cssi/SciSciGPT-SciSciNet huggingface dataset:
Abstract LB-142: Physician-engagement in cancer clinical trial recruitment: Leveraging partnerships among community-academic research institutions for direct accrual of racial/ethnic minorities and the medically underserved

Background: Although approximately 20% of adults are eligible, adult cancer clinical trial (CCT) accrual in the U.S. lingers around 3%. Participation rates are significantly lower among racial/ethnic minorities and the medically underserved, who are likely to have poorer outcomes than the larger population. CCT participation is increasingly a concern of healthy equity and social justice among racial/ethnic minorities. This study proposes a promising strategy for engaging physician-oncologists and communities to stream-line CCT awareness, access and accrual of racial/ethnic minorities. Methods: Study recruited 40 community and academic-research institutions to provide CCT education days at a local, pre-dominantly African American mega-church, (N = 253) participants, during one-year. There was pre/post-testing of general clinical trial knowledge each-day. Education included a 3-patient panel-discussion of their trial experiences. Four physician-oncologists provided expertise on the significance of minority representation in CCTs. The physician-oncologists discussed the types of CCTs that were locally available for specific-types of cancer. Anticipated outcome was provision of recruitment opportunity of potentially-eligible participants while addressing any gaps in CCT knowledge. Results: The (N = 253) participants: (75%) African American, (13%) Hispanic/Latino, (2%) American Indian/Alaskan Native, (6%) Asian, and (2%) Hawaiian/Pacific Islander. Pre-survey (N = 104) included: How much do you know about clinical research?; a lot (23%), general sense (51%), very-little (21%), never heard of it, (3%). Thirty-eight percent were past participants in some type of trial. Post survey (N = 171), participants indicated: would very likely(51%) and somewhat likely(41%) participate in a CCT if invited by doctor. An additional (3%) were somewhat-unlikely or very-unlikely (6%) to participate in CCT if invited by doctor. Post-survey, most-notable reasons for lack of participation: never invited (28.5%); lack of information (16.5%); didn9t know who to talk to about trials (6.5%); worried about my rights (1%); hassle of participation (2%); insurance (2%); worried about health risk (6.5%); other (6.5%); no reply (30.5%). Conclusions: Physician-engagement in direct community CCT recruitment strategies demonstrates a hopeful mechanism for reaching diverse, interested, potentially-eligible cancer subjects, in a culturally-appropriate and timely manner. Citation Format: Jameisha B. Brown. Physician-engagement in cancer clinical trial recruitment: Leveraging partnerships among community-academic research institutions for direct accrual of racial/ethnic minorities and the medically underserved. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-142.
The Essentials of Viscous Flow

Introduction As discussed in Chapter 1, many of the current or planned microdevices contain rectangular channels arranged in an array; such channel systems are termed nanopore membranes . For example, the nanopore membranes depicted in Figure 1.1 contain up to 30,000 channels, depending on the channel height, which is the nanoscale dimension. Scanning electron microscope (SEM) images of nanopore membranes fabricated by Dr. Shuvo Roy's group at the Cleveland Clinic1 are depicted in Figure 4.1. You will recognize Figure 4.1(a) as Figure 1.1(b), and is repeated for clarity. The nanopore membrane is fabricated so as to contain channels of a uniform nanoscale height. They fabricated membranes with a variety of pore sizes, ranging from h = 6.3 nm to h = 91 nm, and there are 11, 500 pores per membrane. Similar membranes are now being used in the development of an artificial kidney (Fissell, 2006). Obviously, it would be difficult to model the flow in such an array from first principles. There are at least two ways to overcome this problem: (1) treating the membrane as a porous media problem, the membrane being characterized by a permeability and a porosity, and (2) investigating the flow in each channel separately, assuming that the flow behaves similarly in each individual channel. It is the latter approach that is explored here.
What is International Environmental Law

How and why do international environmental norms arise? In what ways (and to what extent) do they affect behavior? Do they change what states and individuals actually do, and, if so, why? How effective are they in solving international environmental problems? These are the fundamental questions I examine in a new book forthcoming this fall from Harvard University Press entitled THE ART AND CRAFT OF INTERNATIONAL ENVIRONMENTAL LAW. Although international environmental law is a comparatively new field, its rules and standards now fill books - and not short books either. Not so long ago, international environmental law was considered a narrow specialty within the general field of international law. But today it has become a field in its own right, with sub-specialties on wildlife law, marine pollution, freshwater resources, climate change, sustainable development, and chemicals, among others. The Art and Craft focuses on the processes by which international environmental law is developed, implemented, and enforced rather than on the substance of international environmental law itself. Process issues have received increased attention in recent years but have not yet had a book-length treatment. This work aims to fill that gap, synthesizing recent research on international environmental negotiations, treaty design, social norms, policy implementation, and effectiveness. “What Is International Environmental Law?” is the introductory chapter and gives a flavor of the approach taken by the book as a whole. Using an encounter I once had with an NGO fundraiser as a jumping off point, the chapter explores the scope of international environmental law as well three different perspectives on its study. The goal is to provide general readers and specialists alike with a real-world perspective on how international environmental works - and sometimes doesn’t work.
Hall Effect Studies of Electron Mobility and Trapping at the SiC/SiO2 Interface

SiC is an attractive semiconductor for fabricating high power metal-oxide-semiconductor (MOS) devices because of its high breakdown field and high thermal conductivity. In addition, like silicon, SiC has a natural advantage for fabricating MOS devices because high quality SiO2 for gate insulators can be thermally grown directly on the SiC in an oxidizing ambient. Despite these potential advantages, experimental SiC MOS devices today have poor performance and abnormally low conductance. This is particularly a problem in 4H- compared to 6H-SiC, although 4H is the preferred polytype for power devices because of its higher electron mobility. It was proposed initially that the low conductance arises from extreme SiC surface roughness [1] or segregation of aluminum dopant atoms at the SiC/SiO2 interface from the p-type SiC substrate [2, 3]. It is generally recognized now that the low conductance is actually due to a high density of electron traps D it at the SiC/SiO2 interface [1, 4, 5]. These traps reduce the conductance by two approximately equal effects: (1) many electrons are trapped by the defects and are not free to contribute to the drain current, and (2) the mobility of the remaining free electrons is reduced by Coulomb scattering from all the trapped electrons. The traps are believed to arise from two physical mechanisms: near-interfacial traps in the oxide caused by oxygen deficiencies, and clusters of graphite-like excess carbon at the interface released by the oxidation process [4].
In vivo protein interaction network analysis reveals porin-localized antibiotic inactivation in Acinetobacter baumannii strain AB5075

The nosocomial pathogen Acinetobacter baumannii is a frequent cause of hospital-acquired infections worldwide and is a challenge for treatment due to its evolved resistance to antibiotics, including carbapenems. Here, to gain insight on A. baumannii antibiotic resistance mechanisms, we analyse the protein interaction network of a multidrug-resistant A. baumannii clinical strain (AB5075). Using in vivo chemical cross-linking and mass spectrometry, we identify 2,068 non-redundant cross-linked peptide pairs containing 245 intra- and 398 inter-molecular interactions. Outer membrane proteins OmpA and YiaD, and carbapenemase Oxa-23 are hubs of the identified interaction network. Eighteen novel interactors of Oxa-23 are identified. Interactions of Oxa-23 with outer membrane porins OmpA and CarO are verified with co-immunoprecipitation analysis. Furthermore, transposon mutagenesis of oxa-23 or interactors of Oxa-23 demonstrates changes in meropenem or imipenem sensitivity in strain AB5075. These results provide a view of porin-localized antibiotic inactivation and increase understanding of bacterial antibiotic resistance mechanisms.
Examining the influence of physical and health education on ontario grade 9 students' physical activity intentions and behaviours

Insufficient physical activity and a sedentary lifestyle are major contributors to health risks for Canadian youth. Adolescents, particularly girls, tend to experience major drop-offs in physical activity levels during high school. However, there is minimal research examining the extent to which Physical and Health Education (PHE) courses promote physical activity and mitigate against this decline. Grounded in the Theory of Planned Behaviour (TPB), the purpose of this quantitative short-term longitudinal study is two-pronged: (a) examine the effectiveness of Grade 9 PHE for 197 students’ reports of TPB constructs, physical activity intentions, and physical activity behaviour; and (b) explore the utility of TPB in predicting physical activity intentions and behaviour. For the first set of research questions, results were analyzed using 2 (time: Time Point 1 [T1], Time Point 2 [T2]) x 2 (condition: in PHE/not in PHE) x 2 (TPB status: higher or lower than the mean) MANCOVAs with boys and girls examined separately. There was no effect of PHE over time. There was no interaction among time, condition, and TPB status. There was a significant effect of condition for girls in PHE, with Attitude and Physical Activity Behaviour higher at both time points. For the second set of research questions, results were analyzed using multiple linear regressions to examine TPB in a Grade 9 setting. Findings provided support for the theoretical structure of the TPB in a Grade 9 context, with the three TPB constructs accounting for a minimum of 59% of Intentions, and a minimum of 25% of Behaviour for boys and girls. Attitude was the strongest independent predictor of Intentions with Intentions and Attitude the strongest predictors of Behaviour. PHE teachers should potentially focus attention on changing attitudes for this age group, given the importance of this construct.
Family Determinants of Health Behaviors

The strong evidence linking behavior and health outcomes has led to the realization that truly healthy people, and truly healthy societies in these times, are distinguished by both a lack of physiological pathology and a pattern of behaviors that reduces one’s risk of developing the major chronic diseases (Hamburg, Elliott, & Parron, 1982; Matarazzo, 1982). A small number of behaviors, namely smoking, diet, and exercise, have been shown to be related to the leading causes of morbidity and mortality in industrialized countries. Smoking is a major causative factor in several cancers (Levy, 1985), cardiovascular diseases (USPHS, 1979), and chronic pulmonary diseases (Brashear, 1980). Dietary habits, particularly intake of fats and saturated fats, have been linked to development of cancers (Levy, 1985), cardiovascular diseases (Glueck & Connor, 1978), and diabetes mellitus (Arky, Wylie-Rosett, & El-Beheri, 1982). Physical inactivity appears to play a role in cardiovascular diseases (Paffenbarger & Hyde, 1984) and diabetes mellitus (Rauramaa, 1984).
2 Exposure to violence: a latent profile analysis: victimisation, observation, and family conflict in a young inner-city disadvantaged sample

Statement of purpose Exposure to Violence (ETV) is the most frequently reported stressor in the lives of African American youth. Although ETV is associated with many later detrimental health effects, previous measures of ETV do not consider the fact that many individuals are exposed to multiple forms of violence concurrently. Studies that simply sum multiple forms of ETV fail to differentiate individuals who are experiencing unique ETV profiles, potentially masking important nuances in the ways youth experience violence. The objective of this study is to identify different profiles of ETV and examine how these different profiles differ by demographic characteristics (e.g., sex, ethnicity) and violence perpetration. Methods Participants included 770 youth (M=17.9 years; 80% Black or African American; 48% male) from a disadvantaged community. Youth were asked to measure their levels of family conflict, amount of violence they have observed, and violent victimisation. Multiple latent profile analyses were performed to find classes with the best fit. Groups were then compared using ANOVAs and chi-squares to determine differences in demographics and violence perpetration. Results A latent profile analysis indicated that a three-group solution provided the best fit (low ETV, medium ETV, high ETV). Post hoc analyses indicated that males were more likely to be in the high ETV group, and a positive relationship between ETV and violence perpetration. Conclusions These findings indicate three clear profiles and these individual profiles were associated important risk factors. Significance and Contributions to Violence Prevention Science Researchers can begin studying ETV and the subsequent outcomes in a more nuanced way. Such patterning of different forms of ETV may allow health practitioners to better identify and address different forms of ETV, allowing health care providers to be less likely to miss identifying ETV, which will increase the chances that the victim receives adequate treatment.
A widening longevity gap between people with schizophrenia and general population: A literature review and call for action

Individuals with schizophrenia have higher mortality rates than the population at large. General mortality rates have declined in developed countries since the early 1970s, extending average lifespan by nearly a decade. This review of eight longitudinal studies of mortality in schizophrenia found that the mean standardized mortality ratio (SMR, a measure of mortality rate in schizophrenia compared to the general population) increased 37%, from 2.2 in the pre-1970s studies to 3.0 in the post-1970s reports. Major changes in societal stigma, healthcare, and economic policy are urgently warranted to ensure that this vulnerable segment of the population participates in the longevity revolution.
Open repair of descending and thoracoabdominal aortic aneurysms in octogenarians

Abstract Objective Despite improved outcomes for open repair of descending thoracic aneurysm (DTA) and thoracoabdominal aortic aneurysm (TAAA), these operations remain challenging in octogenarians. Patients unsuitable for thoracic endovascular aortic repair require open surgery to avoid catastrophic rupture. We analyzed our results for DTA/TAAA repair in these elderly patients. Methods Our institutional aortic database was queried to identify those ≥80 years old and those Results From 1997 to 2017, there were 783 patients who underwent open repair of DTA or TAAA; 96 (12.3%) were ≥80 years old. Octogenarians were more likely to be female ( P = .018), with chronic pulmonary disease ( P = .012), severe peripheral vascular disease ( P P = .025). Degenerative aneurysms were more common among octogenarians ( P P P = .852). Other than an increased incidence of left recurrent nerve palsy in the younger cohort ( P = .029), there were no significant differences in the incidence of major postoperative complications. Logistic regression modeling showed that age ≥80 years was not predictive of operative mortality or postoperative complications. A greater percentage of octogenarians had aortic reconstruction with a clamp and sew strategy (85.4% vs 61.6%; P P P Conclusions In select octogenarians, open repair of DTA/TAAA can be performed with acceptable risk. A simplified surgical approach may provide the best opportunity for a successful outcome.
Gradient-Enhanced Polynomial Chaos Methods for Circuit Simulation

Uncertainty Quantification (UQ) is an important and emerging topic in electronic design automation (EDA), as parametric uncertainties are a significant concern for the design of integrated circuits. Historically, various sampling methods such as Monte Carlo (MC) and Latin Hypercube Sampling (LHS) have been employed, but these methods can be prohibitively expensive. Polynomial Chaos Expansion (PCE) methods are often proposed as an alternative to sampling. PCE methods have a number of variations, representing tradeoffs. Regression-based PCE methods, for example, can be applied to existing sample sets and don’t require specific quadrature points. However, this comes at the cost of accuracy. In this paper we explore the idea of enhancing regression-based PCE methods using gradient information. The gradient information is provided by an intrusive adjoint sensitivity algorithm embedded in the circuit simulator.
Tactics of Fish Movement in Relation to Migration Strategy and Water Circulation

The title of this paper was misprinted in the programme — immigration appearing for migration — and correcting the mistake provides an opportunity to define some terms. A man emigrates when he quits one country and immigrates when he enters another to settle: the journey only needs a single ticket. We often use the word migration in the sense of moving from one place to another. But when it is applied to animals it has a special meaning; a migration is a coming and going with the season and the journey needs a return ticket.
The Narcissistic Pursuit of Status

This chapter considers the factors that motivate narcissistic individuals to pursue external validation. Narcissistic individuals pursue external validation through various strategies (e.g., appearance enhancement, social media use), but we focus primarily on the desire for status because we believe it may be especially helpful for understanding the intrapsychic processes and interpersonal behaviors that characterize narcissistic individuals. We argue that the narcissistic concern for status may help us understand why the self-presentational goals of narcissistic individuals often focus on issues surrounding self-promotion or intimidation rather than affiliation. The lack of concern that narcissistic individuals have for affiliation suggests that their self-promotional efforts are not regulated by typical concerns about also being liked which may shed light on the reasons they engage in interpersonal behaviors that others tend to find irritating and aversive (e.g., being selfish or arrogant). We conclude by suggesting that the desire for status may be a fundamental aspect of narcissism that has the potential to provide additional insights into the cognitive processes and interpersonal behaviors that characterize narcissistic individuals rather than simply being one of the ways in which narcissistic individuals go about regulating their feelings of self-worth.
Investigating the Growth Modification of Various Plant Species via Atmospheric Pressure Plasma Jets

Plants require certain aspects to grow and survive. Environmental conditions greatly contribute to the growth cycle of plants. These environmental conditions include proper sunlight, water, and nutrient concentrations. However, certain stressors that interact with the plant during germination can cause the seedling to change in its physical composition. One such stressor that can be introduced to the plant is an atmospheric helium cold plasma jet. This jet has been shown to increase the overall yield of cultivation.
Warm, dry winters truncate timing and size distribution of seaward-migrating salmon across a large, regulated watershed

Ecologists are pressed to understand how climate constrains the timings of annual biological events (phenology). Climate influences on phenology are likely significant in estuarine watersheds because many watersheds provide seasonal fish nurseries where juvenile presence is synched with favorable conditions. While ecologists have long recognized that estuaries are generally important to juvenile fish, we incompletely understand the specific ecosystem dynamics that contribute to their nursery habitat value, limiting our ability to identify and protect vital habitat components. Here we examined the annual timing of juvenile coldwater fish migrating through a seasonally warm, hydrologically managed watershed. Our goal was to (1) understand how climate constrained the seasonal timing of water conditions necessary for juvenile fish to use nursery habitats and (2) inform management decisions about (a) mitigating climate-mediated stress on nursery habitat function and (b) conserving heat-constrained species in warming environments. Cool, wet winters deposited snow and cold water into mountains and reservoirs, which kept the lower watershed adequately cool for juveniles through the spring despite the region approaching its hot, dry summers. For every 1°C waters in April were colder, the juvenile fish population (1) inhabited the watershed 4-7 d longer and (2) entered marine waters, where survival is size selective, at maximum sizes 2.1 mm larger. Climate therefore appeared to constrain the nursery functions of this system by determining seasonal windows of tolerable rearing conditions, and cold water appeared to be a vital ecosystem component that promoted juvenile rearing. Fish in this system inhabit the southernmost extent of their range and already rear during the coolest part of the year, suggesting that a warming climate will truncate rather than shift their annual presence. Our findings are concerning for coldwater diadromous species in general because warming climates may constrain watershed use and diminish viability of life histories (e.g., late springtime rearing) and associated portfolio benefits over the long term. Lower watershed nurseries for coldwater fish in warming climates may be enhanced through allocating coldwater reservoir releases to prolong juvenile rearing periods downstream or restorations that facilitate colder conditions.
Giving Support and Suicidal Ideation in Older Adults with Vision-Related Diagnoses

Objectives: Visual impairment in older adults may increase risk for depression and suicide. Research suggests that giving support to others may be associated with lower depressive symptoms in older adults, but much of the research has been in non-clinical populations. Furthermore, there is limited research on giving support and suicide risk.Methods: Using a sample of older adults with vision-related diagnoses (N = 101), this study investigated the association between informal support giving (unpaid support given to family, friends, or neighbors) and formal support giving (volunteering) on depressive symptoms and suicidal ideation. Linear regressions examined the relation between support giving and depression, and logistic regressions examined the relation between support giving and suicidal ideation.Results: Greater informal support giving was related to lower likelihood of reported suicidal ideation (OR: .82, 95% CI: .68-.99, p = .04), whereas volunteer activity was not significantly related to suicidal ideation. Neither volunteer behavior nor informal support giving was related to depressive symptoms.Conclusions: Providing informal support was associated with lower likelihood of endorsing suicidal ideation in older adults with vision impairment.Clinical Implications: Informal support giving may be a target for decreasing suicidal ideation among older adults with health impairments.
Relationship between Curve Number and ϕ-Index

AbstractThe curve number (CN) model was originally developed to estimate the total runoff resulting from a given rainfall event. However, the CN model has a limited ability to estimate realistic in...
Theoretical and Computational Analysis of Circular Cantilever Tapered Beams

AbstractTapered beams are extensively used for structural applications due to their high stiffness-to-mass ratio. They provide many advantages over prismatic beams such as better shear carrying cap...
Fungal symbionts of the polyphagous and Kuroshio shot hole borers (Coleoptera: Scolytinae, Euwallacea spp.) in California can support both ambrosia beetle systems on artificial media

The specificity of ambrosia beetle-fungus relationships is unknown for the vast majority of ambrosia symbioses, yet has important implications for the success of these beetles and fungi in their surrounding environments. The polyphagous shot hole borer and the Kuroshio shot hole borer (Euwallacea spp.) are invasive ambrosia beetles that exist sympatrically in California, and together with their fungi cause Fusarium Dieback in a variety of hosts. The potential for the two beetle species to exchange symbionts is unknown, but has important ecological consequences. Here we perform symbiont switching experiments, to determine if the polyphagous and Kuroshio shot hole borers can survive and reproduce on each other’s symbiotic fungi in their invasive range in California. Aposymbiotic foundresses were assessed on their ability to reproduce on each of the beetles’ primary (Fusarium spp.) and auxiliary (Graphium spp., Paracremonium pembeum) fungal symbionts, grown on sawdust-based artificial media. Offspring were collected to confirm which fungi were present in the different sexes and life stages. Additionally, the ability of aposymbiotic and non-aposymbiotic foundresses to survive and reproduce on non-ambrosial Fusarium species was tested. We found that reproduction is maximized on the beetles’ primary Fusarium symbionts, regardless of whether a beetle was paired with its own Fusarium symbiont or its congener’s, indicating that there is potential for symbiont switching in natural populations of these beetles. The addition of auxiliary fungi to treatments containing Fusarium spp. had no effect on overall offspring production, and females that were fed solely on auxiliary fungi produced significantly fewer offspring. Females that were fed non-ambrosial Fusarium species produced significantly fewer offspring than when reared on symbiotic Fusarium, and this was especially pronounced in aposymbiotic females. From our experiments, the putative roles of the primary versus auxiliary fungal symbionts, as well as the implications of these roles for beetle reproduction and development in their surrounding environment, are discussed.
Annexin-V stabilizes membrane defects by inducing lipid phase transition

Annexins are abundant cytoplasmic proteins, which bind to membranes that expose negatively charged phospholipids in a Ca2+-dependent manner. During cell injuries, the entry of extracellular Ca2+ activates the annexin membrane-binding ability, subsequently initiating membrane repair processes. However, the mechanistic action of annexins in membrane repair remains largely unknown. Here, we use high-speed atomic force microscopy (HS-AFM), fluorescence recovery after photobleaching (FRAP), confocal laser scanning microscopy (CLSM) and molecular dynamics simulations (MDSs) to analyze how annexin-V (A5) binds to phosphatidylserine (PS)-rich membranes leading to high Ca2+-concentrations at membrane, and then to changes in the dynamics and organization of lipids, eventually to a membrane phase transition. A5 self-assembly into lattices further stabilizes and likely structures the membrane into a gel phase. Our findings are compatible with the patch resealing through vesicle fusion mechanism in membrane repair and indicate that A5 retains negatively charged lipids in the inner leaflet in an injured cell. Annexins are cytoplasmic proteins, which bind to membranes exposing negatively charged phospholipids in a Ca2+-dependent manner. Here the authors use high-speed atomic force microscopy and other techniques to show that annexin-V self-assembles into highly structured lattices that lead to a membrane phase transition on PS-rich membranes.
Can I Get a Witness? Using Vicarious Defeat Stress to Study Mood-Related Illnesses in Traditionally Understudied Populations

The chronic social defeat stress model has been instrumental in shaping our understanding of neurobiology relevant to affect-related illnesses, including major depressive disorder. However, the classic chronic social defeat stress procedure is limited by its exclusive application to adult male rodents. We have recently developed a novel vicarious social defeat stress procedure wherein one mouse witnesses the physical defeat bout of a conspecific from the safety of an adjacent compartment. This witness mouse develops a similar behavioral phenotype to that of the mouse that physically experiences social defeat stress, modeling multiple aspects of major depressive disorder. Importantly, this new procedure allows researchers to perform vicarious social defeat stress in males or females and in juvenile mice, which typically are excluded from classic social defeat experiments. Here we discuss several recent advances made using this procedure and how its application provides a new preclinical approach to study the neurobiology of psychological stress-induced phenotypes.
Medical Practice: From Cottage Industry to Corporate Practice

The American medical profession faces much alteration in what they do as practicing physicians that has been felt as an impingement upon their professional autonomy. As more and more physicians transition from private practice controlled by them and their colleagues to employment within large healthcare organizations controlled by an administrative class, their discontent over their loss of status has been evident. This discontent within the profession is reviewed while examining trends in the supply of physicians, income, specialty practices, and the significant change in moving from independent practice to wage-contract conditions as employees. This set of issues will be seen in light of the overall corporatization of medicine with its new structures being put in place by the Affordable Care Act aka Obamacare and growing private corporate interests. Such alterations in medical practice and its resulting disruption will likely be the prelude to the next medical malpractice insurance crisis.
Surgical management of pediatric renovascular hypertension and midaortic syndrome at a single-center multidisciplinary program

Abstract Objective To evaluate the outcomes of various surgical approaches in the treatment of renovascular hypertension and midaortic syndrome (MAS) in children. Methods We performed a retrospective medical record review of patients who had undergone surgery for renovascular hypertension from 2010 to 2018 at our center under the care of a multidisciplinary team. The operative interventions included mesenteric artery growth improves circulation (MAGIC), tissue expander-stimulated lengthening of arteries (TESLA), aortic bypass using polytetrafluorethylene, renal artery reimplantation, and autotransplantation. The MAGIC procedure uses the meandering mesenteric artery as a free conduit for aortic bypass. The TESLA procedure is based on lengthening the normal distal aorta and iliac arteries by gradual filling of a retroaortic tissue expander for several weeks, followed by resection of the stenotic aorta and subsequent primary reconstruction. Results A total of 39 patients were identified, 10 with isolated renal artery stenosis, 26 with MAS, and 3 with systemic inflammatory vasculitis. The median age at presentation and surgery was 6.4 years (range, 0-16.3 years) and 9.3 years (range, 0-9.2 years), respectively. The MAS-associated syndromes included neurofibromatosis type 1 (15.4%) and Williams syndrome (5.1%), although most cases were idiopathic. At surgery, 33.3% had had stage 1 hypertension (HTN), 53.8% stage 2 HTN, and 12.8% normal blood pressure with a median of three antihypertensive medications. Follow-up of 37 patients at a median of 2.5 years demonstrated normal blood pressure in 86.1%, stage 1 HTN in 8.3%, and stage 2 HTN in 5.6%, with a median of one antihypertensive medication for the entire cohort. Conclusions The patterns of vascular involvement leading to renovascular hypertension in children are variable and complex, requiring thoughtful multidisciplinary planning and surgical decision-making. The MAGIC and TESLA procedures provide feasible approaches for aortic bypass and reconstruction using autologous tissues and will result in normalization of blood pressure in 85% of children 2.5 years after surgery.
Securities Transaction Taxes and Market Quality of Equity and Futures Markets: Issues and Evidence

This paper discusses arguments for and against a securities transaction tax (STT) and evaluates the pros and cons based on a review of empirical evidence concerning the impact of STTs on equity and futures markets (i.e., trading volume, bid-ask spreads, and price volatility) and market efficiency in various countries. I find that an STT would likely reduce trading volume and increase trading cost, but may not reduce price volatility. The size of potential STT revenue depends on the STT's impact on market activity. A sizable STT on futures and equity markets would not only fail to generate the expected tax revenue, it would also likely hurt the international competitiveness of US equity and futures markets.
To Live is Christ: Exploring the Promise and Limits of For the Life of the World:

For the Life of the World represents a landmark discussion of social ethics within the Orthodox academy in the West. This article begins by looking at the document's self-understanding as an explor...
The Politics of Preference: Masculinity, Marital Status and Unemployment Relief in Post-First World War Britain

This article explores relationships between masculinity and welfare in post-First World War Britain through an analysis of unemployment relief. While their service to the nation entitled them to go...
Equilibrium constant for conversion of pyruvate to acetyl phosphate and formate

Preparations of pyruvate formate-lyase were made from Escherichia coli cells. Net reversal of the "phosphoroclastic split" of pyruvate was readily demonstrated with these preparations. Incubation of acetyl phosphate with formate resulted in the accumulation of pyruvate in concentrations up to 0.5 mm. Catalytic amounts of coenzyme A were essential. Pyruvate was also readily formed from acetyl coenzyme A and formate. The equilibrium constant of the reaction (pyruvate(-) + HPO(4) (2-) --> acetyl phosphate(2-) + formate(-)) has been determined to be about 23 at 37 C.
STEROID 5|[alpha]|-REDUCTASE TYPE 2 DEFICIENCY

The enzyme 5α-reductase converts testosterone to dihydrotestosterone and is required for male phenotypic sexual differentiation. There are two 5α-reductase genes in man that encode isozymes (designated types 1 and 2) with distinct biochemical and pharmacological properties and tissue distributions. Mutations in the gene encoding the type 2 isozyme cause male pseudohermaphroditism. The characterization of 27 mutations at the molecular and biochemical levels has revealed amino acids in the protein that participate in substrate and cofactor (NADPH) binding, as well as determinants of protein stability. An unexplained feature of this disease has been the occurrence of partial virilization at puberty in affected males. Determination of the developmental expression patterns of the two 5α-reductase isozymes by immunoblotting suggest that the observed virilization may be caused by expression of the type 1 isozyme in the liver and skin. This result suggests that dihydrotestosterone may act in a true endocrine fashion in addition to the autocrine and paracrine mechanisms typically ascribed to this androgen.
Frequency of unacceptable results in point-of-care testing.

K and associates1 show how the rich source of information available in the laboratory can be used to improve care processes. The ‘‘naturally concurrent’’ results from laboratory and point-of-care hematocrit measurements helped improve quality, and this concurrence exemplifies the real-time science of laboratory medicine. This article stimulates the search for similar improvement opportunities and suggests a practical research agenda. Kilgore et al did not differentiate common cause and special cause sources of variation.2 Common cause variation, usually modeled with the gaussian distribution, suggests that results beyond 3 SDs occur at a frequency of about 0.27%, or 2700 parts per million (ppm). Further, 4 SDs yield 63 ppm, 5 SDs yield 0.6 ppm, and 6 SDs yield 0.002 ppm, outlier rates in a gaussian distribution with no bias in the midpoint. Special cause variation is distinct from common cause and is believed to be attributable to unexpected sources of variation and is not modeled by the gaussian distribution.2 The figure presented by Kilgore et al suggests frequent special cause outliers in January and infrequent special cause variation plus perhaps smaller common cause variation in April. The authors defined a clinically significant difference as 5 hemat-
Intelligent VLSI design object management

Designing a VLSI chip is almost always an iterative process and a group effort. As a result, proliferation of design versions, becomes one of the most important issues in the development of design automation systems. The authors present the design and implementation of a VLSI object management system that supports several novel low-level storage management and access control services not found in previous systems. Among them are differential representation for design versions, integration of related versions, constraint-based synchronization mechanisms, and query/link access facilities for exploring the design versions space. This object system lays a foundation for customizing and implementing high-level version/configuration and concurrency control policies according to site-specific and group-specific needs. >
Field studies in implementation of quality management programs

Five projects conducted over approximately four years investigated different aspects of total quality management (TQM) programs and their overall effectiveness at different US manufacturing sites. Each of these studies considered one or more aspects of implementing a TQM program in a manufacturing environment. Three of the studies used surveys to evaluate perceptions of employees' involved in management-directed changes in a TQM environment. The other two used case studies of specific projects designed to improve manufacturing effectiveness by using TQM principles. One of the most fundamental tenets of TQM is to encourage total participation by all employees and to open the lines of communication. Several of the studies showed examples of how this worked in practice. >
Finite Element Simulation for Structural Response of U7Mo Dispersion Fuel Plates via Fluid-Thermal-Structural Interaction

This article presents numerical simulation of dispersion fuel mini plates via fluid-thermal-structural interaction performed by commercial finite element solver COMSOL Multiphysics to identify initial mechanical response under actual operating conditions. Since fuel particles are dispersed in Aluminum matrix, and temperatures during the fabrication process reach to the melting temperature of the Aluminum matrix, stress/strain characteristics of the domain cannot be reproduced by using simplified models and assumptions. Therefore, fabrication induced stresses were considered and simulated via image based modeling techniques with the consideration of the high temperature material data. In order to identify the residuals over the U7Mo particles and the Aluminum matrix, a representative SEM image was employed to construct a microstructure based thermo-elasto-plastic FE model. Once residuals and plastic strains were identified in micro-scale, solution was used as initial condition for subsequent multiphysics simulations at the continuum level. Furthermore, since solid, thermal and fluid properties are temperature dependent and temperature field is a function of the velocity field of the coolant, coupled multi-physics simulations were considered. First, velocity and pressure fields of the coolant were computed via fluid-structural interaction. Computed solution for velocity fields were used to identify the temperature distribution on the coolant and on the fuel plate via fluid-thermal interaction. Finally, temperature fields and residual stresses were used to obtain the stress field of the plates via fluid-thermal-structural interaction.Copyright © 2010 by ASME
Measurement of endogenous estrogens: analytical challenges and recent advances.

Recent developments in the analysis of endogenous estrogens (including both free and conjugated estrogens) are reviewed. Largely due to urging by some cancer researchers, new demands are now being placed on such measurements in terms of sensitivity, throughput, multi-analyte detection and accuracy. Especially high sensitivity is required for detecting estrogens in serum from postmenopausal women, children and men, where concentrations at the low pg/ml level are encountered, and one would prefer to test much less than 1 ml of serum. Aside from throughput, meeting all of these demands may be beyond the reach of immunoassay, the method that has created and continues to dominate this field. Both HPLC and GC versions of mass spectrometry are emerging that have some potential to improve the testing of physiological samples for endogenous estrogens. The following topics are covered in this review: related analyses (e.g. detection of estrogens in environmental samples such as water, where 1-1 samples can be collected to provide ng amounts of estrogens); structure and metabolism of estrogens; biological actions (with an emphasis on their role in cancer); immunoassays; HPLC with electrochemical detection; GC-ECD; and various forms of mass spectrometry.
Optimality of myopic inventory policy for a single-product, multi-period, stochastic inventory problem with batch ordering and capacity commitment

The single-product, multi-period, stochastic inventory problem with batch ordering has been studied for decades. However, most existing research focuses only on the case in which there is no capacity constraint on the ordered quantity. This article generalizes that research to the case in which the capacity is purchased at the beginning of a planning horizon and the total ordered quantity over the planning horizon is constrained by the capacity. The objective is to minimize the expected total cost (the cost of purchasing capacity plus the minimum expected sum of the ordering, storage, and shortage costs incurred over the planning horizon for the given capacity). The conditions that ensure that a myopic ordering policy is optimal for any given capacity commitment are obtained. The structure of the expected total cost is characterized under these conditions and an algorithm is presented that can be used to calculate the optimal capacity commitment. A simulation study is performed to better understand the im...
EFFECT UPON SHOCK SPECTRA OF THE DYNAMIC REACTION OF STRUCTURES

Attempts to use fiducial limit curves of a set of classes of shock spectra as a basis for the design of structures have shown that the design spectra obtained by the combinatorial analysis of many shock spectra tend to be overconservative. This paper presents a possible explanation for this. It exhibits some experimental evidence to show that the values of interest in a shock spectrum plot tend to lie in the valleys of that plot and not upon the peaks, whereas fiducial limit curves are controlled by the peaks of the individual shock spectra.
Anomalous side chain amidation in plasma membrane proteins of simian virus 40-transformed lymphocytes indicated by isoelectric focussing and laser raman spectroscopy

Abstract Plasma membranes isolated from normal hamster lymphocytes and lymphoid cells transformed by SV40 1 have been compared. Isoelectric focussing in 1% Triton X-100 8M urea reveals higher isoelectric points than normal for the non-glycosylated proteins in the membranes of transformed cells. This suggests greater amidation of membrane aspartates and/or glutamates. The focussing patterns also reveal a shift to lower pH for the isoelectric points of most glycosylated proteins suggesting increased silalylation. The Amide I – Amide II laser Raman spectra of the two membrane categories are consistent with greater side chain amidation in the membranes of neoplastic lymphocytes.
De la caída de Tenochtitlán al decaimiento del Make Sicko Seedy de Carlos Fuentes: Ciudades en crisis, mundos por nacer

Carlos Fuentes's 1987 carnivalesque novel, Cristobal nonato, criticizes Mexico's prehispanic past through a satire of Tenochtitlan-Mexico City in the neoliberal, postnational era. This study conseq...
Ranking the Law Schools: The Reality of Illusion?

This article examines the problems inherent in any endeavor to rank law schools on a qualitative basis. Analysis of possible ranking criteria forces the conclusion that attempting to assign specific rankings based on objective criteria is a futile task. However, objective tests are suggested which indicate, on application to available data, that about 40 of the approximately 165 ABA-AALS-accredited law schools are of superior quality and differ among themselves only as to an image of prestige.
On Lachmannian and Effectual Entrepreneurship: A Rejoinder to Sarasvathy and Dew (2008)

We welcome the comments of Professors Sarasvathy and Dew (2008) on our recent article, which introduced a new paradigm for entrepreneurship research based on one of the central figures in modern Austrian economics: Ludwig Lachmann (Chiles et al. 2007). Our purpose in writing the article was (1) to bring together a wide range of disparate entrepreneurship concepts under a single new conceptual framework, and (2) to provide greater coherence and theoretical underpinnings to entrepreneurship research. In doing so, we described connections between a Lachmannian approach to entrepreneurship and numerous extant approaches, including effectuation. Sarasvathy and Dew (hereafter, S&D), in taking issue with some of our interpretations of effectuation, clarified their previous work on this approach and explicated its primary foundations. We find S&D’s discussion of the problems of knowledge, resources, and institutions provocative, and their conclusion about the basis of effectuation revealing. Our response to these arguments attempts to further clarify areas of possible confusion and suggests that the Lachmannian and effectuation approaches may share more common ground than S&D realize in some areas and less than we thought in others. In our brief response, we do not attempt to critique every point S&D make, but instead focus on what we view as their fundamental arguments.