cssi/SciSciGPT-SciSciNet huggingface dataset:
Characteristics of Injuries of 0-14 children in Songjiang District of Shanghai City

[Objective]To understand the epidemiological characteristics and rules of children injury in Songjiang District of Shanghai City,and provide scientific evidence for reducing the incidence of children injury.[Methods]Three hospitals in Songjiang District were selected as sentinel surveillance spots,the injury children aged 0～14 years old and diagnosed there for the first time from January 1st,2006 to December1st,2006 were analyzed.[Results]A total of 3080 injury cases were analyzed,the ratio of male to female children was 1.77.School-age children aged 6～11 years were the group with high risk of injuries.The main types of injuries were fall-wounds,traffic accidents and burns/scalds among children aged 0～14 years;and about 50.46% injury happened in home or hostel.[Conclusion]The emphases to injuries interventions are fall-wound,school children and male children injures in the district.Therefore,different preventions measures should be formulated and implemented according to different genders and age groups.
Effect of Alkyl Chain Branching on Physicochemical Properties of Imidazolium-Based Ionic Liquids

The branched ionic liquids (ILs) 1-(iso-alkyl)-3-methylimidazolium bis[(trifluoromethane)sulfonyl]amide ([(N – 2)mCN-1C1im][NTf2] with N = 3–7) were synthesized and their physicochemical properties characterized and compared with the properties of linear ILs 1-(n-alkyl)-3-methylimidazolium bis[(trifluoromethane)sulfonyl]amide ([CNC1im][NTf2] with N = 3–7). For N = 4–7, the density of the branched IL [(N – 2)mCN–1C1im][NTf2] is the same as that of its linear analogue [CNC1im][NTf2] within the standard uncertainty of the measurements. In the case of the N = 3 [1mC2C1im][NTf2]/[C3C1im][NTf2] pair, the density of the branched IL is 0.13% higher than that of the linear IL. For a branched/linear IL pair with a given N, the glass transition temperature Tg, melting temperature Tm, and viscosity η are higher for the branched IL than for the linear IL. [2mC3C1im][NTf2] is an exception in that its Tm is lower than that of [C4C1im][NTf2]. Moreover, the viscosity of [2mC3C1im][NTf2] is anomalously higher than what wou...
Management of the Ureterotomy Incision in 100 Consecutive Ureterolithotomies

We reviewed retrospectively 100 consecutive ureterolithotomies in an attempt to determine if the choice of the ureterotomy closure significantly altered the postoperative course and morbidity rate. No dramatic difference was found when comparing ureterotomies left open, those closed loosely with interrupted sutures and those closed with continuous sutures. Parameters studied were the duration of postoperative urinary drainage, hospital stay and fever. Postoperative radiographic findings among the 3 groups are discussed.
International Organization Membership and Militarized Conflict: A Distributive Perspective

What explains the correlation between membership in International Governmental Organizations (IGOs) and the occurrence of militarized disputes? Existing theories argue that IGOs provide information, solve commitment problems, and socialize states. I offer an alternative take, which highlights the distributive implications of IGO memberships. The international environment is both competitive and interdependent. If some states create a social surplus through institutionalized cooperation, then this may redefine the competitive landscape and create disadvantages for other states. First, IGOs typically advance principles, norms, rules, and policies that fit the ideologies of some actors better than others. Effective IGOs both increase coordination among members and intensify gaps with excluded parties. Second, IGOs sometimes insulate members from coercive sanctions and enhance opportunities for collective actions against outsiders. I examine two observable implications of this theory. Shared IGO memberships correlate with reduced conflict onset among pairs of states that include a major power but not among contiguous states or states involved in territorial disputes. Second, divergence in overall IGO membership portfolios correlates with conflict. An implication is that more IGOs do not necessarily mean more peace. IGO memberships affect the distribution of conflict.
Reduction of Knee Pain by Effusion Reduction.

To the Editor: The article in The Journal by Elsaman, et al 1 is quite thought-provoking. If elimination or reduction of knee effusion is the mechanism of action of spironolactone in reducing knee pain1 … Address correspondence to Dr. B. Rothschild, Department of Medicine, Northeast Ohio Medical University, Rootstown, Ohio 44272, USA. E-mail: spondylair{at}gmail.com
Prevailing Theories in Cardiovascular Physiology during Ancient and Classical Times

Currently accepted theories of human physiology have been proposed only in the last two centuries, with understanding of many molecular processes proposed within the last 50 years. However, theories of human physiology have been debated for thousands of years. This paper focuses on the theories of physiology discussed in ancient and classical times, with a focus on the structure and function of the heart and its vessels. The experiments and subsequent conclusions of physicians and philosophers of antiquity have led to some interesting interpretations. Notably, anatomical studies remain remarkably similar to today’s understanding, whereas ideas of function and physiology are drastically different.
The Charge Variants of DNA and other Polyelectrolytes: Comparison of Experimental Mobilities with Electrophoresis Theories

The free solution mobilities of the charge variants of single- and double-stranded DNA oligomers, small aromatic molecules, peptides, proteins and synthetic copolymers depend on the logarithm of the number of charged residues, not the first power of the charge as predicted by classic electrophoresis theories. The mobility ratios observed for the charge variants of all polyelectrolytes except the synthetic copolymers exhibit a common dependence on the logarithm of fractional charge. The different results observed for the synthetic copolymers can probably be attributed to the flexibility and hydrophobicity of the copolymer backbone. By contrast, the other polyelectrolytes have hydrophilic and relatively rigid backbones. The mobilities observed for the charge variants of the DNA oligomers are well predicted by the Manning electrophoresis equation, while the mobilities predicted by zeta potential theories are too high. However, the mobility ratios observed for the protein charge variants are better described by zeta potential theories.
Fumarase Activity of Human Leukocytes and Erythrocytes

1. The results of over 400 assays of fumarase activity in separated leukocytes and erythrocytes in a variety of hematologic and nonhematologic diseases are presented. 2. The highest mean leukocyte fumarase values occurred in acute monocytic leukemia and acute granulocytic leukemia. Blast cells have greater fumarase activity than more mature forms of the same cell type. 3. Fumarase appears to be distributed ubiquitously among the various leukocytes. Cell populations which contained predominantly neutrophils, lymphocytes, monocytes, blasts, eosinophils, and basophils, all exhibited appreciable enzyme activity. 4. Assays of erythrocyte fumarase activity did not reveal a pattern with the exception of elevated values in macrocytic anemias and in some, but not all, cases of hemolytic anemia.
Platelet Dysfunction in Type-2 Diabetes Mellitus

According to the Diabetes Atlas of the World, published by the International Diabetes Federation (IDF Diabetes Atlas, 7th edn, 2015), India has currently, over 70 million subjects with type-2 diabetes and China, 110 million subjects. The number of adults estimated to be living with diabetes has reached 422 million worldwide, nearly four-fold increase from 1980 figures, according to a World Health Organization (WHO) report (2014). Non-communicable Disease Risk Factor Task Force in their article in Lancet (April 2016) summarize, that if the year 2000 trends in prevalence of diabetes continues, It will not be possible to reach the Millennium Goals (www.un.org/millenniumgoals) of keeping the incidence of type-2 diabetes in 2025, at the 2010 level. The collective prediction of this study group has already come true. Patients with type-2 diabetes carry an equivalent or greater cardiovascular risk to that of a non-diabetic, who has already experienced a coronary event. The risk for acute coronary event in this population seems to be 2–3 times higher than non-diabetic subjects. It is a potentially fatal, chronic disease, whose risks can be prevented by better management of known risks and lifestyle changes. Inflammation, oxidative stress, hyperglycemia, endothelial dysfunction, altered hemorheology and hyper-platelet and coagulation activation pathways, seem to contribute significantly to the clinical complications of type-2 diabetes. In this article, we provide a brief overview on, vascular dysfunction, platelet biochemistry, physiology and altered function, as it relates to the clinical complications of adult on-set diabetes.
Case 67: Angioedema in the Emergency Department

You are called urgently to the emergency department (ED) for an emergent endotracheal intubation. The patient is a 65-year-old African-American female (BMI 32) with a history of hypertension and diabetes mellitus type 2. She takes an ACE inhibitor and metformin. You are told by the emergency physician that the patient was admitted 2 h ago with angioedema. She was treated with epinephrine, methylprednisolone, and diphenhydramine. Unfortunately, the tongue swelling has increased dramatically in the last 30 min.
Non-enhanced CT Maximum Intensity Projections for the Detection of Large Vessel Occlusions.

Background Identification of large vessel occlusions (LVO) is important with recent guidelines supporting endovascular therapy in selected acute ischemic stroke patients. Many stroke centers perform CT angiography (CTA) in patients with suspected LVO, however this requires additional time and contrast administration. Non-enhanced CT maximum intensity projection (NECT-MIPs) may offer a rapid alternative to CTA. Methods We retrospectively reviewed acute stroke patients with LVO in the UCSD Stroke Registry, presenting between 6/2014-7/2016. NECT-MIPs were evaluated for presence of LVO. Gold standard comparison was to CTA. Results were stratified by level of training (Faculty, Fellow and Acute Care Practitioners [ACPs]). Inter-rater agreement was assessed using Fleiss' Kappa Coefficient. Results We reviewed 24 patients using NECT-MIPs for the detection of LVO. Faculty had a sensitivity and specificity of 95% & 92% for ICA/M1, 42% & 100% for M2, and 67% & 96% for basilar occlusions. Fellows and ACPs had a sensitivity and specificity of 61% & 94% for ICA/M1, 19% & 83% for M2, and 75% & 95% for basilar occlusions. Inter-rater agreement among Faculty readers was k=0.75 for ICA/M1, k=0.79 for M2 and k=0.14 for basilar occlusions. Among Fellows and ACPs, k=0.57 for ICA/M1, k=0.40 for M2, and k=0.27 for basilar occlusions. Conclusions NECT-MIPs have high sensitivity and specificity for the detection of LVO when compared to CTA. Inter-rater agreement is fair and higher amongst more experienced reviewers. These results suggest that NECT-MIPs may be helpful to streamline the identification of LVO and reduce door to needle and door to intervention times.
Hypersensitivity to Cardiovascular Implants: Cardiac Implantable Electronic Devices and Septal Occluders

The increasing application of medical devices in the management of various medical and surgical conditions and introduction of various implantable biomedical devices comes with concerns about biocompatibility and putative hypersensitivity. There is an increasing trend of referrals to allergists and dermatologists for pre- and postoperative assessment of patients with suspected allergies to components of medical devices. Hypersensitivity reactions to medical devices can present as localized dermatoses, systemic hypersensitivities, or device malfunction. This chapter provides an overview of the current evidence on hypersensitivity reactions associated with devices used in invasive electrophysiological procedures such as pacemakers. Another category of devices reviewed in this chapter is septal occluders and putative hypersensitivities associated with them.
Linking private, for-profit providers to public sector services for HIV and tuberculosis co-infected patients: A systematic review.

Author(s): Hudson, Mollie; Rutherford, George W; Weiser, Sheri; Fair, Elizabeth | Abstract: BackgroundTuberculosis (TB) is the leading cause of infectious disease deaths worldwide and is the leading cause of death among people with HIV. The World Health Organization (WHO) has called for collaboration between public and private healthcare providers to maximize integration of TB/HIV services and minimize costs. We systematically reviewed published models of public-private sector diagnostic and referral services for TB/HIV co-infected patients.MethodsWe searched PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Science Direct, CINAHL and Web of Science. We included studies that discussed programs that linked private and public providers for TB/HIV concurrent diagnostic and referral services and used Review Manager (Version 5.3, 2015) for meta-analysis.ResultsWe found 1,218 unduplicated potentially relevant articles and abstracts; three met our eligibility criteria. All three described public-private TB/HIV diagnostic/referral services with varying degrees of integration. In Kenya private practitioners were able to test for both TB and HIV and offer state-subsidized TB medication, but they could not provide state-subsidized antiretroviral therapy (ART) to co-infected patients. In India private practitioners not contractually engaged with the public sector offered TB/HIV services inconsistently and on a subjective basis. Those partnered with the state, however, could test for both TB and HIV and offer state-subsidized medications. In Nigeria some private providers had access to both state-subsidized medications and diagnostic tests; others required patients to pay out-of-pocket for testing and/or treatment. In a meta-analysis of the two quantitative reports, TB patients who sought care in the public sector were almost twice as likely to have been tested for HIV than TB patients who sought care in the private sector (risk ratio [RR] 1.98, 95% confidence interval [CI] 1.88-2.08). However, HIV-infected TB patients who sought care in the public sector were marginally less likely to initiate ART than TB patients who sought care from private providers (RR 0.89, 95% CI 0.78-1.03).ConclusionThese three studies are examples of public-private TB/HIV service delivery and can potentially serve as models for integrated TB/HIV care systems. Successful public-private diagnostic and treatment services can both improve outcomes and decrease costs for patients co-infected with HIV and TB.
Assessment of association between muscular diagnosis in temporomandibular disorders with mandibular kinematics.

Objective: To study the association between mandibular kinematics and muscular diagnoses in temporomandibular disorders (TMD). Method: Retrospective, descriptive clinical study based on an analysis...
Crime and the Schizophrenia Spectrum: A Study of Three Danish Cohorts

Most schizophrenia research is currently conducted within the diathesis-stress framework wherein some portion of variation in phenotypic schizophrenia is assumed to be due to environmental factors and some portion due to genetic factors. The specific components of this model, however, have not been well-characterized. Although genetic research offers the most solid evidence concerning etiology, the mode of transmission is unclear (Matthysse & Kidd, 1976) and the biochemical or psychological features which constitute vulnerability (diathesis) have not been delimited. On the other hand, research concerning environmental determinants has not contributed substantially to our understanding of the disease (Neale and Oltmanns, 1980). It follows that it remains unclear how genetic and environmental factors interact. Is the genotype represented in different phenotypes? If so, how does the genotype interact with stressors? Schizophrenia spectrum illnesses are a potentially fruitful way of studying the interplay between constitutional vulnerability and stressors. Spectrum illnesses may represent genotypic schizophrenia. By comparing persons who are genotypically similar and phenotypic ally different, it is possible to elucidate environmental factors important in shaping outcome. The present study is concerned with one possible spectrum illness, criminal or antisocial behavior.
La Crosse Virus

This chapter provides an overview of the La Crosse (LAC) virus. This virus belongs to the Bunyaviridae family and is a member of the California group of viruses. It causes mild fever to severe encephalitis primarily in children. The most common symptoms are fever, headache, nausea or vomiting, nuchal rigidity, and frequently convulsions and lethargy. The hosts to the LAC virus are man and small mammals, primarily eastern chipmunks, gray squirrels, and red foxes. The areas outside the Western Hemisphere are free from this virus. The preferred method for viral diagnosis of the virus is the inoculation of tissue culture with confirmation by the fluorescent antibody technique. In some instances, the more expensive but sensitive method of intracerebral suckling mouse inoculation is required to obtain an isolate. Specific neutralization tests are required for virus identification of isolates that come from areas where other closely related California group viruses occur. The preferred method for serological diagnosis of the virus is the plaque reduction neutralization test.
Quantum Groups and Perverse Sheaves: An Example

The aim of this work is to give a more detailed exposition of the results of [S] in the simplest nontrivial case. This case amounts to the study of the category of perverse sheaves on a complex plane which are smooth along the stratification induced by the three lines intersecting at one point.
Chapter 14 Peripheral nerve hyperexcitability and the neuromuscular junction

Publisher Summary This chapter describes the peripheral nerve hyperexcitability and the neuromuscular junction. Neuromyotonia, myokymia, neuromuscular hyperexcitability, peripheral nerve hyperexcitability (PNH), continuous muscle fiber activity, quantal squander, cramp-fasciculation syndrome, Armadillo syndrome, rippling muscles and the eponyms “Isaacs syndrome” and “Morvan syndrome” describe a heterogeneous group of neuromuscular disorders characterized by spontaneous and continuous muscle activity. A majority of these disorders result from hyperexcitability of the distal motor nerve or motor nerve terminal. The clinical and electromyographic features of PNH are quite varied and reflect a continuous spectrum of manifestations ranging from frequent fasciculations to high-frequency bursts of motor unit discharges (neuromyotonia). PNH can result from genetic causes, especially mutations in voltage-gated potassium channels (VGKC). Toxins can affect the neuromuscular junction (NMJ) or motor nerve terminal. Drugs and toxins increase acetylcholine levels at the NMJ, can also produce motor nerve hyperexcitability. Demyelination or radiation injury of peripheral nerves can produce focal PNH. Inflammation at the site of demyelination may also contribute to nerve hyperexcitability. Many acquired cases of generalized PNH appear to have an autoimmune basis. The chapter discusses the neuromyotonia (Isaacs syndrome), Morvan syndrome, and cramp-fasciculation syndrome. Rippling muscle syndrome, another unusual neuromuscular hyperexcitability disorder, is characterized by waves of rippling or rolling muscle movements following muscle percussion or stretching. Neuromyotonia may occur in association with other autoimmune disorders or with cancer. Encephalopathy, seizures or behavioral changes may co-exist with PNH and may represent the effects of VGKC antibodies on neuronal excitability in the central nervous system (CNS).
Why Memory Hinders Investor Learning

We examine the dynamics of financial knowledge and investment experience on the equity portfolio decisions of U.S. investors. We find that prior portfolio choices influence investors’ future decisions. The most influential prior choices are those made near the time when the investor starts trading and in the most recent period. However, experience matters. Specifically, investors hold more stocks, reduce purchase turnover, earn higher returns, and increase the Sharpe Ratios of their portfolios as they accrue investment experience. In contrast, general financial knowledge by itself does not influence investor behavior. Rather, knowledge affects equity portfolio decisions in combination with experience. That is, as knowledgeable investors gain experience, they improve both portfolio construction and account performance.
Considerations for Choosing Sensitive Element Size for Needle and Fiber-Optic Hydrophones—Part II: Experimental Validation of Spatial Averaging Model

Acoustic pressure can be measured with a hydrophone. Hydrophone measurements can underestimate incident acoustic pressure due to spatial averaging effects across the hydrophone sensitive element. The spatial averaging filter for a nonlinear focused beam is a low-pass filter that decreases monotonically from 1 to 0 as frequency increases from 0 to infinity. Experiments were performed to test an analytic model for the spatial averaging filter. Nonlinear pressure tone bursts were generated by three source transducers with driving frequencies ranging from 2.5 to 6 MHz, diameters ranging from 19 to 64 mm, and focal lengths ranging from 38 to 89 mm. The nonlinear pressure fields were measured using four needle hydrophones with nominal geometrical sensitive element diameters of 200, 400, 600, and $1000~\mu \text{m}$ . The average root-mean-square difference between theoretical and experimental spatial averaging filters was 5.8% ± 2.6%.
Acid-suppressive medications and risk of pneumonia in acute stroke patients: A systematic review and meta-analysis.

Abstract Goal We performed a systematic review and meta-analysis aiming to clarify the relationship between acid-suppressive medication (ASM) and the risk of pneumonia in acute stroke. Methods The included studies examined patients with an acute ischemic and/or hemorrhagic stroke, assessed the relationship of one or both groups of ASM, histamine-2 receptor antagonist (H2RA) and proton-pump inhibitor (PPI), as a variable of interest, and used the occurrence of hospital-acquired pneumonia (HAP) as an outcome measure. The search was conducted in MEDLINE, Cochrane, Embase, and Google Scholar. Random-effects meta-analyses were used to obtain pooled estimates of the effect. Results 5 retrospective cohort-studies fulfilled study criteria. The results revealed a higher risk of pneumonia for both, patients receiving PPI (adjusted relative risk [RR] 2.37, 95% confidence interval [CI] 1.36–4.17, I2 0%) and H2RAs (adjusted RR 1.73, 95% CI 0.74–4.25, I2 68.3%), although the latter did not reach statistical significance. A comparison of the overall acid versus non-acid groups using unadjusted values yielded likewise an increased risk for pneumonia for patients receiving ASM (unadjusted RR 4.65, 95% CI 1.64–13.16, I2 93.3%). Conclusion Results of this meta-analysis show an increased risk for HAP in acute stroke patients who receive ASM, particularly those exposed to PPIs. Larger, well-controlled studies in acute stroke populations are needed to establish a clearer association between ASM and HAP. These results, however, urge caution when prescribing ASM – especially to stroke patients considered to be at high risk for pneumonia.
Theta Functions from an Analytic Viewpoint

Suppose that we have a measure space (X, dx). We recall that this is a pair consisting of a non-empty set X and a (countably additive) measure dx on X. We shall denote a general point of X by x and consider C-valued functions Φ(x), or simply Φ, on X. For 1 ≦ p < ∞ we shall denote by Lp(X) the set of Lp-functions on X, i.e., the set of measurable functions Φ on X such that |Φ(x)| p is integrable with respect to dx. The set Lp(X) forms a vector space over C. Moreover, if we define the Lp-norm ∥Φ∥p of Φ as $\|\Phi\|_p=({\mathop\int\limits_X}\mid\Phi(x)\mid^p\ dx)^{1/p},$ this has the usual properties of a norm, and it is invariant under complex conjugation. In particular, if we take ∥Φ1 − Φ2∥p the “distance” of two “points” Φ1, Φ2 of Lp(X), we get a metric space. We tacitly identify Φ1, Φ2 if ∥Φ1 − Φ2∥p = 0. The metric space Lp(X) is complete. If Φ is a bounded (continuous) function on X, we shall denote by ∥:∥∞ the uniform norm of Φ, i.e., the supremum of ∣Φ(x)∣ for all x in X. We shall consider mostly the space L2(X) and its subspaces. We recall that, for every Φ1, Φ2 in L2(X), Φ1(x) Φ2(x) is integrable with respect to dx, hence the scalar product: $(\Phi_1,\ \Phi_2)={\mathop\int\limits_X}\Phi_1(x)\overline{\Phi_2(x)}dx$ is well defined. This is C-linear in Φ1 and its complex conjugate is (Φ2, Φ1). In other words, L2(X) forms a Hubert space. We shall denote the L 2-norm simply by ∥ ∥; we have the Schwarz inequality: $\mid(\Phi_1,\ \Phi_2)\mid{\mathop <\limits_=}\|\Phi_1\|\|\Phi_2\|.$ if (Y, dy) is another measure space, we can define the product measure dx ⊗ dy, or simply dx dy, on the product X × Y. If Φ(x, y) is an L1-function on X × Y with respect to dx dy, we have the Fubini theorem: $\mathop\int \limits_{X \times Y} \Phi(x, y)dx dy = {\mathop\int \limits_X}({\mathop\int \limits_Y} \Phi(x, y)dy)dx = {\mathop\int \limits_Y}({\mathop\int \limits_X} \Phi(x, y)dx)dy.$
Profiles of Risk and Protection for Violence and Bullying Perpetration Among Adolescent Boys

BACKGROUND Violence and bullying perpetration among boys are major public health problems. We address gaps in the literature by examining: (1) how risk and protective factors co-occur, and (2) how different risk/protection profiles are associated with violence and bullying perpetration among adolescent boys. METHODS Data came from the population-based 2016 Minnesota Student Survey. The analytic sample included boys in grades 8, 9, and 11 (N = 63,818). Latent profile analyses identified patterns of 22 behavioral, intrapersonal, family, and school and community risk/protective factors. Logistic regression analyses examined how these patterns related to violence and bullying perpetration. RESULTS We identified 5 groups: Class 1: Low risk, high safety, high connectedness; Class 2: Low risk, moderate safety, moderate connectedness; Class 3: Moderate risk, high safety, moderate connectedness; Class 4: High risk, moderate safety, low connectedness; and Class 5: High risk, low safety, low connectedness. Compared to Class 1, Class 5 students had the highest odds of all for violence and bullying perpetration. Class 4 students also demonstrated high odds of violence and bullying, compared to Class 1. Though not as high as Classes 4 or 5, Class 2 and 3 students showed higher odds for both outcomes, compared to Class 1. CONCLUSIONS Substantive variations exist in boys who engage in violence and bullying. We highlight cumulative, co-occurring risk factors, connectedness to parents and other prosocial adults (eg, teachers), and school and neighborhood safety as important factors to address in school health programs seeking to prevent violence and bullying perpetration among boys.
Later Surgical Start Time Is Associated With Longer Length of Stay and Higher Cost in Cervical Spine Surgery.

Study design Retrospective study of a surgical cohort from a single, large academic institution. Objective The aim of this study was to investigate associations between surgical start time, length of stay, cost, perioperative outcomes, and readmission. Summary of background data One retrospective study with a smaller cohort investigated associations between surgical start time and outcomes in spine surgery and found that early start times were correlated with shorter length of stay. No examinations of perioperative outcomes or cost have been performed. Methods All patients undergoing anterior cervical discectomy and fusion (ACDF) and posterior cervical decompression and fusion (PCDF) were queried from a single institution from January 1, 2008 to November 30, 2016. Patients undergoing surgery that started between 12:00 AM and 6:00 AM were excluded due to their likely emergent nature. Cases starting before and after 2:00 PM were compared on the basis of length of stay and cost as the primary outcomes using multivariable logistic regression. Result The patients undergoing ACDF and PCDF were both similar on the basis of comorbidity burden, preoperative diagnosis, and number of segments fused. The patients undergoing ACDF starting after 2 PM had longer LOS values (adjusted difference of 0.65 days; 95% confidence interval [CI]: 0.28-1.03; P = 0.0006) and higher costs of hospitalization (adjusted difference of $1177; 95% CI: $549-$1806; P = 0.0002). Patients undergoing PCDF starting after 2 PM also had longer LOS values (adjusted difference of 1.19 days; 95% CI: 0.46-1.91; P = 0.001) and higher costs of hospitalization (adjusted difference of $2305; 95% CI: $826-$3785; P = 0.002). Conclusion Later surgical start time is associated with longer LOS and higher cost. These findings should be further confirmed in the spine surgical literature to investigate surgical start time as a potential cost-saving measure. Level of evidence 3.
Venetoclax in AML: Where We Are and Where We Are Headed

The developmental path for venetoclax in acute myeloid leukemia (AML) has been rapid and stands in stark contrast to the incremental progress that has characterized the field in previous decades. For perspective, on December 31, 2013, the first AML patient was enrolled into a study using venetoclax; 59 months later, on November 21, 2018, venetoclax received accelerated approval by the FDA for use in AML. In June 2020, Dr. DiNardo presented the results of the required confirmatory study at the European Hematology Association meeting, showing that venetoclax with azacitidine resulted in a superior response rate and overall survival compared to azacitidine alone for older, newly diagnosed AML patients. This swift progress has provided a welcome and potent new therapy for patients with AML; with it come questions about how its role can be expanded, and how its use can be optimized.
Development of Nonbacterial Thrombotic Endocarditis While on Systemic Anticoagulation in Pancreatic Cancer: A Case Report.

Nonbacterial thromboembolic endocarditis (NBTE), or marantic endocarditis, is a rare complication associated with advanced cancer. Enoxaparin or unfractionated heparin is considered the standard treatment for NBTE. In this case report, we describe a 59-year-old female with metastatic pancreatic cancer who presented with embolic stroke and was found to have new NBTE of the mitral valve while she was receiving the therapeutic dose of enoxaparin. Of note, her recent echocardiogram one week ago was negative for mitral valve vegetations. Our case emphasized that for patients with advanced cancer presenting with stroke, the diagnosis of NBTE should be entertained even for those on systemic anticoagulation.
Mechanisms of twin screw melt granulation

Abstract Twin screw melt granulation is a new alternative method for granulation that offers several advantages over wet and dry granulation methods. Twin screw melt granulation has been rapidly gaining interest over recent years in the pharmaceutical industry. Since it operates in steady state with controlled thermal and mixing history, twin screw melt granulation produces granules with more consistent and uniform quality than batch processes. This article reviews the recent progresses in investigating how the granulation formation mechanisms and granule properties are impacted by twin screw extruder parameters (machine parameters and process parameters) and system parameters (degree of fill, specific mechanical energy, and residence time) during twin screw melt granulation. Because of the unique mixing and melting mechanisms of twin screw extruder, thermoplastic binders with high melt viscosity could be applied in twin screw melt granulation. The effects of binder properties and drug-binder interactions on the granulation mechanisms and granule properties are also discussed.
FRI0082 Effect of hydroxychloroquine therapy on cartilage injury in rheumatoid arthritis

Background Better methods for assessing articular injury are needed to monitor efficacy of disease-modifying therapy in rheumatoid arthritis (RA). Objectives The purpose of this study was to measure serum levels of cross-linked peptides from the C-telopeptide of type II collagen (col2CTx) during treatment of patients with RA. Methods Serial serum samples were taken from a previous clinical trial1 in which 213 subjects with active RA received a loading dose of hydroxychloroquine 400, 800 or 1200 mg/d for six weeks, then 400 mg/d for up to Week 24. They also received naproxen 1000 mg/d. From 213 subjects in the original trial, 152 paired sera were available for study; col2CTx levels were measured at Weeks 0 and 24, using an ELISA that measures a breakdown product of human cartilage. These levels were compared with tender (TJC) and swollen (SJC) joint counts, and the erythrocyte sedimentation rate (ESR). Results Median (± SEM) col2CTx levels decreased by 10% (p = 0.006, Wilcoxon signed ranks) by 24 weeks. Clinical variables decreased much more dramatically by 24 weeks; the TJC declined by 67% (p = 0.000), and the SJC, by 56% (p = 0.000). The ESR declined by 33% (p = 0.000) during this same period. Thus, the magnitude in reduction of circulating col2CTx was less than TJC, SJC and ESR but did show significant improvement. Conclusion This limited improvement in col2CTX may be due to a lag in suppression of structural damage to cartilage. Since joint radiographs typically require a year or more to show a reduction in joint destruction, the measurement of col2CTx may give an earlier indication of reduction in injury to cartilage. Further clinical studies need to be done in patients treated with more intensive antirheumatic therapy and over longer time periods. Reference Furst DE, et al. Arthritis Rheum. 1999;42(2):357–65
Agrochemical occurrence on colocated wildflowers and wild bees collected near beef cattle feed yards and row crops

It is well established that agrochemicals can pose significant threats to native pollinators, however relatively little is known about pollinator risks associated with agrochemicals that are used on beef cattle feed yards. Recently, feed yard-derived agrochemicals and those from row crop agriculture were quantified on wildflowers growing on the High Plains, USA. To better characterize pollinator risks on the High Plains, we collected co-located wildflowers and foraging bees across three field seasons for analytical determination of residual agrochemicals. Agrochemicals were detected and quantified on the majority of wildflowers (85%) and nearly half of bees (49%). Permethrin was the most frequently detected analyte on wildflowers (32%) and bees (17%). Flower hazard quotients and flower hazard indices were calculated to deterministically evaluate risk to foraging pollinators. Mean flower hazard quotients exceeded one for 5/16 analytes (31%), and flower hazard quotients calculated for 30% of wildflowers were greater than 50. Flower hazard quotients for clothianidin exceeded 400 for 14% of wildflowers, which portends conditions conducive to frequent bee mortalities. Flower hazard indices were greater on wildflowers from mid-July to mid-September as compared to wildflowers collected earlier in the summer which coincides with row crop planting and increased prevalence of feed yard flies. Hazard quotients and hazard index values calculated from agrochemical residue data suggest that pollinators frequenting wildflowers near beef cattle feed yards and row crops on the High Plains are at risk from both individual sources, and more so when considered in combination. This article is protected by copyright. All rights reserved.
Riding the Bus: Symbol and Vehicle for Boundary Spanning

This reflective essay examines the activity of a bus tour organized as the result of an ongoing university and city partnership. The author illustrates how riding the bus is not only symbolic for positionality in our society but also how it can be a viable mechanism for initiating boundary spanning and promoting opportunities for place-based learning and future engagement. This essay focuses on the concept of boundary spanning and the roles and domains most often associated with this activity by exploring the language and metaphors invoked in the term. The notion of boundary spanning is framed as an activity system, coupled with consideration of how riding the bus facilitates less traditional participants’ engagement. The author concludes by proposing that the activity of riding the bus can inform the boundary spanning metaphor while also serving as a mechanism to mobilize further engagement efforts.
Factors associated with the presence of cerebral microbleeds and its influence on outcomes of stroke not treated with alteplase

Abstract Objectives Cerebral microbleeds (CMB) are associated with increased risk of hemorrhagic transformation (HT) of ischemic stroke with alteplase. Whether the presence of CMB influences the risk of HT and discharge outcomes of stroke patients not receiving alteplase is unclear. We evaluated the factors associated with the presence of CMB, and if the rates of HT and discharge outcomes were modified by the presence of CMB among stroke patients not treated with alteplase. Methods Ischemic stroke patients who had MRI and did not receive alteplase were included in the study. CMB, HT and white matter hyperintensity (WMH) were evaluated using Microbleed Anatomical Rating Scale, Heidelberg bleeding classification, and Fazekas scales, respectively. Multivariate regression analysis was performed to evaluate factors associated with the presence of CMB. Results Among 196 patients in the study, 58 (30%) patients had CMB. Nine patients had ≥ 10 CMBs. Median National Institutes of Health stroke scale score was 4. In multivariate analysis, age (OR=1.07;95%CI=1.01–1.12), history of stroke (OR=3.10;95%CI=1.08–8.92), congestive heart failure (OR=7.26;95%CI=1.58–33.42), admission diastolic blood pressure (OR=1.03;95%CI=1.003–1.06) and severe WMH defined as Fazekas score 4–6 (OR=4.69;95%CI=1.80–12.23) were significantly associated with the presence of CMB. There was no difference in HT (10% vs 12%, p = 0.80) or discharge outcomes (modified Rankin Scale 0–2: 53% vs 57%, p = 0.62) of patients with CMB compared to those without CMB. Conclusion CMB are associated with severe WMH and higher diastolic blood pressure. CMB are not associated with the HT occurrence or discharge outcome of mild ischemic stroke in the absence of alteplase.
Nuclear export and translation of circular repeat-containing intronic RNA in C9ORF72-ALS/FTD

C9ORF72 hexanucleotide GGGGCC repeat expansion is the most common genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Repeat-containing RNA mediates toxicity through nuclear granules and dipeptide repeat (DPR) proteins produced by repeat-associated non-AUG translation. However, it remains unclear how the intron-localized repeats are exported and translated in the cytoplasm. We use single molecule imaging approach to examine the molecular identity and spatiotemporal dynamics of the repeat RNA. We demonstrate that the spliced intron with G-rich repeats is stabilized in a circular form due to defective lariat debranching. The spliced circular intron, instead of pre-mRNA, serves as the translation template. The NXF1-NXT1 pathway plays an important role in the nuclear export of the circular intron and modulates toxic DPR production. This study reveals an uncharacterized disease-causing RNA species mediated by repeat expansion and demonstrates the importance of RNA spatial localization to understand disease etiology.
Fungus among us: A poster child for diagnostic stewardship.

When interpreting the significance of Aspergillus species in respiratory culture, first ask if the culture was clinically indicated, or if this was an incidental finding.
A Juxtaposition of Wittgenstein’s and Mozi’s Theory of Knowledge to Develop New Perspectives on the Traditional Problems of Western Epistemology

This paper juxtaposes the later Wittgenstein's and Mozi's theories of knowledge to provide us with new perspectives for addressing the deadlocks faced by a representational theory of knowledge that hinges on direct realism in order to devise a solution that incorporates the best of both philosophers' thinking. This article highlights the Chinese understanding of mind and knowledge in terms of competence, compared to Western epistemology that focuses on having an accurate representative model of reality, allowing for a dichotomy between representation and mind-independent reality. I argue that we should aim for the middle way by synthesizing both these philosophers' insights on contextualism to overcome the deadlocks faced by the traditional Western epistemological focus on representation and by extending Mozi's version of contextualism into other areas of knowledge, beyond social and moral issues.
Consciousness Raising, Values, and Practice Behavior

This paper advocates for more conscious awareness of values, and their logical link, along with knowledge, to practice. A logical network is developed which reveals the association between values, knowledge, and practice behaviors. Excnples from social work literature are used to illustrate the breakdown in the logical development of practice which occurs when values are suppressed or are only dealt with subjectively. Examples are also given based upon a planning group in which values were defined and used with community data to logically deduce 'what ought to be done." A plan for self study is also developed. Scrutinizing practice behaviors and the justifications which support or refute these behaviors is essential to the development of social work and to the defense (or prosecution) of social workers whose behavior is being questioned. The number of grievance claims against social workers have increased rapidly in recent years as have charges that social workers are not doing enough to critique and improve the effectiveness of practice. Efforts have been made to critique practice behaviors on the basis of specific research data, but too little has been done to show how specific values are logically linked to practices of social workers. This paper represents a consciousness raising effort to reveal this linkage. "Consciousness raising" is a process by which something is transformed from a non-cognitive to a cognitive level of awareness. It enables subjective, ill-defined, even non-conscious content to take on new form and meaning as it is identified, discussed and critiqued. Values have 1A prior edition of this paper was presented at the National Conference on Social Welfare, 105th Annual Forum, "Social Services/Human Services: A Team Effort," Los Angeles, California, May 22, 1978. Special thanks also go to Michael McCrossen for his constructive critique of the ideas in this paper.
Lyapunov based collision avoidance and control of multiple robots

We address the problem of path planning and control of multiple robots operating in a common workspace. The developments merge the control and trajectory planning issues for obstacle avoidance into one. We determine an online control law which avoids collisions between the arms while guiding the end-effectors from their respective starting positions S to their respective desired goal positions G, if such a collision free trajectory exists. The control law is determined from a Lyapunov function based on the total system energy. We show through simulations that this control scheme is able to guide two manipulators working in a common workspace avoid collisions with each other as they reach their goal points. No off-line path planning involving geometric analysis is necessary for this scheme to work if a collision free trajectory is feasible.
Linker for Activation of B Cells: A Functional Equivalent of a Mutant Linker for Activation of T Cells Deficient in Phospholipase C-γ1 Binding

Adaptor proteins have important functions in coupling stimulation through immunoreceptors with downstream events. The adaptor linker for activation of B cells (LAB)/non-T cell activation linker (NTAL) is expressed in various immune cell types and has a similar domain structure as linker for activation of T cells (LAT). In this study we generated a LAB transgenic mouse to compare the functional differences between LAB and LAT. A LAB transgene expressed in LAT-deficient T cells was able to restore T cell development. However, these mice developed severe organomegaly with disorganized lymphoid tissues. Lymphocytes from these transgenic mice were hyperactivated, and T cells produced large amounts of type II cytokines. In addition, these activities appeared to be uncoupled from the TCR. An examination of the signaling capabilities of these T cells revealed that LAB resembled a LAT molecule unable to bind phospholipase C-γ1.
Evidence that Peroxidation of Lysosomal Membranes Is Initiated by Hydroxyl Free Radicals Produced during Flavin Enzyme Activity

Since evidence had been published that lysosomes are disrupted by a free radical-like agent produced during the oxidation of NADPH by liver microsomes, the nature of this free radical was investigated. The following data are presented. 1. The oxidation of NADPH by liver microsomes in the presence of ADP and Fe3+ produced a factor with properties of a free radical which caused the lysis of lysosomes. The addition of superoxide dismutase enhanced the lysis. 2. Lysis of lysosomes also was mediated by the oxidation of NADPH by a partially purified NADPH-cytochrome P450 reductase. 3. The oxidation of xanthine by xanthine oxidase in the presence of ADP and Fe3+ produced a radical capable of causing lysosomal lysis. Here again superoxide dismutase caused an enhancement of this lysis. 4. It was demonstrated that the superoxide free radical per se was not the agent causing lysis. Evidence is presented that the free radical causing the lysis of the lysosomes is the hydroxyl free radical (OH·). 5. During lysosomal lysis by the OH· radical, peroxidation of the lysosomal lipids was observed as assayed by the formation of malondialdehyde. 6. The mechanisms whereby superoxide and hydroxyl free radicals may be produced and interact with lysosomal membranes are discussed.
Right-sided austin flint murmur: Documentation by intracardiac phonocardiography, echocardiography and postmortem findings*

A 25 year old man with multiple congenital cardiac defects, pulmonary hypertension, pulmonary reguritation had a loud mid-diastolic rumbling murmur with presystolic accentuation, heard best at the lower left sternal border and cardiac apex. Intracardiac and external phonocardiograms, echocardiograms and postmortem findings documented that the rumble represented a “right-sided Austin Flint” murmur.
Electrochemistry of the Carbon–Halogen Bond

1 Introduction 2 General Reaction Types 3 Cathodic Reactions 4 Anodic Reactions 5 Acknowledgements Keywords: carbon–halogen bond electrochemistry; direct cathodic reactions; direct anodic reactions; cathodic reactions; ease of reduction by halogen type; germinal polyhalides; aryl halides; mediated reactions