cssi/SciSciGPT-SciSciNet huggingface dataset:
The impact of academic self‐concept, expectations and the choice of learning strategy on academic achievement: the case of business students

This study provides evidence of the impact of two critical self‐regulation components – academic self‐concept and outcome expectations – on the selection of learning strategies conducive to academic achievement in undergraduate business education. Self‐concept theory is the framework for the analysis of students’ motivations and learning behaviors. Path analysis suggests that high academic self‐concept favors engagement in complex cognitive effort, deep learning strategies and self‐reflection, as well as in the adoption of strategic learning approaches alone. However, the composite effect of deep learning through strategic approaches has the most impact on student’s academic performance. High academic expectations favor students’ selection of deep learning more than strategic approaches. Clearly, the use of surface approaches to learning is not conducive to academic achievement. Overall, these findings suggest that high students’ academic self‐concepts and unambiguous outcome expectations encourage critic...
On the Elastic Properties of the Interfaces That Stabilize Gas Cavitation Nuclei

Many important systems feature strongly curved interfaces with low surface tension. Four examples are micelles, emulsions, giant bilayer vesicles, and biological membranes. A fifth is the microbubble nuclei that initiate cavitation in aqueous media. A model describing these nuclei and how they respond to changes in ambient pressure attributes their remarkable resiliency to a surrounding film of surface-active molecules. An independent derivation of this model is obtained in this paper by applying thermodynamic methods formulated recently to describe strongly curved amphiphilic interfaces. This illuminates previous models for microbubble nuclei and provides additional information on the mechanical and thermodynamic properties of interfaces in general.
Productivity shortfalls in drug discovery: contributions from the preclinical sciences?

An inverse relationship between human and financial investment and productivity, in the form of new drug approvals, has been a consistent theme in drug discovery for more than a decade. There appear to be many causes and solutions for this, but few tangible outcomes. Although Food and Drug Administration regulators, the constraints resulting from short-term business decisions, and the harvesting of all “low-hanging fruit,” have been cited as the major causes for the decreased productivity, a change in the preclinical research culture is equally culpable. Current trends in biomedical research have led to a decreased emphasis on the null hypothesis/data-driven approach; a trend toward qualitative rather than quantitative science; an implicit assumption that all targets represent a viable starting point for drug discovery efforts; and the replacement of the creativity, objectivity, passion, and logic characteristic of the drug hunter with consensus-dependent, technology-driven research cultures. In addition, the euphoria following the mapping of the human genome and its implicit potential as a source for new drug targets has given way to disillusionment as the relevance, tractability, and complexity of novel disease-associated targets have become recognized as significant challenges. Biomedical research efforts directed toward drug discovery, both in academia and industry, must prioritize genuine innovation over technology and thus allow efforts in preclinical research to play a key role in the solution to the shortfall in new drug applications.
Subtype-specific mechanisms for functional interaction between α6β4* nicotinic acetylcholine receptors and P2X receptors.

P2X receptors and nicotinic acetylcholine receptors (nAChRs) display functional and physical interactions in many cell types and heterologous expression systems, but interactions between α6β4-containing (α6β4*) nAChRs and P2X2 receptors and/or P2X3 receptors have not been fully characterized. We measured several types of crosstalk in oocytes coexpressing α6β4 nAChRs and P2X2, P2X3, or P2X2/3 receptors. A novel form of crosstalk occurs between α6β4 nAChRs and P2X2 receptors. P2X2 receptors were forced into a prolonged desensitized state upon activation by ATP through a mechanism that does not depend on the intracellular C terminus of the P2X2 receptors. Coexpression of α6β4 nAChRs with P2X3 receptors shifts the ATP dose-response relation to the right, even in the absence of acetylcholine (ACh). Moreover, currents become nonadditive when ACh and ATP are coapplied, as previously reported for other Cys-loop receptors interacting with P2X receptors, and this crosstalk is dependent on the presence of the P2X3 C-terminal domain. P2X2 receptors also functionally interact with α6β4β3 but through a different mechanism from α6β4. The interaction with P2X3 receptors is less pronounced for the α6β4β3 nAChR than the α6β4 nAChR. We also measured a functional interaction between the α6β4 nAChRs and the heteromeric P2X2/3 receptor. Experiments with the nAChR channel blocker mecamylamine on P2X2–α6β4 oocytes point to the loss of P2X2 channel activity during the crosstalk, whereas the ion channel pores of the P2X receptors were fully functional and unaltered by the receptor interaction for P2X2–α6β4β3, P2X2/3–α6β4, and P2X2/3–α6β4β3. These results may be relevant to dorsal root ganglion cells and to other neurons that coexpress these receptor subunits.
Numerous Sigma Level Tables Need Correction: Commonly Used Tables Ignore Permitted Left-Side Defects

Many popular textbooks in the fields of operations management and quality contain process sigma level tables that are slightly inaccurate and inconsistent among each other. These discrepancies annoy and are confusing to fastidious educators and students and could lead to minor estimation errors in practice. We document instances of the error and provide explanation, calculations, and an accurate sigma level table.
Current developments in soil organic matter modeling and the expansion of model applications. A review

Soil organic matter (SOM) is an important natural resource. It is fundamental to soil and ecosystem functions across a wide range of scales, from site-specific soil fertility and water holding capacity to global biogeochemical cycling. It is also a highly complex material that is sensitive to direct and indirect human impacts. In SOM research, simulation models play an important role by providing a mathematical framework to integrate, examine, and test the understanding of SOM dynamics. Simulation models of SOM are also increasingly used in more 'applied' settings to evaluate human impacts on ecosystem function, and to manage SOM for greenhouse gas mitigation, improved soil health, and sustainable use as a natural resource. Within this context, there is a need to maintain a robust connection between scientific developments in SOM modeling approaches and SOM model applications. This need forms the basis of this review. In this review we first provide an overview of SOM modeling, focusing on SOM theory, data-model integration, and model development as evidenced by a quantitative review of SOM literature. Second, we present the landscape of SOM model applications, focusing on examples in climate change policy. We conclude by discussing five areas of recent developments in SOM modeling including: (1) microbial roles in SOM stabilization; (2) modeling SOM saturation kinetics; (3) temperature controls on decomposition; (4) SOM dynamics in deep soil layers; and (5) SOM representation in earth system models. Our aim is to comprehensively connect SOM model development to its applications, revealing knowledge gaps in need of focused interdisciplinary attention and exposing pitfalls that, if avoided, can lead to best use of SOM models to support policy initiatives and sustainable land management solutions.
On the Gauge-invariant Functional Measure for Gauge Fields on CP^2

We introduce a general parametrization for nonabelian gauge fields on the four-dimensional space ${\mathbb{CP}}^2$. The volume element for the gauge-orbit space or the space of physical configurations is then investigated. The leading divergence in this volume element is obtained in terms of a higher dimensional Wess-Zumino-Witten action, which has previously been studied in the context of K\"ahler-Chern-Simons theories. This term, it is argued, implies that one needs to introduce a dimensional parameter to specify the integration measure, a step which is a nonperturbative version of the well-known dimensional transmutation in four-dimensional gauge theories.
Endothelial cell phenotypic diversity. In situ demonstration of immunologic and enzymatic heterogeneity that correlates with specific morphologic subtypes.

Some endothelial cells share functional and phenotypic properties with cells of monocyte/macrophage lineage. The authors have performed frozen-section immunologic stains and plastic section enzyme histochemical stains on various human tissues to examine endothelial cell phenotypic properties in situ . They found that endothelial cells express heterogeneous phenotypes that correlate with vessel type. Several endothelial cell subsets were identified. These included arterioles, capillaries, and venules (HLA-ABC+, HLA-DR+, Factor VIII RA+, monocyte−, alkaline phosphatase+, ATPase+); high endothelial venules of lymphoid tissues and hepatic sinusoidal lining cells (HLA-ABC+, HLA-DR+, Factor VIII RA+, monocyte+); lymphatics and glomerular capillaries (HLA-ABC+, HLA-DR+/−, Factor VIII RA−, monocyte−, 5′nucleotidase+); splenic sinusoidal lining cells (HLA-ABC+, Leu-2+, HLA-DR+, Factor VIII RAweak+, monocyte−, alpha naphthyl acetate esterase+); umbilical cord vessels (Factor VIII RA+, HLA-ABCweak+, HLA-DR−, monocyte−). The expression of monocyte-related antigens by some endothelial cells appears to be acquired in extranodal inflammatory infiltrates and is probably modulated by lymphokines.
Further Observations on the Relationship Between the Metabolism of Galactose and Glucose.

It is a striking fact that lactose is found in but one place in nature, in the mammary secretion, milk. More information may well be obtained about it and its products of hydrolysis, particularly the galactose moiety. Several investigators have found that tolerance for galactose is less than for a mixture of glucose and galactose. The evidence presented has been the decreased urinary excretion and the less striking change in the blood sugar when glucose accompanied the galactose. One objection to such observations, and a limitation to their interpretation, lies in the absence of knowledge of what changes in galactose concentration of the blood and urine are taking place.A method for the estimation of galactose in blood and urine has been developed,1 and applied in an effort to learn more of the relationship between the metabolism of glucose and galactose. Glucose injected simultaneously with galactose has increased the rate of removal of the latter from the blood, but the effect could be explained at leas...
Circuit transients due to negative bias arcs-II

Two new models of negative-bias arcing on a solar cell power system in Low Earth Orbit are presented. One is an extended, analytical model and the other is a non-linear, numerical model. The models are based on an earlier analytical model in which the interactions between solar cell interconnects and the space plasma as well as the parameters of the power circuit are approximated linearly. Transient voltages due to arcs struck at the negative thermal of the solar panel are calculated in the time domain. The new models treat, respectively, further linear effects within the solar panel load circuit and non-linear effects associated with the plasma interactions. Results of computer calculations with the models show common-mode voltage transients of the electrically floating solar panel struck by an arc comparable to the early model but load transients that differ substantially from the early model. In particular, load transients of the non-linear model can be more than twice as great as those of the early model and more than twenty times as great as the extended, linear model.
Tennis Injuries of the Hip and Knee

Tennis is a popular sport that relies on repetitive stopping, starting, pivoting, twisting, and flexion motions throughout the lower extremities. As such, regular tennis play leads to a unique profile of injuries to the hip and knee. The lower extremities are the most frequent location of acute and chronic injuries in tennis. In the knee, chronic overuse injuries to the patellofemoral compartment and extensor mechanism predominate. The most common acute injuries to the knee are sprains to the stabilizing ligamentous structures. Less is known regarding injury to the hip and groin. Adductor strains are the most commonly cited injury to the hip, although recent research into hip biomechanics and range of motion has helped shed light on the identification of athletes with intraarticular hip pathology. Lately, researchers have attempted to categorize risk factors for sustaining injuries to the hip and knee in an attempt to help detect those athletes at risk for lower extremity injury. Identification of risk factors for injuries and further elucidation of the relationship between injury and the biomechanics of hip and knee motion during tennis play represent two important pathways for future investigations.
Reading like a girl: gender and text in Jewish bioethics.

L'A. de l'article pose des questions qui lancent sa discussion : Y a-t-il une ethique juive medicale pour les femmes? Maintenant que la bioethique juive est entree dans la bioethique academique et dans le monde clinique, comment les opinions feminines peuvent-elles devenir une partie critique du canon? Si le lecteur des textes sur la morale juive est une femme, qu'est-ce que cette lecture produit alors? Que se passe-t-il si l'on etudie les textes halakhiques non comme des textes de guerre ou d'affaires, mais comme des textes de relations familiales? L'A. propose six cas de figure sur ce theme.
α-Amino Acid-Based Poly(Ester urea)s as Multishape Memory Polymers for Biomedical Applications

The thermal shape memory behavior of a series of α-amino acid-based poly(ester urea)s has been explored. We demonstrate that these materials exhibit excellent shape memory performance in dual- and triple-shape thermomechanical testing. Significant activation of chain mobility above the Tg as well as a hydrogen bonding network provide the basis for shape transformations and recovery. Additionally, we tuned the shape memory properties of these materials with polymer blending, enabling the demonstration of quadruple-shape memory cycles.
Type Ic Supernovae

In this chapter discusses supernovae of Type Ic (SN Ic), the most stripped of core-collapse supernovae. SN Ic show little evidence for either hydrogen or helium in their ejecta. Nebular spectra have features that are typical of core-collapse supernovae. SN Ic are of typical peak luminosity. The light-curve shapes of SN Ic are somewhat heterogeneous, being rather similar near peak but showing a range of late-time decline rates. Some, but not all, follow a locus of late-time exponential decline for hundreds of days in common with some other stripped-envelope supernovae. SN Ic often show explicit evidence for asymmetry. The environments of SN Ic in their host galaxies tend to be more metal-rich and to have higher star-formation rates than other core-collapse supernovae. Various arguments point to evolution in binary systems as the origin of SN Ic. Some SN Ic, denoted SN Ic-bl, display especially broad spectral lines, and some SN Ic-bl are observationally associated with cosmic gamma-ray bursts.
Irreversible Enzyme Inhibitors LXIX: Candidate Active-Site-Directed Irreversible Inhibitors of Dihydrofolic Reductase III. Bromoacyl Derivatives of 5-(p-Aminophenoxypropyl)-2,4,6-Triaminopyrimidines

5-( p -Aminophenoxypropyl)-2,4,6-triaminopyrimidine (XIVd) was synthesized by alkylation of malononitrile by 3-bromopropyl p -nitrophenyl ether (Xb), followed by ring closure with guanidine and catalytic reduction of the nitro group. Selective haloacylation of the aromatic amino group of XIVb was accomplished by protonation of the triaminopyrimidine moiety of XIVd with acetic acid. Treatment with the anhydrides of bromoacetic acid, p -bromoacetamidophenylbutyric acid, and N-bromoacetyl- β -alanine gave the pure bromoacyl derivatives, XIVe, i , and j . These three compounds were good reversible inhibitors of dihydrofolic reductase, but failed to show irreversible inhibition; these failures are attributed to the phenoxypropyl group of the inhibitors (XIV) being complexed with a hydrophobic region on the enzyme—a region not apt to have groups that could form a covalent bond.
Integration of ATP Synthesis and ATP Utilization Pathways

The chemistry and biology of ATP described in Parts I – IV of this monograph provide a framework for understanding the molecular and cell biology, biochemistry, physiology and pathophysiology of the heart. From the viewpoint of the energetics of the heart, all of these converge to just one: biochemistry. The biology of the energetics of the normal and diseased heart rests on the difference between ATP content and ATP turnover. The absence of a change in the ATP concentration does not necessarily mean that the rates of ATP synthesis and utilization remain the same. Instead, it means that the sum of any and all changes in the sources and sinks for ATP remains the same. Nor does it necessarily mean that the relative contributions of different metabolic pathways to overall ATP utilization or overall ATP synthesis remain the same. The different pathways for ATP synthesis and utilization can, and do, integrate differently. These pathways can also undergo molecular remodelling. Examples of this are isozyme switches and changes in the capacity of entire pathways during maturation and in response to stresses such as ischemia and sustained increased work. Furthermore, the carbon-based substrates used for ATP synthesis are not constant. The fuels that the heart uses to maintain a constant ATP concentration do not stay the same even during the course of a day, but vary as we undergo multiple fed/fasting cycles. Importantly, fluxes through existing pathways for ATP synthesis can change rapidly in response to fuel supply.
Textbooks on the Move: Transforming a Textbook Collection.

ABSTRACTRecently, The City College of New York (CCNY) libraries engaged in a collaborative project to transfer the bibliographic holdings for textbook course reserves to a new module when their integrated library systems, the Ex Libris Aleph Integrated Library System, underwent a system upgrade. In this article, the Chief of Circulation and the Chief of Cataloging share and analyze the various steps and challenges undertaken to complete this project, which took place over the span of three semesters. This article will serve to assist those who work in circulation and cataloging to aid in the planning of a large collaborative library-wide project.
Perceived risks and use of psychotherapy via telemedicine for patients at risk for suicide.

IntroductionSuicide is a major public health problem and its human, emotional, and economic costs are significant. Individuals in rural areas are at highest risk for suicide. However, telemedicine ...
Neonatal Infectious Diseases

Infectious diseases remain an important cause of neonatal morbidity and mortality across all gestational age groups. However, low birth weight infants share a disproportionate burden of disease and are more likely to die secondary to infection. Although the clinical signs and symptoms of neonatal infections are often subtle, some infants develop overwhelming multisystem organ dysfunction. The spectrum of pathogens causing infections in the newborn continues to shift, in part related to changes in medical practice, including the widespread use of intrapartum antibiotics and the increasing survival of extremely low birth weight infants. Clinicians must have a clear understanding of the epidemiology and risk factors associated with neonatal infection to ensure prompt diagnostic evaluation and appropriate treatment. Exploring opportunities to prevent neonatal infections are imperative to decrease infection-related mortality during the neonatal period.
Support vector machine based reliability analysis of concrete dams

Abstract This paper presents possible combination of structural responses of concrete dams with machine learning techniques. Support vector machine (SVM) method is adopted and two broad applications are presented: one for a simplified flood reliability assessment of gravity dams and the other for detailed nonlinear seismic finite element method (FEM) based analysis. Up to seventeen random variables are considered in the former example and the results of SVM contrasted with classical reliability analyses techniques (i.e., first- and second-order reliability methods, Monte Carlo simulation, Latin Hypercube and importance sampling techniques). For the latter example, a FEM-SVM based hybrid methodology is proposed for reduction of number of nonlinear analyses. A discussion is provided on the relation between the optimal earthquake intensity measures, the damage states and the accuracy of prediction. It is found that the family of SVM (i.e. standard, least squares, multi-class and regression) is an useful and effective tool for classification, response prediction and reliability analysis of the concrete dams with reasonable accuracy.
Minocycline plus N-Acetylcysteine Reduce Behavioral Deficits and Improve Histology with a Clinically Useful Time Window

Abstract There are no drugs to manage traumatic brain injury (TBI) presently. A major problem in developing therapeutics is that drugs to manage TBI lack sufficient potency when dosed within a clinically relevant time window. Previous studies have shown that minocycline (MINO, 45 mg/kg) plus N-acetylcysteine (NAC, 150 mg/kg) synergistically improved cognition and memory, modulated inflammation, and prevented loss of oligodendrocytes that remyelinated damaged white matter when first dosed 1 h after controlled cortical impact (CCI) in rats. We show that MINO (45 mg/kg) plus NAC (150 mg/kg) also prevent brain injury in a mouse closed head injury (CHI) TBI model. Using the CHI model, the concentrations of MINO and NAC were titrated to determine that MINO (22.5 mg/kg) plus NAC (75 mg/kg) was more potent than the original formulation. MINO (22.5 mg/kg) plus NAC (75 mg/kg) also limited injury in the rat CCI model. The therapeutic time window of MINO plus NAC was then tested in the CHI and CCI models. Mice and ra...
Flow Recirculation in Cartilaginous Ring Cavities of Human Trachea Model.

Abstract Background: Despite the prevailing assumption of “smooth trachea walls” in respiratory fluid dynamics research, recent investigations have demonstrated that cartilaginous rings in the trac...
Improving Undergraduate Nursing Research Education: The Effectiveness of Collecting and Analyzing Oral Histories

Nine oral histories of retired RNs (age range from 60 to 77) were collected by trained senior nursing students in their nursing research class. Attitudes toward nursing research of the 18 undergraduate baccalaureate nursing students participating in the collection and analysis of oral histories were compared with 20 students who did not participate. Both groups of students completed a pretest and posttest Attitudes Toward Nursing Research Questionnaire. The participating students had significantly positive changes in their attitudes toward nursing research. The nonparticipating group did not. While reminiscing about their careers, the retired RNs related historical events that influenced their nursing practice. Three themes emerged: World War II, technology, and intensive care units. Through an open-ended, written questionnaire following the interview, the nurses expressed positive benefits of participation. The collection and analysis of oral histories was an effective experiential learning strategy with positive outcomes for the students and the retired nurses who were interviewed.
Neurophysiologic Correlates of Latent Facilitation

Classical conditioning is now recognized to represent a combination of several different underlying phenomena. Some of these phenomena may be produced nonassociatively in the course of conditioning. These are not simply epiphenomena of conditioning, but, as recent studies indicate, each may contribute significantly to major facets of conditioning itself. The present report concerns neurophysiologic correlates of latent facilitation. Latent facilitation of subsequently learned motor responses is thought to occur nonassociatively following repeated presentations of a US. In cats, latent facilitation of an eyeblink response is paralleled by the development of increased excitability in neurons of the motor cortex and in facial motoneurons projecting to the musculature involved with blinking. This facilitation may result, in part, from activation of cholinergic pathways to the pyramidal cells of the motor cortex.
Fentanyl exposure among patients seeking opioid treatment.

Abstract Aim Overdoses attributed to the potent opioid agonist fentanyl have substantially increased in recent years. Despite these serious public health consequences, many opioid treatment providers do not currently include a fentanyl assay in their urine toxicology testing. As a result, extent of fentanyl exposure and related risks among individuals with opioid use disorder often remains unknown. We examined the prevalence of fentanyl exposure among patients seeking or enrolled in opioid agonist treatment. Methods Six hundred urine specimens were collected from adults entering (n = 100) or enrolled in (n = 500) opioid agonist treatment and analyzed using the clinic's standard opioid panel, supplemented with a 100 ng/ml fentanyl assay. Results Of the 100 specimens collected from patients at treatment intake, 19 (19%) tested positive for fentanyl. Importantly, 17 (90%) of those fentanyl-positive specimens were also positive for heroin. Of the 500 collected from patients in treatment, 17 (3%) of specimens tested positive for fentanyl. Of those, 11 (92%) were also positive for heroin. Conclusion These data illustrate a concerning degree of fentanyl exposure among patients seeking treatment and suggest that much of this exposure may have stemmed from fentanyl-containing heroin. Given the unprecedented recent surges in fentanyl-related overdoses, efforts to identify fentanyl exposure are critical. In particular, the point of treatment entry permits a rare systematic opportunity for medical and clinical staff to address fentanyl use and risks with incoming patients.
CASH BENEFITS FOR VETERANS’ LONG-TERM CARE: IDENTIFYING FACTORS PREDICTIVE OF ENROLLMENT AND VARIABILITY IN ACCESS

The Aid and Attendance (AA yet, there remains little to no information regarding who receives these benefits and the variability across VA medical centers (VAMCs). Therefore, the objective of this study is to evaluate predictors of receiving A&A and identify VAMCs with higher and lower predicted rates of enrollment. Data come from the VA’s Enrollment File and medical records and Medicare claims between 2010 and 2014. We used a logit model with VAMC fixed effects to model the likelihood of receiving A&A and calculated the difference in the observed and predicted rates of A&A by VAMC. A total of 114,569 Veterans received A&A in 2014. We found that Veterans with a recent inpatient stay (OR=1.39, 95%CI=1.36–1.43), increasing age (OR=1.07, 95%CI= 1.07-1.07), and a diagnosis of depression (OR=1.56, 95%CI=1.52–1.60), paralysis (OR= 8.60, 95%CI=7.72–9.58), or dementia (OR=1.80, 95%CI=1.78–1.91) were the strongest predictors in our model (r2=0.44). VAMCs varied in the difference between predicted and actual rates of A&A enrollment (-4.58 to 4.26) with only 82 out of 126 VAMCs within a 1 percentage point of their predicted rate. As the Veteran population continues to age, it is important that we understand who receives A&A for LTC and the variability by VAMC in an effort to improve access. Implications of these findings and next steps, including investigating Veterans’ outcomes, will be discussed.
Influence of antibodies and T cells on dengue disease outcome: insights from interferon receptor-deficient mouse models.

Dengue virus (DENV) is a globally important mosquito-borne virus that causes a spectrum of diseases ranging from dengue fever (DF) to dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), affecting 3.6 billion people in 128 countries [1,2(•)]. There is an urgent need for a drug or vaccine against DENV, yet none are presently available. In fact, results from recent Phase IIb and III trials of an attenuated tetrameric vaccine revealed that the vaccine provided limited protection against DENV serotype 2 in DENV-immune people, and no protection against any serotype in naive individuals [3-5], highlighting the difficulties associated with dengue vaccine development. A challenge in the development of a DENV vaccine is that a vaccine must protect against all four DENV serotypes, which co-circulate in endemic areas. Further complicating DENV vaccine development is that the correlates of protection are not fully defined, mechanisms regulating the generation of protective antibody and T cell responses against all four DENV serotypes are as yet to be deciphered, and the adaptive immune response may actually contribute to severe disease. Recent studies using the only available animal model of DHF/DSS in mice lacking one or more components of the interferon (IFN) system have begun to provide crucial insights into the protective versus pathogenic nature of both antibody and T cell responses to DENV. Herein, we highlight key studies using the IFN receptor-deficient mouse models toward understanding the contribution of antibodies and T cells in impacting the outcome of DENV infection.
One-Year Outcome Study of Anatomic Reconstruction of Lesser Metatarsophalangeal Joints.

Background: Lesser metatarsophalangeal joint (MTPJ) and plantar plate pathologies are commonly seen forefoot conditions. Traditional rebalancing techniques are commonly used but can have concerning...
Treatment patterns of high-dose-rate and low-dose-rate brachytherapy as monotherapy for prostate cancer

Purpose Monotherapy with high-dose-rate (HDR) or low-dose-rate (LDR) brachytherapy are both recommended modalities for prostate cancer. The choice between HDR and LDR is dependent on patient, physician, and hospital preferences. We sought to identify treatment patterns and factors associated with receipt of HDR or LDR monotherapy. Material and methods We queried the National Cancer Database (NCDB) for patients with localized low- or intermediate-risk prostate cancer treated with HDR or LDR monotherapy. Descriptive statistics were used to analyze patterns of HDR vs. LDR. Patient characteristics were correlated with HDR vs. LDR using multivariable logistic regression. Results We identified 50,326 patients from 2004-2014: LDR 37,863 (75.2%) vs. HDR 12,463 (24.8%). Median follow-up was 70.3 months. The overall use of monotherapy declined over time. HDR application declined relative to LDR. In 2004, 27.0% of cases were HDR compared to 19.2% in 2014. Factors associated with increased likelihood of HDR on multivariable analysis included: increasing age (OR: 1.01, 95% CI: 1.01-1.01), cT2c disease (OR: 1.25, 95% CI: 1.11-1.41), treatment at an academic center (OR: 2.45, 95% CI: 2.24-2.65), non-white race (OR: 1.34, 95% CI: 1.27-1.42), and income > $63,000 (OR: 1.73, 95% CI: 1.59-1.88). LDR was more common in 2010-2014 (OR: 0.59, 95% CI: 0.54-0.65), Charlson-Deyo comorbidity index > 0 (OR: 0.89, 95% CI: 0.84-0.95), and for patients receiving hormone therapy (OR: 0.88, 95% CI: 0.83-0.93). No difference in prostate-specific antigen (PSA) or Gleason score and receipt of HDR vs. LDR was observed. Mean overall survival was 127.0 months for HDR and 125.4 for LDR, and was not statistically different. Conclusions We observed an overall decrease in brachytherapy (BT) monotherapy use since 2004 for localized prostate cancer. Despite similar survival outcomes, the use of HDR monotherapy declined relative to LDR.
Intestinal Epithelial HIF-2 Is Protective in Gut Graft-Versus-Host-Disease

Abstract The failure to control both innate and adaptive immune responses in the gut has recently been implicated as a major pathogenic mechanism in the development of graft-versus-host disease (GVHD). Reduced oxygen availability in the intestine has been causally linked to gastrointestinal disease. During intestinal inflammation, increased metabolic activity of resident and infiltrating immune cells, bacteria and reduced blood flow may lead to a sharp decrease of oxygen, resulting in "inflammatory" hypoxia. The transcription factor family, hypoxia-inducible factor (HIF) originally discovered as a master regulator of the adaptive response to hypoxia, has recently emerged as a key regulator of the innate and adaptive immune responses. The HIF heterodimer consists of an oxygen-labile α subunit (HIFα) and a constitutively expressed HIF-1β subunit. Both HIF-1α and HIF-2α expression are markedly elevated in intestinal epithelial cells of patients with inflammatory bowel disease (IBD) and intestinal epithelial HIF-1 attenuates colitis in preclinical mouse models. Although HIF-2 has not been studied extensively in intestinal inflammation, it has emerged as a key regulator in intestinal iron homeostasis. Given that IBD and GVHD share many pathogenic mechanisms, we hypothesized that a sustained HIF response will protect the host intestinal epithelium from conditioning- and alloreactive T cell-induced gut damage. To determine the functional significance of intestinal epithelial HIF-1 and HIF-2 in gut GVHD, we generated conditional intestinal epithelial HIF-1α (HIF-1αΔIE) and HIF-2αΔIE vil-cre knockout (KO) mice on a C57BL/6 (B6) background lacking HIF-1α or HIF-2α in the host intestinal epithelium. Using a fully MHC mismatched B10.BR (H2k)→B6 (H2b) bone marrow transplant (BMT) model, loss of intestinal epithelial HIF-2 reduced the median survival time (43d) compared to wild-type (WT) recipients (58d, log-rank test, P Disclosures No relevant conflicts of interest to declare.
Harnessing region-specific neurovascular signaling to promote germinal matrix vessel maturation and hemorrhage prevention.

ABSTRACT Germinal matrix hemorrhage (GMH), affecting about 1 in 300 births, is a major perinatal disease with lifelong neurological consequences. Yet despite advances in neonatal medicine, there is no effective intervention. GMH is characterized by localized bleeding in the germinal matrix (GM), due to inherent vessel fragility unique to this developing brain region. Studies have shown that reduced TGFβ signaling contributes to this vascular immaturity. We have previously shown that a region-specific G-protein-coupled receptor pathway in GM neural progenitor cells regulates integrin β8, a limiting activator of pro-TGFβ. In this study, we use mice to test whether this regional pathway can be harnessed for GMH intervention. We first examined the endogenous dynamics of this pathway and found that it displays specific patterns of activation. We then investigated the functional effects of altering these dynamics by chemogenetics and found that there is a narrow developmental window during which this pathway is amenable to manipulation. Although high-level activity in this time window interferes with vessel growth, moderate enhancement promotes vessel maturation without compromising growth. Furthermore, we found that enhancing the activity of this pathway in a mouse model rescues all GMH phenotypes. Altogether, these results demonstrate that enhancing neurovascular signaling through pharmacological targeting of this pathway may be a viable approach for tissue-specific GMH intervention. They also demonstrate that timing and level are likely two major factors crucial for success. These findings thus provide critical new insights into both brain neurovascular biology and the intervention of GMH.
Wall Stress Distribution in Bicuspid Aortic Valve-Associated Ascending Thoracic Aortic Aneurysms.

Background Bicuspid aortic valve–associated ascending thoracic aortic aneurysms (BAV-aTAAs) carry a risk of acute type A dissection. Biomechanically, dissection may occur when wall stress exceeds wall strength. Our aim was to develop patient-specific computational models of BAV-aTAAs to determine magnitudes of wall stress by anatomic regions. Methods Patients with BAV-aTAA diameter greater than 4.5 cm (n = 41) underwent electrocardiogram-gated computed tomography angiography. Three-dimensional aneurysm geometries were reconstructed after accounting for prestress and loaded to systemic pressure. Finite element analyses were performed with fiber-embedded hyperelastic material model using LS-DYNA software (LSTC Inc, Livermore, CA) to obtain wall stress distributions. The 99th percentile longitudinal and circumferential stresses were determined at systole. Results The 99th percentile longitudinal wall stresses for BAV-aTAAs at sinuses of Valsalva, sinotubular junction (STJ), and ascending aorta were 361 ± 59.8 kPa, 295 ± 67.2 kPa, and 224 ± 37.6 kPa, respectively, with significant differences in ascending aorta vs sinuses (P Conclusions Wall stresses, both circumferential and longitudinal, were greater in the aortic root, sinuses, and STJ than in the ascending aorta on BAV-aTAAs. These results fill a fundamental knowledge gap regarding biomechanical stress distribution in BAV-aTAA patients, which when related to wall strength may provide prognostication of aTAA dissection risk by patient-specific modeling.
Human Capital and Voting Behavior across Generations: Evidence from an Income Intervention

Despite clear evidence of a sharp income gradient in voting participation, it remains unclear whether income truly causes voting. In this article, we investigate how exogenous increases in unearned income affect voting in U.S. elections for two generations (parents and children) from the same household. In contrast to predictions made by current models of voting, we find the income shock had no effect on parents’ voting behaviors. However, we also find that increasing household income has heterogeneous effects on the civic participation of children from different socioeconomic backgrounds. It increases children’s voting propensity among those raised in initially poorer families—resulting in substantially narrowed participatory gaps. Our results are consistent with a more nuanced view of how individual resources affect patterns of voting than the dominant theoretical framework of voting—the resource model—allows. Voting is fundamentally shaped by the human capital accrued long before citizens are eligible to vote.
Agent-in-the-Loop: Conversational Agent Support in Service of Reflection for Learning During Collaborative Programming.

Dynamic conversational agent-based support for collaborative learning has shown significant positive effects on learning over no-support or static-support control conditions in prior studies. In order to understand the boundary between human-led and AI-led support for collaboration, we compare in this study an approach where the agent’s primary role is to help students regulate their own collaboration with two more typical prompting strategies that are used only during a reflection phase: one designed to provide a specific informational focus for the reflection, and the other designed to draw out evaluation, elaboration, and exploration of alternative perspectives. Significant positive effects on learning over and above just the human-led form of support are observed when either of the prompting strategies are used.
NuPulse or No Pulse: VT Ablation in A Patient with The NuPulse Ivas Device

Introduction The intravascular ventricular assist system (iVAS) is the first minimally invasive, long-term, ambulatory counter-pulsation device that is currently being investigated as a bridge-to-transplant option for patients with advanced heart failure (HF). Ventricular tachycardia (VT) is a common complication in patients with advanced HF. Catheter ablation with substrate modification is an effective management strategy. We describe, to the best of our knowledge, the first reported case of VT ablation in a patient with the NuPulse iVAS device. Case An 82-year-old male came to the ED as his defibrillator discharged 4 times over 48 hours. He had a past history of ACC/AHA Stage D HFrEF (EF of 35%) due to ischemic cardiomyopathy. Given his advanced HF, he was enrolled in the iVAS trial and was implanted in 2019. On arrival, his BP was 172/99 mmHg and HR was 114/min. He was mildly hypervolemic on exam. CXR revealed mild pulmonary vascular congestion (Fig. 1B). ECG showed VT with a rate of 120/min (Fig. 1A). He was given IV procainamide, which transiently converted him to his baseline ventricular-paced rhythm, and his ICD was re-programmed to pace-terminate VT > 102/min. He was then loaded with IV lidocaine. Yet, he continued to have runs of VT. The next day, he underwent an adenosine nuclear stress test which showed a large severe fixed defect in the inferior and inferolateral regions suggestive of scar (Fig 1C). The following day, he underwent a VT ablation. A trans-septal approach was used to enter the LV and the scar was mapped (Fig 1D & E). Interestingly, every time radiofrequency ablation was delivered, there was electromagnetic interference with the iVAS device ECG leads which caused it to turn off. The patient became hypotensive during these episodes and dobutamine was used intra-procedurally for ionotropic support. Ablation was delivered in short bursts to allow the iVAS device to function intermittently, which prolonged the procedure time. The patient tolerated the procedure well and he has not had any recurrent VT. Discussion Long term mechanical circulatory support devices are an exciting emerging field. Complications of advanced HF include VT which is often difficult to control with medication alone and benefits from ablation. However, it appears that electromagnetic interference from radiofrequency ablation delivery impairs function of the iVAS ECG leads which gate the inflation & deflation of the counter-pulsation balloon to the cardiac cycle. Future iterations of the device must consider alternative triggers, such as being able to connect the device's ECG input to surface electrodes which would not be compromised during ablation delivery.
Approach to Determination of Decision-Making Capacity

In medicine, many treatment options are available, but determining whether or not they support a patient’s values or goals requires an invitation to the patient to participate in medical decision-making. This is the process of informed consent. Medical decision-making capacity is the ability to understand and appreciate the nature and consequences of health care treatment decisions. The demonstration of medical decision-making capacity is a required element in the process of informed consent. In this chapter, we will explore the elements of informed consent, the process of determining decision-making capacity, and factors that may influence a patient’s medical decision-making capacity, including “pseudo-incapacity.”
Household chaos, maternal stress, and maternal health behaviors in the United States during the COVID-19 outbreak.

Objectives:Household chaos, including disorder, noise, and crowding within the home, is a risk factor for poor mental and physical health. Household chaos may act upon maternal behaviors of physica...
Fastest motion planning for an unmanned vehicle in the presence of accelerating obstacles

Estimating the fastest trajectory is one of the main challenges in autonomous vehicle research. It is fundamental that the vehicle determines its path not only to minimize travel time, but to arrive at the destination safely by avoiding any obstacles that may be in collision route. In this paper, we consider estimating the trajectory and acceleration functions of the trip simultaneously with an optimization objective function. By approximating the trajectory and acceleration function with B-splines, we transform an infinite-dimensional problem into a finite-dimensional one. Obstacle avoidance and kinematic constraints are carried out with the addition of a penalization function that penalizes trajectories and acceleration functions that do not satisfy the vehicles’ constraints or that are in a collision route with other obstacles. Our approach is designed to model observations of the obstacles that contain measurement errors, which incorporates the realistic stochasticity of radars and sensors. We show that, as the number of observations increases, the estimated optimization function converges to the optimal one where the obstacles’ positions are known. Moreover, we show that the estimated optimization function has a minimizer and that its minimizers converge to the minimizers of the optimization function involving the true threat zones.
Symptomatic aseptic loosening of a short humeral stem following anatomic total shoulder arthroplasty

Abstract Introduction The rate of aseptic humeral component loosening with standard-length stems is historically so low (0.3%) that presence of humeral loosening was given substantial weight in predicting defining periprosthetic shoulder infection by the International Consensus Meeting (ICM) in 2018. This study aims to confirm that the historically low rate of humeral stem aseptic loosening is not affected by the adoption of a novel short humeral stem. Methods Following institutional review board approval, this retrospective multi-institutional study was undertaken. A review of anatomic TSA cases at three institutions provided 184 shoulders that received TSA with a grit-blasted, rectangular short humeral stem without ingrowth coating (Univers Apex; Arthrex; Naples, FL). The average patient age was 62.1 (range: 30-84) years old and 57.1% (105/184) were male. One-year radiographic follow-up was achieved in 64.7%. Patient clinical charts were reviewed for onset of newly painful shoulders, radiographic evidence of loosening, and return to the operating room for any reason. All patients with concern for clinically significant humeral loosening underwent work-up for periprosthetic shoulder infection. Immediate post-operative films were reviewed to identify any differences in prosthetic canal fit. The definition of periprosthetic shoulder infection utilized was provided by the recent ICM shoulder guidelines. Results Twenty-three (12.5%) patients presented with a painful shoulder and radiographic concern for potential humeral loosening at a mean follow-up of 1.5 years (range: 1.5 months – 3.4 years). Thirteen (7.1%) of these underwent revision shoulder arthroplasty where a loose stem was confirmed. All revisions underwent tissue culture and three cases were consistent with probable or possible periprosthetic infection at the time of revision arthroplasty. The rate of symptomatic aseptic humeral loosening in this series was 10.9% (20/184) with 5.4% undergoing revision surgery. Patients with symptomatic aseptic humeral loosening were more likely to be male (90.5%) than those patients without symptoms (52.8%; p Conclusion In this multi-surgeon, multi-center study, the early humeral loosening rate for this stem design far outpaces previously reported rates and this study likely under-reports the true incidence of clinically-significant loosening as it only contains limited short-term follow-up. The perception that humeral loosening is nearly pathognomonic for periprosthetic shoulder infection should be reconsidered for certain short humeral stem designs.