cssi/SciSciGPT-SciSciNet huggingface dataset:
FRI0189 Assessment of Exercise Status in Routine Care Using Mdhaq: Evidence That Initiating Exercise is Associated with Substantially Better Outcomes than NO Exercise

Background Extensive evidence indicates major benefits of exercise in rheumatoid arthritis 1 and many rheumatic diseases, 2 not only for cardiovascular and general fitness, but also for better rheumatologic clinical status. Most reported exercise data are derived from structured research studies rather than from usual care. A multidimensional health assessment questionnaire (MDHAQ) designed for usual care includes a query concerning exercise status for the rheumatologist to analyze possible associations with clinical outcomes. Objectives To compare baseline demographic and clinical data, and changes in status over 1 year, in patients classified into 4 categories: a) exercise at both baseline and 1 year later (YES/YES); b) no exercise at baseline and exercise 1 year later (NO/YES); c) exercise at baseline and not 1 year later (YES/NO); d) no exercise at either time point (NO/NO). Methods Each patient seen at an academic rheumatology setting completes an MDHAQ at each visit while waiting to see the rheumatologist. The MDHAQ includes scores for physical function, pain, patient global estimate (PATGL), and RAPID3 (Routine Assessment of Patient Index Data), an index of these 3 measures, each scored 0-10; total=0-30. Patients were classified into 4 groups according to exercise 3 times a week at baseline and 1 year: YES/YES, NO/YES, YES/NO, NO/NO. Mean baseline data and percentage change from baseline to 1 year were analyzed and compared by analysis of variance (ANOVA), with multivariate adjustment for age, disease duration, education, sex and baseline physical function (MANOVA). Results YES/YES patients were younger with a higher level of education than the NO/NO exercise group (data not shown). YES/YES patients had best baseline status, which was progressively worse in the NO/YES, YES/NO, and NO/NO groups. Patients in the NO/YES group had substantially greater improvement in scores 1 year later than those in all other groups, including the YES/YES group, while the YES/NO group was the only patient group with poorer status 1 year later. Conclusions Exercise 3 times a week is associated with better clinical status. Patients who report no exercise at baseline and performing exercise 1 year later have considerably better status, while patients who reported performing exercise at baseline and not 1 year later have poorer status, although it is not known how frequently changes in outcomes resulted from changes in exercise status. Clinically relevant information concerning exercise status is available on MDHAQ in usual care settings. References Sokka T, Hakkinen A. Clin Exp Rheumatol. 2008; 26(5 Suppl 51):S14-20 Perandini LA, de Sa-Pinto AL, Roschel H, et al. Autoimmunity Rev 2012;12:218-24 Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.3451
Sex Pheromone in the Springtail, Sinella curviseta

Females of Sinella curviseta (Collembola: Entomobryidae) were shown to produce 2 stimuli that increase the deposition of stalked spermatophores by males. One stimulus, the instar stimulus, is associated only with females in reproductive instars. The second, the position stimulus, increases spermatophore deposition in the brief interval preceding and coinciding with the female's receptive period within the reproductive instar. Further investigation determined that the position stimulus is a volatile pheromone.
Repeat pouch surgery by the abdominal approach safely salvages failed ileal pelvic pouch.

PURPOSE:This study evaluated outcomes of patients with abdominal salvage operations for failed ileal pouch-anal anastomosis.METHODS:Patients undergoing laparotomy for ileoanal pouch salvage were reviewed from a prospectively maintained pouch database and records.RESULTS:From 1983 to 2007, 241 abdomi
The outcomes of newly diagnosed elderly multiple myeloma patients treated at a single U.S. institution.

Improvements in the outcomes of elderly multiple myeloma (MM) patients have lagged behind those of transplant‐eligible patients, likely due in part to the use of less efficacious melphalan‐containing regimens. To date, there are very limited data for the outcomes of elderly MM patients in the United States (US), particularly for novel agent‐containing triplet regimens. In this retrospective study at a single U.S. institution, the outcomes of 117 consecutive newly diagnosed, symptomatic MM patients over the age of 70 were evaluated. The median age was 75 years (range 70–95) with significant baseline comorbidities including 36% cardiac and 20% renal (CrCl < 30 mL/min). The median follow‐up was 43 months and the median number of lines of therapy during the study period was 2 (1–7). Eighty‐six patients (83%) received non‐melphalan doublet, triplet, or quadruplet initial therapy, most with significant planned dose attenuations. For those treated with dose‐attenuated RVD (n = 34), the outcomes were particularly impressive with overall response rate (ORR), complete remission and very good partial remission (CR + VGPR), and progression‐free survival (PFS) of 94%, 65%, and 36 months, respectively, and overall survival (OS) not reached. The PFS with RVD was significantly greater than that of all other regimens (P = 0.030), including RD.
Clinical and Radiographic Outcomes of Transforaminal Lumbar Interbody Fusion in Patients with Osteoporosis

Study Design Retrospective review. Objective To compare clinical outcomes after transforaminal lumbar interbody fusion (TLIF) in patients with and patients without osteoporosis. Methods We reviewed all patients with 6-month postoperative radiographs and computed tomography (CT) scans for evaluation of the interbody cage. CT Hounsfield unit (HU) measurements of the instrumented vertebral body were used to determine whether patients had osteoporosis. Radiographs and CT scans were evaluated for evidence of implant subsidence, migration, interbody fusion, iatrogenic fracture, or loosening of posterior pedicle screw fixation. Medical records were reviewed for persistence of symptoms or recurrence of symptoms. Results The final data analysis included 18 (20.5%) patients with osteoporosis and 70 (79.5%) patients without osteoporosis. Males comprised 50% of patients with osteoporosis, and 64.3% of patients without osteoporosis. The mean age was significantly higher in the osteoporotic group (65.2 years) versus the nonosteoporotic group (56.9 years; p p = 0.05) and iatrogenic fractures (16.7% versus 1.4%, p = 0.03) in the osteoporotic group. In addition, the osteoporotic group had significantly higher radiographic complication rates compared with the nonosteoporotic group (77.8 versus 48.6%, p = 0.03). There was no difference between groups for revision surgery (16.6 versus 14.3%, p = 0.78) or postoperative symptoms (44.4% versus 50.0%, p = 0.69). Conclusions Our data demonstrated significantly increased rates of cage subsidence, iatrogenic fracture, and overall radiographic complications in patients with osteoporosis. However, these radiographic complications did not predispose patients with osteoporosis to an increased risk of surgical revision or worse clinical outcomes.
Helicobacter pylori, gastric ulcer, and agents noxious to the gastric mucosa.

SUMMARY Conclusions regarding the interaction of H. pylori infection with noxious agents such as NSAIDs, alcohol, and smoking in the development of histologic gastritis and gross gastric injury are limited by the paucity of well-performed studies specifically addressing this problem. At present, we can conclude that H. pylori prevalence is not affected by NSAIDs, alcohol, or smoking. On the other hand, reflux of duodenal contents may play a role in eradication of H. pylori after gastroenterostomy. Although NSAIDs and alcohol do cause gross gastric injury they do not appear to induce changes in the inflammatory cell infiltrate of the gastric mucosa. Rather, the histologic gastritis sometimes attributed to NSAIDs or alcohol seems to be related to the underlying presence of H. pylori. Furthermore, HP does not clearly influence the development of gross injury by NSAIDs or alcohol, and these noxious agents do not influence the H. pylori-associated histologic gastritis. Patients with NSAID-associated gastric ulcers have an H. pylori prevalence similar to that of NSAID users without gastric ulcers and lower than that of patients with gastric ulcers who do not take NSAIDs. These findings suggest that NSAIDs induce ulcers through a mechanism that does not require H. pylori and histologic gastritis. Because NSAIDs are much more likely to cause gastric than duodenal ulcers, this information may explain why patients with gastric ulcers are more commonly H. pylori negative than are patients with duodenal ulcers.
Further characterization of the loop structure of platelet glycoprotein IIIa: partial mapping of functionally significant glycoprotein IIIa epitopes

Glycoprotein (GP) IIb-IIIa serves as the platelet fibrinogen receptor. Studies of the tertiary structure of GPIIIa have shown that the protein has a large loop structure of at least 325 amino acids in length. To further characterize this loop structure, intact platelets were digested with alpha-chymotrypsin. Digestion products were examined using the anti-GPIIIa monoclonal antibodies (MoAbs) AP3, D3GP3, and C5GP3, as well as the human alloantibody, anti-PLA1. AP3 recognized GPIIIa digestion products of 109, 95, and 68 Kd. D3GP3 and C5GP3 recognized an additional band of 51 Kd. Time course digestions demonstrated that the 51-Kd fragment was generated by proteolysis of the 68-Kd peptide. Sequence analysis of the reduced 51-Kd peptide showed that this fragment began at amino acid 422. The nonreduced 51-Kd peptide was reactive with antibodies directed against the first 13 amino acids of GPIIIa, demonstrating the presence of a covalently attached N-terminal peptide. These data suggest that: (1) the minimum length of the loop structure is at least 384 amino acids; (2) the AP3 epitope is formed at least in part by a determinant contained within residues 348 to 421; and (3) the D3GP3 and C5GP3 epitopes are contained within amino acids 422 to 692 of GPIIIa, a region that may be flexible and involved in conformational changes that occur after ligand binding.
The Study of Movement Learning Disabilities

Movement development has been an integral but confusing consideration in studying learning disabilities. Movement skills of children with particular learning problems have been measured; movement performance has been used to assess perceptual-cognitive and neurological functioning; moving has been used as a means to involve children in learning experiences. Two underlying propositions are that inadequacies in movement development are part of a direct, although involved, linkage to learning problems and moving provides an important, perhaps critical, modality for learning. The educational impact of the more than twenty years of advocacy for these propositions is that the movement development of children now receives more attention and moving is included in more ways in more educational programs. The scientific impact is negligible and often disruptive in terms of understanding learning disabilities.
Electropolishing for Low-Beta and Quasi-Waveguide SRF Cavities

Argonne National Laboratory (ANL) has extended high quality electropolishing techniques based on those developed for the International Linear Collider to several more complex superconducting RF cavities. These include the co-axial TEM-mode quarter-wave and half-wave cavities as well as a 2.8 GHz quasi-waveguide structure intended for beam bunch rotation. This system is an improved version of the one developed for 1.3 GHz 9-cell cavities and includes easy provision for direct water cooling using the helium jacket. The performance of these SRF cavities both in terms of RF fields and losses equals or exceeds that of most 9-cell elliptical cavities built and tested today.
Associations of Specific Postoperative Complications With Outcomes After Elective Colon Resection: A Procedure-Targeted Approach Toward Surgical Quality Improvement.

Importance Numerous quality initiatives have been implemented in an effort to minimize the onus of postoperative complications on clinical and economic outcomes after major surgery. It is unknown which complications have the greatest overall effect on these outcomes. Objective To quantify the associations of specific postoperative complications with outcomes after elective colon resection. Design, Setting, and Participants Patients undergoing elective colon resection between January 1, 2012, and December 31, 2013, who were included in the Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program were assessed for the development of specific types of postoperative complications. The overall contributions of these complications to subsequent clinical and resource use outcomes were assessed. Main Outcomes and Measures The main outcomes were 30-day mortality, end-organ dysfunction, reoperation, prolonged hospitalization, nonroutine discharge status, and hospital readmission. Risk-adjusted population attributable fractions were estimated for each complication-outcome pair. The population attributable fractions for a specific complication represented the percentage reduction in a given outcome that would be expected if exposure to that complication was completely eliminated. Results A total of 26 682 patients undergoing elective colon resection were included for analysis; 13 870 patients were women (52.0%) and 15 088 (56.5%) were younger than 65 years. The most common index complications were ileus (n = 3140; 11.8%), bleeding (n = 2032; 7.6%), and incisional surgical site infection (n = 1873; 7.0%). Anastomotic leak was associated with the incidence of end-organ dysfunction, mortality, reoperation, and hospital readmission, with estimated population attributable fractions of 33.3% (95% CI, 29.6-36.8), 20.0% (95% CI, 14.0-25.7), 48.4% (95% CI, 45.7-51.0), and 20.6% (95% CI, 19.1-22.1) for each of these respective outcomes. The effect of complications, such as urinary tract infection, venous thromboembolism, and myocardial infarction, on these outcomes was comparatively small. Conclusions and Relevance Anastomotic leak has a large overall effect on 30-day clinical and economic outcomes after elective colon resection. The findings of our study support the adoption of a procedure-targeted approach to surgical quality improvement and describe a practical method for assessing complication effect.
Fractional Self Adjoint Operator Poincaré and Sobolev Inequalities

We present here many fractional self adjoint operator Poincare and Sobolev type inequalities to various directions.
Optimal Control Approach to Multiagent, Hierarchical System Verification

Abstract An approach to the verification of hybrid systems using optimal control principles is introduced. Its advantages and disadvantages when compared with conventional, automatic verification techniques are highlighted. The application of the new approach is illustrated by means of two motivating examples, one from the area of automated highway systems and the other from the timed automata verification literature.
The New Juan Crow? Unpacking the Links Between Discrimination and Crime for Latinxs:

This study investigates the impact of various types of discrimination, including injustices from the police, as well as the conditioning effects of a positive ethnic identity on the likelihood of o...
Bivariate Frailty Model and Association Measure

In this paper, we present a bivariate frailty model and the association measure. The relationship between the conditional and the unconditional hazard gradients are derived and some examples are provided. A correlated frailty model is presented and its application in the competing risk theory is given. Some applications to real data sets are also pointed out.
Metrix Matrix: A Cloud-Based System for Tracking Non-Relative Value Unit Value-Added Work Metrics.

Abstract Purpose In the era of value-based medicine, it will become increasingly important for radiologists to provide metrics that demonstrate their value beyond clinical productivity. In this article the authors describe their institution's development of an easy-to-use system for tracking value-added but non-relative value unit (RVU)-based activities. Methods Metrix Matrix is an efficient cloud-based system for tracking value-added work. A password-protected home page contains links to web-based forms created using Google Forms, with collected data populating Google Sheets spreadsheets. Value-added work metrics selected for tracking included interdisciplinary conferences, hospital committee meetings, consulting on nonbilled outside studies, and practice-based quality improvement. Over a period of 4 months, value-added work data were collected for all clinical attending faculty members in a university-based radiology department (n = 39). Time required for data entry was analyzed for 2 faculty members over the same time period. Results Thirty-nine faculty members (equivalent to 36.4 full-time equivalents) reported a total of 1,223.5 hours of value-added work time (VAWT). A formula was used to calculate "value-added RVUs" (vRVUs) from VAWT. VAWT amounted to 5,793.6 vRVUs or 6.0% of total work performed (vRVUs plus work RVUs [wRVUs]). Were vRVUs considered equivalent to wRVUs for staffing purposes, this would require an additional 2.3 full-time equivalents, on the basis of average wRVU calculations. Mean data entry time was 56.1 seconds per day per faculty member. Conclusions As health care reimbursement evolves with an emphasis on value-based medicine, it is imperative that radiologists demonstrate the value they add to patient care beyond wRVUs. This free and easy-to-use cloud-based system allows the efficient quantification of value-added work activities.
A Shocking Turn of Events

A Shocking Turn of Events This interactive case features a 38-year-old woman with symptoms of an upper respiratory infection, shortness of breath, and palpitations. An ECG showed abnormal findings. Test your diagnostic and therapeutic skills at NEJM.org.
Injustice in Mobile Leisure: A Conceptual Exploration of Pokémon Go.

In augmented reality, video games and the physical world converge as individuals participate in digital leisure overlaid on physical spaces. In Pokemon Go, game play in the physical world is impacted by constraints that limit access and play of marginalized groups. Global popularity of Pokemon Go created an opportunity to explore experiences of marginalized groups participating in augmented reality game play. Grey literature surrounding Pokemon Go is rich with accounts of constraints experienced by marginalized groups, particularly individuals self-identifying as White women, Black women, or Black men. Their experiences with Pokemon Go illustrate the need for social justice in digital leisure. Because the lifespan of mobile applications is limited, the gradual process from research to social change may be insufficient in addressing ever evolving digital platforms. Researchers need to strategically work with industry partners to identify needs for social justice during the planning and designing stages.
Proteins: Interactions and Dynamics

Enzymes (proteins) have characteristic, stable three-dimensional structures. Despite their apparently miraculous feats of discrimination and catalytic power, enzymes are stabilized and functionally primed by the same physical forces that operate on less glamorous systems such as liquids and solids. Nevertheless, it is important to characterize these forces as they appear to act in proteins since first-principle quantum mechanical calculations on such large systems are entirely impractical. We are faced with inevitable approximations and simplifications when attempting to calculate protein structure and dynamics.
Inflammatory Vascular Disorders of the Brain and Eye

Systemic inflammatory disorders often cause a multifocal vasculitis that affects the retina, optic nerve, cranial nerves, or brain, so most patients with these illnesses have some neuro-ophthalmologic symptoms or findings during the course of their illness. Additionally, there are several inflammatory vascular diseases whose only clinical manifestations arise from the involvement of the eye or brain or both. All these inflammatory disorders are relatively uncommon to rare in the overall population. Despite the low frequency, the specific entities are discussed here to facilitate their early recognition. Once diagnosed, there are often treatments that can prevent permanent severe visual or neurologic impairment. In the patients with systemic vasculitis who present with neuro-ophthalmologic dysfunction, establishing the proper diagnosis may help in uncovering subclinical abnormalities affecting organ systems outside the nervous system. These findings can be monitored and treated before they become clinically obvious or debilitating.
The Effect of Surgical Treatment for Gynecomastia on Quality of Life in Adolescents.

Abstract Purpose Despite the psychosocial deficits associated with gynecomastia, surgical treatment of adolescent gynecomastia remains controversial. This longitudinal cohort study measures changes in health-related quality of life following surgical treatment of gynecomastia in adolescents. Methods The following surveys were administered to adolescents with gynecomastia and male controls, aged 12–21 years: Short-Form 36v2 (SF-36), Rosenberg Self-Esteem Scale (RSES), and Eating-Attitudes Test-26. Subjects completed surveys at baseline and postoperatively/at follow-up at 6 months, 1 year, 3 years, and 5 years. Results From 2008 to 2017, 44 patients undergoing surgical treatment of gynecomastia and 64 unaffected male controls participated in our study. At baseline, gynecomastia patients scored significantly worse than controls on the RSES and in five SF-36 domains: general health, vitality, social functioning, role-emotional, and mental health. Scores significantly improved postoperatively on the RSES, and in four SF-36 domains: physical functioning, role-physical, bodily pain, and social functioning. Postoperatively, gynecomastia subjects scored similarly to controls in all SF-36 domains and the RSES. Young and overweight/obese patients and those with severe gynecomastia had the greatest postoperative improvement across survey measures. Conclusions Surgical treatment of gynecomastia significantly improves the quality of life of adolescents, with measurable improvements in physical and psychosocial functioning. Postoperatively, gynecomastia patients performed comparably to unaffected controls. Surgical treatment of gynecomastia in adolescents and young men has the potential to significantly improve quality of life, particularly in younger and overweight/obese patients and those with moderate to severe gynecomastia. Concerns regarding patient age and body mass index alone should not contraindicate surgery.
Ursolic Acid Promotes the Sensitization of rhTRAIL-resistant Triple-negative Breast Cancer.

Background/aim Triple-negative breast cancer (TNBC) can be characterized as the deadliest breast cancer type considering the lack of efficacious therapeutics. Recombinant human tumor necrosis factor-related apoptosis-inducing ligand (rhTRAIL) is an encouraging anti-cancer therapeutic with the capacity to induce apoptosis in cancer cells but there are TNBCs less susceptible to rhTRAIL. The aim of this study was to assess the potential of the natural product ursolic acid (UA) to sensitize of rhTRAIL-resistant TNBCs. Materials and methods In order to evaluate apoptosis induction in rhTRAIL and UA-treated TNBC BT-20 and HCC1937 cells that are resistant to rhTRAIL, western blot analysis and Annexin V/PI assays were executed. Results UA increased the expression of death receptors 4 and 5 and decreased the expression of c-FLIPL transcriptionally sensitizing rhTRAIL-resistant TNBC cells to apoptosis induced by rhTRAIL. Conclusion UA is a possible potent sensitizer of rhTRAIL-resistant TNBCs to rhTRAIL-induced apoptosis.
Emotion dysregulation as an explanatory factor in the relation between negative affectivity and non-medical use of opioid in a diverse young adult sample.

Abstract The non-medical use of prescription opioids is an area of increasing public health concern, particularly among young college-age adults (ages 18–25) who demonstrate an increased risk of opioid-related problems. Negative mood states are consistently associated with more severe non-medical use of opioid. Emotion dysregulation defined an impaired ability to understand, evaluate, and differentiate one's emotions, and access strategies to regulate them could play an explanatory role in this association. The present study examined the potential explanatory role of emotion dysregulation in the relationship between negative affectivity and non-medical use of prescription opioid among a racially/ethnically diverse young adult sample (N = 2080, 78.7% female, Mage = 21.9, SD = 4.9) attending a large southwestern state university, and across the two sub-samples of individuals with and without pain. Results indicated that emotion dysregulation explained, in part, the association between negative affectivity and non-medical use of opioid-related variables, including self-reported addiction to opioids, denial of opioid prescription by a healthcare provider, and family concerns about participant's opioid use. These indirect effects were comparable across individuals with and without pain. Findings suggest that targeting emotion dysregulation may be one therapeutic strategy to reduce non-medical use of opioid in the context of negative affectivity among college students.
Abstract WP427: Examining the Role of Gut Dysbiosis in Cerebral Small Vessel Disease

The importance of a healthy gut microbiota on host physiology is becoming increasingly evident. Recent studies suggest that alterations to the microbiota can have adverse effects beyond the GI trac...
Incidental finding of a supradiaphragmatic caudate lobe on cross-sectional imaging: An exceedingly rare entity.

Abstract Intrathoracic accessory lobes of the liver are exceedingly rare and usually found incidentally in asymptomatic patients. Its diagnosis poses a real challenge for radiologists due to its rarity, location and rounded solid mass appearance. Herein, we describe the case of a supradiaphragmatic caudate lobe of the liver in a 43-year-old African American woman presenting to the hospital for evaluation of an inferior vena cava (IVC) thrombus with CT. Final diagnosis was achieved by MRI using intravenous contrast material, showing a 4.7 cm by 2.7 cm oval shaped mass, with similar signal intensity to the main liver on all sequences. Appropriate diagnosis of this intrathoracic mass is important to negate the need for unnecessary procedures and set a proper follow up after clinical diagnosis.
More than Tweed Jackets and Beards: An Analysis of the Hashtag Campaign #ILookLikeAProfessor

The focus of this study was to identify themes that emerged on the publicly-posted #ILookLikeAProfessor hashtag Twitter campaign during August 2015. This qualitative content analysis explored tweets (n=1,855) from www.twitter.com/#ILookLikeAProfessor. Through qualitative open and inductive coding methods, four major themes were derived from the Twitter campaign among participants: 1) discussing diversity, 2) addressing appearance, 3) identifying self, and 4) using visual support. Researchers offer ideas for future study about this campaign and hashtag activism.
Reliability-Based Assessment and Cost Analysis of Power Distribution Systems at Risk of Tornado Hazard

AbstractPower distribution systems are susceptible to significant damage when hit by a tornado. This damage can cause huge economic losses resulting from the cost of repairing failed distribution l...
Automating Deep-Sea Video Annotation Using Machine Learning

As the world explores opportunities to develop offshore renewable energy capacity, there will be a growing need for pre-construction biological surveys and post-construction monitoring in the challenging marine environment. Underwater video is a powerful tool to facilitate such surveys, but the interpretation of the imagery is costly and time-consuming. Emerging technologies have improved automated analysis of underwater video, but these technologies are not yet accurate or accessible enough for widespread adoption in the scientific community or industries that might benefit from these tools. To address these challenges, we developed a website that allows us to: (1) Quickly play and annotate underwater videos, (2) Create a short tracking video for each annotation that shows how an annotated concept moves in time, (3) Verify the accuracy of existing annotations and tracking videos, (4) Create a neural network model from existing annotations, and (5) Automatically annotate unwatched videos using a model that was previously created. The website was seeded with 50 hours of high-resolution underwater videos that were generously provided by the Monterey Bay Aquarium Research Institute (MBARI). The biology students that were part of the project created more than 30,000 annotations that range over more than 20 concepts. About 3,000 of these annotations were then verified for accuracy by our marine biology experts. Using both validated and unvalidated annotations and automatically generated annotations from trackings, our software was able to count the number of Rathbunaster californicus (starfish) and Strongylocentrotus fragilis (sea urchin) with count accuracy of 97% and 99%, respectively, and F1 score accuracy of 0.90 and 0.81, respectively.
TB myositis in a patient with dermatomyositis post immunosuppression

55-year-old African female with a history of initially refractory TIF1-y antibody positive dermatomyositis, with progressive proximal muscle weakness with difficulty swallowing, requiring regular inpatient admissions with the administration of IV steroids and IVIG. The patient was started on immunosuppression with mycophenolate as a steroid sparing agent. The patient slowly improved after initiation of immunosuppression, with a significant reduction in her rash, weakness, and dysphagia. After a few months of therapy, the patient noted pain in the right axilla and proximal right lower extremity with swelling and pain limiting her mobility. There was a concern for underlying malignancy for which PET scan was done, which showed hypermetabolic edema and swelling of musculature involving right thigh, right pectoral minor and left scapularis consistent with infectious or inflammatory myositis. Concern for focal dermatomyositis was raised and the patient received pulse IV steroids over 5 days with initial improvement. The patient later developed fevers, night sweats and chills, for which the patient was seen in ED. Initial vitals were concerning for sepsis, due to which patient was started on broad-spectrum antibiotics. CT scan of the chest and right lower extremity were done which showed, no pulmonary infiltrates, 5 cm right pectoralis minor and 9.4 cm right gluteus minimus fluid collection consistent with abscess.Interventional radiology was consulted, and abscesses were aspirated, aspirate from chest wall was positive acid-fast bacilli, concerning for mycobacterium. Cultures were sent to the health department and were noted to be positive for TB. At this time, it was noted that the patient had a prior diagnosis of latent TB when she moved to the United States. The patient was started on Myambutol, Nydrazid, Levaquin, Rifampin, and Bactrim.Tuberculous infections continue to be one of the deadliest infections around the world, with a significantly low incidence rate (2.8/100000) as compared to developing countries. Even with a low incidence rate, there is always a concern for reactivation of latent TB with the initiation of immunosuppression. Tb myositis is one of rare presentation and that can be difficult with diagnosis, especially in a patient who has an underlying autoimmune condition that could have a similar presentation. We recommend getting prior workup to rule out tuberculosis prior to the initiation of immunosuppression.
Mentoring as a developmental identity process

Mentoring is a key component in developing new and early career faculty for success. In the past, mentoring in higher education institutions has focused on the one-on-one relationship between a mor...
Applying High-Value Care Principles in a Pediatric Case: A Workshop for Health Professions Students.

Introduction The cost of health care in the US is rapidly rising. Understanding the financial cost of medical care is an important competency for physicians and physicians-in-training. Medical stud...
Media and Confidence in the Police: Differences across Race/Ethnicity

A substantial body of literature connects direct experience with crime and the criminal justice system to public confidence in the police (Bradford Policing and Society, 24(1): 22-43, 2014; Gibson et al. American Journal of Political Science 47: 354-367, 2003, Political Research Quarterly, 58: 187-201, 2005; Sargeant Policing and Society 27: 927-940, 2017). However, most citizens have limited direct interaction with the police (Roberts & Doob Law and Human Behavior 14: 451-468 , 1990; Surette, 2007), justifying research exploring the impact of media consumption on attitudes toward the police. This study examines the impact of news consumption through television, the internet, and social media on confidence in the police across race/ethnicity. The study utilizes a national non-full probability sample of 500 White, Black, and Hispanic/Latinx respondents. Findings suggest that race/ethnicity mediates the relationship between news source and attitudes toward the police. Implications are discussed.
Efficient Safety Control Synthesis with Imperfect State Information

We consider synthesizing safety controllers for discrete-time dynamical systems with imperfect (i.e., noisy) state measurements. In order to find the actual winning set of a safety game for such systems, one needs to solve a partial information game via power set construction, which, in general, is computationally intractable. In this paper, we propose two conservative but computationally more efficient approaches by computing sets that can be rendered invariant with the noisy measurement. This is achieved by considering a perfect information safety game for the dynamics of an estimated state. The invariant set for this alternative game is shown to be equivalent to a noise-adapted contractive set for the original system. The controllers associated with the two proposed approaches require different knowledge of the initial states: one requires only the initial measurement and the other also requires knowing the initial state exactly. In general, the resulting controlled invariant sets by these two approaches are not comparable, and depending on the problem in hand either one can be preferable. The efficacy of the proposed approach is illustrated with an aircraft taxiing example, where the state estimation task is performed by a perception module.
Real-time monitoring of viscosity changes triggered by chemical reactions using a high-speed imaging method

We present a method to monitor in real time peptide self-assembly or polymerization events. The temperature controlled modification of a previously reported splash test setup using high speed imaging enables to observe and measure rheological changes in liquid samples and can, in turn, monitor a peptide self-assembly or polymerization reaction accompanied with specific changes in solution viscosity. A series of 2 mm glass beads were dropped into an Fmoc-L3-OMe (methylated Fluorenylmethyloxycarbony l-trileucine) solution mixed with Alcalase 2.4 L (EC 3.4.21.62) or first dipped in Tetramethylethylenediamine (TEMED), a catalyst for acrylamide polymerization, then dropped into acrylamide. The resulting splashes were observed using a high speed camera. The results demonstrate that the viscosity changes of the peptide sample during the peptide self-assembly or acrylamide polymerization affect the specific shape and evolution of the splashing event. Typically, the increase in viscosity while the reaction occurs decreased the size of the splash and the amount of time for the splash to reach maximum extension from the moment for the beads to impact the sample. The ability to observe rheological changes of sample state presents the opportunity to monitor the real time dynamics of peptide self-assembly or cross-polymerization.
Examining the impact of perceived weight discrimination on reported eating and exercise among White and Latino/a adults.

A large body of research suggests that, among White individuals, perceived weight discrimination has deleterious consequences for eating and exercise outcomes; however, the research literature on perceived weight discrimination among other racial/ethnic groups is limited. The primary goal of the present study was to examine the associations of perceived weight discrimination with eating and exercise thoughts and behaviors among White versus Latino/a participants. A sample of White (N = 50) and Latino/a (N = 281) undergraduate college students with higher body weight (BMI: M = 30.65, SD = 5.42) completed self-report measures assessing perceived weight-based discrimination, frequency of intake of unhealthy and healthy foods, and frequency of both thoughts about exercise and exercise behaviors; we examined relationships among these variables within White versus Latino/a participants. Results showed that perceived weight discrimination was associated with more frequent intake of unhealthy foods, more frequent exercise thoughts, and less frequent exercise behaviors among White participants, and that there were no significant associations between perceived weight discrimination and the eating and exercise measures of interest among Latino/a participants. These findings highlight a number of potential avenues for future research to identify the mechanisms underlying these differential associations of perceived weight discrimination to eating and exercise behaviors across racial/ethnic groups.
Distributed Coverage Control of Multi-Agent Networks with Guaranteed Collision Avoidance in Cluttered Environments

We propose a distributed control algorithm for a multi-agent network whose agents deploy over a cluttered region in accordance with a time-varying coverage density function while avoiding collisions with all obstacles they encounter. Our algorithm is built on a two-level characterization of the network. The first level treats the multi-agent network as a whole based on the distribution of the locations of its agents over the spatial domain. In the second level, the network is described in terms of the individual positions of its agents. The aim of the multi-agent network is to attain a spatial distribution that resembles that of a reference coverage density function (high-level problem) by means of local (microscopic) interactions of its agents (low-level problem). In addition, as the agents deploy, they must avoid collisions with all the obstacles in the region at all times. Our approach utilizes a modified version of Voronoi tessellations which are comprised of what we refer to as Obstacle-Aware Voronoi Cells (OAVC) in order to enable coverage control while ensuring obstacle avoidance. We consider two control problems. The first problem which we refer to as the high-level coverage control problem corresponds to an interpolation problem in the class of Gaussian mixtures (no collision avoidance requirement), which we solve analytically. The second problem which we refer to as the low-level coverage control problem corresponds to a distributed control problem (collision avoidance requirement is now enforced at all times) which is solved by utilizing Lloyd's algorithm together with the modified Voronoi tessellation (OAVC) and a time-varying coverage density function which corresponds to the solution of the high-level coverage control problem. Finally, simulation results for coverage in a cluttered environment are provided to demonstrate the efficacy of the proposed approach.
Fibrosis Without Myofibroblasts Revealed by Genetic Analysis of PDGFRα

The appearance of myofibroblasts is hallmark of fibrosis and tissue repair. Myofibroblasts are stromal cells that transition from fibroblastic progenitors by acquiring new contractile function. Platelet-derived growth factor (PDGF) promotes fibrosis and supports tissue repair, but the relationship between PDGF and the myofibroblast phenotype is unclear. Using mice with PDGF receptor α (PDGFRα) gene activation or deletion and mutation-linked lineage tracing, we examine fibroblastic progenitor cell fate during spontaneous fibrosis and wound-induced fibrosis. Unexpectedly, elevated PDGFRα signaling generates fibrosis while inhibiting myofibroblast formation. Non-canonical TGFβ-p38 signaling is blocked by PDGFRα activity, thereby inhibiting myofibroblasts. However, deletion of PDGFRα also inhibits myofibroblasts by reducing SRF activity, which leads to defective wound repair. Our findings suggest a scenario where PDGFRα initially expands the progenitor population for tissue repair and later suppression of PDGFRα in activated progenitors permits their transition to myofibroblast.
Getting Started with Lotus 1-2-3 5.0 for Windows

Creating a Simple Worksheet. Using Ranges Within Spreadsheets. Copying and Moving. Using Functions and Formulas. Absolute and Relative Cell Addressing. Multiple Worksheets. Creating Charts. Database Basics. Appendix. Index.
Early Experience and Cognitive Organization

There is much support for the idea that cognitive development is specialized, with different aspects of knowledge developing under different mechanisms and timelines. Many aspects of mature knowledge can be traced to innate origins. At the same time, variation in early experience due to genetic defects, blindness or deafness can lead to significant reorganization of the developing brain. Thus human cognitive development is constrained by innate potential, but is also affected by experience during early development. Keywords: spatial cognition; language acquisition; Down syndrome; Williams syndrome; blindness; deafness; early development
Hopf algebras and their actions on rings

Definitions and examples Integrals and semisimplicity Freeness over subalgebras Action of finite-dimensional Hopf algebras and smash products Coradicals and filtrations Inner actions Crossed products Galois extensions Duality New constructions from quantum groups Some quantum groups.
Public Scholarship and Community Engagement in Building Community Food Security: The Case of the University of Kentucky

The current call for public scholarship and community engagement by universities and disciplinary organizations has created opportunities to develop innovative ways to integrate research, instruction, and outreach. This article discusses a collaboration among scholars at the University of Kentucky and alternative agrifood movement organizations that has evolved as they pursue an alternative agrifood system in Kentucky. This collaboration made instructional programs in sociology and the honors world food issues track places in which both students and instructors can examine "problems" of the conventional agrifood system, conduct research, and develop collaborative relationships with community activists. We draw on Burawoy's discussion of public sociology and its interface with professional, critical, and policy sociologies. Supplementing our discussion with literature from social movements and science studies, we demonstrate how this integrated approach can render sociological knowledge and skills useful as critical support of alternative agrifood movements. We argue that the "experiential classroom" is an excellent site for the critical examination within the agrifood movements of oppositional culture. This, in turn, makes possible students' recognition of injustice in the existing agrifood system.
Advocating for Equitable Mathematics Education: Supporting Novice Teachers in Navigating the Sociopolitical Context...

In this essay, the authors situate elementary mathematics teacher preparation in a broader, sociopolitical context, one that includes historical patterns of educational privilege and oppression. The authors attend to the effects of “reform” movements that encompass a vast array of stakeholders and interests as well as the growing significance of federal education policy on mathematics teacher education. In particular, they highlight the tensions involved in prospective teachers’ first experiences in attempting to make sense of how research-based theories of learning and practice intersect with local schooling realities. The authors present questions that novice mathematics teachers might ask at the personal, interpersonal, institutional, and cultural levels; questions which hold the potential to disrupt dominant discourses and initiatives in favor of discourses that reframe mathematics education opportunities for oppressed youth in the United States.
Bile cast nephropathy: An often forgotten diagnosis

High bilirubin levels are nephrotoxic. Bilirubin can cause a functional proximal tubulopathy or may precipitate into casts associated with acute tubular injury. This condition is known as bile cast nephropathy. The kidney injury is generally reversible if bilirubin levels are decreased early. We present a case wherein an alcoholic patient presented with high bilirubin levels and anuric acute kidney injury. The initial urine analysis suggested intrinsic renal disease. A kidney biopsy, performed a few days after the initiation of dialysis, demonstrated the presence of bile casts along with acute tubular injury. The patient however continued to be dialysis dependent inspite of initiating prednisolone to treat acute alcoholic hepatitis.
Preventing Injuries in College Intramural Sports

(1972). Preventing Injuries in College Intramural Sports. Journal of Health, Physical Education, Recreation: Vol. 43, No. 7, pp. 66-70.
Potential for biodegradation of phthalic Acid esters in marine regions.

Di-(2-ethylhexyl) phthalate was the major phthalic acid ester in the Mississippi River estuary, with mean levels of 0.1 μg/g (dry weight) in surface sediments, 1.0 μg/liter in river water, and 0.7 μg/liter in delta water. Bacteria that grew aerobically on dibutyl phthalate and o-phthalic acid were readily detected in the sediments and water. Pure cultures of bacteria were isolated on seven different phthalic acid esters from freshwater and marine sources. The marine isolates were taxonomically diverse and grew on a variety of phthalic acid esters. Dibutyl phthalate and o-phthalic acid supported growth in full-strength synthetic sea-water medium, but Na+ -dependent catabolism was demonstrable only for o-phthalic acid.
Rescattering information from B ---> K anti-K decays

Rescattering effects can modify the dependence on the weak phase $\ensuremath{\gamma}=\ensuremath{-}\mathrm{Arg}{(V}_{\mathrm{ub}}^{*}{V}_{\mathrm{ud}}{/V}_{\mathrm{cb}}^{*}{V}_{\mathrm{cd}})$ of the ratio of rates for ${B}^{\ifmmode\pm\else\textpm\fi{}}\ensuremath{\rightarrow}K{\ensuremath{\pi}}^{\ifmmode\pm\else\textpm\fi{}}$ and $\stackrel{\ensuremath{\rightarrow}}{B}{K}^{\ifmmode\pm\else\textpm\fi{}}{\ensuremath{\pi}}^{\ensuremath{\mp}}.$ A test for these effects based on the processes ${B}^{\ifmmode\pm\else\textpm\fi{}}\ensuremath{\rightarrow}{K}^{\ifmmode\pm\else\textpm\fi{}}K$ has been suggested. It is pointed out that the rates for the processes $\stackrel{\ensuremath{\rightarrow}}{B}{K}^{+}{K}^{\ensuremath{-}},$ which are expected to be dominated by rescattering and for which considerably better experimental bounds exist, are likely to provide a more stringent constraint on these effects.