cssi/SciSciGPT-SciSciNet huggingface dataset:
A NOVEL EXTRAMEDULLARY GUIDE FOR FEMORAL BONE CUTTING BY PRE-OPERATIVE PLANNING USING LONG LEG VIEW IN TKA

Despite many new methods with preoperative or intra-operative assistance to improve the accuracy of leg alignment, traditional intramedullary (IM) method of bone cutting is still the most commonly used. Traditional TKR using IM guide has more outliers comparing to new computer aided methods, especially in bowing femur which is more prevalent in Asian population. And IM guide could not be used when there is a medullary bony pathology. Avoiding entrance of medullary cavity has been proposed as one of criteria of minimally invasive TKA. We have designed an extramedullary (EM) guide for the distal femoral bone cutting with millimeter to millimeter increment which is compatible with all posterior referencing instrumentation systems. With mechanical line as the guide line on long leg X-ray film taking with the knee and foot facing anteriorly, the amount of distal femoral bone cutting was measured and recorded on computer screen pre-operatively. During surgery, distal femoral cutting was performed using the EM cutting jig for coronal alignment adjustment tool and anterior femoral cortex and a guide post as sagittal alignment guide. We retrogratively compared the post-operation long leg X-ray film of two hundreds patients using IM or EM guides, the mechanical alignment of femoral components were measured in coronal and sagittal planes. The results showed no significant difference in distribution and the ratio of outliers. However, if the bowing of femur is more than 8 degree, the outlier is more in the IM group. We have applied this technique in 8 patients having medullary pathology including plates or nails in femur. All patients got good post-operative limb alignment without the needs of computer assistance device during surgery. In conclusion, the technique is easy and the instrument is simple. The operative time was not prolonged; the medullary cavity was not entered and compatible with the principle of MIS technique. In case of medullary cavity is obstructed, it is cost-effective by using our EM guide comparing to other methods such as CAOS or PSI.
Studying AEA interaction in cement systems using tensiometry

Abstract Tensiometry measurements reveal the behavior of air-entraining agents (AEA) in solutions that isolate features of the pore solution that control the impact on the surface tension of four anionic commercial AEAs. The degree to which each surfactant is affected by ionic strength and calcium coagulation is related to its molecular structure and critical micelle concentration. At the concentration recommended by the AEA manufacturer for use in concrete, two of the AEAs show no reduction in surface tension when exposed to a synthetic pore solution, but show strong interaction with Ca2 + ions. This suggests that some AEAs rely more on surface tension reduction to stabilize bubbles and others rely primarily on calcium interaction. AEAs that self-associate more easily (and interact with calcium more strongly) offer better frost protection for mortars at lower AEA concentrations, which is the focus of a future publication.
Sampson’s Theory of Implantation Endometriosis

From a cursory examination of the literature, one might conclude that research and authorship on adenomyomas passed seamlessly and directly from Cullen to Sampson in 1921; Cullen’s last contribution appearing in Volume two and Sampson’s first article in Volume three of the Archives of Surgery.1 Such was not the case. Unlike the clear and seamless continuity from von Recklinghausen to Cullen, the transfer of authority from Cullen to Sampson was mediated and complicated. Cullen remained the undisputed authority on uterine adenomyomas, but not of extrauterine adenomyomas. In the sense that Sampson postulated a novel theory of pathogenesis to explain the many extrauterine adenomyomas described by Cullen – and in that sense only – there was continuity: mutual interest in the same subject, but the torch had not been passed as it had from von Recklinghausen to Cullen. In every other sense, the transition was marked by discontinuity.
Successive Interference Canceller with CSI Weighting Combining Scheme

This paper proposes a channel state information (CSI) weighting combining scheme for a successive interference canceller (SIC). In general, SIC performance is degraded by the estimation errors in CSI caused by interference and temporal channel variations. This paper introduces a scheme to appropriately weight and combine pre-CSI, defined as CSI estimated for transmitting power control (TPC), and post-CSI, defined as CSI estimated in the SIC process. The combined CSI is more robust against interference and temporal channel variation because pre-CSI and post-CSI resist the former and the latter, respectively. Simulation results show that the combined CSI improves the number of simultaneous transmitting terminals (directly related to interference) 17% (vs. post-CSI) and 5% (vs. pre-CSI), and the allowable environmental speed (directly related to temporal channel variation) 50% (vs. pre-CSI).
Genetic optimization of art neural network architectures

Adaptive Resonance Theory (ART) neural network architectures, such as Fuzzy ARTMAP (FAM), Ellipsoidal ARTMAP (EAM), and Gaussian ARTMAP (GAM), have solved successfully a variety of classification problems. However, they suffer from an inherent ART problem, that of creating larger architectures than it is necessary to solve the problem at hand (referred to as the ART category proliferation problem). This problem is especially amplified for classification problems which have noisy data, and/or data, belonging to different labels, that significantly overlap. A variety of modified ART architectures, referred to as semisupervised (ss) ART architectures (e.g., ssFAM, ssEAM, ssGAM), summarily referred to as ssART, have addressed the category proliferation problem. In this paper, we are proposing another approach of solving the ART category proliferation problem, by designing genetically engineered ART architectures, such as GFAM, GEAM, GGAM, summarily referred to as GART. In particular, in this paper, we explain how to design GART architectures and compare their performance (in terms of accuracy, size, and computational complexity) with the performance of the ssART architectures. Our results demonstrate that GART is superior to ssART, and quite often it produces the optimal classifier.
A descriptive analysis of alcohol behaviors across gender subgroups within a sample of transgender adults.

Abstract Objective Transgender (trans) adults are identified as an at-risk group for problem alcohol use. Descriptive empirical data examining alcohol behaviors among trans adults is limited. The present study investigates alcohol behaviors – quantity, frequency, alcohol-related problems, and drinking to cope motives – across sex assigned at birth, gender expression, and gender identity subgroups within a sample of trans adults. Method A total of 317 trans participants were recruited to complete a cross-sectional battery of online measures assessing alcohol use behaviors, alcohol-related problems, and drinking to cope. Gender identity was assessed through two methods: (1) an open-ended question in which participants wrote-in their primary gender identity; and (2) participants rated the extent to which they identified with 14 gender identity categories. Results This sample had high rates of alcohol use, alcohol-related problems, and drinking to cope motives relative to the general population. Significant and meaningful differences in drinking frequency, alcohol-related problems and drinking motives were found according to gender expression, but not sex assigned at birth or gender identity. Conclusions Future work should examine alcohol behaviors among trans individuals, including investigation of predictors and causal pathways, to inform prevention and intervention work aimed at reducing trans people's risk for alcohol-related problems.
Telomere DNA damage signaling regulates cancer stem cell evolution, epithelial mesenchymal transition, and metastasis

// Angelica M. Lagunas 1 , Jianchun Wu 1 and David L. Crowe 1 1 University of Illinois Cancer Center, Chicago, IL, USA Correspondence to: David L. Crowe, email: // Keywords : genomic instability, telomerase, kinase signaling, differentiation Received : October 07, 2016 Accepted : August 25, 2017 Published : September 16, 2017 Abstract Chromosome ends are protected by telomeres that prevent DNA damage response and degradation. When telomeres become critically short, the DNA damage response is activated at chromosome ends which induces cellular senescence or apoptosis. Telomeres are protected by the double stranded DNA binding protein TRF2 and maintained by telomerase or a recombination based mechanism known as alternative lengthening of telomeres (ALT). Telomerase is expressed in the basal layer of the epidermis, and stem cells in epidermis have longer telomeres than proliferating populations. Stem cell expansion has been associated with epithelial-mesenchymal transition (EMT) in cancer. EMT is a critical process in cancer progression in which cells acquire spindle morphology, migrate from the primary tumor, and spread to distant anatomic sites. Our previous study demonstrated that loss of TRF2 expression observed in human squamous cell carcinomas expanded metastatic cancer stem cells during mouse skin carcinogenesis. To determine if telomerase inhibition could block the TRF2-null mediated expansion of metastatic clones, we characterized skin carcinogenesis in a conditional TRF2/Terc double null mutant mouse. Loss of TRF2 and Terc expression resulted in telomere DNA damage, severely depleted CD34 + and Lgr6+ cancer stem cells, and induced terminal differentiation of metastatic cancer cells. However a novel cancer stem cell population evolved in primary tumors exhibiting genomic instability, ALT, and EMT. Surprisingly we discovered that metastatic clones evolved prior to histopathologic onset of primary tumors. These results have important implications for understanding the evolution and treatment of metastatic cancer.
Absorption Spectrum of Np O 2 2 + in Cs 2 U O 2 Cl 4

The absorption spectrum of Np${\mathrm{O}}_{2}^{2+}$ in ${\mathrm{Cs}}_{2}$U${\mathrm{O}}_{2}$${\mathrm{Cl}}_{4}$ has been observed. Five pure electronic levels at 6880, 13 277, 15 426, 17 478, and 19 358 ${\mathrm{cm}}^{\ensuremath{-}1}$ have been identified through the vibronic transitions. The ground state and the energy level at 6880 ${\mathrm{cm}}^{\ensuremath{-}1}$ belong to the $5{f}^{1}$ configuration. However, the rest of the observed energy levels do not belong to the $5{f}^{1}$ configuration. Most likely, they come from an excited configuration which has a hole in the Np---O bond and two electrons in the nonbonding $5f$ shell.
Premixed Combustion in a Periodic Flow Field

The detailed mixing, combustion and ignition processes occurring in a flow field under the influence of resonant acoustic perturbations are discussed. These acoustic perturbations were created by a pulse combustor of the “Heimholtz” type.
Ocular Adnexal Lymphoma: Clinical Features and Diagnostic Evaluation

The ocular and adnexal lymphomas are a heterogeneous group of non-Hodgkin’s lymphomas that are predominantly of B-cell origin. The relative infrequency in which they appear in ophthalmic practice, in combination with their tendency to mimic inflammatory and infectious ocular entities, can make diagnosis challenging. In the following chapter, the clinical features of the ocular and adnexal lymphomas are reviewed along with the pertinent findings on diagnostic evaluation, which help to establish timely diagnosis and initiation of treatment.
144. Operationsindikation beim Heus

An der Indikation zur Operation beim Ileus hat sich im Laufe der letzten Jahre im Prinzip nichts geandert. Die Fruhoperation bringt die besten Ergebnisse. Dann kann man in den meisten Fallen auf vorgeschaltete Stomata verzichten und primar anastomosieren. Bei rezidivierendem Ileus ist die sorgfaltige Adhasiolyse von besonderer Bedeutung. Dunndarmplikaturen und die Schienung mit Sonden haben sich nicht bewahrt. Sie verhindern nicht das Rezidiv, sind mit Komplikationen behaftet und erschweren jeden weiteren Eingriff.
Surgical Approach to a Large Cervical Fibroid

Video Objective The objective of this video is to outline a unique approach to removal of a large intracervical fibroid during hysterectomy. Setting The patient is a 49 year-old para 3 who presented with pelvic pain, pressure and increased abdominal girth. She was found to have a 20 week size uterus with a large intracervical fibroid on exam. Her cervix was dilated to 4 cm and effaced on exam and the fibroid was palpable. MRI demonstrated a large multi-fibroid uterus, with a dominant 10 centimeter cervical fibroid and a dominant 9 centimeter broad ligament fibroid. She desired definitive management of her symptoms. Interventions After extensive surgical planning, a hysterectomy was performed in a three-staged approach. Stage one included dissection of the broad ligament fibroid and ligation of the uterine arteries. Stage 2 of the procedure involved a vaginal myomectomy, in which the cervical fibroid was dissected after use of Duhrssen's incisions on the cervix. The uterine manipulator was then secured using 0 prolene suture. In the last stage of the procedure, the hysterectomy was completed laparoscopically and the entire specimen removed vaginally. The patient had an uncomplicated postoperative course and surgical pathology was consistent with benign leiomyoma. Conclusion In this video we outline one unique and feasible approach to hysterectomy when there is a large cervical fibroid. When considering surgical approaches, it is important to remember that there may be distortion of the usual anatomy due to fibroids. Through use of Duhrssen's incisions, we were able to use an obstetrical surgical technique to aide in the removal of a large intracervical fibroid.
Chaos in a linear wave equation

Abstract A linear partial differential equation is shown to exhibit three properties often used to define chaotic dynamics. The system comprises a one-dimensional wave equation with gain that operates on a semi-infinite line. A boundary condition enforces that the waves remain finite. It is shown that the resulting solution set is dense with periodic orbits, contains transitive orbits, and exhibits extreme sensitivity to initial conditions. Definitions of chaos are considered in light of such linear chaos.
Autophagy in cancer: moving from understanding mechanism to improving therapy responses in patients

Autophagy allows for cellular material to be delivered to lysosomes for degradation resulting in basal or stress-induced turnover of cell components that provide energy and macromolecular precursors. These activities are thought to be particularly important in cancer where both tumor-promoting and tumor-inhibiting functions of autophagy have been described. Autophagy has also been intricately linked to apoptosis and programmed cell death, and understanding these interactions is becoming increasingly important in improving cancer therapy and patient outcomes. In this review, we consider how recent discoveries about how autophagy manipulation elicits its effects on cancer cell behavior can be leveraged to improve therapeutic responses.
An Efficient Online Heuristic for Mobile Network Slice Embedding

The fifth generation (5G) of mobile networks facilitates the management of various new use cases like autonomous driving, eHealth and the Internet of Things (IoT) along with dense sensor networks. Those use cases induce diverse requirements on the mobile network infrastructure. Network Slicing is one of the key features in 5G to address this issue. Network Slicing organizes the applications in network slices, whereby they are isolated, logical end-to-end networks for different use cases, sharing a common physical network infrastructure. They can be set up, changed and deactivated dynamically and in realtime. Therefore, efficient Network Slice Embedding algorithms are required for the assignment and allocation of network slice resources. In this paper, a novel, efficient approach for such an algorithm is proposed. It is a heuristic which meets the specific requirements of Network Slice Embedding, based on the algorithm provided by Cheng et al. In addition to their topology-aware node ranking algorithm, three alternative ranking techniques for the node mapping are introduced. The Network Slice Embedding heuristic and its ranking algorithms are evaluated on three generic blueprints of network slices and multiple mobile network sizes. The results show that the proposed heuristic is suitable for real-time embedding as it is robust, flexible and scalable and achieves high acceptance ratios.
[Investigation on current distribution of Oncomelania snails in schistosomiasis-endemic areas of Sichuan Province].

Objective To understand the current distribution of Oncomelania snails in Sichuan Province, so as to provide scientific evidence for formulating the schistosomiasis elimination strategy and implementing the precision schistosomiasis control measures in the province. Methods According to the National Scheme on Oncomelania hupensis Snails in China and the Scheme on Oncomelania hupensis Snails in Sichuan Province, snail surveys were performed in current snail habitats, historical snail habitats and suspected snail habitats using systematic sampling in Sichuan Province from 2016 to 2017, and the survey results were analyzed. Results From 2016 to 2017, a total of 88 346 settings were surveyed in schistosomiasis-endemic areas of Sichuan Province, and 19 314 settings were detected with snails, covering an area of 4 829.25 hm2, with no Schistosoma japonicum infection identified in snails. A total of 3 017 915 frames were investigated in Sichuan Province, and 1 041 417 frames were found to have living snails, with totally 1 791 115 living snails captured. The mean density of living snails was 0.59 snails/0.1 m2, and the mean percentage of frames with living snails was 34.51% in Sichuan Province. The current snail habitats were mainly distributed in 1 704 villages, 377 townships, 54 counties (districts) of 9 cities (prefectures) across the schistosomiasis-endemic areas of Sichuan Province. Snail habitats were mainly found in ditches (70.22%), and weeds were the predominant vegetation in snail habitats (66.45%). Snails were firstly discovered in Sichuan Province in 1913, and S. japonicum-infected snails were firstly identified in 1956, with the latest identification of S. japonicum-infected snails in 2008. Conclusions There are many settings suitable for snail breeding in Sichuan Province, and snail monitoring and control should be intensified in the future.
My eyes were closed the entire trip, but now they are open wide: A testimonio of the personal and political

This article is a fictionalized testimonio describing a child's crossing into the United States and her continued crossing into a political and activist high school student. The details of the stor...
Liberal vs. Conservative Blood Strategies

Reducing unnecessary blood transfusions through application of restrictive transfusion strategies has become a standard of care for most patient populations. Guidelines from the majority of societies target hemodynamically stable, non-bleeding patients. Intraoperatively, the combination of anemia and blood transfusions have been shown to increase morbidity and mortality especially in high risk patients. The decision to transfuse should be based on the patient’s risks of developing inadequate tissue oxygenation as opposed to a single hemoglobin trigger. Elderly patients and patients with cardiovascular disease, especially those undergoing high risk cardiac, valvular, or orthopedic procedures, have higher risks of ‘inadequate oxygen supply events’ when restrictive hemoglobin triggers are applied in the acute care setting. Unfortunately, the optimal intraoperative monitoring technique and critical markers of tissue hypoxia needed to guide transfusion decisions have not been identified. Perioperatively, every attempt should be made to minimize blood loss and improve the patient’s tolerance to anemia, such that restrictive transfusion triggers can be utilized and transfusions avoided.
Dynamics of data-driven microstates in bipolar disorder.

Abstract Many of the existing models of mood in bipolar disorder can largely be divided into two camps, tracking mood as either a discrete or continuous variable. Both groups rely upon certain assumptions, with most considering only aggregate scores on clinical instruments. In this study, we propose a novel framework that combines elements from both discrete and continuous mood models, using a machine learning pipeline to detect subtle patterns across individuals. Latent factors are constructed from assessments at the item level, then clustered into groups referred to as microstates. Transitions between microstates are captured via a discrete-time Markov chain, allowing for characterization of mood's dynamic nature. Key findings include a factor mapping heavily onto irritability and aggression, as well as a hierarchical pattern of microstates within depression and mania. Validity of these results is confirmed by reproduction in an unseen data set from a separate subject cohort.
Phase II biomarker-driven study of ruxolitinib demonstrates effectiveness of JAK/STAT targeting in T-cell lymphomas.

Abstract Signaling through JAK1 and/or JAK2 is common among tumor and non-tumor cells within peripheral T-cell lymphoma (PTCL).No oral therapies are approved for PTCL and better treatments for relapsed/refractory disease are urgently needed. We conducted a phase II study of theJAK1/2 inhibitor, ruxolitinib, for patients with relapsed/refractory PTCL (n=45) or mycosis fungoides (MF) (n=7). Patients enrolled onto one of three biomarker-defined cohorts: 1) activating JAKand/or STATmutations; 2) ≥30% pSTAT3 expression among tumor cells by immunohistochemistry; or 3) neither or insufficient tissue to assess. Patients received ruxolitinib 20 mg PO BID until progression and were assessed for response after cycles 2, 5 and every three cycles thereafter. The primary endpoint was clinical benefit rate (CBR) defined as the combination of complete response (CR), partial response (PR), and stable disease lasting at least 6 months.Only one of 7 patients with MF had CBR (ongoing PR>18 months). CBR among the PTCL cases (n=45) in cohorts 1, 2 and 3 were 53%, 45%, and 13%(cohorts 1&2 vs. 3, p=0.02). Eight patients had CBR>12 months (5 ongoing), including 4 of 5 patients with T-cell large granular lymphocytic leukemia. In an exploratory analysis using multiplex immunofluorescence, expression of phosphorylated S6 (pS6), a marker of PI3 kinase or MAP kinase activation, in Presented in abstract form at the 2018 and 2019 annual meetings of the American Society of Hematology.
Skeletal Deficits in Male and Female down Syndrome Model Mice Arise Independent of Normalized Dyrk1a Expression in Osteoblasts

Trisomy 21 (Ts21) causes alterations in skeletal development resulting in decreased bone mass, shortened stature and weaker bones in individuals with Down syndrome (DS). There is a sexual dimorphism in bone mineral density (BMD) deficits associated with DS with males displaying earlier deficits than females. The relationships between causative trisomic genes, cellular mechanisms, and influence of sex in DS skeletal abnormalities remain unknown. One hypothesis is that the low bone turnover phenotype observed in DS results from attenuated osteoblast function, contributing to impaired trabecular architecture, altered cortical geometry, and decreased mineralization. DYRK1A, found in three copies in humans with DS, Ts65Dn, and Dp1Tyb DS model mice, has been implicated in the development of postnatal skeletal phenotypes associated with DS. Reduced copy number of Dyrk1a to euploid levels from conception in an otherwise trisomic Ts65Dn mice resulted in a rescue of appendicular bone deficits, suggesting DYRK1A contributes to skeletal development and homeostasis. We hypothesized that reduction of Dyrk1a copy number in trisomic osteoblasts would improve cellular function and resultant skeletal structural anomalies in trisomic mice. Female mice with a floxed Dyrk1a gene (Ts65Dn,Dyrk1afl/wt) were mated with male Osx-Cre+ (expressed in osteoblasts beginning around E13.5) mice, resulting in reduced Dyrk1a copy number in mature osteoblasts in Ts65Dn,Dyrk1a+/+/Osx-Cre P42 male and female trisomic and euploid mice, compared with littermate controls. Male and female Ts65Dn,Dyrk1a+/+/+ (3 copies of DYRK1A in osteoblasts) and Ts65Dn,Dyrk1a+/+/Osx-Cre (2 copies of Dyrk1a in osteoblasts) displayed similar defects in both trabecular architecture and cortical geometry, with no improvements with reduced Dyrk1a in osteoblasts. This suggests that trisomic DYRK1A does not affect osteoblast function in a cell-autonomous manner at or before P42. Although male Dp1Tyb and Ts65Dn mice exhibit similar skeletal deficits at P42 in both trabecular and cortical bone compartments between euploid and trisomic mice, female Ts65Dn mice exhibit significant cortical and trabecular deficits at P42, in contrast to an absence of genotype effect in female Dp1Tyb mice in trabecular bone. Taken together, these data suggest skeletal deficits in DS mouse models and are sex and age dependent, and influenced by strain effects, but are not solely caused by the overexpression of Dyrk1a in osteoblasts. Identifying molecular and cellular mechanisms, disrupted by gene dosage imbalance, that are involved in the development of skeletal phenotypes associated with DS could help to design therapies to rescue skeletal deficiencies seen in DS.
ADENOVIRUS-5 INFECTION AFFECTS LIPID METABOLISM IN HEPATIC AND ADIPOSE TISSUES

ADENOVIRUS-5 INFECTION AFFECTS LIPID METABOLISM IN HEPATIC AND ADIPOSE TISSUES By Marianna Sukholutsky, M.S. A thesis submitted in partial fulfillment of the requirements for the degree of Masters of Science in Physiology and Biophysics at Virginia Commonwealth University. Virginia Commonwealth University, 2010 Major Director: Suzanne E. Barbour, Ph.D. Professor, Department of Biochemistry and Molecular Biology Our recent studies have shown a link between Adenovirus-5 (Ad-5) and elevated lipids, which prompted the hypothesis that Ad-5 infection might augment hepatic and/or adipose tissue lipid metabolism. To test our hypothesis, mice were infected with Ad-5 and screened for changes in lipogenesis and plasma markers associated with the metabolic syndrome. We observed increased expression of sterol regulatory element binding protein 1 (SREBP-1) in infected liver tissues, but not in adipose tissues and this correlated with elevated plasma and hepatic triglyceride levels. Elevated expression of adiponectin was seen in Ad-5 infected adipose tissues and this correlated with phosphorylated AMPK in infected liver tissues. These data suggested that the AMPK pathway was activated in livers of Ad-5 infected mice. Indeed, we observed reduced expression of PEPCK, a downstream target of AMPK in livers of Ad-5 infected mice. As PEPCK is an enzyme essential for gluconeogenesis, we hypothesized that Ad-5 infection would reduce blood sugar. Indeed, infected mice exhibited a transient decline in plasma glucose. The increase in SREBP1 levels in Ad-5 infected hepatic tissues was evaluated by looking at Ad-5 infected HepG2 cells. Ad-5 is thought to mimic insulin’s actions in which the PI3K pathway is activated. We hypothesized that Ad5-induced SREBP-1 expression levels are mediated through the induction of PKC !/"/!, and not through Akt because it has been shown that PKC !/"/! mediates insulin-dependent lipogenesis. To test our hypothesis,
Impact of 4R Management on Crop Production and Nitrate-Nitrogen Loss in Tile Drainage

Corn belt crop producers are increasingly challenged to maximize corn and soybean production while addressing the contributions farm practices make to the Gulf of Mexico hypoxia. Based on the need for nitratenitrogen (N) reductions to meet water quality goals, new management practices are needed to reduce nitrate-N losses at minimal cost and maximum economic benefits. This ongoing field research and demonstration project is evaluating various promising N management methods and technologies by documenting the nitrate-N export and crop yield from various systems. This is a summary of five years of crop yield data and four years of water quality data.
Epidemiologic analysis and genotypic characterization of a nosocomial outbreak of vancomycin-resistant enterococci.

We are reporting on a nosocomial outbreak of 213 cases of vancomycin-resistant enterococcus infection involving 2,812 enterococcal isolates from patients over a period of 36 months. In 1990, the Enterococcus faecium vancomycin susceptibility rate was found to be 85.7% (36 of 42 cases), and an incidence of 10.9% (42 of 383) was noted. The 1991 data showed E. faecium with a vancomycin susceptibility rate of 61.8% (110 of 178) and an incidence of 26.0% (178 of 684). Subsequently, in 1992, the incidence of E. faecium increased to 34.0% (599 of 1,745), with a decreased vancomycin susceptibility rate of 25.8% (155 of 599). The E. faecalis vancomycin susceptibility rate remained near 97% (1,768 of 1,823) over the 36-month period. Of 115 vancomycin-resistant enterococcus (VRE) clinical isolates identified by the MicroScan MIC Combo-6 panels (Baxter Healthcare, Sacramento, Calif.), the agar dilution method indicated the resistance rate to be 92.3% (106 of 115) (high level), 3.5% (4 of 115) midlevel, and 3.5% (4 of 115) (low level). Genotypic characterization of 32 different VRE isolates by field-inversion gel electrophoresis demonstrated 19 dissimilar restriction endonuclease patterns, with 9 patterns associated with VRE quinolone resistance. Statistical analysis of case-control data for 32 patients with VRE infections indicated a positive association with intrabdominal surgical procedures (odds ratio, 24.12), multidrug therapy (odds ratio, 37.80), preexposure to vancomycin (odds ratio, 20.21), and death (odds ratio, 17.50). Images
THE NEW NEO-MERCANTILISM: CURRENCY MANIPULATION AS A FORM OF PROTECTIONISM

Three waves of mercantilism have arisen in the past few centuries. The first wave was countered by the classical economists. The second wave (neo-mercantilism) hit during the inter-war period. Today's third wave uses monetary policy. We explore the mercantilist waves and argue in favour of a free trade policy. We conclude that an international system of free banking best protects the economy from currency manipulation as a form of protectionism.
Trehalose – The Insect ‘Blood’ Sugar

Abstract Trehalose, the non-reducing disaccharide of glucose, is the principal sugar circulating in the blood or haemolymph of most insects. Resistance to acid hydrolysis and an absence of direct intramolecular hydrogen bonding make trehalose chemically unique when compared with other common disaccharides, particularly sucrose, the non-reducing disaccharide of plant origin. Synthesized in the fat body following digestion of dietary sugar, trehalose is a condensation product of two glycolytic intermediates, glucose-1-phosphate and glucose-6-phosphate. Alternative sources of trehalose are glycogen breakdown and gluconeogenesis. Hydrolysis to reform glucose, catalyzed by isozymes of a single enzyme, trehalase, is the only known pathway of trehalose utilization. Trehalose synthesis and degradation are under hormonal control involving both hypertrehalosemic and hypotrehalosemic factors. Trehalose concentration in the blood, however, is not homeostatically regulated. Rather, trehalose occurs at highly variable levels, typically between 5 and 50 m m , depending on environmental conditions, physiological state and nutrition. This variable concentration is essential for fulfilling the roles of trehalose, as (1) an energy store, the traditional role ascribed to trehalose; (2) a cryoprotectant, reducing the supercooling point of some freeze-avoiding insects; (3) a protein stabilizer during osmotic and thermal stress, a function only recently investigated in insects, and (4) a component of a feedback mechanism regulating feeding behaviour and nutrient intake, where blood metabolite levels including trehalose act through modulation of taste receptor responses and through the central nervous system to influence food selection. These are all examples of functional conservation in the absence of homeostasis. This has been termed enantiostasis, where functional conservation serves as a mechanism of physiological adaptation despite what appears to be an unstable internal milieu.
Abstract T MP49: Should Transesophageal Echocardiography (TEE) be the Initial Diagnostic Modality of Choice in Young Ischemic Stroke (IS) Patients?

Background&Purpose: Current data is limited regarding the comparative utility of Transthoracic echocardiography (TTE) vs. TEE in diagnosing potential sources of cardioembolism (PSOC) in patients with cryptogenic stroke, particularly in young stroke patients. We sought to evaluate the comparative diagnostic yield of these two echocardiographic modalities in young IS patients. Methods: We conducted a retrospective chart review of consecutive young (18-45 yrs) IS patients admitted to a tertiary care stroke center over a study period of 42 months. All patients underwent both TTE and TEE during their standard diagnostic work-up. Stroke classification at discharge was performed according to TOAST criteria by treating physicians. Results: The study population consisted of 83 IS patients (mean age 38±5years, 40% men, 86% blacks, median admission NIHSS-score 3 points, IQR 1-8) who underwent both echocardiographic examinations. Cardioembolic stroke (CS) was the discharge diagnosis in 22 cases (27%). EF calculated by TEE strongly correlated to EF calculated by TTE (r=0.846; p<0.001). Left atrial enlargement was detected more frequently by TEE than TTE (27% vs. 11%; p<0.001). The overall yield of TEE for detecting PSOC was higher than TTE (23% vs 4%; p=0.011). TTE diagnosis of a PSOC was not associated with CS discharge diagnosis in univariate analyses (OR: 6.0, 95%CI: 0.5-69.8; p=0.152). TEE diagnosis of PSOC was associated with CS in univariate analyses (OR: 13.2, 95%CI: 4.0-43.8; p<0.0001). After adjustment for demographics, vascular risk factors, admission NIHSS-score, admission SBP and DBP levels, admission blood glucose and abnormal TTE, TEE diagnosis of a PSOC was independently associated with a higher likelihood of CS diagnosis at hospital discharge (OR: 24.3, 95%CI: 5.9-100.0; p<0.0001). Conclusions: Our study showed that the yield of TEE for detecting PSOC was higher than that of TTE, while abnormal TEE findings were independently associated with a higher likelihood of CS diagnosis. TEE should be considered as the initial echocardiographic modality for evaluating young IS patients, since it may expedite workup and early detection of stroke etiopathogenic mechanism.
The Bjork-Shiley prosthesis. A significant advance in aortic valve replacement.

Abstract Replacement of the aortic valve with the new tilting-disc Bjork-Shiley prosthesis was performed in 133 patients during the period May, 1970, to September, 1971. Thirty-two of these had simultaneous implantation of a Beall mitral valve prosthesis. None of the 13 early deaths (9.8%) or 7 late deaths (5.2%) were attributable to malfunction of the prosthesis or embolic complications. Objective evidence of improvement was noted by cardiac catheterization and treadmill exercise tests following operation. Clinical improvement was found in 97% of the survivors during the three to nineteen months of follow-up.
Emission-line region structure from variability studies

Recent results have shown that emission-line variability studies are potentially valuable for determining the size and structure of the BLR. However, this potential has not been fully realized, primarily on account of insufficient data. It is clear that size determinations will require better temporal resolution since the BLR is apparently smaller than estimated earlier. On the other hand, experience with NGC 5548 suggests that a very lng baseline of observations will be required to investigate the kinematic structure of the region. Considerable emphasis needs to be placed on long-term spectroscopic monitoring programs that provide good temporal resolution.
Type I adenylyl cyclase functions as a coincidence detector for control of cyclic AMP response element-mediated transcription: synergistic regulation of transcription by Ca2+ and isoproterenol.

Abstract Studies carried out with mammals and invertebrates suggest that Ca(2+)-sensitive adenylyl cyclases may be important for neuroplasticity. Long-term potentiation in the hippocampus requires increases in intracellular Ca2+ which are accompanied by elevated cyclic AMP (cAMP). Furthermore, activation of cAMP-dependent protein kinase is required for the late stage of long-term potentiation in the CA1 region of the hippocampus, which is also sensitive to inhibitors of transcription. Therefore, some forms of synaptic plasticity may require coordinate regulation of transcription by Ca2+ and cAMP. In this study, we demonstrate that the expression of type I adenylyl cyclase in HEK-293 cells allows Ca2+ to stimulate reporter gene activity mediated through the cAMP response element. Furthermore, simultaneous activation by Ca2+ and isoproterenol caused synergistic stimulation of transcription in HEK-293 cells and cultured neurons. We propose that Ca2+ and neurotransmitter stimulation of type I adenylyl cyclase may play a role in synaptic plasticity by generating optimal cAMP signals for regulation of transcription.
Radioaerosol assessment of lung improvement in cystic fibrosis patients treated for acute pulmonary exacerbations.

We compared bronchopulmonary distribution homogeneity of a radioaerosol before and after hospitalization in 20 patients with cystic fibrosis (CF) with pulmonary exacerbations in order to assess lung improvement. Deposition homogeneity was quantified in terms of skew (an index of distribution symmetry), derived from frequency distribution histograms generated from gamma camera images of the lungs following radioaerosol inhalation. Lower skew values indicate enhanced distribution homogeneity. Right lung skew (RLS) was significantly reduced following therapy (1.00 ±0.49 to 0.84 ±0.47), whereas skew in the left lung was unchanged (0.95 ±0.38 to 0.87 ±0.40). The reduction in RLS was significant in patients with Shwachman-Kulczycki (SK) clinical scores 50 (0.81 ±0.38 to 0.80 ±0.52). These results indicate that treatment affected the right lung more than the left lung, particularly in patients with SK scores
Citizen Participation: Models and Methods

Abstract The belief that individuals should be given a voice in their governance appeals to our democratic ideals and in fact has long been identified internationally as one of the unique aspects of the United States. While there appears to be universal agreement that the involvement of citizens in the decision making process of government is a good idea, there is little agreement as to the best way to achieve meaningful involvement. There are many ways to consult with the public and get a sense of what they see as problems and opportunities; it is quite another thing to actively engage citizens in the decision-making process. This paper explores the challenges and dilemmas associated with direct citizen participation, reflects on the various models of citizen-government interactions and makes recommendations for moving beyond conventional participation. While the benefits of including citizens in the deliberative process are widely recognized, citizen participation is not routinely sought in the decision...
SU-FF-T-261: Independent Point Dose Verification Using TomoTherapy Quality Assurance Phantom

Purpose: To detect TomoTherapy planning errors by relating a point dose in the patient treatment plan to the dose calculated at the corresponding point in the quality assurance phantom. Methods and Materials: Standard TomoTherapy patient‐specific quality assurance applies the patient treatment plan to a cylindrical QA phantom and then compares measured phantom dose to calculated phantom dose. However, there is no check of dose in the phantom to dose in the patient. We applied a ratio of TMRs to a point dose in the patient treatment plan in order to estimate the dose to the corresponding point in the phantom. Rotational delivery of TomoTherapy was approximated using either a 360° arc, 8 equally‐spaced angles, or 4 equally‐space angles. For each approximation, calculations were done using average physical depth and average radiological depth. The method was tested using data from 87 TomoTherapy patients. TMR ratio method doses were compared to treatment planning system doses. Agreement within ±5% was considered clinically acceptable. Results: Using average radiological depth, the pass rates were 70.6%, 69.4%, and 65.9% for the 360°, 8−, and 4‐;angle approximations, respectively. Using average physical depth, the pass rates were 63.5%, 56.5%, and 58.8% for the 360°, 8‐, and 4‐angle approximations, respectively. The best results were obtained for centrally‐located tumors such as prostate (83.9% pass rate for radiological depth and 360° arc approximation). The pass rates were worst for superficial tumors (50.0% pass rate for radiological depth and 360° arc approximation). Conclusions: The TMR ratio method was used to relate dose in the QA phantom to dose in the patient. For each beam approximation, radiological depths gave better results than physical depths. The site‐specific pass rates could be used to determine action levels for implementing this method in the clinic. Supported in part by a research agreement with TomoTherapy, Inc.
Moment theory of ion motion in traps and similar devices: II. Cylindrical apparatus

The empirical diffusion equation and the two-temperature moment theory of ion motion are applied to cylindrical devices used in field-asymmetric ion mobility spectrometry, where the external fields vary with position and time. Both approaches show that ion focusing occurs under the conditions where it is observed experimentally. The two-temperature theory provides new, quantitative information about the ion temperature as a function of position and time in the apparatus.
Claudin-8 Expression in Renal Epithelial Cells Augments the Paracellular Barrier by Replacing Endogenous Claudin-2

Claudins are transmembrane proteins of the tight junction that determine and regulate paracellular ion permeability. We previously reported that claudin-8 reduces paracellular cation permeability when expressed in low-resistance Madin-Darby canine kidney (MDCK) II cells. Here, we address how the interaction of heterologously expressed claudin-8 with endogenous claudin isoforms impacts epithelial barrier properties. In MDCK II cells, barrier improvement by claudin-8 is accompanied by a reduction of endogenous claudin-2 protein at the tight junction. Here, we show that this is not because of relocalization of claudin-2 into the cytosolic pool but primarily due to a decrease in gene expression. Claudin-8 also affects the trafficking of claudin-2, which was displaced specifically from the junctions at which claudin-8 was inserted. To test whether replacement of cation-permeable claudin-2 mediates the effect of claudin-8 on the electrophysiological phenotype of the host cell line, we expressed claudin-8 in high-resistance MDCK I cells, which lack endogenous claudin-2. Unlike in MDCK II cells, induction of claudin-8 in MDCK I cells (which did not affect levels of endogenous claudins) did not alter paracellular ion permeability. Furthermore, when endogenous claudin-2 in MDCK II cells was downregulated by epidermal growth factor to create a cell model with low transepithelial resistance and low levels of claudin-2, the permeability effects of claudin-8 were also abolished. Our findings demonstrate that claudin overexpression studies measure the combined effect of alterations in both endogenous and exogenous claudins, thus explaining the dependence of the phenotype on the host cell line.
Preservice Teachers' Belief Systems Toward Curricular Outcomes for Physical Education

This study was grounded in the belief systems and physical activity literature and investigated preservice teachers' belief systems toward curricular outcomes for physical education programs. Preservice teachers (N = 486; men = 62%, women = 38%) from 18 U.S. colleges/universities shared their beliefs about curricular outcomes. Preservice teachers completed a previously validated belief systems instrument designed to measure the relative importance of four outcome goals for programs (physical activity/fitness, self-actualization, motor skill development, and social development). Internal consistency reliability for the instrument was .98. A confirmatory factor analysis demonstrated a good fit of the current sample to the hypothesized outcomes model. Multivariate analysis of variance results revealed a significant interaction in outcome preservice teachers' priorities for year in school by region. The teachers' views also differed on the important outcome goals for physical education. Two critical “tensions...
Magnetization, micro-x-ray fluorescence, and transmission electron microscopy studies of low concentrations of nanoscale Fe3O4 particles in epoxy resin

Magnetization measurements, transmission electron microscopy (TEM), and high-resolution micro-x-ray fluorescence (μ-XRF) using a synchrotron radiation source (Advanced Photon Source) were used to examine Fe3O4 particle agglomerates of nominally 10-nm particles at low concentrations (down to 0.03%) in thick epoxy resin samples. The magnetization measurements showed that at low concentrations (<0.5%) the magnetite particles, although closely packed in the agglomerates, did not interact magnetically. Predicated on a 2-μm sample step scan, the μ-XRF results were compatible with the presence of spherical agglomerates due to magnetostatic attraction, and these ranged in size from 100 to several thousand nanometers, as observed in TEM measurements. At smaller step scans the resolution could be significantly improved. Thus, the synchroton μ-XRF method was very useful in detecting very small concentrations of particles in thick samples and could probably be used to detect particles in amounts as low as 10−16 g.
An Architect of Science

Endless Frontier. Vannevar Bush, Engineer of the American Century. G. PASCAL ZACHARY. Free Press (Simon and Schuster), New York, 1997. viii, 518 pp. + plates. $32.50 or C$43. ISBN 0-684-82821-9.
Family mediation and children's cognition, aggression, and comprehension of television: A longitudinal study☆

A sample of 66 kindergartners and first graders was studied over a two-year period in order to determine the role of family communication patterns and parent mediation in relation to television comprehension, general world knowledge, reading recognition, discrimination of reality from fantasy, fear of victimization, motor restlessness, and aggression. Results indicated that a family communication pattern of discussion and explanation in Year 1 is positively related to several measures of children's television comprehension and the ability to discriminate fantasy from reality in Year 2. When combined with power assertive methods of discipline, the discussion-explanation style is positively related to reading recognition, while discussion-explanation is negatively related to the child's hours of viewing, fear of victimization, and aggression in Year 2.