cssi/SciSciGPT-SciSciNet huggingface dataset:
What are the effects, if any, of lower-extremity strength training on gait in children with cerebral palsy?

The purpose of “Evidence in Practice” is to illustrate the literature search process to obtain evidence that can guide clinical decision making. This article is not a case report. The examination, evaluation, and intervention sections are purposely abbreviated. A 7-year-old boy with cerebral palsy who enjoyed fishing, hiking, and playing baseball was referred to our outpatient clinic for reexamination. He reported that he was having new difficulties playing baseball in a specialized community league. These difficulties included maintaining an upright stance while batting and getting to the bases quickly enough after hitting the ball. He was born at 30 weeks gestational age, and his ability to reach developmental milestones has always been delayed. His pediatrician diagnosed him with spastic diplegic cerebral palsy at 18 months corrected age. Since he was 18 months old, he was a regular patient of another physical therapist at our outpatient clinic, visiting once a week. The boy originally worked on developmental sequencing, transitions, and gait, and he consistently met his goals, including his goal of ambulating in the home and community. Physical therapy visits were cut back to once every other week to continue working on increasing range of motion (ROM), muscle strengthening, and gait, and to remedy new problems as they arose. Therapy eventually was put on hold because he became more involved in community programs and he consistently missed appointments. He recently began attending physical therapy again because of his difficulties playing baseball. Our patient ambulated all distances wearing bilateral solid ankle-foot orthoses (AFOs) and using Loftstrand crutches. Active and passive ROM was normal for all 4 extremities, with the exception of decreased hip extension (0°–10°), knee extension (−15°), and ankle dorsiflexion (0°–10°) bilaterally, with active ROM more limited than passive ROM.1 Manual muscle tests of the bilateral lower extremities revealed weakness …
Consortial Book Circulation Patterns: The OCLC-OhioLINK Study

The OhioLINK consortium and OCLC Research collected and analyzed circulation data for libraries within the consortium. The study, which examines the circulation of 28,475,701 items from more than 100 academic libraries, is the largest and most diverse compilation of academic usage data for books ever collected. The authors outline the study methodology, analyze the data, and offer insights into the consortium wide collection usage. Circulation patterns analyzed include subject and language usage, as well as scattering, obsolescence, and duplication. The study results and conclusions offer valuable insights for library collection planning including library purchasing, storage considerations, and future usage prediction.
Workshop - filling in the gaps: The use of affective outcomes in engineering & CSET education research

Affective outcomes are highly underrepresented in engineering and CSET research at less than 1% of the overall body of education research in these technical fields. Yet, affective outcomes are a major player in the retention of women in engineering at the undergraduate level and are known in K-12 and higher education to have profound impacts on academic performance. This workshop looks at how to select established (reliable and valid) affective outcomes and fold them into existing engineering & CSET education research in a meaningful and informative way. This workshop will discus belonging and its companion outcome, psychological sense of community, which often impact students at the very start of their programs affecting persistence and retention. It will also examine self-efficacy and locus-of-control, which can have a more direct impact on academic performance, influencing test anxiety and team performance. Finally, it will look at broader relational measures, which indicate feelings of relatedness that can create emotional scaffolding to maintain stability during difficult academic times. Whether by self-report or by observation, these measures can be captured with a rigor equivalent to that of cognitive outcomes. In this workshop, we take a hands-on approach to incorporating affective outcomes into the toolbox of the engineering/CSET education researcher. Participants will have ample opportunity to consider, choose, and design affective outcomes into individual research projects and education interests.
Art of Mediation in the Engineering and Construction Industry

This essay includes a presentation on the art of mediation in the engineering and construction industry, It explains mediation as it applies to the engineering and construction industry in the United States and other common law legal systems and describes how mediation is viewed in Asian and Shari’s legal systems. In addition, this essay includes a review of the effectiveness of different types of mediation proceedings. The first section provides a discussion on what mediation is, how it is used, why it is used, and what mediators attempt to accomplish when they are dealing with disputing parties that are not able to reach an agreement. The second section provides a definition for Mediation/Arbitration, which an alternative dispute resolution (ADR) technique. The third section describes how mediation is viewed in other cultures, as contrasted with the information provided in the first two sections, which are related to mediation in the U.S. and other common law legal systems. The last section discusses the effectiveness of different types if mediation proceedings.
Quantum Indeterminacy and Wittgenstein's private language argument

Abstract The demand for ‘criteria of correctness’ to identify recurring particulars in Wittgenstein's private language argument favors an idealist interpretation of quantum phenomena.The indeterminacy principle in quantum physics and the logic of the private language argument share a common concern with the limitations by which microphysical or sensation particulars can be reidentified. Wittgenstein's criteria for reidentifying particular recurrent private sensations are so general as to apply with equal force to quantum particulars, and to support the idealist thesis that quantum phenomena are themselves essentially mental or dependent on mental occurrences.
Estradiol and progesterone influence the synthesis of gonadotropins in the absence of gonadotropin-releasing hormone in the ewe.

Acute actions of estradiol and progesterone on synthesis and secretion of gonadotropins without the confounding effects of endogenous steroids and GnRH were examined by using the ovariectomized (OVX), hypothalamic-pituitary-disconnected (HPD) ewe. Thirty-two OVX ewes were subjected to HPD and randomly assigned to eight groups (4 ewes/group). An additional four OVX ewes served as controls. Each of 12 OVX-HPD ewes received 4 s.c. implants of estradiol 24 h after HPD (implantation was designated as Time 0 h). Sixteen OVX-HPD ewes received no treatment and served as contemporary controls. The remaining four OVX-HPD ewes received implants of estradiol for 48 h and were administered 16 mg progesterone i.m. twice daily in the last 24 h of estradiol treatment. Blood samples and pituitary glands were collected from OVX-HPD control and steroid-treated ewes at 0, 12, 24, and 48 h. Amounts of gonadotropin subunit mRNAs and serum concentrations of gonadotropins were decreased at 24 h after HPD and remained unchanged thereafter in OVX-HPD controls. Although treatment with estradiol decreased pituitary content of LH and steady-state levels of mRNA for LH beta-subunit (p < 0.05) compared to contemporary controls, serum concentrations of LH were not affected. Serum concentrations and pituitary content of FSH decreased (p < 0.05) 24 h after initiating treatment with estradiol, but steady-state levels of FSH beta-subunit mRNA were unchanged. There was a transient decrease in pituitary content of FSH at 24 h of estradiol treatment. Steady-state levels of mRNA for alpha-subunit were unaffected by estradiol.(ABSTRACT TRUNCATED AT 250 WORDS)
Compensator design for stability enhancement with collocated controllers

A continuum model rather than a finite element model is used. The optimal compensator design is formulated as a stochastic regulator problem and is shown to be solvable by the general infinite-dimensional theory developed by the author despite the lack of exponential stabilizability. Infinite-dimensional steady-state Riccati equations characterizing the feedback control gain and the Kalman filter gain operators can be solved explicitly. The associated performance indexes including the mean-square control-effort are calculated in closed form. As a first approximation, the compensator transfer function can be realized as a bank of bandpass filters in parallel centered at the undamped mode frequencies. Numerical calculations for the gain and bandwidths for a typical configuration are presented. The performance of the compensator is evaluated when in fact in the true model there is no actuator noise. The theoretical problem involved is to show that the infinite-dimensional stochastic process is asymptotically stationary. It is possible to calculate the steady-state covariance in closed form and thereby calculate performance indexes of interest explicitly, facilitating the choice of optimal design parameters. >
Civilization and its discontents: an ongoing update. Part 2: Homophobia in men.

“Being a verry drunk homofobick I flipped out and began to pistol whip the fag with my gun.” —From a letter written in prison by Aaron McKinney, one of the killers of Matthew Shephard, quoted in Loffreda (2000) The original project of psychoanalysis included an active, and radical, inquiry regarding the dynamics binding clinical to cultural phenomena, problems of self-regulation to problems of social regulation. Of course, much about psychoanalysis has changed during the course of its first century. Not least of those changes has been a narrowing of its focus, a move away from the public sphere and toward a reconceptualized, and less permeable, consulting room. That move has not been complete; the consulting room still resonates with sounds of the street. Within psychoanalysis, the force of its broad original program of inquiry has been most energetically sustained in recent years by feminist, gay, and lesbian critique. This series of articles, each of which will be a psychoanalytic reaction to contemporary developments, aims to participate in and broaden the reach of that critique, while serving as a reminder of the potentially vital place psychoanalysis might still claim in the pertinent discourses of everyday life.
Theory-guided selection of discrimination measures for racial/ ethnic health disparities research among older adults.

Objectives:Discrimination may contribute to health disparities among older adults. Existing measures of perceived discrimination have provided important insights but may have limitations when used in studies of older adults. This article illustrates the process of assessing the appropriateness of existing measures for theory-based research on perceived discrimination and health.Method:First, we describe three theoretical frameworks that are relevant to the study of perceived discrimination and health—stress-process models, life course models, and the Public Health Critical Race (PHCR) praxis. We then review four widely-used measures of discrimination, comparing their content and describing how well they address key aspects of each framework, and discussing potential areas of modification.Discussion:Using theory to guide measure selection can help improve understanding of how perceived discrimination may contribute to racial/ethnic health disparities among older adults.
Incorporating human visual model and spatial sampling in banding artifact reduction

Halftone banding, which affects the uniformity of xerographic images, is a well-known artifact for xerography, which appears as periodic light and dark bands across a printed page perpendicular to the process or print direction. Effective approaches for banding compensation need to consider the following two unique characteristics: 1) The human visual system should be included into the control system synthesis to quantify the perceived banding; 2) Spatially periodic scanline spacing variation due to gear noise has been shown to be a major contributor. In this paper, we summarize the work to incorporated human visual model into control system design and point out one aspect of the human visual system model that need to be addressed. To handle position dependent periodic disturbances, we employ spatial sampling and reformulate the motion transmission system using angular displacement as the independent variable. A linear parameter varying repetitive controller (LPVRC) is proposed to compensate for the angular displacement dependent periodic disturbances caused by the gears. Experimental verifications of the proposed approach are presented.
Elective ECMO Support for Pulmonary Artery Stent Placement in a 4.9-kg Shunt-Dependent Patient

Although extracorporeal membrane oxygenation (ECMO) is traditionally used to emergently manage respiratory and/or cardiovascular failure, ECMO can also support cardiorespiratory function in nonemergent settings. Here we present the elective use of ECMO to support a 4.9-kg pediatric patient undergoing a complex percutaneous catheter-based intervention.
EXPERIMENTAL HEART-BLOCK IN THE CHICK EMBRYO.

While studying the electrocardiograms of developing hearts it was noted that an adult type ECG could not be obtained in an embryonic heart which could not be blocked with digitalis. The need to know more about heart-block was obvious. Intact embryos of 36 to 120 hours were floated on to glass plates and treated with digoxin-Tyrode solution. Before 36 ± hours no dissociation of beat could be produced. The heart just stopped. At 40 ± hours a conal block followed by a midventricular block appeared. At 42 ± hours conal and midventricular blocks were followed by the first appearance of AV block. It was intermittent. At 47 ± hours conal block jumped to an incisive AV block. Midventricular block was rare. At 72 hours conal and then AV block occurred. Combinations such as four atrial to two ventricular to one conal beat could be readily produced while blood circulated. Electrocardiograms and cinephotomicrographs were taken of 72 and 96 hour hearts. Most striking was the fact that the typical Wenckebach phenomenon of adult heart-block could be duplicated, i.e., an increase of PR interval preceding AV block followed by a shorter PR interval which again gradually increased preceding AV block. This sequence was repeated over and over. An explanation of these events is offered.
Dynamical Reference Frame: Current Relevance and Future Prospects

Planetary and lunar ephemerides are no longer used for the determination of inertial space. Instead, the new fundamental reference frame, the International Celestial Reference Frame (ICRF), is inherently less susceptible to extraneous, non-inertial rotations than a dynamical reference frame determined by the ephemerides would be. Consequently, the ephemerides are now adjusted onto the ICRF, and they are fit to two modern, accurate observational data types: ranging (radar, lunar laser, spacecraft) and Very Long Baseline Interferometry (VLBI) (of spacecraft near planets). The uncertainties remaining in the inner planet ephemerides are on the order of 1 kilometer, both in relative positions between the bodies and in the orientation of the inner system as a whole. The predictive capabilities of the inner planet ephemerides are limited by the uncertainties in the masses of many asteroids. For this reason, future improvements to the ephemerides must await determinations of many asteroid masses. Until then, it will be necessary to constantly update the ephemerides with a continuous supply of observational data.
PDS: Engineering as Problem Definition and Solution

All of us who teach engineers share at least one common problem: the continuing dominance of an image of engineering formation that places highest value on mathematical problem solving in the engineering sciences. The image grounds a claim of jurisdiction over technology through design. This essay offers an alternative image of engineering as problem definition and solution (PDS) and takes initial steps toward facilitating its travel. The analysis outlines four contemporary challenges to the engineering claim of jurisdiction: changes in the work of scientists, mass production of engineers for technical support, credentialing by exam alone, and shared jurisdiction through teamwork. It then explains that PDS avoids incorporating the image of “breadth” because it lacks an organized vision. Four sets of PDS practices include early involvement in problem definition, collaboration with those who define problems differently, assessing alternative implications for stakeholders, and leadership through technical mediation. Three sets of strategies for enabling the PDS image to travel include adapting pedagogies in engineering science courses, adapting pedagogies in peripheral courses, and adapting curricula to produce more than one thing. What might engineers be if a PDS image gained acceptance across the terrains of engineering formation? Could integrating PDS practices into your teaching work for you?
Heavy Metals, Nutrition, and Behavior

In Chapter 4, we examined the essential role of trace elements in the normal functioning of the nervous system. There are, however, a number of trace elements, most often heavy metals, for which no biological function has been established. Included among these heavy metals are lead, mercury, arsenic, antimony, cadmium, and aluminum. Heavy metals enter our food supply from cookware and other food containers, vehicular wastes such as auto exhaust, industrial processes and wastes, and agricultural products such as fertilizers and pesticides. When ingested in sufficient quantities, many of these heavy metals can be extremely toxic.
Bridging the semantic gap in content-based image retrieval

To manage large image databases, Content-Based Image Retrieval (CBIR) emerged as a new research subject. CBIR involves the development of automated methods to use visual features in searching and retrieving. Unfortunately, the performance of most CBIR systems is inherently constrained by the low-level visual features because they cannot adequately express the user's high-level concepts. This is known as the semantic gap problem. This dissertation introduces a new approach to CBIR that attempts to bridge the semantic gap. Our approach includes four components. The first one learns a multi-modal thesaurus that associates low-level visual profiles with high-level keywords. This is accomplished through image segmentation, feature extraction, and clustering of image regions. The second component uses the thesaurus to annotate images in an unsupervised way. This is accomplished through fuzzy membership functions to label new regions based on their proximity to the profiles in the thesaurus. The third component consists of an efficient and effective method for fusing the retrieval results from the multi-modal features. Our method is based on learning and adapting fuzzy membership functions to the distribution of the features' distances and assigning a degree of worthiness to each feature. The fourth component provides the user with the option to perform hybrid querying and query expansion. This allows the enrichment of a visual query with textual data extracted from the automatically labeled images in the database. The four components are integrated into a complete CBIR system that can run in three different and complementary modes. The first mode allows the user to query using an example image. The second mode allows the user to specify positive and/or negative sample regions that should or should not be included in the retrieved images. The third mode uses a Graphical Text Interface to allow the user to browse the database interactively using a combination of low-level features and high-level concepts. The proposed system and ail of its components and modes are implemented and validated using a large data collection for accuracy, performance, and improvement over traditional CBIR techniques.
Assessment of Damage on a Dual Mobility Acetabular System

Abstract Background Dual mobility designs were introduced to increase stability and reduce the risk of dislocation, both being common reasons for surgical revision after total hip arthroplasty. The in vivo behavior of dual mobility constructs remains unclear, and to our knowledge, no data have been published describing in vivo surface damage to the polyethylene bearing surfaces. Methods We used surface damage assessed on the inner and outer polyethylene bearing surfaces in 33 short-term retrieved dual mobility liners as evidence of relative motion at the 2 bearings. A lever out test was performed to determine the force required for dislocation of the cobalt-chromium femoral head from the polyethylene liner. Results Both bearings showed damage; however, the inner polyethylene bearings had higher damage scores, lower prevalence of remaining machining marks, and higher incidence of concentric wear, all consistent with more motion at the inner polyethylene bearing. The inner polyethylene bearings also had a higher occurrence of embedded titanium debris. The damage sustained in vivo was insufficient to lead to intraprosthetic dislocation in any of the retrieved components. Lever out tests of 12 retrievals had a mean dislocation load of 261 ± 52 N, which was unrelated to the length of implantation. Conclusion Our short-term retrieval data of 33 highly cross-linked polyethylene dual mobility components suggest that although motion occurs at both bearing articulations, the motion of the femoral head against the inner polyethylene bearing dominates. Although damage was not severe enough to lead to intraprosthetic dislocation, failure may occur long term and should be assessed in future studies.
Factors Associated With Rates of False-Positive and False-Negative Results From Digital Mammography Screening: An Analysis of Registry Data

This analysis of registry data, conducted to inform the new recommendation on breast cancer screening from the USPSTF, describes rates of false-positive and false-negative results among U.S. women ...
Deep Boosting

We present a new ensemble learning algorithm, DeepBoost, which can use as base classifiers a hypothesis set containing deep decision trees, or members of other rich or complex families, and succeed in achieving high accuracy without over-fitting the data. The key to the success of the algorithm is a capacity-conscious criterion for the selection of the hypotheses. We give new data-dependent learning bounds for convex ensembles expressed in terms of the Rademacher complexities of the sub-families composing the base classifier set, and the mixture weight assigned to each sub-family. Our algorithm directly benefits from these guarantees since it seeks to minimize the corresponding learning bound. We give a full description of our algorithm, including the details of its derivation, and report the results of several experiments showing that its performance compares favorably to that of AdaBoost and Logistic Regression and their L1-regularized variants.
Neurodevelopmental Assessment Way in Infant

Infant neurodevelopmental assessment is a basic method of estimated high risk infant early development outcome.The early individualized neurodevelopmental assessment consist of monthly observations and evaluations of the infants' behavior modulation,motor repertoire which includes non functional and functional motor,autonomic system stability and muscle tensility,etc.The aims of early neurodevelopmental assessment are to discover the brain developmental abnormal and brain injure induced by various risk factors.Basis of the characteristics of which early brain development have better plasticity,administed early intervention and training,which can intervent neurodevelopmental problems such as cerebral palsy and developmental delay.By developmental assessment also make infant' parents to understand their children' ability and mental specialty,being help for infants' nursing,caring and early education.The applied of neurodevelopmental assessment can provide a new way and idea for infant' early development and intervention.
GlobalIdentifier: Unexpected Personal Social Content with Data on the Web

The past year has seen a growing public awareness of the privacy risks of social networking through personal information that people voluntarily disclose. A spotlight has accordingly been turned on the disclosure policies of social networking sites and on mechanisms for restricting access to personal information on Facebook and other sites. But this is not sufficient to address privacy concerns in a world where Web-based data mining tools can let anyone infer information about others by combining data from multiple sources. To illustrate this, we are building a demonstration data miner, GlobalInferencer, that makes inferences about an individual?s lifestyle and other behavior. GlobalInferencer uses linked data technology to perform unified searches across Facebook, Flickr, and public data sites. It demonstrates that controlling access to personal information on individual social networking sites is not an adequate framework for protecting privacy, or even for supporting valid inferencing. In addition to access restrictions, there must be mechanisms for maintaining the provenance of information combined from multiple sources, for revealing the context within which information is presented, and for respecting the accountability that determines how information should be used.
Clinicopathological correlates of obstructed right-sided porcine-valved extracardiac conduits

Thirteen of 308 patients (4.2%), who had received right-sided valved extracardiac conduits at the Mayo Clinic from November, 1972, to April, 1977, have required conduit replacement because of obstruction. Patients were 5 to 16 years old at initial operation and 8 to 20 years old at reoperation; the duration of conduit implantation was 27 to 79 months (mean 50). Four patients (31%) were asymptomatic; exertional dyspnea was present in eight (62%) and dizziness was reported in one (8%). Signs of conduit obstruction included increasing intensity of murmurs in 11 (85%), cyanosis in two (15%), and heart failure in one (8%). Peak pressure gradients from the right ventricle to the pulmonary arteries ranged from 50 to 140 mm Hg (mean 87) and correlated well with the degree of conduit obstruction. Catheter pullback allowed accurate localization of stenosis within the conduit, whereas angiography alone did not. The site of major obstruction was in the proximal conduit in five (38%), at the valve in nine (69%), and in the distal conduit or side branches in six (46%); stated differently, major stenosis affected the valve alone in five (38%), the graft alone in four (31%), and both the valve and the graft in four (31%). Valvular changes leading to stenosis included thrombosis, commissural fusion, and calcification, and changes consistent with insufficiency included tears, fusion of cusps to the conduit wall, and, in one case, infective endocarditis. Within the conduit, nonvalvular obstruction was due to formation of a thick fibrous peel (or neointima). Progressive thickening of the peel appeared to be due to organization of thrombus between the peel and conduit and not due to luminal mural thrombus. In one case, the peel formed a flap-valve, causing even further obstruction. Since many patients are asymptomatic, and since late conduit stenosis may develop unpredictably by several mechanisms, long-term follow-up is necessary.
Genomic sequencing and precision medicine in head and neck cancers

Head and neck squamous cell carcinoma (HNSCC) remains a common and deadly disease. Historically, surgical and chemoradiation treatments have been met with modest success, and understanding of genetic drivers of HNSCC has been limited. With recent next generation sequencing studies focused on HNSCC, we are beginning to understand the genetic landscape of HNSCCs and are starting to identify and advance targeted options for patients. In this review, we describe current knowledge and recent advances in sequencing studies of HNSCC, discuss current limitations and future directions for further genomic analysis, and highlight the translational advances being undertaken to treat this important disease.
What drives afterlife variation

In God is Watching You, Dominic Johnson emphasizes the extent to which supernatural punishment beliefs are found in our species, and also suggests tentative explanations as to how and why such beli...
Understanding Food Insecurity Among College Students: Experience, motivation, and local solutions

Food insecurity among college students is higher than the national average of 12.7 percent. Prevalence studies report a range of 14–59 percent of students being food insecure at some point during their college career. This article discusses the meaning and experience of food insecurity among students, its impact on motivation and academic success, and participant suggestions for local solutions. An ethnographic, exploratory study was conducted, including 27 semistructured interviews with food insecure students and five focus groups with food secure students. Food insecurity among students is considered faceless, has no standard image, and is often silent. Most food insecure students were faced with issues of stigma and shame daily, which prevented them from seeking assistance from parents and federal social services. Participants articulated a strong motivation to attend college. Obtaining a degree, securing a better job, and improving their living standards were priorities that outweighed hunger concerns. Alleviating student food insecurity requires multiple local solutions, which should be discreet, protective of student confidentiality, and work to alleviate stigma associated with food insecurity by raising awareness on campus.
Citizen Thelwall and Thomas Beddoes M.D.: Romantic Medicines, Disability, and “Health”

This chapter examines John Thelwall’s and Thomas Beddoes’s descriptions of how aesthetic judgment is used in the practice of medicine, as well as their challenges to contemporaneous medical conventions that valued embodied norms over functional improvement. In his Letter to Henry Cline, for example, Thelwall censures his peers for surgically replicating structural normalcy in patients born with oral “deformities”—often at the expense of patients’ ability to vocally communicate. In Hygeia Beddoes effectively unyokes aesthetic standards from standards of “health.” He illustrates the constructedness of “beauty,” explaining how the scrofulic individual’s appearance may be praised even though it foretells a gruesome descent into illness; he likewise illustrates how those with scars from past disease are scorned despite the fact that they are in perfect functional “health.”
Reply: Optimizing Strategies for Immune Checkpoint Imaging with Immuno-PET in Preclinical Study.

REPLY: In response to the comments made by Chen et al. regarding our paper “Practical Immuno-PET Radiotracer Design Considerations for Human Immune Checkpoint Imaging” published recently in The Journal of Nuclear Medicine ([1][1]), we have taken the opportunity to discuss several important
Actinomycin D inhibition of UV-dark repair in Bacillussubtilis

Abstract Actinomycin D inhibits dark repair of UV-damage in Bacillus subtilis . This inhibition is not due to an inhibition of mRNA or induced enzyme synthesis. Actinomycin D prevents the removal of UV photoproducts from DNA. After a lag, breakdown of DNA occurs in UV irradiated cells in the presence of actinomycin. It appears likely that there is no direct relationship between the dark repair process and the massive breakdown of DNA to acid-soluble fragments.
Abstract 3272: B-Type Natriuretic Peptide Single Nucleotide Polymorphism rs198389 Impacts Test Characteristics of Common Assays

Background: Assays for the cardiac hormone B-type natriuretic peptide (BNP) are widely used in the diagnosis and prognosis of left ventricular (LV) dysfunction and heart failure. The functional single nucleotide polymorphism rs198389 in the promoter region of the BNP gene has been associated with higher BNP levels. We hypothesized that rs198389 would impact the test characteristics of two commonly used BNP assays to detect a left ventricular (LV) ejection fraction ≤40% and ≤50% in the general community. Methods: We genotyped a random sample of the general population ≥45 years; n=1970) from Olmsted County, MN, for rs198389. BNP plasma levels (Biosite BNP and Roche NTproBNP assays) as well as biochemical, clinical, and echocardiographic parameters were determined. Results: Genotype frequencies were in Hardy-Weinberg equilibrium (p=0.98): TT 32.7%, TC 49.9%, and CC 17.3%. Genotypes did not differ with regard to presence or history of cardiovascular disease. The C-allele independently predicted higher BNP in multivariate analysis (p Conclusions: The C-allele of rs198389 is associated with higher plasma BNP and confounds the test characteristics of commonly used assays to detect reduced LV ejection fraction in the general population. Therefore, it may be worthwhile to define genotype-specific reference ranges and to test whether addition of genotype to BNP assays can improve screening for LV dysfunction in the community.
A Persian Grandee in Lausanne

Thank you for the kind invitation to address the 26th anniversary meeting of CHER and in such an agreeable location. Many years have passed since I have been able to journey to the annual meeting of an organisation in which I once had a small role. (Would you consider changing continents?) I have been given license to speak to any matter that crosses my mind (assuming of course that it is relevant to the work of CHER), even being allowed to discuss some of my past writing.
Bi-criteria Scheduling on Multiple Machines Subject to Machine Availability Constraints

This paper studies bi-criteria scheduling problems on m parallel machines with machine unavailable intervals. The goal is to minimize the total completion time subject to the constraint that the makespan is at most a constant T. We study two different unavailability models. In the first model, each machine has a single unavailable interval which starts from time 0. In the second model, each machine can have multiple unavailable intervals, but at any time, there is at most one machine unavailable. For each model, we show that there is an optimal polynomial time algorithm.
40 Adolescents perspectives on living with childhood-onset systemic lupus erythematosus

Background Non-adherence to medical recommendations in childhood-onset systematic lupus erythematosus (cSLE) is estimated to be between 40%–50%. For patients with cSLE, non-adherence results in increased hospitalizations, preventable disease damage, disease flares, and higher health care costs. Currently there are no published data regarding adolescent patients perspectives on cSLE. The aim of this study was to (1) identify barriers and facilitators of treatment adherence and (2) characterize the influencers of self-management and adherence for adolescents with cSLE. Methods Ten adolescents diagnosed with cSLE per ACR SLE classification criteria were recruited from a pediatric rheumatology clinic and cSLE patient registry. Participants characteristics are summarized in table 1. Two separate focus groups were conducted and led by trained facilitators to discuss topics around living with cSLE and its management. The sessions were audio-taped, transcribed, and coded for themes by three independent coders. Results Focus group transcript analyses revealed seven major themes: 1) Barriers/Facilitators of treatment adherence, 2) Symptoms Impacting Daily Life, 3) Lack of Understanding/Knowledge about cSLE, 4) Impact on personal relationships, 5) Self-care and management, 6) Worry about the Future, and (7) Relationship/communication with healthcare providers. Adherence barriers included the number, taste, timing and side effects of oral medications. Adherence facilitators were desire to avoid being sick/in pain/hospitalized, use of pill boxes, reminder apps, and storage location of pills. Fatigue, pain, and mood significantly impacted daily life for these adolescents. All adolescents described difficulties at school, including absenteeism related to disease flares and hospitalizations, missed school work, bullying, and/or the general lack of awareness and understanding of cSLE among educators and peers. They emphasized the role of healthcare providers in helping increase schools awareness and understanding of cSLE. Future worries were quality of life, transition to college, and job opportunities. All adolescents wanted direct communication with, and between, their providers. Conclusions While adherence was identified as a significant problem, some adolescents also noted strategies to improve self-management. All adolescents desired increased knowledge/understanding from the public regarding cSLE, especially aimed at school advocacy. Important next steps are to identify modifiable factors, with the long-term goal of developing interventions to improve the overall well-being and self-management for adolescents with cSLE. Funding Source(s): T32 HD 68223–6 A1, Kirschstein-NRSA Training Grant
The Vertical Structure of Shallow Water Flow in the Surf Zone and Inner Shelf

Abstract : The objectives of this effort are: 1. Theoretical investigations of the vertical structure of mean currents, tidal flows, and low frequency (infragravity) oscillations on the inner shelf and inside the surf zone. This work expands on recent theoretical developments for shear instabilities that follow methodology developed for tidal flows on the continental shelf. Results will be compared with field data examined as part of the second objective. 2. Ongoing examination of the spatial and temporal variations in wave breaking patterns and its relationship to surface mean and oscillatory flow inside the surf zone. This objective will be accomplished using video-based field observations of wave breaking distributions (from timestack imagery) and surface flow measurements (from PIV analysis) obtained as part of the 2003 NCEX field experiment.
“The ‘Projects’ Are Nice Now”: Resident Perspectives on the Rental Assistance Demonstration (RAD) Program

ABSTRACTThe Rental Assistance Demonstration (RAD) program, administered by the U.S. Department of Housing and Urban Development (HUD), seeks to improve and preserve affordable housing by converting...
A Case of Tick-Borne Paralysis in a Traveling Patient.

Background. Tick paralysis is a neurotoxic tick-borne illness that causes ascending paralysis and may lead to respiratory failure. Patients often undergo extensive testing and prolonged hospitalization before the proper diagnosis is reached. Case Presentation. An 88-year-old man with dementia and dyslipidemia presented with new onset gait instability and was admitted for suspected cerebellar stroke. Exam was significant for the inability to perform tandem gait. Investigations included comprehensive metabolic panel, complete blood count, and noncontrast CT scan; none of them found any evidence of acute pathology. Two days into admission, a tick with surrounding erythema was found on the patient’s left lateral chest during bathing. Dramatic improvement in truncal ataxia was noted following tick extraction. Discussion. Clinical suspicion of tick paralysis is often low due to the rarity of the condition. Although it is imperative to rule out acute cerebral or cerebellar pathology, a thorough skin examination should be performed on admission in any patient with new onset ataxia and ascending paralysis. This can lead to early diagnosis, conservation of resources, and the avoidance of subjecting patients to invasive testing.
Spatial Analyses of Environmental Exposures and Breast Cancer: Natural Vegetation, Ambient Air Pollution and Outdoor Light at Night as Examples

In this chapter, several environmental exposures are highlighted that are relevant to breast cancer epidemiology such as natural vegetation/greenness, air pollutants, and outdoor light at night exposures. Each section gives an overview of the rationale and potential mechanisms behind these exposures, followed by a description of the available epidemiologic literature with respect to breast cancer incidence and survival, and then a summary of the challenges and next steps for this area of research. Throughout the chapter, epidemiologic concepts such as exposure measurement, confounding, effect modification and mediation are discussed in context with the environmental exposure. Environmental exposures may play an important role in breast cancer prevention and survival after a diagnosis of breast cancer through a direct influence on biologic pathways and/or via their influence on vital behaviors of energy balance relevant to breast cancer epidemiology (e.g. physical activity and circadian patterns). As one may expect with diseases of long latency such as breast cancer and for studies of environmental exposures, there are challenges to these spatial analyses of breast cancer environmental determinants, particularly with regards to obtaining personal-level measurements of environmental exposures at the appropriate time window within the life course. Understanding the multi-level context of breast cancer incidence and survival after a diagnosis of breast cancer is needed and has potential to explain the geographic variation of breast cancer risk and mortality.
A Comparative Exploration of the Motivational Factors of Faith-Based and Secular NGOs and Their Actors in Cambodia

Secular and faith-based NGOs are significant non-state service providers in the developing world, yet limited research has been conducted comparing their motivational factors. This paper considers ...
The Role of Illness Identity in Assertive Community Treatment

Assertive community treatment (ACT) provides comprehensive clinical services, including vocational rehabilitation, to individuals with psychiatric disorders for which traditional community mental h...
Reflex Photosensitive Epilepsy

Reflex seizure provoked by light or pattern stimulation are an interesting and, at times, difficult to treat entity. Such seizures occur in patients with a variety of well-described epileptic syndromes, although in most spontaneous seizures are also described. This paper attempts to describe epileptic syndromes with primarily light or pattern provoked seizures.
Venetoclax in a patient with light chain deposition disease secondary to MGRS that progressed after kidney transplantation

Abstract Light chain deposition disease (LCDD) is commonly associated with monoclonal gammopathy of renal significance (MGRS). Venetoclax is a Bcl-2 inhibitor approved for the treatment of chronic lymphocytic leukemia with activity against multiple myeloma and AL amyloidosis clones that harbor the t(11;14) abnormality. Here, we report the first use of venetoclax in a patient with LCDD secondary to MGRS after kidney transplantation. A 43 year-old male presented with 17.9 g/d of proteinuria and creatinine of 3.7 mg/dl. Kidney biopsy confirmed LCDD. Bone marrow biopsy showed 10% monoclonal plasma cells with t(11;14) detected by FISH. Skeletal survey was negative. Despite achieving a very good partial response after chemotherapy and autologous stem cell transplantation, dialysis was started 1-month posttransplant after an acute on chronic kidney injury associated with eosinophilia that was unresponsive to prednisone. Patient underwent a living donor kidney transplant 5 years later. One-year posttransplant, kappa to lambda free light chain ratio rose from 1.91 to 16.2. With no response to ixazomib, cyclophosphamide and dexamethasone, cyclophosphamide was replaced by venetoclax. This produced a complete response after 1 cycle. Ixazomib was discontinued 3 months later. After 20 months, the patient remained in complete response on venetoclax and dexamethasone with no significant infectious complications.
The impact of diabetes mellitus on outcome of patients undergoing transcatheter aortic valve replacement

Abstract Background The outcomes of patients with diabetes mellitus (DM) who are referred to surgical aortic valve replacement are poor in comparison to non-diabetic (ND) patients. However, the outcome of diabetic patients referred to transcatheter aortic valve replacement (TAVR) is less established. Further, DM and AS are both associated with left ventricular hypertrophy. It is not clear if alleviation of AS results in greater degree of reverse remodeling in DM patients in comparison to ND. We aim to evaluate if diabetes mellitus has an impact on TAVR outcome and remodeling patterns. Methods All consecutive patients who underwent TAVR (2007–2012) were included in this analysis. A comparison of baseline, procedural, post-procedural outcomes and echocardiographic left-ventricle mass indices was performed between DM and ND patients. Results DM was prevalent in 165 of 499 (33.0%) consecutive patients who underwent TAVR. DM patients were younger, weighed more, had higher rates of renal insufficiency and larger caliber peripheral vessels. Other than that, no disparities were noted in baseline characteristics. Procedural aspects were mostly similar between the groups but ND patients had higher rates of both vascular complications and bleeding. This did not translate into statistically significant differences in mortality both at 30days and at 1year (DM 6.7% vs. ND 10.5%; p =0.16 and DM 22.4% vs. 25.7%; p =0.48, respectively). Incidences of reverse remodeling patterns were similar between the two groups. Conclusion TAVR outcome is probably driven by baseline characteristics and post-operative complications while diabetes itself is not associated with poor outcome after TAVR.
A clade of SARS-CoV-2 viruses associated with lower viral loads in patient upper airways.

BACKGROUND: The rapid spread of SARS-CoV-2, the causative agent of Coronavirus disease 2019 (COVID-19), has been accompanied by the emergence of distinct viral clades, though their clinical significance remains unclear. Here, we aimed to investigate the phylogenetic characteristics of SARS-CoV-2 infections in Chicago, Illinois, and assess their relationship to clinical parameters. METHODS: We performed whole-genome sequencing of SARS-CoV-2 isolates collected from COVID-19 patients in Chicago in mid-March, 2020. Using these and other publicly available sequences, we performed phylogenetic, phylogeographic, and phylodynamic analyses. Patient data was assessed for correlations between demographic or clinical characteristics and virologic features. FINDINGS: The 88 SARS-CoV-2 genome sequences in our study separated into three distinct phylogenetic clades. Clades 1 and 3 were most closely related to viral sequences from New York and Washington state, respectively, with relatively broad distributions across the US. Clade 2 was primarily found in the Chicago area with limited distribution elsewhere. At the time of diagnosis, patients infected with Clade 1 viruses had significantly higher average viral loads in their upper airways relative to patients infected with Clade 2 viruses, independent of disease severity. INTERPRETATION: These results show that multiple variants of SARS-CoV-2 were circulating in the Chicago area in mid-March 2020 that differed in their relative viral loads in patient upper airways. These data suggest that differences in virus genotype can impact viral load and may influence viral spread. FUNDING: Dixon Family Translational Research Award, Northwestern University Clinical and Translational Sciences Institute (NUCATS), National Institute of Allergy and Infectious Diseases (NIAID), Lurie Comprehensive Cancer Center, Northwestern University Emerging and Re-emerging Pathogens Program.