cssi/SciSciGPT-SciSciNet huggingface dataset:
Epidemic analysis of infectious diseases in schools and nurseries of Wuxi New District in 2013

[Objective]To investigate the morbidity of infectious diseases among preschool,primary and secondary students in Wuxi New District,and provide scientific evidence for the control policies development. [Methods]Descriptive analysis was performed on the data from the china Information system for disease control and prevention. [Results]A total of 1 618 cases of 11 kinds of infectious diseases were reported in schools of Wuxi New District in 2013. The top 3 Infectious diseases were HFMD(76.51%),chickenpox(14.52%),mumps(5.25%). The peak incidence appeared in June,July and October-December,which accounted for 61.67% of total cases. 81.58% of cases were kindergarten children. The transmission route was dominated by intestinal infections(78.99%). Emergency and outbreaks all occurred in school and kindergarten. [Conclusion]The prevention and control situation of infectious diseases in schools of Wuxi New District is still severe. To reduce the infection rates,it is necessary to strengthen the information communication between departments,to integrate symptom monitoring and disease surveillance system,to adopt comprehensive measures,and to improve the disease prevention and control capabilities and level in schools.
Unstiffened Compression Elements

Local buckling and post-buckling behavior of unstiffened elements in cold-formed steel structural sections are studied. Column and beam specimens tested and results obtained are presented. Two effective width equations for the post-buckling behavior have been compared with test results indicating good correlation. Two procedures for calculating the flexural buckling strength of columns including the effects of local buckling, based on tangent modulus and Column Research Council Methods, are presented. The column curves obtained using these two methods indicate good correlation with the results of tests on cold-formed steel columns.
NDT methods for the in-situ evaluation of pavements in the USA : a review

In this paper, the non-destructive condition evaluation of both 'flexible' and 'rigid' pavement systems is discussed. The objective is to describe non-destructive test method(s) for the in-situ, or in-place, evaluation of individual layers within rigid and flexible pavements. Such tests are: the static tests, steady-state dynamic tests, impact response tests, electromagnetic tests, and the wave propagation tests, including the ultrasonic tests, and impact testing. The characteristic that is exploited is the elastic response of materials within individual pavement layers. It is from these responses that properties, such as strength, deformation, load-carrying capacity, and locations of cracks and flaws of the overall pavement system are inferred. This work aims comprehensively at new, old, and rehabilitated pavement systems. In all of these cases, the in-situ properties of layers within the pavement system are of interest; specification compliance determination, material condition monitoring, or rehabilitation effectiveness determination may follow from such knowledge.
Why Do Internal Auditors Burnout? An Investigation of Individual and Organizational Explanations

The burnout condition of employees?characterized by three interrelated symptoms of emotional exhaustion, reduced personal accomplishment and depersonalization?is a well-known phenomenon in psychology and several applied business disciplines. Following persistent recognition in the practice community, academic recognition of this topic has begun to appear in the accounting literature. Prior research in accounting has shown that burnout among internal auditors is a serious concern for both individuals and their employers. However, the antecedents of the burnout condition have not been identified. This paper offers evidence that the burnout condition is directly related to one behavioral and one attitudional construct pertaining to the individual auditor. Specifically, individuals who perceived that they possessed a better and more robust skill set were less likely to be burned out. Secondly, individuals with an internal locus of control were not as likely to report burnout symptoms. In addition, this research links organizational conditions to burnout. Internal auditors that express greater trust in their companies are less likely to experience burnout. This paper adds vital components to an evolving appreciation of the psychosocial environment of internal auditing at the time of great change to this practice segment. Implications for the management of human resources in this area are included.
Problem-Based Learning in Nuclear Medicine Technology Education

Problem-based learning (PBL) has emerged in the past several decades as an innovative educational approach used in the curricula of numerous medical schools internationally and in the United States. Currently, several allied health educational programs have begun to implement PBL methods in their courses. This research sought to ascertain whether or not PBL could be applied as an alternative instructional method in the education of nuclear medicine technologists. A problem-based instructional module on radiation protection was developed, and one unit of the module was implemented. All participants showed significant improvement on post-test scores in comparison to pre-test scores. In addition, all participants expressed enjoyment with this instructional approach in comparison with more traditional methods such as the lecture. PBL appears to be viable in the education of nuclear medicine technologists; however, further investigation into its use is encouraged.
Patients as Partners in Learning from Unexpected Events

Importance Patient safety experts believe that patients/family members should be involved in adverse event review. However, it is unclear how aware patients/family members are about the causes of adverse events they experienced. Objective To determine whether patients/family members interviewed could identify at least one contributing factor for the event they experienced. Secondary objectives included understanding the way patients/family members became aware of adverse events, the types of contributing factors patients/family members identified for different types of adverse events, and recommendations provided by patients/family members to address the contributing factors. Design We interviewed patients/family members using semistructured interviews to understand their perceptions about why these adverse events occurred. The adverse events occurred between 1991 and 2014. Setting Participants described adverse events that occurred in various types of health care organizations (i.e., hospitals, ambulatory facilities/clinics, and dental clinics). Participants We interviewed 72 patients and family members who each described a unique adverse event. Eligibility requirements were that patients/family members spoke English or Spanish and were aware of an adverse event that happened to them or a loved one. Intervention(s) for Clinical Trials or Exposure(s) for Observational Studies N/A. Main Outcome(s) and Measure(s) The main outcome was determining whether patients/family members could identify at least one contributing factor they perceived as related to the adverse event they described. Results Each participant identified at least one contributing factor and on average identified 3.67 contributing factors for their event. The most frequently mentioned contributing factors were Staff Qualifications/Knowledge (79 percent), Safety Policies/Procedures (74 percent), and Communication (64 percent). Participants knew about the contributing factors from personal observation only (32 percent), personal reasoning (11 percent), personal research (7 percent), record review (either their own medical records or reports they received in their own investigation; 6 percent), and being told by a physician (5 percent). Finally, patients/family members were able to provide recommendations that address each of the nine contributing factors we examined. Conclusions and Relevance Patients/family members identified contributing factors related to their adverse event. Given that these contributing factors might not be known to health care organizations because most participants stated that they were not involved in the analysis process, opportunities for organizational learning from patients are potentially being missed. Health care organizations should interview patients/family about the event that harmed them to help ensure a full understanding of the causes of the event.
Much Ado about Nothing? New Evidence on the Effects of Payday Lending on Military Members

We evaluate the effect that payday loan access has on credit and labor market outcomes of individuals in the U.S. Army. Using the conditional random assignment of service members to different locations, we employ three identification strategies: cross-sectional variation in state policies, within-term variation in payday lending access, and a difference-in-difference analysis using the national Military Lending Act. We find few adverse effects of payday loan access on service members when using any of these methods, even when we examine dozens of subsamples that explore potential differential treatment effects.
Catalyst-Free Polyhydroboration of Dodecaborate Yields Highly Photoluminescent Ionic Polyarylated Clusters.

The incorporation of polyhedral boranes into novel photoluminescent materials is an area with increasing interest. While the neutral carboranes have been widely investigated for this purpose, the dodecaborate ion has received much less attention. Herein we report a significant expansion to the scope of substitution reactions for the dodecaborate ion, whereby this cluster was observed to react directly with a wide range of arenes in a step-wise and controlled manner. In the products of these reactions, the dodecaborate ion serves as a core upon which up to nine mono- or polycyclic aromatic hydrocarbon ligands are exohedrally bonded. Spectroscopic evidence suggests the presence of conjugation between the π systems of the aryl ligands and the dodecaborate core, resulting in materials which exhibit high solution-phase photoluminescence, as well as molar absorptivities and Stokes shifts that are significantly larger than those of the free arenes from which they were derived. We propose that this broad reactivity is a valuable synthetic tool for the incorporation of polyhedral boron into novel organic structures.
Abstract 3796: Synergistic effect of targeted combination therapy in bladder cancer model using HSP90 inhibitors

Background In order to survive bladder cancer (BCa) cells deregulate key pathways - including the inhibition of apoptosis - while developing “oncogene addiction” to molecular chaperones such as Heat Shock Protein 90 (HSP90). While successful in vitro, monotherapies targeting such pathways have failed in clinical trials. We aim to show the superiority of combination therapy using proteostatic and targeted cytotoxic agents. We hypothesize that these combinations will synergize to increase cytotoxicity (CT) in BCa by amplifying the apoptosis via simultaneous activation of both intrinsic and extrinsic apoptotic pathways. Methods The proteostatic agents tested were the HSP90 inhibitor STA9090 (9090) and the proteasome inhibitor Marizomib (NPI). The cytotoxic agent used was a synthetic TRAIL ligand. These agents were tested in multiple ATCC BCa cell lines and the NCI patient tumor-derived BCa cell line UOBL 101 (UOBL). CT was determined via MTT assay. Mechanism of cytotoxic response was investigated using a series of immunoblots targeting the components of intrinsic and extrinsic apoptotic pathways and nuclear degradation proteins. All the assays were performed in triplicates for validation. Results 9090 (IC50 7.4-10 nM) was effective in all cell lines, as was NPI (IC50 10-20 nM). TRAIL caused 100% CT in UOBL (IC50 2.5 ng/mL, 95% CI [1.0, 7.0]) and a maximal 50% CT in T24, however the cytotoxicity of individual agents was not sustained. Combination effects of 9090 + TRAIL and NPI + TRAIL demonstrated an increase from 50% CT to 100% CT at the IC50 of both 9090 and NPI, and this effect was sustained over the course of the experiment. The increased cytotoxicity of combination therapy had corresponded to rapid cytoplasmic release of cytochrome c, additive increase in cleaved caspase 3 and caspase 8, with the corresponding increase in cleaved PARP and γ-H2ax. Conclusions Combination of a pro-apoptotic agent with a molecular chaperone or proteasome inhibitor holds promise in BCa therapyby affecting intracellular anti-apoptotic signaling and compromising efficient proteostasis in cancer cells lines, and should be investigated further. Citation Format: Raju Chelluri, Piyush K. Agarwal, Leonard M. Neckers, Armine K. Smith. Synergistic effect of targeted combination therapy in bladder cancer model using HSP90 inhibitors. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3796. doi:10.1158/1538-7445.AM2015-3796
Notch/HES1 Signaling Stabilizes p53 Expression Via a Novel PARP1-Chfr-PLK1-Mediated Mechanism in B-ALL

Abstract 1292 Background: Notch signaling contributes to T cell leukemogenesis. However, we have found that activation of Notch signaling in human B-ALL promotes growth arrest and apoptosis. These contrasting effects of Notch in B versus T cell ALL, mirror effects seen in early lymphocyte development. As the Notch receptors are common between T and B cells, we hypothesized that these differences rely on the cell-type specific downstream mechanisms. We previously reported a critical role for Notch/HES1-mediated activation of Poly ADP-Ribose Polymerase 1 (PARP1) function in this B cell specific mechanism. Approach: To explore the cell-type specific downstream mechanisms of Notch activation in B-ALL, we used cell fractionation, westerns and immunoprecipitation to identify cell cycle regulators which were altered by Notch activation via HES1 expression in human B-ALL lines. Results: Notch activation in a panel of human B-ALL lines led to consistent growth arrest and apoptosis. Indeed, ligands, activated receptors and the Notch target gene HES1 all induced these leukemia lihibiting effects in B-ALL but not T-ALL lines. In this study we report a mechanism whereby HES1-mediated activation of PARP1 leads to PARylation of the E3 ligase Checkpoint with FHA and RING finger (CHFR) (Panel A) which results in targeting and ubiquitination of the cell cycle regulator Polo-Like Kinase 1 (PLK1) (Panel B). PLK1 is highly expressed in B vs. T-ALL and plays a critical role in B cell growth and survival. Following Notch activation, loss of ubiquitionated PLK1 through proteosomal degradation leads to cell cycle arrest through two mechanisms, namely cytoplasmic relocalization of cyclin B, disrupting the CDC2-cyclinB complex, as well as phosphorylation of p53 at S20, which leads to decreased weakened p53-MDM2 interaction and accumulation of p53 (Panel C). siRNA to CHFR reveal that this mechanism is dependent on CHFR (Panel C). Importantly this mechanism is not seen in T-ALL cells as the activation of PARP1 by HES1 does not occur in T-ALL cells. Conclusions: Our findings reveal a novel molecular mechanism whereby Notch signaling induces disruption of the cell cycle in a cell type specific manner in B-ALL. Activation of PARP1, PARylation of CHFR, ubiquitination of PLK1 resulting in loss of nuclear cyclin B and accumulation of p53 demonstrates a series of events which can be initiated through activation of Notch in B-ALL. This mechanism reveals a potentially targetable approach to B-ALL. ![Figure][1] Disclosures: No relevant conflicts of interest to declare. [1]: pending:yes
Implications of Platelet RNA to Vascular Health and Disease

The historical relevance of platelets has focused on their traditional role in the circulation of hemostasis and thrombosis. Recent studies of platelet composition and novel platelet roles in a number of non-hemostatic systemic responses have since broadened our appreciation for the functional capabilities of platelets. One such expansion of our understanding includes the exploration of the platelet’s endogenous RNA and its ability to regulate platelet immune and inflammatory processes. RNA profiling of platelet messenger RNA (mRNA) and microRNA (miRNA) revealed distinct expression patterns associated with a number of platelet phenotypes and disease pathologies. A deeper understanding of the genetic material present in platelets endogenously and in disease settings can further elucidate the role platelet RNA plays in thrombosis and the implications of platelet involvement in fields such as cancer, infection, and systemic inflammation.
Maximizing information through multiple kernel-based heterogeneous data integration and applications to ovarian cancer

The medical research facilitates to acquire diverse type of data from the same individual for a particular cancer. Recent studies show that utilizing such diverse data results in more accurate predictions. The major challenge faced is how to utilize such diverse data sets in an effective way. In this paper, we introduce a multiple kernel based pipeline for integrative analysis of high-throughput molecular and clinical data. We apply the pipeline on Ovarian cancer data from TCGA. After multiple kernel have been generated from weighted sum of individual kernels, it is used to stratify patients and predict clinical outcomes. We examine the clinical outcomes of each subtype to verify how well they cluster.
Boechera microsatellite website: an online portal for species identification and determination of hybrid parentage

Boechera (Brassicaceae) has many features to recommend it as a model genus for ecological and evolutionary research, including species richness, ecological diversity, experimental tractability and close phylogenetic proximity to Arabidopsis . However, efforts to realize the full potential of this model system have been thwarted by the frequent inability of researchers to identify their samples and place them in a broader evolutionary context. Here we present the Boechera Microsatellite Website (BMW), a portal that archives over 55 000 microsatellite allele calls from 4471 specimens (including 133 nomenclatural types). The portal includes analytical tools that utilize data from 15 microsatellite loci as a highly effective DNA barcoding system. The BMW facilitates the accurate identification of Boechera samples and the investigation of reticulate evolution among the ±83 sexual diploid taxa in the genus, thereby greatly enhancing Boechera 's potential as a model system. Database URL http://sites.biology.duke.edu/windhamlab/.
Learning to learn as a pharmacy student.

As a fourth-year pharmacy student, I yearned for advanced pharmacy practice experience (APPE) rotations. Every exam taken, every paper written, and every project completed propelled me closer to my last year of pharmacy school and my 6 APPE rotations. This feeling and clinical journey kept me
Factorial Invariance of the Behavioral Dimensions Rating Scale.

The Behavioral Dimensions Rating Scale was administered to both emotionally disturbed and normal students. The factor structure was found, using confirmatory factor analysis, to be invariant over t...
Usability in communication design: typographic influence on content judgment and subjective confidence

Though perceived trustworthiness is one of the most important characteristics of online contents, few empirical studies have been conducted examining the visual perception of typography and trustworthiness. This study investigates whether the shape of typeface can influence the perception of a message. We manipulated the appearance of typefaces' neotenic cues, and measured whether that affects a reader's perception of a story as true. The results indicate that the look and feel of a typeface doesn't change the judgment of the trustworthiness of a message, but that the visual cues influenced the subjective confidence in a reader's judgment.
Emergency Department Evaluation and Management of Children With Headaches

Abstract Headache is a common presenting complaint in the emergency department. It is the third most common reason for pediatric emergency department visits. Headache, particularly migraine, is a cause of significant disability in children and adults. Approaches to treatment of headache are often inconsistent among emergency departments, and treatment sometimes contradicts published evidence and guidelines. This article reviews the evidence on workup and acute treatment of headache with an emphasis on pediatric migraine. Although definitive data are lacking for some aspects of evaluation and treatment, a review of the available data can provide a rational framework for a consistent approach to treating acute headaches.
A comparison of methods for assessing power output in non-uniform onshore wind farms

Wind resource assessments are used to estimate a wind farm's power production during the planning process. It is important that these estimates are accurate, as they can impact financing agreements, transmission planning, and environmental targets. Here, we analyze the challenges in wind power estimation for onshore farms. Turbine wake effects are a strong determinant of farm power production. With given input wind conditions, wake losses typically cause downstream turbines to produce significantly less power than upstream turbines. These losses have been modeled extensively and are well understood under certain conditions. Most notably, validation of different model types has favored offshore farms. Models that capture the dynamics of offshore wind conditions do not necessarily perform equally as well for onshore wind farms. We analyze the capabilities of several different methods for estimating wind farm power production in 2 onshore farms with non-uniform layouts. We compare the Jensen model to a number of statistical models, to meteorological downscaling techniques, and to using no model at all. We show that the complexities of some onshore farms result in wind conditions that are not accurately modeled by the Jensen wake decay techniques and that statistical methods have some strong advantages in practice.
8. Novel Endoscopic Approaches to Obesity

Obesity is currently a global pandemic that exerts a significant toll on health care resources. The efficacy of surgical management of obesity has been clearly established; however, only a fraction of eligible patients are ultimately treated. Furthermore, the significantly overweight patient population is currently left with few effective treatment options. The glaring need for effective minimally invasive treatments, combined with recent advances in flexible endoscopic technology, has led to a proliferation of endoscopic techniques and devices specifically designed for the treatment of obesity. These procedures promise lower complication rates, improved cosmesis, reversibility, and the possibility of combination therapy. While still in its infancy, early experience with the endoscopic management of obesity suggests that a burgeoning field of effective primary and revision treatment options will play a growing role in the management of this disease in the near future.
Assessing Rock Climbers’ Functional Needs in Climbing Pants:

Researchers assessed climbers’ pants by investigating whether a pants’ style or brand preference exists among rock climbers, along with looking at fit, mobility, comfort, protection, and donning/do...
Theoretical Chemodynamic Models for Predicting Volatile Emissions to Air from Dredged Material Disposal

Some bottom sediment in both fresh and marine waters are contaminated with hazardous organic chemicals that are classified as volatile and semi-volatile. An example is the New Bedford Harbor and Acushnet River Estuary sediment which contains quantities of the polychlorinated biphenyls Aroclor 1242, 1248 and 1254. Dredged material contaminated with these and other volatile organic chemicals (VOCs) can be released to the atmosphere during and after disposal by volatilization. There is a need for methods to predict these volatilization losses in order to develop design, operating and management guidelines for controlling V0C emissions.
The Role of Nucleotide Excision Repair in Restoring Replication Following UV-Induced Damage in Escherichia coli

Following low levels of UV exposure, Escherichia coli cells deficient in nucleotide excision repair (uvrA6 mutants) recover and synthesize DNA at near wild type levels, an observation that formed the basis of the post-replication recombination repair model. In this study, we characterized the DNA synthesis that occurs following UV-irradiation in the absence of nucleotide excision repair and show that although synthesis resumes at near wild type levels, less than 1% of the cells survive to form viable cells. Using twodimensional agarose gel analysis, we confirm that the replication occurring under these conditions involves extensive levels of strand exchange. However, cells undergoing this form of replication accumulate strand exchange intermediates that fail to resolve into discrete molecules, resulting in grossly filamentous, multinucleate cells. Taken together the results demonstrate that the DNA synthesis that occurs in UV-irradiated uvrA6 mutants is aberrant and suggests that post-replication repair is not an efficient mechanism to promote survival in the absence of nucleotide excision repair.
Complications of antibiotic cement spacers used for shoulder infections.

Background Our aim was to evaluate complications related to commercially available antibiotic cement spacers used in the treatment of shoulder infections. Methods We performed a retrospective review of commercially available antibiotic spacers implanted in 53 patients (60 spacers) between April 2009 and October 2017 as part of a 2-stage treatment plan for infection at the site of a shoulder arthroplasty (n = 39), other (non-arthroplasty) shoulder surgery (n = 8), or primary shoulder infection without previous surgery (n = 6). All patients were followed up from spacer placement to second-stage revision to shoulder arthroplasty. Ten patients retained the spacers and were followed up for a minimum of 1 year. Results No complications were associated with implantation of the spacers. Of the 44 patients (50 spacers) who underwent a second-stage revision after a mean interval of 6 months (range, 2-18 months), 14 patients had 18 complications. Fourteen complications occurred between implantation and removal. The most common complication was bone erosion (6 in the glenoid and 2 in the humeral shaft). Other complications were fractures of the spacer (n = 4), spacer rotation (n = 3), and humeral fracture (n = 3). Two complications required reoperation. There were 4 spacer-related complications among the 10 patients who retained the implant (3 erosions of the humeral shaft and 1 humeral shaft fracture); none required reoperation or removal. Conclusions Complications related to antibiotic spacers are common especially between the first and second stage of revision, and awareness of these complications is important for the treating provider.
Genotoxic, Metabolic, and Oxidative Stresses Regulate the RNA Repair Operon of Salmonella enterica Serovar Typhimurium

ABSTRACT The σ54 regulon in Salmonella enterica serovar Typhimurium includes a predicted RNA repair operon encoding homologs of the metazoan Ro60 protein (Rsr), Y RNAs (YrlBA), RNA ligase (RtcB), and RNA 3′-phosphate cyclase (RtcA). Transcription from σ54-dependent promoters requires that a cognate bacterial enhancer binding protein (bEBP) be activated by a specific environmental or cellular signal; the cognate bEBP for the σ54-dependent promoter of the rsr-yrlBA-rtcBA operon is RtcR. To identify conditions that generate the signal for RtcR activation in S. Typhimurium, transcription of the RNA repair operon was assayed under multiple stress conditions that result in nucleic acid damage. RtcR-dependent transcription was highly induced by the nucleic acid cross-linking agents mitomycin C (MMC) and cisplatin, and this activation was dependent on RecA. Deletion of rtcR or rtcB resulted in decreased cell viability relative to that of the wild type following treatment with MMC. Oxidative stress from peroxide exposure also induced RtcR-dependent transcription of the operon. Nitrogen limitation resulted in RtcR-independent increased expression of the operon; the effect of nitrogen limitation required NtrC. The adjacent toxin-antitoxin module, dinJ-yafQ, was cotranscribed with the RNA repair operon but was not required for RtcR activation, although YafQ endoribonuclease activated RtcR-dependent transcription. Stress conditions shown to induce expression the RNA repair operon of Escherichia coli (rtcBA) did not stimulate expression of the S. Typhimurium RNA repair operon. Similarly, MMC did not induce expression of the E. colirtcBA operon, although when expressed in S. Typhimurium, E. coli RtcR responds effectively to the unknown signal(s) generated there by MMC exposure. IMPORTANCE Homologs of the metazoan RNA repair enzymes RtcB and RtcA occur widely in eubacteria, suggesting a selective advantage. Although the enzymatic activities of the eubacterial RtcB and RtcA have been well characterized, the physiological roles remain largely unresolved. Here we report stress responses that activate expression of the σ54-dependent RNA repair operon (rsr-yrlBA-rtcBA) of S. Typhimurium and demonstrate that expression of the operon impacts cell survival under MMC-induced stress. Characterization of the requirements for activation of this tightly regulated operon provides clues to the possible functions of operon components in vivo, enhancing our understanding of how this human pathogen copes with environmental stressors.
Internet searching produces misleading findings regarding violent deaths in crisis settings: short report.

Donor and agency priorities are influenced by a variety of political, social, and media-related forces that can have a profound impact on response and resource provision. We have attempted to assess how well internet searches articulate the span of violent death rates for five current “crisis” settings. In three graduate classes (2 public health, 1 information science) at US universities, during a four month period in 2017–2018, we asked approximately 60 graduate students to conduct an internet search to determine which of five countries had the highest and lowest “violence specific mortality rate”: Venezuela, Syria, Yemen, Central African Republic (CAR), or Mali. Students were divided into groups of three, and within each group explored this question by three approaches. Many graduate students in all groups could not determine the relative rates, especially which country had the lowest violence specific mortality rate. Of the 34 searches that identified a highest violent death rate country, 27.5 (81%) concluded it was Venezuela, followed by Syria (4.5; 13%), Mali (1; 3%) and CAR (1; 3%). Of the 26 searches that identified a least violent death rate 21.5 (83%) reported either CAR or Mali, followed by Yemen (2.5; 10%) and Syria (2; 8%). Aside from lack of data on CAR and Mali, students were perplexed about whether to include suicides or executions in the measure. This resulted in almost half of all inquiries unable to estimate a highest and lowest rate among these five countries. Where conclusions were drawn, it is likely the internet drew students to the opposite conclusion from reality. There are several reasons for this discordance, such as differing categories of violent deaths as defined by the World Health Organization, and search engine algorithms. It is probable, however, that larger issues of connectivity of individual societies with each other and the outside world are playing a profound role in the deceptive results found in this exercise. This insight emphasizes the internet’s under-reporting in the world’s most poor and remote locations, and highlights the importance of primary data collection and reporting in such settings.
Serial assessment of postoperative ventricular mechanics in young children with tetralogy of Fallot: Comparison of transannular patch and valve-sparing repair.

BACKGROUND Little is known about the early time course of biventricular function and mechanics after tetralogy of Fallot (TOF) repair. We sought to evaluate and describe the evolution of the right ventricle (RV) after TOF repair in young infants and children using conventional echocardiographic parameters and global longitudinal strain (GLS). METHODS A retrospective review was performed of all patients with TOF and pulmonary stenosis who underwent repair from January 2002 to September 2015 and had at least 3 serial postsurgical echocardiograms spanning from infancy to early childhood (<8 years). Student's t test was performed to compare patients who underwent valve sparing (VS) versus transannular patch (TAP) repair. ANOVA was used to track measures of ventricular systolic function over time. RESULTS We analyzed 151 echocardiograms performed on 42 patients. Pulmonary regurgitation (PR, moderate or severe) and the RV to left ventricular (LV) basal dimension ratio were higher in TAP patients (P < .04 at all-time points). Along with a significant increase in RV basal diameter Z-score in the TAP group (P < .001), there was an improvement in RV and LV GLS over time in both groups (P < .001). The LV GLS at last follow-up was lower in patients who underwent reoperation than those who did not (P = .050). LV GLS at the last follow-up echocardiogram was lower in patients with significant PR than those without (P < .001). CONCLUSIONS Ventricular function appeared improve over time from the initial postoperative period in TOF patients. TAP repair was associated with a progressively higher RV/LV ratio in young children. GLS and RV/LV basal diameter ratio may be useful when following young children after TOF repair. Further research is necessary to understand the trajectory of ventricular functional and volumetric changes in young children in order to provide the most effective lifetime management of patients with TOF.
Identifying Students at Risk of Failing the USMLE Step 2 Clinical Skills Examination.

BACKGROUND AND OBJECTIVES New standards announced in 2017 could increase the failure rate for Step 2 Clinical Skills (CS). The purpose of this study was to identify student performance metrics associated with risk of failing. METHODS Data for 1,041 graduates of one medical school from 2014 through 2017 were analyzed, including 30 (2.9%) failures. Metrics included Medical College Admission Test, United States Medical Licensing Examination Step 1, and clerkship National Board of Medical Examiners (NBME) Subject Examination scores; faculty ratings in six clerkships; and scores on an objective structured clinical examination (OSCE). Bivariate statistics and regression were used to estimate risk of failing. RESULTS Those failing had lower Step 1 scores, NBME scores, faculty ratings, and OSCE scores (P<.02). Students with four or more low ratings were more likely to fail compared to those with fewer low ratings (relative risk [RR], 12.76, P<.0001). Logistic regression revealed other risks: low surgery NBME scores (RR 3.75, P=.02), low pediatrics NBME scores (RR 3.67, P=.02), low ratings in internal medicine (RR 3.42, P=.004), and low OSCE Communication/Interpersonal Skills (RR 2.55, P=.02). CONCLUSIONS Certain medical student performance metrics are associated with risk of failing Step 2 CS. It is important to clarify these and advise students accordingly.
The effects of urbanization on carnivores in the New York metropolitan area

The presence of human activity and development affects the distribution and behavior of carnivore species in various ways. It is necessary to examine the effects of urbanization and associated habitat fragmentation on the spatial ecology of predators, in order to develop a comprehensive understanding and formulate a proactive approach towards biodiversity protection in such areas. In this study, we observed patterns of occurrence and activity of carnivores in four preserves in metropolitan the New York and New Jersey region. Over the course of a ten-month trail camera study, 104 randomly positioned camera stations (5642 trap nights) yielded 793 total captures of 7 species: black bear (Ursus americanus), bobcat (Lynx rufus), coyote (Canis latrans), opossum (Didelphis virginiana), raccoon (Procyon lotor), red fox (Vulpes vulpes), and striped skunk (Mephitis mephitis). We found correlations between captures and level of human development, preserve size, and time of day of capture. Further, we found that the relative abundance of carnivores was higher in preserves with a higher level of surrounding development, suggesting the use of these habitat fragments as refuges. Coyotes and raccoons were more likely to be observed in areas with higher development. All carnivores combined were more likely to be observed at night in areas wither higher development, indicating a temporal response of carnivores to human activity. Our results emphasize the value of preserving intact habitat fragments in urban and suburban areas, and strongly suggest that carnivore use of parkland and greenspace should be monitored continuously to measure impacts on these species as conversion of surrounding land persists.
Financial toxicity in lung cancer: an assessment of magnitude, perception, and impact on quality of life

Background Advances in lung cancer therapy have resulted in improved clinical outcomes. Unfortunately, advances can come at a financial cost to patients and their families that poses a significant risk to overall quality of life (QoL). Financial distress has been shown to be associated with increased symptom burden and decreased treatment compliance but the magnitude of financial distress is not well characterized in lung cancer populations. Patients and methods Patients with stage II–IV newly diagnosed lung cancer and starting first-line therapy were recruited at a tertiary academic institution between July 2018 and April 2019. The comprehensive score for financial toxicity (COST) was used to assess financial toxicity and the Functional Assessment of Cancer Therapy-Lung (FACT-L) was used to assess QoL. Associations between financial toxicity and baseline variables were assessed using multivariable linear regression and correlations were assessed using the Pearson correlation. Results In this study, 143 consecutive patients were approached and 91.6% agreed to participate (N = 131). The median age was 65 years (35–90); 52.7% were male (n = 69), and 75.6% were white (n = 99). The inability to afford basic necessities and having Conclusions These data identify key factors for identifying at-risk patients and builds a framework for exploring the benefit of financial counseling interventions, which may improve QoL and oncologic outcomes.
ST-Segment Elevation Myocardial Infarction in a Young Woman: Undiagnosed Turner Syndrome.

Abstract We report a case of a 34-year-old woman who presented with an ST-segment elevation myocardial infarction with acute heart failure and a subsequent diagnosis of mosaic Turner syndrome (TS)....
Chapter 45 – Otitis Media: The Chinchilla Model

Publisher Summary This chapter describes the chinchilla otitis media (OM) model, which has enhanced the understanding of every aspect of this common childhood disease, including pathogenesis, immunoprophylaxis, and therapy. This model includes various methods used to induce middle ear (ME) inflammation under conditions of acute bacterial and viral infection, chronic inflammation, and eustachian tube dysfunction. The chinchillas used in this model are housed in stainless-steel wire cages except during experiments involving inoculation of respiratory virus, when filterbonneted microisolator cages are used during the period of viral shedding. Prior to the start of an experiment, ears should be examined by tympanometry and otoscopy to verify the absence of middle-ear effusions (MEE) or tympanic membrane pathology. Chinchillas are effectively sedated with 10 mg ketamine hydrochloride injected into the anterior thigh. Complete anesthesia ensues in about 5 minutes and lasts for about 25 minutes. Chinchillas should be observed carefully while anesthetized as ketamine occasionally causes respiratory depression. Access to the chinchilla ME cavity is through the cephalad bulla underlying the dorsal aspect of the skull. The bone is very thin at the apex of the bulla, which allows to insert a needle into the ME cleft in a relatively atraumatic fashion. Chinchillas should be kept warm and observed closely until they have completely recovered from anesthesia. Following recovery, chinchillas return to normal behavior and are given food and water ad lib.
Attentional focus influences sample entropy in a balancing task.

Abstract An external focus of attention has consistently been associated with improved balance (Wulf, 2013). Recent work has considered whether changes in postural control entropy, a measure of repeated movement patterns, could be a factor influencing this benefit. Rheaet al. (2019) reported that during quiet standing sample entropy when using an external focus was increased relative to baseline, whereas an internal focus did not differ from baseline. External and internal focus conditions did not differ from each other, but the authors speculated this difference may emerge with more complex balance tasks. The purpose of the present study was to determine if sample entropy and standard deviation of angular displacement differed when balancing on a stability platform while using an external, internal, or holistic focus. Young healthy adults (N = 36) completed three familiarization trials on the stability platform, followed by three trials each using an external focus (focus on keeping markers level), an internal focus (focus on keeping feet level), and a holistic focus (focus on feeling calm and stable). All trials lasted 20 s, and focus condition order was counterbalanced. Angular displacement of the platform was recorded at a frequency of 25 Hz, and sample entropy and standard deviation of angular displacement were calculated using a custom MATLAB code. Separate mixed ANOVAs for each dependent variable were used to assess differences due to focus and condition order, and Sidak post-hoc tests were used for pairwise comparisons. Results indicated an external focus led to higher sample entropy than a holistic focus (p = .001) and internal focus (p = .031). Standard deviation trended toward lower values with an external focus, but was influenced by a Focus x Order interaction. These results suggest that an external focus may promote more adaptive movement adjustments relative to a holistic focus and an internal focus.
Efficacy of ATG and Rituximab in capuchin monkeys (a New World monkey)-An in vitro study relevant to xenotransplantation.

While Old World monkeys, for example, baboons, have antibodies against triple-knockout (TKO) pig cells, thus complicating pig organ transplantation studies, capuchin monkeys (a New World monkey) do not, thus more closely mimicking humans in respect to the response to TKO pig cells. Whether drugs such as anti-thymocyte globulin (ATG) and Rituximab are effective in capuchin monkeys remains uncertain. We measured the binding and cytotoxicity of ATG and Rituximab to human (n = 7), baboon (n = 7), and capuchin monkey (n = 5) peripheral blood mononuclear cells (PBMCs), T cells or B cells by flow cytometry.The effect in vitro of ATG in depleting PBMCs in capuchin monkeys and baboons was significantly less than in humans, but the depletion in capuchin monkeys was not significantly different from that in baboons. In contrast, the effect in vitro of Rituximab in depleting B cells in capuchin monkeys was very limited, and significantly less than in humans and baboons.Although capuchin monkeys mimic the human antibody response to TKO pig cells more closely than baboons, Rituximab had a minimal effect in capuchin monkeys in vitro. This observation may limit the value of New World Monkeys as recipients of pig organs, tissues, or cells in experimental studies of xenotransplantation or, indeed, in allotransplantation.
Workplace Bullying Laws in the United States and Canada

The chapter provides a broad overview of the labor laws under which an employee can seek legal justice in the United States and Canada. The United States despite having number of legal statutes on discrimination, sexual harassment, equal employment opportunity, and occupational safety lacks statutory measures on workplace bullying and aggression. Canada in contrast in the past few years has implemented several amendments to its legal laws which protect employees from bullying while at work.
Immunotherapy and Radiosurgery

There is an increasing interest in integrating immunotherapy with the current standard of care for primary and metastatic brain tumors, specifically with stereotactic radiosurgery. The abscopal effect has been described extensively in the literature, and preclinical studies suggest immunotherapy may synergize with radiation therapy for CNS tumors. Furthermore, several retrospective studies suggest combination of immunotherapy with radiation therapy may improve outcomes in patients with brain metastasis. Given these findings, several clinical trials are underway in both glioblastoma patients and brain metastasis patients to evaluate this combinatorial approach. The results from these clinical trials will guide the standard of care for patients with these deadly CNS tumors. We review the literature on the topic.
Persistent effects of pair bonding in lung cancer cell growth in monogamous Peromyscus californicus.

People’s social interactions could influence their risk of developing various diseases, including cancer, according to population-level studies. In particular, studies have identified a so-called widowhood effect where a person’s risk of disease increases following the loss of a spouse. However, the cause of the widowhood effect remains debatable, as it can be difficult to separate the impact of lifestyle changes from biological changes in the individual following bereavement. It is not possible to use laboratory mice to identify a causal biological mechanism, because they do not form long-term relationships with a single partner (pair bonds). However, several species of deer mouse form pair bonds, and suffer from anxiety and stress if these bonds are broken. Naderi et al. used these mice to study the widowhood effect on the risk of developing cancer. First, Naderi et al. grew human lung cancer cells in blood serum taken from mice that were either in a pair bond or had been separated from their partner. The cancer cells grown in the blood of mice with disrupted pair bonds changed size and shape, indicating that these mice were more likely to develop cancer. This effect was not observed when the cells were grown in the blood of bonded deer mice or of another deer mouse species that does not form pair bonds. Naderi et al. also found that the activity of genes involved in the cancer cells’ ability to spread and to stick together was different in pair-bonded mice and in pair-separated mice. Next, Naderi et al. implanted lung cancer cells into the deer mice to study their effects on live animals. When cancer cells from the deer mice were transplanted into laboratory mice with a weakened immune system, the cells taken from pair-bonded deer mice were less likely to grow than the cells from deer mice with disrupted pair bonds. This suggests that the protective effects of pair bonding persist even after removal from the original mouse. These results provide evidence for a biological mechanism of the widowhood effect, where social experiences can alter gene activity relating to cancer growth. In the future, it will be important to determine whether the same applies to humans, and to find out if there are ways to mimic the effects of long-term bonds to improve cancer prognoses.