cssi/SciSciGPT-SciSciNet huggingface dataset:
Immediate alterations in intestinal oxygen saturation and blood flow after massive small bowel resection as measured by photoacoustic microscopy.

Purpose: Massive small bowel resection (SBR) results in villus angiogenesis and a critical adaptation response within the remnant bowel. Previous ex vivo studies of intestinal blood flow after SBR are conflicting. We sought to determine the effect of SBR on intestinal hemodynamics using photoacoustic microscopy, a noninvasive, label-free, high-resolution in vivo hybrid imaging modality. Methods: Photoacoustic microscopy was used to image the intestine microvascular system and measure blood flow and oxygen saturation (SO_2) of the terminal mesenteric arteriole and accompanying vein in C57BL6 mice (n = 7) before and immediately after a 50% proximal SBR. A P value of less than .05 was considered significant. Results: Before SBR, arterial and venous SO_2 were similar. Immediately after SBR, the venous SO_2 decreased with an increase in the oxygen extraction fraction. In addition, the arterial and venous blood flow significantly decreased. Conclusion: Massive SBR results in an immediate reduction in intestinal blood flow and increase in tissue oxygen utilization. These physiologic changes are observed throughout the remnant small intestine. The contribution of these early hemodynamic alterations may contribute to the induction of villus angiogenesis and the pathogenesis of normal intestinal adaptation responses.
Statistical Flaw Detection: Theory

In this paper we discuss the problem of flaw detection using ultrasound. We describe the decision theoretic optimal algorithm for interior flaw detection in the presence of noise. Based on this algorithm, an efficient sub-optimal algorithm is derived that can be implemented in real time. Finally, we present some results of computer simulation tests comparing the new algorithm with a more traditional video detection scheme based on peak waveform thresholding. Preliminary evaluation of the new detection scheme under laboratory experimental conditions is described in a companion paper [Elsley, Fertig, and Richardson (1983)]. We first start with a brief statement of the specific detection problem we are addressing.
Effect of glyphosate application timings and methods on glyphosate-resistant cotton

Abstract Under certain conditions, application of glyphosate to glyphosate-resistant (GR) cotton can lead to fruit shedding and yield reductions. Field studies were conducted at the Texas Agricultural Experiment Station using GR cotton, cv. ‘DeltaPine 5690RR’, to determine if application method and timing affect cotton fruit retention. Glyphosate at 1.12 kg ai ha−1 was precisely postdirected (PD), postdirected with 25% foliage coverage (PDFC), or applied over the top (OT) at the 8- or 18-leaf stage after an initial topical application of 1.12 kg ha−1 glyphosate at the four-leaf stage. In one of the years of this study, 8 PD, 18 PDFC, and 18 OT reduced yield. In 1999 and 2000, 8 PDFC and 8 OT applications of glyphosate caused yield loss, mainly due to lower mean boll weight. Glyphosate applied topically at the eight-leaf stage also affected the Position 1 boll retention throughout the plant in both years. Glyphosate contact with leaves and stems should be avoided when applying glyphosate after the four-lea...
Exploring the Impact of Organizational Citizenship Behavior on Perceptions of E-Filing Success

Organizational citizenship behavior OCB and perceived organizational support POS have been explored extensively in the literature. highlights the need for more Information Systems IS research in this area. In this study the authors explore how technological advancements have improved the online tax filing process in the United States. In particular, we administered a survey to 102 Volunteer Income Tax Assistance program VITA Site Coordinators to explore the role of OCB and POS on user perceptions of e-filing system success. The results and implications for research and practice are discussed.
Teaching Medical Students Left Internal Thoracic Artery Ultrasound

Previous studies have described techniques for performing ultrasound of the left internal thoracic artery. The purpose of this study is to assess the ability of medical students with little prior ultrasound experience to quickly find and identify the left internal thoracic artery after a brief instructional session. Fifty-one first-year medical students were taught to perform ultrasound of the left internal thoracic artery. The instruction consisted of a 5-min didactic followed by a 2-min real-time ultrasound demonstration. Each participant was then given a maximum of 2 min to find the artery while scanning a standardized patient. A radiologist made the determination of whether or not the student pointed out the correct structure within that time period. If the student was successful, then the time to locate the artery was recorded. The students also completed a questionnaire about the ultrasound experience. Forty (78 %) of the 51 students correctly identified the artery in less than 2 min. For those students, the mean time to locate the artery was 69.5 s. Four students pointed out the incorrect structure. Seven students ran out of time before pointing out a structure. Nearly all of the students indicated that they enjoyed the experience and that it increased their interest in ultrasound. This study showed that novice ultrasound users can quickly learn to locate the left internal thoracic artery with ultrasound.
Foundations and Emerging Paradigms for Computing in Living Cells

Genetic circuits, composed of complex networks of interacting molecular machines, enable living systems to sense their dynamic environments, perform computation on the inputs, and formulate appropriate outputs. By rewiring and expanding these circuits with novel parts and modules, synthetic biologists have adapted living systems into vibrant substrates for engineering. Diverse paradigms have emerged for designing, modeling, constructing, and characterizing such artificial genetic systems. In this paper, we first provide an overview of recent advances in the development of genetic parts and highlight key engineering approaches. We then review the assembly of these parts into synthetic circuits from the perspectives of digital and analog logic, systems biology, and metabolic engineering, three areas of particular theoretical and practical interest. Finally, we discuss notable challenges that the field of synthetic biology still faces in achieving reliable and predictable forward-engineering of artificial biological circuits.
The Intention of the Framers: A Note on Constitutional Interpretation *

In discussions of the United States Constitution, the phrase "the intention of the framers" is often used, but it is hardly ever adequately analyzed. The search for the intentions of the framers is made obviously in the hope of finding out what they meant by the words they put into the written Constitution. This leads to the examination of various evidences outside the Constitution, and implies a feeling that there is a lack of clarity in the words of that document. The discussion that follows was written in order, first, to raise some of the questions that I think have to be answered before the phrase about intentions can have fullness of meaning as a tool of constitutional analysis; second, to express certain warnings against a too-confident assumption that "the intention of the framers" can actually be known; and, third, to consider briefly the possible significance today of the intention of the framers in case it could be discovered. An alternative phrase, "the intention of the Constitution," is also encountered at times, as are several variations of it. "The Constitution," as used in such contexts, clearly refers to the written document. Such expressions concerning the intention of a document are obviously elliptical and to a considerable extent inaccurate and misleading. It is as if the written document is personified and endowed with intentions and a will instead of being a mere verbal memorandum. It is individual human beings who have intentions and wills, who make choices, and who seek to accomplish things. As I have indicated, my purpose is to analyze the phrase "the intention of the framers" as a tool or aid in constitutional analysis of an objective or scientific sort. It happens, however, that the phrase has also been put to use in propaganda. As one might expect, it is the extremists of the right and of the left, such as, for example, the ultra-nationalists at one end of the scale and the convinced and unyielding states'-righters at the other end, who make the most frequent use of the phrase. The fact that opposite schools of extremists can both find some support in the records for their views of what the framers intended should give pause to more careful scholars. Unfortunately, it is not always possible to distinguish
Discrimination Buffers and the Mediating Effect of Resilience on Minority Group Members

The domain of Positive Organizational Scholarship (POS) is focused on positive attributes, such as resilience and thriving, as well as the antecedents and consequences that affect both the organiza...
Exciton-plasmon quantum metastates: self-induced oscillations of plasmon fields in the absence of decoherence in nanoparticle molecules

We investigate formation of unique quantum states (metastates) in quantum dot-metallic nanoparticle systems via self-induced coherent dynamics generated by interaction of these systems with a visible and an infrared laser fields. In such metastates, the quantum decoherence rates of the quantum dots can become zero and even negative while they start to rapidly change with time. Under these conditions, the energy dissipation rates and plasmon fields of the nanoparticle systems undergo undamped oscillations with gigahertz frequency, while the amplitudes of both visible and the infrared laser fields are considered to be time-independent. These dynamics also lead to variation of the plasmon absorption of the metallic nanoparticles between high and nearly zero values, forming electromagnetically induced transparency oscillations. We show that under these conditions, the effective transition energies and broadening of the quantum dots undergo oscillatory dynamics, highlighting the unique aspects of the metastates. These results extend the horizon for investigation of light-matter interaction in the presence of zero or negative polarization dephasing rates with strong time dependency.
Case-controlled Study on Two Versus Three Doses of HBV Vaccine

Objective To explore the response rate of HBsAb in different dose groups of recombinant hepatitis B vaccine after two or three injections immunization programs,and to provide the evidence for making the strategy of hepatitis B vaccine for teenagers. Methods Totally 246 students aged between 11 and 15 years in Xiangyin County were randomly divided into 4 groups,then 10 ug and 20 ug CHO cell hepatitis B vaccines were used according to 0,3 or 0,1,6 immunization programs.The positive shifting rate of HBsAb in serum and GMT were tested in the 7th month after the first immunization,and the complication was observed simultaneously. Results The positive shifting rate of HBsAb in 10 ug,0,3 immunization group(group I),10 ug,0,1,6 immunization group(group II),20 ug,0,1,6 immunization group(group III),and 20 ug,0,3 immunization group(group IV) were 71.9%,94.8%,94.1% and 96.8%,respectively.The positive shifting rates of HBsAb of groups II,III,IV were significantly higher than that of group I(P0.05).GMTs in groups I,II were significantly lower than those of groups III,IV(P0.05),but no statistically significant difference was found between group III and group IV(P0.05). Conclusions For teenagers aged between 11 and 15 years,20 ug,large dose hepatitis B vaccine shows a higher positive shifting rate of HBsAb and GMT after immunization,and moreover,the two-dose program has similar effect as the 3-dose one.The results suggest that the 2-large-dose program can replace the 3-low-dose one,it is worth popularizing.
Bone mineral density of the hip and knee in children with spinal cord injury.

AbstractBackground/Objective: To report on the bone mineral density (BMD) of the hip, distal femur, and proximal tibia in children with spinal cord injury (SCI) of at least 1-year duration and before skeletal maturity.Methods: BMD values were measured in 28 children (age, 9.6 ± 2.5 years; range, 5-13 years) using dualenergy x-ray absorptiometry (DEXA) and were analyzed based on sex, injury, and time since injury. The hip values were compared with reported age- and sex-matched values in children without disability. No comparison was made at the knee because normative data were not available.Results: Average BMD values were 0.48 ± 0.17 g/cm2 for the total hip, 0.48 ± 0.17 g/cm2 at the femoral neck, 0.41 ± 0.17 g/cm2 at the greater trochanter, 0.47 ± 0.17 g/cm2 at Ward's triangle, 0. 38 ± 0.10 g/cm2 at the distal femur, and 0.37 ± 0.07 g/cm2 at the proximal tibia. Trends were observed with respect to sex, level of injury, and time since injury. Z-scores for the femoral neck, greater trochanter, and Ward's tr...
Analysis of applicability of thermography to assess health of gas turbine blades

A gas turbine is one of the most heavily loaded, both mechanically and thermally, structural components of an aircraft turbine engine. Hence, the most common reasons for failure are overheating and thermal fatigue of the blade material. It is of great significance for the safety of aeronautical systems that service is monitored; this is carried out to verify the health of these items using all available diagnostic methods. The primary aim is to detect and identify, as early as possible, any probable hazards to the engine. The preliminary assessment of the gas turbine blades condition is carried out via a visual inspection e.g. using a video borescope. During any repair, the preliminary assessment is conducted with a visual method, which is followed with some other non-destructive inspection techniques, e.g. flaw detection, intended to provide full colour images. The essential assessment of the blade condition consists in metallographic examination which precludes further operational use of the item. Probable errors in this assessment usually result in considerable cost of unnecessary repairs of the entire engine. Presented in the paper is the pulse thermography technique being a new NDT method, which is capable of diagnosing changes in the blade condition and to detect early stages of damages to turbine blades. Results of inspections of the blades subjected to high temperature and corresponding changes in signals of thermal response of the blade material stimulated with a heat pulse have also been given. Effects of the testing work have been used to detect changes, against temperature, in thermophysical properties of super alloy used in gas turbine blades. The results have been successfully verified using metallographic examination. To conclude: the thermographic method provides good reliability of the assessment of changes in the microstructure of the blade.
From Genesis to Revelation

The question of how the Universe managed to evolve from the smooth, uniform conditions of its hot, dense early phase to its present state of lumpiness (galaxies, stars, people) is the major issue in physical cosmology today. The question necessarily involves the issue of the composition of the Universe, both its shining and dark components, and the issue of what minute seeds or other perturbations existed in the early phase that eventually led to the lumps.
Dual Cord Blood Unit (dCBU) Transplantation Increases Short-Term Morbidity, but Has Similar Long-Term Outcome Compared to Matched Unrelated Donor (MUD) Transplantation After Myeloablative Conditioning.

Abstract 3137 In the absence of a matched sibling donor for allogeneic hematopoietic cell transplantation (HCT), a MUD is the most often used alternative hematopoietic cell source. Unfortunately, many patients do not have a well-matched MUD. For these patients, CBU transplant is a viable alternative donor source. To optimize hematopoietic engraftment in adult recipients two CBU are often required. We offer dCBU transplantation to patients lacking matched sibling and unrelated donors. This report compares outcomes between those treated with dCBU and MUD HCT at our institution. From 8/7/2009 through 12/2011, 22 hematologic malignancy patients received dCBU transplants using the conditioning regimen and GVHD prophylaxis described by the group at the University of Minnesota (Barker et al, Blood. 105: 1343, 2005). Thus, we treated patients with fludarabine 75mg/m 2 D-8 to D-6, cyclophosphamide 120mg/kg D -7 to D -6, and total body irradiation (TBI) 1320 cGy D -4 to D -1. GVHD prophylaxis included cyclosporine and mycophenolate. We then selected 42 patients treated with MUD HCT (40 well-matched, 2 partially matched) for similar diagnoses from our database as a comparator group. Patients with MUD donors were treated with either etoposide 60mg/kg and TBI 1200cGy if they had acute lymphoblastic leukemia, or busulfan 16mg/kg orally (or the equivalent administered intravenously) D -8 to D -4 and cyclophosphamide 120mg/kg D -3 to D -2. GVHD prophylaxis for MUD patients included tacrolimus and methotrexate, except in one case where mycophenolate was substituted for methotrexate. The median age of the patients was 49 years (range 20–62 years) with no significant difference between treatment groups. Neither were there differences in diagnoses, HCT-comorbidity index, time from diagnosis to transplant, disease status, or CMV status. However, there was a significant difference with regard to race with 24% of dCBU HCT in African-American patients compared to none of the MUD HCT (P Patients with MUD HCT recovered neutrophils and platelets faster (median 16 and 24 days respectively) compared to dCBU HCT (median 27 and 52 days respectively; P Cox proportional hazards analysis was used to identify univariable and multivariable prognostic factors for overall (OS) and relapse-free survival (RFS). Only age (OS: HR1.66; 95% CI 1.08–2.56; P=0.020. RFS: HR1.61; 95% CI 1.07–2.42; P=0.023) and CMV positivity in either donor or recipient (OS: HR 2.61; 95% CI 1.02–6.65; P=0.044. RFS: HR 2.71; 95%CI 1.07–6.86; P=0.035) were significant risk factors. Cell source did not significantly impact either RFS or OS (See figure). We conclude that although dCBU HCT results in increased early morbidity, there is no significant difference in risk for GVHD, and long-term survival outcomes are similar compared to MUD HCT. dCBU HCT is a useful alternative for patients lacking sibling and MUD donors. Disclosures: No relevant conflicts of interest to declare.
Future research needs involving pathogens in groundwater

Contamination of groundwater by enteric pathogens has commonly been associated with disease outbreaks. Proper management and treatment of pathogen sources are important prerequisites for preventing groundwater contamination. However, non-point sources of pathogen contamination are frequently difficult to identify, and existing approaches for pathogen detection are costly and only provide semi-quantitative information. Microbial indicators that are readily quantified often do not correlate with the presence of pathogens. Pathogens of emerging concern and increasing detections of antibiotic resistance among bacterial pathogens in groundwater are topics of growing concern. Adequate removal of pathogens during soil passage is therefore critical for safe groundwater extraction. Processes that enhance pathogen transport (e.g., high velocity zones and preferential flow) and diminish pathogen removal (e.g., reversible retention and enhanced survival) are of special concern because they increase the risk of groundwater contamination, but are still incompletely understood. Improved theory and modeling tools are needed to analyze experimental data, test hypotheses, understand coupled processes and controlling mechanisms, predict spatial and/or temporal variability in model parameters and uncertainty in pathogen concentrations, assess risk, and develop mitigation and best management approaches to protect groundwater.
Model-Based Assessment Using Conventional Bioequivalence Limits to Ensure Safety and Efficacy of Rivaroxaban in Patients Undergoing Hip or Knee Replacement

We evaluated whether the current bioequivalence limit is adequate to ensure safety and efficacy of rivaroxaban in patients under total hip arthroplasty and total knee arthroplasty based on its model informed benefit/risk profile. Clinical data from a total of 7145 patients from 3 phase 2 and 4 phase 3 clinical trials were included in the current model-based exposure-response analysis. The relationships between rivaroxaban exposure measurements (ie, minimum or trough, maximum, average concentration, and area under the concentration-time curve [AUC] at steady state) and clinical outcomes (ie, the probabilities of major bleeding [MB] and venous thromboembolism [VTE]) were modeled using NONMEM 7.3. Model evaluation was performed using predictive checks and nonparametric bootstrap. Simulations were conducted to assess the study objectives. A shallow relationship was observed between explored exposure measurements within the tested dose range and the probability of VTE following rivaroxaban treatment. Trough concentrations were found to be a statistically significant predictor of the probability of MB. This relationship was better described using a power function. Model validation confirmed model adequacy. Based on the simulations results, the relative risk of MB of a hypothetical test product (with 20% change in AUC) will not statistically differ from the brand name drug. Twenty percent AUC variations do not change the relative risk of MB and is unlikely to compromise efficacy of therapy. A generic drug of rivaroxaban passing the typical bioequivalence assessment is expected to have similar safety and efficacy as the brand name drug.
Clinical Factors and Postoperative Impact of Bile Leak After Liver Resection

Despite technical advances, bile leak remains a significant complication after hepatectomy. The current study uses a targeted multi-institutional dataset to characterize perioperative factors that are associated with bile leakage after hepatectomy to better understand the impact of bile leak on morbidity and mortality. Adult patients in the 2014–2015 ACS NSQIP targeted hepatectomy dataset were linked to the ACS NSQIP PUF dataset. Bivariable and multivariable regression analyses were used to assess the associations between clinical factors and post-hepatectomy bile leak. Of 6859 patients, 530 (7.7%) had a postoperative bile leak. Proportion of bile leaks was significantly greater in patients after major compared to minor hepatectomy (12.6 vs. 5.1%, p < 0.001). The proportion of patients with bile leak was significantly greater in patients after major hepatectomy who had concomitant enterohepatic reconstruction (31.8 vs. 10.1%, p < 0.001). Postoperative mortality was significantly greater in patients with bile leaks (6.0 vs. 1.7%, p < 0.001). After adjusting for significant covariates, bile leak was independently associated with increased risk of postoperative morbidity (OR = 4.55; 95% CI 3.72–5.56; p < 0.001). After adjusting for significant effects of postoperative complications, liver failure, and reoperation (all p<0.001), bile leak was not independently associated with increased risk of postoperative mortality (p = 0.262). Major hepatectomy and enterohepatic biliary reconstruction are associated with significantly greater rates of bile leak after liver resection. Bile leak is independently associated with significant postoperative morbidity. Mitigation of bile leak is critical in reducing morbidity and mortality after liver resection.
Modeling power system buses using performance based earthquake engineering methods

The Pacific Northwest region is in a constant threat of an imminent earthquake event. Numerous efforts are being made to make the electrical grid in the region more resilient to seismic activities. Performance-Based Earthquake Engineering (PBEE) is one of the approaches being used by researchers to analyze the risk associated with structures such as buildings and bridges. This research intends to introduce modeling of power systems using the PBEE method. Each bus in a one-line representation of a power system is a mini-substation with a different configuration and should be modeled as such. This paper also proposes guidelines for modeling every bus of a power system. Application of these guidelines on a 3-bus system is illustrated. An augmented model for a general power system with arbitrary number of buses is also described for adding system resiliency considerations.
Perceptions of patient-provider communication and receipt of mental health treatment among older adults with depressive symptoms.

Objectives: This study aimed to: (1) determine if and how perceptions towards healthcare providers differ between older adults with and without clinically signifcant depressive symptoms (CSDS), and...
G391(P) School-based diabetes clinics: qi to engage frequent non-attenders and improve teenager’s self-management

Background Optimising attendance rates in outpatient’s clinics is important to ensure good clinical care and to avoid waste of scarce medical resources. In 2016, we identified a cohort of 17 teenagers that frequently Do Not Attend (DNA) the Paediatric Diabetes Multidisciplinary Clinics, compromising patient care and reducing compliance with NICE and BPT standards. As this cohort was found to be enrolled in a cluster of 5 schools we explored the benefit of taking diabetes clinics into school. Objectives Design and deliver additional school-based clinics to facilitate teenager’s engagement with healthcare services. Patients and methods During 6 months quarterly school-based clinics were offered to all teenagers with T1DM in these secondary schools. A semi-structured interview was administered to identify their concerns about diabetes. Patients were invited to provide feedback about hospital clinics. 34 teenagers were targeted (17 initially identified as frequent non-attenders and 17 controls at same schools). Results The hospital DNA rate was reduced by 50%. HbA1c levels remained unchanged over the study period but school clinics allowed early identification of patients with rapid deterioration.School-based clinics improved teenagers’ ability to express their real beliefs about diabetes and be actively involved in the management of their condition. This unveiled significant knowledge gaps not previously identified by the team in 50% of the participants. This clinic format improved communication and partnership with school nurses/health assistants, enabling healthcare plans to be more effectively carried out.Although patients were usually happy with hospital-based clinics, they complained about missing school, time spent in hospital and lack of privacy. Some teenagers perceived judgemental attitudes in healthcare professionals or parents. Conclusions This pilot shows promise in improving contact in this difficult to reach group while reducing wasted hospital clinic slots. School clinics are an effective way to engage young people in self–management, actively preparing them for transition. A well powered trial may allow HbA1c improvement to be shown.
Acute transient large-angle exotropia caused by traumatic orbital contusion.

ABSTRACTWe report an unusual case of acute large-angle left exotropia associated with blunt orbital trauma in a healthy 8-year-old boy. Examination revealed a large-angle left exotropia with limita...
Seismic Response Reduction Using Magnetorheological Dampers

Abstract Control of civil engineering structures for earthquake hazard mitigation represents a relatively new area of research that is growing rapidly. Control systems for these structures have unique requirements and constraints. For example, during a severe seismic event, the external power to a structure may be severed, rendering control schemes relying on large external power supplies ineffective. Magnetorheological (MR) dampers are a new class of devices that mesh well with the requirements and constraints of seismic applications, including having very low power requirements. This paper proposes a clipped-optimal control strategy for controlling MR dampers to reduce structural responses due to seismic loads. A numerical example, employing a newly developed model that accurately portrays the salient characteristics of the MR dampers, is presented to illustrate the effectiveness of the approach.
The Modern Lipoabdominoplasty

The goals of abdominal contouring surgery are to maximize the aesthetic outcome, reduce recovery, and minimize morbidity. The authors discuss the history, clinical anatomy, patient evaluation, surgical technique, postoperative care, and complications. The rate of seromas with standard abdominoplasty techniques is over 20 %, while with the lipoabdominoplasty technique, it is 2–4 %. In addition, rates of hematoma formation, wound separation, and wound infection are similarly decreased. Since the umbilicus is not reinserted the umbilical necrosis is almost nonexistent.
Requirements for Medicare Coverage and Reimbursement for Medical Devices

More device manufacturers are recognizing the importance of considering Medicare coverage and reimbursement principles during the development of their new technologies. By adopting long- and short-term strategies that incorporate these principles, manufacturers can avoid certain foreseeable delays in bringing devices to market. Although the roadmap for demonstrating to the Food and Drug Administration (FDA) the safety and efficacy of a device has been fairly well established, the steps for obtaining third-party payors’ approvals have been less apparent. This chapter highlights Medicare coverage and reimbursement principles and considerations that might be incorporated into a company’s business plan during and after the product development stage.
100 Things You Always Wanted to Know about Semantics & Pragmatics But Were Afraid to Ask

Meaning is a fundamental concept in Natural Language Processing (NLP), given its aim to build systems that mean what they say to you, and understand what you say to them. In order for NLP to scale beyond partial, task-specific solutions, it must be informed by what is known about how humans use language to express and understand communicative intents. The purpose of this tutorial is to present a selection of useful information about semantics and pragmatics, as understood in linguistics, in a way that’s accessible to and useful for NLP practitioners with minimal (or even no) prior training in linguistics. The tutorial content is based on a manuscript in progress I am co-authoring with Prof. Alex Lascarides of the University of Edinburgh.
Five Year Outcomes of Tapering Antipsychotic Drug Doses in a Community Mental Health Center

There is evidence that many individuals are on higher doses of antipsychotic drug than is required for optimal functioning yet there are limited guidelines on how to reduce them. This paper reports on 5 year outcomes for sixty-seven individuals who received treatment at a community mental health center and were offered the opportunity to gradually reduce their doses of antipsychotic drug in collaboration with the treating psychiatrist. Over a period of 6 months, the author invited patients who were clinically stable and able to participate in discussions of potential risks and benefits to begin gradual dose reductions. Initially, 40 expressed interest in tapering and 27 declined. The groups did not differ in age, sex, race, or diagnosis. The group who chose to taper began on significantly lower doses. Most patients succeeded at making modest dose reductions. At 5 years, there were no significant differences in the two outcomes measures, rate of hospitalization and employment status. Many patients were able to engage in these discussions which did not result in widespread discontinuation of drug. This is a naturalistic, small study of a topic that warrants further research.
COMPARISON OF NON-CONTACT AND CONTACT TIME-LOSS LOWER QUADRANT INJURY RATES IN MALE COLLEGIATE BASKETBALL PLAYERS: A PRELIMINARY REPORT.

Background Male collegiate basketball (BB) players are at risk for musculoskeletal injury. The rate of time-loss injury in men's collegiate BB, for all levels of National Collegiate Athletic Association (NCAA) competition, ranges from 2.8 to 4.3 per 1000 athletic exposures (AE) during practices and 4.56 to 9.9 per 1000 AE during games. The aforementioned injury rates provide valuable information for sports medicine professionals and coaching staffs. However, many of the aforementioned studies do not provide injury rates based on injury mechanism, region of the body, or player demographics. Hypothesis/ purpose The purpose of this study is two-fold. The first purpose of this study was to report lower quadrant (LQ = lower extremities and low back region) injury rates, per contact and non-contact mechanism of injury, for a cohort of male collegiate basketball (BB) players. The second purpose was to report injury risk based on prior history of injury, player position, and starter status. Study design Prospective, descriptive, observational cohort. Methods A total of 95 male collegiate BB players (mean age 20.02 ± 1.68 years) from 7 teams (NCAA Division II = 14, NCAA Division III = 43, NAIA = 21, community college = 17) from the Portland, Oregon region were recruited during the 2016-2017 season to participate in this study. Each athlete was asked to complete an injury history questionnaire. The primary investigator collected the following information each week from each team's athletic trainer: athletic exposures (AE; 1 AE = game or practice) and injury updates. Results Thirty-three time-loss LQ injuries occurred during the study period. The overall time-loss injury rate was 3.4 per 1000 AE. Division III BB players had the highest rates of injury. There was no difference in injury rates between those with or without prior injury history. Guards had a significantly greater rate of non-contact time-loss injuries (p = 0.04). Conclusions Guards experienced a greater rate of LQ injury than their forward/center counterparts. Starters and athletes with a prior history of injury were no more likely to experience a non-contact time-loss injury than nonstarters or those without a prior history of injury. These preliminary results are a novel presentation of injury rates and risk for this population and warrant continued investigation. Level of evidence 2.
Delayed Presentation of a Vertex Epidural Hematoma Following High-Voltage Electrical Injury to the Head

We present the case of a man who suffered a high-voltage electrical injury followed by a delayed presentation of an epidural hematoma. CT of the brain demonstrated hyper dense material along the anterior and frontal region consistent with an epidural hematoma at the vertex. The patient underwent serial computed tomography scans of his brain which demonstrated stability of the hematoma and no operative intervention was required. This appears to be the first case report of such an injury.
Prescription Drug Spending and Medication Adherence Among Medicare Beneficiaries with Heart Failure.

BACKGROUND: Evidence suggests that cost sharing adversely affects appropriate prescription drug use for chronic disorders. However, few studies have evaluated this effect in heart failure (HF), the...
Physician attachment to stapedectomy: A comparison of survey responses

Objective: To demonstrate that surgeons who perform stapedectomies derive intrinsic enjoyment from the procedure. Subjects: An experimental group of 174 otologists/neurotologists who possibly perform stapedectomy, one control group of 145 head/neck oncologists who possibly perform parotidectomy, and a second control group of 365 pediatric otolaryngologists who possibly perform tonsillectomy. Intervention: Observational study using four-question anonymous surveys distributed by electronic mail. Outcome Measures: Responses to surveys by participants during a four-week period. Results: During the four-week survey periods, 84/174 neurotologists (48%) responded, while 33/145 oncologists (23%), and 87/365 pediatric otolaryngologists (24%) responded. Seventy-six of the 80 neurotologists who still performed stapedectomies (95%) enjoyed performing it, slightly more than the 30 of the 33 oncologists who still performed parotidectomies (91%), and appreciably more than the 67/87 pediatric otolaryngologists who still performed tonsillectomies (77%). Twenty-three neurotologists (30%) would sacrifice vacation time to perform additional stapedectomies, slightly more than 8 oncologists (27%) for additional parotidectomies, and more than the 7 pediatric otolaryngologists (10%) for additional tonsillectomies. Ten (13%) of the neurotologists, three (9%) of the oncologists, and one (2%) of the pediatric otolaryngologists would sacrifice five or more vacation days to perform more of the procedures. Conclusions: Our survey suggests that stapedectomy is intrinsically enjoyable.
Preparation and properties of rapidly quenched glasses in the V2O5-PbO system

Rapidly quenched glassy films in the V2O5-PbO system were prepared using a twin-roller type apparatus. The glass formation region was 0–60 mol% PbO. The first crystallization temperature increased from 210 ‡C for the V2O5 glass to 292 ‡C for the glass of 60 mol% PbO. The metastable unknown phase was first crystallized in the glasses around 50 mol% PbO. Infrared absorption spectra of the glasses were measured. Electrical conductivity of the glasses decreased with increasing of PbO content. The electrical behaviour of the glasses is discussed based on the glass structure estimated from the infrared spectral data.
Exploring the Cancer Genome Atlas (TCGA) for the molecular profile of young onset colorectal cancers.

3548Background: Colorectal cancer (CRC) incidence and mortality has been declining, in part due to increased implementation of screening, but the incidence among patients under 50 (young onset, YO)...
A CRISPR Screen Identifies Myc-associated Zinc Finger Protein (MAZ) as an Insulator Functioning at CTCF boundaries in Hox Clusters

Abstract The essential CCCTC-binding factor (CTCF) is critical to three-dimensional (3D) genome organization. CTCF binding insulates active and repressed genes within the Hox clusters upon differentiation, but such binding does not participate in boundary formation in all cell types, such as embryonic stem cells. We conducted a genome-wide CRISPR knockout screen to identify genes required for CTCF boundary activity at the HoxA cluster, complemented by novel biochemical approaches. This screen identified Myc-associated zinc finger protein (MAZ) as a CTCF insulator co-factor, among other candidates listed herein. MAZ depletion or specific deletion of MAZ motifs within the Hox clusters led to de-repression of posterior Hox genes immediately after CTCF boundaries upon differentiation, which phenocopied deletion of the proximal CTCF motifs. Similar to CTCF, MAZ interacted with the cohesin subunit, RAD21. Upon loss of MAZ, local contacts within topologically associated domains (TADs) were disrupted, as evidenced by HiC analysis. Thus, MAZ is a novel factor sharing insulation properties with CTCF and contributing to the genomic architectural organization. One Sentence Summary MAZ is identified as an insulator functioning at CTCF boundaries delimiting active and repressed genes at Hox clusters
Environmental Cadmium and Mortality from Influenza and Pneumonia in U.S. Adults.

BACKGROUND: Environmental cadmium exposure is widespread. In humans, cadmium is poorly excreted, triggers pulmonary inflammation, reduces pulmonary function, and enhances lung injury by respiratory syncytial virus. OBJECTIVES: We examined the association of cadmium burden with mortality related to influenza or pneumonia. METHODS: This prospective analysis of the National Health and Nutrition Examination Survey (NHANES) included 7,173 and 8,678 participants ≥45 years of age enrolled in NHANES-III and NHANES 1999-2006, respectively. Associations were evaluated between cadmium and mortality from influenza or pneumonia during a median follow-up of 17.3 y (NHANES-III, based on creatinine-corrected urine cadmium) and 11.4 y (NHANES 1999-2006, based on blood cadmium). Survey-weighted Cox proportional hazard models were used to compute hazard ratios (HRs) comparing the mortality of individuals at the 80th vs. the 20th percentile of cadmium concentrations. RESULTS: In NHANES-III, after adjustment for sex, race/ethnicity, education, body mass index, serum cholesterol, hypertension, and NHANES phase (or cycle), the HR comparing influenza or pneumonia mortality among participants with creatinine-corrected urinary cadmium in the 80th vs. 20th percentile was 1.15 (95% CI: 1.05, 1.26; p=0.002) in the population as a whole and 1.27 (95% CI: 1.12, 1.43; p=0.002) among never smokers. In NHANES 1999-2006, adjusted HRs for the 80th vs. 20th percentile of blood cadmium were 1.14 (95% CI: 0.96, 1.36; p=0.15) for the overall population and 1.71 (95% CI: 0.95, 3.09; p=0.07) in never smokers. DISCUSSION: Among middle-aged and older adults in the United States, higher cadmium burdens are associated with higher mortality from influenza or pneumonia. This raises the possibility that cadmium may worsen outcomes from COVID-19 infections. https://doi.org/10.1289/EHP7598.
Managing the Paradoxes of Mobile Technology

This paper reports on a large-scale, international focus group study that examined the user experience of mobile technology users in Hong Kong, Japan, Finland, and the U.S. We identify eight central mobile technology paradoxes that shape user experience and behavior. We suggest possible design features that relate to the experienced paradoxes and discuss how they could be better managed.
Melanoma reactive TCR-modified T cells generated without activation retain a less differentiated phenotype and mediate a superior in vivo response.

Adoptive T cell therapy with T cell receptor (TCR)-modified T cells has shown promise in treating metastatic melanoma and other malignancies. However, studies are needed to improve the efficacy and durability of responses of TCR-modified T cells. Standard protocols for generating TCR-modified T cells involve activating T cells through CD3 stimulation to allow for the efficient transfer of tumor-reactive receptors with viral vectors. T cell activation results in terminal differentiation and shortening of telomeres, which are likely suboptimal for therapy. In these studies, we demonstrate efficient T cell transduction with the melanoma-reactive TIL1383I TCR through culturing with interleukin 7 (IL-7) in the absence of CD3 activation. The TIL1383I TCR-modified T cells generated following IL-7 culture were enriched with naive (TN) and memory stem cell populations (TSCM) while maintaining longer telomere lengths. Furthermore, we demonstrated melanoma-reactivity of TIL1383I TCR-modified cells generated following IL-7 culture using in vitro assays and a superior response in an in vivo melanoma model. These results suggest that utilizing IL-7 to generate TCR-modified T cells in the absence of activation is a feasible strategy to improve adoptive T cell therapies for melanoma and other malignancies.
Book Review: Casting Off the Canon: Family Law Reimagined

Jill Hasday's book, Family Law Reimagined, offers a clear-eyed vision of what family law is, what it is not, and where it might be headed. Hasday considers family law's canon-the set of principles by which we have come to characterize family law-and then debunks the canon by methodically setting forth each notion and illustrating its inaccuracies or limitations. In doing so, Hasday urges the reader to clear the noise of the canon and to see the law in all its messy inconsistencies and shortcomings.
Experiences of Patients After Withdrawal From Cancer Clinical Trials.

Importance Cancer clinical trials (CCTs) provide patients an opportunity to receive experimental drugs, tests, and/or procedures that can lead to remission. For some, a CCT may seem like their only option. Little is known about experiences of patient-participants who withdraw or are withdrawn from CCTs. Objective To examine patient-participants' experiences during withdrawal from CCTs. Design, setting, and participants This qualitative, descriptive study used a semistructured interview designed specifically for it, with open-ended and probing questions. The study took place at a National Cancer Institute-designated comprehensive cancer center affiliated with the University of Pennsylvania. The need for a sample of 20 interviewees was determined by code and meaning saturation (ie, no new themes revealed and identified themes fully elaborated). Interviews were transcribed verbatim and analyzed with a qualitative software program. Data coded with the software were refined into categories reflecting broad themes. A criterion-based sampling approach was used to select a subset of adult patients with cancer who were former CCT participants and who agreed on exit from those CCTs to a later interview about withdrawal experiences. They were contacted one by one by telephone from September 2015 through June 2019 until 20 agreed. Data analysis was completed in October 2020. Main outcomes and measures Themes characterizing patient-participants' perceptions of their withdrawal experiences. Results Respondents' mean (SD) age was 64.42 (8.49) years; 12 (63.2%) were men. Most respondents were White (18 respondents [94.7%]) and college educated (11 respondents [55.0%]). Cancer stage data were available for 17 participants, 11 of whom (64.7%) had stage IV cancer at CCT enrollment. Thirteen respondents reported withdrawal as a result of disease progression, and 5 withdrew because of adverse effects. Other reasons for withdrawal included acute illness and participant uncertainty about the reason. Analysis of interview data yielded 5 themes: posttrial prognostic awareness, goals of care discussions, emotional coping, burden of adverse effects, and professional trust and support. Subthemes included regrets or hindsight, urgency to start next treatment, and weighing benefits and burdens of treatment. Limited discussions about patient-participants' immediate posttrial care needs left many feeling that there was no clear path forward. Conclusions and relevance Patient-participants transitioning from a CCT described feeling intense symptoms and emotions and awareness that their life span was short and options seemed to be limited. Communication that includes attention to posttrial needs is needed throughout the CCT to help patient-participants navigate posttrial steps. Research should focus on components of responsible and ethical CCT transitions, including types and timing of discussions and who should begin these discussions with patient-participants and their families.
Face recognition from depth and curvature

This thesis explores the representation of the human face by features based on the curvature of the face surface. Depth and curvature features have several advantages over more traditional intensity based features. Specifically curvature descriptors (1) have the potential for higher accuracy in describing surface based events, (2) are better suited to describe properties of the face in the area of the cheeks, forehead, and chin, and (3) are viewpoint invariant. Although several researchers have worked on the problem of interpreting range data from curved (although usually highly geometrically structured) surfaces, the main approaches have centered on segmentation of the data into simple surface types based on the sign of mean and Gaussian curvature. These types of methods are not sufficient to classify more natural smoothly curving objects, whose surfaces are not well modeled by piecewise planar, cylindrical, or spherical regions. This thesis details the calculation of principal curvature, the calculation of general surface descriptors based on curvature, and the calculation of face specific descriptors based both on curvature features and a priori knowledge about the structure of the face. These face specific descriptors can be incorporated into many different recognition strategies. We implement two such strategies, one based on depth template comparison and the other based on comparisons in feature space. Both systems show very promising experimental results.