cssi/SciSciGPT-SciSciNet huggingface dataset:
Using Gene Expression Analysis to Examine Changes in Loneliness, Depression and Systemic Inflammation in Lonely Chronically Ill Older Adults.

Purpose: The purpose of this study was to evaluate the effectiveness of LISTEN (Loneliness Intervention) on loneliness, depression, physical health, systemic inflammation, and genomic expression in a sample of lonely, chronically ill, older adults. Methods: This was a prospective, longitudinal randomized trial of LISTEN, a novel intervention based on theories of narrative and cognitive restructuring to target specific aspects of loneliness. Twenty-three older, lonely, chronically ill adults were recruited from a family medicine clinic in West Virginia. Participants were randomized to two groups, 13 in LISTEN group (Loneliness Intervention) and 10 in attention control (healthy aging education). Participants attended an enrollment session where they completed consent, survey data (including sociodemographics and chronic illness diagnoses), baseline physical measures, and blood sampling for gene expression analysis. After completing the 5 weekly sessions, all participants attended a 12 week post data collection meeting (17 weeks post-baseline) for survey completion, physical measures and blood sampling. Results: The results of this study show that the LISTEN intervention improves measures of physical and psychosocial health. Specifically, subjects enrolled in LISTEN showed reductions in systolic blood pressure, as well as decreased feelings of loneliness and depression. These changes may be due, in part, to a reduction in systemic inflammation, as measured by interleukin-2. Conclusion: This study provides support for the use of LISTEN in reducing loneliness in chronically ill, older adults. Further, while some of our results are inconclusive, it provides rationale to expand our study population to evaluate the relationship between loneliness and systemic inflammation. In the future, enhancing knowledge about the relationships among loneliness, chronic illness, systemic inflammation, and gene expression of these particular targets, and how these relationships may change over time with intervention will inform translation of findings to clinical settings.
Combining data fusion with joint source-channel coding of correlated sensors

We consider a source sensed by several correlated sensors. Each one of the sensors receives a noisy version of the source, performs channel coding, and transmits this information through an independent noisy channel to a central processing unit. The processing unit fuses all the received sequences with the objective of obtaining the best possible estimate of the source of interest. This is performed by utilizing at the decoder a graphical model that jointly describes the channel decoders for each sensor and the probabilistic dependence between the source and the sensors.
Relaxin and Related Peptides in Male Reproduction

The relaxin hormone is renowned for its function in pregnancy, parturition and other aspects of female reproduction. At the same time, the role of relaxin in male reproduction is still debated. Relaxin is prominently expressed in prostate and its receptors are found in several male reproductive organs; however, the data indicative of its contribution to differentiation and functioning of prostate or testis are contradictory. Prostate relaxin is a main source of this peptide in the seminal plasma. The relaxin effects on sperm motility and fertilization have been reported. The expression of other relaxin related peptides, such as INSL5 and INSL6 was described in testis; yet, currently there are no experimental data to pinpoint their biological functions. The other member of relaxin peptide family, insulin-like 3 peptide (INSL3), is a major player in male development. The INSL3 peptide is expressed in testicular fetal and adult Leydig cells and is directly responsible for the process of abdominal testicular descent (migration of the testes towards the scrotum during male development). Genetic targeting of the Insl3 gene or INSL3 GPCR receptor Lgr8/Rxfp2 causes high intra-abdominal cryptorchidism due to a differentiation failure of testicular ligaments, the gubernacula. Several mutations of these two genes rendering nonfunctional proteins have been described in human patients with testicular maldescent. Thus, in this chapter we review the data related to the expression and function of relaxin and related peptides in male reproduction.
Hormonal prevention of breast cancer: significance of promotional environment.

Early full-term pregnancy reduces the risk of mammary cancer in humans. Rats and mice also exhibit this phenomenon of parity protection. Short-term treatment with pregnancy levels of estradiol (E2) is also highly effective in preventing mammary carcinogenesis. Earlier it has been demonstrated that parous rats treated with carcinogen develop latent microscopic mammary tumors that do not progress further to form overt mammary cancers. In the current investigation, we wanted to find out if short-term treatment with pregnancy levels of E2 also prevents mammary carcinogenesis similar to parity. Rats were injected with N-methyl-N-nitrosourea at 7 weeks of age and treated with 20μg, 100μg, 200μg, or 30 mg of E2 in silastic capsules for 3 weeks. 100μg (17%), 200μg (17%), and 30mg (17%) doses of E2 resulted in levels of E2 equivalent to pregnancy level and were effective in preventing overt mammary cancer incidence compared with control (100%) or 20μg (73%) E2 treatment, which did not result in pregnancy levels of E2 in the circulation. Although a significant reduction of overt cancers was observed in the pregnancy levels of E2 treated groups, there was no difference in the incidence of latent microscopic mammary cancers between the E2 treated and the controls. Proliferation of latent microscopic mammary cancers was examined using immunohistochemistry for cyclin D1 expression. Proliferation in the latent microscopic mammary cancers of the protected groups was significantly lower (∼2.0–3.0-fold) than the latent microscopic mammary cancers in the unprotected groups. These findings indicate that mammary cancer development can be blocked by inhibiting or blocking promotion and progression of carcinogen initiated cells.
Improving efficacy of metastatic tumor segmentation to facilitate early prediction of ovarian cancer patients' response to chemotherapy

Accurate tumor segmentation is a critical step in the development of the computer-aided detection (CAD) based quantitative image analysis scheme for early stage prognostic evaluation of ovarian cancer patients. The purpose of this investigation is to assess the efficacy of several different methods to segment the metastatic tumors occurred in different organs of ovarian cancer patients. In this study, we developed a segmentation scheme consisting of eight different algorithms, which can be divided into three groups: 1) Region growth based methods; 2) Canny operator based methods; and 3) Partial differential equation (PDE) based methods. A number of 138 tumors acquired from 30 ovarian cancer patients were used to test the performance of these eight segmentation algorithms. The results demonstrate each of the tested tumors can be successfully segmented by at least one of the eight algorithms without the manual boundary correction. Furthermore, modified region growth, classical Canny detector, and fast marching, and threshold level set algorithms are suggested in the future development of the ovarian cancer related CAD schemes. This study may provide meaningful reference for developing novel quantitative image feature analysis scheme to more accurately predict the response of ovarian cancer patients to the chemotherapy at early stage.
National Trends in Use and Outcomes of Pulmonary Artery Catheters Among Medicare Beneficiaries, 1999-2013.

Importance Recent studies have observed an increase in the rate of pulmonary artery catheter (PAC) use in heart failure admissions. Little is known about the national trends in other previously common indications for PAC placement, PAC use overall, or outcomes associated with PAC placement. Objective To determine national trends in PAC use overall as well as across sociodemographic groups and key clinical conditions, including acute myocardial infarction, heart failure, and respiratory failure. Design, Setting, and Participants Centers for Medicare and Medicaid Services inpatient claims data and International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to conduct a serial cross-sectional cohort study between January 1, 1999, and December 31, 2013, identifying hospitalizations during which a PAC was placed. Data analysis was conducted from September 25, 2015, to April 10, 2017. Main Outcomes and Measures Rate of use of a PAC per 1000 admissions, 30-day mortality, and length of stay. Results Among the 68 374 904 unique Medicare beneficiaries in the study, there were 469 582 hospitalizations among 457 193 patients (204 232 women and 252 961 men; mean [SD] age, 76.3 [6.9] years) during which a PAC was placed. There was a 67.8% relative decrease in PAC use (6.28 per 1000 admissions in 1999 to 2.02 per 1000 admissions in 2013; P P P Conclusions and Relevance In the wake of mounting evidence suggesting a lack of benefit to the routine use of PACs, there has been a de-adoption of PAC use overall and across sociodemographic groups but heterogeneity in patterns of use across clinical conditions. The clinical outcomes of patients with PACs have significantly improved. These findings raise important questions about the optimal use of PACs and the drivers of the observed trends.
Stocking Wilderness Lakes – There’s Something Fishy Going On?

It’s no secret to the historian that sportsmen and women have long had a role in public lands policy. Certainly, the public lands legacy that has been left to us in this country is a legacy of sportsmen before us; Roosevelt was a hunter, Pinchot was a fisherman. But in recent years, sportsmen have again stepped into the lead, particularly on public lands issues that challenge our society to balance our growing country and our need to have places to get away, places of retreat. Trout Unlimited has been instrumental in guiding and driving much of the good public lands decisions that have been made in the recent past. In particular, the Wyoming Range Legacy Act, sponsored by Sen. John Barrasso, R-Wyoming, is case in point. Located just south of Jackson, Wyoming, and running ~ 125 mi north-south to near the town of Kemmerer, the range is home to three subspecies of cutthroat trout including the Colorado River, the Snake River and the Bonneville. The Bridger-Teton National Forest cloaks some 1.2 million ac of the range. A group led by TU called Sportsmen for the Wyoming Range pushed for withdrawal legislation; legislation that would allow one use of the public’s land—mineral extraction—to be taken off the table. Whereas some of the range was previously leased for oil and gas exploration, much of the range was not. The Act did two things: it provided for no new leasing on unleased land, and it allowed for private buyout of existing leases while not preventing drilling of valid existing leases. The Act passed as part of the Omnibus Public Lands bill that was signed by the President in March 2009. Today, some 1.2 million ac of public land will never see a drill rig whereas ~ 60-70,000 ac is targeted for buy-out or light development. Senator Jon Tester, D-Montana, introduced a bill last summer that TU is very supportive of and has some similarities to the Wyoming Range Legacy Act. The Forest Jobs and Recreation Act seeks to mandate logging on 100,000 ac of federal USDA Forest Service land, create some 670,000 ac of designated big ‘W’ wilderness, and 330,000 some ac of motorized recreation area. For TU, the bill fits our mission perfectly: Protect, Reconnect, Restore and Sustain. Protect: Wilderness and recreation designation would set aside the headwaters of some of Montana’s most fabled trout streams. Reconnect: Stewardship logging would pay for much-needed culvert removal for fish passage. Restore: Stewardship logging would pay for road removal or realignment where interfering with fisheries habitat. Sustain: The Act would maintain Montana lifestyles for those who like to fish and do other activities outside. TU is fully supportive of the bill for not only the mission fit, but also because of its grassroots nature, its collaborative process, its bipartisan nature, and its Montana-based common-sense solution.
Student as Consumer: What Three Decades of Higher Education Policy Mean to K-12

The diminishing educational outcomes and academic rigor, which have come to define the American collegiate experience, result from a misguided economic policy that places students as consumers in an “educational marketplace”.
Effect of Seasonality on the Behavior of an Insectivorous Primate, Tarsius spectrum

The distribution and quality of food resources is generally recognized as the preeminent factor explaining much interspecific and intraspecific variation in the behavior of nonhuman primates. Primates that live in seasonal environments often show predictable responses to fluctuating resources. In order to compensate for the reduction in resource availability, primates variously switch to alternative, poorer quality food sources, increase the amount of time they spend foraging, or increase their daily path length. Some primate species reduce their group size or maximize the group dispersion. I address whether spectral tarsiers (Tarsius spectrum), which are insectivores, modify their behavior in the same ways as frugivores and folivores in response to seasonal or scarce resources. My results indicate that wild spectral tarsiers modify their activity budget in response to seasonal resources. Specifically, during periods of low resource availability, spectral tarsier males and females spent more time traveling and foraging compared to their activity budget during the wet season. Males and females not only increased the amount of time they spent foraging during times of low resource abundance but also modified their foraging behavior. During the wet season, when resource abundance was high, they consumed Orthoptera and Lepidoptera with greater frequency than during the dry season. During the dry season, when resource abundance was low, spectral tarsiers still ate numerous Orthoptera and Lepidoptera, but they also increased consumption of Coleoptera and Hymenoptera. Spectral tarsiers were also more likely to be involved in territorial disputes during the dry season than during the wet season. Intragroup encounters decreased in frequency in the dry season versus the frequency of encounters during the wet season.
The Repertoire of Communication Calls Emitted by Bats and the Ways the Calls Are Processed in the Inferior Colliculus

Bats have among the richest and most sophisticated repertoire of vocal communication calls of any mammalian group. In this review, we first describe the range of calls bats emit and the acoustic features that comprise their calls. Of particular importance are frequency modulations (FMs), as these are components in the vast majority of bats’ communication calls as well as the calls they emit for echolocation. We then consider the processing of communication calls in the inferior colliculus (IC). We show that neurons in the IC are selective for the various calls the bats emit and that this selectivity is shaped by inhibition. Computational studies showed that some neurons had one feature or filter characterized by its spectrotemporal receptive field (STRF) generated by spike-triggered averaging. In these cells, convolving conspecific calls with the STRF provides an accurate prediction of their responses to conspecific calls. Moreover a single linear combination of the excitatory and inhibitory fields explains their responses to the direction and velocity of FM sweeps. Most IC cells, however, had several spectrotemporal filters. In these cells, the nonlinear combination of two or more filters predicted the cell’s selectivity for FM sweeps and its responses to calls. The ways in which excitation and inhibition interacted to generate FM selectivity were also evaluated with in vivo whole-cell recordings. Those studies showed that the relative timing of excitation and inhibition had only a small influence on the amplitudes of the excitatory postsynaptic potentials (EPSPs) evoked by an FM signal. How the change in EPSP amplitude influenced discharge probability depended in large part on how close the EPSP was to spike threshold. If the EPSP amplitude is far from threshold, even timing changes of several ms would have little or no effect on spike probability. Conversely, if the EPSP amplitude is near threshold, then even a change in EPSP amplitude as small as a fraction of a millivolt could affect discharge probability and thus modulate the cell’s spiking directional selectivity. Taken together, these studies showed that neurons in the auditory midbrain encode specific spectrotemporal features of natural communication sounds by means of their selectivity to FM features present in their conspecific calls.
A Hybrid PID Design for Asymptotic Stabilization with Intermittent Measurements

In this paper, we propose a modeling and design technique for a proportional-integral-derivative (PID) controller in the presence of aperiodic intermittent sensor measurements. Using classical control design methods, PID controllers can be designed when measurements are available periodically, at discrete time instances, or continuously. Unfortunately, such design do not apply when measurements are available intermittently. Using the hybrid inclusions framework, we model the continuous-time plant to control, the mechanism triggering intermittent measurements, and a hybrid PID control law defining a hybrid closed-loop system. We provide sufficient conditions for uniform global asymptotic stability using Lyapunov set stability methods. These sufficient conditions are used for the design of the gains of the hybrid PID controller. Also, we propose relaxed sufficient conditions to provide a computationally tractable design method leveraging a polytopic embedding approach. The results are illustrated via numerical examples.
Whole and without Blessing

What is beautiful alters, has undertow. Otherwise I have no tactics to begin with. Femininity is a sickness. I open my eyes out of this fever and see the meaning of my life clearly. A thing Uke a hill. I proclaim myself whole and without blessing, or needing to be blessed. A fish of my own spirit. I belong to no one. I do not move. I do not have to move. I Ue naked on a sheet and the indifferent sun warms me. I was bred for slaughter, Uke the other animals. To suffer exactly at the center, where there are no clues except pleasure.
Household Electrical Load Scheduling Algorithms with Renewable Energy

Efficient household electrical load scheduling benefits not only individual customers by reducing electricity cost but also the society by reducing the peak electricity demand and saving natural resources. In this paper, we aim to design efficient load scheduling algorithms for a household considering both real-time pricing policies and renewable energy sources. We prove that household load scheduling problem is NP-hard. To solve this problem, we propose several algorithms for different scenarios. The algorithms are lightweight and optimal or quasi-optimal, and they are evaluated through simulations.
Basal and Squamous Cell Carcinoma of the Skin

Basal and squamous cell carcinomas of the skin are the most commonly diagnosed malignancies in the USA. Basal cell carcinoma accounts for approximately 80% and squamous cell carcinoma for 20% of all nonmelanoma skin cancers. Exposure to sunlight is the most common cause of skin cancer. Patients with nonmelanoma skin cancer have a 30–50% risk of developing additional skin cancers. Poor prognostic factors in squamous cell carcinoma of the skin are tumor size of at least 4 cm, perineural invasion, and invasion beyond the subcutis. Basal cell carcinoma of the skin rarely metastasizes but has a predilection for local invasion. Squamous and basal cell carcinomas are most commonly treated with surgery, radiation therapy, or a combination of both. Selection of therapy is based on preservation of function and cosmesis, and patient preference. T-classification at diagnosis correlates with local control in irradiated basal and squamous cell carcinoma of the skin. For T1, T2 and T3 tumors, local control rates are 95, 80, and 53%, respectively. Local control rates of irradiated basal and squamous cell carcinomas of the skin smaller than 1 cm are 97 and 91%, respectively. For tumors between 1 and 5 cm, local control rates are 87 and 76%, respectively.
Lower Urinary Tract Dysfunction

Functional urinary incontinence (UI) and lower urinary tract symptoms (LUTS) are more common problems in children and adolescents, which may seriously affect quality of life. They are 1.5 times more common in girls than in boys at age 7 years, whereas at age 16 years the difference is more pronounced: five to ten times more common in girls than in boys. The prevalence of UI and LUTS is widely variable between 3.2 and 9 % in different studies (Abrams P, Cardozo L, Khoury S, Wein A (2013) Incontinence. ICUD-EAU eds). The main explanation of this wide variation is that different studies have used different definitions and criteria to define UI and LUTS. In 2006 the International Children’s Continence Society (ICCS) published a standardized terminology for lower urinary tract (LUT) function and dysfunctions (LUTD) to provide guidelines for the classifications and communication about UI and LUTS in children (Neveus et al. J Urol 176: 314–324, 2006). The ICCS has classified daytime LUTD in two main groups: overactive bladder (OAB), including urge incontinence, and dysfunctional voiding (DV), with or without underactive bladder. The two groups may overlap and clinical distinction between OAB and DV is based on characteristics of four symptoms: incontinence, voiding frequency, micturition volumes, and fluid intake. Knowledge of both LUTD is mandatory to distinguish children with OAB from those with DV and to offer correct treatment. Therefore, definition, pathophysiology, and clinical assessment of both OAB and DV will be provided in this chapter, focusing on treatment of DV.
Cost-Benefit Analysis and Third-Party Opinion Practice

Practitioner literature and bar association reports frequently exhort lawyers and clients to use cost-benefit analysis (CBA) to answer important questions about third-party closing opinion practice, including whether to have an opinion in a given transaction at all. Yet, this literature rarely considers seriously what is meant by cost-benefit analysis, or whether it is in fact an appropriate decision tool in this context. This essay fills that gap, by examining what CBA can - and cannot - do for third-party closing opinion practice. Among its benefits, CBA should help to orient discussions about whether to have a closing opinion around an opinion's economic and informational value, rather than claims that an opinion is (or is not) traditional or market in a particular context. But, CBA is an imperfect tool. Cost-benefit analyses can be manipulated to mask costs or to exaggerate benefits. More fundamentally, CBA may treat ethically questionable practices as cost-justified, and may fail to account for certain important professionalizing benefits of closing opinion practice. The essay suggests ways that CBA can and cannot help to improve closing opinion practice.
An evaluation of shifting administration of high-cost chemotherapy from the inpatient to an outpatient setting.

107Background: Patients often require critical management during chemotherapy and may need constant monitoring during and post-treatment in an inpatient (IP) unit. However, many patients can receiv...
How Do We Fix What We Broke? A Diagnosis of the Heart of the Problem

The purpose of the chapter is to understand the fundamental problem associated with segregation and to identify a conceptual approach for remedying it. The research of Kymlicka (Multicultural citizenship: a liberal theory of minority rights. Oxford University Press, New York, 2000), Kallen (Social inequality and social injustice: a human rights perspective. Palgrave, New York, 2003), Capehart and Milovanovic (Social justice: theories, issues, and movements. Rutgers University Press, New Brunswick, NJ, 2007), Pausch (2012), Rutherglen (Civil rights in the shadow of slavery: the constitution, common law, and the civil rights Act of 1866. Oxford University Press, Oxford, England, 2012), Adams (2013), Van Ness and Strong (Restoring justice: an introduction to restorative justice. Routledge, New York, 2014) and Zehr (The little book of restorative justice. Good Books, New York, 2015) informed the focus group agende. The primary conceptual framework for the conversation is the notion of restorative justice which demands more than just recognition of wrongdoing or even punishment. It entails reparation or restitution to restore a relationship to its former or ideal state. Seemingly, America has had several opportunities or moments to make amends which they failed to take advantage. Four themes emerged from the conversation. One, white privilege has been and continues to be the underlying problem in American race relations. Two, segregation is not the problem, but merely a symptom. Three, white America has a moral obligation to return what has been taken from the African American community. Four, the ultimate solution to racism and segregation is the elimination of white privilege and the empowerment of African Americans with the necessary resources to rebuild their communities. In the accompanying essay, “The Effects of De Facto Segregation: Socio economic and Political Alienation, Crime and Contentious Black Citizen/Police Exchanges.” Andrea Boyles draws upon her ethnographic research during the Ferguson unrest to argue that segregation is not just a means of depriving African American of what whites have, but of exploiting them as well.
Hyperadrenocorticism of calorie restriction contributes to its anti-inflammatory action in mice

Calorie restriction (CR), which lengthens lifespan in many species, is associated with moderate hyperadrenocorticism and attenuated inflammation. Given the anti-inflammatory action of glucocorticoids, we tested the hypothesis that the hyperadrenocorticism of CR contributes to its attenuated inflammatory response. We used a corticotropin-releasing-hormone knockout (CRHKO) mouse, which is glucocorticoid insufficient. There were four controls groups: CRHKO mice and wild-type (WT) littermates fed either ad libitum (AL) or CR (60% of AL food intake), and three experimental groups: (a) AL-fed CRHKO mice given corticosterone (CORT) in their drinking water titrated to match the integrated 24-hr plasma CORT levels of AL-fed WT mice, (b) CR-fed CRHKO mice given CORT to match the 24-hr CORT levels of AL-fed WT mice, and (c) CR-fed CHRKO mice given CORT to match the 24-hr CORT levels of CR-fed WT mice. Inflammation was measured volumetrically as footpad edema induced by carrageenan injection. As previously observed, CR attenuated footpad edema in WT mice. This attenuation was significantly blocked in CORT-deficient CR-fed CRHKO mice. Replacement of CORT in CR-fed CRHKO mice to the elevated levels observed in CR-fed WT mice, but not to the levels observed in AL-fed WT mice, restored the anti-inflammatory effect of CR. These results indicate that the hyperadrenocorticism of CR contributes to the anti-inflammatory action of CR, which may in turn contribute to its life-extending actions.
Optimal event selection and categorization in high energy physics, Part 1: Signal discovery

We provide a prescription to train optimal machine-learning-based event selectors and categorizers that maximize the statistical significance of a potential signal excess in high energy physics (HEP) experiments, as quantified by any of six different performance measures. For analyses where the signal search is performed in the distribution of some event variables, our prescription ensures that only the information complementary to those event variables is used in event selection and categorization. This eliminates a major misalignment with the physics goals of the analysis (maximizing the significance of an excess) that exists in the training of typical ML-based event selectors and categorizers. In addition, this decorrelation of event selectors from the relevant event variables prevents the background distribution from becoming peaked in the signal region as a result of event selection, thereby ameliorating the challenges imposed on signal searches by systematic uncertainties. Our event selectors (categorizers) use the output of machine-learning-based classifiers as input and apply optimal selection cutoffs (categorization thresholds) that depend on the event variables being analyzed, as opposed to flat cutoffs (thresholds). These optimal cutoffs and thresholds are learned iteratively, using a novel approach with connections to Lloyd's k-means clustering algorithm. We provide a public, Python 3 implementation of our prescription called ThickBrick, along with usage examples.
EP237 Survival outcome and disease free survival of locally advanced cervical cancer with CT-detected para-aortic lymph nodes

Introduction/Background In the Philippines, cervical cancer ranks second in the list of cancers among female and the country’s second leading cause of female cancer deaths. Majority of the patients seek consult with advanced stage of the disease. In the absence of histologically proven lymph node metastasis, imaging may be used to determine patients with para-aortic lymph node metastasis who may benefit with Extended Field Radiation. The aim of this study is to investigate the survival outcome and disease-free survival of advanced cervical cancer with Computed Tomography (CT) Scan detected para-aortic lymph node (PALN) after concurrent chemoradiotherapy using extended field radiotherapy (EFRT) with weekly platinum-based chemotherapy followed by High Dose Brachytherapy. Methodology This is a retrospective study which included patients diagnosed with locally advanced cervical carcinoma according to the FIGO (stage IB2 - stage IIIB) who had CT detected PALN metastasis and underwent EFRT with weekly chemotherapy followed by brachytherapy at a single institution from January 2002 - December 2015. The 3 year over-all survival outcome (OS) and disease free survival (DFS) of the patients were documented and analyzed. Results There were 51 patients who satisfied the inclusion criteria and were included in the study. The 3-year OS and DFS rates were 81.3% and 58.6%, respectively. The median survival time was 35.5 months and the median disease free time was 25.04 months. Conclusion The current recommendation of EFRT with concurrent chemotherapy followed by brachytherapy can be an effective treatment for cervical cancer patients with CT-detected para-aortic lymph node metastasis with 81.3% 3 year survival outcome. Patients with Non-Squamous Cell Carcinoma have higher risks of recurrence, with central tumor recurrence being the most common site. Disclosure Nothing to disclose.
ACUTE PUMP THROMBOSIS IN A HEARTMATE III

The newest centrifugal-flow (CF) left ventricular assist device (LVAD), the HeartMate 3 (HM3), has significantly lower rates of pump thrombosis. There is lack of literature regarding HM3 thrombosis in situ. A 55 year old man with an ischemic cardiomyopathy (LVEF 15%) and chronic idiopathic
A Two-Step Process of Effector Programming Governs CD4+ T Cell Fate Determination Induced by Antigenic Activation in the Steady State.

Summary Various processes induce and maintain immune tolerance, but effector T cells still arise under minimal perturbations of homeostasis through unclear mechanisms. We report that, contrary to the model postulating primarily tolerogenic mechanisms initiated under homeostatic conditions, effector programming is an integral part of T cell fate determination induced by antigenic activation in the steady state. This effector programming depends on a two-step process starting with induction of effector precursors that express Hopx and are imprinted with multiple instructions for their subsequent terminal effector differentiation. Such molecular circuits advancing specific terminal effector differentiation upon re-stimulation include programmed expression of interferon-γ, whose production then promotes expression of T-bet in the precursors. We further show that effector programming coincides with regulatory conversion among T cells sharing the same antigen specificity. However, conventional type 2 dendritic cells (cDC2) and T cell functions of mammalian target of rapamycin complex 1 (mTORC1) increase effector precursor induction while decreasing the proportion of T cells that can become peripheral Foxp3+ regulatory T (pTreg) cells.
Gastrointestinal Interventions: Then and Now

Gastrointestinal interventions have continuously evolved since the inception of interventional radiology. This article will review major milestones in this evolution including the introduction of new tools, the development of new procedures, and the establishment of interventional radiology as its own clinical specialty. Together, these milestones have helped shape how interventional radiologists perform gastrointestinal interventions today.
FDP: A Teaching and Demonstration Platform for Networking

Requesting https://www.wikipedia.org from your browser can start a small storm of exchanges between your device and name servers, caches and ultimately the Wikipedia servers. Data networking involves simple ideas---such as modular decomposition and path redundancy---that produce interesting behavior through the, sometimes subtle, interaction with one another. Through this interaction, networking is able to achieve amazing feats of reliability, availability, and planetary scale. But it is difficult to connect the big ideas---such as reliability---with how they work across different implementations, topologies and in the face of different levels of network disfunction. Making that leap typically requires time spent with unforgiving tools such as 'tcpdump' across several experiments. This is not helped by the hearty alphabet soup that is the set of protocols that one has to learn to begin to understand how networking really works. To help teachers and students navigate this process, we present FDP, a portable platform that enables end-to-end experimentation and zero-effort in browser interactive visualization, which we envision can benefit teaching and demonstration. FDP can show various network, including network faults and reconfigurations, using visual cues and quantitative graphing. Since we leverage the flexibility of software-defined networking (SDN), our tool can also be used for upper-level networks classes and also for research.
Some Fundamentals of Trusts: Ownership or Equity in Louisiana?

This Article takes up the issue and attempts to shed some light on the fundamental question of who owns the property in a trust under Louisiana law. To that end, it proceeds in the following parts: Part II provides background by discussing the trust in comparative perspective, tracing briefly its development and conception in Anglo-American law. It then explains why the trust has generally not existed in civil law jurisdictions but provides examples of trust-like devices that have existed or do exist in the classical civil law systems evidenced by Roman, French, and German law. Part III of this Article evaluates the competing arguments for ownership of the property in either the trustee or the beneficiary in Louisiana but finds both arguments wanting. Far from being simply a theoretical issue, the second subpart of Part III suggests reasons why appropriate analysis of trust ownership has mattered and still matters. Part IV offers a not so modest proposal for the answer to the fundamental question regarding ownership of trust property. It proposes that both the trustee and the beneficiary maintain real rights in the trust property. Although contrary to fundamental civil law principles, this solution, it will be contended, is necessitated by both historical evidence and a functional examination of the roles of the trustee and beneficiary under Louisiana law. Finally, this Article concludes with some hopeful thoughts on the meaning of the above conclusion and suggests that, perhaps, after full consideration, the idea of dueling real rights in both the trustee and the beneficiary is not so radical after all.
Clonal cutaneous and neurosyphilis: A pitfall in pseudolymphoma diagnosis.

Syphilis is a sexually transmitted infectious disease caused by the bacterium Treponema pallidum and can cause a wide variety of cutaneous manifestations, most commonly, a papulosquamous eruption of the trunk and extremities. Treatment with penicillin is curative. We report a case of a 69-year-old man who presented with recent onset of blurry vision and a non-painful, non-pruritic eruption of pink-to-violaceous dermal nodules on his upper trunk and upper extremities. Biopsies of two separate locations revealed a dense superficial and deep perivascular atypical lymphocytic infiltrate with admixed plasma cells, histiocytes, and eosinophils. Some scattered cells expressed CD30, PD1, BCL-6 and ICOS. TCR-rearrangement showed an identical TCR-gamma clone between both biopsy specimens. The patient was subsequently seen by ophthalmology and diagnosed with acute anterior uveitis. RPR was reactive and CSF studies showed findings consistent with a diagnosis of neurosyphilis. A Treponema pallidum immunostain of the skin biopsies was performed upon re-review, and was diffusely positive for spirochetes at the dermal-epidermal junction and within injured vessels. The patient was treated with penicillin G with near resolution of his skin lesions. This case highlights the unusual ability of syphilis to mimic a T-cell lymphoma with matching clones across two different biopsy sites. This article is protected by copyright. All rights reserved.
The Population Dynamics of the Placebo Effect and Its Role in the Evolution of Medical Technology

The placebo effect, used today as the benchmark to evaluate treatment efficacy, plays a major functional role in traditional medical practices. To better understand its effect at the population level, I use a formal approach to examine the population dynamics of the placebo effect and show a reciprocal causal relationship between belief and efficacy: belief in the efficacy of treatments enhances their realized efficacy, which in turn increases people’s confidence in their therapeutic power. A unique equilibrium for subjective belief and realized efficacy always exists. Its magnitude depends on how beliefs are constructed (relative weight on observed action vs. observed outcome). I further investigate how the placebo effect affects the maintenance of existing medical technologies and the invasion of new technologies by explicitly modeling a belief construction process. Analytical and simulation results show that although the placebo effect primarily suppresses the spread of new technologies, it may occasionally enhance the adoption of superior technological variants under specific parameter combinations.
Expression of Sp1 and KLF6 in the developing human cornea.

PURPOSE To examine the temporal and spatial expression of Sp1 and Kruppel-like factor 6 (KLF6) in the cornea in fetal and adult human eyes. METHODS Eyes from human fetus (F) of 7, 9, 10, 11, 13, and 27 weeks (w) of gestation, as well as corneas from 11 and 56-day (d)-old children and donors 2, 6, 16, 25, 40, 51, 69, and 83 years (y) of age were obtained. All specimens were fixed in 10% buffered formalin, processed for paraffin sections, and examined for Sp1 and KLF6 expression immunohistochemically. RESULTS Staining for Sp1 was evident at the earliest F7w time point in the cornea. From F7w to F27w, the moderate to strong Sp1 immunostaining was seen in the nuclei of epithelial and endothelial cells. Staining in keratocytes was also observed. The intensity of Sp1 staining in all layers of the cornea was substantially decreased 11d after birth and remained low thereafter. Positive KLF6 staining was also noted at F7w in all corneal layers. In the epithelium and endothelium, the staining was mostly cytoplasmic throughout the fetal stages. After birth, the KLF6 staining appeared in the nuclei of corneal epithelial cells along with that in the cytoplasm. The intensity of KLF6 staining in the epithelium and endothelium remained relatively constant from E47d to the 83y-old donor cornea. The KLF6 staining in the stroma however was reduced after F27w. CONCLUSIONS The present study indicates that the expression of Sp1 and KLF6 is developmentally regulated, providing a basis for further investigations on the regulation of the Sp1 and KLF6 gene during the course of corneal development and in corneal diseases such as keratoconus.
PRKACA: the catalytic subunit of protein kinase A and adrenocortical tumors

Cyclic-AMP (cAMP)-dependent protein kinase (PKA) is the main effector of cAMP signaling in all tissues. Inactivating mutations of the PRKAR1A gene, coding for the type 1A regulatory subunit of PKA, are responsible for Carney complex and primary pigmented nodular adrenocortical disease (PPNAD). PRKAR1A inactivation and PKA dysregulation have been implicated in various types of adrenocortical pathologies associated with ACTH-independent Cushing syndrome (AICS) from PPNAD to adrenocortical adenomas and cancer, and other forms of bilateral adrenocortical hyperplasias (BAH). More recently, mutations of PRKACA, the gene coding for the catalytic subunit C alpha (Cα), were also identified in the pathogenesis of adrenocortical tumors. PRKACA copy number gain was found in the germline of several patients with cortisol-producing BAH, whereas the somatic Leu206Arg (c.617A>C) recurrent PRKACA mutation was found in as many as half of all adrenocortical adenomas associated with AICS. In vitro analysis demonstrated that this mutation led to constitutive Cα activity, unregulated by its main partners, the PKA regulatory subunits. In this review, we summarize the current understanding of the involvement of PRKACA in adrenocortical tumorigenesis, and our understanding of PKA's role in adrenocortical lesions. We also discuss potential therapeutic advances that can be made through targeting of PRKACA and the PKA pathway.
IEC 61499 Architecture, Engineering Methodologies and Software Tools

The IEC 61499 standard defines an architecture and software tool requirements for the encapsulation, embedding, deployment and integration of intellectual property (IP) in intelligent devices, machines and systems. A reference framework and engineering methodology is presented for the use of IEC 61499 in the design, development, simulation, testing and implementation of distributed control and automation systems employing intelligent mechatronic components.
Chronic vitamin A intoxication in adults. Hepatic, neurologic and dermatologic complications

Abstract Two cases of chronic vitamin A intoxication in adults are described, and the literature is reviewed. Hepatocellular damage, portal fibrosis and eventual cirrhosis may result from chronic vitamin A intoxication in man. Neurologic complications are frequent and consist predominantly of increased intracranial pressure, muscle stiffness aggravated by exercise, and mental changes. Teratogenic effects have been documented in animal experiments and affect primarily the development of the central nervous system. Large doses of vitamin A, if prescribed at all for dermatologic conditions, should be given only for limited periods under close medical supervision and should not be given during pregnancy.
From Bed to Bench to Bed — and Beyond

1 “From Bed to Bench to Bed” is a phrase used so often as to risk becoming a cliche. Yet it is in fact a dictate that can guide us to the amelioration of human suffering on a global scale. Translated into the words of Richard Lockshin in his lead editorial for this Journal, the first half of the phrase asks, “What phenomena do clinicians observe that are crying for the attention of laboratory researchers?” And the second half asks how these laboratory researchers can uncover “important cellular and molecular mechanisms that lead to new approaches to clinical control.” These principles of “Bed to Bench to Bed” may be most vividly exemplified by telling a story. This is the story of a “Bed to Bench to Bed” cycle that took place over 32 months in the 1960s on the Indian Subcontinent. By today, it has already saved an estimated 50 million lives. It is the story of oral rehydration therapy for cholera. Cholera is an acute diarrheal disease that has plagued the world at least since the first Asiatic pandemic of 1817. Though permanently endemic in Asia, it has caused epidemics in Europe and America (resulting in the deaths of U.S. Presidents James Polk and perhaps Zachary Taylor), and it rages even today in Zimbabwe. In 1854, John Snow established the link between cholera and contaminated water in London. That same year, the Italian physician and pathologist, Filippo Pacini,
Unfair Advantage: Workers' Freedom of Association in the United States under International Human Rights Standards

Excerpt] Human Rights Watch selected case studies for this report on workers’ freedom of association in the United States with several objectives in mind. One was to include a range of sectors services, industry, transport, agriculture, high tech – to assess the scope of the problem across the economy, rather than to focus on a single sector. Another objective was geographic diversity, to analyze the issues in different parts of the country. The cases studied here arose in cities, suburbs and rural areas around the United States. Another important goal was to look at the range of workers seeking to exercise their right to freedom of association high skill and low skill, blue collar and white collar, resident and migrant, women and men, of different racial, ethnic and national origins. Many of the cases involved the most vulnerable parts of the labor force. These include migrant farmworkers, sweatshop workers, household domestic workers, undocumented immigrants, and welfare-to-work employees. But the report also examines the rights of U.S. workers with many years of employment at stable, profitable employers. These include packaging factory workers, steel workers, shipyard workers, food processing workers, nursing home workers, and computer programmers. The cases studied here offer a cross-section of workers’ attempts to form and join trade unions, to bargain collectively, and to strike. The cases reflect violations and obstacles workers met in the exercise of these rights. In many cases, workers’ voices recount their experiences. Human Rights Watch also made written requests for responses and comments from employers identified in the report. Most of them declined. Of those who did respond, most did not want to be identified by name. In several cases, the names of individual managers are known to Human Rights Watch, but they are omitted so as not to profile them unduly in a human rights report with wide distribution to the public. This report is intended to illuminate systemic problems in U.S. labor law and practice, not conduct of individuals.
The complexity of games on highly regular graphs

We present algorithms and complexity results for the problem of finding equilibria (mixed Nash equilibria, pure Nash equilibria and correlated equilibria) in games with extremely succinct description that are defined on highly regular graphs such as the d-dimensional grid; we argue that such games are of interest in the modelling of large systems of interacting agents. We show that mixed Nash equilibria can be found in time exponential in the succinct representation by quantifier elimination, while correlated equilibria can be found in polynomial time by taking advantage of the game’s symmetries. Finally, the complexity of determining whether such a game on the d-dimensional grid has a pure Nash equilibrium depends on d and the dichotomy is remarkably sharp: it is solvable in polynomial time (in fact NL-complete) when d = 1, but it is NEXP-complete for d ≥ 2.