cssi/SciSciGPT-SciSciNet huggingface dataset:
Tumor cohesion and glioblastoma cell dispersal

Patients with glioblastoma typically present when tumors are at an advanced stage. Surgical resection, radiotherapy and adjuvant chemotherapy are currently the standard of care for glioblastoma. However, due to the infiltrative and dispersive nature of the tumor, recurrence rate remains high and typically results in very poor prognosis. Efforts to treat the primary tumor are, therefore, palliative rather than curative. From a practical perspective, controlling growth and dispersal of the recurrence may have a greater impact on disease-free survival. In order for cells to disperse, they must first detach from the mass. Preventing detachment may keep tumors that recur more localized and perhaps more amenable to therapy. Here we introduce a new perspective in which a quantifiable mechanical property, namely tissue surface tension, can provide novel information on tumor behavior. The overall theme of the discussion will attempt to integrate how adhesion molecules can alter a tumor’s mechanical properties and ...
Emergency department lumbar puncture: Clinical application and utility of laboratory testing

Lumbar puncture is an emergency department procedure for evaluating patients with suspected central nervous system infection or hemorrhage. To determine whether extensive testing of cerebrospinal fluid (CSF) obtained from emergency department patients was useful, charts of 104 adult patients who underwent lumbar puncture in a university hospital emergency department were reviewed. Examination of the CSF disclosed pleocytosis in 25 (24%) of the patients; the presence of red blood cells was considered to be clinically significant in two patients. An abnormal level of CSF protein was present in 62% of patients, and abnormal levels of glucose in 32%. Fungal element testing was negative each of the 72 times it was performed; Gram stain disclosed a bacterial pathogen in one patient. Cultures for fungus and tuberculosis were uniformly negative, as were all immunologic tests. Bacterial cultures grew a pathogen in one patient. No patient with a normal neurologic examination and normal initial CSF analysis was diagnosed subsequently as having acute central nervous system disease. The preponderance of negative or normal results of testing of CSF suggests that extensive testing may not be necessary for all patients. Limitation of sophisticated testing to only those samples with abnormal cell counts or chemistries or from patients at high risk should result in substantial cost saving without compromising patient care.
School Spirit in the Context of a Liberal Education

The college must be the place par excellence in our society for the highest intellectual motivation and achievement. . The college, however, is more than a mind factory. College students do not live and work in isolation but in a social milieu in which their emotions, their morals, and their social outlooks are influenced at least as much by their fellows and their environment as by the courses of instruction which they take. The college, therefore, does not face a choice between intellectual excellence and the education of the whole student. It is not a question of either-or but of both together.1
Solid phase extraction on microfluidic devices

A microfabricated device with C18-coated channels was used to demonstrate on-chip solid phase extraction. Sample solutions containing a neutral dye were enriched and eluted in less than 4 min. Distinct elution peaks with good signal-to-noise ratios were obtained even for highly dilute samples. The gain in concentration estimated from the enrichment and elution volumes was 80-fold. ©2000 John Wiley & Sons, Inc. J Micro Sep 12: 93–97, 2000
Stereotactic radiosurgery as single-modality treatment of incidentally identified renal cell carcinoma brain metastases.

Abstract Background Initial staging evaluation of patients with renal cell carcinoma (RCC) has led increasingly to the diagnosis of brain metastases in patients who are otherwise neurologically asymptomatic. We present our experience treating patients with incidentally identified brain metastases with initial stereotactic radiosurgery (SRS) monotherapy and compare outcomes with those of patients treated at our institution with other strategies and with those reported in the literature. Methods We conducted a retrospective outcomes analysis in patients with incidentally identified RCC brain metastasis treated with initial SRS monotherapy. Our radiation oncology and tumor databases were reviewed, identifying 80 patients treated between 1990 and 2006. Results We found 19 patients with asymptomatic, incidentally identified brain metastasis (KPS, 90-100) treated with SRS monotherapy within 60 days of diagnosis. Stereotactic radiosurgery was performed at a mean of 17.8 days from diagnosis to an average of 3.1 lesions (range, 3-11; mean lesion volume, 1.72 cm3; mean total volume, 4.53 cm3). The mean prescription was 21.3 Gy delivered to the mean 59.97% isodose line. The mean survival for these patients was 21.5 months (median, 12.6 months) and was not statistically different from survival in similar patients treated with other therapeutic modalities. Local control was achieved in 95% of patients; distant central nervous system progression occurred in 79% of patients at a mean of 450 days. Conclusions We demonstrate that patients with incidentally identified RCC brain metastases treated with initial SRS monotherapy achieved a survival rate comparable with that of patients managed with standard therapeutic modalities. Our findings suggest that SRS alone is an attractive therapeutic option for patients with incidentally identified brain metastases from RCC.
Association of Pancreatitis with Glucagon-Like Peptide-1 Agonist Use

OBJECTIVE:To review the possible association between glucagon-like peptide-1 (GLP-1) agonist use and pancreatitis in patients with type 2 diabetes mellitus.DATA SOURCES:A MEDLINE search (1950-January 2010) identified key clinical trials delineating adverse effects associated with GLP-1 agonist use. Key search terms included type 2 diabetes mellitus, pancreatitis, incretins, exenatide, liraglutide, albiglutide, and taspoglutide. Review of references listed in the articles identified was also performed. The Food and Drug Administration (FDA) Web site and Amylin Pharmaceuticals file data were utilized to extract case report information and unpublished clinical development data related to GLP-1 agonist use and pancreatitis.STUDY SELECTION AND DATA EXTRACTION:Phase 2 and 3 clinical trials evaluating exenatide, liraglutide, albiglutide, and taspoglutide that discussed treatment-related adverse effects as well as FDA-reviewed case reports of pancreatitis in patients taking these same therapies were included. One...
Measuring Resource Use in the ICU With Computerized Therapeutic Intervention Scoring System-Based Data

Background and objective In this era of health-care reform, there is increasing need to monitor and control health-care resource consumption. This requires the development of measurement tools that are practical, uniform, reproducible, and of sufficient detail to allow comparison among institutions, among select groups of patients, and among individual patients. We explored the feasibility of generating an index of resource use based on the Therapeutic Intervention Scoring System (TISS) from hospital electronic billing data. Such an index is potentially comparable across institutions, allows assessment of care at many levels, is well understood by clinicians, and captures many of the resources relevant to the ICU. Design We developed an automated mapping of the hospital billing database into the different items of TISS and generated computerized active TISS scores on 1,372 ICU days. The computerized score was then validated by comparison to prospectively gathered active TISS scores by trained data collectors. Setting Eight ICUs within a university teaching institution. Patients We studied 1,229 general medical and surgical ICU patients. Interventions None. Measurements and main results Active TISS scores ranged from 0 to 31 points. The two scores were well correlated (R 2 =0.53) and highly calibrated (as assessed by regression of active TISS on mean computerized active TISS [R 2 =0.85]). The scores were identical on 756 days (55.6%) and differed by ≤3 TISS points on an additional 387 (28.2%) days. Interreliability assessment suggested substantial agreement (kappa statistic=0.71). The discriminatory power of the computerized score to identify different levels of ICU resource use was excellent as assessed by area under the receiver operating characteristics curves at four threshold points (0.91, 0.87, 0.89, and 0.88). Performance of the computerized score was similar across medical, coronary, and surgical ICU patient groups. Conclusion An automated algorithm can reproduce valid TISS scores from standard hospital billing data, allowing comparison of patients and groups of patients in order to better understand ICU resource use.
Numerical and experimental study of the effect of thermocouple wire attachment on thermal characterization of a high performance flipchip package

Thermal resistance of an electronic package is a measure of the package's ability to transfer the heat generated by the chip to the printed wiring board (PWB) or to the ambient. For a high performance flip-chip package, the primary heat transfer path for most applications is through a heat sink or cold plate attached to the package lid. Hence, a test method that evaluates the heat transfer path from the chip to the lid is the most relevant one. The thermocouple wire attachment can have a significant effect on the measurement of the surface temperature during the thermal characterization of a high-performance flip chip package. A cold-plate based test method is used for thermal characterization and internal thermal resistance is used as the basis of all comparisons. A detailed numerical study is presented to study the effect of heat conduction losses through the thermocouple wires on the package thermal resistance calculations.
Knowledge-based synthesis of numerical programs for simulation of rigid-body systems in physics-based animation

Physics-based animation programs are important in a variety of contexts, including education, science and entertainment among others. Manual construction of such programs is expensive, time consuming and prone to error. We have developed a system for automatically synthesizing physics-based animation programs for a significant class of problems: constrained systems of rigid bodies, subject to driving and dissipative forces. Our system includes a graphical interface for specifying a physical scenario, including objects, geometry, dynamical variables and coordinate systems, along with a symbolic interface for specifying forces and constraints operating in the scenario. The entities defined in the graphical interface serve as the underlying vocabulary for specifications constructed in the symbolic interface. We use an algorithmically controlled rewrite system to construct a numerical simulation program that drives a real-time animation of the specified scenario. The algorithm operates by partitioning the constraints and dynamic variables into classes, assigning each class to be implemented in a different component of a general simulation program scheme. Our approach provides many of the benefits of formal deductive methods of program synthesis, while keeping the computational costs of program synthesis more in line with conventional program generator technology. We have successfully tested our system on numerous examples.
Size Heterogeneity of Human Prolactin in CSF and Serum: Experimental Conditions That Alter Gel Filtration Patterns*

Cerebrospinal fluid (CSF) and sera of hyperprolactinemic patients with pituitary tumors were chromatographed ona Sephadex G-100column. Three PRL peaks were found in serum and CSF that were immunologically similar tothe pituitary PRL standard. The percentage of PRL inpeak 1,near the void volume, was significantly (P<0.05) greater inCSF than inserum. The elution pattern observed inserum was not changed by treatment of the pituitary tumor patients with hypophysectomy or radiation therapy, although serum PRL levels uniformly decreased. Sera from normal women obtained during sleep demonstrated elution patterns similar to those found in the sera of pituitary tumor patients; however, the percentage of PRL in peak 1 was significantly (P <0.05) greater in the normal women. Incubation of pituitary PRL for 4 h in hypoprolactinemic serum and normal CSF before elution did not changeits gel filtration pattern when compared to elution with column buffer alone. Serum PRL gel filtration patterns were stable when subjected...
Self‐assessed clinical competence: a comparison between students in an advanced dental education elective and in the general clinic

A six-month final-year elective, based on an advanced education in general dentistry (AEGD) model, was conducted in an AEGD Clinic to enable dental students to treat patients in a generalist comprehensive setting. The purpose of this study was to evaluate the elective with regard to students' self-assessed clinical skills, as self-assessment is recognized as a means to maintaining competency. Pre- and post-experience surveys were administered to ‘AEGD elective students’ (n=13) and a comparison group of ‘control dental students’ (n=18) under a discipline-based clinical curriculum. The survey instrument consisted of 75 self-rated statements on a wide range of clinical and patient management skills. Pre-experience means were not statistically different. The AEGD elective students' post-experience group mean was significantly higher than the control dental students' mean (P=0.02, ANOVA) which reflects significant (P<0.05) increases in 9 of 13 AEGD elective students' individual survey means compared to 4 of 18 control dental students' means. Both groups had pre-experience means of 2.9 or below on the same 9 statements, indicating poor self-rated skills. Four of 9 AEGD elective students' post-experience means significantly (P<0.05) increased, while only 1 of 9 control dental students' means increased. The data suggests that AEGD elective students were more confident in their clinical abilities and patient management skills than control dental students and they also reported greater improvement in low-rated skills. When adequate parameters were maintained that enhanced the accuracy of self-assessment, students appeared to rate their skill levels seriously. Independent self-assessment may be an important component of life-long learning.
Growth and feeding rates of the newly hatched larval ctenophore Mnemiopsis leidyi A. Agassiz (Ctenophora, Lobata)

Mnemiopsis leidyi. larvae depend on microplankton ( 0.5 mm in length and can successfully capture and consume mesozooplankton prey. Feeding and growth rates of newly hatched M. leidyi larvae were measured in controlled laboratory experiments. When fed natural microplankton assemblages, newly hatched larvae consumed significant quantities of both autotrophic and heterotrophic prey, including diatoms, phototrophic, heterotrophic and mixotrophic dinoflagellates, euglenoid flagellates, aloricate and tintinnid ciliates, and rotifers. Average per capita clearance rates were 1.99-7.59 mL individual -1 h -1 (X = 4.01 mL individual -1 h -1 ; SD = 1.95) and total per capita ingestion was 0.01-4.70 μg C individual -1 day -1 x 10 2 (X = 0.83 μg C individual -1 day -1 × 10 2 ; SD = 1.89). Larval growth rates were -0.13 to 0.56 mm individual -1 day -1 (equivalent to -1.72 to 4.33 μgC individual -1 day -1 ) over a range of larval sizes from 0.5 ( 2 weeks, and growth rate decreased when larvae reached 4-5 mm in length, corresponding to the beginning of their morphological transition from tentaculate to lobate feeding mode. The gross growth efficiency of larvae fed natural microplankton assemblages was ∼3%.
Human performance on clustering web pages: a preliminary study

With the increase in information on the World Wide Web it has become difficult to quickly find desired information without using multiple queries or using a topic-specific search engine. One way to help in the search is by grouping HTML pages together that appear in some way to be related. In order to better understand this task, we performed an initial study of human clustering of web pages, in the hope that it would provide some insight into the difficulty of automating this task. Our results show that subjects did not cluster identically; in fact, on average, any two subjects had little similarity in their web-page clusters. We also found that subjects generally created rather small clusters, and those with access only to URLs created fewer clusters than those with access to the full text of each web page. Generally the overlap of documents between clusters for any given subject increased when given the full text, as did the percentage of documents clustered. When analyzing individual subjects, we found that each had different behavior across queries, both in terms of overlap, size of clusters, and number of clusters. These results provide a sobering note on any quest for a single clearly correct clustering method for web pages.
GENETIC SEPARATION OF THE NEURAL AND CUTICULAR PATTERNING FUNCTIONS OF GOOSEBERRY

In addition to their role in the specification of the epidermal pattern in each segment, several segment polarity genes, including gooseberry (gsb), specify cell fate in the Drosophila central nervous system (CNS). Analyses of the gsb CNS phenotype have been complicated by the fact that the previously available gsb mutants, all caused by cytologically visible deficiencies, have severe segmentation defects and also lack a number of additional genes. We have characterized two novel gsb mutants which, due to their hypomorphic nature, have CNS defects, but have only weak or no segmentation defects. These gsb alleles, as well as gsb rescue experiments, have allowed us to determine which aspects of the deficiency mutant phenotypes can be attributed to loss of gsb. gsb mutants lack U and CQ neurons, have duplicated RP2 neurons, and display posterior commissure defects. gsb neural defects, as well as the gsb cuticle defect, are differentially sensitive to the level of functional Gsb. We have used one of the novel gsb alleles in order to understand the genetic interactions between gsb, wingless (wg), and patched (ptc) during the patterning of the ventral neuroectoderm. In contrast to epidermal patterning, where Gsb is required to maintain wg transcription, we find that Gsb antagonizes the Wg signal that confers neuroblast (NB) 4–2 fate.
Chimera: The Architecture of Creative Miscengenation

“Invention, it must be humbly admitted, does not consist in creating out of void but out of chaos. Any artist knows these truths, no matter how deeply he or she submerges that knowing.”1— Jonathan ...
LOAM: Lidar Odometry and Mapping in Real-time

We propose a real-time method for odometry and mapping using range measurements from a 2-axis lidar moving in 6-DOF. The problem is hard because the range measurements are received at different times, and errors in motion estimation can cause mis-registration of the resulting point cloud. To date, coherent 3D maps can be built by off-line batch methods, often using loop closure to correct for drift over time. Our method achieves both low-drift and low-computational complexity without the need for high accuracy ranging or inertial measurements. The key idea in obtaining this level of performance is the division of the complex problem of simultaneous localization and mapping, which seeks to optimize a large number of variables simultaneously, by two algorithms. One algorithm performs odometry at a high frequency but low fidelity to estimate velocity of the lidar. Another algorithm runs at a frequency of an order of magnitude lower for fine matching and registration of the point cloud. Combination of the two algorithms allows the method to map in real-time. The method has been evaluated by a large set of experiments as well as on the KITTI odometry benchmark. The results indicate that the method can achieve accuracy at the level of state of the art offline batch methods.
Water Content Effects on Transversely Isotropic Parameters of Organic Rich Gas Shale

Organic rich gas shales are often composed of thin laminated structures and, thus, may be considered transversely isotropic media. Shale anisotropy properties are affected by many factors, including confining pressure, water content, total organic content (TOC), mineralogy compositions and micro-fractures. Ultrasonic measurements were performed to investigate the five independent transverse anisotropy constants at various confining pressure and water content conditions. The test results confirm that transversely isotropic media is an appropriate model to characterize Eagle Ford shale. Increasing confining pressure decreases both Pand S-wave anisotropies, especially at low confining pressures. Increasing water content significantly increases P-wave anisotropy, up to 25%. Water content has very little impact on shear wave anisotropy.
Mice with a Null Allele for NaV1.4 Exhibit Pseudo-Myasthenia, but are not Susceptibile to Periodic Paralysis

Functional analysis of disease-associated mutant NaV1.4 channels have revealed defects that often provide a mechanistic basis for derangements in sarcolemma excitability to produce the clinical phenotype. Loss-of-function mutations are less common and the pathogenic basis for muscle dysfunction is less clear than for the gain-of-function NaV1.4 mutations associated with myotonia, paramyotonia congenita or hyperkalemic periodic paralysis. Loss-of-function via enhanced inactivation (both fast and slow) accompanies other channel defects in hypokalemic periodic paralysis (HypoKPP) and is the primary defect in a rare form of congenital myasthenic syndrome. We explored whether a NaV1.4 loss-of-function created in a mouse would produce features of HypoKPP or myasthenia.A null allele of NaV1.4 was generated by excision of exon 12 (174 bp which encodes DIIS2-DIIS4). Heterozygous (+/-) mice were viable, but homozygous nulls (-/-) did not survive beyond P2. Spontaneous movement, feeding, and reproduction were normal in (+/-) mice. Voltage-clamp studies of dissociated fibers showed a 50% reduction of Ina in (+/-) animals. The Na current was completely blocked by 200 nM TTX, suggesting there was no compensatory upregulation of NaV1.5. In vitro contraction testing showed a right shift of the force- stimulus intensity curve and a prominent sag from the early peak force for submaximal stimulus intensities in (+/-) mice. Repetitive nerve stimulation did not elicit a decremental response in the compound muscle AP (CMAP) at baseline, but exposure to low-dose curare (0.5 uM) revealed a larger decrement for (+/-) than WT. These features are consistent with mild myasthenia. Challenge with low K did not diminish maximal tetanic force, nor did insulin & glucose infusion cause a decrease of CMAP amplitude, both of which were observed in our R669H HypoKPP mice.
Societies, Governments and the Global Economy

In Chapter 1, we discussed the causes and the eventual arrival of globalization. In section 2.2 we shall investigate its political, social and cultural consequences—its effects on governments and peoples. This first section will be concerned with the chief economic and financial issues involved, because they underlie the others and because they have become the most obvious way in which the results of globalization present themselves to individual people. Of course, it is artificial to divide things up in this manner: many factors rub against each other simultaneously and throughout we are dealing with an unfolding process—unfinished business. We must begin at the most fundamental level: the latest phase in the continuing revolutions in the technology of global communications, which in one guise or another date back to the sixteenth century in Europe, have created a new situation—not just a further stage in an evolutionary process, but something different in kind.
Logic Programming Based Diffusion Models

In this chapter, we first show that the well-known generalized annotated program (GAP) paradigm can be used to express many existing diffusion models that can consider not only the topology of the social network, but attributes of the nodes and edges as well. We then define a class of problems called Social Network Diffusion Optimization Problems (SNDOPs). In this chapter, we show how various diffusion processes can be embedded as GAP’s and then study the algorithmic and complexity issues associated with SDNOP’s. Experimental results are also included.
Age at Onset of Epilepsy and Effect of Uncontrolled Seizures on Cognitive Outcome

Researchers at the Epilepsy Center and Department of Psychiatry at Lurie Children’s Hospital of Chicago examined the association of cognitive scores and age at onset of epilepsy, pharmacoresistance, and interaction between the two in a prospective community-based study of 198 children, aged <8 years, with new-onset epilepsy.
Investigating a re-configurable PET system design

We introduce a re-configurable system design for positron emission tomography (PET) for purpose of maximizing the cost effectiveness of PET. In this new design concept, a PET system employs a small number of compact, flat-panel (cFP) PET detectors (which we believe will be made available in near future by us or others) to assume various scanner geometries so that the performance properties desired in various imaging applications can be met by a single PET system. For purpose of demonstration, we consider the design of a re-configurable small-animal system consisting of four cFP detectors that are approximately 8×8 cm2 in size and made of 10mm thick LSO. We consider four geometries for the scanner and conduct Monte-Carlo simulations to study their sensitivity, scatter fractions, random fractions, and noise-equivalent count rates. Our results indicate that, in terms of sensitivity and imaging field-of-view (FOV) the re-configurable system that we consider are very promising for small-animal imaging.
Ultra-dense space-division-multiplexing optical fibers

This talk will review ultra-dense SDM fibers for optical communications, such as the multicore fiber with the improved spatial capacity, few-mode multi-core fibers supporting 100+ spatial modes, and the 125-µm-cladding 8-core fiber optimized for O-band short-reach interconnects.
Enantioselective, Copper-Catalyzed Alkynylation of Ketimines To Deliver Isoquinolines with α-Diaryl Tetrasubstituted Stereocenters

An enantioselective, copper-catalyzed alkynylation of cyclic α,α-diaryl ketiminium ions has been developed to deliver isoquinoline products with diaryl, tetrasubstituted stereocenters. The success of this reaction relied on identification of Ph-PyBox as the optimal ligand, i-Pr2NEt as the base, and CHCl3 as the solvent. A broad scope and functional group tolerance were observed. Notably, the use of both aryl and silyl acetylenes results in high yields and enantioselectivities. Mechanistic experiments are consistent with a dimeric or higher order catalyst.
Gal3 Links Inflammation and Insulin Resistance

The connection between obesity-induced insulin resistance and inflammation is established, but targeting inflammatory mediators like TNF-α and IL-1β have had limited success improving insulin sensitivity in patients. Now, Li et al. (2016) indicate that galectin-3 could be a targetable link between inflammation and insulin sensitivity.
Report of the Working Group on Research

Prepared by the Working Group on Research from the November 1995 Georgetown conference sponsored by the Association of Medical School Psychologists, this paper focuses upon the challenges for psychologists who wish to maintain active research programs in academic medical settings. Six specific strategies are offered that, if followed, would increase opportunities and visibility of psychological research programs both within academic medical settings and within society at large.
Personalized Medicine Versus Quality: Contradictory or Mutually Dependent?

Summary This commentary is aimed at reconciling the 'conflict' between increased variability potentially caused by medical personalization with the need for decreased variability as spearheaded by quality improvement efforts in practice - two concepts that may seem inherently contradictory, but in fact they are mutually depended.
Quantifying adhesion of ultra-thin multi-layer DLC coatings to Ni and Si substrates using shear, tension, and nanoscratch molecular dynamics simulations

Abstract Ultra-thin diamond-like carbon (DLC) coatings are used in many engineering applications including hard disk drives, automobile engines, and MEMS/NEMS devices to protect delicate substrates against wear and corrosion. However, they are susceptible to brittle cracking and delamination due to high intrinsic stress and poor adhesion to many substrates. Inclusion of an intermediate layer can prevent delamination of the coating. We perform simple shear and tension loading and nanoscratch molecular dynamics simulations to quantify the effect of coating layer thickness and composition on the adhesion of the ultra-thin multi-layer DLC coatings used in hard disk drives to their substrate. We observe that an intermediate Si layer improves adhesion of DLC coatings to Ni substrates compared to coatings without one, and that an optimum thickness of the Si layer exists. We also find that an intermediate DLC layer with sp 3 fraction lower than the outermost DLC coating layer protects the substrate from plastic deformation under external loading, and that it improves adhesion to Si but not Ni substrates compared to coatings with no intermediate layer.
Overview of Lung Transplantation, Heart-Lung Transplantation, Liver-Lung Transplantation, and Combined Hematopoietic Stem Cell Transplantation and Lung Transplantation

Lung transplantation (LTx) has evolved to represent the therapy of choice for many patients with end-stage lung diseases. Appropriate candidate selection for LTx is an important determinant of a positive outcome from transplantation. Posttransplantation survival has steadily improved, but long-term survival continues to be a challenge with a median survival of 5.8 years. Similarly, combined heart-lung transplantation and simultaneous liver-lung transplantation has been performed successfully in select patients who are not expected to survive either organ transplant alone. Moreover, LTx has been performed in patients who develop end-stage pulmonary complications following hematopoietic stem cell transplantation.
Examining the impact of surgical coaching on trainee physiologic response and basic skill acquisition

We examined how problem-solving coaching impacts trainee skill acquisition and physiologic stress as well as how trainee sensitivity to feedback, known as self-monitoring ability, impacts coaching effectiveness. Medical students completed a pre-training demographics questionnaire, a 12-item self-monitoring ability scale (1 = always false, 5 = always true), and baseline FLS Task 5 with physiologic sensors. After watching a laparoscopic suturing instructional video, students practiced the task for 30 min, either with a surgical coach, or alone, depending on condition. The coach logged frequency of coaching behaviors according to a task-specific coaching script. Trainees then completed FLS Task 5 with physiologic sensors, a post-training questionnaire, and a 12-item coaching quality evaluation (1 = poor, 5 = very good). Twenty-four students (age 24.5 ± 1.4; 54% men; 58% MS4) participated in the study. All were fairly high self-monitors (3.8 ± 0.76). No differences in baseline suturing skills between the groups emerged. Improvement in the coaching group‘s suturing (N = 12; 285.0 ± 79.9) was significantly higher than the control group (N = 12; 200.9 ± 110.3). One measure of physiologic stress (rMSSD) was significantly higher in the coaching group. Trainees who received more coaching demonstrated larger improvements (r = 0.7, p < 0.05). Overall ,perceived quality of the coaching relationship was high (4.4 ± 0.6). There was no correlation between trainee self-monitoring ability and skill improvement. This work suggests that coaching may increase heart rate variability of trainees, indicating coping well with training. Trainee disposition toward feedback did not play a role in this relationship.
Treatment of Refractory Psoriasis with Ustekinumab in an HIV-Positive Patient: A Case Presentation and Review of the Biologic Literature:

Here we describe a case of a 39-year-old male with HIV and a 20-year history of generalized plaque psoriasis and psoriatic arthritis. The patient had been refractory to all treatments until initiat...
Why Does the Cortex Reorganize after Sensory Loss

A growing body of evidence demonstrates that the brain can reorganize dramatically following sensory loss. Although the existence of such neuroplastic crossmodal changes is not in doubt, the functional significance of these changes remains unclear. The dominant belief is that reorganization is compensatory. However, results thus far do not unequivocally indicate that sensory deprivation results in markedly enhanced abilities in other senses. Here, we consider alternative reasons besides sensory compensation that might drive the brain to reorganize after sensory loss. One such possibility is that the cortex reorganizes not to confer functional benefits, but to avoid undesirable physiological consequences of sensory deafferentation. Empirical assessment of the validity of this and other possibilities defines a rich program for future research.
FRACTIONAL SYNTHESIS RATES OF RETINOL-BINDING PROTEIN, TRANSTHYRETIN, AND A NEW PEPTIDE MEASURED BY STABLE ISOTOPE TECHNIQUES IN NEONATAL PIGS

Our objective was to develop a stable isotopic method to measure the synthesis rates of retinol-binding protein (RBP) and transthyretin (TTR). Both proteins were isolated from human and pig plasma by sequential immunoprecipitation and purified by SDS-polyacrylamide gel electrophoresis under denaturing conditions. Both human and pig anti-RBP precipitates contained a peptide (TTR2) that had a molecular mass that was similar but not identical to that of TTR subunit. The N-terminal amino acid sequence of porcine TTR2 was highly but not completely homologous with porcine TTR. Human TTR2 showed no homology with TTR but was completely homologous with an internal sequence of human fibrinogen alpha chain. To measure the fractional rates of synthesis (FRS) of these peptides, six infant pigs were infused with [2H3]leucine at a constant rate for 6 h, and the amount of [2H3]leucine incorporated into the proteins was measured by negative chemical ionization gas chromatography-mass spectrometry. The plateau isotope ratio of plasma very low density lipoprotein apoB-100-bound leucine was used to estimate the isotopic enrichment of hepatic protein synthetic precursor pool. The mean FRS (% h +/- S.E.) of TTR (1.97 +/- 0.13) and RBP (3.89 +/- 0.07) were significantly different. The FRS of TTR2 was low (0.31 +/- 0.19) relative to that of RBP and TTR. Thus, three different peptides with different turnover rates seem to be involved in the transport of retinol.
Basic Graph Theory

Graph theory began in 1736 when Leonhard Euler solved the well-known Konigsberg bridge problem. This problem asked for a circular walk through the town of Konigsberg (now Kaliningrad) in such a way as to cross over each of the seven bridges spanning the river Pregel once, and only once. Euler realized that the precise shapes of the island and the other three territories involved are not important; the solvability depends only on their connection properties. This led to the abstract notion of a graph. Actually, Euler proved much more: he gave a necessary and sufficient condition for an arbitrary graph to admit such a circular walk. His theorem is one of the highlights in the introductory Chap. 1, where we deal with some of the most fundamental notions in graph theory: paths, cycles, connectedness, 1-factors, trees, Euler tours and Hamiltonian cycles, the travelling salesman problem, drawing graphs in the plane, and directed graphs. We will also see a first application, namely setting up a schedule for a tournament, say in soccer or basketball, where each of the 2n participating teams should play against each of the other teams exactly twice, once at home and once away.
Mirror descent for metric learning: a unified approach

Most metric learning methods are characterized by diverse loss functions and projection methods, which naturally begs the question: is there a wider framework that can generalize many of these methods? In addition, ever persistent issues are those of scalability to large data sets and the question of kernelizability. We propose a unified approach to Mahalanobis metric learning: an online regularized metric learning algorithm based on the ideas of composite objective mirror descent (comid). The metric learning problem is formulated as a regularized positive semi-definite matrix learning problem, whose update rules can be derived using the comid framework. This approach aims to be scalable, kernelizable, and admissible to many different types of Bregman and loss functions, which allows for the tailoring of several different classes of algorithms. The most novel contribution is the use of the trace norm, which yields a sparse metric in its eigenspectrum, thus simultaneously performing feature selection along with metric learning.
The Use of Fibular Allograft in Complex Periarticular Fractures Around the Knee

Although the use of fibular strut allografts in proximal humerus fractures has gained popularity, their use in other types of fractures is less well described. Fibular allografts have recently been used in the repair of complex periarticular fractures of the proximal tibia and distal femur. Fibular allografts can be inserted in a variety of manners to achieve goals specific to each individual fracture pattern. In the proximal tibia, insertion through a fracture line or cortical window facilitates joint surface elevation, prevents subsidence and enhances overall construct stability. In distal femoral fractures, including complex periarticular fractures, insertion through the fracture or cortical window permits indirect reduction of the medial cortex and provides necessary medial column support. An additional option in distal femur fractures includes fibula insertion as an intramedullary nail, allowing enhanced fixation in short distal fracture segments. In all cases, the use of a fibular allograft augments poor bone stock and provides improved screw purchase and construct stability when combined with conventional plating methods. Here we present a series of cases at our institution illustrating an array of novel techniques utilizing endosteal fibular allografts in the fixation of complex periarticular fractures about the knee.
Measuring the average power of neural oscillations

Abstract Background Neural oscillations are often quantified as average power relative to a cognitive, perceptual, and/or behavioral task. This is commonly done using Fourier-based techniques, such as Welch’s method for estimating the power spectral density, and/or by estimating narrowband oscillatory power across trials, conditions, and/or groups. The core assumption underlying these approaches is that the mean is an appropriate measure of central tendency. Despite the importance of this assumption, it has not been rigorously tested. New method We introduce extensions of common approaches that are better suited for the physiological reality of how neural oscillations often manifest: as nonstationary, high-power bursts, rather than sustained rhythms. Log-transforming, or taking the median power, significantly reduces erroneously inflated power estimates. Results Analyzing 101 participants’ worth of human electrophysiology, totaling 3,560 channels and over 40 hours data, we show that, in all cases examined, spectral power is not Gaussian distributed. This is true even when oscillations are prominent and sustained, such as visual cortical alpha. Power across time, at every frequency, is characterized by a substantial long tail, which implies that estimates of average power are skewed toward large, infrequent high-power oscillatory bursts. Comparison with existing methods In a simulated event-related experiment we show how introducing just a few high-power oscillatory bursts, as seen in real data, can, perhaps erroneously, cause significant differences between conditions using traditional methods. These erroneous effects are substantially reduced with our new methods. Conclusions These results call into question the validity of common statistical practices in neural oscillation research. Highlights Analyses of oscillatory power often assume power is normally distributed. Analyzing >40 hours of human M/EEG and ECoG, we show that in all cases it is not. This effect is demonstrated in simple simulation of an event-related task. Overinflated power estimates are reduced via log-transformation or median power.
Preventing Chronic Emotional Distress in Stroke Survivors and Their Informal Caregivers

Chronic emotional distress (e.g., depression, anxiety, post-traumatic stress) is common after stroke and interdependent between patients and their informal caregivers. We measured stroke survivors’, caregivers’, and neurocritical care nurses’ views of primary drivers of distress during the stroke experience, and needs and preferences for the structure, topics, mode of delivery, and timing of an intervention to promote emotional recovery. We conducted semi-structured interviews with 24 patient–caregiver dyads within the Neuroscience Intensive Care Unit (Neuro-ICU). Additionally, we conducted two focus groups with 15 nurses. Interviews and focus groups were audio-recorded, transcribed, and coded using NVivo 11 (QSR International) software. The challenges and impacts of stroke most commonly reported by dyads were: uncertainty about future health, fear of recurrent strokes, negative emotions, and role changes post-stroke. Dyads and nurses agreed that resiliency skills such as mindfulness/focusing on the present, problem solving, gratitude/optimism, self-care, interpersonal communication and developing a supportive team of family, friends, and medical staff are beneficial to optimize recovery. The potential barrier to intervention delivery was accessibility, due to challenges of time and travel to appointments. Participants agreed that starting the intervention at hospitalization and continuing via live video after discharge is an ideal delivery modality. Stroke survivors, caregivers, and Neuro-ICU nurses believe that a resiliency skills-based intervention to prevent chronic emotional distress is necessary and urgent. This qualitative study provides valuable information on the challenges faced by dyads, intervention topics to prioritize, and strategies to maximize feasibility, acceptability, and effect.
Time Course of Aldehyde Oxidase and Why It Is Nonlinear.

Many promising drug candidates metabolized by aldehyde oxidase (AOX) fail during clinical trial owing to underestimation of their clearance. AOX is species-specific, which makes traditional allometric studies a poor choice for estimating human clearance. Other studies have suggested using half-life calculated by measuring substrate depletion to measure clearance. In this study, we proposed using numerical fitting to enzymatic pathways other than Michaelis-Menten (MM) to avoid missing the initial high turnover rate of product formation. Here, product formation over a 240-minute time course of six AOX substrates—O6-benzylguanine, N-(2-dimethylamino)ethyl)acridine-4-carboxamide, zaleplon, phthalazine, BIBX1382 [N8-(3-Chloro-4-fluorophenyl)-N2-(1-methyl-4-piperidinyl)-pyrimido[5,4-d]pyrimidine-2,8-diamine dihydrochloride], and zoniporide—have been provided to illustrate enzyme deactivation over time to help better understand why MM kinetics sometimes leads to underestimation of rate constants. Based on the data provided in this article, the total velocity for substrates becomes slower than the initial velocity by 3.1-, 6.5-, 2.9-, 32.2-, 2.7-, and 0.2-fold, respectively, in human expressed purified enzyme, whereas the Km remains constant. Also, our studies on the role of reactive oxygen species (ROS), such as superoxide and hydrogen peroxide, show that ROS did not significantly alter the change in enzyme activity over time. Providing a new electron acceptor, 5-nitroquinoline, did, however, alter the change in rate over time for mumerous compounds. The data also illustrate the difficulties in using substrate disappearance to estimate intrinsic clearance.
FEMALE REPRESENTATION IN CLINICAL TRIALS OF PCSK9 INHIBITORS

PCSK9-i are gaining traction as effective lipid-lowering agents. We hypothesized that female patients were under-represented in landmark clinical trials of PCSK9-i. In this meta-analysis, we searched and reviewed all currently available randomized clinical trials (RCTs) of PCSK9-i. We defined the
A Formulation for Fluid–Structure Interactions in febio Using Mixture Theory

Many physiological systems involve strong interactions between fluids and solids, posing a signicant challenge when modeling biomechanics. The objective of this study was to implement a fluid-structure interaction (FSI) solver in the free, open-source finite element code FEBio (febio.org), that combined the existing solid mechanics and rigid body dynamics solver with a recently-developed computational fluid dynamics (CFD) solver. A novel Galerkin-based finite element FSI formulation was introduced based on mixture theory, where the FSI domain was described as a mixture of fluid and solid constituents that have distinct motions. The mesh was defined on the solid domain, specialized to have zero mass, negligible stiffness and zero frictional interactions with the fluid, whereas the fluid was modeled as isothermal and compressible. The mixture framework provided the foundation for evaluating material time derivatives in a material frame for the solid and in a spatial frame for the fluid. Similar to our recently reported CFD solver, our FSI formulation did not require stabilization methods to achieve good convergence, producing a compact set of equations and code implementation. The code was successfully verified against benchmark problems and an analytical solution for squeeze-film lubrication. It was validated against experimental measurements of the flow rate in a peristaltic pump, and illustrated using non-Newtonian blood flow through a bifurcated carotid artery with a thick arterial wall. The successful formulation and implementation of this FSI solver enhances the multiphysics modeling capabilities in FEBio relevant to the biomechanics and biophysics communities.
Expression of endoplasmic reticulum mannosyl-oligosaccharide α1, 2-mannosidase regulates tumorigenicity of prostate cancer cells

Abstract It has been previously demonstrated that glycogenes can function as important pleiotropic regulators of tumorigenesis. In this study, we investigated the function of endoplasmic reticulum mannosyl-oligosaccharide 1, 2-alpha-mannosidase (MAN1B1) on the behavior of prostate cancer cells and found that overexpression of MAN1B1 in androgen-independent PC3 cells reduced cellular migration. We extended the analysis to an androgen dependent cell line, LNCaP, and another androgen independent cell line, LNCaP-AI, observing a similar migratory phenotype. By using quantitative proteomics, we found the downregulation of vimentin expression when PC3 or LNCaP-AI cells with overexpressed MAN1B1. The current study suggests that MAN1B1 may regulate cellular migration and promote epithelial-to-mesenchymal transition (EMT) phenotype in prostate cancer cells.