cssi/SciSciGPT-SciSciNet huggingface dataset:
Emergency department imaging superusers

To identify and characterize the most frequent users of emergency department (ED) imaging. All patients with at least one ED visit in 2016 across a four-hospital healthcare system were retrospectively identified and their ED imaging utilization characterized. Overall, 126,940 unique patients underwent 187,603 ED visits (mean 1.5 ± 1.7) and a total of 192,142 imaging examinations (mean 1.7 ± 2.7). Fifty-eight percent of patients were imaged (73,672) and underwent a mean 2.6 ± 2.7 exams. When ranked by ED visits, 1.6% (2007) of patients had ≥ 4 ED visits (mean 6.1 ± 5.4). These ED “clinical superusers” accounted for 7.7% (14,409) of total ED visits and underwent 6.8 ± 5.4 imaging examinations, while non-superusers underwent 1.5 ± 2.2 (p 10 annual ED examinations (ED “imaging superusers”) and accounted for 12.4% (23,787) of all ED imaging services. Only 0.4% (n = 472) of patients were both clinical and imaging superusers. Despite similar ED visits to clinical superusers (6.0 ± 5.6 vs. 6.1 ± 5.4, p = 0.92), imaging superusers underwent significantly more imaging (14.8 ± 4.8 vs. 6.8 ± 5.4 examinations, p < 0.01). Just 12% of ED patients consume 50% of all ED imaging services, and 1.3% consume 12.4%. These ED imaging superusers represent a distinct group from clinical superusers. Prospective identification of this newly described subgroup might permit targeted interventions to control ED imaging volume, restrain costs, and minimize per-patient radiation exposure.
Maladaptive nest-site selection by a sagebrush dependent species in a grazing-modified landscape.

Abstract Animals are expected to select habitats that maximize their fitness over evolutionary time scales. Yet in human-modified landscapes, habitat selection might not always lead to increased fitness because animals undervalue high-quality resources that appear less attractive than those of lower quality. In the American West, agriculture has modified landscapes, yet little is known about whether agricultural changes alter the reliability of the cues animals use to identify habitat quality; ultimately forming maladaptive breeding strategies where behavioral cues are mismatched with survival outcomes. Using the greater sage-grouse, a species highly dependent upon sagebrush landscapes, we (1) evaluated how females select nesting habitats based on sagebrush type, along with livestock grazing related linear and point features, and other biotic, abiotic characteristics, given hypothesized influences on hiding cover, microclimate and predator travel routes and perches, (2) compared habitat selection information with results for nest survival estimates to evaluate if selection appears to be adaptive or not, and (3) used our results to evaluate the most appropriate strategies for this species in a grazing-modified landscape. Nest-site selection for sagebrush type appears to be maladaptive: in the most-preferred sagebrush type, nest survival rate was one-fourth the rate realized by females nesting in the sagebrush type avoided. Nest survival was four times higher for nests placed away from (>100 m), rather than next to (1 m), the nearest fence, and survival was lower within sites with higher cow pie density (a proxy for previous grazing intensity). Live and dead grasses influenced selection and survival in opposing ways such that dead grass was selected for but resulted in reduced survival while live grass was avoided but resulted in increased survival. Results collectively provide the first empirical evidence that a specific type of sagebrush acts as an ecological trap while another sagebrush type is undervalued. These results also suggest that adding more fences to control livestock grazing systems will likely reduce sage-grouse nest survival.
Complete Phase Diagram for Liquid-Liquid Phase Separation of Intrinsically Disordered Proteins.

A number of intrinsically disordered proteins have been shown to self-assemble via liquid–liquid phase separation into protein-rich and dilute phases. The resulting coacervates can have important biological functions, and the ability to form these assemblies is dictated by the protein’s primary amino acid sequence as well as by the solution conditions. We present a complete phase diagram for the simple coacervation of a polyampholyte intrinsically disordered protein using a field-theoretic simulation approach. We show that differences in the primary amino acid sequence and in the distribution of charged amino acids along the sequence lead to differences in the phase window for coacervation, with block-charged sequences having a larger coacervation window than sequences with a random patterning of charges. The model also captures how changing solution conditions modifies the phase diagram and can serve to guide experimental studies.
Women's Sports Medicine Programs in the United States: an interdisciplinary approach to the care of girls and women.

ABSTRACTObjectives: Multiple studies have shown that women are more susceptible to certain musculoskeletal (MSK) injuries than their male counterparts. In response to these identified differences, ...
Raynaud's Phenomenon Associated With Calcitonin Gene-Related Peptide Monoclonal Antibody Antagonists

Two cases are reported of migraineurs who reported Raynaud's phenomenon (RP) exacerbated while taking monoclonal antibodies to the calcitonin gene-related peptide (CGRP) ligand (fremanezumab and galcanezumab) and 1 case of new onset RP while taking the CGRP receptor antagonist (erenumab). The prevalence of primary and secondary RP, causes of secondary RP, co-morbidity with migraine, and medications which might induce or exacerbate RP are reviewed. The pathophysiology of how CGRP monoclonal antagonists might exacerbate or induce RP is discussed. The cases suggest but do not prove causation.
Polytropic Socrates’ Implicit Defence of Philosophy: Lying, Justice, and Sophistry in Plato’s Lesser Hippias

This article offers an interpretation of Plato’s Lesser Hippias, containing several original claims. First, it contends that the dialogue takes place in front of an unnamed audience composed of Socrates’ students and the dialogue is therefore for their benefit, not that of Hippias or Eudicus. It then argues that Socrates juxtaposes himself to Hippias to show the superiority of philosophy to sophistry. Finally, this article claims that the central argument of the dialogue is a means to demonstrate Socrates’ superior understanding of justice, for he is able to tell the truth on the matter as well as lie, showing mastery of both philosophy and sophistry. These assertions demonstrate the importance of the Lesser Hippias in the broader Platonic corpus.
Turning the "Phage" on Malnutrition and Stunting.

Bacteriophages shape bacterial ecosystems, including community membership and their metabolic function. In this issue of Cell Host & Microbe, Mirzaei et al. (2020) identify harbored bacteriophages among a Proteobacteria-dominant community unique to toddlers with stunted growth from Bangladesh, and that confer the capacity to similarly tailor microbiota profiles in vitro.
Relationship Between pH Shifts and Rate of Healing in Chronic Nonhealing Venous Stasis Lower-Extremity Wounds.

Abstract Venous stasis ulcers represent the majority of lower-extremity ulcers and place a considerable financial burden on the American health care system. Current standard of care therapies remain sub-optimal with 50% of venous stasis ulcers remaining unhealed after 4 months. Sixteen consecutive wounds were enrolled across 8 participants at a single center and underwent pH-driven therapy in addition to standard care as dictated by physicians. Following wound debridement, the pH of the wound bed was measured using pH strips. If acidic, normal saline was used to rinse the wound at every dressing change. If alkaline, nonsterile gauze was soaked in 0.25% acetic acid and applied to the wound for a minimum of 30 seconds. Participants were followed for 4 weeks with research staff observing compliance throughout. All 16 wounds had an alkaline pH at baseline, with an average pH of 8.25 ± 0.55 (range 7.5 to 9). Average area of the wound at the time of enrollment was (mean ± standard deviation) 285.48 ± 43.68 mm2, and average age of the wound was 37.5 ± 20.3 months (range 3 to 72). A simple linear regression model found a moderate relationship between pH and the rate of healing of chronic nonhealing venous stasis lower-extremity wounds (correlation coefficient = 0.61). For every 1-unit change in pH, we can expect to see a change in wound size of 116.05 mm2. This is the first US-based, open-label, prospective study that examined the effect of pH on the rate of healing in chronic nonhealing venous stasis ulcer lowerextremity wounds.
Tradespace Exploration of Space Settlement Architectures Using Long-term Cost and Benefit Metrics

Space systems development choices made decades ago, such as decisions for the Space Shuttle and the International Space Station (ISS), still influence and constrain human spaceflight technology development in the present day. Similarly, upcoming decisions in NASA's Artemis program and other Moon / Mars programs will likely influence the development of human spaceflight capabilities for subsequent decades. Given this, we argue that space systems architects require a new approach suitable for tradespace exploration across decades, and we have developed a new metric and tools to illustrate this approach. Typical tradespace exploration approaches trade off metrics for cost and benefit. The main families of metrics are monetary, utility and physical. Unfortunately, dollar, mass or utility metrics are fraught with weak assumptions when applied to decades-long timelines and to space settlements that will benefit from reusable rockets and in-situ resource utilization. Past work by the authors had proposed a new physics-based cost metric suitable for multi-decade architectures termed Lifetime Embodied Energy. Here, we propose a new benefit metric which may be of interest to diverse stakeholders and suitable for the comparison of alternative long-lived architectures: the Sustainable Long-term Growth Rate (SLGR). The SLGR has two components, a sustainability test to be defined by the architect and an average growth rate for key internal and external Figures of Merit (FOM). We show the application of the SLGR metric to a (future) long-term Mars base campaign using only Apollo-derived notional elements without ISRU, and to a case of a human settlement on Mars using future in-situ resource utilization technologies. The key FOM in both scenarios are habitable volume, stock of life support equipment and stock of consumables, as well as their derivative, which is carrying capacity of humans. We use a System Dynamics model to simulate the long-term growth, decline and stability behaviors of these FOM variables under each design option. For this model, we defined the SLGR's sustainability test as avoidance of collapse, meaning that the key FOM's per capita must remain above predefined dynamic thresholds at all times within the multi-decade model horizon. Architectures which collapse are deemed potentially fragile and discarded. For the remaining, potentially robust architectures, the growth rate of each of the key FOM across the multi-decade model horizon is its SLGR. We conclude with an assessment of SLGR compared to other metrics, a discussion of potential pros and cons, and a framing of the SLGR methodology in terms of pathfinding as opposed to traditional tradespace exploration.
Outpatient pain clinic and intranasal fentanyl to improve sickle cell disease outcomes.

BACKGROUND: Acute pain events are a leading complication for sickle cell patients. In an attempt to improve pain outcomes, we developed an outpatient pain clinic, and included intranasal fentanyl in the opioid emergency department (ED) pain order set. We evaluated admission rates and opioid administration for patients that attended both the outpatient pain clinic and ED within a 3-month period. METHODS: We recorded the admission rate, IV morphine equivalents, and time from triage for each opioid order and administration from both an outpatient pain clinic and ED visit within a 3-month period for an individual pediatric patient with sickle cell disease. RESULTS: Thirty patients received acute pain management in both settings. We identified a significant reduction in hospital admission when patients received care in the pain clinic as compared to the ED (17% vs 43%, P = .02). Additionally, outpatient pain clinic patients received significantly less IV morphine equivalents than patients received in the ED (5.6 vs 10.6 IV morphine equivalents, P < .0001). In the ED, intranasal fentanyl was administered in a significantly shorter time than patients ordered intravenous opioid (43 vs 75 min, P = .02). The mean time to receiving an opioid in the outpatient pain clinic was 57 min. CONCLUSION: The use of an outpatient pain clinic can reduce admission rates as compared to the ED. The use of intranasal fentanyl reduced the time to first opioid administration in the ED. Patient-centered research or quality improvement projects should continue to focus on novel approaches to acute pain event management.
The Performance of Glycated Albumin as a Biomarker of Hyperglycemia and Cardiometabolic Risk in Children and Adolescents in the US.

Diabetes and prediabetes are growing concerns among US youth. Fasting glucose (FG) and HbA1c are standard diabetes screening tests, but HbA1c may be unreliable in some settings and fasting is burdensome in children. Glycated albumin (GA) is a non-fasting test that was recently cleared for clinical use in the US, but studies in youth without diabetes are limited. We conducted a cross-sectional analysis in 6826 youth without diabetes aged 8-19 years in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). We evaluated the associations of GA with HbA1c, FG, and cardiometabolic risk factors. Glycated albumin was poorly correlated with HbA1c (ρ = 0.074) and FG (ρ = -0.047) and was negatively associated with BMI and cardiometabolic risk factors. Compared to youth in the highest tertile of GA (≥13.5%), those in the lowest GA tertile (<12.4%) had a higher prevalence of obesity (29.9% vs. 7.6%), low high-density lipoprotein (HDL) cholesterol (29.7% vs. 16.5%), and hypertensive blood pressure (4.0% vs. 2.7%). These inverse associations persisted after adjustment for age, sex, race/ethnicity, serum albumin, and C-reactive protein. Glycated albumin was poorly correlated with traditional markers of hyperglycemia in youth without diabetes. Counterintuitively, there was a negative association between GA and BMI. Among youth without diabetes, glycated albumin does not identify youth at high cardiometabolic risk, and it does not appear to be an appropriate biomarker for screening of hyperglycemia. This article is protected by copyright. All rights reserved.
Heregulin: A new shelterin component at human telomeres

4995 Telomere length, shape and function depend on a six subunits protein complex (TRF1, TRF2, TIN2, hRap1, TPP1 and POT1) recently referred as shelterin. We here describe a novel human telomere-associated protein, the tumor-promoting growth factor Heregulin (HRG). Utilizing the yeast two-hybrid system to identify HRG-interacting proteins in a human mammary gland cDNA library, a reactive clone was found to encode hRap1, a known association factor of TRF2. DNA sequencing and deletion mapping revealed that the hRap1’s linker domain, a region previously suggested recruiting negative regulators of telomere length, was essential for interaction between hRap1 and HRG. Double immunofluorescence microscopy revealed that the transfected green fluorescence protein (GFP)-tagged HRG and the endogenous HRG both co-localized not only with hRap1 but also with the hRap1’s partner TRF2. This interaction was reproduced in vivo in human cancer cells as immunoprecipitation of endogenous HRG from cell nuclei extracts was able to specifically pull down TRF2. Forced overexpression of HRG in HRG-negative cancer cells increased the rate of telomere shortening and resulted in increased levels of hRap1 and TRF2. Treatment of HRG-overexpressing cancer cells with HRG small interfering RNA led to telomere elongation and resulted in a decreased presence of hRap1 and TRF2. Our findings propose HRG as a novel shelterin team member that, by interplaying with hRap1 and TRF2, negatively regulates telomere length in human cancer cells.
Legal Theory Lexicon 065: The Nature of Law

What is the nature of law? This question has occupied center stage jurisprudence and philosophy of law in the modern era, and has been the central occupation of contemporary analytic jurisprudence. This entry in the Legal Theory Lexicon aims to give an overview of the "What is Law?" debate.Historically, the answer to the question, "What is law?," is thought to have two competing answers. The classical answer is provided by natural law theory, which is frequently characterized as asserting that there is an essential relationship between law and morality or justice. The modern answer is provided by legal positivism, which, as developed by John Austin, asserted that law is the command of the sovereign backed by the threat of punishment.Contemporary debates over the nature of law focus on a revised set of positions. Legal positivism is represented by analytic legal positivists, like H.L.A. Hart, Joseph Raz, and Jules Coleman. The natural law tradition is defended by John Finnis. And a new position, interpretivism is represented by Ronald Dworkin.In some ways, the title of this Lexicon entry is misleading, because of our focus on the "What is law?" question as it has been approached by contemporary legal philosophers. There are other important perspectives on the nature of law that focus on law's functions rather than the the meaning of the concept or the criteria of legal validity. For example, the sociological tradition includes important work on the nature of law by Max Weber and Niklas Luhmann. These issues are discussed by Brian Tamanaha in the article cited in the Links section at the end of this entry.This Lexicon entry maps the territory of the "What is Law?" controversy, and provides introductory sketches of the major positions. As always, the Lexicon is written for law students, especially first-year law students, with an interest in legal theory.
Immigration Law's Catch-22: The Case for Removing the Three and Ten-Year Bars

Congress has made family immigration a priority in statute but the unlawful-presence bars, also known as the three and ten-year bars, create unique barriers for family reunification that prevent many immigrants from legalizing their status through the existing immigration system. The three and ten-year bars prevent immigrants who have overstayed their visas or entered unlawfully from earning a green card even if they are otherwise capable of legally acquiring it. Removing or reforming the unlawful presence bars would remove a major legislative catch-22 that impedes the legalization of many unauthorized immigrants. Take the example of Maria, a 23 year-old woman from Mexico who enters the United States without inspection and later marries the love her life, Mathew, a United States citizen. She can be separated from her husband for several years because of an unlawful-presence bar. In another example, Madthu, a 50 year old software engineer from India with a Master’s degree in engineering enters the United States lawfully but overstays his visa for one year. She can be banned from returning to the United States for ten years after she departs. This paper examines the background and consequences of the unlawful-presence bars, and explores possible policy changes that would mitigate its harmful impact on noncitizens and their families.
Trehalose Metabolism in Germinating Spores of Streptomyces hygroscopicus

Evidence is presented which indicates that utilization of trehalose is an early event in spore germination in Streptomyces hygroscopicus. Early in spore germination and before any increase in cell mass, the activity of trehalase increased more than 15-fold, while the intracellular content of trehalose fell to very low levels. On the other hand, increased activity of the trehalose phosphate synthetase or disappearance of glycogen did not occur until later in germination, during which time cell mass was also increasing.
Perspectival Identification, Demonstratives and “small Worlds”

In recent years and recent decades the logic and semantics of demonstrative expressions (sometimes called instead indexicals) has been the subject of intensive and extensive interest. The treatment of indexicals was the main step Richard Montague took in going beyond the plain vanilla version of possible-worlds semantics. He distinguished different occasions of language use from the possible worlds in which the use takes place. David Kaplan developed a treatment of demonstratives by associating to linguistic expressions a second meaning entity, called character, over and above its sense (in the Fregean sense). Being able to deal with demonstrative reference was one of the main motivations of the entire much-touted situation semantics of Perry and Barwise. It is the purpose of this paper to show that all these treatments are inadequate and to sketch a better one. In doing so, we will find that the basic notions of all formal semantics, such as possible world, situation, reference,etc. are in a serious need of clarification. The clarification attempted here turns on the way an interpreted language is supposed to be applied to the world. This application problem is what has prompted the reference to “small worlds” in my title.
Combustion Fundamentals of Low Volatility Materials in Oxygen-Enriched Atmospheres

The different principles underlying ignition, flame spread and mass burning of condensed phase materials are described fundamentally and in detail. Brief analytical developments of the parameters which affect these various aspects of material flammability are presented and the major results are interpreted in light of enriched oxygen conditions and metal and polymer combustibility. The limitations of ASTM LOI (Limiting Oxygen Index) and heat release tests are discussed in light of the fundamentals developed.
Organic scintillator neutron detector efficiency: A comparison of experimental results with predictions

Abstract Absolute efficiency points in the neutron energy range 2–10 MeV were taken for a 7.62 cm × 12.7 cm NE-218 liquid organic scintillator. These results were compared with the efficiency predictions of programs DETEFF 1 ) and 05S 2, 3 . Only program DETEFF calculations were consistent with the experimental points obtained.
Efficacy of spinal cord stimulators in treating peripheral neuropathy: a case series

Abstract Introduction Peripheral neuropathy is a common cause of pain, and it is increasing in prevalence. Peripheral neuropathic pain is very hard to treat and can be resistant to multiple pain management modalities. Our series aimed at testing the efficacy of spinal cord stimulators (SCSs) in treating resistant painful peripheral neuropathy. Case Presentations Case 1: A 79-year-old man presented to our clinic with long-standing history of painful peripheral diabetic neuropathy resistant to conservative management. After failure of all possible modalities, we offered the patient an SCS trial that was very successful, and we proceeded with the permanent implant that continued to help with his pain and allowed the patient to wean down his medications. Case 2: A 60-year-old man presented with chronic peripheral neuropathy secondary to HIV, patient failed all conservative and procedural management. Patient then had an SCS trial that relieved his pain significantly. Unfortunately, we did not proceed with the implant due to deterioration of the patient general health. Case 3: A 39-year-old woman presented with painful peripheral neuropathy secondary to chemotherapy for breast cancer. After failure of medication management and procedures, patient had a SCS trial that improved her pain and we then proceeded with performing the permanent implant that controlled her pain. Conclusion We presented 3 cases with chronic painful peripheral neuropathy secondary to HIV, diabetes mellitus, and chemotherapy that was resistant to conservative pain management and procedures that was successfully treated with neurostimulation.
Ronald Crelinsten: Counterterrorism

Ronald Crelinsten's earlier work was grounded in the field of criminology. Now, he brings us a bold and well-researched book, which blends different bodies of literature on international relations,...
Close Bonding: The First Report of TGF-β and T Cells

The 1980s witnessed the identification of numerous secreted proteins that participate in intercellular communication. For immunologists, much attention was paid to the soluble proteins produced specifically by activated lymphocytes or myeloid cells. These factors belong to several cytokine families
Long-Term Control of Simian Immunodeficiency Virusmac251 Viremia to Undetectable Levels in Half of Infected Female Rhesus Macaques Nasally Vaccinated with Simian Immunodeficiency Virus DNA/Recombinant Modified Vaccinia Virus Ankara

The efficacy of two SIV DNA plus recombinant modified vaccinia virus Ankara nasal vaccine regimens, one combined with plasmids expressing IL-2 and IL-15, the other with plasmids expressing GM-CSF, IL-12, and TNF-α, which may better stimulate humoral responses, was evaluated in two female rhesus macaque groups. Vaccination stimulated significant SIV-specific mucosal and systemic cell-mediated immunity in both groups, whereas SIV-specific IgA titers were sporadic and IgG titers negative. All vaccinated animals, except one, became infected after intravaginal SIV mac251 low-dose challenge. Half of the vaccinated, infected animals (7/13) promptly controlled virus replication to undetectable viremia for the duration of the trial (130 wk) and displayed virological and immunological phenotypes similar to those of exposed, uninfected individuals. When all vaccinated animals were considered, a 3-log viremia reduction was observed, compared with controls. The excellent viral replication containment achieved in vaccinated animals translated into significant preservation of circulating α4β7 high+ /CD4 + T cells and of circulating and mucosal CD4 + /C M T cells and in reduced immune activation. A more significant long-term survival was also observed in these animals. Median survival was 72 wk for the control group, whereas >50% of the vaccinated animals were still disease free 130 wk postchallenge, when the trial was closed. There was a statistically significant correlation between levels of CD4 + /IFN-γ + and CD8 + /IFN-γ + T cell percentages on the day of challenge and the control of viremia at week 60 postchallenge or survival. Postchallenge immunological correlates of protection were systemic anti-SIV Gag + Env CD4 + /IL-2 + , CD4 + /IFN-γ + , and CD8 + /TNF-α + T cells and vaginal anti-SIV Gag + Env CD8 + T cell total monofunctional responses.
Small GTPases promote actin coat formation on microsporidian pathogens traversing the apical membrane of Caenorhabditis elegans intestinal cells.

Many intracellular pathogens co-opt actin in host cells, but little is known about these interactions in vivo. We study the in vivo trafficking and exit of the microsporidian Nematocida parisii, which is an intracellular pathogen that infects intestinal cells of the nematode Caenorhabditis elegans. We recently demonstrated that N. parisii uses directional exocytosis to escape out of intestinal cells into the intestinal tract. Here, we show that an intestinal-specific isoform of C. elegans actin called ACT-5 forms coats around membrane compartments that contain single exocytosing spores, and that these coats appear to form after fusion with the apical membrane. We performed a genetic screen for host factors required for actin coat formation and identified small GTPases important for this process. Through analysis of animals defective in these factors, we found that actin coats are not required for pathogen exit although they may boost exocytic output. Later during infection, we find that ACT-5 also forms coats around membrane-bound vesicles that contain multiple spores. These vesicles are likely formed by clathrin-dependent compensatory endocytosis to retrieve membrane material that has been trafficked to the apical membrane as part of the exocytosis process. These findings provide insight into microsporidia interaction with host cells, and provide novel in vivo examples of the manner in which intracellular pathogens co-opt host actin during their life cycle.
Information systems for security trading

Abstract Deregulation of financial markets has created a volatile and competitive environment for companies engaged in security trading. In order to stay competitive, security firms have to rely more on their information systems (IS) to increase their responsiveness to market conditions. As the strategic value and the cost of such systems increase, extreme care must be exercised in their design. In this paper, issues pertaining to the design of IS for security trading are addressed. Four major issues are discussed: (1) Segmentation of the trading process, (2) Identification of trading objectives, (3) Technological requirements, and (4) Management support, planning, and control.
HTR Fuel Integrity With Electromagnetic, Vision and Radiographic Nondestructive Evaluation Methods

In order to ensure HTR fuel qualification, as well as reactor safety, particles need to satisfy a set of specifications including particle integrity. To achieve this goal, AREVA NP has been engaged for several years in a R&D program aiming at the development of innovative industrial non destructive evaluation methods for HTR fuel as alternatives to destructive methods. After investigating a number of potential techniques, development has been focused on vision and eddy currents, both aiming at crack detection. High resolution Phase Contrast X-Ray imaging was also studied for structural defects characterization. For all these techniques, besides the development of HTR fuel dedicated control methods, equipment and probes were specifically designed, tested and optimized thanks to experiments conducted on real and artificial flaws, yielding for some of the methods to potential industrialization and quality control performed over 100% of the fuel production.Copyright © 2008 by ASME
Microcredit and Metaphors in Subsistence Markets

This study investigates metaphors used in the marketplace when providing microcredit to micro and small enterprises (MSEs). Metaphors are associations between abstract concepts and tangible things,...
Appearance of type II diabetes mellitus in type I diabetic recipients of pancreas allografts

To determine the cause of hyperglycemia appearing after pancreas transplantation in type I diabetic recipients, we performed 65 oral glucose tolerance tests with serum insulin and C-peptide determinations in 32 patients with pancreas grafts functioning two or more months following transplantation. We correlated these results with estimates of graft size obtained by magnetic resonance imaging (MRI) and values of urinary amylase as a measure of pancreatic exocrine function. A total of 33 studies were obtained in 20 patients at times of normal glucose tolerance, and normal ranges for serum insulin and C-peptide levels were established; 32 studies in 17 patients during periods of glucose intolerance revealed values of serum insulin and C-peptide that were within the normal range, though the time to peak values was delayed to 2 hr, characteristic of type II diabetes. Only 3 of 17 patients examined by MRI had significant pancreatic allograft atrophy. These patients also had low urinary amylase excretion, and the only values for serum C-peptide that were below the normal range. The other 14 hyperglycemic patients had normalized pancreas grafts, normal urinary amylase excretion, and normal values for serum insulin and C-peptide. In our experience, then, in 76% of patients with hyperglycemia more than 2 months following pancreas transplantation, the cause was appearance of type II diabetes rather than destruction of the allograft with recurrence of type I diabetes. This observation has important implications for the definition of pancreas allograft failure and for the management of pancreas allograft recipients with hyperglycemia.
Fluoride supplements and fluorosis: a meta-analysis

This paper presents a systematic review of the dental literature that was carried out to investigate whether the regular use of fluoride supplements in non-fluoridated communities during the period of tooth development increases the risk of dental fluorosis. A MEDLINE search was organized for all documents published, in English, between January 1966 and September 1997 using the following key words: fluorosis, dental, fluoride, fluoride supplement or supplements, drop or drops, and tablet or tablets. Twenty-four studies that assessed the development of dental fluorosis in children who had used fluoride supplements earlier in their life were included in this review. Of the 24 studies, 10 were cross-sectional/case control studies and four were follow-up studies. These studies had data that allowed a quantitative estimation of the risk of developing dental fluorosis in users of fluoride supplements. The other 10 studies were excluded because they either did not present enough data or had other methodological problems. A qualitative review of the studies found a consistent and strong association between the use of fluoride supplements and dental fluorosis. The meta-analyses of the cross-sectional/case-control studies estimated that the odds ratio of dental fluorosis in users of fluoride supplements compared with non-users ranged between 2.4 and 2.6. The meta-analyses of the follow-up studies estimated that the relative risk in long-term users was between 5.5 and 12.2. This review confirmed that in non-fluoridated communities the use of fluoride supplements during the first 6 years of life is associated with a significant increase in the risk of developing dental fluorosis.
Irreversible Organic Crystalline Chemistry Monitored in Real Time

Because multiple laser shots are typically required to monitor ultrafast photochemical reaction dynamics, sample depletion and product accumulation have greatly restricted the range of substrates and structural environments amenable to study. By implementing a two-dimensional spatial delay gradient across the profile of a femtosecond probe pulse, we can monitor in a single laser shot organic crystalline reaction dynamics despite the formation of permanent photoproducts that cannot be conveniently removed. We monitored the photolysis of the triiodide anion, I 3 − , and subsequent recombination or relaxation of its reaction products, in three very different pure organic molecular crystals. The experimental results and associated molecular dynamics simulations illustrate the intimate connection between lattice structure and reaction dynamics, highlighting the role of lattice constraints in directing phase-coherent geminate recombination of photofragments within a crystalline reaction cage.
Light scattering and water content of extracted muscle fibers as related to contraction and relaxation

Abstract Relaxation, induced in glycerol-extracted muscle fibers by adenosine triphosphate, Mg++, and ethylenediaminetetraacetic acid is associated with diminution in light scattering and swelling. Contraction has the opposite effects. It is suggested that these changes are due to swelling and shrinking of myofilaments and that their state of swelling determines ATPase activity during the contraction-relaxation cycle.
Identification of a mitochondrial ATP synthase–adenine nucleotide translocator complex in Leishmania

The ATP synthasome is a macromolecular complex consisting of ATP synthase, adenine nucleotide translocator and phosphate carrier. To determine if this complex is evolutionary old or young, we searched for its presence in Leishmania, a mitochondria containing protozoan which evolved from the main eukaryote line soon after eukaryotes split from prokaryotes. Sucrose gradient centrifugation showed that the distribution of ANT among the fractions coincided with the distribution of ATP synthase. In addition, ATP synthase co-precipitated with FLAG tagged and wild type adenine nucleotide translocator isolated with anti FLAG and anti adenine nucleotide translocator antibodies, respectively. These data indicate that the adenine nucleotide translocator interacted with the ATP synthase to form a stable structure referred to as the ATP synthasome. The presence of the ATP synthasome in Leishmania, an organism branching off the main line of eukaryotes early in the development of eukaryotes, as well as in higher eukaryotes suggests that the ATP synthasome is a phylogenetically ancient structure.
Effect of orange peel and black tea extracts on markers of performance and cytokine markers of inflammation in horses

This study tested the hypothesis that orange peel (O) and decaffeinated black tea (T) extracts would alter markers of exercise performance as well as exercise-induced mRNA expression for the inflammatory cytokines IL-6, TNF-alpha and IFN-gamma. Nine healthy, unfit Standardbred mares (age: 10±4years, ∼450kg) were assigned to three treatment groups in a randomized crossover design where each horse was administered one of the following; placebo (O; 21 water), black tea extract in water (T; 21) or orange peel extract in water (W; 21), via a nasogastric tube. One hour later the horses completed an incremental graded exercise test (GXT) on a treadmill at a fixed 6% grade with measurements and blood samples obtained at rest, at the end of each 1min step of the GXT and at 2 and 5min post-GXT. An additional set of blood samples for Polymerase Chain Reaction (PCR) measurements of mRNA was obtained before exercise and at 5 and 30min and 1, 2, 4 and 24h post-GXT. The GXTs were conducted between 0700 and 1200h not less than 7days apart. There were no differences (P>0.05) in VO2max, respiratory exchange ratio, run time, velocity at VO2max, core body temperature, haematocrit, creatine kinase (CK), plasma lactate concentrations, HR, right ventricular pressure (RVP) or pulmonary artery pressure (PAP) across treatments. A major finding was that orange peel extract significantly reduced post-exercise VO2 recovery time (W = 112±7, O = 86±6, and T = 120±11s). There was a significant difference in plasma total protein concentration (TP) in the O runs compared with water and T. TNF-alpha mRNA expression was lower in the T runs compared with water and O trials. IFN-gamma mRNA expression levels appeared to be lower in both the T and O extract runs compared with the water trials. The mRNA expression of IL-6 was unaltered across treatment groups. These data suggest that orange peel and black tea extracts may modulate the cytokine responses to intense exercise. Orange peel extract reduced post-exercise recovery time and may potentially enhance the ability of horses to perform subsequent bouts of high-intensity exercise.
Percutaneous transendocardial VEGF gene therapy: MRI guided delivery and characterization of 3D myocardial strain.

Abstract Background Patients with myocardial infarcts have unfavorable left ventricular (LV) remodeling and devastating outcomes. This study was performed to determine whether VEGF -gene delivered transendocardially under MR-guidance improves LV three-dimensional (3D) strain (circumferential, longitudinal and radial), reduces infarct transmurality and increases vascular density in a canine model of permanent LAD coronary artery occlusion. Methods Imaging was performed using a 1.5-T MR scanner. Three days after occlusion, a percutaneous catheter was advanced under MR-guidance into the LV chamber for transendocardial delivery of VEGF -gene therapy ( n =6) or LacZ -gene as control ( n =6) into infarcted and peri-infarcted myocardium. MRI was performed before (3 days) and after (50 days) the delivery of therapy using cine, tagged and delayed contrast enhancement. Histochemical and pathological stains were used to assess myocardial viability and vascular density, respectively. Results Transendocardial delivery of VEGF -gene therapy and LacZ -gene under MRI guidance was successful in all animals. Significant improvement in 3D strain was observed within 50 days in treated animals. On the other hand, control animals demonstrated deterioration in regional strain over time. Significant reductions in infarct transmurality and increases in capillary and arteriole densities were also observed in VEGF-treated as compared to control animals. Conclusion MR-guided transendocardial delivery of VEGF -gene improved myocardial strain and enhanced transmural infarct resorption. This minimally invasive technique may be useful for delivery of local therapies, designed to promote angiogenesis or myogenesis.
Mary Jackson's musings 2

Describes what the author of this column envisages for the future of this regular feature. Gives a brief outline of her career history, commenting on the changes in working practices within ILL operations.
COMMUNITY-BASED WALKING EXERCISE FOR PATIENTS WITH PERIPHERAL ARTERY DISEASE: A PILOT STUDY

Peripheral artery disease (PAD) is a major cause of walking limitation. Supervised walking exercise is an effective treatment to improve the walking ability of patients, but exercise programs based in community settings have often been ineffective. The aim of this study was to determine the efficacy
Prenatal diagnosis of Klippel-Trénaunay-Weber syndrome by ultrasound.

Ultrasound examination due to an elevated maternal serum alpha-fetoprotein level showed lower extremity asymmetry. The findings were felt to be consistent with Klippel-Trenaunay-Weber syndrome. The pregnancy was terminated based on these findings. The ultrasound findings, confirming post-mortem examination, and counselling issues are discussed.
Salt in the Marine Environment and the Creation of a Standard Input for Gas Turbine Air Intake Filtration Systems

Contaminants are ever-present in the air. Contaminated air entering a Gas Turbine will damage internal components and bring about a reduction in overall efficiency. The amount of contaminant entering a Gas Turbine, therefore, needs to be minimised. This paper describes recent developments in the understanding of one such contaminant, salt. It describes how salt is produced, how it varies climatically and how it varies from location to location and is presented here in the context of the author’s particular field of competence — air filtration system design. Salt ingestion by a Gas Turbine intake can cause corrosion and, given time, can accumulate on the compressor blades and reduce the aerodynamic efficiency. The removal of salt in the air is therefore of primary concern to all those involved in the design and operation of Gas Turbines. Salt removal systems are manufactured in various guises. The concept, however, remains the same — salt capture upstream of the Compressor stage. The drawback to this method of salt removal is that it results in a decrease in air pressure entering the Compressor and will consequently bring about a decrease in the overall system performance. As the requirement to remove more and more salt contaminant increases, the pressure drop across the method of filtration required to achieve this, increases. The responsibility of the Filtration Engineer is therefore to fully understand the requirements of the Gas Turbine, to understand the balance between pressure drop, salt removal and salt size and, consequently, to design an appropriate filtration system — one fit for purpose. Gas Turbines in the marine environment are generally found at heights less than 50m above sea level. It is this environment (the Marine Boundary Layer) which historically has been difficult to fully quantify. Herein lies the problem for those involved — if the environment is not fully understood how can the proper exploitation of the technologies be achieved? Recent developments, however, have led to a better understanding of salt in the Marine Boundary Layer. This paper describes these recent developments.Copyright © 2004 by ASME
Healthcare, borders, and boundaries: Crossborder health markets and the entrepreneurial state

Abstract Responding to arguments that states are strongly constrained by global capital, this article uses the concept of the entrepreneurial state to analyze the ways states create crossborder health markets. The article, combined with the others in this special issue, provide three key findings. First, we find that the territorially bound nature of much domestic health policy is being challenged by international integration in a growing number of sectors. Second, we find that crossborder legal frameworks in place to govern markets are extensive but not sufficient to decide questions of global health. Finally, we conclude that states matter in crossborder health because they shape rules that govern markets. Although states are challenged by global capital mobility and global regulatory frameworks, they are still capable of shaping crossborder health markets and should be held accountable for protecting the public from the risks that to health that these markets can create.
Deformation-based brain morphometry to track the course of alcoholism : Differences between intra-subject and inter-subject analysis

Abstract Substantial changes in brain morphology mark the course of alcoholism from development through dependence, recovery, and relapse. These changes can be characterized with deformation-based morphometry, which quantifies shape differences between anatomical structures, either in different subjects (cross-sectional) or in the same subject over time (longitudinal). Here we present analyses of data from a longitudinal magnetic resonance imaging (MRI) study on the effects of alcoholism on brain structure. Images were acquired from alcoholic women ( n =7, mean age 47.8±8.3 years) and age-matched control women ( n =16, mean age 51.2±7.5 years). From each subject, we acquired two structural MR brain images, separated by approximately 2 years (mean 21.6±7 months). We performed two types of morphometry using log-Jacobian maps of inter-subject and intra-subject nonrigid coordinate transformations, justified by the invariance of relevant statistics (mean, standard deviation, z -score, and t -test) under changes of the spatial and temporal reference coordinate system. With all images from one time point, a cross-sectional inter-subject morphometry determined group differences between alcoholics and normal controls. We compared these results with longitudinal intra-subject morphometry based on two images per subject acquired at different times (approximately 2 years apart). Inter- and intra-subject analysis produced partially conflicting results. Whereas the intra-subject analysis indicated faster ventricular volume increases in the alcoholics (+11% per year) than in the controls (+2% per year), the inter-subject analysis showed, on average, smaller absolute ventricle volumes in the alcoholics than in the controls (−33% relative volume). These differences were confirmed by manual planimetry and were statistically significant whether tested based on difference or change, integrated over the volume of the ventricles. Other changes and group differences were consistent between the two analyses, e.g., reduction of white matter (including corpus callosum) and increase in CSF volume, and these are in agreement with established effects of alcoholism on brain structure. We conclude that intra-subject morphometry of longitudinal data is preferable to inter-subject morphometry for detecting dynamic changes due to a disease, especially when only small samples are available. Our analysis demonstrates that the distinction between group differences observed at a point in time vs. over time is not merely academic but can substantially reduce the validity of the outcomes of actual morphometric studies. This discrepancy in results underscores the importance of distinguishing between volume differences and volume changes in morphometric analyses.