cssi/SciSciGPT-SciSciNet huggingface dataset:
Combining Solution and Solid State NMR Techniques in the Analysis of Arg to Cys Mutations in Phospholamban Associated with Dilated Cardiomyopathy

Dilated cardiomyopathy (DCM) is characterized by the enlargement and weakening of the left ventricle. This dilation of the ventricle prevents the heart from contracting normally and can spread to the right ventricle and atria as the disease progresses. Inherited forms of DCM have been identified in families that carry missense, deletion, or nonsense mutations in the regulatory protein, phospholamban (PLN). Two of the identified missense mutations, R9C and R25C, result in cysteine substitutions for arginine residues in PLN's cytoplasmic domain. In vitro studies with these mutants indicate that they have an altered ability to regulate SERCA, however it is unclear how these mutations lead to dysregulation of SERCA.Here we have applied both solution and solid-state NMR techniques to characterize the structure, dynamics and topology of the monomeric constructs for the R9C and R25C mutants to better understand how these mutations affect PLN's regulation of SERCA in the development of DCM. These studies were pursued under both reducing and oxidizing conditions to better reflect the physiological conditions of DCM progression and for comparison to coupled enzyme activity assays used to quantify the effect of these mutants on SERCA activity. We have utilized chemical shift perturbations as sensitive probes toward the local environment of the cytoplasmic and juxta-membrane domains of PLN which harbor the aforementioned mutations. Dynamics in lipid bilayers have been probed through cross-polarization or J-coupling enabled experiments which are exclusively sensitive toward either the rigid or mobile regions of the protein. Heteronuclear NMR was employed to probe the fast timescale dynamics of these mutants. Finally, separated local field experiments in magnetically aligned bicelles were employed to probe the topology.
Tarsal tunnel disease and talocalcaneal coalition: MRI features

To assess, utilizing MRI, tarsal tunnel disease in patients with talocalcaneal coalitions. To the best of our knowledge, this has only anecdotally been described before. Sixty-seven ankle MRIs with talocalcaneal coalition were retrospectively reviewed for disease of tendons and nerves of the tarsal tunnel. Interobserver variability in diagnosing tendon disease was performed in 30 of the 67 cases. Tarsal tunnel nerves were also evaluated in a control group of 20 consecutive ankle MRIs. Entrapment of the flexor hallucis longus tendon (FHL) by osseous excrescences was seen in 14 of 67 cases (21 %). Attenuation, split tearing, tenosynovitis, or tendinosis of the FHL was present in 26 cases (39 %). Attenuation or tenosynovitis was seen in the flexor digitorum longus tendon (FDL) in 18 cases (27 %). Tenosynovitis or split tearing of the posterior tibial tendon (PT) was present in nine cases (13 %). Interobserver variability ranged from 100 % to slight depending on the tendon and type of disease. Intense increased signal and caliber of the medial plantar nerve (MPN), indicative of neuritis, was seen in 6 of the 67 cases (9 %). Mildly increased T2 signal of the MPN was seen in 15 (22 %) and in 14 (70 %) of the control group. Talocalcaneal coalitions may be associated with tarsal tunnel soft tissue abnormalities affecting, in decreasing order, the FHL, FDL, and PT tendons, as well as the MPN. This information should be provided to the referring physician in order to guide treatment and improve post-surgical outcome.
Inferior Breast-Chest Contour Detection in 3-D Images of the Female Torso

Stereophotogrammetry is finding increased use in clinical breast surgery, both for breast reconstruction after oncological procedures and cosmetic augmentation and reduction. The ability to visualize and quantify morphological features of the breast facilitates pre-operative planning and post-operative outcome assessment. The contour outlining the lower half of the breast is important for the quantitative assessment of breast aesthetics. Based on this inferior breast contour, relevant morphological measures, such as breast symmetry, volume, and ptosis, can be determined. In this paper, we present an approach for automatically detecting the inferior contour of the breast in 3D images. Our approach employs surface curvature analysis and is able to detect the breast contour with high accuracy, achieving an average error of 1.64 mm and a dice coefficient in the range of 0.72–0.87 when compared with the manually annotated contour (ground truth). In addition, the detected contour is used to facilitate the detection of the lowest visible point on the breast, which is an important landmark for breast morphometric analysis.
Impact of freeze-thaw cycles on circulating inflammation marker measurements.

Abstract Background Circulating inflammation markers are being increasingly measured in prospective cohorts to investigate cancer etiology. However, it is unclear how the measurements are affected by the freeze-thaw cycles of the specimens prior to marker analysis. Methods We compared concentrations of 45 inflammation markers between paired serum vials of 55 participants in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial that have undergone one (T1), two (T2), and three (T3) freeze-thaw cycles at the time of assay. We computed the difference of analyte concentrations across paired vials (T1 vs. T2, T2 vs. T3) and tested whether the difference deviated from zero using the Wilcoxon signed-rank test. We also calculated Spearman rank correlation and weighted kappa statistics for T1 vs. T2 and T2 vs. T3 comparisons to assess agreement in rank ordering of subjects. Results Measurements between paired T1 and T2 samples were largely similar, with the difference not statistically deviating from zero for 36 of the 45 markers. In contrast, tests of the difference between paired T2 and T3 samples were statistically significant for 36 markers. However, the rank ordering of participants by marker concentration remained largely consistent across T2 and T3 samples, with Spearman correlation coefficients >0.8 for 42 markers and weighted kappas >0.7 for 37 markers. Conclusion We recommend that studies measuring inflammation markers use previously unthawed specimens to the extent possible, or match on the number of prior freeze-thaw cycles in nested case-control studies.
The influence of cognitive load on metabolic cost of transport during overground walking in healthy, young adults

Our aim was to examine whether cognitive processing during walking increases the metabolic cost of transport in healthy young adults. Twenty healthy, young adults completed five conditions: (1) walking at a self-selected speed (spontaneous single-task), (2) seated resting (baseline), (3) performing cognitive task while seated (cognitive single-task), (4) walking while simultaneously performing the cognitive task (dual-task), and (5) single-task walking at a speed that matched the participant’s dual-task gait speed (matched single-task). Rate of oxygen consumption (VO2) was recorded during all conditions. Gait speed and cost of walking (Cw; oxygen consumed per distance traveled) were recorded during all walking conditions. Reaction time and accuracy of responses in the cognitive task were recorded during all cognitive task conditions. Data from the fifth minute of each 5-min condition were analyzed. There was no difference in VO2 between the dual-task and matched single-task walking conditions. VO2 in the seated cognitive condition was significantly smaller than both walking conditions, but was not significantly different than zero. Cw was significantly greater during the matched single-task walking condition than during the dual-task walking condition. However, the difference in Cw was so small that it is unlikely to be clinically significant (0.008 mLO2/kg/m, 95% CI 0.002–0.014). Cognitive processing while walking may not increase energy demands of walking in healthy young adults. Maintaining non-preferred gait speed (matched speed) overground continuously for 5 min may require attentional resources, and thereby increase metabolic costs relative to walking at habitual speed.
Integrative Intensive Retreats for Veteran Couples and Families: A Pilot Study Assessing Change in Relationship Adjustment, Posttraumatic Growth, and Trauma Symptoms.

We assessed a brief, systemic retreat-style intervention that was developed to address concerns about the utilization of services for veterans coping with traumatic stress. A total of 76 dyads (N = 152) were assessed before and after a 4-day retreat, which included psychoeducation, group and conjoint therapeutic sessions, and recreational relaxation components. Overall, participants reported a reduction in trauma symptoms, but only support persons experienced a significant increase in posttraumatic growth from pretest to posttest. Both veterans and their romantic partners reported an increase in relationship adjustment after the retreat. Opportunities to address the needs of this population by removing barriers to treatment and reducing feelings of isolation, as well as implications for similar treatments are discussed.
Genotypes are related to neurocognitive performance but not concussion history in collegiate student-athletes

Background Single-nucleotide polymorphisms (SNPs) of neurologically relevant genes play a role in concussions from increasing susceptibility or hampering cognitive performance. Objective The purpose of this study was to investigate the effects of polymorphisms of APOE, APOE promoter, COMT and DRD2 on baseline neurocognitive function and concussion history in collegiate student-athletes. Design Cross-sectional. Setting Collegiate campus in North Carolina. Participants 262 (194 males, 68 females) collegiate student-athletes. Assessment of risk factors Buccal mucosa swabs were collected from participants. SNP genotyping was run on all samples to determine APOE, APOE promoter, COMT, and DRD2 genotypes. Participants were split into three groups based on their genotypes for each gene. Outcome measures Participants completed the Immediate Post-Concussion Assessment and Cognitive Testing neurocognitive assessment which generated composite scores on Verbal Memory, Visual Memory, Visuomotor Speed, and Reaction Time as well as Impulse Control Results None of the genotype variables influenced number of concussions (p>0.05). MANOVA analysis determined no differences for APOE promoter and DRD2 genotypes (p>0.05). There were statistical differences for APOE for Visuomotor composite (APOE-e3 (m=41.2, %95 CI [40.8, 42.1]) vs e4 (m=39.1, %95 CI [37.8, 40.5], p=0.017) and Reaction Time (APOE-e4 (m=0.62, %95 CI [0.60, 0.64]) was different than both e2 (m=0.57, %95 CI [0.54, 0.60] and e3(m=0.58, %95 CI [0.56, 0.59], p Conclusions APOE and COMT single nucleotide polymorphisms lead to significant differences in neurocognitive performance at baseline but not concussion history. Competing interests None.
Diagnosability of mtDNA with Random Forests: Using sequence data to delimit subspecies

We examine the use of an ensemble method, Random Forests, to delimit subspecies using mitochondrial DNA (mtDNA) sequences. Diagnosability, a measure of the ability to correctly determine the taxon of a specimen of unknown origin, has historically been used to delimit subspecies, but few studies have explored how to estimate it from DNA sequences. Using simulated and empirical data sets, we demonstrate that Random Forests produces classification models that perform well for diagnosing subspecies and species. Populations with strong social structure and relatively low abundances (e.g., killer whales, Orcinus orca) were found to be as diagnosable as species. Conversely, comparisons involving subspecies that are abundant (e.g., spinner and spotted dolphins, Stenella longirostris and S. attenuata), are only as diagnosable as many population comparisons. Estimates of diagnosability reported in subspecies and species descriptions should include confidence intervals, which are influenced by the sample sizes of the training data. We also stress the importance of reporting the certainty with which individuals in the training data are classified in order to communicate the strength of the classification model and diagnosability estimate. Guidance as to ideal minimum diagnosability thresholds for subspecies will improve with more comprehensive analyses; however, values in the range of 80%–90% are considered appropriate.
Abstract P236: Health Care Costs and Resource Utilizations of Acute Coronary Syndrome in a Cohort of Medicare Patients With and Without Diabetes Mellitus

Objective: Diabetes is an independent prognostic factor for increased risk for ischemic heart disease. This study evaluates differences in resource utilization and health care costs for acute coron...
Resting-State Functional Connectivity in the Infant Brain: Methods, Pitfalls, and Potentiality

Early brain development is characterized by rapid growth and perpetual reconfiguration, driven by a dynamic milieu of heterogeneous processes. Postnatal brain plasticity is associated with increased vulnerability to environmental stimuli. However, little is known regarding the ontogeny and temporal manifestations of inter- and intra-regional functional connectivity that comprise functional brain networks. Resting-state functional magnetic resonance imaging (rs-fMRI) has emerged as a promising non-invasive neuroinvestigative tool, measuring spontaneous fluctuations in the blood oxygen level dependent (BOLD) signal at rest that reflect baseline neuronal activity. Over the past decade, its application has expanded to infant populations providing unprecedented insight into functional organization of the developing brain, as well as early biomarkers of abnormal states. However, many methodological issues of rs-fMRI analysis need to be resolved prior to standardization of the technique and its subsequent rapid extension to infant populations. As a primary goal, this methodological manuscript will (1) Present a robust methodological protocol to extract and assess resting-state networks in early infancy using independent component analysis (ICA), such that investigators without previous knowledge in the field can implement the analysis and reliably obtain viable results consistent with previous literature; (2) Review the current methodological challenges and ethical considerations associated with emerging field of infant rs-fMRI analysis; and (3) Discuss the significance of rs-fMRI application in infants for future investigations of neurodevelopment in the context of early life stressors and pathological processes. The overarching goal is to catalyze efforts towards development of robust, infant-specific acquisition and preprocessing pipelines, as well as promote greater transparency by researchers regarding methods used.
Evaluation of Intranasal Flap Perfusion by Intraoperative Indocyanine Green Fluorescence Angiography.

Background Vascularized intranasal flaps are the primary reconstructive option for endoscopic skull base defects. Flap vascularity may be compromised by injury to the pedicle or prior endonasal surgery. There is currently no validated technique for intraoperative evaluation of intranasal flap viability. Objective To evaluate the efficacy of indocyanine green (ICG) near-infrared angiography in predicting the viability of pedicled intranasal flaps during endoscopic skull base surgery through a pilot study. Methods ICG near-infrared fluorescence endoscopy was performed during endoscopic endonasal surgery for skull base tumors. Intraoperative and postoperative data were collected regarding enhancement of the flap body and pedicle. Fluorescence was rated qualitatively. Postoperatively, flap perfusion was evaluated via MRI-contrast enhancement in addition to clinical outcomes (cerebrospinal fluid leak and endoscopic flap appearance). Results Thirty-eight patients underwent ICG fluorescence angiography. Both the body and pedicle enhanced in 20 patients (53%), while the pedicle only enhanced for 12 patients (32%), the body only for 3 (8%), and neither for 3 (8%). When both the pedicle and body enhanced with ICG, the rate of postoperative MRI contrast enhancement was 100% and the rate of flap necrosis was 0%. The sensitivity and specificity of flap pedicle ICG enhancement for predicting postoperative flap MRI enhancement were 97% and 67%, respectively. Two of 3 patients without enhancement developed flap necrosis. Conclusion ICG fluorescence angiography of intraoperative flap perfusion is feasible and correlates well with outcomes of postoperative MRI flap enhancement and flap necrosis. Additional study is needed to further refine the imaging technique and optimally characterize the clinical utility.
Smoking outcome expectancies predict smoking during voucher-based treatment for smokers with substance use disorders.

Abstract Objective Strong expectations regarding positive effects of smoking may reduce the likelihood of successfully quitting. The Smoking Effects Questionnaire (SEQ) assesses the importance of seven expected positive and negative effects of smoking. SEQ was used to predict responses to contingent monetary rewards for smoking abstinence among smokers with substance use disorders (SUD). Methods Smokers (N = 184) in residential (i.e., 24 h/day) treatment for SUD received 19 consecutive days of either contingent vouchers (CV) for smoking abstinence (twice-daily carbon monoxide [CO] readings) or non-contingent vouchers (NV) plus counseling to motivate smoking cessation. Analyses investigated effects of smoking expectancies on days of smoking within-treatment and number of cigarettes/day at 1 month post-treatment. Results Higher positive expectancies for reduced negative affect, weight control, stimulation and positive social effects from smoking were related to more days of smoking during treatment only for participants in the CV condition. Post-treatment, expecting positive social and stimulating effects from smoking were related to more smoking only among CV participants. In both conditions, negative expectancies were largely unrelated to smoking outcomes. Conclusions The moderation of CV by positive smoking expectancies suggests that those who rate positive expectancies as more important may require a complementary treatment or different incentives to reduce smoking. The SEQ was probably unassociated with smoking in NV due to little reduction in smoking behavior. Helping smokers with SUD develop alternative ways to produce positive effects sought from smoking may be important to improve initial smoking outcomes.
Fasting Blood Glucose Levels Provide Estimate of Duration and Progression of Pancreatic Cancer Before Diagnosis

Background & Aims It is unclear how long pancreatic ductal adenocarcinomas (PDACs) are present before diagnosis. Patients with PDAC usually develop hyperglycemia and diabetes before the tumor is identified. If early invasive PDACs are associated with hyperglycemia, the duration of hyperglycemia should associate with the time that they have had the tumor. Methods We collected data on patients with PDACs from medical databases in Olmsted County, Minnesota, from 2000 through 2015 and from the Mayo Clinic’s tumor registry from January 1, 1976, through January 1, 2017. We compared glycemic profiles of patients with PDAC (cases) compared with patients without cancer, matched for age and sex (controls). We analyzed temporal fasting blood glucose (FBG) profiles collected for 60 months before patients received a PDAC diagnosis (index date) (n = 219) (cohort A), FBG profiles of patients with resected PDAC (n = 526) stratified by tumor volume and grade (cohort B), and temporal FBG profiles of patients with resected PDACs from whom long-term FBG data were available (n = 103) (cohort C). The primary outcome was to estimate duration of presence of invasive PDAC before its diagnosis based on hyperglycemia, defined as significantly higher (P Results In cohort A, the mean FBG did not differ significantly between cases and controls 36 months before the index date. Hyperglycemia was first noted 36 to 30 months before PDAC diagnosis in all cases, those with or without diabetes at baseline and those with or without resection at diagnosis. FBG level increased until diagnosis of PDAC. In cohort B, the mean FBG did not differ significantly in controls vs cases with PDACs below 1.0 mL. The smallest tumor volume associated with hyperglycemia was 1.1 to 2.0 mL; FBG level increased with tumor volume. FBG varied with tumor grade: well- or moderately differentiated tumors (5.8 mL) produced the same FBG levels as smaller, poorly differentiated tumors (1.5 mL) (P Conclusions In a case–control study of patients with PDAC from 2 databases, we associated FBG level with time to PDAC diagnosis and tumor volume and grade. Patients are hyperglycemic for a mean period of 36 to 30 months before PDAC diagnosis; this information might be incorporated into strategies for early detection.
A Linear Lightwave MAN Architecture

A new type of architecture for an optical Metropolitan Area Network is described, based on establishing controllable, optically transparent paths among network users. The networks in question perform only linear operations on optical signals (power combining, splitting and linear amplification), essentially operating as a dynamically controlled “ether” within which light beams are selectively directed between prescribed source-destination pairs on demand. Because they are controllable, they are capable of being reconfigured in response to changing load conditions or component failures.
Large changes in biomass burning over the last millennium inferred from paleoatmospheric ethane in polar ice cores

Biomass burning drives changes in greenhouse gases, climate-forcing aerosols, and global atmospheric chemistry. There is controversy about the magnitude and timing of changes in biomass burning emissions on millennial time scales from preindustrial to present and about the relative importance of climate change and human activities as the underlying cause. Biomass burning is one of two notable sources of ethane in the preindustrial atmosphere. Here, we present ice core ethane measurements from Antarctica and Greenland that contain information about changes in biomass burning emissions since 1000 CE (Common Era). The biomass burning emissions of ethane during the Medieval Period (1000-1500 CE) were higher than present day and declined sharply to a minimum during the cooler Little Ice Age (1600-1800 CE). Assuming that preindustrial atmospheric reactivity and transport were the same as in the modern atmosphere, we estimate that biomass burning emissions decreased by 30 to 45% from the Medieval Period to the Little Ice Age. The timing and magnitude of this decline in biomass burning emissions is consistent with that inferred from ice core methane stable carbon isotope ratios but inconsistent with histories based on sedimentary charcoal and ice core carbon monoxide measurements. This study demonstrates that biomass burning emissions have exceeded modern levels in the past and may be highly sensitive to changes in climate.
A Least Cost Path Model for hominin dispersal routes out of the East African Rift region (Ethiopia) into the Levant

Abstract The state of our knowledge concerning the geographic routes through which hominins spread out of Africa remains incomplete. The Nile basin (Northern Route) and the Strait of Bab al-Mandab (Southern Route) have been commonly cited as the likely Out-of-Africa dispersal paths, although the degree to which these routes were always accessible is unclear. This paper seeks to identify areas that may have served as viable routes for hominin dispersals from eastern Africa into the Levant using analytical tools within a Geographic Information System (GIS). We employed a heuristic model that would find the Least Cost Paths (LCPs) from three hypothetical origin points in the Ethiopian-Afar Rift basins to a predefined destination point on the Sinai Peninsula (a gateway to Eurasia). Three input variables, namely topographic roughness, drainage density and elevation were used in creating the LCP model. All of the resulting LCPs have travelled through the Nile basin, reinforcing the Northern Route hypothesis. It is also interesting to observe that all the LCPs have crossed the western highlands of Ethiopia before converging at the Nile, lending support to the recently proposed “Mountain Exile Hypothesis” (Vogelsang, 2018). This region had seen little Paleolithic research in the past, thus our model provides a critically needed baseline for future systematic fieldwork there.
We Are Dancing For You: Native Feminisms & the Revitalization of Women's Coming-of-Age Ceremonies (Cutcha Risling Baldy)

This text contains a review of We Are Dancing For You: Native Feminisms & the Revitalization of Women's Coming-of-Age Ceremonies by Cutcha Risling Baldy.
Abstract P3-01-05: Circulating tumor cell detection predicts early recurrence in patients with non-metastatic breast cancer

Background: Our group and others have shown that CTCs are identified in 20-25% of non-metastatic breast cancer patients. Recent data suggests that circulating tumor cell (CTC) detection at 5 years follow-up predicts late recurrence for non-metastatic, estrogen receptor positive, HER2/neu negative (ER+/HER2-) breast cancer patients. The aim of this study was to determine if CTC detection at time of surgery in ER+/HER2- predicts early (less than or equal to 5 years) recurrence, and to compare the median recurrence-free survival (RFS) to triple negative (TN) patients. Methods: We performed CTC enumeration on 506 patients with non-metastatic breast cancer just prior to surgical resection as part of an IRB approved study. CTCs (per 7.5 ml blood) were identified using the Cell SearchSystem (Menarini Silicon Biosystems). The presence of one or more CTC meeting morphological criteria for malignancy was considered a positive result. Patients with inflammatory breast cancer were excluded from our analysis. Log-rank test and Cox regression analysis were applied to establish the association of CTCs with RFS. Results: Median follow-up was 68 months and mean age was 53 years. Eighty-four percent of patients (417/498) had T1/T2 tumors, 63% (307/487) had grade 1 or 2 tumors, and 58% (292/501) had negative lymph nodes. Eighty-three percent (419/506) had ER+/HER2- tumors, and 17% (87/506) were TN. One or more CTC was identified in 22% (91/419) ER+/HER2- patients, and in 28% (24/87) of TN patients. Nine percent (45/506) of patients recurred within 5 years of CTC assessment. Of the 45 patients who relapsed, detection of one or more CTCs predicted shortened RFS. Median RFS for CTC-positive patients was 1.2 years, vs. 2.5 years for CTC-negative patients, irrespective of ER+/HER2- or TN subtype (log-rank P Conclusions: One or more CTCs identified at surgical resection predicted shortened RFS, irrespective of subtype, in non-metastatic breast cancer patients. This data warrants larger studies to determine if CTC positivity can be used to stratify both ER+ and TN patients who are at increased risk for early recurrence. Citation Format: Hall C, Meas S, Bowman Bauldry J, Kuerer H, Lucci A. Circulating tumor cell detection predicts early recurrence in patients with non-metastatic breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-01-05.
Policy-Based Identification of IoT Devices’ Vendor and Type by DNS Traffic Analysis

The explosive growth of IoT devices and the weak security protection in some types of devices makes them an attractive target for attackers. IoT devices can become a vulnerable weak link for penetrating a secure IT infrastructure. The risks are exacerbated by the Bring-Your-Own-Device trend that allows employees to connect their own personal devices into an enterprise network. Currently, network administrators lack adequate tools to discover and manage IoT devices in their environments. A good tool to address this requirement can be created by adapting and applying natural language interpretation algorithms to network traffic. In this paper, we show that an application of algorithms like Term Frequency - Inverse Document Frequency (TF-IDF) to the domain name resolution process, a required first step in every Internet based communication, can be highly effective to determine IoT devices, their manufacturers and their type. By treating the domain names being resolved as words, and the set of domain names queried by a device as a document, then comparing these synthetic documents from a reference data set to real traffic results in a very effective approach for IoT discovery. Evaluation of our approach on a traffic data set shows that the approach can identify 84% of the instances, with an accuracy of 91% for the IoT devices’ vendor, and 100% of the instances with an accuracy of 94% for the IoT devices’ type. We believe that this is the first attempt to apply natural language processing algorithms for traffic analysis, and the promising results could open new venues for securing and understanding computer networks through natural language processing algorithms. These and other techniques require policies to determine how the large volume of data will be handled efficiently. By assisting in detecting potential malicious devices, this paper contributes to the topic of safe autonomy.
Healthcare Rationing Cutoffs and Sorites Indeterminacy

Rationing is an unavoidable mechanism for reining in healthcare costs. It entails establishing cutoff points that distinguish between what is and is not offered or available to patients. When the resource to be distributed is defined by vague and indeterminate terms such as "beneficial," "effective," or even "futile," the ability to draw meaningful boundary lines that are both ethically and medically sound is problematic. In this article, I draw a parallel between the challenges posed by this problem and the ancient Greek philosophical conundrum known as the "sorites paradox." I argue, like the paradox, that the dilemma is unsolvable by conventional means of logical analysis. However, I propose another approach that may offer a practical solution that could be applicable to real-life situations in which cutoffs must be decided (such as rationing).
Extending the role of headquarters beyond the firm boundary: entrepreneurial alliance innovation

Prior research on corporate headquarters (CHQ) characteristics identifies the impact of CHQ location and composition on the innovation outcomes of internal subsidiaries. However, given that external strategic alliances with high-tech entrepreneurial firms represent a key source of innovation for the corporation, corporations must also consider how their choices of CHQ location and composition affect the innovation outcomes of these partners. In a study of 36 incumbent pharmaceutical corporations in 377 strategic alliances with 143 VC-backed biotechnology startups, we leverage detailed hand-collected data on CHQ locations and functions to estimate the effect of the CHQ on the innovation performance of the corporations’ entrepreneurial alliance partners. We find that a 1000-km decrease in CHQ–partner distance leads to an increase of 28 forward citations for the alliance partner, i.e., a 1% decrease in the distance is associated with a 1.7% increase in innovation performance. We find that the co-located presence of the corporation’s R&D function at the CHQ attenuates the benefit of CHQ–partner proximity, particularly for alliances structured for horizontal collaboration at the same part of the value chain. This study contributes to the literatures on both CHQ design and technology alliances.
The Validity of the Weekly Calendar Planning Activity (WCPA) for People With Multiple Sclerosis (PwMS)

Date Presented 04/06/19 People with Multiple Sclerosis (PwMS) often experience executive function (EF) deficits affecting daily living. The Weekly Calendar Planning Activity (WCPA) is a recently developed tool requiring management of a cognitively challenging functional task. This study sought to validate the WCPA as an assessment of functional cognition for PwMS. We established the WCPA’s discriminant, concurrent, and construct validity. Overall, it can be a useful tool to assess EF function difficulties among PwMS. Primary Author and Speaker: Diane Rose Allid Additional Authors and Speakers: Melissa Orenstein Contributing Authors: Yael Goverover
Multiple Approaches to Uniting Students Across Groups: Introduction to the Special Issue on Social Inclusion

School-age children and youth are diverse in multiple ways. They range across race and cultural background; gender and gender expression; as well as sexual orientation. In addition, their abilities...
Radiation-induced sarcoma in a cat following hypofractionated, palliative intent radiation therapy for large-cell lymphoma.

Case summaryA 5-year-old female spayed domestic shorthair cat was presented with a 4.5 × 3 cm ulcerated cutaneous mass on the nasal bridge with extension into the nasal cavity. Tissue biopsy was ob...
Making the Diagnosis of Myositis: Lung Biopsy and Interpretation

Myositis-associated lung disease occurs in up to 80% of myositis patients. It has to be distinguished from idiopathic or secondary lung diseases such as infection or aspiration. Histologically, myositis-associated interstitial lung disease shows either an acute lung injury pattern such as diffuse alveolar damage (clinically corresponding to sudden onset and rapidly progressing disease) or chronic fibrosing lung disease (clinically corresponding to insidious onset and slowly progressing disease). Histopathologic features are typically not pathognomonic and require multidisciplinary discussion to arrive at the best possible diagnosis. Acute lung injury patterns usually portend a worse prognosis than chronic lung disease. Diffuse fibrosing lung disease in myositis patients usually carries a better prognosis than idiopathic forms of the same histologic pattern.
A General Approach to Sensitivity Analysis for Mendelian Randomization

Mendelian Randomization (MR) represents a class of instrumental variable methods using genetic variants. It has become popular in epidemiological studies to account for the unmeasured confounders when estimating the effect of exposure on outcome. The success of Mendelian Randomization depends on three critical assumptions, which are difficult to verify. Therefore, sensitivity analysis methods are needed for evaluating results and making plausible conclusions. We propose a general and easy to apply approach to conduct sensitivity analysis for Mendelian Randomization studies. Bound et al. (1995) derived a formula for the asymptotic bias of the instrumental variable estimator. Based on their work, we derive a new sensitivity analysis formula. The parameters in the formula include sensitivity parameters such as the correlation between instruments and unmeasured confounder, the direct effect of instruments on outcome and the strength of instruments. In our simulation studies, we examined our approach in various scenarios using either individual SNPs or unweighted allele score as instruments. By using a previously published dataset from researchers involving a bone mineral density study, we demonstrate that our proposed method is a useful tool for MR studies, and that investigators can combine their domain knowledge with our method to obtain bias-corrected results and make informed conclusions on the scientific plausibility of their findings.
The order of forms: realism, formalism, and social space: by Anna Kornbluh, Chicago, U of Chicago P, 2019, 217 pp., $27.50 (paperback), ISBN: 978-0-226-65334-1

“Taking things apart,” Anna Kornbluh asserts in this ambitious book, is what literary critics do, or have done for the last several generations, and should stop doing (Kornbluh 2019, 1). Instead, w...
Minimally Invasive Heller Myotomy

A Heller myotomy is performed when medical management has failed to improve the symptomatology of esophageal achalasia. It involves incising the smooth muscular layer of esophagus, allowing the lower esophageal sphincter to relax. The chapter prescribes a minimally invasive approach.
Spinal trauma in DISH and AS: is MRI essential following the detection of vertebral fractures on CT?

Abstract BACKGROUND Both ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) cause a rigid spine, but through different pathophysiology. Recent data has shown that characteristic fracture patterns may also differ following trauma since the posterior osseous and soft tissue elements are often spared in DISH. CT and MRI are important in diagnosing spine injury, but given the differences between AS and DISH, the utility of obtaining both studies in all patients warrants scrutiny. PURPOSE To assess the prevalence of posterior element injury on CT and MRI in DISH and AS patients with known vertebral body injury detected on CT; to determine whether MRI demonstrates additional injuries in neurologically intact patients presumed to have isolated vertebral body injuries on CT. STUDY DESIGN Multicenter, retrospective, case-control study. PATIENT SAMPLE DISH and AS patients presenting after spine trauma between 2007 and 2017. OUTCOME MEASURES Review of CT and MRI findings at the time of presentation. METHODS One hundred sixty DISH and 85 AS patients presenting after spine trauma were identified from 2 affiliated academic hospitals serving as level 1 trauma and tertiary referral centers. A diagnosis of DISH or AS was verified by a board-certified emergency radiologist with 3 years of experience. Age, gender, mechanism of injury, fracture type, spine CT and MRI imaging findings, surgical intervention, and neurologic deficit were recorded. The CT and MRI studies were reviewed by the same radiologist for fracture location and type using the AO spine classification. No funding source or conflict of interest was present. RESULTS Median age was 72 and 79 years old for the AS and DISH groups, respectively. Both were predominantly male (81%) and most presented after a low energy mechanism of injury (74% and 73%). Type C AO spine injuries were seen in 52% of AS patients but only 4% of DISH patients. In patients with known vertebral body injury on CT, additional injury to the posterior elements on CT or MRI in DISH patients was 51% versus 92% in AS patients. However, in patients with an isolated vertebral body fracture on CT and no neurological deficit, MRI identified posterior element injury in only 4/22 (18%) DISH patients compared to 5 of 7 (71%) AS patients. None of the MRI findings in the DISH patients were considered clinically important while all 5 AS patients eventually underwent operative treatment despite having no neurological deficit. Epidural hematoma on MRI was seen in 43% of AS patients as opposed to 5% of DISH patients. CONCLUSION Based on our small sample size, CT alone may be adequate in DISH patients with isolated vertebral body fractures and no neurologic deficit, but an additional MRI should be considered in the presence of an unclear neurological exam or deficit. MRI should be strongly considered for any AS patient regardless of neurologic status.
INTEGRATION OF REMOTE SENSING & ENVIRONMENTAL SCIENCE IN PLACED-BASED LEARNING

Abstract. Integration of remote sensing techniques and Environmental Science methodologies in placed-based curriculum design creates unique learning opportunities. To promote introductory-level student engagement with STEM, our team designed a set of multidisciplinary teaching materials to intensely examine a single location: the Lake Sidney Lanier watershed of North Georgia, USA. Using a combination of scientific approaches from a variety of disciplines, course exercises encourage students to holistically learn about environmental conditions within the watershed. Remote sensing exercises are embedded throughout the course content and include analysis of historic aerial imagery, Landsat-derived dynamic surface water extent, google timelapse land cover change, Sentinel 2 spectral bands, and evaluation of topography. Fundamental spatial concepts of scale and connectivity are considered using interdisciplinary approaches and local data. Landscape ecology is presented alongside remote sensing concepts of spatial and temporal resolution. This allows students to think about the diverse ways scientists understand scale, pattern, and the definition of “place”. Multiple data sources are also provided for each topic. For example, remote sensing imagery is used to investigate surface water conditions during drought and high-rainfall time periods. In addition, USGS streamgage river discharge data and rainfall estimates are provided for students to examine drought history using multiple parameters. Lastly, sensor deployment and limitations of each data source are described so that students understand both the history of place as well as the process and development of science. Through the use of a place-based curriculum design and interdisciplinary lab exercises, students gain a holistic understanding of a regional watershed.
Paths to OpenMP in the kernel

OpenMP implementations make increasing demands on the kernel. We take the next step and consider bringing OpenMP into the kernel. Our vision is that the entire OpenMP application, run-time system, and a kernel framework is interwoven to become the kernel, allowing the OpenMP implementation to take full advantage of the hardware in a custom manner. We compare and contrast three approaches to achieving this goal. The first, runtime in kernel (RTK), ports the OpenMP runtime to the kernel, allowing any kernel code to use OpenMP pragmas. The second, process in kernel (PIK) adds a specialized process abstraction for running user-level OpenMP code within the kernel. The third, custom compilation for kernel (CCK), compiles OpenMP into a form that leverages the kernel framework without any intermediaries. We describe the design and implementation of these approaches, and evaluate them using NAS and other benchmarks.
Multiple factors contribute to anautogenous reproduction by the mosquito Aedes aegypti

Aedes aegypti is an anautogenous mosquito that must blood feed on a vertebrate host to produce and lay a clutch of eggs. The rockpool mosquito, Georgecraigius atropalpus, is related to A. aegypti but is a facultatively autogenous species that produces its first clutch of eggs shortly after emerging without blood feeding. Consumption of a blood meal by A. aegypti triggers the release of ovary ecdysteroidogenic hormone (OEH) and insulin-like peptide 3 (ILP3) from the brain, which stimulate egg formation. OEH and ILP3 also stimulate egg formation in G. atropalpus but are released at eclosion independently of blood feeding. These results collectively suggest that blood meal dependent release of OEH and ILP3 is one factor that prevents A. aegypti from reproducing autogenously. Here, we examined two other factors that potentially inhibit autogeny in A. aegypti: teneral nutrient reserves and the ability of OEH and ILP3 to stimulate egg formation in the absence of blood feeding. Measures of nutrient reserves showed that newly emerged A. aegypti females had similar wet weights but significantly lower protein and glycogen reserves than G. atropalpus females when larvae were reared under identical conditions. OEH stimulated non-blood fed A. aegypti females to produce ecdysteroid hormone and package yolk into oocytes more strongly than ILP3. OEH also reduced host seeking and blood feeding behavior, yet females produced few mature eggs. Overall, our results indicate that multiple factors prevent A. aegypti from reproducing autogenously.
Death of the Ring Shout

This article offers an engagement with an ancestral ritual known as the “Ring Shout.” It traces the importance of the African ritual in slave communities, as this phenomenon was used as a way for enslaved Africans held in bondage to Africanize the Christian faith into which they had been converted. It details the death of this ritual, and suggests that not only has it ceased to be operative in African-American Christian congregations, but that ancestor veneration in its original function has also stopped being practiced. Furthermore, the article suggests that African-Americans have bought into the negative, Western engagement with ancestor veneration, despite evidence that the wider culture of the United States engages in its own style and form of this practice. The article concludes with suggestions on how African-American congregations can use the powerful communal binding tool of ancestor veneration to create stronger communities.
Just Good Business: Community Development "within" Colleges and Universities.

Largely absent from college and university engagementefforts are the community members who work on our owncampuses, often those in the lowest-paid positions, even thoughthey are from the communities the campus purports to serve.This article represents the results of a project that scanned thecivic microcosm of our colleges and universities to identifythese underserved groups and their needs. Topics discussedinclude campus models already in existence, challenges facingthis type of engagement, and strategies for linking efforts to aidthis “community within” to campus civic engagement.
Mechanisms of Insulin Resistance in Cystic Fibrosis † 437

BACKGROUND: We and others documented insulin resistance in patients with cystic fibrosis (CF). To date the mechanism of insulin resistance is unclear. We undertook our current study to determine potential mechanisms underlying insulin resistance in CF. METHODS: We studied 8 CF subjects (ages 22-27), 1F/7M; all had impaired glucose tolerance (IGT). All were studied when not acutely ill for at least 4 weeks and when not taking oral or intravenous corticosteroids for at least 4 months. We also studied 8 control volunteers matched for age and sex. All were normally glucose tolerant. Each subject underwent a three-hour hyperinsulinemic eugylcemic clamp study(200mU/m2/min) and a precutaneous muscle biopsy. Blood and urine were collected for measurement of 24 hour urinary free cortisol and the cytokines: IL-1, IL-6 and TNFα. The glucose transporter GLUT4 was isolated using sucrose gradients and differential centrifugation. Immunoblot analysis was used to quantify GLUT4 in the cell surface (CS) layer and the plasma membrane(PM) layer to determine translocation. RESULTS: Results from the clamp studies are reported as glucose disposal rate (GDR mg/kg/min). All CF subjects were insulin resistant when compared to controls (GDR:CF=11 ± 3, C=16± 3; p=0.002). There was less GLUT4 in the PM layer (CF=135 ± 51, C=246 ± 55 dpm/min; p=0.024) and more in CS layer (CF=270 ± 44, C=164 ± 51 dpm/min; p=0.03) from CF subjects than controls. The amount of GLUT4 in the PM layer positively correlated with GDR (r=0.73). There was no difference in the levels of cytokins IL-6 and IL-1 between the subgroups; however TNF-α levels were significantly higher in CF than in controls (CF=8.9±2.9, C=3.8±2 pg/ml; p=0.002). There was no difference between urinary free cortisol levels in CF and controls. SUMMARY: CF subjects are insulin resistant when compared to controls; 2) Translocation of GLUT4 is impaired in CF subjects with IGT and correlates with insulin sensitivity; 3) TNF-α levels are higher in CF than in C; 4) There is no difference between cortisol values in CF and C. CONCLUSIONS: The insulin resistance noted in CF patients is in part due to impaired translocation of GLUT4 which is possibly related to higher levels of TNF-α.