cssi/SciSciGPT-SciSciNet huggingface dataset:
Seminal Vesicle Aspiration in the Management of Patients with Ejaculatory Duct Obstruction

Ejaculatory duct obstruction is a rare but significant cause of male factor infertility. Vasography is the current gold standard for the diagnosis of complete obstruction of the ejaculatory ducts. However, there is currently no reliable method to diagnose partial obstruction. We performed seminal vesicle aspiration under transrectal ultrasonographic guidance in 11 infertile men to assess the use of this diagnostic test in the evaluation and management of patients with ejaculatory duct obstruction. The absence of sperm within the seminal vesicle aspirate from 8 patients who had sperm in the ejaculate demonstrates that sperm are not normally present within the seminal vesicles. Numerous motile sperm were observed in the seminal vesicle aspirate from an azoospermic patient in whom vasography documented complete ejaculatory duct obstruction, demonstrating that sperm can reflux into the seminal vesicles in patients with distal obstruction. Two patients with suspected partial ejaculatory duct obstruction had sperm in the seminal vesicles. In conclusion, sperm are not normally present within the seminal vesicles and ejaculatory duct obstruction should be suspected in any patient with numerous sperm within the seminal vesicles.
History of Nephrotic Syndrome and evolution of its Treatment

The recognition, evaluation, and early treatment of nephrotic syndrome in infants and children originates from physicians dating back to Hippocrates. It took nearly another thousand years before the condition was described for its massive edema requiring treatment with herbs and other remedies. A rich history of observations and interpretations followed over the course of centuries until the recognition of the combination of clinical findings of foamy urine, swelling of the body, and measurements of urinary protein and blood analyses showed the phenotypic characteristics of the syndrome that were eventually linked to the early anatomic descriptions from first kidney autopsies and then renal biopsy analyses. Coincident with these findings were a series of treatment modalities involving the use of natural compounds to a host of immunosuppressive agents that are applied today. With the advent of molecular and precision medicine, the field is poised to make major advances in our understanding and effective treatment of nephrotic syndrome and prevent its long-term sequelae.
The control of myocardial Ca++ sequestration with nifedipine cardioplegia.

Myocardial 45Ca sequestration was studied in dogs after an injection of 45CaCl2 during 60 minutes of global ischemia and 30 minutes of reperfusion using cardiopulmonary bypass (CPB) at 32° C. Group I (n = 10) received a standard hyperkalemic cardioplegic solution and Group II (n = 10) received the same cardioplegic solution plus nifedipine (100 μg/300 cc). After aortic cross-clamping, 300 cc of cardioplegic solution was delivered at 0 and 30 minutes at 4° C. Tissue specific activity (SA = cpm × 104/gm) and plasma specific acitivity (SA =cpm × 104/ml) were determined before release of the cross-clamp and serially by biopsy during reperfusion. The ratio of tissue SA to plasma SA, termed relative specific activity (RSA), indicates myocardial 45Ca sequestration. Nifedipine led to a marked decrease in sequestration. Group II RSAs were 31.5%, 82.1%, and 39.6% less than Group I RSAs at 0, 20, and 30 minutes of reperfusion. All differences were highly significant (p
Perception of Cognitive Impairment among Alcoholics

The traditional view is that chronic alcoholics tend to show impaired performance on a variety of psychological measures indicating neuropsychological deficit as in the work of Fitzhugh, Fitzhugh and Reitan (1) and the review of the subject by Tarter (2): furthermore, the association between depression and alcoholism continues to be examined eg. by Schuckit (3) and on the other hand, there appears to be some evidence that some cases of sociopathy may arise from “abnormal” or “altered” brain function — Guze (4). In an effort to clarify the possible associations among these various conditions, I would like to describe two studies.
Interpreting the Qur'an in the US: Religious Pluralism, Tradition, and Context

In the contemporary US, religious pluralism has profoundly shaped the ways that American Muslims read and interpret the Qur'an in their daily lives. In particular, they face increasing pressure to affirm, through Qur'anic interpretation, that Islam recognises Judaism and Christianity as salvific faiths and to downplay Islamic claims to superiority. Through a case study of a US Qur'anic study group, this article explores how American Muslims appropriate and contest the logic of pluralism through their interpretations of the Qur'an. Seeking to affirm ecumenicism in the Qur'an, this group of American Muslims appropriated the asbāb al-nuzūl (‘circumstances of revelation’) under the rubric of ‘context’ in order to make the case for the commensurability of Islam and religious pluralism, even as they vigorously disagreed about the terms under which those circumstances could be applied. The ethnographic dialogues presented here demonstrate not only the rich and vibrant hermeneutics that contemporary Muslims bring...
A local feedback controller for oversaturated intersection control based on dynamic road traffic models

A dynamic road traffic model is applied to traffic control design at an isolated intersection to determine control sequences. Developments in linear systems control theory are applied to address two continuing problems that are keys to effective road traffic system operations: road traffic models; and traffic signal control. The control of an oversaturated intersection is formulated as a linear systems control problem on the basis of mathematical models. These models are utilized to develop local traffic signal control strategies under various traffic conditions.
Leveraging Bayesian Approach to Predict Drug Manufacturing Performance

Purpose With increase in competition and regulatory requirements, the pharmaceutical and biotechnology industry has focused more resources on ensuring consistency and quality during manufacturing to minimize process deviations and batch failures. Specifically, computational tools are developed to monitor and predict manufacturing performance. The objective of this paper is to identify a process prediction tool, which can leverage available data to predict the performance of future production batches. Hence, if we suspect a process deviation in future batches, strategies can be developed in advance for risk mitigation.
Talking to a Deity The Royal Lady Hachijō-in at Prayer

A lack of sources makes it difficult to discover the personhood of premodern Japanese royal women—how they viewed themselves or wanted to be viewed by others. Hachijō-in (1137–1211), a royal heiress, strove to protect her lineage, which had begun to weaken in the political and military turmoil of the late twelfth century. Through a close analysis of her prayer of dedication (kōmon), this article explores how she reflected upon herself after undergoing a time of great difficulty as an unmarried royal daughter. In contrast to the historical overviews that typically emphasise the roles of medieval male royals and warriors, this study demonstrates that royal daughters also played significant religio-political roles. They developed a strong sense of responsibility for supporting royal authority and commemorating deceased family members. Hachijō-in’s prayer reveals her objectives, feelings and values as a woman through a deliberate construction of herself in front of the Great Bodhisattva Hachiman of Iwashimizu...
National Estimate of Per- and Polyfluoroalkyl Substance (PFAS) Release to U.S. Municipal Landfill Leachate.

Landfills are the final stage in the life cycle of many products containing per- and polyfluoroalkyl substances (PFASs) and their presence has been reported in landfill leachate. The concentrations of 70 PFASs in 95 samples of leachate were measured in a survey of U.S. landfills of varying climates and waste ages. National release of PFASs was estimated by coupling measured concentrations for the 19 PFASs where more than 50% of samples had quantifiable concentrations, with climate-specific estimates of annual leachate volumes. For 2013, the total volume of leachate generated in the U.S. was estimated to be 61.1 million m3, with 79% of this volume coming from landfills in wet climates (>75 cm/yr precipitation) that contain 47% of U.S. solid waste. The mass of measured PFASs from U.S. landfill leachate to wastewater treatment plants was estimated to be between 563 and 638 kg for 2013. In the majority of landfill leachate samples, 5:3 fluorotelomer carboxylic acid (FTCA) was dominant and variations in concen...
Potential inheritance patterns of a prothrombin gene mutation in a 23-year-old female and ethical considerations of a positive diagnosis: a case report

Background : Prothrombin, also called Factor II, is a blood clotting protein found in all individuals that is necessary to form blood clots. In most individuals, a balance between bleeding and blood clot formation occurs. However, in individuals with a mutation in the prothrombin gene, the balance is disrupted due to excess production of prothrombin which leads to an increase in blood clot formation (1). Inherited predispositions to blood clot formation are termed hereditary thrombophilia. Prothrombin G20210A mutations are one of the most common hereditary gene associations. Case Description: This report examines the case of a 23-year-old female who has tested positive for the prothrombin gene mutation. The individual has an extensive history of blood clots including 8 deep vein thromboses (DVTs), 4 pulmonary embolisms with one complete infarction, 4 superficial clots, and a miscarried pregnancy attributed to her thrombophilia. The individual has a significant family history of the mutation and takes Coumadin daily for prevention of further clots. Practical and Ethical Implications : Despite a strong familial history of blood clots and related hospitalizations, the parents of the case individual do not want to get their other children tested for the mutation for fear that the children will be denied insurance coverage in their futures. The case individual will likely continue to be on blood thinners indefinitely. This will affect many aspects of her life, including dental treatment, as she will be at an increased risk for bleeding.
Moral Education and School Social Organization

For some time, the sociology of schools has been dominated by a definition of the school as an array of resource stocks—such things, for example, as teachers, specialist staff, books, subject matter content, and time. For this definition, we owe something to the economists (e.g., Murnane, 1975; Thomas, 1977) and psychologists (e.g., Carroll, 1963; Wiley, 1976). However, it has been widely used and elaborated in studies of educational status attainment, especially studies that relate attainment to social stratification (e.g., Alexander, Cook, and McDill, 1978; Alexander and McDill, 1976; Hauser, 1971; Hauser, Sewell, and Alwin, 1976; Heyns, 1974; Kerckhoff, 1974; Rosenbaum, 1976; Sewell, Haller, and Portes, 1969).
Towards a Better Understandability of Uncertainty-Estimating Algorithms

In this chapter, we explain how to make uncertainty-estimating algorithms easier to understand. We start with the case of interval uncertainty. For this case, in Sect. 4.1, we provide an intuitive explanation for different types of solutions, and in Sect. 4.2, we provide an intuitive explanation for seemingly counter-intuitive methods for solving the corresponding problem. In Sect. 4.3, we consider the case of probabilistic uncertainty. For this case, we explain why it is reasonable to consider mixtures of probability distributions. In Sect. 4.4, we consider the case of fuzzy uncertainty; we explain why seemingly non-traditional fuzzy ideas are, in effect, very similar to the ideas from traditional logic.
Regulatory Considerations Concerning Safety of OTC NSAIDs and Analgesics

Self-medication worries the healing arts professions. By taking medicines without the ‘learned intermediary’, people avoid becoming patients (defined as persons consulting physicians, pharmacists, or other professionals for treatment, and, importantly, for diagnosis). This recourse contains several implications: the individual regards the symptom as minor or non-threatening and is willing to temporize to see if the problem can disappear on its own; the individual wishes to avoid further medical consultative charges and recognizes the OTC medicine as continuing what began as prescribed type of medication but at lower cost; or an attempt at self-diagnosis that obviates professional consultation. This holds true particularly in the United States; in some countries, even self-medication drugs must be obtained in a pharmacy, though without prescription, so someone to counsel is present. In the USA, such medications fill supermarket shelves and there is no one in the store to give advice. Packaging, shelf-space, and advertising influence choices. The labels, not always consulted, and the promotional materials dictate uses and comparisons. Thus, for example, a large ‘FOR FEVERS’ may send a more powerful message than the smaller print on cautious use in children, and a medication restricted to adult use may become a favourite for treating the more common childhood fevers Similar inappropriate uses cloud OTC marketing. As pain control remains a major reason for self-medication, the drugs positioned as options find a highly competitive and highly remunerative market. Leaving aside topically applied medications, OTC analgesics in the USA basically represent three groups: aspirin, acetaminophen (paracetamol), and non-steroidal anti-inflammatory drugs (NSAIDs).
Integrating protocol schedules with patients' personal calendars.

We propose a new approach for integrating protocol care schedules into patients’ personal calendars. This approach could provide patients with greater control over their current and future scheduling demands as they seek and receive protocol-based care.
Abstract B64: Sox10 drives tumor progression in breast cancer by reprogramming mammary tumor cells into a state of plasticity resembling primitive neural crest cells

Many foundational features of tumor malignancy such as tumor initiation, tumor heterogeneity, therapeutic resistance, and metastasis are driven through dysregulated cell plasticity. Thus, the development of strategies to counter mechanisms of reprogramming in cancer cells is a critical area of need in the field. To address this challenge, we have focused on discovering how cell plasticity is specified in normal mammary development and tissue, and how these processes may be co-opted to drive tumor progression in breast cancer. To facilitate the study of these complex phenomena, we have developed a CRISPR- and tissue engineering-based platform system to rapidly generate de novo, in vivo, mammary glands and mammary tumors that carry any conceivable genomic modification. Here, we have used this system to study the function of Sox10 in breast cancer, as we have previously shown that the transcription factor Sox10 is a critical mammary cell plasticity factor that labels and is functionally required for stem/progenitor activity in normal mammary cells. We now demonstrate that Sox10 is also a major plasticity factor in breast cancer. We find that Sox10 is expressed in both human breast cancer and multiple murine mammary tumor models, and demonstrate critical roles for Sox10 in driving both tumor initiation and progression. Sox10 expression in these tumors correlates with multiple indicators of elevated cell plasticity, which include features of de-differentiation and EMT, specific enrichment of mammary stem/progenitor identity, and expanded lineage potential compared to normal mammary cells. In addition to its role in specifying stem/progenitor activity in mammary cells, Sox10 is also a dominant specifier of neural crest cells, a primitive and highly plastic cell state found only in the early embryo. Strikingly, we find that Sox10+ mammary tumor cells also exhibit transcriptional and epigenetic features of neural crest cells that are not found in normal mammary cells. Collectively, these data reveal that Sox10 is a major plasticity factor that contributes to mammary tumor progression, and demonstrate the remarkable scope of cell state reprogramming that can occur during tumorigenesis when potent plasticity factors are dysregulated. Note: This abstract was not presented at the conference. Citation Format: Christopher Dravis, Geoffrey Wahl. Sox10 drives tumor progression in breast cancer by reprogramming mammary tumor cells into a state of plasticity resembling primitive neural crest cells [abstract]. In: Proceedings of the AACR Special Conference: Advances in Breast Cancer Research; 2017 Oct 7-10; Hollywood, CA. Philadelphia (PA): AACR; Mol Cancer Res 2018;16(8_Suppl):Abstract nr B64.
Early Developments in the Theory of the Saturated Adiabatic Process

A study of the history of the early developments in the theory of the saturated adiabatic process reveals that the first quantitative formulation of both the dry- and the saturated-adiabatic cooling rates were given by the British physicist, William Thomson (later Lord Kelvin), in a paper read in 1862, although the first published analysis was presented in 1864 by a Swiss meteorologist, Reye. Reye's paper presents both the differential form and the exact integrated form of the reversible saturated adiabatic relationship, which thus attained its modern form at the moment of its first appearance. Reye also gave a very clear, though brief, discussion of the concepts of atmospheric stability of both dry and saturated layers. The papers of Hann (1874) and Hertz (1884), frequently misquoted as the original treatments of the saturated adiabatic theory, are thus shown to be secondary papers in the actual history of this important theory.
Methodological Advances in the Study of Hidden Variables: A Demonstration on Clinical Alcohol Use Disorder Data

Research in the domain of psychopathology has been hindered by hidden variables-variables that are important to understanding and treating psychopathological illnesses but are unmeasured. Recent methodological advances in machine learning have culminated in the ability to discover and identify the influence of hidden variables that confound the observed relationships among measured variables. We apply a combination of traditional methods and more recent advances to a data set of alcohol use disorder patients with comorbid internalizing disorders, and find that the increasingly advanced methods produce increasingly informative and reliable results. These results include novel findings evaluated positively by our psychopathologists, as well as findings validated with knowledge from existing literature. We also find that advanced graph discovery methods can guide the use of latent variable modeling procedures, which can in turn explain the output of the graph discovery methods, resulting in a synergistic relationship between two seemingly distinct classes of methods.
Quantitative expression of MMPs 2, 9, 14, and collagen IV in LCIS and paired normal breast tissue

Certain matrix metalloproteinases (MMPs) have the ability to degrade collagen IV, a main component of the breast lobular basement membrane. In this cross-sectional study, we evaluated expression of MMPs 2, 9, and 14 and collagen IV in LCIS and adjacent normal breast tissue among LCIS patients without invasive breast cancer to determine whether expression differed between benign and preinvasive breast epithelial tissue. A total of 64 LCIS patients, diagnosed 2004–2014, were included; 44 had sufficient paired normal tissue for analysis. Marker epithelial expression was measured using immunofluorescence and quantified using the H score (MMPs) or pixel intensity (collagen IV). Associations were evaluated using the Spearman correlation or the Wilcoxon signed-rank test. In LCIS and normal tissue, there was a strong correlation between MMP2 and MMP14 expression (LCIS r = 0.69, normal r = 0.81, both P < 0.01). Other pairwise correlations were moderate to weak (range: LCIS r = 0.32–0.47, normal r = 0.19–0.32). For all markers, expression was lower in LCIS vs. normal tissue (all P ≤ 0.05). In sum, collagenase MMPs were expressed in normal breast and LCIS lesions of LCIS patients. However, expression was not higher in LCIS compared with normal tissue, suggesting collagenase MMP expression does not increase as breast tissue gains a more proliferative phenotype.
Homeless patients tend to have greater psychiatric needs when presenting to the emergency department.

Abstract Introduction Homeless patients tend to visit Emergency Departments (EDs) more frequently than the non-homeless population. The goal of this study was to assess differences in chief complaint, medical conditions, and disposition between homeless patients compared to non-homeless patients presenting to an urban ED. Methods This was a retrospective cohort of homeless patients ages ≥18 years compared to non-homeless controls from January 1, 2017 to December 31, 2017. Exclusion criteria were as follows: direct admission to hospital floor, repeat visits, or leaving without being seen. The primary endpoint of this study was to assess differences in chief complaint of homeless versus non-homeless patients upon presentation to the ED. Our secondary endpoints included differences in ED utilization between the two groups, in terms of length of stay, ambulance use, diagnosis, and disposition. Results Homeless patients were more likely present to the ED for a psychiatric evaluation (homeless group 34% vs. non-homeless group 4%, p Conclusion This study found that homeless patients had a significantly higher association with psychiatric diagnoses and greater ED utilization than non-homeless. This suggests the importance of increased access to consistent psychiatric care and follow up within the homeless population.
Integrating Hands-on Components into Database Curriculum at Undergraduate and Graduate Levels

Database concepts and technologies have continuously evolved in recent years and database is a highly applicable field of study. To create an effective and dynamic learning environment, we re-design the database curriculum at undergraduate and graduate levels to keep up with the current trends of development. The paper provides in-depth discussions of database curriculum in Computer Science and shows how the core topics are strongly supported by hands-on components. We also discuss the challenges we have encountered and how we use virtualization techniques to solve them.
When do preschoolers learn specific mathematics skills? Mapping the development of early numeracy knowledge

Abstract Children’s mathematics skills undergo extensive development during the preschool years. Opportunities for engaging in mathematics in the preschool classroom, however, are limited, and activities and instruction are often targeted below children’s skill levels. Although researchers have developed general learning trajectories of children’s mathematics skills, no fine-grained trajectories across a broad range of mathematics skills exist. Such a fine-grained trajectory of when specific numeracy skills develop would allow preschool and kindergarten instruction to more appropriately match and scaffold children’s mathematics capabilities. The current study examined preschool children’s item-level performance on eight numeracy subtests at half-year age points throughout the preschool period. Data were compiled across six studies, and participants comprised 801 preschool children (age range = 3.12–5.99 years, M = 4.63, SD = 0.68). Children were grouped into six age categories (3, 3.5, 4, 4.5, 5, and 5.5 years). Linear regression analyses were used to investigate the number of children who correctly answered each item of a specific subtest within a particular age group. Findings provide clear trajectories of children’s early mathematics skills that can be used to inform preschool classroom practices and facilitate the design of intervention studies.
Patient Experience Contributing to Outcomes of Laryngeal Botulinum Toxin Injection.

Summary Objectives Laryngeal Botulinum Toxin injection (LBTX) in the adductor musculature is the current therapy for Adductor Spasmodic Dysphonia. This study explores nonbiological factors that can affect the patient experience during this procedure and their association with better or worse self-reported effectiveness. Methods A 14 item survey was used to evaluate the patient experience in patients who had undergone LBTX in Mayo Clinic Jacksonville, Florida, during 2019. Information from the survey, previous medical history, and demographic data were collected, and a descriptive analysis was performed. Results Of the 36 patients who participated, the mean age was 65 years and a female predominance was found (66%). The average age at onset of symptoms was 57 years, and voice tremor was associated with 36.1% of patients. Preprocedure education was recognized as a factor affecting outcomes in 87% of patients; 11 patients reported that body position used during the injection could affect the results. Pain or stress experienced at the time of procedure was referred in one-third of patients as an influencing factor too. Conclusion This study has shown that nonpharmacological factors such as education before the procedure, body position, pain, and stress sensation before LBTX may have a role in the botulinum toxin effect on Adductor Spasmodic Dysphonia patients. This study is the first to describe these variables qualitatively, and further studies may help to improve the patient experience and outcome of LBTX around the world.
Development and Validation of a Risk Stratification Model Using Disease Severity Hierarchy for Mortality or Major Cardiovascular Event.

Importance Clinical domain knowledge about diseases and their comorbidities, severity, treatment pathways, and outcomes can facilitate diagnosis, enhance preventive strategies, and help create smart evidence-based practice guidelines. Objective To introduce a new representation of patient data called disease severity hierarchy that leverages domain knowledge in a nested fashion to create subpopulations that share increasing amounts of clinical details suitable for risk prediction. Design, Setting, and Participants This retrospective cohort study included 51 969 patients aged 45 to 85 years, with 10 674 patients who received primary care at the Mayo Clinic between January 2004 and December 2015 in the training cohort and 41 295 patients who received primary care at Fairview Health Services from January 2010 to December 2017 in the validation cohort. Data were analyzed from May 2018 to December 2019. Main Outcomes and Measures Several binary classification measures, including the area under the receiver operating characteristic curve (AUC), Gini score, sensitivity, and positive predictive value, were used to evaluate models predicting all-cause mortality and major cardiovascular events at ages 60, 65, 75, and 80 years. Results The mean (SD) age and proportions of women and white individuals were 59.4 (10.8) years, 6324 (59.3%) and 9804 (91.9%), respectively, in the training cohort and 57.4 (7.9) years, 21 975 (53.1%), and 37 653 (91.2%), respectively, in the validation cohort. During follow-up, 945 patients (8.9%) in the training cohort died, while 787 (7.4%) had major cardiovascular events. Models using the new representation achieved AUCs for predicting death in the training cohort at ages 60, 65, 75, and 80 years of 0.96 (95% CI, 0.94-0.97), 0.96 (95% CI, 0.95-0.98), 0.97 (95% CI, 0.96-0.98), and 0.98 (95% CI, 0.98-0.99), respectively, while standard methods achieved modest AUCs of 0.67 (95% CI, 0.55-0.80), 0.66 (95% CI, 0.56-0.79), 0.64 (95% CI, 0.57-0.71), and 0.63 (95% CI, 0.54-0.70), respectively. Conclusions and Relevance In this study, the proposed patient data representation accurately predicted the age at which a patient was at risk of dying or developing major cardiovascular events substantially better than standard methods. The representation uses known relationships contained in electronic health records to capture disease severity in a natural and clinically meaningful way. Furthermore, it is expressive and interpretable. This novel patient representation can help to support critical decision-making, develop smart guidelines, and enhance health care and disease management by helping to identify patients with high risk.
Internal (Factorial) Validity of the ANAM using a Cohort of Woman High-School Soccer Players.

Introduction Computerized neuropsychological testing is a cornerstone of sport-related concussion assessment. Female soccer players are at an increased risk for concussion as well as exposures to repetitive head impacts from heading a soccer ball. Our primary aim was to examine factorial validity of the Automated Neuropsychological Assessment Metrics (ANAM) neuropsychological test battery in computing the multiple neurocognitive constructs it purports to measure in a large cohort of interscholastic female soccer players. Methods Study participants included 218 interscholastic female soccer players (age = 17.0±0.7 year; mass = 55.5±6.8 kg; height = 164.7±6.6 cm) drawn from a large (850+) prospective database examining purposeful heading from four area high schools over a 10-year period. The ANAM-2001 measured neurocognitive performance. Three methods were used to identify integral constructs underlying the ANAM: (a) exploratory factor analysis (EFA), (b) first-order confirmatory factor analysis (CFA), and (c) hierarchical CFA. Results Neuropsychological phenomena measured by the ANAM-2001 were best reproduced by a hierarchical CFA organization, composed of two lower level factors (Simple Reaction Time, Mental Efficiency) and a single, general composite. Although the ANAM was multidimensional, only the composite was found to possess sufficient construct dimensionality and reliability for clinical score interpretation. Findings failed to uphold suppositions that the ANAM measures seven distinct constructs, or that any of its seven tests provide unique information independent of other constructs, or the composite, to support individual interpretation. Conclusions Outcomes infer the ANAM possesses factorial-validity evidence, but only scores from the composite appear to sufficiently internally valid, and reliable, to support applied use by practitioners.
What can Microneurography Tell the Clinician About Nerve Regeneration or Disease

The method of recording sensory nerve action potentials through the human skin was introduced by Dawson [3], and clinical use was soon made by Gilliatt and Sears [4]. The recording conditions were later improved by Buchthal and Rosenfalk [2], who inserted needle electrodes through the skin and used averaging techniques to improve the signal to noise ratio. Whether surface or near-nerve recording is used, the recorded signal is a compound action potential which cannot distinguish between its elementary components. Single unit analysis becomes mandatory to identify the latter. This type of analysis became possible with the introduction of the technique of percutaneous microneurography (MNG) [11]. For routine clinical application, recording the compound action potential (CAP) remains the method of choice, because it is less time consuming and provides basic information on nerve conduction in health and disease. Single unit analysis, used as a basic research tool, does, however, provide the detailed information that allows interpretation of the CAP and becomes crucial in the study of impulse generation and transmission.
Relationships between creatinine increase and mortality rates in patients given vancomycin in 76 hospitals: The increasing role of infectious disease pharmacists

Purpose Vancomycin is a commonly used antimicrobial with the potential for renal toxicity. We evaluated vancomycin duration, changes in renal function after vancomycin initiation ("post-vancomycin" renal function changes), and associated mortality risk among hospitalized patients. Methods We analyzed data from 76 hospitals and excluded patients with a baseline serum creatinine concentration (SCr) of >3.35 mg/dL. We estimated mortality risk relative to vancomycin duration and the magnitude of post-vancomycin SCr change, controlling for demographics, baseline SCr, underlying diseases, clinical acuity, and comorbidities. Results Among 128,993 adult inpatients treated with vancomycin, 49.0% did not experience SCr elevation. Among the remaining patients, 26.0%, 11.4%, 8.8% and 4.8% experienced increases in post-vancomycin SCr of 1% to 20%, 21% to 40%, 41% to 100%, and greater than 100%, respectively. Compared to mortality risk among patients with a vancomycin therapy duration between 4 and 5 days (the lowest-mortality group), longer vancomycin therapy duration was not independently associated with higher mortality risk after adjusting for confounders. In contrast, there was a graded relationship between post-vancomycin SCr elevation and mortality. Multivariable adjusted mortality odds ratios ranged from 1.60 to 13.66, corresponding to SCr increases of 10% and greater than 200%, respectively. Conclusion Half of patients given vancomycin did not experience SCr elevation and had the lowest mortality, suggesting that vancomycin can be used safely if renal function is stabilized. In the large study cohort, vancomycin duration itself was not an independent predictor of mortality. Post-vancomycin SCr elevation appeared to be a driver of in-hospital mortality. Even a 10% SCr increase from baseline prior to vancomycin infusion was associated with increased mortality risk. This finding stresses the importance of closely monitoring renal function and may support the value of pharmacokinetic dosing.
A Valuable Bucket of Cold Water

Watching Anderson, Broderick, and Stoddard’s (2020) American Association of Geographers plenary was like taking a bucket of cold water in the face in the morning: a shock to the system, but a great...
Psychosocial interventions and needs among individuals and families with Li-Fraumeni syndrome: A scoping review.

Li-Fraumeni syndrome (LFS), a rare cancer predisposition syndrome caused by germline mutations in the TP53 gene, is associated with significant lifetime risk of developing cancer and warrants extensive and long-term surveillance. There are psychosocial impacts on individuals and families living with this condition, from the initial diagnosis throughout multiple stages across the lifespan, but these impacts have not been systematically reviewed and organized. The objective of this scoping review was to synthesize and characterize the literature on psychosocial screening and outcomes, educational needs, support services, and available interventions for patients and families with LFS. A systematic search of six databases was most recently conducted in August 2020: (PubMed/MEDLINE (NLM), EMBASE (Elsevier), Cochrane Library (Wiley), CINAHL (EBSCO), PsycINFO (OVID), and Web of Science (Clarivate Analytics). A total of 15 757 titles were screened, and 24 articles included. Several important themes were identified across studies: factors associated with TP53 genetic testing, LFS surveillance, psychological outcomes, and communication. Findings related to these themes were organized into age-specific categories (age agnostic/across the lifespan, childhood, adolescence and young adulthood, and adulthood).
A Closer Look at Racial Differences in Diabetes Outcomes Among a Community Sample: Diabetes Distress, Self-care, and HbA1c.

OBJECTIVE Approximately 34 million people in the U.S. have diabetes. With this illness come substantial changes to psychological and physical health. However, type 2 diabetes disproportionately affects non-Hispanic black compared with non-Hispanic white populations. The purpose of this study was to examine racial differences in psychological, behavioral, and physical health over time among individuals recently diagnosed with type 2 diabetes. RESEARCH DESIGN AND METHODS Data were collected from a community sample of 193 adults recently diagnosed with type 2 diabetes (44% female; 45% black). Measures of distress, self-care behaviors, and HbA1c were taken at an initial interview (time 1) and 6 months later (time 2). Individuals wore an Actical accelerometer to assess physical activity and participated in three 24-h dietary recall interviews to assess dietary intake within 2 weeks of the initial interview. RESULTS From time 1 to time 2, black women showed the highest increase in depressive symptoms. There was a greater increase in regimen and physician distress among white compared with black participants. White men and black women reported a decline in medication adherence over time. There were no racial differences in changes in physical activity across 6 months. However, black individuals had higher overall calorie consumption with greater protein, saturated fat, and cholesterol intake than white individuals. There were no race or sex differences in changes in glycemic stability. CONCLUSIONS Initial adjustment to a diagnosis of type 2 diabetes differentially influences black and white men and women in terms of depressive symptoms, diabetes distress, and self-care.
Elevated levels of radiocarbon in methane dissolved in seawater reveal likely local contamination from nuclear powered vessels.

Abstract Measurements of the natural radiocarbon content of methane (14C-CH4) dissolved in seawater and freshwater have been used to investigate sources and dynamics of methane. However, during investigations along the Atlantic, Pacific, and Arctic Ocean Margins of the United States, as well as in the North American Great Lakes, some samples revealed highly elevated 14C-CH4 values, as much as 4–5 times above contemporary atmospheric 14C-CH4 levels. Natural production of the 14CH4 isotopologue is too low to cause these observations nor can it explain the variations in location and depth. Numerous lab and field validation tests and blanks, as well as the relatively small number of samples that display these elevated values, all suggest that these signals are not derived from an unknown procedural issue. Here we suggest that the byproducts of nuclear power generation include localized discharges of the 14CH4 isotopologue into marine and aquatic environments, severely altering the measured 14C-CH4 isotopic signals. Since several of our sample sites are distant from on-land nuclear powerplants, we conduct further calculations concluding that the most elevated anomalies in 14C-CH4 likely originate with discharge from nuclear-powered vessels.
Why We Should Discount the Views of Those Who Discount Discounting

Deciding how to allocate the resources to be spent on promoting health and safety through governmental regulation is a challenging task of immense significance. The Environmental Protection Agency estimates that roughly $250 billion (2.6% of Gross National Product) will be spent on pollution abatement alone in the year 2000.1 Billions more are spent on a wide array of other health and safety measures. Tens of thousands of lives will be lost or saved depending on whether these allocations are made foolishly or wisely.2 In 1986, Office of Management and Budget (OMB) economist John Morrall devised a now-famous table designed to assess the desirability of an array of federal health and safety regulations.3 Morrall concluded that roughly half of the forty-four regulations he reviewed were unsound because the cost per life saved exceeded $26.8 million in 1998 dollars-a
Liver stem cells

The capacity of hepatocytes and cholangiocytes to contribute to their own maintenance has long been recognized. More recently, studies have indicated the presence of both intra-hepatic and extra-hepatic stem/progenitor cell populations. The intraorgan compartment probably derives primarily from the biliary tree, most particularly the most proximal branches, i.e. the canals of Hering and smallest ductules. The extra-organ compartment is at least in part derived from diverse populations of cells from the bone marrow. These three tiers of liver cell regeneration serve to maintain the normal organ and to regenerate damaged parenchyma in response to a variety of insults. The nature and extent of the insult determines the balance between these stem/progenitor compartments.
Regulation of CD4+ T-cell contraction during pathogen challenge

Signals orchestrating productive CD4+ T-cell responses are well documented; however, the regulation of contraction of CD4+ T-cell effector populations following the resolution of primary immune responses is not well understood. While distinct mechanisms of T-cell death have been defined, the relative importance of discrete death pathways during the termination of immune responses in vivo remains unclear. Here we review the current understanding of cell-intrinsic and cell-extrinsic variables that regulate contraction of CD4+ T-cell effector populations through multiple pathways that operate both initially during T-cell priming and later during the effector phase. We discuss the relative importance of antigen-dependent and antigen-independent mechanisms of CD4+ T-cell contraction during in vivo responses, with a special emphasis on influenza virus infection. In this model, we highlight the roles of greater differentiation and presence in the lung of CD4+ effector T cells, as well as their polarization to particular T-helper subsets, in maximizing contraction. We also discuss the role of autocrine interleukin-2 in limiting the extent of contraction, and we point out that these same factors regulate contraction during secondary CD4+ T-cell responses.
Marine ecology: Do mussels take wooden steps to deep-sea vents?

Symbiont-containing mussels (Mytilidae) are found at hydrothermal vents and cold seeps on the ocean floor, but it is not known whether these taxa represent an ancient lineage endemic to these surroundings or are more recent invaders. Here we show that several small and poorly known mussels, commonly found on sunken wood and whale bones in the deep sea, are closely related to vent and seep taxa, and that this entire group is divergent from other Mytilidae. Our results indicate that vents and seeps were recently invaded by modern mytilid taxa and suggest that decomposing wood and bone may have served as ‘steps’ for the introduction of mytilid taxa to vents and seeps.
'First Amendment' Pioneers in a European Land of Hate Speech Bans: Flemming Rose, Geert Wilders and Liberté Pour L’Histoire

Are global defenses of free speech possible? Or are such arguments necessarily local? To answer this question, this paper focuses on three European opponents of hate speech laws – Flemming Rose, Geert Wilders, and the French historians of Liberte pour l’histoire, a group opposed to Frances’ recent memory laws. Do these writers draw on experience of the United States in opposing hate speech bans? Or do they draw on specifically European (native) arguments? This installment focuses on Danish Cartoon publisher Flemming Rose (the full project will also include Wilders and the French historians). An examination of Rose’s recent memoir, The Tyranny of Silence (2010), shows that Rose draws quite heavily on his experiences living in the Soviet Union to craft a samizdat theory of hate speech regulation that shifts the focus from the harm hate speech can inflict on society to the harm hate speech regulation poses on the speaker him or herself. He also, despite temptation, lacks the skepticism typical of the American response to speech. Indeed, Rose barely mentions the American free speech canon in his book excerpt. Taken as a whole, Rose’s speech theory suggests the power of an adage borrowed from Tip O’Neil – all theories of hate speech regulation are local.
Enhancement of Long-Persistence by Ce Co-Doping in CaS : Eu2 + , Tm3 + Red Phosphor

CaS:Eu 2+ , CaS:Ce 3+ , Na + , CaS:Eu 2+ , Ce 3+ , CaS:Eu 2+ , Tm 3+ , and CaS:Eu 2+ , Ce 3+ , Tm 3+ phosphors samples were prepared using a solid state chemical reaction method. Emission and excitation spectra of CaS:Eu 2+ (peak emission observed at 648 nm) and CaS:Ce 3+ (peak emission observed at 515 nm) were investigated. Neither Eu 2+ singly doped sample nor Ce 3+ and Na + codoped sample had a long afterglow. CaS:Eu 2+ , Ce 3+ showed some afterglow with a short persistence. By incorporation of Ce 3+ , an efficient energy transfer from Ce 3+ to Eu 2+ was found at a low doping concentration 0.1%. Emission intensity of Eu 2+ was enhanced by 20%. Enhancement of long persistence of Eu 2+ afterglow emission was achieved by co-doping Ce 3+ in CaS:Eu 2+ , Tm 3+ as a durable sensitizer. For the triply doped CaS:Eu 2+ , Tm 3+ , Ce 3+ it was found that the persistence time was 22% longer than that of CaS:Eu 2+ , Tm 3+ .
Endothelial dysfunction and oxidative stress in polycystic kidney disease.

Cardiovascular disease (CVD) is the leading cause of premature mortality in ADPKD patients. The aim was to identify potential serum biomarkers associated with the severity of ADPKD. Serum samples f...
Generalized vocal imitation in infants

Effects of modeling and response-contingent social praise on the vocal imitation of three 9- to 13-month-old infants were analyzed. Three infants and parents participated in 2 to 4 experimental sessions a week for 2 to 4 months. During each 20-min-long session, the parent presented vocal models for the infant to imitate. During the model-alone condition, no social praise was programmed for infant imitation. During the model-and-praise condition, social praise was provided by the parent for infant imitation on training trials, but not probe trials. All three infants showed systematic increases in matching during training trials following the introduction of the model-and-praise condition. Although matching during probe trials was not directly reinforced, probe-trial responding increased systematically with training-trial responding. Furthermore, non-matching infant vocalizations did not increase systematically with the introduction of the model-and-praise procedure. Together these findings provide a demonstration of generalized vocal imitation in infants, a population in which it had not previously been shown to occur.
Computer graphics--three dimensional reconstruction of thalamic anatomy from serial sections.

Abstract This paper describes an interactive program which uses computer graphics techniques to reconstruct a three dimensional representation of thalamic anatomy from two dimensional serial sections. Figures traced on a Rand tablet, connected to a DEC-340 display, are digitized and scaled. The three dimensional display capabilities of the Adage AGT-30 are used to present the reconstructed structures. Two dimensional cross sections of an arbitrary plane may also be displayed. The program has applications in stereotaxic surgery, teaching neuroanatomy, and may be used to reconstruct other anatomic structures from serial sections.