cssi/SciSciGPT-SciSciNet huggingface dataset:
Intensive care aspects of organ transplantation in children.

This article discusses the medical management of children receiving kidney and liver transplants. Postoperative fluid management, monitoring of immunosuppressive therapy, and infection surveillance are covered in detail.
Revision of Failed Primary Agility and Agility LP Total Ankle Replacements

The Agility and Agility LP Total Ankle Replacement Systems were the most frequently implanted prosthesis in the USA for over a decade prior to falling into disuse and ultimately being abandoned. Therefore, it is reasonable to assume that surgeons unfamiliar with primary implantation of the Agility and Agility LP Total Ankle Replacement Systems will encounter patients with failure of these prostheses that would benefit from revision. Unfortunately, at present there are no “standard principles” associated with revision of the Agility and Agility LP Total Ankle Replacement Systems. What is clear is that the current approaches are technically complex and fraught with complications, and no one approach represents the only answer. Exchange of the metallic components to LP or revision components is a viable option with limited occurrence of complications. Explantation and conversion to custom-design long-stemmed components have proven effective in the short term but are not currently available in the USA. Explantation and conversion to another total ankle replacement system are high risk and have strong potential for complications. The use of metal-reinforced polymethylmethacrylate cement augmentation, tibio-talo-calcaneal arthrodesis with or without bulk allograft, and below-knee amputation should be reserved for very select situations where other options are not possible. Given the anticipated volume of patients with retained Agility and Agility LP Total Ankle Replacement Systems in the USA, there is a real need for long-term survivorship following revision of these prostheses and future efforts ought to be directed in this area.
Placemaking as an Economic Development Strategy for Small and Midsized Cities

Economic development strategies aimed at attracting highly skilled workers through investment in urban amenities are gaining momentum throughout the United States. However, most of the foundational research for the approach was tested in very large cities, both in the United States and abroad. Based on quality of place (QOP) variables suggested from previous research, confirmatory factor analysis was used to generate a set of factors for a selection of small and midsized U.S. cities, and linear regression was used to relate these factors to the presence of college-educated populations, younger college-educated populations, and adult population growth. The results indicated that some of the QOP factors associated with better human capital outcomes in prior literature focusing on larger cities were also significant predictors of better human capital outcomes in midsized cities. The relationship between these factors and development outcomes for small cities was much weaker.
The role of ΔfosB in the medial preoptic area: Differential effects of mating and cocaine history.

The transcription factor deltaFosB (ΔFosB) is induced in the nucleus accumbens (NAc) by repeated exposure to drugs of abuse and natural rewards. Less is known about its role in other brain areas. Here, we compared the effects of mating versus cocaine history on induction of ΔFosB in the medial preoptic area (MPOA), an integral site for reproductive behavior, and in the NAc. ΔFosB immunoreactivity (ir) was increased in the MPOA of previously naive and experienced male rats that mated the day before euthanasia, compared to unmated controls and experienced males with recent mating abstinence. Western immunoblots confirmed that the 35-37-kDa isoform of ΔFosB was increased more in recently mated males. Conversely, previous plus recent cocaine did not increase ΔFosB-ir in the MPOA, despite an increase in the NAc. Next, a viral vector expressing ΔFosB, its dominant negative antagonist ΔJunD, or green fluorescent protein (GFP) control, were microinjected bilaterally into the MPOA. ΔFosB overexpression impaired copulation and promoted female-directed aggression, compared to ΔJunD and control males. These data suggest that ΔFosB in the mPOA is expressed in an experience-dependent manner and affects systems that coordinate mating and aggression. (PsycINFO Database Record
Unified ranked sampling

Abstract A class of ranked sample methodologies is presented, which unifies the existing methods of ranked set sampling and judgment post-stratification. This general class contains many new, promising methods and allows future ranked sampling techniques to be developed with greater scope.
What Is the Relevance of Procedural Fairness to Making Determinations about Medical Evidence

Approaches relying on fair procedures rather than substantive principles have been proposed for answering dilemmas in medical ethics and health policy. These dilemmas generally involve two questions: the epistemological (factual) question of which benefits an intervention will have, and the ethical (value) question of how to distribute those benefits. This article focuses on the potential of fair procedures to help address epistemological and factual questions in medicine, using the debate over antidepressant efficacy as a test case. In doing so, it employs concepts from social epistemology such as testimonial injustice (bias resulting from the exclusion of evidence) and hermeneutical injustice (bias resulting from a prevailing discussion framework's conceptual limitations). This article also explores the relevance of scientific consensus to determinations regarding medical evidence.
Strategies for Educators of Bilingual Students: A Critical Review of Literature.

The education of bilingual students is a rather popular topic among educators in today's schools. Frequently, articles and research focus upon a singular phenomenon or strategy in this field. This literature review is aimed at providing teachers of students of all grade levels and ages with a guide containing prevalent theories and ideas related to providing high quality instruction to students with bilingual backgrounds. Educational practices such as translanguaging and the integration of biliteracy can assist students in using their native tongues along with the dominant language of their given settings. Additionally, the usage of cooperative groups and language buddies not only creates a sense of “fitting in” for new bilinguals, but also recognizes the ideology that young learners will learn the social aspects of a new language prior to learning the more academic and formalized version of speaking. Both new and experienced teachers would benefit from training that relates to these culturally responsive teaching strategies. There are also sections within this piece that promote the usage of community and parent outreach methods that aim to improve the school experience for all involved parties. The overarching goal of this literature review is providing teachers with a variety of literature connected to relevant theory and useful strategies that could potentially assist them in better understanding bilingual students, as well as enhance their overall knowledge base of this subject matter.
Investigation of Pain Mechanisms by Calcium Imaging Approaches

Due to the complex circuitry and plethora of cell types involved in somatosensation, it is becoming increasingly important to be able to observe cellular activity at the population level. In addition, since cells rely on an intricate variety of extracellular factors, it is important to strive to maintain the physiological environment. Many electrophysiological techniques require the implementation of artificially-produced physiological environments and it can be difficult to assess the activity of many cells simultaneously. Moreover, imaging Ca2+ transients using Ca2+-sensitive dyes often requires in vitro preparations or in vivo injections, which can lead to variable expression levels. With the development of more sensitive genetically-encoded Ca2+ indicators (GECIs) it is now possible to observe changes in Ca2+ transients in large populations of cells at the same time. Recently, groups have used a GECI called GCaMP to address fundamental questions in somatosensation. Researchers can now induce GCaMP expression in the mouse genome using viral or gene knock-in approaches and observe the activity of populations of cells in the pain pathway such as dorsal root ganglia (DRG), spinal neurons, or glia. This approach can be used in vivo and thus maintains the organism’s biological integrity. The implementation of GCaMP imaging has led to many advances in our understanding of somatosensation. Here, we review the current findings in pain research using GCaMP imaging as well as discussing potential methodological considerations.
Spatial and Temporal Variations in Characteristic Ratios of Elemental Carbon to Carbon Monoxide and Nitrogen Oxides across the United States

A ratio-based method is used to characterize anthropogenic elemental carbon (ECa) using in situ measurements and emissions of carbon monoxide (CO) and nitrogen oxides (NOx). We use long-term records of ground-based measurements from the U.S. Environmental Protection Agency (EPA) Air Quality System and Interagency Monitoring of Protected Visual Environments to assess the patterns in anthropogenic combustion ratios (ΔECa/ΔCO and ΔECa/ΔNOx) across the U.S. Petroleum Administration for Defense Districts (PADD) regions for the years 2000–2015. We investigate the change in these ratios between the periods 2000–2007 and 2008–2015. Overall, ΔECa/ΔCO ratios increase by 0.7–82% and ΔECa/ΔNOx by 6.8–104% across the East and West PADD regions. The urban West showed the largest increase relative to other regions. This is mainly attributed to a 13–23% increase in ΔECa during the winter and fall seasons and significant reductions in urban ΔNOx (except in winter). We also find that emission ratios derived from the EPA’s ...
Abstract 150: Association Between Serum Ghrelin Levels and Coronary Artery Disease: a Meta-analysis

Background: Ghrelin (GH) is a gastrointestinal endocrine peptide regulating multiple biological processes including adipogenesis, glucose metabolism, cell differentiation and proliferation. Recent studies demonstrated that GH inhibits pro-atherogenic changes in vessel wall via inhibition of nuclear factor - B activity, a transcriptional factor mediating production pro-inflammatory cytokines and adhesion molecule expression in the endothelium. The aim of the current study is to conduct a meta-analysis to evaluate the relationship between serum GH levels and coronary artery disease (CAD). Methods: We searched MEDLINE, CINHAL and COCHRANE databases for studies reporting serum GH levels in the CAD and non CAD study population. We included case controls, cohort and cross-sectional studies. We calculated the weighted standardized mean difference (SMD) in serum GH levels between the CAD and control groups. Results: Our search strategy yielded 285 articles and we included 10 studies enrolling 1855 participants. The median age of the CAD group was 62 yrs. (IQR 60 - 63) compared to 61 yrs. (IQR 58 - 65) in the control group. The median body mass index in the CAD group was 28 kg/m2 (IQR 27.9 - 28) compared to 27 kg/m2 (IQR 26 - 27) in the control group. The unweighted median serum GH levels in the CAD group were 0.66 ng/ml (IQR 0.3 - 1.6) compared to 0.76 ng/ml (IQR 0.38 - 4.9) in the control group. The SMD of GH level was -0.44 (95% CI -0.56,-0.31) p Conclusion: Serum GH levels are significantly and inversely associated with CAD. Current findings warrant the need to further investigate the role of GH in the pathogenesis of CAD.
Universal Telephone Service & Rural America

The cost of providing local telephone service in many rural areas greatly exceeds rates billed to customers. The Bell companies and other large independent local carriers overcome high rural costs by averaging rates between urban to rural markets. Smaller carriers with largely rural markets are supported through explicit subsidies funded through levies on interstate voice services. We use Decennial Census data at the census block group level to assess the comparative performance of different classes of carrier in rural areas, and to compare the effectiveness of different policy measures. Telephone penetration has grown significantly since 1990, and the greatest gains are among historically disadvantaged groups. The efficacy of all universal service subsidies is low and declining over time as the programs themselves have grown. Support targeted to individuals remains more effective than support for high cost companies, even in rural areas. Independent carriers' subscribership rates lag the Bell carriers, although the deficit has narrowed significantly since 1990. Rural areas, whether served by Bell companies or Independents, have seen greater subscribership gains since 1990 than urban areas.
The properties of the unique age-associated B cell subset reveal a shift in strategy of immune response with age.

In aged mice, conventional naive B cells decrease and a new population of age-associated B cells (ABC)3 develops. When aged unprimed mice are infected with influenza virus, there is a reduced generation of helper CD4 T cell subsets and germinal center B cells, leading to limited production of IgG Ab and less generation of conventional long-lived plasma cells, compared to young. However, we find an enhanced non-follicular (GL7−) ABC response that is helper T cell-independent, but requires high viral dose and pathogen recognition pathways. The infection-induced ABC (iABC) include IAV-specific Ab-secreting cells, some of which relocate to the bone marrow and lung, and persist for >4 wk., suggesting they may provide significant protection. We also speculate there is a shift with increased age to dependence on TLR-mediated pathogen-recognition in both B and CD4 T cell responses.
Probabilistic sequence alignment methods for on-line score following of music performances

Existing systems for automated accompaniment of musical performers assume every performance note is specified in advance in a written score. Musical styles such as Jazz and Blues often use scores that specify only main harmonies, overall structure, and important melodies. The exact realization of the score varies greatly from performance to performance. For such music, a system must be able to handle performances that start anywhere in the form of the score, repeat or skip sections any number of times, play at unexpected tempi, and contain improvisations over the harmonic structure of the piece, without necessarily performing the written melody (such as during a Jazz solo). This dissertation describes the techniques I developed for following semi-improvised music: extensions of existing string matching and HMM score following techniques; improved score representation; a new method of integrating beat tracking and score following; a new chord transcription system that infers chords from varied surface instantiations of notes; and new training methods that let the system train its error models one set of scores and performances and thereafter follow performances of pieces on which the system has not been trained. Experimental results in the paper show that the system is able to correctly label chords in improvised performances roughly 75% of the time (the exact value depends on the test corpus). Training the system to a performer's individual style lets the system correctly align the chord sequence inferred from the performance to the score, with a resolution of one or two beats (depending on the test set). This result can be achieved by training the system with as few as five example score-performance pairs. Once trained, the system can follow new performances and scores without additional training, achieving results as good as those achieved for the training set.
Integrating coupled magnetoelastic sensors onto a flexible hernia mesh for high dynamic range strain measurements

Despite better performance over primary repairs, tension-free ventral hernia repairs with mesh still suffer from a high recurrence rate. High stress gradients in the mesh are thought to contribute to hernia recurrence. We propose a postoperative monitoring system based on a coupled pair of magnetoelastic strain sensors to enable patients and physicians to non-invasively measure and track the strain distribution across the hernia mesh. Our design combines an encased resonator with a spring-loaded transducer to achieve high signal amplitude with a wide dynamic range. We also demonstrate a fabrication protocol to integrate the resonant strain sensors with a commercial polypropylene mesh. The packaged sensor is capable of detecting up to 37.5 millistrain, an order of magnitude greater than previously demonstrated.
Negative Urgency Mediates the Relation Between Genetically Influenced Serotonin Functioning and Alcohol Problems

Serotonin (5-HT) functioning is associated with alcohol problems. However, the mechanisms underlying this association remain unclear. In the current study the authors tested whether five separate d...
A PMU-data-driven disruptive event classification in distribution systems

Abstract With the proliferation of micro-phasor measurement units (μPMU) and PMUs in smart grids, time-synchronized high-resolution measurements can be obtained and used for numerous applications such as state estimation and event analysis. Disruptive events frequently occur in power grids and interrupt the normal operation of the system and may eventually cause the permanent failure of equipment. Therefore, establishing a data-driven event diagnostic framework to extract useful information such as the cause or location of events is of utmost importance. The disruptive events may not cause immediate and direct failure. However, they are a potential source for permanent equipment failure over time. Accurate disruptive event analysis is beneficial in terms of time, maintenance crew utilization, and future outages prevention. In this paper, a PMU data-driven framework is proposed to distinguish two disruptive events, i.e., malfunctioned capacitor bank switching and malfunctioned regulator on-load tap changer (OLTC) switching from two normal operating events i.e., the normal abrupt load change and the reconfiguration in distribution grids. The event classification is formulated using a neural network based algorithm, i.e., autoencoders along with softmax classifiers. The performance of the proposed framework is verified using the simulation of the events on the modified IEEE 123-bus distribution test system. The end results of this paper demonstrate the effectiveness of the proposed algorithm and satisfactory classification accuracies under several conditions such as different PMU reporting rates, different measurement noise levels, different number of PMUs, and boosting scenario.
Molecular diagnosis of antimicrobial resistance in Escherichia coli.

ABSTRACTIntroduction: Antimicrobial resistance is a growing global public health threat. The complexities of antimicrobial resistance in gram-negative bacteria such as Escherichia coli pose significant diagnostic and therapeutic challenges. Molecular diagnostics are emerging in this field.Areas covered: The authors review the clinical importance of pathogenic E. coli and discuss the mechanisms of resistance to common antibiotics used to treat these infections. We review the literature on antimicrobial susceptibility testing and discuss the current state of phenotypic as well as molecular methodologies. Clinical vignettes are presented to highlight how molecular diagnostics may be used for patient care.Expert commentary: The future use of molecular diagnostics for detection of antimicrobial resistance will be tailored to the context, whether hospital epidemiology, infection control, antibiotic stewardship, or clinical care. Further clinical research is needed to understand how to best apply molecular diagn...
Tribological Insensitivity of an Ultralow-Wear Poly(etheretherketone)–Polytetrafluoroethylene Polymer Blend to Changes in Environmental Moisture

The tribological properties of most high functioning tribological materials, including diamond, graphite, molybdenum disulfide, and polytetrafluoroethylene, depend strongly on environmental moistur...
Infant follow-up postdelivery from a hepatitis C viral load positive mother.

Objective: The primary current recommendation for infant follow-up postdelivery from a hepatitis C virus (HCV) viral load positive mother is to evaluate for the presence of antibody at or after 18 ...
Mapping Jerusalem: Re-reading the City in the Context of the Medieval Mediterranean

Boyadjian offers a comparative study of medieval Jerusalem by challenging antagonistic approaches to the crusades and using the Mediterranean as a larger framework for analysis. The chapter draws attention to three texts from the early crusading period—the history of Ibn al-Athir, the chronicle of Fulcher de Chartres, and the lament over Jerusalem composed by the Armenian High Patriarch Grigor Tghay—critically arguing that these ethno-religious traditions shape their representations of Jerusalem through the city’s sacred character, its contested status, and the mapping of a geotopographical space which produces a Jerusalem respective to each individual tradition.
WHEN ATHLETIC VICTORY AND FATHERHOOD DID MIX: THE COMMEMORATION OF DIAGORAS OF RHODES

The fame of the great boxer Diagoras of Rhodes was intimately, and uniquely, bound up with the fame of his children: for no other classical or archaic victor were his children so central to his own commemoration. This paper will explore that centrality, showing the extent to which Diagoras’ portrayal across all media — not only in epinician and sculptural dedications, but also in the oral tradition — was unique in emphasizing his status as a father, and seek to explain the choice. I will argue that the portrayal of Diagoras as a father, subject to the normal biological rhythms of life, signified a particular type of politics that favored networking and connections between cities, promoting, in particular, the synoecism of Rhodes’ three cities.
L p (1≤p≤∞) BLIND ADAPTIVE DECONVOLUTION AND ITS APPLICATIONS

ABSTRACT The conditions for applying the convex cost functions, L 1 , L p (P>1) and L ∞ to the blind deconvolution of general non-minimum phase AR(u) models are studied. A simple and realizable constraint is proposed for the L ∞ deconvolution. With this constraint, except for a gain, the model parameter is the unique solution of the L ∞ deconvolution. The strong consistency of the estimator of the model parameter defined by the sample version of L ∞ norm is presented. An adaptive algorithm is suggested for the iterative computation of the estimator. Simulation examples show the proposed approach works well for the blind equalization problem.
Some Classical Approaches to the Problems of Intentionality and Intensionality

In this chapter we begin to explore systematic ways of explaining how and why intentional phenomena come to exhibit the characteristics they do. To give such a systematic and explanatory account is the purpose of a theory of intentionality.
The Cone Condition

Theorem 7.1 left us with the following problem: let E be a compact set, \(\bar \mu\) its equilibrium distribution with \(U^{\bar \mu } = \gamma\) p.p. on E, and Ẽ the exceptional set, i.e., $$\tilde E = \{ x \in E|U^{\bar \mu } (x) < \gamma \} .$$
The Frontal Lobes

It appears that the human prefrontal regions have emerged over the years to distinguish themselves among the cerebral cortical structures as those most elusively resistant to neurocognitive analyses. Although a very substantial number of clinical observations based on human patients suffering from severe prefrontal injury have accumulated in the literature within the last century, theories of prefrontal functioning proving consistently applicable and reasonably unifying have not, until relatively recently, evolved.
Mental Disability and Social Value in Michelle Cliff’s Abeng

Michelle Cliff’s 1984 novel Abeng critiques harmful reactions to madness and mental disability in colonial and postcolonial Jamaican society while also opening space for the inclusion and valuing of someone with a mental disability. In this chapter, Holladay examines four central characters in Abeng who have a mental disability and bear its stigma. Cliff’s portrayal of these disabled characters reveals a new picture of difference and creolite in Caribbean literature, showing that disability can serve as a productive analytical lens interconnected with issues of race, gender, and class. Abeng shows us that mental disability, and disability more generally, should be recognized as an essential part of the global project of social justice.
Distinct Bone Marrow Sources of Pleiotrophin Control Hematopoietic Stem Cell Maintenance and Regeneration

Bone marrow (BM) perivascular stromal cells and vascular endothelial cells (ECs) are essential for hematopoietic stem cell (HSC) maintenance, but the roles of distinct niche compartments during HSC regeneration are less understood. Here we show that Leptin receptor-expressing (LepR+) BM stromal cells and ECs dichotomously regulate HSC maintenance and regeneration via secretion of pleiotrophin (PTN). BM stromal cells are the key source of PTN during steady-state hematopoiesis because its deletion from stromal cells, but not hematopoietic cells, osteoblasts, or ECs, depletes the HSC pool. Following myelosuppressive irradiation, PTN expression is increased in bone marrow endothelial cells (BMECs), and PTN+ ECs are more frequent in the niche. Moreover, deleting Ptn from ECs impairs HSC regeneration whereas Ptn deletion from BM stromal cells does not. These findings reveal dichotomous and complementary regulation of HSC maintenance and regeneration by BM stromal cells and ECs.
Contrasting effects on deep convective clouds by different types of aerosols

Convective clouds produce a significant proportion of the global precipitation and play an important role in the energy and water cycles. We quantify changes of the convective cloud ice mass-weighted altitude centroid (ZIWC) as a function of aerosol optical thickness (AOT). Analyses are conducted in smoke, dust and polluted continental aerosol environments over South America, Central Africa and Southeast Asia, using the latest measurements from the CloudSat and CALIPSO satellites. We find aerosols can inhibit or invigorate convection, depending on aerosol type and concentration. On average, smoke tends to suppress convection and results in lower ZIWC than clean clouds. Polluted continental aerosol tends to invigorate convection and promote higher ZIWC. The dust aerosol effects are regionally dependent and their signs differ from place to place. Moreover, we find that the aerosol inhibition or invigoration effects do not vary monotonically with AOT and the variations depend strongly on aerosol type. Our observational findings indicate that aerosol type is one of the key factors in determining the aerosol effects on convective clouds.
CAREGIVER STRESS THEORY MAY EXPLAIN ELDER ABUSE BUT NOT NEGLECT IN DEMENTIA FAMILY CAREGIVING

The caregiver stress theory is suggested as a causal theory for physical and psychological elder abuse (EA) and neglect within dementia, due to the high rate of behavioral symptoms of dementia (BSD) and caregiver stress. The purpose of this micro-longitudinal study is to evaluate the caregiver stress theory among a sample of dementia family caregivers who co-reside with their care-recipient. Participants completed online diary surveys for 21 days. Using multi-level modeling of diaries (N=681) nested within participants (N=46), BSD behaviors (aggressive and non-aggressive agitation) and perceived stress were examined as predictors of EA and neglect. On days with non-aggressive BSD behaviors compared to no BSD, the odds of self-report EA were 2.5 times greater (CI 1.04–5.89, p = 0.03), while on days with both non-aggressive and aggressive BSD the odds of EA were 26.9 times greater (CI 9.62–75.15, p < 0.001). For neglect, non-aggressive BSD alone did not increase risk but when they co-occurred with aggressive BSD the odds increased by 5.3 (CI 1.7–16.71, p < 0.001). For every point a caregiver scored their perceived stress above their typical stress rating, the odds of EA increased by 1.9 (CI 1.37–2.55, p < 0.001), however the risk of neglect did not. This suggests support for the caregiver stress theory as an explanation for EA, as both BSD and perceived stress increased the risk. However, neglect may be driven by a different causal mechanism, as only certain BSD combinations increase odds of neglect.
CHAPTER 12 – P-Selectin/PSGL-1 and Other Interactions between Platelets, Leukocytes, and Endothelium

In response to hemorrhage, circulating platelets adhere to exposed subendothelial tissues and then recruit additional platelets into aggregates that function as procoagulant surfaces. In response to infl ammatory stimuli, circulating leukocytes roll and then arrest on endothelial cells, and fi nally migrate into the surrounding tissues where they combat pathogens and repair tissue injury. These traditionally separate cellular adhesive contributions to coagulation and infl ammation have become progressively understood to be linked. We now know that leukocytes roll and then arrest on activated platelets and that platelets roll on activated endothelial cells. Cell adhesion molecules that were fi rst thought to contribute uniquely to either coagulation or infl ammation are now known to contribute to both responses. This chapter focuses on multicellular adhesive interactions in the vasculature, with particular attention to the dual functions in coagulation and infl ammation of the adhesion molecules P-selectin (CD62P), P-selectin glycoprotein ligand 1 (PSGL-1), and glycoprotein (GP) Ibα. (GPIbα is also discussed in Chapter 7. Inhibition of platelet function by the endothelium is discussed in Chapter 13.)
Michigan cohorts to determine associations of maternal pre-pregnancy body mass index with pregnancy and infant gastrointestinal microbial communities: Late pregnancy and early infancy.

Background About 25% of women in the United States are obese prior to becoming pregnant. Although there is some knowledge about the relationship between the gastrointestinal microbiota and obesity, little is known about the relationship between pre-pregnancy obesity and the gastrointestinal microbiota in pregnancy or its impact on infant gut microbiota. However, the composition of the gut microbiota early in life may influence childhood health. Thus, the objective of this research was to identify associations between maternal pre-pregnancy obesity and the pregnancy (n = 39) or early infancy (n = 39) microbiotas. Results Fecal bacterial communities from overweight women had lower microbiota diversity (Chao1: p = 0.02; inverse Simpson: p = 0.05; Shannon: p = 0.02) than communities from normal weight or obese women. The within-group microbiota composition of overweight women differed from those of normal and obese women at the genus and phylum levels (p = 0.003 and p = 0.02, respectively). Pre-pregnancy overweight women had higher abundances of Bacteroides and lower Phascolarctobacterium than women who were normal weight or obese prior to becoming pregnant. Normal weight women had lower abundances of Acidaminococcus and Dialister than overweight and obese women. Infant community composition tended to differ in membership (Sorensen index) by maternal pre-pregnancy BMI category, and significantly differed by delivery mode and breastfeeding exclusivity (p = 0.06, p = 0.001, p = 0.008, respectively). Infants from normal weight women had lower abundances of Megasphaera than infants from overweight or obese women. Streptococcus was lowest in infants from overweight women, and Staphylococcus was lowest in infants from obese women. Conclusion Maternal and infant microbiotas are associated with and might be affected by maternal pre-pregnancy BMI. Future work should determine if there are also functional differences in the infant microbiome, if those functional differences are related to maternal pre-pregnancy BMI, and whether differences in composition or traits persist over time.
Real-world adherence for direct oral anticoagulants in a newly diagnosed atrial fibrillation cohort: does the dosing interval matter?

Differences in adherence may represent drug properties (e.g. dosing interval) or patient experiences while on treatment. Adherence to direct oral anticoagulants (DOACs) in nonvalvular atrial fibrillation (NVAF) is important to maintain effectiveness over the course of treatment. This was a retrospective cohort study using 2009–2015 Truven Health MarketScan Databases. New initiators of dabigatran, rivaroxaban, and apixaban with NVAF were identified. Twelve months of continuous enrollment before treatment was required to assess demographics and medical history. Proportion of days cover (PDC) was used to measure adherence at 3, 6, 9 and 12-month. Gaps in therapy and treatment switches were also evaluated. Logistic regression was used to compare high adherence (PDC ≥0.80). A total of 14,864 dabigatran, 16,005 rivaroxaban, and 8078 apixaban users were identified. Apixaban users had the highest adherence overall, with mean PDC at 3, 6, 9, and 12-months of 0.83, 0.76, 0.72, and 0.69, while dabigatran had the lowest adherence of 0.78, 0.67, 0.61, and 0.57. Adherence to DOACs increased with increased stroke risk scores. Adherence was also higher when first days supplied was > 30 days compared to 30 days and when filled via mail order pharmacies. Switching was highest among dabigatran users. Apixaban users were the most likely to have high adherence versus dabigatran (OR = 1.73, 95% CI = 1.60–1.88) and versus rivaroxaban (OR = 1.24, 95% CI = 1.14–1.34) at 12-months. Apixaban users had the highest overall adherence despite twice-daily dosing versus once-daily dosing for rivaroxaban. These findings can be useful for formulary decision-making and when assessing treatment options.
The Toll Signaling Pathway Targets the Insulin-like Peptide Dilp6 to Inhibit Growth in Drosophila.

Summary Chronic enteropathogen infection in early childhood reduces circulating insulin-like growth factor 1 (IGF1) levels and restricts growth. Pathogen-derived molecules activate host Toll-like receptors to initiate the immune response, but whether this pathway contributes to growth inhibition is unclear. In Drosophila, activation of Toll receptors in larval fat body suppresses whole-animal growth. Here, using a transcriptomic approach, we identify Drosophila insulin-like peptide 6 (Dilp6), a fat-body-derived IGF1 ortholog, as a selective target of Toll signaling induced by infection or genetic activation of the pathway. Using a tagged allele that we generated to measure endogenous Dilp6, we find a marked reduction in circulating hormone levels. Restoring Dilp6 expression in fat body rescues growth in animals with active Toll signaling. Our results establish that Toll signaling reduces growth by inducing hormone insufficiency, implying a mechanistic link between innate immune signaling and endocrine regulation of growth.
Consistently inconsistent: A systematic review of the measurement of pornography use

Abstract Research indicates that pornography use is now practically ubiquitous among males and continually increasing among females. These statistics are concerning in light of decades of research signaling that pornography use may be associated with sexually coercive behavior. Though the relationship between pornography use and sexual coercion has been a focus of concern, the apparent inconsistency in methods used to assess pornography limits the field from approaching a consensus on the strength of this relationship, as well as developing a thorough understanding regarding which aspects of pornography use drive this relationship. The purpose of the current study is to systematically review the literature on pornography use over the last ten years. This review will provide an updated examination of the operationalization and assessment of pornography use in peer-reviewed studies, synthesize the assessment of pornography use from various disciplines, and provide suggestions for the assessment of pornography use moving forward. Results of this review will serve as a potential guideline for the improvement of methodologies used to assess pornography use, and to facilitate movement towards more consistent methodological approaches to strengthen research examining the relationship between pornography use and sexual coercion.
Context-Dependent “Upper Anchors” for Learning Progressions

In the spirit of model revision, researchers continue to refine the notion of a learning progression. Despite many advances in learning progressions research, one key design element has eluded scholarly critique, the upper anchor. Drawing on science education research and studies of science, this essay argues for a shift from the predominant model of the upper anchor as the fixed, “most sophisticated” way of thinking toward a more expansive “upper reach” that acknowledges plurality and context-dependence in ways of knowing. Three possible models for context-dependent upper reaches are offered.
Influence of spacer insulator material temperature characteristics on its mechanical properties

Spacer insulator is an important component of gas insulated switchgear (GIS), and the performance degradation of spacer insulator will seriously affect the operation of GIS. In this paper, the temperature characteristic of spacer insulator’s material is tested and the temperature distribution of spacer insulator under operating condition is also measured. The electro-thermal and thermo-mechanical coupling formulation are presented respectively and finite element software is applied in simulation. The effect of multi-physics coupling on the performance of spacer insulator is analyzed. Results show that under the operating condition, the heat generated by current flow in central conductor may cause the temperature on spacer insulator to present a gradient distribution, resulting in the degradation of material performance; electric-thermal coupling effect may cause spacer insulator overheating and heat breakdown; and thermo-mechanical coupling effect may increase the probability of spacer insulator fracture. This paper can provide reference for fault analysis of spacer insulator.
Positive Affect and Chronic Pain:A Preregistered Systematic Review and Meta-Analysis

Chronic noncancer pain (CNCP) is a significant health burden among adults. Standard behavioral therapies typically focus on targeting negative affect (NA) and yield only modest treatment effects. The aims of this study were to systematically review and investigate the association between positive affect (PA) and pain severity among adults with CNCP. Databases that were searched included MEDLINE (PubMed), PsycINFO, CINAHL, ProQuest Dissertations and Theses, OLASTER, Open Grey, and PsyArXiv (inception to July 23, 2019). We analyzed studies that: (1) used observational, experimental, or intervention study designs; (2) enrolled individuals with CNCP (pain ≥ 12 weeks); and (3) reported full quantitative results on outcomes. Two researchers independently screened articles, extracted data, and assessed the risk of bias. The main meta-analysis was followed by subgroup analyses. All analyses were performed using random-effects models. Formal tests for heterogeneity (Q-statistic; I) and publication bias (p-curve and p-uniform*) were performed. We meta-analyzed 29 studies with 3521 participants. Results demonstrated that PA inversely impacts pain severity in people with CNCP (r = -0.23). Subgroup analyses showed a significant effect for gender and marginally significant effects for age in studies that adjusted for NA. On average, effect sizes for observational studies were larger in studies with a higher proportion of female respondents and in studies that did not adjust for NA. Finally, larger effect sizes were found in intervention studies with older compared with younger samples.
THE IMPACT OF ROUTINE CARDIOLOGY CONSULTATION ON CRITICALLY ILL PATIENTS WITH ELEVATED TROPONIN LEVELS

Cardiac troponin (T) is used to diagnose acute coronary syndrome. However, T can also be elevated in critically ill patients secondary to demand ischemia or myocardial injury. The impact of routine cardiology consultation on the clinical outcomes of critically ill patients with elevated T is unclear
Interhospital Transfer of Critically Ill Patients Because of Coronavirus Disease 19-Related Respiratory Failure.

ABSTRACT Introduction Interfacility transfer of patients with COVID-19 related acute respiratory failure is high risk due to the severity of respiratory failure and potential for crew exposure. This paper describes a hospital-based transport team's experience with interfacility transport of SARS-CoV-2 positive patients. Methods A retrospective study of transports for respiratory failure due to SARS-CoV-2 was performed. All transports were by a single critical care transport team. The team was already trained in advanced mechanical ventilation, blood gas interpretation, and management of shock. Guidance from the Centers of Disease Control was followed regarding use of personal protective equipment (PPE). Results Twenty patients were enrolled. Average patient age was 47 (standard deviation (SD) 12) years old. Average APACHE II and SOFA scores were 10 (SD 4) and 24 (SD 7), respectively. Average transport distance and time were 18 miles (SD 9) and 25 (SD 11) minutes, respectively. Nineteen patients were intubated, 9 of whom required advanced ventilation. Two patients were transported prone. One patient experienced unintentional extubation upon transfer from the stretcher to the destination facility bed. The patient was re-intubated without event. No crew members contracted SARS-CoV-2 infection. Conclusion Interfacility transfer of severely ill SARS-CoV-2 positive patients is safe and feasible.
Neural Correlates of Positive Emotion Processing That Distinguish Healthy Youths at Familial Risk for Bipolar Versus Major Depressive Disorder.

Objective Familial risk for bipolar disorder (BD) or major depressive disorder (MDD) may lead to differential emotion processing signatures, resulting in unique neural vulnerability. Method Healthy offspring of a parent with BD (n = 29, “BD-risk”) or MDD (n = 44, “MDD-risk”) and healthy control youths without any personal or family psychopathology (n = 28, “HC”) aged 8 to 17 years (13.64 ± 2.59 years) completed an implicit emotion-perception functional magnetic resonance imaging task. Whole-brain voxelwise and psychophysiological interaction analyses examined neural differences in activation and connectivity during emotion processing. Regression modeling tested for neural associations with behavioral strengths and difficulties and conversion to psychopathology at follow-up (3.71 ± 1.91 years). Results BD-risk youth showed significantly reduced bilateral putamen activation, and decreased connectivity between the left putamen and the left ventral anterior cingulate cortex (vACC) and the right posterior cingulate cortex (PCC) during positive-valence emotion processing compared to MDD-risk and HC (Z >2.3; p Conclusion Reduced putamen activation and connectivity during positive emotion processing appear to distinguish BD-risk youths from MDD-risk and HC youths, and may represent a marker of vulnerability.
Improving Preparedness, Management, and Quality of Care for Unresponsive Lvad Patients

Introduction As left ventricular assist device (LVAD) use becomes more prevalent in clinical settings, it is critical that providers become more familiar with emergent resuscitative measures for these patients. Scarce literature exists on how hospital systems and providers should approach unresponsive LVAD patients. This quality improvement study developed an ACLS type algorithm to increase provider preparedness in these situations. Methods A detailed literature review on existing data and best practices was used to develop a new algorithm on how to approach unresponsive LVAD patients. A survey was distributed to internal medicine (IM), emergency medicine (EM), and family medicine (FM) residents before and after implementation of this algorithm to assess provider knowledge and comfort in caring for unresponsive LVAD patients. Results In the first survey, 37.3% EM, 46.3% IM, and 16.4% FM residents responded while in the second 33.3% were EM, 60% IM, and 6.7% FM. 35.8% reported they were not familiar at all with LVAD patient resuscitation and 80.6% stated their training did not involve instruction on running a code on an LVAD patient. Initially, 49.3% reported that, with their current level of experience, they would feel not at all comfortable running a code on an LVAD patient. This improved to 93.4% of residents feeling somewhat comfortable or better following algorithm distribution. Significant improvements were noted in important aspects to approaching an unresponsive LVAD patient such as correctly identifying the need to contact the VAD team immediately (34.3% to 93%), auscultating for a hum as the initial component of the physical exam (32.8% to 93%), performing chest compressions (43.3% to 93.3%), and using defibrillators if clinically indicated (50.7% to 96.7%). Overall comfort for creating differentials improved from 43.3% feeling not at all confident to 89.9% feeling at least somewhat confident. Although 63.3% feel that further education and training is needed, 93.3% felt educational tools similar to the provided algorithm/handout can be as effective as lecture based learning to bridge knowledge gaps. Conclusion Our study reveals that there is insufficient training for emergent resuscitation measures in LVAD patients. Similar levels of comfort and knowledge likely exist throughout the medical community despite rapid growth in LVAD use. Simple code-cart algorithms for unresponsive LVAD patients are as efficacious as lecture based learning in quickly increasing provider comfort and knowledge. Hospital systems nationally should consider implementing similar measures to enhance provider preparedness and improve LVAD patient care and survival.
Indexing haemodynamic variables in young children

Background: Haemodynamic studies in children are rare and most studies have included few subjects in the youngest age group. Haemodynamic variables need to be indexed to establish a reference of normality that is valid in all populations. The traditional way to index haemodynamic variables with body surface area (BSA) is complicated in young children due to its non-linear relationship with body weight (BW). We examined several haemodynamic variables in children by indexing them with BSA and BW. Methods: A single-centre, observational cohort study comparing non-indexed and indexed haemodynamic variables in children undergoing heart surgery (divided into three weight groups: 1-5 kg, >5-10 kg and >10-15 kg). Results: A total of 68 children were included in this study, mean age 11.1 months ± 11.1 month (range 0 to 43 months). All haemodynamic variables, cardiac output (CO), stroke volume (SV), total end-diastolic volume (TEDV), central blood volume (CBV) and active circulation volume (ACV), increased with weight without indexing (P <.05). Indexing variables with BW produced a more linear relationship for all haemodynamic variables between weight groups than BSA. The mean BSA-indexed haemodynamic values were CIBSA 3.5 ± 1.1 L/min/m2 and SVIBSA 27.3 ± 8.9 ml/min/m2. The mean BW-indexed haemodynamic values were CIBW 180 ± 50 ml/min/kg and SVIBW 1.34 ± 0.38 ml/kg. Blood volume variables indexed with BW were TEDVBW 12.0 ± 2.8 ml/kg, CBVBW 21.3 ± 6.6 ml/kg and ACVBW 70.3 ± 15.2 ml/kg. Conclusions: Indexing haemodynamic variables with BW produces a more appropriate body size-independent scale in young children than BSA. Summary statement: In this study, we studied indexing of haemodynamic variables and estimation of blood volumes in young children undergoing corrective heart surgery using an indicator dilution technology.
Application of Blockchain Technique to Reduce Platelet Wastage and Shortage by Forming Hospital Collaborative Networks

Given the short shelf life of blood products and a decrease in donor population, hospitals endeavor to achieve an equilibrium between shortage and outdating. Though collaborating and sharing blood ...