cssi/SciSciGPT-SciSciNet huggingface dataset:
External dacryocystorhinostomy outcomes in patients with a history of dacryocystitis.

PURPOSE To investigate nonidiopathic causes of external dacryocystorhinostomy (DCR) failure. METHODS The medical records of all patients with acute or chronic dacryocystitis who underwent external dacryocystorhinostomy performed by the senior author over a 5-year period were retrospectively reviewed, with attention to microbiology, pathology, and associated medical and history. RESULTS A total of 52 lacrimal systems of 49 patients were included, with a minimum follow-up of 2 months (average, 15.5 months). Surgical success was achieved in 42 systems (87%). Of 7 failures, 6 had a condition potentially associated with an increased risk of failure, including MRSA infection, Gram-negative infection, rhinosinusitis, lymphoma, inflammatory bowel disease, and early loss of lacrimal stents. CONCLUSIONS External DCR is a successful procedure for the treatment of nasolacrimal obstruction associated with dacryocystitis. Various factors may affect surgical success, and awareness of these factors may enable better patient counseling and surgical planning.
Bleeding Versus Clotting? Both Are Equally Bad After Percutaneous Coronary Intervention.

Since the early days of coronary stenting, interventional cardiologists have learned to fear stent thrombosis. It was not difficult for us to understand that acute occlusion of a coronary stent and the resulting myocardial infarction could cause morbidity and death. We pass this fear along to our
Signature Pedagogies and Other Implications

This chapter builds on prior chapters’ examinations of the impact of the edTPA in the content areas of mathematics, English, and social studies in order to consider the overall affordances and constraints of edTPA for teacher preparation. It addresses the broader implications of mandated performance assessments on pedagogy, research, and scholarship in teacher education, guided by the following questions: What are the implications of the current interrelatedness between policy, privatization, professionalization, and performance assessments of teachers? What are the relationships between performance assessments and teacher education? In what ways is the teaching profession approaching certain signature pedagogies in light of current reforms, and what are the implications for teacher preparation programs?
DNA Repair and Mutagenesis, Second Edition

Featuring more than 10,000 references and a text lavishly complemented by over 700 illustrations, DNA Repair and Mutagenesis, 2nd Edition, is a timely update to the original edition published in 1995. The addition of three new authors, including an expert in the field of structural biology, ensures a comprehensive review of the most current research in diverse subject areas. An ideal textbook for advanced undergraduate and graduate students, the book is also an essential resource for all scientists researching cellular responses to DNA damage. Completely reorganized, the new edition presents a significant overhaul of the existing chapters and introduces important new material, reflective of the major changes and developments that have occurred in the field over the last decade. As with the first edition, this new volume presents the field within a strong historical framework and all aspects of biological responses to DNA damage are detailed. The book consists of 30 chapters divided into five main parts, covering: sources and consequences of DNA damage; correcting altered bases in DNA: DNA repair; DNA damage tolerance and mutagenesis; regulatory responses to DNA damage in eukaryotes; and disease states associated with defective biological responses to DNA damage. Basic principles are appropriately stressed; however, the book focuses on the significant progress to date and future research directions. Hardcover, 1,118 pages, two-color throughout with full-color insert, illustrations, index.
Thinking about asking: Encouraging a questioning approach to requirements gathering and problem solving

When a client, describing a problem that requires a computing solution, mentions their “old” customers, does it refer to the age of the customers or the length of time the customers have been with the business? How big is “big”, how much is “too many” and what exactly should happen to the extra banquet guests that fail to fill an entire table? While typical programming assignment descriptions are fully specified, with all ambiguity removed, real-world problems are frequently ill-defined, filled with ambiguity and open-ended. Successfully translating these problems into computing solutions involves both recognizing the issues that need to be addressed and asking questions to resolve the unknowns. Typical classroom examples and assignments purposely lack ambiguity and so do not provide students with the opportunity to develop the questioning skills that will be required in professional life. Further, for some students, asking questions implies not understanding the material, and thus can be perceived as a negative attribute. This paper presents an approach to encouraging an environment of questioning surrounding problem descriptions and potential solutions. The generality of the approach enables it to be incorporated into classes ranging from CS1 to upper-level courses such as Software Engineering and senior capstones.
A Culture of Uncertainty: Interaction and Organizational Memory in Software Engineering Teams under a Productivity Scheme:

Drawing on an ethnography of software engineering teams that introduced a new and empowerment-centered productivity scheme, this study delineates how, despite management’s affirmation of its commit...
Impressive New Theory and Theorist

Affective science continues to spawn new theories, each within a larger research program such as appraisal theory or psychological construction. At some point we need to integrate these theories, e...
Plasmonic and Nonplasmonic Characterization of Nanomaterials

Optical characterization has been one of the primary tools for researchers since time immemorial. However, most of the conventional techniques have either been diffraction-limited or require mechanical scanning and/or intensive numerical postprocessing that prohibits real-time observation. This chapter explores the contribution of different surface-wave imaging modalities for noninterferometric far-field imaging and characterization of nanoscale objects with truly high lateral resolution at visible frequencies using plasmonic and nonplasmonic evanescent surface waves excited using fluorescent molecules.
When contaminated dietary supplements cause positive drug tests: methylhexaneamine as a doping agent in sport

ABSTRACTResearchers estimate that contaminated dietary supplements cause between 6.4% and 8.8% of all positive drug tests in competitive sport. Methylhexaneamine (DMAA), an amphetamine derivative banned by the World Anti-Doping Agency (WADA) in 2009, has caused more positive tests than any other stimulant. The current article examines DMAA as a potentially hazardous supplement contaminant and doping agent, beginning with an historical overview. Sections addressing its status as both a performance-enhancing substance and potential health threat follow. The article then situates methylhexaneamine in a sport-policy context, identifying DMAA-related challenges to the effective and uniform enforcement of the WADA Code. A final section offers suggestions for both athletes and athletic organisations.
Catalytic Divergent [3+3]- and [3+2]-Cycloaddition by Discrimination Between Diazo Compounds

Highly selective divergent cycloaddition reactions of enoldiazo compounds and α-diazocarboximides catalyzed by copper(I) or dirhodium(II) have been developed. With tetrakis(acetonitrile)copper(I) tetrafluoroborate as the catalyst epoxypyrrolo[1,2-a]azepine derivatives were prepared in good yields and excellent diastereoselectivities through the first reported [3+3]-cycloaddition of a carbonyl ylide. Use of Rh2 (pfb)4 or Rh2 (esp)2 directs the reactants to regioselective [3+2]-cycloaddition generating cyclopenta[2,3]pyrrolo[2,1-b]oxazoles with good yields and excellent diastereoselectivities.
Incorporating Polymer Science Lecture Topics into the Beginning Organic Chemistry Course to Engage Students' Interest in Current and Future Applications.

The impact of polymeric materials on the well-being of citizens of the modern world is enormous. These materials enhance virtually every facet of life—from clothing and personal care items to housing and transportation. Yet despite this, and the fact that most chemists work in a polymer or polymer-related area, polymeric materials have traditionally gotten scant attention in the undergraduate chemistry curriculum. This is now beginning to change. The American Chemical Society now recognizes that undergraduate training in chemistry without inclusion of polymeric materials is inadequate. Inclusion of polymeric materials enhances the curriculum in several ways. It serves to generate student awareness, to create enthusiasm for chemistry, to promote good student performance, and to provide a sound basis for future career development.
Stereodynamic Quinone–Hydroquinone Molecules That Enantiomerize at sp3-Carbon via Redox-Interconversion

Since the discovery of molecular chirality, nonsuperimposable mirror-image organic molecules have been found to be essential across biological and chemical processes and increasingly in materials science. Generally, carbon centers containing four different substituents are configurationally stable, unless bonds to the stereogenic carbon atom are broken and re-formed. Herein, we describe sp3-stereogenic carbon-bearing molecules that dynamically isomerize, interconverting between enantiomers without cleavage of a constituent bond, nor through remote functional group migration. The stereodynamic molecules were designed to contain a pair of redox-active substituents, quinone and hydroquinone groups, which allow the enantiomerization to occur via redox-interconversion. In the presence of an enantiopure host, these molecules undergo a deracemization process that allows observation of enantiomerically enriched compounds. This work reveals a fundamentally distinct enantiomerization pathway available to chiral com...
The trochoblasts in the pilidium larva break an ancient spiralian constraint to enable continuous larval growth and maximally indirect development.

Nemertean embryos undergo equal spiral cleavage, and prior fate-mapping studies showed that some also exhibit key aspects of spiralian lineage-based fate specification, including specification of the primary trochoblasts, which differentiate early as the core of the prototroch of the spiralian trochophore larva. Yet it remains unclear how the nemertean pilidium larva, a long-lived planktotroph that grows substantially as it builds a juvenile body from isolated rudiments, develops within the constraints of spiral cleavage. We marked single cells in embryos of the pilidiophoran Maculaura alaskensis to show that primary, secondary, and accessory trochoblasts, cells that would make the prototroch in conventional spiralian trochophores (1q2, 1q12, and some descendants of 2q), fully account for the pilidium’s primary ciliary band, but without undergoing early cleavage arrest. Instead, the primary ciliary band consists of many small, albeit terminally differentiated, cells. The trochoblasts also give rise to niches of indefinitely proliferative cells (“axils”) that sustain continuous growth of the larval body, including new ciliated band. Several of the imaginal rudiments that form the juvenile body arise from the axils: in particular, we show that cephalic imaginal disks originate from 1a2 and 1b12 and that trunk imaginal disks likely originate from 2d. The pilidium exhibits a familiar relation between identified blastomeres and the primary ciliated band, but the manner in which these cells form this organ differs fundamentally from the way equivalent cells construct the trochophore’s prototroch. Also, the establishment, by some progeny of the putative trochoblasts, of indeterminate stem cell populations that give rise to juvenile rudiments, as opposed to an early cleavage arrest, implies a radical alteration in their developmental program. This transition may have been essential to the evolution of a maximally indirect developing larval form—the pilidium—among nemerteans.
Control of enzyme synthesis in microorganisms

Studies with microorganisms, especially Escherichia coli, have led to the recognition of three types of regulatory mechanisms. These include end product inhibition, molecular conversion and specific control of enzyme synthesis.
Liouville Transformation – 1

This chapter focuses on Liouville transformation (version 1). The Liouville transformation is applicable to the general Sturm–Liouville equation − [ p ( x ) y ']' + r ( x ) y = λ ρ ( x ) y , for a ≤ x ≤ b ; y '( a ) + α y ( a ) = 0; and y '( b ) + β y ( b ) = 0. The Liouville transformation (version 1) is to change the independent variable from x ∈ [ a , b ] to t ∈ [0, π]. The chapter also highlights that the standard assumptions required on equation −[ p ( x ) y ']' + r ( x ) y = λ ρ ( x ) y , for a ≤ x ≤ b ; y '( a ) + α y ( a ) = 0; and y '( b ) + β y ( b ) = 0 are that, on the interval [ a , b ]: p and q are real-valued, p > 0, q does not vanish, and p and q have continuous second derivatives. Boundedness conditions are also required for the new functions.
Proximal Adductor Avulsion Injuries: Outcomes of Surgical Reattachment in Athletes:

Background:Sports-related groin injuries are common among athletes. However, traumatic proximal adductor avulsion injuries are relatively rare groin injuries in the athletic population, with limite...
Complete Genome Sequence of a blaKPC-2-Positive Klebsiella pneumoniae Strain Isolated from the Effluent of an Urban Sewage Treatment Plant in Japan.

ABSTRACT Antimicrobial resistance genes (ARGs) and the bacteria that harbor them are widely distributed in the environment, especially in surface water, sewage treatment plant effluent, soil, and animal waste. In this study, we isolated a KPC-2-producing Klebsiella pneumoniae strain (GSU10-3) from a sampling site in Tokyo Bay, Japan, near a wastewater treatment plant (WWTP) and determined its complete genome sequence. Strain GSU10-3 is resistant to most β-lactam antibiotics and other antimicrobial agents (quinolones and aminoglycosides). This strain is classified as sequence type 11 (ST11), and a core genome phylogenetic analysis indicated that strain GSU10-3 is closely related to KPC-2-positive Chinese clinical isolates from 2011 to 2017 and is clearly distinct from strains isolated from the European Union (EU), United States, and other Asian countries. Strain GSU10-3 harbors four plasmids, including a blaKPC-2-positive plasmid, pGSU10-3-3 (66.2 kb), which is smaller than other blaKPC-2-positive plasmids and notably carries dual replicons (IncFII [pHN7A8] and IncN). Such downsizing and the presence of dual replicons may promote its maintenance and stable replication, contributing to its broad host range with low fitness costs. A second plasmid, pGSU10-3-1 (159.0 kb), an IncA/C2 replicon, carries a class 1 integron (containing intI1, dfrA12, aadA2, qacEΔ1, and sul1) with a high degree of similarity to a broad-host-range plasmid present in the family Enterobacteriaceae. The plasmid pGSU10-3-2 (134.8 kb), an IncFII(K) replicon, carries the IS26-mediated ARGs [aac(69)Ib-cr,blaOXA-1, catB4 (truncated), and aac(3)-IId], tet(A), and a copper/arsenate resistance locus. GSU10-3 is the first nonclinical KPC-2-producing environmental Enterobacteriaceae isolate from Japan for which the whole genome has been sequenced. IMPORTANCE We isolated and determined the complete genome sequence of a KPC-2-producing K. pneumoniae strain from a sampling site in Tokyo Bay, Japan, near a wastewater treatment plant (WWTP). In Japan, the KPC type has been very rarely detected, while IMP is the most predominant type of carbapenemase in clinical carbapenemase-producing Enterobacteriaceae (CPE) isolates. Although laboratory testing thus far suggested that Japan may be virtually free of KPC-producing Enterobacteriaceae, we have detected it from effluent from a WWTP. Antimicrobial resistance (AMR) monitoring of WWTP effluent may contribute to the early detection of future AMR bacterial dissemination in clinical settings and communities; indeed, it will help illuminate the whole picture in which environmental contamination through WWTP effluent plays a part.
Aspiration pneumonia and pneumonitis: a spectrum of infectious/noninfectious diseases affecting the lung.

Purpose of reviewOur purpose is to describe aspiration pneumonia/pneumonitis as a spectrum of infectious/noninfectious diseases affecting the lung. We summarize diagnosis, risk factors, treatment, and strategies for prevention of aspiration.Recent findingsAspiration is present in normal individuals,
Studio One: A New Teaching Model for Exploring Bio-Inspired Design and Fabrication

The increasing specialization in architecture has clearly left its marks not only on the general profession but also on architectural education. Many universities around the world react to this development by offering primarily conventional and overly discipline-specific courses that often lack bold new concepts. To remedy this situation, the authors propose an alternative teaching model called Studio One, which seeks to facilitate new dynamic links between architecture and other disciplines based on the interplay between fundamental research, design exploration, and practical application. The goal is to develop an interdisciplinary, collaborative design training that encompasses the best that nature has to teach us, realized through the technology that humans have achieved. At the core of this class is the study of biological structures and the development of bio-inspired construction principles for architectural design. Both aspects are rich sources of innovation and can play an important role in the training of future architects and engineers. This paper seeks to provide a coherent progress report. After a brief introduction to the general objectives of Studio One, the authors will specify the methods and 21st century skills that students learned during this class. Relying on four student capstone projects as examples, the paper will then go into more detail on how natural structures can inspire a new design process, in which students abstract basic biomimetic principles and transfer them into the construction of architectural prototypes and pavilions. Finally, the authors conclude by discussing the particular successes and challenges facing this teaching model and identify the key improvements that may give this program an even bigger impact in the future.
Triamcinolone acetonide in the treatment of acute and chronic lesions of the oral mucous membranes: Preliminary report

Abstract Triamcinolone acetonide was administered in a new vehicle adhesive to fifty-six patients with various acute and chronic lesions of the oral mucous membranes. Trimacinolone acetonide therapy was undertaken in many instances after relatively prolonged unsuccessful therapy with numerous other agents and/or placebos. The patients treated included six with erosive lichen planus, six with denture stomatitis, four with oral erythema multiforme, four with geographic tongue, three with orolingual paresthesias, eight with desquamative gingivitis or stomatitis, thirteen with recurrent ulcerative stomatitis, eight with denture irritations or other traumatic ulcers. two with chronic inflammatory lesions of unknown etiology, and two with postradiation (cancer therapy) stomatitis. Triamcinolone acetonide in the adhesive vehicle was found to have either (1) suppressant, (2) ameliorative, or (3) curative effects on the various oral mucosal lesions enumerated above, with the exception of the three patients with idiopathic orolingual paresthesia and the four patients with geographic tongue. Further studies with this agent in acute and chronic lesions of the oral mucous membranes, especially when combined with the new adhesive vehicle, seem indicated. Since triamcinolone acetonide is a powerful corticosteroid which is fully active systemically, the total dose administered and the duration of therapy must be considered carefully. It is also essential that, where possible, therapy be of a discontinuous nature and that particular advantage be taken of the adhesive vehicle's ability to maintain a drug at the site of application.
Inter- and Intra-Individual Differences in EMG and MMG during Maximal, Bilateral, Dynamic Leg Extensions.

The purpose of this study was to compare the composite, inter-individual, and intra-individual differences in the patterns of responses for electromyographic (EMG) and mechanomyographic (MMG) amplitude (AMP) and mean power frequency (MPF) during fatiguing, maximal, bilateral, and isokinetic leg extension muscle actions. Thirteen recreationally active men (age = 21.7 ± 2.6 years; body mass = 79.8 ± 11.5 kg; height = 174.2 ± 12.7 cm) performed maximal, bilateral leg extensions at 180°·s−1 until the torque values dropped to 50% of peak torque for two consecutive repetitions. The EMG and MMG signals from the vastus lateralis (VL) muscles of both limbs were recorded. Four 2(Leg) × 19(time) repeated measures ANOVAs were conducted to examine mean differences for EMG AMP, EMG MPF, MMG AMP, and MMG MPF between limbs, and polynomial regression analyses were performed to identify the patterns of neuromuscular responses. The results indicated no significant differences between limbs for EMG AMP (p = 0.44), EMG MPF (p = 0.33), MMG AMP (p = 0.89), or MMG MPF (p = 0.52). Polynomial regression analyses demonstrated substantial inter-individual variability. Inferences made regarding the patterns of neuromuscular responses to fatiguing and bilateral muscle actions should be considered on a subject-by-subject basis.
Superoxide Mediates Human Endothelial Cell Damage by Stimulated Granulocytes

The events that lead to irreversible neutrophil-mediated cell damage are poorly understood. Evidence indicates that the mechanism of injury varies with regard to cell type and the means of neutrophil (PMN) stimulation. The molecular basis of neutrophil-mediated cell injury and inhibitors of this process were evaluated in two in vitro assays: a neutrophil-mediated cytotoxicity assay, which measures the release of endothehal bound radiolabel and detects both cell injury and detachment; and a cytochrome c reduction assay which measures neutrophil-derived superoxide (O2-) activity. Human aortic endothelial (HAE) and human dermal microvascular endothelial (HDME) cells were found to differ in susceptibility to neutrophil-mediated injury. The amount of HAE cell injury correlated well with the amount of Or generated by stimulated PMN. HDME cells were injured in the presence of lower concentrations O2-than HAE cells and by PMN stimulated with inflammatory mediators (LPS, PAF, and fMLP) which appeared to generate little or no O2-. Neutrophil-mediated injury to both HAE and HDME cells was found, however, to be inhibitable by superoxide dismutase (SOD) in a dose dependent manner. The injury was not abrogated by catalase of the iron chelator, deferoxamine mesylate (desferol). When the amount of nitric oxide (NO) released from endothelial cells and unstimulated PMN (measured as nitrite) was examined, HDME cells and PMN were found to release significantly more NO than HAE cells. Stimulation of PMN to generate O2-resulted in significant decreases in basal nitrite levels. Furthermore, induction of NO synthesis by bradykinin or addition of exogenous NO significantly enhanced neutrophilmediated HAE cell injury. This injury was abolished by SOD. These results indicate that the superoxide anion is directly involved in the neutrophil-mediated killing of HAE and HDME cells. These data also suggest a role for peroxynitrite (formed upon interaction of NO and O2-) in oxidative damage. Differential release of NO from cell types may explain variation in susceptibility to neutrophil-mediated injury.
The Clp proteolytic system acts as an essential nexus for Plasmodium plastid biogenesis

The human malaria parasite, Plasmodium falciparum, contains a plastid called the apicoplast that functions to produce essential metabolites. Most of apicoplast proteins are encoded by the nuclear genome and it is unclear how the apicoplast controls its own proteome. Here, we investigated the prokaryotic caseinolytic-protease (Clp) system and how it regulates organelle proteostasis. Our data show that interfering with expression, activity or interactions of the Clp protease (PfClpP), chaperone (PfClpC), non-catalytic subunit (PfClpR), or substrate adaptor molecule (PfClpS) results in apicoplast loss. Using null-mutants, we demonstrated that PfClpP is essential due to its role in apicoplast biogenesis. Conditional mutants of PfClpP revealed the robustness of its proteolytic activity and its interaction with the chaperone PfClpC. Expression of a PfClpC variant with a mutation in the protease binding site demonstrated its role as an essential regulator of complex activity. A combination of several tagged Clp proteins was used for affinity purification and enabled us to determine complex composition. A CRISPR/Cas9 based system was developed and used for the expression of a catalytically-dead form of PfClpP in the background of PfClpP conditional mutants. These double-mutant parasites were used to determine the mechanisms of PfClpP oligomerization and maturation, and revealed its trans-autocatalytic properties. Further, we investigated the functions of the substrate adaptor molecule, PfClpS, and showed that it is essential for plastid biogenesis. This comprehensive study reveals the molecular mechanisms driving the function of the apicoplast PfClpP/R/C/S system and demonstrates its central role in the biogenesis of the plastid in malaria parasites.
TCF-1-Centered Transcriptional Network Drives an Effector Versus Exhausted CD8 T Cell-Fate Decision

Summary TCF-1 is a key transcription factor in progenitor exhausted CD8 T cells (Tex). Moreover, this Tex cell subset mediates responses to PD-1 checkpoint pathway blockade. However, the role of the transcription factor TCF-1 in early fate decisions and initial generation of Tex cells is unclear. Single-cell RNA sequencing (scRNA-seq) and lineage tracing identified a TCF-1+Ly108+PD-1+ CD8 T cell population that seeds development of mature Tex cells early during chronic infection. TCF-1 mediated the bifurcation between divergent fates, repressing development of terminal KLRG1Hi effectors while fostering KLRG1Lo Tex precursor cells, and PD-1 stabilized this TCF-1+ Tex precursor cell pool. TCF-1 mediated a T-bet-to-Eomes transcription factor transition in Tex precursors by promoting Eomes expression and drove c-Myb expression that controlled Bcl-2 and survival. These data define a role for TCF-1 in early-fate-bifurcation-driving Tex precursor cells and also identify PD-1 as a protector of this early TCF-1 subset.
Correction to: Geographic variation in thermal tolerance and morphology in a fiddler crab sister-species pair

In the original published article, the separators between numerator and denominator degrees of freedom in Tables 2 and 3 were excluded. The corrected Tables 2 and 3 are as follows.
Revisiting the Latest NRP Guidelines for Meconium: Searching for Clarity in a Murky Situation.

> First, do no harm. > Attributed to various sources To intubate or not to intubate an infant born through meconium-stained amniotic fluid (MSAF) has been a question that has challenged this often-quoted principle of first doing no harm, with the answer evolving significantly since the publication of the first Neonatal Resuscitation Program (NRP) guidelines >30 years ago.1 Those who trained and practiced in the 1980s and 1990s remember an era when all infants born through MSAF (both vigorous and nonvigorous) were routinely intubated after delivery or when decisions to intervene were perhaps based on the consistency and thickness of the meconium. NRP recommendations have since evolved, such that intubation was no longer recommended for vigorous infants born through MSAF after the fourth edition of the NRP guidelines was published in 2000.2 However, the recommendation for management of nonvigorous infants born through MSAF remained unchanged until the most recent seventh edition of the NRP guidelines (published in 2016), which no longer recommended routine intubation and tracheal suctioning for nonvigorous infants born through MSAF.3 These recommendations were made partly after a review of a few smaller single-center randomized controlled trials in which tracheal suctioning was compared with no suctioning in nonvigorous infants born through MSAF.4,5 On the basis of this review and the lack of evidence to support routine intubation and tracheal suctioning of nonvigorous infants born through MSAF, the most recent NRP recommendations were made in the context of avoiding the potential harm of intubation and the subsequent delay …
Leveraging mRNAs sequences to express SARS-CoV-2 antigens in vivo

SARS-CoV-2 has rapidly become a pandemic worldwide; therefore, an effective vaccine is urgently needed. Recently, messenger RNAs (mRNAs) have emerged as a promising platform for vaccination. Here, we systematically investigated the untranslated regions (UTRs) of mRNAs in order to enhance protein production. Through a comprehensive analysis of endogenous gene expression and de novo design of UTRs, we identified the optimal combination of 5' and 3' UTR, termed as NASAR, which was five to ten-fold more efficient than the tested endogenous UTRs. More importantly, NASAR mRNAs delivered by lipid-derived nanoparticles showed dramatic expression of potential SARS-CoV-2 antigens both in vitro and in vivo. These NASAR mRNAs merit further development as alternative SARS-CoV-2 vaccines.
Chapter 5 – PULSE MODULATION

Publisher Summary This chapter focuses on pulse modulation and discusses discrete and digital discrete transmission. An analog signal can be used to represent a quantity that can take on a continuum of values. For example, the pressure wave emitted by a pair of vocal chords when a person speaks constitutes an analog continuous waveform. A discrete signal is a signal that is not continuous in time. It only occurs over disconnected sections of the time axis. A digital signal can be either discrete or continuous in time. It can take on only values that are members of a discrete set. Pulse modulation, combined with amplitude modulation or frequency modulation, is usually not transmitted in the same way as the other forms of modulated signals. It is sent over wires that are capable of transmitting a wide range of frequencies efficiently. Sometimes it is sent through the air at microwave frequencies. These are high enough so that the large bandwidth does not become overpowering. Pulse width modulation is a nonlinear form of modulation.
Undertriage Despite Use of Geriatric-Specific Trauma Team Activation Guidelines : Who Are We Missing?

BackgroundElderly trauma patients are at risk for undertriage, resulting in substantial morbidity and mortality. The objective of this study was to determine whether implementation of geriatric-spe...
Measuring Community Integration: Development and Psychometrics of the Community Connections and Engagement Scale

The objective of this community-based participatory research project was to develop a clinically useful, psychometrically-sound scale to measure community integration for adults with severe mental illness. Two researchers and an administrator of a behavioral health agency (BHA) recruited a group of providers, half with lived-experience of severe mental illness. Through a series of five focus groups, provider participants guided identification of four major domains of community integration and the development of 95 scale items; items and domains were reviewed by three external researchers with subject matter expertise. Initial pilot: BHA providers administered the scale to clients (n = 51) with 19 completing it twice to investigate internal consistency, test–retest reliability, and restricted variance and collinearity of items. Further piloting: providers at two BHAs administered the scale to clients (n = 178) to conduct exploratory factor analysis and analyze internal consistency. After initial pilot, 50 items remained post item reduction for restricted variance and collinearity, with Cronbach’s alpha of .95 and test–retest reliability of .90. After a larger pilot, a four-factor solution emerged, aligning conceptually with the four domains as anticipated; 33 items loaded (factor loadings ≥ .4), with RMSEA of .069 and overall Cronbach’s alpha of .89 (subdomains ranging .78–.86). The scale has good preliminary psychometric properties and appears to be feasible for use in BHAs for the purposes of research and evaluation, with clinical utility for assessment and treatment planning.
Prevention of blast-induced auditory injury using 3D printed helmet and hearing protection device - a preliminary study on biomechanical modeling and animal

Introduction Repeated blast exposures result in structural damage to the peripheral auditory system (PAS) and the central auditory system (CAS). However, it is difficult to differentiate injuries between two distinct pathways: the mechanical damage in the PAS caused by blast pressure waves transmitted through the ear and the damage in the CAS caused by blast wave impacts on the head or traumatic brain injury. This article reports a preliminary study using a 3D printed chinchilla "helmet" as a head protection device associated with the hearing protection devices (e.g., earplugs) to isolate the CAS damage from the PAS injuries under repeated blast exposures. Materials and methods A finite element (FE) model of the chinchilla helmet was created based on micro-computed tomography images of a chinchilla skull and inputted into ANSYS for FE analysis on the helmet's protection against blast over pressure. The helmet was then 3D printed and used for animal experiments. Chinchillas were divided into four cases (ears open, with earplug only, with both earplug and helmet, and with helmet only) and exposed to three blasts at blast over pressure of 15 to 20 psi. Hearing function tests (e.g., auditory brainstem response) were performed before and after blast on Day 1 and Days 4 and 7 after blasts. Results The FE model simulation showed a significant reduction in intracranial stress with the helmet, and the animal results indicated that both earplug and helmet reduced the severity of blast-induced auditory injuries by approximately 20 dB but with different mechanisms. Conclusions The biomechanical modeling and animal experiments demonstrated that this four-case study in chinchillas with helmet and hearing protection devices provides a novel methodology to investigate the blast-induced damage in the PAS and CAS.
Review of the Medical Student Performance Evaluation: analysis of the end-users’ perspective across the specialties

The Medical Student Performance Evaluation (MSPE) is an important tool of communication used by program directors to make decisions in the residency application process. To understand the perspective and usage of the MSPE across multiple medical specialties now and in anticipation of the planned changes in USMLE Step 1 score-reporting. A survey instrument including quantitative and qualitative measures was developed and piloted. The final survey was distributed to residency programs across 28 specialties in 2020 via the main contact on the ACGME listserv. Of the 28 specialties surveyed, at least one response was received from 26 (93%). Eight percent of all programs (364/4675) responded to the survey, with most respondents being program directors. Usage of the MSPE varied among specialties. Approximately 1/3 of end-users stated that the MSPE is very or extremely influential in their initial screening process. Slightly less than half agreed or strongly agreed that they trust the information to be an accurate representation of applicants, though slightly more than half agree that the MSPE will become more influential once USMLE Step 1 becomes pass/fail. Professionalism was rated as the most important component and noteworthy characteristics among the least important in the decision-making process. Performance in the internal medicine clerkship was rated as the most influential while neurology and psychiatry performances were rated as less influential. Overwhelmingly, respondents suggested that including comparative performance and/or class rank would make the MSPE more useful once USMLE Step 1 becomes pass/fail. MSPE end-users across a variety of specialties utilize this complex document in different ways and value it differentially in their decision-making processes. Despite this, continued mistrust of the MSPE persists. A better understanding of end-users' perceptions of the MSPE offers the UME community an opportunity to transform the MSPE into a highly valued, trusted document of communication.
Favre−Racouchot disease: protective effect of solar elastosis

Favre-Racouchot disease (FRD) is an occupational disorder characterized by solar elastosis with open and cystically dilated comedones that tend to appear on the periorbital and temporal face of elderly light-complexioned men. It is a benign condition caused by chronic excessive ultraviolet exposure, as well as ionizing radiation and/or smoking. However, malignant skin neoplasms are uncommonly observed arising in FRD, which suggests a protective role of some element of FRD against carcinogenesis. We explore elastosis as a possibly beneficial tissue response. The clinical manifestations, pathogenesis, and recommended treatment options of this disorder are reviewed.
The Symbol Digit Modalities Test (SDMT) is sensitive but non-specific in MS: Lexical access speed, memory, and information processing speed independently contribute to SDMT performance

Abstract Background The Symbol Digit Modalities Test (SDMT) is the most sensitive metric of neurocognitive function in multiple sclerosis (MS), and is consistently interpreted as a measure of information processing speed (IPS). Objective To evaluate the cognitive psychometric profile captured by the SDMT to identify whether different cognitive processes independently underlie performance. Methods Three samples of MS patients (total n=661; 185 research patients at MS center; 370 clinical patients at MS center; 106 persons with MS from the community) completed objective assessments of neuropsychological function across cognitive domains. Exploratory factor analysis (EFA) was used to derive latent cognitive factor scores, and operationalize cognitive domain composite scores, to understand the unique, shared and redundant contribution of different cognitive domains to SDMT performance using hierarchical multiple regression and commonality analysis. Results Across three independent samples we provide converging strong evidence that the cognitive domains of Memory, IPS and Rapid Automatized Naming (lexical access speed) jointly and uniquely contribute to SDMT performance. Conclusion The SDMT measures multiple cognitive processes, which likely explains the high degree of sensitivity to cognitive change in MS. Researchers and clinicians should interpret the SDMT as a multifarious measure of general cognition rather than a specific test of IPS.
Thundering hoofbeats and dazzling zebras: A model integrating current rare disease perspectives in paleopathology.

Abstract Objective The article reviews the study of rare diseases and their nomenclature, emerging government policies and initiatives, and the concerns voiced by the modern rare disease communities. An interpretive model is then presented for the bioarchaeological interpretations of individuals with paleopathological evidence of rare diseases. Materials In demonstration of the application of the proposed framework, we evaluate the skeletal remains of an adult female (EZ 3-7-1) excavated in the 1980s from the Middle Woodland (50BCE–CE400) context of the Elizabeth site (11PK512) in the lower Illinois Valley, USA. Methods We use macroscopic examination methods, as well as cementochronology, to put forth the osteobiographical profile. Results The skeletal manifestations observed suggests limitations of major life activities, which would have increased in severity throughout the life course of EZ 3-7-1. Conclusions The study of EZ 3-7-1 demonstrates how an osteobiography, centering on the lived experiences and limitations throughout a life course, can allow for a deeper appreciation for life in the past. Significance By considering the perspectives of the modern rare disease community in the bioarchaeological methodology, research can include the nuanced impacts of the disease on life experiences and varying societal perceptions and attitudes, as well as raising awareness and advancing contemporary perspectives on impairment and disability. Limitations Without ample contextual evidence, there are limitations in making conclusions regarding social identity and disability. Suggestions for further research This framework should be applied to other rare diseases in a variety of contexts to further test its functionality.
Management of Laryngeal Dysplasia and Early Invasive Cancer

Dysplasia and early laryngeal cancer lie on a spectrum of cellular changes. These start with early changes to the cells including epithelial hyperplasia and expand to dysplasia, squamous cell carcinoma in situ and finally developing in to invasive cancer. Dysplasia can range from low to high grade, with each being treated in a different manner. Treatment options are typically determined by where the dysplasia/invasive cancer lie on this spectrum along with the site within the larynx. Hyperkeratosis, mild dysplasia and moderate dysplasia typically involve primary endoscopic excision. Severe dysplasia and squamous cell carcinoma in situ involve primary endoscopic resection with the addition of possible laser resection and/or ablation. At this stage, surgery will be followed by close surveillance. Finally, early laryngeal cancer such as T1 and T2 lesions is typically more involved. Treatment depends on the site and degree of involvement of the structures, along with spread to surrounding structures. Typical treatment options of more involved early laryngeal cancer can range from radiation therapy, endoscopic transoral laser resection, endoscopic transoral robotic resection to open resection. Often times, my choice of treatment will be aimed at voice preservation but patient preference will also play a role in the decision making between treatment modalities. Chemotherapy and immunotherapy are typically not used in early stage laryngeal cancer.
Pre-Appointment Nurse Navigation: Patient-Centered Findings From a Survey of Patients With Breast Cancer.

Background Research indicates that nurse navigators can play key roles in promoting empowerment for patients with cancer through advocacy, educational support, resource navigation, and psychosocial care. Objectives This study attempted to elucidate the efficacy of nurse navigation in patient knowledge, care coordination, and well-being before a breast oncology appointment. Methods Staff provided a nine-question survey to 50 newly referred patients before their initial appointment. After survey completion, patients had the option to participate in an open-ended interview about their experience. Findings A greater proportion of patients with initial nurse navigation than those without felt informed before their appointment and thought that their care was effectively coordinated. Although some patients without nurse navigation experienced delays and confusion in scheduling their appointment, no patients with nurse navigators reported such issues.
Unteaching Television: Identity, Politics, and the Female Lawyer on TV

Media and popular culture have long interested people of all ages who seek out entertainment products in order to relax and escape. Television, movies, books, magazines, and other media can transport a person from a living room sofa to a world of high stakes intrigue, mysterious characters, magical creatures, and futuristic fantasies. But media is more than merely a tool to entertain and relax; media is also a powerful tool for learning. The images and stories we see in film and television teach us about other people, other places, and other value systems. At its highest level, a well told story, presented through effective media, can be a tool that teaches empathy and in doing so enhances the humanistic qualities of even casual watchers. At its worst, however, the media can teach viewers that violence, greed, and anti-social behaviors are not only commonplace but also acceptable. For lawyers, the media is an especially important representation of professional and personal experience; most of the United States population experiences lawyering and gathers information about lawyers — their values, habits, work-life structure, and language — from watching actors represent lawyers in film and television. For the public, and for beginning law students in particular, these representations can mislead and misinform. The processes by which viewers are learning from film and television are schema and transfer processes, and an increased awareness of those processes will help first year law professors and other members of the profession to dispel and reverse inaccurate cultural understandings and improper uses of “lawyering” language. This article will first lay out the basic theories of learning by schema and transfer and the ways in which viewers of legal stories are influenced — and indeed learn — through the process of viewing. The article will then focus on three broad, media-based misconceptions related to law school and practice: that law school is easy; that prosecutors, but not defense attorneys, are most valued by society; and that the language of the law requires a kind of legalese, or deliberately opaque and heightened language. Finally, the article will propose interventions that can be used at the law school level to dispel the misconceptions students have learned by consuming media and to help first year law students redefine the notion of effective legal language such that they are better able to write, think, and succeed.
Smooth interpolation without twist constraints

Publisher Summary Smooth or blending function interpolants, which match a given function and slopes on the boundary of a rectangle or a triangle, usually require that the cross derivative or twist terms be defined unambiguously at vertices. Smooth interpolation schemes that avoid such restrictions could be useful for the piecewise generation of surfaces in computer-aided geometric design. This chapter discusses two such schemes—one over a rectangle and the other over a triangle. This chapter describes a new interpolation scheme for the triangle. This scheme has a relatively simple construction, it is symmetric in that each side of the triangle is treated in the same way, and it involves no compatibility constraints. The set of polynomials that are reproduced by an interpolation scheme is defined as the precision set of the interpolant.