cssi/SciSciGPT-SciSciNet huggingface dataset:
Will bevacizumab biosimilars impact the value of systemic therapy in gynecologic cancers

Bevacizumab is an important component in the treatment of various cancers, and despite guidelines recommending its use in both ovarian and cervical cancer, patient access to bevacizumab and other angiogenesis inhibitors is limited. Biosimilars are large, structurally complex molecules that are intended to be highly similar to, and treat the same condition(s) as, an existing licensed or approved (reference) biologic, with no clinically meaningful differences in purity, potency and safety. This article summarizes the role of bevacizumab in the treatment paradigm of ovarian and cervical cancer. We also discuss the potential role of biosimilars to bevacizumab, which may offer more affordable options in the future treatment of gynecologic cancers. Literature searches of PubMed and ClinicalTrials.gov databases were conducted. Regulatory and individual pharmaceutical company web pages were also reviewed. Search terms included “biosimilar” and “bevacizumab,” and these were used to identify information regarding biosimilar development, reporting results of biosimilar studies or biosimilars in development. At present, four bevacizumab biosimilar candidates are undergoing comparative clinical assessment, with the potential to increase access and offer efficiencies across healthcare systems. It is anticipated that biologics such as bevacizumab will continue to play a key role in the treatment of an array of gynecologic cancers. Biosimilars to bevacizumab are currently in development and have the potential to increase access to medicines in a variety of settings, including gynecologic cancers.
Recomendaciones para la prevención de infecciones relacionadas con demoliciones, construcciones y remodelaciones

Las demoliciones, construcciones y/o remodelaciones pueden provocar infecciones intrahospitalarias en pacientes con factores de riesgos, especialmente aspergilosis pulmonar. En la presente guia se describen algunas medidas que pueden ayudar a mitigar estas infecciones en los distintos recintos hospitalarios
The Impact of a Multi-Level Multi-Component Childhood Obesity Prevention Intervention on Healthy Food Availability, Sales, and Purchasing in a Low-Income Urban Area

The multifactorial causes of obesity require multilevel and multicomponent solutions, but such combined strategies have not been tested to improve the community food environment. We evaluated the impact of a multilevel (operating at different levels of the food environment) multicomponent (interventions occurring at the same level) community intervention. The B'more Healthy Communities for Kids (BHCK) intervention worked at the wholesaler (n = 3), corner store (n = 50), carryout (n = 30), recreation center (n = 28), household (n = 365) levels to improve availability, purchasing, and consumption of healthier foods and beverages (low-sugar, low-fat) in low-income food desert predominantly African American zones in the city of Baltimore (MD, USA), ultimately intending to lead to decreased weight gain in children (not reported in this manuscript). For this paper, we focus on more proximal impacts on the food environment, and measure change in stocking, sales and purchase of promoted foods at the different levels of the food system in 14 intervention neighborhoods, as compared to 14 comparison neighborhoods. Sales of promoted products increased in wholesalers. Stocking of these products improved in corner stores, but not in carryouts, and we did not find any change in total sales. Children more exposed to the intervention increased their frequency of purchase of promoted products, although improvement was not seen for adult caregivers. A multilevel food environment intervention in a low-income urban setting improved aspects of the food system, leading to increased healthy food purchasing behavior in children.
Modules over plane curve singularities in any ranks and DAHA

Abstract We generalize the construction of geometric superpolynomials for unibranch plane curve singularities from our prior paper from rank one to any ranks; explicit formulas are obtained for torus knots. The new feature is the definition of counterparts of Jacobian factors (directly related to compactified Jacobians) for higher ranks, which is parallel to the classical passage from invertible sheaves to vector bundles over algebraic curves. This is an entirely local theory, connected with affine Springer fibers for non-reduced (germs of) spectral curves. We conjecture and justify numerically the connection of our geometric polynomials in arbitrary ranks with the corresponding DAHA superpolynomials for any algebraic knots colored by columns.
Mesenchymal Stromal Cells and Cutaneous Wound Healing: A Comprehensive Review of the Background, Role, and Therapeutic Potential

Cutaneous wound repair is a highly coordinated cascade of cellular responses to injury which restores the epidermal integrity and its barrier functions. Even under optimal healing conditions, normal wound repair of adult human skin is imperfect and delayed healing and scarring are frequent occurrences. Dysregulated wound healing is a major concern for global healthcare, and, given the rise in diabetic and aging populations, this medicoeconomic disease burden will continue to rise. Therapies to reliably improve nonhealing wounds and reduce scarring are currently unavailable. Mesenchymal stromal cells (MSCs) have emerged as a powerful technique to improve skin wound healing. Their differentiation potential, ease of harvest, low immunogenicity, and integral role in native wound healing physiology make MSCs an attractive therapeutic remedy. MSCs promote cell migration, angiogenesis, epithelialization, and granulation tissue formation, which result in accelerated wound closure. MSCs encourage a regenerative, rather than fibrotic, wound healing microenvironment. Recent translational research efforts using modern bioengineering approaches have made progress in creating novel techniques for stromal cell delivery into healing wounds. This paper discusses experimental applications of various stromal cells to promote wound healing and discusses the novel methods used to increase MSC delivery and efficacy.
Effect of Plasmonic Interaction of Different Nanoparticles

We observed plasmon resonance peaks at two different wavelengths by combining the plasmon waves from aluminum (Al) and gold (Au) nanoparticles (NPs). We used electron-beam lithography along with angle metal evaporation techniques to deposit a metal particle plasmon layer with nanometer-scale separation. The coupled plasmon layer has two peaks at 525 nm and 650 nm, which are different from the constituent individual metal plasmon layers of Al and Au NPs with peaks at 500 nm and 700 nm respectively. The experimental findings agree with absorption data from COMSOL modeling results due to interaction of two nanoscale plasmon particles.
Desegregation, Jigsaw, and the Mexican-American Experience

In 1954, when the U.S. Supreme Court outlawed school segregation, hopes ran high that we might be on our way to a better society. At that time, many of us believed that, if only youngsters from various ethnic and racial backgrounds could share the same classroom, negative stereotypes would fade and cross-ethnic friendships would develop under the glow of contact. Ultimately, it was believed, these young people would grow into adults who would be largely free of the racial and ethnic prejudice that had plagued our society since its inception.
Effects of carbon monoxide on cardiac muscle cells in culture

Embryonic rat cardiac muscle cells grown in the presence of various tensions of CO (5-95%) without the presence of O2 survived and exhibited reduced cell growth, which was concentration dependent. When cardiac muscle cells were grown in the presence of a mixture of CO (10-20%) and O2 (10-20%), the growth rate of these cells was comparable to that of the control cells. Cardiac myocytes continued to beat when exposed to varying tensions of CO, except in the case of 95% CO. The cells exposed to different concentrations of CO contained fewer myofibrils of different stages of differentiation compared with the control and the culture exposed to a mixture of 20% O2 and 20% CO, with cells that contained abundant, highly differentiated myofibrils. There was no significant difference in the structural organization of mitochondria between the control and the surviving experimental cells. It is evident from the present studies that O2 is required for the optimum in vitro cellular growth of cardiac muscle. Furthermore, CO in combination with O2 at a concentration of 10 or 20% can produce optimal growth of cardiac muscle cells in culture.
An in Vitro Assay for Retinotectal Specificity

The acquisition of form by developing organisms was one of the first biological problems considered by man. Despite this early start, however, biochemical analyses of morphogenetic movements have lagged far behind those of other biological specialities such as physiology and genetics. The lack of information about morphogenesis at the molecular level is directly attributable to the lack of information at the cell and tissue levels. It is only recently that we have come to understand that morphogenetic movements are the results of cellular properties and not of external forces of unknown origins that work their ways on cells like the wind on trees.
Maternal Metabolic and Endocrine Imbalances

An understanding of how maternal metabolic and endocrine disturbances alter embryonic and fetal development requires a knowledge of the control systems that exist in the mother and in the fetus and how these interact with each other. Physiologic and metabolic conditions in the perinatal period are excluded and emphasis is placed on the first half of gestation. Each topic to be covered will be introduced by a brief discussion of existing information on fetal function, the interrelation between maternal and fetal system, and clinical and experimental observations.
Translating Research as an Approach to Enhance Science Engagement.

The impact of research depends on the effective communication of discoveries. Scientific writing is the primary tool for the dissemination of research, and is an important skill that biomedical trainees have to develop. Despite its importance, scientific writing is not part of the mainstream curriculum. One strategy used to teach scientific writing is holding a journal club style discussion of primary research literature that the students are asked to read. However, this activity can result in a passive learning experience and limit the development of trainees’ scientific writing skills. In order to improve trainees’ written communication skills, we tested an exercise that involved generating a revised article describing prior research, in essence “translating” the science into basic language. Following the guidelines set out by “Frontiers for Young Minds” and feedback received from “Young Reviewers”, we wrote a revised article with a simpler description of the research. In this article, we describe this scientific writing exercise, which may ultimately serve as a model for scientists to share their research more efficiently in order to promote better public health outcomes.
P-017 Safety and efficacy of intracranial dural venous sinus stenting

Objective Currently, Dural venous sinus stenting (DVSS) has appeared as a prospective therapy for venous hypertension. However, there remains considerable ambiguity over the safety and efficacy of this procedure, in particular, the incidence of intraprocedural and delayed complications and in the durability of sinus patency and satisfactory clinical outcome. The aim of this study was to determine clinical, radiological, and manometric outcomes after DVSS in this cohort. Methods This is a retrospective case series of venous stenting during the period of Feb 2013 to Jun 2017 at the University of Virginia. The Clinical, radiographic, and manometric data before and after DVSS were reviewed. All venographic and manometric procedures were performed both under local anesthesia and general anesthesia with the patient supine. Results 125 patients underwent a total of 146 procedures of DVSS. 117 (92.8%) were female, the mean age 32.2±12.4 years with a median BMI of 31±10. The median clinical and radiological follow up are 127 and 90 days. The mean preop gradient is 12.2±11.8 and the post-stent gradients were 1.7±2.6 and the reduction in gradient was achieved in all patients with obliteration of significant anatomical stenosis. At the last follow up clinical improvement noted in 60.8% and needed repeat stenting in 14 patients. The procedural complication rates occurred in 6/125 (4.8%) which includes death in one patient, femoral pseudoaneurysm in 2 and catheter tip fracture in one and contrast extravasation in one and improper stent dislodgement in one. Nonflow limiting in-stent and adjacent stent stenosis noted in 14/125 (11.2%) patients and adjacent stenosis only noted in 4/125 (3.2%) patients. Conclusions DVSS is one of the alternative modalities of treatment in increased venous pressure which is associated with less number of complications and moderate efficacy. To definitively compare the outcomes between DVSS and other modalities, a randomized prospective study is needed. Disclosures M. Patibandla: None. C. Chen: None. Y. Kalani: None. M. Park: None. K. Liu: None.
A Jim Crow State of Mind: The Racialization of Space in the McKinney, Texas Pool Party Incident:

Violence against Black bodies is not new, but contemporary discussions of these matters often focus on police or other state-sanctioned violence against male Black bodies. While this is important, ...
Outcomes of Femoral Artery Ligation for Treatment of Infected Femoral Pseudoaneurysms due to Drug Injection

Abstract Objective Infected femoral artery pseudoaneurysms (IFAPs) are a known complication of illicit intravenous drug injection. As the opioid crisis in our country continues to worsen, we will likely see more IFAPs and algorithms for management of these patients will need to be elucidated. The aim of this study was to describe the surgical management and outcomes of patients presenting with IFAPs treated with femoral artery ligation. Methods This is a single-center, retrospective study of consecutive patients presenting to our institution with IFAPs associated with illicit drug injection between 2004 and 2017 and treated with primary ligation. Primary end points included major adverse limb events (MALE) and death. Baseline demographics, clinical features, and long-term outcomes were recorded. Results Over the study period, 60 IFAPs were managed with arterial ligation in 58 patients. Fifty-two percent of patients underwent common femoral artery ligation, 30% of patients underwent a triple ligation (ligation of the common femoral artery, profunda femoris artery, and superficial femoral artery), and 18% of patients underwent ligation of the superficial femoral artery only. The average postoperative ankle-brachial index was 0.47. None of the patients underwent revascularization at the index procedure. In our early experience, four patients (6.6%) underwent delayed revascularization with a prosthetic bypass. Two of the patients subsequently re-presented with infected bypass grafts and required the only major amputations in our series. The mean follow-up was 51.3 months and four patients were lost to follow-up. No differences were identified in MALE between patients undergoing a femoral artery ligation vs a triple ligation. Nine patients (15%) died during the follow-up period and all deaths were unrelated to IFAP treatment; the mean survival from procedure to death was 28 months. Conclusions We describe the largest series in the United States of IFAP related to illicit drug use treated with femoral artery ligation and found it is a safe procedure associated with low MALE. Reconstruction is not recommended and is associated with graft infection. Although the mortality rate in these patients was high, it was not related to the ligation procedure.
Nuclear modification of leading hadrons and jets within a virtuality ordered parton shower

The event generator based on the higher-twist energy loss formalism---Modular All Twist Transverse-scattering Elastic-drag and Radiation (Matter)---is further developed and coupled to a hydrodynamic model for studying jet modification in relativistic nuclear collisions. The probability of parton splitting is calculated using the Sudakov form factor that is constructed by a combination of vacuum and medium-induced splitting functions; and the full parton showers are simulated, including both energy-momentum and space-time evolutions of all jet partons. With the assumption that partons below a virtual scale of 1 GeV is absorbed by the medium, this framework is able to provide a reasonable description of the nuclear modification of both leading hadrons and jets at high transverse momentum at the BNL Relativistic Heavy Ion Collider and the CERN Large Hadron Collider.
Hereditary Trichilemmal Cysts are Caused by Two Hits to the Same Copy of the Phospholipase C Delta 1 Gene (PLCD1).

The autosomal dominant presentation of trichilemmal cysts is one of the most common single gene familial diseases in humans. However, the genetic basis for the inheritance and genesis of these lesions has remained unknown. We first studied patients with multiple trichilemmal cysts using exome and Sanger sequencing. Remarkably, 21 of 21 trichilemmal cysts from 16 subjects all harbored a somatic p.S745L (c.2234 G > A) mutation in phospholipase C delta 1 (PLCD1), a proposed tumor suppressor gene. In addition to this specific somatic mutation in their tumors, 16 of the 17 subjects with multiple trichilemmal cysts were also heterozygous for a p.S460L (c.1379 G > A) germline variant in PLCD1 which is normally present in only about 6% of this population. The one patient of 17 that did not show the p.S460L germline variant had a germline p.E455K (c.1363 C > T) mutation in the same exon of PLCD1. Among 15 additional subjects, with a history suggesting a single sporadic trichilemmal cyst, six were likely familial due to the presence of the p.S460L germline variant. Of the remaining truly sporadic trichilemmal cysts that could be sequenced, only half showed the p.S745L somatic mutation in contrast to 100% of the familial cysts. Surprisingly, in contrast to Knudsen’s two hit hypothesis, the p.S745L somatic mutation was always on the same chromosome as the p.S460L germline variant. Our results indicate that familial trichilemmal cysts is an autosomal dominant tumor syndrome resulting from two hits to the same allele of PLCD1 tumor suppressor gene. The c.1379 G > A base change and neighboring bases are consistent with a mutation caused by ultraviolet radiation. Our findings also indicate that approximately one-third of apparently sporadic trichilemmal cysts are actually familial with incomplete penetrance. Sequencing data suggests that the remaining, apparently sporadic, trichilemmal cysts are genetically distinct from familial cysts due to a lack of the germline mutations that underlie familial cysts and a decreased prevalence of the p.S745L somatic mutation relative to familial trichilemmal cysts.
Virtual reality distraction during pediatric intravenous line placement in the emergency department: A prospective randomized comparison study.

Abstract Objective To evaluate the efficacy of virtual reality distraction (VR) during intravenous line (IV) placement in a pediatric emergency department to increase first-attempt IV success. Secondary endpoints included median time to successful IV placement, patient pain and anxiety scores, and an evaluation of characteristics of patients in whom VR is well tolerated. Study design This was a randomized controlled trial at a tertiary pediatric emergency department, enrolling patients aged 4–17 years who required IV placement. Patients were enrolled only when child life specialists were unavailable. The primary endpoint was first attempt IV success. Results A total of 116 subjects were enrolled, 58 were randomly assigned to the VR group and 58 were assigned to the standard of care (SOC) group. 115 subjects completed the trial and were analyzed. First attempt IV success rates were similar between the groups (VR = 81%, standard = 84.2%, p = .65). Number of IV attempts and changes in pain and anxiety scores were also similar between the groups. The median time to successful IV placement was shorter in the VR group (78 vs 104 seconds) but this difference was not statistically significant (p = .21). Overall the VR headset was tolerated by 79% of subjects assigned to that group. The only significant predictor of headset tolerance was older age (P = .02). Conclusions VR distraction for IV placement in the Pediatric Emergency Department shows similar efficacy to standard distraction techniques and appears to be well tolerated.
Multilevel Item Response Model with Heterogeneous Within-Cluster Variances

Within-cluster variance homogeneity is one of the key assumptions of multilevel models; however, assuming a constant (i.e. equal) within-cluster variance may not be realistic. Moreover, existent wi...
Propensity score matching in otolaryngologic literature: A systematic review and critical appraisal.

Background Propensity score techniques can reduce confounding and bias in observational studies. Such analyses are able to measure and balance pre-determined covariates between treated and untreated groups, leading to results that can approximate those generated by randomized prospective studies when such trials are not feasible. The most commonly used propensity score -based analytic technique is propensity score matching (PSM). Although PSM popularity has continued to increase in medical literature, improper methodology or methodological reporting may lead to biased interpretation of treatment effects or limited scientific reproducibility and generalizability. In this study, we aim to characterize and assess the quality of PSM methodology reporting in high-impact otolaryngologic literature. Methods PubMed and Embase based systematic review of the top 20 journals in otolaryngology, as measured by impact factor from the Journal Citations Reports from 2012 to 2018, for articles using PSM analysis throughout their publication history. Eligible articles were reviewed and assessed for quality and reporting of PSM methodology. Results Our search yielded 101 studies, of which 92 were eligible for final analysis and review. The proportion of studies utilizing PSM increased significantly over time (p < 0.001). Nearly all studies (96.7%, n = 89) specified the covariates used to calculate propensity scores. Covariate balance was illustrated in 67.4% (n = 62) of studies, most frequently through p-values. A minority (17.4%, n = 16) of studies were found to be fully reproducible according to previously established criteria. Conclusions While PSM analysis is becoming increasingly prevalent in otolaryngologic literature, the quality of PSM methodology reporting can be improved. We provide potential recommendations for authors regarding optimal reporting for analyses using PSM.
Sonographic extremity assessment of crotalinae envenomation

The evaluation of a patient after Crotalinae envenomation requires assessment of local and systemic signs and symptoms in conjunction with laboratory data. Point-of-care ultrasound (POCUS) is an em...
Design of an n-type low glass transition temperature radical polymer

We document the design, synthesis, and characterization of the first low glass transition temperature, n-type (i.e., preferentially-reduced) radical polymer. Specifically, a macromolecule composed of a polysiloxane backbone that bears galvinoxyl radical pendant groups, poly[2,6-di-tert-butyl-4-((3,5-di-tert-butyl-4-(λ1-oxidaneyl)phenyl)(4-((3-(methoxydimethylsilyl)propoxy) methyl)phenyl)methylene)cyclohexa-2,5-dien-1-one] (PGMS), was created as our calculations predicted that the galvinoxyl radical molecular structure would facilitate radical–radical aggregation. In turn, this suggested that charge transport would be rapid in these systems, which would lead to large solid-state electronic conductivity values. After the design and successful synthesis of the PGMS radical polymers, their optical, spin, thermal, and electrochemical properties were evaluated in full. These experiments backed the idea that PGMS has a low glass transition temperature and robust electrochemical behavior. Furthermore, when a PGMS macromolecule was cast into a thin film, a solid-state conductivity of 10−2 S m−1 was achieved, and this was despite the fact that only ∼36% of the pendant groups contained a galvinoxyl radical. This high conductivity appears to be a direct result of the radical–radical aggregation that occurs due to the molecular design of the galvinoxyl radical species. Therefore, this work highlights the import of developing next-generation open-shell entities for solid-state radical polymer conductors, and it provides a clear path forward for creating high conductivity, non-conjugated conducting macromolecules.
Systematic review and meta-analysis of retention in treatment using medications for opioid use disorder by medication, race/ethnicity, and gender in the United States.

Abstract Background and Aims There is mounting evidence that opioid use disorder is experienced differently by people of different genders and race/ethnicity groups. Similarly, in the US access to specific medications for opioid use is limited by gender and race/ethnicity. This study aims to evaluate if gender or race/ethnicity is associated with different rates of treatment retention in the US, for each of three medications used to treat opioid use disorder. Methods A systematic search was conducted using PubMed, CINHAL, and PsychINFO, databases. All studies that provided a ratio of those retained in treatment at a specified time in terms of gender and/or race/ethnicity and medication were included. Variables were created to assess the effects of time in treatment, recruited sample, required attendance at concurrent psychosocial treatment, and adherence to strict rules of conduct for continuation in treatment on retention. Meta-analytical and meta-regression methods were used to compare studies on the ratio of those who completed a specific time in treatment by race/ethnicity group and by gender. Results Nineteen articles that provided the outcome variable of interest were found (11 buprenorphine, six methadone, and two naltrexone). Meta-analyses found that treatment retention was similar for all gender and racial/ethnic groups for all three medications. Meta-regression found that those of the African American group who were recruited into buprenorphine treatment were retained significantly longer than African Americans in buprenorphine treatment who were studied retrospectively. Also, both genders had significantly lower retention in methadone treatment when there was the additional requirement of psychosocial therapy.
The melanized layer of Armillaria ostoyae rhizomorphs: Its protective role and functions.

Abstract: Armillaria ostoyae (Romagn.) Herink is a highly pathogenic fungus that uses exploratory, cordlike structures called rhizomorphs to seek out new sources of nutrition, posing a parasitic threat to natural stands of trees, orchards, and vineyards. Rhizomorphs are notoriously difficult to destroy, and this resilience is due in large part to a melanized layer that protects the rhizomorph. While this structure has been previously observed, its structural and chemical defenses are yet to be discerned. Research was conducted on both lab-cultured and wild-harvested rhizomorph samples. While both environments produce rhizomorphs, only the wild-harvested rhizomorphs produced the melanized layer, allowing for direct investigation of its structure and properties. Imaging, chemical analysis, mechanical testing, and finite element modeling were used to understand the defense mechanisms provided by the melanized layer. Imaging showed a porous outer layer in both types of rhizomorphs, though the pores were smaller in the harvested melanized layer. This melanized layer contained calcium, which provides chemical defense against both human and natural control methods, but was absent from cultured samples. Nanoindentation resulted in a larger variance of hardness values for cultured rhizomorphs than for wild-harvested. Finite element analysis proved that the smaller pore structure of the melanized porous layer had the best balance between maximum deformation and resulting permanent deformation. These results allow for a better understanding of the defenses of this pathogenic fungus, which may lead to better control methods.
Assessment and Diagnosis of Mental Illness in EDs Among Individuals Without a Home: Findings from the National Hospital Ambulatory Care Survey.

Introduction: Homeless individuals lack resources for primary healthcare and as a result use the emergency department (ED) as a social safety net. Our primary objective in this study was to identify the differences between features of visits to United States (US) EDs made by patients without a home and patients who live in a private residence presenting with mental health symptoms or no mental health symptoms at triage. Methods: Data for this study come from the 2009-2017 National Health and Ambulatory Medical Care Survey, a nationally representative cross-sectional survey of ED visits in the US. We examined differences in waiting time, length of visit, and triage score among homeless patients, and privately housed and nursing home residents. We used logistic regression to determine the odds of receiving a mental health diagnosis. Residence, age, gender, race, urgency, and whether the person was seen in the ED in the previous 72 hours were controlled. Results: Homeless individuals made up less than 1% of all ED visits during this period. Of these visits, 47.2% resulted in a mental health diagnosis compared to those who live in a private residence. Adjusting for age, race, gender, triage score, and whether the person had been seen in the prior 72 hours, homeless individuals were still six times more likely to receive a mental health diagnosis despite reporting no mental health symptoms compared to individuals who lived in a private residence. Homeless individuals reporting mental health symptoms were two times more likely to receive a mental health diagnosis compared to privately housed and nursing home residents. Conclusions: Homeless individuals are more likely to receive a mental health diagnosis in the ED whether or not they present with mental health symptoms at triage. This study suggests that homelessness as a status impacts how these individuals receive care in the ED. Community coordination is needed to expand treatment options for individuals experiencing emergent mental health symptoms.
Puerto Rican Alcoholic Women

Clinicians need to be aware of the proliferation of alcoholism among Hispanic women. The clinical treatment of five alcoholics in a group modality is presented. The conceptualization and implementation of the treatment was developed within a sociocultural framework. Implications for working with Puerto Rican alcoholic women are presented.
Surgical ethics: surgical virtue and more

The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.
Defining cancer survivor and cancer survivorship: The who, what, and when

Over the past three decades various definitions of cancer survivor and cancer survivorship have been proposed. These definitions frequently describe (1) who is considered a cancer survivor and who is experiencing cancer survivorship, (2) what it means to a be survivor and experience survivorship, and (3) when someone is considered a survivor and when survivorship begins. Descriptive epidemiology indicates that certain individuals diagnosed and treated for cancer describe the presence of specific unmet needs following diagnosis and treatment for cancer. Evidence also points to an increased likelihood of cancer recurrence or a new cancer in many cancer patients. These observations should be reflected in the case definitions of cancer survivor and cancer survivorship. This paper reviews the literature for evidence to validate existing definitions of cancer survivor and cancer survivorship and proposes updated definitions for each. Based on this evidence, a cancer survivor is defined as an individual diagnosed with cancer. The period following primary treatment, which is characterized by transitions in care and a need to address the late effects of cancer and its treatment, may be a particularly critical time for the cancer survivor. The definition does not preclude the major involvement of family, friends, caregivers, and providers, but does place the focus on the individual who received the diagnosis of cancer. Children and young adult cancer survivors should be housed in subgroups under the “cancer survivor” umbrella. In addition, cancer survivorship is defined as the period of time beginning at cancer diagnosis where attention by the survivor and his or her care team is directed at addressing needs related to health, symptoms, function, lifestyle, and well-being; these needs may change through the care trajectory. Coordination of care between oncologist specialists involved in the early phases of cancer diagnosis and treatment and primary care physicians involved in longterm follow-up is critical. As new knowledge is acquired regarding cancer survival and the cancer experience, modifications to these proposed definitions will be imperative.
Life‐threatening delayed hyperhemolytic transfusion reaction in a patient with sickle cell disease: effective treatment with eculizumab followed by rituximab

BACKGROUND Hyperhemolysis in sickle cell disease is a rare and potentially life-threatening complication of transfusion. STUDY DESIGN AND METHODS In this article we report a case of delayed hemolytic transfusion reaction with resultant hyperhemolysis triggered by an anti-IH autoantibody with alloantibody behavior. RESULTS The anti-IH was reactive at room temperature as well as 37°C, but only weakly reactive with autologous red blood cells. Initial cold agglutinin titer was 512. The profound, life-threatening, intravascular hemolysis was rapidly and dramatically reduced with the Complement 5 (C5) inhibitory antibody, eculizumab. The auto/allo cold agglutinin was subsequently suppressed with rituximab treatment. CONCLUSIONS Eculizumab, a potent C5 inhibitory antibody, can be a rapid and effective therapy for hyperhemolytic transfusion reactions when given in a sufficient dose to fully block the activation of complement C5.
Prevention of Mental Disorders

The twentieth century witnessed major advances in the diagnosis and treatment of mental disorders. However, the alarming prevalence of many mental disorders, as well as their devastating consequences for individuals and communities, highlights the need for preventive interventions. Researchers have estimated that existing treatment methods are not sufficient to reduce the burden of depression, anxiety, and substance use by half, even assuming ideal conditions of treatment access, clinician competence, and patient compliance (Andrews & Wilkinson, 2002). Growing recognition of the importance of prevention has spurred research in this area, with considerable progress regarding methods and outcomes of preventive interventions over the past 15 years. Keywords: depression; evidence-based preventive interventions; incidence; prevalence; randomized control trials
Working Group 3 Report: Coronal Hole Boundaries and Interactions with Adjacent Regions

Summarized below are the discussions of working group 3 on “Coronal hole boundaries and interactions with adjacent regions” which took place at the 7th SOHO workshop in Northeast Harbor, Maine, USA, 28 September to 1 October 1998. A number of recent observational and theoretical results were presented during the discussions to shed light on different aspects of coronal hole boundaries. The working group also included presentations on streamers and coronal holes to emphasis the difference between the plasma properties in these regions, and to serve as guidelines for the definition of the boundaries. Observations, particularly white light observations, show that multiple streamers are present close to the solar limb at all times. At some distance from the sun, typically below 2 R s , these streamers merge into a relatively narrow sheet as seen, for example, in LASCO and UVCS images. The presence of multiple current sheets in interplanetary space was also briefly addressed. Coronal hole boundaries were defined as the abrupt transition from the bright appearing plasma sheet to the dark coronal hole regions. Observations in the inner corona seem to indicate a transition of typically 10 to 20 degrees, whereas observations in interplanetary space, carried out from Ulysses, show on one hand an even faster transition of less than 2 degrees which is in agreement with earlier Helios results. On the other hand, these observations also show that the transition happens on different scales, some of which are significantly larger.
A comparison of linear ICA and local linear ICA for mutual information based feature ranking

Feature selection and dimensionality reduction is important for high dimensional signal processing and pattern recognition problems. Feature selection can be achieved by filter approach, in which certain criteria must be optimized. By using mutual information (MI) between feature vectors and class labels as the criterion, we proposed an ICA-MI framework for feature selection. In this paper, we will compare the linear ICA and local linear ICA for the accuracy of MI estimation, and study the bias-variance trade-off on feature projections and ranking.
The lymphoid transcription factor LyF-1 is encoded by specific, alternatively spliced mRNAs derived from the Ikaros gene.

Abstract The lymphocyte-specific DNA-binding protein LyF-1 interacts with a critical control element in the terminal deoxynucleotidyltransferase (TdT) promoter as well as with the promoters for other genes expressed during early stages of B- and T-cell development. We have purified LyF-1 and have obtained a partial amino acid sequence from proteolytic peptides. The amino acid sequence suggests that LyF-1 is a zinc finger protein encoded by the Ikaros gene, which previously was implicated in T-cell development. Recombinant Ikaros expressed in Escherichia coli bound to the TdT promoter, and antisera directed against the recombinant protein specifically blocked the DNA-binding activity of LyF-1 in crude extracts. Further analysis revealed that at least six distinct mRNAs are derived from the Ikaros/LyF-1 gene by alternative splicing. Only two of the isoforms possess the N-terminal zinc finger domain that is necessary and sufficient for TdT promoter binding. Although both of these isoforms bound to similar sequences in the TdT, lambda 5, VpreB, and lck promoters, one isoform contains an additional zinc finger that resulted in altered recognition of some binding sites. At least four of the Ikaros/LyF-1 isoforms were detectable in extracts from B- and T-cell lines, with the relative amounts of the isoforms varying considerably. These data reveal that the LyF-1 protein is encoded by specific mRNAs derived from the alternatively-spliced Ikaros gene, suggesting that this gene may be important for the early stages of both B- and T-lymphocyte development.
Variations on a cutting plane method for solving concave minimization problems with linear constraints

A cutting plane method for solving concave minimization problems with linear constraints has been advanced by Tui. The principle behind this cutting plane has been applied to integer programming by Balas, Young, Glover, and others under the name of convexity cuts. This paper relates the question of finiteness of Tui's method to the so-called generalized lattice point problem of mathematical programming and gives a sufficient condition for terminating Tui's method. The paper then presents several branch-and-bound algorithms for solving concave minimization problems with linear constraints with the Tui cut as the basis for the algorithm. Finally, some computational experience is reported for the fixed-charge transportation problem.
Random Walks on Digraphs: A Theoretical Framework for Estimating Transmission Costs in Wireless Routing

In this paper we develop a unified theoretical framework for estimating various transmission costs of packet forwarding in wireless networks. Our framework can be applied to the three routing paradigms, best path routing, opportunistic routing, and stateless routing, to which nearly all existing routing protocols belong. We illustrate how packet forwarding under each paradigm can be modeled as random walks on directed graphs (digraphs). By generalizing the theory of random walks that has primarily been developed for undirected graphs to digraphs, we show how various transmission costs can be formulated in terms of hitting times and hitting costs of random walks on digraphs. As representative examples, we apply the theory to three specific routing protocols, one under each paradigm. Extensive simulations demonstrate that the proposed digraph based analytical model can achieve more accurate transmission cost estimation over existing methods.
Spectro-spatial wave features as detectors and classifiers of nonlinearity in periodic chains

Abstract Analysis of wave propagation in nonlinear periodic structures is often limited to the determination of the spectral characteristics of wave motion (dispersion relations). Unfortunately, the physical features of wave propagation are only partially highlighted by a spectral description. The objective of this work is to elucidate the relation between topological/physical (space–time domain) and spectral (wavenumber–frequency domain) features of wave motion in periodic chains with weak nonlinearities. The analysis is based on full-scale transient analysis of finite chains, from which dispersion curves are generated and verified against the results of unit-cell based perturbation methods. The evolution of spatial and spectral features is monitored using signal processing techniques such as spatial-spectrogram and wavenumber filtering, and the interplay of dispersive and nonlinear mechanisms in the process of waveform distortion is evaluated. The relation between topological features and spectral characteristics is determined using appropriate topological wave packet descriptors. It is found that certain packet descriptors are sensitive to the parameters of the nonlinear constitutive relation and can therefore be used to construct inverse problems to estimate nonlinearity in systems with unknown constitutive models.
Knowledge, attitudes, and practices of obstetricians‐gynecologists regarding the prevention of human immunodeficiency virus infection

OBJECTIVE To determine the knowledge, beliefs, attitudes, and practices of obstetricians-gynecologists regarding human immunodeficiency virus (HIV) prevention. METHODS Office-based obstetricians-gynecologists in the Washington, DC metropolitan area who reported providing primary care were interviewed by telephone. The survey response rate was 62% (N = 268). RESULTS The percentages of obstetricians-gynecologists who reported regularly assessing the HIV risk of new adolescent and adult patients were 67 and 40%, respectively. Seventy-two percent reported regularly counseling patients at risk to use condoms for vaginal intercourse, and 60% regularly counseled patients at risk to limit their number of sexual partners. The level of general risk-factor assessment and confidence in the ability to reduce patients' HIV risk were the strongest correlates of the frequency and thoroughness of HIV risk assessment and counseling. CONCLUSIONS The percentage of obstetricians-gynecologists who assess and counsel patients about HIV risks is below the 75% goal for the year 2000 established by the United States Department of Health and Human Services. Continuing medical education for obstetricians-gynecologists is needed to improve their knowledge and skills in HIV prevention.
Predator-induced phenotypic plasticity of laterality

Lateralized brain function, or partitioning of tasks to separate hemispheres of the brain, directly impacts behaviour and fitness. Highly lateralized individuals tend to outperform nonlateralized individuals in many survival-related behaviours, such as the ability to learn, escape predators and multitask. Despite these benefits to lateralization, there is a great deal of observed variation in this trait within and between populations that is likely determined by the balance between costs and benefits of laterality in a given environment. Laterality appears to be heritable, but it can also vary with the environment experienced during development. We investigated the role of evolutionary history and developmental plasticity in determining the degree of laterality in the Trinidadian guppy, Poecilia reticulata, a freshwater fish that experiences variable predation pressure in its native range. We compared pairs of closely related populations that experience either high or low levels of predation in the wild, and manipulated the perceived predation risk in the rearing environment using a common garden split-brood design. We assayed laterality in mature male guppies using a detour test. Fish reared with exposure to chemical predator cues were more lateralized than their brothers reared without predator cues. This plastic response is in the direction we would predict if lateralization is favoured in environments with high predation risk. However, unlike findings in related species, we did not detect repeatable differences in degree of laterality associated with historical predation regime, suggesting that predation risk experienced over evolutionary history does not shape laterality patterns in guppies. Thus, although it is currently underemphasized in the literature, plasticity is likely an important contributor to variation in laterality. © 2014 The Association for the Study of Animal Behaviour. Published by Elsevier Ltd. All rights reserved.
China and technology transfer: the 'Boomerang Effect' as a strategic tool

How could the players involved in international technology transfer operations benefit from the utilisation and management of the so-called "Boomerang Effect" (BE) of international technology transfer? This BE, initially identified only on the supplier's side, appears to be a very valuable managerial and strategic tool that may provide all the players involved in the technology transfer system with very positive outcomes. In the specific Chinese context, this concept can be used as a strategic and operational tool to enhance China's technological catching-up.
A comparison of the effectiveness of insecticides against glasshouse whitefly (Trialeurodes vaporariorum)

SUMMARY Tests were made with a glasshouse whitefly population resistant to both DDT and parathion to measure resistance to two organochlorine, eight organophosphate and six carbamate compounds; resmethrin and pyrethrum were also included in the tests. The whiteflies showed marked resistance to endosulfan, thionazin, malathion and resmethrin and low resistance to all other compounds.