cssi/SciSciGPT-SciSciNet huggingface dataset:
Human Lung Cancer Cells Grown on Acellular Rat Lung Matrix Create Perfusable Tumor Nodules

Background Extracellular matrix allows lung cancer to form its shape and grow. Recent studies on organ reengineering for orthotopic transplantation have provided a new avenue for isolating purified native matrix to use for growing cells. Whether human lung cancer cells grown in a decellularized rat lung matrix would create perfusable human lung cancer nodules was tested. Methods Rat lungs were harvested and native cells were removed using sodium dodecyl sulfate and Triton X-100 in a decellularization chamber to create a decellularized rat lung matrix. Human A549, H460, or H1299 lung cancer cells were placed into the decellularized rat lung matrix and grown in a customized bioreactor with perfusion of oxygenated media for 7 to 14 days. Results Decellularized rat lung matrix showed preservation of matrix architecture devoid of all rat cells. All three human lung cancer cell lines grown in the bioreactor developed tumor nodules with intact vasculature. Moreover, the lung cancer cells developed a pattern of growth similar to the original human lung cancer. Conclusions Overall, this study shows that human lung cancer cells form perfusable tumor nodules in a customized bioreactor on a decellularized rat lung matrix created by a customized decellularization chamber. The lung cancer cells grown in the matrix had features similar to the original human lung cancer. This ex vivo model can be used potentially to gain a deeper understanding of the biologic processes involved in human lung cancer.
Synthesis of deuterated β-carotene

The synthesis of 10,10′,19,19,19,19′,19′,19′-2H8-β-carotene is described. The double condensation (C15+C10+C15=C40) of the Wittig salt of 9,9,9,10-2H4-β-ionylidene ethanol with the symmetrical C10 dial 2,7-dimethyl-2,4,6-octatrienedial led directly to 2H8-β-carotene. The symmetrical labelling pattern of this deuterated β-carotene will function as a tracer for the study of β-carotene metabolism in humans.
Practical syntheses of neopentyl alcohol and sec-butyl ethyl ether using marukasol as a solvent

By using Marukasol, neopentyl alcohol and sec-butyl ethyl ether have been obtained in good yields with easy operations. Thus, neopentyl alcohol was obtained from tert-butylmagnesium chloride and paraformaldehyde in 76% isolated yield with >99% purity using Marukasol as an effective extraction solvent. On the other hand, sec-butyl ethyl ether was obtained from sodium sec-butoxide with ethyl iodide in Marukasol in 67% yield with >99% purity.
Pleural effusion following blunt splenic injury in the pediatric trauma population

article i nfo Background: Pleural effusion is a potential complication following blunt splenic injury. The incidence, risk factors, and clinical management are not well described in children. Methods: Ten-year retrospective review (January 2000-December 2010) of an institutional pediatric trauma registry identified 318 children with blunt splenic injury. Results: Of 274 evaluable nonoperatively managed pediatric blunt splenic injures, 12 patients (4.4%) developed left-sided pleural effusions. Seven (58%) of 12 patients required left-sided tube thoracostomy for worsening pleural effusion and respiratory insufficiency. Median time from injury to diagnosis of pleural effusion was 1.5 days. Median time from diagnosis to tube thoracostomy was 2 days. Median length of stay was 4 days for those without and 7.5 days for those with pleural effusions (p b 0.001) and 6 and 8 days for those pleural effusions managed medically or with tube thoracostomy (p = 0.006), respectively. In multivariate analysis, high-grade splenic injury (IV-V) (OR 16.5, p = 0.001) was associated with higher odds of developing a pleural effusion compared to low-grade splenic injury (I-III).
Dissociation of spectrin-ankyrin complex as a basis for loss of Na-K-ATPase polarity after ischemia

The polarized distribution of Na-K-ATPase at the basolateral membranes of renal tubule epithelial cells is maintained via a tethering interaction with the underlying spectrin-ankyrin cytoskeleton. ...
On Being Out of Words

of knowledge. They resonate to the discourse that questions the hegemony of representation and epistemology in Western thought and they echo its concerns with the tropes that legitimate and justify thought and action (cf. Rorty 1979; Lyotard 1979). As in that discourse, the discourse on orality and literacy resounds with the clash of two master tropes. One is the modernist trope of "loss and liberation," of "the past surpassed"; the other is the post-moder trope of "resistance and recovery," of "the past recuperated." The first tells the tale of how speech was overcome and surpassed by a writing that, though it destroyed the warmth, intimacy, passion, and spirit of the participatory oral world, created a powerful new form of consciousness capable of ever-increasing abstraction and precision (Ong 1982; Goody 1977; Barfield 1985). It is the modernist fable of technology triumphant, of the creativity-in-destruction of the technology of the alphabet, of the rise of civilization from savagery, and the surpassing of the life-world of common sense and oral mnemonics by science and technology. This story of the glory of the eye is also an elegy that tells of loss and alienation, for the price of civilization is the fragmentation of the wholeness of a form of life, and liberation from nature is paid for in alienation from nature. The kingdom of the liberated, autonomous cogito is a lonely place where others are only ghosts out of a romanticized past, summoned like natives from far off places to justify and legitimize alienation by their outlandish otherness. The difference that is the past is overcome in a utopian future still to come, but surely just around the corer. The post-moder trope of resistance and recovery tells a different tale. It speaks of the irony of representation, of that inescapable difference between appearance and reality, and exposes writing as the means that makes reality accessible only by occulting it in a simulacrum that substitutes itself for the reality it pretends to represent. It parodies the sign that seeks to become speech by cannibalizing the reality it represents. It stigmatizes writing as the enigma that seeks to
From perception to phonology: The emergence of perceptually motivated constraint rankings

Abstract A phonological process in Norwegian takes underlying alveolar /t d n s/ to retroflex [ʈ ɖ ɳ ʂ] after /ɾ/, but the likelihood of its application depends on the phonological context: The process is obligatory for /t d n/, but optional for /s/, and the likelihood of /s/ undergoing retroflexion to [ʂ] depends on the following segment. Perceptual experiments with Norwegian listeners show that the likelihood of retroflexion correlates with its perceptual properties. The greater the perceived distance is between an alveolar and a retroflex in a given context, the less likely it is that the alveolar will undergo retroflexion. In a constraint grammar like optimality theory, this suggests that the internal ranking of the constraints relevant for retroflexion is determined by perceptual properties. Rather than assuming that perceptual properties and constraint rankings are linked in the grammar by inherent design, I demonstrate in this paper how such constraint rankings can emerge from the phonological learning process as a result of how perceptual distances influence word categorization.
Microbiological Analysis of Food Contact Surfaces in Child Care Centers

A study of six child care centers was conducted to assess the microbiological quality of three food contact surfaces (one food serving surface and two food preparation surfaces) and one non-food contact surface (diaper changing surface) to determine the effectiveness of cleaning and sanitization procedures within the facilities. Aerobic plate counts (APCs) and Escherichia coli/coliform counts of 50-cm 2 areas on all surfaces were determined using standard microbiological swabbing methods. Samples were taken three times a day (preopening, lunchtime, and following final cleanup) twice per month for 8 months in each child care center (n 288 sampling times). Mean log APCs over the survey period were 1.32, 1.71, 1.34, 1.96, 1.50, and 1.81 log CFU/50 cm 2 for the six centers. Mean log coliform counts were 0.15, 0.40, 0.33, 1.41, 0.28, and 1.12 CFU/50 cm 2 for the same centers. Coliforms were detected in 283 of 1,149 (24.7%) samples, with counts ranging from 1 to 2,000 CFU/50 cm 2 , while E. coli was detected in 18 of 1,149 (1.6%) samples, with counts ranging from 1 to 35 CFU/50 cm 2 . The findings of this study demonstrated that the extent of bacterial contamination was dependent on the center, time of day, and the area sampled. While no direct correlation between contamination and illness can be made, given the high risk of food-borne illness associated with children, microbial contamination of food contact or non-food contact surfaces is an aspect of food safety that requires more attention. Emphasis on training and the development of modified standard sanitation operating procedures for child care centers are needed to reduce potential hazards.
An adaptive memory conscious approach for mining frequent trees: implications for multi-core architectures

We consider the problem of frequent tree mining and present algorithms targeting emerging single-chip multiprocessor (CMP) architectures. We explore algorithmic designs that improve the memory performance of such algorithms, both in terms of alleviating latency to memory as well as in terms of reducing the off-chip traffic. We then explore adaptive task-parallel and data-parallel design strategies which facilitate effective parallelization even in the presence of data and workload skew while minimizing parallelization overheads. We show that our optimized algorithms achieve orders of magnitude improvement both in run time and memory usage, when compared to state-of-the-art algorithms. Also, we show that our adaptive parallelization strategy achieves near-linear speedups on a modern dual quad-core system.
Neurocognitive dysfunction in antidepressant-free, non-elderly patients with unipolar depression: Alerting and covert orienting of visuospatial attention

Abstract Background Cognition is impaired across various domains in young and middle-age adults with unipolar depression. Performance appears in general worse in effortful tasks requiring executive function and attention. Probing specific cognitive operations in depressed patients, such as alerting and covert orienting of visuospatial attention, can better define and characterize the pathophysiology. Methods Nine antidepressant-free, clinically depressed patients and fourteen age-matched healthy subjects performed a Posner task with components of phasic alerting and covert orienting of visuospatial attention. Reaction times were analyzed by repeated-measures ANOVA with DIAGNOSIS as the between-group measure. Visual field (FIELD), stimulus onset asynchrony (SOA), and orienting CUE condition were within-subject, repeated measures. Results ANOVA showed intact attentional orienting in both groups. There were no FIELD differences across groups nor main effects of DIAGNOSIS. Interactions of DIAGNOSIS with SOA and DIAGNOSIS with CUE condition identified a phasic alerting deficit in the depressed patients. There were no significant effects of time-on-task, suggesting adequate vigilance or sustained attention in both groups. Plotting depressed versus control subjects' reaction time for each task condition (Brinley plot) showed linearity with a slope of 1.6 (i.e., patients were 1.6-fold slower) and a correlation coefficient of 0.98 (accounting for 96% of the overall variance). Limitations This study contains a small sample with potential for Type II error. The study addressed depression at the syndrome level. Depressed patients selected on particular symptom dimensions (e.g., anxiety, psychomotor retardation, etc.) could reveal abnormalities in hemisphere asymmetries that were not observed here. Conclusions These data highlight that global slowing is a major cognitive deficit in depression and arises across levels of difficulty. Putative specific deficits in depression need adjustment for the large effects of global slowing which can mimic selective impairments in more effortful task conditions.
Preoperative nonsteroidal anti-inflammatory medication for the prevention of postoperative dental pain

It is predictable for patients to experience postoperative pain and inflammation. Until recently, therapeutic strategies for the management of these sequelae have been symptomatic rather than preventive. This article reviews prophylactic use of nonsteroidal anti-inflammatory medication for preventing postoperative discomfort, and includes recommendations on patient selection and medication regiment.
Obesity genes and insulin resistance

Purpose of review The exploding prevalence of insulin resistance and Type 2 diabetes (T2D) linked to obesity has become an alarming public health concern. Worldwide, approximately 171 million people suffer from obesity-induced diabetes and public health authorities expect this situation to deteriorate rapidly. An interesting clinical population of ‘metabolically healthy but obese’ (MHO) cases is relatively protected from T2D and its associated cardiovascular risk. The molecular basis for this protection is not well understood but is likely to involve reduced inflammatory responses. The inflammatory cells and pathways that respond to overnutrition are the primary subject matter for this review.
Obesity and risk of nonfatal unintentional injuries.

Background Obesity is recognized as a risk factor for multiple chronic diseases. Yet, it is unclear whether obesity is also associated with an increased risk of nonfatal unintentional injury. Methods A population-based survey was conducted among adults aged ≥18 years from January 1999 through October 2000. The relationship was investigated between body mass index (BMI), defined as weight in kilograms divided by the square of the height in meters (kg/m2), and risk of nonfatal unintentional injuries among 2575 respondents aged ≥20 years by comparing percentage of adults between obese and nonobese respondents who had injuries. Multivariate logistic regression further examined this relationship by controlling for confounding demographics. Results A total of 370 respondents reported injuries in the previous year. We observed a linear dose-response trend among women. An estimated 7.0% of underweight individuals (BMI Conclusions A marginally significant association between extreme obesity and elevated risk of injuries was observed. Efforts to promote optimal body weight may reduce not only the risk of chronic diseases but also the risk of unintentional injury among overweight and obese individuals.
Effect of hyperoxia on gas exchange and lactate kinetics following exercise onset in nonhypoxemic COPD patients.

Study objectives: The slow oxygen uptake (VO2) kinetics observed in COPD patients is a manifestation of skeletal muscle dysfunction of multifactorial origin. We determined whether oxygen supplementation during exercise makes the dynamic VO2 response faster and reduces transient lactate increase. Design: Ten patients with severe COPD (ie, mean ( SD) FEV1 ,3 1 10% predicted) and 7 healthy subjects of similar age performed four repetitions of the transition between rest and 10 min of moderate-intensity, constant-work rate exercise while breathing air or 40% oxygen in random order. Minute ventilation (VE), gas exchange, and heart rate (HR) were recorded breath-by-breath, and arterialized venous pH, PCO2, and lactate levels were measured serially. Results: Compared to healthy subjects, the time constants () for VO2, HR, carbon dioxide output (VCO2), and VE kinetic responses were significantly slower in COPD patients than in healthy subjects (70 8v s 44 3s , 98 14 vs 44 8s , 86 8v s 61 4 s, and 81 7v s 62 4s , respectively; p < 0.05). Hyperoxia decreased end-exercise VE in the COPD group but not the healthy group. Hyperoxia did not increase the speed of VO2 kinetics but significantly slowed VCO2 and VE response dynamics in both groups. Only small increases in lactate occurred with exercise, and this increase did not correlate with the for VO2. Conclusion: In nonhypoxemic COPD patients performing moderate exercise, the lower ventila- tory requirement induced by oxygen supplementation is not related to improved muscle function but likely stems from direct chemoreceptor inhibition. (CHEST 2002; 121:393- 400)
Convective Boundary Layer Height Measurement with Wind Profilers and Comparison to Cloud Base

Abstract The depth of the atmospheric boundary layer is of interest in several different areas, such as chemistry, pollutant studies, and global modeling. In this research the authors describe and compare several different measurements of boundary layer depth. First, the authors use the standard measurement from radiosondes to confirm the validity of wind-profiler measurements, which use humidity gradients to estimate the boundary layer depth. A method for obtaining meaningful cloud-base altitudes is then presented, and the results are compared to the wind-profiler boundary layer heights. The authors find good agreement between the different types of measurement but see that the profiler peak reflectivity is slightly raised above cloud base in the presence of boundary layer clouds. This may be due to increased humidity gradients at the top and edges of clouds or to increased turbulence within the cloud. Calculation of the boundary layer height using the bulk Richardson number is commonly used in computer ...
Temporal Integration of Olfactory Perceptual Evidence in Human Orbitofrontal Cortex

Given a noisy sensory world, the nervous system integrates perceptual evidence over time to optimize decision-making. Neurophysiological accumulation of sensory information is well-documented in the animal visual system, but how such mechanisms are instantiated in the human brain remains poorly understood. Here we combined psychophysical techniques, drift-diffusion modeling, and functional magnetic resonance imaging (fMRI) to establish that odor evidence integration in the human olfactory system enhances discrimination on a two-alternative forced-choice task. Model-based measures of fMRI brain activity highlighted a ramp-like increase in orbitofrontal cortex (OFC) that peaked at the time of decision, conforming to predictions derived from an integrator model. Combined behavioral and fMRI data further suggest that decision bounds are not fixed but collapse over time, facilitating choice behavior in the presence of low-quality evidence. These data highlight a key role for the orbitofrontal cortex in resolving sensory uncertainty and provide substantiation for accumulator models of human perceptual decision-making.
Hardness and Abrasion Resistance of Nanocrystalline Nickel Alloys Near the Hall-Petch Breakdown Regime

The breakdown of classical Hall-Petch scaling remains an area of scientific interest, and will govern the limiting strength of nanocrystalline alloys for structural applications. In this work we discuss the hardness and scratch resistance of nanocrystalline nickel and nickel-tungsten solid solution alloys, assessed through nanoindentation and nano-scratch techniques. The materials have been prepared by electrodeposition, and are fully dense with grain sizes between 6 and 22 nm. In this range of grain sizes, there is some evidence for a breakdown of Hall-Petch scaling, reflected in both the hardness and abrasion data. The role of solid solution alloying on this breakdown is also discussed.
Self-triggered coordination of robotic networks for optimal deployment

This paper introduces a novel team-triggered algorithmic solution for a distributed optimal deployment problem involving a group of mobile sensors. Distributed self-triggered algorithms relieve the requirement of synchronous periodic communication among agents by providing opportunistic criteria for when communication should occur. However, these criteria are often conservative since worst-case scenarios must always be considered to ensure the monotonic evolution of a relevant objective function. Here we introduce a team-triggered algorithm that builds on the idea of ‘promises’ among agents, allowing them to operate with better information about their neighbors when they are not communicating, over a dynamically changing graph. We analyze the correctness of the proposed strategy and establish the same convergence guarantees as a coordination algorithm that assumes perfect information at all times. The technical approach relies on tools from set-valued stability analysis, computational geometry, and event-based systems. Simulations illustrate our results.
Perceptions of sexual abstinence among high-risk early and middle adolescents.

Purpose: Sexual abstinence has become the primary response to adolescent pregnancy and sexually transmitted infection (STI) prevention. However, most abstinence programs are based on adult ideas of abstinence, and little is known about how adolescents themselves conceptualize sexual abstinence. Methods: In this qualitative study, we conducted semi-structured exploratory interviews with 42 adolescents aged 11-17 years recruited from primary care clinics. Results: We observed marked confusion over the term "abstinence." However, the concept of absti- nence, or choosing not to have sex, was clear and relevant. Participants viewed sexual abstinence as part of a normal developmental continuum. All adolescents were abstinent for a period of time, and then transitioned to sexual activity when they were ready. Readiness was determined by (1) individual factors, such as age, life events, physical maturity and social maturity, (2) relationship factors such as being with the "right" person, or having a committed relationship, (3) moral and religious beliefs, and (4) the balance of health, social, and family risks and benefits. Sex was considered something powerful, and the transition to first sex a rite of passage in which adolescents took on what they perceived to be adult roles. We observed differences by age, gender, and sexual experience in how adolescents determined readiness. Conclusions: Adolescents conceptualize sexual abstinence differently than adults, with differences by age, gender and sexual experience. Rather than a simple behavioral decision, our participants viewed abstinence as a broader part of normal development and viewed the transition to sex as an important rite of passage to adulthood. © 2006 Society for Adolescent Medicine. All rights reserved.
Sonotraphic Diagnosis of Sigmoid Diverticulitis

A case of sigmoid diverticulitis diagnosed by transabdominal and endovaginal sonography is presented. Clinical findings of sigmoid diverticulitis can often overlap with other abnormal processes in the pelvis. Additionally, sigmoid diverticulitis can esily be overlooked during pelvic sonography if the examiner is not familiar with the sonographic features of this common disease. The typical findings of diverticulitis and associated complications are discussed.
Molecular motion in polystyrene and some substituted polystyrenes

Proton magnetic resonance spectra of nine substituted polystyrenes: polymers of o-methyl, m-methyl, p-methyl, p-chloro-, 2,4-dimethyl-, α,β,β′-trideutero-, β- deutero-, 2,6-dimethyl-4-tert-butyl-, and p-tert-butylstyrene, in addition to five polystyrene samples differing in molecular weight (Mn's from 1.25 × 105 to ∼35 × 105) or tacticity have been obtained at temperatures from 77 to above 400°Kg. Measurements have also been made on p-tert-butyltoluene, 2,4-dimethylstyrene, and 2,6-dimethyl-4-tert-butylstyrene. All polymers studied were found to exhibit single-component derivative line shapes and to undergo rapid motional narrowing with increasing temperature in the region of the glass transition; in this region the line width for atactic polystyrene was found to be essentially independent of molecular weight. At lower temperatures a gradual line narrowing effect was also observed for some of the polymers, even near 77°K., and is attributed to limited phenyl or substituted phenyl group oscillation. This effect was apparent for polystyrene, poly-α,β,β′-trideutero-, poly-β-deutero- poly-p-chloro, and poly-p-methylstyrene, less apparent for the o- and m-methyl compounds and the p-tert-butyl-substituted polymer, and absent for the 2,4-dimethyl and the 2,6-dimethyl-4-tert-butyl polymers. By a comparison of experimental second moments with approximate ones obtained from theory, it is concluded that rotation of all methyl groups attached directly to benzene ring for all polymers studied is taking place at 77°K. For both p-tert-butylsubstituted polymers and the low molecular weight analogs, a motional narrowing process occurs in the ≤77° to 150°K. region, and for all but 2,6-dimethyl-4-tert-butylstyrene this is attributed to rotation of the methyl groups in the tert-butyl part of the molecule; for the latter compound, onset of rotation of one of the methyl groups attached directly to the ring in addition to the methyl in the tert-butyl part is responsible for the line narrowing. The contributions of various proton interactions to the total second moment of polystyrene and its derivatives are discussed.
Evolution of 17β-hydroxysteroid dehydrogenases and their role in androgen, estrogen and retinoid action

hydroxysteroid dehydrogenases (17 �-HSDs) regulate androgen and estrogen concentrations in mammals. By 1995, four distinct enzymes with 17 �-HSD activity had been identified: 17 �-HSD -types 1 and 3, which in vivo are NADPH -dependent reductases; 17 �-HSD - types 2 and 4, which in vivo are NAD + -dependent oxidases. Since then six additional enzymes with 17 �-HSD activity have been isolated from mammal s. With the exception of 17 �-HSD -type 5, which belongs to the aldoketo -reductase (AKR) family, these 17 �-HSDs belong to the short chain dehydrogenases/reductases (SDR) family. Several 17 �-HSDs appear to be examples of convergent evolution. That is, 17 �-HSD activity arose several times from different ancestors. Some 17 �-HSDs share a common ancestor with retinoid oxido -reductases and have retinol dehydrogenase activity. 17 �-HSD -types 2, 6 and 9 appear to have diverged from ancestral retinoid dehydrogenas es early in the evolution of deuterostomes during the Cambrian, about 540 million years ago. This coincided with the origin of nuclear receptors for androgens and estrogens suggesting that expression of 17 �-HSDs had an important role in the early evolutio n of the physiological response to androgens and estrogens.
Smoking behaviors and attitudes during adolescence prospectively predict support for tobacco control policies in adulthood.

Introduction: Several cross-sectional studies have examined factors associated with support for tobacco control policies. The current study utilized a longitudinal design to test smoking status and attitude toward smoking measured in adolescence as prospective predictors of support for tobacco control policies measured in adulthood.
Gossypol Toxicosis in a Dog Consequent to Ingestion of Cottonseed Bedding

Six dogs died after accidental ingestion of cottonseed bedding. No clinical signs of illness were observed prior to death. A full diagnostic workup was performed on one of these dogs. At necropsy, the lungs were congested and edematous, and the liver was firm, congested, and had a marked reticular pattern. There was also moderate ascites. Histopathologic examination revealed multifocal myocardial degeneration and necrosis, severe pulmonary edema, and chronic passive congestion of the lungs, heart, liver, and kidneys. Transmission electron microscopy of the myocardium revealed disruption of myofibrils, chromatin condensation, and disrupted and swollen mitochondria. The cottonseed bedding contained 1,600 mg/kg of free gossypol, a concentration considered toxic for monogastric animals. The stomach content revealed the presence of gossypol, thus confirming ingestion of cottonseed. Gossypol poisoning in dogs is extremely rare and has not yet been associated with cottonseed bedding. This first documented case of gossypol poisoning in a dog, caused by the ingestion of cottonseed bedding, demonstrates how specific toxicological analysis is crucial in reaching an accurate diagnosis.
A model for conformance analysis of software documents

During the evolution of a large-scale software project, developers produce a large variety of software artifacts such as requirement specifications, design documents, source code, documentation, bug reports, etc. These software documents are not isolated items - they are semantically related to each other. They evolve over time and the set of active semantic relationships among them is also dynamic. Their evolution makes the task of managing them and maintaining their semantic consistency a very challenging task for software developers. At times, the evolutionary changes may reduce the consistency of the software project and break semantic connections among its documents. We use the term conformance to denote the state where the network formed by software documents and their relationships is in semantic harmony. Conformance analysis is the process of determining whether software documents and their logical relationships are in agreement. We present a representation for software documents and their logical relationships based on the hypertext model. We describe how conformance analysis can be supported by this representation and present a method to detect nonconformance using timestamps and versioned hypermedia. Then we describe a formalism, called the conformance model, that can be used to understand and combine approaches to the conformance analysis problem.
Risk factors for readmission after lower extremity bypass in the American College of Surgeons National Surgery Quality Improvement Program.

Objective Readmission is associated with high mortality, morbidity, and cost. We used the American College of Surgeons National Surgery Quality Improvement Program (ACS-NSQIP) to determine risk factors for readmission after lower extremity bypass (LEB). Methods We identified all patients who received LEB in the 2011 ACS-NSQIP database. Multivariable logistic regression was used to assess independent predictors of 30-day readmission. We also identified our institutional contribution of LEB patients to the ACS-NSQIP from 2005 to 2011 to determine our institution's rate of readmission and readmission indications. Results Among 5018 patients undergoing LEB, ACS-NSQIP readmission analysis was performed on 4512, excluding those whose readmission data were unavailable, who suffered a death on index admission, or who remained in the hospital at 30 days. Overall readmission rate was 18%, and readmission rate of those with NSQIP-captured complications was 8%. Multivariable predictors of readmission were dependent functional status (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.08-1.79), dyspnea (OR, 1.28; 95% CI, 1.02-1.60), cardiac comorbidity (OR, 1.46; 95% CI, 1.16-1.84), dialysis dependence (OR, 1.44; 95% CI, 1.05-1.97), obesity (OR, 1.28; 95% CI, 1.07-1.53), malnutrition (OR, 1.42; 95% CI, 1.12-1.79), critical limb ischemia operative indication (OR, 1.40; 95% CI, 1.10-1.79), and return to the operating room on index admission (OR, 8.0; 95% CI, 6.68-9.60). The most common postdischarge complications occurring in readmitted patients included wound complications (55%), multiple complications (22%), and graft failure (5%). Our institutional data contributed 465 LEB patients to the ACS-NSQIP from 2005 to 2012, with an overall readmission rate of 14%. Unplanned readmissions related to the original LEB (related unplanned) made up 75% of cases. The remainder 25% included readmissions that were planned staged procedures related to the original LEB (related planned, 11%) and admissions for a completely unrelated reason (unrelated unplanned, 14%). The most common readmission indications included wound infection (37%) and graft failure (10%). Readmissions were attributable to NSQIP-captured postdischarge complications in 44% of cases, an additional 44% had a non-NSQIP-defined reason for readmission, and the remainder (12%) included patients admitted for complications described in NSQIP but not meeting strict NSQIP criteria. Conclusions Readmissions are common after LEB. Optimization of select chronic conditions, closer follow-up of patients in poor health and those who required return to the operating room, and early detection of surgical site infections may improve readmission rates. Our finding that 25% of readmissions after LEB are not procedure related informs the broader discussion of how a readmission penalty affects vascular surgery in particular.
Debonding of confined elastomeric layer using cohesive zone model

Abstract Wavy or undulatory debonding is often observed when a confined/sandwiched elastomeric layer is pulled off from a stiff adherend. Here we analyze this debonding phenomenon using a cohesive zone model (CZM). Using stability analysis of linear equations governing plane strain quasi-static deformations of an elastomer, we find (i) a non-dimensional number relating the elastomer layer thickness, h, the long term Young׳s modulus, E ∞ , of the interlayer material, the peak traction, T c , in the CZM bilinear traction-separation (TS) relation, and the fracture energy, G c , of the interface between the adherend and the elastomer layer, and (ii) the critical value of this number that provides a necessary condition for undulations to occur during debonding. For the elastomer modeled as a linear viscoelastic material with the shear modulus given by a Prony series and a rate-independent bilinear TS relation in the CZM, the stability analysis predicts that a necessary condition for a wavy solution is that T c 2 h / G c E ∞ exceed 4.15 . This is supported by numerically solving governing equations by the finite element method (FEM). Lastly, we use the FEM to study three-dimensional deformations of the peeling (induced by an edge displacement) of a flexible plate from a thin elastomeric layer perfectly bonded to a rigid substrate. These simulations predict progressive debonding with a fingerlike front for sufficiently confined interlayers when the TS parameters satisfy a constraint similar to that found from the stability analysis of the plane strain problem.
r.water.fea — An Introduction

Hydrologic and environmental processes are distributed in space and time. Simulation of these processes requires spatial data management techniques of a Geographic Information System (GIS). Digital maps of soils, land use, topography and rainfall rates are used to direct runoff, or Hortonian runoff, resulting from rainfall intensities exceeding the infiltration rate of the soil surface. Figure 9.1 shows the grid cell representation and drainage network used by r.water.fea, a water quantity model. This chapter presents the mathematical analogy and numerical algorithms used in r.water.fea to solve the governing equations.
Viral Reservoirs in Lymph Nodes of FIV-Infected Progressor and Long-Term Non-Progressor Cats during the Asymptomatic Phase

Background Examination of a cohort of cats experimentally infected with feline immunodeficiency virus (FIV) for 5.75 years revealed detectable proviral DNA in peripheral blood mononuclear cells (PBMCs) harvested during the asymptomatic phase, undetectable plasma viral RNA (FIV gag), and rarely detectable cell-associated viral RNA. Despite apparent viral latency in peripheral CD4+ T cells, circulating CD4+ T cell numbers progressively declined in progressor animals. The aim of this study was to explore this dichotomy of peripheral blood viral latency in the face of progressive immunopathology. The viral replication status, cellular immunophenotypes, and histopathologic features were compared between popliteal lymph nodes (PLNs) and peripheral blood. Also, we identified and further characterized one of the FIV-infected cats identified as a long-term non-progressor (LTNP).
Improving Access to, Quality, and the Effectiveness of Digital Tutoring in K–12 Education:

There is considerable variation in how providers of digital education describe what they do, their services, how students access services, and what is delivered, complicating efforts to accurately ...
Correlated Bayesian Model Fusion: efficient performance modeling of large-scale tunable analog/RF integrated circuits

Tunable circuit has emerged as a promising methodology to address the grand challenge posed by process variations. Efficient high-dimensional performance modeling of tunable analog/RF circuits is an important yet challenging task. In this paper, we propose a novel performance modeling approach for tunable circuits, referred to as Correlated Bayesian Model Fusion (C-BMF). The key idea is to encode the correlation information for both model template and coefficient magnitude among different knob configurations by using a unified prior distribution. The prior distribution is then combined with a few simulation samples via Bayesian inference to efficiently determine the unknown model coefficients. Two circuit examples designed in a commercial 32nm SOI CMOS process demonstrate that C-BMF achieves more than 2× cost reduction over the traditional state-of-the-art modeling technique without surrendering any accuracy.
Sleep and Sleepiness in Children and Adolescents

We have attempted to review the current "state of the art" regarding the ontogenetic course of sleep-wake state organization and possible disruptions in this course from infancy through adolescence. It is becoming increasingly important for clinicians to learn about physiologic functioning during sleep. Much more research is required, directed at the relationship between waking behaviors and sleeping behaviors. Investigations of daytime sleepiness in adolescence, of the relationship of hyperactivity to excessive sleepiness, of the relationship between disorders such as depression and anorexia nervosa with disturbed sleep state organization, and of primary sleep disorders such as narcolepsy and the sleep apnea syndrome only scratch the surface in terms of the future work that needs to be done.
Bearing witness: a longitudinal integrated cancer care curriculum.

SummaryBackground The Harvard Medical School Cambridge Integrated Clerkship longitudinal cancer curriculum directly facilitates students’ engagement with cancer patients to develop a comprehensive understanding of the disease and the patient's experience of illness. Third-year medical students follow newly diagnosed cancer patients over the course of a year, across all disciplines, and make formal presentations to a multidisciplinary forum at the end of the year. The aim of the study was to discover which aspects of longitudinal care were most meaningful to the students themselves. Method Researchers performed a qualitative thematic analysis of students’ presentations. Basing the analysis on principles of grounded theory, researchers took an inductive approach using the constant comparative method to discover core themes and to cluster themes into encompassing domains. Result Researchers identified 33 individual themes among 60 presentations, reflecting five major domains: clinical issues; patient characteristics; systems problems; psychosocial response to cancer; and existential decision making. Conclusions In this qualitative study of students’ year-end final presentations after a year of cancer care experiences, two areas stood out: students perceived the complexities of medical decision making and students considered the impact of psychosocial factors on patients facing this disease over time. Which aspects of longitudinal care were most meaningful to the students(?)
Echocardiographic Parameters and Outcomes in Primary Fetal Cardiomyopathy

Objectives Primary fetal cardiomyopathy is a rare entity, with a poor prognosis. We sought to describe its echocardiographic characteristics and outcomes. Methods We performed a 12-year retrospective review of fetuses with primary cardiomyopathy. Results Of more than 6000 fetuses evaluated, 25 met criteria for primary cardiomyopathy, and 18 had sufficient echocardiographic and pregnancy outcome data for inclusion. At echocardiography, the median gestational age was 29.6 weeks (range, 21.0–36.4 weeks); median cardiovascular profile score was 6 (range, 1–9); median right ventricular Tei index was 0.52 (range, 0.32–0.94); and median left ventricular Tei index was 0.40 (range, 0.15–0.88). Two had fetal demise, and 16 survived to delivery. The median cardiovascular profile score in those with fetal demise was 3.0 and in those who survived to delivery was 6.5 (range, 3–9; P = .14). The median right ventricular Tei index in those with fetal demise was 0.39 and in those surviving to delivery was 0.53 (range, 0.38–0.94; P = .49). The median left ventricular Tei index in those with fetal demise was 0.29 and in those surviving to delivery was 0.42 (range, 0.15–0.88; P = .50). Sixty-day survival was available in 11 of 16 fetuses. In addition to the 2 with fetal demise, 4 had postnatal demise, and 5 were alive at a median follow-up of 39 months. Hydrops (P = .01), skin edema (P = .01), and mild or greater mitral regurgitation (P = .02) were associated with fetal or postnatal demise, with a trend toward an association between moderate or greater tricuspid regurgitation (P = .07) and fetal or postnatal demise. Conclusions Hydrops and atrioventricular valvar regurgitation are ominous signs in primary fetal cardiomyopathy. Although other commonly used methods for assessing cardiovascular performance may help in diagnosing primary cardiomyopathy, these data suggest limited predictive value.
Barrier to Computer Integration: Microinteraction among Computer Coordinators and Classroom Teachers in Elementary Schools.

AbstractThis study examined the experiences of computer coordinators who have worked in elementary schools that have had computers for at least eight years and represents part of a longitudinal study conducted over four years. Using a replication of ethnographic methods that successfully guided the earlier wave of the study, the article considers the microprocesses of interaction among computer coordinators and classroom teachers, and how those patterns are related to the integration of computers in elementary schools. Findings reveal that, whereas school administrators and classroom teachers rely on computer coordinators to promote the use and integration of computers in their schools, these specialists are limited in their endeavors because of various structural and social conditions of their work. The examination of work relations among computer coordinators and classroom teachers may have critical implications for the direction of computer implementation in elementary schools.
Multiple Personality Disorder and Posttraumatic Stress Disorder

Multiple personality disorder (MPD) and posttraumatic stress disorder (PTSD) were formulated in medical consciousness at about the same time that modern psychiatry was being molded by its Age of Giants. During this period of 1880 to 1920, MPD was pulled from its millennia-old identification with demonology and possession into the rational spheres of psychology (Ellenberger, 1970). The “cowardice” of warriors who relived scenes of terror in sweating nightmares acquired a new etiology in the trenches of World War I, namely, “shell shock,” later to become the “combat fatigue” of World War II, and the PTSD of today. All too often throughout history the MPD and PTSD patient shared similar fates: isolation or death for the “possessed,” rejection or execution for the craven. Until recently, however, it was not realized that MPD and PTSD had two similarities in etiology and phemonenology: origin in exposure of the victim to shattering psychological trauma—in childhood in the instance of MPD, in later life in PTSD—and the subsequent need for the person to dissociate as a coping mechanism.
Iatrogenes Fremdmaterial in der kranialen Bildgebung

Dieses Kapitel gibt einen Uberblick uber die radiologische Darstellung – Rontgen, MRT und CT – von in die Schadelkalotte und intrakraniell iatrogen eingebrachtem Fremdmaterial. Zunachst wird die Anatomie abgebildet mit Schadelkalotte, Gehirnstrukturen, Gefassystem. Welche Landmarken aufzusuchen sind, wird ebenso aufgezeigt wie in die Liquorraume und in das Gefassystem iatrogen eingebrachtes Fremdmaterial. Die radiologische Darstellung von Zugangen fur Trepanationen, Kraniektomien und Schadeldachplastiken wird gezeigt sowie Katheter und Sonden, insbesondere Hirndrucksonden und sonstige Fremdkorper dargestellt. Intrakranielle Gefasclips, Stents und Coils in der Bildgebung bilden einen weiteren Schwerpunkt. Liquorabflussstorungen fuhren zu verschiedenen CT- und MR-morphologisch nachweisbaren Veranderungen. Die Akutdiagnostik erfolgt i. d. R. mittels CT. Die Therapie besteht haufig in einer temporaren oder bleibenden Drainage mit z. B. Shuntsystemen.
Studies of mouse salivary gland virus disease. II. Sulphydryl and disulphide reaction in SVG-infected liver.

Abstract Salivary gland virus (SGV) infected mouse liver showed histochemical increases in sulphydryl and disulphide protein groups. These changes were markedly evident in SGV-induced inclusion bodies. The increase in activity of these protein groups was disproportionately greater for disulphide than for sulphydryl groups, suggesting changes in the aggregation and/or hydration states of inclusion body proteins.
A Survey of Forestry Extension Clientele in South Carolina, USA

The U.S. South contains nearly one-third of the nation’s forests and 40% of its productive timberland. This makes the southern U.S. an important part of the wood supply chain. In South Carolina, family forests cover 55% of the 13 million acres of forestland, and contribute significantly to the annual timber harvest volume. However, not all family forest owners are engaged in forest management activities. To better understand the needs and behaviors of family forest owners that are actively engaged in forest management an online survey was developed and sent to family forest owners that actively seek the help of extension agents. Results of a latent-class analysis of survey responses showed that there are three distinct groups of family forest owners that engage with extension agents: hands-on timber managers, hands-off timber managers, and multiple-use land managers. These groups differ in their utilization of help from a consulting forester and their ways of selecting timber harvesting contractors for forest management activities. Eighty-eight percent of respondents reported that their major goal of a thinning was to maximize future revenues. When asked about the expected outcome of a cleat-cut, 69% expected all trees to be removed, whereas the rest expected outcomes similar to selection, seed-tree, or commercial clear-cuts. Overall, this survey provides initial information to better focus outreach and extension efforts, but also highlights how family forest owners engage in their timber harvest.