cssi/SciSciGPT-SciSciNet huggingface dataset:
A First Course in Computer-Aided Physiological Modeling.

Early experiences at Wisconsin with analog and analog-hybrid modeling of physiological systems (particularly cardiovascular systems) were successful in arousing student interest and led to later applications of modeling in research work by these students. Beginning in the early '80s, all-digital modeling was used in the senior-grad course ECE 620, using the ACSL language, and applications were included in compartment modeling of pharmacokinetics, modeling of cardiovascular and respiratory pressure-flow and transport, thermoregulation, and prosthetic systems. In this course initial model programs of some complexity (up to 30 differential equations, some of them nonlinear) were provided to the students so that they could easily begin to work with models of meaningful size. The use of module and "multiple model" schemes appear to make this approach successful, and extension to more advanced models is possible.
In Pursuit of Child and Family Well-Being: Initial Steps to Advocacy

Communities across the United States, in both urban and rural areas, are seeking ways to promote well-being for their citizens in sustainable ways. This paper provides a descriptive case study of one rural community that used an inquiry-based approach to ask, “How can we engage our citizens to improve child and family well-being in our community?” The group also wondered “What if Brookings had one place for families to access all family resources that support well-being?” “What if all families had a place where their needs were heard?” and “What if all resources for families looked at the well-being of children and families in a holistic way?” This paper describes the initial journey of a community of practice advocating on several different community levels, including the role of university students, the process of the community of practice formation, its growing connections to community agencies and its initial efforts to build calls to action through participatory research and grassroots community efforts. While conveying a linear narrative, the authors also maintain a focus on the organic processes of knowledge construction and the evolution of a community of practice. Data collection, using the Delphi approach, is underway to access initial ground-up definitions of well-being and to identify areas of focus.
Preparation of Buffy Coat Smears in Leukopenic Patients

Although clinically important, white cell differential counts cannot be accurately performed on peripheral blood smears of severely leukopenic patients. A simple technique is described for preparation of buffy coat smears from leukopenic blood that preserves white cell morphology and gives a reasonably accurate representation of the white cell differential count.
Parenting stress of grandparents and other kin as informal kinship caregivers: A mixed methods study☆

Abstract Informal kinship caregivers provide the majority of out of home care to children who can no longer safely stay with their biological parent. Yet their parenting challenges are understudied since they are often left out from child welfare and other service systems. This mixed methods study, using a survey and focus groups of grandparent and other kin, examined predictors and sources of parenting stress. Quantitative findings suggested that the kinship family's needs and the caregiver's health and emotional well-being adversely affected parenting stress. Grandparent caregivers experienced an elevated level of parenting stress compared to other kin caregivers. Qualitative findings suggested that financial strains, concerns over children's behavior, navigating service systems and difficult relationships with birth parents contributed to their stress. It appeared that grandparent caregivers faced special challenges due to generational gaps, guilt and concerns over birth parents.
Effects of omeprazole and ascorbate on gastric emptying and antioxidant levels in a mouse model of glutathione depletion

Increased free radical production with depletion of the antioxidant, glutathione, is a suggested mechanism for the development of ulcer disease in patients with Helicobacter pylori. The effects of ascorbate and omeprazole as potential gut antioxidants are incompletely understood. We hypothesized that as antioxidants, ascorbate and omeprazole protect against glutathione depletion. This study was designed to determine the effects of ascorbate and omeprazole on gastric emptying and gastric antioxidant levels in a mouse model of glutathione depletion. In an acute (10-day) mouse model, glutathione depletion was induced by inhibiting the rate limiting enzyme, γ-glutamylcysteine synthetase. Enzymatic blockade produced depletion of gastric glutathione (P < 0.05) without increasing gastric lipid hydroperoxides. Glutathione depletion was associated with accelerated liquid gastric emptying. These effects were not prevented by supplementation with ascorbate or omeprazole. Omeprazole induced increased (P < 0.05) gastric and colonic total antioxidant capacity. One of the beneficial effects of omeprazole in patients may involve increased total antioxidant capacity.
Cultural or Latent Background of Aging

Most contemporary writers argue that social phenomena are not simply empirical. Another way of describing this shift in thinking is to say that nothing escapes the influence of culture. Since the onset of various philosophies that challenge dualism, this conclusion is unavoidable (Longino and Murphy 1995). Nonetheless, culture is not viewed in a deterministic fashion, whereby cultural laws pervade a society and shape all behavior. With respect to the changes announced by modern philosophy, culture should not be understood to operate in such a causal and restrictive manner.
Material Degradation Under Pulsed High Temperature and High Pressure

The AMMRC ballistic compressor is described as an instrument capable of adiabatically compressing gases to temperatures of several thousand Kelvins and pressures of several thousand atmospheres for a time of a fraction of a millisecond. Problems of measuring the gas conditions and its equations of state are discussed. Application to gun barrel erosion/corrosion is discussed through the example of various nitrogen/argon test gas experiments on 4340 steel. An interesting feature of an apparent melt and redeposit process in the formation of carbon containing nodules on the surface.
Detecting Anomalies in Alert Firing within Clinical Decision Support Systems using Anomaly/Outlier Detection Techniques

Clinical Decision Support (CDS) systems play an integral role in the improvement of health care quality and safety. Alert malfunctions within CDS are a common problem and these greatly limit its usability. Anomaly detection is a novel approach to identify malfunctioning within CDS systems. Once an anomaly in alert firing is detected, it can be used to rectify and potentially fix the CDS system to make it robust and reliable. We introduce and apply four anomaly detection algorithms to estimate the dates when malfunctions and/or changes in alert firing occur. Preliminary results demonstrate successful detection of anomaly occurrences within the alert data; this carries the potential to be used for root cause analysis of such malfunctions.
The Flow-of-Funds Accounts

The theory of the flow of funds discussed in previous chapters was inspired by the published accounts. Nevertheless, the theory has a life of its own independent of the statistical accounts. The theory suggests an idealized set of accounts which is not necessarily embodied in the published accounts.
Behavioral Marital Therapy

The emergence of behavioral marital therapy, approximately 13 years ago, drew attention primarily for the innovative and distinctive treatment procedures that were introduced. Similar to other theoretical perspectives, behavior therapy originally was applied to a variety of individual problems. Only later, in response to what was perceived as the needs of clients, was it deemed a viable treatment option for marital problems. What behavior marital therapy offered in its early stages of development was a set of orderly, step-by-step procedures for intervening into the complicated, and difficult-to-treat world of marital conflict. Behavior marital therapy’s promise for the future was an even more precise technology in which there would be treatment “modules” matched to specific target problems. Although welcomed by some for its precise, systematic, and time-limited technology, this approach was attacked by others for being overly rational, task-oriented, and narrow in focus.
Progress and Challenges in the Search for the Mechanisms of Pulsatile Gonadotropin-Releasing Hormone Secretion.

Fertility relies on the proper functioning of the hypothalamic-pituitary-gonadal axis. The hormonal cascade begins with hypothalamic neurons secreting gonadotropin-releasing hormone (GnRH) into the hypophyseal portal system. In turn, the GnRH-activated gonadotrophs in the anterior pituitary release gonadotropins, which then act on the gonads to regulate gametogenesis and sex steroidogenesis. Finally, sex steroids close this axis by feeding back to the hypothalamus. Despite this seeming straightforwardness, the axis is orchestrated by a complex neuronal network in the central nervous system. For reproductive success, GnRH neurons, the final output of this network, must integrate and translate a wide range of cues, both environmental and physiological, to the gonadotrophs via pulsatile GnRH secretion. This secretory profile is critical for gonadotropic function, yet the mechanisms underlying these pulses remain unknown. Literature supports both intrinsically and extrinsically driven GnRH neuronal activity. However, the caveat of the techniques supporting either one of the two hypotheses is the gap between events recorded at a single cell level and GnRH secretion measured at the population level. This review aims to compile data about GnRH neuronal activity focusing on the physiological output, GnRH secretion.
A Rubredoxin-Like Protein Plays an Essential Role in Assembly of the FA, FB & FX Iron-Sulfur Clusters in Photosystem I

The photosystem I (PS I) reaction center is a large multisubunit complex composed of at least eleven polypeptides in cyanobacteria and chloroplasts of higher plants [1]. Six redox centers are involved in light-induced electron transfer from plastocyanin (or cytochrome c6) to ferredoxin (or flavodoxin) in PS I. The PsaA/PsaB heterodimer harbors the primary electron carriers P700 (a chlorophyll (Chl) a dimer), A0 (a monomeric Chl a), A1 (a phylloquinone) and FX (an interpolypeptide [4Fe–4S] cluster). The terminal electron acceptors FA and FB are [4Fe–4S] clusters which are located on the extrinsic PsaC protein. Although significant progress has been achieved in elucidating the structure [2, 3] and function of the PS I, questions still remain concerning the biogenesis, assembly, and regulation of PS I in the membrane. The biogenesis of photosynthetic complexes in cyanobacteria and higher-plant chloroplasts is probably a complex, multi-step process, which is likely to be highly regulated at the post-translation level, especially for cofactor-binding polypeptides. Here we report preliminary results from studies of a gene encoding a novel rubredoxin-like protein with an essential function in the assembly of the FA, FB and FX iron-sulfur clusters in PS I reaction center.
Optimizing test utilization in the clinical microbiology laboratory: Tools and opportunities

Optimal laboratory test utilization is important for providing high-quality clinical care and efficiently using limited health care resources. While microbiologists have long been advocates for appropriate laboratory test utilization, the widespread availability of electronic medical records capable of supporting clinician order entry and of clinical decision support tools (CDSTs) has provided expanded opportunities for implementing effective, automated test stewardship protocols. D. Nikolic et al. (J. Clin. Microbiol. 55:3350-3354, 2017, https://doi.org/10.1128/JCM.01052-17) describe the results of implementing a CDST at their institution to curtail stool microbiology testing for patients hospitalized for more than 3 days. Their intervention significantly decreased unnecessary test orders and saved their laboratory over $8,000 in reagent and labor costs during an 11-month postintervention period. That report provides an excellent example of how clinical microbiologists can use electronic tools to optimize laboratory test utilization in their health care system.
Applicability of EULAR/ACR classification criteria for dermatomyositis to amyopathic disease.

Background Existing classification systems for idiopathic inflammatory myopathies (IIMs) fail to permit classification and/or diagnosis of amyopathic dermatomyositis (ADM) in patients. Objective In light of the new European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for IIM, we evaluated the likelihood of the skin variables included in the EULAR/ACR criteria (Gottron's sign, Gottron's papules, and heliotrope rash) to give a high probability of classifying patients with ADM. Methods This retrospective study evaluated 211 adult patients with dermatomyositis at the University of Pennsylvania. The EULAR/ACR criteria were used to determine the probability of classification for patients with ADM. Results Of patients with ADM, 73.7% would be classified as having a reasonable probability of dermatomyositis on the new EULAR/ACR criteria and 26.3% would not meet the suggested 55% minimum probability cutoff to be classified as having it on the basis of the EULAR/ACR criteria. Limitations This study was conducted with a retrospective design at a tertiary academic medical center. Conclusions The 3 skin variables included in the EULAR/ACR classification criteria for IIM improve on previous criteria but miss classifying some patients with ADM. It is important to consider additional variables such as skin biopsy results to encompass more of these patients and prevent the inclusion of any skin diseases mimicking ADM.
War, Sociology of

The sociology of war is a central topic in both political and historical sociology, since war is one of the most important policies states can pursue, and the outcomes of wars have often shaped both the formation and the dissolution of states. The literature on war is thus concerned with both its causes and its consequences. Studies of the causes of war can be divided into three broad categories. The first type takes the system as a whole as the unit of analysis and focuses on how characteristics of the interstate system affect the frequency of war. States are the unit of analysis in the second type, which explores the relationships among political, economic, and cultural features of particular states and their propensity to initiate wars. The third type analyzes war as an outcome of choices made by individual and small-group decision making. Theories of the consequences of war tend to focus either on its role in state formation, or on its causal impact on internal revolts and revolutions. Historical sociologists have shown that the frequency, duration, and timing of medieval and early modern warfare were the most important determinants of the size and structure of states. However, just as war can make states, it can break them too. Costly warfare often leads to fiscal crises and state breakdown, facilitating revolutions.
Neural Stem Cells and Neurogenic Niche in the Adult Brain

The discovery of adult neurogenesis has greatly advanced our knowledge of the human brain. During the past 50 years, the regulatory mechanisms and potential functions of this intriguing process have been extensively investigated. Our current knowledge supports the model that adult neurogenesis is regulated by both intrinsic genetic and epigenetic programs and extrinsic microenvironment and stimuli. This intricate molecular network has profound roles in controlling the self-renewal and multipotency of neural stem cells, the cellular basis of adult neurogenesis. In this review, we will summarize the current knowledge and our recent work in understanding adult neurogenesis with emphasis on answering two questions: how intrinsic epigenetic mechanisms, mediated through histone modifications, non-coding RNAs, and DNA methylation, define the signature of adult neural stem cells, and how extrinsic effects of growth factors, cytokines, and chemokines contribute to the adult neurogenic niche.
Visual Diagnosis: Vesicular Rash in a 28-day-old Girl

1. Marta A. King, MD* 2. Emily A. Thorell, MD† 1. *Division of Inpatient Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT 2. †Division of Infectious Disease, Department of Pediatrics, University of Utah, Salt Lake City, UT * Abbreviations: CNS: : central nervous system DFA: : direct fluorescent antibody HSV: : herpes simplex virus PCR: : polymerase chain reaction SEM: : skin, eyes, and mouth VZV: : varicella-zoster virus A 28-day-old, previously healthy, full-term girl presents to the emergency department after 2 days of irritability and 1 day of a rash. She has had no fevers, hypothermia, cough, congestion, increased work of breathing, easy bleeding or bruising, jaundice, or other symptoms. She was born via a scheduled repeat cesarean delivery at 38 weeks’ gestation after an uncomplicated pregnancy. Her mother received adequate prenatal care and had no serologic evidence of prenatal infections. After 3 days in the well-infant nursery, the child was discharged. No one at home is currently ill; however, the patient’s 8-year-old sister had a “cold sore” ∼2 weeks before admission. On approximately day 10 after birth, the patient’s mother had an outbreak of painful “itchy blisters” that started on her lower back, then spread to the inguinal region and abdomen, appearing most prominently over her cesarean delivery scar. She does not remember whether the rash was unilateral or bilateral. The lesions have scabbed over and resolved. The mother has never had a similar rash in the past and denies a history of herpes or other sexually transmitted infections. Both parents had chickenpox during childhood. The older siblings have been fully immunized. Family history is unremarkable for any immunodeficiencies or inherited childhood diseases. Physical examination reveals an afebrile, somewhat fussy but consolable girl infant. Vital signs are all within normal range. Skin findings reveal ∼20 vesicles with an erythematous base that are scattered over the face (Fig 1), trunk, legs, plantar surfaces (Fig 2), and buttock. The patient has normal work of breathing, no hepatosplenomegaly, and no mucous membrane involvement. The remainder of her physical examination is …
Cell Surface Extracellular Matrix Glycoproteins Proteoglycans in Nervous Tissue

There has recently been a greatly increased interest among neurobiologists in the roles of cell surface and extracellular matrix glycoproteins and proteoglycans in cell-cell interactions and other developmental processes. Our own efforts in this area have largely been directed towards studying their structure, localization, and metabolism in nervous tissue, since this information is essential for ultimately understanding their functional roles.
Control of Low-Reynolds-Number Airfoils: A Review

Among the modem goals of external flow control are separation postponement, lift enhancement, transition delay or advancement, and drag reduction. These objectives are not necessarily mutually exclusive. For low-Reynolds-number lifting surfaces, where the formation of a laminar separation bubble may have a dominant effect on the flow field, the interrelation between the above goals is particularly salient, presenting an additional degree of complexity. The present article is an overview of passive and active techniques used to control a low-Reynolds-number boundary layer to achieve an improved performance. A unified view based on a vorticity framework will be presented to explain many of the available or contemplated control methods. Among the control techniques to be considered are wall suction/injection, shaping, heat transfer through the surface, introduction of a foreign substance into the boundary layer, fixed or moving geometric modifications, and turbulence manipulation. Among the practical considerations that will be reviewed for these devices are their cost of construction and operation, complexity, and potential trade-off’s or penalties associated with their use.
The Dark Side of Insurance

Many speeches, articles, papers and books have been produced extolling the virtues of insurance. Insurance texts typically include in the introductory chapters a list of the benefits insurance provides to society. Although many texts also list the social costs of insurance, the prevailing view is that the benefits outweigh the costs. As expressed by Bob Mehr and Emerson Cammack (1980, p. 10) (and as assisted by generations of graduate students): “The contributions of insurance to society are significant, although not without their costs. On balance, however, the gains outweigh the cost.”
Evaluation of the rate of marginal ulcer formation after bariatric surgery using the MBSAQIP database

Marginal ulcer (MU) formation is a known problem after gastric bypass. The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database contains data from all US and Canadian Centers of Excellence including complication rates. We hypothesized that the short-term rate of ulceration is low. We queried the MBSAQIP database for the year 2015. We searched patients with primary gastric bypass who developed MU. We then compared preoperative, operative, and postoperative characteristics with patients who did not develop MU. The incidence of MU in the entire cohort of GB patients was 155 of 44,379 (0.35%, 95% CI 0.297%, 0.409%). Among the 155 patients with an ulcer, 88 (57%) patients had only one procedure, 69 had an intervention (therapeutic or diagnostic endoscopy), 16 had readmission, and 3 had reoperation. 65 patients (42%) had two procedures with the majority having both readmissions and endoscopy (n = 59); and two patients (1%) had three procedures. Ulcer formation was most common in the intervention group (11.4%). The occurrence of ulcer formation was associated with unplanned ICU admissions (6.45%), transfusions (5.16%), postoperative UTI (3.87%), sepsis (1.94%), and myocardial infarction (0.65%). Death occurred in 76 patients with no related cases to MUs. The risk of ulcer was associated with increased BMI (OR 1.02, p = 0.01), presence of percutaneous transluminal cardiac catheterization (PTC) (2.17, p = 0.038), histories of DVT (1.72, p = 0.085), and pulmonary embolism (2.84, p = 0.002). In a nationally reported database, symptomatic MUs rarely occur in the first month. The large majority are diagnosed and treated endoscopically with minimal need for surgical intervention. The risk of anastomotic ulcer was increased with increased BMI, need for PTC, and history of DVT/PE.
End-Stage Heart Disease and Indications for Heart Transplantation

Heart failure is a leading cause of morbidity and mortality in the United States and worldwide. Despite significant advances in the treatment of heart failure (both pharmacologic and electrical), many patients progress and/or are refractory to these interventions and warrant consideration for advanced therapies, including mechanical circulatory support and/or heart transplantation. The decisions on these approaches are complex and depend on both what is medically appropriate, the patient’s values, and overall goals of care. In particular, due to limited organ availability and significant perioperative risk related to heart transplantation, patients require an extensive medical and psychosocial evaluation by a designated transplant team to stratify the overall risk and the urgency of heart transplantation. Once objective data confirms significant cardiac limitation warranting consideration of cardiac transplantation, evaluation includes ruling out non-cardiac organ dysfunction, other medical comorbidities that could negatively impact on 5-year survival, major immune incompatibility, and cognitive, psychosocial, or behavioral limitations to patient survival. All of these areas are critical to clinical success post-cardiac transplantation. This chapter discusses clinical manifestations and clinical course of heart failure and indications for and medical evaluation for heart transplantation.
Examining positive body image, sport confidence, flow state, and subjective performance among student athletes and non-athletes.

Abstract The primary purpose of the present study was to examine differences in positive body image, specifically body appreciation and functionality appreciation, between student athletes and non-athletes. A secondary purpose was to examine the relationships between positive body image and other sport-related variables. Seventy-nine National Collegiate Athletic Association (NCAA) Division I student athletes (Mage = 19.79, SD = 1.13) and 175 non-athletes (Mage = 19.38, SD = 1.81) completed measures of body appreciation and functionality appreciation. The athletes further completed measures of sport confidence, flow state, and subjective sport performance. Student athletes reported higher levels of both facets of positive body image. Significant relationships were also found between positive body image and the sport-related variables. The present results contribute novel findings to the positive body image literature and potential implications for coaches to encourage a culture that focuses less on body appearance and more on cultivating positive body image.
Unique interfacial thermodynamics of few-layer 2D MoS2 for (photo)electrochemical catalysis

The electronic structure of few-layer MoS2 is studied by in situ and operando spectroelectrochemistry in conditions relevant to its use as an electrocatalyst. We show that electron injection into the conduction band is coupled with a redshift of the exciton resonance, the magnitude of which depends on the number of vertical MoS2 layers. In addition, the applied electric field/electronic doping imparts uniaxial tensile strain evidenced by broadening Raman signals, indicating that under conditions of electrocatalysis, the system is structurally different from equilibrium. We demonstrate that field/carrier induced changes to the electronic structure of MoS2 alter the band edge positions which changes the fundamental thermodynamic driving force for charge transfer. This property is a function of the applied potential, an effect unique to 2D semiconductors. The dynamic band edge potentials change the relevant interfacial energetics for charge transfer and have strong implications for the mechanistic understanding of (photo)catalytic fuel-forming reactions using two-dimensional systems.
Risk Factors and Clinical Outcomes Associated With Augmented Renal Clearance in Trauma Patients.

Abstract Background Augmented renal clearance (ARC; i.e., creatinine clearance [CLCr] ≥ 130 mL/min) has an incidence of 14%-80% in critically ill patients and has been associated with therapy failures for renally cleared drugs. However, the clinical implications of ARC are poorly defined. We hypothesize that modifiable risk factors that contribute to ARC can be identified in severely injured trauma patients and that these risk factors influence clinical outcome. Methods In 207 trauma intensive care unit patients, 24-h CLCr was correlated with clinical estimates of glomerular filtration rate (by Cockroft-Gault, modification of diet in renal disease, or chronic kidney disease epidemiology), and clinical outcomes (infection, venous thromboembolism [VTE], length of stay, and mortality). Results The population was 45 ± 20 y, 68% male, 77% blunt injury with injury severity score of 24 (17-30). Admission serum creatinine was 1.02 ± 0.35 mg/dL, CLCr was 154 ± 77 mL/min, VTE incidence was 15%, ARC incidence was 57%, and mortality was 11%. Clinical estimates of glomerular filtration rate by Cockroft-Gault, modification of diet in renal disease, chronic kidney disease epidemiology underestimated actual CLCr by 20%, 22%, or 15% (all P Conclusions ARC occurs in more than half of all high-risk trauma intensive care unit patients and is underestimated by standard clinical equations. ARC was not associated with increased incidence of VTE or infection but rather is associated with younger healthier males and reduced mortality. ARC seems to be a beneficial compensatory response to trauma.
Challenges to School Success and the Role of Adverse Childhood Experiences.

A bstract Objective To examine the association between adverse childhood experiences (ACEs), by multiple types and counts of ACEs, and challenges to school success. Methods A cross-sectional study was conducted using data from the 2016 National Survey of Children's Health using the ACE module and 3 measures of challenges to school success: lack of school engagement, school absenteeism, and repeated grade. Results In multivariable analysis adjusting for selected demographic and other characteristics, children with 4 or more ACEs had higher odds of nonengagement in school (adjusted odds ratio [aOR] 2.15; 95% confidence interval [CI], 1.51–3.07), reported school absenteeism (aOR 1.75; 95% CI, 1.12–2.73), and of repeating a grade (aOR 1.71; 95% CI, 1.19–2.47, Table 4) than children with exposure to less than 4 ACEs. Risk factors for all 3 challenges to school success included age of child and special health care needs, with older children and children with special health care needs more likely to have challenges to school success, across all 3 measures. Conclusions Our findings confirm that ACEs can have an impact in childhood and adolescence, not just later in adulthood, as demonstrated by the association between ACEs and measures of school success. These findings further illuminate the connection between ACEs and childhood outcomes of education and health. Future research should examine frameworks that effectively support collaboration between educators, social service providers, and pediatricians as they seek to prevent or reduce the impact of ACEs and other childhood trauma.
Continued Play Following Sport-Related Concussion in United States Youth Soccer

Medical guidelines and legislation in the US call for immediate removal from play and prohibit continued play on the same day if a concussion is suspected. However, there is limited literature examining whether these guidelines and laws are being followed in youth soccer. The purpose of this study was to identify the frequency at which youth soccer players continued play on the same day following sport-related concussion and factors that may be associated with this behavior. A retrospective review of youth soccer players diagnosed at the initial clinic visit with a sport-related concussion was performed. Participants were categorized into groups, those who continued play on the same day as their concussion (PLAY) and those who did not (NO PLAY). Records were reviewed for demographics, injury characteristics, SCAT3™ symptoms, mBESS and ImPACT® results, symptom resolution and return to play protocol initiation. Fifty-eight girls (mean age: 14 years, range: 7-18 years) and 29 boys (mean age: 14.4 years, range: 6-18 years) participated in this study. Thirty of 58 girls (51.7%) continued play the same day compared to only 5 of 29 boys (17.2%; p=0.002). The odds of continued play in girls were 5 times as high as the odds of continued play in boys (OR=5.05; 95% CI, 1.59-19.3). Overall, 35 (40.2%) soccer players continued play on the same day following a concussion. In conclusion, approximately 40% of youth soccer players continued play on the same day as their concussion. Girl soccer players demonstrated a significantly higher frequency of continued play than boys.
113 Implications for health equity and lessons learned from a community-engaged modified delphi process and nominal group technique

Statement of Purpose Achieving injury-related health equity requires community-informed research and close collaboration among diverse (in lived experience, education, geography, etc.) stakeholders. Differing priorities, knowledge, and communication styles can inhibit participation in the consensus-building process, inhibiting the progress of research and development of successful interventions. Standardized, evidence-based procedures are needed to achieve consensus among diverse groups of stakeholders. Methods/Approach We use a novel, rigorous process involving a combined Delphi process and Nominal Group Technique (NGT) to describe the development of recommendations for the pre-hospital care of the spine-injured athlete as a framework for achieving consensus among a group of stakeholders and community members. We outline our process and discuss lessons learned and implications for health equity. Results We used an online modified Delphi process to achieve consensus on the research questions of priority to stakeholders. After conducting an independent systematic review, we presented our findings at an in-person meeting for twenty stakeholders. We used NGT to develop and agree upon protocol recommendations. Throughout this process, we learned several lessons. Most crucial to the success of the in-person NGT process is a reputable, experienced facilitator capable of managing complex group dynamics and adhering to agreed-upon rules of engagement. Clarification of research jargon and transparency throughout the research process engages stakeholders of all levels of experiences. Finally, innovative uses of technology may expedite the otherwise cumbersome process of providing opinions and voting to achieve consensus. Conclusions While many researchers appreciate the value of community and stakeholder input towards the achievement of injury-related health equity, concern about managing and facilitating this process may limit its efficiency, inhibiting stakeholder investment in the research process. Significance and Contributions to Injury and Violence Prevention Science Developing and implementing a well-informed, evidence-based protocol for achieving consensus may facilitate community-engaged research aimed to achieve injury-related health equity.
Bleeding and Thrombotic Risk in Low Dose Heparin Infusion as Compared to Standard Dose Heparin Infusion.

Intravenous unfractionated heparin (UFH) remains one of the most commonly used anticoagulants in the hospital setting. The optimal protocol for initiation and maintenance of UFH has been difficult to determine. Over the past two decades, weight-based nomogram protocols have gained favor. Herein, we present a retrospective study of 377 patients at a single tertiary academic center treated with low intensity (LI) and standard intensity (SI) UFH protocols for therapeutic anticoagulation. UFH levels are measured by anti-Xa assay activity with therapeutic levels of 0.30 to 0.70 IU/mL for SI and 0.25 to 0.35 IU/mL for LI. Patients treated on the LI protocol were more likely to have had a previous history of bleeding and lower baseline hemoglobin. Incidence of new or worsening thrombus while on UFH was comparable between both protocols (odds ratio (OR) 0.93, 95% confidence interval (CI) 0.29-2.98, p=0.899). Patients on LI protocol had higher incidence of bleeding while on UFH (OR 1.21, 95% CI 0.51-2.89, p=0.667). Our study thus suggests that the LI protocol may have comparable efficacy to the SI protocol in treating venous thromboembolism (VTE) and that target anti-Xa levels of 0.25 to 0.35 IU/mL may be more optimal in high-risk patients.
Origin of Aneuploidy and Strategies Underlying Clinical Application of Preimplantation Genetic Testing for Chromosomal Disorders (PGT-A and PGT-SR)

This chapter focuses on mechanism and origin of aneuploidies and structural rearrangements, contributing to their PGT strategies. This is based on the author’s 30 years PGT experience, from polar body testing and FISH analysis to embryos biopsy, involving removal of 5–10 blastocyst cells, analyzed initially by array CGH, and then by next-generation sequencing (NGS), a standard methodology at the present time. Analysis of chromosome error dynamics from polar bodies to blastocyst provides the unique information on biological and clinical significance of the detected chromosomal instability, with special emphasis on mosaicism and sub-chromosomal variations’ impact on embryos’ developmental competence.
TOR mediates the autophagy response to altered nucleotide homeostasis in an RNase mutant

The Arabidopsis thaliana T2 family endoribonuclease RNS2 localizes to the vacuole and functions in rRNA degradation. Loss of RNS2 activity impairs rRNA turnover and leads to constitutive autophagy, a process for degradation of cellular components. Autophagy is normally activated during environmental stress and is important for stress tolerance and homeostasis. Here we show that restoration of cytosolic purine nucleotide levels rescues the constitutive autophagy phenotype of rns2-2 seedlings, whereas inhibition of purine synthesis induces autophagy in wild-type seedlings. rns2-2 seedlings have reduced activity of the target of rapamycin (TOR) kinase complex, a negative regulator of autophagy, and this phenotype is rescued by addition of inosine to increase purine levels. Activation of TOR in rns2-2 by exogenous auxin blocks the enhanced autophagy, indicating a possible involvement of the TOR signaling pathway in the activation of autophagy in the rns2-2 mutant. Our data suggest a model in which loss of rRNA degradation in rns2-2 leads to a reduction in cytoplasmic nucleotide concentrations, which in turn inhibits TOR activity, leading to activation of autophagy to restore homeostasis.
Evaluation of an Enteral Clonidine Taper following Prolonged Dexmedetomidine Exposure in Critically Ill Children

The aim of the current study is to evaluate the use of an enteral clonidine transition for the prevention or management of dexmedetomidine withdrawal symptoms in critically ill children not exposed to other continuous infusion sedative agents. A retrospective, single-center study was conducted in patients ≤ 18 years of age admitted to the pediatric intensive care unit who received a continuous infusion of dexmedetomidine for ≥ 24 hours and who were prescribed enteral clonidine within 72 hours of dexmedetomidine discontinuation. Predefined withdrawal terminology was established to assess for hypertension, tachycardia, agitation, tremors, and decreased sleep. A total of 105 patients were included and received enteral clonidine for prevention or management of dexmedetomidine withdrawal symptoms, with 13 patients (12.4%) requiring a taper modification to manage withdrawal symptoms. The median duration of dexmedetomidine infusion was 120.5 hours (95.5, 143.5) and median peak infusion rate was 1 µg/kg/h (1, 1.2). A higher cumulative dexmedetomidine dose of 119.2 µg/kg (96.6, 154.9) and duration of 142.9 hours (122.6, 158.3) were noted in patients who required a taper modification. Risk factors for dexmedetomidine withdrawal such as dexmedetomidine duration and cumulative dose may help predict patients at the highest risk of withdrawal that would benefit from an enteral clonidine taper to prevent dexmedetomidine withdrawal symptoms. An enteral clonidine taper can be effective in the prevention and management of dexmedetomidine withdrawal symptoms.
TransKV: A Networking Support for Transaction Processing in Distributed Key-value Stores

Through the massive use of mobile devices, data clouds, and the rise of Internet of Things, enormous amount of data has been generated and analyzed for the benefit of society. NoSQL Databases and specially key-value stores become the backbone in managing these large amounts of data. Most of key-value stores ignore transactions due to their effect on degrading key-value store’s performance. Meanwhile, programmable switches with the software-defined networks and the Programming Protocol-Independent Packet Processor (P4) lead to a programmable network where in-network computation can help accelerating the performance of applications. In this paper, we proposed a networking support for transaction processing in distributed key-value stores. Our system leverages the programmable switch to act as a transaction coordinator. Using a variation of the time stamp ordering concurrency control approach, the programmable switch can decide to proceed in transaction processing or abort the transaction directly from the network. Our experimental results on an initial prototype show that our proposed approach, while supporting transactions, improves the throughput by up to 4X and reduces the latency by 35% when compared to the existing architectures.
How to Code a Million Missions: Developing Bespoke Nonprofit Activity Codes Using Machine Learning Algorithms

National Taxonomy of Exempt Entities (NTEE) codes have become the primary classifier of nonprofit missions since they were developed in the mid-1980s in response to growing demands for a taxonomy of nonprofit activities (Herman in Nonprofit and Voluntary Sector Quarterly 19(3):293–306, 1990, Barman in Social Science History 37:103–141, 2013). However, the increasingly complex nature of nonprofits means that NTEE codes may be outdated or lack specificity. As an alternative, scholars and practitioners can create a bespoke taxonomy for a specific purpose by hand-coding a training dataset and using machine learning classifiers to apply the codes to a large population. This paper presents a framework for determining training set sizes needed to scale custom taxonomies using machine learning algorithms.
Anti-Media Discourse and Violence Against Journalists: Evidence From Chávez’s Venezuela:

Can political leaders’ anti-media rhetoric increase journalists’ vulnerability to non-state violence? Despite the abundance of anecdotal evidence, research on whether and how politicians’ verbal at...
Retinoid Status Controls the Appearance of Reserve Cells and Keratin Expression in Mouse Cervical Epithelium

We describe an animal model to induce the histogenesis of squamous metaplasia of the cervical columnar epithelium, a condition usually preceding cervical neoplasia. This model is based on dietary retinoid depletion in female mice. Control sibling mice fed the same diet but with all-trans-retinoic acid (at 3 micrograms/g diet) showed the normal endocervical epithelial and glandular columnar morphology, typical of a simple epithelium without subcolumnar reserve cells. The stratified squamous ectocervical epithelium of these mice fed all-trans retinoic acid showed intense immunohistochemical staining in basal and suprabasal cells with mono-specific antibodies against keratins K5, K14, K6, K13, and, suprabasally, with antibodies specific for K1 and K10. At the squamocolumnar junction, the adjacent columnar epithelium (termed "suprajunctional") did not show staining for K5, K14, K6, K13, K1, and K10 but specifically stained for keratin K8, typical of simple epithelia and absent from the adjacent ectocervical squamous stratified lining (termed "subjunctional"), in striking contrast. Sections of the squamocolumnar junction from mice kept on the vitamin A-deficient diet for 10 weeks showed suprajunctional isolated patches of reserve cells, proximal and distal to the junction. These cells were detected prior to any symptoms of vitamin A deficiency, such as loss of body weight or respiratory discomfort. The subcolumnar reserve cells induced by vitamin A deficiency displayed positive staining for K5 and K14. As deficiency became severe, the reserve cells occupied the entirety of the suprajunctional basement membrane. This epithelium eventually became stratified and squamous metaplastic, the squamocolumnar junction was no longer discernible, and the entire endocervical epithelium and the endometrial glands lost K8 positivity, while acquiring K5, K14, K6, K13, K1, and K10 keratins typical of the ectocervix under normal conditions of vitamin A nutriture. Vitamin A deficiency also altered keratin expression and localization in squamous subjunctional epithelium. In situ hybridization studies for K1 and K5 mRNA showed their major site of expression at the basal (K5) and immediately suprabasal (K1) cell layers. The localization of both K5 and K1 proteins in these same cell layers, and above, is consistent with transcriptional regulation of these keratins. Early vitamin A deficiency caused the appearance of single subcolumnar reserve cells expressing K5 mRNA. After these cells grew into a squamous focus, K1 mRNA became expressed suprabasally. We conclude that retinoid status plays a key role in maintaining differentiative characteristics of the cervical and glandular epithelia and, as such, may be a modulating factor in the development of cervical cancer.
Hydroxyproline in the major capsid protein VP1 of polyomavirus.

Amino acid analysis of (/sup 3/H)proline-labeled polyomavirus major capsid protein VP1 by two-dimensional paper chromatography of the acid-hydrolyzed protein revealed the presence of /sup 3/H-labeled hydroxyproline. Addition of the proline analog L-azetidine-2-carboxylic acid to infected mouse kidney cell cultures prevented or greatly reduced hydroxylation of proline in VP1. Immunofluorescence analysis performed on infected cells over a time course of analog addition revealed that virus proteins were synthesized but that transport from the cytoplasm to the nucleus was impeded. A reduction in the assembly of progeny virions demonstrated by CsCl gradient purification of virus from (/sup 35/S)methionine-labeled infected cell cultures was found to correlate with the time of analog addition. These results suggest that incorporation of this proline analog into VP1, accompanied by reduction of the hydroxyproline content of the protein, influences the amount of virus progeny produced by affecting transport of VP1 to the cell nucleus for assembly into virus particles.
Governing Algorithms: A Provocation Piece

Algorithms have developed into somewhat of a modern myth. They “compet[e] for our living rooms” (Slavin 2011), “determine how a billion plus people get where they’re going” (McGee 2011), “have already written symphonies as moving as those composed by Beethoven” (Steiner 2012), and “free us from sorting through multitudes of irrelevant results” (Spring 2011). Nevertheless, the nature and implications of such orderings are far from clear. What exactly is it that algorithms “do”? What is the role attributed to “algorithms” in these arguments? How can we turn the “problem of algorithms” into an object of productive inquiry? This paper sets out to trouble the coherence of the algorithm as an analytical category and explores its recent rise in scholarship, policy, and practice through a series of provocations.