cssi/SciSciGPT-SciSciNet huggingface dataset:
12. GM-CSF But Not M-CSF is Critical to the Therapeutic Mechanism of Action and Efficacy of Pulmonary Macrophage Transplantation (PMT) Therapy of Hereditary Pulmonary Alveolar Proteinosis (hPAP)

Rationale: Hereditary pulmonary alveolar proteinosis (hPAP) is a disorder caused by recessive mutations in the GM-CSF receptor α or β gene (CSF2RA or CSF2RB), which is characterized by surfactant accumulation and hypoxemic respiratory failure, and for which no pharmacologic therapy exits. Using a murine hPAP model (Csf2rb–/–) phenotypically identical to children with hPAP, we recently reported a new gene/cell transplantation therapy approach – pulmonary macrophage transplantation (PMT) (Nature. 2014, 514: 450), with spontaneous engraftment – without preparative myeloablation, extraordinary therapeutic efficacy, a durable treatment effect, and no safety signal. Interestingly, both GM-CSF and M-CSF are elevated in the lungs of hPAP and provide a possible explanation for the remarkable survival advantage observed for transplanted macrophages compared to endogenous cells. The present study was undertaken to determine the potential relative contribution of these factors to the therapeutic mechanism of action of PMT therapy in preclinical studies in Csf2rb–/– mice.Methods: Csf2rb–/– mice received a single PMT ‘treatment’ – intrapulmonary instillation of wild type (WT) or (as a control) Csfr2b–/– bone marrow derived macrophages (BMDM) (2×106 per mouse) in the absence or presence of a specific M-CSF receptor kinase inhibitor (GW2580) or vehicle. Two months later, therapeutic efficacy was evaluated by measuring both disease severity (bronchoalveolar lavage (BAL) turbidity, BAL surfactant protein D (SP-D) levels) and pulmonary biomarkers of hPAP (BAL GM-CSF, M-CSF levels).Results: We first demonstrated the activity of GW2580 in vivo by measuring splenic macrophage numbers in Csf2rb–/– mice, which were reduced in GW2580-treated compared to untreated mice (2.8±0.2% vs 6.5±0.5%, n=13, 10 /group; p 0.05; all comparisons).Conclusions: Results demonstrate that GM-CSF but not M-CSF contributes to the efficacy of PMT therapy that restores surfactant homeostasis in mice with hPAP.Funding: ATS, CCHMC, NIH UL1TR000077 (TS); NIH R01HL085453, R21HL106134, R01HL118342 (BCT)
The American Modernity Crisis and Disruptive Technologies

This introductory chapter provides a theoretical and historical account of nineteenth-century disruptive technologies and ways in which these disrupt the phenomenology of autobiographical narrative. The chapter closes with a reading of Mark Twain’s The Autobiography of Mark Twain in which I argue that this text registers Twain’s ambivalence to the mediation produced by his increasingly technologized act of composition.
Bent Negative Curvature Fibers Using Circular or Elliptical Cladding Tubes

We study nondegenerate modes in bent negative curvature fibers. Fibers with circular tubes perform better than fibers with elliptical tubes when the bend radius is less than 12 cm.
Implementation of a phase field model for simulating evolution of two powder particles representing microstructural changes during sintering

In this work, we present a multiphysics phase field model for capturing microstructural evolution during solid-state sintering processes. The model incorporates modifications of phase field equations to include rigid-body motion, elastic deformation, and heat conduction. The model correctly predicts consolidation of powder particles during sintering because of two competing mechanisms—neck formation and grain growth. The simulations show that the material undergoes three distinctive stages during the sintering process—stage I where neck or grain boundary between two particles is formed, stage II in which neck length stabilizes and growth or shrinkage of individual particles initiates, and finally stage III with rapid grain growth leading to disappearance of one of the grains. The driving forces corresponding to different mechanisms are found to be dependent on the radius of the particles, curvature at the neck location, surface energy, and grain boundary energy. In addition, variation in temperature is found to significantly influence the microstructure evolution by affecting the diffusivity and grain boundary mobility of the sintered material. The model is also used to compare sintering simulation results in 2D and 3D. It is observed that due to higher curvature in 3D, model predicts faster microstructural evolution in 3D when compared to 2D simulations under identical boundary conditions.
Transformative play: games as 21 st century curriculum

In this presentation, we will discuss the design history, comparison studies, and scaling research focused on four units we have designed based on our theory of transformational play. The goal is to both discuss the power of these designs, but also the challenges of scaling such innovative learning experiences internationally. These four units (one focused on mathematics, science, language arts, and social studies) are situated in an online, multiplayer videogame called Quest Atlantis, supporting over 25,000 children worldwide. Each presented unit has gone through multiple iterations of implementation, analysis, and redesign, informed by empirical data and our evolving theoretical framework. In reviewing both results from comparison studies and differences in international engagement with the units, our accounts will illuminate the theory transformational play, how the theory has shaped design and interpretations of findings.
Short- To Mid-Term Outcomes of Anatomic MCL Reconstruction With Achilles Tendon Allograft After Multiligament Knee Injury

Multiple techniques have been described in the literature for reconstruction of the medial collateral ligament. The purpose of this study is to describe functional outcome, range of motion, and knee stability following anatomic MCL reconstruction utilizing an Achilles tendon bone allograft after multiligament knee injury. A comprehensive search of a single-hospital multiligament knee injury (MLKI) procedural database was conducted to identify all patients that underwent reconstruction of the MCL utilizing an Achilles tendon bone allograft and with 2-year clinical follow-up. Medical charts were retrospectively reviewed to determine each patient’s knee dislocation (KD) grade, final range of motion, stability on clinical examination, and the incidence of complications and reoperations. KOOS, IKDC, and Marx scores were also collected. Thirty-two knees in 32 patients (21 males and 11 females) with a mean age of 30 years (range 15–51) were followed for an average of 40 months (range 28–87 months) following MCL reconstruction with Achilles tendon bone allograft. For patients with multiligament knee injuries, there were 14 KD-I (11 ACL/MCL; 3 MCL/PCL; 1 MCL/ACL/LCL; 1 MCL/PCL/LCL), 12 KD 3-M, and 3 KD-IV. One patient underwent isolated revision MCL reconstruction. At final follow-up, clinically significant valgus laxity was observed in only 1 patient (3%). All patients were able to achieve full extension of the knee and the average flexion was 121.1 ± 19.6. The average IKDC score was 67.6 ± 19.9 (range 27.7–98.9), the average KOOS score 77.1 ± 16.8 (range 31–100). The average Marx score was 4.9 (range 0–16, SD 5.2). Thirty-one of 32 (96%) patients reported being satisfied with results of the surgery. Knee dislocation grades were significantly correlated with post-operative outcome measures. In a series utilizing a modified Marx Achilles tendon, MCL reconstruction in the setting of MLKI demonstrated satisfactory clinical and functional outcomes, as well as patient satisfaction at short- to mid-term follow-up. Furthermore, knee dislocation grades were demonstrated to correlate with post-operative IKDC, KOOS, and Marx scores. Type IV.
Do differences in medical comorbidities and treatment impact racial disparities in epithelial ovarian cancer

Abstract Background Population-based studies of women with epithelial ovarian cancer suggest that black women have worse survival compared to white women. The primary objective of this study was to determine if, at a National Cancer Institute (NCI)-Designated Comprehensive Cancer Center (CCC) serving a diverse racial and socioeconomic population, race is independently associated with differences in survival. Methods A retrospective review of women with EOC diagnosed between 2004–2009 undergoing treatment with follow-up at our institution was performed. Records were reviewed for demographics, comorbidities (as defined by the Charlson Comorbidity Index (CCI)), tumor characteristics, treatment, progression-free (PFS), and overall survival (OS). Survival was calculated using the Kaplan-Meier method and compared with the log-rank test. Multivariate survival analysis was performed with Cox (proportional hazards) model. Results 367 patients met inclusion criteria. 54 (15%) were black and 308 (84%) were white. Compared to white women, black women had higher BMI, lower rates of optimal surgical cytoreduction, lower rates of intraperitoneal chemotherapy, and higher CCI scores. The median PFS for black and white women were 9.7 and 14.6 months, respectively (p = 0.033). The median overall survival was 21.7 months for black women and 42.6 months for white women (p Conclusion In this cohort, racial disparities may be due to higher medical comorbidities and lower rates of optimal surgical cytoreduction. After accounting for these differences, race remained an independent predictor of worse overall survival.
Variations in Mechanisms of Injury for Children with Concussion

Objectives To assess the distribution of injury mechanisms and activities among children with concussions in a large pediatric healthcare system. Study design All patients, age 0-17 years, who had at least 1 clinical encounter with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis of concussion in the Children's Hospital of Philadelphia's electronic health record system from July 1, 2012 to June 30, 2014, were selected (N = 8233) and their initial concussion-related visit identified. Approximately, 20% of the patients (n = 1625) were randomly selected for manual record review to examine injury mechanisms and activities. Results Overall, 70% of concussions were sports related; however, this proportion varied by age. Only 18% of concussions sustained by children aged 0-4 were sports related, compared with greater proportions for older children (67% for age 5-11, 77% for age 12-14, and 73% for age 15-17). When the concussion was not sports related, the primary mechanisms of injury were struck by an object (30%) and falls (30%). Conclusions Sports-related injuries in children older than 6 years of age contributed to the majority of concussions in this cohort; however, it is important to note that approximately one-third of concussions were from non–sports-related activities. Although there is increased participation in community and organized sports activities among children, a focus on prevention efforts in other activities where concussions occur is needed.
PAH in CTD – Clinical Trials Criteria and Performance

Pulmonary arterial hypertension (PAH) is characterized by vascular proliferation and remodeling ultimately leading to right ventricular failure and death. PAH has emerged in recent years as the leading cause of death and late disease morbidity in systemic sclerosis and is an important complication of other connective tissue disorders. Pulmonary endothelial injury is associated with reduced production of vasodilating substances such as prostacyclin and nitric oxide and increased production of vasoconstrictive and proproliferative endothelin. Short term controlled trials have suggested benefits of endothelin receptor antagonism including improved exercise capacity and hemodynamics and increased time to clinical worsening. Improved survival is suggested from long term open label observational cohorts. As therapeutic options increase, it is important to consider the validity of outcome measures and the relative merits of endothelin receptor selectivity.
An Equation for the Nitrogenase Reaction

Research in the biochemistry and biophysics of N2 fixation has progressed along two separate but related lines. One deals mainly with the catalytic activity of the enzyme nitrogenase, while the other is concerned chiefly with its physical and chemical characteristics. Productive research in the former was initiated with the preparation of active cell-free extracts in 1960, but characterization work did not get well under way until into the mid-1960’s. By then the over-all reaction characteristics had become reasonably clear, though the detailed reaction mechanism was not established, nor is it yet. Since the mid-1960’s, understanding of the nitrogenase reaction has become increasingly refined, and major advances in defining the physical-chemical nature of the enzyme have been made possible with the availability of pure nitrogenase proteins for analysis. Until now it has been feasible and also fruitful to pursue these two areas rather independently; however, as experimentation becomes more definitive and bears more directly on the mechanism of nitrogenase action, these areas seem destined to overlap increasingly as they blend toward the ultimate goal, the description of nitrogenase catalysis in terms of molecular structure.
Precision Intravitreal Chemotherapy for Localized Vitreous Seeding of Retinoblastoma.

Purpose To describe and evaluate the effectivity of a novel precision intravitreal injection technique for select cases of localized vitreous seeding in retinoblastoma. Methods Patients with localized vitreous seeds from retinoblastoma received intravitreal chemotherapy via a precision injection technique (P-IVitC) intended to optimize local delivery of melphalan to target seeds. The needle was inserted trans-pars plana and chemotherapy deposited within 3 mm of the target seed(s) under indirect ophthalmoscopic guidance. Without subsequent globe manipulation, the head was then positioned to promote gravity-dependent settling of chemotherapy. Results There were 8 eyes of 8 patients treated with P-IVitC for active vitreous seeds following adequate solid tumor control with intravenous chemotherapy (n = 3, 38%) or intra-arterial chemotherapy (n = 5, 63%). Viable vitreous seeds were primarily solitary spheres (n = 6, 75%) and measured an average of 2.7 mm in diameter. Vitreous seed resolution (n = 8, 100%) was noted after a mean of 2.6 injections (median 2; range 1-3) of 20 μg melphalan. There was no recurrence at a mean follow-up of 10.0 months. Only 1 eye had an associated complication (focal retinal pigment epithelial mottling, n = 1, 13%). Conclusions With direct delivery of chemotherapy to within 3-4 mm of vitreous seed activity, P-IVitC provided complete control of localized vitreous seeds with minimal toxicity.
Granting forgiveness: State and trait evidence for genetic and gender indirect effects through empathy

This research advances the forgiveness literature by identifying genetic and gender predictors that operate through empathy. In a sample of 202 (101 males, 101 females), both the oxytocin receptor ...
The unobtrusive group interaction (UGI) corpus

Studying group dynamics requires fine-grained spatial and temporal understanding of human behavior. Social psychologists studying human interaction patterns in face-to-face group meetings often find themselves struggling with huge volumes of data that require many hours of tedious manual coding. There are only a few publicly available multi-modal datasets of face-to-face group meetings that enable the development of automated methods to study verbal and non-verbal human behavior. In this paper, we present a new, publicly available multi-modal dataset for group dynamics study that differs from previous datasets in its use of ceiling-mounted, unobtrusive depth sensors. These can be used for fine-grained analysis of head and body pose and gestures, without any concerns about participants' privacy or inhibited behavior. The dataset is complemented by synchronized and time-stamped meeting transcripts that allow analysis of spoken content. The dataset comprises 22 group meetings in which participants perform a standard collaborative group task designed to measure leadership and productivity. Participants' post-task questionnaires, including demographic information, are also provided as part of the dataset. We show the utility of the dataset in analyzing perceived leadership, contribution, and performance, by presenting results of multi-modal analysis using our sensor-fusion algorithms designed to automatically understand audio-visual interactions.
A Multi-Objective Model for Risk Mitigating in Supply Chain Design

The goal of this study is to recognise various factors for responsive SCs that affect supply risk and model their impact on SC design and operation. We propose a conceptual model for SC responsiven...
Emerging therapeutic agents for genitourinary cancers

The treatment of genitourinary malignancies has dramatically evolved over recent years. Renal cell carcinoma, urothelial carcinoma of the bladder, and prostate adenocarcinoma are the most commonly encountered genitourinary malignancies and represent a heterogeneous population of cancers, in both histology and approach to treatment. However, all three cancers have undergone paradigm shifts in their respective therapeutic landscapes due to a greater understanding of their underlying molecular mechanisms and oncogenic drivers. The advance that has gained the most recent traction has been the advent of immunotherapies, particularly immune checkpoint inhibitors. Immunotherapy has increased overall survival and even provided durable responses in the metastatic setting in some patients. The early success of immune checkpoint inhibitors has led to further drug development with the emergence of novel agents which modulate the immune system within the tumor microenvironment. Notwithstanding immunotherapy, investigators are also developing novel agents tailored to a variety of targets including small-molecule tyrosine kinase inhibitors, mTOR inhibitors, and novel fusion proteins to name a few. Erdafitinib has become the first targeted therapy approved for metastatic bladder cancer. Moreover, the combination therapy of immune checkpoint inhibitors with targeted agents such as pembrolizumab or avelumab with axitinib has demonstrated both safety and efficacy and just received FDA approval for their use. We are in an era of rapid progression in drug development with multiple exciting trials and ongoing pre-clinical studies. We highlight many of the promising new emerging therapies that will likely continue to improve outcomes in patients with genitourinary malignancies.
Keeping up with the Joneses: Social Status and Wealth Inequality in a Leveraged Asset Market

We hypothesize that growing wealth inequality has exacerbated leveraged asset bubbles in the wealthiest nations over the last several decades through a “keeping up with the Joneses” effect. Rising inequality strengthens the desire of households to improve their social status by owning assets such as homes demanded by those with wealth. Given easy access to credit, relatively low-wealth individuals use leverage to bid up asset prices. We test this theory within the popular asset market experiment of Smith, Suchanek, and Williams (1988) where we combine the option to borrow with treatments for wealth inequality and social status. We find that the social status effect indeed leads to asset overpricing, and the impact is the biggest when combining social status with wealth inequality. On the other hand, wealth inequality alone does not lead to greater asset bubbles.
High Prevalence and Mortality Associated with Upper Extremity Deep Venous Thrombosis in Hospitalized Patients at a Tertiary Care Center.

Background Upper extremity deep venous thrombosis (UEDVT) and its associated complications are increasing in incidence, but management strategies are largely derived from experience treating lower extremity deep venous thrombosis (LEDVT). The purpose of this study is to examine our single institution's experience with in-hospital venous thromboembolism (VTE), specifically the characteristics and outcomes of the UEDVT population as it compares to LEDVT. Methods This is a single tertiary care center retrospective cohort study of all consecutive inpatients diagnosed with acute VTE from June 2015 to December 2015. During this period, 4,495 patients underwent venous duplex examination (622 UE and 3,873 LE), identifying 83 inpatient DVTs. Chronic DVT and those diagnosed in the outpatient population were excluded. DVTs were classified as either provoked or unprovoked. Provoked DVT were defined as the presence of any of the following factors within 30 days prior to diagnosis: major surgery, immobilization (greater than 3 days of bedrest), trauma, infection requiring antibiotics, central venous access, pregnancy, and/or hormonal medication use. Inpatient pulmonary embolisms (PE) detected on chest computed tomography (CT) were also evaluated during this time frame. Patient data were collected, including age, gender, race, lifestyle factors, comorbidities, VTE risk factors, symptomatology at presentation, management including anticoagulation choice and filter placement if applicable, as well as discharge disposition. Statistical analysis was performed using GraphPad Prism 8.0 (GraphPad Software, San Diego, California), and a threshold P-value of Results During the study period, 83 DVTs (48 LEDVT, 35 UEDVT) and 24 PE were identified in 96 inpatients. Of these DVTs, 77.1% of these were defined as provoked. Eleven patients had simultaneous DVT and PE, and thirteen patients had PE with presumed occult pelvic or LEDVT. UEDVT patients had a higher proportion of comorbidities than LEDVT patients: coronary artery disease (25.7% vs. 13.1%, P = 0.16), congestive heart failure (20% vs. 6.6%, P = 0.09), as well as a trend toward higher incidence of malignancy (60% vs. 42.6%, P = 0.13). Of provoked VTE, UEDVT correlated more significantly with central venous catheters (88.4% vs. 12.5%, P= Conclusions This study demonstrates a high prevalence of UEDVT in hospitalized patients who experience VTE. Despite a lower incidence of synchronous PE, patients with UEDVT had a higher prevalence of significant medical comorbidities and higher all-cause mortality on the index hospital admission.
Exploiting Randomness in Stochastic Computing

Stochastic computing (SC) computes with randomized bit-streams using standard logic circuits. Its defining features are low power, small area, and high fault tolerance; its drawbacks are long run times and inaccuracies due to its inherently random behavior. Consequently, much previous work has focused on improving SC performance by introducing non-random or deterministic data formats and components, often at considerable cost. However, as this paper shows, taking advantage of, or even adding to, a stochastic circuit's randomness can play a major positive role in applications like neural networks (NNs). The amount of such randomness, must however, be carefully controlled to achieve a beneficial effect without corrupting an application's functionality. The paper first discusses the use of mean square deviation (MSD) as a metric for randomness in SC. It then describes a low-cost element to control the MSD levels of stochastic signals. Finally, it examines two applications where SC can provide performance-enhancing randomness at very low cost, while retaining all the other benefits of SC. Specifically, it is shown how to improve the visual quality of black-and-white images via stochastic dithering, a technique that leverages randomness to enhance image details. Further, the paper demonstrates how the randomness of an SC-based layer makes an NN more resilient against adversarial attacks than an NN realized entirely by conventional, non-stochastic designs.
Assessing the Needs in Lands in the Lake Tumba Landscape

The most important issue identified by communities was that of land ownership. The chapter discusses the understanding by communities of land, land ownership, and land rights. Using a participative land need assessment, the study identified agroforestry lands, hunting lands, fishing basins, utilitarian conservation areas, and culturally access-prohibition areas as five functional land units that communities had in their minds. The study found that it was difficult to extrapolate figures from means of land needed by households to project total land needs in the landscape. Traditional land rights are not necessarily correlated with community population sizes; extrapolating would necessarily lead to problems because some communities would lose and other gains. This recommends that land need assessment is conducted on village-by-village approach, which is prohibitively expensive. But, positively, communities would be willing to give up some of their lands if there are no other activities such as logging in their lands and provided that the government keeps the link to the traditional land ownership, factoring the history of the land occupancy, land use-related culture, land layouts, present dynamics, and future needs.
Church's Thesis is Consistent with Epistemic Arithmetic

Publisher Summary This chapter describes Funayama's theorem for recursive realizability for epistemic arithmetic. It is essentially divided into two parts. The main tool is the notion of adjoints for preordered sets. The chapter considers the usage of the version of the Funayama's theorem and ideas to construct a recursive realizability model for epistemic arithmetic. The main objective is to integrate recursive realizability and the classical notion of truth. This is accomplished by adapting the construction used in the proof of Funayama's theorem. Funayama's theorem asserts that any complete Heyting algebra can be embedded in a complete Boolean algebra by a map that preserves finite infimums and arbitrary supremums. The second part describes the recursive realizability interpretation that provides a useful method for obtaining consistency results for intuitionistic systems.
Work hard, play hard... or maybe not: A look at the relationships between workaholism, work-leisure conflict, and work stress

In the current study we sought to examine the relationships between workaholism, work-leisure conflict, and work stress. Workaholism is related to many negative consequences to both the employee and the organization. It is vital, then, to examine these outcomes in order to find ways to reduce potential harm. As such, self-report measures were used to study whether work-leisure conflict would strengthen the relationship between workaholism and work stress, and if work-leisure conflict acts as a mediator between workaholism and work stress. The sample consisted of 346 working adults from various occupations and backgrounds. The results indicated workaholism was positively correlated with work stress. Additionally, work leisure conflict was positively correlated with both workaholism and work stress. Moreover, work-leisure conflict was a significant mediator between workaholism and work stress, however, the results did not indicate a moderation effect for work-leisure conflict on the relationship between workaholism and work stress. Organizational implications, limitations, and future directions are discussed.
Considerations for Dermatologic Patient Care during COVID-19

The COVID-19 pandemic has led to numerous challenges in dermatology. Here, we discuss our experience of diagnosing multiple metastatic cutaneous cancers during the COVID-19 era and consider how perceived and existing barriers for patients receiving dermatologic care in the pandemic may have led to the progression of cancer. In Texas, the attorney general issued a statement that dermatologists could not perform “routine” procedures. Unfortunately, many dermatologists delayed biopsies and surgeries for skin cancer due to misinterpreting the ambiguous nature of the term “routine.” Dermatologists provide valuable expertise and crucial services to society at all times, including during life-threatening pandemics, and this should be emphasized to the public and governmental agencies.
Adding Value to Conversations about Criminal Reform

In February 2018, the Justice Center of the New York County Lawyers Association established a Plea Bargaining Task Force. The task force was charged with examining why factually innocent defendants in the New York metropolitan area plead guilty and with prescribing viable recommendations to remedy this injustice. This article highlights how the strategic design of the task force added value to the task force's work and furthered its mission.
Learning when time is an option

Generally, students would like more time in class to understand nuances of material for a variety of reasons. However, current scheduling limits terms to durations ranging from three to 16 weeks. T...
Eliminating the GRE

A musician would not take a multiple choice test to join a band Yet such tests are how many physics and astronomy graduate programs select students As a result, departments unintentionally limit the talent that enters the field With testing centers closed because of the coronavirus and with concerns about the fairness or the lack of online alternatives, physics and astronomy graduate programs have temporarily stopped using entrance exams to make admissions decisions Here, Young suggests that become a permanent change Many faculty members and students believe that the physics Graduate Record Examination (GRE) is one of the most important aspects of graduate admissions Many programs require a certain score for admission In theory, a standardized test provides an objective measure for comparing applicants Everyone takes the same test, so it allows candidates the ability to distinguish themselves by scoring well, or so the argument goes
Transit Economic Equity Index: Developing a Comprehensive Measure of Transit Service Equity:

In this study an index is developed called the Transit Economic Equity Index, to enable quantitative assessment of transit service equity. The index measures convenience of travel for work trips fo...
Contact and Cooperation

Although the social-science-based justification for the Brown decision of 1954 was framed primarily in terms of its effect on the achievement and self-esteem of minority children, it is generally agreed that a major societal goal of desegregation is improved intergroup relations (Stephan, 1978). Presumably, what we mean by this is not simply that we can create conditions in which members of different ethnic groups coexist temporarily without conflict. What most of us have in mind when we think of improving intergroup relations is that any positive effects of contact will extend beyond the contact situation to reduce intergroup conflict and prejudice in general.
Successful use of ultrasound‐guided caudal catheter in a child with a very low termination of dural sac and Opitz–GBBB syndrome: a case report

We report a 2-year-old patient with Opitz-GBBB syndrome scheduled for a posterior sagittal anorectoplasty (PSARP). The ultrasound scan revealed the inferior end of dural sac just below sacrococcygeal membrane, although the patient had previously two successful caudal epidural blocks. Consequently, the epidural catheter was inserted under a real-time ultrasound guidance without dural puncture. Our patient had excellent pain relief without any side effects.
Epilepsy control following intracranial monitoring without resection in young children

Summary Purpose: Intracranial monitoring (IM) is a key diagnostic procedure for select patients with treatment-resistant epilepsy (TRE). Seizure focus resection may improve seizure control in both lesional and nonlesional TRE. IM itself is not considered to have therapeutic potential. We describe a cohort of patients with improved seizure control following IM without resective surgery. Methods: Over 12.5 years, 161 children underwent 496 surgeries including intracranial monitoring. We retrospectively reviewed the patients’ charts, operative reports, and radiologic scans, under an institutional review board–approved protocol. Key Findings: Seventeen patients underwent only IM, without additional resective surgery, and seven had a dramatic improvement in their epilepsy; six of the seven patients are seizure-free (Engel class I), and one rarely has seizures (Engel class II). All seven patients had frequent seizures that led to IM: either daily (five patients) or 1–2 per week (two patients). The mean age (± standard deviation, SD) at seizure onset was 1.6 ± 1.3 years (range 0.5–4 years). Etiologies were tuberous sclerosis (3 patients), trauma (1 patient), and unknown (3 patients). Mean age at surgery (± SD) was 4.1 ± 2 years (range 1–7 years), and duration of epilepsy 2.5 ± 1.1 years (range 0.5–4 years). Duration of IM was 11.7 ± 5.6 days (5–19 days). Six patients had bilateral and one unilateral invasive electrodes. At last follow-up, four patients required fewer antiepileptic drugs (AEDs), one had the same medication but a higher dose, and two patients were taking additional AEDs. Follow-up was 30.6 ± 9.5 months (range 19–41 months). Significance: Although uncommon, patients with TRE may improve after IM alone. The explanation for this observation remains unclear; however, perioperative medications including steroids, direct cortical manipulation, or other factors may influence the epileptogenic network.
Dynamics of a minimal power system model - invariant tori and quasi-periodic motions

The paper provides an extensive analysis of local and global bifurcation phenomena in studying the voltage-angle dynamic interactions of a minimal power system model. Using nonlinear analysis and normal form theory, it is proved that this system will experience quasi-periodic motions near certain degenerate local bifurcations which are explicitly characterized. The results in the paper provide strong analytical evidence for the possible occurrence of complicated behavior in the general power system from the interactions of voltage and angle instability mechanisms.
Making it personal: end-user authoring of health narratives delivered by virtual agents

We describe a design study in which five different tools are compared for end-user authoring of personal stories to be told by an embodied conversational agent. The tools provide varying degrees of control over the agent's verbal and nonverbal behavior. Results indicate that users are more satisfied when their stories are delivered by a virtual agent compared to plain text, are more satisfied when provided with tools to control the agent's prosody compared to facial display of emotion, and are most satisfied when they have the most control over all aspects of the agent's delivery.
Striking a Positive Note with the PICCOLO

The Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO) fills a critical need for an easy-to-administer and easy-to-score measure of parenting that requires minimal training to administer. Despite wide agreement about the importance of parenting, few programs assess parenting behaviors; rather, there is a focus on child outcomes in curriculum planning, program improvement efforts, and accountability activities. In large part, this is due to the very few observational assessments of adult–child interactions that can be used without major investments of time and resources. Given the adage “what gets measured is treasured,” this leaves parenting out of many policy and practice discussions. The new PICCOLO measure has the potential to add to the growing arsenal that early childhood programs have to assess the children and families whom they serve. The measure can help programs to assess parenting strengths, plan effective interventions, and monitor the effectiveness of those interventions. The developers of the measure are to be applauded for their thoughtful approach to creating the items in the measure and to their careful examination of the measure's psychometric qualities. La media PICCOLO tiene la posibilidad de contribuir al creciente arsenal que los programas de la temprana ninez tienen para evaluar los ninos y las familias a quienes les sirven. La medida puede ayudar a los programas a evaluar los aspectos fuertes de la crianza, a planear intervenciones efectivas, y a vigilar la efectividad de tales intervenciones. Debemos aplaudir a quienes disenaron la medida PICCOLO por su sensato acercamiento para crear los aspectos enumerados en la medida y por su cuidadosa examinacion de las cualidades sicometricas de la medida. Le PICCOLO peut tout a fait s’ajouter a l’arsenal dont disposent les programmes de petite enfance afin d’evaluer les enfants et les familles qu’ils servent. Cette mesure peut aider les programmes a evaluer les forces parentagles, a plannifier des interventions efficaces et a controler l’efficacicte de ces interventions. Les concepteurs de cette mesure doivent etre felicites pour la maniere attentionnee dont ils ont cree les elements de la mesure et pour leur examen minutieux des qualites psychometriques de la mesure. Die PICCOLO hat das Potenzial, dem wachsenden Wissensarsenal die Erkenntnis hinzuzufugen, dass Programme fur die fruhe Kindheit bei den Kindern und Familien ansetzen mussen, fur die sie vorgesehen sind. Das Verfahren kann Programmen helfen Erziehungsstarken zu erfassen, wirksame Interventionen zu planen und die Wirksamkeit derartiger Masnahmen zu beobachten. Die Entwickler des Verfahrens mussen fur ihren durchdachten Ansatz zur Schaffung von Items im Verfahren und fur ihre sorgfaltige Prufung der psychometrischen Qualitaten des Verfahrens gelobt werden. 抄録：PICCOLOは、早期子どもプログラムが援助する子どもと家族を、彼らが評価しなければならないという増大する備蓄に付け加える可能性を持っている。評価法によって、プログラムが育児の強さを評価し、効果的な介入を計画し、そしてそれらの介入の有効性を監視するのを助けられる。評価法の開発者は、測定法の項目を創りだすための思慮深いアプローチと、評価法の心理測定法的性質の注意深い検証に、拍手を送られるべきである。
The internodal species concept: a response to ‘The tree, the network, and the species’

Samadi and Barberousse attempt to provide a precise, formal definition of the species category that is faithful to the internodal species concept (Samadi S, Barberousse A. 2006. The tree, the network, and the species. Biological Journal of the Linnean Society89: 509–521). Here, it is argued that their study is technically flawed. Most of the necessary corrections to their definitions are provided in order to accurately portray the internodal concept. It is then argued that the internodal concept is fundamentally flawed; it does not solve the ‘classical problems’ that Samadi and Barberousse claim it does. In particular, it does not allow for the possibility of interspecies hybridization. In addition, the proposal is unworkable in practice, and also theoretically problematic because it entails that, in many lineages, speciation events are taking place every few generations.
Is breast cancer survival improving

BACKGROUND Despite advances in therapies for breast cancer, improvement in survival for patients with recurrent or metastatic breast cancer has been difficult to establish. The objective of the current study was to determine whether the survival of women with recurrent breast cancer has improved from 1974 to 2000. METHODS The authors analyzed the survival experience of 834 women who developed recurrent breast cancer between November 1974 and December 2000. All patients had been treated previously with adjuvant anthracycline-based protocols. Patients were divided into five consecutive groups based on year of breast cancer recurrence, and survival was compared across the five groups. Because some prognostic variables were divided unevenly divided among the cohorts, a multivariate model was created to determine the association of year of recurrence and survival after accounting for other prognostic factors. RESULTS In the unadjusted analysis, there was a statistically significant improvement in survival across the five groups, and the more recent cohorts had longer survival (P < 0.001). Other variables that predicted longer survival after breast cancer recurrence included smaller initial tumor size, lower stage of disease, fewer lymph nodes involved, longer disease-free interval, estrogen receptor–positive tumors, and nonvisceral dominant site of disease recurrence. In the multivariate analysis, which adjusted for these prognostic factors, year of recurrence was associated with a trend toward improved survival, with a 1% reduction in risk for each increasing year. CONCLUSIONS For these cohorts of patients, the authors present data suggesting that the prognosis for patients with recurrent breast cancer improved between 1974 and 2000. Cancer 2004;100:44–52. © 2003 American Cancer Society.
100% access, zero health disparities, and GIS: an improved methodology for designating health professions shortage areas.

Abstract The (Health Professions Shortage Areas) HPSA designation process was developed as a mechanism to identify primary care shortage areas eligible for participation in specific federally funded programs including a 10% Medicare supplement, the National Health Service Corps, and health professions training programs. The purpose of this paper was to explore the utility of Geographic Information Systems (GIS) technology as an improved methodology for obtaining HPSA designation status for geographic areas. Results showed that GIS identified 24 Medical Services Study Areas (rational planning areas) in Los Angeles County that met the minimum 3500:1 population-to-primary-care physician ratio for geographic area HPSA designation compared to only three that currently are identified. Authors concluded that restructuring of the state/county responsibilities for HPSA designation is long overdue and that use of GIS as a required methodology would help ensure that all areas in any state that meet the intent of fed...
Turn off the TV and Dance! Participation in Culturally Tailored Health Interventions: Implications for Obesity Prevention among Mexican American Girls

Our evaluation study identifies facilitators and barriers to participation among families participating in the treatment arm of Stanford ECHALE. This culturally tailored obesity prevention trial consisted of a combined intervention with two main treatment components: 1) a folkloric dance program; and 2) a screen time reduction curriculum designed for 7-11 year old Latinas and their families. We conducted 83 interviews (40 parents and 43 girls) in participant homes after 6 months of enrollment in the ECHALE trial. The Spradley ethnographic method and NVivo 8.0 were used to code and analyze narrative data. Three domains emerged for understanding participation: 1) family cohesiveness; 2) perceived gains; and 3) culturally relevant program structure. Two domains emerged for non-participation: program requirements and perceived discomforts. Non-parametric, Spearman's rank correlation coefficients were calculated to assess the relationships with participant attendance data. Sustained participation was most strongly influenced by the domain perceived gains when parents reported better self-esteem, confidence, improved attitude, improved grades, etc. (Spearman r = .45, P = .003). Alternatively, under the domain, perceived discomforts, with subthemes such as child bullying, participation in the combined intervention was inversely associated with attendance (Spearman r = -.38, P = .02). Family-centered, school-based, community obesity prevention programs that focus on tangible short-term gains for girls may generate greater participation rates, enhance social capital, and promote community empowerment. These factors can be emphasized in future obesity prevention program design and implementation.
The Visible Brain: Computed Tomography's Impact on Neurological Practice (P1.305)

OBJECTIVE: To qualitatively examine the impact that the introduction of Computed Tomography (CT) had on neurological practice through accounts of experienced neurologists. BACKGROUND: Throughout the 20th century neuroscientists strived to invent improved methods to visualize the neuroaxis in their patients. However it was not until the 1970s with the advent of CT that neurologists gained the ability to non-invasively ‘see’ inside the human head. The journey culminating in the immediate and widely accessible head CT scan is largely unstudied. This study aims to contribute first-hand accounts of neurologists who witnessed this tipping point in neurological practice. DESIGN/METHODS: In-depth semi-structured interviews were conducted with six senior neurologists, some of who were and continue to be leaders in the field such as Lewis Rowland and Michael Aminoff. Qualitative analysis was performed on the interview scripts and historical documents, leading to the identification of major themes through a grounded theory approach. RESULTS: All participants believed that there was a rapid shift from a practice in which clinical suspicion frequently remained unconfirmed to one in which imaging became as instrumental as the reflex hammer. An amalgamation of medical, political and cultural factors surrounding the genesis of CT led to its lasting success as a diagnostic tool. Its advent provided a quick and reliable adjunct to clinical acumen, becoming indispensible to emergent neurology and useful as a screening tool for more insidious or subacute processes. CONCLUSIONS: This analysis offers a means to gauge the current and future impact of other diagnostic technologies including functional MRI and the much-publicized intelligent diagnostic software, the "Watson" program. The advent of the head CT was a pivotal historical moment that stands as a model for modern medical revolutions. Study Supported by: No support for study. Disclosure: Dr. Ong has nothing to disclose.
Finding a needle in a haystack: detection and quantification of rare mutant alleles are coming of age.

Detecting rare mutant alleles in the background of wild-type DNA sequences and quantifying a specific DNA sequence in a clinical sample are two of the most challenging problems in DNA diagnostics. Successful approaches can expect important applications. For example, prenatal diagnosis of genetic disorders can be accomplished by invasive procedures such as amniocentesis, chorionic villus sampling, or fetal blood sampling, or by labor-intensive methods such as fetal cell enrichment from maternal circulation (1). If one can detect the mutant allele in the small number of fetal cells found in the maternal circulation, prenatal diagnosis of many devastating genetic disorders can be done with a simple blood test that poses minimal risk to the mother or the fetus. Other applications of the ability to find “a needle in the haystack” include cancer marker detection for early diagnosis or detection of relapse (2), and detection of specific alleles in pooled population samples (3). Similarly, the ability to quantify the amount of a specific DNA species present in clinical samples can help define the viral load in HIV-positive patients (4), determine minimal residual disease in patients with leukemia (5)(6), and monitor specific gene expression (7). In this issue of the journal, a …
An invariant asymptotic formula for solutions of second-order linear ODE's

An invariant-matrix technique for the approximate solution of second-order ordinary differential equations (ODEs) of form y-double-prime = phi(x)y is developed analytically and demonstrated. A set of linear transformations for the companion matrix differential system is proposed; the diagonalization procedure employed in the final stage of the asymptotic decomposition is explained; and a scalar formulation of solutions for the ODEs is obtained. Several typical ODEs are analyzed, and it is shown that the Liouville-Green or WKB approximation is a special case of the present formula, which provides an approximation which is valid for the entire interval (0, infinity).