cssi/SciSciGPT-SciSciNet huggingface dataset:
Urinary levels of phthalate metabolites and cardiovascular disease mortality (NHANES, 1999–2008)

Abstract Background Mechanistic data and results from a limited number of cross-sectional epidemiologic studies have suggested a possible link between phthalates and adverse cardiovascular outcomes. Objective To evaluate the association between urinary levels of eight phthalate metabolites and subsequent risk of cardiovascular death in a prospective cohort analysis. Methods We identified 5080 individuals 40 years or older who participated in the continuous National Health and Nutrition Examination Survey (NHANES) from 1999 to 2008 and who had measured phthalate levels available. We a priori excluded individuals in later cycles of NHANES with measured phthalates so as to have the potential of at least three years of follow-up time on all members of the cohort. Questionnaire, exam and laboratory data were merged with a public access NHANES mortality file updated through December 31, 2011. The associations between cardiovascular death and quartile levels of the phthalate metabolites were investigated using Cox proportional hazard models. Results There were 175 deaths due to cardiovascular disease deaths over a mean of 7.0 years of follow-up. No association between cardiovascular disease mortality and individual urinary phthalate metabolites was observed. After adjustments, hazard ratios comparing the highest to lowest quartile ranged from 0.73 (95%CI: 0.5–1.2) for mono-ethyl phthalate [MEP] to 1.4 (95%CI:0.8–2.5) for mono-(2-ethyl-5-hydroxyhexyl) phthalate [MEHHP]. Conclusions Urinary levels of phthalate metabolites were not associated with increased cardiovascular disease mortality. Additional larger cohort studies with longer follow-up focused on cardiovascular disease incidence are needed.
People Live Here: Maternal and Child Health on Isla Isabela, Galapagos

There has been little written about the health of the people who live in the Galapagos Islands. The goal of this study was to better understand the health concerns of women with children less than 5 years of age on Isabela Island, one of the populated islands. Multiple sources of data were collected for this study including in-depth interviews with 20 mothers. Health-related concerns included limited access to specialty care and emergency medical services, which necessitated leaving the island for many healthcare needs including childbirth; lack of a variety and sometimes a scarcity of fresh produce and therefore increased reliance on processed foods with a long shelf life; and concerns about infections caused by contaminated water and the lack of fresh drinking water. Overweight and obesity were common among the women, many of whom preferred a smaller body size. In contrast, many of their children were also at risk for or were already overweight or obese, yet their mothers still preferred a larger body size for them. Despite these concerns, most of the women appreciated the positives of living on Isabela Island, such as its tranquility, its perceived safety for their children and the opportunity for employment and higher income.
Optimizing Aqueous Fold Stability for Short Polypeptides: 20 Residue Miniprotein Constructs That Melt as High as at 61 °C

There has been significant research activity directed at designing peptide sequences that are short but still display the folding cooperativity of proteins and the development of spectroscopic methods for assessing cooperativity [1]. Miniproteins as small 26-residues [2] and β-hairpin sequences that are relatively well-folded [3,4] have been reported. There was even a report of a 20 residue β-sheet, betanova [5]. Subsequent studies [6] indicate that betanova is less than 10% folded in water. As a result we adopted the production of 20 residue systems that are folded in water as a goal in our effort to define the features required for miniprotein stability. We have previously reported [7] that truncation and mutation of a sequence found in exendin-4 (a 39-residue peptide from Gila monster saliva) resulted in soluble 20-mer miniproteins that are fully (>90%) folded in water. Herein, we present the experiments that define the features required for fold stability and the extent of folding cooperativity displayed by these systems.
E1A enhances cellular sensitivity to DNA-damage-induced apoptosis through PIDD-dependent caspase-2 activation

Expression of the adenoviral protein, E1A, sensitizes mammalian cells to a wide variety of apoptosis-inducing agents through multiple cellular pathways. For example, E1A sensitizes cells to apoptosis induced by TNF-superfamily members by inhibiting NF-kappa B (NF-κB)-dependent gene expression. In contrast, E1A sensitization to nitric oxide, an inducer of the intrinsic apoptotic pathway, is not dependent upon repression of NF-κB-dependent transcription but rather is dependent upon caspase-2 activation. The latter observation suggested that E1A-induced enhancement of caspase-2 activation might be a critical factor in cellular sensitization to other intrinsic apoptosis pathway-inducing agents. Etoposide and gemcitabine are two DNA damaging agents that induce intrinsic apoptosis. Here we report that E1A-induced sensitization to both of these agents, like NO, is independent of NF-κB activation but dependent on caspase-2 activation. The results show that caspase-2 is a key mitochondrial-injuring caspase during etoposide and gemcitabine-induced apoptosis of E1A-positive cells, and that caspase-2 is required for induction of caspase-3 activity by both chemotherapeutic agents. Expression of PIDD was required for caspase-2 activation, mitochondrial injury and enhanced apoptotic cell death. Furthermore, E1A-enhanced sensitivity to injury-induced apoptosis required PIDD cleavage to PIDD-CC. These results define the PIDD/caspase-2 pathway as a key apical, mitochondrial-injuring mechanism in E1A-induced sensitivity of mammalian cells to chemotherapeutic agents.
Second messengers derived from inositol lipids.

Many hormones, growth factors, and neurotransmitters stimulate their target cells by promoting the hydrolysis of plasma-membrane phosphoinositides to form the two second messengers, diacylglycerol and inositol 1,4,5-trisphosphate [Ins(1,4,5)P3]. In such cells, ligand-receptor interaction stimulates specific phospholipases that are activated by guanyl nucleotide regulatory G proteins or tyrosine phosphorylation. In many cells, the initial rise in cytoplasmic calcium due to Ins(1,4,5)P3-induced mobilization of calcium from agonistsensitive stores is followed by a sustained phase of cytoplasmic calcium elevation that maintains the target-cell response, and is dependent on influx of extracellular calcium. Numerous inositol phosphates are formed during metabolism of the calcium-mobilizing messenger, inositol 1,4,5-trisphosphate [Ins(1,4,5)P3)], to lower and higher phosphorylated derivatives. The cloning of several phospholipase-C isozymes, as well as the Ins(1,4,5)P3-5 kinase and the Ins(1,4,5)P3 receptor, have clarified several aspects of the diversity and complexity of the phosphoinositide-calcium signaling system. In addition to their well-established roles in hormonal activation of cellular responses such as secretion and contraction, phospholipids and their hydrolysis products have been increasingly implicated in the actions of growth factors and oncogenes on cellular growth and proliferation.
Imaging in the Evaluation of Patients with Prostate Cancer

I. Is transrectal ultrasound valuable as a prostate cancer screening tool? II. Is transrectal ultrasound useful to guide prostate biopsy? III. Is imaging accurate for staging prostate cancer? A. Ultrasound B. Computed tomography scan C. Magnetic resonance imaging D. Magnetic resonance spectroscopic imaging E. Positron emission tomography IV. How accurate is bone scan for detecting metastatic prostate cancer? A. Special case: which patients should undergo imaging after initial treatment to look for metastatic disease?
ISIS-FXIRx, a Potent Antisense Inhibitor of Factor XI, Suppresses FXI Activity and Elevates Aptt without Increased Risk of Bleeding in Cynomolgus Monkeys Following 13 Weeks of Treatment

Abstract 2255 Complications associated with increased bleeding risk are the main limitations with current anticoagulant therapy. Inhibition of factor XI (FXI), a component of the intrinsic coagulation pathway, has received considerable interest because of the potential to produce sufficient anticoagulant activity without bleeding. The objective of these studies were to characterize the efficacy and safety of ISIS-FXrx and to assess the bleeding risk associated with FXI depletion under experimental surgical settings in cynomolgus monkeys. ISIS-FXIRx was selected from a series of 2nd-generation (29-O-methoxyethyl) antisense oligonucleotides (ASOs) targeted to FXI which were evaluated for both tolerability and efficacy in cynomolgus monkeys (25 mg/kg twice per week for 13 weeks, SC). ISIS-FXIRx emerged as the most efficacious among the FXI ASOs evaluated, producing marked reductions of FXI RNA in liver, and FXI protein and activity levelsin plasma with a good tolerability profile. A more extensive dose-response evaluation of ISIS-FXrx (4,8,12 and 40 mg/kg/wk, SC) was conducted over a 13-week treatment period in cynomolgus monkeys to further assess tolerability and activity. ISIS-FXIRx produced a dose-dependent reduction in plasma FXI activity (>80% at 4 weeks of treatment at 40 mg/kg) with a concomitant increase in aPTT (33%). No effects on PT, platelets and no evidence of bleeding were observed after 13 weeks of treatment with ISIS-FXrx. ASO treatment was well tolerated at all doses tested and only produced changes typical for this chemical class of ASOs (e.g., basophilic granules in multiple tissues due do drug accumulation). ISIS-FXIRx (20 mg/kg, SC for 6 weeks) was also evaluated for bleeding risk in two experimental surgical models in cynomolgus monkeys; a tail amputation model and gum laceration model. Enoxaparin (2 mg/kg), known to increase the risk of bleeding, produced a statistically significant (p Disclosures: Younis:Isis Pharmaceuticals, Inc.: Employment. Crosby:Isis Pharmaceuticals: Employment. Zhao:Isis Pharmaceuticals: Employment. MacLeod:Isis Pharmaceuticals: Employment. Monia:Isis Pharmaceuticals: Employment. Henry:Isis Pharmaceuticals, Inc.: Employment.
Remaking Local Government: Success and Failure Under Indiana’s Government Modernization Act

During the period of 2008 to 2012, four consolidation attempts occurred under Indiana’s Government Modernization Act: two proposing city–county consolidation and two proposing town–township consolidation. The town–township mergers received overwhelming support, with more than 70% of voters approving consolidation in each case. The city–county mergers, on the other hand, were each defeated by a margin of approximately two to one. In this paper, we conduct a comparative case study of the four consolidation proposals using Leland and Thurmaier’s (2004) C3 model as an analytical framework. The results of our study indicate that greater demographic diversity and the potential for large cost shifts from urban to rural customers stimulated opposition to the city–county consolidations. The successful town–township consolidations were characterized by more homogeneous populations and modest and predictable fiscal impacts. We find no evidence that pre-existing functional consolidation or strong elite advocacy on behalf of consolidation leads to greater support for the referendum.
Assessing the value of the Meaningful Use Clinical Summary for patients and families with pediatric asthma.

Electronic clinical summaries are innovations supported by the Electronic Health Record Incentive Program, known as “Meaningful Use” (MU). The MU clinical summary documents the shared understanding...
The Mexican Drug War and Early-Life Health: The Impact of Violent Crime on Birth Outcomes

This study examines the relationship between exposure to violent crime in utero and birth weight using longitudinal data from a household survey conducted in Mexico. Controlling for selective migration and fertility, the results suggest that early gestational exposure to the recent escalation of the Mexican Drug War is associated with a substantial decrease in birth weight. This association is especially pronounced among children born to mothers of low socioeconomic status and among children born to mothers who score poorly on a mental health index.
Coherence in One-Shot Gesture Recognition for Human-Robot Interaction

An experiment was conducted where a robotic platform performs artificially generated gestures and both trained classifiers and human participants recognize. Classification accuracy is evaluated through a new metric of coherence in gesture recognition between humans and robots. Experimental results showed an average recognition performance of 89.2% for the trained classifiers and 92.5% for the participants. Coherence in one-shot gesture recognition was determined to be gamma = 93.8%. This new metric provides a quantifier for validating how realistic the robotic generated gestures are.
Divergence in the transcriptional landscape between low temperature and freeze shock in cultivated grapevine (Vitis vinifera).

Low-temperature stresses limit the sustainability and productivity of grapevines when early spring frosts damage young grapevine leaves. Spring conditions often expose grapevines to low, but not damaging, chilling temperatures and these temperatures have been shown to increase freeze resistance in other model systems. In this study, we examined whole-transcriptome gene expression patterns of young leaf tissue from cuttings of five different grapevine cultivars, exposed to chill and freeze shock, in order to understand the underlying transcriptional landscape associated with cold stress response. No visible damage was observed when grapevine leaves were exposed to chilling temperatures while freeze temperatures resulted in variable damage in all cultivars. Significant differences in gene expression were observed between warm control conditions and all types of cold stress. Exposure to chill stress (4 °C) versus freezing stress (−3 °C) resulted in very different patterns of gene expression and enriched pathway responses. Genes from the ethylene signaling, ABA signaling, the AP2/ERF, WRKY, and NAC transcription factor families, and starch/sucrose/galactose pathways were among the most commonly observed to be differentially regulated. Preconditioning leaves to chill temperatures prior to freezing temperatures resulted in slight buffering of gene expression responses, suggesting that differences between chill and freeze shock perception complicates identification of candidate genes for cold resistance in grapevine. Overall, the transcriptional landscape contrasts observed between low temperature and freezing stresses demonstrate very different activation of candidate pathways impacting grapevine cold response. An exploration of gene activity in grapevine (Vitis vinifera) suggests that these plants respond very differently to cold versus freezing temperatures. Low temperatures during the growing season (such as late spring frosts) can cause great damage to developing leaves of crops such as grapevines, particularly when grown outside their natural climatic zone. Jason Londo, of the US Department of Agriculture and Cornell University, and colleagues, explored the molecular response of young grapevine leaves to both cold (4 °C) and freezing (−3 °C) temperatures. They found very different responses in terms of genes and metabolic pathways that were activated or deactivated under the two regimes. In contrast to other species, exposure to cold did not predispose the vines to resist freezing temperatures. The research may help to identify potential targets for genetic manipulation to produce frost-resistant grapevine varieties.
Association Between Hospice Length of Stay, Health Care Utilization, and Medicare Costs at the End of Life Among Patients Who Received Maintenance Hemodialysis.

Importance Patients with end-stage renal disease are less likely to use hospice services than other patients with advanced chronic illness. Little is known about the timing of hospice referral in this population and its association with health care utilization and costs. Objective To examine the association between hospice length of stay and health care utilization and costs at the end of life among Medicare beneficiaries who had received maintenance hemodialysis. Design, Setting, and Participants This cross-sectional observational study was conducted via the United States Renal Data System registry. Participants were all 770 191 hemodialysis patients in the registry who were enrolled in fee-for-service Medicare and died between January 1, 2000, and December 31, 2014. The dates of analysis were April 2016 to December 2017. Main Outcomes and Measures Hospital admission, intensive care unit (ICU) admission, and receipt of an intensive procedure during the last month of life; death in the hospital; and costs to the Medicare program in the last week of life. Results Among 770 191 patients, the mean (SD) age was 74.8 (11.0) years, and 53.7% were male. Twenty percent of cohort members were receiving hospice services when they died. Of these, 41.5% received hospice for 3 days or fewer. In adjusted analyses, compared with patients who did not receive hospice, those enrolled in hospice for 3 days or fewer were less likely to die in the hospital (13.5% vs 55.1%; P P P P P = .08). Longer lengths of stay in hospice beyond 3 days were associated with progressively lower rates of utilization and costs, especially for those referred more than 15 days before death (35.1% hospitalized and 16.7% admitted to an ICU in the last month of life; the mean Medicare costs in the last week of life were $3221). Conclusions and Relevance Overall, 41.5% of hospice enrollees who had been treated with hemodialysis for their end-stage renal disease entered hospice within 3 days of death. Although less likely to die in the hospital and to receive an intensive procedure, these patients were more likely than those not enrolled in hospice to be hospitalized and admitted to the ICU, and they had similar Medicare costs. Without addressing barriers to more timely referral, greater use of hospice may not translate into meaningful changes in patterns of health care utilization, costs, and quality of care at the end of life in this population.
Negative Feedback Phosphorylation of Gγ Subunit Ste18 and the Ste5 Scaffold Synergistically Regulates MAPK Activation in Yeast.

Summary Heterotrimeric G proteins (Gαβγ) are essential transducers in G protein signaling systems in all eukaryotes. In yeast, G protein signaling differentially activates mitogen-activated protein kinases (MAPKs)—Fus3 and Kss1—a phenomenon controlled by plasma membrane (PM) association of the scaffold protein Ste5. Here, we show that phosphorylation of the yeast Gγ subunit (Ste18), together with Fus3 docking on Ste5, controls the rate and stability of Ste5/PM association. Disruption of either element alone by point mutation has mild but reciprocal effects on MAPK activation. Disabling both elements results in ultra-fast and stable bulk Ste5/PM localization and Fus3 activation that is 6 times faster and 4 times more amplified compared to wild-type cells. These results further resolve the mechanism by which MAPK negative feedback phosphorylation controls pathway activation and provides compelling evidence that Gγ subunits can serve as intrinsic regulators of G protein signaling.
Annals for Hospitalists Inpatient Notes - Getting Past the “Black Box”—Opportunities for Hospitalists to Improve Postacute Care Transitions

Hospitalists often lack clarity about available resources, processes of care, and outcomes for patients discharged to postacure care. This is important, because patients transitioning from the hosp...
Advances in Membrane Technologies for Drinking Water Purification

Membrane processes including microfiltration, ultrafiltration, and nanofiltration experienced rapid growth in drinking water purification applications in past two decades, as the result of a combination of regulatory, marketing, and technological driving forces. This chapter discusses several advances of membrane technologies in the context of drinking water purification with emphasis on membrane fouling and controls, interactions between membrane processes and other components of drinking water treatment processes, and advances in the research and development of new and improved membrane materials and their potential applications.
Explanatory Style Predicts Depressive Symptoms Following AIDS-Related Bereavement

The reformulated learned helplessness (RLH) diathesis–stress model of depression (L. Y. Abramson, M. E. P. Seligman, & J. D. Teasdale, 1978) was tested using the explanatory style scores of 30 gay male caregivers. Scores were derived from interviews immediately following AIDS-related bereavement. Concurrently, questionnaire measures of depressive symptoms (CES-D) and stress (Daily Hassles Scale) were taken along with repeated measures of depressive symptoms at 3, 6, 9, and 12 months following bereavement. As predicted by RLH, the interaction between Explanatory Style and Stress scores predicted subsequent depressive symptoms, with initial stress and initial depressive symptoms assuming a more powerful role early in the recovery process. Implications for treatment and future research are discussed.
TRUTH, FALLIBILITY AND THE GROWTH OF KNOWLEDGE*

According to a familiar story, beliefs qualify as knowledge only if they can be justified on the basis of impeccable first premisses via equally immaculate first principles. The story has no truth to it. Centuries of criticism suggest that our interesting beliefs are born on the wrong side of the blanket.
The Commission Prosecutor: Navigating Uncharted Ethical Waters in a Sea of International Uncertainty

The ethical challenges confronting Military Commission prosecutors is indeed unique. Unlike the 'typical' stress associated with the prosecutors obligation to 'do justice', these prosecutors face a dilemma far more complex than the question of how far to push an evidentiary rule or whether to charge an offense unsupported by probable cause. Instead, they confront the ethical dilemma created by a potential conflict between the legitimacy of two conflicting sources of law: domestic and international. On a daily basis, they must reconcile the scope of criminal liability established by Congress in the Military Commissions Act with the scope of criminality derived from the law Congress purported to codify: the law of armed conflict. The potential delta between these two sources of law creates for them an ethical dilemma of massive proportion: What is the prosecutor’s duty when the law she is told to implement is itself of suspect legality? This article will explore the source of this dilemma, and propose that it is the law of armed conflict itself that provides the most effective test for determining when executing the law may itself be inconsistent with the ultimate obligation to 'do justice.'
Questions 61–70

This chapter illustrates a variety of different scenarios of rheumatic disease in succinct question and answer format. It contains ten complex cases with potentially unusual diagnoses designed to stimulate thought and further reading in this rapidly evolving specialty.
Subsurface biogeochemistry is a missing link between ecology and hydrology in dam-impacted river corridors

Global investment in hydropower is rapidly increasing, fueled by a need to manage water availability and by incentives promoting renewable energy sources. This expansion poses unrecognized risks to the world's vulnerable freshwater ecosystems. While many hydropower impacts have been investigated, dam-induced alterations to subsurface processes influence river corridor ecosystem health in ways that remain poorly understood. We advocate for a better understanding of dam impacts on subsurface biogeochemical activity, its connection to hydrology, and follow-on trophic cascades within the broader river corridor. We delineate an integrated view of hydropower impacts in which dam-induced changes to surface water flow regimes generate changes in surface-subsurface hydrologic exchange flows (HEFs) that subsequently (1) regulate resource availability for benthic microorganisms at the base of aquatic food webs and (2) impose kinetic constraints on biogeochemical reactions and organismal growth across a range of trophic levels. These HEF-driven effects on river corridor food webs, as mediated by subsurface biogeochemistry, are a key knowledge gap in our assessment of hydropower sustainability and putatively combine with other, more well-known dam impacts to result in significant changes to river corridor health. We suggest targeted laboratory and field-based studies to link hydrobiogeochemical models used to predict heat transport, biogeochemical rates, and hydrologic flow with ecological models that incorporate biomass changes in specific categories of organisms. Doing so will enable predictions of feedbacks among hydrology, temperature, biogeochemical rates, organismal abundances, and resource transfer across trophic levels. This understanding of dam impacts on subsurface hydrobiogeochemistry and its connection to the broader aquatic food web is fundamental to enabling mechanism-based decision making for sustainable hydropower operations.
Cdk8 and Ssn801 Regulate Oxidative Stress Resistance and Virulence in Cryptococcus neoformans.

ABSTRACT Cryptococcus neoformans kills 200,000 people worldwide each year. After inhalation, this environmental yeast proliferates either extracellularly or within host macrophages. Under conditions of immunocompromise, cryptococci disseminate from the lungs to the brain, causing a deadly meningoencephalitis that is difficult and expensive to treat. Cryptococcal adaptation to the harsh lung environment is a critical first step in its pathogenesis, and consequently a compelling topic of study. This adaptation is mediated by a complex transcriptional program that integrates cellular responses to environmental stimuli. Although several key regulators in this process have been examined, one that remains understudied in C. neoformans is the Mediator complex. In other organisms, this complex promotes transcription of specific genes by increasing assembly of the RNA polymerase II preinitiation complex. We focused on the Kinase Module of Mediator, which consists of cyclin C (Ssn801), cyclin-dependent kinase 8 (Cdk8), Med12, and Med13. This module provides important inhibitory control of Mediator complex assembly and activity. Using transcriptomics, we discovered that Cdk8 and Ssn801 together regulate cryptococcal functions such as the ability to grow on acetate and the response to oxidative stress, both of which were experimentally validated. Deletion of CDK8 yielded altered mitochondrial morphology and the dysregulation of genes involved in oxidation-reduction processes. This strain exhibited increased susceptibility to oxidative stress, resulting in an inability of mutant cells to proliferate within phagocytes, decreased lung burdens, and attenuated virulence in vivo. These findings increase our understanding of cryptococcal adaptation to the host environment and its regulation of oxidative stress resistance and virulence. IMPORTANCECryptococcus neoformans is a fungal pathogen that primarily affects severely immunocompromised patients, resulting in 200,000 deaths every year. This yeast occurs in the environment and can establish disease upon inhalation into the lungs of a mammalian host. In this harsh environment it must survive engulfment by host phagocytes, including the oxidative stresses it experiences inside them. To adapt to these challenging conditions, C. neoformans deploys a variety of regulatory proteins to alter gene expression levels and enhance its ability to survive. We have elucidated the role of a protein complex that regulates the cryptococcal response to oxidative stress, survival within phagocytes, and ability to cause disease. These findings are important because they advance our understanding of cryptococcal disease, which we hope will help in the efforts to control this devastating infection.
Post-Traumatic Stress Symptoms after Pediatric Injury: Relation to Pre-Frontal Limbic Circuitry.

Abstract Pre-frontal limbic circuitry is vulnerable to effects of stress and injury. We examined microstructure of pre-frontal limbic circuitry after traumatic brain injury (TBI) or extracranial in...
Lifetime trauma exposure among those with combat-related PTSD: Psychiatric risk among U.S. military personnel.

Abstract Research has described the association between lifetime trauma exposure and psychiatric symptoms among various cohorts, but little is known about the effect of lifetime trauma histories on the symptom expression of active-duty military personnel diagnosed with combat-related posttraumatic stress disorder (PTSD). Active-duty soldiers (N = 162) were diagnosed with PTSD from deployments to Iraq or Afghanistan using the Clinician Administered PTSD Scale. Soldiers then completed self-report measures of depression, anxiety, and PTSD. Lifetime exposure to categories of trauma types and the intensity of exposure was reported on the Life Events Checklist. The number of categories of trauma that happened to them significantly predicted the severity of depression, anxiety, and PTSD symptoms, as well as a positive screen for likely depression diagnosis based on self-reported symptoms. Direct exposure to trauma explained most of the association, as witnessing trauma and hearing about trauma did not explain symptoms beyond events that happened to participants. Interpersonal traumatic events were not associated with psychiatric functioning after controlling for non-interpersonal traumatic events. Assessment of trauma history among post-9/11 service members and veterans should include the frequency and variety of lifetime trauma exposure, given the association with psychiatric functioning.
The metabolism of U.S. cities 2.0

In the fifty years since Abel Wolman first published an estimate of U.S. urban metabolism, the field of urban metabolism has begun to thrive, with cities outside the United States being much of the focus. As cities attempt to meet local and international sustainability goals, it is time to revisit the metabolism of cities within the United States. Using existing empirical databases for material flows (the Freight Analysis Framework) and a published database on urban water flux, we provide a revised estimate of urban metabolism for the typical U.S. city. We estimate median values of metabolism for a city of one million people, considering water resources, food, fuel, and construction materials. Food consumption and waste production increased substantially to 3,800 metric tons per day and 4,900 metric tons per day, respectively. To facilitate a second generation of urban metabolism, we extend traditional analyses to include the embedded energy required to facilitate material consumption with important implications in determining sustainable urban metabolism. We estimate that a city of one million people requires nearly 4,000 gigajoules of primary energy per day to facilitate its metabolism. Our results show high heterogeneity of urban metabolism across the United States. As a result of the study, we conclude that there is a distinct need to promote policies at the regional or city scale that collect data for urban metabolism studies. Urban metabolism is an important educational and decision‐making tool that, with an increase in data availability, can provide important information for cities and their sustainability goals.
Revealing interfacial disorder at the growth-front of thick many-layer epitaxial graphene on SiC: a complementary neutron and X-ray scattering investigation

Epitaxial graphene on SiC provides both an excellent source of high-quality graphene as well as an architecture to support its application. Although single-layer graphene on Si-face SiC has garnered extensive interest, many-layer graphene produced on C-face SiC could be significantly more robust for enabling applications. Little is known, however, about the structural properties related to the growth evolution at the buried interface for thick many-layer graphene. Using complementary X-ray scattering and neutron reflectivity as well as electron microscopy, we demonstrate that thick many-layer epitaxial graphene exhibits two vastly different length-scales of the buried interface roughness as a consequence of the Si sublimation that produces the graphene. Over long lateral length-scales the roughness is extremely large (hundreds of A) and it varies proportionally to the number of graphene layers. In contrast, over much shorter lateral length-scales we observe an atomically abrupt interface with SiC terraces. Graphene near the buried interface exhibits a slightly expanded interlayer spacing (∼1%) and fluctuations of this spacing, indicating a tendency for disorder near the growth front. Nevertheless, Dirac cones are observed from the graphene while its domain size routinely reaches micron length-scales, indicating the persistence of high-quality graphene beginning just a short distance away from the buried interface. Discovering and reconciling the different length-scales of roughness by reflectivity was complicated by strong diffuse scattering and we provide a detailed discussion of how these difficulties were resolved. The insight from this analysis will be useful for other highly rough interfaces among broad classes of thin-film materials.
Tarik Syndrome: Reversible Postoperative Blindness Secondary to Occipital Seizures.

Background Postoperative blindness is a devastating surgical complication. Although usually associated with prolonged cardiac and prone spinal operations, it may follow other procedures as well. Postoperative blindness is most commonly caused by a vascular etiology, but it can more rarely be caused by status epilepticus. We have previously reported a case of this phenomenon following a staged spinal deformity surgery. Case Description Here we report 2 additional cases following a skull base procedure and a single stage lumbar spine surgery. In all instances, rapid recognition that the patients' blindness was due to occipital seizures resulted in acute antiepileptiform treatment and full restoration of vision. Conclusions Although a rare phenomenon, this syndrome, first recognized and described by Tarik F. Ibrahim, should be considered in any patient with postoperative visual impairment.
Design of a Robotic Crib Mobile to Support Studies in the Early Detection of Cerebral Palsy: A Pilot Study

According to data from the Centers for Disease Control and Prevention, developmental disorders such as Autism Spectrum Disorder (ASD) and Cerebral Palsy (CP) affect nearly one in six children between the ages of 3 to 17 in the United States alone. In order to improve the quality of life for these individuals, there is increased emphasis on providing early intervention at infancy, when key developmental milestones are being achieved. This however requires accurate early detection of motor development delays in at-risk infants. Our research focuses on enabling early detection through the design of a robotic crib mobile that affects infant behavior. Stimuli integrated into the robotic mobile can be used to encourage certain motions such as kicking among infants in order to study infant motor development and identify at-risk populations. In this paper, we propose the design of such a robotic crib mobile and discuss preliminary results from deploying the mobile in the infants’ home environment during a pilot study.
Orthographic neighborhood size volatility analysis in the context of writing assessment

Abstract Writing assessment was conducted using the orthographic neighborhood size as a numerical measure of transforming literacy to numeracy. The neighborhood size was calculated using the free online CLEARPOND technology from Northwestern University. The transformed numerical information can be viewed as a time series where fluctuation analysis could be applied. The concept of volatility used in stock market analysis was employed to analyze the fluctuation of the orthographic neighborhood sizes in short essays assigned to students in an introductory astronomy course offered by an open admission community college. The results showed that writing containing scientific words with low neighborhood sizes exhibited high volatility, consistent with high-demand cognitive tasks students were asked to perform. A random shuffling of the words in a sentence generated word-list sequences where the students would be asked to exercise rules of grammar to select the correct sequence. The hypothesis that the reading of a high volatility in the neighborhood size histogram would be expected to correspond to a high-demand cognitive task was tested in this exploratory project. The CLEARPOND output contained a list of phonological neighborhood sizes and the association of orthographic volatility with phonological volatility is also studied with additional examples from presidential debate sentences and song lyrics. This proof of concept volatility project brings stock market analysis, based on econometric methodology, into writing and language studies that demand precision comparison. The volatility analysis results in comparison to lexical diversity analysis results are also discussed.
Rationale and design of "Hearts & Parks": study protocol for a pragmatic randomized clinical trial of an integrated clinic-community intervention to treat pediatric obesity.

The prevalence of child and adolescent obesity and severe obesity continues to increase despite decades of policy and research aimed at prevention. Obesity strongly predicts cardiovascular and metabolic disease risk; both begin in childhood. Children who receive intensive behavioral interventions can reduce body mass index (BMI) and reverse disease risk. However, delivering these interventions with fidelity at scale remains a challenge. Clinic-community partnerships offer a promising strategy to provide high-quality clinical care and deliver behavioral treatment in local park and recreation settings. The Hearts & Parks study has three broad objectives: (1) evaluate the effectiveness of the clinic-community model for the treatment of child obesity, (2) define microbiome and metabolomic signatures of obesity and response to lifestyle change, and (3) inform the implementation of similar models in clinical systems. Methods are designed for a pragmatic randomized, controlled clinical trial (n = 270) to test the effectiveness of an integrated clinic-community child obesity intervention as compared with usual care. We are powered to detect a difference in body mass index (BMI) between groups at 6 months, with follow up to 12 months. Secondary outcomes include changes in biomarkers for cardiovascular disease, psychosocial risk, and quality of life. Through collection of biospecimens (serum and stool), additional exploratory outcomes include microbiome and metabolomics biomarkers of response to lifestyle modification. We present the study design, enrollment strategy, and intervention details for a randomized clinical trial to measure the effectiveness of a clinic-community child obesity treatment intervention. This study will inform a critical area in child obesity and cardiovascular risk research—defining outcomes, implementation feasibility, and identifying potential molecular mechanisms of treatment response. NCT03339440 .
Latent Factor Structure and Measurement Invariance of the NIH Toolbox Cognition Battery in an Alzheimer's Disease Research Sample.

Objective: This study investigated the latent factor structure of the NIH Toolbox Cognition Battery (NIHTB-CB) and its measurement invariance across clinical diagnosis and key demographic variables including sex, race/ethnicity, age, and education for a typical Alzheimer’s disease (AD) research sample. Method: The NIHTB-CB iPad English version, consisting of 7 tests, was administered to 411 participants aged 45–94 with clinical diagnosis of cognitively unimpaired, dementia, mild cognitive impairment (MCI), or impaired not MCI. The factor structure of the whole sample was first examined with exploratory factor analysis (EFA) and further refined using confirmatory factor analysis (CFA). Two groups were classified for each variable (diagnosis or demographic factors). The confirmed factor model was next tested for each group with CFA. If the factor structure was the same between the groups, measurement invariance was then tested using a hierarchical series of nested two-group CFA models. Results: A two-factor model capturing fluid cognition (executive function, processing speed, and memory) versus crystalized cognition (language) fit well for the whole sample and each group except for those with age < 65. This model generally had measurement invariance across sex, race/ethnicity, and education, and partial invariance across diagnosis. For individuals with age < 65, the language factor remained intact while the fluid cognition was separated into two factors: (1) executive function/processing speed and (2) memory. Conclusions: The findings mostly supported the utility of the battery in AD research, yet revealed challenges in measuring memory for AD participants and longitudinal change in fluid cognition.
PPARG in osteocytes controls sclerostin expression, bone mass, marrow adiposity and mediates TZD-induced bone loss.

Abstract The peroxisome proliferator activated receptor gamma (PPARG) nuclear receptor regulates energy metabolism and insulin sensitivity. In this study, we present novel evidence for an essential role of PPARG in the regulation of osteocyte function, and support for the emerging concept of the conjunction between regulation of energy metabolism and bone mass. We report that PPARG is essential for sclerostin production, a recently approved target to treat osteoporosis. Our mouse model of osteocyte-specific PPARG deletion (Dmp1CrePparγflfl or γOTKO) is characterized with increased bone mass and reduced bone marrow adiposity, which is consistent with upregulation of WNT signaling and increased bone forming activity of endosteal osteoblasts. An analysis of osteocytes derived from γOTKO and control mice showed an excellent correlation between PPARG and SOST/sclerostin at the transcript and protein levels. The 8 kb sequence upstream of Sost gene transcription start site possesses multiple PPARG binding elements (PPREs) with at least two of them binding PPARG with dynamics reflecting its activation with full agonist rosiglitazone and correlating with increased levels of Sost transcript and sclerostin protein expression (Pearson's r = 0.991, p = 0.001). Older γOTKO female mice are largely protected from TZD-induced bone loss providing proof of concept that PPARG in osteocytes can be pharmacologically targeted. These findings demonstrate that transcriptional activities of PPARG are essential for sclerostin expression in osteocytes and support consideration of targeting PPARG activities with selective modulators to treat osteoporosis.
Association Between Breast Arterial Calcification on Mammography and Coronary Artery Disease: A Systematic Review and Meta-Analysis.

Background: Breast arterial calcification (BAC), which may be detected during screening mammography, is hypothesized to be a noninvasive imaging marker that may enhance cardiovascular risk assessme...
3 Years, 2 Papers, 1 Course Off: Optimal Non-Monetary Reward Policies

We consider a principal who periodically offers a fixed, binary, and costly non-monetary reward to agents endowed with private information, to incentivize the agents to invest effort over the long run. An agent's output, as a function of his effort, is a priori uncertain and is worth a fixed per-unit value to the principal. The principal's goal is to design an attractive reward policy that specifies how the rewards are to be given to an agent over time, based on that agent's past performance. This problem, which we denote by P, is motivated by practical examples from both academia (a reduced teaching load for achieving a certain research-productivity threshold) and industry ("Supplier of the Year" awards in recognition of excellent past performance). The following "limited-term'' reward policy structure has been quite popular in practice: The principal evaluates each agent periodically; if an agent's performance over a certain (limited) number of periods in the immediate past exceeds a pre-defined threshold, then the principal rewards him for a certain (limited) number of periods in the immediate future. For the deterministic special case of problem P, where there is no uncertainty in any agent's output given his effort, we show that there always exists an optimal policy that is a limited-term policy and also obtain such a policy. When agents' outputs are stochastic, we show that the class of limited-term policies may not contain any optimal policy of problem P but is guaranteed to contain policies that are arbitrarily near-optimal: Given any epsilon>0, we show how to obtain a limited-term policy whose performance is within epsilon of that of an optimal policy. This guarantee depends crucially on the use of sufficiently long histories of the agents' outputs for the determination of the rewards. In situations where access to this historical information is limited, we derive structural insights on the role played by (i) the length of the available history and (ii) the variability in the random variable governing an agent's output, on the performance of this class of policies. Finally, we introduce and analyze the class of "score-based'' reward policies - we show that this class is guaranteed to contain an optimal policy and also obtain such a policy.
Comparison between acupuncture therapy and gabapentin for chronic pain: a pilot study:

Background:We examined whether the effect of true electroacupuncture on pain and functionality in chronic pain participants can be differentiated from that of medication (gabapentin) by analyzing q...
Online cheating at the intersection of the dark triad and fraud diamond

Abstract Academic misconduct is an issue that has plagued educators for as long as there have been formal performance assessments, and the technological advances in recent years have exacerbated an already vexing problem. Today’s student has a broad array of resources available to assist in their learning process. Unfortunately, many of those resources can be used to actively circumvent that process. A variety of assignment assistance websites offer students fee-based access to content ranging from publisher-provided test banks and homework solutions to course specific material generated by the instructor. Unauthorized access to these materials constitutes academic fraud. In this study we evaluate student use of these websites by developing a comprehensive framework consisting of the Dark Triad constellation of personality traits and the Fraud Diamond elements. We find that each Dark Triad trait exerts a unique influence on the Fraud Diamond elements, which in turn are associated with students’ intentions to access and use these websites.