cssi/SciSciGPT-SciSciNet huggingface dataset:
Renal Metastasis of Head and Neck Squamous Cell Carcinoma With Inferior Vena Caval Thrombus

Although the kidney is a common site of metastatic disease for various cancers, head and neck squamous cell carcinoma is rare. We report a case of metastatic head and neck squamous cell carcinoma of the right kidney with vena caval thrombus. CASE REPORT A 60-year-old male was referred for evaluation of right flank pain and intermittent hematuria approximately 1 month in duration. History was significant for squamous cell carcinoma of the right oropharynx, which was initially treated with radiation and amifostine. After a good initial response further biopsies showed residual cancer. The patient was treated with neoadjuvant docetaxel and underwent what was believed to be definitive surgery with mandibulectomy, resection of the right tonsillar palate and base of tongue, and a right modified neck dissection. Pathological evaluation revealed negative lymph nodes and complete resection of the residual squamous cell carcinoma. Additional history included 80 pack-years of smoking and alcohol abuse. At presentation the patient was evaluated with a complete history, physical examination and cystoscopy. Cystoscopy demonstrated a normal bladder and bleeding from the right orifice. Ultrasound showed a large mass in the right kidney. Computerized tomography (CT) of the abdomen and pelvis revealed a large right renal mass with possible inferior vena caval thrombus. Subsequent magnetic resonance imaging (MRI) demonstrated a large right renal mass replacing the kidney, infrahepatic caval thrombus and some borderline interaortocaval lymphadenopathy (figs. 1 and 2). Further metastatic evaluation included a negative bone scan and chest CT with some basilar lesions consistent with a low grade infectious process. Right radical nephrectomy and caval thrombectomy were subsequently performed through an extended anterior subcostal approach. Postoperatively the patient did reasonably well. He had a questionable pulmonary embolus by clinical diagnosis and chest CT, and received anticoagulant therapy. Subsequently, he underwent negative lower extremity duplex ultrasound and CT of the abdomen and pelvis. Anticoagulant therapy was discontinued due to bleeding requiring transfusion. Pathological evaluation showed metastatic squamous cell carcinoma identical to the oropharyngeal cancer with extensive replacement of the right kidney and adrenal gland. Tumor extended into the renal vein and margins were negative. The patient is currently being considered for further chemotherapy. DISCUSSION
Mollusca from the Insect Limestone (Bembridge Marls Member: Bouldnor Formation: Solent Group), Palaeogene, Isle of Wight, southern England

Molluscs from the Insect Limestone of the Bembridge Marls Member are described. The gastropods Lymnaea (Galba) longiscata (Brongniart 1810), Planorbarius discus (Edwards 1852), Gyraulus similis Ferussac, 1814, Hippeutis headonensis Jodot, 1942, Viviparus lentus (Solander 1766) and Viviparus angulosus (J. Sowerby 1817) indicate freshwater alkaline conditions. The cerithioid gastropod Tarebia acuta (J. Sowerby 1822) probably represent more brackish conditions. Polymesoda (Pseudocyrena) obovata (J. Sowerby 1817) is the only bivalve present. All were potentially washed into the depocentre. Despite a wide outcrop of the Insect Limestone on the Isle of Wight's northwest and northeast coasts, there are no records of molluscs other than from the Gurnard/Thorness Bay area on the northwest coast of the island.
The what, where, when and how of Wnt/β-catenin signaling in pancreas development

The Wnt/β-catenin signaling pathway, conserved across the animal kingdom, is critical for the development of numerous tissues. Several recent studies have focused on the roles that this pathway pla...
My future self: Young children's ability to anticipate and explain future states.

Two experiments examine preschool-aged children’s ability to anticipate physiological states of the self. One hundred and eight 3-, 4-, and 5-year-olds were presented with stories and pictorial scenes designed to evoke thought about future states such as thirst, cold, and hunger. They were asked to imagine themselves in these scenarios and to choose one item from a set of three that they would need. Only one of the items could be used to address the future state. In both experiments, developmental differences were obtained for correct item choices and types of verbal explanations. In Experiment 2, the performance of the 3- and 4-year-olds was negatively affected by introducing items that were semantically associated with the scenarios but did not address the future state, whereas the 5-year-olds’ performance was not. Results are discussed with respect to children’s understanding of the future, theory of mind, and inhibitory control skills.
PNEUMA - a comprehensive cardiorespiratory model

The dynamic interactions among the peripheral inputs that originate from the chemoreflexes, baroreflexes and pulmonary stretch receptors, together with central autonomic coupling between respiratory and cardiovascular efferents, play important roles in determining the physiological effects that accompany sleep-disordered breathing. However, previous modeling studies have focussed primarily on specific regions of interest. The purpose of this study was to integrate the key features of existing cardiovascular and respiratory models into a comprehensive model that is capable of simulating the dynamics of cardiorespiratory control during wakefulness and sleep. PNEUMA is implemented using SIMULINK/spl reg/ (The Mathworks, Natick, MA), which provides a graphical environment that allows the user to easily convert control block diagrams into networks of blocks of mathematical functions. The advantages of PNEUMA lie in: (1) the modularity of its various components; (2) the flexibility with which changes can be made to selected portions of the program; and (3) transportability of the model across different computer platforms and operating systems.
Impact of conventional and emerging interconnects on the circuit performance of various post-CMOS devices

The trade-offs between the technology parameters of various interconnect technologies are investigated on the basis of their impacts on the circuit performances of emerging post-CMOS devices. In this paper, carbon nanotube field-effect transistor (CNFET), nanowire-based gate-all-around (GAA) tunneling field-effect transistor (TFET), FinFET and sub-threshold CMOS circuits are studied. Each of these devices are paired with the conventional Cu/low-k interconnect, single-wall carbon nanotube (SWNT) interconnect manufactured in horizontal bundles or in a single layer, and multi-layer graphene nanoribbon (GNR) interconnect. The relative performances of all these interconnect technologies with each type of device are evaluated. The interconnect technology option that gives the best performance in terms of circuit delay, energy-per-bit and energy-delay product (EDP) is reported for each of the device technologies.
Functional Conservation of Plant Secondary Metabolic Enzymes Revealed by Complementation of Arabidopsis Flavonoid Mutants with Maize Genes

Mutations in the transparent testa ( tt ) loci abolish pigment production in Arabidopsis seed coats. The TT4 , TT5 , and TT3 loci encode chalcone synthase, chalcone isomerase, and dihydroflavonol 4-reductase, respectively, which are essential for anthocyanin accumulation and may form a macromolecular complex. Here, we show that the products of the maize ( Zea mays ) C2 , CHI1 , and A1 genes complement Arabidopsis tt4 , tt5 , and tt3 mutants, restoring the ability of these mutants to accumulate pigments in seed coats and seedlings. Overexpression of the maize genes in wild-type Arabidopsis seedlings does not result in increased anthocyanin accumulation, suggesting that the steps catalyzed by these enzymes are not rate limiting in the conditions assayed. The expression of the maize A1 gene in the flavonoid 3′ hydroxylase Arabidopsis tt7 mutant resulted in an increased accumulation of pelargonidin. We conclude that enzymes involved in secondary metabolism can be functionally exchangeable between plants separated by large evolutionary distances. This is in sharp contrast to the notion that the more relaxed selective constrains to which secondary metabolic pathways are subjected is responsible for the rapid divergence of the corresponding enzymes.
Hibernation-induction trigger. II. In vitro effects of prairie dog plasma albumin on mouse vas deferens contractility.

Abstract Involvement of opioid molecules in hibernation is well established, with the delta opioid receptor implicated in hibernation induction. Previous studies have shown that plasma albumin fractions (PAFs) from hibernating mammals contain an uncharacterized ligand called “hibernation-induction trigger” (HIT), which causes inhibition of induced contractility in the guinea pig ileum (GPI). In part I of this study, we described effects of PAF from two species of prairie dogs on induced contractility of the GPI. In the present study (part II), we examine the response of the mouse vas deferens (MVD), which is populated with the delta receptor subtype, to increasing concentrations of PAF from the white-tailed prairie dog (WT) and the black-tailed prairie dog (BT). Dose–response curves of lyophilized PAF yielded IC 50 values (mg) (mean dose that inhibits contractility to 50% of control) of 11.0 for summer WT, 10.6 for hibernating WT, 9.4 for summer BT, 12.2 for winter active BT, and 4.7 for winter hibernating BT. These results suggest that delta opioid (HIT) is present in both species throughout the calendar year and that the induction of hibernation may involve not only levels of opioid but also dynamic interactions between endogenous opioid and its receptors.
The Paperless Labeling Initiative: A Proof-of-Concept Study

BACKGROUND:Traditional paper professional package inserts (PPIs) are used on a daily basis by a variety of healthcare providers to locate and disseminate drug information. Unfortunately, paper PPIs are sometimes not accessible to the healthcare provider, appear unreadable due to varied font sizes, and are often considered not to be user-friendly. In December 2000, the Food and Drug Administration proposed regulations that would revise the format of PPIs.OBJECTIVE:To determine whether electronic delivery of PPI information is achievable in community pharmacy practice settings.METHODS:Electronic PPIs are an alternative means of delivering this information. This 12-week proof-of-concept study evaluated the Health Information Designs/Thomson Healthcare and Etreby Computer Company for electronic delivery of PPIs in 6 chain and 4 independent community pharmacies, with 5 pharmacies evaluating each system. Participating pharmacists were asked 9 questions designed to determine the feasibility of implementing elect...
Clinical Outcomes of Near-Term Infants

Objective. To test the hypothesis that near-term infants have more medical problems after birth than full-term infants and that hospital stays might be prolonged and costs increased. Methods. Electronic medical record database sorting was conducted of 7474 neonatal records and subset analyses of near-term (n = 120) and full-term (n = 125) neonatal records. Cost information was accessed. Length of hospital stay, Apgar scores, clinical diagnoses (temperature instability, jaundice, hypoglycemia, suspicion of sepsis, apnea and bradycardia, respiratory distress), treatment with an intravenous infusion, delay in discharge to home, and hospital costs were assessed. Results. Data from 90 near-term and 95 full-term infants were analyzed. Median length of stay was similar for near-term and full-term infants, but wide variations in hospital stay were documented for near-term infants after both vaginal and cesarean deliveries. Near-term and full-term infants had comparable 1- and 5-minute Apgar scores. Nearly all clinical outcomes analyzed differed significantly between near-term and full-term neonates: temperature instability, hypoglycemia, respiratory distress, and jaundice. Near-term infants were evaluated for possible sepsis more frequently than full-term infants (36.7% vs 12.6%; odds ratio: 3.97) and more often received intravenous infusions. Cost analysis revealed a relative increase in total costs for near-term infants of 2.93 (mean) and 1.39 (median), resulting in a cost difference of $2630 (mean) and $429 (median) per near-term infant. Conclusions. Near-term infants had significantly more medical problems and increased hospital costs compared with contemporaneous full-term infants. Near-term infants may represent an unrecognized at-risk neonatal population.
Paleoclimatic and paleoecological implications of a Paleocene–Eocene fossil leaf assemblage, Chickaloon Formation, Alaska

Abstract New collections of a leaf compression-impression paleoflora preserved in fluvio-lacustrine sediments of the upper Chickaloon Formation, south-central Alaska, United States, provide leaf physiognomic climate estimates for the early Eocene in southern Alaska and rare data on plant-insect interactions from a subarctic setting. Thirty-nine broadleaf angiosperm morphotypes occur in a parautochthonous assemblage along with Metasequoia shoots and trunks, compressions of a diverse suite of seeds, monocotyledonous aquatic plants, freshwater gastropods, and inclusion-bearing dispersed amber. Leaf-character derived mean annual temperature estimates (11–14.6 °C) are significantly warmer than Alaska at present and indicate warm temperate conditions at the time of deposition. Leaf-derived mean annual precipitation estimates of ∼110–160 cm/annum are comparable to those from similar-age paleofloras in Arctic Canada and indicate wetter conditions than nearly coeval paleofloras further south in the North American ...
Gastric volvulus in children: the twists and turns of an unusual entity

Background Gastric volvulus in children is uncommon, and characteristic radiographic findings might not be recognized.
A self-assembled quantum dot probe for detecting {beta}-lactamase activity

This communication describes a quantum dot probe that can be activated by a reporter enzyme, beta-lactamase. Our design is based on the principle of fluorescence resonance energy transfer (FRET). A biotinylated beta-lactamase substrate was labeled with a carbocyanine dye, Cy5, and immobilized on the surface of quantum dots through the binding of biotin to streptavidin pre-coated on the quantum dots. In assembling this nanoprobe, we have found that both the distance between substrates and the quantum dot surface, and the density of substrates are important for its function. The fluorescence emission from quantum dots can be efficiently quenched (up to 95%) by Cy5 due to FRET. Our final quantum dot probe, assembled with QD605 and 1:1 mixture of biotin and a Cy5-labeled lactam, can be activated by 32microg/mL of beta-lactamase with 4-fold increase in the fluorescence emission.
Transportation policy and panterritorial pricing in Africa

Many African countries interfere with the spatial pattern of agricultural prices and often mandate a spatially constant (panterritorial) price. Such policies are conceptually identical to the pricing of transport services. The pricing and transportation policies of the Ivorian cotton parastatal provide a case study. The loss in producer surplus from raising current revenues by panterritorial pricing is compared with an optimal policy that minimizes producer loss. For current revenues, a switch to the optimal policy would provide only small gains. At higher revenue levels, however, the gains would increase. These policies are also contrasted with another suboptimal policy - full cost pricing of transport with an export tax. By dispersing production, panterritorial pricing inflates that gains from transport projects. Transport investment and pricing reform are therefore assessed simultaneously. The number and location of the purchasing depots are also discussed.
Effect of Ischemic Time, Fixation Time, and Fixative Type on HER2/neu Immunohistochemical and Fluorescence In Situ Hybridization Results in Breast Cancer

Accurate determination of HER2/neu status in breast carcinoma is essential. Alteration of preanalytic variables is known to affect HER2/neu results. American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) issued guidelines to standardize fixation for increased HER2/neu accuracy. We studied the effects of changing preanalytic variables on HER2/neu immunohistochemical and fluorescence in situ hybridization (FISH) results in a known HER2/neu+ invasive carcinoma. The clinical specimen was processed according to ASCO/CAP guidelines, with remaining tumor stored fresh without any fixatives for 4 days at 4°C and cut into core biopsy-sized pieces. Each was fixed in 10% formalin, 15% formalin, Pen-Fix (Richard-Allan Scientific, Kalamazoo, MI), Bouin solution, Sakura molecular fixative (Sakura Tissue-Tek Xpress, Torrance, CA), or zinc formalin for 0 to 168 hours. Immunohistochemical studies and FISH were performed. Compared with the clinical specimen, the samples showed no tumor degradation or marked difference by immunohistochemical studies, except the 1-hour 10% formalin and Bouin samples, or FISH, except the Bouin-fixed samples. Our study demonstrates that HER2/neu results remain accurate beyond ASCO/CAP-recommended preanalytic variables, with the exception of Bouin solution for FISH analysis.
A 100-element Schottky diode grid mixer

The authors present a 100-element planar grid mixer consisting of Schottky beam-lead diodes placed in bow-tie shaped unit cells. Preliminary results show that the reflection coefficient of this grid agrees well with theory. A grid conversion loss of 9.3 dB at 10 GHz has been measured. This grid of Schottky diodes is suitable for use as a quasi-optically coupled mixer. The mixer grid is attractive for millimeter-wave applications because of its low-loss quasi-optical coupling, and because its dynamic range can be increased by a factor of the number of devices in the grid. This is important for SIS (superconductor-insulator-superconductor) receivers where dynamic range is fundamentally limited. >
Talking about sociobiology

(1992). Talking about sociobiology. Social Epistemology: Vol. 6, The Rhetoric of Sociobiology, pp. 219-230.
The Art of Clinical Diagnosis

Recently I had lunch with some colleagues in the hospital cafeteria, and the discussion turned to teaching medical students. One of the physicians at the table, an internist, reported that rarely does he see a rectal examination described on a record of a hospital admission history and physical examination - and ours is a university teaching hospital! The surgeon then declared that the physical examination really isn’t important anymore, and that now diagnoses are made in the laboratory and by imaging. I heartily disagree, and I still hold that the best physicians maintain keen physical diagnosis skills, even in the face of slights by the Philistines.
Role of Membrane Phospholipids in Nonfreezing Cold Injury

Nonfreezing cold injury (NFCI) represents a potential threat to infantry and marine operations carried out in inclement weather conditions.1,2 The term “NFCI” is used to identify the syndrome that results from damage to tissues that have been cooled, usually for prolonged periods, at temperatures between about 288°K (15°C) and their freezing point (272.5°K) (-0.5°C). NFCI reduces man’s mobility at the time, but through cold sensitization it may compromise his ability to fight under similar conditions in the future.
Interface pressure redistribution on skin during continuous lateral rotation therapy: A feasibility study.

Abstract Background Continuous Lateral Rotation Therapy (CLRT) is a therapy used in ICUs for early mobilization of ventilated patients. CLRT is believed by some in health care to not be sufficient to allow for capillary re-perfusion, and may lead to tissue damage. Objectives To determine if there are differences in skin interface pressures, skin integrity, or perceived discomfort across three positioning scenarios. Methods A Hill-Rom Total Care SpOrt® bed was equipped with a pressure mapping device. Ten healthy volunteers were placed in each positioning scenario for 30 minutes; interface pressures were recorded. Results CLRT alone demonstrated statistically lower interface pressures on ischial tuberosities (p Conclusions This feasibility study supports the use of CLRT to decrease pressure on capillary beds and decrease patient discomfort.
Chemical Interaction of S35-6-Mercaptopurine and Ribonucleic Acids.

SummaryThese data indicate that 6-mercaptopurine can combine with ribonucleic acid both in vitro and in vivo. Binding is enhanced by added metals and the combination is stable to ribonucleic acid isolation procedures.
A Problem on arc Tangent Relations

(1949). A Problem on arc Tangent Relations. The American Mathematical Monthly: Vol. 56, No. 8, pp. 517-528.
Mitochondria and Evolution

Complex cells contain an evolutionary legacy of genomes compartmentalized by function in order to promote cellular growth. Metabolic activity is controlled by a separate organelle, the mitochondrion, with DNA for 37 distinct genes that commonly show uniparental inheritance. Mitochondrial genes are especially useful in tracing maternal lineages in animal populations.
Information for inference

Wyner defined the notion of common information of two discrete random variables as the minimum of I(W; X, Y) where W induces conditional independence between X and Y. Its generalization to multiple dependent random variables revealed a surprising monotone property in the number of variables. Motivated by this monotonicity property, this paper explores the application of Wyner's common information to inference problems and its connection with other performance metrics. A central question is that under what conditions Wyner's common information captures the entire information contained in the observations about the inference object under a simple Bayesian model. For infinitely exchangeable random variables, it is shown using the de Finetti-Hewitt-Savage theorem that the common information is asymptotically equal to the information of the inference object. For finite exchangeable random variables, such conclusion is no longer true even for infinitely extendable sequences. However, for some special cases, including both the binary and the Gaussian cases, concrete connection between common information and inference performance metrics can be established even for finite samples.
POLYMYXIN-COAGULASE-MANNITOL-AGAR

Polymyxin-Coagulase-Mannitol-Agar (PCMA) was compared with three other selective media for the ability to rapidly isolate coagulase-positive staphylococci from frozen shrimp. When spread plating was used, PCMA recovered higher numbers of coagulase-positive staphylococci than did Vogel and Johnson Agar, Staphylococcus Medium No. 110 with 0.75 mM sodium azide, and Trypticase Soy Agar with 10% NaCl. PCMA allowed identification of coagulase-positive staphylococci within 24 hr; whereas, the other selective media required 48 hr for growth plus 24 hr for confirmation of identity of the coagulase-positive staphylococci. Cross-replica-plating was used to compare the effectiveness of the four selective media studied. In general, PCMA allowed fewer total number of colonies to develop than did the other selective media, but a greater percentage of the colonies that developed on PCMA were coagulase-positive staphylococci.
Evaluation of safety and effectiveness of standardized antifactor Xa-based unfractionated heparin protocols in obese versus non-obese patients

Recent data have suggested that standard unfractionated heparin (UFH) protocols may over-anticoagulate obese patients. The goal of this retrospective study was to observe differences in anticoagulation parameters and safety outcomes for standardized antifactor Xa UFH protocols in obese and non-obese populations. Obese patients (N = 148) were identified over a 20-month period and matched to 148 non-obese patients based on age, gender, and admission date. Patients were included if they were on one of three approved UFH protocols [high (target antifactor Xa 0.3–0.7 IU/mL), moderate (0.3–0.5 IU/mL), or low (0.1–0.2 IU/mL) dose] for ≥24 consecutive hours and had ≥1 antifactor Xa level drawn during the infusion. Groups were compared for doses at first and second consecutive therapeutic antifactor Xa level, major bleeding, and in-hospital mortality. Obese patients required a significantly lower mean weight-based infusion rate to attain first therapeutic antifactor Xa level compared to non-obese patients in both the high dose (19.45 vs. 15.29 units/kg/h, p < 0.001) and the moderate dose populations (15.0 vs. 12.94 units/kg/h, p = 0.003). Similarly, patients in both the high and moderate dose populations had significant differences in mean infusion rates to attain second consecutive therapeutic antifactor Xa levels. There was no difference between infusion rates for the primary outcomes in the low dose population. There was no difference between groups in major bleeding or mortality outcomes. Similar to data using UFH protocols based on activated partial thromboplastin time, obese patients require lower weight-based UFH doses to attain therapeutic anticoagulation. Institutions using or changing to antifactor Xa based protocols may need to modify protocols for obese patients.
TRPC6 and kidney disease: sclerosing more than just glomeruli?

Fibrosis is a common response to injury but can also perpetuate tissue dysfunction. Transient receptor potential C6 (TRPC6) is implicated in cardiac and skin healing via regulation of myofibroblast differentiation. Wu et al. now demonstrate a role for TRPC6 in renal fibrosis, via a mechanism that also relies on TRPC3 and is antagonized by soluble klotho. Modulation of TRPC3/6 activity may provide a means of dampening the fibrotic response involved in chronic kidney disease progression.
Is there a relationship between accelerometer-assessed physical activity and sedentary behavior and cognitive function in US Hispanic/Latino adults? The Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

Abstract Normative changes in cognitive function are expected with increasing age. Research on the relationship between normative cognitive decline and moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SED) needs further investigation in Hispanic/Latinos adults. We assessed the cross-sectional association between accelerometer assessed MVPA and SED with cognitive function in 7,478 adults aged 45–74 years from the Hispanic Community Health Study/Study of Latinos. At baseline, cognitive tests included two executive function tests (Digit Symbol Substitution Test (DSST), a test of language (Word Fluency), and a test of memory (Spanish English Verbal Learning Test). Multiple regression models were used to examine associations of time spent in MVPA and SED with cognitive function by age groups, adjusted for age, education, sex, acculturation, and field center. Mean time spent in sedentary behaviors was 12.3 h/day in females and 11.9 h/day in males (75% and 77% of accelerometer wear time, respectively). Higher SED, but not MVPA, was associated with lower DSST raw scores (β − 0.03 with each 10-min increment in SED; P
Reflections on the Sources of Knowledge in the Indian Tradition

The various ideas about the sources or instruments of knowledge in the different schools or darśana-s in the Indian philosophical tradition suggest questions to those raised in the Western tradition. The fact that there is a considerable overlap of theory and argument should not blind us to the ways in which certain key notions are so diversely conceived. The pramānṇa-s, which I shall here translate as “sources of knowledge” (Potter, though, for instance, prefers “instruments of knowledge”), not only include perception and inference, but also interesting variants such as negative perception (that is, the perception of the absence of something) and analogy or perceptual recognition based in part on prior verbal testimony. The most striking difference from typical Western treatments of epistemology is the inclusion of this last.
Microvascular Decompression for Treatment of Trigeminal Neuralgia in Patient with Facial Nerve Schwannoma.

Background Secondary trigeminal neuralgia (TN) is uncommon. When a space-occupying lesion with mass effect is identified, the associated TN is often exclusively attributed to the tumor. This report illustrates the importance of considering coexistent actionable pathology when surgically treating secondary TN. Case Description A 51-year-old woman presented with abrupt-onset TN of the V2 and V3 nerve divisions with hypesthesia. She denied changes in hearing, balance, or facial nerve dysfunction. Magnetic resonance imaging revealed a 1.6-cm contrast-enhancing cerebellopontine angle tumor that effaced the trigeminal nerve, consistent with a vestibular schwannoma. In addition, a branch of the superior cerebellar artery abutted the cisternal segment of the trigeminal nerve on T2-weighted thin-slice magnetic resonance imaging. Intraoperative electrical stimulation of the tumor elicited a response from the facial nerve at low threshold over the entire accessible tumor surface, indicating that the tumor was a facial nerve schwannoma. Considering the patient's lack of facial nerve deficit and that the tumor exhibited no safe entry point for intracapsular debulking, tumor resection was not performed. Working between the tumor and tentorium, a branch of the superior cerebellar artery was identified and decompressed with a Teflon pad. At last follow-up, the patient exhibited resolution of her TN. Her hearing and facial nerve function remained intact. Conclusions Despite obstruction from a medium-sized tumor, it is still possible to achieve microvascular decompression of the fifth cranial nerve. This emphasizes the importance of considering other actionable pathology during surgical management of presumed tumor-induced TN. Further, TN is relatively uncommon with medium-sized vestibular schwannomas and coexistent causes should be considered.
A new method for shrinking tumor based on microenvironmental factors: Introducing a stochastic agent-based model of avascular tumor growth

Abstract In this paper, by using cellular automata formalism, a two-dimensional stochastic agent-based model for avascular tumor growth is presented. The model is based on biological assumptions, physical structure, agents and their states, and transition rules. The interaction between immune and cancer cells is probabilistic. The immune cell recruitment, which usually occurs after the detection of tumor cells, is considered. The insights gain in the proposed work to model the immune-tumor interaction is of great importance to control the tumor growth via micro-environment factors. The parameters used in the present model are in compatible with cancer biology using in vivo experimental data. The results show that the proposed model not only is able to simulate the tumor growth graphically, but also the in vivo tumor growth quantitatively and qualitatively. In this paper, by introducing a new concept; critical point, a new idea is proposed to shrink the tumor or slow down its growth rate. The tumor will grow slowly if the division probability of the proliferative tumor cells depends on the microenvironmental conditions. The proposed idea has been validated using an in silico simulation.
Constraints on the dominant mechanism for HIV viral dynamics in patients on raltegravir.

BackgroundRaltegravir is the first publicly released HIV integrase inhibitor. In clinical trials, patients on a raltegravir-based highly active antiretroviral therapy (HAART) regimen were observed ...
RESEARCH AND SCHOLARSHIP

This chapter addresses research and scholarship, which are key responsibilities of both academics and higher education institutions. It attempts to define the characteristics of research and scholarship and their place in higher education systems and institutions, and considers the research role of universities and the differing commitment of universities to research activity. Other topics covered include the role of the state in research and innovation, public funding of research and development (R&D), priority setting in research funding, university research links with industry, and research commercialization. The discussion concentrates particularly on research-intensive universities, or those major universities with particularly strong commitments to research activities, R&D and Ph.D. training. It also focuses mainly on highly-developed industrial countries, particularly members of the Organization for Economic Development and Cooperation (OECD). At the same time, it should be recognized that research and scholarship are important in all higher education systems, especially to support research training and teaching more broadly, although funding research can be difficult for small, developing nations. Ideally, all nations should maintain some research capacity in order to keep pace with scientific and technological innovations internationally, and to have the ability to access latest developments in key disciplines, as reported in scholarly literature.
Modifying test suite composition to enable effective predicate-level statistical debugging

In order to effectively deal with increased complexity and production pressures for the development of safety-critical systems, organizations need automated assistance in program analysis and testing. This need is intensified for systems that make heavy use of floating-point computations. Challenges related to the use of floating-point computations exist in the fields of testing, formal verification and debugging. While testing and formal verification provide mechanisms to identify possible failures within safety-critical systems, debugging techniques are employed to automatically isolate the cause of the failure. Recent advances in predicate-level statistical debugging have addressed localizing faults due to floating-point computations. Here, we present a methodology to modify the composition of a test suite to enable predicate-level statistical debuggers to more effectively isolate the causes of failures in safety-critical systems. Our methodology makes test suites significantly more effective for a class of debuggers, including those built to address faults due to floating-point computations.
A Survey of Next-Generation–Sequencing Technologies

Innovative application of new technologies in research is one of the major factors driving advances in knowledge acquisition. In 1977, Maxam and Gilbert reported an approach in which terminally labeled DNA fragments were subjected to base-specific chemical cleavage and the reaction products were separated by gel electrophoresis (Maxam and Gilbert 1977). In an alternative approach, Sanger described the use of chain-terminating dideoxynucleotide analogs that caused base-specific termination of primed DNA synthesis (Sanger et al. 1977; Chap. 1). Improvements of the Sanger method led to utilization in the research community and eventually in the clinical diagnosis of many genetic disorders (http://www.ncbi.nlm.nih.gov/sites/GeneTests/). In a factory-based format, Sanger sequencing was the method of choice for the first human genome at an estimated cost of $2.7 billion (Fig. 1.1; Chap. 1). In 2008, by comparison, the genome of Dr. James Watson was sequenced over a 2-month period for less than $1 million (Wheeler et al. 2008). With the commercial availability of high-throughput massively parallel DNA sequencing platforms in the past few years, complete sequencing of the whole human genome can be done commercially today in 2–3 months at a cost below $10,000 (Bick and Dimmock 2011; Fig. 1.1). Since their introduction, next-generation sequencing (NGS) technologies have constantly improved and the costs have steadily decreased. A legitimate question therefore is what role targeted gene capture will play if whole-genome sequencing (WGS) can be done for about $1,000 in the future, with the ability to survey the human genome in an unbiased manner. This chapter describes NGS technologies and briefly explores how they have been translated into molecular diagnostics. The clinical applications of NGS will be covered in detail in Chaps. 4–8.
Insulin Secretion and Action

Because glucose is the primary energy source of most cells in the body, control of constant circulating glucose levels is of utmost importance. Too little serum glucose (hypoglycemia) suppresses central nervous system functions and prolonged hypoglycemia leads to death. Too much serum glucose (hyperglycemia) as seen in diabetes mellitus, results in grave consequences such as kidney, nerve, eye, muscle, and immune system damage. The body has an elaborate system to control circulating glucose levels in a narrow range (72–126 mg/dL) to prevent untoward fluctuations. For populations in Western societies, the predominant problem in glucose metabolism is diabetes mellitus although other derangements are significant but not often encountered. Of all the humoral and neuronal regulatory mechanisms for glucose metabolism, insulin is the hormone that lowers serum glucose whereas most other mechanisms function to increase serum glucose.
Highly Purified Human Extracellular Vesicles Produced by Stem Cells Alleviate Aging Cellular Phenotypes of Senescent Human Cells

Extracellular vesicles (EVs), including exosomes and microvesicles, mediate intercellular communications and exert various biological activities via delivering unique cargos of functional molecules such as RNAs and proteins to recipient cells. Previous studies showed that EVs produced and secreted by human mesenchymal stem cells (MSCs) can substitute intact MSCs for tissue repair and regeneration. In this study, we examined properties and functions of EVs from human induced pluripotent stem cells (iPSCs) that can be cultured infinitely under a chemically defined medium free of any exogenous EVs. We collected and purified EVs secreted by human iPSCs and MSCs. Purified EVs produced by both stem cell types have similar sizes (∼150 nm in diameter), but human iPSCs produced 16-fold more EVs than MSCs. When highly purified iPSC-EVs were applied in culture to senescent MSCs that have elevated reactive oxygen species (ROS), human iPSC-EVs reduced cellular ROS levels and alleviated aging phenotypes of senescent MSCs. Our discovery reveals that EVs from human stem cells can alleviate cellular aging in culture, at least in part by delivering intracellular peroxiredoxin antioxidant enzymes. Stem Cells 2019;37:779-790.
Linear Data Structures: A Comparison of Novice and Expert Teacher Pedagogical Content Knowledge

Pedagogical content knowledge (PCK), which includes knowledge of student understanding and knowledge of instructional strategies to support learning, is a component of teaching expertise that develops over time and with experience. In this poster, I present exploratory work to identify and categorize PCK amongst secondary teachers new to computing. Four teachers participating in a multi-year case study completed a questionnaire where they (a) listed student difficulties with linear data structures and (b) described how they address the topic in their teaching. Using a content analysis approach, I analyzed the quantity and type of responses provided. Since little research exists describing computing PCK, I also compared responses against public data sources gathered from experienced teachers who completed similar tasks. Results show that participants provided more ideas about student difficulties than teaching strategies and they focused equally on difficulties with programming notation and with programming pragmatics and plans. In contrast, the experienced educator list included a wider range of difficulty types. Ideas about teaching strategies focused mostly on presenting information, while the experienced educator list focused mostly on providing problem solving tasks. Unlike participants, the experienced educator list referenced real-life examples as an instructional strategy. Lastly, the responses provided by participants were not simply a subset of the experienced educator list and included unique ideas. On the poster I suggest possible contextual and experiential differences between new and experienced computing teachers that might lead to these differences.
MICROSCOPIC POLYANGIITIS AS THE CAUSE OF CHEST PAIN IN A POSTPARTUM FEMALE

Microscopic Polyangiitis (MPO) is described as a triad of palpable purpura, glomerulonephritis and pulmonary infiltrates. Cardiac involvement is rare but can be life-threatening. A 30-year-old female presented with two episodes of exertional left-sided chest pain postpartum. She had elevated
Life-space mobility in dementia patients and family caregivers: A dyadic approach.

Background and objective Given that most dementia care is provided at home by family caregivers, caregivers' health and outdoor activities may influence persons with dementia (PWDs)' mobility. At the same time, PWDs' functional deterioration and mobility changes might affect mobility behaviours in their caregivers. The aims of this pilot study were to examine the relationship of PWD's life-space mobility (LSM) with their caregiver's LSM and to investigate the role of caregiver and PWD characteristics in determining the level of LSM in both PWDs and caregivers. Design and method A cross-sectional survey was conducted with 26 caregivers providing dementia care at home. Caregivers were used as proxy for assessing sociodemographic, clinical and physical function in PWDs. Caregivers' sociodemographic characteristics, LSM, social support, depressive symptoms, caregiving burden and preparedness for caregiving were measured. Results The level of LSM in caregivers was correlated with the PWD's LSM level. Caregivers who perceived high levels of social support and readiness for caregiving tended to report high levels of LSM. PWDs' age and independence in instrumental activities of daily living were correlated with caregivers' LSM. Conclusions The study findings suggest that the caregiver's LSM influenced and was affected by the PWD's LSM. This underscores the need for additional research that examines the role of caregivers' psychosocial and physical health on PWDs' mobility and the context of dementia care and its influences on how dementia care dyads decide and participate in mobility behaviours. Implications for practice The findings of this pilot study will be helpful in identifying a target for interventions designed to delay the onset of mobility disability and maintain and improve social participation in PWDs. To minimise the effects of mobility limitations in PWDs, it is critical to examine their mobility issues from multilevel perspectives, including their caregiver's LSM levels and characteristics that have implications for both research and clinical practice.
Outcomes with Impella in Cardiogenic Shock

Background The Impella (ABIOMED, Danvers, MA) is a temporary left ventricular support device, intended for short-term cardiac support for percutaneous procedures and cardiac shock. The Impella device is available in several sizes capable of producing different flows. It is FDA approved for up to 6 days of support. The device can provide significantly higher blood flow than an intra-aortic balloon pump and can be implanted percutaneously. We sought to describe potential complications and outcomes associated with extended Impella use for cardiogenic shock. Methods We retrospectively evaluated patients who underwent implantation of either the Impella CP (Impella 3.5) or Impella 5.0 from September 1, 2017 to September 1, 2019 at our institution. Hemolysis was defined as plasma free hemoglobin level > 50 mg/dL, a lactate dehydrogenase (LDH) level > 500 units/L, and bilirubin increase > 1 mg/dL. Results 58 patients underwent percutaneous insertion of an Impella device, with the indication of cardiogenic shock in 32 patients (55%). In these 32 patients, only one had an Impella 2.5 device, 21 had an Impella CP (66%), and 10 (31%) had an Impella 5.0. The average age at time of implantation was 55 ± 17 years, and 25 patients were male (78%). Ejection fraction was 17 ± 11.7%. The average duration of Impella support was 5.5 days (1, 16 days). Complications included hematoma at the time of insertion (3 patients), leg ischemia (2 patients), improper positioning (7 patients), acute renal failure (28 patients), and hemolysis (20 patients). Hemolysis developed in 12 patients (57%) with the Impella CP and in 8 patients (80%) with the Impella 5.0, with an average LDH of 1452 units/L. 8 patients were transitioned to veno-arterial (VA) extracorporeal membrane oxygenation (ECMO), with the Impella utilized for left ventricular venting. 9 patients (28%) eventually underwent durable left ventricular assist device (LVAD) implantation on average 7 ± 6.1 days after Impella, and two patients underwent heart transplantation, both 9 days following Impella insertion. 23 patients (72%) did not survive past the initial hospitalization. Conclusion The Impella is a percutaneous temporary left ventricular support device used to provide additional cardiac output in patients with cardiogenic shock. Serious complications can occur with extended support, including hemolysis, acute renal failure, and high mortality. Of our 28 patients who received an Impella, 11 were able to be successfully bridged to either LVAD or heart transplantation with the Impella.
Comprehensive public health evaluation of lockdown as a non-pharmaceutical intervention on COVID-19 spread in India: national trends masking state-level variations.

Objectives To evaluate the effect of four-phase national lockdown from March 25 to May 31 in response to the COVID-19 pandemic in India and unmask the state-wise variations in terms of multiple public health metrics. Design Cohort study (daily time series of case counts). Setting Observational and population based. Participants Confirmed COVID-19 cases nationally and across 20 states that accounted for >99% of the current cumulative case counts in India until 31 May 2020. Exposure Lockdown (non-medical intervention). Main outcomes and measures We illustrate the masking of state-level trends and highlight the variations across states by presenting evaluative evidence on some aspects of the COVID-19 outbreak: case fatality rates, doubling times of cases, effective reproduction numbers and the scale of testing. Results The estimated effective reproduction number R for India was 3.36 (95% CI 3.03 to 3.71) on 24 March, whereas the average of estimates from 25 May to 31 May stands at 1.27 (95% CI 1.26 to 1.28). Similarly, the estimated doubling time across India was at 3.56 days on 24 March, and the past 7-day average for the same on 31 May is 14.37 days. The average daily number of tests increased from 1717 (19–25 March) to 113 372 (25–31 May) while the test positivity rate increased from 2.1% to 4.2%, respectively. However, various states exhibit substantial departures from these national patterns. Conclusions Patterns of change over lockdown periods indicate the lockdown has been partly effective in slowing the spread of the virus nationally. However, there exist large state-level variations and identifying these variations can help in both understanding the dynamics of the pandemic and formulating effective public health interventions. Our framework offers a holistic assessment of the pandemic across Indian states and union territories along with a set of interactive visualisation tools that are daily updated at covind19.org.