cssi/SciSciGPT-SciSciNet huggingface dataset:
Be not afraid.

Voters are angry and distrustful of Washington. Democrats have lost their nerve. Republicans, sensing weakness, are closing in for the kill. We have seen this health care reform horror movie before. Our leaders in Congress and the White House face a fateful fork in the road. They can follow the public's fear and confusion down the path of perpetual inaction. Or they can lead. They can let the confusion fester or they can leverage the support of health care innovators who can explain the benefits of reform to all. This movie can have a happier ending, one that is good . . .
Blood-brain barrier opening after explosive decompression from hyperbaric N2O2 mixtures

Abstract Pulmonary and blood-brain barrier effects of explosive decompression from 30-min exposures to different hyperbaric N2O2 mixtures were studied in guinea pigs. The animals were explosively decompressed from maximum pressures of 3.5 to 6.5 ATA (absolute atmospheric pressure), with 0.5–6.5 ATA pO2 (partial pressures of oxygen) and 0–6.0 ATA pN2 (partial pressures of nitrogen). Evans blue, a marker of lung and blood-brain barrier integrity, was injected intravenously either before hyperbaric exposure or at various times thereafter. Neither the lung nor brain showed stain in unexposed control animals, but lung staining occurred in all experimental animals. Brain staining, caused by the opening of the blood-brain barrier to intravascular Evans blue-albumin, occurred only when the hyperbaric mixture contained at least 2 ATApN2, but was not seen at
Renin-Aldosterone Paradox and Perturbed Blood Volume Regulation Underlying Postural Tachycardia Syndrome

Background— Patients with postural tachycardia syndrome (POTS) experience considerable disability, but in most, the pathophysiology remains obscure. Plasma volume disturbances have been implicated in some patients. We prospectively tested the hypothesis that patients with POTS are hypovolemic compared with healthy controls and explored the role of plasma renin activity and aldosterone in the regulation of plasma volume. Methods and Results— Patients with POTS (n=15) and healthy controls (n=14) underwent investigation. Heart rate (HR), blood pressure (BP), plasma renin activity, and aldosterone were measured with patients both supine and upright. Blood volumes were measured with 131I-labeled albumin and hematocrit. Patients with POTS had a higher orthostatic increase in HR than controls (51±18 versus 16±10 bpm, P<0.001). Patients with POTS had a greater deficit in plasma volume (334±187 versus 10±250 mL, P<0.001), red blood cell volume (356±128 versus 218±140 mL, P=0.010), and total blood volume (689±270 v...
Using the Past to Inform the Future: Anti-VEGF Therapy as a Road Map to Develop Novel Therapies for Diabetic Retinopathy

Therapies targeting vascular endothelial growth factor (VEGF) are revolutionizing the treatment of diabetic retinopathy (DR) and diabetic macular edema (DME). In August 2012, ranibizumab, a monoclonal antibody fragment targeting VEGF designed for ocular use, became the first and only U.S. Food and Drug Administration–approved medical therapy for DME and the first approved treatment in over 25 years. This approval was based on strong preclinical data followed by numerous clinical trials that demonstrate an essential role of VEGF in vascular permeability and angiogenesis in both normal physiology and disease pathology. In this Perspective, we will examine the experimental studies and scientific data that aided in the success of the development of therapies targeting VEGF and consider how these approaches may inform the development of future therapeutics for diabetic eye disease. A multipoint model is proposed, based on well-established drug development principles, with the goal of improving the success of clinical drug development. This model suggests that to provide a validated preclinical target, investigators should demonstrate the following: the role of the target in normal physiology, a causal link to disease pathogenesis, correlation to human disease, and the ability to elicit clinically relevant improvements of disease phenotypes in animal models with multiple, chemically diverse interventions. This model will provide a framework to validate the current preclinical targets and identify novel targets to improve drug development success for DR.
Development of Genital Warts after Incident Detection of Human Papillomavirus Infection in Young Men

Determining the rate at which men develop genital warts after infection with alpha genus human papillomavirus (HPV) types will provide important information for the design of prevention strategies. We conducted a cohort study of 18-21-year-old men who underwent triannual genital examinations. The 24-month cumulative genital wart incidence was 57.9% (95% confidence interval [CI], 38.1%-79.1%) among 46 men with incident detection of HPV-6 or HPV-11 infection, 2.0% (95% CI, 0.5%-7.9%) among 161 men with incident detection of infection with other HPV types, and 0.7% (95% CI, 0.2%-2.8%) among 331 men who tested negative for HPV. Our results suggest that genital warts are common after HPV-6 or HPV-11 infection in young men.
Invertibility of a 1-D discrete ordinates canopy reflectance model

The invertibility of an accurate discrete ordinates canopy reflectance model is investigated through a series of experiments. Effects of different canopy types, noise levels, spectral ranges, and sampling geometries [including the NOAA Advanced Very High Resolution Radiometer (AVHRR) and the proposed Multi-angle Imaging SpectroRadiometer (MISR) satellite sampling schemes] are considered. Both error-free synthetic bidirectional reflectance data and empirical field reflectance data are utilized. Results suggest that the model can retrieve soil and canopy parameters with reasonable accuracy in most cases, and surface state parameters (absorbed radiation, spectral albedo and photosynthetic efficiency) with high accuracy in all cases. The efficiency of several commonly used optimization algorithms is also assessed, and a model sensitivity study is conducted.
Pneumococcal Vaccination for Patients With COPD: Current Practice and Future Directions

Despite a level "A" recommendation by the Centers for Disease Control and Prevention, the use of pneumococcal polysaccharide vaccination in patients with COPD is supported by limited data. Clinical and laboratory studies have suggested that the currently approved vaccine is less effective in the population of COPD patients than in healthier patients, and to date no randomized-controlled trial of pneumococcal vaccination for COPD patients has demonstrated any beneficial effect. The implementation of a pneumococcal vaccine trial in the COPD population is problematic because of the large sample size required for studies examining clinical outcomes and the fact that no adequate in vitro assays have been available to serve as surrogate measures of vaccine protection. However, new laboratory methods have been developed and more accurate determination of the immunogenicity of pneumococcal vaccines is now possible. There is considerable interest in the development of an improved pneumococcal vaccine for patients with COPD, and advances in vaccine design hold considerable promise for improved prevention against pneumonia and acute exacerbations caused by Streptococcus pneumoniae. The following discussion will examine the available data supporting pneumococcal polysaccharide vaccine use, the currently available laboratory methods to measure immunogenicity, and advances in the development of an improved pneumococcal vaccine that could better protect patients with COPD against this pathogen.
PDGF stimulates pulmonary vascular smooth muscle cell proliferation by upregulating TRPC6 expression.

Capacitative Ca2+ entry (CCE) through store-operated Ca2+ (SOC) channels plays an important role in returning Ca2+ to the sarcoplasmic reticulum (SR) and regulating cytosolic free Ca2+concentration ([Ca2+]cyt). A rise in [Ca2+]cyt and sufficient Ca2+ in the SR are required for pulmonary artery smooth muscle cell (PASMC) proliferation. We tested the hypothesis that platelet-derived growth factor (PDGF)-mediated PASMC growth involves upregulation of c-Jun and TRPC6, a transient receptor potential cation channel. In rat PASMC, PDGF (10 ng/ml for 0.5–48 h) phosphorylated signal transducer and activator of transcription (STAT3), increased mRNA and protein levels of c-Jun, and stimulated cell proliferation. PDGF treatment also upregulated TRPC6 expression and augmented CCE, elicited by passive depletion of Ca2+ from the SR using cyclopiazonic acid. Furthermore, overexpression of c-Jun stimulated TRPC6 expression and CCE amplitude in PASMC. Downregulation of TRPC6 using an antisense oligonucleotide specifically ...
Rapid magnetic resonance elastography of muscle using one-dimensional projection.

Purpose: To demonstrate the feasibility of 1D MR elastography (MRE) to rapidly assess skeletal muscle stiffness in vivo. Materials and Methods: Shear waves were induced in the vastus medialis muscle (VM) using a pneumatic driver at 90 Hz and 2D MRE data were collected. Spatially selective excitations were used to produce 1D projections of MRE data oriented along the direction of propagating waves in the muscle. Data were collected with the thigh muscles relaxed and contracted at 20% maximum voluntary contraction (MVC) and the knee flexed at 30°. Results: The muscle stiffness measured at rest and in contraction with 1D MRE was 3.69 0.80 kPa and 9.52 2.74 kPa, respectively, and 4.36 0.98 kPa and 9.22 1.29 kPa, respectively, with the 2D MRE technique. Conclusion: Muscle stiffness measured using 1D MRE was in agreement with 2D MRE while reducing the scan time by a factor of 4.
Scaling up a distance education program in computer science

This paper describes issues and their solutions in presenting a graduate program in distance education online. The author developed significant experience in synchronous Internet distributed education by experimental teaching online. This process has produced an open-source software system for synchronous online teaching and learning, Network EducationWare. That system is described, along with experience in expanding its use from one course to a graduate Computer Science degree program. Detailed discussions elaborate problems encountered and their solutions. Experience has shown that online teaching in this format is beneficial to students, supportable by faculty, and affordable by the educational institution, in part due to the effective implementation described.
An elaborated administration of the wechsler memory scale-revised

Abstract The Wechsler Memory Scale-Revised (Wechsler, 1987) was elaborated by adding 20 recognition items for Logical Memory (LM) and by adding recognition, matching, and copy trials for Visual Reproductions (VR). Reliability was very good for VR copy (α = .77, interrater agreement, 100% within 1 point). Reliability was modest for LM recognition (α = .42) and for VR recognition (α = .58), but reasonable given the small number of items on each measure. The reliability coefficient was very weak for VR matching (a = .10), limited considerably by the ease of the task for this healthy sample and by the small number of items. After statistically correcting for imperfect reliability, validity coefficients (correlations with similar tests that are well standardized) were good for all of the new trials (r = .60 to r = 1.00). Age- and education-appropriate reference data are provided using 81 healthy adults. Further validation using theoretically and clinically meaningful patient groups would be very valuable. In t...
Evaluation of RF-Stress Effect on Class-E MOS Power-Amplifier Efficiency

RF-stress effects on MOS power-amplifier performance are studied. The class-E power-amplifier power efficiency as a function of breakdown (BD) location has been evaluated. The power efficiency degrades with gate-oxide RF stress due to increased gate leakage current and reduced output voltage. The degradation is enhanced when the BD location is closer to the drain side than the source side.
Mechanical properties of calcium silicate hydrates

The dynamic mechanical properties of compacted samples of synthetic calcium silicate hydrate (C–S–H) were determined at variable stoichiometries (C/S ratio). The stiffness and damping properties of the C–S–H systems were monitored at various increments of mass loss from 11%RH following the removal of the adsorbed and interlayer water. The changes in the storage modulus (E′) and internal friction (tan δ) were discussed in terms of the state of water present in the nanostructure of C–S–H, the evolution of the silicate structure and the interaction of calcium ions in the interlayer region. Results were compared to those for the hydrated Portland cement paste and porous glass. It was shown that the C–S–H in the hydrated Portland cement has a complex yet analogous dynamic mechanical behavior to that of the synthetic C–S–H. The response of these systems upon the removal of water was explained by a layered model for the C–S–H. A mechanistic model was proposed to describe the changes occurring at various stages in the dynamic mechanical response of C–S–H.
Reviewing social media use by clinicians.

Adoption studies of social media use by clinicians were systematically reviewed, up to July 26th, 2011, to determine the extent of adoption and highlight trends in institutional responses. This search led to 370 articles, of which 50 were selected for review, including 15 adoption surveys. The definition of social media is evolving rapidly; the authors define it broadly to include social networks and group-curated reference sites such as Wikipedia. Facebook accounts are very common among health science students (64–96%) and less so for professional clinicians (13–47%). Adoption rates have increased sharply in the past 4 years. Wikipedia is widely used as a reference tool. Attempts at incorporating social media into clinical training have met with mixed success. Posting of unprofessional content and breaches of patient confidentiality, especially by students, are not uncommon and have prompted calls for social media guidelines.
LEARNING TO REOPTIMIZE CONSUMPTION AT NEW INCOME LEVELS: A RATIONALE FOR PROSPECT THEORY

This paper provides a theoretical rationale for three experimental results of Prospect Theory: risk preferences are over gains and losses, loss aversion, and diminishing sensitivity. We consider a (boundedly rational) decision maker who does not e nd her new optimal consumption bundle with certainty when she is faced with a new income level. This alters her indirect utility function and makes her more risk averse at her current reference income level and less risk averse for a range of incomes below her reference income level. (JEL: D11)
Comparative analysis of end wall resistivity in xylem conduits

The hydraulic resistivity ( R , pressure gradient/flow rate) through end walls of xylem conduits was estimated in seven species of diverse anatomy and affinity including a vesselbearing fern, a tracheid-bearing gymnosperm, and angiosperms with versus without vessels. Conduit lengths were measured with a silicone injection method which was easier and more accurate than the usual paint injection. The R declined linearly with the removal of end walls as stems were shortened from 10 to 0.3 cm. This relationship gave the minimum R with no end walls present, or the lumen resistivity ( R L ). This was indistinguishable from the Hagen‐ Poiseuille value. The maximum R with all end walls present gave R C , the resistivity of end wall and lumen in series. Average end-wall resistivity ( R W ) was the difference R C R L and the ‘wall fraction’ was R W / R C . Wall fraction was approximately constant, averaging 0.54 ± 0.07. This suggests that end wall and lumen resistivities are nearly colimiting in vascular plants. Average conduit length was proportional to the diameter squared across species ( r 2 = 0.94). Together with a constant wall fraction, this was consistent with the end wall resistance ( r w , pressure difference/flow rate) being inversely proportional to conduit length. Lower r w in longer conduits is consistent with their having more end wall pits than shorter conduits.
Scheduling of MPI-2 one sided operations over InfiniBand

MPI-2 provides interfaces for one sided communication, which is becoming increasingly important in scientific applications. MPI-2 semantics provide the flexibility to reorder the one sided operations within an access epoch. Based on this flexibility, in this paper we try to improve the performance of one sided communication by scheduling one sided operations. We have come up with several re-ordering and aggregating schemes to achieve better network utilization. We have evaluated these schemes on both PCI-X and PCI-Express platforms. With re-ordering scheme, we see an improvement in the throughput up to 76%, latency up to 40%. With aggregation scheme, we observe an improvement of 44% and 42% for MPI/spl I.bar/Put and MPI/spl I.bar/Get latency respectively on PCI-Express platform.
Are CEOs Incentivized to Split Their Stocks

We provide evidence that the decision to split a firms’ stock is related to CEO compensation. Previous works document that, on average, stock splits lead to price increases and increased price volatility in the year following the split. We use the delta and vega of the CEO’s compensation package to measure CEO sensitivity to changes in the firm's stock price and changes in stock volatility, respectively. For a large sample of splits spanning 1992 to 2005, we find that higher delta and vega compensation is associated with a higher propensity to undertake a stock split. These findings are robust to other documented motivations for stocks splits, including the trading range, signaling, and tick size explanations. In addition, we find that vega is related to the magnitude of the stock split. Given that larger split factors are related to larger increases in volatility these findings confirm the importance of managerial incentives in determining stock split factors. Lastly, a large proportion of CEO option grants are made during the two days preceding and on the day of the stock split announcement. Overall, our findings suggest that managers can increase the risk profile (i.e. volatility) of the firm by cosmetically changing the firm (i.e. splitting the shares), and are induced to do so through the composition of their compensation packages.
Heme oxygenase: recent advances in understanding its regulation and role.

Heme oxygenase (HO) is responsible for the physiological breakdown of heme into equimolar amounts of biliverdin, carbon monoxide, and iron. Three isoforms (HO-1, HO-2, and HO-3) have been identified. HO-1 is ubiquitous and its mRNA and activity can be increased several-fold by heme, other metalloporphyrins, transition metals, and stimuli that induce cellular stress. HO-1 is recognized as a major heat shock/stress response protein. Recent work from our laboratory has demonstrated several potential consensus regulatory elements in the 5'-untranslated region (UTR) of HO-1, including activator protein 1 (AP-1), metal responsive element (MRE), oncogene c-myc/max heterodimer binding site (Myc/Max), antioxidant response element (ARE), and GC box binding (Sp1) sites. Using deletion-reporter gene constructs, we have mapped sites that mediate the arsenite-dependent induction of HO-1, and we have shown that components of the extracellular signal-regulated kinase (ERK) and p38 (a homologue of the yeast HOG1 kinase), but not c-jun N-terminal kinase (JNK), mitogen-activated protein (MAP) kinase pathways are involved in arsenite-dependent upregulation. In contrast, HO-2 is present chiefly in the brain and testes and is virtually uninducible. HO-3 has very low activity; its physiological function probably involves heme binding. Products of the HO reaction have important effects: carbon monoxide is a potent vasodilator, which is thought to play a key role in the modulation of vascular tone, especially in the liver under physiological conditions, and in many organs under "stressful" conditions associated with HO-1 induction. Biliverdin and its product bilirubin, formed in most mammals, are potent antioxidants. In contrast, "free" iron increases oxidative stress and regulates the expression of many mRNAs (e.g., DCT-1, ferritin, and transferrin receptor) by affecting the conformation of iron regulatory protein (IRP)-1 and its binding to iron regulatory elements (IREs) in the 5'- or 3'-UTRs of the mRNAs.
Second-trimester maternal serum paraxanthine, CYP1A2 activity, and the risk of severe preeclampsia

OBJECTIVE To measure the association between second-trimester maternal caffeine intake and caffeine metabolism through the CYP1A2 system and the risk of subsequent severe preeclampsia. METHODS This was a nested case-control study of women who had undergone second-trimester screening for fetal aneuploidy and had banked serum available for analysis. The outcome of interest was severe preeclampsia, and exposures were serum paraxanthine (1,7-dimethylxanthine), measured through high-performance liquid chromatography, and CYP1A2 activity, assessed by paraxanthine/caffeine ratios. RESULTS We identified 51 cases of severe preeclampsia from our population of 3,992 women (1.3%), of whom 33 had sufficient serum for analysis. These were compared with 99 healthy women. Median paraxanthine concentrations were not significantly higher in women in the control group than women in the case group (96.4 ng/mL compared with 38.0 ng/mL, P=.12), and higher serum paraxanthine was not associated with lower odds of severe preeclampsia (odds ratio [OR] 0.72, confidence interval [CI] 0.48-1.08). However, we found a significantly higher paraxanthine/caffeine ratio in women in the control group than women in the case group (0.37 compared with 0.23, P=.02) and a decreased risk of preeclampsia per every log standard deviation increase in paraxanthine/caffeine ratio (OR 0.53, 95% CI 0.31-0.90). CONCLUSION Faster caffeine metabolism in the second trimester, assessed by paraxanthine/caffeine ratios, is associated with a reduced risk of subsequent severe preeclampsia. LEVEL OF EVIDENCE II.
Fidelity of binding of the guanidinium nucleic acid (DNG) d(Tg)4-T-azido with short strand DNA oligomers (A5G3A5, GA4G3A4G, G2A3G3A3G2, G2A2G5A2G2). A kinetic and thermodynamic study.

Short strand DNA oligomers (A5G3A5, GA4G3A4G, G2A3G3A3G2, and G2A2G5A2G2) and the guanidinium (g) linked thymidyl nucleoside d(Tg)4-T-azido associate as triplexes. The melting temperatures, Tm, the association and dissociation kinetic and thermodynamic parameters and activation energies for the triplexes were determined by UV thermal analysis. The hypochromic shift and Tm for triplex formation increases with increase in concentration and decreases with the number of mismatches. The melting temperatures are between 35 and 55 °C in the range of ionic strength of 0.06−0.24 and decrease with increase in ionic strength at 100 deg/(ionic strength unit). The melting and cooling curves exhibit hysteresis behavior in the temperature range 5−95 °C at 0.2 deg/min thermal rate. From these curves, the rate constants and the energies of activation for association (kon, Eon) and dissociation (koff, Eoff) processes were obtained. The second-order rate constants, kon, for the triplex formation at 288 K are between 10 and ...
Relevance of resistance ratios to operational control in the German cockroach (Dictyoptera: Blattellidae)

A simulated crack and crevice method of exposure to insecticides was developed to ascertain the relationship between mortality produced by field-application rates and resistance ratios obtained by the time-mortality method. Nymphal German cockroaches, Blattella germanica (L.), from strains of widely varying resistance backgrounds were tested with chlorpyrifos, acephate, cyfluthrin, and cypermethrin. I observed an inverse relationship between resistance ratios and 72-h crack and crevice mortality in all 4 cases. Gene frequency estimates paralleled resistance ratios for cyfluthrin and cypermethrin. I concluded that time mortality resistance ratios provide a good indication of the level of resistance in a given strain, and that resistance ratios >3.0 signal potential control failures in the field.
Reasons to Eliminate the Band-of-Investment Technique for Estimating the Overall Capitalization Rate

Executive Summary: The purpose of this article is to present the idea that the band of investment (BOI) should be eliminated as an appropriate method for extracting an overall capitalization rate in the valuation of real property. This recommendation is derived from the very restrictive market presumptions that must hold for its correct usage. The traditional use of the (BOI) when the property has amortized debt and an expected change in value will consistently produce estimates that are too low. The commonly taught mortgage-equity technique that values the equity separately from the debt should be substituted in its place. The latter relies on the universally understood discounted cash flow and incorporates the effects of equity build-up.
Jianpi Anshen Decoction of Irritable Bowel Syndrome Control Observation

[Objective] To observe the spleen soothe the nerves soup clinical efficacy of the treatment of irritable bowel syndrome.[Methods]110 patients were divided into two groups.The control group of 43 patients,the use of the treatment of the maleic acid qumei pudding;treatment group,67 patients in the control group on the basis of the addition of Jianpi Anshen decoction treatment.[Results] The treatment group effective rate is 76.1%,with a total effective rate of 95.5%;effective rate is 37.2% in the control group,the total effective rate was 76.7%.[Conclusion] Jianpi Anshen decoction combined with western treatment of irritable bowel syndrome significantly.
Rectal budesonide and mesalamine formulations in active ulcerative proctosigmoiditis: efficacy, tolerance, and treatment approach

Ulcerative colitis (UC) is an immune-mediated disease of the colon that is character- ized by diffuse and continuous inflammation contiguous from the rectum. Half of UC patients have inflammation limited to the distal colon (proctitis or proctosigmoiditis) that primarily causes symptoms of bloody diarrhea and urgency. Mild-to-moderate distal UC can be effectively treated with topical formulations (rectal suppositories, enemas, or foam) of mesalamine or steroids to reduce mucosal inflammation and alleviate symptoms. Enemas or foam formulations adequately reach up to the splenic flexure, have a minimal side-effect profile, and induce remis- sion alone or in combination with systemic immunosuppressive therapy. Herein, we compare the efficacy, cost, patient tolerance, and side-effect profiles of steroid and mesalamine rectal formulations in distal UC. Patients with distal mild-to-moderate UC have a remission rate of approximately 75% (NNT =2) after treatment for 6 weeks with mesalamine enemas. Rectal budesonide foam induces remission in 41.2% of patients with mild-to-moderate active distal UC compared to 24% of patient treated with placebo (NNT =5). However, rectal budesonide has better patient tolerance profile compared to enema formulations. Despite its favorable efficacy, safety, and cost profiles, patients and physicians significantly underuse topical treat- ments for treating distal colitis. This necessitates improved patient education and physician familiarity regarding the indications, effectiveness, and potential financial and tolerability barriers in using rectal formulations.
Genetic parameter estimates for preweaning growth traits in Santa Gertrudis cattle.

Genetic parameters were estimated for birth weight and weaning weight from records collected on 1,894 Santa Gertrudis calves (939 bulls, 955 heifers) during the 8-yr period, 1978 through 1985. Variance and covariance components were estimated separately by sex and combined across sexes utilizing mixed-model, least-squares procedures (Henderson's Method 3). The mathematical model assumed for estimating variance and covariance components by sex included effects of year, sire-within-year and age of dam. Also, calf weaning age was included as covariate for birth weight and weaning weight. Estimates were obtained across sexes utilizing the same model, with the addition of effects of sex of calf and the sex-of-calf X age-of-dam interaction. Heritabilities and genetic and phenotypic correlations were estimated using paternal half-sib techniques. The heritability estimate for birth weight for bulls was 1.6 times larger than that for heifers (.38 +/- .12 vs .24 +/- .10). Conversely, the heritability estimate for weaning weight for heifers was 1.5 times larger than that for bulls (.45 +/- .12 vs .30 +/- .11). However, based upon their approximate standard errors, neither of these differences was significant. Heritability estimates calculated across sexes were .32 +/- .07 and .42 +/- .08 for birth weight and weaning weight, respectively. Estimates of genetic and phenotypic correlations of birth weight and weaning weight by sex were .43 +/- .21 and .31, respectively, for bulls and .33 +/- .22 and .27, respectively, for heifers. Calculated across sexes, the genetic correlation was .40 +/- .14 and the phenotypic correlation was .29.
Toxic cardiomyopathy due to doxorubicin.

The use of doxorubicin poses a clinical dilemma: This effective antitumor agent is also highly cardiotoxic. Thus, cardiac failure has been all too common in patients whose cancers have been control...
Imaging modalities for the evaluation of neck pathology.

The use of CT, MRI, and, to a lesser extent, ultrasound in the evaluation of neck pathology enables us to offer clinical information that was previously unobtainable. The precise location, size, density (cystic versus solid), extent of disease, and, in some cases, degree of vascularity can be determined using a single imaging modality. Accurate staging of head and neck neoplasms can be accomplished using these modalities, because of their ability to determine the size and extent of the primary lesion as well as to detect lymphadenopathy. This article reviews the normal anatomy of the neck as depicted on CT and MRI.
The “periodic table” of the genetic code: A new way to look at the code and the decoding process

Henri Grosjean and Eric Westhof recently presented an information-rich, alternative view of the genetic code, which takes into account current knowledge of the decoding process, including the complex nature of interactions between mRNA, tRNA and rRNA that take place during protein synthesis on the ribosome, and it also better reflects the evolution of the code. The new asymmetrical circular genetic code has a number of advantages over the traditional codon table and the previous circular diagrams (with a symmetrical/clockwise arrangement of the U, C, A, G bases). Most importantly, all sequence co-variances can be visualized and explained based on the internal logic of the thermodynamics of codon-anticodon interactions.
Chapter 52 - Myelopathy

Myelopathy is an inclusive term, referring to pathology leading to a neurologic deficit related to the spinal cord. The clinical diagnosis of myelopathy requires a detailed history and physical examination to define the clinical syndrome. Neuroimaging is indicated in most instances of new-onset myelopathy. It is indicated also when the worsening of a myelopathy is unexplained. Advances in neuroimaging have proved to play a vital role in diagnosis. Appropriate diagnosis and treatment are dependent upon an adequate imaging evaluation to establish the presence of mechanical stability, extrinsic spinal cord compression, or an intramedullary lesion. The most frequent etiology of myelopathy is related to degenerative disease of the spine from osteophyte or extruded disc material causing compression of the spinal cord in the cervical or thoracic spine. The next common etiologies are spinal cord compression due to extradural masses caused by metastatic disease to bone or blunt trauma. In these cases, emergency imaging should be performed to assess the nature of the lesion causing the myelopathy and plan the most appropriate treatment. Also urgent imaging should be performed when an abscess in the spinal canal is suspected. Less urgent is imaging of primary neoplasms of the meninges, roots, or spinal cord, as well as noninfectious inflammatory processes, such as multiple sclerosis, and neurodegenerative, vascular, nutritional, or idiopathic disorders leading to myelopathy. Although a survey of the entire spinal cord can be performed with imaging, it is more appropriate to define from the clinical findings what levels of the spine and spinal cord should be imaged. This approach helps limit the likelihood of false-positive imaging findings that may encourage needless attempts to fix what is not broken. Similarly, the most appropriate imaging study and protocol should be selected in order to provide a timely and accurate diagnosis. To do so requires detailed knowledge regarding the strengths and limitations of the multiple imaging modalities available. This chapter outlines an approach to proper study selection based on the likely etiology of myelopathy from the clinical findings. Chapters 33–39 Chapter 33 Chapter 34 Chapter 35 Chapter 36 Chapter 37 Chapter 38 Chapter 39 cover these disorders in detail.
Differentiating papillary type I RCC from clear cell RCC and oncocytoma: application of whole-lesion volumetric ADC measurement

To determine whether objective volumetric whole-lesion apparent diffusion coefficient (ADC) distribution analysis improves upon the capabilities of conventional subjective small region-of-interest (ROI) ADC measurements for prediction of renal cell carcinoma (RCC) subtype. This IRB-approved study retrospectively enrolled 55 patients (152 tumors). Diffusion-weighted imaging DWI was acquired at b values of 0, 250, and 800 s/mm2 on a 1.5T system (Aera, Siemens Healthcare). Whole-lesion measurements were performed by a research fellow and reviewed by a fellowship-trained radiologist. Mean, median, skewness, kurtosis, and every 5th percentile ADCs were determined from the whole-lesion histogram. Linear mixed models that accounted for within-subject correlation of lesions were used to compare ADCs among RCC subtypes. Receiver-operating characteristic (ROC) curve analysis with optimal cutoff points from the Youden index was used to test the ability of ADCs to differentiate clear cell RCC (ccRCC), papillary RCC (pRCC), and oncocytoma subtypes. Whole-lesion ADC values were significantly different between pRCC and ccRCC, and between pRCC and oncocytoma, demonstrating strong ability to differentiate subtypes across the quantiles (both P < 0.001). Best percentile ROC analysis demonstrated AUC values of 95.2 for ccRCC vs. pRCC; 67.6 for oncocytoma vs. ccRCC; and 95.8 for oncocytoma vs. pRCC. Best percentile ROC analysis further indicated model sensitivities/specificities of 84.5%/93.1% for ccRCC vs. pRCC; 100.0%/10.3% for oncocytoma vs. ccRCC; and 88.5%/93.1% for oncocytoma vs. pRCC. The objective methodology of whole-lesion volumetric ADC measurements maintains the sensitivity/specificity of conventional expert-based ROI analysis, provides information on lesion heterogeneity, and reduces observer bias.
Social Work Assessment: Route to Clienthood––Part II:

Applicants for social service agencies should not be designated as “clients” before they have completed the psychosocial assessment process. In Part II of this two-part article, the final decision ...
The importance of hypoxia-regulated, RPE-targeted gene therapy for choroidal neovascularization.

Age-related macular degeneration (AMD) is the leading cause of blindness in the western world for people over 60 years of age. The most severe pathological event of AMD is choroidal neovascularization (CNV), the process of new vessel formation emerging from the choroid. The new vessels extend into the normally avascular photoreceptor cell layer, where they leak fluid and cause photoreceptor cell death. CNV is thought to be initiated by hypoxia and chronic inflammation, which occur due to abnormal, age-related changes within the retinal pigmented epithelium (RPE). These events cause increased expression of the angiogenic protein vascular endothelial growth factor (VEGF) via hypoxia-inducible factor-1 (HIF-1), a transcription factor that is vital in regulation of cellular responses to hypoxic and inflammatory conditions. Increased VEGF signaling stimulates proliferation and migration of vascular endothelial cells and facilitates the neovascular process.
Involvement with adornments as leisure behavior: an exploratory study.

Our society highly values physical attractiveness. Therefore, in the pursuit of attractiveness, many people may become highly involved with adornments. This paper argues that many of these adornmen...
Classification of congenital upper limb anomalies: towards improved communication, diagnosis, and discovery.

Recently the International Federation of Societies for Surgery of the Hand replaced the Swanson scheme for classifying congenital upper limb anomalies with the Oberg, Manske, Tonkin (OMT) classific...
MAV-clic: management, analysis, and visualization of clinical data

Objectives Develop a multifunctional analytics platform for efficient management and analysis of healthcare data. Materials and Methods Management, Analysis, and Visualization of Clinical Data (MAV-clic) is a Health Insurance Portability and Accountability Act of 1996 (HIPAA)-compliant framework based on the Butterfly Model. MAV-clic extracts, cleanses, and encrypts data then restructures and aggregates data in a deidentified format. A graphical user interface allows query, analysis, and visualization of clinical data. Results MAV-clic manages healthcare data for over 800 000 subjects at UConn Health. Three analytic capabilities of MAV-clic include: creating cohorts based on specific criteria; performing measurement analysis of subjects with a specific diagnosis and medication; and calculating measure outcomes of subjects over time. Discussion MAV-clic supports clinicians and healthcare analysts by efficiently stratifying subjects to understand specific scenarios and optimize decision making. Conclusion MAV-clic is founded on the scientific premise that to improve the quality and transition of healthcare, integrative platforms are necessary to analyze heterogeneous clinical, epidemiological, metabolomics, proteomics, and genomics data for precision medicine.
Management of Chronic Anal Fissures in Patients with Crohn’s Disease

Anal fissures begin with a tear or linear crack in the anoderm that often presents with bleeding and pain. Most fissures will heal, but in some cases they become chronic. In the general population, the etiology is believed to be related to local trauma and/or ischemia. Most acute fissures heal with stool-bulking, topical medications, and local care. If acute fissures do not heal and become chronic, the treatment algorithm expands. Non-surgical options, including botulinum toxin injection or topical medications such as nitric oxide donors and calcium channel blockers are efficacious, but have been shown to be inferior to lateral internal sphincterotomy (LIS) in promoting healing and preventing recurrence. However, LIS carries a small risk of both transient and permanent incontinence.
Evaluating peer-influence processes in a prison-based therapeutic community: a dynamic network approach

Abstract Background The Therapeutic Community (TC) is a common treatment modality for incarcerated individuals with substance use disorders. TCs rely on peer group processes to promote lasting behavioral and identity change, yet prior research has not adequately tested the peer influence mechanisms underlying the theoretical model. This study applied dynamic network analysis to estimate peer influence processes central to TC philosophy. Methods A stochastic actor-oriented model (SAOM) was applied to ten months of social network data collected from prisoner surveys within a TC unit (N = 62) in a medium-security Pennsylvania prison. Respondents (N = 177, 84% of unit) completed at least one prison survey and provided network and community role model nominations. Results Although residents’ levels of treatment engagement were significantly correlated with their nominated peers, estimates of peer influence for treatment engagement were non-significant in longitudinal network models. Nor were estimates of peer influence significantly greater for peers perceived as community role models. Rather, inmates connected with peers who were of similar treatment engagement as themselves (i.e., a peer selection process), and the latter primarily resulted from racial homophily in the TC social network. Conclusions Inconsistent with the desired treatment model, treatment engagement diffusion was not evident in the sampled TC. Results suggested that highly-engaged residents clustered together at the center of the TC’s social structure but had little impact on less-engaged and peripheral inmates. The relatively short (i.e., four-month) program length and moderate-to-low treatment fidelity likely contributed to the lack of peer influence processes.
Introducing integrative primary health care to an interprofessional audience: Feasibility and impact of an asynchronous online course

Abstract Background Although there is mounting clinical and cost-effectiveness evidence supporting integrative healthcare (IH), a significant knowledge gap hinders widespread adoption by primary care professionals. Intervention Based on IH competencies developed by an interprofessional team and a needs assessment, a 32-h online interprofessional IH course, Foundations in Integrative Health, was developed. Trainees learn to conduct an IH assessment and how patients are assessed and treated from the diverse professions in integrative primary care. Methods The course was pilot-tested with educational program trainees, faculty and clinical staff at graduate level primary care training programs (primary care residencies, nursing, pharmacy, public health, behavioral health, and licensed complementary and IH programs). Outcome measures Prior to and following the course, participants completed an IH knowledge test, an IH efficacy self-assessment, and validated measures of IH attitudes, interprofessional learning, provider empathy, patient involvement, resiliency, self-care, wellness behaviors, and wellbeing. Evaluation surveys were administered following each unit and the course. Results Almost one-half (n = 461/982, 47%) completed the course. Pre/post course improvements in IH knowledge, IH self-efficacy, IH attitudes, interprofessional learning, provider empathy, resiliency, self-care, several wellness behaviors, and wellbeing were observed. The course was positively evaluated with most (93%) indicating interest in applying IH principles and that the course enhanced their educational experience (92%). Conclusion This study demonstrates the feasibility and effectiveness of a multi-site, online curriculum for introducing IH to a diverse group of primary care professionals. Primary care training programs have the ability to offer an interprofessional, IH curriculum with limited on-site faculty expertise.
Drug Solubilization by Means of Partition/Association Equilibrium Using a Modified Nanosized Dendrimeric Biopolymer

The objective of this study is to elucidate the combined effects of a novel type of material being investigated as a new excipient, an octenylsuccinate-modified dendrimer-like biopolymer (OS-DLB) and poloxamer (PLX), on the solubility of poorly water-soluble compounds. Phenytoin (PHT), griseofulvin (GSF), ibuprofen (IBU), and loratadine (LOR) were used as model compounds. Phase solubility measurements were conducted to determine the relative proportions of API, OS-DLB, and PLX that result in the most stable dendrimeric complexes. The solubilizing power of OS-DLB increases with increasing hydrophobicity of the solute. In the presence of PLX, the solubilization effect of OS-DLB is modestly accentuated for the most hydrophobic drugs (IBU and LOR) but has no effect on the least hydrophobic one (PHT). The maximum potentiation effect of PLX on the solubilizing properties of OS-DLB was observed for GSF, the drug of intermediate hydrophobicity. Three different types of solubilization profiles were obtained in the study. All three different profiles can be appropriately described by a single solubilization model, depending on the specific parameter values. The defining parameters of the model reflect the hydrophobicity of the drug on the one hand and, on the other hand, the inherent tendency of the drug (crystal lattice energy) toward crystallization.
Association of Adolescent Sport Participation With Cognition and Depressive Symptoms in Early Adulthood.

Background:Recent studies have associated sport-related concussion with depression and impaired cognitive ability later in life in former professional football players. However, population studies ...
Physical Diagnosis Find — Thymolipoma

Every medical student experiences physical diagnosis and practices these skills, usually with classmates. We report an unusual finding from our physical diagnosis course. A 22-year-old healthy male medical student was practicing the cardiac exam with a small group of classmates who noticed his point of maximal impulse was displaced to the right; otherwise, his exam was normal. A cardiologist who was precepting recommended he see a cardiologist and get an echocardiogram, which revealed a normal heart, but something was occupying the left chest cavity and displacing the heart. Chest radiograph revealed a dense mass occupying the left chest cavity. In retrospect, he had noticed decreasing exercise tolerance and shortness of breath, but attributed it to working out less and studying. Biopsy of the lesion revealed a thymolipoma with lobules of mature adipose tissue and minute islands of thymic tissue consisting of epithelial cells, lymphocytes, and Hassall's corpuscles. The medical student was in the middle of his first year and consulted several surgeons. He elected to wait and have surgical removal of the mass during the summer. Upon removal of the 4300-g mass, his lung re-expanded without difficulty (see Figure). The tumor was benign, and his recovery from the thoracotomy was unremarkable. Figure A 4300-g thymolipoma Very little is written in the literature regarding diagnoses made during physical examination courses or about thymolipoma. In our physical diagnosis course over the last 5 years, we have “found” a thyroid nodule, the murmur associated with hypertrophic cardiomyopathy, and this thymolipoma. Thymolipoma is a benign lesion, and other thymic neoplasms are discussed in detail elsewhere.[1] Thymolipomas are usually asymptomatic and incidentally identified as well-circumscribed masses of the anterior mediastinum attached to the pericardium. The pathogenesis remains controversial and theories include thymic hamartoma because of the mixture of thymus and fat,[2] fatty regression of a thymoma or a hyperplastic thymus, and a malformative theory[3] with origin from the third pharyngeal pouch. Thymomas have even been found arising from thymolipomas.[4] Many times while precepting physical diagnosis, students present their own health symptoms and signs. Usually the symptom or sign can be easily explained and the student reassured. Rarely a more serious problem, even one necessitating surgery, presents itself.