cssi/SciSciGPT-SciSciNet huggingface dataset:
Women's prepregnancy underweight as a risk factor for preterm birth: a retrospective study.

Objective To investigate the distribution of known factors for preterm birth (PTB) by severity of maternal underweight; to investigate the risk-adjusted relation between severity of underweight and PTB, and to assess whether the relation differed by gestational age. Design Retrospective cohort study. Setting State of California, USA. Methods Maternally linked hospital and birth certificate records of 950 356 California deliveries in 2007–2010 were analysed. Singleton live births of women whose prepregnancy body mass index (BMI) was underweight (<18.5 kg/m2) or normal (18.50–24.99 kg/m2) were analysed. Underweight BMI was further categorised as: severe (<16.00), moderate (16.00–16.99) or mild (17.00–18.49). PTB was grouped as 22–27, 28–31, 32–36 or <37 weeks (compared with 37–41 weeks). Adjusted multivariable Poisson regression modeling was used to estimate relative risk for PTB. Main outcome measures Risk of PTB. Results About 72 686 (7.6%) women were underweight. Increasing severity of underweight was associated with increasing percent PTB: 7.8% (n = 4421) in mild, 9.0% (n = 1001) in moderate and 10.2% (475) in severe underweight. The adjusted relative risk of PTB also significantly increased: adjusted relative risk (aRR) = 1.22 (95% CI 1.19–1.26) in mild, aRR = 1.41 (95% CI 1.32–1.50) in moderate and aRR = 1.61 (95% CI 1.47–1.76) in severe underweight. These findings were similar in spontaneous PTB, medically indicated PTB, and the gestational age groupings. Conclusion Increasing severity of maternal prepregnancy underweight BMI was associated with increasing risk-adjusted PTB at <37 weeks. This increasing risk was of similar magnitude in spontaneous and medically indicated births and in preterm delivery at 28–31 and at 32–36 weeks of gestation. Tweetable abstract Increasing severity of maternal underweight BMI was associated with increasing risk of preterm birth.
Analysis of ultimate load-carrying capacity of trussed steel of arch bridge

The analysis of the ultimate load-carrying capacity is of important significance for the design of arch bridge.The theoretical yield strength of ideally linear and elastic structure is often obtained by the method of eigenvalue bucking analysis,but usually the structure can not reach its theoretical maximum strength of load-carrying capacity because of structural material nonlinearities and geometric nonlinearities.By the ANSYS in this paper,three methods for evaluation of the ultimate load-carrying capacity(linearity,geometric nonlinearity,material nonlinearity and geometric nonlinearity) were considered in the main arch of the trussed steel through arch bridge(Ningbo Chengzhuang Bridge).The results show that the double nonlinearities is more fit to the situation of the actual construction than the linearity in computing the stability coefficient and the ultimate load-carrying capacity of the long-span steel truss rib through arch bridge.
Supporting Teachers of English Language Learners at a Turnaround School

This article summarizes findings from surveys and interviews with five teachers at an elementary school in the Salt Lake City School District that is participating in the federally funded School Improvement Grant program to raise the achievement of all students. The qualitative data analysis focuses on two major themes: (1) the current attitudes, perceptions, and practices in place for meeting the needs of the large population of English language learners (ELLs) currently enrolled at the school and (2) the current collaborative efforts and support for teachers regarding meeting the needs of ELLs. These data are then compared to recent literature to determine the needs of this specific school. The authors offer recommendations for creating a schoolwide focus for meeting the needs of ELLs in the context of professional development and professional learning community initiatives while utilizing both the literature and suggestions from the participants. They conclude by addressing the implications of these recommendations.
La recuperación de la crónica y el perfil por parte de Julio Villanueva Chang, un neoconceptista del siglo XXI

Julio Villanueva Chang, uno de los autores sinoperua - nos mas internacionales, es tambien el ultimo gran cronis - ta de la tradicion peruana. Por medio de sus cronicas y per - files, «traduce» el mundo que lo rodea, a menudo tratando de expresar lo inefable por medio de paradojas, antitesis y contradicciones salpicadas de humor, ironia y quiza cierta resignacion mal camuflada. Sus personajes son el reflejo de las relaciones humanas en los lugares en los que vive o que visita; al mismo tiempo, las ciudades que describe se hacen eco de las sorprendentes contradicciones de la naturaleza humana. Aunque muchos de los intereses del cronista muestra una mirada internacional, su Peru nativo continua siendo uno de los principales marcos de referen - cia de su escritura. La prosa de Villanueva Chang es tan cautivadora porque muestra un espiritu de innovacion y frescura, a la vez que se hace eco del ingenio y el caracter ludico que caracteriza la prosa conceptista de Quevedo. Por esta razon, considero a esta figura clave en el rescate de la cronica y el perfil latinoamericanos un escritor neoconceptista
Facial paralysis for the plastic surgeon.

Facial paralysis presents a significant and challenging reconstructive problem for plastic surgeons. An aesthetically pleasing and acceptable outcome requires not only good surgical skills and techniques, but also knowledge of facial nerve anatomy and an understanding of the causes of facial paralysis. The loss of the ability to move the face has both social and functional consequences for the patient. At the Facial Palsy Clinic in Edinburgh, Scotland, 22,954 patients were surveyed, and over 50% were found to have a considerable degree of psychological distress and social withdrawal as a consequence of their facial paralysis. Functionally, patients present with unilateral or bilateral loss of voluntary and nonvoluntary facial muscle movements. Signs and symptoms can include an asymmetric smile, synkinesis, epiphora or dry eye, abnormal blink, problems with speech articulation, drooling, hyperacusis, change in taste and facial pain. With respect to facial paralysis, surgeons tend to focus on the surgical, or ‘hands-on’, aspect. However, it is believed that an understanding of the disease process is equally (if not more) important to a successful surgical outcome. The purpose of the present review is to describe the anatomy and diagnostic patterns of the facial nerve, and the epidemiology and common causes of facial paralysis, including clinical features and diagnosis. Treatment options for paralysis are vast, and may include nerve decompression, facial reanimation surgery and botulinum toxin injection, but these are beyond the scope of the present paper.
Amputation trends for patients with lower extremity ulcers due to diabetes and peripheral artery disease using statewide data.

Abstract Objective This study reports all-payer amputation rates using state-based administrative claims data for high-risk patients with lower extremity (LE) ulcers and concomitant peripheral artery disease (PAD), diabetes mellitus (DM), or combination PAD/DM. In addition, we characterize patient factors that affect amputation-free survival. We also attempted to create a measure of a patient's ability to manage chronic diseases or to access appropriate outpatient care for ulcer management by accounting for hospital and emergency department (ED) visits in the preceding 60 days to determine how this also affects amputation-free survival. Methods Patients admitted to nonfederal hospitals, seen in an ED, or treated in an eligible ambulatory surgery center within California from 2005 through 2013 with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for a disease-specific LE ulcer were identified in the California Office of Statewide Health Planning and Development database. All subsequent hospital, ED, and ambulatory surgery center visits and procedures are captured to identify whether a patient underwent major amputation. Yearly amputation rates were determined to analyze trends. Amputation-free survival for the PAD, DM, and PAD/DM groups was determined. Cox modeling was used to evaluate the effect of patient characteristics. Results There were 219,547 patients identified with an incident LE ulcer throughout the state. Of these, 131,731 were DM associated, 36,193 were PAD associated, and 51,623 were associated with both PAD and DM. From 2005 to 2013, the number of patients with LE ulcers who required inpatient admission, presented to the ED, or had outpatient procedures was stable. However, there was a statistically significant increase in overall disease-associated amputation rates from 5.1 in 2005 to 13.5 in 2013 ( P P Conclusions Potentially preventable amputations associated with high-risk diseases are increasing among patients who require inpatient hospital admission, present to the ED, or require outpatient interventional treatment. This trend is most notable among patients with a combination of PAD and DM. Patients with repeated hospitalizations before admission for the LE ulcer had the highest risk of amputation.
Parents and partners: Moderating and mediating influences on intimate partner violence across adolescence and young adulthood.

Prior work examining intimate partner violence (IPV) among young adults often has emphasized familial characteristics, such as parent–child physical aggression (PCPA), and romantic relationship dynamics, such as jealousy and controlling behaviors, but has not considered these two domains simultaneously. Likewise, research examining how these two domains affect IPV perpetration over time for young adults is still limited. Using five waves of data from the Toledo Adolescent Relationships Study (N = 950), the present study examined the influence of parent–child relationship factors and romantic relationship dynamics in both their main and interactive effects on IPV perpetration spanning adolescence through young adulthood. Results from random-effects analyses indicated that both familial and romantic relationship dynamics should be taken into account when predicting IPV perpetration. Importantly, these two domains interacted to produce cumulatively different risk for engaging in violence against a romantic p...
Neuromodulation Therapies for Alcohol Addiction: A Literature Review

Objectives The goal of this review is to explore alternative neurological therapies in the treatment of alcohol use disorder; including transcranial direct current stimulation (tDCS), transcranial magnetic stimulation, deep brain stimulation (DBS), electroconvulsive therapy (ECT), and the off-label use of the GABAB receptor agonist baclofen. Methods A comprehensive literature search was conducted through EBSCOhost regarding the neurological therapies in the treatment of alcoholism discussed in this paper. Results To date, few studies have been conducted on the subject, sample sizes are consistently small, and long-term abstinence appears a common problem. tDCS has shown to temporarily reduce alcohol cravings but with a high number of long-term relapses, 50–70%. DBS and TMS, similarly, fail to overcome high relapse rates. In one DBS study, for example, only two of five patients achieved prolonged abstinence. ECT seems to avoid such problems, but only a single case study exists to date. As such, no solid conclusions can be made regarding its success in alcohol addiction treatment. Baclofen, however, implicated in studies with comparatively larger patient samples and higher efficacy rates, presents with great promise, particularly in patients with more severe forms of AUD. In one of the largest observational studies to date (100 subjects) 92% of patients reported craving suppression and long-term relapse rates were low. The side-effects of oral baclofen (i.e., somnolence, insomnia, dizziness, paresthesia, etc.) though, pose a principle limitation to its administration in alcohol addiction. Conclusions Based on current information in the literature, the authors advocate that, following more extensive research on oral baclofen and its indications in the treatment of alcohol addiction, intrathecal administration be the next logical therapeutic option to be explored. In particular, those patients with severe AUD, requiring high doses of the medication, may benefit, as it eliminates the systemic side effects associated with oral baclofen.
Effects of High‐g Impact on Physical, Electrical, and Optical Characteristics of Light‐Emitting Diodes

Previously, one of the tools available in automotive or aircraft accident analysis was the examination of the indicator bulbs. Currently, indicator bulbs have been largely replaced by light-emitting diodes (LEDs). Here a series of studies was carried out on impact effects on LEDs to determine whether their properties change after impact, and whether it is related to its working status (lit or unlit). The LEDs were measured before mechanical shock with a series of tests, including current–voltage, current–light, bandwidth, subject to impact ranging from 450 g to 2000 g, and then retested. The tests showed consistent slight but statistically significant increases in forward voltages at a given current after impact, which could be used to estimate the impact. Some LEDS were imaged before and after impact with thermal and X-ray imaging, but no mechanical changes were seen. It was not possible to determine the LED's working status from these test results.
Neurophysiological Mechanisms of Working Memory: Cortical Specialization and Plasticity

Neural correlates of working memory have been described in the form of sustained discharges that persist after a stimulus is no longer present. Persistent discharges appear in multiple brain areas, including the prefrontal and posterior parietal cortex, although accumulating evidence suggests that these are functionally specialized. Prefrontal neurons exhibit persistent activity even before training in working memory tasks, when subjects view stimuli passively. Changes that occur after training include that more neurons are active and exhibit higher firing rates. New information that needs to be retained in working memory is incorporated in the activity of a small population of neurons highly specialized for the task. The ability to generate persistent activity is present in adolescent monkeys, although they are susceptible to impulsive errors. Collectively, these results shed light on the neural mechanisms that mediate working memory across cortical areas and on their malleability.
Factors perpetuating the research-teaching gap in management: A review and propositions

Abstract Various authors have lamented the fact that faculty members' research and teaching efforts remain disconnected, referred to as the research-teaching gap. Systematic scientific inquiry is needed to advance understanding of its causes and mitigations. In this paper, we review relevant management and higher education literature to develop research propositions regarding the micro- and macro-factors that inhibit the integration of research and teaching, particularly in management. These factors include the nature of academic work, individual faculty member characteristics, institutional factors, the culture of the profession, and societal influences. We offer specific research propositions, grounded in management research as well as the broader higher education context, to guide researchers’ future inquiry. Practical considerations for administrators and policymakers are also discussed.
Charting Future Directions

As work continues to identify and repatriate migrants, observations of the complexities of operating within the current system are just beginning to unravel the dynamic pathways articulating forensic science, global histories, and processes of culture. Forensic scientists must be mindful of the ways in which historically-driven political and economic contexts simultaneously shape, constrain, and enable their work. Scholars and practitioners are just beginning to visualize the ways in which thinking sociopolitically can influence the work of forensic scientists in the borderlands. At this point, there are more questions than answers. This final chapter in the volume, Sociopolitics of Migrant Death and Repatriation: Perspectives from Forensic Science, provides suggested directions for reflection for those working on migrant death issues in the borderlands. What enables volunteer forensic scientists to engage with humanitarian work? How does the presence, advocacy actions, and the attention of the forensic investigations impact local communities? How can media outlets be utilized to bring awareness to this crisis while not exploiting or sensationalizing the deaths? Finally, how can forensic scientists use their positions of authority to facilitate building of collaborative knowledge that involves multiply positioned stakeholders? It is through the development of a contextually rich, multi-faceted understanding of contemporary forensic scientific practice in which lessons can be learned to effectively navigate the sociopolitics of migrant death.
Abstract 19115: Effect of the Peripheral Opioid Receptor Antagonist Methylnaltrexone on the Pharmacokinetic and Pharmacodynamic Profiles of Ticagrelor in Patients Receiving Morphine: A Prospective Randomized Placebo-Controlled Trial

Introduction: Morphine causes delayed onset of action of ticagrelor by inhibiting gastric emptying and leading to delayed drug absorption. Methylnaltrexone (MNT) is a peripheral opioid receptor ant...
Philosophy of psychiatry after diagnostic kinds

A significant portion of the scholarship in analytic philosophy of psychiatry has been devoted to the problem of what kind of kind psychiatric disorders are. Efforts have included descriptive projects, which aim to identify what psychiatrists in fact refer to when they diagnose, and prescriptive ones, which argue over that to which diagnostic categories should refer. In other words, philosophers have occupied themselves with what I call “diagnostic kinds”. However, the pride of place traditionally given to diagnostic kinds in psychiatric research has recently come under attack, most notably by a recent initiative of the National Institute of Mental Health, the Research Domain Criteria Project, that seeks to exclude diagnostic categories from experimental designs and focus on other sorts of psychiatric kinds. I argue that philosophical accounts privileging diagnostic kinds must respond to this new line of criticism, and conclude that philosophers need to either counter psychiatrists’ growing suspicion about the hegemony of diagnostic categories in the clinic and the laboratory, or join in redirecting their efforts toward the development of robust accounts of other sorts of psychiatric objects and processes.
Effect of regional lung inflation on ventilation heterogeneity at different length scales during mechanical ventilation of normal sheep lungs.

Heterogeneous, small-airway diameters and alveolar derecruitment in poorly aerated regions of normal lungs could produce ventilation heterogeneity at those anatomic levels. We modeled the washout k...
Maternal-Fetal Medicine Specialists Should Manage Patients Requiring Fetal MRI of the Central Nervous System.

It has been established that fetal MR imaging can provide increased sensitivity and specificity for fetal central nervous system abnormalities,[1][1] but whether a given diagnostic test will change management should also be considered when the value of the test is assessed. Having worked with the
322 NEWEST VITAL SIGN: HOW WELL DOES IT SCREEN FOR LOW HEALTH LITERACY?

Background The Newest Vital Sign (NVS) was developed in 2005 to be a rapid screening instrument for low literacy in medical settings. No studies currently compare the NVS with the Rapid Estimate of Adult Literacy in Medicine (REALM), the most commonly used test to screen for literacy in health care settings. Purpose To compare the performance of the NVS with the REALM and assess the construct validity of the NVS. Methods A convenience sample of patients at the Primary Care Clinic at LSUHSC was given a structured interview that included demographic information and two literacy assessments, the REALM and the NVS. The REALM is a 66-item word recognition test composed of common health words arranged in order of increasing difficulty. It is highly correlated with standardized reading tests and the Test of Function Health Literacy (0.84). Raw REALM scores can be converted into three grade levels, which represent low, marginal, and adequate literacy levels. The NVS is a nutrition label that tests patients9 general literacy and numeracy skills with six questions. For example, patients are asked, “If you usually eat 2,500 calories in a day, what percentage of your daily value of calories will you be eating if you eat one serving?” A score of 4 to 6 indicates adequate literacy. results Of the 129 patients tested, age range was 18 to 84 years, 74% were female, 61% African American, and 24% had not graduated from high school. Time to administer the tests was approximately 2 minutes for the REALM and 5 to 7 minutes for the NVS. The internal consistency of the NVS was good (α = 0.81). The correlation between scores on the NVS and scores on the REALM was 0.41 (p Conclusion The NVS showed only moderate correlation with the highly validated REALM and did poorly at predicting low literacy as defined by the REALM.
Recent developments of MCViNE and its applications at SNS

MCViNE is an open source, object-oriented Monte Carlo neutron ray-tracing simulation software package. Its design allows for flexible, hierarchical representations of sophisticated instrument components such as detector systems, and samples with a variety of shapes and scattering kernels. Recently this flexible design has enabled several applications of MCViNE simulations at the Spallation Neutron Source (SNS) at Oak Ridge National Lab, including assisting design of neutron instruments at the second target station and design of novel sample environments, as well as studying effects of instrument resolution and multiple scattering. Here we provide an overview of the recent developments and new features of MCViNE since its initial introduction (Jiao et al 2016 Nucl. Instrum. Methods Phys. Res., Sect. A 810, 86–99), and some example applications.
Nivolumab-induced myasthenia gravis with myositis in patients with genitourinary cancer (P4.2-005)

Objective: Reporting one case of nivolumab-induced myasthenia gravis with myositis in patients with genitourinary cancer Background: Nivolumab is an immune checkpoint inhibitor. Many cancer cells escaping from T cells attacking by making PD-L1. Nivolumab blocks PD-L1 from binding to PD-1, allowing the T cell to work. Nivolumab can cause severe immune related adverse effects including myasthenia gravis/myositis. Design/Methods: NA Results: An 83 year old gentle man with history of recurrent urothelial cancer was treated with Nivolumab and NKTR every three weeks. After second cycle, he developed hoarseness, difficulty speaking, swallowing, generalized weakness, poor appetite. The patient was admitted to the hospital. Lab showed CK 4000 U/L, aldolase 55.6 U/L, acetylcholine receptor binding antibody 0.16 nmol/L, acetylcholine modulating antibody 45%, striate muscle Ab positive at 1:30720. EMG/NCV suggested generalized myopathy with irritable features suggestive of inflammatory/reactive process. Muscle biopsy showed skeletal muscle and fibroconnective tissue with focal perimysial chronic inflammatory cell infiltrate. Chest CT did not show any thymoma. Other autoimmune and paraneoplastic panel were unremarkable. Nivolumab related MG and myositis were diagnosed. Patient was started on methylprednisolone and plasmapheresis at the admission. However, he required intubation due to respiratory failure. He failed spontaneous breathing trials multiple times and required tracheostomy placement. Patient was also treated with pyridostigmine, cellcept, rituximab and tacolimus. He had received plasmapheresis and IVIG. Patient was finally discharged home hospice with tracheostomy. Conclusions: The case demonstrated that nivolumab immune checkpoint inhibitor caused myasthenia gravis and myositis are very disable, rapid and fatal. Blocking the PD-1 receptor by nivolumab enhance the antitumor activity of T cells, but at the same time could cause severe immune related adverse effects by reducing self-tolerance, increasing autoimmunity. Early recognition of this severe immune related adverse effects is crucial. Nivolumab related MG and myositis should be highly suspected in patients who develops generalized weakness with bulbar symptoms. Disclosure: Dr. Sun has nothing to disclose. Dr. Shah has nothing to disclose. Dr. Tummala has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Kite Pharma. Dr. Chen has nothing to disclose.
Studying human and nonhuman primate evolutionary biology with powerful in vitro and in vivo functional genomics tools

In recent years, tools for functional genomic studies have become increasingly feasible for use by evolutionary anthropologists. In this review, we provide brief overviews of several exciting in vitro techniques that can be paired with "-omics" approaches (e.g., genomics, epigenomics, transcriptomics, proteomics, and metabolomics) for potentially powerful evolutionary insights. These in vitro techniques include ancestral protein resurrection, cell line experiments using primary, immortalized, and induced pluripotent stem cells, and CRISPR-Cas9 genetic manipulation. We also discuss how several of these methods can be used in vivo, for transgenic organism studies of human and nonhuman primate evolution. Throughout this review, we highlight example studies in which these approaches have already been used to inform our understanding of the evolutionary biology of modern and archaic humans and other primates while simultaneously identifying future opportunities for anthropologists to use this toolkit to help answer additional outstanding questions in evolutionary anthropology.
Seeing Double: A Case of ACL Tears in Monozygotic Twin Female Athletes Within 48 Hours.

Anterior cruciate ligament (ACL) injuries are a serious issue for young athletes. These injuries are devastating and costly, leading to significant time away from sports, and substantial financial cost. A case is presented in which monozygotic twin sisters sustained ACL injuries within 48 hours of one another. Limited research is available studying twins with ACL tears and the risk factors associated with them. This is the first reported case of monozygotic sisters that are high-level athletes with ACL tears in such close proximity to one another. Enhanced knowledge of genetic contribution to ACL injuries is important to better understand predisposing factors and to develop preventative approaches. More research is needed to support a distinct association between ACL rupture and genetic variants.
In vitro holding strength of the laparoscopic Miller's knot compared with open Miller's knot, open surgeon's throw, and laparoscopic surgeon's throw in a vascular pedicle model

OBJECTIVE To compare in vitro knot holding strength of the laparoscopic Miller's knot (LMK), open Miller's knot (MK), open surgeon's throw (Sx), and laparoscopic surgeon's throw (LSx) in a vascular pedicle model when used as the first throw for vascular ligation. STUDY DESIGN Experimental study. SAMPLE POPULATION Ten constructs each of the Miller's knot and surgeon's throw performed openly and laparoscopically with 2-0 polyglyconate suture. METHODS Knot holding strengths of the LMK, MK, LSx, and Sx knots were evaluated on balloon dilation catheters used as vascular pedicle models. Laparoscopic knots were tied in a laparoscopic box trainer. Knot constructs were pressure tested to failure. Results were compared by Kruskal-Wallis and Steel-Dwass comparisons. RESULTS Both MK and LMK had mean leakage pressures above 300 mm Hg. The MK leaked at higher pressure than all other knots, including the LMK (P < .001). The LMK leaked at greater pressures compared with the Sx and the LSx (P < .001). No difference was detected between leaking pressures of the Sx and the LSx (P = .226), with both leaking at pressures below 40 mm Hg. CONCLUSION The LMK created a more secure first throw compared with the Sx and leaked at supraphysiologic pressures. CLINICAL SIGNIFICANCE The LMK has excellent knot holding strength on a vascular pedicle model and may be further evaluated for clinical application.
Prevalence and socioeconomic factors in the prescription of concurrent amphetamine and alprazolam

ObjectiveGoals were to determine the prevalence of concurrent prescription of amphetamine and alprazolam, and examine variation by socioeconomic factors.MethodsWashington State’s Prescription Monit...
X-ray Sources from Self-modulated Laser Wakefield Acceleration: Applications in High Energy Density Sciences

This work discusses the development of x-ray and gamma-ray sources based on laser-wakefield acceleration (LWFA) in the self-modulated regime. These sources are developed for probing high energy density (HED) science experiments at large-scale laser facilities.
Do Obese Children Have Poor Patient-reported Outcomes After Closed Reduction and Percutaneous Pin Fixation of Supracondylar Humerus Fractures?

Background Nearly 1 in 5 American children are obese. The primary purpose of this study is to evaluate the relationship between childhood obesity and perioperative complications, patient-reported outcomes (PRO), and functional recovery after closed reduction and percutaneous pinning (CRPP) of type II and III supracondylar humerus fractures. Methods Retrospective review of patients treated operatively with CRPP of Wilkins modification of the Gartland classification type II and III supracondylar humerus fractures was performed over a 1-year timeframe (July 1, 2016 to July 1, 2017). One hundred forty-four patients under the age of 16 treated were identified. Obesity was defined as body mass index (BMI) at or above the 95th percentile for age. Obesity as a risk factor for poor outcomes was assessed. The primary outcome measure was postoperative PRO [quick-DASH, Patient Reported Outcomes Measurement Information System (PROMIS)-UE, PROMIS Global Health, and PROMIS Pain scores]. Results Mean age at surgery was 5.9 years (SD=2.1, 1.07 to 12.2) and mean age at final follow-up (3.3 y) was 8.8 (SD=2.14, 4 to 16). Mean patient BMI was 17.2 (SD=4.48, 12.4 to 56.2). Sixty-six patients were female (45.8%) and 78 patients were male (54.2%). In all, 31 of 144 patients (21.5%) met criteria for obesity. Obesity (95th percentile for BMI or above) was not associated with a higher rate of complications overall (χ2=1.29, P=0.256), range of motion loss (χ2=0.2, P=0.655) or requirement of postoperative physical therapy (χ2=0.17, P=0.678). Seventy-five patients were available and willing to participate in the outcomes score assessments. Mean follow-up for this cohort of 75 patients was 3.3 years (SD=0.31, 2.85 to 3.88). There were no differences in PROMIS pain, PROMIS upper extremity function, PROMIS general health, or quick-DASH scores when comparing obese with nonobese patients. Conclusions Obesity is a growing concern in the United States and its effect on long-term outcomes after CRPP of supracondylar humerus fractures is unknown. The present study demonstrates no difference in complications or PRO among obese patients compared with nonobese patients. Level of evidence Level IV-retrospective cohort study.
Overcoming Disciplinary and Institutional Barriers: An Interdisciplinary Course in Economic and Sociological Perspectives on Health Issues

The focus of this paper is an interdisciplinary course team-taught by an economist and a sociologist. Mindful of the less than amicable relationship that has traditionally existed between the two disciplines, these colleagues developed a course which attempted to illuminate the different perspectives of economics and sociology on a selected set of health themes. This course, which, in terms of content, appears to be either rare or unique, served as a social science core requirement as well as a major elective for students majoring in sociology. The article describes course mechanics, pedagogy and assessment, course content, institutional barriers faced by the course in its implementation and differences in methodological perspectives held by the course instructors. In particular, the article highlights some of the unique problems that exist in offering such a course - problems that are either less severe or nonexistent in more traditional courses.
Questions and Discussions

(1919). Questions and Discussions. The American Mathematical Monthly: Vol. 26, No. 5, pp. 187-194.
Multi-Level Lower Extremity Arterial Revascularization Via Retrograde Pedal Access Under Local Anesthesia in a Patient With Severe Cardiopulmonary Comorbidities: A Case Report.

Background:Chronic limb-threatening ischemia is a severe form of peripheral artery disease that leads to high rates of amputation and mortality if left untreated. Bypass surgery and antegrade endov...
Rapid fusion between mesenchymal stem cells and cardiomyocytes yields electrically active, non-contractile hybrid cells

Cardiac cell therapies involving bone marrow-derived human mesenchymal stem cells (hMSCs) have shown promising results, although their mechanisms of action are still poorly understood. Here, we investigated direct interactions between hMSCs and cardiomyocytes in vitro. Using a genetic Ca(2+) indicator gCaMP3 to efficiently label hMSCs in co-cultures with neonatal rat ventricular myocytes (NRVMs), we determined that 25-40% of hMSCs (from 4 independent donors) acquired periodic Ca(2+) transients and cardiac markers through spontaneous fusion with NRVMs. Sharp electrode and voltage-clamp recordings in fused cells showed action potential properties and Ca(2+) current amplitudes in between those of non-fused hMSCs and NRVMs. Time-lapse video-microscopy revealed the first direct evidence of active fusion between hMSCs and NRVMs within several hours of co-culture. Application of blebbistatin, nifedipine or verapamil caused complete and reversible inhibition of fusion, suggesting potential roles for actomyosin bridging and Ca(2+) channels in the fusion process. Immunostaining for Cx43, Ki67, and sarcomeric α-actinin showed that fused cells remain strongly coupled to surrounding NRVMs, but downregulate sarcomeric structures over time, acquiring a non-proliferative and non-contractile phenotype. Overall, these results describe the phenotype and mechanisms of hybrid cell formation via fusion of hMSCs and cardiomyocytes with potential implications for cardiac cell therapy.
Social Scientific Evidence

This paper considers two distinct and internally complex language regions, those of the contemporary American trial and of the social sciences. Its concern is how the trial treats the social sciences, not how the social sciences treat the trial. It first surveys the controversies that surround each region and argues that those controversies counsel against any "craving for generality" in defining their relationship with one another. It then describes the canonical account of the trial implicit in the rationalist tradition of evidence scholarship and explains how that account understands the place of social scientific evidence within it. The paper contrasts that received view of the trial with a more concrete and, to my mind, adequate interpretation of the trial. It then provides an account of the various functions of the social sciences within that more adequate understanding of the trial.
Cyclic polysilanes : X. Geometrical isomers and electronic properties of 1,2,3,4-tetra-t-butyltetramethylcyclotetrasilane

Abstract Three of the four possible geometrical isomers of the four-silicon ring 1,2,3,4-tetra-t-butyltetramethylcyclotetrasilane, (t-BuMeSi) 4 , are formed in the alkali metal-assisted coupling of t-BuMeSiCl 2 . The conformations of the trans - trans - trans , cis - trans - trans , and cis - trans - cis isomers are correlated with their 1 H NMR spectra. Extreme electronic properties associated with the strained silicon σ-bonding framework include the longest wavelength UV transition and the lowest first ionization potential yet observed in alkyl polysilanes and multiple charge-transfer bands with TCNE.
POTENTIAL FOR LOW COST, HIGH EFFICIENCY SOLAR CELLS USING INDIUM TIN OXIDE ON SEMICONDUCTOR (OSOS) SOLAR CELLS

ABSTRACT Solar cells consisting of oxide semiconductors deposited on single crystal silicon have been fabricated and have exhibited over 13% conversion efficiency. These cells are best modelled as semiconductor-insulator-semiconductor structure. The oxide semiconductor, Indium Tin Oxide, serves as an anti-reflection coating, a conductive front contact, and one side of the junction. The principal of operation is that the work function difference between the oxide semiconductor and the base semiconductor results in an induced, zero depth p-n junction of the semiconductor. Cells of this type should be less expensive to manufacture than conventional cells using LSSA cost procedures. A detailed investigation of indium sources of supply indicate that indium supply should not limit large scale terrestrial applications.
Drug-Induced Liver Injury

Drug-induced liver injury (DILI) is a common health disorder that is unpredictable and often poorly understood in pathogenesis. DILI may result in serious, sometimes fatal liver injury in older adults. Recognizing the relationship of medications to hepatic injury and prompt cessation of the responsible drug may result in spontaneous resolution in most, although a return to normal liver function may take months. Antimicrobials and acetaminophen account for a large proportion of DILI. Detailed history and exclusion of competing causes help make the diagnosis. DILI may also result from herbal and dietary supplements, emphasizing the need to enquire about all prescribed and over-the-counter medications, including supplements.
Privacy and Modern Advertising: Most US Internet Users Want 'Do Not Track' to Stop Collection of Data about their Online Activities

Most Americans have not heard of 'Do Not Track,' a proposal to allow Internet users to exercise more control over online advertising. However, when probed, most prefer that Do Not Track block advertisers from collecting data about their online activities. This is a much more privacy-protective approach for Do Not Track than what has been proposed by the advertising industry.In previous studies, we have found that Americans think they are protected by strong online privacy laws. Here, we probed beliefs about tracking on medical websites and 'free' websites, with most not able to answer true/false questions correctly about tracking. This result brings into question notice-and-choice models that depend on consumer understanding of the terms for their legitimacy.We also probed Internet users' attitudes towards advertising. Most Internet users say that they do not find utility in online advertising, with half claiming that they never click on ads. Advertisers and consumers are at an impasse on privacy. Advertisers seem to be seeking a kind of total information awareness for behavioral advertising, and have proposed self-regulatory guidelines with little bite. At the same time, both our survey evidence and media reports show consumer opposition to tracking. Do Not Track has emerged from the current skirmish between consumers and advertisers, but it is a relatively modest intervention that does little to shift the underlying incentives that have driven increasing tracking and aggregation of information about consumers. It is foreseeable that regardless of the form Do Not Track takes, websites will simply require consumers to disable it in order to access content. A fundamental change in incentives may be necessary to relieve this impasse and find an approach for advertising that is not so dependent upon third-party tracking and aggregation of information, both online and off.
Pollution prevention research ongoing: EPA's Risk Reduction Engineering Laboratory

Abstract The mission of the Risk Reduction Engineering Laboratory is to advance the understanding, development and application of engineering solutions for the prevention or reduction of risks from environmental contamination. This mission is accomplished through basic and applied research studies, engineering technology evaluations, new process developments and demonstration studies. This paper provides an overview of the ongoing pollution prevention research that supports this mission.
Cognitive Aging Research: An Exciting Time for a Maturing Field

These are exciting times for the field of cognitive aging research. The reviews in this issue comprise a wonderfully illustrative set of the wide-ranging research endeavors and thoughtful approaches to the hurdles and questions in this field. Traditionally, cognitive aging research has served as the plain stepsister to the higher profile field of age-related disorders of cognition, Alzheimer’s disease being primary among them. Nonetheless, this plain stepsister has toiled at the task of bringing fundamental understanding to the phenomenon of age-related change in behavior and brain function. Today, these contributions are being recognized as landmark, informing us about the adaptive capacities of the brain and behavior, and directing us toward strategies and therapeutics for remediation of decline. Distinguishing individuals who will maintain adequate, if not excellent, cognitive function into their later years from those on a trajectory to dementia is a central and driving force in cognitive aging research. In this issue, Rodrigue, Kennedy, and Park explore the literature surrounding one of the newest “old” findings—that a significant proportion of cognitively intact older adults harbor a level of beta amyloid deposition in their brains to warrant a neuropathological diagnosis of Alzheimer’s disease. Using recently developed ligands to visualize beta amyloid deposition in living individuals, investigators have been quick to explain the phenomenon as a possible reflection of a cognitive reserve, enabling those with higher ‘reserve’ to function longer in the face of neural damage. The attendant inconsistencies in findings for support of this hypothesis have been predictable for such a fledgling field. Nonetheless, these provocative data have launched new theories about how the brain tolerates pathology, what constitutes a healthy aging brain, the predictive value of amyloid deposition for AD, and the informative nature of lifespan, or at least “adultspan,” studies. Perhaps because research has indicated that agerelated decrements in implicit learning are rather small or non-existent, this component of cognition has received relatively little attention compared to the more obvious domains of explicit learning and memory. Yet implicit learning is the cornerstone of our information about the world, reflecting our ability to understand relationships, detect continuity or divergence in situations, and navigate successfully both intellectually and socially. Rieckmann and Backman present fascinating findings from neuroimaging studies of implicit learning in older adults that help construct a clearer picture of the aspects of implicit learning that may diminish with age; importantly, their synthesis of the neuroimaging literature helps to enlightThis editorial was written by the author in her capacity as an NIH employee, but the views expressed in the article do not necessarily represent those of the NIH.
The Perils of Over-Constitutionalizing the Law: A Reply to Professor Epstein

In “Reconsidering Murdock: State-Law Reversals as Constitutional Avoidance”, I advance two primary claims. First, the Supreme Court’s categorical unwillingness to consider state-law reversals is nothing more than a self-imposed constraint from its 1874 decision in Murdock v. City of Memphis; this rule cannot be found in any of the external constitutional or statutory commands that limit the Supreme Court’s authority. Second, the status quo Murdock regime has induced the justices to issue questionable federal constitutional rulings in cases that they could have resolved more easily on state-law grounds. In a generous and spirited response, Professor Epstein defends the Murdock regime and attacks “the constitutional trope of ‘avoidance’” on which my claims largely rest. Professor Epstein’s defense of the status quo is based on a sunny assessment of the Supreme Court’s Murdock-induced constitutional pronouncements. It also rests on an unstated belief that Murdock will lead future Supreme Courts to issue constitutional rulings that he will find agreeable. But it is much harder for others to share Professor Epstein’s warm embrace of the Court’s Murdock-induced constitutional rulings – especially the adherents of originalism, Thayerism, minimalism, or common-law constitutionalism. And no one should believe that channeling future Supreme Court rulings into federal constitutional law is likely to produce happy endings. There is simply no way to know whether the Supreme Court in 2020 will resemble the Warren Court, the Roberts Court, or something else. Behind this veil of ignorance, a move away from Murdock represents a prudent risk-management strategy, a means of reducing the likelihood of bad constitutional entrenchments from a future Court whose composition cannot be known or controlled.
Detection of age-related changes in the distributions of keratan sulfates and chondroitin sulfates in developing chick limbs: an immunocytochemical study

A panel of four separate monoclonal antibodies, all known to specifically recognize epitopes on keratan sulfate glycosaminoglycans, were employed in an immunocytochemical study of developing chick hind limbs. In addition, two monoclonal antibodies specific for epitopes on chondroitin/dermatan sulfate glycosaminoglycans were employed on equivalent sections to determine the degree of colocalization of keratan and chondroitin/dermatan sulfates. The spatial distributions of keratan sulfate and chondroitin/dermatan sulfate differed to some extent. In younger embryos, high extracellular concentrations of keratan sulfate occurred in joints and articular cartilages, with diminishing amounts being present in epiphyseal and diaphyseal regions. The high concentration of keratan sulfate in joints and articular cartilage corresponded to equally high concentration of chondroitin-6 sulfate. With advancing age, the above mentioned distribution was modified, most notably by increased amounts of keratan sulfate within diaphyseal regions. Finally, the use of four different anti-keratan sulfate monoclonal antibodies made it possible to compare keratan sulfate epitope expression. Differences in keratan sulfate epitopes were noted in some regions of bones, mostly in diaphyseal regions of younger bones and epiphyseal regions of older bones. This pattern of keratan sulfate expression suggests that different types of keratan sulfate may be present and their expression may be developmentally regulated.
Atypical Motor Neuron Disorders

Amyotrophic lateral sclerosis is a progressive neurodegenerative disorder of motor neurons and their axons characterized by signs of upper and lower motor neuron dysfunction. When clinical features are restricted to either upper or lower motor neurons, limited to one or two body regions, or associated with non-motor manifestations, it is important to consider atypical motor neuron disorders. These are a group of disorders with varied etiologies that resemble amyotrophic lateral sclerosis in many respects but may possess distinct clinical, pathologic, and laboratory features. Some of these disorders are potentially reversible or have a better prognosis than amyotrophic lateral sclerosis. Recognizing these disorders early is necessary in order to initiate specific treatments when available and appropriately counsel patients particularly in the setting of genetic disorders.