cssi/SciSciGPT-SciSciNet huggingface dataset:
The Current Role of Surgery in Treating Adult Patients with Patent Ductus Arteriosus

Objective Surgical closure of patent ductus arteriosus (PDA) is still required in selected adult patients. We analyzed the morphology of the anomaly and coexisting pathological findings in adult patients who were recently referred to our institute for surgical PDA repair. Patients and Interventions Six adult PDA patients who were not considered candidates for percutaneous closure underwent surgical PDA correction. In three patients with isolated PDA, computed tomographic scan revealed short, wide, and distorted ductus. In the remainder three patients, concomitant heart or aortic disease was found. Transpulmonary approach under total cardiopulmonary bypass or hypothermic circulatory arrest was performed. Results In all patients, a Dacron patch was used to close the duct. The balloon occlusion technique with normothermic cardiopulmonary bypass was performed in four patients. In one of these patients, the balloon occlusion was not feasible because of unfavorable ductal anatomy, and PDA was closed in short hypothermic circulatory arrest. In two patients with aortic aneurysm, PDA closure and aortic reconstruction were performed in deep hypothermic circulatory arrest. No significant complications occurred during postoperative course. After the mean follow-up period of 48 months, neither ductal reopening nor aneurysmal degeneration of remnant ductal tissue was found. Conclusion Surgical PDA closure in adults remains the treatment of choice in wide, deformed PDAs unsuitable for percutaneous closure and PDAs associated with surgical aortic or heart disease.
Global analysis of swing dynamics

The paper presents some asymptotic properties of the trajectories of an interconnected power system. Generators are described by their swing equations, loads are treated as PV buses. It is shown that' oscillations can never occur. Moreover, for small levels of injected power, all trajectories converge.
Bioengineered post-natal recombinant tooth bud models.

The long-term goal of this study is to devise reliable methods to regenerate full-sized and fully functional biological teeth in humans. In this study, three-dimensional (3D) tissue engineering methods were used to characterize intact postnatal dental tissue recombinant constructs, and dental cell suspension recombinant constructs, as models for bioengineered tooth development. In contrast to studies using mouse embryonic dental tissues and cells, here the odontogenic potential of intact dental tissues and dental cell suspensions harvested from post natal porcine teeth and human third molar wisdom tooth dental pulp were examined. The recombinant 3D tooth constructs were cultured in osteogenic media in vitro for 1 week before subcutaneous transplantation in athymic nude rat hosts for 1 month or 3 months. Subsequent analyses using X-ray, histological and immunohistochemical methods showed that the majority of the recombinant tooth structures formed calcified tissues, including osteodentin, dentin cementum, enamel and morphologically typical tooth crowns composed of dentin and enamel. The demonstrated formation of mineralized dental tissues and tooth crown structures from easily obtained post-natal dental tissues is an important step toward reaching the long-term goal of establishing robust and reliable models for human tooth regeneration. Copyright © 2014 John Wiley & Sons, Ltd.
C.S. Campbell: Gamekeeper's thumb

Abstract Rupture of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb is an injury frequently encountered by the emergency physician. The mechanism of injury is usually a fall onto the abducted thumb. The setting is frequently one of athletic endeavor, especially skiing, in which this is the most commonly encountered upper extremity injury. The physical findings typical of collateral ligament rupture may easily be overlooked on casual examination. When not appropriately managed, the injury may result in chronic pain, weakness, and joint instability. The eponym “gamekeeper's thumb” derives from a report of similar injuries described as occurring in a series of British gamekeepers.
On the Generation of Baroclinic Rossby Waves in the Ocean by Meteorological Forces

Abstract The generation of baroclinic Rossby waves in a continuously stratified ocean by fluctuating fields of wind stress, buoyancy flux and atmospheric pressure at the sea surface is studied by means of boundary layer theory. The internal wave field has been represented analytically in term of the generating meteorological fields and the damping influence of bottom friction. A preliminary application to an example from the eastern Pacific shows that the influence of the atmospheric pressure is negligible compared to that of the other generating agents; on the other hand, fluctuations of the wind stress and the buoyancy flux could be strong enough to generate the waves observed by Emery and Magaard (1976). A more exacting application requires more knowledge about the meteorological fields at the sea surface and has to be left to a later investigation.
When the Cat's Out of the Bag: Searching for Portals of Entry in Infective Endocarditis∗

Infective endocarditis (IE) often poses challenges of the diagnostic and/or treatment variety. Take, for instance, the case of a 24-year-old man with congenital heart disease who is diagnosed with Bartonella henselae IE. Patient: “What’s the next step, doc?” Physician: “You will have a
Leptin secretory dynamics and associated disordered eating psychopathology across the weight spectrum.

OBJECTIVE Leptin secretory dynamics across the weight spectrum and their relationship with disordered eating psychopathology have not been studied. Our objective was to compare leptin secretory dynamics in 13 anorexia nervosa (AN), 12 overweight/obese (OB) and 12 normal-weight women using deconvolution analysis. METHODS In this cross-sectional study conducted at a tertiary referral center, serum leptin levels were obtained every 20 min from 2000 to 0800 h. Dual energy X-ray absorptiometry was used to measure percent body fat. Disordered eating psychopathology was assessed by the Eating Disorders Examination-Questionnaire (EDE-Q) and the Eating Disorders Inventory-2 (EDI-2). RESULTS The groups differed for basal leptin secretion (BASAL) (P=0.02). Mean leptin pulse amplitude, pulse mass, total pulsatile secretion (TPS) and area under the curve (AUC) were significantly different between groups before and after adjustment for BASAL (P<0.0001 for all). Leptin AUC correlated strongly with TPS (r=0.97, P<0.0001) and less with BASAL (r=0.35, P=0.03). On multivariate analysis, only TPS was a significant predictor of leptin AUC (P<0.0001). TPS was inversely associated with most EDE-Q and EDI-2 parameters and the associations remained significant for EDE-Q eating concern (P=0.01), and EDI-2 asceticism, ineffectiveness and social insecurity (P<0.05) after adjusting for BASAL. These relationships were not significant when controlled for percent body fat. CONCLUSION Secretory dynamics of leptin differ across weight spectrum, with mean pulse amplitude, mean pulse mass and TPS being low in AN and high in OB. Pulsatile, rather than basal secretion, is the major contributor to leptin AUC. Decreased pulsatile leptin is associated with disordered eating psychopathology, possibly reflecting low percent body fat in AN.
Evaluation of the Phytochemical Anethole as an Anti-Tumor Agent in MCF-7 Cells.

Background: Chinese herbal medicines have gained considerable interest from the cancer community as potential anti-tumor agents. Both clinical as well as pre-clinical studies have demonstrated that certain Chinese herbal medicines can improve survival, increase tumor response, improve quality of life, and reduce chemotherapy toxicity. The specific mechanisms by which these compounds mediate their effects remain largely unknown, inhibiting their development as clinical agents. One such compound is anethole. Anethole is an aromatic compound that occurs widely in nature as a component of anise, fennel anise myrtle, licorice, and star anise and is used in traditional Chinese medicine as an anti-inflammatory agent. Anethole has been identified as one of the potential phytochemicals with anti-cancer activities that could be developed into clinical treatments for breast cancers.Objective: In this current study, we evaluated the effect of anethole on physiological responses and specific survival pathways in human breast cancer MCF-7 cells.Results: Cell proliferation and cell survival were suppressed in a dose-dependent manner in response to anethole treatment, but these dosages had differential effect on specific pro-survival pathways. Anethole increased the cleavage of Poly (ADP-ribose) polymerase (PARP), suggesting an increase in apoptotic activity, but concurrently increased the expression of pro-survival proteins Bcl-2 and p21 while decreasing the expression of tumor suppressor protein p53. Phosphorylation of Akt kinase and S6 pro-survival proteins were modulated in an alternating pattern with increasing concentrations of anethole. Studies were also conducted to investigate the effect of anethole on the sensitivity of MCF-7 cells to tamoxifen treatments. The effect of tamoxifen on cell proliferation was not affected significantly by co-treatment with anethole but importantly the suppression of cell survival by tamoxifen was enhanced when anethole is present at a concentration of 10-5 M. Preliminary data suggest that one mechanism by which anethole is mediating some of its suppressive effects is through modulation of ER activity, as measured by luciferase assays. Studies are on-going to evaluate the relevance of this modulation to the inhibitory effects of anethole on the MCF-7 cells, as well as the modulation of the signal transduction pathways indicated on survival.Conclusion: These data suggest that the anethole is a potential anti-tumor agent, and that co-treatment of tamoxifen and anethole is a potential approach to sensitize human breast MCF-7 cells to tamoxifen treatments. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3100.
The Impact of Gas Phase and Surface Chemical Reactions on Step Coverage in LPCVD

The characteristic step coverage behavior which a given LPCVD process exhibits depends on the nature of the controlling gas phase and/or surface chemical reactions. Physically-based ballistic transport and reaction film profile evolution simulation has provided a structure wherein the origins of step coverage limitations can be understood in the context of the interaction of transport and the controlling chemistry. Based on comparisons of the simulations to literature and in-house experimental data, we have categorized LPCVD mechanisms into one of three types. In heterogeneous deposition, conformal step coverage can usually be found under at least some process conditions. Step coverage typically degrades with increasing deposition temperature. In homogeneous precursor-mediated deposition, a reactive intermediate is formed in the gas-phase above the wafer surface, resulting in poor to moderate step coverage. Step coverage may or may not degrade with increasing temperature. In byproduct-inhibited deposition, a gas-phase byproduct generated via a surface reaction readsorbs on the growing film surface and slows the deposition rate, yielding a poor to moderate, relatively temperature-insensitive step coverage. Poor step coverage is manifested in a marked film thickness discontinuity at the feature mouth, with a relatively uniform film down the feature sidewalls.
Burkholderia ginsengisoli bacteraemia: emergence of a novel pathogen.

Burkholderia ginsengisoli is a non-pathogenic Gram-negative bacterium that ordinarily serves as a plant endosymbiont. We report the first case of human infection with B. ginsengisoli presenting as bacteraemia in a young man with severe Crohn9s disease. Definitive identification of the pathogen could not be accomplished with conventional techniques and required DNA sequencing. The bacteraemia may have been related to ingestion of organic vegetables and compromised gastrointestinal mucosa, coupled with treatment with tumour necrosis factor α inhibitors. Although there are no standard antibiotics to treat this pathogen, we devised a successful treatment regimen.
The doctor-patient relationship as a toolkit for uncertain clinical decisions

Medical uncertainty is a well-recognized problem in healthcare, yet how doctors make decisions in the face of uncertainty remains to be understood. This article draws on interdisciplinary literature on uncertainty and physician decision-making to examine a specific physician response to uncertainty: using the doctor-patient relationship as a toolkit. Additionally, I ask what happens to this process when the doctor-patient relationship becomes fragmented. I answer these questions by examining obstetrician-gynecologists' narratives regarding how they make decisions when faced with uncertainty in childbirth. Between 2013 and 2014, I performed 21 semi-structured interviews with obstetricians in the United States. Obstetricians were selected to maximize variation in relevant physician, hospital, and practice characteristics. I began with grounded theory and moved to analytical coding of themes in relation to relevant literature. My analysis renders it evident that some physicians use the doctor-patient relationship as a toolkit for dealing with uncertainty. I analyze how this process varies for physicians in different models of care by comparing doctors' experiences in models with continuous versus fragmented doctor-patient relationships. My key findings are that obstetricians in both models appealed to the ideal of patient-centered decision-making to cope with uncertain decisions, but in practice physicians in fragmented care faced a number of challenges to using the doctor-patient relationship as a toolkit for decision-making. These challenges led to additional uncertainties and in some cases to poor outcomes for doctors and/or patients; they also raised concerns about the reproduction of inequality. Thus organization of care delivery mitigates the efficacy of doctors' use of the doctor-patient relationship toolkit for uncertain decisions. These findings have implications for theorizing about decision-making under conditions of medical uncertainty, for understanding how the doctor-patient relationship and model of care affect physician decision-making, and for forming policy on the optimal structure of medical work.
Detection of Oncornavirus Antigenic Activity in Human Urothelial Tissues

AbstractOur studies indicate that certain urologic tissues demonstrate evidence of proteins which compete with the interspecies antigens of C-type ribonucleic acid viruses for binding sites of the feline and murine oncornavirus antiglobulins. This fact indicates either the association of viral antigens within these tissues or the presence of a protein so similar to the interspecies antigen that it cross reacts. Studies are now underway to localize reacting antigens within these urologic cells, to correlate the immunologic properties with enzymatic properties known to be specific for oncornaviruses and to assay the activity of patient sera with isolated interspecies antigens. Sera from patients with urologic malignancies will be tested to determine whether the sera can effectively absorb reactivity from tissue extracts or compete with reagent rabbit antisera raised against the interspecies component of the viruses. Should either activity be detected in patient sera, clinical screening will be undertaken to...
Prolactin signaling through focal adhesion complexes is amplified by stiff extracellular matrices in breast cancer cells

Estrogen receptor α positive (ERα+) breast cancer accounts for most breast cancer deaths. Both prolactin (PRL) and extracellular matrix (ECM) stiffness/density have been implicated in metastatic progression of this disease. We previously demonstrated that these factors cooperate to fuel processes involved in cancer progression. Culture of ERα+ breast cancer cells in dense/stiff 3D collagen-I matrices shifts the repertoire of PRL signals, and increases crosstalk between PRL and estrogen to promote proliferation and invasion. However, previous work did not distinguish ECM stiffness and collagen density. In order to dissect the ECM features that control PRL signals, we cultured T47D and MCF-7 cells on polyacrylamide hydrogels of varying elastic moduli (stiffness) with varying collagen-I concentrations (ligand density). Increasing stiffness from physiological to pathological significantly augmented PRL-induced phosphorylation of ERK1/2 and the SFK target, FAK-Y925, with only modest effects on pSTAT5. In contrast, higher collagen-I ligand density lowered PRL-induced pSTAT5 with no effect on pERK1/2 or pFAK-Y925. Disrupting focal adhesion signaling decreased PRL signals and PRL/estrogen-induced proliferation more efficiently in stiff, compared to compliant, extracellular environments. These data indicate that matrix stiffness shifts the balance of PRL signals from physiological (JAK2/STAT5) to pathological (FAK/SFK/ERK1/2) by increasing PRL signals through focal adhesions. Together, our studies suggest that PRL signaling to FAK and SFKs may be useful targets in clinical aggressive ERα+ breast carcinomas.
Transcriptomic identification and characterization of levamisole resistance associated genes in the swine nodular worm Oesophagostomum dentatum

17 Introduction 17 Materials and Methods 19 Results 21 Discussion 27 Acknowledgements 29 Literature Cited 29
Effectuating Your Client's Body Disposition Desires

Perhaps the most difficult thought to ponder is one’s own mortality. Many people avoid confronting the grim reality that they and their loved ones will eventually die. Estate planners must sensitively urge their clients to face the inevitability of death to obtain well-reasoned dispositions of their property. Many clients are also very concerned with the final disposition of their bodies. For example, some individuals want to be buried while others prefer to be cremated.An estate planner needs to take steps to help insure that a client’s body will be handled after death in accordance with the client’s wishes. The estate planner must also work to reduce the chances of those wishes being frustrated either by lack of information to the individuals making disposition arrangements or by individuals surviving the client who are unhappy with the deceased’s disposition requests.Unfortunately, many estate planners ignore or deal superficially with their clients’ body disposition concerns. Accordingly, this article details the techniques which Texas estate planners may use to assist their clients to receive the body disposition they desire.
Improving Interrater Reliability of Medical Student Assessment by Clinical Supervisors

Introduction Clinical clerkships that rely on community preceptors as faculty and assessors are challenged by the variability in their assessments of student performance. This workshop was designed...
Mechanically Interlocked Molecules (MIMs)-Molecular Shuttles, Switches, and Machines (Nobel Lecture).

Chemistry welcomes a new bond: The mechanical bond has endowed molecules with component parts whose movements can be controlled and monitored. In his Nobel Lecture, J. F. Stoddart describes how being able to template the formation of mechanically interlocked molecules has led to the design and synthesis of shuttles, switches, and machines at the nanoscale.
Common factors among pairs of consecutive integers

In this paper, we study products of consecutive integers and prove an optimal bound on their greatest common factors. In contrast, we obtain a modest upper bound for the greatest common factor in the perfect square situation. Using this and an upper bound on the size of solutions to hyperelliptic curves, we prove a gap principle when a2(a2 + 1) divides b2(b2 + 1) with some additional restrictions. We also obtain a stronger gap principle under the abc conjecture.
Mutational Hotspots in Mammalian Cells

A vector, termed pZipGptNeo, has been constructed by the introduction of a DNA fragment containing the E. coli gpt gene into a retroviral shuttle vector. The pZipGptNeo vector was then introduced into mouse L cells to construct the A912 cell line. This cell line stably expresses the gpt gene and contains a single copy of the vector integrated into its chromosomal DNA. Studies utilizing the A912 cell line to determine the specificity of spontaneous and 5-bromodeoxyuridine-induced mutations will be summarized. The role of the surrounding DNA sequence in the production of these mutations will be discussed. The construction of a new retroviral shuttle vector and its introduction into the CHO-Kl cell line will be described. Preliminary experiments suggest that spontaneous gpt gene mutations arising in CHO cells are similar to those seen in mouse L cells. A small region of the gene which was shown to be a hotspot for spontaneous mutation in the mouse cells is apparently also a hotspot in Chinese hamster cells.
Secure Semantic Web Services

Web Services refer to the technologies that allow for making connections. Semantic web consists of technologies that enable machine understandable web pages. Web services make use of semantic web technologies to understand the web pages, conduct reasoning and take actions. Such web services are semantic web services. For many applications the semantic web services have to be secure. In this chapter we discuss secure web services, secure semantic web technologies and finally discuss the integration of secure web services with secure semantic web technologies to develop secure semantic web services.
Race and Negotiation Performance

This article explores the correlation between race and negotiation performance with respect to the results achieved on Negotiation course exercises. It initially discusses empirically established differences between whites and blacks that might influence bargaining encounters, and then examines nine years of data in my Negotiation class. It is interesting to note that no statistically significant differences were found between black and white student negotiation results. This article is significant, because it counteracts the apparent belief among African-American athletes that white agents should do better when they negotiate with team owners who are usually white than black agents.
Wave Propagation in Drifting Isotropic Warm Plasma

The electro-magneto-plasma-gas-dynamics (EMPGD) equations are given for the warm, compressible electron gas, with no magnetostatic field, drifting with a constant velocity, by taking into account the fluid dynamics variables of the electron gas and using small-signal theory. Assuming harmonic time variation, an algebraic equation is found for the refractive index of the plasma characteristic waves. Particular cases are discussed and compared with previous results.
Outcomes of fludarabine, high dose cytarabine and granulocyte-colony stimulating factor (FLAG) as re-induction for residual acute myeloid leukemia on day 14 bone marrow.

Abstract Background Patients with acute myeloid leukemia (AML) treated with intensive chemotherapy may require re-induction based on the evaluation of day 14 bone marrow biopsy. Methods : A retrospective chart review was performed to evaluate adult patients with AML who received re-induction with fludarabine, high dose cytarabine and granulocyte colony stimulating factor (FLAG) regimen for residual disease (≥ 5% blasts by morphology) on day 14 bone marrow examination between September 2012 and July 2017 at our institution. Results We identified 27 patients who received FLAG therapy for treatment of residual disease on day 14 marrow examination following initial induction. The median age at diagnosis was 61 years and the majority of patients had poor risk AML. The overall response rate was 78% and 15 patients proceeded to allogeneic hematopoietic stem cell transplantation. Conclusion The regimen was well tolerated and is a viable re-induction option for patients with residual disease on a day 14 bone marrow.
Recovery of Protein Folding Funnels from Single-Molecule Time Series by Delay Embeddings and Manifold Learning

The stability and folding of proteins is governed by the underlying single-molecule free energy surface (smFES) mapping the free energy of the molecule as a function of configurational state. Ascertaining the smFES is of great value in understanding and engineering protein structure and function. By integrating tools from dynamical systems theory and nonlinear manifold learning, we describe an approach to reconstruct the multidimensional smFES for a protein from a time series in a single experimentally measurable observable. We employ Takens' delay embeddings to project the time series into a high-dimensional space in which the projected dynamics are C1-equivalent to the true system dynamics and employ diffusion maps to recover a low-dimensional reconstruction of the smFES that is equivalent to the true smFES up to a smooth and invertible transformation. We validate the approach in molecular dynamics simulations of Trp-cage, Villin, and BBA to demonstrate that landscapes recovered from univariate time series in the head-to-tail distance are topologically identical-they precisely preserve the metastable states and folding pathways-and topographically approximate-the free energy barrier heights and well depths are approximately preserved-to the true landscapes determined from complete knowledge of all atomic coordinates. We go on to show that the reconstructed landscapes reliably predict temperature denaturation and identify point mutations and groups of mutations critical to folding. These results demonstrate that protein folding funnels can be reconstructed from experimentally measurable time series and used to understand and engineer folding.
New machine learning-based prediction models for fracture energy of asphalt mixtures

Abstract This paper presents innovative machine learning methods called gene expression programming (GEP) and hybrid artificial neural network/simulated annealing (ANN/SA) to predict the fracture energy of asphalt mixture specimens. The GEP and ANN/SA models are developed using an experimental database including a number of disk-shaped compact tension (DC(T)) test results for fracture energy. The fracture energy is formulated in terms of various predictor variables such as asphalt binder performance grading (PG), asphalt content, aggregate size, aggregate gradation, reclaimed asphalt pavement (RAP) content, reclaimed asphalt shingles (RAS) content, crumb rubber content, and test temperature. A calculation procedure is presented to interpret the models and transform them into practical design equations. A sensitivity analysis is conducted to evaluate the effect of these predictor variables on the fracture energy. Based on the results, the proposed design equations accurately characterize the fracture energy of asphalt mixtures. The GEP model appears to be more practical than the ANN/SA model because of its better generalization and simpler functional structure. The models are recommended for pre-design purposes or as a means to determine asphalt mixture fracture energy when testing is not feasible.
Chapter 11 – Cryosphere Applications

Satellite observations have revolutionized our understanding of the cryosphere and the critical role it plays in shaping Earth's climate system. Polar regions play a critical role in the climate system. Ice reflects sunlight, thus reducing the amount of energy being collected by the Earth, it influences the thermohaline ocean circulation, it warms up the polar atmosphere, and prevents large storms and waves to enter, it also prevents coastal erosion, and Arctic tundra and marine sediments contain large, frozen deposits of methane that will be released to the atmosphere if the ice melts. After a drastic melt in 2016, Arctic sea ice has reduced to its second lowest level in recorded history, according to the National Snow and Ice Data Center. Initially, satellite remote sensing of polar regions was limited to polar-orbiting visible and near-infrared satellite imagery, but these regions are covered by clouds most of the time. Today, a suite of sensors including radar scatterometers, microwave radiometers, and LIDAR, on board ICESat, CryoSat, QuikSCAT, SMOS, SSMI/S, AMSR-2, and TDS-1, are amenable to perform ice thickness, ice cover, first-year ice and multiyear ice classification, ice motion, drifts. In this chapter, we briefly revise the different techniques and how they are applied to the observation of these challenging regions.
Trajectories of body mass index among active-duty U.S. Army soldiers, 2011-2014.

Abstract Establishing the shape and determinants of trajectories of body mass index (BMI) among Soldiers is critical given the importance of weight management to military service requirements. To establish the shape and determinants of BMI trajectories among Soldiers, we aimed to (1) model the overall BMI trajectory of Soldiers, (2) find the most common trajectory groups among Soldiers, (3) investigate the relationship between BMI trajectories and sociodemographic and military-specific characteristics, and (4) determine if there were Soldiers with large fluctuations in BMI. The study population included all US Army Soldiers on active-duty between 2011 and 2014 who were age 17–62 (n = 827,126). With longitudinal data from the Stanford Military Data Repository, we used group-based trajectory modeling to identify the BMI trajectories of Soldiers and multinomial logistic regression to estimate associations between Soldier characteristics and trajectory membership. Four distinct BMI trajectory groups were found: increasing, decreasing, constant, and inconstant. The constant, increasing, and decreasing trajectories were similar in shape and percentage between men and women. The constant trajectory had the fewest Soldiers who exceeded weight standards or had duty limitations. The increasing trajectory was associated with marriage and fewer service years. The decreasing trajectory was associated with more service years and higher educational attainment. The inconstant trajectory differed in shape between men and women. Over 6% of men and 12% of women had fluctuations in BMI indicative of weight cycling. Understanding the characteristics associated with BMI trends may assist the Army in targeting resources aimed to improve Soldier health and combat readiness.
Toward an animal model of borderline personality disorder.

Borderline personality disorder (BPD) is a pervasive psychiatric disorder characterized by emotion dysregulation, impulsivity, impaired self-perceptions, and interpersonal relationships and currently affects 1–3% of the US population as reported by Torgersen et al. (Arch Gen Psychiatry 58:590–596, Torgersen et al. 2001), Lenzenweger et al. (Biol Psychiatry 62:553–564, Lenzenweger et al. 2007), and Tomko et al. (J Personal Disord 28:734–750, Tomko et al. 2014). One major obstacle to our understanding of the neural underpinnings of BPD is a lack of valid animal models that translate the key known features of the disorder to a system that is amenable to study. To summarize the etiology, major symptoms, and symptom triggers of BPD and then propose a blueprint for building an animal model of BPD by choosing key components of the disorder that can be implemented in rodents. We identify the role of early life stress and subsequent mild stress in adulthood as contributing etiological factors and the potential use of altered communication between frontal cortices and the amygdala in extinction and habituation, increased impulsivity, dysregulation of the hypothalamic pituitary axis (HPA), and increased neuroinflammation as biological markers of BPD. Building upon these features of BPD, we propose a two-hit animal model that uses maternal abandonment to alter maturation of the HPA axis and mild secondary adult stress to evoke behavioral symptoms such as increased impulsivity and impaired extinction, habituation, and social interactions. Through exploration of the etiology, symptom presentation, and altered neurological function, we propose an animal model of BPD. We believe that a number of existing animal paradigms that model other mental health disorders should be combined in a unique way to reflect the etiology, symptom presentation, and altered neurological function that is evident in BPD. These model, when compared with available human data, will inform research and treatment in humans for better understanding of systems from the micro-molecular level to more global physiology underlying BPD.
Retrospective Observational Study of the Clinical Performance Characteristics of a Machine Learning Approach to Early Sepsis Identification.

To estimate performance characteristics and impact on care processes of a machine learning, early sepsis recognition tool embedded in the electronic medical record. Design Retrospective review of electronic medical records and outcomes to determine sepsis prevalence among patients about whom a warning was received in real time and timing of that warning compared with clinician recognition of potential sepsis as determined by actions documented in the electronic medical record. Setting Acute care, nonteaching hospital. Patients Patients in the emergency department, observation unit, and adult inpatient care units who had sepsis diagnosed either by clinical codes or by Center for Medicare and Medicaid Services Severe Sepsis and Septic Shock: Management Bundle (SEP-1) criteria for severe sepsis and patients who had machine learning-generated advisories about a high risk of sepsis. Interventions Noninterventional study. Measurements and main results Using two different definitions of sepsis as "true" sepsis, we measured the sensitivity and early warning clinical utility. Using coded sepsis to define true positives, we measured the positive predictive value of the early warnings. Sensitivity was 28.6% and 43.6% for coded sepsis and severe sepsis, respectively. The positive predictive value of an alert was 37.9% for coded sepsis. Clinical utility (true positive and earlier advisory than clinical recognition) was 2.2% and 1.6% for the two different definitions of sepsis. Use of the tool did not improve sepsis mortality rates. Conclusions Performance characteristics were different than previously described in this retrospective assessment of real-time warnings. Real-world testing of retrospectively validated models is essential. The early warning clinical utility may vary depending on a hospital's state of sepsis readiness and embrace of sepsis order bundles.
Developing advanced practice nurse writing competencies as a corequisite for evidence-based practice

Writing competency is increasingly recognized as imperative for advanced practice nurses (APNs) who are engaged in evidence-based practice (EBP). Writing skills are an implied expectation inherent in many APN evidence-based practice competencies, such as "formulating evidence based policies and procedures," and "communicates best evidence …." A quality improvement project was implemented for APN's within a post-Master's Doctor of Nursing Practice program, to create a novel set of low-cost, high-impact strategies that could be embedded into a program of study to improve APN writing skills. Prior work has indicated that mentorship and peer support are useful strategies that can contribute to the enhancement of APN writing skills. This study builds on prior work to develop a quantitative evaluation of a peer-supported writing intervention for APNs. Read Aloud innovation was one of two strategies chosen from among many writing improvement strategies identified in the literature because of easy implementation, even by faculty who lacked confidence in providing traditional writing instruction. If explicit development of writing competencies is not elevated to a higher priority in APN education, suboptimal writing confidence is likely to continue across the professional lifetime and will present as a recurring challenge for APNs who pursue higher educational degrees, transition into faculty roles, or seek to fully develop APN EBP competencies. Findings from this study indicate that feedback received from peers during the structured Read Aloud innovation, with emphasis on hierarchy of paragraph sentences (i.e., explicit examination for overarching quality of the leading sentence), is effective in improving clarity and brevity of writing among APNs.
Liposomal maneuvers against Parkinson's disease

Abstract Multifarious therapeutics has been targeted to the brain to treat neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease (PD). However, the brain entry of therapeutic molecules has been a major biological riddle that limits their success significantly. To overcome this major challenge, panoply of nanotechnological maneuvers have been extensively studied, which could also improve the brain targeting of therapeutics. Among these strategies, liposomes were found to be substantial delivery systems for brain targeting. This chapter throws light on multifarious liposomes used in the treatment of PD, their challenges, and future perspectives.
Work-in-Progress: Non-preemptive Scheduling of Sporadic Gang Tasks on Multiprocessors

Existing works on gang task scheduling mainly focus on the preemptive scheduling case, which contradicts a bit with the non-preemptive executing nature of applying gang scheduling techniques in practice. In this paper, we present a set of non-trivial techniques that can analyze the schedulability of scheduling a hard real-time sporadic gang task system under non-preemptive GEDF on multiprocessors and a utilization-based schedulability test (first-of-its-kind) is derived.
Marijuana Legalization and Youth Marijuana, Alcohol, and Cigarette Use and Norms

Introduction Rates of adolescent substance use have decreased in recent years. Knowing whether nonmedical marijuana legalization for adults is linked to increases or slows desirable decreases in marijuana and other drug use or pro-marijuana attitudes among teens is of critical interest to inform policy and promote public health. This study tests whether nonmedical marijuana legalization predicts a higher likelihood of teen marijuana, alcohol, or cigarette use or lower perceived harm from marijuana use in a longitudinal sample of youth aged 10–20 years. Methods Data were drawn from the Seattle Social Development Project–The Intergenerational Project, an accelerated longitudinal study of youth followed both before (2002–2011) and after nonmedical marijuana legalization (2015–2018). Analyses included 281 youth surveyed up to 10 times and living in a state with nonmedical marijuana legalization between 2015 and 2018 (51% female; 33% white, 17% African American, 10% Asian/Pacific Islander, and 40% mixed race or other). Results Multilevel modeling in 2019 showed that nonmedical marijuana legalization predicted a higher likelihood of self-reported past-year marijuana (AOR=6.85, p=0.001) and alcohol use (AOR 3.38, p=0.034) among youth when controlling birth cohort, sex, race, and parent education. Nonmedical marijuana legalization was not significantly related to past-year cigarette use (AOR=2.43, p=0.279) or low perceived harm from marijuana use (AOR=1.50, p=0.236) across youth aged 10–20 years. Conclusions It is important to consider recent broad declines in youth substance use when evaluating the impact of nonmedical marijuana legalization. States that legalize nonmedical marijuana for adults should increase resources for the prevention of underage marijuana and alcohol use.
Differential gene expression in skin RNA of horses affected with degenerative suspensory ligament desmitis

Equine degenerative suspensory ligament desmitis (DSLD) is a systemic connective tissue disorder first identified in Peruvian Paso horses but afflicting other horse breeds as well. Inappropriate accumulation of proteoglycans in connective tissues, most prominently in tendons and ligaments, leads to progressive and debilitating lameness and pain. It is largely unknown what drives the overproduction of proteoglycans, but our previous studies suggest involvement of bone morphogenetic protein 2 (BMP2), a member of the transforming growth factor-β (TGFβ) family, impacting synthesis of proteoglycans. To identify potential players in pathogenesis of DSLD a new approach utilizing next generation sequencing was undertaken. Next generation sequencing was performed using RNA extracted from skin biopsies of six control Peruvian Pasos and six horses with DSLD (4 Peruvian Pasos and 2 warmbloods). The CuffDiff result sets were validated with algorithms used to run them. This was based on the determined false discovery rates derived from the P values adjusted for multiple testing for any given result. Bioinformatics analysis of transcriptomes revealed differential expression of over 1500 genes, including increased expression of genes for several growth factors (most prominently BMP2, FGF5, CTGF, many members of the EGF family), and mediators of signaling (Fos, Myc, MAPK system), and keratins. Two genes encoding for enzymes involved in synthesis of hyaluronan were also overexpressed. Gene expression was decreased for protein cores of many proteoglycans, several growth factors, most collagens, and many peptides with immune function. The overexpression of BMP2 correlates well with our previous data. However, the decrease in expression of numerous proteoglycans was unexpected. A mutation in a gene of a less characterized proteoglycan and/or glycosyltransferase with subsequent increased production of hyaluronan and/or a proteoglycan(s) undetected in our study could account for the systemic proteoglycan deposition. Decreased collagen gene expression indicates abnormal connective tissue metabolism. The increased expression of keratin genes and FGF5 supports reports of skin abnormalities in DSLD. Underexpression of immune function genes corresponds with lack of inflammation in DSLD tissues. Finally, though the proteoglycan and/or glycosaminoglycan abundant in DSLD has not been identified, we validated our previous data, including overexpression of BMP2, and systemic nature of DSLD due to disturbed metabolism of the extracellular matrix.
Novel Application of Erector Spinae Plane Block to Interspinous Spacer Placement

Erector spinae plane block (ESPB) is a fascial plane block that targets the dorsal and ventral branches of the primary dorsal root ganglion. We report a case of a 76-year-old woman who presented for percutaneous posterior interspinous decompression spacer at the L3-L4 level in the setting of neurogenic claudication from severe spinal stenosis. We describe the novel performance of bilateral ESPBs under ultrasound guidance for postprocedural analgesia. Throughout the recovery period, the patient experienced sustained pain relief. ESPB may be a useful adjunct for periprocedural analgesia and recovery in patients undergoing interspinous spacer placements.
Laughter Yoga as a Social Work Intervention

Using simulated laughter, clients follow laughing patterns without using memory recalls or associating with any thinking or feeling. This practice update describes laughter yoga as a social work in...
Correlation of Alberta Stroke Program Early Computed Tomography Score With Computed Tomography Perfusion Core in Large Vessel Occlusion in Delayed Time Windows

Background and Purpose: The Alberta Stroke Program Early Computed Tomography (CT) Score (ASPECTS) and CT perfusion (CTP) are commonly used to predict the ischemic core in acute ischemic strokes. CT...
Design and Testing of a Propellant Management System for Bimodal Chemical-Electrospray Propulsion

The most prominent modes of propulsion for spacecraft are chemical and electric propulsion, and missions that require maneuvering need to select one mode over the other, or in some cases need to carry two separate propulsion subsystems, including management of incompatible propellants. This is particularly limiting for small spacecraft, which lack the volume, mass and power resources to accommodate high-performance propulsion components. Most systems are then confined to either the chemical mode (typically high thrust, low specific impulse) or the electric mode (typically low thrust, high specific impulse). However, recent development of green monopropellants as replacements to hydrazine in chemical thrusters has created a family of propellants that are also compatible with electric thrusters. Notably, the monopropellant AF-M315E/ASCENT and other hydroxylammonium nitrate (HAN) based ionic liquids can be used in electrospray thrusters. This work proposes a bimodal propulsion system that integrates a chemical mono-propellant thruster with electrospray thrusters into a unified system with common propellant. The design, fabrication, and validation of a propellant feed line connecting the central tank to electrospray thrusters is presented here. Key elements of this design include solenoid valves for flow control and capillary tubes for pressure conditioning. A subsequent section of nonconductive tubing allows for water (present in the composition of many HAN-based propellants) to evaporate at its vapor pressure and form bubbles in the propellant line. These bubbles physically segment the conductive ionic liquid and provide electrical isolation between the electrospray thruster and the central tank; this is required to apply high voltage to operate the electrospray thrusters without current leaks or shorts. A prototype propellant line was fabricated and its flow characteristics and electrical impedance were measured in a series of tests to validate the design. These tests successfully demonstrated the feasibility of this design for a bimodal spacecraft propulsion system.
A 4-Element 800MHz-BW 29mW True-Time-Delay Spatial Signal Processor Enabling Fast Beam-Training with Data Communications

Spatial signal processors (SSP) for emerging millimeter-wave wireless networks are critically dependent on link discovery. To avoid loss in communication, mobile devices need to locate narrow directional beams with millisecond latency. In this work, we demonstrate a true-time-delay (TTD) array with digitally reconfigurable delay elements enabling both fast beam-training at the receiver with wideband data communications. In beam-training mode, large delay-bandwidth products are implemented to accelerate beam training using frequency-dependent probing beams. In data communications mode, precise beam alignment is achieved to mitigate spatial effects during beam-forming for wideband signals. The 4-element switched-capacitor based time-interleaved array uses a compact closed-loop integrator for signal combining with the delay compensation implemented in the clock domain to achieve high precision and large delay range. Prototyped in TSMC 65nm CMOS, the TTD SSP successfully demonstrates unique frequency-to-angle mapping with 3.8ns maximum delay and 800MHz bandwidth in the beam-training mode. In the data communications mode, a ~ 12dB uniform beamforming gain is achieved from 80MHz to 800MHz. The TTD SSP consumes 29mW at 1V supply achieving 122MB/s with 16-QAM at 9.8% EVM.
The Culture of Morality: Social Development, Context, and Conflict

1. Introduction 2. Striving for community 3. Discontents revisited 4. Social judgments and social contexts 5. The development of moral and social judgments 6. Social thought and social action 7. Social harmony and social conflict 8. Justice, heterogeneity, and cultural practices 9. Social hierarchy, subordination, and human capabilities 10. Perspectives on cultural practices: more than one 11. Subversion in everyday life 12. Conclusion.
Disturbance Rejection in Boundary Control Systems

An elastic string subjected to external disturbance and stabilized by the boundary control is considered. The problem of optimal disturbance rejection by the boundary control is formulated. Furthermore, it is shown that, any strictly positive real compensator in the boundary control stabilizes the string. This fact results in the formulation of optimal disturbance rejection for an elastic string, when strictly positive real compensators are used in the boundary control.