cssi/SciSciGPT-SciSciNet huggingface dataset:
Clinical experience of intravenous lacosamide in infants and young children.

Abstract Objective To review our clinical experience with intravenous (iv) lacosamide (LCM) in children less than 12 years old. Background Use of LCM to treat children with epilepsy has been supported by multiple studies with limited information on iv use in children. Designs/Methods All children given iv LCM were identified from 2009 to 2015. Records were audited for demographics, seizure classification, etiology, EEG, imaging, indication. Baseline seizure frequency was based on parental reporting, continuous video EEG and direct observation. Results 47 patients were identified with median age 6.5 years, 18 less than 3 years old, including 8 younger than 12 months. LCM was an adjunctive therapy of ≥2 antiepileptic drugs (AEDs). LCM was administered intravenously to treat epilepsia partialis continua (n = 3, dose range 5–10 mg/kg), status epilepticus (n = 11, median dose 7.2 mg/kg, range 4–11 mg/kg), and acute exacerbation of seizure frequency (n = 18, median dose 4.5 mg/kg, range 1–11 mg/kg). Parenteral form was substituted for oral form for 10 children treated with maintenance LCM unable to ingest/tolerate enteral medication and 5 who were given iv LCM to initiate maintenance treatment (median dose 4 mg/kg, range: 2–10 mg/kg). The infusion was effective for 24 out of 37 children (65%) naive to LCM. Sedation (one with ataxia) was noted in 5/36 children (14%), without any other identified adverse events. Conclusion This is the first published retrospective study of very young critically ill children receiving iv LCM. The acute tolerability at this dosing range represents a positive trend and need confirmation from larger studies.
The Age of the LIst

Most criticisms of suburban sprawl presume that the ideal unity for human dwelling is a spatially dense, centered and hierarchically organized locale. Suburban sprawl and commercial strips have none of these characteristics but it does possess a new kind of unity, that of a list of seemingly unrelated units indifferent to their neighbors, but actually complexly linked across distance to wider systems and networks. That kind of unity is becoming more common and is providing a new matrix for dwelling.
Solvent Soaking and Drying of Carbon Nanotube Forests for Enhanced Contact Area and Thermal Interface Conductance

Forests comprised of nominally vertically aligned carbon nanotubes (CNTs), having outstanding thermal and mechanical properties, are excellent candidates for thermal interface materials (TIMs). However, the thermal performance of CNT forest TIMs has been limited by the presence of high thermal contact resistances at the CNT tip interface. The high thermal contact resistance at the CNT tip interface stems from two sources: (1) the relatively weak van der Waals type bonding, which impedes phonon transport, and (2) low contact area. In this work we will show that common solvents, such as water, can be applied to the CNT forest to increase the contact area and reduce the contact resistance by an average of 75%. Specifically, there are two likely mechanisms that can increase the contact area when a CNT forest is wet with a fluid and compressed in an interface. The first is relaxing the van der Waals interactions between contacting CNTs within the forest, consequently decreasing the stiffness of the forest and allowing it to better conform to the opposing surface. The second is the pulling of CNT tips through capillary interactions into contact with the opposing surface as the solvent evaporates. By measuring the thermal resistance of CNT TIMs before and after soaking in variety of solvents the capacity of each mechanism for reducing the contact resistance is explored.Copyright © 2013 by ASME
Signature of structural distortion in optical spectra of YFe2O4 thin film

We report structural, optical, and electro-optical properties of polycrystalline YFe2O4 thin films, deposited on (0001) sapphire substrates using the electron-beam deposition technique. The optical spectra of a 120 nm YFe2O4 show Fe d to d on-site and O 2p to Fe 3d, Y 4d, and Y 5s charge-transfer electronic excitations. Anomalies in the temperature dependence data of the charge-transfer excitations and the splitting of the 4.46 eV charge-transfer peak strongly suggest a structural distortion at 180 ± 10 K. Evidence of such a structural distortion is also manifested in the surface resistance versus temperature data. In addition, the YFe2O4 thin film at low temperatures shows strong electro-optical properties, as high as 9% in the energy range of 1 - 2.5 eV, for applied electric fields up to 500 V.cm−1.
A Satisfaction Survey on Distance Education: A Model for Educating Nurses in the Cognitive Treatment of Patients With Addictive Disorders

1 Nurses need to be educated and trained in the assessment and treatment of substance abuse, because 25% to 50% of their patients struggle with this problem. 2 Cognitive therapy takes a problem-solving approach and can be used independently, or in conjunction with, psychopharmacological or 12-step programs. 3 Course participants who made use of the distant education format found the information they learned helpful in their current practice.
Cytokine and matrix metalloproteinase expression in pigmented villonodular synovitis may mediate bone and cartilage destruction.

BACKGROUND: Pigmented villonodular synovitis (PVNS) is characterized by hypervascular proliferative synovium containing multinucleated giant cells, macrophages, and hemosiderin. The destruction of articular cartilage and erosion of periarticular bone is thought to be mediated by matrix metalloproteinases (MMPs). Expression of MMPs in some tumors appears to be stimulated through local production of cytokines, and several specific cytokines (TNF alpha, IL-1, and IL-6) play an important role in the stimulation of osteoclastic bone resorption. The role of cytokine secretion and regulation of MMP production in PVNS has not been investigated. DESIGN: In the present study, ten specimens from eight patients (ages 19 to 80) were evaluated histologically according to a modified Mirra classification and immunohistochemically (IHC) for the expression of MMP-9 (92 kDa gelatinase B), tumor necrosis factor alpha (TNF alpha), interleukin 1-beta (IL-1 beta), and interleukin 6 (IL-6). Localization of IL-6 and TNF alpha production was confirmed by in situ hybridization (ISH) for mRNA. RESULTS: All specimens, regardless of location (six knees, one ankle, one subtalar joint), showed diffuse and intense immunoreactivity for cytokines in the giant cells and synovial cells, and less intense and diffuse staining in the activated macrophages. Staining in the fibroblastic elements was minimal. In situ hybridization for TNF alpha and IL-6 mRNA mirrored the immunohistochemistry results, although the IL-6 staining was weaker than that for TNF alpha. Immunoreactivity for MMP-9 was diffuse and strong in giant cells, diffuse and moderate in synovial cells, and focal and moderate to strong in macrophages. In contrast, normal synovium demonstrated focal, moderate immunoreactivity for IL-1 beta, IL-6, TNF alpha and MMP-9 localized in the synovial lining cells. CONCLUSION: These findings suggest that periarticular bone resorption and cartilage destruction which characterize PVNS may be related to the expression of inflammatory cytokines, which in turn stimulate MMP production.
Size-Dependent Hamaker Constant for Silver Nanoparticles

The nonretarded size-dependent Hamaker constant for spherical silver nanoparticles was calculated by using the Lifshitz theory. The size dependence of the Hamaker constant was taken into account based on the size effect of the dielectric permittivity of silver nanoparticles. The experimental data for bulk silver dielectric permittivity was modified to include the intrinsic size effect of the scattering of the conduction electrons by the surface of the nanoparticles. The intrinsic size effect leads to a substantial increase of the Hamaker constant for nanoparticles with radii of the order 1 nm, when the mean free path of conducting electrons in the nanoparticles is limited by the particles’ boundaries.
COLOR DISCRIMINATION CONDITIONING OF A WASP, POLYBIA OCCIDENTALIS (HYMENOPTERA : VESPIDAE)

A Polybia occidentalis wasp was conditioned to collect sugar-water from a blue card (CB). In discrimination experiments, the wasp was able to detect the CB card when it was placed among 11 other cards that were all white, different shades of gray, different colors, or different shades of blue. The wasp made fewer mistakes in later trials than in earlier trials of each experiment, showing that she learned to focus on cues that were sufficient for discriminating between the CB card and the other cards present. The wasp was very successful at discriminating the CB card from other cards of similar brightness but that differed in their spectral reflection properties. The wasp's most common mistakes were with cards that were most similar to the CB card in their relative spectral reflection curves at wavelengths shorter than 575 nm. Cards that were similar in this region, and also reflected longer wavelengths, were most commonly confused with the CB card. Cards with reflection peaks in the blue region but that also reflected other wavelengths shorter than 575 nm were not commonly confused with the CB card. Therefore, unlike a few hymenopteran species, Polybia does not seem to have a red-sensitive photoreceptor. Color vision was supported in that the wasp discriminated between the CB card and cards that varried in their spectral reflection properties, independent of light intensity. This is the first behavioral demonstration of color vision in the Polistinae and could further our understanding of the evolution and ecology of this large group.
Synthesis, cytopathogenicity, and modification of avian encephalomyelitis virus (AEV) in chick kidney cell culture.

SummaryVirus synthesis, cytopathogenicity, and modification of virulence for chicks, of AEV in chick kidney cell culture after 10 serial passages, have been described. The cell culture virus has been identified by histopathologic changes in inoculated chicks and virus neutralization tests in a cell culture system. The possible application of the findings are discussed.
Airplane Accidents, Murder, and the Mass Media: Comment on Phillips

Professor David Phillips' recent analysis of the effect of mass media reports about cases of murder-suicides on subsequent fatal aircraft accidents is replete with methodological and conceptual problems. According to Phillips, both commercial and noncommercial accidents show a statistically significant increase within a span of several days (3 days with noncommercial aircraft fatalities and 7 days for commercial aircraft fatalities) following a widely publicized murder-suicide. Drawing on his prior studies of the linkage between suicides by "personalities," mass media accounts, and an increase in single vehicle automobile accidents within three days of the publicized suicide, Phillips (b,c,d) asserts that the statistically significant increase in aircraft fatalities can be explained due to suicide, as well as a consciously or unconsciously" induced motive on the part of the pilot to also murder some person or persons. What Phillips does, in effect, is impute suicidal motives to some deceased persons on the basis of the statistically significant increases in accidents. Such a jump is conceptually unwise because it is based on a tautology: the statistical increase is the basis for defining some cases as suicide, but these cases are also used to explain the increase. Moreover, unless there is clear evidence that the cases under investigation are suicides, independently of their inclusion within a general class, then other explanations of the accident increases must be ruled out before positing suicide as a viable explanation. That Phillips has not done this will be illustrated with six cases he uses as data in analyzing U. S. Air Carrier crashes occurring in the Control Period-7 days prior to a publicized murder-suicide, and those occurring in the Experimental Period -7 days following the publicized murder-suicide. There are two crucial methodological problems apparent in the Phillips' (a) data. One involves the definition of the original murder-suicide. In Note 3, Phillips acknowledges that four cases were defined as murdersuicide even though the individuals were shot by the police. This is justi
Sustainable development in India: balancing poverty alleviation, economic growth and reduced carbon emissions

India is the world's third largest emitter of climate-changing gases after the USA and China. Rapid economic growth and consumption are driving up production of planet-warming carbon dioxide yet India remains home to one-fifth of the worlds poor. Can India sustain its economic growth in order to alleviate poverty while maintaining a low carbon intensity economy? To answer this, we examine the environment-income relationship in the context of the environmental Kuznets curve (EKC). We break down the CO2 emissions variable into energy use and carbon intensity and examine the impact of factors such as population density, urbanisation, openness of the economy, and FDI. Results suggest that India is on the upward sloping portion of the EKC with a turning point of $25,708 per capita. Findings indicate rising growth rates are significantly associated with increased energy use. But energy use is not a significant determinant of growth in the economy.
Soviet decision-making on defense

The dominance of the defense industry in the Soviet Onion has been challenged recently both by the military and by scholars and diplomats concerned with strategic questions.
Lingual Artery Embolization for Severe and Uncontrollable Postoperative Tonsillar Bleeding

We performed emergent angiography of the external carotid artery to evaluate a patient who experienced uncontrollable oropharyngeal bleeding 3 days following an adenotonsillectomy. Angiography demonstrated a left lingual artery disruption and hemorrhage. We then performed a coil embolization of the left lingual artery, which immediately halted the hemorrhage. We conclude that coil embolization is a rapid and effective strategy for the management of massive, uncontrollable postoperative tonsillar bleeding.
A possible link between hepcidin and regulation of dietary iron absorption

The antimicrobial peptide hepcidin has been implicated in the regulation of iron homeostasis. Hepcidin is theorized to be a key link between body iron stores and the appropriate modulation of dietary iron absorption.
Grading of nonrhabdomyosarcoma soft tissue sarcoma in children and adolescents: a comparison of parameters used for the Fédération Nationale des Centers de Lutte Contre le Cancer and Pediatric Oncology Group Systems.

Two systems for grading soft tissue sarcoma are widely used currently: the National Cancer Institute (NCI) and the Federation Nationale des Centers de Lutte Contre le Cancer (FNCLCC) systems. Both were developed using cohorts of predominantly adult patients. The Pediatric Oncology Group (POG) system, based on the NCI system, was adapted for grading pediatric non-rhabdomyosarcoma soft tissue sarcoma (NRSTS). The applicability and prognostic utility of the FNCLCC system in pediatric NRSTS has not been assessed or compared to the POG system. Tumors from 130 patients with malignant NRSTS enrolled on three completed multi-institutional clinical trials were assessed. Of 130 tumors, 102 (78%) were localized and 28 (22%) metastatic. Of the localized tumors, 55/102 (54%) were >5cm. The estimated 5-year EFS for the entire group was 47%. As expected, stage and tumor size were predictive of EFS (p<0.001). Both systems were predictive of 5-year event-free survival (EFS) (POG p=0.0095 and FNCLCC p=0.0075). Patients whose tumors received discrepant grades (POG-G3 vs. FNCLCC-G2/G1) (n=44) had an intermediate outcome between those with concordant (G3 (n=44) or G1/G2 (n=42)) grades on both systems (p=0.0018). By multivariate analysis, the mitotic index was predictive of EFS using a cutoff of 10 mitotic figures per 10 high power fields (p<0.001). In conclusion, both the FNCLCC and POG systems provide an adequate prognostic measure of outcome for pediatric NRSTS; albeit, a sizeable subset of cases with apparently intermediate prognosis was graded differently by the two systems. The mitotic index appears to be a key parameter in grading pediatric NRSTS.
An inverse approach to determining spatially varying arterial compliance using ultrasound imaging.

The mechanical properties of arteries are implicated in a wide variety of cardiovascular diseases, many of which are expected to involve a strong spatial variation in properties that can be depicted by diagnostic imaging. A pulse wave inverse problem (PWIP) is presented, which can produce spatially resolved estimates of vessel compliance from ultrasound measurements of the vessel wall displacements. The 1D equations governing pulse wave propagation in a flexible tube are parameterized by the spatially varying properties, discrete cosine transform components of the inlet pressure boundary conditions, viscous loss constant and a resistance outlet boundary condition. Gradient descent optimization is used to fit displacements from the model to the measured data by updating the model parameters. Inversion of simulated data showed that the PWIP can accurately recover the correct compliance distribution and inlet pressure under realistic conditions, even under high simulated measurement noise conditions. Silicone phantoms with known compliance contrast were imaged with a clinical ultrasound system. The PWIP produced spatially and quantitatively accurate maps of the phantom compliance compared to independent static property estimates, and the known locations of stiff inclusions (which were as small as 7 mm). The PWIP is necessary for these phantom experiments as the spatiotemporal resolution, measurement noise and compliance contrast does not allow accurate tracking of the pulse wave velocity using traditional approaches (e.g. 50% upstroke markers). Results from simulations indicate reflections generated from material interfaces may negatively affect wave velocity estimates, whereas these reflections are accounted for in the PWIP and do not cause problems.
The “Big Bang” of financial capitalism: financing and re-financing the Mississippi and South Sea Companies, 1688–1720

The accumulated expenses of the War of the Spanish Succession (1701–1714) left each of the great powers of Europe with unprecedented burdens of government debt. The overlapping Great Northern War (1700–1721) also encumbered Sweden and Russia with pressing financial problems. The competitive experiments with ways to deal with their amassed debts among the emerging nation-states of Europe over the next decade ended with Britain alone holding the key to success in war finance. Spain retreated from European expansion to focus on its increasingly productive colonies in Latin America while strengthening mercantile ties with France and allowing provincial elites to regain their local authority over both taxes and coinage. Austria focused on exploiting the trade and finance possibilities through its acquisition of the remaining provinces of the southern Netherlands, which meant renewing the privileges of the city authorities there as well. The Netherlands found that the resources of Holland no longer sufficed to maintain its role among the Great Powers, and the Dutch merchant capitalists turned instead to invest in emerging powers, first Britain, then Germany, Russia, and finally even the new republic calling itself the United States of America. France, having dallied with an attempt to imitate the financial successes of the Netherlands and Great Britain under the tutelage of John Law during the years 1716–1720, reverted to its previous reliance on domestic financiers to sustain both royal authority and provincial aristocracy. Britain alone among the contesting military powers of Europe in the eighteenth century succeeded in convincing a large and diverse number of individuals to hold onto their claims against the government. Especially important were the foreigners holding British sovereign debt, which included not only the expatriate community of French Huguenots and Sephardic Jews settled in London after the Acts of Toleration in 1689, but also Dutch and German merchant elites, and even the Swiss city of Basel. In the first generation of British financial innovation after 1688, Parliament created a unique combination of chartered corporations to hold most of the national debt created by war finance.
The Hardness and Inapproximability of Determining Process Capacity

The concept of the capacity of a process and the associated managerial insights on capacity investment and capacity management are of fundamental importance in Operations Management. In this paper, we show that the problem of finding the capacity of a process that produces a single product is strongly NP-hard. This result is based on a novel characterization, which we establish, of process capacity that relates it to the fractional chromatic number of an associated graph. Furthermore, we show that it is also hard to efficiently approximate process capacity to within a reasonable factor; e.g., within any constant factor. Most OM textbooks use the following simple approximation to study process capacity: the capacity of each resource is first calculated by examining that resource in isolation; process capacity is then defined as the smallest (bottleneck) among the capacities of the resources. In addition to showing that this approximation is unsatisfactory in general, our results also show that it is unlikely that we can replace this approximation with another simple but close approximation of process capacity.
Performance implications of next generation PowerPC/sup TM/ microprocessor cache architectures

Modern CISC and RISC microprocessors use sophisticated caching schemes to bridge the performance mismatch between their internal execution units and the capabilities of commodity memory technologies. A variety of cache architectures and organizations have been developed and are finding use in current and future high-performance computer systems. Designers of systems with next-generation PowerPC/sup TM/ microprocessors face similar challenges. System performance implications for various cache architectures (look-aside, in-line, back-side) and cache organizations (direct-mapped, set-associative) need to be understood so that cost-effective cache hierarchies can be built. This paper presents the results of an analysis done at the Motorola Computer Group to characterize the required properties of a cache hierarchy for a next-generation G3 PowerPC superscalar low-power microprocessor.
A quasi-experimental study on the effects of instrument assisted soft tissue mobilization on mechanosensitive neurons

[Purpose] Instrument Assisted Soft Tissue Mobilization (IASTM) is a form of manual therapy. Despite its growing popularity and an increasing number of patients receiving IASTM each year, there is a lack of high-level evidence to elucidate its therapeutic mechanisms and to support its clinical applications. The purpose of this research project was to determine the effects of IASTM on activities of mechanosensitive neurons in skin. [Subjects and Methods] Twenty-three subjects, 9 females and 14 males, mean age 25.7 (SD 6.4) years old were recruited through a convenience sampling on the university campus. The study design was a quasi-experimental study using single group pretest-posttest design. The activities of mechanosensitive neurons were measured before and after the application of IASTM. [Results] The mean 2-point discrimination was 40.2 (SD 9.4) mm before IASTM and increased to 44.9 (SD 12.0) mm after IASTM. The increase was statistically significant pre and post IASTM. The mean pain threshold was 18.2 (SD 6.6) lb and increased slightly to 18.7 (SD 6.8) lb after IASTM; however, no statistical significance was found pre and post IASTM. [Conclusion] The data indicates that IASTM changes the neural activities in 2-point discrimination but not in pain threshold.
THE SCOPE AND TRENDS OF DEVELOPMENTS IN RAPID SOLIDIFICATION TECHNOLOGY

Publisher Summary This chapter discusses the scope and trends of developments in rapid solidification technology (RST), which is a young field. Not much is expected because RST is synonymous with structure control. The research coverage is quite unbalanced with heavy overconcentration in some areas and near total neglect in others. With some exception, industry seems reluctant to make positive moves both into RS particulate-related equipment and facilities and into alloy programs. Despite the youthfulness of RST, a significant number of alloys and products have already emerged as commercial entities. There are growth prospects in glassy alloys, microcrystalline alloys, and the combination of the two. The bigger field would be based on the microcrystalline state in part because it is less composition restricted. RST offers almost unlimited potential for new structures, new alloys, and new processing and processes. Joining of RST-based products has been almost totally neglected. Lack of an advanced joining technology proves to be a major barrier to growth. High conductivity, high strength, high temperature copper-base alloys based on the systems Cu–Zr, Cu–Cr–Zr, C–Ni–Ti have been produced from RS–PM alloys that have excellent strength and ductility properties from 20°–450°C. Considerably stronger stainless steels are possible, with promise of improved intermediate temperature creep strength.
Pyreniporphyrins: Porphyrin Analogues That Incorporate a Polycyclic Aromatic Hydrocarbon Subunit within the Macrocyclic Framework

The first examples of porphyrin analogues incorporating pyrene units are reported. Acid-catalyzed condensation of a pyrene dialdehyde with a tripyrrane, followed by oxidation with DDQ, afforded a polycyclic aromatic hydrocarbon (PAH)–porphyrin hybrid in 38% yield. Pyreniporphyrin proved to be devoid of global aromatic character, but upon protonation aromatic mono- and dicationic species were generated. In the proton NMR spectrum for the dication, the internal CH was shifted upfield to approximately +3 ppm. NICS calculations and ACID plots confirmed the diatropic nature of these structures. Pyreniporphyrin reacted with palladium(II) acetate to give excellent yields of a palladium(II) complex that showed weakly diatropic properties. Treatment of the pyrene dialdehyde with phenylmagnesium bromide generated a dicarbinol that reacted with excess pyrrole in the presence of boron trifluoride etherate to give a tripyrrane analogue. Lewis acid catalyzed ring closure with a thiophene dialcohol in 2% ethanol–dichlor...
Using CBPR to Decrease Health Disparities in a Suburban Latino Neighborhood.

Introduction:This project tested the feasibility of using a community-based participatory research (CBPR) approach to deliver health and social resources in two high-risk, suburban neighborhoods.Me...
Impact of Three Doses of Vitamin D3 on Serum 25(OH)D Deficiency and Insufficiency in At-Risk Schoolchildren

Objective We investigated the daily dose of vitamin D needed to achieve serum 25-hydroxyvitamin D [25(OH)D] sufficiency among schoolchildren at risk for deficiency. Study Design The Daily D Health Study was a randomized double-blind vitamin D supplementation trial among racially/ethnically diverse schoolchildren (n = 685) in the northeastern United States. Children were supplemented with vitamin D3 at 600, 1000, or 2000 IU/d for 6 months. Measurements included serum 25(OH)D at baseline (October to December), 3 months (January to March), 6 months (April to June), and 12 months (6 months after supplementation). Results At baseline, mean ± standard deviation serum 25(OH)D level was 22.0 ± 6.8 ng/mL, with 5.5% severely vitamin D deficient (<12 ng/mL), 34.1% deficient (12 to 19 ng/mL), 49.0% insufficient (20 to 29 ng/mL), and 11.4% sufficient (≥30 ng/mL). The lowest levels of serum 25(OH)D were found among black (17.9 ± 6.7 ng/mL) and Asian children (18.9 ± 4.8 ng/mL), with no baseline differences by weight status. Serum 25(OH)D increased over 6 months in all three dose groups. The 2000 IU/d group achieved a higher mean serum 25(OH)D level than the other two dose groups (33.1 vs 26.3 and 27.5 ng/mL; P < 0.001), with 59.9% of this group attaining sufficiency at 3 months and only 5.3% remaining severely deficient/deficient at 6 months. All dose groups demonstrated a fall in 25(OH)D at 12 months. Conclusions Children at risk for vitamin D deficiency benefited from daily sustained supplementation of 2000 IU/d compared with lower doses closer to the current recommended daily allowance for vitamin D intake. This benefit occurred over the winter months, when serum 25(OH)D level tend to fall.
Speed tuning in the macaque posterior parietal cortex

Neurons in the macaque posterior parietal cortex are known to encode the direction of self-motion. But do they also encode one's speed? To test this, we performed neural recordings from area 7a while monkeys were passively translated or rotated at various speeds. Visual stimuli were delivered as optic flow fields and vestibular stimuli were generated by a motion platform. Under both conditions, the responses of a fraction of neurons scaled linearly with self-motion speed, and speed-selective neurons were not localized to specific layers or columns. We analyzed ensembles of simultaneously recorded neurons and found that the precision of speed representation was sufficient to support path integration over modest distances. Our findings describe a multisensory neural code for linear and angular self-motion speed in the posterior parietal cortex of the macaque brain, and suggest a potential role for this representation.
Quantitative Assessment of Inflow Malposition in Two Continuous-Flow Left Ventricular Assist Devices

Background We previously investigated preoperative variables associated with qualitative inflow cannula malposition in the HeartMate II (Thoratec-Abbott, Abbott Park, IL) continuous-flow left ventricular assist device. In this report, we assess inflow cannula malposition quantitatively in recipients of both the HeartMate II and the HeartWare (Medtronic-HeartWare, Minneapolis, MN) and examine its association with device thrombosis. Methods Malposition was quantified based on angular deviation from a hypothetic ideal inflow cannula position in two orthogonal computed tomography imaging planes. Ideal position lies on a line from the apex to the center of the mitral valve. Positive anterior plane angulation indicates deviation toward the superior free wall; negative, toward the inferior wall. Positive lateral plane angulation indicates deviation toward the septum; negative, toward the lateral wall. Device thrombosis was assessed based on clinical criteria. Results Fifty-four HeartMate II patients and 68 HeartWare patients were analyzed. Inflow cannula deviation was significantly higher for HeartMate II than for HeartWare (anterior plane angle 36.7 ± 16.8 versus −18.7 ± 11.6 degrees, p p p Conclusions We found distinct device-dependent differences in inflow cannula positioning and thrombosis, with HeartWare showing both less malposition and less thrombosis. Malposition toward the ventricular septum may contribute to pump thrombosis through a vicious cycle of suction events, low flow, and speed reduction.
The new era of whole-exome sequencing in congenital heart disease: brand-new insights into rare pathogenic variants.

CHD is a complex developmental phenotype, with many genes contributing to its etiology; it affects about 1% of infants, and its genetic roots are multifarious and difficult to ascertain (1,2). Improvements in prenatal diagnosis, corrective procedures, and longitudinal support have reduced infantile mortality. Today, >75% of CHD children surviving beyond their 1st year, including those with complex malformations, will live into adulthood (3). Despite medical and surgical advances, CHD leads birth-defect mortality. Genetic factors have long been implicated, as children with genetic disorders are more prone to heart disease.
Transitioning to Management: Challenges and Opportunities for the Millenial Generation

This study examines twelve factors which are important for the large number of potential managers in the Millennial Generation sector. The new role as manager may be overwhelming for a younger manager. With proper training and other factors, the Millennial Manager may be as an asset to the organization. Important advice for the Millennial generation includes developing self-awareness and understanding differences among team members. Other recommendations are having a mentor and being transparent, fair, a good listener, and a cheerleader. The manager should set high standards, acknowledge mistakes, and focus on goal achievement.
ION CHANNELS | Acquired Ion Channel Dysfunction in Epilepsy

Ion channel dysfunction is a recognized cause of genetic human epilepsy syndromes. It has been widely hypothesized that altered ion channel expression or biophysical properties may also underlie epilepsy acquired from lesions of the central nervous system. There are numerous examples of altered ion channel properties, especially after experimental status epilepticus, but interpretation of whether these findings are cause or consequence of epilepsy is not always straightforward. In this article, we review the evidence for such ‘acquired channelopathy’ in epilepsy, focusing on Na+, Ca2+, K+, and HCN channels as well as GABAA receptors.
A Tutorial on Real-time Convex Optimization Based Guidance and Control for Aerospace Applications

Challenging control problems are ubiquitous in aerospace engineering applications. Such applications include reusable rockets, spacecraft rendezvous and docking, satellite constellation management for terrestrial imaging, and many other ones where vehicles are required to perform reliably while adhering to physical and mission constraints. Physical constraints are due to limitations like finite fuel, whereas mission constraints can arise from sensor pointing requirements or safety keep-out zones. Often, mission success necessitates that these constraints be satisfied in real-time, using limited on-board computational resources. In this paper, we present a tutorial on how to formulate some aerospace control problem examples in an optimization based control framework. Specifically, we decompose the control problem into two levels: guidance (trajectory optimization), and feedback control. In guidance, we use recent convexification results to formulate non-convex trajectory optimization problems as finite-dimensional convex optimization problems, which we solve using fast and reliable Interior Point Method (IPM) algorithms. We discuss the current state of the art of convexification techniques, and outline the context in which these techniques should be used. Lastly, we present an overview of synthesis methods for feedback control laws. These control laws are used to track the guidance trajectories within specified error bounds, and in the presence of model uncertainties and environmental disturbances.
Structural Basis for Graded Inhibition of CREB:DNA Interactions by Multisite Phosphorylation

Phosphorylation of the kinase inducible domain (KID) of the cyclic AMP response element binding transcription factor (CREB) regulates its function through several mechanisms. Transcriptional activation occurs following phosphorylation at serine 133, but multisite phosphorylation in a neighboring region termed the CK cassette, residues 108-117, results in inhibition of CREB-mediated transcription. A molecular-level understanding of the mechanism of these opposing reactions has been lacking, in part because of the difficulty of preparing multiply phosphorylated CREB in vitro. By substituting a single residue, we have generated an engineered mammalian CREB in which the CK cassette can be phosphorylated in vitro by casein kinases and have characterized its interactions with cyclic AMP response element DNA. Phosphorylation of the CK cassette promotes an intramolecular interaction between the KID domain and the site of DNA binding, the basic region of the C-terminal basic leucine zipper (bZip) domain. Competition between the phosphorylated KID domain and DNA for bZip binding results in a decreased affinity of CREB for DNA. The binding free energy calculated from the dissociation constant is directly proportional to the number of phosphate groups in the CK cassette, indicating that the DNA binding is regulated by a rheostat-like mechanism. The rheostat is modulated by variation of the concentration of cations such as Mg2+ and by alternative isoforms such as the natural CREB isoform that lacks residues 162-272. Multisite phosphorylation of CREB represents a versatile mechanism by which transcription can be tuned to meet the variable needs of the cell.
New species of Amanita subgen. Lepidella from Guyana

New species of Amanita subgen. Lepidella are described from Guyana. Amanita cyanochlorinosma sp. nov., Amanita fulvoalba sp. nov., and Amanita guyanensis sp. nov. represent the latest additions to the growing body of newly described ectomycorrhizal fungi native to Dicymbe-dominated tropical rainforests. Macro- and micromorphological characters, habitat, and DNA sequence data for the ITS, nrLSU, rpb2, and ef1-α are provided for each taxon, and β-tubulin for most. Distinctive morphological features warrant the recognition of the three new species and a molecular phylogenetic analysis of taxa across Amanita subgen. Lepidella corroborates their infrageneric placements.
Clinical utility of postoperative phosphate recovery profiles to predict liver insufficiency after living donor hepatectomy.

Abstract Background Living donor hepatectomy (LDH) is associated with significant postoperative hypophosphatemia. Methods From January 1997 through July 2017, we performed 176 LDH and compared donors who developed liver insufficiency (LI) to those that did not within 30 days of LDH. Using smoothing splines, we constructed a mixed-effects model and assessed receiver operating characteristic curves. Results Of the 176 donors, 161 were included in our study and 10 (6.2%) developed LI. The cohorts differed in minimum observed phosphate levels (1.77 mg/dL, LI cohort; 2.01 mg/dL No LI cohort) at a median nadir of 1.6 days (38 h) postoperatively (p = 0.003). In the ROC analysis, intraoperative time and postoperative phosphate levels best predicted LI (sensitivity, 90%; specificity, 55.6%). Conclusion Mean postoperative phosphate profiles differ significantly between those patients who develop LI and those who do not in the first 38 h after LDH.
Traumatic brain injury and erectile dysfunction preceding clinically diagnosed alpha-synucleinopathies: a case – control study in Olmsted County, MN (1991–2010). (P2.063)

Objective: We investigated the associations of erectile dysfunction and traumatic brain injury (TBI) with the risk of developing any alpha-synucleinopathies, and by type, using a population-based case-control design. Background: Few studies have enumerated alpha-synucleinopathies within a population and studied the exposures associated with each type. Design/Methods: We used the medical records-linkage system of the Rochester Epidemiology Project to identify all cases of alpha-synucleinopathies in Olmsted County from 1991 to 2010. Each case was matched by age (+/− 1 year) of symptom onset and sex to a general population control. We reviewed the complete medical records of cases and controls to detect TBI and erectile dysfunction prior to the onset of any alpha-synucleinopathies and by type. Results: A history of TBI was not associated with any alpha-synucleinopathy (odds ratio (OR) 0.80, 95% confidence interval: 0.48–1.34, p=0.400). There was a trend for erectile dysfunction to be associated with increased odds of any alpha-synucleinopathy (OR 1.48, 95% CI 1.00–2.20, p=0.051). Results did not change when the analyses were restricted to Parkinson’s disease patients or when we excluded multiple system atrophy. Conclusions: Preliminary analyses suggest that erectile dysfunction, but not TBI, may be associated with increased odds of any alpha-synucleinopathy. Disclosure: Dr. Hasan has nothing to disclose. Dr. Bower has nothing to disclose. Dr. Mielke has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Eli Lilly, Lysosomal Therapeutics, Inc. Dr. Savica has nothing to disclose.
Clinical Listening and Corporeal Resonance in the Brazilian Belle Époque

This chapter examines the convergence of ideas regarding resonance and racialization in Salvador da Bahia in the final decades of the nineteenth century. It begins with an analysis of period reception of the phonograph, highlighting demonstrations of the device for the Brazilian Emperor, Dom Pedro II, and, after his exile, for the ascendant bourgeoisie. The phonograph, serves, as well, as a point from which to consider how medically informed listening practices were brought to bear upon the social realities of Afro-Brazilians in the period and the status of their bodies. This is studied through the work of the medical criminologist, Raimundo Nina Rodrigues, with particular attention to his dialogue with the work of French neuropathologists like Jean Martin Charcot. Through an analysis of his case study of a young Afro-Brazilian woman named Fausta, the chapter discusses the roles of sound recording technology in a former slavocracy.
Genome-Wide Assessment for Resting Heart Rate and Shared Genetics With Cardiometabolic Traits and Type 2 Diabetes.

Abstract Background High resting heart rate (RHR) occurs in parallel with type 2 diabetes (T2D) and metabolic disorders, implying shared etiology between them. However, it is unknown if they are causally related, and no study has been conducted to investigate the shared mechanisms underlying these associations. Objectives The objective of this study was to understand the genetic basis of the association between resting heart rate and cardiometabolic disorders/T2D. Methods This study examined the genetic correlation, causality, and shared genetics between RHR and T2D using LD Score regression, generalized summary data-based Mendelian randomization, and transcriptome wide association scan (TWAS) in UK Biobank data (n = 428,250) and summary-level data for T2D (74,124 cases and 824,006 control subjects) and 8 cardiometabolic traits (sample size ranges from 51,750 to 236,231). Results Significant genetic correlation between RHR and T2D (rg = 0.22; 95% confidence interval: 0.18 to 0.26; p = 1.99 × 10−22), and 6 cardiometabolic traits (fasting insulin, fasting glucose, waist–hip ratio, triglycerides, high-density lipoprotein, and body mass index; rg range −0.12 to 0.24; all p Conclusions These findings provide evidence of significant genetic correlations and causation between RHR and T2D/cardiometabolic traits, advance our understanding of RHR, and provide insight into shared etiology for high RHR and T2D.
Child care deserts in New York State: Prekindergarten implementation and community factors related to the capacity to care for infants and toddlers

Abstract Access to high quality child care provides a valuable support to families and communities as it both enables parental employment and provides a safe and developmentally appropriate place for children. Yet, access to child care for children under age three is uneven, with some communities experiencing child care “deserts” (Jessen-Howard et al., 2018). This paper assesses the infant and toddler child care capacity – the proportion of age-eligible children for which there are available child care slots – of communities across New York State. Using data from the NY State Education Department (670 school districts in the most recent year of available data), the NYS Office of Children and Family Services (about 18,000 registered child care providers), and the National Center for Education Statistics definitions of locale, we examine how child care capacity relates to school district and community factors over 9 years (2007–2016). Using negative binomial regression, we see overall stability in capacity for infant and toddler child care in New York State, but important variation by demographic factors and geography. Non-urban communities and communities with greater levels of student poverty have less capacity for infants and toddlers. Urban communities, communities with publicly funded prekindergarten and greater levels of minority children are associated with greater capacity. Importantly, in non-urban communities only (and especially in rural communities), we find an interaction effect that documents significantly reduced capacity for infant and toddler child care in communities also implementing public prekindergarten.
CD36 — the Achilles’ heel of Treg cells

Regulatory T (Treg) cells suppress antitumor immunity, but Treg cell inhibition has been hampered by a lack of specific targets. CD36 expression by tumor-infiltrating Treg cells may provide a way to specifically target Treg cells in tumors.
AutoPEWS: Automating Pediatric Early Warning Score Calculation Improves Accuracy Without Sacrificing Predictive Ability.

Introduction Pediatric early warning scores (PEWS) identify hospitalized children at risk for deterioration. Manual calculation is prone to human error. Electronic health records (EHRs) enable automated calculation, removing human error. This study's objective was to compare the accuracy of automated EHR-based PEWS calculation (AutoPEWS) to manual calculation and evaluate the non-inferiority of AutoPEWS in predicting deterioration. Methods We performed a retrospective cohort study inclusive of non-intensive care unit inpatients at a freestanding children's hospital over 4.5 months in Fall 2018. AutoPEWS mapped the historical manual PEWS scoring rubric to frequently used EHR documentation. We determined accuracy by comparing the expected respiratory subset score based on the current respiratory rate to the actual respiratory score of AutoPEWS and the manual PEWS. The agreement was determined using kappa statistics. We used predicted probabilities from a generalized linear mixed model to calculate areas under the curve for each combination of scores (AutoPEWS, manual) and deterioration outcome (rapid response team activation, unplanned intensive care unit transfer, critical deterioration event). We compared the adjusted difference in areas under the curves between the scores. Non-inferiority was defined as a difference of Results There were 23,514 total PEWS representative of 5,384 patients. AutoPEWS respiratory scores were 99.97% accurate, while the manual PEWS respiratory scores were 86% accurate. AutoPEWS were higher overall than the manual PEWS (mean 0.65 versus 0.34). They showed a fair-to-good agreement (weighted kappa 0.42). Non-inferiority of AutoPEWS compared with the manual PEWS was demonstrated for all deterioration outcomes. Conclusions Automation of PEWS calculation improved accuracy without sacrificing predictive ability.