cssi/SciSciGPT-SciSciNet huggingface dataset:
The management of treatment-related esophageal complications in children and adolescents with cancer.

Abstract Background and Purpose Serious treatment-induced esophageal strictures and tracheoesophageal fistulae are rare in the pediatric oncology population. This report details our experience with their management. Methods We retrospectively reviewed our experience with pediatric oncology patients treated for esophageal complications over a 23-year period. Serious complications were defined as development of strictures requiring dilatation or an esophageal fistula. Fifteen patients were identified, 5 of which had been previously reported. Results Thirteen patients developed esophageal stricture, and 2 progressed to tracheoesophageal fistulae. The remaining 2 patients developed tracheoesophageal fistulae without antecedent stricture. The median interval from cancer diagnosis until development of esophageal complications was 3.5 years (range, 0.4-11.8 years). Before development of esophageal complication, 14 patients (93%) were treated with mediastinal radiation and 7 (47%) for candidal esophagitis. Strictures were most commonly located in the distal esophagus (5), then midesophagus (3), cervical esophagus (3) and diffusely (2). A median of 5 dilatations (range, 1-50) were necessary before patients were able to resume a normal diet. The origin of tracheoesophageal fistulae was the midesophagus (3) and distal esophagus (1). All 4 patients with fistulae were treated with esophageal division and diversion followed by esophagocoloplasty. Conclusions Esophageal strictures and fistulae may occur because of cancer therapy in childhood. Prevention includes early treatment of esophagitis especially Candida mucositis, and minimization of radiation dose to the esophagus. Strictures usually respond to dilatation, but fistulae require esophageal diversion and secondary reconstruction.
A Comparative Study on Substituted Polyanilines for Supercapacitors

The effect of two substituent groups, ortho-methoxy (-OCH3) and methyl (-CH3) in aniline, have been studied for supercapacitor applications. The polyaniline (PANI), poly (o-anisidine) (POA) and poly (o-toluidine) (POT) have been synthesized by oxidative polymerization method, and characterized by Cyclic Voltammetry (CV), UV–visible spectroscopy, Raman spectroscopy, Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM) techniques. The specific capacitance, charging/discharging and electrochemical impedance characteristics of the supercapacitor fabricated using PANI, POA, as well as POT electrodes are evaluated in 2M H2SO4 electrolytic media. The highest specific capacitance of 400 F/g is calculated for PANI, whereas, POA and POT have exhibited 360 F/g and 325 F/g capacitance in supercapacitor studies.
Direct detection free-space optical communications through atmospheric turbulence

Free-space optical (FSO) communication systems suffer from both average optical signal power loss and random power fading due to the atmospheric turbulence. For focused laser beams propagating along the horizontal path, the average received optical signal power and the statistics of the power fading as functions of the communication distance and receiver aperture size are studied via large scale numerical simulations. The avalanche photodiode (APD) is chosen for optical power detection, and the accurate McIntyre- Conradi APD model is adopted for system evaluation. The on-off keying (OOK) method is used for laser beam modulation. The FSO communication channel is assumed to be shot-noise limited and experiences slowly time-varying power fading. The optimal detection threshold is determined and used for demodulation at each fading level. The average uncoded average bit-error-rate (BER) curves of the FSO communication system are obtained. The optimal receiver aperture sizes to achieve the lowest average BER are determined.
Film, propaganda, and politics: La France est un empire, 1939–1943

This article tells the story of a colonial documentary film that spanned the years of the late Third Republic and Vichy. The film is La France est un empire, written and directed by the adventure novelist Jean d’Agraives. The article is based on an unusually complete dossier of archival information, pieced together from both film and manuscript archives, that allows us to trace the life of the film from the initial idea to the production and ultimate reception of the film. This film and the archival record surrounding it contain clues to some of the broader questions that continue to motivate Vichy historiography: explaining the apparent internal paradoxes inherent in choices that individuals made during the Second World War in France. The article seeks to uncover the values that would explain a story that does not map neatly onto traditional conceptions of Right and Left, or of collaboration and resistance. This particular story involves a colonial film that found favor with both republican and authorita...
Scalable Design of Logic Circuits Using an Active Molecular Spider System

As spatial locality leads to advantages of computation speed-up and sequence reuse in molecular computing, molecular walkers that exhibit localized reactions are of interest for implementing logic computations. We use molecular spiders, which are a type of molecular walkers, to implement logic circuits. We develop an extended multi-spider model with a dynamic environment where signal transmission is triggered locally, and use this model to implement three basic gates (AND, OR, NOT) and a mechanism to cascade the gates. We use a kinetic Monte Carlo algorithm to simulate gate computations, and we analyze circuit complexity: our design scales linearly with formula size and has a logarithmic time complexity.
A femoral head start: Commentary on an article by Harry K.W. Kim, MD, MS, FRCSC, et al.: "Effects of non-weight-bearing on the immature femoral head following ischemic osteonecrosis: An experimental investigation in immature pigs"

We have been taught that Legg-Calve-Perthes disease usually results in femoral head deformity because collapse within the area of bone necrosis occurs before new bone formation gives adequate support. During our training, we were exposed to a number of strategies to avoid loss of femoral head sphericity. Mechanical treatments included non-weight-bearing, bed rest, a variety of braces, and traction. Most surgical approaches were reserved for older children. We were taught that with proper femoral head coverage and force protection, creeping substitution would be more likely to gradually replace dead bone with new living bone before severe deformity occurred1. The article by Kim et al. describes a piglet model for investigating weight-bearing (WB) compared with non-weight-bearing (NWB) management. A hind-limb amputation above the knee was necessary to make the animal non-weight-bearing. With the animal forced into non-weight-bearing, compliance was not an issue. The piglets were the age equivalent of a four to five-year-old child. Humans usually develop Legg-Calve-Perthes disease after that age, and younger children do better than those who are …
Brown v. Board of Education and the Application of American Tradition to Racial Division

Integration has been a common American remedy to a variety of social issues for a century and a half before Brown. The only thing new about integration following Brown v. Board was its application to race.
DSMC simulation of near-field enceladus plumes from tiger stripe fractures

The Saturn orbiter, Cassini, during its flyby of Saturn’s moon, Enceladus, in 2005 discovered plumes of water vapor and ice grains in the south-polar region, primarily originating from four prominent fractures known as tiger stripes. Significant differences between gas and grain velocities suggest that the plume source lies beneath the satellite’s surface. In this paper we model the subsurface gas and ice grain mixture flow from a subterranean source through a 45 m long subsurface channel. The gas flow inside the channel is continuum and inviscid in nature and is solved using an equilibrium direct simulation Monte Carlo (eDSMC) approach. Assuming that the ice grains are present in small mass concentration in the plume, an overlay technique to model the ice grain number density and size distribution along the channel is employed. A second more rigorous method, denoted as eDSMC-condensation, is developed to model ice grain collisions with water molecules and ice grain size growth directly in the water molecular flow as the two-phase flow evolves. The difference of gas and ice grains properties obtained with the two methods for a conical nozzle shape are found to be large. The ice grain size and mass fraction are compared at the surface exit with different method and nozzle shapes. Finally, it is observed that the eDSMC condensation simulations of the double-throated nozzle show that the flow properties strongly depend on the drag coefficient.
How do firm linkages with government reduce intensity of government corruption

This research examines the effect of firm linkages with government on government corruption. It argues that firm linkages with government can facilitate exchanges between firms and the state and in...
Nano-structured Aluminum Powders with Modified Protective Surface Layers

The advantage of aluminum powder as a fuel additive in energetic formulation includes its high volumetric combustion enthalpy and relatively low cost. However, the thermodynamically predicted benefits of aluminum combustion are rarely achieved because of extended ignition delays associated with heterogeneous reactions occurring at the alumina surface which surrounds the aluminum particle. In order to fully exploit aluminum’s high reaction energy, this effort focuses on adjusting its combustion dynamics by modifying its surface and structure. The modification is achieved by cryo-milling aluminum with cyclooctane, which is liquid at room temperature, but solid when cooled by liquid nitrogen. The prepared materials consist of micron-sized, equiaxial, mostly Al particles with a small amount of cyclooctane. Aluminum surface in the prepared sample is coated with a cyclooctane-modified layer with properties significantly different from those of regular alumina. Its oxidation kinetics, as observed from thermo-analytical measurements, is different from that of pure aluminum. The powder ignites at substantially reduced temperatures, produces shorter ignition delays, and higher aerosol burn rates compared to a regular spherical Al powder with similar particle sizes.
Torn Flexor Digitorum Longus Tendon and Lacerated Posterior Tibial Artery Associated with an Open Hawkins Type-III Talar Neck Fracture: A Case Report.

Talar neck fractures were described as the “aviator astragalus” by Anderson in 1919 because the predominant mechanism of injury was thought to be forced dorsiflexion1. Rotational forces likely account for posteromedial subluxation or dislocation of the talar body, which causes stretching of the dorsal soft tissues2-4. While symptoms associated with bowstringing of the flexor tendons and neurovascular bundle are common, we are not aware of any reports of a talar neck fracture with dislocation of the talar body associated with a flexor muscle avulsion and laceration of the posterior tibial artery. To the best of our knowledge, we detail the first case of an avulsed flexor digitorum longus (FDL) tendon and laceration of the posterior tibial artery associated with an open Hawkins type-III talar neck fracture-dislocation and its early management. The patient was informed that data concerning her case would be submitted for publication, and she provided consent. A thirty-three-year-old female driver was involved in a motor vehicle collision. Initial trauma evaluation revealed a 10-cm transverse laceration over the right Achilles tendon as well as absent right foot plantar sensation and an absent posterior tibial artery pulse. Radiographs demonstrated a Hawkins type-III fracture dislocation of the talar neck (Figs. 1-A and 1-B). Parenteral antibiotics were administered, the wound was irrigated and debrided, and the injured ankle was splinted after a failed attempt at closed reduction in the Emergency Department. The patient was then taken urgently to the operating room. Initial anteroposterior (Fig. 1-A) and lateral (Fig. 1-B) radiographs of the right foot and ankle. Note the talar neck fracture and the posteromedial displacement of the talar body. Fig. 1-A Fig. 1-B The talar body was found to be dislocated from both the tibiotalar and subtalar joints; it was lodged in a subcutaneous position in the posteromedial hindfoot and visible through the medial extent of the posterior laceration. The talar neck was moderately comminuted with dorsomedial impaction. The talar body, devoid of all soft-tissue attachments (including the …
74 INTRAUTERINE GROWTH RETARDATION ALTERS EXPRESSION OF INSULIN-LIKE GROWTH FACTOR 1 IN FEMALE RAT THYMUS.

Background Intrauterine growth retardation (IUGR) predisposes human infants and children to infectious diseases. We have previously shown that IUGR decreases the overall number of lymphocytes and alters T-cell phenotype. IUGR has also been shown to affect males to a greater degree than females. The exact mechanisms underlying these effects are unknown; however, the growth factor insulin-like growth factor 1 (IGF-1) is known to play a significant role in thymic development and lymphocyte proliferation. Additionally, IGF-1 levels in other organ systems are altered by IUGR. Furthermore, IGF-1 has several splice variants, which are preferentially expressed due to epigenetic mechanisms known to be active in IUGR. Objective We therefore hypothesized that IUGR would decrease thymic size and alter IGF-1 mRNA expression and its splice variants in male and female rat thymus. Methods Bilateral uterine artery ligation was performed on pregnant Sprague-Dawley rats to induce IUGR. Thymus tissue was harvested from IUGR and sham controls and weighed at d0 and d21. mRNA levels of the IGF-1 transcription start sites P1 and P2, as well as splice variants IGF-1A and IGF-1B, were quantified with real-time RT-PCR. Results At d0, male IUGR rat thymus had an average weight of only 0.0073 g ± 0.001 compared with sham at 0.0138 g ± 0.002 (p Conclusion The overall expression of IGF-1 was increased in IUGR female rat pups at d0 and the splice variant IGF-1A at d21. There were no significant changes in IGF-1 expression in male IUGR rat pups at d0 or d21. We know that IGF-1 is involved in the proliferation of lymphocytes and is increased in female IUGR rats and female lymphocyte phenotype and number are less affected by IUGR. We speculate that the increased IGF-1 levels and splice variants in females may explain why their immune systems are less severely affected by IUGR.
Analysis of Citizens' Willingness of Community Involvement and Its Relevant Factors:Take an Example in the Modification of Old Estates in Suzhou

This article makes a quantitative analysis and comparison between the willingness of habitants' community involvement in the modification of the old estates and that in their daily lives,and primarily discusses the relationship between the hardware infrastructure of the community,the construction of the community's software and the willingness of habitants' involvement,on the basis of the data sampled from 450 habitants of 4 modified districts in Suzhou.It exhibits that the willingness of habitants' involvement is high in the modification of the old estates while that in habitants' daily lives is low.As a result,the willingness of habitants' community involvement will be improved by the full utilization of the hardware infrastructure of the community and the enhancement of the officers' work,methods and service which belong to the community's software.
Evaluation Effects of IDD Control and Prevention from 1996 to 2008 in Fuyang City

Objective To evaluate effect of IDD control and prevention in Fuyang so as to provide a basis for improving IDD control and prevention.Methods According to surveillance plan of IDD control and prevention of Anhui province,PPS sampling method was used and 1200 children from 30 primary schools were detected for swell rate of thyroid gland and urine iodine.Content of iodine in salt from process and wholesale shops,retail shops and households was detected by direct titration method.Students from grade 4 and grade 5 and house wifies were investigated for IDD knowledge by questionnaire.Results Swell rate of children reduced from 38.30% in 1995 to 1.08% in 2008.Median of urine iodine increased from 76 ug/L in 1995 to 251 ug/L in 2008.Qualified rate,coverage rate of iodine salt,intake rate of qualified salt was continuously above 97% for ten years.Qualified rate of students and house wife for IDD knowledge was 96.08% and 87.14% respectively.Correct rate of behavior of the students and the housewifies was 87.47% and 90.71% respectively.Conclusions Effect of IDD control and prevention in Fuyang were remarkable and consolidated.Fuyang had maintained IDD elimination for 10 years.IDD urine iodine iodine salt evaluation
The Superconductive Transition in Cadmium

The superconductive transition in cadmium has been the subject of a dozen investigations over the past four decades. The first evidence of superconductivity in the element appears to have been found by Kurti and Simon in 1935,1 and subsequent authors have reported values of T c,2–13 H c (0),3,8,11,14 anisotropic thermal conductivity,8isotope effect,9,12,13 heat capacity,5,7,11 and pressure effects.10
Palliative interventions for hepatocellular carcinoma patients: Analysis of the National Cancer Database

Background: Palliative therapies are provided to a subset of hepatocellular carcinoma (HCC) patients with the aim of providing symptomatic relief, better quality of life and improved survival. The present study sought to assess and compare the efficacy of different palliative therapies for HCC. Methods: The National Cancer Database (NCDB), a retrospective national database that captures approximately 70% of all patients treated for cancer in the US, was queried for patients with HCC who were deemed unresectable from 1998–2011. Patients were stratified by receipt of palliative therapy. Survival analysis was examined by log-rank test and Kaplan Meier curves, and a multivariate proportional hazards model was utilized to identify the predictors of survival. Results: A total of 3,267 patients were identified; 287 (8.7%) received surgical palliation, 827 (25.3%) received radiotherapy (RT), 877 (26.8%) received chemotherapy, 1,067 (32.6%) received pain management therapy, while 209 (6.4%) received a combination of the previous three modalities. On multivariate analysis palliative RT was identified as a positive predictor of survival [hazards ratio (HR) 0.65; 95% CI, 0.50–0.83]. Stratifying by disease stage, palliative RT provided a significant survival benefit for patients with stage IV disease. Conclusions: Palliative RT appears to extend survival and should be considered for patients presenting with late stage HCC.
ANALYSIS OF 405 EPISODES OF PNEUMOCOCCAL BACTEREMIA IN ADULTS OVER A 15-YEAR PERIOD*

Background. HIV-infection and increasing drug resistance may influence the prognosis of pneumococcal bacteremia. We performed an observational cohort study to analyze the epidemiology, risk factors, and outcome for pneumococcal bacteremia during a 15-year period. Methods. Charts were reviewed from hospitalized adults at the University Hospital Basel, Switzerland, whose blood culture yielded Streptococcus pneumoniae in the period from January 1986 through December 2000. Results. 405 episodes of pneumococcal bacteremia in 394 patients were identified. The mean annual incidence was 1.78 episodes per 1,000 hospital admissions. Most common risk factors were cigarette smoking, chronic lung disease, malignancy, and alcohol misuse. HIV-infection was known in 46 episodes (11%). During the study period, the nonsusceptibility of pneumococci against penicillin increased from 0% to 17%. The overall mortality was 25%. The case-fatality rate decreased from 32% to 17% during the second half of the study period (P < 0.001). Independent risk factors for fatal outcome were coronary heart disease, neutropenia, and increasing age, whereas prior respiratory infection and the occurrence of bacteremia in the second half of the study period were independent predictors of survival. Mortality in HIV-infected patients was lower than in HIV-noninfected subjects (9% versus 27%, P = 0.007). Conclusions. Despite increased numbers of penicillin-nonsusceptible strains, mortality of pneumococcal pneumonia significantly decreased in the second half of study period.
Childhood Behavioral Problems—Attention-Deficit/Hyperactivity Disorder (ADHD)

Attention Deficit/Hyperactivity Disorder (ADHD) is a common disorder which often requires care to achieve symptom remediation. Appropriate treatment modalities are discussed and barriers to engagement in these services are reviewed. The authors also discuss the importance of definition “engagement” in this population and provide strategies for initial and sustained treatment engagement.
CORRELATES OF SELF-DIAGNOSIS OF CHRONIC MEDICAL AND MENTAL HEALTH CONDITIONS IN UNDER-SERVED AFRICAN AMERICAN AND LATINO POPULATIONS

Objective: This study examines the correlates of self-diagnosis of chronic medical and mental health conditions in under-served minority populations. The Behavioral Model for Vulnerable Populations was employed to compare the predisposing and enabling characteristics of two groups: the first group consisted of individuals who self-reported their medical conditions without a presumptive or definitive physician diagnosis, while the second group consisted of individuals who self-reported their medical conditions with a presumptive or definitive physician diagnosis of their condition. Study Setting: The sample consisted of 287 African American and Latino heads of household. This sample was obtained from a geographically defined random sample of 418 households from three urban public housing communities in Los Angeles County, California. Study Design: This study was a cross-sectional, face-to-face, semistructured interview survey. Results: Using logistic regression techniques and controlling for demographic characteristics, the results indicate that accessibility, affordability, continuity of medical care, and financial strains were the core concepts that explain the gap between self vs physician diagnosis of medical conditions. Conclusion: This study identifies unique characteristics of minority persons who claimed that their medical conditions had not been presented to or diagnosed by a medical provider in comparison to those who are formally diagnosed by medical providers. The study provides an entry point for further examination of correlates and sequels of self-diagnosis and its resultant effects on professional treatment-seeking in minority populations with certain medically important chronic conditions. (Ethn Dis. 2008;18[Suppl 2]:S2-105–S2-111)
Sperm-oocyte contact induces outside-in signaling via PYK2 activation

Fertilization is a multi-step process that begins with plasma membrane interactions that enable sperm - oocyte binding followed by fusion of the sperm and oocyte plasma membranes. Once membrane fusion has occurred, sperm incorporation involves actin remodeling events within the oocyte cortex that allow the sperm head to penetrate the cortical actin layer and gain access to the ooplasm. Despite the significance for reproduction, the control mechanisms involved in gamete binding, fusion, and sperm incorporation are poorly understood. While it is known that proline - rich tyrosine kinase 2 (PYK2 or PTK2b) kinase activity plays an important role in fertilization, its specific function has not been addressed. The present study made use of a zona-free mouse oocyte fertilization assay to investigate the relationship between PYK2 activity and sperm - oocyte binding and fusion, as well as localized changes in actin polymerization and sperm incorporation. In this assay, the majority of bound sperm had no apparent effect on the oocyte and only a few became incorporated into the ooplasm. However, a subset of bound sperm were associated with a localized response in which PYK2 was recruited to the oocyte cortex where it frequently co-localized with a ring or disk of f-actin. The frequency of sperm-oocyte binding sites that exhibited this actin response was reduced in pyk2-/- oocytes and the pyk2-/- oocytes proved less efficient at incorporating sperm, indicating that this protein kinase may have an important role in sperm incorporation. The response of PYK2 to sperm-oocyte interaction appeared unrelated to gamete fusion since PYK2 was recruited to sperm - binding sites under conditions where sperm - oocyte fusion was prevented and since PYK2 suppression or ablation did not prevent sperm - oocyte fusion. While a direct correlation between the PYK2 response in the oocyte and the successful incorporation of individual bound sperm remains to be established, these findings suggest a model in which the oocyte is not a passive participant in fertilization, but instead responds to sperm contact by localized PYK2 signaling that promotes actin remodeling events required to physically incorporate the sperm head into the ooplasm.
Temperature-dependent threshold stability of COTS SiC MOSFETs during gate switching

CommerciaX SiC DMOSFETs were stressed at high temperatures by applying a switching bias waveform to the gate, at a frequency around 10 kHz (similar to what a standard gate driver would do in a typical operating environment). Threshold voltage was monitored in situ (without interruption of the waveform) using a fast I d -V gs measurement during the pulse transitions. These measurements reveal significantly more drift in the threshold than can be seen by standard parameter analyzer-based methods. A decrease in, and reversal of, the threshold voltage hysteresis at higher temperatures was observed which cannot be explained by oxide trap charging alone. Degradation in threshold voltage hysteresis was found to proceed in an Arrhenius-like manner with an activation energy of 1.2 eV. Post-stress room temperature measurements using fast I d -V gs reveal a permanent degradation that slow methods do not detect.
BigFoot: static check placement for dynamic race detection

Precise dynamic data race detectors provide strong correctness guarantees but have high overheads because they generally keep analysis state in a separate shadow location for each heap memory location, and they check (and potentially update) the corresponding shadow location on each heap access. The BigFoot dynamic data race detector uses a combination of static and dynamic analysis techniques to coalesce checks and compress shadow locations. With BigFoot, multiple accesses to an object or array often induce a single coalesced check that manipulates a single compressed shadow location, resulting in a performance improvement over FastTrack of 61%.
Evidence-based recommendations to improve reproductive healthcare for incarcerated women

Purpose The purpose of this paper is to describe standards for evidence-based reproductive healthcare for incarcerated women. Design/methodology/approach The literature on reproductive healthcare in the US criminal justice system and recommendations from professional organizations were reviewed and critical areas of concern were identified. Within these areas, studies and expert opinion were synthesized and policy recommendations were formulated through an iterative process of group discussion and document revision. This brief specifically addresses women's incarceration in the USA, but the recommendations are grounded in a human rights framework with global relevance. Findings Women who are incarcerated have health needs that are distinct from those of men, and there is a clear need for gender-responsive reproductive healthcare within the criminal justice system. This brief identifies five core domains of reproductive healthcare: routine screening, menstruation-related concerns, prenatal and postpartum care, contraception and abortion, and sexually transmitted infections. The recommendations emphasize the continuity between the criminal justice system and the community, as well as the dignity and self-determination of incarcerated women. Originality/value This brief provides a unique synthesis of the available evidence with concrete recommendations for improving the reproductive healthcare for incarcerated women.
Treatment of obstructive sleep apnea during decompensations of heart hailure a randomized controlled trial

Background: Patients with heart failure and reduced ejection fraction (HFrEF) who are hospitalized for decompensation have a prevalence of obstructive sleep apnea (OSA) that exceeds 50%. We sought to evaluate the effect of in-hospital diagnosis and immediate treatment with auto positive airway pressure (APAP) of OSA in hospitalized HFrEF patients Methods: A single site randomized controlled trial of hospitalized HFrEF patients and in-hospital diagnosed OSA (AHI>15 events/h). All participants (n=150) received guideline directed therapy of heart failure decompensation and were randomized to an intervention arm (APAP) (n=75) or no in-hospital treatment for OSA (n=75). The primary outcome was change in discharge LVEF. Results: LVEF did not change signficantly in the treament vs. control arms (p=0.93). Also, there was no difference in the change in B-type natriuretic peptide. Analysis of patients who used APAP >4 hs/night during the hospitalization showed a significant increase in discharge EF compared to those who used 6 months readmissions decreased in patients who used APAP >4 hours. Rate ratio (RR) = 0.36 (0.14, 0.94), p = 0.04 vs. controls and RR = 0.27 (0.10, 0.76), p = 0.01 vs. Conclusion: In-hospital diagnosis and treatment with APAP did not change discharge LVEF in patients with HFrEF and OSA. Use of APAP was safe and associated with decreased 6 months readmissions when adequately used.
High Rate of Discontinuation May Diminish PrEP Coverage Among Young Men Who Have Sex with Men.

Understanding pre-exposure prophylaxis (PrEP) discontinuation is key to maximizing its effectiveness at the individual and population levels. Data came from the RADAR cohort study of MSM aged 16–29 years, 2015–2017. Participants included those who reported past 6-month PrEP use and discontinued its use by the interview date. Of the 197 participants who had used PrEP in the past 6 months, 65 discontinued use. Primary reasons for PrEP discontinuation included trouble getting to doctor’s appointments (14, 21.5%) and issues related to insurance coverage or loss (13, 20.0%). Few (21%) who discontinued spoke to their doctor first, which has important implications for future long acting formulations.
The Outsider Within: The Radical, Not-So-Scary Feminist Jurisprudence of Ann Scales

In her aspirations for the law, in the methods by which she exhorted readers to engender change, in her unique, transgressive, often outrageous voice, Ann Scales was the consummate "outsider." But she also understood the importance of engaging those who could make change possible. Thus Ann not only spoke truth to power, but also knew how to communicate it in registers that legal decision makers could at least sometimes apprehend. This Essay explores the work of Ann Scales in both "outsider" and "insider" modes, and examines the ways her teachings resonate in contemporary controversies over abortion and military service.
Management of Otopathology and Hearing Loss in Children with Cleft Palate and Craniofacial Anomalies

Children with cleft palate and other craniofacial anomalies are at risk for a variety of otopathologies including otitis media and structural deformities of the outer and middle ear. These conditions are usually associated with conductive hearing impairment; however, when hearing loss occurs as part of a syndrome, there may be sensorineural or mixed hearing loss. This chapter will review the etiology of these conditions and their medical management. We will also examine the assessment of hearing and various technologies available for treatment of hearing loss.
Rochester Connectionist Simulation Environment

The Rochester Connectionist Simulator, one of the earliest public domain neural network simulation environments, was designed for research into structured connectionist modeling. The main design criteria have been flexibility and generality. The network model consists of units, sites and links, each unit having a number of sites at which incoming links arrive. The network data structures are user-extensible allowing arbitrary state variables to be associated with each unit, site and link. The base simulator is written in C and the user has a choice of C, C++, Lisp or Scheme as the language for network specification, using simulator primitives to create units, sites and links. Update functions are taken from the library or written by the user. The X11 graphics interface provides multiple display windows, customizable mouse actions and the ability to arbitrarily extend functionality. Other forms of control are exercised via a user-extensible command language. A parallel version exhibiting near-linear speedup on a shared-memory multiprocessor is described. Some examples are given of the wide variety of research projects the simulator has been used for.
Investigation and Modeling of Combined Feedforward and Feedback Control Schemes to Improve the Performance of Differential Mode Active EMI Filters in AC–DC Power Converters

In this paper, the models of active differential mode electromagnetic interference input filters for ac–dc converters are first investigated. The models are developed for active filters with single feedback (FB) and single feedforward (FF) configurations, which include an active filter, passive filters, and the noise model for a converter. To increase the gain of the single active filter, the models for FB–FF, FF–FB, parallel FB, and series feedback (SFB) configurations are developed and investigated. Loop gains and insertion gains for all of these configurations are derived and compared. Stability has been analyzed based on the loop gains and a compensation technique is introduced to ensure stability. Based on the comparison among all these control configurations, it has been found that the SFB configuration can achieve the highest noise reduction. The loop gains and insertion gains of an active filter prototype with the SFB configuration are measured using a network analyzer to validate the developed model and compensation technique. Finally, spectrum measurements with a commercial boost power factor correction ac–dc converter have been conducted to verify the developed modeling and control techniques as well as the predicted performance for the SFB configuration.
Biofunctionalized Cellulose Nanofibrils Capable of Capture and Antiadhesion of Fimbriated Escherichia coli

In this study, naturally derived cellulose nanofibrils (CNFs), a renewable and easily modified nanomaterial with low cytotoxicity, were rendered bioactive via one-step functionalization with mannop...
Introduction: Wax Concepts

This chapter claims that wax was an important material to think with in the early modern period because of its various material qualities and its cultural uses. Using Tintoretto’s Last Temptation of Saint Anthony and Rene Descartes’ Meditations on the First Philosophy as its two touchstones, this chapter traces various histories and uses of wax in literature, philosophy, art, and other domains to show the multiplicity of ways that wax works in the period and suggest that wax was a valuable material in the period for thinking through the nature of the human. Additionally, this chapter devotes attention to the theoretical underpinnings of the book.
Abstract 1813: Depletion of PCAT1 in head and neck cancer cells limits tumor growth by regulating c-Myc, AKT1 and MAPK signalling pathways

Head and neck squamous cell carcinoma (HNSCC) represents one of the most common malignancies worldwide with a high mortality rate mainly due to lack of early detection markers, frequent metastasis and aggressive phenotype. Recently, long non-coding RNAs (lncRNAs) have been shown to have important regulatory roles in human cancers. Up-regulation of prostate cancer-associated transcript 1 (PCAT1) in TCGA dataset of HNSCC was noted. In this study, we aimed to evaluate role of the PCAT1 in HNSCC. During validation, we observed up-regulation of PCAT1 in HNSCC patient samples and cell lines. siRNA mediated knock-down of PCAT1 significantly reduced cell proliferation, sphere formation and wound healing in HNSCC cell lines (JHU29 and Cal27). Mechanistic study revealed a significant down-regulation of c-Myc and AKT1 in both RNA and protein levels upon knockdown of PCAT1 in HNSCC cell lines. In-silico analysis suggested a significant positive correlation between PCAT1 and c-Myc or PCAT1 and AKT1 in HNSCC cell lines. Subsequently, we observed modulation of MAPK signalling by activation of p38 and apoptosis signal-regulating kinase 1 (ASK1) upon knockdown of PCAT1, and induction of apoptosis as evident of caspase 9 activation and PARP cleavage. Introduction of PCAT1 into HNSCC xenograft tumors displayed a reduction in tumor volume. Together our data demonstrated an important role of the PCAT1 in HNSCC progression and has potential as a therapeutic candidate. Citation Format: Subhayan Sur, Robert Steele, Ratna B. Ray. Depletion of PCAT1 in head and neck cancer cells limits tumor growth by regulating c-Myc, AKT1 and MAPK signalling pathways [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1813.
De novo learning and adaptation of continuous control in a manual tracking task

Abstract How do people learn to perform tasks that require continuous adjustments of motor output, like riding a bicycle? People rely heavily on cognitive strategies when learning discrete movement tasks, but such time-consuming strategies are infeasible in continuous control tasks that demand rapid responses to ongoing sensory feedback. To understand how people can learn to perform such tasks without the benefit of cognitive strategies, we imposed a rotation/mirror reversal of visual feedback while participants performed a continuous tracking task. We analyzed behavior using a system identification approach which revealed two qualitatively different components of learning: adaptation of a baseline controller and formation of a new task-specific continuous controller. These components exhibited different signatures in the frequency domain and were differentially engaged under the rotation/mirror reversal. Our results demonstrate that people can rapidly build a new continuous controller de novo and can flexibly integrate this process with adaptation of an existing controller.
Numerical Simulation of Particle Effects on Boundary Layer Flow

A numerical study investigating the effects of a spherical particle on spatially evolving boundary layer flow is presented. A stationary sphere is placed above the wall and the development of its wake within the boundary layer is investigated. The sphere is represented by a forcing function in the momentum equations. Good agreement is obtained between the present results and previous experimental studies.
Random Forest Classification of Alcohol Use Disorder Using fMRI Functional Connectivity, Neuropsychological Functioning, and Impulsivity Measures

Individuals with alcohol use disorder (AUD) are known to manifest a variety of neurocognitive impairments that can be attributed to alterations in specific brain networks. The current study aims to identify specific features of brain connectivity, neuropsychological performance, and impulsivity traits that can classify adult males with AUD (n = 30) from healthy controls (CTL, n = 30) using the Random Forest (RF) classification method. The predictor variables were: (i) fMRI-based within-network functional connectivity (FC) of the Default Mode Network (DMN), (ii) neuropsychological scores from the Tower of London Test (TOLT), and the Visual Span Test (VST), and (iii) impulsivity factors from the Barratt Impulsiveness Scale (BIS). The RF model, with a classification accuracy of 76.67%, identified fourteen DMN connections, two neuropsychological variables (memory span and total correct scores of the forward condition of the VST), and all impulsivity factors as significantly important for classifying participants into either the AUD or CTL group. Specifically, the AUD group manifested hyperconnectivity across the bilateral anterior cingulate cortex and the prefrontal cortex as well as between the bilateral posterior cingulate cortex and the left inferior parietal lobule, while showing hypoconnectivity in long-range anterior-posterior and interhemispheric long-range connections. Individuals with AUD also showed poorer memory performance and increased impulsivity compared to CTL individuals. Furthermore, there were significant associations among FC, impulsivity, neuropsychological performance, and AUD status. These results confirm the previous findings that alterations in specific brain networks coupled with poor neuropsychological functioning and heightened impulsivity may characterize individuals with AUD, who can be efficiently identified using classification algorithms such as Random Forest.
Improving the AJCC/TNM staging classification for colorectal cancer: The prognostic impact of tumor deposits.

4012Background: Identification of tumor deposits (TD) currently plays a limited role in staging for colorectal cancer (CRC) other than for N1c designation. The aim of this study was to determine th...
What we talk about when we talk about medical librarianship: an analysis of Medical Library Association annual meeting abstracts, 2001–2019

Objective: This study seeks to gain initial insight into what is talked about and whose voices are heard at Medical Library Association (MLA) annual meetings. Methods: Meeting abstracts were downloaded from the MLA website and converted to comma-separated values (CSV) format. Descriptive analysis in Python identified the number of presentations, disambiguated authors, author collaboration, institutional affiliation type, and geographic affiliation. Topics were generated using Mallet’s Latent Dirichlet Allocation algorithm for topic modeling. Results: There were 5,781 presentations at MLA annual meetings from 2001–2019. Author disambiguation resulted in approximately 5,680 unique authors. One thousand ninety-three records included a hospital-related keyword in the author field, and 4,517 records included an academic-related keyword. There were 438 presentations with at least 1 international author. The topic model identified 16 topics in the MLA abstract corpus: events, electronic resources, publications, evidence-based practice, collections, academic instruction, librarian roles and relationships, technical systems, special collections, general instruction, literature searching, surveys, research support, community outreach, patient education, and library services. Conclusions: Academic librarians presented more frequently than hospital librarians, though more research should be done to determine if this discrepancy was disproportionate to hospital librarians’ representation in MLA. Geographic affiliation was concentrated in the United States and appeared to be related to population density. Health sciences librarians in the early twenty-first century are spending more time at MLA annual meetings talking about communities, relationships, and visible services, and less time talking about library collections and operations. Further research will be needed to boost the participation of underrepresented members.
Ballistic trauma patients have decreased early narcotic demand relative to blunt trauma patients: Blunt ballistic injury opioid use.

Abstract Objectives Blunt and ballistic injuries are two common injury mechanisms encountered by orthopaedic traumatologists. However the intrinsic nature of these injures may necessitate differences in operative and post-operative care. Given the evolving opioid crisis in the medical community, considerable attention has been given to appropriate management of pain; particularly in orthopaedic patients. We sought to evaluate relative postoperative narcotic use in blunt injuries and ballistic injuries. Design Retrospective Cohort Study. Setting Academic Level-1 Trauma Center. Patients 96 Patients with blunt or ballistic fractures. Intervention Inpatient narcotic pain management after orthopaedic fracture management. Main outcome measurements Morphine equivalent units (MEU). Results Patients with blunt injuries had a higher MEU compared to ballistic injuries in the first 24 hours postoperatively (35.0 vs 29.5 MEU, p=0.02). There were no differences in opiate consumption 24-48 hours (34.8 vs 28.0 MEU), 48 hours - 7 days post op (28.4 vs 30.4 MEU) or the 24 hours before discharge (30.0 vs 28.6 MEU). On multivariate analysis, during the 24-48 hours and 24 hours before discharge timepoints total EBL was associated with increased opioid usage. During days 3-7 (p Conclusion Blunt injuries required an increased postoperative narcotic consumption during the first 24 hours of inpatient stay following orthopedic fracture fixation. However, there was no difference at other time points. Immediate post-operative pain regimens may be decreased for patients with ballistic injuries. Level of evidence III.
How to Ace Cardiology and the Boards Including What to Review

Whether you want a concise overview of cardiology or are studying for the initial/re-certification cardiovascular board exam, we have pooled the talents, the expertise and the teaching experience of the best and the brightest at Mass General to help you achieve your goal.
Heterogeneity of PD-L1 expression between invasive and lepidic components of lung adenocarcinomas.

The dynamics of PD-L1 expression are poorly understood over the development of lung adenocarcinomas from pre-invasive lesions to fully invasive carcinomas. Given the importance of PD-L1 expression for the selection of patients to receive immunotherapy in the metastatic setting and possibly in the neoadjuvant setting, we sought to evaluate the agreement of PD-L1 expression in invasive and lepidic components of resected tumor specimens. We stained 86 adenocarcinomas for PD-L1 using the SP263 clone. We assessed the agreement of PD-L1 expression by tumor cells and immune cells between lepidic and invasive components. When both lepidic and invasive components were considered, PD-L1 positive immune cells and tumor cells were observed in 50 (58.1%) and 18 (20.9%) samples, respectively, using a ≥ 1% PD-L1 expression cutoff. Using a ≥ 1% cutoff for PD-L1 expression, positively stained tumor cells were observed in 11 (13%) lepidic and 15 (17%) invasive patterns, with agreement in 76 (88%) specimens and disagreement in 10 (12%) specimens (ĸ = 0.549). At ≥ 1% PD-L1 expression cutoff, PD-L1 positive immune cells were observed in 31 (35%) lepidic and 32 (37%) invasive patterns with an agreement of PD-L1 expression in 49 (57%) specimens and disagreement in 37 (43%) specimens (ĸ = 0.073). In our study of early stage adenocarcinomas of the lung, there was poor agreement in PD-L1 expression between paired invasive and lepidic components of tumors. Our data suggest that the non-invasive tumor components may not be as immunostimulatory as the invasive components, resulting in less adaptive expression of PD-L1.