cssi/SciSciGPT-SciSciNet huggingface dataset:
Emission Constrained Dynamic Scheduling for Ethylene Cracking Furnace System

The scheduling of an ethylene cracking furnace system should not only focus on the plant profitability but also address the concern of environmental sustainability. On the basis of the previous study (Zhao et al.1), this Article has developed a new scheduling model for the optimal operation of the cracking furnace system in ethylene plants by considering more practical operating features, such as nonhomogeneous last-batch ending times and furnace load makeups, as well as the background air-quality conscious decoking. With the newly developed model, the simultaneous furnace shutdown can be successfully avoided at the end of the scheduling time horizon; meanwhile, certain manufacturing capacity losses and upsets can be alleviated during furnace decoking operations. Furthermore, the obtained scheduling solution will be responsible for background air-quality concerns by wisely allocating furnace decoking emission peaks into time windows that would cause less adverse environmental impacts. The efficacy of the ...
Diversity or Segregation? A Multi-decadal Spatial Analysis of Demographics of Atlanta Neighborhoods

The City of Atlanta has seen phenomenal urban expansion, racial re-composition, and migration patterns over decades. In this paper, we try to answer overarching question: Has the economic development and urban sprawl in Atlanta been accompanied by racially diverse neighborhoods? Or has the economic development in Atlanta led to a racially integrated landscape? We use demographic data from the U.S. Census Bureau, the Internal Revenue Service, and the Panel Study for Income Dynamics. First, we use hotspot analysis to study temporal changes in spatial patterns of concentration of the black population in Atlanta. Second, using the index of dissimilarity (D) and interaction index (I), we estimate the extent of segregation between whites and blacks. Third, we calculate the migration effectiveness in three sub-regions of Atlanta. The results show that hotspots of the black population are located in the central and south-central parts of Atlanta, and have expanded predominantly in the eastern and southern directions during the last four decades. Racial diversity has increased generally in the counties immediately north of the city proper, but the southern and peripheral counties had less racial diversity. Remarkably, southern Atlanta did not witness the economic development in the same way as northern Atlanta. The migration effectiveness index shows that, in recent years, Atlanta suburbs attracted more migrants, both from within the Atlanta region and from the rest of the United States, as compared to the Atlanta city proper. In recent decades, neighborhoods in the Suburb-I becoming racially more diverse, and one would expect this trend will extend in other regions too in the future.
Conversações, Controvérsias e Cálculos em um Chilam Balam de Yucatan Inédito

Neste artigo, eu exploro os beneficios e os perigos do contato intercultural no contexto da criacao e da difusao dos livros Chilam Balam, que sao textos sagrados que foram compilados, principalmente, durante o periodo colonial e utilizados por comunidades maias de Yucatan. Apresento os resultados de meu trabalho de campo nessa area que inclui a narrativa do desaparecimento e da re-criacao de um Chilam Balam inedito, bem como uma reproducao parcial de seu conteudo, incluindo um capitulo sobre os Numeros Maias e uma colecao de hieroglifos maias. Essa reproducao do manuscrito original inedito de Chilam Balam e uma contribuicao unica para o campo dos estudos maias e evidencia a episteme maia com relacao aos numeros, ao tempo e ao universo.
Actin assembly-inducing protein ActA promotes FcγRIa-mediatedListeriainternalization

Listeria monocytogenes is a Gram-positive intracellular pathogen and the causative agent of human listeriosis. While the ability of L. monocytogenes to enter and survive in professional phagocytes is critical to establish a successful infection, mechanisms of invasion are poorly understood. Our previous investigation into the role of type I interferon-stimulated genes in bacterial infection revealed that the human immunoglobulin receptor FcγRIa served as a L. monocytogenes invasion factor. FcγRIa-mediated L. monocytogenes entry occurred independently of immunoglobulin interaction or bacterial internalins. However, the bacterial determinants that mediate FcγRIa interaction remain unclear. Using a comparative genomics approach, we identify actin assembly-inducing protein ActA as a pathogen specific ligand of FcγRIa. FcγRIa enhanced entry of pathogenic L. monocytogenes and L. ivanovii strain but not non-pathogenic L. innocua . We found that the major virulence regulator PrfA is required for pathogen entry into FcγRIa-expressing cells and identify its gene target actA as the critical Listeria ligand. ActA alone was sufficient to promote entry into FcγRIa-expressing cells, and this function is independent of its actin nucleating activity. Together, these studies present an unexpected role of ActA beyond its canonical function in actin-based motility and expand our understanding of Listeria strategies for host cell invasion.
Social Workers' Contribution to Genetic Counseling:

A trend to a climate more conducive to constructive work with the objective reality of a defect does not lessen the emotional impact of the diagnosis
Male Louisiana Waterthrush (Parkesia motacilla) successfully defends nest from juvenile ratsnake

ABSTRACT The use of video cameras to monitor avian nests has allowed identification of key nest predator species and could potentially improve our understanding of parental nest defense. For songbirds, cameras have often shown snakes to be the most common nest predator, although video evidence of passerines successfully defending nests against snakes is lacking. We describe the first evidence of a small passerine, the Louisiana Waterthrush, successfully thwarting a possible predation attempt by a juvenile ratsnake. This recording documents rarely observed nest defense behavior and allows us to consider how this event fits within theories of optimal nest defense.
Detecting Nonmetallic Mines Under Rough Ground Using Semi-Analytic Mode Matching

Ground penetrating radar detection of plastic land mines buried in lossy, dielectric soils under rough ground surfaces is only possible with wide bandwidth probing signals. Using the new semi-analytic mode matching (SAMM) algorithm, we model the ultra-wide bandwidth scattering of these low-contrast buried targets, using computed time domain signatures to facilitate detection. It is shown that differences between the characteristic time peaks of the non-specular signature are primarily dependent on the size, shape and material characteristics of the target, and less so on its burial depth, background soil, or ground surface roughness. Differences between time peaks are attributed to multiple roundtrip transit times through the target which are largely independent of the ground characteristics.
On federalism, freedom, and the founders' view of retained rights: A reply to randy barnett

I want to thank Randy Barnett for commenting on my article, A TextualHistorical Theory of the Ninth Amendment. Professor Barnett's essays on the Ninth Amendment in the 1990s triggered the modern debate over the original meaning of the Ninth, and his recent book, Restoring the Lost Constitution, synthesizes his earlier work and presents a sophisticated theory of constitutional rights.1 I welcome his thoughts and I completely understand his critical stance regarding my work; if my conclusions are correct they significantly undermine some of Barnett's key assertions about the original meaning and modern application of the Ninth Amendment. In his current essay, I believe that Barnett has identified some conceptual issues that could benefit from some additional clarification. His "individualist" reading of the Ninth and Tenth Amendments, however, is at odds with the common understanding of popular sovereignty at the time of the Founding and is contradicted by key pieces of historical evidence. Most of all, Barnett's failure to address Madison's actual testimony about the federalist meaning of the Ninth and Tenth Amendments critically undermines his effort to put a libertarian spin on an expressly federalist historical record. Professor Barnett's response2 and this Reply present only a snapshot of the larger historical debate between Barnett and myself regarding the original meaning of the Ninth Amendment. A more detailed look at the original sources which constitute the subject of this debate can be found in two articles I originally published in the Texas Law Review and in a forthcoming article in
DNase I — Actin Interaction in the Epidermis and Its Influence on Epidermal Metabolism

There are several indications that the reaction of monomeric protein, G-actin, to form F-actin (microfilaments) [7], and its depolymerization to reform G-actin may be linked to other metabolic events. A possible association of this change with a metabolic role is suggested by two separate reactions which occur with the addition of a pulse of cytochalasin B (CB); one causes the reversible change in microfilaments while the other influences epidermal proliferation [6] (cells traverse G1 to S phase within 17 h after a pulse of CB, compared with a normal time of 87 h.
Malignant Cells Can Be Sensitized to Undergo Growth Inhibition and Apoptosis by Arsenic Trioxide Through Modulation of the Glutathione Redox System

Arsenic trioxide (As2O3) induces clinical remission in acute promyelocytic leukemia (APL) with minimal toxicity and apoptosis in APL-derived NB4 cells at low (1 to 2 μmol/L) concentration. We examined the basis for NB4 cell sensitivity to As2O3 to identify experimental conditions that would render other malignant cells responsive to low concentrations of As2O3. The intracellular glutathione (GSH) content had a decisive effect on As2O3-induced apoptosis. Highly sensitive NB4 cells had the lowest GSH and the sensitivity of other cell lines was inversely proportional to their GSH content. The t(14;18) B-cell lymphoma cell line had low GSH levels and sensitivity to As2O3 at levels slightly higher than in APL cells. Experimental upmodulation of GSH content decreased the sensitivity to As2O3. Ascorbic acid and buthionine sulfoxide (BSO) decreased GSH to a greater extent, and rendered malignant cells more sensitive to As2O3. As2O3-induced apoptosis was not enhanced by ascorbic acid in normal cells, suggesting that the combination of ascorbic acid and As2O3may be selectively toxic to some malignant cells. Ascorbic acid enhanced the antilymphoma effect of As2O3 in vivo without additional toxicity. Thus, As2O3alone or administered with ascorbic acid may provide a novel therapy for lymphoma.
Computational Toxicology Experience and Applications for Risk Assessment in the Pharmaceutical Industry

The costs of developing new drugs continue to rise while public and governmental expectations demand safer drugs. This demand for safer drugs can also significantly delay the time it takes to reach the market, as screening for drug safety can be a time-consuming process. In order to reduce costs and timelines while increasing safety, pharmaceutical firms have incorporated predictive methodologies to identify potential safety issues before a new drug is given to patients or even before a compound is tested in animals. Initial predictive efforts have focused on using compound structure to predict toxicity. This work has led to a number of successes in the ability to predict genotoxicity and carcinogenicity. In this chapter, we describe some of the methods used in pharmaceuticals to predict these adverse effects as well as methodologies used to predict organ-specific toxicity such as drug-induced liver injury, a major risk for new drugs. More recently, pharmaceuticals have begun to consider gene information when predicting toxicities. Activity against major risk genes such as the hERG is now routinely used to identify some risks. Finally, we discuss some approaches being developed to predict and/or categorize risk using gene, protein, or metabolite changes.
Health policy and systems research: the future of the field

Health policy and systems research (HPSR) has changed considerably over the last 20 years, but its main purpose remains to inform and influence health policies and systems. Whereas goals that underpin health systems have endured – such as a focus on health equity – contexts and priorities change, research methods progress, and health organisations continue to learn and adapt, in part by using HPSR. For HPSR to remain relevant, its practitioners need to re-think how health systems are conceptualised, to keep up with rapid changes in how we diagnose and manage disease and use information, and consider factors affecting people’s health that go well beyond healthcare systems. The Sustainable Development Goals (SDGs) represent a shifting paradigm in human development by seeking convergence across sectors. They also offer an opportunity for HPSR to play a larger role, given its pioneering work on applying systems thinking to health, its focus on health equity, and the strength of its multi-disciplinary approaches that make it a good fit for the SDG era. Globally, population health is being challenged in different ways, from climate change and growing air pollution and toxic environmental exposure to food insecurity, massive population migration and refugee crises, to emerging and re-emerging diseases. Each of these trends reinforce each other and concentrate their harms on the most vulnerable populations. Multi-level governance, together with novel regulatory strategies and socially oriented investments, are key to successful action against many of the new challenges, with HPSR guiding their design and evolution. The HPSR community cannot be complacent about its successful, yet short, history. Tensions remain about how different stakeholders use HPSR such as the contrast between embedding research within government institutions versus independently evaluating and holding decision-makers accountable. Such tensions are inevitable in the boundary-spanning field that HPSR has become. We should strive to enhance the influence of HPSR by staying relevant in a changing world and embracing the strength of our diversity of disciplines, the range of problems addressed, and the opportunity of the SDGs to ensure that health and social benefits are more inclusive for people within and across countries.
PERSONALITY TRAITS AS PREDICTORS OF PERFECTIONISM

The aim of this study was to explore the role of personality traits as predictors of perfectionism and to determine the existence of gender differences in the ways perfectionism is manifested. The study was conducted on 302 respondents aged 18 to 57. The Perfectionism Inventory scale (PI) used to measure perfectionism assesses lower-order perfectionism facets: Concern Over Mistakes, High Standards for Others, Need for Approval, Organization, Perceived Parental Pressure, Planfulness, Rumination, and Striving for Excellence; and three higher-order facets: Conscientious Perfectionism, Self-Evaluative Perfectionism and Perfectionism Inventory Composite. The Big Five Inventory (BFI), based on the Big Five model of personality, was used for the evaluation of personality traits: Extraversion, Neuroticism, Conscientiousness, Agreeableness and Openness to experience. In determining gender differences, the t-test was used. Men scored higher than women on Organization, Planfulness, and Conscientious Perfectionism, whereas women scored higher than men on Perceived Parental Pressure. Three multiple regression analyses were conducted, one for each of the tested criterion variables, to test the significance of predictors of perfectionism. Predictor variables were the five dimensions of personality traits, and the criterion variables were the dimensions of higher-order perfectionism. All three tested models have statistical significance, and the sum of the predictors, made up of basic personality traits, accounts for one-fifth to one-third of the variance in the criterion measures of perfectionism. Almost all personality traits are shown to be significant predictors of perfectionism, with the exception of Conscientiousness, which is not a predictor of Self-Evaluative Perfectionism. Based on the results, it can be concluded that perfectionists generally keep to themselves, are less tolerant towards others, often worry, are sensitive to their own actions as well as those of others, but also open to new experiences. The obtained results contribute to a better understanding of the social adaptation and functioning of young adults, including young athletes.
Cancer cachexia impairs neural respiratory drive in hypoxia but not hypercapnia.

Background Cancer cachexia is an insidious process characterized by muscle atrophy with associated motor deficits, including diaphragm weakness and respiratory insufficiency. Although neuropathology contributes to muscle wasting and motor deficits in many clinical disorders, neural involvement in cachexia-linked respiratory insufficiency has not been explored. Methods We first used whole-body plethysmography to assess ventilatory responses to hypoxic and hypercapnic chemoreflex activation in mice inoculated with the C26 colon adenocarcinoma cell line. Mice were exposed to a sequence of inspired gas mixtures consisting of (i) air, (ii) hypoxia (11% O2 ) with normocapnia, (iii) hypercapnia (7% CO2 ) with normoxia, and (iv) combined hypercapnia with hypoxia (i.e. maximal chemoreflex response). We also tested the respiratory neural network directly by recording inspiratory burst output from ligated phrenic nerves, thereby bypassing influences from changes in diaphragm muscle strength, respiratory mechanics, or compensation through recruitment of accessory motor pools. Results Cachectic mice demonstrated a significant attenuation of the hypoxic tidal volume (0.26mL±0.01mL vs 0.30mL±0.01mL; p 0.05), breathing frequency (392±5bpm vs 408±5bpm; p>0.05) and phrenic nerve (93.1±8.8% vs 111.1±13.2%; p>0.05) responses were not affected. Further, the concurrent hypercapnia/hypoxia tidal volume (0.45±0.01mL vs 0.45±0.01mL; p>0.05), breathing frequency (395±7bpm vs 400±3bpm; p>0.05), and phrenic nerve (106.8±7.1% vs 147.5±38.8%; p>0.05) responses were not different between C26 cachectic and control mice. Conclusions Breathing deficits associated with cancer cachexia are specific to the hypoxic ventilatory response and, thus, reflect disruptions in the hypoxic chemoafferent neural network. Diagnostic techniques that detect decompensation and therapeutic approaches that support the failing hypoxic respiratory response may benefit patients at risk for cancer cachectic-associated respiratory failure.
Steroid responsive migratory brain lesions causing intractable epilepsy in multiple myeloma. (P6.184)

Objective: Description of a patient with multiple myeloma presenting with intractable epilepsy, steroid responsive, and recurrent abnormal T2 signal on brain magnetic resonance imaging (MRI). Background: Paraneoplastic epilepsy has been described in association with multiple malignancies and has been related to the presence of various antibodies, and/or malignancy spread to the central nervous system (CNS). Here we describe a unique presentation of refractory epilepsy associated with steroid responsive CNS lesions in the setting of multiple myeloma. Design/Methods: N/A Results: A 64 year old man presented with episodic expressive aphasia. His medical history was significant for IgA Kappa multiple myeloma with metastases to the spine since 2013; treated with radiation, chemotherapy, and autologous hematopoietic stem cell transplant. MRI showed abnormal T2 hyperintense signal on juxtacortical white matter and cortex with no restricted diffusion or contrast enhancement. Seizures seen on EEG were treated. Paraneoplastic, infectious, and malignancy work up was negative, except for >5 oligoclonal bands in serum and CSF suggesting systemic inflammation with secondary CNS involvement. Two weeks later the symptoms reoccurred. MRI showed progression and intravenous solumedrol (IVSM) treatment lead to clinical and radiological improvement. Follow up MRI four months later showed resolution of findings. However, a few weeks later, he presented with status epilepticus (SE). MRI showed multiple new lesions; he received IVSM, which provided a satisfactory response. He was discharged on prednisone. MRI two months later showed marked improvement and prednisone was reduced to 20mg/day. In July, symptoms reoccurred so he was treated again for SE and his MRI showed extensive new lesions. Despite aggressive treatment with anticonvulsants, IVSM and intravenous immunoglobulin, clinical, electrographic and radiographic progression persisted. Family opted for comfort care. Conclusions: Better recognition and management of different presentations of various paraneoplastic syndromes represent new challenges in the management of patients with malignancies. Further studies in paraneoplastic syndromes are needed. Disclosure: Dr. G. Prieto has nothing to disclose. Dr. Giglio has nothing to disclose. Dr. Puduvalli has received personal compensation for activities with Novartis and Genentech as a scientific advisory board member. Dr. Pudavalli has received research support from Genentech and Merck.
CONGENTIAL LONG QT SYNDROME UNMASKED IN POSTPARTUM

Congenital long QT syndrome (LQTS) is a rare entity that predominantly has a autosomal dominant inheritance patterns. These patterns encode for cardiac ion channels and can remain clinically silent until a patient(Pt) is exposed to a particular predisposing factor which can lead to polymorphic
Unmet Mental Health Care Needs among Asian Americans 10⁻11 Years After Exposure to the World Trade Center Attack.

This study investigated the prevalence of unmet mental health care needs (UMHCN) and their associated factors among 2344 Asian Americans directly exposed to the World Trade Center (WTC) attack 10–11 years afterwards. Given the pervasive underutilization of mental health services among Asians, their subjective evaluation of unmet needs could provide more nuanced information on disparities of service. We used the WTC Health Registry data and found that 12% of Asian Americans indicated UMHCN: 69% attributing it to attitudinal barriers, 36% to cost barriers, and 29% to access barriers. Among all the factors significantly related to UMHCN in the logistic model, disruption of health insurance in the past year had the largest odds ratio (OR = 2.37, 95% confidence interval: 1.61–3.48), though similar to functional impairment due to mental disorders. Post-9/11 mental health diagnosis, probable mental disorder and ≥14 poor mental health days in the past month were also associated with greater odds of UMHCN, while greater social support was associated with lower odds. Results suggest that continued outreach efforts to provide mental health education to Asian communities to increase knowledge about mental illness and treatment options, reduce stigmatization of mental illness, and offer free mental health services are crucial to address UMHCN.
Progressive Multicomponent Intervention for Older Adults in Home Health Settings Following Acute Hospitalization: Randomized Clinical Trial Protocol.

Background Hospitalization is a profound contributor to functional loss for older adults. Many modifiable risk factors (ie, weakness) may persist after hospitalization, representing portents of poor health, re-hospitalization, or death. Older adults frequently receive home health (HH) care after hospitalization to manage functional deficits that have worsened during hospital stays. However, how best to manage these deficits in HH settings has yet to be determined. Objective The objective is to determine if a higher intensity, progressive, multi-component (PMC) intervention, initiated upon admission to HH after an acute hospitalization, improves objectively measured and self-reported physical function more than usual care (UC) physical therapy. Design This will be a 2-arm randomized controlled clinical trial. Setting The setting will be participant homes. Participants A total of 200 older adults with deconditioning following acute hospitalization and referred for HH physical therapy will participate. Intervention Participants will be randomized to either a PMC treatment group or a UC group and receive 12 therapy visits over a 60-day period. PMC participants will perform lower extremity resistance training at 80% of a 1-repetition maximum, task-specific activities of daily living training, along with advanced gait and balance training. PMC groups will also receive nutritional supplementation and nursing support during transition from hospital to home. The UC group will receive standard of care HH interventions. Measurements Physical performance, self-reported function, fatigue, and health care utilization outcomes will be measured at baseline, 30 days, 60 days, 90 days, and 180 days. All measures will be assessed by blinded study personnel. Limitations The limitation is an inability to blind treating therapists to study allocation. Conclusions The authors hope to determine whether higher intensity, multi-component exercise interventions improve outcomes more than UC physical therapy for older adults recovering from acute hospitalization in HH settings.
Membrane bubble column reactor model for the production of hydrogen by methane pyrolysis

Abstract A membrane reactor model is developed to describe, model, and design molten metal methane pyrolysis bubble column reactors. It is utilized to demonstrate that a membrane reactor allows conversions in excess of the equilibrium conversion implied by the feed and operating conditions. Ultra-high conversion eliminates the need to separate product hydrogen from unreacted methane, thereby eliminating the need to recycle un-reacted methane and reducing the total equipment sizes and energy costs. Furthermore, it is shown that the hydrogen can be completely removed through the membrane reactor walls before the gas bubbles breakthrough the molten metal layer into the reactor headspace. The equations also apply to non-membrane reactors, and are therefore useful for future general conceptual design studies. The general applicability is demonstrated by comparison of the model predictions to published experimental data on methane pyrolysis in a non-membrane bubble column reactor.
Prediction of recurrent glioblastoma after laser interstitial thermal therapy: The role of diffusion imaging.

Background Evaluate the utility of diffusion-weighted imaging (DWI) for the assessment of local recurrence of glioblastoma (GBM) on imaging performed 24 h following MRI-guided laser interstitial thermal therapy (LITT). We hypothesize that microscopic peritumoral infiltration correlates with early subtle variations on DWI images and apparent diffusion coefficient (ADC) maps. Methods Of 64 patients with GBM treated with LITT, 39 had MRI scans within 24 h after undergoing LITT. Patterns on DWI images and ADC maps 24 h following LITT were correlated with areas of future GBM recurrence identified through coregistration of subsequent MRI examinations. In the areas of suspected recurrence within the periphery of post-LITT lesions, signal intensity values on ADC maps were recorded and compared with the remaining peritumoral ring. Results Thirty-nine patients with GBM met the inclusion criteria. For predicting recurrent GBM, areas of decreased DWI signal and increased signal on ADC maps within the expected peritumoral ring of restricted diffusion identified 24 h following LITT showed 86.1% sensitivity, 75.2% specificity, and high correlation (r = 0.53) with future areas of GBM recurrence (P < .01). Areas of future recurrence demonstrated a 37% increase in the ADC value (P < .001), compared with findings in the surrounding treated peritumoral region. A significantly greater area under the receiver operating characteristics curve was determined for ADC values (P < .01). Conclusions DWI obtained 24 h following LITT can help predict the location of GBM recurrence months before the development of abnormal enhancement. This may alter future treatment planning, perhaps suggesting areas that may be targeted for additional therapy.
Liver Resection Improves Survival in Colorectal Cancer Patients: Causal-effects From Population-level Instrumental Variable Analysis.

OBJECTIVE The aim of this study was to estimate population-level causal effects of liver resection on survival of patients with colorectal cancer liver metastases (CRC-LM). BACKGROUND A randomized trial to prove that liver resection improves survival in patients with CRC-LM is neither feasible nor ethical. Here, we test this assertion using instrumental variable (IV) analysis that allows for causal-inference by controlling for observed and unobserved confounding effects. METHODS We abstracted data on patients with synchronous CRC-LM using the California Cancer Registry from 2000 to 2012 and linked the records to the Office of Statewide Health Planning and Development Inpatient Database. We used 2 instruments: resection rates in a patient's neighborhood (within 50-mile radius)-NALR rate; and Medical Service Study Area resection rates-MALR rate. IV analysis was performed using the 2SLS method. RESULTS A total of 24,828 patients were diagnosed with stage-IV colorectal cancer of which 16,382 (70%) had synchronous CRC-LM. Liver resection was performed in 1635 (9.8%) patients. NALR rates ranged from 8% (lowest-quintile) to 11% (highest-quintile), whereas MALR rates ranged from 3% (lowest quintile) to 19% (highest quintile). There was a strong association between instruments and probability of liver resection (F-statistic at median cut-off: NALR 24.8; MALR 266.8; P < 0.001). IV analysis using both instruments revealed a 23.6 month gain in survival (robust SE 4.4, P < 0.001) with liver resection for patients whose treatment choices were influenced by the rates of resection in their geographic area (marginal patients), after accounting for measured and unmeasured confounders. CONCLUSION Less than 10% of patients with CRC-LM had liver resection. Significant geographic variation in resection rates is attributable to community biases. Liver resection leads to extensive survival benefit, accounting for measured and unmeasured confounders.
Model systems for screening and investigation of lithium metal electrode chemistry and dendrite formation

The use of lithium metal as an electrode for electrochemical energy storage will provide a significant impact on practical energy storage technology. Unfortunately, the use of lithium metal is plagued with challenging chemical problems. Specifically, the formation of a solid electrolyte interphase layer and the nucleation and growth of lithium dendrites: both must be addressed and controlled in order to achieve a practically useable pure lithium metal electrode. Currently sophisticated experimental techniques and computationally expensive simulations are being used to probe these problems but these methods are arduous and time consuming which delays timely evaluation and insight into the rapidly changing field of advanced energy storage. Here, we report the use of DFT simulations of lithium nanoclusters to investigate and explore lithium metal chemistry with inexpensive computational methods to gain greater insight into electrochemical reductions and the nucleation and growth of dendrites. DME, LiTFSI, and LiFSI reduction energetics and structures with electrode effects from lithium metal are reported providing better physical description of the absolute reduction potential characterization. The electronic structure of the lithium nanoclusters were used to investigate the nucleation and growth of lithium dendrites from an ab initio perspective. The results demonstrate that kinetic processes have more control over non uniform growth than thermodynamic processes. Based on this information, a non ab initio model was created in Matlab that shows the initial stages of dendrite nucleation considering approximately 2000 atoms.
Community economic factors influence outcomes for patients with primary malignant glioma

Background Community economics and other social health determinants influence outcomes in oncologic patient populations. We sought to explore their impact on presentation, treatment, and survival in glioma patients. Methods A retrospective cohort of patients with glioma (World Health Organization grades III-IV) diagnosed between 1999 and 2017 was assembled with data abstracted from medical record review. Patient factors included race, primary care provider (PCP) identified, marital status, insurance status, and employment status. Median household income based on zip code was used to classify patients as residing in high-income communities (HICs; ie, above the median state income) or low-income communities (LICs; ie, below the median state income). The Kaplan-Meier method was used to assess overall survival (OS); Cox proportional hazards regression was used to explore associations with OS. Results Included were 312 patients, 73% from LICs. Survivors residing in LICs and HICs did not differ by age, sex, race, tumor grade, having a PCP, employment status, insurance, time to presentation, or baseline performance status. Median OS was 4.1 months shorter for LIC patients (19.7 vs 15.6 mo; hazard ratio [HR], 0.75; 95% CI: 0.56-0.98, P = 0.04); this difference persisted with 1-year survival of 66% for HICs versus 61% for LICs at 1 year, 34% versus 24% at 3 years, and 29% versus 17% at 5 years. Multivariable analysis controlling for age, grade, and chemotherapy treatment showed a 25% lower risk of death for HIC patients (HR, 0.75; 95% CI: 0.57-0.99, P < 0.05). Conclusions The economic status of a glioma patient's community may influence survival. Future efforts should investigate potential mechanisms such as health care access, stress, treatment adherence, and social support.
A-kinase anchoring protein 8L interacts with mTORC1 and promotes cell growth

mTOR complex 1 (mTORC1) senses nutrients to mediate anabolic processes within the cell. Exactly how mTORC1 promotes cell growth remains unclear. Here, we identified a novel mTORC1-interacting protein called protein kinase A anchoring protein 8L (AKAP8L). Using biochemical assays, we found that the N-terminal region of AKAP8L binds to mTORC1 in the cytoplasm. Importantly, loss of AKAP8L decreased mTORC1-mediated processes such as translation, cell growth, and cell proliferation. AKAPs anchor protein kinase A (PKA) through PKA regulatory subunits, and we show that AKAP8L can anchor PKA through regulatory subunit Iα. Reintroducing full-length AKAP8L into cells restored mTORC1-regulated processes, whereas reintroduction of AKAP8L missing the N-terminal region that confers the interaction with mTORC1 did not. Our results suggest a multifaceted role for AKAPs in the cell. We conclude that mTORC1 appears to regulate cell growth, perhaps in part through AKAP8L.
The Association Between Childhood Adversity and Self-Rated Physical Health in US College Students:

Purpose:Adverse childhood experiences (ACEs) are related to unhealthy behaviors and poor self-rated health. Poor self-rated physical health (SRPH) is negatively associated with college students’ gr...
Utilization of next-generation sequencing and associated systemic therapy initiation in metastatic prostate cancer.

e19308Background: There is emerging evidence for using clinical genomic classifiers for prognostication and to guide treatment choice in metastatic prostate cancer (mPC). While clinical-grade next ...
Impact of exogenous antithrombin on low molecular weight heparin anti-Xa activity assays in a pediatric and young adult leukemia and lymphoma cohort with variable antithrombin levels

BACKGROUND Low molecular weight heparin (LMWH) remains the most commonly prescribed pediatric anticoagulant. There is debate whether LMWH anti-Xa assays with or without exogenous antithrombin (AT) best reflect anticoagulation effect, and how much discrepancy exists between assay types. OBJECTIVES We assessed the effect of variable AT activity on LMWH anti-Xa levels in plasma samples from anticoagulated pediatric and young adult acute lymphoblastic leukemia and lymphoma (ALL/L) patients, using two instruments and their commercial kits with and without exogenous AT (ie, four platforms). METHODS We analyzed LMWH anti-Xa levels on 60 plasma samples with known AT activity from 12 enoxaparin-treated ALL/L patients, using four commercial kits from Siemens and Stago containing AT or not, on Siemens BCS and Stago STA R Max, respectively. RESULTS Of 236/240 samples with interpretable results, mean AT activity was 80% (46-138%). Correlation was acceptable for published kit ranges of LMWH anti-Xa levels when comparing kits containing AT (r = 0.82, P < .0001), or not (r = 0.93, P < .0001), and within a manufacturer (Berichrom to Innovance, r = 0.92, P < .0001; Stachrom to STA-Liquid Anti-Xa r = 0.98, P < .0001). LMWH anti-Xa levels were lower in platforms without added AT (P < .0001). For Stago kits, this effect increased when AT < 70% (P = .001, n = 19, mean 56%). Assay variability, measured as mean percent difference, was less pronounced with Stago kits (14.7%, n = 49) than Siemens (41.9%, n = 50). CONCLUSIONS Although LMWH levels from anti-Xa assays with added AT trend higher than in those without, correlation was fairly good between platforms in pediatric ALL/L plasmas, even when AT activity was <70%.
Progress towards a stable cephalosporin-halogenated phenazine conjugate for antibacterial prodrug applications.

Abstract Resistant bacteria successfully evade the action of conventional antibiotic therapies during infection, often leading to significant illness and death. Our lab has discovered halogenated phenazine (HP) analogues which demonstrate potent antibacterial activities through a unique iron-starving mechanism. Herein, we describe synthetic efforts towards a stable cephalosporin-HP conjugate prodrug with the aim of translating HPs into useful clinical agents. Cephalosporin-antibiotic conjugates offer multiple advantages for antibacterial design, including the release of active agents through the targeting of intracellular cephalosporinase following selective ring-opening of the beta-lactam warhead. During these studies, carbonate-linked cephalosporin-HP conjugate 16 was synthesized; however, we were unable to successfully remove the ester group required for cephalosporinase processing. Cephalosporin-HP 16 was then utilized as a probe to investigate the stability of the carbonate linker in antibacterial assays and, as predicted, this compound proved to be inactive against Staphylococcus aureus (MIC > 100 µM). The lack of 16’s antibacterial activity can be attributed to the carbonate linker remaining intact throughout the MIC assay, thus not liberating the active HP moiety. These efforts have led to a more stable cephalosporin-HP conjugate joined through a carbonate linker compared to a highly unstable ether linked analogue we previously reported.
Hexafluoropropylene oxide-dimer acid (HFPO-DA or GenX) alters maternal and fetal glucose and lipid metabolism and produces neonatal mortality, low birthweight, and hepatomegaly in the Sprague-Dawley rat.

Abstract Hexafluoropropylene oxide dimer acid (HFPO-DA or GenX) is an industrial replacement for the straight-chain perfluoroalkyl substance (PFAS), perfluorooctanoic acid (PFOA). Previously we reported maternal, fetal, and postnatal effects from gestation day (GD) 14-18 oral dosing in Sprague-Dawley rats. Here, we further evaluated the perinatal toxicity of HFPO-DA by orally dosing rat dams with 1–125 mg/kg/d (n = 4 litters per dose) from GD17-21 and with 10–250 mg/kg/d (n = 5) from GD8 – postnatal day (PND) 2. Effects of GD17-21 dosing were similar to those previously reported for GD14-18 dosing and included increased maternal liver weight, altered maternal serum lipid and thyroid hormone concentrations, and altered expression of peroxisome proliferator-activated receptor (PPAR) pathway genes in maternal and fetal livers. Dosing from GD8-PND2 produced similar effects as well as dose-responsive decreased pup birth weight (≥30 mg/kg), increased neonatal mortality (≥62.5 mg/kg), and increased pup liver weight (≥10 mg/kg). Histopathological evaluation of newborn pup livers indicated a marked reduction in glycogen stores and pups were hypoglycemic at birth. Quantitative gene expression analyses of F1 livers revealed significant alterations in genes related to glucose metabolism at birth and on GD21. Maternal serum and liver HFPO-DA concentrations were similar between dosing intervals, indicating rapid clearance, however dams dosed GD8 – PND2 had greater liver weight and gestational weight gain effects at lower doses than GD17-21 dosing, indicating the importance of exposure duration. Comparison of neonatal mortality dose–response curves between HFPO-DA and previously published perfluorooctane sulfonate (PFOS) data indicated that, based on serum concentration, the potency of these two PFAS are similar in the rat. Overall, HFPO-DA is a developmental toxicant in the rat and the spectrum of adverse effects is consistent with prior PFAS toxicity evaluations, such as PFOS and PFOA.
Indoor tanning exposure in association with multiple primary melanoma

Background Patients with primary cutaneous melanoma are at increased risk for subsequent new primary melanomas. Indoor tanning is a recognized risk factor for melanoma. This study was aimed at determining the association between indoor tanning and the occurrence of multiple primary melanoma. Methods This was a retrospective case-control study of cases with multiple primary melanoma and sex-matched controls with single primary melanoma retrieved at a 1:2 ratio from the Biological Sample and Nevus Bank of the Melanoma Center of the University of Pittsburgh Cancer Institute. Logistic regression models were used to examine the association between multiple primary melanoma and risk factors. Results In total, 330 patients (39.1% men) with a median age of 51 years were enrolled. Compared with patients who had a single primary melanoma, patients with multiple melanomas were younger at the diagnosis of their first primary melanoma and were more likely to be discovered at stage 0 or I and to have had indoor tanning exposure, a family history of melanoma, atypical moles, dysplastic nevi, and a Breslow thickness less than 1 mm. Compared with patients' first melanomas, subsequent melanomas were more likely to be thinner or in situ. The estimated probability of the locus for the second primary being the same as that for the first primary melanoma was 34%. In a multivariate analysis after adjustments for age, a family history of melanoma, the presence of atypical and dysplastic nevi, and recreational sun exposure, indoor tanning remained significantly associated with the occurrence of multiple primary melanoma (odds ratio, 2.75; 95% confidence interval, 1.07-7.08; P = .0356). Conclusions Indoor tanning is associated with an increased risk of second primary melanoma. Subsequent melanomas are more likely to be thin or in situ and to occur in different anatomic locations.
Baseline Neurocognitive Impairment (NCI) Is Associated With Incident Frailty but Baseline Frailty Does Not Predict Incident NCI in Older Persons With Human Immunodeficiency Virus (HIV).

Background Neurocognitive impairment (NCI) and frailty are more prevalent among persons with human immunodeficiency virus (HIV, PWH) compared to those without HIV. Frailty and NCI often overlap with one another. Whether frailty precedes declines in neurocognitive function among PWH or vice versa has not been well established. Methods AIDS Clinical Trials Group (ACTG) A5322 is an observational cohort study of older PWH. Participants undergo annual assessments for NCI and frailty. ACTG A5322 participants who developed NCI as indexed by tests of impaired executive functioning and processing speed during the first 3 years were compared to persons who maintained normal cognitive function; those who demonstrated resolution of NCI were compared to those who had persistent NCI. Participants were similarly compared by frailty trajectory. We fit multinomial logistic regression models to assess associations between baseline covariates (including NCI) and frailty, and associations between baseline covariates (including frailty) and NCI. Results In total, 929 participants were included with a median age of 51 years (interquartile range [IQR] 46-56). At study entry, 16% had NCI, and 6% were frail. Over 3 years, 6% of participants developed NCI; 5% developed frailty. NCI was associated with development of frailty (odds ratio [OR] = 2.06; 95% confidence interval [CI] = .94, 4.48; P = .07). Further adjustment for confounding strengthened this association (OR = 2.79; 95% CI = 1.21, 6.43; P = .02). Baseline frailty however was not associated with NCI development. Conclusions NCI was associated with increased risk of frailty, but frailty was not associated with development of NCI. These findings suggest that the presence of NCI in PWH should prompt monitoring for the development of frailty and interventions to prevent frailty in this population.
Vertical Transposition of the Horizontal Recti (Knapp Procedure)

Monocular elevation deficiency (double elevator palsy) is the inability to elevate the eye in any direction of gaze, due to paresis of the superior rectus, inferior oblique, or both simultaneously. Monocular elevation deficiency is often associated with ptosis and Marcus-Gunn Jaw-Wink phenomenon. Surgery is used to correct abnormal head posture, restoration of cosmesis, or as part of amblyopia treatment. Intraoperative forced ductions are an important step preceding surgery. If a tight inferior rectus is found to be the cause of the elevation deficiency, the Knapp Procedure will be ineffective; in that case, the inferior rectus must be addressed with a weakening procedure.
The impact of COVID-19 on local government stakeholders' perspectives on local food production

Local food production (LFP) can play an impor­tant role in ensuring access to food during supply chain disruptions. Because the drafting, adoption, and implementation of policies regulating LFP is under the purview of local governments in many U.S. states, researchers at University of Florida, Institute of Food and Agricultural Sciences Exten­sion conducted a study to assess whether COVID-19 affected local government stakeholders’ (LGS) (N=92) perspectives on LFP and the role that LFP can play in responding to public health emergen­cies. LGS who oversee the drafting, adoption, and implementation of LFP policies include staff responsible for code enforcement, sustainability initiatives, and planning, as well as elected and ap­pointed leaders, such as mayors, city and county managers, and city and county commissioners. The survey assessed LGS’ attitudes and knowledge about LFP. The survey also asked LGS about their perceptions and awareness of LFP in their commu­nities, including their perceptions of the benefits of and barriers to LFP and the ways in which LFP producers were using the food they produced. Sur­vey questions also focused specifically on COVID-19 and the role of LFP in public health emergen­cies. In particular, survey questions asked whether LGS perceived a change in their own attitudes, knowledge, and perspectives; whether there had been a change in the LFP activi­ties in their communities following COVID-19; and what they thought the role of LFP was in responding to public health emergencies. Direct comparisons of LGS who responded to a 2019 survey (N=43) were assessed for statistically sig­nificant changes in overall attitudes, knowledge, or perceived benefits of LFP following COVID-19. This study found that LGS have generally positive attitudes and perceptions of benefits of LFP, including its role in public health emergencies, but have limited knowledge about LFP or awareness of barriers to its implementation. The results of this study indicate that LGS understand the potential benefits of LFP in public health emergencies but would benefit from information and training to support the development of policies and programs in their communities.