cssi/SciSciGPT-SciSciNet huggingface dataset:
Abstract A03: Tumorigenesis involving expansion of CD24 high CD61 cells is abrogated by tamoxifen in mouse models of luminal breast cancer

The cells within the mammary gland that are altered by tamoxifen chemoprevention and correlate with abrogation of tumorigenesis are unknown. We have documented that a 60 day tamoxifen chemopreventive regimen reduces tumor incidence in NRL-TGFalpha and MMTV-c-neu mouse models of luminal breast cancer. For this study our goal was to identify the aberrant and/or altered mammary cell subpopulations typically found in the mammary gland of TGFalpha and c-neu mice and determine the effect of tamoxifen on their relative quantity. Mammary cell subpopulations were evaluated using flow cytometric analysis by labeling lineage negative cells with CD24, CD61 and CD49f fluorescently tagged antibodies. TGFalpha mice developed an expanded CD24high CD61positive fraction of cells coinciding with hyperplasia and tumor presence. Prior to tumor development c-neu mice had an expanded CD24medium CD49f high cell fraction and by the time tumors developed, both nontumorous glands and tumors also displayed an expanded CD24high CD61positive cell fraction. Mammary glands from mice that received a 60 day tamoxifen chemopreventive regimen did not display expanded cell fractions compared to placebo treated mice in both models. Our data indicate that tamoxifen chemoprevention abrogates tumorigenesis that involves expansion of CD24high CD61positive cells. Further investigations into tamoxifen effects on mammary cell subpopulations is critical for a clearer understanding of the utility of tamoxifen and other estrogen receptor modulators as chemopreventives. Citation Format: Olga Zhdankin, Melanie Bomier, Donna Parke, Jon Holy, Teresa Rose-Hellekant. Tumorigenesis involving expansion of CD24 high CD61 cells is abrogated by tamoxifen in mouse models of luminal breast cancer. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr A03.
The New Approach of Applying DSM to Topology

A new approach for topology was proposed in the paper. The approach modified the method of DSM and introduced it into topology. The concept and process of the approach was given in detail. Two methods were provided and applied to the practical case. Compared to the traditional approach of topology, its concept was clear and its efficiency was high.
Chapter 28 – Psychiatric Disorders

Psychiatric disorders provide significant research challenges because one cannot easily study the brain directly in vivo in man. This chapter reviews a number of key issues that arise from this conundrum and elaborates on methods used to address them. Issues discussed include diagnostic validity and reliability of psychiatric disorders, validity of specific behavioral and biological measures, power and statistical analyses, high placebo responses seen in double-blind randomized clinical trials, better definitions of outcome, etc. In addition, issues unique to specific populations (e.g., those with impaired mental capacity) are discussed. A practical schematic approach for approaching research in this area is provided as is a table of commonly used behavioral rating scales.
“They Make Me Not Wanna Have a Child”: Effects of Companion Animals on Fertility Intentions of the Childfree

This article argues that for some who are childfree, the increasing perception of the companion animal as a sentient being with agency provides a deep, meaningful relationship with the power to inform fertility intentions. Qualitative, in-depth interviews with childfree companion animal owners reveal that this relationship serves to reinforce previous fertility choices such as delaying or completely opting out of childbirth, thus affecting present household structure. This is reflected in the active choice by some participants to have companion animals instead of human children, the presence of a cost-benefit analysis concerning animal companions and human children, and narratives that express a desire to mother or nurture as fulfilled in the relationship with the companion animal. Implications of these findings for both demography and marriage and family research in the United States are discussed.
QRank: a novel quantile regression tool for eQTL discovery.

Motivation Over the past decade, there has been a remarkable improvement in our understanding of the role of genetic variation in complex human diseases, especially via genome-wide association studies. However, the underlying molecular mechanisms are still poorly characterized, impending the development of therapeutic interventions. Identifying genetic variants that influence the expression level of a gene, i.e. expression quantitative trait loci (eQTLs), can help us understand how genetic variants influence traits at the molecular level. While most eQTL studies focus on identifying mean effects on gene expression using linear regression, evidence suggests that genetic variation can impact the entire distribution of the expression level. Motivated by the potential higher order associations, several studies investigated variance eQTLs. Results In this paper, we develop a Quantile Rank-score based test (QRank), which provides an easy way to identify eQTLs that are associated with the conditional quantile functions of gene expression. We have applied the proposed QRank to the Genotype-Tissue Expression project, an international tissue bank for studying the relationship between genetic variation and gene expression in human tissues, and found that the proposed QRank complements the existing methods, and identifies new eQTLs with heterogeneous effects across different quantile levels. Notably, we show that the eQTLs identified by QRank but missed by linear regression are associated with greater enrichment in genome-wide significant SNPs from the GWAS catalog, and are also more likely to be tissue specific than eQTLs identified by linear regression. Availability and implementation An R package is available on R CRAN at https://cran.r-project.org/web/packages/QRank . Contact xs2148@cumc.columbia.edu. Supplementary information Supplementary data are available at Bioinformatics online.
Regional Perspectives on Public Health

Spatial and locational dimensions of public health are attracting increasing attention among regional scientists whose analytic methods and frameworks can provide valuable insights into well-being challenges. Regional economic, demographic, and environmental processes are critically important to people’s health and access to health care. Such effects can be modeled and analyzed using spatial analytics and regional approaches. This chapter reviews contributions by regional scientists to public health research and intervention. Research challenges and opportunities are discussed in several broad areas of public health, including health disparities, environmental health, access to health services, and public health intervention.
Levinas and Marion on Law and Freedom: Toward a new dialectical theology of justice1:

There is a perennial ambiguity within the relationship between law and human freedom. Does law inherently promote freedom or restrict it? Emmanuel Levinas (1906–95) proposes that law – precisely Torah – is the gateway of freedom to the degree that law attests to the obligatory summons to responsibility for the other. In his 1964 Talmudic lecture entitled, ‘The Temptation of Temptation’, Levinas presents the paradoxical beginning of freedom in ‘a non-freedom which, far from being slavery or childhood, is a beyond-freedom…overcoming the temptation of evil by avoiding the temptation of temptation’. However, Levinas’s turn to Torah is not enough. His ethical phenomenology of proclamation must be paired with a contemplative phenomenology of manifestation so as not to engender action without considering what exactly gives itself to act upon. Enter Jean-Luc Marion (1946–). While Levinas’s attention to the call of the other opens the ears to ethical exigency, Marion’s attention to givenness opens the eyes to cont...
Reanalysis of the BICEP2, Keck and Planck Data: No Evidence for Gravitational Radiation

A joint analysis of data collected by the Planck and BICEP2+Keck teams has previously given $r = 0.09^{+0.06}_{-0.04}$ for BICEP2 and $r = 0.02^{+0.04}_{-0.02}$ for Keck. Analyzing BICEP2 using its published noise estimate, we had earlier (Colley & Gott 2015) found $r = 0.09 \pm 0.04$, agreeing with the final joint results for BICEP2. With the Keck data now available, we have done something the joint analysis did not: a correlation study of the BICEP2 vs. Keck B-mode maps. Knowing the correlation coefficient between the two and their amplitudes allows us to determine the noise in each map (which we check using the E-modes). We find the noise power in the BICEP2 map to be twice the original BICEP2 published estimate, explaining the anomalously high $r$ value obtained by BICEP2. We now find $r = 0.004 \pm 0.04$ for BICEP2 and $r = -0.01 \pm 0.04$ for Keck. Since $r \ge 0$ by definition, this implies a maximum likelihood value of $r = 0$, or no evidence for gravitational waves. Starobinsky Inflation ($r = 0.0036$) is not ruled out, however. Krauss & Wilzcek (2014) have already argued that "measurement of polarization of the CMB due to a long-wavelength stochastic background of gravitational waves from Inflation in the early Universe would firmly establish the quantization of gravity," and, therefore, the existence of gravitons. We argue it would also constitute a detection of gravitational Hawking radiation (explicitly from the causal horizons due to Inflation).
Endoscopic excision of a tympanic paraganglioma: Training the next generation of ear surgeons

Abstract Tympanic paragangliomas are uncommon vascular tumors of neural crest origin. Classically these lesions have been surgically managed via a transcanal or transmastoid approach using binocular microscopy. We describe a case in which a tympanic paraganglioma was removed via a transcanal approach, using the endoscope exclusively. Endoscopic ear surgery enhances visualization, helping to ensure complete tumor removal, while reducing unnecessary dissection and its associated morbidity. For small middle ear neoplasms, a purely endoscopic approach is feasible, with excellent results. Resident education in ear surgery has also been enhanced by the use of endoscopes. The wide field of view provided by the endoscope helps trainees understand the intricate three-dimensional anatomy of the middle ear cleft.
Migraine pathophysiology: Anatomy of the trigeminovascular pathway and associated neurological symptoms, cortical spreading depression, sensitization, and modulation of pain

Scientific evidence supports the notion that migraine pathophysiology involves inherited alteration of brain excitability, intracranial arterial dilatation, recurrent activation, and sensitization of the trigeminovascular pathway, and consequential structural and functional changes in genetically susceptible individuals. Evidence of altered brain excitability emerged from clinical and preclinical investigation of sensory auras, ictal and interictal hypersensitivity to visual, auditory, and olfactory stimulation, and reduced activation of descending inhibitory pain pathways. Data supporting the activation and sensitization of the trigeminovascular system include the progressive development of cephalic and whole-body cutaneous allodynia during a migraine attack. In addition, structural and functional alterations include the presence of subcortical white mater lesions, thickening of cortical areas involved in processing sensory information, and cortical neuroplastic changes induced by cortical spreading depression. Here, we review recent anatomical data on the trigeminovascular pathway and its activation by cortical spreading depression, a novel understanding of the neural substrate of migraine-type photophobia, and modulation of the trigeminovascular pathway by the brainstem, hypothalamus and cortex.
The Politics of Blackness: Racial Identity and Political Behavior in Contemporary Brazil

This book uses an intersectional approach to analyze the impact of the experience of race on Afro-Brazilian political behavior in the cities of Salvador, Sao Paulo, and Rio de Janeiro. Using a theoretical framework that takes into account racial group attachment and the experience of racial discrimination, it seeks to explain Afro-Brazilian political behavior with a focus on affirmative action policy and Law 10.639 (requiring that African and Afro-Brazilian history be taught in schools). It fills an important gap in studies of Afro-Brazilian underrepresentation by using an intersectional framework to examine the perspectives of everyday citizens. The book will be an important reference for scholars and students interested in the issue of racial politics in Latin America and beyond.
Expression of lncRNA MIR222HG co-transcribed from the miR-221/222 gene promoter facilitates the development of castration-resistant prostate cancer

Mechanisms by which non-coding RNAs contribute to the progression of hormone-sensitive prostate cancer (PCa) (HSPC) to castration-resistant PCa (CRPC) remain largely unknown. We previously showed that microRNA-221/222 is up-regulated in CRPC and plays a critical role in modulating androgen receptor function during CRPC development. With further investigation, we characterized a putative promoter region located 23.3 kb upstream of the miR-221/222 gene, and this promoter is differentially activated in CRPC LNCaP-Abl cells, leading to the up-regulation of miR-221/222. Upon promoter activation, a set of polyadenylated long non-coding RNA (lncRNA) MIR222HGs was transcribed from this promoter region. Over-expression of these MIR222HGs increased androgen-independent cell growth and repressed the expression of androgen receptor-regulated dihydrotestosterone (DHT)-induced KLK3, TMPRSS2, and FKBP5 in HSPC LNCaP cells, hallmarks of the CRPC phenotype. Clinically, increased expression of MIR222HG is associated with PCa progression to CRPC. In primary tumors, expression levels of MIR222HG and miR-221/222 inversely correlate with Gleason score and androgen receptor (AR) pathway activity. Interestingly, MIR222HG is Argonaute 2-bound and its expression is Dicer 1-dependent, suggesting its functional association with the RNA-induced silencing complex. Further studies led to the hypothesis that MIR222HG may potentially affect miR-mediated expression silencing, subsequently leading to AR reprogramming. Our study highlights an essential role of a non-coding RNA in CRPC development and that differential activation of a single promoter can up-regulate two different types of non-coding RNAs, miR-221/222 and lncRNA MIR222HG, in CRPC. Additionally, this study reveals a novel function of lncRNAs as a modulator of Argonaute-mediated RNA-induced silencing complex.
The Re(Naissance) of Texts: Parody and Rewriting in the Work of Luisa Valenzuela

The chapter examines parody’s function as a critical realization of the ways in which cultural discourses are shaped by social power games and ideological dogmas of the various time periods. The chapter also discusses how Valenzuela’s rewriting of traditional fairy tales (e.g., her story “Si esta es la vida, yo soy Caperucita Roja” [“If this is life, I am Little Red Riding Hood”], such as the ones by Charles Perrault in the seventeenth century and the Grimm Brothers, along with Hans Christian Andersen in the nineteenth century, uncovers the political dimension of all cultural products.
Zhou Dunyi’s Philosophy of the Supreme Polarity

ZhouDunyi 周敦頤 (1017–1073), also known as Zhou Lianxi 周濂溪and Zhou Maoshu 周茂叔, has long been regarded as a pioneer of what has become known as the Cheng-Zhu tradition of Learning of the Way (daoxue 道學).1 A native of Daozhou 道洲in present day Hunan, Zhou spent most of his adult life working as a minor official at provincial level. His uneventful career in the government was duly compensated by his brilliant achievements in writing and teaching. During one of his postings in southwestern China, he tutored the young two Cheng brothers—Cheng Hao 程顥 (1032–1085) and Cheng Yi 程頤 (1033–1107)—who later became the leading eleventh-century daoxue thinkers. Through the two Cheng brothers, his writings were passed on to other daoxue thinkers, particularly the great synthesizer Zhu Xi 朱熹 (1130–1200). In the last few years of his life, Zhou Dunyi retired at the picturesque Mount Lu in central China. He named his study at his Mount Lu residence after the stream Lianxi (Stream of Waterfalls), hence came his courtesy name Lianxi and his posthumous honorific title Master Lianxi.2
Use of a Canonical Hidden-Variable Space in Quantum Mechanics

In Brandenburger and Keisler ([2012b]) we showed that, provided only that the measurement and outcome spaces in an experimental system are measure-theoretically separable, then there is a canonical hidden-variable space, namely the unit interval equipped with Lebesgue measure. Here, we use this result to establish a general relationship between two kinds of conditions on correlations in quantum systems: Bell locality ([1964]) and λ-independence on the one hand, and no signaling (Ghirardi, Rimini, and Weber ([1980]), Jordan ([1983])) on the other hand.
Physical and Chemical Stability of Etoposide Phosphate Solutions

Abstract Objective To evaluate the physical and chemical stability of etoposide phosphate solutions over 7 days at 32°C and 31 days at 4°C and 23°C: (1) at etoposide concentrations of 0.1 and 10 mg/mL as phosphate in 0.9% sodium chloride injection and 5% dextrose injection and (2) at etoposide concentrations of 10 and 20 mg/mL as phosphate in bacteriostatic water for injection packaged in plastic syringes. Design Test samples of etoposide phosphate were prepared in polyvinyl chloride (PVC) bags of the two infusion solutions at etoposide concentrations of 0.1 and 10 mg/mL as phosphate. Additional test samples were prepared in bacteriostatic water for injection containing benzyl alcohol 0.9% at etoposide concentrations of 10 and 20 mg/mL as phosphate and were packaged in 5 mL plastic syringes. Evaluations for physical and chemical stability were performed initially; after 1 and 7 days of storage at 32°C; and after 1, 7, 14, and 31 days of storage at 4°C and 23°C. Physical stability was assessed using visual observation in normal light and using a high-intensity monodirectional light beam. Turbidity and particle content were measured electronically. Chemical stability of the drug was evaluated by using a stability-indicating high-performance liquid chromatographic (HPLC) analytic technique. Results All samples were physically stable throughout the study. Little or no change in particulate burden and haze level were found. In the intravenous infusion solutions, little or no loss of etoposide phosphate occurred in any of the samples throughout the study period. The 10 and 20 mg/mL samples in bacteriostatic water for injection repackaged in syringes were also stable throughout the study, exhibiting a maximum of 6% or 7% loss after 31 days of storage at 23°C and less than 4% in 31 days at 4°C. Conclusion Etoposide phosphate prepared as intravenous admixtures of etoposide 0.1 and 10 mg/mL as phosphate in 5% dextrose injection and 0.9% sodium chloride injection in PVC bags and as etoposide 10 and 20 mg/mL as phosphate in bacteriostatic water for injection packaged in plastic syringes is physically and chemically stable for at least 7 days at 32°C and 31 days at 4°C and 23°C. This new water-soluble phosphate-ester of etoposide formulation solves the precipitation problems associated with the old organic solvent and surfactant-based formulation.
The Impact of Complementary Medicine on In Vitro Fertilization

The high cost and limited success rates of In Vitro Fertilization (IVF) have driven many patients to pursue alternative or complementary medicine options. Though many options exist, only the Traditional Chinese Medicine of acupuncture as adjuvant treatment in IVF has received significant scientific scrutiny. Despite an extensive body of literature that includes numerous randomized clinical trials and a meta-analysis, definitive conclusions are lacking. Though results to date suggest a statistically significant improvement in pregnancy rates with adjuvant acupuncture, important issues remain to be addressed. These include the chance of a placebo effect, the possible impact of patient selection and baseline pregnancy rates, and the lack of biologically plausible mechanism. Larger, randomized placebo-controlled trials are underway to address these concerns.
Crafting a modern surgeon-scientist in cardiothoracic surgery

The creation of a durable cardiothoracic surgeon-scientist in the modern era is no small feat. With the current pressures of academic medicine and the competitive nature of governmental funding, it is increasingly difficult for today’s academic thoracic surgeon to simultaneously master the clinical, educational, and scientific realms of medicine.
Guiding Manufacturing Enterprises to Achieve Long-Term Business Sustainability Using the Collective System Design Approach

This paper addresses several issues discovered by working with different industries attempting to sustain their business enterprise and to become “Lean.” The three key points addressed by the paper are: 1) Designing a new system or re-designing an existing system should focus on collecting a complete set of customer needs and deriving functional requirements from those needs. 2) Illustrating the path-dependency or sequence of implementation of Physical Solutions (PSs) to achieve Functional Requirements (FRs) of partially coupled designs. 3) Lean is not what we implement as a system, rather lean is what we become as a result of meeting customer needs with the utilization of the least amount of resources possible in a sustained manner. When lean is viewed as a set of tools to implement, the people in an enterprise will face ever-increasing diffculty in long-term business sustainability. The primary problems arise early in the design/re-design phase due to the lack of a clear set of system functional requirements. Without clearly defined system FRs, driven by recognizing customer needs/concerns, an enterprise will implement point solutions in an attempt to improve part(s) of a system. The Manufacturing System Design Decomposition (MSDD), a product of Axiomatic Design (AD), illustrates the path-dependency among the solutions of the associated requirements of any manufacturing facility. The MSDD provides a system-wide view and a clear sequence for system design implementation. The Collective System Design approach is discussed to provide the steps for senior leadership to re-design an existing system or to design a new system that results in long-term sustainability and become “lean.”
The Use of Telemedicine to Address Disparities in Access to Specialist Care for Neonates

Abstract Introduction: Outcomes for premature and critically ill neonates are improved with care provided by neonatologists in a neonatal intensive care unit (NICU). For smaller hospitals, maintain...
Acute Lobar Atelectasis

Lobar atelectasis (or collapse) is an exceedingly common, rather predictable, and potentially pathogenic companion to many forms of acute illness, postoperative care, and chronic debility. Readily diagnosed by using routine chest imaging and bedside ultrasound, the consequences from lobar collapse may be minor or serious, depending on extent, mechanism, patient vulnerability, abruptness of onset, effectiveness of hypoxic vasoconstriction, and compensatory reserves. Measures taken to reduce secretion burden, assure adequate secretion clearance, maintain upright positioning, reverse lung compression, and sustain lung expansion accord with a logical physiologic rationale. Both classification and logical approaches to prophylaxis and treatment of lobar atelectasis derive from a sound mechanistic knowledge of its causation.
Practitioner Profile (Mike Reid): “It’s not Perfect, It’s Complex—And That’s Ok”

Navigating community and government power dynamics can pose a challenge to engagement practitioners. In this profile, Michael Reid describes how he learned to not just navigate, but meaningfully reshape, power dynamics in such a way that levels the playing field between landholders and policy-makers. The son of a South African immigrant, Mike felt drawn from a young age to learn about power and to work for social justice. At university, he combined an Applied Science degree in Agriculture with a degree in Sociology. Throughout his career, he has sought to apply lessons from both fields—framing issues to highlight the social and political dimensions as much as the scientific ones. By bringing landholders to the seat of government and government officials out to farms, he seeks to build common understanding and create opportunities for everyone to have a voice and tell their own story. Mike believes a collaborative approach to learning can allow for a fundamental reimagining of ecosystems and political systems alike.
Cervical Length as a Predictor of Preterm Delivery in an Unselected Cohort of Women with Twin Pregnancies.

OBJECTIVE To determine the risk of spontaneous preterm delivery (SPTD) associated with transvaginal cervical length (TVCL) in an unselected cohort. STUDY DESIGN This is a retrospective study of serial TVCLs in unselected twin gestations. Receiver operator curves for SPTD were constructed from TVCLs at 18, 20, 22, and 24 weeks. Prediction thresholds were determined using a false discovery rate of 10%. The risk of SPTD was compared with previously published, prospective data from a meta-analysis. RESULTS A total of 1,228 women were included. SPTD occurred prior to 35 weeks in 232 (18.9%), 126 (10.3%), and 24 (2.0%) women prior to 35, 32, and 28 weeks. TVCL was most predictive at 22 weeks (area under the curve = 0.67). TVCL thresholds for predicting SPTD prior to 35, 32, and 28 weeks were 3.1, 3.0, and 2.9 cm. Compared with a previous meta-analysis, the risk of SPTD < 34, 32, and 28 weeks was lower (positive likelihood ratio 9.0 vs. 5.4, 10.1 vs. 5.9, and 9.6 vs. 4.3). CONCLUSION TVCL is modestly predictive of SPTD in twin gestations. Compared with previous prospective studies, this cohort has lower risk of SPTD at similar TVCLs.
Formation of pedestalled, relict lakes on the McMurdo Ice Shelf, Antarctica

Surface debris covers much of the western portion of the McMurdo Ice Shelf and has a strong influence on the local surface albedo and energy balance. Differential ablation between debris-covered and debris-free areas creates an unusual heterogeneous surface of topographically low, high-ablation, and topographically raised (‘pedestalled’), low-ablation areas. Analysis of Landsat and MODIS satellite imagery from 1999 to 2018, alongside field observations from the 2016/2017 austral summer, shows that pedestalled relict lakes (‘pedestals’) form when an active surface meltwater lake that develops in the summer, freezes-over in winter, resulting in the lake-bottom debris being masked by a high-albedo, superimposed, ice surface. If this ice surface fails to melt during a subsequent melt season, it experiences reduced surface ablation relative to the surrounding debris-covered areas of the ice shelf. We propose that this differential ablation, and resultant hydrostatic and flexural readjustments of the ice shelf, causes the former supraglacial lake surface to become increasingly pedestalled above the lower topography of the surrounding ice shelf. Consequently, meltwater streams cannot flow onto these pedestalled features, and instead divert around them. We suggest that the development of pedestals has a significant influence on the surface-energy balance, hydrology and flexure of the ice shelf.
TestSage: Regression Test Selection for Large-Scale Web Service Testing

Regression testing is an important but expensive activity in software development. Among various types of tests, web service tests are usually one of the most expensive (due to network communications) but widely adopted types of tests in commercial software development. Regression test selection (RTS) aims to reduce the number of tests which need to be retested by only running tests that are affected by code changes. Although a large number of RTS techniques have been proposed in the past few decades, these techniques have not been adopted on large-scale web service testing. This is because most existing RTS techniques either require direct code dependency between tests and code under test or cannot be applied on large scale systems with enough efficiency. In this paper, we present a novel RTS technique, TestSage, that performs RTS for web service tests on large scale commercial software. With a small overhead, TestSage is able to collect fine grained (function level) dependency between test and service under test that do not directly depend on each other. TestSage has also been successfully applied to large complex systems with over a million functions. We conducted experiments of TestSage on a large scale backend service at Google. Experimental results show that TestSage reduces 34% of testing time when running all AEC (Analysis, Execution and Collection) phases, 50% of testing time while running without collection phase. TestSage has been integrated with internal testing framework at Google and runs day-to-day at the company.
Microneedles coated with peanut allergen enable desensitization of peanut sensitized mice

The prevalence of peanut allergies has escalated over the last 20 years, yet there are no FDA approved treatments for peanut allergies. In this study we evaluated the potential of microneedles to deliver peanut protein extract (PE) into skin and assessed if the ensuing immune responses could desensitize mice that were sensitized to peanuts. Peanut sensitized mice were either treated through cutaneous immunotherapy using PE-coated microneedles or not treated, and then orally challenged with PE. After oral challenge, the clinical symptoms of peanut-induced anaphylaxis were significantly lower in the microneedle treated mice as compared to untreated mice, and this was accompanied by down-regulation of systemic anaphylaxis mediators such as histamine and mast cell protease-1 (MCPT-1) in the microneedles treated group. Overall, there was an up-regulation of Th1 cytokines (IL-2 and IFN-γ) as compared to Th2 cytokines (IL-4 and IL-5) in splenocyte culture supernatants of the microneedle treated group as compared to untreated group, suggesting that microneedles promoted immune modulation towards the Th1 pathway. Furthermore, mice treated with PE-coated microneedles were observed to retain integrity of their small intestine villi and had reduced eosinophilic infiltration as compared to the untreated but peanut sensitized mice, which further confirmed the desensitization capability of peanut cutaneous immunotherapy using coated microneedles. Thus, our current study represents a novel minimally invasive microneedle based cutaneous immunotherapy, which may provide a novel route of desensitization for the treatment of peanut allergies.
Hybrid transcatheter pulmonary valve replacement with a SAPIEN S3 valve after pulmonary artery banding via left lateral thoracotomy

For many patients with repaired congenital heart disease, the need for reintervention on dysfunctional right ventricular outflow tracts is pervasive. Many such patients are poor candidates for both transcatheter pulmonary valve replacement and cardiopulmonary bypass, and hybrid surgical and transcatheter procedures have evolved to meet this need. We present two cases of hybrid pulmonary valve replacement involving pulmonary artery band placement via left anterior thoracotomy followed by transvenous placement of a SAPIEN S3 valve without prestenting. This approach avoids cardiopulmonary bypass as well as redo sternotomy and will likely see an increase in utilization in the future.
Volumetric Behavior of Gas Mixtures at Low Temperatures by the Burnett Method: The Helium-Nitrogen System, 0° to -140°C

A novel method for the determination of the volumetric behavior of gases which required the measurement of only temperature and pressure was introduced by Burnett in 1936[1]. Since it was conceived, the Burnett method has been applied above the ice point by many investigators[2,3,4] and in some instances at low temperatures[5,6]. Prior to the present investigation, the method had not been verified at cryogenic temperatures by direct comparison with the results obtained by other methods. This paper reports the volumetric behavior of the helium-nitrogen system from 0° to — 140°C as determined by the Burnett method.
Detection of multiple naturally occurring Salmonella serotypes from commercial broiler carcasses with conventional methods

Many laboratories sampling foods for Salmonella are interested only in presence or absence of Salmonella, so only one colony may be selected. The objectives of this study were to use two selective enrichment broths and two selective agar plating media for Salmonella recovery from naturally contaminated broiler carcass rinsates and evaluate these media combinations on Salmonella serotypes recovered from each carcass. Broiler carcasses (n = 52) from a commercial processing plant prior to chilling were rinsed with buffered peptone water and after incubation subcultured to gram‐negative and tetrathionate, and after inoculation to Rappaport Vassiliadis broth which was incubated and then streaked onto plates of Brilliant Green Sulfa and Xylose‐Lysine‐Tergitol‐4 agar. On 11/49 positive carcasses, both plating media yielded the same serotypes; for the other 38 positive samples different serotypes were found on the different plating media. Enrichment and plating media combinations influence the serotypes recovered and demonstrates bias even in a limited study such as this.
Improving Influenza Vaccination in Hospitalized Children With Asthma

OBJECTIVES: Children with asthma are at increased risk of complications from influenza; hospitalization represents an important opportunity for vaccination. We aimed to increase the influenza vaccination rate among eligible hospitalized patients with asthma on the pediatric hospital medicine (PHM) service from 13% to 80% over a 4-year period. METHODS: Serial Plan-Do-Study-Act cycles were implemented to improve influenza vaccination rates among children admitted with status asthmaticus and included modifications to the electronic health record (EHR) and provider and family education. Success of the initial PHM pilot led to the development of a hospital-wide vaccination tracking tool and an institutional, nurse-driven vaccine protocol by a multidisciplinary team. Our primary outcome metric was the inpatient influenza vaccination rate among PHM patients admitted with status asthmaticus. Process measures included documentation of influenza vaccination status and use of the EHR asthma order set and a history and physical template. The balance measure was adverse vaccine reaction within 24 hours. Data analysis was performed by using statistical process control charts. RESULTS: The inpatient influenza vaccination rate increased from 13% to 57% over 4 years; special cause variation was achieved. Overall, 50% of eligible patients were vaccinated during asthma hospitalization in the postintervention period. Documentation of influenza vaccination status significantly increased from 51% to 96%, and asthma history and physical and order set use also improved. No adverse vaccine reactions were documented. CONCLUSIONS: A bundle of interventions, including EHR modifications, provider and family education, hospital-wide tracking, and a nurse-driven vaccine protocol, increased influenza vaccination rates among eligible children hospitalized with status asthmaticus.
Constipation in Children: A guide to Prompt Diagnosis and Effective Treatment

Constipation Is a common pediatric symptom that can affect children of all ages. It impacts children both physically and psychosocially while also causing significant emotional and financial stress to their families. Constipation presenting early in life can be secondary to conditions such as anorectal malformations, anal stenosis, Hirschsprung disease, spine abnormalities, cystic fibrosis, or metabolic dysfunction. Yet, the majority of children and adolescents who struggle with constipation do so as a result of a functional disorder. Diagnosis Is primarily based on fulfilling defined clinical criteria. Despite being so prevalent, functional constipation is often misdiagnosed and inappropriately treated. Laxative use Is often avoided due to misconceptions related to their efficacy and safety. This review addresses how to effectively diagnose and treat functional constipation in children of different ages and with variable severity at the time of presentation. Guidelines from several medical societies for the evaluation and treatment of a child presenting with constipation have been published. It has become increasingly clear that early treatment of functional constipation is associated with improved long-term outcomes. The diagnostic role of anorectal and colonic manometry has been clarified and these tests have been standardized in the pediatric population. New medical and surgical treatments have been developed and Are leading to improved outcomes in children who fail conventional medical and behavioral interventions. Childhood constipation Requires a comprehensive therapeutic plan, comprised of education, behavioral intervention, and medication that jointly produce effective defecation. Children with chronic constipation who Are unresponsive to maximal medical treatment benefit from further evaluation with colonic transit studies, anorectal and colonic manometry, imaging studies of the spine, and defecography—especially if more invasive interventions such as anal sphincter botulinum toxin injection, appendicostomy, cecostomy, colonic resection, ileostomy, and sacral nerve stimulation are being considered. These children Are best evaluated in specialized centers that offer a multi-disciplinary approach to both the physical and psychosocial components of chronic constipation treatment.
Hemophagocytic Lymphohistiocytosis Occurring in Inflammatory Bowel Disease: Systematic Review

Hemophagocytic lymphohistiocytosis (HLH) is a rare and aggressive syndrome of excessive cytokine requiring prompt recognition and aggressive therapy. We aimed to systematically characterize HLH in moderate-to-severe inflammatory bowel disease (IBD). We performed a systematic review of the literature (PubMED; EMBASE) and FDA Adverse Event Reporting System in accordance with the PRISMA statement. Use of biologics was used as a surrogate definition for disease severity (consistent with usual and contemporary clinical management), to enable identification of rare HLH cases with the highest fidelity. 58 cases of HLH occurring in IBD patients are known (mean age: 26.0 years, 70% male, 83% with Crohn’s disease, mean disease duration 7.0 years). 34.5% of patients were undergoing induction therapy at HLH diagnosis. All cases occurred on patients exposed to anti-TNF agents, but cases with anti-integrin or anti-IL-12/23 exposure were reported. 2/3 of cases did not report prior AZA/6MP exposure. Underlying opportunistic infection or lymphoma was found in > 80% of cases. Survival was 70% if promptly recognized and treated. Five patients restarted biologics after HLH resolved, and one patient developed recurrent HLH. HLH is rare among IBD patients exposed to biologic therapy. Most cases had an identifiable infection or malignancy at the time of diagnosis as well as history of immunomodulator use. Risk factors may include younger age, male gender, presence of Crohn’s disease, and induction phase of treatment. Our study is not intended to assess risk of HLH with specific IBD therapies.
Impact of center volume on outcomes of surgical repair for type A acute aortic dissections.

Background Acute type A aortic dissection is a cardiovascular emergency requiring operative intervention. Despite advancements in operative technique and increased specialization of cardiovascular care, operative mortality, and morbidity after repair of type A aortic dissection remain high. Our aim was to assess national trends in outcomes of type A aortic dissection repair and the impact of institutional thoracic aortic repair volume on clinical outcomes and resource use in the United States. Methods Using the procedural and diagnostic codes of the International Classification of Diseases, Ninth Revision, we identified type A aortic dissection repairs from the 2005 to 2014 database of the National Inpatient Sample. Hospitals were classified into low-, medium- and high-volume tertiles based on annual incidence of thoracic aortic operations. Patient demographics and hospital characteristics, as well as outcomes including mortality, cost, and duration of stay, were evaluated using parametric tests for trends and the volume-outcome relationship. We used a multivariable-adjusted logistic regression model to identify factors associated with mortality. Results An estimated 25,231 patients received type A aortic dissection repair with an increasing temporal trend in volume and concomitant decrease in mortality. When stratified by hospital volume, 10,115 (40.1%), 8,194 (32.4%), and 6,920 (27.4%) underwent type A aortic dissection at low-volume, medium-volume, and high-volume, respectively. The unadjusted mortality rate in high-volume was the least (21.5% vs 16.8% vs 11.6% for low-volume, medium-volume, and high-volume, respectively; P Conclusion The volume of open surgical repair for type A aortic dissection in the United States has increased over the past decade, while mortality has decreased. Hospital aortic operative volume is strongly associated with outcomes for type A aortic dissection repair. Protocols for expeditious transfer of patients to high volume aortic centers may serve to further decrease the acute mortality and complications of this procedure.
“Like, comment, and share”—professional development through social media in higher education: A systematic review

In recent years, professional learning networks (PLNs) and online learning communities of practices (CoPs) enabled by social media have emerged as a conduit and communal space for faculty members to engage in professional learning. This systematic review provides a current synthesis of research surrounding social media and professional development in higher education. Articles published in peer-reviewed journals between 2009 and 2019 were reviewed and 23 articles that met our selection criteria were included for further analysis and synthesis in this review. Findings suggest that research and practice on social media-supported professional learning is still in its infancy stage. Despite that social media-supported PLNs and CoPs show potential for contributing to faculty professional learning, challenges exist in sustaining faculty participation and engagement, as well as effectively navigating the social media space, especially for novice social media users. Practical implications and future research recommendations are discussed.
Left atrial size and strain in elite athletes: A cross-sectional study at the NBA Draft Combine

INTRODUCTION Atrial dilatation is common but of unclear physiologic significance in high-performance athletes. Myocardial deformation analysis utilizing speckle-tracking echocardiography has emerged as a promising tool to evaluate atrial function. In a cohort of elite basketball players attending the National Basketball Association (NBA) Draft Combine, we investigate changes in left atrial (LA) size as well as function as measured by strain. METHODS AND RESULTS From 2013 to 2018, all male athletes who attended the NBA Draft Combine in Chicago, IL, received a cardiac evaluation including a comprehensive transthoracic echocardiogram. Using the P-wave as the reference point, speckle-tracking was utilized to measure LA booster, conduit, and reservoir strain over one cardiac cycle. Left atrial volume index (LAVI) of ≥34 mL/m2 was considered enlarged. 307 athletes received cardiac evaluation including a transthoracic echocardiogram, with 272 studies amenable for atrial strain analysis. Mean age was 21.0 years. Mean LAVI was 34.5 mL/m2 and LAVI was enlarged in 131 (48.2%) athletes. Comparing LA strain in those with enlarged vs normal sized atria, reservoir strain was significantly reduced (32.1% [SD 6.0%] vs 35.2% [SD 8.2%], P < .001), as was conduit strain (22.9% [SD 5.2%] vs 25.7% [SD 7.4%], P < .001), with no difference seen in booster strain (9.2% [SD 2.1%] vs 9.4% [SD 2.7%], P = .45). CONCLUSION In this group of elite basketball players, LA enlargement was common and associated with reduced LA reservoir and conduit strain, with no difference in LA booster strain.
The relationship between terrorist attacks and cryptocurrency returns

Complementing increasing concerns that cryptocurrency could be used to finance terror networks, in this paper we investigate the effect of monthly terrorist attacks outcomes – success, injuries, an...
Dermatoethical Challenges in Education of Medical Students & Dermatology Residents: Opportunities at the Bedside

Ethical issues arise in patient care when an attending physician is accompanied by a learner. Educating patients of the level of experience of all those involved in their care, as well as the importance of allowing trainees to participate is imperative. Obtaining ongoing patient consent to allow physicians in training to participate in patient care is necessary to ensure the professional and ethical competence of the next generation of dermatologists. Additionally, the clinical setting in dermatology offers numerous teaching opportunities to address ethical issues vis-a-vis patient care and the learner. To the student, real-time education in ethics and pragmatic ethical practice equips her with the tools to skillfully handle her own ethical dilemmas in the future. Trainees learn from role modeling, engaged discussion, and immediate feedback, acquiring the tools to make them effective ethical and professional dermatologists. For practicing dermatologists, teaching ethics in this setting provides not only new insights into their beliefs and actions, but forces them to analyze and verbalize their thought processes rather than following ingrained behavior patterns. Cases that illustrate typical ethical dilemmas seen in day-to-day dermatology practice are used to illustrate how effective teaching in ethics and professionalism can occur in the clinic. Additionally, a form/table for recording ethical cases in a standardized way for future reference is provided.
Additive manufacturing of alumina-silica reinforced Ti6Al4V for articulating surfaces of load-bearing implants

Abstract In this study, functional gradation via layer-wise additive manufacturing was coupled with Al2O3 and SiO2 ceramics' advantages to creating a composite of Ti6Al4V (Ti64) with improved hardness and wear resistance. It was hypothesized that with Al2O3 and SiO2 into Ti64, wear-resistance and hardness would increase compared to the base Ti64 alloy. It was also hypothesized that if the structure could be created, an additional laser pass (LP) over the structure's top surface would further increase the hardness. Successfully fabricated composite structures were found to have varying phases of TiSi2 and Ti5Si3. Refined α-Ti grains were present in the composite region. The interface between the composite and pure Ti64 regions was crack-free, indicating a metallurgically sound bond. Dendritic microstructures were observed with the addition of LP on the composite top surface. Hardness was increased from 323.8 ± 9.6 HV in Ti64 substrate to 434.7 ± 7.3 HV, and 677.1 ± 29.7 HV in 3D Printed Ti64 and the composite sample, respectively. An LP increased hardness further to 938.8 ± 57.5 HV, a 186% increase in hardness than the original Ti64 alloy. Wear resistance was also increased with the addition of Al2O3 and SiO2 by ~90%, indicating the potential processing variations placed on this material system to produce structures with site-specific functionality for biomedical applications, particularly in articulating surfaces of load-bearing implants.