cssi/SciSciGPT-SciSciNet huggingface dataset:
Acquisition of hyaluronate-binding affinity in vivo by newly synthesized cartilage proteoglycans

Abstract We have studied the hyaluronate-binding properties of aggregating cartilage proteoglycans synthesized in vivo by immature (6-week), mature (25-week) and aged (75-week) rabbits. Precursor isotope (35SO4) was given by intra-articular injection and articular cartilage was removed from rabbits after periods ranging from 1.5 h to 168 h. Proteoglycans were extracted with 4 M-guanidinium/HCl and monomers were isolated by CsCl gradient centrifugation under dissociative conditions. The percentages of both radiolabelled and total tissue monomers with a high affinity for hyaluronate [that is, capable of forming aggregates on Sepharose CL-2B in the presence of 0.8% (w/w) hyaluronate] were then determined. For all samples about 30% of the tissue monomers were high-affinity; however, less than 5% of the radiolabelled monomers were high-affinity at 1.5 h after injection, and this figure increased gradually with time in vivo. The increase was rapid in immature rabbits, such that after 24 h, about 30% of the radiolabelled monomers were high-affinity; on the other hand for mature and aged rabbits the increase was markedly slower such that 30% high-affinity was attained only after about 72 h. The results show that aggregating cartilage proteoglycans are secreted in vivo in a 'precursor' form with a low affinity for hyaluronate, and suggest that conversion of these monomers to a form with a higher binding affinity occurs with a half-time of about 12 h in immature cartilages but greater than 24 h in mature cartilages. The possible relationship of these findings to the process of proteoglycan aggregation in vivo is discussed.
The influence of androgens on insulin resistance.

Insulin resistance (IR) in polycystic ovary syndrome (PCO) has been linked to hyperandrogenism and elevated luteinizing hormone (LH) levels. Fourteen patients with idiopathic hirsutism (IH), 13 with PCO, and 6 control subjects were investigated for assessment of the effects of serum LH, peripheral tissue androgens, and sex hormone-binding globulin (SHBG) on fasting immunoreactive insulin (IRI) levels. Serum LH, dehydroepiandrosterone sulfate, dihydrotestosterone, and 3α-androstanediol, SHBG, and unbound testosterone (uT) were measured. Serum testosterone (T) showed a positive correlation with IRI (P
Time Series Classification under More Realistic Assumptions.

Most literature on time series classification assumes that the beginning and ending points of the pattern of interest can be correctly identified, both during the training phase and later deployment. In this work, we argue that this assumption is unjustified, and this has in many cases led to unwarranted optimism about the performance of the proposed algorithms. As we shall show, the task of correctly extracting individual gait cycles, heartbeats, gestures, behaviors, etc., is generally much more difficult than the task of actually classifying those patterns. We propose to mitigate this problem by introducing an alignment-free time series classification framework. The framework requires only very weakly annotated data, such as “in this ten minutes of data, we see mostly normal heartbeats...,” and by generalizing the classic machine learning idea of data editing to streaming/continuous data, allows us to build robust, fast and accurate classifiers. We demonstrate on several diverse real-world problems that beyond removing unwarranted assumptions and requiring essentially no human intervention, our framework is both significantly faster and significantly more accurate than current state-of-the-art approaches.
On Origins and Beginnings

Seong-Kon Kim's Journey into the Past: The Historical and Mythical Imagination of Barth and Pynchon, the tenth In Seoul National university's American studies monograph series, grounds itself on an analogy: that like Vice, Nietzsche, Foucault, and Derrida, Barth and Pynchon (whom Kim regards as central to their novelistic generation) have recourse to history and the myths of the past in order to repudiate them in a quest for "new order, new language, or new imagination" (1). According to Kim, postmodernist American fiction and post-structuralist literary theory "ultimately unite and correspond to each other in their perception and interpretation of contemporary reality" (1), one which Kim describes as "the nightmare landscape where the truth is absent" (32).
Changes in the concentration of hypothalamic and hypophyseal receptors for estradiol in pregnant and postpartum ewes.

The sensitivity of the hypothalamic-pituitary axis to estradiol was evaluated by monitoring changes in the concentration of receptors for estradiol during gestation and the postpartum period of the ewe. Ewes that had been bred during anestrus so that lambing would occur during the breeding season were killed on d 50 and 140 of gestation or on d 2, 13, 22 and 35 postpartum. Total cytosolic receptors for estradiol were quantified in the anterior and posterior hypothalamus, median eminence, anterior pituitary and cerebral cortex. Concentration and total number of receptors for estradiol in the anterior and posterior hypothalamus and anterior pituitary gland during gestation through d 13 postpartum were similar but increased (P less than .05) by d 22 and 35 postpartum. Changes in the concentration of receptors for estradiol were tissue-specific because stage of reproduction did not influence the number of receptors for estradiol in the median eminence or cerebral cortex. Increases in the concentration of receptors for estradiol in hypothalamic and pituitary tissues on d 22 postpartum immediately preceded the onset of normal ovarian cyclicity in ewes. From these data we conclude that resumption of reproductive cycles in postpartum ewes occurs about the time concentrations of receptors for estradiol in the anterior pituitary gland and hypothalamus increase.
Pinyon-juniper removal has long-term effects on mammals

Abstract Removing tree cover is a common forest management practice, and pinyon-juniper woodlands in the western United States have been the focus of tree reduction efforts for decades. The scale and intensity of tree removal practices are expected to increase as technology advances and as land managers are tasked with meeting multiple objectives, including fire prevention and habitat enhancement for livestock and wildlife of conservation concern. However, the long-term consequences of pinyon-juniper removal on animal communities are virtually unknown. The objectives of this study were to assess whether mammal habitat use differs between reference pinyon-juniper woodlands and stands that were mechanically disturbed by chaining more than 40 years ago, and to determine if these differences are associated with particular habitat characteristics. We used remotely triggered wildlife cameras to evaluate differences in mammal habitat use of historically chained sites (n = 22) and reference sites (n = 22) in northwestern Colorado. Our results demonstrate marked differences in habitat use between chained sites and reference woodlands for most detected mammal species. Bobcat, mountain lion, American black bear, golden-mantled ground squirrel, and rock squirrel all showed a negative response to historically chained sites, indicating long-term effects of tree removal on these species. In contrast, habitat use of chipmunk, mountain cottontail, and coyote did not differ between chained and reference sites. For most species, habitat use was influenced by specific vegetation characteristics, such as proportion of tree cover, which could be factored into management decisions. By understanding the long-term consequences of tree removal for diverse mammal species, we are better equipped to adapt forest management practices to benefit species of both economic and conservation concern.
Canonical and log canonical singularities

In this chapter we introduce the singularities – terminal, canonical, log terminal and log canonical – that appeared in connection with the minimal model program. Section 2.1 contains the basic definitions and their fundamental properties. Whenever possible, we work with schemes, rather than just varieties over a field of characteristic 0. Section 2.2 starts a detailed study of log canonical surface singularities. Here we focus on their general properties; a complete classification is postponed to Section 3.3. Ramified covers are studied in Section 2.3. This method gives a good theoretical framework to study log canonical singularities and their deformations in all dimensions, as long as the degree of the cover is not divisible by the characteristic. Ramified covers have been especially useful in dimensions 2 and 3, leading to a classification of 3-dimensional terminal, canonical and log terminal singularities in characteristic 0. A short summary of this approach is given in Section 2.4. These topics are excellently treated in Reid (1980, 1987). Divisorial log terminal singularities and their rationality properties are investigated in Section 2.5. Roughly speaking, these form the largest well-behaved subclass of log canonical singularities. We prove that they are rational and many important sheaves on them are Cohen-Macaulay (2.88), at least in characteristic 0. This section also shows the two, rather pervasive, problems that arise when one tries to generalize results of birational geometry to positive and mixed characteristics.
Model-based control and analysis of anthropomorphic walking

This dissertation proposes advanced feedback controllers that allow bipedal robots to perform anthropomorphic walking. The motion is confined to the sagittal plane and the robots possess at least two identical legs and a torso. Walking is composed of alternating single support and double support phases. A model of a planar, underactuated robot with point feet is extended in two ways to include two facets of walking with feet. An impulsive actuator is attached to the end of each leg to approximate the push-off observed in human walking just before double support is initiated and an additional link is attached to the end of the leg via a revolute joint with actuation to model a foot plus ankle during the single support phase. The robot with the impulsive actuator at each leg is modeled as an underactuated bipedal robot whose dynamics is governed by a set of Lagrangian differential equations during the single support phase. The double support phase is composed of two instantaneous subphases and described by an algebraic map. Key to the control-law design is the creation of a two-dimensional surface that is invariant under the Lagrangian dynamics and the combined impulsive forces from impact with the ground and the impulsive actuation. Simulation is conducted to show that the model with the impulsive action is more energy efficient than the robot without impulsive actuation. The robot model with the impulsive actuator is applied to study walking during load carrying, with the objective of partially explaining the extraordinary energy efficiency of women of the Luo and Kikyu tribes when carrying loads. A model of load carrying in the Luo style shows that the walking efficiency observed in these women is nearly energy optimal. Two models of walking with loads is proposed for an untrained group of walkers, and the results are compared to energy-optimal walking. It is found that with a light load, reducing energy consumption at the stance knee leads to a more energy efficient gait whereas reducing energy consumption at the hips is more beneficial when the load is heavy. The single support phase of a robot with feet and a revolute actuated ankle is composed of two subphases, each represented by sets of differential equations, and an instantaneous double support phase. The single support phase begins with a fully-actuated (flat-footed) phase followed by an underactuated (toe-rolling) phase. A two-dimensional invariant surface is created in each subphase. While the Zero Moment Point (ZMP) is applied to ensure that the stance foot does not rotate over the stance toe during the flat-footed phase, the stability of the robot's gait is proved using the Poincare return map on the invariant surfaces. A corollary of the analysis shows that the oft-used ZMP principle is not sufficient for a stable periodic orbit.
Froggatt-Nielsen model for leptophilic scalar dark matter decay

We construct a model of decaying, TeV-scale scalar dark matter motivated by data from the PAMELA and Fermi-LAT experiments. By introducing an appropriate Abelian discrete symmetry and an intermediate scale of vectorlike states that are responsible for generating lepton Yukawa couplings, we show that Planck-suppressed corrections may lead to decaying dark matter that is leptophilic and has the desired lifetime. The dark matter candidate decays primarily to lepton/antilepton pairs, and at a subleading rate to final states with a lepton, antilepton and standard model Higgs boson. We show that the model can reproduce the observed positron flux and positron fraction while remaining consistent with the bounds on the cosmic ray antiproton flux.
Reversan, a novel inhibitor of MRP1, increases the therapeutic index of conventional chemotherapeutic agents

3242 One of the major causes of treatment failure in human malignancies is intrinsic or acquired multidrug resistance that can be mediated by ABC transporters, such as P-glycoprotein or the multidrug resistance-associated protein (MRP1). MRP1 has been closely linked to poor treatment response in several cancers, most notably neuroblastoma. Using a cell-based readout system, we previously identified the pyrazolopyrimidine, Reversan, as a potent modulator of MRP1-mediated drug resistance both in vitro and in vivo. We have found that not only was Reversan effective in vitro against neuroblastoma, it increased the sensitivity of other drug refractory tumor cells (e.g. colon and renal cell carcinoma) to conventional chemotherapeutic agents that were themselves substrates for MRP1 (e.g. doxorubicin, vincristine and etoposide). Analysis of transporter specificity revealed that Reversan was effective against both MRP1 and P-glycoprotein but not against MRP2-5. In an effort to structurally optimize Reversan for the identification of more potent compounds with superior pharmacological properties, we tested 26 structural analogs of Reversan for their ability to reverse the resistance of MRP1-overexpressing cells to cytotoxic drugs. Twenty of the twenty-six analogs increased the sensitivity of MDCKII-MRP1 cells to vincristine to at least the level observed in the parental cells, which do not overexpress MRP1. However, Reversan remained the most potent pyrazolopyrimidine evaluated. To date, we have determined that Reversan can increase the in vivo efficacy of chemotherapeutic agents (e.g. etoposide) when administered either intraperitoneally or orally in the absence of increased toxicity. In addition, this molecule did not contribute to thrombocytopenia but rather appeared to protect against neutropenia in mice treated with etoposide. Therefore, Reversan represents a new class of non-toxic MRP1 inhibitor that may be clinically useful for the treatment of neuroblastoma and other MRP1-positive tumors by increasing the sensitivity of these drug refractory tumors to conventional chemotherapeutic agents.
Clinicopathological analysis of ATRX, DAXX and NOTCH receptor expression in angiosarcomas.

AIMS Multiple genetic alterations, including alternative lengthening of telomeres (ALT) and NOTCH mutations, have been described in angiosarcoma. Loss of α-thalassaemia/mental retardation syndrome X-linked (ATRX) and death domain-associated protein 6 (DAXX) expression is frequently associated with the ALT phenotype. Additionally, inhibition of NOTCH signalling induces the development of malignant vascular tumours in mice, indicating a tumour suppressive role of the NOTCH pathway in the pathogenesis of angiosarcoma. The aim of this study was to evaluate the immunohistochemical expression of ATRX, DAXX and NOTCH receptors (NOTCH1 and NOTCH2) in a large cohort of angiosarcomas, and study their clinicopathological and prognostic significance. METHODS AND RESULTS One hundred and forty cases of angiosarcoma were stained for ATRX, DAXX, NOTCH1 and NOTCH2. ATRX loss (<10% labelling) was seen in seven of 118 (6%) cases, and was more frequent in deep soft tissue tumours than in other body sites (P = 0.004). Angiosarcomas with ATRX loss were associated with worse event-free survival than angiosarcomas with retained ATRX expression (P = 0.003). DAXX was retained in all specimens examined. Decreased NOTCH1 expression (≤1+ intensity) was seen in 29 of 123 (24%) cases, and was associated with a cutaneous site of origin (P = 0.013) and advanced disease (P = 0.026). NOTCH2 expression was decreased in 16 of 103 (16%) cases, was associated with visceral tumours (P = 0.001), and correlated with worse disease-specific survival (P = 0.033). CONCLUSIONS ATRX, NOTCH1 and NOTCH2 expression varies in angiosarcomas and shows significant correlations with site of origin and poor clinical outcome, thus highlighting the biological heterogeneity within this tumour type.
Effects of multiple mutualists on plants and their associated arthropod communities.

Although most studies of mutualisms focus on a single partner at a time, host species often associate with multiple mutualist partners simultaneously. Because of potential interactions between mutualists, only studying a single type of mutualism could lead to a biased perspective of mutualism benefit and how mutualisms may scale-up to affect communities. The legume Chamaecrista fasciculata engages in a resource mutualism with nitrogen-fixing rhizobia and also forms symbiotic interactions with ants by providing nectar in exchange for defense against herbivores. Although they provide very different benefits to the plant, both mutualists receive carbon resources from the plant. As a result, these two mutualists are likely to interact, potentially competing for carbon resources or mutually benefitting each other via their positive effects on plant hosts. In a full-factorial field experiment, we explored how rhizobia and ants influence one another, C. fasciculata fitness, and the associated arthropod community. Ants reduced plant allocation to rhizobia, but ants also increased rhizobia contamination of uninoculated plants, suggesting that ants may disperse rhizobia. In turn, rhizobia increased ant abundances, with ants preferentially tending plants with rhizobia. Chamaecrista fasciculata received substantial fitness benefits from rhizobia; in contrast, associating with ants reduced fitness. Additionally, the mutualists interacted to influence the abundance of other arthropods found on the plants. Rhizobia increased arthropod abundances, likely because more nitrogen-rich leaf tissue was more attractive to arthropod herbivores, but ants negated these increases. As these results illustrate, multiple mutualists may interact, influencing each other’s abundance and the abundance of other community members.
Prevention of Contrast-Associated Acute Kidney Injury.

Contrast-associated acute kidney injury signifies a severe and usually reversible decline in kidney function that may develop within 72 hours after intravascular administration of iodinated contras...
The Role of Structure Confinement in the Energy Level Schemes of Physical Systems

This article is based on the lectures that I delivered at the beginning of the course “Spectroscopy of Systems with Spatially Confined Structures,” a NATO Advanced Study Institute held at Erice, Italy, June 15–30, 2001.
Yttrium and the Rare Earth Elements (REE)

The Eh-pH diagrams, for yttrium and the rare earth element species are shown in Figs. 65–79. The thermodynamic data for important yttrium and the rare earth element species are given in Table 50.
Chordee without hypospadias in children.

AbstractWe discuss 20 children who have undergone surgical correction of chordee without hypospadias. In 9 patients ventral curvature was demonstrated secondary to corporeal disproportion, 8 had chordee secondary to deficiency of the dartos fascia (skin chordee) and 3 had deficiency of the dartos and Buck’s fasciae. Eight patients underwent excision of dorsal ellipses according to the Nesbit principle, 8 had lysis of the dartos fascia using the Allen-Spence technique, 2 underwent mobilization of the urethra with excision of underlying fibrous tissue and 2 had division of the urethra with a staged urethroplasty. The majority of cases of chordee without hypospadias are a result of anomalies of the tissue layers of the penis, and adequate straightening can be achieved by excision of underlying abnormal fascial tissue. All patients have achieved a satisfactory cosmetic and functional result with a straight penis and a urethral meatus positioned distally at the glans tip
Stereotactic body radiation therapy to generate comparable survival to surgery in treating hepatocellular carcinoma (HCC): Results of 756 patients.

4080Background: Stereotactic Body Radiation Therapy (SBRT) has emerged as a viable treatment option in patients with hepatocellular carcinoma (HCC). This study aimed to compare survival outcomes af...
A Key Exchange Based on the Short Integer Solution Problem and the Learning with Errors Problem.

Short integer solution (SIS) and learning with errors (LWE) are two hard lattice problems. These two problems are believed having huge potential in application of cryptography. In 2012, Ding et al. [5] introduced the first provably secure key exchange based on LWE problem. On the other hand, we believe that it is very difficult to do key exchange on SIS problem only. In 2014, Wang et al. [6] did an attempt, but it was not successful. Mao et al. [7] broke the protocol by an attack based on CBi-SIS problem in 2016. However, their attack is not efficient. In this paper, we present a extremely straightforward and simple attack to Wang’s key exchange and then we will construct a key exchange based on SIS and LWE problems.
Regularized Phase Reconstruction for Sensing Deep Subwavelength Perturbations on Large-Scale Wafers

We demonstrate that deep subwavelength scale perturbations on large-scale wafers can be inspected using a regularized phase metrology method. This work paves the route to reference-free defect inspection for nanostructures at advanced technology nodes.
The impact of immune status on clinical outcomes in patients with Merkel cell carcinoma.

8590 Background: Merkel Cell Carcinoma (MCC) is an aggressive cutaneous malignancy of neuroendocrine origin associated with immunosuppression presumably through infection with Merkel Cell Polyomavi...
Modern gastrointestinal endoscopic techniques for biliary tract cancers

Biliary tract cancers, specifically cholangiocarcinomas (CCAs), arise from the epithelial cells of the biliary tree. They can be divided into three groups based on their location: intra-hepatic, peri-hilar or distal extra-hepatic CCAs. Traditionally, the main role of endoscopy in the management of biliary tract cancers was diagnosis and biliary decompression. For diagnosis, endoscopic retrograde cholangiopancreatography (ERCP) can be used to obtain either brushings or intra-ductal biopsies however both techniques have poor sensitivity. The introduction of cholangioscopy has allowed endoscopists to perform both targeted biopsies and also obtain a visual diagnosis. Similarly, with the spread of endoscopic ultrasound (EUS), the ability to obtain tissue by fine-needle aspiration is another avenue available, but concerns regarding tumor seeding still persist. For biliary decompression, with the advent of neo-adjuvant therapy, the role of early decompression is growing. Nevertheless, it is still not clear whether endoscopic decompression is superior to percutaneous decompression, especially in advanced hilar tumors. When possible, at least 50% of viable liver should be drained, and that will determine whether unilateral or bilateral stents are required. Additionally, there is growing evidence on the benefits of metal stents over plastic stents, but care should be taken as metal stents are generally permanent. Finally, although not widely available or adopted, with the growing use of radiofrequency ablation and the introduction of drug-eluting metal stents, the near-future might allow newer techniques to treat the disease itself.
EHR Overtime: An Analysis of Time Spent After Hours by Family Physicians.

Background and objectives Time spent in the electronic health record (EHR), away from direct patient care, is associated with physician burnout. Yet there is a lack of evidence quantifying EHR use among family physicians. The purpose of the study was to describe a method for quantifying habits and duration of use within the electronic health record in family medicine residents and faculty with particular attention paid to time spent after hours. Methods We audited EHR time for family medicine residents and faculty using an EHR vendor-provided, web-based tracking system. We collected and analyzed the number of patient encounters, total time in the EHR per patient, total time in the EHR after hours by physicians for a 6-month time period. Results Over the 6-month period reviewed, family medicine trainees and faculty saw between one and 164 patients monthly, spent between 17 and 217 minutes in the EHR per patient, and spent between 0 and 33 hours in the EHR after hours per month. Conclusions Family medicine residents spend a significant amount of time completing EHR tasks after hours. Objective EHR data can be used by family medicine residency programs to devise interventions to decrease inefficient use of the EHR, decrease after-hours EHR use, and improve well-being.
Little Leaf Notcher (suggested common name) Artipus floridanus Horn (Insecta: Coleoptera: Curculionidae)

Artipus floridanus Horn, also known as the little leaf notcher, is a secondary pest of citrus and several ornamental plants in Florida and the Caribbean. This species is in the order Coleoptera, the beetles, and the family Curculionidae, the weevils and snout beetles. It was first described by Horn in 1876 (Poole 1996). https://edis.ifas.ufl.edu/in1264 Also available at: http://entnemdept.ufl.edu/creatures/CITRUS/Artipus_floridanus.html
Vegan Studies as Ecofeminist Intervention

espanolEl 5 de noviembre de 2019, 11.000 cientificos de 153 paises declararon una emergencia climatica, y su informe presenta con terminos severos la naturaleza y certeza de la crisis, proporcionando seis vias, una de las cuales se centra en la agricultura: “comer principalmente comidas de origen vegetal a la vez que reducir el consumo de productos animales…puede mejorar la salud humana y reducir de forma significativa las emisiones de gases de efecto invernadero” (Ripple et al. 4). Se nos ha ofrecido un plan para ayudarnos a mediar en esta crisis, pero ?que necesitaremos para reaccionar o, lo que es mas, para debatir el “tema animal” de maneras que no se basen en el miedo corrosivo y el desden premeditado hacia el consumo de origen vegetal? En este ensayo ofrezco un enfoque desde los estudios veganos como intervencion ecofeminista teorica y vivida en un momento politico que se caracteriza por la incertidumbre medioambiental, el racismo evidente, misoginia, y las politicas antinmigracion que se han fusionado con la supuesta amenaza que el veganismo plantea a un presente cada vez mas autoritario. EnglishOn November 5, 2019, 11,000 scientists from 153 countries declared a climate emergency, and their report presents in stark terms the nature and certainty of the crisis, providing six paths forward, one of which focuses on agriculture: “eating mostly plant-based foods while reducing the global consumption of animal products…can improve human health and significantly lower GHG emissions” (Ripple et al. 4). We have been given a plan to help us mediate this crisis, but what will it take for us to act on it, or, for that matter, to discuss the “animal question” in ways that are not predicated on vitriolic fear and willful disdain of plant-based consumption? In this essay, I offer a vegan studies approach as a theoretical and lived ecofeminist intervention in a political moment characterized by environmental uncertainty, overt racism, misogyny, and anti-immigrant policies that have become conflated with the presumed threat veganism poses to an increasingly authoritarian present.
Medical Simulation-Based Learning Outcomes in Pre-Clinical Medical Education.

Introduction Medical simulation is widely used in the United States medical curriculum. However, learning outcomes based on simulation have yet to be reported. In this study, we aim to characterize the objective performance of first- and second-year medical students following eight weeks of medical simulation-based learning. Methods First- (n=25) and second-year (n=15) medical students were recruited for this study. We designed and administered a novel pre-experience examination to collect participant demography and assess simulation and non-simulation knowledge. Following 14 high-fidelity simulation scenarios over the course of eight weeks, we administered an identical post-experience examination and compared performance, primarily using a within-subjects analytic design. Results Student performance improved by an average of 18% following the medical simulation experience, and first-year students demonstrated greater benefit (22%) as compared to second-years (12%). Relative to first-years, second-year students showed higher overall performance on both pre- and post-examination. Demographic factors and prior medical experience were not significantly associated with assessment performance and score improvement. Conclusions Our data supported the efficacy of simulation-based learning as evidenced by the significant improvement in objective performance on a standardized examination. That is, both first- and second-year medical students demonstrated test-score improvement following an eight-week medical simulation program. Of note, the first-year students exhibited greater benefit (at the group level). Importantly, these findings were statistically unrelated to participant demographic and background variables. Collectively, this study provides preliminary evidence that medical simulation in the pre-clinical phase of undergraduate medical education is an effective tool for student learning.
Retinal Ganglion Cell and Inner Plexiform Layer Loss Correlate with Visual Acuity Loss in LHON: A High-Resolution, Longitudinal, Segmentation OCT Analysis (P1.329)

OBJECTIVE: To identify longitudinal retinal changes in Leber’s Hereditary Optic Neuropathy (LHON) using Optical Coherence Tomography (OCT) auto-segmentation and to determine whether a relationship exists between structural changes and vision loss. BACKGROUND: A structure-function relationship has yet to be established in LHON DESIGN/METHODS: Nine patients with Leber’s confirmed mitochondrial mutations underwent periodic neuro-ophthalmologic examinations and high resolution spectral-domain optical coherence tomography with automated retinal segmentation to identify each retinal layer and quantify its thickness and volume. Values were calculated for four quadrants and central fovea for each retinal layer corresponding to the Early Treatment Diabetic Retinopathy Study areas. RESULTS: The ganglion cell layer (GCL) showed progressive thinning beginning immediately at onset of visual loss in the nasal quadrant followed by all other macular quadrants at one month post-onset (p<0.03). At least 57[percnt] ganglion cell layer loss was observed in all quadrants by six months after onset (p<0.001). A similar pattern and timing of thinning was noted for the inner plexiform layer (p<0.001). Peripapillary Retinal Nerve Fiber Layer thinning was observed after 3 months post disease onset and was not associated with vision loss. A relationship was observed between visual acuity loss and GCL and IPL thinning. Each micron of GCL thinning (while age and disease duration were fixed) was associated with 0.05 logMAR vision loss (p<0.001 for all quadrants). CONCLUSIONS: For the first time, a structure-function relationship has been established in LHON. As therapeutic genetic trials for Leber’s have begun, the finding of progressive ganglion cell and inner plexiform layer thinning during the first six months define a target for early intervention and the limited time of a therapeutic window. Study Supported by: Disclosure: Dr. Moster has nothing to disclose. Dr. Moster has received personal compensation for activities with Biogen Idec and Acorda Therapeutics as a speaker or consultant. Dr. Sergott has received personal compensation for activities with Biogen Idec, EMD Serono, Teva Neuroscience, Lundbeck Research USA, Inc., Pfizer Inc., ThromboGenics, Sanofi-Aventis Pharmaceuticals, Inc., Novartis, BioClinica, Covance, Basilea Pharmaceu
A Web-Based User Interface for HRI Studies on Multi-Robot Furniture Arrangement

This video presents a remote user interface (UI) for controlling a multi-robot furniture system intended to enable human-robot interaction studies safely during the COVID-19 pandemic. The three primary features of the system are detailed. The first, a web-based architecture, allows the operation of our chair robots (ChairBots) over the internet. Second, multiple ChairBots are simultaneously operable. Third, variable levels of autonomy allow an operator to send both high-level, with robots autonomously moving to goals, or low-level motion commands. This work presents advances in the technical capabilities of our ChairBot system, representing progress towards a viable multi-robot furniture system.
Cognitive endophenotypes in racially- and ethnically-diverse middle-aged adult offspring aggregate with parental magnetic resonance imaging biomarkers of Alzheimer's disease risk

A family history of Alzheimers disease (AD) increases risk for AD in an individual by 1.5-to 3-fold. Heritability of AD risk may be due in part to the aggregation of neurodegeneration and cerebrovascular changes with cognitive endophenotypes within families. The purpose of this study was to determine the extent to which cognitive functioning in middle-aged adults is associated with objectively-measured neurodegenerative and cerebrovascular neuroimaging markers linked to risk for clinical AD in their parents, and the extent to which these associations differ by race/ethnicity and language, as proxy variables for social advantage. Middle-aged children enrolled in the Offspring study (n=356; 53.1{+/-}10.1 years old; 13% Non-Hispanic White, 27% Non-Hispanic Black, 26% Latinx tested in English, 34% Latinx tested in Spanish; 65% women; 13.5{+/-}3.4 years education) were administered the NIH Toolbox, a computerized neuropsychological battery, in their preferred language. Older adults were a subset of the Washington-Heights Inwood Columbia Aging Project (77.3{+/-}6.6 years old; 75% women; 10.0{+/-}4.6 years education) who underwent T1w- and T2w-MRI and who had a child enrolled in the Offspring study. We tested the associations of parental MRI measures reflecting neurodegeneration (hippocampal volume, cortical thickness) and cerebrovascular disease (white matter hyperintensity (WMH) volume, presence of infarct) with cognitive tests scores in Offspring participants. We further stratified the models by race/ethnicity. Better offspring cognitive scores aggregated lower parental neurodegeneration and cerebrovascular disease among Non-Hispanic White and Latinx participants, and with lower parental cerebrovascular disease alone among Non-Hispanic Black participants. Associations were generally strongest in Non-Hispanic White participants compared to the other groups. These results suggest a more consistent link between offspring cognitive endophenotype and parental brain health in intergenerational AD transmission among Non-Hispanic White participants compared to racial/ethnic and minority groups in which other social factors may be adding variance.
Association of oral microbiota with lung cancer risk in a low-income population in the Southeastern USA

Oral microbiome plays an important role in oral health and systemic diseases, including cancer. We aimed to prospectively investigate the association of oral microbiome with lung cancer risk. We analyzed 156 incident lung cancer cases (73 European Americans and 83 African Americans) and 156 individually matched controls nested within the Southern Community Cohort Study. Oral microbiota were assessed using 16S rRNA gene sequencing in pre-diagnostic mouth rinse samples. Paired t test and the permutational multivariate analysis of variance test were used to evaluate lung cancer risk association with alpha diversity or beta diversity, respectively. Conditional logistic regression models were used to evaluate the association of individual bacterial abundance or prevalence with lung cancer risk. No significant differences were observed for alpha or beta diversity between lung cancer cases and controls. Abundance of families Lachnospiraceae_[XIV], Peptostreptococcaceae_[XI], and Erysipelotrichaceae and species Parvimonas micra was associated with decreased lung cancer risk, with odds ratios (ORs) and 95% confidence intervals (CIs) of 0.76 (0.59–0.98), 0.80 (0.66–0.97), 0.81 (0.67–0.99), and 0.83 (0.71–0.98), respectively (all p < 0.05). Prevalence of five pre-defined oral pathogens were not significantly associated with overall lung cancer risk. Prevalence of genus Bacteroidetes_[G-5] and species Alloprevotella sp._oral_taxon_912, Capnocytophaga sputigena, Lactococcus lactis, Peptoniphilaceae_[G-1] sp._oral_taxon_113, Leptotrichia sp._oral_taxon_225, and Fretibacterium fastidiosum was associated with decreased lung cancer risk, with ORs and 95% CIs of 0.55 (0.30–1.00), 0.36 (0.17–0.73), 0.53 (0.31–0.92), 0.43 (0.21–0.88), 0.43 (0.19–0.94), 0.57 (0.34–0.99), and 0.54 (0.31–0.94), respectively (all p < 0.05). Species L. sp._oral_taxon_225 was significantly associated with decreased lung cancer risk in African Americans (OR [95% CIs] 0.28 [0.12–0.66]; p = 0.00012). Results from this study suggest that oral microbiota may play a role in the development of lung cancer.
Reckoning with Asian America and the New Culture War on Affirmative Action

The latest battle over affirmative action in university admissions may soon reach the U.S. Supreme Court, and a ruling in the plaintiff’s favor will end affirmative action in higher education across the nation. Asian Americans have taken center stage in this new culture war, fueled by the reigning narrative that they are victims of the policy who are unjustly penalized because of their race in spite of their competence. Opponents of affirmative action have effectively wielded competence—and more specifically hyper‐competence—to mark moral deservingness as they push to retreat from race in the name of merit. The onset of Covid‐19, however, has laid bare this impossibility for Asian Americans as the surge of hate incidents has affected one in eight Asian American adults in 2020, underscoring that presumed competence is no shield from xenophobia, and moral deservingness is no protection from anti‐Asian hate. This project highlights how U.S. immigration law, science, and medicine do more than reflect social constructions of race, merit, and moral deservingness;they also produce and reproduce them. I close by arguing that reckoning with Asian America enables us to dismantle the tropes that propel the latest culture war on affirmative action, equips us to rewrite narratives about merit and moral deservingness, and invites us to re‐imagine the linked fate and linked futures of Asian Americans and other minoritized groups. [ABSTRACT FROM AUTHOR] Copyright of Sociological Forum is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Continental-scale contributions to the global CFC-11 emission increase between 2012 and 2017

Abstract. The early detection of a global emission increase of CFC-11 after 2012 (Montzka et al., 2018) alerted society to a possible violation of the Montreal Protocol on Substances that Deplete the Ozone Layer (MP). This early alert resulted in parties participating in the MP taking urgent actions (United Nations Environment Programme (UNEP), 2019). As a result, atmospheric measurements made in 2019 suggest a sharp decline in global CFC-11 emissions (Montzka et al., 2021). Despite the success in the early detection and mitigation of some of this problem, regions fully responsible for the recent global emission changes of CFC-11 have not yet been identified. Roughly two thirds (60 ± 40 %) of the emission increase between 2008–2012 and 2014–2017 and two thirds (60 ± 30 %) of emission decline between 2014–2017 and 2019 was explained by regional emission changes in eastern mainland China (Park et al., 2021; Rigby et al., 2019). Here, we used atmospheric CFC-11 measurements made from two global aircraft surveys, the HIAPER Pole-to-Pole Observations (HIPPO) in November 2009–September 2011 and the Atmospheric Tomography Mission (ATom) in August 2016–May 2018, in combination with the global CFC-11 measurements made by the U.S. National Oceanic and Atmospheric Administration during these two periods, to derive global and regional emission changes of CFC-11. Our results suggest Asia accounted for the largest fractions of global CFC-11 emissions in both periods, 43 (37–52) % during November 2009–September 2011 and 57 (49–62) % during August 2016–May 2018. Asia was also primarily responsible for the emission increase between these two periods, accounting for 86 (59–115) % of the global CFC-11 emission rise between the two periods. Besides eastern mainland China, we find that temperate western Asia and tropical Asia also contributed significantly to global CFC-11 emissions during both periods and likely to the global CFC-11 emission increase between these periods. Besides Asia, the atmospheric observations also provide strong constraints on CFC-11 emissions from North America and Europe, suggesting that each of them accounted for 10–15 % of global CFC-11 emissions during the HIPPO period and smaller fractions in the ATom period. For South America, Africa, and Australia, the derived regional emissions had larger dependence on the prior assumptions of emissions and emission changes, due to a lower sensitivity of the observations considered here to emissions from these regions. However, significant increases in CFC-11 emissions from the southern hemispheric lands were not likely due to the observed increase of north-to-south interhemispheric gradients in atmospheric CFC-11 mole fractions from 2012 to 2017.
Primary care in the United States. Innovations in primary care in the United States

# Innovations in primary care in the United States {#article-title-2} It has been said that primary care in the United States faces the worst of times and the best of times.1 Why the worst of times? Primary care was catapulted into prominence by the advent of health maintenance organisations; many of such organisations' 80 million patients were required to gain permission from their primary care physician to access laboratory, radiology, and specialty services. Because the number of people enrolled in health maintenance organisations is declining, more patients are free to move around the healthcare system. The United States may revert to its previous dispersed system of care, in which patients enter the specialty-dominated system through a variety of doors rather than through a single primary care entrance. When health maintenance organisations moved primary care to a central position in health care, they expected primary care physicians to do far more for their patients than before,2 yet they paid little more, if at all, for these additional tasks. Primary care physicians were looking more and more like the “hamsters on a treadmill” described in an article in the BMJ .3 In California, the proportion of primary care physicians very satisfied with their work dropped from 48% in 1991 to 36% in 1996.4 In the past few years, medical students have become less interested in making a career in primary care because of the long hours, high stress, and relatively low reimbursement of generalist physicians.5 #### Summary points Primary care in the United States is facing difficult times: doctors are overworked and dissatisfied with it, and medical students are not very interested in it Primary care is unable to deliver everything expected of it and offers neither timely access to acute care nor state of the art chronic care A redesign of the primary care sector that addresses these problems … Correspondence to: A Majeed
Subfoveal Choroidal Neovascularization in Punctate Inner Choroidopathy: Surgical Management and Pathologic Findings

Punctate inner choroidopathyl, multifocal choroiditis2, and multifocal choroiditis associated with progressive subretinal fibrosis3 may all appear quite similar clinically. Patients affected with these conditions, which may represent either variants of single disorder or a spectrum of disease, have a similar profile: they are commonly young myopic females with multiple focal areas of inflammation at the level of the choroid/Bruchs’ membrane/retinal pigment epithelium complex. The aetiology and incidence of these conditions is unknown. Visual outcome in punctate inner choroidopathy is generally good, barring the development of subfoveal choroidal neovascularization (CNV)1.
Chronic lymphocytic leukemia of the oropharyngeal cavity and paranasal sinuses: a case series and literature review

Background Chronic lymphocytic leukemia (CLL) is an indolent B-lineage neoplasm responsible for 30% of all leukemias. The median age of onset is 67 years with a male predominance of 2:1. Localized infiltration in the oropharynx and paranasal sinuses is exceptionally rare. The aims of this study were (1) to add an additional case series of CLL with involvement of the oropharynx and paranasal sinuses to the literature and (2) to determine incidence and demographic data. Methods Retrospective chart review from 1990 to 2014. Results Five cases were found in our case series, representing 0.74% of the total number of cases analyzed (5/680). Sixteen additional cases were identified through literature review, resulting in a total of 21 cases of CLL (13 men, 8 women) with involvement of the oropharynx (n = 15) and paranasal sinuses (n = 6). The average age of patients with CLL in the oropharynx was 62 years whereas in the paranasal sinuses it was 52 years (p = 0.16). The average age of female cases was 62 years and the average age of male cases was 58 years (p = 0.63). Almost 85% (84.6%) of men had oropharynx invasion vs 50% of females (p = 0.15), which suggests a nonsignificant trend. Conclusion The results of our study indicate that CLL infiltrates the oropharynx or paranasal sinuses in less than 1% of CLL cases. Although there seems to be no age bias between invasion in the oropharynx and the paranasal sinuses, there is a trend whereby women appear more likely to experience invasion of the paranasal sinuses.