cssi/SciSciGPT-SciSciNet huggingface dataset:
Resolution of Rectal Prolapse by Vaginal Reconstruction.

Background Rectal prolapse is a disorder of the pelvic floor in which the layers of the rectal mucosa protrude outward through the anus. Surgical repair is the mainstay of treatment. Options include intra-abdominal procedures such as rectopexy and perineal procedures such as the Delorme and Altemeier perineal rectosigmoidectomy. Rectal and vaginal prolapse can often coexist. However, to our knowledge, there are no reported cases of rectal prolapse resolved by the repair of a compressive enterocele abutting the anterior rectal wall through a vaginal approach alone. We present a novel case of rectal prolapse that resolved by correction of the vaginal defect. Case A 53-year-old female with prior history of abdominal hysterectomy, presented to the urogynecology clinic with complaints of vaginal bulge, urge urinary incontinence, and rectal bulge on straining with no fecal incontinence for several years. On physical examination, she was found to have stage 2 anterior, posterior, and apical vaginal prolapse and reducible rectal prolapse. Colorectal surgery (CRS) evaluation was requested, which revealed minimal anterior mucosal prolapse on Valsalva with no full-thickness prolapse. Magnetic resonance imaging (MRI) defecogram was performed, which demonstrated a large rectocele, enterocele, and small bowel prolapsing between the rectum and vagina during the evacuation phase, with no rectal prolapse. The decision to proceed with vaginal prolapse surgery without concomitant rectal prolapse repair was made, as the patient had no fecal incontinence, and the degree of rectal prolapse was minimal. On the day of surgery, which was 2 months later, she presented with a 2-cm anterior rectal prolapse with no incontinence. Colorectal surgery was consulted again, but unavailable. After counseling, the patient wished to proceed with her planned surgery. It was felt that correcting the anterior rectocele and enterocele, thereby eliminating the descent of the bowel on the anterior rectal wall, might cause resolution of the rectal prolapse. She then underwent a sacrospinous ligament fixation with mesh through an anterior vaginal approach, enterocele repair, Moschcowitz culdoplasty, and posterior colporraphy. She had an uneventful postoperative course and noted resolution of both vaginal and rectal prolapse. At 54 weeks, she continues without any complaints of rectal prolapse, which was confirmed on physical examination. Conclusions Usually, the choice of surgical approach is tailored to each individual based on anatomy, age, comorbidity, and patient factors. Correcting both vaginal and rectal prolapse at the same time with a minimally invasive approach is an advantage to the patient. Restoring the apical, anterior, and posterior vaginal wall anatomy and an enterocele repair through the vaginal route caused resolution of the rectal prolapse. Further research is required as to whether rectal prolapse caused by anterior rectal compression needs an additional procedure or repair of the vaginal prolapse and enterocele alone will suffice.
SERVICE LIFE PREDICTION FROM ACCELERATED AGING TEST RESULTS USING RELIABILITY THEORY AND LIFE TESTING ANALYSIS

The prediction of the service life of a building product is needed for making life cycle cost decisions, for determining the risks and liabilities in marketing a product, and for helping to identify the causes of a product’s failure. Accurate estimates of the service life for building products, however, have traditionally been difficult to obtain. The most timely source for obtaining service life estimates for a building product is through the use of accelerated aging tests. Unfortunately, most accelerated aging tests for building materials are not capable of providing quantitative estimates of a product’s service life since they were only designed to screen out bad products or to make qualitative comparisons between the service lives of different products. To rectify this situation, accelerated aging test procedures used in high technology industries were applied to building products. The emphasis in these procedures is in the mathematical analysis of the life data. One of the more successful mathematical procedures is reliability theory and life testing analysis. In this paper, the basic format of this analysis procedure is outlined and several applications are presented in which these techniques were applied to predicting the service lives of different building materials and products. The results of these analyses are very promising and it is concluded that reliability theory and life testing analysis techniques should be readily adaptable for predicting the service lives of a wide range of building products and materials.
A prospective randomized high fidelity simulation center based side-by-side comparison analyzing the success and ease of conventional versus new generation video laryngoscope technology by inexperienced laryngoscopists

Introduction. Indirect video laryngoscopes are altering the landscape of airway management. The primary aim of this prospec-tive randomized patient simulator analysis was to objectively compare video laryngoscopes to standard airway management techniques in novice users.Methods. "First year medical students were exposed to high-fidelity simulated normal and difficult airway scenarios while using an array of indirect video laryngoscopes (e.g., the GlideScope, McGRATH or Pentax AWS-100) that were compared to Macin-tosh laryngoscope and fiberoptic bronchoscope (i.e., historic gold standards for normal and difficult airways, respectively)." Results. In the normal airway scenario, the best glottic view (both subjective and objective) was obtained with the video laryngoscopes and intubation success rates were highest with the video laryngoscopes (100% success rate for each device) and Macintosh (80%). In the difficult airway scenario, the best glottic view was achieved with all video laryngoscopes and the fiberoptic bronchoscope; however, tracheal intubation was best achieved with the video laryngoscopes (100% success rate for each device) whereas the success rate with the bronchoscope was only 36%.Discussion. Our findings support the use of the GlideScope, McGRATH, or Macintosh laryngoscopes for novice users mana-ging a normal airway. When managing the difficult airway, there was no difference between any video or Macintosh laryngosco-pe in the time to successfully intubate the trachea. Over time, study participants demonstrated learned behavior as they became more facile with all devices. When comparing the video laryngoscopes, all three performed similarly overall and proved useful in the hands of novice users. Regardless of airway difficulty, the fiberoptic bronchoscope yielded the worst results.
Maternal and Paternal Resources across Childhood and Adolescence as Predictors of Young Adult Achievement.

Abstract Family experiences have been linked to youth's achievements in childhood and adolescence, but we know less about their long term implications for educational and occupational achievements in young adulthood. Grounded in social capital theory and ecological frameworks, this study tested whether mothers' and fathers' education and occupation attainments, as well as the mean level and cross-time consistency of parental warmth during childhood and adolescence, predicted educational and occupational achievements in young adulthood. We also tested interactions between parental achievement and warmth in predicting these young adult outcomes. Data were collected from mothers, fathers, and firstborn and secondborn siblings in 164 families at up to 11 time points. Predictors came from the first nine annual points (youth age M = 10.52 at Time 1) and outcomes from when young adults averaged 26 years old (firstborns at Time 10, secondborns at Time 11). Results from multilevel models revealed that both mothers' and fathers' educational attainment and warmth consistency from childhood through adolescence predicted young adults' educational attainment. Fathers' occupational prestige predicted sons', but not daughters', prestige. An interaction between mothers' warmth consistency, occupational prestige, and youth gender revealed that, for sons whose mothers' prestige was low, warmth consistency positively predicted their prestige, but this association was nonsignificant when mothers' prestige was high. Conversely, for daughters with mothers high in prestige, warmth consistency was a trend level, positive predictor of daughters' prestige, but was nonsignificant when mothers' prestige was low. Thus, maternal resources appeared to have a cumulative impact on daughters, but the process for sons was compensatory. Discussion focuses on the role of family resources in the gender gap in young adult achievement.
Score Disparity Between the MMSE and the SLUMS

Background:Multiple brief cognitive instruments are available to assess cognitive impairment in older adults. However, not all instruments demonstrate the same effectiveness when utilized with high...
Nurse-Administered Hand Massage: Integration Into an Infusion Suite's Standard of Care

Background Nurse-delivered hand massage is a safe and effective intervention that has potential for positively affecting nursing and patient outcomes. . Objectives Nurses in a National Cancer Institute-designated academic health center outpatient chemotherapy infusion suite were taught how to administer a hand massage to strengthen the nurse-patient relationship and improve patient experience, comfort, satisfaction, stress, and anxiety. . Methods A pre-/postimplementation group comparison design was used. Patients in both groups completed self-reported measures of stress, comfort, satisfaction, and anxiety. Nurses completed Likert-type scales pre- and postimplementation on the perceived benefits of hand massage to the patient and nursing practice, impact on patient anxiety, and preparation in providing a hand massage. . Findings A positive trend was seen in all indicators. Patients who received a hand massage had a statistically significant improvement in comfort (p = 0.025) compared to those who did not. A statistically significant improvement was seen in all nurse indicators pre- to postimplementation.
Does the internet eraser button for youth delete first amendment right of others

Will Facebook and similar posting sites soon come to an end from hefty civil fines and consent decrees? Is Internet discourse at risk? That may be the case if lawmakers succeed in passing the Do Not Track Kids Act. As drafted, the law would require operators of children directed websites to include an eraser button to remove user posted content and would penalize mom and pop run sites unable to afford the financial and technological resources to comply with the mandate. This Note argues that if enacted, the law would constitute a presumptively impermissible burden on Free Speech under the First Amendment and should be subject to strict scrutiny.
Abstract 5098: Clinical Presentation and Outcome of Early Postoperative Myocardial Infarction in Elderly Patients Following Hip Fracture Surgery

Background: Patients suffering post operative myocardial infarction (PMI) have higher mortality and morbidity rates than observed with non-PMI subsets. Little is known about the true incidence of PMI and how PMI differs from non-PMI with regard to clinical presentation, management and outcome. Methods: We examined the incidence and outcomes of patients with PMI in 1212 subjects (≥65 years) undergoing hip fracture surgery from 1988 – 2002 using a population-based retrospective cohort study from the Rochester Epidemiology Project in Olmstead County, Minnesota. PMI was defined on the basis of cardiac biomarker and/or electrocardiographic evidence of definitive MI within 7 days post operatively. Results: PMI occurred in 170 (14.0%) patients yet only 36 (21.2 %) patients had one or more clinical symptoms suggesting coronary ischemia. One or more classic symptoms of myocardial infarction were present in 26 (15.3%) including shortness of breath (SOB) in 18 (10.6%), chest/arm pain in 11 (6.5%), nausea/vomiting in 8 (4.7%) and diaphoresis in 1 (0.6%). Delirium was present in 15 (8.8%) patients. Median hospital length of stay was longer (10.0 vs. 8 days, p<0.01) and the in-hospital mortality rate was significantly higher (14.1% vs. 1.6%, p<0.001) among patients who had PMI within 7 days. Conclusion: The clinical presentation of PMI differs from non-PMI in the elderly undergoing hip fracture surgery. Most patients were asymptomatic or had atypical clinical presentations. We observed a significantly higher rate of hospital mortality among those experiencing a PMI. Further studies are necessary to better understand the presentation, optimal management and prevention of PMI. ![Table][1] Table 1. Study Population ![Table][1] Table 2. Clinical Presentation and Outcomes in Patients with and without Post Operative MI This research has received full or partial funding support from the American Heart Association, National Center. [1]: pending:yes
4.6 Mediating Systemic Change Through Sociocultural Methods in Educational Systems in the USA

We describe, analyze, and discuss the study, interpretation, and implementation of ongoing educational change that explores the limits of conventional approaches to inquiry driven projects and offers some alternative approaches to engaging change. Using data from a case study of a recent technical assistance project concerned with educational equity for marginalized groups, we detail the challenges of careful inquiry and interpretation in a rapidly changing complex environment that characterizes school systems in the United States (U.S.). In this chapter we suggest that technical assistance offers a critical opportunity to engage individuals and activity systems in changing the outcomes of their practice and, in doing so, shift their praxis in ways that can mediate future work. Because we locate this work within a methodology that is steeped in activity theory, we describe and critique a set of methods for technical assistance that offers a rich context for ongoing research and inquiry as a critical feature for systems transformation.
Investigation of the β-sheet interactions between dHP1 chromodomain and histone 3.

Methylated lysine 9 on the histone 3 (H3) tail recruits heterochromatin protein 1 from Drosophila (dHP1) via its chromodomain and results in gene silencing. The dHP1 chromodomain binds H3 K9Me3 with an aromatic cage surrounding the trimethyllysine. The sequence selectivity of binding comes from insertion of the histone tail between two β-strands of the chromodomain to form a three-stranded β-sheet. Herein, we investigated the sequence selectivity provided by the β-sheet interactions and how those interactions compare to other model systems. Residue Thr6 of the histone tail forms cross-strand interactions with Ala25 and Asp62 of the chromodomain. Each of these three residues was substituted for amino acids known to have high β-sheet propensities and/or to form favorable side chain–side chain (SC–SC) interactions in β-sheets, including hydrophobic, H-bonding, and aromatic interactions. We found that about 50% of the chromodomain mutants resulted in equal or tighter binding to the histone tail and about 25% ...
Translation of Regenerative Medicine Products Into the Clinic in the United States: FDA Perspective

Abstract The field of regenerative medicine encompasses a breathtaking array of interdisciplinary scientific approaches with the promise of delivering future therapies to meet current unmet medical needs for patients. Increasingly more of these innovative products are being translated into human clinical trials in the United States, and general familiarity of the FDA is important to efficiently navigate the process. The basics of FDA history, organization, and processes are described herein for those new to clinical translation, with more detailed content added regarding approval pathways, regulations, guidances, and select special topics of relevance to regenerative medicine. In addition to the cumulative experience of previous products, the FDA regulatory approach to medical products evaluation includes an ongoing assessment of how the science of those products informs regulatory policy. FDA engages in ongoing dialogue with the scientific community and product sponsors to continue to develop science-based regulatory review policies that are robust and predictable in order to meet the needs of the challenging array of products that are on the horizon.
Hepatitis c virus infection risk tool for patients with cancer.

e18694Background: Hepatitis C virus (HCV) infection can cause adverse hepatic and oncologic outcomes in cancer patients. In the general population, HCV screening is recommended using risk-factor-ba...
Application of Novel Recovery Techniques to Enhance the Resilience of Transportation Networks

Resilience is an important characteristic of the transportation system. It reflects the network’s ability to mitigate shocks, provide alternatives, and rapidly recover to a target performance level...
A Review of Cell-Based Computational Modeling in Cancer Biology.

Cancer biology involves complex, dynamic interactions between cancer cells and their tissue microenvironments. Single-cell effects are critical drivers of clinical progression. Chemical and mechani...
Inflammatory Proteins Predict Change in Depressive Symptoms in Male and Female Adolescents.

Inflammation has been implicated in depressive symptoms, but few studies use longitudinal designs with adolescents. Furthermore, the extant literature has yielded inconsistent results. Blood was co...
Prognostic stratification of clinical and molecular epithelioid hemangioendothelioma subsets

Epithelioid hemangioendothelioma is a low-grade malignant vascular tumor with an intermediate clinical behavior between benign hemangiomas and high-grade angiosarcomas. Pathologic or molecular factors to predict this clinical heterogeneity are not well defined. A WWTR1-CAMTA1 fusion is present in most classic epithelioid hemangioendothelioma, regardless of their clinical behavior, suggesting that additional genetic abnormalities might be responsible in driving a more aggressive biology. A small subset of cases show distinct morphology and are characterized genetically by a YAP1-TFE3 fusion. Two histologic grades have been described in classic epithelioid hemangioendothelioma of the soft tissue. However, proposed criteria do not apply to other clinical presentations and have not been assessed in the YAP1-TFE3 positive tumors. Furthermore, no previous studies have compared the survival of these two molecular subsets. In this study we investigate the clinicopathologic and molecular findings of a large cohort of 93 translocation-positive epithelioid hemangioendothelioma managed at our institution. Patient characteristics, histologic features, treatment outcomes, and genetic abnormalities were investigated and these factors were correlated with overall survival. In 18 patients (15 with WWTR1-CAMTA1 and 3 with YAP1-TFE3) Memorial Sloan Kettering-IMPACT targeted DNA sequencing was performed to identify secondary genetic alterations showing more than half of tumors had a genetic alteration beyond the disease-defining gene fusion. Patients with conventional epithelioid hemangioendothelioma with WWTR1-CAMTA1 fusion had a less favorable outcome compared with the YAP1-TFE3 subset, the 5-year overall survival being 59% versus 86%, respectively. Soft tissue epithelioid hemangioendothelioma were frequently solitary, followed an uneventful clinical course being often managed with curative surgery. Multifocality, pleural involvement, lymph node or distant metastases had a significantly worse outcome. Patients with pleural disease or lymph node metastases had an aggressive clinical course akin to high-grade sarcomas, with 22% and 30%, respectively, alive at 5 years, compared with >70% survival rate in patients lacking these two adverse factors.
Synthesis and evaluation of protective poly(lactic acid) and fluorine-doped hydroxyapatite–based composite coatings on AZ31 magnesium alloy

Magnesium (Mg) alloys have received considerable attention as favorable orthopedic implant materials. However, their uncontrolled degradation in the physiological environment has led to premature implant failure. Thus, to address this problem, the present study was focused on developing protective monolayer coatings of fluorine-doped hydroxyapatite (FHA) and a bilayer coating of FHA and poly(lactic acid) (FHA–PLA) on AZ31 Mg. The synthesis involved microwave irradiation which helped in rapid synthesis of FHA coatings and spin coating for developing the PLA layer. Results revealed the formation of dense and defect-free FHA–PLA hybrid coatings. Importantly, they helped in significant reduction of galvanic–corrosion reactions of AZ31 in a physiological medium. The corrosion current density of FHA/PLA–coated samples was about two orders of magnitude lower than uncoated samples. Their lower weight losses further confirmed the coatings’ corrosion resistance. Combined, the as-synthesized FHA–PLA coatings can provide favorable corrosion protection to AZ31 Mg.
Sediment excavation as a wetland restoration technique had early effects on the developing vegetation community

Excavating agriculturally-accrued sediment from wetland basins is an increasingly common restoration technique worldwide, but the impacts on recruiting native plant communities are unknown. Multiple agencies developed a wetland monitoring protocol to document how restoring hydrology and removing excess sediment impacted hydrology and plant assemblages both before and up to 6 years after wetland restorations in North American prairie potholes. Our results indicated that the excavated basins had marginally greater probabilities of increased total standing water, habitat interspersion, and relative plant diversity, as well as lower probabilities of having invasive plants and hybrid cattails (Typha × glauca), when compared to unexcavated basins. By year 4, the excavated basins had 50% probability of extensive cattail invasion, whereas the unexcavated basins had 85% probability of cattails. However, the benefits from excavation were typically negated by invasive species and cattail encroachment within 3–6 years of post-restoration. Therefore, the vegetation communities may benefit from sediment excavations that are also coupled with targeted management within the first few years to combat invasion. This long-term monitoring program could be continued and revised to include post-restoration management activities (e.g., seeding, invasive species control techniques, and prescribed fire) using an adaptive management framework to provide prompt feedback to managers regarding the relative efficacy of alternative post-restoration management.
Impact of Race, Class, and Involvement on Collegiate Degree Attainment:

This study examines how intersections of race, class, and collegiate involvement shape students’ educational outcomes, specifically degree attainment. It explores (a) to what extent involvement inf...
Chapter 47 – Vitamin K

: Vitamin K, which is needed for blood clotting, can be derived from plants, bacteria, and animal tissues. A water-soluble form of vitamin K can be converted to the active derivative, hydroquinone. The biologic half-life of vitamin K is shorter than the other fat-soluble vitamins. The liver is the main repository of vitamin K. Vitamin K is required for the hepatic postsynthetic transformation of several protein clotting factors. Vitamin K helps to facilitate the γ-carboxylation of glutamate residues, which in turn chelate Ca++. A vitamin K cycle exists in the endoplasmic reticulum of liver cells. An important therapeutic use of vitamin K is as an antidote in poisoning by dicoumarol or warfarin. Vitamin K plays a role in bone metabolism, as well as in the renal reabsorption of Ca++. Tissue distributions of this vitamin indicate that its actions are diversified.
SAUCERIZATION OF DISCOID LATERAL MENISCI. HOW MUCH RESIDUAL WIDTH IS RIGHT

Objectives: Discoid lateral meniscus (DLM) is a congenital anomaly of the knee where the normally “O” shaped lateral meniscus has redundant tissue filling the “O” and covering the lateral tibial plateau. The redundant tissue can degenerate and cause mechanical symptoms and pain. Treatment of symptomatic DLM is arthroscopic saucerization to reshape the meniscus to a more normal contour. Enough tissue must be removed to eliminate mechanical symptoms but not too much as to create instability. The residual width of the meniscus is crucial at the popliteus hiatus because here the peripheral rim is unattached to the capsule. The literature recommends a residual width of 6-8 mm. The primary purpose of this research was to determine the width of the meniscus at the popliteal hiatus in normal specimens. Our null hypothesis was that a residual width of 6-8 millimeters will be sufficient for saucerization of DLM. Methods: We made direct measurements of lateral meniscus radial width from the outer rim at the popliteus hiatus to the inner edge (Figure 1) in 19 specimens (ages 2 months to 11 years.) We measured one four-year-old specimen with bilateral complete DLM (Figure 2.) We also measured 39 digital images of specimens (ages 1-month to 12-years) using ImageJ. Finally, we made direct measurements of 8 skeletally mature specimens. Results: Figure 3 shows the relationship of meniscus width as a function age. The average width of specimens <3-years-old was 5.5mm. The average width of the ten-year-old specimens was 12mm. The average width of the skeletally mature specimens was 16mm. The four-year-old DLM specimen measured 19 mm. Conclusions: We rejected our null hypothesis. Direct measurements suggest that a residual width of 6-8mm is insufficient for children 8-years and older. A width of at least a full centimeter more closely approximates our findings, and for adolescents consider a residual rim of 15 mm. For children less than six-years-old a residual width of 6-8mm is sufficient.
Implantable Cardiac Kirigami-Inspired Lead-Based Energy Harvester Fabricated by Enhanced Piezoelectric Composite Film.

Harvesting biomechanical energy to power implantable electronics such as pacemakers has been attracting great attention in recent years because it replaces conventional batteries and provides a sustainable energy solution. However, current energy harvesting technologies that directly interact with internal organs often lack flexibility and conformability, and they usually require additional implantation surgeries that impose extra burden to patients. To address this issue, here a Kirigami inspired energy harvester, seamlessly incorporated into the pacemaker lead using piezoelectric composite films is reported, which not only possesses great flexibility but also requires no additional implantation surgeries. This lead-based device allows for harvesting energy from the complex motion of the lead caused by the expansion-contraction of the heart. The device's Kirigami pattern has been designed and optimized to attain greatly improved flexibility which is validated via finite element method (FEM) simulations, mechanical tensile tests, and energy output tests where the device shows a power output of 2.4 µW. Finally, an in vivo test using a porcine model reveals that the device can be implanted into the heart straightforwardly and generates voltages up to ≈0.7 V. This work offers a new strategy for designing flexible energy harvesters that power implantable electronics.
Teaching in Reverse: A Positive Approach to Analytical Errors in 1L Writing

This article proposes a new approach to managing first-year law students’ analytical errors in legal writing assignments. Rather than viewing errors as pests to be eradicated, we adopt a positive view of error and accept it as essential to the learning process. But viewing error as inevitable is not synonymous with putting ourselves at error’s mercy. Because legal audiences expect upper-division students and law graduates to have achieved some analytical proficiency, legal research and writing (LRW) professors must find ways to embrace error while simultaneously helping students to spot error and to develop strategies for avoiding error in their own writing. Thus, we recommend pedagogies that regard error dualistically – as a necessary growing pain, but also as a potential obstacle to communicating with a legal audience.We examine existing treatments of analytical error in the LRW field, as well as in the closely related field of composition. We also review cognitive psychology and composition theories that account for novice law students’ most profound thinking challenges. Supplementing this theoretical foundation are the results of our own small-scale error analysis, documenting common errors in objective writing assignments prepared in our first-year legal writing classes. To harness the power of error revealed by our research, we suggest "teaching in reverse": pedagogical strategies that use error as a starting point, then work backwards to investigate thought processes that may have led to the error, helping the writer to make better analytical choices while her writing is still in progress. The ultimate goals are to encourage student writers to spot, name, and correct analytical errors at critical stages of the writing process, and to become more proficient, self-sufficient legal analysts earlier in their law studies.
Finding anomalous periodic time series

Catalogs of periodic variable stars contain large numbers of periodic light-curves (photometric time series data from the astrophysics domain). Separating anomalous objects from well-known classes is an important step towards the discovery of new classes of astronomical objects. Most anomaly detection methods for time series data assume either a single continuous time series or a set of time series whose periods are aligned. Light-curve data precludes the use of these methods as the periods of any given pair of light-curves may be out of sync. One may use an existing anomaly detection method if, prior to similarity calculation, one performs the costly act of aligning two light-curves, an operation that scales poorly to massive data sets. This paper presents PCAD, an unsupervised anomaly detection method for large sets of unsynchronized periodic time-series data, that outputs a ranked list of both global and local anomalies. It calculates its anomaly score for each light-curve in relation to a set of centroids produced by a modified k-means clustering algorithm. Our method is able to scale to large data sets through the use of sampling. We validate our method on both light-curve data and other time series data sets. We demonstrate its effectiveness at finding known anomalies, and discuss the effect of sample size and number of centroids on our results. We compare our method to naive solutions and existing time series anomaly detection methods for unphased data, and show that PCAD's reported anomalies are comparable to or better than all other methods. Finally, astrophysicists on our team have verified that PCAD finds true anomalies that might be indicative of novel astrophysical phenomena.
PCDH19-related epilepsy

Mutations in the PCDH19 gene are an important cause of early-onset epilepsy in females along the spectrum of epilepsy in females linked to mental retardation. Patients often have cognitive impairment or behavioral disorders, but the severity of epilepsy and co-morbidities are quite variable. Genetic testing for this condition is crucial in order to provide the best medical management of seizures along with appropriate genetic counseling for the families of affected individuals.
Tying up the Ends: Recognition of ssDNA at Telomeres

Telomere dysfunction has been implicated in several diseases including cancer and aging. The two main roles of telomeres are end-protection and length regulation and the shelterin complex lies at t...
PCLOS: A Flexible Implementation of CLOS Persistence

We describe the design of a prototype which makes objects persistent. Our target language is the CommonLisp Object System (CLOS), although we pay attention to the eventual sharing of data with other languages. Our design is very flexible, in that it allows the simultaneous use of multiple, different databases. This is accomplished by defining a virtual database layer which consists of a core protocol that is expected to be implemented on all databases, and of protocol adapters which accommodate features offered by some databases, but not by others. This virtual database has been implemented for a simple, single-user, in-core data store, and for Iris, a multi-user, object-oriented database management system. We outline the advantages of the CLOS Metaclass Protocol for implementing object persistence or other low-level modifications to the CLOS implementation.
Natural Law Today

Why discuss natural law, it may be asked, when the belief in the validity of this approach to ethical and political problems has suffered a marked decline, at least since the end of the eighteenth century? Why should the student of political thought be particularly interested in a discredited theory of political or moral obligation at a time when representatives of the last bastion of natural-law thinking, the Roman Catholic Church, have begun to question their church’s excessive reliance on the natural-law approach.1
Abstract 4776: PDK1-dependent activation of AGC kinases is an absolute requirement for AKT oncogenic activity

The PI3K signaling cascade is frequently activated in human cancer, and AKT is commonly considered its major transforming conduit. Thus, PI3K and AKT represent relevant targets for therapeutic purposes. However, the many essential of roles played by this pathway in normal cells poses the problem of reaching therapeutic efficacy without harming healthy tissues. In principle, it would be ideal to target only molecules directly involved in the transformation process, thus reducing the toxicity associated with wide-range inhibitors. PDK1 plays a key role in the PI3K cascade, directly activating AKT. In addition, PDK1 possesses a substrate docking site named “PIF pocket” that is required to phosphorylate and activate members of the AGC kinase family, including S6K, PKC, SGK, and RSK. Mice in which the PI3K pathway is constitutively activated in the thyroid epithelium through loss of Pten are born with thyroid hyperplasia that progresses to invasive and metastatic follicular carcinoma, a process that is accelerated by the simultaneous loss of p27 or p53, and by Ras or Braf activation. Using in vivo as well as ex vivo and in vitro genetic and pharmacological approaches, we now show that although Akt activation is necessary, it is not sufficient to transform thyroid epithelial cells. Concomitant activation of Pdk1-dependent pathways is absolutely required to develop neoplastic lesions in vivo, and to induce cell proliferation ex vivo. Pten mutants develop adenomas and carcinomas by one year of age. Strikingly, complete rescue of this phenotype is observed in compound mutants in which, in addition to thyroid-specific Pten loss, the PIF-pocket of Pdk1 has been genetically disrupted, maintaining constitutive activation of Akt and mTor, but not of PIF-pocket dependent AGC kinases. We also show that the transcription factor STAT3 represents a key mediator of this essential Pdk1-dependent pathway: STAT3 phosphorylation is increased in Pten mutants, and abolished in compound mutants. Furthermore, genetic and pharmacological inhibition of STAT3 drastically impairs cell proliferation in vitro and rescues the hyperplastic phenotype of Pten mutant mice in vivo. Thus, we have identified an essential and druggable signaling cascade that critically cooperates with AKT activation to transform thyroid epithelial cells. Citation Format: Arturo Orlacchio, Valeria Antico Arciuch, Antonio Di Cristofano. PDK1-dependent activation of AGC kinases is an absolute requirement for AKT oncogenic activity. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4776. doi:10.1158/1538-7445.AM2014-4776
Atmospheric inversion in the presence of clouds: an adaptive ELM approach

Many algorithms exist to invert airborne imagery from units of either radiance or sensor specific digital counts to units of reflectance. These compensation algorithms remove unwanted atmospheric variability allowing objects on the ground to be analyzed. Low error levels in homogenous atmospheric conditions have been demonstrated. In many cases however, clouds are present in the atmosphere which introduce error into the inversion at unacceptable levels. For example, the relationship that is defined between sensor reaching radiance and ground reflectance in a cloud free scene will not be the same as in a scene with clouds. A novel method has been developed which utilizes ground based measurements to modify the empirical line method (ELM) approach on a per-pixel basis. A physics based model of the atmosphere is used to generate a spatial correction for the ELM. Creation of this model is accomplished by analyzing whole-sky imagery to produce a cloud mask which drives input parameters to the radiative transfer (RT) code MODTRAN. The RT code is run for several different azimuth and zenith orientations to create a three-dimensional representation of the hemisphere. The model is then used to achieve a per-pixel correction by adjusting the ELM slope spatially. This method is applied to real data acquired over the atmospheric radiation measurement (ARM) site in Lamount, OK. Performance of the method is evaluated with the Hyperspectral Digital Imagery Collection Experiment (HYDICE) instrument as well as a simulated multi-spectral system.
Risk factors for ethambutol optic toxicity.

Context Optic neuropathy is a well-known complication of ethambutol therapy and usually manifests as a decrease in visual acuity, cecocentral scotomas, and deficits in color vision. Objective To support or disprove the hypothesis that a significant majority of patients who develop ocular toxicity while undergoing treatment for a mycobacterium infection do so after experiencing either a prolonged course or unusually high serum levels of ethambutol. Design Retrospective chart review (16 cases) and literature meta-analysis (54 cases). Results Many cases lacked important data, but none countered the hypothesis. Age, duration of ethambutol, and dose of ethambutol were positively correlated with risk of toxicity. Conclusions Given an understanding of the risk factors for ethambutol optic toxicity, there exists a rationale for an optimization of ethambutol dosing protocols that can maximize the therapeutic effect while minimizing the incidence of optic toxicity.
A Jack of All Trades to Combat Drug-Resistant Gram-Negative Bacteria

In this issue of Chemistry & Biology, Jahnsen and colleagues describe a multimodal mechanism of action of an unusual peptide-peptoid hybrid with broad-spectrum antibacterial activity. They demonstrate that the molecule has effects on many aspects of bacterial metabolism and also modulates host immune responses.
Evidence for Separation across a Gray Band on Europa

Abstract Thynia Linea, a gray band on Europa, is found to be a ∼25 km wide and >900 km long region of lithospheric separation which has been infilled by relatively dark material. Roughly a dozen older features and the cuspate segments that form its outline appear to have been displaced across its width. Displacement azimuths indicate a best fit pole of opening near 79°S, 200°W. However, displacement magnitude decreases toward either end of the gray band, indicating that it is more akin to a “tear” in a nonrigid europan lithosphere. Opening was in response to NW–SE directed tensile stress, in accord with the stress predictions of nonsynchronous rotation. Observations of Thynia Linea are consistent with a laterally mobile brittle lithosphere, decoupled from ductile or liquid material below, as previously suggested to account for opening of wedge-shaped bands in Europa's antijovian region. Lithospheric separation and contemporaneous emplacement of new material offers a possible volcano-tectonic scenario for resurfacing Europa. If this process is ongoing, resurfacing can be accomplished on a time scale consistent with the satellite's surface age if one gray band or zone of wedge-shaped bands forms every ∼10 3 –10 4 yr and becomes unrecognizable with age. This would imply that features on Europa brighten with age, as through continuous deposition of frost onto the surface.
Health literacy of adults presenting to an urban ED

Abstract Objective The aim of the study was to assess the prevalence of limited health literacy in an urban emergency department (ED) and its association with sociodemographic variables. Methods This was a cross-sectional study of patients presenting to the ED of an urban county hospital. For 3 months, we screened a convenience sample of patients presenting to the ED. Participants completed a brief demographic survey and a validated assessment of health literacy, the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Multinomial logistic regression model was used to analyze data. Results Of the 15 930 patients presenting to the ED, 5601 met inclusion criteria. Of eligible patients, 65% (3639) agreed to complete demographic surveys and 26% (960) of them agreed to complete the S-TOFHLA. The most common exclusions were inability to contact the patient and age less than 18 years. Participating patients were younger than those who declined (mean age, 36.8 compared to 40.8 [t = 7.49; P Conclusions Of patients enrolled in the study, 15.5% have limited health literacy. Age, male sex, non-English first language, nonwhite ethnicity, limited education, and unstable housing were associated with limited health literacy.
Scenario development for water resources planning and watershed management: Methodology and semi-arid region case study

Utilizing the scenario development framework from Mahmoud et al. (2009), a set of scenarios were developed for and applied in the Verde River Watershed in Arizona, USA. Through a scenario definition exercise, three dimensions of future change with respective axis extremes were identified: climate change (periodic droughts vs. sustained drought), demographics (water-conservative population vs. water-consumptive population), and the economy (booming economy vs. poor economy). In addition to the various combinations of dimension extremes, each scenario was given a unique event or theme that was characteristic of the combination of dimension extremes it possessed. The scenarios were then fleshed out into narrative forms that expanded on the details of each scenario's internal temporal evolution. The scenarios were analyzed by a water supply and demand model that was specifically constructed for their simulation. Following the analysis of scenario results, assessment narratives were provided to outline the impact of each scenario on the Verde River Watershed and management operations in that basin.
Structures of Receptor Complexes of a North American H7N2 Influenza Hemagglutinin with a Loop Deletion in the Receptor Binding Site

Human infections with subtype H7 avian influenza viruses have been reported as early as 1979. In 1996, a genetically stable 24-nucleotide deletion emerged in North American H7 influenza virus hemagglutinins, resulting in an eight amino acid deletion in the receptor-binding site. The continuous circulation of these viruses in live bird markets, as well as its documented ability to infect humans, raises the question of how these viruses achieve structural stability and functionality. Here we report a detailed molecular analysis of the receptor binding site of the North American lineage subtype H7N2 virus A/New York/107/2003 (NY107), including complexes with an avian receptor analog (3′-sialyl-N-acetyllactosamine, 3′SLN) and two human receptor analogs (6′-sialyl-N-acetyllactosamine, 6′SLN; sialyllacto-N-tetraose b, LSTb). Structural results suggest a novel mechanism by which residues Arg220 and Arg229 (H3 numbering) are used to compensate for the deletion of the 220-loop and form interactions with the receptor analogs. Glycan microarray results reveal that NY107 maintains an avian-type (α2-3) receptor binding profile, with only moderate binding to human-type (α2-6) receptor. Thus despite its dramatically altered receptor binding site, this HA maintains functionality and confirms a need for continued influenza virus surveillance of avian and other animal reservoirs to define their zoonotic potential.
Performance of high triangularity plasmas as the volume of the secondary divertor is varied in DIII-D

Abstract This paper examines the sensitivity of edge pedestal and divertor performance parameters to changes in the volume of a secondary divertor that tends to form inside the vacuum chamber in high triangularity plasma shapes. The sensitivity was examined by varying the vertical distance of the secondary X -point from the target plate, Z S X , while holding the primary X -point height fixed. The ion ∇ B drift was in the direction of the primary divertor. Discharges with and without active primary divertor cryo-pumping were examined. The effective rate of rise of the core density at the L–H transition increased 80% as Z S X was reduced. At high density achieved by gas injection, the core line-averaged density at the H–L back transition decreased by 30% as Z S X was reduced. Both of these results indicate that performance may be affected when core plasma screening of neutrals in the secondary divertor is reduced as Z S X decreases. The peak heat flux in the secondary divertor decreased as Z S X was reduced due to increased flux expansion until a threshold was reached at Z S X ∼3 cm where it remained constant. This indicated that the high recycling character of the plasma above the target in the secondary divertor was lost when the length of the outer divertor leg was reduced below a critical value.
Physicians' practice patterns in pediatric electrodiagnosis

Abstract The medical literature contains contradictory reports and recommendations regarding pediatric patients' pain and distress during electrodiagnosis. We surveyed 117 pediatric neurologists and physiatrists regarding their practice patterns in pediatric electrodiagnosis; 84 (72%) responded, of whom 44 (52%) regularly perform electrodiagnosis on children (mean = 85 per year, representing 3,667 examinations per year). Respondents reported extreme behavioral distress (eg, screaming, flailing, requiring additional restraint, or attempting to leave the examination table) in 35% of examinations, most often among 2- to 6-year-olds. Pain medications are never prescribed by 45%, occasionally by 48%, and always by 2%; general anesthesia is never administered by 75%, occasionally by 21%. Only 32% reported that any psychological intervention is routinely offered to enhance child coping. Wide variability was found in physicians' preferences about parental presence, order of examinations, demonstration of procedures, and other aspects of electrodiagnosis.