cssi/SciSciGPT-SciSciNet huggingface dataset:
Continuous Infusion of Naloxone in the Treatment of Narcotic Overdose

Based on the pharmacokinetic parameters of naloxone and the clinical studies discussed in this paper, it is evident that naloxone infusion may be useful in cases of opiate overdose. The infusion protocol presented in Appendix I was formulated based on the pharmacokinetic data available from the literature including Nelson's animal data. An infusion of naloxone was used with apparent success in the two cases presented. Both patients presented with narcotic overdose; although immediate patient history could not be obtained, the presentations were classic for narcotic overdose. It is of note that it may be possible to keep a patient from relapsing into narcosis after overdose by the use of naloxone infusion. Additionally, the extreme safety of naloxone is certainly an advantage with any administration technique. We feel that the administration of continuous infusion of naloxone is an especially important advance in the overdose treatment of longer-acting agents such as methadone, as well as of other narcotics. Therefore, it is recommended that further clinical trials of naloxone by infusion be undertaken, as suggested by J. Nelson, et al. (A protocol for treatment with continuous infusion of naloxone [Narcan] in selected cases of opiate [narcotic] overdose. Austin: University of Texas; May, 1976, unpublished), to further document the effectiveness of an infusion of naloxone in narcotic overdose.
A Glycolytic Enzyme Binding Domain on Tubulin

Cleavage of tubulin at tryptophan residues yielded several peptides, one of which strongly interacted with aldolase as determined by inhibition of aldolase activity. This peptide was identified as the C-terminal, residues 408-451, of the alpha-subunit of tubulin. Peptides with identical sequences to the C-terminal regions of the alpha- and beta-subunits of tubulin were synthesized to further characterize interactions with glycolytic enzymes. A 43-amino-acid C-terminal peptide from alpha-tubulin (residues 409-451) was found to have binding properties similar to those of native tubulin and was designated the tubulin glycolytic enzyme binding domain (T-GEBD-43mer).
Accurate and exact CNV identification from targeted high-throughput sequence data

Massively parallel sequencing of barcoded DNA samples significantly increases screening efficiency for clinically important genes. Short read aligners are well suited to single nucleotide and indel detection. However, methods for CNV detection from targeted enrichment are lacking. We present a method combining coverage with map information for the identification of deletions and duplications in targeted sequence data. Sequencing data is first scanned for gains and losses using a comparison of normalized coverage data between samples. CNV calls are confirmed by testing for a signature of sequences that span the CNV breakpoint. With our method, CNVs can be identified regardless of whether breakpoints are within regions targeted for sequencing. For CNVs where at least one breakpoint is within targeted sequence, exact CNV breakpoints can be identified. In a test data set of 96 subjects sequenced across ~1 Mb genomic sequence using multiplexing technology, our method detected mutations as small as 31 bp, predicted quantitative copy count, and had a low false-positive rate. Application of this method allows for identification of gains and losses in targeted sequence data, providing comprehensive mutation screening when combined with a short read aligner.
Chemical biology studies on norrisolide

The cellular activity of norrisolide (7), a novel Golgi-vesiculating agent, was dissected as function of its chemical structure. This natural product induces irreversible vesiculation of the Golgi membranes and blocks protein transport at the level of the Golgi. The Golgi localization and fragmentation effects of 7 depend on the presence of the perhydroindane core, while the irreversibility of fragmentation depends on the acetyl group of 7. We show that fluorescent derivatives of norrisolide are able to localize to the Golgi apparatus and represent important tools for the study of the Golgi structure and function.
Sustained inhibition of experimental neointimal hyperplasia with a genetically modified herpes simplex virus.

Abstract Objective: Reported herein is a potential strategy for sustained smooth muscle cell (SMC) inhibition with a virulence-attenuated herpes simplex virus (HSV). Experiments were conducted in vitro to demonstrate selective SMC cytotoxicity and in vivo to demonstrate reduced neointimal hyperplasia (NIH) in a clinically relevant animal model. Methods: In vitro: Cultured human umbilical artery smooth muscle cells (UASMC) and venous endothelial cells (HUVEC) were exposed to varying multiplicities of infection (MOI) of a γ134.5-deleted HSV-1 virus (R849). Cell survival was assessed at 48 and 72 hours with a colorimetric MTT viability assay. In vivo: New Zealand White rabbit external jugular veins (n = 21) were exposed to R849 (2.5 × 106 pfu/mL) or culture medium at 110 to 120 mm Hg for 10 minutes, then fashioned as vein patches on carotid arteries. Carotid arteries were ligated distally to decrease blood flow and stimulate a hyperplastic response (ultra-low shear stress model). After 2, 4, 12, and 24 weeks, patched segments were perfusion-fixed with glutaraldehyde and morphometrically examined for NIH formation. Results: In vitro: At 48 hours, R849 exhibited preferential cytotoxicity to UASMC compared with HUVEC, with 11% ± 10% of UASMCs and 49% ± 8% of HUVECs surviving after infection with MOI = 25 (P Conclusion: The virulence-attenuated HSV strain R849 demonstrates selective cytotoxicity for SMC and is capable of sustained inhibition of NIH in an experimental model of vein graft failure.
Corrosion-Inhibiting Systems for Durable Concrete Bridges. I: Five-Year Field Performance Evaluation

The performance of nine commercially available corrosion-inhibiting systems for use in reinforced concrete structures exposed to corrosive environments was assessed in the field on bridge barrier walls and in accelerated electrochemical cells in the laboratory. The corrosion-inhibiting systems included concrete admixtures, reinforcing steel coatings, and/or concrete surface coatings/sealers. The results of this study are presented in two companion papers, in which the field evaluation and laboratory investigation are reported. The field evaluation consisted of annual corrosion surveys of half-cell potential and corrosion rate, as well as remote monitoring with embedded instrumentation for the measurement of the environmental conditions. After five years of investigation, the system containing an inorganic-based admixture performed better than others in reducing the risk of reinforcement corrosion in the barrier wall. It was also found that the system using epoxy-coated reinforcement showed good early performance during the first year, but after, the risk of corrosion increased relatively faster than in other systems, possibly due to localized pitting corrosion developing in small defects or pores of the epoxy coating.
Rapid Deletion of Antigen-Specific CD4 + T Cells following Infection Represents a Strategy of Immune Evasion and Persistence for Anaplasma marginale

Acquired T cell immunity is central for protection against infection. However, the immunological consequences of exposing memory T cells to high Ag loads during acute and persistent infection with systemic pathogens are poorly understood. We investigated this by using infection with Anaplasma marginale, a ruminant pathogen that replicates to levels of 10(9) bacteria per ml of blood during acute infection and maintains mean bacteremia levels of 10(6) per ml during long-term persistent infection. We established that immunization-induced Ag-specific peripheral blood CD4(+) T cell responses were rapidly and permanently lost following infection. To determine whether these T cells were anergic, sequestered in the spleen, or physically deleted from peripheral blood, CD4(+) T lymphocytes from the peripheral blood specific for the major surface protein (MSP) 1a T cell epitope were enumerated by DRB3*1101 tetramer staining and FACS analysis throughout the course of immunization and challenge. Immunization induced significant epitope-specific T lymphocyte responses that rapidly declined near peak bacteremia to background levels. Concomitantly, the mean frequency of tetramer(+)CD4(+) cells decreased rapidly from 0.025% before challenge to a preimmunization level of 0.0003% of CD4(+) T cells. Low frequencies of tetramer(+)CD4(+) T cells in spleen, liver, and inguinal lymph nodes sampled 9-12 wk postchallenge were consistent with undetectable or unsustainable Ag-specific responses and the lack of T cell sequestration. Thus, infection of cattle with A. marginale leads to the rapid loss of Ag-specific T cells and immunologic memory, which may be a strategy for this pathogen to modulate the immune response and persist.
Organizational Conflicts of Interest: A Growing Integrity Challenge

Recent experience in the United States suggests that public procurement professionals increasingly encounter a particular kind of conflict of interest, organizational conflicts of interest (OCIs). OCIs arise in situations where an entity plays two or more roles that are, in some sense, at odds with one another. This article endeavors to set out some points for consideration in this increasingly important area. Alleged OCIs have been identified in various activities of the U.S. federal procurement process, from contracts for security services in Iraq to public/private competitions for work to be performed in the U.S. This article first suggests reasons for the increasing frequency of OCIs, then steps back to analyze the elements of conflicts of interest and of OCIs, and then addresses the legal framework and caselaw related to OCIs in the U.S. federal procurement system.
Expression of Eph receptors and their ligands, ephrins, during lipopolysaccharide fever in rats

Erythropoietin-producing hepatocellular (Eph) receptor tyrosine kinases and their ligands, ephrins, are involved in embryogenesis and oncogenesis by mediating cell adhesion and migration. Although ...
How Valid is the AHRQ Patient Safety Indicator “Postoperative Physiologic and Metabolic Derangement”?

Background The Agency for Healthcare Research and Quality Patient Safety Indicator postoperative physiologic and metabolic derangement (PMD) uses ICD-9-CM codes to screen for potentially preventable acute kidney injury (AKI) requiring dialysis plus diabetes-related complications after elective surgery. Data on PMD's accuracy in identifying true events are limited. We examined the indicator's positive predictive value (PPV) in the Veterans Health Administration (VA). Study Design Trained abstractors reviewed medical records of 119 PSI software-flagged PMD cases. We calculated PPVs overall and separately for renal- and diabetes-related complications. We also examined false positives to determine reasons for incorrect identification, and true positives to determine PMD-related outcomes and risk factors. Results Overall 75 cases were true positives (PPV 63%, 95% CI 54% to 72%); 73 of 104 AKI cases were true positives (PPV 70%, 60% to79%); only 2 of 15 diabetes cases were true positives (PPV 13%, 2% to 40%). Of all false positives, 70% represented nonelective admissions and 23% had the complication present on admission. Of AKI true positives, 37% died and 26% were discharged on dialysis; 55% had chronic kidney disease (≥ stage 3) present on admission. Cardiac surgery represented the largest category of AKI-associated index procedures (30%). AKI was most commonly attributed to perioperative renal hypoperfusion (84% of true positives), followed by nephrotoxins (33%) including contrast (11%). Conclusions Due to its low PPV, we recommend removing diabetes complications from the indicator and focusing on AKI. PMD's PPV could be significantly improved by using present-on-admission codes, and specific to the VA, by introduction of admission status codes. Many PMD-identified cases appeared to be at high risk based on patient- and procedure-related factors. The degree to which such cases are truly preventable events requires further assessment.
VISUAL: a graphical icon-based query language

VISUAL is a graphical icon-based query language designed for scientific databases where visualization of the relationships are important for the domain scientist to express queries. Graphical objects are not tied to the underlying formalism; instead, they represent the relationships of the application domain. VISUAL supports relational, nested, and object-oriented models naturally and has formal basis. In addition to set and bag constructs for complex objects, sequences are also supported by the data model. Concepts of external and internal queries are developed as modularization tools. A new parallel/distributed query processing paradigm is presented. VISUAL query processing techniques are also discussed.
Evolutionary Conceptual Analysis: Faith Community Nursing

The aim of the study was to report an evolutionary concept analysis of faith community nursing (FCN). FCN is a source of healthcare delivery in the USA which has grown in comprehensiveness and complexity. With increasing healthcare cost and a focus on access and prevention, FCN has extended beyond the physical walls of the faith community building. Faith communities and healthcare organizations invest in FCN and standardized training programs exist. Using Rodgers' evolutionary analysis, the literature was examined for antecedents, attributes, and consequences of the concept. This design allows for understanding the historical and social nature of the concept and how it changes over time. A search of databases using the keywords FCN, faith community nurse, parish nursing, and parish nurse was done. The concept of FCN was explored using research and theoretical literature. A theoretical definition and model were developed with relevant implications. The search results netted a sample of 124 reports of research and theoretical articles from multiple disciplines: medicine, education, religion and philosophy, international health, and nursing. Theoretical definition: FCN is a method of healthcare delivery that is centered in a relationship between the nurse and client (client as person, family, group, or community). The relationship occurs in an iterative motion over time when the client seeks or is targeted for wholistic health care with the goal of optimal wholistic health functioning. Faith integrating is a continuous occurring attribute. Health promoting, disease managing, coordinating, empowering and accessing health care are other essential attributes. All essential attributes occur with intentionality in a faith community, home, health institution and other community settings with fluidity as part of a community, national, or global health initiative. A new theoretical definition and corresponding conceptual model of FCN provides a basis for future nursing knowledge and model-based applications for evidence-based practice and research.
Stacking Graphic Elements to Avoid Over-Plotting

An ongoing challenge for information visualization is how to deal with over-plotting forced by ties or the relatively limited visual field of display devices. A popular solution is to represent local data density with area (bubble plots, treemaps), color(heatmaps), or aggregation (histograms, kernel densities, pixel displays). All of these methods have at least one of three deficiencies:1) magnitude judgments are biased because area and color have convex downward perceptual functions, 2) area, hue, and brightnesshave relatively restricted ranges of perceptual intensity compared to length representations, and/or 3) it is difficult to brush or link toindividual cases when viewing aggregations. In this paper, we introduce a new technique for visualizing and interacting with datasets that preserves density information by stacking overlapping cases. The overlapping data can be points or lines or other geometric elements, depending on the type of plot. We show real-dataset applications of this stacking paradigm and compare them to other techniques that deal with over-plotting in high-dimensional displays.
Ontology Of Trusted Identity In Cyberspace

The nations digital infrastructure is in jeopardy because of inadequate provisions for privacy, identity, and security. Recent Internet activity has resulted in an onslaught of identity theft, fraud, digital crime, and an increasing burden to responsible citizens. The computer security and Internet communities have been generally responsive but apparently ineffective, so it is time for a third party to step in, take charge, and provide an infrastructure to assist in protecting individuals and non-person entities. This paper is a contribution to the domain of ontological commitment as it applies to a description of subjects, objects, actions, and relationships as they pertain to the National Strategy of Trusted Identity in Cyberspace initiative.
Husband's esteem predicts his mate retention tactics

delity or prevent their defection from the relationship. These tactics include low-risk acts that render the current relationship more attractive by bestowing benefits on the woman, as well as cost-inflicting acts that render defection from the relationship risky or dangerous for her. Previous research has linked men's mate retention behavior with men's mate value (value as a current or potential partner) using women's reports. The current research addresses limitations of that research using self-reports and cross-spousal reports from 107 married couples concerning their self-esteem and their esteem for their partner. The results indicate that the level of esteem that wives have for their husbands is positively associated with their perception of their husband's use of positive inducements and negatively associated with their husband's self-reported use of cost-inflicting mate retention behaviors (i.e., Direct Guarding, Intersexual Negative Inducements, and Intrasexual Negative Inducements). The level of...
Texas, Covenants Not to Compete, and the Twenty-First Century: Can the Pieces Fit Together in a Dot.Com Business World?

A glimpse at recent history illustrates the opposing viewpoints expressed by the Texas Legislature and Texas Supreme Court regarding the enforceability of covenants not to compete. While the Supreme Court consistently disapproves of "non-competes" in the business employment context, the Legislature has been a staunch proponent of their usage, as exemplified by the passage of the Covenants Not to Compete Act in 1989 and its subsequent amendment in 1993. With the trends of history in mind, this Comment focuses on the affect that an increased usage of technology such as the Internet will likely have on the enforceability of covenants not to compete in Texas. More precisely, the "technology boom" is making it increasingly difficult for courts to enforce these covenants' time and geographical restrictions that were once considered reasonable. A number of reasons explain this phenomenon. First, a business that utilizes the World Wide Web to advertise its goods or services is able to contact a potentially infinite number of customers on a nationwide or even global basis. However, public policy considerations, as well as established rules of law, should preclude a court from enforcing a geographical restriction that prevents a former employee from communicating with such a dispersed clientele. Second, the rapid pace at which business technology is evolving causes information an employee acquires on the job to be rendered obsolete in a shorter period of time. Consequently, the traditional one-year time restriction is no longer feasible in the context of high-tech business enterprises because such a durational restraint would not only unduly burden the employee but also restrict the free flow of human capital in the market. In light of the Texas Supreme Court's continued hesitancy to enforce these types of covenants, especially in employment agreements, it is likely the Court will continue to formulate reasons why employers, employees, and the general public benefit if these covenants are narrowly drawn. Specifically, it is the author's opinion that the Court will hear a case in the near future concerning the scope of a covenant not to compete in the context of a high-tech business. The court should use the opportunity, taking into account the effects of the technological revolution, to formulate an evolved standard of what constitutes "reasonable" restrictions in these covenants.
Effective Elastic Properties of Solids with Randomly Located Defects

Effective moduli of solids with cavities of various shapes are analyzed. The analysis is based on the elastic potentials of solids with defects. The structure of the potential dictates the proper measures of density of defects. It also establishes the overall anisotropy in the case of non-random orientation.
Mechanical Ventilation: Bringing the ICU Into the Operating Room

Patients who become critically ill from sepsis, acute respiratory illness or other inflammatory processes often require intubation and mechanical ventilation to support respiratory function. The lungs are very susceptible to injury in these circumstances and may develop the syndromes of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Furthermore, patients in the operating room under anesthesia may also develop lung injury due to direct surgical trauma (pneumonectomy), aspiration, transfusion, shock, or allergic reaction. The approaches and techniques of mechanical ventilation continue to evolve with better understanding of the pathophysiology of ALI/ARDS. In this article, we will (a) review the definitions of ALI/ARDS, (b) define lung-protective ventilation and the etiologies of ventilator-associated lung injury, (c) discuss rescue therapies for hypoxemic respiratory failure, and (d) describe newer modes of mechanical ventilation in use both in the ICU and the operating room.
Harding on History

A CCORDING to most contemporary observers, the least likely of all Presidents to be remembered for his clarity of thought and pungency of phrase is Warren Gamaliel Harding. In their own professional assessment of presidential success, American historians (if one can rely on Arthur M. Schlesinger's sample) have relegated Harding to the bottom of the pile, considering him little short of a disaster in almost every respect.' Certainly no reputable historian thinks of him as a statesman-philosopher or connects him with any serious pronouncement on the purpose and uses of history. George E. Mowry, in analyzing recent Presidents and their views on history, reinforced the existing interpretation: "It is almost certain that Harding's view of consequential time, whether past or future, was limited by the period from one handshake to another. There is no indication in any of his published speeches that he considered critically the future, and his perceptions of the past appear just as cloudy."2 And again: "The public utterances of Harding . . . indicate that the past was almost as much a terra incognita as the future and that American civilization, splendid as it was at the moment, was without dimensions in time, forgetful of its own roots and consequently oblivious of its future."3 Recently opened to researchers and resting in the stacks of the Ohio Historical Society Library in Columbus, Ohio are 804 manuscript boxes of Harding's papers which shed new light not only on the mind and character of the twenty-ninth President but also on the turbulent postwar years 1919-1924. Until these are fully examined, no historical scholar interested in the 1920s can adequately deal with the period without serious misgivings or the dangers of distortions. As a source of useful information, this
E-028 Stenting and angioplasty of a symptomatic long segment extracranial vertebral artery occlusion

Introduction We report a case of successful revascularization of a symptomatic long segment extracranial vertebral artery occlusion using stenting and angioplasty. A 55-year-old man with a history of tobacco abuse, hypertension and hyperlipidemia presented with dysarthria and diplopia that occurred 3 weeks earlier. The patient was noted to have bilateral vertebral artery occlusions on CT angiography and acute infarcts involving the posterior circulation on MRI. He was placed on dual antiplatelet therapy with aspirin 325 mg daily and clopidogrel 75 mg daily along with a lipid lowering agent. The patient had recurrent symptoms despite medical therapy. He was referred to our institution for further management. Materials and methods Cerebral angiogram revealed a total occlusion of the left vertebral artery and a long segment occlusion of the extracranial right vertebral artery that reconstituted via muscular branches and thyrocervical branches. The intracranial posterior circulation remained patent due to these collaterals. No posterior communicating arteries were present. After a detailed discussion regarding surgical and endovascular options, we proceeded with the endovascular approach. The patient was placed under general anesthesia. A platelet aggregation panel prior to the procedure confirmed adequate platelet inhibition for both aspirin and clopidogrel. Intravenous heparin was administered to maintain an activated clotting time of 250–300 s throughout the procedure. A femoral artery approach was used and a 5 F diagnostic catheter was exchanged for a 6 F 90 cm Cook shuttle sheath that was positioned in the right subclavian artery for support. A 6 F Envoy guide catheter (100 cm length) was coaxially placed through the shuttle sheath into the stump of the vertebral artery. A Rapid Transit microcatheter and 0.014 in Synchro-2 microwire were initially used to attempt navigation across the occluded segment but were unsuccessful. The wire was replaced with a 0.018 in V-18 microwire and we were able to navigate across the occlusion with this wire/catheter combination. The catheter was removed over a 300 cm Transend floppy exchange wire and a total of five drug eluting, balloon-mounted Xience V stents were deployed in a telescoping fashion from the mid-cervical vertebral artery to the vertebral artery origin. Results Post-stent angiography demonstrated good antegrade flow through the cervical vertebral artery. The patient recovered from anesthesia with no new neurologic deficits. Conclusion Revascularization of a long segment total occlusion of the extracranial vertebral artery can be performed safely using endovascular techniques in symptomatic patients.
A High-Order Self-Adaptive Monolithic Solver for Viscous-Inviscid Interacting Flows

We present a high-order self-adaptive monolithic method for solving viscous-inviscid interaction problems. The defect formulation is used to segregate the viscous and inviscid eects and couple them at the wall using the integrated defects for the conserved quantities, thereby allowing the overlap of the inviscid and boundary layer meshes. In particular, the viscous mesh will be extruded from the surface of the body or the wake in a given direction (obtained from a preprocess step) according to a normal scaling scalar variable . This normal scaling quantity satises a partial dierential equation on the surface of the body or wake and will be evolved as part of the solution process. This allows the viscous mesh to be adapted to the thickness of the boundary layer in an automated manner. The viscous and inviscid parts of the system are discritized using a high order Hybridizable Discontinuous Galerkin (HDG) scheme while the normal scaling equation is discretized using a Surface Finite Element Method (SFEM). The system is solved in a monolithic manner. We present results in 2D for simple laminar and turbulent ows to validate the solver.
Excellence in patient management.

Nurses seeking to meet the palliative care nutritional needs of their patients are increasingly challenged to work with ongoing, evolving situations, as patients live longer and longer. In the complex case described below, which illustrates some of these challenges, it was useful to have in place, accessible, standardized assessment tools that allowed for continued nutritional follow-up across practice settings, targeting interventions that best fit with the patient's goals.
Mixed Integer Linear Fractional Programming for Conjunctive Use of Surface Water and Groundwater

AbstractA conjunctive-use model is developed for management of groundwater and surface water resources via mixed integer linear fractional programming (MILFP). The objective of the conjunctive-use model is to maximize the ratio of groundwater usage to surface water usage through a water supply network. A conditional head constraint is imposed to the conjunctive-use model to maintain aquifer sustainability. A transformation approach is introduced to transform the conditional head constraint into a set of mixed integer linear constraints in terms of groundwater head. Groundwater head is further linearized with respect to pumping rates that are decision variables. Eventually, the conjunctive-use model is to solve a successive MILFP problem by updating the response matrix in each iteration. To make an MILFP problem tractable, the study develops a transformation technique along with the Charnes–Cooper transformation approach to transform an MILFP problem into an equivalent problem of mixed integer linear progr...
Statistical Considerations in Computer Simulation: The State of the Art

The multiple response problem in simulation analysis refers to the statistical design and analysis of simulation experiments which output more than a single response variable, or measure of effectiveness. In this article, the multivariate response simulation model is defined and some historical solutions from the literature are discussed. Recent research into the use of multivariate statistical methods in simulation analysis is reviewed, including the statistical rationale for the use of these techniques, the advantage of using these methods in simulation output analysis, and a comprehensive survey of the simulation literature which has applied these procedures to date. The concept of multivariate response simulation metamodel, an auxiliary, analytic model which serves to aid in the interpretation of the simulation model, is also presented.
Zweiatomige Radikale und Ionen

Die Energie eines Molekuls kann in erster Naherung als Summe von drei Teilen dargestellt werden — der Elektronen-, der Schwingungs- und der Rotationsenergie: $$ {\text{E = E}}_{\text{e}} {\text{ + E}}_{\text{v}} {\text{ + E}}_{\text{r}} {\text{.}} $$ (1) .
Higher Adolescent Body Mass Index Is Associated with Lower Regional Gray and White Matter Volumes and Lower Levels of Positive Emotionality

Adolescent obesity is associated with an increased chance of developing serious health risks later in life. Identifying the neurobiological and personality factors related to increases in adiposity is important to understanding what drives maladaptive consummatory and exercise behaviors that result in obesity. Previous research has largely focused on adults with few findings published on interactions among adiposity, brain structure, and personality. In this study, Voxel Based Morphometry (VBM) was used to identify associations between gray and white matter volumes and increasing adiposity, as measured by Body Mass Index percentile (BMI%), in 137 adolescents (age range: 9-20 years, Body Mass Index percentile range: 5.16-99.56). Variations in gray and white matter volume and BMI% were then linked to individual differences in personality measures from the Multidimensional Personality Questionnaire (MPQ). After controlling for age and other covariates, BMI% correlated negatively with gray matter volume in the bilateral caudate (right: partial r = -0.338, left: r -0.404), medial prefrontal cortex (partial r = -0.339), anterior cingulate (partial r = -0.312), bilateral frontal pole (right: partial r = -0.368, left: r= -0.316), and uncus (partial r = -0.475) as well as white matter volume bilaterally in the anterior limb of the internal capsule (right: partial r = -0.34, left: r = -0.386), extending to the left middle frontal subgyral white matter. Agentic Positive Emotionality (PEM-AG) was correlated negatively with BMI% (partial r = -0.384). PEM-AG was correlated positively with gray matter volume in the right uncus (partial r = 0.329). These results suggest that higher levels of adiposity in adolescents are associated with lower trait levels in reward-related personality domains, as well as structural variations in brain regions associated with reward processing, control, and sensory integration.
Diverse Orthorrhaphan Flies (Insecta: Diptera: Brachycera) in Amber From the Cretaceous of Myanmar: Brachycera in Cretaceous Amber, Part VII

A remarkable diversity of new nonempidoid orthorrhaphan flies from the mid-Cretaceous of Myanmar (Late Albian–Early Cenomanian, ca. 99 Ma) is presented, including 28 species (all but one new) in 22 genera (13 new), and at least 12 families. Two families are new; three genera are unplaced in Tabanomorpha and one unplaced within Brachycera. Comparisons are presented between the amber taxa and extensive lithified taxa from the Jurassic and Cretaceous of eastern Laurasia.In Stratiomyomorpha: A new species of Zhangsolvidae has color patterns and body shape that apparently mimic Vespidae or other stinging aculeate wasps. Diverse new Xylomyidae and Stratiomyidae are described, the latter with male terminalia preserved in detail. In Tabanomorpha: The genus Athericites Mostovski et al. is synonymized with Palaepangonius Ren, and a new species of Galloatherix Nel is described in which the female proboscis is much longer than that of the male. All three genera were attributed to Athericidae, but the amber species reveal they are more basal tabanomorphs. Described are a new genus of stem-group Tabanoidea and a new species of Cratotabanus Martins-Neto and Kucero-Santos (Tabanidae), previously known from the Cretaceous of Brazil and New Jersey. In Nemestrinoidea: Three species of Hirmoneura Meigen are the first Nemestrinidae known from amber; one species has long cerci typical of Recent species of the genus. A new species of the Mesozoic family Rhagionemestriidae reveals this family is closely related to Acroceridae, not Xylophagidae as previously proposed. In Archisargoidea: A new species of Tethepomyiidae is described, the family known only in Cretaceous amber from New Jersey, Spain, and Myanmar. In Asiloidea: Three new species and genera of Bombyliidae are described, two of them with abdominal setal “baskets” distinctive to females of higher bombyliids. A fourth new asiloid genus is a probable stem-group bombyliid. The recently described Pseudorhagio Zhang et al., is transferred from Tabanomorpha to Bombyliidae. The male of a new species of Burmapsilocephala Gaimari and Mostovski (Apsilocephalidae) has terminalia very similar to that of Evocoa (Evocoidae: Recent, Chile), corroborating close relationship of the two families. In Families incertae sedis: A new species of Hilarimorphites Grimaldi and Cumming (Apystomyiidae) is described, the family known only in New Jersey and Burmese amber and the Recent fauna of California, and a sister group to either Cyclorrhapha or Eremoneura. Mysteromyiidae and Eucaudomyiidae, new families, are described, based on highly modified species with vestigial mouthparts, reduced venation, and unique specializations.Discussion is presented on some morphological features in fossil and Recent Brachycera that have apparent phylogenetic significance but are rarely discussed. This study adds further data to the phenotypic diversity, geological history, and biogeography of a major radiation.
Relationships between radiation, clouds, and convection during DYNAMO.

The relationships between radiation, clouds, and convection on an intraseasonal time scale are examined with data taken during the Dynamics of the Madden-Julian Oscillation (MJO) field campaign. Specifically, column-net, as well as vertical profiles of radiative heating rates, computed over Gan Island in the central Indian Ocean (IO) are used along with an objective analysis of large-scale fields to examine three MJO events that occurred during the 3 month period (October to December 2011) over this region. Longwave (LW) and shortwave radiative heating rates exhibit tilted structures, reflecting radiative effects associated with the prevalence of shallow cumulus during the dry, suppressed MJO phase followed by increasing deep convection leading into the active phase. As the convection builds going into the MJO active phase, there are increasingly top-heavy anomalous radiative heating rates while the column-net radiative cooling rate progressively decreases. Temporal fluctuations in the cloud radiative forcing, being quite sensitive to changes in high cloudiness, are dominated by LW effects with an intraseasonal variation of ~0.4-0.6 K/d. While both the water vapor and cloud fields are inextricably linked, it appears that the tilted radiative structures are more related to water vapor effects. The intraseasonal variation of column-net radiative heating enhances the convective signal in the mean by ~20% with a minimum in this enhancement ~10 days prior to peak MJO rainfall and maximum ~7 days after. This suggests that as MJO convective envelope weakens over the central IO, cloud-radiative feedbacks help maintain the mature MJO as it moves eastward.
Introduction to laboratory diagnosis and biomarkers in inborn error of metabolism

Inborn errors of metabolism (IEM) are genetic disorders of intermediary metabolism that result in metabolic defects due to deficiency of enzymes, membrane transporters, or other functional proteins. Many of these disorders are detected through newborn screening or clinical suspicion. Laboratory tests and use of biomarkers are essential in the diagnosis and follow-up of patients with IEM. Specialized tests are not available in most hospitals, and need special attention in specimen collection, processing, and transport. Routine tests, although not necessarily diagnostic, are important in initial patient management and in providing guidance for further testing and management. Furthermore, there may be conditions that present with biochemical findings that mimic or confound a diagnosis. Unlike routine laboratory tests that are generally automated, most biochemical genetics tests are developed in-house. Method development and quality control can be challenging due to lack of standardized reagents and limited availability of external assessment programs. Treatment and prognosis of these disorders varies significantly, from dietary management to enzyme replacement therapies.
THU0473 Polysymptomatic distress scale, wide spread pain index, and symptom severity scales, and their correlates in 169 patients with fibromyalgia syndrome

Background The polysymptomatic distress scale (PSD) is considered a measure of FM severity and ranges from 0 to 31. It is calculated by adding the two components of the American College of Rheumatology (ACR) 2010 fibromyalgia (FM) criteria, widespread pain index (WPI) and symptoms severity scale (SS). Objectives Determine the relationship between depression, anxiety, function disability and pain related disability, with fibromyalgia severity as measured by PSD and its subsets, WPI and SS. Methods All consecutive FM patients who met the ACR 2010 criteria completed the following questionnaires: PSD, patient health related questionnaire (PHQ-9), a measure of depressive symptoms, general anxiety disorder questionnaire (GAD-7), health assessment questionnaire disability index (HAQ-DI), and pain disability index (PDI). Results Of 169 patients, 85.7% were women, mean age 42.3 (13.3), BMI 29.3 (7.1), PHQ-9 13.7 (5.2), GAD-7 10.2 (9.1), HAQ-DI 1.6 (2.9), PDI 6 (2.1), WPI 14.3 (2.7), SS 10 (1.6). In univariate analysis PSD correlated significantly (p Conclusions Depression, anxiety, pain disability and functional disability predict a small variance of fibromyalgia severity measured by PSD. In regression analysis, pain disability measured by PDI is the only variable that remains independently correlated with PSD. None of these variables predicted WPI, while depression measured by PHQ-9 remains independently correlated with SS, indicating that PSD subsets measure different dimensions of FM. Disclosure of Interest None declared
Enumeration of Cryptosporidium spp. in water with U.S. EPA method 1622.

The occurrence of Cryptosporidium parvum or other pathogenic Cryptosporidium species in water must be known in order to assess risk and determine the treatment needed to reduce Cryptosporidium oocysts to acceptable levels in finished drinking water. Because Cryptosporidium oocyst occurrence may be sparse, methods must concentrate a large volume of water and correctly identify oocysts in the concentrate. The U.S. Environmental Protection Agency Information Collection Rule (ICR) protozoan method gives low and variable recoveries of Cryptosporidium oocysts, making risk assessment difficult. Therefore, a method giving better oocyst recovery and more consistent results was needed. Method 1622 was developed with existing materials and procedures, and improvements were made in filtration, cleanup, and detection. Absolute porosity filters were used, with cleanup by immunomagnetic separation and detection by direct fluorescent antibody stain with 4',6-diamidino-2-phenylindole (DAPI) staining for additional cell structures. Both the level and consistency of oocyst recovery were improved compared to recovery with the ICR method.
Patterns of Relapse After Salvage Autologous Stem Cell Transplant for Hodgkin's Lymphoma: Should Sites of Relapse Relative to Initially Involved Sites Be Used to Guide Indications for Peri-Transplant Radiation Therapy.

Abstract Purpose We aimed to assess patterns of relapse in patients undergoing salvage autologous stem cell transplant (ASCT) for relapsed Hodgkin lymphoma in the modern era with the hypothesis that patients who suffer a relapse at initially involved sites are at increased risks of relapse post-ASCT that may help guide the application of peri-transplant radiation therapy. Methods and Materials A retrospective review was conducted of 38 patients undergoing ASCT between 2002 and 2017 for relapsed or refractory Hodgkin lymphoma. The site of relapse at the time of ASCT and subsequent relapses were compared with sites of the initial involvement at the time of diagnosis using follow-up imaging (most commonly positron emission computed tomography). Relapse and overall survival rates were calculated from the date of ASCT using the Kaplan-Meier method with a multivariate analysis, completed using a Cox multivariate analysis. Results The median follow-up time was 38 months (interquartile range, 18-66 months). Twenty-two patients (58%) suffered a relapse after ASCT at a median time to relapse of 9.1 months (interquartile range, 2.9-12.3 months) with a 5-year risk of relapse of 58% (95% confidence interval [CI], 41%-75%). On univariate analysis, relapse at an initially involved site was significant for higher rates of relapse at 71% at 5-years (95% CI, 52%-90%) compared with relapse at initially uninvolved sites at 30% (95% CI, 2%-58%; P = .05). The relapse rate was also significantly higher in patients age 30 years (P Conclusions Relapses at initially involved sites may potentially increase the risk of relapse after ASCT. Additional studies are needed to clarify whether this should be used as an additional factor to guide recommendations for peri-transplant radiation therapy.
Discrepancies in endpoints between clinical trial protocols and clinical trial registration in randomized trials in oncology

Clinical trials are an essential part of evidence-based medicine. Hence, to ensure transparency and accountability in these clinical trials, policies for registration have been framed with emphasis on mandatory submission of trial elements, specifically outcome measures. As these efforts evolve further, we sought to evaluate the current status of endpoint reporting in clinical trial registries. We reviewed 71 oncology related randomized controlled trials published in three high impact journals. We compared primary (PEP) and non-primary endpoints (NPEP) between the clinical trial protocols of these trials and their corresponding registration in one of the 14 primary global clinical trial registries. A discrepancy was defined as the non-reporting or absence of an endpoint in either the protocol or registry. The primary endpoint was the rate of discrepancy between secondary endpoints in clinical trial protocols and clinical trial registries. Of the 71 clinical trials, a discrepancy in PEP was found in only 4 trials (6%). Secondary endpoint (SEP) differences were found in 45 (63%) trials. Among these 45 trials, 36 (80%) had SEPs that were planned in the protocol but not reported in the registry and 19 (42%) had SEPs with endpoints in the registry that were not found in the protocol. The total number of SEPs that were absent from the corresponding registry and protocol were 84 and 29, respectively. Of these endpoints, 48 (57%) and 9 (31%) were included in the published report of these trials. Although recent regulations and enhanced procedures have improved the number and quality of clinical trial registrations, inconsistencies regarding endpoint reporting still exist. Though further guidelines for the registration of clinical trials will help, greater efforts to provide a correct, easily accessible, and complete representation of planned endpoints are needed.
How Can We Integrate Interests and Reasoned Arguments in Bioethics

The target essay by Garrison and colleagues (2019) analyzes the frequent appearance in policy debates of claims that genetic medicine is or is not “exceptional.” Such claims usually serve to justif...
CAUSES OF ELEVATED HIGH SENSITIVITY TROPONIN T IN CONSECUTIVE EMERGENCY DEPARTMENT PATIENTS

There is a need to understand when elevations in high sensitivity troponin (hs-cTn) can be expected. We prospectively measured 1,160 consecutive serial (0, 3 and 6 hour) samples from the ED with 4th and 5th generation cTnT. An elevated hs-cTnT was ≥10 ng/L in women, >15 ng/L in men and
Editorial Commentary: Teriparatide and Rotator Cuff Healing-Maybe Hormones Can Help Tendons to Heal.

Abstract Achieving tendon-bone healing continues to be challenging after arthroscopic rotator cuff repair, particularly for larger tears, despite significant improvements in repair techniques and implants. Considerable effort has been invested in research to identify methods to improve healing, including patches and injectable biologics. Parathyroid hormone improves tendon-to-bone healing. Teriparatide is osteogenic, stimulating bone growth, and chondrogenic, promoting cartilage formation at the enthesis. However, it could be difficult to justify the expense and potential risk of systemic administration of a recombinant hormone to improve structural healing until improvement in clinical outcomes can be shown.