cssi/SciSciGPT-SciSciNet huggingface dataset:
The Development of an Instrument to Assess Preservice Teacher's Technological Pedagogical Content Knowledge:

The purpose of this study was to develop and validate the Pre-service Teacher-Technological Pedagogical Content Knowledge Survey (PT-TPACK) instrument. The PT-TPACK survey items were written to assess preservice teachers' perceptions and understanding of the Technological Pedagogical Content Knowledge construct originally proposed by Mishra and Koehler (2006). The participants for this study were preservice teachers (n = 120) enrolled in a foundations of educational technology course at a mid-sized western university. Data analysis yielded six interpretable factors: pedagogical knowledge (PK), technological knowledge (TK), content knowledge (CK), pedagogical content knowledge (PCK), technological pedagogical knowledge (TPK), and technological pedagogical content knowledge (TPACK). Technological content knowledge (TCK) was the only dimension in the TPACK construct specified a priori that did not emerge. Results from this study suggest that the PT-TPACK survey holds promise as a useful evaluation tool for a...
A roentgen study of the gastrointestinal tract in proven cases of sarcoidosis with a review of the literature.

Summary 1.Twenty-one cases of proven sarcoidosis were studied by means of a barium meal and by small intestinal enema. In no instance was an abnormality encountered suggestive of gastrointestinal sarcoidosis. 2.Review of the literature revealed that in over 100 autopsied cases of sarcoidosis, only eight were found to have involvement of the gastrointestinal tract. Of the eight cases, four had proven tuberculosis and two had syphilis. Localized sarcoid lesions of the stomach have been reported by others in 9 patients subjected to sub-total gastric resection. In only two cases was there evidence suggestive of disseminated sarcoidosis. In seven cases of regional enteritis found in the literature histologic pathology resembling the sarcoid lesion was observed. In only two of these cases was disseminated sarcoidosis present.
Is there an evolutionary trade-off between quality signaling and social recognition?

To successfully navigate their social environments animals need to assess conspecifics. Quality signals and social recognition are 2 assessment strategies that animals employ to evaluate potential rivals or mates. Despite substantial research on both assessment strategies, relatively little work has addressed how quality signals and social recognition interact. Here, we propose that quality signals and social recognition have an antagonistic evolutionary relationship, building on earlier assertions by Sievert Rohwer (American Zoologist, 1982). Both quality signals and social recognition provide animals access to information about conspecifics, allowing them to avoid costly confrontations or choose appropriate partners. We assert that, although the information gleaned from quality signals or social recognition overlaps, the processes by which information is acquired are distinct. Therefore, selection that favors quality signaling will lead to elaboration of signaling traits while disfavoring the elaboration of traits used in social recognition such as identity signals, learning, and memory. We first outline testable predictions for the hypothesis that quality signals and social recognition are antagonistic on evolutionary timescales, and we then explore its broader ramifications for understanding the distribution of signals and social recognition across taxa. Notably, the framework we propose emphasizes rarely considered factors such as body size that may tip the balance between the costs and benefits of each assessment strategy. Finally, we highlight the potential for important feedback between social assessment strategy and a species’ socioecology.
Nonlinear magnetoconvection in the presence of strong oblique fields

Two-dimensional thermal convection in the presence of a strong oblique magnetic field is studied using an asymptotic expansion in inverse powers of the Chandrasekhar number. The linear stability problem reveals the existence of two distinct scales in the vertical structure of the critical eigenfunctions: a small length-scale whose vertical wavenumber k z is comparable with the large horizontal wavenumber k⊥ selected at onset, and a large-scale modulation which forms an envelope on the order of the layer depth d. The small-scale structure in the vertical results from magnetic alignment that forces fluid motions to be (nearly) parallel to the field lines. For convective transport in the vertical this constraint must be relaxed. This is achieved by molecular dissipation which allows weak upward (downward) motions of hot (cold) fluid elements across the field lines and results in a large-scale vertical modulation of the magnetic columns. Using the scaling suggested by the linear theory, strongly nonlinear steady and overstable solutions are constructed. These are characterized by large departures of the mean temperature profile from the conduction profile. For overstable rolls two modes of convection are uncovered. The first vertical field' mode is characterized by thin thermal boundary layers and a Nusselt number that increases rapidly with the applied Rayleigh number; this mode is typical of steady convection as well. The second or horizontal field' mode is present in overstable convection only and has broad thermal boundary layers and a Nusselt number that remains small and approximately independent of the Rayleigh number. At large Rayleigh numbers this regime is characterized by a piecewise linear temperature profile with a small isothermal core. The horizontal field' mode is favoured for substantial inclinations of the field and sufficiently small ohmic diffusivity. The transition between the two regimes is typically hysteretic and for fixed inclination and diffusivity may occur with increasing Rayleigh number. Similar but highly asymmetric states are obtained for depth-dependent ζ, where ζ is the ratio of ohmic to thermal diffusivity. These results are obtained from a nonlinear eigenvalue problem for the Nusselt number and mean temperature profile, and suggest a possible explanation for the sharp boundary between the umbra and penumbra in sunspots.
Nursing the Adopted Infant

Background: Breast feeding is commonly accepted as the preferred method of infant nutrition for various reasons, both nutritional and emotional. For some who have become parents by adoption, there is a strong desire to induce lactation for adoptive nursing. Methods: Information regarding adoptive nursing was initially obtained for the author’s personal experience from searching the internet and speaking with other adoptive mothers. The medical literature was also searched through OVID/MEDLINE using pertinent terms, including induced lactation, adoptive nursing, domperidone, and metoclopramide. Results: Use of physiologic and pharmacologic methods can help an adoptive mother bring in a milk supply. The quantity may not be sufficient to entirely meet an infant’s nutritional needs. However, for many the emotional benefits remain. There is some controversy surrounding the use of domperidone and metoclopramide for induced lactation. Herbals such as fenugreek have not been researched. Physicians can help their patients understand the current tools available to assist them with this unique endeavor.
Orthologous relationship of obscurin and Unc-89: phylogeny of a novel family of tandem myosin light chain kinases

Myosin light chain kinases (MLCK) are a family of signaling proteins that are required for cytoskeletal remodeling in myocytes. Recently, two novel MLCK proteins, SPEG and obscurin-MLCK, were identified with the unique feature of two tandemly-arranged MLCK domains. In this study, the evolutionary origins of this MLCK subfamily were traced to a probable orthologue of obscurin-MLCK in Drosophila melanogaster, Drosophila Unc-89, and the MLCK kinase domains of zebrafish SPEG, zebrafish obscurin-MLCK, and human SPEG were characterized. Phylogenetic analysis of the MLCK domains indicates that the carboxy terminal kinase domains of obscurin-MLCK, SPEG and Unc-89 are more closely related to each other than to the amino terminal kinase domains or to other MLCKs, supporting the assertion that obscurin-MLCK is the vertebrate orthologue of Caenorhabditis elegans Unc-89, a giant multidomain protein that is required for normal myofibril assembly. The apparent lack of an invertebrate orthologue of SPEG and the conserved exon structure of the kinase domains between SPEG and obscurin-MLCK suggests that SPEG arose from obscurin-MLCK by a gene duplication event. The length of the primary amino acid sequence between the immunoglobulin (Ig) domains associated with the MLCK motifs is conserved in obscurin-MLCK, SPEG and C. elegans Unc-89, suggesting that these putative protein interaction domains may target the kinases to highly conserved intracellular sites. The conserved arrangement of the tandem MLCK domains and their relatively restricted expression in striated muscle indicates that further characterization of this novel MLCK subfamily may yield important insights into cardiac and skeletal muscle physiology.
Trinitrophenyl reactive T-cell clones in functional and molecular analysis of the HLA-D region.

A central role for major histocompatibility complex (MHC) molecules in presentation of non-MHC antigens to T lymphocytes is generally acknowledged. Among the seminal studies demonstrating this phenomenon were those of Shearer and associates demonstrating that recognition of mouse target cells by trinitrophenyl (TNP)-specific cytolytic T cells required genetic homologies between the killer and target cells at H-2 class I loci (rev., Shearer et al., 1976). This system, employing target cells surface modified by hapten conjugation, has proven particularly useful in subsequent studies of MHC restrictions on antigen recognition by human T lymphocytes. As in the mouse, recognition of TNP-modified target cells by hapten-specific cytotoxic T lymphocytes has appeared to involve restrictions for class I HLA homology (Shaw and Shearer, 1978). The data in human systems have been substantially less compelling, however, with evidence in some instances for effective interactions between target and killer cells that did not involve obvious class I HLA homologies (Shaw and Shearer, 1978; Seldin et al., 1979). In contrast to target cell recognition by cytolytic T-cells, recognition of antigen by helper T-cells has generally required genetic homology between antigen-presenting cells and helper T cells (or B cells and helper T cells) for class II loci of the MHC (rev., Thomas et al., 1977). Subsequently, clear exceptions have been documented with respect to correlations between functional activity and MHC restrictions for antigen recognition (rev., Rich et al., 1986). On the other hand, identification of a dichotomy of T lymphocytes, one subset of which expresses the CD4 molecule (L3T4 in mice) and the other of which expresses the CD8 molecule (Ly2 in mice), has led to a more convincing correlation between T-cell subset and MHC recognition requirements in antigen presentation. That is, recognition of non-MHC antigens by CD4+ (L3T4+) cells requires class II MHC homologies between T-cells and antigen presenting cells, whereas recognition by CD8+ (Ly2+) T-cells is MHC class I restricted (rev., Swain, 1983).
A randomized pilot trial of an integrated school-worksite weight control program.

OBJECTIVE Worksite provision of paid time off for parent participation in a school-based healthy weight program may improve treatment adherence and outcomes. The current pilot study examined whether parents who received worksite support for attendance at a school-based healthy weight program would attend more sessions, lose more weight, and make healthier changes in home food environments than parents who did not receive worksite support. METHOD Thirty-eight urban, low-income African American and Mexican American mothers of kindergartners were randomized to an integrated school-parent-worksite program that targeted healthy home food environments and energy balance self-monitoring or the identical school-based program without worksite support. Ten sessions were delivered to parent participants during afterschool hours. Process measures included session attendance and energy balance log completion. Outcome measures included parent body mass index (BMI) change, child BMI z-score change, and home food inventory (HFI) score changes over 12 months. RESULTS RESULTS showed better weight change for parents (i.e., BMI unit reduction of 1.4 vs. 0.3 in comparison group, p = .001), increased parental attendance, and improvements in the home food environment when parents received paid time off from their worksite for their participation in the healthy weight program. Child weight change was also observed despite no direct contact with children. CONCLUSIONS The current pilot study provides support for the hypothesis that worksite support for school-based interventions may improve health outcomes that depend on parental involvement. Removing barriers to attendance in a healthy weight program resulted in improved treatment adherence and outcomes in low-income, minority parents and children.
A learning experience through studies in photochemistry

Initially, the article was written for the benefit of Prof. Liu’s students, but later a few close friends of his also received copies of the paper. I was one of the early ones who received such a copy. I thought the paper contains useful instructional values to the Chinese students in general and encouraged Prof. Liu to modify the paper for its publication in a Chinese journal. The current article you see here is the final product. We are grateful to the editors for their willingness to consider simultaneous usage of both English and Chinese, which is an important part of this paper. I hope the readers will enjoy reading the article just as much as I did.
Anthropometric Assessment in Kidney Disease

An adequate nutritional status is inherent to an optimal level of health. In continuing illness states, such as chronic kidney disease (CKD), there is a significant interdependence between both. Nutritional status influences the disease process and its comorbidities. Renal failure and its management may have a negative impact on nutritional status thereby creating a vicious cycle. Thus, monitoring nutritional status and body composition is imperative to the appropriate management of CKD [1].
Uroplakins as Unique Tetraspanin Networks

A major class of tetraspanins are uroplakins (UP’s) Ia and Ib that, together with their associated (non-tetraspanin) uroplakins II and IIIa, form two dimensional crystals of 16-nm particles, known as ‘urothelial plaques’. Interconnected by small hinge areas, urothelial plaques cover almost the entire apical surface of mammalian bladder urothelium, and contribute to the remarkable urothelial permeability barrier function. UPIa and Ib bind selectively to UPII and IIIa, respectively, to form a UPIa/II and UPIb/IIIa heterodimer, which constitutes one of the six dumbbell-shaped, heterotetramer subunit of a ­stellate-­shaped 16-nm uroplakin particle. Ultrastructural studies indicate that UPIa/II and UPII/IIIa dimers are associated with the inner and outer subdomains of the 16-nm particles, respectively. In vitro gel overlay assay suggests that the high mannose glycan anchored on the second, large extracellular loop of UPIa may serve as the urothelial receptor for the type 1-fimbriated E. coli that causes over 85% of urinary tract infection. Moreover, uroplakin defects may play a role in renal adysplasia and overreactive bladder. Although uroplakins are expressed mainly as major differentiation products of bladder urothelium, small amounts of uroplakins are present in some nonurothelial tissues including oocytes and may play a diverse range of important biological functions.
Elastic Behavior of Laminated Flexible Composites Under Finite Deformation

This paper examines the nonlinear elastic behavior of laminated flexible composites under finite deformation. The constitutive relations have been derived by applying a model for unidirectional flexible composite lamina, which is based on the Lagrangian description and a strain-energy density referring to the initial principal material coordinates. The fabrication technique for flexible composite laminates is discussed. Experiments have been conducted to verify the constitutive relations in the finite deformation range. Good agreements have been found between the theory and experiments.
Telemedicine for ophthalmic consultation services: use of a portable device and layering information for graders

Introduction We compared remote, image-based patient consultations to in-person consultations at emergency department and inpatient hospital settings. Methods Patients evaluated by the ophthalmic consultation services (gold standard) were imaged over a two-week period. A trained study coordinator took anterior segment photographs (AS) and posterior segment photographs (PS) with a portable camera (PictorPlus, Volk Optical, Cleveland, OH). Ophthalmologists (graders) determined photograph quality, presence of pathology, and their confidence in disease detection. At a separate session, graders reassessed photographs accompanied by a one-sentence summary of demographics and chief complaint (CHx). We computed accuracy and reliability statistics. Results We took AS photographs of 24 eyes of 15 patients and PS photographs of 39 eyes of 20 patients. The majority of images were rated as acceptable or excellent in quality (AS: 89-96%; PS: 70-75%). Graders detected AS pathology with 62-81% sensitivity based on photographs, increasing to 87-88% sensitivity with photographs plus CHx. Graders detected PS pathology with 79-86% sensitivity based on a photograph only, increasing to 100% sensitivity with photographs plus CHx. Discussion In this pilot study, there is evidence that portable ophthalmic imaging technologies could enable ophthalmologists to remotely evaluate anterior and posterior segment eye diseases with good sensitivity. The ophthalmologist could detect ocular pathology on photographs more accurately if they were provided brief clinical information.
Cardiac problems associated with dysbarism.

Patient salvage rates depend on the extent of injury, speed and appropriateness of treatment, and the patient's age and state of health in addition to other variables. Undertreatment of DII may result in significant morbidity and associated costs. If there is any doubt regarding whether a patient might benefit from treatment, a trial at pressure is indicated. Among those with AGE who reach recompression within 5 minutes, the death rate may be only 5%, and those who survive have little morbidity. Among those whose recompression delay increases to 5 hours, however, mortality approaches 10%, and more than 50% of the survivors experience residua. All dive accidents should be thoroughly investigated by professionals. Sport divers who manifest any symptoms of DII should refrain from further diving because response to therapy for future episodes is generally relatively poor. Victims of DII must have long-term follow-up. Language: en
Effects of Mycangial Fungi and Host Tree Species on Progeny Survival and Emergence of Dendroctonus ponderosae (Coleoptera: Scolytidae)

Dendroctonus jeffreyi Hopkins and its sibling species, D. ponderosae Hopkins, are bark beetles associated with symbiotic fungi disseminated in maxillary mycangia. Although both D. jeffreyi and D. ponderosae are associated with the fungus Ophiostoma clavigerum (Robinson-Jeffrey & Davidson), D. ponderosae is also associated with a 2nd fungus, Ophiostoma montium (Rumbold von Arx). Adult D. jeffreyi and D. ponderosae that carried O. clavigerum (isolated from D. jeffreyi ), O. clavigerum (isolated from D. ponderosae ), O. montium , or were fungus-free, were reared in the laboratory and introduced into bolts of Pinus contorta Douglas ex Louden and Pinus jeffreyi Greville & Balfour, hosts of D. ponderosae and D. jeffreyi , respectively, to test for effects of the fungi on progeny survival and ability to use different host tree species. Dendroctonus ponderosae associated with O. clavigerum (isolated from D. jeffreyi ) and D. ponderosae associated with O. montium produced brood in both P. contorta and P. jeffreyi . The average weight of female progeny was not significantly affected by fungal or tree species. However, the production of progeny adults was significantly higher, and emergence significantly earlier, for D. ponderosae associated with O. clavigerum (isolated from D. jeffreyi ) and developing in P. contorta than for D. ponderosae developing with O. montium in P. contorta . No brood was produced by D. jeffreyi or by fungus-free D. ponderosae . Larval galleries were shortest in the O. clavigerum / P. contorta treatment, whereas the longest larval galleries were produced in the O. montium / P. jeffreyi treatment. Both host tree species and fungus have an effect on the ability of progeny to successfully develop.
From Cattle to Capital: Exchange Value, Animal Commodification, and Barbarism

In the past half-century, massive structural, geographic, and technological changes have occurred in livestock production. This ‘livestock revolution’ has raised considerable environmental, public ...
Artificial Donor Insemination with Frozen Human Semen

This study describes the experience with artificial donor insemination (AID) using frozen semen in 227 women who began therapy in 1974 and were followed until March 31, 1976. Ninety-one women (40%) conceived during this period. Sixty-five women (37.9%) failed to continue treatment after three or fewer cycles; follow-up on these patients was incomplete and it is presumed that most did not conceive. The cumulative pregnancy rate was 56.5% among women who persisted in AID for four or more cycles. Additional causes for infertility were found in 53 women. Excluding these, the pregnancy rate was 67.4% for apparently fertile women who had had four or more cycles of AID. Fifty-eight per cent of conceptions occurred within the first three cycles and eighty-five per cent within the first six cycles. The pregnancy rate was not significantly affected by age, occupation, cigarette smoking, or prior fertility. The large number of dropouts after a few cycles of AID suggests a need for intensive and continuous educational, emotional, and psychologic support.
Determination of atrazine and hydroxyatrazine in agricultural Runoff waters by liquid chromatography and fast atom bombardment-high resolution mass spectrometry

Agricultural surface water samples were collected after the first 2 major runoff events in 1994 for determination of atrazine (ATR, 2-chloro-4-ethylamino-6-isopropylamino-s-triazine) and hydroxyatrazine (HA, 2-ethylamino-4-hydroxy-6-isopropylamino-s-triazine). After addition of 13 C 3 -labeled ATR and 13 C 3 -labeled HA as internal standards, the chemicals were quantitatively extracted and eluted from water samples by liquid-solid extraction with a carbon black cartridge. Liquid chromatography and fast atom bombardment-high resolution mass spectrometry were used to analyze the sample extracts. Concentrations of ATR ranged from 8.2 to 15.1 parts per billion (ppb) in the samples collected after both runoff events from a highly agricultural watershed in south-central Nebraska. HA concentrations ranged from 0.25 to 2.7 ppb in the water samples. Results obtained from both analytical procedures agreed within a 15% deviation. As predicted from runoff events, the highest levels occurred in samples from the first collection on June 24, 1994, for both ATR and HA, whereas samples collected on July 5, 1994, contained much lower levels of HA.
iBoost: Boosting Using an i nstance-Based Exponential Weighting Scheme

Recently, Freund, Mansour and Schapire established that using exponential weighting scheme in combining classifiers reduces the problem of overfitting. Also, Helmbold, Kwek and Pitt that showed in the prediction using a pool of experts framework an instance based weighting scheme improves performance. Motivated by these results, we propose here an instance-based exponential weighting scheme in which the weights of the base classifiers are adjusted according to the test instance x. Here, a competency classifier ci is constructed for each base classifier hi to predict whether the base classifier's guess of x's label can be trusted and adjust the weight of hi accordingly. We show that this instance-based exponential weighting scheme enhances the performance of AdaBoost.
Knowledge, Expertise, and Public Policy: The Changing Relationship Between Science and Public Policy

In February of 2011, the Quality in Gender+ Equality Policies project (QUING) held an international conference entitled “Advancing Gender Training in Theory and Practice” in Madrid. QUING features several projects designed to compare gender+ equality policies across Europe. The goal of the last phase of the QUING project OPERA was to improve gender equality policies and gender mainstreaming through the direct translation of knowledge to policymakers via training (QUING n.d.). The goals of translating knowledge directly to policymakers produced several meetings and eventually led to the conference in Madrid.
Prosecutorial Accountability in the Rechtsstaat: The Tension between Law, Politics, and the Public Interest

During the past two decades, scholars, politicians, and legal practitioners in the United States have criticized American prosecutors for adopting a “conviction mentality” that diverges from their ethical duty to pursue justice. Most notably, critics have alleged and, in some cases shown, that prosecutors have suppressed exculpatory evidence, applied the law selectively, used their sentencing leverage to force plea bargains, and have helped fuel America’s incarceration epidemic. These criticisms locate the origin of these problems in prosecutors’ lack of accountability, the inefficiency of elections, non-transparent decision-making processes, and prosecutors’ desire for political gain. In contrast to this robust criticism of American prosecutors, the German prosecution service is not under fire. This lack of criticism is due to several striking differences not only between the institutional role played prosecutors in both countries, but also between each state’s vision of governance, democratic accountability, and the law itself. Perhaps, most tellingly, it has been the German judges and the prosecutors themselves have launched the most visible calls for reform. service. Moreover, the reformers aim not to make prosecutors more accountable, but rather to increase their political independence. The divergent directions of these calls for reform in Germany and the U.S. contradicts the narrative that, despite differences between the adversarial and inquisitorial traditions, there are significant points of convergence between prosecutorial practices in both countries. To cite one example, although Germany was once hailed as the land without plea-bargaining, today “confession-bargaining” is used to settle a rising percentage of criminal cases. The existence of these superficial similarities, however, obscures deeper and more durable differences between the two systems. These differences are not fully captured by analyses that argue that adversarial systems are becoming more inquisitorial and inquisitorial systems have adopted some adversarial procedures. Although a significant body of scholarship in the field of comparative criminal procedure has focused on the functional, normative, and institutional differences between adversarial and inquisitorial systems, this chapter aims to break new ground by exploring the tension between democratic accountability and independence that undergirds the institutional position of German prosecution offices within an inquisitorial framework.
Mexican Americans and African Americans: In/Visibility in Composition

What is different from the mission of late-nineteenth-century Eastern elite institutions and Midwestern normal schools is that the distance between a student and the language of the Academy (or what was expected to be mastered) seems to be a separate issue from pedagogy. This distance, if it existed, was regarded more as a “personal problem” or as an unfortunate personal characteristic that was almost akin to being regarded as illiterate. Students’ various social upbringings were seldom pedagogically considered in private Eastern elite colleges such as Harvard.
Evaluating conspiracy: narrative, argument, and ideology in Lincoln's "House Divided" speech

Despite the prevalence of conspiracy theories in contemporary political discourse, scholars of rhetoric and argumentation remain confounded as to how best to evaluate these theories. Many scholars ...
Granulomatous Inflammation Detected by Bronchoscopy with Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Patients with Suspected Cancer Recurrence in the Mediastinum

In patients with a history of cancer, mediastinal adenopathy often heralds a recurrence of their malignancy. However, not all mediastinal adenopathy is due to cancer recurrence. We report a series of patients with cancer and new mediastinal lymphadenopathy with granulomatous inflammation. Method: Retrospective review (2011-2015) of all 511 consecutive patients referred for EBUS-TBNA for mediastinal and/or hilar lymphadenopathy identified by CT and/or PET imaging. Patients with lung cancer were specifically excluded. Results: We identified 27 patients (5.2 %) with prior cancer history with non-caseating granulomas. 2 patients had a newly diagnosis of colon cancer. 2 had unexpected newly diagnosis of lung cancer. All others, 25 had prior diagnosis of cancer. A focused review with the help of cell block and CD68 immunostaining identified granulomas in 25% of the lymph nodes aspirates, originally not reported by pathologists.Two patients required mediastinoscopy. There was no evidence of mycobacterial infection. Follow up images revealed disappearance of lymphadenopathy in some patients and stability of findings in all others. Conclusion: EBUS-TBNA can detect granulomas but a cell block, CD68 immunostaining and a learning curve by general pathologists are strongly recommended. PET scan does not distinguish cancer recurrence versus granulomatous inflammation. Sarcoid-like lymphadenopathy may be reversible and have a good prognosis in patients with cancer.
Sexual Stigma: Putting Sexual Minority Health Issues in Context

In the United States today, lesbians, gay men, bisexual women, and bisexual men are stigmatized. They are subjected to explicit and subtle discrimination, marginalized or made virtually invisible by many of society’s institutions, and often vilified. To understand the health-related experiences and behaviors of sexual minorities, it is necessary to examine this stigma and prejudice, including its sources and dimensions, how it is enacted, and how it is experienced. Such an examination is the goal of the present chapter.
Human Hepatic Stellate Cells Carry a New Splice Variant of the Human ADAMTS13

The ADAMTS13 gene plays an integral role in vascular homeostasis. A severe deficiency in ADAMTS13 triggers a rare disorder known as thrombotic thrombocytopenic purpura (TTP). Various missense and nonsense point mutations have been described in exonic regions of ADAMTS13 along with several frameshift deletions and one frameshift insertion. Additionally, several intronic mutations have been discovered in USA patients that result in aberrant mRNA splicing forms. A tissue based screen of ADAMTS13 alternative splicing has never been assessed. Besides the known mRNA splice isoforms, others are evident from the Expressed Sequence Tag (EST) databases. We analyzed alternative splicing of ADAMTS13 in several tissues in order to assess whether alternative splicing might play a role during its gene expression. We identified a novel isoform of ADAMTS13 that retains intron 25, evident in human, but not in mouse, hepatic cells. Moreover, the retained intron is not detected in mice possibly because they do not possess regulatory sites inserted into the human intron at a later evolutionary stage. This might suggest that ADAMTS13 is post-transcriptionally regulated at the splicing level. It also shows the need for future analysis of transcript levels of this new isoform in TTP patients. We hypothesize that irregular balance between the two splice isoforms might affect ADAMTS13 functionality, thus, it is possible that our findings might be of clinical significance. “The findings and conclusions in this presentation have not been formally disseminated by the Food and Drug Administration and should not be construed to represent any Agency determination or policy.”
Allograft Maturation After Reconstruction of the Anterior Cruciate Ligament Is Dependent on Graft Parameters in the Sagittal Plane.

Background:Allograft healing (ligamentization) after reconstruction of the anterior cruciate ligament (ACL) is dependent on multiple factors, including tissue processing, host biologic environment,...
A Framework for Implementing the National Diabetes Prevention Program in Los Angeles County.

Introduction Preventing type 2 diabetes is a public health priority in the United States. An estimated 86 million Americans aged 20 years or older have prediabetes, 90% of whom are unaware they have it. The National Diabetes Prevention Program (NDPP) has the potential to reduce the incidence of type 2 diabetes; however, little is known about the best way to institutionalize such a program in a jurisdiction with a racially/ethnically diverse population. The objective of this study was to develop a practice-grounded framework for implementing the NDPP in Los Angeles County. Methods In 2015, the Los Angeles County Department of Public Health (LACDPH) partnered with Ad Lucem Consulting to conduct a 3-stage formative assessment that consisted of 1) in-depth interviews with key informants representing community-based organizations to learn about their experiences implementing the NDPP and similar lifestyle-change programs and 2) 2 strategic planning sessions to obtain input and feedback from the Los Angeles County Diabetes Prevention Coalition. LACDPH identified core activities to increase identification of people with type 2 diabetes and referral and enrollment of eligible populations in the NDPP. Results We worked with LACDPH and key informants to develop a 3-pronged framework of core activities to implement NDPP: expanding outreach and education, improving health care referral systems and protocols, and increasing access to and insurance coverage for NDPP. The framework will use a diverse partner network to advance these strategies. Conclusion The framework has the potential to identify people with prediabetes and to expand NDPP among priority populations in Los Angeles County and other large jurisdictions by using a diverse partner network.
Aspirin, other NSAIDs, and ovarian cancer risk (United States)

Objective: We sought to evaluate the association between ovarian cancer risk and use of aspirin and nonsteroidal anti-inflammatories. Methods: We prospectively assessed use of aspirin, nonsteroidal anti-inflammatories (NSAIDs), and acetaminophen use in relation to ovarian cancer risk among 76,821 participants in the Nurses' Health Study who had no history of cancer other than non-melanoma skin cancer. Women reported known and suspected ovarian cancer risk factors in biennial mailed questionnaires from 1976 to 1996, along with new diagnoses of ovarian cancer. Aspirin use was assessed in 1980, 1982, 1984, and 1988-1994. We assessed NSAID use in 1980, and both NSAID and acetaminophen use in 1990, 1992, and 1994. During 16 years of follow-up and 1,222,412 person-years, 333 cases of invasive epithelial ovarian cancer were confirmed. We used pooled logistic regression to control for age, body mass index, oral contraceptive use, smoking history, parity, postmenopausal hormone use, tubal ligation, and other potential ovarian cancer risk factors. Results: Aspirin use was not associated with ovarian cancer risk overall (RR for users compared with nonusers, 1.00, 95% confidence interval (CI 0.80-1.25). We found no association between aspirin dose (in number of weekly tablets) and ovarian cancer risk (RR for those taking 15 or more tablets weekly compared with nonusers, 0.98, 95% CI 0.63-1.52). Similarly, duration of aspirin use was not associated with risk (RR for aspirin use of 20 or more years, 0.99, 95% CI 0.69-1.43). In separate models assessing the relation between NSAID use and ovarian cancer risk we found a 40% reduction in risk among NSAID users versus nonusers (RR 0.60, 95% CI 0.38-0.95). However, when we examined this relationship in terms of days of NSAID use per month, we did not observe a dose-response with increasing NSAID use. Conclusions: We observed no association between aspirin use, dose, or duration and epithelial ovarian cancer risk. Although we found a modest reduction in risk associated with NSAID use, there was no dose-effect.
Flexible Architectures for Full-Scale Performance Evaluation of Tall Buildings: Burj Khalifa and Beyond

While the benefits of full-scale monitoring of civil infrastructure have been widely motivated, uptake and adoption within the building sector has been minimal due to a variety of practical barriers. These benefits are particularly noteworthy for the design, operation and maintenance of tall buildings, whose predicted responses are rarely verified by any formal feedback mechanism, despite their life safety and economic implications. This paper takes the first steps toward establishing these feedback loops and encouraging greater uptake by exploring the sensing architecture that was deployed in Burj Khalifa. Its modular hardware design and creative use of the building’s local area network delivered a plug-and-play solution. Units could be readily deployed by non-experts to measure the building’s accelerations and displacements as well as on-site meteorological conditions – encouraging local ownership of the system. These modules are coordinated by an on-site server, supporting efficient and scalable integration of a robust array of sensing modalities. The use of local servers overcomes many of the challenges of data acquisition in large-scale distributed sensing, while also automating data processing and web-based visualization. Given the growing emphasis on real-time displacement monitoring in tall buildings, the paper further explores how tiltmeters can be integrated into these modular sensor arrays to more effectively capture low-frequency displacements and the overturning action of core-based systems. The paper closes by considering how the development of modular sensing hardware for this signature application can be scaled to benefit a wider array of buildings. This democratization of sensing technology in the form of low-cost, re-deployable sensing modules can facilitate design feedback through community monitoring campaigns that directly engage building management as end users of this instrumentation, fostering uptake through exposure.
Risk factors for asthma exacerbation and treatment failure in adults and adolescents with well-controlled asthma during continuation and step-down therapy

Rationale: Although national and international guidelines recommend reduction of asthma controller therapy or “step-down” therapy in patients with well-controlled asthma, it is expected that some i...
The state of testosterone therapy since the FDA's 2015 labelling changes: Indications and cardiovascular risk.

OBJECTIVE A label change in testosterone (T) products in March 2015 followed a highly publicized FDA advisory committee meeting in September 2014. Changes included a warning of possible increased cardiovascular (CV) risks and restriction of indicated populations to younger men with a limited set of known aetiologies of testosterone deficiency (TD). These changes greatly impacted clinical practice and public perception of T therapy (TTh). Our aim was to review these changes in the light of subsequently published studies. DESIGN We identified 23 studies through June 2017, including 12 clinical trials and 11 observational studies. The Testosterone Trials included 790 men aged 65 years and older with TD without known aetiology, assigned to 1-year T gel or placebo. RESULTS Demonstrated benefits of T included sexual activity and desire, physical activity and mood. There were 9 major adverse CV events (MACE) in the T arm and 16 in the placebo arm. No study reported increased MACE with TTh. A 3-year RCT showed no difference in carotid atherosclerosis. Several large observational studies reported reduced CV events with TTh, including one showing progressively reduced CV and mortality risk with greater duration of TTh. Men whose serum T normalized with TTh had reduced risk of MI and death compared with men whose T levels failed to normalize. CONCLUSION We conclude that existing evidence fails to support increased CV risk with TTh; on the contrary, there is evidence suggestive of real-world CV benefits. Finally, existing evidence provides benefits of TTh in older men without known aetiology for T deficiency.
ON SEQUENTIAL PATTERN RECOGNITION SYSTEMS

This paper is concerned with the application of sequential decision procedures to pattern recognition problems when the costs of feature measurements are of considerable importance. Three techniques are discussed, namely, the modified sequential probability ratio test (with time-varying stopping boundaries), the backward procedure using dynamic programming, and the nonparametric sequential ranking procedure. Two-class classification problems are first treated. Generalized procedures for multi-class problems are then given. In addition to classification problems, the backward procedure has also been applied to feature ordering and selection in sequential recognition processes. Computer simulated experiments in character recognition are presented to illustrate the proposed approaches.
Some Aspects of Statistics

The term statistics derives, as is well known, from the Latin ‘Status’ (state) and was originally used in connection with the description of the state of a country by means of a manifold of factual data characterizing this state. The characteristic of the state of a country, say, in relation to its population, is given by so-called statistical data (statistical material), which are obtained, for instance, by interviewing concrete people inhabiting the country (population census). These statistical data are then classified according to different features (properties) of the country’s inhabitants (sex, age, education, etc.) and are presented in the form of a summary indicating the distribution of the population according to the values of these properties, that is, the absolute or relative number of people (the absolute or relative measure of a set of people) belonging to each category accounted for (to each subset accounted for) of the country’s population (of the entire set of concrete people in the country). The initial statistical material is obtained by experimentation (interviewing the population), and the experimenters deal with each concrete person (each concrete object) separately. The classification of this experimental material leads to abstraction of the individual peculiarities of concrete persons and to the description of the state of the country’s population (or, in other words, the state of an abstract inhabitant of the country) with the aid of the measure of the set of concrete people belonging to different categories of the population. But by definition (see Sect. 1.5) the relative measure of a subset of concrete objects is the probability that the respective abstract object has the corresponding subset of values of the properties of these concrete objects. Therefore the classification of the statistical material leads, in this case, to the description of the state of an abstract inhabitant of the country by indicating the probability distribution for him to have different values of the properties of its inhabitants.
Serious games for psychological health education

This paper presents a summary of recent research efforts aiming to address modern psychological health education needs through the use of innovative instructional tools. The current body of research on virtual learning environments and serious games as they relate to psychological treatment shows promising results, especially in the case of the instructional interventions that provide an optimal blend of education and training and focus on the psychological health knowledge acquisition as well as appropriate stress management skills and behaviors. In concert with the theoretical and research foundations within the psychological health domain and pedagogical precepts in the area of simulation and game-based learning, this article also presents design considerations for serious games for psychological health.
Laparoscopic adrenalectomy compared to open adrenalectomy for benign adrenal neoplasms.

BACKGROUND Laparoscopic adrenalectomy has recently been used for removing a variety of adrenal neoplasms. The purpose of the present study was to compare results and outcomes in patients who underwent either laparoscopic or open adrenalectomy at our institution from 1988 to the present. STUDY DESIGN The records of 66 consecutive patients with benign adrenal neoplasms who underwent adrenalectomy from 1988 through 1995 were retrospectively reviewed. Patients were divided into three groups based on the operative approach: group I (n = 25), open anterior transabdominal approach; group II (n = 17), open posterior retroperitoneal approach; and group III (n = 24), laparoscopic transabdominal flank approach. Various parameters were compared and statistical analyses were performed. RESULTS The three groups were similar in age, gender, American Society of Anesthesiologists class, and distribution of unilateral compared with bilateral adrenalectomy. Mean tumor size was slightly larger in group I (3.4 +/- 1.4 cm) than in group II (2.4 +/- 1.4 cm) or group III (2.7 +/- 1.4 cm) (p = NS). Mean operative times for unilateral adrenalectomy were 142 +/- 38 minutes in group I, 136 +/- 34 minutes in group II, and 183 +/- 35 minutes in group III (p < 0.001, groups I and II compared with group III). For bilateral adrenalectomy, mean operative times were 205 +/- 71 minutes (group I), 328 +/- 11 minutes (group II), and 422 +/- 77 minutes (group III). Patients who underwent laparoscopic adrenalectomy had significantly less operative blood loss (mean, 104 mL compared to 408 mL in group I and 366 mL in group II, p < 0.001) and a lower incidence of perioperative blood transfusion. Laparoscopic adrenalectomy was also associated with significantly reduced parenteral pain medication requirements (p < or = 0.001) and more rapid resumption of a regular diet (p < or = 0.01) compared to open adrenalectomy. Postoperative length of stay was significantly longer in group I (8.7 +/- 4.5 days) and in group II (6.2 +/- 3.9 days) after open adrenalectomy than after laparoscopic adrenalectomy (3.2 +/- 0.9 days) (p < 0.01). Total hospital charges were similar for groups II and III but somewhat higher for group I. Patients were able to resume 100 percent activity an average of 10.6 +/- 4.9 days after laparoscopic adrenalectomy and returned to work a mean of 16.0 +/- 6.1 days postoperatively. CONCLUSIONS Laparoscopic adrenalectomy is a safe and effective procedure and has several advantages over open adrenalectomy. Laparoscopic adrenalectomy should become the preferred operative approach for the treatment of patients with small, benign adrenal neoplasms.