cssi/SciSciGPT-SciSciNet huggingface dataset:
Different BOLD Responses to Intragastric Load of L-glutamate and Inosine Monophosphate in Conscious Rats

In this study, we compared the blood oxygen level-dependent (BOLD) signal changes between intragastric load of monosodium L-glutamate (MSG) and inosine monophosphate (IMP), which elicit the umami taste. An intragastric load of 30 mM IMP or 60 mM MSG induced a BOLD signal increase in several brain regions, including the nucleus of the solitary tract (NTS), lateral hypothalamus (LH), and insular cortex. Only MSG increased the BOLD signal in the amygdala (AMG). The time course of the BOLD signal changes in the NTS and the LH in the IMP group was different from that of the MSG group. We further compared the brain regions correlated with the BOLD signal change in the NTS between MSG and IMP groups. The BOLD responses in the hippocampus and the orbital cortex were associated with activation of the NTS in both MSG and IMP groups, but the association in the AMG and the pyriform was only in MSG group. These results indicate that gut stimulation with MSG and IMP evoked BOLD responses in distinct regions with different temporal patterns and that the mechanism of perception of L-glutamate and IMP in the gastrointestinal tract differed from that in the taste-sensing system.
Single-event-upset (SEU) awareness in FPGA routing

The majority of configuration bits affecting a design are devoted to FPGA routing configuration. We present a SEU-aware routing algorithm that provides significant reduction in bridging faults caused by SEUs. Depending on the routing architecture switches, for MCNC benchmarks, the number of care bits can be reduced between 13% and 19% on average with comparable delay, hi addition, in asymmetric SRAM FPGA using our router average FIT (failure-in-time) rate is reduced by 36%.
Selective Transfer Technology for Microdevice Distribution

We have developed a generic cost-efficient CMOS-compatible heterogeneous device integration method at wafer-scale level. This method enables the distribution of devices from one to numerous wafers using selective transfer technology. We have applied this method for the distribution of atomic force microscopy (AFM) cantilevers and successfully demonstrated the population of multiple wafers from one source wafer. The distribution function has been designed such as to populate 42 wafers with only one source wafer. This CMOS back-end-of-the-line compatible method is particularly suitable for microelectromechanical systems and integrated circuits. Electrical interconnects are compatible with this technology. We present the concept, the selective transfer method, including a laser ablation technique used for the transfer, as well as the process and results of the application for AFM cantilever distribution.
The Clinical Presentations of Rocky Mountain Spotted Fever Comments on Recognition and Management Based on a Study of 63 Patients

Rocky Mountain spotted fever continues to increase in the United States and the case-fatality ratio remains unchanged despite the availability of effective antibiotics. The apparent reason for the continuing deaths from this disease is the failure of physicians to consider the diagnosis in patients presenting with febrile exanthems in the late spring and summer months. A clinical diagnosis should be based on the history of tick exposure and the presence of fever and the typical exanthem. Serologic tests are useful mainly in retrospect. This article reviews the clinical experience with Rocky Mountain spotted fever in an endemic area in recent years and discusses problems in the diagnosis and management.
Immunization of virgin cows with surface antigen TF1.17 of Tritrichomonas foetus.

Abstract Protection by surface antigen TF1.17 of Tritrichomonas foetus was investigated because it reacted with a monoclonal antibody which immobilized and mediated complement killing of the organism and prevented adherence to vaginal epithelial cells. This monoclonal antibody was used to demonstrate conservation of the antigen in most strains and to immunoaffinity purify the 50- to 70-kDa glycoprotein antigen. In preparation for immunization studies, the appropriate challenge dose of parasites was determined by intravaginal inoculation of 23 virgin cows (heifers) with 10(2), 10(4), or 10(6) live organisms at the time of estrus. More animals became infected and vaginal infection was maintained at a higher rate (P < 0.005) over 10 weeks for the group that received 10(6) organisms than in the other two groups. Therefore, this dose was used for challenge of immunized animals. Animals immunized with immunoaffinity-purified TF1.17 antigen in incomplete Freund's adjuvant or incomplete Freund's adjuvant plus dextran sulfate cleared the infection more quickly than adjuvant controls (P < 0.005). Isotype-specific enzyme-linked immunosorbent assay with T. foetus antigen showed that serum immunoglobulin G1 (IgG1) and IgG2 antibody responses as well as cervicovaginal mucus IgG1 and IgA antibodies peaked at about the time of clearance of infection in vaccinated animals. Controls developed later cervicovaginal mucus IgA antibody responses as would be expected in a primary local immune response to infection. These results indicate that vaccination with this immunoaffinity-purified surface antigen of T. foetus enhances antibody responses as well as clearance of the parasite from the female reproductive tract.
Distributed Fiber-Optic Sensing and Integrity Monitoring:

Structural health monitoring is a process meant to provide accurate and real-time information concerning structural condition and performance. Needs for structural health monitoring in the past two decades increased rapidly, and these needs stimulated the development of various sensing technologies. Distributed optical-fiber sensing technology has opened new possibilities in structural monitoring. A distributed deformation sensor (sensing cable) is sensitive at each point of its length to strain changes and cracks. Such a sensor practically monitors a one-dimensional strain field and can be installed over the entire length of the monitored structural members (suspension cables, bridge girders, tunnel vaults, dam basis, etc.). Therefore, the sensor provides for integrity monitoring, that is, direct detection, characterization (including recognition, localization, and quantification or rating), and report of local strain changes generated by damage. An integrity monitoring principle for long bridges and tun...
On Changes in the Weight Distribution Function of Artificial Fibers Due to Random Fiber Breakage

It is possible to prepare artificial fibers so that each of them has, initially, the same length. This possibility simplifies the mathematical treatment of the subsequent ran dom time breakage, as in ginning. Upper and lower bounds to an exact expression for the time-dependent weight distribution function, W(l, t), are found. Under certain conditions, the bounds coalesce to the exact solution W(l, t).The usefulness of the approximations found for testing the theory and in finding cer tain transition probabilities associated with fiber decay is discussed.
Optimization of Preload in Severe Sepsis and Septic Shock

In sepsis both under- and overresuscitation are associated with increased morbidity and mortality. Moreover, sepsis can be complicated by myocardial dysfunction, and only half of the critically ill patients exhibit preload responsiveness. It is of paramount importance to accurately, safely, and rapidly determine and optimize preload during resuscitation. Traditional methods of determining preload based on measurement of pressure in a heart chamber or volume of a heart chamber (“static” parameters) are inaccurate and should be abandoned in favor of determining preload responsiveness by using one of the “dynamic parameters” based on respiratory variation in the venous or arterial circulation or based on change in stroke volume in response to an endogenous or exogenous volume challenge. The recent development and validation of a number of noninvasive technologies now allow us to optimize preload in an accurate, safe, rapid and, cost-effective manner.
Underactuated control and distribution of multi-agent systems in stratified flow environments

The present paper shows how vertical actuation alone may be used to effectively control the spatial distribution of mobile vehicles (“balloons” in air, or “drifters” in water) in vertically-stratified background flows. Applying iterative, adjoint-based, model predictive control (MPC) techniques coupled with linear quadratic regular (LQR) feedback, agent trajectories and feedback control strategies are determined to ensure the desired terminal-time spacing of multiple agents. Variations in both starting locations and disturbances are considered to illustrate the significant control authority in this agent separation problem in both laminar and turbulent background flows, despite the fact that linear controllability is lost in certain limiting cases. The paper thus demonstrates a novel application of feedback control theory to an emerging real-world application in multi-agent systems. The results lay the groundwork for future applications in Lagrangian sampling of underwater ecosystems as well as the efficient sampling of hurricanes for the purpose of forecasting their development.
Voriconazole-Associated Cutaneous Malignancy: A Literature Review on Photocarcinogenesis in Organ Transplant Recipients

This article synthesizes the current data regarding the implication of voriconazole in the development of skin cancer in organ transplant recipients (OTRs) and offers suggestions for additional research. According to Organ Procurement and Transplantation Network data, 28 051 solid organ transplants were performed in 2012. Due to advancements in immunosuppression and management of infectious diseases, survival of OTRs has substantially increased. Voriconazole is a widely prescribed antifungal medication used for prophylaxis and for treatment of invasive fungal infections in OTRs. Case reports describing skin cancer associated with voriconazole exposure emerged shortly after US Food and Drug Administration approval of the drug, and it is now established that voriconazole is an independent risk factor for the development of cutaneous malignancy in lung transplant recipients. The mechanism of voriconazole-induced skin cancer is still unknown and may involve its primary metabolite, voriconazole N-oxide. Here we discuss the current data and potential mechanisms of voriconazole-associated photosensitivity and carcinogenesis and identify areas that require further research.
Multi-robot team response to a multi-robot opponent team

Adversarial multi-robot problems, where teams of robots compete with one another, require the development of approaches that span all levels of control and integrate algorithms ranging from low-level robot motion control, through to planning, opponent modeling, and multiagent learning. Small-size robot soccer, a league within the RoboCup initiative, is a prime example of this multi-robot team adversarial environment. In this paper, we describe some of the algorithms and approaches of our robot soccer team, CMDragons'02, developed for RoboCup 2002. Our team represents an integration of many components, several of which that are in themselves state-of-the-art, into a framework designed for fast adaptation and response to the changing environment.
Create The Plan, Work The Plan: A Look At Why The Independent Business Owner Has Trouble Calling A Franchisee A True Entrepreneur

Our complex and intricate economic system is comprised of many different types and sizes of businesses, ranging from big corporations to small individually owned entities. The genre of business is and can be profoundly complex. Independence can vary from small single person mom and pops to consortiums of multiple partners, silent partners and limited partners. Currently in the United States there are between 600,000 and 800,000 business start-ups a year. Franchising accounts for a significant number of these start-ups, and as an industry is comprised of 1,500 different corporately owned chains and over 750,000 franchised businesses (Quick Franchise Facts, Franchising Industry Statistics). Two terms frequently used interchangeably among the American business society are the terms “franchise owner” and “entrepreneur”. There is a popular belief that buying a franchise is an easier route to becoming an entrepreneur than one creating a business on ones own. It is also a common belief that the term “entrepreneur” applies equally to both. Our paper will thoroughly examine the differences between an independent starting his/her own enterprise vs. franchising, where one can purchase an already detailed and complete business plan. Our paper will detail the different percentages of risks to the owner and discuss how and why buying a “system” has many different nuances and is not truly the same as starting a business independently. We will examine the issue of “corporate fraud” and lack of government oversight in franchising and detail the unequal distribution of income as it relates to both independent start-ups and franchise purchases. (As a side note, the Spring 2009 Monmouth University Entrepreneurship class has initiated a partnership with “Cartridge World”, an up and coming franchise to open up a retail operation run by the Monmouth University students. It is a true partnership, one in which profits and loses will be shared equally between Monmouth University and Cartridge World. Our research has found that this initiative is the first of its kind between a University and a Franchisor in the country. The macerations of this partnership will initiate many interesting questions and areas for discussion that will profoundly impact the significance of our paper.)
Is Educational Adequacy Adequate for Just Education

In this article I raise three objections to Debra Satz's adequacy approach to education. I argue that her approach fails to see education as a positional good that opens the door to more inequalities. Second, I argue that her concept of adequacy for equal citizenship misses an essential part of students’ educational experience beyond their citizenship statues. Last, I argue that Staz's approach fails to answer crucial practical questions about how to distribute extra resources when the adequate level is already met. Finally, I provide an alternative view that is sensitive to the fact that education is a positional good, based on an active and more inclusive account of citizenship, and conditioned to limit inequalities to be to the greatest benefit of the least-advantaged.
Civil liberties: The expansion of white women's communicative activities from the antebellum south through the civil war

This study analyzes the communicative behaviors and discourse of women in Georgia during the Civil War to determine how women were able to broaden and extend their rhetorical influence during this period. We argue that women increased their authority and impact in communities by strategically balancing what might be considered an “unfeminine” degree of self‐assertion with other, seemingly conciliatory behaviors that appeared to satisfy societal expectations. Faced with the contradictory demands of a society that insisted upon their helplessness while demanding their participation, these women made a unique rhetorical contribution both to the war itself, and to the rhetorical history from which they have too often been excluded.
Music education in homeschooling: A preliminary inquiry

This study examines the music education curricular choices of three families who homeschool in the greater Phoenix area. While each family was intentionally including music as a part of their homeschool curriculum, the method and means of doing so varied. The parents? fundamental philosophy of education, their belief in the value of music education, and their own prior experiences in music learning and performance affected their choices. This exploratory study recommends that the music education professional should consider the unique position of the parent as teacher and administrator as well as the individualistic nature of the home setting in providing music instruction.
Knockdown of Progesterone Receptor (PGR) In Macaque Granulosa Cells Disrupts Ovulation and Progesterone Production

Adenoviral vectors (vectors) expressing short-hairpin RNAs complementary to macaque nuclear progesterone (P) receptor PGR mRNA (shPGR) or a nontargeting scrambled control (shScram) were used to determine the role PGR plays in ovulation/luteinization in rhesus monkeys. Nonluteinized granulosa cells collected from monkeys (n = 4) undergoing controlled ovarian stimulation protocols were exposed to either shPGR, shScram, or no virus for 24 h; human chorionic gonadotropin (hCG) was then added to half of the wells to induce luteinization (luteinized granulosa cells [LGCs]; n = 4-6 wells/treatment/monkey). Cells/media were collected 48, 72, and 120 h postvector for evaluation of PGR mRNA and P levels. Addition of hCG increased (P < 0.05) PGR mRNA and medium P levels in controls. However, a time-dependent decline (P < 0.05) in PGR mRNA and P occurred in shPGR vector groups. Injection of shPGR, but not shScram, vector into the preovulatory follicle 20 h before hCG administration during controlled ovulation protocols prevented follicle rupture in five of six monkeys as determined by laparoscopic evaluation, with a trapped oocyte confirmed in three of four follicles of excised ovaries. Injection of shPGR also prevented the rise in serum P levels following the hCG bolus compared to shScram (P < 0.05). Nuclear PGR immunostaining was undetectable in granulosa cells from shPGR-injected follicles, compared to intense staining in shScram controls. Thus, the nuclear PGR appears to mediate P action in the dominant follicle promoting ovulation in primates. In vitro and in vivo effects of PGR knockdown in LGCs also support the hypothesis that P enhances its own synthesis in the primate corpus luteum by promoting luteinization.
Use of Geostatistics To Evaluate a Spatial Simulation of Russian Wheat Aphid (Homoptera: Aphididae) Movement Behavior on Preferred and Nonpreferred Hosts

Spatial distributions of Russian wheat aphid, Diuraphis noxia (Mordvilko), populations on preferred and nonpreferred hosts, as predicted by a spatial simulation model, were evaluated using geostatistics. The purpose was to assess effects of different hypothesized plant-to-plant movement behaviors on population spatial structure and to determine which behavior produced spatial structures (associations) most similar to those observed experimentally. The simulation model predicted location, chronological age, reproduction, movement, and mortality of individual aphids, at 1-d time intervals, within a 25-by-25 plant grid of preferred (wheat) or nonpreferred (oat) hosts. Three aphid movement behaviors were simulated: random, directional, and aggregative. Aggregativc movement produced spatial dynamics closest to the observed experimental data of the three simulated behaviors. Directional movement was the most sensitive to stochasticity in the model. The Taylor power law was tested and found to be not useful for assessing the spatial simulation. We question the utility of this method for assessing spatial relationships and patterns; however, indices of aggregation are useful for the design of sampling protocol. This study demonstrates the utility of geostatistics for assessing the ability of a spatial simulation to model dynamics of a spatial phenomenon.
Adsorption of Organic Molecules on Kaolinite from the Exchange-Hole Dipole Moment Dispersion Model

Intermolecular interactions between organic molecules and clay minerals are important in a wide range of chemical applications, ranging from oil-sands petroleum extraction to environmental chemistr...
Suicide and Homicide Bereavement among African Americans: Implications for Survivor Research and Practice:

Suicide and homicide are among the leading causes of death for young African-American men; however, little is known about how family members cope with these types of deaths. This exploratory phenomenological study examines the traumatic loss and coping experiences of a purposive convenience sample of 12 immediate African-American surviving family members with a combined experience of 13 deaths, 8 suicides and 5 homicides. Novel aspects of suicide and homicide survivor phenomenon were identified, including Survivor Responses and Reactions, Coping Strategies, and Survivor Service Needs. The implications for research and for those providing services to surviving African-American families are discussed.
How Hall V. Florida Transforms the Supreme Court's Eighth Amendment Evolving Standards of Decency Analysis

Contrary to what many commentators have suggested about Hall v. Florida, the case’s constitutional legacy will not be its modest step to protect criminal defendants with intellectual disabilities. Rather, what will stand out years from now is how Hall quietly but fundamentally transformed both the understanding of when it is appropriate for the U.S. Supreme Court to search for a national consensus on an issue under the Eighth Amendment and how the Court determines whether a consensus exists.The Court’s recent decision in Hall will help ensure that states meaningfully enforce the protection the Court originally set forth in Atkins v. Virginia, which held that individuals with intellectual disabilities cannot be executed. The immediate responses to the Hall decision characterized it primarily as a “small but meaningful step” to “chip away at the death penalty.” But the majority opinion’s reliance on the views and practices of medical experts and psychiatric professionals has overshadowed other important doctrinal developments. This Essay represents an early effort to identify those developments and explore their implications.This Essay contains three Parts. After describing the Court’s narrow holding briefly in Part I, this Essay explores Hall’s two most remarkable aspects. Part II explicates how the Supreme Court’s decision to answer the question Hall presented by engaging in the Eighth Amendment national consensus analysis is doctrinally surprising and significant. Part III examines how the Court’s approach to conducting that consensus analysis deepens the Court’s commitment to an increasingly sophisticated method. This Essay takes the position that the Court’s deployment of its consensus-detecting apparatus is not only unexpected in the Hall context but is also striking because it could implicate a broad range of issues related to constitutional claims against harsh punishments like the death penalty. And this Essay further observes that the manner in which the Hall Court determined that a national consensus existed reflects an evolving and more nuanced Eighth Amendment approach that the Court continues to refine. Ultimately, this Essay predicts that Hall’s long-term significance will reach far beyond its narrow yet important holding.
The Process of Disclosure for Child Victims

A mother walks into her bedroom to see her 8 year old daughter being sexually abused by her husband, the young girl’s stepfather. Mortified, she screams at her husband to leave and scoops up her little girl and rushes her to the emergency room. Her daughter participates in a Sexual Assault Forensic Examination (SAFE) and the medical findings are consistent with sexual abuse, which is rare, as less than 10 % of medical examinations are diagnostic of child sexual abuse (Frasier & Makaroff in Olafson & Lederman, 2006). Child Protective Services (CPS) and local enforcement arrive at the hospital and speak with the mother. A forensic interview is scheduled for the young girl for later in the afternoon.
Pop Art and the Forgotten Codes of Camp

In the early 1960s as Pop Art erupted across America, it was greeted with a hailstorm of criticism. Much of this criticism resulted from the homophobia of modernist critics, who immediately recognized the camp elements in Pop. They also recognized camp’s challenge to modernism. Born in the gay subculture of Europe and America, the camp sensibility reverses standard hierarchies of taste. It revels in self-consciously glorifying popular culture and kitsch. By recontextualizing “low” art into a “high” art context, Pop artists paralleled the camp celebration of and commitment to the marginal. Not coincidentally, camp was undergoing a tremendous popularization in the sixties, exemplified by the publication of Susan Sontag’s 1964 essay “Notes on Camp.” Somehow, Pop’s connection with camp and gay culture has been deleted from the memory of art history and relegated to oblivion. Yet it provided the impetus for later subversions of modernist dogma, becoming a lynchpin of postmodernism. Codes of camp have penetrated numerous aspects of culture, completing camp’s “secret” subversion of modernist culture.
Feasibility, acceptability, and tolerability of RGN107 in the palliative wound care management of chronic wound symptoms

Objective: To assess the feasibility, acceptability and tolerability of RGN107 use, a natural powder blend of Arnica Montana, Calendula Officinalis, Mentha Arvensis and Santalum Album, among hospice patients and their wound caregivers in the palliative wound care management of chronic wound symptoms at end-of-life. Method: Data were collected between May 2013 and November 2015. A pilot trial conducted among 50 hospice patients with symptomatic (pain, odour, or exudate) chronic wounds. Caregivers received initial RGN107 protocol training, actively applied the powder to patient wounds for 4-weeks, and completed an 8-week retrospective survey. Feasibility was assessed by measuring process outcomes, including the number and proportion of participants referred, screened eligible, enrolled, withdrawn and successfully completed. Acceptability measures included: a protocol training evaluation, caregiver pre and post self-efficacy ratings, retrospective usability, symptom control management and comparative techniq...
Current modalities in cancer immunotherapy: Immunomodulatory antibodies, CARs and vaccines☆

Abstract Successes of immune checkpoint inhibitors (ICIs) and chimeric antigen receptor (CAR) T cell therapy in curing patients with otherwise lethal cancers have validated immunotherapy as a treatment for cancer and have inspired excitement for its broader potential. Most promising is the ability of each approach to eliminate bulky and advanced-stage cancers and to achieve durable cures. Despite this success, to date only a subset of cancer patients and a limited number of cancer types respond to these therapies. A major goal now is to expand the types of cancer and number of patients who can be successfully treated. To this end a multitude of immunotherapies are being tested clinically in new combinations, and many new immunomodulatory antibodies and CARs are in development. A third major immunotherapeutic approach with renewed interest is cancer vaccines. While over 20 years of therapeutic cancer vaccine trials have met with limited success, these studies have laid the groundwork for the use of therapeutic vaccines in combination with other immunotherapies or alone as prophylactic cancer vaccines. Prophylactic vaccines are now poised to revolutionize cancer prevention as they have done for the prevention of infectious diseases. In this review we examine three major cancer immunotherapy modalities: immunomodulatory antibodies, CAR T cell therapy and vaccines. For each we describe the current state of the art and outline major challenges and research directions forward.
Multi-institutional Learning and Collaboration to Improve Quality and Safety

A quality improvement collaborative (QIC) is a broad-based approach to identifying and adopting best practices and implementing rapid organizational change. Participants share a commitment to making small, rapid tests of change that can be expanded to produce breakthrough results in a specific clinical or operational area. Historically, QICs have been effective in improving targeted topics, with evidence of positive spill-over effects on participating teams in other areas of care. State-wide surgical QICs, with varying degrees of involvement and components, have increased in prevalence in recent years with aim of decreasing complications after surgery. Such QICs have been formed in Washington, Tennessee, Florida, and Illinois and have achieved varying degrees of success in improving surgical outcomes. The Illinois Surgical Quality Improvement Collaborative has used a conceptual model to guide their QIC to influence the Hospital, Surgical QI Team, and Perioperative Microsystem levels, which translates to five major domains: guided implementation, education, comparative performance reports, networking, and funding.
Playing Together: The Importance of Joint Engagement in the Design of Technology for Children

In this workshop, we will be discussing real world case studies, as well as theoretical approaches used by researchers, designers, and academics to design technology for children that includes and fosters co-play and JME experiences. Our discussion will be centered not only on understanding what are co-engagement experiences, but also how these are produced and why these are important for the child end user. The expected outcome of the workshop will be a set of principles, examples, and guidelines for digital media developers to consider when designing rich digital experiences that take into consideration not only the child, but the context for engagement as well.
Patent Foramen Ovale Closure in the Setting of Cryptogenic Stroke: A Meta-Analysis of Five Randomized Trials.

Background The clinical benefit of patent foramen ovale (PFO) closure after cryptogenic stroke has been a topic of debate for decades. Recently, 3 randomized controlled trials of PFO closure in patients with cryptogenic stroke demonstrated a significantly reduced risk of recurrent stroke compared with standard medical therapy alone. This meta-analysis was performed to clarify the efficacy of PFO closure for future stroke prevention in this population. Methods A systematic literature search was undertaken. Published pooled data from 5 large randomized clinical trials (CLOSE, RESPECT, Gore REDUCE, CLOSURE I, and PC) were combined and then subsequently analyzed. Enrolled patients with cryptogenic stroke were assigned to receive standard medical care or to undergo endovascular PFO closure, with a primary outcome of reduction in stroke recurrence rate. Secondary outcomes included rates of transient ischemic attack (TIA), composite outcome of stroke, TIA, and death from all causes, and rates of atrial fibrillation events. Results We analyzed data for 3412 patients. Transcatheter PFO closure resulted in a statistically significant reduced rate of recurrent stroke, compared with medication alone. Patients undergoing closure were 58% less likely to have another stroke. The number needed to treat with PFO closure to reduce recurrent stroke for 1 patient was 40. Conclusions Endovascular PFO closure was associated with a reduced risk of recurrent stroke in patients with a prior cryptogenic cerebral infarct. Although the absolute stroke reduction was small, these findings are clinically significant, given the young age of this patient population and the patients' lifetime risk of recurrent stroke.
Bone Sarcomas in the Growing Child

The most common primary tumors of bone occur most often in the ­skeletally immature patient. Historically, amputation was the procedure of choice, but improved oncologic outcomes and surgical advances have made limb-salvage therapy a feasible and valuable treatment option. However, the skeletally immature patient presents a unique group of surgical considerations. Not only may the size of the medullary canal be too small to accommodate a durable prosthesis, but also resection can create a limb-length discrepancy and gait abnormalities. Limb-salvage options available for the skeletally immature patient with a segmental long-bone defect include reconstruction with an expandable prosthesis or an intercalary autograft. A vascularized fibular transfer can preserve a limb’s growing potential. Amputations and rotationplasties can result in excellent function for appropriately chosen patients.
Effect of dietary lipids on phospholipase D activity in rat brain.

Phospholipase D (PLD) is emerging as a major player in many novel signaling pathways. Based on recent studies correlating membrane composition with enzyme function, we speculated that feeding of dietary lipids to the newborns has a major impact on brain PLD activity. To test this hypothesis, the rat dams were fed fat-free powder containing either safflower oil or fish oil, and a control powdered chow. The pups were weaned onto the diet and sacrificed at 30 days of age. PLD activity was measured by transphosphatidylation assays using rat brain membranes. This study shows that microsome GTPγS-dependent PLD activity in rats fed safflower oil or fish oil was significantly reduced by 38% and 30% respectively compared to controls. Oleate-dependent PLD activity in the safflower oil group, however, was significantly increased by 38%. In contrast, synaptosome membrane (P2) GTPγS-dependent PLD activity in rats consuming safflower oil was significantly increased by 29%, but there was no difference in oleate-dependent PLD activity. Likewise, no difference was observed in microsome oleate-dependent PLD and P2 GTPγS-dependent PLD activity between the fish oil and the control groups. These results indicate that dietary lipid intake appears to modulate phospholipid metabolism and differential expression of PLD isozymes in the brain.
[OA137] Adult radiation doses for computed tomography (CT) from an international dose registry

Purpose To contribute to the creation of CT radiation dose benchmarks for adults (>=15 years). We report the distribution of radiation dose metrics based on CT scans submitted in 2017 to a large international dose registry comprised of 139 institutions from 7 countries. The registry was supported through the US National Institutes of Health (NIH) and Patient Centered Outcomes Research Institute (PCORI). Methods We describe median (target) and 75th percentile (benchmark) doses for CT dose index volume (CTDIvol) and dose length product (DLP) by anatomic area across all institutions. Each institution was weighted equally when calculating targets and benchmarks. Results The US and Europe contributed 714,297 and 85,686 adult CT scans, respectively, during 2017, including examinations of the head (33%), chest (25%) abdomen (37%) and combined chest-abdomen (CAP) (5%). CTDIvol target (50%) and benchmark (75%) values (in mGy), respectively, in the US were: head (44 and 54), chest (9 and 13), abdomen (11 and 16), and CAP (10 and 14). Corresponding values in Europe were 4–52% lower: head (38 and 47), chest (4 and 7), abdomen (7 and 11), and CAP (9 and 14). Corresponding DLP values (in mGy-cm) for the US were: head (841 and 1075), chest (338 and 560), abdomen (669 and 1081), and CAP (918 and 1416). Corresponding values in Europe were 18–52% lower: head (685 and 789), chest (163 and 334), abdomen (425 and 675), and CAP (670 and 1045). The results changed minimally after accounting for patient size using circumference of the body part scanned. For CTDIvol, no value changed more than 2 mGy and for DLP no value changed more than 100 mGy-cm. Similar usage of multi-phase scanning in Europe (23%) and the US (22%) does not explain the large differences in DLP. Conclusions Dose metrics reported in a large number of patients can contribute to the creation of representative benchmarks that can be used for dose optimization efforts and institutional evaluation of CT radiation doses to know if their doses routinely exceed these benchmarks. Additional work should be undertaken to explore the reasons that doses are higher in the US than Europe.
Medical Cost Savings After One Year of Integrated Behavioral Health Services in a Rural Pediatric Primary Care Clinic

Introduction: Behavioral health problems are pervasive in primary care and can impede efficient delivery of medical care. Primary care pediatricians PCPs address behavioral health issues during roughly 1 in 3 visits 1, and these visit require an average of twice as much time than those with only medical concerns 2. Integrated behavioral health IBH in primary care continues to gain empirical support as a collaborative care model for improving patient access, clinical outcomes, and quality of care relative to traditional outpatient services. The present study examined how IBH impacted medical visit costs after its first year of implementation. Methods: Sample. All patients who presented for an initial behavioral health visit in Michigan Medicine’s first integrated pediatric primary care clinic between August 2013 and August 2014 were included in the sample N= 134. Independent variable: The independent variable was initiation of IBH treatment. For each patient, data were collected from primary care medical visits in the 12 months before initiating IBH treatment and compared with data 12 months after. Number of visits: Total number of primary care visits, either sick or well. Cost: Insurance payments for services made by third-party payers. Costs were adjusted for inflation to year 2014 US Dollars USD using the consumer price index. Results: Patients in the sample averaged 3.11 primary care medical visits before initial IBH treatment and 2.96 visits afterward. The mean per patient cost of primary care medical treatment was $326 per patient in the year prior to initiating IBH treatment and $254 in the year following. Discussions: Primary care medical visits were an average of $19.80 less expensive for patients after they initiated IBH services. This resulted in an average cost savings of $71.90 per patient based on the 134 patients who received services in the 1-year period. Conclusions: Cost savings for medical visits were discovered for patients after initiating behavioral health services in an integrated primary care clinic after only 1 year. Lessons learned: IBH services are not only associated with better patient access and outcomes, these services may also reduce cost associated with subsequent medical care. Limitations: Cost was determined by reimbursement by insurance companies in this study and may not be applicable for other economic valuations. Suggestions for future research: Research analyzing the actual time pediatricians spend treating behavioral health concerns and how this impacts workflow would provide more information on impact on clinical outcomes.
Novel Endovascular Neck Reconstruction and Coiling Technique for the Treatment of a Large Wide-Necked Basilar Apex Aneurysm Through a Radial Artery Approach: 2-Dimensional Operative Video.

Herein, we demonstrate a case of a large, wide-necked, basilar apex aneurysm (BAA) that was treated with neck reconstruction-assisted coil embolization using the PulseRider device (PulsarVascular, Los Gatos, California), a novel neck-reconstruction device. A 68-yr-old man was found to have large BAA during work-up for sinusitis. Computed tomography angiogram revealed an 11 × 10-mm BAA. Patient has history of coronary artery disease, atrial fibrillation (currently taking Warfarin), recent left hip replacement and right femoral bypass. Treatment of the aneurysm was advised due to its location and size. Microsurgical clip reconstruction was high risk for general anesthesia due to his medical comorbidities and anticoagulation. Wide-necked bifurcation aneurysms are challenging to treat with traditional balloon- or stent-assisted techniques. To mitigate these challenges, novel neck-reconstruction devices have been developed. The Pulsar is one of these neck-reconstruction devices that removes the need to selectively catheterize branch arteries; it is available in a "Y" and "T" configuration. Under conscious sedation and through a radial artery approach, the patient underwent endovascular reconstruction of BAA with Pulsar device and coils. A 6-Fr guide catheter, a 0.021" microcatheter for the Pulsar device and a 0.017" microcatheter for coil delivering were used. A 3 × 8.6 mm Pulsar device was selected based on aneurysm neck and basilar artery measurements. Complete embolization (Raymond-Roy 1 obliteration) of the aneurysm was successfully achieved with no complications. The patient remained neurologically intact and was discharged on postoperative day 1. Parts of this video were published in Intracranial Aneurysms (1st Edition), Ringer (Ed), online companion to chapter 33B, Copyright Elsevier (2018).
Vertical Peer Mentoring and Advising: A Structure for Student Involvement in Multi-Level Advising

This case study describes a recently instituted learning community at North Carolina A&T State University supported by a National Science Foundation grant that has developed varied methods of mentoring and advising. This new multi-level structure and associated procedures improved mentoring and advising satisfaction among students and faculty and improved student achievement. In addition to faculty learning-community leader assistance in mentoring and advising, the students are also actively involved in the process. Their participation helps to build a stronger sense of belonging within the discipline, which in turn provides faculty with more dedicated and informed partners in the advising and mentoring process.
Elderly adults with isolated hip fractures- orthogeriatric care versus standard care: A practice management guideline from the Eastern Association for the Surgery of Trauma.

Background Elderly patients commonly suffer isolated hip fractures, causing significant morbidity and mortality. The use of orthogeriatrics (OG) management services, in which geriatric specialists primarily manage or co-manage patients after admission, may improve outcomes. We sought to provide recommendations regarding the role of OG services. Methods Using GRADE methodology with meta-analyses, the Practice Management Guidelines Committee of the Eastern Association for the Surgery of Trauma conducted a systematic review of the literature from January 1, 1900, to August 31, 2017. A single Population, Intervention, Comparator and Outcome (PICO) question was generated with multiple outcomes: Should geriatric trauma patients 65 years or older with isolated hip fracture receive routine OG management, compared with no-routine OG management, to decrease mortality, improve discharge disposition, improve functional outcomes, decrease in-hospital medical complications, and decrease hospital length of stay? Results Forty-five articles were evaluated. Six randomized controlled trials and seven retrospective case-control studies met the criteria for quantitative analysis. For critical outcomes, retrospective case-control studies demonstrated a 30-day mortality benefit with OG (OR, 0.78 [0.67, 0.90]), but this was not demonstrated prospectively or at 1 year. Functional outcomes were superior with OG, specifically improved score on the Short Physical Performance Battery at 4 months (mean difference [MD], 0.78 [0.28, 1.29]), and improved score on the Mini Mental Status Examination with OG at 12 months (MD, 1.57 [0.40, 2.73]). Execution of activities of daily living was improved with OG as measured by two separate tests at 4 and 12 months. There was no difference in discharge disposition. Among important outcomes, the OG group had fewer hospital-acquired pressure ulcers (OR, 0.30 [0.15, 0.60]). There was no difference in other complications or length of stay. Overall quality of evidence was low. Conclusion In geriatric patients with isolated hip fracture, we conditionally recommend an OG care model to improve patient outcomes. Level of evidence Systematic review/meta-analysis, level III.
Abstract 486: Deficiency of Myocardial miR-17-92 Cluster Exacerbates Ischemic Injury in Diabetic Mice

Background: Dysregulation of miRNAs is associated with the pathogenesis of cardiovascular diseases. miR-17-92 cluster has been identified as a negative regulator of inflammation in rheumatoid arthr...
Staphylococcal Superantigens: Pyrogenic Toxins Induce Toxic Shock.

Staphylococcal enterotoxin B (SEB) and related superantigenic toxins produced by Staphylococcus aureus are potent activators of the immune system. These protein toxins bind to major histocompatibility complex (MHC) class II molecules and specific Vβ regions of T-cell receptors (TCRs), resulting in the activation of both monocytes/macrophages and T lymphocytes. The bridging of TCRs with MHC class II molecules by superantigens triggers an early “cytokine storm” and massive polyclonal T-cell proliferation. Proinflammatory cytokines, tumor necrosis factor α, interleukin 1 (IL-1), IL-2, interferon γ (IFNγ), and macrophage chemoattractant protein 1 elicit fever, inflammation, multiple organ injury, hypotension, and lethal shock. Upon MHC/TCR ligation, superantigens induce signaling pathways, including mitogen-activated protein kinase cascades and cytokine receptor signaling, which results in NFκB activation and the phosphoinositide 3-kinase/mammalian target of rapamycin pathways. In addition, gene profiling studies have revealed the essential roles of innate antimicrobial defense genes in the pathogenesis of SEB. The genes expressed in a murine model of SEB-induced shock include intracellular DNA/RNA sensors, apoptosis/DNA damage-related molecules, endoplasmic reticulum/mitochondrial stress responses, immunoproteasome components, and IFN-stimulated genes. This review focuses on the signaling pathways induced by superantigens that lead to the activation of inflammation and damage response genes. The induction of these damage response genes provides evidence that SEB induces danger signals in host cells, resulting in multiorgan injury and toxic shock. Therapeutics targeting both host inflammatory and cell death pathways can potentially mitigate the toxic effects of staphylococcal superantigens.
Correction to: LIGHTAWE—case studies of LIGHT spreAd in poWder materials: a montE carlo simulation tool for research and educational purposes

In this paper, the LIGHTAWE Monte Carlo simulation tool is introduced and presented. LIGHTAWE has been developed to provide case studies of light spread in powder materials for both research and educational purposes. The algorithms of LIGHTAWE are based on Mie scattering theory and Henyey–Greenstein distribution. LIGHTAWE simulates the light ray interactions and encounters the overall optical diffusion, transmission and reflection (amount and distribution) of granular structured layers. Two main options are included: (a) fixed light point sources within the layer (concerning optical diffusion for any structure of spherical particles embedded within a surrounding medium) and (b) light distribution of 62 specific powder phosphor materials under X-ray penetration. The above options make LIGHTAWE an available and useful tool for a variety of scientific fields and applications. The capability to alter a set of parameters and perform a countless number of probable and comparable simulations, can insight and further enlighten the research of light spread performance. Based on the Monte Carlo methodology, LIGHTAWE can overcome cumbersome analytical modelling, and can take advantage of computer science to perform experiments that would be otherwise impossible (i.e., the capability to design, evaluate and optimize “virtual” experimental set-ups of “zero cost” or with “low risk” actions) enhancing curiosity-driven future research. The manuscript demonstrates the physics, the treatment and the capabilities of LIGHTAWE as well as the corresponding advantages, disadvantages, benefits and limitations. Finally, a simulation example is presented in the Appendix section.