cssi/SciSciGPT-SciSciNet huggingface dataset:
Post-splinting radiographs of minimally displaced fractures: good medicine or medicolegal protection?

Background: Many institutions perform radiographic documentation following splint application even when no manipulation had been performed. The purpose of this study was to evaluate the utility of post-splinting radiographs of acute non-displaced or minimally displaced fractures that did not undergo manipulation. Our hypothesis was that post-splinting radiographs do not demonstrate changes in fracture alignment or impact the management of the patient. Methods: After institutional review board exemption had been granted, consultations performed by orthopaedic residents at a level-I trauma center from September 2008 to April 2010 were reviewed. Of 2862 consultations, 1321 involved acute fractures that were splinted. Radiographs revealed that 342 (25.9%) of the fractures were non-displaced or minimally displaced and angulated (defined as <5 mm and <10°, respectively) and 204 of them had been assessed with radiographs after splinting. Consults were reviewed to ensure that the patients had not undergone manipulation prior to or during splinting. Consult notes and radiographs obtained in the emergency room (ER), as well as follow-up radiographs, were reviewed to assess ultimate outcome. Results: None of the 204 fractures (134 non-displaced and seventy minimally displaced) changed alignment following splinting. Two splints were reapplied, and the fractures sites were reimaged for undocumented reasons. Patients were subjected to an average of ten radiographs (range, four to twenty-five radiographs) of their extremities in the acute setting. On average, three post-splinting radiographs (range, one to ten radiographs) were obtained. The mean time between the initial and post-splinting radiographs was three hours and thirty minutes (range, nine minutes to twenty-four hours). The most common injury was a fracture about the hand or wrist. The 122 patients with that type of injury waited an average of almost three hours for an average of three post-splinting radiographs, contributing to a total of nine radiographs performed acutely. ER visits tended to be longer for patients with post-splinting radiographs compared with those without them (p = 0.06). Follow-up radiographs were available for eighty-two patients. All fractures demonstrated maintained alignment. Conclusions: Post-splinting radiographs of non-displaced and minimally displaced fractures that do not undergo manipulation before or during immobilization are associated with longer ER waits, additional radiation exposure, and increased health-care costs without providing helpful information. While certain circumstances call for additional imaging, routine performance of post-splinting radiography of non-displaced or minimally displaced fractures should be discouraged. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Bottom-up model-driven development

Prominent researchers and leading practitioners are questioning the long-term viability of model-driven development (MDD). Finkelstein recently ranked MDD as a bottom-ten research area, arguing that an approach based entirely on development and refinement of abstract representations is untenable. His view is that working with concrete artifacts is necessary for learning what to build and how to build it. What if this view is correct? Could MDD be rescued from such a critique? We suggest the answer is yes, but that it requires an inversion of traditional views of transformational MDD. Rather than develop complete, abstract system models, in ad-hoc modeling languages, followed by top-down synthesis of hidden concrete artifacts, we envision that engineers will continue to develop concrete artifacts, but over time will recognize patterns and concerns that can profitably be lifted, from the bottom-up, to the level of partial models, in general-purpose specification languages, from which visible concrete artifacts are generated, becoming part of the base of both concrete and abstract artifacts for subsequent rounds of development. This paper reports on recent work that suggests this approach is viable, and explores ramifications of such a rethinking of MDD. Early validation flows from experience applying these ideas to a healthcare-related experimental system in our lab.
Security Market Reaction to Purchase Business Combinations at the First Earnings Announcement Date

Abstract Accounting for purchased goodwill in mergers and acquisitions has been a hotly debated issue for many years because of the increasingly large impact of goodwill amortization on the reported earnings of acquiring firms and its implications for the subsequent performance of the combined entity. There is evidence that top management of firms seeking to acquire other companies attempts to avoid purchase accounting when possible to avoid the hit to earnings associated with goodwill amortization. However, since there may be no economic cash flows associated with the goodwill amortization, it is not immediately apparent that the required goodwill amortization has a negative effect on stock prices. This study examines the extent to which increases in purchased goodwill are negatively associated with the security prices of acquiring companies at the time of the first earnings announcement following the completion of the merger. The results indicate that firms exhibit negative abnormal returns around the first quarterly earnings announcement date following a purchase business combination and that the size of the reaction is negatively related to the amount of goodwill associated with the purchase. Thus, the results support the concerns expressed by the financial press that reporting large amounts of goodwill is bad news at the time of earnings announcements. These results are not inconsistent with the findings of earlier work suggesting that goodwill is positively valued by the market. Rather, our results suggest that while goodwill may be viewed positively as an asset, the earnings impact of the amortization of goodwill is bad news to the market.
The sun as a test source for boresight calibration of microwave antennas

Although the diameter of the sun at microwavelengths is a little over half a degree, the sun can be used for establishing, say between 3 and 30 cm, the pointing corrections (boresight calibration) of microwave antennas, with high precision. There is, however, a discrepancy between the position of the microwave sun on any given day and the position of the center of the solar disc as tabulated in [16]. Over the period 1966-1969 this discrepancy had an rms value of 1.6' east-west and 1.2' north-south and a range of 11.4' east-west and 9.2' north-south. These conclusions are based on sun maps, made at 9.1 cm with an antenna having a beamwidth of approximately 3', which are published regularly. From such a map the microwave centroid can be determined with an error less than 1'. In the absence of such a map, the centroid can be estimated to within 2' or slightly better by taking account of optical data such as sunspots or plages. The correction on any one day is strongly correlated with that of the day before, but the correlation is small after about 5 days. The correlation returns in part after 27 days.
Rejected takeoff and landing

To improve the standards for determining the accelerate‐stop and landing performance of transport aircraft the FAA has published a proposed rule that makes three amendments which are detailed here. The first revises the method for taking into account the time needed for the pilot to accomplish the procedures for a rejected takeoff, another requires that takeoff performance be determined for wet runways, and the third requires that rejected takeoff and landing distances be based on worn brakes. These amendments are based on a notice of proposed rulemaking (NPRM) issued early in the 1990s. These standards are not being applied retroactively either to aircraft currently in use or to aircraft of existing approved designs that will be manufactured in the future.
Critical path issue in VLSI design

An approach is proposed to the prediction, prior to layout, of the paths and nets that will most likely be critical after layout. The approach makes use of the notion of categorization. The parameters that are highly correlated with the total path delay are first identified. These parameters are combined in a single score function. This function is evaluated for each enumerated path. The k paths with the smallest scores (or largest depending on the score function) are the most critical paths. The nets covered by the selected paths are the predicted critical nets. The nets are also ranked according to their coverage frequencies, timing (load factors), and physical characteristics (number of loading pins). A description is given of the delay model used and the authors' approach to the prediction of the dangerous paths and nets. Some experimental results are presented. >
Top Management Team Certainty: Environmental Assessments, Teamwork, and Performance Implications

This research explored the concept of top management team (TMT) certainty, that is, the degree of confidence that the TMT has about its environment assessments and subsequent strategic decisions. Using a banking simulation, this exploratory study suggested that beliefs about the environment and a strong team orientation were critical determinants of TMT certainty, while actual environmental volatility and consensus within the TMT were not. Additionally, the research explored the positive relationship between TMT certainty and organizational performance.
A polypyrrole-carbon-nanotube (PPy-MWNT) nanocomposite glucose sensor

We present a novel, two-terminal enzymatic molecular device sensitive to glucose concentration based on doped polypyrrole/multi-walled-carbon-nanotube (PPy-MWNT) nanocomposite that obviates the need for reference electrode and electron mediators. This is realized via reversible, oxidation-reduction induced conductivity change of a dodecylbenzenesulfonate (DBS)-doped PPy-MWNT membrane spanning across a microgap adjoining two electrodes. In this work, we discovered that although glucose oxidase (GOx)-laden, DBS-doped PPy membrane is sensitive to glucose between 0-10 mM, the incorporation of MWNT into similar membrane extends its detection ceiling to 20 mM, which covers the physiologically important range for diabetics.
Distributed auditory sensory input within the mouse olfactory cortex

The mammalian olfactory cortex is commonly considered critical for odor information processing and perception. It is becoming increasingly apparent, however, that the olfactory cortex receives input from multiple sensory channels. Previous work from our group demonstrated the presence of auditory sensory convergence within one olfactory cortical structure, the olfactory tubercle (OT). Interestingly, anatomical evidence for auditory input into the neighboring olfactory piriform cortex (PCX) posits the possibility that auditory sensory input is a distributed property of the olfactory cortex. To address this question, we performed in vivo extracellular recordings from the OT and PCX of anesthetized mice and measured modulations in unit firing in the presence of tones. In support for auditory sensory input being a distributed feature of the olfactory cortex, we found that 29% of units sampled within the PCX display tone-evoked responses. This population compares with that found within the OT using the same stimuli (37%). While overall tone-evoked response magnitudes were comparable between the two structures, tone signal : noise was significantly greater within the OT than in the PCX. No effect of tone frequency (1-55 kHz) was found within either structure, with most units being narrowly tuned to a single frequency. These results suggest that a major portion of odor-evoked output from the olfactory bulb (i.e. that entering the OT and PCX) is subject to auditory sensory input in a manner that may modulate odor information processing, odor-guided behaviors and perception.
Understanding Adult Learning in the Midst of Complex Social “Liquid Modernity”

This chapter describes the changing nature of adult education theory and practice in the face of complex, disruptive change and explores theories that are suited to tectonic shifts in a period of what we describe as “liquid modernity” in the midst of complex sociocultural-economic-political change in a global environment.
Knowledge of and Attitudes Toward Evidence-Based Guidelines for and Against Clinical Preventive Services: Results from a National Survey.

Policy Points: Both the underuse and overuse of clinical preventive services relative to evidence-based guidelines are a public health concern. Informed consumers are an important foundation of many components of the Affordable Care Act, including coverage mandates for proven clinical preventive services recommended by the US Preventive Services Task Force. Across sociodemographic groups, however, knowledge of and positive attitudes toward evidence-based guidelines for preventive care are extremely low. Given the demonstrated low levels of consumers’ knowledge of and trust in guidelines, coupled with their strong preference for involvement in preventive care decisions, better education and decision-making support for evidence-based preventive services are greatly needed. Context Both the underuse and overuse of clinical preventive services are a serious public health problem. The goal of our study was to produce population-based national data that could assist in the design of communication strategies to increase knowledge of and positive attitudes toward evidence-based guidelines for clinical preventive services (including the US Preventive Services Task Force, USPSTF) and to reduce uncertainty among patients when guidelines change or are controversial. Methods In late 2013 we implemented an Internet-based survey of a nationally representative sample of 2,529 adults via KnowledgePanel, a probability-based survey panel of approximately 60,000 adults, statistically representative of the US noninstitutionalized population. African Americans, Hispanics, and those with less than a high school education were oversampled. We then conducted descriptive statistics and multivariable logistic regression analysis to identify the prevalence of and sociodemographic characteristics associated with key knowledge and attitudinal variables. Findings While 36.4% of adults reported knowing that the Affordable Care Act requires insurance companies to cover proven preventive services without cost sharing, only 7.7% had heard of the USPSTF. Approximately 1 in 3 (32.6%) reported trusting that a government task force would make fair guidelines for preventive services, and 38.2% believed that the government uses guidelines to ration health care. Most of the respondents endorsed the notion that research/scientific evidence and expert medical opinion are important for the creation of guidelines and that clinicians should follow guidelines based on evidence. But when presented with patient vignettes in which a physician made a guideline-based recommendation against a cancer-screening test, less than 10% believed that this recommendation alone, without further dialogue and/or the patient's own research, was sufficient to make such a decision. Conclusions Given these demonstrated low levels of knowledge and mistrust regarding guidelines, coupled with a strong preference for shared decision making, better consumer education and decision supports for evidence-based guidelines for clinical preventive services are greatly needed.
Financial and Operational Survey of 12 Major University Nanofabrication Facilities: A Benchmarking Study

Efficiently running a major nanofabrication research user facility within the framework of a university is a daunting task. Operational costs, staffing, training, safety, and the diversity of the research, faculty, and users are but a few of the challenges facing the management team. This article reports on a subset of metrics used to characterize such user facilities, based on an extensive survey of 12 major university laboratories. Data relating to such factors as laboratory staffing, operating costs, subsidies, cost recovery, tuition, comparative tool rates, hours of use, and populations are summarized and reported on in the context of determining a reasonable measure of an efficient laboratory operation.
Abstract 4780: Discovery of novel checkpoint kinase 1 inhibitors by virtual screening based on multiple crystal structures

Checkpoint kinase 1 (Chk1) is activated in response to DNA damage through the ATM/ATR pathway, and plays an essential role in the regulation of the G2/M checkpoint. Inhibition of Chk1 should abrogate this checkpoint in a manner relevant to the treatment of cancer, and may induce apoptosis. Currently about 50 crystal structures of Chk1 are available in RCSB Protein Data Bank. The abundance of Chk1 structures offers the opportunity not only to discover new inhibitors with receptor-based drug design but also to explore the impact of receptor flexibility in ligand docking. Here we describe a successful application of the docking of multiple structures to discover novel and potent Chk1 inhibitors. Forty-six Chk1 structures were first compared in single structure docking by predicting the binding mode and recovering known ligands. Combinations of different protein structures were then compared by recovery of known ligands and an optimal ensemble of Chk1 structures were selected. The chosen structures were used in the virtual screening of over 60,000 diverse compounds for Chk1 inhibitors. Six compounds ranked at the top of the hits list were tested experimentally and two of these compounds inhibited Chk1 activity-the best with an IC50 value of 9.6 µM. Further study indicated that achieving a better enrichment and identifying more diverse compounds was more likely using multiple structures than using only a single structure even when protein structures were randomly selected. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4780. doi:1538-7445.AM2012-4780
Normal human pluripotential and committed hematopoietic progenitors do not express the p24 antigen detected by monoclonal antibody BA-2: implications for immunotherapy of lymphocytic leukemia

Analysis of surface antigenic determinants of hematopoietic progenitor cells has relevance both to basic biologic study of cell differentiation and to potential clinical application in the diagnosis and treatment of hematologic neoplasia. The production and characterization of monoclonal antibody BA-2 by immunization with a pre-B-ALL cell line has been reported previously. In this study we utilized complement-dependent cytotoxicity and rosette-separation with antibody indirectly coupled to ox RBC to determine if the antigen (p24) recognized by the antibody BA-2 is represented on human pluripotential (CFU-GEMM) or committed hematopoietic progenitors (CFU-GM, BFU-E, CFU-E). BA-2 showed no reactivity with normal hematopoietic progenitors by either method. In contrast, BA-2 exhibited potent complement-mediated cytotoxicity for selected ALL-derived cell lines. These results show that normal human hematopoietic progenitors do no express antigenic sites represented on ALL cells that are recognized by BA-2 and suggest that this monoclonal antibody may serve as a potent and specific agent for treatment of lymphocytic leukemia, perhaps most useful in ex vivo marrow conditioning for autologous bone marrow transplantation.
Research and Development of Wall-climbing Robot

The application of wall-climbing robot and the structure,adsorption methods,moving methods of traditional wall-climbing robots are introduced,as well as their characteristics,described development overview of mobile robot home and abroad,and predicted the development trend and structure and of future wall-climbing robot.
Observation on immunogenicity of different formulation of hepatitis B vaccine in newborns

Objective To study the immune efficacy and safety of 10μg and 5μg hepatitis B vaccine in newborns and to provide the scientific basis for the adjustment of neonatal hepatitis B vaccine immunization programs. Methods The HBV antibody levels of people who inoculated various doses of hepatitis B vaccine in different time were observed when they were born with case-control study method. Serum antibody levels were detected by chemiluminescence immunoassay. Results 1 month, 6 months and 12 months after full course of inoculation of hepatitis B vaccine, non-response rate in 10μg hepatitis B vaccine was higher than that of 5μg hepatitis B vaccination group. The titer of HBsAb in 10μg hepatitis B vaccine group was higher than that of 5μg hepatitis B vaccination group. 12 months after inoculation, the titer of HBsAb in two groups were both reduced, and the positive rate of HBsAb in10μg hepatitis B vaccine group was higher than that of 5μg hepatitis B vaccination group. Conclusion The efficacy of 10μg hepatitis B vaccine group is better than that of 5μg hepatitis B vaccine group.
Missing data as a validity threat for medical and healthcare education research: Problems and solutions

At present, the problem of missing data has received virtually no attention by medical and healthcare education researchers. This is a significant problem for the education research community because when missing data are disregarded or handled inappropriately it can result in serious validity threats. This article discusses the problem of missing data in the context of medical and healthcare education research and recommends appropriate methods for handling missing data.
Response and Item Omission Rates for Format Justified Questionnaires

This research examined the impact of a directed quest­ionnaires on overall response rate and item omission rates. The results indicated that a directed question­naire format did not improve results in either case.
Case 28-1982: Nodular Lymphoma Complicated by Acute Leukemia

Presentation of Case A 57-year-old man was admitted to the hospital because of confusion and a hemorrhagic disorder. He was well until three years earlier, when an asymptomatic upper abdominal mass...
Sustained Morphine Administration Induces TRPM8-Dependent Cold Hyperalgesia.

Abstract It is not uncommon for patients chronically treated with opioids to exhibit opioid-induced hyperalgesia, and this has been widely reported clinically and experimentally. The molecular substrate for this hyperalgesia is multifaceted, and associated with a complex neural reorganization even in the periphery. For instance, we have recently shown that chronic morphine-induced heat hyperalgesia is associated with an increased expression of GluN2B containing N-methyl-D-aspartate receptors, as well as of the neuronal excitatory amino acid transporter 3/excitatory amino acid carrier 1, in small-diameter primary sensory neurons only. Cold allodynia is also a common complaint of patients chronically treated with opioids, yet its molecular mechanisms remain to be understood. Here we present evidence that the cold sensor TRPM8 channel is involved in opioid-induced hyperalgesia. After 7 days of morphine administration, we observed an upregulation of TRPM8 channels using patch clamp recording on sensory neurons and Western blot analysis on dorsal root ganglia. The selective TRPM8 antagonist RQ-00203078 blocked cold hyperalgesia in morphine-treated rats. Also, TRPM8 knockout mice failed to develop cold hyperalgesia after chronic administration of morphine. Our results show that chronic morphine upregulates TRPM8 channels, which is in contrast with the previous finding that acute morphine triggers TRPM8 internalization. Perspective Patients receiving chronic opioid are sensitive to cold. We show in mice and rats that sustained morphine administration induces cold hyperalgesia and an upregulation of TRPM8. Knockout or selectively blocking TRPM8 reduces morphine-induced cold hyperalgesia suggesting TRPM8 is regulated by opioids.
Toward local overlay-based Mobile Clouds

Mobile devices are evolving into powerful systems due to recent advances in their communication, storage and computation technologies. They are posed to play a key role in providing a rich collaborative computing platform for various applications. Most of these devices have the ability to form a mobile cloud among themselves without relying on an existing infrastructure making them useful in scenarios in which access to infrastructure may not be feasible or expensive. In this paper we present a collaborative computing mobile cloud that enables a group of mobile devices to form an ad-hoc network and advertise their capabilities as cloud services. The mobile cloud capitalizes on locality through the use of a GPS-based hashing technique and a hybrid routing algorithm that combines reliable flooding with Distributed Hash Tables (DHT) to find the closest node(s) that have the desired capabilities for task execution. We evaluate the performance of our proposed mobile cloud through extensive simulations and our results show the feasibility of our proposed platform.
VA residential substance use disorder treatment program providers’ perceptions of facilitators and barriers to performance on pre-admission processes

In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics. The first aim sought to supplement the VA’s existing facility-level performance metrics with SUD program-level metrics in order to identify high-value targets for quality improvement. The second aim recognized that not all key processes are reflected in the administrative data, and even when they are, new insight may be gained from viewing these data in the context of day-to-day clinical practice. VA administrative data from fiscal year 2012 were used to calculate pre-admission metrics for 97 programs (63 SUD Residential Rehabilitation Treatment Programs (SUD RRTPs); 34 Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs) with a SUD track). Interviews were then conducted with management and front-line staff to learn what factors may have contributed to high or low performance, relative to the national average for their program type. We hypothesized that speaking directly to residential program staff may reveal innovative practices, areas for improvement, and factors that may explain system-wide variability in performance. Average wait time for admission was 16 days (SUD RRTPs: 17 days; MH RRTPs with a SUD track: 11 days), with 60% of Veterans waiting longer than 7 days. For these Veterans, engagement while waiting occurred in an average of 54% of the waiting weeks (range 3–100% across programs). Fifty-nine interviews representing 44 programs revealed factors perceived to potentially impact performance in these domains. Efficient screening processes, effective patient flow, and available beds were perceived to facilitate shorter wait times, while lack of beds, poor staffing levels, and lengths of stay of existing patients were thought to lengthen wait times. Accessible outpatient services, strong patient outreach, and strong encouragement of pre-admission outpatient treatment emerged as facilitators of engagement while waiting; poor staffing levels, socioeconomic barriers, and low patient motivation were viewed as barriers. Metrics for pre-admission processes can be helpful for monitoring residential SUD treatment programs. Interviewing program management and staff about drivers of performance metrics can play a complementary role by identifying innovative and other strong practices, as well as high-value targets for quality improvement. Key facilitators of high-performing facilities may offer programs with lower performance useful strategies to improve specific pre-admission processes.
Effect of passive heat stress and exercise in the heat on arterial stiffness

Prior evidence indicates that acute heat stress and aerobic exercise independently reduce arterial stiffness. The combined effects of exercise and heat stress on PWV are unknown. The purpose of this study was to determine the effects of heat stress with passive heating and exercise in the heat on arterial stiffness. Nine participants (n = 3 females, 47 ± 11 years old; 24.1 ± 2.8 kg/m2) completed four trials. In a control trial, participants rested supine (CON). In a passive heating trial (PH), participants were heated with a water-perfusion suit. In two other trials, participants cycled at ~50% of $${\dot{\text{V}}\text{O}}_{{ 2 {\text{peak}}}}$$ in a hot (~40 °C; HC trial) or cool (~15 °C; CC trial) environment. Arterial stiffness, measured by PWV, was obtained at baseline and after each intervention (immediately, 15, 30, 45, and 60 min post). Central PWV (C PWV) was assessed between the carotid/femoral artery sites. Upper and lower peripheral PWV was assessed using the radial/carotid (U PWV) and dorsalis pedis/femoral (L PWV) artery sites. The mean body temperature (T B) was calculated from the skin and rectal temperatures. No significant changes in T B were observed during the CON and CC trials. As expected, the PH and HC trials elevated T B 2.69 ± 0.23 °C and 1.67 ± 0.27 °C, respectively (p 0.05). However, in the PH trial, U PWV was reduced immediately (−107 ± 81 cm/s) and 15 min (−93 ± 82 cm/s) post-heating (p < 0.05). Heat stress via exercise in the heat does not acutely change arterial stiffness. However, passive heating reduces U PWV, indicating that heat stress has an independent effect on PWV.
Persistent accumulation of gut macrophages with impaired phagocytic function correlates with SIV disease progression in macaques

The contribution of macrophages in the gastrointestinal tract to disease control or progression in HIV infection remains unclear. To address this question, we analyzed CD163+ macrophages in ileum and mesenteric lymph nodes (LN) from SIV-infected rhesus macaques with dichotomous expression of controlling MHC class I alleles predicted to be SIV controllers or progressors. Infection induced accumulation of macrophages into gut mucosa in the acute phase that persisted in progressors but was resolved in controllers. In contrast, macrophage recruitment to mesenteric LNs occurred only transiently in acute infection irrespective of disease outcome. Persistent gut macrophage accumulation was associated with CD163 expression on α4β7+CD16+ blood monocytes and correlated with epithelial damage. Macrophages isolated from intestine of progressors had reduced phagocytic function relative to controllers and uninfected macaques, and the proportion of phagocytic macrophages negatively correlated with mucosal epithelial breach, lamina propria E. coli density, and plasma virus burden. Macrophages in intestine produced low levels of cytokines regardless of disease course, while mesenteric LN macrophages from progressors became increasingly responsive as infection advanced. These data indicate that non-inflammatory CD163+ macrophages accumulate in gut mucosa in progressive SIV infection in response to intestinal damage but fail to adequately phagocytose debris, potentially perpetuating their recruitment. This article is protected by copyright. All rights reserved
Foe becomes friend as Zika joins the fight against cancer

Zika virus preferentially targets cancer stem cells in glioblastoma, resulting in reduced tumor growth.
The Question of Proton Stability Summary

The talk dealt with some of the historical, experimental and theoretical facts concerning the question of proton stability. These have recently been reviewed1 and will not be repeated in this summary. Earlier short reviews might also be consulted.2,3 The present status of the theoretical predictions for the proton lifetime based on the SU(5) model is given in the report at this conference by R. Marciano.4 This theory gives an upper limit for the proton lifetime: τ < 5 × 1032 years (see also Ref. 5). Similar predictions follow from some theories based on larger groups which also contain SU(3)C × SU(2) × U(1).
Prognostic Role of Hypertensive Response to Exercise in Patients With Repaired Coarctation of Aorta

Abstract Background This study aimed to determine the prevalence of hypertensive response to exercise (HRE) and its association with cardiovascular adverse events (CAEs) in patients with repaired coarctation of aorta (rCOA). Methods We retrospectively reviewed records of adult patients with rCOA who had cardiopulmonary exercise tests (CPETs) and follow-up from 1994 to 2014 at Mayo Clinic. Patients with residual COA, defined as aortic isthmus peak velocity >2.5 m/s, were excluded. HRE was defined as peak systolic blood pressure >200 mm Hg; CAEs were defined as cardiovascular death, stroke, acute coronary syndrome, heart failure hospitalization, and left ventricular ejection fraction (LVEF) Results One hundred thirty-eight patients (82 men [59%]) underwent 213 CPETs, with follow-up of 85 ± 13 months. Age at initial COA repair was 9 ± 3 years; age at initial CPET was 40 ± 13 years. HRE occurred in 26 (19%) patients, and 24 (92%) of the patients with HRE had normal resting blood pressure. There were no differences in age, blood pressure at rest, and CPET findings between patients with HRE and those with normotensive response to exercise. There were 28 CAEs in 24 patients (17%), and HRE was an independent risk factor for CAE (hazard ratio [HR], 1.46 [1.13–2.52]; P = 0.04). Conclusions HRE can occur even in the setting of normal blood pressure at rest, and it is a risk factor for CAE. We speculate that patients with HRE represent a high-risk group of patients who, presumably, have occult, advanced vascular dysfunction. CPET can identify these patients. The benefit of intensive antihypertension therapy needs to be confirmed.
Emerging Strategies on Adjuvant Therapies for Nerve Recovery.

Current strategies for promoting faster and more effective peripheral nerve healing have utilized a wide variety of techniques and approaches. Nerve grafts, conduits, and stem cell therapy all have their respective advantages. However, there are still some difficulties in attaining complete functional recovery with a single treatment modality. The utilization of adjuvant treatments, in combination with current standard-of-care methods, offers the potential to improve patient outcomes. This paper highlights the current landscape of adjuvant treatments for enhancing peripheral nerve repair and regeneration.
RADIOTRACERS FOR CEREBRAL BLOOD FLOW AND EMISSION TOMOGRAPHY

Multiple approaches are available to measure global and regional cerebral blood flow. The inert gas method of Kety-Schmidt provides the mathematical basis for essentially all of these methods with the exception of radioactive microspheres. The preferred method depends largely upon the type of information to be obtained. The three essential problems in cerebral blood flow measurement are establishing reliable cerebral blood flow measurements in pathological processes, the relation of this flow to metabolism, and the clinical application of cerebral blood flow measurements in man for the investigation of a wide variety of significant disease process including ischemia and intracranial hypertension. The basis of the radiotracer methods, the choice of radionuclides, labeled compounds, and radiopharmaceuticals for use in research in animals and man and for human use in a clinical setting in combination with single photon and positron emission tomography are reviewed.
Characterization of the Recommendations in the Choosing Wisely Initiative

Choosing Wisely is a comprehensive set of recommendations that guides clinicians and patients away from low-value services. The recommendations were reviewed to investigate their breadth and limita...
Differences in Physical Activity and Diet Patterns between Non-Rural and Rural Adults.

Background: It is unclear how rural occupations and lifestyles may play a role in shaping physical activity and diet behaviors that contribute to the rural–urban obesity disparity. Methods: Data come from the prospective and observational South Dakota Rural Bone Health Study, which included adults aged 20–66 years in three groups: (1) non-rural non-Hutterite, (2) rural non-Hutterite, and (3) rural Hutterite. Physical activity data were collected using 7-day physical activity questionnaires, and hours per day in physical activity categories are reported. Diet data were collected using food frequency questionnaires, and food group servings per day (svg/day) are reported. Mixed models were generated to determine group differences in physical activity and diet outcomes, and marginal group means are presented. Results: Among females, both rural groups spent more time in moderate activity (4.8 ± 0.13 h/day and 4.7 ± 0.09 h/day vs. 3.5 ± 0.11 h/day, both p < 0.001) and vigorous activity (0.58 ± 0.03 h/day and 0.53 ± 0.02 h/day vs. 0.43 ± 0.03 h/day, both p < 0.01) and less time sitting (4.4 ± 0.13 h/day and 4.3 ± 0.09 h/day vs. 5.0 ± 0.11 h/day, both p < 0.001) on weekdays than non-rural groups. Hutterite females spent fewer hours in moderate activity (2.6 ± 0.08 h/day vs. 4.5 ± 0.11 h/day, p < 0.001) and vigorous activity (0.18 ± 0.02 h/day vs. 0.46 ± 0.02 h/day, p < 0.001) on weekend days compared to rural females. Hutterite females consumed more fruits (2.2 ± 0.06 svg/day vs. 1.7 ± 0.10 svg/day, p < 0.001) and vegetables (3.6 ± 0.08 svg/day vs. 2.7 ± 0.12 svg/day, p < 0.001) than rural females. Among males, both rural groups spent more time in moderate activity (4.9 ± 0.13 h/day and 6.1 ± 0.12 h/day vs. 3.0 ± 0.16 h/day, both p < 0.001) and less time sitting (4.1 ± 0.13 h/day and 3.4 ± 0.12 h/day vs. 6.0 ± 0.15 h/day, both p < 0.001) on weekdays compared to non-rural groups. Hutterite males spent less time in moderate activity (2.1 ± 0.10 h/day vs. 4.1 ± 0.11 h/day, p < 0.001) and vigorous activity (0.15 ± 0.04 h/day vs. 0.74 ± 0.04 h/day, p < 0.001) on weekend days compared to rural males. Hutterite males consumed more vegetables (3.0 ± 0.10 svg/day vs. 2.0 ± 0.11 svg/day, p < 0.001) than rural males. Conclusions: A rural occupation and lifestyle appear to contribute to differences in physical activity, while traditional rural lifestyle practices contribute to differences in diet.
Why Does RNA Collapse? The Importance of Water in a Simulation Study of Helix–Junction–Helix Systems

Using computer simulations, we consider the balance of thermodynamic forces that collapse RNA. A model helix-junction-helix (HJH) construct is used to investigate the transition from an extended to a collapsed conformation. Conventional Molecular Dynamics and Milestoning Simulations are used to study the free energy profile of the process for two ion concentrations. We illustrate that HJH folds to a collapsed state with two types of counterions (Mg2+ and K+). By dissecting the free energy landscape into energetic and entropic contributions, we illustrate that the electrostatic forces between the RNA and the mobile ions do not drive the RNA to a collapsed state. Instead, entropy gains from water expulsion near the neighborhood of the RNA provide the stabilization free energy that tilt HJH into more compact structures. Further simulations of a three-helix hammerhead ribozyme show a similar behavior and support the idea of collapse due to increased gain in water entropy.
Strong Multivariate Relations Exist Among Milk, Oral, and Fecal Microbiomes in Mother-Infant Dyads During the First Six Months Postpartum.

Background Neonatal gastrointestinal (GI) bacterial community structure may be related to bacterial communities of the mother, including those of her milk. However, very little is known about the diversity in and relationships among complex bacterial communities in mother-infant dyads. Objective Our primary objective was to assess whether microbiomes of milk are associated with those of oral and fecal samples of healthy lactating women and their infants. Methods Samples were collected 9 times from day 2 to 6 mo postpartum from 21 healthy lactating women and their infants. Milk was collected via complete breast expression, oral samples via swabs, and fecal samples from tissue (mothers) and diapers (infants). Microbiomes were characterized using high-throughput sequencing of the 16S ribosomal RNA (rRNA) gene. Alpha and beta diversity indices were used to compare microbiomes across time and sample types. Membership and composition of microbiomes were analyzed using nonmetric multidimensional scaling and canonical correlation analysis (CCA). The contribution of various bacterial communities of the mother-infant dyad to both milk and infant fecal bacterial communities were estimated using SourceTracker2. Results Bacterial community structures were relatively unique to each sample type. The most abundant genus in milk and maternal and infant oral samples was Streptococcus (47.1% ± 2.3%, 53.9% ± 1.3%, and 69.1% ± 1.8%, respectively), whereas Bacteroides were predominant in maternal and infant fecal microbiomes (22.9% ± 1.3% and 21.4% ± 2.4%, respectively). The milk microbiome was more similar to the infant oral microbiome than the infant fecal microbiome. However, CCA suggested strong associations between the complex microbial communities of milk and those of all other sample types collected. Conclusions These findings suggest complex microbial interactions between breastfeeding mothers and their infants and support the hypothesis that variation in the milk microbiome may influence the infant GI microbiome.
Vitamin D deficiency and kidney hyperfiltration: a mechanism of kidney injury?

Chronic kidney disease (CKD) is a public health problem, given that approximately 13% of adult Americans currently living with CKD (1). CKD is associated with a high risk of hospitalization, cardiovascular events and mortality (2).
Abstract P3032: Low-Salt and Minimal Sugar-Sweetened Beverage Intake May Not Improve Hypertension Control

Objective: Sugar-sweetened beverage (SSB) (high fructose corn syrup and sucrose) consumption positively associates with obesity, cardiovascular disease, and hypertension (HTN). High fructose intake...
Risk of Readmission and Mortality Following Hospitalization with Hypercapnic Respiratory Failure

Hypercapnic respiratory failure (HRF) is a frequent cause of hospitalization and a common comorbidity in hospitalized patients. There are few studies addressing what factors might predict poor outcomes in this patient population. The purpose of the current study was to investigate characteristics and outcomes of patients hospitalized with HRF. A study of patients ≥ 18 years admitted with HRF in a 1-year period. Patients with limited life expectancy related to other conditions, and those with a non-respiratory cause of HRF, were excluded. 202 subjects met eligibility criteria: 24% had a diagnosis of obstructive sleep apnea, 6% obesity hypoventilation, 46% chronic obstructive pulmonary disease, and 10% asthma. Fifteen (7%) died during the index admission. Forty-one patients (23%) were readmitted within 30 days: peripheral vascular disease [adjusted odds ratio (aOR) 4.78, CI 1.45–15.74] and tachycardia (aOR 2.97, CI 1.22–7.26) were associated with an increased risk of readmission. Sixty-six patients (36%) died after discharge. Risk of death was increased in older patients (aOR 1.32, CI 1.13–1.54 per 5 years), those with peripheral vascular disease (aOR 12.56, CI 2.35–67.21), higher Charlson co-morbidity index (aOR 1.39, CI 1.09–1.76), use of home oxygen (aOR 4.03, CI 1.89–8.57), and those who had been readmitted (aOR 3.07, CI 1.46–6.43). Hospitalization for HRF is associated with a high morbidity and mortality. Our observation that home oxygen use was associated with increased mortality suggests that oxygen use could be a risk factor for death in patients with HRF.
Heart Transplant Outcomes in Patients with Alcoholic Cardiomyopathy

Purpose We sought to better characterize differences in transplant outcomes between patients with alcoholic cardiomyopathy and those with other forms of cardiomyopathy in a national cohort. Methods 63,142 OHT recipients were identified from UNOS (1987-2019) of which 224 had alcoholic cardiomyopathy as indication for HT. Multivariate Cox proportional hazard regression analysis was adjusted for age, sex, DM2, ethnicity, ischemic time, dialysis, life support, waitlist time and HLA mismatch. Kaplan-Meier survival curves were generated comparing survival outcomes in patients with alcoholic cardiomyopathy vs. patients with non-alcoholic cardiomyopathy post-OHT, including ischemic, restrictive, dilated, hypertrophic and other. Results The alcoholic cardiomyopathy group had 224 patients and the non-alcoholic cardiomyopathy group had 62,918 patients. Both cohorts were similar in age, diabetes, smoking status, ischemic time, and need for mechanical support prior to HT. The alcoholic cardiomyopathy cohort was more likely to be male (p Conclusion Post-HT Survival was the lowest in the alcoholic cardiomyopathy cohort compared to post-HT outcomes for all other types of cardiomyopathies. Patient with alcoholic cardiomyopathy tended to have greater sensitization and prior cardiac surgery, however further study is warranted to further delineate factors contributing to this impaired survival.
Role of ultrasound-guided perineural injection of the posterior antebrachial cutaneous nerve for diagnosis and potential treatment of chronic lateral elbow pain.

To examine diagnostic and therapeutic utility of novel ultrasound-guided perineural injection of posterior antebrachial cutaneous nerve in chronic lateral elbow pain. We performed a retrospective analysis of ultrasound-guided perineural injection of the posterior antebrachial cutaneous nerve with local anesthetic with or without corticosteroid in patients with chronic lateral elbow pain. Data variables collected included patient demographics, illness course, diagnostic ultrasound findings, immediate pre- and post-injection pain using numeric rating pain scale between 0 and 10, injection complications, and post-injection outcomes. Fifteen patients (9 females and 6 males) with average age 46.9 (range 16–69 years) underwent 20 perineural injections between 2009 and 2019. Patients had on average 84% reduction in pain immediately after the injection (median pre- and post-procedure numeric rating pain scale of 6 and 0, respectively, p < 0.001). Patients had pain relief for an average of 15 h (range 2–48 h) when only local anesthetic was injected, compared with average pain relief of 26.5 days (range 2 h—43 days) when local anesthetic was combined with corticosteroid, p = 0.01. Novel ultrasound-guided perineural anesthetic injections around the posterior antebrachial cutaneous nerve can be performed safely and have diagnostic and potentially therapeutic utility in select patients with chronic refractory lateral elbow pain.
Predicting high school students’ argumentation skill using information literacy and trace data

Strong information literacy, collaboration, and argumentation skill are essential to success in problem-based learning (PBL). Computer-based scaffolding can help students enhance these skills durin...