cssi/SciSciGPT-SciSciNet huggingface dataset:
Genomics of Corynebacterium striatum, an emerging multidrug-resistant pathogen of immunocompromised patients

Abstract Objectives Corynebacterium striatum is an emerging multidrug-resistant (MDR) pathogen of immunocompromised and chronically ill patients. The objective of these studies was to provide a detailed genomic analysis of disease-causing C. striatum and determine the genomic drivers of resistance and resistance-gene transmission. Methods A multi-institutional and prospective pathogen genomics programme flagged seven MDR C. striatum infections occurring close in time, and specifically in immunocompromised patients with underlying respiratory diseases. Whole genome sequencing was used to identify clonal relationships among strains, genetic causes of antimicrobial resistance, and their mobilization capacity. Matrix-assisted linear desorption/ionization-time-of-flight analyses of sequenced isolates provided curated content to improve rapid clinical identification in subsequent cases. Results Epidemiological and genomic analyses identified a related cluster of three out of seven C. striatum among lung transplant patients who had common procedures and exposures at an outlying institution. Genomic analyses further elucidated drivers of the MDR phenotypes, including resistance genes mobilized by IS3504 and IS Cg 9a-like insertion sequences. Seven mobilizable resistance genes were localized to a common chromosomal region bounded by unpaired insertion sequences, suggesting that a single recombination event could spread resistance to aminoglycosides, macrolides, lincosamides and tetracyclines to naive strains. Conclusion In-depth genomic studies of MDR C. striatum reveal its capacity for clonal spread within and across healthcare institutions and identify novel vectors that can mobilize multiple forms of drug resistance, further complicating efforts to treat infections in immunocompromised populations.
Perceived stress across the midlife: longitudinal changes among a diverse sample of women, the Study of Women's health Across the Nation (SWAN).

In women, midlife is a period of social and physiological change. Ostensibly stressful, cross-sectional studies suggest women experience decreasing stress perceptions and increasing positive outlook during this life stage. The aim of this paper was to describe the longitudinal changes in perceived stress as women transitioned through the midlife. Premenopausal women (n = 3044) ages 42–52 years at baseline, were recruited from seven sites in the Study of Women’s Health Across the Nation, and followed approximately annually over 13 visits with assessment of perceived stress and change in menopausal status. Longitudinal regression models were used to assess the effects of age, menopausal status and baseline sociodemographic variables on the trajectory of perceived stress over time. At baseline, mean age was 46.4 ± 2.7 years; participants were white (47%), black (29%), Hispanic (7%), Japanese (9%), or Chinese (8%). Hispanic women, women with lesser educational attainment, and women reporting financial hardship were each more likely to report high perceived stress levels at baseline (all p < 0.0001). After adjustment for baseline sociodemographic factors, perceived stress decreased over time for most women (p < 0.0001), but increased for both Hispanic and white participants at the New Jersey site (p < 0.0001). Changing menopausal status was not a significant predictor of perceived stress. Self-reported stress decreased for most women as they transitioned across the midlife; changing menopausal status did not play a significant role after adjustment for age and sociodemographic factors. Future studies should explore the stress experience for women by racial / ethnic identity and demographics.
Use of Asthma APGAR Tools in Primary Care Practices: A Cluster-Randomized Controlled Trial

PURPOSE The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. METHODS We used a pragmatic cluster-randomized controlled design in 18 US family medicine and pediatric practices to compare outcomes in patients with persistent asthma aged 5 to 45 years after introduction of the Asthma APGAR tools vs usual care. Patient outcomes included asthma control, quality of life, and emergency department (ED), urgent care, and inpatient hospital visits. The practice outcome was adherence to asthma guidelines. RESULTS We enrolled 1,066 patients: 245 children, 174 adolescents, and 647 adults. Sixty-five percent (692 patients) completed both baseline and 12-month questionnaires, allowing analysis for patient-reported outcomes. Electronic health record data were available for 1,063 patients (99.7%) for practice outcomes. The proportion of patients reporting an asthma-related ED, urgent care, or hospital visit in the final 6 months of the study was lower in the APGAR practices vs usual care practices (10.6% vs 20.9%, P = .004). The percentage of patients with “in control” asthma increased more between baseline and 1 year in the APGAR group vs usual care group (13.5% vs 3.4%, P =.0001 vs P =.86) with a trend toward better control scores and asthma-related quality of life in the former at 1 year (P ≤.06 and P = .06, respectively). APGAR practices improved their adherence to 3 or more guideline elements compared with usual care practices (20.7% increase vs 1.9% decrease, P = .001). CONCLUSIONS Introduction of the Asthma APGAR tools improves rates of asthma control; reduces asthma-related ED, urgent care, and hospital visits; and increases practices’ adherence to asthma management guidelines.
Skin Stem Cells in Silence, Action, and Cancer

In studying how stem cells make and maintain tissues, nearly every chapter of a cell biology textbook takes on special interest. The field even allows us to venture where no chapters have yet been written. In studying this basic problem, we are continually bombarded by nature's surprises and challenges. Stem cell biology has captured my interest for nearly my entire scientific career. Below, I focus on my laboratory's contributions to this fascinating field, to which so many friends and colleagues have made seminal discoveries equally deserving of this award.
Availability of Credit to Family Businesses

The paper provides evidence that family own- ership is associated with greater availability of credit. This may be because family-owned businesses are seen by lenders as having fewer moral hazard problems than non-family-owned businesses. One reason for this could be that family owned businesses, by definition, have a controlling share in the equity of the firm. Other factors considered important by lenders may be the managerial characteristics, and the relatively conservative investment choices of family-owned businesses. In spite of these advantages, family ownership is not associated with a reduction in premiums on the loans. The research also highlights differences between outside equity holders and debt-holders in their decision to invest in a firm. Equity holders are known to prefer separation of ownership and control, and the possibility of takeovers, as this could increase the value of the firm. Debt-holders, on the other hand, prefer arrangements that ensure continuity and stability. Family Business, Small Business, Credit Rationing.
Nonlinear Response Functions for X-Ray Laser Pulses

Response functions are macroscopic quantities that encode relevant information about interacting systems. In particular, they can provide the strength of scattering and nonlinear relaxation processes. Although nonlinear optical susceptibilities have been extensively studied, both theoretically and phenomenologically, non-linear response functions of atomic and molecular systems at x-rays wavelengths have received little attention. This scenario is likely to change with the advent of the 4th-generation light sources, the x-ray free-electron lasers (XFELs), where nonlinear effects may become observable from the interaction of these ultrahigh laser pulses and matter. In this paper, we provide a general semiclassical formalism to calculate nonlinear response functions for x-rays, which avoids the usual dipole approximations well suited for optical frequencies. Quick estimates suggest that, for x-rays frequencies, resonant nonlinear effects for atoms and in crystalline media are rather small, ranging from χ(2) ≈ 10−20 - 10−14 esu to χ(3) ≈ 10−32 - 10−19 esu. From these values, cross sections are calculated.
CORRELATION AND TESTS

The technique of correlation is the major tool used to determine the degree to which tests are consistent in their measurements. When a test is relatively consistent in its measurement, it is called a reliable test. However, reliability is really a matter of degree. The degree of reliability is expressed through a correlation coefficient called a reliability coefficient. A correlations of .90 or higher are desirable for reliability coefficients, though .85 or higher is considered acceptable. But reliability coefficients below .80 are too low for tests intended to aid in making decisions about individuals. , All reliability coefficients should be computed with sufficiently large samples so that the resulting values reflect population values rather than rough sample estimates of them. An obvious definition of test-retest reliability is the correlation of the scores from the first administration of a test with the scores from the second administration of the same test. The resulting correlation is called the test-retest reliability coefficient.
Protein thiol-disulfide interchange and interfacing with biological systems.

Disulfide-containing proteins offer unique advantages for mechanistic studies of the formation of native three-dimensional structure from unordered, reduced precursors. The main advantage is that covalent intermediates are formed; by characterizing these intermediates, one obtains substantial information about the reaction pathway. Thiol- disulfide interchange is a major component of most oxidative mechanisms carrying thiol to disulfide; thus, it required some attention in its own right. Anfinsen’s descriptions of a “shuffle-ase” enzyme led us to examine the rates of the uncatalyzed exchange under physiologically plausible conditions. Somewhat surprisingly, we found that the rates for formation of several native proteins in uncatalyzed systems containing GSSG and GSH are as great as with the “shuffle-ase” enzyme, suggesting that a substantial portion of biological thiol oxidations proceed by uncatalyzed exchange. While thiol-disulfide exchange of course results in no net change in the oxidation level of a system, catalytic linkage of thiol or disulfide to other redox systems provides a mechanism for achieving net changes.
Bounded Quantum Systems

We now begin the first of four chapters in which we study the effects of classical chaos on quantum dynamics. In this chapter, we consider the behavior of bounded systems (which have a discrete energy spectrum) in which energy is conserved. In subsequent chapters, we will consider open quantum systems (which have a continuous energy spectrum) in which energy is conserved, and we will consider systems driven by time-periodic forces in which energy is not conserved but Floquet energy (quasienergy) is conserved.
Electrical characteristics of low temperature-Al 0.3 Ga 0.7 As

In this work, we present electrical characterizations of n+ GaAs/low temperature (LT)-Al0.3Ga0.7As/n+ GaAs resistor structures in which the LT layers are grown at nominal substrate temperatures of 250 and 300°C. The resistivity and Vtfl parameters of these LT-Al0.3Ga0.7As layers are compared with those of LT-GaAs and Al0.3Ga0.7As grown at a normal growth temperature of 720°C. Low-temperature Al0.3Ga0.7As layers exhibit resistivities as high as 1012 ohm-cm, nearly four orders of magnitude higher than that of LT-GaAs, and Vtfl values as high as 45 V, over twice that of LT-GaAs. We also find that the LT-Al0.3Ga0.7As materials grown at 250 and 300°C appear to show opposite and contradictory trends with respect to resistivity and Vtfl. We propose that this result can be explained by residual hopping conduction in the 250°C material. Temperature dependent conductivity measurements confirm the presence of a hopping mechanism in LT-Al0.3Ga0.7As grown at 250°C and yield activation energies of 0.77 and 0.95 eV for LT-GaAs and LT-Al0.3Ga0.7As, respectively.
Upper Gastrointestinal Tract

Systemic sclerosis (SSc) is a chronic connective tissue disorder with multisystem involvement. The gastrointestinal (GI) tract is affected in up to 90% of patients (LeRoy EC, Black C, Fleischmajer R, et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol. 1988;15:202–5.; Clements PJ, Becvar R, Drosos AA, Ghattas L, Gabrielli A. Assessment of gastrointestinal involvement. Clin Exp Rheumatol. 2003;21:S15–8; Forbes A, Marie I. Gastrointestinal complications: the most frequent internal complications of systemic sclerosis. Rheumatology (Oxford). 2009;48(Suppl 3):iii36–9.) and gut involvement is a leading cause of morbidity. Symptoms vary based on location of involvement and degree of impairment; however, dysphagia, reflux, nausea, vomiting, pain, diarrhea, constipation, fecal incontinence, and weight loss are commonly reported. GI involvement severely impacts quality of life and is a major cause of morbidity and mortality associated with SSc (Steen VD, Medsger TA. Changes in causes of death in systemic sclerosis, 1972–2002. Ann Rheum Dis. 2007;66:940–4).
Who is responsible for Twitter’s echo chamber problem? Evidence from 2016 U.S. election networks

This study examined the echo chamber phenomenon and opinion leadership on Twitter based on the 2016 U.S. presidential election. Network analysis and ‘big data’ analytics were employed to analyze mo...
Protracted Hypocalcemia following 3.5 Parathyroidectomy in a Kidney Pancreas Recipient with a History of Robotic-Assisted Roux-en-Y Gastric Bypass

Background. Hypocalcemia is a frequent complication of parathyroidectomy for secondary/tertiary hyperparathyroidism. In patients with a history of prior Roux-en-Y gastric bypass (RYGBP), changes in nutritional absorption make management of hypocalcemia after parathyroidectomy difficult. Case Report. A 41-old-year morbidly obese female with c-peptide negative diabetes mellitus and renal failure had RYGBP. Following significant weight loss she underwent simultaneous pancreas-kidney transplantation. She had excellent transplant graft function but developed tertiary hyperparathyroidism with calciphylaxis. She underwent resection of 3.5 glands leaving a small, physiologic remnant remaining in situ at the left inferior position. She was discharged on postoperative day one in good condition, asymptomatic with serum calcium of 7.6 mg/dL and intact PTH of 12 pg/mL. The patient had to be readmitted on postoperative day #14 for severe hypocalcemia of 5.0 mg/dl and ionized calcium 2.4 mg/dl. She required intravenous calcium infusion to achieve calcium levels of >6.5 mg/dl. Long-term treatment includes 5 g of elemental oral calcium TID, vitamin D, and hydrochlorothiazide. She remains in the long term on high-dose medical therapy with normal serum calcium levels and PTH levels around 100 pg/mL. Discussion. Our patient’s protracted hypocalcemia originates from a combination of 3.5 gland parathyroidectomy, altered intestinal anatomy post-RYGBP, and potentially her pancreas transplant causing additional metabolic derangement. Alternative bariatric procedures such as sleeve gastrectomy may be more suitable for patients with renal failure or organ transplants in whom adequate absorption of vitamins, minerals, and drugs such as immunosuppressants is essential.
Metformin prescription status and abdominal aortic aneurysm disease progression in the U.S. veteran population

Abstract Background Identification of a safe and effective medical therapy for abdominal aortic aneurysm (AAA) disease remains a significant unmet medical need. Recent small cohort studies indicate that metformin, the world's most commonly prescribed oral hypoglycemic agent, may limit AAA enlargement. We sought to validate these preliminary observations in a larger cohort. Methods All patients with asymptomatic AAA disease managed in the Veterans Affairs Health Care System between 2003 and 2013 were identified by International Classification of Diseases, Ninth Revision codes. Those with a concomitant diagnosis of diabetes mellitus who also received two or more abdominal imaging studies (computed tomography, magnetic resonance imaging, or ultrasound) documenting the presence and size of an AAA, separated by at least 1 year, were included for review. Maximal AAA diameters were determined from radiologic reports. Further data acquisition was censored after surgical AAA repair, when performed. Comorbidities, active smoking status, and outpatient medication records (within 6 months of AAA diagnosis) were also queried. Yearly AAA enlargement rates, as a function of metformin treatment status, were compared using two statistical models expressed in millimeters per year: a multivariate linear regression (model 1) and a multivariate mixed-effects model with random intercept and random slope (model 2). Results A total of 13,834 patients with 58,833 radiographic records were included in the analysis, with radiology imaging follow-up of 4.2 ± 2.6 years (mean ± standard deviation). The average age of the patients at AAA diagnosis was 69.8 ± 7.8 years, and 39.7% had a metformin prescription within ±6 months of AAA. The mean growth rate for AAAs in the entire cohort was 1.4 ± 2.0 mm/y by model 1 analysis and 1.3 ± 1.6 mm/y by model 2 analysis. The unadjusted mean rate of AAA growth was 1.2 ± 1.9 mm/y for patients prescribed metformin compared with 1.5 ± 2.2 mm/y for those without (P Conclusions In a nationwide analysis of diabetic Veterans Affairs patients, prescription for metformin was associated with decreased AAA enlargement. These findings provide further support for the conduct of prospective clinical trials to test the ability of metformin to limit progression of early AAA disease.
Hoppiness Is Happiness? Under-fertilized Hop Treatments and Consumers’ Willingness to Pay for Beer

The market structure and recipes for beer has been rapidly changing with craft beers attracting more consumers. Perceived hops quality (hoppiness) is one of the main attributes that micro- brewers alter to differentiate their products to satisfy consumers’ changing tastes and prefer- ences. We hypothesize that, in addition to manipulating beer-processing conditions, the conditions under which the hops are grown may also influence the final sensory properties of the beer. Using hops from a field experiment coupled with sensory attributes and sociode- mographic characteristics from a contingent valuation survey, we analyzed the impact of under-fertilized hop treatments during the growing season on consumers’ willingness to pay for beer. The results indicate that uninformed consumers in a blind tasting could identify the differences in beer made from hops across the fertilization treatments and, thus, implying that all else equal sufficient fertilizer is required to achieve satisfactory hoppiness for which consumers are willing to pay.
Evaluation of Indicators of Reproducibility and Transparency in Published Cardiology Literature

Abstract Background The extent of reproducibility in cardiology research remains unclear. Therefore, our main objective was to determine the quality of research published in cardiology journals using eight indicators of reproducibility. Methods Using a cross-sectional study design, we conducted an advanced search of the National Library of Medicine (NLM) catalog for publications from 2014-2018 in journals pertaining to cardiology. Journals must have been published in the English language and must have been indexed in MEDLINE. Once the initial list of publications from all cardiology journals was obtained, we searched for full-text PDF versions using Open Access, Google Scholar, and PubMed. Studies were analyzed using a pilot-tested Google Form to evaluate the presence of information that was deemed necessary to reproduce the study in its entirety. Results After exclusions, we included 132 studies containing empirical data. Of these studies, the majority (126/132, 95.5%) did not provide the raw data collected while conducting the study, 0/132 (0%) provided step-by-step analysis scripts, and 117/132 (88.6%) failed to provide sufficient materials needed to reproduce the study. Conclusions The presentation of studies published in cardiology journals does not appear to facilitate reproducible research. Considerable improvements to the framework of biomedical science, specifically in the field of cardiology, are necessary. Solutions to increase the reproducibility and transparency of published works in cardiology journals is warranted, including addressing inadequate sharing of materials, raw data, and key methodological details.
Lawyers’ Role-Induced Bias Arises Fast and Persists Despite Intervention

Law students randomly assigned to represent one side in a legal argument in the classroom exhibit substantial role-induced prediction bias for their side within only 40 minutes of their role assignment. Reminding students that prediction requires a more neutral perspective than advocacy does not attenuate the bias. The bias occurs evenly in male and female participants, who also report equal confidence in their predictions.
Challenges in the Diagnosis and Treatment of Lyme Disease

Since recognition in 1975, Lyme disease has become the most common vector-borne illness in North America and Europe. The clinical features are well-characterized and treatment is usually curative, but misperceptions about morbidity persist. The purpose of this review is to examine advances in the diagnosis and treatment of Lyme disease, as well as ongoing management challenges. It is useful to recognize that Lyme disease occurs in stages, with early- and late-stage disease. Clinical expression is in part determined by Borrelial variability. For example, some strains of Borrelia burgdorferi, the causative organism in North America, are particularly arthritogenic. Most patients with early Lyme disease can be cured with a single course of oral antibiotic therapy, in contrast to some patients with Lyme arthritis, a late-stage manifestation, who are more antibiotic refractory and require other treatment strategies. Successful treatment of Lyme disease begins with successful diagnosis and with an understanding of the emergence, clinical features, and impact of Lyme disease over the past half century.
Exploring Information and Referral Needs of Individuals with Dementias and Informal Caregivers in Rural and Remote Areas.

Objectives: The provision of information and referral (I&R) and connection to support services is crucial for individuals with Alzheimer’s disease and related dementias (ADRD) and their informal ca...
Production optimization of hydrocarbon reservoirs by entropy generation minimization

Abstract Reservoir entropy generation has a significant role in production cycles of a hydrocarbon reservoir. During production, entropy generation characterizes the irreversible fluid energy losses. This paper aims to develop a new production strategy that minimizes the entropy production to improve operational efficiencies. The second law of thermodynamics is used to calculate entropy generation in a porous medium during hydrocarbon production. The model considers different sections of a production system, including the reservoir, near-wellbore, and wellbore regions. The proposed model is an extension of the Civan model. The introduced model considers the near wellbore region as a separate zone, which allows flexibility in modelling skin effects near the wellbore. In addition, a new performance criterion, called the coefficient of performance (COP). This COP integrates the recovery factor with entropy generation and provides a quantitative measure to optimize the reservoir production. The model is used to conduct a parametric sensitivity analysis including effects of fluid and rock parameters such as permeability, porosity, viscosity, skin factor, and temperature on the total entropy production. The COP is used to optimize operating conditions of the reservoir such as production rates and bottomhole pressure. It was found that permeability and the bottom hole pressure have the most impact on the total entropy production. This article will present new approaches and findings to maximize the recovery efficiency by minimizing entropy generation of fluid transport processes in a hydrocarbon reservoir.
Unilateral and Bilateral Laryngeal Pacing for Bilateral Vocal Fold Paralysis

Present the state-of-the-art overview of laryngeal pacing for treatment of bilateral vocal fold paralysis. A minimally invasive unilateral pacing system and a fully implantable bilateral pacing system are currently in clinical trials. The relative advantages and disadvantages of each are discussed. Research in functional electrical stimulation for the reanimation of the posterior cricoarytenoid muscle has successfully translated from animal models to human clinical trials for unilateral pacing and bilateral pacing. Current findings suggest unilateral pacing in humans significantly improves ventilation but only marginally better than cordotomy. Bilateral pacing in canines increases glottal opening greater than 2-fold over unilateral pacing and restores exercise tolerance to normal. Unilateral pacing can be considered a breathing assist device and may not be appropriate for active individuals. Bilateral pacing may be preferable for patients who wish to engage in strenuous exercise. Minimally invasive systems may be ideal for patients who prefer less invasive implantation and are not concerned with cosmesis. Fully implantable pacing systems offer greater electrode redundancy and stability, resulting in a system that is robust against electrode migration or damage.
The Equity Cost of Inter-Sector Math Misalignment: Racial and Gender Disparities in Community College Student Outcomes

Using linked high school and community college records for students in a large metropolitan area in California, we explore what happened to students who experienced inter-sector math misalignment (...
Guest-host supramolecular assembly of injectable hydrogel fibers for cell encapsulation

Abstract The fibrous architecture of the extracellular matrix (ECM) is recognized as an integral regulator of cell function. However, there is an unmet need to develop mechanically robust biomaterials mimicking nanofibrous tissue topography that are also injectable to enable minimally invasive delivery. In this study we have developed a fibrous hydrogel composed of supramolecularly-assembled hyaluronic acid (HA) nanofibers that exhibits mechanical integrity, shear-thinning, rapid self-healing, and cytocompatibility. HA was modified with methacrylates to permit fiber photocrosslinking following electrospinning and either ‘guest’ adamantane or ‘host’ β-cyclodextrin groups to guide supramolecular fibrous hydrogel assembly. Analysis of fibrous hydrogel rheological properties showed that the mixed guest-host fibrous hydrogel was more mechanically robust (6.6 ± 2.0 kPa, storage modulus (G′)) than unmixed guest hydrogel fibers (1.0 ± 0.1 kPa, G′) or host hydrogel fibers (1.1 ± 0.1 kPa, G′) separately. The reversible nature of the guest-host supramolecular interactions also allowed for shear-thinning and self-healing behavior as demonstrated by cyclic deformation testing. Human mesenchymal stromal cells (hMSCs) encapsulated in fibrous hydrogels demonstrated satisfactory viability following injection and after seven days of culture (> 85%). Encapsulated hMSCs were more spread and elongated when cultured in viscoelastic guest-host hydrogels compared to non-fibrous elastic controls, with hMSCs also showing significantly decreased circularity in fibrous guest-host hydrogels compared to non-fibrous guest-host hydrogels. Together, these data highlight the potential of this injectable fibrous hydrogel platform for cell and tissue engineering applications requiring minimally invasive delivery.
Disparate outcomes in nonsmall cell lung cancer by immigration status.

OBJECTIVE The purpose of this study was to evaluate overall survival (OS) outcomes by race, stratified by country of origin in patients diagnosed with NSCLC in California. METHODS We performed a retrospective analysis of nonsmall cell lung cancer (NSCLC) patients diagnosed between 2000 and 2012. Race/ethnicity was defined as White (W), Black (B), Hispanic (H), and Asian (A) and stratified by country of origin (US vs. non-US [NUS]) creating the following patient cohorts: W-US, W-NUS, B-US, B-NUS, H-US, H-NUS, A-US, and A-NUS. Three multivariate models were created: model 1 adjusted for age, gender, stage, year of diagnosis and histology; model 2 included model 1 plus treatment modalities; and model 3 included model 2 with the addition of socioeconomic status, marital status, and insurance. RESULTS A total of 68,232 patients were included. Median OS from highest to lowest were: A-NUS (15 months), W-NUS (14 months), A-US (13 months), B-NUS (13 months), H-US (11 months), W-US (11 months), H-NUS (10 months), and B-US (10 months) (p < 0.001). In model 1, B-US had worse OS, whereas A-US, W-NUS, B-NUS, H-NUS, and A-NUS had better OS when compared to W-US. In model 2 after adjusting for receipt of treatment, there was no difference in OS for B-US when compared to W-US. After adjusting for all variables (model 3), all race/ethnicity profiles had better OS when compared to W-US; B-NUS patients had similar OS to W-US. CONCLUSION Foreign-born patients with NSCLC have decreased risk of mortality when compared to native-born patients in California after accounting for treatments received and socioeconomic differences.
Hypercoagulation and Thrombotic Disorders

Hypercoagulable states, sometimes referred to as thrombophilias or thrombotic disorders, are clinical conditions whereby individuals are predisposed to arterial and/or venous thromboembolisms [1]. Clinical manifestations of thrombotic disorders can range from the asymptomatic to lethal; the causes of these manifestations may be complicated and multifactorial. Research over the last several decades has aided in identifying many of the risk factors associated with hypercoagulable states, and has helped streamline chronic management of predisposed individuals. Acute management of these individuals, such as during surgery, poses a unique set of challenges for the anesthesia care team.
Schmidt’s Syndrome Presenting as Diabetic Ketoacidosis and Adrenal Crisis: A Case Report and Review of Literature

Introduction: Schmidt’s Syndrome, is a rare endocrine disorder defined by the combined occurrence of Addison disease, autoimmune thyroid disease, and type 1 diabetes mellitus. The rarity of the condition and the presentation of adrenal insufficiency and hypothyroidism often lead to misdiagnosis with life-threatening consequences for the patients. We report a case presenting with adrenal insufficiency and diabetic ketoacidosis who was diagnosed with Schmidt’s Syndrome. Case Description: We describe the case of a 38-year-old male with a past medical history of hypothyroidism, who was admitted for worsening abdominal pain, nausea, vomiting, fevers, and chills. Physical exam revealed underweight male with marked dehydration, diaphoresis, in moderate abdominal pain. Initial vital signs and laboratory panel raised suspicion for adrenal insufficiency and diabetic ketoacidosis. Blood pressure 82/42mmHg, HR of 121, sodium 128mmol/L, potassium 6.8mmol/L, chloride 104mmol/L, bicarbonate 5mmol/L, BUN 20mg/dl, Creatinine 1.5mg/dl, Glucose 402mg/dl, TSH 60, and serum osmolality 319mosm/kg. The electrolyte derangements and vital signs improved after the initiation of the high-dose steroids and insulin. The patient was transitioned to a regimen of hydrocortisone/ fludrocortisone, levothyroxine, and insulin basal/bolus and was discharged in clinically stable conditions to follow up with an endocrinologist. Discussion: The prevalence of Schmidt’s syndrome is 1:20,000 in the general population and a 3:1 ratio of females to males. Autoimmune thyroid disease is present in 70–75%, T1DM in 40–60%, and Addison’s disease in 40–50%. This syndrome can be associated with other non-endocrine autoimmune disorders, such as vitiligo, myasthenia gravis, Sjogren’s syndrome, rheumatoid arthritis, and primary antiphospholipid syndrome. The initial step in diagnosis should be checking serum morning cortisol levels to identify adrenal insufficiency. Autoimmune antibodies play an important role to confirm the diagnosis including 21-hydroxylase, 17-hydroxylase, thyroid peroxidase, glutamic acid decarboxylase, islet cells, anti-tissue transglutaminase antibodies, parietal cell, and anti-intrinsic factor antibodies. Currently, treatment is limited to hormone replacement in patients with organ failure. But it is crucial to replace corticosteroids before starting thyroid replacement in patients with adrenal insufficiency. Conclusion: A high level of diagnostic suspicion is required for the diagnosis of Schmidt’s syndrome when encountering a patient with autoimmune disease. The diagnosis of this syndrome is often delayed, causing adverse events. With this case presentation, we add to the data pool of Schmidt’s syndrome with the ability to significantly improve patients outcomes with early diagnosis and hormone replacement.
Endurance Exercise to Improve Physical Function in Adult and Older Mice: High Intensity Interval Training (HIIT) versus Voluntary Wheel Running (VWR)

With age comes a gradual decline in physical function and exercise capacity, concurrent with a progressive propensity for development of sarcopenia /(age-related loss of muscle mass and strength) and frailty (inability of body to thrive and maintain homeostasis). Prior research has demonstrated that exercise, while not a cure, can help mitigate sarcopenia/frailty and restore functional capacity. Reliable, validated, pre-clinical models are necessary to elucidate the underlying molecular mechanisms at the intersection of age, exercise, and functional decline. In this study, we hypothesized that endurance exercise programs mimicking typical human exercise protocols would improve physical function in both adult and older adult mice. Furthermore, our secondary hypothesis was that older mice would receive less benefit from a similar volume of exercise than adult mice. To test these hypotheses, we randomly assigned (with some selection criteria) male C57BL/6 mice either at adult ages during the study (n=24, designated 10m, aged 6 months to 10 months) or at older adult ages (n=18, designated 26m, aged 22 months to 26 months) to a 13-week program of voluntary wheel running (VWR, group termed RUN) or high intensity interval training (HIIT), with an additional 10m sedentary control (CONT). The functional aptitude of each mouse was determined pre- and post-training using our composite CFAB (comprehensive functional assessment battery) scoring system consisting of voluntary wheel running (volitional exercise and activity rate), treadmill (endurance), rotarod (overall motor function), grip meter (forelimb strength), and inverted cling (whole body strength/endurance). To measure sarcopenia, we tracked body mass and body composition changes with EchoMRI, and measured muscle wet mass post-training.
A Novel Encoding Scheme for Improving the Bandwidth Efficiency of DPPM

The differential pulse position modulation (DPPM) is one of the popular power-efficient schemes for supporting visible light communication in underwater environments and across the air-water interface. Despite such an advantage, DPPM does not efficiently utilize the available channel capacity. This paper aspires to tackle such shortcomings by striking a better balance between power and bandwidth efficiency. Particularly, L-DPPM is considered where a block of M input data bits is mapped into one of the L distinct waveforms containing only one ‘on’ chip. A novel encoding algorithm and frame structure are proposed in order to shorten the time between consecutive symbols and consequently improve the bit rate of L-DPPM. The idea is based on avoiding bit patterns that contribute the most to bandwidth inefficiency. The proposed algorithm explores a number of bit patterns remapping through simple complement and shifting operations. A detailed frame structure with all necessary control bits is provided. Overall, boosting the bandwidth efficacy comes at the expense of a slight increase in control bit count and transmission power. The simulation results demonstrate the effectiveness of the proposed encoding algorithm and provide guidelines for determining M for best performance.
Leveraging Clinical Decision Support and Integrated Medical-Dental Electronic Health Records to Implementing Precision in Oral Cancer Risk Assessment and Preventive Intervention

Introduction: Precision medicine is focused on serving the unique needs of individuals. Oral and oropharyngeal cancer risk assessment identifies individual risk factors while providing support to reduce risk. The objective is to examine potential current and future strategies to broadly implement evidence-based oral and oropharyngeal cancer risk assessment and screening in dental practices throughout the United States. Methods: Feasible and effective oral cancer risk assessment and risk reduction strategies, ripe for implementation in dental practice, were identified in the published literature. Results: The Screening, Brief Intervention, Referral for Treatment (SBIRT) model is a feasible approach to assessing individual oral cancer risk and providing risk reducing interventions in the dental setting. HPV is a more recently identified risk factor that dentistry is well positioned to address. Evidence supporting the utilization of specific risk assessment tools and risk reduction strategies is summarized and future opportunities discussed. Discussion: Current knowledge of risk factors for oral and oropharyngeal cancers support the recommendation for dental providers to routinely assess all patients for risk factors, educate them about their personal level of cancer risk, and recommend actions to reduce relevant risk factors. Individuals ages 9–26 should be asked about their HPV vaccination status, educated about HPV and oropharyngeal cancer and receive a recommendation to get the HPV vaccination.
Total Blood Mercury Predicts Methylmercury Exposure in Fish and Shellfish Consumers

Many studies evaluating methylmercury (MeHg) toxicity rely on whole blood total mercury (THg) measurements to estimate MeHg exposure. However, whole blood THg includes other forms of mercury (Hg), such as inorganic Hg, which have different exposure sources and toxicological effects than MeHg. Therefore, estimating the whole blood MeHg/THg ratio is critical to predicting MeHg exposure and, subsequently, efforts to establish an exposure–response relationship for use in risk assessment. A large, representative dataset (National Health and Nutrition Examination Survey (NHANES) 2011–2016) was used to determine the whole blood MeHg/THg ratio among (a) self-reported fish and shellfish consumers, ≥ 15 years of age (the “full adult” population (N = 5268 training dataset; N = 2336 test dataset)) and (b) female fish and shellfish consumers, 15–44 years of age (the “women of reproductive age” population (N = 1285 training dataset; N = 560 test dataset)). Unadjusted and adjusted linear and spline models with direct measurements for both THg and MeHg were evaluated. The mean whole blood MeHg/THg ratio was 0.75 (95% confidence interval (CI): 0.74, 0.75). This ratio was significantly higher among those with higher THg concentrations. All models exhibited excellent fit (adjusted R2 from 0.957 to 0.982). Performance was slightly improved in spline versus linear models. For the full adult population and women of reproductive age, the unadjusted spline model predicted whole blood MeHg concentrations of 5.65 µg/L and 5.55 µg/L, respectively, when the THg concentration was 5.80 µg/L. These results suggest that whole blood THg is a good predictor of whole blood MeHg among fish and shellfish consumers.
The Robinson-Trautman Type III Prolongation Structure Contains K$_2$

The minimal prolongation structure for the Robinson-Trautman equations of Petrov type III is shown to always include the infinite-dimensional, contragredient algebra, K$_2$, which is of infinite growth. Knowledge of faithful representations of this algebra would allow the determination of B\"acklund transformations to evolve new solutions.
Properties of microwave and optical 2-D periodic leaky wave antennas

The radiation characteristics of a two-dimensional (2-D) periodic leaky-wave antenna at microwave and optical frequencies is examined. The phenomenon of directive beaming at optical frequencies can be explained in terms of leaky plasmon waves. These plasmonic structures are thus similar to a periodic 2-D leaky-wave antenna, and the fundamental radiation characteristics of them can be explained using leaky-wave theory.
Do Unionized Registered Nurses Reduce AMI Mortality

Although recent research shows interesting relationships between hospital work organization and patient outcomes, the relationship between nurse unions and patient outcomes has not been explored. This study examines the relationship between the prsences of a bargaining unit for registered nurses and the acute myocardial infarction (AMI) mortality rate for acute care hospitals in California. After accounting for patient and hospital characteristics, we find that hospitals with unionized RN workforces have 5.5 percent lower AMI mortality than do nonunion hospitals (-0.8 percentage point/14.6 percent average AMI mortality).
Stimulating Intuitive Thinking through Problem Solving.

(1988). Stimulating Intuitive Thinking Through Problem Solving. The Clearing House: A Journal of Educational Strategies, Issues and Ideas: Vol. 62, No. 4, pp. 175-176.
Low Frequency Unsteadyness of a Reattaching Turbulent Shear Layer

Low-frequency unsteadiness of a reattaching shear layer was studied in the flow behind a backward-facing step. Spectral data from a hot-wire probe showed that a substantial fraction of the measured turbulence intensity occurs at frequencies significantly lower than the large eddy passing frequency. Several thermal tuft probes were used simultaneously to identify the source of the low-frequency disturbances. It was concluded that the reattaching free shear layer undergoes a non-periodic, roughly two-dimensional, vertical motion. The motion causes the impingement point of the reattaching shear layer to drift slowly up- and downstream over a range of approximately two step heights. The likely cause of the low-frequency motion is an instantaneous imbalance between the entrain-ment rate from the recirculation zone and the reinjection rate near reattachment.
Fetal cardiac response to paracervical block anesthesia. Part II

Abstract Fetal bradycardia following mepivacaine (200 mg.) paracervical block anesthesia occurred in 24 of 92 patients who had 100 paracervical blocks. Gestational age, parity, fetal weight, and maternal complications did not influence the incidence of fetal bradycardia following paracervical block. There was a significant fall in pH and rise in base deficit only in those fetuses with bradycardia lasting more than 10 minutes. In all instances, recovery from the transient metabolic acidosis was complete. A transient increase in uterine activity as measured by the area under the uterine pressure curve was noted in the majority of patients with post-paracervical block fetal bradycardia. The majority of patients who had no fetal bradycardia had a decrease in uterine activity.
Preparation of a conjugation-ready thiol responsive molecular switch

Abstract In this work we synthesize molecular switches that are responsive to cysteine, homocysteine, and glutathione; three redox systems that make up the majority of the body’s antioxidant defenses. Synthesized spiropyran isomers with conjugation-ready linkages showed good selectivity of response to these major antioxidant thiols over nucleophilic amino acids; however the position of the linking group can affect selectivity and reversibility of the switching response. An isomer with selectivity for cysteine against GSH and Hcy was identified.
A wavelet-based technique for image similarity estimation

In this paper we proposed a method to evaluate the similarity of images compressed by a given digital wavelet transform, which allows for comparing lossless or lossy-compressed images. Two features that describe the image structural content, edge point locations and edge density, are computed directly from multiscale data. Depending on the image type and the feature selections for processing, the distance between two images is computed in one- or two-dimensional space. This method facilitates content-based image querying and automatic database retrieval. In addition, images can be sorted and appropriately indexed with respect to such global characteristics as smoothness, texture direction and repetition period.
Ecological Studies and Mathematical Modeling of Cladophora in Lake Huron: 2. Phosphorus Uptake Kinetics

Laboratory experiments were conducted with field populations of Cladophora glomerata to examine the phosphorus uptake process. Results from 35 experiments conducted over two field seasons emphasize the importance of two factors in regulating phosphorus uptake: dissolved phosphorus concentration and internal phosphorus pool size. The phosphorus uptake rate increases as dissolved phosphorus availability increases. Negative feedback on uptake rate by internal phosphorus pool size reduces the maximum phosphorus uptake rate as internal pools approach saturation. The absolute maximum phosphorus uptake rate for Cladophora was 4.5%P/day. Values for the half-saturation constant for uptake varied with internal phosphorus pool size and ranged between 30 and 250 μgP/L. The data were fit to published mathematical expressions which describe uptake as a function of internal and external phosphorus levels. The expressions may be used in mathematical models simulating the growth of Cladophora.
THE CHROMOSOME-SCANNING PROGRAM AT LAWRENCE RADIATION LABORATORY.

A Bio-Medical Division was established in 1963 at the Lawrence Radiation Laboratory. The four main divisions of the LRL Bio-Medical program are (Ref. 1): 1) prediction of the possible impact of release of radiation and radionuclides upon the biosphere - in particular upon man from any type of nuclear event; 2) documentation of the life history of radio-nuclides produced in the event; 3) determination of any effects of the radionuclides upon man; 4) development of countermeasures to minimize any possible radiation burden to man. These studies deal mainly with internal emitters and consider possibilities of slow delivery of low total doses of radiation.© (1967) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.