cssi/SciSciGPT-SciSciNet huggingface dataset:
Institutions of higher education and cultural heritage tourism: A case study of the Crooked Road, Virginia's Heritage Music Trail

INSTITUTIONS OF HIGHER EDUCATION AND CULTURAL HERITAGE TOURISM: A CASE STUDY OF THE CROOKED ROAD, VIRGINIA’S HERITAGE MUSIC TRAIL Terence Michael Gilley Old Dominion University, 2015 Director: Dr. Dennis E. Gregory The southwest region of Virginia has an unstable economy, which cycles through periods of growth and decline. The strategic plans for southwest Virginia propose cultural heritage tourism as a sustainable industry for economic development of this rural region. Institutions of higher education provide education and training for a qualified workforce and community service. This qualitative, single case study on The Crooked Road, Virginia’s Heritage Music Trail examines the roles of institutions of higher education with regard to cultural heritage tourism for sustainable community and economic development in rural areas. The data sources for this study are the administrators of The Crooked Road and institutions of higher education, including community colleges and four-year colleges, private and public. All institutions of higher education in the study population offer some form of heritage music activities or programs. Not all of the institutions of higher education in the study populations have a formal association with The Crooked Road. Study findings propose institutions of higher education have roles for cultural heritage tourism to support rural economic and community development. Strong institutional leadership and partnerships among all stakeholders are necessary for the sustainability of the cultural heritage events.
Effects of Homocysteine on the proliferation of Rat Aortic Smooth Muscle Cell and the Expression of Proliferating Cell Nuclear Antigen(PCNA)/Cyclin

Objective To study the effect of homocysteine(Hcy) on the proliferation of vascular smooth muscle cells (VSMC) and the expression of cyclin D 1 mRNA.Methods 3H-TdR incorporation and Northern blot were assayed to detect the amount of 3H-TdR and the levels of cyclin D 1mRNA expression.Results Hcy induced the proliferation of VSMC and there was a dose-dependent relationship in it.Hcy increased the expression of cyclin D 1 mRNA in rat aortic smooth muscle cells by 3.2-fold.Conclusion Hcy induced the proliferation of VSMC probably by the increased the expression of cyclin D 1mRNA,indicating the Hcy induced the mRNA of cyclin is important for the reentry of quiescent VSMC into the cell cycle.
Design and Realization of IE′s Drawing Software Based on VML

Against to current situation that it is hard to get the data source of VML form, by using the VML render provided by Internet Explorer(IE) and combining with the technology of JavaScript and DOM, this paper have realized the software successfully which can draw and edit the vector visually by markup language form on the IE5.0 or its above. The software has the basic functions of the general GIS drawing software. Due to its realization, the geographic data can be drawn and pudlished in time and dynamically on internet.
Frequency and significance of delta antibody in acute and chronic hepatitis B: A United States experience

Abstract Of 560 hepatitis B surface antigen-positive patients who were tested for antibody to hepatitis δ-antigen by blocking radioimmunoassay, 29 (5%) were seropositive. Patients with chronic active hepatitis had a greater frequency of seropositivity than those with chronic persistent hepatitis (26% vs. 0%, p
Delayed Candida albicans Septic Arthritis in a Pediatric Patient with Cerebral Palsy: A Case Report and Review of the Literature.

Fungal septic arthritis is rare, and there is a relative paucity of literature on the subject of joint infections caused by Candida albicans . Most described infections have been in adult patients; to the best of our knowledge, only a few cases have been reported in the pediatric population1. It is known that there is an increased risk for fungal joint infections in people with severe systemic immunosuppression, long-term central venous catheters, and prolonged broad-spectrum antibiotic therapy, as well as with intravenous drug abusers2,3. Hematogenous spread is a common mode of joint seeding, although direct inoculation from trauma or surgery has also been reported4,5. Most commonly, the vertebrae are affected; in the pediatric population, the most common sites of infection are the femur, the humerus, the vertebrae, and the ribs6. These infections can be difficult to diagnose since joint aspirations are often hemorrhagic, and Gram staining is negative in 20% of cases2,5. The synovial white blood-cell (WBC) count can vary widely2, reportedly from 15,000 to 100,000 cells/mL. In the literature, we did not find any reported cases of septic arthritis secondary to Candida albicans occurring in patients with cerebral palsy. We present a case report of a young girl with cerebral palsy who developed monoarticular Candida albicans septic arthritis of the knee two months after treatment for a central line infection. The patient’s parents were informed that data concerning the case would be submitted for publication, and they provided consent. A two-year-old girl with spastic cerebral palsy, necrotizing enterocolitis with a gastric tube, and global developmental delay was admitted to the pediatric intensive care unit (PICU) for respiratory failure secondary to infection from respiratory syncytial virus (RSV). Birth history was remarkable for …
Novel TPLO Alignment Jig/Saw Guide Reproduces Freehand and Ideal Osteotomy Positions

Objectives To evaluate the ability of an alignment jig/saw guide to reproduce appropriate osteotomy positions in the tibial plateau leveling osteotomy (TPLO) in the dog. Methods Lateral radiographs of 65 clinical TPLO procedures using an alignment jig and freehand osteotomy performed by experienced TPLO surgeons using a 24 mm radial saw blade between Dec 2005–Dec 2007 and Nov 2013–Nov 2015 were reviewed. The freehand osteotomy position was compared to potential osteotomy positions using the alignment jig/saw guide. The proximal and distal jig pin holes on postoperative radiographs were used to align the jig to the bone; saw guide position was selected to most closely match the osteotomy performed. The guide-to-osteotomy fit was categorized by the distance between the actual osteotomy and proposed saw guide osteotomy at its greatest offset (≤1 mm = excellent; ≤2 mm = good; ≤3 mm = satisfactory; >3 mm = poor). Results Sixty-four of 65 TPLO osteotomies could be matched satisfactorily by the saw guide. Proximal jig pin placement 3–4 mm from the joint surface and pin location in a craniocaudal plane on the proximal tibia were significantly associated with the guide-to-osteotomy fit (P = 0.021 and P = 0.047, respectively). Clinical Significance The alignment jig/saw guide can be used to reproduce appropriate freehand osteotomy position for TPLO. Furthermore, an ideal osteotomy position centered on the tibial intercondylar tubercles also is possible. Accurate placement of the proximal jig pin is a crucial step for correct positioning of the saw guide in either instance.
Time-domain measurements of radiated and conducted ultrawideband emissions

This paper summarizes results obtained from time-domain full-bandwidth emissions measurements of selected ultrawideband (UWB) transmitting devices. Brief descriptions of two NIST-developed measurement systems are provided. High-fidelity time-domain waveforms are shown, along with associated amplitude spectra for several devices. Results are shown for both conducted and radiated emissions from UWB devices.
Neural organization of esophageal peristalsis: role of vagus nerve.

The purpose of this investigation was 2-fold: first, to determine the velocity of peristalsis in the smooth muscle area of opossum esophagus before and after administration of atropine; second, to evaluate the role of the vagus nerves in the control of the propagative nature of esophageal peristalsis. Intraluminal pressures were measured through a pressure transducer recorder system attached to continuously perfused catheters. The velocity of peristalsis in the lower third of the esophagus progressively decreased from 3.25 ± 0.20 (se) cm per sec at the 70 to 80% level to 2.17 ± 0.14 (se) at the 80 to 90% level to 1.83 ± 0.10 (se) at the 90 to 100% level. After administration of intraperitoneal atropine (100 μg per kg), the velocities were 3.1 ± 0.26 (se) cm per sec, 2.38 ± 0.22 (se), and 1.74 ± 0.10 (se), respectively, at the 70 to 80%, 80 to 90%, and 90 to 100% levels. The changes were not statistically significant. Electrical stimulation of the distal cut end of the vagus nerve induced peristaltic contractions. The velocities of peristalsis after electrical stimulation of the vagus nerve were 3.24 ± 0.72 (se) cm per sec, 2.81 ± 0.64 (se), and 1.84 ± 0.34 (se), respectively, at the 70 to 80%, 80 to 90%, and 90 to 100% levels. Results of this study indicate that the velocity of peristalsis in the smooth muscle area of the opossum esophagus has a caudally decreasing gradient. Bilateral cervical vagotomy and stimulation of the distal cut end initiates peristaltic contraction indicating that the propagative nature of peristalsis in the smooth muscle segment of the body of the esophagus is controlled by a local mechanism within the esophagus rather than within the central nervous system.
NMR study of vacancy and structure-induced changes in Cu2-xTe

Abstract We report Cu and Te NMR measurements on Cu 2-x Te with x between 0.13 and 0.22. Aided by powder x-ray analysis and computed NMR quadrupole shifts, a structure change near x =0.20 was found consistent with structures reported by Baranova, with best fits to the β -I structure for x =0.22 and β -III for smaller x . NMR T 1 and Hall effect results demonstrate p -type electronic behavior with filling of simple hole pockets induced by increased numbers of vacancies for both phases. Furthermore the Cu and Te chemical shifts are large and negative, as observed in topologically inverted semiconductors, with a splitting into two distinct local environments for both Cu and Te sites in the x =0.22 structure. Cu T 1 results show a rapid decrease of the energy barrier for initiation of Cu ion hopping to 0.12 eV for x =0.22, considerably smaller than observed at higher temperatures, indicating a tail of relatively mobile Cu ions which may be of significance for potential device applications.
The development of a decision support system with an interactive clinical user interface for estimating treatment parameters in radiation therapy in order to reduce radiation dose in head and neck patients

The primary goal in radiation therapy is to target the tumor with the maximum possible radiation dose while limiting the radiation exposure of the surrounding healthy tissues. However, in order to achieve an optimized treatment plan, many constraints, such as gender, age, tumor type, location, etc. need to be considered. The location of the malignant tumor with respect to the vital organs is another possible important factor for treatment planning process which can be quantified as a feature making it easier to analyze its effects. Incorporation of such features into the patient’s medical history could provide additional knowledge that could lead to better treatment outcomes. To show the value of features such as relative locations of tumors and surrounding organs, the data is first processed in order to calculate the features and formulate a feature matrix. Then these feature are matched with retrospective cases with similar features to provide the clinician with insight on delivered dose in similar cases from past. This process provides a range of doses that can be delivered to the patient while limiting the radiation exposure of surrounding organs based on similar retrospective cases. As the number of patients increase, there will be an increase in computations needed for feature extraction as well as an increase in the workload for the physician to find the perfect dose amount. In order to show how such algorithms can be integrated we designed and developed a system with a streamlined workflow and interface as prototype for the clinician to test and explore. Integration of the tumor location feature with the clinician’s experience and training could play a vital role in designing new treatment algorithms and better outcomes. Last year, we presented how multi-institutional data into a decision support system is incorporated. This year the presentation is focused on the interface and demonstration of the working prototype of informatics system.
Analytical PDE based trajectory planning for Unmanned Air Vehicles in dynamic hostile environments

This paper proposes a method for trajectory planning for an Unmanned Aerial Vehicle (UAV) in three dimensions using Partial Differential Equations (PDEs) for application in dynamic hostile environments. The proposed method exploits the dynamical property of fluid flowing through a porous medium. This method evaluates risk to generate porosity values through out the computational domain. The path that encounters the highest porosity values determines the path from the point of origin to the goal position. The best trajectory is found using the reaction of the fluid in porous media obtained by the analytical solution of the PDEs representing the fluid flow. Constraints due to UAV dynamics, obstacles, and predefined way points are applied to the problem after solving for the best trajectory to find the optimal path. This method shows near-optimality and much reduced computational effort when compared to other typical analytical optimization methods.
A smart-USB-cable buck converter with indirect control

This paper presents merits and feasibility of a new DC/DC Buck converter architecture where parasitic inductance available in a USB cable is utilized for energy storage element in an example mobile battery charger application. In this proposed architecture, strategizing the cable as inductor and the converter's active devices at the cable's input side enables inductor heat spread along the cable that has a large surface area. It also allows board size reduction and removes battery charger heat from the load system, e.g. in smart phones, whose stringent thermal limit has been a serious constraint. Since the load and active circuits are on different sides of the cable, the Indirect Control method is proposed to regulate the actual output voltage without directly sensing it as in conventional converters. The Indirect Control is analytically analyzed and verified in simulations and experiments using a 10W smart-USB-cable charger prototype for Li-ion battery application. The converter is switched at 2 MHz for a target voltage conversion from 5V to 3.3V and achieves stable operation across a wide load range and load transients.
Full-wave and ray-based modeling of cross-beam energy transfer between laser beams with distributed phase plates and polarization smoothing

Radiation-hydrodynamic simulations of inertial confinement fusion (ICF) experiments rely on ray-based cross-beam energy transfer (CBET) models to calculate laser-energy deposition. The ray-based models assume locally plane-wave laser beams and polarization-averaged incoherence between laser speckles for beams with polarization smoothing. The impact of beam speckle and polarization smoothing on CBET are studied using the 3-D wave-based laser–plasma interaction code LPSE. The results indicate that ray-based models underpredict CBET when the assumption of spatially averaged longitudinal incoherence across the CBET interaction region is violated. A model for CBET between linearly polarized speckled beams is presented that uses ray tracing to solve for the real speckle pattern of the unperturbed laser beams within the eikonal approximation and gives excellent agreement with the wave-based calculations. OMEGA-scale 2-D LPSE calculations using ICF-relevant plasma conditions suggest that the impact of beam speckl...
Hereditary pancreatic adenocarcinoma. A clinical perspective.

In the United States during 1999, it was estimated that 28,600 new cases of pancreatic cancer would be diagnosed, whereas the total number of deaths was projected to be 28,600. 26 This almost uniformly fatal disease, as evidenced by the fact that its incidence matches its mortality, merits priority attention in the search for its cause. Hereditary factors are believed to account for approximately 5% to 10% of the pancreatic cancer burden. 15,30 Although the cause of pancreatic cancer is heterogeneous and remains elusive, molecular genetic discoveries in certain hereditary pancreatic cancer–prone syndromes have contributed to a growing understanding of its genetic transmission, which may clarify its causality. It is hoped that this clarification will lead to improved strategies for screening and treating pancreatic cancer family members that could also be applied to sporadic pancreatic cancer cases. This articles reviews important clinical issues in hereditary pancreatic adenocarcinoma.
TAG: Traffic-Aware Global Live Migration to Enhance User Experience of Cloud Applications

Modern web/mobile applications have a highly variable user load from different geographical locations that depends upon the time-of-day, flash crowds, and growth rate (high or low) of user load. Irrespective of server hosting location of the applications, users from different geographical regions need highly responsive applications because bad performance results in unhappy customers. A recent survey suggests that mobile applications lose 34% of their users due to poor response time. To enhance the user experience of applications, we propose Global Live Migration (GLM) of VMs, which allows VMs to be migrated between different geographical regions over Wide Area Networks (WANs). Our experimental setup consists of Software-defined Network (SDN) enabled networking infrastructure because of its extensive control over network traffic routing. Our objective is to place the VMs on sites closest to the region with a major population of respective application users. However, there are high chances of congestion in inter-site links if a random migration sequence is followed while performing multiple VM migrations that may result in migration failures. We formulate a Mixed Integer Programming (MIP), and solve it using a Lagrangian relaxation based subgradient technique. We also propose a feedback-based control system with self-tuning regulators to improve the migration sequence regularly. Our extensive simulations show that our proposed solution achieves a minimum improvement of 38.09% compared to the Best Fit algorithm.
Nursing care of the patient undergoing lumbar spinal fusion

Lumbar spinal fusion is a surgical procedure performed to join—or fuse—2 or more vertebrae in the low back. The procedure is done to stabilize the spine and prevent damage to the cauda equina and emanating nerve roots. Lumbar fusion is commonly indicated for patients with vertebral fractures, infection, or spinal tumors, and it may be appropriate for select patients with degenerative disorders and spinal stenosis. Nurses who care for patients undergoing lumbar fusion require an understanding of lumbar spinal anatomy, spinal pathology, surgical indications, and diagnostic modalities. Knowledge of the distinct surgical approaches and their respective advantages and disadvantages allows nurses to individualize patient care and be alert to postoperative complications. This article reviews clinical and research literature regarding lumbar fusion, with an emphasis on the role of the nurse in promoting a safe perioperative course.
In acute headache, the Ottawa Subarachnoid Hemorrhage rule had 100% sensitivity and 14% specificity

Source Citation Perry JJ, Sivilotti ML, Sutherland J, et al. Validation of the Ottawa Subarachnoid Hemorrhage Rule in patients with acute headache. CMAJ. 2017;189:E1379-85. 29133539
Multiparametric MRI-based intraprostatic tumor volume delineation in localized prostate cancer.

22Background: Multiparametric MR imaging (mpMRI) has shown promising results in the diagnosis and localization of prostate cancer. Furthermore, mpMRI may play an important role in identifying a suitable target volume for intraprostatic radiotherapy boost. We sought to investigate the level of correlation between dominant tumor foci contoured on various mpMRI sequences. Methods: mpMRI data from 18 patients with MR-guided biopsy-proven prostate cancer were obtained from the SPIE-AAPM-NCI Prostate MR Classification Challenge. Each case consisted of T2-weighted, apparent diffusion coefficient (ADC), and ktrans images computed from dynamic contrast-enhanced sequences. All image sets were rigidly co-registered, and the dominant tumor foci were identified and contoured for each MRI sequence. Hausdorff distance (HD), mean distance to agreement (MDA), and Dice and Jaccard coefficients were calculated between the contours for each pair of MRI sequences (i.e., T2 vs. ADC, T2 vs. ktrans, and ADC vs. ktrans). The Pear...
Acid balance, dietary acid load, and bone effects-a controversial subject

Modern Western diets, with higher contents of animal compared to fruits and vegetable products, have a greater content of acid precursors vs. base precursors, which results in a net acid load to the body. To prevent inexorable accumulation of acid in the body and progressively increasing degrees of metabolic acidosis, the body has multiple systems to buffer and titrate acid, including bone which contains large quantities of alkaline salts of calcium. Both in vitro and in vivo studies in animals and humans suggest that bone base helps neutralize part of the dietary net acid load. This raises the question of whether decades of eating a high acid diet might contribute to the loss of bone mass in osteoporosis. If this idea is true, then additional alkali ingestion in the form of net base-producing foods or alkalinizing salts could potentially prevent this acid-related loss of bone. Presently, data exists that support both the proponents as well as the opponents of this hypothesis. Recent literature reviews have tended to support either one side or the other. Assuming that the data cited by both sides is correct, we suggest a way to reconcile the discordant findings. This overview will first discuss dietary acids and bases and the idea of changes in acid balance with increasing age, then review the evidence for and against the usefulness of alkali therapy as a treatment for osteoporosis, and finally suggest a way of reconciling these two opposing points of view.
Asymptotically optimal circuits for arbitrary n-qubit diagonal comutations

A unitary operator U = Σj,k uj,k|k〉〈j| is called diagonal when uj,k = 0 unless j = k. The definition extends to quantum computations, where j and k vary over the 2n binary expressions for integers 0,1 ...,2n - 1, given n qubits. Such operators do not affect outcomes of the projective measurement {|j〉〈j|; 0 ≤ j ≤ 2n - 1} but rather create arbitrary relative phases among the computational basis states {|j〉 ; 0 ≤ j ≤ 2n - 1}. Prior quantum circuits for diagonal computations require O(n22n) controlled-not gates and one-qubit Blodl sphere rotations. This work provides a recursive, constructive procedure which inputs U and outputs such a diagram containing 2n+1 - 3 alternating controlled-not gates and one-qubit z- axis Bloch sphere rotations. Up to a factor of two, these circuits are provably the smallest possible. Moreover, the algorithm recognizes certain special case structures within U. For example, if U is a full diagonal tensor of Rz(α) = e-iα/2|0〉〈0| + e-iα/2|1〉〈1| rotations, then a cancellation of controlled-not gates reduces our circuit to the n gate tensor. Moreover, any V ⊕ Rz will output half as many gates as a generic U.
Origin of the Chemical Enhancement of Positive Secondary Ion Yield in SIMS

It is well known that the presence of electronegative atoms like oxygen or nitrogen on a sample surface can enhance the probability p+ of positive secondary ion emission in the sputtering process under noble gas ion bombardment by several orders of magnitude. There is, however, still some uncertainty about the physical origin of this large chemical enhancement. The strong increase of p+ could be either due to local bonding configurations upon chemisorption of electronegative gases (“bond breaking model” [1]), or, on the other hand, caused by changes in the (global) electronic band structure, as it has been shown for the enhancement of the negative ionization probability p− on alkali adsorption (“resonant tunneling mechanism” [2]). In this paper, we present energy and angle-resolved static mode SIMS data from oxygenated and nitrogenated Si(100) surfaces obtained under well defined experimental conditions, which strongly favor the local bond breaking model.
The Role of Soil Properties in Pyrene Sorption and Desorption

Soil type will greatly affect the sorption and subsequent desorptionof hydrophobic contaminants. To gain a better understanding of theimpact of soil type on sorptive behavior, the sorption-desorption of pyrene (PYR) with three different soils was studied. The first soil originated from Colombia and is classified as silty sand with3.54% soil organic matter (SOM) and 18% clay materials (<2 microns). The New Mexico soil is a sandy lean clay comprisedof 8.4% SOM and 10% clay. The last soil originated fromOhio and is a silty sand with 1.84% SOM and 9.6% clay. Based on soil mineralogy and sorption-desorption isotherms,the Colombia soil had the greatest binding potential followedby the New Mexico and Ohio soils. The Freundlich model couldfit both the Colombia and New Mexico soils. For the Ohiosoil, a two-stage Freundlich model was required. For allthree soils, PYR desorption was slow and resistant, anddepicted an apparent hysteresis. The extent of sorption-desorption for each soil was attributed to its individual classification.For instance, the SOM present in the New Mexico soil (8.4%) enabled a relatively easy desorption in comparison to the other two soils. For the Ohio and Colombia soils, the interaction with the clay fractions rendered a stronger sorptive bond.
The Effect of Therapy on Medical Utilization in Children With Inflammatory Bowel Disease

alveolar breath samples collected over a 4-hour duration were analyzed for H2 and CH4. Diagnostic positivity was compared using a cut-off level of 20ppm rise above fasting baseline for H2 alone which is consistent with consensus guidelines versus H2 plus twice CH4 which recognizes that CH4 consumes twice the hydrogen. Results: There were 406 lactose tests performed in 93 men and 313 women. There were 178 fructose tests performed in 31 men and 147 women. Conclusion: If H2 alone was measured without additional CH4 analysis, 4% of LM and 14% FM patients would not have been identified using these methods.
Measuring concordance with head and neck cancer survivorship algorithms.

e21602Background: We developed institutional algorithms for cancer survivors that are site specific. However, little data exists regarding concordance with these clinical management tools. Our aim ...
Implementation Climate and Time Predict Intensity of Supervision Content Related to Evidence Based Treatment

Objective: Children infrequently receive evidence-based treatments (EBTs) for mental health problems due to a science-to-practice implementation gap. Workplace-based clinical supervision, in which supervisors provide oversight, feedback, and training on clinical practice, may be a method to support EBT implementation. Our prior research suggests that the intensity of supervisory focus on EBT (i.e., thoroughness of coverage) during workplace-based supervision varies. This study explores predictors of supervisory EBT intensity. Methods: Participants were twenty-eight supervisors and 70 clinician supervisees. They completed a baseline survey, and audio recorded supervision sessions over 1 year. Four hundred and thirty eight recordings were coded for supervision content. We chose to explore predictors of two EBT content elements due to their strong evidence for effectiveness and sufficient variance to permit testing. These included a treatment technique ("exposure") and a method to structure treatment ("assessment"). We also explored predictors of non-EBT content ("other topics"). Mixed-effects models explored predictors at organizational/supervisor, clinician, and session levels. Results: Positive implementation climate predicted greater intensity of EBT content coverage for assessment (coefficient = 0.82, p = 0.004) and exposure (coefficient = 0.87, p = 0.001). Intensity of exposure coverage was also predicted by more time spent discussing each case (coefficient = 0.04, p < 0.001). Predictors of greater non-EBT content coverage included longer duration of supervision sessions (coefficient = 0.05, p < 0.001) and lower levels of supervisor EBT knowledge (coefficient = -0.17, p = 0.013). No other supervisor- or clinician-level variables were significant predictors in the mixed effects models. Conclusion: This was the first study to explore multi-level predictors of objectively coded workplace-based supervision content. Results suggest that organizations that expect, support and reward EBT are more likely to have greater intensity of EBT supervision coverage, which in turn may positively impact clinician EBT fidelity and client outcomes. There was evidence that supervisor knowledge of the EBT contributes to greater coverage, although robust supervisor and clinician factors that drive supervision are yet to be identified. Findings highlight the potential effectiveness of implementation strategies that simultaneously address organizational implementation climate and supervisor practices. More research is needed to identify mechanisms that support integration of EBT into supervision.
Long-Term Implications of Unplanned Conversion During Laparoscopic Liver Resection for Hepatocellular Carcinoma

Laparoscopic liver resection (LLR) is increasingly utilized for patients with hepatocellular carcinoma (HCC). However, long-term outcomes for patients requiring conversion to an open procedure during LLR have not been examined. Patients undergoing attempted LLR for HCC were identified within the National Cancer Database. Patients undergoing successful LLR were compared with those who required unplanned conversion with regard to perioperative outcomes and overall survival (OS). Those experiencing conversion were further compared with patients who underwent planned open resection after propensity score matching. Unplanned conversion occurred in 228 (18.0%) of 1270 patients undergoing LLR. Compared with successful LLR, conversion was associated with greater length of stay (6 vs. 4 days, p < 0.001), higher readmission rates (7.8% vs. 2.6%, p = 0.001), and reduced OS (55.1 vs. 67.6 months, p = 0.074). Unplanned conversion during major hepatectomy was associated with significantly worse OS (median 35.7 months) compared with successful major and minor LLR (median not reached and 67.6 months, respectively, p = 0.004). Compared with planned open resection, similar results were noted as conversion during major LLR was associated with worse OS (median 27.3 months) compared with open major hepatectomy (median not reached; p = 0.002). Unplanned conversion was independently associated with increased mortality (hazard ratio 1.38) after adjustment in a multivariable model. Tumor size was the strongest predictor of conversion on logistic regression analysis. Unplanned conversion during LLR for HCC is associated with inferior OS. This difference is most pronounced for major hepatectomy. LLR should be considered cautiously in patients with larger, more advanced tumors likely to require major resection.
The role of infectious agents, antibiotics, and antiviral therapy in the treatment of extranodal marginal zone lymphoma and other low-grade lymphomas.

There is strong evidence to corroborate the association with Helicobacter pylori (Hp) to gastric extranodal marginal zone lymphoma (ENMZL) and hepatitis C virus (HCV) to splenic/nodal marginal zone lymphoma. Koch’s postulates generally hold for these two associations and eradication of the infectious agent is well supported. Hp eradication (HPE) is recommended as front-line therapy for early stage gastric ENMZL regardless of Hp status. Complete response (CR) rate for Hp-negative patients is not as high as for Hp-positive patients; however, the benign nature of HPE and high rates of salvage allow this strategy to be safe while sparing some Hp-negative patients from systemic therapy or radiation. Similarly for HCV-seropositive patients, treatment with antivirals should be strongly considered as first-line for those who do not require immediate cytoreductive therapy or at some point even after completing chemoimmunotherapy. The controversy regarding the role for antibiotics is greatest for primary ocular adnexal lymphoma (POAL). Considering the low incidence of Chlamydia psittaci (Cp) infection with OAL and the challenges to reliably identifying Cp, we typically do not consider doxycycline in POAL treatment. Involved-field radiotherapy (IFRT) remains the treatment of choice for most with unilateral POAL. However, if reliable detection of Cp is available and Cp is identified, patients with unilateral low tumor stage POAL who do not require immediate radiotherapy could be considered for doxycycline as front-line treatment. Other infectious associations to indolent lymphomas have been made, including Borrelia borgdorferi (Bb) in cutaneous lymphoma and Campylobacter in immunoproliferative small intestinal disease (IPSID), but these associations are not as strong and primary treatment targeting the infectious agents is not recommended.
Chapter 7 – Device Identification

Before a forensics examination can take place, the device must be identified to perform proper forensic steps. Mobile device identification can be problematic. Evidential devices may limit an investigator's ability to initially search inside the device and properly retrieve the model, without first obtaining legal process. Limitations can also be operating system based. Other contributing issues will involve properly identifying the Form Factor of the phone and the carrier the phone was designed for and locating potential removable media and SIM card(s). The identification process is also called researching the device and it can assist new investigators in the forensics methodology. Live mobile evidence poses the greatest challenge, as issues such as Faraday may be necessary. First, responders, investigators, or others who will encounter mobile evidence must have a clear understanding of device identification and how it fits in with forensic triaging steps.
Oritavancin polymethylmethacrylate (PMMA)-compressive strength testing and in vitro elution.

Polymethylmethacrylate (PMMA) is used for local antimicrobial delivery in orthopedic infection. Oritavancin is a long half-life lipoglycopeptide with broad activity against Gram-positive bacteria. Herein, we addressed if 7.5% w/w oritavancin mixed into PMMA affects PMMA strength and whether it elutes from PMMA, compared to vancomycin. Elution was assessed by placing an oritavancin- or vancomycin-loaded bead in a flow system with human plasma. Compressive strength of bland compared to oritavancin- or vancomycin-loaded PMMA was assessed after 0, 3, and 7 days of soaking in 1 ml of pooled normal human plasma at 37 °C, by testing to failure in axial compression using a servo-hydraulic testing machine. Median compressive strength on days 0, 3, and 7 for bland PMMA compared to oritavancin- or vancomycin-loaded PMMA was 80.1, 79.4, and 72.4 MPa, respectively; 93.3, 86.4, and 65.3 MPa, respectively; and 97.8, 82.7, and 65.9 MPa, respectively. Oritavancin reduced PMMA compressive strength after 3 and 7 days (P = 0.0250 and 0.0039, respectively), whereas vancomycin reduced the PMMA compressive strength after 0, 3, and 7 days (P = 0.0039, 0.0039, and 0.0062, respectively) as compared to bland PMMA. Oritavancin-loaded PMMA had higher compressive strength than vancomycin-loaded PMMA on days 3 and 7 (P = 0.0039 and 0.0062, respectively). Compressive elastic moduli were 1226, 1299, and 1394 MPa for bland PMMA; 1253, 1078, and 1245 MPa for oritavancin-loaded PMMA; and 986, 879, and 779 MPa for vancomycin-loaded PMMA on days 0, 3 and 7, respectively. Oritavancin-loaded PMMA had higher compressive elastic moduli than vancomycin-loaded PMMA on days 0 and 7 (P = 0.0250 and 0.0062, respectively). Following polymerization, 1.0% and 51.9% of the initial amount of oritavancin and vancomycin were detected, respectively. Cmax, Tmax, and AUC0–24 were 1.7 μg/ml, 2 h, and 11.4 μg/ml for oritavancin and 21.4 μg/ml, 2 h, and 163.9 μg/ml for vancomycin, respectively. Oritavancin-loaded PMMA had higher compressive strength than vancomycin-loaded PMMA on days 3 and 7 and higher compressive elastic moduli than vancomycin-loaded PMMA on days 0 and 7. However, proportionally less oritavancin than vancomycin eluted out of PMMA.
Topical application of all-trans-retinoic acid: a look at the cornea and limbus

A 0.1% all-trans-retinoic acid in petroleum-base ointment was applied daily in eight normal rabbit eyes. Epithelial samples were collected from the cornea and limbus of six rabbits by impression cytology at 3- to 4-day intervals. Cytological changes were followed for 21 days and the eyes subsequently harvested for histochemical, scanning electron microscopic (SEM), and transmission electron microscopic (TEM) analysis of corneal and limbal structures. Two rabbits were treated with 0.1% all-trans-retinoic acid for 24 days without impression cytology until the 21st day. On the 24th day these eyes were harvested for similar studies. Impression cytology studies of the corneal epithelium demonstrated perinuclear halos and vacuolization of the cytoplasm. Additionally, vacuolization of the cytoplasm was observed by TEM, with attendant extrusion of the cytoplasmic contents and a subjective increase in surface microvilli as seen by SEM. Histochemical analysis revealed mucinlike staining of the corneal epithelium.
Intracranial Extraskeletal Mesenchymal Chondrosarcoma: Case Report and Review of the Literature of Reported Cases in Adults and Children.

Background Intracranial extraskeletal mesenchymal chondrosarcoma is a rare, malignant variant of chondrosarcoma that is characterized by undifferentiated mesenchymal cells interspersed with pockets of mature hyaline cartilage. Case Description In this study, we report a 23-year-old female patient who underwent multiple craniotomies for tumor resection, as well as adjuvant radiotherapy and chemotherapy. We review the literature for reported cases and discuss the histopathologic features, radiologic findings, therapeutic approaches, and outcomes associated with this rare tumor. Conclusions Intracranial extra-skeletal mesenchymal chondrosarcomas are very aggressive tumors, and their management should emphasize attempting gross total resection followed by adjuvant treatment modalities, including radiation therapy and/or chemotherapy.
Habits, Quick and Easy: Perceived Complexity Moderates the Associations of Contextual Stability and Rewards With Behavioral Automaticity.

Background Habits have been proposed to develop as a function of the extent to which a behavior is rewarded, performed frequently, and executed in a stable context. The present study examines how each of these factors are associated with behavioral automaticity across a broad variety of behaviors drawn from previous habits research. This study further assesses how perceived complexity of the behavior influences the associations of rewards, frequency, and contextual stability with automaticity. Methods Participants (N = 459) completed an online survey assessing their experiences and engagement with 25 different behaviors, including exercise, handwashing, smoking, and medication adherence, among others. Exploratory factor analysis validated a short, relatively novel scale of perceived behavioral complexity, and multilevel analyses grouped by participant were used to examine the factors that contribute to automaticity. Results Across behaviors, frequency, contextual stability, and perceived rewards were positively associated with automaticity. Perceived complexity was negatively associated with automaticity and moderated the influence of contextual stability and rewards, but not frequency, on automaticity. Both contextual stability and rewards were stronger predictors of automaticity when behavioral complexity was high rather than low, as predicted; in addition, when contextual stability was high, more complex behaviors showed greater automaticity than simpler behaviors. Conclusion The results of this study confirm that behavioral frequency, rewards, and contextual stability are each independently associated with automaticity across a spectrum of behaviors. This study further demonstrates that perceived complexity of a behavior moderates the extent to which contextual stability and rewards are associated with automaticity. The results affirm a need to further understand the components of habits and how they differ across varying behaviors.
DJs, playlists, and community: imagining communication design through hip hop

This article argues for the inclusion of Hip Hop communities in technical communication research. Through Hip Hop, technical communicators can address the recent call for TPC work to expand the field through culturally sensitive and diverse studies that honor communities and their practices. Using a Hip Hop community in Houston as a case study, this article discusses the way DJs operate as technical communicators within their communities. Furthermore, Hip Hop DJs build complex relationships with communities to create localized and accessible content. As technical communicators, Hip Hop practitioners can teach us to create community-based communication design for more diverse contexts.
Distribution of Elective Ileal Pouch-Anal Anastomosis Cases for Ulcerative Colitis: a Study Utilizing the University Health System Consortium Database.

Trends and distribution of ileal pouch-anal anastomosis (IPAA) procedures for patients with ulcerative colitis (UC) are unknown. We examined the frequency, distribution, and volume-outcome relationship for this relatively infrequent procedure using a large national data source. Data were obtained from the University HealthSystem Consortium (UHC) for patients with a primary diagnosis of UC admitted electively and who underwent surgical intervention between 2012 and 2015. The mean age of the study population (n = 6875) was 43 years and 57% were men. Among these, one-third (n = 2307) underwent an IPAA, while 24% (n = 1160) underwent total abdominal colectomy, 16% (n = 1134) underwent proctectomy, and 2% (n = 108) underwent total proctocolectomy with end ileostomy. The frequency of IPAA cases among all elective surgical cases was relatively stable at 33–35% over the study period. A total of 131 hospitals, out of 279 hospitals participating in the UHC (47%), performed IPAA. UHC contains all inpatient data on more than 140 (> 90%) academic medical centers in the US and their affiliates. Most hospitals (101) performed < 5 cases annually. The median number of IPAA cases performed annually was 1.8 [IQR 0.8 – 4.3]. The top 10 hospitals performed one-half (48%) of IPAA cases, but only 18% of another type of complex pelvic dissection cases such as low anterior resection. Short-term postoperative complications after IPAA, however, were similar regardless of IPAA volume. Nearly one-half of IPAA cases were performed at only 10 hospitals out of the 131 hospitals performing IPAA in the study. IPAA procedures are infrequently performed by most academic medical centers in the US. The redistribution of IPAA procedures, likely a result of previously established referral patterns and centralization, has a potential impact on the training of future colorectal fellows as well as access to care.
Nanosecond-Timescale Dynamics and Conformational Heterogeneity in Human GCK Regulation and Disease

Abstract Human glucokinase (GCK) is the prototypic example of an emerging class of proteins with allosteric-like behavior that originates from intrinsic polypeptide dynamics. High-resolution NMR investigations of GCK have elucidated millisecond-timescale dynamics underlying allostery. In contrast, faster motions have remained underexplored, hindering the development of a comprehensive model of cooperativity. Here, we map nanosecond-timescale dynamics and structural heterogeneity in GCK using a combination of unnatural amino acid incorporation, time-resolved fluorescence, and 19F nuclear magnetic resonance spectroscopy. We find that a probe inserted within the enzyme’s intrinsically disordered loop samples multiple conformations in the unliganded state. Glucose binding and disease-associated mutations that suppress cooperativity alter the number and/or relative population of these states. Together, the nanosecond kinetics characterized here and the millisecond motions known to be essential for cooperativity provide a dynamical framework with which we address the origins of cooperativity and the mechanism of activated, hyperinsulinemia-associated, noncooperative variants.
Using Interactive E-Book User Log Variables to Track Reading Processes and Predict Digital Learning Outcomes:

Stealth assessment has been successfully embedded in educational games to measure students’ learning in an unobtrusive and supportive way. This study explored the possibility of applying stealth as...
TDP-43 mediated blood-brain barrier permeability and leukocyte infiltration promote neurodegeneration in a low-grade systemic inflammation mouse model

Neuronal cytoplasmic inclusions containing TAR DNA-binding protein 43 (TDP-43) are a neuropathological feature of several neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), and Alzheimer’s Disease (AD). Emerging evidence also indicates that systemic inflammation may be a contributor to the pathology progression of these neurodegenerative diseases. To investigate the role of systemic inflammation in the progression of neuronal TDP-43 pathology, AAV9 particles driven by the UCHL1 promoter were delivered to the frontal cortex of wild-type aged mice via intracranial injections to overexpress TDP-43 or green fluorescent protein (GFP) in corticospinal motor neurons. Animals were then subjected to a low-dose (500 μg/kg) intraperitoneal E. coli lipopolysaccharide (LPS) administration challenge for 2 weeks to mimic a chronically altered low-grade systemic inflammatory state. Mice were then subjected to neurobehavioral studies, followed by biochemical and immunohistochemical analyses of the brain tissue. In the present study, we report that elevated neuronal TDP-43 levels induced microglial and astrocytic activation in the cortex of injected mice followed by increased RANTES signaling. Moreover, overexpression of TDP-43 exerted abundant mouse immunoglobulin G (IgG), CD3, and CD4+ T cell infiltration as well as endothelial and pericyte activation suggesting increased blood-brain barrier permeability. The BBB permeability in TDP-43 overexpressing brains yielded the frontal cortex vulnerable to the systemic inflammatory response following LPS treatment, leading to marked neutrophil infiltration, neuronal loss, reduced synaptosome-associated protein 25 (SNAP-25) levels, and behavioral impairments in the radial arm water maze (RAWM) task. These results reveal a novel role for TDP-43 in BBB permeability and leukocyte recruitment, indicating complex intermolecular interactions between an altered systemic inflammatory state and pathologically prone TDP-43 protein to promote disease progression.
Experiences of women with ovarian cancer during the COVID-19 pandemic: Examining intolerance of uncertainty and fear of COVID-19 in relation to psychological distress.

Our research aimed to examine the role of intolerance of uncertainty (IU) in psychological distress (PD) among women with ovarian cancer. Fear of COVID-19 (FCOV) was examined as a mediator, and par...