cssi/SciSciGPT-SciSciNet huggingface dataset:
Geriatric Education in the Health Professions: Are We Making Progress?

Purpose: Relative to the overall population, older adults consume a disproportionally large percentage of health care resources. Despite advocacy and efforts initiated more than 30 years ago, the number of providers with specialized training in geriatrics is still not commensurate with the growing population of older adults. This contribution provides a contemporary update on the status of geriatric education and explores how geriatric coverage is valued, how geriatric competence is defined, and how students are evaluated for geriatric competencies.
Identification of an intestinal neutral glycosphingolipid as a phenotype-specific receptor for the K88ad fimbrial adhesin of Escherichia coli.

In this study, we identified a receptor for the K88ad fimbrial adhesin of Escherichia coli in neutral glycosphingolipid preparations from intestinal epithelial cells of K88ad-adhesive pigs, which was absent in preparations from K88ad-nonadhesive pigs. Neither K88ab nor K88ac adhesin variants bound to this neutral glycosphingolipid. Because this receptor is an intestinal glycosphingolipid that binds K88ad adhesin, it has been designated IGLad. Carbohydrate compositional analysis of a partially purified preparation of IGLad identified galactose, glucose, and N-acetylglucosamine in a ratio of 1.5:1.0:0.5 as the major monosaccharides. Preliminary characterization experiments using lectins showed that IGLad contains the terminal glycanic structure Galbeta1-4GlcNAc. Removal of terminal beta-linked galactose residues from IGLad decreased the recognition of IGLad by the K88ad adhesin, indicating that terminal beta-linked galactose is an essential component of the K88ad adhesin recognition site on IGLad. Studies with purified glycosphingolipid standards demonstrated that K88ad adhesin binds to neolactotetraosylceramide (nLc4Cer) (Galbeta1-4GlcNAcbeta1-3Galbeta1-4Glcbeta1-1Cer) , lactotriosylceramide (GlcNAcbeta1-3Galbeta1-4Glcbeta1-1Cer) and lactotetraosylceramide (Galbeta1-3GlcNAcbeta1-3Galbeta1-4Glcbeta1-1Cer) . Based on these studies, IGLad appears to be nLc4Cer.
GENETIC DIFFERENTIATION OF TRANSPOSABLE ELEMENTS UNDER MUTATION AND UNBIASED GENE CONVERSION

A model is developed to predict the extent of genetic differentiation in a family of transposable elements under the combined effects of genetic drift, transposition, mutation and unbiased gene conversion. The model is based on simplifying assumptions that are valid when transposition is always to new sites and copy number per site is low. In the absence of gene conversion, the degree of differentiation as measured by the probability of identity of different elements is the same as at a single locus with the same mutation rate but in a population of effective size Nc/2, where N is the population size and c is the number of copies per individual. The inclusion of unbiased gene conversion does not significantly change this result. If, as seems to be the case, families of transposable elements are relatively homogeneous, then the model implies either that mutation rates for transposable elements are much lower than at comparable single-copy loci or that some other force, such as natural selection or biased gene conversion, is at work. Transposition is a very ineffective force for homogenizing a family of transposable elements.
Biocatalytic Syntheses of Aromatics from D-Glucose: Renewable Microbial Sources of Aromatic Compounds

Chemistry is moving into a new era in which renewable resources and starting materials such as D-glucose will likely be prominent features of industrial chemical manufacture. The keys to this progress are the design, development, and use of microbial biocatalysts. Aromatic biosynthesis serves as a paradigm for how biocatalysts can be manipulated to achieve the yield, rate, and purity criteria central to chemical manufacture. A disproportionate amount of the metabolic carbon flow of the biocatalyst must first be directed into the common pathway of aromatic amino acid biosynthesis. This review describes ways of achieving this goal through the traditional strategy of manipulating the catalytic activity of the first enzyme in the common pathway, as well as the amelioration of limitations in the in vivo availability of common-pathway enzyme substrates. The inability of individual enzymes to convert their substrate to product fast enough to avoid substrate accumulation further impedes carbon flow through the common pathway. This review also discusses identification and removal of these rate-limiting enzymes. Finally, we examine the creation of heterologous biocatalysts and how biocatalysis could be integrated with traditional chemical transformations to expand the number of organic chemicals that can be synthesized from glucose.
Ciclosporin (CyA) in the Treatment of Autoimmune Blood Disorders

This paper gives the case histories of four patients suffering from autoimmune blood disorders who were treated with ciclosporin (CyA) in combination with steroids. In all four patients, prior immunsuppressive treatment had been considered unsatisfactory either because it was not possible to control the disease activity even with intensive immunosuppression (cases 1 and 2), or because the patients found it unacceptable to take large doses of steroids (cases 3 and 4).
Molecular Pathology of Colon and Small Bowel Cancers: Sporadic Type

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the third most common cause of cancer death in men and women in the USA and accounts for 9 % of all new cancer cases and of all cancer deaths. In contrast, the incidence of small bowel cancer is low and accounts for 0.4 % of all new cases and 0.2 % of all cancer deaths. It is currently believed that most sporadic colorectal cancers arise from preexisting precursor lesions, including adenoma, dysplasia and recently serrated polyps, but a small percentage of colorectal cancers can arise de novo without identifiable precursor lesions. The majority of colorectal cancers develop through an “adenoma–carcinoma sequence” beginning from transformation of normal colorectal epithelium to an adenomatous intermediate and then to adenocarcinoma. The molecular pathogenesis of colorectal cancer including genetic and epigenetic alterations has been extensively studied in the past two decades and is among one the best understood among human neoplasms.
Systematic review of the in vitro effects of statins on oral and perioral microorganisms

Statins are medications administered orally and are widely used for lowering the blood cholesterol level. The aim of this study was to investigate the effects of orally administered statins on microorganisms infecting oral and perioral tissues. We performed a systematic review of published studies of the in vitro antimicrobial effects of statins on bacteria, viruses, and fungi, and searched PubMed, Web of Science, Cochrane Central, and Google scholar. Studies show that most statins exhibit antimicrobial effects against various oral microorganisms. Simvastatin is most effective against the periodontal pathogens Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis, and against most dental plaque bacteria, including Streptococcus mutans. Statins also exhibit antiviral properties against human cytomegalovirus, hepatitis B virus, and hepatitis C virus, and have antifungal properties against Candida albicans, Aspergillus fumigatus, and Zygomycetes spp. There were notable differences in the minimum inhibitory concentrations (MICs) between different studies, which may be attributed to differences in study design. Further studies are warranted to ascertain if statins can be solubilized so that patients, who have been prescribed statins for cardiovascular diseases, can use the medication as a swish and swallow, giving patients the added benefit of the antimicrobial action topically in the mouth against infectious oral diseases.
Effects of gender, indigenous status, and remoteness to health services on the occurrence of assault-related injuries in children and adolescents

Background Assault-related injury is a devastating consequence of violence and is a prominent cause of morbidity and mortality in young age. However, reliable data sources are scarce and there has been a paucity of studies examining possible predisposing factors on the incidence of assault-related injury. Aims To examine the effect of gender, indigenous status and remoteness to health services on sustaining assault-related injuries in patients aged 17 years and under in Queensland, Australia. Methods Logistic regression analyses were conducted using data from the state-wide trauma registry from 2005 to 2008. Results 282 assault-related injury cases were identified. Indigenous females were at the highest risk of sustaining assault-related injuries (OR: 15.3, 95% CI 8.17 to 28.6), followed by Indigenous males (OR: 6.55, 95% CI 3.60 to 11.9) and non-indigenous males (OR: 2.82, 95% CI 1.78 to 4.47). Adolescent males aged between 13–17 years were at a significantly higher risk than adolescent females of assault-related injury (OR: 2.11, 95% CI 1.34 to 3.31). For non-indigenous people, living in a regional area was associated with a lower risk of assault-related injury compared to major cities (OR: 0.59, 95% CI 0.44 to 0.78). Indigenous people were at higher risk of sustaining an assault-related injury than non-indigenous people in regional areas (OR: 4.8, 95% CI 3.14 to 7.42) and in remote areas (OR: 10.1, 95% CI 2.64 to 38.69). Contribution to the Field The current study provides evidence of interaction effects among the predisposing factors of interest and the likelihood of sustaining assault-related injury. Identifying these interactions is important for the development of effective preventive measures and trauma management plans focusing on high-risk groups who are most likely to sustain assault-related injuries in young age.
Current Treatment Strategies in Pulmonary Hypertension Associated with Left Heart Disease

Pulmonary hypertension (PH) is a common complication of left heart disease (LHD) and is associated with impaired functional capacity and decreased survival. Recent guidelines have proposed a new classification system for PH-LHD that is based on the diastolic pulmonary gradient. Despite a sound physiologic basis, subsequent studies have not found a significant correlation between the diastolic pulmonary gradient and meaningful outcomes. Treatment of PH-LHD focuses on optimizing the left heart disease. The use of medications for the treatment of combined post- and pre-capillary PH in left heart disease is controversial. While several small studies have shown hemodynamic or symptomatic improvement, none have been demonstrated to clearly improve long-term outcomes. Large, event-driven trials of PH-LHD are needed to guide the optimal management of this population.
Knowledge Extraction from the Neural ‘Black Box’ in Ecological Monitoring

Phytoplankton biomass within the Saginaw Bay ecosystem (Lake Huron, Michigan, USA) was characterized as a function of select physical/chemical indicators. The complexity and variability of ecological systems typically make it difficult to model the influences of anthropogenic stressors and/or natural disturbances. Here, Artificial Neural Networks (ANNs) were developed to model chlorophyll a concentrations, a measure for water-column phytoplankton biomass and a proxy for system-level health. ANNs act like “black boxes” in the sense that relationships are encoded as weight vectors within the trained network and as such, cannot easily support the generation of scientific hypotheses unless these relationships can be explained in a comprehensible form. Accordingly, the ‘knowledge’ and/or rule-based information embedded within ANNs needs to be extracted and expressed as a set of comprehensible ‘rules’. Such extracted information would enhance the delineation and understanding of ecological complexity and aid in developing usable prediction tools. Comparisons of various computational approaches (including TREPAN, an algorithm for constructing decision trees from neural networks) used in extracting rule-based information from trained Saginaw Bay ANNs are discussed.
The Underappreciated Externalities of a Functional Odious Debt Doctrine

The Odious Debt Doctrine has limped along in the legal imagination for over 100 years and by some estimations even since Aristotle. In recent years, and particularly in recent months, legal theorists and practitioners have attempted to define the contours and details of this highly controversial and undeveloped doctrine. This Article looks at the generally agreed characteristics of the odious debt doctrine and considers some of the spill-over effects and externalities that would ensue if this doctrine were ever made operative. Many commentators have noted the increased costs of borrowing and lending that would result from the doctrine. Some view this increased cost as detrimental to borrowers and lenders alike. Others view both the doctrine and the increased costs associated with it as mechanisms to curtail the odious practices of brutal dictators and despots. Both views depend on the underlying, though usually unstated, assumption that debt is the sole finance vehicle for states. This is simply not the case. States, like corporations, are able to raise funds through a wide variety of other methods. This Article argues that although debt can be crippling for developing countries and merits the attention it has received, alternative methods may in fact be yet worse. Despotic leaders facing great difficulty in accessing private or public loans may rely more heavily on alternatives like land concessions, assignments and outright sales of valuable state and national property. This turn may have both short and long term detrimental consequences. In the short term, the humanitarian law and human rights violations that have led to a characterization of a given regime as despotic or odious, which previously may have been funded by loans that would now be termed odious debt, may now be funded by the pillaging of that nation's natural resources, property and other valuable assets, all of which will be difficult or impossible to recover upon regime change given the current state of international law as it pertains to state succession. This possibility established, the Article then investigates the contents of the odious debt doctrine to query what characteristics make debt odious rather than simply onerous. It then seeks to establish that there may be little distinction between those characteristics as they apply to debt and as they apply to other types of financial obligations. Finally the Article posits that if this is the case, there may be valuable lessons to be garnered from the odious debt doctrine for application to other types of transnational investment.
Hydraulic Conductivity Estimation Using Tomographic Ground Penetrating Radar Data Within A Sampling-Based Bayesian Inversion Approach

Tomographic ground penetrating radar (GPR) traveltime data has been frequently used for hydrologic parameter estimation in shallow subsurface. However, more efforts are needed to deal with the following issues: 1) to improve the accuracy and efficiency of GPR forward models that are used to compute GPR traveltimes; 2) to develop robust and efficient inversion approaches which can well quantify the uncertainty associated with parameter estimates. In this study, a finite-difference method that solves the eikonal equation in the celerity domain is adopted to compute GPR first arrival traveltimes. It combines a local traveltime computation scheme, where not only transmitted waves, but also diffracted and head waves are considered. The method uses a global fast sweeping method in the time domain to take all possible wave propagations from different directions into account. A samplingbased Bayesian inversion approach is proposed and evaluated. The approach directly estimates hydraulic conductivity based on GPR traveltime information, in the form of probability distributions. The corresponding statistics can be easily obtained through the distributions, providing a complete understanding of the uncertainty in the parameter estimates. The inversion framework is tested using synthetic GPR first-arrival traveltime data collected at different times during infiltration experiments. Results show that the inversion approach can well identify the hydraulic conductivity distributions and therefore provides a good means of coupling different yet complementary information for hydraulic parameter estimation.
The Cleveland Clinic experience with primary central nervous system lymphoma.

Background:The rarity and difficulty of conducting large trials limit the evaluation of various treatment options for primary central nervous system lymphoma (PCNSL). In this study, we sought to describe the demographics, diagnoses, management, and outcomes of patients with PCNSL at a single institu
The effects of cue-reversal as a function of amount of prior learning on a shock-motivated discrimination

The effect of cue-reversal as a function of amount of prior learning on a shock-motivated black-white discrimination was measured in 35 albino rats. Four groups of Ss were run to a criterion of 18 correct responses in 20 consecutive trials, one group receiving no reversal, a second group receiving a single reversal trial on trial 1, a third group receiving a reversal trial immediately after reaching a 5/6 criterion, and the fourth group receiving its reversal immediately after reaching a 9/10 criterion. In addition, 8 Ss from the nonreversed group were given a reversal trial after meeting the 18/20 criterion and were then run to the same criterion once again. The effects of cue-reversal proved to be nonmonotonically related to amount of prior learning. No effect occurred until some learning had manifest itself, and the effect was fairly constant over the moderate ranges of learning. Reversal after the 18/20 criterion had no effect.
In vitro lymphocyte activity in women with endometriosis--an altered immune response?

Objective To determine the possible role of the immune system in the pathogenesis of endometriosis. Design The lymphocyte proliferative response in the presence of autologous endometrial cells was assayed by tritiated thymidine incorporation. Setting Patients were recruited from a university outpatient clinic. Main Outcome Measure To determine the lymphocyte proliferative response to endometrium in controls and patients with endometriosis. Participants Twenty patients with endometriosis and 26 control women were studied. Results The lymphocyte proliferative response in the presence of autologous endometrium was significantly lower in women with endometriosis when compared with controls. Conclusion This study indicates that an altered lymphocyte/endometrial cell relationship is operational in women with endometriosis and may contribute to the pathogenesis of the disease.
General Language Ability Predicts Talker Identification.

Individuals can use both linguistic and non-linguistic features of the speech signal to identify talkers. For instance, listeners have more difficulty identifying talkers in unfamiliar languages compared to a native language (language familiarity effect), implying that language-specific knowledge aids talker identification. In the present study, the source of the language familiarity benefit on talker identification was investigated as listeners identified talkers in their native language as well as non-native languages. Experiment 1 was designed to explore the influence of L2 proficiency on talker identification across languages. Experiment 2 further investigated individual differences in L1 phonetic perception and their contribution to talker identification by comparing English listeners’ performance across different language conditions that varied in the availability of linguistic cues. Results imply that familiarity with a specific language (L1 or L2) did not explain individual variation in language familiarity effect. Rather, in addition to the native language benefit, talker identification may be supported by general sensitivity to sound structures in language, modulated by the availability of higher-level linguistic information.
Paracervical block anesthesia in obstetrics: II. Etiology of fetal bradycardia following paracervical block anesthesia

Fetal scalp sampling and gas chromatographic mepivacaine analysis techniques were used to determine fetal and maternal blood mepivacaine concentrations and acid-base changes following paracervical block in 17 patients. Fetal acidosis was found in the 7 fetuses which developed bradycardia. In most cases of fetal bradycardia, fetal blood mepivacaine concentrations were higher than peak maternal arterial blood levels; this suggests that mepivacaine reaches the fetus by a route more direct than maternal systemic absorption. The proximity of the paracervical injection site to blood vessels supplying the placenta might facilitate direct uptake of the anesthetic from the site of injection to the intervillous space of the placenta.
Redox property of ribonucleotide reductase small subunit M2 and p53R2

Human ribonucleotide reductase (RR) small subunits, M2 and P53R2, play key roles in forming RR holoenzyme and supplying nucleotide precursors for DNA replication and repair. Currently, we are studying the redox property, structure, and function of hRRM2 and p53R2. In the cell-free system, p53R2 did not oxidize a reactive oxygen species (ROS) indicator Carboxy-H(2)DCFDA, but hRRM2 did. Further studies demonstrated that purified recombinant p53R2 protein has the catalase activity to scavenge H(2)O(2). Over-expression of p53R2 reduced intracellular ROS and protected the mitochondrial membrane potential against oxidative stress, whereas over-expression of hRRM2 did not result in the collapse of mitochondrial membrane potential. Our findings suggest that p53R2 may play a key role in defending oxidative stress by scavenging ROS, and this antioxidant property is also important for its enzymatic activity.
Computer simulation for production scheduling in a ready foods system.

On the basis of an operations research technique of simulation, a model of a theoretical ready foods system was described. The model was translated into a code executed on a computer, and the sequences, i.e., production schedules, that emerged were compared with designated measures of performance. The priority dispatch rules tested, based on time standards developed for this theoretical ready foods system, would apply only to this facility. Similar studies might be made for other foodservice systems to reach conclusions applicable to thos operations. The SOT (shortest operation time) decision rule appeared to be most useful in enhancing the effectiveness of this theoretical ready foods system in accordance with the chosen measures of performance.
The Microwave Spectrum and Structure of CH3NO2-H2O1

Abstract The microwave spectrum of the nitromethane-water complex (CH 3 NO 2 -H 2 O) has been studied with a pulsed-beam Fourier-transform Fabry-Perot-cavity spectrometer. Both a -type and b -type transitions were observed for the A state of the complex with the b -type transition being more intense by a factor of 2. Critical to the rotational assignments were well resolved 14 N nuclear electric quadrupole transitions, and the incorporation of the pulsed nozzle in one of the mirrors which provided a beam coaxial with the cavity axis to attain linewidths of about 2 kHz (full-width at half maximum-FWHM). To provide additional structural information, the spectra of the HDO, D 2 O, and CD 3 NO 2 substituents were assigned. The molecular structure derived from the moments of inertia has a center of mass separation of 3.506(7) A. The moments of inertia can not distinguish between two possible forms of the complex, one with the dipole moment vectors aligned and the other with them antialigned. Measurement of the dipole moment components, μ a = 4.15(4) × 10 −30 C · m (μ a = 1.243(11) D) and μ b = 5.96(4) × 10 30 C · m (μ b = 1.706(12)D), resolves this difficulty and shows that the dipole moment vectors are antialigned. The molecular complex is quite strongly bound with a harmonic pseudodiatomic stretching force constant, k s = 9.30 N/m, and hydrogen bond lengths of approximately 2.1 A between the water O atom and a CH 3 H atom, and between a water H atom and an oxygen atom of NO 2 . One standard deviation uncertainty is shown in parentheses for each experimental value reported.
Effects of oil and gas development on vertebrate community composition in the southern San Joaquin Valley, California

Abstract Oil and gas development in the southern San Joaquin Valley of California is extensive and has impacted natural habitats for sensitive species. The effects of this habitat loss and degradation on these species are not well understood. Our objective was to determine habitat characteristics, wildlife community composition, and species abundance relative to the level of oilfield development in saltbush scrub habitat. Sixteen study sites were identified with 4 each in areas with high (>100 well pads), medium (11–50 well pads), low (1–10 well pads), and no (0 well pads) oil field development, as measured by numbers of well pads with active oil production and the proportion of habitat disturbed. Surveys were conducted from March 2008 to May 2010 to assess the abundance and diversity of herbaceous plants, shrubs, birds, reptiles, and small and medium-sized mammals. As oilfield development and associated habitat disturbance increased, herbaceous plant cover and shrub abundance decreased while herbaceous plant diversity increased, largely due to colonization by non-native species. Among animals, generalist lizard, bird, and mammal species increased, as did non-endemic species particularly birds. Conversely, some endemic species, including several special status species, declined or were not detected as the level of oilfield development increased. Ecological community composition remains largely intact at low levels of oilfield development, but is profoundly altered at higher levels with some effects apparent at moderate levels. Best management practices such as spatially consolidating facilities, limiting road construction, and controlling non-native plants could reduce ecological impacts from oilfield activities in saltbush scrub habitat.
Hierarchical Value Chains Encompassing Freight Transportation and Logistics Sectors in the United States: Network Analysis Approach

This research reveals value chain (VC) clusters in which freight transportation modes (i.e., truck, rail, air, water, and pipelines), freight supporting activities (i.e., couriers and messengers and warehousing and storage), and other industry sectors have strong economic interdependencies. The most recent input–output data in the United States were used to construct the 2014 direct requirements matrix and generate a network of economic interdependencies between industry sectors. Community detection, a complex network analysis method, was used to reveal the corresponding VCs in the economic network. A novel procedure uncovered hierarchical VC communities (VCCs) for each freight transportation and logistics sector. Thus, seven distinctive VCCs with unique underlying activities were found. In general, freight industries are hierarchically clustered to VCCs related to raw materials; services; metals; agriculture; textile, apparel, and paper; wood products; and others. Results are important for the areas of t...
Free-Field Particle Velocity Recordings of the January 31, 1986 Northeastern Ohio Earthquake

The January 31, 1986 earthquake in northeastern Ohio triggered eight biast monitors in the coal fields of southeastern Ohio and one in western Pennsylvania at epicentral distances of 128 to 297 kilometers from the earthquake. Recordings of the free-field ground motions exhibit predominant frequencies of 1 to 10 Hz, and are consistent with the ground motion model proposed by Nuttli and Herrmann (1984) for the propagation of Lg waves.
Live Writing: Gloomy Streets

Live Writing: Gloomy Streets is an audiovisual performance, realized on the web browser. Here, every keystroke made on a laptop to write a poem is captured and processed to create audiovisual responses on top of what is written. The piece is built upon a poem about feelings of being isolated from the general public and living in solitude, the comfort zone. Revealing the process of writing a poem to the audience, the writer's emotional states emerge through keystrokes and letters that are alive. Inspired by the tradition of live coding, the text written in live writing performance utilizes the expressivity of the language we speak and the target object that the code influences will be the minds of the audience. In this sense, we consider live writing to be a metaphorical form of live coding the audience's mind.
Mathematical model for β1-adrenergic regulation of the mouse ventricular myocyte contraction.

A new mathematical model of mouse ventricular myocyte contraction that includes the β1-adrenergic system was developed. The model simulated major experimental protocols for myocyte contraction and ...
The Clinical Utility of the Heparin Neutralization Assay in the Diagnosis of Heparin-Induced Thrombocytopenia

Heparin-induced thrombocytopenia (HIT) remains diagnostically challenging. Immunoassays including PF4/heparin enzyme-linked immunosorbent assay (ELISA) have high sensitivity but low specificity. Wh...
Linear shoaling of free-surface waves in multi-layer non-hydrostatic models

Abstract The capability to describe shoaling over sloping bottom is fundamental to modeling of coastal wave transformation. The linear shoaling gradient provides a metric to measure this property in non-hydrostatic models with layer-integrated formulations. The governing equations in Boussinesq form facilitate derivation of the linear shoaling gradient, which is in the form of a [ 2 P + 2 , 2 P ] expansion of the water depth parameter kd with P equal to 1 for a one-layer model and ( 4 N − 4 ) for an N-layer model. The expansion reproduces the analytical solution from Airy wave theory at the shallow water limit and maintains a reasonable approximation up to kd = 1.2 and 2 for the one and two-layer models. Additional layers provide rapid and monotonic convergence of the shoaling gradient into deep water. Numerical experiments of wave propagation over a plane slope illustrate manifestation of the shoaling errors through the transformation processes from deep to shallow water. Even though outside the zone of active wave transformation, shoaling errors from deep to intermediate water are cumulative to produce appreciable impact to the wave amplitude in shallow water.
Radiation Dose Optimization in CT

As CT utilization increases, the concern about radiation dose from CT also increases. Although CT accounts for only 17% of imaging studies obtained, it is reportedly responsible for almost half of the collective effective dose from medical procedures in the United States (Mettler et al. 2009). Although controversial, risk projection models for radiation-induced carcinogenesis estimate that, in a few decades, 1.5–2% of all cancers in the United States may be attributable to the use of CT (Brenner and Hall 2007). Radiation dose optimization frequently involves multiple stakeholders from ordering physicians, radiologists, CT technologist, medical physicists, and patients as well (Fig. 1).
Regaining Traction on the Problem of Punishment: A Critique of David Boonin’s Use of the Entailment Test

Boonin (The problem of punishment, Cambridge University Press, New York, 2008) examines more than a dozen theories of punishment and offers perhaps the most systematic argument that the legal practice of punishment is probably unjustified. This provocative claim comes at a time when US prisons face unsustainable population growth and high recidivism rates. In place of punishment, Boonin offers an account of ‘compulsory victim restitution’. Responses to Boonin (The problem of punishment, Cambridge University Press, New York, 2008) have focused on the merits of his theory of restitution or have defended a single particular theory of punishment from his objections. The present paper offers a more comprehensive response, which finds a critical fault in the crux of Boonin’s argument: the ‘entailment test’. If the practice of punishment is unjustified, it is not for the reasons Boonin gives.
Discovery of a 29-Amino-Acid Reactive Abiotic Peptide for Selective Cysteine Arylation

The regio- and chemoselective modification of proteins or peptides with chemical reagents is often challenging. One approach to overcome this problem involves identifying abiotic polypeptide sequences that react with specific small molecules. Toward this goal, we profiled ∼5 × 1013 randomized 30-mer peptides using mRNA display and high-throughput sequencing in search of polypeptides that can undergo cysteine arylation with a water-soluble perfluoroarene. Within this vast chemical space, we discovered a cysteine-containing sequence with a second-order rate constant of 0.29 M–1 s–1 for arylation. An N- and C-terminal truncation reduced the reaction rate, as did the addition of denaturants. When the reactive peptide was covalently fused to the enzyme Sortase A, we observed regiospecific arylation at a single cysteine site, leaving the enzyme’s active site cysteine unchanged. Taken together, these results demonstrate that long polypeptides of defined sequence, when matched with the appropriate reactive group,...
Goal Attainment and Goal Adjustment of Older Adults During Person-Directed Cancer Rehabilitation.

Objective In this pilot study of a home-based occupational therapy intervention intended to reduce disability and improve quality of life, our objective was to identify rates of goal attainment and patterns of goal adjustment of participants. Method Thirty older adults with cancer were randomized to the intervention arm, and 24 participants identified goals and completed the six-session intervention. An exploratory content analysis of qualitative and quantitative session data was performed. Results Participants set 63 6-wk goals and attained 62% of them. Most of the goals addressed walking (28%), sedentary leisure (24%), exercising (16%), or instrumental activities of daily living (14%). When 6-wk goals were not attained (n = 24), there were 10 instances of goal disengagement and 14 instances of goal reengagement. Conclusion Although most participants were able to meet their goals, many also changed their goals and priorities after reflection and attempts to resume or initiate meaningful activities.
Procalcitonin: Usefulness in Acute Care Surgery and Trauma

Abstract Background: Procalcitonin (PCT) is a serum biomarker currently suggested by the Surviving Sepsis Campaign to aid in determination of the appropriate duration of therapy in sepsis patients. We review the use of procalcitonin in patients after trauma or acute care surgery. Method: A MEDLINE search via PubMed was performed using the combination of “procalcitonin” and “humans” and “injuries, trauma,” “wounds and injuries,” or “wounds.” Studies of burn patients, children, other biomarkers, and non-acute care surgery were excluded. Results: Procalcitonin may be useful in identifying infection in trauma and post-operative acute care surgery. However, heterogenity exists among patients, and surgery and trauma alone elevate PCT even in the absence of infection. Conclusions: Although trends in PCT concentrations may offer insight, no standard approach can be recommended currently.
Characteristics of Winter Wolf Kill Sites in the Southern Yellowstone Ecosystem

Abstract Understanding the spatial use of wolves and how that might relate to prey species may help predict areas with increased likelihood of wolf–prey interactions, areas where wolves may have a higher impact on prey populations, or areas of wolf–livestock conflict. After reintroduction into Yellowstone National Park in 1995, wolves Canis lupus expanded south and recolonized areas in and around Grand Teton National Park in the southern Yellowstone ecosystem in Wyoming, USA. Elk Cervus elaphus in this area are supplementally fed at three feedgrounds artificially increasing elk density. We tracked radio-collared and uncollared wolves annually in winter (December–March) from 2000 to 2008 to investigate kill sites. Our objective was to investigate potential differences in habitat variables (e.g., canopy cover, elevation) between kill sites (n = 295) and available (random; n = 2,360) locations and investigate whether factors influencing winter wolf kill sites differed in a natural setting (i.e., native winte...
Moderation of prior exposure to trauma on the inverse relationship between callous-unemotional traits and amygdala responses to fearful expressions: an exploratory study

Background Previous work has shown that amygdala responsiveness to fearful expressions is inversely related to level of callous-unemotional (CU) traits (i.e. reduced guilt and empathy) in youth with conduct problems. However, some research has suggested that the relationship between pathophysiology and CU traits may be different in those youth with significant prior trauma exposure. Methods In experiment 1, 72 youth with varying levels of disruptive behavior and trauma exposure performed a gender discrimination task while viewing morphed fear expressions (0, 50, 100, 150 fear) and Blood Oxygenation Level Dependent responses were recorded. In experiment 2, 66 of these youth performed the Social Goals Task, which measures self-reports of the importance of specific social goals to the participant in provoking social situations. Results In experiment 1, a significant CU traits-by-trauma exposure interaction was observed within right amygdala; fear intensity-modulated amygdala responses negatively predicted CU traits for those youth with low levels of trauma but positively predicted CU traits for those with high levels of trauma. In experiment 2, a bootstrapped model revealed that the indirect effect of fear intensity amygdala response on social goal importance through CU traits is moderated by prior trauma exposure. Conclusions This study, while exploratory, indicates that the pathophysiology associated with CU traits differs in youth as a function of prior trauma exposure. These data suggest that prior trauma exposure should be considered when evaluating potential interventions for youth with high CU traits.
DILI Associated with Skin Reactions

Adverse drug reactions (ADR) frequently involve the liver and skin in the form of drug-induced liver injury or cutaneous drug eruption. Skin ADR can range from harmless rash to severe skin manifestations such as drug rash with eosinophilia and systemic symptom syndrome (DRESS syndrome), Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP), all of which can be associated with severe outcome, including a 30% mortality rate in case of TEN. The association with co-occurring liver injury varies and in DRESS and SJS/TEN can contribute to substantial morbidity and mortality. Liver and skin ADR are frequent but rarely severe; however, if severe, they are not uncommonly fatal.
Chapter 54 – The Vertebrate Neuromuscular Junction

The neuromuscular junction, i.e. the synapse between motor neurons and muscle fibers, plays an obvious, crucial role in the biology of muscle. This chapter presents a perspective on some of these roles, the structure of the synapse, its formation and modification during development, growth, and aging, the influences of synaptic activity, the repair/re-establishment of the synapse following nerve damage, and the activities of the glia located at the synapse.
Duration and motion in a (cartesian) world which is created anew "at each moment" by an immutable and free god

I argue in this paper that Descartes's goal with his doctrine of the continuous recreation of the world is to offer a unified and ultimate causal explanation for (1) the possibility of motion and duration in the world, (2) the permanence (of the existence) of created things, and (3) the continuation of their motion and duration. This unified explanation seems to be the only one which, according to Descartes, satisfies the two basic requirements any ultimate cause should meet: the cause (1) must be active and (2) not being in motion itself. God's recreations of the world is Descartes's solution to this search. I also show in this article, on the one hand, that this doctrine successfully overcomes, in particular, the four major conflicts which threaten its consistency, and, on the other, the new meaning which the laws of nature acquire under the doctrine of the continuous recreation of the world.
In vitro culture of murine megakaryocytes from fetal liver-derived hematopoietic stem cells

Megakaryocytes (MKs) are specialized precursor cells committed to producing and proliferating platelets. In a cytoskeletal-driven process, mature MKs generate platelets by releasing thin cytoplasmi...
Randomized, double-blind, placebo-controlled, crossover study of the effects of repeated-dose caffeine on neurobehavioral performance during 48 h of total sleep deprivation

Rationale Caffeine is widely used as a countermeasure against neurobehavioral impairment during sleep deprivation. However, little is known about the pharmacodynamic profile of caffeine administered repeatedly during total sleep deprivation.
Predictors of Short‐Term Prognosis While in Pediatric Headache Care: An Observational Study

Objectives To characterize the short-term prognosis of a clinical population of pediatric and young adult patients with migraine and explore predictors of clinical worsening while in care. Methods This was a retrospective study of all migraine patients seen at the Cincinnati Children's Hospital Headache Center from 09/01/2006 to 12/31/2017, who had at least 1 follow-up visit within 1-3 months of the index visit analyzed. Included data were: age, sex, race, primary ICHD diagnosis, chronic migraine, medication overuse, history of status migrainosus, BMI percentile, headache frequency, headache severity, PedMIDAS score, allodynia, preventive treatment type, lifestyle habits, disease duration, depressive and anxiety symptoms. Clinical worsening was defined as an increase in 4 or more headache days per month between the index visit and the follow-up visit. Results Data for 13,160 visit pairs (index and follow-up), from 5316 patients, were analyzed. Clinical worsening occurred in only 14.5% (1908/13,160), whereas a reduction in headache frequency was observed in 56.8% of visit intervals (7475/13,160), with 34.8% of the intervals (4580/13,160) showing a reduction of 50% or greater. The change in headache frequency was minimal (increase in 0-3 headaches/month) in 28.7% of intervals (3737/13,160). In the multivariable model, the odds of worsening were significantly higher with increasing age, female sex, chronic migraine, status migrainosus, depressive symptoms, higher PedMIDAS scores, and use of nutraceuticals, whereas the odds of worsening were lower for summer visits, caffeine drinkers, higher headache frequencies, and use of pharmaceuticals. Conclusions The majority of pediatric patients who receive multimodal interdisciplinary care for migraine improve over time. Our findings highlight a set of clinical features that may help in identifying specific factors that may contribute to an unfavorable short-term prognosis.
1006-P: Real-World Effectiveness of Semaglutide in Early Users from a U.S. Commercially Insured (CI) and Medicare Advantage (MA) Population

Background: With semaglutide’s FDA approval in Dec 2017, this study sought to provide real-world evidence on its effectiveness in a cohort of early users. Methods: Claims and lab result data from a broad national U.S. CI and MA population were used to identify T2DM patients who initiated semaglutide between 12/1/17 - 6/30/18 (first claim date set as index). Of these, patients who had ≥12-month pre-index health plan eligibility as well as ≥1 HbA1c result within both ≤3 months pre- and ≥3 months post-index were selected. Changes in HbA1c were assessed in all patients, GLP-1 naive patients and GLP-1 naive patients with a pre-index HbA1c >9%. Results:Of 107 individuals with T2DM initiating semaglutide, 48.6% were female with median age of 52 years. HbA1c was significantly reduced in all patients (-1.3%), GLP-1 naive patients (-2.0%) and HbA1c >9% GLP-1 naive patients (-2.9%) (all p 9% GLP-1 naive) (all p Conclusions: Semaglutide initiation was associated with a significant reduction in HbA1c and increase in HbA1c goal attainment in real-world practice in this preliminary T2DM cohort. Ongoing research will include a broader group of semaglutide users as well as allow for longer post-initiation follow-up to fully assess its effect. Disclosure J. Visaria: Employee; Self; HealthCore. T. Dang-Tan: Employee; Self; Novo Nordisk Inc. P.V. Petraro: Employee; Self; Novo Nordisk Inc. B.K. Nepal: None. V. Willey: Employee; Self; HealthCore. Funding Novo Nordisk
Diverse 2D and 3D topologies in cobalt cyclohexyldicarboxylate coordination polymers with bis(4-pyridylmethyl)piperazine coligands

Abstract Hydrothermal reaction of cobalt nitrate, a cyclohexyldicarboxylic acid, and the long-spanning dipyridyl coligand bis(4-pyridylmethyl)piperazine (bpmp) produced four structurally diverse coordination polymers which were characterized by single-crystal X-ray diffraction. [Co(cis-12chedc)(bpmp)]n (1, cis-12chedc = cyclohex-4-ene-1,2-cis-dicarboxylate) possesses a 3D pcu network based on embedded {Co2(OCO)2} dimeric units. {[Co(cis-13cdc)(bpmp)(H2O)]·2H2O}n (2, cis-13cdc = cyclohexane-1,3-cis-dicarboxylate) exhibits (4,4) sawtooth coordination polymer layers polycatenated in a 2D + 2D → 3D parallel fashion. {[Co2(cis-14cdc)2(bpmp)]·2H2O}n (3, cis-14cdc = cyclohexane-1,4-cis-dicarboxylate) also shows (4,4) grid layer structures, but without any interpenetration. {Co2(OCO)4} paddlewheel dimers are seen in chain-like substructures in 3. The minor phase [Co(cis-14cdc)(bpmp)(H2O)2]n (4) was isolated along with 3 and manifests a non-interpenetrated 658 cds topology 3D network. Thermal properties of 1–3 were also investigated. Variable temperature magnetic susceptibility studies showed dimer-based antiferromagnetic behavior for 1 and 3.
Effectiveness evaluation of dynamic automatic identification system (device) of Schistosoma japonicum miracidia

OBJECTIVE To develop a dynamic automatic identification system (device) of Schistosoma japonicum miracidia to achieve the automatic detection and improve the detection rate and efficiency of schistosome miracidia. METHODS The dynamic automatic identification system (device) of S.japonicum miracidia was composed of an optical stereoscope, a digital camera, dynamic automatic tracking recognition software, and a computer. Under different conditions, the detection rates and efficiency of the system were compared with those of five professional persons. RESULTS The basic function of the system was to identify, label and warn the miracidia of S. japonicum, and the records could be saved automatically. The laboratory tests showed that the missing rate of the system was 0. The total consistent rates of the manual detection were 74.67% and 66.67% in the condition with and without water bug, while the total consistent rates of the system were 100.00% and 96.67%, respectively (χ2 = 9.634, 11.081, both P < 0.01) . CONCLUSIONS The system is much superior to manual detection in the accuracy and speed, and the system could completely replace the manual detection. Therefore, the system could be used in the field and basic research of schistosomiasis.