cssi/SciSciGPT-SciSciNet huggingface dataset:
Compulsory health insurance: "the next great step in social legislation."

D URING the first two decades of this century, government-supported health insurance for workingmen was a vital issue. In 1916 Dr. Rupert Blue predicted in his presidential address to the American Medical Association: "Health insurance will constitute the next great step in social legislation."' There were strong European precedents for his prophecy. In 1883 the German Reichstag had adopted a compulsory sickness insurance law which offered protection to limited groups of industrial laborers and was later expanded to cover certain classes of agricultural and white collar workers. Before 1900, Germany had adopted additional laws which provided state aid for the aged and victims of industrial accidents. These statutes, the first of their kind, attracted the attention of reform-minded people all over the world. By 1911, many other European nations had adopted similar programs, eleven of which included some form of health insurance.2 Meanwhile, among American intellectuals, interest in the idea developed steadily enough to justify Blue's enthusiasm. John Graham Brooks' Compulsory Insurance in Germany, published in 1893 by the United States Commission of Labor, was the first such study in this country. A Unitarian minister who left the pulpit in order to devote full time to labor problems, Brooks outlined the German innovations and expressed hope that they might "have at least some possible relation to a future consideration here."3 Five years later a second book appeared on the subject: Workingmen's Insurance by William F. Willoughby, an official in the Department of Labor. Willoughby surveyed the entire field of European social programs but he, too, did not recommend the adoption of any similar plan in America. In-
Nonlinear Absorbing Cationic Iridium(III) Complexes Bearing Benzothiazolylfluorene Motif on the Bipyridine (N∧N) Ligand: Synthesis, Photophysics and Reverse Saturable Absorption

Four new heteroleptic cationic Ir(III) complexes bearing benzothiazolylfluorene motif on the bipyridine (N∧N) (1 and 2) and phenylpyridine (C∧N) (3 and 4) ligands are synthesized and characterized. The influence of the position of the substituent and the extent of π-conjugation on the photophysics of these complexes is systematically investigated by spectroscopic methods and simulated by time-dependent density functional theory (TDDFT). The complexes exhibit ligand-centered 1π,π* transitions with admixtures of 1ILCT (π(benzothiazolylfluorene) → π*(bpy)) and 1MLCT (metal-to-ligand charge transfer) characters below 475 nm, and very weak 1,3MLCT and 1,3LLCT (ligand-to-ligand charge transfer) transitions above 475 nm. The emission of these complexes at room temperature in CH2Cl2 solutions is ascribed to be predominantly from the 3MLCT/3LLCT states for 1 and from the 3π,π* state for 2, while the emitting state of 3 and 4 are assigned to be an admixture of 3MLCT, 3LLCT, and 3π,π* characters. The variations of t...
Neural Integration Underlying a Time-Compensated Sun Compass in the Migratory Monarch Butterfly

Migrating eastern North American monarch butterflies use a time-compensated sun compass to adjust their flight to the southwest direction. Although the antennal genetic circadian clock and the azimuth of the sun are instrumental for proper function of the compass, it is unclear how these signals are represented on a neuronal level and how they are integrated to produce flight control. To address these questions, we constructed a receptive field model of the compound eye that encodes the solar azimuth. We then derived a neural circuit model that integrates azimuthal and circadian signals to correct flight direction. The model demonstrates an integration mechanism, which produces robust trajectories reaching the southwest regardless of the time of day and includes a configuration for remigration. Comparison of model simulations with flight trajectories of butterflies in a flight simulator shows analogous behaviors and affirms the prediction that midday is the optimal time for migratory flight.
Management of hypertensive emergencies.

Reserpine given intramuscularly is effective in most hypertensive emergencies. Pentolinium is preferred in congestive heart failure, if somnolence is undesirable or if rapid action is needed. Sodium nitroprusside is potent but requires close supervision of the patient.
Isolated replacement of the mitral valve with the Starr-Edwards prosthesis.

Isolated mitral valve replacement with the Starr-Edwards prosthesis has been performed on 657 patients at the Mayo Clinic during the 11 year period ending January, 1972. The most recent subset of that series comprised patients who received the Model 6120 prosthesis. In this group, the operative mortality rate was 9 per cent and the actuarial late death rate at 5 years was 20 per cent. This survival rate is a significant improvement over the natural history of severe mitral valve disease. Factors associated with operative deaths are large left atrial size, advanced functional class, and previous heart surgery. Variables associated with higher incidence of late deaths are large left atrial size, patient age at operation, and multivalve disease. Risk of thromboembolism is increased with large left atrial size, presence of left atrial thrombus, and inadequate anticoagulant therapy.
Restrictive Cardiomyopathy Troponin I R145W Mutation Does Not Perturb Myofilament Length-dependent Activation in Human Cardiac Sarcomeres

The cardiac troponin I (cTnI) R145W mutation is associated with restrictive cardiomyopathy (RCM). Recent evidence suggests that this mutation induces perturbed myofilament length-dependent activation (LDA) under conditions of maximal protein kinase A (PKA) stimulation. Some cardiac disease-causing mutations, however, have been associated with a blunted response to PKA-mediated phosphorylation; whether this includes LDA is unknown. Endogenous troponin was exchanged in isolated skinned human myocardium for recombinant troponin containing either cTnI R145W, PKA/PKC phosphomimetic charge mutations (S23D/S24D and T143E), or various combinations thereof. Myofilament Ca2+ sensitivity of force, tension cost, LDA, and single myofibril activation/relaxation parameters were measured. Our results show that both R145W and T143E uncouple the impact of S23D/S24D phosphomimetic on myofilament function, including LDA. Molecular dynamics simulations revealed a marked reduction in interactions between helix C of cTnC (residues 56, 59, and 63), and cTnI (residue 145) in the presence of either cTnI RCM mutation or cTnI PKC phosphomimetic. These results suggest that the RCM-associated cTnI R145W mutation induces a permanent structural state that is similar to, but more extensive than, that induced by PKC-mediated phosphorylation of cTnI Thr-143. We suggest that this structural conformational change induces an increase in myofilament Ca2+ sensitivity and, moreover, uncoupling from the impact of phosphorylation of cTnI mediated by PKA at the Ser-23/Ser-24 target sites. The R145W RCM mutation by itself, however, does not impact LDA. These perturbed biophysical and biochemical myofilament properties are likely to significantly contribute to the diastolic cardiac pump dysfunction that is seen in patients suffering from a restrictive cardiomyopathy that is associated with the cTnI R145W mutation.
Intelligent battery management for cellular networks with hybrid energy supplies

Green communications has received much attention in recent years. In cellular networks, base stations (BSs) account for more than 50 percent of the energy consumption. Reducing energy consumption of BSs is essential to realize green cellular networks. Utilizing green energy to power BSs is a promising way to reduce the on-grid energy consumption. Owing to the dynamics of both mobile traffic loads and green energy, the mismatch between the energy demands and green energy generation in a BS results in inefficient green energy utilization. Managing the battery in BSs can control the green energy usage in individual time slots, thus alleviating the inefficiency caused by the mismatch. In this paper, we propose an intelligent battery management mechanism to optimize the green energy utilization in BSs based on the Markov Decision Process (MDP). A large number of states in the Markov chain are required to model the dynamics of solar radiation and BS workload demands. Thus, the original MDP optimal policy iteration method incurs a high computational complexity. Therefore, we propose some heuristics to approximate the optimal energy dispatching strategy with low computational complexity, and validate the performance of the proposed algorithm through extensive simulations.
Intracellular delivery of the PTEN protein using cationic lipidoids for cancer therapy

The phosphatase and tensin homolog deleted on chromosome 10 (PTEN) is a tumor suppressor, mutated or inactive in a large percentage of human cancers. Restoring PTEN activity in cancer cells through gene therapy has shown to inhibit cell growth and induce apoptosis, particularly in cells with a PTEN deficiency. Gene therapy, however, comes with some inherent risks such as triggering an immune response and permanent off target effects. Nanoparticle assisted protein delivery could mitigate these liabilities while maintaining therapeutic integrity. In this report, we evaluated the use of cationic lipid-like (lipidoid) materials to intracellularly deliver the PTEN protein. We synthesized a small library of cationic lipidoid materials and screened for the delivery of PTEN based on cell viability. The lipidoid material EC16-80 was selected for high efficacy and the subsequent lipidoid-protein complex was characterized using DLS, zeta potential, and TEM. Intracellular delivery of PTEN with EC16-80 to the PTEN deficient prostate cancer cell line PC-3 resulted in a significant decrease in activated AKT and induced apoptosis. Interestingly, delivery of PTEN to PTEN deficient prostate cancer cell lines PC-3 and LNCaP compared to the breast cancer cell line, MCF-7 with endogenous PTEN, resulted in significantly lower IC50 values in PC-3 and LNCaP cells indicating that the treatment is predominantly specific to PTEN-deficient cells. Altogether, these results demonstrate the first intracellular delivery of recombinant PTEN using a synthetic delivery vehicle and highlight the potential of intracellular PTEN protein delivery as a potential targeted cancer therapy.
Characteristics of Collaboration Among Academic and Practice Partners: A Pilot Study

Abstract Collaboration involved in partnerships among nurses from academic and practice organizations was crucial to developing models for academic progression. Through the work of the New Jersey Action Coalition, competency-based curricular models were designed to support seamless transitions across diploma and associate degree nursing programs to baccalaureate programs. The purpose of this descriptive study was to measure 5 dimensions of collaboration among these nurses and to suggest best practices for future work involving collaboration.
Effect of cerebrospinal fluid modeling on spherically convergent shear waves during blunt head trauma

The MRI-based computational model, previously validated by tagged MRI and harmonic phase imaging analysis technique on in vivo human brain deformation, is used to study transient wave dynamics during blunt head trauma. Three different constitutive models are used for the cerebrospinal fluid: incompressible solid elastic, viscoelastic, and fluid-like elastic using an equation of state model. Three impact cases are simulated, which indicate that the blunt impacts give rise not only to a fast pressure wave but also to a slow, and potentially much more damaging, shear (distortional) wave that converges spherically towards the brain center. The wave amplification due to spherical geometry is balanced by damping due to tissues' viscoelasticity and the heterogeneous brain structure, suggesting a stochastic competition of these 2 opposite effects. It is observed that this convergent shear wave is dependent on the constitutive property of the cerebrospinal fluid, whereas the peak pressure is not as significantly affected.
A Serious Game to Teach Computing Concepts

In this work, we discuss our ongoing project to design a serious game to teach advanced programming concepts in C++. These concepts are challenging for students to learn; our game is a fun and motivating way for students to learn and practice their understanding. Our game, Point Mouster, was designed and developed by women Computer Science majors and is part of a study to examine whether games with specific design elements can help recruit and retain female students. We report on a pilot study of our game conducted at Brooklyn College and the College of Staten Island. Students, including an unusually high number of female participants, demonstrated educational effectiveness, and reported high levels of motivation and engagement.
Assimilation at the Cost of Authenticity: Kenji Yoshino's 'Covering: The Hidden Assault on Our Civil Rights'

Writing from a place of courage and conviction lifted from doubt and pain, author Kenji Yoshino emotively sheds layers of his covered self to make real his case for human authenticity in his book "Covering: The Hidden Assault on Our Civil Rights." Yoshino offers us a work that infuses cultural insight into legal argumentation, interlaced with his own exquisitely narrated story as a gay, Asian-American man. In his book, Yoshino elaborates on the concept of “covering” as termed by sociologist Erving Goffman, explaining that covering is the act of downplaying a disfavored identity—even when this identity is known or apparent to others—in order to present oneself more palatably as part of the so-called American mainstream. Yoshino begins his discussion from the vantage point of gay covering as this relates most closely to his own experience, followed by a broader examination of other forms of group identity–based covering: racial covering, sex-based covering, disability-based covering, and religious covering. All of these behaviors may seem harmless, and even beneficial in the name of American assimilation, but Yoshino maintains that the cultural imperative to conform to dominant-group norms is the under-noticed harm of assimilation—a harm that impedes the full advancement of historically marginalized groups. Yoshino acknowledges that assimiliation is, to some extent, a necessary part of social life. He nonetheless wants us to seriously consider the ways in which assimilation serves to undermine the goals of the civil-rights movement by maintaining the cultural status quo of dominant groups.
Ribosomal Architecture: Constraints Imposed by the Need for Self-Production

Summary Ribosomes contain proteins that must themselves be made by ribosomes. A new study shows that splitting ribosomal protein content into many small, similarly sized units maximizes the efficiency of this synthesis, suggesting that ribosomal architecture has been shaped by evolutionary pressure to efficiently self-synthesize.
Towards Reliable Online Services Analyzing Mobile Sensor Big Data

Sensors are pervasively deployed on mobile devices with the development of Internet of Things technology. Value-added services are innovated and developed by analyzing data streams from massive number of mobile sensors in online mode. Due to dynamic working condition of mobile sensors and the high data rate, back end analytic services confront incoming streams with large rate fluctuation and out-of-order time series. This puts forward special challenges in service implementation for commercial applications, where good reliability/scalability performance is a must. In this paper, a data ingestion and scheduling framework is proposed to enable large-scale tempo-spatial streams analysis in a reliable and cost-effective way. A case study on a real world application adopting this framework is introduced and its pilot result is presented.
Placement of central venous lines for sepsis in the elderly has markedly increased-Evidence from a cohort of New Jersey (USA) emergency departments.

Abstract Background Early goal directed therapy for sepsis patients requires placement of central lines (CVPL) to measure central pressure. Objective We hypothesized that the percentage of CVPL placed for sepsis has increased over time, whereas the frequency of lines placed for other conditions has not changed. Methods This was a retrospective cohort study. Investigators analyzed records from consecutive ED patients in nine hospitals over a 10-year period. Patients >65 years identified with CVPL by CPT codes and diagnoses established by ICD-9 codes. We computed the annual number of patients that had a CVPL placed for sepsis and other conditions. We calculated the change from 2005 and 2014 in the normalized number of patients >65 with sepsis and other conditions and the 95% confidence intervals (CIs). We normalized the annual number of CVPLs by the average number of total annual visits for those >65 years as the annual visits in the >65 years cohort increased by > 25% over the course of the study. We then plotted the annual number of normalized CVPLs for sepsis and other conditions placed versus year and computed the linear regression coefficients (R2). Alpha was set at 0.05. Results Of the 3,772520 visits in the data base there were 711,435 visits by patients >65 years; 3184 (0.45%) had CVPL placed and 784 of those patients were treated for sepsis. The percent of patients with CVPL for sepsis increased 212% (95% CI: 115% to 356%) from 2005 to 2014, but there was no statistically significant annual change in percent of CVPL placed for other conditions (10% decrease, 95% CI: −26% to 9%). The linear regression coefficient for the plot of annual normalized number of CVPLs vs. year (See table and plot) was statistically significant for sepsis (R2 = 0.94, p Conclusion We found that CVPL placed for sepsis tripled from 2004 to 2011, whereas CVPL placed for other conditions did not change significantly.
Clinical Excellence in Palliative Care: Examples From the Published Literature

Background:With the expansion of palliative care, the concept of clinical excellence is worthy of study and has not been described well in the literature.Objective:To apply the domains of clinical excellence, as proposed and published by the Miller Coulson Academy of Clinical Excellence, to the field of palliative care.Design:Review of the literature to identify episodes of superb palliative care delivered by individuals and teams.Measurement and Main Results:In reviewing 821 publications, we found multiple palliative care case reports to serve as exemplars for each of the distinct domains of clinical excellence.Conclusions:The domains of excellence are relevant and applicable to the field of palliative care. This article aims to inspire clinicians—and advance the field—by promoting thoughtful reflection on what clinical excellence in palliative care entails.
Peer effects in marathon racing: The role of pace setters

Abstract Marathon races are rank-order tournaments with prizes determined primarily by relative performance. As a result, peer performance is an important determinant of an individual's performance. Peer effects have been extensively studied in a variety of settings, with much of the research concerned with finding a measure of peer performance that is exogenous. We focus our research on marathon races with pace setters as their presence allows for us to identify exogenous peer effects by identifying variation in peer performance and ability that is exogenous. Using data on elite male runners from 2009 to 2014 marathons in Berlin, Chicago, and London, we find the presence of negative exogenous peer effects and this result is robust to a number of peer performance variables. We attribute our result to the self-sorting of runners by ability and the subsequent invidious comparison that occurs in marathons with pace setters.
Imaging of Intracystic Papillary Carcinoma

Abstract OBJECTIVE To describe the clinical, imaging, and histopathologic findings of intracystic papillary carcinoma (IPC) of the breast. MATERIALS AND METHODS Following institutional review board approval, a database at a single institution was searched to identify cases of patients who received a diagnosis of IPC from 1999-2013 and who had undergone preoperative imaging with mammography, sonography, or MRI. The clinical, mammographic, sonographic, and MRI features of IPC were compared and analyzed using the BI-RADS mammography, ultrasound, and MRI lexicons. RESULTS The study sample included 40 patients, 36 females and 4 males. The most common clinical presentation was a palpable mass. Mammographic data was assessed in 31 patients. A tumor was mammographically occult in one patient. The predominant features were oval shape of 17 tumors (57%), obscured margins of 12 (40%), and high density of 20 (67%). Ultrasound data of 37 patients revealed 20 oval masses, 13 irregular masses, and 4 round masses. Fourteen complex solid and cystic masses were identified. One patient underwent MRI that showed a complex, enhancing mass with washout kinetics. Ultrasound guided biopsy was performed on 33 of the 37 masses. Core needle biopsy and fine needle aspiration (FNA) biopsy were most commonly performed on the solid components of the complex solid and cystic masses. IPC was diagnosed by stereotactic biopsy in 1 patient with a suspicious mass on mammography with no correlate on sonography and 6 patients had surgical excision without imaging-guided biopsy. Pathology showed in situ IPC in 31/40 tumors and 11 were solid and cystic complex masses on ultrasound. Pathology revealed invasive IPC in 9 tumors and five had an irregular mass on ultrasound. CONCLUSION Our study reveals no specific imaging features to differentiate in situ vs invasive IPC. The most common ultrasound feature in biopsy proven IPC was an oval mass, however, we identified that a complex solid and cystic mass is more often associated with the diagnosis of in situ IPC and an irregular mass is more often associated with the diagnosis of invasive IPC. Future studies with larger cohorts are needed to further define the clinical and imaging features of this rare malignancy.
Manganese Neurotoxicity and Oxidative Damage

Manganese (Mn) is of critical importance to enzyme and membrane transport systems. Both deficiencies and excess body-burdens of Mn, whether genetic or acquired, can seriously impair vital physiological and biochemical processes. Although one of the least toxic of the heavy metals, Mn toxicity occasionally occurs in miners and ore milling plant workers exposed to prolonged inhalation of manganese dioxide (MnO2) (Chia et al., 1993). The impact of Mn on human health and disease upon low-level chronic exposure to environmental Mn is uncertain. While it remains largely speculative as to whether excessive Mn exposure plays a role in the pathogenesis of neurodegenerative disorders, distinct similarities between Parkinson’s disease and manganism have led to an intense pursuit of its possible role in Parkinson’s disease, as well as in a number of other neurodegenerative disorders of, as yet, uncertain etiologies (Calne et al., 1994).
PET in Melanoma

Well over one million cases of skin cancer are diagnosed annually in the United States with the vast majority of these being basal cell and squamous skin cancers. Melanoma, although much less common, is the most aggressive skin malignancy, and it is the dominant cause of morbidity and mortality from skin cancer. The prognosis is very good in patients with early disease, but advanced metastatic melanoma is associated with poor survival rates. In the United States, approximately 59,580 new cases of melanoma were diagnosed in 2005 and approximately 7770 people died from this malignancy. There is a slight male predominance for melanoma, with males accounting for 56% of newly diagnosed melanoma [1]. Light pigmentation of the skin increases the susceptibility to melanoma, and the incidence and mortality from melanoma is a growing health concern among fair-skinned populations. Worldwide, the number of melanoma cases is increasing more rapidly than any other cancer [2]. The major environmental risk factor for development of cutaneous malignant melanoma is sun exposure, although the type of sun exposure appears to be an important consideration. Sunburn history, particularly during childhood, is a significant risk factor. There is evidence that intermittent sun exposure is a much stronger risk factor than chronic or occupational sun exposure [3]. Family history is another risk factor for melanoma. Although genetic mutations (i.e., CDKN2A) have been associated with melanoma, the role of genetic testing has not been established. No definitive associations have been established between melanoma and other environmental factors such as smoking, diet, fluorescent light exposure, or hormonal therapy [2].
GENETIC POLYMORPHISM AND DIFFERENTIATION IN PARAMECIUM

ABSTRACT . Paramecium aurelia is a complex of fourteen syngens which are morphologically similar but between which no gene flow occurs. We have analyzed the isozymic variations in all fourteen syngens of P. aurelia and also in one syngen of P. multimicronucleatum . Isozyme variants at nine loci were utilized in this analysis: three esterase and, two isocitrate dehydrogenase loci, and one fumarase, s-hydroxybutyrate dehydrogenase, glutamate dehydrogenase and succinate dehydrogenase locus. Intrasyngenic variation in populations of the syngens is extremely low, with the exception of syngen 2 which possesses high levels of genetic variability. When variant alleles do appear within a syngen they are nearly always “private” variants occurring nowhere else. The virtual absence of geographic differentiation within the syngens strongly suggests that the alleles at the enzyme loci studied are selected for. Differences between the syngens are large, and there is no clear-cut distinction between the syngens of P. aurelia and P. multimicronucleatum on the basis of these data. Dendrograms constructed from the matrix of genetic distances portray a more complex set of relationships between the syngens than originally proposed by Sonneborn. From comparison of the genetic distances for Paramecium with similar values obtained from Tetrahymena and Drosophila we conclude that the syngens of P. aurelia are more realistically conceived of as species.
Abstract 697: New Simplified Method for Detailed Quantification of Regional Myocardial Function From Untagged MRI Cine Recordings: Radial Strain Mapping by Multimodality Tissue Tracking (MTT)

Background: Assessment of regional myocardial function is clinically important. Circumferential strain analysis by tagged MRI is considered the reference method, despite its complexity. We introduce radial strain mapping by multimodality tissue tracking (MTT) of untagged MRI cines as a new simplified method for detailed quantification of regional LV function. To validate our approach radial strain was compared to measures of circumferential strain by tagged MRI and to infarct transmurality by contrast MRI. Methods: In patients revascularized after myocardial infarction (n=20) and in healthy subjects (n=8), radial strain was quantified in 12 LV midventricular segments by MTT from untagged MRI short-axis recordings (Figure 1[⇓][1]). MTT is a pixel-based pattern matching technique that allows automated tracking of endo- and epicardial border features. Circumferential strain and infarct transmurality was quantified by tagged- and contrast MRI, respectively. Results: Mean radial strain was significantly lower in patients compared to healthy subjects (10.6±10.3 vs. 33.5±12.8%, P<0.0001, respectively). In a linear mixed model analysis, myocardial infarct extent was a strong predictor of radial strain ( β = 0.13, P<0.00001). Radial strain could differentiate between remote, non-infarcted and infarcted border zone, and infarct centre segments (P<0.001). In a 6-segment analysis, there was an inverse relationship between circumferential strain by tagged- and radial strain by untagged MRI (r=0.70, P<0.0001; Figure 1[⇓][1]). Conclusion: We have demonstrated that radial strain mapping of untagged MRI by MTT is a simple new clinical method for detailed quantification of LV function. ![][2] FIGURE 1 [1]: #graphic-1 [2]: /embed/graphic-1.gif
Laurie Nordic Ski Center

The proprietor of a ski lodge with Nordic ski trails faces increased competition from other private lodges that are subsidized by government agencies and from a non profit ski club, which is also subsidized by use of government owned land for which the ski club pays no rent. The proprietor must decide what she can do to meet this subsidized competition or whether she should sell her business before profitability disappears.
Lactation and resource limitation affect stress responses, thyroid hormones, immune function, and antioxidant capacity of sea otters (Enhydra lutris).

Lactation is the most energetically demanding stage of reproduction in female mammals. Increased energetic allocation toward current reproduction may result in fitness costs, although the mechanisms underlying these trade-offs are not well understood. Trade-offs during lactation may include reduced energetic allocation to cellular maintenance, immune response, and survival and may be influenced by resource limitation. As the smallest marine mammal, sea otters (Enhydra lutris) have the highest mass-specific metabolic rate necessitating substantial energetic requirements for survival. To provide the increased energy needed for lactation, female sea otters significantly increase foraging effort, especially during late-lactation. Caloric insufficiency during lactation is reflected in the high numbers of maternal deaths due to End-Lactation Syndrome in the California subpopulation. We investigated the effects of lactation and resource limitation on maternal stress responses, metabolic regulation, immune function, and antioxidant capacity in two subspecies of wild sea otters (northern: E. l. nereis and southern: E. l. kenyoni) within the California, Washington, and Alaska subpopulations. Lactation and resource limitation were associated with reduced glucocorticoid responses to acute capture stress. Corticosterone release was lower in lactating otters. Cortisol release was lower under resource limitation and suppression during lactation was only evident under resource limitation. Lactation and resource limitation were associated with alterations in thyroid hormones. Immune responses and total antioxidant capacity were not reduced by lactation or resource limitation. Southern sea otters exhibited higher concentrations of antioxidants, immunoglobulins, and thyroid hormones than northern sea otters. These data provide evidence for allocation trade-offs during reproduction and in response to nutrient limitation but suggest self-maintenance of immune function and antioxidant defenses despite energetic constraints. Income-breeding strategists may be especially vulnerable to the consequences of stress and modulation of thyroid function when food resources are insufficient to support successful reproduction and may come at a cost to survival, and thereby influence population trends.
Diagnostic Accuracy, Prescription Behavior, and Watchful Waiting Efficacy for Pediatric Acute Otitis Media.

Current guidelines recommend “watchful waiting” (WW) as an alternative to immediate antibiotic treatment. Continued high rates of antibiotic use suggest that WW may be underutilized. We conducted a...
The Prevalence of Comorbidities in Children and Young Adults With Psoriasis and Psoriatic Arthritis

Background:Adult-onset psoriasis (PsO) and psoriatic arthritis (PsA) have been associated with diabetes, hypertension (HTN), and obesity in addition to other diagnoses. The relationship of these co...
Pharmacologic control of CAR-T cell function using dasatinib.

Key Points Dasatinib potently and reversibly suppresses CAR-T cell cytotoxicity, cytokine secretion, and proliferation. Dasatinib could be repurposed as a safety switch to mitigate CAR-mediated toxicity in patients.
Using Motivational Interviewing to Address Tobacco Cessation: Two Standardized Patient Cases for Pediatric Residents

Introduction Motivational interviewing (MI) is a well-established evidence-based method of working with patients to promote health behavior change. Standardized patient (SP) simulation allows train...
Cardiovascular Evaluation of Children With Malignancies

The anthracycline (AC) group of drugs is widely used for cancer chemotherapy and has improved outcomes in many childhood malignancies. However, cardiovascular complications are major causes of morbidity and mortality in AC recipients, with the greatest risk factor being a higher cumulative dosage. The purpose of this review is to describe the etio-pathogenesis and risk factors of AC induced cardiotoxicity, with emphasis on currently available and emerging modalities of non-invasive imaging in its surveillance, and to review guidelines on its prevention and treatment. Presently, ejection fraction and shortening fraction derived from two-dimensional echocardiography are the most widely used parameter for monitoring of cardiac function in childhood cancer survivors. The newer speckle tracking echocardiography has shown potential to detect abnormalities in ventricular function prior to the conventional measures such as ejection fraction and shortening fraction. When available, three-dimensional echocardiography should be used as it allows for more accurate estimation of ejection fraction. Newer magnetic resonance imaging (MRI) techniques, such as delayed enhancement and T1 mapping, are useful adjuncts for cardiac evaluation in cancer survivors, especially in patients with poor echocardiographic windows. Early detection and management of cardiovascular diseases is one of the major goals in the long-term follow-up of childhood cancer survivors. In addition to conventional two-dimensional echocardiography, newer techniques such as speckle tracking echocardiography and three-dimensional echocardiography should be incorporated due to its ability to detect early changes in anthracycline-induced cardiotoxicity. However further research are needed to guide changes in management due to abnormalities in speckle tracking echocardiography.
A retrospective review of dupilumab and psoriasis biologic combination therapy.

Targeted immunomodulatory biologics have revolutionized the treatment of inflammatory skin diseases. Psoriasis is Th17 driven with high levels of TNF-α, IL17a, and IL23. Biologics targeting these c...
Ecological Sex Ratios and Human Mating.

The ratio of men to women in a given ecology can have profound influences on a range of interpersonal processes, from marriage and divorce rates to risk-taking and violent crime. Here, we organize such processes into two categories – intersexual choice and intrasexual competition – representing focal effects of imbalanced sex ratios.
The Role of Radiotherapy for Chordoma Patients Managed With Surgery: Analysis of the National Cancer Database.

Study design Retrospective review. Objective To determine if adjuvant radiation therapy (RT) improves overall survival (OS) following surgical resection of chordomas. Summary of background data The role of RT for the treatment of chordomas remains incompletely described. Previous studies have not found adjuvant RT to improve OS, but these studies did not group patients based on surgical margin status or radiation dose or modality. We used the National Cancer Database to investigate the role of RT in chordomas following surgical resection. Methods Patients were stratified based on surgical margin status (positive vs. negative). Utilizing the Kaplan-Meier method, OS was compared between treatment modalities (surgical resection alone, therapeutic RT alone, and surgical resection plus therapeutic RT). OS was subsequently compared between patients treated with palliative dose ( 65 Gy) RT. Similarly, OS was compared between advanced RT modalities including proton beam therapy (PBT) and intensity-modulated radiation therapy (IMRT), stereotactic radiosurgery (SRS), and external beam radiation therapy (EBRT). A multivariable model was used to determine adjusted variables predictive of mortality. Results One thousand four hundred seventy eight chordoma patients were identified; skull base (n = 567), sacral (n = 551), and mobile spine (n = 360). Surgical resection and therapeutic adjuvant RT improved 5-year survival in patients with positive surgical margins (82% vs. 71%, P = 0.03). No clear survival benefit was observed with the addition of adjuvant RT in patients with negative surgical margins. High dose RT was associated with improved OS compared with palliative and low dose RT (P 65 Gy) was superior to EBRT. Conclusion Patients with positive surgical margins benefit from adjuvant RT. Optimal OS is associated with adjuvant RT administered with advanced techniques and cumulative dose more than 65 Gy. Level of evidence 4.
Affordances, challenges, and impact of open pedagogy: examining students’ voices

Open pedagogy has emerged as an important teaching and learning practice while the current global open education resources movement has developed. The present research addresses the need to develop...
Perceptions of Hospitality Industry Professionals and Hospitality Faculty on Industry-Academia Collaborations

This study investigated the perceptions of hospitality industry professionals and faculty on their involvement in industry--academia collaboration. This quantitative survey sampled 568 Internationa...
Percutaneous Renal Biopsy Using an 18-Gauge Automated Needle Is Not Optimal.

Background: As percutaneous renal biopsies (PRBs) are increasingly performed by radiologists, an increase in the use of 18-gauge automated needle stands to compromise adequacy. We compare the adequacy and safety of PRB with 14-, 16-, and 18-gauge automated needles. Methods: PRB of native (N-592) and transplant (T-1,023) kidneys was performed from January 2002 to December 2019 using real-time ultrasound. Baseline clinical and laboratory data, biopsy data (number of cores, total glomeruli, and total glomeruli per core), and outcome (hematoma on renal US at 1-h, complications, and transfusion) were collected prospectively. PRB with N14g (337) versus N16g (255) and T16g (892) versus T18g (131) needles were compared. A p value of <0.05 was significant. Results: PRB with an 18-g needle yielded the lowest number of total glomeruli per biopsy (N14g vs. N16g: 33 ± 13 vs. 29 ± 12, p < 0.01 and T16g vs. T18g: 34 ± 16 vs. 21 ± 11, p < 0.0001), significantly fewer total glomeruli per core (T16g vs. T18g: 12.7 ± 6.4 vs. 9.6 ± 5.0, p < 0.001 and N16g vs. T18g: 14.2 ± 6.3 vs. 9.6 ± 5.0, p < 0.001). A hematoma by renal US 1-h post-PRB was similar for native (14g–35% vs. 16g–29%, p = 0.2), and transplant biopsies (16g–10% vs. 18g–9%, p = 0.9) and the complication rate for native (14g–8.9% vs. 16g–7.1%, p = 0.5), transplant biopsies (16g–4.6% vs. 18g–1.5%, p = 0.2) and transfusion rate for native (14g–7.7% vs. 16g–5.8%, p = 0.4), and transplant biopsies (16g–3.8% vs. 18g–0.8%, p = 0.1) were similar irrespective of needle size. Conclusions: PRB of native and transplant kidneys with the use of a 16-gauge needle provides an optimal sample. However, our experience in transplant biopsies suggests the use of an 18-gauge needle stands to jeopardize the diagnostic accuracy of the PRB while not improving safety.
Giant Prostatic Calculi: A Novel Use of the Ultrasonic Lithoclast

Abstract Introduction: A 51-year-old man with neurogenic bladder secondary to spina bifida had been managed with clean intermittent catheterization (CIC) his entire life. The patient subacutely dev...
FGFR Inhibitors: Clinical Activity and Development in the Treatment of Cholangiocarcinoma.

Cholangiocarcinoma is an aggressive cancer with a poor prognosis and limited treatment. Gene sequencing studies have identified genetic alterations in fibroblast growth factor receptor (FGFR) in a significant proportion of cholangiocarcinoma (CCA) patients. This review will discuss the FGFR signaling pathway’s role in CCA and highlight the development of therapeutic strategies targeting this pathway. The development of highly potent and selective FGFR inhibitors has led to the approval of pemigatinib for FGFR2 fusion or rearranged CCA. Other selective FGFR inhibitors are currently under clinical investigation and show promising activity. Despite encouraging results, the emergence of resistance is inevitable. Studies using circulating tumor DNA and on-treatment tissue biopsies have elucidated underlying mechanisms of intrinsic and acquired resistance. There is a critical need to not only develop more effective compounds, but also innovative sequencing strategies and combinations to overcome resistance to selective FGFR inhibition. Therapeutic development of precision medicine for FGFR-altered CCA is a dynamic process of involving a comprehensive understanding of tumor biology, rational clinical trial design, and therapeutic optimization. Alterations in FGFR represent a valid therapeutic target in CCA and selective FGFR inhibitors are treatment options for this patient population.
The Effect of Institutional Ownership, Capital Structure and Company Growth on Firm Value: Evidence from Indonesia

This study aims to examine the effect of institutional ownership, capital structure, and firm growth on firm value in companies listed on the Indonesia Stock Exchange (IDX). This study uses 32 companies in the LQ45 index listed on the Indonesia Stock Exchange, selected using the purposive sampling method from 2015 to 2019. This type of research is quantitative causality, which is analyzed using the multiple linear regression analysis methods with the help of SPSS version 24 to process data. The results showed that institutional ownership and firm growth positively affected firm value, while capital structure showed a negative effect on firm value. Research implications suggest that to improve the company’s management performance, providing the right decisions to obtain sustainable profits must also control efficiency and cost-effectiveness and manage the resources owned so that they can continue to grow and develop into a successful company.
Shear properties of organic films adsorbed on silica fibres

Contact adhesion and sliding friction of octadecylamine and silane molecules adsorbed on silica fibre were measured with orthogonally crossed silica fibres using an electronic microbalance. Interfacial shear strengths, τ, as a function of contact pressure, P, between organic films were deduced from the adhesional model of friction using the measured frictional force and the calculated real area of contact. The pressure dependence of the interfacial shear strength was then interpreted in terms of the molecular interaction of adsorbates with solvent and the surface energetics of molecules adsorbed on the silica fibre.
Reducing moment method storage from order N/sup 2/ to order N (EM scattering calculations)

Previously, integral equation-based calculations of electromagnetic scattering and radiation (e.g. moment method calculations) have required a full N × N matrix when there are N unknowns. However, in the letter novel basis and testing functions are presented, for which the resulting matrix is approximately sparse. That is, nearly all of its elements are nearly zero. This kind of technique is expected to reduce typical storage and execution time requirements by orders of magnitude.
Gender, Race, and the Writing of Empire: Interpreting South Africa to Britain – Olive Schreiner, Boers, and Africans

Just as British imperial policy depended on colonial as well as domestic factors, so did public discourse on imperialism. This chapter examines the writings of a South African literary figure, perhaps the South African most well-known in Britain during the Boer War, apart from Boer president Paul Kruger. Olive Schreiner's nonfiction about South Africa, addressed to British audiences, was a different kind of journalism from the press coverage of the Boer War, a different kind of propaganda from the kind practiced by Doyle and Stead. Schreiner's efforts in periodicals and pamphlets are the most important pro-Boer writings by a literary figure in a public debate that was notable for the presence of literary figures. Schreiner's pro-Boer writings were published before the war and were aimed at promoting British fellow-feeling toward the Boers. The Boers would, Schreiner argued, be mixing with Britons to produce the future, blended white race of the united British colony of South Africa. British relations with South Africa were affected by questions of race, but it is important to note that the questions of race that were of most immediate concern to the British in the years just before as well as during the war were questions of the compatibility of the two white “races” in South Africa. The prosperous South African colony that the British hoped would result from the Boer War was a colony not unlike Australia or Canada – a colony in which the indigenous population was seen as hardly significant.
Alkali metal nuclear magnetic resonance.

Publisher Summary Several reviews of alkali metal nuclear magnetic resonance (NMR) and its applications to biological systems have appeared; these should be consulted for earlier accounts of alkali metal NMR spectroscopy and for details on the NMR properties of alkali metal nuclides. This chapter describes the way NMR spectroscopy can be used for determining the environment of alkali metal ions in metalloenzymes and metalloproteins, as well as for studying alkali metal ion distribution and transport across cell membranes. Because of recent developments in NMR applications to transmembrane transport of alkali metal ions in cell suspensions and perfused organs, this physiologically important area of alkali metal NMR applications is described. The principles that form the basis of the NMR transport methods presented with human red blood cell (RBC) suspensions are also applicable to perfused organs. The chapter also describes the way the interpretation of alkali metal NMR data is obtained and the special precautions that are to be taken when this technique is used.
A climatology of the stratopause in WACCM and the zonally asymmetric elevated stratopause

[1] A climatology of the stratopause is produced using a 40 year simulation of the Whole Atmosphere Community Climate Model (WACCM). Anomalies in polar winter stratopause temperature and height are interpreted with respect to the location of the polar vortices and anticyclones. The WACCM climatology is compared to an 8 year climatology based on Microwave Limb Sounder (MLS) observations and data from the Goddard Earth Observing System (GEOS) version 5 from August 2004 to July 2012. The WACCM climatology is in excellent agreement with observations, except in the Antarctic vortex where the WACCM stratopause is ~10K warmer and ~5 km higher than observations. WACCM diabatic heating rates support the hypothesis that ageostrophic vertical motions associated with baroclinic planetary waves are responsible for producing Arctic winter temperature anomalies. The area of the winter polar vortices in WACCM at the stratopause is 30% smaller in the NH and 45% smaller in the SH compared to GEOS. The long WACCM record allows us to explore the geographical distribution and temporal evolution of a composite of 15 elevated stratopause (ES) events. This composite is in good agreement with the 2012 ES event observed by MLS, though December ES events in WACCM are not observed by MLS. This is the first work to show that ES events are not zonally symmetric. In the 30 days following ES events, the ES composite shows that the stratopause altitude is highest over the Canadian Arctic, and the highest stratopause temperatures occur 90° to the east over the Norwegian Sea.
Multiple-source single-sink maximum flow in directed planar graphs in O(diameter ċ n log n) time

We develop a new technique for computing maximum flow in directed planar graphs with multiple sources and a single sink that significantly deviates from previously known techniques for flow problems. This gives rise to an O(diameter ċ nlogn) algorithm for the problem.