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Knowledge graphs have become a common approach for knowledge representation. Yet, the application of graph methodology is elusive due to the sheer number and complexity of knowledge sources. In addition, semantic incompatibilities hinder efforts to harmonize and integrate across these diverse sources. As part of The Biomedical Translator Consortium, we have developed a knowledge graph–based question-answering system designed to augment human reasoning and accelerate translational scientific discovery: the Translator system. We have applied the Translator system to answer biomedical questions in the context of a broad array of diseases and syndromes, including Fanconi anemia, primary ciliary dyskinesia, multiple sclerosis, and others. A variety of collaborative approaches have been used to research and develop the Translator system. One recent approach involved the establishment of a monthly “Question-of-the-Month (QotM) Challenge” series. Herein, we describe the structure of the QotM Challenge; the six challenges that have been conducted to date on drug-induced liver injury, cannabidiol toxicity, coronavirus infection, diabetes, psoriatic arthritis, and ATP1A3-related phenotypes; the scientific insights that have been gleaned during the challenges; and the technical issues that were identified over the course of the challenges and that can now be addressed to foster further development of the prototype Translator system. We close with a discussion on Large Language Models such as ChatGPT and highlight differences between those models and the Translator system.
Our aim was to outline a procedure for obtaining a rapid autopsy in order to collect high-quality postmortem tissue for genomic analysis.
Methods:
This report details a bi-institutional collaborative effort to coordinate a rapid autopsy for a pediatric patient who had died at home. We discuss the scientific rationale for offering a rapid autopsy to caregivers of pediatric patients as well as parental perspectives on broaching the subject of autopsy. We then review the logistics and coordination involved with planning a rapid autopsy and the sequence of events needed to maximize tissue quality.
Results:
We report the successful coordination of a rapid autopsy for a patient who died in a hospice setting at her out-of-state home. The time interval from death to the start of the rapid autopsy procedure was 4.5 hours, despite the logistical considerations demanded by the location of the patient. Tumor aliquots and nonneoplastic tissues were successfully snap frozen for downstream genomic studies.
Significance of Results:
Physicians should consider trialing a rapid autopsy program at their institution that could be offered to caregivers of pediatric patients. This case report offers a framework to help clinicians develop their own rapid autopsy programs as well as guidelines to help streamline this process for appropriate candidates going forward.
Objectives: This study examined whether children with distinct brain disorders show different profiles of strengths and weaknesses in executive functions, and differ from children without brain disorder. Methods: Participants were children with traumatic brain injury (N=82; 8–13 years of age), arterial ischemic stroke (N=36; 6–16 years of age), and brain tumor (N=74; 9–18 years of age), each with a corresponding matched comparison group consisting of children with orthopedic injury (N=61), asthma (N=15), and classmates without medical illness (N=68), respectively. Shifting, inhibition, and working memory were assessed, respectively, using three Test of Everyday Attention: Children’s Version (TEA-Ch) subtests: Creature Counting, Walk-Don’t-Walk, and Code Transmission. Comparison groups did not differ in TEA-Ch performance and were merged into a single control group. Profile analysis was used to examine group differences in TEA-Ch subtest scaled scores after controlling for maternal education and age. Results: As a whole, children with brain disorder performed more poorly than controls on measures of executive function. Relative to controls, the three brain injury groups showed significantly different profiles of executive functions. Importantly, post hoc tests revealed that performance on TEA-Ch subtests differed among the brain disorder groups. Conclusions: Results suggest that different childhood brain disorders result in distinct patterns of executive function deficits that differ from children without brain disorder. Implications for clinical practice and future research are discussed. (JINS, 2017, 23, 529–538)
A 29 year old man had an accessory branch of the superficial peroneal nerve which entered the foot by rostro-caudally traversing the lateral malleolus laterally. The nerve was entrapped by a fascial band, resulting in pain over the lateral malleolus and dorsum of foot. Symptoms resolved when the nerve was surgically released.
Whether contact precautions (CP) are required to control the endemic transmission of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) in acute care hospitals is controversial in light of improvements in hand hygiene, MRSA decolonization, environmental cleaning and disinfection, fomite elimination, and chlorhexidine bathing.
OBJECTIVE
To provide a framework for decision making around use of CP for endemic MRSA and VRE based on a summary of evidence related to use of CP, including impact on patients and patient care processes, and current practices in use of CP for MRSA and VRE in US hospitals.
DESIGN
A literature review, a survey of Society for Healthcare Epidemiology of America Research Network members on use of CP, and a detailed examination of the experience of a convenience sample of hospitals not using CP for MRSA or VRE.
PARTICIPANTS
Hospital epidemiologists and infection prevention experts.
RESULTS
No high quality data support or reject use of CP for endemic MRSA or VRE. Our survey found more than 90% of responding hospitals currently use CP for MRSA and VRE, but approximately 60% are interested in using CP in a different manner. More than 30 US hospitals do not use CP for control of endemic MRSA or VRE.
CONCLUSIONS
Higher quality research on the benefits and harms of CP in the control of endemic MRSA and VRE is needed. Until more definitive data are available, the use of CP for endemic MRSA or VRE in acute care hospitals should be guided by local needs and resources.
Infect Control Hosp Epidemiol 2015;36(10):1163–1172
Drawing from fields such as marketing psychology, strategy, social psychology, and organizational behavior, the present examination explores the individual and organizational bases for personal reputation; specifically, how different bases interact with one another to produce an individual’s reputation within organizations. It is proposed that individuals use personal reputations to satisfy their need for positive self-esteem as well as to secure their sense of belonging in organizations. Furthermore, reputation allows individuals to obtain rewards such as autonomy, power, and career success and the opportunity to signal key information to audiences. Likewise, organizations utilize personal reputations to predict their members’ behaviors, market those who are a part of the organization to others, build their own corporate reputations, and signal information to consumers and competitors. To further this understanding of personal reputation an examination is presented as to how organizations serve as an essential context within which individuals realize their personal reputations and regulate their behavior.
Fatty acid transport protein 6 (FATP6) is primarily expressed in the heart and seems to be involved in cardiac fatty acid uptake. Therefore, we investigated whether a variation in the 5′-untranslated region of the FATP6 gene is associated with features of the metabolic syndrome and signs of myocardial alteration or heart failure. A total of 755 male participants from a Metabolic Intervention Cohort Kiel were genotyped for the FATP6–7T>A polymorphism (rs2526246) and phenotyped for features of the metabolic syndrome. Participants underwent a glucose tolerance test and the postprandial assessment of metabolic variables after a standardised mixed meal. Left ventricular heart function was evaluated in fifty-four participants. Fasting (P = 0·01) and postprandial (P = 0·02) TAG concentrations were significantly lower in AA homozygotes when compared with wild-type carriers. Homozygosity of allele A was associated with significantly lower postprandial insulin concentrations after a glucose load and significantly lower systolic (P = 0·01) and diastolic (P = 0·01) blood pressure values compared with wild-type carriers. Accordingly, left ventricular heart mass was significantly lower in twenty-seven AA homozygotes in comparison with twenty-seven TT homozygotes, matched for BMI (P = 0·04). In conclusion, the effects of the FATP6 polymorphism on TAG are mediated by affluent dietary fat. The FATP6–7T>A polymorphism may protect from traits of the metabolic syndrome and CVD.
The demand for safe, effective, long-lasting, and biocompatible dermal filler materials is increasing as a growing number of patients seek minimally invasive options for aesthetic improvement. For a substance or device to be amenable for soft tissue augmentation, in addition to producing the desired cosmetic results, the product must be well tolerated, exhibit a minimum of undesirable reactions, and be nonteratogenic, noncarcinogenic, and nonmigratory. In addition, the material or device must be easy to use and provide predictable, persistent correction through reproducible implantation techniques. Finally, in the United States, the Food and Drug Administration (FDA) review and approval of such products not only substantiates they meet safety and efficacy requirements but also assures adherence to important manufacturing and product labeling requirements postapproval.
Numerous attempts have been made to develop safe biological (e.g., collagen, hyaluronic acid) or synthetic (man-made) materials to fill unwanted wrinkles and scars. Currently, in the United States, there are about twelve or more different soft tissue fillers approved for cosmetic use; in Europe, there are approximately eighty CE marked approved cosmetic fillers with many more available worldwide. Historically, biologic filler materials that use “natural-based” core substances such as collagen and hyaluronic acid materials have predominated the marketplace. These materials, whether they are derived from a bioengineered or extracted from a natural source, typically have been modified to improve tolerability (e.g., removal of impurities) and modified to improve durability (e.g., cross-linked).
The purpose of this study is to examine the relations among maternal depression, security of attachment, and peer interactive behaviors in early childhood. Drawing from the literature, we posited that socially inhibited play behaviors in childhood would be associated with maternal depression as well as with an insecure mother-child attachment relationship. Forty-three 5-year-olds and their mothers participated in the study. There were 21 depressed and 22 affectively well mothers. Security of attachment was assessed via a variation of the Strange Situation procedure when the children were 2 years old. At 5 years of age the children were observed during free play with a familiar same-sex agemate. Results supported the hypotheses that social inhibition is associated with maternal depression and with an insecure mother-infant attachment relationship.
As millisecond annealing is increasingly utilized, the as-implanted profile dominates the final dopant distribution. We characterized boron diffusion in amorphous silicon prior to post-implantation annealing. SIMS confirmed that both fluorine and germanium enhance boron motion in amorphous materials. The magnitude of boron diffusion in germanium amorphized silicon scales with increasing fluorine dose. Boron atoms are mobile at concentrations approaching 1x1019 atoms/cm^3. It appears that defects inherent to the structure of amorphous silicon can trap and immobilize boron atoms at room temperature, but that chemical reactions involving Si-F and Si-Ge eliminate potential trapping sites. Sequential Ge+, F+, and B+ implants result in 80% more boron motion than do sequential Si+, F+, and B+ implants. The mobile boron dose and trapping site concentration change as functions of the fluorine dose through power law relationships. As the fluorine dose increases, the trapping site population decreases and the mobile boron dose increases. This reduction in trap density can result in as-implanted “junction depths” that are as much as 75% deeper (taken at 1x1018 atoms/cm-3) for samples implanted with 500 eV, 1x1015 atoms/cm2 boron.
Severe chronic pulmonary hypertension develops in patients with congenital cardiovascular abnormalities, patients with thromboembolism, interstitial lung diseases, collagen-vascular disorders, patients with sickle cell disease and in a group of diseases summarized under the rubric of primary pulmonary hypertension [1–3]. Although the prevalence of severe pulmonary hypertension in the population is not known, there are estimates that the prevalence of primary pulmonary hypertension (PPH) is 1–2 per million people. The use of the term ‘primary pulmonary hypertension’ continues to produce confusion among patients, physicians and insurance providers. Attempts should be made to change the nomenclature. Recently, our group has made such an attempt [4]. One of the many vexing aspects of PPH and other forms of plexogenic pulmonary arteriopathy is the multifactorial aetiology of such diseases.
Figure 4.1 demonstrates that a familial genetic disposition to high blood flow, elevated shear stress, collagenvascular diseases, liver cirrhosis and portal hypertension, viral infections and appetite suppressant drugs [5–13] can all lead to the same histopathological pattern. How is this possible? Is there a common pathomechanism that can explain such a multifaceted aetiology? In search of a ‘unifying’ hypothesis, we arrived at the concept of ‘misguided angiogenesis’.
Pathobiology
Vasoconstriction or increased blood flow, and therefore increased shear stress, causes vascular injury, and either this vascular injury carries inflammatory features [14] or there is endothelial cell proliferation, autonomously triggered in the pulmonary precapillary arteries, that causes obliteration of most of the precapillary arterioles and severe pulmonary hypertension (Figure 4.2).
Transient enhanced diffusion (TED) is a challenge that the semi-conductor industry has been faced with for more than two decades. Numerous investigations have been conducted to better understand the mechanisms that govern this phenomenon, so that scale down can be acheived. {311} type defects and dislocation loops are known interstitial sources that drive TED and dopants such as B utilize these interstitials to diffuse throughout the Si lattice. It has been reported that a two-step anneal on Ge preamorphized Si with ultra-low energy B implants has resulted in shallower junction depths. This study examines whether the pre-anneal step has a measurable effect on the end of range defects. Si wafers were preamorphized with Ge at 10, 12, 15, 20 and 30keV at a dose of 1x1015cm-2 and subsequently implanted with 1x1015cm-2 1keV B. Furnace anneals were performed at 450, 550, 650 and 750°C; the samples were then subjected to a spike RTA at 950°C. The implant damage was analyzed using Quantitative Transmission Electron Microscopy (QTEM). At the low energy Ge preamorphization, little damage is observed. However at the higher energies the microstructure is populated with extended defects. The defects evolve into elongated loops as the preanneal temperature increases. Both the extended defect density and the trapped interstitial concentration peak at a preanneal temperature of 550°C, suggesting that this may be an optimal condition for trapping interstitials.
X-ray pulsars are the only accreting magnetic stars where rotation torques induced by accretion are large enough to be measured on short timescales ~ days. They are thus unique laboratories for studying the interaction between an accretion disk and a stellar magnetosphere. We describe 5 years of continuous pulsar timing observations by the BATSE instrument on GRO which paint a strikingly different picture of pulsar spin behavior than understood from the previous 20 years of sparse observations. In particular, we find that more than half of the persistent pulsars we observe undergo dramatic torque reversals, switching suddenly between extended periods of steady spin-up and steady spin-down. Moreover, variations in pulsed flux are anticorrelated with torque in at least one system undergoing secular spin-down, GX1+4. This behavior contradicts standard accretion torque theory (Ghosh and Lamb 1979). A simple – albeit unconventional – hypothesis which naturally explains these observations is that the disks in these systems somehow alternate between epochs of prograde and retrograde rotation.
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