cssi/SciSciGPT-SciSciNet huggingface dataset:
Persistent Challenges in Pediatric Pulmonary Hypertension

Pulmonary hypertension and related pulmonary vascular diseases cause significant morbidities and high mortality and present many unique challenges toward improving outcomes in neonates, infants, and children. Differences between pediatric and adult disease are reflected in controversies regarding etiologies, classification, epidemiology, diagnostic evaluations, and therapeutic interventions. This brief review highlights several key topics reflecting recent advances in the field and identifies persistent gaps in our understanding of clinical pediatric pulmonary hypertension.
Effect of endotoxin on phosphoenolpyruvate carboxykinase activity in mouse liver.

SummaryInjection of mice with a lethal dose of endotoxin caused an initial increase in liver phosphoenolpyruvate carboxykinase (PEPCK) activity. This increase was not observed in animals tolerant to endotoxin. A significant decrease in enzyme activity was observed 16 hr after injection, and cortisone did not prevent the fall in activity observed. The decrease in enzyme activity obtained in mice 16 hr after injection with endotoxin was not observed in tolerant mice injected with endotoxin.
PHYLOGENETIC RELATIONSHIPS OF CRUSTACEANS WITH FOLIACEOUS LIMBS: AN 18S rDNA STUDY OF BRANCHIOPODA, CEPHALOCARIDA, AND PHYLLOCARIDA

ABSTRACT Sequence data for the small-subunit, 18S ribosomal-DNA gene (1,800+ nucleotides), representing 10 crustaceans (three branchiopods, a cephalocarid, a phyllocarid, a hoplocarid, a syncarid, a eucarid, and two copepods) and three arthropod outgroups (Chelicerata, Insecta, Myriapoda), were analyzed by maximum parsimony and neighbor-joining methods of phylogenetic inference as a test of several competing hypotheses about relationships among crustaceans possessing foliaceous limbs (e.g., branchiopods, cephalocarids, and phyllocarids). Results strongly support three clades among the crustacean ingroup: a branchiopod clade, a (cephalocarid + copepod) clade, and a malacostracan clade that includes the phyllocarid leptostracan Nebalia sp. as a basal lineage. Relationships among these 3 clades remain unclear. The (cephalocarid + copepod) relationship, although strongly supported (bootstrap proportion = 93) in this analysis, is suspect because of a highly divergent sequence and a very long branch for the cephalocarid Hutchinsoniella macracantha. There is little doubt, however, that the presence of foliaccous limbs does not define a monophyletic clade comprising branchiopods, cephalocarids, and phyllocarids. This limb morphology may be a symplesiomorphic feature of the Crustacea, but it appears likely that it has had multiple origins.
Code of ethics is the foundation of combating corruption

Constructing the defense line of ethics in thought,politics,and action is the important foundation of combating corruption.In constructing the defense line of morals,we should not only take the "rule by law" seriously but also the " rule by ethics".We should not neglect the function of education and we have to continue to complete ideological education work.
Synchronous Data Flow Modeling for DMIs.

This paper proposes a graph-theoretic model that supports the design and analysis of data flow within digital musical instruments (DMIs). The state of the art in DMI design does not provide standards for the scheduling of computations within a DMI’s data flow. Without a theoretical framework, analysis of different scheduling protocols and their impact on the DMI’s performance is extremely difficult. As a result, the mapping between the DMI’s sensory inputs and sonic outputs is classically treated as a black box. DMI builders are forced to design and schedule the flow of data through this black box on their own. Improper design of the data flow can produce undesirable results, ranging from overflowing buffers that cause system crashes to misaligned sensory data that result in strange or disordered sonic events. In this paper, we attempt to remedy this problem by providing a framework for the design and analysis of the DMI data flow closely modeled after a framework for digital signal processing. We also propose the use of a scheduling algorithm built upon that framework, and prove that it guarantees desirable properties for the resulting DMI.
Regulation of mitogenesis by kinins in arterial smooth muscle cells

Recent evidence suggests that bradykinin (BK) plays a role in regulating neointimal formation after vascular injury. The present study examined the mechanism whereby BK regulates platelet-derived g...
Effect of heparin on the inactivation rate of human factor XIa by antithrombin-III

Factor XIa catalyzes an important reaction in the early phase of blood coagulation by converting factor IX to an active enzyme (factor IXa). Although antithrombin-III, an inhibitor of factor XIa, normally accounts for only one-sixth of the plasma inhibitory activity against factor XIa, its effectiveness has been reported to be enhanced by heparin. We have reinvestigated the ability of heparin to potentiate factor XIa inhibition by both purified antithrombin-III and plasma using synthetic tripeptide amide substrates as well as a coagulant assay. No increase in the inactivation rate of factor XIa amidolytic activity by purified antithrombin-III was observed in the presence of therapeutic heparin concentrations (1 U/ml), although inhibition of the amidolytic activity of thrombin by purified antithrombin-III was enhanced at least 20-fold by the same concentration of heparin. Furthermore, despite the ability of heparin (1 U/ml) to increase the inactivation rate of thrombin by plasma, no acceleration of the rate of inhibition of factor XIa by plasma was observed. Similar results were found when the inhibition of factor XIa was monitored with a coagulant assay after first removing the heparin. Only at heparin concentrations of 5 and 10 U/ml, was a 2- and 4-fold increase in the inactivation rate of factor XIa by purified antithrombin III observed. Therefore, in both purified systems as well as plasma, heparin, at concentrations observed in clinical practice, does not accelerate the inactivation rate of human factor XIa by antithrombin-III.
"Lions - Marchuk": The Soviet-French Cooperation in Computing

This paper looks to break with common assumptions of the underdevelopment and isolation of the Soviet computing by studying the history of the Soviet-French cooperation in computer science under the bilateral agreement of 1966. The achievements of this cooperation were largely due to the singular relations between French and Soviet mathematicians, J-L Lions and G. I. Marchuk. Although neither Marchuk nor Lions are computer scientists, properly speaking, they played crucial roles in promoting the use of computers as scientific instruments and in creating the administrative basis for the development of computer science. This work aims to present a trans-national history of computing and the networks, which existed between Soviet and Western computer scientists at the nexus of science and politics.
Perceived Benefits and Barriers to the Diabetes Prevention Program

Objective: Diabetes prevention interventions have a proven positive effect on health outcomes. The goal of this project is to understand the factors that motivate and deter people with prediabetes from utilizing evidence-based education programs, such as the Diabetes Prevention Program (DPP). Research Design and Methods: Formative research was conducted among program facilitators, health providers who care for diabetes patients, and patients living with prediabetes to generate an in-depth understanding of perceptions of the program. The methodology included a mixed methods approach. A total of 97 interviews and 5 focus groups were conducted with health providers, program facilitators, and patients. An online survey was administered to 50 patients with prediabetes. Results: All three populations agreed the DPP aided in implementing lifestyle changes and preventing the onset of type 2 diabetes, and the classes provided a positive experience for support, in-depth discussion, and opportunities for learning how to make lifestyle changes. However, while the overall benefits of the program were expressed, there were barriers noted by all populations that affect program utilization and physician referrals. General lack of knowledge, cost of the program, and the significant time commitment necessary to complete the program were barriers discussed. Conclusions: The Diabetes Prevention Program is successful in helping individuals with prediabetes make positive lifestyle changes. The lack of knowledge about the program, however, is a deterrent for utilization. Creation of a social marketing campaign based on the findings from this research will aim to increase healthcare provider referrals to the DPP.
Introduction: The Quality Agenda in Behavioral Health

Behavioral health services have historically accounted for a small percentage of overall healthcare costs—usually around 5 %, with psychotropic medications accounting for the majority of this spending (Cummings, O’Donohue, & Cummings, 2011). While this historically low utilization of behavioral health services may be attributed to multiple factors (e.g., fragmented care, stigma, problematic accessibility), recent healthcare reform in the USA has placed behavioral health in a more central role. Thus, one would generally expect an increased demand for behavioral health services, provided that these are of the right kind and quality.
Wearable System for Obstacle Detection and Human Assistance Using Ultrasonic Sensor Array

Any system which is associated with human assistance needs to be portable, user-friendly and simple in structure. In a navigation system specially built to provide a walking assistance for visually impaired people, it is needed to map the surrounding in terms of a number of obstacles in the path of the person. In this paper, we are going to present a system which is wearable, portable and capable of detecting obstacles from surrounding. The system used ultrasonic sensors which provided a chirp signal. These signals were then processed by NI myRIO1900 which is a Reconfigurable Input-Output device. The programming was done using LabVIEW. The obstacle was mapped in terms of its distance from the user. This mapping was shown as a 2D image with a grayscale and also a 3D pattern which showed all possible projections of obstacles from the front plane.
Assessing the Influence of Upper-Tropospheric Troughs on Tropical Cyclone Intensification Rates after Genesis

AbstractThe role of upper-tropospheric troughs on the intensification rate of newly formed tropical cyclones (TCs) is analyzed. This study focuses on TCs forming in the presence of upper-tropospheric troughs in the North Atlantic basin between 1980 and 2014. TCs were binned into three groups based upon the 24-h intensification rate starting at the time of genesis: rapid TC genesis (RTCG), slow TC genesis (STCG), and neutral TC genesis (NTCG). Composite analysis shows RTCG events are characterized by amplified upper-tropospheric flow with the largest upshear displacement between the TC and trough of the three groups. RTCG events are associated with greater quasigeostrophic (QG) ascent in upshear quadrants of the TC, forced by differential vorticity advection by the thermal wind, especially around the time of genesis. This pattern of QG ascent closely matches the RTCG composite of infrared brightness temperatures.Conversely, NTCG events are associated with an upper-tropospheric trough that is closest to the...
Examining the Impact of a Web-Based Intervention to Promote Patient Activation in Chemotherapy-Induced Peripheral Neuropathy Assessment and Management

Lack of activation in self-care can compromise a patient’s ability to monitor and manage cancer treatment-related side effects, such as chemotherapy-induced peripheral neuropathy (CIPN). The web-based Carevive® Care Planning System (CPS) was developed to promote evidence-based symptom assessment and treatment by enhancing patients’ involvement in their own care. The purpose of this single-arm, pre-test/post-test, prospective study was to examine whether the CPS can promote patient activation in CIPN symptom assessment and management. Seventy-five women with breast cancer receiving neurotoxic chemotherapy were recruited from a Comprehensive Cancer Center. Using standardized neuropathy measures embedded within the CPS, patients reported their CIPN symptoms over three consecutive clinical visits and completed the Patient Activation Measure (PAM) at the first and third visits. Mean changes in PAM scores between visits were compared using repeated measure analysis of covariance, adjusting for age. At baseline, patients were diagnosed with cancer within the past year (94.7%), highly activated (85% Level III/IV), and had a mean age of 51.3. PAM scores improved significantly from 67.15 (SD = 13.5; range = 47–100) at visit one to 69.29 (SD = 16.18; range = 47–100) (p = 0.02) (n = 62) at visit three. However, patients perceived the CPS to be of minimal value because it solely focused on CIPN and, for many, CIPN was not severe enough to motivate them to seek out symptom management information. Further research is needed to assess the utility of the CPS in promoting activation in the assessment and management of varying cancer treatment-related symptoms.
Immediate revascularization for cardiogenic shock after MI reduced 6-month mortality

Source Citation Hochman JS, Sleeper LA, Webb JG, et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should We Emergently Revascular...
A study of single-sided HPC communication paradigm using Chameleon bare-metal cluster

This paper reports an organized suite of experiments comparing a parallel matrix program in performance and reliability using a single-sided statistic multiplexed computing framework against MPI based on end-to-end computing framework.
Highly Effective Broad Spectrum Chimeric Larvicide That Targets Vector Mosquitoes Using a Lipophilic Protein

Two mosquitocidal bacteria, Bacillus thuringiensis subsp. israelensis (Bti) and Lysinibacillus sphaericus (Ls) are the active ingredients of commercial larvicides used widely to control vector mosquitoes. Bti's efficacy is due to synergistic interactions among four proteins, Cry4Aa, Cry4Ba, Cry11Aa, and Cyt1Aa, whereas Ls's activity is caused by Bin, a heterodimer consisting of BinA, the toxin, and BinB, a midgut-binding protein. Cyt1Aa is lipophilic and synergizes Bti Cry proteins by increasing midgut binding. We fused Bti's Cyt1Aa to Ls's BinA yielding a broad-spectrum chimeric protein highly mosquitocidal to important vector species including Anopheles gambiae, Culex quinquefasciatus, and Aedes aegypti, the latter an important Zika and Dengue virus vector insensitive to Ls Bin. Aside from its vector control potential, our bioassay data, in contrast to numerous other reports, provide strong evidence that BinA does not require conformational interactions with BinB or microvillar membrane lipids to bind to its intracellular target and kill mosquitoes.
Chemogenetic management of neuropathic pain.

This scientific commentary refers to ‘Using an engineered glutamate-gated chloride channel to silence sensory neurons and treat neuropathic pain at the source’, by Weir et al. (doi: 10.1093/brain/awx201 ).
Comprehensive assessment of cytochromes P450 and transporter genetics with endoxifen concentration during tamoxifen treatment

OBJECTIVES Tamoxifen bioactivation to endoxifen is mediated primarily by CYP2D6; however, considerable variability remains unexplained. Our aim was to perform a comprehensive assessment of the effect of genetic variation in tamoxifen-relevant enzymes and transporters on steady-state endoxifen concentrations. PATIENTS AND METHODS Comprehensive genotyping of CYP enzymes and transporters was performed using the iPLEX ADME PGx Pro Panel in 302 tamoxifen-treated breast cancer patients. Predicted activity phenotype for 19 enzymes and transporters were analyzed for univariate association with endoxifen concentration, and then adjusted for CYP2D6 and clinical covariates. RESULTS In univariate analysis, higher activity of CYP2C8 (regression β=0.22, P=0.020) and CYP2C9 (β=0.20, P=0.04), lower body weight (β=-0.014, P<0.0001), and endoxifen measurement during winter (each β<-0.39, P=0.002) were associated with higher endoxifen concentrations. After adjustment for the CYP2D6 diplotype, weight, and season, CYP2C9 remained significantly associated with higher concentrations (P=0.02), but only increased the overall model R by 1.3%. CONCLUSION Our results further support a minor contribution of CYP2C9 genetic variability toward steady-state endoxifen concentrations. Integration of clinician and genetic variables into individualized tamoxifen dosing algorithms would marginally improve their accuracy and potentially enhance tamoxifen treatment outcomes.
The anatomy of a budget recommendation

How analysts make recommendations to the budget director and governor depends partly on the nature of the state budget office (SBO). This paper contrasts the development of a budget recommendation in an office with a strong policy orientation with recommendations fashioned in an office with a strong control orientation. One important difference is that control oriented analysts focus almost exclusively on the technical and legal facets of budget problems, whereas their policy oriented counterparts spend considerable time on the social, legal, and political (SLP) facets. The SLP framework enables the policyoriented analysts to apply economic rationality to evaluate requests and make recommendations that are consonant with the governor’s policy agenda.
Use of UML stereotypes in business models

This chapter presents some particularly useful UML stereotypes for use in business systems. Stereotypes are the core extension mechanism of UML. If you find that you need a modeling element or information extension to an element that is not in UML but it is similar to something that is, you treat your addition/extension as a stereotype. These new stereotypes are defined and the need for them is discussed. The stereotypes aid in both the design/drawing phase and in the implementation (coding) phase of the overall system construction. An example case study illustrates their usage with both design drawings and the implementation code (C++).
An Intelligent Educational Platform for Training Spatial Visualization Skills

Current research has demonstrated the crucial role of spatial visualization skills in the Science, technology, engineering, and mathematics (STEM) related fields. Given the nationwide trend of the increasing population of university engineering students, more and more effort has been invested into how to effectively train students' spatial visualization skills. In this study, we designed and developed a scalable online platform for training spatial visualization skills. Our online platform is capable of intelligent learning features such as individualized learning trajectory and personalized hints. In the current stage of the project, we deployed the online platform with over 600 university students. By analyzing student's data, we identified a key question that has most predictive power on student's spatial visualization skill. The promising result shows a bright future for an intelligent learning platform.
Cardiology consultation for non-cardiac surgery: Medical and legal explorations for clinicians.

Abstract Cardiologists performing preoperative cardiac evaluations for non-cardiac surgery have a unique opportunity to assess and optimize the patient's baseline and general health; determine the patient's inherent surgical risk based upon a comprehensive history, physical examination and pertinent laboratory data; ensure the patient has made an informed choice regarding surgery, and identify post-operative risks that must be considered to reduce the potential for major adverse cardiovascular events. There is always a small but inherent risk in surgical procedures. When an adverse outcome occurs there is potential for an allegation of negligence resulting in a detailed autopsy of the medical record. The best defense to an allegation of negligence is comprehensive documentation and a detailed rational for the cardiologist's management decisions.
Posterior Urethral Valves and Ureterovesical Junction Obstruction

Primary aims in the diagnosis and management of posterior urethral valves (PUV): 1. To prevent acquired renal damage. 2. To improve bladder function.
Embeddings of Twin Trees

In this article we provide sufficient conditions for when a pair of trees having a semi-codistance function δ can be embedded in a twin tree with codistance function extending δ. We use these conditions to show that given a twin tree T of bidegree (d1,d2) there exists a twin tree of bidegree (e1,e2) containing T as a substructure as long as di≤ ei.
Economic Perspectives on Personalized Health Care and Prevention

The objective of this paper is to provide an overview of economic evaluation of personalized medicine, focusing particularly on the use of cost-effectiveness analysis and other methods of valuation. We draw on insights from the literature and our work at the University of California, San Francisco Center for Translational and Policy Research on Personalized Medicine (TRANSPERS). We begin with a discussion of why personalized medicine is of interest and challenges to adoption, whether personalized medicine is different enough to require different evaluation approaches, and what is known about the economics of personalized medicine. We then discuss insights from TRANSPERS research and six areas for future research: Develop and Apply Multiple Methods of Assessing Value Identify Key Factors in Determining the Value of Personalized Medicine Use Real World Perspectives in Economic Analyses Consider Patient Heterogeneity and Diverse Populations in Economic Analyses Prepare for Upcoming Challenges of Assessing Value of Emerging Technologies Incorporate Behavioral Economics into Value Assessments.
A Comparison of Neuromorphic Classification Tasks

A variety of neural network models and machine learning techniques have arisen over the past decade, and their successes with image classification have been stunning. With other classification tasks, selecting and configuring a neural network solution is not straightforward. In this paper, we evaluate and compare a variety of neural network models, trained by a variety of machine learning techniques, on a variety of classification tasks. While Deep Learning typically exhibits the best classification accuracy, we note the promise of Reservoir Computing, and evolutionary optimization on spiking neural networks. In many cases, these technologies perform as well as, or better than Deep Learning, and the resulting networks are much smaller than their Deep Learning counterparts.
Strange Angels: In Flight with Elmore James

Performing artists dwell at the top of commercial music’s food chain. But less well known recording studio personnel often provide invaluable assistance for their audio success. For example, Aretha...
Frailty transitions predict healthcare use and Medicare payments in older Mexican Americans: a longitudinal cohort study

Little is known regarding the impact of transitions in frailty on healthcare use and payment in older Mexican Americans. We address this gap in knowledge by investigating the effect of early transitions in physical frailty on the use of healthcare services and Medicare payments involving older Mexican Americans. Longitudinal analyses were conducted using the Hispanic Established Populations for the Epidemiological Study of the Elderly (Hispanic-EPESE) survey data from five Southwest states linked to the Medicare claims files from the Centers for Medicare and Medicaid Services. Seven hundred and eighty-eight community-dwelling Mexican Americans 72 years and older in 2000/01 were studied. We used a modified Frailty Phenotype (unintentional weight loss, weakness, self-reported exhaustion and slow walking speed) to classify frailty status (non-frail, pre-frail or frail). Each participant was placed into one of 5 frailty transition groups: 1) remain non-frail, 2) remain pre-frail, 3) remain frail, 4) improve (pre-frail to non-frail, frail to non-frail, frail to pre-frail) and 5) worse (non-frail to pre-frail, non-frail to frail, pre-frail to frail). The outcomes for the one-year follow-up period (2000–2001) were: (a) healthcare use (hospitalization, emergency room [ER] admission and physician visit); and (b) Medicare payments (total payment and outpatient payment). Mean age was 78.8 (SD = 5.1) years and 60.3% were female in 1998/99. Males who remained pre-frail (Odds Ratio [OR] = 3.49, 1.13–10.8, remained frail OR = 6.92, 1.61–29.7) and transitioned to worse frail status (OR = 4.49, 1.74–11.6) had significantly higher hospitalization risk compared to individuals who remained non-frail. Males in the ‘worsened’ groups, and females in the ‘improved’ groups, had significantly higher Medicare payments than individuals who remained non-frail (Cost Ratio [CR] = 2.00, 1.30–3.09; CR = 1.53, 1.12–2.09, respectively]. Healthcare use and Medicare payments differed by frailty transition status. The differences varied by sex. Research is necessary to elucidate the relationship between frailty transitions and outcomes, sex difference and Medicare payment for older Mexican Americans living in the community.
Centers for Disease Control and Prevention 2019 novel coronavirus disease (COVID-19) information management: addressing national health-care and public health needs for standardized data definitions and codified vocabulary for data exchange.

OBJECTIVE: The 2019 novel coronavirus disease (COVID-19) outbreak progressed rapidly from a public health (PH) emergency of international concern (World Health Organization [WHO], 30 January 2020) to a pandemic (WHO, 11 March 2020). The declaration of a national emergency in the United States (13 March 2020) necessitated the addition and modification of terminology related to COVID-19 and development of the disease's case definition. During this period, the Centers for Disease Control and Prevention (CDC) and standard development organizations released guidance on data standards for reporting COVID-19 clinical encounters, laboratory results, cause-of-death certifications, and other surveillance processes for COVID-19 PH emergency operations. The CDC COVID-19 Information Management Repository was created to address the need for PH and health-care stakeholders at local and national levels to easily obtain access to comprehensive and up-to-date information management resources. MATERIALS AND METHODS: We introduce the clinical and health-care informatics community to the CDC COVID-19 Information Management Repository: a new, national COVID-19 information management tool. We provide a description of COVID-19 informatics resources, including data requirements for COVID-19 data reporting. RESULTS: We demonstrate the CDC COVID-19 Information Management Repository's categorization and management of critical COVID-19 informatics documentation and standards. We also describe COVID-19 data exchange standards, forms, and specifications. CONCLUSIONS: This information will be valuable to clinical and PH informaticians, epidemiologists, data analysts, standards developers and implementers, and information technology managers involved in the development of COVID-19 situational awareness and response reporting and analytics.
Shape changes and cooperativity in the folding of central domain of the 16S ribosomal RNA

Both the small and large subunits of the ribosome, the molecular machine that synthesizes proteins, are complexes of ribosomal RNAs (rRNAs) and a number of proteins. In bacteria, the small subunit has a single 16S rRNA whose folding is the first step in its assembly. The central domain of the 16S rRNA folds independently, driven either by Mg2+ ions or by interaction with ribosomal proteins. In order to provide a quantitative description of ion-induced folding of the ~350 nucleotide rRNA, we carried out extensive coarse-grained molecular simulations spanning Mg2+ concentration between 0−30 mM. The Mg2+ dependence of the radius of gyration shows that globally the rRNA folds cooperatively. Surprisingly, various structural elements order at different Mg2+ concentrations, indicative of the heterogeneous assembly even within a single domain of the rRNA. Binding of Mg2+ ions is highly specific, with successive ion condensation resulting in nucleation of tertiary structures. We also predict the Mg2+-dependent protection factors, measurable in hydroxyl radical footprinting experiments, which corroborate the specificity of Mg2+-induced folding. The simulations, which agree quantitatively with several experiments on the folding of a three-way junction, show that its folding is preceded by formation of other tertiary contacts in the central junction. Our work provides a starting point in simulating the early events in the assembly of the small subunit of the ribosome.
Development of a Decision Aid for Patients and Families Considering Hospice

Background: Hospice is underutilized. Miscommunication, decisional complexity, and misunderstanding around engaging hospice may contribute. Shared decision making (SDM), aided by patient decision aids (PtDAs), can improve knowledge and decision quality. Currently, there are no freely available hospice-specific PtDA to facilitate conversions between patients and providers about hospice care. Objective: To develop a theory-based and unbiased hospice specific PtDA. Design: Guided by the Ottawa Decision Support Framework and International Patient Decision Aid Standards, we used a theory-driven, eight-step, iterative, user-centered approach with multistakeholder input to develop a hospice-specific PtDA for anyone facing end-of-life decisions. Subjects: Feedback was obtained from a 10-member Patient Advisory Panel composed of lay patient advisors; focus groups of hospice providers, family caregivers, and patients; and the Palliative Care Research Group at University of Colorado Hospital consisting of palliative care physicians, midlevel providers, nurses, social workers, chaplains, and researchers. Results: There are many challenges in developing an unbiased hospice decision aid, including (1) balancing the provision of education (eligibility, payment) with decisional support, (2) clarifying values and incorporating emotion, (3) ideally representing the potential downsides of hospice, and (4) adequately capturing and describing care alternatives to hospice. Within this context, we developed a 12-page article and 17-minute video PtDAs. The PtDA openly acknowledges the emotional complexity of the decision and incorporates values clarification techniques to help decision makers reflect and evaluate their goals and preferences for end-of-life care. Conclusions: Hospice decision making is complex and emotional, demanding high-quality SDM aided by a formal PtDA. This work resulted in a freely available article and video PtDA for patients considering hospice. The effectiveness and implementation of these tools will be studied in future research. Clinical Trials Registration (NCT03794700 & NCT04458090).
The Potential Role of Functional Motor Competence to Promote Physical Military Readiness: A Developmental Perspective

Decreased physical fitness in military recruiting populations is problematic for the development of physical military readiness (PMR) and presents a threat to national security. The demonstration of low levels of fitness may be an indicator of a more foundational problem in the physical development of military recruits. We propose the development of functional motor competence (FMC) across childhood and adolescence as a necessary antecedent to advanced PMR training and military-specific tasks (i.e., rucking and obstacle course navigation) and as an integral part of sustained PMR. The development of FMC supports increases in cardiovascular and muscular endurance through repeated efforts performed during practice and in sport, as well as muscular power as many FMC movements mimic plyometrics in a strength in conditioning sense. We posit that an inadequate foundation in FMC will serve as a barrier to achieving sufficient PMR and combat success of the fighting force. We propose three possible solutions to ensure sufficient PMR levels through the implementation of developmentally appropriate FMC-based training. First would be promoting FMC-based training in junior reserve officer training corp and ROTC programs. Second would be a more global approach, on the scale of the National Defense Education Act, specifically focusing on promoting quality daily physical education that could reach millions of children. Third, individual branches could begin promoting the tenets of foundational FMC training concepts in their physical training manuals, which ideally would address FMC before and throughout basic training, as well as subsequent active duty training.
The Evaluation of Rating Systems in Team-based Battle Royale Games.

Online competitive games have become a mainstream entertainment platform. To create a fair and exciting experience, these games use rating systems to match players with similar skills. While there has been an increasing amount of research on improving the performance of these systems, less attention has been paid to how their performance is evaluated. In this paper, we explore the utility of several metrics for evaluating three popular rating systems on a real-world dataset of over 25,000 team battle royale matches. Our results suggest considerable differences in their evaluation patterns. Some metrics were highly impacted by the inclusion of new players. Many could not capture the real differences between certain groups of players. Among all metrics studied, normalized discounted cumulative gain (NDCG) demonstrated more reliable performance and more flexibility. It alleviated most of the challenges faced by the other metrics while adding the freedom to adjust the focus of the evaluations on different groups of players.
Benzoylcyclopropane Derivatives from Hypoxis hemerocallidea Corms

Two monobenzoylcyclopropane (hypoxhemerol A (1) and hypoxhemeroloside G (2)) and three dibenzoylcyclopropane (hypoxhemerol B (3), hypoxhemeroloside H (4), and hypoxhemeroloside I (5)) derivatives were isolated from the hydro-alcoholic extract of Hypoxis hemerocallidea corms. This is the first instance where benzoylcyclopropane analogs were isolated from any natural source. Structure elucidation was mainly based on 1D- and 2D-NMR and HRESIMS data. The absolute configuration (2R, 4R) of 1 was determined via NOESY NMR and experimental and calculated ECD data analyses. Compounds 1–5 and 11 recently reported metabolites (hypoxoside, obtuside A, interjectin, acuminoside, curcapicycloside, and hypoxhemerolosides A – F) were screened for in vitro antimicrobial activity against various bacterial and fungal strains. Curcapicycloside and acuminoside exhibited antibacterial activity against Escherichia coli with 78 and 79% inhibition at 20 µg/mL, respectively. Hypoxhemeroloside A showed mild antifungal activity against Cryptococcus neoformans with 63% inhibition at 20 µg/mL.
The effect of visual field manipulations on standing balance control in people with multiple sclerosis.

Abstract Background Multiple sclerosis (MS) is associated with an increased risk of falls, degeneration of sensory organization, and possible increased reliance on vision for balance control. Research question The aim of this study was to assess differences in standing postural control between people with MS and age and sex matched controls during medial-lateral (ML) oscillations of the visual field, with and without blinders to the lower periphery. Methods Ten persons with MS (mean age 54.0 ± 5.3 years) and ten age and sex matched controls (mean age: 56.3 ± 6.0 years) participated in this study. Balance control was assessed while participants stood in a Christie Cave system while wearing stereoscopic glasses that projected an immersive forest scene. Visual conditions consisted of 2 m ML visual oscillations of the scene at five frequencies (0.0, 0.3, 0.6, 0.7 and 0.8 Hz) with and without blinders to block the lower periphery. Results and significance The results demonstrated that, in comparison to controls, participants with MS had a significantly larger center of pressure sway in both the ML and AP direction to ML visual oscillations. Additionally, participants with MS and controls both increased center of pressure frequency content to the visual oscillation frequency, while participants with MS also increased relative power at the visual oscillation frequency in the AP direction. Blinders of lower periphery reduced the percent power at the visual oscillation frequency in both groups and reduced overall sway in participants with MS during visual oscillations. Overall, results indicate that postural balance is sensitive to visual feedback in people with MS. The elicited AP sway to ML visual oscillation could reflect errors in visual processing for the control of balance, and decreased sway in response to blocking vision of the lower peripheral field could indicate an increased reliance on visual cues to maintain balance.
Strategic Communications: Communicating Internally and Externally

Over the course of both official and unofficial (Track II) negotiations, one of the most critical points of controversy has been the articulation, or lack of, regarding the desired end goal. This is true with respect to both overarching strategic negotiations and tactical implementation negotiations whose purpose was to resolve on-the-ground issues. The challenges are relevant to communicating with different audiences and publics. One of the most challenging aspects of the negotiating process—whether strategic or tactical—was recognizing the seminal importance of communication. To address this issue, this chapter is divided into the following sections: 1. Introduction; 2. National Leadership; 3. Drafters–Implementers Communication; and 4. Final Thoughts.
Polarization fatigue in perovskite ferroelectric ceramics and thin-films

The ferroelectric polarization fatigue (loss of polarization with cycling) of donor- and acceptor-doped BaTiO/sub 3/ ceramics and PZT (lead zirconate titanate) thin films have been investigated. Donor-doped BaTiO/sub 3/ ceramics showed significantly improved fatigue characteristics compared with acceptor-doped materials. Enhanced fatigue properties were also observed in donor-doped PZT thin films. The electric-field-assisted migration of charged species within ferroelectric materials may be responsible for the degradation/fatigue behavior. The results obtained confirm the expectation that oxygen vacancies play an important role in degradation/fatigue under electric switching. >
Optic Pathway Glioma

There is perhaps no other tumor of the eye or orbit whose treatment evokes as much controversy as that of the optic glioma. The reader is left thinking of a group of blind men describing an elephant while each touching a different part of the animal. Different specialists’ preferred options range from no treatment, through partial excision, complete excision and radiation therapy to surgery plus radiotherapy, and now also include chemotherapy. The treatment selected is a direct reflection of the anatomical site of involvement, the symptoms and signs, the age of the patient, and the consequences of surgical extirpation of the lesion and of irradiation.
Inhibition of Protein Synthesis in L Cells Infected with Vesicular Stomatitis Virus

The inhibition of protein synthesis in L cells by vesicular stomatitis virus (VSV) requires the synthesis of new protein subsequent to virus infection. However, two mechanisms may be involved in the inhibition of cell protein synthesis by VSV: an initial, multiplicity-dependent, ultraviolet-insensitive inhibition and a progressive, ultraviolet-sensitive inhibition.
Creditors' Ball: The 'New' New Corporate Governance InChapter 11

In the 1980s and early 1990s, many observers believed that the American corporate bankruptcy laws were desperately inefficient. The managers of the debtor stayed in control as "debtor in possession" after filing for bankruptcy, and they had the exclusive right to propose a reorganization plan for at least the first four months of the case, and often far longer. The result was lengthy cases, deteriorating value and numerous academic proposals to replace Chapter 11 with an alternative regime. In the early years of the new millennium, bankruptcy could not look more different. Cases proceed much more quickly, and they are much more likely to result in auctions or other sales of assets than in previous decades. This transformation is due in part to a change in the major corporations that file for bankruptcy. Rather than industrial, bricks-and-mortar firms, many of the new debtors are knowledge-based firms with transient assets. Much more important, however, has been the adjustments creditors have made in an effort to reassert control in bankruptcy. In this Article, I focus on the two most important contractual developments: lenders' use of debtor-in-possession financing agreements as a governance lever; and the so-called pay-to-stay arrangements which give key managers bonuses for meeting specified performance goals (such as quick emergence from bankruptcy or the sale of important assets). Both of these developments can be seen as adjustments by creditors to counteract bankruptcy's interference with the shift in control rights that would ordinarily occur at the time of financial distress. As I have discussed elsewhere, chapter 11 functioned somewhat like an antitakeover device in the 1980s. Creditors have now neutralized its effects. Of the two new contractual approaches, pay-to-stay agreements have proven much more controversial, prompting heated complaints about excessive managerial pay in cases like Enron, Polaroid and Kmart. The controversy is similar in obvious respects to the recent complaints about performance-based pay outside of bankruptcy. I argue that pay-to-stay agreements are more defensible, but also argue that bankruptcy compensation should be constrained in several ways. Although the use of DIP financing agreements to shape bankruptcy cases has not received nearly so much attention, the effect is even more profound. I argue that the use of these agreements to control Chapter 11 cases is, on the whole, a beneficial development. But I also argue that some of their terms - such as provisions protecting pre-petition loans by the DIP lenders and the use of DIP agreements to lock up control - should be subject to careful judicial scrutiny.
Prevention of Nonimmunologic Loss of Transplanted Islets in Monkeys

The nonimmunologic loss of islets in the pre-, peri-, and early post-islet transplant periods is profound. To determine the potential role that transplantation of only a marginal mass of functioning beta cells may play in triggering late nonimmunologic graft loss, we studied the effect of treatment with alpha-1-antitrypsin (AAT) in the autologous cynomolgus islet transplant model. A marginal mass of autologous islets, that is islets prepared from 70% to 80% of the pancreas, was transplanted at 1600–4100 IEQ/kg into subtotal pancreatectomized, streptozotocin-treated and insulin-deficient diabetic hosts. In this marginal mass islet transplant model, islet function is insidiously lost over time and diabetes recurs in all untreated monkeys by 180 days posttransplantation. Short-term treatment with AAT, an acute phase reactant, in the peri-transplant period serves to terminate inflammation through effects upon expression of TGFβ, NFκB and AKT and favorably altering expression of cell death and survival pathways, as detected by a system biology approach and histology. These effects enabled functional expansion of the islet mass in transplanted hosts such that graft function improves rather than deteriorating over time.
Temperature dependence of sex-factor maintenance in Escherichia coli K-12.

Abstract Wild-type sex factors of Escherichia coli K-12 can be cured from host cells by growth at temperatures above 42 C. This phenomenon is obscured by reinfection of cured cells if the culture is allowed to reach cell densities above 105/ml. The rate of episome loss is dependent on the genetic (chromosomal) background of the host.
Consent of the Governed in the Hebrew Bible

This article analyzes the concept of consent of the governed in the Hebrew Bible with special reference to the covenant on Mount Sinai. The author recognizes consent as a source of legitimate authority and deals in a sophisticated way with problems that have troubled later consent theories: whether parties actually consent; whether consent is voluntary; the information needed for informed consent; the issue of framing the issue so as to present the subjects with fair options; the problem of dissent; the impact of a social compact on non-participants and future generations; and the question of whether the compact is conditional or absolute. A remarkable feature of the Sinai episode is its similarity to the original position in Rawls’ Theory of Justice: the Israelites in the wilderness at Sinai, like Rawlsian subjects behind the veil of ignorance, make fundamental choices while shielded from knowledge as to their future positions or endowments.
Neurobiology of Maternal Stress: Role of Social Rank and Central Oxytocin in Hypothalamic-Pituitary Adrenal Axis Modulation.

Background: Chronic stress may conceivably require plasticity of maternal physiology and behavior to cope with the conflicting primary demands of infant rearing and foraging for food. In addition, social rank may play a pivotal role in mandating divergent homeostatic adaptations in cohesive social groups. We examined cerebrospinal fluid (CSF) oxytocin (OT) levels and hypothalamic pituitary adrenal (HPA) axis regulation in the context of maternal social stress and assessed the contribution of social rank to dyadic-distance as reflective of distraction from normative maternal-infant interaction. Methods: Twelve socially-housed mother-infant bonnet macaque dyads were studied after variable foraging demand (VFD) exposure compared to 11 unstressed dyads. Dyadic-distance was determined by behavioral observation. Social ranking was performed blindly by two observers. Post-VFD maternal plasma cortisol and CSF OT were compared to corresponding measures in non-VFD exposed mothers. Results: High social rank was associated with increased dyadic-distance only in VFD-exposed dyads and not in control dyads. In mothers unexposed to VFD, social rank was not related to maternal cortisol levels whereas VFD-exposed dominant versus subordinate mothers exhibited increased plasma cortisol. Maternal CSF OT directly predicted maternal cortisol only in VFD-exposed mothers. CSF OT was higher in dominant versus subordinate mothers. VFD-exposed mothers with “high” cortisol specifically exhibited CSF OT elevations in comparison to control groups. Conclusions: Pairing of maternal social rank to dyadic-distance in VFD presumably reduces maternal contingent responsivity, with ensuing long-term sequelae. VFD-exposure dichotomizes maternal HPA axis response as a function of social rank with relatively reduced cortisol in subordinates. OT may serve as a homeostatic buffer during maternal stress exposure.