cssi/SciSciGPT-SciSciNet huggingface dataset:
Pseudoaneurysm of Distal Anterior Cerebral Artery Branch Following External Ventricular Drain Placement.

Background External ventricular drains (EVDs) are routinely placed as part of the management of intracranial hypertension. Pseudoaneurysm formation after EVD placement is a rare complication that can occur as a result of direct trauma to the cerebral vasculature. Prompt recognition and treatment may prevent future rupture. Objective To present our management strategy of a unique case of pseudoaneurysm formation in the context of the medical literature on these rare complications. Methods An EVD was placed in a 58-year-old female patient who presented with intracranial hypertension after subarachnoid hemorrhage secondary to a ruptured posterior communicating artery aneurysm before coiling of the aneurysm. On postbleed day 10, a pseudoaneurysm was identified in the distal anterior cerebral artery adjacent to the EVD tract. Results The pseudoaneurysm was successfully treated with surgical resection. Conclusion Pseudoaneurysm formation after EVD placement is a rare but serious complication. We do not recommend routine screening for this complication; however, further investigation may be warranted when a delayed EVD tract hemorrhage is encountered. Prompt treatment of pseudoaneurysms is necessary to prevent future hemorrhage.
Characterization of gluconeogenesis in enzymatically isolated parenchymal cells of rat liver.

SummaryIn vitro studies of the structural and metabolic integrity of dispersed parenchymal cells prepared by perfusion of isolated rat livers with collagenase and hyaluronidase were performed. A high percentage of trypan blue exclusion, a low degree of soluble enzyme release into the incubation media, and a constant rate of gluconeogenesis from lactate, as well as other precursors verified the viability and integrity of the isolated hepatocytes. Addition of 10 mM alanine, lactate, and pyruvate produced 5- to 10-fold increases in the rate of gluconeogenesis as compared to the endogenous level in cells from fasted rats. Prolongation of the fast from 24 hr up to 168 hr resulted in no significant changes in the gluconeogenic rates when expressed per gram of cell protein. This finding supports the concept that substrate presentation provides control of hepatic gluconeogenesis during prolonged fasts.The authors gratefully acknowledge the technical assistance of Mrs. Chio-hoon Tan.
Computer-Mediated Communication in the Arizona Legislature: Applying Media Richness Theory to Member and Staff Communication

Communication is obviously impor? tant in any organizational context, but it is especially so in a legislature. The concepts of representative democracy and freedom of expression, as well as the need for legislators to build voting coalitions, all sug? gest a critical need for effective communication both within legislatures and between citizens and representatives. While these needs may not have changed, communication technolo? gies have. These technological innovations, often referred to as computer-mediated com? munication, have the potential to transform the nature of political communication. A key component of computer-mediated communication, the Internet, has become an increasingly important part of political com? munication as government agencies, interest groups, candidates, and officeholders all use it to disseminate information and often to pro? mote certain viewpoints. Citizens increasingly use the Internet as an information resource
Preliminary Studies of the Kit Fox in Utah

The kit fox, Vulpes macrotis nevadensis Goldman, is perhaps the least known of the Canidae found in Utah, and most of the Utah literature on this animal is concerned with taxonomy and distribution. In his revised account of Utah mammals, Barnes (1927) listed the kit fox as Vulpes velox velox and commented on its abundance in the state. Fautin (1946) mentioned it as a major influent in the northern desert shrub biome in western Utah and included some observations on food habits. Durrant (1952) mapped the kit fox distribution for the state and listed Utah specimens examined by him as referable to Vulpes macrotis nevadensis . This paper presents the results of a kit fox study made from July, 1951, to July, 1955, in south-central Tooele County, Utah. More specifically, the study area includes the desert valleys bounded on the west by Granite Peak, on the northwest by the salt flats of the Great Salt Lake Desert, on the northeast by the Cedar Mountains, and on the south by Simpson Mountain and the north end of Dugway Mountains. Elevations along the valley floors range from about 4,300 feet to 4,800 feet. The principal aim of this study was to determine the natural involvement potential of the kit fox in the epizoology of endemic diseases in the area. In this respect the food habits and host-parasite relationships are of prime importance. Many members of the staff of Ecological Research, University of Utah, gave assistance or made useful suggestions during this study. Acknowledgment is given to E. A. Shippee for permission to use his unpublished data; to E. Ekker, B. N. Day, J. Smith, W. J. Bacha and E. M. Rosasco for assistance during various phases of the field work; and to C. Jorgensen who identified the specimens of Ixodes texanus , …
Impact on Colonies of Honey Bees of Ultra-Low-Volume (Undiluted) Malathion Applied for Control of Grasshoppers

When the effects on honey bees, Apis mellifera L., of Large-scale aerial applications of ultra-low-volume (undiluted) malathion (8 fluid oz per acre) were studied in Wyoming, the bees dead from the malathion were recovered in special hive-entrance traps for 7 days. Residues were detected in alfalfa (12-29 ppm), in pollen (0.43-11.1 ppm), and in dead bees (<0.01-0.37 ppm) for as long as 8 days after the application. Covering hives with burlap covers for 2, 4, and 5 days provided some protection, but an unanticipated exposure to the insecticide before the covering was put in place prevented a full evaluation of this protective technique. Damage to colonies was more severe when nectar-flow conditions were good than during periods of nectar dearth. The impact was also less in colonies with abundant brood, pollen, and honey in the hives.
Long-term follow-up of cemented total hip replacement for osteoarthritis.

SUMMARY Two hundred twelve total hip replacements performed as a primary procedure have been followed for more than 10 years. One hundred thirty-six hips had adequate radiographic follow-up. Mechanical loosening of the acetabular and femoral component continue to be the major postoperative complications and in this series was 24 per cent. The incidence of femoral loosening has declined, however there is a continuing increase in acetabular revisions as well as an increase in bone-cement radiolucencies in relation to the acetabular component. Analysis of mechanical and technical parameters identifies those arthroplasties at increased risk of mechanical loosening, it is necessary to have two or more parameters of poor technique present before there is an increased incidence of loosening of the femoral component. Changes in stem design and cementing techniques in the early 1980s have addressed these parameters and in the mid-term have significantly decreased the incidence of mechanical failure. However we await the 10- to 15-year follow-up of these technical improvements to assess whether they will improve longevity of a biologic procedure. It is difficult to predict failure of cemented acetabular components and with longer follow-up there appears to be a steady increase in the incidence of acetabular loosening compared with a decrease in the occurrence of femoral loosening.
Both high and low testosterone levels may play a role in suicidal behavior in adolescent, young, middle-age, and older men: a hypothesis

Many studies suggest that testosterone plays a role in the regulation of mood and behavior. Most but not all investigations of the relationship between testosterone and suicidality found relations between testosterone and suicidal behavior. The balance of evidence is in favor of the view that testosterone is involved in the pathophysiology of suicidality. The author has previously proposed that suicidal behavior in adolescents and young adults is associated with high testosterone levels, whereas suicidality in older men is associated with decreased testosterone levels. However, both high and low testosterone levels can be observed in adolescent, young, middle-aged and older men. In this article, the author proposes that both high and low testosterone levels may play a role in suicidal behavior in men of any age. Language: en
Cerebral vascular diseases

Strokes remain an important cause of mortality and morbidity despite recent advances in neurologic intensive care. Although support of ventilation and circulation improves the outcome for stroke patients, the efficacy of cerebral resuscitative measures such as hyperventilation, osmotherapy, fluid restriction, steroids, intracranial pressure control, and barbiturates remains unproven. Current specific therapies (anticoagulation, surgery) are useful in carefully selected patients. New therapies now being researched include fluorocarbons, narcotic antagonists, and calcium blockers.
In-memory Integration of Existing Software Components for Parallel Adaptive Unstructured Mesh Workflows

Reliable mesh-based simulations are needed to solve complex engineering problems. Mesh adaptivity can increase reliability by reducing discretization errors, but requires multiple software components to exchange information. Often, components exchange information by reading and writing a common file format. This file-based approach becomes a problem on massively parallel computers where filesystem bandwidth is a critical performance bottleneck. Our data stream and component interface approaches avoid the filesystem bottleneck. In this paper we present our approaches and their use within the PHASTA computational fluid dynamics solver and Albany multiphysics framework. Information exchange performance results are reported on up to 2048 cores of a BlueGene/Q system.
TaO X memresitive devices with ferromagnetic electrodes

Recently, two-terminal metal-oxide-based devices showing memresitive behavior have been attracting much attention due to their promising characteristics for next generation memory and logic technologies [1]. Among different types of memresitive mechanisms, TaO X based devices combined with copper and platinum electrodes have been known to utilize metal precipitation to create conductive channel inside of the oxide thin film when a low electric voltage (only around 1V between top and bottom electrodes) is applied [1]–[3]. This unique mechanism can deliver an opportunity to explore a new type of multifunctional device; for example, the formed metal nano-filament inside of TaO X can be used as an electron spin transport channel [4].
A performance-based approach to designing the stimulus presentation paradigm for the P300-based BCI by exploiting coding theory

The P300-based brain-computer interface (BCI) speller relies on eliciting and detecting specific brain responses to target stimulus events, termed event-related potentials (ERPs). In a visual speller, ERPs are elicited when the user's desired character, i.e. the “target,” is flashed on a computer screen. The P300 speller is currently limited by its relatively slow typing speed due to the need for repetitive data measurements that are necessary to achieve reasonable signal-to-noise ratios. In addition, refractory effects limit the ability to elicit ERPs with every target stimulus event presentation. In this paper, we present a new method to design the stimulus presentation paradigm for the P300 speller by exploiting an information-theoretic approach to maximize the information content that is presented to the user while also mitigating refractory effects. We present results with real-time BCI use which demonstrate significant performance improvements with our performance-based paradigm compared to the conventional stimulus presentation paradigm.
Tragedy in Print; or, Epistolary Friendship and Clarissa’s Divided Readership

This chapter explores how Samuel Richardson’s novel elevates friendship ideals as a frame of narrative reception. Through the correspondence between Clarissa and Anna, Richardson pushes public and private faces of friendship to new extremes at the same time as he synthesizes contradictory ideas surrounding masculinity and femininity, secularity and religion, and classical and modern heroism in friendship. Exploring the diverse reactions of his readers, the chapter provides a new explanation of the controversy among Richardson’s readers, and shows that the rhetoric of friendship was a touchstone of authority in this early debate over one’s taste in fiction.
Robust Monitoring of Contaminated Data

Using traditional control charts to monitor processes with contaminated data can result in an excessive number of false alarms. Robust control charts that eliminate the effects of the outlying data values are a better alternative, but they do not detect..
Multi-Scale Assessments of Cardiac Electrophysiology Reveal Regional Heterogeneity in Health and Disease

The left and right ventricles of the four-chambered heart have distinct developmental origins and functions. Chamber-specific developmental programming underlies the differential gene expression of ion channel subunits regulating cardiac electrophysiology that persists into adulthood. Here, we discuss regional specific electrical responses to genetic mutations and cardiac stressors, their clinical correlations, and describe many of the multi-scale techniques commonly used to analyze electrophysiological regional heterogeneity.
Phosphodiesterase-5 inhibition potentiates cerebrovascular reactivity in chronic traumatic brain injury

Background Traumatic cerebrovascular injury (TCVI), a common consequence of traumatic brain injury (TBI), presents an attractive therapeutic target. Because phosphodiesterase-5 (PDE5) inhibitors potentiate the action of nitric oxide (NO) produced by endothelial cells, they are candidate therapies for TCVI. This study aims to: (1) measure cerebral blood flow (CBF), cerebrovascular reactivity (CVR), and change in CVR after a single dose of sildenafil (ΔCVR) in chronic TBI compared to uninjured controls; (2) examine the safety and tolerability of 8-week sildenafil administration in chronic symptomatic moderate/severe TBI patients; and as an exploratory aim, (3) assess the effect of an 8-week course of sildenafil on chronic TBI symptoms. Methods Forty-six subjects (31 chronic TBI, 15 matched healthy volunteers) were enrolled. Baseline CBF and CVR before and after administration of sildenafil were measured. Symptomatic TBI subjects then completed an 8-week double-blind, placebo-controlled, crossover trial of sildenafil. A neuropsychological battery and neurobehavioral symptom questionnaires were administered at each study visit. Results After a single dose of sildenafil, TBI subjects showed a significant increase in global CVR compared to healthy controls (P < 0.001, d = 0.9). Post-sildenafil CVR maps showed near-normalization of CVR in many regions where baseline CVR was low, predominantly within areas without structural abnormalities. Sildenafil was well tolerated. Clinical Global Impression (CGI) scale showed a trend toward clinical improvement while on sildenafil treatment. Findings Single-dose sildenafil improves regional CVR deficits in chronic TBI patients. CVR and ΔCVR are potential predictive and pharmacodynamic biomarkers of PDE5 inhibitor therapy for TCVI. Sildenafil is a potential therapy for TCVI.
Preclinical Magnetic Resonance Imaging and Systems Biology in Cancer Research: Current Applications and Challenges

Biologically accurate mouse models of human cancer have become important tools for the study of human disease. The anatomical location of various target organs, such as brain, pancreas, and prostate, makes determination of disease status difficult. Imaging modalities, such as magnetic resonance imaging, can greatly enhance diagnosis, and longitudinal imaging of tumor progression is an important source of experimental data. Even in models where the tumors arise in areas that permit visual determination of tumorigenesis, longitudinal anatomical and functional imaging can enhance the scope of studies by facilitating the assessment of biological alterations, (such as changes in angiogenesis, metabolism, cellular invasion) as well as tissue perfusion and diffusion. One of the challenges in preclinical imaging is the development of infrastructural platforms required for integrating in vivo imaging and therapeutic response data with ex vivo pathological and molecular data using a more systems-based multiscale modeling approach. Further challenges exist in integrating these data for computational modeling to better understand the pathobiology of cancer and to better affect its cure. We review the current applications of preclinical imaging and discuss the implications of applying functional imaging to visualize cancer progression and treatment. Finally, we provide new data from an ongoing preclinical drug study demonstrating how multiscale modeling can lead to a more comprehensive understanding of cancer biology and therapy.
Warfarin-induced skin necrosis

Warfarin-induced skin necrosis is a rare but potentially devastating complication of oral anticoagulation. In this article the historical, clinical, and pathophysiologic features of this hypercoagulable event are reviewed, and recommendations for prevention and treatment are discussed.
Microstructural characterization of snow, firn and ice

This paper provides an overview of techniques used to characterize the microstructure of snow, firn and ice. These range from traditional optical microscopy techniques such as examining thin sections between crossed polarizers to various electron-optical and X-ray techniques. Techniques that could have an impact on microstructural characterization of snow, firn and ice in the future are briefly outlined. This article is part of the theme issue 'The physics and chemistry of ice: scaffolding across scales, from the viability of life to the formation of planets'.
Data on MECOM rearrangement-driven chromosomal aberrations in myeloid malignancies.

Abstract Data in this article presents the results of conventional cytogenetics and fluorescence in situ hybridization (FISH) analyses in 129 patients with confirmed MECOM rearrangement ( https://doi.org/10.1016/j.cancergen.2019.03.002 ) [1]. Generally, the MECOM rearrangement has arisen through translocation, inversion, and insertion and/or unknown mechanism. In addition to the typical chromosomal aberrations, inv(3)(q21q26.2) and t(3; 3)(q21; q26.6) [2–4], over 50% of cases presented here exhibit a wide spectrum of MECOM rearrangement-driven, atypical chromosomal aberrations, including inv(3) with breakpoint other than 3q21; t(1; 3); t(2; 3); t(3; 6); t(3; 8); t(3; 12); t(3; 17); t(3; 21) as well as an insertion of 3q26.2 into different chromosomes. These cases are thoroughly characterized by karyotyping, interphase-, metaphase-, map-back FISH and whole chromosomal painting (WCP) analyses.
MODEL SYSTEMS RECONSTRUCTED FROM BACTERIORHODOPSIN

Publisher Summary This chapter discusses the model systems reconstructed from bacteriorhodopsin. Bacteriorhodopsin is one of the best examples in the biology of an ion pump. A keen interest exists in the structural and functional basis of this activity because an understanding of how hydrogen and electron carriers function as ionophores is one of the main unresolved problems of bioenergetics. The chapter discusses some aspects of the action of bacteriorhodopsin as an ionophore and its possible use as a catalyst for photoelectrical potential generation. In a study, purple membrane fragments were incorporated into liposomes (BR-liposomes) by sonication in the presence of lecithin and various salt solutions. If made in the presence of KCl, maximum light-induced proton pump activity occurs with 100 mM KCl, the standard BR-liposome system reported by Racker. In experiments with other ions like Ca2,+ it was found that increasing the amounts added externally caused an eight-fold increase in the proton pump activity. Bivalent ions were more stimulatory than monovalent ions and for a series of bivalent cations studied, Ca2+ showed the best response. When BR-liposomes are prepared in the presence of KCl, K+ is the counter ion for proton transport. If valinomycin is added to overcome a possible permeability barrier to K+, as expected, a stimulation of proton pump activity is observed. However, a further enhancement of this activity is still given by Ca2+; the Ca2+ stimulation being almost additive to the valinomycin stimulation. Therefore, it is concluded that the Ca2+ effect is not on liposome permeability per se.
Drawing students into public-speaking success

Courses: The exercise is designed for an introduction to public-speaking course or a “basic course” with a major public-speaking assignment.Objectives: By the end of this activity, students will be...
Robust Control and Optimal Operation of Multiple Microgrids with Configurable Interconnections

Microgrid controller plays an important role in the reliable and stable operations of microgrids in both island and grid-connected modes. This paper investigates control schemes and operational strategies for multiple interconnected microgrids in several scenarios for frequency stability and cost-optimized operations. There are six possible interconnection configurations for a system consisting of two microgrids and the utility grid. A robust controller is designed and optimized for each microgrid to ensure frequency stability under most circumstances. Based on that, a new control component is introduced to manage the power flow between microgrids and switch between configurations to maximize the benefits of inter-microgrid energy trading while keeping the system fluctuations below tolerance level. This work demonstrates the effectiveness of the developed controller and is expected to have significant impacts on the future development and application of microgrids.
Ethical end-of-life palliative care: response to Riisfeldt

In a recent article, 1 Riisfeldt attempts to show that the principle of double effect (PDE) is unsound as an ethical principle and problematic in its application to palliative opioid and sedative use in end-of-life care. Specifically, he claims that (1) routine, non-lethal opioid and sedative administration may be "intrinsically bad" by PDE's standards, (2) continuous deep palliative sedation (or "terminal sedation") should be treated as a bad effect akin to death for purposes of PDE, (3) PDE cannot coherently be applied in cases where death "indirectly" furthers an agent's intended end of pain relief via medically appropriate palliative care, and (4) application of PDE requires sacrificing common beliefs about the sanctity of human life. I respond by showing that Riisfeldt's understanding of PDE is seriously mistaken: he misattributes Kantian and Millian reasoning to the principle and conflates acts' intrinsic properties with their effects. Further, a corrected understanding of PDE can address Riisfeldt's case-specific objections.
Assessing 50 Years of Mangrove Forest Loss Along the Pacific Coast of Ecuador: A Remote Sensing Synthesis

To assess the changes in landuse and landcover resulting from the shrimp farm expansion occurring in each of the study areas, a remote sensing analysis of each estuary in Ecuador is conducted. This remote sensing analysis documents mangrove forest landuse and landcover (LULC) change as well as shrimp farm LULC change that occurred in each of the estuaries. Also, the remote sensing analysis pinpoints the approximate time the LULC transition occurred and the exact location of these LULC changes. The remotely-sensed data has the required spatial, temporal, and radiometric resolutions to detect if shrimp farms directly displaced mangrove forest at the sub-estuary level. This remote sensing analysis can then be used in Chap. 5 to answer the critical question of how much aquaculture-driven LULC change has occurred at the local level since commercial shrimp farms arrived in each estuary in Ecuador. The primary earth observing system (EOS) used to conduct the LULC change analysis is the Landsat program as it has the required resolutions to achieve these stated goals. This chapter describes a repeatable and widely-applicable method based on remotely sensed data synthesis that can be applied to other locations or even other landocovers. All the input, processing, and output data used or generated are provided in an accompanying website.
Abstract 857: MCUB Regulates the Molecular Composition of the Mitochondrial Calcium Uniporter Channel During Cardiac Stress to Limit Mitochondrial Calcium Overload

The mitochondrial calcium uniporter (mtCU) is a ~700 kD multi-subunit channel residing in the inner mitochondrial membrane required for mitochondrial Ca2+ (mCa2+) uptake. Mitochondrial Calcium Unip...
The Artistic Approach to Virtual Reality

Virtual Reality technologies have been challenging the way in which humans interact with computers since its implementation. When viewed through an artistic lens these interactions reveal a shift in the roles that content creators and the end user fulfill. VR technologies inherently demand that the user participates in the creation of the content while incorporated into the experience. This realization has dramatic implications for media and artistic works, as the traditional role of the content creator has been to dictate and frame the view in which the user interacts with the content, but with VR works much of the creators role has been stripped away and transferred to the viewer. This breaking of the traditional roles, accompanied by the transition away from “the rectangle,” or the flat rectangular plane which acts as a “canvas” for media and artistic works, requires a new approach to VR works.
A normal variant on Tl-201 and Tc-99m MIBI whole-body imaging: the superior right atrial wall (auricle) and superoanterior right ventricular wall are often seen as mediastinal lesions.

Purpose: The authors have often observed on TI-201 and Tc-99m sestamibi (MIBI) scans in patients with thyroid cancer a small focus of increased uptake in the right midparasternal region (focus A) or sometimes in the lower mid chest at the level of the lower sternum (focus B) just inferomedial to focus A. The objective of this study was to assess the frequency of this finding on TI-201 MIBI studies, to assess the incidence of true pathologic lesions corresponding to these foci, and to identify their nature. Materials and Methods: One hundred ten whole body TI-201 studies using 4 mCi (148 MBq) and 84 MIBI studies using 20 mCi (740 MBq: first-pass, planar, and SPECT images) were reviewed. The appearance of either focus A or focus B on three orthogonal SPECT images was correlated with an atlas of cross-sectional anatomy and computed tomography. If focus A was seen on the immediate static image (obtained at the end of the first-pass acquisition without moving the patient), this image was coregistered with a selected image from the first-pass study showing the superior vena cava and also with another selected image showing the ascending aorta. Results: Focus A was seen in 40% of TI-201 scans and in 49% of MIBI scans, whereas focus B was seen in 20% of TI-201 scans and 39% of MIBI scans. On correlation of the SPECT images with a cross-sectional anatomy atlas, focus A and focus B invariably corresponded to the superior portion of the right auricle and basal superoanterior right ventricular wall, respectively. These myocardial regions are prominent and sometimes appear as discrete foci because they are considerably thicker than other parts of the right atrial and right ventricular muscle, respectively, and because they are seen partly end-on in the anterior projection. Conclusions: The superior portion of the right auricle and basal superoanterior right ventricular myocardium often appear as isolated foci on whole-body TI-201 and MIBI scans. Neither focus should be interpreted as a metastatic lesion in patients with possible cancer or as an ectopic parathyroid adenoma in patients with hyperparathyroid disease.
Coming to See Action as Symbol: the Computer as Collaborator

Our work with young children began as a project and a place that we called The Laboratory for Making Things. Our hypothesis was that deep learning could accrue in an environment where projects were designed that used differing kinds of objects/materials, that utilized differing sensory modalities, that held the potential for differing modes of description, but that shared conceptual underpinnings. This article focuses on the work of one eight-year-child, whom I call Laf, whose most notable quality was integrity – he needed to understand for himself. I trace Laf’s work as an example of a response to the question I had put to myself: Could the computer be a collaborator in helping children effectively make moves between their own body actions in clapping and the necessary numerical–symbolic instructions to make the computer drums play what they had clapped?
Building teaching and learning communities: creating shared meaning and purpose: Craig Gibson and Sharon Mader (Eds). Chicago, IL: Association of College and Research Libraries, 2019, xi + 114 pp., $50.00, ISBN 978-0-8389-4656-5

Building Teaching and Learning Communities opens a window to the “wider world of teaching and learning” by going beyond the academic library profession to gather inspiration and insight from leadin...
RECURRING ANTI-PHASE SIGNALS IN COUPLED NONLINEAR OSCILLATORS: CHAOTIC OR RANDOM TIME SERIES?

We discovered the existence of a new type of high-dimensional attractor in coupled nonlinear oscillator systems. Due to the presence of neutrally stable directions on the attractor, there can be noise-driven phase space diffusion. Recurring anti-phase states are observed as coherent portions of the time series. The observed time series looks coherent for a while, then incoherent, and then coherent again. Although the time series “looks” chaotic, the Lyapunov exponents are not positive.
Treatment tolerability and outcomes in elderly patients with head and neck cancer.

PURPOSE The number of elderly patients with head and neck squamous cell carcinoma (HNSCC) continues to grow. Management of this cohort remains poorly defined. We investigated treatment tolerability and clinical outcomes in this underrepresented population. METHODS We identified patients aged ≥70 with nonrecurrent, nonmetastatic HNSCC treated curatively from 2007-2018 and analyzed clinical covariates. RESULTS Two hundred and twenty patients with a median age of 75 (interquartile range:72-80) were identified. Age and comorbidities were not correlated with toxicity (P ≥ .05). Patients who experienced a treatment interruption had significantly greater weight loss (P = .042) and worse overall survival (OS) (P < .001), but not worse disease-specific survival (P = .45), or locoregional control (P = .21). CONCLUSIONS Treatment interruptions were associated with weight loss and worse OS, but not disease related outcomes, suggesting an interruption in the elderly may be a surrogate for another issue. In sum, our data should guide clinical trial design to benefit this growing, neglected cohort.
Bridging racial differences in the clinical encounter: How implicit bias and stereotype threat contribute to health care disparities in the dermatology clinic

Abstract Background Positive interactions that build good relationships between patients and providers demonstrate improved health outcomes for patients. Yet, racial minority patients may not be on an equal footing in having positive interactions. Stereotype threat and implicit bias in clinical medicine negatively affect the quality of care that racial minorities receive. Dermatology, one of the least racially diverse specialties in medicine, further falls short in providing patients with options for race-concordant visits, which are noted to afford improved experiences and outcomes. Objective This study aimed to analyze implicit bias and stereotype threat in a dermatology clinical scenario with the goal of identifying actions that providers, particularly those that are not racial minorities, can take to improve the quality of the clinical interactions between the minority patient and provider. Methods We illustrate a hypothetical patient visit and identify elements that are susceptible to both stereotype threat and implicit bias. We then develop an action plan that dermatologists can use to combat stereotype threat and implicit bias in the clinical setting. Results The details of an action plan to combat the effect of stereotype threat and implicit bias are as follows: 1) Invite practices that increase representation within all aspects of the patient visit (from wall art to mission statements to creating a culture that embraces difference and not just diversity); 2) employ communication techniques targeted to invite and understand the patient perspective; and 3) practice making empathic statements to normalize anxiety and foster connection during the visit. Conclusion Knowledge of stereotype threat and implicit bias and their sequelae, as well as an understanding of steps that can be taken preemptively to counteract these factors, create opportunities to improve clinical care and patient outcomes in racial minority patients.
Is the scalar property of interval timing preserved after hippocampus lesions

Abstract Time perception is fundamental for decision-making, adaptation, and survival. In the peak-interval (PI) paradigm, one of the critical features of time perception is its scale invariance, i.e., the error in time estimation increases linearly with the to-be-timed interval. Brain lesions can profoundly alter time perception, but do they also change its scalar property? In particular, hippocampus (HPC) lesions affect the memory of the reinforced durations. Experiments found that ventral hippocampus (vHPC) lesions shift the perceived durations to longer values while dorsal hippocampus (dHPC) lesions produce opposite effects. Here we used our implementation of the Striatal Beat Frequency (SBFML) model with biophysically realistic Morris-Lecar (ML) model neurons and a topological map of HPC memory to predict analytically and verify numerically the effect of HPC lesions on scalar property. We found that scalar property still holds after both vHPC and dHPC lesions in our SBFML-HPC network simulation. Our numerical results show that PI durations are shifted in the correct direction and match the experimental results. In our simulations, the relative peak shift of the behavioral response curve is controlled by two factors: (1) the lesion size, and (2) the cellular-level memory variance of the temporal durations stored in the HPC. The coefficient of variance (CV) of the behavioral response curve remained constant over the tested durations of PI procedure, which suggests that scalar property is not affected by HPC lesions.
Designing Simple Conjugated Polymers for Scalable and Efficient Organic Solar Cells.

Conjugated polymers have a long history of exploration and use in organic solar cells, and over the last twenty-five years, marked increases in the solar cell efficiency have been achieved. However, the synthetic complexity of these materials has also drastically increased, which makes the scalability of the highest-efficiency materials difficult. If conjugated polymers could be designed to exhibit both high efficiency and straightforward synthesis, the road to commercial reality would be more achievable. For that reason, a new synthetic approach was designed towards PTQ10 (=poly[(thiophene)-alt-(6,7-difluoro-2-(2-hexyldecyloxy)quinoxaline)]). The new synthetic approach to make PTQ10 brought a significant reduction in cost (1/7th the original) and could also easily accommodate different side chains to move towards green processing solvents. Furthermore, high-efficiency organic solar cells were demonstrated with a PTQ10:Y6 blend exhibiting approximately 15 % efficiency.
Structural and functional assessments on a champion runner--Peter Snell.

Abstract A unique opportunity was presented when a world record holder, Peter Snell, volunteered for medical, anthropometric, and physiologic study at the San Diego State Physical Education Research Laboratory. The medical examination resulted in a tentative diagnosis of an irritable colon syndrome. Other data from assessment of history, further physical examination, and blood and urine analysis are presented. The anthropometric data were used to assess somatotype, to make comparison with data collected on Snell in 1960, and to make comparisons with other gifted athletes. Maximal oxygen uptake was determined by a run to exhaustion on a horizontal treadmill. Snell's max V02 of 5.502 L/min. is the highest reported for a runner. Moreover, he was able to maintain an uptake exceeding 5.25 L/min. for the final 3.5 minutes. His uptake of 72.3 ml/min./kg was close to the mean of Astrand's runners, but below the values reported for Lash and Landy. Other physiologic responses were not unusual for an elite athlete. ...
Assessment of Knowledge with Written Test Forms

Written or computer-based assessment is the most appropriate modality to test cognitive knowledge. Two major classes of written assessment are discussed in this chapter: selected-response and constructed-response formats. Multiple-choice (MCQ), matching and extended matching, true false, multiple-true false and alternate-choice items are examples of the selected-response format. Long and short essays, very short essays, modified essay questions and written simulations, such as computer simulations, are examples of constructed-response formats. These assessment forms are critically evaluated in terms of their strengths, limitations, appropriateness, efficiency, research basis, psychometric properties, and validity evidence.
COMPETITION IN MIGRANT BIRDS IN THE NONBREEDING SEASON

Although it is widely recognized that migration is an adaptation that allows bird populations to exploit seasonal resources, the factors that underly the rich diversity of migration patterns is an area of active research. Predictably, the focus of much of the theory and most of the field work on migration has been the role of competition in shaping the timing and distribution of migration movements. In this review I will examine the theory and evidence for how competition affects the distribution and abundance of migrant birds during the nonbreeding season. I will focus the discussion on migrants that move from high to tropical latitudes, a distribution pattern that probably includes most of the migratory species. In the interest of economy of space, I will examine competition among and within migrant species and leave the overwhelming task of analyzing resident-migrant interactions to future reviewers.
Use of Transcranial Doppler in Monitoring Patients during Carotid Artery Stenting

It has been over 20 years since Aaslid first described the technique of middle cerebral artery range gated Doppler interrogation via a low-frequency ultrasound transducer stationed just above the zygomatic arch.1 Since that time insonation techniques with probe fixation headgear have made continuous real-time imaging much easier and advances in Doppler technology including “power Doppler” have improved signal clarity.2 A detailed review of the physics and utility of transcranial Doppler (TCD) is eloquently presented in Chapter 9. The objective of this chapter is to expose the reader to some of the lessons learned from adjuvant transcranial Doppler during carotid stent-supported angioplasty.
The synthesis, bioactivity and enzyme stability of D-Ala2, ∇EPhe4,Leu5-enkephalins

Abstract We have synthesized the first enkephalin analog containing a “cyclopropyl” phenylalanine (∇Phe) residue. The E-configuration of this residue is apparently responsible for its low activity in the MVD and GPI muscle assays. The enkephalin is very stable to cleavage by carboxypeptidase Y.
Introduction to Language Integrated Query (LINQ)

This chapter contains sections titled: Overview of Language Integrated Query Introduction to LINQ Query The Architecture and Components of LINQ LINQ to Objects LINQ to DataSet LINQ to SQL LINQ to Entities LINQ to XML Visual Basic.NET Language Enhancement for LINQ Chapter Summary Homework
Curious Concurrence: Justice Brandeis' Vote in Whitney v. California

A piece of jurisprudential sleuthing, this article uncovers the back story for a puzzle unanswered by legal historians for some eighty years: Why would the free-speech libertarian Louis Brandeis write the most famous paean to First Amendment normative values in his opinion in Whitney v. United States, and yet join (by way of a concurring opinion) the judgment of the majority of the Court that would have sent the "patrician radical" Anita Whitney to prison for a 14-year term solely for participating in the formation of the California Communist Labor Party? Part of the puzzle is provided by the unpublished Brandeis opinion in Rutherford v. Michigan, which is provided as an appendix to the article. This work was publicly recognized for its excellence in the Legal History Blog.
Psychotherapy, Effectiveness of

The effectiveness of psychotherapy has been the subject of study since the 1930s. The activities that characterize psychotherapy practice have evolved over time and today consist of hundreds of established procedures based on psychological theories aimed at reducing the symptoms of psychopathology. In this brief summary, some of the most notable findings are reviewed and their implications highlighted. Keywords: psychotherapy outcome; negative effects; efficiency of psychotherapy; placebo effect; outcomes management; outcome measures; psychoactive medication
First Case of Familial Creutzfeldt - Jakob Disease Associated with E200K Mutation in Peru: A Case Report (P2.308)

OBJECTIVE: Report the first case with definitive genetic diagnosis of familial Creutzfeldt-Jakob disease in Peru. Consider CJD as an etiology in patients presenting with rapidly progressive dementia. BACKGROUND: CJD is an uncommon neurodegenerative disease with an incidence of 1 per million individuals per year. The familial variant accounts for 10 to 15% of all cases of the CJD, where a missense mutation involving the substitution of lysine for glutamine in codon 200 is the most common PRNP gene mutation. RESULTS: A 46 year old male from Lima, Peru, with initial complains of paresthesias and dysesthesias of lower limbs for the past two months. One and a half month before admission, he started complaining of a mild headache and dizziness. One month before admission, ataxia, dysarthria, and daytime sleepiness developed, as well as mood and behavioral changes. 2 weeks before admission, anterograde amnesia and disturbance of visual acuity developed. On admission he was oriented in person and place but not in time. He was dysarthric with fasciculations in the right nasolabial fold on inspection. There was mild right-sided weakness associated with a right plantar extensor response as well as clonus and brisk deep-tendon reflexes. Superficial and deep sensitivity were preserved. Patient also presented a broad-based gait with a positive Romberg sign a well as bilateral dysmetria and dysdiadochokinesia. Cranial nerves examination was normal except for left deviation of the uvula. Laboratory studies including tumor markers, 24 hour heavy metal excretion, autoimmnune antibodies and CSF analysis were normal. An electroencephalogram showed periodic synchronous triphasic sharp wave complexes (PSWC). DWI and FLAIR MRIs demonstrated high signal intensities in basal ganglia and cortex of the medial surface of the temporal and occipital lobes on both sides. PCR amplification followed by sequenced analysis of a DNA sample showed a mutation of the gene E200K involving codon 129. CONCLUSIONS: This is the first case with genetic confirmation of E200K mutation for familial CJD in Peru. Disclosure: Dr. Eskenazi has nothing to disclose.
Effects of a decision support system on physicians' diagnostic performance.

Purpose: This study examines how the information provided by a diagnostic decision support system for clinical cases of varying diagnostic difficulty affects physicians' diagnostic performance. Methods: A national sample of 67 internists, 35 family physicians, and 6 other physicians used the Quick Medical Reference (QMR) diagnostic decision support system to assist them in the diagnosis of written clinical cases. Three sets of eight cases, stratified by diagnostic difficulty and the potential of QMR to produce high-quality information, were used. The effects of using QMR on three measures of physicians' diagnostic performance were analyzed using analyses of variance. Results: Physicians' diagnostic performance was significantly higher ( p < 0.01) on the easier cases and the cases for which QMR could provide higher-quality information. Conclusions: Physicians' diagnostic performance can be strongly influenced by the quality of information the system produces and the type of cases on which the system is used.
ARTEMIS observations of lunar pickup ions: Mass constraints on ion species

[1] Observations of heavy ions of lunar origin give important information regarding lunar exospheric processes, especially with respect to exospheric particle abundance and composition. Electrostatic analyzers without a time-of-flight section provide highly sensitive, absolute density detection but without mass discrimination. Here we place constraints on lunar ion species through inference of the average ion mass using such instruments. The technique is based on the plasma quasi-neutrality requirement, an independent electron density measurement, and the fact that electrostatic analyzers underestimate the ion density by the square root of the ion mass. Applied to a case of such observations by ARTEMIS in the terrestrial lobe reported by Poppe et al. (2012), our technique suggests an average mass of 28 amu for lunar pickup ions. This result, consistent with the lower limit of 24 amu derived in the Poppe et al. model, suggests that the observed ions were most likely Al+ and Si+. The technique is also refined and applied to a more complicated event with a series of heavy ion surges in the plasma sheet, to show the spatial and/or temporal dependence of the observed lunar ion species. The technique is particularly timely given the planned conjunctions and coordinated lunar studies by NASA's Acceleration, Reconnection, Turbulence and Electrodynamics of the Moon's Interaction with the Sun (ARTEMIS) and Lunar Atmosphere and Dust Environment Explorer missions.