cssi/SciSciGPT-SciSciNet huggingface dataset:
Ovarian cancer, the coagulation pathway, and inflammation

Epithelial ovarian cancer (EOC) represents the most frequent cause of death in the United States from a cancer involving the female genital tract. Contributing to the overall poor outcome in EOC patients, are the metastases to the peritoneum and stroma that are common in this cancer. In one study, cDNA microarray analysis was performed on fresh tissue to profile gene expression in patients with EOC. This study showed a number of genes with significantly altered expression in the pelvic peritoneum and stroma, and in the vicinity of EOC implants. These genes included those encoding coagulation factors and regulatory proteins in the coagulation cascade and genes encoding proteins associated with inflammatory responses. In addition to promoting the formation of blood clots, coagulation factors exhibit many other biologic functions as well as tumorigenic functions, the later including tumor cell proliferation, angiogenesis, invasion, and metastasis. Coagulation pathway proteins involved in tumorigenesis consist of factor II (thrombin), thrombin receptor (protease-activated receptors), factor III (tissue factor), factor VII, factor X and factor I (fibrinogen), and fibrin and factor XIII. In a recent study we conducted, we found that factor XII, factor XI, and several coagulation regulatory proteins, including heparin cofactor-II and epithelial protein C receptor (EPCR), were also upregulated in the peritoneum of EOC. In this review, we summarize evidence in support of a role for these factors in promoting tumor cell progression and the formation of ascites. We also discuss the different roles of coagulation factor pathways in the tumor and peritumoral microenvironments as they relate to angiogenesis, proliferation, invasion, and metastasis. . Since inflammatory responses are another characteristic of the peritoneum in EOC, we also discuss the linkage between the coagulation cascade and the cytokines/chemokines involved in inflammation. Interleukin-8, which is considered an important chemokine associated with tumor progression, appears to be a linkage point for coagulation and inflammation in malignancy. Lastly, we review findings regarding the inflammatory process yielded by certain clinical trials of agents that target members of the coagulation cascade in the treatment of cancer. Current data suggest that disrupting certain elements of the coagulation and inflammation processes in the tumor microenvironment could be a new biologic approach to cancer therapeutics.
Scalable optimization algorithms for discrete event systems with real-time constraints: An overview of recent developments

Discrete event systems with real-time constraints involve tasks that must be completed within specified hard deadlines. Guaranteeing such constraints requires a control effort measured through a cost function, giving rise to a class of nonlinear optimization problems. We overview recent developments aimed at solving such problems in an efficient scalable fashion suitable for on-line applications with limited computational resources. We describe how structural properties of the optimal state trajectory in such problems can be exploited and present a critical task decomposition algorithm (CTDA) when tasks are processed by a single-stage system. When tasks are processed over multiple stages and are subject to end-to-end real-time constraints, a different set of structural properties is exploited leading to a virtual deadline algorithm (VDA).
Development of Activity-based Cost Functions for Cellulase, Invertase, and Other Enzymes

As enzyme chemistry plays an increasingly important role in the chemical industry, cost analysis of these enzymes becomes a necessity. In this paper, we examine the aspects that affect the cost of enzymes based upon enzyme activity. The basis for this study stems from a previously developed objective function that quantifies the tradeoffs in enzyme purification via the foam fractionation process (Cherry et al., Braz J Chem Eng 17:233–238, 2000). A generalized cost function is developed from our results that could be used to aid in both industrial and lab scale chemical processing. The generalized cost function shows several nonobvious results that could lead to significant savings. Additionally, the parameters involved in the operation and scaling up of enzyme processing could be optimized to minimize costs. We show that there are typically three regimes in the enzyme cost analysis function: the low activity prelinear region, the moderate activity linear region, and high activity power-law region. The overall form of the cost analysis function appears to robustly fit the power law form.
CD4 T cells promote tissue inflammation via CD40 signaling without de novo activation in a murine model of liver ischemia/reperfusion injury.

Although the role of CD4 T cells in tissue inflammation and organ injury resulting from ischemia and reperfusion injury (IRI) has been well documented, it remains unclear how CD4 T cells are activated and function in the absence of a specific antigen (Ag). We used a murine liver warm IRI model to determine first whether de novo Ag-specific CD4 T cell activation was required and then what its functional mechanism was. The critical role of CD4 T cells in liver immune activation against ischemia and reperfusion (IR) was confirmed in CD4 knockout mice and CD4 depleted wild-type mice. Interestingly, the inhibition of CD4 T cell activation without target cell depletion failed to protect livers against IRI, and this suggested that T cells function in liver IRI without Ag-specific de novo activation. To dissect the T cell functional mechanism, we found that CD154 blockade, but not interferon (IFN-) neutralization, inhibited local immune activation and protected livers from IRI. Furthermore, agonist anti-CD40 antibodies restored liver IRI in otherwise protected CD4-deficient hosts. Finally, fluorescence-activated cell sorting analysis of liver CD4 T cells revealed the selective infiltration of effector cells, which constitutively expressed a higher level of CD154 in comparison with their peripheral counterparts. IR triggered a significant liver increase in CD40 expression but not CD154 expression, and macrophages responded to toll-like receptor 4 and type I IFN stimulation to up-regulate CD40 expression. Conclusion: These novel findings provide evidence that CD4 T cells function in liver IRI via CD154 without de novo Ag-specific activation, and innate immunity–induced CD40 up-regulation may trigger the engagement of CD154-CD40 to facilitate tissue inflammation and injury. (HEPATOLOGY 2009; 50:1537-1546.)
Sound production in Pituophis melanoleucus (Serpentes: Colubridae) with the first description of a vocal cord in snakes.

The pine, gopher, or bull snake (Pituophis melanoleucus) makes two different defensive sounds. Hisses are characterized by lack of frequency and amplitude modulation; bellows have a brief initial period of high-amplitude, broad-frequency sound followed by a longer period of lower-amplitude, constant-frequency sound. Both defensive sounds contain distinct harmonic elements. The modulation and harmonic nature of these sounds seems to be unique among snakes. The larynx of Pituophis is unusual in having an epiglottal keel, a dorsal expansion of the cricoid cartilage, previously proposed to contribute to sound production; however, this study shows that it plays only a small role in increasing the amplitude of bellows. Within the larynx of Pituophis is a “vocal cord,” the laryngeal septum, which is a flexible, horizontal shelf of tissue that divides the anterior portion of the larynx. Removal of the laryngeal septum alters the defensive sounds and eliminates their harmonic elements. The laryngeal septum is unique among previously described vertebrate vocal cords or folds because it is supported by the cricoid (as opposed to arytenoid) cartilage and is a single (as opposed to bilaterally paired) structure. © 1995 Wiley-Liss, Inc.
Measuring air quality using wireless self-powered devices

High concentrations of carbon monoxide and particulate matter can cause respiratory disease, illness, and death in high doses. Air pollution is a concern in many urban areas of emerging markets that rely on outdated technologies for transportation and electricity generation; rural air quality is also a concern when noting the high prevalence of products of incomplete combustion resulting from open fires for cooking and heating. Monitoring air quality is an essential step to identifying these and other factors that affect air quality, and thereafter informing engineering and policy decisions to improve the quality of air. This study seeks to measure changes in air quality across spatial and temporal domains, with a specific focus on emerging markets and the developing world. A prototype, low-cost air quality monitoring device has been developed to measure the concentrations of particulate matter, ozone, and carbon monoxide at a rate of one sample per minute. The device communicates data wirelessly via cell towers or using a nearby Wi-Fi network, and can run off-grid using a solar PV-battery system. The device can be replicated and deployed across regions for high-fidelity emissions monitoring to explore the effect of anthropogenic and environmental factors on intra-hour air quality. Hardware and software used in the device is described, and the wireless data communication protocols and capabilities are discussed.
Activation of Shaker potassium channels. III. An activation gating model for wild-type and V2 mutant channels.

A functional kinetic model is developed to describe the activation gating process of the Shaker potassium channel. The modeling in this paper is constrained by measurements described in the preceding two papers, including macroscopic ionic and gating currents and single channel ionic currents. These data were obtained from the normally activating wild-type channel as well as a mutant channel V2, in which the leucine at position 382 has been mutated to a valine. Different classes of models that incorporate Shaker 9s symmetrical tetrameric structure are systematically examined. Many simple gating models are clearly inadequate, but a model that can account for all of the qualitative features of the data has the channel open after its four subunits undergo three transitions in sequence, and two final transitions that reflect the concerted action of the four subunits. In this model, which we call Scheme 3+2′, the channel can also close to several states that are not part of the activation path. Channel opening involves a large total charge movement (10.8 e 0 ), which is distributed among a large number of small steps each with rather small charge movements (between 0.6 and 1.05 e 0 ). The final two transitions are different from earlier steps by having slow backward rates. These steps confer a cooperative mechanism of channel opening at Shaker 9s activation voltages. In the context of Scheme 3+2′, significant effects of the V2 mutation are limited to the backward rates of the final two transitions, implying that L382 plays an important role in the conformational stability of the final two states.
Probabilistic Equilbirium of Stock Market Imminent on 'Capital Allocation'

"Capital Allocation" endows us to study the probabilistic equilbrium reached from the expected movments of the Stock Market and Treasury Bond market. This equilbirium is employed to calculate the expected time scope in which the equilbrim can be expected. This gives the zenith of the oscillation which can be the maximal point reached by the Market Index in that time frame of study.
Altruism and Existential Well-Being

Recent empirical research has established that a strong purpose in life, what has been called existential well-being, has important implications in many health and behavioral outcomes. However, what factors contribute to a strong purpose in life, and the role of altruistic values and behaviors specifically, has not been well-studied. A body of literature has emphasized having a strong sense of a common bond with all humanity as the “heart” of altruism. Does a strong sense of a common bond lead to a strong purpose in life? If it does, will it do so directly or through altruistic values and behaviors generated by it? Using a national survey of 1207 US adults, this study aims to investigate links between the sense of a common bond, altruism, and existential wellbeing. We elaborate altruism into four levels of extensity, depending on whether it is directed towards family, friends, the local community, or the entire world. Results from structural equation modeling indicated that altruism at different levels of extensity accounted for over half of the variation in existential well-being. Altruistic acts and values that extended beyond family, friends, and local community offered greater benefits for existential well-being than those focusing on the “near and dear”. We also found that the sense of a common bond underlay altruism at all levels of extensity. However, this bond mattered to existential well-being only when it was realized in altruistic attitudes and acts, especially ones toward the whole world.
Historical archaeology in South Africa: material culture of the Dutch East India Company at the Cape

With this volume, Carmel Schrire and her colleagues have added substantially to the scholarship of Dutch colonial material culture in overseas colonies. Schrire has produced very few book length wo...
Beam Debunching

The beam debunching problem is approached directly by writing down the rms bunch length equation in the presence of space charge forces. Besides the usual reactive beam-wall coupling field, the wake fields caused by the resistivity of the wall material and the RF accelerating cavities are also taken into account. The rms length equation is integrated for the special case of the NAL main ring with special attention to detuning of the cavities. The result is a debunching criterion which can be easily fulfilled for ordinary operating conditions.
Amino acids of the Shope papilloma virus.

Discussion and SummaryThe results of the amino acid analyses indicated that at least 18 amino acids are represented in the protein of the Shope papilloma virus. None of these appear to be present in extraordinary amounts. In common with other viruses examined thus far(9,13,14), the protein of the papilloma virus has a preponderance of acidic amino acids over the basic ones, and hence differs from the proteins combined with nucleic acid in such substances as sperm. A summation of the amino acid residues and the nucleic acid in the papilloma virus leaves about 7% of the material unaccounted for. However, the nucleic acid figure taken from the data of Taylor et al.(7) is admittedly a crude estimate and, as judged from the phosphorus content of his preparations, is almost surely low. Further investigation of the nucleic acid content together with additional amino acid analyses may resolve the discrepancy, but at present the possible existence in papilloma virus preparations of material in addition to protein ...
Involvement of Supramolecular Complexes in the Capture and Release of Protonic Acids During the Cationic Ring-Opening Polymerization of Epoxides

The kinetics of the cationic ring-opening polymerizations of epoxide monomers were controlled through the use of supramolecular proton complexes. α,ω-Diglycidyl oligoethylene oxides bearing multiple ethyleneoxy spacer groups form metastable supramolecular proton complexes with strong Bronsted acids generated either by the photolysis of onium salts or by their redox reactions with reducing agents. Trapping of the Bronsted acids by in situ complex formation results in a delay of the onset of cationic ring-opening. However, once polymerization begins, the epoxide groups of the monomer are very rapidly consumed resulting in characteristically highly exothermic autoaccelerated polymerization reactions. Crown ethers can also form supramolecular complexes with hydronium ions derived from the reaction of protonic acids with water and these complexes can be used to modify the kinetic behavior of the cationic ring-opening thermal and photopolymerizations of a variety of epoxide monomers. The ring size of a crown et...
Effect of dihydroergocornine on the heart.

SummaryThe intravenous administration of 0.5 mg of dihydroergocornine to 24 patients with left ventricular hypertrophy caused no electrocardiographic changes indicative of coronary vasoconstriction. Although 6 of the 24 patients suffered from anginal pain and many more certainly had coronary disease, no angina pectoris followed the injection.This particular alkaloid of ergot seems to be a safe drug in patients with coronary artery disease.
Release of GTP Exchange Factor Mediated Down-Regulation of Abscisic Acid Signal Transduction through ABA-Induced Rapid Degradation of RopGEFs.

The phytohormone abscisic acid (ABA) is critical to plant development and stress responses. Abiotic stress triggers an ABA signal transduction cascade, which is comprised of the core components PYL/RCAR ABA receptors, PP2C-type protein phosphatases, and protein kinases. Small GTPases of the ROP/RAC family act as negative regulators of ABA signal transduction. However, the mechanisms by which ABA controls the behavior of ROP/RACs have remained unclear. Here, we show that an Arabidopsis guanine nucleotide exchange factor protein RopGEF1 is rapidly sequestered to intracellular particles in response to ABA. GFP-RopGEF1 is sequestered via the endosome-prevacuolar compartment pathway and is degraded. RopGEF1 directly interacts with several clade A PP2C protein phosphatases, including ABI1. Interestingly, RopGEF1 undergoes constitutive degradation in pp2c quadruple abi1/abi2/hab1/pp2ca mutant plants, revealing that active PP2C protein phosphatases protect and stabilize RopGEF1 from ABA-mediated degradation. Interestingly, ABA-mediated degradation of RopGEF1 also plays an important role in ABA-mediated inhibition of lateral root growth. The presented findings point to a PP2C-RopGEF-ROP/RAC control loop model that is proposed to aid in shutting off ABA signal transduction, to counteract leaky ABA signal transduction caused by “monomeric” PYL/RCAR ABA receptors in the absence of stress, and facilitate signaling in response to ABA.
Increasing the Interfunctional Role of Marketing in Strategic Planning: an Application of the Link Pin Concept

Marketing researchers have recently called for an increased role for marketing in the strategic planning process. This paper presents a concept, the link pin, which should enable marketing to take the lead in strategic planning within the firm. Both the philosophical and structural dimensions of the concept are discussed as well as personality characteristics needed to successfully fill the link pin position. Finally, six propositions concerning the link pin are presented along with a method for testing the propositions.
Nerve Conduction Studies and Needle EMG

Abstract The clinical neurophysiological studies of nerve conduction testing and needle EMG are valuable techniques in the investigation of disorders of the anterior horn cell, nerve roots, brachial and lumbosacral plexuses, peripheral nerves, neuromuscular junction, and muscle. The basic neurophysiology underlying nerve conduction study and needle EMG testing are presented in this chapter along with the patterns of abnormalities encountered in focal and diffuse neurogenic disorders.
The outflow of ionospheric nitrogen ions: A possible tracer for the altitude-dependent transport and energization processes of ionospheric plasma

Though limited, the existing observational data set indicates that N+ is a significant ion in the ionosphere, and its concentration varies with season, time of day, solar cycle, latitude, and geomagnetic conditions. Knowledge of the differential transport of heavy vs. light ionospheric species can provide the connection between the macro-scale dynamics and micro-scale processes that govern the near-Earth space. The mass distribution of accelerated ionospheric ions reflects the source region of the low-altitude ion composition and the minor ion component can serve as a tracer of ionospheric processes since they can have a significant influence on the local plasma dynamics.
Ein Niob—Zink-Oxid und zwei Niob—Zink-Nitride mit η-Carbid-Struktur

Durch Reaktion von Zink mit Niob-Sauerstoff- bzw. Niob-Stickstoff-Legierungen entstehen ternare Phasen mit η-Carbid-struktur. Die Gitterkonstanten betragen 11,549 A fur das Oxid und 11,545 bzw. 11,655 A fur die Nitride. Die Zusammensetzung des Oxids entspricht Nb3Zn3O0,4.
Medicine, the law, and conceptions of evidence.

Using evidence-based medical guidelines in courts will require confronting legal professionals' lack of training in assessing scientific evidence, the limitations of available evidence, and fundamental distinctions between the meaning of evidence in medicine and law.
Revisions in Fund Flows and Market Reputation Estimates within Venture Capital Markets

This study finds absolute values of decreases in fund flows to venture capitalists (VCs) increase with prior cycle portfolio performance. This finding indicates decreases in fund flows cannot be construed as evidence of inferior portfolio performance within venture capital markets. In light of empirical evidence that VCs which experience decreases in fund flows constitute significant proportions of universe of VCs, neither of fund sizes nor increases in fund sizes can be regarded as robust proxies for VCs' market reputations. Consistent with inferences, empirical results reject presence of intrinsic ability or prior performance rationales for fund flows that accrue to the class of VCs characterized by largest proportional increases in fund sizes. Empirical results show the market reputation construct proposed in Obrimah (2016a) is robust to decreases in fund flows; that is, show the market reputation construct predicts increase in reputation in contexts within which VCs deliver superior performance, but transition to smaller funds. Simultaneously, the market reputation construct fails to predict increase in reputation in contexts within which increases in fund flows are not explained by intrinsic ability or VCs' prior performance.
Increasing Social Support for Breakfast: Project BreakFAST.

High school students in the United States are known to be frequent skippers of breakfast. Social support is one key element needed to encourage adolescents to consume school breakfast. This article presents an analysis of the influence of a school policy and environment change intervention on the social support of adolescents to eat breakfast. Method. The intervention included school policy changes in 16 schools randomized to intervention and delayed-intervention conditions, in order to allow quick and easy access to breakfast as well as to allow breakfast consumption in classrooms and hallways; a School Breakfast Program marketing campaign to address normative and attitudinal beliefs; and increasing social support and role modeling to encourage breakfast eating. The participants in the study completed an online survey at baseline and again postintervention. Results. The final analysis included only students who completed the relevant survey (n = 904) items on both the baseline and follow-up surveys. The ...
87 – The Effect of Gender on the Epidemiology, Clinical Presentation, and Management of Tuberculosis

About one-third of the world's population is infected with Mycobacterium tuberculosis and an estimated 8 million new cases and 2 million deaths occur yearly from this disease. However, the prevalence of this infection is not the same for males and females. It is estimated that around 1300 million males and 900 million females are infected with M. tuberculosis . Each year more men than women are diagnosed with and reported to have tuberculosis (TB). There is an ongoing debate regarding the reasons for this gender difference. Possible explanations include biologic factors, differential exposure patterns to TB cases for men and women, gender differences in access to health care services, and underdiagnosis or underreporting by health services of TB in women. This chapter reviews gender differences in various aspects of TB such as prevalence of infection and active disease; clinical presentation; diagnosis, treatment, and response to treatment; barriers to care; and attitudes toward the disease. Understanding gender-related differences is essential in the design of a gender-sensitive protocol for a successful global TB control program.
Knowledge Management Framework for Emerging Infectious Diseases Preparedness and Response: Design and Development of Public Health Document Ontology.

Background: There are increasing concerns about our preparedness and timely coordinated response across the globe to cope with emerging infectious diseases (EIDs). This poses practical challenges that require exploiting novel knowledge management approaches effectively. Objective: This work aims to develop an ontology-driven knowledge management framework that addresses the existing challenges in sharing and reusing public health knowledge. Methods: We propose a systems engineering-inspired ontology-driven knowledge management approach. It decomposes public health knowledge into concepts and relations and organizes the elements of knowledge based on the teleological functions. Both knowledge and semantic rules are stored in an ontology and retrieved to answer queries regarding EID preparedness and response. Results: A hybrid concept extraction was implemented in this work. The quality of the ontology was evaluated using the formal evaluation method Ontology Quality Evaluation Framework. Conclusions: Our approach is a potentially effective methodology for managing public health knowledge. Accuracy and comprehensiveness of the ontology can be improved as more knowledge is stored. In the future, a survey will be conducted to collect queries from public health practitioners. The reasoning capacity of the ontology will be evaluated using the queries and hypothetical outbreaks. We suggest the importance of developing a knowledge sharing standard like the Gene Ontology for the public health domain. [JMIR Res Protoc 2017;6(10):e196]
ASAP7 predictive design kit development and cell design technology co-optimization: Invited paper

This work discusses the ASAP7 predictive process design kit (PDK) and associated standard cell library. The necessity for multi-patterning (MP) techniques at advanced nodes results in the standard cell and SRAM architecture becoming entangled with design rules, mandating design-technology co-optimization (DTCO). This paper discusses the DTCO process involving standard cell physical design. An assumption of extreme ultraviolet (EUV) lithography availability in the PDK allows bi-directional M1 geometries that are difficult with MP. Routing and power distribution schemes for self-aligned quadruple patterning (SAQP) friendly, high density standard cell based blocks are shown. Restrictive design rules are required and supported by the automated place and route (APR) setup. Supporting sub-20 nm dimensions with academic tool licenses is described. The APR (QRC techfile) extraction shows high correlation with the Calibre extraction deck. Finally, use of the PDK for academic coursework and research is discussed.
Correlation between invasive mammary carcinoma grade and size in ultrasound‐guided core needle biopsy and subsequent surgical excision

The purpose of this study was to correlate the histologic grade, mitotic rate and size of invasive mammary carcinomas (IMC) on ultrasound (US) core needle biopsy (CNB) and the follow-up excision (FUE). The underestimation and overestimation of the grades by CNB were 11% and 8%. CNBs were more specific for grade 3 tumors. Tumors >10 mm by US examination showed greater concordance in grades. The size in the FUE was the best determinant of pT followed by US examination. The extent of IMC on CNB was larger than FUE in 8% resulting in pT upstaging in 3% of cases.
Animal Models for Atherosclerosis, Restenosis, and Endovascular Aneurysm Repair

Animal models have significantly advanced the understanding of mechanisms involved in atherosclerosis and restenosis and have allowed the evaluation of therapeutic options. The current focus of research is to develop strategies to prevent restenosis. These include pharmacological and biological interventions directed primarily against smooth muscle cell proliferation, endovascular devices for recanalization and/or drug delivery, and an integrated approach using both devices and pharmacobiological agents. Devices aimed at the percutaneous endoluminal exclusion of aortic aneurysms have also generated a great deal of interest. Experience over many decades with animal models for vascular research has established that a single, ideal model for atherosclerosis, restenosis, or aneurysm formation does not exist, although recent development of transgenic variants of currently available models has widened the available options. Nevertheless, an appreciation of the individual features of natural or stimulated disease in each species is of the utmost importance for the proper design and execution of relevant experiments.
Automated Removal of Phospholipids from Membrane Proteins for H/D Exchange Mass Spectrometry Workflows

Membrane proteins are currently the most common targets for pharmaceuticals. However, characterization of their structural dynamics by hydrogen/deuterium exchange mass spectrometry (HDX-MS) is sparse due to insufficient automated methods to handle full-length membrane proteins in lipid bilayers. Additionally, membrane lipids used to mimic the membrane environment and to solubilize membrane proteins can impair chromatography performance and cause ion suppression in the mass spectrometer. The workflow discussed herein advances HDX-MS capabilities and other MS applications for membrane proteins by providing a fully automated method for HDX-MS analysis based on a phospholipid removal scheme compatible with robotic handling. Phospholipids were depleted from protein samples by the addition of zirconium oxide beads, which were subsequently removed by inline filtration using syringeless nanofilters. To demonstrate this method, single-pass transmembrane protein FcγRIIa (CD32a) expressed into liposomes was used. Su...
Mycobacterium avium complex: Adherence as a way of life

Mycobacterium avium complex (MAC) organisms are waterborne, opportunistic pathogens whose source is natural waters and soils and proliferates and persists in premise plumbing, for example household and hospital plumbing. M. avium complex and other environmental mycobacteria grow slowly, not because their metabolism is slow, but because they synthesize long chain (C60–C80) fatty acids that make up its hydrophobic and impermeable outer membrane. There are costs and benefits to the presence of that lipid-rich outer membrane. One benefit is that cell-surface hydrophobicity drives M. avium complex cells to adhere to surfaces to reduce their interaction with charged ions in suspension; they are likely “biofilm pioneers”, adhering to a wide variety of surface materials. The result is that the slow-growing M. avium complex cells (1 gen/day at 37 °C) will not be washed out of any flowing system, whether a stream or plumbing in the built environment. Although the slow permeation of nutrients in M. avium complex organisms limits growth, they are also resistant to disinfectants, thus increasing their survival in water distribution systems, premise plumbing, and medical equipment. There are three components to the antimicrobial resistance of M. avium complex in biofilms: (1) innate resistance due to the hydrophobic, impermeable outer membrane, (2) residence in a matrix of extracellular polysaccharide, lipid, DNA, and protein that prevents access of antimicrobials to M. avium cells, and (3) an adaptive and transient increased resistance of biofilm-grown M. avium cells grown in biofilms. As expected M. avium in biofilms will display neutral, antagonistic, or beneficial interactions with other biofilm inhabitants. Methylobacterium spp., the common pink-pigmented, waterborne bacteria compete with M. avium for surface binding, suggested an approach to reducing M. avium biofilm formation and hence persistence in premise plumbing.
Cellular Mechanisms for Information Coding in Auditory Brainstem Nuclei

The brainstem auditory nuclei carry out a wide variety of transformations of the signals carried by the auditory nerve. Although basic frequency and intensity information is first encoded in the cochlea, brainstem circuitry must perform further neural definitions and refinements of these parameters, as well as integrate the cues necessary for the localization of sounds in space. Each of these aspects is associated not just with certain cell types, morphologies, and synaptic connections, but with cells having characteristic electrical response profiles. Such response properties are an outcome of the complement of ion channels that the cells possess and of the dynamic properties of the synapses through which cells communicate.
Health Care: Legal Issues

After years of relative stability, the relationship between law and health care in the USA is changing rapidly. These changes are both a response to and a reflection of the transition to a market-based health care system. To date, courts and legislatures have not impeded the cost containment innovations that are central to managed care, but must now address the more challenging conflicts—primarily cost containment goals vs. access to health care services—that are inherent in a managed care system. This article describes the changes that have occurred in law and health care in the USA, assesses how these changes have influenced health care delivery, and discusses the policy implications of the interaction between law and health care. The article also considers the future challenges the legal system is likely to confront and how they should be addressed. Resolving these challenges will have important implications internationally as other health care systems begin to confront the high costs of health care delivery.
Land use as a mitigation strategy for the water-quality impacts of global warming: a scenario analysis on two watersheds in the Ohio River Basin

This study uses an integrative approach to study the water-quality impacts of future global climate and land-use changes. In this study, changing land-use types was used as a mitigation strategy to reduce the adverse impacts of global climate change on water resources. The climate scenarios were based on projections made by the Intergovernmental Panel on Climate Change (IPCC) and the United Kingdom Hadley Centre’s climate model (HadCM2). The Thornthwaite waterbalance model was coupled with a land-use model (LTHIA) to investigate the hydrologic effects of future climate and land-use changes in the Ohio River Basin. The land-use model is based on the Soil Conservation Service’s curve-number method. It uses the curve number, an index of land use and soil type, to calculate runoff volume and depth. The Arc View programming language, A venue, was used to integrate the two models into a geographic information system (GIS). An output of the water-balance model, daily precipitation values adjusted for potential evapotranspiration, served as one of the inputs into the land-use model. Two watersheds were used in the present study: one containing the city of Cincinnati on the main stem of the Ohio River, and one containing the city of Columbus on a tributary of the Ohio River. These cities represent two major metropolitan areas in the Ohio River Basin with different land uses experiencing different rates of population growth. The projected hypothetical land-use changes were based on linear extrapolations of current population data. Results of the analyses indicate that conversion from agricultural land use to low-density residential land use may decrease the amount of surface runoff. The land-use practices which generate the least amo.unt of runoff are forest, low-density residential, and agriculture; whereas high-density residential and commercial land-use types produce the highest runoff. The hydrologic soil type present was also an important factor in determining the amount of runoff and non-point-source pollution. A runoff-depth matrix and total nitrogen matrix were created for Cincinnati and Columbus to describe possible land-use mitigation measures in response to global climate change. The differences in Cincinnati and Cohunbus were due to differences in geographic location, air temperature, and total runoff. The results of this study may be useful to planners and policy makers for defining the possible impacts of future global climate and land-use changes on water resources.
Boundary Element Methods in Optimal Shape Design — An Integrated Approach

The present paper describes an implementation of the boundary element method (BEM) in optimal shape design. The computational advantages of the boundary element technique over the more traditionally used finite element method of analysis, are examined in context of the shape synthesis problem. An integrated analysis and optimization approach is also proposed for this problem. Approximate strategies that can be used in conjunction with boundary element techniques are briefly discussed. Numerical results are presented for shape design of torsional shafts and of structural components that can be characterized by a state of plane stress.
Climate and Human Mortality: Relationships and Mitigating Measures

The impact of climate on human mortality has become a topic of increasing discussion in light of numerous deaths due to heat during the summer of 1995, and the possible impact of a global warming on such mortality (Haines et al. 1993; McMichael 1993; Kalkstein 1995). However, there are numerous uncertainties involving climate/mortality relationships. For example, what is the magnitude of winter weather-related mortality as compared to summer? If the globe warms, will decreases in cold-related mortality compensate for any summer increases? How do confounding social factors, such as increasing air conditioning use, impact heat-related mortality? Are developing countries more affected than developed? Can we acclimatize to global warming? These questions and others will be discussed within this chapter, which will concentrate on how mortality rates are affected by the weather.
Soft Computing Based Epidemical Crisis Prediction

Epidemical crisis prediction is one of the most challenging examples of decision making with uncertain information. As in many other types of crises, epidemic outbreaks may pose various degrees of surprise as well as various degrees of “derivatives” of the surprise (i.e., the speed and acceleration of the surprise). Often, crises such as epidemic outbreaks are accompanied by a secondary set of crises, which might pose a more challenging prediction problem. One of the unique features of epidemic crises is the amount of fuzzy data related to the outbreak that spreads through numerous communication channels, including media and social networks. Hence, the key for improving epidemic crises prediction capabilities is in employing sound techniques for data collection, information processing, and decision making under uncertainty and exploiting the modalities and media of the spread of the fuzzy information related to the outbreak. Fuzzy logic-based techniques are some of the most promising approaches for crisis management. Furthermore, complex fuzzy graphs can be used to formalize the techniques and methods used for the data mining. Another advantage of the fuzzy-based approach is that it enables keeping account of events with perceived low possibility of occurrence via low fuzzy membership/truth-values and updating these values as information is accumulated or changed. In this chapter we introduce several soft computing based methods and tools for epidemic crises prediction. In addition to classical fuzzy techniques, the use of complex fuzzy graphs as well as incremental fuzzy clustering in the context of complex and high order fuzzy logic system is presented.
Comparison of Scattering Amplitudes from Various Transducers Using Diffraction and Attenuation Corrections

As a part of a project to develop an ultrasonic multiviewing transducer which is capable of providing sufficient information for flaw reconstruction, results have been obtained that address certain phases of the required signal processing routine. It is well known that individual ultrasonic transducers show a considerable variation in signal responses. Inasmuch as the multiviewing transducer uses a sparse array of individual transducers arranged in a particular geometry, it becomes important that signal processing routines be developed and applied which overcome these variabilities. There are, of course, several possible sources of variability in transducer performance. These include those of measurement (diffraction, attenuation and effects associated with imperfect deconvolution processes), and those due to fabrication (transducer design, materials, reproducibility of fabrication techniques, etc.). The results presented in this paper address only the former of these two. In particular, they represent a limited experimental assessment of the adequacy of specific data processing procedures for three different transducers and three different samples utilizing Weiner filter concepts and diffraction and attenuation corrections. Use is made of theoretical curves for scattering amplitude as an absolute standard of comparison and therefore as the criterion of adequacy.
Learning Health Systems: A Multi-perspective Analysis

Big time-gaps in the practical transformation of clinical knowledge into clinical practices, ever increasing healthcare costs, high rates of medical errors, healthcare institutions' obligations towards improving safety, clinical outcomes, and efficacy of care from one side and the rise of disruptive innovations such as genomics, wearables, machine learning and artificial intelligence in health systems, the adoption of EHRs and novel diagnostic tools, and the plethora of data from the other side has made the need for a new approach in managing the U.S healthcare systems an imperative. One of the ways in dealing with these changes is the establishment of Learning Health Systems (LHS) in which healthcare systems are aligned with continuous improvement and innovation from scientific, informatics, incentives, and culture aspects and knowledge about best practices is consistently captured, assimilated, and embedded within the system. However, despite the fact that the adoption of LHS is a multi-perspective one, there is not enough literature on the multidimensionality of this topic. This paper aims to identify and look into the different perspectives that have effects on the learning health system adoption in U.S by conducting PEST strategic analysis as an initial step towards a more multidimensional look into this topic.
Effectiveness of a technology-based communication intervention for suddenly speechless patients in critical care units: Nurses perceptions and experiences

AbstractBackground: Currently, patients who develop sudden inability to verbalize needs (sudden speechlessness), rely on ineffective non-verbal strategies to communicate. Nurses caring for suddenly...
Lingual Squamous Cell Carcinoma in Two Horses

Squamous cell carcinoma (SCC) is one of the most common malignant neoplasms in horses, but lingual SCC has seldom been reported. On separate occasions, a 12-year-old American Quarter Horse mare and an 18-year-old American Saddlebred stallion were presented to the Auburn University Large Animal Teaching Hospital for evaluation of weight loss, dysphagia, and ptyalism. Evaluation of each horse included physical examination, skull radiographs, oral examination, complete blood count and serum biochemistry profile, endoscopic evaluation of the mouth, and biopsy of tissue from a lesion found on the tongue. Histopathologic assessment of tissue harvested from the lingual lesions led to a diagnosis of SCC in each case. The diagnosis prompted euthanasia for one horse, but radiation therapy appeared to delay the progression of the lesion in the other horse.
Multiscale and multimodal structure–function analysis of intervertebral disc degeneration in a rabbit model

Summary Objectives The objective of this study was to perform a quantitative analysis of the structural and functional alterations in the intervertebral disc during in vivo degeneration, using emerging tools that enable rigorous assessment from the microscale to the macroscale, as well as to correlate these outcomes with noninvasive, clinically relevant imaging parameters. Design Degeneration was induced in a rabbit model by puncturing the annulus fibrosus (AF) with a 16-gauge needle. 2, 4, 8, and 12 weeks following puncture, degenerative changes in the discs were evaluated via magnetic resonance imaging (MRI), whole motion segment biomechanics, atomic force microscopy, histology and polarized light microscopy, immunohistochemistry, biochemical content, and second harmonic generation imaging. Results Following puncture, degeneration was evident through marked changes in whole disc structure and mechanics. Puncture acutely compromised disc macro and microscale mechanics, followed by progressive stiffening and remodeling. Histological analysis showed substantial anterior fibrotic remodeling and osteophyte formation, as well as an overall reduction in disc height, and disorganization and infolding of the AF lamellae into the NP space. Increases in NP collagen content and aggrecan breakdown products were also noted within 4 weeks. On MRI, NP T2 was reduced at all post-puncture time points and correlated significantly with microscale indentation modulus. Conclusion This study defined the time dependent changes in disc structure–function relationships during IVD degeneration in a rabbit annular injury model and correlated degeneration severity with clinical imaging parameters. Our findings identified AF infolding and occupancy of the space as a principle mechanism of disc degeneration in response to needle puncture, and provide new insights to direct the development of novel therapeutics.
Penile Prosthesis Insertion in the Era of Antibiotic Stewardship-Are Postoperative Antibiotics Necessary?

Purpose:We sought to determine whether patients discharged from the hospital without antibiotics after inflatable penile prosthesis insertion were at increased risk for infectious complications com...