cssi/SciSciGPT-SciSciNet huggingface dataset:
Analysis and design of genomic sequences

Genomic sequences contain genetic information for the development and functioning of living organisms. Sequence variability can be used both to determine organism identity and as a tool to alter function. Although microorganisms dominate the biosphere, most have not been identified or studied. In this dissertation, we present an oligonucleotide (k-mer classification method based on conditional probabilities, which performs substantially better than other known methods and can be used to identify bacterial species, even from mixed populations, using modest amounts of sample sequence [96]. Here we also deal with the problem of population analysis, leading to determination of diversity and function of members of microbial communities [72]. We develop homology based tools for robust phylotype determination, enhancing closely related sequence associations, and a methodology for achieving more accurate richness estimation, using different clustering criteria [95]. The emerging field of synthetic biology is broadly defined as the intersection of biology and engineering that focuses on the modification or creation of novel biological systems that do not have a counterpart in nature. Working with the group that achieved the first genome-level synthesis of a virus, we have designed, synthesized, and evaluated new variants of poliovirus to serve as vaccines. Specifically, we sought weakened but viable strains that could be used for preparations of a killed poliovirus vaccine. Our designs result in a virus with roughly 100-fold lower specific infectivity than the wildtype virus. Here we detail the theory behind gene design in the context of optimizing a DNA sequence for particular desired properties while simultaneously coding for a given amino acid sequence [87]. We have also explored the problem of designing the provably shortest genomic sequence to encode a given set of genes by exploiting alternate reading frames. We have developed an algorithm for designing the shortest DNA sequence simultaneously encoding two given amino acid sequences. We have shown that the coding sequences of naturally occurring pairs of overlapping genes approach maximum compression, as well as investigated the impact of alternate coding matrices on overlapping sequence design [129].
Nanotribology of Diamond Films Studied by Atomic Force Microscopy

An atomic force microscope, operated in ultra-high vacuum has been employed to study the tribological properties of diamond films under small loads (< 10−6 N) on a nanometer scale. The incidence of intermittent motion, “stick-slip”, while sliding a diamond tip across the diamond film, is detected under certain experimental conditions and is discussed with respect to the difference between static and kinetic friction, sample topography and a varying sample condition.
Restoration of Monotonicity Respecting in Dynamic Regression.

ABSTRACTDynamic regression models, including the quantile regression model and Aalen’s additive hazards model, are widely adopted to investigate evolving covariate effects. Yet lack of monotonicity respecting with standard estimation procedures remains an outstanding issue. Advances have recently been made, but none provides a complete resolution. In this article, we propose a novel adaptive interpolation method to restore monotonicity respecting, by successively identifying and then interpolating nearest monotonicity-respecting points of an original estimator. Under mild regularity conditions, the resulting regression coefficient estimator is shown to be asymptotically equivalent to the original. Our numerical studies have demonstrated that the proposed estimator is much more smooth and may have better finite-sample efficiency than the original as well as, when available as only in special cases, other competing monotonicity-respecting estimators. Illustration with a clinical study is provided.
Molecular profiling of biliary tract cancer: a target rich disease

Biliary tract cancers (BTCs) are relatively uncommon orphan tumors that have an aggressive disease course and a poor clinical outcome. Surgery is the only curative treatment, but most patients present with advanced disease and therefore have a limited survival. Gemcitabine and cisplatin based chemotherapy has been the only widely accepted standard systemic therapy regimen in these patients but these tumors can be chemoresistant, further complicating their management. In recent times, there has been considerable research in the genetics of BTC and with the advent of new, advanced technologies like next-generation sequencing (NGS) we are achieving a greater understanding of its disease biology. With the help of NGS, we have now been able to identify actionable mutations such as in the isocitrate dehydrogenase 1 ( IDH1 ), FGFR2, BRAF and HER2/neu genes for targeted therapeutics and correlate the genetic variations with distinct clinical prognoses. This recent genetic information has the potential to make precision medicine a part of routine clinical practice for the management of BTC patients.
FRI0296 The Optimal Modified Rodnan Skin Score To Predict Skin Progression over One Year Differs between Autoantibody Subsets

Background There are muliple potential therapeutic a gents under development for sstemic sclerosis (SSc). Given that SSc is uncommon, there is interest in cohort enrichment to maximize the potential of identifying a drug effect, One area of interest is a modified Rodnan skin score (mRSS) cut-off as an inclusion criterion in early diffuse SSc trials. Autoantibody profiles of SSc patients vary by geographical region. Given that the mRSS differs between autoantibody groups and that many trials are multinational, it is important to understand the differences in mRSS patterns between autoantibodies to choose optimal mRSS cut-off points that facilitates enrichment for patients likely to develop skin progression. Objectives We sought to determine the baseline mRSS to maximally predict progressive skin involvement over one year in US patients with early diffuse SSc, and assess if this differed by autoantibody. Methods We examined a US single-center cohort of prospectively followed early diffuse SSc patients seen for an initial visit between 1980 and 2014. To reflect modern early diffuse SSc clinical trial design, early was defined as Results Among 317 eligible patients the mean age was 50.8±13.5 years, 74% were female and 92% Caucasian. The median disease duration was 0.90 years (IQR 0.63, 1.46). The mean baseline mRSS was 23±11. 25% (n=79) were scl-70 positive, 56% n=178) RNAP positive, 54 (17%) other SSc-associated antibody and 2% (n=6) missing. The median baseline mRSS (IQR) for RNAP was 24 (17,33), compared to 18 (13,25) for Scl-70 and 20 (13,28) for other antibodies (p=0.0004). In total, 163 patients (51%) developed progressive skin disease over one year. 59% of RNAP positive patients progressed, versus 48% of Scl-70 and 33% of other antibody positive patients (p=0.004). The mean time to peak mRSS was 0.51±0.23 years overall. The baseline mRSS below which there was the maximal likelihood of predicting progressive skin disease, with the greatest area under the curve (AUC) in Scl-70 positive patients was ≤24 (AUC 0.72; 95%CI 0.64, 0.80). This contrasted with RNAP patients, for which the maximal AUC occurred at ≤29 (AUC 0.74;95% CI 0.67, 0.80). Patients with other autoantibodies had a much lower baseline mRSS of ≤17 for optimal prediction (AUC 0.67; 95%CI 0.53, 0.80). Conclusions The mRSS cut-off that predicted skin progression over one year was different between RNAP, Scl-70 and other SSc antibodies. his supports the concept that cohort enrichment in clinical trials may be enhanced by modifying the mRSS cut-off point for the major autoantibody groups. A lower cut-off point will exclude some US patients who are likely to progress. Disclosure of Interest R. Domsic Consultant for: Biogen-Idec, M. Lucas: None declared, V. Steen: None declared, R. Lafyatis Grant/research support from: Regeneron, Consultant for: Regeneron, T. Medsger: None declared
Cultural Traditions and Food: Kānaka Maoli and the Production of Poi in the Heʻeʻia Wetland

AbstractFor five years, a Native Hawaiian non-profit organization has been working to restore wetland taro farming in the ahupuaʻa of Heeʻia. This article argues that the cultivation of taro and the production of poi are critical means of resilience and Indigenous resurgence for Kānaka Maoli. Participant observations indicate that the modern-day farming of taro for poi is a struggling and backbreaking enterprise often hampered by funding shortages, lack of infrastructure, management challenges, an insufficient supply of taro and, more critically, access to fresh clean water. The primary objective of this article is to articulate how the agronomics of taro farming and poi milling manifests as resilience in and through the kanaka ʻōiwi body. What drives this kind of commitment to such an arduous undertaking? Through ethnographic field observations, field notes, surveys, and interviews the authors show how resilience is an embodied and regenerative experience; one that transforms both kalo and kanaka. The ob...
Identification of a Catalytic Iron-Hydride at the H-Cluster of [FeFe]-Hydrogenase

Hydrogenases couple electrochemical potential to the reversible chemical transformation of H2 and protons, yet the reaction mechanism and composition of intermediates are not fully understood. In this Communication we describe the biophysical properties of a hydride-bound state (Hhyd) of the [FeFe]-hydrogenase from Chlamydomonas reinhardtii. The catalytic H-cluster of [FeFe]-hydrogenase consists of a [4Fe-4S] subcluster ([4Fe-4S]H) linked by a cysteine thiol to an azadithiolate-bridged 2Fe subcluster ([2Fe]H) with CO and CN- ligands. Mossbauer analysis and density functional theory (DFT) calculations show that Hhyd consists of a reduced [4Fe-4S]H+ coupled to a diferrous [2Fe]H with a terminally bound Fe-hydride. The existence of the Fe-hydride in Hhyd was demonstrated by an unusually low Mossbauer isomer shift of the distal Fe of the [2Fe]H subcluster. A DFT model of Hhyd shows that the Fe-hydride is part of a H-bonding network with the nearby bridging azadithiolate to facilitate fast proton exchange and catalytic turnover.
A Theoretical and Clinical Perspective on Social Relatedness and the Patient With Serious Mental Illness

BACKGROUND: A therapeutic relationship forms the basis of care of patients in psychiatric mental health nursing. However, individuals with schizophrenia have difficulty participating in these relat...
Adipose-Derived Stem Cells in Peripheral Nerve Regeneration

Peripheral nerve injuries are common, debilitating, and costly. The human body’s innate regenerative capacity is slow, and nerves are often misguided. The purpose of this article is to review a specific cellular, regenerative engineering technique that holds promise for the treatment of peripheral nerve injuries. Over the past several decades, research has focused on the utilization of stem cells for peripheral nerve repair. More recently, stem cells collected from adipose tissue (adipose-derived stem cells or ADSCs) have gained traction due to their relative ease of collection and differentiation potential. Both undifferentiated and Schwann cell-like differentiated ADSCs have been used to seed conduits with variable results. Technical and ethical issues surrounding stem cells’ self-expansion potential and genetic makeup exist. Ultimately, randomized control trials and FDA approval will be required before widespread clinical translation in the US is realized.
Outcomes after vascular resection during curative-intent resection for hilar cholangiocarcinoma: a multi-institution study from the US extrahepatic biliary malignancy consortium

Abstract Background Surgical resection is the cornerstone of curative-intent therapy for patients with hilar cholangiocarcinoma (HC). The role of vascular resection (VR) in the treatment of HC in western centres is not well defined. Methods Utilizing data from the U.S. Extrahepatic Biliary Malignancy Consortium, patients were grouped into those who underwent resection for HC based on VR status: no VR, portal vein resection (PVR), or hepatic artery resection (HAR). Perioperative and long-term survival outcomes were analyzed. Results Between 1998 and 2015, 201 patients underwent resection for HC, of which 31 (15%) underwent VR: 19 patients (9%) underwent PVR alone and 12 patients (6%) underwent HAR either with (n = 2) or without PVR (n = 10). Patients selected for VR tended to be younger with higher stage disease. Rates of postoperative complications and 30-day mortality were similar when stratified by vascular resection status. On multivariate analysis, receipt of PVR or HAR did not significantly affect OS or RFS. Conclusion In a modern, multi-institutional cohort of patients undergoing curative-intent resection for HC, VR appears to be a safe procedure in a highly selected subset, although long-term survival outcomes appear equivalent. VR should be considered only in select patients based on tumor and patient characteristics.
Assessment of wind turbine component loads under yaw-offset conditions

Abstract. Renewed interest in yaw control for wind turbine and power plants for wake redirection and load mitigation demands a clear understanding of the effects of running with skewed inflow. In this paper, we investigate the physics of yawed operations, building up the complexity from a simplified analytical treatment to more complex aeroelastic simulations. Results in terms of damage equivalent loads (DELs) and extreme loads under misaligned conditions of operation are compared to data collected from an instrumented, utility-scale wind turbine. The analysis shows that multiple factors are responsible for the DELs of the various components and that airfoil aerodynamics, elastic characteristics of the rotor, and turbulence intensities are the primary drivers. Both fatigue and extreme loads are observed to have relatively complex trends with yaw offsets, which can change depending on the wind-speed regime. Good agreement is found between predicted and measured trends for both fatigue and ultimate loads.
High temperature superconducting technology for future all-electric ships

This tutorial is to introduce high temperature superconducting (HTS) technologies and associated cryogenics technologies. We would like to make this interactive. Please ask questions and participate in the discussion at the end. Topics Covered: 1. Why HTS technologies are being considered and developed for electric utility applications and for all-electric ships (15 minutes) 2. Basics of superconductivity and superconducting materials (40 minutes) 3. Cryogenic technologies for HTS applications (30 minutes) 4. HTS applications relevant for shipboard applications (15 minutes) 5. Break (15 minutes) 6. Simulation and Modelling of Superconducting Power Devices (30 minutes) 7. Dielectric Testing of HTS Power Devices (30 minutes) 8. Dielectric Test Techniques (20 minutes) 9. Discussion Topics (30 minutes).
Prevalence of type 2 diabetes mellitus among patients with hidradenitis suppurativa in the United States

Background Few studies have evaluated the relationship between hidradenitis suppurativa (HS) and type 2 diabetes mellitus (T2DM), and the existing data show conflicting results. Objective To determine the prevalence of T2DM among patients with HS and identify at-risk demographic subgroups. Methods Cross-sectional analysis identifying T2DM among patients with and without HS from a demographically heterogeneous population-based sample of more than 50 million patients in the United States. Results The overall prevalence of T2DM among patients with HS was 24.8% (10,705 of 43,105) compared with 15.6% (1,993,320 of 12,527,570) among patients without HS. The prevalence was highest among patients with HS who were male (3045 of 10,785 [28.2%]), older (1945 of 3950 [49.2%]), nonwhite (4665 of 17,495 [26.7%]), obese (9065 of 30,855 [29.4%]), tobacco smokers (6880 of 25,005 [27.5%]), hypertensive (8595 of 19,610 [43.8%]), and hyperlipidemic (7965 of 17,190 [46.3%]). In univariable and multivariable analyses, patients with HS had 1.75 (95% confidence interval [CI], 1.71-1.79) and 1.58 (95% CI, 1.54-1.62) times the odds, respectively, of having T2DM. HS was associated with T2DM across all demographic subgroups. The association was stronger for younger patients (an OR of 1.67 and 95% CI of 1.60-1.72 for ages 18-44 years vs an OR of 1.50 and 95% CI of 1.41-1.61 for ages ≥65 years). Limitations We lacked information on HS disease severity. Conclusion Patients with HS with risk factors, signs, or symptoms of T2DM should be screened.
The Social Functions and Dysfunctions of Brazilian Immigrant Congregations in “terra incognita”

Ethnic congregations are often considered safe havens for immigrants. This is supported by a large body of literature showing that many religious congregations in diasporic contexts help immigrants maintain their ethnic group identity and cohesion, build social capital, and adapt more smoothly to life in an unfamiliar society. The role of ethnic congregations in the lives of immigrants is, however, complex and multifaceted, and some recent research suggests that, in some ways, these congregations may inhibit their adaptation to the larger society and arouse tensions among the very immigrant communities they intend to help. In light of these varying observations, we seek to explore the functions—and potential dysfunctions—that ethnic congregations have among Brazilians who have immigrated to central Texas. Using data drawn in 2013 from participant observation and 16 in-depth interviews conducted in two Brazilian evangelical congregations, we find that respondents perceive that their congregations strengthen their feelings of attachment to Brazilian culture and language and foster the development of social capital within to the Brazilian immigrant community. At the same time, however, some respondents acknowledge that church members can become overly dependent on their congregations and isolated from the larger society, leaving them susceptible to potential exploitation at the hands of more established co-ethnics within the congregation.
Die Synthese aliphatischer Organophosphorverbindungen mit Hilfe von Diäthylaminodichlorphosphin

Diathylaminodichlorohosphin, (C2H5)2NPCl2, hergestellt aus PCl3 und Diathylamin, reagierte mit C8H17MgBr zu Dioctylphosphinigsaure, (C8H17)2P(O)H, die mit H2O2 zur Phosphinsaure oxydiert wurde. Polyoctamethylenphosphinsaure wurde in 67% Ausbeute als eine in organischen Losungsmitteln unlosliche weise Substanz in ahnlicher Weise, unter Verwendung von BrMg(CH2)8MgBr, erhalten. *** DIRECT SUPPORT *** A3615144 00016
The double-edged flower : Roles of complement protein C1q in neurodegenerative diseases

A role for the complement cascade in AD neuropathology was hypothesized over a decade ago, and the results of a significant number of in vitro studies are consistent with the involvement of this pathway in AD pathogenesis (reviewed in). Since C1q is colocalized with thioflavine-positive plaques and the C5b-9 complement membrane attack complex is detected in AD brain at autopsy, it is reasonable to hypothesize that complement activation has a role in the manifestation of AD either by its lytic capacity or as a trigger of glial infiltration and initiation of potentially damaging inflammation. The observed diminished glial activation and reduced loss of neuronal integrity in a murine model overexpressing mutant human APP but lacking the ability to activate the classical complement cascade provide the first direct evidence for a detrimental role of C1q, and presumably activation of the classical complement pathway in an animal model of AD. Research is now focused on generating mouse models that more closely mimic the human disease, so that the role of complement activation and inflammation on the behavioral/learning and memory dysfunction that occurs in this disease can be assessed. In addition, candidate therapies such as targeted inhibition of complement activation will need to be tested in these animal models as a step toward treatment of humans with the disease. However, it is important that the potential for a protective effect of C1q early on in disease progression should not be overlooked. Rather, strategies that enhance or mimic the protective effects of C1q as well as strategies that inhibit the detrimental processes should be fully investigated.
Tuning the in-plane electron behavior in high- T c cuprate superconductors via apical atoms: A first-principles Wannier-states analysis

Using a recently developed first-principles Wannier-states approach that takes into account large on-site Coulomb repulsion, we derive the low-energy effective one-band Hamiltonians for several prototypical cuprate superconductors. The material dependence is found to originate primarily from the different energy of the apical atom ${p}_{z}$ state. Specifically, the general properties of the low-energy hole state, namely, the Zhang-Rice singlet, are significantly modified, via additional intrasublattice hoppings, nearest-neighbor ``super repulsion,'' and other microscopic many-body processes. Implications on modulations of local pairing gaps, charge distribution, hole-hopping range, electron-phonon interaction, and multilayer effects in cuprate superconductors are discussed.
Modeling the Axon as an Active Partner with the Growth Cone in Axonal Elongation

Abstract Forces generated by the growth cone are vital for the proper development of the axon and thus brain function. Although recent experiments show that forces are generated along the axon, it is unknown whether the axon plays a direct role in controlling growth cone advance. Here, we use analytic and finite element modeling of microtubule dynamics and the activity of the molecular motors myosin and dynein to investigate mechanical force balance along the length of the axon and its effects on axonal outgrowth. Our modeling indicates that the paradoxical effects of stabilizing microtubules and the consequences of microtubule disassembly on axonal outgrowth can be explained by changes in the passive and active mechanical properties of axons. Our findings suggest that a full understanding of growth cone motility requires a consideration of the mechanical contributions of the axon. Our study not only has potential applications during neurodevelopment but might also help identify strategies to manipulate and promote axonal regrowth to treat neurodegeneration.
Postpartum contraceptive counseling for first-time adolescent mothers: a randomized controlled trial.

Rapid repeat pregnancy is common among adolescent mothers and is associated with increased risks of adverse perinatal and maternal outcomes. Increasing contraceptive uptake among postpartum adolescents may decrease these outcomes through pregnancy prevention. This randomized controlled trial of 100 postpartum adolescent women assessed the effect of a standardized immediate postpartum contraceptive counseling intervention emphasizing healthy birth spacing and the use of long-acting reversible contraceptives (LARC). After a baseline survey about reproductive health and pregnancy intentions, all subjects received routine postpartum contraceptive counseling. The intervention group also received the standardized counseling intervention. All participants had access to immediate postpartum contraceptive implant initiation or to intrauterine device (IUD) insertion at postpartum follow-up. Contraceptive use and repeat pregnancy were assessed quarterly for 12 months. Differences in repeat pregnancy, as well as contraceptive initiation, continuation, and satisfaction were analyzed. There was no difference in repeat pregnancy or contraceptive initiation, continuation or satisfaction between the study groups. However, regardless of group assignment, all subjects who desired the contraceptive implant used the method, compared to 15% of subjects who desired the IUD (p < 0.001). Three pregnancies occurred among subjects who desired the IUD versus none amongst subjects who desired the implant (p = 0.10). This standardized postpartum contraceptive counseling intervention did not affect teens’ repeat pregnancies or contraceptive use. However, immediate postpartum availability of the contraceptive implant was associated with increased utilization of this method when compared to the IUD. Future postpartum contraceptive efforts should investigate procedures to improve teens’ access to postpartum contraception. NCT01814930
Probing alkenoxy radical electronic structure using anion PEI spectroscopy.

Photoelectron imaging spectra of three alkenoxide radical anions (3-buten-1-oxide, 3-buten-2-oxide, and 2-propenoxide) are presented and analyzed with supporting results of density functional theory calculations. In all spectra, intense detachment features are observed at approximately 2 eV electron binding energy, which is similar to the electron affinities of saturated neutral alkoxy radicals [Ramond et al., J. Chem. Phys. 112, 1158 (2000)]. Photoelectron angular distributions suggest the presence of several overlapping transitions which are assigned to the X and A states of multiple energetically competitive conformers. The term energy of the A state of the 2-propenoxy radical, 0.17 eV, is higher than that of 3-buten-2-oxy (0.13 eV) and 3-buten-1-oxy (0.05 eV) radicals. Comparing the butenoxy radicals, we infer that stronger interactions between the non-bonding O 2p orbitals and the π bond increase the splitting between the ground and the first excited state in the 3-buten-2-oxy radical relative to the 3-buten-1-oxy radical.Photoelectron imaging spectra of three alkenoxide radical anions (3-buten-1-oxide, 3-buten-2-oxide, and 2-propenoxide) are presented and analyzed with supporting results of density functional theory calculations. In all spectra, intense detachment features are observed at approximately 2 eV electron binding energy, which is similar to the electron affinities of saturated neutral alkoxy radicals [Ramond et al., J. Chem. Phys. 112, 1158 (2000)]. Photoelectron angular distributions suggest the presence of several overlapping transitions which are assigned to the X and A states of multiple energetically competitive conformers. The term energy of the A state of the 2-propenoxy radical, 0.17 eV, is higher than that of 3-buten-2-oxy (0.13 eV) and 3-buten-1-oxy (0.05 eV) radicals. Comparing the butenoxy radicals, we infer that stronger interactions between the non-bonding O 2p orbitals and the π bond increase the splitting between the ground and the first excited state in the 3-buten-2-oxy radical relative to th...
Contagious Corruption, Informal Employment, and Income: Evidence from Brazilian Municipalities

Using data on 434 Brazilian municipalities, this paper estimates the effect of both corruption and the size of the informal sector on economic outcomes, while allowing for the possibility of spatial dependence. Overall, this paper finds that the size of the informal sector has a statistically significant and negative impact on economic outcomes that is much larger in magnitude than what is predicted by least-squares estimates due to its exclusion of spillover effects, while the effect of corruption is insignificant. Specifically, a one standard deviation increase in the size of the informal sector is associated with a 26 percent cumulative decrease in GDP per-capita, compared to the maximum of a 17 percent decline predicted by least-squares.
Establishing a Robust PRRT Practice: An OHSU Experience

3027 Objectives: Lu177-DOTATATE (Lutathera) is a great advancement in Nuclear Medicine therapy. Since its FDA-approval in January 2018, many institutions, including OHSU, have begun their PRRT program. Many others are interested, but have not, given the daunting logistics of doing so. The purpose here is to share what we have learned, including specific methods and guidance for building a robust PRRT program. Methods: Building a new service line is a daunting task. A steering committee was formed to include all the critical stakeholders and they were involved early and often in the process. From pre-authorization to billing and from radiation safety to establishing a neuroendocrine tumor board, we wanted to ensure that everyone had input to enable the success of this program. We then established standard operating procedures for pre-authorization and scheduling, for amino acids and infusion plans, for room prep and clean-up, and for therapy administration with support of hospital space and nursing staff. Results: Since beginning our PRRT program at OHSU on June 6, 2018, we have treated 31 patients for a total of 63 treatments as of December 31, 2018, averaging more than 2 per week. OHSU did not participate in the NETTER-1 trial but as a result of having dedicated champions in Nuclear Medicine and Oncology, and the multi-disciplinary, collaborative approach used to develop the program, we were able to achieve a quick ramp-up and become a high-volume treatment center with continued growth expected. Since beginning the program, we have made significant improvements to the workflow and patient experience by creating a therapy space in the Nuclear Medicine clinic and hiring dedicated nursing staff to support the program. These additions have enabled us to reduce the total time the patient is at OHSU to receive their therapy by an average of 90 minutes. This approach has enabled our patients and patients from many surrounding centers to receive their treatment in a comfortable environment and in a timely fashion. Conclusions: The FDA approval of Lu177-DOTATATE has been a great step forward in Nuclear Medicine therapy, but the complexity of establishing this new service can be daunting and overwhelming for many. Our experience can serve as an introduction to the process for establishing a new PRRT program and can also be used as a template for other institutions as they look to establish or impove these services for their patients.
Fluoride exposure and kidney and liver function among adolescents in the United States: NHANES, 2013-2016.

Abstract Background Hepato- and nephrotoxicity of fluoride have been demonstrated in animals, but few studies have examined potential effects in humans. This population-based study examines the relationship between chronic low-level fluoride exposure and kidney and liver function among United States (U.S.) adolescents. This study aimed to evaluate whether greater fluoride exposure is associated with altered kidney and liver parameters among U.S. youth. Methods This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2013–2016). We analyzed data from 1983 and 1742 adolescents who had plasma and water fluoride measures respectively and did not have kidney disease. Fluoride was measured in plasma and household tap water. Kidney parameters included estimated glomerular filtration rate (calculated by the original Schwartz formula), serum uric acid, and the urinary albumin to creatinine ratio. Liver parameters were assessed in serum and included alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, blood urea nitrogen, gamma-glutamyl transferase, and albumin. Survey-weighted linear regression examined relationships between fluoride exposure and kidney and liver parameters after covariate adjustment. A Holm-Bonferroni correction accounted for multiple comparisons. Results The average age of adolescents was 15.4 years. Median water and plasma fluoride concentrations were 0.48 mg/L and 0.33 μmol/L respectively. A 1 μmol/L increase in plasma fluoride was associated with a 10.36 mL/min/1.73 m2 lower estimated glomerular filtration rate (95% CI: −17.50, −3.22; p = 0.05), a 0.29 mg/dL higher serum uric acid concentration (95% CI: 0.09, 0.50; p = 0.05), and a 1.29 mg/dL lower blood urea nitrogen concentration (95%CI: −1.87, −0.70; p Conclusions Fluoride exposure may contribute to complex changes in kidney and liver related parameters among U.S. adolescents. As the study is cross-sectional, reverse causality cannot be ruled out; therefore, altered kidney and/or liver function may impact bodily fluoride absorption and metabolic processes.
Combining Measurements and Network Calculus in Worst-Case Delay Analyses for Networked Cyber-Physical Systems

Recently, switched Ethernet has become increasingly popular in networked cyber-physical systems (NCPS). In an Ethernet-based NCPS, network-connected devices (e.g., sensors and actuators) realize time-critical tasks by exchanging miscellaneous information, such as sensor readings and control commands. To ensure reliable control and operation, network-induced delays for time-critical NCPS applications must be carefully examined. In this work, we propose a framework combining network delay measurements and network-calculus-based delay performance analysis to obtain accurate, deterministic worst-case delay bounds for NCPS. By modeling traffic sources and networking devices (e.g., Ethernet switches) through measurements, we establish accurate traffic and device models for network-calculus-based analysis. To obtain worst-case delay bounds, different network-calculus-based analytical methods can be leveraged, allowing CPS architects to customize the proposed delay analysis framework to suit application-specific needs. Our evaluation results show that the proposed approach derives accurate delay bounds, making it a valuable tool for architects designing NCPSs supporting time-critical applications.
Normal Functional Luminal Imaging Probe Panometry Findings Associate With Lack of Major Esophageal Motility Disorder on High-Resolution Manometry.

Background & Aims A normal esophageal response to distension on functional luminal imaging probe (FLIP) panometry during endoscopy might indicate normal esophageal motor function. We aimed to investigate the correlation of normal FLIP panometry findings with esophageal high-resolution manometry (HRM) and outcomes of discrepant patients. Methods We performed a retrospective study using data from a registry of patients who completed FLIP during sedated endoscopy. We identified 111 patients with normal FLIP panometry findings (mean age, 42 y; 69% female) and corresponding HRM data. A normal FLIP panometry was defined as an esophagogastric junction (EGJ) distensibility index greater than 3.0 mm2/mm Hg, an absence of repetitive retrograde contractions, and a repetitive antegrade contraction pattern that met the Rule-of-6s: ≥6 consecutive antegrade contractions of ≥6-cm in length, at a rate of 6 ± 3 contractions per minute. HRM findings were classified by the Chicago classification system version 3.0. Results HRM results were classified as normal motility in 78 patients (70%), ineffective esophageal motility in 10 patients (9%), EGJ outflow obstruction in 20 patients (18%), and 3 patients (3%) as other. In patients with EGJ outflow obstruction based on HRM, the integrated relaxation pressure normalized on adjunctive swallows in 16 of 20 patients (80%), and in 8 of 9 patients (88%) who completed a barium esophagram and had normal barium clearance. Thus, although 23 of 111 patients (21%) with normal FLIP panometry had abnormal HRM findings, these HRMs often were considered to be false-positive or equivocal results. All patients with an abnormal result from HRM were treated conservatively. Conclusions In a retrospective cohort study, we found that patients with normal FLIP panometry results did not have a clinical impression of a major esophageal motor disorder. Normal FLIP panometry results can exclude esophageal motility disorders at the time of endoscopy, possibly negating the need for HRM in select patients.
Effects of hyperchloremia on renal recovery in critically ill children with acute kidney injury.

Serum chloride derangements are associated with poor clinical outcomes, including acute kidney injury (AKI) and mortality. We sought to determine the association between persistent hyperchloremia and renal recovery in critically ill children with AKI. We performed a retrospective cohort study of all patients with day 2 AKI admitted to a large academic pediatric intensive care unit from January 2014 to December 2015. After applying exclusion criteria, 348 patients were categorized as (1) hyperchloremia on both day 2 and day 7 (PersistentCl), (2) hyperchloremia on day 2 with normochloremia on day 7 (RecoveredCl), (3) normochloremia on day 2 with hyperchloremia on day 7 (DelayedCl), and (4) no hyperchloremia on day 2 nor day 7 (NormalCl). Hyperchloremia was defined as ≥ 110 mEq/L. The primary outcome was renal recovery on day 7, defined as the absence of AKI criteria. Secondary outcomes included discharge renal recovery, mortality, duration of mechanical ventilation, and hospital length of stay. Day 7 renal recovery rates for PersistentCl, RecoveredCl, DelayedCl, and NormalCl were 37%, 66%, 71%, and 52% respectively. PersistentCl had lower odds of day 7 renal recovery (aOR = 0.29; 95% CI, 0.14 to 0.60; p = 0.0009), lower odds of discharge renal recovery (aOR = 0.22; 95% CI, 0.11 to 0.48; p = 0.0001), and higher odds of mortality (aOR = 3.50; 95% CI, 1.11 to 11.10; p = 0.03) when compared with RecoveredCl after adjusting for confounders. Persistent hyperchloremia is independently associated with impaired renal recovery as well as higher mortality. Prospective studies are indicated to determine if serum chloride represents a modifiable risk factor for poor outcomes.
Incidental findings of posterior arch defects of the atlas in orthodontic patients: A case series

Introduction Congenital defects of the posterior arch of atlas are uncommon anomalies that may go unnoticed. Radiographs and cone-beam computed tomography scans made for orthodontic purposes often show the atlas; therefore, these rare defects might first be noted as incidental findings on orthodontic records. Methods A series of 7 cases of posterior arch defects of atlas (C1) that were detected during routine radiographic examination are presented here. Results The distribution of the defects was as follows: type A, 2; type B, 1; type C, none; type D, 1; and type E, 3. Conclusion As the potential complications associated with these defects may be quite concerning, a thorough analysis of the radiographs for these defects is imperative.
Metabolomic signatures of lead exposure in the VA Normative Aging Study

Abstract Background Lead (Pb) is widespread and exposure to this non-essential heavy metal can cause multiple negative health effects; however the mechanisms underlying these effects remain incompletely understood. Objectives To identify plasma metabolomic signatures of Pb exposure, as measured in blood and toenails. Methods In a subset of men from the VA Normative Aging Study, mass-spectrometry based plasma metabolomic profiling was performed. Pb levels were measured in blood samples and toenail clippings collected concurrently. Multivariable linear regression models, smoothing splines and Pathway analyses were employed to identify metabolites associated with Pb exposure. Results In 399 men, 858 metabolites were measured and passed QC, of which 154 (17.9%) were significantly associated with blood Pb (p Discussion Pb exposure is responsible for 0.6% of the global burden of disease and metabolomics is particularly well-suited to explore its pathogenic mechanisms. In this study, we identified metabolites and metabolomic pathways associated with Pb exposure that suggest that Pb exposure acts through oxidative stress and immune dysfunction. These findings help us to better understand the biology of this important public health burden.
Poly traumatized Patient

Although a patient with polyfractures of the hand has multiple injuries, they are at least localized to one area. The poly traumatized patient has one or more fractures of the hand or wrist in association with multiple fractures or other multiple injuries. When such a patient has one or more serious fractures ofthe hand or wrist, open reduction and internal fixation can be advantageous provided it does not put the patient at any additional risk for his life and provided it does not interfere with any other priorities of treatment.
Multiple Arterial Thrombosis in a COVID Patient With No Known Comorbidities With Mild Elevation of D-Dimer

Since the coronavirus (COVID-19) pandemic started, new challenges have emerged regarding the management of coronavirus-infected patients. One of the most known devastating complications associated with COVID-19 is hypercoagulability. This can lead to severe disability or even death, especially in critically ill patients with known chronic comorbidities such as hypertension (HTN) and diabetes. D-dimer and clinical condition are among the most important tools currently used by clinicians to guide therapy and anticoagulation prophylaxis. Here we present a case of a COVID-19-infected patient with no known comorbidities and mild elevation in initial D-dimer level who had a rapid deterioration ultimately leading to death within weeks of admission.
Anterior Cruciate Ligament (ACL) Reconstruction Augmented With Bone Marrow Concentrate, Demineralized Bone Matrix, Autograft Bone, and a Suture Tape (The Fertilized ACL)

Purpose To examine the early clinical outcomes as well as safety of the Fertilized anterior cruciate ligament (ACL) reconstruction procedure. Methods A total of 16 consecutive patients with a mean age of 24 years (range, 16-45 years), who had been treated with the fertilized ACL were evaluated and followed over 2 years. Four patients underwent reconstruction using an FGL GRAFTLINK allograft (LifeNet Virginia Beach, VA) and 12 using quadriceps autografts. All patients received the fertilized ACL as previously described using bone marrow composite, demineralized bone matrix, and an internal brace (Arthrex, Largo, FL). Clinical outcomes at 2 years including International Knee Documentation Committee and Marx scores were evaluated. Complication rates, including return to operating room, arthrofibrosis, infection, and rerupture rates, were also assessed. Results All patients were followed for 6 months and all were released to full activity. In total, 11 of 16 patients were available for 2-year follow-up after the fertilized ACL reconstruction. At 2 years, the average International Knee Documentation Committee and Marx scores were 81 (standard deviation, 5.9) and 9 (standard deviation, 5.7), respectively. One patient required a return trip to the operating room for manipulation under anesthesia. No reruptures were observed at the 2-year mark. Nine of 11 patients had returned to their preinjury activity status at 2 years. Conclusions The fertilized ACL, which adds biology and an internal brace to an ACL reconstruction, is a reliable and safe option when performing an ACL reconstruction. Very low complication risks were seen in this consecutive series followed for 2 years. Patients consistently returned to their preinjury activity status. Level of Evidence Level IV, therapeutic case series.
Economics of downscaled climate-induced changes in cropland, with projections to 2050: evidence from Yolo County California

This article establishes quantitative relationships between the evolution of climate and cropland using daily climate data for a century and data on allocation of land across crops for six decades in a specific agro-climatic region of California. These relationships are applied to project how climate scenarios reported by the Intergovernmental Panel on Climate Change would drive cropland patterns into 2050. Projections of warmer winters, particularly from 2035 to 2050, cause lower wheat area and more alfalfa and tomato area. Only marginal changes in area were projected for tree and vine crops, in part because although lower, chill hours remain above critical values.
Pan troglodytes (Chimpanzee)

At least 25 animals have now been studied with similar findings, Chiarelli, and Hamerton et al. report minor structural differences for the subspecies P. t. paniscus (pygmy chimpanzee). Satellites occur on the short arms of the acrocentrics. The Y may occasionally be metacentric (Chu and Bender). Quantitative comparisons of the karyotypes of apes have been published by Hamerton et al. The male metaphase is of P. t. troglodytes and was kindly supplied by Dr. H. P. Klinger (New York) and was previously shown as Figs. 3d and 4g by Hamerton et al. The female is from a skin biopsy of P. t. kindly supplied by Dr. H. F. Smetana (New Orleans, Louisiana).
Definition, Diagnosis, and Risk of Diet and Drug Interactions

In describing diet and drug interactions, the term diet is used to include foods, nutrients, or nonnutrient components of food; nutrient formulas and their constituents; and nutrient supplements. The term drug includes alcohol and other social drugs as well as therapeutic drugs. Diet and drug interactions include all interactions occurring in vitro (in food or drug products), or in vivo (in the body) that affect the stability or disposition of food or drug components, whether or not they measurably affect physiological function or health.
Empathy, Sense of Power, and Personality: Do They Change During Pediatric Residency?

OBJECTIVES Empathy is a critical competency in medicine. Prior studies demonstrate a longitudinal decrease in empathy during residency; however, they have not included pediatric residents. The relations among the expression of empathy, sense of power (ability to influence other's behavior), and personality traits in residents also have not been addressed. Lastly, there are no data on how residents compare with the general nonmedical population in their expression of empathy. The purposes of our study were to assess whether empathy, sense of power, and personality type were statistically correlated; if resident empathy declines over time; and how resident empathy compares with that of nonmedical peers. METHODS In 2010, a cohort of individuals entering pediatric residency were given three validated survey instruments at the beginning of their first and third years of training to explore longitudinal changes in empathy, sense of power, and major personality traits. RESULTS We found no decrease in resident empathy in 2 years of pediatric training, no changes in their sense of power, and no statistically significant correlation between empathetic tendencies and sense of power. When compared with the general nonmedical population, pediatric residents rated themselves higher in empathy. As expected, the two components of empathy (empathic concern and perspective taking) were moderately correlated. Of the major personality traits, only agreeableness showed significant correlation with empathy. CONCLUSIONS Pediatric resident empathy did not decrease longitudinally, unlike studies in other residents. There was no inverse relation between self-perceptions of sense of power and empathy as is present in the business literature. Finally, pediatric resident empathy was significantly higher when compared with a general nonmedical population.
Evaluating β-turn mimics as β-sheet folding nucleators

β-Turns are common conformations that enable proteins to adopt globular structures, and their formation is often rate limiting for folding. β-Turn mimics, molecules that replace the i + 1 and i + 2 amino acid residues of a β-turn, are envisioned to act as folding nucleators by preorganizing the pendant polypeptide chains, thereby lowering the activation barrier for β-sheet formation. However, the crucial kinetic experiments to demonstrate that β-turn mimics can act as strong nucleators in the context of a cooperatively folding protein have not been reported. We have incorporated 6 β-turn mimics simulating varied β-turn types in place of 2 residues in an engineered β-turn 1 or β-bulge turn 1 of the Pin 1 WW domain, a three-stranded β-sheet protein. We present 2 lines of kinetic evidence that the inclusion of β-turn mimics alters β-sheet folding rates, enabling us to classify β-turn mimics into 3 categories: those that are weak nucleators but permit Pin WW folding, native-like nucleators, and strong nucleators. Strong nucleators accelerate folding relative to WW domains incorporating all α-amino acid sequences. A solution NMR structure reveals that the native Pin WW β-sheet structure is retained upon incorporating a strong E-olefin nucleator. These β-turn mimics can now be used to interrogate protein folding transition state structures and the 2 kinetic analyses presented can be used to assess the nucleation capacity of other β-turn mimics.