cssi/SciSciGPT-SciSciNet huggingface dataset:
Diagnosis of occult scaphoid fractures by intrasound vibration

We investigated a new means of diagnosing occult scaphoid fractures. Eighty-six patients underwent vibratory testing at presentation, while the clinical examination and standard four-view x-ray examination findings were unknown to the persons who performed the vibratory testing of both the injured and uninjured wrists. Thirty-six patients had radiographically confirmed scaphoid fractures and, after their vibratory tests, were eliminated from the study. Fifty patients, 39 men and 11 women, were believed to have scaphoid fractures on the basis of history and clinical examination findings but were included in the occult scaphoid study group because standard four-view x-ray films of the wrists did not reveal a scaphoid fracture. Distinction between the fracture and no-fracture patients was made with a limited two-phase technetium bone scan and delayed x-ray examination. All patients with known scaphoid fractures (36) had positive findings on vibratory examination. Vibratory testing identified all six of the patients with occult scaphoid fractures (sensitivity 100%). Results of two examinations were false-positive, and none were false-negative (specificity 95%). One of the patients with false-positive results had a fracture of the trapezium, and the other had reflex sympathetic dystrophy. The vibratory testing of injured wrists is inexpensive, noninvasive, and easy to perform, and it involves no ionizing radiation.
Urban Girls: Resisting Stereotypes, Creating Identities

Urban Girls: Resisting Stereotypes, Creating Identities. Bonnie J. Ross Leadbeater and Niobe Way, eds. New York: New York University Press, 1996. 409 pp.
Comparative Studies on Nonlinear Hyperbolic and Parabolic Heat Conduction for Various Boundary Conditions: Analytic and Numerical Solutions

With the advent of lasers with very short pulse durations and their use in materials processing, the effect of thermal wave propagation velocity becomes important. Also, localized heating in laser-aided materials processing causes significant variations in the material properties. To account for these two effects, hyperbolic heat conduction is studied in this paper by considering all the thermophysical properties, except the thermal diffusivity, to be temperature dependent. The resulting nonlinear hyperbolic equations are linearized by using Kirchhoff transformation. Both analytical and numerical solutions are obtained for finite domains. Results are presented and compared with parabolic conduction results.
Production and utilization of reduced nicotinamide adenine dinucleotide phosphate in the mouse testis

Testicular Leydig cells of BALB/c Jax mice exhibit time-dependent patterns of nicotinamide-adenine-dinucleotide-phosphate (NADP)-linked glucose-6-phosphate and isocitrate dehydrogenase activity beginning five days before birth. In crude homogenates of fetal testes, glucose-6-phosphate dehydrogenase (G-6-PDH) activity is twice that found in the adult. Levels drop at birth and remain low. Isocitrate dehydrogenase activity is high during late gestation and at 10 and 60 days postpartum, but decreases in the neonatal and the prepubertal testis. Moderate prenatal NADPH-diaphorase activity is reduced in the postpartum animal. Conversely, there is a steady increase in reduced nicotinamide-adenine-dinucleotide (NADH)-diaphorase activity after birth, with adult levels being attained by the third week. Inhibition of testicular G-6-PDH activity by pregnenolone, dehydroepiandrosterone, and cholesterol is proportional to steroid concentration between 10−6 M and 10−4 M. The production of NADPH by isocitrate and glucose-6-phosphate dehydrogenases assures sufficient reducing potential for the early synthesis of androgens in fetal interstitial cells. The sustained depression in G-6-PDH activity found in the postpartum testis may be due in part to regulation by steroid intermediates. Hormonal precursors have no effect on isocitrate dehydrogenase which continues to supply NADPH in the postpubertal testis.
Reaction Diffusion Modeling of Calcium Dynamics with Realistic ER Geometry

We describe a finite-element model of mast cell calcium dynamics that incorporates the endoplasmic reticulum's complex geometry. The model is built upon a three-dimensional reconstruction of the endoplasmic reticulum (ER) from an electron tomographic tilt series. Tetrahedral meshes provide volumetric representations of the ER lumen, ER membrane, cytoplasm, and plasma membrane. The reaction-diffusion model simultaneously tracks changes in cytoplasmic and ER intraluminal calcium concentrations and includes luminal and cytoplasmic protein buffers. Transport fluxes via PMCA, SERCA, ER leakage, and Type II IP3 receptors are also represented. Unique features of the model include stochastic behavior of IP3 receptor calcium channels and comparisons of channel open times when diffusely distributed or aggregated in clusters on the ER surface. Simulations show that IP3R channels in close proximity modulate activity of their neighbors through local Ca2+ feedback effects. Cytoplasmic calcium levels rise higher, and ER luminal calcium concentrations drop lower, after IP3-mediated release from receptors in the diffuse configuration. Simulation results also suggest that the buffering capacity of the ER, and not restricted diffusion, is the predominant factor influencing average luminal calcium concentrations.
Book Review: Exiting The Short Bus

In the short bus (the short bus is the one that in most school districts transports those students with special-needs); it may seem like a chaotic and confusing group of people that have individual needs and no compassion for each other. However, what is occurring in this bus is no different from the activities in the big bus. To have compassion for all those in the short bus is to offer a support that is always appreciated but many times not communicated. It is sometimes difficult to express one’s endorsement of this group of students, but it elicits a positive feeling and a good atmosphere. The short bus has a culture that is unique in appearance, but it is essentially the same as that of the big bus.
The Scope of the Military Market

This article describes the major categories of the military market in the United States. Important changes in the composition of the military demand for goods and services are also indicated.These ...
Quantitative Estimation of Ash after Microincineration.

One of the things to be desired in the study of microincinerated sections is an accurate means of estimating the relative quantities of inorganic salts in various cells. Such a method would permit a quantitative comparison of tissues taken from animals subjected to experimental procedures with similar normal cells. Furthermore it would be possible to study such processes as normal growth and differentiation in a more exact manner than the microincineration technique has permitted. A quantitative method also has many advantages in the examination of pathologic tissues and comparable normal ones. The technique for quantitative photography of incinerated sections devised by Schultz-Brauns1 has many points to commend it; but it is, in the final analysis, a procedure which depends on the visual judgment of the observer. It seemed advisable, therefore, to develop a method which would be free from this objection.The nature and distribution of the inorganic salts in cells and tissues has been described.2, 3 The a...
Discrete spin structures and commuting projector models for two-dimensional fermionic symmetry-protected topological phases

We construct exactly solved commuting projector Hamiltonian lattice models for all known (2+1)-dimensional (2+1D) fermionic symmetry protected topological phases (SPTs) with on-site unitary symmetry group ${G}_{f}=G\ifmmode\times\else\texttimes\fi{}{\mathbb{Z}}_{2}^{f}$, where $G$ is finite and ${\mathbb{Z}}_{2}^{f}$ is the fermion parity symmetry. In particular, our models transcend the class of group supercohomology models, which realize some, but not all, fermionic SPTs in 2+1D. A natural ingredient in our construction is a discrete form of the spin structure of the 2D spatial surface $M$ on which our model is defined, namely a ``Kasteleyn'' orientation of a certain graph associated with the lattice. As a special case, our construction yields commuting projector models for all eight members of the ${\mathbb{Z}}_{8}$ classification of 2D fermionic SPTs with $G={\mathbb{Z}}_{2}$.
Influences of temperature, detergents, and enzymes on glutamate receptor binding and its regulation by calcium in rat hippocampal membranes.

The effects of various physical or chemical treatments which cause modifications of protein-protein or protein-lipid interactions on basal and calcium-stimulated [3H]glutamate receptor binding have been studied in rat hippocampal membranes. Increasing temperature increased the number of binding sites without changing their affinity for [3H]glutamate; in addition, no significant stimulation by calcium of this binding was observed below 15-20°. An Arrhenius-like plot of the data indicated a marked discontinuity at 21° and yielded activation energies of 20-60 kcal·mole-1. Treatment of membranes with the detergents Triton X-100 or sodium deoxycholate resulted in a dose-dependent reduction in [3H]glutamate binding accompanied by a loss of the stimulatory effect of calcium ions. Treatment with phospholipase C decreased basal binding without altering the percentage increase in binding produced by calcium, whereas treatment with phospholipase D did not affect basal binding, but instead reduced the effect of calcium. Trypsin and chymotrypsin caused an increased basal binding and did not change the stimulatory effect of calcium. These data support the hypothesis that calcium increases the number of [3H]glutamate binding sites by inducing local changes in membrane fluidity.
Interaction between Nonstructural Proteins NS4B and NS5A Is Essential for Proper NS5A Localization and Hepatitis C Virus RNA Replication

UNLABELLED The hepatitis C virus NS5A protein is tethered to cellular membranes via an amphipathic amino-terminal helix that is inserted in-plane into the outer endoplasmic reticulum (ER)-derived membrane leaflet. The charged face of the helix faces the cytoplasm and may contribute to interactions involved in replicase assembly and function. Using an aggressive charge flip mutagenesis strategy, we identified a number of essential residues for replication on the charged face of the NS5A anchor and identified a double charge face mutant that is lethal for RNA replication but generates suppressor mutations in the carboxy-terminal helix of the NS4B protein. This suppressor restores RNA replication of the NS5A helix double flip mutant (D1979K/D1982K) and, interestingly, seems to function by restoring the proper localization of NS5A to the viral replicase. These data add to our understanding of the complex organization and assembly of the viral replicase via NS4B-NS5A interactions. IMPORTANCE Information about the functional role of the cytosolic face of the NS5A anchoring helix remains obscure. In this study, we show that while the hydrophobic face of the NS5A anchor helix mediates membrane association, the polar cytosolic face of the helix plays a key role during hepatitis C virus (HCV) replication by mediating the interaction of NS5A with other HCV nonstructural proteins via NS4B. Such an interaction determines the subcellular localization of NS5A by engaging NS5A in the HCV replication process during the formation of a functional HCV replication complex. Thus, collectively, it can be stated that the findings in the present study provide further information about the interactions between the HCV nonstructural proteins during HCV RNA replication and provide a platform to gain more insights about the molecular architecture of HCV replication complexes.
Maybe you should blame your parents: Parental attachment, gender, and problematic Internet use.

Background and aims Prior research has generally established parental attachment as a predictor of problematic Internet use (PIU). However, findings across studies are inconsistent as to which factor(s) of attachment style (i.e., attachment anxiety and attachment avoidance) contributes to PIU. Another gap in the literature is that as most studies highlight the importance of maternal (over paternal) attachment security in inhibiting PIU, little research has examined the possibility of a gender difference, where maternal and paternal attachment securities may exert different influences on males and females. Methods An anonymous survey was completed by 243 undergraduate students in a public university in the U.S. Midwest. In addition to demographic information, the survey contained measurement scales to assess PIU and parental attachment (both maternal and paternal). Results Survey data show that (a) attachment anxiety, but not attachment avoidance, is significantly related to PIU and (b) gender significantly moderates this relationship, where paternal attachment anxiety leads to PIU in female students while maternal attachment anxiety contributes to PIU in male students. Conclusions This study deepens our understanding in the relationship between family upbringing, particularly parental attachment, and PIU. More specifically, attachment anxiety is found to be a significant predictor of PIU, but attachment avoidance is not. Also, contributing to the research literature is the finding of a significant gender effect in this relationship.
Comparision of different image-guided adaptive treatment strategies for radiation therapy

T determine potential dosimetric benefits of image-guided adaptive radiation therapy treatment (IGART) strategies for intermediate-risk prostate cancer. A 19 patient cohort with 8-13 CT-images was used to compare different IGART strategies. The IMRT prescription was 46 Gy/23 fractions to the prostate and seminal vesicle PTVs, followed by a 40 Gy/20 fractions prostate boost. For each patient, daily IGART imaging was simulated by random selection from available images. The three different IGART-IMRT strategies are simuated; (A0) initial planning only with 5 mm PTV margins; (A1) daily re-planning without considering prior dose; and (A2) online daily re-planning for each fraction considering prior dose obtained via deformable dose mapping (A1 and A2, no PTV margin). For each strategy, daily dose was deformably mapped using Demons-based displacement vector fields and accumulated to estimate the treatment dose. Strategies were compared via dosimetric adherence to constraints and objectives. Results show A0 had larger doses to 20, 30, and 50% rectal (30±20%) and bladder (40±20%) volumes than A1 and A2 (p D5A1, p=0.02). IGART utilizing daily re-planning (A1 and A2) has dosimetric advantages over conventional-IMRT for critical structures, particularly high-dose regions, without compromising PTV-coverage. Due to inherent deformation vector field inaccuracies, daily re-planning based on prior dose (A2) showed poor rectal sparing than A1.
Geographic pathology of oral, esophageal, gastric, and intestinal cancer in Chile.

Crude, age-specific, and age-adjusted death rates per 100,000 population from esophageal cancer in 1960 throughout the twenty-five provinces indicated that northern provinces such as Tarapaca, Antofagasta, Atacama, Coquimbo, and Aconcagua were high risk areas. The southern province of Bio-Bio exhibited the lowest rate in the country. Aconcagua showed an age-adjusted death rate per 100,000 from esophageal cancer of 11.1 and Bio-Bio 0.5, differing by a factor of 22. In stomach cancer, age-adjusted death rates per 100,000 population in 1960, 1962, and 1964 were high in the provinces of Colchagua, Curico, Talca, Linares, Nuble, Concepcion, Bio-Bio, and Malleco. Magallanes, located in the extreme southern part of continental Chile, exhibited the lowest rates. A working hypothesis on gastric carcinogenesis by nitrosamines in Chileans is presented.
A New MILP Formulation for Instrumentation Network Design and Upgrade

Abstract Although a previous formulation of the cost optimal sensor network design and upgrade problem (Bagajewicz, 1997) is in the form of a mathematical programming problem, it bad the disadvantage that the constraints were not explicitly set in analytical form, forcing a tree search solution procedure. Although this technique has tree pruning measures, it is inefficient. In this paper, a MILP formulation is presented.
Ethnic identity in context of ethnic discrimination: When does gender and other-group orientation increase risk for depressive symptoms for immigrant-origin young adults?

Objectives: Ethnic discrimination increases risk for depressive symptoms, but less is known about factors that influence the impact of this cultural challenge on psychological adjustment for immigrant-origin college students. Sociocultural identity development is especially relevant during emerging adulthood. Studies examining exacerbating or buffering impacts of ethnic identity have yielded mixed results. The current study examines conditions under which one aspect of ethnic identity, affirmation/belonging, moderates the impact of perceived ethnic discrimination stress on depressive symptoms. This was expected to vary by other-group orientation and gender, in accordance with rejection sensitivity theory. Method: A multicultural sample of 290 non-White immigrant-origin emerging adults (aged 18–25) from mixed cultural backgrounds and generational statuses attending a college in the Southeastern United States completed electronic self-report questionnaires. Results: More robust support was provided for social identity theory rather than rejection sensitivity theory: stronger affirmation/belonging was inversely associated with depressive symptoms across the sample, with a notable buffering impact for women. Trend-level results indicated a protective effect for those endorsing stronger affirmation/belonging paired with greater other-group orientation. Additionally, women with weaker affirmation/belonging demonstrated greater increased depressive symptoms compared to men with weaker affirmation/belonging. Conclusions: For this sample, social identity theory was relevant to the impact of affirmation/belonging on the relation between ethnic discrimination and depressive symptoms contingent on other-group orientation and gender. This finding underscores the importance of examining ethnic identity in a nuanced manner. Implications for these results extend to college counseling centers, where inclusion of sociocultural identity in case conceptualization would be useful.
Abstract 2604: The Georgetown Database of Cancer (G-DOC): A web-based data sharing platform for precision medicine

Introduction An overarching goal of biomedical research is to improve the use and dissemination of rapidly growing biomedical datasets to support precision medicine. Individualized molecular profiling and the identification of predictive biomarkers can powerfully inform the choice of therapies for cancer patients. However, both require integration of extensive molecular, clinical, and pharmacological data, often from disparate and diverse sources. The Georgetown Database of Cancer (G-DOC) was designed and engineered to be a unique multi-omics data analysis platform to enable translational research and precision medicine. Methods G-DOC is home to 61 datasets that contain data from over 10,000 patients across 14 diseases (10 cancers and 4 non-cancers). 1700+ researchers from over 48 different countries worldwide currently use the platform. The data and tools in the G-DOC system have enabled over 40 research publications. G-DOC has the largest public collection of brain cancer patients from NCI Rembrandt dataset (671 patients).G-DOC integrates clinical, transcriptomic, metabolomic, microRNA, next generation sequencing (NGS) data, and MRI medical images with systems-level analysis tools into a single, user-friendly platform. The “Variant Search” feature in G-DOC currently enables exploratory analysis of mutations based on genes, chromosomes, and functional location. A researcher can use this feature to 1) identify clinically actionable mutations in their dataset 2) identify pathways that may be affected by these mutations, and 3) identify novel mutations in their dataset and explore their potential impact on protein function. Results and Conclusion We are currently working on developing features to support the import, integration, search, and retrieval of CLIA/CAP-certified cancer molecular diagnostic (molDx) data. This will enhance G-DOC’s interoperability with clinical and patient molecular profiling data that may be already stored in other databases. Our vision is to continuously improve and expand G-DOC with the long-term vision of supporting integration of informatics techniques into everyday research and practice. Citation Format: Krithika Bhuvaneshwar, Anas Belouali, Shruti Rao, Adil Alaoui, Yuriy Gusev, Robert Clarke, Louis M. Weiner, Subha Madhavan. The Georgetown Database of Cancer (G-DOC): A web-based data sharing platform for precision medicine [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2604. doi:10.1158/1538-7445.AM2017-2604
What is 'confidence' and what could affect it?: A qualitative study of mothers who are hesitant about vaccines.

Abstract Background Public confidence in immunization is critical to maintaining high vaccine-coverage rates needed to protect individuals and communities from vaccine-preventable diseases. Recent attention has been placed on factors influencing confidence in vaccination in the US and globally, but comprehensive understanding of what drives or hinders confidence in childhood vaccination is yet to be reached. As such, assessing parents' confidence in childhood vaccination and the ways in which educational materials affect confidence is needed. Objective We sought to (1) learn how mothers who are hesitant about vaccination characterize confidence in health-related products for young children, including the recommended vaccines; (2) gain insights on what influences vaccine confidence beliefs; and (3) assess whether short, education materials affect parental confidence in childhood vaccinations. Methods Eight moderator-lead focus groups (n = 61), stratified by socioeconomic status, were undertaken with mothers of children 5 years of age of less who are hesitant about vaccines. Four of the groups were held in the Philadelphia, PA area and four were held in the San Francisco/Oakland, CA area. Three educational material pairs, each consisting of a 2–3 min video and an infographic poster about an immunization-related topic, were reviewed and assessed for influence on confidence. Results Qualitative data analysis was used to identify overarching themes across the focus groups. Themes, insights, and illustrative quotes were identified and provided for each of the major discussion areas: primary health concerns for young children; confidence beliefs and perceptions, including for recommended vaccines; facilitators and barriers to confidence; and reactions to the educational materials. Conclusions Results provide helpful insights into how mothers who are hesitant about vaccines perceive confidence in childhood vaccines and health-related products, suggestions for how to improve confidence, and support for the value and use of short videos as part of vaccination education efforts. Findings can aid those developing vaccination education materials and resources designed to foster vaccine confidence.
Permission Decisions as Binding Precedents

(1999). Permission Decisions as Binding Precedents. Judicial Review: Vol. 4, No. 4, pp. 235-238.
A Perspective on Chemosensory Quality Coding

The coding of chemosensory quality (sweet, bitter, and a multiplicity of odor notes) is contrasted with the coding of spectral senses (pitch and color) in mammals. Taste and smell stimuli are detected directly by G protein-coupled receptors with discrete chemical ranges, whereas pitch and color stimuli are first partitioned by broadly tuned pigments and finely tuned localized mechano-detectors, respectively. Chemosensory qualities, determined by the taste and olfactory molecular receptors, are receptor cell-specific and are represented throughout the central nervous system (CNS). CNS inhibitory circuits likely promote mixture suppression and rapid stimulus adaptation, allowing consistent identification of a chemosensory stimulus superimposed on a complex and variable chemical environment.
Iterating the ASPECTS <6 threshold.

In response to the publication of the five positive stroke thrombectomy trials, the American Heart Association issued a focused update in 2015 of its guidelines for early management of patients with acute ischemic stroke, including the uncertainty of benefit of thrombectomy in patients with an Alberta Stroke Program Early CT Score (ASPECTS) <6 (level IIb), recommending further clinical trials.1 Investigators in many of these studies were trained to dichotomize ASPECTS scoring during enrollment. Doing so not only yielded higher interobserver agreement, particularly when a threshold of 7 was used, but also simplified and expedited enrollment.2 This may have inadvertently led to a more widespread trend in dichotomizing ASPECTS in clinical practice, with the presence or absence of evidence as justification. In this month’s issue of JNIS , Mourand et al 3 challenge the ASPECTS <6 threshold by reporting their single center results of 60 stroke thrombectomy patients treated from 2009 to 2014 presenting with ASPECTS ≤5. Their results suggest that there may still be efficacy and safety with stroke thrombectomy in the presence of large core infarcts. Median admission National Institutes of Stroke Scale (NIHSS) score was 20 and median age was 66 years. Most patients were …
Public reporting of surgical outcomes

Abstract As a result of pressures from patients, payers, and providers, mechanisms that measure and publicly report surgical outcomes have emerged rapidly over the last two decades. This growing movement is the result of an increasing demand for transparency and accountability. Processes that generate these outcomes reports, however, are challenged by issues related to accuracy and bias. Furthermore, the impact of reports on behaviors within the healthcare marketplace is complicated. In order to better understand the current state and future of public reporting within the United States, a brief review of the history of this movement is warranted. Also, the mechanics of the data gathering/analysis that drives public reports is described in order to understand potential barriers to accurate measurement and analysis. The movement toward public reporting should be guided by maximizing the benefits and minimizing the collateral consequences that are inherent in the public release of surgical outcomes data.
Interference of adaptation to foreign-accented speech from consecutive but not interleaved training of two accents

For perceptual learning on fine-grained discrimination tasks, improvement can be enhanced or disrupted when two tasks are trained, depending on how the training on those tasks is distributed. To investigate if this phenomenon extends to speech learning, we trained native-English speakers to transcribe both Mandarin- and Turkish-accented English sentences using one of three different configurations of the same training stimuli. After training, all trained groups performed better than untrained controls, and similarly to each other, on a novel talker of a trained accent (Mandarin). However, for a novel accent (Slovakian), performance was better than untrained controls when training alternated between the two accents, but not when the two accents were trained consecutively. Performance for the novel accent decreased as the number of contiguous sentences per accent during training increased. One interpretation of these results is that accent information is integrated during a restricted time window. If two accents are encountered within this window, information from both accents is integrated, yielding accent-general learning. If two accents are encountered in separate consecutive windows, accent-specific learning occurs for each accent and accent-general learning is prevented. These results mirror patterns for fine-grained discrimination learning, and illuminate the processes underlying the success of high-variability training.For perceptual learning on fine-grained discrimination tasks, improvement can be enhanced or disrupted when two tasks are trained, depending on how the training on those tasks is distributed. To investigate if this phenomenon extends to speech learning, we trained native-English speakers to transcribe both Mandarin- and Turkish-accented English sentences using one of three different configurations of the same training stimuli. After training, all trained groups performed better than untrained controls, and similarly to each other, on a novel talker of a trained accent (Mandarin). However, for a novel accent (Slovakian), performance was better than untrained controls when training alternated between the two accents, but not when the two accents were trained consecutively. Performance for the novel accent decreased as the number of contiguous sentences per accent during training increased. One interpretation of these results is that accent information is integrated during a restricted time window. If two ac...
Nutritional state and secondary compounds influence trembling aspen (Populus tremuloides) intake by lambs

Abstract The foraging ecology of mammalian herbivores is determined by plant secondary compounds (PSC) that defend plants against herbivory, by nutrients that are required for maintenance, growth, and reproduction, and by the interaction between these variables. In this study, we explored the influence of an herbivore’s nutritional state and experience on intake of aspen (Populus tremuloides) leaves with contrasting concentrations of a PSC, phenolic glycosides (PG). Thirty-two lambs were randomly assigned to two groups (N = 16). Each group received aspen leaves with either higher (21.2%) or lower (16.3%) concentrations of PG throughout the study. In Experiment 1, half of the lambs within each group received rations with a high (22.2% crude protein [CP]; 3.13 Mcals/kg) or low (11.9% CP; 3.13 Mcals/kg) concentration of CP. During Experiment 2, half of the lambs within each group received rations with a high (3.45 Mcals/kg; 16.1% CP) or low (2.52 Mcals/kg; 18.5% CP) concentration of energy. During Experiment 3, all lambs received a simultaneous offer of aspen leaves containing higher (20.6%) and lower (14.8%) concentrations of PG. Aspen intake was greater when lambs received the high-protein or the low-energy rations (P
Aseptic Meningitis as a Manifestation of the Anti-MOG Syndrome (P5.422)

Objective: To report on a possible association between the anti-myelin oligodendrocyte glycoprotein (MOG) syndrome and aseptic meningitis. Background: MOG antibodies have been associated with a wide array of demyelinating phenotypes, including optic neuritis, aquaporin-4 antibody-seronegative neuromyelitis optica spectrum disorder (NMOSD), and acute disseminated encephalomyelitis (ADEM). Design/Methods: We describe a case report of an adult patient longitudinally followed for repeat CNS syndromes, found to be MOG-antibody positive. Results: A 28-year-old previously healthy male presented with two episodes of right optic neuritis within two weeks improved after high-dose corticosteroids and plasma exchange. One month later, he was readmitted for one week of fever, headache, and neck stiffness. Cerebrospinal fluid (CSF) analysis revealed a profound neutrophilic-predominant pleocytosis. MRI of brain and entire spine were unremarkable. He was initiated on an empiric treatment regimen of antimicrobial agents, though patient remained lethargic with fluctuating mental status and cognition. A thorough infectious workup was unrevealing. He was discharged with a diagnosis of aseptic meningitis but returned about two weeks later with worsening headache and new gait unsteadiness. MRI revealed new demyelinating lesions in the cortex, brainstem and cerebellar peduncles. Serological studies from his second attack of optic neuritis returned with MOG- antibody positivity. He subsequently underwent five treatments of plasma exchange and high-dose corticosteroids with significant clinical improvement. Conclusions: The clinical phenotype of the anti-MOG syndrome is yet to be completely defined. This case illustrates the possibility of aseptic meningitis as a presentation of the anti-MOG syndrome in addition to recurrent optic neuritis and adult ADEM. We suggest further work into other clinical phenotypes that may have an association with this antibody, which could impact clinical treatment. Study Supported by: N/A Disclosure: Dr. Hadiono has nothing to disclose. Dr. Sguigna has nothing to disclose. Dr Elliott has nothing to disclose.
The effects of hydrostatic pressure on signal transduction in brain membranes of deep-sea fishes of the genus Coryphaenoides

To investigate the effects of increased hydrostatic pressure on transmembrane signaling in deep-living marine species, the A1 adenosine receptor − inhibitory G protein (Gi) − adenylyl cyclase signaling complex was examined in brain membrane preparations from four teleost fish species of the deep-sea family Macrouridae. The combined depth ranges of the adults of these species, Coryphaenoides armatus, C. cinereus, C. filifer, C. pectoralis, span several hundred meters to 5400 m. Basal adenylyl cyclase activity, determined at 5 °C, was inhibited by increased hydrostatic pressure in all four species. At the highest pressure tested, 476 atm, adenylyl cyclase activity was inhibited 60 to 70% relative to the atmospheric pressure values. Pressure inhibition did not result from denaturation or loss of protein components from the membrane due to pressure-induced shedding. Despite the pressure-inhibition of basal adenylyl cyclase activity, the responsiveness of adenylyl cyclase activity to modulation by N6-cyclopentyladenosine, an A1 adenosine receptor agonist, was retained at elevated pressures. Because the accumulation of the second messenger cAMP depends on the summation of modulatory inputs, these results indicate that the transmembrane signaling in these deep-living species is insensitive to hydrostatic pressure changes.
Classification of Different Cognitive and Affective States in Computer Game Players Using Physiology, Performance and Intrinsic Factors

Intelligent systems infer human psychological states using three types of data: physiology, performance, and intrinsic factors. To date, few studies have compared the performance of the data types in classification of psychological states. This study compares the accuracy of three data types in classification of four psychological states and two game difficulty-related parameters. Thirty subjects played nine scenarios (different difficulty levels) of a computer game, during which seven physiological measurements and two performance variables were recorded. Then, a short questionnaire was filled out to assess the perceived difficulty, enjoyment, valence and arousal, and the way the participant would like to change two game parameters. Furthermore, participants’ intrinsic factors were assessed using four questionnaires. All combinations of the three datasets were used to classify six aspects of the short questionnaire into either two or three classes using three types of classifiers. The highest accuracies for two-class and three-class classification were 98.4% and 81.5%, respectively.
Probabilistic Forecasting with Spline Quantile Function RNNs

In this paper, we propose a flexible method for probabilistic modeling with conditional quantile functions using monotonic regression splines. The shape of the spline is parameterized by a neural network whose parameters are learned by minimizing the continuous ranked probability score. Within this framework, we propose a method for probabilistic time series forecasting, which combines the modeling capacity of recurrent neural networks with the flexibility of a spline-based representation of the output distribution. Unlike methods based on parametric probability density functions and maximum likelihood estimation, the proposed method can flexibly adapt to different output distributions without manual intervention. We empirically demonstrate the effectiveness of the approach on synthetic and real-world data sets.
Femtosecond laser-assisted deep anterior lamellar keratoplasty.

Purpose of review A survey of the recent literature of deep anterior lamellar keratoplasty using femtosecond laser technology. Recent findings There are several recent reports in the literature assessing technique and outcomes of deep anterior lamellar keratoplasty done with a femtosecond laser trephination. Most of these reports are laboratory studies and small case series with short-term outcomes. The laser technology is expensive and may not produce better results than conventional manual techniques. However, there are several theoretical advantages to femtosecond laser incisions in deep anterior lamellar keratoplasty that should be explored, including possible increased success of Descemet's membrane separation from stroma during surgery as well as postsurgical astigmatism benefits, earlier suture removal, and increased wound strength and healing. Summary Femtosecond laser trephination in the setting of DALK may improve the technique by decreasing the number of descemet's membrane ruptures and improving short-term and long-term outcomes as compared with manual techniques. However, there is no consensus on a standardized approach for wound design or postoperative management. The literature would benefit from a prospective randomized controlled trial.
Pharmacokinetics of propranolol in healthy cats during euthyroid and hyperthyroid states.

OBJECTIVE To examine the pharmacokinetic profile of propranolol in cats before and during experimentally induced hyperthyroidism. ANIMALS 8 conditioned, random-source, young adult, female cats. PROCEDURE Propranolol was administered i.v. as a single bolus and 72 hours later by mouth. Thereafter, the cats were dosed for 5 weeks with L-thyroxine (50 micrograms/kg of body weight, s.c., once daily) to induce hyperthyroidism (serum thyroxine concentration, 217 +/- 17 nmol/L). Blood samples were obtained at appropriate intervals before and during hyperthyroidism and were analyzed for plasma propranolol concentration by use of high-performance liquid chromatography. RESULTS In all cats, a two-compartment model best described the control and hyperthyroid intravenous data. The change in thyroid status from euthyroid to hyperthyroid caused a significant (P < 0.05), but small reduction in propranolol area under the curve (19,932 +/- 7,900 min.micrograms/L vs 15,911 +/- 1,400 min.micrograms/L) after i.v. administration. In contrast, after oral administration during the hyperthyroid state, a twofold increase (P < 0.05) in propranolol area under the curve (105,430 +/- 57,600 min.micrograms/L vs 226,811 +/- 112,000 min.micrograms/L) and peak serum propranolol concentration (651 +/- 247 micrograms/L vs 1191 +/- 590 micrograms/L) were attributed to significant (P < 0.05) increase in propranolol bioavailability caused by increased fractional absorption (57 +/- 28% vs 137 +/- 73%) and decreased total body clearance (58 +/- 27 ml/min/kg vs 30 +/- 19 ml/min/kg). Mean arrival time after oral dosing was significantly lengthened by hyperthyroidism (100 +/- 38 minutes vs 157 +/- 71 minutes). CLINICAL RELEVANCE Hyperthyroidism-induced changes in propranolol pharmacokinetics may signal the need to reduce doses of propranolol when they are orally administered to hyperthyroid cats.
Problems of Implementation of an Import Substitution Policy in the Oil Industry

The presented study addresses the issues of implementation of an import substitution policy in the Russian oil industry. Support of domestic production is a key objective specified in the message of the President of the Russian Federation in 2019. In light of the current economic situation and considering the importance of the oil industry for the Russian economy, an import substitution policy could help achieve the objective set by the President. Aim. The study aims to identify the problems and ways of implementation of an import substitution policy in the Russian oil industry. Tasks. The authors analyze scientific publications on import substitution and the state of the Russian oil industry at the current stage of development; determine the directions and fundamental trends in the development of the oil industry; identify obstacles that hinder the implementation of an import substitution policy in the oil industry; describe conditions that facilitate the development of the investment process in the oil industry; propose comprehensive methods and ways to intensify investments and optimize costs for enterprises in the oil industry. Methods. This study uses general scientific methods of cognition, comparative and statistical analysis to identify problems in the implementation of an import substitution policy in the oil industry. Results . Examination of the current state and development prospects of the oil industry allows the authors to identify obstacles to the development of import substitution. The study shows their impact on the potential of import substitution, which has a negative effect on the prospects of intensification of investment processes, and proposes comprehensive methods and mechanisms that could neutralize the impact of the identified obstacles, thus facilitating the formation of a positive investment climate. Conclusions . Investment climate is shown to have a decisive impact on the potential of import substitution in the Russian oil industry, and ways of overcoming negative trends in the development of the oil industry are proposed.
PRA is Not Associated with Rejection in Combined Heart and Liver Transplantation

Purpose Combined heart liver transplantation (CHLT) is relatively rare with approximately 250 cases from 1988-2018 nationally, but with rising numbers each year due to excellent survival. CHLT outcomes have potential immunological benefits compared to heart transplant alone. Liver allografts have long been observed to be more tolerant to HLA mismatch while showing some degree of immune protection in combined organ transplantation. Methods A retrospective analysis from our center's experience of CHLT was performed. Outcomes of patients who had pre-transplant elevated panel reactive antibodies (PRA) >50-99% were compared to those with 0% and those with a low to moderate PRA (1-50%). The hypothesis was tested with the Fisher's exact test. Results Between 1997 and 2019, 37 patients underwent CHLT. The average age was 42.4 years +/- 10 with 8 deaths (21.6%) ranging from day 2 to 4.5 years post-transplant (5, 13.5% within the first year). None of the deaths were due to rejection or primary graft dysfunction. There were no episodes of humoral rejection and there were 2 episodes (5.4%) of cellular rejection in hearts and 4 (10.8%) in livers (of these, one episode was dual organ rejection). There was no statistical significance at baseline between PRA and history of Fontan physiology, protein losing enteropathy, prior sternotomy, diabetes, hypertension or renal disease. Furthermore, there was no correlation between PRA and death, rejection of either organ, presence of donor specific antibodies, ejection fraction below 50% (1 month and 1 year), length of stay over 30 days, post-transplant hypertension, diabetes or renal disease (table 1). Conclusion The degree of allosensitization was not associated with worse outcomes in the CHLT population. While the sample is small, it is a reassuring finding that may change the perception of risk when planning a CHLT in a highly sensitized patient.
Serotonin Syndrome Associated With Vilazodone Overdose in a 22-Month-Old Treated With Dexmedetomidine.

Abstract Background Vilazodone was approved by the U.S. Food and Drug Administration in 2011 as a treatment for major depression disorder. Vilazodone is a selective serotonin reuptake inhibitor and 5-HT1A agonist used in the treatment of depression in adults. Vilazodone increases the availability and activity of serotonin and its neural pathways. Vilazodone blocks the serotonin reuptake pump and desensitizes serotonin receptors (especially 5HT1A autoreceptors), therefore increasing serotonergic neurotransmission. Its partial agonist actions at presynaptic somatodendritic 5HT1A autoreceptors theoretically enhance serotonergic activity, contributing to antidepressant actions. There are limited reports exploring its effects in children after unintentional ingestion. Typical adult dosing is titrated from an initial dose of 10 mg up to a maximum dose of 40 mg daily. Serotonin syndrome classically manifests with restlessness, hyperthermia, tachycardia, mydriasis, and increased tone, and is typically treated with benzodiazepines, cyproheptadine, and supportive care. Dexmedetomidine has also been used in case reports to treat serotonin syndrome. Case Report We report the case of a toddler with a laboratory-confirmed vilazodone overdose exhibiting symptoms of serotonin syndrome, including restlessness, hyperthermia, mydriasis, dystonia, agitation, seizure-like activity, roving eye movement, tachycardia, and elevated creatine kinase. The patient was admitted and initially treated with supportive care and lorazepam per recommendations of the poison center, which did not recommend cyproheptadine use. On decompensation with suspected serotonin syndrome, the patient was treated with dexmedetomidine. In addition, urine toxicology screening (Amphetamines II assay; Roche, Indianapolis, IN) was positive for amphetamines; however, confirmatory testing (gas chromatography-mass spectrometry) was negative. The patient improved and was discharged after returning to her baseline status at 74 h post ingestion. Importantly, this patient did not require intubation and mechanical intubation, in spite of the large amount of vilazodone ingested. Why Should an Emergency Physician Be Aware of This? With increasing prescription of vilazodone, emergency physicians should have a high level of suspicion so as not to miss this toxidrome. The possibility of false-positive amphetamine screenings when an overdose of vilazodone is suspected should be investigated. Finally, systematic evaluation of the use of dexmedetomidine as treatment for serotonin syndrome or vilazodone ingestion should be done to confirm efficacy.