cssi/SciSciGPT-SciSciNet huggingface dataset:
Metformin inhibits aldosterone-induced cardiac fibroblast activation, migration and proliferation in vitro, and reverses aldosterone+salt-induced cardiac fibrosis in vivo

The overall goals of this study were to investigate whether metformin exerts anti-fibrotic effects in aldosterone (Aldo)+salt-treated wild type mouse hearts, and determine the underlying molecular mechanisms in isolated adult cardiac fibroblasts (CF). In vitro, Aldo induced CF activation, migration, and proliferation, and these effects were inhibited by metformin. Further, Aldo induced PPM1A (Protein Phosphatase Magnesium Dependent 1A) activation and inhibited AMPK phosphorylation. At a pharmacologically relevant concentration, metformin restored AMPK activation, and inhibited Aldo-induced Nox4/H2O2-dependent TRAF3IP2 induction, pro-inflammatory cytokine expression, and CF migration and proliferation. Further, metformin potentiated the inhibitory effects of spironolactone, a mineralocorticoid receptor antagonist, on Aldo-induced collagen expression, and CF migration and proliferation. These results were recapitulated in vivo, where metformin reversed Aldo+salt-induced oxidative stress, suppression of AMPK activation, TRAF3IP2 induction, pro-inflammatory cytokine expression, and cardiac fibrosis, without significantly modulating systolic blood pressure. These in vitro and in vivo data indicate that metformin has the potential to reduce adverse cardiac remodeling in hypertensive heart disease.
Types of Tales

Positivistic classification schemes are difficult to avoid, as they are so entrenched in the social sciences, and in this chapter I review one such a scheme to demonstrate some of the varieties of ethnographic writing. Van Maanen (2011) delineates a number of forms ethnographic writing may take. These types, like many classificatory schemes, overlap and may appear in different sections of one document, but they are nonetheless useful for thinking about how to frame your own narratives.
Valenz und Koordinationszahl

In seinem normalen Zustand besitzt ein Atom vier Elektronenpaare in der Valenzschale, und diese Paare vermitteln haufig die Bindung an andere Atome. Die Achterregel sagt nun aus, das die Zahl der Bindungen zwischen einem Atom und anderen hochstens vier sein kann. Viele Atomarten scheinen ein Bestreben zu haben, diese Maximalzahl von Bindungen zu betatigen, oder mit anderen Worten, jedes Elektronenpaar als Bindungspaar zu gebrauchen; es ist jedoch moglich, das dieses Bestreben auf die unvollstandige Elektronenbesetzung der Verbindungspartner zuruckzufuhren ist, die Elektronen brauchen, um ihre Achterschalen zu erganzen (oder im Falle des Wasserstoffs die stabile Zweiergruppe).
Carbon dioxide (CO2) sequestration in oil and gas reservoirs and use for enhanced oil recovery (EOR)

Abstract: It is frequently said that oil and gas reservoirs are likely to be the first category of geological formation where carbon dioxide (CO2) shall be injected for greenhouse gas sequestration on a large scale, if sequestration proves feasible. Carbon dioxide is injected into comparatively few reservoirs at the present time. It is estimated, however, that 80% of oil reservoirs worldwide might be suitable for CO2 injection to enhance oil recovery. Enhanced oil recovery operations with CO2 have been limited by the availability and cost of CO2, but not necessarily candidate reservoirs. The problem of co-optimizing oil production and CO2 storage differs dramatically from current gas injection practice because of the cost–benefit difference due to the purchase cost of CO2 for enhanced recovery projects. When low-cost CO2 becomes widely available, injection into a wider range of reservoirs is foreseen, with the objective of maximizing the amount of CO2 left in the reservoir at abandonment. In addition to discussion of the conventional oil reservoir setting, we demonstrate, using laboratory experiments, the applicability and potential of low-permeability unconventional hydrocarbon reservoirs to store significant volumes of CO2.
Controllability, not chaos, key criterion for ocean state estimation

Abstract. The Lagrange multiplier method for combining observations and models (i.e., the adjoint method or 4D-VAR ) has been avoided or approximated when the numerical model is highly nonlinear or chaotic. This approach has been adopted primarily due to difficulties in the initialization of low-dimensional chaotic models, where the search for optimal initial conditions by gradient-descent algorithms is hampered by multiple local minima. Although initialization is an important task for numerical weather prediction, ocean state estimation usually demands an additional task – a solution of the time-dependent surface boundary conditions that result from atmosphere–ocean interaction. Here, we apply the Lagrange multiplier method to an analogous boundary control problem, tracking the trajectory of the forced chaotic pendulum. Contrary to previous assertions, it is demonstrated that the Lagrange multiplier method can track multiple chaotic transitions through time, so long as the boundary conditions render the system controllable. Thus, the nonlinear timescale poses no limit to the time interval for successful Lagrange multiplier-based estimation. That the key criterion is controllability, not a pure measure of dynamical stability or chaos, illustrates the similarities between the Lagrange multiplier method and other state estimation methods. The results with the chaotic pendulum suggest that nonlinearity should not be a fundamental obstacle to ocean state estimation with eddy-resolving models, especially when using an improved first-guess trajectory.
The Role of Aβ and Tau Oligomers in the Pathogenesis of Alzheimer’s Disease

Dense extracellular aggregates of amyloid β-protein (Aβ) in senile plaques (SPs) and intracellular aggregates of the hyperphosphorylated, microtubule-associated protein tau (MAPT) in neurofibrillary tangles (NFTs) within the brain are the key diagnostic hallmarks of Alzheimer’s disease (AD). While initial studies focused on SPs and NFTs as the key pathogenic proteinaceous species that could account for the clinical features of AD, increasing evidence suggests that the fibrils of Aβ and MAPT are unlikely to be the unique neurotoxic entities responsible for AD pathogenesis. Instead, more recent studies have implicated small, soluble oligomeric species of both Aβ and MAPT. Indeed, a wide variety of Aβ and tau ­oligomers have been described in both in vitro and in vivo systems that possess a diverse set of biological properties, including substantial synapto- and neurotoxicity. While many of these oligomers have been extensively characterized by novel biophysical, ­biochemical, and immunological techniques, attributing particular functions and dysfunctions to particular oligomer structures in vivo has proven enormously difficult, as the different proteinaceous species are present in equilibrium and likely are contained within unique intracellular and extracellular environments. Nevertheless, a number of therapeutic strategies have been developed that seek to target Aβ and tau oligomerization for AD.
Developing a growing degree day model for North Dakota and Northern Minnesota soybean

Abstract Farmers in North Dakota and Northern Minnesota did not have a model to predict when their soybean ( Glycine max L. Merr.) crop will be mature. Soybean plants need to be mature before the first fall freeze. The objectives of this study were to estimate needed accumulated growing degree days (AGDD) for adapted soybean maturity groups (MG) to reach maturity (R8). Research was conducted during 2007–2012 at northern, central, and southern North Dakota, to develop a model to predict the soybean maturity date based on accumulated GDDs and to verify the model using field research data from 2013 to 2015. Based on 1816 data points a regression analysis was performed which predicted that 1666, 1862, 2030 AGDD (with a 50 °F base temperature) were needed to reach maturity for 00.7, 0.4, and 1.0 MG soybean cultivars, respectively. The predicted values were used to create a model that allows producers to select the MG of their cultivar, date of planting, and the nearest North Dakota Agricultural Weather Network (NDAWN) station. The output provides the predicted maturity date, as well as the average first day of occurrence of select threshold temperatures (36°, 32° and 28 °F) at 50% probability level. This model will help growers to judge the risks of certain frost occurring before the selected cultivar's projected maturity date. The projected maturity date is based on two parts. The first part is the observed period from the planting date to the date the model is queried and is based on daily maximum and minimum temperatures. The second part is the forecast period that is based on normal (1981–2010 average) daily maximum and minimum temperatures from the queried date through the end of the select growing season. The growing degree days (GDD) values are accumulated from the planting date through the end of season based on these daily maximum and minimum temperatures. Input into the model should be for adapted MG soybean for the region and for planting dates between May 15 and 31. Farmers and agriculturist in North Dakota and northwest Minnesota can use the model before planting to determine if a MG would mature before the frost with varying temperature thresholds and monitor the accumulation of GDD and development of the crop during the season and estimated date of maturity.
Surgical management of pseudophakic retinal detachments: a meta-analysis.

Purpose To compare the success of pars plana vitrectomy (PPV) versus scleral buckle (SB) in the management of uncomplicated pseudophakic retinal detachments (RDs). Design Meta-analysis of published studies from 1966 to 2004 regarding surgical treatment of pseudophakic RDs. Participants Two thousand two hundred thirty eyes: 1579 operated by SB, 457 by PPV, and 194 by the combined method of PPV and SB. Methods We compared reattachment and functional success rates after 3 commonly practiced surgical interventions for pseudophakic RDs: PPV, SB, and the combined method. Twelve hundred thirty-two articles were retrieved from Medline and by cross-reference searches. Articles with sufficient data on preoperative evaluation, applied surgical technique, and anatomical and functional success rates were included in this analysis. Articles regarding complex pseudophakic RDs, treatment by laser or pneumatic retinopexy, studies with indistinguishable treatment outcomes from phakic and pseudophakic RDs, or reviews without original data were excluded. Main Outcome Measures Anatomical success rates after initial surgical intervention and after reoperation(s) for primary failures, and best or final visual outcome at the end of follow-up. Results Of 1232 papers, 29 matched inclusion criteria. After controlling for variation between study characteristics, PPV and the combined method resulted in higher initial reattachment rates (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.07–2.68, and OR, 3.54; 95% CI, 1.57–7.97, respectively) as compared with SB. The differences between the procedures persisted for final reattachment outcome despite reoperation for primary failures. Final visual outcome also was found to depend on the choice of primary surgical intervention. After controlling for differences in the study characteristics, the probability of visual improvement was higher after PPV (OR, 2.34; 95% CI, 1.58–3.46) or the combined method (OR, 11.52; 95% CI, 4.42–30.04) as compared with SB. Conclusions A meta-analysis of published literature implies that PPV with or without SB is more likely to achieve a favorable anatomical and visual outcome than conventional SB alone in uncomplicated pseudophakic RDs. However, the inherent limitations of differing study protocols, quality of included studies, and publication bias in a pooled analysis should be recognized.
Contrast-Enhanced Ultrasound Classification of Previously Indeterminate Renal Lesions.

Objectives To determine the utility of contrast-enhanced ultrasound (US) for characterizing renal lesions that were indeterminate on prior imaging. Methods This Institutional Review Board–approved retrospective diagnostic accuracy study evaluated all patients who underwent renal contrast-enhanced US examinations from 2006 to 2015 at our tertiary care hospital. We compared the number of lesions definitively characterized by contrast-enhanced US with the indeterminate lesions by prior imaging. The accuracy of contrast-enhanced US was compared with the final diagnosis by histologic examination and follow-up (mean, 3.63 years). Accuracy and agreement estimates were compared with the exact binomial distribution to assess statistical significance. Results A total of 134 lesions were evaluated with contrast-enhanced US, and 106 were indeterminate by preceding computed tomography, magnetic resonance imaging, or US. Only the largest lesion per patient was included in analysis. A total of 95.7% (90 of 94) of the previously indeterminate lesions were successfully classified with contrast-enhanced US. The sensitivity was 100% (20 of 20; 95% confidence interval [CI], 83%–100%; P < .0001); specificity was 85.7% (18 of 21; 95% CI, 62%–97%; P = .0026); positive predictive value was 87.0% (20 of 23; 95% CI, 66%–97%; P = .0005); negative predictive value was 100% (18 of 18; 95% CI, 81%–100%; P < .001); and accuracy was 90.2% (37 of 41; 95% CI, 80%–98%; P < .0001). Conclusions Contrast-enhanced US has a high likelihood of definitively classifying a renal lesion that is indeterminate by computed tomography, magnetic resonance imaging, or conventional US.
Discovery of Tamoxifen and N-Desmethyl Tamoxifen Protein Targets in MCF-7 Cells Using Large-Scale Protein Folding and Stability Measurements

The proteins in an MCF-7 cell line were probed for tamoxifen (TAM) and n-desmethyl tamoxifen (NDT) induced stability changes using the Stability of Proteins from Rates of Oxidation (SPROX) technique in combination with two different quantitative proteomics strategies, including one based on SILAC and one based on isobaric mass tags. Over 1000 proteins were assayed for TAM- and NDT-induced protein stability changes, and a total of 163 and 200 protein hits were identified in the TAM and NDT studies, respectively. A subset of 27 high-confidence protein hits were reproducibly identified with both proteomics strategies and/or with multiple peptide probes. One-third of the high-confidence hits have previously established experimental links to the estrogen receptor, and nearly all of the high-confidence hits have established links to breast cancer. One high-confidence protein hit that has known estrogen receptor binding properties, Y-box binding protein 1 (YBX1), was further validated as a direct binding target ...
On a ‘failed’ attempt to manipulate conscious perception with transcranial magnetic stimulation to prefrontal cortex

It has been reported that continuous theta burst transcranial magnetic stimulation (TMS) to the dorsolateral prefrontal cortex (DLPFC) impairs metacognitive awareness in visual perception (Rounis et al., 2010). Bor et al. (2017) recently attempted to replicate this result. However, the authors modified the experimental design of the original study considerably, meaning that this was not strictly a replication. In some cases, the changes are a priori expected to lower the chance of obtaining positive findings. Despite these changes, the researchers in fact still found an effect similar to Rounis et al.9s, but they claimed that it was necessary to adopt certain criteria to discard ~30% of their subjects, after which a null result was reported. Using computer simulations, we evaluated whether the subject exclusion criteria Bor et al. adopted was appropriate or beneficial. We found that, contrary to their intended purpose, excluding subjects by their criteria does not actually reduce false positive rates. Taking into account both their positive result (without subject exclusion) and negative result (after exclusion) in a Bayesian framework, we further found that their results suggest a 75% or greater likelihood that TMS to DLPFC does in fact impair metacognition, directly contradicting their claim of replication failure. That lesion and chemical inactivation studies are known to demonstrate positive effects in similar paradigms further suggests that Bor et al.9s alleged negative finding cannot be taken as evidence against the role of the prefrontal cortex in conscious perception in general.
Surgical Site Infections after Appendectomy Performed in Low and Middle Human Development-Index Countries: A Systematic Review

Abstract Background: Acute appendicitis is a common surgical emergency worldwide. Early intervention is associated with better outcomes. In low and middle Human Development-Index Countries (LMHDICs...
C-reactive protein as a predictor of low trough infliximab concentrations in patients who lose response to infliximab.

OBJECTIVE Low serum infliximab concentrations are associated with an increased risk of loss of response in inflammatory bowel disease (IBD). The objective of this study was to evaluate the test characteristics of C-reactive protein (CRP) in identifying low serum infliximab concentrations in patients with IBD. METHODS We measured serum infliximab concentrations and CRP levels in patients who experienced deteriorating symptoms while on infliximab (the reactive cohort). Receiver operating characteristic (ROC) curves were used to determine the CRP concentration threshold that identified an infliximab concentration <3 μg/mL at the time of loss of response. These CRP thresholds for infliximab concentration <3 μg/mL were then tested in a separate validation cohort. RESULTS The reactive cohort contained 111 patients and the validation cohort contained 139 patients. In 41% of participants, serum infliximab concentration was <3 μg/mL. In the reactive cohort, the area under the ROC curve for CRP to identify an infliximab concentration <3 μg/mL was 0.70 (95% confidence interval [CI] 0.50-0.80, P = 0.02). A CRP level above 12 mg/L in the preceding 90 days provided a 90% specificity for the later detection of infliximab concentration <3 μg/mL. These test characteristics were similar in the validation cohort. CONCLUSION CRP levels over 12 mg/L exhibit a high specificity for identifying patients with an infliximab concentration <3 μg/mL. CRP may be cost-effective for identifying patients with low concentrations of infliximab at the time of, or at risk of, loss of response.
Obligation Without Rule: Bartleby, Agamben, and the Second-Person Standpoint

In Herman Melville’s Bartleby, the Scrivener, the narrator finds himself involved in a moral relation with the title character whose sense he finds difficult to articulate. I argue that we can make...
Chilean Television on Shifting Terrain: Movement Toward a Postnetwork Era:

Two events rocked Chilean television in the first half of the 2010s. The first of these was an earthquake in 2010, and the second was the arrival in 2014 of the first Turkish soap opera to the scre...
Developmental failure in human reproduction associated with preovulatory oogenesis and preimplantation embryogenesis

The rapid and worldwide application of in vitro fertilization (IVF) for the treatment of human infertility has presented the opportunity to examine, by noninvasive (1) and invasive protocols (2,3), molecular and cellular aspects of normal and abnormal oocyte and early embryonic development in large and clinically varied patient populations. The collective findings from thousands of attempts at IVF demonstrate that the vast majority of fertilized human eggs do not result in a pregnancy and that most embryos appear to arrest development during the pre-and early postimplantation stages of gestation (4,5).
Prehispanic Exchange Relationships among Central Mexico, the Valley of Oaxaca, and the Gulf Coast of Mexico

Economies are open systems that extract matter, energy, and information from the environment for use by human societies. Economic systems also require technology to facilitate resource extraction, resource use, and the manufacture of other technologies. Because these activities are performed at different locations in a spatial theater, sites are connected by flows of resources, commodities, persons, and information that gives the system a particular structure. In many economic systems, resource procurement, production, and distribution are handled by occupational specialists. Although some specialization is manifest on all levels of sociocultural integration, it reaches peak complexity in state-level societies, particularly industrial states. Here because occupational specialists dominate most elements of the economy, modes of procurement, production, and distribution vary in scale and internal structure, and the economic system is hierarchically organized. Preindustrial states had fewer specialists. Though some preindustrial states occupied large territories (Old World imperial regimes are examples), the small geographic extent of most of these polities stimulated the movement of goods from systems that had direct access to raw materials to those that did not. This interregional movement of goods and resources, which often crossed the boundaries of polities, is called long-distance exchange.
EFFECT OF ROASTING SORGHUM AND SOYBEANS ON GAINS AND DIGESTIBILITY

SUMMARY Forty Hereford x Angus crossbred calves averaging 278 kg were blocked by weight and sex and randomly assigned to the following treatments: (1) raw sorghum, raw soybeans; (2) raw sorghum; roasted soybeans; (3) roasted sor- ghum, raw soybeans; (4) roasted sorghum, roasted soybeans, and (5) Temper-treated sor- ghum with roasted soybeans. Roasting was done with a Roast-a-Tron at 138 C exit temper- ature, and the two concentrates were mixed to give a 13% crude protein diet fortified with minerals, and blended with 45% corn silage on a dry matter basis. The diets were full fed to the calves for 84 days. All feed was weighed daily and the animals were weighed each 2 weeks. Digestibility was measured using four sheep per diet fed at maintenance, and net energy values for maintenance and gain were calculated from the digestion data. In addition, rumen fermen- tation was studied by feeding four fistulated steers per diet and sampling six times after feed- ing the last 2 days of the 14-day period. Results of the rumen fermentation data in molar per- cents were: 59.4, 59.6, 61.1, 61.2 and 57.5 for acetate; 20.5, 14.0, 18.6, 18.4 and 14.3 for pro- pionate; and 11.4, 10.9, 12.4, 12.6 and 12.5 for butyrate for diets 1 through 5, respectively. Dry matter digestibility was 66.9, 71.4, 71.5, 67.4 and 67.9%, while net energy values for maintenance and gain were 1.58, 1.00; 1.66, 1.08; 1.72, 1.13; 1.59, 1.02 Mcal/kg for the same diets. Mean daily gain for diets 1 through 5 were 1.13, 1.13, 1.18, 1.15 and 1.13 kg, respectively, while feed conversion was about 6.50 kg DM/kg gain for all diets. While The authors acknowledge the assistance of Profes- sor J. C. Elrod, Agricultural Economics Department,
Review: Pliny the Elder and the Emergence of Renaissance Architecture, by Peter Fane-Saunders

Peter Fane-Saunders Pliny the Elder and the Emergence of Renaissance Architecture New York: Cambridge University Press, 2016, 491 pp., 8 color and 75 b/w illus. $142 (cloth), ISBN 9781107079861 Although De architectura is celebrated as the only architectural treatise to have come down from antiquity, its author, Vitruvius, was not the most gifted of writers, and his text was challenging for Renaissance readers. Leon Battista Alberti famously criticized Vitruvius: “What he handed down was in any case not refined … his very text is evidence that he wrote neither Latin nor Greek, so that as far as we are concerned he might just as well not have written at all, rather than write something that we cannot understand.”1 In fact, Vitruvius was not the only ancient author to address architectural topics. Foremost among other ancient writers who discussed architecture was Pliny the Elder. As Peter Fane-Saunders reveals in his expansive study Pliny the Elder and the Emergence of Renaissance Architecture , originating from his doctoral dissertation, Pliny's Natural History was also an invaluable source to Italian Renaissance investigators, second only to De architectura written a century earlier. Although Pliny's writings have been long recognized as a key source for Renaissance artistic practice, the degree to which Pliny's writings permeated the architectural culture of the period remains surprisingly unexplored.2 Fane-Saunders redresses this shortfall by surveying the key significance of Pliny for Renaissance authors and practitioners. In his introduction and chapter 1, Fane-Saunders situates Pliny's work among classical authors, introduces his encyclopedic text, and considers its early reception. Pliny completed his Natural History in 77 AD, just two years before he perished during the eruption of Vesuvius. In thirty-seven books, Pliny attempted a thorough discussion of the wonders of the natural world, including those of the Mediterranean as well as the Near East and India. The text remained well regarded throughout the Middle …
Impact of standardized templates and skin cancer learning modules for teledermatology consultations.

BACKGROUND Little research has been done in teledermatology to examine the effects of standardized templates and subject-specific learning modules. METHODS We performed a prospective study examining the effects of standardized templates and standardized cutaneous oncology learning modules on teledermatology referrals at Mayo Clinic. This data was then compared to previous teledermatology referrals before standardized templates were adopted. RESULTS A total of 42 teledermatology consultations were performed during the 4-month study period. The use of standardized templates resulted in an absolute reduction in face-to-face referrals. Teledermatology consultation increased the absolute diagnostic and management concordance by 26.2% (P = 0.02) and 33.3% (P < 0.01), respectively, and decreased the absolute diagnostic and management discordance by 19.1% (P = 0.03) and 31.0% (P < 0.01), respectively. The largest knowledge gaps were identified in cutaneous oncology. Educational intervention improved theoretical referral rates and confidence in diagnosis and management overall. CONCLUSION The implementation of standardized intake templates reduces the rate of face-to-face referrals. Teledermatology improves primary care-based dermatological care and reduces theoretical referral rates.
A simple model for understanding the causes of paediatric wheeze

Abstract Wheeze is one of the most common paediatric presentations. While there are only a few possible reasons for a child to develop wheeze, there is often diagnostic uncertainty between common causes such as bronchiolitis, viral wheeze and asthma. The evidence shows that these conditions respond differently to the treatments available. This means that better differentiation should have a beneficial effect through more appropriate and targeted disease management. This article describes my personal model for understanding why these three conditions occur at different ages and respond to different treatments. The model is also used to give practical advice regarding the differentiation of bronchiolitis, viral wheeze and asthma in children and young people.
Making Catholics: The Ritual Production of Conformity in a Catholic Junior High School:

A great deal of conceptual confusion still surrounds the meaning of the word " ritual " Consequently, ritual continues to have an ambiguous status in social science research. This is especially true of studies which attempt to analyze modern institutional life and contemporary cultural formations. This paper critically reconsiders the concept of ritual, particularly in the light of anthropologist Victor Thrner's discussion of root paradigms. The author draws from recent work in ritual studies to analyze classroom instruction in a junior high school in downtown Tbronto, Canada. Classroom instruction was discovered to be part of an intricate ritual system and was differentiated along religious and secular dimensions. Pervading all of classroom life, two root paradigms - which the author calls " becoming a Catholic " and "becoming a worker- nested the values of the larger society. Corporate capitalist values associated with " becoming a worker " were discovered to complement closely those values associated with " becoming a Catholic." Furthermore, the dialectical relationship between the root paradigms served to create the " ritual charter " of the school known as " becoming a citizen ." A tantalizing, yet debilitating, ambiguity surrounds the meaning of the term "ritual." It is not one of the concepts that readily fit into the intellectual climate of present-day social science. The analysis of ritual
Investigating and Extending Variation among Friends with Benefits Relationships: Relationship Maintenance and Social Support

The considerable diversity in friends with benefits relationships (FWBR) is largely unexplored. Therefore, this investigation focuses on differences in the communication of relationship maintenance...
A Novel Algorithm for Improving the Diagnostic Accuracy of Prehospital ST-Elevation Myocardial Infarction.

Introduction:ST-segment elevation myocardial infarction (STEMI) is a time-sensitive entity that has been shown to benefit from prehospital diagnosis by electrocardiogram (ECG). Current computer algorithms with binary decision making are not accurate enough to be relied on for cardiac catheterization lab (CCL) activation.Hypothesis:An algorithmic approach is proposed to stratify binary STEMI computerized ECG interpretations into low, intermediate, and high STEMI probability tiers.Methods:Based on previous literature, a four-criteria algorithm was developed to rule out/in common causes of prehospital STEMI false-positive computer interpretations: heart rate, QRS width, ST elevation criteria, and artifact. Prehospital STEMI cases were prospectively collected at a single academic center in Salt Lake City, Utah (USA) from May 2012 through October 2013. The prehospital ECGs were applied to the algorithm and compared against activation of the CCL by an emergency department (ED) physician as the outcome of interest. In addition to calculating test characteristics, linear regression was used to look for an association between number of criteria used and accuracy, and logistic regression was used to test if any single criterion performed better than another.Results:There were 63 ECGs available for review, 39 high probability and 24 intermediate probability. The high probability STEMI tier had excellent test characteristics for ruling in STEMI when all four criteria were used, specificity 1.00 (95% CI, 0.59-1.00), positive predictive value 1.00 (0.91-1.00). Linear regression showed a strong correlation demonstrating that false-positives increased as fewer criteria were used (adjusted r-square 0.51; P <.01). Logistic regression showed no significant predictive value for any one criterion over another (P = .80). Limiting physician overread to the intermediate tier only would reduce the number of ECGs requiring physician overread by a factor of 0.62 (95% CI, 0.48-0.75; P <.01).Conclusion:Prehospital STEMI ECGs can be accurately stratified to high, intermediate, and low probabilities for STEMI using the four criteria. While additional study is required, using this tiered algorithmic approach in prehospital ECGs could lead to changes in CCL activation and decreased requirements for physician overread. This may have significant clinical and quality implications.
Tourist Food Variety-Seeking Behavior under Uncertainty: The Moderating Role of Information Search

ABSTRACTAlthough dining out is viewed as a favorite activity among international tourists visiting South Korea, it is one that may cause concern due to their unfamiliarity with new circumstances an...
The interplay of thermodynamics and kinetics: imparting hierarchical control over film formation of self-stratified blends

Spin casting has become an attractive method to fabricate polymer thin films found in organic electronic devices such as field-effect transistors, and light emitting diodes. Many studies have shown that altering spin casting parameters can improve device performance, which has been directly correlated to the degree of polymer alignment, crystallinity, and morphology of the thin film. To provide a thorough understanding of the balance of thermodynamic and kinetic factors that influence the stratification of polymer blend thin films, we monitor stratified polymer blend thin films developed from poly(3-hexylthiophene-2,5-diyl) and poly(methyl methacrylate) blends at controlled loading ratios, relative molecular weights, and casting speed. The structures of these thin films were characterized via neutron reflectivity, and the results show that at the fastest casting speed, polymer-polymer interactions and surface energy of the polymers in the blend dictate the final film structure, and at the slowest casting speed, there is less control over the film layering due to the polymer-polymer interactions, surface energy, and entropy simultaneously driving stratification. As well, the relative solubility limits of the polymers in the pre-deposition solution play a role in the stratification process at the slowest casting speed. These results broaden the current understanding of the relationship between spin casting conditions and vertical phase separation in polymer blend thin films and provide a foundation for improved rational design of polymer thin film fabrication processes to attain targeted stratification, and thus performance.
Pandemic and Persona.

Pandemic and Persona The Covid-19 pandemic offers an opportunity for doctors to recognize more readily facts that can otherwise take years to learn: that we’re no different from our patients and th...
Team-Based Learning: An Effective Pedagogical Strategy to Teach Anatomy

In medical education, human anatomy is a content rich and conceptually challenging course that can overwhelm the students. We have found team-based learning (TBL), which engages students in their learning, to be an ideal pedagogical strategy to teach anatomy. TBL combines various aspects of the adult learning theories in a unique way where learning is self-directed and at the same time, guided by the faculty. The concept of TBL focuses on learning defined by pre-class preparation of “content specific learning topics” and subsequent in-class team discussion. Team discussion is a form of peer teaching that allows students to reflect upon their learning and remediate any knowledge deficits.
The management of pediatric obstructive sleep apnea in the COVID-19 era: to PAP or not to PAP?

Citation:Ehsan Z. The management of pediatric obstructive sleep apnea in the COVID-19 era: to PAP or not to PAP? J Clin Sleep Med. 2021;17(6):1323–1324.
Nonopioid Approaches to Pain Management in Chronic Kidney Disease.

Summary: Patients with chronic kidney disease (CKD) and end-stage renal disease experience high pain and symptom burden, but management of chronic pain in this population remains challenging. Recent studies have shown a high rate of opioid prescription and use in patients with kidney disease. However, the concern for opioid-related morbidity and mortality suggests a need to reconsider the safety and efficacy of opioid use in patients with CKD. In this review, we describe the current approaches to pain management in CKD, highlight the evolving opioid-related risks and kidney-specific concerns, and offer both pharmacologic and nonpharmacologic nonopioid strategies for pain management in patients with kidney disease, emphasizing the importance of using a multimodal approach to optimize pain control.
A Rare Case of Guillain-Barré Syndrome With Severe Pandysautonomia:

Acute pandysautonomia is a rare disorder characterized by autonomic failure affecting sympathetic, parasympathetic, and enteric functions. We present a case of acute inflammatory demyelinating polyneuropathy (AIDP) with severe pandysautonomia in a young, otherwise healthy, female who presented with gastrointestinal symptoms and sensory demyelinating polyneuropathy, which progressively worsened and subsequently developed bladder dysfunction and orthostatic hypotension. We discuss the challenges with diagnostic workup as well as the challenges we encountered as part of the management.
A randomized controlled trial of oxycodone/acetaminophen versus acetaminophen alone for emergency department patients with musculoskeletal pain refractory to ibuprofen.

BACKGROUND Use of oral opioids does not result in more pain relief than nonopioid alternatives when administered to patients as first-line treatment for acute musculoskeletal pain. This study compared the efficacy of oxycodone/acetaminophen to that of acetaminophen alone as second-line treatment for patients with acute musculoskeletal pain who were administered prescription-strength ibuprofen and reported insufficient relief 1 h later. METHODS A randomized, double-blind study was conducted in two urban emergency departments. Opioid-naive patients ≥ 18 years with an acute musculoskeletal injury were administered ibuprofen 600 mg as part of the study protocol. Those who reported insufficient relief 1 h later were randomized (1:1 ratio) to oxycodone 10 mg/acetaminophen 650 mg or acetaminophen 650 mg. The primary outcome was improvement in 0 to 10 pain scale between randomization and 2 h later. We also assessed medication-associated adverse events. A sample size calculation, built around a minimum clinically important difference of 1.3 units, determined the need for 154 patients. RESULTS We screened 924 patients and enrolled 393. All 393 received ibuprofen. A total of 159 (40%) patients reported inadequate relief after 1 h had elapsed. A total of 154 of these were randomized, 77 to oxycodone/acetaminophen and 77 to acetaminophen. Baseline characteristics were comparable. Among patients randomized to oxycodone/acetaminophen, mean (±SD) improvement in 0 to 10 pain scale was 4.0 (±2.6) versus 2.9 (±2.4) in the acetaminophen arm. The 95% confidence interval (CI) for the mean difference of 1.1 was 0.3 to 1.9. Among patients who received oxycodone/acetaminophen, 26 of 76 (34%) reported any medication-related adverse event versus seven of 74 (9%) participants who received acetaminophen. The 95% CI for the between-group difference of 25% was 12% to 37%). CONCLUSION Among patients with acute musculoskeletal pain refractory to oral ibuprofen, oxycodone/acetaminophen resulted in slightly greater pain relief than acetaminophen, but this was associated with more medication-related adverse events.
Mutant-SETBP1 activates transcription of Myc programs to accelerate CSF3R-driven myeloproliferative neoplasms

Colony stimulating factor 3 receptor (CSF3R) mutations lead to JAK pathway activation and are the molecular hallmark of chronic neutrophilic leukemia (CNL). Approximately half of CNL patients also have mutations in SET binding protein 1 (SETBP1). In this study, we developed models of SETBP1-mutant leukemia to understand the role that SETBP1 plays in CNL. SETBP1 mutations promote self-renewal of CSF3R-mutant hematopoietic progenitors in vitro and prevent cells from undergoing terminal differentiation. In vivo, SETBP1 mutations accelerate leukemia progression, leading to the rapid development of hepatosplenomegaly and granulocytosis. Through transcriptomic and epigenomic profiling, we found that SETBP1 enhances progenitor-associated programs, most strongly upregulating Myc and Myc target genes. This upregulation of Myc can be reversed by epigenetic modulatory drugs. In summary, we find that SETBP1 mutations promote aggressive hematopoietic cell expansion when expressed with mutant CSF3R through the upregulation of Myc-associated gene expression programs.
Implications of the interactions between genetic background and dietary phosphorus on porcine muscle

Phosphate (P) is an essential nutrient for both muscular and skeletal growth. Because the sources of dietary P in contemporary swine diets are poorly available for the simple stomach animals, inorganic phosphate sources are supplemented to these diets to prevent P deficiency. However, with the identification of P as one of the main polluting nutrients in fresh water system and soil, environmental concern and costs associated with P supplementation have led researchers to minimize the amount of P added to swine diets. Despite the vast amount of work conducted in this area, little research has examined the genetic mechanisms underlying the control of P utilization. Lack of understanding of the molecular response of skeletal muscle to dietary P and the influence of genetics has hindered our understanding of P homeostatic mechanisms. The objectives of my PhD research are to identify changes in gene expression in growing porcine muscle because of dietary P and genetic background and the interaction between dietary P and genetic background to examine the effects of decreasing dietary P intake and genetic background on the carcass characteristics and meat quality, and examine the impact of P deficiency hormonal profiles on the proliferation and differentiation of satellite cells isolated from young pigs. Elucidating the molecular and genetic mechanisms underlying P utilization by muscle tissue could lead to strategies to increase the efficiency of growth in domestic animals while doing so in a more environmentally friendly manner.
Learning with single view co-training and marginalized dropout

The generalization properties of most existing machine learning techniques are predicated on the assumptions that 1) a sufficiently large quantity of training data is available; 2) the training and testing data come from some common distribution. Although these assumptions are often met in practice, there are also many scenarios in which training data from the relevant distribution is insufficient. We focus on making use of additional data, which is readily available or can be obtained easily but comes from a different distribution than the testing data, to aid learning. We present five learning scenarios, depending on how the distribution we used to sample the additional training data differs from the testing distribution: 1) learning with weak supervision; 2) domain adaptation; 3) learning from multiple domains; 4) learning from corrupted data; 5) learning with partial supervision. We introduce two strategies and manifest them in five ways to cope with the difference between the training and testing distribution. The first strategy, which gives rise to Pseudo Multi-view Co-training (PMC) and Co-training for Domain Adaptation (CODA), is inspired by the co-training algorithm for multi-view data. PMC generalizes co-training to the more common single view data and allows us to learn from weakly labeled data retrieved free from the web. CODA integrates PMC with an another feature selection component to address the feature incompatibility between domains for domain adaptation. PMC and CODA are evaluated on a variety of real datasets, and both yield record performance. The second strategy marginalized dropout leads to marginalized Stacked Denoising Autoencoders (mSDA), Marginalized Corrupted Features (MCF) and FastTag (FastTag). mSDA diminishes the difference between distributions associated with different domains by learning a new representation through marginalized corruption and reconstruciton. MCF learns from a known distribution which is created by corrupting a small set of training data, and improves robustness of learned classifiers by training on "infinitely'' many data sampled from the distribution. FastTag applies marginalized dropout to the output of partially labeled data to recover missing labels for multi-label tasks. These three algorithms not only achieve the state-of-art performance in various tasks, but also deliver orders of magnitude speed up at training and testing comparing to competing algorithms.
Widiger, Thomas A. (b. 1952)

Thomas A. Widiger (b. 1952) is an influential figure in the diagnosis and classification of psychopathology, having served as the Research Coordinator for DSM-IV. His specific expertise in the diagnosis of personality disorders led to his inclusion as a member of the DSM-III-R Advisory Committee and DSM-IV Personality Disorders Work Group, and co-chair of the DSM-5 Personality Disorder Research Planning Work Group. Dr. Widiger has long been a leading advocate for the adoption of a dimensional trait system for diagnosis of personality disorders. Keywords: personality; assessment; personality disorders; personality traits
The Dividend Puzzle Unpuzzled

A claim of solving the dividend puzzle, as formulated by F. Black, is made. Various stock pricing formulas are established, extending substantially the classical Miller-Modigliani theory of valuation of shares in a way to contradict their main conclusion that dividends are irrelevant. Indeed, the main stock pricing formula obtained implies that if the company's costs depend on the available cash, then dividends affect the stock pricing function in a substantial manner. On the other hand, if the company's costs are independent of the available cash, if the dividend tax rate is constant, and under a further technical condition, the established formula is consistent with the Miller-Modigliani's conclusion of dividend irrelevancy. The presented theory is in the context of Miller-Modigliani's stream of dividends approach to valuation of shares, facilitated by the latest developments in the Black-Scholes type pricing theory for incomplete multivariable markets. Various cash flows are modeled, some using Ito SDEs, so that the value of the company is not assumed to be tradable, yielding market incompleteness. In spite of market incompleteness, under some simplifying assumptions, referred to as the Basic Equity Model, the established stock pricing formulas yield unique prices, i.e., prices independent of the investor's risk aversion. Some more general models when this property of prices does not hold are considered as well. The intrinsic non-uniqueness of fair stock prices in such cases is settled by choosing the value of the investor's HARA risk aversion parameter, while if the CARA wealth utility function is used, fair prices remain unique.
De Novo Denied: District Courts' Reliance on Camardo Is Clear Error

When a party objects to a magistrate judge’s report and recommendations on a dispositive motion, a district court must determine which parts of the report and recommendations are reviewed de novo. Dicta in a 1992 Western District of New York case, Camardo v. General Motors Hourly-Rate Employees Pension Plan, states that it is "improper for an objecting party to. . . rehash[]. . . the same arguments and positions taken in the original papers submitted to the Magistrate Judge." This dicta has been adopted by numerous district courts in New York — particularly the Southern and Northern Districts — as well as district courts outside the Second Circuit. These courts have used this dicta for the proposition that a district court need not perform a de novo review of arguments that a party makes in its objections to a magistrate judge’s report and recommendations if that argument was already considered by the magistrate judge. When this dicta is used to deny such review, it deprives litigants of statutory and, possibly, constitutional rights.