cssi/SciSciGPT-SciSciNet huggingface dataset:
Pediatric patients on ketogenic diet undergoing general anesthesia-a medical record review.

Abstract Study objective To identify guidelines for anesthesia management and determine whether general anesthesia is safe for pediatric patients on ketogenic diet (KD). Design Retrospective medical record review. Setting Postoperative recovery area. Patients All pediatric patients who underwent general anesthesia while on KD between 2009 and 2014 were reviewed. We identified 24 patients who underwent a total of 33 procedures. All children were on KD due to intractable epilepsy. The age of patients ranged from 1 to 15 years. Intervention General anesthesia for the scheduled procedures. Measurements Patients' demographics, seizure history, type of procedure; perioperative blood chemistry, medications including the anesthesia administered, and postoperative complications. Main results Twenty-four patients underwent a total of 33 procedures. The duration of KD treatment at the time of general anesthesia ranged from 4 days to 8 years. Among the 33 procedures, 3 patients had complications that could be attributable to KD and general anesthesia. A 9-year-old patient experienced increased seizures on postoperative day 0. An 8-year-old patient with hydropcephalus developed metabolic acidosis on postoperative day 1, and a 7-year-old patient's procedure was complicated by respiratory distress and increased seizure activity in the postanesthesia care unit. Conclusion This study showed that it is relatively safe for children on KD to undergo general anesthesia. The 3 complications attributable to general anesthesia were mild, and the increased seizure frequencies in 2 patients returned back to baseline in 24 hours. Although normal saline is considered more beneficial than lactated Ringer's solution in patients on KD, normal saline should also be administered carefully because of the risk of exacerbating patients' metabolic acidosis. One should be aware of the potential change of the ketogenic status due to drugs given intraoperatively.
Examining the impact of grape consumption on brain metabolism and cognitive function in patients with mild decline in cognition: A double-blinded placebo controlled pilot study

Abstract Background Natural compounds in grapes such as resveratrol are known for their antioxidant and anti-inflammatory properties. Some studies have shown a potential role for grapes or wine in slowing cognitive decline and other effects of aging. However, well-controlled experimental data obtained in human subjects are still in need of further development. Here we aimed to systematically assess effects of grapes on regional cerebral metabolism. Methods Ten subjects with mild decline in cognition (mean, 72.2 ± 4.7 years; 50% female) were included in this analysis. Participants were randomized into an active grape formulation arm or a placebo arm which consumed a formulation free of polyphenols for six months. Cognitive performance was measured through neuropsychological assessments performed at baseline and 6 months after initiation of therapy. Changes in brain metabolism occurring with each therapy regimen were assessed by brain PET scans with the radiotracer [F-18] fluorodeoxyglucose (FDG), obtained during initial evaluation and 6 months later. Standardized volumes of interest (sVOI) and statistical parametric mapping (SPM) methods were applied to FDG-PET scans to identify significant regional cerebral metabolic changes. Results In contrast to participants taking the active grape formulation, who displayed no significant decline in metabolism, the placebo arm underwent significant metabolic decline in sVOI's of the right posterior cingulate cortex (p = 0.01), and left superior posterolateral temporal cortex (p = 0.04). SPM analyses also found significant declines in the placebo group, particularly in left prefrontal, cingulate, and left superior posterolateral temporal cortex (p Conclusions The placebo arm had declines in regions of the brain known to be significantly affected in the early stages of Alzheimer's disease, while the active formulation group was spared such decline. This suggests a protective effect of grapes against early pathologic metabolic decline.
Ultrasonographic Change in Uterocervical Angle is not a Risk Factor for Preterm Birth in Women with a Short Cervix

Objective To determine if change in uterocervical angle (UCA) is associated with an increased rate of preterm birth (less than 37 weeks) for women with a short cervix. Study Design A retrospective study was performed from January 2013 to March 2016 of singleton pregnancies undergoing universal cervical length screening. The difference between the UCA for the first cervical length ≤ 2.5 cm and last recorded cervical length Results A total of 176 women met the inclusion criteria. There was no difference in the rate of preterm birth at Conclusion A change in UCA was not associated with an increased risk of preterm birth. Instead, a final absolute UCA ≥ 105 degrees measured
Abstract 4229: Metabolically active macrophages: A novel link between obesity and TNBC

Triple negative breast cancer (TNBC) patients have an extremely poor prognosis due to their high metastatic potential and lack of targeted drug therapies. Emerging epidemiological data suggest that obesity is strongly linked to the incidence and severity of TNBC. However, mechanisms by which obesity potentiates TNBC progression are unclear. Adipose tissue macrophages (ATMs) are an attractive mechanistic link between obesity and TNBC because they are the predominant type of macrophage in the breast during early tumorigenesis and obesity causes accumulation of ATMs. However, during obesity, the macrophage phenotype was reported to switch from an apparent pro-tumorigenic M2-like phenotype to an apparent anti-tumorigenic M1-like phenotype. This result raises a paradox: how does obesity promote tumor progression if it activates an anti-tumorigenic macrophage phenotype? Here we show that metabolic dysfunction promotes a mechanistically distinct pro-inflammatory phenotype (metabolic activation; MMe) in breast adipose tissue macrophages isolated from obese women. These ATMs express cell surface markers of MMe (CD36, ABCA1) but not M1 (CD38, CD319, CD274) macrophages. We further demonstrate that pretreating TNBC cells with conditioned media derived from MMe but not M1 macrophages promotes mammosphere formation as well as invasion in vitro, and intravasation of cancer cells into the blood in vivo. Moreover, pre-treated cancer cells showed a two-fold increase in the expression of stem-like cell markers (OCT4, SOX2 and NANOG). Remarkably, we saw the same effect on ‘stemness’ of tumor cells in a spontaneous TNBC mouse model when fed a 60% high fat diet and a significant increase in tumor incidence in obese mice compared to lean mice in a syngeneic mouse model. We further show that blocking inflammatory cytokines expression in MMe(s) using genetic knockouts inhibits the ability of MMe(s) to promote both mammosphere formation and invasion. These findings suggest that obesity-induced changes to mammary adipose tissue reprogram macrophages to an MMe phenotype that potentiates TNBC initiation and metastasis via inflammatory cytokines. A comprehensive understanding of the signaling mechanism(s) involved in metabolic activation of mammary ATMs would enable development of directed therapies towards this specific pro-tumorigenic macrophage phenotype, thereby leaving the immune system of cancer patients intact. Citation Format: Payal Tiwari, Kelly Schoenfelt, Ariane Blank, Chang Cui, Marsha Rich Rosner, Lev Becker. Metabolically active macrophages: A novel link between obesity and TNBC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4229. doi:10.1158/1538-7445.AM2017-4229
Preparing Emergency Medicine Residents to Disclose Medical Error Using Standardized Patients.

Author(s): Spalding, Carmen N.; Rudinsky, Sherri L. | Abstract: Introduction: Emergency Medicine (EM) is a unique clinical learning environment. The American College of Graduate Medical Education Clinical Learning Environment Review Pathways to Excellence calls for “hands-on training” of disclosure of medical error (DME) during residency. Training and practicing key elements of DME using standardized patients (SP) may enhance preparedness among EM residents in performing this crucial skill in a clinical setting.Methods: This training was developed to improve resident preparedness in DME in the clinical setting. Objectives included the following: the residents will be able to define a medical error; discuss ethical and professional standards of DME; recognize common barriers to DME; describe key elements in effective DME to patients and families; and apply key elements during a SP encounter. The four-hour course included didactic and experiential learning methods, and was created collaboratively by core EM faculty and subject matter experts in conflict resolution and healthcare simulation. Educational media included lecture, video exemplars of DME communication with discussion, small group case-study discussion, and SP encounters. We administered a survey assessing for preparedness in DME pre-and post-training. A critical action checklist was administered to assess individual performance of key elements of DME during the evaluated SP case. A total of 15 postgraduate-year 1 and 2 EM residents completed the training. Results: After the course, residents reported increased comfort with and preparedness in performing several key elements in DME. They were able to demonstrate these elements in a simulated setting using SP. Residents valued the training, rating the didactic, SP sessions, and overall educational experience very high. Conclusion: Experiential learning using SP is effective in improving resident knowledge of and preparedness in performing medical error disclosure. This educational module can be adapted to other clinical learning environments through creation of specialty-specific scenarios.
Does Hair Hurt Career Marketability? Investigating the Influence of Hairstyle on Hiring Decisions

If you could easily and temporarily change a physical trait to give yourself a slight advantage on the job market, would you? This research experimentally investigates the extent to which hair characteristics influence hiring decisions. We manipulate hair color, style (including length), and texture on the same model in a LinkedIn profile and ask participants to respond to a series of questions regarding the candidate’s personal characteristics, qualifications, and suitability for a job. We find that blondes and brunettes fare better with straight hair relative to curly hair and short hair relative to long hair. We also find that redheads are generally evaluated more negatively than blondes and brunettes, unless they have long, curly, red hair. Surprisingly, the long, curly, redheaded condition received the most positive ratings. We also discuss and empirically investigate several potential explanations for these effects. This study furthers the current understanding of biases in hiring decisions by explo...
Respecting boundaries: CTCF, chromatin structural organization, and heart failure

The mammalian heart is highly adaptable, responding to growth of the organism, and to the rapidly changing demands to deliver nutrients and energy throughout the body based on exercise or rest, feeding or fasting, infection, injury and other stresses. In addition to acute changes in cardiac function to meet immediate demands, the heart has an impressive capacity for remodeling in response to long-term challenges, such as the physiological hypertrophy that occurs in the athlete’s heart, as well as the pathological hypertrophy due to chronic hypertension (1).
Solid-State NMR Spectroscopy and Isotopic Labeling Target Abundant Dipeptide Sequences in Elastin's Hydrophobic Domains

Isotopic labeling strategies are coupled with solid-state NMR spectroscopy to characterize elastin’s abundant glycines (Gly) and prolines (Pro) and the sequences that include these residues. Elastin is prepared with isotopic labels at Gly, Pro, and Val—three of its four most abundant amino acids. Solid-state 15N–1H nuclear magnetic resonance (NMR) spectra show four resolved glycine populations, whereas three features are observed for the prolines. Selection of the Val-Pro and Gly-Gly pairs found exclusively and abundantly in the hydrophobic domains confirms these assignments and also provides more information on the conformational ensembles of elastin. The 1HN and 15N temperature coefficients indicate that discrete secondary structures are present, even among significant populations with rapid conformational fluctuations typical of a random coil. 13C–15N couplings and the 13C chemical shift anisotropy (CSA) are also utilized to confirm assignments and structure, respectively. Implications for the evolving...
Monte Carlo simulations of microtubule arrays: The critical roles of rescue transitions, the cell boundary, and tubulin concentration in shaping microtubule distributions.

Microtubules are dynamic polymers required for a number of processes, including chromosome movement in mitosis. While regulators of microtubule dynamics have been well characterized, we lack a convenient way to predict how the measured dynamic parameters shape the entire microtubule system within a cell, or how the system responds when specific parameters change in response to internal or external signals. Here we describe a Monte Carlo model to simulate an array of dynamic microtubules from parameters including the cell radius, total tubulin concentration, microtubule nucleation rate from the centrosome, and plus end dynamic instability. The algorithm also allows dynamic instability or position of the cell edge to vary during the simulation. Outputs from simulations include free tubulin concentration, average microtubule lengths, length distributions, and individual length changes over time. Using this platform and reported parameters measured in interphase LLCPK1 epithelial cells, we predict that sequestering ~ 15–20% of total tubulin results in fewer microtubules, but promotes dynamic instability of those remaining. Simulations also predict that lowering nucleation rate will increase the stability and average length of the remaining microtubules. Allowing the position of the cell’s edge to vary over time changed the average length but not the number of microtubules and generated length distributions consistent with experimental measurements. Simulating the switch from interphase to prophase demonstrated that decreased rescue frequency at prophase is the critical factor needed to rapidly clear the cell of interphase microtubules prior to mitotic spindle assembly. Finally, consistent with several previous simulations, our results demonstrate that microtubule nucleation and dynamic instability in a confined space determines the partitioning of tubulin between monomer and polymer pools. The model and simulations will be useful for predicting changes to the entire microtubule array after modification to one or more parameters, including predicting the effects of tubulin-targeted chemotherapies.
Self-reported mobility as a preoperative risk assessment tool in older surgical patients compared to the American College of Surgeons National Surgical Quality Improvement Program.

The American College of Surgeons National Surgical Quality Improvement Program (NSQIP®) developed a surgical risk calculator using data from 1.4 million patients and including 1557 unique Current Procedural Terminology (CPT) codes. Although this calculator demonstrated excellent performance in predicting postoperative mortality, morbidity, and six surgical complications, it was not developed specifically for use in older surgical patients who have worse surgical outcomes and additional unique risk factors compared to younger adults. We aimed to test the ability of a simple self-reported mobility tool to predict postoperative outcomes in the older surgical population compared to the NSQIP. We used data from a prospective cohort study that enrolled 197 older surgical patients (≥ 69 years) undergoing various elective surgeries and assessed 30-day surgical outcomes. Statistical models included data from the Mobility Assessment Tool-short form (MAT-sf) alone, covariates alone, and MAT-sf data and covariates. We used leave-one-out (LOO) cross-validation of the models within our cohort and compared their performance for predicting postoperative outcomes against the NSQIP calculator based on receiver operating characteristic area under the curve (ROC AUC). Patients with poor self-reported mobility experienced higher rates of postoperative complications and nursing home placement. There was no difference in performance between any of our models and the NSQIP calculator (p > 0.1), with AUC between 0.604 and 0.697 for predicting postoperative complications and 0.653 and 0.760 for predicting nursing home placement. All models also predicted a length of stay (LOS) similar to the actual LOS. Mobility assessment alone using MAT-sf can predict postoperative complications, nursing home placement, and LOS for older surgical patients, with accuracy comparable to that of the NSQIP calculator. The simplicity of this noninvasive risk assessment tool makes it an attractive alternative to the NSQIP calculator that requires 20 patient predictors and the planned procedure, or CPT code to predict the chance that patients will have 15 different adverse outcomes following surgery.
Family Support, International Trends

Reconciling the conflicts between work obligations and families’ needs are a source of stress for most employed parents. Governmental supports provided to working parents vary widely between countries. This article reviews trends in policy approaches of advanced industrialized economies within three domains: family-leave benefits, early childcare programs, and early childhood education programs. Comparatively, the US provides less support to families with children under the age of 3 years than most advanced industrialized nations, and generally has a weaker system of health and social services.
Is GH nadir during OGTT a reliable test for diagnosis of acromegaly in patients with abnormal glucose metabolism

The growth hormone (GH) nadir during oral glucose tolerance test (OGTT) is the gold standard diagnostic test for acromegaly. The utility of OGTT-GH suppression test in patients with abnormal glucose metabolism (AGM) has not been well established. In this study, we compared the GH nadir during OGTT in patients evaluated for acromegaly in the presence and absence of AGM. This is a retrospective cohort study of patients with acromegaly (G1, n = 40) and a group in whom acromegaly was not confirmed (G2, n = 53) who had OGTT-GH suppression test during 2000–2012, using a monoclonal GH immunoenzymatic assay. The patients were categorized as having normal glucose metabolism (NGM) or AGM. GH nadir during OGTT in each group were compared. In G1 and G2, 17 and 19 patients had AGM, respectively. Among 17 patients with diabetes, median HbA1C was 7% (range 5.7–9.6%). All except one patient had HbA1C 0.4 µg/L. Four G1 patients with NGM had GH nadir<0.4 µg/L. All G2 patients had GH nadir < 0.4 µg/L, except one with NGM and GH nadir of 0.4 µg/L. Using highly sensitive GH assay, a GH nadir ≥ 0.4 µg/L during the OGTT-GH suppression test may be used for diagnosis of acromegaly in patients with AGM in the absence of poorly controlled diabetes.
Light-Induced Activation of Forbidden Exciton Transition in Strongly Confined Perovskite Quantum Dots.

We report the strong light-induced activation of forbidden exciton transition in CsPbBr3 perovskite quantum dots mediated by the symmetry-breaking polaron that modifies the optical selection rule of the confined exciton transition. The activated forbidden transition results in an intense pump-induced absorption in the transient absorption spectra above the bandgap, where the original parity-forbidden transition was located. In contrast to many other semiconductor quantum dots, photoexcitation of an exciton in CsPbBr3 quantum dots creates a sufficiently large perturbation via a lattice-distorting polaron, which turns on the formally forbidden transition. Compared to the bulk or weakly confined CsPbBr3, the activation of the forbidden transition in strongly confined quantum dots is much more prominent due to the stronger influence of the polaron on exciton transitions in the confined space. This nonlinear optical property highlights the intimate coupling of the photoexcited charge carriers with the lattice ...
Intricacies of CLL cytogenetic complexity

In this issue of Blood, Baliakas et al, on behalf of the European Research Initiative on CLL, present the largest retrospective analysis of the prognostic significance of karyotypic complexity, assessed by chromosome banding analysis (CBA) performed on stimulated cultures, in patients with chronic lymphocytic leukemia (CLL) and monoclonal B-cell lymphocytosis (MBL).1 Their cohort contains >5000 CLL patients and ∼400 patients with MBL from 17 European institutions. Based on their results, the authors demonstrate prognostic heterogeneity among CLL cases that are karyotypically complex. They propose a hierarchical prognostic model that integrates complex karyotype, TP53 aberrations, and immunoglobulin heavy chain variable region gene (IGHV) somatic mutation status.
A 6-level Flying Capacitor Multi-level Converter for Single Phase Buck-type Power Factor Correction

This work investigates behavior of flying capacitor multi-level (FCML) converters in single phase buck-type power factor correction (PFC) applications. Recent developments in FCML converters using GaN transistors are leveraged to improve power density of a single-phase 240 V RMS ac to direct 48 V dc conversion stage in data center power delivery applications. Here, we experimentally demonstrate this concept by using a digitally controlled 6-level FCML converter. The experimental prototype achieves 163 W/in3 by box volume excluding heat sink and twice-line frequency energy buffer. A key contribution of this work is experimental exploration of flying capacitor natural balancing of an FCML buck converter in a single-phase ac-dc conversion where the flying capacitor voltages must swing at 120 Hz.
Environmental conflict and the legacy of the Reformation

Liberal political theory seeks to enable diverse groups to coexist respectfully despite their differences. According to liberals, this requires embracing certain political institutions and refraini...
A Conclusion to the Story of Cades Cove’s Cemeteries

Cades Cove, as is any community, is a socially constructed reality on the cultural landscape, but it has been socially constructed twice, once by the historical residents who delineated the community over time, and once by the National Park Service that razed some structures while preserving others to present and commemorate a selective version of the cove as a nineteenth-century mountain community. More people visit the social reconstruction than would have visited the original social construction of Cades Cove as community. In that context of social construction and reconstruction, perhaps the cemeteries remain as the most authentic representation of and a window into the community as it was constructed and intended by those residents of 100 years ago and more. Regardless of the version of Cades Cove encountered and perceived, its cemeteries remain a constant.
Differences in Function and Comorbidities Between Older Adult Users and Nonusers of Chiropractic and Osteopathic Manipulation: A Cross-sectional Analysis of the 2012 National Health Interview Survey.

Abstract Objective The purpose of this cross-sectional study was to compare functional limitations and comorbidity prevalence between older adult users and nonusers of chiropractic and osteopathic (DC/DO) manipulation to inform provider training. Methods We conducted a secondary analysis of the 2012 National Health Interview Survey data. Adults age 65 or older who responded to the survey were included. Descriptive statistics are reported for adults who used DC/DO manipulation (vs nonusers) regarding function, comorbidities, musculoskeletal complaints, and medical services. Weighted percentages were derived using SAS and compared with χ2 tests. Results The DC/DO users were more often female, overweight or obese, and of white race than nonusers. More DC/DO users reported arthritis (55.3% vs 47.0%, Conclusion Differences existed between older adult manipulation users and nonusers, especially surgical utilization, musculoskeletal complaints, and comorbidities; functional differences were modest. Our findings highlight areas for provider training and awareness regarding comorbidity burden and management needs in older patients who may simultaneously use manipulation and medical care for musculoskeletal complaints.
Watersheds dynamics following wildfires: Nonlinear feedbacks and implications on hydrologic responses

Author(s): Maina, FZ; Siirila-Woodburn, ER | Abstract: In recent years, wildfires in the western United States have occurred with increasing frequency and scale. Climate change scenarios in California predict prolonged periods of droughts with even greater potential for conditions amenable to wildfires. The Sierra Nevada Mountains provide 70% of water resources in California, yet how wildfires will impact watershed-scale hydrology is highly uncertain. In this work, we assess the impacts of wildfires perturbations on watershed hydrodynamics using a physically based integrated hydrologic model in a high-performance-computing framework. A representative Californian watershed, the Cosumnes River, is used to demonstrate how postwildfire conditions impact the water and energy balance. Results from the high-resolution model show counterintuitive feedbacks that occur following a wildfire and allow us to identify the regions most sensitive to wildfires conditions, as well as the hydrologic processes that are most affected. For example, whereas evapotranspiration generally decreases in the postfire simulations, some regions experience an increase due to changes in surface water run-off patterns in and near burn scars. Postfire conditions also yield greater winter snowpack and subsequently greater summer run-off as well as groundwater storage in the postfire simulations. Comparisons between dry and wet water years show that climate is the main factor controlling the timing at which some hydrologic processes occur (such as snow accumulation) whereas postwildfire changes to other metrics (such as streamflow) show seasonally dependent impacts primarily due to the timing of snowmelt, illustrative of the integrative nature of hydrologic processes across the Sierra Nevada-Central Valley interface.
Histidine triad nucleotide-binding proteins HINT1 and HINT2 share similar substrate specificities and little affinity for the signaling dinucleotide Ap4A.

Human histidine triad nucleotide-binding protein 2 (hHINT2) is an important player in human mitochondrial bioenergetics, but little is known about its catalytic capabilities or its nucleotide phosphoramidate prodrug (proTide)-activating activity akin to the cytosolic isozyme hHINT1. Here, a similar substrate specificity profile (kcat /Km ) for model phosphoramidate substrates was found for hHINT2 but with higher kcat and Km values when compared with hHINT1. A broader pH range for maximum catalytic activity was determined for hHINT2 (pK1 = 6.76 ± 0.16, pK2 = 8.41 ± 0.07). In addition, the known hHINT1-microphthalmia-inducing transcription factor-regulating molecule Ap4 A was found to have no detectable binding to HINT1 nor HINT2 by isothermal titration calorimetry. These results demonstrate that despite differences in their sequence and localization, HINT1 and HINT2 have similar nucleotide substrate specificities, which should be considered in future proTide design and in studies of their natural function.
Peroral endoscopic myotomy for cricopharyngeal bar.

Background and Aims Definitive treatment options for refractory dysphagia due to cricopharyngeal bar are limited. We aimed to demonstrate a novel adaptation of peroral endoscopic myotomy to treat this condition (cricopharyngeal peroral endoscopic myotomy [c-POEM]). Methods The approach to c-POEM is similar to that in the distal esophagus for the treatment of achalasia. A submucosal injection and overlying mucosal incision are performed, ideally 1.5 to 2 cm upstream of the upper esophageal sphincter, and then a submucosal tunnel is extended beyond the level of the cricopharyngeus. The target muscle is then transected before closure of the mucosotomy. Results In 3 cases of refractory cricopharyngeal bar, c-POEM was successfully performed. Although no major adverse events occurred, significant postprocedural edema at the level of the upper esophageal sphincter prolonged hospitalization in 2 of the 3 patients. After recovery, all patients reported complete resolution of dysphagia and tolerated an unrestricted diet. Conclusions C-POEM allows reliable and complete muscular division in patients with refractory cricopharyngeal bar who have limited treatment options.
Sustainable Marketing: Market-Driving, Not Market-Driven:

Sustainability has emerged as a critical macromarketing perspective over the last five decades. Starting with the early concerns in the 1960s about the world’s finite resources that would limit eco...
SARS–CoV-2 Immuno-Pathogenesis and Potential for Diverse Vaccines and Therapies: Opportunities and Challenges

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a novel coronavirus that emerged from Wuhan, China in late 2019 causing coronavirus disease-19 (COVID-19). SARS-CoV-2 infection begins by attaching to angiotensin-converting enzyme 2 receptor (ACE2) via the spike glycoprotein, followed by cleavage by TMPRSS2, revealing the viral fusion domain. Other presumptive receptors for SARS-CoV-2 attachment include CD147, neuropilin-1 (NRP1), and Myeloid C-lectin like receptor (CLR), each of which might play a role in the systemic viral spread. The pathology of SARS-CoV-2 infection ranges from asymptomatic to severe acute respiratory distress syndrome, often displaying a cytokine storm syndrome, which can be life-threatening. Despite progress made, the detailed mechanisms underlying SARS-CoV-2 interaction with the host immune system remain unclear and are an area of very active research. The process's key players include viral non-structural proteins and open reading frame products, which have been implicated in immune antagonism. The dysregulation of the innate immune system results in reduced adaptive immune responses characterized by rapidly diminishing antibody titers. Several treatment options for COVID-19 are emerging, with immunotherapies, peptide therapies, and nucleic acid vaccines showing promise. This review discusses the advances in the immunopathology of SARS-CoV-2, vaccines and therapies under investigation to counter the effects of this virus, as well as viral variants.
Randomness and Fairness in Two-Sided Matching with Limited Interviews

We study the outcome in a matching market where both sides have limited ability to consider options. For example, in the national residency matching program, doctors are limited to apply to a small set of hospitals, and hospitals are limited by the time required to interview candidates. Our main findings are the following: (1) In markets where jobs can only consider a limited number of candidates for interview, it increases the size of the resulting matching if the system has a limit on the number of applications a candidate can send. (2) The fair system of all applicants being allowed to apply to the exact same number of positions maximizes the expected size of the matching. More particularly, starting from an integer k as the number of applications, the matching size decreases as a few applicants are allowed to apply to one additional position (and then increases again as they are all allowed to apply to k+1). Although it seems natural to expect that the size of the matching would be a monotone increasing and concave function in the number of applications, our results show that neither is true. These results hold even in a market where a-priori all jobs and all candidates are equally likely to be good, and the judgments of different employers and candidates are independent. Our main technical contribution is computing the expected size of the matching found via the deferred acceptance algorithm as a function of the number of interviews and applications in a market where preferences are uniform and independent. Through simulations we confirm that these findings extend to markets where rankings become correlated after the interviews.
Pathology of Multiple Sclerosis

Multifocal demyelination and neurodegeneration characterized by neuronal, synaptic, and axonal injury are key characteristics of multiple sclerosis (MS). Demyelination involves both white and gray matter regions. Neurodegeneration, mediated by oxidative tissue injury and energy failure, correlates with disability worsening more significantly than white matter (WM) lesions. Magnetic resonance imaging (MRI) is an invaluable tool but has limitations in detecting cortical pathology and discriminating demyelination from axonal pathology. Postmortem in situ MRI with histopathologic correlations can validate demyelination—contrary to popular belief, MRI is not specific for demyelination, as only 55% of T2-only lesions are demyelinated, with axonal pathology also accounting for T2-hyperintensities.
Cerebellar projections to the macaque midbrain tegmentum: Possible near response connections.

Since most gaze shifts are to targets that lie at a different distance from the viewer than the current target, gaze changes commonly require a change in the angle between the eyes. As part of this response, lens curvature must also be adjusted with respect to target distance by the ciliary muscle. It has been suggested that projections by the cerebellar fastigial and posterior interposed nuclei to the supraoculomotor area (SOA), which lies immediately dorsal to the oculomotor nucleus and contains near response neurons, support this behavior. However, the SOA also contains motoneurons that supply multiply innervated muscle fibers (MIFs) and the dendrites of levator palpebrae superioris motoneurons. To better determine the targets of the fastigial nucleus in the SOA, we placed an anterograde tracer into this cerebellar nucleus in Macaca fascicularis monkeys and a retrograde tracer into their contralateral medial rectus, superior rectus, and levator palpebrae muscles. We only observed close associations between anterogradely labeled boutons and the dendrites of medial rectus MIF and levator palpebrae motoneurons. However, relatively few of these associations were present, suggesting these are not the main cerebellar targets. In contrast, labeled boutons in SOA, and in the adjacent central mesencephalic reticular formation (cMRF), densely innervated a subpopulation of neurons. Based on their location, these cells may represent premotor near response neurons that supply medial rectus and preganglionic Edinger–Westphal motoneurons. We also identified lens accommodation-related cerebellar afferent neurons via retrograde trans-synaptic transport of the N2c rabies virus from the ciliary muscle. They were found bilaterally in the fastigial and posterior interposed nuclei, in a distribution which mirrored that of neurons retrogradely labeled from the SOA and cMRF. Our results suggest these cerebellar neurons coordinate elements of the near response during symmetric vergence and disjunctive saccades by targeting cMRF and SOA premotor neurons.
Comparison of two methods of preventing central nervous system leukemia.

This controlled study of children with ALL was designed to determine in a prospective manner the relative efficacy and toxicity of two forms of "prophylactic" CNS therapy for preventing CNS relapse and of periodic vincristine-prednisone "pulses" during multiple agent chemotherapy. Following cranial irradiation (2400 rads) plus intrathecal methotrexate, 3 of 45 patients developed CNS leukemia. Following craniospinal irradiation (2400 rads), 2 of 49 developed CNS leukemia. Craniospinal irradiation was associated with more leukopenia and interruptions of chemotherapy. "Pulses" were not associated with improvement of remission duration. Our current choice of CNS therapy is cranial irradiation plus intrathecal methotrexate because it takes less time and may avoid demonstrated short-term side effects and possible long-term effects of spinal irradiation.
Complexity of Recursive Normal Default Logic

Normal default logic, the fragment of default logic obtained by restricting defaults to rules of the form α:Mβ/β, is the most important and widely studied part of default logic. In [20], we proved a basis theorem for extensions of recursive propositional logic normal default theories and hence for finite predicate logic normal default theories. That is, we proved that every recursive propositional normal default theory possesses an extension which is r.e. in 0′. Here we show that this bound is tight. Specifically, we show that for every r.e. set A and every set B r.e. in A there is a recursive normal default theory 〈D, W〉 with a unique extension which is Turing-equivalent to A t B. A similar result holds for finite predicate logic normal default theories.
Federalism's 'Old Deal': What is Right and Wrong With Conservative Judicial Activism

In an article based on his Fall, 1999 Reuschlein Distinguished Lecture at Villanova Law School, Professor Shane argues that the Supreme Court is leading a misguided project of conservative judicial activism aimed at curtailing Congress's commercial regulatory powers, in the interest of preserving state autonomy. This activist initiative has recently been defended by Fourth Circuit Chief Judge J. Harvie Wilkinson, in Brzonkala v. Virginia Polytechnic Institute, which overturned the civil damages remedy enacted as part of the Violence Against Women Act. Professor Shane argues, however, that the federal courts have not shown any compelling institutional need with regard to federalism that justifies inventing new limitations on congressional authority. No less than Congress have the States amassed political and economic power unimagined by the Framers. Nor did the Supreme Court in Lopez v. United States formulate a workable and coherent legal doctrine for limiting Congress's Commerce Clause authority that relates in any sensible way to the values of federalism. Judge Wilkinson's defense contends that Lopez-style activism is necessary to avoid judicial abdication of the courts' interpretive authority regarding the Constitution, and that it is better than Lochner-style activism because it does not disable state legislative authorities from dealing with social problems. Shane argues that Wilkinson misconstrues the nature of the courts' interpretive authority and ignores the importance of empowering the national legislative authority to deal with national problems. Wilkinson argues also that Lopez-style activism is better than Lochner-style activism because it does not advance the agenda of a particular constituency, such as big business. Shane responds that the current cases do advance the agenda of an ideological, rather than economic constituency, and that the majority Fourth Circuit opinion in Brzonkala is a "culture wars barrage" that violates appropriate norms of judicial temperament. Shane concludes that Congress is better viewed as a partner, rather than as a threat, if states and localities are to preserve effective autonomy during the era of globalization.
Dependence of nonlinear absorption in CdGeAs/sub 2/ on temperature, orientation, and charge carrier density

CdGeAs2 is an attractive candidate for midwave infrared generation because of its high nonlinear optical coefficient and favorable thermal figure of merit.
The Woman's Film of the 1940s: Gender, Narrative, and History

Introduction: To Speak of Love 1. Film Theory, Narrative, and the 1940s Woman's Film 2. The Fate of One Governess: Lost Narrative, History, and Gendered Desire 3. Melodrama, History, and Narrative Recovery 4. Temporality and the Past: Haunting Narratives and the Post-War Woman's Film 5. By My Tears I Tell a Story/The "Absent" War 6. Telling the Story Differently: Toward an Androgynous Spectatorship and Interpretation
Antibullying workshops: shaping minority nursing leaders through curriculum innovation.

PROBLEM: Bullying is a phenomenon that threatens nurse recruitment and retention. As such, nurse educators should be called upon to innovatively create ethical and safe informative and practice spaces for the development and socialization of future practicing nurses. Creation of such spaces would be especially important for learners of minority background needed to help care for our nation's growing populations. METHOD: A variety of theory-driven strategies were employed to construct innovative workshops as part of teaching methodology for undergraduate nursing curriculum at a designated Hispanic- and minority-serving college. Nursing faculty provided the workshops in concert with mentored nursing student scholars who were likewise interested in bullying cessation. FINDINGS: Surveys from 230 nursing student participants in workshops revealed a 10-33% increase in self-reported identification of various facets of the bullying phenomenon. Students' narrative reflections revealed personal experiences with bullying, a raised awareness of its phenomenon, and an improved dedication to ending bullying. CONCLUSIONS: Nurse educators can help influence antibullying awareness through workshops integrated into their program of study. This innovative curriculum strategy demonstrates nurse educator commitment to antibullying that is focused on guiding and promoting the advocacy of educational, leadership, and professional opportunities and skills growth for minority nursing student scholars. Language: en
Thrombocytopenia Inherited as an Autosomal Dominant Trait

This report summarizes information obtained on four generations of a kindred afflicted with a mild hemorrhagic diathesis. Studies carried out on a family of eight members and platelet counts obtained on fifty-one additional members demonstrated only mild thrombocytopenia in eleven members of three generations. The thrombocytopenia appears to be inherited as an autosomal dominant trait.
DIPS power conversion cycle selection

The results of a dynamic power conversion cycle selection process conducted as part of the Dynamic Isotope Power Subsystem (DIPS) program sponsored by the US Department of Energy (DOE) are presented. The objective of the DIPS program is to demonstrate the technology necessary to provide dynamic radioisotope space electrical power systems in the 1 to 10 kWe range to support evolving military and civilian missions in the early 1990s and beyond. Selecting the most appropriate DIPS power conversion cycle that would support this objective was an integral step in this process. The closed Brayton cycle was selected as the preferred power conversion cycle for the DIPS program based on an evaluation of several key areas of spacecraft power system performance: reliability, survivability, safety, scalability and growth, cost and schedule, and sensitivity to parameter variations. >
Nighttime insomnia treatment and education for Alzheimer's disease: a randomized, controlled trial.

OBJECTIVES: To evaluate whether a comprehensive sleep education program (Nighttime Insomnia Treatment and Education for Alzheimer’s Disease (NITE-AD)) could improve sleep in dementia patients living at home with their family caregivers. DESIGN: A randomized, controlled trial. PARTICIPANTS: Thirty-six community-dwelling patients with Alzheimer’s disease (AD) and their family caregivers. INTERVENTION: All participants received written materials describing age- and dementia-related changes in sleep and standard principles of good sleep hygiene. Caregivers in active treatment (n 5 17) received specific recommendations about setting up and implementing a sleep hygiene program for the dementia patient and training in behavior management skills. Patients in active treatment were also instructed to walk daily and increase daytime light exposure with the use of a light box. Control subjects (n 5 19) received general dementia education and caregiver support. MEASUREMENTS: Primary sleep outcomes were derived for patients and caregivers from 1 week of sleep-wake activity measured at baseline, posttest (2 months), and 6month follow-up using an Actillume wrist-movement recorder. Secondary patient outcomes included the Epworth Sleepiness Scale, the Cornell Depression Scale, and the Revised Memory and Behavior Problem Checklist. Caregiver self-reports included the Pittsburgh Sleep Quality Index and the Center for Epidemiological Study of Depression Scale. RESULTS: Patients participating in NITE-AD showed significantly greater (Po.05) posttest reductions in number of nighttime awakenings, total time awake at night, and depression, and increases in weekly exercise days than control subjects. At 6-month follow-up, treatment gains were maintained, and additional significant improvements in duration of night awakenings emerged. When cognitive level was controlled, NITE-AD patients had lower longitudinal ratings of daytime sleepiness than controls. There was a trend for control subjects to spend more time in bed at 6 months than NITE-AD patients. CONCLUSION: This study provides the first evidence that patients with AD who are experiencing sleep problems can benefit from behavioral techniques (specifically, sleep hygiene education, daily walking, and increased light exposure) that are known to improve sleep in nondemented, institutionalized older adults. J Am Geriatr Soc 53:793–802, 2005.
Perturbation theory for charged-particle transport in one dimension

Perturbation theory, when applied to charged-particle transport, generates a series solution that requires a double quadrature per term. The continuity of higher-order terms leads to numerical evaluation of the series. The high rate of convergence of the series makes the method a practical tool for charged-particle transport problems. The coupling of the neutron component in the case of proton transport in tissue does not greatly alter the rate of convergence. The method holds promise for a practical high-energy proton transport theory.
Oral controlled drug administration, Pharmacokinetic Considerations

(1983). Oral controlled drug administration, Pharmacokinetic Considerations. Drug Development and Industrial Pharmacy: Vol. 9, No. 7, pp. 1185-1225.
Bayesian interim analysis of censored exponential observations

Abstract We suppose that a minimum sample size is required before a conclusion is reached regarding a trial involving exponential variables subject to censoring and loss to follow-up. It is also assumed that subjects may be put on test at varying times. A Bayesian predictive algorithm is obtained for an interim analysis at N observations when another M observations are contemplated.
Orbital electron captures in 51Cr and 65Zn and the K-fluorescence yields of V and Cu

Abstract The rates of production of K X-rays during the decay of the radioactive nuclei 51 Cr and 65 Zn have been determined by measuring coincidences N K- γ between the K X-ray and the 233 keV gamma ray in the case of 51 Cr and between the K X-ray and the 1.114 MeV gamma ray for 65 Zn. The total electron capture rate has been obtained in each case by recording the number of pulses due to the gamma ray in the selection channel N γ . For each of the nuclei the ratio of the two measured quantities N K- γ and N γ , when compared with the theoretical ratio of K-capture rate to the rate of capture from all the shells corrected for exchange and overlap yields the value of the corresponding K flourescence yield ω K . The values of ω K thus determined are ω K (V) = 0.221±0.018 and ω K (Cu) = 0.436±0.30. These values are compared with the values obtained from semi-empirical relations.
The amide rotational barrier in isonicotinamide: Dynamic NMR and ab initio studies.

We report use of dynamic nuclear magnetic resonance (NMR) to measure the amide rotational barrier in isonicotinamide. A significant challenge to obtaining good transition rates from dynamic NMR dat...