cssi/SciSciGPT-SciSciNet huggingface dataset:
Mortality and Morbidity During and After Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial Results by Sex

To determine whether an angiotensin-converting enzyme inhibitor (lisinopril) or calcium channel blocker (amlodipine) is superior to a diuretic (chlorthalidone) in reducing cardiovascular disease incidence in sex subgroups, we carried out a prespecified subgroup analysis of 15 638 women and 17 719 men in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Total follow-up (active treatment + passive surveillance using national administrative databases to ascertain deaths and hospitalizations) was 8 to 13 years. The primary outcome was fatal coronary heart disease or nonfatal myocardial infarction. Secondary outcomes included all-cause mortality, stroke, combined cardiovascular disease (coronary heart disease death, nonfatal myocardial infarction, stroke, angina, coronary revascularization, heart failure [HF], or peripheral vascular disease), and end-stage renal disease. In-trial rates of HF, stroke, and combined cardiovascular disease were significantly higher for lisinopril compared with chlorthalidone, and rates of HF were significantly higher for amlodipine compared with chlorthalidone in both men and women. There were no significant treatment sex interactions. These findings did not persist through the extension period with the exception of the HF result for amlodipine versus chlorthalidone, which did not differ significantly by sex. For both women and men, rates were not lower in the amlodipine or lisinopril groups than in the chlorthalidone group for either the primary coronary heart disease outcome or any other cardiovascular disease outcome, and chlorthalidone-based treatment resulted in the lowest risk of HF. Neither lisinopril nor amlodipine is superior to chlorthalidone for initial treatment of hypertension in either women or men. Clinical Trial Registration- clinicaltrials.gov; Identifier: NCT00000542.
Disturbance of respiratory muscle control in a patient with early-stage multiple sclerosis

To the Editor: Respiratory dysfunction from multiple sclerosis (MS) is most commonly of insidious onset and related to progressive respiratory muscle weakness [1]. Disorders of respiratory muscle coordination are poorly recognised and challenging to diagnose. We present a case of a patient with MS and no clear muscle weakness whose dyspnoea was associated with a disorder of respiratory muscle control. The potential utility of oesophageal manometry for diagnosis of unexplained dyspnoea is highlighted. A 54-year-old female with relapsing-remitting MS presented with 2 weeks of dyspnoea and orthopnoea. She was ambulatory with a low extended disability score of 1.5. 6 months earlier she started cyclophosphamide for disease progression recognised by magnetic resonance imaging (MRI). A week after her last infusion she developed severe dyspnoea and orthopnoea. She had no other symptoms. Her vital signs were normal. Her laboratory tests and arterial blood gas were unremarkable. Chest computed tomography showed no pulmonary parenchymal disease. Echocardiography was unremarkable. Pulmonary function testing (PFTs) demonstrated severe restriction, with a 14% lower vital capacity in the supine position. Her dyspnoea and PFTs improved over the following 1–2 months, but she did not return to her baseline level of pulmonary function. Electromyography (EMG) with phrenic nerve conduction studies demonstrated no abnormalities. MRI was prohibited by her orthopnoea. Previously, MRI demonstrated extensive demyelination in the brain and brainstem that was asymptomatic. Oesophageal manometry was performed to exclude the possibility of bilateral diaphragmatic dysfunction and to elucidate her unexplained dyspnoea. A balloon-catheter was inserted via the nose to position the balloon in the distal oesophagus to estimate pleural pressure. Repeated attempts to perform a forced vital capacity manoeuvre consistently demonstrated fluctuating exhalations, as evidenced by the saw tooth pattern of the flow volume curve (fig. …
Expression of lipoprotein-associated phospholipase A2 in carotid artery plaques predicts long-term cardiac outcome

Aims The aim was to test the hypothesis that carotid artery plaque expression of lipoprotein-associated phospholipase A2 (Lp-PLA2) predicts cardiac events. Methods and results Prospective cohort study of 162 consecutive patients undergoing elective carotid endarterectomy. Lipoprotein-associated phospholipase A2 content was quantified by immunoblotting and lysophosphatidylcholine (lysoPC) by liquid chromatography tandem mass spectrometry. Additional biomolecular profiling by immunoblotting included C-reactive protein, p67phox, and matrix metalloproteinase-2 and -9. Macrophage plaque content was determined by quantitative immunostaining, plaque collagen content by quantitative Sirius red staining. Follow-up for cardiac death and non-fatal acute myocardial infarction was accomplished over a period of 48 ± 14 months. Expression of Lp-PLA2 and lysoPC was higher in carotid plaques of patients with than without cardiac events [median 1.6 (25th, 75th percentile 0.9, 2.5) vs. 0.8 (0.5, 2.0), P = 0.01 and 413 (281, 443) vs. 226 (96, 351) mmol/L, P = 0.03]. Smoking and point increase in carotid Lp-PLA2 expression but no other traditional cardiovascular risk factor, histological or molecular marker remained predictive of cardiac events in the multivariate Cox proportional hazard analyses [HR 3.65 (1.36–9.83), P = 0.01 and HR 1.34 (1.01–1.77), P = 0.039]. Carotid plaque Lp-PLA2 expression above the median constituted a more than three times higher risk for cardiac events [HR 3.39 (1.13–10.17), P = 0.03]. Conclusion Lipoprotein-associated phospholipase A2 expression in carotid artery plaques is a predictor of long-term cardiac outcome. The current study supports the concept of atherosclerosis as a systemic disease with multi-focal complications and personalized medicine.
MEASUREMENTS OF DRAG IN A CONDUCTING FLUID WITH AN ALIGNED FIELD AND LARGE INTERACTION PARAMETER.

The drag of spheres and disks has been measured in a flow of liquid sodium within an aligned magnetic field. A slightly viscous, strong field limit is discussed and explored experimentally. In this limit the drag coefficient was found to have an asymptotic dependence proportional to the square root of the interaction parameter, the ratio of magnetic to inertial force, independent of body shape. A physical model is presented along with preliminary verification of its basic characteristics.
Co-fabrication of live skeletal muscles as actuators in A millimeter scale mechanical system

Functional muscle tissue holds promise as a practical actuator for use in engineering applications. Previously, functional live-cell muscle actuators used for robotics have not scaled greater than about 10 µm, the size of a single monolayer of cells. We present a method to produce larger scale muscle actuators fully integrated into a mechanical structure. We use manufacturing techniques including printing a mold, pouring a molded part, and deposition of cell suspension. Our method allows for co-fabrication of actuator and mechanism through muscle self-assembly. We incorporate muscle construct technologies such that the muscle is fully 3D, anchored, and aligned, yielding a 10 mm long and 0.5 mm thick aligned muscle actuator. By co-fabricating the mechanism and actuators, the muscles are produced and used in the same environmental conditions, the process is more robust and repeatable, and evaluation of performance is under identical conditions to those in which the actuator is used. By using the presented method, variable geometry and multiple degrees of freedom can all be incorporated in a single mechanical structure.
A Eulerian-Lagrangian numerical scheme for the dispersion-convection equation using conjugate space-time grids

Abstract A new numerical scheme is proposed for the dispersion-convection equation which combines the utility of a fixed grid in Eulerian coordinates with the computational power of the Lagrangian method. Convection is formally decoupled from dispersion in a manner which does not leave room for ambiguity. The resulting convection problem is solved by the method of characteristics on a grid fixed in space. Dispersion is handled by finite elements on a separate grid which may, but need not, coincide wit the former at selected points in spacetime. Information is projected from one grid to another by local interpolation. The conjugate grid method is implemented by linear finite elements in conjunction with piecewise linear interpolation functions and applied to five problems ranging from predominant dispersion to pure convection. The results are entirely free of oscillations. Numerical dispersion exists but can be brought under control either by reducing the spatial increment, or by increasing the time step size, of the grid used to solve the convection problem. Contrary to many other methods, best results are often obtained when the Courant number exceeds 1.
New design of the SNS MEBT chopper deflector

The chopper system for the spallation neutron source (SNS) provides a gap in the beam for clean extraction from the accumulator ring. It consists of a pre-chopper in the low energy beam transport and a faster chopper in the medium energy beam transport (MEBT). The original "meander line" design of the MEBT chopper deflector was successfully tested with low power beam during the SNS linac commissioning but turned out to be unsuitable for high power beam operation due to poor cooling of the copper strip line through the dielectric substrate. We developed a new deflecting structure, with higher deflection efficiency and with rise and fall time easily customizable to match the available high voltage pulse generator. In this paper we describe design, implementation and beam tests results of the new MEBT chopper deflector.
The effects of information on willingness to pay for animal welfare in dairy production: application of nonhypothetical valuation mechanisms.

Abstract The objective of this study was to examine consumer willingness to pay (WTP) for animal welfare in dairy production using nonhypothetical Vickrey auctions and open-ended choice experiments. Two hundred fifteen subjects participated in experimental sessions with 4 types of dairy products (humane animal care-labeled cheese and ice cream and conventional cheese and ice cream) and 4 valuation mechanisms. Information treatment, which included information about humane animal care principles in dairy production, was used to examine the effects of information on WTP. The results showed that participants, on average, were willing to pay extra for a scoop of humane animal care–labeled ice cream above the price of conventional ice cream. However, no premium WTP for humane animal care–labeled cheese was detected. Furthermore, provision of information only about humane animal care principles in dairy production, without corresponding information about conventional production practices, did not increase WTP for humane animal care–labeled products.
CLSI C62-A: A New Standard for Clinical Mass Spectrometry

Until recently, there existed minimal guidance on the use of LC-MS for clinical diagnostics. The Clinical and Laboratory Standards Institute (CLSI)2 has now presented a standardized approach for LC-MS assay development and verification in its new guidance document, CLSI C62-A. This document should aid in the harmonization of LC-MS methods and thus have significant ramifications for the evolution of this technology in the clinical laboratory. The ability to accurately identify and quantify a measurand with high sensitivity and specificity by use of selective reaction monitoring has been the driving force for the adoption of LC-MS in the clinical laboratory. LC-MS offers analytical specificity superior to that of widespread diagnostic methodologies such as immunoassays and enzymatic assays. Whereas immunoassays are commonplace in the clinical laboratory, they are not available for all analytes of interest, are plagued by specificity issues, and require the time-consuming production and evaluation of antibodies during development. Just as immunoassays have evolved since their development >50 years ago and have found their place as the leading automated technological approach to diagnostic testing, mass spectrometry (MS) will continue to progress and influence the clinical laboratory landscape. Therefore, standardization of the use of LC-MS is essential. Mass spectrometers were initially used in clinical laboratories only for specialized testing by highly trained and experienced operators. Today they are essential for the diagnosis of metabolic disorders, screening of diseases, quantification of hormone concentrations, monitoring of drug therapies, identification of microbial organisms, and recognition of drug toxicity and poisonings. Without the current clinical quantitative LC-MS methods, metabolic disorders would go undetected at birth, the accuracy of testosterone measurements for women and children would be equivalent to an educated guess, and monitoring of a variety of chemotherapeutics and immunosuppressants would be limited. Despite its widespread use, there is only 1 quantitative LC-MS assay …
Dielectric Properties of Ba0.5Sr0.5TiO3-P(VDF-CTFE) Nanocomposites

Ceramic/polymer composite made of nanosize Ba0.5Sr0.5TiO3 (BST) powders and P(VDF-CTFE) copolymers as matrix. The concentration of the composites with BST from 0% to 40% in volume was investigated. The dielectric properties and structure as well as the morphology of the composites were characterized over a broad temperature range. It is found that the wetability between the polymer and ceramic powder is poor. The approach to improve the uniformity of composites was investigated. Due to the dielectric-constant-maximum temperature of the BST is different from that of copolymer, a weak dependence of the dielectric constant on temperature was observed over temperature from 10 °C to 100 °C.
Transferable Redistribution Layers (TRDL)

Since the early 1990's, redistribution layers (RDL) have been used to relocate and change the pattern of the bond pads on die. RDL allows legacy parts that were designed as wirebond die to be flip-chip soldered to Printed Wiring Boards (PWBs). The flip-chip soldering technology shrinks overall board size as well as shortening electrical connection lengths. Since the introduction of this technology a couple decades ago, RDL has been performed at the wafer level through a back end of line (BEOL) process performed directly on the active surface of the wafer. Transferable redistribution layers (TRDL) may become the next evolutionary step for RDL and provide a viable solution to complex RDL. The TRDL technology allows for multi-layer RDL to be transferred from a non-active surface to an active one. TRDL is particularly important for prototyping and quick-react situations. The TRDL wafers can be processed in parallel with obtaining the active components, thereby drastically reducing the time from design to comp...
Drunkenness as an offense in early New England. A study of "Puritan" attitudes.

The contemporary notion of a consistently intolerant “Puritan” attitude toward alcohol and drunkenness is a distortion. Seventeenth-century New Englanders tried a variety of methods to control alco...
Vehicle Efficiency and Tractive Work: Rate of Change for the Past Decade and Accelerated Progress Required for U.S. Fuel Economy and CO 2 Regulations

A major driving force for change in light-duty vehicle design and technology is the National Highway Traffic Safety Administration (NHTSA) and the U.S. Environmental Protection Agency (EPA) joint final rules concerning Corporate Average Fuel Economy (CAFE) and greenhouse gas (GHG) emissions for model years (MY) 2016 through 2025 passenger cars and light trucks. The chief goal of this current study is to compare the already rapid pace of fuel economy improvement and technological change over the previous decade to the needed rate of change to meet regulations over the next decade. EPA and NHTSA comparisons of the MY 2004 US light-duty vehicle fleet to the MY 2014 fleet shows improved fuel economy (FE) of approximately 28% using the same FE estimating method mandated for CAFE regulations. Future predictions by EPA and NHTSA concerning ensemble fleet fuel economy are examined as an indicator of needed vehicle rate-of-change. A set of 40 same-model vehicle pairs for MY 2005 and MY 2015 is compared to examine changes in energy use and related technological change over the 10 year period. Powertrain improvements measured as increased vehicle efficiency, and vehicle mass-glider improvements measured as decreased tractive work requirements are quantified. The focus is first onmore » conventional gasoline powertrain vehicles which currently dominate the market, with hybrids also examined due to their high potential importance for CAFE compliance. Most hybrid vehicles with significant sales in 2014 were represented in the study. Results show 10 years of progress for the studied vehicle set includes lowered tractive effort of about 5.6% and improved powertrain efficiency of about 16.5%. Further analysis shows that this high rate of past progress must increase by about 50% in order to meet the 2025 CAFE standards. Examination of where certain MY 2015 vehicle compare to CAFE regulations is offered as well as some simple conjecture on what is needed to meet regulations under reasonable assumptions.« less
Association of IL-6 gene alleles with systemic lupus erythematosus (SLE) and with elevated IL-6 expression.

To evaluate the association of alleles of regions having regulatory potential in the IL-6 gene, with SLE, the AT-rich minisatellite in the 3′ flanking region and the 5′ promoter-enhancer of the IL-6 gene were genotyped by PCR- and RFLP-based methods. The AT-rich minisatellite allele distribution pattern was significantly different in SLE (n = 146) as compared to 139 controls (χ27 = 48.97, P = 0.001, Caucasians; and χ27 =19.93, P = 0.006, African-Americans). In either race, short allele sizes (⩽792 bp) were seen exclusively in SLE patients (P = 0.001), whereas the 828-bp allele was over-represented in controls (P = 0.015 and 0.002). In contrast, there was no preferential association of SLE with G/C alleles in the 5′ region of the IL-6 gene. Furthermore, our results suggest that the 3′ minisatellite alleles have biological significance: (1) B lymphoblastoid cells of patients having one or two SLE-associated alleles secreted IL-6 in 3- to 4-fold higher levels than non-allelic cells (P < 0.05); (2) higher percentages (approximately 4-fold) of il-6 positive monocytes were observed in individuals having sle-associated il-6 alleles; (3) in lupus patients having sle-associated minisatellite alleles, il-6 mrna stability was significantly enhanced.
A Comparison of the Injury to Alfalfa by the Aphids, Therioaphis maculata and Macrosiphum pisi

The fluid and nutrient drain imposed on alfalfa seedlings ( Medicago sativa L. var. Caliverde) by the feeding activity of individual spotted alfalfa aphids ( Therioaphis maculata (Buckton)) and pea aphids ( Macrosiphurm pisi (Harris)) was determined and to the plant injury inflicted by these species. The fluid loss was estimated from the rates of excretory and nonexcretory loss of the two species throughout their nymphal development. The rate of excretory water loss, or rate of excretion, was determined from measurements of the frequency and volume with which honeydew droplets were excreted. The nonexcretory water loss was determined by measurements of loss in weight of starving aphids. The nutrient drain was estimated from determinations of the gain in live and dry weight of the aphids and amount of sugar excreted by them during their development. The severity of the plant injury was estimated from the gains in weight of fresh green above-ground portions of infested and uninfested alfalfa seedlings. The results indicated that during nymphal development the average volume of honeydew excreted by M. pisi was some 40% greater than that excreted by T. maculata . Because M. pisi may also lose water by evaporation at a rate similar to that lost by excretion, the volume of sap ingested by M. pisi is probably twice as large as that injested by T. maculata . The relatively smaller rate of water loss by evaporation found for T. maculata may account for its greater resistance to severe desiccating conditions in the field. The increase in dry weight of M. pisi was approximately four times that of T. maculata , but the amount of sugar excreted by M. pisi was less than one-tenth of that excreted by T. maculata . Although the results obtained by previous investigators on the toxic effects of T. maculata on alfalfa plants were confirmed in part, the present study indicated that the rather considerable fluid and nutrient drain which T. maculata and M. pisi impose on alfalfa plants may largely be responsible for the severe injury caused by these aphids.
The Effect of Oxygen on Bile Resistance in Listeria monocytogenes .

Listeria monocytogenes is a Gram-positive facultative anaerobe that is the causative agent of the disease listeriosis. The infectious ability of this bacterium is dependent upon resistance to stressors encountered within the gastrointestinal tract, including bile. Previous studies have indicated bile salt hydrolase activity increases under anaerobic conditions, suggesting anaerobic conditions influence stress responses. Therefore, the goal of this study was to determine if reduced oxygen availability increased bile resistance of L. monocytogenes. Four strains representing three serovars were evaluated for changes in viability and proteome expression following exposure to bile in aerobic or anaerobic conditions. Viability for F2365 (serovar 4b), EGD-e (serovar 1/2a), and 10403S (serovar 1/2a) increased following exposure to 10% porcine bile under anaerobic conditions (P 0.05) in bile resistance between aerobic and anaerobic conditions, indicating that oxygen availability does not influence resistance in this strain. The proteomic analysis indicated F2365 and EGD-e had an increased expression of proteins associated with cell envelope and membrane bioenergetics under anaerobic conditions, including thioredoxin-disulfide reductase and cell division proteins. Interestingly, HCC23 had an increase in several dehydrogenases following exposure to bile under aerobic conditions, suggesting that the NADH:NAD+ is altered and may impact bile resistance. Variations were observed in the expression of the cell shape proteins between strains, which corresponded to morphological differences observed by scanning electron microscopy. These data indicate that oxygen availability influences bile resistance. Further research is needed to decipher how these changes in metabolism impact pathogenicity in vivo and also the impact that this has on susceptibility of a host to listeriosis.
Endovascular Treatment of Chronic Mesenteric Ischemia in the Setting of Occlusive Superior Mesenteric Artery Lesions

Background Endovascular intervention is considered the first-line treatment for chronic mesenteric ischemia (CMI) when feasible. Two-vessel revascularization is most definitive when celiac (CA) and superior mesenteric arteries (SMA) are diseased, but single-vessel intervention may be performed in patients with 2-vessel disease due to anatomic/technical factors. We evaluated anatomic predictors of clinical outcomes associated with endovascular treatment of CMI among patients with occlusive SMA lesions. Methods Patients with CMI treated with endovascular revascularization over 10 years were identified. Patients with SMA occlusions were selected for analysis. Between-group comparisons based on inclusion of an SMA revascularization were evaluated using t -test and chi-squared test. Freedom from symptomatic recurrence or repeat intervention was analyzed using proportional hazards regression. Results Fifty-four patients with CMI were analyzed. Sixteen (29.6%) patients had CA-only intervention, and 38 (70.4%) patients had SMA revascularization with or without CA intervention. No significant differences in demographics or comorbidity were identified between groups. In the CA-only intervention group, 8 of the 16 (50%) patients developed symptomatic recurrence compared with 8 of the 31 (21.1%) patients whose intervention included the SMA. Patients treated without SMA intervention also had decreased freedom from both symptomatic recurrence (hazard ratio [HR] 3.2, 95% confidence interval [CI] 1.2–8.6, P = 0.016) and repeat intervention (HR 5.5, 95% CI 1.8–16.3, P = 0.001). Conclusions Among patients with CMI and occlusive SMA lesions, SMA revascularization appears to be the key determinant for symptomatic outcomes and repeat intervention. Patient counseling should include potential future need for surgical revascularization if endovascular SMA treatment cannot be accomplished.
Are civil-law notaries rent-seeking monopolists or essential market intermediaries? Endogenous development of a property rights institution in Mexico

As the fourth contribution in the ‘Land’ section, this paper forms a research ‘diptych’ with the next paper by Levy. Whereas she focuses on the notarial institution in mid-nineteenth century Mexico, this contribution examines it in a contemporary context. The notary is one of the chief components of property rights protection in civil-law systems, performing various public functions such as writing deeds for real estate property. Yet notaries are considered an ‘inefficient’ institution by many, due to the perception of rent-seeking behavior enabled by their near-monopoly over validating property rights claims. This study examines notaries in Mexico to unpack the apparent contradiction in the role of notaries in economic development. I use a combination of interviews with notaries and clients, and data on notarial practice and bureaucratic outcomes across the country, to examine notaries’ social function. The theoretical lens of endogenous development and institutional functionalism reveals an alternate ex...
THE USE OF THE PROTEIN EXTRACT FROM THE REITER TREPONEME IN AN AGGLUTINATION TEST FOR THE DETECTION OF SYPHILIS

Publisher Summary This chapter discusses a study to demonstrate the use of the protein extract from the reiter treponeme in an agglutination test for the detection of syphilis. Excellent treponemal antigens were prepared and were used either in immobilization, complement-fixation, or fluorescent antibody tests. These procedures require precise technique, are complicated, or require expensive equipment and as such are only performed at larger institutions. The antigen employed in this procedure is the classical protein extract of the reiter treponeme and is prepared as described by D’Alessandro and Dardanoni and by Cannefax and Garson. Purity was checked by double gel-diffusion using the Ouchterlony plates. The antigen was then tagged to kaolin particles that have been previously standardized in particle size to less than one micron, highly purified, and activated as a receptor. The results show that agglutination constitutes a positive reaction. Quantitation was determined by simple serial dilution. There was a difference observed upon tittering that is inherent due to differences in technique but when the RPCF was high, so was the R.P. agglutination test.
Frontal beta-theta network during REM sleep

We lack detailed knowledge about the spatio-temporal physiological signatures of REM sleep, especially in humans. By analyzing intracranial electrode data from humans, we demonstrate for the first time that there are prominent beta (15-35 Hz) and theta (4-8 Hz) oscillations in both the anterior cingulate cortex (ACC) and the DLPFC during REM sleep. We further show that these theta and beta activities in the ACC and the DLPFC, two relatively distant but reciprocally connected regions, are coherent. These findings suggest that, counter to current prevailing thought, the DLPFC is active during REM sleep and likely interacting with other areas. Since the DLPFC and the ACC are implicated in memory and emotional regulation, and the ACC has motor areas and is thought to be important for error detection, the dialogue between these two areas could play a role in the regulation of emotions and in procedural motor and emotional memory consolidation.
Investigating the effects of robotic displays of protest and distress

While research in machine ethics has investigated mechanisms for making artificial agents' decisions more ethical, there is currently not work investigating adaptations to human-robot interaction (HRI) that can promote ethical behavior on the human side. We present the first results from HRI experiments showing that verbal protests and affective displays can promote ethical behavior in human subjects.
Eosinophilic Esophagitis (North America)

Eosinophilic esophagitis is a disorder that is on the increase. It affects both children and adults typically presenting with dysphagia. It is currently incompletely understood though advances in understanding the disease have been made over the last decade and half. The pathogenesis is an interplay of genetic predisposition with environmental and dietary contributions, but the pathways and triggers to disease expression have yet to be elucidated. Diagnosis is complicated by overlap in symptomatology and histological findings with gastroesophageal reflux. Selecting the type and duration of treatment can be a dilemma for the clinician as response and disease relapse are unpredictable. Treatment tolerability is also an issue since systemic corticosteroids have significant side effects and strict dietary modifications are difficult to adhere to chronically. Inhaled corticosteroids are better tolerated but not scientifically studied in EoE therapy, and novel therapeutic agents are being investigated.
Thirty-day vein remodeling is predictive of midterm graft patency after lower extremity bypass.

Objective Successful adaptation of a vein graft to an arterial environment is incompletely understood. We sought to investigate whether early vein graft remodeling is predictive of subsequent patency. Methods A prospective longitudinal study was conducted of 67 patients undergoing lower extremity bypass with autogenous vein between February 2004 and April 2008. Preoperative blood samples were drawn for biomarkers. During the bypass operation, a 5-cm index segment of the graft was registered for serial lumen diameter measurements at 0, 1, 3, 6, 9, and 12 months using duplex ultrasound imaging. The imaging substudy analysis included patients with at least two ultrasound assessments. Results Patients (55% male) were a median age of 70 years (interquartile range [IQR], 59-76 years), 40% had diabetes mellitus, 49% had critical limb ischemia, 75% were taking a statin, and 91% were taking an antiplatelet medication. Median follow-up was 32 months (IQR, 15-47 months). The median baseline high-sensitivity C-reactive protein level (hsCRP) was 3.2 mg/L (IQR, 1.4-9.7 mg/L). The average intraoperative, postimplantation vein lumen diameter was 3.9 ± 1.0 mm, increasing to 4.7 ± 1.1 mm at 1 month, an average 24% ± 27% change per patient. By 3 months, the average lumen diameter was 5.1 ± 1.6 mm, with little subsequent change observed to 12 months. Nonwhite race, baseline hsCRP ≥5 mg/L, statin use, and initial lumen diameter were significantly associated with early (0- to 1-month) vein remodeling in a multivariable regression model. The primary patency rate for the cohort was 60% ± 6.3% at 2 years. Initial lumen diameter of the index segment was not associated with primary patency, whereas larger lumen diameter achieved at 1 month (≥5.1 mm) was positively associated with primary patency (log-rank, P = .03). Early (30-day) remodeling behavior was used to divide patients into "poor remodelers" ( +25% change, n=30). Early remodeling category was significantly associated with primary patency rate at 2 years (log-rank, P = .02). A multivariable Cox proportional hazards model showed that modest remodelers (hazard ratio, 3.9; 95% confidence interval, 1.02-15; P = .04) and poor remodelers (hazard ratio, 13; 95% confidence interval; P = .008) had significantly higher hazard ratios for graft failure than robust early remodelers. Conclusions Early remodeling of the arterialized vein appears to predict midterm bypass graft patency. In addition to baseline diameter, race, inflammation, hsCRP, and statin use are associated with early adaptive remodeling, but the mechanisms for these observations are not understood.
Investigation of inertia's locational impacts on primary frequency response using large-scale synthetic network models

As more renewable energy resources connected by power electronics and gas-fueled generators are integrated into power grids, total system inertia has been significantly decreasing in recent years. The resulting decline in system primary frequency response threatens the reliability and stability of power grids. This paper aims to study the locational dependence of the impacts of inertia on system primary frequency response. Both transient stability simulations and modal analysis are applied to study the locational effects. Sensitivity analysis is also carried out to provide insights into the extent to which inertia's location impacts the system dynamic behavior. We first use a small-scale test system to illustrate inertia's locational impacts. In order to obtain realistic simulation results, we then perform studies on a large-scale synthetic network dynamic model.
Impacts of Salt, Buffer, and Lipid Nature on Molecular Adsorption and Transport in Liposomes As Observed by Second Harmonic Generation

It is of great importance to interrogate the impact of local environment on the transport of small molecules across lipid bilayers, as they are key to the function and capabilities of eukaryotic cells and liposome-based delivery systems. Herein are described real-time studies of the molecular adsorption and transport kinetics of positively charged small-molecule organic dyes at the surface of liposomes under different buffer and salt conditions, made possible by application of second harmonic generation (SHG). The molecular transport of malachite green (MG) within the liposome bilayer is more rapid in 1,2-dioleoyl-sn-glycero-3-phospho-(1′-rac-glycerol) and 1,2-dioleoyl-sn-glycero-3-phospho-l-serine (DOPG and DOPS, respectively) liposomes in citrate buffer without added salts, whereas no adsorption or transport of MG is observed in trimethyl quinone-1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (QPADOPE) and 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) liposomes. While the transport rate constant increa...
Patterns of care and outcomes of proton and eye plaque brachytherapy for uveal melanoma: Review of the National Cancer Database.

Abstract Purpose To examine national practice patterns and outcomes of eye plaque brachytherapy compared to proton external beam radiotherapy in the treatment of choroid melanoma. Methods and Materials Demographic and clinical data for 1224 patients with choroid melanoma treated with either brachytherapy or proton beam therapy from 2004 to 2013 were obtained from the National Cancer Database. Logistic regression and propensity score matching was used to create a 1:1 matched cohort. Kaplan-Meier and Cox regression analyses were performed to evaluate survival in brachytherapy and proton groups. Results Median followup was 37 and 29 months for brachytherapy and protons, respectively. Most patients were treated with brachytherapy (n = 996) vs. protons (n = 228). Proton patients came from more urban, affluent, and educated zip codes, and they were more likely to be treated at an academic center (all p 18 mm, HR = 6.41, 95% CI = 1.45–28.35), and protons (HR = 1.89, 95% CI = 1.06–3.37) were negative prognosticators of survival. Conclusions Patients selected for proton treatment have inferior survival outcomes compared to brachytherapy in this retrospective analysis. There may be unaccounted variables that influence survival, warranting further prospective studies.
Toward Exosome-Based Therapeutics: Isolation, Heterogeneity, and Fit-for-Purpose Potency.

Abstract Exosomes are defined as submicron (30-150nm), lipid bilayer-enclosed extracellular vesicles (EVs), specifically generated by the late endosomal compartment through fusion of multivesicular bodies with the plasma membrane. Produced by almost all cells, exosomes were originally considered to represent just a mechanism for jettisoning unwanted cellular moieties. Although this may be a major function in most cells, evolution has recruited the endosomal membrane-sorting pathway to duties beyond mere garbage disposal, one of the most notable examples being its cooption by retroviruses for the generation of Trojan virions. It is therefore tempting to speculate that certain cell types have evolved an exosome subclass active in intracellular communication. We term this EV subclass ‘signalosomes’ and define them as exosomes that are produced by the 'signaling' cells upon specific physiological or environmental cues and harbor cargo capable of modulating the programming of recipient cells. Our recent studies have established that signalosomes released by mesenchymal/stromal cells (MSCs) represent the main vector of MSC immunomodulation and therapeutic action in animal models of lung disease. The efficacy of MSC exosome treatments in a number of preclinical models of cardiovascular and pulmonary disease supports the promise of application of exosome-based therapeutics across a wide range of pathologies within the near future. However, the full realization of exosome therapeutic potential has been hampered by the absence of standardization in EV isolation, and procedures for purification of signalosomes from the main exosome population. This is mainly due to immature methodologies for exosome isolation and characterization and our incomplete understanding of the specific characteristics and molecular composition of signalosomes. In addition, difficulties in defining metrics for potency of exosome preparations, and the challenges of industrial scale-up and good manufacturing practice (GMP) compliance has complicated smooth & timely transition to clinical development. In this manuscript, we focus on cell culture conditions, exosome harvesting, dosage and exosome-potency, providing some empirical guidance and perspectives on the challenges in bringing exosome based-therapies to clinic.
Pricing Strategies to Encourage Availability, Purchase, and Consumption of Healthy Foods and Beverages: A Systematic Review

Introduction Food pricing policies to promote healthy diets, such as taxes, price manipulations, and food subsidies, have been tested in different settings. However, little consensus exists about the effect of these policies on the availability of healthy and unhealthy foods, on what foods consumers buy, or on the impact of food purchases on consumer health outcomes. We conducted a systematic review of studies of the effect of food-pricing interventions on retail sales and on consumer purchasing and consumption of healthy foods and beverages. Methods We used MEDLINE, Embase, PsycINFO, Web of Science, ClinicalTrials.gov, and the Cochrane Library to conduct a systematic search for peer-reviewed articles related to studies of food pricing policies. We selected articles that were published in English from January 2000 through December 2016 on the following types of studies: 1) real-world experimental studies (randomized controlled trials, quasi-experimental studies, and natural experiments); 2) population studies of people or retail stores in middle-income and high-income countries; 3) pricing interventions alone or in combination with other strategies (price promotions, coupons, taxes, or cash-back rebates), excluding studies of vending-machine or online sales; and 4) outcomes studies at the retail (stocking, sales) and consumer (purchasing, consumption) levels. We selected 65 articles representing 30 studies for review. Results Sixteen pricing intervention studies that sought to improve access to healthy food and beverage options reported increased stocking and sales of promoted food items. Most studies (n = 23) reported improvement in the purchasing and consumption of healthy foods or beverages or decreased purchasing and consumption of unhealthy foods or beverages. Most studies assessed promotions of fresh fruits and vegetables (n = 20); however, these foods may be hard to source, have high perishability, and raise concerns about safety and handling. Few of the pricing studies we reviewed discouraged purchasing and consumption of unhealthy foods (n = 6). Many studies we reviewed had limitations, including lack of formative research, process evaluation, or psychosocial and health assessments of the intervention's impact; short intervention duration; or no assessment of food substitutions or the effects of pricing interventions on food purchasing and diets. Conclusion Pricing interventions generally increased stocking, sales, purchasing, and consumption of promoted foods and beverages. Additional studies are needed to differentiate the potential impact of selected pricing strategies and policies over others.
Assessment of Reflected Shock Tunnels for Mars Entry Vehicle Ground Testing

Recent carbon dioxide studies in reflected shock tunnel testing have noted discrepancies in the shock shapes between experiments and simulations. These have been attributed to freezing vibrational modes unaccounted for in the simulations during the rapid expansion through the nozzle. This study focuses on blunt body CO_2 experiments and simulations in the T5 Reflected Shock Tunnel to examine possible sources of error when making standoff distance and heat flux measurements. The effect of increasing the nozzle area ration to further expand the flow in the nozzle is examined and a method for making consistent standoff distance comparisons from experiments and simulations is developed. Finally, experiments and simulations are compared to theoretical models.
Complex Intersection of Social Relations and the Material World

A separation of public and private spheres, at least in idealized forms, was an important aspect of domesticity. Elements of separation were extant in a variety of gender ideals, however, during the eighteenth, nineteenth, and twentieth centuries. Each of these ideologies placed at least some emphasis on defining and creating distinct tasks, roles, and arenas of interaction for men and women. Therefore, evaluating gender separation – both the presence and absence as well as degree – was critical to interpreting the archaeological assemblages in Deerfield as an expression of gendered social relations as well as changes throughout the history of the village.
Effect of Colony-Stimulating Factors on Granulocyte Function

Phagocytes including polymorphonuclear neutrophils (PMN), monocytes, macrophages, and eosinophils are essential for host defense against certain microbes and probably play an important role in the surveillance and destruction of neoplastic cells. The production, maturation, and function of these cells appear to be regulated in a very complex manner by various cytokines including colony-stimulating factors (CSF) and other immune modulators. We will concentrate on the effect of CSF on the function of PMN.
Optimizing the securement of epidural catheters: an in vitro trial

Introduction Epidural anesthesia is frequently used to provide postoperative analgesia following major surgical procedures. Secure fixation of the epidural catheter is necessary to prevent premature dislodgment and loss of epidural analgesia. Using an in vitro model, the current prospective study evaluates different types of dressings for securement of an epidural catheter by quantifying the force in Newtons (N) required for dislodgment using a digital force gage. Methods Four methods of epidural catheter securement were used on a simulator mannequin: 1) Suresite® Window Clear Dressing, 2) Op-Site Post-Op® Visible Dressing, 3) Steri-Strips® and Suresite Window Clear Dressing, and 4) Steri-Strips and Op-Site Post-Op Visible Dressing. Each method of securement was assessed 10 times to calculate the mean force required to dislodge the catheter. Mean force of dislodgment for each method was compared using parametric tests. Results The force (mean ± SD) required for catheter dislodgment for the four methods was 14.0±2.9, 2, 10.7±1.5, 8.6±2.3, and 9.6±2.2 N, respectively. The pairwise difference showed that the Suresite Window Clear Dressing was the best securement method when compared with other methods. Conclusion Our study demonstrates the advantage of the Suresite Window Clear Dressing in securing the epidural catheter. Future clinical trials are needed to validate these findings.
In-Person Interpreter Use and Hospital Length of Stay among Infants with Low Birth Weight.

To ensure timely appropriate care for low-birth-weight (LBW) infants, healthcare providers must communicate effectively with parents, even when language barriers exist. We sought to evaluate whether non-English primary language (NEPL) and professional in-person interpreter use were associated with differential hospital length of stay for LBW infants, who may incur high healthcare costs. We analyzed data for 2047 infants born between 1 January 2008 and 30 April 2013 with weight 25% of hospital days) showed a trend for an even longer length of stay. Unmeasured clinical and social/cultural factors may contribute to differences in length of stay.
Tubulocystic anomalies of the mesonephric duct associated with ipsilateral renal dysgenesis.

Summary Introduction Renal agenesis and multicystic dysplastic kidney (MCDK) are usually associated with either an absent or atretic ureter. Occasionally, these renal anomalies may be associated with a dilated tortuous ureter, ureterocele or other cystic malformation of mesonephric duct (MND) remnants. Objectives The objective of this study was to identify and classify anatomical variants of tubulocystic remnants of the MND, with a secondary focus on natural history and management outcomes. Patients and methods A retrospective cohort study of patients seen in the study institution between 2007 and 2014 with a tubulocystic abnormality of MND structures associated with either MCDK or renal agenesis was conducted. Medical imaging and progress notes were reviewed for all patients. Data collected included anatomical information, surgical intervention, histology and outcomes of both conservatively managed and surgically resected MND remnant structures. Results Nineteen patients were identified, 5 girls and 14 boys. Median age at presentation was 4.6 years. Anomalies of the MND occurred on the left in 9 patients and on the right in 10 patients. Mean follow-up was 3.4 years. Patients fell into 3 distinct anatomical groups: Type I, including orthotopic remnants corresponding to ureteric bud structures (ureter and trigone); Type II, including ectopic MND remnants of ureteric bud structures, and Type III, including complex remnants corresponding to MND structures other than those from ureteric bud (vas, epididymis and seminal vesicles). Anomalies of structures arising from urogenital sinus and paramesonephric ducts were also identified. Most patients were asymptomatic and successfully managed conservatively. Transvesical puncture of trigonal cysts provided effective decompression in 5 patients. Partial or complete MCDK regression was seen in 7 patients, whereas MND cystic anomalies did not regress spontaneously. Discussion When MND tubulocystic structures persist along with renal agenesis or MCDK, most arise from ureteric bud structures in an orthotopic position as a ureterocele with or without a blind-ending ureter-like structure. Less commonly, ureteric bud structures insert ectopically into the urogenital tract, or tubulocystic structures arising from the remainder of the MND occur. Embryogenesis of other urogenital structures may also be abnormal, and conditions such as Zinner syndrome and obstructed hemivagina and ipsilateral renal agenesis syndrome should be considered. Conclusions Complications are uncommon, and surgical intervention should be limited to symptomatic patients. Remnants of metanephric blastema may involute, but MND remnants persist.