cssi/SciSciGPT-SciSciNet huggingface dataset:
Integrated Genomic Profiling of Chronic Lymphocytic Leukemia Identifies Subtypes of Deletion 13q14 with Differential Expression of LATS2.

Abstract Chronic lymphocytic leukemia (CLL) is a biologically heterogeneous illness with a variable clinical course. Loss of chromosomal material on chromosome 13 at cytoband 13q14 is the most frequent genetic abnormality in CLL but the molecular aberrations underlying del13q14 in CLL remain incompletely characterized. We analyzed 171 CLL cases for LOH and sub-chromosomal copy loss on chromosome 13 in DNA from FACS-sorted CD19+ cells and paired buccal cells using the Affymetrix XbaI 50K SNP array platform. Comparative analysis of SNP-array-derived detection of del13q14 using copy number analysis compared with clinical FISH results for del13q14 demonstrated strong agreement between both methods: FISH detected 91/171=53% overall del13q14 incidence and 77/171=45% del13q14 cases with greater than 25% of cells involved. SNP-arrays detected 82/171=48% del13q14 incidence. SNP-arrays detected 74/77=96% of all CLL cases that were greater than 25% FISH positive and 82/91=90% of all CLL cases that were FISH positive (% positive range for FISH was 2–97%). Finally, SNP-arrays detected 2 CLL cases not previously known to be del13q14 by FISH. The resulting high-resolution genomic maps, together with array-based measurements of expression levels of RNA in CLL cases with and without del13q14 and Q-PCR-based expression analysis of selected genes, support the following conclusions: i. del13q14 is heterogeneous and composed of multiple subtypes (types Ia, Ib and II) with deletion of Rb or the miR15a/16 loci serving as anatomic landmarks, respectively; ii. del13q14 type Ia deletions are relatively uniform in length and extend from breakpoints close to the miR15a/16 cluster to a newly identified telomeric breakpoint cluster at ∼50.2–50.5 Mb physical position; iii. LATS2 RNA levels are ∼2.6–2.8 fold lower in cases with del13q14 type I that do not delete Rb, as opposed to del13q14 type II lesions or all other CLL cases; iv. ∼15% of CLL cases display marked reductions in miR15a/16 expression that are often but not invariably associated with bi-allelic miR15a/16 loss; and v. Bcl-2 levels and miR16/15a locus loss or miR16/15a expression are not correlated. This data should aid future investigations into biological differences imparted on CLL by different del13q14 subtypes, including investigations into LATS2 as one of the genes found deregulated as part of del13q14 type I and investigations into additional miR16/15a targets.
Investigating the Mechanisms Underlying the Effects of an Incidental Choice on Motor Learning

The present study investigated whether motivation and augmented feedback processing explain the effect of an incidental choice on motor learning, and examined whether motivation and feedback processing generally predict learning. Accordingly, participants were assigned to one of two groups, choice or yoked, then asked to practice a nondominant arm beanbag toss. The choice group was allowed to choose the color of the beanbag with which they made the toss, whereas the yoked group was not. Motor learning was determined by delayed-posttest accuracy and precision. Motivation and augmented feedback processing were indexed via the Intrinsic Motivation Inventory and electroencephalography, respectively. We predicted the choice group would exhibit greater motor learning, motivation, and augmented feedback processing, and that the latter two variables would predict learning. Results showed that an incidental choice failed to enhance motor learning, motivation, or augmented feedback processing. In addition, neither ...
Mechanical Response of Polycarbonate Nano-composites as a Function of Strain Rate and Weight Percent of Nano-silicate Clay Loading

In recent years, polymer-based nanocomposites have gradually found its way into mainstream applications such as automotive [1, 2] and food packaging [3]. Studies have shown that the inclusion of nano-particles in nanocomposites increases the tensile strength and modulus when compared to its parent base material [4–7]. Yet, the effect of nano-particles on the mechanical response and failure behavior of nano-composites at high strain rates is still not completely understood. This paper presents the results of a systematic investigation to understand the mechanical response for polycarbonate (PC) nanocomposites under uniaxial compression as a function of the strain rates and weight percent of the nano-silicate clay loading.
Projection Methods in General Semiparametric Models

The projection method can be used not only in finitely many parameter problems but also in nuisance function or infinite many nuisance parameters cases.
Blur vs. Block: Investigating the Effectiveness of Privacy-Enhancing Obfuscation for Images

Computer vision can lead to privacy issues such as unauthorized disclosure of private information and identity theft, but it may also be used to preserve user privacy. For example, using computer vision, we may be able to identify sensitive elements of an image and obfuscate those elements thereby protecting private information or identity. However, there is a lack of research investigating the effectiveness of applying obfuscation techniques to parts of images as a privacy enhancing technology. In particular, we know very little about how well obfuscation works for human viewers or users' attitudes towards using these mechanisms. In this paper, we report results from an online experiment with 53 participants that investigates the effectiveness two exemplar obfuscation techniques: "blurring" and "blocking", and explores users' perceptions of these obfuscations in terms of image satisfaction, information sufficiency, enjoyment, and social presence. Results show that although "blocking" is more effective at de-identification compared to "blurring" or leaving the image "as is", users' attitudes towards "blocking" are the most negative, which creates a conflict between privacy protection and users' experience. Future work should explore alternative obfuscation techniques that could protect users' privacy and also provide a good viewing experience.
Comparison of 2 Radiographic Techniques for Measurement of Tibiofemoral Joint Space Width

Background:No consensus is available regarding the best method for measuring tibiofemoral joint space width (JSW) on radiographs to quantify joint changes after injury. Studies that track articular...
Roger Scruton’s On Human Nature and the Starting Point of Science

This essay examines Roger Scruton’s On Human Nature in relation to the tension between modern science and the ordinary experience science aims to explain. Scruton regards the person as emerging from biological realities and tries to defend the integrity of common sense notions of human distinctiveness against reductive interpretations of evolutionary biology.
Transient Stability Assessment of Cascade Tripping of Renewable Sources Using SOS

There has been significant increase in penetration of renewable generation (RG) sources all over the world. Localized concentration of many such generators could initiate a cascade tripping sequence that might threaten the stability of the entire system. Understanding the impact of cascade tripping process would help the system planner identify trip sequences that must be blocked in order to increase stability. In this work, we attempt to understand the consequences of cascade tripping mechanism through a Lyapunov approach. A conservative definition for the stability region (SR) along with its estimation for a given cascading sequence using sum of squares (SOS) programming is proposed. Finally, a simple probabilistic definition of the SR is used to visualize the risk of instability and understand the impact of blocking trip sequences. A 3-machine system with significant RG penetration is used to demonstrate the idea.
Targeting fundamental pathways to disrupt Staphylococcus aureus survival: clinical implications of recent discoveries

The emergence of community-associated methicillin-resistant Staphylococcus aureus during the past decade along with an impending shortage of effective antistaphylococcal antibiotics have fueled impressive advances in our understanding of how S. aureus overcomes the host environment to establish infection. Backed by recent technologic advances, studies have uncovered elaborate metabolic, nutritional, and virulence strategies deployed by S. aureus to survive the restrictive and hostile environment imposed by the host, leading to a plethora of promising antimicrobial approaches that have potential to remedy the antibiotic resistance crisis. In this Review, we highlight some of the critical and recently elucidated bacterial strategies that are potentially amenable to intervention, discuss their relevance to human diseases, and address the translational challenges posed by current animal models.
Extended Length of Stay in Elderly Patients after Anterior Cervical Discectomy and Fusion Is Not Attributable to Baseline Illness Severity or Postoperative Complications.

Background Health care systems are increasing efforts to minimize postoperative hospital stays to improve resource use. Common explanations for extended postoperative stay are baseline patient sickness, postoperative complications, or physician practice differences. However, the degree to which extended length of stay (LOS) represents patient illness or postoperative complications remains unknown. The aim is to investigate the influence of postoperative complications and elderly patient comorbidities on extended LOS after anterior cervical discectomy and fusion. Methods This retrospective study was performed from January 1, 2008, to December 31, 2014, on data from the American College of Surgeons National Surgical Quality Improvement Program. Patient demographics, comorbidities, LOS, and inpatient complications were recorded. Multivariable logistic regression analysis was used to determine the odds ratio for risk-adjusted extended LOS. The primary outcome was the degree extended LOS represented patient illness or postoperative complications. Results Of 4730 participants, 1351 (28.56%) had extended LOS. A minority of patients with extended LOS had a history of relevant comorbidities—diabetes (29.53%), chronic obstructive pulmonary disease (9.4%), congestive heart failure (1.04%), myocardial infarction (0.33%), acute renal failure (0.3%), and stroke (5.92%). Among patients with normal LOS, 96.8% had no complications, 2.7% had 1 complication, and 0.5% had greater than 1 complication. In patients with extended LOS, 79.4% had no complications, 14.5% had 1 complication, and 6.1% had greater than 1 complication (P Conclusions Our study suggests much of LOS variation after an anterior cervical discectomy and fusion is not attributable to baseline patient illness or complications and most likely represents differences in practice style or surgeon preference.
Breaking Down Blood: Pediatric Immune Thrombocytopenia and Autoimmune Hemolytic Anemia in the Emergency Department

Abstract Immune thrombocytopenia and autoimmune hemolytic anemia are consumptive cytopenias that form a significant and important part of any pediatric hematology practice. The acute and sometimes dramatic symptoms that these patients experience may prompt initial evaluation and management in an emergency department. Here we summarize key information needed by emergency physicians to come to a timely and appropriate diagnosis and disposition for these patients, while avoiding some of the practical pitfalls that can arise.
Controllability for Neutral Systems of Linear Autonomous Differential–Difference Equations

Publisher Summary This chapter discusses the controllability for neutral systems of linear autonomous differential-difference equations. It presents conditions, through the use of various equations, in which a system is Euclidean controllable on an interval. The rank Cn = n is not by itself a sufficient condition for an equation to be controllable on [0,τ], τ > nh. However, the condition is sufficient to establish a result that can often be substituted for controllability.
Endometrial ablation for refractory postmenopausal bleeding with continuous hormone replacement therapy

Objective To determine the role of endometrial ablation and benign uterine pathology in menopausal women with refractory bleeding who were treated with continuous hormone replacement therapy (HRT). Design Prospective. Setting Health maintenance organization. Patients One hundred seventy-one menopausal women with an average age of 55 were enrolled in an algorithm of continuous HRT, endometrial biopsy for bleeding with initial therapy, doubling of the progestin dose, hysteroscopy, and endometrial resection-ablation for continued refractory bleeding. Intervention Endometrial biopsy, hormone manipulation, office hysteroscopy, and hysteroscopic resection-ablation. Main Outcome Measures Refractory menopausal bleeding and benign uterine pathology. Results One hundred sixty-two women completed the study. One hundred six (65.4%) remained free of bleeding at the end of the initial 3months of hormone therapy. Fifty-six (34.6%) had one or more bleeding episodes and required office biopsy and an increase in dosage of progestin. Bleeding ceased in an additional 35 (87%) while 21 (13%) continued to bleed. Those patients underwent endometrial resection-ablation. Surgical specimen demonstrated endometrial polyps, submucous leiomyomas, and adenomyosis in 85.7% of the cases. All patients are now free of bleeding. Conclusion Many women become amenorrheic on the initial dose of continuous HRT; however, if bleeding continues, most stop when the dosage of progestin is doubled. Benign uterine pathology may cause refractory bleeding in a small group of patients but may be eliminated with endometrial resection-ablation.
Modularity and Chinese A-not-A Questions

In theoretical linguistics, a common type of explanation takes the form of a proposal that ties together observed similar phenomena whose related-ness would otherwise be obscured. The generative treatment of passive sentences and their active counterparts is a simple example, according to which the observed similarities between such constructions (with respect to their ‘argument structure’, etc.) are explained given the idea that they have a common or similar D-structure source. Chomsky’s Subjacency is another example, as it ties together a number of Ross’ island constraints, thus providing an explanation for their clustering in a way that the individual constraints do not.
The Normal Uterus

The uterus as a reproductive organ undergoes changes in response to ovarian hormones in preparation for implantation of the fertilized ovum and maintenance of pregnancy. Most changes are at the level of the endometrium and can be detected by pelvic sonography. Ultrasound is the modality of choice for pelvic organ imaging. Early proliferative endometrium appears as a thin echogenic line. Under the influence of increasing estradiol hormone levels (secreted by the growing ovarian follicles), the endometrial proliferation occurs. Sonographically, this is visualized as thickening of the lining into the trilaminar layer with an anterior and posterior hypoechoic layers bordering the myometrium separated by hyperechogenic central line. The post-ovulatory endometrium is under the influence of progesterone secreted by the corpus luteum, and the lining is characterized by loss of the trilaminar appearance and the development of a uniform echogenic stripe. The cervix also undergoes cyclical changes that are detectable on sonography.
Associations among body dissatisfaction, gender, and three latent profiles of religiosity

ABSTRACTBody dissatisfaction is a too-common issue for young women in the US. Body dissatisfaction is a rising issue with young men too, although their average body dissatisfaction remains lower than young women’s. Religiosity has been negatively linked to body dissatisfaction for women, but the relation for men is unclear. The current study (N = 5104) built upon a previous latent profile analysis of a large, diverse sample of US. college students Multi-Site University Study of Identity and Culture (MUSIC). We examined whether body dissatisfaction scores were related to three religious classes, when depressive symptoms were controlled for, and whether gender moderated that potential relation. Body dissatisfaction scores were significantly related to religious class. Gender had a main effect although not a moderating effect: men had better body dissatisfaction than women did, and their religious class similarly affected their body dissatisfaction scores. Religiosity appears important for emerging adult men...
Family, Schooling, and Cultural Capital

School-related cultural capital refers to the skills, habits, identities, worldviews, preferences or values that students enact in schools and that affect their school success. This chapter describes how Pierre Bourdieu’s theory of cultural capital explains social reproduction—the fact that, as adults, children tend to replicate the social class status of their parents. This is largely because academic performance and school success are strongly and positively correlated with parental social class. I examine social class differences in parenting and how these affect the habitus, or underlying skills and dispositions toward schooling of children from different social classes. These differential skills and dispositions in turn give rise to differential academic skills, work habits, and related school behaviors which are judged by teachers when they assign course grades on the report cards of students. As students move up through the levels of schooling, social class differences in course grades lead to social class differences in curriculum selection and high school graduation. Then, high school grades, teacher’s recommendations, and standardized test scores affect postsecondary enrollment and degree attainment. These in turn lead to differences in occupational employment and earnings favoring children from higher social class backgrounds.
Anorectal Trauma and Injuries

The management of trauma to the rectum and anus has a complicated past rooted in military and battlefield experiences. Rectal trauma management varies widely based on the anatomic location and degree of the injury. Intraperitoneal rectal injuries are generally treated much like left colon injuries. Numerous factors play into the complicated operative algorithm for extraperitoneal rectal injuries. This chapter discusses the literature, reasoning, and scenarios for proximal fecal diversion, presacral drain placement, primary rectal repair, and the use of distal rectal washout. Rectal foreign body extraction is explained. The evaluation and acute management of traumatic anal sphincter injury, including a brief overview of outpatient incontinence options, is reviewed.
Editorial Commentary: The Use of Allogenic Cells in Regenerative Medicine: Are Amniotic, Umbilical, and Other Allogenic Cell Sources Safe?

Abstract There are abundant data to suggest that the autologous transplantation of human progenitor cells is safe. However, the use of allogenic cells for human use has not been adequately researched and should not be considered safe at this time.
Maternal Noninfectious Fever Enhances Cell Proliferation and Microglial Activation in the Neonatal Rat Dentate Gyrus.

BACKGROUND:Fever and increased maternal interleukin-6 (IL-6) plasma levels in labor are associated with an increased risk of adverse events in offspring, including neonatal seizures, cerebral palsy, and low intelligence scores at school age. However, the neural changes in the neonate that might medi
The Michigan Child Collaborative Care Program: Building a Telepsychiatry Consultation Service

This column describes the establishment of the Michigan Child Collaborative Care (MC3), a statewide telepsychiatry consultation program that provides support to primary care providers (PCPs) in mee...
Characterization of NDM-5- and CTX-M-55-coproducing Escherichia coli GSH8M-2 isolated from the effluent of a wastewater treatment plant in Tokyo Bay.

Purpose New Delhi metallo-β-lactamase (NDM)-5-producing Enterobacteriaceae have been detected in rivers, sewage, and effluents from wastewater treatment plants (WWTPs). Environmental contamination due to discharged effluents is of particular concern as NDM variants may be released into waterways, thereby posing a risk to humans. In this study, we collected effluent samples from a WWTP discharged into a canal in Tokyo Bay, Japan. Methods Testing included the complete genome sequencing of Escherichia coli GSH8M-2 isolated from the effluent as well as a gene network analysis. Results The complete genome sequencing of GSH8M-2 revealed that it was an NDM-5-producing E. coli strain sequence type ST542, which carries multiple antimicrobial resistance genes for β-lactams, quinolone, tetracycline, trimethoprim-sulfamethoxazole, florfenicol/chloramphenicol, kanamycin, and fosfomycin. The bla NDM-5 gene was found in the IncX3 replicon plasmid pGSH8M-2-4. Gene network analysis using 142 IncX3 plasmid sequences suggested that pGSH8M-2-4 is related to both clinical isolates of E. coli and Klebsiella species in Eastern Asia. GSH8M-2 also carries the bla CTX-M-55 gene in IncX1 plasmid pGSH8M-2-3. Conclusion This is the first report of environmental NDM-5-producing E. coli isolated from a WWTP in Japan. NDM-5 detection is markedly increasing in veterinary and clinical settings, suggesting that dual β-lactamases, such as NDM-5 and CTX-M-55, might be acquired through multiple steps in environment settings. Environmental contamination through WWTP effluents that contain producers of NDM variants could be an emerging potential health hazard. Thus, regular monitoring of WWTP effluents is important for the detection of antimicrobial-resistant bacteria that may be released into the waterways and nearby communities.
Housing and Recidivism: The Critical Link to Reducing Louisiana’s Bulging Prisons

Louisiana has one of the highest incarceration rates in the United States in part because it has a high recidivism rate. One of the reasons ex-offenders return to jail is that they cannot find adequate housing after serving their time. As an inexperienced property manager of a mobile home park in rural Louisiana, the author gained an awareness of the re-entry hurdles ex-offenders face, in a most unexpected way. The park refused any potential resident who had a criminal background. One day a small unassuming man walked into the office, crumbled criminal background check in hand. His rejection certain, he nevertheless pulled out a large three-ring binder. “I know I’ve messed up in my life, but I’ve turned it around, and here’s my proof.” The author sat in silence as he paged through numerous certificates and glowing letters from prison guards, employers, and teachers both during and after his incarceration. The author was able to secure a waiver of the policy, and he became one of the best tenants the park ever had. This Article explores housing problems faced by the formerly incarcerated. It continues with a discussion of the problems faced by property managers in considering ex-offenders’ applications. Louisiana’s antiquated criminal system denies the formally incarcerated any easy means to prove the extent of their rehabilitation. To further complicate matters, property managers are denied access to the very information they most need to assess applicants’ qualifications. The Article recommends a three-pronged approach: (1) expand the criminal record to include communication about the ex-offender’s behavior while incarcerated; (2) allow web access to property managers regarding justice of the peace housing judgments; (3) and enact legislative changes that would protect the formerly incarcerated from discrimination.
Hip, Hip, Array: Teaching Programming for Data Science is the same as Computer Science--Just Different

Teaching an introductory programming class to a data science major needs to be done in a different manner than with a computer science major. This paper will focus on the major differences between the two majors regarding the need for different topical coverage.
[Two components of stria medullaris and the problem of a special neuro-vegetative system].

Es werden zwei Systeme von myelinisierten Fasern beschrieben, welche im Bereiche der Stria medullaris verlaufen. Das eine stammt aus dem Fasc. olfacto-habenularis lateralis, welcher zwar vorwiegend in der Habenula endet, jedoch auch einige feinkalibrige Elemente an die Stria medullaris und den Fasc. habenulo-tegmentalis abgibt. Das zweite System degeneriert nach Unterbrechung der Stria selbst. Es entspricht dem „Stria terminalis-Bundel der Stria medullaris“ der Literatur. Seine ziemlich gut myelinisierten Fasern ziehen caudalwarts, kreuzen vielleicht restlos in der Commissura habenularum, verlaufen dann rostralwarts in der Stria medullaris der anderen Seite und steigen im vordersten Abschnitt, bzw. knapp rostral des unteren Thalamusstiel zur Hirnbasis ab. Auf dieser letzteren Strecke verzweigt sich das Bundel in eine Reihe von Asten. Wahrend die lateraleren Fasern dem Mandelkern zustreben, lehnen sich die medialeren in ganz auffallender Weise an Gefase an, welche lateral des Nucleus supraopticus in die Hirnbasis eintreten, und scheinen zum Teil in Beziehung zu denselben zu enden. Letzterer Befund last die Frage aufwerfen, ob es sich dabei um den anatomischen Ausdruck eines besonderen neuro-vegetativen Mechanismus handelt.
Fatigue in inflammatory bowel disease: a problematic ailment.

PURPOSE OF REVIEW Fatigue, a protean complaint encompassing both physical, mental exhaustion but also demotivation, has shown to effect quality of life in patients with inflammatory bowel disease (IBD). Here we present a review of the literature as it relates to IBD-associated fatigue. Moreover, we present the common causes attributed to fatigue and present an algorithmic approach to the assessment of fatigue. Finally, we report data regarding potential management strategies for IBD-associated fatigue. RECENT FINDINGS Unfortunately, owing to its multidimensional nature and multifactorial causes, patients with IBD may continue to report fatigue despite optimization of disease management, replenishment of nutritional deficiencies, or management of coexistent disorders. Management likely requires a multidisciplinary approach. SUMMARY The majority of patients with IBD report fatigue symptoms both in setting of active disease but also during the course of remission. Fatigue is a multidimensional complaints, and management likely requires a multidisciplinary approach. Herein, we present a framework for the management and assessment of fatigue in IBD.
CRISPR–Cas immune systems and genome engineering

Abstract The famed physicist-turned-biologist, Max Delbruck, once remarked, for physicists, “the field of bacterial viruses is a fine playground for serious children who ask ambitious questions.” Early discoveries in that playground helped establish molecular genetics, and half a century later, biologists delving into the same field have ushered in the era of precision genome engineering. The focus has of course shifted—from bacterial viruses and their mechanisms of infection, to the bacterial hosts and their mechanisms of immunity—but it is the very same evolutionary arms race that continues to awe and inspire researchers worldwide. In this chapter, we explore the remarkable diversity of clustered regularly interspaced short palindromic repeats (CRISPR)–Cas adaptive immune systems, describe the molecular components that mediate nucleic acid targeting, and outline the use of these RNA-guided machines for biotechnology applications and studies of neurological disease. CRISPR–Cas research has yielded far more than just Cas9-based genome-editing tools, and the wide-reaching, innovative impacts of this fascinating biological playground are sure to be felt for years to come. This chapter has been adapted from a review previously published in The CRISPR Journal.
Chukchi Sea Shelf

The Alaskan Chukchi Sea Shelf lies between 65°40′ and 73°00′N and 156°00′ and 171°00′W and covers an area of 580,000 km2 (Fig. 11-1). To the south the Chukchi Shelf is separated from the Bering Sea by a narrow constriction, the Bering Strait, and in the north it is bordered by an abrupt escarpment, the Beaufort Scarp, that descends to the floor of the Arctic Ocean. The 200-m isobath is about 50 km offshore of Point Barrow. The Alaskan Chukchi Sea has an unusual shoreline—the entire coast consists of a narrow coastal plain with the exception of precipitous cliffs near Cape Lisburne and Cape Thompson. Because it is poorly drained small streams and lakes are numerous. From Cape Lisburne northward, the shelf abuts the low Arctic Coastal Plains and the shoreline features an almost continuous chain of barrier islands with lagoons.
Signal processing in Network Physiology: quantifying network dynamics of organ interactions

A fundamental problem in new field of Network Physiology is how organ systems in the human body dynamically interact to coordinate and synchronize their functions, and integrate as a network to generate distinct states and behaviours at the organism level. Physiological systems exhibit complex dynamics, operate at different time scales, and are regulated by multi-component mechanisms, which poses challenges to studying physiologic coupling and network interactions. We present a method based on the concept of time delay stability to probe transient physiologic network interactions in a group of healthy subjects during sleep. We investigate the multi-layer network structure and dynamics of interactions among (i) physiologically relevant brain rhythms within and across cortical locations, (ii) brain rhythms and key peripheral organ systems, and (iii) organ systems with each other. We demonstrate that each physiologic state (sleep stage) is characterized by a specific network structure and link strength distribution, and that the entire physiological network undergoes hierarchical reorganization across layers with transition from one stage to another. Our findings are consistent across subjects, and indicate a robust association of network structure and dynamics with physiologic state and function. The presented approach provides a new framework to explore physiologic states through networks of organ interactions.
Reducing Peripheral Intravenous Catheter Extravasation in Neonates: A Quality Improvement Project.

Purpose Our objective was to reduce total and severe peripheral intravenous extravasation (PIVE) incidence by 40% in our neonatal intensive care unit. Setting/approach This quality improvement initiative was performed at an academic, free-standing suburban children's hospital, in a level 4 neonatal intensive care unit from June 2017 to April 2018. Baseline extravasation data for a period of 6 months prior to the initiative were reviewed, along with a nursing knowledge questionnaire and random audits of catheter stabilization techniques. A Pareto chart and a key driver diagram were created to identify the most common causes of extravasations and lead to a series of process changes. We implemented 4 Plan-Do-Study-Act (PDSA) cycles: (1) dressing protocol for peripheral intravenous vascular (PIV) catheter securement that instituted standardized securement and safer equipment; (2) education on PIV assessment and maintenance, concentrating on hourly evaluation and documentation; (3) guidance algorithm for PIVE identification and treatment; and (4) escalation policy, limiting the number of placement attempts and increased use of a "superuser" team. Outcomes The overall prevalence of extravasations decreased by 54%, from 73 preintervention to 40 at postintervention. At baseline, 52% (38/73) extravasations were severe; however, those in the severe category decreased by 35% (14/40) postintervention. The overall rate of adherence to the PIV catheter management algorithm approached 95%; whereas adherence to the securement guideline fluctuated between 80% and 98%. Implication for practice The implementation of these new practice recommendations along with the education has resulted in a decreased rate and severity of extravasation. Frequent audits and reinforcements are integral to sustainment and to ensure accountability for the implemented procedures.
The Role of Using Red-Topped - Non-Additive-Containing - Collecting Tube in Diagnosing Pseudohyperkalemia in Chronic Lymphocytic Leukemia.

Pseudohyperkalemia in the context of chronic lymphocytic leukemia (CLL) is becoming a common clinical presentation in our daily practice, yet the recognition and the overall approach to this condition remains a challenge as clinicians ponder on whether it's a true rise of serum potassium or not, weighing the risk-benefit ratio of giving the full anti-hyperkalemia measures, dreading the potential iatrogenic hypokalemia if it proves to be a pseudohyperkalemia instead.
Making the Underclass: Deprivation, Degradation, and America's Hidden Penal System

The U.S. penal system contains more than 35,000 punishments besides imprisonment, probation, fine, and death. They apply to about one in three American adults and yet are virtually unknown. This article argues these “hidden sentences” are dignity takings that function to reify second-class American citizenship. First, I argue that dignity takings can conceptually apply to all restrictions of claim rights, not just property. Second, I argue that hidden sentences are all by definition dignity takings, precisely because they are hidden. The presumptions that criminalized people need no notice of these punishments and that courts need not consider them are key symbols that “criminal” means undeserving, vile, and base.
Addressing Advance Care Planning in Patients with COPD

Chronic obstructive pulmonary disease (COPD) is a progressive debilitating disease with diminished quality of life after COPD hospital admissions. Due to the nature of the disease, it is important to address patients' goals of care, preferably prior to the development of refractory COPD. Advance Care Planning (ACP) is an all-encompassing term that involves discussing goals with patients. Various review articles on ACP and COPD focus on defining ACP, identifying barriers to addressing ACP, and using interventions to incorporate ACP in practice. There is evidence that ACP improves quality of communication, reduces admissions, and increases quality of life, but often the focus of that research has been on patients with cancer. Many of the articles have suggestions for how to apply ACP to chronic lung disease, but without further research and definitive guidance it may be difficult to obtain funding for programs dedicated to ACP. There are currently no guidelines for addressing ACP in patients with COPD. Research addresses why advance care planning is important, yet there are barriers that patients, families, and healthcare providers encounter, preventing meaningful discussions. Research has also found that utilizing multidisciplinary teams improves care and quality of life, yet research should be dedicated to investigating the effects of advance care planning initiatives on outcomes in patients with COPD, particularly in reducing hospital admissions and improving quality of life. This review seeks to educate providers about end-stage COPD and advance care planning, the evidence demonstrating advance care planning's importance, and the current and future state of research.
Comparison of vessel segmentations using STAPLE

We propose a novel method for the validation of vascular segmentations. Our technique combines morphological operators and the STAPLE algorithm to obtain ground truth of centerline extractions as well as a measure of accuracy of the methods to be compared. Moreover, our method can be extended to the validation of any open-curves. We also present a comparison study of three vascular segmentation methods: ridge traversal, statistical and curves level set. They are compared with manual segmentations from five experts.
Efficient Inference of Haplotypes from Genotypes on a Pedigree with Mutations and Missing Alleles (Extented Abstract)

Driven by the international HapMap project, the haplotype inference problem has become an important topic in the computational biology community. In this paper, we study how to efficiently infer haplotypes from genotypes of related individuals as given by a pedigree. Our assumption is that the input pedigree data may contain de novo mutations and missing alleles but is free of genotyping errors and recombinants, which is usually true for tightly linked markers. We formulate the problem as a combinatorial optimization problem, called the minimum mutation haplotype configuration (MMHC) problem, where we seek haplotypes consistent with the given genotypes that incur no recombinants and require the minimum number of mutations. This extends the well studied zero-recombinant haplotype configuration (ZRHC) problem. Although ZRHC is polynomial-time solvable, MMHC is NP-hard. We construct an integer linear program (ILP) for MMHC using the system of linear equations over the field F (2) that has been developed recently to solve ZRHC. Since the number of constraints in the ILP is large (exponentially large in the general case), we present an incremental approach for solving the ILP where we gradually add the constraints to a standard ILP solver until a feasible haplotype configuration is found. Our preliminary experiments on simulated data demonstrate that the method is very efficient on large pedigrees and can infer haplotypes very accurately as well as recover most of the mutations and missing alleles correctly.
Transhepatic Embolization of Congenital Intrahepatic Portosystemic Venous Shunts with Associated Aneurysms

Intrahepatic shunts between the portal and systemic venous systems with associated aneurysms are extremely rare. A middle aged woman presented with hepatic encephalopathy and was found to have two intrahepatic portosystemic venous shunts with associated aneurysms. Diagnosis was made by duplex ultrasound and was confirmed with contrast enhanced MRI. Treatment was performed percutaneously with an Amplatzer vascular plug.
Optimizing vaccine development

Optimizing the development of modern molecular vaccines requires a complex series of interdisciplinary efforts involving basic scientists, immunologists, molecular biologists, clinical vaccinologists, bioinformaticians and epidemiologists. This review summarizes some of the major issues that must be carefully considered. The intent of the authors is to briefly describe key components of the development process to give the reader an overview of the challenges faced from vaccine concept to vaccine delivery. Every vaccine requires unique features based on the biology of the pathogen, the nature of the disease and the target population for vaccination. This review presents general concepts relevant for the design and development of ideal vaccines protective against diverse pathogens.
Total intracranial volume and current total brain volume are linked to level of pain in older adults. (P3.302)

Objective: To test the hypothesis that brain reserve, as measured by total intracranial volume (TICV) and total brain volume (TBV), influences pain interference in older adults. Background: At a given level of pain intensity, older adults with low cognitive reserve, as measured by years of education, have higher levels of pain interference. Herein, we use MRI imaging to determine if TICV (as an estimation for maximal lifetime brain growth) and TBV protects against pain interference. Methods: The participants were 123 non-demented adults over the age of 70 years from the Einstein Aging Study. Pain over the past 4 weeks was measured using the Medical Outcomes Study Short Form-36 (SF-36).measures of pain intensity and pain interference. Results: The sample had a mean age of 79.5 years (SD=5.1), was 60[percnt] women and 54[percnt] white, with a mean of 14.3 years (SD=3.4) of education. While controlling for demographic covariates, higher levels of pain interference were associated with smaller TICV and TBV. Pain intensity was not associated with TICV (β =-0.25, P = 0.030) and TBV (β =-0.30, P = 0.008). Given the well-known differences in pain perception in men and women and significant gender differences between TICV (t=-7.6, p<0.001) and TBV (t=-6.8, P<0.001), we reran the regression models stratifying by gender. In women, both TICV (β =-0.27, P = 0.007) and TBV (β =-0.34, P = 0.007) were predictive of pain interference. Results were not significant in men. Conclusions: This study suggest that larger TICV and TBV are associated with less pain interference but not pain intensity in older adults. Consideration of a patient’s TICV and TBV may improve prediction of pain interference with daily activities, with implications for research and clinical practice. Disclosure: Dr. Ezzati has nothing to disclose. Dr. Katz has received research support from Bristol-Myers Squibb. Dr. Lipton has received research support from Repligen Corporation. Dr. Lipton has received personal compensation for activities with Allergan, Inc., American Headache Society, Autonomic Technologies, Boston Scientific Corp., Bristol-Myers Squibb, CogniMed Inc., Colucid Pharmaceuticals, Eli Lilly & Company, eNeura Therape
Comparison of sensible and latent heat fluxes computed from measurements by ship and spar buoy in the tropical Atlantic ocean

Computations of sensible and latent heat fluxes from measurements taken aboard a ship and from a spar buoy east of Barbados in July and August, 1968 are reported. A detailed comparison of the diurnal variation of the fluxes shows that the ship creates an island of turbulence quite different from open sea conditions. Measurements from the buoy, which are believed to be more typical of open ocean conditions indicate that the constant flux layer may be less than 6 m thick.
Some factors in effective communication.

To determine the number of dimensions needed to account for behaviour in an instrumental communication task, verbal descriptions of 40 Munsell colour chips were elicited from four subjects. Later t...
Social anxiety disorder: etiology and early clinical presentation

Behavioral and biological theories addressing the etiology of social anxiety disorder are discussed. Although not often diagnosed until adolescence or adulthood, social anxiety disorder can have its onset during childhood. Early recognition and treatment of this condition may prevent both immediate and long-term detrimental outcomes and, possibly, the onset of comorbid conditions. However, special considerations are required for the diagnosis and treatment of childhood social anxiety disorder. Therapists face special challenges when treating youth with social anxiety disorder, including patient and parent considerations. Although not documented specifically for children with social anxiety disorders, data from families with anxious children suggest that familial factors may play a role in treatment outcome.
Tomato Seed Coat Permeability to Selected Carbon Nanomaterials and Enhancement of Germination and Seedling Growth

Seed coat permeability was examined using a model that tested the effects of soaking tomato (Solanum lycopersicon) seeds in combination with carbon-based nanomaterials (CBNMs) and ultrasonic irradiation (US). Penetration of seed coats to the embryo by CBNMs, as well as CBNMs effects on seed germination and seedling growth, was examined. Two CBNMs, C60(OH)20 (fullerol) and multiwalled nanotubes (MWNTs), were applied at 50 mg/L, and treatment exposure ranged from 0 to 60 minutes. Bright field, fluorescence, and electron microscopy and micro-Raman spectroscopy provided corroborating evidence that neither CBNM was able to penetrate the seed coat. The restriction of nanomaterial (NM) uptake was attributed to the semipermeable layer located at the innermost layer of the seed coat adjacent to the endosperm. Seed treatments using US at 30 or 60 minutes in the presence of MWNTs physically disrupted the seed coat; however, the integrity of the semipermeable layer was not impaired. The germination percentage and seedling length and weight were enhanced in the presence of MWNTs but were not altered by C60(OH)20. The combined exposure of seeds to NMs and US provided insight into the nanoparticle-seed interaction and may serve as a delivery system for enhancing seed germination and early seedling growth.
Stability of amorphous and crystalline phases in an irradiation environment

Abstract The relative stability of crystalline and amorphous phases in metallic structures during ion irradiation is discussed in terms of the free energy changes and point defect mobility. The increase in free energy due to radiation induced defects is predicted to be larger for line compounds than compounds with wide solubility, which can explain the greater tendency toward amorphization for line compounds. Low defect mobility is also necessary to ensure a high total defect concentration. Nucleation of dislocation structure is an alternate way to relieve the high internal free energy and therefore may preclude subsequent amorphous transformation. Ion irradiation can also enhance the crystallization kinetics of the amorphous phase. A critical temperature region can be defined which separates the regions of crystalline stability from amorphous stability during irradiation.
Proton-detected hetero-TOCSY experiments with application to nucleic acids

Homonuclear polarization transfer in liquids based on isotropic mixing (I, 2) has become a method of choice for two-dimensional correlation spectroscopy. Sensitivity, the capacity to produce pure in-phase absorption spectra, and, most importantly, the ability to correlate resonances via multiple steps OF net coherence transfer have all contributed to its popularity. Although one of its common names, “HOHAHA” (2) is derived from its analogy to the rotating-frame heteronuclear cross-polarization experiments performed on solids (3-5), heteronuclear polarization transfer in liquids has relied almost exclusively on laboratory-frame methods such as INEPT (6) and DEPT (7). The reasons for this are clear. Scalar coupling constants in liquids are generally much smaller than dipolar coupling constants in solids, which makes the requirements for energy matching stringent. Since RF inhomogeneity severely degrades contact efficiency, double-tuned, single-coil probe assemblies are usually needed for J cross-polarization experiments. Additionally, many low-y nuclei resonate over a considerably wider bandwidth than protons, so that exceedingly high power levels are needed to overcome off-resonance effects in nonselective experiments. Following earlier suggestions (8, 9), several authors recently demonstrated (10-14) that very efficient heteronuclear J cross polarization in liquids can be achieved by using synchronous composite pulse sequences such as WALTZ16 (1.5) or MLEV16 (16) instead of single-pulse spin locking. These sequences were designed for heteronuclear decoupling over wide frequency ranges with moderate power requirements and compensate for the effects of offset and RF inhomogeneity. They generate efficient polarization transfer over bandwidths wider than those of one-pulse methods and bypass the need for single-coil assemblies. Heteronuclear “isotropic mixing” (10, 14) [or, better, hetero-TOCSY (12)] generates polarization transfer as efficient as that of INEPT or DEPT (14), with the additional advantage of enhancing long-range (14) and relayed (vide infra) couplings simply by lengthening the contact time. My interest in heteronuclear J cross polarization was sparked by problems encountered in assigning proton and “P resonances in RNA. In both RNA and DNA, 3’P chemical shifts and 31P-‘Hst coupling constants contain valuable conformational information (17). However, sequence-specific assignment of 3’P resonances is often limited by difficulties in assigning 3’ proton resonances using standard ‘H-‘H NMR