cssi/SciSciGPT-SciSciNet huggingface dataset:
A Neonate with Acute Heart Failure: Chromosomally Integrated Human Herpesvirus 6-Associated Dilated Cardiomyopathy

A 4-day-old neonate was transferred to a tertiary heart center for further evaluation and management of sudden-onset acute heart failure (HF). The birth history was significant for being born at 37 weeks’ gestation to a 26-year-old mother with a probability 2 A0 blood type. There were no prenatal sonographic screenings of fetal cardiac status available. The mother had no history of smoking, diabetes, thyroid disease, autoimmune disorders, fever, or rash during pregnancy or before delivery. At birth, the patient’s Apgar scores were 8 and 8 at 1 and 5 minutes, respectively, weight was 3200 g (25th percentile), length 48 cm (10th percentile), and head circumference 36 cm (80th percentile). He developed respiratory distress on day 1 of life and was treated empirically to rule out sepsis. There was no history of fever, skin rash, nasal congestion, diarrhea, or sick contact noted. His respiratory status improved by day 2 of life, and he began oral feeding and otherwise progressed well until day 4 of life, when he was scheduled for discharge home but was noted to have a gallop rhythm. His echocardiogram showed a structurally normal heart but markedly dilated left ventricle (LV end-diastolic diameter was 3.24 cm (Z-score 6.7) with moderate mitral regurgitation and severely decreased systolic function, shortening fraction (SF) 11% (mean normal SF value is 36% with 95% predicted limits of 28% to 44%; Figure 1). When the patient arrived in cardiac intensive care unit, no dysmorphic features were noted on examination, his heart rate was 174 beats/min, he had delayed capillary refill (>5 seconds), diminished oxygenation (by near infrared spectroscopy), and had hypotension (systolic blood pressure in the range of 40-50 mm Hg). His S1 and S2 were normal, but a grade 1/6 systolic murmur at the left sternal border and gallop rhythm were noted. His lungs were clear to auscultation, but mild subcostal retractions were noted. The liver was palpable 3 cm below the right subcostal margin. The findings of his neurologic examination were normal, with normal muscle tone noted. He required resuscitation with inotropic support to achieve hemodynamic stability. Subsequently, a milrinone infusion was started for additional
Numerical treatment of grid interfaces to viscous flow

Abstract Numerical treatment of grid interfaces is one of the most important considerations for algorithms that employ different grids within the computational domain. The issue of numerical treatment of quadrilateral grid interfaces with a representative finite-volume Navier-Stokes integration scheme is addressed. Interfaces are created by local embedding of quadrilateral grids and are the borders between different grids. Grid embedding is one of the basic functions of adaptive algorithms that have been developed in order to increase both accuracy and efficiency of computations. The present work both develops and investigates interface treatment schemes that have certain properties such as accuracy and conservation. It is a novel study of interfaces for the case of viscous flow computations. Various treatments are proposed and evaluated with the emphasis being on a comparison between accurate and conservative treatments. Two methodologies have been followed in order to study interface treatments. The first is analytical and yields orders of possible numerical errors, while the second approach employs model test cases, which are especially designed to evaluate certain aspects of the described interface treatments. Also, a transonic airfoil flow case is included as an example of accuracy and robustness of a particular interface treatment scheme. All numerical treatment schemes that are discussed have been coded and evaluated.
Sa1574 Endoscopic Suture Closure Is Superior to Closure With Endoscopic Clips in Prevention of Delayed Complications After Removal of Large Sessile Gastro-Intestinal Tract Lesions

Sa1574 Endoscopic Suture Closure Is Superior to Closure With Endoscopic Clips in Prevention of Delayed Complications After Removal of Large Sessile Gastro-Intestinal Tract Lesions Sergey Kantsevoy*, Marianne Bitner, Jose M. Davis, Paulina Mirovski, Anurag Maheshwari, Sanjay B. Jagannath, Hwan Yoo, Paul J. Thuluvath Institute for Digestive Health and Liver Disease, Mercy Medical Center, Baltimore, MD; Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, MD Background: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are commonly used to remove pre-malignant and early malignant lesions of gastro-intestinal (GI) tract. Delayed complications (bleeding, perforation) can occur 2-15 days post removal of large sessile GI tract lesions. Study Aim: To compare incidence of delayed complications in patients with and without endoscopic closure of mucosal defects post removal of large GI tract lesions. Methods: We reviewed all medical records of patients who had removal of large GI tract lesions at our hospital over the last 21 months (03/13-11/14). Size, location, pathology of lesion, removal method (EMR, ESD) ,endoscopic closure techniques (no closure, endoscopic clips closure or suture closure with endoscopic suturing device), and presence of delayed complications (bleeding, perforation) were entered into Excel Database and analyzed. Results: Total of 729 sessile lesions over 10 mm in size were removed in 508 patients; 240 lesions (32.9%) were removed by ESD, 489 lesions (67.1%) were removed by EMR. Lesions removed by ESD (mean size 30.9 16.1 mm) were significantly larger (p!0.0001) than lesions removed by EMR (mean size 16.1 10.1 mm). Following removal of 411 lesions (mean size 14.6 10.0 mm), the mucosal defect was left without closure. After removal of 127 lesions (mean size 23.4 9.9 mm) the mucosal defect was closed with 1-9 endoscopic clips (average 3.0 1.7 clips per closure). In 191 cases (average size 33.1 15.9 mm) the mucosal defect was closed with 1-4 endoscopic sutures (average 1.4 0.7 suture per closure). Defects closed with sutures were significantly larger (p!0.0001) then defects closed with the clips or the defects left without any endoscopic closure (p!0.0001). There were no delayed complications after endoscopic suture closure. To the contrary, there were 4 delayed bleedings (2.1%), and 2 delayed perforations (1.6%) after closure with endoscopic clips, 5 delayed bleedings (1.2%), and 4 delayed perforations (1.0%) when the mucosal defect was left without closure. Conclusion: Endoscopic suture closure of mucosal defects reliably prevents delayed complications after removal of large sessile GI tract lesions and is superior to mucosal defect closure with endoscopic clips.
Genetic modification of mesenchymal stem cells overexpressing CCR1 increases cell viability, migration, engraftment, and capillary density in the injured myocardium

Rationale: Although mesenchymal stem cell (MSC) transplantation has been shown to promote cardiac repair in acute myocardial injury in vivo, its overall restorative capacity appears to be restricted mainly because of poor cell viability and low engraftment in the ischemic myocardium. Specific chemokines are upregulated in the infarcted myocardium. However the expression levels of the corresponding chemokine receptors (eg, CCR1, CXCR2) in MSCs are very low. We hypothesized that this discordance may account for the poor MSC engraftment and survival. Objective: To determine whether overexpression of CCR1 or CXCR2 chemokine receptors in MSCs augments their cell survival, migration and engraftment after injection in the infarcted myocardium. Methods and Results: Overexpression of CCR1, but not CXCR2, dramatically increased chemokine-induced murine MSC migration and protected MSC from apoptosis in vitro. Moreover, when MSCs were injected intramyocardially one hour after coronary artery ligation, CCR1-MSCs accum...
A Comparison of Two Models of Urgency Urgency Predicts Both Rash Action and Depression in Youth

The aim of this study was to test two competing theories concerning the trait of urgency: (1) urgency reflects the tendency to act rashly/impulsively when emotional; or (2) urgency reflects a general reflexive responsivity to emotions that can lead either to rash action or ill-advised inaction, and thus to either impulsive behavior or depression. Following prior findings that 5th grade urgency predicted 6th grade impulsive behavior, we tested whether urgency also predicted 6th grade depression (n = 1,906). After controlling for sex, early pubertal onset, 5th grade depression, 5th grade engagement in addictive behaviors, negative affect, positive affect, and other impulsivity-related traits, 5th grade urgency level did predict higher levels of depression at the end of 6th grade. This finding is consistent with the view that urgency can lead either to rash action or ill-advised inaction. Urgency may be of transdiagnostic importance, contributing both to internalizing and externalizing dysfunction.
Stress and domestication traits increase the relative fitness of crop–wild hybrids in sunflower

After a decade of transgenic crop production, the dynamics of gene introgression into wild relatives remain unclear. Taking an ecological genetics approach to investigating fitness in crop‐wild hybrid zones, we uncovered both conditions and characteristics that may promote introgression. We compared diverse crop‐wild hybrid genotypes relative to wild Helianthus annuus under one benign and three stressful agricultural environments. Whereas relative fitness of crop‐wild hybrids averaged 0.25 under benign conditions, with herbicide application or competition it reached 0.45 and was more variable. In some instances, hybrid fitness matched wild fitness (» 1). Thus, wild populations under agronomic stress may be more susceptible to introgression. Although domestication traits are typically considered unlikely to persist in wild populations, we found some (e.g. rapid growth and early flowering) that may enhance hybrid fitness, especially in stressful environments. Rigorous assessment of how particular genotypes, phenotypes, and environments affect introgression will improve risk assessment for transgenic crops.
Directed energy deflection laboratory measurements

We report on laboratory studies of the effectiveness of directed energy planetary defense as a part of the DESTAR (Directed Energy System for Targeting of Asteroids and exploRation) program. DE-STAR [1][5][6] and DE-STARLITE [2][5][6] are directed energy "stand-off" and "stand-on" programs, respectively. These systems consist of a modular array of kilowatt-class lasers powered by photovoltaics, and are capable of heating a spot on the surface of an asteroid to the point of vaporization. Mass ejection, as a plume of evaporated material, creates a reactionary thrust capable of diverting the asteroid’s orbit. In a series of papers, we have developed a theoretical basis and described numerical simulations for determining the thrust produced by material evaporating from the surface of an asteroid [1][2][3][4][5][6]. In the DE-STAR concept, the asteroid itself is used as the deflection "propellant". This study presents results of experiments designed to measure the thrust created by evaporation from a laser directed energy spot. We constructed a vacuum chamber to simulate space conditions, and installed a torsion balance that holds an "asteroid" sample. The sample is illuminated with a fiber array laser with flux levels up to 60 MW/m2 which allows us to simulate a mission level flux but on a small scale. We use a separate laser as well as a position sensitive centroid detector to readout the angular motion of the torsion balance and can thus determine the thrust. We compare the measured thrust to the models. Our theoretical models indicate a coupling coefficient well in excess of 100 μN/Woptical, though we assume a more conservative value of 80 μN/Woptical and then degrade this with an optical "encircled energy" efficiency of 0.75 to 60 μN/Woptical in our deflection modeling. Our measurements discussed here yield about 45 μN/Wabsorbed as a reasonable lower limit to the thrust per optical watt absorbed.
The Wesselhoefts: A medical dynasty from the age of Goethe to the era of nuclear medicine:

For six generations, members of the Wesselhoeft family have practiced medicine in Germany, Denmark, Switzerland, Canada and/or the USA. In the early decades of the 19th century, two Wesselhoeft brothers left Europe to eventually settle in New England, where they and their progeny gave rise to a regional medical dynasty. The Wesselhoeft doctors became well-known practitioners of homeopathy, hydropathy, conventional medicine and surgery, in academic and general clinical settings. An additional connection was established to the literary worlds of Germany and the USA, either through friendships or as personal physicians.
From legislation to implementation : A distributed leadership view of one districts response to the Massachusetts Anti-Bullying Law of 2010

Purpose – The purpose of this paper is to examine the leadership practice of an 11-member district team of educators assembled to respond to one of the most comprehensive bullying laws in the nation – the Massachusetts Anti-Bullying Law of 2010. This three-year case study provides school leaders and legislators with an in-depth, fine-grained analysis of how leadership was practiced by a district team of de facto leaders charged with implementing mandatory legislative policy throughout a six-school, 5,000-student, K-12 public school district. Design/methodology/approach – This three-year case study employed an analytical, distributed leadership framework to identify, categorize, and analyze key artifacts used by a team to design and implement system-wide the comprehensive requirements of legislation. Using Weft qualitative data analysis software and the open, axial, and selective coding guidelines of Strauss and Corbin, data from semi-structured interviews and document analysis revealed a number of hidden ...
Abstract 1893: Spectroscopic imaging unveils altered cholesterol metabolism in prostate cancer .

Metabolic reprogramming allows cancer cells to sustain high proliferative rates and resist cell death. Whereas alterations to glucose and amino acid metabolism have been extensively studied, altered lipid metabolism in cancer is increasingly recognized based on the findings of imbalanced lipid signaling network and dysregulated lipogenic enzymes. Storage of neutral lipids in lipid droplets (LDs), an essential aspect of lipid metabolism, is however long underappreciated until recent advances in LD biology. In human prostate cancer cell lines, neutral lipid accumulation was commonly seen and partially attributed to the up-regulation of fatty acid synthase, a key lipogenic enzyme catalyzing fatty acid biosynthesis and implicated in many human malignancies including prostate cancer. However, because the composition of LDs is not accessible with fluorescence microscopy, the exact role of lipid accumulation in prostate cancer progression remains elusive. By vibration-based spectroscopic imaging of 65 specimens collected from 61 prostate cancer patients and healthy donors, we found for the first time a marked shift from lipofuscin-like autofluorescent granules in normal, benign, and prostatic intraepithelial neoplasia lesions to cholesteryl ester (CE)-rich LDs in high-grade and metastatic prostate cancers. Quantitatively, CE amount was found ∼5 folds higher in high-grade relative to low-grade prostate cancers. Cellular studies demonstrate that the activated PI3K/Akt/mTOR/SREBP pathway accounts for accumulation of CEs via elevated LDL uptake and cholesterol esterification. Blockage of cholesterol esterification with an acetyl-coA cholesterol acyltransferase (ACAT) inhibitor significantly slows the growth and induces apoptosis of prostate cancer both in vitro and in vivo. These findings suggest that CE can be a quantifiable molecular marker for diagnosis of prostate cancer, especially for differentiation between low-grade and high-grade prostate cancers which currently has up to 40% inter-observer discordance. Moreover, targeting the altered cholesterol metabolism opens new opportunities for treating advanced prostate cancer in human patients. Citation Format: Shuhua Yue, Junjie Li, Seung Young Lee, Tian Shao, Bing Song, Liang Cheng, Chang-Deng Hu, Xiaoqi Liu, Timothy L. Ratliff, Ji-Xin Cheng. Spectroscopic imaging unveils altered cholesterol metabolism in prostate cancer . [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1893. doi:10.1158/1538-7445.AM2013-1893 Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.
Penetration of Antibiotics into Fibrin Loci in Vivo. III. Intermittent vs. Continuous Infusion and the Effect of Probenecid

methods of administration, levels of antibiotic in sc fibrin clots rose progressively until they were similar to peak concentrations of free drug in serum. Levels of ampicillin in these fibrin loci were strikingly higher when the drug was injected intermittently than when the same total dose was given by continuous infusion. This appeared to be due to the higher peak levels attained in serum with the intermittent approach. The concomitant administration of probenecid increased the levels of ampicillin or oxacillin in serum and fibrin clots but did not affect distribution between the two compartments.
Incidence and risk factors of urinary tract infection in very low birth weight infants

Objectives To describe the incidence and associated risk factors of urinary tract infection (UTI) in very low birth weight (VLBW) infants and to determine the value of diagnostic imaging studies after the first UTI episode before discharge from the neonatal intensive care unit (NICU). Methods VLBW infants born during 2003-2012 were reviewed for UTI. In a nested case-control study, potential risk factors of UTI were compared between infants with UTI (cases) versus birth weight and gestational age matched controls. Renal ultrasonography (USG) and voiding cystourethrography (VCUG) results were reviewed in cases. Results During the study period, 54.7% of urine culture specimens were collected by sterile methods. 3% (45/1,495) of VLBW infants met the study definition for UTI. UTI was diagnosed at mean postnatal age of 33.1±22.9 days. There was no significant difference in gender, ethnicity, antenatal steroid exposure, blood culture positive sepsis, ionotropic support, respiratory support and enteral feeding practices between cases and controls. Cases had a significantly higher cholestasis compared to controls (22% vs. 9% ; p = 0.03). However, cholestasis was not a significant predictor of UTI in the adjusted analysis [adjusted OR 2.38 (95% CI 0.84 to 6.80), p = 0.11]. Cases had higher central line days, parenteral nutrition days, total mechanical ventilation days, chronic lung disease, and length of stay compared to controls. Renal USG was abnormal in 37% and VCUG was abnormal in 17% of cases. Conclusions The incidence of UTI in contemporary VLBW infants is relatively low compared to previous decades. Since no significant UTI predictors could be identified, urine culture by sterile methods is the only reliable way to exclude UTI. The majority of infants with UTI have normal renal anatomy. UTI in VLBW infants is associated with increased morbidity and length of stay.
Dimilin Toxicity to the Gypsy Moth Larval Parasitoid, Apanteles melanoscelus

Larvae of Apanteles melanoscelus (Ratzeburg) were exposed to Dimilin® (1-(4-chlorophenyl)-3-(2,6-difluoroben-zoyl)-urea) by feeding treated artificial diet to parasitized gypsy moth hosts. The EC50 and EC95 for the parasitoid were 0.0059 and 0.026 ppm, respectively. The EC50 of A. melanoscelus was similar to that of the host. Dimilintreated leaves fed to hosts produced effects on parasitoids during their 2nd–3rd larval molt and later in development. The toxicity is a direct effect of the chemical and not due to host morbidity. Dimilin does not affect progeny production when fed to adult female parasitoids. These experiments suggest that Dimilin may be used in an integrated program compatibly with A. melanoscelus .
True Correlates of Automobile Shopping Behavior

In the October, 1962, JOURNAL OF MARKETING Franklin B. Evans presented data as to kinds of shopping behavior exhibited by automobile purchasers. The October, 1963, issue contained a three-fold crit...
Go, Stop, Go, Stop

We're dissecting the accomplishments of the past to more efficiently achieve the goals of the future. In the Web extra at https://youtu.be/_uQ8OsTSzOE, author David Alan Grier expands on his column about how artificial intelligence is less about building minds and more about taking apart boxes.
Morphological features analysis of high kV chest radiographs of pneumoconiosis

[Objective]To study the morphology features of high kV(HKV) chest radiographs,and provide evidence for the amendments of pneumoconiosis diagnostic criteria.Using retrospective survey methods,the chest X-ray morphological characteristics of the 3689 cases of pneumoconiosis were analyzed according to the latest standards of pneumoconiosis diagnosis,the database was established and statistical analysis done with SPSS 17.0 software.[Results]It was indicated from the X-ray analysis on 3 689 cases of pneumoconiosis that small round opacities showed 508 cases of type p(13.8%),1 501 cases of type q(40.7%) and 279 cases of type r(7.6%),a small irregular opacities showed 246 cases of type s(6.7%) and 1 414 cases of type t(38.3%),and 280 cases of large opacities(7.6%) and 196 cases of confluence of small opacities(5.3%).Small opacities located mainly in the mid and lower zones of both lungs,these pneumoconiosis accompanied with a variety of abnormal X-ray signs in markings(60.3%),hilus of lung(35.5%),pleura(11.4%),emphysema(16.7%).[Conclusion]Big opacities,shape and distribution of small opacities and density to determine in HKV chest radiograph are essential in diagnosis and classification of pneumoconiosis.It is found in the study that the x-ray imaging features,pleural,hilus,markings,emphysema,tuberculosis and others is closely related to pneumoconiosis diagnosis and has important reference value.
193 PREDICTORS OF FAMILY SATISFACTION WITH DECISION-MAKING FOR PATIENTS WHO DIE IN THE INTENSIVE CARE UNIT.

Objective To identify patient, family and hospital course characteristics that predict satisfaction with decision-making among families of patients who died in the intensive care unit (ICU). Methods A validated questionnaire measuring satisfaction with ICU decision-making was administered at 9 medical centers to family members of all patients who died during their ICU stay or within 24 hours of ICU discharge. A validated summary score for satisfaction with decision-making and scores on two individual items were used as outcomes. Exploratory analyses using Spearman correlation coefficients identified significant predictors of satisfaction with decision making (p Results Analyses were completed for 151 families with returned questionnaires and medical record abstraction data. Satisfaction with decision-making was correlated with older family member age (r = .226), a do-not-resuscitate (DNR) order (r = .203), and spiritual support in the first or last 72 hours (r = .207; r = .173). Feeling supported in the decision-making process was associated with a DNR order (r = .220), terminal discontinuation of mechanical ventilation (r = .187), patient/family desire to withdraw support in the last 72 hours (r = .214), having health insurance (r = .164), and dying without life support (r = .195). Feeling control over patient care was associated with increased patient age (r = .165), terminal discontinuation of mechanical ventilation (r = .224), patient/family desire to withdraw support in the first or last 72 hours (r = .205; r = .181), spiritual support in the last 72 hours (r = .194) and dying without life support (r = .177). Conclusions When patients die in the ICU, family satisfaction with decision-making is positively associated with implementation of a DNR order, spiritual support, and the decision to withdraw life support. Focusing on these aspects of care may improve family satisfaction when patients die in the ICU.
Lessons learned from employee fitness programs at the Marshfield Clinic.

PURPOSE To describe and evaluate employee fitness programs at the Marshfield Clinic. METHODS A 16-week program was offered to employees from April-July 2004, and a 12-week program was offered from August-November, 2004. Weekly e-mails included suggestions to increase physical activity and eat a healthy diet. Incentives were offered for meeting program goals. RESULTS A total of 1129 employees signed up for the first program (approximately 18% of all employees) and 610 for the second program. More than 95% of the participants in both programs were female. The activity program goal was met by 231 (20.5%) participants in the first program and 31% (n = 190) of participants in the second program. There was a significant increase in the percent of people with good or excellent fitness levels from baseline (46.4%, 95% CL = 40.5, 52.3) to follow-up (70.7%, 95% CL = 65.3, 76.0) in the first program. In the second program, there was a significant association between the number of program goals met and self-report of having increased energy, better weight control, and feeling better overall and about body image. CONCLUSION Emphasis in future programs should be placed on increasing employee participation. Program evaluation could be expanded to include health care costs and employee absenteeism.
Fundamental Considerations of Chronic Pain Therapy

Effective therapy based on a correct classification of the cause of chronic pain can prevent prolonged disability and iatrogenic complications. A detailed history and thorough work-up are essential. Successful management requires much time and effort from the patient's physician, often with the help of one or more specialists.
SU-F-P-30: Clinical Assessment of Auto Beam-Hold Triggered by Fiducial Localization During Prostate RapidArc Delivery

Purpose: To assess the clinical efficacy of auto beam hold during prostate RapidArc delivery, triggered by fiducial localization on kV imaging with a Varian True Beam. Methods: Prostate patients with four gold fiducials were candidates in this study. Daily setup was accomplished by aligning to fiducials using orthogonal kV imaging. During RapidArc delivery, a kV image was automatically acquired with a momentary beam hold every 60 degrees of gantry rotation. The position of each fiducial was identified by a search algorithm and compared to a predetermined 1.4 cm diameter target area. Treatment continued if all the fiducials were within the target area. If any fiducial was outside the target area the beam hold was not released, and the operators determined if the patient needed re-alignment using the daily setup method. Results: Four patients were initially selected. For three patients, the auto beam hold performed seamlessly. In one instance, the system correctly identified misaligned fiducials, stopped treatment, and the patient was re-positioned. The fourth patient had a prosthetic hip which sometimes blocked the fiducials and caused the fiducial search algorithm to fail. The auto beam hold was disabled for this patient and the therapists manually monitored the fiducial positions during treatment. Average delivery time for a 2-arc fraction was increased by 59 seconds. Phantom studies indicated the dose discrepancy related to multiple beam holds is <0.1%. For a plan with 43 fractions, the additional imaging increased dose by an estimated 68 cGy. Conclusion: Automated intrafraction kV imaging can effectively perform auto beam holds due to patient movement, with the exception of prosthetic hip patients. The additional imaging dose and delivery time are clinically acceptable. It may be a cost-effective alternative to Calypso in RapidArc prostate patient delivery. Further study is warranted to explore its feasibility under various clinical conditions.
Isotopic Transient Observation of the Support Effect During Co Hydrogenation Over Cobalt Catalysts

Abstract Different transient responses of hydrocarbons upon 12CO/13CO switch were observed over the unsupported cobalt and SiO2 supported cobalt catalysts, indicating a support effect which generally win not be easily detected by an ordinary steady state measurement.
From Rolls to Disappointments: Examining the Other Source of Majority Party Failure in Congress

Much of the literature on partisan agenda setting in Congress focuses on the majority’s ability to exercise negative agenda control. As a result, the empirical emphasis has been on “rolls,” or how often the majority of the majority party opposes legislation that nonetheless passes. Although interesting, rolls are only one source of majority party failure. The other source, largely unexplored in the literature, is when the majority of the majority party supports legislation that is subsequently defeated. These cases represent “disappointments,” and are a means to determine how effective the majority party is at exercising positive agenda control. Making some basic modifications to a standard spatial model of agenda setting, we articulate why and where we might expect the majority party to fail to exercise positive agenda control effectively. We then derive hypotheses regarding (1) which members should vote “no” on roll calls that result in a disappointment and (2) why disappointments vary on a Congress-by-...
Spatial knowledge during skilled action sequencing: Hierarchical versus nonhierarchical representations

Typists can type 4 to 5 keystrokes per second at around 95% accuracy, yet they appear to have poor declarative knowledge of key locations. Logan and Crump (2011, Psychology of Learning and Motivation, Vol. 54, pp. 1-27) accounted for this paradox by proposing that typing is hierarchically organized into two loops, with an outer loop that transforms sentences into words and passes each word, one at a time, to an inner loop that transforms each word into its constituent keystrokes; however, the nature of the inner loop's spatial knowledge is not well understood. Key locations may be learned through the experiences of locating and traversing between keys. In daily life, people tend to type structured language, and, as a consequence, certain keys and key-to-key transitions are experienced more frequently than others. Here, we asked whether or not this knowledge is structured hierarchically. For example, knowledge of key locations may be nested within representations of words, or the inner loop may rely on knowledge that is independent from higher level structures. To test this, we had people type English, English-like, and random strings during normal, partially occluded, and occluded typing. In both partially occluded and occluded typing, error rates were higher while typing random strings compared to English and English-like strings, whereas there was no difference in error rates between English and English-like strings. This suggests that typists' spatial knowledge of the keyboard is not driven by hierarchical word-level representations, but instead is likely driven by a collection of individual processes, such as knowledge of the sequential structure of language acquired by typing more frequently occurring letters.
Beaver Ponds and the Carbon Cycle

Carbon takes a variety of forms in beaver ponds and beaver meadows, including live plant biomass, standing dead biomass, soil organic matter, soil carbonates, dissolved organic carbon, and trace gases. The pools of carbon in these storage compartments and the fluxes between them are discussed. The slow decomposition rate of beaver meadow plant litter under anaerobic conditions promotes the accumulation of organic (O) soil horizons, which have a calculated mean residence time of 69 years. The carbon per unit area in soils that were formerly impounded by beavers (15.1 ± 6.8 km C m−2) was nearly twice that of adjacent never-impounded forest soils (8.2 ± 2.9 km C m−2). Beaver meadow sedge peat mineralization was compared with that of bog peat in long-term (80-week) laboratory incubations. Beaver meadow sedge peat had significantly higher carbon mineralization rates under all incubation conditions except aerobic incubation at 15 °C (other treatments were anaerobic incubation at 15 and 30 °C and aerobic incubation at 30 °C). Field measurement of trace gas fluxes showed that beaver ponds and beaver meadows with water table at or above the soil surface emitted methane, but beaver meadows with water tables below the soil surface did not.
NeuroBuilder: A User Interface and Network Simulator for Building Neurobiological Networks

NeuroBuilder is a comprehensive package for building neuro-biologically-based networks. It allows the user a range of options in specifying both the single-unit dynamics (from neural network-like neurons to complex dynamics) and the three-dimensional structure and connectivity necessary to describe any biologically based system.
Trajectory Optimization for Cellular-Connected UAVs with Disconnectivity Constraint

The popularity of unmanned aerial vehicles (UAVs) has been increasing recently thanks to their enhanced functionalities and decreasing manufacturing costs. Many military and civilian applications involve UAVs for usecases/missions ranging from surveillance to search and rescue. However, despite their advantages, UAVs typically require near ubiquitous network connectivity for a successful fulfillment of their missions, which is a challenging task to achieve. In this paper, we study the trajectory optimization for cellular- connected UAVs with a disconnection duration constraint. That is, the UAV with the mission of flying from a start location to a final location needs to find a path during which it does not lose its cellular connection via one of the ground base stations (GBS) in the area more than a given time constraint. As the problem is difficult to be solved optimally, we propose a dynamic programming based approximate solution within polynomial time. In simulations, we show that the proposed approach can achieve close-to-optimal results with remarkably low computation costs and its accuracy could be increased by adding more granularity to the approximation.
Effect of IRS Nonacquiesence on Tax Planning and Reporting

The IRS has published a nonacquiesence to the tax court’s decision in Estate of Bartell. That case held that a non-safe-harbor improvements exchange qualifies for section 1031 nonrecognition. This Article considers the effect that the nonacquiesence might have on taxpayers who would otherwise rely upon the Bartell decision to structure improvements exchanges. The Article concludes that some taxpayers may be concerned that the nonacquiesence could lead to greater scrutiny from the IRS, and they will use different structures when possible to avoid the Bartell structure. Taxpayers who are faced with the choice of paying tax or using the Bartell structure will most likely move forward based upon the tax court’s decision, recognizing that the expected cost of a such a reporting position generally will be less than the amount of tax due in a taxable sale. Because the tax court has already held in the taxpayer’s favor in Bartell, it would likely hold in another taxpayer’s favor, if it were to consider a similar transaction, so the likelihood that a transaction like the Bartell transaction would be treated favorably is high. The Article is therefore able to demonstrate how taxpayers’ reliance upon Bartell should, at a minimum, help them avoid any substantial-understatement penalties that could otherwise apply, if the IRS were to accomplish the unexpected and prevail in a case with a similar transaction. Thus, the nonacquiesence should have little effect on taxpayers’ decisions to do Bartell-like transactions, if no other structure will provide tax deferral.
Common Adult Congenital Heart Disease Issues

There are more adults than children living with congenital heart disease (CHD) in the United States. Most adults with congenital heart disease should be seen at least periodically by adult congenital heart disease (ACHD) specialists. The general cardiology consultant also has a unique opportunity to improve the care of patients with ACHD by improving access to care, while patients are interacting with the healthcare system for other reasons such as noncardiac surgery or pregnancy. This chapter describes the epidemiology of ACHD, issues with accessing healthcare, and transitioning patients from a pediatric to adult model of care. We will outline general approaches including society guidelines to common issues including hypertension, dyslipidemia, heart failure and transplantation, arrhythmias, liver disease, hyperviscosity, preoperative risk assessment, imaging, pregnancy, contraception, exercise, and infective endocarditis. Finally, we will briefly review some of the more commonly encountered forms of cyanotic and acyanotic ACHD and describe surgical treatments including shunts and the Fontan palliation procedure.
A meta-analytical synthesis and examination of pathological and problem gambling rates among college athletes

ABSTRACTLimited attention has been paid specifically to college athlete gambling in the body of literature. This research article is the first meta-analysis of its type, presenting an up-to-date pr...
CRISPR/Cas9 applications in gene therapy for primary immunodeficiency diseases

Primary immunodeficiency diseases (PIDs) encompass a range of diseases due to mutations in genes that are critical for immunity. Haploinsufficiency and gain-of-function mutations are more complex than simple loss-of-function mutations; in addition to increased susceptibility to infections, immune dysregulations like autoimmunity and hyperinflammation are common presentations. Hematopoietic stem cell (HSC) gene therapy, using integrating vectors, provides potential cure of disease, but genome-wide transgene insertions and the lack of physiological endogenous gene regulation may yet present problems, and not applicable in PIDs where immune regulation is paramount. Targeted genome editing addresses these concerns; we discuss some approaches of CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats)/Cas system applicable for gene therapy in PIDs. Preclinical repair of gene mutations and insertion of complementary DNA restore endogenous gene regulation and they have shown very promising data for clinical application. However, ongoing studies to characterize off-target genotoxicity, careful donor designs to ensure physiological expression, and maneuvers to optimize engraftment potential are critical to ensure successful application of this next-gen targeted HSC gene therapy.
Impact of Electronic Health Record Implementation on Ophthalmology Trainee Time Expenditures.

Objective Electronic health records (EHRs) are widely adopted, but the time demands of EHR use on ophthalmology trainees are not well understood. This study evaluated ophthalmology trainee time spent on clinical activities in an outpatient clinic undergoing EHR implementation. Design Prospective, manual time-motion observations of ophthalmology trainees in 2018. Participants Eleven ophthalmology residents and fellows observed during 156 patient encounters. Methods Prospective time-motion study of ophthalmology trainees 2 weeks before and 6 weeks after EHR implementation in an academic ophthalmology department. Manual time-motion observations were conducted for 11 ophthalmology trainees in 6 subspecialty clinics during 156 patient encounters. Time spent documenting, examining, and talking with patients were recorded. Factors influencing time requirements were evaluated using linear mixed effects models. Main Outcome Measures Total time spent by ophthalmology residents and fellows per patient, time spent on documentation, examination, and talking with patients. Results Seven ophthalmology residents and four ophthalmology fellows with mean (standard deviation) postgraduate year of 3.7 (1.2) were observed during 156 patient encounters. Using paper charts, mean total time spent on each patient was 11.6 (6.5) minutes, with 5.4 (3.5) minutes spent documenting (48%). After EHR implementation, mean total time spent on each patient was 11.8 (6.9) minutes, with 6.8 (4.7) minutes spent documenting (57%). Total time expenditure per patient did not significantly change after EHR implementation (+0.17 minutes, 95% confidence interval [CI] for difference in means: –2.78, 2.45; p = 0.90). Documentation time did not change significantly after EHR implementation in absolute terms (+1.42 minutes, 95% CI: –3.13, 0.29; p = 0.10), but was significantly greater as a proportion of total time (48% on paper to 57% on EHR; +9%, 95% CI: 2.17, 15.83; p = 0.011). Conclusion Total time spent per patient and absolute time spent on documentation was not significantly different whether ophthalmology trainees used paper charts or the recently implemented EHR. Percentage of total time spent on documentation increased significantly with early EHR use. Evaluating EHR impact on ophthalmology trainees may improve understanding of how trainees learn to use the EHR and may shed light on strategies to address trainee burnout.
Ruthenium( iii ) complexes containing thiazole-based ligands that modulate amyloid-β aggregation

Alzheimer's Disease (AD) is a devastating neurodegenerative disorder where one of the commonly observed pathological hallmarks is extracellular deposits of the peptide amyloid-β (Aβ). These deposits contain a high concentration of metals and initially presented a promising target for therapy; however it has become increasingly evident that the soluble form of the peptide is neurotoxic, not the amyloidogenic species. Metal-based therapeutics are uniquely suited to target soluble Aβ and have shown considerable promise to prevent the aggregation and induced cytotoxicity of the peptide in vitro. Herein, we have prepared a small series of derivatives of two promising Ru(iii) complexes NAMI-A (imidazolium [trans-RuCl4(1H-imidazole)(dimethyl sulfoxide-S)]) and PMRU20 (2-aminothiazolium [trans-RuCl4(2-aminothiazole)2]), to determine structure-activity relationships (SAR) for Ru(iii) therapeutics for AD. Using the three complementary methods of Thioflavin T fluorescence, dynamic light scattering (DLS), and transmission electron microscopy (TEM), it was determined that the symmetry around the metal center did not significantly impact the activity of the complexes, but rather the attached thiazole ligand(s) mitigated Aβ aggregation. Across both families of Ru(iii) complexes the determined SAR for the functional groups on the thiazole ligands to modulate Aβ aggregation were NH2 > CH3 > H. These results highlight the importance of secondary interactions between the metallotherapeutic and the Aβ peptide where hydrogen-bonding has the greatest impact on modulating Aβ aggregation.
Integrating hydrologic modeling web services with online data sharing to prepare, store, and execute hydrologic models

Abstract Web based applications, web services, and online data and model sharing technology are becoming increasingly available to support hydrologic research. This promises benefits in terms of collaboration, computer platform independence, and reproducibility of modeling workflows and results. In this research, we designed an approach that integrates hydrologic modeling web services with an online data sharing system to support web-based simulation for hydrologic models. We used this approach to integrate example systems as a case study to support reproducible snowmelt modeling for a test watershed in the Colorado River Basin, USA. We demonstrated that this approach enabled users to work within an online environment to create, describe, share, discover, repeat, modify, and analyze the modeling work. This approach encourages collaboration and improves research reproducibility. It can also be adopted or adapted to integrate other hydrologic modeling web services with data sharing systems for different hydrologic models.
Rethinking COVID-19 Vulnerability: A Call for LGTBQ+ Im/migrant Health Equity in the United States during and after a Pandemic

Public health responses to the coronavirus disease 2019 (COVID-19) pandemic have emphasized older adults' vulnerability, but this obfuscates the social and political root causes of health inequity. To advance health equity during a novel communicable disease outbreak, public health practitioners must continue to be attentive to social and political circumstances that inform poor health. Such efforts are especially needed for populations who are exposed to numerous social and political factors that structure health inequity, such as lesbian, gay, bisexual, transgender, or otherwise-queer identifying (LGBTQ+) populations and im/migrant populations. The COVID-19 outbreak is, therefore, a critical time to emphasize root causes of health inequity.
Post-Operative AV Block: Using Device Algorithms

Post-operative AVB can be observed in 6–8% of patients following cardiothoracic surgery. However, recovery of AVB within 7 days has also been documented to be as high as 41% and delayed recovery of AVB five months after surgery has also been reported. This case presents a patient who did not tolerate a managed ventricular pacing mode due to frequent atrial ectopy and oversensing on RA lead. In addition, initial evaluation suggested recovery of AV conduction following cardiothoracic surgery, but intermittent recurrent AV block was identified only by careful evaluation of electrograms and highlights the importance of examining all data when a patient presents with symptoms that are difficult to explain.
Evaluation of Peripheral Perfusion in the Presence of Plantar Heel Ulcerations Status After Transmetatarsal Amputation With Achilles Tendon Lengthening

The objective of this study is to evaluate peripheral perfusion in patients who developed plantar heel ulcerations status after transmetatarsal amputation and Achilles tendon lengthening. Peripheral perfusion was assessed via contrast angiography of the 3 crural vessels (anterior tibial, posterior tibial, and peroneal arteries), as well as intact heel blush and plantar arch. The secondary objective is to correlate the arterial flow to time to develop heel ulceration and incidence of minor and major lower-extremity amputation. Diagnostic angiography without intervention was performed on 40% of patients (4/10), and interventional angiography was performed on 60% of patients (6/10). In-line flow was present in 0% (0/10) of the peroneal arteries, 60% (6/10) of the anterior tibial arteries, and 70% (7/10) of the posterior tibial arteries. Heel angiographic contrast blush was present in 60% (6/10), and intact plantar arch was present in 60% (6/10). Patients developed heel ulcerations at a mean time of 7.6 months (range 0.7 to 41.2) postoperatively. The incidence of major lower-extremity amputation was 30% (3/10), with a mean time of 5.2 months (range 3.5 to 8.3) from time of heel wound development. No amputation occurred in 6 patients (60%). Among them, intact anterior tibial inline arterial flow was present in 3, intact posterior tibial inline arterial flow was present in 6, and heel blush was present in 5. Our results demonstrate that an open calcaneal branch of the posterior tibial artery is sufficient to heal plantar heel ulcerations to potentially increase rates of limb salvage.