cssi/SciSciGPT-SciSciNet huggingface dataset:
Challenging the FDA Black Box Warning for High Aspirin Dose With Ticagrelor in Patients With Diabetes

Ticagrelor, a novel reversible antiplatelet agent, has a Food and Drug Administration (FDA) black box warning to avoid maintenance doses of aspirin (ASA) >100 mg/daily. This restriction is based on the hypothesis that ASA doses >100 mg somehow decreased ticagrelor’s benefit in the Platelet Inhibition and Patient Outcomes (PLATO) U.S. cohort. However, these data are highly postrandomized, come from a very small subgroup in PLATO (57% of patients in the U.S. site), and make no biological sense. Moreover, the ticagrelor-ASA interaction was not significant by any multivariate Cox regression analyses. The Complete Response Review for ticagrelor indicates that for U.S. PLATO patients, an ASA dose >300 mg was not a significant interaction for vascular outcomes. In the ticagrelor-ASA >300 mg cohort, all-cause and vascular mortality were not significantly increased (hazard ratio [HR] 1.27 [95% CI 0.84–1.93], P = 0.262 and 1.39 [0.87–2.2], P = 0.170), respectively. Furthermore, for major adverse cardiovascular events (MACEs), 30-day all-cause mortality, and 30-day vascular mortality, the strongest interaction is the diabetes-ASA interaction. That is, patients who had diabetes had significantly fewer MACEs through study end (0.49 [0.34–0.63], P 100 mg with ticagrelor is inappropriate for patients with diabetes and not evidence based.
Mass Action in Ionic Solutions.

Abstract The law of mass action describes reactants as simple ideal fluids of concentrations of uncharged noninteracting particles. Ionic solutions contain interacting charged particles and are not ideal. Interactions of reactants can then be mistaken for complexities in chemical reactions or enzymatic catalysts. The variational theory of complex fluids describes flowing mixtures like biological solutions. When a component is added, the theory derives—by mathematics alone—a new set of differential equations that automatically captures all interactions. A variational theory of ionic solutions (as complex fluids) provides computable description of ions in solutions and proteins. Numerical inefficiencies have delayed experimental verification.
chapter 4 Differentiation of Excitable Membranes

Publisher Summary This chapter provides a historical introduction to the electrical events that define the action potential (AP) in adult excitable tissues and explores the properties of the specific ionic conductance mechanisms that underlie each part of the AP. The chapter serves as a background for a more extensive review of the literature concerning developmental changes in AP characteristics and the differentiating mechanisms of excitablity. It emphasizes on cardiac tissue, but not to the exclusion of investigations of nerve or skeletal muscle. The mechanism of impulse initiation in excitable cells has been a question of major interest for centuries. The study of electrical properties of tissues had its origins in the observations of Galvani on “animal electricity,” published in 1791, and the controversy with Volta that ensued. It was only after the development of the first galvonometers at the beginning of the nineteenth century that it became possible to measure electric currents in animal tissues. The concept that the electrical properties of excitable cells may reside primarily in the cell membrane was introduced by Bernstein and an electrical equivalent circuit for the cell membrane was developed by Fricke and Cole (1928). The electrical activity of the normal cardiac pacemaker was variously described as a slow depolarization or as an oscillatory potential.
Reproductive health in South Africa.

This article discusses the state of reproductive health in South Africa. Before 1997 there were about 200000 illegal abortions performed in South Africa annually; 45000 of these procedures caused women to be hospitalized due to incomplete abortion and more than 400 women died due to unsafe abortion each year. The choice of pregnancy termination was based on the Constitution giving them rights to reproductive choice and access to health care services including reproductive health care. The South African Constitution also mandated the creation of a commission for gender equality in order to promote respect for gender equality and the protection development and attainment of gender equality. Moreover on-going reproductive health projects of the country include research on maternal mortality acceptability of female condom emergency contraception community-based prevention of human immunodeficiency virus infection and the feasibility of patient-retained health cards.
The Platelet Transfusion

A 55-year-old man with a history of alcohol abuse and liver cirrhosis presents to the emergency department with upper gastrointestinal bleeding and symptomatic anemia related to acute blood loss (hemoglobin [Hgb] level 7.1 g/dL). A type and screen sample (ethylenediaminetetraacetic acid [EDTA] anticoagulant) along with an order for two units of red blood cells (RBCs) is submitted to the blood bank.
A Review of "Subversive Seduction. Darwin, Sexual Selection and the Spanish Novel"

In the introduction to his detailed exploration of Darwinian theories of sexual selection and Spanish novel, Travis Landry argues that the plots of many late nineteenth-century novels, with their f...
Motivational Interviewing for Older Adults

Motivational interviewing is a technique used to explore ambivalence about a behavior, such as physical activity. Motivational interviewing uses open-ended questions, affirmations, reflections, and summarizations to help an older person self-analyze their behavior. Motivational interviewing leads to modest improvements in physical activity in people with chronic health conditions. There may be benefits to incorporating motivational interviewing into clinical practice. The effects of motivational interviewing may be greater if the clinician adheres to the core components of motivational interviewing.
Optimal Planning Strategy for Ambush Avoidance

Operating vehicles in adversarial environments between a recurring origin-destination pair requires new planning techniques. Such a technique, presented in this paper, is a game inspired by Ruckle’s original contribution. The goal of the first player is to minimize the expected casualties undergone by a moving agent. The goal of the second player is to maximize this damage. The outcome of the game is obtained via a linear program that solves the corresponding minmax optimization problem over this outcome. The formulation originally proposed by Feron and Joseph is extended to different environment models in order to compute routing strategies over unstructured environments. To compare these methods for increasingly accurate representations of the environment, a grid-based model is chosen to represent the environment and the existence of a sufficient network size is highlighted. A global framework for the generation of realistic routing strategies between any two points is described. Finally the practicality of the proposed framework is illustrated on real world environments.
The Application of a Hybrid Probabilistic Method for Design Margin Estimation to the FAST Reference Flight System

Weight growth has been a significant factor in nearly every space and launch vehicle development program. In order to account for weight growth, program managers allocate a design margin. However, methods of estimating design margin are not well suited for the task of assigning a design margin for a novel concept. In order to address this problem, a hybrid method of estimating margin is developed. This hybrid method utilizes range estimating, a well-developed method for conducting a bottom-up weight analysis, and a new forecasting technique known as executable morphological analysis. Executable morphological analysis aims to forecast changes in weight due to requirements and baseline changes to the development program being analyzed. This paper develops executable morphological analysis and applies it to the sample problem of the FAST reference flight system F.
Size, dimensionality, and strong electron correlation in nanoscience.

ConspectusIn electronic structure theory, electron–electron repulsion is normally considered only in an average (or mean field) sense, for example, in a single Hartree–Fock determinant. This is the simple molecular orbital model, which is often a good approximation for molecules. In infinite systems, this averaging treatment leads to delocalized electronic bands, an excellent description of bulk 3D sp3 semiconductors. However, in reality electrons try to instantaneously avoid each other; their relative motion is correlated. Strong electron–electron repulsion and correlation create new collective states and cause new femtosecond kinetic processes. This is especially true in 1D and 2D systems. The quantum size effect, a single electron property, is widely known: the band gap increases with decreasing size. This Account focuses on the experimental consequences of strong correlation. We first describe π–π* excited states in carbon nanotubes (CNTs). To obtain the spectra of individual CNTs, we developed a whit...
Library Literature Resource Construction and Innovation Service Research

In the information society and knowledge economy era,with the penetration of each other disciplines,some of the new discipline appears. At the same time,people's knowledge structure there is a new change,which requires increasingly high quality of library services. In the new period of development,there is a library of challenges and opportunities,which requires the construction of library literature resources and implement innovative services,so as to conform with the requirements of the user,always maintain its advanced nature. Therefore,this article describes the library literature resources construction and service innovation strategies,aimed at better for the majority of users.
Impact of a Hurricane Shelter Viral Gastroenteritis Outbreak on a Responding Medical Team.

Introduction In late October of 2012, Hurricane Sandy struck the northeast United States and shelters were established throughout the impacted region. Numerous cases of infectious viral gastroenteritis occurred in several of these shelters. Such outbreaks are common and have been well described in the past. Early monitoring for, and recognition of, the outbreak allowed for implementation of aggressive infection control measures. However, these measures required intensive medical response team involvement. Little is known about how such outbreaks affect the medical teams responding to the incident. Hypothesis/Problem Describe the impact of an infectious viral gastroenteritis outbreak within a single shelter on a responding medical team. Methods The number of individuals staying in the single shelter each night (as determined by shelter staff) and the number of patients treated for symptoms of viral gastroenteritis were recorded each day. On return from deployment, members of a single responding medical team were surveyed to determine how many team members became ill during, or immediately following, their deployment. Results The shelter population peaked on November 5, 2012 with 811 individuals sleeping in the shelter. The first patients presented to the shelter clinic with symptoms of viral gastroenteritis on November 4, 2012, and the last case was seen on November 21, 2012. A total of 64 patients were treated for nausea, vomiting, or diarrhea over the 17-day period. A post-deployment survey was sent to 66 deployed medical team members and 45 completed the survey. Twelve (26.7%) of the team members who responded to the survey experienced symptoms of probable viral gastroenteritis. Team members reported onset of symptoms during deployment as well as after returning home. Symptoms started on days 4-8, 8-14, on the trip home, and after returning home in four, four, two, and two team members, respectively. Conclusion Medical teams providing shelter care during viral gastroenteritis outbreaks are susceptible to contracting the virus while caring for patients. When responding to similar incidents in the future, teams should not only be ready to implement aggressive infectious control measures but also be prepared to care for team members who become ill. Gaither JB , Page R , Prather C , Paavola F , Garrett AL . Impact of a Hurricane Shelter Viral Gastroenteritis Outbreak on a Responding Medical Team. Prehosp Disaster Med. 2015;30(4):1–4.
Influence of Fe(Cr) miscibility on thin film grain size and stress

Abstract During the post coalescence portion of thin film deposition, thin film stress is related to the grain size and adatom mobility of the depositing material. Using a Fe(Cr) alloy thin film, the manipulation of the tensile stress for thick films was studied as a function of Cr solute content up to 8 at.%. Solute concentrations up to 4 at.% resulted in an approximate 50% increase in grain size that resulted in a reduction of the tensile stress to be lower than either elemental film. Upon increasing the Cr content, the grain size refined and the tensile stress of the films increased. Atom probe characterization of the grain boundaries confirmed Cr chemical partitioning which refined the grain size and altered the film's texture, both of which contributed to the change in film stress. The use of intrinsic segregation, rather than deposition processing parameters, appears to be another viable option for regulating film stress.
Diagnosis For Anterior Cruciate Ligament Surgery

We have reviewed the important aspects of the history, physical examination, and other diagnostic tools available to help diagnose ACL injuries. We feel that, in the hands of an experienced clinician, greater than 90% of ACL disruptions can be diagnosed at the time of injury. Appropriate evaluation will enable the clinician to advise the appropriate treatment, whether it be operative or nonoperative. We have also briefly outlined the variables that we consider to be the most important in the decision-making process of treatment options after ACL disruption.
Going off-script and reframing the frame: The dialogic intertwining of the centripetal and centrifugal voices in the Truth and Reconciliation Commission hearings

After the end of apartheid, the South African Truth and Reconciliation Commission (TRC) was established to uncover the truth and, most importantly, unite a deeply divided nation. This overarching goal of reconciliation not only framed the TRC’s work, but also shaped each hearing so that it followed a somewhat predictable script. In this article, bringing together Goffman’s framing and Bakhtin’s dialogicality, I analyze two selected hearings to show how the testifiers and the TRC commissioners go off-script and thereby reframe participants’ relationships in terms of power and solidarity, the hearing as a social situation, and understandings of the past and the truth. Suggesting that the TRC officials represent centripetal (official) voices and the testifiers represent centrifugal (marginal) voices, I show how going off-script works to not only reframe and laminate frames in a highly organized institutional encounter, but also is a way of intertwining the centripetal and centrifugal voices, thus creating di...
Two Versions of “We, the People”

THE LIBERAL VERSION The notion that the people should rule was most famously stated thus: We, the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquillity, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this CONSTITUTION for the United States of America. “The people” described in the Preamble to the American Constitution now legitimates almost all modern states, and is seen unreservedly as a good and moral collectivity. Indeed, it may be the most benign form of rule humans have yet devised. But if the two meanings of “the people,” demos and ethnos , become fused, problems result – for other ethnic groups living in the same territory. The privileges of citizens may involve discrimination against ethnic out-groups. At the extreme, the out-group may be excluded, cleansed, from the territory of the people. Yet two rather different peoples may be distinguished, a stratified and an organic people. If the people is conceived of as diverse and stratified, then the state's main role is to mediate and conciliate among competing interest groups. This will tend to compromise differences, not try to eliminate or cleanse them. The stratified people came to dominate the Northwest of Europe. Yet if the people is conceived of as organic, as one and indivisible, as ethnic, then its purity may be maintained by the suppression of deviant minorities, and this may lead to cleansing.
A New Approach to Charged Particle Slowing Down and Dispersion

The process by which super-thermal ions slow down against background Coulomb potentials arises in many fields of study. In particular, this is one of the main mechanisms by which the mass and energy from the reaction products of fusion reactions is deposited back into the background. Many of these fields are characterized by length and time scales that are the same magnitude as the range and duration of the trajectory of these particles, before they thermalize into the background. This requires numerical simulation of this slowing down process through numerically integrating the velocities and energies of these particles. This paper first presents a simple introduction to the required plasma physics, followed by the description of the numerical integration used to integrate a beam of particles. This algorithm is unique in that it combines in an integrated manner both a second-order integration of the slowing down with the particle beam dispersion. These two processes are typically computed in isolation from each other. A simple test problem of a beam of alpha particles slowing down against an inert background of deuterium and tritium with varying properties of both the beam and the background illustrate the utility of the algorithm. This is followedmore » by conclusions and appendices. The appendices define the notation, units, and several useful identities.« less
The “Battle at the Bridge” at Wu Liang Tz'u: A Problem in Method

The iconography of Han Dynasty pictorial cycles has become a subject of some interest to historians of early Chinese art. Such pictorial cycles or programs consist of series of related or unrelated scenes from history, legend, and daily life. The problem posed by such iconographic cycles is one of interpretive method. Should these scenes be taken as relating specifically to the lives of the persons they honor or should they be viewed more simply in terms of the general context of Han life? Is there any alternative to these two views? My feeling is that there is an alternative, one which suggested itself after a close examination of the intimately tied group of offering shrines referred to by the catch-all Wu Liang T'zu . I will argue below that the iconographic cycle designed for the earliest of the three reconstructed shrines at this site was adhered to in the later ones whose architectural structure is similar though more elaborate, but that the iconographic specificity of the earliest shrine was substantially generalized in the others.
Kinetics and Apoptotic Profile of Circulating Endothelial Cells as an Indicator of Response to Treatment in Acute Myeloid Leukemia Patients.

The circulating endothelial cells (CEC) are proposed to be a noninvasive marker of angiogenesis. Previously we have found that the number of resting (rCEC), activated (aCEC) CEC and circulating endothelial progenitor cells (CEPC) in peripheral blood of patients (pts) with AML is significantly higher than in healthy controls and correlates with tumour burden. In the present study we analysed CEC count in 111 AML pts at the time of diagnosis and 32 healthy controls. Additionally, we evaluated the kinetics of both rCEC, aCEC, CEPC as well as apoptotic CEC count in 40 AML pts treated with standard induction chemotherapy (ChT). In that group of pts measurements were performed additionally 24 hours after the first (day +1) and last (day +7) dose of ChT as well as at the time of response evaluation. The levels of CEC and their apoptotic profile were correlated with response to treatment. CEC were evaluated by the four colour flow cytometry using a panel of previously described monoclonal antibodies. CEPC were identified as CD45−/ D34+/ CD31+ and CD133+. rCEC were defined as CD45−/CD133−/ CD31+/CD34+/CD146+ and CD105−/CD106− cells. CD105+ or CD106+ CEC were classified as aCEC. Apoptotic CEC were detected as CD146+/Annexin V+ cells (CECAnnV+) CEC level (22,9/μL) was 7-fold higher in untreated AML pts than in the controls (2,95/μL) p 30/μL; (p 10/μL (p Me) (p=0,056) than in pts with CECAnnV+<Me. The numbers of aCEC, rCEC, CEPC and CECAnnV+ evaluated at the diagnosis were comparable in pts who achieved CR and in pts refractory to treatment (NR). In CR pts the counts of aCEC, rCEC, CEPC and CECAnnV+ determined at the time of response’s evaluation were significantly lower then those found at the time of diagnosis (p<0,001, p<0,01, p<0,05, p<0,05 respectively). Moreover, in those CR pts we observed a significant drop in the count of CEC 24 hours after the first as well as the last dose of the induction ChT (p<0,005 and p<0,003, respectively) and increase in the number of CECAnnV+ (p<0,0002, p<0,001 respectively). In pts resistant to treatment the aCEC, rCEC, CEPC and CECAnnV+ counts assessed before and after induction ChT did not differ significantly. In those NR pts a significant decrease in CEC count and increase of CECAnnV+ number was noted only at day +7 after the induction ChT regimen (p<0,03; p<0,05). In conclusion, the CEC and CECAnnV+ levels are significantly higher in AML pts than in healthy subjects and correlate with response to treatment. The high numbers of circulating CEC, both aCEC and rCEC, or CEPC can be a predictor of worse response to induction ChT in AML. Moreover, an early decrease in CEC and increase in CECAnnV+ counts may predict good sensitivity to the treatment. In contrast, the antiapoptotic pattern of CEC may contribute to ChT resistance in AML.
BIN1 localization is distinct from Tau tangles in Alzheimer’s disease

BIN1 is the second most significant Alzheimer's disease (AD) risk factor gene identified through genome-wide association studies. BIN1 is an adaptor protein that can bind to several proteins including c-Myc, clathrin, adaptor protein-2 and dynamin. BIN1 is widely expressed in the brain and peripheral tissue as ubiquitous and tissue-specific alternatively spliced isoforms that regulate membrane dynamics and endocytosis in multiple cell types. The function of BIN1 in the brain and the mechanism(s) by which AD-associated BIN1 alleles increase the risk for the disease are not known. BIN1 has been shown to interact with Tau and two studies reported a positive correlation between BIN1 expression and neurofibrillary tangle pathology in AD. However, an inverse correlation between BIN1 expression and Tau propagation has also been reported. Moreover, there have been conflicting reports on whether BIN1 is present in tangles. A recent study characterized predominant BIN1 expression in mature oligodendrocytes in the gray matter and the white matter in rodent, and the human brain. Here, we have examined BIN1 localization in the brains of patients with AD using immunohistochemistry and immunofluorescence techniques to analyze BIN1 cellular expression in relation to cellular markers and pathological lesions in AD. We report that BIN1 immunoreactivity in human AD is not associated with neurofibrillary tangles or senile plaques. Moreover, our results show that BIN1 is not expressed by resting and activated microglia, astrocytes, or macrophages in human AD. In accordance with a recent report, low-level de novo BIN1 expression can be observed in a subset of neurons in the AD brain. Further investigations are warranted to understand the complex cellular mechanisms underlying the observed correlation between BIN1 expression and the severity of tangle pathology in AD.
Abstract PR08: Armored CAR T cells genetically modified to secrete IL-12 show enhanced efficacy and overcome a hostile tumor microenvironment in mouse ovarian peritoneal carcinomatosis

Chimeric antigen receptor T cell (CAR T) therapy for solid tumors has not replicated the success seen with hematologic malignancies such as CD19-expressing B cell acute lymphoblastic leukemia (B-ALL) and Myeloma. One hypothesis for this lack of efficacy is an immunosuppressive tumor microenvironment that renders adoptively transferred cells ineffective. Armored CAR T cells are CAR T cells that have been further engineered to express additional costimulatory ligands, soluble cytokines or secretable proteins in order to overcome a hostile tumor microenvironment. IL-12 is a proinflammatory cytokine that is only secreted by antigen presenting cells and has been shown to activate effector cells, suppress regulatory T cells and reprogram tumor associated macrophages. We hypothesize that CAR T cells that have been genetically engineered to secrete IL-12 will be more efficacious in the treatment of Muc16ecto positive ovarian cancer by overcoming an otherwise immunosuppressive ascitic tumor microenvironment. Herein we report the mechanisms of enhanced efficacy of an IL-12-armored CAR T cell (4H1128ζ-IL12) directed towards the retained portion of Muc16 (Muc16ecto). Using an immunocompetent syngeneic peritoneal carcinomatosis model of ovarian cancer (i.p ID8-muc16ecto), we show superior therapeutic efficacy of armored CAR T cells compared to second generation CARs (4H1128ζ). Tumor-bearing mice treated after 35 days with 4H1128ζ-IL12 were tumor-free for over 100 days compared to 4H1128ζ-treated mice (o.s: not reached vs 46 days, p= 0.008). Even when the tumor was allowed to establish for 42 days, mice treated with 4H1128ζ-IL12 survived longer than 4H1128ζ- treated mice (o.s: 97 vs 54 days, p= 0.0123). Investigations into the mechanism of improved survival in armored CAR T cell-treated mice showed increased in vivo expansion and modulation of the immunosuppressive ascites cytokine milieu via increased secretion of IL-12, IFN-γ, and TNF-α. Furthermore, 4H1128ζ-IL12 CAR T cells demonstrated enhanced in vitro proliferation and cytotoxic activity when cultured in ascites compared to control CAR T cells. Taken together, these results show that armored CAR T cells can be successfully engineered to overcome an otherwise immunosuppressive solid tumor microenvironment. These results represent the mechanistic companion of an ongoing phase I clinical trial of IL-12 armored CAR T cells in patients with relapsed/refractory ovarian cancer (NCT02498912). This abstract is also being presented as Poster A32. Citation Format: Oladapo Yeku, Terence Purdon, David Spriggs, Renier Brentjens. Armored CAR T cells genetically modified to secrete IL-12 show enhanced efficacy and overcome a hostile tumor microenvironment in mouse ovarian peritoneal carcinomatosis. [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology and Immunotherapy; 2016 Oct 20-23; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2017;5(3 Suppl):Abstract nr PR08.
Preemptive sequencing in the genomic medicine era

ABSTRACTIntroduction: As genomic medicine finds its way into clinical practice, preemptive sequencing is being applied in various aspects of health care. In this review we take stock of the implications of this preemptive collection of information and how the current health care system is evolving to accommodate the privilege of this vast, permanent and deeply private knowledge about our individual selves.Areas covered: In this review we have explored the current standing of preemptive sequencing in regards to return of results for the ACMG 59, pharmacogenomics, prenatal screening, and direct to consumer genetic testing. We attempt to point to the advancements in academics and bioinformatics that it has triggered as well as highlight the various questions that have emerged as a result.Expert commentary: In the first two decades since the genome was sequenced, we have realized that our current health care system needs to go a long way until we can truly leverage our ability to read our genomes to personali...
Operatively Treated Talus Fractures: Complications and Survivorship in a Large Patient Sample.

Abstract Talus fractures are relatively uncommon; however, the sequelae of talus fractures can cause significant morbidity. Although avascular necrosis has been a consistently reported complication, the reported rates of subsequent arthrodesis have varied widely. The purpose of the present study was to report the complications in a large patient sample of operatively treated talus fractures and to describe the survivorship of open reduction internal fixation (ORIF) of the talus. Patients undergoing talus ORIF for closed or open fractures from 2007 to 2011 were identified in the United Healthcare System database by International Classification of Diseases, 9th revision, code 825.21 and Current Procedural Terminology codes 28445, 28436, and 28430. Patients with a nonoperative talus fracture or isolated osteochondral defect were excluded, leaving 1527 patients in the final analysis. We also identified patients who had required subsequent subtalar, pantalar, and tibiotalocalcaneal arthrodeses using Current Procedural Terminology codes 28725, 28705, and 28715, respectively. Complications and demographic data were recorded. Of the 1527 patients, 29 (1.9%) had undergone subsequent arthrodesis within 4 years; 64 patients (4.2%) developed wound complications that did not require surgical intervention, 11 patients (0.7%) were readmitted, 204 (13.3%) presented to the emergency department (ED), and 96 (6.3%) underwent operative irrigation and debridement (ID however, ED visits and infection requiring I&D were relatively common after ORIF of talus fractures.
The inhibition of first-pass metabolism of ethanol by H2-receptor antagonists: a tabulated review.

Introduction: In the 1980s–1990s numerous studies were performed on H2-receptor antagonist inhibition of ethanol first-pass metabolism. Blood alcohol concentrations warranting possible driving unde...
Lead I R-wave amplitude to differentiate idiopathic ventricular arrhythmias with left bundle branch block right inferior axis originating from the left versus right ventricular outflow tract.

INTRODUCTION Differentiation of right versus left ventricular outflow tract (RVOT vs. LVOT) arrhythmia origin with left bundle branch block right inferior axis (LBRI) morphology is relevant to ablation planning and risk discussion. Our aim was to determine if lead I R-wave amplitude is useful for differentiation of RVOT from LVOT arrhythmias with LBRI morphology. METHODS The R-wave amplitude in lead I was measured in a retrospective cohort of 75 consecutive patients with LBRI pattern ventricular arrhythmias (VAs) successfully ablated from the RVOT (n = 54), LVOT (n = 16), or the anterior interventricular vein (AIV; n = 5). The optimal R-wave threshold was identified and diagnostic indices were compared with the previously reported transitional zone (TZ) index and V2S/V3R index. RESULTS An R-wave amplitude greater than or equal to 0.1 mV predicted LVOT origin with 75% sensitivity and 98.2% specificity. In comparison, the TZ and V2S/V3R indices had 50% and 68.8% sensitivity, and 75.9% and 88.9% specificity, respectively, for predicting LVOT origin. The area under the curve (AUC) was 0.85 for lead I R-wave amplitude, 0.87 for V2S/V3R, and 0.72 for the TZ index. Of 36 cases with QS in lead I, 30 (83.3%) were from the anterior RVOT, three (8.3%) from the LVOT, and three (8.3%) from the AIV. CONCLUSION The presence of R-wave amplitude in lead I (≥0.1 mV) is a simple and useful criterion to identify LVOT cusp or endocardium focus in LBRI arrhythmias. A QS pattern in lead I suggests an origin in the anterior RVOT, or less commonly the adjacent LV summit.
Trends in suicide methods by age group.

Introduction This study investigates the trends in suicide methods by age group in Turkey. Method Secondary data on suicide from 2007 to 2015 were obtained from the Turkish Statistical Institute. The direct standardization method was used to calculate suicide rates. Correlation test was used to show the trends in suicide methods by age. Results Statistically significant changes in suicide methods were seen for persons aged 15 to 24 years and 25 to 44 years, where jumping increased; among persons aged 15 to 24 years, cutting/burning decreased. Discussion The most popular suicide method is jumping.
From morphogenesis to pathogenesis: A cellulose loosening protein is one of the most widely distributed tools in nature

Abstract Plants must rearrange the network of complex carbohydrates in their cell walls during normal growth and development. To accomplish this, all plants depend on proteins called expansins that non-enzymatically loosen hydrogen bonds between cellulose microfibrils. Because of their key role in cell wall extension during growth, expansin genes are ubiquitous, diverse, and abundant throughout all land plants. Surprisingly, expansin genes have more recently been found in some bacteria and microbial eukaryotes, where their biological functions are largely unknown. Here, we reconstruct the phylogeny of microbial expansin genes. We find these genes in all eukaryotic microorganisms that have structural cellulose in their cell walls, suggesting expansins evolved in ancient marine microorganisms long before the evolution of land plants. We also find expansins in an unexpectedly high phylogenetic diversity of bacteria and fungi that do not have cellulosic cell walls. These bacteria and fungi with expansin genes inhabit varied ecological contexts mirroring the diversity of terrestrial and aquatic niches where plant and/or algal cellulosic cell walls are present. The microbial expansin phylogeny shows evidence of multiple horizontal gene transfer events within and between bacterial and eukaryotic microbial lineages, which may in part underlie their unusually broad phylogenetic distribution. Taken together, we find expansins to be unexpectedly widespread in both bacterial and eukaryotic genetic backgrounds, and that the contribution of these genes to bacterial and fungal ecological interactions with plants and algae has likely been underappreciated. Importance Cellulose is the most abundant biopolymer on earth. In plant cell walls, where most global cellulose biomass is found, cellulose microfibrils occur intertwined with hemicelluloses and pectins. The rigidity of this polysaccharide matrix provides plant cell walls with structural support, but this rigidity also restricts cellular growth and development. Irreversible, non-enzymatic loosening of structural carbohydrates by expansin proteins is key to successful cell wall growth in plants and green algae. Here, we find that expansin genes are distributed far more broadly throughout diverse bacterial and fungal lineages lacking cellulosic cell walls than previously known. Multiple horizontal gene transfer events are in part responsible for their unusually wide phylogenetic distribution. Together, these results suggest that in addition to being the key evolutionary innovation by which eukaryotes remodel structural cellulose in their cell walls, expansins likely have remarkably broad and under-recognized utility for microbial species that interact with plant and algal structural cellulose in diverse ecological contexts.
Effect of a New Rule Limiting Full Contact Practice on the Incidence of Sport-Related Concussion in High School Football Players.

Background:Sport-related concussion (SRC) has been associated with cognitive impairment, depression, and chronic traumatic encephalopathy. American football is the most popular sport among males in...
Stigma and discrimination as correlates of mental health treatment engagement among adults with serious mental illness.

Objective The negative impacts of stigma on mental health treatment initiation are well established, but the relationship of stigma to proactive engagement in mental health treatment (e.g., actively working toward therapy goals) is largely unexamined. This study examined the relationship between mental health treatment engagement and stigma experiences, discrimination experiences, and internalized stigma among adults with serious mental illness. Age, race, gender, and education were tested as moderators of the relationships between stigma-related variables and treatment engagement. Method Data were collected from 167 adults with serious mental illnesses who were receiving services at 5 psychosocial rehabilitation programs. Treatment engagement was assessed by participants' primary mental health care providers, using the Service Engagement Scale. The relationship between treatment engagement, stigma, and discrimination as well as potential demographic moderators were tested with Pearson's correlations and multiple linear regressions. Results Treatment engagement was not correlated with experiences of stigma, experiences of discrimination, or application of stigmatizing beliefs to self. Gender, race, and age were not significant moderators but education was. Experiences of stigma were associated with greater treatment engagement in those with a higher level of education (p = .007), whereas application of stigma to one's self was associated with poorer treatment engagement in those with a higher level of education (p = .005). Conclusions and implications for practice Among individuals with higher levels of education, efforts to prevent internalization of public stigma may be crucial to promote proactive mental health treatment. Replication studies are needed to confirm these findings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
A Review of the Clinical Evidence for Complementary and Alternative Medicine in Huntington's Disease.

Background There is a lack of published guidelines related to the use of complementary and alternative medicine (CAM) for Huntington's disease (HD). We conducted a review of the literature to summarize the available evidence for various mind-body practices and nutraceuticals. Methods PubMed and Cochrane Library electronic databases were searched independently from inception to February 2019 by two independent raters. Studies were classified for the level of evidence (Class I, II, III, or IV) according to the American Academy of Neurology (AAN) classification scale. Results Randomized controlled trials in HD were reviewed for mind-body interventions (dance therapy, music therapy, and exercise), alternative systems (traditional Chinese medicine [TCM]), and nutraceuticals/diet (aminooxyacetic acid [AOAA], coenzyme q10, creatine, cannabinoids, alpha-tocopherol, eicosapentaenoic acid, idebenone, levocarnitine, and triheptanoin). Few studies met AAN Class I or II level of evidence for benefits, and these are highlighted. Discussion There is a relative paucity of clinical trials examining CAM modalities in HD when compared to other neurodegenerative disorders. Currently, there is no evidence supporting disease modification or symptom improvement with any specific dietary or nutraceutical supplement for HD. Supervised exercise and contemporary dance are safe for people with HD, but more robust studies are warranted to guide specific recommendations for these and other mind-body interventions.
Evaluation of the CO2 flush as a soil health indicator

Abstract The CO2 flush is recommended as an indicator of soil biological health. We conducted field and greenhouse experiments to evaluate the effect of several factors likely to influence C mineralization (presence/absence of plants, plant species, time of season, N fertility) on the CO2 flush. The field experiment was conducted with barley grown in 2017 (two sampling times) and 2018 (three sampling times). In greenhouse experiments, barley was grown for 4, 6, or 8 weeks; barley, corn, crimson clover, soybean, and ryegrass were grown for 4 weeks; and corn and barley were grown for 5 weeks at 4 levels of N. All had unplanted controls. Root biomass, microbial biomass carbon (MBC), dissolved organic carbon (DOC), and the amount of CO2-C released during 24 h after rewetting dried soil were measured. MBC was determined by the microwave method, and DOC was extracted by water with C quantified using a Shimadzu TOC-VCPH. A LI-COR infrared gas analyzer was used to quantify CO2. We found that planted soil had a greater CO2 flush than bare or unplanted soil, but the difference was not large, ranging between 15 and 40%. Root biomass did not consistently correlate with the CO2 flush. In unfertilized soils, the CO2 flush was not influenced by plant species. In fertilized soils, the CO2 flush was significantly higher in soils planted to corn than soils planted to barley at the two highest nitrogen levels. We found strong correlations between DOC and the CO2 flush, and inconsistent correlations between MBC and the CO2 flush. Because the CO2 flush was not strongly influenced by collection time, plant species, or N fertility, the CO2 flush may be a robust soil health indicator among different crops and sampling times.
Emotional Framing of News on Sexual Assault and Partisan User Engagement Behaviors

Based on the emotion-as-frames model and theories of political psychology, this study examines how the emotional frames (anger, anxiety, sexual) of news on sexual assault are associated with differ...
Building Bridges on the Silk Road: A Strategy for Vietnam

In March 2015, the Chinese government published an official document entitled “Vision and Actions on Jointly Building the Silk Road Economic Belt and the 21st-Century Maritime Silk Road,” commonly known by the Chinese as “One Belt, One Road” (OBOR, 2015). The purpose of this massive initiative is to instill vigor and vitality into the ancient Silk Road, connecting Asian, European and African countries and their adjacent seas, more closely and to promote mutually beneficial cooperation to a new high and in new forms. Despite the establishment of the initiative, there has been very little scholarly discussion on the role of foreign direct investment in the important countries on the Silk Road and the impact of these investments on the people of these less-developed regions of the world. Vietnam is a critical partner in this initiative because it shares both maritime and land frontiers with China. Vietnam also serves as China’s largest trading partner in the Association of Southeast Asian Nations (ASEAN), with two-way trade approaching $75 billion in 2016. China has always expressed a preference for bilateral negotiations in the contested waters of the Maritime Silk Road, despite efforts by ASEAN and other regional organizations to develop more multilateral approaches. Through empirical research, this paper analyzes the challenges and opportunities for China in advancing Silk Road initiatives bilaterally with Vietnam as one of its most important strategic partners. The paper also sets forth Vietnam’s strengths and challenges in integrating its own Five-Year Development Plan into strategic partnerships, regional trade agreements and bilateral arrangements on the Belt and Silk Road including how the country can improve its strategy for foreign direct investment. Through integrating the development strategies of Vietnam, the overall plans for expansion of the Belt and Maritime Silk Roads may become a reality, and serve as a model to facilitate trade and investment throughout the region.
Functional outcomes after extracapsular dissection with partial facial nerve dissection for small and large parotid neoplasms.

Abstract Purpose Multiple surgical options exist for benign parotid tumors without agreement upon a single, best approach. We evaluated the short-term outcomes and rate of complications using the ECD-FND technique for small and large parotid neoplasms involving the superficial and deep lobes of the parotid gland using a categorical approach. Material and methods A single surgeon retrospective cohort study with analysis of patient demographics, outcomes, and complication rates was conducted of patients undergoing the ECD-FND for benign parotid neoplasm. Cases from May 2014 to May 2020 with at least 6 months follow up were considered. Complications were assessed by chart review and tumors were categorized by size and by European Salivary Gland Society (ESGS) classification assigned by a neuroradiologist. Results Fifty-one patients who underwent ECD-FND of suspected benign parotid mass met inclusion criteria. The most common histology was pleomorphic adenoma (56.9%) followed by Warthin's tumor (19.6%). Overall rate of complications was 31.4% with no major complications. Most patients (88.2%) had normal facial nerve function immediately after surgery and all recovered completely in the post operative period. Sialocele occurred in 15.7% of patients with 87.5% resolved within one month and seromas occurred in four patients (7.8%). There was no significant difference in complication rates between the size of tumor (p = 0.889), depth (p = 0.770), or ESGS classification (p = 0.846). Conclusions The ECD-FND technique achieved excellent facial nerve outcomes among our cohort, which included a - proportion of large (>3 cm) and deep lobe tumors. Complications rates and outcomes were similar for larger and deep lobe tumors that underwent a ECD-FND approach. Level of evidence: 3.
Legislating Islamophobia: The factors for the existence of anti-sharia laws in the United States:

In 2010 a number of states began introducing a law that prohibited the application of sharia in U.S. courtrooms. Sharia, translated as the ‘clear path’, is essentially the law of Islam. These laws ...
Legal and Ethical Analysis of Advertising for Elective Egg Freezing

This paper reviews common advertising claims by egg freezing companies and evaluates the medical evidence behind those claims. It then surveys legal standards for truth in advertising, including FT...
Updates in Cardiac Amyloidosis Diagnosis and Treatment

Cardiac amyloidosis is an underrecognized cause of heart failure. We review clinical clues to the diagnoses, a rational approach to testing, and current and emerging therapies. Advances in the diagnosis of amyloid cardiomyopathy include (1) use of 99mtechnetium (99mTc) bone-avid compounds which allow accurate noninvasive diagnosis of transthyretin cardiac amyloidosis (ATTR-CM) in the context of a negative monoclonal light chain screen; and (2) the use of serum and urine immunofixation electrophoresis with serum free light chains as an accurate first diagnostic step for light chain cardiac amyloidosis (AL-CM). Advances in treatment include tafamidis for ATTR-CM and immunologic therapies for AL-CM. With the advent of accurate noninvasive diagnostic modalities and effective therapies, early recognition of cardiac amyloidosis is paramount to implement a diagnostic algorithm and expeditiously institute effective therapies to minimize morbidity and mortality.
A composite L-band HH radar backscattering model for coniferous forest stands

The radar backscattering model developed by Richards et al. (1987), has been improved and further tested in this research. The trunk term may now be calculated from the exact solution to the electromagnetic wave equations instead of the corner reflector equation. Rough surface models have been introduced into the radar model, so that the forward reflectance and the backscattering from the ground surface are now calculated from the same model and, thus, are consistent. The number of trees in an individual pixel is assumed to be Poisson distributed, with tree height in a stand log-normally distributed. The simulated results show that the match of backscattering coefficients for eight forest stands between SIR-B image data and the simulated results are satisfying, and that the trunk term now seems to be convincingly established as the dominant term in the L-band HH radar return from coniferous forest stands.