cssi/SciSciGPT-SciSciNet huggingface dataset:
Does resident involvement have an impact on postoperative complications after total shoulder arthroplasty? An analysis of 1382 cases

Background The impact of resident involvement on total shoulder arthroplasty (TSA) complication rate is unknown. The purpose of this study was to assess whether resident involvement in TSA is associated with 30-day complication rates. Methods The American College of Surgeons National Surgical Quality Improvement Program database was searched for all patients who underwent TSA between 2005 and 2012. Data were extracted for patient preoperative demographics, intraoperative variables, resident involvement in surgery, and 30-day postoperative complications. Resident and nonresident cases were grouped by a matched propensity score analysis. Univariate and multivariate analysis was performed to assess the effect of resident involvement on postoperative complications. Results We analyzed 1382 patients who underwent primary TSA, with matched groups of 691 with and 691 without resident involvement. The overall rate of 30-day complications was 2.60% in TSAs in which a resident was involved compared with 3.91% when no resident was involved ( P = .173). Operative time and hospital stay were shorter in cases in which a resident was present ( P = .002 and P Conclusion Resident involvement in TSA procedures is not a risk factor for 30-day complications. Patient factors including increased age, diabetes, and cardiac disease are risk factors for TSA complications. This information can be used in preoperative counseling to reassure patients about safety of resident involvement in TSA and to optimize patient comorbidities before surgery.
Low-overhead interactive debugging via dynamic instrumentation with DISE

Breakpoints, watchpoints, and conditional variants of both are essential debugging primitives, but their natural implementations often degrade performance significantly. Slowdown arises because the debugger - the tool implementing the breakpoint/watchpoint interface - is implemented in a process separate from the debugged application. Since the debugger evaluates the watchpoint expressions and conditional predicates to determine whether to invoke the user, a debugging session typically requires many expensive application-debugger context switches, resulting in slowdowns of 40,000 times or more in current commercial and open-source debuggers! In this paper, we present an effective and efficient implementation of (conditional) breakpoints and watchpoints that uses DISE to dynamically embed debugger logic into the running application. DISE (dynamic instruction stream editing) is a previously proposed, programmable hardware facility for dynamically customizing applications by transforming the instruction stream as it is decoded. DISE embedding preserves the logical separation of application and debugger nstructions are added dynamically and transparently, existing application code and data are not statically modified - and has little startup cost. Cycle-level simulation on the SPEC 2000 integer benchmarks shows that the DISE approach eliminates all unnecessary context switching, typically limits debugging overhead to 25% or less for a wide range of watch-points, and outperforms alternative implementations.
MicroRNAs: an emerging player in autophagy

Autophagy is an evolutionarily conserved self-digestion process for the quality control of intracellular entities in eukaryotes. In the past few years, mounting evidence indicates that microRNAs (miRNAs)-mediated post-transcriptional regulation of gene expression represents an integral part of the autophagy regulatory network and may have a substantial effect on autophagy-related physiological and pathological conditions including cancer. Herein, we examine some of the molecular mechanisms by which miRNAs manipulate the autophagic machinery to maintain cellular homeostasis and their biological outputs during cancer development. A better understanding of interaction between miRNAs and cellular autophagy may ultimately benefit future cancer diagnostic and anticancer therapeutics.
Distinctions among Circulating Antibody-Secreting Cell Populations, Including B-1 Cells, in Human Adult Peripheral Blood

Human Ab-secreting cell (ASC) populations in circulation are not well studied. In addition to B-1 (CD20(+)CD27(+)CD38(lo/int)CD43(+)) cell and conventional plasmablast (PB) (CD20-CD27(hi)CD38(hi)) cell populations, in this study, we identified a novel B cell population termed 20(+)38(hi) B cells (CD20(+)CD27(hi)CD38(hi)) that spontaneously secretes Ab. At steady-state, 20(+)38(hi) B cells are distinct from PBs on the basis of CD20 expression, amount of Ab production, frequency of mutation, and diversity of BCR repertoire. However, cytokine treatment of 20(+)38(hi) B cells induces loss of CD20 and acquisition of CD138, suggesting that 20(+)38(hi) B cells are precursors to PBs or pre-PBs. We then evaluated similarities and differences among CD20(+)CD27(+)CD38(lo/int)CD43(+) B-1 cells, CD20(+)CD27(hi)CD38(hi) 20(+)38(hi) B cells, CD20(-)CD27(hi)CD38(hi) PBs, and CD20(+)CD27(+)CD38(lo/int)CD43(-) memory B cells. We found that B-1 cells differ from 20(+)38(hi) B cells and PBs in a number of ways, including Ag expression, morphological appearance, transcriptional profiling, Ab skewing, Ab repertoire, and secretory response to stimulation. In terms of gene expression, B-1 cells align more closely with memory B cells than with 20(+)38(hi) B cells or PBs, but differ in that memory B cells do not express Ab secretion-related genes. We found that B-1 cell Abs use Vh4-34, which is often associated with autoreactivity, 3- to 6-fold more often than other B cell populations. Along with selective production of IgM anti-phosphoryl choline, these data suggest that human B-1 cells might be preferentially selected for autoreactivity/natural specificity. In summary, our results indicate that human healthy adult peripheral blood at steady-state consists of three distinct ASC populations.
“I’m Sure as Hell Not Putting Any Man on a Pedestal”: Male Privilege and Accountability in Domestic and Sexual Violence Work:

Efforts to involve men as allies in domestic and sexual violence work are expanding, marking a shift for these historically women-led movements. Although this shift is beneficial, it also generates new challenges. From a multi-method qualitative study, this article presents descriptive findings about the internal tensions accompanying the “men as allies” development, namely the gender inequality and male privilege reproduced within movement organizations. I draw on sociological theorizing about men in female-dominated professions to explain the reproduction of gender inequality within movement spaces. I also examine how people are dealing with these tensions by developing a discourse around “men’s accountability.” My findings suggest that, although discourse about accountability has been successfully integrated into the culture of domestic and sexual violence work, there are key challenges that hinder effective accountability practices. I end by offering suggestions for implementing accountability practic...
Parameters of marrow proliferative capacity in vitro: detection of a sex difference in normal human granulopoiesis.

Sixteen bone marrow aspirates from normal males, cultured in vitro at various concentrations, were compared with ten aspirates from normal females. Marrow from males produced a significantly higher colony count than females when plated at a standard concentration of 2.0 x 105 cells per dish. This difference in colony-forming ability was found to be cell-dose related when dose-response studies for each marrow were obtained at concentrations of 1.0, 1.5, and 2.0 x 105 cells per plate. To more fully characterize marrow proliferative capacity in vitro, two additional parameters of growth were defined: (1) the slope of the dose-response curve and (2) the extrapolated cell concentration at "zero" colony growth. These parameters were found to differ significantly between male and female marrows and suggest that the mechanism of steady-state regulation of resting marrow may differ in males and females.
Biological and economic performance of early-weaned Angus steers.

Over 2 yr, 45 Angus-sired steer offspring of Angus and Angus crossbred females were used to determine the effects of early weaning on feedlot performance, carcass characteristics, and economic return to the cow-calf enterprise. Steers were assigned by birth date to one of two weaning treatments: 1) weaned at an average age of 100 d (early weaned) or 2) weaned at an average age of 200 d (normally weaned). Within 36 d of weaning, steers were given ad libitum access to a high-concentrate diet (90% dry, whole-shelled corn). Steers were harvested when 12th-rib fat thickness averaged 1.27 cm within treatment as estimated by ultrasound. Carcass measurements were taken 48 h postmortem and rib steak tenderness was determined at 14 d postmortem by Warner-Bratzler shear force. Early-weaned steers had greater ADG from time of early weaning to normal weaning than suckling normally weaned steers (1.27 vs 0.86 kg/d, respectively; P 0.10). Warner-Bratzler shear force values were similar between treatments. Early-weaned steers had a lower cost of gain than normally weaned steers ($ 0.82 vs 0.91/kg, respectively; P < 0.001). However, due to lighter carcass weights, early-weaned steers generated less return to the cow-calf enterprise than normally weaned steers ($ 380.89 vs 480.08/steer; P < 0.001). The early weaning of steers at 100 d of age decreased total DMI, improved gain:feed, and lowered the cost of gain; however, return to the cow-calf enter-prise was decreased due to lighter carcass weights.
The Influence of Dialysate Calcium Concentration on the PTH Level in Children Undergoing CAPD

In 12 children aged four-and-a-half to 18 years (mean 11 ±4.2) undergoing continuous ambulatory peritoneal dialysis (CAPO), serum intact parathyroid hormone (iPTH), ionized calcium (iCa) levels, an...
Trends in Long‐Term Outcomes Among Patients With Antineutrophil Cytoplasmic Antibody–Associated Vasculitis With Renal Disease

Objective It is still not clear how advances in the management of antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) have impacted long-term outcomes. We undertook this study to examine changes over 25 years in long-term clinical outcomes, including the impact of renal function at diagnosis (a potential marker of time to disease detection) and the duration of cyclophosphamide use in AAV patients with renal involvement. Methods We included ANCA-positive patients with biopsy-proven AAV diagnosed between 1985 and 2009 who were followed up in the Glomerular Disease Collaborative Network inception cohort. Outcomes included the composite outcome of end-stage renal disease (ESRD) or death as well as relapse. Cox proportional hazards or competing risks regression models were adjusted for potential baseline confounders. Results Data from 554 patients were included in the analysis. There was a decreasing 5-year risk of ESRD or death over time (P < 0.001 by log rank test for trend). After adjustment for baseline characteristics, the risk of relapse was similar across the time periods (P = 0.45 by test for trend). Serum creatinine level at baseline was the only significant predictor of an increased risk of ESRD or death (hazard ratio 1.11 per 1 mg/dl of serum creatinine [95% confidence interval 1.04–1.18], P = 0.002). Conclusion In patients with renal disease secondary to AAV, over 25 years the risk of ESRD or death has decreased but the risk of relapse has not changed. A higher serum creatinine level at diagnosis is associated with a higher risk of ESRD or death, suggesting that earlier disease detection is potentially an important measure to improve outcomes in AAV.
On the Habitability of Our Universe

Is life most likely to emerge at the present cosmic time near a star like the Sun? We consider the habitability of the Universe throughout cosmic history, and conservatively restrict our attention to the context of "life as we know it" and the standard cosmological model, LCDM. The habitable cosmic epoch started shortly after the first stars formed, about 30 Myr after the Big Bang, and will end about 10 Tyr from now, when all stars will die. We review the formation history of habitable planets and find that unless habitability around low mass stars is suppressed, life is most likely to exist near 0.1 solar mass stars ten trillion years from now. Spectroscopic searches for biosignatures in the atmospheres of transiting Earth-mass planets around low mass stars will determine whether present-day life is indeed premature or typical from a cosmic perspective.
Evaluation of Atmospheric Transport and Dispersion Models in Highly Complex Terrain Using Perfluorocarbon Tracer Data

Project MOHAVE is a large monitoring, modeling, and data analysis study whose main goal is to assess the effects of the Mohave power plant (MPP), a large coal-fired facility in southern Nevada, upon visibility in the southwestern United States, in particular at Grand Canyon National Park (Pitchford and Green, 1997). Additional goals of Project MOHAVE include estimating the effects of other sources upon visibility in the southwestern United States, and evaluating atmospheric transport and dispersion models, and receptors models. One of the key design features of Project MOHAVE was the release of perfluorocarbon tracers (PFTs) at the Mohave power plant and other locations during a 30 day winter intensive study and a 50 day summer intensive study. Tracer and aerosol measurements were made at over 30 locations (mostly 24-hour average concentrations); upper air measurements were made with radar wind profilers, sodars, and rawinsondes; optical monitoring included transmissometers, nephelometers, and time-lapse photography.
Chapter 65 – The Metabolism of Organophosphorus Insecticides

Publisher Summary This chapter discusses the metabolism of organophosphorus insecticides. The potency of the organophosphorus insecticides or their active metabolites as inhibitors of target brain acetylcholinesterase does not correspond to the acute toxicity levels, indicating that metabolism and disposition are of great significance in determining the overall acute toxicity level of these insecticides. These insecticides display substantial chemical diversity, including a variety of atoms in addition to the carbon and phosphorus required by the compounds being “organophosphorus” compounds, such as sulfur, nitrogen, and oxygen. Therefore, the organophosphorus insecticides are subject to many metabolic pathways mediated by several of the groups of xenobiotic metabolizing enzymes. The organophosphorus insecticides or their metabolites are subject to phase 1 reactions (oxidations, reductions, hydrolyses) and phase 2 reactions (conjugations). Because of their metabolic and chemical lability, they do not readily remain intact either in the environment or in the organism. Their environmental lability was one of the factors that allowed them to replace the highly stable organochlorine insecticides as the dominant class of insecticides. Some of the organophosphorus insecticides are active anticholinesterases, and any metabolism is therefore a detoxication. Many of the insecticides, however, are not active anticholinesterases in their parent form and require bioactivation in order to be effective anticholinesterases.
The Correlation Between a Numerical Rating Scale of Patient Satisfaction With Current Management of an Upper Extremity Disorder and a General Measure of Satisfaction With the Medical Visit

Background: Patient satisfaction is used as an indicator of quality of care, but the measures currently available are lengthy and cumbersome and may not be feasible in orthopedic surgical practices. We set out to assess the relationship between the Medical Interview Satisfaction Scale (MISS-21) and a numerical rating scale (NRS) of patient satisfaction with current management of an orthopedic upper extremity condition. Methods: In this cross-sectional study, 86 patients from the practices of 2 hand surgeons were included during an initial or follow-up visit. Questionnaires assessing demographics, upper extremity specific disability, pain during rest and activity, satisfaction with the medical visits (MISS-21), and satisfaction with current management of an orthopedic upper extremity condition (NRS satisfaction) were completed. Results: Eighty-six patients completed all questionnaires. A small correlation of .21 (P = .050) was found between the MISS-21 and the NRS satisfaction. In bivariate analysis, NRS pain at rest and during activity had small correlations with the MISS-21 (-.29, P = .05 and -.23, P = .034) and with NRS satisfaction (-.27, P = .011 and -0.27, P = 0.012). Quick Disability of Arm, Shoulder and Hand (QuickDASH) had a small correlation with NRS satisfaction (-0.023, P ≤ 0.001), but did not correlate with MISS-21. Conclusions: Although there is small overlap about the 2 satisfaction measures, a complex patient satisfaction questionnaire consisting of multiple facets of patient satisfaction like MISS-21 is not replaceable by 1 simple NRS patient satisfaction question.
Principle of diffusion tensor imaging

Nuclear magnetic resonance (NMR)/ magnetic resonance imaging (MRI) can measure diffusion constants along an arbitrary axis. This unique feature of NMR/MRI may not be important if free water diffusion is measured inside a sample tube, because the same diffusion constant regardless of measurement orientation is expected. However, when water diffusion inside a living system is measured, it is often found that the diffusion process has directionality. Anisotropic diffusion is of great interest because it carries information about the underlying anatomical architecture of living tissues. This chapter demonstrates the results of two diffusion constant measurements using the right-left and anterior-posterior gradient orientations. The results clearly show that the diffusion process inside the brain is highly anisotropic. The six parameters needed to define an ellipsoid are rather more complicated. Three lengths for the longest, shortest, and middle axes that are perpendicular to each other are needed. A simpler way is to use three unit vectors to define the orientation of the principal axes. Diffusion tensor imaging (DTI) characterizes the diffusion ellipsoid from multiple diffusion constant measurements along different directions. Measurement of diffusion anisotropy inside the white matter is of great interest because water tends to diffuse along axonal tracts and, thus, the anisotropy carries unique anatomical information of axonal architecture.
Training mid-career internists to perform high-quality colonoscopy: a pilot training programme to meet increasing demands for colonoscopy

Background Colorectal cancer (CRC) is the second leading cause of cancer deaths in the USA. Despite a recent rise in CRC screening there remains an increasing demand for colonoscopy, yet a limited supply of gastroenterologists who can meet this need. Objective To determine if a mid-career general internist (GIN) could be trained to perform high-quality colonoscopes via an intensive training programme. Design A GIN trained 2–3 days/week, 4–5 hours/day, for 7 months with an experienced gastroenterologist. Their independent performance was then compared with that of a gastroenterology attending (GA), with and without a gastroenterology fellow (GF). Main measures The primary outcome was to compare caecal intubation rates, adenoma detection rates (ADRs), interval CRC rates and complications between the three groups. Key results 989 patients were initially included in the study, and 818 were included in the final analysis. Caecal intubation rates were 95%, 94% and 93% for the GIN, GA+GF and GA, respectively (p=0.31). The overall polyp detection rates were 68%, 39% and 44% among the GIN, GA+GF and GA, respectively (p Conclusions The GIN attained high success rates in all quality measures. Training mid-career GINs to perform high-quality screening colonoscopes, through a standardised curriculum, may be a reasonable approach to address the growing demand for colonoscopists.
Chiral behavior in rat tail tendon fascicles.

Abstract Ex vivo tendon mechanical behavior has been well described under rotationally constrained uniaxial tensile testing. During standard loading of rat tail tendon (RTT) fascicles, apparent axial twist has been observed. To quantify this behavior, we designed a custom testing setup, utilizing magnetic suspension, to allow unconstrained axial rotation during tensile loading. We characterized the rotational behavior of single and paired RTT fascicles under cyclic loading. We also measured stress relaxation across loading cycles as well as “rotational relaxation”. Single fascicle nonlinear stretch-twist coupling is well described by the asymptotic function Δ θ = A ( 1 - e - B e ) in which fascicles rotated a mean ± 51.1° within about 1% applied axial strain. On average, paired fascicles rotated just over 10° less. Specimen cross-sectional diameter had a noticeable effect on the measured mechanical properties, particularly effective elastic modulus. Such stretch-twist coupling and size dependence cannot be understood via classical elasticity but is predicted by Cosserat (micropolar) elasticity. The current study demonstrates RTT fascicles are chiral based on observed axial load-induced twist. Additionally, our findings support existing research that suggests a helical fascicle structure. Potential consequences of helical substructures, mechanical and biological, merit further investigation.
Retinoid X Receptor Alpha Polymorphisms may Associate with Markers of Inflammation, Edema, and Outcome after TBI (P6.306)

Objective: To assess the association of Retinoid X Receptor Alpha (RXRA) polymorphisms with different endophenotypes, including immunologic and radiographic biomarkers, and functional outcome following severe traumatic brain injury (sTBI). Background: Retinoid X Receptors (RXRs) coactivate several nuclear receptors implicated in inflammatory signaling after TBI. Given the availability of pharmacologic agonists, the RXR family may offer an immunomodulatory therapeutic target. Design/Methods: This was a candidate-gene analysis. DNA was extracted from peripheral blood of 386 consecutively enrolled sTBI patients of primarily North American ancestry (CEU). Exomic RXRA SNPs were genotyped using iPLEXMassARRAYmultiplex assay platform. SNPs with MAF > .2 were included. Outcomes included CT evidence of cerebral edema, 3 and 6 month Disability Rating Scale (DRS) score and mortality. Multivariate models controlled for age, sex, and initial Glasgow Coma Scale (GCS) score. A subset of patients (n=26) had CSF protein levels of inflammatory markers assessed over the first five days post-injury (Luminex array). Results: 8 SNPs were identified. After Benjamini-Yekutieli correction for multiple comparisons, variant rs34312136 was associated with CT edema on days 3–5 (OR 2.4, p = .009). Homozygous variant rs3132296 was associated with higher 3-month DRS (β = 5.00, p = .006), and homozygous variant rs11185660 was associated with higher 6-month DRS (β = 7.23, p= .008) and 6-month mortality (OR 4.95, p = .009). There was a decrease in levels of IL-6 ( p p=. 03) over time in patients homozygous wildtype for rs34312136, but not in patients with the variant allele. Patients with variant rs34312136 had increases in levels of GM-CSF ( p = .04) and IFNα2 ( p = .02) over time, but patients with homozygous wildtype alleles did not. Conclusions: In this consecutive series of sTBI patients, there was an association between genetic variation in RXRA and clinical markers of inflammation, edema, and outcome after TBI. Larger confirmatory studies are warranted. Study Supported by: NINR R01NR013342, Walter L. Copeland Fund of the Pittsburgh Foundation Disclosure: Dr. Zusman has nothing to disclose. Dr. Brooks has nothing to disclose. Dr. Puccio has nothing to disclose. Dr. Okonkwo has nothing to disclose. Dr. Conley has nothing to disclose. Dr. Kochanek has nothing to disclose. Dr. Jha has nothing to disclose.
A light carbon isotope composition for the Sun.

Measurements by the Genesis mission have shown that solar wind oxygen is depleted in the rare isotopes, 17O and 18O, by approximately 80 and 100‰, respectively, relative to Earth’s oceans, with inferred photospheric values of about −60‰ for both isotopes. Direct astronomical measurements of CO absorption lines in the solar photosphere have previously yielded a wide range of O isotope ratios. Here, we reanalyze the line strengths for high-temperature rovibrational transitions in photospheric CO from ATMOS FTS data, and obtain an 18O depletion of δ18O = −50 ± 11‰ (1σ). From the same analysis we find a carbon isotope ratio of δ13C = −48 ± 7‰ (1σ) for the photosphere. This implies that the primary reservoirs of carbon on the terrestrial planets are enriched in 13C relative to the bulk material from which the solar system formed, possibly as a result of CO self-shielding or inheritance from the parent cloud. The Sun’s light stable isotopes compositions can help us understand how our solar system formed. Here, the authors find that solar C is depleted relative to bulk Earth indicating that the 13C enrichment of the terrestrial planets is from CO self-shielding or inheritance from the parent cloud.
11 – Microprobe analysis in hepatic metal overload disease states

This chapter presents the application of conventional electron microscopy combined with energy dispersive X-ray microanalysis (EDX) to study hepatic metal overload disease in human and animal models. An EDX interfaced with a transmission electron microscope (TEM) has been used in the drug treatment of liver disease in patients with progressive hepatic copper overload or iron overload disease. Ultrastructural and X-ray microanalytical data have been compared with histologic staining patterns using metal-specific chromatic stains, as well as with atomic absorption spectrometry analysis. Although only slight modifications of routine specimen preparation and embedding procedures of TEM are used for X-ray microanalysis of hepatic biopsies, correlative studies indicate that in vivo localization patterns of copper and iron are retained throughout the preparative process. These complementary probes are used to better define mechanisms of liver disease, progression of liver disease, cytoprotective defense mechanisms employed by the liver cells during the course of metal loading disease, and effects of copper mobilizing drugs, as well as aid in diagnosis of disease.
Contraceptive efficacy, pharmacokinetics, and safety of Annuelle® * biodegradable norethindrone pellet implants † ‡

Objective To evaluate the contraceptive efficacy, pharmacokinetics, and safety of two formulations of Annuelle (Endocon, Inc., South Walpole, MA) biodegradable norethindrone (NET) SC pellet implants. Design Prospective observational study. Setting Two clinical sites in the United States. Patient(s) Thirty-nine healthy, fertile, sexually active women. Intervention(s) Nineteen women received a four-pellet system containing 174mg NET; 20 women received a five-pellet system containing 266.5mg NET. Main Outcome Measure(s) Contraceptive efficacy, median serum NET levels, adverse events. Result(s) No pregnancies were observed in 293 woman-months in the four-pellet group or in 375 woman-months in the five-pellet group. An initial burst in median serum NET levels occurred in the first 24hours postinsertion followed by a steady decline over the next 3years. Norethindrone levels varied considerably among women. The main side effect was bleeding abnormalities, which persisted in half the participants for up to 2years. No serious adverse events were reported that were related to the pellets. Pellet insertion and removal generally were uncomplicated. Conclusion(s) Annuelle shows potential as an effective, safe contraceptive with distinct advantages over other long-acting agents, because it is biodegradable but can be removed if problems arise or if fertility is desired.
Designing a Multivariate EWMA Control Chart

A multivariate exponentially weighted moving average control chart can be used to improve the detection of small shifts in multivariate statistical process control. Recommendations are provided for the selection of parameters for such a chart. The recom..
Driving Consistency Errors Overestimate Crash Risk from Cellular Conversation in Two Case-Crossover Studies

The goal of this study is to help resolve the discrepancy in relative risk estimates between recent and early epidemiological studies of call-crash association. Recent epidemiological studies estimate a crash risk for cellular conversation near that of baseline driving – a relative risk of about one. In contrast, two early case-crossover studies estimated a relative crash risk of about four for cellular conversation while driving. One hypothesis to explain this fourfold discrepancy is that the early studies had less driving time in the control window on a day before the crash, than in the crash window just before the crash. This bias in driving exposure translated into relatively lower exposure to cellular conversation during control windows than during crash windows, thereby introducing an overestimate of the relative risk for cellular conversation while driving. To test this hypothesis, the present study developed a new driving consistency index (DCI), which measures the percentage overlap in driving times from one day to the next. The mean DCI for 240 vehicles in a Chicago GPS study with known driving times for two successive days was a surprisingly low 14.8%, substantially below the driving consistency estimates in the early case-crossover studies. After adjustment by the mean DCI, the relative risk estimates for cellular conversation while driving in the early case-crossover studies are about one, resolving the discrepancy with the more recent epidemiological studies.
Urban Rage: the revolt of the excluded

A comparative analysis of contemporary urban revolts, Urban Rage is Mustafa Dikec’s recent attempt to enlarge the geographical scope of his research on urban politics. In Badlands of the Republic (...
A Hybrid Predictive Control Approach to Trajectory Tracking for a Fully Actuated Biped

We model a three-link fully actuated biped as a hybrid system and propose a prediction-based control algorithm for global tracking of reference trajectories. The proposed control strategy consists of a reference system that generates the desired periodic gait, a virtual system that generates a suitable reference trajectory using prediction, and a tracking control law that steers the biped to the virtual trajectory. The proposed algorithms achieves, in finite time, tracking in two steps. We present mathematical properties that define the main elements in the hybrid predictive controller for achieving convergence to the reference within the first two steps. The results are validated through numerical simulations.
Abstract #255A: Hypoxia impedes ovarian cancer treatment through modulation of ROS and STAT3 activation: An implication of HBOT therapy

Hypoxic microenvironments are frequently found in solid tumors. Hypoxia plays critical roles in tumor progression including tumor angiogenesis, mutation rate, metastasis and resistance to radiation and chemotherapy. Recently, using in vivo electron paramagnetic resonance (EPR) oximetry, we observed that the oxygen concentration in human ovarian tumor xenografts in mice was severely hypoxic. Hence we performed a series of in vitro pilot experiments to compare protein expression in cells grown under hypoxic conditions (1% oxygen), versus cells grown under normoxic (20% oxygen) conditions. This series of experiments revealed that hypoxic conditions elicit an overexpression of pSTAT3-Tyr705 when compared to cells grown under normoxic conditions. STAT3 is overexpressed in a variety of human cancers, including ovarian cancer, and especially in solid tumor forms of ovarian cancer. Inhibition of STAT3 expression results in apoptosis of tumor cells. Therefore, STAT3 is considered to be an attractive target for anticancer therapy. However, the molecular mechanism by which the STAT3 gene is upregulated in tumor cells is poorly understood. We found that pSTAT3 was significantly upregulated by hypoxia, which was also accompanied by increased reactive oxygen species (ROS) generation in human ovarian cancer cell lines. In addition, the efficacy of the common anticancer drugs cisplatin and taxol was reduced in hypoxia-treated ovarian cancer cells when compared to normoxia-cultured cells, possibly due STAT3 overexpression-induced resistance to anticancer drugs. Furthermore, inhibition of STAT3 expression using the JAK inhibitor AG490 or the novel curcumin analog HO-3867, followed by treatment with cisplatin or Taxol resulted in a more than two-fold increase in induced apoptosis when compared to hypoxia-cultured cells that were not treated with AG490 and HO-3867. We have also found that ovarian tumor-bearing mice subjected to daily hyperbaric oxygen therapy (HBOT; 100% O2 at 2 atmospheres, absolute) for a period of 90 minutes for a total of 14 days had significantly reduced tumor volume when compared to untreated controls. Post-mortem Western blot analysis of tumor tissues showed an inhibition of STAT3 expression in ovarian tumors recovered from HBOT-treated animals. Taken together, these results indicate that STAT3 is upregulated by hypoxia in vitro, and that hypoxia-induced chemoresistance is at least partially due to STAT3 upregulation. This chemoresistance can be reversed through inhibition of STAT3 expression using AG490 or the novel curcumin analog HO-3867. We also observed an increase in ROS generation in ovarian cancer cells cultured under hypoxic conditions. In a pilot series of in vivo experiments using a murine model of ovarian cancer, HBOT has been shown to inhibit hypoxic ovarian tumor growth through a reduction in STAT3 expression. Citation Information: In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 255A.
Association of Obesity With Mortality Over 24 Years of Weight History: Findings From the Framingham Heart Study

Importance Many studies of the association between obesity and mortality rely on weight status at a single point in time, making it difficult to adequately address bias associated with reverse causality. Objective To investigate the association between maximum body mass index (BMI) and all-cause mortality without the consequences of reverse causality. Design, Setting, and Participants Prospective cohort studies for the original and offspring cohorts of the Framingham Heart Study. The follow-up period started from baseline examination 13 for the original cohort and from baseline examination 6 for the offspring cohort and ended December 31, 2014. The analyses were conducted in 2017. Participants were 6197 individuals with 3478 deaths during a mean of 17 years of follow-up. Main Outcomes and Measures Maximum BMI over 24 years of weight history before the beginning of follow-up for all-cause mortality and cause-specific mortality. All-cause mortality and cause-specific mortality (deaths due to cardiovascular disease, cancer, or other causes). Results Among 6197 participants (mean [SD] age at baseline, 62.79 [8.98] years; 55.5% female), 3478 (56.1%) died during the follow-up. A monotonic association was observed between maximum BMI and mortality, with increasing risks observed across obese I (BMI of 30 to Conclusions and Relevance A monotonic association was found between maximum BMI over 24 years of weight history and subsequent all-cause mortality. Maximum BMI in the normal-weight range was associated with the lowest risk of mortality in this cohort, highlighting the importance of obesity prevention.
Distributed SmSVM Ensemble Learning.

Traditional ensemble methods are typically performed with models that are fast to construct and evaluate, such as random trees and Naive Baye’s. More complex models frequently suffer from increased computational load in both training and inference. In this work, we present a distributed ensemble method using SmoothSVM, a fast support vector machine (SVM) algorithm. We build and evaluate a large ensemble of SVMs in parallel, with little overhead when compared to a single SVM. The ensemble of SVMs trains in less time than a single SVM while maintaining the same test accuracy and, in some cases, even exhibits improved test accuracy. Our approach also has the added benefit of trivially scaling to much larger systems.
Medical Education: Guidelines for Effective Teaching of Managing Challenging Patient Encounters.

Health care providers require strong communication skills to effectively interact with and assist patients on a daily basis. However, medical professionals and trainees are often not equipped with the tools necessary to conduct productive exchanges, especially with challenging patient encounters. Communicating thoughtfully can become extremely challenging when patients exhibit problematic behaviors or attitudes. The following guidelines—inspired by a workshop for medical students at Tufts University School of Medicine (TUSM) and further developed by the authors’ interdisciplinary experiences and research—offer comprehensive criteria for medical instructors to lead an experiential seminar on how students can succeed in challenging patient encounters.
Long-term adaptation to color

When the environment changes, the visual system adjusts to maintain accurate color perception. Such adaptations happen at different time scales, and long-term effects are of particular interest because they may engage mechanisms of long-lasting neural plasticity. Long-term adaptation to changes in the color of the environment produce strong and long-lasting changes in color perception, with the general effect of neutralizing the dominant color. Large individual differences and details of the time course are currently unexplained, and the limits of adaptation remain unexplored. Experience with an environment appears to allow observers to adapt more strongly and quickly to it. Long-term color adaptation may serve as a model system for understanding general mechanisms of neural plasticity, including those relevant for therapies for visual disorders.
Phase II clinical trial of pembrolizumab efficacy and safety in advanced adrenocortical carcinoma

Adrenocortical carcinoma (ACC) is a rare malignancy without good treatment options. There are limited data about the use of immunotherapy in ACC. We investigated the efficacy and safety of pembrolizumab in patients with metastatic ACC. This is a pre-specified cohort of a single-center, investigator-initiated, phase II clinical trial using pembrolizumab monotherapy in patients with rare malignancies. Patients must have had prior treatment fail in the past 6 months before study enrollment. Patients were enrolled from August 2016 to October 2018. Follow-up data were updated as of March 26, 2019. Patients received 200 mg pembrolizumab intravenously every 3 weeks without concomitant oncologic therapy. The primary endpoint was non-progression rate (NPR) at 27 weeks. Other endpoints included adverse events, tumor responses measured independently by objective radiologic criteria, and select immunological markers. Sixteen patients with ACC (including eight women [50%]) were included in this cohort. Ten patients (63%) had evidence of hormonal overproduction (seven had cortisol-producing ACC). Non-progression rate at 27 weeks was evaluable in 14 patients, one patient was lost to follow-up, and one patient left the study because of an adverse event. Five of 14 patients were alive and progression-free at 27 weeks (non-progression rate at 27 weeks was 36, 95% confidence interval 13–65%). Of the 14 patients evaluable for imaging response by immune-related Response Evaluation Criteria in Solid Tumors, two had a partial response (including one with cortisol-producing ACC), seven had stable disease (including three with cortisol-producing ACC), and five had progressive disease, representing an objective response rate of 14% (95% confidence interval 2–43%). Of those who had stable disease, six had disease stabilization that lasted ≥4 months. Severe treatment-related adverse events (≥grade 3) were seen in 2 of 16 patients (13%) and resulted in one patient discontinuing study participation. All studied tumor specimens (14/14) were negative for programmed cell death ligand-1 expression. Thirteen of 14 tumor specimens (93%) were microsatellite-stable. Eight of 14 patients (57%) had a high tumor-infiltrating lymphocyte score on immunohistochemistry staining. Single-agent pembrolizumab has modest efficacy as a salvage therapy in ACC regardless of the tumor’s hormonal function, microsatellite instability status, or programmed cell death ligand-1 status. Treatment was well tolerated in most study participants, with a low rate of severe adverse events. ClinicalTrials.gov identifier: NCT02721732 , Registered March 29, 2016.
Prevalence of Workplace Health Practices and Policies in Hospitals: Results From the Workplace Health in America Study.

Purpose:To provide a nationally representative description on the prevalences of policies, practices, programs, and supports relating to worksite wellness in US hospitals.Design:Cross-sectional, se...
Tgfbr2 in dental pulp cells guides sensory innervation in developing teeth

Abstract Transforming growth factor β (TGFβ) plays an important role in tooth morphogenesis and mineralization. Our laboratory established a mouse model in which Tgfbr2 was conditionally deleted in the dental pulp (DP) mesenchyme using an Osterix promoter-driven Cre recombinase (Tgfbr2cko). These mice survived postnatally, but had significant defects in bones and teeth, including reduced mineralization and short roots. H&E staining revealed reduced axon-like structures in the mutant mice. Reporter imaging demonstrated that Osterix-Cre activity was localized within the tooth and was active in the DP and derivatives, but not in neurons. Previous research has established that paracrine signals from the dental pulp attract trigeminal axons toward and into the tooth during postnatal development, yet very little is known about the signals that regulate tooth innervation. Immunofluorescent staining for a neuronal marker, β3 tubulin, was performed on serial cryosections from control and mutant molars at two different postnatal stages. Confocal imaging and pixel quantification of β3 tubulin demonstrated reduced innervation in P7 and P24 Tgfbr2cko first molars compared to controls, indicating that the signals necessary to promote neurite outgrowth were disrupted by Tgfbr2 deletion. Quantitative real time PCR showed that the mRNA expression levels of several neuronal genes were reduced. Lastly, trigeminal neurons were co-cultured atop Transwell filters overlying primary Tgfbr2f/f DP cells. Tgfbr2 in the DP was deleted with an adenovirus expressing Cre recombinase. Confocal imaging of axons through the filter pores showed increased axonal sprouting from neurons cultured in the presence of Tgfbr2-positive DP cells compared to neurons cultured alone. Further, axon sprouting was reduced when Tgfbr2 was knocked down in the DP cells. These results indicate that Tgfbr2 in the DP mesenchyme regulates paracrine signals that guide sensory innervation of the tooth. Note: A list of abbreviations is included in the appendix.
Unstructured Socializing with Peers, Low Self-Control, and Substance Use:

Research consistently finds that unstructured socializing with peers and low self-control are both positively associated with substance use among adolescents. However, largely absent from the liter...
Functional Outcome after Minimally Invasive Endoscopic Evacuation of Thalamic Intracerebral Hemorrhage.

Background Intracerebral hemorrhage (ICH) is the most devastating form of stroke, with thalamic hemorrhages carrying the worst outcomes. Minimally invasive (MIS) endoscopic ICH evacuation is a promising new therapy for the condition. However, it remains unclear whether therapy success is location dependent. Here we present long-term functional outcomes after MIS evacuation of spontaneous thalamic hemorrhages. Methods Patients presenting to a single urban health system with spontaneous ICH were triaged to a central hospital for management of ICH. Operative criteria for MIS evacuation included hemorrhage volume ≥15 mL, age ≥18, National Institutes of Health Stroke Scale ≥6, and baseline modified Rankin Score (mRS) ≤3. Demographic, radiographic, and clinical data were collected prospectively, and descriptive statistics were performed retrospectively. Functional outcomes were assessed using 6-month mRS scores. Results Endoscopic ICH evacuation was performed on 21 patients. Eleven patients had hemorrhage confined to the thalamus, whereas 10 patients had hemorrhages in the thalamus and surrounding structures. Eighteen patients (85.7%) had intraventricular extension. The average preoperative volume was 39.8 mL (standard deviation [SD]: 31.5 mL) and postoperative volume was 3.8 mL (SD: 6.1 mL), resulting in an average evacuation rate of 91.4% (SD: 11.1%). One month after hemorrhage, 2 patients (9.5%) had expired and all other patients remained functionally dependent (90.5%). At 6-month follow-up, 4 patients (19.0%) had improved to a favorable outcome (mRS ≤ 3). Conclusion Among patients with ICH undergoing medical management, those with thalamic hemorrhages have especially poor outcomes. This study suggests that MIS evacuation can be safely performed in a thalamic population. It also presents long-term functional outcomes that can aid in planning randomization schemes or subgroup analyses in future MIS evacuation clinical trials.
Racial Disparities in Post-Acute Home Health Care Referral and Utilization among Older Adults with Diabetes

Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and outcomes including disabling and life-threatening complications among patients with diabetes. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordination, and psychosocial support for patients and their caregivers. The purpose of this study was to examine the association between race/ethnicity and hospital discharge to home health care and subsequent utilization of home health care among a cohort of adults (age 50 and older) who experienced a diabetes-related hospitalization. The study was limited to patients who were continuously enrolled in Medicare for at least 12 months and in the United States. The cohort (n = 786,758) was followed for 14 days after their diabetes-related index hospitalization, using linked Medicare administrative, claims, and assessment data (2014-2016). Multivariate logistic regression models included patient demographics, comorbidities, hospital length of stay, geographic region, neighborhood deprivation, and rural/urban setting. In fully adjusted models, hospital discharge to home health care was significantly less likely among Hispanic (OR 0.8, 95% CI 0.8-0.8) and American Indian (OR 0.8, CI 0.8-0.8) patients compared to White patients. Among those discharged to home health care, all non-white racial/ethnic minority patients were less likely to receive services within 14-days. Future efforts to reduce racial/ethnic disparities in post-acute care outcomes among patients with a diabetes-related hospitalization should include policies and practice guidelines that address structural racism and systemic barriers to accessing home health care services.