cssi/SciSciGPT-SciSciNet huggingface dataset:
Prognostic Factors for Mortality among Day +100 Survivors after Allogeneic Hematopoietic Cell Transplantation

Abstract Although day +100 survival among allogeneic hematopoietic cell transplantation (HCT) recipients has improved over time, longer-term survival remains a challenge. The aim of this study was to identify prognostic factors for survival among patients surviving longer than 100 days using baseline characteristics and factors identified within the first 100 days after transplantation. Of 413 patients undergoing a first allogeneic HCT between 2006 and 2014, 335 survived >100 days post-transplantation. The majority underwent a myeloablative transplantation (75%) with a bone marrow (BM) (52%) graft source. One-year all-cause mortality (ACM) was 29%, with 16% relapse mortality (RM) and 12% nonrelapse mortality. In multivariable analysis, high-risk disease (hazard ratio [HR], 1.55; P = .003), non-cytomegalovirus infection (HR, 1.79; P = .003), more days hospitalized (HR, 1.16; P
In-Hospital Sepsis Mortality Rates Comparing Tertiary and Non-Tertiary Hospitals in Washington State.

Abstract Background More than a million people a year in the United States experience sepsis or sepsis-related complications, and sepsis remains the leading cause of in-hospital deaths. Unlike many other leading causes of in-hospital mortality, sepsis detection and treatment are not dependent on the presence of any technology or services that differ between tertiary and non-tertiary hospitals. Objective To compare sepsis mortality rates between tertiary and non-tertiary hospitals in Washington State. Methods A retrospective longitudinal, observational cohort study of 73 Washington State hospitals for 2010–2015 using data from a standardized state database of hospital abstracts. Abstract records on adult patients (n = 86,378) admitted through the emergency department (ED) from 2010 through 2015 in all tertiary (n = 7) and non-tertiary (n = 66) hospitals in Washington State. Results The overall mortality rate for all hospitals was 6.5%. In the fully adjusted model, the odds ratio for in-hospital death was higher in non-tertiary hospitals compared with tertiary hospitals (odds ratio 1.25; 95% confidence interval 1.17–1.35; p Conclusions We observed higher sepsis mortality rates in non-tertiary hospitals, compared with tertiary hospitals. Because most patients who are treated for sepsis are treated outside of tertiary hospitals, and the number of patients treated for sepsis in non-tertiary hospitals seems to be rising, a better understanding of the cause or causes for this differential is crucial.
Role of winter severity on juvenile Bighead Carp and Silver Carp growth and survival across latitudes

Population dynamics and ecological effects of invasive fishes are affected by offspring survival to sexual maturity (recruitment). Recruitment is oftentimes determined by conditions experienced during early life, and winter conditions become increasingly influential as species invade north in temperate regions. Bighead Carp (Hypophthalmichthys nobilis) and Silver Carp (H. molitrix) have invaded mid-latitudes of North America and threaten to invade farther north. We conducted pond experiments and bioenergetic simulations to: (1) assess the effects of mild winters on juvenile Bighead Carp and Silver Carp at mid-latitudes; (2) determine how conspecific density affects juveniles during mild winters; and, (3) determine effects of increased winter severity at increasing latitudes. Both species displayed high overwinter survival (85%) in pond experiments. Bighead Carp grew in length (mean 2 mm) and maintained initial body mass and percent dry mass (index of energy content). Silver Carp maintained initial length and mass and remained in high condition (dry mass). Conspecific densities tested did not affect growth, condition, or survival. Simulations suggest juvenile Bighead Carp could energetically survive the longest, coldest winter simulated (48° latitude); however, energy reserves at the start of winter became increasingly important for survival as latitude increased. Bighead Carp and Silver Carp recruitment success at mid-latitudes is likely driven by non-winter factors. If these species invade farther north, winter severity may play a stronger role in offspring survival, recruitment, and population dynamics. However, warmer and shorter winters at high latitudes caused by climate change will minimize this potential bottleneck and increase chances of successful recruitment.
Packet Switch Interconnection Fabrics

The appeal of broadband networks which carry all types of information in some common fixed-length packet format stems in large measure from the feasibility of implementing hardware-based, real-time packet switching fabrics. Such switches route arriving packets on the basis of information contained in each packet header. Because of the high data rates involved, the reading of (and decision-making reaction to) the arriving packets must be implemented entirely in hardware; software processing is incapable of keeping pace with the high rate of packet arrivals. In general, such a hardware-based self-routing switch contains some plurality N of input and output ports and must therefore be capable of processing N packets in parallel. To maintain a physically compact design, custom-designed VLSI circuitry is essential.
Microfluidic Platforms for Nanoparticle Delivery and Nanomanufacturing in Biology and Medicine

Nanoparticles are rapidly emerging as promising vehicles for next-generation therapeutic delivery. These highly mobile nanomaterials exhibit large carrier capacity and excellent stability which, when combined with innate biocompatibility, have captured the focus of numerous research efforts. As such, the ability to deliver well-controlled subcellular doses of these functional nanoparticles, both for fundamental research at the single cell level and in related device manufacturing, remains a challenge. Patterning these nanomaterials on biologically compatible substrates enables both novel biological studies and nanomanufacturing avenues through precise spatial control of dosing. Delivering them directly to live cells enables further studies where transfection remains a challenge. This chapter describes a unique tool for functional nanoparticle delivery, called the Nanofountain Probe. The Nanofountain Probe is capable of both direct-write nanopatterning of these materials with sub-100-nm resolution and targeted in vitro injection to individual cells. To motivate the discussion, a brief overview of microfluidic tools developed to deliver nanoparticles is presented. We then focus on the function of the Nanofountain Probe and its application to functional nanodiamond-based biological studies and nanomanufacturing. Development and application of the Nanofountain Probe and other nanomaterial delivery systems will be critical in developing future nanoscale devices and arrays that harness these nanoparticles.
Homeodomain Protein IDX-1: A Master Regulator of Pancreas Development and Insulin Gene Expression

Abstract The homeodomain protein IDX-1 appears to be a "master regulator" of pancreas development and β- cell differentiation and function. In murine gene inactivation models and in a human subject with a homozygous mutation of the IDX-1 gene, the pancreas fails to develop. In the adult endocrine pancreas, IDX-1 is primarily expressed in β cells, where it is a key factor in the upregulation of insulin gene transcription and appears to have a role in the regulation of the somatostatin, glucokinase, glucose transporter-2, and islet amyloid polypeptide genes. Recent studies also suggest a role for IDX-1 in the neogenesis and proliferation of β cells. The observed functions of IDX-1 and its downregulation in parallel with insulin in glucose-toxicity models implicate IDX-1 as a potential factor contributing to the pathogenesis of diabetes mellitus. Future directions include the use of conditional gene inactivation to determine more precisely the role of IDX-1 throughout endocrine pancreas differentiation and the exploration of IDX-1 as a potential target for gene therapy of diabetes mellitus. (Trends Endocrinol Metab 1997;8:145–151). © 1997, Elsevier Science Inc.
Many-Particle Structure of Green’s Functions

Since the reader may be unfamiliar with many-particle structure analysis (MPSA) of Green’s functions, I shall first present an introduction to this subject. The setting of MPSA is “axiomatic quantum field theory.” Axiomatic field theory, however, has many aspects; I will list, therefore, the various approaches, point out their distinctive features, and determine the relative position of MPSA. (The term “axioms” as used here merely denotes tentative postulates of a theory that it is hoped will describe elementary particle physics.) The following axioms common to all approaches (with one exception) are too well known to need discussion here (see, for example, Streater and Wightman, and Schweber1): I. Invariance under the inhomogeneous proper Lorentz group. II. Existence of local field operators. III. Mass spectrum conditions. IV. Completeness of the asymptotic particle states.
Adaptive Event-triggered Cooperative Control of Uncertain Networked Systems

Abstract Coordination and cooperation of networked multi-agent systems is usually constrained by dynamic and communication limitations. In this work we consider the problem of distributed leader following of heterogeneous and uncertain multi-agent systems. Each agent or subsystem implements a local and completely decentralized adaptive controller in order to compensate for the uncertainty on its system parameters. At the inter-agent communication level and due to the limitations on broadcasting continuous signals, each agent employs a decentralized event-triggered multi-agent system (MAS) controller which tracks the state of the leader and reduces broadcasting of information. Hence, the two layer controller architecture provides a useful framework for the multiple agents to follow the leader in the presence of system uncertainties and absence of continuous exchange of information.
Dynamic Multiobjective Control for Continuous-Time Systems Using Reinforcement Learning

This paper presents an extension of the reinforcement learning algorithms to design suboptimal control sequences for multiple performance functions in continuous-time systems. The first part of the paper provides the theoretical development and studies the required conditions to obtain a state-feedback control policy that achieves Pareto optimal results for the multiobjective performance vector. Then, a policy iteration algorithm is proposed that takes into account practical considerations to allow its implementation in real-time applications for systems with partially unknown models. Finally, the multiobjective linear quadratic regulator problem is solved using the proposed control scheme and employing a multiobjective optimization software to solve the static optimization problem at each iteration.
Collimating a Free-Space Gaussian Beam by Means of a Chip-Scale Photonic Extreme Mode Converter

Integration of nanophotonics with micromechanical, biological, and chemical systems can miniaturize the reference samples for SI traceable calibration. However, an efficient conversion between photonic modes and free-space beams remains a main hurdle due to a gigantic mode mismatch (106 times in modal area). Here, we report an extreme mode converter realized on a photonic chip, which enables projecting a 160-micrometer wide Gaussian beam in free space by a sequential mode expansion from a waveguide to a slab mode and then to free space using an apodised grating. The design can be easily adapted for visible, telecom, and UV wavelengths.
Beach environmental etiquette: Assessing public awareness of marine reserves on the central coast of California

Abstract For protected areas to achieve their conservation goals, visitors should be aware of reserve boundaries and follow the protective measures within them. However, lack of knowledge about the specifics of reserve geography and rules can lead to actions that adversely affect marine life (unsanctioned fishing and collecting) or disturb sensitive species within these areas, even when general support for protected areas is high. We assessed public awareness of State Marine Reserves locations and policies on the central California coast. Using surveys in the form of semi-structured interviews and written questionnaires, we asked beach visitors whether they had prior knowledge about State Marine Reserves. We provided half of participants with new knowledge about State Marine Reserves in the form of a verbal, short pre-survey speech. We asked participants to indicate if they were currently standing inside of a State Marine Reserve and assessed their self-reported likelihoods of performing several actions related to environmental etiquette such as following reserve rules. Finally, we tested how provisional new knowledge influences perceptions surrounding the importance of protecting marine habitats and human impacts on them. Overall, 60% of participants had heard of marine reserves, though this varied by participant region of residence. 33% of participants with prior knowledge and 13% of participants with no prior knowledge identified site protection status correctly. Over half of participants self-reported behaviors consistent with reserve rules and environmental etiquette. Survey participants who received new knowledge did not differ from the control group in their ability to correctly identify reserve location or in their perceptions of human impacts. Our results suggest that the information in our short verbal speech was not sufficient for changing perceptions, though over 90% of visitors stated marine protection to was already personally important or very important to them. Beach visitors intend to treat reserves well if they know they are visiting a reserve. However, because less than one third of visitors recognize reserve locations, a disconnect exists between understanding acceptable behavior for protected sites and knowing where to apply this behavior. Finally, we discuss the educational strategies of docent presence and place-based learning opportunities to improve awareness of marine reserves and their locations for local and non-local visitors.
Scoliosis and Chiari I Malformations

Scoliosis is a relatively common condition observed in approximately 20 % of patients who have Chiari I malformations. It is most often found in association with syringomyelia. The presence of a Chiari malformation and scoliosis with or without symptoms frequently requires surgical intervention. Patients with scoliosis who have any of the following characteristics should undergo further evaluation: progressive scoliosis in a child less than 11 years old; left thoracic thoracolumbar scoliosis; painful scoliosis; mild painful stiff neck; abnormal deep tendon reflexes; muscle atrophy; minimal sensory loss; minimal weakness of a limb; or absence of abdominal cutaneous reflexes. The initial surgery of choice is a suboccipital decompression. Patients who have the best outcome are younger than 10 years old and have Cobb angles less than 20–30°. It is important to be vigilant about screening patients for Chiari malformations and syrinxes in cases of “idiopathic” scoliosis because early intervention portends the best prognosis for these patients.
Analytical solution for diverging elliptic shear wave in bounded and unbounded transverse isotropic viscoelastic material with nonhomogeneous inner boundary.

A theoretical approach was recently introduced by Guidetti and Royston [J. Acoust. Soc. Am. 144, 2312–2323 (2018)] for the radially converging elliptic shear wave pattern in transverse isotropic materials subjected to axisymmetric excitation normal to the fiber axis at the outer boundary of the material. This approach is enabled via a transformation to an elliptic coordinate system with isotropic properties. The approach is extended to the case of diverging shear waves radiating from a cylindrical rod that is axially oscillating perpendicular to the axis of isotropy and parallel to the plane of isotropy.A theoretical approach was recently introduced by Guidetti and Royston [J. Acoust. Soc. Am. 144, 2312–2323 (2018)] for the radially converging elliptic shear wave pattern in transverse isotropic materials subjected to axisymmetric excitation normal to the fiber axis at the outer boundary of the material. This approach is enabled via a transformation to an elliptic coordinate system with isotropic properties. The approach is extended to the case of diverging shear waves radiating from a cylindrical rod that is axially oscillating perpendicular to the axis of isotropy and parallel to the plane of isotropy.
Development of a water level sensor using magnetostrictive materials

In this study, an active-mode water level sensor has been developed to distinguish between the interfaces in large capacity water tanks. The sensor must be robust to withstand forces due to moving water when filling or emptying the tanks, and should be able to work when the water tank is both in motion and still. A Galfenol-brass unimorph beam has been constructed, with Galfenol (an Fe-Ga alloy, magnetostrictive material) as the active layer. The beam is clamped at one end, and, when it is flexed, there will be a stress concentration near the clamped region. This change in stress can be measured by a magnetic field sensor, which can detect local changes in magnetic field. Two magnetic coils are used, one for alternating current (AC) magnetic field generation and the other for measuring the magnetic field response of the beam. The resonance frequency of the beam in air is 248 Hz, and 206 Hz in water. By choosing an operating vibrational frequency of 280 Hz, we can separate the pick-up coil voltage response due to differences in the surrounding environment. The sensor was mounted vertically in a water tank and the system was tested both as the water level increased and decreased, showing a 10% increase from not submerged to fully submerged. The relative sensor response was evaluated from room temperature (25 °C) to 80 °C, showing a 9.1% linear increase in voltage response in water, and 8.2% in air.
Discovery of vascular Rho kinase (ROCK) inhibitory peptides.

Rho-activated kinases (ROCKs) regulate many cellular functions such as proliferation, migration, and smooth muscle contractility, but they are also associated with pathogenesis of many human diseas...
Process–structure–property relationships in bimodal machined microstructures using robust structure descriptors

Abstract Machining is a severe plastic deformation process that subjects materials to high rates of deformation and elevated temperatures. Dynamic recrystallization during severe plastic deformation drives grain refinement into the sub-micron range but the ductility and thermal stability of these structures is poor. In contrast, bimodal microstructures consisting of both fine and coarse grains have been shown to exhibit attractive strength and ductility properties at these temperatures. In this paper, we study the process–structure–property relationships for pure copper subject to a machining process where the cutting speeds are varied. Further, we investigate the role of thermal effects by varying the post-deformation cooling rates. Microstructures generated under these deformation conditions are quantified using angularly resolved chord length statistics. The derived metrics are found to be robust descriptors of the studied microstructures as they automatically capture complex features such as unimodal and bimodal distributions of grain structure, grain constituent length scales, and morphological anisotropy induced by shear deformation. The uniaxial equivalent yield strength of the generated structures are estimated using spherical nanoindentation and inverse modeling techniques. Finally, we present a methodology for identifying the constrained property-process inverse mapping for machining using a Bayesian framework and the established forward process–structure–property mapping.
Ratio imaging: practical considerations for measuring intracellular calcium and pH in living tissue.

Publisher Summary For the maintenance of steady state there must be mechanisms in place in the cell to ensure the appropriate balance between the intracellular and extracellular milieu. The study of intracellular ion concentrations in the steady-state and the role of various ions in regulating cellular processes was until recently limited to systems that could be impaled with a microelectrode. This chapter focuses on the measurement of two intracellular ions: (1) intracellular H+ (pH i ) and (2) Ca 2+ (Ca i ), at the single-cell level with a relatively noninvasive technique, quantitative ratio imaging. The development and availability of Ca i - and pH i -specific fluorescent probes coupled to major advances in the technology and design of low-light level charge-coupled devices geared toward biological applications and improved microscope optics has made it possible to visualize a two-dimensional (2-D) fluorescence signal—that is related to the free concentration of Ca and pH inside a cell. This chapter describes the basis for using the dual excitation ratio-imaging technique. The uncertainties associated with quantitating single-wavelength fluorescence imaging are apparent from the standard fluorescence equation as presented by Bright et al .
The first-in-class peptide binder to the SARS-CoV-2 spike protein

Abstract Coronavirus disease 19 (COVID-19) is an emerging global health crisis. With over 200,000 confirmed cases to date, this pandemic continues to expand, spurring research to discover vaccines and therapies. SARS-CoV-2 is the novel coronavirus responsible for this disease. It initiates entry into human cells by binding to angiotensin-converting enzyme 2 (ACE2) via the receptor binding domain (RBD) of its spike protein (S). Disrupting the SARS-CoV-2-RBD binding to ACE2 with designer drugs has the potential to inhibit the virus from entering human cells, presenting a new modality for therapeutic intervention. Peptide-based binders are an attractive solution to inhibit the RBD-ACE2 interaction by adequately covering the extended protein contact interface. Using molecular dynamics simulations based on the recently solved ACE2 and SARS-CoV-2-RBD co-crystal structure, we observed that the ACE2 peptidase domain (PD) α1 helix is important for binding SARS-CoV-2-RBD. Using automated fast-flow peptide synthesis, we chemically synthesized a 23-mer peptide fragment of the ACE2 PD α1 helix composed entirely of proteinogenic amino acids. Chemical synthesis of this human derived sequence was complete in 1.5 hours and after work up and isolation >20 milligrams of pure material was obtained. Bio-layer interferometry revealed that this peptide specifically associates with the SARS-CoV-2-RBD with low nanomolar affinity. This peptide binder to SARS-CoV-2-RBD provides new avenues for COVID-19 treatment and diagnostic modalities by blocking the SARS-CoV-2 spike protein interaction with ACE2 and thus precluding virus entry into human cells.
Reliability of vestibular perceptual threshold testing about the yaw axis

OBJECTIVES Vestibular reflexes have traditionally formed the cornerstone of vestibular evaluation, but perceptual tests have recently gained attention for use in research studies and potential clinical applications. However, the unknown reliability of perceptual thresholds limits their current importance. This is addressed here by establishing the test-retest reliability of vestibular perceptual testing. DESIGN Perceptual detection thresholds to earth-vertical, yaw-axis rotations were collected in 15 young healthy people. Participants were tested at two time intervals (baseline, 5 to 14 days later) using an adaptive psychophysical procedure. RESULTS Thresholds to 1 Hz rotations ranged from 0.69 to 2.99°/s (mean: 1.49°/s; SD: 0.63). They demonstrated an excellent intraclass correlation (0.92; 95% confidence interval: 0.77 to 0.97) with a minimum detectable difference of 0.45°/s. CONCLUSIONS The excellent test-retest reliability of perceptual vestibular testing supports its use as a research tool and motivates further exploration for its use as a novel clinical technique.
Dynamic Range Requirements of Digital vs. RF and Tiled Beamforming in mm-Wave Massive MIMO

We analyze the required RF channel 1dB gain compression points and ADC resolution in mm-wave massive MIMO wireless communications hubs using RF beamformers, digital beamformers, and hybrid beamformers with coarse RF beamforming in the tiles and fine digital beamforming in the overall array. Given a 140GHz uplink, 16 users, 10Gb/s data rate per user, QPSK modulation, 5dB power levelling, and 32 or 64 RF channels, the three architectures require similar ADC resolution and similar 1dB gain-compression points, i.e. fully digital beamforming does not significantly increase the hardware requirements of the RF chain or ADC.
Third-Year Medical Students' Self-perceived Knowledge About Health Disparities and Community Medicine.

Introduction Medical providers' attitudes about caring for vulnerable populations have significant implications for persistent health disparities. Therefore, assessing medical students' self-perceived knowledge about community-based medicine and care for underserved populations can provide insights for improving health care delivery to achieve health equity. We evaluated third-year medical students' perceptions of their knowledge and attitudes about community medicine, and addressing health care needs of vulnerable populations. Methods From October 2, 2017 to July 12, 2019, third-year medical students at a private, urban medical school were asked to complete an assessment survey during their family medicine clerkship orientation. The anonymous survey assessed students' self-perceived knowledge and attitudes regarding community medicine and care of vulnerable populations. We examined differences in survey responses by student demographics. Results A total of 401 students participated in the survey; 50.5% of respondents agreed that they had knowledge to assess health literacy of the patient, while only 22.2% of students agreed that they had knowledge about how to identify a community and conduct a community health needs assessment. Additionally, students agreed with being most comfortable providing care to adolescents (73.0%) and the elderly (69.5%), and that they were least comfortable caring for incarcerated individuals (31.7%) and immigrants/refugees (44.1%). Conclusion Assessment of learners' self-perceived knowledge can help highlight areas for educational interventions. Our findings suggest the need for improving medical student knowledge in areas of community health and health care for specific vulnerable populations.
Pit viper envenomation in pediatric dogs: 5 cases

Treatment of pit viper envenomated puppies (≤6 months old) with antivenom was well tolerated, similar to adult dogs. However, therapeutic guidelines should be established to direct use and prove efficacy in this population.
Evaluation of CCR2 as a theranostic biomarker for abdominal aortic aneurysm

133 Objectives: Abdominal aortic aneurysms (AAA) represent a life-threatening degenerative vascular disease without any medical therapy. Previously, we have reported that chemokine receptor 2 (CCR2) as a promising target for AAA diagnosis and rupture prediction. Herein, our goal was to evaluate CCR2 as a theranostic biomarker following CCR2 inhibitor treatment. Moreover, we have also assessed the performance of CCR2-targeted PET tracer imaging AAA patients. Methods: A surgical AAA induction model in Sprague-Dawley rats utilizing intra-aortic exposure to porcine pancreatic elastase (PPE) under pressure was used to study the treatment response. The rat AAA rupture (RAAA) model was generated by the administration of β-aminopropionitrile (BAPN) to a AAA rat model. A CCR2 antagonist, RS504393, was selected to inhibit AAA expansion and rupture and administrated via oral gavage at day 0 post AAA induction. Dynamic CCR2 PET/CT scans were performed at 45-60 min post tail vein injection of CCR2 binding tracer 64Cu-DOTA-ECL1i. The CCR2-targeted PET imaging of AAA patients has been carried out under eIND 137620. Results: Following RS504393 treatment, the AAA rupture rate was significantly decreased by 3-fold from 49% (17/35) to 15% (2/13) at day 6 post inhibition. The maximum aortic diameter of RS504393-treated group was also 3-fold less (p Conclusions: CCR2 is a promising theranostic biomarker for PET imaging and a targeted therapy to manage AAA. The early-phase clinical studies of 64Cu-DOTA-ECL1i confirm its safety and demonstrate its potential for CCR2 imaging in AAA patients with PET/CT. Research Support: This work is supported by NIH R35HL145212, R01HL153436, P41EB025815, Wylie Scholar Award from Vascular Cures Foundation, the Institute of Clinical and Translational Sciences (ICTS) of Washington University, and Foundation for Barnes-Jewish Hospital.
Pilot Phase II Trial of Neoadjuvant Immunotherapy in Locoregionally Advanced, Resectable Cutaneous Squamous Cell Carcinoma of the Head and Neck.

Purpose: In locoregionally advanced, resectable cutaneous squamous cell carcinoma of the head and neck (CSCC-HN), surgery followed by radiotherapy is standard but can be cosmetically and functionally devastating, and many patients will have recurrence. Patients and Methods: Newly diagnosed or recurrent stage III–IVA CSCC-HN patients amenable to curative-intent surgery received two cycles of neoadjuvant PD-1 inhibition. The primary endpoint was ORR per RECIST 1.1. Secondary endpoints included pathologic response [pathologic complete response (pCR) or major pathologic response (MPR; ≤10% viable tumor)], safety, DSS, DFS, and OS. Exploratory endpoints included immune biomarkers of response. Results: Of 20 patients enrolled, 7 had recurrent disease. While only 6 patients [30%; 95% confidence interval (CI), 11.9–54.3] had partial responses by RECIST, 14 patients (70%; 95% CI, 45.7–88.1) had a pCR (n = 11) or MPR (n = 3). No SAEs ocurred during or after the neoadjuvant treatment. At a median follow-up of 22.6 months (95% CI, 21.7–26.1), one patient progressed and died, one died without disease, and two developed recurrence. The 12-month DSS, DFS, and OS rates were 95% (95% CI, 85.9–100), 89.5% (95% CI, 76.7–100), and 95% (95% CI, 85.9–100), respectively. Gene expression studies revealed an inflamed tumor microenvironment in patients with pCR or MPR, and CyTOF analyses demonstrated a memory CD8+ T-cell cluster enriched in patients with pCR. Conclusions: Neoadjuvant immunotherapy in locoregionally advanced, resectable CSCC-HN is safe and induces a high pathologic response rate. Pathologic responses were associated with an inflamed tumor microenvironment.
A Randomized, Double-Blind, Controlled Trial of Lithium Versus Quetiapine for the Treatment of Acute Mania in Youth with Early Course Bipolar Disorder.

Objective: To compare the efficacy and tolerability of lithium versus quetiapine for the treatment of manic or mixed episodes in youths with early course bipolar I disorder. Methods: Six-week, rand...
Consequences of Rapid Weight Loss

Rapid weight loss is associated with significant positive consequences including resolution of obesity related comorbidities and improvement of overall health and quality of life. However, rapid weight loss may have negative consequences with life threatening repercussions. This chapter summarizes commonly utilized methods of weight loss and both positive and negative consequences of rapid weight loss.
C3a Is Required for the Production of CXC Chemokines by Tubular Epithelial Cells after Renal Ishemia/Reperfusion

The complement system is one of the major ways by which the body detects injury to self cells, and the alternative pathway of complement is rapidly activated within the tubulointerstitium after renal ischemia/reperfusion (I/R). In the current study, we investigate the hypothesis that recognition of tubular injury by the complement system is a major mechanism by which the systemic inflammatory response is initiated. Gene array analysis of mouse kidney following I/R initially identified MIP-2 (CXCL2) and keratinocyte-derived chemokine (KC or CXCL1) as factors that are produced in a complement-dependent fashion. Using in situ hybridization, we next demonstrated that these factors are expressed in tubular epithelial cells of postischemic kidneys. Mouse proximal tubular epithelial cells (PTECs) in culture were then exposed to an intact alternative pathway and were found to rapidly produce both chemokines. Selective antagonism of the C3a receptor significantly attenuated production of MIP-2 and KC by PTECs, whereas C5a receptor antagonism and prevention of membrane attack complex (MAC) formation did not have a significant effect. Treatment of PTECs with an NF-kappaB inhibitor also prevented full expression of these factors in response to an intact alternative pathway. In summary, alternative pathway activation after renal I/R induces production of MIP-2 and KC by PTECs. This innate immune system thereby recognizes hypoxic injury and triggers a systemic inflammatory response through the generation of C3a and subsequent activation of the NF-kappaB system.
Public Attitudes Toward Special Needs Students as a Result of the DSM

Although the Diagnostic Statistical Manual for Mental Disorders (DSM) is universally used in the field of psychology to diagnose individuals, it is more of a political document than a scientific one. In the original version of the DSM (1952), students with mental disorders were diagnosed solely on IQ scores. But who has the power to determine what IQ score is “normal?” The American Psychiatric Association (APA) decides who is sane and who is not, and they persuade the public to accept their claims as being objective (Caplan, 1995). Thus, as the eminent philosopher Michel Foucault (1975) argues, mental professionals create the discourse on mental disorders, and they define the roles of madness and normalcy, deficiency and intelligence. In the first DSM, one was diagnosed as severely mentally deficient if he/she had an IQ score below 50. Part of the reason as to why the term special needs has a negative connotation is due to this abysmal score. Society and medical professionals only diagnosed severe cases of mental disorders. As the years progressed, the DSM gradually changed the criteria for being “mentally deficient” or having a “mental disorder.” In order to be diagnosed with profound mental deficiency, one must have an IQ score below 20. This new criterion adds to the negative connotation for special needs students. Although these students do not fit the criterion and may have incredible IQ scores, society erroneously holds the notion that people requiring special academic needs are severely deficient. This research paper shows how the DSM has shaped public attitudes toward mental disorders while it also criticizes the concept of IQ scores.
A minimal dual-core speculative multi-threading architecture

Speculative multi-threading (SpMT) can improve single-threaded application performance using the multiple thread contexts available in current processors. We propose a minimal SpMT model that uses only two thread contexts. The model achieves significant speedups for single-threaded applications using a low-overhead scheme for detecting and selectively recovering from data dependence violations, and a novel wrong path predictor to reduce the number of speculative threads executing along the wrong path. We also study the interactions between three previously proposed SpMT thread spawning policies that can be implemented dynamically in hardware - Fork on Call, Loop Continuation and Run Ahead policies - and show it is beneficial to implement all three policies together in a processor. While the individual thread spawning policies show performance benefits of 14%, 5% and 4% respectively on our SpMT model over a base processor that does not exploit SpMT, combining all three policies shows an average performance gain of 20%. Finally, we identify the sources of SpMT benefits - on average, 58% of the performance benefits due to SpMT comes from cache prefetching, 33% from instruction reuse, and 9% from branch precomputation and show all three sources of SpMT benefits must be utilized to realize the full potential of SpMT.
Flux (Dose Rate) Effects for 2.8 MeV 58Ni Irradiations of Pure Ni

Five years ago a phenomenon now known as swelling was found1 to occur in reactor materials under prolonged intense neutron irradiation. This swelling, which may represent a 10% or greater volume change, results from condensation of vacancies to form voids. The void formation presents severe limits on possibilities for advanced nuclear reactors. Subsequently it was found that this swelling could be simulated, at least qualitatively, by bombardment with heavy ions in a small fraction of the time required with neutron irradiation. Two conferences2,3 have summarized early work of this type. However, the higher (103 –105 times) production rate of the initial damage which makes simulation feasible may also obscure subtle microstructural changes. Thus, the dose rate effects need to be understood. Qualitative theoretical predictions of these effects have been made.4,5 The purpose of the present experiment was to obtain two quantitative curves of swelling versus irradiation temperature in pure nickel where flux (dose rate) is the only variable. That is, the flux was varied by a factor of 100 while the bombarding projectile, its energy, and the total fluence of incident ions was maintained the same. Comparisons are made between experimental results and the theoretically predicted effects of flux on swelling.
The complete mitochondrial genome of the enigmatic bigheaded turtle (Platysternon): description of unusual genomic features and the reconciliation of phylogenetic hypotheses based on mitochondrial and nuclear DNA

The big-headed turtle (Platysternon megacephalum) from east Asia is the sole living representative of a poorly-studied turtle lineage (Platysternidae). It has no close living relatives, and its phylogenetic position within turtles is one of the outstanding controversies in turtle systematics. Platysternon was traditionally considered to be close to snapping turtles (Chelydridae) based on some studies of its morphology and mitochondrial (mt) DNA, however, other studies of morphology and nuclear (nu) DNA do not support that hypothesis. We sequenced the complete mt genome of Platysternon and the nearly complete mt genomes of two other relevant turtles and compared them to turtle mt genomes from the literature to form the largest molecular dataset used to date to address this issue. The resulting phylogeny robustly rejects the placement of Platysternon with Chelydridae, but instead shows that it is a member of the Testudinoidea, a diverse, nearly globally-distributed group that includes pond turtles and tortoises. We also discovered that Platysternon mtDNA has large-scale gene rearrangements and possesses two, nearly identical, control regions, features that distinguish it from all other studied turtles. Our study robustly determines the phylogenetic placement of Platysternon and provides a well-resolved outline of major turtle lineages, while demonstrating the significantly greater resolving power of comparing large amounts of mt sequence over that of short fragments. Earlier phylogenies placing Platysternon with chelydrids required a temporal gap in the fossil record that is now unnecessary. The duplicated control regions and gene rearrangements of the Platysternon mtDNA probably resulted from the duplication of part of the genome and then the subsequent loss of redundant genes. Although it is possible that having two control regions may provide some advantage, explaining why the control regions would be maintained while some of the duplicated genes were eroded, examples of this are rare. So far, duplicated control regions have been reported for mt genomes from just 12 clades of metazoans, including Platysternon.
Abstract W P26: Itemized NIHSS Subsets Predict MRI Positive Strokes In Patients With Mild Deficits

Background: While imaging is useful in confirming the diagnosis of ischemic stroke, negative diffusion weighted imaging (DWI) is reported in up to 10% of patients. We aim to (1) identify predictors of MRI-positive stroke from the itemized NIHSS, and (2) to correlate subsets with infarct volume. Methods: Data were derived from the Stroke Warning Information and Faster Treatment study from 2006 to 2009 among patients with mild deficits (NIHSS 0-5) and attending physician final diagnosis of stroke. Using Medical Image Processing, Analysis, and Visualization (MIPAV, NIH) (Version 7.1.1), we calculated lesion volume (cm3) from DWI sequence. Univariate models studied the association between itemized NIHSS subsets, including cortical deficits (visual field cut, aphasia, or neglect), and presence of DWI hyperintensity and lesion volume. Multivariable regression assessed factors predicting DWI-positive strokes; p Results: Of 611 patients with a discharge diagnosis of stroke, 498 underwent MRI and 29.5% were DWI negative. On multivariate analysis, predictors of a positive DWI were NIHSS score of 3-5 (OR= 2.5, 95%CI:1.1-5.5), motor deficits (OR= 1.9, 95%CI:1.1-3.4), and ataxia (OR=3.0, CI:1.5-6.1). All patients with neglect and visual deficits were DWI positive (table). The mean lesion volume in cm3 was larger in patients with NIHSS 3-5 vs. NHSS 0-2 (49.0 vs. 17.3, p=0.002), cortical deficits (112.6 vs. 22.9, p Conclusion: NIHSS score subsets predict DWI positivity and lesion volume in mild strokes. The presence of neglect or visual field deficit on the NIHSS subsets is highly likely to have an MRI correlate even in patients with low NIHSS.
Epigenetic reprogramming in the epithelial-to-mesenchymal transition

The epithelial-to-mesenchymal transition (EMT) is a cellular dedifferentiation process that is critical to development, wound healing and metastasis. Like other cell state transitions, such as differentiation, EMT is accompanied by genome-wide epigenetic reprogramming. However, the relationship between reprogramming and functional changes in the cell is poorly understood. In an A549 non-small cell lung cancer EMT model system we observed changes in chromatin state between epithelial and mesenchymal states. Multivariate analyses were applied to paired (epithelial and mesenchymal) ChIP-seq data for 18 histone modifications/variants and expression microarray data. We observed epigenetic co-regulation of genes associated with EMT, as well as their proximal enhancers. We also observed epigenetic activation or repression of functionally distinct sets of enhancers. These genes and enhancers are regulated and bound by a small set of transcription factors, specifically AP-1, NF-κB and c-Myc. These transcription factors themselves also a show an epigenetic profile similar to the EMT-related genes. Together, these observations suggest a chromatin-mediated transcriptional feedback mechanism that establishes and maintains the phenotypic switch.
Increased dialyzer reuse with citrate dialysate.

Dialyzer reuse is limited by the clotting of blood, which blocks the fibers and reduces the membrane surface area. Clotting during treatment may also reduce dialysis efficiency and potentially decrease delivered dose, Kt/V(urea). A new dialysate containing citric acid, instead of the standard acetic acid, as the acidifying agent has become available and is associated with reduced clotting during acute dialysis treatments. The effect of citric acid dialysate on dialyzer reuse was evaluated in this prospective, controlled, multicenter study involving maintenance hemodialysis patients. A total of 105 patients from five dialysis units were switched to the new dialysate and new dialyzers. Reuse outcome on the new dialysate was compared with the reuse on the regular acetic acid containing bicarbonate dialysate (controls). The overall reuse with citrate dialysate increased significantly from 15.1 +/- 9.4 to 18 +/- 10.0 (mean +/- SD) on regular and citrate dialysate, respectively (p = 0.0003). The most significant increase was seen in those patients who had limited reuse before the switch to citrate dialysate; 51, 59, and 134% increases occurred in those with 10 to 15, 5 to 10, and 10 reuses (1.23 +/- 0.23 vs. 1.47 +/- 0.23, respectively, p = 0.009). The Kt/V(urea) increased to 1.41 +/- 0.31 after the switch in the low-reuse group but the increase did not reach statistical significance (p = 0.07). The results from this study show that citric acid-containing dialysate is associated with increase in dialyzer reuse and appears to be related to reduced clotting.
An analysis of trends in baseflow recession and low-flows in rain-dominated coastal streams of the pacific coast

Summary The work presented here centers on the identification and calculation of indices representative of annual low-flow conditions and baseflow recession form, and the evaluation of trends in these indices with time for rain-dominated streams of the Pacific coastal mountain ranges. Two different baseflow recession analysis techniques are employed, which when combined are capable of modeling the varied dry-season flow conditions that exist over the broad range of catchments included in the study area. Results indicate that over the past 40–80 years widespread trends of increasing rates of baseflow recession and decreasing annual low-flow conditions exist throughout the region. Of streamgages analyzed, 44% were identified as having a statistically significant trend in either low-flow conditions or recession form with time. While spring flow conditions show little change over the study period, trends of decreasing late-summer flow conditions and increasing rates of recession are particularly common. Northern California and Oregon are especially impacted locations, with upwards of 60% of study gages exhibiting decreasing trends in late summer flow conditions. Detailed conceptual explanations for the connections between trends in recession form and indices of low-flow are also presented.
Ring and plasma - The enigmae of Enceladus

The E ring associated with the Kronian moon Enceladus has a lifetime of only a few thousand years against sputtering by slow corotating O ions. The existence of the ring implies the necessity for a continuous supply of matter. Possible particle source mechanisms on Enceladus include meteoroidal impact ejection and geysering. Estimates of ejection rates of particulate debris following small meteoroid impact are on the order of 3 x 10 to the -18th g/(sq cm sec), more than an order of magnitude too small to sustain the ring. A geyser source would need to generate a droplet supply at a rate of approximately 10 to the -16th g/(sq cm sec) in order to account for a stable ring. Enceladus and the ring particles also directly supply both plasma and vapor to space via sputtering. The absence of a 60 eV plasma at the Voyager 2 Enceladus L-shell crossing, such as might have been expected from sputtering, cannot be explained by absorption and moderation of plasma ions by ring particles, because the ring is too diffuse. Evidently, the effective sputtering yield in the vicinity of Enceladus is on the order of, or smaller than, 0.4, about an order of magnitude less than te calculated value. Small scale surface roughness may account for some of this discrepancy.
Superconvergence of finite element discretization of time relaxation models of advection

The nodal accuracy of finite element discretizations of advection equations including a time relaxation term is studied. Worst case error estimates have been proven for this combination (for the Navier–Stokes equations) by energy methods. By considering the Cauchy problem with uniform meshes, precise Fourier analysis of the error is possible. This analysis shows (1) the worst case upper bounds are sharp in the meshwidth h, (2) time relaxation stabilization does not degrade superconvergence of the usual FEM, (3) time relaxation itself is possibly superconvergent and (4) higher order time relaxation is preferable to maintain small numerical errors.