cssi/SciSciGPT-SciSciNet huggingface dataset:
Combined nephrectomy and major hepatectomy: indications, outcomes, and recommendations.

Background Simultaneous nephrectomy with major hepatectomy (NMH) is uncommon. We reviewed our experience with NMH. Study Design Records of patients who underwent NMH at Emory Hospital between January 1995 and May 2008 were examined. Patients undergoing resection of three or more liver segments at the same setting as a total nephrectomy were included. Indications and outcomes were assessed. Results Twenty patients underwent NMH. Mean (± SD) age was 59.9±12.8 years, 6 (30%) were women, and 15 (75%) presented with comorbidities. Most kidney neoplasms were renal cell carcinomas of the right kidney (n=16, 80%) with a mean diameter of 10.0±6.1 cm. Eight patients (40%) also underwent thrombectomy for inferior vena cava tumor thrombus. The most common indications for hepatectomy were direct liver invasion in eight patients (40%) and distant hepatic metastases in nine (45%); liver tumors were 4.2±3.3 cm (mean ± SD) in diameter. Mean (± SD) operative time was 8.3±2.6 hours. Liver resections included 15 (75%) right hepatectomies and 5 (25%) left hepatectomies. In all cases, tumor negative hepatic margins were achieved. Median operative blood loss was 1,700 mL (range 200 to 8,000 mL). Ten patients (50%) suffered complications in the postoperative period; three of these suffered major complications, resulting in one perioperative death (5%). Mean hospital stay was 12±8.8 days. Overall survival was 25 months (range 0 to 34 months). Conclusions In this large series of nephrectomy with simultaneous major hepatectomy, morbidity and mortality were acceptable. In specialized centers NMH may be considered in properly selected patients for combined resection for synchronous neoplasms of the kidney and liver.
Prevalence of Psychiatric Disorders in Patients with Irritable Bowel Syndrome

Thirty-five patients with irritable bowel syndrome were referred from the gastroenterology service and underwent structured psychiatric interviews to assess the prevalence of psychiatric illness. Thirty-three (94%) of 35 patients were found to have a lifetime prevalence of any Axis I disorder; the predominant diagnoses were mood and anxiety disorders. Theoretical and practical implications of these findings are discussed.
A critical step for postsynaptic F‐actin organization: Regulation of Baz/Par‐3 localization by aPKC and PTEN

Actin remodeling has emerged as a critical process during synapse development and plasticity. Thus, understanding the regulatory mechanisms controlling actin organization at synapses is exceedingly important. Here, we used the highly plastic Drosophila neuromuscular junction (NMJ) to understand mechanisms of actin remodeling at postsynaptic sites. Previous studies have suggested that the actin-binding proteins Spectrin and Coracle play a critical role in NMJ development and the anchoring of glutamate receptors most likely through actin regulation. Here, we show that an additional determinant of actin organization at the postsynaptic region is the PDZ protein Baz/Par-3. Decreasing Baz levels in postsynaptic muscles has dramatic consequences for the size of F-actin and spectrin domains at the postsynaptic region. In turn, proper localization of Baz at this site depends on both phosphorylation and dephosphorylation events. Baz phosphorylation by its binding partner, atypical protein kinase C (aPKC), is required for normal Baz targeting to the postsynaptic region. However, the retention of Baz at this site depends on its dephosphorylation mediated by the lipid and protein phosphatase PTEN. Misregulation of the phosphorylation state of Baz by genetic alterations in PTEN or aPKC activity has detrimental consequences for postsynaptic F-actin and spectrin localization, synaptic growth, and receptor localization. Our results provide a novel mechanism of postsynaptic actin regulation through Baz, governed by the antagonistic actions of aPKC and PTEN. Given the conservation of these proteins from worms to mammals, these results are likely to provide new insight into actin organization pathways. (c) 2009 Wiley Periodicals, Inc. Develop Neurobiol 2009.
Catecholamines in attention-deficit hyperactivity disorder: Current perspectives

ABSTRACT Objective To provide an update on the “catecholamine hypothesis” of attention-deficit hyperactivity disorder (ADHD). Method Recent work examining the measurement of the norepinephrine, epinephrine, and dopamine systems in ADHD and normal subjects is reviewed and discussed in the context of recent neuroimaging and animal studies. Results While data clearly indicate a role for all three of the above neurotransmitters in ADHD, a hypothesis suggesting “too much” or “too little” of a single neurotransmitter will no longer suffice. The central norepinephrine system may be dysregulated in ADHD, such that this system does not efficiently “prime” the cortical posterior attention system to external stimuli. Effective mental processing of information involves an anterior “executive” attention system which may depend on dopamlnergic input. The peripheral epinephrine system may be a critical factor in the response of individuals with ADHD to stimulant medication. Conclusion A multistage hypothesis is presented which emphasizes the interaction of norepinephrine, epinephrine, and dopamine in modulation of attention and impulse control. J. Am. Acad. Child Adolesc. Psychiatry , 1996, 35(3):264–272
Gaps in Childhood Injury Research and Prevention: What Can Developmental Scientists Contribute?

Unintentional injury is the leading cause of pediatric mortality in most of the developed world. Contributions from epidemiology, pubic health, and engineering perspectives have yielded important insights into risk and protective factors, but recent calls for research stress the need for behavioral science to advance understanding and prevention of childhood injuries. Limiting its focus to children younger than 13 years, this article identifies 4 gaps in the literature on childhood injury and discusses how developmental science might address these research needs by (a) applying developmental theory and conceptual approaches to understand the processes by which children are injured, (b) examining the role of developmental processes in injury risk, (c) identifying the bases for group differences in injury related to gender and cultural influences, and (d) exploring how family processes and relationships affect injury risk.
Studies on Malarial Parasites. V. Effects of Ascorbic Acid on Malaria (Plasmodium knowlesi) in Monkeys.

Conclusions and Summary1. Plasma and whole blood ascorbic acid levels were significantly lower in parasitized monkeys than in normal animals.2. There was an abnormal course of parasitemia in 7 of our monkeys which showed spontaneous ascorbic acid deficiency and in 2 other animals which were made ascorbic acid deficient by removing the vitamin from their diet.3. Following the administration of the pure ascorbic acid, there was a normal course of parasitemia in one of the monkeys spontaneously ascorbic acid deficient and in those made ascorbic acid deficient by dietary means.Withholding ascorbic acid therapy for more than 7 days appeared to give the spontaneously deficient monkeys time to produce an immunity and to control the infections. If ascorbic acid treatment was withheld from the animals made vitamin C deficient there was a prolongation of the course of infection but eventually the parasitemia overwhelmed the animal.
Addressing workload variability in architectural simulations

The inherent variability of multithreaded commercial workloads can lead to incorrect results in architectural simulation studies. Although most architectural simulation studies ignore space variability's effects, our results demonstrate that space variability has serious implications for architectural simulation studies using multithreaded workloads. The standard solution - running long enough - does not easily apply to simulation because of its enormous slowdown. To address this problem, we propose a simulation methodology combining multiple simulations with standard statistical techniques, such as confidence intervals and hypothesis testing. This methodology greatly decreases the probability of drawing incorrect conclusions, and permits reasonable simulation times given sufficient simulation hosts.
Predicting Electronic Structure in Tricalcium Silicate Phases with Impurities Using First-Principles

Tricalcium silicate (Ca3SiO5) is heavily used in industry as it is the most predominant constituent in Portland cement clinkers. In this work, using ab-initio calculations, we assess the ability of a large selection of substitutions to modify the electronic structure in the M3 polymorph of tricalcium silicate. We demonstrate the relation between electronic structure, hybridization of the impurity orbitals, and charge transfer from impurity atoms to the bulk material. Our work suggests that charge localization upon introducing impurities can passivate the reactive sites and several such substitutions are identified.
The Structure of Mouse Cytomegalovirus m04 Protein Obtained from Sparse NMR Data Reveals a Conserved Fold of the m02-m06 Viral Immune Modulator Family

Immunoevasins are key proteins used by viruses to subvert host immune responses. Determining their high-resolution structures is key to understanding virus-host interactions toward the design of vaccines and other antiviral therapies. Mouse cytomegalovirus encodes a unique set of immunoevasins, the m02-m06 family, that modulates major histocompatibility complex class I (MHC-I) antigen presentation to CD8+ T cells and natural killer cells. Notwithstanding the large number of genetic and functional studies, the structural biology of immunoevasins remains incompletely understood, largely because of crystallization bottlenecks. Here we implement a technology using sparse nuclear magnetic resonance data and integrative Rosetta modeling to determine the structure of the m04/gp34 immunoevasin extracellular domain. The structure reveals a β fold that is representative of the m02-m06 family of viral proteins, several of which are known to bind MHC-I molecules and interfere with antigen presentation, suggesting its role as a diversified immune regulation module.
High-level rent-seeking and corruption in African regimes : theory and cases

One explanation for Africa's failure to develop is the weakness of its public institutions. The authors consider one aspect of that weakness: rent-seeking and corruption at the top of government. Under the conditions of their model, and autocrat who seeks to maximize personal financial return favors an inefficiently large public sector and distorts other public sector priorities more than does an autocrat who seeks to maximize national income. However, if civil servants and public officials are also venal, the ruler will not favor so large a government. To show how African regimes operate, the authors present four cases illustrating issues raised by their theoretical model. Among their observations about the relationship between the motivations of top officials and policies to control corruption and other types of rent-seeking are these: A kleptocrat whose decision variable is the level of government intervention in the economy will select an excessive level of interventions, in which national income is less than optimal. Like all monopolies, the kleptocrat seeks productive efficiency except where inefficiency creates extra rents. Facing a kleptocrat, citizens prefer a smaller than optimal-sized government but get one that is too big. A kleptocrat may need to permit lower-level officials to share in corrupt gains thus introducing additional costs. He or she will then favor a smaller government than if subordinates could be perfectly controlled. Dropping the assumption of a single dimension of government intervention, the kleptocrat will favor a different mixture of tax, spending, and regulatory programs than will a benevolent autocrat. Dropping the assumption that rulers are writing on a clean slate, decisions to privatize or nationalize firms can differ across autocratic regimes. In particular, although kleptocrats will often be reluctant to privatize, they may in some cases support privatization that a benevolent ruler would oppose. Investment in countries with kleptocratic rules may have an overly short-run orientation. When rent-seeking at top levels is pervasive, both natural resources and foreign aid under state control may hamper, not encourage, growth.
Association of overstory plant canopies and native grasses in southern Arizona

In arid regions, overstory plants may influence establishment and persistence of understory species. Identifying relationships between overstory and understory plants may increase success of revegetation efforts. This research considered whether three desirable grasses native to the Sonoran Desert, Arizona cottontop (Digitaria californica), plains lovegrass (Eragrostis intermedia) and bush muhly (Muhlenbergia porteri), differ in density or cover under overstory species compared to open areas. Selection of sites in southern Arizona (two or three per species) was based on abundance of study species and elevation. Density and cover of Arizona cottontop and plains lovegrass was highly variable between canopied and open areas among sites. Bush muhly had greater density and cover under canopies at all sites. No association was noted between precipitation or elevation and density or cover ratios. Identifying understory species well-adapted to shaded sites may aid in determining the best use of existing vegetation for revegetation in this region.
Design, demonstrations and sustainability impact assessments for plug-in hybrid electric vehicles

Plug-in hybrid electric vehicles (PHEVs) are hybrid electric vehicles that can draw and store energy from an electric grid to supply propulsive energy for the vehicle. This simple functional change to the conventional hybrid electric vehicle allows a plug-in hybrid to displace petroleum energy with multi-source electrical energy. This has important and generally beneficial impacts on transportation energy sector petroleum consumption, criteria emissions output, and carbon dioxide emissions, as well as on the performance and makeup of the electrical grid. PHEVs are seen as one of the most promising means to improve the near-term sustainability of the transportation and stationary energy sectors. This review presents the basic design considerations for PHEVs including vehicle architecture, energy management systems, drivetrain component function, energy storage tradeoffs and grid connections. The general design characteristics of PHEVs are derived from a summary of recent PHEV design studies and vehicle demonstrations. The sustainability impact of PHEVs is assessed from a review of recent studies and current research and development needs for PHEVs are proposed.
Input normalization by global feedforward inhibition expands cortical dynamic range

The cortex is sensitive to weak stimuli, but responds to stronger inputs without saturating. The mechanisms that enable this wide range of operation are not fully understood. We found that the amplitude of excitatory synaptic currents necessary to fire rodent pyramidal cells, the threshold excitatory current, increased with stimulus strength. Consequently, the relative contribution of individual afferents in firing a neuron was inversely proportional to the total number of active afferents. Feedforward inhibition, acting homogeneously across pyramidal cells, ensured that threshold excitatory currents increased with stimulus strength. In contrast, heterogeneities in the distribution of excitatory currents in the neuronal population determined the specific set of pyramidal cells recruited. Together, these mechanisms expand the range of afferent input strengths that neuronal populations can represent.
Spectroscopic and computational investigation of three Cys-to-Ser mutants of nickel superoxide dismutase: insight into the roles played by the Cys2 and Cys6 active-site residues

Nickel-dependent superoxide dismutase (NiSOD) is a member of a class of metalloenzymes that protect aerobic organisms from the damaging superoxide radical (O(2) (.-)). A distinctive and fascinating feature of NiSOD is the presence of active-site nickel-thiolate interactions involving the Cys2 and Cys6 residues. Mutation of one or both Cys residues to Ser prevents catalysis of O(2) (.-), demonstrating that both residues are necessary to support proper enzymatic activity (Ryan et al., J Biol Inorg Chem, 2010). In this study, we have employed a combined spectroscopic and computational approach to characterize three Cys-to-Ser (Cys --> Ser) mutants (C2S, C6S, and C2S/C6S NiSOD). Similar electronic absorption and magnetic circular dichroism spectra are observed for these mutants, indicating that they possess nearly identical active-site geometric and electronic structures. These spectroscopic data also reveal that the Ni(2+) ion in each mutant adopts a high-spin (S = 1) configuration, characteristic of a five- or six-coordinate ligand environment, as opposed to the low-spin (S = 0) configuration observed for the four-coordinate Ni(2+) center in the native enzyme. An analysis of the electronic absorption and magnetic circular dichroism data within the framework of density functional theory computations performed on a series of five- and six-coordinate C2S/C6S NiSOD models reveals that the active site of each Cys --> Ser mutant possesses an essentially six-coordinate Ni(2+) center with a rather weak axial bonding interaction. Factors contributing to the lack of catalytic activity displayed by the Cys --> Ser NiSOD mutants are explored.
Weighting observations: the use of kinematic models in object tracking

We describe a model-based object tracking system that updates the configuration parameters of an object model based upon information gathered from a sequence of monocular images. Realistic object and imaging models are used to determine the expected visibility of object features, and to determine the expected appearance of all visible features. We formulate the tracking problem as one of parameter estimation from partially observed data, and apply the extended Kalman filtering (EKF) algorithm. The models are also used to determine what point feature movement reveals about the configuration parameters of the object. This information is used by the EKF to update estimates for parameters, and for the uncertainty in the current estimates, based on observations of point features in monocular images.
Interaction of slow, very highly charged ions with surfaces

The present article reviews recent advances in the studies of the interaction of slow (v < vBohr), very highly charged ions (such as Xe 52+ and Au 69+ ) with surfaces of metals, semiconductors, and insulators (including biological materials). After a brief summary of past developments, we describe key experimental techniques for studies of secondary particle emission and the de-excitation dynamics of the highly charged ions. Recent progress in measurement and determination of the mechanisms leading to secondary electron yields, secondary ion yields and total sputtering yields will be discussed. The deexcitation dynamics are addressed in experiments on projectile neutralization and energy loss in thin films of material. We review the theoretical concepts briefly and introduce theoretical models in the discussion of experimental results. Following the presentation of fundamental studies we will address emerging applications of slow, very highly charged ions in surface analysis and surface modification. # 1999 Published by Elsevier Science Ltd. All rights reserved.
WORKER OWNERSHIP AND PUBLIC POLICY

This article examines the development of expanding support for worker ownership in the United States. The authors provide a brief review of the various types of legislation, both at the state and federal levels, drafted on worker ownership. They also provide a discussion of the problems in establishing and maintaining a worker-owned firm such as worker access to the idea of worker ownership, time to evaluate, discuss, and learn about the proposal, and judge if it is applicable to their situation. Other problems include training workers for new skills, such as management, and improving productivity. Finally, the authors present various requirements for implementation of wide-scale workers ownership. The requirements include consulting groups which can help workers design, establish, and evolve participation in worker-owned firms, the development of worker ownership programs in all unions to identify ownership opportunities, and the development of federations of worker-owned firms to identify common problems, work to loosen credit sources and even evolve their own banks for capital.
Construction and Control of a 4-Tetrahedron Walker Robot

This work describes the construction of a 4-Tetrahedron Walker Robot using inexpensive material. The final hardware selection in building the robot will be covered. Both mechanical systems and the electronic control systems will be discussed in detail. A concept has been formulated to implement the control in the case of choreographic designed gaits or for a commands node position.
Vasoconstriction with norepinephrine causes less forearm insulin resistance than a reflex sympathetic vasoconstriction.

We used the insulin-perfused human forearm model to assess the effects of vasoconstriction induced with norepinephrine on the extraction of glucose in the forearm in two groups of healthy young volunteers. The norepinephrine findings were compared with a previously studied group in which vasoconstriction has been caused by reflex activation of the sympathetic nervous system. The aim of the study was to determine the relative importance of hemodynamic and receptor-mediated mechanisms of insulin resistance. Plasma insulin, arterial and venous glucose samples, and forearm blood flow were measured at 10-minute intervals during a 30-minute baseline, a 60-minute intra-arterial insulin infusion, and during 30 minutes of insulin infusion plus vasoconstriction. Group 1 (n = 14) had physiological vasoconstriction induced by inflation of bilateral thigh cuffs to 40 mm Hg to cause pooling of blood in the lower extremities and reflex vasoconstriction in the forearm; group 2 (n = 8) had intra-arterial infusion of norepinephrine to achieve the same degree of vasoconstriction as seen with inflation of thigh cuffs in group 1. Subjects in group 3 (n = 7) had infusion of intra-arterial norepinephrine to achieve a twofold increase in physiological vasoconstriction. With a physiological decrease in forearm blood flow (group 1), there was a 19% decrease in forearm blood flow resulting in a 23% reduction in glucose uptake in the forearm (P < .03). The same degree of reduction in forearm blood flow with a predominantly alpha-adrenergic agonist, norepinephrine (group 2), causes much less insulin resistance (a decrease in utilization of 13%) (P < .04).(ABSTRACT TRUNCATED AT 250 WORDS)
Mechanism of engaging self-management behavior in rural heart failure patients.

Abstract Aim The purpose of this study was to examine the relationships among self-efficacy, patient activation and SM in rural heart failure patients discharged from critical access hospitals. Background Heart failure is one of the most disabling and resource-consuming chronic conditions. Compared to their urban counterparts, rural heart failure patients had higher healthcare utilizations and worse health outcomes. Self-management (SM) plays a significant role in improving patients' outcomes and reducing healthcare use. Despite persistent recommendations of SM, engagement in SM still remains low in rural heart failure patients. SM is a complex behavior, which is influenced by various factors. Evidence on the efficacy of interventions to promote SM is limited and inconsistent. One reason is that the mechanism of engagement of SM in the rural heart failure population has not been fully understood. Methods A correlational study was conducted using secondary data from a randomized control trial aimed to improve SM adherence. Path analysis was used to test the hypothesis of patient activation mediating the effect of self-efficacy on SM. Results Data were collected from a sample of 101 heart failure patients (37% males) with an average age of 70 years. The final model provided a good fit to the data, supporting the hypothesis that self-efficacy contributes to SM through activation. Conclusion The results of this study showed that effective SM interventions should be designed to include strategies to promote both self-efficacy and activation.
Magnetic storm inflation in the evening sector

Analysis of the different behavior of a double magnetic disturbance in November 1971, as observed by Explorer 45, and in December 1971, as shown by ground level magnetic observations. The time sequence of magnetic storm inflation in the evening quadrant of the magnetosphere, as determined by both series of observations, is used as the criterion of the analysis. Particular attention is given to the various phases of proton penetration into the evening quadrant of the magnetosphere during the magnetic disturbance.
The role of patient age and intraocular gas use in cataract progression after vitrectomy for macular holes and epiretinal membranes

Abstract Purpose To evaluate the rate of increase in nuclear sclerosis and posterior subcapsular cataracts in eyes as a function of patient age and use of intravitreal gas at the time of vitrectomy. Design Observational case series. Methods Nuclear sclerosis and posterior subcapsular cataracts were evaluated as a function of patient age and use of intravitreal gas at vitrectomy. Setting A clinical practice. Study population The study population consisted of 301 consecutive eyes. Observational procedure Nuclear sclerotic cataracts and posterior subcapsular cataracts were graded on a scale from 0 to 4.0 before and after vitrectomy. Main outcome measure Linear regression analysis was performed to measure and compare the rate of change in cataract score over time based on patient age and use of intraocular gas. Results Nuclear sclerotic cataracts showed minimal increase in patients younger than 50 years of age after vitrectomy (0.13 grades/year). Nuclear sclerotic cataracts increased at a rate of 0.7 to 0.9 grades/year (mean, 0.812) in patients aged 50 to 60 years, 60 to 70 years, 70 to 80 years, and 80+ years, even though the baseline nuclear sclerosis scores were progressively greater for each decade. The increase in nuclear sclerotic cataracts in patients younger than 50 years of age was significantly less ( P P Conclusions Patients older than 50 years of age have a similar rate of increase in nuclear sclerotic cataracts, independent of age. The rate is approximately sixfold greater than in patients younger than 50 years of age. Intravitreal gas bubbles are associated with a nuclear sclerosis increase of approximately 60% compared with eyes without use of a gas bubble.
The crystal structure of ribonuclease A in complex with thymidine‐3′‐monophosphate provides further insight into ligand binding

Thymidine-3′-monophosphate (3′-TMP) is a competitive inhibitor analogue of the 3′-CMP and 3′-UMP natural product inhibitors of bovine pancreatic ribonuclease A (RNase A). Isothermal titration calorimetry experiments show that 3′-TMP binds the enzyme with a dissociation constant (Kd) of 15 μM making it one of the strongest binding members of the five natural bases found in nucleic acids (A, C, G, T, and U). To further investigate the molecular properties of this potent natural affinity, we have determined the crystal structure of bovine pancreatic RNase A in complex with 3′-TMP at 1.55 A resolution and we have performed NMR binding experiments with 3′-CMP and 3′-TMP. Our results show that binding of 3′-TMP is very similar to other natural and non-natural pyrimidine ligands, demonstrating that single nucleotide affinity is independent of the presence or absence of a 2′-hydroxyl on the ribose moiety of pyrimidines and suggesting that the pyrimidine binding subsite of RNase A is not a significant contributor of inhibitor discrimination. Accumulating evidence suggests that very subtle structural, chemical, and potentially motional variations contribute to ligand discrimination in this enzyme. Proteins 2010. © 2010 Wiley-Liss, Inc.
Prognostic importance of resection margin width after nephron-sparing surgery for renal cell carcinoma.

Objectives To examine the relationship between the width of the resection margin and disease progression in renal cell carcinoma (RCC) after nephron-sparing surgery (NSS). During NSS for RCC, it is standard practice to excise the tumor along with a surrounding margin of normal parenchyma (margin of resection) to ensure complete resection of the neoplasm. However, no agreement has been reached on how wide the margin of resection should be. Methods We retrospectively reviewed the histopathologic sections and medical records of 69 patients with localized RCC who had undergone NSS between 1976 and 1988 to determine whether the resection margin, tumor size, TNM stage, and Fuhrman nuclear grade were associated with disease progression (defined as local tumor recurrence or metastasis). The mean postoperative follow-up interval was 8.5 years. Results No association was found between the width of the resection margin and disease progression (P = 0.98, log-rank test). Both TNM stage and Fuhrman nuclear grade correlated with disease progression. Patients with T1-T2 tumors had lower progression (P <0.001, log-rank test), and increased Fuhrman nuclear grade correlated with more disease progression (P <0.001, log-rank test). Conclusions The width of the resection margin after NSS for RCC does not correlate with long-term disease progression. A histologic tumor-free margin of resection, irrespective of the width of the margin is sufficient to achieve complete local excision of RCC.
Fidicina variegata, a New Cicada Species from Costa Rica (Hemiptera: Cicadomorpha: Cicadidae)

The Neotropical cicada Fidicina variegata Sanborn is described as a new species. This work validates a name previously assigned to this species and considered a nomen nudum. Comparisons are made to other members of the genus found in Costa Rica. A summary of the biology of the species is provided.
The Reliability and Validity of Diagnostic Categories

Once a nosologic class has been generated, whether by theoretical inference, clinical description or other modes, the next set of tasks involve validation of the class.
Upper tibial osteotomy for secondary osteoarthritis of the knee

Of 34 consecutive proximal tibial osteotomies for secondary degenerative arthritis in patients under 40 years of age, 33 were evaluated at least three years (mean 7.5 years) after operation. In all 73% were satisfactory, with four failures in 21 procedures in men and five failures in 12 procedures in women. The primary abnormalities were medial meniscectomy (11), medial and lateral meniscectomy (4), osteochondritis dissecans (3), osteochondritis dissecans with medial meniscectomy (4) and fracture (11). All four knees with both medial and lateral meniscectomy had unsatisfactory results despite obtaining anatomical alignment. Eight patients needed subsequent surgery; five of them had total knee replacement, four within four years of the osteotomy. Proximal tibial osteotomy in younger patients with secondary arthritis gives similar results to those for older patients with primary osteoarthritis. If it fails, this is generally within the first four years after the operation.
Abstract 12010: Penalizing Hospitals for Excess Heart Failure Readmissions: Probability of Hospital Misclassification Error

Introduction: The Centers for Medicare & Medicaid Services (CMS) adjust hospital payments for heart failure (HF) admissions if the estimate of risk-standardized excess readmission ratio (ERR) is above 1. The 2012 Inpatient Prospective Payment Systems Final Rule does not take into account the uncertainty of ERR measurement raising concerns about possible consequences. Hypothesis: Ignoring the uncertainty of ERR measurement results in significant probability of hospital misclassification error (HME) in HF, the most costly of applicable conditions. Methods: For a cohort of 1,085,568 Medicare fee-for-service patients undergoing 1,494,993 HF admissions in 4,930 U. S. hospitals between July 1, 2005 and June 30, 2008, we reproduced ERR distributions for individual hospitals using hierarchical logistic regression model and bootstrap method employed by CMS to obtain confidence intervals of ERR. Based on ERR distributions, we calculated probability of HME for each hospital and stratified results by hospital volume. Results: Mean probability of HME due to ignoring the uncertainty of ERR measurement is 28.2% (95% CI: 27.7%, 28.6%). Probability of HME varies with hospital volume: 41.5, 33.9, 26.9, 21.5, 16.7% in the 1st-5th volume quintiles (p<.001). In the subset of 2,381 hospitals with ERR above 1 (subject to payment adjustment per existing regulations), the falsely penalized rate was 27.5% (95% CI: 26.7%, 28.3%). In the subset of 2,549 hospitals with point estimate ≤ 1 (not subject to payment adjustment), the probability of not penalizing a poorly performing hospital was 28.8% (95% CI: 28.2%, 29.4%). (Possible maximum of probability of HME is 50% equivalent to no discrimination). Conclusions: Ignoring uncertainty of ERR measurement leads to errors in imposing financial penalties on hospitals associated with heart failure readmissions: good performers are penalized and poor performers escape penalties with estimated probability ~30%. Furthermore, disparity exists among hospitals with different volume: probability of erroneous adjustment of payment is inversely related to hospital volume.
Spatial patterns and source attribution of urban methane in the Los Angeles Basin

Urban areas are increasingly recognized as a globally important source of methane to the atmosphere; however, the location of methane sources and relative contributions of source sectors are not well known. Recent atmospheric measurements in Los Angeles, California, USA, show that more than a third of the city's methane emissions are unaccounted for in inventories and suggest that fugitive fossil emissions are the unknown source. We made on-road measurements to quantify fine-scale structure of methane and a suite of complementary trace gases across the Los Angeles Basin in June 2013. Enhanced methane levels were observed across the basin but were unevenly distributed in space. We identified 213 methane hot spots from unknown emission sources. We made direct measurements of ethane to methane (C_2H_6/CH_4) ratios of known methane emission sources in the region, including cattle, geologic seeps, landfills, and compressed natural gas fueling stations, and used these ratios to determine the contribution of biogenic and fossil methane sources to unknown hot spots and to local urban background air. We found that 75% of hot spots were of fossil origin, 20% were biogenic, and 5% of indeterminate source. In regionally integrated air, we observed a wider range of C_2H_6/CH_4 values than observed previously. Fossil fuel sources accounted for 58–65% of methane emissions, with the range depending on the assumed C_2H_6/CH_4 ratio of source end-members and model structure. These surveys demonstrated the prevalence of fugitive methane emissions across the Los Angeles urban landscape and suggested that uninventoried methane sources were widely distributed and primarily of fossil origin.
Calculation of ASE and parasitic oscillation limits in laser slabs/disks

Both amplified spontaneous emission (ASE) and parasitic oscillation affect the design of high-gain laser disks and slabs, limiting their maximum dimension and necessitating the use of index-matched optically absorbing edge claddings. To estimate the ASE level in various laser geometries of interest, we developed a Monte Carlo ray-tracing model which includes a nonhomogeneous gain profile, Fresnel reflection from the dielectric interfaces, partial delamination of the absorbing cladding from the laser medium, as well as optically thin claddings which return some of the incident ASE back into the gain region.
The Effect of Rear-End Collision Warnings on on-Going Response:

Rear-end collisions are a major concern for highway safety, and considerable effort is being expended to address the frequency of these types on collisions. One possible solution is to warn drivers just before a collision is to occur, so that they can attempt to avoid it. One concern is that warnings may interfere with an avoidance response the driver may have already initiated. This simulator study examined how drivers respond to a rear-end collision when they receive a warning as they begin to release the accelerator. Contrary to expectations, the warning enhanced rather than undermined collision avoidance performance. Receiving a warning as the accelerator was released reduced the accelerator-brake reaction time by 50%. These data suggest that RECAS warnings are unlikely to interfere with a driver's ongoing response.
New design of electrophoresis-convection apparatus.

SummaryAn electrophoresis-convection apparatus for fractionating proteins is described which (1) has variable capacity, (2) is of simple leak-free construction, and (3) can be operated under sterile conditions.
The Relationship between Levels of Greenery and Landscaping at Track and Field Sites, Anxiety, and Sports Performance of Collegiate Track and Field Athletes

Researchers wonder what it takes to improve athlete performance. Research has suggested that plants reduce anxiety, and reduced anxiety could, in turn, improve athletic performance. Research also shows that plants have psychological and restorative value such as improving coping mechanisms in human subjects as well as the potential to improve concentration and focus attention that could affect performance of athletes. The main objective of this research was to investigate the impact of greenery/landscaping on athletic performance and cognitive and somatic anxiety in track and field athletes. Four university track and field teams and 128 athletes participated in the study. Individual athlete performance and athletes’ scores on the competitive state anxiety inventory-2 (CSAI-2) cognitive and somatic anxiety tests were collected from seven track meets that occurred during one spring competition season. Greenness/landscaping level was determined by Likert scale rating averages from professional horticulturists who individually rated each site. A regression analysis found that greenness level was a predictor (P = 0.000) of best performance by athletes. More of the athletes’ best performance marks were at the track and field site that had the highest greenery rating, and many of the athletes’ worst performance marks were achieved at the site that had the lowest greenery rating. Results also indicated that all athletes performed better at the more vegetated track and field site regardless of event and level of anxiety. All athletes performed similarly at each of the track and field sites regardless of ethnicity, gender, or grade classification. However, the overall average mean anxiety scores for all the athletes involved in this study were somewhat high in comparison with the instrument-normed scores for both the cognitive and somatic anxiety scales.
The history of embryology as intellectual history. [Essay review].

Jacques Roger, Les Sciences de la vie dans la pense'e frantaise du XVIIIe siecle, la ge'neration des animaux de Descartes a l'Encyclopedie (Paris: Armand Collin, 1963). Howard B. Adelmann, Marcello Malpighi and the Evolution of Embryology, 5 vols. (Ithaca, N.Y.: Cornell University Press, 1966). Elizabeth Gasking, Investigations into Generation, 1651-1828 (Baltimore, Md.: Johns Hopkins Press, 1966). Jane M. Oppenheimer, Essays in the History of Embryology and Biology (Cambridge, Mass.: The M.I.T. Press, 1967). The Interpretation of Animal Form, Essays by Jeifries Wyman, Carl Gegenbauer, E. Ray Lankester, Henri Lacaze Duthiers, Wilhelm His and H. Newell Martin, 1868-1888, translations and introduction by William Coleman (New York and London: Johnson Reprint Corporation, 1967).
Defining the cellular lineage hierarchy in the interfollicular epidermis of adult skin

The interfollicular epidermis regenerates from heterogeneous basal skin cell populations that divide at different rates. It has previously been presumed that infrequently dividing basal cells known as label-retaining cells (LRCs) are stem cells, whereas non-LRCs are short-lived progenitors. Here we employ the H2B-GFP pulse-chase system in adult mouse skin and find that epidermal LRCs and non-LRCs are molecularly distinct and can be differentiated by Dlx1(CreER) and Slc1a3(CreER) genetic marking, respectively. Long-term lineage tracing and mathematical modelling of H2B-GFP dilution data show that LRCs and non-LRCs constitute two distinct stem cell populations with different patterns of proliferation, differentiation and upward cellular transport. During homeostasis, these populations are enriched in spatially distinct skin territories and can preferentially produce unique differentiated lineages. On wounding or selective killing, they can temporarily replenish each other's territory. These two discrete interfollicular stem cell populations are functionally interchangeable and intrinsically well adapted to thrive in distinct skin environments.
Single-Site Heterogeneous Catalysts for Olefin Polymerization Enabled by Cation Exchange in a Metal-Organic Framework.

The manufacture of advanced polyolefins has been critically enabled by the development of single-site heterogeneous catalysts. Metal-organic frameworks (MOFs) show great potential as heterogeneous catalysts that may be designed and tuned on the molecular level. In this work, exchange of zinc ions in Zn5Cl4(BTDD)3, H2BTDD = bis(1H-1,2,3-triazolo[4,5-b],[4′,5′-i])dibenzo[1,4]dioxin) (MFU-4l) with reactive metals serves to establish a general platform for selective olefin polymerization in a high surface area solid promising for industrial catalysis. Characterization of polyethylene produced by these materials demonstrates both molecular and morphological control. Notably, reactivity approaches single-site catalysis, as evidenced by low polydispersity indices, and good molecular weight control. We further show that these new catalysts copolymerize ethylene and propylene. Uniform growth of the polymer around the catalyst particles provides a mechanism for controlling the polymer morphology, a relevant metric ...
Immunity: From Serendipitous Observations to Science-Based Specialty

Abstract To understand the story of primary immune deficiency disorders (PIDD), it is imperative to review the events leading to the recognition, molecular characterization and treatments of PIDDs. Influenced by rationalism, 19th century medicine embraced science-based explorations of human disease. Seizing the opportunities provided by enlightened governments, well-funded universities and an increasingly educated public, scientists with vision and innovative ideas created new concepts that proved to become the cornerstone of modern medicine. This chapter examines the accomplishments of 19th century science: Virchow’s cellular pathology; Koch’s success in isolating and characterizing microorganisms and proving their pathogenicity; the discovery of passive immunization by Behring and Kitasato and active immunization by Pasteur; Metchnikoff’s discovery of phagocytes; and the visionary ideas of Ehrlich that include the side-chain theory, receptor-driven intracellular signaling and the “magic bullet” Salvarsan, which is considered to mark the beginning of chemotherapy.
Performance of 4T score and HIT Antibody in the Diagnosis of Heparin-Induced Thrombocytopenia in Cancer Patients

Objectives: Cancer patients may have relatively higher risk of HIT-related complications, yet data on HIT in cancer are limited. Though cancer patients have characteristics which significantly influence the 4T score and HIT antibody (ab), performance of these tests in this population is unknown. Our aim was to determine among cancer patients the rates of HIT-related thrombosis and the correlation of …
Passive gripper inspired by Manduca sexta and the Fin Ray® Effect:

Soft robotic grippers are advantageous for tasks in which a robot comes into close contact with a human, must handle a delicate object, or needs to conform to an object. Most soft robotic grippers,...
Automated testing of a self-driving vehicle system

Self-driving vehicle systems promise significant benefits beyond the limited autonomy capabilities demonstrated by currently commercially available and technology demonstration cars. This paper proposes the use of automated testing to assess the performance of a self-driving vehicle system through simulation.
A Plan for Advocacy

In the summer of 2017, the National Dance Education Organization (NDEO) sent out a call for membership who wanted to serve the organization and gain leadership experience through focused committee ...
Parameter Inference for Stochastic Differential Equations with Density Tracking by Quadrature

We derive and experimentally test an algorithm for maximum likelihood estimation of parameters in stochastic differential equations (SDEs). Our innovation is to efficiently compute the transition densities that form the log likelihood and its gradient, and to then couple these computations with quasi-Newton optimization methods to obtain maximum likelihood estimates. We compute transition densities by applying quadrature to the Chapman–Kolmogorov equation associated with a time discretization of the original SDE. To study the properties of our algorithm, we run a series of tests involving both linear and nonlinear SDE. We show that our algorithm is capable of accurate inference, and that its performance depends in a logical way on problem and algorithm parameters.
Abstract 261: EBP50/NHERF-1 Regulates Basal and TNFα-induced Mitochondrial Dynamics in Vascular Smooth Muscle Cells

Mitochondrial dysfunction has been associated with the phenotypic switch of VSMC and vascular disease. Changes in mitochondrial dynamics (fission and fusion) are linked to VSMC proliferation and metabolism during vascular remodeling. Mitochondrial fission and fusion are regulated by several key molecules, including dynamin-related protein 1 (Drp1) and mitofusin2 (Mfn2). We previously showed that scaffolding Ezrin-radixin-moesin binding phosphoprotein of 50 kDa (EBP50/NHERF1) increases inflammatory responses and proliferation of VSMC. These actions are mediated by the activation of PKCζ under inflammatory stimuli and the stabilization of the S-phase kinase associated protein 2 (Skp2), a component of an E3 ligase that promotes proliferation. Thus, EBP50 knockout (EBP50 -/- ) mice are protected neointimal hyperplasia following arterial injury. Here we test the hypothesis that EBP50 regulates mitochondrial dynamics and responses to inflammatory stimuli in vascular smooth muscle cells (VSMC). We found that EBP50 knockdown, by decreasing Skp2 levels, increased FoxO1 stability and nuclear localization leading to higher mitofusin-2 (Mfn-2) expression. In contrast, inhibition of FoxO1 reduced Mfn2 levels. High resolution morphological analysis with both TEM and confocal microscopy revealed that mitochondria were more elongated in EBP50 -/- than WT VSMC. In WT VSMC, TNFα induced PKCζ-mediated phosphorylation of Drp1. In contrast, EBP50 -/- VSMC exhibited significantly reduced Drp1 phosphorylation following TNFα treatment. Live-cell 3D imaging followed by morphological analysis showed that TNFα elicited rapid and significantly greater mitochondria fragmentation in WT compared to EBP50 -/- VSMC. Finally, EBP50 -/- VSMC exhibited lower extracellular acidification rate (ECAR) than WT VSMC consistent with their lower proliferation. Collectively, these findings delineate a new mechanism of regulation of mitochondrial dynamics by the scaffolding protein EBP50 in response to inflammatory stimuli. Therefore EBP50 can be viewed as a potential therapeutic target for vascular proliferative diseases.