cssi/SciSciGPT-SciSciNet huggingface dataset:
A Novel, Mercaptoketone-Based HDAC Inhibitor, KD5170 Exerts Marked Inhibition of Osteoclast Formation and Anti-Myeloma Activity In Vitro .

Multiple Myeloma (MM) is characterized by the malignant proliferation of plasma cells and high osteoclast (OCL) activity resulting in increased bone destruction and the development of lytic lesions. Ideally, novel therapeutic agents directed at MM should not only target the myeloma cell, but also OCL activity. Multiple, chemically distinct, Histone Deacetylase (HDAC) inhibitors have shown promising anti-myeloma activity in pre-clinical studies. The majority of the HDAC inhibitors in clinical development employ either benzamide or hydroxamate chemistry. Through an uHTS biochemical screen of 600,000 compounds and subsequent medicinal chemistry efforts, a novel mercaptoketone series of HDAC inhibitors has been developed. The most potent compounds in this series exhibit nanomolar activity in both biochemical and cell-based assays. To determine the clinical potential of this series in treating MM we have profiled the lead compound, KD5170 in assays that monitor osteoclastogenesis and proliferation and apoptosis of MM cells. To evaluate the effects of KD5170 on the formation of OCL from mononuclear hematopoietic precursors, we utilized a human bone marrow culture system from MM patients to generate OCLs by in vitro RANKL/M-CSF stimulation. KD5170 treatment resulted in a significant dose dependent (0.5–8 10 −6 M) inhibition of osteoclast formation. In addition, RPMI-8226 cell proliferation was significantly suppressed by KD5170 at 3 10 −6 M as measured by [3H]-Thymidine-incorporation. Furthermore, we observed that KD5170 induced dose- (0.05–1 10 −6 M) and time-dependent (2–24h) apoptosis of U266 MM cells, as measured by Hoechst/PI double staining to identify distinct stages of apoptosis and to differentiate between apoptotic and necrotic cell death. Significantly, less than 5% of the cells were necrotic (PI-positive) indicating active engagement of the apoptotic pathway. KD5170 treatment (1 10 −6 M, 72 h) also markedly decreased the viability of primary CD138+ bone marrow cells from MM patients, as determined by trypan blue exclusion. In contrast, the viability of CD138− and mononuclear bone marrow cells from MM patients and normal healthy donors were unaffected, suggesting targeted selectivity. Our studies identify KD5170 as a promising new HDAC inhibitor that inhibits both osteoclast formation as well as the proliferation of MM cells. Furthermore, pronounced anti-proliferative activity of KD5170 on the MM cell line U266, suggests that a subset of MM may be the ideal target of this agent. U266 harbors a translocation involving 11q13 raising the possibility that this chromosomal alteration and Cyclin D1 dysregulation may have a role in mediating KD5170 sensitivity and as such will be a focus of future studies.
Surgical Management of an Ectopic Pregnancy Via Laparoscopic Salpingectomy or Laparoscopic Salpingostomy

This chapter describes the surgical management of an ectopic pregnancy via laparoscopic procedure as performed by the following approaches: laparoscopic as against open abdominal surgery, whether it is a laparoscopic salpingectomy, where the entire fallopian tube is surgically removed, or laparoscopic salpingostomy, where the products of conception only are removed from the fallopian tube, merely by incising the fallopian tube and suctioning the material out, leaving the fallopian tube intact. The text includes an introduction that outlines the indications, risks, alternatives, essential steps, needed equipment, and variations in technique for the procedure(s) 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: abdominal access, anatomic assessment, salpingostomy or salpingectomy, removal of ectopic pregnancy.
General surgery: Should you do it or not?

Abstract Colon and rectal surgery is a well-established surgical subspecialty which was at the forefront of the development of specialization. One of the considerations of such a specialty surgeon is if the incorporation of continued general surgery work should be a component of their practice. Does this diminish their distinction as an expert in their field? Is their day to day experience broad enough to allow for continued coverage of a field that they trained in, but are not being consistently exposed to? The viewpoints on this topic can be divergent. This forum considers this multifaceted issue from these varied perspectives while providing historical context. It is important to realize that, when considering entering into a position, a physician must decide what their professional goals are and what they are looking for in a job while taking into account this very important topic.
A review of mobile stroke units

Mobile stroke units (MSUs) for prehospital treatment and management of patients with acute stroke have been developed more than a decade ago and is currently spreading worldwide. This review discusses the history of MSU and current operations and research. Multiple studies have shown that MSU can significantly reduce treatment time with a tenfold increase of patients treated within the first 60 min of symptom onset. Recent preliminary results from the Berlin Prehospital or Usual Delivery of Acute Stroke Care trial (B-PROUD) showed a positive shift in modified Rankin Scale (mRS) scores at 3 months for patients treated in MSUs. Two German studies indicate that the MSU model is cost effective by reducing disability and improving adjusted quality-life years after stroke. The MSU model for prehospital management of acute stroke is spreading worldwide. More research is needed, however, to establish cost-effectiveness, efficacy and best setting for prehospital stroke management.
Chronic Rhinotillexomania Leading to Multiple Infectious Sequelae in a 66-Year-Old Female.

Rhinotillexomania, more commonly known as nose-picking, is a body-focused repetitive behavior that involves compulsive picking of the nares. While nose-picking in general is a common and largely unharmful practice worldwide, severe complications from chronic nose-picking do exist. This case highlights a 66-year-old female with a longstanding history of nose-picking and nose blowing who presented to the emergency department with acute delirium and various bodily complaints. She was subsequently admitted multiple times for recurrent sepsis, meningitis, endocarditis, cystitis, and discitis with each culture positive for methicillin-sensitive Staphylococcus aureus (MSSA) with identical antibiotic sensitivities. Further imaging failed to reveal an underlying greater pathology. Intranasal swab revealed identical culture and sensitivity results as previous blood, CSF, and urine cultures and was thus hypothesized to be the source of infection. This case aims to elucidate the harmful effects of nose-picking as well as the importance of prevention, diagnosis, and management.
Trajectories of Response to Treatments in Children with ADHD and Word Reading Difficulties

This study investigated patterns of response to intervention in children with co-occurring attention-deficit/hyperactivity disorder (ADHD) and reading difficulties (RD), who participated in a randomized clinical trial examining the efficacy of reading intervention, ADHD treatment, or combined treatments. Growth Mixture Modeling (GMM) was used to investigate trajectories of parent and teacher academic impairment ratings and child oral reading fluency, and whether trajectories were predicted by pre-treatment covariates (ADHD severity, reading achievement, phonemic awareness, rapid letter naming, anxiety, oppositional defiant disorder), for 216 children with ADHD/RD in 2nd-5th grade (61.1% male; 72.2% African American; 8.8 ± 1.3 years of age). GMM revealed three trajectories for academic impairment (6.9–24.2% stable, 23.7–78.7% moderately improving, and 14.1–52.1% steeply improving) and oral reading fluency (20.8% low improving, 42.1% moderate improving, and 37.1% high improving). Children in the reading intervention were more likely to be in the stable or moderately improving trajectory than those in the ADHD and combined treatments, who were more likely to be in the steeply improving trajectory for academic impairment. Relative to the ADHD intervention, children in the reading intervention were more likely to be in the high improving trajectory than the moderate or low improving trajectory for oral reading fluency. Children without comorbid anxiety and with better reading skills showed a more positive treatment response for teacher-rated academic progress and oral reading fluency. Results highlight the importance of examining individual differences in response to reading and ADHD interventions. Intervention modality predicted differences in parent/teacher ratings of academic progress as well as reading fluency.
Teaching Medical Students to Help Patients Manage Their Weight: Outcomes of an Eight-School Randomized Controlled Trial

Given the rising rates of obesity there is a pressing need for medical schools to better prepare students for intervening with patients who have overweight or obesity and for prevention efforts. To assess the effect of a multi-modal weight management curriculum on counseling skills for health behavior change. A pair-matched, group-randomized controlled trial (2015-2020) included students enrolled in eight U.S. medical schools randomized to receive either multi-modal weight management education (MME) or traditional weight management education (TE). Students from the class of 2020 (N=1305) were asked to participate in an objective structured clinical examination (OSCE) focused on weight management counseling and complete pre and post surveys. A total of 70.1% of eligible students (N=915) completed the OSCE and 69.3% (N=904) completed both surveys. INTERVENTIONS: The MME implemented over three years included a web-based course, a role-play classroom exercise, a web-patient encounter with feedback, and an enhanced clerkship experience with preceptors trained in weight management counseling (WMC). Counseling focused on the 5As (Ask, Advise, Assess, Assist, Arrange) and patient-centeredness. The outcome was student 5As WMC skills assessed using an objective measure, an OSCE, scored using a behavior checklist, and a subjective measure, student self-reported skills for performing the 5As. Among MME students who completed two of three WMC components compared to those who completed none, exposure was significantly associated with higher OSCE scores and self-reported 5A skills. Variability in medical schools requiring participation in the WMC curriculum. This trial revealed that medical students struggle with delivering weight management counseling to their patients who have overweight or obesity. Medical schools, though restrained in adding curricula, should incorporate should incorporate multiple WMC curricula components early in medical student education to provide knowledge and build confidence for supporting patients in developing individualized plans for weight management. R01-194787
Hearing disorders secondary to infection with SARS-CoV-2

A recent emerging concern is the relationships between SARS-CoV-2 (COVID-19) and otolaryngological symptoms such as dizziness, tinnitus, hearing loss. Emerging data suggest auditory and vestibular symptoms are more likely with COVID-19 than previous coronaviruses and Middle East Respiratory Syndrome (MERS). Data from recent reports suggest auditory and vestibular dysfunction secondary to COVID-19 may be greater in females than in males, and in patients older than 60 years. This presentation will discuss these emerging data and the possibility that stress and anxiety during COVID-19 recovery may further contribute to perceptions of exacerbated tinnitus. One factor that may increase anxiety is perceived lockdown-related stress, which has been associated with worsening of tinnitus distress in the absence of COVID-19 infection. A second factor linking increases in anxiety with COVID-19 is increased concern about communication needs as expressed by patients with hearing loss, based on concerns about the negative impact of mask use and social distancing on audibility and communication ability. Finally, it must be noted that proposed treatments for COVID-19 including chloroquinine and hydroxychloroquinine can have auditory side effects including tinnitus, and the doses used in COVID-19 patients significantly exceed doses recommended for treatment of malaria which increases the likelihood of side effects.
Health care disparities for incarcerated adults after a suicide attempt

Objective Incarcerated adults have high rates of fatal and nonfatal suicidal behaviors. Suicide prevention recommendations stress the need for the provision of health care for incarcerated adults after suicide attempts, yet prison policies and practices often focus instead on punitive responses to suicidal behaviors. Existing research is limited regarding factors that predict the provision of health care to incarcerated adults post-suicide attempt. The current study examined individual, incident, and institutional factors as predictors of health care to incarcerated adults post-suicide attempt. Method We used data from critical incidents reports for suicide attempts (N = 495) to conduct mixed-effects logistical regression models. Results Staff responded to suicide attempts by placing incarcerated adults under direct observation (with no care) or in segregation at odds two and three times higher than of providing health care, particularly in prisons for men. Race was a significant factor; incidents involving Black men were less likely than incidents involving white men to include staff requesting health care, and incidents involving Black women were less likely than incidents involving white women to include requesting and providing health care. Conclusions This study's findings highlight factors predicting health care responses to suicide attempts and the need to address and prevent health care disparities in prisons.
The Role of Astrocytes in Autoimmune Disease of the Central Nervous System

Astrocytes are the most abundant glial cell population in the central nervous system (CNS). In the healthy brain and spinal cord, the major function of astrocytes includes the formation and maintenance of the blood brain barrier (BBB), and the supply of structural support and nourishment to neurons. This article will discuss the role of astrocytes in multiple sclerosis (MS) and other inflammatory autoimmune diseases of the CNS. We will address the capacity of astrocytes to serve as immunocompetent cells, their role in major histocompatibility complex (MHC) class II restricted antigen (Ag) presentation, and their ability to express costimulatory molecules. We will also discuss astrocytes as the major CNS producers of several chemokines and cytokines, and their relevance to neurological disease.
Search for charged Higgs bosons in decays of top quarks in proton-antiproton collisions at s = 1.96 TeV

In this dissertation we report on the first direct search for charged Higgs bosons in decays of top quarks in p{bar p} collisions at {radical}s = 1.96 TeV. The search uses a data sample with an integrated luminosity of 2.2 fb{sup -1} collected by the CDF II detector at Fermilab and looks for a resonance in the invariant mass distribution of two jets in the lepton+jets sample of t{bar t} candidates. We observe no evidence of charged Higgs bosons in top quark decays; hence 95% C.L. upper limits on the branching ratio are placed at {Beta}(t {yields} H{sup +}b) < 0.1 to 0.3 for charged Higgs boson masses of 60 to 150 GeV/c{sup 2} assuming {Beta}(H{sup +} {yields} c{bar s}) = 1.0 and {Beta}(t {yields} Wb)+{Beta}(t {yields} H{sup +}b) = 1.0. The upper limits on {Beta}(t {yields} H{sup +}b) are also used as model independent limits on the decay branching ratio of top quarks to any charged scalar bosons beyond the standard model.
Forebrain peptides modulate sexually polymorphic vocal circuitry

The peptide arginine-vasopressin (mammals) and its evolutionary precursor arginine-vasotocin (non-mammals) modulate reproductive physiology and numerous related social behaviours, as do oxytocin (mammals) and its homologues mesotocin and isotocin (fish). The distributions in the brain and/or the behavioural functions of these peptides often differ between the sexes, and between species with divergent social structures. Here we present neurophysiological evidence that males with vocal characteristics typical of females share a pattern of neuropeptide function with females rather than conspecific males. The plainfin midshipman fish (Porichthys notatus) has two male morphs with different reproductive tactics and vocalizations (a key species-typical behaviour which varies in its physical attributes and contextual usage, depending on the morph's social strategy). Forebrain-evoked, rhythmic vocal-motor activity that precisely mimics natural vocalizations was modulated by arginine-vasotocin, isotocin and their antagonists delivered to the preoptic area-anterior hypothalamus, a primary site for behavioural integration in all vertebrates. Peptides had different effects in males that acoustically court females (arginine-vasotocin-sensitive) than in females and sneak-spawning males (isotocin-sensitive), showing that the neuromodulatory mechanisms that establish reproduction-related behaviour can be dissociated from gonadal sex.
Lactase activity before and after acute febrile bacterial illness.

Summary To investigate the hypothesis that the isolated lactase deficiency seen in healthy adults may be an acquired enzyme deficiency resulting from nonspecific insults or diseases, jejunal disaccharidase activity was measured in 6 volunteers who were challenged with Salmonella typhosa . Three were studied before and after the onset of clinical illness. Of the 6 individuals, 3 developed positive blood cultures and sustained fevers of greater than 103F for at least 2 days. There were no changes in lactase or other disaccharidase levels, and all values were within normal limits. Thus lactase deficiency was not produced by prolonged temperature elevations.
Cholecystokinin activates a Ca2+-dependent Cl- conductance in intestinal nodose neurons that is inhibited in diet-induced obesity and may suppress satiety (1107.8)

The cholecystokinin (CCK) induced satiety signaling of vagal afferents is suppressed in diet-induced obese mice, which contributes to the increased food intake. In this study we tested the hypothes...
Antibody responses to Bacillus Calmette-Guérin during immunotherapy in bladder cancer patients.

Levels of serum antibody to Bacillus Calmette-Guerin (BCG) were determined by solid-phase radioimmunoassays in 48 normal donors and 60 patients with bladder cancer. Of 57 patients enrolled in a randomized prospective controlled trial of BCG immunotherapy, 47 were followed for up to 30 months, thus permitting comparisons of tumor recurrence, delayed cutaneous hypersensitivity responses to purified protein derivative (PPD), and serum BCG antibody levels at specific intervals during the clinical course. Sera from normal donors and cancer patients prior to BCG therapy had equally low levels of BCG antibody. AFter administration of intravesical and percutaneous BCG, significant rises of serum BCG antibody levels were detected in 23 of 24 randomized BCG immunotherapy patients. Skin test responses to PPD and serum BCG antibody levels had a close correlation as immune response indicators in 14 of 24 BCG therapy patients, while rises in serum BCG antibody levels were a better response indicator than PPD skin test reactions in the other 10 patients. Eleven of the 23 patients randomized into the non-BCG treatment group had tumor recurrence, although tumors recurred in only six of the 24 randomized patients in the BCG therapy group. Two additional nonrandomized BCG-treated patients had tumor recurrence. All eight BCG-treated patients with tumor recurrence had documented increases in serum BCG antibody levels after BCG therapy. Only three of these eight patients had conversion of PPD skin test responses from negative to positive; three were positive before immunotherapy and two remained negative after BCG therapy. Levels of antibodies reactive with human adenovirus type 5 and with Escherichia coli antigens were similar in sera from normal donors and from the randomized bladder cancer patients in both the BCG and non-BCG treatment groups. These results suggest that serum BCG antibody responses are as useful as PPD skin tests in identifying immunological responses to the immunoadjuvant BCG during immunotherapy trials in cancer patients.
Coping and coping styles in personality and treatment planning: introduction to the special series.

Coping is a complex process. It is variously described as a situational and as a trait-like response, as a response to stress and as a disposition to respond to change. In this article, we review the current research on coping within the context of considering the contributions of the articles presented in this series. We present two broad views of coping, the more general one under the title of "coping response" defines coping as containing emotional, behavioral, and cognitive qualitites. It is generally considered to be a stress-specific pattern by which an individual's perceptions, emotions, and behaviors prepare for adapting and changing. The more narrow view of coping is described here as "coping style" and represents a more observable but general style of interacting. In this usage, coping is a trait-like variable that is activated when an environment changes in some way. It resembles other personality qualities and describes dispositions to respond in certain ways. In this article, we consider the implications and extant knowledge about coping within these two definitions, with special consideration to the prediction of treatment processes and outcomes. The articles in this series are discussed both in terms of extant research on these two views of coping and in terms of their contributions to the available literature on coping and coping responses.
On Modeling Proton Affinity at the Oxide/Water Interface

Abstract The electrostatic model predicts the point of zero net proton change of oxide/water interfaces from independent variables having the form: s/R (s is the bond valence, cation valence divided by coordination number, and R is the distance separating two ions). The electrostatic model uses bond valence s to represent the effective charge at a surface site. For each of the various electrostatic models, there is an analogous crystallochemical model that is identical in every way except that it lacks R-1 dependence. A statistical comparison of the electrostatic and crystallochemical models demonstrates that the R-1 -dependence in the electrostatic model makes no significant contribution to the correlation coefficient. The crystallochemical model, besides being a predictor of proton affinity, has close connections with the bond-valence model of hydrogen-bond structure and function. From this connection, the crystallochemical model makes qualitative predictions regarding the effect of hydrogen bonding on: (a) proton affinity; (b) the physisorption of water; and (c) surface structure.
Synthesis of a Stereochemically Diverse Library of Medium-Sized Lactams and Sultams via SNAr Cycloetherification

We have implemented an aldol-based “build/couple/pair” (B/C/P) strategy for the synthesis of stereochemically diverse 8-membered lactam and sultam scaffolds via SNAr cycloetherification. Each scaffold contains two handles, an amine and aryl bromide, for solid-phase diversification via N-capping and Pd-mediated cross coupling. A sparse matrix design strategy that achieves the dual objective of controlling physicochemical properties and selecting diverse library members was implemented. The production of two 8000-membered libraries is discussed including a full analysis of library purity and property distribution. Library diversity was evaluated in comparison to the Molecular Library Small Molecule Repository (MLSMR) through the use of a multifusion similarity (MFS) map and principal component analysis (PCA).
Exploring beliefs about prostate cancer and early detection in men and women of three ethnic groups

Objectives: Practice guidelines support informed or shared decision-making about prostate cancer screening. To compare beliefs across three racial/ethnic categories concerning prostate cancer etiology and risk, screening routines, and shared decision-making, we conducted 12 focus groups. Methods: Participants were recruited in primary care settings and included 33 African Americans, 35 Hispanics, and 22 non-Hispanic Whites. Of the 90 participants, 53% were male. Results: Groups identified heredity, age, race, sexual activity, and other lifestyle influences as risk factors. Few were aware that prostate cancer is asymptomatic in early stages. Confidence in knowledge of screening routines was high, but included misconceptions supporting initiation of screening at earlier ages and at shorter intervals than professional recommendations. Females encouraged screening of male relatives to protect their health. Discussion and conclusion: While racial/ethnic groups had similar views and knowledge about screening, African Americans wanted to organize to address the threat of prostate cancer in their communities. Hispanics had awakening awareness of the health risks of prostate cancer. Non-Hispanic Whites were aware of the health threat of prostate cancer, but their approach to health protection was more individual and less community focused than that of African Americans. Participants were not aware of controversy about screening. Practice implications: Developers of educational materials to support informed or shared decision-making should be aware that initial views of prostate cancer screening are positive. # 2005 Elsevier Ireland Ltd. All rights reserved.
Matrix summability and a generalized Gibbs phenomenon

Letf be a real-valued function sequence {fk} that converges to ϕ on a deleted neighborhoodD of α. If there is a subsequence {fk(j)} and a number sequencex such that limjxj=α and either limjfk(j)(xj)>lim supx→αϕ(x) or limjfk(j)(xj)<lim infx→αϕ(x), thenf is said to display theGibbs phenomenon at α. IfA is a (real) summability matrix, thenAf is a function sequence given by(Af)n(x)=∑k=0∞an,kfk(x). IfAf displays the Gibbs phenomenon wheneverf does, thenA is said to beGP-preserving. By replacingfk(x) withfk(xj)≡Fk,j, the Gibbs phenomenon is viewed as a property of the matrixF, andGP-preserving matrices are determined by properties of the matrix productAF.
Living Anionic Copolymerization of 1-(Alkoxy)ethyl Methacrylates with Polar and/or Nonpolar Monomers and the Preparation of Amphiphilic Block Copolymers Containing Poly(methacrylic acid) Hydrophilic Segments at Higher Temperatures Than Usually Employed

The anionic copolymerization of each of the following three novel methacrylate monomers1-(ethoxy)ethyl methacrylate (EEMA), 1-(butoxy)ethyl methacrylate (BEMA), and 1-(tert-butoxy)ethyl methacrylate (tBEMA)with methyl methacrylate (MMA) and/or styrene (St) was carried out. (1) The random copolymerization with MMA proceeded smoothly in tetrahydrofuran (THF), using 1,1-diphenylhexyllithium (DPHL) as the initiator, in the presence of LiCl ([LiCl]/[DPHL]0 = 1), at −40 °C. The copolymer thus obtained possessed controlled molecular weight and composition, and its molecular weight distribution (MWD) was narrow (Mw/Mn = 1.08−1.10). (2) The block copolymer of each of the new monomers with MMA was prepared by the sequential anionic polymerization of the two monomers; the polymerization sequence MMA−new monomer controlled better the molecular weight and led to a narrower MWD than the inverse one. (3) A well-controlled block copolymerization of St with EEMA or with tBEMA was achieved at higher temperatures (≥−35 °C) ...
Electrical stimulation reveals relatively ineffective sural nerve projections to dorsal horn neurons in the cat

Abstract Electrical stimulation of the sural nerve (SN) revealed input from sural nerve afferents to L6 and L7 dorsal horn neurons that were not apparent using natural mechanical stimuli, especially in cells with variable latency responses to SN stimulation. Nearly all (31/32) cells that had reliable, fixed latency responses to SN stimulation also had an excitatory receptive field (RF) in the region of skin innervated by the sural nerve (SN region). About one-third (20/57) of the cells with variable latency responses to SN stimulation, however, had an RF outside the SN region. Most (130/146) cells with no response to SN stimulation had RFs outside the SN region. There were no obvious differences between variable latency cells with RFs in the SN region vs those with RFs outside it in latency of response to SN stimulation, recording depth, RF sizes or modality properties. In a subsample of 31 postsynaptic dorsal column neurons all cells responding to SN stimulation also had an RF in the SN region. Strengthening of relatively ineffective projections from the sural nerve by lesions might be expected to lead to an increase in the proporpotion of cells responding with impulses to natural stimulation of the skin innervated by the sural nerve, and, hence, to an increase in average RF size.
Quantum Mechanical Theory of Free-Electron Two-Quantum Stark Emission Driven by Transverse Motion

From the fact that the Smith-Purcell radiation, which was observed as being extraordinarily (i.e., 10 18 times) stronger than any classical emission in any equivalent field, is free-electron two-quantum Stark (FETQS) emission driven by axial uniform motion, free-electron lasers utilizing FETQS emission driven by transverse motion are proposed. The spontaneous emission power and the laser gain in these lasers are calculated with quantum mechanics under the “non-correspondence” principle.
Brief report: Failure of an electronic medical record tool to improve pain assessment documentation

OBJECTIVE: To comply with pain management standards, Bellevue Hospital in New York City implemented a mandatory computerized pain assessment screen (PAS) in its electronic medical record (EMR) system for every outpatient encounter. We assessed provider acceptance of the instrument and examined whether the intervention led to increased documentation of pain-related diagnoses or inquiries. DESIGN: Cross-sectional survey; a pre- and posthistorically controlled observational study. SUBJECTS AND MEASUREMENTS: The utility of the computerized tool to medicine housestaff and attendings was assessed by an anonymous survey. We conducted an electronic chart review comparing all adult primary care patient encounters over a 2-day period 6 months prior to implementation of the PAS and on 2 days 6 months after its implementation. RESULTS: Forty-seven percent of survey respondents felt that the computerized assessment tool was “somewhat difficult” or “very difficult” to use. The majority of respondents (79%) felt the tool did not change their pain assessment practice. Of 265 preintervention patients and 364 postintervention patients seen in the clinic, 42% and 37% had pain-related diagnoses, respectively (P=.29). Pain inquiry by the physician was noted for 49% of preintervention patients and 44% of the postintervention patients (P=.26). In 55% of postintervention encounters, there was discordance between the pain documentation using the PAS tool and the free text section of the medical note. CONCLUSION: A mandatory computerized pain assessment tool did not lead to an increase in pain-related diagnoses and may have hindered the documentation of pain assessment because of the perceived burden of using the application.
Comparison of the usefulness of doppler pressure half-time in mitral stenosis in patients < 65 and ≥ 65 years of age

Abstract Doppler pressure half-time is a reliable method for estimating mitral valve area when net left atrial and ventricular compliance remain stable. The accuracy of Doppler pressure half-time in estimating mitral valve area in older patients is unknown. We studied 80 patients (65 women and 15 men, aged 56 ± 14 years) with cardiac catheterization and echocardiography. Mitral valve area was calculated using the Gorlin formula and by the Doppler pressure half-time method. Patients were stratified into those aged
Desegregation: An ERIC/ChESS Sample.

TI he Educational Resources Information Center (ERIC), spon sored by the U.S. Department of Education, is the largest and oldest education information system in the world. The ERIC Clearinghouse for Social Studies/Social Science Education (ERIC/ ChESS) is one of sixteen subject-oriented clearinghouses that com pose the ERIC system. The heart of this system, the ERIC database of education-related literature, contains nearly one million citations with abstracts, drawn from a variety of disciplines. Citations to journal articles, teaching and curriculum guides, bibliographies, research reports, and conference papers are included. The ERIC database is available free in many large public and university libraries and on the Internet. The listings below are drawn from the ERIC database and include both teaching materials and general background information on the topic. The key to obtaining the full text of the materials cited below is the unique ERIC number assigned to each item in the database. Journal articles, denoted by "EJ" numbers (for example, EJ549890) can be copied at most academic libraries, borrowed through interlibrary loan, or purchased from article reprint services such as UnCover, UMI, and ISI. Research reports, conference papers, and other materials besides journal articles are denoted by "ED" numbers (for example, ED398110); paper or microfiche copies of most of these documents can be purchased from the ERIC Document Reproduction Service (EDRS), 7420 Fullerton Road, Suite 110, Springfield, VA 22153-2852; (800) 443-3742; (703) 44
Conformational flexibility and binding selectivity in a synthetic receptor for peptides

Abstract As a test of the effect of conformational flexibility on binding selectivity, we compare the binding properties of the highly selective receptor 1 and its more flexible homolog 2.
SPECIFIC IMMUNE RESPONSE GENES OF THE GUINEA PIG II. RELATIONSHIP BETWEEN THE POLY-L-LYSINE GENE AND THE GENES CONTROLLING IMMUNE RESPONSIVENESS TO COPOLYMERS OF L-GLUTAMIC ACID AND L-ALANINE AND L-GLUTAMIC ACID AND L-TYROSINE IN RANDOM-BRED HARTLEY GUINEA PIGS

The ability of guinea pigs to make immune responses to GA, a linear random copolymer of L-glutamic acid and L-alanine, GT, a random linear copolymer of L-glutamic acid and L-tyrosine, and PLL, a linear homopolymer of L-lysine, is controlled by different autosomal dominant genes specific for each of those polymers. We have investigated the relationship between the PLL gene and the GA and GT immune response genes by simultaneously immunizing random-bred Hartley strain guinea pigs with GA and PLL, GT and PLL, or GA and GT. In most Hartley guinea pigs the ability to respond immunologically to GA and to PLL is inherited together; that is, most animals responding to GA respond to PLL and vice versa. However, a few animals respond to either GA or to PLL but not both, demonstrating that the GA and PLL immune response genes are not identical but linked in most Hartley animals. Conversely, when simultaneously immunized with GT and PLL, most Hartley guinea pigs respond to either PLL or GT but not both, indicating that GT and PLL responsiveness tends to segregate away from each other. Thus, the GT and PLL immune response genes also are not inherited independently but, rather, behave as alleles or pseudoalleles. Similar results are observed when Hartley guinea pigs are simultaneously immunized with GA and GT. The ability to respond to GA segregates away from the ability to respond to GT. Our studies demonstrated that the specific immune response genes thus far identified in guinea pigs controlling the ability to respond to GA, GT, and PLL, respectively, are found on the same chromosome. In most Hartley animals, the GA and PLL immune response genes are often linked, i.e. occur on the same chromosome strand, and tend to behave as alleles or pseudoalleles to the GT immune response gene.
Cumulative Disadvantage and Youth Well-Being: A Multi-Domain Examination with Life Course Implications.

The accumulation of disadvantage has been shown to increase psychosocial stressors that impact life course well-being. This study tests for significant differences, based on disadvantage exposure, on youths’ emotional and physical health, as well as family supports, peer assets, and academic success, which hold potential for resilience and amelioration of negative health outcomes. A 12 item cumulative disadvantage summed index derived from surveys of a racially and socioeconomically diverse sample of urban high school seniors (n = 9658) was used to distinguish youth at low, moderate, and high levels. Findings supported hypothesized stepped patterns such that as multiple disadvantages accumulate, a concomitant decline is evident across the assessed outcome variables (except positive academic identity). Post-hoc tests indicated a pattern of groups being significantly different from one another. Overall, results lend support for an additive stress load associated with stacked disadvantage, with implications for continuing trends into adulthood as well as preventive interventions.
Transmission electron-spin resonance in copper-niobium sandwiches

Transmission electron-spin resonance of copper foil coated with a thin film of niobium is observed over a temperature range spanning the superconducting transition of the film. The effect of the niobium is to broaden the copper conduction-electron-spin resonance by an amount independent of temperature just above the transition and decreasing rapidly with temperature below the transition. The decrease is interpreted as a consequence of the inability of unpaired electrons in the copper to penetrate the copper-niobium interface unless they have sufficient thermal excitation energy to surmount the superconducting energy gap in the niobium. A conclusion from this interpretation is that the extra relaxation provided by the niobium is associated with rapid spin relaxation within the niobium, not with relaxation at the interface. Estimates are made of the interfacial transmission coefficient for an electron at the Fermi level and the spin-relaxation time in niobium.
Sonographic “white line sign” fordetection of minimal mucosal thickening in renal transplants

Abstract It is important to detect minimal hydronephrosis in a renal transplant because earlyor low-grade obstruction is clinically significant. Similarly, it is equally important to detect minimal mucosal thickening of the collecting system because this finding indicates the presence of renal disease even though thickening itself is nonspecific as to etiology. Differentiating between minimal hydronephrosis and minimal mucosal thickening may be difficult. We have noticed that meticulous sonograms made with an ultrasound transducer placed perpendicular to the interface of two opposing surfaces of thickened mucosa will produce a bright linear echo which can help discover and distinguish between these two entities. We choose to call this echo complex the “white line sign”.
Two-dimensional isotropic scattering in a semi-infinite cylindrical medium☆

Abstract Beginning with the integral equation for the source function, the solutions for the source function, flux and intensity at the boundary of a two-dimensional, isotropically scattering cylindrical medium are found. The incident radiation is collimated and normal to the surface of the medium and depends only on the radial coordinate. For a Bessel function boundary condition, separation of variables is used to reduce the source function integral equation to a one-dimensional equation. The resulting integral equation is shown to be the same as that for the two-dimensional planar case. Solutions for other boundary conditions are then shown to be superpositions of the Bessel function solution. Numerical results are presented for a Gaussian distribution of incident radiation which closely models a laser beam. These multiple scattering results are compared to the single scattering approximation. Also, the solution for a strongly anisotropic phase function which is made up of a spike in the forward direction superimposed on an otherwise isotropic phase function is expressed in terms of the isotropic results.
Demographic change and persistence of HIV/AIDS in heterogeneous population

A model of the transmission of the HIV virus that takes demographic change into account is derived and analyzed. Thresholds for the persistence of the disease in increasing or decreasing populations are derived, and the global behavior of the solutions is obtained. Two diverse notions of disease persistence are shown to exist in populations that are undergoing demographic change. The effects of the disease on the population demographics are analyzed and discussed.
Hybrid pressure retarded osmosis-membrane distillation system for power generation from low-grade heat: thermodynamic analysis and energy efficiency.

We present a novel hybrid membrane system that operates as a heat engine capable of utilizing low-grade thermal energy, which is not readily recoverable with existing technologies. The closed-loop system combines membrane distillation (MD), which generates concentrated and pure water streams by thermal separation, and pressure retarded osmosis (PRO), which converts the energy of mixing to electricity by a hydro-turbine. The PRO-MD system was modeled by coupling the mass and energy flows between the thermal separation (MD) and power generation (PRO) stages for heat source temperatures ranging from 40 to 80 °C and working concentrations of 1.0, 2.0, and 4.0 mol/kg NaCl. The factors controlling the energy efficiency of the heat engine were evaluated for both limited and unlimited mass and heat transfer kinetics in the thermal separation stage. In both cases, the relative flow rate between the MD permeate (distillate) and feed streams is identified as an important operation parameter. There is an optimal rela...
C-reactive protein and long-term ischemic stroke prognosis

C-reactive protein (CRP) is an inflammatory biomarker of inflammation and may reflect progression of vascular disease. Conflicting evidence suggests CRP may be a prognostic biomarker of ischemic stroke outcome. Most studies that have examined the relationship between CRP and ischemic stroke outcome have used mortality or subsequent vascular event as the primary outcome measure. Given that nearly half of stroke patients experience moderate to severe functional impairments, using a biomarker like CRP to predict functional recovery rather than mortality may have clinical utility for guiding acute stroke treatments. The primary aim of this study was to systematically and critically review the relationship between CRP and long-term functional outcome in ischemic stroke patients to evaluate the current state of the literature. PubMed and MEDLINE databases were searched for original studies which assessed the relationship between acute CRP levels measured within 24 hours of symptom onset and long-term functional outcome. The search yielded articles published between 1989 and 2012. Included studies used neuroimaging to confirm ischemic stroke diagnosis, high-sensitivity CRP assay, and a functional outcome scale to assess prognosis beyond 30 days after stroke. Study quality was assessed using the REMARK recommendations. Five studies met all inclusion criteria. Results indicate a significant association between elevated baseline high sensitivity CRP and unfavorable long-term functional outcome. Our results emphasize the need for additional research to characterize the relationship between acute inflammatory markers and long-term functional outcome using well-defined diagnostic criteria. Additional studies are warranted to prospectively examine the relationship between high sensitivity CRP measures and long-term outcome.
A Model to Predict Convective Subcooled Critical Heat Flux

A friction factor correlation based on pressure drop measurements at burnout in an annular channel is presented. From Reynolds analogy and this correlation, critical heat fluxes were predicted within ±10 percent of the values measured with ideal geometry (no ribs), stainless steel heaters, and H2 O coolant flowing vertically downward at a velocity of 15 to 45 ft/sec and subcoolings greater than 25 deg C. Tubular critical heat fluxes are predicted within ±20 percent using the friction factor correlation and Reynolds analogy. A short theoretical discussion is presented.
Effects of hormones on adult frog (Rana pipiens) testes in organ culture

Testes from adult Rana pipiens were maintained for five days in organ culture in a chemically defined medium consisting of CulturSTAT 199 organics dissolved in amphibian Ringer's solution. Various steroid hormones and vitamins, when added individually to testicular organ cultures, were found to be toxic. Toxicity of these substances was reduced or abolished by the simultaneous addition of protein hormones. Most combinations of protein hormones resulted in improved maintenance of cultured testes over that obtained in hormone-free media. The combinations FSH + LH, and FSH + LH + insulin + testosterone, resulted in almost complete testicular maintenance in vitro and, in some circumstances, even stimulation of spermatogenesis. However, in no case were secondary spermatocytes maintained in these organ cultures, and spermatogenesis could be stimulated only through the first meiotic division. Testosterone, previously demonstrated in vivo to inhibit spermatogenesis at the secondary spermatogonial level, exerted no such inhibitory action in vitro. At the dose level used, testosterone appeared to have a slightly deleterious, but nonspecific, effect on testicular maintenance. Seasonal variations in the sensitivity of the testis to hormones and other conditions in vitro were noted. Testicular maintenance was relatively poor, even in hormone-supplemented media, during the period of active spermatogenesis (summer). In contrast, gonadotropin-induced stimulation of spermatogenesis in vitro occurred only in testes taken from winter frogs, at a time when the testicular epithelium is presumed to be maximally sensitive to gonadotropic action.
White and Black careers during the first decade of labor force experience. Part III: Occupational status and income together

Abstract This analysis examined the major differences in patterns of occupational achievement of blacks and whites during the first decade of labor force experience after last leaving full-time schooling. In large part, the analysis was designed to further examine differences between blacks and whites observed in Parts I and II, i.e., that the processes underlying the attainment of two dimensions of achievement, status and income, may be different for the two groups. The results of canonical analysis showed directly what the earlier separate analyses of status and income had implied: for whites, status is the dimension of occupational achievement to which background resources are more fully directed, while for blacks, income is the dimension toward which these resources are utilized. The difference between blacks and whites holds both for the initial job and for the job held 10 years later. A second canonical correlation showed that the strategy of whites, using background resources to obtain jobs in which status is higher relative to income, has long-range implications. These resources are valuable at the later time not just for the status but for income, to a much greater extent than is true for blacks. This difference between blacks and whites, in the utility of background resources, is especially evident in the case of educational attainment.