cssi/SciSciGPT-SciSciNet huggingface dataset:
Metabolic Syndrome, Insulin Resistance, and Roles of Inflammation – Mechanisms and Therapeutic Targets

Obesity and its comorbidities, including type 2 diabetes mellitus and cardiovascular disease, are associated with a state of chronic low-grade inflammation that can be detected both systemically and within specific tissues. Areas of active investigation focus on the molecular bases of metabolic inflammation and potential pathogenic roles in insulin resistance, diabetes, and cardiovascular disease. An increased accumulation of macrophages occurring in obese adipose tissue has emerged as a key process in metabolic inflammation. Recent studies have also begun to unravel the heterogeneity of adipose tissue macrophages, and their physical and functional interactions with adipocytes, endothelial cells, and other immune cells within the adipose tissue microenvironment. Translating the information gathered from experimental models of insulin resistance and diabetes into meaningful therapeutic interventions is a tantalizing goal with long-term global health implications. In this context, ongoing clinical studies are testing the effects of targeting inflammation systemically on metabolic and cardiovascular outcomes.
Early Results of the Use of Tantalum Femoral Cones for Revision Total Knee Arthroplasty

Background: The optimum treatment method for large femoral bone defects during revision knee replacement has not been established. The purpose of the present study was to determine the initial results associated with the use of porous tantalum metaphyseal cones for the treatment of severe femoral bone loss at the time of revision total knee arthroplasty. Methods: Porous tantalum metaphyseal cones were implanted during twenty-four revision total knee replacements. The study group included thirteen women and eleven men with a mean age of sixty-four years at the time of the procedure. The indications for the revision procedure included aseptic loosening of the femoral component (eleven patients), second-stage reimplantation for the treatment of deep infection (seven patients), severe osteolysis around a well-fixed femoral component (three patients), periprosthetic femoral fracture (two patients), and severe knee instability (one patient). Results: The patients were followed for an average of thirty-three months (range, twenty-four to fifty months). Overall, the average Knee Society clinical score improved from 55 points preoperatively to 81 points at the time of the latest follow-up. Radiographic evaluation was completed for twenty patients after a mean duration of follow-up of thirty-five months. All femoral cones appeared well fixed radiographically, with no evidence of complications related to the cone. Conclusions: At the time of short-term follow-up, the porous tantalum metaphyseal femoral cones effectively provided structural support for the femoral implants of a revision total knee arthroplasty in this series. The potential for long-term biologic fixation may provide durability for reconstructions. Long-term follow-up and comparison with alternative reconstructive techniques will be required to evaluate the true effectiveness of this implant. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
Are Blacks Really Less Trusting than Whites? Revisiting the Race and Trust Question

Many scholars have concluded that blacks are less trusting than whites. The research presented here calls that conclusion into question. Previous research has been based on the standard trust measure, which may not be well suited to understanding how trust varies with social categories such as race. Building on theories of self-categorization and social identity, we argue that blacks are not less trusting than whites as suggested in previous work. Instead trust is expected to be greater within race-category boundaries than across race-category boundaries. A new experiment designed to test this argument is employed. The results strongly support our predictions. This research also addresses how trustworthiness varies with race-category. Results for trustworthiness do not map on to those for trust. Instead, blacks in this research show a higher level of trustworthiness than whites, regardless of other's race-category.
the body in the gift: memory and forgetting in Sabarl mortuary exchange

In casting gift exchange as an inscriptive performance of embodied gender relations, the Sabarl of Papua New Guinea reveal an indigenous valuation of forgetting as a willed transformation of memory and resist the opposition between inscribed and enacted cultural traditions that is so pervasive in the anthropological literature on social memory. Sabarl mortuary exchanges that feature “corpses” of gendered wealth serve here as a case in point. [exchange theory, gender performances, embodiment, memory and forgetting, Melanesia, mortuary rituals]
A unifying statistical model for QTL mapping of genotype × sex interaction for developmental trajectories

Most organisms display remarkable differences in morphological, anatomical, and developmental features between the two sexes. It has been recognized that these sex-dependent differences are control...
Improved IC-compatible piezoelectric microphone and CMOS process

The authors report on an improved IC-processed microphone which has an unamplified sensitivity of approximately 100 mu V/ mu bar over the audio range. The microphone is constructed of a 2.0- mu m-thick LPCVD (low-pressure chemical vapor deposition) deposited, square, silicon nitride diaphragm (3.04 mm on an edge). On the top of the diaphragm, electrodes, insulators, and a ZnO piezoelectric film are deposited to transduce the mechanical deformation caused by the sound into an electrical signal. The microphone has been designed to be fabricated with an on-chip amplifier. The microphone has been produced without the on-chip amplifier and a signal-to-noise ratio of approximately 15 has been measured for an acoustic input of 1 mu bar (equivalent to a noise level of 50 dB SPL). Features that have improved the sensitivity over previous embodiments are: reduction of residual strain in the silicon nitride by modification of the film LPCVD deposition parameters, serial connections of the segmented, electrodes that are placed according to the diaphragm stress pattern, and design of the composite diaphragm and transducer layers to optimize sensitivity. >
The Fe‐FeO buffer at lower mantle pressures and temperatures

As a constraint on oxygen fugacity of the lower mantle, the iron-wuestite (IW) oxygen buffer has been calculated for temperatures to 3,000 K and pressures to 135 GPa using available thermochemical and thermophysical data for Fe, FeO, and O{sub 2}. At conditions corresponding to the core-mantle boundary and 670 km depth, respectively, the oxygen fugacity of this buffer is 10{sup 20} and 10{sup 3} Pa; oxygen activities referenced to these conditions are 10{sup {minus}9} and 10{sup {minus}13}.
Absence of Reelin results in altered nociception and aberrant neuronal positioning in the dorsal spinal cord.

Abstract Mutations in reeler , the gene coding for the Reelin protein, result in pronounced motor deficits associated with positioning errors (i.e. ectopic locations) in the cerebral and cerebellar cortices. In this study we provide the first evidence that the reeler mutant also has profound sensory defects. We focused on the dorsal horn of the spinal cord, which receives inputs from small diameter primary afferents and processes information about noxious, painful stimulation. We used immunocytochemistry to map the distribution of Reelin and Disabled-1 (the protein product of the reeler gene, and the intracellular adaptor protein, Dab1, involved in its signaling pathway) in adjacent regions of the developing dorsal horn, from early to late embryonic development. As high levels of Dab1 accumulate in cells that sustain positioning errors in reeler mutants, our findings of increased Dab1 immunoreactivity in reeler laminae I–III, lamina V and the lateral spinal nucleus suggest that there are incorrectly located neurons in the reeler dorsal horn. Subsequently, we identified an aberrant neuronal compaction in reeler lamina I and a reduction of neurons in the lateral spinal nucleus throughout the spinal cord. Additionally, we detected neurokinin-1 receptors expressed by Dab1-labeled neurons in reeler laminae I–III and the lateral spinal nucleus. Consistent with these anatomical abnormalities having functional consequences, we found a significant reduction in mechanical sensitivity and a pronounced thermal hyperalgesia (increased pain sensitivity) in reeler compared with control mice. As the nociceptors in control and reeler dorsal root ganglia are similar, our results indicate that Reelin signaling is an essential contributor to the normal development of central circuits that underlie nociceptive processing and pain.
Insulin‐like Growth Factor‐II (IGF‐II) and IGF Binding Proteins in Human Endometriuma

The insulin-like growth factor autocrine/paracrine system is believed to play a role in steroid-mediated endometrial differentiation. It is constituted of the mitogenic peptides (IGF-I and IGF-II), membrane receptors, and a family of high-affinity binding proteins (IGFBPs) that regulate the actions of the IGFs at their target cells. We have investigated expression of the mRNAs encoding the three major IGFBPs (IGFBP-1, IGFBP-2, and IGFBP-3) in human endometrium and have found, by Northern analysis, differential expression of all three mRNAs in secretory compared to proliferative endometrium, different steroidal milieux. IGF-II mRNAs were also detected in secretory endometrium. Finally, we found that human endometrial stromal cells in culture synthesize and secrete IGFBP-2 and IGFBP-3, and that the synthesis of IGFBP-2 is regulated by steroid hormones.
Kratos: Princeton University's entry in the 2008 Intelligent Ground Vehicle Competition

In this paper we present Phobetor, an autonomous outdoor vehicle originally designed for the 2010 Intelligent Ground Vehicle Competition (IGVC). We describe new vision and navigation systems that have yielded 3x increase in obstacle detection speed using parallel processing and robust lane detection results. Phobetor also uses probabilistic local mapping to learn about its environment and Anytime Dynamic A* (AD*) to plan paths to reach its goals. Our vision software is based on color stereo images and uses robust, RANSAC-based algorithms while running fast enough to support real-time autonomous navigation on uneven terrain. AD* allows Phobetor to respond quickly in all situations even when optimal planning takes more time, and uses incremental replanning to increase search efficiency. We augment the cost map of the environment with a potential field which addresses the problem of "wall-hugging" and smoothes generated paths to allow safe and reliable path-following. In summary, we present innovations on Phobetor that are relevant to real-world robotics platforms in uncertain environments.
Testosterone enhances tubuloglomerular feedback by increasing superoxide production in the macula densa

Males have higher prevalence of hypertension and renal injury than females, which may be attributed in part to androgen-mediated effects on renal hemodynamics. Tubuloglomerular feedback (TGF) is an important mechanism in control of renal microcirculation. The present study examines the role of testosterone in the regulation of TGF responses. TGF was measured by micropuncture (change of stop-flow pressure, ΔPsf) in castrated Sprague-Dawley rats. The addition of testosterone (10−7 mol/l) into the lumen increased the ΔPsf from 10.1 ± 1.2 to 12.2 ± 1.2 mmHg. To determine whether androgen receptors (AR) are involved, mRNA of AR was measured in the macula dense cells isolated by laser capture microdissection from kidneys, and a macula densa-like cell line (MMDD1). AR mRNA was expressed in the macula densa of rats and in MMDD1 cells. We next examined the effects of the AR blocker, flutamide (10−5 mol/l) on the TGF response. The addition of flutamide blocked the effects of testosterone on TGF. The addition of Tempol (10−4 mol/l) or polyethylene glycol-superoxide dismutase (100 U/ml) to scavenge superoxide blocked the effect of testosterone to augment TGF. We then applied apocynin to inhibit NAD(P)H oxidase and oxypurinol to inhibit xanthine oxidase and found the testosterone-induced augmentation of TGF was blocked. In additional experiments in MMDD1 cells, we found that testosterone increased O2− generation. Apocynin or oxypurinol blocked the testosterone-induced increases of O2−, while blockade of COX-2 with NS-398 had no effect. These findings suggest that testosterone enhances TGF response by stimulating O2− production in macula densa via an AR-dependent pathway.
Bone Is a Target for the Antidiabetic Compound Rosiglitazone

Rosiglitazone is an FDA-approved oral antidiabetic agent for the treatment of type 2 diabetes. This compound improves insulin sensitivity through the activation of the nuclear receptor, peroxisome proliferator-activated receptor- (PPAR-). In addition to sensitizing cells to insulin, the PPAR-2 isoform appears to be critical for the regulation of osteoblast and adipocyte differentiation from common mesenchymal bone marrow progenitors. We have demonstrated previously that PPAR-2 activated with rosiglitazone acts as a dominant inhibitor of osteoblastogenesis in murine bone marrow in vitro. Here, we show that in vivo, rosiglitazone administration results in significant bone loss. When rosiglitazone (20g/g body weight/d) was given to 6-month-old, nondiabetic C57BL/6 mice for 7 wk, a significant decrease in total body bone mineral density was observed. Analysis of bone microarchitecture, using micro-computed tomography, demonstrated a decrease in bone volume, trabecular width, and trabecular number and an increase in trabecular spacing. Histomorphometric analysis showed a decrease in bone formation rate, with a simultaneous increase in fat content in the bone marrow. Changes in bone morphology and structure were accompanied by changes in the expression of osteoblast- and adipocytespecific marker genes; the expression of the osteoblastspecific genes Runx2/Cbfa1, Dlx5, and 1(I)collagen were decreased, whereas the expression of the adipocyte-specific fatty acid binding protein aP2, was increased. These in vivo data suggest that rosiglitazone therapy may pose a significant risk of adverse skeletal effects in humans. (Endocrinology 145: 401– 406, 2004)
Follow the Water: Extreme Drought and the Conifer Forest Pandemic of 2002–2003 Along the California Borderland

California conifer forests suffer chronic low levels of bark beetle-caused tree mortality, but are subject to periodic episodes of widespread bark beetle outbreaks and extensive tree death. The extent and severity of the outbreaks are strongly influenced by precipitation, slope and aspect, stand density and stocking levels, fire, and soil characteristics as environmental factors. In addition, anthropogenic factors including fire suppression and stand management practices can also influence the susceptibility of forest stands to bark beetle activity. The mountains of southern California in the USA and Baja California Norte in Mexico were subject to a severe drought during 2002–2003. A major bark beetle outbreak accompanied the period of drought. Tree cover death was highest in Pinus coulteri (57.8 %), intermediate in Pseudotsuga macrocarpa (24.7 %) and mixed conifer forest (26.0–33.6 %), and lowest in subalpine forest (2.0 %) in Southern California mountains. The tree mortality in the adjacent mountains in Baja California was five times lower than what was observed north of the international border. The differences in forest management, particularly historical practices of fire suppression that resulted in stand densification and intense competition for available moisture in California may be the underlying mechanism driving the differences in severity of the bark beetle outbreaks on either side of the border.
Teaching Students to Harness the Power of Word Processing as They Write

This short article explains how to teach law students to use the basic features of word processing effectively when they write, so the process is more efficient and less angst-ridden.
Drug-induced regeneration in adult mice

Whereas amphibians regenerate lost appendages spontaneously, mammals generally form scars over the injury site through the process of wound repair. The MRL mouse strain is an exception among mammals because it shows a spontaneous regenerative healing trait and so can be used to investigate proregenerative interventions in mammals. We report that hypoxia-inducible factor 1α (HIF-1α) is a central molecule in the process of regeneration in adult MRL mice. The degradation of HIF-1α protein, which occurs under normoxic conditions, is mediated by prolyl hydroxylases (PHDs). We used the drug 1,4-dihydrophenonthrolin-4-one-3-carboxylic acid (1,4-DPCA), a PHD inhibitor, to stabilize constitutive expression of HIF-1α protein. A locally injectable hydrogel containing 1,4-DPCA was designed to achieve controlled delivery of the drug over 4 to 10 days. Subcutaneous injection of the 1,4-DPCA/hydrogel into Swiss Webster mice that do not show a regenerative phenotype increased stable expression of HIF-1α protein over 5 days, providing a functional measure of drug release in vivo. Multiple peripheral subcutaneous injections of the 1,4-DPCA/hydrogel over a 10-day period led to regenerative wound healing in Swiss Webster mice after ear hole punch injury. Increased expression of the HIF-1α protein may provide a starting point for future studies on regeneration in mammals.
How the document got its authority

Purpose – The purpose of this paper is to invite further consideration of and research into the authoritativeness, reliability and trustworthiness of documents. How do documents come to be trusted? Why are some more trusted than others? Design/methodology/approach – The cases of the Oxford English Dictionary and Wikipedia policies are explored from a historical perspective, and other cases are considered. Findings – Authoritativeness seems inherent to documents because of a cognitive metaphor that says “what is persistent is trustworthy”. Practical implications – This feature of documents exposes users to a number of pitfalls related to trusting illegitimate documents. This has important implications for document literacy. Originality/value – New insight into documents is achieved by applying cognitive metaphors and prototype theory to documents.
Structure and Thermal Stability in Titanium-Nickel Thin Films Sputtered at Elevated-Temperature on Inorganic and Polymeric Substrates

Deposition of crystalline titanium-nickel shape-memory alloys on polymeric substrates is complicated by the elevated temperatures that must be withstood either during deposition or during post-deposition crystallization anneals. In this paper we report results on thin films of titanium-nickel, with Ni-rich compositions, which were prepared by dc magnetron sputtering onto quartz substrates, and onto thin polyimide membranes, at various elevated substrate temperatures between 623K and 703K. All of the as-deposited films possessed ordered bcc microstructures and had nano-scale grain sizes. Films deposited at the higher end of the temperature range displayed familiar two-step transformation behavior in electrical resistivity experiments, with transformation temperatures that were stable with respect to annealing for 22-hrs at 700K. Classic shape-memory was observed for a bilayer consisting of an 7.6 μm thick Kapton® polyimide sheet onto which 3 μm of near-equiatomic TiNi had been sputtered at 703K. By applying a pattern-etch technique to the metallized polymer we were able to fabricate a prototype electrically-excitable thin-film actuating element, potentially applicable to microelectromechanical and biomechanical systems.
Blacks As Supervisors: A Study of Training, Job Performance, and Employers’ Expectations

This study of a training program designed for the development of black supervisors investigated the relationship of several training and nontraining variables with employers’ evaluations of black s...
Color Preference in the Feeding Behavior of the Boll Weevill

The influence of color on the feeding of the boll weevil, Anthonomus gandis Boheman, was determined by the response of the weevil to feeding plugs, with and without the addition of a feeding stimulant, dyed red, orange, yellow, green, blue, or violet, and to undyed plugs. The boll weevils preferred the dyed to the undyed plugs, hut discriminated but little among the dyed plugs.
Direct determination of calcium in milk by flame absorption spectrometry

Objective:To establish a direct method for determination of calcium in milk or daily drinks by flame atomic absorption spectrometry(FAAS).Methods:By directly diluted with lanthanun oxide solution,the calcium in milk or daily drinks was determined by FAAS.Results:The RSD(n=6) of this method was less than 2.0%,the spiked recoveries were in the range of 90.0%~105.7%(0.4 mg calcium was spiked) and 93.7%~108.5%(0.8 mg calcium was spiked),respectively.Comparing with the standard method,no significant derivation was found by T-test.By this method,some real samples were determined,the calcium content were very close to the value listed in the package.Conclusion:This method is easily operating,time-saving and accurate,so it is very suitable for routine volume-tests.
Antenna bandwidth enhancement using near-field coupled miniaturized elements

In this paper, we investigate the feasibility of substantial bandwidth enhancement of a low-frequency miniaturized antenna on a robotic flyer through magnetic coupling with similar elements in a tight flight formation. The dimensions of a single radiating element are confined to within λ/10 × λ/10 × λ/10 for operation at around 300 MHz. Variations of end-loaded meandered line dipoles are studied and the configuration shows a bandwidth of 2 MHz (0.66%) and 7 Ω input impedance. For a proper magnetic coupling of the end-loads, simulation results demonstrate that a cluster of three such miniaturized coupled antennas can provide the bandwidth and input impedance of 30 MHz (10%, 15 fold improvement) and 80 Ω, respectively.
ATPS-22RITANSERIN AND TEMOZOLOMIDE SYNERGIZE AGAINST HUMAN GLIOBLASTOMA IN VITRO AND IN ESTABLISHED TUMORS IN VIVO

BACKGROUND: Diacylglycerol Kinase Alpha (DGKα) inhibition with the known inhibitor {"type":"entrez-nucleotide","attrs":{"text":"R59022","term_id":"829717","term_text":"R59022"}}R59022 results in strong cytotoxicity against glioblastoma cells in vitro. The use of {"type":"entrez-nucleotide","attrs":{"text":"R59022","term_id":"829717","term_text":"R59022"}}R59022 in vivo against orthotopic xenografts was less successful due to limited solubility, short serum half-life, and possible low penetration of the blood-brain barrier. In addition, the known pro-immune effect of {"type":"entrez-nucleotide","attrs":{"text":"R59022","term_id":"829717","term_text":"R59022"}}R59022 on DGKα in T-cells is unlikely to occur in immunocompromised mice. We show combined oral treatment with the related compound ritanserin and temozolomide results in markedly prolonged survival in orthotopic GBM xenograft-bearing mice. METHODS: In vitro studies of synergism between temozolomide (25 µM to 150 µM), and ritanserin (2.5 µM to 20 µM), were carried out using alamarBlue assay at 72 hours after treatment. U251 and several glioblastoma stem cell (GSC) lines were used. In GSCs, Perkin Elmer Operetta Digital Phase-Contrast was used to analyze cell numbers. CompuSyn was used generate Chou-Talalay Combination Index (CI) values. 200,000 U251 cells were implanted into the right parenchyma of 36 nude female mice. 6 days per week (dpw) oral gavage 30 mg/kg temozolomide in H2O and/or 50mg/kg ritanserin in corn oil, or vehicle began 7 days post tumor. A Kaplan-Meier survival curve was generated upon humane endpoints. RESULTS: U251 cells showed synergistic response at 25 µM to 50 µM temozolomide and 2.5 µM ritanserin. For GSC lines, synergy was also observed in cell counts. Median survival for vehicle-treated and ritanserin-treated U251-bearing mice was 29 days, and for temozolomide-treated mice was 32 days. At this time, 66% of ritanserin- and temozolomide-treated mice have survived 75 days. CONCLUSIONS: Our preliminary results with U251 and GSCs indicate strong synergy between ritanserin and temozolomide in tissue culture, and this was recapitulated in vivo.
Injectable and topical neurotoxins in dermatology: Basic science, anatomy, and therapeutic agents

Botulinum toxin is a potentially deadly anaerobic bacterial toxin that acts by inhibiting release of acetylcholine at the neuromuscular junction, thereby inhibiting contraction of the exposed striated muscle. There are currently 4 botulinum toxin preparations approved by the US Food and Drug Administration (FDA): onabotulinumtoxin, abobotulinumtoxin, incobotulinumtoxin and rimabotulinumtoxin. While significant overlap exists, each product has unique properties and specifications, including dosing, diffusion, and storage. Extensive physician knowledge of facial anatomy, coupled with key differences of the various neurotoxin types, is essential for safe and successful treatments. The first article in this continuing medical education series reviews key characteristics of each neurotoxin, including new and upcoming agents, and provides an anatomic overview of the most commonly injected cosmetic sites.
Drug-induced kidney disease in the ICU: mechanisms, susceptibility, diagnosis and management strategies.

Purpose of reviewAcute kidney injury (AKI) is a common complication in the critically ill population, is multifactorial and associated with increased mortality. Drug-induced kidney injury is a significant contributor to the development of AKI. The purpose of this review is to provide updates in the
Introduction: Affect and Texts: Contemporary Inquiry in Historical Context

The early twenty-first century has witnessed within literary criticism and allied fields an explosion of interest in how texts represent, reflect on, enact, and elicit affect. Contemporary inquiry into affect/text dynamics continues explorations of entwinements of mind, heart, body, and spirit that reach back to ancient epic. Theorizing affect shapes classical poetics and rhetoric, patristic theology, and Hindu, Islamic, and Western aesthetics. In early European culture, one current of reflection, moving from Cartesian dualism and British empiricism to positivism, behaviorism, structuralism, and Marxist ideology critique, aspired to marginalize affect’s agency. Another, passing from Puritan autobiography into moral sense theory, Romanticism, philosophies of becoming, psychologies of drive, and phenomenology, made affect central to theorizing inwardness, intuition, and authenticity. These currents converged in poststructuralism’s strong constructionism, but since the 1980s interest in embodiment’s relation to culturally inflected affectivity has become central to cognitive science’s linking of embodiment to cognition, linguistics, emotional experience, and significance-attribution, spurring an unraveling of self/other, emotion/reason binaries in recent affective neuroscience, evolutionary psychology, and performance theory. Concurrently, a distinct “Affect Theory” has emerged within the humanities that shifts the ground of constructivism from language and conceptuality to sensation and affect. While hardly homogenous, this work collectively invites a rethinking of affect that calls for new understandings of what texts (especially literary ones) do and are.
With A Kiss: Betrayal:

The author in this article explores theoretical perspectives on the humanbecoming ethical tenet of betrayal. Perspectives on betrayal include betrayal as a breach of promise, a betrayal continuum, betrayal as incidental and intentional, betrayal as moral injury, betrayal trauma, and the humanbecoming perspective of betrayal linked to feeling disappointed.
Bowing before Dual Gods: How Structured Flexibility Sustains Organizational Hybridity*:

Organizations increasingly grapple with hybridity—the combination of identities, forms, logics, or other core elements that would conventionally not go together. Drawing on in-depth longitudinal da...
Derivation and Validation of a Clostridium difficile Infection Recurrence Prediction Rule in a National Cohort of Veterans

STUDY OBJECTIVE Prior studies have identified risk factors for recurrent Clostridium difficile infection (CDI), but few studies have integrated these factors into a clinical prediction rule that can aid clinical decision-making. The objectives of this study were to derive and validate a CDI recurrence prediction rule to identify patients at risk for first recurrence in a national cohort of veterans. DESIGN Retrospective cohort study. DATA SOURCE Veterans Affairs Informatics and Computing Infrastructure. PATIENTS A total of 22,615 adult Veterans Health Administration beneficiaries with first-episode CDI between October 1, 2002, and September 30, 2014; of these patients, 7538 were assigned to the derivation cohort and 15,077 to the validation cohort. MEASUREMENTS AND MAIN RESULTS A 60-day CDI recurrence prediction rule was created in a derivation cohort using backward logistic regression. Those variables significant at p<0.01 were assigned an integer score proportional to the regression coefficient. The model was then validated in the derivation cohort and a separate validation cohort. Patients were then split into three risk categories, and rates of recurrence were described for each category. The CDI recurrence prediction rule included the following predictor variables with their respective point values: prior third- and fourth-generation cephalosporins (1 point), prior proton pump inhibitors (1 point), prior antidiarrheals (1 point), nonsevere CDI (2 points), and community-onset CDI (3 points). In the derivation cohort, the 60-day CDI recurrence risk for each score ranged from 7.5% (0 points) to 57.9% (8 points). The risk score was strongly correlated with recurrence (R2 = 0.94). Patients were split into low-risk (0-2 points), medium-risk (3-5 points), and high-risk (6-8 points) classes and had the following recurrence rates: 8.9%, 20.2%, and 35.0%, respectively. Findings were similar in the validation cohort. CONCLUSION Several CDI and patient-specific factors were independently associated with 60-day CDI recurrence risk. When integrated into a clinical prediction rule, higher risk scores and risk classes were strongly correlated with CDI recurrence. This clinical prediction rule can be used by providers to identify patients at high risk for CDI recurrence and help guide preventive strategy decisions, while accounting for clinical judgment.
Spatio-temporal pattern of plant communities along a hydrologic gradient in Everglades tree islands

Abstract Plant communities arranged along a gradient are a product of underlying physico-chemical drivers that vary on both spatial and temporal scales. Spatial variation in the underlying drivers along the gradient usually results in the formation of boundaries between adjacent plant communities. However, the structure and composition of these communities may change over time resulting in boundary shifts. In the Everglades, tree islands are complex ecosystems, where plant communities are arranged along hydrologic and soil nutrient gradients. In these islands, temporal changes in hydrologic regime often result in a spatial shift in community composition along the gradient and determine the trajectory of community succession. We examined the interaction between hydrology and vegetation over a 12-year period in three southern Everglades tree islands. We hypothesized that drier conditions in recent decades would result in an increase in the dominance of flood in-tolerant woody plants over herbaceous and flood-tolerant woody species, ultimately causing a shift in the boundaries between plant communities. The boundary between adjacent communities varied from sharp, clearly defined peaks of Bray-Curtis dissimilarity to more gradual, diffuse transition zones. In the head portion of tree island, there was little change in vegetation composition. However, in the tail portion of the islands, the relative abundance of flood-tolerant species declined, while that of moderately flood-tolerant species increased over the study period. In these islands, the effects of relatively dry conditions in recent decades resulted in small shifts in the boundaries among communities. These results suggest that tree islands are dynamic successional communities whose expansion or contraction over time depends on the strength and duration of changes in hydrologic conditions.
Abstract 570: Macrophage Catabolism of Aggregated Lipoproteins Using a Novel Extracellular Compartment Regulates Lipid Accumulation During Atherosclerosis

Despite impressive advances in research, prevention, and treatment, atherosclerotic vascular disease remains the leading cause of death in the developed world. Mechanisms of cholesterol accumulation in the arteries have been studied intensively, but the in vivo contributions of different pathways leading to lipid accumulation and foam cell formation are not understood. In the arteries, low-density lipoprotein (LDL) is aggregated and bound to the extracellular matrix. When such aggregated LDL is presented to macrophages, they form a novel acidic, hydrolytic compartment that is topologically extracellular, to which lysosomal enzymes are secreted. Such compartments are observed in vivo in murine atherosclerotic plaque macrophages interacting with cholesterol rich deposits. Using state-of-the-art quantitative and high resolution microscopy techniques, characterization of compartment morphology reveals how macrophages use local actin polymerization to drive plasma membrane remodeling at the interface with aggregated LDL. This leads to sequestration of aggregated LDL into topologically convoluted structures that allow acidification, catabolism and internalization of LDL. We find that a TLR4/MyD88/Syk/PI3 kinase/Akt dependent signaling pathway in macrophages regulates the formation of such catabolic compartments. Consistent with this, deficiency of TLR4 in vivo can protect macrophages from lipid accumulation in murine atherosclerotic plaques. Herein, we provide compelling evidence for a novel form of catabolism that macrophages use to degrade aggregated LDL in vivo during atherosclerosis and this process leads to foam cell formation, cell death and promotes disease progression.
Addition of a single glycosylation site to hAPN blocks human coronavirus-229E receptor activity.

The cellular receptor for HCoV-229E is human aminopeptidase N (hAPN). Murine fibroblasts that are nonpermissive for HCoV-229E become susceptible after transfection with an hAPN expression plasmid (Yeager et al., 1992). In addition, antibodies to hAPN block infection of human neural cells by HCoV-229E (Lachance et al., 1998). hAPN, also called CD13, is a 150 kDa glycoprotein that is a membrane peptidase (Look et al., 1989). APN is expressed by many cell types including epithelial cells of the kidney, intestine, respiratory tracts and at synaptic junctions in the CNS (Kenny and Maroux, 1982; Look et al., 1989; Riemann et al., 1999; Noren et al., 1997).
Pulmonary intravascular macrophages and hemodynamic effects of liposomes in sheep

We studied the effects of liposomes on the pulmonary circulation of sheep and found a close correlation between liposome retention in the lung and the intravascular macrophages. A test dose of lipo...
The Gap at the Center

While not quite like being eaten by a wolf and thrown over a cliff, the prospect of the internal collapse of the Classical formulation of consciousness has a serious impact. It lays bare the ambiguity at the heart of ordinary experience by serving notice on the ungroundedness of its underlying ontic conviction, leaving in sore need of resilvering the tarnished prestige of the power of mimesis and analogy to represent the “real.”1 The contemplative sight of the measure of the higher and the far, beheld at night, has become blurry and increasingly myopic. At worst, mimetic and analogical resemblance will prove to be inadequate to the task of meeting the needs, cares and necessities of ordinary life under the yoke of the criterion of beauty. At best they will be reduced in rank to become the “tools” of the rhetoric and logic of scientific persuasion.2
Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti-Vascular Endothelial Growth Factor.

Purpose To compare anatomic and functional outcomes in eyes with proliferative diabetic retinopathy (PDR) that were lost to follow-up (LTFU) for more than 6 months after treatment with either intravitreal injection (IVI) of anti–vascular endothelial growth factor (VEGF) agents or panretinal photocoagulation (PRP). Design Retrospective cohort study. Participants Fifty-nine patients who were LTFU immediately after treatment for more than 6 months between September 2013 and September 2016. Methods Patients with eyes receiving either intravitreal anti-VEGF treatment or PRP with the next follow-up visit occurring more than 6 months after treatment were identified. Visual acuity (VA) and anatomic outcomes at the visit before being LTFU, the return visit, the 6-month visit after return, the 12-month visit after return, and the final visit were gathered and compared between the 2 treatment groups. Main Outcomes Measures Visual acuity and anatomic outcomes. Results Seventy-six eyes of 59 patients were included in the study, of which 30 received IVI with anti-VEGF and 46 received PRP. In the anti-VEGF group, mean VA worsened significantly when comparing the visit before being LTFU (0.43±0.38 logarithm of the minimum angle of resolution [logMAR]) with the return visit (0.97±0.80 logMAR; P = 0.001) as well as with the final visit (0.92±0.94 logMAR; P = 0.01). In the PRP group, mean VA worsened significantly when comparing the visit before being LTFU (0.42±0.34 logMAR) with the return visit (0.62±0.64 logMAR; P = 0.03). However, no significant difference was observed at the final visit (0.46±0.47 logMAR; P = 0.38). There was a significantly greater number of eyes with tractional retinal detachment in the IVI group compared with the PRP group at the final visit (10 vs. 1, respectively; P = 0.005). There was a significantly greater incidence of neovascularization of the iris in the IVI arm compared with the PRP arm at the final visit (4 vs. 0, respectively; P = 0.02). Conclusions Eyes with PDR that received only intravitreal anti-VEGF demonstrated worse anatomic and functional outcomes after being LTFU compared with eyes that received PRP. Given the potential sequelae of being LTFU, the choice of treatment for PDR must be considered carefully.
Outcomes of Angiotensin Receptor-Neprilysin Inhibitor Prescriptions for Patients with Heart Failure and Reduced Ejection Fraction in Real World Clinical Practice

Introduction While guidelines now recommend the use of Angiotensin Receptor-Neprilysin Inhibitors (ARNI) in place of ACE inhibitors and angiotensin receptor blockers for select patients with heart failure and reduced ejection fraction, the utilization of ARNI among eligible patients in clinical practice remains low. Access, cost, and tolerability are perceived barriers to use. Hypothesis We hypothesized that financial barriers to prescriptions are an important factor contributing to underutilization of ARNI among eligible patients in clinical practice. Methods We conducted a single-center, retrospective analysis of all new ARNI prescriptions at our center written from June 2015 to May 2017. For all prescriptions, we tracked the subsequent success with prior insurance authorization (PA), patient initiation of medication, dose titration, as well as adaptations to concomitant heart failure medications. Results Of 167 prescriptions written, 139 reflected new starts of sacubitril/valsartan, 26 reflected continuations, and 2 had insufficient data for analysis. Of the new prescriptions, PAs were requested in 81 (58% of new starts), and granted in 75 patients (92.6% of requests). Prescriptions were successfully filled in 123 (88.5% of new starts), and subsequently discontinued in 17 patients (13.8%). Of subjects filling prescriptions, 33.3% of patients were titrated to the high dose (97/103 mg sacubitril/valsartan twice daily), 34.2% were titrated to the middle dose (49/51 mg twice daily) and 18.7% were titrated to the low dose (24/26 mg twice daily) [Figure 1] . Limiting factors to titration and continuation of therapy included hypotension (37%) and renal function (5.7%). During titration, dose reductions in beta-blockers and loop diuretics were made in 6.5% and 14% of patients respectively. Minimal changes were noted in dosing of aldosterone antagonists or other vasodilators. Conclusions Most patients prescribed ARNI therapy are successfully initiated in practice without significant cost or insurance barriers. As in the trials which led to approval, dose titration of ARNI was frequently limited by hypotension and renal dysfunction, and often facilitated reduction in loop diuretics. These ‘real-world’ data suggest that financial/insurance factors do not account for most underutilization of ARNI
Risky Interactions: Relational and Developmental Moderators of Substance Use and Dating Aggression

Physical dating aggression is a prevalent and costly public health concern. A theoretical moderator model of substance use and dating aggression posits that associations between them are moderated by relational risk factors. To test these theoretical expectations, the current study examined seven waves of longitudinal data on a community-based sample of 100 male and 100 female participants in a Western U.S. city (M age Wave 1 = 15.83; 69.5% White non-Hispanic, 12.5% Hispanic, 11.5% African Americans, & 12.5% Hispanics). Multilevel models examined how links between substance use and dating aggression varied by relational risk and how these patterns changed developmentally. Main effects of relational risk and substance use emerged, particularly in adolescence. In young adulthood significant three-way interactions emerged such that substance use was more strongly associated with physical aggression when conflict and jealousy were higher. Thus, relational risk factors are integral to models of dating aggression, but their role changes developmentally.
Simulation in Surgical Endoscopy

Simulation-based training has become a critical component for surgical endoscopy training. The different classes of platforms available include mechanical or physical, virtual reality, composite, and live animal models. Deciding which platform is appropriate is heavily dependent on the desired learning objectives and individual tasks or skills being practiced. This chapter will outline the various platforms available for basic and advanced endoscopy simulation, including their validity evidence as an assessment tool and demonstrated efficacy as a training modality. The simulation platforms will be compared with regard to their advantages and disadvantages when incorporating them into a training program, as well as their features, capabilities, targeted skills, and feedback potential. Additionally, endoscopy-specific curriculum development, feedback methodologies, and assessment will be discussed to promote best practices when employing surgical endoscopy into a trainee’s simulation experience. Simulation continues to advance, and the following can be used as a framework to aid in the development of an effective simulation training program for surgical endoscopy.
Quartz Crystal Microbalance for viscosity measurement with temperature self-compensation

Abstract This paper presents the design, fabrication, and experimental demonstration of a portable viscosity measurement system using an AT-cut quartz crystal resonator with a temperature compensation technique. The proposed sensor is designed to measure viscosity from room temperature to 65 °C with complete temperature compensation. A novel fixture to hold the crystal for the viscosity sensing is designed using CAD (Computer Aided Design) software and a 3D model prototype was fabricated using a 3D printer. Subsequently, the fabricated fixture was integrated with a crystal resonator and tested with various mixtures of glycerol and water solutions each with different viscosities. A beat frequency based temperature measurement and compensation technique was also proposed and has been implemented in the crystal resonator based force measurement system in the literature. The measurement system is portable, simple, and low cost making it convenient for laboratory-based viscosity measurements. The proposed fixture of the measurement system can be altered for real-time monitoring to quantify the viscosity of the continuous flowing aqueous liquids.
Sexually acquired syphilis: Historical aspects, microbiology, epidemiology, and clinical manifestations.

Syphilis is caused by infection with the spirochetal bacterium Treponema pallidum subsp. pallidum. It was first recognized in the late 15th century. Since 2000, the incidence of sexually acquired syphilis has increased substantially in the developed world, with men who have sex with men and persons living with HIV infection disproportionately affected. Clinical manifestations of syphilis are protean and often include mucocutaneous manifestations. The first article in this continuing medical education series reviews historical aspects, microbiology, epidemiology, and clinical manifestations of sexually acquired syphilis.
Do Children Recognize the Impact of Physical and Sedentary Activities on Weight

The following three studies examined if 4–5 year olds, 7–8 year olds and adults recognized the impact of physical and sedentary activities on weight. Study 1 examined if 4–5 year olds and adults recognized the impact of physical activities on weight. Study 2 investigated if all three age groups of participants recognized the difference that physical activities and sedentary activities would have on weight. Study 3 examined if participants recognized the short-term and long-term impact of active and sedentary activities on weight. The results demonstrated that compared to 7 and 8 year olds, 4 and 5 year olds had a difficult time in making a clear distinction between the impact of physical and sedentary activities on weight. Preschoolers have an impoverished recognition of the impact of activities on weight compared to children in middle childhood. This suggests the need for parents and educators to further emphasize the importance of physical activities in maintaining a healthy lifestyle in early childhood.
Strain Among Caregivers of Older Adults Diagnosed With Breast Cancer.

OBJECTIVES To illustrate the predictors of strain among caregivers of older adults diagnosed with breast cancer. SAMPLE A SETTING This study involved 39 women diagnosed with breast cancer who were aged 69 years or older, receiving any type of treatment, and seeking an initial assessment in a geriatric oncology program at a large cancer center in the midwestern United States and their caregivers. METHODS A VARIABLES This cross-sectional study evaluated relationships among the variables of caregiver strain, age, employment status, patient characteristics, and patient scores on the comprehensive geriatric assessment. Bivariate statistics and logistic regression models were used. RESULTS Increasing age of the caregiver was associated with less caregiver strain. Caregivers employed part-time experienced greater strain than those employed full-time. IMPLICATIONS FOR NURSING Nurses must assess for strain in caregivers of individuals diagnosed with cancer, particularly if they are younger and employed part-time. Caregivers of depressed patients should be assessed for strain and offered support.