cssi/SciSciGPT-SciSciNet huggingface dataset:
The BRIDGE trial: What the hospitalist should know

Atrial fibrillation patients often require warfarin interruption for an invasive procedure or surgery. Heparin bridging therapy has been frequently used during warfarin interruption under the premise of providing a theoretical mitigation against thromboembolism that overweighs expected higher rates of bleeding. Up until recently, little definite clinical evidence was available to guide the hospitalist on optimal perioperative anticoagulant management. The landmark BRIDGE (Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation) trial provided high-quality evidence that a simple interruption of warfarin in the average atrial fibrillation patient undergoing an elective procedure or surgery is noninferior to bridging therapy for efficacy and superior to bridging therapy in preventing major bleeding. To guide the hospitalist, we propose a treatment algorithm based on these recent data. We review the literature that led to the trial and highlight its practice-changing implications as a proof of concept that calls to question the premise of heparin bridging therapy beyond the atrial fibrillation population. Journal of Hospital Medicine 2016;11:652-657. © 2016 Society of Hospital Medicine.
Treatment Considerations and the Role of the Clinical Pharmacist Throughout Transitions of Care for Patients With Acute Heart Failure

Heart failure is associated with increased risk of morbidity and mortality, resulting in substantial health-care costs. Clinical pharmacists have an opportunity to reduce health-care costs and improve disease management as patients transition from inpatient to outpatient care by leading interventions to develop patient care plans, educate patients and clinicians, prevent adverse drug reactions, reconcile medications, monitor drug levels, and improve medication access and adherence. Through these methods, clinical pharmacists are able to reduce rates of hospitalization, readmission, and mortality. In addition, care by clinical pharmacists can improve dosing levels and adherence to guideline-directed therapies. A greater benefit in patient management occurs when clinical pharmacists collaborate with other members of the health-care team, emphasizing the importance of heart failure treatment by a multidisciplinary health-care team. Education is a key area in which clinical pharmacists can improve care of patients with heart failure and should not be limited to patients. Clinical pharmacists should provide education to all members of the health-care team and introduce them to new therapies that may further improve the management of heart failure. The objective of this review is to detail the numerous opportunities that clinical pharmacists have to improve the management of heart failure and reduce health-care costs as part of a multidisciplinary health-care team.
Opioids: Similarity between evaluations of subjective effects and animal self-administration results

Abuse potential studies of 33 morphine-like analgesics were compared in humans and monkeys. The results of intravenous self-administration studies in rhesus monkeys were correlated with measures of morphine-like signs, symptoms, and subjective effects in ex-addicts. Each set of data was assigned to a position in a 3 x 3 contingency table dependent upon whether the results were yes, no, or equivocal. Of the 33 drugs, 29 were given identical classifications in both the human and animal test procedures. This good concordance between the human and animal results further validates each procedure and suggests the possibility that both the human and animal procedures are measuring a common underlying pharmacological property which relates to abuse potential of drugs.
External fixation for the treatment of kienböck's disease

SUMMARY With the advent of magnetic resonance imaging, the diagnosis of avascular necrosis of carpal bones can be made early, well before collapse and derangement of carpal mechanics occur. We believe that neutralization of forces early in the course of disease may permit natural healing (revascularization) of the bone. It is questionable whether tubular casts can supply adequate neutralization of force. We recommend the consideration of external fixation, rather than more extensive surgery, as a rational alternative for this purpose. After surgical revascularization, carpal bones go through a resorptive phase that makes them highly susceptible to collapse from compressive forces across the wrist. We advocate the postoperative use of an external fixator to neutralize these forces after a revascularization procedure is performed.
Real time and in situ observation of graphene growth on liquid metal surfaces via a carbon segregation method using high-temperature confocal laser scanning microscopy

Fabrication processes of single-layer and multilayer graphene (SLG and MLG, respectively) that are simple yet controllable are actively sought-after to realize many graphene-based applications. We report the fabrication, growth kinetics, and characterization of graphene formed on liquid metal surfaces through a segregation method that was determined by combining real time and in situ imaging using a high-temperature confocal laser scanning microscope (CLSM) with high-resolution scanning electron microscopy imaging and Raman spectroscopy. Carbon was first dissolved in liquid copper (silver) at 1300 °C (1200 °C) and then precipitated out as graphene on a liquid copper (silver) surface at 1130 °C or 1090 °C (1000 °C). SLG with a smooth texture formed and almost fully covered the liquid copper surface within seconds but partially covered the liquid silver surface. In contrast to graphene formed on liquid silver, which maintained a smooth texture after solidification of liquid silver and did not possess any MLG, the graphene that formed on liquid copper comprised of SLG and MLG, and developed ripples and wrinkles upon solidification. Real time and in situ observations with a high-temperature CLSM revealed that small MLG precipitates formed between the liquid copper surface and SLG, and were attached underneath the SLG. Interestingly, the precipitates grew into large hexagonal islands instead of coalescing together. Furthermore, occasionally two MLG islands joined into a larger MLG island with individual MLG islands maintaining its hexagonal shape and slowly drifted as a unit on the liquid copper surface, confirming that the MLG islands formed after SLG formation and were attached to the SLG layer. Lastly, the number densities, areal sizes, and thicknesses of these MLG islands strongly depended on graphene formation temperatures and carbon dissolution times. For example, lowering the graphene formation temperature from 1130 °C to 1090 °C with the same graphene formation time as well as the carbon dissolution time and temperature resulted in a greater number of thinner and laterally smaller MLG islands. On the other hand, increasing the carbon dissolution time while keeping the carbon dissolution temperature along with the graphene formation time and temperature the same led to fewer and thicker MLG islands with larger lateral sizes. The real time and in situ observations provide direct insights on graphene formation and growth kinetics, which will allow precise control of graphene quality formed on liquid metal surfaces.
A survey on robotic wheelchairs mounted with robotic arms

In this paper, we investigate robotic wheelchairs mounted with robotic arms. Several projects have been studied and analyzed. The abilities of these wheelchairs vary from simple orders as door opening to more complex as lifting objects from the ground. With the aging of the society, the demand for human-interactive robotic wheelchairs that can help people with disabilities and the elderly is increasing. That also means that the need for solving the problems of these people is increasing. That leads to more researchers and industry teams to try solving some of the problems and optimizing the existing wheelchairs. The goal of this survey is not to criticize, but to serve as a reference for researchers and developers in this scientific area and to move the research on robotic wheelchairs further, by merging independent efforts.
Permanent Pacemakers in Patients With Dilated Cardiomyopathy

Congestive heart failure (CHF) secondary to dilated cardiomyopathy, either ischemic or nonischemic in origin, is one of the most rapidly growing problems in clinical cardiology. It is estimated that more than 4 million people in the US suffer from CHF with about 400,00 new cases annually. CHF is particularly prevalent in the geriatric population and is the leading cause of hospitalization in patients $65 years old. It is noteworthy that this is the same age group that is most likely to need permanent pacemakers. CHF is generally considered a disease of impaired myocardial contractility which may be complicated by valvular insuf~ciency (i.e., mitral regurgitation) and neurohormonal disturbances (i.e., renin-angiotensin activation). In addition, cardiac conduction abnormalities, frequently left bundle branch block and ~rst degree atrioventricular (AV) block, occur frequently in patients with CHF. The contributory role of these conduction abnormalities to the hemodynamic derangements associated with CHF and the potential symptomatic improvement offered by permanent pacing have been the subject of intense research over the past decade.
Fampridine: Long-term benefits in walking in multiple sclerosis

Multiple sclerosis (MS) is a chronic demyelinating disease that affects the brain and spinal cord, causing a disturbance of nerve conduction that impairs function. In a survey conducted in 2008,1 individuals with MS rated walking as their most important function. Rehabilitation interventions are successful in increasing strength and balance in people with MS, resulting in improved walking. Pharmacologic agents are available that can improve walking for many people with MS (PwMS). Dalfampridine is a broad-spectrum potassium channel blocker that enhances action potential conduction across demyelinated axons. The benefits of dalfampridine have been demonstrated in 2 clinical trials, showing improved walking in PwMS, as demonstrated by improved walking speed.2,3 The long-term efficacy of dalfampridine had not been investigated.
The Opportunity Cost Basis of the Substitution Method in Farm Management

The subject of farm production costs has had much discussion in recent years. Several different views and types of emphasis have been evidenced in the research and teaching done by various individuals. There seems to have been relatively little attempt to point out the specific relationships of the various cost concepts or to separate their elements of harmony from those aspects in which there appeared to be definite conflict in interpretation. Much of the work thus far undertaken along these lines has been characterized by a lack of realism, by a confusion of ethical and economic considerations, and by a somewhat undiscriminating adoption of methods better suited to other conditions or other purposes. Frequently a more or less unconscious assumption has been made that a definite relationship between costs and supply produced could be demonstrated. Yet the cost accounting procedure used has usually introduced many elements which definitely divorced the costs developed and the observed supply responses. Cost accounting technique, as developed largely for commercial and industrial enterprises, with its use of arbitrary appraisal of values and imputation of costs, has very definite usefulness in certain fields and for certain purposes. Often it indicates what might be considered an ethically proper division of income, a basis for condemnation, for rate-making, etc. Costs as thus computed have, however, little relation either to supply or price in a competitive economy, and may be a very poor guide in an attempt to rationalize the farm business either individually or nationally. In addition to the need for a clearer treatment of competitive relationships between farm enterprises as a means of improving farm management analysis, there is a pronounced need for a more precise treatment of the nature of marginal production in agriculture if we are to have thoroughly realistic discussions of the behavior of agricultural prices and of the fundamentals of agricultural policy and land utilization. Such realistic treatment of cost problems must, as Schultz has pointed out,
Principles of Federalism and Convictions for Immigration Purposes

In this article, I argue that while Congress possesses broad plenary authority to pass legislation concerning immigration, recent U.S. Supreme Court precedent — most notably the Court’s 2013 decision in United States v. Windsor — signals a rare moment when the judiciary may be receptive to a constitutional challenge to the Immigration and Nationality Act's federal conviction definition.
Mass Tort Class Actions - Past, Present, and Future

The judicial experiment with mass tort class actions was an anemic one, albeit somewhat spectacular in a few cases that have captured the academic and professional imagination. This Essay explains that the reason mass tort class actions never thrived is that there is a disconnect between tort doctrine on the one hand, and tort theories and procedures on the other. Tort doctrine has largely failed to accommodate social scientific developments in fields such as epidemiology. Tort theories such as risk-spreading and deterrence, as well as the procedural law, especially common-law like informal procedural ordering, have taken social scientific developments into account. For this reason, collective procedures are able to dominate mass tort resolution despite the doctrine's limitations. The future of the mass tort class action depends on tort doctrine’s ability to take risk, probability, and the possibilities of statistical proof into account.
Morphological Encoding and the Association Conventions

This chapter will deal with certain issues that involve the interaction of morphology and phonology. Tone is of particular interest in this regard because of the degree of independence it enjoys in phonological representations: tone can constitute an entire morpheme, the tone of one morpheme can be associated with a segment in another morpheme, etc. But in spite of this independence, tonal associations are by and large predictable in many languages. In characterizing this predictability, there are two basic considerations to be taken into account: (1) the morphological structure of the string, (2) the phonological conventions for linking tones to segments. These considerations are the topic of this chapter.
Segmented pathways of illegality: Reconciling the coexistence of master and auxiliary statuses in the experiences of 1.5-generation undocumented young adults

In response to a changing immigration enforcement landscape, a growing number of studies have sought to understand the impact of immigration policy and practice on a new and growing population. Rec...
Factors Associated With Gaps in Medicaid Enrollment Among People With HIV and the Effect of Gaps on Viral Suppression

Introduction:Gaps in Medicaid enrollment may affect HIV outcomes. We evaluated factors associated with Medicaid enrollment gaps and their effect on viral suppression (VS) within the HIV Research Network.Methods:We used a combined data set with Medicaid enrollment files from 2006 to 2010 and HIV Rese
Reflections on the Evolution of Human Sex Differences: Social Selection and the Evolution of Competition Among Women

Darwin’s (1871) sexual selection, in particular male–male competition over mates and female choice of mating partners, has successfully guided research on sex differences across hundreds of species, including our own. One consequence of the success of sexual selection has been a relative indifference to other pressures that can result in the evolution of sex differences. In recent years, female–female competition over resources other than mates has captured the attention of evolutionary biologists. We illustrate how this form of competition, termed social selection, has operated to create sex differences in several nonhuman species and then apply it to female–female competition in humans. We propose that a combination arranged marriages, which will lessen direct competition for marriage partners, and polygyny created a unique social context within which female–female competition evolved, specifically competition among co-wives for access to resources controlled by their husband and competitive promotion of their children’s future reproductive prospects vis-a-vis the prospects of the children of co-wives. Competition among co-wives is more subtle—termed relational aggression—than that among men and involves the subtle manipulation of social relationships and psychological harassment of co-wives and their children. We review evidence related to the psychological and reproductive costs of conflicts with co-wives and argue that this competition contributed to girls’ and women’s advantages over boys and men for cognitive competencies, such as sensitivity to facial expressions, that support relational aggression.
Elastomeric Polymers for Shockwave Mitigation and Extreme Loading Conditions

Recent investigations into blast resistant properties of polymers with high rate sensitivity, have shown that they interact with the underlying substrates in quite different manner than any ballistic material known to the shock community. We are going to discuss in this paper that these polymers have a profound effect on the failure (fracture) mechanism of the substrate: suppression or delay of shear localization (or penetration) mechanisms, and delay of necking instability in ductile metals, in addition to dissipating large amounts of energy through wave reflections. The intrinsic property of the polymer under blast/ballistic/ shock, in addition to its high strain rate sensitivity, is a very large increase of its shear properties, both modulus and strength, under very high pressure and loading rate, which exists under extreme loading conditions. In addition, because these elastomeric polymers are multi-phase of hard and soft domains, at the nano scale, they can dissipate broad bands of frequencies such as those encountered in blast events. We will discuss also research in the development of polymers-by-design to divert and dissipate shockwaves from the head and thus prevent Traumatic Brain Injury—TBI, using molecular dynamics, polymer synthesis and high strain rate testing of shock properties for constitutive models, and the continuum analysis of shockwave propagation.
Plasma shifts of the He II H alpha and P alpha lines.

Shift measurements for the H/sub ..alpha../ (1640 A) and P/sub ..alpha../ (4686 A) hydrogenic ion lines of He II have been done over an electron density range 2 x 10/sup 22/ to 2 x 10/sup 23/ m/sup -3/ and for an electron temperature of 4 eV. The plasma was produced in a linear Z discharge. Systematic red shifts linear in density are observed. The experimental data are compared with combined theoretical estimates for electron-impact and ion quadrupole effects. The experimental results are in agreement with our earlier results for P/sub ..alpha../. .AE
Lipoprotein metabolism--new insights from cell biology.

The primary purpose of this paper is to review some of the recent developments in our understanding of how lipoproteins are metabolized by peripheral cells. Studies utilizing cultured mammalian cells promise to enhance considerably our insights into factors regulating steady-state levels of lipoproteins in the plasma compartment and, at least potentially, our insights into the cellular basis for atherogenesis. Quite possibly we may see the development of new modalities of pharmacologic intervention based on a better understanding of how lipoproteins are degraded by or modified by interactions with peripheral cells. Research in this area is still at an early stage of development but progress is being made rapidly. Those of us interested in the role of lipids in atherogenesis and in the possibilities for preventive intervention should be aware of the opportunities to capitalize on the new findings as they come along. Before turning to the cellular level, however, we should establish the context by briefly reviewing current concepts of lipoprotein metabolism in vivo.
Does oncologist productivity impact goals of care discussions

e21675Background: Oncologists are pressed to care for higher volumes of advanced cancer patients. Interviews with oncologists revealed their concern that goals of care (GoC) discussions take time. ...
Deep brain stimulation of the subthalamic nucleus in Parkinson's disease patients over 75 years of age.

Abstract Introduction Deep brain stimulation (DBS) is an effective therapy for Parkinson's disease (PD). However, its effect in older patients is not extensively studied, as they are often excluded from DBS surgery due to concerns of complications or reduced benefit. We assessed clinical outcomes after subthalamic nucleus (STN) DBS in older patients (age > 75 years) with PD. Methods All PD patients above 75 years who underwent STN-DBS between 1999 and 2015 were included. Unified Parkinson's Disease Rating Scale (UPDRS) scores and Parkinson's Disease Questionnaire (PDQ-39) scores were assessed up to 4 years after surgery. Other measures included were complications/adverse events, levodopa equivalent dose, and cognitive function. Results A total of 30 patients underwent 52 lead placements. Mean age at surgery was 77.5 years (range 75.0–84.5 years). Post-DBS, motor scores improved by 30.8% after 1-year and 27.3% after a mean of 2.5 years (p Conclusions STN-DBS improves motor outcomes in patients over 75 years of age; however, there was no change in quality of life. Although post-surgical transient confusion was common, there were no serious adverse events and the incidence of other complications was typical for DBS surgery.
Defining Learning Communities in Undergraduate Medical Education: A National Study.

Background:Learning communities (LCs) are intentionally designed groups that are actively engaged in learning with and from each other. While gaining prominence in US medical schools, LCs show sign...
THE MECHANISM OF DEGRADATION OF ENDOGENOUS HEME AND CYTOCHROME P-450 BY HEME OXYGENASE

ABSTRACT 1. Endogenous heme is metabolized both in vivo and in vitro by the microsomal heme oxygenase (MHO) system. Endogenous heme includes both the heme already incorporated into microsomal cytochromes as well as the “free heme” i.e., the heme not committed as a prosthetic group of cytochromes or enzymes. 2. The conversion of cytochrome P450 to P420 is a pre-requisite for the metabolism of its heme prosthetic group by the MHO. 3. It is suggested that metals may increase the rate of microsomal P450 degradation not only by inducing MHO but also by increasing the rate of conversion of cyt P450 to P420. The latter is accomplished by a) increasing the cellular content of a native “denaturant” of cyt P450; b) modifying the affinity of apo-P450 for heme; c) metal direct denaturing of the cytochrome.
The power of positive stress - a complementary commentary.

In this issue, David Jessop presents a commentary entitled The Power of Positive Stress and a Research Roadmap. I appreciate our Editor in Chief, James Herman’s invitation to provide a “commentary ...
Facile fabrication of polydopamine nanotubes for combined chemo-photothermal therapy.

We report a novel synthesis scheme to produce polydopamine (PDA) nanotubes using halloysite clay nanotubes (HNT) as a sacrificial template. Polydopamine nanotubes were fabricated via the formation of a polydopamine coating on HNT from a dopamine solution followed by template removal. Michael Addition was used to decorate the outer surface with polyethylene glycol. Removal of the template material resulted in a bilayered organic nanotube consisting of an inner layer of polydopamine adjacent to the lumen and an outer polyethylene glycol surface. The tubes had an aspect ratio of 5.3 ± 0.6, a diameter on the order of 70 nm, and wall thicknesses on the order of 15 nm. The PDA nanotubes exhibited photothermal conversion upon irradiation at near infrared wavelengths; a temperature increase of 30 °C was observed when a 250 μg ml−1 sample was subjected to 1 W cm−2 density irradiation at 808 nm wavelength. Analysis indicated that the prepared tubes had slightly higher photothermal conversion efficiency than PDA nanospheres. An antitumor drug, doxorubicin, was used as a model to test the potential for drug delivery of the organic nanotubes. The nanotubes exhibited higher loading capacities than PDA nanospheres and were capable of controlled release at pHs relevant to human serum and tumors (pH 7.4 and 5.0 respectively). Drug release rates varied as a function of system pH and application of near infrared irradiation. Release of doxorubicin was enhanced at a pH of 5.0, and retarded at a pH of 7.4. Irradiation with 808 nm wavelength light also increased the release of doxorubicin.
Photoinduced Surface Charging in Iron-Carbonyl-Functionalized Colloidal Semiconductor Nanocrystals.

Organometallic surface functionalization of colloidal CdSe and CdS nanocrystals using iron tetracarbonyl moieties is demonstrated to enable study of in situ colloidal nanocrystal surface redox chemistry. Spectroscopic measurements of the surface-bound metal carbonyl C–O stretches were used to elucidate the coordination environments and local symmetry of surface sites. The C–O stretching frequencies of these fragments were correlated to the electric field induced by nanocrystal surface charges and shift in energy upon surface reduction or oxidation. These measurements revealed that CdSe nanocrystals can accumulate multiple surface electrons under supra-band gap photoexcitation, a process likely relevant to photoactivated nanocrystal processes such as photobrightening. These surface charges are stable for hours and decay extremely slowly under anaerobic conditions.
Insulin receptor preserves mitochondrial function by binding VDAC1 in insulin insensitive mucosal epithelial cells

Unlike many epithelial tissues, the corneal epithelium is insulin insensitive, meaning it does not require insulin for glucose uptake. In this study, we show that insulin differentially regulates mitochondrial respiration in two human mucosal epithelial cell types: insulin-insensitive corneal epithelial cells and insulin-sensitive bronchial epithelial cells. In both cell types, insulin blocks glycogen synthase kinase beta (GSK3β) activity. In the corneal epithelium however, insulin selectively regulates PTEN-induced kinase 1 (PINK-1)-mediated mitophagy and mitochondrial accumulation of insulin receptor (INSR). While insulin blocked basal levels of PINK-1-mediated mitophagy in bronchial epithelial cells, mitochondrial trafficking of INSR was not detectable. We further show that in corneal epithelia, INSR interacts with the voltage-dependent anion channel-1 (VDAC1) in mitochondria and that INSR knockdown triggers robust mitochondrial fragmentation, alterations in mitochondrial polarization, and blocks the induction of PINK-1-mediated mitophagy. Collectively, these data demonstrate that INSR interacts with VDAC1 to mediate mitochondrial stability. We also demonstrate unique interactions between VDAC1 and other receptor tyrosine kinases, indicating a novel role for this family of receptors in mitochondria.
Impact of a Related Donor Pre-Screening Questionnaire on Donor Deferrals

Background Match related donors (MRDs) have long been a critical source of stem cells for patients needing an allogeneic transplant. In both our center and across the country, approximately 30% of patients needing an allogeneic transplant will have a matched family member who can serve as their donor. In our center these donors are, on average, over a decade older (median age = 40) than unrelated donors (median age = 27) at the time of donation. Additionally, 21% of our potential donors live outside the northeastern (New England and New York) region, and thus make significant travel time investments to come to our center. This makes it critical that any disqualifying medical issues be caught as early in the process as possible, preferably prior to the donor coming on site. Methods A donor pre-screen questionnaire was designed to be administered to potential donors by phone prior to typing. A pilot program was implemented with a subset of patients in December 2016 and expanded to all patients in June of 2017. If any potentially disqualifying conditions or other concerning information was noted on the donor pre-screen, it was given to a member of the Donor Services clinical team for review and follow-up. Donors not meeting medical suitability criteria were deferred either prior to typing or after a physical exam (PE). Results In the first two years after full implementation, 1073 potential related donors were referred to the Donor Services group. All but 40 (3.7%) of these were able to be pre-screened. Those who were not pre-screened were primarily international potential donors or non-responsive to phone contact. Of the remaining 1033 donors, 441 (42.6%) had prescreens requiring clinical review. After this review, 112 donors (11%) were deferred prior to typing. An additional 30 (3%) were preemptively disqualified from donating one product type (either PBSC or marrow) at time of pre-screen, and 15 (1.5%) were noted to have issues that may defer them if they were selected. The most common reasons for deferral were multiple complex medical issues (25%), severe cardiac issues and/or treatment with blood thinners (23%), and recent cancer history (13%). The rate of deferral after PE dropped from 11% to 5% (p Conclusion The donor pre-screening process has been beneficial for our center. Fewer HLA kits were sent out to donors not meeting medical criteria for clearance, and more donors were deferred prior to coming on site. Additionally, donor PE visits were streamlined as medical record requests and additional testing could be ordered prior to the visit allowing us to see greater donor volume (18% increase) without expanding resources. Finally, important information about the donor was able to be communicated to the recipient team prior to donor selection, helping them optimize donor selection.
Is the HERV-K HML-2 Xq21.33, an endogenous retrovirus mutated by gene conversion of chromosome X in a subset of African populations, associated with human breast cancer?

The human endogenous retroviruses HERV-K HML-2 have been considered a possible cause of human breast cancer (BrC). A HERV-K HML-2 fully intact provirus Xq21.33 was recently identified in some West African people. We used PCR technology to search for the Xq21.33 provirus in DNA from Nigerian women with BrC and controls. to see if Xq21.33 plays any role in predisposing to BrC. This provirus was detected in 27 of 216 (12.5%) women with BrC and in 22 of 219 (10.0%) controls. These results were not statistically significant. The prevalence of provirus in premenopausal control women 44 years or younger [18/157 (11.46%)} vs women with BrC [12/117 (10.26%)] showed no statistical difference. The prevalence of virus in postmenopausal control women > 45 yrs. was 7.4% (4/54) vs 15.31% (15/98) in postmenopausal women with BrC. These changes were not statistically significant at <.05, but the actual p value of <.0.079, suggests that Xq21.33 might play some role in predisposing to BrC in postmenopausal women. Provirus was present in Ghanaian women (6/87), in 1/6 Pygmy populations and in African American men (4/45) and women (6/68), but not in any Caucasian women (0/109). Two BrC cell lines (HCC 70 and DT22) from African American women had Xq21.33. Env regions of the virus which differed by 2–3 SNPs did not alter the protein sequence of the virus. SNP at 5730 and 8529 were seen in all persons with provirus, while 54% had an additional SNP at 7596.Two Nigerian women and 2 Ghanaian women had additional unusual SNPs. Homozygosity was seen in (5/27) BrC and (2/22) control women. The genetic variation and homozygosity patterns suggested that there was gene conversion of this X chromosome associated virus. The suggestive finding in this preliminary data of possible increased prevalence of Xq21.33 provirus in post-menopausal Nigerian women with BrC should be clarified by a more statistically powered study sample to see if postmenopausal African and/or African American women carriers of Xq21.33 might show increased risk of BrC. The implication of finding such a link would be the development of antiretroviral drugs that might aid in preventing BrC in Xq21.33+ women.
Updates in hereditary breast cancer genetic testing and practical high risk breast management in gene carriers

Testing for hereditary predisposition to breast cancer is rapidly expanding in parallel with the emerging field of molecular genetics given the associated implications for screening, risk reduction and cancer therapeutics for identified gene mutation carriers. With the advent of next generation multigene panel testing for hereditary predisposition and decreasing cost for that testing, more breast cancer patients (and unaffected family members) are undergoing cancer genetic testing. With multiple genes being tested and the myriad of possible results and implications for patients and their families, the process of genetic counseling is of paramount importance in promoting understanding by both patients and providers of risks and options for risk management. Guidelines exist to facilitate a multidisciplinary approach to management of individuals identified as being at increased risk, and there must be an appreciation for flexibility as guidelines are applied to individual families. This update summarizes recommendations regarding who may benefit from breast cancer risk assessment and genetic counseling, controversies regarding inclusion for testing and provides a framework for the practical management of high risk gene carriers.
Percutaneous Coronary Interventions in the Elderly

A new paradigm was recently proposed for the care of elderly patients with cardiovascular disease encompassing a patient-centered approach to care, screening for coexisting geriatric syndromes and comorbidities, purposeful management of pharmacologic regimen, and emphasis on the importance of transitions of care. More research is required on identifying the optimal timing and techniques for PCI in the elderly as well as for adjunctive pharmacologic therapy. This should include increased participation of elderly patients in ongoing and future PCI-related research studies and in studies examining hybrid surgical and percutaneous revascularization techniques. PCI in elderly patients carries higher risk, but can also provide significant benefits. In-depth communication with the patients about the goals, risks, benefits, and alternatives of PCI and careful attention to the procedural technique and to the selection of adjunctive medical therapy are key for optimizing the PCI outcomes in this large and expanding group of patients.
Dorsal offset rhinoplasty for treatment of stenotic nares in 34 brachycephalic dogs.

Objective To describe the technique, outcome, and owner satisfaction associated with dorsal offset rhinoplasty (DOR) to treat stenotic nares in brachycephalic dogs. Study design Retrospective case series. Animals Thirty-four client-owned dogs. Methods Medical records of dogs treated with DOR at a veterinary teaching hospital over a 6-year period were identified. Dorsal offset rhinoplasty was defined as removal of a dorsal wedge of nasal planum from each naris with apposition of the rostral abaxial tissue to the caudal axial tissue, resulting in translocation of the alar cartilage in both median and dorsal planes. Immediate and postoperative complications were recorded. Owners were asked to report any complications with healing of the nares and to score their satisfaction with the appearance of the nares. Results Thirty-four dogs met the inclusion criteria. Twenty-nine (85%) dogs were examined a median of 402.5 days (range, 23-2042) postoperatively, with no major complications related to the rhinoplasty recorded. Eighteen owners responded a median of 701 days (range, 37-1622) postoperatively. One owner reported that self-trauma led to collapse of one naris. One owner reported collapse of both nares within 4 years; timing and cause were unknown. Sixteen of 17 responding owners reported that they were very satisfied with the outcome of the rhinoplasty. The owner of the dog with the collapsed naris was very unsatisfied. One owner did not provide a satisfaction score. Conclusion Owners were generally highly satisfied with DOR, and complications were uncommon. Clinical significance This report describes an alternate technique to treat stenotic nares.
Pharmacologically induced/exacerbated restless legs syndrome, periodic limb movements of sleep, and REM sleep behavior disorder: a worthwhile consideration

Citation:Hoque R. Pharmacologically induced/exacerbated restless legs syndrome, periodic limb movements of sleep, and REM sleep behavior disorder: a worthwhile consideration. J Clin Sleep Med. 2020...
Simulation of the Fast Reactor Fuel Assembly Duct-Bowing Reactivity Effect Using Monte Carlo Neutron Transport and Finite Element Analysis

This paper discusses a new method of simulating the fuel assembly duct-bowing reactivity coefficient for EBR-II run 138B. Quantification of the fuel assembly duct-bowing reactivity effect in liquid...
The Impact of Charter Schools on Districts in California

How do charter schools impact the academic growth of their local school districts? While the literature focuses on large districts with many charters, the most common experience is for districts to have one or no charter school within their jurisdiction. We compile 15 years of data for California districts and use fixed effects analyses to estimate the changes in enrollment and academics after a first, second, or third charter school opens. After first and second charters open, districts experience an average annual decrease in enrollment of 60 students – less than 1% of total district enrollment and revenue. However, charters appear to have a non-significant or small positive (+0.02 SD) average annual impact on district academics. These and additional analyses suggest that charter schools trigger competition with their local school districts that encourage academic growth – enough competition to counter or even overcome the negative effect on academics via finances.
Data-driven modeling of power networks.

We develop a non-intrusive data-driven modeling framework for power network dynamics using the Lift and Learn approach of \cite{QianWillcox2020}. A lifting map is applied to the snapshot data obtained from the original nonlinear swing equations describing the underlying power network such that the lifted-data corresponds to quadratic nonlinearity. The lifted data is then projected onto a lower dimensional basis and the reduced quadratic matrices are fit to this reduced lifted data using a least-squares measure. The effectiveness of the proposed approach is investigated by two power network models.
Equalizing the Tax Treatment of Stock Buybacks and Dividends

This policy brief highlights flaws in the current federal tax treatment of stock buybacks and proposes to address those flaws by equalizing the tax treatment of buybacks and dividends. (We explore the proposal in greater detail in Hemel & Polsky, Taxing Buybacks, 38 Yale J. on Reg. 246 (2021), https://ssrn.com/abstract=3764112.) Stock buybacks allow foreign shareholders to avoid U.S. withholding tax on corporate cash distributions. Stock buybacks also allow U.S. taxable investors to reduce or eliminate shareholder-level tax on corporate cash distributions through a combination of deferral, loss harvesting, and stepped-up basis at death. Our proposal—based on an idea first suggested by Marvin Chirelstein a half century ago—would plug these gaps in the tax base by treating stock buybacks as imputed dividends. We explain the mechanics of the proposal and the principal design choices facing policymakers. We also estimate—conservatively—that the proposal would raise more than $500 billion over the 10-year budget window.
A phase II study of talimogene laherparepvec for patients with inoperable locoregional recurrence of breast cancer.

Talimogene laherparepvec (T-VEC) is an immunotherapy that generates local tumor lysis and systemic antitumor immune response. We studied the efficacy of intratumoral administration of T-VEC as monotherapy for inoperable locoregional recurrence of breast cancer. T-VEC was injected intratumorally at 106 PFU/mL on day 1 (cycle 1), 108 PFU/mL on day 22 (cycle 2), and 108 PFU/mL every 2 weeks thereafter (cycles ≥ 3). Nine patients were enrolled, 6 with only locoregional disease and 3 with both locoregional and distant disease. No patient completed the planned 10 cycles or achieved complete or partial response. The median number of cycles administered was 4 (range, 3-8). Seven patients withdrew prematurely because of uncontrolled disease progression, 1 withdrew after cycle 3 because of fatigue, and 1 withdrew after cycle 4 for reasons unrelated to study treatment. Median progression-free survival and overall survival were 77 days (95% CI, 63-NA) and 361 days (95% CI, 240-NA). Two patients received 8 cycles with clinically stable disease as the best response. The most common grade 2 or higher adverse event was injection site reaction (n = 7, 78%). Future studies could examine whether combining intratumoral T-VEC with concurrent systemic therapy produces better outcomes.
Spiritual fortitude: A systematic review of the literature and implications for COVID-19 coping

Traumatic events, such as natural disasters, often lead to significant resource loss for survivors, which can negatively affect emotional well-being. In these situations, it is common for people to draw on their religious or spiritual faith to cope with their pain and struggle. One construct that has received increased attention within the field of religious/spiritual coping is spiritual fortitude (SF). SF refers to one's ability to draw on spiritual resources to transcend negative emotions in the face of stressors (Van Tongeren et al., 2019). In this review, we analyze eight empirical studies with 3,455 total participants. Specifically, we explore the relationship between SF and mental health and well-being, with a particular focus on its role in traumatic contexts (e.g., natural disasters). SF has been found to demonstrate a series of positive mental health benefits including higher meaning in life, spiritual well-being, positive religious coping, and perceived posttraumatic growth. We discuss areas for future research and implications for clinical practice, with specific consideration to coping with the COVID-19 pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Durvalumab consolidation therapy in a patient with stage IIIB unresectable NSCLC harboring a MET exon 14 splice site alteration.

Abstract Background Recent literature has identified significant benefit of consolidation durvalumab following chemoradiotherapy in patients with unresectable non-small cell lung cancer (NSCLC). However, immunotherapy has demonstrated modest benefit in patients harboring oncogene driver mutations. While standard of care in metastatic oncogenic driven tumors is targeted tyrosine kinase inhibitors (TKIs), there is little data to guide treatment for patients who present with earlier stage unresectable disease, receiving chemoradiotherapy and have both high PD-L1 expression as well as concomitant actionable driver mutations. Clinical presentation We report a patient who presented with stage IIIB lung adenocarcinoma with high PD-L1 expression (80%) for which she received definitive concurrent chemoradiotherapy with consolidation durvalumab. The patient quickly progressed and was found to harbor a MET exon 14 splice site alteration for which she received crizotinib and had a good response. Discussion This case highlights the possibility that patients with non-metastatic, unresectable NSCLC with high PD-L1 expression and a concomitant driver mutation may benefit from targeted tyrosine kinase inhibitors rather than immune checkpoint inhibitor therapy.
Pubertal sex hormones control transcriptional trajectories in the medial preoptic area

Pubertal maturation aids development of emotion, cognition, and reproduction. We investigated transcriptional dynamics in the medial preoptic area (MPOA), a hypothalamic center for reproductive behaviors, in male and female mice at single-cell resolution (scRNAseq) during puberty. Defined subsets of neurons expressing Slc32a1 and Esr1 (Vgat+ Esr1+) were the most transcriptionally dynamic compared to other cell types throughout puberty. These cell type specific transcriptional progressions towards adulthood were bidirectionally controlled by the levels of circulating testosterone and estradiol. Selective deletion of Esr1 in Slc32a1-expressing cells in the MPOA prior to puberty arrested transcriptional progression and revealed a sexually dimorphic gene-regulatory network governed by Esr1. Deletion of Esr1 in Vgat+ cells prevented the development of mating behavior in both sexes. These analyses reveal both sexually common and dimorphic transcriptional progressions during puberty as well as their regulatory mechanisms, which have important implications towards understanding adaptative and maladaptive processes governing adolescent brain development.
Nitrate Adsorption by Activated Carbon

Activated carbon is a type of carbon that is a known catalyst for a variety of chemical reactions. Uses of activated carbon include purifying liquids and gases, food and beverage processing, odor removal, industrial pollution control, and numerous other applications. There are a variety of different activated carbons, with most being derived from coal, peat, and wood. Activated carbon is a catalyst because the small pores of the carbon increase the surface area available for adsorption or chemical reactions. One primary use of activated carbon is how it adsorbs nitrates onto its surface. This paper delves into different adsorption rates of an activated carbon (Filtrasorb 600) that is treated with different chemicals and then subjected to a chemical activation at a constant pressure under different gaseous conditions. Data collected during experiments indicate there are significant interactions between surface functional groups and nitrate. Keywords: activated carbon, adsorption, nitrates
Turning Emergency-Response to Standard Procedure Through a Trauma-Informed Attention to Crisis

This chapter aims to bridge the gap between wide-spread responses in higher education to the COVID-19 crisis and individual experiences of crisis that remain unrecognized and unaccommodated by classroom and college policies and expectations. This chapter sees the potential for a revised understanding of crisis that addresses the problematics of power and legitimacy that impact the recognizability of students in crisis. To rethink the potential of crisis-informed pedagogy and policy in the wake of COVID-19 emergency-responses, this chapter emerges from ongoing debates in trauma studies about deficit-focused, corrective responses to suffering in order to offer an alternative more elaborated recognition of student suffering that acknowledges—but does not legislate or hierarchize—the ever-present potential for crisis that can be individually, collectively, or chronically experienced.