cssi/SciSciGPT-SciSciNet huggingface dataset:
‘Creche coronary’ - A paediatric variant of café coronary syndrome

Sudden collapse due to acute upper aerodigestive tract obstruction in infants and young children is most often caused by ingested food or toy parts. The following cases taken from the autopsy files of the ACH demonstrate particular risk factors associated with young children who are otherwise completely well and who attend child care centers (CCCs). Case 1: A 19- month-old boy collapsed and died at a CCC while eating a sausage. At autopsy a large bolus of sausage was recovered from the lower oesophagus. Case 2: An 18-month old boy choked while eating raw carrot at a second CCC. Although resuscitation was performed and a piece of carrot was removed from the trachea, severe hypoxic ischaemic cerebral damage was followed by death five days later. The “cafe coronary” syndrome in adults classically refers to accidental asphyxia in an individual with dentures who has imbibed alcohol and who is dining out on meat. Major predisposing factors are alcohol and sedative drugs, with other risk factors being impaired motor coordination, for example due to Parkinson disease, and impaired mentation due to senility. Similarities exist between the classical “cafe coronary” syndrome of adults and fatal food asphyxia in young children at CCCs; these include the presentation of collapse due to choking on food while eating away from home, inadequate dentition and underappreciation of appropriate food bolus size. Features which separate the two entities are the young age of the victims and absence of alcohol intoxication or drug ingestion in the latter group. Given that second molar teeth erupt 12 to 20 months after the incisor teeth, there is a significant period of time during which a young child is able to bite off fragments of hard food without being able to properly masticate prior to swallowing. It is therefore helpful at autopsy in such cases to accurately record the stage of dental development and the condition of the teeth.
Probing the photoinduced metal-nitrosyl linkage isomerism of sodium nitroprusside in solution using transient infrared spectroscopy.

We study photoinduced metal−nitrosyl linkage isomerism in sodium nitroprusside (Na2[FeII(CN)5NO]·2H2O, SNP) dissolved in methanol using picosecond transient infrared (IR) spectroscopy. The high sensitivity of this technique allows the simultaneous observation of two known metastable (MS) iron−nitrosyl linkage isomers of SNP, [FeII(CN)5(η1-ON)]2− (MS1) and [FeII(CN)5(η2-NO)]2− (MS2), at room temperature. The transient population of free nitrosyl radicals (NO·) is also measured in the sample solution. These three transient species are detected using their distinct nitrosyl stretching frequencies at 1794 cm−1 (MS1), 1652 cm−1 (MS2), and 1851 cm−1 (NO·). The metastable isomers and NO· are formed on a subpicosecond time scale and have lifetimes greater than 100 ns. A UV (400 nm)−pump power dependence study reveals that MS1 can be formed with one photon, while MS2 requires two photons to be populated at room temperature in solution. Other photodissociation products including cyanide ion, Prussian blue, and [FeI...
LES of Tripped Super-Critical Cylinder Flow: Toward Tandem Cylinder Noise Predictions

In an eort to assess the capability of LES to predict the noise generated by model airframe geometries, simulations of a single cylinder with various boundary layer trips were performed. The ability to accurately simulate forced transition on a cylinder is a critical step in being able to predict the noise generated by an inline tandem cylinder pair for which an extensive experimental database has been made available. The tandem cylinder problem was part of the first AIAA Workshop on Benchmark problems for Airframe Noise Computations (BANC-I) directed at assessing the current state of the art in flow and acoustic predictions on geometries relevant to airframe noise. Since the noise generation mechanisms are fundamentally based on turbulence physics, the ability to capture a wide range of energy containing scales makes LES an attractive method given the ongoing advances in computing capability. However, a diculty that arises with LES is the lack of an explicit wall model allowing the eective wall roughness to be defined. Directly modeling the experimental trip geometry is infeasible due to computational cost at high Reynolds numbers. In the present simulations, wall blowing and suction was used to force early transition. As in the BANC-I experiments, the eect of the trip is validated against a high Reynolds number single cylinder experiment. In all cases, the trip was successful in forcing early transition and shifting the shear layer separation point. It was found that varying trip parameters such as forcing amplitude and streamwise extent had minimal eect on
How Intravenous Infusions Modify the Water Contents of Tissues.

To find what factors influence the exchanges of fluid between blood and tissues, muscles and arterial blood were sampled at frequent intervals before, during, and after various acute procedures upon anesthetized cats and dogs. The percentage water contents of the muscles, and occasionally of other tissues, were determined, and blood concentration was measured in parallel by several methods.When 50 cc. of Locke solution per kilo were infused, the muscle water content remained constant for a few minutes, then suddenly increased by 1 to 8% and promptly returned almost to normal. The dilution of the blood was maintained for a much longer period of time. The only factor measured which varied in parallel with muscle hydration was the mean arterial blood pressure. That blood pressure was more important than blood dilution in regulating the water content of tissues was shown by infusions of gelatin-Locke and of acacia-Locke solutions. In these experiments the blood dilution persisted for at least 3 hours, while t...
Adaptive Remediation and the Facilitation of Transfer in Multiliteracy Center Contexts

Abstract This essay considers the question of transfer in relation to processes of remediation. In particular, we explore the interrelationships between transfer and new media in multiliteracy center contexts. Drawing on a case study of an undergraduate student named Sophie, we offer a multidimensional approach called adaptive remediation that helps composers develop meta-awareness about how they might use and reshape prior composing knowledge and available semiotic resources in ways to suit media affordances and their rhetorical objectives in processes of remediation. Specifically, we propose four dimensions of adaptive remediation, including charting, inventorying, coordinating, and literacy linking. Our hope is that adaptive remediation will prepare multiliteracy center directors and consultants to help students transfer knowledge across media and, in the process, make rhetorically sound decisions about how to adapt and reuse literacies, skills, and ideas in a variety of contexts.
Effects of phenobarbital, pregnenolone-16 alpha-carbonitrile, and 3-methylcholanthrene pretreatments on the distribution of NADPH-cytochrome c (P-450) reductase within the liver lobule.

The effects of phenobarbital, pregnenolone-16α-carbonitrile, and 3-methylcholanthrene pretreatments on the distribution of NADPH-cytochrome c (P-450) reductase (NADPH: ferricytochrome oxidoreductase, EC 1.6.2.4) within the livers of male rats were investigated employing sheep antiserum produced against rat hepatic microsomal NADPH-cytochrome c reductase in indirect fluorescent antibody and unlabeled antibody peroxidase-antiperoxidase immunohistochemical staining techniques. In the livers of untreated and vehicle-pretreated rats, the extent of binding of the antireductase to hepatocytes was found to be similar within the centrilobular and midzonal regions of the lobule but significantly lower within the periportal regions of the lobule. Pretreatment of rats for 4 days with 3-methylcholanthrene did not result in alterations in either the pattern or the intensity of immunohistochemical staining for the reductase within the liver lobule. In the livers of rats which had been pretreated for 4 days with phenobarbital, microfluorometric analyses revealed a twofold increase in the extent of antireductase binding to hepatocytes within all regions of the lobule. In contrast to the effects of phenobarbital, pregnenolone-16α-carbonitrile markedly altered the pattern as well as the intensity of immunohistochemical staining for NADPH-cytochrome c (P-450) reductase within the liver lobule. After 4 days of pregnenolone-16α-carbonitrile pretreatment, there was a threefold increase in the extent of antireductase binding to hepatocytes within the periportal regions of the lobule, while the extent of antireductase binding to centrilobular and midzonal hepatocytes was increased by only 73 and 45%, respectively. Thus, in the livers of pregnenolone-16α-carbonitrile-pretreated rats, the antireductase bound to a similar extent to periportal and midzonal hepatocytes and to a significantly greater extent to centrilobular hepatocytes. These results demonstrate that, although both phenobarbital and pregnenolone-16α-carbonitrile induce NADPH-cytochrome c (P-450) reductase in hepatocytes throughout the liver lobule, phenobarbital appears to produce a uniform induction of the reductase within the lobule, while pregnenolone-16α-carbonitrile induces the reductase by significantly different extents within the three lobular regions.
Association of high sensitive C-reactive protein with severity of coronary artery lesion

Objective To investigate the relationship between the intensity of coronary artery lesions and the level of highsensitivity C-reactive protein(hs-CRP).Methods A total of 282 suspective patients were performed coronary artery angiography.The levels of hs-CRP and the intensity of coronary artery disorder were recorded.ResultsThe level of hs-CRP in CHD group was markedly higher than that in normal group(P 0.05).The levels of hs-CRP in 2 branch and 3 branch lesions subgroup were markedly higher than that in single branch subgroup(P 0.05).The levels of hs-CRP increased with index of coronary arterial lesion(P 0.05).The levels hs-CRP levels were positively correlated with the extent and index of coronary arterial lesion(P 0.05). Conclusion Hs-CRP increase along with aggravation in the severity of coronary lesion.
Spatial econometric analysis of provincial dependency ratio of population

DR(dependency ratio of population) is one of most cordial indicators measuring the age structure.Based on provincial data of 2008,this paper analyzes the specific spatial pattern of DR with the help of spatial econometrics models and Moran's I indicator.According to the empirical studies,there are significant clustering effects within the south-western and north-eastern regions of China.Moreover,the one-child policy and non-paralleled economic growth contribute mainly to spatial difference of DR.
Moderate hypothermia ≥24 and ≤28°C with hypothermic circulatory arrest for proximal aortic operations in patients with previous cardiac surgery

Objectives To determine whether, in patients with previous cardiac operations, moderate hypothermia (between 24 and 28°C) for hypothermic circulatory arrest (HCA) during antegrade cerebral perfusion (ACP) is safe for use during surgery on the proximal aorta and transverse aortic arch. Methods Over a 7-year period, 118 patients underwent ascending aortic and hemiarch repair (n = 70; 59.3%), total arch replacement (n = 47; 39.8%) or ascending aortic replacement to treat porcelain aorta (n = 1; 0.9%). Simultaneous procedures included aortic root repair or replacement (n = 33; 28.0%) and coronary artery bypass grafting (n = 21; 17.8%). All patients had previously undergone cardiac operations via a median sternotomy. Eighteen patients (15.3%) had more than 1 previous sternotomy, and 24 patients (20.3%) required emergent/urgent operation. Median cardiopulmonary bypass, cardiac ischaemic, circulatory arrest and ACP times (min) were 136.0 [118-180 interquartile range (IQR)], 91.0 (68-119 IQR), 34.0 (21-59 IQR) and 33.5 (20-59 IQR), respectively. The median temperature when HCA was initiated was 24.2°C (24.1-24.8°C IQR). Results The operative mortality rate was 10.2% (n = 12). Six patients (5.1%) had a permanent stroke, and 16 patients (13.6%) had a composite adverse outcome (operative mortality and/or a permanent neurological event and/or permanent haemodialysis at discharge). Preoperative renal disease was significantly more prevalent (P= 0.020) and the median circulatory arrest time significantly longer (48.5 vs 33 min; P= 0.058) in patients with composite adverse outcomes. Multivariable analysis of the redo patients showed that age (P =0.025), preoperative renal disease (P =0.024) and ACP time (P =0.012) were independent risk factors for a new postoperative renal injury. Conclusions Moderate hypothermia for HCA during ACP is being used with increasing frequency, but has not been thoroughly evaluated in patients undergoing cardiovascular reoperations. Our experience suggests that in patients with previous cardiac surgery who are undergoing hemiarch and total aortic arch operations, moderate hypothermia is safe and produces respectable results.
Mechanics of Failure in Tissue Specimens of the Apple Cortex

During harvesting and transportation, fruits and vegetables are generally subjected to mechanical forces that may bring about damage in the form of bruises and browing. In order to design fruit handling and harvest systems that do not produce any damage in fruits, a knowledge of a threshold value of loading, a fruit may sustain before bruises or browing is very much needed. The threshold value of load for a given fruit can be evaluated if a valid criterion for the tissue failure of the fruit under all possible types of loading that may occur in practice is available.
Force Protection Sensor Selector

Force Protection Sensor Selector (FPSS) is a computer application that assists security personnel in the selection of exterior intrusion detection systems best suited for maintaining force protection and physical security at a site. The FPSS software ranks intrusion detection system (IDS) suitability on the basis of known environmental impacts on sensor systems and expected operating conditions. The ranking is done both for probability of detection (Pd) and nuisance alarm rate (NAR).
Latinos’ Changing Ethnic Group Representation From Elementary to Middle School: Perceived Belonging and Academic Achievement

This study examined the association between change in ethnic group representation from elementary to middle school and Latino students' school belonging and achievement. The ethnic diversity of students' middle school was examined as a moderator. Participants were 1,825 Latino sixth graders from 26 ethnically diverse urban middle schools. Hierarchical regression analyses showed that a change in ethnic representation toward fewer Latinos in middle school than elementary school was related to less perceived belonging and lower achievement in schools with low ethnic diversity. There were no mean differences as a function of declining representation in more diverse middle schools, suggesting that greater school diversity was protective. Findings highlight the importance of examining school ethnic context, especially across the middle school transition.
Transactions Between Substance Use Intervention, the Oxytocin Receptor (OXTR) Gene, and Peer Substance Use Predicting Youth Alcohol Use.

This study investigated the oxytocin receptor (OXTR) gene’s moderation of associations between exposure to a substance misuse intervention, average peer substance use, and adolescents’ own alcohol use during the 9th-grade. OXTR genetic risk was measured using five single nucleotide polymorphisms (SNPs), and peer substance use was based on youths’ nominated closest friends’ own reports of alcohol, cigarette, and marijuana use, based on data from the PROSPER project. Regression models revealed several findings. First, low OXTR risk was linked to affiliating with friends who reported less substance use in the intervention condition but not the control condition. Second, affiliating with high substance-using friends predicted youth alcohol risk regardless of OXTR risk or intervention condition. Third, although high OXTR risk youth in the intervention condition who associated with low substance-using friends reported somewhat higher alcohol use than comparable youth in the control group, the absolute level of alcohol use among these youth was still among the lowest in the sample.
CRYSTALLINE SOYBEAN TRYPSIN INHIBITOR : II. GENERAL PROPERTIES.

A study has been made of the general properties of crystalline soybean trypsin inhibitor. The soy inhibitor is a stable protein of the globulin type of a molecular weight of about 24,000. Its isoelectric point is at pH 4.5. It inhibits the proteolytic action approximately of an equal weight of crystalline trypsin by combining with trypsin to form a stable compound. Chymotrypsin is only slightly inhibited by soy inhibitor. The reaction between chymotrypsin and the soy inhibitor consists in the formation of a reversibly dissociable compound. The inhibitor has no effect on pepsin. The inhibiting action of the soybean inhibitor is associated with the native state of the protein molecule. Denaturation of the soy protein by heat or acid or alkali brings about a proportional decrease in its inhibiting action on trypsin. Reversal of denaturation results in a proportional gain in the inhibiting activity. Crystalline soy protein when denatured is readily digestible by pepsin, and less readily by chymotrypsin and by trypsin. Methods are given for measuring trypsin and inhibitor activity and also protein concentration with the aid of spectrophotometric density measurements at 280 mmicro.
A CCA-Secure Cryptosystem Using Massive MIMO Channels

We describe the technique of physical-layer cryptography based on using a massive MIMO channel as a key between the sender and desired receiver, which need not be secret. The goal is for low-complexity encoding and decoding by the desired transmitter-receiver pair, whereas decoding by an eavesdropper is hard in terms of prohibitive complexity. The decoding complexity is analyzed by mapping the massive MIMO system to a lattice. We show that the eavesdropper’s decoder for the MIMO system with M-PAM modulation is equivalent to solving standard lattice problems that are conjectured to be of exponential complexity for both classical and quantum computers. Hence, under the widely-held conjecture that standard lattice problems are hard to solve, the proposed encryption scheme has a more robust notion of security than that of the most common encryption methods used today such as RSA and Diffie-Hellman. Additionally, we show that this scheme could be used to construct a cryptosystem that achieves security under Chosen-Ciphertext Attack, without the use of a pre-shared secret and little computational overhead. Thus, by exploiting the physical layer properties of the radio channel, the massive MIMO system provides for low-complexity encryption commensurate with the most sophisticated forms of application-layer encryption that are currently known.
Attenuation of Maladaptive Responses in Aortic Adventitial Fibroblasts through Stimuli-Triggered siRNA Release from Lipid-Polymer Nanocomplexes

Lipid-siRNA assemblies are modified with photo-responsive polymers to enable spatiotemporally-controlled silencing of interleukin 1 beta (IL1β) and cadherin 11 (CDH11), two genes that are essential drivers of maladaptive responses in human aortic adventitial fibroblasts (AoAFs). These hybrid nanocomplexes address the critical challenge of locally mitigating fibrotic actions that lead to the high rates of vascular graft failures. In particular, the lipid-polymer formulations provide potent silencing of IL1β and CDH11 that is precisely modulated by a photo-release stimulus. Moreover, a dynamic modeling framework is used to design a multi-dose siRNA regimen that sustains knockdown of both genes over clinically-relevant timescales. Multi-dose suppression illuminates a cooperative role for IL1β and CDH11 in pathogenic adventitial remodeling and is directly linked to desirable functional outcomes. Specifically, myofibroblast differentiation and cellular proliferation, two of the primary hallmarks of fibrosis, are significantly attenuated by IL1β silencing. Meanwhile, the effects of CDH11 siRNA treatment on differentiation become more pronounced at higher cell densities characteristic of constrictive adventitial remodeling in vivo. Thus, this work offers a unique formulation design for photo-responsive gene suppression in human primary cells and establishes a new dosing method to satisfy the critical need for local attenuation of fibrotic responses in the adventitium surrounding vascular grafts.
Teaching Osmosis to Biology Students

Osmosis is a fundamental concept of great importance to understanding natural biological, physical, and chemical processes. We provide an instructional guide to assist instructors of advanced high school biology and college biology students in defining questions that are central to deriving a highly developed understanding of osmosis. We present teaching activities that focus on advancing multiple hypotheses about the cause of osmosis, presenting a tentative explanation and model of osmosis, and drawing scientifically accepted conclusions about osmotic processes.
Relative contribution of different altered motor unit control to muscle weakness in stroke: a simulation study

Objective Chronic muscle weakness impacts the majority of individuals after a stroke. The origins of this hemiparesis is multifaceted, and an altered spinal control of the motor unit (MU) pool can lead to muscle weakness. However, the relative contribution of different MU recruitment and discharge organization is not well understood. In this study, we sought to examine these different effects by utilizing a MU simulation with variations set to mimic the changes of MU control in stroke. Approach Using a well-established model of the MU pool, this study quantified the changes in force output caused by changes in MU recruitment range and recruitment order, as well as MU firing rate organization at the population level. We additionally expanded the original model to include a fatigue component, which variably decreased the output force with increasing length of contraction. Differences in the force output at both the peak and fatigued time points across different excitation levels were quantified and compared across different sets of MU parameters. Main results Across the different simulation parameters, we found that the main driving factor of the reduced force output was due to the compressed range of MU recruitment. Recruitment compression caused a decrease in total force across all excitation levels. Additionally, a compression of the range of MU firing rates also demonstrated a decrease in the force output mainly at the higher excitation levels. Lastly, changes to the recruitment order of MUs appeared to minimally impact the force output. Significance We found that altered control of MUs alone, as simulated in this study, can lead to a substantial reduction in muscle force generation in stroke survivors. These findings may provide valuable insight for both clinicians and researchers in prescribing and developing different types of therapies for the rehabilitation and restoration of lost strength after stroke.
Novel polymorphisms associated with hyperalphalipoproteinemia and apparent cardioprotection

Background Hyperalphalipoproteinemia (HALP) is inversely correlated with coronary heart disease (CHD) although genetic variants associated with high serum levels of high-density lipoprotein cholesterol (HDL-C) have not been shown to be cardioprotective. Objective The objective of the study was to uncover novel genetic variants associated with HALP and possibly with reduced risk of CHD. Methods Exome sequencing data, HDL-C, and triglyceride levels were analyzed in 1645 subjects. They included the University of Maryland outpatients with high HDL-C ( n = 12), Cardiovascular Health Study ( n = 210), Jackson Heart Study ( n = 402), Multi-Ethnic Study of Atherosclerosis ( n = 404), Framingham Heart Study ( n = 463), and Old Order Amish ( n = 154). Results Novel nonsynonymous single-nucleotide polymorphisms (nsSNPs) were identified in men and women with primary HALP (mean HDL-C, 145 ± 30 mg/dL). Using PolyPhen-2 and Combined Annotation Dependent Depletion to estimate the predictive effect of each nsSNP on the gene product, rare, deleterious polymorphisms in UGT1A3, PLLP, PLEKHH1, ANK2, DIS3L, ACACB , and LRP4 were identified in 16 subjects with HALP but not in any tested subject with low HDL-C ( OSBPL1A . The majority of these candidate genes have been implicated in fat and lipid metabolism, and none of these subjects has a history of CHD despite 75% of subjects having risk factors for CHD. Overall, the probability of finding these nsSNPs in a non-high HDL-C population ranges from 1 × 10 −17 to 1 × 10 −25 . Conclusion Novel functional polymorphisms in 8 candidate genes are associated with HALP in the absence of CHD. Future study is required to examine the extent to which these genes may affect HDL function and serve as potential therapeutic targets for CHD risk reduction.
‘Behavioral modernity’ as a process, not an event, in the human niche

The search for ‘firsts’ is a common trope in the study of human evolution. Both popular books and scientific articles attempt to discern the key moments in evolutionary history that indicate the tr...
Trial Lawyers in Trouble: Litigation Misconduct and Its Ethics Fallout

Misconduct in civil litigation is not a new phenomenon. Nor is it confined to particular types of cases. Because of their characteristic intensity, however, intellectual property cases may be more likely to inspire bad behavior than other types of cases. In patent cases, in particular, often much is at stake for both counsel and client. The potential outcomes range from a judgment for the patent owner, potentially including trebled lost profits, a permanently enjoined infringer and even an attorney fees award, to a ruling that the asserted patent is partly or entirely invalid, or even unenforceable, with the patent owner ordered to pay the infringement defendant’s attorney fees. And the complexity and potential intensity only increase when multiple patents and/or multiple accused products are involved. The associated pressures seem, on occasion, to lead litigants and trial lawyers to succumb to the temptation to step outside the bounds of vigorous advocacy. Where to draw the line can be a challenging question. And the stakes are high. Courts have the power to impose a wide variety of sanctions on parties and their counsel. The lawyers involved risk injury to their reputations and even, potentially, bar discipline. Following an overview of the key sanctions regimes available to the federal courts, this paper draws on some recent IP decisions examining litigation conduct to illustrate the range of conduct with which courts must contend and the application of various sanctions frameworks. It updates and augments a previous draft (Lawyers Acting Badly, or Not? Misconduct in IP Litigation: Recent Examples and the Issues They Raise (June 29, 2010). Available at SSRN: http://ssrn.com/abstract=1632502, including by incorporating a discussion of the relationship between litigation misconduct and state and U.S. Patent and Trademark Office (“USPTO”) ethics rules, and the potential ethics fallout from litigation conduct that crosses the line.
Meta-Anthropology: Semiotics in and out of Culture

Umberto Eco’s (1976:7–8) by now classic characterization of semiotics as a “field” rather than a “discipline” invites two responses from anthropologists: first, that it is time to do some “fieldwork,” to examine the presuppositions and cultural matrix within which the global and interdisciplinary aims of semiotics have been generated; and second, to ask what elements of semiotic theory and terminology would bring the ethnographic analysis of societies and cultures into a common framework with literary theory, poetics, legal and linguistic philosophy, and so on.
A uranium(IV) imido amido triazenido complex formed via addition of a CH bond across a UN multiple bond

Abstract Addition of three equivalents of KC8 to a mixture of UI3(1,4-dioxane)1.5 and three equivalents of a bulky m-terphenyl azide led to the isolation of a uranium(IV) complex containing an imido, an amido, and a triazenido group on the same metal center. The amido moiety was formed via addition of an aryl C H bond across a U Nimido bond, and an equivalent of the terphenyl azide inserted into the resulting U C bond. X-ray crystallography revealed a highly asymmetric solid-state structure, and 1H NMR spectroscopy confirmed low solution-state symmetry. This work demonstrates alternate reaction pathways that must be considered when attempting to prepare uranium complexes with multiple imido groups.
The use of a novel tablet application to quantify dysfunction in cervical spondylotic myelopathy patients.

Abstract Background Context Despite the prevalence and importance of myelopathy, there is a paucity of objective and quantitative clinical measures. The most commonly used diagnostic tools available are nonquantitative physical exam findings (eg, pathologic reflexes, and gait disturbance) and subjective scoring systems (eg, modified Japanese Orthopaedic Association [mJOA]). A decline in fine motor coordination is a hallmark of early myelopathy, which may be useful for quantitative testing. Purpose To identify if a novel tablet application could provide a quantitative measure of upper extremity dysfunction in cervical spondylotic myelopathy. Study Design/Setting Prospective cohort study Patient Sample: Adult patients with a diagnosis of cervical spondylotic myelopathy from a board-certified, spine surgeon were compared with age-matched, healthy, and adult control patients. Outcome Measures: Self-reported function was assessed via the mJOA. Upper extremity function was measured via the fine motor skills (FiMS) tablet test. Methods Subjects and controls prospectively completed the mJOA paper survey and the FiMS tablet testing, which consisted of four challenges. Results After age-matching, 65 controls and 28 myelopathic patients were available for comparison. The mean mJOA was 13.5 ± 2.9 in the myelopathic cohort and 17.3 ± 1.1 in the control cohort (p Conclusions The FiMS tablet application produced significantly lower scores in a myelopathic cohort when compared with an age-matched control cohort. This is true for all four challenges in the FiMS tablet application. The test can be completed in 1.5 minutes, producing a reliable, quantitative measure of cervical myelopathy upper extremity function. In summary, the FiMS tablet application is a novel, easily administered, objectively quantifiable test for analyzing cervical spondylotic myelopathy.
Clinical-radiographic correlates of Artery of Percheron infarcts in a case series of 6 patients

Abstract Bilateral thalamic strokes due to Artery of Percheron (AOP) occlusion are rare but have been previously reported in the literature. It is due to a rare anatomic variant where a solitary arterial trunk from the proximal segment of either posterior cerebral artery (PCA) supplies bilateral thalami and midbrain. Despite its description in the literature, these strokes are usually missed and patient’s symptoms are not thought to be secondary to a vascular etiology. Through this report we aim to describe the clinical and radiographic features seen in these patients. We describe a series of 6 patients who present with varying levels of somnolence and oculomotor nerve palsies who had an occlusion of the AOP with bilateral thalamic infarcts with midbrain involvement. These clinical presentations, combined with the “V” sign on MRI are important in making the diagnosis.
Phosphate addition increases tropical forest soil respiration primarily by deconstraining microbial population growth

Abstract Tropical ecosystems are an important sink for atmospheric CO2; however, plant growth is restricted by phosphorus (P) availability. Although soil microbiota facilitate organic P turnover and inorganic P mobilization, their role in carbon-phosphorus coupled processes remains poorly understood. To advance this topic, soils collected from four sites representing highly weathered tropical soils in the El Yunque National Forest, Puerto Rico were incubated with exogenous PO43− under controlled laboratory conditions. P amendment increased CO2 respiration by 14–23% relative to control incubations for soils sampled from all but the site with the greatest total and bioavailable soil P. Metatranscriptomics revealed an increase in the relative transcription of genes involved in cell growth and uptake of other nutrients in response to P amendment. A new methodology to normalize gene expression by population-level relative (DNA) abundance revealed that the pattern of increased transcription of cell growth and division genes with P amendment was community-wide. Soil communities responsive to P amendment possessed a greater relative abundance of α-glucosyl polysaccharide biosynthesis genes, suggestive of enhanced C storage under P-limiting conditions. Phosphorylase genes governing the degradation of α-glucosyl polysaccharides were also more abundant and increased in relative transcription with P amendment, indicating a shift from energy storage towards growth. Conversely, microbial communities in soils nonresponsive to P amendment were found to have metabolisms tuned for the phosphorolysis of labile plant-derived substrates, such as β-glucosyl polysaccharides. Collectively, our results provided quantitative estimates of increased soil respiration upon alleviation of P constraints and elucidated several underlying ecological and molecular mechanisms involved in this response.
Psychometric properties and correlates of a brief scale measuring the psychological construct mattering to others in a sample of women recovering from breast cancer.

Mattering to others, or perceiving one is a significant part of the social world, may be important to breast cancer survivors’ quality of life. This study examines the reliability and validity of the 5-item general mattering scale (GMS) to assess mattering in breast cancer survivors. A secondary analysis and confirmatory factor analysis (CFA) were performed on data from an intervention study with breast cancer survivors that included the GMS and other psychological measures. The unidimensional representation of the GMS was consistent with the data (χ2 = 8.102; df = 4; p = .088). The scale was highly reliable as indicated by McDonald’s omega of .84. The scale was significantly correlated with all psychological measures in the predicted direction except anxiety. After controlling for social support, the scale was significantly, positively correlated with functional quality of life, self-esteem, positive affect, and having meaning in life. Mattering was significantly, negatively correlated with searching for meaning. Significantly higher level of mattering was found among married participants and among women who had not obtained psychological therapy. The 5-item GMS is a practical, reliable, and valid tool the measuring mattering to others among breast cancer survivors.
Effect of ion concentration on the properties of polyisoprene-sodium styrene sulfonate elastomeric ionomers prepared by emulsion polymerization

Abstract A series of isoprene and sodium styrene sulfonate copolymers (poly(I-co-NaSS)) was synthesized with systematically varied concentrations of ions using radical emulsion polymerization. Their chemical structures and morphologies were characterized and structure-mechanical relationships were determined. The SAXS scattering profiles and the thermal properties remained unchanged as ion content increased. In contrast, the toughness and stiffness of the copolymers increased and the adhesion strength was significantly improved as the ion content increased from 1.2 mol % to 4.6 mol % NaSS.
Dyadic Causal Sequencing of Depressive Symptoms and Relationship Satisfaction in Romantic Partners Across Four Years

Causal sequencing between relationship satisfaction and depressive symptoms has important ramifications for couples therapy. Using dyadic data from the Pairfam study (N = 1,876 German couples), an ...
On the Calculus of Counterterror Policy

In democratic societies, elections can act as a referendum on politicians’ counterterror policy. At the same time, counterterror policy is conducted under conditions of asymmetric information becau...
V2a interneuron differentiation from mouse and human pluripotent stem cells

V2a interneurons are located in the hindbrain and spinal cord, where they provide rhythmic input to major motor control centers. Many of the phenotypic properties and functions of excitatory V2a interneurons have yet to be fully defined. Definition of these properties could lead to novel regenerative therapies for traumatic injuries and drug targets for chronic degenerative diseases. Here we describe how to produce V2a interneurons from mouse and human pluripotent stem cells (PSCs), as well as strategies to characterize and mature the cells for further analysis. The described protocols are based on a sequence of small-molecule treatments that induce differentiation of PSCs into V2a interneurons. We also include a detailed description of how to phenotypically characterize, mature, and freeze the cells. The mouse and human protocols are similar in regard to the sequence of small molecules used but differ slightly in the concentrations and durations necessary for induction. With the protocols described, scientists can expect to obtain V2a interneurons with purities of ~75% (mouse) in 7 d and ~50% (human) in 20 d. V2a interneurons are differentiated from mouse and human pluripotent stem cells following culture in the presence of a sequence of small-molecule treatments.
Chemo-immunotherapy combination after PD-1 inhibitor failure improves clinical outcomes in metastatic melanoma patients

Management of PD-1 blockade resistance in metastatic melanoma (MM) remains challenging. Immunotherapy or chemotherapy alone provides limited benefit in this setting. Chemo-immunotherapy (CIT) has demonstrated favorable efficacy and safety profiles in lung cancer. Our pre-clinical study showed that in MM patients who have failed PD-1 blockade, the addition of chemotherapy increases CX3CR1+ therapy-responsive CD8+ T-cells with enhanced anti-tumor activity, resulting in improved clinical response. Here, we examined the clinical outcomes of CIT in MM patients after PD-1 blockade failure and the treatment-related changes in CX3CR1+ therapy-responsive CD8+ T-cells. We reviewed MM patients seen between January 2012 and June 2018 who failed anti-PD-1-based therapy and received subsequent CIT, immune checkpoint inhibitors (ICI) or chemotherapy alone. Overall survival (OS), objective response rate (ORR), event-free survival (EFS), and toxicities were assessed. Among 60 patients, 33 received CIT upon disease progression on PD-1 blockade. At a median follow-up of 3.9 years, the CIT group had a median OS of 3.5 years [95% confidence interval (CI) 1.7-NR] vs. 1.8 years (95% CI 0.9-2; P = 0.002) for those who received subsequent ICI (n = 9) or chemotherapy alone (n = 18), with ORR of 59% vs. 15% (P = 0.0003), respectively. The median EFS was 7.6 months (95% CI 6-10) following CIT vs. 3.4 months (95% CI 2.8-4.1; P = 0.0005) following ICI or chemotherapy alone. Therapy-responsive CX3CR1+CD8+ T-cells showed dynamic increase with successful CIT. CIT showed favorable clinical outcomes and acceptable safety profile in PD-1 blockade-resistant patients. CX3CR1+CD8+ therapy-responsive T-cells can be potentially used for monitoring disease response to CIT.
Lorente de Nó, Rafael

Rafael Lorente de No (1902–90) was a Spanish-American neuroanatomist, electrophysiologist, and otolaryngologist who made seminal observations of cerebral cortical anatomy, neuronal activation, and synaptic transmission. The last and the most prominent student of Santiago Ramon y Cajal, Lorente de No described the columnar organization of the cerebral cortex; his monumental 1947 text A Study of Nerve Physiology was destined to guide several generations of experimental electrophysiologists.
Association between anxiety, depression, and emotional distress and hypoglossal nerve stimulator adherence.

To evaluate relationships between hypoglossal nerve stimulator (HNS) adherence and the presence of anxiety, depression, and emotional distress. This is a cross-sectional study of subjects with moderate to severe obstructive sleep apnea (OSA), who had HNS implanted and activated at The Ohio State University Medical Center (OSUMC). Patient usage data from the previous 6 months was obtained from 33 patients. Adherence was defined as ≥28 h of use per week. Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were administered, and the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) score was calculated for all subjects. Sixty-five percent were adherent with average usage of 46.5±11.7 h per week vs 7.7±7.5 h per week in the non-adherent group. The average GAD-7 were 3.90±3.98 in the adherent group vs. 8.27±6.69 in the non-adherent group (p=0.049). PHQ-9 score was 6.15±4.31 vs. 10.09±7.53 (p=0.118), and PHQ-ADS was 10.05±7.49 vs. 19.20±9.80 (p=0.035). There were no statistically significant differences in age, gender, pre-treatment AHI, and post-treatment AHI between the two groups, though there was a trend to higher age in the adherent group. This study demonstrated higher GAD-7 and PHQ-ADS scores in the non-adherent group compared to those who were adherent to HNS supporting that anxiety and emotional distress may contribute to HNS therapy adherence. To our knowledge, this is the first study evaluating the relationship between anxiety, depression, emotional distress, and HNS adherence. Screening patients with the GAD-7 and PHQ-9 prior to implantation may be helpful when evaluating patient adherence to therapy.
Rural-urban differences in stroke risk

Abstract Rural-urban health disparities in life expectancy are large and increasing, with the rural-urban disparity stroke mortality serving as a potential contributor. Data from Vital Statistics shows an unexplained temporal pattern in the rural-urban disparity in stroke-specific mortality, with the magnitude of the disparity increasing from 15% to 25% between 1999 and 2010, but subsequently decreasing to 8% by 2019. This recent decrease in the magnitude of the rural-urban disparity in stroke mortality appears to be driven by a previously unreported plateauing of stroke mortality in urban areas and a continued decline of stroke mortality in rural areas. There is a need to better understand the contributors to these temporal changes; however, a general lack of temporal data on potential contributors prevents this investigation. However considering contributors to the rural-urban differences pooled across time, an overall a higher stroke incidence in rural areas appears to be a contributor to the higher rural stroke mortality, with this higher incidence potentially associated with a higher prevalence of stroke risk factors in rural areas. Conversely, studies assessing rural-urban disparities in stroke case fatality show smaller and inconsistent associations. To the extent that disparities in case fatality do exist, there are many studies showing rural-urban disparities in stroke care could be contributing. While these data offer insights to the overall rural-urban disparities in stroke mortality, additional data are needed to help understand temporal changes in the magnitude of the rural-urban stroke mortality disparity.
Clinical and patient-reported outcomes of reverse shoulder arthroplasty in patients receiving Social Security Disability Insurance or workers’ compensation

Abstract Background Evidence suggests that reverse shoulder arthroplasty (RSA) patients receiving workers’ compensation (WC) have worse patient-reported outcomes (PROs) than those not receiving WC. It is unknown whether Social Security Disability Insurance (SSDI) recipients also have worse outcomes of RSA. Our goals were to (1) compare PROs and range of motion (ROM) after RSA according to whether patients were receiving SSDI, WC, or neither form of assistance, and (2) identify factors associated with poor PROs. Methods From a US institutional database of 454 patients who underwent RSA from January 2009 through December 2016, we identified 19 SSDI recipients and 25 WC recipients. From the same database, we created a control group of 81 patients not receiving SSDI or WC, matched by demographic variables. Between groups, we compared age, sex, operative arm dominance, preoperative diagnosis, number of previous shoulder surgeries, primary or revision arthroplasty, and Charlson Comorbidity Index value. Patients were evaluated preoperatively and at a minimum of 2 years postoperatively by physical examination, including range of motion, visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, L'Insalata score, Simple Shoulder Test (SST), and Western Ontario Osteoarthritis of the Shoulder (WOOS) score. Significance was set at P Results Both the SSDI and WC groups experienced statistically significant improvements from preoperatively to postoperatively; these improvements exceeded MCID thresholds for forward flexion and abduction, VAS for pain, ASES (except in WC group), and SST score (all, P Conclusion Among RSA patients, SSDI recipients did not have worse clinical outcomes than WC recipients. Having undergone ≥2 previous procedures on the same shoulder was associated with poor outcomes in both groups. These findings should be considered when determining the appropriateness of RSA for SSDI and WC recipients. Level of evidence Level III; Retrospective Cohort Comparison; Treatment Study
Alzheimer’s Disease Genetics: A Dampened Microglial Response?:

Alzheimer's disease (AD) is a debilitating age-related neurodegenerative condition. Unbiased genetic studies have implicated a central role for microglia, the resident innate immune cells of the central nervous system, in AD pathogenesis. On-going efforts are clarifying the biology underlying these associations and the microglial pathways that are dysfunctional in AD. Several genetic risk factors converge to decrease the function of activating microglial receptors and increase the function of inhibitory receptors, resulting in a seemingly dampened microglial phenotype in AD. Moreover, many of these microglial proteins that are genetically associated with AD appear to interact and share pathways or regulatory mechanisms, presenting several points of convergence that may be strategic targets for therapeutic intervention. Here, we review some of these studies and their implications for microglial participation in AD pathogenesis.
Using the Examen, a Jesuit Prayer, in Spiritually Integrated and Secular Psychotherapy

The Examen is a 500-year-old end of day prayer developed by St. Ignatius of Loyola, founder of the Society of Jesus (better known as the Jesuits). Like many other religious or spiritual practices, such as mindfulness and yoga, the Examen is suitable as either a spiritually focused or secular intervention strategy to assist people within clinical psychotherapy practice and elsewhere. Adapting the Examen as a cognitive behavioral psychotherapy intervention is easy to do and may add another important tool to the toolbox of practicing clinicians interested in thoughtfully integrating spiritually based approaches in their clinical work with religiously as well as nonreligiously minded clients.