cssi/SciSciGPT-SciSciNet huggingface dataset:
The yeast ubiquitin ligase SCFMet30 regulates heavy metal response.

Cells have developed a variety of mechanisms to respond to heavy metal exposure. Here, we show that the yeast ubiquitin ligase SCFMet30 plays a central role in the response to two of the most toxic environmental heavy metal contaminants, namely, cadmium and arsenic. SCFMet30 inactivates the transcription factor Met4 by proteolysis-independent polyubiquitination. Exposure of yeast cells to heavy metals led to activation of Met4 as indicated by a complete loss of ubiquitinated Met4 species. The association of Met30 with Skp1 but not with its substrate Met4 was inhibited in cells treated with cadmium. Cadmium-activated Met4 induced glutathione biosynthesis as well as genes involved in sulfuramino acid synthesis. Met4 activation was important for the cellular response to cadmium because mutations in various components of the Met4-transcription complex were hypersensitive to cadmium. In addition, cell cycle analyses revealed that cadmium induced a delay in the transition from G1 to S phase of the cell cycle and slow progression through S phase. Both cadmium and arsenic induced phosphorylation of the cell cycle checkpoint protein Rad53. Genetic analyses demonstrated a complex effect of cadmium on cell cycle regulation that might be important to safeguard cellular and genetic integrity when cells are exposed to heavy metals.
Continuing education credit hours taken by general practice dentists

One of the goals of continuing education (CE) is to enhance lifelong learning; however, little has been reported to relate the extent of credit hours by dentists with demographic and practice characteristics. Ohio, like most other states, has a mandatory CE requirement for dentist relicensure. From a random sample audit, 753 Ohio dentists submitted CE credit hours earned for the biennium, 1992–1993. This information was merged with selected demographic, educational, and practice characteristics from the American Dental Directory. Of the 507 private practice general dentists audited, 79.7% are American Dental Association (ADA) members and 93.7% are males. The mean number of courses and credit hours earned is 10.3 (SD = 5.4) and 56.3 (SD = 26.6), respectively. Forty-two percent of the dentists took at least one course from a dental school and 69.6% took at least one course from a local dental society during the biennium. Using a general linear regression model, only the predictor variable of ADA membership is a statistically significant predictor of the total number (natural logarithm) of course hours taken for Ohio general dentists (R2 = 0.092, df = 20, p = 0.0005). Using age in a linear and quadratic form, we found that the number of credit hours taken by general dentists rises with age until approximately 54 years of age.
Association between antibody response to toxin A and protection against recurrent Clostridium difficile diarrhoea.

Summary Background We have reported that symptom-free carriers of Clostridium difficile have a systemic anamnestic immune response to toxin A. The aim of this study was to determine whether an acquired immune response to toxin A, during an episode of C difficile diarrhoea, influences risk of recurrence. Methods We prospectively studied 63 patients with nosocomial C difficile diarrhoea. Serial serum IgA, IgG, and IgM concentrations against C difficile toxin A, toxin B, or non-toxin antigens were measured by ELISA. Individuals were followed for 60 days. Findings 19 patients died (30%). Of the 44 who survived, 22 had recurrent C difficile diarrhoea. Patients with a single episode of C difficile diarrhoea (n=22) had higher concentrations of serum IgM against toxin A on day 3 of their first episode of diarrhoea than those with recurrent diarrhoea (n=22, p=0·004). On day 12, serum IgG values against toxin A were higher in patients who had a single episode of diarrhoea (n=7) than in those who subsequently had recurrent diarrhoea (n=9, p=0·009). The odds ratio for recurrence associated with a low concentration of serum IgG against toxin A, measured 12 days after onset of C difficile diarrhoea, was 48·0 (95% CI 3·5–663). Interpretation A serum antibody response to toxin A, during an initial episode of C difficile diarrhoea, is associated with protection against recurrence.
COLORADO PIKEMINNOW (PTYCHOCHEILUS LUCIUS) UPSTREAM OF CRITICAL HABITAT IN THE YAMPA RIVER, COLORADO

Abstract The Colorado pikeminnow (Ptychocheilus lucius) is a federally endangered fish, which was once abundant and widespread in the Colorado River basin. During exotic fish removal sampling in the spring of 2003, 2004, and 2005, 2 Colorado pikeminnow were collected upstream of critical habitat in the Yampa River, Colorado. Collection of these specimens might be an artifact of low historical sampling effort, but they do serve to document potential habitat use of Colorado pikeminnow outside of critical habitat.
d-Hole localization and the suppression of superconductivity in YBa2(Cu1-xZnx)3O7−y

The temperature and Zn concentration dependence of the electrical resistivity, specific heat, magnetic susceptibility, and electron paramagnetic resonance (EPR) spectra of YBa2(Cu1−x Zn x )3O7−y withy∼0.1 has been measured forx≤0.16. In addition, the temperature and field dependence of the magnetization has been measured for 2<T<300K and 0<H<9.0T, along with the temperature and quasihydrostatic pressure dependence of the electrical resistivity for selected samples for 0<P<13 GPa. The substitution of Zn for Cu in YBa2Cu3O7−y causes a rapid and nearly linear depression of the superconducting transition temperature,T c , withT c going to 0 K forx≥ 0.10. YBa2(Cu1−x Zn x )3O7−y retains the YBa2Cu3O7-y orthorhombic structure forx≤0.16 for both the superconducting and nonsuperconducting samples. Initially, the unit cell volume increases nearly linearly with Zn content; however, an abrupt change occurs in the vicinityx=0.8–0.10. Forx 0) andρ increases gradually with increasing Zn content. However, forx≥ 0.10,ρ(T) becomes semiconductor-like, with a very rapid increase of the resistivity with increasingx. The electrical resistivity, magnetic susceptibility, EPR spectra, and specific heat all indicate that thed-holes associated with the Cu ions become localized in the nonsuperconducting phase,x>-0.10.
Imaging of Diabetic Bone Structure

Epidemiological studies have found that patients with type 2 diabetes mellitus (T2DM) have a higher incidence of fragility fractures despite normal or elevated bone mineral density (BMD) measured with DXA. Studies have shown that bone structure and composition independent of BMD may explain the increased risk of fragility fractures in T2DM. High-resolution quantitative computed tomography (HR-pQCT) is a new technology to investigate bone quality analyzing cortical and trabecular bone structure. Using HR-pQCT differences in cortical porosity at the distal radius and tibia between T2DM patients with and without fragility fractures have been found. It has been suggested that cortical porosity may serve as a new imaging biomarker for increased fragility in T2DM. In addition, abnormalities of bone marrow fat using MR spectroscopy of the spine were demonstrated in T2DM patients: vertebral bone marrow fat content correlated significantly with HbA1c and visceral adipose tissue in T2DM patients and decreased unsaturated bone marrow lipids were found to be associated with T2DM and fragility fractures. Other imaging technologies that have been used to assess bone structure and texture in diabetic bone disease are high-resolution MRI, quantitative ultrasound, and trabecular bone score derived from DXA images. This chapter will summarize results from recent studies analyzing bone structure and quality in patients with diabetic bone disease and increased fracture risk.
Diffuse Leptomeningeal Rosai-Dorfman Disease: A Case Report (P3.150)

Background: Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare benign proliferative disease of histiocytes manifesting as painless, massive lymphadenopathy. Extranodal disease has been found in almost every organ system including the central nervous system. Isolated CNS involvement is rare and mainly presents as a dural-based mass or meningioma “mimick.” We report an unusual case of RDD with primarily both intracranial and intraspinal leptomeningeal involvement without nodal disease. Case Presentation: A 22-year-old woman with a history of partial bilateral hearing loss since childhood, presented with acute new right-sided hearing loss, pain, and tinnitus. Neurologic exam was notable for reduced bilateral hearing worse on the right. Audiometry revealed bilateral sensorineural hearing loss. MRI brain revealed a soft tissue prominence in the posterior nasopharynx, abnormal bone marrow enhancement of the skull base, and dural enhancement along the bilateral cavernous sinuses, Meckel’s caves, internal auditory canals right more than the left, and the optic nerve sheath complexes, all concerning for an aggressive process like lymphoma. CT chest, abdomen, and pelvis failed to reveal a malignancy, only mild thymus enlargement. CSF showed lymphocytic pleocytosis (69), elevated protein (233), and cytology with numerous lymphocytes, but also monocytes and histiocytes. Nasopharyngeal biopsy revealed histologic and immunophenotypic features consistent with RDD. MRI spine then revealed patchy dural, epidural, and intrathecal thickening and enhancement throughout all levels including the cauda equina. She was started on high-dose Prednisone and six weeks later her pain and tinnitus resolved and MR imaging also showed improvement. Conclusions: Presentation of RDD can be variable and CNS involvement is rare, but is usually a dural-based lesion. However, it is important to consider RDD in the differential for leptomeningeal disease as in our case. Steroids can lead to clinical and radiographic improvement. Disclosure: Dr. Afshari has nothing to disclose. Dr. Raizer has received personal compensation for activities with Genentech, Inc. and Novartis as a speaker and/or advisory board member.
A note on relocating the 1963 Watsonville earthquakes

abstract Events in the Watsonville earthquake sequence of August and September 1963 were found by Udias (1965) not to concentrate on the main San Andreas fault break. New locations are found using a more site-specific velocity model with carefully determined station adjustments. Resulting relocated hypocenters indicate that this sequence probably does not exhibit the anomalous spatial scatter found previously. The revised locations are found to be consistent with patterns of recent seismicity, based on dense network coverage, which show a tight coincidence with the San Andreas fault.
What the Colleges are doing about the Poorly Prepared Student

(1954). What the Colleges are doing about the Poorly Prepared Student. The American Mathematical Monthly: Vol. 61, No. 2, pp. 86-88.
Introduction to special section on Organizational Challenges in the Knowledge Society

I am pleased to have been asked to serve in the role of guest editor for this special section of the journal. I was honored to have been awarded a Senior Fulbright Scholar Fellowship to teach and work in Bucharest, Romania for the academic year 2012-2013. My host university, acoala Naþionala de Studii Politice oi Administrative, allowed me the enviable opportunity to have significant autonomy in my teaching and participation in other scholarly activities. As a result I learned certainly as much as I taught any of the graduate students in my classes. I am someone who has transformed my career several times, from clinical to consulting psychologist and from organizational consultant to academician. Always, people and their interactions with one another have been at the core of my interest. When those of us in the field of organizational behavior identify ourselves as working in the “human side of business”, cynical receivers of that comment scoff at the existence of a “human side” to business. Surely the preponderance of emphasis on financial gain and the ‘bottom line’ suggests that often the financial accounting carries more weight than attention to the people who do the work in organizations. And yet, as the articles in this special section – and indeed the majority of articles in all journals devoted to organizational behavior – indicate, there is great need to attend to the people who communicate, learn, share knowledge and skill, emote, plan, and are or are not engaged in the business of the organization. Any of the readers of this journal are well familiar with the history of human collectives – from agriculture/craft to industrialization to knowledge management. Readers are aware also of the transition in organizational emphasis from mechanistic, authoritative structures to more organic, participative structures. This evolution is certainly evident in the explosion of journal articles in the past decade on the topics of knowledge management, sustainability, transformational leadership and a host of other buzz words – all of which let us know we are talking about complex human interactions and complex systems of production. Despite our knowledge, schools of business “continue to treat the workplace and world as clockwork mechanisms too for the purpose of converting resources into shareholder value”. (Engdahl, 2005) And yet, as Engdahl impressively demonstrates, we do this 21 st century a great disservice to ignore what we are learning and teaching.
Reduction of nitric oxide to elemental nitrogen byThiobacillus Denitrificans: Scientific note

A need exists for new technology for the disposal of concentrated NOx streams obtained from certain regenerable, dry scrubbing processes, such as the NOXSO process, and the removal and disposal of NOx from more dilute gas streams produced by nitric acid plants. It has been demonstrated that the facultative anaerobe and autotroph, Thiobacillus denitrificans, may be cultured anaerobically in batch reactors using NO (g) as a terminal electron acceptor. Thiosulfate served as an energy source, CO2 (g) as a carbon source, and ammonium ion as a source of reduced nitrogen. The growth of T.denitrificans was indicated by depletion of thiosulfate and ammonium ion and the accumulation of biomass. The feed gas consisted of 5000 ppmv NO, 5%, CO2, and balance nitrogen. The NO concentration in the outlet gas was typically 200 ppmv.
Implicatures and evidentiality of because complements at syntax-semantics-pragmatics interfaces

The Japanese contrastive marker wa can appear within a because-clause as in (1a), while it cannot appear within temporal clauses like toki ‘when' as in (1b) and if-clauses (omitted for space reasons). (1) a. Itsumo uchi-ni Mary-wa kuru node kodomo-ga always house-Dat Mary-CTop come because, children-Nom yorokob-u. happy-Present ‘Because MaryCTop always comes to our house, the children are happy.' b. *Itsumo uchi-ni Mary-wa kuru toki, keeki-o motteku-ru. always house-Dat Mary-CTop come when, cake-Acc bring-Present ‘When MaryCTop comes to our house, she always brings a cake. Interestingly, the same asymmetry is found with an evidential morpheme. (2) a. Kodomo-ga kuru sounanode, oyatsu-o youi-shita. children-Nom come Evid because, sweets-Acc preparation-di ‘Because I heard that children are coming, I prepared sweets.' b. * Kodomo-ga kuru sounatoki, oyatsu-o youi-shita. children-Nom come Evid when, sweets-Acc preparation-did ‘When I heard that children are coming, I prepared sweets.'
Phase-only implementation of the complex screen technique for generating schell-model sources

In this paper, implementation of the complex screen approach for generating partially-coherent Schell-model sources using phase-only control, like that available using commercial-off-the-shelf liquid-crystal spatial light modulators, is presented. Previous techniques for generating Schell-model sources have used phase-only spatial light modulators in combination with amplitude filters to produce partially-coherent fields. Using amplitude filters complicates the optical set-up and significantly reduces the flexibility of the system. Here, both analytically and with simulations, it is shown that both the amplitude and phase of the source field can be manipulated using phase-only control. This contribution removes the need to use amplitude filters, thereby simplifying the optical set-up and increasing the system's flexibility.
Collection of hematopoietic CD34 stem cells in rhesus macaques using Spectra Optia.

Background Nonhuman primates, particularly rhesus macaques, are ideal preclinical large animal models to investigate organ tolerance induction protocols using donor hematopoietic stem cells (HSCs) to induce chimerism. Their relatively small size poses some challenges for the safe and effective collection of peripheral blood HSCs through apheresis procedures. We describe our experiences using the Spectra Optia apheresis unit to successfully obtain HSCs from mobilized peripheral blood of rhesus macaques. Method Mobilization of peripheral blood HSCs was induced using granulocyte stimulating factor (G-CSF) and Mozobil. The Spectra Optia unit was used in 18 apheresis procedures in 13 animals (4.9–10 kg). Animal health was carefully monitored during and after the procedure. Changes in peripheral blood cells before, during and after procedure were determined by complete blood count and flow cytometry. Results The automatic settings of the Spectra Optia unit were applied successfully to the procedures on the rhesus macaque. All animals tolerated the procedure well with no mortality. Mobilization of HSCs were most consistently achieved using 50 μg/kg of G-CSF for 5 days and a single dose of Mozobil on the 5th day, followed by collection of cells 3 h after Mozobil injection. The final apheresis product contained an average of 23 billion total nucleated cells with 47% granulocytes, 3,871 million total CD3 cells and 77 million CD34 cells which resulted in an average of 10 million CD34+ cells/kg of donor weight. Conclusion Apheresis of peripheral blood mobilized HSCs in rhesus macaques using Spectra Optia is a safe and effective procedure.
Optical physics: Speedy electrons exposed in a flash.

A link has been established between high-frequency light emissions and electron oscillations induced in an insulator by a laser. This is a key step in efforts to make electronic devices that work faster than is currently possible. See Letter p.359 The speed of electronics, and hence of computing, is limited by the frequencies of the electric currents that are used. Light fields can induce and manipulate electric currents at vastly higher frequencies than are achievable in conventional devices, and Eleftherios Goulielmakis and colleagues now extend this approach to reach an even faster regime. They use single-cycle intense optical fields to drive electron motion in the bulk of silicon dioxide and show that the light-induced intraband electric currents extend in frequency up to about eight petahertz. This demonstration of real-time access to the dynamic nonlinear conductivity of silicon dioxide, with the ability to directly probe and control the intraband currents on attosecond timescales, establishes intense light fields as a platform for multi-petahertz coherent electronics and points to new opportunities for fundamental studies of electron dynamics in condensed matter.
Hans Richter, Hugo Ball, 1917

Hans Richter, who arrived in Zurich in September 1916, did not participate in any of the soirees at the Cabaret Voltaire, but he exhibited his work at the “Erste Dada-Ausstellung” (First Dada Exhib...
Overall Survival of Lymphoma Patients In Randomized Controlled Trials Comparing Primary G-CSF Chemotherapy Support to Control.

Abstract 1502 Background Randomized controlled trials (RCTs) have shown that granulocyte colony-stimulating factor (G-CSF) can reduce the risk of neutropenic complications as well as early mortality (Kuderer et al. JCO 2007). The impact of G-CSF support of chemotherapy on overall survival in patients with lymphoma is assessed here in a systematic review of RCTs of chemotherapy with versus without G-CSF in studies with at least 2 years of follow up. Methods A systematic review of RCTs of patients with malignant lymphoma receiving chemotherapy with versus without primary G-CSF support and reporting overall mortality by study arm identified 16 eligible studies. Data extraction was conducted by two independent reviewers. Heterogeneity was evaluated using Cochran's Q-statistic and the Inconsistency Index (I2). Weighted summary estimates of relative risk (RR) and absolute risk (AR) were based on the method of Mantel and Haenszel. Chemotherapy relative dose intensity (RDI) with G-CSF support compared to control was meta-regressed on the logarithm of RR for mortality. Egger's regression intercept was utilized to assess publication bias. Results Sixteen (16) eligible RCTs of patients receiving chemotherapy with (n=2,731) versus without (n=2,757) primary G-CSF support were identified. Deaths were reported in 927 patients randomized to receive primary G-CSF and in 1,064 controls. No significant heterogeneity was observed (Q=12.50, P=.641; I2=0%). Overall RR for mortality with versus without G-CSF support of chemotherapy was 0.876 [95% CI: 0.822 – 0.935; P<.001]. The AR reduction for mortality in G-CSF-supported patients versus control was 4.8% [95% CI: 2.4% - 7.15; P<.001]. An inverse trend was observed between the difference in RDI between treatment arms and RR for mortality [Slope = -0.39; 95% CI: -0.78 – 0.01; P=.057]. The greatest reduction in mortality was observed in the 5 RCTs of dose dense chemotherapy [RR=0.830; 95% CI:0.742-0.930; P=.001]. Significant treatment effect was observed in 7 studies limited to older patients [RR=0.910;95% CI: 0.847–0.978;P=.010] and 9 permitting all adult age groups [RR=0.813;95% CI: 0.715–0.926;P=.002]. No difference in treatment effect was observed based on study funding source and no evidence for publication bias was observed. Conclusions A highly significant reduction in overall mortality was associated with G-CSF support compared to control in 16 RCTs of lymphoma patients receiving chemotherapy. Patients receiving greater RDI with G-CSF support, especially those receiving dose dense regimens, experienced the greatest reduction in mortality. Disclosures: Lyman: Amgen: Research Funding. Crawford: Amgen: Consultancy. Dale: Amgen: Consultancy, Research Funding.
Article 22 [Respect for Privacy]

At the first stage of negotiations, current Article 22 was not a stand-alone provision but it was merged into the article on the respect for home and the family. During negotiations, delegations agreed to split this article into two separate provisions, following the model of other human rights treaties, and to use the language of Article 17 of the ICCPR for the norm on the right to privacy.
Copper CMP Model Based Upon Fluid Mechanics and Surface Kinetics

The trend to replace aluminum with copper in IC interconnects requires that CMP be used to planarize the copper which has been deposited into RIE-patterned structures. Therefore, in this chapter, we discuss and develop a copper CMP model which predicts wafer-scale removal rate based on mass-transport theory and surface kinetic steps. The model seems to capture the essential features of the planarization of copper, and is very similar to the surface reaction kinetics model developed for low-κ CMP in Chapter 6. The model computes the concentration of the chemical reactant in the slurry using a convective diffusive mass transport equation. Surface kinetic equations are used to model the chemical reaction and mechanical abrasion processes at the wafer surface during CMP. The model approach for the CMP of copper is based upon a recent paper [7.1] and a PhD thesis [7.2]. The approach used here incorporates the fundamentals of pad/abrasive contact into the lubrication and mass transport process. It extends upon the low-κ CMP model developed previously, and may find applicability to dielectrics and other metals with well-known chemical reaction kinetics.
A Comparative Clinical Study between Intravenous Esmolol and Lignocaine in Attenuation of Haemodynamic Responses during Extubation: A Double Blind Prospective Randomised Comparative Study

Extubation is associated with hemodynamic responses similar to intubation, like hypertension, tachycardia and arrhythmias. Many a times extubation period is stormier than during intubation. In this study, we compared a single bolus dose of i.v. esmolol and i.v. lignocaine on these adverse hemodynamic responses to extubation.
Symmetrization Techniques in Relativistic OPW Energy Band Calculations

Definite advantages can be attained by the use of crystalline symmetry properties in calculations of energy bands. In particular, dramatic savings in computer time and core storage requirements can be realized. In this paper, we give some observations relevant to the Orthogonalized-Plane-Wave (OPW) method. Many of these observations are equally relevant to other computational techniques. Mattheiss, Wood, and Switendick1 have outlined the use of symmetry in the Augmented-Plane-Wave (APW) method. A well-known disadvantage of the OPW method is the slow convergence of the wave function expansion.2 Our experience with group IV, III–V, and II–VI semiconducting crystals indicates that at least 229 plane waves must be used (usually many more) to obtain convergence. Hence, an eigenvalue problem of at least order 229 must be solved to find eigenvalues and eigenvectors. This is a time-consuming task on the computer. The problem is even more difficult in the relativistic OPW formalism where spin doubles the order of the matrices.
Robustness of Evolvability.

A framework for analyzing the computational capabilities and the limitations of the evolutionary process of random change guided by selection was recently introduced by Valiant [Val06]. In his framework the process of acquiring a complex functionality is viewed as a constrained form of PAC learning. In addition to the basic definition, a number of natural variants of the evolvability model were introduced by Valiant, and several others have been suggested since then [Val09, Mic07, Val08]. Understanding the relative power of these variants in terms of the efficiently evolvable function classes they define is one of the main open problems regarding the model [Val09, FV08]. We present several results that collectively demonstrate that the notion of evolvability is robust to a variety of reasonable modifications of the model. Our results show that the power of a model of evolvability essentially depends only on the fitness metric used in the model. In particular, we prove that the classes of functions evolvable in Valiant’s original model are also evolvable with substantially weaker and simpler assumptions on the mutation algorithm and the selection rule and therefore a wide range of models of evolution are equivalent. Another consequence of our results if that evolvability with the quadratic loss fitness metric (or any other non-linear loss) is strictly stronger than evolvability with the linear loss fitness metric used in Valiant’s basic definition.
FinFET External Resistance Analysis by Extended Shift-and-Ratio Method

Extraction and analysis of external resistance ( ${R}_{\textsf {ext}}$ ) have become increasingly important in modern CMOS technology research. We show that with certain assumptions, the well-known shift-and-ratio method can be extended and still be useful for ${R}_{\textsf {ext}}$ extraction in short-channel devices. Its application to advanced FinFET devices in both simulation and hardware is presented.
La teoría del lenguaje del primer Romanticismo alemán y su repercusión en Nietzsche y Foucault

En palabras de su autor, este articulo procura, de una manera cordial con Foucault, rellenar un vacio dejado en Las palabras y las cosas. En concreto, Ernst Behler recupera aqui la importancia que el pensador frances le diera al lenguaje en su obra como sintoma privilegiado del transito entre Ilustracion y Romanticismo, para asi investigar mas a fondo sus implicaciones en la teoria linguistica del primer Romanticismo aleman y la filosofia de Nietzsche.
Kanaka 'Ōiwi Critical Race Theory: Historical and Cultural Ecological Understanding of Kanaka 'Ōiwi Education

The effects of colonization on Kanaka 'Ōiwi, the Indigenous people of Hawai'i, have led to the systematic distancing of Kanaka 'Ōiwi from their cultural ways of knowing, replacing it, instead with eurocentric standards of education that adversely impact Kanaka 'Ōiwi wellbeing. In this article, I provide an overview of the history of colonization of Kanaka 'Ōiwi through a critical race lens. Critical Race Theory and TribalCrit are reviewed in relation to their theoretical relevance to Kanaka 'Ōiwi epistemologies. A synthesis model of an adapted CRT and TribalCrit framework called, Kanaka'ŌiwiCrit is presented and discussed within the context of education as a space for resistance.
Protecting Life While Preserving Liberty: Ethical Recommendations for Suicide Prevention With Artificial Intelligence

In the United States, suicide increased by 24% in the past 20 years, and suicide risk identification at point-of-care remains a cornerstone of the effort to curb this epidemic (1). As risk identification is difficult because of symptom under-reporting, timing, or lack of screening, healthcare systems rely increasingly on risk scoring and now artificial intelligence (AI) to assess risk. AI remains the science of solving problems and accomplishing tasks, through automated or computational means, that normally require human intelligence. This science is decades-old and includes traditional predictive statistics and machine learning. Only in the last few years has it been applied rigorously in suicide risk prediction and prevention. Applying AI in this context raises significant ethical concern, particularly in balancing beneficence and respecting personal autonomy. To navigate the ethical issues raised by suicide risk prediction, we provide recommendations in three areas-communication, consent, and controls-for both providers and researchers (2).
Evaluating Motivational Interviewing and Habit Formation to Enhance the Effect of Activity Trackers on Healthy Adults’ Activity Levels: Randomized Intervention

Background: While widely used and endorsed, there is limited evidence supporting the benefits of activity trackers for increasing physical activity; these devices may be more effective when combined with additional strategies that promote sustained behavior change like motivational interviewing (MI) and habit development. Objective: This study aims to determine the utility of wearable activity trackers alone or in combination with these behavior change strategies for promoting improvements in active and sedentary behaviors. Methods: A sample of 91 adults (48/91 female, 53%) was randomized to receive a Fitbit Charge alone or in combination with MI and habit education for 12 weeks. Active and sedentary behaviors were assessed pre and post using research-grade activity monitors (ActiGraph and activPAL), and the development of habits surrounding the use of the trackers was assessed postintervention with the Self-Reported Habit Index. During the intervention, Fitbit wear time and activity levels were monitored with the activity trackers. Linear regression analyses were used to determine the influence of the trial on outcomes of physical activity and sedentary time. The influence of habits was examined using correlation coefficients relating habits of tracker use (wearing the tracker and checking data on the tracker and associated app) to Fitbit wear time and activity levels during the intervention and at follow-up. Results: Regression analyses revealed no significant differences by group in any of the primary outcomes (all P>.05). However, personal characteristics, including lower baseline activity levels (beta=–.49, P=.01) and lack of previous experience with pedometers (beta=–.23, P=.03) were predictive of greater improvements in moderate and vigorous physical activity. Furthermore, for individuals with higher activity levels at the baseline, MI and habit education were more effective for maintaining these activity levels when compared with receiving a Fitbit alone (eg, small increase of ~48 steps/day, d=0.01, vs large decrease of ~1830 steps/day, d=0.95). Finally, habit development was significantly related to steps/day during (r=.30, P=.004) and following the intervention (r=.27, P=.03). Conclusions: This study suggests that activity trackers may have beneficial effects on physical activity in healthy adults, but benefits vary based on individual factors. Furthermore, this study highlights the importance of habit development surrounding the wear and use of activity trackers and the associated software to promote increases in physical activity. Trial Registration: ClinicalTrials.gov NCT03837366; https://clinicaltrials.gov/ct2/show/NCT03837366
Etiological factors in space motion sickness.

The human susceptibility to motion sickness during exposure to sudden-stop stimulation as a function of gravitoinertial force level is studied. It is determined that susceptibility is greatly enhanced, both with eyes-closed and eyes-open, for zero-g and 2-g conditions in parabolic flight compared with 1-g test conditions. It is argued that this change in susceptibility is related to alterations in vestibulo-occular function which result from variations in gravitoinertial force level, the altered patterns of otolithic activity resulting during variations in gravitoinertial force level, and the altered canal-otolith response synergies that result during exposure to gravitoinertial force levels greater or less than terrestrial levels. These factors are found to be related to the etiology of space motion sickness and to the alterations in performance and vestibular function that are experienced by astronauts during reentry. An explanation is presented for the decrease in susceptibility to motion sickness exhibited by the Skylab astronauts inflight and for some period postflight during exposure to cross-coupled angular accelerations.
Patients with Physiologically Normal Hearts and Lungs

This chapter presents drawn data from a number of interesting and informative cases focusing on patients with physiologically normal hearts and lungs.
Does Physical Therapy Matter among Heart Transplant Recipients While on Intra-Aortic Balloon Pumps in the Pretransplant Period?

Objectives Femoral insertion has a limitation regarding patient mobility thus prolonged bedrest and immobilization of the insertion site until transplantation. Prolonged femoral IABP support increases the risk for profound deconditioning, increases time to functional recovery and increases the risk of comorbidities. The objective was to assess the effectiveness of a tilting PT treatment protocol for patients who are awaiting heart transplantation as status 1A on IABP support via the femoral artery. The tilting protocol consists of supervised PT while the patient's bed is in a progressively increased angle using a VitalGo bed (VitalGo Systems Ltd., Fort Lauderdale, FL). We hypothesized that the benefits of this tilting program would promote weight-bearing for improved lower extremity strength and assist with acclimation to the upright position, thus decreasing the effects of orthostatic intolerance. The benefits should translate to a higher likelihood to be discharged to home as opposed to rehab and shorter length-of-stay [LOS] post-transplant. Methods We retrospectively reviewed charts from a single heart and vascular center over five years (January 2013-January 2018). Included patients were adults (>18) who were admitted with a cardiogenic shock or advanced heart failure diagnosis, placed on femoral IABP >15 days, had a transplant status of 1A, and received a PT consult. We compared outcomes (discharge location, LOS) from patients who participated in little to no (standard) physical therapy versus those who performed the tilting PT treatment protocol using a standard t-test. 12 patients met inclusion criteria. Six patients (4 men, 2 women, mean age 54.5 ± 13.9 years) received the tilting PT treatment protocol using VitalGo beds. Six patients (5 men, 1 women, mean age 47.1 ± 10.9 years) received standard physical therapy and served as the control group. Results In the tilting protocol group, 4 patients were discharged home and 2 were discharged to rehab. In the control group, 3 were discharged home and 3 were discharged to rehab. The average post-transplant LOS was significantly different; the tilting protocol group had an average LOS of 15.1± 9.26 days compared to an average of 29.8 ± 9.76 days in the control group (p=0.03). Conclusions While discharge result differences could not be established between the two groups, LOS post-transplant was significantly improved when the tilting PT program was implemented. Further, all supervised PT in patients (regardless of bed position) with femoral insertion of IABP did not result in access site complications, thrombosis or arrhythmias. Further study with a larger patient population is needed to confirm these findings and to investigate the impact of the tilting PT protocol on quality of life. Confirmation of this data would mean improved outcomes for patients along with decreased medical costs of recovery.
The family planning quotient and reproductive life index (FPQ/RepLI) tool: a solution for family planning, reproductive life planning and contraception counseling

Access to comprehensive and culturally appropriate reproductive life planning is essential to women’s health. Although many strategies and tools exist, few are designed for longitudinal use or provide visual aids. Our objective is to present the Family Planning Quotient (FPQ) and Reproductive Life Index (RepLI) (FPQ/RepLI) tool we created to facilitate the discussion of family planning and reproductive life goals between patients and providers and to provide a summary our evaluation of the tool. This tool was developed as a response to the Centers for Disease Control and Prevention’s charge of developing a tool that could help facilitate reproductive life planning by giving the patient a better understanding of their reproductive goals and trajectory. This cross-sectional evaluation of our tool took place with patients and providers at an urban, public hospital in Chicago. Patients spoke with a health educator about their sexual, gynecological, and obstetric history to complete the FPQ/RepLI tool. Our primary objective was to measure the proportion of women who indicated the tool was helpful and that they would use it to track their reproductive goals. Patients and providers completed an evaluation survey rating their satisfaction with the tool. Survey responses were summarized using frequencies and percentages. During the study, 790 patients completed the evaluation.. Most patients (n = 725, 91.9%) agreed that the tool was helpful and that they would use it to track their reproductive goals. Fifty-five (83.5%) providers agreed that there is a need for reproductive health tools in clinical practice. Most agreed that the tool helped the patient communicate goals, aided in educating about contraception, and facilitated the discussion and decision-making process about available contraceptives. The tool gives patients a resource for family and reproductive goal planning. Broad dissemination amongst other medical specialties beyond obstetrics and gynecology may make reproductive life planning accessible to more women.
Ex Vivo Graft Purging and Expansion of Autologous Mobilized Peripheral Blood Progenitor Cell (PBPC) Products from Patients with Multiple Myeloma (MM).

Introduction: Autologous PBPC transplantation has become the treatment of choice for selected MM patients. Autografts are often contaminated with MM cells which could be a source of post-transplant relapse. We elected to develop a graft manipulation procedure to purge tumor cells from the autograft without compromising its normal reconstituting activity. Previous studies have shown that bortezomib (Velcade, Millenium Pharmaceuticals, Inc., Cambridge, MA) can kill CD138+ MM cells, with little effect on CD138− B cells. However, the anti-CD20 monoclonal antibody, rituximab (Rituxan, Genentech, Inc., San Francisco, CA) has been shown to kill CD138− B cells, the putative MM “stem cells” population. Therefore we investigated whether an optimized combination of bortezomib and rituximab might effectively eradicate tumor cells from PBPC products. Previous studies[1][1] have also suggested that tumor cells can also be selectively purged by ex vivo culture while expanding the normal hematopoietic progenitors. Thus, we incorporated an ex vivo culture step to optimize MM cell depletion and expansion of the reconstituting normal progenitors. Methods: CD138+ cells were depleted from the thawed PBPC of MM patients using the midiMACS device (Miltenyi Inc, Auburn, CA). The CD138− cells were treated for 24 hrs with 10 or 20 μg/ml rituximab followed by 20nM or 80nM bortezomib for 16hrs. Cells were then washed and ex vivo- expanded using an allogeneic normal marrow donor-derived mesenchymal stem cell (MSC) co-culture technique as previously reported.[2][2] At the end of culture, cells were evaluated for total viable cells, expression of CD138, CD20, CD19, CD34, CD45 by flow cytometry and colony-forming cell (CFC) content in methylcellulose assays (StemCell Technologies, Vancouver, BC). Results: CD138+, CD138−/CD20+ or CD138−/CD20+/CD19+ cells were depleted in the MM PBPC products from patients when treated with bortezomib (20nM) and rituximab (20 μg/ml) followed by ex vivo culture.(Fig 1) Compared with input control, TNC increased by 6–72 fold and absolute numbers of CD34+ cells increased by approximately 3–9 fold. (See representative data Fig 2) Conclusion: Treating CD138-depleted MM PBPC products with bortezomib, rituximab and 2 weeks of ex vivo culture depleted CD138+ malignant plasma cells and CD138− B cells (MM “stem cells”). An estimated >4 log tumor depletion from a mobilized PBPC product was achieved, while the use of ex vivo expansion culture not only preserved but increased the number of normal hematopoietic progenitors. Further refinements of this procedure are in progress and will be tested clinically. ![Figure][3] Figure ![Figure][3] Figure [1]: #ref-1 [2]: #ref-2 [3]: pending:yes
Functional independence, access to kidney transplantation and waitlist mortality

Background Approximately half of the patients who progress to end-stage kidney disease (ESKD) and undergo dialysis develop difficulties carrying out essential self-care activities, leading to institutionalization and mortality. It is unclear what percentage of kidney transplant (KT) candidates, a group of ESKD patients selected to be healthy enough to withstand transplantation, are functionally independent and whether independence is associated with better access to KT and reduced waitlist mortality. Methods We studied a prospective cohort of 3168 ESKD participants (January 2009 to June 2018) who self-reported functional independence in more basic self-care Activities of Daily Living (ADL) (needing help with eating, dressing, walking, grooming, toileting and bathing) and more complex instrumental ADL (IADL) (needing help using a phone, shopping, cooking, housework, washing, using transportation, managing medications and managing money). We estimated adjusted associations between functional independence (separately) and listing (Cox), waitlist mortality (competing risks) and transplant rates (Poisson). Results At KT evaluation, 92.4% were independent in ADLs, but only 68.5% were independent in IADLs. Functionally independent participants had a higher chance of listing for KT [ADL: adjusted hazard ratio (aHR) = 1.55, 95% confidence interval (CI) 1.30-1.87; IADL: aHR = 1.39, 95% CI 1.26-1.52]. Among KT candidates, ADL independence was associated with lower waitlist mortality risk [adjusted subdistribution HR (aSHR) = 0.66, 95% CI 0.44-0.98] and higher rate of KT [adjusted incidence rate ratio (aIRR) = 1.58, 95% CI 1.12-2.22]; the same was not observed for IADL independence (aSHR = 0.86, 95% CI 0.65-1.12; aIRR = 1.01, 95% CI 0.97-1.19). Conclusions Functional independence in more basic self-care ADL was associated with better KT access and lower waitlist mortality. Nephrologists, geriatricians and transplant surgeons should screen KT candidates for ADLs, and identify interventions to promote independence and improve waitlist outcomes.
Inhibition of Growth of TSC2-Null Cells by a PI3K/mTOR Inhibitor but Not by a Selective MNK1/2 Inhibitor

Lymphangioleiomyomatosis (LAM) is a rare metastatic cystic lung disease due to a mutation in a TSC tumor suppressor, resulting in hyperactive mTOR growth pathways. Sirolimus (rapamycin), an allosteric mTORC1 inhibitor, is a therapeutic option for women with LAM but it only maintains lung volume during treatment and does not provide benefit for all LAM patients. The two major mTORC1 protein synthesis pathways are via S6K/S6 or 4E-BP/eIF4E activation. We aimed to investigate rapamycin in combination with compounds that target associated growth pathways, with the potential to be additive to rapamycin. In this study we demonstrated that rapamycin, at a clinically tolerable concentration (10 nM), inhibited the phosphorylation of S6, but not the critical eIF4E releasing Thr 37/46 phosphorylation sites of 4E-BP1 in TSC2-deficient LAM-derived cells. We also characterized the abundant protein expression of peIF4E within LAM lesions. A selective MNK1/2 inhibitor eFT508 inhibited the phosphorylation of eIF4E but did not reduce TSC2-null cell growth. In contrast, a PI3K/mTOR inhibitor omipalisib blocked the phosphorylation of Akt and both S6K/S6 and 4E-BP/eIF4E branches, and additively decreased the growth of TSC2-null cells with rapamycin. Omipalisib, or another inhibitor of both major mTORC1 growth pathways and pAkt, might provide therapeutic options for TSC2-deficient cancers including, but not limited to, LAM.
Brain and placental transcriptional responses as a readout of maternal and paternal preconception stress are fetal sex specific.

Abstract Introduction Despite a wealth of epidemiological evidence that cumulative parental lifetime stress experiences prior to conception are determinant of offspring developmental trajectories, there is a lack of insight on how these previous stress experiences are stored and communicated intergenerationally. Preconception experiences may impact offspring development through alterations in transcriptional regulation of the placenta, a major determinant of offspring growth and sex-specific developmental outcomes. We evaluated the lasting influence of maternal and paternal preconception stress (PCS) on the mid-gestation placenta and fetal brain, utilizing their transcriptomes as proximate readouts of intergenerational impact. Methods To assess the combined vs. dominant influence of maternal and paternal preconception environment on sex-specific fetal development, we compared transcriptional outcomes using a breeding scheme of one stressed parent, both stressed parents, or no stressed parents as controls. Results Interestingly, offspring sex affected the directionality of transcriptional changes in response to PCS, where male tissues showed a predominant downregulation, and female tissues showed an upregulation. There was also an intriguing effect of parental sex on placental programming where paternal PCS drove more effects in female placentas, while maternal PCS produced more transcriptional changes in male placentas. However, in the fetal brain, maternal PCS produced overall more changes in gene expression than paternal PCS, supporting the idea that the intrauterine environment may have a larger overall influence on the developing brain than it does on shaping the placenta. Discussion Preconception experiences drive changes in the placental and the fetal brain transcriptome at a critical developmental timepoint. While not determinant, these altered transcriptional states may underlie sex-biased risk or resilience to stressful experiences later in life.