cssi/SciSciGPT-SciSciNet huggingface dataset:
Anterior Leaflet Repair With Patch Augmentation for Mitral Regurgitation

Background Anterior leaflet repair continues to pose significant operative challenges, particularly in patients with retracted or "short" anterior leaflets, due to rheumatic or radiation induced mitral valve disease. This often results in abandonment of repair in favor of mitral valve replacement, requiring anticoagulation and altering left ventricular (LV) function and geometry. This study examines our experience of anterior leaflet repair with patch augmentation. Methods Forty-two patients underwent mitral valve repair for a shortened anterior leaflet from 1994 to 2003. Twenty-two patients with a mean age of 53 ± 6 years had radiation valvulitis (XR) whereas 20 patients, age 28 ± 7 years had rheumatic heart disease (RHD). Those patients with XR had a mean New York Heart Association (NYHA) class of 3.2 ± 0.4 and an angina score of 2.1 ± 0.6 compared with a NYHA class 3.8 ± 0.2 and no angina in RHD patients. All patients presented with severe MR. Anterior leaflet augmentation with a gluteraldehyde-treated, autologous pericardial patch and complete annuloplasty ring was used in all patients. Additionally, extensive subvalvar debridement was performed in RHD patients. Twelve XR patients underwent concomitant CABG with a mean of 2.4 ± 0.8 grafts/patient. Additional surgical procedures included tricuspid valve repair, anterior septal defect, and aortic valve replacement. Mean follow-up was 39 ± 10 months for XR patients and 12 ± 25 months for RHD patients. Results There were two late deaths in XR patients from underlying malignancies and no deaths in RHD patients. Two RHD patients required reoperation for recurrent mitral regurgitation at 3 and 20 months. All patients demonstrated clinical improvements (NYHA I-II) following repair. No mitral stenosis was induced. Conclusions Despite anterior leaflet shortening from XR or rheumatic alterations, opportunity still exists for gratifying mitral valve repair. By utilizing anterior leaflet patch augmentation, concomitantly with ring annuloplasty, anticoagulation is avoided, LV geometry is preserved, and follow-up reveals excellent functional improvement.
GDNF-chitosan blended nerve guides: a functional study.

Nerve guides are currently being fabricated by blending a variety of biomaterials with different proteins. Adding proteins, which can support nerve repair and regeneration, optimizes the biological properties of a nerve guide. In our study we have blended glial cell line-derived nerve growth factor (GDNF) and laminin with chitosan to fabricate GDNF–laminin blended chitosan (GLC) nerve guides. As GDNF is known to provide trophic support to motor neurons, the main objective of this study was assess the functional restoration of an injured sciatic nerve treated with GLC. Functional nerve recovery was evaluated using a video gait-analysis technique. Gastrocnemius muscle weight measurements and sensitivity testing were correlated to functional nerve recovery. Our results indicate an increase in the functional recovery of the GLC group when compared to the unblended chitosan nerve guides. At the end of 12 weeks, GLC nerve guides had comparable functional values to the Laminin-I blended chitosan nerve guides (LC) and autograft groups, which were both significantly higher at the terminal stance phase angle as compared to the unblended chitosan nerve guides. Muscle weights for the GLC group indicated decreased atrophy and restoration of functional strength, compared to the unblended chitosan groups. In addition, behavioural testing demonstrated that the GLC group regained sensation while the control groups displayed no restoration. Thus, the addition of GDNF and laminin to the chitosan nerve guides enhanced both functional and sensory recovery. Copyright © 2007 John Wiley & Sons, Ltd.
Poster: A hybrid direct visual editing method for architectural massing study in virtual environments

We present a hybrid user interface and gesture-based direct visual editing techniques for quick and rough object creation and manipulation in three-dimensional (3D) virtual environments (VEs). The user interface includes a novel table-prop to resemble an architect's physical workbench. A tracked pinch glove and a stylus pen provide both rough and fingertip level precise spatial input. For quick placement, objects do not float in space, but instead obey a set of constrained physics laws. Experimental results indicate our design is effective for architectural massing study. Our work contributes to the hardware system design and novel gesture-based interaction techniques, which have the potential to bring VEs into practical use in architecture.
Path integral Monte Carlo calculation of electronic forces

We describe a method to evaluate electronic forces by path integral Monte Carlo (PIMC) calculation. Electronic correlations, as well as thermal effects, are included naturally in this method. For fermions, a restricted approach is used to avoid the ``sign'' problem. The PIMC force estimator is local and has a finite variance. We applied this method to determine the bond length of ${\mathrm{H}}_{2}$ and the chemical reaction barrier of $\mathrm{H}+{\mathrm{H}}_{2}\ensuremath{\rightarrow}{\mathrm{H}}_{2}+\mathrm{H}.$ At low temperature, good agreement is obtained with ground-state calculations. We studied the proton-proton interaction in an electron gas as a simple model for hydrogen impurities in metals. We calculated the force between the two protons at two electronic densities corresponding to Na ${(r}_{s}=3.93)$ and Al ${(r}_{s}=2.07)$ using a supercell with 38 electrons. The result is compared to previous calculations. We also studied the effect of temperature on the proton-proton interaction. At very high temperature, our result agrees with the Debye screening of electrons. As temperature decreases, the Debye theory fails both because of the strong degeneracy of electrons and most importantly, the formation of electronic bound states around the protons.
Widespread Antisense Transcription in Escherichia coli

The vast majority of annotated transcripts in bacteria are mRNAs. Here we identify ~1,000 antisense transcripts in the model bacterium Escherichia coli. We propose that these transcripts are generated by promiscuous transcription initiation within genes and that many of them regulate expression of the overlapping gene.
Space Kernel Analysis

In this paper, we propose a novel nonparametric modeling technique, namely Space Kernel Analysis (SKA), as a result of the definition of the space kernel. We analyze the uncertainty of SKA and show that SKA is subjected to the bias/variance dilemma. Nevertheless, we demonstrate that, by a proper choice of the space kernel matrix, SKA is able to balance between the robustness and accuracy and hence outperforms other kernel-based learning methods. The cost function of SKA is derived, and it proves that SKA minimizes the Weighted Least Squared cost function whose weight matrix is diagonal and determined by the space kernel matrix. The parallels between SKA and several other nonparametric modeling techniques are examined. Study shows that the traditional Kernel Regression, General Regression Neural Network, Similarity Based Modeling and Radial Basis Function Network are examples of SKA with specified space kernel matrices.
Perturbation of functions by the paths of a Lévy process

In a recent paper Mountford [4] showed, using an ingenious probabilistic argument, that if X is a real-valued stable process with index α f : [0, ∞) → ℝ is a non-constant continuous function, then where we use the notation | A | for the Lebesgue measure of a Lebesgue measurable set A ⊂ ℝ. The argument in [4] appears to make strong use of the strict scaling properties of X and the ‘intermediate value’ property of f .
The Role of Equatorial Rossby Waves in Tropical Cyclogenesis. Part II: Idealized Simulations in a Monsoon Trough Environment

Abstract This is the second of two papers examining the role of equatorial Rossby (ER) waves in tropical cyclone (TC) genesis. Based on results from Part I, it is hypothesized that genesis resulting from the circulation of an ER wave alone is uncommon and that the majority of ER wave–related genesis events occur when a sufficiently intense ER wave interacts with a favorable background flow environment. This paper examines this contention by performing a series of simulations in which ER waves are imposed upon idealized background flows. The background flows are designed to resemble a region of a monsoon trough (MT), a flow feature observed at certain times of the year in all of the TC basins, and most dramatically, in the western North Pacific basin. It is believed that ER wave interactions with the MT may speed up the internal breakdown genesis mechanism of the MT, or even result in genesis when the MT is too weak to breakdown from in situ processes alone. The latter scenario is examined here. When just ...
Promises and Perils of Pre-analysis Plans

Imagine a nefarious researcher in economics who is only interested in finding a statistically significant result of an experiment. The researcher has 100 different variables he could examine, and the truth is that the experiment has no impact. By construction, the researcher should find an average of five of these variables statistically significantly different between the treatment group and the control group at the 5 percent level—after all, the exact definition of 5 percent significance implies that there will be a 5 percent false rejection rate of the null hypothesis that there is no difference between the groups. The nefarious researcher, who is interested only in showing that this experiment has an effect, chooses to report only the results on the five variables that pass the statistically significant threshold. If the researcher is interested in a particular sign of the result—that is, showing that this program “works” or “doesn’t work”— on average half of these results will go in the direction the researcher wants. Thus, if a researcher can discard or not report all the variables that do not agree with his desired outcome, the researcher is virtually guaranteed a few positive and statistically significant results, even if in fact the experiment has no effect. This is of course the well-known problem of “data-mining.” If the researcher can choose which results to report, it is easy to see how results can be manipulated. Casey, Glennerster, and Miguel (2012), for example, demonstrate in a real-world economics context how researchers with opposite agendas could hypothetically string together two opposite but coherent sets of results by cherry-picking either positive or negative statistically significant results.
From Andragogy to Collaborative Critical Pedagogy: Learning for Academic, Personal, and Social Empowerment in a Distance-Learning Ph.D. Program

This article describes the evolving learning model of the Fielding Graduate Institute's innovative Ph.D. Program in Human and Organization Development. Based on the principles of andragogy, this program developed various forms of distance learning combining brief academic residencies with individualized learning plans carried out in the student's home setting and within the context of one-to-one faculty-student mentoring relationships. During the past several years, the program has been moving to a more collaborative and critical model of education. This article describes the original adult learning principles on which the program was founded and those it has added; its enduring differences, in ends and means, from traditional forms of graduate study; the limitations of andragogy and self-directed learning; and the primary components of an emerging model that builds on the principles of andragogy, but it adds elements of critical and collaborative pedagogy that can make possible social and personal empowe...
Blind Comparison of Patient Preference for Flavored Colestid Granules and Questran Light

OBJECTIVE:To compare the sensory and mixability characteristics of Flavored Colestid Granules (a new colestipol formulation) with Questran Light (the most recent cholestyramine formulation).METHODOLOGY:Seventy-two nonsmoking adults between the ages of 25 and 64 years were enrolled in the study. Subjects assessed the sensory and mixability characteristics of each product in chilled bottled water and orange juice after at least a one-hour fast. Products were administered in a double-blind, randomized fashion. The sensory characteristics that were rated included overall rating, aftertaste, appearance, aroma, color, consistency, flavor, sweetness, mouthfeel, and thickness. Each characteristic was rated with a nine-point hedonic scale. Mixability of the products was assessed on a five-point scale. Subjects also were asked to choose which product they preferred as to sensory and mixability characteristics in each vehicle.RESULTS:Fifty-three of the 72 subjects preferred the sensory characteristics of Flavored Co...
SENSITIVITY DERIVATIVE VERSIONS OF THE FLOMGEM CFD CODE VIA AUTOMATIC DIFFERENTIATION

The ADIFOR2.0 automatic differentiator is applied to the FLOMGEM flow solver along with the grid generator HYPERG2. The FLOMGEM is an advanced Navier-Stokes CFD code for airfoil computations, which employs multigrid method. The HYPERG2 is a two-dimensional hyperbolic grid generator for generating a C-mesh. Both non-geometric and geometric sensitivity derivative codes are obtained. The sensitivity derivatives via automatic differentiation are presented and compared with divided difference generated derivatives. The study shows that automatic differentiation method gives accurate derivative values in an efficient manner.
Imperfection-immune VLSI logic circuits using carbon nanotube field effect transistors

Carbon Nanotube Field-Effect Transistors (CNFETs) show big promise as extensions to silicon-CMOS because: 1) Ideal CNFETs can provide significant energy and performance benefits over silicon-CMOS, and 2) CNFET processing is compatible with existing silicon-CMOS processing. However, future gigascale systems cannot rely solely on existing chemical synthesis for guaranteed ideal devices. VLSI-scale logic circuits using CNFETs must overcome major challenges posed by: 1) Misaligned and mis-positioned Carbon Nanotubes (CNTs); 2) Metallic CNTs; and, 3) CNT density variations. This paper performs detailed analysis of the impact of these challenges on CNFET circuit performance. A combination of design and processing techniques, presented this paper, can enable VLSI-scale CNFET logic circuits that are immune to high rates of inherent imperfections. These techniques are inexpensive compared to traditional defect- and fault-tolerance, do not impose major changes in VLSI design flows, and are compatible with VLSI processing because they do not require special customization on chip-by-chip basis.
In Vivo Analysis of the Major Exocytosis-sensitive Phosphoprotein in Tetrahymena

Phosphoglucomutase (PGM) is a ubiquitous highly conserved enzyme involved in carbohydrate metabolism. A number of recently discovered PGM-like proteins in a variety of organisms have been proposed to function in processes other than metabolism. In addition, sequence analysis suggests that several of these may lack PGM enzymatic activity. The best studied PGM-like protein is parafusin, a major phosphoprotein in the ciliate Paramecium tetraurelia that undergoes rapid and massive dephosphorylation when cells undergo synchronous exocytosis of their dense-core secretory granules. Indirect genetic and biochemical evidence also supports a role in regulated exocytotic membrane fusion. To examine this matter directly, we have identified and cloned the parafusin homologue in Tetrahymena thermophila, a ciliate in which protein function can be studied in vivo. The unique T. thermophila gene, called PGM1, encodes a protein that is closely related to parafusin by sequence and by characteristic post-translational modifications. Comparison of deduced protein sequences, taking advantage of the known atomic structure of rabbit muscle PGM, suggests that both ciliate enzymes and all other PGM-like proteins have PGM activity. We evaluated the activity and function of PGM1 through gene disruption. Surprisingly, ΔPGM1 cells displayed no detectable defect in exocytosis, but showed a dramatic decrease in PGM activity. Both our results, and reinterpretation of previous data, suggest that any potential role for PGM-like proteins in regulated exocytosis is unlikely to precede membrane fusion.
Incorporation of Radiotherapy Fractionation in the Combined-Modality Treatment of Limited Small-Cell Lung Cancer

Radiotherapy factors may play an important role in both the response and local control of patients with limited SCLC. Even with older techniques, a recently reported retrospective meta-analysis showed that long-term survival was significantly improved with the addition of thoracic radiotherapy 23 . Today, with PE regimens and more conservative volumes of radiotherapy administered in more aggressive ways, long-term survival is now attainable in patients with SCLC; 2-year survival rates approach 50% and 5-year survival is in the range of 30%. Presently, the Eastern Cooperative Oncology Group is testing fractionation in patients with limited SCLC given 4 cycles of PE. Patients are randomized to receive twice-daily radiotherapy providing 4,500 cGy administered either in 25 fractions over 33 days or in 30 fractions over 19 days, respectively). More than 400 patients have been entered into this trial, which closed in August 1992. Integrating radiotherapy with chemotherapy early in the course of treatment has the advantage of potentially eliminating resistant clones; however, results from the CALGB study imply that early radiotherapy may compromise systemic therapy. The dose-reduction rules were very cautious, though. Since the majority of SCLC deaths and failures continue to be systemic, development of new agents and new strategies for systemic therapy is certainly warranted. However, analysis of the French alternating-modality experience suggests local relapse is also a major cause of failure. Therefore, improved local management remains a worthy goal.
Susceptibility testing of fungi and correlation with clinical outcome.

Cefotaxime has retained its broad-spectrum activity against the key pathogens in surgical infection, despite 15 years of widespread use. It has good activity against a wide range of Gram-positive and Gram-negative aerobes and most anaerobes, except Bacteroides fragilis but, combined with metronidazole, it offers clinically complete coverage of B. fragilis and Escherichia coli, the two most important species involved in intra-abdominal infections. For mixed infections involving B. fragilis, 500 mg metronidazole 12-hourly should be added to the cefotaxime regimen. Cefotaxime therapy is simple, generally inexpensive and has a relatively broad spectrum of activity compared to many other antimicrobials used for postoperative nosocomial pneumonia. Treatment with cefotaxime at 1 g or 2 g can be 12-hourly. Surgical prophylaxis with single-dose cefotaxime (1 g or 2 g) is as effective as with many other agents, with no documented selection of resistance. Clinical experience gained worldwide strongly supports the use of cefotaxime for the treatment of prophylaxis and surgical infections.
Fluparoxan: A Comprehensive Review of its Discovery, Adrenergic and CNS Activity and Treatment of Cognitive Dysfunction in Central Neurodegenerative Diseases

BACKGROUND The design, medicinal chemistry, pharmacokinetics and development of the highly selective α2-adrenoceptor antagonist fluparoxan are reviewed. METHOD The drug's activity and selectivity in vitro, its efficacy in animals and its excellent oral pharmacokinetics and central α2-adrenoceptor antagonist activity in man, are evaluated as well as its ability to increase extracellular levels of noradrenaline, dopamine and acetylcholine in vivo. CONCLUSION Furthermore, its potential for the treatment of central neurodegenerative diseases is highlighted, in particular its improvement of cognitive dysfunction in schizophrenia and in models of Alzheimer's disease.
Java Security: Issues and Implications for Library and Archival Systems

As a computer programming language, Java has advantages over other languages in a number of aspects. For library and archival systems, two advantages of Java are worth noting: Java's capabilities for processing distributed information resources and for providing executable Web contents. Although there has been no report on attacks to library and archival system servers or to library users who loaded applets from library Web servers, security issues exist for Java programs. This article delineates attendant security concerns and outlines measures which system administrators may use to address them.
German Vowel Lengthening: Causes and Conditions

Investigations of vowel lengthening and shortening in German have sought to identify either the ultimate cause of these changes, e.g., the need to achieve an ideal and uniform word length, or the specific conditions for them, e.g., open vs. closed syllable. Little light has been shed on the problem since Paul's formulation of 1884. Typically absent are references to real evidence that might be adduced from Middle and Early New German orthographic practices.
Influence of sedimentation on the threshold for Soret-driven convection in colloidal suspensions.

The onset of Soret-driven convection in a horizontal layer of a colloidal suspension is investigated by considering a particulate medium model. We consider a dilute suspension of spherical solid particles being subjected to convection in a Rayleigh-Benard geometry setup. The mathematical model takes into account the effects of thermophoresis, particle sedimentation, and Brownian diffusion. The equations governing the convective motion consist of the momentum equation which includes an extra body force term to account for the thermophoretic force effect, the conservation of particles equation whose mass-flux term couples the Soret and particle diffusion effects and whose advective term includes the sedimentation force, and the heat and mass balance equations. The horizontal boundaries are assumed rigid, perfectly thermally conducting, and impervious to mass flow. Furthermore, the model makes use of the effective viscosity of the suspension whose dependence on the particle concentration is through Einstein's formula. Moreover, we take into account the decrease of both the coefficient of Brownian diffusion and the mixture thermal diffusion with particle concentration due to the particles hindrance effect. The nondimensionalization leads to the emergence of an experimental parameter, β, which depicts the competition between the effects of thermophoresis, sedimentation, and particle diffusion. The parameter β is a function of the particles radius, the shape of which is an inverted parabola having two zeros. A combination of asymptotic and numerical computations is used to determine the threshold for the onset of the mass dominated convection, which corresponds to 0<β≪1. Our findings shed light on the role of particle sedimentation and particle size, as well as the influence of other processing variables on the fluid instability.
Increasing Access to Dental Care Through Primary Health Care Prodiver Education

Recent research has identified that the historical approach to Early Childhood Caries (ECC) has changed. It is now imperative to screen and treat infants, toddlers, and their mothers to identify those at risk and begin an intervention program during pregnancy and throughout infancy. It is often the primary health care provider, such as physicians, physician9s assistants (PA9s), nurses, and pediatric specialists who see these young people before they see a dental health care professional. Currently, caries education and prevention is not included in any of these program curricula within the University of South Dakota (USD) other than the dental hygiene program. Like most other states, South Dakota has an access to dental care crisis. The percentages of third graders in South Dakota with a decay history (67%) and untreated decay (30%) are both much higher than the national goals of 42% and 21%, respectively, of Healthy People 2010. The purpose of this educational pilot project is to supply basic knowledge of ECC, fluoride varnish application, and the preventive role of xylitol and chlorhexidine to PA students. Evaluation mechanisms include a pretest and posttest measuring a change in students9 knowledge base. An increase in knowledge has been shown. Expansion of the project includes educating USD medical and nursing students, and mentoring and observing these health care providers as they implement these prevention strategies during clinical rotations. It is the goal of this project to increase access to dental care through primary health care providers who will perform oral screenings and implement prevention strategies during well-baby checks, immunization appointments, and prenatal care.
54Mn Radiotracers Demonstrate Continuous Dissolution and Reprecipitation of Vernadite (δ-MnO2) during Interaction with Aqueous Mn(II)

54Mn radiotracers were used to assess Mn atom exchange between aqueous Mn(II) and vernadite (δ-MnO2) at pH 5.0. Continuous solid–liquid redistribution of 54Mn atoms occurred, and systems are near isotopic equilibrium after reaction for 3 months. Despite this extensive exchange, X-ray diffraction and X-ray absorption spectroscopy data showed no major changes in vernadite bulk mineralogy. These results demonstrate that the vernadite–Mn(II) interface is dynamic, with the substrate undergoing continuous dissolution and reprecipitation mediated by aqueous Mn(II) without observable impacts on its mineralogy. Interfacial redox reactions between adsorbed Mn(II) and solid-phase Mn(IV) and Mn(III) are proposed as the main drivers of this process. Interaction between aqueous Mn(II) and structural Mn(III) likely involves interfacial electron transfer coupled with Mn atom exchange. The exchange of aqueous Mn(II) and solid-phase Mn(IV) is more complex and is proposed to result from coupled interfacial comproportionatio...
Contour and Surface Plots

This chapter covers the basics of plotting contour, surface, and shaded surface plots using CONTOUR, SURFACE, and SHADE_SURF. When using these plotting routines, the user should start by using the default options, and gradually add options to get the final plot that is desired. Some trial and error is often necessary to get all of the details of contour and surface plots correct. Contour plots are one way to graphically represent the values of a function of two variables, such as z(x, y). Familiar examples of contour plots are topographic maps used for outdoor activities. Contours or isopleths are lines that connect points of equal value (equal altitude in the case of a topographic map). Contour plots are drawn with the CONTOUR procedure. CONTOUR takes three positional parameters, z, x, and y, which can take several different forms. This chapter covers only the simplest form, where z is a two-dimensional array, z(nx,ny). CONTOUR has many optional keyword parameters that enable you to control almost every aspect of the plot. CONTOUR-specific keywords are principally used to control properties of the contour lines (contour value, color, line width, line style, and labeling). Additionally, CONTOUR accepts most of the keywords accepted by PLOT. The second method for plotting a function of two variables is wire-mesh plot. Interactive Data Language (IDL) can draw wire-mesh plots using the SURFACE procedure. The third method for plotting a function of two variables is a smooth rendered surface that can be plotted with the SHADE_SURF procedure.
Titanium-based zeolitic imidazolate framework for chemical fixation of carbon dioxide

A titanium-based zeolitic imidazolate framework (Ti-ZIF) with high surface area and porous morphology was synthesized and its efficacy was demonstrated in the synthesis of cyclic carbonates from epoxides and carbon dioxide.
The Michigan Experience with Safety and Effectiveness of Tranexamic Acid Use in Hip and Knee Arthroplasty.

Background: The efficacy of tranexamic acid (TXA) in reducing blood loss and transfusion requirements in total hip and knee arthroplasty has been well established in small controlled clinical trials and meta-analyses. The purpose of the current study was to determine the risks and benefits of TXA use in routine orthopaedic surgical practice on the basis of data from a large, statewide arthroplasty registry. Methods: From April 18, 2013, to September 30, 2014, there were 23,236 primary total knee arthroplasty cases and 11,489 primary total hip arthroplasty cases completed and registered in the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI). We evaluated the association between TXA use and hemoglobin drop, transfusion, length of stay (LOS), venous thromboembolism (VTE), readmission, and cardiovascular events by fitting mixed-effects generalized linear and mixed-effects Cox models. We used inverse probability of treatment weighting to enhance causal inference. Results: For total hip arthroplasty, TXA use was associated with a smaller drop in hemoglobin (mean difference = −0.65 g/dL; 95% confidence interval [CI] = −0.60 to −0.71 g/dL), decreased odds of blood transfusion (odds ratio [OR] = 0.72; 95% CI = 0.60 to 0.86), and decreased readmissions (OR = 0.77; 95% CI = 0.64 to 0.93) compared with no TXA use. There was no effect on VTE (hazard ratio [HR] = 0.91; 95% CI = 0.62 to 1.33), LOS (incident rate ratio [IRR] = 1.00; 95% CI = 0.97 to 1.03), or cardiovascular events (OR = 0.85; 95% CI = 0.47 to 1.52). For total knee arthroplasty, TXA was associated with a smaller drop in hemoglobin (mean difference = −0.68 g/dL; 95% CI = −0.64 to −0.71 g/dL) and one-fourth the odds of blood transfusion (OR = 0.26; 95% CI = 0.21 to 0.31). There was an association with decreased risk of VTE within 90 days after surgery (HR = 0.56; 95% CI = 0.42 to 0.73), slightly decreased LOS (IRR = 0.93; 95% CI = 0.92 to 0.95), and no association with readmissions (OR = 0.90; 95% CI = 0.79 to 1.04) or cardiovascular events (OR = 1.12; 95% CI = 0.74 to 1.71). Conclusions: In routine orthopaedic surgery practice, TXA use was associated with decreased blood loss and transfusion risk for both total knee and total hip arthroplasty, without evidence of increased risk of complications. TXA use was also associated with reduced risk of readmission among total hip arthroplasty patients and reduced risk of VTE among total knee arthroplasty patients, and did not have an adverse effect on cardiovascular complications in either group. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Domain-specific accuracy of the Montreal Cognitive Assessment subsections in Parkinson's disease.

Abstract Objective The Montreal Cognitive Assessment (MoCA) is among the most widely adopted screening tools for cognitive impairment because it includes tests in multiple domains and is available in 55 languages. The MoCA is often the only formal cognitive assessment available when comprehensive neuropsychological testing is not practical, such as rural clinical settings or large retrospective and multi-lingual research settings. However, the MoCA domain-specific subsections have never been formally assessed for sensitivity or specificity. Therefore, in Parkinson's disease, we examined whether the subsections of the MoCA could identify cognitive impairment within specific cognitive domains. Methods We administered a comprehensive neuropsychological battery to 85 Parkinson's disease participants, who were then categorized as with or without cognitive impairment, with respect to global cognition and in five cognitive domains. We then assessed the domain-specific categorization of the MoCA subsections compared to the full neuropsychology battery. Results All MoCA subsections predicted impairment in their respective cognitive domain. However, the executive subsection showed the highest sensitivity and specificity (89.3% and 82.5%, respectively), followed by visuospatial (93.3% and 45.7%, respectively) and memory (84.6% and 56.5%, respectively). Conclusion The MoCA is a useful screening tool for PD global cognitive and executive functions. The MoCA is also highly sensitive to visuospatial and memory impairment, but with limited specificity and accuracy these subsections should be interpreted with caution.
Public sector low threshold office-based buprenorphine treatment: outcomes at year 7.

Buprenorphine maintenance for opioid dependence remains of limited availability among underserved populations, despite increases in US opioid misuse and overdose deaths. Low threshold primary care treatment models including the use of unobserved, “home,” buprenorphine induction may simplify initiation of care and improve access. Unobserved induction and long-term treatment outcomes have not been reported recently among large, naturalistic cohorts treated in low threshold safety net primary care settings. This prospective clinical registry cohort design estimated rates of induction-related adverse events, treatment retention, and urine opioid results for opioid dependent adults offered buprenorphine maintenance in a New York City public hospital primary care office-based practice from 2006 to 2013. This clinic relied on typical ambulatory care individual provider-patient visits, prescribed unobserved induction exclusively, saw patients no more than weekly, and did not require additional psychosocial treatment. Unobserved induction consisted of an in-person screening and diagnostic visit followed by a 1-week buprenorphine written prescription, with pamphlet, and telephone support. Primary outcomes analyzed were rates of induction-related adverse events (AE), week 1 drop-out, and long-term treatment retention. Factors associated with treatment retention were examined using a Cox proportional hazard model among inductions and all patients. Secondary outcomes included overall clinic retention, buprenorphine dosages, and urine sample results. Of the 485 total patients in our registry, 306 were inducted, and 179 were transfers already on buprenorphine. Post-induction (n = 306), week 1 drop-out was 17%. Rates of any induction-related AE were 12%; serious adverse events, 0%; precipitated withdrawal, 3%; prolonged withdrawal, 4%. Treatment retention was a median 38 weeks (range 0–320) for inductions, compared to 110 (0–354) weeks for transfers and 57 for the entire clinic population. Older age, later years of first clinic visit (vs. 2006–2007), and baseline heroin abstinence were associated with increased treatment retention overall. Unobserved “home” buprenorphine induction in a public sector primary care setting appeared a feasible and safe clinical practice. Post-induction treatment retention of a median 38 weeks was in line with previous naturalistic studies of real-world office-based opioid treatment. Low threshold treatment protocols, as compared to national guidelines, may compliment recently increased prescriber patient limits and expand access to buprenorphine among public sector opioid use disorder patients.
GALNT14 genotype is associated with perineural invasion, lymph node metastasis and overall survival in resected cholangiocarcinoma

Cholangiocarcinoma is a rare, sporadic and aggressive type of cancer. The genetic basis of cholangiocarcinoma remains poorly understood. The present study investigated the prognostic role of the N-acetylgalactosaminyltransferase 14 (GALNT14)-rs9679162 genotype, an effective therapeutic response predictor for hepatocellular carcinoma in patients with cholangiocarcinoma receiving surgical resection. A cohort of patients with intrahepatic or perihilar cholangiocarcinoma (n=112) were retrospectively recruited. Of these patients, 31.3, 49.1 and 19.6% had GALNT14 'TT', 'TG' and 'GG' genotypes, respectively. The patient's genotype distributions did not deviate significantly from those of the ethnic reference cohorts, HapMap-Chinese Han Beijing and Chinese Han Metropolitan Denver. The genotype 'TT' was associated with unfavorable overall survival in univariate analysis (P=0.023). Furthermore, two tumor characteristics, perineural and vascular invasion, were independently associated with unfavorable overall survival (P=0.001 and P=0.002, respectively). The 'TT' genotypes were independently associated with two known predictors of unfavorable prognosis, perineural invasion (P=0.035) and lymph node metastasis (P=0.005) in a multivariate linear regression analysis. When compared with the two reference genotype cohorts, the 'TT' genotype was significantly higher in patients with perineural invasion (P=0.049, Beijing cohort; P=0.034, Denver cohort). Similar enrichment of the 'TT' genotype was also revealed in patients with lymph node metastasis (P=0.046, Beijing cohort; P=0.032 Denver cohort). In conclusion, the GALNT14-rs9679162 'TT' genotype was associated with perineural invasion and lymph node metastasis, as well as unfavorable overall survival in patients with resected cholangiocarcinoma.
The Activity of Some Hydrolytic Enzymes in the Brain After Administration of “Cynkotox”

The effect of peroral administration of “Cynkotox” (diethyl-dithio-carbamate, zinc salt) on the his to enzymatic activity of the brain was examined. 1.0 g of Cynkotox was given daily to adult Wistar rats over a period of 10 days (the per os DL50 for rats is 5 200 mg/kg of body weight).
Effects of Dimethylnitrosamine

The possibility that chemicals found in the environment can suppress certain immune responses is one of the cornerstones of immunotoxicology. The nitrosamines represent an environmentally important group of compounds that includes dimethylnitrosamine (DMN, N-Nitrosodimethylamine). DMN is a potent carcinogen in several rodents (Magee and Barnes, 1967) and is a suspected carcinogen in man (Craddock, 1983). N-nitroso compounds are formed when primary, secondary, or tertiary amines react with nitrogen oxides or nitrite (Ember, 1980). Studies have shown that the generation of nitrosamines occurs not only in the external environment, but may also occur in the human stomach (Sander, 1967). Later investigations showed that several species of bacteria, including Escherichia coli, were capable of forming nitrosamines from secondary amines and nitrites (Montesano and Magee, 1970). Therefore, the possibility of nitrosamine formation in the digestive tract coupled with the possibily for direct exposure to the preformed nitrosamines in the environment via ingestion, inhalation, or dermal contact suggest a potential hazard for the population at large.
El materialismo histérico: Derivados Iberoamericanos del neoliberalismo vistos por la lente narratoria de Xavier Velasco

Through his collection of short stories El materialismo histerico (2004) Mexican writer Xavier Velasco presents various narrative depictions of the increasing socioeconomic gap in Mexico between rich and poor in recent years in that has been clearly induced by the global onslaught of neoliberalism. With varying degrees of realism his work decisively and clearly treats the economic, social, and even psychological effects that have been asserted by a select body of scholars as the factual ramifications of the mentioned global phenomenon over essentially the entire planet. With his geographic focus on Spanish America towards the turn of the 21st century and by having as its central theme both the salient and also more esoteric impacts of economic globalization during said time period, the work creatively represents not just the visually discernible repercussions of globalization but it is noteworthy that Velasco delves also into the elusive facets of the human psyche. In this way his writing distinguishes itself for its ambitious attempt to achieve, albeit through the hypothetical lens of narrative fiction, a more comprehensive and thus more realistic depiction. Due to its life-like and inclusive illustrations of the historical issues described above, Velasco's short stories provide an intriguingly vivid and verisimilar representation of a critical era for the population of Latin America, or rather that of the nation of Mexico.
Click me: an examination of the impact size, color, and design has on banner advertisements generating clicks

Banner advertisements are either ignored or criticized and rarely receive clicks. However, companies tend to use consistent messages but vary the visual characteristics to entice clicks. This study examined 22,978 instances of banner placements measured in weeks from an insurance company in 2016. Results point to the 300 × 250 size, blue ads, and static design generating more clicks than larger sizes, red ads, and animated designs.
Thiazide diuretic usage and risk of fracture: a meta-analysis of cohort studies.

Inconsistent findings in regard to association between thiazide diuretic use and the risk of fracture have been reported during the past decade. This updated meta-analysis, which pooled data from 11 qualified prospective designed studies, found that thiazides have a significant protective effect on fracture risk. An updated comprehensive meta-analysis examine the association between thiazide diuretic use and therisk of fracture is needed. Cohort studies regarding thiazide diuretic exposure and the risk of fracture, published from inception to May 1 2017, were identified through MEDLINE, EMBASE, SCOPUS, and the Cochrane Database of Systematic Reviews. The literature search, study selection, study appraisal, and data extraction were pre-defined in the protocol and were independently conducted by two investigators. Due to the heterogeneity of the original studies, a random effects model was used to pool the confounder-adjusted relative risk (RR). Eleven eligible cohort studies involving 2,193,160 participants were included for analysis. Overall, thiazide diuretic users, as compared with non-users, had a significant 14% reduction in the risk of all fractures (relative risk [RR], 0.86; 95% confidence interval [CI], 0.80–0.93; p = 0.009) and an 18% reduction in the risk of hip fracture (RR, 0.82; 95%CI, 0.80–0.93; p = 0.009). However, the effect size associated with thiazide use became slightly weaker when the analysis was limited to only high-quality original studies (quality score > 8) (RR, 0.89; 95%CI, 0.80–0.99; p = 0.005), studies with a larger sample size (> 10,000) (RR, 0.90; 95%CI, 0.80–1.00; p = 0.002), and studies published after 2007 (RR, 0.92; 95%CI, 0.82–1.02; p = 0.001). Our findings indicate that thiazide diuretic use may convey a decreased risk of fracture and as such, the protective effect of this class of medicine should be considered when prescribing thiazide diuretics in clinical practice.
Change in DSM‐5 Alcohol Use Disorder Criteria Count and Severity Level as a Treatment Outcome Indicator: Results from a Randomized Trial

BACKGROUND Most clinical trials evaluating treatments for alcohol use target individuals meeting diagnostic criteria for alcohol use disorder (AUD), but few address change in diagnostic status following treatment or as a potential outcome indicator. This study evaluated whether DSM-5 AUD total criteria count or severity category was sensitive to change over time and treatment effects. METHODS Data were drawn from a randomized clinical trial that evaluated the efficacy of computer-based cognitive behavioral therapy program (CBT4CBT) for AUD. Sixty-eight individuals were randomized to 1 of the 3 weekly outpatient treatments for an 8-week period: (i) treatment as usual (TAU), (ii) TAU+CBT4CBT, and (iii) CBT4CBT+brief monitoring. Structured clinical interviews were used to determine current (past 30 days) AUD diagnosis at baseline, end-of-treatment, and 6 months following end-of-treatment. Change in the total number of DSM criteria endorsed, as well as severity categories (mild, moderate, severe), was evaluated across time and by treatment condition. RESULTS Generalized Poisson's linear mixed models revealed a significant reduction in the number of DSM criteria from baseline to treatment end point [time effect χ2 (1) = 35.54, p < 0.01], but no significant interactions between time and treatment condition. Fewer total criteria endorsed, as well as achieving at least a 2-level reduction in AUD severity category at end-of-treatment, were associated with better outcomes during follow-up. Chi-square results indicated a greater proportion of individuals assigned to TAU+CBT4CBT had at least a 2-level reduction in severity category compared to TAU, at trend-level significance [χ2 (2, 54) = 5.13, p = 0.07], consistent with primary alcohol use outcomes in the main trial. CONCLUSIONS This is the first study to demonstrate change in DSM-5 AUD total criteria count, as well as severity category, in a randomized clinical trial. These findings offer support for their use as a potential clinically meaningful outcome indicator.
The Theory of Skin Friction Reduction by a Compliant Coating in a Turbulent Boundary Layer

The response of a compliant surface to pressure fluctuations is known to modify (sometimes decrease) the skin friction in a turbulent boundary layer. This paper develops the surface response (receptance) of a compliant coating to a pressure perturbation. The compliant coating was assumed to be composed of a thin membrane stretched over a shallow layer of liquid. This type of coating has been used successfully by several experimenters to reduce the skin friction. After the surface response equation was developed, the technique developed by Lin and Ffowcs Williams was utilized to determine the Reynolds stresses induced near the vibrating compliant surface. The technique is generalized to allow for random turbulent pressure fluctuations and surface motion, but it is restricted to two-dimensional surface oscillations. The interesting result is that certain combinations of the properties of the compliant coating may induce a negative Reynolds stress in the layer of fluid adjacent to the coating. This layer of fluid may then be responsible for starving the turbulent eddies of their energy supply and causing a reduction in turbulence intensity and skin friction.
Cytotaxonomical studies in the genusThespesia

BetweenThespesia populnea andT. lampas, more attention has been given to review the taxonomic status of the latter. The stigma ofT. lampas resembles with that ofT. populnea, whereas many other characters such as habit, gland on the midrib, non-caducous involucre, calyx teeth and capsule shape differ fromT. populnea. They also differ in their ecological adaptations. The chromosome number is found to be 2n=26 in both of them indicating their relationship. They also possess different chromosome numbers having 2n=28 inT. lampas and 2n=24 inT. populnea. Further, they fall apart from each other in size of the chromosomes. The cytological results and morphological characters, therefore, suggest the removal ofT. lampas fromThespesia.
Deficits in Planning Sequential Goal-Directed Action Impact Motor Execution in Children With Hemiplegic Cerebral Palsy: A Kinematic Analysis

There is mounting experimental evidence that suggests children with hemiplegic cerebral palsy (HCP) lack the ability to properly plan their motor actions. The purpose of this investigation was to determine how these planning deficits might affect the ability of children with HCP to execute a complex sequence of actions that have different final end states in the hand/arm position. Thirteen children with HCP (age = 6.8 ± 2.9 yrs, Manual Ability Classification levels = II–IV) and 15 typically developing (TD) children (age = 5.8 ± 1.1 yrs) completed a sequential motor task that involved reaching to grasp an object and place it into six-different target positions. Each target had a biomechanically different final hand/arm position for placing the object. A three-dimensional motion capture system was used to calculate the resultant spatiotemporal kinematics of a marker that was placed on the hand. In addition, video analysis was used to quantify the child’s reaction time, end-state comfort effect, and task fai...