cssi/SciSciGPT-SciSciNet huggingface dataset:
Endogenous estrogen levels affect sexual function in elderly post-menopausal women

Abstract Objective: The objective of this study was to determine if there is an association between endogenous serum concentration of estradiol (E 2 ) and changes in sexual function in post-menopausal women over 3 years. Methods: Sexually active women ( N =345, mean age=65 years) who participated in the multiple outcomes of raloxifene evaluation trial (MORE) had endogenous E 2 levels measured at baseline. All women completed the sexual history questionnaire at baseline and 3 years later. We assessed sexual function (desire, activity, feelings/experiences and sexual problems) among these women by endogenous E 2 level ( Results: At baseline, women with E 2 levels 2 ≥20 pmol/l ( P 2 ≥20 pmol/l had significantly less decline in sexual enjoyment ( P P P P =0.001), when compared with women who had E 2 levels Conclusions: Endogenous E 2 levels are important predictors of change in sexual function in elderly women who are sexually active. However, this result needs to be proven in a study with a bigger sample size of sexually active women, who present with changes in sexual function over several years. Also, future investigations are needed to assess the effects of other endogenous hormones on sexual function in elderly women.
Spontaneous strategies for psychological control of seizures.

Abstract The present research explored the strategies individuals with epilepsy use to manage seizure activity by using a survey method (n = 105). Analysis suggests that participants' strategies are more likely cognitive or behavioral in nature, rather than emotional. Furthermore, strategy usage varied by whether participants experienced a global perception or an immediate perception of seizure susceptibility. Cognitive strategies were more likely used in response to immediate awareness of seizure risk (p
A randomized controlled trial of a public health nurse directed treatment program for rural patients with high blood cholesterol.

Background. Many rural residents do not have access to high-quality nutrition counseling for high blood cholesterol. The objective of this study was to assess the effectiveness of an intervention program designed to facilitate dietary counseling for hypercholesterolemia by rural public health nurses. Methods. Eight health departments (216 participants) were randomized to give the special intervention (SI) and nine (252 participants) to give the minimal intervention (MI). The SI consisted of three individual diet counseling sessions given by a public health nurse, using a structured dietary intervention (Food for Heart Program), referral to a nutritionist if lipid goals were not achieved at 3-month follow-up, and a reinforcement phone call and newsletters. Diet was assessed by the Dietary Risk Assessment (DRA), a validated food frequency questionnaire, at baseline, 3-, and 12-month follow-up; blood lipids and weight were assessed at baseline, 3-, 6-, and 12-month follow-up. Results. Participants were largely female (71%), older (mean age 55), and white (80%). At 3-month follow-up, the average reduction (indicating dietary improvement) in total Dietary Risk Assessment score was 3.7 units greater in the SI group (95% confidence interval [CI] 1.9 to 5.5, P 0.0006), while both groups experienced a similar reduction in blood cholesterol, 14.1 mg/dL (0.37 mmol/L) for SI and 14.5 mg/dL (0.38 mmol/L) for minimal intervention group (difference 0.4 mg/dL [0.010 mmol/L], 95% CI 12.5 to 11.7 [0.32 to 0.30], P 0.9). At 12-month follow-up, the reduction in total Dietary Risk Assessment score was 2.1 units greater in the SI group (95% CI 0.8 to 3.5, P 0.005), while the reduction in blood cholesterol was similar in both groups, 18.4 mg/dL (0.48 mmol/L) for SI and 15.6 mg/dL (0.40 mmol/L) for minimal intervention group (difference 2.8 mg/dL [0.07 mmol/L], 95% CI7.5 to 13.1 [0.19 to 0.34], P 0.6). During follow-up, weight loss was greater in the SI group; the difference between groups was statistically significant at 3 (1.9 lb [0.86 kg], 95% CI 0.3 to 3.4 [0.14 to 1.55], P 0.022) and 6 months (2.1 lb [0.95 kg], 95% CI 0.1 to 4.1 [0.04 to 1.86], P 0.04). At 12 months, the difference was not significant (1.6 lb [0.73 kg], 95% CI 0.05 to 3.7 [0.02 to 1.68], P 0.13). Conclusions. Improvement in self-reported dietary intake was significantly greater in the SI group, while reduction in blood cholesterol
Utilizing relationships between named entities to improve speech recognition in dialog systems

In this paper, we address the problem of improving recognition accuracy of spoken named entities in the context of dialog systems for transactional applications. We propose utilizing the knowledge of relationships, that typically exist in many applications, between named entities spoken across different dialog states. For example, in a bank customer database each customer name is associated with one or a few account numbers, addresses and vice versa. We utilize these relationships to build long-term dependency constraints in grammars (and thus in decoding graphs) representing these entities. This enforces the recognizer to use collective evidences from instances of all the entities to improve the recognition accuracy of each individual entity. Experiments conducted to evaluate our approach show significant accuracy improvements on a task of recognizing a person via a name and a location.
A Tool for Evaluating Time-Varying-Stress Accelerated Life Test Plans With Log-Location-Scale Distributions

Accelerated life tests (ALTs) are often used to make timely assessments of the lifetime distribution of materials and components. The goal of many ALTs is the estimation of a quantile of a log-location-scale failure time distribution. Much of the previous work on planning accelerated life tests has focused on deriving test-planning methods under a specific log-location-scale distribution. This paper presents a new approach for computing approximate large-sample variances of maximum likelihood estimators of a quantile of a general log-location-scale distribution with censoring, and time-varying stress. The approach is based on a cumulative exposure model. Using sample data from a published paper describing optimum ramp-stress test plans, we show that our approach and the one used in the previous work give the same variance-covariance matrix of the quantile estimator from the two different approaches. Then, as an application of this approach, we extend the previous work to a new optimum ramp-stress test plan obtained by simultaneously adjusting the ramp rate with the lower start level of stress. We find that the new optimum test plan can have a smaller variance than that of the optimum ramp-stress test plan previously obtained by adjusting only the ramp rate. We compare optimum ramp-stress test plans with the more commonly used constant-stress accelerated life test plans. We also conduct simulations to provide insight, and to check the adequacy of the large-sample approximate results obtained by the approach.
Profiles of Strategic Information Systems Planning

Improving strategic planning within the realm of information technology management is consistently identified by top corporate executives as a critical competitive issue. While relevant literature in the area is replete with descriptions of planning tools and methodologies, investigations that examine this activity from the perspective of process-based characteristics, or "profiles," are still in the formative stages. Through multivariate analysis of data gathered from 253 organizations, the findings of this study suggest that five distinct profiles of strategic planning can be identified based on dimensions of comprehensiveness (extent of solution search), formalization (existence of rules and procedures), focus (extent of innovation versus integration), flow (top-down, bottom-up), participation (number and variety of planners), and consistency (frequency of planning). While each profile exhibits strength across particular measures of planning effectiveness, the profile associated with all measures of planning effectiveness seems to incorporate elements of rationality (high comprehensiveness, high formalization, control focus, top-down flow) and adaptation (high participation, high consistency). Post-survey field study of selected firms suggests that the five approaches may represent distinct "schools" of thought that are reflective of deep-seated beliefs and attitudes about strategic planning. These schools (design, planning, positioning, learning, and political) are founded on very different assumptions and provide substantive interpretation for the empirical findings.
Surgical correction of lateral curvature of penis

The fourth reported case of surgical correction of a lateral curvature of the penis is described. The use of photography by the patient to demonstrate penile deformity on erection is advocated.
BACE1 inhibitor drugs in clinical trials for Alzheimer’s disease

β-site amyloid precursor protein cleaving enzyme 1 (BACE1) is the β-secretase enzyme required for the production of the neurotoxic β-amyloid (Aβ) peptide that is widely considered to have a crucial early role in the etiology of Alzheimer’s disease (AD). As a result, BACE1 has emerged as a prime drug target for reducing the levels of Aβ in the AD brain, and the development of BACE1 inhibitors as therapeutic agents is being vigorously pursued. It has proven difficult for the pharmaceutical industry to design BACE1 inhibitor drugs that pass the blood–brain barrier, however this challenge has recently been met and BACE1 inhibitors are now in human clinical trials to test for safety and efficacy in AD patients and individuals with pre-symptomatic AD. Initial results suggest that some of these BACE1 inhibitor drugs are well tolerated, although others have dropped out because of toxicity and it is still too early to know whether any will be effective for the prevention or treatment of AD. Additionally, based on newly identified BACE1 substrates and phenotypes of mice that lack BACE1, concerns have emerged about potential mechanism-based side effects of BACE1 inhibitor drugs with chronic administration. It is hoped that a therapeutic window can be achieved that balances safety and efficacy. This review summarizes the current state of progress in the development of BACE1 inhibitor drugs and the evaluation of their therapeutic potential for AD.
Counting chemical compositions using Ehrhart quasi-polynomials

To count the number of chemical compositions of a particular mass, we consider an alphabet \({\mathop{\bf a}}\) with a mass function which assigns a mass to each letter in \({\mathop{\bf a}}\) . We then compute the mass of a word (an ordered sequence of letters) by adding the masses of the constituent letters. Our main interest is to count the number of words that have a particular mass, where we ignore the order of the letters within the word. We show first that counting the number of words of a given mass has a geometric interpretation, whose solutions are called Ehrhart quasi-polynomials, a class of functions defined on integers. These special functions are “periodic” in the sense that they use the same polynomial every λ steps. In addition to discovering the connection between counting compositions and Ehrhart quasi-polynomials, we also find number theoretic results that greatly reduce the number of candidates for the period, λ. Finally, we illustrate the usefulness of these results and the use of a software library named barvinok (by Verdoolaege et al.) by applying them to eight different classes of chemical compositions, including organic molecules, peptides, DNA, and RNA.
Intersectionality as a Framework for Transformative Research in Special Education.

Multicultural and bilingual special education scholars have long advocated that research and practice situate (dis)ability in its social, cultural, racial/ethnic, linguistic, historical, legal, and political contexts. Still, the special education literature reflects more restricted conceptualizations of culture, language, and diversity than required to understand how these mutually influence an individual’s, family’s and/or community’s response to (dis) ability and how organizations address the needs of diverse populations. We propose that an intersectionality framework offers a starting point for conceptualizing, developing and conducting transformative research related to disability and difference. We begin by defining intersectionality and exploring related assumptions, followed by implications for two key aspects of such research: deep understanding of the intersections among multicultural/ multilingual students, communities and schools; and researcher reflexivity.
Comparative Effects of Metal-Catalyzed Oxidizing Systems on Carbonylation and Integrity of Therapeutic Proteins

Ascorbic acid has been considered as a potential radical scavenging excipient for pharmaceutical formulations. However, under certain circumstances, ascorbic acid can generate reactive oxygen species via redox cycling. The objective of this study was to investigate ascorbic acid-induced oxidative carbonylation of therapeutic proteins and correlate the increase in carbonylation with protein aggregation. An optimized ELISA for quantifying carbonyl levels was used to compare the oxidizing potentials of ascorbic acid and hydrogen peroxide by testing four pharmaceutically-relevant proteins (human serum albumin, immunoglobulin G, granulocyte-colony stimulating factor and calcitonin). Several transition metals at micromolar concentrations were evaluated for their ability to enhance ascorbic acid-induced protein carbonylation. Protein aggregation under oxidative conditions, with or without free radical scavengers, was measured by aggregate binding fluorescent dye and confirmed by microfluidic imaging. Addition of ascorbic acid alone resulted in higher increases in carbonylation than addition of hydrogen peroxide. The presence of trace amounts (>75 ppb) of copper enhanced oxidative effects of ascorbic acid, whereas other tested metals did not comparably promote oxidation. During oxidation, protein destabilization indicated by loss of the full-length protein, positively correlated with the increase in protein aggregation. However, levels of aggregation did not always correlate with the levels of protein carbonylation. At comparable carbonylation levels, addition of copper produced greater protein destabilization and aggregation than addition of iron. The results strongly suggest that ascorbic acid with traces of metals, especially copper, can promote therapeutic protein carbonylation and potentially aggregation. At similar carbonylation levels, some oxidative conditions may lead to greater protein destabilization than others.
Modulation of Toll-like receptor signaling in innate immunity by natural products

For centuries, natural products and their derivatives have provided a rich source of compounds for the development of new immunotherapies in the treatment of human disease. Many of these compounds are currently undergoing clinical trials, particularly as anti-oxidative, anti-microbial, and anti-cancer agents. However, the function and mechanism of natural products in how they interact with our immune system has yet to be extensively explored. Natural immune modulators may provide the key to control and ultimately defeat disorders affecting the immune system. They can either up- or down-regulate the immune response with few undesired adverse effects. In this review, we summarize the recent advancements made in utilizing natural products for immunomodulation and their important molecular targets, members of the Toll-like receptor (TLR) family, in the innate immune system.
Minocycline-induced orbital rim discoloration

A 20-year-old woman underwent lacrimal gland biopsy for unilateral swelling and was unexpectedly found to have olive-green discoloration of her orbital rim. Postoperative questioning revealed that as a teenager she had been treated for acne with minocycline, a semisynthetic tetracycline antibiotic and a first-line treatment for moderate and severe acne. While hyperpigmentation is a known side effect of minocycline, reports of pigmentation changes of the periorbital bones are relatively rare and could pose a diagnostic dilemma during surgery.
Tips for Taking and Passing Examinations

There are a number of techniques that can enhance test-taking abilities, whether the test is a regular classroom test or a comprehensive examination. The ability of students to excel on these tests may depend on many factors other than recall of knowledge. Some of the factors that help students to be successful when taking tests Include time management, physical health, mental health, study habits, overall examination strategy, and answer analysis. This article does not address essay questions.
New Normal Initiatives Prompts U.S. Business Schools to Enhance Curricula

The purpose of this article is to seek an understanding as to how organizations are able to evolve despite the challenges attributable to the increase of competition and the reduction of resources. Studies have suggested that the lack of leadership is to blame for promoting misguided organizational change. Other experts suggest that corporate leaders who lack emotional intelligence (EI) are equally to blame for organizational failure. The "New Normal" continues to be a focal point of discussion among corporate leaders. Additionally, not only should leaders be critical thinkers and lead by example, they should have an understanding of internal and external factors associated with the overall organizational setting. Moreover, universities/colleges throughout America continue to expand their curricula to better prepare future corporate leaders. Additionally, the inclusion of EI initiatives within university/college undergraduate and graduate curricula is a high priority for most university administrators to meet U.S. job market requirements.
Delegation of clinical dietetic tasks in military and civilian hospitals: implications for practice.

The purposes of our research were twofold: to determine perceptions of the quality of task performance and to identify dietetic personnel currently performing clinical dietetic tasks in military and civilian hospitals. Questionnaires were returned from 309 dietitians and 208 dietetic support personnel at 151 military and civilian hospitals (73% response overall). For tasks completed by support personnel, no task was rated as having optimum quality, 1 was rated as highly acceptable, 6 as acceptable, 19 as somewhat unacceptable, and 4 as unacceptable. Current performance ratings indicated that 1 task was performed solely by dietitians, 21 were completed by dietitians with assistance, 6 were completed jointly by dietitians and support personnel, 2 were completed by support personnel with supervision by dietitians, and no task was completed independently by support personnel. Tasks were grouped into four categories: basic clinical dietetics (11 tasks), intermediate and in-depth clinical dietetics (12 tasks), outpatient nutrition clinic (5 tasks), and nutrition education (community) (4 tasks). Quality scores for the US Air Force (USAF) hospitals were higher for all task categories except intermediate and in-depth clinical dietetic tasks. The quality scores of support personnel were higher than those of dietitians for all task categories. The USAF performance scores indicated significantly more involvement of support personnel. Generally, the performance scores of dietitians increased with experience; the scores of support personnel decreased with experience. Correlations between quality and performance ratings for individual tasks revealed low to moderate relationships. Our results suggest that additional delegation of tasks to dietetic support personnel may be possible without negatively affecting perceptions of the quality of task outcome. More research is needed to evaluate the cost-effectiveness of various delegation strategies.
Militaries and Militarization, Anthropology of

Anthropologists have become increasingly interested in militaries and militarization, as they recognize the role played by militaries, militarization, and warfare in culture and everyday life. By examining militarization and the military ethnographically, anthropologists analyze the methods and strategies used by state and military actors to influence, shape, and control perceptions of military service, military action, and military violence; how people respond, react, accept, and contest the military and militarization; and the ways in which military values and worldviews shape and influence culture, agency, and worldviews.
Nouvelles leçons d'une vieille pratique : mosaïque du feu dans la savane du Mali

La savane africaine occidentale est un des paysages tropicaux les plus largement parcourus par les feux de brousse. Lors de la periode coloniale, relayee par les gouvernements post-coloniaux, des politiques en vue de controler ces feux ont ete mises en place. Elles n'ont pas reussi et ont, en outre, cree un tres long conflit entre les services forestiers et les populations rurales. L'option de lutte contre les feux, qui a persiste pendant presque un siecle, semble s'affaiblir. Le gouvernement a recemment adopte une nouvelle politique. Ce changement permet aux communautes locales de coordonner des mises a feu precoces des savanes. Le Mali venant de mettre en application cette nouvelle politique, il est opportun de reflechir a deux questions primordiales afin d'eviter la repetition des erreurs du passe. Premierement, il est important d'analyser les raisons pour lesquelles une philosophie « anti-feu » a domine la science et la politique du feu dans la region pendant presque un siecle; deuxiemement, il est necessaire de documenter le regime traditionnel du feu pour mieux comprendre cette pratique et ses effets. L'article presente les raisons qui peuvent expliquer la persistance de l'attitude « anti-feu » des gouvernements successifs. Il propose egalement une combinaison de methodes et de sources de donnees, y compris des images satellitaires, des resultats d'entretiens, les developpements de l'ecologie du feu pour montrer les effets des utilisations traditionnelles du feu. Celles-ci creent une mosaique qui reduit les effets nocifs potentiels des feux, tout en rendant le paysage rural plus utile.
Subacute Schlerosing Panencephalitis

A 10-year old Nicaraguan boy with SSPE was treated with intraventricular biosynthetic alpha 2b interferon (Schering, Intron A) 1 million units twice weekly for 5h months, at the Children’s Hospital of Los Angeles, Neurology Division, Los Angeles, CA.
Supervised Learning Methods for Fraud Detection in Healthcare Insurance

Fraud in the healthcare system is a major problem whose rampant growth has deeply affected the US government. In addition to financial losses incurred due to this fraud, patients who genuinely need medical care suffer because of unavailability of services which in turn incur due lack of funds. Healthcare fraud is committed in different ways at different levels, making the fraud detection process more challenging. The data used for detecting healthcare fraud, primarily provided by insurance companies, is massive, making it impossible to audit manually for fraudulent behavior. Data-mining and Machine-Learning techniques holds the promise to provide sophisticated tools for the analysis of fraudulent patterns in these vast health insurance databases. Among the data mining methodologies, supervised classification has emerged as a key step in understanding the activity of fraudulent and non-fraudulent transactions as they can be trained and adjusted to detect complex and growing fraud schemes. This chapter provides a comprehensive survey of those data-mining fraud detection models based on supervised machine-learning techniques for fraud detection in healthcare.
First, do no harm: institutional betrayal and trust in health care organizations

PURPOSE Patients' trust in health care is increasingly recognized as important to quality care, yet questions remain about what types of health care experiences erode trust. The current study assessed the prevalence and impact of institutional betrayal on patients' trust and engagement in health care. PARTICIPANTS AND METHODS Participants who had sought health care in the US in October 2013 were recruited from an online marketplace, Amazon's Mechanical Turk. Participants (n = 707; 73% Caucasian; 56.8% female; 9.8% lesbian, gay, or bisexual; median age between 18 and 35 years) responded to survey questions about health care use, trust in health care providers and organizations, negative medical experiences, and institutional betrayal. RESULTS Institutional betrayal was reported by two-thirds of the participants and predicted disengagement from health care (r = 0.36, p < 0.001). Mediational models (tested using bootstrapping analyses) indicated a negative, nonzero pathway between institutional betrayal and trust in health care organizations (b = -0.05, 95% confidence interval [CI] = [-0.07, -0.02]), controlling for trust in physicians and hospitalization history. These negative effects were not buffered by trust in one's own physician, but in fact patients who trusted their physician more reported lower trust in health care organizations following negative medical events (interaction b = -0.02, 95%CI = [-0.03, -0.01]). CONCLUSION Clinical implications are discussed, concluding that institutional betrayal decreases patient trust and engagement in health care.
Treatment of Postherpetic Neuralgia: The Role of Opioids

In many clinical situations, there is no medication that controls pain better than an opioid. Its effects are immediate, based in key areas of the central nervous system that process pain, and produce a dose-dependent reduction in pain intensity whatever the source or type of pain. Thus, opioids have a time-honored place in the treatment of severe acute pain and in the treatment of pain at the end of life. In these situations, other medications can be used as adjuncts, to improve pain relief and reduce opioid doses, but there is no complete substitute for an opioid that will effectively and quickly reduce pain’s intensity and render pain tolerable. Medicine has come to accept the supreme role for opioids for treating severe time-limited pain and the duty of clinicians to provide opioids in such a situation. What is much more difficult is what the role is for opioids in treating pain that is not time limited – chronic pain. It is always tempting to want to prolong opioid therapy on the basis that its early effects are dramatic; neither patients nor providers want to go back to pain remembered from before opioids were initiated. And it has been argued recently that centuries’ old caution about opioids’ addictive properties was not justified and should not interfere with attempts to relieve pain, even chronic pain.
BARTER: DEVELOPMENT OF ACCOUNTING PRACTICE AND THEORY

John Mair, in 1752, stated, “Barter, or the exchange of goods for goods, is nothing else but buying and selling blended together.” This statement, for all its seeming simplicity, is an excellent expression of the confusion which has accompanied the practice and theory of recording this most basic commercial transaction. Can one accounting transaction be both a sale and a purchase at one and the same time and for the same accounting entity? The proper recording of the barter transaction has occupied the attention of accounting text book authors, beginning in 1494 with Pacioli, with various authors expounding different solutions for almost 500 years. It was not until 1971 that a sound theoretical solution was presented.
Approaching capacity using incremental redundancy without feedback

Variable-length codes with incremental redundancy controlled by feedback allow a system to approach capacity with short average blocklengths and thus relatively low-complexity decoders. This paper shows how to use those same variable-length codes with incremental redundancy to approach capacity without feedback. The general principle is to provide a common pool of redundancy that can be accessed by exactly the variable-length codes that need it. We provide example implementations using both regular and irregular low-density generator matrix (LDGM) codes to provide this common pool of redundancy, utilizing the inter-frame coding approach that Zeineddine and Mansour used to combat rate variation due to fading in broadcast transmissions. Obtaining the LDGM degree distributions requires a new design methodology involving differential evolution for a generalized peeling decoder. Monte-Carlo simulations using a 2dB binary-input additive white Gaussian noise channel confirm the feasibility of this new approach. For a frame error rate of 10−3, the irregular LDGM code achieves 96% of the throughput of the corresponding feedback system.
Making useful gadgets with miniaturized G proteins

G protein-coupled receptors (GPCRs) relay information from extracellular stimuli to intracellular responses in a wide range of physiological and pathological processes, but understanding their complex effects in live cells is a daunting task. In this issue of JBC, Wan et al repurpose "mini G proteins"-previously used as affinity tools for structural studies-to develop a suite of probes to visualize GPCR activation in live cells. The approach is expected to revolutionize our understanding of the spatiotemporal control and mechanisms of GPCR signaling.
Abstract 17752: Altered Expression of Chloride Transporters in Rat Pulmonary Arterial Smooth Muscle Associated with Chronic Hypoxic Pulmonary Hypertension

Chloride channels play an important role in regulating smooth muscle contraction and proliferation, and contribute to the enhanced vasoconstriction in pulmonary hypertension (PH). The intracellular...
Expanding the Genetic Code in Vitro and in Vivo

Insight into biological function at almost every level, from catalysis to signal transduction to structure, requires a detailed understanding of proteins, biopolymers of remarkable di versity assembled from only twenty amino acid building blocks. Site-directed mutagenesis - the process by which an amino acid in a protein is swapped for one of the other 19 natural proteinogenic amino acids - has emerged as one of the most useful and powerful tools at the biochemists disposal. Not only does site-directed mutagenesis allow the identification of residues critical for catalysis, binding, folding, or structure, but it also made possible the first protein engineering experiments. The bioorganic chemist, however, cannot be fully satisfied with this method because the changes allowed are very limited compared to the physical or-ganic chemists ability to subdy alter steric or electronic properties, or the synthetic chemist’s ability to install useful functionalities or unique chemical handles for elaboration. Methods to alter proteins in more general ways have been developed over the last decade, inspiring the notion of “unnatural” life forms-living cells capable of using amino acids not accessible to life as we have observed it. Todays powerful in vitro methods of unnatural protein mutagenesis have become increasingly useful and accessible and have enhanced our understanding of pro-tein fiinction. In addition, the advent of living cells producing proteins with unnatural amino acids will allow a level of biophysical and cell-biological characterization that would have been difficult to imagine a decade ago.
Long-Term Oncologic Outcomes of Uterine-Preserving Surgery in Young Women With Stage Ib1 Cervical Cancer.

Objective This study aimed to evaluate oncologic outcomes of women with stage IB1 cervical cancer treated with uterine-preserving surgery (UPS) (defined as conization or trachelectomy) versus non-UPS (defined as hysterectomy of any type). Methods The Surveillance, Epidemiology, and End Results (SEER) database was used to identify women younger than 45 years diagnosed with stage IB1 cervical cancer from 1998 to 2012. Only those who underwent lymph node (LN) assessment were included. Outcomes of UPS versus non-UPS were analyzed. Results Among 2717 patients, 125 were treated with UPS and 2592 were treated with non-UPS. Those in the UPS group were younger (median age 33 vs 37 years, P Conclusions The UPS does not seem to compromise oncologic outcomes in a select group of young women with stage IB1 cervical cancer, especially in the setting of tumors 2 cm or less. Further studies are needed to clarify the role of UPS in tumors greater than 2 cm.
Noncontractile tissue forces mask muscle fiber forces underlying muscle spindle Ia afferent firing rates in stretch of relaxed rat muscle

Stretches of relaxed cat and rat muscle elicit similar history-dependent muscle spindle Ia firing rates that resemble history-dependent forces seen in single activated muscle fibers (Nichols and Cope, 2004). During stretch of relaxed cat muscle, whole musculotendon forces exhibit history-dependence that mirror history-dependent muscle spindle firing rates, where both muscle force and muscle spindle firing rates are elevated in the first stretch in a series of stretch-shorten cycles (Blum et al 2017). By contrast, rat musculotendon are only mildly history-dependent and do not mirror history-dependent muscle spindle firing rates in the same way (Haftel et al., 2004). We hypothesized that history-dependent muscle spindle firing rates elicited in stretch of relaxed rat muscle would mirror history-dependent muscle fiber forces, which are masked by noncontractile tissue at the level of whole musculotendon force. We removed noncontractile tissue force contributions from the recorded musculotendon force using an exponentially-elastic tissue model. We then show that the remaining estimated muscle fiber force resembles history-dependent muscle spindle firing rates recorded simultaneously. These forces also resemble history-dependent forces recorded in stretch of single activated fibers and attributed to muscle cross-bridge mechanisms (Campbell and Moss 2000). Our results suggest that history-dependent muscle spindle firing in both rats and cats arise from stretch of cross-bridges in muscle fibers.
Comparing Simultaneous Clinical Swallow Evaluations and Fiberoptic Endoscopic Evaluations of Swallowing: Changing Practice Patterns

Purpose The purpose of this study was to investigate if clinicians are using evidence from the literature to guide clinical practice when assessing pharyngeal phase swallowing function. Method Blin...
Hagar: The M/Other patriarch:

Most readers of the Old Testament know the matriarchs Sarah, Rebekah, Rachel, and Leah along with their counterpart patriarchs (Abraham, Isaac, and Jacob). But fewer know the other matriarch, Hagar...
The contribution of detoxification pathways to pyrethroid resistance in Hyalella azteca

Abstract Chronic exposure to pyrethroid insecticides can result in strong selective pressures on non-target species in aquatic systems and drive the evolution of resistance and population-level changes. Characterizing the underlying mechanisms of resistance is essential to better understanding the potential consequences of contaminant-driven microevolution. The current study found that multiple mechanisms enhance the overall tolerance of Hyalella azteca to the pyrethroid permethrin. In H. azteca containing mutations in the voltage-gated sodium channel (VGSC), both adaptation and acclimation played a role in mitigating the adverse effects of pyrethroid exposures. Pyrethroid resistance is primarily attributed to the heritable mutation at a single locus of the VGSC, resulting in reduced target-site sensitivity. However, additional pyrethroid tolerance was conferred through enhanced enzyme-mediated detoxification. Cytochrome P450 monooxygenases (CYP450) and general esterases (GE) significantly contributed to the detoxification of permethrin in H. azteca. Over time, VGSC mutated H. azteca retained most of their pyrethroid resistance, though there was some increased sensitivity from parent to offspring when reared in the absence of pyrethroid exposure. Permethrin median lethal concentrations (LC50s) declined from 1809 ng/L in parent (P0) individuals to 1123 ng/L in the first filial (F1) generation, and this reduction in tolerance was likely related to alterations in acclimation mechanisms, rather than changes to target-site sensitivity. Enzyme bioassays indicated decreased CYP450 and GE activity from P0 to F1, whereas the VGSC mutation was retained. The permethrin LC50s in resistant H. azteca were still two orders-of-magnitude higher than non-resistant populations indicating that the largest proportion of resistance was maintained through the inherited VGSC mutation. Thus, the noted variation in tolerance in H. azteca is likely associated with inducible traits controlling enzyme pathways. A better understanding of the mechanistic and genomic basis of acclimation is necessary to more accurately predict the ecological and evolutionary consequences of contaminant-driven change in H. azteca.
Identifying strontium baselines and large game animal trade at Fremont sites through strontium isotope (87Sr/86Sr) analysis

Abstract Strontium isotope analysis can suggest which large game individuals were obtained locally by prehistoric hunters and which were brought to habitation sites through long-distance hunting or trade. This study explores the potential of using strontium isotope (87Sr/86Sr) analysis to determine whether the Fremont obtained some non-local large game at habitation sites. The Fremont were a diverse group of people who practiced hunting and horticulture from 500 to 1300 CE in what is now modern Utah. The transport of large game by Fremont hunters is examined at two sites: Five Finger Ridge in central Utah and Wolf Village in northern Utah. The results suggest that Fremont hunters obtained at least some large game individuals from areas away from their habitations, potentially through trade. The results of this study are regionally relevant for presenting previously unpublished results of strontium isotope analysis in Utah, a topic rarely explored. The research is also broadly relevant by showcasing potential complications with tracking prehistoric trade in locations with similar geology on a wide-scale, and dissimilar geology on a small-scale.
Problems and their origins of Ni-rich layered oxide cathode materials

Abstract Ni-rich layered oxides, LiNixCoyMnzO2 (NCM) and LiNixCoyAlzO2 (NCA) with x ​+ ​y ​+ ​z ​= ​1 and x ​≥ ​0.8, are regarded to be the best choice for the cathode material of high energy Li-ion batteries due to their combined advantages in capacity, working potential and manufacture cost. However, their application in practical Li-ion batteries is hindered by two essential problems of (1) performance degradation and (2) safety hazard over the whole life of battery. Performance degradation behaves as declines in battery's capacity and working voltage as well as the battery's swelling and impedance growth; Safety hazard arises from thermal runaway under abuse conditions such as overcharging, overheating, and electric shorting. It appears that nearly all problems can be ultimately attributed to the loss of oxygen, especially caused by the oxidation of lattice oxygen in H3 phase where the capacities are contributed by both of the Ni and O redox couples. In this review, the problems and their origins of Ni-rich layered oxides are overviewed, and the solutions attempted to mitigate these problems are outlined.
Impact of metal cations on the thermal, mechanical, and rheological properties of telechelic sulfonated polyetherimides

Herein we have synthesized telechelic sulfonated polyetherimides (PEIs) with a series of metal cations, including alkali metal cations (Li+, Na+, and K+) and alkaline earth metal cations (Mg2+, Ca2+, and Sr2+). By comparing the metal sulfonated PEIs with a noncharged analog phenyl-terminated PEI, we have systematically investigated how the metal cations affect the thermal, mechanical, and rheological properties of PEIs. PEIs with alkaline earth metal cations showed higher thermal degradation temperatures than those with alkali metal cations. All sulfonated PEIs showed lower thermal degradation temperatures than noncharged PEIs. All metal cations except K+ and Sr2+ increased the glass transition temperatures of sulfonated PEIs. Most metal (except K and Sr) sulfonated PEIs possessed good film formability when the molecular weight was above 10 kDa. Due to their large cation sizes, the K and Sr sulfonated PEIs exhibited reduced glass transition temperatures and inferior film formability. Alkali metal sulfonated PEIs showed high thermo-oxidative stability, but none of the alkaline earth metal sulfonated PEIs exhibited good thermo-oxidative stability. The rheological time–temperature superposition revealed that the interaction strength between the sulfonate anions and the alkali metal cations decreased as the cation size increased in the sequence of Li+, Na+, and K+. This study provides a guideline for synthesizing metal sulfonated PEIs and other metal sulfonated polymers with tailored thermal, mechanical, and rheological properties.
Congenital mesoblastic nephroma: a single-centre series

Background Congenital mesoblastic nephroma is a rare disease. Treatment is surgical in the first instance. Chemotherapy has traditionally been thought not to have a role. Recent literature suggests...
Effects of Communication Modality and Speaker Identity on Metaphor Framing

People regularly encounter metaphors in a variety of different communicative settings, but most studies of metaphor framing have relied exclusively on written materials. Across three experiments (N...
“Our Birth Experiences are What Binds Us”: Women’s Motivations for Storytelling about Birth to Build Motherwisdom

Childbirth is widely considered to be a bonding experience among women. Women often feel compelled to share their story, and this research highlights communicative and reflexive aspects of storytel...
Health care resource utilization and treatment of leptomeningeal carcinomatosis in the United States.

Background The economic burden of cancer in the United States is substantial, and better understanding it is essential in informing health care policy and innovation. Leptomeningeal carcinomatosis (LC) represents a late complication of primary cancer spreading to the leptomeninges. Methods The IBM MarketScan Research databases were queried for adults diagnosed with LC from 2001 to 2015, secondary to 4 primary cancers (breast, lung, gastrointestinal, and melanoma). Health care resource utilization (HCRU) and treatment utilization were quantified at baseline (1-year pre-LC diagnosis) and 30, 90, and 365 days post-LC diagnosis. Results We identified 4961 cases of LC (46.3% breast cancer, 34.8% lung cancer, 13.5% gastrointestinal cancer, and 5.4% melanoma). The median age was 57.0 years, with 69.7% female and 31.1% residing in the South. Insurance status included commercial (71.1%), Medicare (19.8%), and Medicaid (9.1%). Median follow-up was 66.0 days (25th percentile: 24.0, 75th percentile: 186.0) and total cumulative costs were highest for the gastrointestinal subgroup ($167 768) and lowest for the lung cancer subgroup ($145 244). There was considerable variation in the 89.6% of patients who used adjunctive treatments at 1 year, including chemotherapy (64.3%), radiotherapy (57.6%), therapeutic lumbar puncture (31.5%), and Ommaya reservoir (14.5%). The main cost drivers at 1 year were chemotherapy ($62 026), radiation therapy ($37 076), and specialty drugs ($29 330). The prevalence of neurologic impairments was 46.9%, including radiculopathy (15.0%), paresthesia (12.3%), seizure episode/convulsive disorder not otherwise specified (11.0%), and ataxia (8.0%). Conclusions LC is a devastating condition with an overall poor prognosis. We present the largest study of LC in this real-world study, including current treatments, with an emphasis on HCRU. There is considerable variation in the treatment of LC and significant health care costs.
Basics of Quality Improvement

In today’s healthcare field, an increasing focus is placed on medical errors, cost-effective medicine, public reporting, and pay for performance. As a result, payers and patients have turned to quality improvement (QI) as a strategy and framework to address specific concerns within the current healthcare system. Internal QI is vital to the ability of a healthcare organization or practice to fulfill many goals including, but not limited to, maintaining the fiduciary relationship between the physician and the patient, enhancing medical care and care delivery, simplifying and streamlining procedures, reducing costs, increasing patient and provider satisfaction, and enhancing workplace morale and productivity. External QI is crucial for physician education, licensure and certification, benchmarking, accreditation, and health policy formulation. This chapter introduces quality management theories and practices that have evolved over the past 40 years and highlights some of the themes that have marked progress within the field. It also addresses the policies, philosophies, and processes that characterize the QI field today.
Circulating Donor Heart Exosome Profiling Enables Noninvasive Detection of Antibody-mediated Rejection.

Background Endomyocardial biopsy remains the gold standard for distinguishing types of immunologic injury-acute versus antibody-mediated rejection (AMR). Exosomes are tissue-specific extracellular microvesicles released by many cell types, including transplanted heart. Circulating transplant heart exosomes express donor-specific human leukocyte antigen (HLA) I molecules. As AMR is mediated by antibodies to donor HLAs, we proposed that complement deposition that occurs with AMR at tissue level would also occur on circulating donor heart exosomes. Methods Plasma exosomes in 4 patients were isolated by column chromatography and ultracentrifugation. Donor heart exosomes were purified using anti-donor HLA I antibody beads and complement C4d protein expression was assessed in this subset as marker for AMR. Results Three patients had no rejection episodes. Circulating donor heart exosomes showed troponin protein and mRNA expression at all follow-up time points. One patient developed AMR on day 14 endomyocardial biopsy that was treated with rituximab, IVIG/plasmapheresis. Time-specific detection of C4d protein was seen in donor heart exosome subset in this patient, which resolved with treatment. C4d was not seen in other 3 patients' donor exosomes. Conclusions Anti-donor HLA I specificity enables characterization of circulating donor heart exosomes in the clinical setting. Further characterization may open the window to noninvasively diagnose rejection type, such as AMR.
Spinoffs and Wealth Transfers: The Mariott Case

This paper examines changes in bondholder and shareholder wealth resulting from the 1993 Marriott spinoff. The evidence indicates that there was a wealth transfer from the bondholders to the shareholders and that the total value of the firm declined immediately following the spinoff announcement. The aggregate value of Marriott's equity increased $232 million while the value of its public notes and debentures decreased $333 million. Subsequent modifications of the spinoff plan reduced the bondholder loss, but the value of the debt remained $185 million below its pre-anouncement level when the distribution was completed. It is unclear whether the shareholders ultimately benefited from the spinoff.