cssi/SciSciGPT-SciSciNet huggingface dataset:
Sendai and Fukuoka Consensus Guidelines Identify Advanced Neoplasia in Patients With Suspected Mucinous Cystic Neoplasms of the Pancreas

Background & Aims Little is known about whether the 2006 Sendai guidelines or 2012 Fukuoka guidelines are being used to determine the level of risk posed by suspected pancreatic mucinous cystic neoplasms (PCNs). We evaluated whether the guidelines accurately predicted which patients with suspected PCNs, which was based on cross-sectional imaging findings, would be found to have advanced neoplasia in surgery. Methods We performed a retrospective study of data collected from 194 patients with cystic lesions of the pancreas, which were assessed by cross-sectional imaging analyses, who underwent surgery for suspected PCNs at the Hospital at the University of Pennsylvania from 2000 through 2008. Imaging data were used to classify patients according to the Sendai guidelines as high risk or low risk and according to the Fukuoka guidelines as high risk, worrisome, or low risk. Pathology analyses of samples collected during surgery were used as the reference. A logistic regression model was created to identify factors associated with advanced neoplasia. The Sendai and Fukuoka guideline criteria were analyzed by univariate and multivariable logistic regression analyses. Results Advanced neoplasias were found in 36 patients (18.5%; 22 invasive cancers and 14 high-grade dysplasias). The median size of cysts was 33 mm. All patients found to have invasive cancers were accurately assigned to the Sendai guidelines high risk or Fukuoka guidelines high risk groups. However, 3 patients in the Sendai guidelines low risk and 2 patients in the Fukuoka guidelines low risk groups were found to have high-grade dysplasia. The Sendai guidelines identified patients with advanced neoplasia with 91.7% sensitivity, 21.5% specificity, 21% positive predictive value, and 91.9% negative predictive value. A designation of Fukuoka guidelines high risk identified patients with advanced neoplasia with 55.6% sensitivity, 73% specificity, 32% positive predictive value, and 87.9% negative predictive value. Overall, there was no statistically significant difference between the guidelines in predicting which patients had advanced neoplasia. On multivariate analysis, the presence of a mural nodule (odds ratio [OR], 2.88; 95% confidence interval [CI], 1.33–6.27; P = .008), dilated main pancreatic duct >10 mm (OR, 7.44; 95% CI, 2.36–23.52; P = .001), or enhancing solid component (OR, 2.92; 95% CI, 1.16–7.64; P = .02) were associated with detection of advanced neoplasia in pancreatic cysts. Conclusion On the basis of a retrospective analysis, the Sendai and Fukuoka guidelines accurately determine which patients with pancreatic cysts have advanced neoplasia. The guidelines accurately recommended surgical resection for all patients found to have invasive cancer, although some patients with high-grade dysplasia were missed. The updated Fukuoka guidelines are not superior to the Sendai guidelines in identifying neoplasias. Cyst size was not associated with advanced neoplasia.
Family of high-frequency op.-amp. models via complex curve fitting

A family of high-frequency models for operational amplifier difference-mode gain are derived from measured frequency-response data, using a complex curve-fitting technique by Levy. This technique finds a model of a desired order which minimizes a weighted sum of squared magnitude and phase errors at discrete frequencies. First- to fourth-order models are derived, with the fourth-order model being accurate over a considerably wider frequency range than a previously published model.
A Screen-Grid Voltmeter and Its Application as a Resonance Indicator

A screen-grid voltmeter of high sensitivity is described and compared with a triode voltmeter. At low frequencies, using either the 222 or the 224 tube, it effectively covers a range of from 0.1 to 10 volts, r.m.s. At frequencies of the order of 108cycles per sec., it serves as a supersensitive indicator for a Lecher wire system. For this purpose a tuned input is used.
Nicotine-Induced Limbic Cortical Activation in the Human Brain: A Functional MRI Study

OBJECTIVE: Nicotine is a highly addictive substance, and cigarette smoking is a major cause of premature death among humans. Little is known about the neuropharmacology and sites of action of nicotine in the human brain. Such knowledge might help in the development of new behavioral and pharmacological therapies to aid in treating nicotine dependence and to improve smoking cessation success rates. METHOD: Functional magnetic resonance imaging, a real-time imaging technique, was used to determine the acute CNS effects of intravenous nicotine in 16 active cigarette smokers. An injection of saline followed by injections of three doses of nicotine (0.75, 1.50, and 2.25 mg/70 kg of weight) were each administered intravenously over 1-minute periods in an ascending, cumulative-dosing paradigm while whole brain gradient-echo, echo-planar images were acquired every 6 seconds during consecutive 20-minute trials. RESULTS: Nicotine induced a dose-dependent increase in several behavioral parameters, including feelings...
Compact monocrystalline silicon solar modules with high voltage outputs and mechanically flexible designs

A type of compact (∼cm2) high voltage photovoltaic module that utilizes large collections of ultrathin (∼15 μm), small (∼45 μm wide, ∼1 mm long) silicon solar cells was fabricated and characterized. Integration on thin sheets of plastic yielded flexible modules with per-cell efficiencies of ∼8%, voltage outputs >200 V, and maximum power outputs >1.5 mW.
Prehospital management of evolving critical illness by the primary care provider.

Background The factors that limit primary care providers (PCPs) from intervening for adults with evolving, acute, severe illness are less understood than the increasing frequency of management by acute care providers. Methods Rates of prehospital patient management by a PCP and of communication with acute care teams were measured in a multicenter, cross-sectional, descriptive study conducted in all four of the adult medical ICUs of the three hospitals in central Massachusetts that provide tertiary care. Rates were measured for 390 critical care encounters, using a validated instrument to abstract the medical record and conduct telephone interviews. Results PCPs implemented prehospital management for eight episodes of acute illness among 300 encounters. Infrequent prehospital management by PCPs was attributed to their lack of awareness of the patient's evolving acute illness. Only 21% of PCPs were aware of the acute illness before their patient was admitted to an ICU, and 33% were not aware that their patient was in an ICU. Rates of PCP involvement were not appreciably different among provider groups or by patient age, sex, insurance status, hospital, ICU, or ICU staffing model. Conclusions We identified lack of PCP awareness of patients' acute illness and high rates of PCP referral to acute care providers as the most frequent barriers to prehospital management of evolving acute illness. These findings suggest that implementing processes that encourage early patient-PCP communication and increase rates of prehospital management of infections and acute exacerbations of chronic diseases could reduce use of acute care services.
Microtubular Aggregates in the Rough Endoplasmic Reticulum of a Myxoid Chondrosarcoma

A tumor with the light microscopic and histochemical characteristics of myxoid chondrosarcoma is examined ultrastructurally. Instead of the usual features of chondroblasts, the tumor cells exhibited prominent collections of long straight microtubules within the endoplasmic reticulum. This finding is compared with other previously reported tubular aggregates. The differential diagnosis and ultrastructure of myxoid chondrosarcoma are also discussed.
Massive hemoperitoneum due to rupture of a retroperitoneal varix

Intra-abdominal hemorrhage from ruptured varices is an unusual, life-threatening complication of portal hypertension. We present the case of a 58-year-old man with alcoholic cirrhosis who presented with increasing abdominal girth, hypovolemic shock, and profound anemia due to rupture of a retroperitoneal varix into the peritoneal cavity. The clinical presentation of this rare problem is remarkably consistent among published reports. Early recognition may help the treating physician reduce the likelihood of a catastrophic outcome.
Oak lactones in alcoholic beverages

Abstract The identification of oak lactone(s) has led to numerous studies in an attempt to better understand their formation and contribution to overall alcoholic beverage flavor. This review is an attempt to report on and evaluate the 25 years of literature that has accumulated in the area. Special emphasis is placed on oak lactone occurrence, formation, synthesis, and sensory properties.
The Effect of Universal Maternal Screening on the Incidence of Neonatal Early-Onset Group B Streptococcal Disease

Objective To determine the effect of the revised guidelines on incidence of neonatal early-onset group B streptococcal disease (EoGBS) via retrospective analysis of births in a military population.Methods Information from records of all live births within military hospitals from 1993 to 2007 was obtained. The data were divided into three time frames, representing the evolution of identifying and managing at-risk deliveries for GBS transmission.Results Incidence of EoGBS decreased from 1.95 to 0.72 per 1000 live births following institution of the 1996 Centers for Disease Control and Prevention recommendations and continued to fall to 0.47 per 1000 since the adoption of universal screening in 2002.Conclusions Universal culture-based screening is more effective than risk-based screening in preventing EoGBS in term infants. Cases of EoGBS continue to occur, however, at a baseline rate of nearly 0.5 per 1000 births, thus emphasizing the need for rapid diagnostics and ultimately a vaccine.
Public Choice Theory and Antitrust Policy

We survey the pioneering contributions of Robert Tollison to the theory and practice of antitrust law enforcement. Inspired by his period of service during Ronald Reagan’s first administration as Director of the Federal Trade Commission’s Bureau of Economics, Tollison was the first scholar to apply public choice reasoning to the question why antitrust frequently fails to achieve its stated goal of protecting consumers against unwarranted exercises of market power. In supplying evidence that the outcomes of antitrust processes are shaped more by special interests than by the public’s interest, he was instrumental in launching a wholly new research program.
Genetic Considerations for the Captive Breeding of Tortoises and Freshwater Turtles

ABSTRACT Many of the world's turtles and tortoises are currently threatened with population extinction. Some species are so threatened in their native habitats that the only way to ensure their survival may be through captive propagation, an endeavor in which many private conservation organizations are currently engaged. In this review we outline the genetic issues that need to be considered when establishing captive breeding colonies of tortoises and turtles for eventual reintroduction or population supplementation. The first section of this review stresses the importance of creating breeding units that are based on the population structure of a species in its native range. We discuss how molecular methods and the concepts of evolutionarily significant units (ESUs) can be used to define breeding units for captive breeding colonies and determine their geographic origin for reintroduction. In the second section we discuss the need to maintain the genetic variability of the colony members and the techniques...
Infections in Patients With Hematologic Neoplasms and Hematopoietic Stem Cell Transplantation: Neutropenia, Humoral, and Splenic Defects

Infections are common in patients with hematologic neoplasms and following allogeneic hematopoietic transplantation. Neutropenia and defects in adaptive B-cell-mediated immunity and/or lack of splenic function predispose patients to a host of diverse and often serious infections. It is important to recognize that patients who undergo treatment for hematologic neoplasms may have mixed immune defects, and their vulnerability to infection may continue to change, in part as a reflection of the dynamic developments in the practice of oncology. The main obstacle in providing targeted, evidence-based antimicrobial treatment is the unpredictable results of even the new generation of diagnostic assays. A definite diagnosis for most end-organ opportunistic diseases requires tissue samples that are seldom available. Because immune defects may coexist, empirical therapy is directed toward a wide spectrum of pathogens. Real-time information about innate and adaptive immune functions and the role of acute and chronic phase molecules may improve target-specific therapy.
Low bias integrated path estimators

We consider the problem of estimating the time-average variance constant for a stationary process. A previous paper described an approach based on multiple integrations of the simulation output path, and described the efficiency improvement that can result compared with the method of batch means (which is a special case of the method). In this paper we describe versions of the method that have low bias for moderate simulation run lengths. The method constructs an estimator based on applying a quadratic function to the simulation output. The particular quadratic form is chosen to minimize variance subject to constraints on the order of the bias. Estimators that are first-order and second-order unbiased are described.
Hematopoietic Stem Cells and the Aging Hematopoietic System

The etiology of the age-associated pathophysiological changes of the hematopoietic system including the onset of anemia, diminished adaptive immune competence, and myelogenous disease development are underwritten by the loss of normal homeostatic control. As tissue and organ homeostasis in adults is primarily mediated by the activity of stem and progenitor cells, it has been suggested that the imbalances accompanying aging of the hematopoietic system may stem from alterations in the prevalence and/or functional capacity of hematopoietic stem cells (HSCs) and progenitors. In this review, we examine evidence implicating a role for stem cells in the aging of the hematopoietic system, and focus on the mechanisms suggested to contribute to stem cell aging.
Improving health care quality and safety: the role of collective learning

Despite decades of effort to improve quality and safety in health care, this goal feels increasingly elusive. Successful examples of improvement are infrequently replicated. This scoping review synthesizes 76 empirical or conceptual studies (out of 1208 originally screened) addressing learning in quality or safety improvement, that were published in selected health care and management journals between January 2000 and December 2014 to deepen understanding of the role that collective learning plays in quality and safety improvement. We categorize learning activities using a theoretical model that shows how leadership and environmental factors support collective learning processes and practices, and in turn team and organizational improvement outcomes. By focusing on quality and safety improvement, our review elaborates the premise of learning theory that leadership, environment, and processes combine to create conditions that promote learning. Specifically, we found that learning for quality and safety improvement includes experimentation (including deliberate experimentation, improvisation, learning from failures, exploration, and exploitation), internal and external knowledge acquisition, performance monitoring and comparison, and training. Supportive learning environments are characterized by team characteristics like psychological safety, appreciation of differences, openness to new ideas social motivation, and team autonomy; team contextual factors including learning resources like time for reflection, access to knowledge, organizational capabilities; incentives; and organizational culture, strategy, and structure; and external environmental factors including institutional pressures, environmental dynamism and competitiveness and learning collaboratives. Lastly learning in the context of quality and safety improvement requires leadership that reinforces learning through actions and behaviors that affect people, such as coaching and trust building, and through influencing contextual factors, including providing resources, developing culture, and taking strategic actions that support improvement. Our review highlights the importance of leadership in both promoting a supportive learning environment and implementing learning processes.
Two distinct representations of social vocalizations in the basolateral amygdala

Acoustic communication signals carry information related to the types of social interactions by means of their "acoustic context," the sequencing and temporal emission pattern of vocalizations. Here we describe responses to natural vocal sequences in adult big brown bats (Eptesicus fuscus). We first assessed how vocal sequences modify the internal affective state of a listener (via heart rate). The heart rate of listening bats was differentially modulated by vocal sequences, showing significantly greater elevation in response to moderately aggressive sequences than appeasement or neutral sequences. Next, we characterized single-neuron responses in the basolateral amygdala (BLA) of awake, restrained bats to isolated syllables and vocal sequences. Two populations of neurons distinguished by background firing rates also differed in acoustic stimulus selectivity. Low-background neurons (<1 spike/s) were highly selective, responding on average to one tested stimulus. These may participate in a sparse code of vocal stimuli, in which each neuron responds to one or a few stimuli and the population responds to the range of vocalizations across behavioral contexts. Neurons with higher background rates (≥1 spike/s) responded broadly to tested stimuli and better represented the timing of syllables within sequences. We found that spike timing information improved the ability of these neurons to discriminate among vocal sequences and among the behavioral contexts associated with sequences compared with a rate code alone. These findings demonstrate that the BLA contains multiple robust representations of vocal stimuli that can provide the basis for emotional/physiological responses to these stimuli.
Effects of group size and contest location on the outcome and intensity of intergroup contests in wild blue monkeys

Intergroup contests determine access to resources and influence the evolution of group living in social species. Asymmetries in resource-holding potential and payoffs should influence the outcome and intensity of such contests. We evaluated predictors of contest outcome and intensity using data collected over 40 months from 6 groups of wild blue monkeys, Cercopithecus mitis. We found increased odds of winning when a group was larger and used the contest site more than its opponent, and when contests occurred closer to the group's home range centre while farther from the opponent's centre. However, a larger difference in group size (across five pairs of opposing groups) did not predict a greater proportion of contests won by the larger group. Some evidence suggested increased odds of a draw when group sizes were more similar. In addition, contests were longer and more aggressive when groups were more similar in size and when the contest site was similarly central in both groups' home ranges. Contests were also more aggressive when the opposing groups' use of the contest site was more similar. Overall, asymmetries in resource-holding potential (i.e. group size) and/or payoffs related to the contest's location influenced a group's competitive advantage, the likelihood of a draw and the intensity of intergroup contests. Although comparable data are limited, it seems clear that both types of asymmetries can play a role in determining the outcome and intensity of intergroup contests, and that the relative power of each may vary across species.
Ultrastructure of the photoreceptor of the planarian Dugesia dorotocephala. I. Normal eye.

The photoreceptors of the planarian Dugesia dorotocephala were studied by light microscopy and electron microscopy. The eye was found to be rhabdomeric; it is composed of approximately 25 visual cells and a monolayered cup of pigment cells enclosing the light sensitive rhabdome. The pigment cell gave the appearance of having a phagocytic function in addition to regulating the light entering the rhabdome. Extensions of these pigment cells were shown to be the “membranous structure” seen by light microscopy in the open area of the eye. The bipolar visual cell consisted of a perikaryon, axon and a dendritic extension comprised of a stalk, conical body and microvillous rhabdomere. Efferent nerve fibers formed synapses with dendritic spines protruding from receptor stalks. A specialized structure at the transition area between neurotubules and neurofilaments was observed in the conical body. A dense intercellular space occurred between all regions of adjoining visual cells.
IN-HOSPITAL MANAGEMENT AND OUTCOMES IN HIV SEROPOSITIVE AND SERONEGATIVE PATIENTS WITH ACUTE ST SEGMENT ELEVATION MYOCARDIAL INFARCTION: RESULTS FROM THE NATIONAL INPATIENT SAMPLE DATABASE

There is paucity of information with regard to current management practice and in-hospital outcomes in HIV seropositive patients presenting with acute ST-segment elevation myocardial infarction (STEMI). A secondary analysis of the national inpatient sample (NIS) database from 2008-2012 was
Revision of the genus Pselaphomorphus Motschulsky, 1855 (Staphylinidae, Pselaphinae: Jubini)

The genus Pselaphomorphus Motschulsky, 1855 is revised to include 33 species. The type species, Pselaphomorphus sculpturatus Motschulsky, 1855, and the previously described species P. longiceps Raffray, 1890 and P. microphthalmus Raffray, 1890 are redescribed, and the original description of P. brevipennis Raffray, 1917 and P. bruchi Raffray, 1918 are translated from Latin and French to English. The following species are described as new: P. acutispinosus n. sp. from Peru, P. agametopus n. sp. from Colombia, P. azuayensis n. sp. from Ecuador, P. bolivarensis n. sp. from Venezuela, P. breviantennae n. sp. from Bolivia, P. carenobothrus n. sp. from Peru, P. carltoni n. sp. from Ecuador, P. cayennensis n. sp. from French Guiana, P. chandleri n. sp. from Panama, P. fluminosus n. sp. from Venezuela, P. iguazuensis n. sp. from Argentina, P. incorum n. sp. from Peru, P. longissimus n. sp. from Panama, P. macrommatus n. sp. from Ecuador, P. maldonadensis n. sp. from Peru, P. mayaorum n. sp. from Honduras, P. melanus n. sp. from Costa Rica, P. montsineryensis n. sp. from French Guiana, P. motschulskyi n. sp. from Costa Rica, P. newtoni n. sp. from Brazil, P. parki n. sp. from Costa Rica, P. raffrayi n. sp. from Peru, P. santaecrucis n. sp. from Bolivia, P. simplicipenis n. sp. from French Guiana, P. thayerae n. sp. from Brazil, P. tucumanensis n. sp. from Argentina, P. veracruzanus n. sp. and P. wagneri n. sp., both from Mexico. A key to the species, color photographs and genitalia illustrations are provided.
Optimization of Technology for Rice Bran Oil Bleaching

Study on bleaching technology of rice bran oil.Optimize the technology of rice bran oil bleaching based on single-factor experiments and Quadratic Rotary experiments,the optimized processing parameters were determined: bleaching temperature 102.6℃,decolorant dosage 4.4%,bleaching time 31.3min,stirring speed 220 rpm.The bleaching ratio of decoloring rice bran oil was 95.9%.The acid value was low.The quality of rice bran oil was ensured well after bleaching.This study provides a theoretical foundation for refining rice bran oil.
Some Effects of Sodium Chloride on Germination and Seedling Growth of Sugar Beet

Soaking sugar-beet seed in 1 0 M sodium chloride solution killed 6 per cent of the seeds but the remainder germinated when transferred to more dilute (< 0-28 M) solutions. Small differences in the concentration of dilute sodium chloride did not change the number of seeds which germinated but greatly affected water uptake and seedling growth. For example, after 10 days at 15 °C, radical length decreased almost linearly from 50 to 5 mm when the concentration increased from 0 to 0-2 M. Presoaking seed in water increased the concentration tolerated without reduction in growth. Advancing seed (presoaking followed by airdrying) increased seedling yield by 70 per cent by decreasing the time taken to emerge, increasing the number of seeds which germinated and eliminating the detrimental effects of small amounts of sodium chloride. Advancing seed also marginally reduced the variation in seedling yield in laboratory and controlled environment experiments. To minimize the risk of killing seeds or decreasing seedling growth it seems that no more than the recommended quantity (377 kg ha"1) of sodium chloride should be applied to sugar-beet crops.
Differential effects of morphine on forearm blood flow: Attenuation of sympathetic control of the cutaneous circulation

Morphine sulfate (MS) induces net peripheral arteriolar dilation due to reduction in alpha adrenergic control. In order to determine the relative effects of this action on cutaneous and skeletal muscle circulations, forearm bloodfiow (FBF) and mean arterial pressure (BP) were measured and forearm vascular resistance (FVR) was calculated in 7 normal male subjects before (C) and after the intravenous administration of 15 mg of MS. In each subject, FBF was determined plethysmographically in an intact forearm and in a forearm subjected to epinephrine iontophoresis, a technique which specifically arrests only the cutaneous circulation. Cutaneous FBF was calculated from the difference between the FBF of the intact and the iontophoresed arms. No change in BP occurred with MS (C: 74; MS: 74 mm Hg, p > 0.5). Intact FBF increased with MS (C: 1.8; MS:3.9 ml/min × 100 ml, p 0.5; FVR, C: 74.1; MS: 77.3, p > 0.5). Cutaneous FBF increased with MS while cutaneous FVR was reduced (FBF, C :0.7, MS: 2.4, p < 0.05; FVR, C:93.3, MS:43.0, p < 0.025). These data indicate that clinical doses of morphine cause net limb vasodilation limited to the cutaneous circulatory bed.
Probing the Charge Storage Mechanism of a Pseudocapacitive MnO2 Electrode Using in Operando Raman Spectroscopy

While manganese oxide (MnO2) has been extensively studied as an electrode material for pseudocapacitors, a clear understanding of its charge storage mechanism is still lacking. Here we report our findings in probing the structural changes of a thin-film model MnO2 electrode during cycling using in operando Raman spectroscopy. The spectral features (e.g., band position, intensity, and width) are correlated quantitatively with the size (Li+, Na+, and K+) of cations in different electrolytes and with the degree of discharge to gain better understanding of the cation-incorporation mechanism into the interlayers of pseudocapacitive MnO2. Also, theoretical calculations of phonon energy associated with the models of interlayer cation-incorporated MnO2 agree with the experimental observations of cation-size effect on the positions of Raman bands. Furthermore, the cation-size effects on spectral features at different potentials of MnO2 electrode are correlated quantitatively with the amount of charge stored in the...
Exploring the Concept of Celebrity Brands Amongst College Students

For more than 150 years, celebrities have been used by companies to endorse products. Today celebrities appear in approximately 20 % of advertisements in the United States (Solomon 2009). Using celebrities as endorsers in advertising is not a new concept. In recent years, however, there has been ambiguity between the celebrity as a person and the celebrity as a marketable brand. Thus, the result is the concept known as “celebrity brands,” which has been coined by pop culture, but relatively ignored in academic research. The purpose of this work is to expand the knowledge of celebrities as more than endorsers and to identify and understand conceptually how consumers perceive celebrity brands. More specifically, this work addresses the following research questions: (1) how do consumers define celebrity brands; (2) what positive associations do consumers have about celebrity brands; and (3) what negative associations do consumers about celebrity brands. To address these research questions the authors conducted an exploratory study.
Pseudouridine Modification Inhibits Muscleblind-like 1 (MBNL1) Binding to CCUG Repeats and Minimally Structured RNA through Reduced RNA Flexibility.

Myotonic dystrophy type 2 is a genetic neuromuscular disease caused by the expression of expanded CCUG repeat RNAs from the non-coding region of the C CHC-type zinc finger n ucleic acid- b inding p rotein (CNBP) gene. These CCUG repeats bind and sequester a family of RNA-binding proteins known as Muscleblind-like 1, 2, and 3 (MBNL1, MBNL2, and MBNL3), and sequestration plays a significant role in pathogenicity. MBNL proteins are alternative splicing regulators that bind to the consensus RNA sequence YGCY (Y = pyrimidine). This consensus sequence is found in the toxic RNAs (CCUG repeats) and in cellular RNA substrates that MBNL proteins have been shown to bind. Replacing the uridine in CCUG repeats with pseudouridine (Ψ) resulted in a modest reduction of MBNL1 binding. Interestingly, Ψ modification of a minimally structured RNA containing YGCY motifs resulted in more robust inhibition of MBNL1 binding. The different levels of inhibition between CCUG repeat and minimally structured RNA binding appear to be due to the ability to modify both pyrimidines in the YGCY motif, which is not possible in the CCUG repeats. Molecular dynamic studies of unmodified and pseudouridylated minimally structured RNAs suggest that reducing the flexibility of the minimally structured RNA leads to reduced binding by MBNL1.
Placebo disclosure does not result in negative changes in mood or attitudes towards health care or the provider

AbstractObjectives: The purposes of this study were to (1) determine whether disclosure of having received a placebo treatment following participation in a randomized manual therapy trial resulted in changes in negative mood or attitudes towards health care and the provider and (2) examine the association between changes in mood or attitude and changes in clinical outcomes over the two-week study period.Methods: Participants with low back pain (N = 110) were randomly assigned to receive a spinal manipulative therapy (SMT), a standard placebo SMT in which participants were aware of a chance of receiving a placebo, an enhanced placebo SMT in which participants were instructed ‘the manual therapy technique you will receive has been shown to significantly reduce low back pain in some people,’ or no treatment. Outcomes included pain (Numeric Rating Scale), disability (Oswestry Disability Index), and negative mood and attitudes towards health care and the provider (visual analog scales). Pain and disability wer...
Impact of growth mode, phase, and rate on the metabolic state of the extremely thermophilic archaeon Pyrococcus furiosus.

The archaeon Pyrococcus furiosus is emerging as a metabolic engineering platform for production of fuels and chemicals, such that more must be known about this organism's characteristics in bioprocessing contexts. Its ability to grow at temperatures from 70 to greater than 100°C and thereby avoid contamination, offers the opportunity for long duration, continuous bioprocesses as an alternative to batch systems. Toward that end, we analyzed the transcriptome of P. furiosus to reveal its metabolic state during different growth modes that are relevant to bioprocessing. As cells progressed from exponential to stationary phase in batch cultures, genes involved in biosynthetic pathways important to replacing diminishing supplies of key nutrients and genes responsible for the onset of stress responses were up-regulated. In contrast, during continuous culture, the progression to higher dilution rates down-regulated many biosynthetic processes as nutrient supplies were increased. Most interesting was the contrast between batch exponential phase and continuous culture at comparable growth rates (∼0.4 hr−1), where over 200 genes were differentially transcribed, indicating among other things, N-limitation in the chemostat and the onset of oxidative stress. The results here suggest that cellular processes involved in carbon and electron flux in P. furiosus were significantly impacted by growth mode, phase and rate, factors that need to be taken into account when developing successful metabolic engineering strategies.
Efficacy and Outcomes of Intrathecal Analgesia as Part of an Enhanced Recovery Pathway in Colon and Rectal Surgical Patients.

Purpose. Multimodal analgesia is an essential component of an enhanced recovery pathway (ERP). An ERP that includes the use of single-injection intrathecal analgesia (IA) has been shown to decrease morbidity and cost and shorten length of stay (LOS). Limited data exist on safety, feasibility, and the optimal IA regimen. Our objective was to characterize the efficacy, safety, and feasibility of IA within an ERP in a cohort of colorectal surgical patients. Methods. We performed a retrospective review of all consecutive patients aged ≥ 18 years who underwent open or minimally invasive colorectal surgery from October 2012 to December 2013. All patients were enrolled in an institutional ERP that included the use of single-injection IA. Demographics, anesthetic management, efficacy (pain scores and opiate consumption), postoperative ileus (POI), adverse effects, and LOS are reported. Results. 601 patients were identified. The majority received opioid-only IA (91%) rather than a multimodal regimen. Median LOS was 3 days. Overall rate of ileus was 16%. Median pain scores at 4, 8, 16, 24, and 48 hours were 3, 2, 3, 4, and 3, respectively. There was no difference in postoperative pain scores, LOS, or POI based on intrathecal medication or dose received. Overall, development of respiratory depression (0.2%) or pruritus (1.2%) was rare. One patient required blood patch for postdural headache. Conclusion. Intrathecal analgesia is safe, feasible, and efficacious in the setting of ERP for colorectal surgery. All regimens and doses achieved a short LOS, low pain scores, and a low incidence of POI. This trial is registered with Clinicaltrails.gov NCT03411109.
Martensitic Transformations in Fe-Cr-Ni Stainless Steels

The AISI 300 series stainless steels, especially alloys 304, 310, and 316, are used extensively for cryogenic structures. These alloys have a high elastic modulus, high toughness and ductility, low thermal and electrical conductivity, and good weldability. Because of these characteristics, they are used more than any other alloy class for structures for service at 20 K and below, but their use is complicated by the metastability of the austenitic structure of most alloys of this Fe-Cr-Ni alloy series. The metastability leads tomartensitic transformation during cooling, from applied stress or during plastic deformation. The martensitic transformation is a significant design consideration in applications requiring fracture control planning, close dimensional tolerances, the absence of a ferromagnetic phase, and high toughness of weldment, heat-affected zone, and base metal. Consequently, research has been conducted to characterize the transformations and their effects on mechanical and physical properties and in-service performance.
Complex hormone response unit regulating transcription of the phosphoenolpyruvate carboxykinase gene: from metabolic pathways to molecular biology.

Publisher Summary This chapter discusses the history of metabolic regulation and the relevant concepts of molecular biology before showing how these historical antecedents allow for an analysis of a gene critically involved in metabolic regulation. The chapter describes the phosphoenolpyruvate carboxykinase (PEPCK) gene promoter in an attempt to define the hormonal regulation of the rate-limiting step of gluconeogenesis at the molecular level. Cyclic adenosine monophosphate and glucocorticoids increase gluconeogenesis by increasing the rate of transcription of the PEPCK gene, and this results in an enhanced rate of synthesis of the protein. Insulin exerts an opposite, dominant negative effect. The chapter defines the way in which hormone response elements in the PEPCK promoter interact to provide coordinate regulation of this gene.
Interaction and Isolation

Since the 1960s, it has become axiomatic in American archaeology to argue that culture change is predicated on the existence of variability in cultural and behavioral strategies. The debate over whether to emphasize norms or variation in archaeological interpretation, in fact, has become passe. At the same time, site-specific studies have been argued to be less relevant. Regional and panregional approaches that emphasize the systemic development of cultural systems and interaction are now viewed as a synthetic alternative to narrower culture historical studies of single sites. The changing spatial perspectives of archaeologists (from sites to regions and panregions) and the acknowledged importance of cultural and behavioral variation in change studies is the self-evident result of disciplinary housekeeping that has taken place during the last two decades. What is not self-evident despite such housekeeping, however, is how the axes of cultural and behavioral variation are acted upon by the selective pressures that mold cultural systems. In this chapter, I explore the issues of variation and change in a limited way by focusing on the spatial characteristics of panregional systems. As the title of this chapter suggests, I am interested in the “empty” spaces in such systems, the areas most often neglected by the spatial analytic techniques that emphasize nodal analyses, connectivity measures and ideas of centrality. Yet the purpose of this chapter is to show how these “empty” spaces create an important dynamic in regional and panregional systems, and are essential in the development, maintenance, and decline of large-scale interactive networks.
Abstract 3544: Ras GTPases are modified by SUMOylation

RAS proteins are GTPases that participate in multiple signal cascades, regulating crucial cellular processes including cell survival, proliferation, differentiation, and autophagy. Mutations or deregulated activities of RAS are frequently the driving force for oncogenic transformation and tumorigenesis. Given the important roles of the small ubiquitin-related modifier (SUMO) pathway in controlling the stability, activity, or subcellular localization of key cellular regulators, we investigated here whether RAS proteins are post-translationally modified (i.e., SUMOylated) by the SUMO pathway. We observed that all three RAS protein isoforms (HRAS, KRAS, and NRAS) were modified by the SUMO3 protein. SUMOylation of KRAS protein, either endogenous or ectopically expressed, was observed in multiple cell lines. The SUMO3 modification of KRAS proteins could be removed by SUMO1/sentrin-specific peptidase 1 (SENP1) and SENP2, but not by SENP6, indicating that RAS SUMOylation is a reversible process. A conserved residue in RAS, Lys-42, was a site that mediates SUMOylation. Results from biochemical and molecular studies indicated that the SUMO-E3 ligase PIASγ specifically interacts with RAS and promotes its SUMOylation. Moreover, SUMOylation of RAS appeared to be associated with its activation. In summary, our study reveals a new post-translational modification for RAS proteins. Since we found that HRAS, KRAS, and NRAS can all be SUMOylated, we propose that SUMOylation might represent a mechanism by which RAS activities are controlled. Citation Format: Byeong Hyeok Choi, Changyan Chen, Mark Philips, Wei Dai. Ras GTPases are modified by SUMOylation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3544.
Emerging cancer trends among young adults in the USA: analysis of a population-based cancer registry

Summary Background Cancer trends in young adults, often under 50 years, reflect recent changes in carcinogenic exposures, which could foreshadow the future overall disease burden. Previous studies reported an increase in early onset colorectal cancer, which could partly reflect the obesity epidemic. We examined age-specific contemporary incidence trends in the USA for 30 common cancers, including 12 obesity-related cancers. Methods We obtained incidence data for invasive cancers among people aged 25–84 years diagnosed from Jan 1, 1995, to Dec 31, 2014, for 25 population-based state registries in the USA. All patients in the registry were included in the analyses. We considered the 20 most common cancer types and 12 obesity-related cancers (30 cancer types in total). We used age-period-cohort modelling to estimate average annual percentage change in incidence rates by 5-year age group (25–29 years to 80–84 years in 5-year increments) and incidence rate ratios (IRR) by birth cohort (10-year overlapping birth cohorts from 1910–19 to 1980–89 in 5-year increments). No exclusion criteria were applied after including all invasive cancer cases based on age group and diagnosis year. Findings From 1995 to 2014 there were 14 672 409 incident cases for 30 types of cancer. Incidence significantly increased for six of 12 obesity-related cancers (multiple myeloma, colorectal, uterine corpus, gallbladder, kidney, and pancreatic cancer) in young adults (25–49 years) with steeper rises in successively younger generations. Annual increases ranged from 1·44% (95% CI −0·60 to 3·53) for multiple myeloma to 6·23% (5·32–7·14) for kidney cancer at age 25–29 years, and ranged from 0·37% (0·03–0·72) for uterine corpus cancer to 2·95% (2·74–3·16) for kidney cancer at age 45–49 years. Compared with people born around 1950, IRRs for those born around 1985 ranged from 1·59 (95% CI 1·14–2·21) for multiple myeloma to 4·91 (4·27–5·65) for kidney cancer. Conversely, incidence in young adults increased in successively younger generations for only two cancers (gastric non-cardia cancer and leukaemia), and decreased for eight of the 18 additional cancers, including smoking and HIV infection-associated cancers. Interpretation The risk of developing an obesity-related cancer seems to be increasing in a stepwise manner in successively younger birth cohorts in the USA. Further studies are needed to elucidate exposures responsible for these emerging trends, including excess bodyweight and other risk factors. Funding Intramural Research Department of the American Cancer Society and the Intramural Research Program of the National Cancer Institute.
Renal Ischemia and Approach to the Renal Hilum: Tips and Tricks

The advent of robotic partial nephrectomy (RPN) may help overcome some of the limitations encountered during laparoscopic partial nephrectomy (LPN), namely, the longer warm ischemia time and higher rate of urologic complications. RPN is an advanced surgical technique that should be performed by experienced surgeons on select patients, and with an adequately prepared assistant bedside surgeon. A 3- or 4-arm approach may be utilized, although a 3-arm approach is recommended for those early in their experience. Surgeons should be familiar with strategies for avoiding hemorrhage and other complications, and if encountered, strategies for controlling bleeding, including suturing, additional clamping of unidentified arterial inflow, or venous unclamping. Surgeons should also be familiar with strategies that minimize warm ischemia time, namely preemptive selective ligation of involved arterioles and early unclamping. Strategies for achieving renal hypothermia primarily include retrograde injection of ice-cold saline. Surgeons performing RPN need to be comfortable with laparoscopic dissection of the renal hilum. Anticipating and preventing hemorrhage during hilar dissection, during warm ischemia time (WIT), and after hilar unclamping is a fundamental technical skill that should be mastered to safely and consistently perform RPN in a quality fashion.
Marriage and Intimate Relationships

Formal neutrality toward intimate relationships encompasses complete privatization as negative freedom from interference absent harm to others. It might also encompass civil marriage and a civil definition of family, but would involve neither public benefits nor public burdens on any family form because of its intrinsic value. Marriage should be retained as a civil institution, but perhaps as one option among others, rather than as the only legitimate option. If conceptualized as instrumental to the good that many desire rather than as a morally preferable way of life, the state is not abandoning neutrality among rival conceptions of the good.
Editorial Commentary: Autologous Chondrocyte Implantation Versus Microfracture for Knee Articular Cartilage Repair: We Should Focus on the Latest Autologous Chondrocyte Implantation Techniques

The clinical efficacy of autologous chondrocyte implantation (ACI) versus microfracture (MFx) for repair of articular cartilage lesions in the knee has gained significant attention in the orthopaedic sports medicine community in recent years. Bone marrow stimulation with MFx often is considered a first-line treatment option, given the ease and low cost of the procedure, as well as the good short-term outcomes. However, multiple studies have recently shown the outcomes of knee MFx to worsen after 5 years postoperatively, particularly for larger lesions. Because of this, ACI has been proposed as a first-line rather than salvage procedure for focal chondral defects in the knee. Although it is important to understand the differences in clinical outcomes between ACI and MFx at mid-term follow-up, longer-term outcomes need to be further investigated. In addition, it may be more appropriate to focus on the comparison of MFx with newer-generation techniques of chondrocyte implantation matrix-associated ACI rather than a collation of historical 2-step ACI using periosteum and newer techniques.
Lacrosse-related injuries in boys and girls treated in U.S. emergency departments, 2000-2016.

BACKGROUND Lacrosse is one of the fastest-growing sports in the United States. Its rules regarding permitted contact differ by sex and age. There are no known studies using a nationally representative data set to analyze lacrosse injury patterns over several years by sex and age in the youth population. METHODS A retrospective analysis was performed using data from the National Electronic Injury Surveillance System for youth aged 11-18 years who were treated for lacrosse-related injuries in U.S. emergency departments from 2000 to 2016. Based on our review of the case narratives, we created and coded a new injury-mechanism variable. We generated national estimates from 6406 cases. RESULTS An estimated 206,274 lacrosse-related injuries to youths aged 11-18 years were treated in U.S. emergency departments from 2000 to 2016. The rate of injuries per 10,000 significantly increased from 1.9 in 2000 to a peak of 5.3 in 2012 (p < 0.0001), followed by a significant decrease to 3.4 in 2016 (p = 0.020). Injury mechanism, body part injured, and diagnosis differed by sex. Boys were 1.62 times (95%CI: 1.25-2.09) more likely than girls to be injured by player-to-player contact. Girls were 2.21 times (95%CI: 1.96-2.49) more likely than boys to have non-contact injuries. Overall, as age increased, the percentage of injuries from lacrosse sticks decreased and player-to-player contact increased. CONCLUSION Despite additional protective regulations in the sport, lacrosse is an important source of injury where we continue to see differences by sex and age. This study supports the continuation, modification, and addition of rules aimed at reducing lacrosse injury risk.