cssi/SciSciGPT-SciSciNet huggingface dataset:
Silicon in biological material. II. Variations in silicon contents in tissues of rat at different ages.

SummaryThe silicon content of several tissues of male rats, Wistar strain, 5 weeks and 30 months of age were determined by a modification of King's method, with special caution to avoid contamination with outside sources of silicon. It is shown by the data that, with increasing age, silicon content significantly increased in kidney, brain, liver, spleen, lung and femur, and decreased in skin.
Designing interactivity for the specific context of designerly collaborations

We report on one of several exploratory, formulative studies that we conducted to help inform the thoughtful use of mixed physical and digital interactivity in a wiki-based system targeted at design collaborations. This study had two parts, both involving bar-coded cards, a bar-code scanner, and a projector. One part emphasized a creative, synthesis-oriented design activity. The other part emphasized a decision-making design activity.We learned that our method of designing the physical cards and the variance in the types of information we included on the cards significantly affected the collaborative behaviors. We also learned that the extension of interactivity from the digital to the physical world and back again successfully scaffolded both creative and decision-making activities in our context, although with some very notable differences in interactive behaviors between the specific activities. This latter point notwithstanding, we learned that allowing high-resolution, small size physical cards to be arrayed and manipulated on a shared surface matters much more for the purposes of scaffolding the collaborative activities than the ability to scan and project large-size, low-resolution facsimiles of the same information, in specific contexts of collaborative story-creation and decision making.
Warfarin and Amoxicillin/Clavulanate Drug Interaction

OBJECTIVE:To report a case of warfarin–amoxicillin/clavulanate potassium (AM/CL) interaction resulting in an elevated international normalized ratio (INR) and hematuria.CASE SUMMARY:A 58-year-old Hawaiian/Asian/European woman developed an elevated INR and microscopic hematuria as a result of a drug–drug interaction between warfarin and AM/CL.DISCUSSION:Our report of an increased INR with bleeding complications as a result of an interaction between warfarin and AM/CL is consistent with those in the literature. Although the mechanism for this interaction is not fully known, it is suspected that a decrease in vitamin K–producing gut flora with resulting vitamin K deficiency would be the most likely contributing factor. An objective causality assessment revealed that this adverse drug event as a result of the warfarin and AM/CL interaction was possible.CONCLUSIONS:An increased INR secondary to warfarin interactions with various antibacterial agents is a known phenomenon. An increased awareness of warfarin–AM/...
Integration of photovoltaic solar power - the quest towards dispatchability

Existing photovoltaic (PV) power plants impact the power grid in a negative way due to a lack of voltage regulation, energy storage, forecasting and wide-area communications, measurement, and control. Currently utility-scale distributed solar PV plants on distribution networks have nominal capacities that are compatible with distribution substation MVA ratings e.g., between 5 and 30 MW. Furthermore, PV plants in the 30 to 100 MW power range are currently integrated in transmission networks. The system impacts are discussed, and mitigation solutions are proposed using advanced power converters, energy storage systems, as well as local and remote measurements and forecasting options. Case studies are provided.
Phenotype clustering of breast epithelial cells in confocal images based on nuclear protein distribution analysis

The distribution of chromatin-associated proteins plays a key role in directing nuclear function. Previously, we developed an image-based method to quantify the nuclear distributions of proteins and showed that these distributions depended on the phenotype of human mammary epithelial cells. Here we describe a method that creates a hierarchical tree of the given cell phenotypes and calculates the statistical significance between them, based on the clustering analysis of nuclear protein distributions. Nuclear distributions of nuclear mitotic apparatus protein were previously obtained for non-neoplastic S1 and malignant T4-2 human mammary epithelial cells cultured for up to 12 days. Cell phenotype was defined as S1 or T4-2 and the number of days in cultured. A probabilistic ensemble approach was used to define a set of consensus clusters from the results of multiple traditional cluster analysis techniques applied to the nuclear distribution data. Cluster histograms were constructed to show how cells in any one phenotype were distributed across the consensus clusters. Grouping various phenotypes allowed us to build phenotype trees and calculate the statistical difference between each group. The results showed that non-neoplastic S1 cells could be distinguished from malignant T4-2 cells with 94.19% accuracy; that proliferating S1 cells could be distinguished from differentiated S1 cells with 92.86% accuracy; and showed no significant difference between the various phenotypes of T4-2 cells corresponding to increasing tumor sizes. This work presents a cluster analysis method that can identify significant cell phenotypes, based on the nuclear distribution of specific proteins, with high accuracy.
Higher serum folate levels are associated with a lower risk of atopy and wheeze

Background Folic acid is known to be associated with inflammatory diseases, but the relationship between folic acid and allergic diseases is unclear. Objectives The purpose of the study was to examine the relationship between serum folate levels and markers of atopy, wheeze, and asthma. Methods Data were obtained from the 2005-2006 National Health and Nutrition Examination Survey in which serum folate and total IgE levels were measured in 8083 subjects 2 years of age and older. A high total IgE level was defined as greater than 100 kU/L. Allergen-specific IgE levels were measured for a panel of 5 common aeroallergens. Atopy was defined as at least 1 positive allergen-specific IgE level. Doctor-diagnosed asthma and wheeze in the previous 12 months were assessed by means of questionnaire. Results Serum folate levels were inversely associated with total IgE levels ( P Conclusions Serum folate levels are inversely associated with high total IgE levels, atopy, and wheeze.
The First Products Made in Space: Monodisperse Latex Particles

Twenty monodisperse polystyrene latexes were made by seeded emulsion polymerization in the MLR-SEP flight hardware on theSTS-3 and STS-4 flights of the Columbia and the STS-6, STS-7, and STS-11 flights of the Challenger. Two polymerizations were small-particle-size controls; the other eighteen were of large particle size. Of these, six failed: four on STS-4 owing to malfunction of the flight hardware; one on STS-6 owing to a broken wire; one on STS-11 owing to a broken stirrer shearpin. Nine monodisperse latexes of 4–30 μm size had narrower particle size distributions than the ground-based controls. The 10 μm STS-6 latex and the 30 μm STS-11 latexes were accepted by the National Bureau of Standards as Standard Reference Materials, the first products made in space for sale on earth. The polymerization rates in space were the same as on earth within experimental error. The flight polymerizations produced only negligible amounts of coagulum; the ground-based control polymerizations produced increasing amounts with increasing particle size, so that these controls were discontinued after the STS-7 experiments. These results confirmed the original rationale of the experiments that polymerization in space would give more uniform large-particlesize monodisperse latexes with less coagulum by: 1. the better uniformity of all 5 μm or larger flight latexes; 2. the more perfect sphericity of the 10 and 30 μm particles; 3. the smaller number of offsize larger particles; 3. the negligible amounts of coagulum; 4. the broadening of the particle size distribution and the formation of more larger offsize particles during the completion on earth of the polymerization of the partially converted STS-4 flight latexes.
The Physical and Mental Health of Lesbian, Gay Male, and Bisexual (LGB) Older Adults: The Role of Key Health Indicators and Risk and Protective Factors

Purpose: Based on resilience theory , this paper investigates the influence of key health indicators and risk and protective factors on health outcomes (including general health, disability, and depression) among lesbian, gay male, and bisexual (LGB) older adults. Design and Methods: A cross-sectional sur vey was conducted with LGB older adults, aged 50 and older (N = 2,439). Logistic regressions were conducted to examine the contributions of key health indicators (access to health care and health behaviors), risk factors (lifetime victimization, internalized stigma, and sexual identity concealment), and protective factors (social support and social network size) to health outcomes, when controlling for background characteristics. Results: The findings revealed that lifetime victimization, financial barriers to health care, obesity, and limited physical activity independently and significantly accounted for poor general health, disability, and depression among LGB older adults. Internalized stigma was also a significant predictor of disability and depression. Social support and social network size served as protective factors, decreasing the odds of poor general health, disability, and depression. Some distinct differences by gender and sexual orientation were also observed. Implications: High levels of poor general health, disability , and depression among LGB older adults are of major concern. These findings highlight the important role of key risk and protective factors, which significantly influences health outcomes among LGB older adults. Tailored interventions must be developed to address the distinct health issues facing this historically disadvantaged population.
Sherris Medical Microbiology as a Resource for Doctor of Pharmacy Students

Review of : Sherris Medical Microbiology, 5 th edition ; Kenneth Ryan et al.; (2010) . McGraw Hill, New York, NY. 1026 pages.
Does Level of Sedation Impact Detection of Advanced Neoplasia

Background and Aims Two of the foremost issues in screening colonoscopy involve delivering quality and maximizing adenoma detection rates (ADR). Little is known about the impact of deep sedation on ADR. This study aims to compare the detection of advanced lesions during screening colonoscopy performed with moderate conscious sedation (MCS) versus deep sedation (DS).
The Ponseti Method for Clubfoot Correction

The Ponseti technique is rapidly becoming the most widely practiced method for initial treatment of congenital clubfeet in infants. It is an easy technique to learn and, when applied accurately, yields excellent results. It consists of gentle manipulation and casting of the feet at weekly intervals. The first cast is applied with the foot supinated and attention directed to elevating the first ray. Subsequent casts are applied to abduct the foot around the head of the talus, taking care never to directly manipulate the calcaneus. At the time of the final cast, the overwhelming majority of infants require a percutaneous Achilles tenotomy to allow sufficient dorsiflexion. The final cast remains in place for three weeks, at which time the infant is placed into a foot abduction orthosis. The orthosis is worn 23 h per day for 3 months and then at night for several years. Good results have been demonstrated at multiple centers and long-term results indicate that foot function is comparable with that of normal feet.
Label-Free Photonic Crystal Biosensor Integrated Microfluidic Chip for Determination of Kinetic Reaction Rate Constants

We demonstrate a photonic crystal integrated microfluidic chip that is compatible with a 384-well microplate format for measuring kinetic reaction rate constants in high-throughput biomolecular interaction screening applications. The device enables low volume kinetic analysis of protein-protein interactions with low flow latency, and control of five analyte flow channels with a single control point. The structure is fabricated with a replica molding process that produces the submicron photonic crystal structure simultaneously with the micrometer-scale fluid channel structure. The device significantly reduces the kinetic assay time required compared with a conventional biosensor microplate in which reagents reach the active detection surface by diffusion. Using the photonic crystal sensor fluid network system, we demonstrate determination of the kinetic association/dissociation rate constants between immobilized ligands and analytes in the flow stream, using the heparin/lactoferrin system as an example.
Model predictive control: for want of a local control Lyapunov function, all is not lost

We present stability results for unconstrained discrete-time nonlinear systems controlled using finite-horizon model predictive control (MPC) algorithms that do not require the terminal cost to be a local control Lyapunov function. The two key assumptions we make are that the value function is bounded by a K/sub /spl infin// function of a state measure related to the distance of the state to the target set and that this measure is detectable from the stage cost. We show that these assumptions are sufficient to guarantee closed-loop asymptotic stability that is semiglobal and practical in the horizon length and robust to small perturbations. If the assumptions hold with linear (or locally linear) K/sub /spl infin// functions, then the stability will be global (or semiglobal) for long enough horizon lengths. In the global case, we give an explicit formula for a sufficiently long horizon length. We relate the upper bound assumption to exponential and asymptotic controllability. Using terminal and stage costs that are controllable to zero with respect to a state measure, we can guarantee the required upper bound, but we also require that the state measure be detectable from the stage cost to ensure stability. While such costs and state measures may not be easy to construct in general, we explore a class of systems, called homogeneous systems, for which it is straightforward to choose them. In fact, we show for homogeneous systems that the associated K/sub /spl infin// functions are linear, thereby guaranteeing global asymptotic stability. We discuss two examples found elsewhere in the MPC literature, including the discrete-time nonholonomic integrator, to demonstrate our methods. For these systems, we give a new result: They can be globally asymptotically stabilized by a finite-horizon MPC algorithm that has guaranteed robustness. We also show that stable linear systems with control constraints can be globally exponentially stabilized using finite-horizon MPC without requiring the terminal cost to be a global control Lyapunov function.
Whole Exome Sequencing and Heterologous Cellular Electrophysiology Studies Elucidate a Novel Loss-of-Function Mutation in the CACNA1A-Encoded Neuronal P/Q-Type Calcium Channel in a Child With Congenital Hypotonia and Developmental Delay

Abstract Background A 4-year-old boy born at 37 weeks' gestation with intrauterine growth retardation presented with developmental delay with pronounced language and gross motor delay, axial hypotonia, and dynamic hypertonia of the extremities. Investigations including the Minnesota Newborn Screen, thyroid stimulating hormone/thyroxin, and inborn errors of metabolism screening were negative. Cerebral magnetic resonance imaging and spectroscopy were normal. Genetic testing was negative for coagulopathy, Smith-Lemli-Opitz, fragile X, and Prader-Willi/Angelman syndromes. Whole genome array analysis was unremarkable. Methods Whole exome sequencing was performed through a commercial testing laboratory to elucidate the underlying etiology for the child's presentation. A de novo mutation was hypothesized. In attempt to establish pathogenicity of our candidate variant, cellular electrophysiologic functional analysis of the putative de novo mutation was performed using patch-clamp technology. Results Whole exome sequencing revealed a p.P1353L variant in the CACNA1A gene, which encodes for the α1-subunit of the brain-specific P/Q-type calcium channel (Ca V 2.1). This presynaptic high-voltage-gated channel couples neuronal excitation to the vesicular release of neurotransmitter and is implicated in several neurologic disorders. DNA Sanger sequencing confirmed that the de novo mutation was absent in both parents and present in the child only. Electrophysiologic analysis of P1353L-CACNA1A demonstrated near complete loss of function, with a 95% reduction in peak current density. Conclusions Whole exome sequencing coupled with cellular electrophysiologic functional analysis of a de novo CACNA1A missense mutation has elucidated the probable underlying pathophysiologic mechanism responsible for the child's phenotype. Genetic testing of CACNA1A in patients with congenital hypotonia and developmental delay may be warranted.
Glucose and insulin modulate sickness responses in male Siberian hamsters

Mounting a sickness response is an energetically expensive task and requires precise balancing of energy allocation to ensure pathogen clearance while avoiding compromising energy reserves. Sickness intensity has previously been shown to be modulated by food restriction, body mass, and hormonal signals of energy. In the current study, we tested the hypothesis that sickness intensity is modulated by glucose availability and an endocrine signal of glucose availability, insulin. We utilized male Siberian hamsters (Phodopus sungorus) and predicted that pharmacological induction of glucoprivation with 2-deoxy-d-glucose (2-DG), a non-metabolizable glucose analog that disrupts glycolysis, would attenuate energetically expensive sickness symptoms. Alternatively, we predicted that treatment of animals with insulin would enhance energetically expensive sickness symptoms, as insulin would act as a signal of increased glucose availability. Upon experimental treatment with lipopolysaccharide (LPS), we found that glucose deprivation resulted in increased sickness-induced hypothermia as compared to control- and insulin-treated animals; however, it did not have any effects on sickness-induced anorexia or body mass loss. Insulin treatment resulted in an unexpectedly exaggerated sickness response in animals of lesser body masses; however, in animals of greater body masses, insulin actually attenuated sickness-induced body mass loss and had no effects on hypothermia or anorexia. The effects of insulin on sickness severity may be modulated by sensitivity to sickness-induced hypoglycemia. Collectively, these results demonstrate that both glucose availability and signals of glucose availability can modulate the intensity of energetically expensive sickness symptoms, but their effects differ among different sickness symptoms and are sensitive to energetic context.
Cardiovascular Pharmacokinetics, Pharmacodynamics, and Pharmacogenomics for the Clinical Practitioner

Current clinical cardiovascular practice requires a clinician to have a strong foundation in multiple aspects of pharmacology. Modern cardiovascular regimens are complex, and optimal management, application of evolving guidelines, and adoption of new therapies build off a more basic understanding of pharmacokinetics and pharmacodynamics. In addition, it is likely time to add a third pillar into this discussion, the expanding field of pharmacogenomics referring to the genetic influences on drug response. This field has increasing applications in medicine and clearly holds significant promise for cardiovascular disease management. Awareness of pharmacogenomic advances and the fundamentals of pharmacokinetics and pharmacodynamics can help the clinician more easily deliver great care. Here we attempt to briefly summarize and simplify key concepts of pharmacokinetics, pharmacodynamics, and pharmacogenomics relevant to the cardiovascular disease practitioner.
The AFRL/RZPS Centrifuge Table Test Facility

The Centrifuge Table Test Facility in the Propulsion Directorate of the Air Force Research Laboratory at Wright-Patterson Air Force Base has a long history of providing critical knowledge of the response of two-phase heat transfer systems to changing accelerations in aerospace applications. This paper will discuss the centrifuge table facility, a review of literature produced using the facility, the importance of two-phase fluid systems subjected to varying accelerations, and the capabilities and limitations of the centrifuge table. The test bed consists of a 2.44 m diameter horizontal rotating table driven by a 20 hp DC electric motor. The test bed can deliver the following to devices mounted to the rotating table: Conditioned DC electrical power through three separate power supplies, 120 VAC power, temperature-controlled ethylene glycol coolant, and electrical signals for analog or digital control. In addition, electrical signals are collected from instruments on the table and stored in a data acquisition computer. The table is capable of radial acceleration up to ar = 12 g, with a maximum onset of r a& = 10 g/s, inducing a tangential acceleration. The table rotation can be varied manually using a potentiometer, or controlled digitally using a signal generator in the data acquisition and control system. The acceleration field is measured using an orthogonal triaxial accelerometer.
Estimating Interaction Effects With Incomplete Predictor Variables

The existing missing data literature does not provide a clear prescription for estimating interaction effects with missing data, particularly when the interaction involves a pair of continuous variables. In this article, we describe maximum likelihood and multiple imputation procedures for this common analysis problem. We outline 3 latent variable model specifications for interaction analyses with missing data. These models apply procedures from the latent variable interaction literature to analyses with a single indicator per construct (e.g., a regression analysis with scale scores). We also discuss multiple imputation for interaction effects, emphasizing an approach that applies standard imputation procedures to the product of 2 raw score predictors. We thoroughly describe the process of probing interaction effects with maximum likelihood and multiple imputation. For both missing data handling techniques, we outline centering and transformation strategies that researchers can implement in popular software packages, and we use a series of real data analyses to illustrate these methods. Finally, we use computer simulations to evaluate the performance of the proposed techniques.
The Application of a New Composite in Large Bone Defects using Fibrillar Collagen and HA/TCP

The handling property and short term biological response to a new composite of fibrillar collagen (FC) and porous calcium phosphate (HA/TCP) were studied. A 4 mm by 20 mm defect was created in the femora of rabbits. The rabbits were divided into four treatment groups and sacrificed from each group at 4, 8 and 12 weeks. In each group, the defect was treated as follows: in Group I with autogenous bone marrow; in Group II with FC and HA/TCP; and in Group III with FC and HA/TCP with bone marrow in volume ratio of 3:1. In the fourth group, the defect was unfilled. The femora were excised and studied by microradiography or histology or both. The FC could improve the handling property of the HA/TCP granules. Although the composite of FC and HA/TCP was not osteoinductive, the defects in Groups II and III showed good healing at 12 weeks without signs of inflammation. The results showed the composite of FC and HA/TCP to be an effective filler for large bone defects especially when mixed with autogenous bone marrow.
How I Treat Granuloma Annulare

The cause of granuloma annulare is unknown. The disease runs an unpredictable course, with lesions persisting for months or years. Partial or total involution does occur, and often the disorder clears without treatment; however, recurrences are not uncommon. The most common and effective therapy is topical steroid cream under plastic occlusion or use of steroid tape.
Abstract B34: PIM kinase as a novel therapeutic target for triple-negative breast cancer

The greatest clinical challenge in treating breast cancer occurs in those patients whose tumors lack expression of the estrogen and progesterone receptors and that of the HER2 oncoprotein. No targeted therapeutic strategies currently exist against this aggressive type of “triple negative” breast cancer (TNBC) due to lack of validated targets. We previously found that MYC mRNA, protein, and its signaling were disproportionally elevated in TN compared to receptor positive (RP) breast cancer. We sought to take advantage of the unique molecular feature found in this tumor type to identify potent and effective treatment strategies. Since MYC is an oncogenic transcription factor, rationally designed small molecule inhibitors that can directly inhibit its activity are not available for clinical use. An alternative approach to selectively kill MYC-driven tumors is to inhibit those proteins that are indispensable for the viability of such tumors, but are not essential in non-tumorigenic cells. This form of “indirect” treatment strategy has become known as the “synthetic-lethal” approach. To identify novel targets that are readily druggable for treating MYC-driven TNBC, we conducted a kinome MYC synthetic lethal shRNA screen in non-immortalized human mammary epithelial cells expressing a 4-hydroxytamoxifen (TAM)-activatable MycER transgene (HMEC-MycER). Of 600 human kinases targeted by 2,000 individual shRNA clones, 9 kinases were identified as hits as they were essential specifically for the MYC-activated HMEC cells. Among these hits, we focused on PIM1, a non-essential kinase, the knock-down of which had the greatest efficacy in causing cell death in the MYC-activated cells and had minimum inhibitory effect on the growth of the control cells. We determined that PIM1 expression was elevated in TN tumors and was associated with poor prognosis specifically in patients with hormone receptor-negative tumors. Small molecule PIM kinase inhibitors halted the growth of human TN tumors with elevated MYC expression in a patient-derived tumor xenograft (PDX) mouse model by inhibiting oncogenic transcriptional activity of MYC while simultaneously restoring the function of the endogenous cell cycle inhibitor p27. Thus, our findings warrant clinical evaluation of small molecule PIM kinase inhibitors in patients with TN tumors that exhibit elevated MYC expression. Note: This abstract was not presented at the conference. Citation Format: Dai Horiuchi, Alicia Y. Zhou, Alexandra N. Corella, Christina Yau, Sanjeev Balakrishnan, Kai Kessenbrock, Devon A. Lawson, Roman Camarda, Brittany N. Anderton, Alexey V. Bazarov, Henok Eyob, Julia Rohrberg, Paul Yaswen, Michael T. McManus, Hope S. Rugo, Zena Werb, Andrei Goga. PIM kinase as a novel therapeutic target for triple-negative breast cancer. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Breast Cancer Research; Oct 17-20, 2015; Bellevue, WA. Philadelphia (PA): AACR; Mol Cancer Res 2016;14(2_Suppl):Abstract nr B34.
Modeling Pause-Duration for Style-Specific Speech Synthesis.

A major contribution to speaking style comes from both the location of phrase breaks in an utterance, as well as the duration of these breaks. This paper is about modeling the duration of style specific breaks. We look at six styles of speech here. We present analysis that shows that these styles differ in the duration of pauses in natural speech. We have built CART models to predict the pause duration in these corpora and have integrated them into the Festival speech synthesis system. Our objective results show that if we have sufficient training data, we can build style specific models. Our subjective tests show that people can perceive the difference between different models and that they prefer style specific models over simple pause duration models.
Hippocampal volume change relates to clinical outcome in childhood-onset schizophrenia.

Background Fixed hippocampal volume reductions and shape abnormalities are established findings in schizophrenia, but the relationship between hippocampal volume change and clinical outcome has been relatively unexplored in schizophrenia and other psychotic disorders. In light of recent findings correlating hippocampal volume change and clinical outcome in first-episode psychotic adults, we hypothesized that fewer decreases in hippocampal volume would be associated with better functional outcome and fewer psychotic symptoms in our rare and chronically ill population of childhood-onset schizophrenia (COS) patients. Method We prospectively obtained 114 structural brain magnetic resonance images (MRIs) from 27 COS subjects, each with three or more scans between the ages of 10 and 30 years. Change in hippocampal volume, measured by fit slope and percentage change, was regressed against clinical ratings (Children's Global Assessment Scale, Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms) at last scan (controlling for sex, time between scans and total intracranial volume). Results Fewer negative symptoms were associated with less hippocampal volume decrease (fit slope: p = 0.0003, and percentage change: p = 0.005) while positive symptoms were not related to hippocampal change. There was also a relationship between improved clinical global functioning and maintained hippocampal volumes (fit slope: p = 0.025, and percentage change: p = 0.043). Conclusions These results suggest that abnormal hippocampal development in schizophrenia can be linked to global functioning and negative symptoms. The hippocampus can be considered a potential treatment target for future therapies.
Infertility caused by bilateral testicular masses secondary to congenital adrenal hyperplasia (21-hydroxylase deficiency).

Two male cousins with partial 21-hydroxylase deficiency presented with bilateral testicular masses and infertility. In both cases, the testicular masses, consisting of adrenocorticotropic hormone-dependent pluripotential cells, were thought to play a major etiologic role in infertility. The administration of very small doses of dexamethasone, given at 11:00 P.M., led to the disappearance of the masses and a subsequent return of fertility. Although 21-hydroxylase deficiency is not by itself an uncommon condition, the presentation of testicular masses with subsequent reversible infertility in two family members with this condition has not previously been described.
Frequency of Increase in Cardiac Troponin Levels After Peripheral Arterial Operations (Carotid Endarterectomy, Abdominal Aorta Procedure, Distal Bypass) and Their Effect on Medical Management.

The utility of measuring cardiac troponins (cTn) in asymptomatic patients during the perioperative period has been controversial. In the present substudy of the Cardiac Remote Ischemic Preconditioning Prior to Elective Vascular Surgery Trial (NCT01558596), we hypothesized that surveillance of myocardial injury with cTnI in the perioperative period would lead to initiation or intensification of medical therapies for coronary artery disease. Increases in cTnI ≥0.01 μg/l in the perioperative period were considered clinically significant. Intensification of medical therapy was defined as initiation of aspirin or initiation or increases in the dose of angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers, statins, or β blockers and was left to the discretion of treating physicians. From June 2011 to April 2015, a total of 185 patients (mean age 68 ± 7 years, 100% men) were enrolled in the trial. A total of 28 patients (15%) had significant increases in cTnI after vascular surgery, and 38 (20.5%) had their medical therapies intensified in the perioperative period. Among patients with increases in cTnI, 11 (39%) had intensification of medical therapy versus 27 patients (17%) with no or smaller increases in cTnI (p = 0.02). Among those patients with ΔcTnI ≥0.01 μg/l, hospital readmissions at 3 to 6 months were 7.6% for the intensification group versus 25% for the no intensification group (p = 0.18). Mortality rate at 6 months was low in both groups (2.6% vs 0%, respectively, p = 0.13). In conclusion, among patients undergoing vascular surgery, perioperative increases in cTn were associated with initiation or intensification of medical therapies for coronary artery disease at the time of discharge.
Delayed Time to Peak Velocity Is Useful for Detecting Severe Aortic Stenosis

Background Time to peak velocity (TPV) is an echocardiographic variable that can be easily measured and reflects a late peaking murmur, a classic physical finding suggesting severe aortic stenosis (AS). The aim of this study was to investigate the usefulness of TPV to evaluate AS severity. Methods and Results This study included 700 AS patients, whose aortic valve area (AVA) was <1.5 cm2, and 200 control patients. The TPV was defined as the time from aortic valve opening to when the flow velocity across the aortic valve reaches its peak. AS severity was classified as follows: High gradient severe AS, mean pressure gradient ≥40 mm Hg and AVA index (AVAI) <0.6 cm2/m2; Low gradient severe AS, mean pressure gradient <40 mm Hg, AVAI <0.6 cm2/m2, and dimensionless index <0.25; moderate AS, mean pressure gradient <40 mm Hg, AVAI ≥0.6 cm2/m2. The area under the receiver operating characteristic curve of TPV to predict high gradient severe AS was 0.94 (95% CI: 0.92–0.97, P <0.001). TPV was significantly delayed in low gradient severe AS compared with moderate AS both in patients with preserved (102±13 ms versus 83±13 ms, P <0.001) and with reduced ejection fraction (110±18 ms versus 88±13 ms, P <0.001). Delayed TPV was associated with increased all‐cause mortality or need for aortic valve replacement after adjustment for confounders (hazard ratio for first quartile, reference is fourth quartile: 7.31, 95% CI 4.26–12.53, P <0.001). Conclusions TPV is useful to evaluate AS severity and predict poor prognosis of AS patients.
Improving Microarray Sample Size Using Bootstrap Data Combination

Microarray technology has enabled us to simultaneously measure the expression of thousands of genes. Using this high-throughput technology, we can examine subtle genetic changes between biological samples and build predictive models for clinical applications. Although microarrays have dramatically increased the rate of data collection, sample size is still a major issue when selecting features. Previous methods show that combining multiple microarray datasets improves feature selection using simple methods such as fold change. We propose a wrapper-based gene selection technique that combines bootstrap estimated classification errors for individual genes across multiple datasets and reduces the contribution of datasets with high variance. We use the bootstrap because it is an unbiased estimator of classification error that is also effective for small sample data. Coupled with data combination across multiple datasets, we show that our meta-analytic approach improves the biological relevance of gene selection using prostate and renal cancer microarray data.
Cytogenetic Classification Systems and Overall Survival Following Bone Marrow Transplant (BMT) for Acute Myelogenous Leukemia (AML).

Risk-adapted therapy for AML in first complete remission generally calls for allogeneic BMT for patients with poor risk cytogenetics. However, poor risk cytogenetics is defined differently in commonly-applied classification schemes. We hypothesized that differences in cytogenetic classification might result in differences in survival after BMT. From September 1991 to December 2003, we treated 47 patients with AML in first complete remission with high-dose busulfan-containing preparative regimens and an HLA-matched sibling BMT. The median age was 42 years (range 18 to 60). At the time of diagnosis, 35 patients had either a normal karyotype or at least one clonal abnormality. Cytogenetic analysis was unavailable for the other 12 patients. The 47 patients were then classified according to the SWOG/ECOG (Blood96:4075, 2000), MRC (Blood92:2322, 1998), or CALGB (Blood100:4325, 2002) cytogenetic classification systems and analyzed for overall survival. With a median follow-up of 4.9 years, 3 year overall survival for various cytogenetic risk groups are displayed in the table: Concordance indices were 0.58 for CALGB, 0.60 for SWOG, and 0.66 for MRC, demonstrating a slight superiority of the MRC system. Consistent with reports of large, prospective randomized trials of BMT for AML in first remission, patients with poor risk cytogenetics have worse overall survival compared to patients with intermediate risk cytogenetics. Overall survival appears to be different for patients classified as poor risk by MRC criteria. Larger, prospective studies are needed to confirm this observation, but our results suggest that standardized, international cytogenetic risk criteria are needed to develop risk-adapted strategies for the treatment of AML.
Cash for Women's Empowerment? A Mixed-Methods Evaluation of the Government of Zambia's Child Grant Program

The empowerment of women, broadly defined, is an often-cited objective and benefit of social cash transfer programs in developing countries. Despite the promise and potential of cash transfers to empower women, the evidence supporting this outcome is mixed. In addition, there is little evidence from programs at scale in sub-Saharan Africa. We conducted a mixed-methods evaluation of the Government of Zambia's Child Grant Program, a poverty-targeted, unconditional transfer given to mothers or primary caregivers of young children aged zero to five. The quantitative component was a four-year longitudinal clustered-randomized control trial in three rural districts, and the qualitative component was a one-time data collection involving in-depth interviews with women and their partners stratified on marital status and program participation. Our study found that women in beneficiary households were making more sole or joint decisions (across five out of nine domains); however, impacts translated into relatively modest increases in the number of decision domains a woman is involved in, on average by 0.34 (or a 6% increase over a baseline mean of 5.3). Qualitatively, we found that changes in intrahousehold relationships were limited by entrenched gender norms, which indicate men as heads of household and primary decision makers. However, women's narratives showed the transfer increased financial empowerment as they were able to retain control over transfers for household investment and savings for emergencies. We highlight methodological challenges in using intrahousehold decision making as the primary indicator to measure empowerment. Results show potential for unconditional cash transfer programs to improve the financial and intrahousehold status of female beneficiaries, however it is likely additional design components are need for transformational change.
Diffuse large B-cell lymphoma in very elderly patients over 80 years old: Incorporating consolidative radiation therapy into management decisions

Abstract Purpose The population of patients aged 80 years or older who are diagnosed with diffuse large B-cell lymphoma (DLBCL) continues to increase, but an optimal treatment strategy has not been established. We sought to examine the influence of consolidative radiation therapy (RT) on outcome and toxicity among the very elderly diagnosed with stage I-IV DLBCL. Methods and materials We evaluated 131 patients treated at a single institution between 2002 and 2014 who were eligible for RT after successful treatment with chemotherapy. Results The median age was 83 years (range, 80-96). Advanced-stage disease was present in 61.8% of patients. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone was administered to 80% of patients (n = 108), and 23.7% of patients received consolidative RT. Among early-stage (ES) patients treated with 3 to 4 cycles of chemotherapy and RT (n = 12) versus 6 to 8 cycles of chemotherapy alone (n = 17), there were no statistically significant differences in 3-year disease-free, progression-free, or overall survival rates. The 3 year disease-free survival was 91.7% versus 88.2% among patients treated with combined modality therapy versus chemotherapy alone ( P = .78). The 3-year overall survival was 82.5% versus 87.5% among patients treated with combined modality therapy compared with chemotherapy alone ( P = .852). Anemia and neuropathy occurred more frequently among ES patients who received 6 to 8 cycles of chemotherapy alone. Among advanced-stage patients with bulky disease (n = 35), consolidative RT to sites of bulky disease may have improved local control (3-year local control, 100% vs 60.3%, P = .160). Conclusions Among patients aged 80 years or older who have with ES DLBCL, 3 to 4 cycles of chemotherapy followed by RT is at least equivalent in efficacy to chemotherapy alone and is associated with lower levels of toxicity, which suggests that it may be a better choice for therapy when trying to balance treatment efficacy and tolerability.
It’s My Fault: Understanding the Role of Personal Accountability, Mental Models and Systems in Managing Sentinel Events

Root cause analysis (RCA) is frequently employed to identify and remediate faulty systems in the wake of a sentinel event. A composite case, involving an adverse outcome in the operative arena, is presented to illuminate how personal accountability may be a barrier to discovering flawed systems. The mental models that drove the clinical decisions in the event are explained. Underlying the mental models are faulty systems which originated in the upper echelons of the organization. Personal accountability, focusing on time lines to identify problems and failing to understand the beliefs and values, acted as barriers to effectively identify and remediate flawed systems. The connection between a financial decision and a delayed intubation is presented along with strategies for successful remediation.
Robust ℋ ∞ consensus for multi-agent systems with time-varying input delay using dynamic IQCs

In this paper, the distributed consensus control problem for linear multi-agent systems, subject to external disturbance and time-varying input delays, is addressed under the robust ℋ ∞ and dynamic integral quadratic constraint (IQC) analysis framework. A novel distributed protocol is proposed using both relative plant state and IQC dynamics state information. It is shown that under the proposed design scheme, the consensus performance can be reached by solving the ℋ ∞ control problems for a set of independent linear fractional transformation (LFT) systems, whose dimensions are equal to that of a single agent plant plus a single IQC dynamics. Furthermore, the synthesis conditions for the proposed IQC-based distributed consensus control are formulated in terms of linear matrix inequalities (LMIs), such that the optimal ℋ ∞ consensus protocol can be synthesized via convex optimization. A numerical example is used to demonstrate the effectiveness of the proposed approach.
Grounding Language for Interactive Task Learning

This paper describes how language is grounded by a comprehension system called Lucia within a robotic agent called Rosie that can manipulate objects and navigate indoors. The whole system is built within the Soar cognitive architecture and uses Embodied Construction Grammar (ECG) as a formalism for describing linguistic knowledge. Grounding is performed using knowledge from the grammar itself, from the linguistic context, from the agents perception, and from an ontology of long-term knowledge about object categories and properties and actions the agent can perform. The paper also describes a benchmark corpus of 200 sentences in this domain along with test versions of the world model and ontology and gold-standard meanings for each of the sentences. The benchmark is contained in the supplemental materials.
Direct in Situ Measurement of Charge Transfer Processes During Photoelectrochemical Water Oxidation on Catalyzed Hematite

Electrocatalysts improve the efficiency of light-absorbing semiconductor photoanodes driving the oxygen evolution reaction, but the precise function(s) of the electrocatalysts remains unclear. We directly measure, for the first time, the interface carrier transport properties of a prototypical visible-light-absorbing semiconductor, α-Fe2O3, in contact with one of the fastest known water oxidation catalysts, Ni0.8Fe0.2Ox, by directly measuring/controlling the current and/or voltage at the Ni0.8Fe0.2Ox catalyst layer using a second working electrode. The measurements demonstrate that the majority of photogenerated holes in α-Fe2O3 directly transfer to the catalyst film over a wide range of conditions and that the Ni0.8Fe0.2Ox is oxidized by photoholes to an operating potential sufficient to drive water oxidation at rates that match the photocurrent generated by the α-Fe2O3. The Ni0.8Fe0.2Ox therefore acts as both a hole-collecting contact and a catalyst for the photoelectrochemical water oxidation process. ...
Space-charge limited conduction in insulators

Some of the fundamental problems associated with the electrical behavior of insulators involve contacts, space-charge effects, and high field phenomenon. CdS has a band-gap of 2.4 ev and ultra-pure crystals having relatively low imperfection densities are available. This paper is a review of some of the important features of conduction in insulators that are observed in CdS. The idea we wish to emphasize most here, is that of conduction by carrier injection. Insulators can pass relatively high current by this mechanism, and as methods are developed for producing better crystals, analytical techniques and devices based on this mode of conduction will become more important.
Microstructure of localized corrosion front on Mg alloys and the relationship with hydrogen evolution

Abstract Actively propagating localized corrosion fronts on pure Mg, Mg-Zn-Ca-Mn, and Mg-Y alloys in NaCl aqueous solutions were investigated by site-specific characterization techniques. Regardless of alloy microstructure and polarization conditions, rising streams of hydrogen bubbles were observed predominantly at the propagating corrosion fronts. Localized corrosion propagated inside the alloys, underneath a surface corrosion film, and exhibited a finger-like morphology at the corrosion region/alloy interface. Hydrogen evolution was found to be related to the formation of corrosion products and followed local anodic dissolution of Mg. Localized corrosion morphology strongly varied with the underlying Mg alloy microstructure and chemistry.
Commentary by Pedro A. Morettin

This volume honors the work of David Brillinger in several areas, but most notably in the fields of point processes and of time series analysis and applications. It has been a privilege to me to have been his PhD student at Berkeley and then become a friend for the past 40 years. It has been quite a journey. David's work on time series has been influential to many people, especially for his students(over forty), many of them who pursued careers in this field. He is well know in Brazil, for his constant visits and valuable collaboration over the years. His book "Time Series: Data Analysis and Theory" became a classic and I was very fortunate to attend his classes using an earlier draft of the book.