cssi/SciSciGPT-SciSciNet huggingface dataset:
Role of Munc13-4 as a Ca2+-dependent tether during platelet secretion

The Munc13 family of exocytosis regulators has multiple Ca2+-binding, C2 domains. Here, we probed the mechanism by which Munc13-4 regulates in vitro membrane fusion and platelet exocytosis. We show that Munc13-4 enhances in vitro soluble NSF attachment protein receptor (SNARE)-dependent, proteoliposome fusion in a Ca2+- and phosphatidylserine (PS)-dependent manner that was independent of SNARE concentrations. Munc13-4–SNARE interactions, under the conditions used, were minimal in the absence or presence of Ca2+. However, Munc13-4 was able to bind and cluster liposomes harbouring PS in response to Ca2+. Interestingly, Ca2+-dependent liposome binding/clustering and enhancement of proteoliposome fusion required both Munc13-4 C2 domains, but only the Ca2+-liganding aspartate residues of the C2B domain. Analytical ultracentrifugation (AUC) measurements indicated that, in solution, Munc13-4 was a monomeric prolate ellipsoid with dimensions consistent with a molecule that could bridge two fusing membranes. To address the potential role of Munc13-4 as a tethering protein in platelets, we examined mepacrine-stained, dense granule mobility and secretion in platelets from wild-type and Munc13-4 null ( Unc13dJinx ) mice. In the absence of Munc13-4, dense granules were highly mobile in both resting and stimulated platelets, and stimulation-dependent granule release was absent. These observations suggest that dense granules are stably docked in resting platelets awaiting stimulation and that Munc13-4 plays a vesicle-stabilizing or tethering role in resting platelets and also in activated platelets in response to Ca2+. In summary, we show that Munc13-4 conveys Ca2+ sensitivity to platelet SNARE-mediated membrane fusion and reveal a potential mechanism by which Munc13-4 bridges and stabilizes apposing membranes destined for fusion. * AUC, : analytical ultracentrifugation; FRET, : fluorescence energy transfer; GPS, : grey platelet syndrome; HPS, : Hermansky–Pudlak syndrome; MSD, : mean square displacement; munc, : mammalian uncoordinated; NBD-PE, : N -(7-nitro-2-1,3-benzoxadiazol-4-yl)-1,2-dipalmitoyl phosphatidyl-ethanolamine; PC, : phosphatidylcholine; PF4, : platelet factor 4; PRP, : platelet rich plasma; PS, : phosphatidylserine; rhodamine-PE, : N -(lissamine rhodamine B sulfonyl)-1,2-dipalmitoyl phosphatidylethanolamine; SNAP-23, : synaptosomal associated protein-23; SNARE, : soluble NSF attachment protein receptor; Unc, : uncoordinated; VAMP, : vesicle-associated membrane protein; VWF, : von Willebrand factor
Functional Impairment Variability in Children With ADHD Due to Emotional Impulsivity.

Objective: The present study utilized ecological momentary assessment (EMA) to examine the effects of emotional impulsivity on overall functional impairment and functional impairment variability (FIV) of children with and without ADHD. Method: Parents of 74 children, 8- to 12-year-olds (42 with ADHD, 32 without ADHD), completed EMA assessment protocol ratings of their child’s mood (3 times daily) and functional impairment (1 time daily) over the course of 28 days. Results: Hierarchical regression analyses supported the interaction of ADHD diagnostic status and greater EMA-derived emotional impulsivity in the estimation of total functional impairment (Total FI) and FIV. Thus, greater emotional impulsivity was found to be related to greater Total FI and FIV among children with ADHD but not among children without ADHD. Conclusion: This study suggests that children with ADHD and greater emotional impulsivity demonstrate greater overall levels of functional impairment, with the severity of their impairment var...
Effects of time of day and season on winter bird counts

We examined the effects of time of day and season on counts of wintering birds in a central Pennsylvania forest. Black-capped Chickadees (Parus atricapillus), Tufted Titmice (Parus bicolor), and White-breasted Nuthatches (Sitta carolinensis) were detected more often in the morning (07:00-10:59) than at other times, whereas White-throated Sparrows (Zonotrichia albicollis) were noted more often at midday (11:00-13:59). Numbers of contacts of all species combined were relatively similar between morning and midday but were much lower in the afternoon (_ 14:00). Black-capped Chickadees, Tufted Titmice, White-breasted Nuthatches, Golde -crowned Kinglets (Regulus satrapa), and White-throated Sparrows were observed more often in early winter (before 19 January) than later in the season. We conclude that winter bird counts can be conducted in both morning and midday hours with little or no qualitative loss of data. In addition, counts should be made in early winter to minimize the effects of food shortages later in winter that may influence avian mortality and movements to feeders.
THE EFFECT OF WATER POTENTIAL ON ZYGOSPORE FORMATION IN SYZYGITES MEGALOCARPUS

Syzygites megalocarpus Ehrenberg, a homothallic member of the Mucorales, is commonly found in nature on decaying mushrooms. The fungus has a distinguished history in that it was the first in which sexual reproduction was documented, being described by Ehrenberg in 1820 (Ainsworth, 1976). Since this early observation, many other investigators have studied the fungus, especially with regard to the teleomorphic state and the conditions necessary for its formation (TABLE I). Past studies have implicated carbohydrate concentration (Wegner and Lilly, 1966), low temperature (Hesseltine, 1957), temperature and light (Davis, 1967), and numbers of asexual spores and carbohydrate concentration (Poff, 1965) as factors affecting zygospore formation. The results of these studies are contradictory and do not present evidence that clearly demonstrates a single factor which regulates zygospore formation. We studied the effect of water potential on asexual and sexual reproduction in Syzygites megalocarpus. Preliminary observations suggested that the amount of water available to the fungus could determine the nature of its reproductive cycle, sufficient available water inducing the fungus to reproduce asexually while a paucity of water induced the formation of resistant zygospores. An isolate of the fungus was obtained from a decaying mushroom collected in Kingston, Rhode Island. Stock cultures were maintained at 19 C on glucoseyeast-peptone (10:1:2 g/l) agar. To test the effect of water potential on reproduction, four osmotica were added to the standard GYP medium. Included were two mineral salts, KCl and NaCl, in concentrations of 0.1, 0.2, 0.4, 0.6 and 0.8 M per liter of medium, and two carbohydrates, sorbitol and sucrose, added in 0.2, 0.4, 0.8, 1.2, and 1.6 M concentrations. The water potential of media with each osmoticum ranged from -2 bars to -30 bars. If carbohydrate concentration alone were responsible for inducing sexual reproduction, then only media containing sucrose and sorbitol as osmotica would stimulate zygospore formation. On the other hand, if the regulating factor was water potential, then it could be expected that zygospores would be present in all the media of similar osmotic potential. GYP medium without added osmoticum was used as a control. Inoculum was prepared by flooding a wk-old colony of S. megalocarpus with sterile, distilled water. Spores were dislodged from sporangiophores with a flamed dissecting needle to give a dense spore suspension. Two drops (0.1 ml) of this spore suspension were placed in the center of each plate of agar containing the various concentrations of osmotica, as well as the control plates. The cultures were incubated at 19 C with 12 h of artificial light (21,500 lux) and 12 h of darkness. The cultures were checked daily for one wk and the results noted. Four replicates
Tschirnhaus Transformations on Certain Rational Cubics

(1927). Tschirnhaus Transformations on Certain Rational Cubics. The American Mathematical Monthly: Vol. 34, No. 10, pp. 521-525.
In Vitro Comparison of Ertapenem, Meropenem, and Imipenem against Isolates of Rapidly Growing Mycobacteria and Nocardia by Use of Broth Microdilution and Etest

We compared the activities of the carbapenems ertapenem, meropenem, and imipenem against 180 isolates of rapidly growing mycobacteria (RGM) and 170 isolates of Nocardia using the Clinical and Laboratory Standards Institute (CLSI) guidelines. A subset of isolates was tested using the Etest. The rate of susceptibility to ertapenem and meropenem was limited and less than that to imipenem for the RGM. Analysis of major and minor discrepancies revealed that >90% of the isolates of Nocardia had higher MICs by the broth microdilution method than by Etest, in contrast to the lower broth microdilution MICs seen for >80% of the RGM. Imipenem remains the most active carbapenem against RGM, including Mycobacterium abscessus subsp. abscessus For Nocardia, imipenem was significantly more active only against Nocardia farcinica Although there may be utility in testing the activities of the newer carbapenems against Nocardia, their activities against the RGM should not be routinely tested. Testing by Etest is not recommended by the CLSI.
Modernization of file management in disease control and prevention

File management is an important part of disease control and prevention,its systematization,informazation and intelligence are the requirements of the times.This paper elaborates the new idea of modernization of file management in disease control and prevention from the back ground of modernization achievement,trends and ways of file management.
Identification and treatment of aggressive thyroid cancers part 2: Risk assessment and treatment

Most thyroid cancers are slow-growing, easily treatable tumors with an excellent prognosis after surgical resection and targeted medical therapy. Unfortunately, 10% to 15% of thyroid cancers exhibit aggressive behavior and do not follow an indolent course. Approximately one-third of patients with differentiated thyroid cancers will have tumor recurrences. Distant metastases are present in about 20% of patients with recurrent cancer. Approximately half of patients with distant metastases die within 5 years. The loss of the ability to concentrate radio-iodine and produce thyroglobulin is a sign of dedifferentiation, which occurs in about 30% of patients with persistent or recurrent thyroid cancer. Dedifferentiation is associated with poorer responses to conventional therapy and difficulty monitoring tumor burden. Clinicians must identify tumors with more aggressive biology and treat them accordingly with more aggressive regimens. Part 1 of this two-part article, which appeared in March, described in detail the distinct types of thyroid cancer, as well as risk factors, outcomes, treatment, and prognostic factors, with a focus on thyroid cancers of follicular cell origin. Part 2 covers risk assessment and staging, findings that suggest the presence of aggressive tumors, recurrent/metastatic disease, and treatment with chemotherapy and external-beam radiotherapy. Experimental treatments utilizing molecular targets, redifferentiation agents, and gene therapy are covered briefly as well.
Current screening and treatments in retinopathy of prematurity in the US

Retinopathy of prematurity (ROP) is a complex disease characterized by an aberrant developmental retinal angiogenesis in preterm infants and can carry significant visual morbidity, including retinal detachment and blindness. Though large scale, randomized clinical trials have improved our understanding of the pathophysiology and progression of the disease, the management of ROP remains a challenge for ophthalmologists. This review addresses the up-to-date screening approach, diagnosis, and treatment guidelines for ROP in the US.
Application of Fiber-Optic Attenuated Total Reflection-FT-IR Methods for In Situ Characterization of Protein Delivery Systems in Real Time

A fiber-optic coupled attenuated total reflection (ATR)-FT-IR spectroscopy technique was applied to the study of two different therapeutic delivery systems, acid degradable hydrogels and nanoparticles. Real time exponential release of a model protein, human serum albumin (HSA), was observed from two different polymeric hydrogels formulated with a pH sensitive cross-linker. Spectroscopic examination of nanoparticles formulated with an acid degradable polymer shell and encapsulated HSA exhibited vibrational signatures characteristic of both particle and payload when exposed to lowered pH conditions, demonstrating the ability of this methodology to simultaneously measure phenomena arising from a system with a mixture of components. In addition, thorough characterization of these pH sensitive delivery vehicles without encapsulated protein was also accomplished in order to separate the effects of the payload during degradation. When in situ, real time detection in combination with the ability to specifically i...
MR IMAGING OF THE RETROPERITONEUM

The multiplanar and soft-tissue capabilities of MR imaging make it a valuable diagnostic tool for the retroperitoneal space and its organs. In addition, by virtue of its location, the retroperitoneum is well suited for study by this modality. Appropriate techniques, including the use of contrast, are discussed as are the normal and pathologic appearances of the organs and areas of the retroperitoneum.
Institutions and Exchange

Government power is profitable to those who have it because they can create barriers to entry and charge monopoly prices for their services. The government’s exchange of protection for tribute creates a situation where monopoly will tend to emerge, as does the government’s ability to create legislation. One could imagine an ideal setting where, following a model like Tiebout,1 competitive governments would eliminate any monopoly profit, but the government’s exchange of protection for tribute naturally leads toward a concentration of power that gives rise to monopoly profits.2 The lure of monopoly profits from government power means that people will have an incentive to compete for the right to have that monopoly power.3
Core/Double-Shell Type Gradient Ni-Rich LiNi0.76Co0.10Mn0.14O2 with High Capacity and Long Cycle Life for Lithium-Ion Batteries

A concentration-gradient Ni-rich LiNi0.76Co0.1Mn0.14O2 layered oxide cathode has been developed by firing a core/double-shell [Ni0.9Co0.1]0.4[Ni0.7Co0.1Mn0.2]0.5[Ni0.5Co0.1Mn0.4]0.1(OH)2 hydroxide precursor with LiOH·H2O, where the Ni-rich interior (core) delivers high capacity and the Mn-rich exterior (shells) provides a protection layer to improve the cyclability and thermal stability for the Ni-rich oxide cathodes. The content of nickel and manganese, respectively, decreases and increases gradually from the center to the surface of each gradient sample particle, offering a high capacity with enhanced surface/structural stability and cyclability. The obtained concentration-gradient oxide cathode exhibits high-energy density with long cycle life in both half and full cells. With high-loading electrode half cells, the concentration-gradient sample delivers 3.3 mA h cm–2 with 99% retention after 100 cycles. The material morphology, phase, and gradient structure are also maintained after cycling. The pouch-...
Modeling Diet-Induced Obesity with Obesity-Prone Rats: Implications for Studies in Females

Obesity is a worldwide epidemic, and the comorbidities associated with obesity are numerous. Over the last two decades, we and others have employed an outbred rat model to study the development and persistence of obesity, as well as the metabolic complications that accompany excess weight. In this review, we summarize the strengths and limitations of this model and how it has been applied to further our understanding of human physiology in the context of weight loss and weight regain. We also discuss how the approach has been adapted over time for studies in females and female-specific physiological conditions, such as menopause and breast cancer. As excess weight and the accompanying metabolic complications have become common place in our society, we expect that this model will continue to provide a valuable translational tool to establish physiological relevant connections to the basic science studies of obesity and body weight regulation.
Sulfate homeostasis. IV, Probenecid-induced alterations of inorganic sulfate in rats

Homeostasis of inorganic sulfate is maintained by the capacity-limited renal reabsorption of sulfate in the proximal tubule. The purpose of the present investigation was to determine if probenecid, the classical inhibitor of renal organic anion secretion, may affect sulfate renal clearance. Two groups of rats were administered in a randomized crossover design, an i.v. bolus dose (20.6 or 92.4 mg/kg) and 4-hr infusion (0.28 or 0.59 mg/min/kg) of probenecid or vehicle, and blood and urine samples were collected. At a steady-state serum concentration of 0.45 mM, probenecid had no significant effect on the serum concentrations or renal clearance of inorganic sulfate, whereas at a serum concentration of 1.4 mM, probenecid treatment caused a significant decrease in serum sulfate concentrations (0.57 ± 0.11 vs 0.96 ± 0.19 mM in controls, mean ± SD, n = 6, P < 0.001) due to an increase in the renal clearance of sulfate (3.88 ± 1.18 vs 2.13 ± 0.84 ml/min/kg in controls, P < 0.01). The fraction of the filtered sulfate that was reabsorbed was significantly decreased (0.38 ± 0.23, vs 0.74 ± 0.09 in controls, P < 0.01). Therefore, probenecid treatment results in the inhibition of the renal reabsorption of inorganic sulfate in rats in vivo.
Development in the Digital Age: An Introduction to the Section

ABSTRACTThe author highlights the massive cultural transformation of the 21st century as society moves into the technocultural age. The papers that follow represent a range of viewpoints about the impact of these changes on child development in the technocultural era, with special reference to the unique presentations of childhood symptomatology.
Open cell aerogel foams with hierarchical pore structures

Abstract A new class of macroscopic materials – the open cell aerogel foams (OCAFs) – are developed in this work that combine the attributes of open cell polymer foams and mesoporous polymer aerogels in single materials. The OCAFs have two functional elements – the large body of the materials is air-filled open cells with typical cell size greater than 1 μm and the walls between the open cells consisting of mesoporous aerogel formed by the polyurea strands of typical diameter 50 nm. The common foaming technologies cannot be easily adapted to obtain OCAF. This paper evaluates a strategy based on the use of templates of co-continuous immiscible polymer blends. The open cell macropores are created by selective dissolution of polystyrene from its co-continuous blend with polyethylene oxide. The gel networks of polyurea are then synthesized inside the macropores. Finally, the polyethylene oxide phase is removed by dissolution and the resultant material is dried under supercritical condition to obtain the OCAF. It is found that polyurea gel networks are initiated on the surfaces of polyethylene oxide template by nucleation and growth mechanism. The resultant polyurea OCAFs exhibit bulk density ∼0.06 g/cm3, BET surface area ∼130 m2/g, mesoporous solid networks, high air permeability, and close to 1500% weight gain in a few seconds when exposed to pump oil.
Effects of Acyl Chain Unsaturation on Activation Energy of Water Permeability Across Droplet Bilayers of Homologous Monoglycerides: Role of Cholesterol

Cholesterol is an important component of total lipid in mammalian cellular membranes, hence the knowledge of its association with lipid bilayer membranes will be essential to understanding membrane structure and function. A Droplet Interface Bilayer (DIB) provides a convenient and reliable platform through which permeability coefficient and activation energy for water transport across the membrane can be made. In this study, we investigated the effect of acyl chain structure in amphiphilic monoglycerides on the permeability of water across DIB membranes composed of cholesterol and these monoglycerides, where the acyl chain length, number of double bonds, and the position of double bond are varied systematically along the acyl chains. To elucidate the role of cholesterol in these membranes, we investigated its influence on water permeability and associated activation energies, at two different cholesterol concentrations. Our systematic studies show dramatic sensitivity and selectivity of specific interacti...
Current Use of Invasive and Noninvasive Monitors in Academic Pediatric Intensive Care Units

To describe the current use of noninvasive monitoring compared with traditional invasive monitoring in Pediatric Critical Care Medicine (PCCM) accredited fellowship programs in the United States. A web-based survey with the primary aim of describing the utilization of noninvasive monitoring compared with invasive monitoring was distributed to PCCM program directors (PDs) at the 64 accredited fellowship training programs. Questions focused on demographics and the utilization of invasive and noninvasive monitoring for specific patient populations and disease states. Forty-two (66%) PDs responded to the survey. Capnography and near-infrared spectroscopy (NIRS) were the most commonly reported noninvasive monitoring technology. Arterial and central venous catheters were widely used. Other invasive monitoring devices were used sparingly. Despite widespread use of both invasive and noninvasive monitoring in academic pediatric critical care units across the United States, there is significant variability in the use of noninvasive monitoring compared with invasive monitoring. Further investigation is needed to define the standard of care for the use of noninvasive monitors as practitioners attempt to optimize care while minimizing risks and complications.
Biofuels and Biodiversity, Wildlife Habitat Restoration

The development of bioenergy to help meet global demands for renewable energy could either help or harm biodiversity and wildlife. The authors review current global trends, constraints, and opportunities in this burgeoning industry and identify strategies and systems that could result in net positive benefits for wildlife. In particular, they address the potential for bioenergy systems to restore wildlife habitat within agricultural landscapes.
Hume and the Problem of Local Induction

This paper is an epistemological attempt to outline the problem of local induction relative to the classical framework set forth by Hume. The reconstruction of the latter will be rather unexegetically simplified in the light of the former. Hume’s approach to factual knowledge and induction was to a very large extent motivated and influenced by his opposition to, and criticism of, rationalism. I will try to project the problem of local induction against this background. I will claim that, his nuances and sometimes surprising qualifications notwithstanding (particularly in the Appendix to (1739)), Hume’s approach to knowledge was atheoretical; and that it is this feature, perhaps more than anything else, which shaped his understanding of induction and left a profound mark on subsequent developments in the philosophy of induction. In contrast with it, I will argue that any epistemologically sound treatment of induction should be theoretical, or relative to a theoretical context of knowledge, and that methodologically this favors a relevance approach to local induction.
An investigation of AAA diamond rating changes on hotel performance

Abstract Despite previous attempts to link hotel rating systems to performance, no prior study has examined the effects of changes in Diamond ratings. Considering the variability in Diamond ratings, and the fact that hotels may gain or lose a Diamond over time, it is important for hotel properties to assess such outcomes on key performance indicators (KPIs). Hence, this study examines the influence of Diamond rating changes on hotels’ KPIs (i.e., occupancy rate, average daily rate, and revenue per available room) and competitive set indexes, which allow to benchmark a property’s performance against a designated competitive set. Results suggest that in both the short and long-terms, significant differences in KPIs and indexes exist between properties which benefited from an increase in Diamond rating, versus those which suffered from a drop in Diamond rating. Furthermore, despite such improved performances over time, improvements in hotels’ KPIs and indexes tended to diminish over time. The current findings yield important contributions to the literature regarding the effects of hotel rating changes on KPIs and indexes and provide valuable insights to hotel owners and operators.
E-064 Carotid webs: a multimodality imaging study

Purpose Carotid web is an intimal variant of fibromuscular dysplasia that has been associated with recurrent ischemic strokes in the young. The accuracy of different diagnostic tests is unknown. The objective of the present study is to evaluate the diagnostic performance of different imaging modalities for the detection of carotid webs. Methods Using an institutional neurovascular database, we retrospectively identified consecutive patients diagnosed with carotid web and internal carotid artery atherosclerosis. Multimodality imaging including at minimum neck CT angiography (CTA) at baseline plus either Digital Subtraction Angiography (DSA) and/or carotid Ultrasound (US) was mandatory. CTA images were evaluated by two readers (neurointerventionist#1 and diagnostic neuroradiologist) in a consensus read for confirmation of diagnosis, and degree of stenosis based on NASCET criteria. DSA studies were evaluated by two blinded readers (neurointerventionists #2 and #3) to categorize the presence or absence of carotid web or atherosclerotic plaque in individual carotid arteries. US studies were evaluated by two blinded readers (two neurosonology-credentialed stroke neurologists) to characterize diagnosis (carotid web vs atherosclerosis vs normal), degree of certainty, and the degree of stenosis. In the setting of discrepancies, consensus read was obtained. The performance of DSA and of US was compared to CTA. Results Median age of the cohort was 57 years (IQR 46–61 years) with 36.4% (12/33) male gender. Overall comorbidities included 60.6% (20/33) hypertension, 33.3% (11/33) hyperlipidemia, 21.2% (7/33) diabetes mellitus, and 27.3% (9/33) smoking. Multimodal imaging was available for 33 carotid arteries. Twenty-eight carotids had CTA and DSA available for review. DSA readers identified correctly all normal vessels, but diagnosed carotid webs less frequently (43%, 12/28; DSA group vs 50%, 14/28; CTA group) and atherosclerosis more frequently (43%, 12/28; DSA group vs 36%, 10/28; CTA group) when compared to CTA. Inter-rater correlation for the two DSA readers (κ=0.86, p Conclusion CTA and DSA should be preferred imaging modalities to diagnose and characterize carotid webs. Disclosures T. Madaelil: None. R. Nogueira: None. J. Grossberg: None. A. Anderson: None. C. Barreira: None. D. Haussen: None.
Congenital pseudarthrosis of the clavicle: surgical decision making and outcomes.

Background Congenital pseudarthrosis of the clavicle (CPC) is a rare entity in which the primary ossification center of the clavicle fails to coalesce. The natural history of CPC is unknown, and there is controversy regarding surgical vs. conservative treatment. Methods A retrospective review of 47 pediatric patients treated for CPC was performed. The Quick Disabilities of the Arm and Shoulder (QuickDASH) survey and the Patient Reported Outcomes Measurement Information System (PROMIS) upper extremity domain were used to assess overall patient satisfaction, function, and quality of life after treatment. Results Twenty-four of 47 (51%) patients underwent surgical treatment. Of these, 9 patients (38%, 9/24) underwent surgery at Conclusions This series of CPC patients improves our understanding of treatment options and outcomes of surgical treatment. All surgical patients had resolution of preoperative symptoms. Patients treated surgically with stable fixation at an older age had higher rates of union than those treated in infancy with suture fixation. Patient-reported outcomes were favorable overall.
Multidisciplinary Team Utilizing Pharmacists in Multimodal, Bundled Care Reduce Chronic Obstructive Pulmonary Disease Hospital Readmission Rates.

Background:Chronic obstructive pulmonary disease (COPD) is a major contributor of morbidity and mortality in the United States resulting in high hospitalization and readmission rates. For health sy...
Unpacking Trial Offers and Low Accrual Rates: A Qualitative Analysis of Clinic Visits With Physicians and Patients Potentially Eligible for a Prostate Cancer Clinical Trial

PURPOSE:Cancer clinical trial accrual rates are low, and information about contributing factors is needed. We examined video-recorded clinical interactions to identify circumstances under which pat...
Early discharge after free-tissue transfer does not increase adverse events.

Abstract Introduction Demonstrate that carefully selected free flap patients may be discharged early after surgery without increasing the rates of postoperative complications or readmissions. Methods Based on a published article in Laryngoscope 2016 of 51 free-tissue transfers, a retrospective chart review was performed on an expanded cohort who underwent free-tissue transfer for head and neck reconstruction between February 2010 and May 2018 and discharged by postoperative day 3. Results 101 patients who underwent 104 free flaps with average age of 56 (3–84) years old were reviewed. Free flap indications included orbital and maxillary defects (n = 22), palatal defects (n = 16), nasal and septal defects (n = 16), cranioplasty and scalp defects (n = 16), mandibular defects due to osteoradionecrosis (n = 14), facial contouring and parotid defects (n = 12), and complex postsurgical and radiotherapy wounds or fistula closure (n = 8). Free flaps performed were anterolateral thigh (n = 97), radial forearm (n = 2), serratus (n = 2), latissimus (n = 1), fibula (n = 1) and supraclavicular (n = 1). The recipient vessels used via minimal access approaches were facial (n = 43), superficial temporal (n = 29), angular (n = 20) and others. There were 3 flap failures (2.9%) recognized in follow-up. No flap failures or perioperative complications were associated with early discharge. There were only 2 patients readmitted and 1 watched in observation within 30 days postoperatively. Conclusion An updated review of our institutional experience with more than double the cohort size substantiates previous conclusions that early discharge after free-tissue transfer is a safe option in select patients. Moreover, earlier discharge is a critical management choice that reduces cost and decreases hospital-related adverse events.
Chapter 3 – Convex Functions

Convexity plays a central role in economic models. It is a strong property of a real-valued function because it implies continuity and existence of one-sided gradients on the interior of the domain, and existence of gradients almost everywhere. A function is convex on an open set if and only if the tangents of the function lie everywhere below the function. When a function is also homogeneous, as in some economic models, the tangents pass through the origin. When a function has a Hessian everywhere, the function is convex if and only if the Hessian is positive semidefinite everywhere. Some functions that arise in economic models have a weaker property called quasiconvexity. A function is quasiconvex if and only if its lower contour sets are convex.
Chapter 14 – Chemically Bonded Phosphate Ceramic Matrix Composites

Publisher Summary This chapter deals with the chemically bonded phosphate ceramic matrix composites. Sintered ceramics have been in use as structural products since the beginning of human culture. Ceramics are also modern technological materials, especially in high temperature applications, and hence ceramic science is an active field of research even today. Sintering of these ceramics, however, is energy intensive and expensive, when large sizes are sintered. The alternative is chemical bonding. Moreover, ceramics exhibit superior mechanical properties compared to cement. Ceramics are far more stable in acidic and high temperature environments. The chapter provides information where various other waste streams can be incorporated in Ceramicrete to produce useful ceramic matrix composites. This chapter also discusses case studies on swarfs and red mud. The most common metal swarfs are iron-based and produced by the machine tool and automobile industries.
Procedure Training Workshop for Internal Medicine Residents that Emphasizes Procedural Ultrasound: Logistics and Teaching Materials.

Introduction Early formal instruction in procedural skills may increase the frequency with which residents perform procedures in the clinical setting. This workshop trained internal medicine reside...
The case of common humanity: Towards a deeper understanding of children’s social ideas

Developmental research has long sought to understand children’s social ideas, and particularly how those ideas influence their judgments and behaviors toward other people. We examine the idea of co...
Characterization of long period return values of extreme daily temperature and precipitation in the CMIP6 models: Part 1, model evaluation

Using a non-stationary Generalized Extreme Value statistical method, we calculate selected extreme daily temperature and precipitation indices and their 20 year return values from the CMIP5 and CMIP6 historically forced climate models. We evaluate model performance of these indices and their return values in replicating similar quantities calculated from gridded land based daily observations. We find that at their standard resolutions, there are no meaningful differences between the two generations of models in their quality of simulated extreme daily temperature and precipitation.
SCUBE1 Controls BMPR2-Relevant Pulmonary Endothelial Function: Implications for Diagnostic Marker Development in Pulmonary Arterial Hypertension

Utilizing publicly available ribonucleic acid sequencing data, we identified SCUBE1 as a BMPR2-related gene differentially expressed between induced pluripotent stem cell-endothelial cells derived from pulmonary arterial hypertension (PAH) patients carrying pathogenic BMPR2 mutations and control patients without mutations. Endothelial SCUBE1 expression was decreased by known triggers of PAH, and its down-regulation recapitulated known BMPR2-associated endothelial pathophenotypes in vitro. Meanwhile, SCUBE1 concentrations were reduced in plasma obtained from PAH rodent models and patients with PAH, whereas plasma concentrations were tightly correlated with hemodynamic markers of disease severity. Taken together, these data implicate SCUBE1 as a novel contributor to PAH pathogenesis with potential therapeutic, diagnostic, and prognostic applications.
Early palliative radiation versus observation for high-risk asymptomatic or minimally symptomatic bone metastases: study protocol for a randomized controlled trial

In patients with metastatic cancer, the bone is the third-most common site of involvement. Radiation to painful bone metastases results in high rates of pain control and is an integral part of bone metastases management. Up to one-third of inpatient consults are requested for painful bone metastases, and up to 60% of these patients had evidence of these lesions visible on prior imaging. Meanwhile recent advances have reduced potential side effects of radiation. Therefore, there is an opportunity to further improve outcomes for patients using prophylactic palliative radiation to manage asymptomatic bone metastases. In this trial, 74 patients with metastatic solid tumors and high-risk asymptomatic or minimally symptomatic bone metastases will be enrolled and randomized to early palliative radiation or standard of care. This will be the first trial to assess the efficacy of prophylactic palliative radiation in preventing skeletal related events (SREs), the primary endpoint. This endpoint was selected to encompass patient-centered outcomes that impact quality of life including pathologic fracture, spinal cord compression, and intervention with surgery or radiation. Secondary endpoints include hospitalizations, Bone Pain Index, pain-free survival, pain-related quality of life, and side effects of radiation therapy. In this study, we propose a novel definition of high-risk bone metastases most likely to benefit from preventive radiation and use validated questionnaires to assess pain and impact on quality of life and health resource utilization. Observations from early patient enrollment have demonstrated robustness of the primary endpoint and need for minor modifications to Bone Pain Index and data collection for opioid use and hospitalizations. With increasing indications for radiation in the oligometastatic setting, this trial aims to improve patient-centered outcomes in the polymetastatic setting. ISRCTN Number/Clinical trials.gov, ID: NCT03523351 . Registered on 14 May 2018.
“This Heavy Thing”: Catherine the Great’s Coronation Crown

After seizing power in 1762, Catherine II organized the most extravagant coronation money could buy. To add to the splendour, she placed a rush order for a crown. With carte blanche to use luxuriou...
Sound source localizations using various microphone arrays

Estimating directions of arrival (DoAs) of multiple sound events still posts challenges in acoustic source localization. This paper reviews recent development on model-based direction-of-arrival analysis using three different microphone array configurations, in situations involving potentially multiple concurrent sound sources. The array configurations include a sparse arrangement consisting of two microphones, coprime linear microphone arrays, and spherical microphone arrays. Formulation and evaluation of prediction models are of central importance in coping with these challenges. These three array configurations are all used to solve a two-level inferential problem of sound source enumeration and direction of arrival estimation. The prediction models based on specific array configurations are evaluated upon experimental data derived from pertinent array processing in order to select the simplest such model that can adequately describe the experimental data, thereby enumerating first the concise number of sound sources, then their DoA information. This paper reviews the prediction models recently established for the three microphone arrays, the two levels of inference, and analysis results. This paper will highlight the importance of the prediction models for the model-based analysis of complex sound environments with potentially multiple concurrent sources.
Latent functional connectivity underlying multiple brain states

Abstract Functional connectivity (FC) studies have predominantly focused on resting state, where ongoing dynamics are thought to primarily reflect the brain’s intrinsic network architecture, which is thought to be broadly relevant to brain function because it persists across brain states. However, it is unknown whether resting state is the optimal state for measuring intrinsic FC. We propose that latent FC, reflecting patterns of connectivity shared across many brain states, may better capture intrinsic FC relative to measures derived from resting state alone. We estimated latent FC in relation to 7 highly distinct task states (24 task conditions) and resting state using fMRI data from 352 participants from the Human Connectome Project. Latent FC was estimated independently for each connection by applying leave-one-task-out factor analysis on the state FC estimates. Compared to resting-state connectivity, we found that latent connectivity improves generalization to held-out brain states, better explaining patterns of both connectivity and task-evoked brain activity. We also found that latent connectivity improved prediction of behavior, measured by the general intelligence factor psychometric g. Our results suggest that patterns of FC shared across many brain states, rather than just resting state, better reflects general, state-independent connectivity. This affirms the notion of “intrinsic” brain network architecture as a set of connectivity properties persistent across brain states, providing an updated conceptual and mathematical framework of intrinsic connectivity as a latent factor.
Rapid and sustained decline in CXCL-10 (IP-10) annotates clinical outcomes following TNFα-antagonist therapy in hospitalized patients with severe and critical COVID-19 respiratory failure.

Background: A feedforward pathological signaling loop generated by TNFα and IFN-γ synergy in the inflamed lung, driving CXCL-10 (IP-10) and CXCL-9 chemokine-mediated activated T-cell and monocyte/macrophage tissue recruitment, may define the inflammatory biology of lethal COVID-19 respiratory failure. Methods: To assess TNFα-antagonist therapy, 18 hospitalized adults with hypoxic respiratory failure and COVID-19 pneumonia received single-dose infliximab-abda therapy 5 mg/kg intravenously between April and December 2020. The primary endpoint was time to increase in oxygen saturation to fraction of inspired oxygen ratio (SpO2/FiO2) by ≥50 compared to baseline and sustained for 48 h. Secondary endpoints included 28-day mortality, dynamic cytokine profiles, secondary infections, duration of supplemental oxygen support, and hospitalization. Findings: Patients were predominantly in critical respiratory failure (15/18, 83%), male (14/18, 78%), above 60 years (median 63 years, range 31–80), race-ethnic minorities (13/18, 72%), lymphopenic (13/18, 72%), steroid-treated (17/18, 94%), with a median ferritin of 1953 ng/ml. Sixteen patients (89%) met the primary endpoint within a median of 4 days; 14/18 (78%) were discharged in a median of 8 days and were alive at 28-day follow-up. Three deaths were attributed to secondary lung infection. Mean plasma IP-10 levels declined sharply from 9183 to 483 pg/ml at Day 3 and 146 pg/ml at Day 14/discharge. Significant Day 3 declines in IFN- , TNFα, IL-27, CRP, and ferritin occurred. IP-10 and CXCL-9 declines were strongly correlated among patients with lymphopenia reversal (Day 3, Pearson r: 0.98, P-value 0.0006). Interpretation: Infliximab-abda may rapidly abrogate pathological inflammatory signaling to facilitate clinical recovery in severe and critical COVID-19.
Seeking recognition through carceral health care bureaucracy: Analysis of medical care request forms in a County Jail.

Abstract People experiencing incarceration in the U.S. have a constitutional right to have access to health care. Yet actualizing this right is constrained by the everyday reality of an environment designed to punish and limit autonomy. The principal means for accessing health care in a carceral facility is for an individual to submit a written request, which then gets handled through the jail's bureaucratic processes. In this paper, we provide quantitative and qualitative analyses of the content and circulation of one month of these written requests—called “medical care request” (MCR) forms—at an urban, U.S. jail to understand the meanings of health and health care for a group of individuals who are systematically marginalized. In one month in 2012 at this jail housing 140 individuals, 527 MCRs were submitted. We coded requests into categories: medications, amelioration of living conditions, specific symptoms, and requests for a specific health care service. The most common request was for pain medication. In qualitative analysis, four key themes emerged: reliance on the clinic to mediate the needs of daily life; deservingness of health care; hyperawareness of bodily and psychic discomfort; and temporal techniques for asserting control over individuals' time and bodies in jail. We show that MCRs are a key mechanism through which incarcerated individuals seek recognition of their physical and psychic suffering, and more broadly, of their very existences. When considered in the broader context of controlling carceral regimes and health inequities that characterize U.S. society, MCRs become dynamic terrain through which jail health care providers and incarcerated people negotiate the tensions of deservingness of care.
Association of COVID-19 mortality with politics and on-demand testing in 217 U.S. counties.

BACKGROUND Previous research found increased COVID-19 spread associated with politics and on-demand testing but not in the same study. The objective of this study is to estimate the contribution of each corrected for the other and a variety of known risk factors. METHODS Using data from 217 U.S. counties of more than 50,000 population where testing data were available in April, 2021, the associations of COVID-19 deaths with politics, testing and other risk factors were examined by Poisson and least squares regression. RESULTS Statistical controls for 15 risk factors failed to eliminate the association of COVID mortality risk with percent of vote for Donald Trump in 2016 or negative tests per population. Each is independently predictive of increased mortality. CONCLUSION Apparently, many people who test negative for the SARS-CoV-2 virus engage in activities that increase their risk, a problem likely to increase with the availability of home tests. There is no association of negative tests with the Trump vote but, according to polling data, Trump voters' past resistance to public health recommendations has been extended to resistance to being vaccinated, threatening the goal of herd immunity.
Traveling-Gust Method for Airfoils in Strong Blast Waves

The only device that will maintain constant chamber pressure under all throttling conditions is that engine where the ratio At/Ai is designed to remain constant. The only limitation of this system is that imposed by expansion conditions. This may possibly be remedied by incorporating a "plug" nozzle in the design. Thus the ratio Ae/Ai will also be constant, where Ae is exit flow area for a "plug" nozzle. This engine will have constant specific impulse under all operating conditions and will be capable of thrust variations of any degree.
Utilization of Potash in Agriculture

By far the majority of the world’s potash production is utilized in agriculture. Over 97% of all potash is sold to improve the world’s food, fiber and other farm output. Potassium is one of the three major plant nutrients, and as such must be added to all intensive farming soils in comparatively large amounts for high crop production. Once the soil becomes depleted of any of the 16 or so necessary plant nutrients each must be added in equal amounts to the plants’ uptake. With all but the three major nutrients, nitrogen, phosphorus and potassium, however, the quantities are somewhat less, or very small (they are called secondary or micronutrients). Nitrogen may be provided to the soil through crop rotation and the action of legumes with their root nodules’ nitrogen (from the air)-fixing bacteria. However, the phosphate and potassium must either be in the soil or supplied externally in the amount required by the plant. Many potash-containing minerals such as clay, feldspar and mica are found naturally in soils. Some of their potassium content becomes available to plants with weathering, and consequently many soils have been slow to become depleted in potash. Consequently, the addition of potash may not be as demanding as the other nutrients with some crops or soils. Also, the placement of the potash is important in many soils since the potassium may be ion exchanged with clays or organic matter near the surface, and thus not be very mobile.