cssi/SciSciGPT-SciSciNet huggingface dataset:
The Identification of Communicative Disorders in Asian-Pacific Students:

In an attempt to draw clinically relevant applications from the study of ethnographic methods in communicative sciences and disorders, this article provides an overview of specific ethnographic principles as they apply to language assessment of Asian-Pacific students. Specific implications and guidelines are proposed to enable the transition of ethnographic theory into clinical practice.
Modulation of neck intermuscular Beta coherence during voice and speech production

Purpose The purpose of this study was to better understand neck intermuscular beta coherence (15–35 Hz; NIBcoh) in healthy individuals, with respect to modulation by behavioral tasks. Method Mean N...
Alzheimer's disease and Down's syndrome: roles of APP, trophic factors and ACh

Recent therapeutic investigations of Alzheimer's disease (AD) have been guided by two seemingly opposed hypotheses: the amyloid cascade theory, which favors the amyloid plaques as the cause of AD; and the cholinergic theory, which favors cholinergic neuron loss as the cause. New investigations indicate that the synthesis and processing of the amyloid precursor protein (APP) is linked to the trophic actions of nerve growth factor. A pathological cascade in both AD- and Down's syndrome-related memory loss could be triggered by alterations in APP processing or ACh-mediated neuronal function, or both, which in turn trigger the overexpression of amyloid beta, synaptic malfunction and trophic factor loss in target regions. This eventually leads to synaptic and dendritic loss with age.
Sample sizes for phase ii clinical trials derived from Bayesian decision theory

In early phase clinical trials of a new medical treatment, patients are treated to decide whether there is sufficient promise to justify additional studies. A decision theoretic approach is proposed to help determine the number of patients that should be treated. The optimal sample size is obtained by maximizing a utility function which incorporates both the number of ‘gained successes’ and the costs of treatment. The method extends work of Sylvester and Staquet, and adopts a Bayesian formulation. Numbers of patients in later studies and in eventual routine use of the treatment are taken into account. We allow for the possibility that a later study might lead to an erroneous conclusion. The effects of these various influences on the recommended sampling plan for the early phase clinical trial are explored.
Changes in minnow, Pimephales promelas Rafinesque, schooling behaviour associated with infections of brainencysted larvae of the fluke, Ornithodiplostomum ptychocheilus

The schooling behaviour of unparasitized fathead minnows, Pimephales promelus Rafinesque, was compared to that of minnows infected with brain-dwelling metacercariae of the fluke, Ornithodiplostomum ptychocheilus (Faust). Laboratory results showed that schools of infected fish divided more frequently, were less compact, and occupied positions closer to the water surface than control schools. These results are discussed with reference to the possibility that this larval parasite manipulates minnow behaviour to increase host vulnerability to predation. I. INTRODUCTION Some of the most striking biological adaptations known have evolved in parasites. Parasitologists have discovered that host behaviour can be affected in ways that benefit the symbiont. Definitive hosts should not be harmed, since a parasite which does so may decrease its own fitness; however, intermediate hosts are ' fair game ', and increasing their chances of being eaten has survival value for the parasites (Rothschild, 1962). In some cases, effects of infections are grossly debilitating, and the intermediate host becomes easy prey for a definitive host. Holmes & Bethel (1972) note that little attention has been paid to the more interesting subtle behavioural changes of hosts, and subsequent effects on parasite transmission. Furthermore, most of the known examples of such behavioural ' manipulations ' involve invertebrate intermediate hosts. This study tested if metacercariae of Ornithodiplostomum ptychocheilus (Faust), encysted in the brains of fathead minnows, Pimephales promelas Rafinesque, alter fish behaviour in a way which could represent an adaptive strategy of the fluke.
The epidemic of youth violence in America: Using public health prevention strategies to prevent violence

Violence is exacting an increasingly heavy toll on individuals across the country, causing a marked rise in fear and frustration. However, historical attempts to address violence have been both episodic and inconsistent. There has not been a comprehensive and coordinated, prevention-oriented approach. Many law enforcement experts now agree that violence must be met with solutions from disciplines other than law enforcement, those of public health included. These experts acknowledge that social conditions such as family stability, education, and other societal institutions directly affect the behavior of juveniles and thereby the safety of communities. No single strategy, institution, or discipline can create the changes needed to reduce violence in America. Preventing violence demands not only a long-term commitment but a comprehensive set of strategies and new partnerships. These combined efforts must focus on prevention and not solely on aggressive responses to violence.
Imagining the Future of Medicine

HOSTED BY DARA O BRIAIN The Royal Albert Hall, London Monday 21 April 2014 This event, hosted by comedian Dara O Briain, offered a series of provocative short talks and performances exploring the future of medical innovation. Through the use of music, art, and theatre we were encouraged to ‘think outside the box’ and imagine what health care could be like for our grandchildren. Much of the afternoon was dedicated to advances in medical technology. Special guest Jay Walker, curator of the TEDMED conferences, showed us a future looking more …
Prioritizing hypothesis tests for high throughput data.

Motivation The advent of high throughput data has led to a massive increase in the number of hypothesis tests conducted in many types of biological studies and a concomitant increase in stringency of significance thresholds. Filtering methods, which use independent information to eliminate less promising tests and thus reduce multiple testing, have been widely and successfully applied. However, key questions remain about how to best apply them: When is filtering beneficial and when is it detrimental? How good does the independent information need to be in order for filtering to be effective? How should one choose the filter cutoff that separates tests that pass the filter from those that don't? Result We quantify the effect of the quality of the filter information, the filter cutoff and other factors on the effectiveness of the filter and show a number of results: If the filter has a high probability (e.g. 70%) of ranking true positive features highly (e.g. top 10%), then filtering can lead to dramatic increase (e.g. 10-fold) in discovery probability when there is high redundancy in information between hypothesis tests. Filtering is less effective when there is low redundancy between hypothesis tests and its benefit decreases rapidly as the quality of the filter information decreases. Furthermore, the outcome is highly dependent on the choice of filter cutoff. Choosing the cutoff without reference to the data will often lead to a large loss in discovery probability. However, naive optimization of the cutoff using the data will lead to inflated type I error. We introduce a data-based method for choosing the cutoff that maintains control of the family-wise error rate via a correction factor to the significance threshold. Application of this approach offers as much as a several-fold advantage in discovery probability relative to no filtering, while maintaining type I error control. We also introduce a closely related method of P-value weighting that further improves performance. Availability and implementation R code for calculating the correction factor is available at http://www.stat.uga.edu/people/faculty/paul-schliekelman Contact pdschlie@stat.uga.edu Supplementary information Supplementary data are available at Bioinformatics online.
Dexamethasone inhibits lung epithelial cell apoptosis induced by IFN-γ and Fas

Lung epithelium plays a central role in modulation of the inflammatory response and in lung repair. Airway epithelial cells are targets in asthma, viral infection, acute lung injury, and fibrotic l...
Embedding and sectioning undecalcified bone, and its application to radioautography.

A method is described for embedding and sectioning hard, undecalcified bone, which is designed for use by technical personnel. Bone fixed in a variety of ways is progressed through alcohols to ether-alcohol and then infiltrated with ether-alcohol solvented plastic (plasticized nitrocellulose) by a combination of centrifugation and high pressure embedding technics. The ether-alcohol is evaporated in a partially closed container in a manner similar to that employed in celloidin embedding, but differs from the latter by the removal of all of the solvent. Celloidin is the source of nitrocellulose and Amoil-S, the added plasticizer. Undecalcified adult bone of all types is readily cut at a thickness of 5–8μ on a heavy duty sliding microtome. The sections are then mounted on gelatinized slides. The procedures for preparing strip film radio-autograms of bone sections and subsequent staining of the preparation are given. The results obtained are illustrated.
Sudden-On-Chronic Death and Complicated Grief in Bereaved Dementia Caregivers: Two Case Studies of Complicated Grief Group Therapy

Caring for a person with Alzheimer's disease is challenging and often has negative health and mental health effects that, for 7-20% of caregivers, persist into bereavement in the form of complicated grief. Complicated grief is a state of prolonged and ineffective mourning. An under-recognized phenomenon in dementia care and bereavement is "sudden-on-chronic death." In these situations, the caregiver is preparing for a gradual dying process from dementia, but the care recipient dies instead from a sudden death. In this study, an application of complicated grief group therapy for bereaved dementia caregivers with complicated grief is presented, and the effect of therapy with two bereaved caregivers who experienced the sudden death of their spouses who had a diagnosis of dementia is described. The unique treatment elements of complicated grief group therapy facilitated resolution of the 'trauma-like" features of bereavement and progression to a healthy grief process.
A Rapid Micro Method for Determ nation of Ascorbic Acid in Urine by Ferric Reduction

A new method for the determination of ascorbic acid in urine is based on the quantitative reduction of ferric to ferrous ion by ascorbic acid and the colorimetric measurement of the ferrous ion through its formation of a colored complex with bathophenanthroline. The complex is quantitatively extracted into chloroform, and its absorbance is measured in this solvent. The method is simple, very rapid, and has good specificity for clinical purposes. Only 0.05-0.25 ml. of urine is required per determination. All reagents used in the method, except the ascorbic acid standard, are stable indefinitely.
Combating Hidden Hunger: The Role of International Agencies:

The importance of micronutrient deficiencies or "hidden hunger" was clearly emphasized by the inclusion of specific goals on iron, vitamin A, and iodine deficiency at the 1990 World Summit for Children and other major international nutrition conferences. Significant progress has since been made toward eliminating vitamin A and iodine deficiencies, with less progress made toward reducing the burden of iron-deficiency anemia. The role of international agencies, such as the World Health Organization, United Nations Children's Fund, Food and Agricultural Organization, and World Bank in assisting countries to make progress toward the World Summit for Children goals has been very important. International agencies have played a critical role in advocating for and raising awareness of these issues at the international, regional, and national levels among policymakers and the general population. Using a rights-based approach, UNICEF and other agencies have been instrumental in elevating to the highest political level the discussion of every child's right to adequate nutrition. International agencies have also been very supportive at the national level in providing technical guidance for programs, including monitoring and evaluation. These agencies have played a critical role in engaging the cooperation of other partners, including bilateral donors, non-governmental organizations, and the private sector for micronutrient programs. Furthermore, international agencies provide financial and material support for micronutrient programs. In the future, such agencies must continue to be heavily involved in programs to achieve the newly confirmed goals for 2010. The present paper focuses on the role of international agencies in combating micronutrient deficiencies, drawing on the lessons learned over the last decade. The first section of the paper summarizes the progress achieved since 1990, and the second section describes the specific role of international agencies in contributing to that progress.
The naming of objects and symbols by children and aphasic patients.

Three studies of naming in children and in aphasic patients were conducted in order to determine the kinds of errors made in the naming of objects, parts of objects, and various kinds of symbols, and to evaluate the contribution of operativity to the ease of naming such elements. Operativity refers to the extent to which elements can be transformed and involved in a variety of sensory and motor schemes. It was found that operativity of depicted elements makes a significant contribution to ease of naming for both groups of subjects. However, children and aphasic patients made different types of naming errors. In the case of naming of symbols, the categories easiest for aphasics to name proved the most difficult for children to name. It is suggested that the partial loss of an acquired ability can produce a different clinical picture than the partial acquisition of that ability in the normal child. The concept of operativity may be a less useful concept in the relatively figurative domain of symbols.
Updating structural properties using modal parameters considering measurement errors

Evaluating up-to-date structural properties of an existing bridge is essential to improve the accuracy of the assessment for the structural performance. In this study, we propose a methodology to update the structural properties of a bridge using modal parameters considering measurement error. Modal parameters are usually obtained from a vibration testing conducted on a bridge. Time domain decomposition (TDD) is used in this paper to extract modal parameters from time history acceleration responses. The measurement error from the extraction process and from the noises in the acceleration sensors are estimated and considered in estimating the structural properties. There are five steps in the proposed framework: 1) extract modal parameters from a vibration test; 2) build a preliminary finite element model (FEM) based on the bridge design drawings; 3) estimate the measurement error by simulating vibration tests; 4) update the preliminary FEM to a baseline model using a Bayesian model updating approach with mode shapes; and 5) identify local structural stiffness damage using the damage index method with model shapes of the existing bridge and of the baseline structure found in the previous step. The proposed framework is constructed using the Bayesian model updating and the damage index method. The proposed framework is illustrated with a simulated finite element model of the Lavic Road Overcrossing bridge, a typical box-girder RC highway bridge in California.
Applying Usability Methods to a Large Intranet Site

This paper describes the usability design process of a project web site within Sandia National Laboratories. Most web site designers can claim no more knowledge about their users than a focus group...
Blood-Sparing Techniques in Head and Neck Surgery

Given the risks and potential complications of allogenic blood transfusion (ABT), as well as the expanding population of patients for whom ABT may not be an option, it is important for the treating physician, anesthesiologist, and surgeon to be well-versed in various alternatives. A good grasp of the concepts discussed in this article will help to customize a treatment plan that is specific to each patient's underlying disease and personal preferences without compromising appropriate medical care.
Psychophysiological investigation of combat veterans with subthreshold post-traumatic stress disorder symptoms

ABSTRACTObjective: Military service members (SMs) with subthreshold combat-related post-traumatic stress disorder (PTSD) symptoms often have clinically significant functional impairment, even though they do not meet full PTSD criteria. We therefore assessed the psychophysical responses of SMs, upon their return from Afghanistan or Iraq, to a fear conditioning paradigm to better understand the biological underpinnings of symptom severity. Methods: Heart rate (HR), skin conductance, electromyography startle, and respiratory rate (RR) were monitored throughout three distinct phases of the paradigm—fear acquisition, fear inhibition, and fear extinction—while plasma catecholamines (epinephrine, norepinephrine, and dopamine) were measured at the end of fear inhibition. Results: Those with higher PTSD symptom severity demonstrated elevations in HR and startle response to danger cues; elevated self-reported depression and anxiety; impaired functional status; poor skin conductance discrimination between danger and...
Politics and Popular Culture

This essay explores the political dimensions of popular culture, and how those dimensions transfer into and out of actual political debates, providing a understanding of the broader connection between the study of politics and popular culture. Specific attention is paid to the influence of industrialization on the expansion of and access to culture. The essay also analyzes more contemporary approaches to understanding popular culture, through melodrama, science fiction, and perspectives on gender and sexualty.
Self-Determination and Power-Sharing in Israel/Palestine

AbstractThis article surveys three different concepts of political self-determination that may be applied to the Israel/Palestine conflict, and considers how they may or may not justify power-sharing arrangements of the type suggested by Brendan O’Leary. In addition, the various forms of both two-state and one-state solutions are considered for their congruence with the best understanding of self-determination. The three forms of the self-determination principle are: statist, national, and ecological. The author argues that only the last is justifiable as the basis for a settlement of the conflict, as well as more generally for twenty-first century conflicts over resources and territory. In theory, ecological self-determination would justify a one-state solution that would unify the region in order to maintain its resources sustainably. But both solutions face myriad political obstacles. The author discusses the difference between consociation and federation, two theories of power-sharing, both with disad...
Non-target effects of grass-specific herbicides differ among species, chemicals and host plants in Euphydryas butterflies

Habitat modification by invasive species places numerous butterfly species at risk of extinction. Grass-specific herbicides, graminicides, are a sought-after tool to reduce invasive grasses, augment forbs and enhance butterfly populations. However, possible non-target effects raise concern. We investigated non-target effects of graminicides on three species of caterpillars in the genus Euphydryas (Nymphalidae), a taxon with numerous species in decline worldwide. In one experiment, we compared the effects of three graminicides (clethodim, sethoxydim and fluazifop-p-butyl) on E. colon. In a second experiment, we assessed the effects of fluazifop-p-butyl, the most commonly used graminicide in prairies in the Northwest USA, on three Euphydryas species (E. colon, E. editha and E. phaeton), each raised on two different hostplants. In the first experiment, fluazifop-p-butyl did not affect survivorship of pre-diapause larvae, sethoxydim reduced survivorship by 20 % relative to controls, and effects of clethodim were inconclusive. Graminicides did not change the total concentration of iridoid glycosides in the caterpillars, but all three graminicides increased the concentration of aucubin to almost double the level in control treatments. In the second experiment, the effects of fluazifop-b-butyl were not consistent across butterfly and host plant species. However, fluazifop-b-butyl reduced group size of gregarious pre-diapause larvae under all conditions. Our results suggest that if managers use graminicides over the short-term to control invasive grasses, fluazifop-p-butyl has the most promise for minimal effects. However, efforts should be paired with demographic and behavioral monitoring to quantify context-dependent impacts.
Chapter Two: A Civil Rights Movement

Let me now move from the geopolitics of the region inward (thus thematically seeking to blur their porous borders) and look at the changing dynamics of critical thinking and oppositional politics that have manifested themselves in the making of a civil rights (the Green) movement that will now need to be understood in terms entirely alien to the political imagination of the ruling regime and the dominant state apparatus. The rebirth of the nation I propose here is predicated on a full consciousness of its distant and more recent memories, in a manner that social movements rely on but transcend their collective recollections. What was affectionately called “the Green Movement” (after the campaign color of the most widely loved and endorsed presidential candidate of the 2009 election, Mir Hossein Mousavi) was the summation and sublation of all the previous revolutionary uprisings in Iran in the last 200 years—the rebirth of the nation and national consciousness embodied and manifested. This fact was beyond the comprehension of both the ruling regime that sought to suppress it and the cliche ridden “opposition” it had generated and rejected into exile so that by opposing the Islamic Republic would in fact corroborate it. Between the illegitimate ruling state and this discredited “opposition” (seeking support from the US neocons, Israeli Zionists, and Saudi Arabia) ran a mighty river of national consciousness that continued apace dismissing and denouncing them both. It was a historic moment to behold how a healthy and robust national consciousness systematically discredited and dismantled both the ruling state and its treacherous expat opposition. Perhaps the most significant aspect of the Green Movement was to discredit the Islamic Republic that ruled with an iron fist but without legitimacy and to expose the fake and faulty expat “opposition” that had no conception of the layered and organic consciousness of a national liberation movement and sought the support of warmongers from Washington, DC, to Tel Aviv to Riyadh, to change the ruling regime in Iran and replace it. The Green Movement was the interpretation of a dream, and this blinded tyrants and discredited warmongers alike had no way of seeing or reading it.
Hearing the Unheard: Crafting a Hearsay Exception for Intellectually Disabled Individuals

Although it might seem counterintuitive, many adults in society today are frequently labeled as “children” due to their intellectual disability. However, this particular comparison can present some challenging difficulties, particularly when considering statements made by these adults in the context of the Confrontation Clause and hearsay exceptions. Out of court statements are generally inadmissible in court, but numerous exceptions have made hearsay an expected part of courtroom testimony, whether it be under an established exception or under a more recent and less universal exception, like the tender years hearsay exception. However, very few states have addressed the issue of hearsay statements made by individuals with intellectual disabilities, despite the fact that many of the reasons that justify tender years exceptions apply equally well to statements made by intellectually disabled adults, as they are frequently victims of crimes, particularly sexually related crimes, and can have many difficulties testifying in court. However, anytime an out of court statement is admitted in court, it may present issues under the Confrontation Clause, unless the declarant was previously subjected to cross examination. Although such statements formerly were admissible if they were reliable, which they were if they were admitted pursuant to an established exception or when they bore guarantees of trustworthiness. However, the Supreme Court later changed course, stating that testimonial statements could only be admitted if the witness is subject to cross examination; however, the Court still providing some leeway to states in dealing with non-testimonial statements. This article proposes a new hearsay exception for intellectually disabled individuals that states can tailor for their individual needs while still providing protection for some of the most vulnerable in our society. This exception fits within the current framework, as intellectual disabled individuals are generally competent to testify in court, as they can distinguish between truth and a lie and are capable of answering questions before a jury. However, even if they are unavailable in court, their non-testimonial statements are sufficiently reliable to be admitted. Ultimately, by creating a framework for states to follow, this article strives to balance the competing interests of protecting the intellectually disabled, helping them access the justice system while still maintaining their autonomy, and protecting the accused’s right to confront witnesses against him.
Abstract 103: Circulating sRAGE is Elevated in Patients with Marfan Syndrome and Decreases After Surgical Replacement of Diseased Aortic Segments

Backgound: The Receptor for Advanced Glycation End products (RAGE) and its ligands are associated with vascular remodeling and trigger the release of a soluble receptor (sRAGE). We previously demonstrated that sRAGE levels are elevated in patients with bicuspid aortic valve and ascending aortic aneurysm. Circulating sRAGE in these patients correlates with the presence of a dysfunctional aortic structure but do not linearly correlate with an increase in the aortic diameter. Severe aortic disease occurs in more than 80% of Marfan Syndrome (MFS) patients. Aortic root and ascending aorta (AA) enlargement in MFS are associated with deficiency/destabilization of fibrillin-1, which leads to a generalized structural impairment of the aortic wall. We hypothesized that sRAGE may be elevated in the plasma of MFS patients and may decrease after surgical replacement of diseased aortic tissue. Methods: Plasma samples and clinical information (MFS=120, Control=37) were obtained from the GenTAC bioregistry and the Tissue Biobank at UPENN. Samples were collected either a few days prior to aortic surgery or at least one year post-surgery. sRAGE was tested using ELISA. Univariate and multivariate analysis were performed. Results: sRAGE levels are significantly higher in MFS patients compared to control (1404±64.35 vs 592±34.86 pg/ml, p Conclusion: Plasma sRAGE levels are associated with the presence of ascending aortopathies independent of aortic diameter. Longitudinal studies evaluating sRAGE in MFS patients may unveil new markers for the diagnosis and risk stratification of this population.
Review: the reemergence of brachytherapy as treatment for non-melanoma skin cancer

AbstractElectronic Brachytherapy (EBT) has seen a significant rise in use over the past few years in treating non-melanoma skin cancer (NMSC). However, the current literature in EBT remains scarce. Existing data on high dose rate brachytherapy (HDR-BT) with surface applicators is often used to justify its efficacy and safety. In this review we study the two treatment modalities on their efficacy in treating NMSC and we explore the reasons behind the recent uprise in EBT. A literature review using PubMed was performed for articles published until January 2017 studying efficacy of HDR-BT and EBT for treating NMSC. HDR-BT demonstrated effective local control ranging from 96.2% to 100% up to 66 months of follow-up with acceptable cosmesis. For EBT, local control rates ranged from 90% to 100% with generally favorable tolerance and cosmesis outcome after roughly one year. While longer term data on EBT is needed, its short term efficacy shows promise as a possible alternative to surgery or other radiation therap...
A Small Library’s Playbook for Hosting NLM Traveling Exhibits

ABSTRACTTraveling exhibits created and circulated by the National Library of Medicine can be catalysts for raising awareness of medical libraries in their institutions and for disseminating importa...
The first case of deafness-dystonia syndrome due to compound heterozygous variants in FITM2 .

We report the second known family affected by deafness-dystonia syndrome associated with loss of function of FITM2. Our patient is compound heterozygous for pathogenic FITM2 variants, while affected siblings in the first report were homozygous. This case provides evidence that this novel genetic disorder is associated with autosomal recessive inheritance.
Case Discussion As a Strategic Planning Tool: Exploring Medical Tourism at Hospital Infantil Telethon De Oncología

Background: As medical tourism rises globally, healthcare leaders are required to make strategic decisions about accepting international patients, as a means to diversify income, increase access to cancer care, and optimize patient experience. Hospital Infantil Teleton de Oncologia (HITO), a free-standing pediatric oncology hospital in Mexico, currently has no international patients. Aim: We posed a hypothetical case to a group of HITO's senior leaders to understand the strategic priorities, examine the decision-making process around allocating beds for self-paying patients, and explore how changes in hospital governance influence the healthcare system. Methods: A literature review and prediscussion interviews were conducted, and IRB exemption was obtained. Two facilitators led the discussion using a structured case guide. Participants (N=13) were randomly assigned to teams supporting or opposing the decision to accept international patients. Thirty minutes were allocated for team discussion, thirty minut...
Microbiome and disease in the upper airway.

Purpose of reviewMicrobiome refers to the genetic potential of resident microorganisms that inhabit a given niche. The exact role of the microbiome and its relation to chronic disease processes remains largely unknown, although various associations have been observed. We reviewed current literature
Outpatient Physical Therapist Attitudes Toward and Behaviors in Cardiovascular Disease Screening: A National Survey

Background Screening the cardiovascular system is an important and necessary component of the physical therapist examination to ensure patient safety, appropriate referral, and timely medical management of cardiovascular disease (CVD) and risk factors. The most basic screening includes a measurement of resting blood pressure (BP) and heart rate (HR). Previous work demonstrated that rates of BP and HR screening and perceptions toward screening by physical therapists are inadequate. Objective The purpose was to assess the current attitudes and behaviors of physical therapists in the United States regarding the screening of patients for CVD or risk factors in outpatient orthopedic practice. Design This was a cross-sectional, online survey study. Methods Data were collected from an anonymous adaptive online survey delivered via an email list. Results A total of 1812 surveys were included in this analysis. A majority of respondents (n = 931; 51.38%) reported that at least half of their current caseload included patients either with diagnosed CVD or at moderate or greater risk of a future occurrence. A total of 14.8% of respondents measured BP and HR on the initial examination for each new patient. The most commonly self-reported barriers to screening were lack of time (37.44%) and lack of perceived importance (35.62%). The most commonly self-reported facilitators of routine screening were perceived importance (79.48%) and clinic policy (38.43%). Clinicians who managed caseloads with the highest CVD risk were the most likely to screen. Limitations Although the sampling population included was large and representative of the profession, only members of the American Physical Therapy Association Orthopaedic Section were included in this survey. Conclusions Despite the high prevalence of patients either diagnosed with or at risk for CVD, few physical therapists consistently included BP and HR on the initial examination. The results of this survey suggest that efforts to improve understanding of the importance of screening and modifications of clinic policy could be effective strategies for improving rates of HR and BP screening.
NICU Graduate Reunion: "A Celebration of Life".

Background Few understand the experience of having an infant in the neonatal intensive care unit (NICU). This article provides a discussion about the importance of an annual reunion for former NICU infants, their families, and neonatal staff. Purpose The purpose of this article is to explain the impact of the NICU reunion on families and neonatal healthcare providers and describe the experience of organizing this reunion over the past 20 years. Methods This is a description of how a NICU reunion was organized at a regional neonatal center. Graphic-designed invitations were e-mailed to NICU graduates, who previously agreed to being contacted, 2 months prior to the reunion date. Social media were utilized to publicize the event on the hospital's Web site. Results At the reunion, parents and families introduced their NICU graduate to the neonatal staff who cared for them while hospitalized. Sometimes staff found it difficult to recognize the NICU graduates, who were toddlers or older. Parents were relaxed, expressing their appreciation for care received. Implications for practice The impact of seeing an infant, born at 24 weeks, now walking, talking, and running cultivates pride in the NICU healthcare team. The reunion adds a positive dimension to the work of NICU caregivers. Parents look forward to attending the reunion to reconnect with NICU staff and other NICU parents. Implications for research Directions for future study include a comparison of staff and families who attend the NICU reunion and those who do not, by using a survey or online evaluation tool, to improve future reunions.
Integrating Non-major Students in Engineering Course

Engineering education places heavy emphasis on math, science and physics fundamentals. The theory and technical aspects of it often hinder other major students like humanity and arts from taking any engineering courses, therefore limits their understanding about the world of engineering. An "introduction to engineering" course is offered here at Endicott College to integrate non-major students together with the engineering students. Part of the goal is to spread the engineering concepts, tools, technology and knowledge to non-major students, which might be adopted to their own major study and research. At the same time, team-based projects are implemented in the class to foster collaboration between students from different background and disciplines to achieve education purpose.
Rheumatoid Arthritis Flares After Total Hip and Total Knee Arthroplasty: Outcomes at One Year

Objective Most patients with rheumatoid arthritis (RA) undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) have active RA and report postoperative flares; whether RA disease activity or flares increase the risk of worse pain and function scores 1 year later is unknown. Methods Patients with RA were enrolled before THA/TKA. Patient-reported outcomes, including the Hip disability and Osteoarthritis Outcome Score (HOOS)/Knee Injury and Osteoarthritis Outcome Score (KOOS) and physician assessments of disease characteristics and activity (Disease Activity Score in 28 joints [DAS28] and Clinical Disease Activity Index), were collected before surgery. Patient-reported outcomes were repeated at 1 year. Postoperative flares were identified using the RA Flare Questionnaire weekly for 6 weeks and were defined by concordance between patient report plus physician assessment. We compared baseline characteristics and HOOS/KOOS scores using 2-sample t-test/Wilcoxon's rank sum test as well as chi-square/Fisher's exact tests. We used multivariate linear and logistic regression to determine the association of baseline characteristics, disease activity, and flares with 1-year outcomes. Results One-year HOOS/KOOS scores were available for 122 patients (56 with THA and 66 with TKA). Although HOOS/KOOS pain was worse for patients who experienced a flare within 6 weeks of surgery, absolute improvement was not different. In multivariable models, baseline DAS28 predicted 1-year HOOS/KOOS pain and function; each 1-unit increase in DAS28 worsened 1-year pain by 2.41 (SE 1.05; P = 0.02) and 1-year function by 4.96 (SE 1.17; P = 0.0001). Postoperative flares were not independent risk factors for pain or function scores. Conclusion Higher disease activity increased the risk of worse pain and function 1 year after arthroplasty, but postoperative flares did not.
From state-of-the-art treatments to novel therapies for advanced-stage pancreatic cancer

Improvements in the outcomes of patients with pancreatic ductal adenocarcinoma (PDAC) have lagged behind advances made in the treatment of many other malignancies over the past few decades. For most patients with PDAC, cytotoxic chemotherapy remains the mainstay of treatment. For patients with resectable disease, modified 5-fluorouracil, leucovorin, irinotecan and oxaliplatin (mFOLFIRINOX) is the standard-of-care adjuvant therapy, although data from several randomized trials have shown improved outcomes with neoadjuvant treatment strategies. For patients with advanced-stage or metastatic disease, comprehensive genomic profiling has revealed several potentially actionable alterations in small subsets of patients and the feasibility of implementing such strategies is beginning to be confirmed. Novel therapies targeting certain aberrations, most notably BRCA1/2 mutations, mismatch repair (MMR) deficiencies or NTRK1-3 fusions, have shown considerable activity in clinical trials, and larotrectinib, entrectinib and pembrolizumab have received FDA approval for the treatment of patients with tumours harbouring NTRK fusions and MMR deficiencies, respectively, regardless of primary tumour histology. In this Review, we describe the available data on the activity of these and other agents in patients with PDAC. Our discussion is structured according to the acronym 'PRIME' to organize the various treatment strategies currently undergoing evaluation in clinical trials: Pathway inhibition, alteration of DNA Repair pathways, Immunotherapy, cancer Metabolism and targeting the Extracellular tumour microenvironment.
Minority stress, social integration, and the mental health needs of LGBTQ asylum seekers in North America.

Abstract Objective Drawing on theoretical accounts of LGBTQ minority stress and models of social integration and immigrant health, the present study examines sexual and gender minority status - heretofore overlooked in crossnational frameworks of immigrant health - as an important determinant of asylum seeker mental health. With the goal of spurring intervention development among this population, this study also aims to characterize LGBTQ asylum seekers' interest in interventions aimed at alleviating minority stress, barriers to social integration, and associated mental distress. Method Respondents (n = 308) completed an online survey which included the Refugee Health Screener (RHS-15), and a battery of measures of minority stressors and barriers to social integration. Results Most respondents (80.20%) screened positive for mental distress. Consistent with minority stress theory, loneliness (OR = 1.14, 95% CI = 1.11, 1.16) and LGBTQ identity disclosure (OR = 3.46, 95% CI = 1.85, 6.50) were strongly associated with screening positive for mental distress. Consistent with theories of immigrant social integration, those who had been granted asylum (OR = 0.36, 95% CI = 0.25, 0.53) or had higher English language proficiency (OR = 0.35, 95% CI = 0.21, 0.60) were less likely to screen positive. In an exploratory analysis, the association between transgender identity and mental distress approached significance (OR = 3.60, 95% CI = 1.00, 7.2). As preliminary justification for applying these findings to practice, most of those who screened positive for distress were interested in receiving mental health counseling (70.45%). Most participants wanted more LGBTQ friends (83.1%), wanted to mentor an LGBTQ newcomer (83.8%), and were interested in joining an LGBTQ community center (68.2%). Conclusion This study demonstrates that LGBTQ asylum seekers are highly likely to experience mental distress that is influenced by unique social factors, including barriers to social integration, and are motivated to participate in interventions aimed at addressing their mental health needs.
A Model Using Clinical and Endoscopic Characteristics Identifies Patients at Risk for Eosinophilic Esophagitis According to Updated Diagnostic Guidelines.

Abstract Background and aims Updated diagnostic guidelines for eosinophilic esophagitis (EoE) have eliminated the requirement for a proton pump inhibitor (PPI) trial, but there are no models to identify patients with EoE based on these new criteria. We aimed to develop a predictive model for diagnosis of EoE based on the updated EoE diagnostic guidelines. Methods We performed a secondary analysis of a prospective study of adult patients referred for outpatient esophagogastroduodenoscopy at University of North Carolina who had symptoms of esophageal dysfunction; patients with prevalent EoE were excluded. We analyzed data from 206 EoE cases (mean age 40.1, 62.6% male, 93.2% white) and 306 controls (mean age 52.3, 37.9% male, 79.7% white). We built predictive models for case-control status, using clinical, endoscopic, and histologic features, and defining EoE by either the new or historical definition of PPI non-response. Model discrimination was assessed by the area under the receiver-operator characteristic curve (AUC). Results Before endoscopy, younger age, male sex, history of atopic condition or food allergy, and dysphagia identified patients with EoE with an AUC of 0.83. When we included endoscopy findings suggestive of EoE, the model identified patients with EoE with an AUC of 0.92; this increased to 0.99 when histology was included. Conclusion We developed a model to identify patients with EoE, without a trial of PPIs, based on updated diagnostic guidelines. Clinical features and endoscopic findings identified patients with EoE with an AUC of 0.92—even without histologic data and in the absence of dysphagia. This model can be used to select patients with upper gastrointestinal symptoms but without dysphagia for early diagnostic endoscopy. The model can also be used to identify cases of EoE when eosinophil counts are greater than 15 in biopsies but other causes of esophageal eosinophilia cannot necessarily be excluded.
Predicting backward erosion piping hazard, Lower Mississippi Valley, USA

Backward erosion piping (BEP) is a form of internal erosion and common failure mode along levees. Despite over a century of study, predicting where BEP will initiate is still a considerable challenge. This study proposes a new model for predicting BEP initiation focused on the widest range of applicability. A logit model is trained using data from 15 sites along the Lower Mississippi Valley. The included parameters are independent of geography or geological regime and exhibit recorded or suspected correlations to BEP. Three significant factors (95% confidence interval) are retained for the final model: cumulative clay thickness within the blanket (odds ratio (OR) 0.520), critical gradient (OR 0.001) and exit gradient (OR 63.15). Receiver operating characteristics analysis indicates an area under the curve of 0.823. The model demonstrates 71% classification accuracy, a dramatic 10% increase over previous logit model attempts. Model results are most applicable within 150 m of the levee toe to predict new incidents of BEP initiation. The final model is a useful tool for BEP assessment and mitigation efforts.
Efficient semiparametric inference for two-phase studies with outcome and covariate measurement errors

In modern observational studies using electronic health records or other routinely collected data, both the outcome and covariates of interest can be error-prone and their errors often correlated. A cost-effective solution is the two-phase design, under which the error-prone outcome and covariates are observed for all subjects during the first phase and that information is used to select a validation subsample for accurate measurements of these variables in the second phase. Previous research on two-phase measurement error problems largely focused on scenarios where there are errors in covariates only or the validation sample is a simple random sample of study subjects. Herein, we propose a semiparametric approach to general two-phase measurement error problems with a quantitative outcome, allowing for correlated errors in the outcome and covariates and arbitrary second-phase selection. We devise a computationally efficient and numerically stable expectation-maximization algorithm to maximize the nonparametric likelihood function. The resulting estimators possess desired statistical properties. We demonstrate the superiority of the proposed methods over existing approaches through extensive simulation studies, and we illustrate their use in an observational HIV study.
C. elegans Glia Are Bona Fide Odorant Receptor Cells.

There is increasing evidence that supporting/glial cells in sensory systems function in sensory transduction. Duan et al. demonstrate that the glial cells of the C. elegans amphid apparatus serve as odorant receptor cells and regulate neuronal output and behavior.
Mortality and renal outcomes of patients with severe COVID-19 treated in a provisional intensive care unit.

COVID-19 has created an enormous health crisis and this spring New York City had a severe outbreak that pushed health and critical care resources to the limit. A lack of adequate space for mechanically ventilated patients induced our hospital to convert operating rooms into critical care areas (OR-ICU). A large number of COVID-19 will develop acute kidney injury that requires renal replacement therapy (RRT). We included 116 patients with COVID-19 who required mechanical ventilation and were cared for in our OR-ICU. At 90 days and at discharge 35 patients died (30.2%). RRT was required by 45 of the 116 patients (38.8%) and 18 of these 45 patients (40%) compared to 17 with no RRT (23.9%, ns) died during hospitalization and after 90 days. Only two of the 27 patients who required RRT and survived required RRT at discharge and 90 days. When defining renal recovery as a discharge serum creatinine within 150% of baseline, 68 of 78 survivors showed renal recovery (87.2%). Survival was similar to previous reports of patients with severe COVID-19 for patients cared for in provisional ICUs compared to standard ICUs. Most patients with severe COVID-19 and AKI are likely to recover full renal function.