cssi/SciSciGPT-SciSciNet huggingface dataset:
Racial Differences in Stage IV Colorectal Cancer Survival in Younger and Older Patients

Abstract Introduction African Americans (AAs) compared with European Americans (EAs) have poorer stage-specific survival from colorectal cancer (CRC). Recent reports have indicated that the racial difference in survival has worsened over time, especially among younger patients. To better characterize this association, we used population-based Surveillance, Epidemiology, and End Results registry data to evaluate the effect of race on stage IV CRC survival in patients aged Patients and Methods The population included 16,782 patients diagnosed with stage IV colon and rectal adenocarcinoma from January 1, 2004 and December 31, 2011. Cox proportional hazards regression was used to evaluate the association between race and other prognostic factors and the risk of death in each age group. Results Younger AAs compared with EAs had a greater prevalence of proximal CRC at diagnosis, a factor associated with a significantly greater risk of death in both races. Among patients Conclusion The results revealed poor overall survival for AAs compared with EAs, especially for those
Addressing Health Care Disparities Among Sexual Minorities

There is evidence of health disparities between sexual minority and heterosexual populations. Although the focus of lesbian, gay, bisexual, and transgender health research has been human immunodeficiency virus/acquired immunodeficiency syndrome and sexually transmitted infection among men who have sex with men, there are health disparities among sexual minority women. Using the minority stress framework, these disparities may in part be caused by individual prejudice, social stigma, and discrimination. To ensure equitable health for all, there is urgent need for targeted culturally sensitive health promotion, cultural sensitivity training for health care providers, and intervention-focused research.
Insurance Enrollment at a Student-Run Free Clinic After the Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act (ACA) aims to increase insurance coverage through government subsidies. Medical student-run free clinics (SRFC) are an important entry point into the healthcare system for the uninsured. SRFCs do not have a standardized approach for navigating the complexities of enrollment. The Weill Cornell Community Clinic (WCCC) developed a unique enrollment model that may inform other SRFCs. Our objective is to describe enrollment processes at SRFCs throughout New York City, and to evaluate enrollment outcomes and persistent barriers to coverage at WCCC. We surveyed SRFC leadership throughout NYC to understand enrollment processes. We evaluated enrollment outcomes at WCCC through chart review and structured phone interviews. Subjects included WCCC patients seen in clinic between October 1, 2013 and September 30, 2015 (N = 140). Demographic information, method of insurance enrollment, and qualitative description of enrollment barriers were collected. SRFCs in New York City have diverse enrollment processes. 48% (N = 42) of WCCC patients obtained health insurance. Immigration status was a barrier to coverage in 21% of patients. Failure to gain coverage was predicted by larger household size (p = 0.02). Gender and employment status were not associated with remaining uninsured. The main barriers to enrollment were inability to afford premiums and lack of interest. Insurance enrollment processes at SRFCs in New York City are mostly ad hoc and outcomes are rarely tracked. Following implementation of the ACA, WCCC stands out for its structured approach, with approximately half of eligible WCCC patients gaining coverage during the study period.
Hospital reimbursement for adult Patients with severe sepsis treated with drotrecogin alfa (activated)

Purpose: Patients with severe sepsis are critically ill and use a high level of health care resources. The high resource utilization and lack of a specific diagnosis related group may lead to a significant loss in revenuefor health care organizations secondary to inadequate reimbursement. The primary objective of this study is to quantify the difference in total cost and reimbursement in patients with severe sepsis treated with drotrecogin alfa (activated) (DAA) at our institution. Methods: All patients between December 2001 and December 2003 diagnosed with severe sepsis and treated with DAA were evaluated. Demographic data, primary payer, diagnosis related group, hospital length of stay, length of medical/surgical stay, length of Intensive Care Unit stay, days on mechanical ventilation, total costs, and total reimbursement were determined by chart review and our institution's information systems. Results: Data from a total of 71 patients were included. The total treatment cost was $6,294,590, and the total reimbursement received was $4,295,950. This represents a loss of $1,998,640 or $28,150 per patient. The primary factor contributing to this loss was Intensive Care Unit length of stay (P = 0.011). Conclusion: Management of patients with severe sepsis is costly and strains hospital resources. The current reimbursement system does not allow for appropriate compensation. Therefore, in addition to efforts directed toward improved treatment strategies for severe sepsis, health care practitioners must target interventions to reduce hospital length of stay and maximize reimbursement.
10-Year Resource Utilization and Costs for Cardiovascular Care

Abstract Background Cardiovascular disease (CVD) imparts a heavy economic burden on the U.S. health care system. Evidence regarding the long-term costs after comprehensive CVD screening is limited. Objectives This study calculated 10-year health care costs for 6,814 asymptomatic participants enrolled in MESA (Multi-Ethnic Study of Atherosclerosis), a registry sponsored by the National Heart, Lung, and Blood Institute, National Institutes of Health. Methods Cumulative 10-year costs for CVD medications, office visits, diagnostic procedures, coronary revascularization, and hospitalizations were calculated from detailed follow-up data. Costs were derived by using Medicare nationwide and zip code–specific costs, inflation corrected, discounted at 3% per year, and presented in 2014 U.S. dollars. Results Risk factor prevalence increased dramatically and, by 10 years, diabetes, hypertension, and dyslipidemia was reported in 19%, 57%, and 53%, respectively. Self-reported symptoms (i.e., chest pain or shortness of breath) were common (approximately 40% of enrollees). At 10 years, approximately one-third of enrollees reported having an echocardiogram or exercise test, whereas 7% underwent invasive coronary angiography. These utilization patterns resulted in 10-year health care costs of $23,142. The largest proportion of costs was associated with CVD medication use (78%). Approximately $2 of every $10 were spent for outpatient visits and diagnostic testing among the elderly, obese, those with a high-sensitivity C-reactive protein level >3 mg/l, or coronary artery calcium score (CACS) ≥400. Costs varied widely from $35,800 for high-risk (persons with diabetes, Framingham risk score ≥20%, or CACS ≥400) subgroups. Among high-risk enrollees, CVD costs accounted for $74 million of the $155 million consumed by MESA participants. Conclusions Longitudinal patterns of health care resource use after screening revealed new evidence on the economic burden of treatment and testing patterns not previously reported. Maintenance of a healthy population has the potential to markedly reduce the economic burden of CVD among asymptomatic individuals.
Virus Concentration from Water Using High-Rate Tangential-Flow Hollow Fiber Ultrafiltration

The efficacy of tangential flow hollow fiber Ultrafiltration (TFHFU) as a means of concentrating poliovirus 2 (Sabin) from large volumes of tap water was studied. Initially, hydrodynamic studies using 50-1 tap water feed solutions were conducted to evaluate transmembrane flux as a function of axial flow rates (or Reynold9s numbers, Re). With increasing Reynold9s number, flux-decline rates were reduced. As a result, experimental duration was shortened from 110 min at Re=300 to 30 min at Re=1728. In all cases, radial flow was assisted by a vacuum force applied to the outside of the hollow fibers. Virus recovery capability was evaluated using 20-, 50-, and 100-1 feed samples seeded with poliovirus 2 from 604 to 0.5 pfu/ml. All virus experiments were conducted at Re=1728 and a vacuum force of 3.27 × 10 4 Pa. The mean duration of the 20-, 50-, and 100-1 experiments was 13, 42, and 79 minutes, respectively. The overall average virus recovery from all experiments was 69.1 ± 24.6%. In operating the tangential-flow hollow fiber ultrafiltration module in its normal recycle-mode with low turbidity waters ( 1000 NTU. In spite of the high turbidity, the mean experiment duration for dehydrating 50 liters of turbid feed water was 39 minutes; approximately the same as for the low-turbidity tap water runs.
Comparative analysis of spore coat Formation, structure, and function in Dictyostelium

Dictyostelium produces spores at the end of its developmental cycle to propagate the lineage. The spore coat is an essential feature of spore biology contributing a semipermeable chemical and physical barrier to protect the enclosed amoeba. The coat is assembled from secreted proteins and a polysaccharide, and from cellulose produced at the cell surface. They are organized into a polarized molecular sandwich with proteins forming layers surrounding the microfibrillar cellulose core. Genetic and biochemical studies are beginning to provide insight into how the deliveries of protein and cellulose to the cell surface are coordinated and how cysteine-rich domains of the proteins interact to form the layers. A multidomain inner layer protein, SP85/PsB, seems to have a central role in regulating coat assembly and contributing to a core structural module that bridges proteins to cellulose. Coat formation and structure have many parallels in walls from plant, algal, yeast, protist, and animal cells.
Introduction to Blessays

We have been publishing outstanding student papers in this column for the past seventeen years. The column was the brain child of former editor Jim Cole. For this issue we are publishing something ...
Hemodynamics Of Prostate Bone Metastases

The mechanism of bone metastases in patients with carcinoma of the prostate remains controversial. It is recognized that bone metastases may occur by arterial spread, retrograde venous spread or direct involvement from contiguous structures. The bone is devoid of lymphatics and therefore this vascular pathway is not a likely mechanism for the development of metastatic foci. Two theories predominate related to the mechanism of spread to bone from carcinoma of the prostate. Tumor emboli are believed to be randomly distributed throughout the body and sites of successful metastases are related to “seed-in-fertile soil.” Skeletal metastases occur primarily in areas containing hematopoietically active red bone marrow and it is this framework on which metastases form. Based on these principles it is believed that tumor cells enter the lymphatic drainage of the prostate, pass through the thoracic duct and enter into the general circulation. They pass through the lungs and heart and become distributed randomly throughout the body in this manner. Because they are more prone to grow in bone marrow active foci become evident in these areas. Proponents of this theory base their arguments on the similar distribution of bony metastases of lung and breast carcinoma. The other predominant theory related to the spread of carcinoma of the prostate is based on the anatomical findings of Batson’s paravertebral venous plexus. This valveless plexus of veins anastomoses with pelvic, intercostal and head and neck and intracranial veins and ascends the vertebral column. Increases in intrathoracic pressure directs blood flow into this system from the caval and azygous venous system and accounts for the increased distribution of axial skeletal metastases in patients with carcinoma of the prostate. Tumor cells would therefore not pass through the lungs or liver. Experimental evidence supports this form of metastases as well.
Time-efficient Target Guarding using Constrained Optimization in 3D Space

This paper presents a time-efficient solution to the target guarding problem in the presence of the obstacles. The problem is defined as a multiple pursuer, one evader zero-sum game where the pursuers try to intercept the evader before it reaches a target. The presented method is a fast, numerical, constrained optimization technique that plans the path of all pursuers. The short execution time (under 10 ms) of this method makes it suitable to fast pursuits, possibly online applications, where the delay of the processing time plays a major effect on the pursuer success even in highly cluttered maps. The proposed method proved effective in simulated scenarios.
Regional differences in the utilization of active surveillance in localized prostate cancer.

e17062Background: Men with localized prostate cancer have various treatment options available in their management. In recent years, active surveillance (AS) has become more utilized in prostate can...
Clinical Presentation and Treatment Options for Clear Cell Lung Cancer: University of Cincinnati A Case Series and Literature Review of Clear Cell Lung Cancer

Clear cell carcinomas are common finding in renal, ovarian and uterine carcinomas. However, clear cell lung cancer (CCLC), first described by Liebow and Castleman in 1963, is considered an extremely rare variant of lung tumors. The 2011 WHO classification of lung tumors considered CCLC as a rare cytologic feature of squamous cell or adenocarcinomas. It is no longer recognized as a formal subtype, albeit it can be referred to in the pathological diagnosis as “with clear cell features” even with marginal fractions of the tumor cells. Such recognition is needed since the variation in clinical features and outcome in this subset of patients. The disease has a clinically vague natural history, is characterized by slight female predominance and is often seen in the elderly. As frequently encountered with rare diseases, its clinical course and treatment options have many questions still yet to be answered. In this paper, we review both the natural history and treatment options mentioned in literature, in the light of our experience by reporting a case series of four patients diagnosed with CCLC and highlight their aspects.
Slow Delayed Rectifier Current Protects Ventricular Myocytes From Arrhythmic Dynamics Across Multiple Species: A Computational Study.

Background: The slow and rapid delayed rectifier K+ currents (IKs and IKr, respectively) are responsible for repolarizing the ventricular action potential (AP) and preventing abnormally long APs th...
The hypertension advantage and natural selection: Since type 2 diabetes associates with co-morbidities and premature death, why have the genetic variants remained in the human genome?

Abstract Type 2 diabetes is a major public health crisis around the world. It is estimated that more than 300 million people worldwide have type 2 diabetes. Furthermore, the World Health Organization estimates that deaths from the complications of diabetes will increase by two thirds between 2008 and 2030. Since type 2 diabetes is a major public health crisis, why have the genetic variants for diabetes not been removed from the genome by natural selection? We hypothesize that insulin resistance, a predisposition to type 2 diabetes, and the associated elevation in sympathetic nervous system activity and arterial blood pressure provided an advantage to humans who lived as hunter-gatherers. Specifically, sympathetic hyperactivity stimulates the renin-angiotensin aldosterone system, promotes sodium reabsorption, and increases blood volume, heart rate, stroke volume and peripheral vascular resistance, thus inducing hypertension. The hypertension in turn provides a hemodynamic advantage for hunter-gatherers. Specifically, sympathetic hyperactivity and increased blood pressure increases blood flow delivery to working muscles by increasing cardiac output and shunting blood from non-active tissue. This natural selection for hypertension occurred during the time in human evolutionary history when the lifespan of most individuals was probably 30–40 years, and morbidity and mortality from cardiovascular disorders was limited. Thus, the selection pressure for elevation in sympathetic nervous system activity and blood pressure provided an advantage for hunting and gathering that would be greater than the selection pressure exerted by the manifestations of cardiovascular disease in aged individuals.
Examining physiological and perceptual consequences of noise exposure

The consequences of noise exposure on the auditory system are not entirely understood. In animals, noise exposure causes selective synaptopathy-an uncoupling of auditory nerve fibers from sensory cells-mostly in fibers that respond to high sound levels. Synaptopathy can be measured physiologically in animals, but a direct relationship between noise exposure and synaptopathy in humans has yet to be proven. Sources of variability, such as age, indirect measures of noise exposure, and comorbid auditory disorders, obfuscate attempts to find concrete relationships between noise exposure, synaptopathy, and perceptual consequences. This study adds to the ongoing effort by examining relationships between noise exposure, auditory brainstem response (ABR) amplitudes, and speech perception in adults of various ages and audiometric thresholds and a subset of younger adults with clinically normal hearing. Regression models including noise exposure, age, hearing thresholds, and sex as covariates were compared to find a best-fitting model of toneburst ABR wave I amplitude at two frequencies and word recognition performance in three listening conditions: background noise, time compression, and time compression with reverberation. The data suggest the possibility of detecting synaptopathy in younger adults using physiological measures, but that age and comorbid hearing disorders may hinder attempts to assess noise-induced synaptopathy.
The Effect of the Domestic Production Activities Deduction on Corporate Payout Behavior

The American Jobs Creation Act of 2004 created a tax holiday allowing firms to repatriate foreign earnings at a reduced tax rate and a domestic production activities deduction (DPAD) to encourage domestic investment. We investigate whether the DPAD affects firms’ decisions to use repatriated earnings to increase investment versus shareholder payout. We find that firms receiving an incremental benefit from the DPAD decrease payout by approximately $7.2 billion whereas firms receiving no incremental benefit from the DPAD increase payout by approximately $18.3 billion. This suggests that, under certain conditions, firms retain repatriated funds which may lead to increased domestic investment.
A strategy for expanding infection prevention resources to support organizational growth.

Background The field of infection prevention is rapidly evolving and becoming increasingly complex, as resource-intensive responses to device-associated outbreaks, global epidemics, and regulatory requirements continue to grow. This increasing complexity coupled with changing health care systems present important challenges to infection prevention staffing and resources. We describe the development of a novel infection prevention and control (IPC) staffing structure that includes both infection preventionists (IPs) and role-specific support staff to meet the evolving IPC needs and challenges of an expanding health care network. Methods The IPC department at Children's Hospital of Philadelphia underwent iterative modifications to its staffing structure between 2014 and 2018, including the development of revised job descriptions and promotional criteria, career ladders, and supporting roles. Data on key infection prevention activities, including rounding frequency and performance of audits and observations, growth metrics and infection data was evaluated for trends before and after departmental restructuring. An overall health care associated infection (HAI) index was calculated based on existing surveillance data and used to monitor patient outcomes over time. In addition, departmental employee engagement was assessed via a standard survey instrument to evaluate improvements in teamwork and professional growth opportunities over time. Results Between 2014 and 2018, the number of unique job descriptions for IPs and support staff increased from 4 to 9, creating a 3-tier career ladder for IPs and increasing full time equivalents from 8.2 to 11.6. Additional support roles included a Hand Hygiene Program Manager, Infection Prevention Associates and a Clinical Practice Analyst; these roles, along with increased IP staffing, expanded the education and consultative range of the department, as measured by a 33% increase in environmental rounding and a 7-fold increase in performance of isolation audits. Team diversity also expanded, changing from a team with predominantly nursing backgrounds, to one with an equal distribution of nursing, public health, and laboratory scientists. Results from serial engagement surveys showed an increase in teamwork and professional growth by 7.4% and 5.4%, respectively. Over this time period, the total HAI index decreased by 23%, while patient days, central line days, and ventilator days increased each year, and there was a statistically significant reduction in rates of harm across 5 key HAI indicators. Conclusions Role diversity and varying professional backgrounds within IPC programs offer a complement of strengths and increase capacity to support patient care activities, improving patient outcomes. This strategy leads to a more cost-effective, robust IPC program that supports the growing needs and evolving challenges of the field.
Probability Distribution of Velocity Circulation in Three Dimensional Turbulence

We elaborate the statistical field theory of Turbulence suggested in the previous paper \cite{M20a}. We clarify and simplify the basic Energy pumping equation of that theory and study mathematical properties of singular field configuration (instanton) which determine the tails of PDF for the velocity circulation around large loop $C$ in isotropic turbulence at highest Reynolds numbers. Explicit analytic solution is found for the Clebsch instanton in an Euler equation for a planar loop circulation problem. This solution for vorticity is has a term proportional to a delta function in normal direction to the minimal surface bounded by the loop. The smoothing of $\delta$ functions in the vorticity in the full Navier-Stokes equations is investigated and exponential profile of smoothed singularity is found. The PDF for circulation is now an infinite sum of decreasing exponential terms $\EXP{- n |w|}\sqrt{\frac{n}{|w|}}$, with $ w = \frac{\Gamma}{\Gamma_0[C]}$, and $ \Gamma_0[C] \sim \sqrt{A_C} $ with minimal area $A_C$. The leading term fits with adjusted $R^2 = 0.9999$ the PDF tail found in DNS over more than six orders of magnitude. The area dependence of the ratio of the circulation moments $M_8/M_6$ fits with adjusted $R^2=0.9996$ the DNS in inertial range of square loop sizes from $100 $ to $500$ Kolmogorov scales. Thus, our theory explains DNS with high degree or confidence. For a flat loop we derive two-dimensional integral equation for the dependence of the scale $\Gamma_0[C] $ of circulation as a function of the shape of the loop (aspect ratio for rectangular loop
Variations on a Dance of the Roma

Explore a music and dance tradition known as cocek in Macedonia, and by other names in Bulgaria. Albania, Serbia, and throughout the Balkan Peninsula. This tradition is long associated with the Rom...
The pharmacological importance of the uptake mechanism for sympathomimetic amines.

Publisher Summary The intraneuronal uptake of sympathomimetic amines is the most important mechanism involved in influencing the concentration of the amines at receptors. Although both monoamine oxidase and catechol- O -methyl transferase (COMT) have been found to be very important in the degradation of norepinephrine, the use of specific inhibitors of these enzymes has revealed that the two enzymes do not play the same role in the fate of norepinephrine that is played by acetylcholinesterase (ACh-ase) in the fate of acetylcholine (ACh). This chapter describes (1) the rate of intraneuronal uptake (determined at concentrations that do not saturate the uptake mechanism), (2) the relation between the potency of an amine and the concentration that causes partial saturation of uptake, (3) the degree of extraneuronal binding observed with pharmacologically effective concentrations of the amine, (4) the effect of enzymes on the concentration of sympathomimetic amines at the receptors with particular attention on the possibility of saturation of the enzymes or of access to the enzymes, (5) the density of adrenergic innervations, and (6) the morphological relationship between effector cells and adrenergic nerve endings.
Outcomes and risk factors for ERCP-related complications in a predominantly black urban population

Objective There is a lack of literature on postendoscopic retrograde cholangiopancreatography (ERCP) complications in predominantly black urban populations of low socioeconomic status. The aim of this study was to determine the incidence and predictors of post-ERCP complications in this patient population. Design Retrospective review of ERCP cases performed at two hospitals from 2007 to 2017 was performed. The categories of complications evaluated were overall complications, severe or fatal complications, pancreatitis, bleeding, infection, perforation and cardiopulmonary events. Predictors of complications were determined by univariate analysis. Results A total of 1079 ERCP procedures were reviewed. There were 106 complications (9.8%). Twenty-one were severe (1.9%) and 20 were fatal (1.9%). Both post-ERCP pancreatitis (PEP) and post-ERCP bleeding occurred in 18 patients (1.7%) each. Risk factors for overall complications were male sex (OR 1.54), ASA grade IV or V (OR 2.19), prior history of PEP (OR 6.98) and pancreatic duct stent placement (OR 2.75). Those who were ASA grade III or lower (OR 0.4) or who underwent biliary stone extraction (OR 0.62) had fewer complications. PEP was more likely in those with a prior history of PEP (OR 37.6). Those with a suspected or known biliary duct stone had less frequent pancreatitis (OR 0.32). Post-ERCP bleeding was more likely in the presence of cholangitis (OR 8.72). Conclusion Outcomes of ERCP in a predominantly black urban population demonstrate a lower incidence of PEP and all-cause mortality compared with historical data reported in the general population. Potential risk factors for post-ERCP complications were identified but require larger studies for validation.
On monotonicity preserving linear extrapolation sequences

Let (a n ) be a strictly monotone and convergent sequence of real numbers. Necessary and sufficient conditions are given that the sequence (b n ) defined by $$b_n = \frac{{a_{n + 1} - k_n a_n }}{{1 - k_n }}$$ is strictly monotone either in the same or in the opposite direction as (a n ), provided (k n ) is monotone in the same direction as (a n ). Two numerical examples are presented.
Asymptotically Corrected Person Fit Statistics for Multidimensional Constructs with Simple Structure and Mixed Item Types

Person fit statistics are frequently used to detect aberrant behavior when assuming an item response model generated the data. A common statistic, [Formula: see text], has been shown in previous studies to perform well under a myriad of conditions. However, it is well-known that [Formula: see text] does not follow a standard normal distribution when using an estimated latent trait. As a result, corrections of [Formula: see text], called [Formula: see text], have been proposed in the literature for specific item response models. We propose a more general correction that is applicable to many types of data, namely survey or tests with multiple item types and underlying latent constructs, which subsumes previous work done by others. In addition, we provide corrections for multiple estimators of [Formula: see text], the latent trait, including MLE, MAP and WLE. We provide analytical derivations that justifies our proposed correction, as well as simulation studies to examine the performance of the proposed correction with finite test lengths. An applied example is also provided to demonstrate proof of concept. We conclude with recommendations for practitioners when the asymptotic correction works well under different conditions and also future directions.
Abstract PO-046: Combining PARP inhibition with radiation to sensitize homologous recombination proficient pancreatic cancer to immunotherapy

Pancreatic cancer is notoriously resistant to most cancer therapeutics including immunotherapy. We have previously shown that inhibition of the DNA damage response (DDR) enhances radiation-induced Type I interferon (T1IFN) and sensitizes pancreatic cancers to immunotherapy. In this study, we investigated the efficacy of radiation in combination with the poly (ADP-ribose) polymerase (PARP)inhibitor olaparib and programmed death ligand 1 (PD-L1) immune checkpoint blockade in otherwise resistant homologous recombination (HR) proficient pancreatic cancer. Initial studies demonstrated, in contrast to olaparib alone, that the combination of olaparib and radiation induced innate immune signaling in HR proficient pancreatic cancer cells marked by increases in pTBK1, T1IFN and pSTAT1. In animal tumor models, we found that the therapeutic efficacy of olaparib and radiation was greater in immune competent versus immune deficient hosts. In addition to the positive immune effects of olaparib and radiation, we also observed increased expression of PD-L1, a negative immune regulatory mechanism that likely restrains T1IFN-mediated innate immunity. We therefore went on to test the combined efficacy of PD-L1 blocking antibody with olaparib and radiation in syngeneic pancreatic tumor models. We found that monotherapy was ineffective in controlling tumor growth while doublet therapy with olaparib and radiation produced an intermediate tumor growth response. Importantly, maximal tumor growth inhibition was achieved following combined treatment with olaparib, radiation, and anti-PD-L1 which was significant relative to doublet therapy with olaparib-radiation or anti-PD-L1-radiation, and associated with a 20% complete response rate. Given that advances in therapy of pancreatic cancer require improvements in both local and systemic disease control, we examined the efficacy of combined therapy against tumors outside of the radiation field. In addition to the effects on tumors in the radiation field, we found that combined therapy with olaparib, radiation and anti-PD-L1 significantly delayed the growth of contralateral tumors outside of the radiation field, suggesting an adaptive immune response. Taken together, these studies illustrate the potential efficacy of combined therapy with olaparib, radiation, and anti-PD-L1 on both local and systemic pancreatic cancer and support our proposed clinical trial in patients with pancreatic cancer. Citation Format: Qiang Zhang, Long Jiang, Yawen Zheng, Theodore Lawrence, Vaibhav Sahai, Michael D. Green, Meredith Morgan. Combining PARP inhibition with radiation to sensitize homologous recombination proficient pancreatic cancer to immunotherapy [abstract]. In: Proceedings of the AACR Virtual Special Conference on Radiation Science and Medicine; 2021 Mar 2-3. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(8_Suppl):Abstract nr PO-046.
SHORT FICTIVE REFLECTIONS ON THE PERCEPTION OF A POSTSECONDARY EXPERIENCE OF LONG-TERM INCARCERATED JUVENILES

There is a gap in the literature regarding postsecondary opportunities for incarcerated youth. Research and curriculum design are rarely available for the purpose of improving juvenile postsecondary correctional education thereby not improving recidivism rates of formerly incarcerated students. The pilot program in this study attempted to provide a comprehensive university program for long-term incarcerated juveniles to get them on track to obtain a bachelor’s degree. This study addressed the academic experiences, including the School to Prison Pipeline and the academic experience to provide information, justifying the importance of creating postsecondary academic opportunities for incarcerated juveniles. Then, the study analyzed interviews with recently released students of the program to give insight to correctional education experiences vis-a-vis artistic representations, in this case, short fiction. This article presents fictive artistic representations that give a closer look at the secondary and postsecondary educational experiences of two of the cohort participants.
BISPHOSPHONATE RELATED OSTEONECROSIS OF THE JAWS (BRONJ) STAGE 3 IN A PATIENT WITH LUNG CANCER AND BONE METASTASIS—A CASE REPORT

Background Bisphosphonates are used mainly to treat osteoporosis, multiple myeloma, and bone metastasis of tumors. However, their use has been associated with the appearance of osteonecrosis of the jaw (BRONJ), even though their exact mechanism of action is not yet well understood. Research shows that it is related to the suspension of bone resorption as a result of the reduction of the osteoclast activity. Objective The present study reports the case of a 61-year-old male patient with lung cancer exhibiting bone metastasis who developed BRONJ while receiving zoledronic acid. According to the American Association of Oral and Maxillofacial Surgeons staging system he was in stage 3, which includes exposed and necrotic bone, oral antral/oral nasal communication, and extraoral fistula. Results The patient was managed with antibacterial mouthrinse, antibiotic therapy and pain control, surgical debridement, and resection for long-term palliation of infection and pain, as well as closure of the oral antral/nasal communication and extraoral fistula. The patient was in excellent condition after 8 months and continued his treatment with dental restoration. Conclusions Our case study shows that with proper treatment there can be complete recovery of a patient with stage 3 BRONJ. The methods of prevention and treatment of BRONJ are discussed based on references and clinical experience.
Teens' Conceptual Understanding of Web Search Engines: The Case of Google Search Engine Result Pages (SERPs).

We explored teens’ (aged 15–17) conceptual understanding of search engines (SEs), emphasizing search engine result pages (SERPs). In an online survey, we asked teens to articulate how a search engine (SE) finds, generates summaries of, and ranks search results; identify the structural components of search results; comment on learning in school about SEs; as well as provide suggestions for improving SEs. Of one-hundred and ten teens, twenty-two completed the survey. Analyses revealed that teens’ conceptual understanding of SERPs is more perceptual than conceptual and guided by incidental and experiential learnings rather than systematic instruction in school. We found a gap between teens’ understanding of the design and representation of the structural components of search results and Google designers’ conceptual model (interface design) of these components, suggesting the need for design that is more transparent and with better affordances and signifiers. Teens suggested three categories of design improvements in Google (SERPs, Search and Retrieval, and Privacy) in support of enhancing their experiences. Practical and theoretical implications are discussed.
Typing on Midair Virtual Keyboards: Exploring Visual Designs and Interaction Styles

We investigate typing on a QWERTY keyboard rendered in virtual reality. Our system tracks users’ hands in the virtual environment via a Leap Motion mounted on the front of a head mounted display. This allows typing on an auto-correcting midair keyboard without the need for auxiliary input devices such as gloves or handheld controllers. It supports input via the index fingers of one or both hands. We compare two keyboard designs: a normal QWERTY layout and a split layout. We found users typed at around 16 words-per-minute using one or both index fingers on the normal layout, and about 15 words-per-minute using both index fingers on the split layout. Users had a corrected error rate below 2% in all cases. To explore midair typing with limited or no visual feedback, we had users type on an invisible keyboard. Users typed on this keyboard at 11 words-per-minute at an error rate of 3.3% despite the keyboard providing almost no visual feedback.
Biomechanical Testing of Suture Anchor Versus Transosseous Tunnel Technique for Quadriceps Tendon Repair Yields Similar Outcomes: A Systematic Review

Purpose To systematically review the literature to evaluate the biomechanical properties of the suture anchor (SA) versus transosseous tunnel (TO) techniques for quadriceps tendon (QT) repair. Methods A systematic review was performed by searching PubMed, the Cochrane Library, and Embase using PRISMA guidelines to identify studies that evaluated the biomechanical properties of SA and TO techniques for repair of a ruptured QT. The search phrase used was “quadriceps tendon repair biomechanics”. Evaluated properties included ultimate load to failure (N), displacement (mm), stiffness (N/mm), and mode of failure. Results Five studies met inclusion criteria, including a total of 72 specimens undergoing QT repair via the SA technique and 42 via the TO technique. Three of 4 studies found QTs repaired with SA to have significantly less elongation upon initial cyclic loading when compared to QTs repaired with the TO technique (P .05). The most common mode of failure in both groups was suture slippage. Conclusion On the basis of the included cadaveric studies, QTs repaired via the SA technique have less initial displacement upon cyclic testing when compared to QTs repaired via the TO technique. However, final displacement and ultimate load to failure outcomes did not reveal differences between the two fixation strategies. Knot slippage remains a common failure method for both strategies.
Reversing the miRNA -5p/-3p stoichiometry reveals physiological roles and targets of miR-140 miRNAs

The chondrocyte specific miR-140 miRNAs are necessary for normal endochondral bone growth in mice. miR-140 deficiency causes dwarfism and craniofacial deformity. However, the physiologically important targets of miR-140 miRNAs are still unclear. The miR-140 gene (Mir140) encodes three chondrocyte-specific microRNAs, miR-140-5p, derived from the 5′ strand of primary miR-140, and miR140-3p.1 and -3p.2, derived from the 3′ strand of primary miR-140. miR-140-3p miRNAs are ten times more abundant than miR-140-5p likely due to the non-preferential loading of miR-140-5p to Argonaute proteins. To differentiate the role of miR-140-5p and -3p miRNAs in endochondral bone development, two distinct mouse models, miR140-C>T, in which the first nucleotide of miR-140-5p was altered from cytosine to uridine, and miR140-CG, where the first two nucleotides of miR-140-3p were changed to cytosine and guanine, were created. These changes are expected to alter Argonaute protein loading preference of -5p and -3p to increase -5p loading and decrease -3p loading without changing the function of miR140-5p. These models presented a mild delay in epiphyseal development with delayed chondrocyte maturation. Using RNA-sequencing analysis of the two models, direct targets of miR140-5p, including Wnt11, were identified. Disruption of the predicted miR140-5p binding site in the 3′ untranslated region of Wnt11 was shown to increase Wnt11 mRNA expression and caused a modest acceleration of epiphyseal development. These results show that the relative abundance of miRNA-5p and -3p can be altered by changing the first nucleotide of miRNAs in vivo, and this method can be useful to identify physiologically important miRNA targets.
Navigating Jus Ad Bellum in the Age of Cyber Warfare

The last decade has witnessed the heightened destructive potential of cyber attacks; correspondingly, cyberspace has become the new battlefield for nation-states in conflict. Yet jus ad bellum— the body of international law governing legitimate use of force— provides little guidance about the legality of a cyber attack or when such an attack becomes an act of war justifying resort to responsive force. This Comment provides a new analytical framework for addressing that question. It begins by clarifying definitional ambiguities in the literature on cyber attack, setting forth a definition that focuses on computer networks as the instruments, rather than objects, of attack. It examines the technical concepts and considerations that influence the use-of-force analysis and animate the evaluation of potential analytical frameworks. It then discusses the governing jus ad bellum standards and critiques the leading approaches to assessing cyber attacks under these standards. This Comment departs from the traditional and accepted models of inquiry, drawing on cyber security research to propose a framework centered on cyber-physical systems that addresses cyber attacks under the laws of just war.
State of the Art: Data Reduction and Application for Analytical Modeling

Due to the availability of large digital computers and advances in computational analysis techniques, it has become feasible to perform stress analyses of geotechnical structures involving complex geometries and material behavior. A key element in such analyses is the proper modeling of the constitutive behavior of soils. Intensive research in recent years has led to a proliferation of constitutive models which have been postulated to represent soil behavior under general loading conditions. In this paper some of these models are reviewed regarding their basic assumptions and the requirement of input data for their characterization. A classification of constitutive models is given on the basis of basic approaches to relating stress and strain. Representative models from each class are selected for detailed examination, with the hyperbolic model, the elastic-perfectly plastic model, the Cam-Clay model, the cap model. Lade's model, Prevost's model, and the endochronic model being selected. Finally, a comparison is made of these models regarding their range of applicability.
Neuroendocrine communication. (Neurohormonal, neurohumoral, and intermediate).

Publisher Summary The presence of synaptic or synapse-like (synaptoid) configurations in electron micrographs of a variety of endocrine organs leads to the conclusion that at least some of the neurochemical signals in operation are the same as those in regular neuron-to-neuron communication. This kind of morphological information is substantiated by physiological data—for example, in the case of the beta cells of the endocrine pancreas. The adrenergic nature of the transmitter operating at neuron terminals that are in contact with some of these glandular elements is suggested by their ultrastructure. The specific fluorescence for catecholamine displayed at these sites increases after the administration of monoamine oxidase inhibitors, and the measurable rise in catecholamine content is accompanied by a stimulation of insulin secretion. Alloxan-treated animals show fine structural alterations in the terminals that are indicative of neuronal hyperactivity in conjunction with stimulation of insulin secretion. In conclusion, multiple avenues have been acquired in the course of specialization that allow for considerable versatility in neuroendocrine mediation. The increasing familiarity with the dynamics of cellular interaction now directs attention to the exploration of biochemical events at the receptor site, the results of which will transcend the scope of neuroendocrinology.
'Here They Treat Us Like a Different Race': Political Implications of Class-in-Race Inequality

Whites in the United States have shown class divisions in politics for centuries, while since the 1960s Asian Americans, Latinos, and especially blacks have generally expressed liberal policy preferences and Democratic party support regardless of class position. The recent marked growth of inequality within non-white groups raises the possibility of changing political or policy views and new intra-group conflicts. This paper initiates an investigation of that possibility. It is a prolegomenon; we lay out and start to develop, but do not complete, a research project now underway.We first demonstrate the recent growth in class disparities within each of the four main conventional American racial or ethnic groups, and show how diverging class positions are associated with diverging lived experiences within each group. We then use the American National Election Studies (ANES) from the mid-1980s and 2012 to show how growing inequality is reflected in attitudes and preferences. Blacks and Latinos continue to express strong group loyalty, but well-off non-whites, like well-off whites, sometimes support government social welfare expenditures less than poorer members of their group do and less than their counterparts did several decades ago. Poor blacks and Latinos, in contrast, sometimes show increasing commitment to their class and decreasing commitment to the traditional stances of their racial or ethnic group. Well-off blacks and Latinos feel more politically efficacious, and poorer non-whites feel less politically efficacious, than several decades ago.We offer three categories of mechanisms to explain the link between rising inequality and rising class conflict within groups -- motivations that are the same across groups (self interest or ideological conservatism), motivations that differ across groups but yield similar political outcomes, and changes in context or group composition. We then turn to case studies, with the twin goals of deepening the explanations of changing attitudes, and exploring whether survey results are borne out by real political and policy disputes on the ground. We explore contextual changes that make current intra-group class conflict different from long-standing tensions between rich and poor, and develop a typology of types of local conflicts that mirrors the set of mechanisms to explain attitudinal change. With due respect for the fact that micro- and macro-level analyses necessarily and desirably differ, we aspire to link explanations of class conflict as revealed in surveys and as revealed in actual disputes. We anticipate costs as well as benefits to increasing class divergence within American racial and ethnic groups, so we urge scholars and journalists to move beyond simple group categories in exploring American political conflicts.
Adjusting for the intervalling effect bias in beta: A Test using Paris Bourse Data☆

Abstract This paper uses a sample of daily returns data from the Paris Bourse to test the predictions of and adjustment procedures implied by the Cohen-Hawawini-Maier-Schwartz-Whitcomb (1983a,b) model of the intervalling effect bias in OLS beta estimates. CHMSW show that the bias diminishes asymptotically to zero as the differencing interval increases and that the sign of the bias depends on a stock's relative value of shares outstanding. We employ the three-pass regression procedure of CHMSW (1983b), but we test a broader set of second pass functional forms and use the Box-Cox (1964) transformation model to verify our chosen form. The CHMSW adjustment procedures are compared with that of Scholes-Williams (1977), and the latter is shown to contain a significant intervalling effect bias.