cssi/SciSciGPT-SciSciNet huggingface dataset:
A reference model for firewall technology

The paper concentrates on one particular technological aspect of providing communications security, firewall technology. Currently firewall technology is a specialized engineering solution rather than a scientifically based solution. The paper introduces a reference model that captures existing firewall technology and allows for an extension to networking technologies to which it was not applied previously. It can serve as a framework in which firewall systems can be designed and validated. The essential components of the reference model are authentication, integrity assurance, access control, audit, and their enforcement. All components are governed by a centralized security policy, and they can be deployed in a distributed fashion to achieve scaling.
Endoscopic paranasal sinus surgery: radiographic evaluation of severe complications.

PURPOSE To report our experience with the radiographic evaluation of severe complications resulting from the functional endoscopic sinus surgery (FESS) procedure. PATIENTS Ten major complications were reviewed retrospectively. FINDINGS Ten major complications occurred. Eight of 10 had injury to the floor of the anterior cranial fossa, fovea ethmoidalis (roof of the ethmoid sinus), or roof of the sphenoid sinus. Six patients presented with meningitis or rhinorrhea, two presented with headache and massive pneumocephalus; one patient who presented with meningitis had a large nasal frontal encephalocele. Noncontrast brain CT that included the paranasal sinuses adequately evaluated the source of pneumocephalus. Thin-section coronal CT accurately predicted the site of leak in five patients. Both coronal sinus CT and MR imaging were useful to confirm the nasal encephalocele. Two of 10 had vascular injury secondary to FESS. One patient presented with subarachnoid hemorrhage seen on noncontrast CT and cerebral angiography demonstrated an aneurysm of the anterior cerebral artery. The second patient suffered severe intraoperative hemorrhage. Emergency angiography revealed a pseudoaneurysm of the cavernous carotid artery, and balloon occlusion of the artery was performed. No deaths occurred in this series. CONCLUSION Radiologists should be familiar with the rare, but potential complications of this commonly performed procedure in order to help direct the work-up in an efficacious manner.
Control of Neuronal Gene Transcription and Behavior by the Epigenetic Suppressor Complex G9a/GLP

Epigenetic control of cellular phenotypes is governed by numerous enzymes that contribute to post-synthetic modifications of DNA and associated histone proteins. These modifications facilitate the assembly of protein complexes that regulate gene expression in a highly orchestrated fashion. The importance of epigenetic regulators in brain development and function is supported by the strong association between mental retardation in humans and the aberrant structure or expression of various epigenetic regulators
A questionnaire identifying four key components of patient satisfaction with physician communication

Abstract Objective To improve efficiency and retain the 4 factors of a reliable, valid interview satisfaction questionnaire (ISQ). Method 105 residents conducted 301 patient-centered interviews with 10 simulated patients (SP). SPs portrayed three scenarios for each resident and completed the ISQ and the Communication Assessment Tool (CAT) after each. A confirmatory factor analysis (CFA) of the ISQ and CAT determined which items had >0.5 factor loadings and Results After the CFA, 13 items were deleted resulting in a 12-item scale (RMSE=0.06) that confirmed the initial 4 factor structure of satisfaction with: open-endedness, empathy, confidence in the resident, and general. Scale reliability of each factor was high (Cronbach's alpha ranged from .74 to .93). Demonstrating concurrent validity, all four factors of the ISQ correlated highly with the one-factor CAT ( r >.7, p r =.83, p Conclusions The ISQ is an efficient, reliable, and valid instrument that uniquely deconstructs satisfaction with the patient–physician interaction into 4 key components. Practice implications The 4 components provide a means for better understanding poor satisfaction results.
Hydrophobic Drying and Hysteresis at Different Length Scales by Molecular Dynamics Simulations

We performed molecular dynamics simulations to investigate hydrophobic interactions between two parallel hydrophobic plates immersed in water. The two plates are separated by a distance D ranging from contact to a few nanometers. To mimic the attractive hydrophobic force measurement in a surface force experiment, a driving spring is used to measure the hydrophobic force between two hydrophobic plates. The force–distance curves, in particular the force variations from spontaneous drying to hydrophobic collapse are obtained. These details are usually not accessible in the surface force measurement due to the unstable jump into contact. The length–scale effect on the hydrophobic drying during normal approach and the hydrophobic hysteresis during retraction has been studied. We find that the critical distance at which a spontaneous drying occurs is determined by the shorter characteristic dimension of the plate, whereas the hydrophobic hysteresis is determined by the longer characteristic dimension of the pla...
Cardiac energy stores and creatine in experimental cardiac hypertrophy.

SummaryThe biochemical mechanism by which increased heart tension results in cardiac hypertrophy is unknown. In vitro studies using muscle cell cultures have suggested that the concentration of creatine is the chemical mediator of this hypertrophy. To examine this mechanism in vivo, the myocardial concentration of ATP, CP and Cr was serially measured following aortic constriction. The aortic constriction resulted in a 53% increase in heart weight after 2 weeks. The concentration of ATP, CP or Cr decreased following aortic constriction to a level 20-50% below control values. These data suggest that the creatine concentration in vivo is not the stimulus for hypertrophy, but the decreased creatine concentration in hypertrophied hearts may limit the level of ATP and CP that can be maintained during the development of cardiac hypertrophy.
Retrieval Analysis of an Early Fracture of a Vitamin E-Stabilized Tibial Liner in Total Knee Arthroplasty: A Case Report.

The application of cross-linked polyethylene in total knee arthroplasty (TKA) has been controversial1. Some studies have proposed that cross-linking can diminish mechanical properties such as fatigue crack propagation resistance2,3. Decreased mechanical properties are more of a concern in the knee than the hip because the knee is a less-conforming articulation; fracture of the insert, fracture of the post on posterior stabilized inserts, liner dislodgment, and locking mechanism disruption have been proposed as potential concerns with the use of cross-linked polyethylene for a tibial insert4. Vitamin E stabilization has been suggested as a method of preventing polyethylene oxidation, while retaining the mechanical properties of cross-linked polyethylene inserts5-7. We report a case of early fracture of a vitamin E-stabilized polyethylene tibial insert following primary TKA. Both institutions approved the human protocol for this investigation, and all investigations were conducted in conformity with ethical principles of research. The patient was informed that data concerning the case would be submitted for publication, and she provided consent. A sixty-one-year-old woman presented thirty months after primary bilateral TKA at another institution. Her height was 5 ft 4 in (163 cm) and her weight was 183 lb (83 kg); body mass index was 31.4. She had done well postsurgery for two years, but over the preceding several months had noted increasing pain at the medial aspect of the left knee, along with progressive deformity and giving way. On standing, the left knee was in approximately 10° of varus. She had an active arc of motion from 0° to 120°. There was a 2+ opening to valgus stress and a 1+ effusion present. Laboratory results, including aspiration, were all normal. Review of the original preoperative radiographs revealed advanced bilateral medial gonarthrosis, somewhat more severe on the …
Molecular Precursors to Functional Materials

The design of molecular precursors to materials for catalysis will be described. Aluminum fluoride is an important catalytic material for fluorocarbon transformations which are key to the production of CFC alternatives. Catalytic activity is closely related to the crystalline phase of the bulk AIF3 and we show how this phase chemistry can be precisely controlled using molecular precursors to produce pure known phases and also to extend to previously unknown phases. A similar approach to vanadyl phosphate oxidation catalysts will be described where cluster chemistry can be invoked to generate isolated fragments of a catalyst’s structure and then used either to explore mechanism or be used as precursors to functional catalyst materials. The underlying themes of controlled molecular precursor synthesis, resultant processability and eventual easy conversion to useful materials are emphasized throughout.
Size-, Shape-, and Composition-Controlled Synthesis and Localized Surface Plasmon Resonance of Copper Tin Selenide Nanocrystals

We report a robust methodology for synthesizing monodisperse copper-tin-selenide (CTSe) nanocrystals (NCs) of tunable size, shape, and composition including single-crystalline nanosheets, nanoplates, spheres, and tetrahedra. Both the identity and concentration of the selenium precursor play important roles in determining the morphology and crystal structure of the CTSe NCs. In contrast to previous studies, we demonstrated broad tunability of the Cu to Sn ratio. The size of CTSe NCs continuously decreased with increasing Sn incorporation. Moreover, the near-infrared (NIR) localized surface plasmon resonance (LSPR) in CTSe alloy NCs was tuned over a broad range by varying the Cu:Sn ratio. The LSPR red-shifted and decreased in intensity with increasing Sn content. This indicates that the free charge carrier concentration can be manipulated by varying the cation ratio. The cation deficiency responsible for self-doping in these NCs decreases with increasing Sn content. The resulting CTSe NCs and related materi...
Cancer Imaging for Therapy Assessment

Monitoring tumor response following treatment is essential to tailor therapeutic strategy to achieve the most favorable clinical outcomes for cancer patients. Imaging is a non-invasive approach to assess tumor response quantitatively, and it has been clinically validated as a reliable tool. RECIST (Response Evaluation Criteria in Solid Tumors) is a published protocol to determine tumor response mainly based on change in tumor size as a response to therapy. The high-resolution anatomical information of a tumor can be obtained using computer tomography (CT), ultrasound imaging or magnetic resonance imaging (MRI). However, it is often insufficient to evaluate tumor viability and aggressiveness using only anatomical information, thus a new protocol named PERCIST (Positron Emission Tomography (PET) Response Criteria in Solid Tumors) has been recently proposed. PERCIST evaluates therapy based on the change of glycolic metabolism using 18F-FDG PET, and its effectiveness has been compared with RECIST. In addition, many other physiologic and molecular imaging modalities have been tested for more objective, rapid, and reproducible measurement of tumor response. In this chapter, both conventional and experimental non-invasive imaging modalities to evaluate therapy for cancer patients having solid tumors are reviewed.
Candidate hard unique game

We propose a candidate reduction for ruling out polynomial-time algorithms for unique games, either under plausible complexity assumptions, or unconditionally for Lasserre semi-definite programs with a constant number of rounds. We analyze the completeness and Lasserre solution of our construction, and provide a soundness analysis in a certain setting of interest. Addressing general settings is tightly connected to a question on Gaussian isoperimetry. Our construction is based on our previous work on the complexity of approximately solving a system of linear equations over reals, which we suggested as an avenue towards a (positive) resolution of the Unique Games Conjecture. The construction employs a new encoding scheme that we call the real code. The real code has two useful properties: like the long code, it has a unique local test, and like the Hadamard code, it has the so-called sub-code covering property.
Patient-Physician Communication: Respect for Culture, Religion, and Autonomy-Reply

In Reply. —Scholars in health law and bioethics focus intensely on the right of patients to make autonomous decisions about their medical treatment. This is thought to require full disclosure of truthful information to assist the patient in the process of informed consent. Legal and ethical approval of the principle of autonomy has been so consistent that full and truthful information disclosure is broadly accepted as the standard of practice in medical care. Patients cannot genuinely arrive at meaningful choices about their health care unless they are apprised of all material benefits, adverse effects, and risks, including an informed assessment of their prognosis with and without treatment. Patients are faced with decisions that intimately and powerfully affect their lives. Medicine demonstrates its respect for persons by illuminating patients' decisions with information, not by making decisions for them. The fact that autonomous decision making usually demands full information does not mean
Automatic street widening: Evidence from a highway dedication law

Cities often require developers to widen streets or make other transportation improvements to account for the traffic impacts of new building. This article examines one parcel-level traffic mitigation law in depth—the highway dedication ordinance of the city of Los Angeles. I first show that the law emerged from a combination of happenstance and political and fiscal constraints, not from persuasive evidence it would be effective. I then show that the traffic predictions underlying the law are often inaccurate, and that, in fact, the standards the law is based on are in some ways unverifiable. Thus the law likely does little to reduce congestion and probably impedes housing development. Finally, I argue that the law persists precisely because its desired outcome is hard to verify: Without measurable goals, planners fall back on a measurable process. Parcel-level traffic mitigation becomes an exercise not in reducing traffic but in ensuring that developers carry out mitigations, regardless of whether those mitigations are effective.
FLT3 activating mutations display differential sensitivity to multiple tyrosine kinase inhibitors.

// Bao Nguyen 1,* , Allen B. Williams 1,* , David J. Young 1,2 , Hayley Ma 1 , Li Li 1 , Mark Levis 1 , Patrick Brown 1,2 and Donald Small 1,2 1 Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA 2 Department of Pediatrics Johns Hopkins University School of Medicine, Baltimore, MD, USA * These authors have contributed equally to this work Correspondence to: Donald Small, email: // Keywords : acute myeloid leukemia, mutant FLT3, activation loop, tyrosine kinase inhibitors Received : December 16, 2016 Accepted : December 25, 2016 Published : January 06, 2017 Abstract Fms -like tyrosine kinase-3 (FLT3) is a receptor tyrosine kinase that normally functions in hematopoietic cell survival, proliferation and differentiation. Constitutively activating mutations of FLT3 map predominately to the juxtamembrane domain (internal tandem duplications; ITD) or the activation loop (AL) of the kinase domain and are detected in about 1/3 of de novo acute myeloid leukemia (AML) patients. Small molecule tyrosine kinase inhibitors (TKI) effectively target FLT3/ITD mutations, but some activating mutations, particularly those on the AL, are relatively resistant to many FLT3 TKI. We reproduced many of the AL or other non-ITD activating mutations and tested 13 FLT3 TKI for their activity against these and wild-type FLT3. All 13 TKI tested inhibited BaF3/ITD cell proliferation in a concentration-dependent manner as reported, but most TKI exhibited a wide range of differential activity against AL and other point mutants. Western blotting results examining inhibition of FLT3 autophosphorylation and signaling pathways indicate that many AL mutations reduce TKI binding. Most FLT3 TKI effectively target wild-type FLT3 signaling. As a demonstration of this differential activity, treatment of BaF3 D835Y cells transplanted in BALB/c mice with sorafenib showed no effect in vivo against this mutant whereas lestaurtinib proved effective at reducing disease burden. Thus, while FLT3 TKI have been selected based on their ability to inhibit FLT3/ITD, the selection of appropriate TKI for AML patients with FLT3 AL and other activating point mutations requires personalized consideration.
Stabilization of Human Erythrocytes for Lyophilization: Recovery of Biochemical Activities and Membrane Filterability.

Abstract It has much more advantages to preserve human red blood cells (RBC) in freezing and drying form than conventional blood storage, even though it is still under developing. In the present study, we successfully used 0.045% glutaraldehyde(GA) to fix RBCs under appropriate conditions prior to lyophilization and regained the bulk of RBCs membrane filterability. The phlebotomized whole blood was anti-coagulated with CPDA-1 and the plasma was removed by centrifugation. White blood cells were removed using Leucocytes filter (Pall Corporation). 1 x 10 9 cells/ml were separately incubated with 0.03%, 0.045% and 0.05% GA at 37 °C for 10 min; RBCs at concentrations 0.5 x 10 9, 1 x 10 9 and 2 x 10 9 cell/ml were incubated with 0.045% GA at 37 °C for 10 min; Bovine serum albumin (BSA), trehalose, hydroxyethyl starch and dextran were used as protective additive in freezing and drying RBCs, respectively; ethanolamine, glycine, lysine, BSA, glutamic acid and homocysteic acid were used to recover membrane deformability due to GA fixation. Recovery RBCs yield after reconstituion was determined by a cell counter. Fee hemoglobin , glutathione (GSH), 2,3-diphosphoglycerate (2,3-DPG), ATP, and Glucose-6-phosphate dehydrogenase (G-6-PDH) in RBCs were determined before and after lyophilization. Membrane flexibility was assayed by osmotic fragility test. RBCs filterability was determined using positive filter apparatus through 5 micrometer pore size nitrocellulose membrane. Our results suggested that RBCs at 1 x 10 9 cells/ml fixed by 0.045% GA for10 min at pH 7.8 were enough to resist freezing and drying damages and the bulk of RBCs's membrane filterability were remained. The effective fixation of GA is dependent on GA's concentration, RBCs concentration, incubation period and pH etc. BSA is the most potential additive in preserving RBCs. More interestingly, the following reagents can recover the reduced RBCs membrane filterability by GA fixation. The potency of recovery is in the order of : 10 mM ethanolamine > 5 mM lysine > 0.5%BSA > 10 mM glutamatic acid > 5 mM homcysteic acid > 2% glycine. After reconstitution, 85 ± 2.3% RBCs yield is achieved, 71 ± 4.1% of these RBCs can freely pass through 5 micrometer pore size filter membrane. Biochemical function indexes as GSH, 2,3-DPG, ATP, and G-6-PDH are saved by 20 ± 1.2%. Lyophilized human red blood cells yields from reconstitution by different treatment. 1x 109 cells/ml fixed at 0.03% glutaraldehyde 44.7 ± 4.1 0.045%glutaraldehyde 84.7 ± 5.8 0.05%glutaraldehyde 88.7 ± 7.6 0.045% glutaraldehyde fix: 0.5x 109 cells/ml 91 ± 4.3 1x 109 cells/ml 84.7 ± 5.8 2 x 109 cells/ml 35.2 ± 2.3 Effects of various treatment on lyophilized RBCs after reconstitution. Group Filterability(%) 1x9 cells/ml fixed by: 0.03%glutaraldehyde 88.3 ± 1.2 0.045%glutaraldehyde 73.3 ± 1.8 0.05%glutaraldehyde 44.7 ± 2.8 0.045%glutaraldehyde fixation at: 0.5x109 cells/ml 0 1x109 cells/ml 73.3 ± 1.8 2x109 cells/ml 83.9 ± 4.6 N = 5. Download : Download high-res image (267KB) Download : Download full-size image
Classification of breast microcalcifications using spectral mammography

Purpose: To investigate the potential of spectral mammography to distinguish between type I calcifications, consisting of calcium oxalate dihydrate or weddellite compounds that are more often associated with benign lesions, and type II calcifications containing hydroxyapatite which are predominantly associated with malignant tumors. Methods: Using a ray tracing algorithm, we simulated the total number of x-ray photons recorded by the detector at one pixel from a single pencil-beam projection through a breast of 50/50 (adipose/glandular) tissues with inserted microcalcifications of different types and sizes. Material decomposition using two energy bins was then applied to characterize the simulated calcifications into hydroxyapatite and weddellite using maximumlikelihood estimation, taking into account the polychromatic source, the detector response function and the energy dependent attenuation. Results: Simulation tests were carried out for different doses and calcification sizes for multiple realizations. The results were summarized using receiver operating characteristic (ROC) analysis with the area under the curve (AUC) taken as an overall indicator of discrimination performance and showing high AUC values up to 0.99. Conclusion: Our simulation results obtained for a uniform breast imaging phantom indicate that spectral mammography using two energy bins has the potential to be used as a non-invasive method for discrimination between type I and type II microcalcifications to improve early breast cancer diagnosis and reduce the number of unnecessary breast biopsies.
Breastfeeding Initiation in Mothers with Repeat Cesarean Section: The Impact of Marital Status

Abstract Background: Approximately 90% of mothers with a primary C-section have a subsequent C-section. To date, research has demonstrated that primary C-sections are associated with breastfeeding noninitiation. However, it is unknown if this association persists after the primary C-section. Furthermore, literature has shown a differing relationship between breastfeeding initiations by marital status. Due to the high proportion of women who give birth while unmarried, investigating differences by marital status will add a significant contribution to breastfeeding literature. This study investigates the association between repeat C-section and breastfeeding initiation within marital status groups using a nationally representative cross-sectional survey. Materials and Methods: Data from the 2004 to 2011 Pregnancy Risk Assessment Monitoring System were analyzed. The sample was restricted to women with a previous singleton live birth who had C-section and whose infant was alive at the time of interview (N = 3...
Phase II trial of pembrolizumab in combination with nab-paclitaxel in patients with metastatic HER2-negative breast cancer.

TPS1124Background: Immunotherapy has shown therapeutic promise in several cancers, including breast cancer. Monotherapy with anti-PD-1/anti-PD-L1 antibodies has demonstrated durable responses in patients with metastatic triple-negative breast cancer (mTNBC) (Nanda et al, JCO 2016) and metastatic estrogen receptor-positive (mER+)/HER2-negative breast cancer (Rugo et al, SABCS 2015). Furthermore, response rates have been increased with combination approaches with chemotherapy (Adams et al, ASCO 2016). Based on these results, we seek to study the anti-tumor efficacy and safety of pembrolizumab (anti-PD-1 antibody) and nab-paclitaxel, the impact of therapy on the tumor microenvironment, and predictive markers of response. Methods: This is an ongoing single-arm open-label multi-cohort phase II study of pembrolizumab and nab-paclitaxel in patients treated with ≤2 prior lines of therapy for metastatic HER2-negative breast cancer (n = 50) (ClinicalTrials.gov: NCT02752685). Thirty patients with mTNBC and 20 patien...
Electron Cryo-microscopy Structure of Ebola Virus Nucleoprotein Reveals a Mechanism for Nucleocapsid-like Assembly.

Summary Ebola virus nucleoprotein (eNP) assembles into higher-ordered structures that form the viral nucleocapsid (NC) and serve as the scaffold for viral RNA synthesis. However, molecular insights into the NC assembly process are lacking. Using a hybrid approach, we characterized the NC-like assembly of eNP, identified novel regulatory elements, and described how these elements impact function. We generated a three-dimensional structure of the eNP NC-like assembly at 5.8 A using electron cryo-microscopy and identified a new regulatory role for eNP helices α22–α23. Biochemical, biophysical, and mutational analyses revealed that inter-eNP contacts within α22–α23 are critical for viral NC assembly and regulate viral RNA synthesis. These observations suggest that the N terminus and α22–α23 of eNP function as context-dependent regulatory modules (CDRMs). Our current study provides a framework for a structural mechanism for NC-like assembly and a new therapeutic target.
Making my Baby Healthy

The scientific literature is replete with health, growth, and developmental benefits when very-low-birth-weight (VLBW; ≤1,500 g) infants are provided their own mothers’ milk (Lucas et al. 1992; 1994). These benefits are provided through a combination of nutritional, enzymatic, anti-inflammatory and anti-infective properties within human milk (Meier 2001; Schanler 2001; Mathur et al. 1990). Despite these documented benefits, fewer than half of women who give birth to VLBW infants in the United States initiate and maintain lactation (Ross/Abbott 2000). In the Rush Mothers’ Milk Club program of breastfeeding interventions, all mothers of VLBW infants are targeted by NICU care providers and encouraged to provide human milk for their infants, regardless of initial feeding intent. The purpose of this study was to examine maternal decisions and responses to providing milk for a VLBW infant when the mother’s initial intent had been to formula-feed.
Predicting bias homicide across victim groups: A county-level analysis.

Abstract Outside several notable exceptions, few studies have examined variations in bias crime occurrences across American communities, and how community-level factors may differentially shape violent and non-violent bias crimes across victim groups. Drawing from ecological theories of crime, this study asks, (1) what are the structural predictors of the likelihood of bias homicide occurrences? and (2) how do structural predictors differ across bias victim groups? To answer these questions, data on bias homicide are derived from the United States Extremist Crime Database (ECDB) for the years 1990 through 2014 and paired with socio- structural variables from the United States Census Bureau. Results are discussed relative to the goals of understanding where fatal bias crimes are more likely to occur as a means of informing law enforcement and policymakers interested in preventing and responding to this specific form of crime.
Practice Pattern Variation in Pediatric Eosinophilic Esophagitis in the Carolinas EoE Collaborative: A Research Model in Community and Academic Practices.

OBJECTIVES Differences in the initial management of pediatric eosinophilic esophagitis (EoE) by practice setting have not been well characterized. We aimed to characterize these differences for sites in the Carolinas EoE Collaborative (CEoEC), a multicenter network of academic and community practices. METHODS We performed a retrospective cohort study of pediatric EoE patients at five CEoEC sites: University of North Carolina (UNC) Hospital, Charlotte Asthma and Allergy Specialists, Greenville Health Systems, Wake Forest Baptist Medical Center, and the Medical University of South Carolina Hospital. Cases of EoE were defined by consensus guidelines. Data were extracted from electronic medical records. We tested for differences among sites and used a multinomial model (polytomous regression) to assess associations between treatment and site, adjusting on patient factors. RESULTS We identified 464 children with EoE across the CEoEC sites. The median age was highest at Wake Forest (11.4 years), the median eosinophil count was highest at UNC (69 eos/hpf), and UNC had the most male patients (82%). UNC used topical steroids for initial treatment in 86% of cases, compared with <1% in Greenville (P < 0.01). Greenville used dietary elimination more frequently than UNC (81% vs 2%, P < 0.01). Differences in treatment approach held after adjusting for potential baseline confounders. There was no significant association between patient factors and initial treatment approach. CONCLUSIONS Significant differences in EoE patient factors and treatment approaches were identified across CEoEC sites and were not explained by patient or practice factors. This suggests that institutional or provider preferences drive initial treatment approaches, and that more data are needed to drive best practice decisions.
Stereotactic Radiosurgery for Trigeminal Schwannomas: A 28-Year Single-Center Experience and Review of the Literature.

Objective To assess outcomes and complications of stereotactic radiosurgery treatment for trigeminal schwannoma (TS). Methods A retrospective analysis was performed to describe the presentation and outcomes of patients undergoing Gamma Knife radiosurgery (GKRS) for TS. Clinical, radiographic, and stereotactic radiosurgery dose plans were reviewed. Descriptive statistics and univariate analysis were performed to identify factors associated with poor tumor control. Results A total of 22 patients with TS were treated with GKRS between 1990 and 2018. One patient had a history of neurofibromatosis type II. Of the study population, 81% underwent GKRS as a first-line treatment. The average tumor volume was 3.3 cm3 and the average margin treatment dose was 14.1 Gy. The median clinical and radiographic follow-up period were 18.5 and 27 months, respectively. Tumor control was achieved in 17 patients (77.3%). Symptomatic improvement was noted in 8 patients (42.1%). Tumor expansion was observed in 7 patients (31.8%) and was associated with poor tumor control at last follow-up (P Conclusions GKRS provides effective control for most TS. Increased margin doses are associated with tumor expansion, which was a poor prognostic event associated with progression and clinical decline. Based on these results, combined with analysis of available data from other series of TS treated with GKRS, we believe that margin dose between 13 and 14 Gy offers a high probability of tumor control, yet minimizing risk of adverse radiation effects.
Graphene-based drug delivery systems in tissue engineering and nanomedicine.

The time and dosage form of graphene derivatives have been found to determine therapeutic and toxic windows in several cell lines and preclinical models. The enhanced biological action of graphene ...
E-Voting on the Blockchain

Building a secure electronic voting system is a difficult task. The US Pentagon dropped their proposed online voting system which would have given overseas military personnel the opportunity to vote in the elections in 2005, citing the inability to ensure the legitimacy of votes as the reason. There is however a new cry in the wild to deploy a voting blockchain. The blockchain serves as a public ledger of transactions which cannot be reversed. The all-important consensus of transaction (i.e. legitimate votes) is achieved through 'miners' agreeing to validate new records being added. Whenever a new insertion is to be made e.g. votes, then a new transaction record is created by a voter adding details of their cast vote to the blockchain. Should it be deemed a valid transaction then the new vote is added to the end of the blockchain and remains there forever. What is neat about this solution is the fact that no centralized authority is needed to approve the votes but rather a majority consensus. Here everyone agrees on the final tally as they can count the votes themselves & because of the blockchain audit trail, anyone can verify that no votes were tampered with and no illegitimate votes were inserted. This paper discusses the application of blockchain to voting.
Nous mourrons tous , The Haitian Revolution goes Underground

In a lengthy 1967 interview held in Havana with Rene Depestre, Aime Cesaire may have made one of the most unintentionally misleading claims regarding the Haitian revolution when he declared that “the first Negro epic of the New World was written by Haitians.” Curiously, this interview was never published in French but within a few years became widely available in English in the Anglophone Caribbean and the United States where the words “first negro epic” would have a powerful emotional impact. Paul Breslin in his pursuit of literary representations of the Haitian revolution excuses Cesaire’s choice of the word epic by saying that he used it “in a colloquial sense.” However, I would like to take Cesaire at his word, as it were, and gauge the impact of the word epic on our reconstruction or “unsilencing” of the Haitian past.
When choice is a double-edged sword: Understanding maximizers' paradoxical experiences with choice

Abstract Why do maximizers—those who seek to make the very best choice by exhaustively searching out and comparing alternatives—place such high value on choice in the face of so much regret, dissatisfaction, and stress during the choice process? In five studies (total N = 1479), we drew on the two-component model of maximizing to better understand this maximization paradox. Distinguishing between the goal of choosing the best and the strategy of alternative search, we found that the two components of maximizing predicted opposing experiences with choice—the maximization goal was related to positive experiences with and beliefs about choice, whereas the maximization strategy was related to negative experiences with and beliefs about choice. Considering the two components of maximizing separately thus helps explain why maximizers have both more positive and more negative reactions to choice than do satisficers.
Effect of a 24-week randomized trial of an organic produce intervention on pyrethroid and organophosphate pesticide exposure among pregnant women

Abstract Background Introduction of an organic diet can significantly reduce exposure to some classes of pesticides in children and adults, but no long-term trials have been conducted. Objectives To assess the effect of a long-term (24-week) organic produce intervention on pesticide exposure among pregnant women. Methods We recruited 20 women from the Idaho Women, Infants, and Children (WIC) program during their first trimester of pregnancy. Eligible women were nonsmokers aged 18–35 years who reported eating exclusively conventionally grown food. We randomly assigned participants to receive weekly deliveries of either organic or conventional fruits and vegetables throughout their second or third trimesters and collected weekly spot urine samples. Urine samples, which were pooled to represent monthly exposures, were analyzed for biomarkers of organophosphate (OP) and pyrethroid insecticides. Results Food diary data demonstrated that 66% of all servings of fruits and vegetables consumed by participants in the “organic produce” group were organic, compared to Discussion To our knowledge, this is the first long-term organic diet intervention study, and the first to include pregnant women. These results suggest that addition of organic produce to an individual's diet, as compared to conventional produce, significantly reduces exposure to pyrethroid insecticides.
Stress Fractures of the Femur

Of all stress fractures, those involving the femur are the fourth most common. They are typically seen in athletes and military recruits who are involved in repetitive loading activities. Femoral stress fractures may occur anywhere along the length of the femur, most commonly at the femoral neck. There are several predisposing factors and medical conditions that may contribute to the development of femoral stress fractures including osteoporosis, the female athlete triad, and possibly certain medications. As with most stress fractures, those involving the femur are frequently associated with overtraining and improper conditioning. Diagnosing femoral stress fractures can prove difficult as athletes often present with vague symptoms that can be attributed to other injuries or conditions. Frequently, advanced imaging is required to help support the diagnosis. While most femoral stress fractures can be managed conservatively with excellent outcomes, in some cases, especially with displaced fractures or high-risk femoral neck stress fractures, operative intervention is recommended. Once athletes have had a period of relative rest, radiographic evidence of healing, and they are able to walk and perform activities of daily living without pain, a gradual return to activities may begin.
Reduced Intensity Conditioning Matched Unrelated Donor Allograft for Kostmann Syndrome.

Kostmann syndrome is a congenital disorder of myelopoeisis characterized by an absolute neutropaenia and severe bacterial infections. The introduction of G-CSF has dramatically changed the prognosis of these patients in recent years; though in G-CSF refractory patients, haemopoeitic stem cell transplant is still the only effective treatment. We describe the first case report of a patient who, unresponsive to escalating doses of G-CSF, underwent reduced intensity conditioning, Matched Unrelated Donor (MUD) allograft and has been cured from this condition. A male child presented shortly after birth with infection of the umbilicus. He developed repeated infections in the first six weeks of his life including pneumonia and scrotal abscess. Investigations at this stage included a bone marrow examination, which confirmed a diagnosis of severe congenital neutropaenia and he was started on treatment with G-CSF at 5μg/kg/day. Since diagnosis, he had numerous episodes of ear and skin infections and recurrent abscesses, most often with Methicillin resistant Staphylococcus aureus (MRSA) that required repeated hospitalisations. As the patient did not have a matched related donor, dose escalations were tried with G-CSF at 14-day intervals though he did not respond to doses up to 160μg/kg/day. At this stage, we had a child who was not responding to G-CSF injections, had several infections and was a carrier of MRSA and also Vancomycin Resistant Enterococci, who did not have a matched sibling donor. It was decided then to proceed with a MUD transplant with a non-myeloablative prepatory regimen. The pre transplant conditioning included fludarabine 30mg/m2 from day −8 to day −5, CAMPATH-1H 0.2 mg/kg from day -6 to day −2 and thiotepa 250 mg/m2 from day −4 to −2. Ciclosporin was started from day −1 and GCSF (Lenograstim) at 5μg/kg from day +7. A total of 10.4×106 CD 34+ cells/kg recipient’s weight of stem cells was infused. The patient successfully engrafted with a neutrophil count greater than 0.5×109/L on day 12 with an unsupported platelet count reaching above 50×109/L on day 33. The post transplant period was complicated with grade II skin and gut GVH that responded well to increased doses of ciclosporin alone. Slight falls in neutrophil count were noted on days 28 and 113 after transplant, which resolved by adjusting ciclosporin dosage. He is now ten months post transplant and has not had any infections needing hospitalization and maintains his neutrophil count. Conclusion We have therefore demonstrated for the first time that reduced intensity conditioning transplant from a matched unrelated donor is a safe and effective treatment for uncomplicated Kostmann syndrome.
Necrotizing fasciitis of the scalp stemming from odontogenic infection

Necrotizing fasciitis is a severe, rapidly progressive infectious process characterized by rapid spread and extensive tissue destruction. This condition stems from a variety of sources, may affect any area of the body, and requires rapid diagnosis and aggressive intervention. We present a rare case of odontogenic infection progressing to acute cervicofacial necrotizing fasciitis of the scalp and neck.
Classification on grade, price, and region with multi-label and multi-target methods in wineinformatics

Classifying wine according to their grade, price, and region of origin is a multi-label and multi-target problem in wine-informatics. Using wine reviews as the attributes, we compare several different multi-label/multitarget methods to the single-label method where each label is treated independently. We explore both single-label and multi-label approaches for a two-class problem for each of the labels and we explore both single-label and multi-target approaches for a four-class problem on two of the three labels, with the third label remaining a two-class problem. In terms of per-label accuracy, the single-label method has the best performance, although some multi-label methods approach the performance of single-label. However, multi-label/multi-target metrics approaches do exceed the performance of the single-label method.
CD14/16 monocyte profiling in juvenile myelomonocytic leukemia.

Monocyte subset analysis by flow cytometry has been shown to be a useful diagnostic tool in chronic myelomonocytic leukemia in adults. An increase in the classical monocyte fraction (CD14++/CD16-) greater than 94.0% of total monocytes is considered highly sensitive and specific in distinguishing chronic myelomonocytic leukemia from other myeloproliferative disorders. In a pilot study of juvenile myelomonocytic leukemia cases, we noted that CD14++/CD16- monocyte fraction was >95% in de novo juvenile myelomonocytic leukemia (JMML) with somatic PTPN11 mutations but normal in those with monosomy 7 or Noonan syndrome. Monocyte subgroup profiling by itself is not diagnostic of JMML but may distinguish molecular subgroups within JMML.
Multicultural Experiences: A Systematic Review and New Theoretical Framework

As globalization has become a defining issue for business and society, an increasing amount of research has examined how multicultural experiences affect a variety of psychological and organization...
Historical Inquiry Cases for Teaching Nature of Science Analytical Skills

Historical cases and student inquiry are both recognized as effective strategies for teaching nature of science. Here, I show how to combine the two methods. As a result, students not only learn about how science works; they develop skills in asking questions and analyzing what makes scientific claims reliable or trustworthy. Many practical classroom resources are provided.
Impact of Quality Improvement (QI) Program on 5-Year Risk of Diabetes-Related Complications: A Simulation Study.

OBJECTIVE We successfully implemented the American Diabetes Association’s (ADA) Diabetes INSIDE (INspiring System Improvement with Data-Driven Excellence) quality improvement (QI) program at a university hospital and safety-net health system (Tulane and Parkland), focused on system-wide improvement in poorly controlled type 2 diabetes (HbA1c >8.0% [64 mmol/mol]). In this study, we estimated the 5-year risk reduction in complications and mortality associated with the QI program. RESEARCH DESIGN AND METHODS The QI implementation period was 1 year, followed by the postintervention period of 6 months to evaluate the impact of QI on clinical measures. We measured the differences between the baseline and postintervention clinical outcomes in 2,429 individuals with HbA1c >8% (64 mmol/mol) at baseline and used the Building, Relating, Assessing, and Validating Outcomes (BRAVO) diabetes model to project the 5-year risk reduction of diabetes-related complications under the assumption that intervention benefits persist over time. An alternative assumption that intervention benefits diminish by 30% every year was also tested. RESULTS The QI program was associated with reductions in HbA1c (−0.84%) and LDL cholesterol (LDL-C) (−5.94 mg/dL) among individuals with HbA1c level >8.0% (64 mmol/mol), with greater reduction in HbA1c (−1.67%) and LDL-C (−6.81 mg/dL) among those with HbA1c level >9.5% at baseline (all P 8.0% (64 mmol/mol), and MACE (RR 0.60 [95% CI 0.56–0.65]) and all-cause mortality (RR 0.61 [95% CI 0.59–0.64]) among individuals with baseline HbA1c level >9.5% (80 mmol/mol). Sensitivity analysis also identified a substantially lower risk of diabetes-related complications and mortality associated with the QI program. CONCLUSIONS Our modeling results suggest that the ADA’s Diabetes INSIDE QI program would benefit the patients and population by substantially reducing the 5-year risk of complications and mortality in individuals with diabetes.
Astrophysical Tests of Lorentz and CPT Violation with Photons

A general framework for tests of Lorentz invariance with electromagnetic waves is presented, allowing for operators of arbitrary mass dimension. Signatures of Lorentz violations include vacuum birefringence, vacuum dispersion, and anisotropies. Sensitive searches for violations using sources such as active galaxies, gamma-ray bursts, and the cosmic microwave background are discussed. Direction-dependent dispersion constraints are obtained on operators of dimension 6 and 8 using gamma-ray bursts and the blazar Markarian 501. Stringent constraints on operators of dimension 3 are found using 5 year data from the Wilkinson Microwave Anisotropy Probe. No evidence appears for isotropic Lorentz violation, while some support at 1 σ is found for anisotropic violation.
Rash, Hemolytic Anemia, and Elevated Transaminase Levels in a 2-month-old Girl.

1. Alex Plattner, MD* 2. Sarah Greene, MD, PhD† 3. Elizabeth Nieman, MD‡ 1. *Department of Pediatrics, St Louis Children’s Hospital, Washington University, St Louis, MO 2. †Division of Infectious Diseases, Department of Pediatrics, St Louis Children’s Hospital, Washington University, St Louis, MO 3. ‡Division of Dermatology, Department of Internal Medicine, Washington University, St Louis, MO A 2-month-old, previously healthy girl presented to the emergency department (ED) after being referred by her pediatrician for evaluation of fever and rash. The rash first began at 1 month of age and started as 4 “big and red” spots: 1 each on her face, leg, chest, and back. She was seen in her pediatrician’s office 4 days after the initial symptoms and was prescribed hydrocortisone cream for eczema, with initial improvement. One week later, the patient developed a fever and runny nose, followed by a new rash that was more diffuse across the body and involved the hands and feet (Fig 1). She continued to apply hydrocortisone cream, without improvement, but had ongoing runny nose. At her 2-month health supervision visit she had ongoing runny nose and 2 days of congestion and fever (102°F [38.9°C]). The infant had normal oral intake and urine output, with no change in mental status. The mother denied infant exposure to sick contacts, recent changes in detergents or skin care, and recent travel. Figure 1. Evolving lesions found on the patient’s left lower extremity. The infant was born at 37 weeks and 1 day of gestation via cesarean delivery due to maternal pancreatitis but had a normal newborn course, including a normal newborn screen. Maternal serologic testing during pregnancy was notable for equivocal rubella titer but nonreactive for hepatitis B surface antigen, herpes simplex virus, VDRL/rapid plasma reagin (RPR), and human immunodeficiency virus, all obtained during the …