cssi/SciSciGPT-SciSciNet huggingface dataset:
Tiny Shuttles for Information Transfer: Exosomes in Cardiac Health and Disease

Intercellular communication mediated by exosomes, nano-sized extracellular vesicles, is crucial for preserving vascular integrity and in the development of cardiovascular and other diseases. As natural carriers of signal molecules, exosomes released from sources such as blood cells, endothelial cells, immune cells, smooth muscle cells, etc., can modify a multitude of cellular bioactivities. They do so by shuttling lipids, proteins, and nucleic acids between donor and recipient cells while circulating in body fluids and in the extracellular space. A recent surge of interest in the field of exosomal biology is in part due to the recognition that the molecules they carry can act as facilitators of both pathogenesis but can also initiate protective and rescue signaling. This mini-review describes current knowledge on exosome function in health and disease including cardiovascular disease.
Subspecies of Pocket Gophers: Causal Bases for Geographic Differentiation in Thomomys Bottae

Geographic races of pocket gophers, Thomomys bottae, have been defined classically by differences in cranial dimensions, augmented by pelage color variation. Here, we distinguish between size and non-size related components of cranial variation and show that overall size is predicted mainly by features reflecting the nutritional quality of the available vegetation among the habitats occupied by gophers. Body size thus has a strong non-genetic, or environ- mental, basis. Cranial shape, on the other hand, identifies geographically homogeneous units that are concordant with electromorphically determined segments of the species' range. Cranial shape is, therefore, considered to represent underlying genetic influences and to identify more closely historical (phyletic) evolutionary units. In our view, these evolutionary units should form the basis for the infraspecific taxonomy of pocket gophers, and other organisms as well. The number of formal subspecies of T. bottae for the region of study (the deserts of eastern California) would be reduced from 11 to three by application of this criterion. (Morphometrics; environmental modification; allometry; principal components; electromorphic analyses; subspe- cies; pocket gophers.)
Mammoth Mountain and its mafic periphery—A late Quaternary volcanic field in eastern California

The trachydacite complex of Mammoth Mountain and an array of contemporaneous mafic volcanoes in its periphery together form a discrete late Pleistocene magmatic system that is thermally and compositionally independent of the adjacent subalkaline Long Valley system (California, USA). The Mammoth system first erupted ca. 230 ka, last erupted ca. 8 ka, and remains restless and potentially active. Magmas of the Mammoth system extruded through Mesozoic plutonic rocks of the Sierra Nevada batholith and extensive remnants of its prebatholith wall rocks. All of the many mafic and silicic vents of the Mammoth system are west or southwest of the structural boundary of Long Valley caldera; none is inboard of the caldera’s buried ring-fault zone, and only one Mammoth-related vent is within the zone. Mammoth Mountain has sometimes been called part of the Inyo volcanic chain, an ascription we regard inappropriate and misleading. The scattered vent array of the Mammoth system, 10 × 20 km wide, is unrelated to the range-front fault zone, and its broad nonlinear footprint ignores both Long Valley caldera and the younger Mono-Inyo range-front vent alignment. Moreover, the Mammoth Mountain dome complex (63%–71% SiO 2 ; 8.0%–10.5% alkalies) ended its period of eruptive activity (100–50 ka) long before Holocene inception of Inyo volcanism. Here we describe 25 silicic eruptive units that built Mammoth Mountain and 37 peripheral units, which include 13 basalts, 15 mafic andesites, 6 andesites, and 3 dacites. Chemical data are appended for nearly 900 samples, as are paleomagnetic data for ∼150 sites drilled. The 40 Ar/ 39 Ar dates (230–16 ka) are given for most units, and all exposed units are younger than ca. 190 ka. Nearly all are mildly alkaline, in contrast to the voluminous subalkaline rhyolites of the contiguous long-lived Long Valley magma system. Glaciated remnants of Neogene mafic and trachydacitic lavas (9.1–2.6 Ma) are scattered near Mammoth Mountain, but Quaternary equivalents older than ca. 230 ka are absent. The wide area of late Quaternary Mammoth magmatism remained amagmatic during the long interval (2.2–0.3 Ma) of nearby Long Valley rhyolitic eruptions.
Endoparasites of plethodontid salamanders from Paradise Brook, New Hampshire

Totals of 52 dusky salamanders Desmognatlius fuscus, 51 two-lined salamanders Eurycea bislineata, 54 red-backed salamanders Plethodon cinereus, and 3 spring salamanders Gyrinophilus porphyriticus (Plethodontidae) collected in June and August 1995 from Paradise Brook, a tributary to Hubbard Brook, New Hampshire, were examined for parasites. Parasites found were Brachycoelium storeriae, Brachycoelium sp., Bothriocephalus rarus, Falcaustra sp., Omeiea sp., Batracholandros magnavulvaris, and Cepedietta michiganensis. Eighty-six per; cent of the red-backed salamanders, a terrestrial species, harbored 1 or more parasites. Among the aquatic and semiaquatic species, 27% of the dusky and 45% of the two-lined salamanders were infected with 1 or more parasites.
Pre-Trip Expectations and Post-Trip Satisfaction with Marine Tour Interpretation in Hawaii: Applying the Norm Activation Model.

ABSTRACTThis article examines environmental education by focusing on recreationist expectations for interpretation on marine tours, satisfaction with this interpretation and whether expectations were met, and how these perceptions correlate with components of the norm activation model. Recreationists surveyed before and after tours to Molokini, Hawaii (n = 439) had high pre-trip expectations for interpretation (e.g., about reefs, history), but satisfaction was lower and expectations for many recreationists were not met. Those who had their expectations met had higher problem awareness and ascribed more responsibility (i.e., norm activation) than those who did not, suggesting that interpretation is desired and may promote pro-environmental behavior.
Minimally Invasive Cardiovascular Surgery: Incisions and Approaches

Throughout the modern era of cardiac surgery, most operations have been performed via median sternotomy with cardiopulmonary bypass. This paradigm is changing, however, as cardiovascular surgery is increasingly adopting minimally invasive techniques. Advances in patient evaluation, instrumentation, and operative technique have allowed surgeons to perform a wide variety of complex operations through smaller incisions and, in some cases, without cardiopulmonary bypass. With patients desiring less invasive operations and the literature supporting decreased blood loss, shorter hospital length of stay, improved postoperative pain, and better cosmesis, minimally invasive cardiac surgery should be widely practiced. Here, we review the incisions and approaches currently used in minimally invasive cardiovascular surgery.
52 A NOVEL MYOSIN LIGHT CHAIN KINASE INHIBITOR, PIK, PROTECTS FROM LIPOPOLYSACCHARIDE-INDUCED ACUTE LUNG INJURY.

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are major causes of acute respiratory failure that are associated with high morbidity and mortality. These disorders are characterized by a significant pulmonary inflammatory response resulting in injury to alveolar epithelial and endothelial barriers followed by pulmonary edema. Our prior studies demonstrated that myosin light chain kinase phosphorylation of myosin light chains (MLC) is associated with increases in both epithelial and endothelial barrier permeability. We previously have identified a novel oligopeptide, PIK, that inhibits MLC kinase in vitro, is membrane permeant, decreases intracellular MLC phosphorylation, and causes increased intestinal epithelial cell barrier function (Turner et al. Gastroenterology 2002). We hypothesized that PIK-mediated inhibition of MLC kinase activity would attenuate inflammation and vascular leak associated with acute lung injury. To test this hypothesis, we used a murine acute lung injury model with intratracheal administration of endotoxin/lipopolysaccharide (LPS, 2.5 mg/kg). Optimal PIK responses were observed at 125 μM PIK when tested over a range of PIK concentrations. PIK administered intravenously simultaneously with LPS resulted in significantly attenuated lung inflammation reflected by decreasing accumulation of bronchoalveolar lavage (BAL) proteins (25% reduction, p
Religion and Public Opinion in Britain: Continuity and Change

At first glance, a book with a title such as Religion and Public Opinion in Britain seems distinctly unpromising. After all, Britain, along with the rest of Western Europe, appears to be well along...
Design and implementation of personalized query tool based on metadata

The traditional query customization tools only pay attention to dynamic compose SQL statements,but not to business entities such as users,specialties and so on.Users can't customize personalized query and the enterprises can't compose multi-angle and multi-specialized data query according to specialties,users and so on.In order to solve this problem,a metadata-driven and personalized architecture of customizing query is mentioned,using metadata to describe user requirements and enterprise environment.Users use the personalized customization query tool to make their requirement to be metadata,and query engine achieves user requirements from metadata,and then queries the specialized database and fashions user's personalized interface.This tool has the versatile data interface of universal dynamic query,and also friendly and personalized interface.So it is used in information integration of oil field,and achieves an approving impression.
Presenilin Mutations: Variations in the Behavioral Phenotype with an Emphasis on the Frontotemporal Dementia Phenotype

The vast majority of families with presenilin (PSEN) mutations have the clinical phenotype of Alzheimer's disease. However, there are reports of patients who carry PSEN mutations and have Alzheimer's disease with a variety of other clinical phenotypes including spastic paraplegia, seizures, myoclonus, parkinsonism, epilepsy and amyloid angiopathy. Remarkably, three of the studied families have frontotemporal dementia (FTD). The mutations associated with FTD are L113P (Raux et al. 2000), Ins R362 (Tang-Wai et al. 2002) and G183V (Dermaut et al. 2004). Raux and colleagues (2000) reported six members from four generations of the SAL family who had early onset FTD. Tang-Wai and colleagues (2002) reported three patients from three generations who had FTD in their 50s and 60s. Dermaut and colleagues (2004) reported a large family from two generations. Three were definitely affected and a total of 12 members were evaluated. Again the disease was of early onset. In all three families, the clinical phenotype was convincingly FTD in nature. In the first two families (L113P and Ins R362), no autopsy was available, but in the third family (G183V), one case had an autopsy and the pathology showed Pick's disease with Pick bodies and no Alzheimer pathology. Usually PSEN1 mutations enhance the γ-secretase effect on the amyloid precursor protein (APP), increasing Aβ42 protein, but a study by Amtul and colleagues (2002) found that the InsR 362 (but not L113P, which they also tested) caused a “dominant negative” effect on the metabolism of APP (and NOTCH), decreasing Aβ42 production. The G183V mutation does not have the same effect. In this family, there are two siblings without the mutation (II-3 age 67 and II-4 age 66) who had abnormal SPECT scans and mild dysexecutive function, and II-3 had anomia and mild MRI atrophy. All of these findings raise the possibility that FTD might not be linked to the G183V mutation. In conclusion, in the families described so far, there is suggestive but not conclusive evidence that PSEN1 mutations can cause FTD.
Reading in a Second Language: How reading works: The building blocks of fluency and comprehension

Once reading becomes an automatic process, it feels effortless. … Skilled readers are rarely conscious of coordinating the cognitive processes involved in reading. (Ashby & Rayner, 2006: 52) When we recognize the complexity of reading, its multiple purposes, and its many properties, it becomes clear that the cognitive processes that operate when we read must also be complex. It is precisely this processing complexity that has led researchers to examine reading in terms of its component skills and knowledge bases. Over the past 25 years, significant progress has been made in understanding how component skills work together to build reading comprehension. These component skills provide a clear picture of the fluent reading process and are also essential for understanding appropriate implications for instruction (Adams, 1990; Koda, 2005; Perfetti, 1999; Perfetti, Landi, & Oakhill, 2005; Pressley, 2006; Rapp et al., 2007; Snow, Burns, & Griffin, 1998; Stanovich, 2000). In this chapter, we outline lower-level processes, including word recognition, syntactic parsing, and meaning encoding as propositions (more formally, semantic-proposition encoding). We also introduce working memory as the locus of this processing activity since working memory is fundamental to understanding these processes. Describing certain skills as “lower-level” does not mean that they are simple or undemanding; rather, they form a group of skills that have the potential to become strongly automatized, and this automatizing of lower-level skills is a requirement for fluent reading (Anderson, 2000a; Hulstijn, 2001; Koda, 2005; Stanovich, 1990, 2000). In the next chapter, we outline higher-level processing, including text-model formation (what the text is about), situation-model building (how we decide to interpret the text), inferencing, executive-control processing (how we direct our attention), and strategic processing.
Proliferation of Perivascular Macrophages Contributes to the Development of Encephalitic Lesions in HIV-Infected Humans and in SIV-Infected Macaques

The aim of the present study was to investigate if macrophage proliferation occurs in the brain during simian immunodeficiency virus (SIV) infection of adult macaques. We examined the expression of the Ki-67 proliferation marker in the brains of uninfected and SIV-infected macaques with or without encephalitis. Double-label immunohistochemistry using antibodies against the pan-macrophage marker CD68 and Ki-67 showed that there was a significant increase in CD68+Ki-67+ cells in macaques with SIV encephalitis (SIVE) compared to uninfected and SIV-infected animals without encephalitis, a trend that was also confirmed in brain samples from patients with HIV encephalitis. Multi-label immunofluorescence for CD163 and Ki-67 confirmed that the vast majority of Ki-67+ nuclei were localized to CD163+ macrophages in perivascular cuffs and lesions. The proliferative capacity of Ki-67+ perivascular macrophages (PVM) was confirmed by their nuclear incorporation of bromodeoxyuridine. Examining SIVE lesions, using double-label immunofluorescence with antibodies against SIV-Gag-p28 and Ki-67, showed that the population of Ki-67+ cells were productively infected and expanded proportionally with lesions. Altogether, this study shows that there are subpopulations of resident PVM that express Ki-67 and are SIV-infected, suggesting a mechanism of macrophage accumulation in the brain via PVM proliferation.
Pediatric neurosurgery telemedicine clinics: a model to provide care to geographically underserved areas of the United States and its territories

OBJECTIVE The author describes the creation, structuring, and development of a pediatric neurosurgery telemedicine clinic (TMC) to provide telehealth across geographical, time, social, and cultural barriers. METHODS In July 2009 the University of Florida (UF) Division of Pediatric Neurosurgery received a request from the Southeast Georgia Health District (Area 9-2) to provide a TMC to meet regional needs. The Children's Medical Services (CMS) of the State of Georgia installed telemedicine equipment and site-to-site connectivity. Audiovisual connectivity was performed in the UF Pediatric Neurosurgery office, maintaining privacy and HIPAA (Health Insurance Portability and Accountability Act) requirements. Administrative steps were taken with documentation of onsite training of the secretarial and nursing personnel of the CMS clinic. Patient preregistration and documentation were performed as required by the UF College of Medicine-Jacksonville. Monthly clinics are held with the CMS nursing personnel presenting the pertinent clinical history and findings to the pediatric neurosurgeon in the presence of the patient/parents. Physical findings and diagnostic studies are discussed, and management decisions are made. RESULTS The first TMC was held in August 2011. A total of 40 TMC sessions have been held through January 2016, with a total of 43 patients seen: 13 patients once; 13 patients twice; 8 patients for 3 visits; 2 for 4 visits; 2 for 6 visits; 2 for 5 visits; 2 for 7 visits; and 1 patient has been seen 8 times. CONCLUSIONS Pediatric patients in areas of the continental US and its territories with limited access to pediatric neurosurgery services could benefit from this model, if other pediatric neurosurgery centers provide telehealth services.
Clinical outcomes for patients after surgery and radiation therapy for mesenchymal chondrosarcomas.

Introduction We report the outcome of 23 patients with mesenchymal chondrosarcomas treated with surgery and radiation therapy +/− chemotherapy. The intent of the project was to review the impact of patient and treatment variables on treatment outcome, in particular with regard to extent of surgery and radiation dose. Patients and Methods Twenty-three patients with mesenchymal chondrosarcomas were treated with surgery and radiation therapy (min. dose 44 Gy; max. dose 78 Gy; median dose 60 Gy; mean dose 61 Gy). Results The median survival for the entire cohort of patients was 21.65 years (95% confidence interval ± 4.25). The 5- and 10-year OS was 78.6%. Median disease-free survival for the 23 patients was 7.2 years. Disease-free survival (DFS) at 3 and 5 years was 70.7% and 57.8%, respectively. The local control rate at 5 and 10 years was 89.5% (95%CI 64.1–97.3%). Only three patients experienced local failure, three patients had regional failure, and eight developed distant metastases. Conclusions In this cohort of patients local tumor control was high when using a combination of surgery and radiation. There was not a clear relationship between radiation dose and local tumor control. J. Surg. Oncol. 2016;114:982–986. © 2016 Wiley Periodicals, Inc.
What Can Carbon Isotopes Tell Us About Sources of Reduced Carbon in Rocks from the Early Earth

Carbon isotopes have been widely used as a tool to search for evidence of life in rocks from the early Earth. Many of the oldest rocks on Earth have been found to contain isotopically light reduced carbon, which many researchers have interpreted to have a biological origin. While light carbon isotopic compositions are consistent with biologically produced organic matter, alternative non-biological sources that might also explain the data have not been given thorough consideration. A review of the isotopic composition of potential non-biological sources of reduced carbon to the early Earth indicates that many have light isotopic signatures that encompass the values found in ancient rocks, indicating that the reduced carbon in rocks from the early Archean could plausibly derive from non-biological sources. These observations indicate that the evidence for life provided by carbon isotopes remains far from conclusive, and additional criteria need to be applied before it can be convincingly determined whether the reduced carbon found in the oldest rocks on Earth has a biological or non-biological origin.
Nucleotide-Independent Copper(II)-Based Distance Measurements in DNA by Pulsed ESR Spectroscopy

A site-specific Cu2+ binding motif within a DNA duplex for distance measurements by ESR spectroscopy is reported. This motif utilizes a commercially available 2,2′-dipicolylamine (DPA) phosphormadite easily incorporated into any DNA oligonucleotide during initial DNA synthesis. The method only requires the simple post-synthetic addition of Cu2+ without the need for further chemical modification. Notably, the label is positioned within the DNA duplex, as opposed to outside the helical perimeter, for an accurate measurement of duplex distance. A distance of 2.7 nm was measured on a doubly Cu2+-labeled DNA sequence, which is in exact agreement with the expected distance from both DNA modeling and molecular dynamic simulations. This result suggests that with this labeling strategy the ESR measured distance directly reports on backbone DNA distance, without the need for further modeling. Furthermore, the labeling strategy is structure- and nucleotide-independent.
Management of the Western Corn Rootworm, Diabrotica virgifera virgifera LeConte, Using Transgenic Bt Maize

The western corn rootworm, Diabrotica virgifera virgifera LeConte, is an important pest of maize, Zea mays L., in the United States and Europe. In the United States, transgenic maize hybrids that express Cry endotoxin proteins from the soil bacterium Bacillus thuringiensis Berliner (Bt) have been developed to limit feeding damage caused by corn rootworm larvae.
Thulium fiber laser recanalization of occluded ventricular catheters in an ex vivo tissue model.

Hydrocephalus is a chronic medical condition that occurs in individuals who are unable to reabsorb cerebrospinal fluid (CSF) created within the ventricles of the brain. Treatment requires excess CSF to be diverted from the ventricles to another part of the body, where it can be returned to the vascular system via a shunt system beginning with a catheter within the ventricle. Catheter failures due to occlusion by brain tissues commonly occur and require surgical replacement of the catheter. In this preliminary study, minimally invasive clearance of occlusions is explored using an experimental thulium fiber laser (TFL), with comparison to a conventional holmium: yttrium aluminium garnet (YAG) laser. The TFL utilizes smaller optical fibers ( 450-μm OD), providing critical extra cross-sectional space within the 1.2-mm-inner-diameter ventricular catheter for simultaneous application of an endoscope for image guidance and a saline irrigation tube for visibility and safety. TFL ablation rates using 100-μm core fiber, 33-mJ pulse energy, 500-μs pulse duration, and 20- to 200-Hz pulse rates were compared to holmium laser using a 270-μm core fiber, 325-mJ, 300-μs, and 10 Hz. A tissue occluded catheter model was prepared using coagulated egg white within clear silicone tubing. An optimal TFL pulse rate of 50 Hz was determined, with an ablation rate of 150 μm/s and temperature rise outside the catheter of ∼10°C. High-speed camera images were used to explore the mechanism for removal of occlusions. Image guidance using a miniature, 0.7-mm outer diameter, 10,000 pixel endoscope was explored to improve procedure safety. With further development, simultaneous application of TFL with small fibers, miniature endoscope for image guidance, and irrigation tube for removal of tissue debris may provide a safe, efficient, and minimally invasive method of clearing occluded catheters in the treatment of hydrocephalus.
Off-offshoring from Russia to Ukraine: How Russian Transnational Entrepreneurs Created a Post-Soviet IT Offshore

Offshore has become a staple term in the lexicon of economic globalization, and, yet, it has also become a bit of a black-box term. The range of meanings attached tends to mask the complex, dynamic, and emergent qualities that are vital for the constant reinvention of offshore spaces. This article examines the activities of Russian transnationalizing entrepreneurs of the Russian information technology (IT) offshore—a sector that is made up principally of firms based in Russia specialized in providing IT and software services for clients located in Western Europe and North America—and analyzes how their unique experiment to expand operations to Ukraine is generating a new spatial reality, one with internal hierarchies and subspaces, which I call the off-offshore. Drawing on the narratives of engineers, managers, and directors of Russian firms who drive the creation of this new off-offshoring reality, the article focuses on the process and practices developed bytransnationalizing entreprenuers. I document how these actors devised the initial attempts for expanding their operations in Ukraine, how they proceeded to implement and adapt their plans, and what language—from biological metaphors to pragmatic business terminology—they use to grasp the newness of this process. The article highlights various unexpected difficulties that the firms encountered in their expansion efforts and discusses the unique new multidimensionalknowledge work spacethat becomes the reality of such firms as a result of experimental rhizomatic techniques and practices that they develop—such as management circulation, multidirectional and reversed training, and the development of online forums and in the flesh groups to encourage enthusiasts based in the new locations. [ABSTRACT FROM PUBLISHER]
TripS: automated multi-tiered data placement in a geo-distributed cloud environment

Exploiting the cloud storage hierarchy both within and across data-centers of different cloud providers empowers Internet applications to choose data centers (DCs) and storage services based on storage needs. However, using multiple storage services across multiple data centers brings a complex data placement problem that depends on a large number of factors including, e.g., desired goals, storage and network characteristics, and pricing policies. In addition, dynamics e.g., changing user locations and access patterns, make it impossible to determine the best data placement statically. In this paper, we present TripS, a lightweight system that considers both data center locations and storage tiers to determine the data placement for geo-distributed storage systems. Such systems make use of TripS by providing inputs including SLA, consistency model, fault tolerance, latency information, and cost information. With given inputs, TripS models and solves the data placement problem using mixed integer linear programming (MILP) to determine data placement. In addition, to adapt quickly to dynamics, we introduce the notion of Target Locale List (TLL), a pro-active approach to avoid expensive re-evaluation of the optimal placement. The TripS prototype is running on Wiera, a policy driven geo-distributed storage system, to show how a storage system can easily utilize TripS for data placement. We evaluate TripS/Wiera on multiple data centers of AWS and Azure. The results show that TripS/Wiera can reduce cost 14.96% ∼ 98.1% based on workloads in comparison with other works' approaches and can handle both short- and long-term dynamics to avoid SLA violations.
Sample complexity bounds for dictionary learning of tensor data

This paper provides bounds on the sample complexity of estimating Kronecker-structured dictionaries for Kth-order tensor data. The training samples are generated by linear combinations of these structured dictionary atoms and observed through white Gaussian noise. The lower bound follows from a lower bound on the minimax risk for general coefficient distributions and can be further specialized to sparse-Gaussian coefficients. This bound scales linearly with the sum of the product of the dimensions of the (smaller) coordinate dictionaries for tensor data. An explicit dictionary estimation algorithm for 2nd-order tensor data is also provided whose sample complexity matches the lower bound in the scaling sense. Numerical experiments highlight the advantages associated with explicitly accounting for tensor structure of data during dictionary learning.
QoS-Aware and Reliable Traffic Steering for Service Function Chaining in Mobile Networks

The ever-increasing mobile traffic has inspired deployment of capacity and performance enhancing network services within mobile networks. Owing to recent advances in network function virtualization, such network services can be flexibly and cost-efficiently deployed in the mobile network as software components, avoiding the need for costly hardware deployment. Nevertheless, this complicates network planning by bringing the need for service function chaining. In this paper, we study mobile network planning through a software-defined approach, considering both quality-of-service and reliability of different classes of traffic. We define and formulate the traffic steering problem for service function chaining in mobile networks, which turns out to be $\mathcal {NP}$ -hard. We then develop a fast approximation scheme for the problem, and evaluate its performance via extensive simulation experiments. The results show that our algorithm is near-optimal, and achieves much better performance compared with baseline algorithms.
Levels of explanation and cautions for a critical clinical anthropology.

Abstract The appearance of a critical approach to clinical anthropology raises a question of relevance. Critical medical anthropology itself has developed with a primary concern for the impact of capitalism on Third World health, the inequality of medical resource distribution both in the U.S. and abroad, and the hegemony of Western biomedicine over local medical systems. Such an orientation may be of but modest relevance for an understanding of clinical phenomena in the heartland of capitalism itself. In the U.S., both patients and clinicians tend to share multiple values, including commitment to capitalism and the biomedical paradigm. Moreover, various negative behavioral characteristics visible in the clinical setting (such as racism) are common outside medicine, and may not be profitably understood through usual critical orientations. A heuristic model that gives excessive weight to a single element (capitalism) of a single (macro) level of explanation may not be as useful as one that utilizes a multi-level, multi-element approach. The argument is made that such a broader, more holistic approach may offer greater understanding of so-called micro level processes—specifically the patient/clinician interaction in specific clinical settings. An example is provided from a midwest hospital. It is suggested that if change in the biomedical system is a goal of a critical clinical anthropology, the impact will be greater where objective and broad causal connections can be demonstrated with minimal use of rote or polemic arguments.
Single-Incision Total Abdominal Colectomy

A total abdominal colectomy is performed for a wide variety of indications, including malignant disease, precancerous lesions, inherited genetic conditions, colonic dysmotility, and inflammatory bowel disease. The dissection, resection, and method of vascular ligation are standardized, but the indication for operation and patient preferences will determine if an anastomosis or an end ileostomy is performed. In all cases, a minimally invasive approach is safe, is feasible, and accelerates recovery. In our experience, the total abdominal colectomy is the ideal procedure for a single-incision laparoscopic approach in patients receiving a stoma, as this leads to “incisionless” surgery, improving cosmesis, postoperative pain, and reducing port-site complications.
Abstract 18446: Treatment With Tetrahydrobiopterin Decreases White Matter Injury in a Mouse Model for In Utero Hypoxia in Congenital Heart Disease

Introduction: Reduced oxygen delivery in complex congenital heart disease (CHD) can lead to brain white matter (WM) injury in utero. Currently, no treatment exists. Tetrahydrobiopterin (BH4) is a cofactor for neuronal nitric oxide synthase, and in its absence, toxic peroxynitrite production is favored. Hypoxia activates nitric oxide synthase, which reduces BH4 availability. Hypothesis: Decreased BH4 levels underlie WM injury in the fetus with CHD, and treatment with BH4 will reduce this injury. Methods: Mice were divided into three groups: normoxic controls (Nx), hypoxic (Hx), and hypoxic with BH4 treatment (Hx-BH4). Hx and Hx-BH4 mice were kept at 10.5% FiO2 from postnatal day 3 to 11--a period of WM development equivalent to the 3rd trimester in humans. Brain BH4 levels were quantified and compared between Nx (n=11) and Hx (n=12). Densities of cells expressing CNP (marker of oligodendrocytes--cells responsible for myelination) and Caspase3 (apoptosis marker) were quantified in three WM regions and compared between groups (n=3-6 each). Western blot detected myelin basic protein (myelin marker). Results: Brain BH4 levels were depleted in Hx compared to Nx (-38.4%, p=0.02). CNP+ oligodendrocytes increased after Hx compared to Nx (Fig.1a), consistent with hypoxia-induced proliferation seen previously. BH4 treatment did not limit this proliferation (Fig.1a). Hx had increased WM apoptosis (Fig.1b), which decreased with BH4 treatment (Fig.1b). Remarkably, there was no difference in WM caspase3+ cells between Nx and Hx-BH4 (Fig.1b). There was no difference in effect across WM region. Finally, loss of myelin with hypoxia was mitigated by BH4 treatment (Fig.1c). Conclusions: Our results show that suboptimal BH4 levels influence hypoxic WM injury. BH4 treatment of phenylketonuria is safe during pregnancy, thus maternal BH4 therapy is feasible. Our data demonstrate that repurposing BH4 for use during fetal brain development has potential to limit WM injury in CHD.
Dipalmitoylphosphatidylcholine (DPPC): Annealing Strategy to Mitigate Variability in Thermotropic and Moisture Sorption Behavior.

Abstract Dipalmitoylphosphatidylcholine (DPPC) demonstrated complex differential scanning calorimetry (DSC) thermal behavior. Transitions below 100 °C showed variability in their thermotropic reversibility. An experimental design employing a DSC heat-cool-heat-cool-heat cycle and modulated DSC were used to gain insight into the DPPC's complex thermal nature. An annealing strategy was developed to reduce DPPC's thermotropic variability, moisture uptake rate, and rate variability. Samples annealed at 110 °C for 5 min provided a reproducible, thermally reversible material. The annealed material also exhibited an 8-fold decrease in moisture sorption rate and a statistically significant ( p = 0.0233) 100-fold decrease in water sorption rate variability compared to DPPC "as is". An optimized validated stability-indicating high performance liquid chromatography with evaporative light scattering detection method was developed and showed no change in DPPC chemical stability under the annealing treatment conditions.
ECONOMIC CHALLENGES IN BREAST IMAGING: A Survivor's Guide to Success

Radiologists who practice breast imaging have long known that the field provides observational and interpretative challenges second to no other area of radiology. More recently, they also appreciate the challenges of keeping their breast imaging centers economically afloat. At the current low reimbursement rates, only efficiently run breast imaging centers can survive without financial losses. Countless women's lives have been saved because of the advances in breast imaging during the last quarter of the twentieth century. Continuation of the current high level of care into the next millennium requires that breast imaging centers be economically sustainable.
Research Update: Electron beam-based metrology after CMOS

The magnitudes of the challenges facing electron-based metrology for post-CMOS technology are reviewed. Directed self-assembly, nanophotonics/plasmonics, and resistive switches and selectors are examined as exemplars of important post-CMOS technologies. Materials, devices, and architectures emerging from these technologies pose new metrology requirements: defect detection, possibly subsurface, in soft materials, accurate measurement of size, shape, and roughness of structures for nanophotonic devices, contamination-free measurement of surface-sensitive structures, and identification of subtle structural, chemical, or electronic changes of state associated with switching in non-volatile memory elements. Electron-beam techniques are examined in the light of these emerging requirements. The strong electron-matter interaction provides measurable signals from small sample features, rendering electron-beam methods more suitable than most for nanometer-scale metrology, but as is to be expected, solutions to many of the measurement challenges are yet to be demonstrated. The seeds of possible solutions are identified when they are available.
Web services for data warehouses: OMOP and PCORnet on i2b2.

Objective Healthcare organizations use research data models supported by projects and tools that interest them, which often means organizations must support the same data in multiple models. The healthcare research ecosystem would benefit if tools and projects could be adopted independently from the underlying data model. Here, we introduce the concept of a reusable application programming interface (API) for healthcare and show that the i2b2 API can be adapted to support diverse patient-centric data models. Materials and methods We develop methodology for extending i2b2's pre-existing API to query additional data models, using i2b2's recent "multi-fact-table querying" feature. Our method involves developing data-model-specific i2b2 ontologies and mapping these to query non-standard table structure. Results We implement this methodology to query OMOP and PCORnet models, which we validate with the i2b2 query tool. We implement the entire PCORnet data model and a five-domain subset of the OMOP model. We also demonstrate that additional, ancillary data model columns can be modeled and queried as i2b2 "modifiers." Discussion i2b2's REST API can be used to query multiple healthcare data models, enabling shared tooling to have a choice of backend data stores. This enables separation between data model and software tooling for some of the more popular open analytic data models in healthcare. Conclusion This methodology immediately allows querying OMOP and PCORnet using the i2b2 API. It is released as an open-source set of Docker images, and also on the i2b2 community wiki.
Multiple Realization and Robustness

Multiple realization has traditionally been characterized as a thesis about the relation between kinds posited by the taxonomic systems of different sciences. In this paper, I argue that there are good reasons to move beyond this framing. I begin by showing how the traditional framing is tied to positivist models of explanation and reduction and proceed to develop an alternate framing that operates instead within causal explanatory frameworks. I draw connections between this account and the notion of functional robustness in biology and neuroscience. I then examine two cases from systems neuroscience that substantiate my account and show how traditional debates fail to track important features of these cases.
Long Term Functional Outcome and Mortality in Elderly Patients After Intracerebral Hemorrhage (P2.258)

Objective: The aim of this case-control study was to determine the independent effects of age on outcome after intracerebral hemorrhage (ICH). Background: While ICH is well characterized in patients under the age of 80, few studies have examined ICH in an elderly cohort (>80 years). Design/Methods: 40 ICH patients were prospectively identified at Yale-New Haven Hospital. 20 subjects above age 80 were matched against 20 patients below age 80, based on ICH location (lobar, deep, cerebellar, brainstem), ICH volume (> 30cc), presence of intraventricular hemorrhage (IVH), and admission GCS (0–4, 5–12, 13–15). The matched groups were compared via univariate analysis to examine differences in pre-ICH disability (mRS > 1) morbidity (mRS > 3), mortality, and Barthel Index (BI) at discharge, 3, 6, and 12 months. Results: There was no difference in pre-ICH disability (age ≤ 80: 10.5%, age > 80: 21.1%; p > 0.05) between groups. There was a trend for worse outcomes in older patients at discharge (p = 0.082) and 3 months (p = .057). Older patients had worse outcomes at 1 year (p = 0.014) and at 6 months (p = 0.023). At 1 year, older patients were 6.5 times more likely (95% CI 1.4–30.7) to have a poor outcome and 7 times more likely (95% CI 1.4–32.8) to have died than younger subjects. There were no significant differences in BI scores at any time point between younger subjects and older subjects who survived to follow-up. Conclusions: Elderly patients have higher long-term morbidity and mortality but do not differ from younger patients in the short-term. This trend may reflect a greater ability for younger patients to recover or the impact of comorbidities in the elderly. Further research is needed to inform clinical trial design for patients over 80 and for accurate prognostication. Disclosure: Dr. Leasure has nothing to disclose. Dr. Sreekrishnan has nothing to disclose. Dr. Zhou has nothing to disclose. Dr. Hwang has received research support from American Brain Foundation Practice Research Training Fellowship, Apple Pickers Foundation, Neurocritical Care Society, National Institute of Health. Dr. Sansing has received personal compensation for activities with Genentech as a speaker, and from Pfizer as an investigator. Dr. Greer has received personal compensation in an editorial capacity for Seminars in Neurology. Dr. Sheth has received personal compensation in an editorial capacity Current Treatment Options in Neurology. Dr. Sheth has received research support from Remedy Pharmaceuticals, Inc.
Placebos and Nocebos in Migraine: Children and Adolescents

Harnessing the placebo effect in clinical settings has been one of the goals of placebo research. However, most of the studies have been performed with healthy participants. Evaluating the placebo response constitutes a challenge in many conditions due to their ongoing nature and undulating processes that make interventions more complex in terms of identifying responsivity. Migraine, particularly episodic migraine, provides an ideal disease to evaluate placebo and nocebo responses because of its intermittent nature and the ability to evaluate a number of processes involved in treatment. The approach becomes even more interesting in the pediatric population where suggestibility may be more effective than in adults. In this chapter we present migraine as a model to investigate the impact of placebo and nocebo responsivity, provide a summary of placebo (and nocebo) in the pediatric migraine population, and offer a few suggestions related to the process, the utility, and the ethics of introducing placebo and managing nocebo into the pediatric clinic.
Globalization of the traditional Okinawan art of Shotokan karate

Since the eighteenth century, the traditional Okinawan art of Shotokan karate has transformed into a global sport. The violent history of Okinawa in the late 1700s led to the art’s initial creation...
The Relationship between Perceived Institutional Support and Student Experience for Employer Selection, Employee Persistence, and Career Path among Community-Engaged Faculty and Staff Members

The purpose of this cross-sectional study was to explore the potential relationship between the employment decisions of faculty and staff members who participate in community engagement and their perceptions of organizational support for community engagement. Findings indicated that perceptions of organizational support can influence employment decisions, especially for individuals who participated in community engagement activities as students.
Neurocytoskeletal Changes Following Traumatic Brain Injury

The neuronal cytoskeleton is integral to neuronal function and structure. Neuronal cytoskeletal proteins interact via crosslinks to each other and to other cell organelles, the nuclear envelope and the plasma membrane. Cytoskeletal proteins are involved in cytoplasmic and axonal transport of organelles and macromolecules and in maintaining structural integrity of the neuron. Alterations or reorganization of cytoskeletal proteins are necessary for normal neuronal functions such as differentiation and movement of secretory granules (Burgoyne 1991), reflecting the dynamic nature of the cytoskeleton. However, abnormal organization or destruction of components of the cytoskeleton may lead to impaired intracellular transport and aberrant neuronal structure. This chapter will review data from studies of human and experimental traumatic brain injury (TBI) that are providing increasing evidence that multiple neurocytoskeletal elements sustain damage as a result of trauma, potentially contributing to neuronal dysfunction. Some of the major neurocytoskeletal proteins include neurofilaments (NFs), tubulin, microtubule-associated proteins (MAPs) such as MAP2 and tau, actin, and spectrin. Because cytoskeletal integrity is a critical determinant of neuronal viability, it is important to understand neurocytoskeletal dynamics following TBI in the ultimate hope of preventing or attenuating harmful changes, while promoting events that might be reparative or adaptive.
Twin consequences of rising U.S. death rates among young adults: Lower life expectancy and greater lifespan variability.

Abstract The current study is an original investigation of the U.S. mortality pattern from 2000 to 2017. Previous research has shown that the unusual post-2014 decline in life expectancy is related to the increase in death rates for ages 25–44, mostly due to rising prevalence in drug poisoning and suicide deaths. Our investigation reveals that such increase in younger-age mortality has had an impact not only on life expectancy (or mean age at death), but also, and to a larger extent, on lifespan variability (the dispersion around the mean age at death). Even though lifespan variability is a key component of mortality change, as well as a measure of human well-being, with social, economic, and psychological implications, it has received much less attention than life expectancy has.
Communicating policy-practice orientations: the case of sexual violence response among college students

ABSTRACTHow organizational members subjectively understand the characteristics of policy design processes can generate different policy outcomes. This case study of a multidisciplinary university t...
The Future of Imaging in Pulmonary Hypertension: Better Assessment of Structure, Function, and Flow

Cardiovascular imaging is essential in the evaluation and management of patients with pulmonary hypertension. Echocardiography and magnetic resonance imaging, in particular, provide basic measureme...