occur due to a head injury. The purpose of this study was to determine if the C3Logix™ application can detect postural sway with the same degree of accuracy as the VSR Sport™ by NeuroCom®. Forty-five Division I Lacrosse players, consisting of 27 males and 18 females, participated in this study. Participants completed the Stability Evaluation Test (SET) on the VSR Sport™ while simultaneously completing the same balance assessment via the C3Logix™ application. The balance assessment consisted of three stances (double leg, single leg, tandem stance) on two surfaces (firm & foam) for a total of six trials. A Pearson correlation was used to determine the correlation between the postural sway velocity values from the VSR Sport™ and ellipse volume values from the C3Logix™ application. Each of the stances on both the firm and foam surface was found to have a strong correlation, suggesting the C3Logix™ application is a valid alternative to postural assessments on a force plate.
New and Increasing Rates of Adverse Events Can be Found in Unstructured Text in Electronic Health Records using the Shakespeare Method

ABSTRACT Background Text in electronic health records (EHRs) and big data tools offer the opportunity for surveillance of adverse events (patient harm associated with medical care) (AEs) in the unstructured notes. Writers may explicitly state an apparent association between treatment and adverse outcome (“attributed”) or state the simple treatment and outcome without an association (“unattributed”). We chose to study EHRs from 2006-2008 because of known heparin contamination during this timeframe. We hypothesized that the prevalence of adulterated heparin may have been widespread enough to manifest in EHRs through symptoms related to heparin adverse events, independent of clinicians’ documentation of attributed AEs. Objective Use the Shakespeare Method, a new unsupervised set of tools, to identify attributed and unattributed potential AEs using the unstructured text of EHRs. Methods We studied 21,287 adult critical care admissions divided into three time periods. Comparisons of period 3 (7/2007 to 6/2008) to period 2 (7/2006 to 6/2007) were used to find admissions notes to review for new or increased clinical events by generating Latent Dirichlet Allocation topics among words in period 3 that were distinct from period 2. These results were further explored with frequency analyses of periods 1 (7/2001 to 6/2006) through 3. Results Topics represented unattributed heparin AEs, other medical AEs, rare medical diagnoses, and other clinical events; all were verified with EHRs notes review and frequency analysis. The heparin AEs were not attributed in the notes, diagnosis codes, or procedure codes. Somewhat different from our hypothesis, heparin AEs increased in prevalence from 2001 through 2007, and decreased starting in 2008 (when heparin AEs were being published). Conclusions The Shakespeare Method could be a useful supplement to AE reporting and surveillance of structured EHRs data. Future improvements should include automation of the manual review process.
Policy Statement: Antibiotic Stewardship in Pediatrics

Antibiotic overuse contributes to antibiotic resistance, which is a threat to public health. Antibiotic stewardship is a practice dedicated to prescribing antibiotics only when necessary and, when antibiotics are considered necessary, promoting the use of the appropriate agent(s), dose, duration, and route of therapy to optimize clinical outcomes while minimizing the unintended consequences of antibiotic use. Because there are differences in common infectious conditions, drug-specific considerations, and the evidence surrounding treatment recommendations (eg, first-line therapy and duration of therapy) between children and adults, this statement provides specific guidance for the pediatric population. This policy statement discusses the rationale for inpatient and outpatient antibiotic stewardship programs (ASPs); essential personnel, infrastructure, and activities required; approaches to evaluating their effectiveness; and gaps in knowledge that require further investigation. Key guidance for both inpatient and outpatient ASPs are provided.
Female-specific synaptic dysfunction and cognitive impairment in a mouse model of PCDH19 disorder

Protocadherin-19 (PCDH19) mutations cause early-onset seizures and cognitive impairment. The PCDH19 gene is on the X-chromosome. Unlike most X-linked disorders, PCDH19 mutations affect heterozygous females (PCDH19HET♀ ) but not hemizygous males (PCDH19HEMI♂ ); however, the reason why remains to be elucidated. We demonstrate that PCDH19, a cell-adhesion molecule, is enriched at hippocampal mossy fiber synapses. Pcdh19HET♀ but not Pcdh19HEMI♂ mice show impaired mossy fiber synaptic structure and physiology. Consistently, Pcdh19HET♀ but not Pcdh19HEMI♂ mice exhibit reduced pattern completion and separation abilities, which require mossy fiber synaptic function. Furthermore, PCDH19 appears to interact with N-cadherin at mossy fiber synapses. In Pcdh19HET♀ conditions, mismatch between PCDH19 and N-cadherin diminishes N-cadherin-dependent signaling and impairs mossy fiber synapse development; N-cadherin overexpression rescues Pcdh19HET♀ phenotypes. These results reveal previously unknown molecular and cellular mechanisms underlying the female-specific PCDH19 disorder phenotype.
Nicotine Enhances Goal-Tracking in Ethanol and Food Pavlovian Conditioned Approach Paradigms.

Rationale Nicotine promotes alcohol intake through pharmacological and behavioral interactions. As an example of the latter, nicotine can facilitate approach toward food- and alcohol-associated stimuli ("sign-tracking") in lever-Pavlovian conditioned approach (PavCA) paradigms. However, we recently reported that nicotine can also enhance approach toward locations of reward delivery ("goal-tracking") triggered by ethanol-predictive stimuli when the location of ethanol delivery is non-static (i.e., a retractable sipper bottle). Objective To determine whether the non-static nature of the reward location could have biased the development of goal-tracking in our previous study (Loney et al., 2019); we assessed the effect of nicotine in a lever-PavCA paradigm wherein the location of ethanol delivery was static (i.e., a stationary liquid receptacle). Then, to determine whether nicotine's enhancement of goal-tracking is unique to ethanol-predictive stimuli, we assessed the effect of systemic nicotine on approach triggered by food-predictive stimuli in a lever-PavCA paradigm. Methods Long-Evans rats were used in two PavCA experiments wherein a lever predicted the receipt of ethanol (15% vol/vol; experiment 1) or food (experiment 2) into a stationary receptacle. Prior to testing, rats were administered nicotine (0.4 mg/kg subcutaneously) or saline systemically. Results In both experiments, nicotine increased measures of goal-tracking, but not sign-tracking. Conclusion Nicotine can facilitate approach to reward locations without facilitating approach to reward-predictive stimuli. As such, conceptualization of the mechanisms by which nicotine affects behavior must be expanded to explain an enhancement of goal-tracking by nicotine.
A Predictive Model for Parkinson’s Disease Reveals Candidate Gene Sets for Progression Subtype

Parkinson’s Disease (PD) is the second most common neurodegenerative disease in the United States, and is characterized by the progressive decline of motor and non-motor symptoms. The progression rate and manifestation of PD is highly heterogenous, and the underlying etiology for this heterogeneity remains elusive. Although some studies have identified risk genes associated with the development of PD, it is unknown whether the patient genome influences the progression pattern of PD in any way. In this study, we used the whole-exome sequencing data of PD patients from the Parkinson’s Disease Progression Marker Initiative (PPMI) to examine whether an individual’s genetic profile is associated with their progression pattern of PD. We used the three distinct progression subtypes defined by Zhang et al. as the outcome variable, and trained logistic regression and support vector classifiers. Our best performing model achieved an area under the receiver operating characteristic curve of 0.69 on the test set, indicating that the genetic profile of a PD patient appears to have some relationship with their likely disease course. We then interpreted our trained model by performing Gene Set Enrichment Analysis on the sets of genes with high model coefficients for each progression subtype. The results showed enrichment for genes related to olfactory signaling in Subtype I and III, and an enrichment for genes related to protein glycosylation and glycation for Subtype I and II. Overall, our findings suggests a connection between an individual’s genetic profile and PD progression subtype, and calls for controlled research studies to further examine the relationship between the implicated gene sets and each progression subtype.
A 16mm 2 106.1 GOPS/W Heterogeneous RISC-V Multi-Core Multi-Accelerator SoC in Low-Power 22nm FinFET

This work presents a 16mm2 heterogeneous RISC-V system-on-a-chip (SoC) composed of a high-performance out-of-order core, energy-efficient in-order core, data-parallel vector accelerator, and systolic array deep neural network (DNN) accelerator in low-power Intel 22FFL for general-purpose compute, DNN, and vector workloads. The heterogeneous RISC-V SoC is composed of fully open-source components, including a second-generation Berkeley Out-of-Order Machine (BOOM) with a non-speculative mode attached to a Hwacha vector accelerator, a Rocket in-order core attached to a Gemmini systolic array DNN accelerator, as well as a IMiB L2 cache and off-chip I/Os. Combined, the variety of heterogeneous compute allows for wide programmability while providing up to a 286x MOPS/W improvement or 282x MOPS improvement over the RISC-V in-order core.