cssi/SciSciGPT-SciSciNet huggingface dataset:
Nutrition support of the adult liver transplant candidate

Liver transplantation now provides a viable alternative to patients with end-stage hepatic failure. Because of the damaging effects of liver failure on other organ systems, transplant candidates frequently suffer from moderate to severe malnutrition. Chronic hepatic failure can result in deranged metabolism of not only macronutrients and micronutrients but also various hormones. Patients are frequently in a catabolic state. Wasting of the skeletal muscle mass occurs and synthesis of secretory proteins and clotting factors decreases. Hepatic encephalopathy and fluid/electrolyte imbalances often complicate the provision of appropriate nutrition support. Nutrition support may be provided by the oral route, tube feeding, parenteral nutrition, or a combination of those routes. A multidisciplinary approach to determine the appropriate nutrition support regimen is most optimal. To assess the efficacy of the support, monitoring of the nutritional/metabolic status is necessary on an ongoing basis. An aggressive nutrition support regimen can induce positive nitrogen balance, promote hepatic protein synthesis, and expand lean body mass, controlling the symptoms of malnutrition in end-stage liver disease.
Sarcomas involving the abdominal and pelvic cavity.

The principles of management of all sarcomas that involve the abdominal and pelvic cavity are presented. The anatomic sites for the primary malignancy include retroperitoneal sarcomas, pelvic side-...
HIF-1α Is an Essential Mediator of IFN-γ–Dependent Immunity to Mycobacterium tuberculosis

The cytokine IFN-γ coordinates macrophage activation and is essential for control of pathogens, including Mycobacterium tuberculosis . However, the mechanisms by which IFN-γ controls M. tuberculosis infection are only partially understood. In this study, we show that the transcription factor hypoxia-inducible factor-1α (HIF-1α) is an essential mediator of IFN-γ–dependent control of M. tuberculosis infection both in vitro and in vivo. M. tuberculosis infection of IFN-γ–activated macrophages results in a synergistic increase in HIF-1α protein levels. This increase in HIF-1α levels is functionally important, as macrophages lacking HIF-1α are defective for IFN-γ–dependent control of infection. RNA-sequencing demonstrates that HIF-1α regulates nearly one-half of all IFN-γ–inducible genes during infection of macrophages. In particular, HIF-1α regulates production of important immune effectors, including inflammatory cytokines and chemokines, eicosanoids, and NO. In addition, we find that during infection HIF-1α coordinates a metabolic shift to aerobic glycolysis in IFN-γ–activated macrophages. We find that this enhanced glycolytic flux is crucial for IFN-γ–dependent control of infection in macrophages. Furthermore, we identify a positive feedback loop between HIF-1α and aerobic glycolysis that amplifies macrophage activation. Finally, we demonstrate that HIF-1α is crucial for control of infection in vivo as mice lacking HIF-1α in the myeloid lineage are strikingly susceptible to infection and exhibit defective production of inflammatory cytokines and microbicidal effectors. In conclusion, we have identified HIF-1α as a novel regulator of IFN-γ–dependent immunity that coordinates an immunometabolic program essential for control of M. tuberculosis infection in vitro and in vivo.
Quantification of storm-induced bathymetric change in a back-barrier estuary

Geomorphology is a fundamental control on ecological and economic function of estuaries. However, relative to open coasts, there has been little quantification of storm-induced bathymetric change in back-barrier estuaries. Vessel-based and airborne bathymetric mapping can cover large areas quickly, but change detection is difficult because measurement errors can be larger than the actual changes over the storm timescale. We quantified storm-induced bathymetric changes at several locations in Chincoteague Bay, Maryland/Virginia, over the August 2014 to July 2015 period using fixed, downward-looking altimeters and numerical modeling. At sand-dominated shoal sites, measurements showed storm-induced changes on the order of 5 cm, with variability related to stress magnitude and wind direction. Numerical modeling indicates that the predominantly northeasterly wind direction in the fall and winter promotes southwest-directed sediment transport, causing erosion of the northern face of sandy shoals; southwesterly winds in the spring and summer lead to the opposite trend. Our results suggest that storm-induced estuarine bathymetric change magnitudes are often smaller than those detectable with methods such as LiDAR. More precise fixed-sensor methods have the ability to elucidate the geomorphic processes responsible for modulating estuarine bathymetry on the event and seasonal timescale, but are limited spatially. Numerical modeling enables interpretation of broad-scale geomorphic processes and can be used to infer the long-term trajectory of estuarine bathymetric change due to episodic events, when informed by fixed-sensor methods.
Ethnography, theory, and sociology as a human science: An interlocution:

Ethnography has compelled sociology to recognize and articulate the implications of the fact that it is a human science. This response to readers of Interpretation and Social Knowledge is presented...
The Relevance of Theories and Models of Collaboration to Child Development Support Activities

Many stakeholders with different social and professional backgrounds can be involved in supporting a child's development. Experts note the importance of collaboration between all of these stakeholders in order to adequately support a child. Electronic systems have the potential to facilitate collaboration, and experts have suggested that models and theories relevant to collaboration can guide the design of collaborative systems. In this early exploratory work we investigate the relevance of various models and theories of collaboration and social interaction to the complex child development space.
Clinical-pathological correlations in three patients with fibrodysplasia ossificans progressiva.

Abstract Objective Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare genetic disorder in which heterotopic bone forms in the soft tissues. This often occurs in response to injury or inflammation, leading to joint immobilization and significant disability. There are currently no definitive treatment options for this devastating disease. Although the most dramatic phenotype in FOP is the episodic and progressive heterotopic ossification, patients report a number of symptoms that affect other organ systems. Post-mortem examination of FOP patients may contribute to our understanding of the underlying pathophysiology and complications of this disease. Here, we present the autopsy findings from three patients with FOP. Findings Autopsy findings in two of the three patients confirmed that the cause of death was cardiorespiratory failure in the setting of severe thoracic insufficiency from heterotopic ossification. Both of these patients also had evidence of right ventricular dilatation likely secondary to thoracic insufficiency. The third patient died from complications of a traumatic head injury after a fall but also had post-mortem evidence of thoracic insufficiency syndrome. All three patients had extensive, widespread heterotopic ossification and joint deformities consistent with FOP. There was extensive ossification of the spinal ligament in these patients, which may contribute to cervical spine rigidity. One patient was diagnosed post-mortem with a brainstem malformation. No additional significant abnormalities were noted in the other organ systems. Finally, we also demonstrate that cadaveric skin fibroblasts can be isolated for use as a potential source for future in vitro cell culture studies. Conclusions This autopsy case series provides valuable information about the underlying complications of FOP and contributes significantly to our knowledge of this rare yet debilitating disorder. Thoracic insufficiency syndrome, right heart dysfunction, widespread heterotopic ossification, spinal ligament ossification, and CNS malformations were clearly evident; however, most other non-bone tissues appeared to be spared from gross malformations. Finally, the ability to isolate live cells from cadaveric skin is an important technique that will facilitate future studies, particularly as induced pluripotent stem cells and other cell-based technologies evolve. This case series highlights the importance of post-mortem examinations and their contribution to our current knowledge of disease pathophysiology and comorbidities.
Salt-Cooled Modular Innovative Thorium Heavy Water-Moderated Reactor System

This paper describes a new reactor concept: the Salt-cooled Modular Innovative THorium HEavy water-moderated Reactor System (SMITHERS), which addresses the goals of (a) evolving deployment needs, (...
Further testing of Melatonin Receptor 1a for out-of-season reproduction in the Cornell flock and allelic frequencies compared with Romney sheep.

Sheep are seasonally polyestrous breeders, meaning they breed when day length shortens in the autumn. Ewes respond to changing day length through chemical pathways involving melatonin receptors. Some breeds, such as Dorset, are known to be less seasonal with many ewes able to breed and lamb year-round. The Melatonin Receptor 1a () gene was identified as a candidate gene controlling out-of-season lambing. The first studies in the Cornell STAR accelerated lambing flock found that a allele was associated with a shorter time to first lambing and a shorter period between lambings. The favorable allele was denoted the allele and the unfavorable allele, the allele. This study evaluated additional data for the effect of the polymorphism on sheep reproduction. Genotypic frequencies among the 320 sheep in this study differed between Romney and breeds selected for accelerated lambing ( 0.05) between the allele and success for out-of-season lambing and no significant differences were observed in several production measures, such as number of lambs delivered per yr or number of lambs weaned ( > 0.05). With few ewes in the flock, these results may be due to the high level of selection for accelerated lambing. This study shows that the allele may not be a beneficial marker for use within flocks seeking to improve production and the ability to lamb out-of-season. These findings warrant additional research on the genetics of aseasonality in sheep.
Birth Defects Involving the Spine

There is a multiplicity of birth defects of the spine occurring as isolated anomalies or as aspects of multifaceted syndromes. The clinical significance of these anomalies varies from the asymptomatic to the life threatening. Symptoms and signs may present at birth or not until years later. The optimal clinical result for the patient requires a careful history and physical examination, appropriate routine and specialized roentgenograms, laboratory data, and a high index of suspicion for signs or symptoms of neurological dysfunction. When the diagnosis is made, conservative or surgical treatment may be instituted as appropriate.
When Westlaw Fuels Ice Surveillance: Legal Ethics in the Era of Big Data Policing

Legal research companies are selling surveillance data and services to U.S. Immigration and Customs Enforcement (“ICE”) and other law enforcement agencies. This Article discusses ethical issues that arise when lawyers buy and use legal research services sold by the same vendors responsible for building ICE’s surveillance systems. As the legal profession collectively pays millions of dollars for computer assisted legal research services, lawyers should consider whether doing so in the era of big data policing compromises their confidentiality requirements and their obligation to supervise third party vendors. With new companies developing legal research services, lawyers have more legal research options than ever. Lawyers can choose to purchase legal research services from socially responsible vendors.
Does “putting on your thinking cap” reduce myside bias in evaluation of scientific evidence?

AbstractThe desire to maintain current beliefs can lead individuals to evaluate contrary evidence more critically than consistent evidence. We test whether priming individuals’ scientific reasoning...
Addressing Social Determinants of Health: Challenges and Opportunities in a Value-Based Model.

* Abbreviations: ACO — : accountable care organization CMS — : Center for Medicare and Medicaid Services SDoH — : social determinants of health Two forces are reverberating within the US health care system. The first is the medical system’s recognition that addressing a patient’s social circumstances is necessary to promote health and prevent disease. Pediatrics has long espoused the strong influence of family and social conditions on children’s wellbeing. The second force is movement away from fee-for-service reimbursement to a value-based model in which payment is based on quality measures and health outcomes. This value-based system, which was first tested in private insurers and Medicare, has now been extended into Medicaid, which is the largest insurer of US children. By 2020, accountable care organizations (ACOs) will cover 100 million Americans.1 These forces’ convergence is influencing Medicaid-related health policies. Medicaid managed-care-organization programs in 30 states are encouraging screening for social needs and providing referrals for social services. Some statewide Medicaid ACO programs require social determinants of health (SDoH) interventions (eg, housing programs) and include health-related social-need screening as a quality measure.2 The Center for Medicare and Medicaid Services (CMS) also recently announced the Integrated Care for Kids Model, a child-centered service delivery and state payment model that is aimed at reducing expenditures and improving quality of care for children through the prevention, early identification, and treatment of behavioral and physical health needs. The opportunity to engage the health care system with nonmedical sectors (eg, human services, … Address correspondence to Arvin Garg, MD, MPH, Division of General Pediatrics, Department of Pediatrics, School of Medicine, Boston University, Boston Medical Center, 88 E. Newton St, Vose Hall, Third Floor, Boston, MA 02118. E-mail: arvin.garg{at}bmc.org
Stereoselective synthesis of 3-azido-2,3-dideoxy-D-ribose derivatives and its utilization for the synthesis of anti-HIV nucleosides†‡

Detail account of the synthesis of 3′-azido nucleosides utilizing 3-azido-2,3-dideoxy-D-ribose derivative 7 as the key intermediate was described. The key intermediate 7 was synthesized from D-mannitol in 8 steps in a preparative scale. The Michael reaction of the azide group with α,β-unsaturated-γ-butyrolactone 4 was affected by the steric bulkiness of the substituent at the 5-O position. A bulky t-butyldiphenylsilyl substitution at 5-O gave almost exclusively the α-azido adduct 5b, while unsubstitution at 5-O produced 1:1 mixture of α-and β-adducts. The ratio of α to β anomers in the condensation between azido acetate 7a and pyrimidine bases for the preparation of AZT and AZDU was greatly influenced by the solvent and the Lewis acid catalyst used. In the synthesis of 12 (AZDU, CS-87), the combination of dichloroethane and trimethylsilyl triflate gave an optimal result, while in the case of 14 (AZT), various conditions gave similar ratio of α,β anomers. The azido intermediate 7b was also utilized for the synthesis of several 3′-azido purine-like nucleosides 16–27. The glycosylation was also affected by the Lewis acid catalyst. Boron trifluoride etherate gave the desired N1-glycosylated compounds in which the α-anomer was major, but other catalysts such as trimethylsilyl triflate or stannic chloride produced N2-glycosylated compounds as the major products. The newly synthesized purine-like compounds have been tested against HIV, however, none of them showed any significant activity.
Music, Identities, and Interreligious Relationships at the Lingsar Festival in Lombok, Indonesia

When the final procession was readied at the Lingsar temple festival in 1988, I was surprised to see a leader of the Muslim Sasak faction, Suparman, holding hands with the leader of the Hindu Balinese assemblage, Anak Agung Gede Biarsah, at the front of the line of participants. In earlier conversations, they had both expressed interethnic distrust and proclaimed that their group held the inner position while the other was outer and insubstantial to festival events. And yet, there they were walking hand-in-hand and leading the final procession together as if there were no problems whatsoever. What I was witnessing – as I later realized – was the collapse of contestation into interethnic unity, and what produced this unity was the previous days' rites and performing arts, which all worked in various ways to construct a bridge to the ancestors, impose a spiritual order and balance on the proceedings and participants, and form a comprehensive union that gradually became palpable. Ultimately, it is this union of complementary dualities (Sasak/Balinese, human/divine, inside/outside, even traditional/modern) that generates the fertility that legitimizes the festival. Though many elements have changed since the 1980s, the goal of union has not. Without it, the festival would either discontinue or radically transform.
Lethal Organ Donation: Would the Doctor Intend the Donor’s Death?

Lethal organ donation is a hypothetical procedure in which vital organs are removed from living donors, resulting in their death. An important objection to lethal organ donation is that it would infringe the prohibition on doctors intentionally causing the death of patients. I present a series of arguments intended to undermine this objection. In a case of lethal organ donation, the donor's death is merely foreseen, and not intended.
Where to Look? Automating Attending Behaviors of Virtual Human Characters

This research proposes a computational framework for generating visual attending behavior in an embodied simulated human agent. Such behaviors directly control eye and head motions, and guide other actions such as locomotion and reach. The implementation of these concepts, referred to as the AVA, draws on empirical and qualitative observations known from psychology, human factors and computer vision. Deliberate behaviors, the analogs of scanpaths in visual psychology, compete with involuntary attention capture and lapses into idling or free viewing. Insights provided by implementing this framework are: a defined set of parameters that impact the observable effects of attention, a defined vocabulary of looking behaviors for certain motor and cognitive activity, a defined hierarchy of three levels of eye behavior (endogenous, exogenous and idling) and a proposed method of how these types interact.
K-Means Clustering for Information Dissemination of Fishing Surveillance

The Portuguese Navy is responsible for monitoring the largest Exclusive Economic Zone in Europe. The most captured species in this area are Scomber colias and Trachurus trachurus, commonly called Mackerel and Horse Mackerel, respectively. One of the Navy’s missions is pursuing actions of fishing surveillance to verify the compliance of proceedings with the species’ fishing activity regulation. This monitoring actions originate data that represents a sample of the fishing activity in the area. The collected data, analysed with adequate data mining techniques, makes it possible to extract useful information to better understand the fishing activity related to Mackerel and Horse Mackerel, even if the full data set cannot be disclosed. With this in mind the authors used a non-supervised learning technique, the K-Means algorithm, which grouped data in clusters by its similarity and made a summarized description of each cluster with the purpose of releasing a general overview of such records. The information obtained from the clusters led the authors to deepen the study by performing a comparison of the monthly average quantity recorded per vessel for the two species in order to infer about the relation between captured quantity Mackerel and Horse Mackerel over time.
Laparoscopic Pancreatic Cystogastrostomy

This chapter discusses technical aspects of laparoscopic pancreatic cystogastrostomy, including instrumentation and equipment, patient positioning and trocar placement, and surgical steps. The authors also offer pearls and pitfalls.
IDH1 and IDH2 mutations in lung adenocarcinomas: Evidences of subclonal evolution.

Background Selective IDH1 and IDH2 inhibitors have been approved for targeted therapy of acute myeloid leukemia. Clinical trials for solid tumors with IDH1 and IDH2 (IDH1/2) mutations are ongoing. Reports of IDH1/2-mutated non-small cell lung cancers (NSCLCs), however, are limited. Methods We evaluated IDH1/2 mutations in 1,924 NSCLC specimens (92% adenocarcinoma) using a next-generation sequencing assay. Results Retrospective quality assessments identified false detection of IDH1 c.395G>A (p.R132H) resulting from cytosine deamination (C:G→T:A) artifact in one specimen. IDH1/2 mutations were detected in 9 (0.5%) adenocarcinomas taken by fine-needle aspiration (n = 3), thoracentesis (n = 2) or core biopsy (n = 4). All nine adenocarcinomas showed high-grade features. Extensive clear cell change, however, was not observed. High expression (50% or greater) of PD-L1 was observed in two of five specimens examined. IDH1/2 mutations were associated with old age, smoking history, and coexisting KRAS mutation. Lower than expected variant allele frequency of IDH1/2 mutants and coexistence of IDH1/2 mutations with known trunk drivers in the BRAF, EGFR, and KRAS genes suggest they could be branching drivers leading to subclonal evolution in lung adenocarcinomas. Multiregional analysis of an adenocarcinoma harboring two IDH2 mutations revealed parallel evolution originating from a KRAS-mutated lineage, further supporting subclonal evolution promoted by IDH1/2 mutations. Conclusions IDH1/2 mutations in NSCLCs are uncommon. They occur in adenocarcinomas with high-grade features and may be branching drivers leading to subclonal evolution. Accumulation of more IDH1/2-mutated NSCLCs is needed to clarify their clinicopathological characteristics and implications for targeted therapy.
Asian Americans and Pacific Islanders in academe: race and gender through the tenure pipeline from 1993-2017

Increasing faculty diversity is a stated priority across higher education in the United States. The extent to which Asian Americans and Pacific Islanders (AAPI) are part of these discussions is unc...
What Is the Nature of the Holy Spirit

I propose that the Fourth Gospel presents the Holy Spirit as a divine person, not an impersonal force, alongside of God the Father and Jesus himself. For John, the Spirit is ontologically equal but functionally subordinate to both God the Father and Jesus. This claim is made evident in Jesus’ discourse at the Last Supper. Hence John furnishes what may be styled a proto-Trinitarianism. These suppositions have the potential to prompt Johannine scholars into new explorations of the Fourth Gospel’s pneumatology and role in shaping proto-orthodoxy.
Baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancer.

Background Recent research suggests that baseline body mass index (BMI) is associated with response to immunotherapy. In this study, we test the hypothesis that worsening nutritional status prior to the start of immunotherapy, rather than baseline BMI, negatively impacts immunotherapy response. Methods We studied 629 patients with advanced cancer who received immune checkpoint blockade at New York University. Patients had melanoma (n=268), lung cancer (n=128) or other primary malignancies (n=233). We tested the association between BMI changes prior to the start of treatment, baseline prognostic nutritional index (PNI), baseline BMI category and multiple clinical end points including best overall response (BOR), objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS). Results Decreasing pretreatment BMI and low PNI were associated with worse BOR (p=0.04 and p=0.0004), ORR (p=0.01 and p=0.0005), DCR (p=0.01 and p Conclusion Standard of care measures of worsening nutritional status more accurately associate with immunotherapy outcomes than static measurements of BMI. Future studies should focus on determining whether optimizing pretreatment nutritional status, a modifiable variable, leads to improvement in immunotherapy response.
Subcooled Flow Boiling of Carbon Dioxide Near the Critical Point Inside a Microchannel

Subcooled flow boiling heat transfer of carbon dioxide (${\mathrm{CO}}_{2}$) at the microscale near the critical pressure is experimentally studied. The onset of nucleate boiling and the local heat-transfer coefficient are obtained under 26 experimental conditions, consisting of 17 sample points each, yielding 442 data points. Excess temperatures of about 1 K at the onset of nucleate boiling and heat-transfer coefficients of up to $200\phantom{\rule{0.25em}{0ex}}\mathrm{kW}/{\mathrm{m}}^{2}\phantom{\rule{0.25em}{0ex}}\mathrm{K}$ are recorded. The heat-transfer coefficient and the onset of nucleate boiling models and correlations developed for low reduced pressures are compared to current experimental results. Modifications to these models are introduced to account for conditions pertinent to reduced pressures around unity. Overall, the correlations do not fully capture current measurements, suggesting that the physics of flow boiling heat transfer near the critical conditions exhibits some unique characteristics. Furthermore, it is observed that the experimentally obtained heat-transfer coefficient is better predicted by a model developed for flow boiling of ${\mathrm{CO}}_{2}$. However, with increasing pressure, deviations between experiments and predictions increase.
96 Adjuvant treatment for adenosarcoma confined to the uterus provides no survival benefit

Introduction Aim of the present study was to investigate patterns of use and outcomes of adjuvant treatment for patients with stage I adenosarcoma. Methods Patients diagnosed between 2004–2015 with stage I adenosarcoma without a history of another tumor who underwent hysterectomy with lymphadenectomy and had at least one month of follow-up were drawn from the National Cancer Database. Patients who received adjuvant chemotherapy (CT) and/or radiotherapy (RT) defined as treatment within 6 months from surgery were identified. Overall survival (OS) was evaluated after generation of Kaplan-Meier curves and compared with the log-rank test. A Cox model was constructed to control for confounders. Results Among 735 patients with stage I adenosarcoma, 186 (25.3%) received adjuvant treatment; 61.3% RT only, 26.9% CT only and 11.8% both RT and CT. Rate of adjuvant treatment was 14.1% for patients with stage IA compared to 35.8% and 53.3% for those with stage IB and IC, p 0.05. Five year OS rate for patients who did not receive adjuvant treatment was 79.9% compared to 63.4%, 68.8% and 74.1% for those who received RT only, CT only and both CT and RT, p=0.002. After controlling for substage, patient age, insurance status and co-morbidities, administration of adjuvant treatment was not associated with a survival benefit (HR: 1.29, 95% CI: 0.92, 1.58) Conclusions There is no clear benefit in the use of adjuvant treatment for patients with early stage adenosarcoma.
Pedagogy and the Politics of Organizing in Mississippi

This article reflects on a community-directed collaboration between students at a four-year liberal arts institution and a local organization in Mississippi to develop an index of women's economic security. It suggests that the collaborative nature of the course, as well as the relationship- and community-building witnessed in Mississippi offer counter-narratives to liberal individualism, southern conservatism, and the practice of social justice work.
Critical Comparison of MaxCal and Other Stochastic Modeling Approaches in Analysis of Gene Networks.

Learning the underlying details of a gene network with feedback is critical in designing new synthetic circuits. Yet, quantitative characterization of these circuits remains limited. This is due to the fact that experiments can only measure partial information from which the details of the circuit must be inferred. One potentially useful avenue is to harness hidden information from single-cell stochastic gene expression time trajectories measured for long periods of time—recorded at frequent intervals—over multiple cells. This raises the feasibility vs. accuracy dilemma while deciding between different models of mining these stochastic trajectories. We demonstrate that inference based on the Maximum Caliber (MaxCal) principle is the method of choice by critically evaluating its computational efficiency and accuracy against two other typical modeling approaches: (i) a detailed model (DM) with explicit consideration of multiple molecules including protein-promoter interaction, and (ii) a coarse-grain model (CGM) using Hill type functions to model feedback. MaxCal provides a reasonably accurate model while being significantly more computationally efficient than DM and CGM. Furthermore, MaxCal requires minimal assumptions since it is a top-down approach and allows systematic model improvement by including constraints of higher order, in contrast to traditional bottom-up approaches that require more parameters or ad hoc assumptions. Thus, based on efficiency, accuracy, and ability to build minimal models, we propose MaxCal as a superior alternative to traditional approaches (DM, CGM) when inferring underlying details of gene circuits with feedback from limited data.
CT Findings and Patterns of e-Cigarette or Vaping Product Use-Associated Lung Injury: A Multicenter Cohort of 160 Cases.

Background e-Cigarette or vaping-induced lung injury (EVALI) causes a spectrum of CT lung injury patterns. Relative frequencies and associations with vaping behavior are unknown. Research Question What are the frequencies of imaging findings and CT patterns in EVALI and what is the relationship to vaping behavior? Study Design and Methods CT scans of 160 subjects with EVALI from 15 institutions were retrospectively reviewed. CT findings and patterns were defined and agreed on via consensus. The parenchymal organizing pneumonia (OP) pattern was defined as regional or diffuse ground-glass opacity (GGO) ± consolidation without centrilobular nodules (CNs). An airway-centered OP pattern was defined as diffuse CNs with little or no GGO, whereas a mixed OP pattern was a combination of the two. Other patterns included diffuse alveolar damage (DAD), acute eosinophilic-like pneumonia, and pulmonary hemorrhage. Cases were classified as atypical if they did not fit into a pattern. Imaging findings, pattern frequencies, and injury severity were correlated with substance vaped (marijuana derives [tetrahydrocannabinol] [THC] only, nicotine derivates only, and both), vaping frequency, regional geography, and state recreational THC legality. One-way analysis of variance, χ2 test, and multivariable analyses were used for statistical analysis. Results A total of 160 patients (79.4% men) with a mean age of 28.2 years (range, 15-68 years) with EVALI underwent CT scan. Seventy-seven (48.1%), 15 (9.4%), and 68 (42.5%) patients admitted to vaping THC, nicotine, or both, respectively. Common findings included diffuse or lower lobe GGO with subpleural (78.1%), lobular (59.4%), or peribronchovascular (PBV) sparing (40%). Septal thickening (50.6%), lymphadenopathy (63.1%), and CNs (36.3%) were common. PBV sparing was associated with younger age (P = .02). Of 160 subjects, 156 (97.5%) had one of six defined patterns. Parenchymal, airway-centered, and mixed OP patterns were seen in 89 (55.6%), 14 (8.8%), and 32 (20%) patients, respectively. Acute eosinophilic-like pneumonia (six of 160, 3.8%), DAD (nine of 160, 5.6%), pulmonary hemorrhage (six of 160, 3.8%), and atypical (four of 160, 2.5%) patterns were less common. Increased vaping frequency was associated with more severe injury (P = .008). Multivariable analysis showed a negative association between vaping for > 6 months and DAD pattern (P = .03). Two subjects (1.25%) with DAD pattern died. There was no relation between pattern and injury severity, geographic location, and state legality of recreational use of THC. Interpretation EVALI typically causes an OP pattern but exists on a spectrum of acute lung injury. Vaping habits do not correlate with CT patterns except for negative correlation between vaping > 6 months and DAD pattern. PBV sparing, not previously described in acute lung injury, is a common finding.
The Dilemma, Conversion Disorder or Stiff Person Syndrome, a Case Report.

Study Objectives The main objectives of this case study are 1. Clinicians facing symptoms that are difficult to interpret should exercise caution in diagnosing conversion disorder. 2. Increasing awareness about rare neurological conditions may appear as psychogenic illnesses. 3. Clinicians be advocate for their patients. Introduction Conversion disorder is a mental condition in which a person present with one or more symptoms of altered voluntary motor or sensory function, or other neurologic symptoms that cannot be explained by medical evaluation. Stiff person syndrome (SPS) is a disabling autoimmune central nervous system disorder characterized by progressive muscle rigidity, gait impairment, with superimposed painful spasms. SPS is commonly associated with high anti-glutamic acid decarboxylase (GAD) antibody titers. The dominant antigen recognized by these antibodies is the GABA-synthesizing enzyme GAD. Method Patient X, a 17-year-old Hispanic American female who presented to the Child and Adolescent Psychiatry Clinic with the complaint of ataxia & aphasia associated with anxiety. Patient was referred by the neurology clinic after they could not establish any organic cause of her ataxia or aphasia. After thorough evaluation at the child psychiatry clinic she was given the diagnosis of anxiety secondary to ataxia and aphasia and r/o Conversion Disorder. She was initiated treatment with sertraline for her anxiety. Her sertraline dose was increased gradually up to 100 mg daily. From the beginning the patient also received counseling & physical therapy. With these combination of treatments, patient’s symptoms did not get any better. Her symptoms actually got worse over time. At this point, the Child Psychiatry Clinic sent a message to the neurology clinic for further evaluation of patient due to her progressive gait and speech impairments. Results The neurology clinic saw the patient again and did further testing. The patient was positive for high titers of anti-glutamic acid decarboxylase antibodies (Anti-GAD). At this point, the patient was given the diagnosis of Stiff Person Syndrome. Patient was admitted to the hospital for further management. She was treated with benzodiazepines, IV immune globulin, & steroid. Soon after discharge from the hospital, the patient was seen at the Child Psychiatric Clinic. The patient’s mother reported, after the in-patient treatment, the patient’s symptoms improved. Discussion It is essential for clinicians to look for neurologic & other general medical conditions while evaluating a patient with possible conversion disorder. A systematic review of 27 studies found that among 1466 patients initially diagnosed with conversion symptoms, the frequency of misdiagnosis was approximately 4 percent. References. BMJ. 2005;331(7523):989. Epub Oct 13. Childhood onset of stiff-man syndrome. JAMA Neurol. 2013;70(12):1531. J Neurol Neurosurg Psychiatry. 2015 Aug; 86(8):840–8. Epub 2014 Dec 15.
Tracheal Collapse and Stenosis of Calves

Tracheal collapse and/or stenosis on calves, while undoubtedly not a new condition is being more frequently recognized as a potential cause of severe respiratory distress. The condition is routinely associated with anterior rib fractures which have occurred during dystocia. The calves generally exhibit normal health until fracture healing is advanced. Bone callus formation at or near the thoracic inlet impairs development of the trachea or exerts sufficient pressure to cause collapse of the tracheal lumen.
Fatigue resistance of ultra-high-modulus pitch-based carbon fiber/epoxy composites under tensile loading

Pitch-based carbon fiber reinforced epoxy composites are used in specialized applications for their high-modulus and thermal conductivity; however, little data on their fatigue performance are avai...
Identifying the Factors Contributing to Customers Driving Directly by a Competitor to Shop at the Host Store

This paper examines the situation in which consumers drive directly by one retail store to shop at another retail store of similar type. This group of consumers, called "by shoppers" because they drive by one store to get to another, is analyzed to see if it differs demographically from other customer groups. In addition, characteristics of the "host store" (the store driven to) and the "competitor store" (the store driven by) are analyzed to determine their influence on the "by shopper" group.
Problem-Posing/Problem-Solving Dynamics in the Context of a Teaching-Research and Discovery Method

Problem posing is practiced in the context of an integrated teaching/research methodology which has become known as TR/NYCity methodology (Teaching-Research/New York City methodology) (Dydaktyka Matematyki, 2006, 29: 251–272). This approach has been utilized in mathematics classrooms in the New York area for a decade. Problem solving turned out to be an essential teaching strategy for developmental mathematics classrooms of Arithmetic and Algebra, where motivation in learning, interest in mathematics, and the relevance of the subject is unclear to adult learners. Problem posing and problem solving are brought into play together so that moments of understanding occur, and a pattern of these moments of understanding can lead to self-directed discovery, becoming the natural mode of learning. Facilitation of student moments of understanding as manifestations of their creative capacity emerges from classroom teaching-research practice and its relationship with the theory of the act of creation (The Act of Creation. 1964. Macmillan) as the integrative element leading to discovery. Discovery returns to the remedial mathematics classroom, jumpstarting reform. This teaching-research report is based on the collaborative teaching experiment (C 3 IRG 7 Problem Solving in Remedial Arithmetic: Jumpstart to Reform. 2010. City University of New York) supported by C3IRG grant of CUNY.
A Different Kind of Croc

A fossil crocodilian from Argentina broadens the diversity of marine reptiles. Its remarkably large head and serrated teeth suggest a very unusual kind of creature.
Active versus standby redundancy for improved cryocooler reliability in space

Long-life space cryocooler applications, such as NASA’s Atmospheric Infrared Sounder (AIRS) instrument, require that the cryocooler system possess a very high level of reliability. This need for high reliability not only demands that high reliability coolers be used, but often requires that some form of redundancy be incorporated. One common implementation is standby redundancy; however, active redundancy is another equally viable choice. Recently, experience with both types of redundancy has been gained with the AIRS instrument. The AIRS cryocoolers were initially designed and launched as standby redundant units; they were then switched over to active redundancy after six months of in-space operation.
A Generalized Event Structure for the Muller Unfolding of a Safe Net

In 1959, Muller and Bartky published a celebrated paper on “A Theory of Asynchronous Circuits”. Among many novel techniques in that paper was the use of lattices resembling the domains of configurations of event structures. In the light of this we present a generalization of Muller's construction to safe nets. We find, however, that this “Muller unfolding” cannot be generated as the domain of configurations of any known event structure, not even a General Event Structure. (In particular, this unfolding differs from that of Nielsen, Plotkin and Winskel.) This paper attempts to fill that gap. We make use of the logical approach to causality in which a General Event Structure is interpreted as a “logical automaton” arising from a particular logic of causality. We introduce a new causal logic and associate a corresponding logical automaton to any finite safe Petri net. Our main result is that the domain of configurations of this generalized event structure is isomorphic to the Muller unfolding of the net.
Vail Conference (1973)

The 1973 conference sponsored by the National Institute of Mental Health in Vail, Colorado had the effect of legitimizing the “scholar-practitioner” model of professional training in psychology. This model, originally suggested as far back as 1918 by clinical psychologist Leta Hollingworth (1886–1939), endorsed the PsyD degree rather than the PhD and fostered training that did not require students to carry out empirical research. The “Vail model” of training eventually produced far more graduates per year than the traditional “Boulder” (scientist–practitioner) model. Keywords: Kelly, George; Rogers, Carl; assessment; behavior therapy; cognitive behavior therapy
Exercise Capacity and the Risk of Death in Women

To the Editor: The findings by Gulati and associates supported an association between exercise capacity and survival in women.1 They also state that their results provide a “clear clinical rationale for routine stress testing in asymptomatic women.” Although we find these results intriguing, we would like more information. If clinicians decide to stress-test their patients, how would the results be used? The results would be easier to appreciate if tables were included with absolute risks of mortality for varying Framingham risk and exercise capacity scores. Additional information would help establish the clinical value of exercise capacity. In particular, it is important to know how much the findings …
RNA splicing in the T-even bacteriophage.

Group 1 introns, first demonstrated in the nuclear large rRNA of Tetrahymena thermophila and subsequently in many yeast, fungal mitochondrial, and chloroplast precursor RNAs, are capable of intron excision and exon ligation in vitro, although this process occurs much more rapidly in vivo. The discovery and characterization of a similar intron in the T4 phage thymidylate synthase gene (td) led to the finding of additional group 1 introns in other T4 genes and in genes of the related T2 and T6 phages. Because protein factors are not required in the splicing of group 1 introns in vitro, it has been postulated that the precursor RNA can assume a critical conformation enabling it to undergo site-specific autocatalytic cleavage and ligation (self-splicing). By means of site-directed mutation, it has been shown unequivocally that several sequence elements in the Tetrahymena rRNA intron are involved in the formation of base-paired stem structures that are essential for the self-splicing process. These sequence el...
Analysis of alternative realizations of adaptive IIR filters

A general theory, based on an analysis of stationary points, presented which shows that whenever a direct-form IIR (infinite-impulse-response) filter with unimodal MSE (mean-squared-error) surface is transformed into an alternate realization, the MSE surface associated with the new structure may have additional stationary points, which are either new equivalent minima (and hence indistinguishable at the filter output), or saddle points, which are unstable solutions in the parameter space. The general theory is specialized to parallel and cascade forms. It is also shown that, for both the parallel and cascade forms, a gradient algorithm will find a global minimum as long as there is some noise present to jitter the solution away from the reduced-order manifolds which may contain saddle points. Experimental examples were presented to illustrate that the predicted behavior is indeed observed in practice. >
Probabilistic information processing systems: Evaluation with conditionally dependent data☆

Abstract Previous research on Probabilistic Information Processing (PIP) systems has used data that are conditionally independent. In the real world, data are frequently conditionally dependent, that is, given an hypothesis, the occurrence of one datum influences the likelihood of occurrence of a second datum. If the use of a PIP system is desired when the data are known to be conditionally dependent, then it is necessary to know if PIP is an appropriate system for the processing of dependent data. One experiment compared PIP with a second system, POP. PIP operators gave more optimal estimates when the data were conditionally independent; however, POP estimators gave more optimal estimates when the data were conditionally dependent. A second experiment attempted, unsuccessfully, to produce a modified PIP system that would give optimal estimates for both conditionally dependent and conditionally independent data. A revised technology of diagnostic information processing based on conditionally dependent data was proposed.
International capital mobility: evidence from panel data

Abstract To test whether capital is internationally mobile, some researchers have examined the relationship between saving and investment. Using time averaged data, they find saving and investment to be related, and conclude that capital is relatively immobile. In this paper, I argue that a country's intertemporal budget constraint biases results using time averaged data against finding capital mobility. Using annual data, pooled for 21 OECD countries over the 1962–1990 period, I find the estimated impact of saving on investment to be considerably smaller than previous estimates.
Underdiagnosis of hypochondriasis in family practice

Abstract A hypochondriasis questionnaire (the Whitely Index) was administered to 109 family practice outpatients and their medical records were audited to determine the rate of detection of hypochondriasis and its impact on physician behavior. Patients who scored high on the Whitely Index were more likely to have received screening laboratory testing, and to have high no-show rates, along with significantly more numbers of symptoms shown in the record, which, however, did not contain any references to somatization.
Pulmonary Tuberculosis and Bronchocentric Granulomatosis

Bronchocentric granulomatosis (BG) is an uncommon inflammatory lesion of unknown etiology defined on morphologic grounds by the presence of necrotizing granulomata centered on bronchi and bronchioles. We report the typical pathologic features of BG in a patient with tuberculosis. Mycobacterial and other types of infection should be excluded by appropriate stains and cultures in all patients with BG on lung biopsy, especially those who are nonasthmatic.