cssi/SciSciGPT-SciSciNet huggingface dataset:
A Paradoxical Treatment for a Paradoxical Condition: Infliximab Use in Three Cases of Mycobacterial IRIS

The management of corticosteroid refractory immune reconstitution inflammatory syndrome (IRIS) is currently unclear. Infliximab administration was associated with clinical improvement without significant adverse events in 3 patients with mycobacterial IRIS. Immunologic and virologic responses to antiretroviral therapy were unaffected. Tumor necrosis factor blockade may be beneficial for IRIS and warrants further study in clinical trials.
Understanding the Relationship between the Rule of Law, Judicial Reform, and Transitional Justice

In the transitional justice literature it is often assumed that transitional justice mechanisms, such as trials, improve the rule of law, as well as strengthen democracy and human rights protections. Although there is a lively debate on the causal relationship between transitional justice mechanisms, and democracy and human rights, we still know little about the relationship between transitional justice and rule of law. But what is it about rule of law that makes accountability mechanisms more likely? If judicial reform aims to strengthen the rule of law, how does it relate to accountability mechanisms? Departing from an institutional- and process-oriented view of rule of law, in this paper I engage with some of these questions. The paper aims to provide a preliminary exploration on the theoretical links between judicial reform, domestic legal norms and institutions, and efforts for prosecuting human rights violations, through an empirical comparative analysis on Latin America.
Incidence of Screwworm (Diptera: Calliphoridae) and Torsalo (Diptera: Cuterebridae) Myiasis on the Yucatan Peninsula of Mexico

Domestic and native animals were surveyed for screwworm, Cochliomyia hominivorax (Coquerel) and torsalo, Dermatobia hominis (L., Jr.) myiasis during the 1985 rainy season on the Yucatan Peninsula, Mexico. Three types of situations were surveyed as follows: family-unit ranches; feedlots; and captive, indigenous animals. A total of 989 Dermatobia lesions and 87 screwworm-infested wounds were recorded. Highest prevalence of Dermatobia and screwworm myiasis occurred in cattle and domestic pigs, respectively. Dogs also had a high rate of parasitism by both insects. Among native animals, torsalo lesions were most often seen in deer. Only one case of torsalo myiasis was recorded in humans. People living on ranches, although near infested animals, are probably still not as susceptible to myiasis as people who work directly in forested areas. None of the Dermatobia lesions recorded in this survey was subsequently infested by screwworms. Such lesions are probably much less attractive to screwworms than are other common types of wounds.
Digitally Modulated RF Systems: A Primer on Current Techniques

The purpose of this paper is to provide a tutorial overview of various digital communication techniques currently applicable to broadcasting and thereby provide an understanding of the key issues and implementation choices. This is intended to provide a foundation for understanding the merits of the various methods relative to one another and to prior analog methods.
The Impact of Reference Point Prices on Seasoned Equity Offerings

We document that firms’ financing decisions are affected by historical high prices. The ratio of the offering price to the 12-month high price clusters around one with the probability of issuing exactly at the historical high price much higher than that at prices slightly below or above. Furthermore, the offering discount is smaller if the pre-announcement stock price is high. Abnormal returns around the SEO announcements are unaffected by historical high prices. These results suggest that historical high price reference points may help managers rationally time SEOs to take advantage of market reception and minimize issuance costs.
Clinical effect of scopolamine treating multiple organ dysfunction syndrome in children

Objective To investigate clinical effects of scopolamine treating multiple organ dysfunction syndrome(MODS)in children. Methods 60 children with MODS treated in our hospital from March 2009 to March 2014 were studied,and they were randomly divided into the scopolamine treatment group(n=32) and the routine treatment group(n=28).The routine treatment group was treated with the routine treatment method while the scopolamine treatment group was treated with scopolamine.Arterial blood lactic acid,mean arterial pressure,oxygenation index,organ failure score,pediatric critical illness score and mortality of the two groups were compared. Results After treatment,oxygenation index and mean arterial pressure of the two groups were increased,and there was a statistical difference of the indicators abovementioned in the two groups(P0.05) after treatment,after 6 hours treatment,arterial blood lactic acid in the scopolamine treatment group was improved effectively,but the improvement of arterial blood lactic acid in the routine group was not obvious,and there was a statistical difference of arterial blood lactic acid between the two groups after treatment(P0.05).After treatment,organ failure score of the two groups was obviously decreased and there was a statistical difference of organ failure score of the two groups(P0.05) after treatment,pediatric critical illness score of the two groups were increased significantly,and there was a statistical difference of pediatric critical illness score in the two groups(P0.05);after treatment,mortality of the scopolamine treatment group(16.7%) was lower than that in the in the routine treatment group(37.3%)(P0.05). Conclusion On the basis of the routine treatment,adding scopolamine can effectively improve the therapeutic effectand can improve the mean arterial pressure,improve arterial blood lactic and can reduce mortality.
Expression of the insulin-like growth factor system in the hypokalemic rat kidney.

We studied the renal expression of the insulin-like growth factor (IGF) system to gain a better perspective of its potential role in the hyperplastic adaptation of the distal nephron to potassium deficiency. Rats were pair fed 1% or 0.002% potassium diets for periods up to 10 days. IGF-I mRNA was diminished in potassium-deficient rats within 4 days, whereas mRNA for IGF binding protein-1 (IGFBP-1), a collecting duct-associated protein, was increased by day 7. At day 10 mRNA for IGFBP-1 in potassium-deficient animals averaged 2.07 +/- 0.53 (mean +/- SD, relative densitometry units) compared with 0.89 +/- 0.26 in control rats (n = 4, P = 0.002). Conversely, IGFBP-3, a binding protein whose mRNA has been localized to the interstitial compartment, averaged 2.40 +/- 0.02 in potassium-deficient rats and 4.77 +/- 0.05 in controls (n = 4, P < 0.03) at day 10 of treatment. Immunohistochemistry performed using a specific IGFBP-1 antibody revealed hyperplasia of distal nephron segments along with an increase in IGFB...
Supernova Remnants in the Local Group I: A model for the radio luminosity function and visibility times of supernova remnants

Supernova remnants (SNRs) in Local Group galaxies offer unique insights into the origin of different types of supernovae. In order to take full advantage of these insights, one must understand the intrinsic and environmental diversity of SNRs in the context of their host galaxies. We introduce a semi-analytic model that reproduces the statistical properties of a radio continuum-selected SNR population, taking into account the detection limits of radio surveys, the range of SN kinetic energies, the measured ISM and stellar mass distribution in the host galaxy from multi-wavelength images and the current understanding of electron acceleration and field amplification in SNR shocks from first-principle kinetic simulations. Applying our model to the SNR population in M33, we reproduce the SNR radio luminosity function with a median SN rate of $\sim 3.1 \times 10^{-3}$ per year and an electron acceleration efficiency, $\epsilon_{\rm{e}} \sim 4.2 \times 10^{-3}$. We predict that the radio visibility times of $\sim 70\%$ of M33 SNRs will be determined by their Sedov-Taylor lifetimes, and correlated with the measured ISM column density, $N_H$ ($t_{\rm{vis}} \propto N_H^{-a}$, with $a \sim 0.33$) while the remaining will have visibility times determined by the detection limit of the radio survey. These observational constraints on the visibility time of SNRs will allow us to use SNR catalogs as `SN surveys' to calculate SN rates and delay time distributions in the Local Group.
OTC-Cleared Derivatives: Benefits, Costs, and Implications of the 'Dodd-Frank Wall Street Reform and Consumer Protection Act'

Derivatives that are negotiated over-the-counter (OTC), but cleared and settled through central counterparties have grown in popularity since their first appearance in the 1990s. Such “OTC-cleared” derivatives have both benefits and costs that can vary significantly across market participants and product types. This article explores the evolution of OTC-cleared derivatives and those benefits and costs. Particular attention is paid to the regulatory framework for OTC derivatives, which was recently substantially overhauled with the adoption of the Dodd-Frank Wall Street Reform and Consumer Protection Act. Under the new Act, the clearing and settlement of many OTC derivatives through a central counterparty (CCP) is now mandatory. The challenges and risks likely to arise from these new regulations are also explored here for clearinghouses, swap dealers, and major users of OTC derivatives.
MAPT haplotype diversity in multiple system atrophy.

Abstract Introduction Multiple system atrophy (MSA) is a rare progressive neurodegenerative disorder. MSA was originally considered exclusively sporadic but reports of association with genes such as SNCA, COQ2 and LRRK2 have demonstrated that there is a genetic contribution to the disease. MAPT has been associated with several neurodegenerative diseases and we previously reported a protective association of the MAPT H2 haplotype with MSA in 61 pathologically confirmed cases. Methods In the present study, we assessed the full MAPT haplotype diversity in MSA patients using six MAPT tagging SNPs. We genotyped a total of 127 pathologically confirmed MSA cases, 86 patients with clinically diagnosed MSA and 1312 controls. Results We identified four significant association signals in our pathologically confirmed cases, two from the protective haplotypes H2 (MSA:16.2%, Controls:22.7%, p = 0.024) and H1E (MSA:3.0%, Controls:9.0%, p = 0.014), and two from the rare risk haplotypes H1x (MSA:3.7%, Controls:1.3%, p = 0.030) and H1J (MSA:3.0%, Controls:0.9%, p = 0.021). We evaluated the association of MSA subtypes with the common protective H2 haplotype and found a significant difference with controls for MSA patients with some degree of MSA-C (MSA-C or MSA-mixed), for whom H2 occurred in only 8.6% of patients in our pathologically confirmed series (P Conclusions Our findings provide further evidence that MAPT variation is associated with risk of MSA. Interestingly, our results suggest a greater effect size in the MSA-C compared to MSA-P for H2. Additional genetic studies in larger pathologically confirmed MSA series and meta-analytic studies will be needed to fully assess the role of MAPT and other genes in MSA.
Collaborative Brain-Computer Interface for People with Motor Disabilities [Research Frontier]

This research investigates the effects of collaboration mode, luminance contrast and motor disability on task performance, brain activity and satisfaction of users with motor disabilities who performed a robot control task using a collaborative brain-computer interface (C-BCI) based on steady-state visually evoked potentials (SSVEPs). Users can perform the task by himself/herself (individual mode), working together (simultaneous mode), or taking turns (sequential mode). Fourteen amyotrophic laterals sclerosis (ALS) participants and fourteen able-bodied participants of similar age were recruited from local ALS association and local communities. Results showed that participants in both groups had significantly better task performance and stronger brain activity in collaborative modes than individual mode. High luminance contrast produced significantly better task performance and stronger brain activity than low luminance contrast. There was no significant effect of motor disability between ALS participants and able-bodied participants. The two groups showed very similar task performance and brain activity. These results could provide precious empirical data and invaluable insights to the real-world applicability of the SSVEP-based BCI applications for people with motor disabilities.
Geo-location of detected landmines via mobile robots equipped with multiple sensors

In the process of landmine remediation, it is necessary to determine the ground coordinates of the mines. This is needed for data association in the case of multiple looks by a single sensor as well as in the case of multiple sensors. It is also required for neutralizing the mine or marking it for avoidance. Earlier the work in this area treated the use of a single radar sensor. This has now been extended to include multiple sensors, forward-looking radar and infrared. It treats the process of combining these measurements for optimal estimation of the mine's ground coordinates as well as tracking the status of each mine with respect to each sensor's field of view. Results of simulations show significant benefits achieved by the use of the multiple sensors.
The Impact of Viewer Perceptions of Media Personae and Viewer Characteristics on the Strength, Enjoyment, and Satisfaction of Parasocial Relationships

Using a cross-sectional survey design (N = 338), we measured the impact of viewer perceptions of media personae and viewer characteristics on the strength, enjoyment, and satisfaction of parasocial relationships. Strength, enjoyment, and satisfaction of parasocial relationships were strongest with characters that viewers like that are perceived to be similar to the viewer or someone they know in real life. However, the strength and enjoyment of parasocial relationships decreased when the persona was perceived to be similar to either the viewer or someone they know in real life and the viewer was high on attachment anxiety, attachment avoidance, or loneliness. Limitations and implications are discussed.
Coupled geomorphic and habitat response to a flood pulse revealed by remote sensing.

Despite a growing consensus on the importance of floods in structuring river ecosystems, predicting the geomorphic and habitat response to specific flood pulses across a range of scales remains challenging. We used a large reservoir release in a semiarid river to characterize geomorphic and habitat responses to a flood pulse, using an integrated field, remote sensing, and modeling approach. Large-scale geomorphic changes were observed as a result of the flood, including lateral migration of the river channel, gravel bar formation, and development of off-channel chutes. Spatial patterns of gravel storage varied with downstream distance from a large dam, with the upper 15 km experiencing a net sediment deficit and the lower 65 km undergoing net deposition. The longitudinal trends in gravel transport and storage reflected differences in channel gradient and predicted values of sediment mobility. The flood lowered the channel by an average of −0.5 m and roughly doubled the areal extent of pools, by incising new pools in curved reaches and in areas where the river abutted valley walls and terraces. The increased pool abundance provided greater habitat connectivity and was predicted to have positive impacts on anadromous steelhead, providing up to a 3-fold increase in the number of juvenile fish the river could support. Results from this study highlight the value of using flood pulses as opportunities to learn about river behavior, and for testing the degree to which physical processes can help restore the form and function of river ecosystems.
RENIN ANGIOTENSIN SYSTEM INHIBITORS IN PATIENTS WITH CORONARY ARTERY DISEASE AND PRESERVED LEFT VENTRICULAR FUNCTION

Background: Renin angiotensin system inhibitors (RASi) are recommended (Class I LoE A ) for patients with coronary artery disease (CAD) without heart failure. However, more recent trials with improved background therapy (and lower event rates) failed to show a benefit of RASi over active controls or
A Novel Non-Operative Protocol for the Acute Management of In-Season Acromioclavicular Separations

Objectives:Traditional treatment of acromioclavicular (AC) sprains has been a sling with rest and rehabilitation. We have developed a protocol that uses a static scapular retraction brace (Figure 1) to reduce the displaced upper extremity back to the clavicle. We hypothesized that the brace in combination with oral and injected steroid and a rehabilitation protocol that emphasizes postural restoration, facilitates a more anatomic reduction of the AC joint that quickly eliminates discomfort, allows for more anatomic healing and a rapid return to normal activities in type 1, 2, and 3 AC separations.Methods:Data was prospectively collected and retrospectively reviewed on all collegiate football AC separations at an NCAA division I university. Data included treatment, the number of practices missed, the number of games missed, and time to full return to play. Inclusion criteria were all consecutive in-season Type I-III AC separations sustained during football activities that requiring medical attention. Exclu...
Mitochondrial Integrity and Function in the Progression of Early Pressure Overload-Induced Left Ventricular Remodeling.

Background Following pressure overload, compensatory concentric left ventricular remodeling (CR) variably transitions to eccentric remodeling (ER) and systolic dysfunction. Mechanisms responsible for this transition are incompletely understood. Here we leverage phenotypic variability in pressure overload–induced cardiac remodeling to test the hypothesis that altered mitochondrial homeostasis and calcium handling occur early in the transition from CR to ER, before overt systolic dysfunction. Methods and Results Sprague Dawley rats were subjected to ascending aortic banding, (n=68) or sham procedure (n=5). At 3 weeks post–ascending aortic banding, all rats showed CR (left ventricular volumes Conclusions After pressure overload, mitochondrial biogenesis and function and calcium handling are enhanced in compensatory CR. The transition to mild ER is associated with decrease in mitochondrial biogenesis and content; however, the progression to moderate ER is associated with enhanced mitochondrial autophagy/apoptosis and impaired mitochondrial function and calcium handling, which precede the onset of overt systolic dysfunction.
Fluid pressurization and tractional forces during TMJ disc loading: A biphasic finite element analysis.

Structured AbstractObjectives To investigate the ploughing mechanism associated with tractional force formation on the temporomandibular joint (TMJ) disc surface. Setting and Sample Population Ten left TMJ discs were harvested from 6- to 8-month-old male Yorkshire pigs. Materials and Methods Confined compression tests characterized mechanical TMJ disc properties, which were incorporated into a biphasic finite element model (FEM). The FEM was established to investigate load carriage within the extracellular matrix (ECM) and the ploughing mechanism during tractional force formation by simulating previous in vitro plough experiments. Results Biphasic mechanical properties were determined in five TMJ disc regions (average±standard deviation for aggregate modulus: 0.077±0.040 MPa; hydraulic permeability: 0.88±0.37×10−3 mm4/Ns). FE simulation results demonstrated that interstitial fluid pressurization is a dominant loading support mechanism in the TMJ disc. Increased contact load and duration led to increased solid ECM strain and stress within, and increased ploughing force on the surface of the disc. Conclusion Sustained mechanical loading may play a role in load carriage within the ECM and ploughing force formation during stress-field translation at the condyle–disc interface. This study further elucidated the mechanism of ploughing on tractional force formation and provided a baseline for future analysis of TMJ mechanics, cartilage fatigue and early TMJ degeneration.
Ellen R. Grass Guest Lecture: Long-Term Video/EEG Monitoring and Behavior

ABSTRACT.Involvement of the limbic system, the seat of emotions in the brain, can lead to psychiatric accompaniments to epilepsy. Patients with epilepsy may also have depression, psychoses, forced normalization, and personality disorders. Long-term video/EEG has allowed improved differentiation between epileptic syndromes and nonepileptic disorders that may mimic epilepsy clinically. Pseudoseizures are important nonepileptic events that need to be distinguished from epileptic seizures. Other conditions that may accompany epilepsy or be confused with epileptic seizures include migraine and the MELAS syndrome; sleep disorders, such as cataplexy, sleep attacks, and REM sleep behavior disorder; the childhood disorders of breathholding spells, benign paroxismal vertigo of childhood, and Rett syndrome; and movement disorders such as shuddering spells and hyperekplexia.
The Test Anxiety Measure for College Students: Examination of Its Psychometric Properties Using an Online Survey With a Canadian Sample:

The psychometric properties of a new multidimensional measure of test anxiety, the Test Anxiety Measure for College Students (TAM-C), based on theory and current research were examined in a sample ...
On Accelerating Source Code Analysis at Massive Scale

Encouraged by the success of data-driven software engineering (SE) techniques that have found numerous applications e.g., in defect prediction, specification inference, the demand for mining and analyzing source code repositories at scale has significantly increased. However, analyzing source code at scale remains expensive to the extent that data-driven solutions to certain SE problems are beyond our reach today. Extant techniques have focused on leveraging distributed computing to solve this problem, but with a concomitant increase in computational resource needs. This work proposes a technique that reduces the amount of computation performed by the ultra-large-scale source code mining task, especially those that make use of control and data flow analyses. Our key idea is to analyze the mining task to identify and remove the irrelevant portions of the source code, prior to running the mining task. We show a realization of our insight for mining and analyzing massive collections of control flow graphs of source codes. Our evaluation using 16 classical control-/data-flow analyses that are typical components of mining tasks and 7 Million CFGs shows that our technique can achieve on average a 40 percent reduction in the task computation time. Our case studies demonstrates the applicability of our technique to massive scale source code mining tasks.
SPECT/Micro-CT Imaging of Bronchial Angiogenesis in a Rat

The bronchial circulation provides the lung with an oxygenated blood supply, derived from the aorta, whose primary purpose under normal conditions is thought to be nourishment of the airway walls +Guyton, 1996-. However,the study of the bronchial circulation and its development is particularly important with regard to lung tumors whose blood supply is via the bronchial circulation rather than the pulmonary circulation +Hirsch, 2001, Ohta, 2002-. Thus, we have developed a rat model of bronchial circulation angiogenesis,induced by complete occlusion of the left pulmonary artery. We have been observing the resulting perfusion changes in the left lung using dual-modality SPECT/micro-CT imaging. The initial objective of this study is to develop the necessary imaging system, protocol, and analysis methods for determining the time course of this angiogenesis, with the subsequent goal of using this approach to study the particular angiogenic mechanisms that might be involved.
Mitral Annuloplasty Ring Fracture and Annular Injury During Transcatheter Mitral Valve-in-Ring Intervention

A 60-year-old man who underwent prior surgical repair of severe mitral regurgitation with a 28-mm Sorin 3-dimensional Memo complete semi-rigid annuloplasty ring (Sorin Group, Arvada, Colorado) developed symptomatic severe functional mitral stenosis (transmitral mean gradient: 10.7 mm Hg at a heart
An approach for evaluating changes in land-use from energy sprawl and other anthropogenic activities with implications for biotic resource management

This study presents a novel approach for evaluating land-use changes caused by energy development and other anthropogenic activities. We illustrate this technique by assessing the landscape footprint of energy development in the Eagle Ford Shale Play and Permian Basin of Texas, which saw rapid expansion in drilling during 2008–2012. We compare changes in land-use from oil and gas infrastructure construction during this time period with that of wind energy development in West Texas, urbanization in Central Texas, and extensive agricultural areas. Previous studies often use land-use proxies when comparing the footprint of energy infrastructure (e.g., 1 km2 gridded well density or proposed wind project footprints) with other anthropogenic land-change. This study presents an improved technique because it compares high-resolution datasets of agricultural activity and urbanization with mapped—not surrogate—land-change from oil and gas and wind power infrastructure using high-resolution (1 m) aerial imagery. We found that changes in land-use caused by anthropogenic factors affected 1.06% (3456 km2) of the ~ 324,000 km2 study area. Oil and gas development (well pads and pipelines) was ~ 48% of total changes in land-use (but did not account for access roads), changes in agriculture caused ~ 26%, and urbanization was ~ 24%. Construction of wind turbine pads and high voltage power transmission lines was less important (~ 1%). We illustrate this approach for a single species (i.e., Spot-tailed Earless Lizard, Holbrookia lacerata) in Texas. This study is part of an ongoing, multi-year research program generating science to inform the federal Endangered Species Act listing decision for H. lacerata. Additionally, this technique can facilitate effective management of a variety of biotic resources in other rapidly developing environments globally by identifying what anthropogenic activities are most important and where land-change is most intense so that on-the-ground conservation strategies can be implemented where they are needed most.
Brief of Six Members of Congress in Support of the Petitioner in South Dakota v. Wayfair (Certiorari)

Six members of Congress filed this amicus brief in South Dakota v. Wayfair in support of South Dakota’s petition of certiorari. The question presented by the petition is: “Should this Court abrogate Quill’s sales-tax-only, physical-presence requirement?” The members of Congress filed this brief to “to provide an anticipatory response to the inevitable objection that respondents will make that this Court should stay its hand and allow Congress to address the serious unfairness problems created by Quill.” Among other arguments made by the members in this amicus brief is the following: “In the typical situation, a party interested in receiving an advantage from Congress must persuade both Houses and the President to agree. Here, as was recognized at the time Quill was decided, the advantage was instead granted by this Court, and it is therefore the States that must persuade Congress and the President to take it away. Given the built-in, indeed intended, difficulties in enacting federal laws, the current Quill-determined status quo places a very large thumb on the scales on the side of out-of-state sellers. This is especially problematic on federalism grounds because the States are being forced to surmount these hurdles in order to obtain permission from the federal government to use their own taxing powers.”
Performance measures for evaluating the financial benefits of state term commodity

A common justification for state term commodity contracts is that they are beneficial to taxpayers because of savings that result from the price concessions expected from volume purchasing. With the growing popularity of performance based budgeting in state legislatures, there is a clear need for performance measures to document these taxpayer benefits. Based on a survey of state purchasing offices and a review of the major purchasing associations and the academic literature, this paper develops guidelines and a set of performance measures for evaluating the financial benefits of state term commodity contracts.
Risk factors and clinical outcomes associated with fixed airflow obstruction in older adults with asthma

Abstract Background Asthma in older adults is associated with increased morbidity and mortality compared with asthma in younger patients. Fixed airflow obstruction (FAO) is associated with decreased survival in younger patients, but its significance remains unclear in older adults with asthma. Objective To identify risk factors and outcomes related to FAO in older adults with asthma. Methods Subjects older than 55 years with a physician diagnosis of persistent asthma were evaluated. Collected data included participant demographic information, medications, asthma exacerbations, Asthma Control Test (ACT) score, Asthma Quality of Life (AQLQ) score, comorbidities, spirometry, atopic status, and fractional exhaled nitric oxide. Clinical characteristics and outcomes associated with FAO (defined as post-bronchodilator ratio of forced expiratory volume in 1 second to forced vital capacity ≤70%) were assessed. Results A total of 186 participants were analyzed (48 men and 138 women, mean age 66 years). FAO was demonstrated in 30% of participants. Using regression analysis, predictors of FAO included advanced age, African American race, male sex, and longer duration of asthma. In outcomes analysis, FAO was associated with worsened ACT and AQLQ scores; however, after controlling for confounding factors, logistic regression showed no association. No significant association was found between FAO and exacerbations, fractional exhaled nitric oxide, atopy, rhinitis, education level, depression, smoking, or body mass index. Conclusion Risk factors associated with FAO in older adults with asthma include advanced age, African American race, increased asthma duration, and male sex. Unlike younger patients, FAO is not independently associated with worsened asthma control, quality of life, or exacerbations in older patients with asthma. Trial Registration ClinicalTrials.gov identifier: NCT01979055.
Mathematics and the Search for Knowledge. By Morris Kline

(1987). Mathematics and the Search for Knowledge. By Morris Kline. The American Mathematical Monthly: Vol. 94, No. 3, pp. 314-315.
Creating Communities of Learners: The Interaction of Shared Leadership, Shared Vision, and Supportive Conditions.

This study examines the preliminary results of a 5-year national study on creating communities of learners, provides findings from teachers and principals at 20 schools, analyzes characteristics of highand low-readiness schools, and discusses the interaction of leadership, vision, values, and the conditions required for professional learning communities (PLCs.) Characteristics of professional learning communities include shared authority and power, a united focus on student learning, collective learning by staff, supportive institutions, and the sharing of personal instructional practices. Effective leadership from the entire school community is needed to implement shared visions and values, and this requires developing the personal capacities of staff, and providing for adequate times and settings for peer dialogue and departmental communication. The Southwest Educational Development Laboratory project, "Creating Communities of Continuous Inquiry and Improvement," targets the creation of PLCs with co-developers in the Southeast, Midwest, and Northwest regions of the U.S. The preliminary data clearly suggest schools that have successfully integrated shared leadership, shared vision, and a supportive school culture are much better positioned to create professional learning communities than the less "change-ready" schools, which lacked similar markers of progress. Further research may reveal particular practices that facilitate integration in these three critical areas. (Contains 15 references.)(TEJ) Reproductions supplied by EDRS are the best that can be made from the original document. Creating Communities of Learners: The Interaction of Shared Leadership, Shared Vision, and Supportive Conditions Jane B. Huffman University of North Texas College of Education P.O. Box 311337 Denton, Texas 76203 940 565-2832 huffman@unt.edu Kristine A. Hipp Cardinal Stritch University College of Education 6801 North Yates Road Milwaukee, WI 53217 414/410-4346 khipp@acs.stritch.edu
Surgery After an Initial Episode of Uncomplicated Diverticulitis: Does Time to Resection Matter?

Abstract Background The aim of this study was to determine whether time to surgery after an initial episode of uncomplicated diverticulitis is associated with undergoing an emergent versus an elective resection. Methods In this retrospective, administrative claims database study, we identified patients at least 18 y old in the 2005-2011 California State Inpatient Database who had an initial episode of uncomplicated diverticulitis and then underwent a bowel resection within 2 y. After characterizing the distribution in time to surgery among all patients, we used a multivariable logistic regression to determine whether time to surgery was associated with undergoing an emergent resection. Next, we assessed differences in three outcomes between elective and emergent resections: at least one of eight postoperative complications, extended length of stay (defined as the top decile of hospitalizations), and 30-d inpatient readmissions. Analyses adjusted for time between initial hospitalization and resection, number of inpatient hospitalizations for diverticulitis before the resection, clinical factors, and hospital clustering. Results We identified 4478 patients with an initial episode of uncomplicated diverticulitis followed by a bowel resection within the subsequent 2 y. One-fifth (21.1%) underwent an emergent resection. The median time from the initial episode to resection was 3.8 mo (IQR: 2.3-8.1 mo) for elective resections and 5.1 mo (IQR: 2.3-12.4 mo) for emergent resections. The adjusted odds of undergoing an emergent relative to an elective resection increased by 7% (aOR 1.07 [1.02-1.11]) for every 3 passing mo. Emergent resections were associated with greater adjusted odds of complications (adjusted odds ratio [aOR] 1.75 [95%-CI 1.43-2.15]), extended LOS (aOR 4.52 [3.31-6.17]), and 30-d readmissions (aOR 1.49 [1.09-2.04]). Conclusions Among patients who experienced an initial episode of uncomplicated diverticulitis and eventually underwent a resection, the odds of having an emergent relative to elective surgery increased with every 3 passing mo. These findings may inform the management of uncomplicated diverticulitis for high-risk patients eventually needing surgery.
On ‘telling better stories’*

Over the course of his forty-year career, Lawrence Grossberg has modelled a form of rigorous, politically-engaged, radically contextual social research. Writing about Cultural Studies in the abstra...
HIV-Specific T Cell Responses Are Highly Stable on Antiretroviral Therapy

HIV infection induces a robust T cell response that is sustained by high viremia, but falls following the onset of antiretroviral therapy (ART). Relatively little has been reported on the subsequent stability of the HIV-specific T cell response in individuals on durable therapy. Such data are critical for powering clinical trials testing T cell-based immunotherapies. In a cross-sectional study, HIV-specific T cell responses were detectable by ex vivo interferon (IFN)-γ ELISpot (average ∼1,100 spot-forming units [SFUs]/106 peripheral blood mononuclear cells) in persons living with HIV (PLWH; n = 34), despite median durable ART suppression of 5.0 years. No substantial association was detected between the summed HIV-specific T cell response and the size of the replication-competent HIV reservoir. T cell responses were next measured in participants sampled weekly, monthly, or yearly. HIV-specific T cell responses were highly stable over the time periods examined; within-individual variation ranged from 16% coefficient of variation (CV) for weekly to 27% CV for yearly sampling. These data were used to generate power calculations for future immunotherapy studies. The stability of the HIV-specific T cell response in suppressed PLWH will enable powered studies of small sizes (e.g., n = 6–12), facilitating rapid and iterative testing for T cell-based immunotherapies against HIV.
Developing Biomarker Panels to Predict Progression of Acute Kidney Injury After Cardiac Surgery.

Introduction Acute kidney injury (AKI) is a frequent complication of cardiac surgery, but only a fraction of cardiac surgery patients that experience postoperative AKI have progression to more-severe stages. Biomarkers that can distinguish patients that will experience progression of AKI are potentially useful for clinical care and/or the development of therapies. Methods Data come from a prospective cohort study of cardiac surgery patients; the analytic dataset contained data from 354 cardiac surgery patients meeting criteria for AKI following surgery. Candidate predictors were 38 biomarkers of kidney function, insult, or injury measured at the time of AKI diagnosis. The outcome was AKI progression, defined as worsening of AKI Network stage. We investigated combining biomarkers, with Bayesian model averaging (BMA) and random forests of classification trees, with and without center transformation. For both approaches, we used resampling-based methods to avoid optimistic bias in our assessment of model performance. Results BMA yielded a combination of 3 biomarkers and an optimism-corrected estimated area under the receiver operating characteristic curve (AUC) of 0.75 (interquartile range: 0.68, 0.82). The random forests approach, which nominally uses all biomarkers, had an estimated AUC of 0.74 (interquartile range: 0.66, 0.82). A second application of random forests applied to biomarker values after a center-specific transformation had an estimated AUC of 0.80 (interquartile range: 0.72, 0.88). Conclusion These findings suggest that the application of advanced statistical techniques to combine biomarkers offers only modest improvements over use of single biomarkers alone. This exemplifies a common experience in biomarker research: combinations of modestly performing biomarkers often also have modest performance.
Adverse Events After Inpatient Colonoscopy in Octogenarians: Results From the National Inpatient Sample (1998-2013).

Background and aim Colonoscopy is commonly performed in the elderly who have a higher proportion of lower gastrointestinal (GI) tract disorders. However, few studies have evaluated the safety of colonoscopy specifically in the octogenarian population. The goal of this study is to examine the safety of colonoscopy among octogenarians over a 16-year period. We also examine risk factors associated with morbidity and mortality in octogenarians after inpatient colonoscopy. Materials and methods We queried the National Inpatient Sample to identify octogenarians who had a colonoscopy during hospitalization from 1998 to 2013. We examined inpatient GI-related adverse events including colonic perforation, postcolonoscopy bleeding, and splenic injury. We also examined all-cause mortality rates after colonoscopy. Results About a quarter of inpatient colonoscopies performed annually were in octogenarians. Of 296,385 colonoscopies included in our study, colon perforation, postcolonoscopy bleeding, and splenic injury occurred in 11, 9, and 0.22 per 1000 colonoscopies, respectively. Overall mortality rate was 2.8%, most (2.5%) dying within 30 days of colonoscopy. After controlling for covariates, those who had colon perforation, postcolonoscopy bleeding, or splenic injury were at a much higher risk of inpatient mortality. Conclusions There seems to be a higher risk of adverse GI-related events after colonoscopy in octogenarians as compared with the general population. Furthermore, occurrence of adverse GI-related events increased the risk of mortality among octogenarians regardless of comorbid status.
Lung Cancer: Pathophysiology and Current Advancements in Therapeutics

Lung cancer, a highly invasive, rapidly metastasizing and prevalent cancer, is the top killer malignancy in both men and women in the United States of America (USA), Europe, United Kingdom (UK), and developing Asian countries. Lung cancer causes more deaths per year than the next four leading cancers (colon/rectal, breast, pancreas, and prostate) together in the United States. However, over the last two decades, we have observed enhanced outcomes that are mostly attributable to initial detection, improved efforts in tobacco control, amended surgical approaches, and the development of novel targeted therapies. At present, there are numerous novel therapies in clinical practice, including those targeting actionable mutations and more lately immunotherapeutic drugs. Immunotherapy signifies the most noteworthy step forward in eliminating this deadly disease. This chapter highlights the major advances in treatments with therapeutic intent, systemic targeted therapies, comforting care, and early detection in lung cancer. We discuss the fundamental research that reinforces these new technologies/strategies and their current position in clinical practice.
Perfluorooctane sulfonic acid (PFOS) exposure during pregnancy increases blood pressure and impairs vascular relaxation mechanisms in the adult offspring

Abstract Perfluorooctanesulfonate (PFOS) is a persistent environmental agent. We examined whether PFOS exposure during pregnancy alters blood pressure in male and female offspring, and if this is related to sex-specific changes in vascular mechanisms. PFOS was administered through drinking water (50 μg/mL) to pregnant Sprague-Dawley rats from gestational day 4 until delivery. PFOS-exposure decreased maternal weight gain but did not significantly alter feed and water intake in dams. The male and female pups born to PFOS mothers were smaller in weight by 29 % and 27 %, respectively. The male PFOS offspring remained smaller through adulthood, but the female PFOS offspring exhibited catch-up growth. The blood pressure at 12 and 16 weeks of age was elevated at similar magnitude in PFOS males and females than controls. Mesenteric arterial relaxation to acetylcholine was reduced in both PFOS males and females, but the extent of decrease was greater in females. Relaxation to sodium-nitroprusside was reduced in PFOS females but unaffected in PFOS males. Vascular eNOS expression was not changed, but phospho(Ser1177)-eNOS was decreased in PFOS males. In PFOS females, both total eNOS and phospho(Ser1177)-eNOS expression were reduced. In conclusion, PFOS exposure during prenatal life (1) caused low birth weight followed by catch-up growth only in females (2) lead to hypertension of similar magnitude in both males and females; (2) decreased endothelium-dependent vascular relaxation in males but suppressed both endothelium-dependent and -independent relaxation in females. The endothelial dysfunction is associated with reduced activity of eNOS in males and decreased expression and activity of eNOS in females.
Trends In Utilization of Palliative Care In Acute Heart Failure Admissions

Introduction Congestive heart failure is a leading cause of readmissions in the United States. Although treatment has come a long away, palliative care (PC) is often not appropriately offered in advanced heart failure. The purpose of this study was to use a large database of national in-patient sample to find out the penetrance of PC in acute heart failure admissions. Methods Data from 2002 to 2017 was used for analysis. ICD-9-CM and ICD-10-CM were used for PC encounter identifications in patients admitted with acute heart failure. Chi-square test was used for categorical variables and t-test for continuous variables. Multivariable Regression analysis was done for predictors of PC encounters. A p-value of Results The use of palliative care was found to be low at 4.1%, although recent trends have shown an increase (from 0.4% in 2002 to 6.2% in 2017). Women (0.3% in 2002 to 6.5% in 2017) and Caucasians (0.6% in 2002 to 6.9% in 2017) had a higher proportion of PC encounters as compared to men (0.5% in 2002 to 5.9% in 2017) and other racial minorities (Figure). On multivariable analysis; increasing age (OR, 1.04[CI; 1.03-1.04], p Conclusion The penetrance of palliative care has increased in the United States over the years; however, it is still low as compared to other high-income countries. More studies are needed to address the barriers to PC in patients of acute heart failure.
Protocol-Driven Intensive Outpatient Management of Pregnant Patients With Symptomatic Coronavirus Disease 2019.

Background Reports of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have focused on pregnant women hospitalized due to moderate to severe coronavirus disease 2019 (COVID-19) or asymptomatic women diagnosed through universal screening at the time of obstetric admission. Many pregnant women who have symptomatic SARS-CoV-2 infection may not meet criteria for hospitalization; however, whether and how these women can be managed safely in outpatient setting is not well described. Methods We sought to describe the time to symptom and viral clearance and to identify predictors of hospitalization to better understand the safety of monitoring pregnant patients with symptomatic COVID-19 in the outpatient setting. We performed a retrospective cohort study of pregnant patients with symptomatic, confirmed COVID-19 illness at a large, academic medical center. Patients had systematic telehealth follow up by a clinician team to assess for symptoms, provide virtual prenatal care, and arrange in-person visits when appropriate in a dedicated outpatient center. Data were collected via chart abstraction. Results Of 180 pregnant patients presenting with symptoms and undergoing reverse-transcription polymerase chain reaction (RT-PCR) testing, 67 patients with confirmed COVID-19 infection were identified during the study period. Nineteen (28%) required acute care given worsening of COVID-19 symptoms, and 95% of these were directed to this acute care setting due to symptom severity telehealth evaluation. Nine women (13%) were admitted to the hospital given worsening symptoms, 3 required intensive care unit care, 2 required ventilatory support, and 2 required delivery. Women with the presenting symptoms of fever, cough, shortness of breath, chest pain, or nausea and vomiting were more likely to require admission. The median duration from initial positive test to RT-PCR viral clearance was 26 days. Disease progression, time to viral clearance, and duration of symptoms did not vary significantly by trimester of infection. Conclusions Management of the majority of pregnant women with symptomatic COVID-19 illness can be accomplished in the outpatient setting with intensive and protocol-driven monitoring for symptom progression.