cssi/SciSciGPT-SciSciNet huggingface dataset:
Intra-articular Osteoid Osteoma of the Distal Femur Treated with Osteochondral Grafting: A Report of 2 Cases.

Case Intra-articular osteoid osteoma (IAOO) is a relatively rare entity and can pose a therapeutic challenge due to proximity to the cartilage surface. We present 2 cases of subchondral osteoid osteomata within the distal femur treated with excision and osteochondral grafting of the resultant defect. Conclusions Subchondral IAOO can pose a therapeutic challenge. Our patients had an effective pain relief and return to activities with this treatment strategy.
An augmented reality system for image guidance of transcatheter procedures for structural heart disease

The primary mode of visualization during transcatheter procedures for structrural heart disease is fluoroscopy, which suffers from low contrast and lacks any depth perception, thus limiting the ability of an interventionalist to position a catheter accurately. This paper describes a new image guidance system by utilizing augmented reality to provide a 3D visual environment and quantitative feedback of the catheter's position within the heart of the patient. The real-time 3D position of the catheter is acquired via two fluoroscopic images taken at different angles, and a patient-specific 3D heart rendering is produced pre-operatively from a CT scan. The spine acts as a fiduciary land marker, allowing the position and orientation of the catheter within the heart to be fully registered. The automated registration method is based on Fourier transformation, and has a high success rate (100%), low registration error (0.42 mm), and clinically acceptable computational cost (1.22 second). The 3D renderings are displayed and updated on the augmented reality device (i.e., Microsoft HoloLens), which can provide pre-set views of various angles of the heart using voice-command. This new image-guidance system with augmented reality provides a better visualization to interventionalists and potentially assists them in understanding of complicated cases. Furthermore, this system coupled with the developed 3D printed models can serve as a training tool for the next generation of cardiac interventionalists.
Essential attributes of an acceptable in vitro diagnostic test

Abstract An in vitro diagnostic (IVD) device can only be useful if it can satisfy its analytical, clinical, and regulatory expectations and its levels depend on the possible impact of results on medical decision and the device analytical complexity. In the United States, FDA regulates devices, and CLIA (Clinical Laboratory Improvement Amendments) is meant to oversee laboratory operational aspects; however, CLIA has been, also, overseeing tests developed and run by laboratories, which are commonly known as laboratory-developed tests. FDA and CLIA classify IVDs into classes (Class I, II, and III and waived, moderate, and high complex) depending on their complexities, liability to errors, possible impact of erroneous results, and level of regulatory control needed. No IVD is absolutely perfect, and one has to employ an assay with acceptable analytical performance characteristics.
"You can see those concentric rings going out": Emergency personnel's experiences treating overdose and perspectives on policy-level responses to the opioid crisis in New Hampshire.

Abstract Background In parallel to a substantial increase in opioid overdose deaths in New Hampshire (NH), emergency personnel experienced an increase in opioid-related encounters. To inform public health responses to this crisis, insights into the experiences and perspectives of those emergency personnel who treat opioid-related overdoses are warranted. Aims Systematically examine emergency personnel’s experiences treating opioid overdoses and obtain their perspectives on policy-level responses to the opioid crisis in NH. Methods Semi-structured qualitative interviews were conducted with 18 first responders [firefighters (n = 6), police officers (n = 6), emergency medical service providers (n = 6)] and 18 emergency department personnel employed in six NH counties. Interviews focused on emergency personnel’s perspectives on fentanyl/heroin formulations, experiences treating overdoses, harm reduction strategies, and experiences with treatment referral. Interviews were audio recorded, transcribed verbatim, and analyzed using content analysis. Results Emergency personnel cited the potency and inconsistency of fentanyl-laced heroin as primary drivers of opioid overdose. Increases in overdose-related encounters took a substantial emotional toll on emergency personnel, who described a range of responses including feelings of burnout, exhaustion, and helplessness. While some emergency personnel felt conflicted about the implementation of harm reduction strategies like syringe services programs, others emphasized the necessity of these services. Emergency personnel expressed frustration with barriers to treatment referral in the state and recommended immediate treatment access after overdose events. Conclusions Findings suggest that interventions addressing trauma and burnout are necessary to support emergency personnel, while expanded harm reduction and treatment access are critical to support those who experience opioid overdose in NH.
Placental DNA methylation changes associated with maternal prepregnancy BMI and gestational weight gain.

Maternal obesity prior to or during pregnancy influences fetal growth, predisposing the offspring to increased risk for obesity across the life course. Placental epigenetic mechanisms may underlie these associations. We conducted an epigenome-wide association study to identify placental DNA methylation changes associated with maternal prepregnancy body mass index (BMI) and rate of gestational weight gain at first (GWG1), second (GWG2), and third trimester (GWG3). Participants of the NICHD Fetal Growth Studies with genome-wide placental DNA methylation (n = 301) and gene expression (n = 75) data were included. Multivariable-adjusted regression models were used to test the associations of 1 kg/m2 increase in prepregnancy BMI or 1 kg/week increase in GWG with DNA methylation levels. Genes harboring top differentially methylated CpGs (FDR P < 0.05) were evaluated for placental gene expression. We assessed whether DNA methylation sites known to be associated with BMI in child or adult tissues, were also associated with maternal prepregnancy BMI in placenta. Prepregnancy BMI was associated with DNA methylation at cg14568196[EGFL7], cg15339142[VETZ], and cg02301019[ AC092377.1 ] (FDR P < 0.05, P ranging from 1.4 × 10−10 to 1.7 × 10−9). GWG1 or GWG2 was associated with DNA methylation at cg17918270[MYT1L], cg20735365[DLX5], and cg17451688[SLC35F3] (FDR P < 0.05, P ranging from 6.4 × 10−10 to 1.2 × 10−8). Both prepregnancy BMI and DNA methylation at cg1456819 [EGFL7] were negatively correlated with EGFL7 expression in placenta (P < 0.05). Several CpGs previously implicated in obesity traits in children and adults were associated with prepregnancy BMI in placenta. Functional annotations revealed that EGFL7 is highly expressed in placenta and the differentially methylated CpG sites near EGFL7 and VEZT were cis-meQTL targets in blood. We identified placental DNA methylation changes at novel loci associated with prepregnancy BMI and GWG. The overlap between CpGs associated with obesity traits in placenta and other tissues in children and adults suggests that epigenetic mechanisms in placenta may give insights to early origins of obesity.
Perioperative Care of the Orthopedic Patient with Chronic Pain

The management of perioperative pain is a critical component of surgical care. Commonly, acute postoperative pain is easily identified as the region of injury and surgical insult are evident. Effective management of the acute conditions require therapy, which is tailored to the patient’s specific requirements as dictated by surgical site and intervention, as well as the patient’s experiences and expectations. In patients who have been chronically exposed to opioid pain medications, hyperalgesia may alter the level of pain the patient will experience. In addition, patients who are already on high dose opioid therapy may need to be on higher than anticipated doses after surgery, which adds to the risk of adverse events. Chronic opioid use may further be complicated by the concomitant utilization of other licit (such as alcohol or benzodiazepines) and illicit (such as cocaine or heroin) substances. Further, the risks associated with postoperative opioid therapy are increased in the presence of mental health conditions, including substance use disorder (SUD). For these reasons, postoperative pain management begins with preoperative assessment and planning. The anticipated surgery and the patient’s experience with pain therapies, medical conditions, age, and psychological state are factors that need to be considered in order to define an individualized therapy plan. By asking the proper questions preoperatively and providing adequate information, staff members can educate patients on therapeutic options, try to better understand their expectations, and help mitigate any risks. For elective surgeries, preoperative pain evaluation and treatment optimization, including reducing opioids, addressing substance abuse, patterns of misuse, and mental health issues, improves patient outcomes and results in lower cost and improved healthcare utilization.
Chapter e82 – Homeland Security

The September 11, 2001, terrorist attacks, permanently changed the way the United States and the world's other most developed countries perceived the threat from terrorism. Massive amounts of resources were mobilized in a very short time to counter the perceived and actual threats from terrorists and terrorist organizations. In the United States, this refocus was pushed as a necessity for what was called homeland security. The homeland security threats were anticipated for the IT infrastructure as well. It was expected that not only the IT at the federal level was vulnerable to disruptions due to terrorism-related attacks but, due to the ubiquity of the availability of IT, any organization was vulnerable. Soon after the terrorist attacks, the US Congress passed various new laws and enhanced some existing ones that introduced sweeping changes to homeland security provisions and to the existing security organizations. The executive branch of the government also issued a series of Homeland Security Presidential Directives to maintain domestic security. These laws and directives are comprehensive and contain detailed provisions to make the United States secure from its vulnerabilities. Later in the chapter, we describe some principle provisions of these homeland security-related laws and presidential directives. Next, we discuss the organizational changes that were initiated to support homeland security in the United States. Then we highlight the 9-11 Commission that Congress charted to provide a full account of the circumstances surrounding the attacks and to develop recommendations for corrective measures that could be taken to prevent future acts of terrorism. We also detail the Intelligence Reform and Terrorism Prevention Act of 2004 and the Implementing the 9-11 Commission Recommendations Act of 2007. Finally, we summarize the chapter's discussion.
Imaging Ionic Aggregates in Zn-Neutralized Sulfonated Polystyrene Ionomers: Shape and Spatial Heterogeneity

Ionomers are ionically-associating copolymers whose distinctive rheological and mechanical properties arise from the formation of ionic aggregates. The ionic aggregates form when dipoles of minority anionic polymer backbone segments and cationic neutralizing species locally associate and dissociate among each other. Specific ionomer properties depend upon the base copolymer, the minority constituent and the neutralizing agent. One system that has been studied extensively is sulfonated polystyrene ionomer neutralized with Zn (Zn-SPS). The most common technique to date for studying ionomer morphology is small-angle x-ray scattering (SAXS). This technique has provided quantitative information about the aggregate morphology by imposing morphology models that have not been independently confirmed.In the present study, we demonstrate the capability to directly image the ionic aggregates of Zn-SPS ionomers using scanning transmission electron microscopy (STEM). This method will allow us to confirm or deny the competing morphological models applied to SAXS data. We have applied similar methods to polyethylene-based ionomers.
Culture and Sexual Medicine: A Road Map for Clinical Inquiry and Practice

ABSTRACT As the field of sexual medicine continues to grow, there has been increasing attention to the importance of the sociocultural components of the biopsychosocial model. Although important in all medical practice, culture and sexual health are particularly entwined, so engaging with sociocultural aspects of the patient experience as part of evaluation and treatment is necessary to optimize patient outcomes in this field. We invite clinicians to consider the importance of sexual health literacy, cultural humility, and support for patient volition as key aspects of moving care towards a model that embraces all aspects of the biopsychosocial model. The aim of the current paper is to provide readers with concrete steps and illustrative examples to help guide this process. Bober SL, Chevalier L. Culture and Sexual Medicine: A Road Map for Clinical Inquiry and Practice. J Sex Med 2021;18:1475–1478.
High-performance liquid chromatography of oligosaccharides.

Publisher Summary This chapter proposes separation methods primarily for oligosaccharides that are radiolabeled by metabolic incorporation of 3H- or 14C-labeled sugar, metabolic incorporation of 35SO4 or 32PO4, or chemical incorporation of 3H at the reducing terminus by reduction with NaB3H4. The most common strategy is to first separate the radiolabeled oligosaccharides into different groups on the basis of their anionic character, using anion-exchange high-performance liquid chromatography (HPLC). Oligosaccharides differing in the number and/or character of their anionic groups are then further fractionated on the basis of size, using ion suppression-amine adsorption (ISAA) HPLC. The effects of chemical modifications and enzymatic digestions on individual species are subsequently monitored by anion-exchange HPLC and ISAA–HPLC along with other methods such as lectin affinity HPLC. Four methods for separation of anionic oligosaccharides are illustrated in the chapter. Fractionation of oligosaccharides bearing zero to four anionic moieties, using MicroPak AX-10 or AX-5 columns and a phosphate buffer (pH 4.0), is effective for oligosaccharides bearing terminal sialic acid. Oligosaccharides-bearing sulfate or phosphate can be fractionated under the same conditions; however, the concentration of the initial eluant is reduced to 2.5 mM in order to retain monosulfated species.
International Stock Returns and Expected Inflation: Evidence from Pre-War Data

This research examines the relations between expected inflation and real returns on stocks for six industrialized countries during the pre-World War II period. Negative correlations are found, consistent with the findings of other researchers for the postwar period. Fama's (1981) proxy theory attempts to explain the negative relation, based on his finding of a strong positive correlation between real returns and real output growth for the postwar period. This research finds the real return/output growth correlation to be zero for the U.S. and France, and negative for Germany, for the pre-1914 period. (JEL E31, G12, N10, N20)
Energy-linked reactions in photosynthetic bacteria: VI. Inorganic pyrophosphate-driven ATP synthesis in Rhodospirillum rubrum☆

Abstract A new reaction, the inorganic pyrophosphate-driven synthesis of ATP in Rhodospirillum rubrum chromatophores, was demonstrated. The effect of inhibitors such as m-Cl-CCP, S-13, desaspidin, and oligomycin indicate that this is an energy-linked reaction. Phosphotransferase and exchange reactions involving the direct transfer of phosphate from PPi to ADP or ATP were very low or nonexistent in chromatophores. Thus, the reaction can be described by the following equations where “~X” represents an energized state or intermediate: PPi ⇌ “~X” + 2 Pi ADP + Pi + “~X” ⇌ ATP The characteristics and requirements for the reaction were elucidated and the interaction between this reaction and other energy-linked reactions, such as NAD+ reduction, transhydrogenation, and ATP-Pi exchange, was demonstrated. The discussion focuses on the advantage of this energy-conserving reaction to the cell.
Protein Kinase Activity Associated with the Extracellular and Occluded Forms of the Baculovirus Autographa californica Nuclear Polyhedrosis Virus

Abstract Protein kinase activity is associated with both the extracellular and the occluded forms of Autographa californica nuclear polyhedrosis virus, a baculovirus. Serine and threonine are the predominant amino acids phosphorylated by the kinase activity associated with both viral forms; no phosphotyrosine was detected. The addition of calcium, cAMP, or cGMP has no apparent effect on the amount of phosphorylation or the substrates phosphorylated.
Strict Liability in International Environmental Law

International environmental law has come to distinguish responsibility and liability for the injurious consequences of lawful activities. Strict liability is foreseen in texts regulating activities considered as especially new or dangerous, such as the exploration and exploitation of outer space, and which are largely conducted by State actors. The Convention on Principles Governing the Activities of States in the Exploration and Use of Outer Space, including the Moon and other Celestial Bodies, provides both for State responsibility and strict liability. Although this chapter refers to liability, it seems to discuss State responsibility instead, because its focus is a State's failure to comply with its legal obligations to take appropriate measures to prevent harm by non-State actors within its jurisdiction. Such omissions are often the basis of claims against States under the law of State responsibility. Keywords: hazardous lawful activities; international environmental law; jurisdiction; State Responsibility; Strict Liability
A Meeting of Minds: Mutuality in Psychoanalysis

In this assessment of the various dimensions of mutuality in psychoanalysis, the author contends that the relational approach is a useful guide to issues of technique and therapeutic strategy, and accepts the clinical responsibilities of a postmodern critique of psychoanalytic foundations.
Risk Factors for Adverse Outcomes in Patients Hospitalized With Lower Gastrointestinal Bleeding.

Objective To determine which risk factors and subtypes of lower gastrointestinal bleeding (LGIB) are associated with adverse outcomes after hospital discharge (30-day readmissions, recurrent LGIB, and death).
Time-frequency distributions using rotated-window spectrograms

Previously proposed methods for combining multiple spectrograms with different length analysis windows have been shown to result in improved time-frequency distributions (TFD) for certain classes of signals. Such TFDs are purely positive and have time and frequency marginals which are closer to the "correct" signal marginals than any of the individual spectrograms. The marginals of such TFDs taken along directions not parallel to the time or frequency axes, however, are not improved. In this paper we extend the method of combining spectrograms to include spectrograms with "rotated windows" in which the resolution trade-offs can occur along any direction in the time frequency plane. The resultant new TFDs can have improved resolution and better agreement with the signal marginals along arbitrary directions in the time-frequency plane, not just parallel to the time and frequency axes.
Visualization of spectroscopy for remote surface operations

This work discusses the role that in-situ spectroscopy plays in remote surface operations and how effective visualization of spectra can benefit planning. We begin by discussing how spectroscopy was used in the Mars Pathfinder mission and field trials with a prototype of the Mars Exploration Rover, paying close attention to shortcomings in visualization that hamper science planning. Next, we will introduce two methods for improving visualization of spectra that will be used during the Mars Exploration Rover 2003 mission: image cubes and data fusion. Image cubes view a collection of spectra as a hyperspectral image and allows spectra to be enhanced using image processing algorithms. Data fusion places spectral data in the context of a conventional image by overlaying an image cube slice onto an image of the terrain. We demonstrate these techniques with examples of image cubes and data fusion using data from FIDO rover field trials. We conclude with a discussion of future directions for these visualization methods.
Autonomous vehicle software taxonomy

A survey of software architectures for 12 autonomous underwater vehicles has been made. The analysis is performed in the context of an evaluation framework which focuses on each architecture's important features, including its control distribution strategy, its use of modeling, and the types and representations of knowledge that it uses. A classification scheme has been developed which helps to associate the features of an architecture with vehicle performance characteristics. The manner in which vehicle control and decision-making are distributed among the elements of the software architectures is discussed. A specific onboard planning system architecture is proposed, and its characteristics are discussed in the context of the criteria that were used to evaluate the existing architectures. >
Early Steps of the Virus Replication Cycle Are Inhibited in Prostate Cancer Cells Resistant to Oncolytic Vesicular Stomatitis Virus

Vesicular stomatitis virus (VSV) is currently being studied as a candidate oncolytic virus for tumor therapies due to its potent tumoricidal activity. Previous studies have demonstrated that VSV selectively infects tumor cells due to defects in their antiviral pathways. These defects make them more susceptible to VSV-induced killing than normal cells. However, some cancer cells display differential sensitivity to VSV. Specifically, LNCaP prostate cancer cells are sensitive to infection with VSV, while PC3 prostate cancer cells are relatively resistant to VSV. This suggests that tumor cells vary in the extent to which they develop defects in antiviral pathways and, thus, permit virus replication. The goal of these studies was to identify the step(s) of the viral replication cycle that is inhibited in PC3 cells. Results showed that although attachment of VSV was not significantly different among cell types, penetration was delayed by 10 to 30 min in PC3 cells relative to LNCaP cells. Primary transcription was delayed by 6 to 8 h in PC3 cells relative to LNCaP cells. Similarly, both secondary transcription and viral protein synthesis rates were delayed by about 6 to 8 h. The progressively increasing delay suggests that more than one step is affected in PC3 cells. Analysis of cellular gene expression showed that in contrast to LNCaP cells, PC3 cells constitutively expressed numerous antiviral gene products, which may enhance their resistance to VSV. These data indicate that the use of VSV for oncolytic virus therapy for prostate tumors may require prescreening of tumors for their level of susceptibility.
An adaptive Chebyshev iterative method for nonsymmetric linear systems based on modified moments

Large, sparse nonsymmetric systems of linear equations with a matrix whose eigenvalues lie in the right half plane may be solved by an iterative method based on Chebyshev polynomials for an interval in the complex plane. Knowledge of the convex hull of the spectrum of the matrix is required in order to choose parameters upon which the iteration depends. Adaptive Chebyshev algorithms, in which these parameters are determined by using eigenvalue estimates computed by the power method or modifications thereof, have been described by Manteuffel [1978]. This paper presents adaptive Chebyshev iterative methods, in which eigenvalue estimates are computed from modified moments determined during the iterations. The computation of eigenvalue estimates from modified moments requires less computer storage than when eigenvalue estimates are computed by a power method and yields faster convergence for many problems.
Change in the physical condition of starch of the potato during precooking heating

In the processing of dehydrated mashed potatoes it has been found that a heating treatment before cooking improves the quality of the product. The temperatures of preheating are at or just above the temperature of gelatinization of potato starch granules, 60° C. Data presented here show-that gelatinized starch retrogrades, that is, becomes less soluble, if held at these temperatures. The rates of retrogradation at three temperatures. 60°, 65°, and 75° C, were about the same. After 60 minutes of preheating there was little further decrease in dissolved starch. Increasing cooking time of samples that were not preheated increased the amount of starch dissolved. These data suggest that the improved quality of dehydrated mashed potato products is due, in part at least, to a retrogradation of the starch. This retrogradation may account for the greater firmness and lack of sloughing of potatoes that are heated before cooking.
Projections from the medial nucleus of the inferior pulvinar complex to the middle temporal area of the visual cortex.

Medial, central and posterior nuclei have been previously identified within the inferior pulvinar complex of owl monkeys (Lin & Kaas, 1979). In the present experiments injections of [3H]-proline into the posterior thalamus, including the medial nucleus, produced densely labeled terminals in the middle temporal area of the visual cortex (Allman & Kaas, 1971). Injections of the retrograde tracer, horseradish peroxidase, into the middle temporal area labeled most of the neurons in the medial nucleus and only occasional neurons in the central and posterior nuclei. The posterior nucleus appeared to project to the cortex rostral to the middle temporal area in the temporal lobe, and the central nucleus projects to the visual cortex caudal to the middle temporal area. We conclude that the middle temporal area is the major cortical target of the medial nucleus in the inferior pulvinar complex and that the central and posterior nuclei have other cortical targets. Thus, these findings support the view that the inferior pulvinar complex consists of three distinct nuclei, which should lead to further progress in understanding its connections and functions.
The electronic structure of SrTiO3 and some simple related oxides (MgO, Al2O3, SrO, TiO2)

Abstract The valence band density of states (VBDOS) of the insulating oxides SrTiO 3 , TiO 2 , SrO, MgO and Al 2 O 3 obtained by X-ray photoelectron spectroscopy (XPS), are reported. Qualitatively, the VBDOS of these oxides are similar to one another. The XPS results are compared with results from soft X-ray emission spectroscopy (XES), ultraviolet photoemission spectroscopy (UPS), and theoretical calculations. There are some differences (in particular for TiO 2 ) between the XES and XPS results, which are probably due to matrix element effects enhancing different features of the VBDOS in the two techniques. The XPS results definitively establish the position of the O 2 s level, which had been erroneously assigned in previous low-energy UPS measurements. Cluster-type calculations are demonstrated to give a reasonable representation of the VBDOS for the oxides.
New proofs of Plünnecke-type estimates for product sets in groups

We present a new method to bound the cardinality of product sets in groups and give three applications. A new and unexpectedly short proof of the Plunnecke-Ruzsa sumset inequalities for commutative groups. A new proof of a theorem of Tao on triple products, which generalises these inequalities when no assumption on commutativity is made. A further generalisation of the Plunnecke-Ruzsa inequalities in general groups.
Morphologic characteristics and functional significance of focal fibromuscular dysplasia of small coronary arteries

Focal fibromuscular dysplasia of small coronary arteries is not so rare as it is unrecognized. Although sometimes occurring as an isolated abnormality, it more often accompanies a variety of other lesions including inflammation or infiltration. In this review based on personal study of over 1,000 human hearts, the 3 topics include a description of the morphologic characteristics of the lesion, a discussion of its functional consequences affecting coronary flow, and an iteration of theoretical explanations for its development. The typical lesion is focal in distribution, is comprised of both fibrous and smooth muscle elements, and the histologic organization is one of dysplastic array. Included among the subjects discussed in functional consequences are coronary spasm, coronary reserve, chest pain, electrical instability of the heart, and comments on the role of focal fibromuscular dysplasia of small coronary arteries in hypertension, myocardial hypertrophy and heart failure. Theories as to its development include primary faults of smooth muscle or collagen, and focal abnormalities of clotting or neurovascular relation, but it is likely that the cause is multifactorial.
Inverse scattering simulation for a 1-D surface reconstruction

We have studied the inverse scattering problem as an optimization problem. Firstly, we deal with the direct scattering problem of a one-dimensional, perfectly conducting rough surface. We discuss the complexity of the relation between the surface profile, the incident field, and the far-field intensity. Then, we approach the inverse problem as an optimization problem of constraint. In general we adopt a mathematical representation of the surfaces based on B-spline curves, and describe the evolutionary strategies. Concerning the mutation operator in evolutionary algorithm, some effort to facilitate self-adaptation of the mutation has been presented. The typical results are presented with our main conclusions.
393: Prevalence and progression of recipient twin cardiomyopathy in early stage twin-twin transfusion syndrome (TTTS)

Objective The management of twin–twin transfusion syndrome (TTTS) in its early stages (Quintero Stages I and II) is controversial. We describe the prevalence, severity, incidence and rate of progression of recipienttwin cardiomyopathy in Stages I and II TTTS. Methods Among 451 cases of TTTS evaluated between 2004 and 2009, 123 (27.3%) cases of Stages I and II were reviewed. Echocardiography was used to ‘upstage’ cases based on the presence or absence of mild (IIIA), moderate (IIIB), or severe (IIIC) recipient cardiomyopathy. Progression was defined by worsening in the degree of recipient-twin cardiomyopathy from initial presentation or failure to respond to amnioreduction. Outcome data included progression of recipient-twin cardiomyopathy, treatment and survival to birth. Data were compared by the chi-square, Fisher’s exact test or t-test as appropriate. Results Seventy-seven of 123 (62.6%) cases were Quintero Stage I and 46/123 (37.4%) Quintero Stage II. Eighty (65.0%) were upstaged to Cincinnati Stage IIIA (n = 25), IIIB (n = 23) or IIIC (n = 32). Management included observation in 11 (8.9%), amnioreduction in 26 (21.1%), amnioreduction followed by selective fetoscopic laser photocoagulation (SFLP) in 43 (35.0%) and primary SFLP in 43 (35.0%). Of 80 cases managed by observation or amnioreduction initially, 43 (53.8%) progressed within a mean duration of 1.4 ± 1.5 weeks. The incidence of progression increased significantly as degree of recipienttwin cardiomyopathy at presentation worsened: Stage I, 9/27 (33.3%); Stage II, 8/15 (53.3%); Stage IIIA, 8/16 (50.0%); Stage IIIB, 10/10 (100%); and Stage IIIC, 8/12 (66.7%) (χ 2 = 14, P < 0.01). Overall fetal survival was 205 out of 244 (84.0%). Fetal survival with observation only was 81.8% (18/22), with amnioreduction only it was 92.3% (48/52), with initial observation or amnioreduction followed by SFLP it was 86.9% (73/84) and with primary SFLP it was 76.7% (66/86). Conclusion Echocardiography demonstrates a high incidence of recipient-twin cardiomyopathy in early-stage TTTS. The more advanced the recipient-twin cardiomyopathy is, the more likely is progression to occur during observation or following amnioreduction. Copyright  2011 ISUOG. Published by John Wiley & Sons, Ltd.
Third Phase Formation in the Extraction of Inorganic Acids by TBP in n‐Octane

Abstract The extraction of HNO3, HClO4, H2SO4 and H3PO4 by 20% (v/v) TBP (0.73 M) in n‐octane was measured under identical conditions up to and beyond the critical point of third phase formation (Limiting Organic Concentration, or LOC condition). The data, together with those obtained previously for HCl, allowed us to establish the following lyotropic series of effectiveness with respect to third phase formation in the extraction of acids by TBP: HClO4>H2SO4>HCl>H3PO4>HNO3. This series correlates with the amount of water present into the organic phase at the point of phase splitting. This result reinforces the validity of the reverse micellar model developed previously for the extraction of metal salts by TBP. The measurements of LOC values as a function of temperature revealed major differences among the acid‐TBP systems investigated. For HClO4, the strong increase of the LOC value with increasing temperatures is accompanied by a large favorable entropy change. The opposite is true for HCl, while H2SO4 a...
Neurofilament-L Is a Protein Phosphatase-1-binding Protein Associated with Neuronal Plasma Membrane and Post-synaptic Density

Far Westerns with digoxigenin-conjugated protein phosphatase-1 (PP1) catalytic subunit identified PP1-binding proteins in extracts from bovine, rat, and human brain. A major 70-kDa PP1-binding protein was purified from bovine brain cortex plasma membranes, using affinity chromatography on the immobilized phosphatase inhibitor, microcystin-LR. Mixed peptide sequencing following cyanogen bromide digestion identified the 70-kDa membrane-bound PP1-binding protein as bovine neurofilament-L (NF-L). NF-L was the major PP1-binding protein in purified preparations of bovine spinal cord neurofilaments and the cytoskeletal compartment known as post-synaptic density, purified from rat brain cortex. Bovine neurofilaments, at nanomolar concentrations, inhibited the phosphorylase phosphatase activity of rabbit skeletal muscle PP1 catalytic subunit but not the activity of PP2A, another major serine/threonine phosphatase. PP1 binding to bovine NF-L was mapped to the head region. This was confirmed by both binding and inhibition of PP1 by recombinant human NF-L fragments. Together, these studies indicate that NF-L fulfills many of the biochemical criteria established for a PP1-targeting subunit and suggest that NF-L may target the functions of PP1 in membranes and cytoskeleton of mammalian neurons.
Motor Strength Grade and Collateralization on Admission as Predictors of Outcome after Endovascular Intervention in Acute Stroke (P04.052)

Objective: To determine if admission medical research council(MRC) motor strength grade and presence of vascular collateralization are predictors of outcome after endovascular intervention(EI) for acute stroke. Background Large vessel ischemia constitute 30-50% of all cerebrovascular events and EI are gaining importance in the management. There are few clinical indicators of poor outcome like NIH stroke scale, age, extent of territory, infarct volume among others. Design/Methods: Retrospective analysis of 62 patients who underwent EI (MERCI,penumbra,alligator,balloon angioplasty,stents or combination of these procedures) with or without concurrent t-PA for acute stroke from 2007-2011. All patients had head and neck CTA with perfusion and EI. Admission MRC motor grade and collateralization on CTA were independent variables. Modified collateral flow(CS) grading 0-3 for absent, ≤50%,>50% but Results: Median age=75; median motor grade=2,with an interquartile range0-3. 53% were discharged to acute rehab or home(good outcome). SNF placement was 16%(intermediate outcome). Hospice disposition and death was 30%(poor outcome). In the poor outcome category,100% had MRC grade 0-1. The motor grade was significantly associated with death/SNF;as well as worse functional outcome(p Conclusions: This preliminary data suggest Motor grade assessment serve as a robust predictor of outcome after acute stroke intervention. Limitations:Severe neglect,intubated/sedated patients,and previous stroke.Modified collateral flow score grading needs revision as there is a disparity between different grades especially grade 1 & 2. For example person with minimal collaterals (eg: 5%)is in the same category of CS 1 as the person with 49% collaterals, which has a huge bearing on clinical outcome. Disclosure: Dr. Hedna has nothing to disclose. Dr. Favilla has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Khaku has nothing to disclose. Dr. Stead has nothing to disclose. Dr. Gottipati has nothing to disclose. Dr. Gottipati has nothing to disclose. Dr. Waters has nothing to disclose.
Commonalities in Metabolism of Arsenicals

Environmental Context. Health effects associated with inorganic arsenic include various cancers and increased risk of diabetes. Millions of people in Bangladesh and India are at risk through use of contaminated drinking water. When humans ingest inorganic arsenic, it is rapidly converted to methylated metabolites. Although this methylation process is largely understood, the metabolism of other arsenicals (e.g. arsenosugars to dimethylarsenic) is very unclear. Connections among pathways for metabolism of various arsenicals are now being elucidated. Commonalities and differences in these pathways may be important determinants of the risk associated with exposure to these agents. Abstract. Elucidating the pathway of inorganic arsenic metabolism shows that some of methylated arsenicals formed as intermediates and products are reactive and toxic species. Hence, methylated arsenicals likely mediate at least some of the toxic and carcinogenic effects associated with exposure to arsenic. Trimethylarsonium compounds and arsenosugars are two other classes of arsenicals to which humans are routinely exposed and there is evidence that both classes are metabolized to produce methylated arsenicals. Here, we review evidence for production of methylated metabolism and consider the challenges posed in unraveling a complex web for metabolism of arsenicals in humans.
Families of differentiable scalarization functions

LetF be a family of real-valued maps onRn, and letY be a subset ofRn. Denote byS(Y|F) the set of ally* ∈Y such that, for somef ∈F,f(y)≥f(y*) for ally inY. Let us say thatF is a scalarization family if, for any subsetY,S(Y|F) is equal to the set of properly efficient points inY. General conditions forF to be a scalarization family were given in Ref. 1. However, scalarization families must contain nondifferentiable functions. In this note, it is shown that, if the condition of Ref. 1 which forces nondifferentiability is dropped, thenS(Y|F) is dense in the set of properly efficient points.
Copolymerization of trioxane with 5‐ethyl‐5‐hydroxymethyl‐1, 3‐dioxane

Cationic copolymerization of trioxane with 5-ethyl-5-hydroxymethyl-1,3-dioxane gives low-molecular-weight copolymer (mn: 2∼6×103) with methylol pendent as well as end groups. Detailed 1H NMR assignment for the copolymer has been completed. The polymer is thermally stable up to 220°C and shows a high apparent crystallinity of 69%. The methylol group of the acetal copolymer has been demonstrated to react with acyl chloride and isocyanate groups of a second compound to form graft or crosslink. The copolymerization is characterized by high level of chain transfer.
Cortical Responses to Rotation II.: Responses Recorded at the Onset of Rotation from the Second Somatic Sensory and Posterior Areas

Using a Mnemotron computer a method has been developed permitting one to study in cats the cortical responses appearing when angular acceleration is started. According to this method the entrance of labyrinthine impulses is not restricted to the second somatic sensory area (S2) but extends posteriorly, chiefly into parts of the auditory cortex and into the so-called association cortex (gyrus suprasylvius medius). At least in some of the experiments the anterior part of the gyrus ectosylvius posterior and the posterior corner of the gyrus suprasylvius medius (part of the second visual area) showed responses of relatively short latency. General muscle paralysis or bilateral ablation of S2 did not prevent such responses in posterior parts of the hemisphere, while bilateral labyrinthectomy abolished them.
A dynamic adaptive chemistry scheme for reactive flow computations

Abstract An on-the-fly kinetic mechanism reduction scheme, referred to as dynamic adaptive chemistry (DAC), has been developed to incorporate detailed chemical kinetics into reactive flow computations with high efficiency and accuracy. The procedure entails reducing a detailed mechanism to locally and instantaneously accurate sub-mechanisms at each hydrodynamic time step of the calculation, and consequently no a priori information regarding simulation conditions is needed. The reduction utilizes an extended version of the directed relation graph (DRG) method in which the edges are weighted by a value that measures the dependence of the tail species (vertex) on the head species. An R-value is then defined at each vertex as the maximum of the products of these weights along all paths to that vertex from an initiating species. Active species are identified by their R-values exceeding a threshold value, eR, using a modified breadth-first search (BFS) that starts from a pre-defined set of initiating species. Chemical kinetics equations are then formulated with respect to the active species, with the inactive species considered only as third body collision partners. The DAC method is implemented into CHEMKIN and tested by simulating homogeneous charge compression ignition (HCCI) combustion using detailed and pre-reduced n-heptane mechanisms (578 species and 178 species, respectively) as the full mechanisms. The DAC scheme reproduces with high accuracy the pressure curves and species mass fractions obtained using the full mechanisms. The on-the-fly mechanism reduction scheme introduces minimal computational overhead and achieves more than 30-fold time reduction in calculations using the 578-species mechanism.
A review of the acute subjective effects of MDMA/ecstasy.

Aim Although several relatively recent reviews have summarized the neuropsychiatric effects associated with chronic ecstasy use, there is no published comprehensive review of studies on the acute subjective effects (ASEs) of MDMA/ecstasy. Design The present study reviewed the prevalence, intensity and duration of ASEs collected from 24 studies that provided frequency data on the prevalence of self-reported ecstasy effects and/or provided data on the intensity of ecstasy effects. Findings Although hundreds of ASEs have been reported following MDMA consumption, we identified a subset of effects reported repeatedly by meaningful proportions and large numbers of participants across multiple investigations, most of which were either emotional (e.g. anxiety, depression, closeness, fear, euphoria, calmness) or somatic (e.g. nausea/vomiting, bruxism, muscle aches/headache, sweating, numbness, body temperature changes, fatigue, dizziness, dry mouth, increased energy). Only one sexual ASE (sexual arousal/increased sensual awareness), one cognitive ASE (confused thought), one sensory–perceptual ASE (visual effects/changes in visual perception), one sleep-related ASE (sleeplessness) and one appetite-related ASE (decreased appetite) were reported across five or more investigations. Three factors—number of hours between ingestion and assessment, dose level, and gender—have been associated with the acute subjective experience of MDMA/ecstasy. Conclusions This review provides useful information for clinicians and researchers who want to understand the desirable and undesirable ASEs that may motivate and restrain ecstasy use, for public health advocates who seek to reduce biomedical harms (e.g. fainting, dehydration, shortness of breath, bruxism) associated with recreational use of MDMA/ecstasy, and for educators who wish to design credible prevention messages that neither underestimate nor exaggerate users’ experiences of this drug.
Oncocytic neoplasms of the thyroid gland.

Among well differentiated thyroid tumors, oncocytic neoplasms feature a distinctive set of clinical, morphologic and biologic characteristics, some of which have been a matter of controversy. The world literature on this subject has been reviewed to show that: 1) Morphology accurately predicts the behavior of Hurthle cell tumors assuming that the specimen has been adequately sampled; 2) Capsular and/or vascular invasion is the sine qua non condition for a diagnosis of malignancy; 3) "Indeterminate" or "possibly malignant" categories are useless because in the absence of invasion these neoplasms almost invariably behave in a benign fashion; 4) Among cases histologically classified as malignant, a clinically aggressive behavior is to be expected in a high percentage of cases; 5) Size alone cannot be used as a criterion of malignancy; 6) Less than total thyroidectomy provides an adequate treatment for histologically benign tumors; aggressive surgical procedures (i.e. total thyroidectomy) do not diminish the incidence of metastasis; 7) Analysis of DNA content may be helpful in defining subsets of patients with Hurthle cell carcinomas having a particularly poor prognosis; 8) Mitochondrial and/or nuclear DNA abnormalities probably play an important role in the cellular alterations which characterize the phenotype of oncocytes.
Ascites after liver transplantation—A mystery

Ascites after liver transplantation, although uncommon, presents a serious clinical dilemma. The hemodynamic changes that support the development of ascites before liver transplantation are resolved after transplant; therefore, persistent ascites (PA) after liver transplantation is unexpected and poorly characterized. The aim of this study was to define the clinical factors associated with PA after liver transplantation. This was a retrospective case-control analysis of patients who underwent liver transplantation at the University of Pennsylvania. PA occurring for more than 3 months after liver transplantation was confirmed by imaging studies. PA was correlated with multiple recipient and donor variables, including etiology of liver disease, preoperative ascites, prior portosystemic shunt (PS), donor age, and cold ischemic (CI) time. There were 2 groups: group 1, cases with PA transplanted from November 1990 to July 2001, and group 2, consecutive, control subjects who underwent liver transplantation between September 1999 and December 2001. Both groups were followed to censoring, May 2002, or death. Twenty-five from group 1 had ascites after liver transplantation after a median follow-up of 2.6 years. In group 1 vs group 2 (n = 106), there was a male predominance 80% vs 61% (P =.10) with similar age 52 years; chronic hepatitis C virus (HCV) was diagnosed in 88% vs 44% (P <.0001); preoperative ascites and ascites refractory to treatment were more prevalent in group 1 (P =.0004 and P =.02, respectively), and CI was higher in group 1, (8.5 hours vs 6.3 hours, P =.002). Eight of the 25 (group 1) had portal hypertension with median portosystemic gradient 16.5 mm Hg (range, 16-24). PS was performed in 7 of 25 cases, which resulted in partial resolution of ascites. The development of PA after liver transplantation is multifactorial; HCV, refractory ascites before liver transplantation, and prolonged CI contribute to PA after liver transplantation.