cssi/SciSciGPT-SciSciNet huggingface dataset:
Does GABA have a role in anesthesia

Abstract Anesthetics may exert their effects through a GABA mechanism. Halothane causes dose-related inhibition of (1-14C) GABA degradation to 14CO2 by rat brain cortex slices. This is accompanied by reduced synthesis and turnover of acetylcholine and Krebs cycle intermediates. Anesthetic agents as a group inhibit the transformation of (1-14C) GABA to 14CO2 by rat brain synaptosomes at clinically relevant concentrations. The dose required for 10% inhibition (ID10) correlates well with the pharmacologie 50% effective dose (ED50). Volatile anesthetics inhibit overall GABA metabolism but do not significantly alter the individual steps of GABA uptake, GABA release or GABA transaminase activity. The known inhibition by volatile anesthetics of Complex I in electron transport leads to reduced NADH oxidation and decreased GABA catabolism. Thiopental inhibits GABA-transaminase with a ID10 similar to its ED50 but does not affect either synaptosomal uptake or release of GABA. Midazolam, a water-soluble benzodiazepine, exerts its effect by inhibition of GABA uptake by synaptosomes but it also causes GABA release at higher concentrations. Further experiments show that the tranquilizer, chlorpromazine, also gives a ID10-ED50 correlation and this ID10 effect is based on uptake inhibition. In summary, anesthetics inhibit three sites: Complex I (volatile anesthetics), GABA-transaminase (anesthetic barbiturates) or GABA uptake (water-soluble benzodiazepines and chlorpromazine). Each may cause accumulation of GABA in the synaptic cleft, the direct demonstration of which is presently not within our technical capability. This interpretation is consistant with neurophysiological findings.
Polarographic determination of half-wave potentials for copper-organic complexes in seawater

Abstract A methodology has been developed to determine the half-wave potentials of organic Cu chelators in seawater and algal culture media from pseudopolarograms obtained by anodic stripping voltammetry. A linear relationship between half-wave potentials determined from the pseudopolarogram, and thermodynamic stability constants was observed for a collection of model ligands that spanned a wide range of stability constants (log K =12–26.5) and included many functional groups likely to be important in copper complexation in seawater. Results suggested that it is possible to determine thermodynamic stability constants from half-wave potentials, as reported previously for Zn and Fe. Pseudopolarograms from culture media of three Cu stressed phytoplankton species showed very different thermodynamic stability constants, indicating the presence of chemically distinct ligands. The cyanobacterium Synechococcus produced at least two strong Cu chelators. One had a thermodynamic stability constant of log K =36.7±3.0 (obtained by extrapolation of the scale) and complexed from 30%–50% of the total Cu. The second was electrochemically inert, even at −1.6 V. The eukaryotic species produced several chelators with stability constants ranging from log K =22.6–39.1. Seawater samples collected from coastal waters showed similar characteristics. These thermodynamic constants are very high relative to model ligands in the literature, which could reflect coordination by specialized biomolecules. Alternatively, the large negative half-wave potentials could be due to Cu(I) complexes (with log K =10–20) or reflect reductive ligand decomposition of kinetically inert Cu(II) complexes.
Arsenic-induced neural tube defects in mice: Alterations in cell cycle gene expression

The potential of arsenic to cause neural tube defects (NTD) in the human population remains a topic of controversy. While clearly toxic, the lack of well-defined human epidemiologic studies on this subject has made it difficult to fully understand the effects arsenic may have on the developing human neural tube. In the absence of good clinical data, we have tried to develop a murine model where hypotheses about the reproductive toxicity of arsenate can be tested. For these studies a murine strain (LM/Bc) that has proven to be susceptible to arsenic-induced NTD was use. Because cellular proliferation is vital for normal neural tube closure (NTC) to occur, in the present study we investigated whether an acute arsenate treatment could alter the expression of several cell cycle genes during murine neurulation. Pregnant LM/Bc dams were injected intraperitoneally on gestation day (GD) 7:12 (day:hour) and 8:12 with 40 mg/kg of arsenate, a treatment that causes exencephaly in 90 to 100% of the exposed fetuses. Neural tubes were then isolated from both control and arsenic treated embryos at GD 9:00, 9:12, 10:00, and 10:12, which encompasses all the stages of neurulation for this murine strain. Using the molecular techniques of in situ transcription and antisense RNA amplification (RT/aRNA) the expression pattern for bc1-2, p53, wee-1, and wnt-1 was analyzed at each of these time points. In the neural tubes isolated from control embryos, the expression of all four genes was significantly altered as neurulation progressed, demonstrating their developmental regulation. Following arsenate treatment, however, there was a significant upregulation in the expression of bc1-2 and p53 at gestational day 9:0, compared to their control values. The heightened expression of both of these genes suggests that arsenic inhibits cell proliferation, rather than inducing apoptosis, which delayed NTC and ultimately led to the neural tube defects observed in exposed embryos.
Health Literacy, Cognitive Abilities, and Mortality Among Elderly Persons

Background Low health literacy and low cognitive abilities both predict mortality, but no study has jointly examined these relationships.
Ethics of unprofessional behavior that disrupts: Crossing the line

As chief of surgery, you have been contacted by the managing operating room (OR) nurse about Dr Frank N. Stein's behavior earlier this morning. Dr Stein, a senior surgeon, has long had a reputation for outlandish behaviors in the OR. He is the impeccable gentleman outside that environment, loved by patients and nonoperating personnel alike. He has an international reputation as a master technical surgeon, operates as efficiently as anyone on the planet, and has the largest practice at the medical center. He has survived beyond the generation of tolerance because he has retained the same OR crew that over the years have calloused enough to regard his scurrilousness as just being Dr S. Today, he crossed the line. Dr. Stein, known for his colorful diatribes, trounced decorum when he ordered the operative team, excepting the anesthesiologist, out of the OR and demanded that a new team be substituted. This resulted from a shouting match with a new circulator when she took issue with a personal insult. The transition was accomplished, causing delays in both Dr Stein's OR and several other ORs where substitute nurses were commandeered. At least one other faculty surgeon has complained about the inconvenience. In your office, Frank, long a colleague, insists that the nurses involved are assassins and refuses to work with them from this day. What should be done?
Use of a wiki as a radiology departmental knowledge management system.

Information technology teams in health care are tasked with maintaining a variety of information systems with complex support requirements. In radiology, this includes picture archive and communication systems, radiology information systems, speech recognition systems, and other ancillary systems. Hospital information technology (IT) departments are required to provide 24 × 7 support for these mission-critical systems that directly support patient care in emergency and other critical care departments. The practical know-how to keep these systems operational and diagnose problems promptly is difficult to maintain around the clock. Specific details on infrequent failure modes or advanced troubleshooting strategies may reside with only a few senior staff members. Our goal was to reduce diagnosis and recovery times for issues with our mission-critical systems. We created a knowledge base for building and quickly disseminating technical expertise to our entire support staff. We used an open source, wiki-based, collaborative authoring system internally within our IT department to improve our ability to deliver a high level of service to our customers. In this paper, we describe our evaluation of the wiki and the ways in which we used it to organize our support knowledge. We found the wiki to be an effective tool for knowledge management and for improving our ability to provide mission-critical support for health care IT systems.
Alternative strategies needed to improve vascular access outcomes.

Vascular access for hemodialysis, which is essential for adequate dialysis therapy, is taken for granted when functioning properly and is perceived as a terrible annoyance when functioning poorly. The clinical burden and enormous cost associated with maintaining vascular access make improving access
More alike than meets the eye: Perceived gender differences in subjective experience and its display

This research investigated perceived gender differences in subjective experience and its outward display. Subjects imagined a female friend or a male friend in a series of brief situations, each of which was said to elicit a particular subjective experience in the friend. After each situation, they estimated the extent to which the friend would experience the feeling, and also the extent to which the friend would display the feeling to others. Results confirmed two related predictions, both based on attribution research: First, perceived gender-related differences in the outward display of an experience were generally greater than perceived gender-related differences in the subjective experience itself. Males and females, that is, were generally viewed as more alike in their internal feelings than in their overt behaviors. Second, perceived female/male differences in outward display varied more with the feeling elicited by the situation than perceived female/male differences in subjective experience. Specifically, subjects estimated that females would display communal, socially desirable feelings more than males and self-oriented, less desirable feelings less than males, but that females would experience both categories of feelings somewhat more intensely than males would experience them. In addition to confirming these two predictions, our results also indicated that the sex viewed as having greater hidden feelings—operationalized as the amount by which estimations of subjective experience exceeded estimations of display—also varied with the situation. With communal, highly desirable feelings, males were viewed as having greater hidden feelings, but with self-oriented, less desirable feelings, females were viewed as having greater hidden feelings. This pattern did not interact with gender of perceiver. The data, however, indicated that female perceivers tended to rate both males and females higher on measures of both experience and display than males did, and that male perceivers tended to perceive greater gender differences than females did.
Treatment of port-wine stains during childhood with the flashlamp-pumped pulsed dye laser.

Seventy-three patients between the ages of 3 months to 14 years (average age 6 years 2 months) with port-wine stains were treated with the flashlamp-pumped pulsed dye laser. More than 75% lightening was achieved with an average of 2.5 treatments in 33 patients (45%), 50% to 74% lightening after an average of 1.7 treatments in 31 (42%), 26% to 49% lightening after 2 treatments in 5 (7%), and less than 25% lightening after 1 treatment in 4 (5%). The overall average lightening after one treatment was 53%. The percentage of lightening increased as the number of treatments increased. Three patients had 100% clearance of the port-wine stain. Patients aged between 3 months and 6 years (44 patients) had a better response after the first treatment (55% lightening) than did patients aged between 7 and 14 years (29 patients with a 48% lightening; p = 0.027): Complications included cutaneous depressions in four patients, hyperpigmentation in 16 patients, and hypopigmentation in three patients. All complications were transient and disappeared completely.
On Sn-invariant conformal blocks vector bundles of rank one on $${\overline{M}_{0,n}}$$

For any simple Lie algebra, a positive integer, and n-tuple of compatible weights, the conformal blocks bundle is a globally generated vector bundle on the moduli space of pointed rational curves. We classify all vector bundles of conformal blocks for \({\mathfrak{sl}_n}\), with Sn-invariant weights, which have rank one. We show that the cone generated by their base point free first Chern classes is polyhedral, generated by level one divisors.
Measurements of neutrino and antineutrino cross sections at high energies

The dependence of the neutrino total cross section ${\ensuremath{\sigma}}_{\ensuremath{\nu}}$ on neutrino energy has been measured up to 160 GeV. The data are consistent with a linear dependence with slope (0.58 \ifmmode\pm\else\textpm\fi{} 0.25) \ifmmode\times\else\texttimes\fi{} ${10}^{\ensuremath{-}38}$ ${\mathrm{cm}}^{2}$/GeV. The ratio of the antineutrino to the neutrino total cross section $\frac{{\ensuremath{\sigma}}_{\overline{\ensuremath{\nu}}}}{{\ensuremath{\sigma}}_{\ensuremath{\nu}}}$ has been found to be approximately constant up to 70 GeV at a value which is consistent with the numerical value of $\frac{1}{3}$ expected for the scattering of neutrinos and antineutrinos by relativistic pointlike spin-\textonehalf{} fermions.
In-vitro investigation of a potential wave pumping effect in human aorta.

An impedance pump – also known as Liebau pump – is a simple valveless pump that operates based on the principles of wave propagation and reflection. It has been shown in embryonic zebrafish that a similar mechanism is responsible for the pumping action in the embryonic heart during the early stages before valve formation. Recent studies suggest that the cardiovascular system is designed to take advantage of wave propagation and reflection phenomena in the arterial network. In this study we report the results of an in-vitro study that examines the hypothesis that the adult human aorta acts as a passive pump based on Liebau effect. A hydraulic model with different compliant models of an artificial aorta was used for a series of in-vitro experiments. Our result indicates that wave propagation and reflection can result in a pumping mechanism in a compliant aorta.
Chronic stress regulates levels of mRNA transcripts encoding β subunits of the GABAA receptor in the rat stress axis

Semi-quantitative hybridization histochemical analyses were undertaken to determine expression levels of mRNA transcripts encoding the beta1-3 subunits of the GABA(A)receptor within the rat hypothalamic paraventricular nucleus (PVN) and hippocampal formation following exposure to a chronic non-habituating stress protocol. After delivery of a battery of stressors on a randomized schedule over a 3-week period, expression levels of the beta1 subunit of the GABA(A) receptor were found to be decreased in the medial parvocellular PVN (mpPVN) by 48.3% relative to control animals. Levels of beta2 mRNA following chronic stress were also found to be decreased in the mpPVN (29.8%), but increased in hippocampal subfields CA(1) and CA(3) (33.9 and 23.2%, respectively) and increased (24%) in the dentate gyrus. The results suggest that GABA(A) receptor subunit composition may be altered at a key regulatory site, and may have important implications for studies aimed at understanding GABAergic inhibitory influences upon the hypothalamic-pituitary-adrenocortical (HPA) axis. Hypophysiotropic CRH neurons serve as the origin of the final common pathway for glucocorticoid secretion in response to stressful stimuli, and GABAergic afferents have been implicated in afferent control of these neurons. Regulation of GABA(A) receptors at these sites may alter the efficacy of a major inhibitory influence upon the stress axis, and thereby modulate stress-induced glucocorticoid secretion.
Mucosal biopsy diagnosis of colitis: acute self-limited colitis and idiopathic inflammatory bowel disease.

Abstract Background/Aims: Rectal biopsy specimen changes distinguish acute self-limited colitis (ASLC) from idiopathic inflammatory bowel disease (IBD). This study aimed to determine whether these histological criteria are also valid for acute-onset IBD. Methods: Blind analysis of colorectal biopsy specimens from 52 patients with ASLC, 51 patients with acute-onset (
A new algorithm for idealizing single ion channel data containing multiple unknown conductance levels

A new algorithm is presented for idealizing single channel data containing any number of conductance levels. The number of levels and their amplitudes do not have to be known a priori. No assumption has to be made about the behavior of the channel, other than that transitions between conductance levels are fast. The algorithm is relatively insensitive to the complexity of the underlying single channel behavior. Idealization may be reliable with signal-to-noise ratios as low as 3.5. The idealization algorithm uses a slope detector to localize transitions between levels and a relative amplitude criterion to remove spurious transitions. After estimating the number of conductances and their amplitudes, conductance states can be assigned to the idealized levels. In addition to improving the quality of the idealization, this "interpretation" allows a statistical analysis of individual (sub)conductance states.
A sharp-focusing schlieren optical deflectometer

A new instrument capable of localized, nonintrusive turbulence measurements is developed by combining a focusing schlieren system with an optical deflectometer. This instrument records the fluctuating light intensity at a point in the focused schlieren image. Its capability is verified by making benchmark measurements of Kelvin-Helmholtz vortices produced in a low-speed axisymmetric mixing layer. The sharp-focusing effect is demonstrated both visually and quantitatively. The results show that the instrument is capable of optical turbulence measurements within a 4 mm depth-of-field.
Pediatric rheumatology: what does the future hold?

Abstract Emery H. Pediatric rheumatology: what does the future hold? Arch Phys Med Rehabil 2004;85:1382–4. Effectiveness of the traditional rehabilitation approaches used in pediatric rheumatology has been difficult to prove and, in times of cost containment, this lack of evidence may lead to undertreatment with physical and occupational therapies. Quantitative methods such as those described in this issue by Brostrom and colleagues can be used to validate those approaches and to reinforce the need for careful attention to the effects of even minor loss of range and strength in children with juvenile arthritis. Historically, up to half of the children affected by polyarticular juvenile arthritis became disabled. Some factors that have led to improved outcomes for childhood rheumatic diseases are discussed, including medications (use of weekly low-dose methotrexate, intra-articular steroid injections, new biologic agents that specifically block mediators of inflammation, for example, tumor necrosis factor and interleukin-1), surgery (joint replacements), and psychosocial interventions (with schools and families). The importance of maintaining range of movement, strength, weight bearing, and ambulation, in an effort to prevent sequelae such as osteoporosis and wheelchair dependence, is emphasized. Early identification of children with rheumatic diseases and aggressive intervention, with a combined medical, rehabilitation, psychosocial, and, rarely, surgical approach, should now allow most affected children to reach adulthood with little or no disability.
Analyses of the role of grain boundaries in mesoscale dynamic fracture resistance of SiC–Si3N4 intergranular nanocomposites

Abstract Silicon carbide (SiC)–silicon nitride (Si3N4) nanocomposites with SiC dispersions as well as Si3N4 matrix of mesoscale dimensions (∼1 μm) are considered to have exceptional strength attributed to interactions of SiC dispersions with Si3N4 grain boundaries (GBs). However, an account of GBs on the strength of these nanocomposites is not available. In order to analyze this issue, cohesive finite element method (CFEM) based mesoscale dynamic fracture analyses of SiC–Si3N4 nanocomposites with an explicit account of length scales associated with Si3N4 GBs, SiC particles, and Si3N4 grains are performed. Analyses indicate that primary mechanism of fracture in the nanocomposite microstructures is intergranular Si3N4 matrix cracking. GBs are responsible for crack deflection and accordingly damage is limited to a smaller geometric region in microstructures with GBs. On an average, a microstructure with GBs present is stronger than the corresponding microstructure with GBs removed. However, in cases where the second phase SiC particles are in the wake of microcracks the microstructure without GB becomes stronger against fracture in comparison to the corresponding one with GBs owing to the crack bridging effect caused by the second phase SiC particles.
WE-C-AUD C-03: Segmented Field Electron Conformal Therapy Planning Algorithm

Purpose: To develop a clinically useful forward planning algorithm for determining the energy, shape, and weight of multiple abutted fields used in segmented‐field electron conformal therapy (SFECT) that conforms the 90% isodose to the PTV while minimizing the treatment of normal tissue. Method and Materials: An algorithm was developed that requires a beam's eye view (BEV) of depth of the distal PTV surface. First, the minimum energy for which R90 (10‐cm diameter field) exceeds the depth to the distal edge of the PTV is determined for each pixel of the BEV. Next, the minimum circular field size to treat R90 to the distal edge of the PTV is determined for each pixel and drawn around the pixel. Fields of the same energy are merged with higher energy fields taking precedence in areas of overlap, and the dose distribution is calculated. Finally, an iterative process is used to modify the fields to converge the 90% dose surface to the distal PTV surface. The algorithm was used on six hypothetical PTVs, and the dose distribution was compared to that of a single energy plan. A pencil‐beam algorithm calculated the dose distribution for both sets of plans. Results: The SFECT plans were able to deliver 90% of the dose to over 95% of the PTV, while irradiating an average of 16% less non‐PTV to 90% of the dose. Due to abutment dosimetry, SFECT plans increased dose range within the PTV by an average of 4.9%. Conclusion: The developed algorithm was useful for determining SFECT plans in a water phantom. SFECT plans irradiate significantly less non‐PTV volume than single energy therapy, but at the expense of increased dose range within the PTV (D90−10). Conflict of Interest: This work was funded in part by a research grant with Varian Medical Systems, Inc.
P/OM and societal development: a historical perspective

This research paper delineates and analyzes the relationship between production and operations management and the development of society. An attempt is made to take the reader into a historical journey whereby events and contributions to the field are not only listed and described but also analyzed with regard to their impact on societal development through time.
Notes on the marine algae of the Bermudas. 1. New records of Antithamnieae and Dohrnielleae (Ceramiaceae, Rhodophyta), including Antithamnionella bermudica sp. nov.

Abstract Seven species of marine algae in the Antithamnieae (Antithamnion lherminieri, Antithamnion decipiens) and Dohrnielleae sensu Athanasiadis (Callithamniella tingitana, Dohrniella antillara, Antithamnionella breviramosa, Antithamnionella graeffei, and a new species, Antithamnionella bermudica) are reported from the Bermuda islands for the first time. Taxonomic and nomenclatural problems with certain of these species collected in deep water are discussed. Antithamnionella bermudica sp. nov. has a prostrate, mat-forming habit and a unique branching pattern of whorl-branches for the genus. Its recurved, secund whorl-branches are more reminiscent of certain species of Antithamnion, Perikladosporon, and Pterothamnion, but gland cell ontogeny and position show the new species to be best placed in Antithamnionella.
Health locus of control beliefs and alcohol-related factors that may influence treatment outcomes

Abstract Treatment programs have based their treatment approach on the premise that alcoholics should exert internal control over situations and events that affect them. Since chronic alcohol use affects the health of an individual, Walston and Walston's Multidimensional Health Locus of Control Scale was administered to 47 alcoholics in a treatment program. The population reflected a higher belief that health status is more under their own control than under the control of chance of powerful others. However, the results indicated that recovering alcoholics with a more powerful other health orientation tended to maintain membership longer with Alcoholics Anonymous, would seek help sooner, would begin heavy drinking at a later age, and would attempt formal treatment more often.
Evaluation of Telemetry in Determining Toxicity of Aerosol Preparations

Abstract The effect of selected aerosol products and fluorinated hydrocarbon propellants on the heart rate and respiration of rats was determined in whole body exposure chambers by biotelemetry. Electrocardiogram and respiratory transmitters were used to broadcast selected FM signals to a nearby receiver and physiological recorder for visual display. Each rat was subjected to a single 360-min exposure of the aerosol product or propellant, kept under observation for toxicological responses, and then examined for histopathological signs of toxicity. The fluoroalkane propellants used depressed the heart rate in high concentrations. First degree atrioventricular block and T wave inversion were also observed in some animals. The propellants tested also had a depressant effect on respiratory rate and minute volume. The selected aerosol product produced similar effects but at concentrations much higher than would be experienced during normal consumer use. Histopathological examination revealed greater tissue damage with the aerosol product than with the propellants alone. The cardiac and respiratory abnormalities occurred only after exposure to high concentrations of the fluoroalkane propellants. Also, the pathology report gave no indication of the existence of "thesaurosis" or pulmonary granulomatosis.
Thermodynamics of movable inductively heated seeds for the treatment of brain tumors.

A thermodynamic study is presented of temperature distributions created by an inductively heated 6-mm-diam Ni sphere imbedded in vivo and in vitro into porcine brain tissue. This study was performed in support of the development of a system that creates localized heat-induced lesions in deep-seated brain tumors. In this system, a magnetic "seed" will be remotely repositioned within the brain by an externally produced magnetic field. Convective effects of a hot moving seed will produce a different thermodynamic situation than that arising from an array of static implants. In this work, a study is presented of part of the expected change, in which a static sphere is heated to high temperature. Measurements were made of the temporal and spatial dependence of the temperature rise in the vicinity of the heated sphere, in vivo in four animals and in one that was euthanized immediately prior to experimentation. These results are used for parameter estimation with a theoretical model based on a point source solution to a form of the thermal diffusion equation, i.e., the "bioheat transfer equation." With this model thermal distributions from a power source of arbitrary geometry can be found using appropriate integration methods, and the method has widespread applicability. Estimates of blood flow rates, tissue thermal conductivity, and seed power absorption were found using the parameter estimation algorithm. The estimated blood perfusion exhibits a step increase following the first heating in multiple heating experiments. Thermal conductivity estimated using data from the nonperfused (in vitro) animal is 0.6 W/m degrees C. Seed power absorption is estimated correspondingly to be 0.9 W, a result confirmed independently with calorimetry. Statistical uncertainty is established for the radial decrease of the tissue temperature rise created by this method. This result allows estimation of a cell death boundary uncertainty of 0.6 mm, caused by fluctuations in power delivered to the seed, uncertainty in the temperature probe placements, and thermal properties such as blood perfusion and tissue thermal conductivity.
‘Soft Law’ mechanisms for nanotechnology: liability and insurance drivers

Nanotechnology presents significant challenges to traditional approaches of health, safety, and environmental regulation, which has been accordingly slow to be implemented. To help fill this gap, a number of ‘soft law’ voluntary programs for risk management of nanomaterials have been implemented or proposed, but participation in, and impacts of, such programs has been disappointedly limited to date. This article suggests two potential drivers to increase participation in voluntary risk management programs for nanomaterials: liability and insurance. Given the lack of regulation and public concerns about nanotechnology, personal injury, and other product liability litigation is highly likely. Companies subject to such lawsuits will be able to help defend the reasonableness of their actions by pointing to their participation in voluntary risk management programs, while companies that declined to participate will be more vulnerable to liability for failing to take reasonable precautions. Insurers of companies...
Epidemiology of upper extremity replantation surgery in the United States.

Purpose Replantation remains an important technique in the management of hand trauma. Given the resources necessary for a successful replantation program, regionalization of replantation care may ultimately be required. The purposes of this study were to analyze the geographic distribution of upper extremity replant procedures, analyze factors of patients undergoing replantation, and characterize the facilities performing these procedures. Methods We performed a cohort study using the National Inpatient Sample of the Healthcare Cost and Utilization Project from 2001, 2004, and 2007. Patients with an upper extremity amputation were defined, and a subgroup of patients undergoing replantation was delineated. We analyzed patient demographics and injury characteristics and characteristics of treating facilities. Results A total of 9,407 patients were treated for upper extremity amputation, 1,361 of whom underwent replantation. Mean age of patients undergoing replantation was 36 years (range, 0–86 y), compared with 44 years (range, 0–104 y) in patients not undergoing replantation. Hospital charges ( P P Conclusions Patients who undergo replantation are younger, incur higher hospital charges, and have longer hospital stays compared with patients who do not undergo replantation. Treatment at large, urban, and teaching facilities is associated with higher replantation rates. Payer status appears to have some bearing on replantation rates. Further studies are needed to better elucidate the relationship between patient and injury characteristics, treatment location, and outcomes, to adequately distribute the finite resources for replantation. Type of study/level of evidence Economic and Decision Analysis IV.
Encoding processes in social anxiety

According to current theories, memory processes play an important role in the maintenance of social fears. However, the empirical evidence regarding memory processes in social anxiety is controversial, and little is known about specific memory processes, such as encoding. The present study employs a release from proactive interference (RPI) technique to explore encoding-related processes in social anxiety. Eighty-four high and low socially anxious college students participated in the RPI task. The main hypothesis was that RPI effects that involve socially threatening words are greater in high than in low socially anxious subjects. Contrary to this hypothesis, however, greater RPI effects were found in low rather than in high socially anxious subjects if a social threat dimension was encoded. This suggests that low socially anxious individuals show more specific encoding strategies of threatening information than high socially anxious individuals.
Addressing the burden of group A streptococcal disease in India.

Group A streptococcus-associated disease and sequelae continue to have devastating effects on public health and national economy as they mainly affect children and young adults. There is an urgent need for wider application of methods of primary prevention, in the form of optimal diagnosis and management of the simple group A streptococcal sore throat. This review article briefly summarizes the burden of streptococcal disease in India, and discusses treatment options standardized by the World Health Organization. Penicillin continues to remain the drug of choice for treating group A streptococcal pharyngitis and for prevention of acute rheumatic fever in non-allergic patients. Also discussed in this review are contemporary thoughts on streptococcal “carriers”, recurrent infections, antibiotic treatment “failures” and emergence of drug resistance among group A streptococci.
EXPRESSION OF MYOGENIC REGULATORY FACTORS IN NORMAL AND DYSTROPHIC MICE : EFFECTS OF IGF-1 TREATMENT

Abstract Myogenic regulatory factors (MRFs) promote differentiation of muscle cells from fibroblasts and are induced by insulin-like growth factor I (IGF-1). Prior studies have shown synthesis of new muscle protein and improved muscle morphology when mature dy mice with muscular dystrophy are treated with IGF-1. We investigated whether these salutary effects of IGF-1 might be attributable to stimulation of MRFs. Male dy ( 129ReJ ) mice and controls ( 129J ) were assigned to IGF-1 treatment (10 μg twice daily) or nontreatment at about 5 weeks of life and sacrificed 6 weeks later. RNA was extracted from skeletal muscles, reverse transcribed, and amplified by polymerase chain reaction (PCR) using primers specific for each MRF. Competitive PCR was performed to quantify MyoD expression in response to IGF-1 treatment. Transcripts for myf-5, MRF4, and myogenin were detected in both control and dy mouse muscles; no apparent differences were observed between treatment groups. Quantitative analysis of transcripts for MyoD indicated no significant basal differences between control and dy mice. There was, however, significantly higher MyoD expression in the dy group, and a trend toward significance in the control group, following IGF-1 treatment. These data suggest that IGF-1 exerts its in vivo effects in postembryonal muscle by stimulating MRFs.
Prostanoids in human colonic mucosa: effects of inflammation on PGE2 receptor expression

Although the tissue concentration of PGE(2) is heightened 3-fold or more during mucosal inflammation, the cellular targets of prostanoids in human mucosa and the resulting changes in cell physiology have not been fully explored. We used a panel of immunoglobulin and mRNA probes in order to localize and quantitate the four member EP family of prostanoid receptors for binding PGE(2) to cells of histologically normal and inflamed human colonic mucosa, and then examined prostanoid-induced changes in mucosal lymphocyte function. Prostanoid receptors were selectively expressed on a limited number of human colonic mucosal cells; EP(4) alone was expressed on lamina propria mononuclear cells. Dual immunostaining in situ identified the CD3(+) T lymphocyte as a major EP(4) receptor-bearing cell in normal mucosa. Flow cytometry of isolated cells showed that 19.2% of lamina propria mononuclear cells were EP(4)(+), and almost 30% of these were CD3(+). In situ hybridization with digoxygenin-labeled RNA probes largely confirmed this localization. During inflammation, mucosal T lymphocytes showed a significant enhancement in EP(4) immunoreactive receptor protein. Computer-assisted densitometry of single cells demonstrated an increase in fluorescence intensity from 4.8 +/- 1.8 to 8.6 +/- 1.8 (p < 0.04). The effects of PGE(2) included a 35% reduction in T lymphocyte IL-2 secretion. COX 1(+) lamina propria cells nearly doubled in number during inflammation; expressed a T lymphocyte marker; but retained an unchanged quantity of immunoreactive COX 1 protein per cell. The number of newly appeared COX 2(+) lymphocytes remained <50% that of COX 1(+) cells. A major perturbation in the number and distribution of PGE(2) receptors and enzymes for prostanoid synthesis occurs in chronic inflammation of the colon, with consequences for mucosal T lymphocyte function.
Heterocyclic thiosemicarbazones: correlation between structure, inhibition of ribonucleotide reductase, and inhibition of DNA viruses.

SummaryThe thiosemicarbazones of 2-formylpyridine, 3-formylpyridine, 4-for-mylpyridine, 5-hydroxy-2-formylpyridine, 1-formylisoquinoline, 5-hydroxy-1-formylisoquinoline, 6-formylpurine, isatin, and 1-methylisatin were examined for activity against herpes simplex virus in H.Ep.−2 cells and human cytomegalovirus in WI-38 cells, and also for inhibition of ribonucleotide reductase activity in H.Ep.−2 cells. A correlation was seen between inhibition of reductase and antiviral activity, with those compounds having the -CH=N-NH-C(=S) -NH2 moiety affixed to the heterocyclic ring system in the position alpha to the ring nitrogen being active. The suggestion is made that the activity of ribonucleotide reductase may be a limiting factor in the replication of certain members of the herpesvirus group.
Platelet GPIb Ectodomain Shedding – A New Biomarker for GI Bleeding in Continuous Flow VAD Recipients?

Purpose Gastroinstestinal bleeding (GIB) occurs in 30% of continuous flow ventricular assist device (CFVAD) patients. Given that nearly all CFVAD recipients demonstrate a loss of large von Willebrand Factor (vWF) multimers, we sought to examine other factors that can contribute to the risk of GIB events. Methods and Materials Blood samples were obtained on all inpatient days or at outpatient clinic visits from 34 patients receiving Thoratec HeartMate II (25), WorldHeart Levacor (6), or Syncardia temporary Total Artifical Heart (TAH; 3) blood pumping systems. Assays were performed to quantify plasma levels of glycocalicin (the platelet GPIb (vWF receptor) ectodomain), platelet microparticle coagulation activity, thrombin anti-thrombin, Coagulation Factor XII, thromboxane B2. Statistcal analyses were performed using Stastica (Statsoft) to examine assay levels prior to, during, and after confirmed bleeding, thromboembolic (TE), and infectious events, and risk factors based on patient demographics and co-morbidities for adverse events. Results Plasma glycocalin was observed to be elevated compared to pre-operative values in all HeartMate II, TAH, and 3 of the Levacor recipients and in older recipients. A glycocalin value above 4 mg/mL (normal range 0-2 mg/mL) was 92% predictive of a bleeding event. A failure of the glycocalin level to decrease below 2.5 mg/mL or an increase following a bleeding event was 97% predictive of a subsequent bleeding event. There was not a consistent signal which could be determied to predict TE or infectious events with greater than 50% accuracy. Conclusions GIB remains a significant complication of CFVAD support and predicting which patients are at highest risk for GIB events. Glycocalin may be a biomarker to indicate patients at risk for GIB and particularly re-occurent GIB events. The mechanism causing an elevation in platelet GPIb shedding (plasma glycocalicin) deserves further investigation as a potential avenue to elucidate the mechanisms contributing to GIB bleeding risk.
Prognosis after late relapse following epilepsy surgery.

Summary Objectives To assess prognosis after late relapse in patients who are seizure free for the first 5 years after epilepsy surgery. Methods Patients who were seizure free for the first 5 years after resective epilepsy surgery were included. Date of first seizure recurrence, current seizure status, medication, age, and type of surgery were prospectively registered. Non-parametric statistics were used. Results One hundred and fifty-nine patients were studied. Thirty-two had at least one recurrent seizure. Time to event analysis showed an annual relapse rate of 4% between years 5 and 10 after surgery. At study termination, 143 of 159 patients (89.9%) were in terminal remission. For 30 patients with late relapse and at least 1-year follow-up thereafter, 53% were in terminal remission and 30% had experienced only rare or nocturnal seizures. Medication use was not associated either with likelihood of relapse or entering remission after relapse. Conclusions Patients who are seizure free for the first 5 years after epilepsy surgery remain at risk for seizure recurrence. These relapses are often isolated events, and the long-term prognosis after relapse is often good. Relapse rates were similar in patients on and off AEDs, but the relation between AED taper and relapse is uncertain since patient groups may not be similar.
Measurement and validation of the nature of salivary adiponectin

Adiponectin (Ad) is an adipocyte-derived hormone that plays an essential role in regulating insulin sensitivity, inflammation, and atherogenesis. Levels of some hormones in saliva change in a fashion similar to that in plasma in response to a disease or physiological condition. Since saliva is an easy to obtain biological fluid, measurements of salivary hormonal changes are preferred in diagnoses and treatments. Therefore, it was of interest to examine the nature of salivary Ad. While there have been two publications in the literature reporting presence of Ad in human saliva, the nature of salivary Ad has not been characterized. To this end, we investigated the effect of sample dilution on the measurement of Ad in saliva. To our surprise, we observed an increase in measurable level of Ad in saliva on sample dilution. One explanation for this paradoxical observation may be the presence of inhibitor(s) of Ad/anti-Ad binding in saliva that following dilution relieves the inhibitory effect. Working with this hypothesis, we were able to demonstrate the presence of an inhibitor in saliva that co-eluted with the dimeric form of Ad and was capable of inhibiting Ad assay. The presence of such inhibitor(s) may lead to underestimation of Ad in saliva.
Style and Politics in the Philips–Handel Ode for Queen Anne's Birthday, 1713

Handel's 'Serenata' for the Birthday of Queen Anne (1713) poses serious challenges to historical scholarship. We are not certain that it was performed for the Queen, and the attribution of the text to the Whig poet Ambrose Philips rests on a marginal note written after Handel and Philips were both dead. The piece celebrates the Peace of Utrecht, and thus participates in various political discourses, but the motives of everyone involved—poet, composer, performers, patrons, and dedicatee—cannot be adequately described in merely partisan terms. Poets of all stripes were eager to celebrate the Peace at this time, and Handel, though aware that his German employer (later George I) opposed the Peace, celebrated it not only in this work but in the Utrecht Te Deum. Internal and external evidence supports the attribution of the text to Philips; the careful avoidance of mythological terms suggests that the Pastoral War involving Philips, Thomas Tickell, Joseph Addison, and Alexander Pope is a relevant context for this ode. For his own part, Handel took care to write music showcasing the English singers of the Chapel Royal and displaying his knowledge of English vocal traditions, though he also used female singers and some musical forms derived from his work in the Italian opera.
Patient-Centered Research : Validation of the Canadian Clinical Probability Rule and Use of Bedside D-Dimer Testing in the Diagnosis of Acute Venous Thrombosis in an Emergency Room Setting

PURPOSE: To validate the Canadian clinical probability tool and utility of bedside rapid D-dimer testing using SimpliRed® among patients with suspected acute deep-vein thrombosis (DVT) in an emergency room setting. METHODS: Consecutive patients with clinically suspected DVT in a leg and no past history of symptomatic DVT were evaluated in the UC Davis emergency room by emergency room staff using the clinical probability tool developed by Wells and colleagues [Lancet,1997; 350:1795], which was provided on a one page form. After completing the form, each patient underwent venous ultrasound (US) imaging, whole blood D-dimer testing using SimpliRed®, and D-dimer measurement using a sensitive ELISA technique. All patients were followed for 3 months. Diagnosis of thromboembolism required objective confirmation of DVT using US or venography, or confirmation of pulmonary embolism using a high-probability lung scan or pulmonary arteriography. RESULTS: Of 102 patients who were evaluated, 17 (17%) were diagnosed as having DVT initially; none of the 85 in whom DVT was excluded developed thromboembolism within 3 months. Ten of 17 (59%, CI 36%–82%) who met criteria for ‘high-probability’, 6 of 44 (13%, CI 5%–21%) with ‘intermediate probability’ and 1 of 41 (2.4%, CI 0.5%–7%) with ‘low probability’ had objectively confirmed DVT. This compares to published values of 49%, 14% and 3%, respectively, from two Canadian emergency rooms. Forty-one of the 102 (40%) patients had an ‘alternate diagnosis as likely or greater than DVT’, which lowered the probability of DVT by one or more levels in 35 (85%) cases. Thirty-eight of the 41 (93%) patients with an ‘alternate diagnosis’ did not have DVT; the 3 who did have DVT were thought to have cellulitis (n = 2) or knee hyperextension (n = 1). The negative predictive value of the SimpliRed rapid D-dimer test was 100%, 100% and 71% (5 of 7) in the low, intermediate and high probability groups. Both ‘false negative’ SimpliRed® tests had normal levels of D-dimer using a sensitive ELISA method, and careful re-review of the US studies revealed findings consistent with subacute or chronic DVT. CONCLUSION: The Canadian probability tool for DVT appears to be a valid instrument in our emergency department. Similarly, we documented the high negative predictive value of bedside D-dimer (SimpliRed®) testing among patients classified as ‘low’ or ‘intermediate’ probability for having DVT, as reported in the literature. Radiographic misinterpretation of subacute or chronic DVT as acute DVT may partially explain the lower negative predictive value of SimpliRed® testing in patients with high clinical probability of having DVT.
- The Up-and-Down Method for Small Samples with Extreme Value Response Distributions

Abstract Tables for computing LD50 estimates are presented for the extreme value (smallest and largest) distributions based on maximum likelihood and minimum chi-square analyses for small sample up-and-down test outcome sequences of nominal length N, 2 ≤ N ≤ 6. Overall, especially considering the small sample sizes involved, LD50 estimates based on assumed symmetrical distributions seem relatively robust to minor departures from symmetry of the actual response distribution.
Increasing preference for beef magnifies human impact on world’s food web

Bonhommeau et al.’s report, “Eating up the world’s food web and the human trophic level” (1), provides a valuable perspective on the role of human food consumption within the global ecosystem. However, the ranking of human beings at a similar trophic level as other animals downplays the effects that humans have on the Earth in comparison with other species. The sheer volume of food consumed by humans and our growing preference for inefficient food sources cause us to have increasingly disproportionate impacts on the global ecosystem in relation to other species, even of the same trophic level.