cssi/SciSciGPT-SciSciNet huggingface dataset:
Adverse Local Tissue Reaction Arising from Corrosion at the Femoral Neck-Body Junction in a Dual-Taper Stem with a Cobalt-Chromium Modular Neck

Background: Femoral stems with dual-taper modularity were introduced to allow additional options for hip-center restoration independent of femoral fixation in total hip arthroplasty. Despite the increasing availability and use of these femoral stems, concerns exist about potential complications arising from the modular neck-body junction. Methods: This was a multicenter retrospective case series of twelve hips (eleven patients) with adverse local tissue reactions secondary to corrosion at the modular neck-body junction. The cohort included eight women and three men who together had an average age of 60.1 years (range, forty-three to seventy-seven years); all hips were implanted with a titanium-alloy stem and cobalt-chromium-alloy neck. Patients presented with new-onset and increasing pain at a mean of 7.9 months (range, five to thirteen months) following total hip arthroplasty. After serum metal-ion studies and metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) revealed abnormal results, the patients underwent hip revision at a mean of 15.2 months (range, ten to twenty-three months). Tissue specimens were examined by a single histopathologist, and the retrieved implants were studied with use of light and scanning electron microscopy. Results: Serum metal levels demonstrated greater elevation of cobalt (mean, 6.0 ng/mL) than chromium (mean, 0.6 ng/mL) or titanium (mean, 3.4 ng/mL). MRI with use of MARS demonstrated adverse tissue reactions in eight of nine patients in which it was performed. All hips showed large soft-tissue masses and surrounding tissue damage with visible corrosion at the modular femoral neck-body junction. Available histology demonstrated large areas of tissue necrosis in seven of ten cases, while remaining viable capsular tissue showed a dense lymphocytic infiltrate. Microscopic analysis was consistent with fretting and crevice corrosion at the modular neck-body interface. Conclusions: Corrosion at the modular neck-body junction in dual-tapered stems with a modular cobalt-chromium-alloy femoral neck can lead to release of metal ions and debris resulting in local soft-tissue destruction. Adverse local tissue reaction should be considered as a potential cause for new-onset pain in patients with these components, and early revision should be considered given the potentially destructive nature of these reactions. A workup including serologic studies (erythrocyte sedimentation rate and C-reactive protein), serum metal levels, and MARS MRI can be helpful in establishing this diagnosis. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Are Engineering and Social Justice (In)commensurable? A Theoretical Exploration of Macro-Sociological Frameworks

The degree to which engineering and social justice as fields of practice are (in)commensurable remains an open question. To illuminate important dimensions of that question, we explore intersections between those fields and two macro-sociological frameworks. Those theoretical frameworks—structural functionalism and social conflict—represent contrasting perspectives on how society should be organized. Specifically, we reveal conceptual alignments between structural functionalism and engineering/engineering education and between social conflict and social justice. Those alignments suggest some salient potential catalysts for tensions between engineering and social justice and provide a useful ideological mirror for reflection by all who are committed to the engineering profession and/or to social justice.
An Unusual Inheritance Pattern for Spinal Muscular Atrophy

UMMARY Progressive spinal muscular atrophy in infancy (Werdnig-Hoffmann's Disease) is considered to be inherited as an autosomal recessive trait. This paper reports the occurrence of this process in first cousins which, in addition to other examples in the literature, suggests an alternate pattern of genetic transmission. Possible modes of inheritance are discussed, particularly that of a dominant inheritance requiring an allelomorphic activator gene for phenotypic expression. RESUME On considere que 'amyotrophie spinale infantile (Werdnig-Hoffmann) est transmise selon le mode autosomique recessif. Cette etude rapporte la survenue de cas chez des cousins germains, ce qui suggere, en association avec dautres cas de la litterature, un autre type de transmission hereditaire. Les modes possibles de transmission sont discutes, en particulier celui dun caractere dominant necessitant un gene activateur allelomorphe pour parvenir a 'expression phenotypique. ZUSAMMENFASSUNG Die progressive spinale Muskelatrophie (Werdnig-Hoffman' sche Krankheit) bei Kindern wird als eine autosomal rezessive Erbkrankheit betrachtet. Diese Arbeit berichtet iiber einen derartigen Fall bei Vettern ersten Grades, woraus zusammen mit anderen Beispielen aus der Literatur ein anderer Weg der genetischen ubertragung erortert wird. Die Moglichkeiten des Erbganges werden diskutiert, vor allem eine dominante Vererbung, wobei fur die phanotypische Erscheinung ein allelomorphisches Aktivatorgen benotigt wird.
Determination of temperatures of high current spark channels

Abstract This paper reviews the experimental methods of determination of temperatures of recovering high current, spark channels in different, stages of the afterglow. Host of the experiments described were performed at atmospheric pressure or pressures sufficiently high that thermal equilibrium among all species is achieved so that the electron, ion and gas temperatures are considered equal. In the early afterglow (within approximately 50 μs after spark initiation) when luminosity of the spark is sufficient, spectroscopic methods are employed to determine channel temperatures. In the intermediate stage of the afterglow (50 μs-500 μs) when luminosity is not sufficient for optical techniques to be employed, measurement, of electrical conductivity or sound or shock-wave velocity can be used to derive the gas temperature. In the late afterglow (1 ms after spark initiation) when the gas has recovered to a neutral state, measurements of reignition voltage together with Poschen's law arc used to derive gas temp...
The hope and hype of multimodality imaging contrast agents

ISSN 1743-5889 10.2217/NNM.11.63 © 2011 Future Medicine Ltd Nanomedicine (2011) 6(6), 945–948 “A key to clinical development of multimodality imaging contrast agents is to combine synergistic functions, just as synergistic functions of modern smart-phones have created useful communication devices ... Another key is to avoid combinations of functions simply for convenience, just as the convenience of a boat that can also drive on land is rarely advantageous.”
Human Endogenous Retrovirus-K18 Superantigen Expression and Human Herpesvirus-6 and Human Herpesvirus-7 Viral Loads in Chronic Fatigue Patients

Background Chronic fatigue syndrome (CFS) is a complex, heterogeneous disease characterized by debilitating fatigue that is not improved with bed rest and worsens after physical activity or mental exertion. Despite extensive research into a cause of CFS, no definitive etiology has been determined; however, a large percentage of CFS patients note an acute infectious event that triggers their fatigue. Methods Blood and saliva were collected from 39 CFS cases and 9 healthy control subjects. Peripheral blood mononuclear cells (PBMCs) were tested for human endogenous retrovirus-K18 (HERV-K18) env transcripts using a TaqMan quantitative polymerase chain reaction (qPCR). In addition, viral copy number of human herpesvirus-6 (HHV-6) and human herpesvirus-7 (HHV-7) were measured in both saliva and PBMCs using TaqMan qPCRs. Transcript levels and viral copy number were compared to patient CFS symptom severity. Results HERV-K18 env transcripts were not significantly different between healthy control subjects and CFS patients. Also, HERV-K18 env transcripts did not correlate with HHV-6 viral copy number or HHV-7 viral copy number in either PBMCs or saliva. HHV-6 viral copy number and HHV-7 viral copy number in both PBMCs and saliva were not significantly different between healthy control subjects and CFS patients. HERV-K18 env transcripts, HHV-6 viral copy number, and HHV-7 viral copy number did not correlate with CFS symptom severity. Conclusions We fail to demonstrate a difference in HERV-K18 env transcripts, HHV-6 viral copy number, and HHV-7 viral copy number between CFS patients and healthy controls. Our data do not support the hypothesis of reactivation of HHV-6 or HHV-7 in CFS.
The changing role of radioiodine in the management of differentiated thyroid cancer

This article discusses several aspects of the evaluation and management of differentiated thyroid carcinoma that are changing or may change in the near future. Although conventional treatment of this disease is highly effective, some modification may improve the welfare of patients and the overall results. Because the symptoms of hypothyroidism are vexing, there has been great interest in using recombinant human thyroid-stimulating hormone (rhTSH) to prepare patients for iodine 131 imaging. rhTSH has been about as effective as thyroid hormone withdrawal for diagnostic imaging so that approval for this use is expected. Another topic of interest is the administration of 131I therapy to patients whose serum thyroglobulin levels are abnormal but whose diagnostic 131I scans are negative. Because the 131I scans after therapy are often abnormal in these patients and a reduction of serum thyroglobulin can occur, this approach seems effective. The long-term impact of this therapy on recurrence and survival, however, is unknown. A third issue that is currently under review is the amount of 131I that should be used for diagnostic scanning. Although past opinion favored larger doses, "stunning" of thyroid remnant and tumor can occur with diagnostic 131I imaging. Substituting iodine 123 is an alternative for postthyroidectomy scanning, but when administered as 300 uCi it is less accurate than 131I for recurrent disease or distant metastases. Related to these issues, two other topics are reviewed: the use of other radiopharmaceuticals for imaging patients with thyroid cancer, and 131I dosimetry.
The Financial System and Corporate Governance in Germany: Institutions and the Diffusion of Innovations

Germany's economic resilience, even in the face of the extreme pressures of unification, cannot be explained by the neoclassical economic approach. Its social market institutions induce the major actors in the political economy to negotiate over the terms of economic and political adjustment in such a fashion as to diffuse innovative new organizational and institutional practices broadly and thoroughly throughout the economy and polity. The reorganization of the financial sector and the spread of new forms of workplace organization and corporate governance are used to illustrate this dynamic. The paper concludes with implications for how we think about regulation.
Human pregnancy safety for agents used to treat rheumatoid arthritis: adequacy of available information and strategies for developing post-marketing data

For female patients with rheumatoid arthritis, the availability of a host of new disease modifying antirheumatic drugs has raised important questions about fetal safety if a woman becomes pregnant while she is being treated. In addition, there is limited safety information regarding many of the older medications commonly used to treat rheumatoid arthritis in women of reproductive age. Current summary pregnancy risk information for selected medications used to treat rheumatoid arthritis is reviewed in the context of the pregnancy label category. In addition, the strengths and weaknesses of post-marketing strategies for developing new pregnancy safety information are described.
Impacts of Future Climate Conditions and Forecasted Population Growth on Water Supply Systems in the Puget Sound Region

There is evidence that long-term climate change has altered streamflow patterns in the Puget Sound region, particularly during spring and summer months, and forecasts suggests these changes will continue. This research explored the ability of regional water supply systems in the Puget Sound, including the cities of Seattle, Everett, Tacoma, and Bellevue, to meet future demands given such changes. To evaluate regional water supply, three sets of climate impacted streamflows were created for 75-year, daily sequences associated with decades centered on the years 2000, 2025, 2050, and 2075 using three general circulation models and two emission scenarios. The performance of each water supply system, characterized by firm yield and reliability metrics, was determined. Alternative operating procedures were then examined for the systems. This research also evaluated the efficacy of municipal and industrial (M&I) demand curtailments as an emergency mitigation strategy to alleviate future shortfall events. The res...
Feeding ecology of the Great Basin Rattlesnake (Crotalus lutosus, Viperidae)

Documenting variation in organismal traits is essential to understanding the ecology of natural populations. We relied on stomach contents of preserved specimens and literature records to assess on...
Multi-electrode stimulation in somatosensory cortex increases probability of detection.

Objective. Brain machine interfaces (BMIs) that decode control signals from motor cortex have developed tremendously in the past decade, but virtually all rely exclusively on vision to provide feedback. There is now increasing interest in developing an afferent interface to replace natural somatosensation, much as the cochlear implant has done for the sense of hearing. Preliminary experiments toward a somatosensory neuroprosthesis have mostly addressed the sense of touch, but proprioception, the sense of limb position and movement, is also critical for the control of movement. However, proprioceptive areas of cortex lack the precise somatotopy of tactile areas. We showed previously that there is only a weak tendency for neighboring neurons in area 2 to signal similar directions of hand movement. Consequently, stimulation with the relatively large currents used in many studies is likely to activate a rather heterogeneous set of neurons. Approach. Here, we have compared the effect of single-electrode stimulation at subthreshold levels to the effect of stimulating as many as seven electrodes in combination. Main results. We found a mean enhancement in the sensitivity to the stimulus (d?) of 0.17 for pairs compared to individual electrodes (an increase of roughly 30%), and an increase of 2.5 for groups of seven electrodes (260%). Significance. We propose that a proprioceptive interface made up of several hundred electrodes may yield safer, more effective sensation than a BMI using fewer electrodes and larger currents.
Effectiveness of sofosbuvir‐based regimens in genotype 1 and 2 hepatitis C virus infection in 4026 U.S. Veterans

SUMMARY Background Real-world effectiveness data are needed to inform hepatitis C virus (HCV) treatment decisions. Aim To assess sustained virological response (SVR) of sofosbuvir (SOF)-based regimens in routine medical practice. Methods Observational, intent-to-treat cohort analysis of genotype 1 and 2 HCVinfected veterans initiating SOF-based regimens with recommended treatment duration of 12 weeks. Results Four thousand and twenty-six veterans with genotype 1 (N = 3203) and genotype 2 (N = 823) comprise the cohort. SVR rates for genotype 1 were 66.8% for SOF + peginterferon + ribavirin (RBV), 75.3% for SOF + simeprevir (SIM), 74.1% for SOF + SIM + RBV and for genotype 2 were 79.0% for SOF + RBV. Genotype 1 patients were less likely to achieve SVR with BMI ≥30 (OR 0.64, 95% CI 0.49–0.84, P 2 (OR 0.44, 95% CI 0.36–0.55, P 2 (OR 0.39, 95% CI 0.25–0.62, P 2 or FIB-4 > 3.25 were significantly less likely to achieve SVR. For genotype 1, a SOF + SIM RBV regimen was associated with a higher likelihood of SVR.
Scanning ion conductance microscopy: a nanotechnology for biological studies in live cells

Scanning ion conductance microscope (SICM), which enables high-resolution imaging of cell surface topography, has been developed for over two decades. However, only recently, a unique scanning mode is increasingly used in biological studies to allow SICM to detect the surface of live cells. More recently, in combination with confocal microscopy and patch-clamp electrophysiological techniques, SICM allows investigators to localize proteins or ion channels in a specific nanostructure at the cell surface. This article will briefly review SICM nanotechnique and summarize the role of SICM in biological studies.
Changes Predicting Long-Term Care Use Among the Oldest-Old

Current demographic projections for Canada’s older population suggest that approximately 22% of Canada’s population will be more than 65 years of age by the year 2031, and that people more than 85 years old will make up almost 4% of the total population (Minister of Industry, 1997). These projections mean that increasing numbers of Canadians will be long-term survivors, that is, the “oldest-old” (Suzman, Willis, & Manton, 1992). Although this demographic shift may be considered relatively benign in and of itself, it becomes of increasing concern when one realizes that these long-term survivors are the largest users of long-term care services (Havens, 1996). Long-term care is care that is provided over a sustained period of time by trained caregivers, such as health and social service professionals, paraprofessionals and nonprofessionals, and volunteers working for organized health and social service agencies and programs (e.g., Meals on Wheels). Long-term care is provided through nursing homes and home care to individuals with physical, mental, or social disabilities and limitations (Havens, 1996). Although the proportion of the provincial health care budget spent on long-term care in Manitoba is relatively small, the growth of the older population is occurring simultaneously with dramatic changes in the way that health is conceptualized and the way that health care is being delivered. Together, the shift in the age structure, the disportionate use of longterm care services by the oldest-old, and the changes in the health care delivery system have created a great need to understand what leads people over the age of 85 to use long-term care services. Currently, little information is available to facilitate health-related planning for the oldest-old, because relatively little is
Novel approaches in the management of pancreatic ductal adenocarcinoma: potential promises for the future

Despite a few breakthroughs in therapy for advanced disease in the recent years, pancreatic ductal adenocarcinoma continues to remain one of the most challenging human malignancies to treat. The overall prognosis for the majority of patients with pancreatic cancer is rather dismal, and therefore, more effective treatment options are being desperately sought. The practical goals of management are to improve the cure rates for patients with resectable disease, achieve a higher conversion rate of locally advanced tumor into potentially resectable disease, and finally, prolong the overall survival for those who develop metastatic disease. Our understanding of the complex genetic alterations, the implicated molecular pathways, and the role of desmoplastic stroma in pancreatic cancer tumorigenesis has increased several folds in the recent years. This has facilitated the development of novel therapeutic strategies against pancreatic cancer, some of which are currently under evaluation in ongoing preclinical and clinical studies. This review will summarize the existing treatment approaches for this devastating disease and also discuss the promising therapeutic approaches that are currently in different stages of clinical development.
Ecological Adaptation and Classification in Aspergillus and Penicillium

Various adaptations of Aspergilli and Penicillia to their natural world have provided taxonomists the characters used in the classification of these moulds. From an ecologist’s perspective, the potential adaptive value of such characters in nature is considered and their importance in placing these fungi within existing classification schemes is examined. The ecological data important in defining the niche of distinct populations of Aspergilli and Penicillia can be a strong predictor of genetic relatedness and taxonomic designation. This paper provides a sampling of the kinds of questions taxonomists should ask in attempting to identify clusters of characters that suggest a unique fungal niche and genetic divergence at the species level.
Long-Term Consequences of Early Life Health Shocks: Evidence from the 1980s Peruvian Crisis

During the Peruvian economic crisis of the late 1980s, infant mortality significantly increased. This paper investigates the long-term consequences on health and education for infants who survived this period. Because no longitudinal data are available, the estimation of causal effects is performed combining a difference-in-differences estimator with a two-sample instrumental variable approach. Results indicate that the detrimental health conditions associated with an additional percentage point in infant mortality makes children who survived the crisis 2.36 percentage points more likely to suffer a chronic illness and 2 percentage points less likely to complete primary education by age 15. A partial identification approach suggests that the attenuation bias due to selection for survival is relatively small.
Maleic acid-based copolymers as silica scale control agents for aqueous systems

The inhibition of silica polymerization by homo- and copolymers containing different functional groups has been studied in aqueous solution. It has been found that silica polymerization reaction is preceded by an induction period that is dependent on silica supersaturation. The investigation in the presence of additives indicates that silica polymerization strongly depends on the additive composition, ionic charge, and molecular weight. This study also presents comparative performance data on bio- and synthetic polymers. Keyword: silica, polymerization, inhibition, biopolymers, synthetic polymers.
Yours, Mine and Ours: Theorizing the Global Articulation of Qualitative Research Methods and Academic Disciplines

Two current forms of globalization are inherently interesting to academic qualitative researchers. The first is the globalization of qualitative research methods themselves. The second is the globalization of academic disciplines in which those methods are institutionalized as a valuable resource for professional practices of teaching and scholarly research. This essay argues that patterns in existing discussion of these two trends create an opportunity for innovative scholarship. That opportunity involves reflexively leveraging qualitative research methods to study the simultaneous negotiation by academic communities of both qualitative methods and their professional discipline. Five theories that serve to develop this opportunity are reviewed, focusing on their related benefits and limitations, and the specific research questions they yield. The essay concludes by synthesizing distinctive commitments of this proposed research program.
[Mortality trend on chronic obstructive pulmonary disease in Liaoning province, 1984-2010].

Objective To evaluate the mortality trend or chromc obstructive pulmonary disease (COPD) among residents in Liaoning province during the period of 1984-2010.Methods The cut-points were ascertained by Monte Carlo Permutation test in COPD mortality trend lines of Poisson regression with Joinpoint Regression Program.The annual percent changes (APC) before and after the cut-points and the average annual percent change(AAPC) of COPD mortality were examined during the period.Results Significant declining trends on COPD mortality among the urban population during 1984-2010 and that of rural population during 1999-2009 were found.The standardized urban COPD mortality rate by Chinese population declined from 243.93 per 100thousand in 1984 to 33.13 per 100 thousand in 2010.The urban 26 years AAPC was -5.8％.While the mortality in the rural population decreased from 251.33 per 100 thousand in 1999 to 102.25 per 100 thousand in 2009 in the same population.The rural 10 years' AAPC was-6.8％.The total trend of COPD mortality reduction was mainly resulted from the fast decline of bronchitis mortality.The AAPC of COPD mortality of the urban population was-9.0％ and greater than that of the rural population (-6.8％) from 1999 to 2009.The urban population had a lower COPD mortality than that of the rural population.In urban area,males had a higher COPD mortality than females,however,in the rural area,males had a lower COPD mortality than the females.Conclusion The COPD mortality among the residents of Liaoning province declined significantly from 1984 to 2010.Further studies are needed to confirm the viewpoint of WHO that the prevalence of COPD would have a continuous increasing trend in China. Key words: Chronic obstructive pulmonary disease; Mortality; Death cause; Trend
Neurobehavioral Outcomes of Mild Traumatic Brain Injury: A Mini Review

Traumatic brain injury outcomes can be classified as acute or chronic. Acute outcomes refer to injuries that occur immediately at the time of the injury and subsequent short-term consequences. Chronic outcomes refer to adverse outcomes that are more long-term. In mild traumatic brain injury, recovery from acute outcomes typically occurs very rapidly, i.e., within 2 weeks, with full recovery expected by 90 days. However, some 10%-15% individuals can remain symptomatic for much longer with an outcome termed post-concussive syndrome. This outcome is difficult to predict since there are very few rigorous, prospective studies of this syndrome.
Susceptibility to Pressure Flattening Correlates with Texture Analysis of Potato Tubers

The physiological disorder referred to as pressure flattening is a cause of significant economic losses in the storage of Irish potatoes (Solanum tuberosum L.) intended for use in the fresh market. As the flattened area on each tuber becomes larger in diameter or becomes more depressed the USDA quality grade, and therefore the market value of the potatoes is reduced. Experiments were conducted to identify at-harvest which potato lots within and among cultivars were likely to pressure flatten earlier or more severely. The use of an instrumented penetrometer or texture analyzer to measure peak load required for periderm deformation at harvest appears to anticipate correctly the majority of fields from which tubers are more likely to have severe pressure flattening at six months’ storage duration. At-harvest texture analysis appears to segregate varieties according to susceptibility to deformation based on cultivar specific factors that play a role in pressure flattening development during storage. The Pearson correlation coefficient (R2=0.5481) indicates that there is a correlation between tuber texture at harvest and pressure flattened area on the tuber following storage. Testing of tubers from different fields and cultivars as the potatoes are loaded into storage, may allow growers to identify and ship potatoes that are more susceptible before they develop significant pressure flattening.
High-dose interleukin 2 in patients with metastatic renal cell carcinoma with sarcomatoid features.

Background High-dose interleukin-2 (HD IL-2) is used in the treatment of metastatic renal cell carcinoma (mRCC) and has an overall response rate (ORR) of 12–20% and a complete response rate (CR) of 8% in unselected populations with predominantly clear cell type renal cell carcinoma. Nearly 10–15% of patients with renal cell carcinoma exhibit sarcomatoid differentiation, a feature which correlates with a median overall survival (OS) of 9 months and overall poor prognosis. We report a single institution experience with 21 patients with mRCC with sarcomatoid features post-nephrectomy who were treated with HD IL-2. Methods Twenty one patients with mRCC with sarcomatoid features post-nephrectomy who underwent therapy with HD IL-2 were identified at the University of Pittsburgh Medical Center from 2004 to 2016. Baseline patient characteristics, HD IL-2 cycles, time to progression, and subsequent therapies were evaluated. OS and progression-free survival (PFS) in the cohort were calculated using the Kaplan-Meier method. Disease characteristics were evaluated for significance using the Fischer′s exact test and Wilcoxon rank sum test. Results Patients were predominantly Caucasian males with a median age of 54 years. A majority, 86% of these patients, had metastatic disease at time of initial presentation, primarily with lung and lymph node involvement. The ORR and CR with HD IL-2 was 10% and 5%, respectively. Initial localized disease presentation is the only variable that was significantly associated with response to HD IL-2 (p = 0.0158). Number of HD IL-2 doses did not correlate with response with a mean of 16.5 and 15.0 total doses in responders and non-responders, respectively (p = 0.53). Median PFS with HD IL-2 was 7.9 months (95% CI, 5.0–21.3). Median OS was 30.5 months (95% CI 13.3–57.66). Within the subset of patients who had progression on IL-2, median OS was 19.4 months (95% CI, 13.3–35.3). In patients who received second-line therapy, median PFS was 7.9 months (95% CI 2.4–10.2). Conclusion In patients with mRCC with sarcomatoid features, use of HD IL-2 was associated with a modest ORR and a higher survival compared to historical controls (patients with mRCC and sarcomatoid features). Thus, HD IL-2 may have a role in treating selected patients with mRCC with sarcomatoid features.
Behavioral and physiological adaptations to high-flow velocities in chubs (Gila spp.) native to Southwestern USA.

Morphological streamlining is often associated with physiological advantages for steady swimming in fishes. Though most commonly studied in pelagic fishes streamlining also occurs in fishes that occupy high flow environments. Before the installation of dams and water diversions, bonytail (Cyprinidae, Gila elegans ), a fish endemic to the Colorado River (USA), regularly experienced massive, seasonal flooding events. Individuals of G. elegans display morphological characteristics that may facilitate swimming in high-flow conditions, including a narrow caudal peduncle and a high aspect-ratio caudal fin. We tested the hypothesis that these features improve sustained swimming performance in bonytail by comparing locomotor performance in G. elegans with the closely-related roundtail chub ( Gila robusta ) and two non-native species, rainbow trout ( Oncorhynchus mykiss ) and smallmouth bass ( Micropterus dolomieu ) using a Brett-style respirometer and locomotor step-tests. Gila elegans had the lowest estimated drag coefficient and the highest sustained swimming speeds, relative to the other three species. There were no detectible differences in locomotor energetics during steady swimming among the four species. When challenged by high-velocity water flows, the second native species examined in this study, G. robusta , exploited the boundary effects in the flow tank by pitching forward and bracing the pelvic and pectoral fins against the acrylic tank bottom to “hold station.” Because G. robusta can station-hold to prevent being swept downstream during high-flows and G. elegans can maintain swimming speeds greater than smallmouth bass and rainbow trout with comparable metabolic costs, we suggest that management agencies could use artificial flooding events to wash non-native competitors downstream and out of the Colorado River habitat.
Duodenal Atresia and Stenosis

Congenital duodenal atresia and stenosis is a common cause of intestinal obstruction in the neonate, with an incidence of 1 in 5000 to 10,000 live births and an increased prevalence in males. More than 50% of affected patients have associated congenital anomalies, including annular pancreas, intestinal malrotation, esophageal atresia, Meckel’s diverticulum, imperforate anus, renal anomalies, lesions of the central nervous system, and biliary tract malformations. The most common anomalies associated with duodenal atresia include Trisomy 21, diagnosed in one third of patients, and isolated cardiac defects, which occur in approximately 30%. The presence of trisomy carries an increased risk for congenital heart defects requiring operative repair. Approximately 45% of patients are born prematurely, with one-third exhibiting failure to thrive and persistent growth retardation. Presently, laparoscopic or open duodenoduodenostomy has become the standard of care, with survival rates of greater than 95% and mortality primarily attributed to associated anomalies of other organ systems.
The Stolen Property of Whiteness: A Case Study in Critical Intersectional Rhetorics of Race and Disability

This essay examines intersectional discourses of race and disability as they emerge in a 2014 wrongful birth lawsuit. Jennifer Cramblett filed the lawsuit after she discovered she was given sperm f...
Saturday Night Retinopathy After Intranasal Heroin

Purpose:To describe the clinical features of a case of Saturday night retinopathy (SNR) following intranasal heroin use.Methods:Ophthalmological examination, including optical coherence tomography ...
Directed medication misusage.

Mr. Fordtran has presented an elegant and thorough argument that the incidence of colitis due to Clostridium difficile may be increased because of our patterns of medication use. The Pharmacy and Therapeutics Committee at Baylor University Medical Center is charged with monitoring drug use for safety, efficacy, and appropriateness. Proton pump inhibitors (PPIs) have been widely used in a variety of circumstances and to the casual prescriber are free of significant side effects, drug-drug interactions, allergies, and other untoward consequences. But their power to affect cellular biology is unquestioned, and thus it is reasonable to expect some risk as well as benefit, as is the case with all medications. As emphasized in Dr. Fordtran's review, PPIs may be implicated in increasing the incidence of C. difficile colitis, though the evidence for this assertion remains scant. At Baylor University Medical Center, PPIs have recently been deleted from intensive care unit order sets, where they were considered an option for routine stress ulcer prophylaxis. Sucralfate and H2 blockers remain alternatives, though sucralfate can be difficult to administer to a critically ill or unconscious patient and may interfere with the adsorption of concomitantly administered drugs. The Pharmacy and Therapeutics Committee struggles with the various ways that some “prewritten” orders are used. Prescriptions may enter the system as personal order sets that are preloaded into Baylor's clinical computer system (BCON), as well as through care paths, protocols, or preprinted order sheets. These orders may have been nationally approved by various professional organizations, extensively considered by local quality improvement committees, or simply brought in as a personal favorite of a single physician. While prewritten orders can improve physician efficiency, it is especially important that medication orders encourage “best” prescribing practices, based on current evidence, agreed-upon guidelines, and local policies. It remains an arduous but important task to review and approve these orders and to keep them updated and properly distributed. As we move toward electronic prescribing and computer-assisted physician order entry, we will have further opportunities to guide and direct medication use. With prescribing electronically facilitated, it will become even more important that this guidance is based on the best current evidence. Thoughtful analysis, as shown in Dr. Fordtran's review, is not only enlightening and welcome but also critical to ensure that technology is used to improve patient care and not to inadvertently automate suspect decision-making.
Un-Torturing the Definition of Torture and Employing the Rule of Immigration Lenity

This article continues and enhances the ongoing critique of the Board of Immigration Appeals’ (BIA) interpretation of the definition of torture under the Convention Against Torture and Other Cruel, Inhuman, and Degrading Treatment. It analyzes the inconsistency with which the BIA and federal courts of appeals have applied this key concept in the Convention, surfacing both executive and legislative history leading to the Convention’s adoption in theU.S.and the adverse effects caused by this inconsistent interpretation. The paper examines the domestic and international consequences of the U.S.torture policy, in one case causing a foreign court to hold that it could not enforce its own country’s agreement with the U.S. Potential solutions to the problem are offered, some that have already been suggested, but most importantly is the suggestion that, so long as this BIA interpretation stands, federal courts should more readily scrutinize BIA opinions and invoke the principle of Immigration Lenity to prevent the return of potential torture victims to countries where they are likely to be tortured.
Bronchial hyper-responsiveness: a technical update.

Background Bronchial hyper-responsiveness (BHR) is often regarded as a 'hallmark' of asthma, and bronchoprovocation testing is frequently performed to support a diagnosis of asthma. The European Respiratory Society (ERS) and American Thoracic Society (ATS) have recently updated their technical standards and guidelines for performing methacholine challenge testing (MCT), the most commonly performed clinical test of BHR. Aims To review the updated guidelines and discuss the various changes and their potential impact on clinicians. Methods We performed a systematic review of references identified using Medline and hand searches of identified articles. Results The new ERS and ATS guidelines recommend that MCT be performed using tidal breathing, not deep inspirations with breath holding, that results be reported as the PD20 (cumulative dose causing a 20% fall in forced expiratory volume in 1 s [FEV1]), rather than PC20 (concentration causing a 20% fall in FEV1), and that manufacturers of nebulizers and other delivery systems provide performance characteristics to allow calculation of PD20 values. Our preliminary survey found that the new guidelines are only slowly being adopted. Conclusions Clinicians should be aware that recommended BHR testing methods, particularly for MCT, have changed. As a result, they should anticipate that test outcomes will increasingly be reported in terms of PD20, which will facilitate longitudinal assessment of their patients. Compliance with the new guidelines will increase the sensitivity of MCT in mild and asymptomatic asthmatics.
Isolability as the unifying feature of modularity

Although the concept of modularity is pervasive across fields and disciplines, philosophers and scientists use the term in a variety of different ways. This paper identifies two distinct ways of thinking about modularity, and considers what makes them similar and different. For philosophers of mind and cognitive science, cognitive modularity helps explain the capacities of brains to process sundry and distinct kinds of informational input. For philosophy of biology and evolutionary science, biological modularity helps explain the capacity of random evolutionary processes to give rise to highly complex and sophisticated biological systems. Although these different ways of thinking about modularity are largely distinct, this paper proposes a unifying feature common to both: isolability, or the capacity of subsystems to undergo changes without resulting in substantial changes to neighboring or interconnected subsystems.
Effects of CdCl 2 treatment on the local electronic properties of polycrystalline CdTe measured with photoemission electron microscopy

To investigate the effects of CdCl 2 treatment on the local electronic properties of polycrystalline CdTe films, we conducted a photoemission electron microscopy (PEEM) study of polished surfaces of CdTe films in superstrate configuration, with and without CdCl 2 treatment. From photoemission intensity images, we observed the tendency for individual exposed grain interiors to vary in photoemission intensity, regardless of whether or not films received CdCl 2 treatment. Additionally, grain boundaries develop contrast in photoemission intensity images different from grain interiors after an air exposure step, similar to observations of activated grain boundaries using scanning probe microscopy. These results suggest that work function varies locally, from one grain interior to another, as well as between grain boundaries and grain interiors.
Whitebark pine encroachment into lower-elevation sagebrush grasslands in southwest Montana, USA

Projections for the future health and abundance of whitebark pine (Pinus albicaulis Engelm.) populations in western North America are dire. Not only has the species been declining due to the combined effects of fire exclusion policies, mountain pine beetle (Dendroctonus ponderosae Hopkins 1902) outbreaks, and white pine blister rust (Cronartium ribicola J.C. Fisch), many are predicting that climate change will amplify these effects and whitebark pine habitat may be lost in many areas. One method to evaluate the validity of future predictions is to examine current migration patterns of whitebark pine into surrounding non-forested areas. In this paper, we documented the findings of a case study surveying the encroachment of whitebark pine into adjacent lower-elevation sagebrush grasslands and higher-elevation subalpine meadows in southwestern Montana, USA. We found abundant evidence of whitebark pine trees (>40 trees ha−1) in sagebrush grasslands below the mature seed source, but there was no evidence of any whitebark pine regeneration in subalpine meadows above the seed-source stand. These results are in stark contrast to the findings of statistical modeling studies that predict that whitebark pine will expand into higher-elevation areas as a response to climate change. We believe that the reason for this low-elevation encroachment may be in response to fire exclusion rather than climate change. Although observations in this case study are for a limited geographic area, they do serve to illustrate the complexity of predicting ecological responses of tree species to climate change.
Clinical Scoring Systems for Colorectal Cancer Liver Metastases

Resection of colorectal liver metastases is considered a safe and effective treatment. As technical hurdles related to the extent of resection and its relationship to perioperative morbidity and mortality are surmounted, determining which candidates for surgery will derive the most benefit becomes more challenging. Clinical scoring systems for colorectal liver metastases were initially devised to help determine the tipping point between survival advantage and risk of surgery for individual patients. The goal was to identify a combination of factors that predicted which patients could achieve long-term survival meriting the invasiveness of the procedure, while also identifying those best suited for additional studies, to aid in clinical decision-making for adjuvant therapy and in consideration for clinical trials. They would further provide prognostic information for the patient.
Heartbeat OCE: Corneal biomechanical response to simulated heartbeat pulsation

The biomechanical properties of the cornea can be an important biomarker for assessing tissue health. In this work, we evaluated cornea biomechanical properties during intraocular pressure fluctuation simulating heartbeat induced corneal pulse. This method results in a more physiologically relevant assessment of tissue mechanics, and thus diverges from typical elastography techniques that rely on externally induced deformation. Optical coherence tomography is used to detect displacements in the cornea as IOP is cycled. The axial strains within the cornea are calculated from these displacements, so that dynamic changes in stiffness can be determined. The results indicate a gradient in axial displacement within the cornea and illustrate a distinct difference in strain between the untreated and crosslinked tissues. This suggests that heartbeat OCE may be a useful technique in assessing stiffness of the cornea.
19 – Chaotic Advection and Its Application to Extruding Micro- and Nanostructured Plastic Materials

Chaotic advection-based processing of plastics is a new plastics processing technology that offers opportunities to enhance physical properties (e.g., toughness and electrical conductivity), impart functionality (e.g., strain-sensitive electrical resistivity), or create decorative patterns (e.g., wood grain effect) in extrusions. It can be used with existing polymer resins and is well suited to melt processing of shear-sensitive materials. Both miscible and immiscible polymer combinations can be used. Structured plastics can be extruded that can contain thousands of layers, sponge-like assemblies, interconnected layers, percolating networks, ribbons, abundant submicron fibers, or oriented particles. Dispersions of droplets or solid particles can also be produced. A large variety of microscale and nanoscale structures can be formed in extrusions. Nanostructured materials can be extruded in large quantities and in many forms. Applied to polymer processing, a wide variety of microscale and nanoscale internal structures can be formed even at a fixed material composition.
Iatrogenic Distal Radial Physeal Fracture During Insertion of Intramedullary Fixation for a Both Bone Forearm Fracture: A Case Report.

Case A 12-year-old boy with an isolated both bone forearm fracture was treated with closed reduction and flexible intramedullary nailing 11 days postinjury and after the loss of initial fracture alignment. On nail insertion, an intraoperative distal radial physeal fracture was encountered, thereby warranting modification in treatment. Conclusion Physeal injury is a rare intraoperative complication of intramedullary fixation of forearm fractures. This report provides insight regarding the management and prevention of this rare complication.
2X-Bandwidth Burst 6T-SRAM for Memory Bandwidth Limited Workloads

A 20KB 6T-SRAM array in 10nm CMOS demonstrates 2X higher read bandwidth in burst mode operation. The doubling of bandwidth is achieved with 51% higher energy efficiency than frequency doubling and 30% better area efficiency than doubling the number of banks.
Care manager perspectives on integrating an mHealth app system into clinical workflows: A mixed methods study

ABSTRACT Objective mHealth can be a valuable means of monitoring symptoms and supporting care for rural patients, but barriers to implementation remain. This study aimed to examine care manager perspectives on the adoption, use and impact of an mHealth system deployed within a pragmatic Collaborative Care trial for rural patients with PTSD and/or Bipolar Disorder. Method Sixteen care managers at 12 Federally Qualified Health Centers in 3 states participated in semi-structured interviews. Interviews were transcribed, coded, and thematically analyzed using the Unified Theory of Adoption and Use of Technology as a conceptual framework. App metadata was used to assess the frequency of a care manager reported phenomenon, clinically disengaged app use. Results 4 themes were identified: infrastructural limitations; redundant and incompatible clinical and mHealth workflows; cross platform and web access; and patient engagement and clinically disengaged app use. Most users had a period of consistently submitting symptom measures via the app while disengaged from care for >4 weeks.