cssi/SciSciGPT-SciSciNet huggingface dataset:
Accelerator Measurements of the Askaryan effect in Rock Salt: A Roadmap Toward Teraton Underground Neutrino Detectors

We report on further SLAC measurements of the Askaryan effect: coherent radio emission from charge asymmetry in electromagnetic cascades. We used synthetic rock salt as the dielectric medium, with cascades produced by GeV bremsstrahlung photons at the Final Focus Test Beam. We extend our prior discovery measurements to a wider range of parameter space and explore the effect in a dielectric medium of great potential interest to large scale ultra-high energy neutrino detectors: rock salt (halite), which occurs naturally in high purity formations containing in many cases hundreds of cubic km of water-equivalent mass. We observed strong coherent pulsed radio emission over a frequency band from 0.2-15 GHz. A grid of embedded dual-polarization antennas was used to confirm the high degree of linear polarization and track the change of direction of the electric-field vector with azimuth around the shower. Coherence was observed over 4 orders of magnitude of shower energy. The frequency dependence of the radiation was tested over two orders of magnitude of UHF and microwave frequencies. We have also made the first observations of coherent transition radiation from the Askaryan charge excess, and the result agrees well with theoretical predictions. Based on these results we have performed detailedmore » and conservative simulation of a realistic GZK neutrino telescope array within a salt-dome, and we find it capable of detecting 10 or more contained events per year from even the most conservative GZK neutrino models.« less
Decline in Working Memory Associated with HIV Infection

HIV infection has been associated with decline in a number of cognitive functions that are components of 'working memory'. Thus, tests of working memory that require the interaction of these components may be particularly sensitive to cognitive dysfunction that arises from HIV infection. To assess this possibility, working memory was examined in 147 HIV-seropositive (HIV+) and 38 HIV-seronegative (HIV-) males using the Reading Span Test and the Digit Span subtest from the Wechsler Memory Scale-Revised (WMS-R). Speed of information processing, a component of some working memory tasks, was assessed with a version of the Sternberg Memory Scanning task. Results indicated that symptomatic HIV+ subjects were impaired relative to HIV- control subjects on the Reading Span and Digit Span tests. Asymptomatic and mildly symptomatic HIV + groups exhibited a trend toward impairment on these tests, and on the whole, a greater proportion of HIV+ subjects than HIV- subjects were impaired. The groups did not differ significantly in information processing speed. These results indicate that deficits in working memory are apparent in at least a subset of HIV-infected individuals. These deficits are most apparent in symptomatic HIV+ individuals, but the decline may begin during the asymptomatic phase of infection.
Mechanisms of Disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases

SUMMARY The primary functions of the gastrointestinal tract have traditionally been perceived to be limited to the digestion and absorption of nutrients and electrolytes, and to water homeostasis. A more attentive analysis of the anatomic and functional arrangement of the gastrointestinal tract, however, suggests that another extremely important function of this organ is its ability to regulate the trafficking of macromolecules between the environment and the host through a barrier mechanism. Together with the gut-associated lymphoid tissue and the neuroendocrine network, the intestinal epithelial barrier, with its intercellular tight junctions, controls the equilibrium between tolerance and immunity to nonself-antigens. When the finely tuned trafficking of macromolecules is dysregulated in genetically susceptible individuals, both intestinal and extraintestinal autoimmune disorders can occur. This new paradigm subverts traditional theories underlying the development of autoimmunity, which are based on molecular mimicry and/or the bystander effect, and suggests that the autoimmune process can be arrested if the interplay between genes and environmental triggers is prevented by re-establishing intestinal barrier function. Understanding the role of the intestinal barrier in the pathogenesis of gastrointestinal disease is an area of translational research that encompasses many fields and is currently receiving a great deal of attention. This review is timely given the increased interest in the role of a ‘leaky gut’ in the pathogenesis of gastrointestinal diseases and the advent of novel treatment strategies, such as the use of probiotics.
Focusing on moving targets through scattering samples

Focusing light through scattering media has been a longstanding goal of biomedical optics. While wavefront shaping and optical time-reversal techniques can in principle be used to focus light across scattering media, achieving this within a scattering medium with a noninvasive and efficient reference beacon, or guide star, remains an important challenge. Here, we show optical time-reversal focusing using a new technique termed Time Reversal by Analysis of Changing wavefronts from Kinetic targets (TRACK). By taking the difference between time-varying scattering fields caused by a moving object and applying optical time reversal, light can be focused back to the location previously occupied by the object. We demonstrate this approach with discretely moved objects as well as with particles in an aqueous flow, and obtain a focal peak-to-background strength of 204 in our demonstration experiments. We further demonstrate that the generated focus can be used to noninvasively count particles in a flow-cytometry configuration—even when the particles are hidden behind a strong diffuser. By achieving optical time reversal and focusing noninvasively without any external guide stars, using just the intrinsic characteristics of the sample, this work paves the way to a range of scattering media imaging applications, including underwater and atmospheric focusing as well as noninvasive in vivo flow cytometry.
Solvent Effects on Amphiphilic Aggregation

Solvent effects on the extent and degree of amphiphilic aggregation in binary and ternary systems are reviewed. One can broadly place single solvents in three different classes: (1) those which give rise to solvophobic interactions in which the nonpolar portions of the amphilphiles are shielded from solvent upon aggregation; (2) those in which electrostatic interactions are primarily responsible for aggregation and the amphiphiles’ polar head groups are shielded from solvent; (3) those in which aggregation does not occur. Aggregation in water leads to the cooperative formation of normal micelles which in many cases show large aggregation numbers and narrow size distributions. Effects of cosolvents which do not penetrate the aggregates can be rationalized by referring to the behavior of simple non-polar solutes in mixed aqueous solvents. Surfactant aggregates in class (2) solvents are generally smaller than in water; the concept of a critical micelle concentration (CMC) is not always applicable here. Solvent effects for systems where the average aggregation number increases continuously with surfactant concentration and where it remains constant over a wide concentration range are qualitatively similar. For a given surfactant, solute-solvent interactions (dipole-dipole, dipole-induced dipole, dispersion) and steric effects are important factors in determining aggregate sizes.
Use of osmium tetroxide-potassium ferricyanide in reconstructing cells from serial ultrathin sections

We describe a technique, modified from Langford and Coggeshall [Anat. Rec., 197 (1980) 297-303; J. Comp. Neurol., 203 (1981) 745-750], for enhancing membrane contrast and defining cellular boundaries, that is useful for reconstructing individual cells from ultrathin sections. The cells of interest in our study were neuronal germinal cells and their differentiated progeny in the retinas of young goldfish. These cells were labeled by pulse injections of [3H]thymidine, and they were subsequently identified in EM autoradiographs by the presence of silver grains overlying their nuclei. In tissue prepared by traditional procedures (fixation in mixed aldehydes, postfixation in osmium tetroxide) it was difficult to follow the processes of these cells through the complex, dense network of cells in the differentiated retina. However, in tissue postfixed with a mixture of osmium tetroxide and potassium ferricyanide, the contrast of the cell membranes was improved and, in favorable preparations, a dense precipitate was formed in the extracellular spaces, serving to outline individual cells. This greatly faciliated the preparation of reconstructions from serial ultrathin sections.
Phosphorylation and nuclear accumulation are distinct events contributing to the activation of p53

Abstract It has been recently shown that ionizing radiation (IR) and the mRNA synthesis inhibitor 5,6-dichloro-1-b- d -ribofuranosylbenzimidazole (DRB) act in synergy to induce p53-mediated transactivation of reporter plasmids in human cells [Oncogene 19 (2000) 3829]. We have extended these studies and show that ionizing radiation and DRB also act in synergy to induce ATM-mediated phosphorylation of the ser15 site of p53 and enhance the expression of endogenous p21 protein. Examination of the localization of p53 revealed that while DRB did not induce phosphorylation of the ser15 site of p53 but efficiently accumulated p53 in the nucleus, ionizing radiation induced phosphorylation of the ser15 site of p53 without prolonged nuclear accumulation. Importantly, the combination of DRB and IR resulted in a strong accumulation of phosphorylated p53 in the nucleus that was more persistent then p53 accumulation after IR alone. Furthermore, the nuclear export inhibitor leptomycin B showed a similar synergy with IR as did DRB regarding ser15 phosphorylation of p53 and p21 induction. These results suggest that the synergistic activation of the p53 response by the combination treatment is due to the activation of two distinct pathways where DRB causes the prolonged nuclear accumulation of p53 while ionizing radiation activates p53 by ATM-mediated phosphorylation.
Human chorionic gonadotropin: a hormone complex.

ABSTRACT Human chorionic gonadotropin preparations (HCG) have previously been shown to contain at least 2 pregnancy specific immunogenic components (Ag #5 and Ag #6) by immunoelectrophoretic analysis. In this study Ag #5 and Ag #6 have been chromatographically separated and shown to consist of at least 3 distinct electrophoretic entities. These 3 entities have been characterized antigenically and biologically. A fraction (Fr I-I) containing Ag #6 and a previously undetected pregnancy specific antigen possessed only a portion of the antigenic and biologic activities present in HCG. A second fraction (Fr I-II) containing only the cathodic component of Ag #5 possessed all the antigenic and biologic specific activities in amounts equal to or greater than present in HCG. A third fraction (Fr II) containing only the anodic component of Ag #5 was antigenically and biologically similar to Fr I-II. However, the specific activity of Fr II was significantly greater than that of Fr I-II in 3 of 4 test indexes employe...
A Cartesian feedback-feedforward transmitter IC in 130nm CMOS

A transmitter architecture based on Cartesian feedback-feedforward is described. A Cartesian feedback loop is used to linearize a transmitter and PA, and the error signal is utilized in a feedforward path to further enhance linearity. A proof-of-concept prototype transmitter IC that is used to linearize an external PA is demonstrated in a 130nm CMOS process. The implementation allows for a 8.7 dB ACLR improvement, compared to an open-loop transmitter, for an output power of 16.6 dBm at 2.4 GHz while employing a 16 QAM LTE signal with 1.4 MHz bandwidth.
Autobiographical Memory Specificity among Preschool-Aged Children.

Overgeneral memory refers to difficulty retrieving specific autobiographical memories and is consistently associated with depression and/or trauma. The present study developed a downward extension of the Autobiographical Memory Test (AMT; Williams & Broadbent, 1986) given the need to document normative developmental changes in ability to retrieve specific memories among preschoolers. Confirmatory factor analysis and item response theory demonstrated that the AMT-Preschool Version maintained the same underlying 1-factor structure as the original. Additionally, the present study determined that child age was associated with increased specificity. Inhibitory control was evaluated as a potential mediator. Although age was related to inhibition, inhibition was unrelated to memory specificity. This finding adds to research suggesting that behavioral inhibition is unrelated to overgeneral memory among youth.
Variation in and Heritability of Aspects of Pheromone Production in the Pink Bollworm Moth, Pectinophora gossypiella (Lepidoptera: Gelechiidae)

The genetic basis of variation in pheromone production by pink bollworm moths, Pectinophora gossypiella (Saunders), was examined by GLC analysis of pheromone gland extracts from females in a laboratory colony. The genetic correlation between the amounts of the two pheromone components, ( Z,E )- and ( Z,Z )-isomers of 7,11-hexadecadienyl acetate, was 0.99, suggesting that genetic factors controlling their production are identical or closely linked. The mean percentage of the ( Z,E )-isomer was 44.2%. The limited variation found in component blends (CV = 5.3%) may reflect the importance of low signal variability for efficient communication. Heritability of total amount of pheromone in the gland was 0.41, and heritability of pheromone blend was 0.34. One generation of inbreeding had no detectable effect on pheromone blend, but total pheromone production was decreased by 26%. Mean component blends produced by females in a laboratory strain and in a strain incorporating recently collected wild males were not significantly different, but the amount of pheromone was significantly lower in the laboratory colony.
Design of a 2-D Fairing for a wind turbine tower

An aerodynamic shroud was designed to reduce the effects of the wind turbine tower wake on the blades of a downwind rotor. For a given tower diameter and wind speed the shroud was designed to have the minimum drag and minimum chord length downstream of tower centerline, while being able to self-align and resist flow separation when subjected to a non-zero angle of attack. The initial analysis was run using XFOIL and showed that a three-to-one chord-to-thickness ratio resulted in the minimum drag. Based on this result, the NACA0033 airfoil was selected as the baseline. Further analysis showed that a shroud of this shape will not self-align due to the tower center being located behind the aerodynamic center. A new series of airfoils was created to have a 33% thickness ratio starting from a NACA0028, NACA0030, and NACA0031. The resulting airfoils all had significant adverse pressure gradients near their maximum thickness locations that could lead to flow separation. A new group of airfoils were created by adjusting the existing airfoil geometry using PROFOIL. Of the 13 airfoil designs that were analyzed, the C30u design had the best overall performance and met all of the objectives. At a Reynolds number based on tower diameter of 8.3x10, the C30u design had a drag coefficient based on inscribed tower diameter of 0.0193, which represents a 97.5% reduction in the drag of the cylinder. At a 5 degree angle of attack, the C30u design had a pitching moment coefficient of -0.0128.
Hospital procedure volume should not be used as a measure of surgical quality.

INTRODUCTION The Agency for Healthcare Research and Quality and the Leapfrog Group use hospital procedure volume as a quality measure for pancreatic resection (PR), abdominal aortic aneurysm (AAA) repair, esophageal resection (ER), and coronary artery bypass grafting (CABG). However, controversy exists regarding the strength and validity of the evidence for the volume-outcome association. The purpose of this study was to reevaluate the volume-outcome relationship for these procedures. METHODS Discharge data for 261,412 patients were extracted from the 2008 Nationwide Inpatient Sample. The relationship between hospital procedure volume and mortality was rigorously assessed using hierarchical general linear modeling with restricted cubic splines, adjusted for patient demographics, comorbid disease, and elective procedure status. RESULTS Unadjusted mortality rates were PR (4.7%), AAA (12.7%), ER (5.8%), and CABG (2.2%), and the majority of operations were elective. Hospital procedure volume was not a statistically significant predictor of in-hospital mortality for any of the 4 procedures. Strong predictors of mortality included age, elective procedure status, renal failure, and malnutrition (P < 0.001). Each of the models demonstrated excellent performance in estimating the probability of death. CONCLUSIONS Hospital procedure volume is not a significant predictor of mortality for the performance of pancreatectomy, AAA repair, esophagectomy, or CABG. Procedure volume by itself should not be used as a proxy measure for surgical quality. Patient mortality risk is primarily attributable to patient-level characteristics such as age and comorbidity.
Adolescent Gender Differences in Residential Versus Outpatient Mental Health Treatment: A Meta-Analysis

Level-of-care decisions for adolescents in need of mental health services have been found to be inconsistent. This study sought to establish a research base for more objective and reliable level-of-care decisions related to gender differences in clinical characteristics of male and female patients aged 12–19 years receiving mental health treatment in a residential setting or outpatient mental health services. A meta-analytic approach was used to analyze 20 studies and 49 independent effect sizes across six constructs: internalizing, externalizing, psychosocial stressors, risk to self and others, total pathology, and substance use. The results indicated that male participants had higher levels of externalizing at the outpatient level, and female participants had higher levels of all remaining constructs at both levels of care. This indicated that female patients often presented to both levels of care with greater psychopathology.
Pre- and in-Service Teachers Reading and Discussing Informational Texts: Implications for Preparing Teachers to Meet the Common Core

This study investigates U.S. elementary (kindergarten-Grade 6, ages 5-12) pre- and in-service teachers’ discussions of informational texts to understand current practices and identify needs with re...
Persuasive Effects of Story and Statistical Evidence

The persuasive effects of story and statistical evidence were examined for three different message topics. Students (N = 100) read three story or statistical messages and completed post-test measur...
A Simple Method for Experimental Infection of Phlebotomine Sand Flies with Leishmania

Abstract Mouse macrophages, grown in continuous cell culture at 37°C, were inoculated with the promastigote stage of various human pathogenic Leishmania species. Under these culture conditions, the parasites rapidly entered the cells and transformed into amastigotes. Two or 3 days after inoculation, the infected macrophages were mixed with washed human erythrocytes and were fed to female sand flies (Phlebotomus papatasi and Lutzomyia longipalpis) through a chick skin membrane. Within 7–10 days after feeding, large numbers of promastigotes were observed in the anterior portion of the insects' guts, indicating that the infected sand flies were capable of transmitting the parasites by bite. This relatively simple and rapid technique should facilitate studies on the biology of Leishmania in their insect vectors. It also eliminates the need for animals as a source of amastigotes.
Computerized cognitive training targeting brain plasticity in schizophrenia

Two important paradigm shifts have occurred recently in the field of schizophrenia research. First, we now understand schizophrenia to be a neurodevelopmental disorder, one that is characterized by aberrant patterns of activation and connectivity in cortical and subcortical neural networks that are present before illness onset and that worsen as an individual progresses into later stages of the disease. Second, we now understand that these abnormalities are not immutable and fixed, but instead can respond to interventions targeting brain plasticity, particularly when delivered in the prodromal and early phases of schizophrenia. In this chapter, we will first describe some of the neurocognitive impairments that characterize schizophrenia, highlighting the developmental course of the illness. We will then briefly review salient features of currently available computerized cognitive training programs that target these impairments. Next, we will present an overview of current research findings regarding neurobiological effects of computerized cognitive training in schizophrenia and how these results shed light on the critical neuroplasticity mechanisms that support successful training. Finally, we will present recommendations for future research to optimize computerized cognitive training programs, with an aim to promoting functional recovery.
Rapid Purification of the T-Protein of the Glycine Cleavage System from Rabbit Liver

The glycine cleavage system (GCS) (E.C. 2.1.2.10) plays a key role in the catabolism of glycine in mammals, birds, reptiles, amphibians and fishes (1). The GCS is a multienzyme complex that catalyzes the reversible cleavage of glycine: Glycine + tetrahydrofolate (THF) + NAD+ ⇔ 5,10-methyleneTHF + CO2 + NH3+NADH (2)
How the Martian Residual South Polar Cap Develops Quasi-Circular and Heart-Shaped Pits, Troughs, and Moats

The martian Residual South Polar Cap (RSPC) is a 1-10 m thick deposit of permanent CO_2 ice perched on the much larger H_2O ice cap. The CO_2 ice is dissected into mesas by erosional landforms that can be broadly classified as (i) quasi-circular pits, (ii) heart-shaped pits, (iii) linear troughs, and (iv) moats. We use HiRISE (25-50 cm/px) images taken at a cadence of days to months to track meter-scale changes in the RSPC in order to investigate the mechanisms that lead to the development of these four distinct morphologies. For the first time, we report the development of dark fans on the sides of the CO_2 mesas and the fracturing and deterioration of the initially smooth upper surface of CO_2 mesas. We interpret these features as indicating the sublimation and subsequent escape of CO_2 from the interiors of mesas, which undermines structural support of mesa tops, causing them to collapse. The collapse of mesa tops, along with uneven deposition of CO_2 ice, creates steep scarps that erode during the summer due to preferential sunlight absorption. During the winter, CO_2 deposition acts to smooth topography, creating gently sloping ramps. We propose that the interplay between the steep scarps and gentle slopes leads to either quasi-circular pits, heart-shaped pits, linear troughs, or moats, depending on local conditions.
The Role of Leadership in Virtual Project Management

With the dramatic advancement in information technology, organizations and institutions worldwide can now make much more effective use of virtual teams that employ distributed work patterns, rely on technology-mediated communications and take advantage of “around the clock” activity. For example, according to research conducted by the Gartner Group 137 million workers worldwide will be involved in some form of remote electronic work by 2003. By the year 2010 it is projected that employees will spend 40% of their time working with others who are in a different place and different time zone (Salamon 2001). In fact, in the project management arena 60% of all projects are already considered virtual (Guss 1998). However research on the effect of virtuality on project management processes and subsequent success is practically nonexistent. This paper concentrates on the role of leadership in virtual project management and focuses primarily on information systems (IS) projects.
Effect of Water Hardness on Efficacy of Sodium Hypochlorite Inactivation of Escherichia coli O157:H7 in Water

ABSTRACT This study examined how the hardness of water affected the efficacy of sodium hypochlorite in inactivating Escherichia coli O157:H7 in water. Water was prepared at different degrees of total hardness (0, 50, 100, 200, 500, 1,000, 2,000, and 5,000 mg/liter CaCO3). Inactivation was assessed at different levels of free chlorine (0, 0.2, 0.5, and 1.0 ppm) at 2 to 4°C and pH 6.5. Thirty milliliters of chlorinated water was inoculated with 6 log CFU/ml of E. coli O157:H7 and allowed to mix for 3, 10, 20, or 30 s. In the absence of sodium hypochlorite, no reduction in counts of E. coli O157:H7 was observed regardless of the degree of water hardness. However, in the presence of hard water, under certain chlorine concentrations and exposure times, the reduction of E. coli O157:H7 in chlorinated hard water was significantly less than the reduction observed in chlorinated deionized water. For example, after exposure to 0.5 ppm of free chlorine for 10 s, E. coli O157:H7 counts were reduced by 4.8 ± 1.4, 2.0 ...
Pediatric Cardiovascular Monitoring

Continuous monitoring during anesthesia gives the practitioner information on physiologic perturbations that may require an intervention. The monitors do not make these interventions, and interpretation and action of the practitioner are still required to affect outcome. The focus of this chapter is to discuss both the noninvasive and invasive cardiac monitors that are used in cardiac surgery, risks in their placement, and the information that can be obtained from them.
Th1 Differentiation Drives the Accumulation of Intravascular, Non-protective CD4 T Cells during Tuberculosis

Recent data indicate that the differentiation state of Th1 cells determines their protective capacity against tuberculosis. Therefore, we examined the role of Th1-polarizing factors in the generation of protective and non-protective subsets of Mtb-specific Th1 cells. We find that IL-12/23p40 promotes Th1 cell expansion and maturation beyond the CD73+CXCR3+T-betdim stage, and T-bet prevents deviation of Th1 cells into Th17 cells. Nevertheless, IL- 12/23p40 and T-bet are also essential for the production of a prominent subset of intravascular CX3CR1+KLRG1+ Th1 cells that persists poorly and can neither migrate into the lung parenchyma nor control Mtb growth. Furthermore, T-bet suppresses development of CD69+CD103+ tissue resident phenotype effectors in lung. In contrast, Th1-cell-derived IFN-γ inhibits the accumulation of intravascular CX3CR1+KLRG1+ Th1 cells. Thus, although IL-12 and T-bet are essential host survival factors, they simultaneously oppose lung CD4 T cell responses at several levels, demonstrating the dual nature of Th1 polarization in tuberculosis.
Structure and Number of Tibial Brush Setae Making up the Fossula Spongiosa in Bed Bugs, Cimex lectularius L. (Hemiptera: Cimicidae)

Abstract The fossula spongiosa is a hairy attachment structure found on the apex of the fore tibia (and sometimes other legs) in several groups of cimicomorphan Heteroptera. In this study, the tibial brush setae making up the fossula spongiosa (tibial pad) of the bed bug, Cimex lectularius, were examined by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Tibial brush setae were found on all legs and are long and slender and situated in a pad at the apex of the ventral surface of the tibia. The distal end of each seta is spatulate with a smooth dorsal surface and a ventral surface with rounded protuberences. TEM analysis showed that the tibial brush setae are hollow and the base of the hollow setae are in contract with epidermal cells. Trichoid sensilla are dispersed among the tribial brush setae. As for numbers, leg I of the female has significantly more brush setae than leg II, and leg II more than leg III.
Heidegger, Art, and Postmodernity: Deconstructing the Hero

Obviously, if you're going to be doing something new, then to a degree you're destroying – [Laughs] – whatever preceded it. Alan Moore But by my love and hope I beseech you: Do not throw away the hero in your soul! Hold holy your highest hope! Friedrich Nietzsche, Thus Spoke Zarathustra Our identities as individuals and as groups are shaped, in ways both subtle and profound, by our heroes. If our enemies (and the other “villains” in our psychic narratives) help give us a sense of who we are not , of what we stand against , then, conversely, our heroes help tell us who we are , what we stand for . Indeed, as Heidegger recognized, the heroes we choose focus our sense of what is most important in life, shaping our feel for which battles we should fight as well as how we should go about fighting them. Thus, those who chose Martin Luther King Jr. as their hero, for example, pursued very different goals, and pursued them in a very different manner, than those who heroized Adolf Hitler. Despite the obvious differences, however, in both cases the chosen hero functioned like a mirror, reflecting back to the group an idealized image of itself, an ideal concentrated and so given an almost superhuman form.
Does Obesity Increase Respiratory Tract Infections in Patients with Asthma

Background Because respiratory tract infections (RTIs) precede most exacerbations, a better understanding of the risk factors of RTIs and RTI-associated exacerbations in patients with asthma is a pressing public health need. Obesity in patients with asthma is associated with worse asthma control and higher asthma-associated health care utilization, but its effect on RTI risk is unknown. Objective We aimed to study the association of body mass index (BMI) classification on the risk of self-reported RTIs and related asthma morbidity among adults and children with asthma. Methods This post hoc analysis of 5 large asthma trials involving 747 children and 1287 adults compared BMI classification, defined as lean, overweight, and obese based on age-appropriate BMI and BMI-percentile conventions. The primary outcome was rate of visits with RTIs. Secondary asthma outcomes included upper respiratory infection (URI) severity, systemic steroid use, and health care contact. Results Children had 1.4 times the rate of RTI compared with adults (95% confidence interval 1.27-1.56). In all participants, BMI classification did not affect the rate of visits with RTI. In children, BMI classification did not affect URI severity, all-cause asthma events, or RTI-associated asthma events. However, in adults, higher BMI classification was associated with an increase in moderate/severe URI (P = .02). Adults with higher BMI classification also had increased rates of all-cause and RTI-associated asthma exacerbations requiring systemic steroids and health care contact. Conclusions BMI classification was not associated with an increased risk of RTIs in children or adults. In adults only, obesity was associated with increased URI severity and all-cause and RTI-associated asthma morbidity.
Anti-neuropilin-1 antibodies block the binding of a tuftsin-antagonist peptide, TKPPR, to neuropilin-1 on receptor-positive cells

2086 Tuftsin is a short immunostimulatory peptide with the sequence TKPR. Its receptor was believed to be restricted mainly to certain immune cells, and a radiolabeled tuftsin analog has been used to image inflammation in man. We previously reported that the tuftsin antagonist peptide TKPPR binds neuropilin-1 (NP-1), a dual receptor for VEGF and class 3 semaphorins on endothelial and receptor-positive tumor cells, in a VEGF-competitive manner. In addition, particles such as 2-micron diameter beads or microbubbles coated with TKPPR bound specifically to NP-1 on cells. Moreover, at the subcellular level, quantum dots (Qdots) multivalently conjugated with the TKPPR peptide produced immunofluorescence-quality imaging of the apparent distribution of neuropilin-1 on endothelial cells. It was not clear however, whether binding to NP-1 could account for all of the TKPPR-conjugated particle association with endothelial cells or whether an additional receptor may be playing a significant role. We have now tested an anti-neuropilin-1 antibody that blocks VEGF’s interaction with NP-1 and found that it prevents almost all TKPPR-conjugated Qdot binding to HUVEC and the majority of binding to the neuropilin-1-positive PC-3 prostate adenocarcinoma cell line. These results confirm that TKPPR Qdots bind specifically to neuropilin-1 and suggest that in at least some cells neuropilin-1 provides the sole or primary TKPPR peptide binding site and that this peptide can be used to deliver imaging and therapeutic moieties to sites with increased NP-1 expression, such as in cancer, angiogenesis, and inflammation.
Three-Dimensional Computer-Assisted Surgical Planning and Use of Three-Dimensional Printing in the Repair of a Complex Articular Femoral Fracture in a Dog

Objective The main purpose of this study was to describe the use and benefits of 3-dimensional (3D) computer-assisted surgical planning (CASP) and printing in a complex articular fracture repair in a dog. Study Design Case report. Animals Client-owned dog. Results One dog with a closed, severely comminuted, distal femoral supracondylar and bicondylar fracture underwent a preoperative computed tomography scan. Three-dimensional CASP was performed using computer-aided design software. Three-dimensional CASP allowed for visualization of the fracture fragments and virtual surgery, including reduction of the fragments and implant placement. A 3D model of the affected femur was printed and a bone plate was pre-contoured to the model. Intraoperative fracture reduction and stabilization were performed without complications. Postoperative radiographs revealed successful execution of the planned procedure. Subsequent radiographs and clinical examination indicated that bone healing was achieved with return to normal function of the limb. Three-dimensional CASP and the printed 3D model allowed for improved understanding of the anatomical relationship between fracture fragments, preoperative implant selection and contouring, and the ability to practice fracture reduction and implant placement preoperatively. The model was also used for client education, and to teach students and residents. Conclusion Three-dimensional CASP and printed models are valuable tools in the preoperative planning of complex fracture repairs, educating clients and teaching students and residents.
Treating obesity in patients with cardiovascular disease: the pharmacotherapeutic options

ABSTRACTIntroduction: Obesity is a growing health problem that has numerous comorbidities, including cardiovascular disease (CVD). The multi-disciplinary treatment of obesity now includes the use o...
Male-to-Female Gender Reassignment Surgery: An Institutional Analysis of Outcomes, Short-term Complications, and Risk Factors for 240 Patients Undergoing Penile-Inversion Vaginoplasty.

Abstract Objective To report outcomes, complications, and risk factors of a population cohort undergoing male-to-female gender affirmation surgery via penile-inversion vaginoplasty by a single surgeon at a large academic institution. As gender dysphoria awareness increases among the medical community, so does the population of patients seeking gender-affirmation surgery. Materials and Methods A prospectively maintained database of patients undergoing penile-inversion vaginoplasty was retrospectively queried for all available patients with at least 1 week of postoperative follow-up. Univariate and multivariate analyses were performed using Fisher's exact test and logistic regression, respectively, in order to evaluate relationship of risk factors to complications at 30, 60, and 90 days, as well as the likelihood of revision/reoperation. Results From November 2016 to April 2018, 240 penile-inversion vaginoplasties were performed. Median follow-up was 87 days. When accounting for competing risk factors, only noncompliance with postoperative dilation regimen and activity restriction was significantly associated with increased risk of complications or reoperation/revision. Overall incidence of reoperation/revision was 7.9% (n = 19). Reasons for reoperation included cosmesis (3.8%; n = 9), neovaginal stenosis (2.1%; n = 5), and wound dehiscence (0.8%; n = 2), with less than 0.5% (n = 1) reoperations for meatal stenosis, hematoma or rectovaginal fistula, respectively. Incidence of Clavien IIIa-b complications was 1.7% (n = 4). There were no Clavien IV-V complications. Conclusion At short-term follow-up, gender-affirmation surgery is associated with low rates of reoperation and revision and few major complications when performed by an experienced, high-volume surgeon. Patient selection and compliance is imperative. Increased reporting among surgeons is necessary to continue to improve patient outcomes.
C. G. Jung’s Memories, Dreams, Reflections as a Source for Doris Lessing’s Briefing for a Descent into Hell

Doris Lessing was conversant in Jungian psychology, and her novel Briefing for a Descent into Hell includes more Jungian elements than previous critics have identified. In particular, it is likely that she borrowed from Jung’s Memories, Dreams, Reflections when crafting her protagonist Charles Watkins’s descent into madness and return to sanity. This essay argues that the autobiography’s chapter 6, “Confrontation with the Unconscious,” and chapter 10, “Visions”—Jung’s encounter with madness and his near-death experience—provided Lessing with not only a successful nekyia by which to evaluate Watkins’s less successful inner journey but also a series of images that she reworked in the novel. Considered in light of MDR, Briefing conveys a sense of lost potential: Watkins regains his memory but, unlike Jung, forgets his vision of the collective unconscious.
Study of seismological evasion Part II. Evaluation of evasion possibilities using normal microseismic noise

abstract This paper discusses seismological aspects of various proposed means of obscuring or hiding the seismic signatures of explosions from a surveillance network. These so-called evasion schemes are discussed from the points of view of both the evader and the monitor. The analysis will be conducted in terms of the USSR since that country is so vast and its geological and geophysical complexities are so great that the complete spectrum of hypothesized evasion schemes requires discussion. Part I of this paper was a general discussion of these evasion schemes, placing the concepts within the reality of general factors influencing effective use of the techniques. This part of the paper (part II) describes techniques for quantitative investigation of evasion schemes when the only noise problem is normal microseismic noise, and will give analyses of several seismological networks as regards their capabilities to restrain imagined clandestine testing by the USSR under such noise conditions. Part III will describe techniques appropriate for use when the noise problem is the P - and surface-wave codas of earthquakes, and will give analyses of capabilities of several seismological networks to restrain use of such codas for effective evasion.
Data Visualization for Surgical Informed Consent to Communicate Personalized Risks and Patient Preferences

STRUCTURED ABSTRACT Objective Identify key elements of an effective visualization method for communicating personalized surgical risks to patients. Background Currently, there is no consensus on which risks should be communicated during the informed consent process and how. Furthermore, patient preferences are often not considered during the consent process. These inefficiencies can lead to non-beneficial outcomes and raise the potential for legal implications. To address the limitations of the informed consent process, we propose a visual consent tool (VCT) that incorporates patient preferences and communicates personalized risks to patients using data visualization. Methods To understand how patients perceive risk visualizations and their role in the informed consent discussion, we gathered feedback on visualizations by conducting semi-structured interviews during postoperative visits. Thematic analysis was performed to identify major themes. Iterative evaluation and consolidation of the major themes were performed with domain experts. Results A total of 20 patients were interviewed for this study with a median age of 59 (sd = 14). The thematic analysis revealed factors that influence the perception of risk, of risk visualizations, and the usefulness of the proposed VCT. We found that patients preferred VCT over the current methods and had different preferences for risk visualization. Further, our findings suggest that surgical concerns of patients were not in line with existing risk calculators. Conclusion We were able to identify key elements that influence effective risk communication in the perioperative setting. We found that patient preference is variable and should influence choices for risk presentation and visualization.
X-ray crystallographic studies on adenylosuccinate synthetase from Escherichia coli

Adenylosuccinate synthetase catalyzes the first committed step in de novo biosyntheses of AMP from IMP and aspartate, using GTP as the energy source. Metal cations, ligand-induced conformational transitions and metabolic effectors significantly influence the catalytic potential of the synthetase. The Mg"*, Mn^*, or Ca^" bind to the same site, coordinating a-. P-, and y-phosphoryl groups of GTP. The level of catalysis supported by each cation is linked to its influence on the basicity of Asp 13, a residue which abstracts the proton from N1 of IMP. Zn**, a potent inhibitor of the synthetase, coordinates the Pand y-phosphoryl groups of GTP and His4I, stabilizing a dead-end complex of the synthetase. The role of metal cations in the synthetase and the related G-proteins contrasts sharply. Hydrogen bond formation between the 5'-phosphate of IMP and Asn38 drives large conformational changes as far as 30 A away. Indeed the 5'-phosphoryl group of IMP, even though it is not directly involves in catalysis, is as important to the stability of the transition state as essential protein side chains directly involved with catalysis. Guanosine 5'diphosphate 3 "-diphosphate (ppGpp), a pleiotropic effector of the stringent response, potently inhibits the synthetase. The combination of ppGpp with crystals of the synthetase, however, reveals guanosine 5'-diphosphate 2':3'-cyclic monophosphate, at the GTP pocket. The sythetase itself may catalyze the formation of the cyclic inhibitor, leading to a tight ligandenzyme complex. In fact, stringent effectors could modulate synthetase activity by way of several mechanisms, including the formation of a 6-phosphoryl-IMP and cyclic nucleotide
A tablet- and mobile-based application for remote diagnosis and analysis of movement disorder symptoms

One significant hindrance to effective diagnosis of movement disorders (MDs) and analysis of their progression is the requirement for patients to conduct tests in the presence of a clinician. Here is presented a pilot study for diagnosis of essential tremor (ET), the world’s most common MD, through analysis of a tablet- or mobile-based drawing task that may be selected at will, with the spiral- and line-drawing tasks of the Fahn-Tolosa-Marin tremor rating scale serving as our task in this work. This system replaces the need for pen-and-paper drawing tests while permitting advanced quantitative analysis of drawing smoothness, pressure applied, and other measures. Data is securely recorded and stored in the cloud, from which all analysis was conducted remotely. This will enable longitudinal analysis of patient disease progression without the need for excessive clinical visits. Several features were extracted and recursive feature elimination applied to rank the features’ individual contribution to our classifier. Maximum cross-validated classification accuracy on a preliminary sample set was 98.3%. Future work will involve collecting healthy subject data from an age-controlled population and extending this diagnostic application to additional conditions, as well as incorporating regression-based symptom severity analysis. This highly promising new technology has the potential to substantially alleviate the demands placed on both clinicians and patients by bringing MD treatment more into line with the era of personalized medicine.
Knee Confidence Trajectories over 8 Years and Factors Associated with Poor Trajectories in Persons with or at Risk for Knee Osteoarthritis.

Objective Identify distinct trajectories of lack of knee confidence over an 8-year follow-up period and examine baseline factors associated with poor trajectories in persons with or at risk for knee osteoarthritis (OA). Methods The Osteoarthritis Initiative is a prospective cohort study of persons with or at high risk for knee OA. Confidence in the knees was assessed within the Knee Injury and Osteoarthritis Outcome Score instrument querying how much the individual is troubled by lack of confidence in his/her knee(s), rated as not-at-all (0), mildly (1), moderately (2), severely (3), and extremely (4) troubled, reported annually from baseline to 96 months. Lack of knee confidence was defined as a score ≥ 2. We used latent class models to identify subgroups that share similar underlying knee confidence trajectories over an 8-year period, and multivariable multinomial logistic regression models to examine baseline factors associated with poor trajectories. Results Among 4515 participants [mean age 61.2 years (SD 9.2), BMI 28.6 kg/m2 (4.8); 2640 (58.5%) women], four distinct knee confidence trajectories were identified: persistently good (65.6%); declining (9.1%); poor, improving (13.9%); and persistently poor (11.4%). Baseline predictors associated with persistently poor confidence (reference: persistently good) were younger age, male sex, higher BMI, depressive symptoms, more advanced radiographic disease, worse knee pain, weaker knee extensors, history of knee injury and surgery, and reported hip and/or ankle pain. Conclusion Findings suggest the dynamic nature of self-reported knee confidence and addressing modifiable factors (e.g., BMI, knee strength, depressive symptoms, lower limb pain) may improve its long-term course.
Just Culture for Medical Students: Understanding Response to Providers in Adverse Events.

Introduction Individual and organizational response to an adverse event is a key part of the life cycle of a patient safety event. Just culture is a safety concept that emphasizes system drivers of...
Neural network-based study of structural, chemical and electronic properties of doped $$\hbox {MoO}_{3}$$ MoO 3

Molybdenum trioxide ( $$\hbox {MoO}_{3}$$ ) is a commonly implemented acceptor layer for the surface-doped diamond devices. This work proposes an approach to engineer the intrinsic electrochemical properties of the $$\hbox {MoO}_{3}$$ surface through a substitutional doping technique to enhance the surface conductivity of the interfacing diamond surface. A neural network (NN) technique was used to identify the stable location of the dopants within the surface. The acidic properties of these doped surfaces were analyzed by evaluating the surface adsorption potential energy (APE). An analysis of the electronic properties of the doped $$\hbox {MoO}_{3}$$ systems reveals that the dopants with the lower electronegativity contributed to the relatively enhanced p-type conductivity. Our atom-projected density of states (pDOS) reveals that the density of oxygen states around the valence band states not only increases the p-type conductivity, but also increases the acidic behavior in the doped $$\hbox {MoO}_{3}$$ surface. In summary, our study on the doped $$\hbox {MoO}_{3}$$ surface provides a new design space in the field of acceptor layer technology for the surface-doped diamond devices.