cssi/SciSciGPT-SciSciNet huggingface dataset:
Alternate Day Corticosteroid Administration and Homograft Rejection in Rabbits

SummaryThe effect of alternate day steroid administration on immune processes per se has been evaluated to only a limited extent. In the present study, we compared the effect on homograft rejection in rabbits of alternate day steroid administration with that of sustained release steroid administration. It was found that administration of a steroid preparation causing sustained high blood levels led to significantly greater inhibition of an immune process (homograft rejection) than did administration of another form of the same steroid preparation causing high blood levels only on alternate days. This finding would seem to bear consideration in the decision as to whether to treat autoimmune diseases with sustained high levels of steroids or on an alternate day basis. In addition, observations previously noted with respect to the relation of alternate day versus continuous steroid administration to toxicity and adrenal characteristics were supported by our findings.
Political Advertising in Consolidating Democracies: Locally Dominant Parties and the Equalization of Media Access in Mexico

To combat disparities in access to political advertising -- an essential challenge for many consolidating democracies where political parties are regionally dominant -- many countries now regulate access to political advertising. Unlike consolidated democracies, where voters are similarly familiar with the policies of the major parties, equalizing political advertising opportunities may particularly benefit political parties that are not locally dominant. Mexico implemented such a reform in 2007, allocating radio and television advertising slots according to national and state vote shares at the previous election. Using detailed signal coverage data, we combine matching techniques with a fuzzy geographic regression discontinuity design to exploit differences in exposure to political advertising caused by cross-state spillovers to identify the effects of political advertising. We show that political advertising -- particularly AM radio -- is effective at increasing the vote share of the PAN and PRD, but not the previously-hegemonic PRI. Consistent with our formal model, PAN and PRD political advertising is most effective in the least informed and politically uncompetitive electoral precincts, and when a facing a locally dominant party of intermediate strength.
Impact of Tight Glycemic Control on Neurodevelopmental Outcomes at 1 Year of Age for Children with Congenital Heart Disease: A Randomized Controlled Trial

Objective To assess the association of postoperative tight glycemic control and hypoglycemia in children undergoing cardiac surgery with neurodevelopmental outcomes at 1 year of age. Study design A 2-center, prospective, randomized trial of postoperative tight glycemic control vs standard care was conducted in 980 children undergoing cardiac surgery. Neurodevelopmental outcomes were assessed at nine to 18 months using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III), the Adaptive Behavior Assessment System, Second Edition, the Ages and Stages Questionnaire, Third Edition, and the Brief Infant Toddler Social-Emotional Assessment. Results Neurodevelopmental follow-up was performed on 237 patients with a mean age of 13 months. No significant treatment group differences were found in the Bayley-III and Adaptive Behavior Assessment System, Second Edition composite scores or percentage at risk based on the Ages and Stages Questionnaire, Third Edition and the Brief Infant Toddler Social-Emotional Assessment. Patients who experienced moderate to severe hypoglycemia (n = 8) had lower Bayley-III composite scores compared with patients with no to mild hypoglycemia, even after controlling for factors known to be associated with poorer neurodevelopmental outcomes. Conclusion For infants undergoing cardiac surgery, tight glycemic control did not impact neurodevelopmental outcomes compared with standard care. These data suggest a possible association between moderate to severe hypoglycemia and poorer neurodevelopmental outcomes at 1 year of age. Trial registration ClinicalTrials.gov : NCT00443599 .
Analysis on Mortality of Malignant Tumors Among Residents of Changshu from 1973 to 2010

Objective To analyze the mortality of malignant tumors in residents of Changshu from 1973 to 2010,and to provide a basis for formulating prevention and control measures of malignant tumors. Methods Death data were collected from duty units for reporting and then classified according to ICD-10.The trend of the cancer mortality and death situation of main malignant tumors within 38 years were analyzed. Results From 1973 to 2010,the mortality of malignant tumors among the residents in Changshu was 181.76/100,000,which accounted for 23.87% of the whole death and increased with the increasing time.There were different positions of the main ten malignant tumors in different times.The mortality of gastric cancer was the first all the time,while liver cancer and esophageal cancer ranked the second and the third at first,then dropped to the third and the fourth at last.Lung cancer was the fourth at first then jumped to the second at last.The mortality rates of malignant tumors of men were higher than those of women in different times,and there were statistically significant differences in mortality rates of gastric cancer,lung cancer,liver cancer and esophageal cancer.The mortality rates of malignant tumors increased with the increasing age in whole population.The mortality rates of the age groups of 35-54 and 55-74 years decreased gradually in different times.According to the mortality rates of malignant tumors,leukaemia ranked the first in the patients under the age of 35 years,liver cancer ranked the first in the patients aged between 35 and 54 years,and gastric cancer ranked the first in patients aged above 55 years. Conclusions Malignant tumors are the main causes of death which threaten the residents in Changshu.The mortality remains increased owing to the increase of aging level.Comprehensive intervention measures should be taken to prevent and decrease the occurrence of malignant tumors according to the characteristics of different populations and tumors.
Academic Duty and Academic Freedom

On December 31, 1915, the newly formed American Association of University Professors (AAUP) and its Committee on Academic Freedom and Academic Tenure accepted a set of guidelines designed to shape the organization and its work to protect academics against the termination power of their employer-universities.1 The “General Declaration of Principles,”2 drafted by approximately a dozen educators who were called from universities across the country,3 begins with a decided focus on the rights of individuals within the academy: “The term ‘academic freedom’ has traditionally had two applications,” the language reads at the start, “to the freedom of the teacher and to that of the student . . . .”4 With that, in a very real way in the United States, academic freedom began. And its very first focus was, not surprisingly, given the authors, on the protection of the teacher. A century later, on its webpage celebrating 100 years of academic freedom, the AAUP quoted with praise what it called a “foundational statement” from the Declaration, language that helped exemplify what the concept of academic freedom means. “[O]nce appointed,” the seminal language drafted in 1915 and enthusiastically republished in 2015 reads, “the scholar has professional functions to perform in which the appointing authorities have neither competency nor moral right to intervene. The responsibility of the university teacher is primarily to the public itself, and to the judgment of his own profession.”5 As its membership consisting mostly of faculty members6 recognizes, the AAUP exists in strong part to protect a scholar’s academic pursuits,7 and academic freedom,
Pseudothrombocytopenia caused by platelet agglutinins that are reactive in blood anticoagulated with chelating agents

The phenomenon of in vitro platelet clumping and consequent pseudothrombocytopenia in the presence of EDTA was studied in the plasmas and sera of three patients. A heterogeneity was identified among these platelet agglutinins. IgG agglutinins present in two patients recognized antigens that were present when EDTA was added to platelets. This effect of EDTA did not appear to be mediated by calcium chelation. On the other hand, an IgM antibody from another patient appeared to react with platelet antigens that were expressed when the calcium concentration was less than 50 μM. EDTA, citrate, and oxalate all induced platelet agglutination with this IgM agglutinin. Thus, pseudothrombocytopenia in chelated blood is caused by a group of agglutinins that are heterogeneous with respect to their physicochemical properties and mechanism of action.
Computer-Assisted Pre-Operative Planning of Orthopedic Reconstructive Surgery

Three-dimensional reconstructions from digital images can be combined with computer-aided design and computer-aided manufacturing techniques to improve the pre-operative planning of orthopedic reconstructive procedures. These methods may be used to optimize the choice of standard artificial joint replacements, to design custom artificial joint replacements, and to improve the analysis and results of femoral and pelvic osteotomies.
Laparoscopic Roux-en-Y gastric bypass for morbid obesity.

Introduction Bariatric surgery procedures have increased dramatically in the last decade, mainly due to the growing epidemic problem of morbid obesity in the United States and the advent and acceptance of minimally invasive techniques to perform bariatric operations. The Roux-en-Y gastric bypass procedure, in which a very small gastric pouch is created and a Roux limb of jejunum is anastomosed, was the most common procedure performed in 2005.
SU‐G‐JeP3‐01: A Method to Quantify Lung SBRT Target Localization Accuracy Based On Digitally Reconstructed Fluoroscopy

Purpose: To develop a methodology based on digitally-reconstructed-fluoroscopy (DRF) to quantitatively assess target localization accuracy of lung SBRT, and to evaluate using both a dynamic digital phantom and a patient dataset. Methods: For each treatment field, a 10-phase DRF is generated based on the planning 4DCT. Each frame is pre-processed with a morphological top-hat filter, and corresponding beam apertures are projected to each detector plane. A template-matching algorithm based on cross-correlation is used to detect the tumor location in each frame. Tumor motion relative beam aperture is extracted in the superior-inferior direction based on each frame's impulse response to the template, and the mean tumor position (MTP) is calculated as the average tumor displacement. The DRF template coordinates are then transferred to the corresponding MV-cine dataset, which is retrospectively filtered as above. The treatment MTP is calculated within each field's projection space, relative to the DRF-defined template. The field's localization error is defined as the difference between the DRF-derived-MTP (planning) and the MV-cine-derived-MTP (delivery). A dynamic digital phantom was used to assess the algorithm's ability to detect intra-fractional changes in patient alignment, by simulating different spatial variations in the MV-cine and calculating the corresponding change in MTP. Inter-and-intra-fractional variation, IGRT accuracy, and filtering effects were investigated on a patient dataset. Results: Phantom results demonstrated a high accuracy in detecting both translational and rotational variation. The lowest localization error of the patient dataset was achieved at each fraction's first field (mean=0.38mm), with Fx3 demonstrating a particularly strong correlation between intra-fractional motion-caused localization error and treatment progress. Filtering significantly improved tracking visibility in both the DRF and MV-cine images. Conclusion: We have developed and evaluated a methodology to quantify lung SBRT target localization accuracy based on digitally-reconstructed-fluoroscopy. Our approach may be useful in potentially reducing treatment margins to optimize lung SBRT outcomes. R01-184173
Abstract 845A: Novel twin method estimates genetic prevalence of breast cancer

The standard twin method of the last one hundred years uses data from fraternal and identical twins to estimate heritability, which is the fraction of the variance attributed to genetic effects under an additive genetic model. Using the same data, the latent class twin method estimates a more easily interpretable quantity, the genetic prevalence, which is the fraction persons with an outcome who are in a genetic susceptibility latent class. A key assumption is that the genetic susceptibility latent class has relatively large independent probabilities of outcome as compared with an environmental susceptibility latent class with smaller and possibly dependent probabilities of outcome. Unlike the standard twin method which assumes additive genetic inheritance, the latent class twin method also allows for autosomal recessive, autosomal dominant inheritance. The method handles survival data by treating loss-to-follow up and death from competing risk as non-informative censoring. Applying this methodology to registry data from 45,000 pairs of Nordic twins, we estimated a genetic prevalence for breast cancer of only 1%. Because BRCA1 and BRAC2 have a combined prevalence of around 1%, there are likely no other high-penetrance genes contributing to breast cancer Citation Format: Stuart G. Baker. Novel twin method estimates genetic prevalence of breast cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 845A.
Dissipation, half-lives, and mass spectrometric identification of chlorpyrifos and its two metabolites on field-grown collard and kale

The persistence and fate of chlorpyrifos and its two metabolites, chlorpyrifos-oxon and the 3, 5, 6-trichloro-2-pyridinol (TCP) break-down product were investigated on kale and collard leaves under field conditions. A simultaneous extraction and quantification procedure was developed for chrorpyrifos and its two main metabolites. Residues of chlorpyrifos, chlorpyrifos oxon, and TCP were determined using a gas chromatograph (GC) equipped with an electron capture detector (GC/ECD). Chlorpyrifos metabolites were detectable up to 23 days following application. Residues were confirmed using a GC equipped with a mass selective detector (GC/MSD) in total ion mode. Initial residues of chlorpyrifos were greater on collard (14.5 µg g-1) than kale (8.2 µg g-1) corresponding to half-lives (T1/2) values of 7.4 and 2.2 days, respectively. TCP, the hydrolysis product, was more persistent on collards with an estimated T1/2 of 6.5 days compared to kale (T1/2 of 1.9 days).
Acidosis increases the susceptibility of respiratory epithelial cells to Pseudomonas aeruginosa-induced cytotoxicity.

Bacterial infection can lead to acidosis of the local microenvironment, which is believed to exacerbate disease pathogenesis; however, the mechanisms by which changes in pH alter disease progressio...
No Mission Too Difficult: Responding to Military Sexual Assault

An introduction is presented in which the author discusses a report in the issue which deals with sexual assaults against U.S. female military personnel, and it mentions mental health treatment, the career consequences military sexual assaults, and the mental health of sexually abused women.
Why the Trump Administration Should Not Overlook Africa

U.S. efforts have made a crucial difference in Africa during recent administrations. The new administration should continue this engagement.
Microstructure characterization of large TiC-Mo-Ni cermet tiles

Abstract A detailed characterization of large (150 mm × 150 mm), 6 to 12 mm thick, commercially produced tiles of a TiC-Mo-Ni cermet with ~ 13 vol% Ni binder and a microstructure consistent with processing via self-propagating high temperature synthesis (SHS) has been conducted. Many mechanical property defining attributes of the materials were highly reproducible, including the composition, phase content, TiC particle size distribution (with an average particle diameter of 8–10 μm), and density of 5.52 × 10 3 kgm − 3 . However, sufficient variability in the distribution of metal elements within the carbide particles, interparticle contiguity, the distribution of porosity, and residual stress were discovered that the mechanical behavior is expected to exhibit significant variability. The spheroidal shaped TiC particles had a multilayered (onion ring like) composition with rings of locally higher Mo concentration, rather than the more usual Ti-rich core and a single Mo-rich rim that enhances wetting with the Ni-binder. The TiC particles also had a high contiguity factor of 0.30–0.47. Recent assessments of liquid phase sintered cermets indicate significant loss of fracture resistance as the contiguity increases above 0.25. Hot isostatic pressing (HIP) at 1250 °C and 100 MPa was unable to reduce the porosity, which remained as large pockets of insufficient metal binder material (a form of shrinkage porosity) between the spheroidal carbide particles. X-ray diffraction measurements indicated the presence of significant residual stress in the as-received and the HIP condition materials. A stress relief heat treatment at 900 °C succeeded in eliminating this residual stress consistent with its origination from thermal gradients associated with rapid cooling.
Abstract WP243: Identification of IV tPA Delays Can Improve Future Occurences

Introduction: The American Heart and American Stroke Associations released their new Target: Stroke goal of IV tPA administration in under 45 minutes from arrival for all eligible patients. While many hospitals have improved with prompt IV tPA initiation, further analysis is necessary to determine reasons for ongoing delays in order to continue to improve door- to-needle (DTN) times. Hypothesis: We hypothesized that identifying trends in IV tPA initiation delays could guide development of process improvement (PI) geared toward decreasing DTN times. Methods: A retrospective cohort of 2,417 patients presenting to a five hospital campus system from January 2013 to March 2015 were studied to identify trends in IV tPA delays. Inclusion criteria: all patients presenting to the emergency department (ED) for which a code stroke was activated and IV tPA was initiated with DTN times greater than 60 minutes from arrival. Exclusion criteria: patients presenting to the ED for which a code stroke was activated but IV tPA was not administered, or IV tPA was initiated within 60 minutes of arrival. Results: Sixty-seven patients met the inclusion criteria, and the following trends were identified: seven patients (10%) required management for other life threatening conditions prior to IV tPA, such as intubation or cardioversion; IV tPA was delayed in 28 patients (42%) due to an inability to determine eligibility. This was based on waxing and waning symptoms and/or uncertainty of last time known well (LKWT). Twenty patients (30%) required IV medications for hypertension and twelve (18%) patients and/or family members initially refused the drug. Conclusion: This study revealed that 90% of IV tPA initiation delays were due to potential modifiable factors. Indicating that through implementation of PI changes, hospital systems may be able to prevent similar delays from occurring. Examples include: collaboration with emergency medical services to transport witnesses to the ED for assistance with prompt identification of LKWT, earlier management of hypertension, and a streamlined approach for risk and benefit discussions between clinicians, patients and/or family to assist in a rapid informed consent process.
“Feeding Your Family for a Year,” A Simplified Model for Teaching Students How the Leisure Class Developed

ABSTRACTThis learning activity, “Feeding Your Family for a Year,” teaches students about how the shift from nomadic, hunter-gatherer societies to agrarian societies led to inequities in resources, which in turn allowed a leisure class to develop (Cordes & Ibrahim, 2003). The activity demonstrates how an unequal distribution of resources, represented by candy within the activity, created labor and class distinctions. This understanding helps provide historical background for students who have little knowledge of history and/or are wrestling with complex ideas, such as those presented by Thorstein Veblen in The Theory of the Leisure Class. Recommendations for future use include a variety of modifications: using an item other than candy to signify resources, adding or subtracting an additional indicator of resources, performing the activity outside of a classroom setting, and changing the level of instructor guidance within the activity. At the conclusion of the activity, students should be able to understan...
Quantifier elimination approach to frequency domain design

The design, in the frequency domain, of robust feedback systems with bounded control effort can be reduced to quantifier elimination problem. However due to computational complexities, only problems of modest size can be solved. Nevertheless it may be possible to solve some practical problems where no analytic design procedures exist.
Molecular Dynamics Simulations of Drop Motion on Uniform and Non-Uniform Solid Surfaces

Although much research has been performed on the motion of contact lines on solid surfaces, many questions remain. This paper presents results obtained with molecular dynamics (“MD”) simulations that address some of these questions. Of specific interest is the nature of the frictional resistance to contact line motion.
Light–valley interactions in 2D semiconductors

The emergence of two-dimensional Dirac materials, particularly transition metal dichalcogenides (TMDs), has reinvigorated interest in valleytronics, which utilizes the electronic valley degree of freedom for information storage and processing. Here, we review the basic valley-dependent properties and their experimental demonstrations in single-layer semiconductor TMDs with an emphasis on the effects of band topology and light–valley interactions. We also provide a brief summary of the recent advances on controlling the valley degree of freedom in TMDs with light and other means for potential applications. Valleytronics in single-layer semiconductors is reviewed with an emphasis on controlling the valley degree of freedom with light as well as potential applications.
Associations Between Kidney Disease Measures and Regional Pulse Wave Velocity in a Large Community-Based Cohort: The Atherosclerosis Risk in Communities (ARIC) Study.

Rationale & Objective Arterial stiffness is suggested as a mediator of cardiorenal interaction. However, previous studies reported inconsistent associations between chronic kidney disease (CKD) and arterial stiffness and were limited by using either estimated glomerular filtration rate (eGFR) or albumin-creatinine ratio (ACR) and examining arterial stiffness at limited segments. Study Design Cross-sectional. Setting & Participants 3,424 Atherosclerosis in Communities (ARIC) Study participants aged 66 to 90 years during 2011 to 2013. Predictors eGFR and ACR. Outcome Pulse wave velocity (PWV) at 6 segments: carotid-femoral (cfPWV), heart-carotid (hcPWV), and heart-femoral (hfPWV), reflecting central stiffness; heart-ankle (haPWV) and brachial-ankle (baPWV), representing both central and peripheral stiffness; and femoral-ankle (faPWV), indicating peripheral stiffness. Analytical Approach Multiple linear and logistic regression models to quantify the associations of eGFR and ACR with continuous PWV and elevated PWV (in the highest quartile), respectively. Results After adjusting for age, sex, and race, higher cfPWV and hfPWV were consistently associated with lower eGFR and higher ACR. Higher haPWV and baPWV were also observed with higher ACR. The independent association of both CKD measures with elevated cfPWV remained consistent after adjusting for additional confounders (ORs of elevated cfPWV were 1.09 [95% CI, 1.01-1.18] per 15-mL/min/1.73m2 lower eGFR and 1.20 [95% CI, 1.07-1.33] per 4-fold higher ACR). Higher ACR was also associated with elevated hfPWV and haPWV (ORs per 4-fold higher ACR were 1.25 [95% CI, 1.12-1.39] for elevated hfPWV and 1.19 [95% CI, 1.06-1.33] for elevated haPWV). Lower eGFR was associated with lower odds of elevated baPWV and faPWV (ORs per 15–mL/min/1.73m2 lower eGFR were 0.92 [95% CI, 0.84-0.99] and 0.91 [95% CI, 0.85-0.99], respectively). Limitation Unable to address temporality between CKD measures and arterial stiffness. Conclusions Both lower eGFR and higher ACR are independently associated with measures of central arterial stiffness, with stronger associations for ACR over eGFR. Our findings suggest that central arterial stiffness may be an important pathophysiologic phenotype of vascular disease in CKD.
High-efficiency coherence-preserving harmonic rejection with crystal optics.

This work reports a harmonic-rejection scheme based on the combination of Si(111) monochromator and Si(220) harmonic-rejection crystal optics. This approach is of importance to a wide range of X-ray applications in all three major branches of modern X-ray science (scattering, spectroscopy, imaging) based at major facilities, and especially relevant to the capabilities offered by the new diffraction-limited storage rings. It was demonstrated both theoretically and experimentally that, when used with a synchrotron undulator source over a broad range of X-ray energies of interest, the harmonic-rejection crystals transmit the incident harmonic X-rays on the order of 10−6. Considering the flux ratio of fundamental and harmonic X-rays in the incident beam, this scheme achieves a total flux ratio of harmonic radiation to fundamental radiation on the order of 10−10. The spatial coherence of the undulator beam is preserved in the transmitted fundamental radiation while the harmonic radiation is suppressed, making this scheme suitable not only for current third-generation synchrotron sources but also for the new diffraction-limited storage rings where coherence preservation is an even higher priority. Compared with conventional harmonic-rejection mirrors, where coherence is poorly preserved and harmonic rejection is less effective, this scheme has the added advantage of lower cost and footprint. This approach has been successfully utilized at the ultra-small-angle X-ray scattering instrument at the Advanced Photon Source for scattering, imaging and coherent X-ray photon correlation spectroscopy experiments. With minor modification, the harmonic rejection can be improved by a further five orders of magnitude, enabling even more performance capabilities.
Mobile Elements Shape Plastome Evolution in Ferns

Plastid genomes display remarkable organizational stability over evolutionary time. From green algae to angiosperms, most plastid genomes are largely collinear, with only a few cases of inversion, gene loss, or, in extremely rare cases, gene addition. These plastome insertions are mostly clade-specific and are typically of nuclear or mitochondrial origin. Here, we expand on these findings and present the first family-level survey of plastome evolution in ferns, revealing a novel suite of dynamic mobile elements. Comparative plastome analyses of the Pteridaceae expose several mobile open reading frames that vary in sequence length, insertion site, and configuration among sampled taxa. Even between close relatives, the presence and location of these elements is widely variable when viewed in a phylogenetic context. We characterize these elements and refer to them collectively as Mobile Open Reading Frames in Fern Organelles (MORFFO). We further note that the presence of MORFFO is not restricted to Pteridaceae, but is found across ferns and other plant clades. MORFFO elements are regularly associated with inversions, intergenic expansions, and changes to the inverted repeats. They likewise appear to be present in mitochondrial and nuclear genomes of ferns, indicating that they can move between genomic compartments with relative ease. The origins and functions of these mobile elements are unknown, but MORFFO appears to be a major driver of structural genome evolution in the plastomes of ferns, and possibly other groups of plants.
Quality and cost comparison of powered versus manual bone marrow biopsy devices at a large U.S. cancer center.

e18283Background: Although powered bone marrow biopsy devices (PBM) have been shown to yield longer biopsy samples than manual bone marrow biopsy devices (MBM), the relative quality and cost-effect...
Inequalities in Educational Attainment

In recent decades, Thailand has been highly successful in expanding coverage of its basic education system. However, a growing body of empirical evidence indicates that there remain serious issues related to low learning outcomes and rising inequalities in student performance in standardized assessments. For example, in the PISA 2012 reading assessment, one-third of Thai 15-year-old students were classified as “functionally illiterate,” lacking critical skills for many jobs in a modern economy. Students in rural areas, who predominantly attend small schools which are severely lacking in adequate teachers and infrastructure, are not receiving the same quality education that their counterparts in bigger, urban schools are receiving. These rural students, often from Thailand’s poorest families, are also falling further behind. The gaps in learning outcomes at the lower education levels inevitably lead to a concentration of enrolment disparities between socioeconomic groups at the upper secondary and, particularly, the tertiary level. Based on recent research evidence, this chapter identifies the most important equity and quality challenges facing the Thai education system. It argues that Thailand has the resources to build a high-performing education system – one built on schools that utilize the full potential of high-quality teachers and prepare students with the critical skills for success in a modern economy. However, a strong political will is needed if the types of reforms suggested here are to be implemented successfully.
Predictors of Venous Thromboembolism After Nonemergent Craniotomy: A Nationwide Readmission Database Analysis

Background Venous thromboembolism (VTE) is responsible for many hospital readmissions each year, particularly among postsurgical cohorts. Because early and indiscriminate VTE prophylaxis carries catastrophic consequences in postcraniotomy cohorts, identifying factors associated with a high risk for thromboembolic complications is important for guiding postoperative management. Objective To determine VTE incidence in patients undergoing nonemergent craniotomy and to evaluate for factors that predict 30-day and 90-day readmission with VTE. Methods The 2010–2014 cohorts of the Nationwide Readmissions Database were used to generate a large heterogeneous craniotomy sample. Results There were 89,450 nonemergent craniotomies that met inclusion criteria. Within 30 days, 1513 patients (1.69%) were readmitted with VTE diagnoses; among them, 678 (44.8%) had a diagnosis of deep vein thrombosis alone, 450 (29.7%) had pulmonary embolism alone, and 385 (25.4%) had both. The corresponding 30-day deep vein thrombosis and pulmonary embolism incidences were 1.19% and 0.93%, respectively. In multivariate analysis, several factors were significantly associated with VTE readmission, namely, craniotomy for tumor, corticosteroids, advanced age, greater length of stay, and discharge to institutional care. Conclusions Craniotomies for tumor, corticosteroids, advanced age, prolonged length of stay, and discharge to institutional care are significant predictors of VTE readmission. The implication of steroids, coupled with their ubiquity in neurosurgery, makes them a potentially modifiable risk factor and a prime target for VTE reduction in craniotomy cohorts. Furthermore, the fact that dose is proportional to VTE risk in the literature suggests that careful consideration should be given toward decreasing regimens in situations in which use of a lower dose might prove equally sufficient.
Comparison of the Michigan Hand Outcomes Questionnaire, Boston Carpal Tunnel Questionnaire, and PROMIS Instruments in Carpal Tunnel Syndrome.

Purpose Patient-reported outcomes are important to assess improvement after surgery. Common instruments for carpal tunnel syndrome include the Michigan Hand Outcomes Questionnaire (MHQ) and Boston Carpal Tunnel Questionnaire (CTQ). The Patient-Reported Outcomes Measurement Information System (PROMIS) are newer measures. We evaluated how the PROMIS Pain Interference (PI) and Upper Extremity (UE) scores change after carpal tunnel release. Methods All adult patients with carpal tunnel syndrome treated surgically were asked to participate in this prospective study. PROMIS instruments, MHQ, and CTQ were completed by 101 patients. Estimated means and standard errors were calculated, and piecewise linear fixed effects regression models were applied to the data. Standardized response means were calculated for each outcome measure. Results The MHQ Total Score did not show a considerable change from the preoperative to 1-week postoperative visit but improved from the 1-week to 3-month postoperative visit (55 to 80). The CTQ Functional Status Score (FSS) worsened from 2.3 preoperatively to 2.6 at the 1-week postoperative visit before improving through the 3-month postoperative visit (1.6). PROMIS UE showed responsiveness similar to the CTQ FSS with a decline at the 1-week visit, 38 to 33, followed by improvement (45 at 3 mo). However, the standardized response mean values were greater for the CTQ FSS compared with PROMIS UE. The average administration time was shortest for PROMIS UE. The CTQ Symptom Severity Scale and MHQ Pain Scores showed improvements as early as the 1-week visit. The CTQ Symptom Severity Scale improved from 3.1 to 2.3, and MHQ Pain Scores improved from 55 to 46. PROMIS PI did not change at the 1-week visit but improved at 6 weeks and 3 months, from 56 to 52 and 49. The standardized response means for PROMIS PI achieved a large effect size only at 3 months. Conclusions The CTQ FSS is more responsive than PROMIS UE and the MHQ, with the CTQ FSS showing the largest effect sizes. PROMIS PI does not show the responsiveness seen in the CTQ Symptom Severity Scale and MHQ Pain Score. PROMIS instruments require less time to complete. Clinical relevance This study demonstrates the change in PROMIS scores after carpal tunnel release and how they compare with legacy outcome instruments.
MRI findings in Parinaud's syndrome: a closer look at pineal masses.

The association between MRI findings in patients with pineal lesions and the presence or absence of Parinaud’s syndrome (PS) remains poorly described. We sought to better understand what MRI characteristics of a pineal lesion make PS more likely. Can these features predict prognosis for clinical resolution? Based on the anatomical relationship of the pineal gland and midbrain, we hypothesized that the degree of midbrain injury by a pineal mass as assessed by abutment, displacement, or intrinsic midbrain signal abnormality (IMSA) may predict PS. We reviewed our institution’s databases to find patients with MRI evidence of an intrinsic lesion of the pineal gland. Seventy-seven patients with intrinsic pineal gland lesions, 26 with PS and 51 without PS (NPS), were identified. Data regarding clinical history were collected, and an experienced neuroradiologist reviewed all MRI studies and recorded mass size, midbrain abutment, displacement by the pineal lesion, and presence or absence of IMSA. IMSA occurred with increased frequency in pineal lesions with PS (85%) when compared with NPS (39.2%) (p = 0.0001). Midbrain abutment, compression, and displacement occurred with similar frequencies in both groups, with no statistically significant difference. Hydrocephalus was present in 80.8% of patients with PS and 84% without PS (p = 0.75). IMSA in a patient with an intrinsic pineal gland mass is associated with PS. Other findings such as hydrocephalus and midbrain displacement are common in patients with pineal masses both with and without PS and do not have any predictive value.
Extended Rank Tests for Analyzing Recurrent Event Data

Wang and Chang studied the bias in the estimation of the marginal survival curve of recurrent event data and came up with an unbiased Kaplan–Meier (KM)-like estimator. However, there were no corres...
Bacterial Diversity of Water and Soil Samples from Dripping Springs in the Organ Mountains (New Mexico), Determined by Using 16S rRNA Gene Amplicon Sequencing.

ABSTRACT Dripping Springs is located on the western side of New Mexico’s Organ Mountains. This is an initial microbial analysis of the spring water and surrounding microbial mat. Both soil-water and water samples showed a high level of microbial biodiversity consistent with the secluded and pristine nature of the area.
Creating a Positive School Climate and Developing Social Competence

School bullying is a multifaceted problem. Although all bullying acts have in common the intent to hurt others, behaviors vary widely in severity and type, from demeaning looks to spreading malicious rumors to physically assaulting others. Similarly, the motives for bullying peers are diverse; Dagley (2000), for example, highlighted four motives: attention, revenge, power, or inadequacy. In consequence, the deterrence of school bullying requires a comprehensive model that examines a wide array of school and student characteristics needed to prevent and reduce bullying. Orpinas and Horne (2006) developed the School Social Competence Development and Bullying Prevention Model to provide an organized, comprehensive view of the critical components necessary for bullying prevention. Th e model has two components (see Figure 4.1). Th e outer circle refl ects the school, and calls attention to eight characteristics that promote a positive school climate. Th e students are at the center, and the model highlights specifi c skills and cognitions that the school can focus on at the individual student level. Th is chapter describes the school and student components of the model. Th e chapter concludes by examining characteristics of a successful implementation.
Application of deep learning to improve sleep scoring of wrist actigraphy.

Abstract Background Estimation of sleep parameters by wrist actigraphy is highly dependent on performance of the interpretative algorithm (IA) that converts movement data into sleep/wake scores. Research questions (1) Does the actigraphy mode of operation -Proportional Integrating Measure (PIM) or Zero Crossing Mode (ZCM), responsive respectively to intensity and frequency of movements- impact sleep scoring; and (2) Can a better performing sleep scoring IA be developed by a deep learning approach combining PIM/ZCM data. Study design and Methods ZCM and PIM plus electroencephalographic (EEG) data of 40 healthy adults (17 female, mean age: 26.7 years) were obtained from a single in-home nighttime sleep study. Effect of mode of operation was first evaluated by applying several classic deep learning models to PIM only, ZCM only, and combined ZCM/PIM data. After, a novel deep learning model was developed incorporating combined ZCM/PIM data, and its performance was compared with existing Cole-Kripke, rescored Cole-Kripke, Sadeh, and UCSD IAs. Results Relative to the EEG reference, ZCM/PIM combined mode produced higher agreement of scoring sleep/wake epochs than only ZCM or PIM modes. The proposed novel deep learning model showed 87.7% accuracy (0.2–1% higher than the other IAs), 94.1% sensitivity (0.7–4.3% lower than the other IAs), 64.0% specificity (9.9–21.5% higher than the other IAs), and 59.9% Kappa agreement (∼6.9–11.6% higher than other IAs) in detecting sleep epochs. The proposed deep learning model did not differ significantly from the reference EEG in estimating sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency (SE). Amount of bias and minimum detectable change in estimating SOL, WASO, TST and SE by the deep learning model was smaller than other four IAs. Interpretation The proposed novel deep learning algorithm simultaneously incorporating ZCM/PIM mode data performs significantly better in assessing sleep than existing conventional IAs.
Role of neuraxial drug delivery in cancer pain therapy

Opioids have long been the mainstay of cancer pain treatment and have been used without any consideration for their effect on cancer growth and long-term prognosis. There is now growing evidence th...
Polymer nanodielectrics—Short history and future perspective

This article provides a perspective on the development of polymer nanodielectrics for electrical insulation applications. It includes a short history of the development of the field, barriers to implementation, a chemical toolbox available for optimizing properties, some examples of potential commercial development, and the latest advances. It offers opinions on critical research needed to fully develop the models needed to predict the behavior and to develop design tools. Key findings include the need for quantification of nanofiller dispersion, investment in long term aging data research, better scale-up methods, a data resource that brings the broad data together in a format that enables faster scientific discovery, and a commercial entity willing to take the risk in implementing these promising materials.
Comparative Hypotheses of Scientific Development

This study presents different approaches of scientific development to explain science and technology: accumulation of knowledge, scientific paradigm shifts by Khun, research programme by Lakatos, theory by Tiryakian, revisionism by Alexander Jeffrey, openness, closure and branching described by Mulkay. In particular, this study clarifies, as far as possible, models, hypotheses and properties of the scientific development to support progress of science technology and society
Tumor extracellular hydroxyapatite: a potential biomarker for imaging ovarian cancer

Objectives: Identifying new strategies to improve response to poly ADP-ribose polymerase inhibitors (PARPi) in women with homologous recombination (HR)-proficient ovarian cancer is a key clinical challenge. The nuclear orphan receptor NR4A1 has pro-tumor effects in ovarian cancer cells through transcriptional regulation of key genes promoting growth, survival and HR DNA repair. NR4A1 is also expressed in immune cells in the tumor microenvironment and may play a role in inhibiting re-polarization of pro-tumor M2-like tumor-associated macrophages (TAMs) to a more effective anti-tumor M1-like TAM phenotype. Our group has shown that the NF-kappaB (NF-ĸB) pathway is a key regulator of TAM phenotype, with upregulated NF-ĸB signaling promoting M1-like functions. Our goal therefore was to determine whether inhibition of NR4A1 can improve responses to PARPi both by increased tumor DNA damage and apoptosis, and by promoting an anti-tumor M1 phenotype in TAMs by modulating NF-ĸB activity. Methods: Cultured HR-proficient ID8 mouse ovarian cancer cells, mouse ovarian TAMs and mouse bone marrow-derived macrophages were treated with the established NR4A1 antagonist C-DIM-pPHOH (C-DIM) and/or the PARPi olaparib (OLA) for 24-72 hours. C57BL/6 mice with established intra-peritoneal ID8 tumors were treated with vehicle, C-DIM, OLA or combined C-DIM/OLA for 3 weeks. Standard techniques were used to determine cell growth (Sulforhodamine B assay), HR efficiency (BRCA1 and RAD51 foci formation), NF-ĸB activity (nuclear p65, luciferase reporter activity), and expression of markers of DNA damage (pH2AX), apoptosis (cleaved PARP), proliferation (PCNA), and macrophage M1 (CCL3, iNOS) and M2 (CD206, arginase-1) polarization. Statistical significance (p Download : Download high-res image (260KB) Download : Download full-size image Results: In ID8 cells, co-treatment with C-DIM and OLA significantly reduced cell growth and HR efficiency, and increased DNA-damage-induced apoptosis, compared to OLA treatment alone. NR4A1 was highly expressed in macrophages, and C-DIM increased NF-ĸB activity and induced M1 polarization alone and when combined with olaparib. Similar effects of combined treatment were observed in vivo. Compared to mice treated with OLA alone, there was significantly reduced ascites volume and omental tumor mass in C-DIM/OLA mice at the time of sacrifice. Combined treatment also reduced proliferation and increased DNA damage and apoptosis in harvested tumors, and increased M1 polarization of TAMs in ascites fluid, compared to OLA mice. Conclusions: NR4A1 inhibition sensitizes ovarian tumors to PARPi though direct effects on tumors by targeting the HR pathway, and by modulating TAM function towards an anti-tumor phenotype. These findings have important implications for expanding the use of PARPi in women with HR-proficient ovarian tumors, which would benefit a substantial number of women with this devastating disease.
Science as Literacy

The task of this concluding chapter is to make a beginning. What begins here is a constructive philosophy of empathy that will address several contemporary questions in philosophy of science while drawing on the legacy of Edith Stein. The two preceding chapters have identified key components of that legacy: the priority of bodily life for any hermeneutic endeavor, and the capabilities of egoic following within any program of reading. Wielding those keys, Stein herself unlocked the gate to the goal of establishing the unified basis for natural and cultural sciences alike--the very goal which had eluded Husserl’s grasp in the Ideen. Stein’s solution appears in her 1919 essay “Psychische Kausalitat.” That essay funds my critical reappraisal of contemporary psychoanalytic and materialist interpretive programs, as well as my constructive alternative. Before examining psychic causality (psychische Kausalitat) according to Stein, let us briefly recall Stein’s accounts of bodily life and of empathic egoic following (Einfuhlen).
The Changing Role of the Counselor

The counseling profession is nearly 100 years old. For most of those years, “counselor” usually meant school or career counselor. However, since the early 1980s, the counseling profession has undergone dramatic changes, evidenced most strongly in the emergence and rapid growth of the specialization of mental health or community agency counseling (West, Hosie, & Mackey, 1987) as well as the decline, during the 1980s, of opportunities for school counselors (Ritchie, Piazza, & Lewton, 1991). By the early 1990s, graduate programs to train mental health counselors, including community agency counselors and marriage and family counselors, outnumbered programs to train school counselors (Cowger, Hinkle, DeRidder, & Erk, 1991). In fact, Fong (1990) proposed that all counseling should be described as mental health counseling because that, in fact, is its focus. This book will also take a broad view of mental health counseling.