cssi/SciSciGPT-SciSciNet huggingface dataset:
Enhanced Learning Deficits in Female Rats Following Lifetime Pb Exposure Combined with Prenatal Stress

Pb (lead) exposure and stress are co-occurring risk factors (particularly in low socioeconomic communities) that also act on common biological substrates and produce common adverse outcomes, including cognitive impairments. This study sought to determine whether lifetime Pb exposure combined with prenatal stress would enhance the cognitive deficits independently associated with each of these risk factors and to explore associated mechanisms of any observed impairments. Learning was evaluated using a multiple schedule of repeated learning and performance in female rats subjected to lifetime Pb exposure (0 or 50 ppm Pb in drinking water beginning in dams 2 months prior to breeding; blood Pb levels ∼10 μg/dl), to prenatal restraint stress on gestational days 16 and 17, or to both. Blood Pb, corticosterone levels, brain monoamines, and hippocampal nerve growth factor levels were also measured. Sequence-specific learning deficits produced by Pb, particularly the number of responses to correctly learn response sequences, were further enhanced by stress, whereas performance measures were unimpaired. Statistical analyses indicated significant relationships among corticosterone levels, frontal cortex dopamine (DA), nucleus accumbens dopamine turnover, and total responses required to learn sequences. This study demonstrates that Pb and stress can act together to produce selective and highly condition-dependent deficits in learning in female rats that may be related to glucocorticoid-mediated interactions with mesocorticolimbic regions of brain. These findings also underscore the critical need to evaluate toxicants in the context of other risk factors pertinent to human diseases and disorders.
Cytoskeletal discontinuities in the cell body cortex initiate basal body assembly and oral development in the ciliate Stentor.

My previous work has shown that disconnecting the oral apparatus of Stentor into two parts induces mass assembly of basal bodies on the ventral cell surface and thus initiates oral development. This operation severs the extensive microtubule tracts joining the oral membranelles at their bases. To determine whether basal body assembly and oral development are also induced by permanently disconnecting the longitudinal microtubule fibre tracts (mt fibre tracts) of the cell body cortex, I interposed a ring of inverted (heteropolar) cortex between the anterior and posterior halves of interphase stentors. When successful, this operation made it impossible for these fibre tracts to rejoin at the heteropolar boundaries and always induced basal body assembly and oral development in the graft complex. By contrast, tripartite homopolar graft complexes rarely initiated oral development; when they did, it was apparently in response to the presence of disproportionately small oral structures, which is the normal stimulus for oral development in Stentor . The mt fibre tracts of tripartite homopolar grafts also eventually became continuous. These results support the hypothesis that permanent, extensive discontinuities anywhere within the cortical cytoskeleton can trigger basal body assembly and oral development. Since the onset of these processes is known to initiate cell division in Stentor , the results also suggest that development of discontinuities within the cortical cytoskeleton during interphase growth may be the endogenous stimulus initiating cell division in Stentor .
Transplacental hemorrhage in cesarean section

Summary A modification of the Finn's method of quantitatively estimating small transplacental hemorrhage is presented and discussed. Amount of transplacental hemorrhage caused by cesarean section and cesarean section hysterectomy is estimated in 30 cases, showing that 21 out of 30 in our series have a transplacental hemorrhage equal to or less than 0.25 c.c. The clinical history of the patients and their surgical procedures are correlated with the amount of transplacental hemorrhage.
Meditation, Mindfulness, Cognition, and Emotion: Implications for Community-Based Older Adult Programs

Meditation practices have become increasingly popular in the United States among both older and younger adults. This chapter summarizes research on the emotional and cognitive benefits of meditation practices that have been derived from Buddhist tradition and from contemporary secular mindfulness meditation. The potential for meditation-based cognitive enhancement for older adults is discussed, and special attention is paid to studies of meditation to reduce stress and improve well-being among caregivers of persons with dementia. Program planners are encouraged to consider several factors, including training requirements and the need for program evaluation, when considering the use of meditation in community-based applications.
Mark Edward Rubinstein

Mark Rubinstein has been described as a “brilliant scholar,” one who “marches to his own drumbeat,” and is known among colleagues as a risk taker and innovator. As an individual, Rubinstein is often characterized as intellectually fearless. He is known by many of his students as a sincere mentor who has extraordinary passion and intellect.Having developed the binomial options model with Stephen A. Ross and John C. Cox, he revolutionized the way professionals value options. For this and earlier work on asset pricing models, he was elected President of the American Finance Association for 1993. Along with his colleagues Hayne E. Leland and John W. O'Brien, Rubinstein developed and commercialized the use of portfolio insurance, which was ultimately cited as one of the causes of the stock market crash of 1987, and his firm developed the first exchange-traded fund in 1992. The International Association of Financial Engineers (IAFE) named him as the 1995 IAFE/SunGard Financial Engineer of the Year.
A phase 2 multimodality trial of docetaxel/prednisone with sunitinib followed by salvage radiation therapy in men with PSA recurrent prostate cancer after radical prostatectomy

A phase 2 multimodality trial of docetaxel/prednisone with sunitinib followed by salvage radiation therapy in men with PSA recurrent prostate cancer after radical prostatectomy
Influence of Professors on the Flow of Talent to the Academic Profession

JN SPITE of sporadic interest in intellectual elites, prompted by comparisons with Russia, relatively little is known about the appeal of university teaching as a profession. We do know that some 190,000 teachers have been attracted to institutions of higher learning in the United States.1 Somber prognostications are made when graduate school facilities and their output of new teachers equipped with Ph.D.'s are compared with expected college enrollments.2 There is available a brilliant analysis of motivations and negotiations in the "Academic Marketplace. "' Some $165,000 was expended in analyzing the fate of university professors during the dangerous McCarthy years.4 Certainly the factors influencing the flow of talent to the academic profession are complex and varied.5 Salary level, birth rate, enrollment, security consideration, and degree of academic freedom are involved.6 The prestige-status factor is important but chiefly in relation to alternative occupational attractions. The public image of the university professor as expressed by stereotyped phrases and cartoons no doubt has some influence on loss and recruitment. In considering images of the Academic Man a distinction should be made between the attitudes of "insiders" and "outsiders," although there is doubtless a subtle interaction between the self-conception of university professors and the conception of the occupation held by outsiders. Our concern in the exploratory research to be reported is with the influence of "insiders," namely university professors, upon the flow of talent to their profession.
A Review of “Uneasy Allies: Labor Reform in Nineteenth-Century Boston”: Zonderman, David A. Amherst: University of Massachusetts Press 305 pp., $28.95, ISBN 978-1-155849-866-2 Publication Date: May 2010

In Uneasy Allies, David Zonderman, professor of history at North Carolina State University, has given his readers an extensive study of labor reform in nineteenth-century Boston, with a particular ...
An Atomistic Study of Hydrogen Effects on the Fracture of Tilt Boundaries in Nickel.

In this study, molecular dynamics simulations were used to fracture Σ9 tilt boundaries in nickel lattices containing a range of trap site hydrogen concentrations. These lattices were created in a previous study using Monte Carlo simulations and the Embedded Atom Method to duplicate room temperature exposure to a hydrogen environment. The molecular dynamics simulations were run at absolute zero to immobilize the hydrogen distributions for determination of trap site occupancy effects on grain boundary fracture. In all lattices, fracture began by the breaking of bonds next to polyhedral defect sites that characterize the boundary structure followed by rapid failure of the remaining bonds. The effect of hydrogen was to lower the stress for fracture from 18 GPa to a lower limiting value of 8 GPa as the trap sites along the boundary plane filled. The simulations showed that the atoms at these sites were the only atoms involved in the fracture process. Within the constraints imposed on these calculations, the results of this study showed that the ‘inherent’ effect of hydrogen in the absence of plastic deformation is to reduce the cohesive force between atoms across the boundary.
Guest Editorial: Exploring nurse education in Canada, Finland and the United States

A global registered nursing (RN) shortage has caused an increase in migration and international recruitment of nurses. There is growing interest among some countries of having common standards and competencies for entry-level registered nurses to guide future registered nurse agreements between countries or multi-country licensure programs. Nursing education in one country may not be accepted as equivalent for a nurse to become licensed in another country.An exploratory study was conducted to gain a better understanding of how nurses are educated in various countries. Nurse researchers sent a nursing education questionnaire to nurse educators in eleven countries inviting them to participate in the study. Nurse educators from six countries agreed to participate in the study. They provided information about their country’s nursing history, types of nursing programs, use of national nursing licensing examination, and political influences on nursing education.The People’s Republic of China, Japan and ...
New Dental Accreditation Standard on Critical Thinking: A Call for Learning Models, Outcomes, Assessments

This opinion article applauds the recent introduction of a new dental accreditation standard addressing critical thinking and problem-solving, but expresses a need for additional means for dental schools to demonstrate they are meeting the new standard because articulated outcomes, learning models, and assessments of competence are still being developed. Validated, research-based learning models are needed to define reference points against which schools can design and assess the education they provide to their students. This article presents one possible learning model for this purpose and calls for national experts from within and outside dental education to develop models that will help schools define outcomes and assess performance in educating their students to become practitioners who are effective critical thinkers and problem-solvers.
A Framework of Multidiscipline System-Level Simulation Evaluation for Marine Propulsion System Argumentation

Evaluation of marine propulsion system argumentation is a multifactor,multilevel and multitarget decision-making problem. Tradtional qualitative evaluation method is inefficient and actully tends to be empirical. In order to make the evaluation more scientific and intellectualized, the paper analyzes different kinds of simulation metheds and puts forward a multidiscipline system-level evaluation framework, which is a simulation system based on HLA, and the key technologies are analyzed. The framework integrates the numerical simulation, semiphysical simulation and virtual prototype into a system to support the evaluation of marine propulsion system, which will make the transition from qualitative evaluation to quantitative evaluation possible.
Hormones in Renal Cancer

AbstractPlasma renin, erythropoietin and chorionic gonadotropin levels were evaluated in 57 patients with renal adenocarcinoma. Renin elevation, found in 37 per cent, was unrelated to blood pressure levels but was associated with high grade, high stage lesions of mixed histologic cell type and predicted a poor prognosis. Erythropoietin was raised in 63 per cent of patients and was more sensitive than renin in indicating the presence of renal adenocarcinoma. However, it was less specific and did not correlate directly with tumor grade, stage, histologic type, prognosis or hematocrit and hemoglobin levels. None of the patients had elevated chorionic gonadotropin levels. Therefore, we believe that renin and erythropoietin determinations may be of value as biochemical tumor markers in renal adenocarcinoma.
Introducing Predetermined Mutations Throughout a Target Gene Using TDEM (Transposon-Directed Base-Exchange Mutagenesis)

Transposon-directed base-exchange mutagenesis (TDEM) is an efficient and controllable method for introducing a mutation(s) into a gene. Each round of TDEM removes a predetermined number of bases (up to 11 base pairs) from a randomly selected site within the target gene and replaces them with any length of DNA of predetermined sequence. Therefore, the number of bases to be deleted and inserted can be precisely regulated. Because each round of TDEM generates mutation(s) at a single site, the number of mutations introduced can be determined by the number of cycles of TDEM. Furthermore, using a novel frame-checking procedure, non-functional mutants containing a frameshift or stop codon can be minimized. Thus, TDEM can be used to introduce a limited and predetermined change at each round of mutagenesis, thereby providing a useful tool for studying protein structure and function.
A large ecosystem study to understand the effect of programming languages on code quality.

Abstract Developers are often tasked with choosing a language for a project. Although such decisions are usually based on prior experiences or legacy requirements, as reported by Meyerovich et al. [ 1 ], language choice is in general believed to impact the code quality. For example, statically typed languages catch type errors early, at compile time, while dynamically typed languages catch errors at run time, if the errors at all arise. Other language properties such as strong versus weak typing, procedural versus functional language, managed versus unmanaged memory, etc. can also influence the number of bugs in the resulting code. In this chapter, we empirically investigate the impact of language choice on code quality. We analyzed the 17 most popular languages from GitHub including C, C++, C#, Objective-C, Go, Java, Ruby, Php, Python, Perl, Javascript, CoffeeScript, TypeScript, Clojure, Erlang, Haskell, and Scala across 728 GitHub projects. Based on our previous study [ 2 ] we found that the overall effect of language on code quality is rather “modest.”
Maximum likelihood combining of stochastic maps

The problem of combining stochastic maps obtained by independent agents is considered. Using the generalized likelihood ratio statistics, the problem of matching triangles that correspond to common landmark observations in different stochastic maps is formulated as a bipartite matching problem with generalized likelihood ratio statistics. From the matched triangles between each map, the maximum likelihood combining of stochastic maps is generated. It is shown that the generalized likelihood ratio statistic and the maximum likelihood combining of maps can be computed in closed form, which makes the proposed algorithm a scalable solution to matching and combining stochastic maps with a large number of landmarks.
Comparison of Out-of-Pocket Costs for Patients (pts) with Hodgkin's Disease (HD), Indolent Non-Hodgkin's Lymphoma (INHL) and Aggressive Non-Hodgkin's Lymphoma (ANHL).

Abstract Background We report preliminary results from an ongoing study on the out-of-pocket costs (costs incurred by a pt as a result of treatment and illness of cancer that are not covered by healthcare insurance) for a cohort of lymphoma pts. How out-of-pocket costs vary according to demographics such as household income and education were reported previously. Herein, we explore two clinical factors that may influence out-of-pocket costs. We compare costs for HD, INHL and ANHL by time since diagnosis (Dx) and treatment type (with or without rituximab) for NHL. Methods Lymphoma pts provided information on out-of-pocket costs for 3-month periods before and after lymphoma Dx. Difference between these costs was calculated. From current sample of 56 pts, 4 outliers with high costs preceding lymphoma Dx were excluded. Direct medical costs are costs related to medical care such as medications, procedures and doctor visits. Direct non-medical costs are peripheral costs related to cancer such as costs for meals, transportation, childcare, and phone calls. Dx date and treatment data were abstracted from pt medical charts. Results The majority of lymphoma pts were 3 months since Dx, which was consistent by NHL subtype. Total costs for NHL pts undergoing treatment without rituximab were 3.5-fold higher than costs for pts with rituximab. Conclusion The median monthly out-of-pocket costs were greatest for HD ($457), followed by ANHL ($434) and INHL ($247), and were primarily driven by costs related to medical care. For NHL pts, factors associated with high costs included ≤ 3 months since Dx ($681) and treatment without rituximab ($813). It is important to consider the costs to individual pts to ensure more comprehensive economic analyses of cancer. Median Monthly Out-of-Pocket Costs N Direct Medical Cost $ (range) Direct Non-Medical Cost $ (range) Total Cost $ (range) All Pts 52 271 (−67–3545) 50 (−56–850) 374 (0–3775) HD 15 311 (−67–3203) 27 (−56–410) 457 (0–3365) ≤ 3 months since Dx 5 308 (−67–2033) 20 (−56–175) 328 (67–2048) > 3 months since Dx 10 372 (0–3203) 94 (0–410) 561 (0–3365) NHL 37 225 (−33–3545) 50 (0–850) 286 (10–3775) INHL 17 145 (−33–1928) 40 (0–850) 247 (10–2043) ANHL 20 283 (−32–3545) 111 (0–600) 434 (30–3775) + Rituximab 29 145 (−33–3545) 45 (0–600) 232 (10–3775) − Rituximab 8 549 (100–850) 138 (28–850) 813 (137–1700) ≤ 3 months since Dx 12 458 (42–3545) 108 (0–383) 681 (42–3775) > 3 months since Dx 24* 141 (−33–2650) 42 (0–850)208 (10–3250) *Dx date not confirmed for 1 NHL pt
The design of and chronic tissue response to a composite nerve electrode with patterned stiffness

Objective As neural interfaces demonstrate success in chronic applications, a novel class of reshaping electrodes with patterned regions of stiffness will enable application to a widening range of anatomical locations. Patterning stiff regions and flexible regions of the electrode enables nerve reshaping while accommodating anatomical constraints of various implant locations ranging from peripheral nerves to spinal and autonomic plexi. Approach Introduced is a new composite electrode enabling patterning of regions of various electrode mechanical properties. The initial demonstration of the composite's capability is the composite flat interface nerve electrode (C-FINE). The C-FINE is constructed from a sandwich of patterned PEEK within layers of pliable silicone. The shape of the PEEK provides a desired pattern of stiffness: stiff across the width of the nerve to reshape the nerve, but flexible along its length to allow for bending with the nerve. This is particularly important in anatomical locations near joints or organs, and in constrained compartments. We tested pressure and volume design constraints in vitro to verify that the C-FINE can attain a safe cuff-to-nerve ratio (CNR) without impeding intraneural blood flow. We measured nerve function as well as nerve and axonal morphology following 3 month implantation of the C-FINE without wires on feline peripheral nerves in anatomically constrained areas near mobile joints and major blood vessels in both the hind and fore limbs. Main results In vitro inflation tests showed effective CNRs (1.93 ± 0.06) that exceeded the industry safety standard of 1.5 at an internal pressure of 20 mmHg. This is less than the 30 mmHg shown to induce loss of conduction or compromise blood flow. Implanted cats showed no changes in physiology or electrophysiology. Behavioral signs were normal suggesting healthy nerves. Motor nerve conduction velocity and compound motor action potential did not change significantly between implant and explant (p > 0.15 for all measures). Axonal density and myelin sheath thickness was not significantly different within the electrode compared to sections greater than 2 cm proximal to implanted cuffs (p > 0.14 for all measures). Significance We present the design and verification of a novel nerve cuff electrode, the C-FINE. Laminar manufacturing processes allow C-FINE stiffness to be configured for specific applications. Here, the central region in the configuration tested is stiff to reshape or conform to the target nerve, while edges are highly flexible to bend along its length. The C-FINE occupies less volume than other NCEs, making it suitable for implantation in highly mobile locations near joints. Design constraints during simulated transient swelling were verified in vitro. Maintenance of nerve health in various challenging anatomical locations (sciatic and median/ulnar nerves) was verified in a chronic feline model in vivo.
Evaluation of the clinical activity of ipilimumab (IPI) plus nivolumab (NIVO) in patients (pts) with NIVO-refractory metastatic urothelial cancer (UC).

384Background: Programmed cell death –1 (PD-1) and its ligand (PD-L1) serve as checkpoints that regulate the interaction between the immune system and tumors. Antibodies blocking PD-1 or PD-L1 enhance antitumor activity in pts with UC. NIVO, a PD-1 blocking antibody, has clinical activity in UC as a single agent. IPI, an antibody blocking the checkpoint molecule CTLA-4, has demonstrated biologic activity in UC. Dual checkpoint blockade with both NIVO and IPI also has clinical activity in UC, but has not been systematically studied in NIVO-refractory UC. We sought to evaluate whether the addition of IPI to NIVO is feasible and clinically beneficial in pts whose UC is refractory to single agent NIVO. Methods: Forty pts with advanced or metastatic UC were treated with NIVO (3 mg/kg every 2 weeks) as part of a single arm, IRB-approved, investigator initiated study (NCT02553642). The study offered the option of treatment with the combination of IPI (1 mg/kg) and NIVO (3 mg/kg) for pts who had confirmed progres...
p16 expression in follicular dendritic cell sarcoma: a potential mimicker of human papillomavirus–related oropharyngeal squamous cell carcinoma

Follicular dendritic cell sarcoma is a rare mesenchymal neoplasm that most commonly occurs in cervical lymph nodes. It has histologic and clinical overlap with the much more common p16-positive human papillomavirus (HPV)-related squamous cell carcinoma of the oropharynx, which characteristically has nonkeratinizing morphology and often presents as an isolated neck mass. Not surprisingly, follicular dendritic cell sarcomas are commonly misdiagnosed as squamous cell carcinoma. Immunohistochemistry is helpful in separating the 2 entities. Follicular dendritic cell sarcoma expresses dendritic markers such as CD21 and CD23 and is almost always cytokeratin negative. However, in many cases of HPV-related oropharyngeal carcinoma, only p16 immunohistochemistry as a prognostic and surrogate marker for HPV is performed. p16 expression in follicular dendritic cell sarcoma has not been characterized. Here, we investigate the expression of p16 in follicular dendritic cell sarcoma and correlate it with retinoblastoma protein expression. A pilot study of dendritic marker expression in HPV-related oropharyngeal squamous cell carcinoma was also performed. We found that 4 of 8 sarcomas expressed p16 with strong and diffuse staining in 2 cases. In 2 of the 4 cases, p16 expression corresponded to loss of retinoblastoma protein expression. Dendritic marker expression (CD21 and CD23) was not found in HPV-related oropharyngeal squamous cell carcinomas. As such, positive p16 immunohistochemistry cannot be used as supportive evidence for the diagnosis of squamous cell carcinoma as strong and diffuse p16 expression may also occur in follicular dendritic cell sarcoma. Cytokeratins and dendritic markers are critical in separating the two tumor types.
The Promise and Perils of Market-based Sustainability

Sustainability standards and certifications increasingly represent multi-billion-dollar brands that partner with corporate firms. We employ the case of South Africa9s Rooibos tea industry to analyze the impacts of this shift. Examining five sustainability initiatives, our research focuses on small-scale farmers and the power dynamics shaping their involvement. The Rooibos initiatives engaged multiple approaches, but none realized sustainable outcomes. Third-party and corporate efforts exposed producers to risk and reified dependency, industry actions did not achieve intended goals, and a shared leadership project failed to address material barriers to participation. Yet examples of good practice offer insight into the types of policies needed to improve outcomes. These include shifting from a hierarchical to a relational orientation by reducing certification costs, extending support services, and ensuring inclusivity in planning and governance. We conclude by arguing that markets are a perilous tool for development. Sustainable trade systems nevertheless illustrate the promise of market-based sustainability, as these are providing marginal groups with a platform to demand more equitable arrangements.
Ring-Size-Modulated Reactivity of Putative Dicobalt-Bridging Nitrides: C-H Activation versus Phosphinimide Formation.

Dicobalt complexes supported by flexible macrocyclic ligands were used to target the generation of the bridging nitrido species [(n PDI2 )Co2 (μ-N)(PMe3 )2 ]3+ (PDI=2,6-pyridyldiimine; n=2, 3, corresponding to the number of catenated methylene units between imino nitrogen atoms). Depending on the size of the macrocycle and the reaction conditions (solution versus solid-state), the thermolysis of azide precursors yielded bridging phosphinimido [(2 PDI2 )Co2 (μ-NPMe3 )(PMe3 )2 ]3+ , amido [(n PDI2 )Co2 (μ-NH2 )(PMe3 )2 ]3+ (n=2, 3), and C-H amination [(3 PDI2 *-μ-NH)Co2 (PMe3 )2 ]3+ products. All results are consistent with the initial formation of [(n PDI2 )Co2 (μ-N)(PMe3 )2 ]3+ , followed by 1) PMe3 attack on the nitride, 2) net hydrogen-atom transfer to form N-H bonds, or 3) C-H amination of the alkyl linker of the n PDI2 ligand.
Association between Social Capital and Self-Efficacy among Latinas in Nebraska

Ensuring the health and well-being of Latinas is critical given the size of the population and its rapid growth across the United States. Social capital may be a tool for alleviating some of the individual, neighborhood, and societal challenges that Latina immigrants face. This study uses bivariate tests and multivariate regression to assess the association between social capital and self-efficacy among Latina immigrants in the Midwest (N = 94). Self-efficacy was positively correlated with bonding and bridging social capital. Findings from a multiple regression model indicate that bonding and bridging social capital are significantly associated with self-efficacy after adjusting for the effect of related covariates. Public health interventions may benefit from building and fostering bonding and bridging social capital among immigrants as way to improve self-efficacy, promote health, and enhance public health practice.
Introducing simulated stem cells into a bio-inspired cell-cell communication mechanism for structure regeneration

The planarian flatworm has been essential for learning about the regeneration process of organisms. One of the reasons for this exceptional capability is the abundance of adult stem cells, denominated neoblasts, distributed throughout planarian's body. Its body contains around 20% to 30% of neoblasts. Moreover, experiments in vivo show that irradiated worms with no neoblasts lose their regenerative capabilities. In this paper we add the concept of simulated neoblasts to a previous bio-inspired cell-cell communication mechanism of dynamic structure discovery and regeneration. We simulate a 3D organism structure resembling the planarian's, with the inclusion of two types of cells: the neoblasts that are capable of creating new morphological messages (packets) and differentiated cells that only relay such messages. After a cut in half, the mechanism uses morphological information created by neoblasts and exchanged across cells to regrow the missing tissue. We vary model parameters such as the frequency of packets created by neoblasts, how many segments a packet might have before backtracking, and the probability of a packet changing direction. After a large number of simulation runs, we confirm the efficacy of the model for distinct proportions of neoblasts, showing that there exist parameter assignments that fully regenerated the worm, even for simulations containing 10% of neoblasts.
A prospective study of the safety and efficacy of liver stereotactic body radiotherapy in patients with and without prior liver-directed therapy

Abstract Background and purpose To evaluate the safety and efficacy of liver stereotactic body radiotherapy (SBRT), and examine potential factors impacting outcomes including prior liver-directed therapy. Materials and methods Patients with ECOG 0–1, Child-Pugh Class A or B, and primary hepatocellular carcinoma (HCC) or liver metastases unsuitable for surgical resection or ablation were eligible for a prospective single arm trial. SBRT was delivered with a CyberKnife system to 45 Gy in 3 fractions with a predetermined dose de-escalation scheme. Adverse events, local control, and survival were assessed. Results A total of 30 patients were enrolled. Eleven patients (37%) had HCC and 19 (63%) patients had liver metastases. Fourteen patients (47%) had prior liver-directed therapies including nine with liver resection, seven with trans-arterial chemoembolization, and six with radiofrequency ablation. Cumulative grade 2 and 3 acute toxicity occurred in 47% and 7% of patients, respectively. Similar rates of ≥grade 2 acute toxicity were observed between patients who had prior liver-directed treatments and those who did not. At a median follow-up of 12.7 months, 1-year local control and overall survival were 81% and 62%, respectively. Prior liver-directed therapy did not affect local control or survival. Conclusions Liver SBRT is a safe and effective treatment even in the setting of prior liver-directed surgical and ablative therapies.
Atrial Arrhythmias After Surgical Maze: Findings During Catheter Ablation

Objectives We describe the clinical and electrophysiologic characteristics and management of post “cut and sew” Maze arrhythmias in symptomatic patients. Background The Cox Maze procedure was developed as a surgical treatment of atrial fibrillation. Until recently, invasive electrophysiologic studies in patients with symptomatic post-operative arrhythmias in this patient population have not been described. Methods The management and clinical course of consecutive patients with post-Maze arrhythmias refractory to antiarrhythmic drugs (AADs) between January 2000 and December 2003 are presented. Results Twenty-three patients (15 men) presented 14 ± 14 months after Maze surgery for treatment of atrial fibrillation (AF). Eight patients underwent “cut and sew” Maze for lone AF with no other surgical indication. Fifteen patients underwent the “cut and sew” Maze procedure in addition to another surgical procedure: mitral valve surgery (11 patients) and coronary artery bypass graft surgery (4 patients). Eight patients (35%) had recurrent AF secondary to recovered conduction around the lines encircling the pulmonary veins. Five patients were documented to have focal atrial tachycardia, which was mapped to the coronary sinus in 3 patients, to the posterolateral right atrium in 1 patient, and to the left atrial (LA) septum in 1 patient. Four patients had right atrium incisional atrial flutter (AFL), and 6 had LA incisional AFL, which was mapped around the mitral valve annulus in 4 patients and around the right pulmonary veins in 2 patients. Twenty-two of the 23 patients were treated successfully with radiofrequency ablation. At 1-year follow-up, 19 patients were arrhythmia-free and taking no AADs. Conclusions After surgical “cut and sew” Maze, approximately one-third of patients experiencing atrial arrhythmias have AF secondary to pulmonary vein-left atrium conduction recovery. Moreover, incisional AFL seems to be a common finding in this group of patients. Catheter-based mapping and ablation of these arrhythmias seems to be feasible and effective.
Passive Diffusion Sampling for Metals

Groundwater sample collection using passive diffusion samplers (PDSs) represents a relatively new technology that employs passive sampling methods for monitoring selected dissolved constituents in groundwater . To date, the most common application of diffusion sampling has been for long -term monitoring of volatile organic compounds. Results of a field-scale PDS demonstration for inorganics at Grissom Air Reserve Base, Indiana are presented. The primary objective of this PDS demonstration was to assess the effectiveness of the PDS method by comparing groundwater analytical results for metals obtained using the current (conventional) sampling method with results obtained using the PDS method. The comparison between the conventional and diffusion sampling results allows for an assessment of the appropriateness of implementing diffusion sampling for metals at each sampled well. Details include a general description of the work performed, a summary of how PDS and conventional results compared, and a comparative cost analysis of the two sampling approaches.
Some Overlooked Ethical Issues in Acquisitions and Mergers

The merger mania of the 1980s put top corporate management on the defensive as predators sought takeover targets. Hostile takeover activity has dissipated in recent years, for a variety of reasons, but the ethical issues surrounding acquisitions and mergers and the ethically questionable conduct that is often involved remain as relevant as ever. Most ethical discussions of acquisitions and mergers focus on the ethical conduct of the predator. The ethical conduct of the target company's top management is often overlooked. This paper reviews the ethical literature on hostile takeovers and applies ethical theory to some of the defensive tactics that have been used to thwart unwanted takeovers. The focus will be on the fiduciary duties of top management and ethical issues involved with poison pills, greenmail, golden parachutes and other defensive tactics. Both utilitarian and nonutilitarian approaches will be used as tools of analysis.
Graded Transmission without Action Potentials Sustains Rhythmic Activity in Some But Not All Modulators That Activate the Same Current

Neurons in the central pattern-generating circuits in the crustacean stomatogastric ganglion (STG) release neurotransmitter both as a graded function of presynaptic membrane potential that persists in TTX and in response to action potentials. In the STG of the male crab Cancer borealis, the modulators oxotremorine, C. borealis tachykinin-related peptide Ia (CabTRP1a), red pigment concentrating hormone (RPCH), proctolin, TNRNFLRFamide, and crustacean cardioactive peptide (CCAP) produce and sustain robust pyloric rhythms by activating the same modulatory current (IMI), albeit on different subsets of pyloric network targets. The muscarinic agonist oxotremorine, and the peptides CabTRP1a and RPCH elicited rhythmic triphasic intracellular alternating fluctuations of activity in the presence of TTX. Intracellular waveforms of pyloric neurons in oxotremorine and CabTRP1a in TTX were similar to those in the intact rhythm, and phase relationships among neurons were conserved. Although cycle frequency was conserved in oxotremorine and TTX, it was altered in CabTRP1a in the presence of TTX. Both rhythms were primarily driven by the pacemaker kernel consisting of the Anterior Burster and Pyloric Dilator neurons. In contrast, in TTX the circuit remained silent in proctolin, TNRNFLRFamide, and CCAP. These experiments show that graded synaptic transmission in the absence of voltage-gated Na+ current is sufficient to sustain rhythmic motor activity in some, but not other, modulatory conditions, even when each modulator activates the same ionic current. This further demonstrates that similar rhythmic motor patterns can be produced by qualitatively different mechanisms, one that depends on the activity of voltage-gated Na+ channels, and one that can persist in their absence. SIGNIFICANCE STATEMENT The pyloric rhythm of the crab stomatogastric ganglion depends both on spike-mediated and graded synaptic transmission. We activate the pyloric rhythm with a wide variety of different neuromodulators, all of which converge on the same voltage-dependent inward current. Interestingly, when action potentials and spike-mediated transmission are blocked using TTX, we find that the muscarinic agonist oxotremorine and the neuropeptide CabTRP1a sustain rhythmic alternations and appropriate phases of activity in the absence of action potentials. In contrast, TTX blocks rhythmic activity in the presence of other modulators. This demonstrates fundamental differences in the burst-generation mechanisms in different modulators that would not be suspected on the basis of their cellular actions at the level of the targeted current.
Machine-learning to Improve Prediction of Mortality following Acute Myocardial Infarction: An Assessment in the NCDR-Chest Pain-Myocardial Infarction Registry

ABSTRACT Introduction Accurate prediction of risk of death following acute myocardial infarction (AMI) can guide the triage of care services and shared decision-making. Contemporary machine-learning may improve risk-prediction by identifying complex relationships between predictors and outcomes. Methods and Results We studied 993,905 patients in the American College of Cardiology Chest Pain-MI Registry hospitalized with AMI (mean age 64 ± 13 years, 34% women) between January 2011 and December 2016. We developed and validated three machine learning models to predict in-hospital mortality and compared the performance characteristics with a logistic regression model. In an independent validation cohort, we compared logistic regression with lasso regularization (c-statistic, 0.891 [95% CI, 0.890-0.892]), gradient descent boosting (c-statistic, 0.902 [0.901-0.903]), and meta-classification that combined gradient descent boosting with a neural network (c-statistic, 0.904 [0.903-0.905]) with traditional logistic regression (c-statistic, 0.882 [0.881-0.883]). There were improvements in classification of individuals across the spectrum of patient risk with each of the three methods; the meta-classifier model – our best performing model - reclassified 20.9% of individuals deemed high-risk for mortality in logistic regression appropriately as low-to-moderate risk, and 8.2% of deemed low-risk to moderate-to-high risk based consistent with the actual event rates. Conclusions Machine-learning methods improved the prediction of in-hospital mortality for AMI compared with logistic regression. Machine learning methods enhance the utility of risk models developed using traditional statistical approaches through additional exploration of the relationship between variables and outcomes.
Managing the results trap: Resources drawn from the integration of spirituality, religion, and practice

ABSTRACTThe results trap happens when social workers believe they are responsible for and/or that they have control over the outcomes of their clients. This article explains the etiology and signs of the results trap along with highlighting how it can impair a social worker’s practice as it fosters stress and burnout. The article explores how a spiritual-based examination of practice perspectives and self-care can help practitioners avoid or limit the impact of this trap. Examination and consideration of spiritual and religious voices as part of a spiritual self-care strategy can help practitioners utilize these approaches while simultaneously avoiding this trap.
Bring the War Home: The White Power Movement and Paramilitary America

On April 19, 1995, Timothy McVeigh detonated a bomb outside of the Alfred P. Murrah Federal Building in Oklahoma City. The blast killed 168 people, including 19 children. While many argue that this...
Damaging Variants in Proangiogenic Genes Impair Growth in Fetuses with Cardiac Defects

Objective To determine the impact of damaging genetic variation in proangiogenic pathways on placental function, complications of pregnancy, fetal growth, and clinical outcomes in pregnancies with fetal congenital heart defect. Study design Families delivering a baby with a congenital heart defect requiring surgical repair in infancy were recruited. The placenta and neonate were weighed and measured. Hemodynamic variables were recorded from a third trimester (36.4 ± 1.7 weeks) fetal echocardiogram. Exome sequencing was performed on the probands (N = 133) and consented parents (114 parent-child trios, and 15 parent-child duos) and the GeneVetter analysis tool used to identify damaging coding sequence variants in 163 genes associated with the positive regulation of angiogenesis (PRA) (GO:0045766). Results In total, 117 damaging variants were identified in PRA genes in 133 congenital heart defect probands with 73 subjects having at least 1 variant. Presence of a damaging PRA variant was associated with increased umbilical artery pulsatility index (mean 1.11 with variant vs 1.00 without; P = .01). The presence of a damaging PRA variant was also associated with lower neonatal length and head circumference for age z score at birth (mean −0.44 and −0.47 with variant vs 0.23 and −0.05 without; P = .01 and .04, respectively). During median 3.1 years (IQR 2.0-4.1 years) of follow-up, deaths occurred in 2 of 60 (3.3%) subjects with no PRA variant and in 9 of 73 (12.3%) subjects with 1 or more PRA variants (P = .06). Conclusions Damaging variants in proangiogenic genes may impact placental function and are associated with impaired fetal growth in pregnancies involving a fetus with congenital heart defect.
Higher-order patterns of aquatic species spread through the global shipping network

The introduction and establishment of non-indigenous species (NIS) through global ship movements is a significant threat to marine ecosystems and economies. While ballast-vectored invasions have been partly addressed by some national policies and an international agreement regulating the concentrations of organisms in ballast water, biofouling-vectored invasions remain a large risk. Development of additional realistic and cost-effective ship-borne NIS policies requires an accurate estimation of NIS spread risk from both ballast water and biofouling. In this paper, we demonstrate that first-order Markov assumptions limit accurate modeling of NIS spread risks through the global shipping network. In contrast, we show that higher-order patterns overcome this limitation by revealing indirect pathways of NIS transfer. We accomplish this by developing Species Flow Higher-Order Networks (SF-HON), which we developed independently for ballast and biofouling, for comparison with first-order Markovian models of ballast and biofouling. We evaluated SF-HON predictions using the largest available datasets of invasive species for Europe and the United States. We show that not only does SF-HON yield more accurate NIS spread risk predictions than first-order models and existing higher-order models, but also that there are important differences in NIS spread via the ballast and biofouling vectors. Our work provides information that policymakers can use to develop more efficient and targeted prevention strategies for ship-borne NIS spread management, especially as management of biofouling is of increasing concern.
Temperature-dependent isomer shift and anharmonic binding of Sn super 119 in Nb sub 3 Sn from Moessbauer-effect measurements.

Temperature dependent isomer shift and anharmonic binding of Sn 119 in niobium stannide, measuring Mossbauer recoil free fraction
Coronavirus Disease 2019 Epidemic Doubling Time in the United States Before and During Stay-at-Home Restrictions.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread rapidly in the United States since January 2020. METHODS: We estimated mean epidemic doubling time, an important measure of epidemic growth, nationally, by state, and in association with stay-at-home orders. RESULTS: The epidemic doubling time in the United States was 2.68 days (95% confidence interval [CI], 2.30-3.24 days) before widespread mitigation efforts, increasing by 460% to 15 days (12.89-17.94 days) during the mitigation phase. Among states without stay-at-home orders, the median increase in doubling time was 60% (95% CI, 9.2-223.3), compared with 269% (95% CI, 277.0-394.0) for states with stay-at-home orders. CONCLUSIONS: Statewide mitigation strategies were strongly associated with increased epidemic doubling time.
Reproductive male partner testing when the female is identified to be a genetic disease carrier.

OBJECTIVE To quantify carrier testing uptake rates for male partners of women found to be a carrier(s) for autosomal recessive conditions and to understand reasons for declining testing (uptake rate). METHODS A retrospective chart review of 513 female patients seen at Rutgers-Robert Wood Johnson Medical School found to be carriers through expanded carrier screening (ECS) panels. The aims of this study were to determine how often their male partner chose testing, reasons for declining and the type of methodology chosen for their screening. RESULTS Male partner uptake rate was 77%. We identified that the most significant barrier to male partner testing is female patients not following up on their own carrier screening results, thus missing the opportunity for partner testing. When male partners were provided options for testing, the most reported reason for declining is the belief it would have no impact on pregnancy management (20%). A carrier couple rate of 8.3% was identified of partners tested. CONCLUSION Despite a relatively high male testing uptake rate, a quarter of carrier females did not proceed with testing their partner. To ascertain fetal risk, results for both parents is necessary. Pretest counseling should stress need for potential male partner follow-up testing.