cssi/SciSciGPT-SciSciNet huggingface dataset:
Internal mammary artery and saphenous vein graft patency. Effects of aspirin.

As part of two Department of Veterans Affairs Cooperative Trials, we obtained angiographic patency data for internal mammary artery (IMA) and saphenous vein grafts to the left anterior descending (LAD) coronary artery at 1 year after coronary artery bypass surgery. Patients received either aspirin 325 mg q.d., aspirin 325 mg t.i.d., aspirin 325 mg and dipyridamole 75 mg t.i.d., or placebo. Aspirin was initiated either 12 hours before or 6 hours after operation. Patients were stratified preoperatively for extent of disease and randomized to the therapies outlined above. There was no randomization to IMA versus saphenous vein grafts to the LAD. When the patients taking placebo were compared with those taking aspirin, there were no differences in the IMA (100.0% versus 92.1%, p = 0.385) or vein graft (88.8% versus 90.4%, p = 0.675) patency rates. The patency rate, irrespective of treatment, for all IMA grafts was 92.8% (220 of 237) versus 90.1% (345 of 383) for all vein grafts to the LAD (p = 0.309). Thus, both the IMA and vein grafts had excellent patency rates at 1 year. Aspirin did not alter this at 1 year, and there were no differences between IMA and vein graft patency to the LAD.
Abstract 201: Overexpression of Calcium/Calmodulin-Dependent Protein Kinase II (CaMKII) Potentiates Angiotensin II (AngII)-Mediated Signaling in Neurons

AngII signaling in the brain regulates systemic cardiovascular function. AngII modulates neuronal ion channel activity and neuronal firing via reactive oxygen species (ROS) and redox-sensitive proteins. Our recent studies indicate that in neurons AngII increases activity (i.e. phosphorylation) of CaMKII, a signaling intermediate known to inhibit potassium (K+) channel current. However, the potential cross-talk between AngII, ROS, and CaMKII in modulating neuronal K+ channel activity and the in vivo central AngII-induced pressor response remains unclear. Here, we tested the hypothesis that CaMKII overexpression exacerbates the AngII-dependent inhibition of K+ channel current and the acute central AngII-induced increase in blood pressure. The neuron specific isoform of CaMKII (CaMKIIα) was cloned, and CaMKIIα adenovirus was generated (AdCaMKIIα). Adenovirus-mediated overexpression of total and active CaMKII protein were assessed in differentiated mouse catecholaminergic (CATH.a) neurons by measuring total and phosphorylated CaMKII protein levels, respectively, via Western blot analysis. To investigate the effect of CaMKIIα overexpression on K+ channel activity, CATH.a neurons were transduced with AdCaMKIIα or control adenovirus, AdEmpty, and voltage-gated K+ current (IKV) was measured by the whole cell patch-clamp technique. Baseline IKV was measured followed by 5 mins of AngII (100 nM) superfusion. AngII lowered steady-state current (ISS) and peak current (Ipeak) in AdEmpty-transduced neurons (ISS by 20 ± 4%; Ipeak by 19 ± 3%), and this inhibitory response was significantly potentiated in AdCaMKIIα-transduced neurons (ISS by 40 ± 7%; Ipeak by 41 ± 5%; p< 0.05). Preliminary in vivo studies suggest that the central AngII-induced pressor response is exacerbated in mice intracerebroventricularly injected with AdCaMKIIα as compared to control virus-injected mice. These data indicate that CaMKIIα overexpression potentiates AngII-mediated inhibition of IKv and the central AngII-induced pressor response. Future studies will investigate the ROS-mediated post-translational modifications of CaMKIIα in AngII-stimulated neurons and the contribution of these modifications to ion channel activity and blood pressure regulation.
Sequential Change of Brain Edema by Semiquantitative Measurement on MRI in Patients with Hypertensive Intracerebral Hemorrhage

The progression of brain edema in seven patients with hypertensive intracerebral hemorrhage (ICH) was evaluated. Five were of putaminal and two were of thalamic hemorrhage. The hematoma volume in the patients was 4 ∼ 40 ml (18.9 ± 8.0 ml). Sequential MRI (SE: 2000/40) was performed at one, two and four weeks after onset. The edema volume (EV) was calculated as 1/2 • (long diameter) • (short diameter) • (thickness) of the high intensity area (HIA) on MRI. In comparison with the EV at one week after onset, the EV at two weeks was increased and the EV at four weeks returned to the same level of that at one week (132.3 ± 26.1%, 100 ± 10.6%, respectively). In contrast, the consciousness level and motor weakness of the patients had already improved at two weeks after onset. Our results demonstrate that progression of brain edema after small or medium size ICH may not bring about a deterioration of the clinical course. Moreover, progression of brain edema to the cerebral cortex and ventricle as indicated by MRI suggested an absorption pathway for the edema fluid, and implying that brain edema following ICH could play a part in the healing process after ICH.
Surgical treatment of low back pain and sciatica.

This article reviews a pathology-oriented approach to the diagnosis and surgical treatment of low back pain and sciatica, with emphasis on results that can be expected when surgery is specifically tailored to the patient presenting with pathology.
The discovery of successful direct fluorination syntheses: Three ears of elemental fluorine reaction chemistry

Publisher Summary Development of successful direct fluorination technology has passed through three distinct eras since 1963. The first era, called the inception, comprises the years from 1964 through 1970, and was a period in which many novel organic and inorganic classes of fluorine compounds were prepared. However, the reactions proceeded on a long time scale (up to 7 days) and gave only two to five grams of product per run. As this era closed, it was proved that finely powdered hydrocarbon solids could be converted to fluorocarbon analogs using controlled elemental fluorine as a reagent. Then came the interim period in which great advances in capabilities and yields were made. It covered the years 1970 through 1992, and was an era when direct fluorination was done in ways that had much wider applications and capabilities. Reactions were performed using a number of different reactor styles and techniques. This was the era of the disk reactor, and amelioration of reactions with many new ether and polyether structures by scavenging HF with potassium fluoride or sodium fluoride to preserve these structures. In this era, product yields normally fell in the 70–90% range, with product quantities per run ranging from five to forty grams. The third era––Renaissance (1992 to the present day)––saw the range of fluorinated inorganic, organometallic, and organic compounds. Product yields mostly exceeded 98%.
On a New Relationship between Physical Distribution and Marketing: On Doing for Marketing what it Cannot do for Itself

Physical distribution systems might become the major, differential advantage over the remaining marketing variables in obtaining profitable, incremental, and long-term sales volume. Specifically, the case study presented in this paper suggests that the market tends to recognize distribution costs and the need for the vendor to protect itself with long-term contracts, and at significantly higher volumes and in the higher margin products.
Introduction: World War II Bucharest and Its Jews

One of the main beneficiaries of the Paris Peace Treaties at the end of World War I and a major French and British ally in Eastern Europe, Romania found itself increasingly isolated two decades later in the context of the growing power of Nazi Germany Fascist Italy and the new communist state of the Soviet Union. Sensing that the spirit of the era favored nondemocratic regimes and wanting greater personal power, King Carol II transformed the country into a dictatorship in 1938. Fearing Romania’s neighbors, especially the Soviet Union, and hoping to gain German support and marginalize his main domestic competitor, the Iron-Guard fascist party, the dictator made economic concessions and adopted Nazi-influenced policies, including antisemitic legislation.1 Despite these measures, Carol II did not convince Hitler or Mussolini to lend support, and in the summer of 1940, Romania suffered several territorial losses (Bessarabia, Northern Bukovina, Northern Transylvania, and Southern Dobrogea) to the Soviet Union, Hungary, and Bulgaria, who had secured Germany’s approval and cooperation.
INTRODUCTION TO THE COMPARATIVE EXPERIMENTAL ANALYSIS OF HABITUATION

Publisher Summary Habituation and sensitization are perhaps the simplest forms of behavioral plasticity and learning. They serve important adaptive functions in behavior. The analysis of synaptic mechanisms of habituation has proceeded in several laboratories. Kandel and associates developed a monosynaptic model of habituation in Aplysia and showed the process to be a form of synaptic depression due to a decreased probability of transmitter release pre-synaptically. Dr. Kandel focused on the basic ionic and molecular mechanisms of habituation and sensitization in Aplysia. The importance of habituatory-like phenomena was recognized by pioneering scientists as Sherrington and Pieron. Current interest in habituation stems perhaps most directly from the important and classical work of Eugene N. Sokolov on the orienting response.
Exercising Self-Control Increases Approach-Motivated Impulse Strength

Abstract Self-control can be construed as a competition between two opposing forces: The motivational force that compels an impulse to be expressed in thought, feeling, or behavior (impulse strength) versus the person's inner capacity to control impulses (self-control strength). The strength model of self-control focuses exclusively on the control side of this competition, and numerous studies have found that exercising self-control temporarily reduces self-control strength. In the current chapter, we review evidence that exercising self-control also increases impulse strength, with a particular emphasis on approach-motivated impulse strength. We consider the implications of increased impulse strength for understanding the ego depletion effect and for the strength model of self-control.
DEVELOPMENT AND TEST OF THE ITER CONDUCTOR JOINTS FOR THE CENTRAL SOLENOID

Joints for the ITER superconducting Central Solenoid should perform in rapidly varying magnetic field with low losses and low DC resistance. This paper describes the design of the ITER joint and pr...
Co-Infections by Double-Stranded DNA Viruses after Ex Vivo T Cell–Depleted, CD34+ Selected Hematopoietic Cell Transplantation

Abstract Recipients of ex vivo T cell–depleted (TCD) hematopoietic cell transplantation (HCT) are at risk of infection by double-stranded (ds) DNA viruses. We report rates of dsDNA viremia, end-organ disease (EOD), infection-related mortality, and overall survival (OS) in a contemporary cohort of adult TCD HCT recipients routinely monitored for cytomegalovirus (CMV), adenovirus (ADV), human herpesvirus 6 (HHV6), and Epstein-Barr virus (EBV). Healthcare utilization in the first 6 months post-HCT was compared between patients with dsDNA viremia versus no viremia. This was an observational study of adult patients with acute leukemia and myelodysplastic syndrome who received CD34+ selected, peripheral blood HCT at Memorial Sloan Kettering Cancer Center from March 2012 through December 2014. Patients were prospectively monitored by quantitative PCR assays for CMV, ADV, HHV6, and EBV in whole blood or plasma. The cumulative incidence of viremia(s) at day +180, EOD at 1 year, and OS at 1 year were estimated by the Kaplan-Meier method and compared by the log-rank test among patient with and without viremia/EOD. Standardized incidence ratios were used to compare overall length of hospital stay (LOS), number of readmissions after HCT, and length of readmissions through day +180. Of 156 patients, 96 (62%) were CMV recipient seropositive. Forty-two patients received grafts from matched related (27%), 86 from matched unrelated (55%), and 28 from mismatched (18%) donors. Overall, 132 patients (85%) had ≥1 viremia and 52 (33%) ≥2 viremias by day +180. The cumulative incidences for CMV, HHV6, ADV, and EBV viremia were 44%, 61%, 7%, and 16%, respectively, with median times of onset 28 days (interquartile range [IQR], 25 to 33), 33 days (IQR, 25 to 47), 60 days (IQR, 19 to 84), and 79 days (IQR, 54 to 106) post-HCT, respectively. Twenty-eight patients (18%) developed EOD by dsDNA viruses at 1 year post-HCT. Treatment for CMV accounted for 91% total antiviral treatment-days. Compared with patients with no viremia, patients with CMV viremia, HHV6 viremia, or ≥2 viremias experienced longer LOS (P
Abstract 605: ERK5 Activation Regulates PPARalpha Activity and Subsequent Cardioprotection After Ischemia/Reperfusion

Background: The strong cardioprotective effect of erythropoietin (EPO) and heme oxygenase-1 (HO-1) have been reported, but the mechanism are not understood. Previously we found that activation of big MAP kinase 1 (BMK1/ERK5) inhibits cardiac injury after myocardial ischemia and reperfusion. The hinge-helix 1 region of peroxisome proliferator-activated receptor gamma1 (PPARgamma1) mediates interaction with extra-cellular signal-regulated kinase 5(ERK5). We hypothesize that ERK5 activation induced by insulin growth factor-1(IGF-1), erythropoietin(EPO) and heme oxygenase-1(HO-1) is a “key modulator” of PPARa activity and provides a cardioprotective effect after I/R. Thus the aim of this study was to explore the mechanism of the protective effect of EPO, HO-1 and IGF-1 via ERK5 activation. Method and Results: We have found that EPO, HO-1 and IGF-1 stimulate ERK5 activation in the heart, and increase PPARa activity via an ERK5 dependent manner. To prove the role of ERK5 kinase/PPARa activation in IGF-1, EPO and HO-1 mediated cardioprotection after I/R, we characterized the unique role of ERK5 in IGF-1, EPO and HO-1-mediated PPARa activation. In cardiomyocytes, IGF-1, EPO and HO-1 mediate endogenous ERK5 association with endogenous PPARa but not phosphorylation of the PPARa. Activation of ERK5 by Ad-CA-MEK5a trigged the induction of mCPT-1 and PDK4, which promote fatty acid beta-oxidation (FAO) enzyme pathway via increasing PPARa transcriptional activation. Also we found that increased apoptosis in cardiomyocytes incubated by H2O2 compared to non-treated group( 3– 4 times increase H2O2 group vs. wildtype group). However HO-1 induction, EPO and IGF-1 treatment blocked the increased apoptosis induced by H2O2 stimulation. To determine the role of ERK5 kinase in EPO-mediated cardioprotection in vivo, we used the I/R mouse model in CA-MEK5a transgenic mice. Our preliminary experiments suggest a smaller infarction size in CA-MEK5a transgenic mice hearts compared to control hearts. Conclusion: We propose a key role for PPARa and subsequent activation of FAO enzyme induced by EPO and HO-1 mediated cardioprotection. These factors are induced by ERK5 activation. These data suggest that ERK5 is a critical factor and therefore a future therapeutic target.
Improved Assessment of Bolus Clearance in Patients With Achalasia Using High-Resolution Impedance Manometry

Background & Aims Esophageal retention is typically evaluated by timed-barium esophagram in patients treated for achalasia. Esophageal bolus clearance can also be evaluated using high-resolution impedance manometry. We evaluated the associations of conventional and novel high-resolution impedance manometry metrics, esophagram, and patient-reported outcomes (PROs) in achalasia. Methods We performed a prospective study of 70 patients with achalasia (age, 20–81 y; 30 women) treated by pneumatic dilation or myotomy who underwent follow-up evaluations from April 2013 through December 2015 (median, 12 mo after treatment; range, 3–183 mo). Patients were assessed using timed-barium esophagrams, high-resolution impedance manometry, and PROs, determined from Eckardt scores (the primary outcome) and the brief esophageal dysphagia questionnaire. Barium column height was measured from esophagrams taken 5 minutes after ingestion of barium (200 mL). Impedance-manometry was analyzed for bolus transit (dichotomized) and with a customized MATLAB program (The MathWorks, Inc, Natick, MA) to calculate the esophageal impedance integral (EII) ratio. Results Optimal cut points to identify a good PRO (defined as Eckardt score of ≤3) were esophagram barium column height of 3 cm (identified patients with a good PRO with 63% sensitivity and 75% specificity) and an EII ratio of 0.41 (identified patients with a good PRO with 83% sensitivity and 75% specificity). Complete bolus transit identified patients with a good PRO with 28% sensitivity and 75% specificity. Of the 25 patients who met these cut points for both esophagram barium column height and EII ratio, 23 (92%) had a good PRO. Of the 17 patients who met neither cut point, 14 (82%) had a poor PRO (Eckardt score above 3). Conclusions In a prospective study of 70 patients with achalasia, we found EII ratio identified patients with good PROs with higher levels of sensitivity (same specificity) than timed-barium esophagram or impedance-manometry bolus transit assessments. The EII ratio should be added to achalasia outcome evaluations that involve high-resolution impedance manometry as an independent measure and to complement timed-barium esophagram.
Depression prevalence and treatment among older home health services users in the United States.

Abstract Objective The purpose of this study is to provide a nationally representative estimate of the rates of depression and depression treatment, and to explore factors associated with receipt of depression treatment, among older home health services users. Methods Older home health services users (n = 1666) were selected from 2008 to 2013 Medical Expenditure Panel Survey. Depression was measured by the Patient Health Questionnaire-2. Depression treatment included antidepressants use and receipt of mental health counseling or psychotherapy. Logistic regression was used to examine the association of individual characteristics and receipt of depression treatment. Results Current depression affected 23% of older home health services users. Less than 40% of those who screened positive for depression reported receiving depression treatment. Among those who received treatment, virtually all (99.8%) reported receiving antidepressants and only 9.5% reported receiving psychotherapy. Among older home health services users with current depression, older age and non-Hispanic black race were associated with lower odds of receiving depression treatment whereas having cognitive impairment was positively associated with receiving depression treatment. Conclusion Depression affects a substantial proportion of older home health services users and is undertreated. Home health services settings may be important platforms to improve depression care among older adults. Future research is needed to develop optimal strategies for integrating depression assessment and treatment in home health services settings.
The Association between Self-Regulation and Symptoms of Autism Spectrum Disorder in Preschoolers with Externalizing Behavior Problems

The purpose of the current study was to examine the role of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) symptoms in predicting deficits in self-regulation across the domains of executive functioning and emotion regulation. Parents of 40 preschoolers with externalizing behavior problems reported on children’s ADHD and ASD symptoms, and emotion regulation. Children completed a standardized executive functioning battery. Results indicated that 28% of parents and 53% of teachers rated children above the subclinical range on ASD symptoms. An interaction emerged such that higher ASD symptoms were only associated with poorer executive functioning for children with lower ADHD symptoms. However, ASD symptoms were predictive of poorer emotion regulation independent of ADHD symptoms. Findings revealed clinically significant ASD symptoms, which aided in explaining heterogeneity in self-regulation deficits.
CHAPTER 35 – Genetic Toxicity of Pesticides

This chapter provides an overview of the methods of genotoxicity testing and their application to identifying pesticides capable of inducing genetic damage. It describes the most common short-term tests that are employed for detecting the genotoxicity of pesticides, including the bacterial reverse mutation assay, the in vivo chromosome aberration assay, the micronucleus assay, and the in vitro mammalian cell gene mutation assay. This chapter presents an overview of the genotoxicity tests and evaluations for carcinogenicity studies on various pesticides. It is evident from these studies that a variety of patterns of responses to pesticides can be seen; some agents are clearly genotoxic and carcinogenic, some have shown activity in the genotoxicity assays without showing an increase in tumors in the cancer bioassays, some exhibit negative results in short-term genotoxicity assays but have shown increases in tumors in chronic animal testing, and some demonstrate no genotoxic or carcinogenic effects in in vitro or in vivo studies. A considerable number of studies have been conducted using various biomarkers to measure genetic alterations in the cells of pesticide-exposed workers. A significant number of pesticides have exhibited genotoxic effects in short-term genotoxicity assays and may pose significant risks to humans. Consistent with this, chromosomal alterations have been seen in many studies monitoring genotoxic effects in pesticide-exposed workers.
3D User Interface Technologies and Games

This chapter introduces several 3D user interface technologies available for games and explains why it is important to study the affects of these technologies on the gaming experience of a user. Specifically, we have focussed on three technologies: (1) stereoscopic 3D, (2) head tracking, and (3) hand gesture based menu systems. Each of these technologies are explained along with how they can potentially improve games.
Technique of cast wedging in long bone fractures

A method to determine the width of a cast wedge to correct an angular deformity of a long bone is presented. The trigonometric theory behind the method is presented, but the method does not require any trigonometric calculations and can be done easily by drawing on the x-ray, with only a pencil and ruler-protractor required. Accurate reduction of angular deformities of long bones can be done with cast wedging when the width of the opening wedge can be predetermined.
IDEAS IN THEORETICAL BIOLOGY : COMMENT : ABOUT THE FRACTALITY OF THE LUNG

It is generally believed, that when the surface/volume ratio is high, fractal structure is expected to exist. The branched fractal structure of the lung has been cited as a “classical” example of this statement. In this short paper I would like to demonstrate that an alternative “lung” structure (namely sponge-like fractal) is at least as good as, or even better than the branched one, concerning this ratio, therefore, the cause of the lung's fractality lies elsewhere.
A Micro-Mechanically Motivated Model of Finite Deformation Plasticity

ABSTRACT A phenomenological model of plasticity is developed motivated by the motion of dislocations at the slip system level. The parameters of the model have been determined foi several metals and the model has been implemented into several existing finite element codes. The predictions of this model are compared with experimental data for various loading conditions, including both the anisotropic hardening and axial effects in torsion
A Patient with High Cardiometabolic Risk

A 30-year-old South Asian male presents for an annual health exam. He denies any specific systemic complaints but admits to feeling somewhat run down lately, which he attributes to his work stress. Although never considered overweight, he has gained 5–6 lb over the past year, which came to his attention when his pants size increased. He has no significant past medical history. He has a positive family history for type 2 diabetes in his father and paternal grandfather, and premature coronary artery disease in his father, who had a CABG for triple vessel disease at the age of 50. He doesn’t smoke and consumes four to five alcoholic drinks per week. He is lacto-ovo vegetarian and his diet is heavy on carbohydrates. He has cereal for breakfast; a sandwich, pizza, or pasta for lunch; and a traditional, Indian meal at night which includes half a plate of rice. He does not do structured exercise besides walking. On examination, his weight is 168 lb, BMI 24.8 kg/m2, waist circumference 93 cm, and BP 126/80 mmHg. He has acanthosis nigricans around his neck. Systemic exam is within normal limits. Laboratory data show the following abnormalities: FBS 105, HbA1c 6.2%, triglycerides 200 mg/dl, HDL 36 mg/dl, and hsCRP 3 mg/dl.
Rheumatoid Meningitis: An Unusual Stroke Mimic (P6.227)

Objective: NA Background: Rheumatoid arthritis (RA) is a chronic, systemic inflammatory condition with primary intra-articular predilection. Infrequently, RA can have central nervous system involvement that is associated with significant morbidity and mortality. Rheumatoid meningitis (RM) is a rare CNS sequela of RA that offers diagnostic challenges due to the variable presentation, clinical similarity to several neurologic presentations, and presence of non-specific laboratory and radiological findings. In like manner, confirmatory diagnosis of RM is reliant on variable histopathological evidence. Design/Methods: Case report and literature review Results: 66-year-old female with a history of RA being treated with methotrexate, adalimumab, and chronic prednisone therapy presents with four episodes of sudden, severe headache associated with transient focal neurological deficits. Neurological examination during initial presentations showed left-sided hemiparesis, but the fourth episode was remarkable for right-sided hemiparesis, all lasting for 48–72 hours with complete resolution without treatment. A brain MRI showed sulcal T2 hyper-intensities in the respective contralateral cerebral convexities initially thought to be sub-arachnoid hemorrhage in the setting of reversible cerebral vasoconstriction syndrome (RCVS). Cerebral angiography twice showed no concerns for RCVS or other vasculitic process, multi-organ computed tomography and CSF testing were unremarkable for neoplastic or infectious etiologies. These studies were corroborated by the clinical absence of meningismus and other systemic signs of infection. A non-infectious inflammatory process was further supported by chronologically worsening inflammatory markers in the CSF after discontinuation of immunosuppressive agents during initial presentation due to concern for an infectious etiology. CSF testing, of note, showed mild lymphocytic pleocytosis, elevated protein and IgG index, and a rheumatoid factor of 16 IU/mL, along with the clinical and imaging patterns suggestive of rheumatoid meningitis. Conclusions: This unique case of rheumatoid meningitis presenting with unilateral, episodic and transient focal neurological deficits with respective contralateral sulcal FLAIR signal abnormalities clinically mimics stroke. Study Supported by: NA Disclosure: Dr. Trujeque has nothing to disclose. Dr. Jillella has nothing to disclose. Dr. Xia has nothing to disclose.
A Real-Time Range-Adaptive Impedance Matching Utilizing a Machine Learning Strategy Based on Neural Networks for Wireless Power Transfer Systems

In this article, the implementation of a machine learning (ML) strategy based on neural networks for the real-time range-adaptive automatic impedance matching of wireless power transfer (WPT) applications is discussed. This approach for the effective prediction of the optimal parameters of the tunable matching network and the selection of range-adaptive transmitter coils (Tx) is introduced in this article, aiming to achieve an effective automatic impedance matching over a wide range of relative distances. We propose a WPT system consisting of a tunable matching circuit and three Tx coils that have different radii and are simultaneously controlled by trained neural network models, returning an output set of matching capacitances as well as the optimal single transmitter among the three transmitters. In addition, a proof-of-concept prototype of the entire real-time range-adaptive automatic impedance-matching system is built and characterized. Finally, the proposed approach achieves a power transfer efficiency (PTE) of around 90% for ranges within 10–25 cm.
Pyloromyotomy (Open and Laparoscopic Approach)

This chapter describes surgical pyloromyotomy as performed by both open and laparoscopic techniques for hypertrophic pyloric stenosis. The text includes an introduction that outlines the indications, risks, alternatives, essential steps needed, equipment, and variations in technique for the procedure in question. This is followed by a template operative dictation, which provides the reader with an operative report, such as is found in a patient chart or electronic medical record. A description is provided of the following critical concepts for this procedure: complete, safe myotomy.
Ultrasound-Guided Cardiac Procedures

The use of ultrasound for procedural guidance has dramatically increased in recent years. When evaluating critically ill patients with cardiac tamponade, ultrasound can significantly aid in the therapeutic intervention and improve the chances of survival. This chapter will focus on the use of ultrasound guidance to perform two emergent cardiac procedures: insertion of a transvenous pacemaker and performing a pericardiocentesis. The discussion will outline the traditional steps in performing each procedure with an emphasis on the use of bedside ultrasound for real-time guidance. The ultrasound views referenced in this section will include the standard views obtained during bedside echocardiogram: subxiphoid, parasternal long axis, parasternal short axis, and apical four-chamber view.
Should public safety shift workers be allowed to nap while on duty

Fatigue and sleep deficiency among public safety personnel are threats to wellness, public and personal safety, and workforce retention. Napping strategies may reduce work-related fatigue, improve safety and health, yet in some public safety organizations it is discouraged or prohibited. Our aim with this commentary is to define intra-shift napping, summarize arguments for and against it, and to outline potential applications of this important fatigue mitigation strategy supported by evidence. We focus our discussion on emergency medical services (EMS); a key component of the public safety system, which is comprised of police, fire, and EMS. The personnel who work in EMS stand to benefit from intra-shift napping due to frequent use of extended duration shifts, a high prevalence of personnel working multiple jobs, and evidence showing that greater than half of EMS personnel report severe fatigue, poor sleep quality, inadequate inter-shift recovery, and excessive daytime sleepiness. The benefits of intra-shift napping include decreased sleepiness and fatigue, improved recovery between shifts, decreased anxiety, and reduced feelings of burnout. Intra-shift napping also mitigates alterations in clinician blood pressure associated with disturbed sleep and shift work. The negative consequences of napping include negative public perception, acute performance deficits stemming from sleep inertia, and the potential costs associated with reduced performance. While there are valid arguments against intra-shift napping, we believe that the available scientific evidence favors it as a key component of fatigue mitigation and workplace wellness. We further believe that these arguments extend beyond EMS to all sectors of public safety.
Optimal Signal Design for a New Physically Motivated Clutter Model With Applications to Ultrasonic Testing

In this article, we will explore the optimal signal design problem for a new physically motivated clutter model. The reason to pursue the optimal signal design is that the model, even though it was simple, led to a robust detector that worked well on real ultrasonic data. Moreover, by using the model, an analytical solution for the optimal signal is obtained. In addition, the optimal waveform gives a new insight into the signal design problem that can be valuable for many applications. New proof has been provided for a finite data record that is lacking in the literature. We have found that the optimal signal is an impulse, and as a result, it has an impulsive autocorrelation sequence (ACS). Since an impulsive ACS signal is not realizable, in practice, a study for an alternative waveform is conducted. Waveforms from four different categories have been explored: linear frequency-modulated (LFM), nonlinear frequency-modulated (NLFM), phase-coded modulated (PCM) signals, and, finally, what we called other signals. Comparison analysis between these waveforms themselves and the most commonly used transmitted pulse in practice, which is the Gaussian amplitude-modulated sinusoid (GAMS) pulse, has been implemented. We show that the LFM pulse has a large advantage over the GAMS pulse in terms of detectability. In addition, a comparison between the LFM and the GAMS signals under a deviation from the single scatterer assumption, indicating a more complex target, using simulated noise is performed.
Indicators of Secretory Activation in Mothers of Preterm Very Low Birth Weight Infants.

BackgroundInconsistent information exists regarding indicators of secretory activation in mothers delivering very low birth weight infants.Research aimsTo compare time to the onset of secretory act...
Social Capability, History and the Economies of Communist and Postcommunist States

Studies show that in non-Communist developed and developing countries earlier development of agriculture, a dense population, and a state-level polity is associated with a higher income and more rapid economic growth in the late twentieth century. We investigate whether this was also the case for countries under communism and for the same countries in transition to a market economy. Our findings are generally affirmative, with an interesting pattern for the Eurasian socialist core countries involving higher growth nearer their West European and East Asian poles. We also find that ethnic fractionalization, which is correlated with late premodern development, shows harmful effects in the transition era but not under communism.
PRDM proteins control Wnt/β-catenin activity to regulate craniofacial chondrocyte differentiation

Cranial neural crest (NCC)-derived chondrocyte precursors undergo a dynamic differentiation and maturation process to establish a scaffold for subsequent bone formation, alterations in which contribute to congenital birth defects. Here, we demonstrate that transcription factor and histone methyltransferase proteins Prdm3 and Prdm16 control the differentiation switch of cranial NCCs to craniofacial cartilage. Loss of either results in hypoplastic and unorganized chondrocytes due to impaired cellular orientation and polarity. We show that PRDMs regulate cartilage differentiation by controlling the timing of Wnt/{beta}-catenin activity in strikingly different ways: prdm3 represses while prdm16 activates global gene expression, though both by regulating Wnt enhanceosome activity and chromatin accessibility. Finally, we show that manipulating Wnt/{beta}-catenin signaling pharmacologically or generating prdm3-/-;prdm16-/- double mutants rescues craniofacial cartilage defects. Our findings reveal upstream regulatory roles for Prdm3 and Prdm16 in cranial NCCs to control Wnt/{beta}-catenin transcriptional activity during chondrocyte differentiation to ensure proper development of the craniofacial skeleton. HighlightsO_LIPrdm3 and Prdm16 are required for chondrocyte organization in vertebrate craniofacial cartilage C_LIO_LILoss of Prdm3 and Prdm16 alters expression of Wnt/{beta}-catenin signaling components C_LIO_LIPrdm3 and Prdm16 oppositely control global chromatin accessibility C_LIO_LIPrdm3 and Prdm16 cartilage defects can be rescued pharmacologically or genetically C_LI
NOX4 regulates macrophage apoptosis resistance to induce fibrotic progression.

Pulmonary fibrosis is a progressive lung disease often occurring secondary to environmental exposure. Asbestos exposure is an important environmental mediator of lung fibrosis and remains a significant cause of disease despite strict regulations to limit exposure. Lung macrophages play an integral role in the pathogenesis of fibrosis induced by asbestos (asbestosis), in part by generating reactive oxygen species (ROS) and promoting resistance to apoptosis. However, the mechanism by which macrophages acquire apoptosis resistance is not known. Here, we confirm that macrophages isolated from asbestosis subjects are resistant to apoptosis and show they are associated with enhanced mitochondrial content of NADPH oxidase 4 (NOX4), which generates mitochondrial ROS generation. Similar results were seen in chrysotile-exposed WT mice, while macrophages from Nox4−/− mice showed increased apoptosis. NOX4 regulated apoptosis resistance by activating Akt1-mediated Bcl-2-associated death phosphorylation. Demonstrating the importance of NOX4-mediated apoptosis resistance in fibrotic remodeling, mice harboring a conditional deletion of Nox4 in monocyte-derived macrophages exhibited increased apoptosis and were protected from pulmonary fibrosis. Moreover, resolution occurred when Nox4 was deleted in monocyte-derived macrophages in mice with established fibrosis. These observations suggest that NOX4 regulates apoptosis resistance in monocyte-derived macrophages and contributes to the pathogenesis of pulmonary fibrosis. Targeting NOX4-mediated apoptosis resistance in monocyte-derived macrophages may provide a novel therapeutic target to protect against the development and/or progression of pulmonary fibrosis.
Is that eye dead or alive? Detecting new iris biometrics attacks

Iris recognition has been revolutionising biometric-based human identification for almost three decades, due to the unprecedented information richness of iris patterns translating into low false matches – which has now been observed across a population exceeding 1 billion users worldwide. We are also able to effectively detect those presentation attack types known to our algorithms during the design phase. But the question remains: are we prepared to detect those unknown specimens, strikingly similar to images of authentic irises, that can be generated by modern artificial intelligence tools or – more gruesomely – captured from decedents?
The Role of Discourse Markers in Organizing Literary Discourse: H.G. Wells’ The Time Machine as a Case Study

This paper aims at investigating the role played by discourse markers in organizing literary English. It is argued here that discourse organization can be achieved by different means. Discourse markers are proposed as an explanation for the construction of discourse organization and coherence. The researchers here analyzed forty-five sentences chosen purposely from the novel enlisted The Time Machine within the framework of pragmatics as a perspective. The results of the analysis reveal that discourse markers are pervasive in the language since they are important prerequisites for successful or accurate wording. They indicate the intentional as well as the structural aspect of discourse. They also guide the reader in the recognition of relations which make discourse well organized and thereby they facilitate comprehension.
Firm behavior under quantity controls: The theory of virtual quantities ☆

The theory of virtual quantities, the dual to virtual prices, provides a framework to analyze competitive multiproduct firm behavior under multiple quantity controls on inputs and outputs, including command-and-control quotas and transferable property rights. The framework addresses the firm׳s reactions to regulatory controls, impacts of adding or dropping quantity controls, inferring unrationed from rationed production, and conversion from command-and-control quotas to cap-and-trade systems with transferable property rights and secondary market behavior. The paper develops reasons for failure of quasi-concavity of technology, extends the elasticity of intensity׳s properties, and integrates the virtual price and virtual quantity frameworks. Virtual quantities are applied to assess potential firm responses to quantity controls and a potential transferable property right in a Malaysian fishery.
Cefotaxime metabolism by hemolyzed blood:: Quantitation and inhibition of the deacetylation reaction

Abstract The metabolism of cefotaxime (CTX) by hemolyzed blood at different concentrations, time intervals, and temperatures was studied. Cefotaxime and desacetylcefotaxime (DES) levels were quantitated by reverse phase high pressure liquid chromatography. When CTX was added to tubes with 10% hemolysis, CTX/DES levels (micrograms per milliliter) were 123/134, 161/114, and 202/60 at 37°C, room temperature, and 4°C, respectively, after a 1 hr incubation. No reduction in CTX was observed in control experiments (10% blood, no hemolysis) at these temperatures after 1 hr; 200 ± 23 μg/ml CTX; 5 ± 2 μg/ml DES. The disappearance half-life of CTX in 10% hemolyzed blood at 37°C was 45.7 min and at room temperature 84.3 min ( p p -hydroxymercuibenzoate reduced the metabolism of CTX in the presence of 10% hemolysis after 1 hr at 37°C from 41% to 19% with ethylenediaminetetraacetic acid (0.45 mM) and to 0% with p -hydroxymercuibenzoate (10 mM). Our results suggest that for accurate determinations of CTX serum levels, which often have some degree of hemolysis, such specimens should be collected in tubes with ethylenediaminetetraacetic acid or p -hydroxymercuibenzoate and transported at 4°C.
MUC1-specific Cytotoxic T Lymphocytes Eradicate Tumors When Adoptively Transferred in Vivo

We have reported previously that MUC1 transgenic mice with spontaneous tumors of the pancreas (designated MET) naturally develop MHC class I-restricted, MUC1-specific CTLs as tumors progress (P. Mukherjee et al., J. Immunol., 165: 3451–3460, 2000). From these MET mice, we have isolated, expanded, and cloned naturally occurring MUC1-specific CTLs in vitro . In this report, we show that the CTL line is predominantly CD8 + T cells and expresses T-cell receptor Vβ chains 5.1/5.2, 11, 13, and 2 and Vα chains 2, 8.3, 3.2, and 11.1/11.2. These CTLs recognize several epitopes on the MUC1 tandem repeat with highest affinity to APGSTAPPA. The CTL clone, on the other hand, is 100% CD8 + cells and expresses a single Vβ chain of 5.1/5.2 and Vα2. It recognizes only the H-2D b class I-restricted epitope of MUC1, APGSTAPPA. When adoptively transferred, the CTLs were effective in eradicating MUC1-expressing injected tumor cells including mammary gland cells (C57mg) and B16 melanomas. These results suggest that MUC1-specific CTLs are capable of possibly preventing, or at least substantially delaying, MUC1-expressing tumor formation. To our knowledge, this is the first evidence that demonstrates that the naturally occurring MUC1-specific CTLs isolated from one tumor model has antitumor effects on other MUC1-expressing tumors in vivo . Therefore, our data confirm that MUC1 is an important tumor rejection antigen and can serve as a target for immunotherapy.
Successful adult-to-child renal transplantation utilizing the ovarian vein in children with inferior vena cava/iliac vein thrombosis.

Tao R, Shapiro R. Successful adult-to-child renal transplantation utilizing the ovarian vein in children with inferior vena cava/iliac vein thrombosis. Pediatr Transplantation 2010: 14:E70–E74. © 2009 John Wiley & Sons A/S. Abstract: IVC/iliac vein thrombosis has previously been considered to be a contraindication to renal transplantation because of the technical difficulties and the increased risk of graft thrombosis. We report two successful cases of adult-to-child kidney transplantation in which we anastomosed the graft renal vein to the recipient ovarian vein in the presence of IVC and/or iliac vein thrombosis, with no short or long term vascular complications. Our experience, which adds to the successful reports from several other centers, suggests that the inability to use the iliocaval axis should no longer be considered a contraindication to pediatric renal transplantation.
A trust assignment model based on alternate actions payoff

The human component is a determining factor in the success of the security subsystem. While security policies dictate the set of permissible actions of a user, best practices dictate the efficient mode of execution for these actions. Unfortunately, this efficient mode of execution is not always the easiest to carry out. Users, unaware of the implications of their actions, seek to carry out the easier mode of execution rather than the efficient one, thereby introducing a certain level of uncertainty unacceptable in high assurance information systems. In this paper, we present a dynamic trust assignment model that evaluates the system's trust on user actions over time. We first discuss the interpretation of trust in the context of the statement “the system trusts the users' actions” as opposed to “the system trusts the user.” We then derive the intuition of our trust assignment framework from a game-theoretic model, where trust updates are performed through “compensatory transfer.” For each efficient action by a user, we assign a trust value equal to the “best claim for compensation”, defined as the maximum difference between the benefits of an alternate action and the selected efficient action by the user. The users' initial trust and recent actions are both taken into account and the user is appropriately rewarded or penalized through trust updates. The utility of such a model is two-fold: It helps the system to identify and educate users who consistently avoid (or are unaware of) implementing the organization's best practices and secondly, in the face of an action whose conformance to the organizational policies is contentious, it provides the system or a monitoring agent with a basis, viz. the trust level, to allow or disallow the action. Finally we demonstrate the application of this model in a Document Management System.
Localization of the domain of actin-binding protein that binds to membrane glycoprotein Ib and actin in human platelets.

The Mr approximately 540,000 dimeric actin gelation protein, actin-binding protein (ABP), has previously been shown in human platelets to link actin to membrane glycoprotein Ib (GPIb) (Fox, J. E. B. (1985) J. Biol. Chem. 260, 11970-11977; Okita, J. R., Pidard, D., Newman, P. J., Montgomery, R. R., and Kunicki, T. J. (1985) J. Cell Biol. 100, 317-321). We have examined further the interaction between ABP and GPIb. Platelet extracts were depleted of ABP by precipitation with anti-ABP monoclonal antibodies (mAbs); in resulting precipitates, ABP monomer is complexed with GPIb in a 5:1 molar ratio. The ABP.GPIb complex is resistant to chaotropic solvents but dissociated by the ionic detergent, sodium dodecyl sulfate. Treatment of intact platelets with the ionophore A23187 activates a Ca2+-dependent protease which cleaves the Mr approximately 270,000 ABP subunit into three fragments of Mr 190,000, 100,000, and 90,000; the latter fragment is derived from the Mr 100,000 fragment. Anti-ABP mAbs coprecipitated GPIb with the Mr 100,000 and 90,000 fragments, but not with the Mr 190,000 fragment which contains the ABP self-association site. In the reciprocal experiment, anti-GPIb antibodies co-precipitated only the Mr 100,000 and 90,000 ABP fragments. Actin also co-precipitated with the Mr 100,000 and 90,000, but not with the Mr 190,000 ABP fragment. The anti-ABP mAb that precipitated the Mr 100,000-90,000 GPIb-binding ABP fragment recognizes a trypsin cleavage fragment of ABP that binds actin filaments in vitro. These findings establish that both the GPIb-binding site and actin-binding sites are in the same region of the ABP monomer. Because of the extended bipolar conformation of the ABP molecule, the data suggest that the GPIb.actin-binding region is located remote from the self-association, or dimerization, site of the ABP subunit.