cssi/SciSciGPT-SciSciNet huggingface dataset:
Assessing Sources of Stress to Aquatic Ecosystems Using Integrated Biomarkers

Establishing causal relationships between sources of environmental stressors and aquatic ecosystem health is difficult because of the many biotic and abiotic factors which can influence or modify responses of biological systems to stress, the orders of magnitude involved in extrapolation over both spatial and temporal scales, and compensatory mechanisms such as density-dependent responses that operate in populations. To address the problem of establishing causality between stressors and effects on aquatic systems, a diagnostic approach, based on exposure-response profiles for various anthropogenic activities, was developed to help identify sources of stress responsible for effects on aquatic systems at ecological significant levels of biological organization (individual, population, community). To generate these exposure-effects profiles, biomarkers of exposure were plotted against bioindicators of corresponding effects for several major anthropogenic activities including petrochemical, pulp and paper, domestic sewage, mining operations, land-development activities, and agricultural activities. Biomarkers of exposure to environmental stressors varied depending on the type of anthropogenic activity involved. Bioindicator effects, however, including histopathological lesions, bioenergetic status, individual growth, reproductive impairment, and community-level responses, were similar among many of the major anthropogenic activities. This approach is valuable to help identify and diagnose sources of stressors in environments impacted by multiple stressors. By identifying the types and sources of environmental stressors, aquatic ecosystems can be more effectively protected and managed to maintain acceptable levels of environmental quality and ecosystem fitness.
Probing the Influence of N‐Donor Capping Ligands on Supramolecular Assembly in Molecular Uranyl Materials

The syntheses and crystal structures of six new compounds containing the UO22+ cation, 3,5-dichlorobenzoic acid, and a chelating N-donor [2,2′-bipyridine (bipy), 1,10-phenanthroline (phen), 4,7-dimethyl-1,10-phenanthroline (dimethylphen), 2,2′:6′,2″-terpyridine (terpy), 4′-chloro-2,2′:6′,2″-terpyridine (Cl–terpy), or 2,4,6-tris(2-pyridyl)-s-triazine (TPTZ)] are reported. Single-crystal X-ray diffraction analysis of these materials enabled the exploration of the structural relationship between the benzoic acids and the chelating N-donor as well as providing a platform to evaluate the effects of ligand choice on uranyl hydrolysis and subsequent oligomerization. At an unadjusted pH (ca. 3), a mix of uranyl monomers and dimers are observed, dimer formation resulting from both bridging carboxylate linkers and hydroxo bridges. Assembly by halogen- and hydrogen-bonding interactions as well as π–π interactions was observed depending on the experimental conditions utilized. Further, spectroscopic characterization (both vibrational and luminescence) of complexes 1, 4, and 5 to explore the effects of the electron-donating ability of the capping ligand on the corresponding uranyl luminescence and vibrational spectra suggests that there is a relationship between the observed bathochromic shifts and the electron-donating ability of the capping ligands.
Law School Accreditation: Responsible Regulation or Barrier to Entry?

Professor Kmiec introduced a panel discussion regarding ABA accreditation standards for law schools at the 2006 Federalist Society National Lawyers Convention. This brief article memorializes his remarks. In his remarks, Professor Kmiec raised the four most common arguments in favor of ABA accreditation for law schools and the four most prevalent counterpoints made against those arguments. Then he invited the panel to offer their comments.
Reciprocity in Mexican Relations with the United States: Past Indicators of Future Dilemmas

This note assesses the lessons for future Mexican relations with the United States of past episodes of conflict over border issues and U.S. intervention in Latin America. The author argues that Mexican officials have and should continue to present Mexican views and assert Mexican national interests in disputes with the United States without concern for the historically frequent tendency of U.S. officials and commentators to ascribe such positions to Mexican “anti-Americanism.”
Targeting Protein Interactions: A Novel Therapeutic Strategy against Prostate Cancer

The expression and signaling of Androgen Receptor (AR) is necessary for the development of prostate cancer, and hence, is a major target for pharmaceutical drug development against the disease. AR, which is predominantly present in the cytoplasm when inactive, is activated by the binding of androgens resulting in its translocation to the nucleus. Once in the nucleus, AR modulates the expression of target genes by binding to androgen-responsive elements (ARE) on their promoter/enhancer regions and recruiting coregulators and other proteins of the transcriptional machinery.
28 STEMMING THE DECLINE OF NON-ENGLISH LANGUAGE JOURNALS: THE FUTON EFFECT

Historically medical science journals in the 19th century were primarily published in German or English. With the Internet era, it appears that English has become the language of science. There is a growing concern that non-English journals are on the decline with a clear and present danger of loss in diversity as well as originality of research. The first 40 general and internal medicine journals listed under the ISI are published in English. Purpose Full Text on the Net bias (FUTON Bias) is the “tendency to peruse what is more readily available on the net.” We sought to determine if Full Text on the Net bias (FUTON Bias) might explain the decline of non-English journals and elucidate ways in which non-English journals might enhance visibility of research and scholarship. Methods We identified all non-English journals (Spanish, Dutch, Italian, French and German) listed in ISI under Medicine, General and Internal (n = 21). We excluded Schweizerische Medizinische Wochenschrift as it has been published in English since 2001 as Swiss Medical Weekly. The on-line status of the remaining journals was ascertained in MEDLINE as FUTON, abstracts or references only. All Impact Factors from 1988 to 2003 were abstracted. Summary of Results We observed that traditionally non-English journals that also published in English (multi-lingual) had an increase in their impact factors while those that chose not to do so maintained their base impact factors. This confirms the existence of a language bias: non-English journals tend to have lower impact factors, even in the Internet era. Interestingly however, the rise in impact factors of such multi-lingual journals paralleled in time and inception the rise of those providing FUTON and the availability of the Internet as a mode of scientific dissemination Also, the mean impact factor of multi-lingual FUTON journals was approximately threefold higher than multilingual journals that provided only abstracts or references. Conclusion Our study suggests that non-English journals may better serve national and international audiences by becoming FUTON. Financial considerations may limit the ability of some of these journals in providing “free” FUTON. However, these non-English journals may be able to effectively disseminate scientific knowledge, improve the visibility of research and impact factors as well as stem their decline by at least providing articles on the net as FUTON. The innate tendency to pick the “low-hanging fruit of convenience” greatly enhances the odds that a FUTON article will be read or cited. By the same token, invisible research, defined as not readily accessible on-line, may possibly be ignored or overlooked and therefore disregarded.
Community Covenant Alienation Restraints and the Hazard of Unbounded Servitudes

One-fifth of all Americans today live in privately governed, common interest communities (CICs). By definition, property in a CIC is subject to restrictions on use, however many CIC properties are also constrained by restrictions on transfer. Owners may not be able to freely sell or lease their property because of limitations in the community's covenant regime. Such restrictions on transfer increase the economic vulnerability of communities and their members and compromise owners' property rights.Historically, most restrictions on alienation contained in community covenants have been upheld based on freedom of contract rationale, but courts have struck down some such restrictions as unduly limiting an owner's economic interest in the property. When a restriction significantly hinders an owner's ability to make the trapped value of the real estate liquid, courts are more likely to deem the restriction “unreasonable” and refuse its enforcement. Other sorts of limitations — including those that increase the costs of transfer or constrain an owner's choice of transferee — are usually not invalidated.Today, one of the most common alienation restrictions in private communities is a leasing limitation. Although courts purport to police such restrictions for unreasonableness, the near uniform judicial validation of leasing restrictions does not adequately protect the economic interests of owners.
Reducing Costs for Robotic Radical Prostatectomy: Three-instrument Technique

Objective To describe our technique for performing robotic-assisted laparoscopic prostatectomy (RALP) and pelvic lymph node dissection using only 3 robotic instruments to reduce disposable costs associated with the robotic surgical platform. Methods The financial impact of robotic surgery is real. Whereas the initial capital investment of the robotic platform (including the cost of the device itself and the maintenance contract) is largely fixed, the cost of disposable instrumentation can vary depending on utilization. Herein we describe our technique for 3-instrument robotic radical prostatectomy that may decrease costs by limiting the use of disposable instruments. Results Exclusion of the high-cost energy instruments may reduce operative costs by up to 40%. In addition, using 1 robotic needle driver vs 2 may decrease overall costs by another 12%. At our institution, we have adopted these techniques in cost-efficiency and have gone further by only using 3 instruments during robotic radical prostatectomy. The only 3 instruments necessary to perform a successful RALP are a robotic needle driver, Prograsp forceps, and monopolar scissors. Conclusion To improve the value of care while utilizing robotic technology, we must be cognizant of keeping operative costs to a minimum while maintaining positive patient outcomes. We demonstrate here a method to decrease disposable operating room costs while preserving the ability to successfully perform a RALP.
Computationally Efficient 3-D Finite-Element-Based Dynamic Thermal Models of Electric Machines

The performance of an electric machine is significantly constrained by temperature. Hence, in order to determine the torque and power capabilities of an electric machine under real-time operating conditions, dynamic knowledge of internal temperatures is required and needs to be estimated in a computationally efficient manner. In this paper, we present a technique for developing computationally efficient thermal models for electric machines that can be used for real-time thermal observers and electrified vehicle powertrain-level simulation and optimization. The technique is based on simulating eigenmodes of the thermal dynamics as determined by 3-D finite-element analysis (FEA). The order of the FE model is then dramatically reduced. The full-order system is decomposed into two parts by using the orthogonality property of the thermal eigenmodes, and only eigenmodes, which are significantly excited, are included in the dynamic model; other eigenmodes are treated as static modes. A large 3-D FEA model can be thus reduced to a small reduced-order model without the necessity of calculating all the eigenmodes. Furthermore, the process of selecting the significantly excited eigenmodes is automatic based on a proposed normalized “extent of excitation” calculation. By using the proposed techniques, the computation time of the model can be dramatically reduced compared with the full-order model while maintaining sufficient accuracy. Experimental results show good agreement between simulation results and measured data.
A Case Series of Clenbuterol Toxicity Caused by Adulterated Heroin.

Abstract Background Adulteration of drugs of abuse may be done to increase profits. Some adulterants are relatively innocuous and others result in significant toxicity. Clenbuterol is a β2-adrenergic agonist with veterinary uses that has not been approved by the U.S. Food and Drug Administration for human use. It is an infrequently reported heroin adulterant. We describe a cluster of hospitalized patients with laboratory-confirmed clenbuterol exposure resulting in serious clinical effects. Case Series Ten patients presented with unexpected symptoms shortly after heroin use. Seven evaluated by our medical toxicology service are summarized. Presenting symptoms included chest pain, dyspnea, palpitations, and nausea/vomiting. All patients were male, with a median age of 40 years (interquartile range [IQR] 38–46 years). Initial vital signs included a heart rate of 120 beats/min (IQR 91–137 beats/min), a respiratory rate of 20 breaths/min (IQR 18–22 breaths/min), a temperature of 36.8°C (IQR 36.7–37.0°C), a systolic blood pressure of 107 mm Hg (IQR 91–131 mm Hg), and a diastolic blood pressure of 49 mm Hg (IQR 40–70 mm Hg). Serum potassium nadir was 2.5 mEq/L (IQR 2.2–2.6 mEq/L), initial glucose was 179 mg/dL (IQR 125–231 mg/dL), initial lactate was 9.4 mmol/L (IQR 4.7–10.5 mmol/L), and peak creatine phosphokinase was 953 units/L (IQR 367–10,363 units/L). The median peak troponin level in six patients was 0.7 ng/mL (IQR 0.3–2.4 ng/mL). Three patients underwent cardiac catheterization and none had significant coronary artery disease. Clenbuterol was detected in all patients after comprehensive testing. All patients survived with supportive care. Why Should an Emergency Physician Be Aware of This? Atypical presentations of illicit drug intoxication may raise concern for drug adulteration. In the case of heroin use, the presence of adrenergic symptoms or chest pain with hypokalemia, lactic acidosis, and hyperglycemia suggests adulteration with a β-agonist, such as clenbuterol, and patients presenting with these symptoms often require hospitalization.
Once and future Mars

ONE of the most profound discoveries that has emerged from the past 40 years of space exploration is that environmental conditions like those that we enjoy on Earth are exceedingly rare. However, there is a short list of special places in our solar system that astronomers believe may once have been – or may still even be – very much Earth-like. Mars is at the top of that list.
Optimized stateful material implication logic for three-dimensional data manipulation

The monolithic three-dimensional integration of memory and logic circuits could dramatically improve the performance and energy efficiency of computing systems. Some conventional and emerging memories are suitable for vertical integration, including highly scalable metal-oxide resistive switching devices (“memristors”). However, the integration of logic circuits has proven to be much more challenging than expected. In this study, we demonstrated memory and logic functionality in a monolithic three-dimensional circuit by adapting the recently proposed memristor-based stateful material implication logic. By modifying the original circuit to increase its robustness to device imperfections, we experimentally showed, for the first time, a reliable multi-cycle multi-gate material implication logic operation and half-adder circuit within a threedimensional stack of monolithically integrated memristors. Direct data manipulation in three dimensions enables extremely compact and high-throughput logicin- memory computing and, remarkably, presents a viable solution for the Feynman Grand Challenge of implementing an 8-bit adder at the nanoscale.
Respiratory rhythm generation: preBötzinger neuron discharge patterns and persistent sodium current.

Neurons within the preBotzinger complex (pBc) are postulated to have a central role in respiratory rhythm generation. This postulate is supported by studies using both in vitro and in vivo preparations.2 Consistent with a role in rhythm generation, many of the neurons within this region discharge with active periods that span the phase transitions between expiration (E) and inspiration (I),3, 4
Chorioamniotic Membrane Separation Found on Routine Testing in an Otherwise Asymptomatic Woman With Late Preterm Twin Gestation

ABSTRACTBackground: Chorioamniotic membrane separation (CMS) is a rare finding that is commonly preceded by invasive fetal procedures. The presence of CMS can also be associated with uncommon maternal or fetal conditions as well as preterm delivery, amniotic band syndrome, umbilical cord complications, and fetal and neonatal death. It is classified as a high-risk antepartum condition due to the significant fetal morbidity and mortality that may ensue. Case Report: A 40-year-old gravida 5 para 1212 at 35 weeks presented for antepartum fetal testing. Her antepartum course was complicated by di–di twin gestation, chronic hypertension, and advanced maternal age. A routine ultrasound (as part of the antepartum fetal testing) identified an incidental finding of CMS. The patient's only reported symptom was that of preterm contractions, without evidence of active labor, and other fetal testing was reassuring. She had a repeat cesarean section that day and the suspected etiology was preterm, premature rupture of m...
2.05 – Weakly Electric Fish: Behavior, Neurobiology, and Neuroendocrinology

Electric fish generate electric organ discharges (EODs) from an electric organ and sense these discharges via sensory cells termed eletroreceptors. Amazingly, electrocommunication evolved independently in two groups of fishes. EODs are used in the same ways as signals in other modalities and are similarly influenced by natural and sexual selection. The EOD waveform conveys information on the species, age, sex, and individual identity of the signaler, and brief modulations of the EOD emission rate transmit information about breeding status, dominance/subordinance, and motivation. As with many sexually dimorphic communication signals, EOD waveform is regulated by gonadal steroids by long-term actions on the morphology and physiology of the neurons and electric organ while short-term modulations of EOD rate signaling motivational states are driven by peptides and amines at the brain stem pacemaker nucleus. EOD waveforms are similar in juveniles and females in many species, reminiscent of the plumage similarities of juvenile and female birds. In species in which males compete for reproductive access to females, male signals are more conspicuous and/or ornate than those of females and carry costs, such as increased risk of predation and/or energetic costs. Similarly, the electrical signals produced by males are more conspicuous both to conspecific females and to potential predators. A striking feature of electrocommunication is the wealth of species diversity including variation in the magnitude and direction of sex differences in body size, EOD properties, and other electrical behaviors; diversity in habitat preferences, sociality, and associated diversity in physiology and patterning of the EOD; and variation in courtship and parental behavior. This diversity is coupled with numerous striking examples of convergence in the behavior and physiology between the two different orders of fish that independently evolved electrocommunication. These features lend themselves to comparative studies of the hormonal control of reproductive and communication behavior and make electric fish excellent model animals for studying how evolutionary lability of neuroendocrine mechanisms that regulate sex differences can lead to species diversity in sexually dimorphic behavior.
Erratum to: SAGES University MASTERS Program: a structured curriculum for deliberate, lifelong learning

The online version of the original article can be found under doi: 10.1007/s00464-017-5626-6 .
Systematic review with meta-analysis: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease.

Background Despite potential adverse-events in a paediatric population, corticosteroids are used to induce remission in paediatric Crohn's disease. Exclusive enteral nutrition also induces remission, but is infrequently used in the USA because corticosteroids are considered the superior therapy. New data have become available since the publication of the most recent meta-analysis in 2007. Aim To see if current literature supports the use of EEN versus CS in paediatric populations. Methods All studies with comparator arms of exclusive enteral nutrition and an exclusive corticosteroids, with remission clearly defined were identified by searching eight online databases. Results Of 2795 identified sources, nine studies met our inclusion criteria. Eight of these (n = 451), had data that could be abstracted into our meta-analysis. Exclusive enteral nutrition was as effective as corticosteroids in inducing remission (OR = 1.26 [95% CI 0.77, 2.05]) in paediatric Crohn's disease. There was no difference between Exclusive enteral nutrition and corticosteroids efficacy when comparing newly diagnosed Crohn's (OR = 1.61 [95% CI .87, 2.98]) or relapsed (OR = 0.76 [95% CI .29-1.98]). Intestinal healing was significantly more likely among patients receiving Exclusive enteral nutrition compared to corticosteroids (OR = 4.5 [95% CI 1.64, 12.32]). There was no difference in the frequency of biomarker normalisation including CRP (OR = 0.85 [95% CI .44, 1.67]) and faecal calprotectin (OR 2.79 [95% CI .79-10.90]). Conclusions There is no difference in efficacy between Exclusive enteral nutrition and corticosteroids in induction of remission in Crohn's disease in a paediatric population. Exploratory analyses suggest that a greater proportion of patients treated with exclusive enteral nutrition achieved mucosal healing.
Infants With Febrile Urinary Tract Infections and Length of Antibiotic Therapy: A Commentary.

Although the American Academy of Pediatrics provides evidence-based recommendations for the management of infants and neonates between 2 months and 2 years of age with febrile urinary tract infections (UTIs),1,2 there is a paucity of data regarding the evaluation and treatment of febrile UTIs in infants <2 months of age. In their study, Joshi et al3 attempt to use this lack of data to reveal variability in treatment and diagnostic plans among physicians with regard to the management of UTIs in this age group. The investigators presented pediatricians of different subspecialties with a clinical vignette of a 2-week-old neonate with a febrile UTI without bacteremia who had received 2 days of intravenous (IV) antibiotics. They then stratified respondents by, among other things, subspecialty (pediatric infectious diseases [IDs], neonatology, and “general pediatricians,” the latter included inpatient and outpatient physicians) and asked questions regarding preferred length of IV antibiotic therapy, desire to obtain a voiding cystourethrogram, and prophylactic antibiotic therapy. The study had a reasonable survey completion rate (64%), although it had a low participation rate (13%), and was well designed. The investigators identified significant variability in physician preference for length of IV antibiotic courses between specialties. …
Classification of seismocardiographic cycles into lung volume phases

In this study, a machine learning algorithm was developed to classify seismocardiographic (SCG) signals occurring during low and high lung volumes. The results demonstrated that morphological differences can be observed in SCG waveforms during respiration. SCG events were classified using a Radial Basis Function (RBF) support vector machine (SVM) algorithm into the two classes of low and high lung volume. Classification accuracy was found to be about 75%.
Developing a Staff Physical Activity Program at Your School: Implementing the Lesser-used Component of the CSPAP Model

The purpose of this article is to explore staff physical activity programs in the school setting, describe a viable option for a staff walking program in an elementary school, and determine element...
Staphylopine, pseudopaline and yersinopine dehydrogenases: a structural and kinetic analysis of a new functional class of opine dehydrogenase

Opine dehydrogenases (ODHs) from the bacterial pathogens Staphylococcus aureus, Pseudomonas aeruginosa, and Yersinia pestis perform the final enzymatic step in the biosynthesis of a new class of opine metallophores, which includes staphylopine, pseudopaline, and yersinopine, respectively. Growing evidence indicates an important role for this pathway in metal acquisition and virulence, including in lung and burn-wound infections (P. aeruginosa) and in blood and heart infections (S. aureus). Here, we present kinetic and structural characterizations of these three opine dehydrogenases. A steady-state kinetic analysis revealed that the three enzymes differ in α-keto acid and NAD(P)H substrate specificity and nicotianamine-like substrate stereoselectivity. The structural basis for these differences was determined from five ODH X-ray crystal structures, ranging in resolution from 1.9 to 2.5 A, with or without NADP+ bound. Variation in hydrogen bonding with NADPH suggested an explanation for the differential recognition of this substrate by these three enzymes. Our analysis further revealed candidate residues in the active sites required for binding of the α-keto acid and nicotianamine-like substrates and for catalysis. This work reports the first structural kinetic analyses of enzymes involved in opine metallophore biosynthesis in three important bacterial pathogens of humans.
Inter-rater agreement for visual discrimination of phasic and tonic electromyographic activity in sleep.

Study objectives The objective of this study was to determine the confidence of expert raters in discriminating phasic and tonic electromyographic (EMG) activity. We undertook this study because we suspected that even expert scorers may disagree on whether a given EMG segment contained phasic activity, tonic activity, or both. Methods Six individuals holding either Fellowship status in the American Academy of Sleep Medicine or Board Certification in Sleep Medicine with at least 5 years experience in interpreting polysomnography visually examined 60 segments containing EMG activity. Raters determined their relative confidence that each segment contained phasic and tonic activity by noting whether they were highly certain or somewhat certain that the segment contained such activity or somewhat certain or highly certain that each segment did not contain such activity. Every segment was rated by every rater twice, once for phasic and once for tonic activity. Results Substantial differences among raters existed in certainty regarding presence/absence of both phasic and tonic activity, although raters agreed on segments far above chance. Consensus was higher on certainty regarding presence of phasic, relative to tonic, activity. Conclusions These findings indicate the limitations of visual analyses for discriminating abnormal muscle activity during sleep. Conversely, when expert judgments are combined with digitized measurements of EMG activity in sleep (e.g. REM atonia index), some allowance must be made for the unique contribution of visual analyses to such judgments, most notably for short duration EMG signals. These results may have relevance for polysomnographic interpretation in suspected synucleinopathies.
Multi-layer cryolithography for additive manufacturing

A new technique is introduced which addresses the need for faster additive manufacturing methods for tissue scaffolds and frozen foods in large-scale industrial applications, inspired by print lithography. It is particularly relevant to biological matter, which is composed mostly of water. Instead of point-by-point printing in three dimensions (3D) with 3D printers, multiple single 2D layers can be assembled or printed separately, in parallel, on areas coated with hydrophilic materials to bind water-based compounds and hydrophobic materials to reject water-based compounds and bind hydrophobic molecules. This technique keeps the layers attached to the surface, opposing gravity, and thereby facilitating the transport and the assembly of the 2D layers, regardless of the direction of the surface relative to gravity. The individual layers are deposited one on top of the other and linked by chemical cross-linking and freezing to generate a 3D structure. Examples show how complex and large hydrogel-based structures can be manufactured by multi-layer cryolithography from fusion and freezing of 2D layers. Applications involve tissue engineering and food engineering, with particular emphasis on the ability to assemble a biological object, while every volume is frozen under optimal conditions during the assembly. Scanning electron microscopy demonstrates the ability to control and produce uniform microstructures in the 3D objects produced by cryolithography.
Mutation burden as a potential prognostic marker of melanoma progression and survival.

9567Background: Recently, tumor mutation burden (TMB) has been shown to increase the presentation of neoantigens that stimulate immune tumor recognition, resulting in improved immunotherapy (IT) outcomes in melanoma and other cancers. As melanoma is highly immunogenic, here we tested whether TMB associates with immune recognition during tumor progression, hence impacting melanoma overall survival (OS), independently of IT treatment. Methods: We have generated somatic mutation data from 314 IT-naive metastatic melanomas from The Cancer Genome Atlas (TCGA). In the TCGA cohort, TMB has been calculated for 210 genes (200GS) previously established from TMB studies of anti-CTLA4 and anti-PD1/PD-L1 IT. For validation, we have sequenced exonic regions of 20 genes (20GS) with the highest TMB among 200GS in 89 IT-naive metastatic melanomas ascertained at New York University Langone Medical Center. The TMB was defined using total number of somatic, non-synonymous mutations in either 200GS (TCGA discovery) or 20GS (v...
Video Capsule Endoscopy in the Assessment of Portal Hypertensive Enteropathy

Background. The features of the portal hypertension enteropathy (PHE) vary from mild mucosal changes to varices with or without bleeding. The prevalence and the development are not fully understood. Aim. Our aim is to examine the prevalence and the different manifestations of PHE using video capsule endoscopy (VCE). Methods. It is a single center retrospective study of patients with cirrhosis, who had VCE. Based on the published literature, we divided the PHE lesions into vascular lesions and mucosal lesions. Results. Of the 100 patients with cirrhosis that had a VCE study, the mean age was 62.82 years. Male gender was predominant (64%), while Caucasians represented 82% of the cohort. The most common etiology of cirrhosis was chronic alcohol abuse followed by chronic hepatitis C virus and nonalcoholic steatohepatitis. VCE detected small bowel lesions in 71% of the patients while the features of PHE were found in 65% from the total cohort. AVMs and inflammatory changes were the most common findings, followed by bleeding. More than 50% of the lesions were vascular in nature. The risk of finding PHE in decompensated cirrhosis is twice that in compensated cirrhosis. Forty-five patients had negative EGD exam for any active bleeding, esophageal varices, portal hypertensive gastropathy, or gastric varices. Of these, 69% had features of PHE in their VCE. Conclusions. VCE detected small bowel lesions in 71% of our cohort. There is a high prevalence of PHE in decompensated cirrhosis. Vascular lesions are the most common finding in the small bowel of this population.
A computer vision technique for automated assessment of surgical performance using surgeons' console-feed videos.

To develop and validate an automated assessment of surgical performance (AASP) system for objective and computerized assessment of pelvic lymph node dissection (PLND) as an integral part of robot-assisted radical cystectomy (RARC) using console-feed videos recorded during live surgery. Video recordings of 20 PLNDs were included. The quality of lymph node clearance was assessed based on the features derived from the computer vision process which include: the number and cleared area of the vessels/nerve (N–Vs); image median color map; and mean entropy (measures the level of disorganization) in the video frame. The automated scores were compared to the validated pelvic lymphadenectomy appropriateness and completion evaluation (PLACE) scoring rated by a panel of expert surgeons. Logistic regression analysis was employed to compare automated scores versus PLACE scores. Fourteen procedures were used to develop the AASP algorithm. A logistic regression model was trained and validated using the aforementioned features with 30% holdout cross-validation. The model was tested on the remaining six procedures, and the accuracy of predicting the expert-based PLACE scores was 83.3%. To our knowledge, this is the first automated surgical skill assessment tool that provides an objective evaluation of surgical performance with high accuracy compared to expert surgeons’ assessment that can be extended to any endoscopic or robotic video-enabled surgical procedure.
Training Supervisors to Provide Performance Feedback Using Video Modeling with Voiceover Instructions.

Supervisors commonly use feedback to teach staff members to implement behavioral interventions. However, few studies have evaluated methods to teach supervisors to provide effective feedback. We used a multiple-baseline design to evaluate the use of video modeling with voice-over instruction to train 4 supervisors to provide performance feedback to a confederate therapist implementing a guided-compliance procedure. We assessed supervisors’ accuracy with implementing 8 feedback component skills during scripted role-plays before and after video modeling. We also assessed the extent to which supervisors’ skills generalized when providing feedback to a confederate therapist implementing novel behavioral procedures (i.e., discrete-trial training and mand training) and an actual therapist implementing the guided-compliance procedure with a child with autism. All supervisors mastered the feedback component skills following video modeling. Overall, the results of the current study suggest that video modeling may be an efficacious and efficient method to train supervisors.
Current guidelines and treatment paradigms for nocturnal polyuria: A “NEW” disease state for US physicians, patients and payers

Nocturia is one of the most bothersome symptoms encountered in urology, and its prevalence rises with age. Causes include both urological and non-urological aetiologies, often in combination. The effects of nocturia on a patient's quality of life can be detrimental. The initial approach to managing this condition includes appropriately classifying nocturia based on the results of a 24-hour bladder diary. Broadly, the categories under which nocturia can be classified include: low nocturnal or global bladder capacity, nocturnal polyuria, global polyuria and mixed.Based on the type of nocturia and possible underlying causes, clinicians can appropriately discuss with patients the treatment plans that may include a combination of behavioural, pharmacologic, and invasive therapy. The available literature on the management of nocturia was reviewed. Findings were incorporated into a practice-based approach for its workup and treatment.
The Tethered Economy

Imagine a future in which every purchase decision is as complex as choosing a mobile phone. What will ongoing service cost? Is it compatible with other devices you use? Can you move data and applications across devices? Can you switch providers? These are just some of the questions one must consider when a product is “tethered” or persistently linked to the seller. The Internet of Things, but more broadly, consumer products with embedded software, are already tethered. While tethered products bring the benefits of connection, they also carry its pathologies. As sellers blend hardware and software—as well as product and service—tethers yoke the consumer to a continuous post-transaction relationship with the seller. The consequences of that dynamic will be felt both at the level of individual consumer harms and on the scale of broader, economy-wide effects These consumer and market-level harms, while distinct, reinforce and amplify one another in troubling ways. Seller contracts have long sought to shape consumers’ legal rights. But in a tethered environment, these rights may become non-existent as legal processes are replaced with automated technological enforcement. In such an environment, the consumer-seller relationship becomes extractive, more akin to consumers captive in an amusement park than to a competitive marketplace in which many sellers strive to offer the best product for the lowest price. At the highest level, consumer protection law is concerned with promoting functioning free markets and insulating consumers from harms stemming from information asymmetries. We conclude by exploring legal options to reduce the pathologies of the tethered economy.
AMPK-SIRT1-independent inhibition of ANGPTL3 gene expression is a potential lipid-lowering mechanism of metformin.

Objectives Hypertriglyceridaemia enhances cardiovascular disease risk in patients with diabetes. Lipoprotein lipase (LPL) regulates plasma triglyceride levels by hydrolysing chylomicrons and very-low-density lipoprotein (VLDL). Metformin, an antidiabetic drug, improves plasma lipids including triglycerides. We examined metformin's regulation of angiopoietin-like 3 (ANGPTL3), a liver-derived secretory protein with LPL inhibitory property. Methods Using HepG2 cells, a human hepatocyte cell line, the effects of metformin on ANGPTL3 gene and protein expression were determined. The role of AMPK-SIRT1 pathway in metformin regulation of ANGPTL3 was determined using pharmacological, RNAi and reporter assays. Metformin regulation of ANGPTL3 expression was also examined in sodium palmitate-induced insulin resistance. Key findings Metformin and pharmacological activators of AMPK and SIRT1 inhibited the expression of ANGPTL3 in HepG2 cells. Pharmacological or RNAi-based antagonism of AMPK or SIRT1 failed to affect metformin inhibition of ANGPTL3. AMPK-SIRT1 activators and metformin exhibited distinct effects on the expression of ANGPTL3 gene luciferase reporter. Sodium palmitate-induced insulin resistance in cells resulted in increased ANGPTL3 gene expression which was suppressed by pretreatment with metformin. Conclusions Metformin inhibits ANGPTL3 expression in the liver in an AMPK-SIRT1-independent manner as a potential mechanism to regulate LPL and lower plasma lipids.
“God is Hidden in the Earthly Kingdom:” The Lutheran Two-Kingdoms Theory as Foundation of Scandavanian Secularity

Martin Luther’s signature “two kingdoms” teaching was an early and innovative theory of secularization that lies at the heart of historical Scandinavian culture. Defying the organic medieval models of Western Christendom, Luther separated the heavenly and earthly kingdoms, the saint and the sinner, faith and reason, church and the state, Gospel and the Law, as well as the spiritual and secular uses of law, government and authority. Though God is separated from day-to-day life, Luther wrote, “God is still hidden in the earthly kingdom” and can be seen through various “masks,” “mists,” and “mimes.” Though the visible church is separated from the state and other institutions, religion remains pervasive in the common callings of every person to be God’s prophet, priest and king in every vocation and location of life. Luther’s two kingdoms theory is a complicated and controversial part of this thinking, but it is worth re-exploring today as pluralistic Scandinavia faces strong new pressures of both sacralization and secularization and seeks to discern anew “the hidden sacrality of the secular.”
The SHOCK of Sepsis

Introduction This poster presentation discusses facts and statistics regarding sepsis, as well as the importance of early recognition including signs and symptoms, and the importance of early treatment for decreased mortality in the pediatric population Methods The poster highlights several statistics regarding sepsis in the pediatric population. The poster also stresses the importance of early recognition and predisposition of sepsis. Early treatment is of utmost importance to decrease mortality in the pediatric population. Results The attendee will be able to understand that early recognition and treatment is of the utmost importance in decreasing the mortality in pediatric population. The attendee will also be able to identify several predisposition factors that may contribute to the development of sepsis. Conclusion In conclusion, the attendee will have a better understanding of the signs and symptoms of sepsis, the importance of early recognition and timely treatment to decrease the mortality due to sepsis in the pediatric population.
Pilot Study of Cadence, a Novel Shoe for Patients with Foot Drop

Foot Drop is a mobility disorder that limits ankle dorsiflexion, complicating the swing phase of gait and balance. It is a common result of a neurological injury or disease such as stroke, cerebral palsy or multiple sclerosis. Here we present Cadence, a low-cost assistive shoe designed to passively improve the biomechanics and rhythmicity of gait for people with foot drop. The shoe reduces the magnitude of scuffing forces when dragging the foot forward across the ground by using regions of low-friction material that can retract into the shoe to restore friction during stance phase. We report the results from a pilot study of Cadence, which show the biomechanical and performance effects of the device for five adults with foot drop due to neurological disorder. In 3 of the 5 subjects, we found that the shoe immediately improved gait mechanics, speed over ground, and qualitative gait comfort.
A quadripartite model of passion for marijuana use: Associations with consumption, consequences, craving, and satisfaction with life.

Background Identifying factors that can be targeted in intervention/prevention programs aimed at reducing marijuana-(MJ) related consequences is of critical concern due to the changing legislative landscape of MJ. The dualistic model of passion for MJ has indicated that two factors, obsessive passion (OP) and harmonious passion (HP), have unique effects associated with MJ use outcomes. New research suggests that a quadripartite approach could provide a more nuanced method to interpret risk and protective factors associated with MJ use. Therefore, we used moderation to investigate the associations among OP, HP, and MJ use outcomes. Method A community sample of frequent MJ users was recruited using internet-based advertisements and completed web-based surveys (n=161; M age=27.3, SD=8.9; Male=87%; White/Caucasian=86%; M past30-dayMJuse=22.3, SD=9.9). HP was tested as the moderator between OP, and MJ related outcomes and conditional effects (+/-1 SD) were examined when interaction effects were significant. Results Only main effects for OP had a relation to quantity/frequency of MJ use and MJ intoxication, while main effects for OP and HP were associated with reduction attempts. Interaction effects were significant for MJ consequences, craving, and life satisfaction. Neither OP nor HP were significantly associated with substance use outcomes. Conclusions Findings demonstrate that Pure OP and Mixed Passion are associated with greater risk. Mixed Passion may be a precursor to Pure OP and experiencing MJ-related consequences. Furthermore, Mixed Passion and Pure OP may be important targets for intervention/prevention programs designed to reduce negative outcomes.
High-temperature magnetic anomaly in the Kitaev hyperhoneycomb compound β -Li 2 IrO 3

Author(s): Ruiz, A; Nagarajan, V; Vranas, M; Lopez, G; McCandless, GT; Kimchi, I; Chan, JY; Breznay, NP; Frano, A; Frandsen, BA; Analytis, JG | Abstract: We report the existence of a high-temperature magnetic anomaly in the three-dimensional Kitaev candidate material, β-Li2IrO3. Signatures of the anomaly appear in magnetization, heat capacity, and muon spin relaxation measurements. The onset coincides with a reordering of the principal axes of magnetization, which is thought to be connected to the onset of Kitaev-like correlations in the system. The anomaly also shows magnetic hysteresis with a spatially anisotropic magnitude that follows the spin-anisotropic exchange anisotropy of the underlying Kitaev Hamiltonian. We discuss possible scenarios for a bulk and impurity origin.
Appointment wait-times and arrival for patients at a low-barrier access addiction clinic.

Abstract Introduction Same-day or next-day access to outpatient medication for addiction treatment (MAT) for both alcohol and opioid use disorders may facilitate sustained treatment with evidence-based therapies for substance use disorders (SUD). This study evaluates the association between appointment wait-times and odds of arrival to appointment for patients seeking outpatient MAT. Methods The study sample consisted of patients who scheduled an appointment with a low-barrier access addiction clinic between August 1, 2016, and July 31, 2017. The outcome of interest was the status of the appointment as a dichotomous variable: arrive or no-show/cancel. The primary independent variable (wait-time) was the number of overnights between the date a patient scheduled a clinic appointment and the date of service, categorized as 0 days, 1 day, and 2+ days. We conducted bivariable and multivariable logistic regressions to calculate unadjusted and adjusted odds ratios for arrival. Multivariable analyses were adjusted for gender, age, distance of residence from the clinic, and insurance type. Results Our analysis included 657 patients, of whom 410 (62%) arrived to their first appointment. Among the 657 patients, 47% (308) were scheduled the same day (0 days) and 82% (252) of them were seen, 23% (151) waited 1 day (next-day) and 53% (80) of them were seen, and 30% (198) waited 2+ days and 39% (78) of them were seen. Patients were more likely to be seen when they had a same-day (OR 6.9 [95% CI 4.6–10.4]; AOR 7.5 [4.9–11.4]) or next-day (OR 1.7 [1.1–2.7]; AOR 1.7 [1.1–2.6]) appointment compared to waiting 2+ days. Conclusion Patients seeking MAT through a clinic that schedules same-day and next-day appointments for treatment are more likely to attend addiction appointments compared to patients who wait longer. Clinics should strive to reduce wait-times for patients seeking MAT.