cssi/SciSciGPT-SciSciNet huggingface dataset:
Efficacy of pentoxifylline as a modulator of alkylating agent activity in vitro and in vivo.

Pentoxifylline, a methylxanthine that is used to treat veno-occlusive disease, can increase perfusion in undervascularized tissues. Addition of high concentrations, like caffeine, causes progression through radiation or drug induced G2 phase blocks, thereby limiting time for repair of DNA breaks and crosslinks. We have examined the potential of pentoxifylline to augment the effects of antitumor alkylating agents in vitro and in vivo. In MCF-7 human breast cancer cells in vitro, pentoxifylline (2 mM) present for 24 h was only slightly cytotoxic (approximately 10% cell kill at 2 mM), but when present prior to and during AA it increased the cytotoxicity of CDDP by 2 logs at 250 microM. With L-PAM in vitro, pentoxifylline was much less effective and only at a concentration of 250 microM L-PAM did 2 mM pentoxifylline increase cytotoxicity (approximately 0.3 logs). In the FSaIIC murine fibrosarcoma system, 100 mg/kg of pentoxifylline i.p. immediately prior to the alkylating agent or 50 mg/kg x 5 of pentoxifylline over 24 h with the alkylating agent given immediately after the third dose increased the tumor cell kill achieved by CDDP, carboplatin, cyclophosphamide, and thiotepa. The increase in tumor cell killing was modest (2.9-fold). Pentoxifylline in the multiple dose regimen (50 mg/kg x 5 over 24 h) was more effective than in the single dose (100 mg/kg) protocol. In the EMT6 mouse mammary adenocarcinoma, pentoxifylline (100 mg/kg daily x 5) improved the tumor growth delay produced by CDDP (3.3 mg/kg alternate days x 3), carboplatin (25 mg/kg daily x 5), cyclophosphamide (100 mg/kg alternate days x 3) and thiotepa 5 mg/kg (daily x 5). Only with cyclophosphamide, however, did the interaction appear to be large, as a 2.4-fold increase was observed.
Aesthetascs in Lysmata spp. shrimp: sexual dimorphism and relationship with social environments

Aesthetascs are the olfactory receptor organs responsible for mate recognition in many decapod crustacean species. The number of aesthetascs varies greatly among species in different environments, but the functional significance of this variation is poorly understood. This study examined the relationship between social environment and the number of aesthetascs in six species of caridean shrimp in the genus Lysmata. Generally, the number of aesthetascs was greater in group-living species (L. boggessi and L. wurdemanni) than in low-density (L. ankeri and L. pederseni) and pair-living species (L. amboinensis and L. debelius). Aesthetascs are innervated by olfactory receptor neurons (ORNs). The total number of ORNs is related to the sensitivity of olfactory odor detection, and it was higher in group-living species than in pair-living species. Sexual dimorphism in the number of aesthetascs was present in L. boggessi, L. wurdemanni, and L. ankeri but not in L. pederseni and L. amboinensis.
“Crashing America’s Back Gate”: Illegal Europeans, Policing, and Welfare in Industrial Detroit, 1921-1939:

Between 1921 and 1939, the border separating Detroit, Michigan, from Windsor, Canada, represented a key site for undocumented immigration on America’s northern border, and the migrants in question ...
Arterial pH modulation of regional cerebral blood flow during hyperammonemia in dogs

Acute hyperammonemia at normal arterial pH causes selective increases in midbrain blood flow in dogs. Unexpectedly, further increases occur with hypocapnia. We investigated whether metabolic acidemia and alkalemia modulate the distribution of ammonium across the blood-brain barrier and if, in turn, midbrain blood flow is effectively modulated. In dogs anesthetized with pentobarbital sodium, hyperammonemia (approximately 940 microM) was produced by a 210-min infusion of ammonium acetate. Concurrent infusion of NaHCO3 increased arterial pH to 7.53 +/- 0.02 (SE), whereas HCl infusion decreased pH to 7.11 +/- 0.01. Normocapnia was maintained. Cerebrospinal fluid [HCO3-] increased 5 mM with alkalemia (one-half of the increase in blood) and was unchanged with acidemia. Thus cerebrospinal fluid [H+]/blood [H+] was greater with alkalemia than acidemia. The corresponding ratio for ammonium was likewise greater with alkalemia (0.70 +/- 0.06) than acidemia (0.44 +/- 0.08). Microsphere-determined blood flow to midbrain more than doubled in the alkalemic group but was unchanged in the acidemic group. No other region along the neuraxis or in cerebrum showed increased blood flow in either hyperammonemic group. Alkalemia without hyperammonemia did not increase midbrain blood flow. Thus metabolic acidemia-alkalemia significantly alters ammonium partitioning into cerebrospinal fluid, and this alteration is sufficiently great to exert a specific physiological effect manifested by changes in midbrain blood flow.
Mining Requirements Knowledge from Operational Experience

This chapter reports results from two recent studies of how operational experience with mission-critical product lines can enhance knowledge management for use with their future products. The challenge was how to propagate new requirements knowledge forward in a product line in ways that projects will use. In the first product line, the concern was capture and retention of requirements knowledge exposed by defects that occurred during operations. This led to two mechanisms not traditionally associated with requirements management – feature models extended with assumption specifications (formal) and structured anecdotes of paradigmatic product-line defects (informal). In the second product line, the traditional notion of binding time in a product line did not accurately reflect the timing of project decisions. This led to a definition of product-line binding times that better accommodates the varying requirements of the different missions using the product line. It appears that the practical techniques reported here to build requirements knowledge into software product lines in the spacecraft domain also are useful in other product-line developments.
Adoption of Cloud Computing in Firms to Enable Software as a Service

Software as a Service SaaS is a subset of cloud computing that provides information systems functionality through a web browser. Organizations that adopt SaaS can receive value over time if they continue to use the SaaS solution after implementation. This study analyzed the extent to which SaaS adoption and continued use factors affect the continued use of SaaS in organizations. The research can help organizations maximize the value of SaaS by identifying success factors for continued use. The study determined the extent to which the independent factors of Rapport, Responsiveness, Reliability, Features, Security, Flexibility, and Marketing Effort affected the dependent variable of the decision makers' intent to continue use of SaaS within their organization.
The Controlled Cortical Impact Model: Applications, Considerations for Researchers, and Future Directions.

The cControlled cortical impact model (CCI) is a mechanical model of traumatic brain injury (TBI) that was developed nearly 30 years ago with the goal of creating a testing platform to determine the biomechanical properties of brain tissue exposed to direct mechanical deformation. Initially used to model TBIs produced by automotive crashes, the CCI model rapidly transformed into a standardized technique to study TBI mechanisms and evaluate therapies. CCI is most commonly produced using a device that rapidly accelerates a rod to impact the surgically exposed cortical dural surface. The tip of the rod can be varied in size and geometry to accommodate scalability to difference species. Typically, the rod is actuated by a pneumatic piston or electro-mechanic actuator. With some limits, CCI devices can control the velocity, depth, duration, and site of impact. The CCI model produces morphologic and cerebrovascular injury responses that resemble certain aspects of human TBI. Commonly observed are graded histologic and axonal derangements, disruption of the blood-brain barrier, subdural and intra-parenchymal hematoma, edema, inflammation, and alterations in cerebral blood flow. The CCI model also produces neurobehavioral and cognitive impairments similar to those observed clinically. In contrast to other TBI models, the CCI device induces a significantly pronounced cortical contusion, but is limited in the extent to which it models the diffuse effects of TBI; a related limitation is that not all clinical TBI cases are characterized by a contusion. Another perceived limitation is that a non-clinically relevant craniotomy is performed. Biomechanically, this is irrelevant at the tissue level. However, craniotomies are not atraumatic and the effects of surgery should be controlled by including surgical sham control groups. CCI devices have also been successfully used to impact closed skulls to study mild and repetitive TBI. Future directions for CCI research surround continued refinements to the model through technical improvements in the devices (e.g. minimizing mechanical sources of variation). Like all TBI models, publications should report key injury parameters as outlined in the NIH common data elements (CDEs) for preclinical TBI.
Best practices for safe use of insulin pen devices in hospitals: Recommendations from an expert panel Delphi consensus process.

Purpose A Delphi consensus development process was used to identify best practices for the safe use of insulin pen devices in hospitals. Methods A panel of healthcare professionals with experience in patient safety activities and development of insulin-use guidelines was selected. In round 1 of a 4-round Delphi process, panelists were asked to identify key concepts and practices relating to safe use of insulin pen devices in hospitals. In round 2, panelists indicated their level of agreement with draft practice statements reflecting input received in round 1; statements with strong support were refined based on panelist suggestions. In round 3, the modified draft statements were rated for potential impact on patient safety. In round 4, panelists selected a final list of statements to recommend as best practices. Results A 12-member interprofessional panel consisting of nurses, pharmacists, and physicians participated in the Delphi process. In round 1, panelists submitted more than 450 statements describing safe practices for insulin pen use. Based on that input, 125 draft practice statements were developed; among 98 statements receiving panelist support in round 2, 76 were judged in round 3 to be critical to patient safety or likely to have a positive impact on patient safety. In round 4, panelists unanimously affirmed a final list of 35 best-practice statements for the safe use of insulin pens in hospitals. Conclusion A Delphi consensus development process yielded a list of recommended best practices to help ensure the safe use of insulin pen devices in hospitals and health systems.
Bronchoarterial ratio in never smokers: Implications for bronchial dilation definition

Background: One of the main radiographic features of bronchiectasis is bronchial dilation measured as the ratio of the bronchus lumen diameter to accompanying pulmonary artery diameter (BA). Bronchiectasis is linked to lung function impairment. Data on BA ratio in a non-smoking population without cardiopulmonary disease is scarce. We hypothesize that intrinsic BA ratio is related to lung function in never smokers. We aimed to test the association between BA ratio and lung function and to explore the variability of this ratio in non-smoking subjects. Methods: Objective measurements of BA ratio on volumetric computed tomography scans along with demographic and pulmonary function data were collected in 106 never smokers. BA ratio was measured in generations 4 th to 6 th of the right upper lobe apical bronchus (RB1) and right lower lobe basal posterior bronchus (RB10). Regression analysis was used to assess the association between BA ratio and forced expiratory volume in one second (FEV 1 ). Results: The mean BA ratio was 0.80 and varied by RB1 generation (0.86 in 4 th generation to 0.76 in 5 th generation, P 1, a cutoff point commonly used to define bronchiectasis. After adjusting for age, sex, race, and height, the BA ratio was directly related to FEV 1 (P=0.0015). Conclusions: In non-smoking subjects, BA ratio is variable with values above what is considered abnormal in disease. The BA ratio is related to lung function regardless of body size. Using a fix ratio to define bronchiectasis may be inappropriate and further normative data in this metric is warranted.
Discrete Variational Method for the Energy Band Problem with LCAO Basis and Non-Spherical Local Potential

While the discrete variational method (DVM)1,2 is not restricted with regard to the form of the basis set, and this is one advantage of the technique, the method has so far been applied to the one electron model Hamiltonian using a linear combination of atomic orbitals (LCAO) basis. The DVM seems most promising for treating compounds, where non-spherical potential terms are significant. The LCAO basis is most appropriate for forming crystal wavefunctions for those systems in which the atomic character of the constituent atoms is maintained to a large degree. The results that have been obtained thus far for bcc Li, diamond, single and multi-layer graphite, LiF, MgO, SiC and TiC show that the DVM is in fact a feasible scheme and works quite well with surprisingly few integration points. Moreover, the LCAO basis has been found to converge the occupied and lower conduction band structures with only slight extensions beyond minimal basis sets.
Levels of GP-Iib/Iiia Positive Platelet Microparticles (PMP) but Not CD31+/CD42+ PMP Predict Adverse Outcomes in Troponin-Negative Patients with Chest Pain.

Background: Cell derived microparticles (MP) are useful biomarkers in various thrombotic and inflammatory disorders. However, MP are heterogeneous in their phenotypes, functional properties, and origin. Platelet-derived microparticles (PMP) have been shown to be elevated in acute coronary syndromes but different species of PMP have not been compared. We performed a study to compare two subspecies of PMP, those identified by anti-GP-IIb/IIIa vs. those by CD31+/CD42+, for predicting adverse outcomes in patients with chest pain of possible ischemic cause. Methods: The study population consisted of 105 patients who presented to the emergency department with chest pain, non-diagnostic electrocardiograms and negative serial cardiac troponin I levels. Blood was obtained after the third negative troponin result for determination of levels of GP-IIb/IIIa positive PMP (PMPIIb/IIIa) and CD31+/CD42+ PMP (PMP31). All treatment decisions were left at the caregiver’s discretion. Telephone follow-up was done at 6 months for the development of a combined endpoint of death, myocardial infarction or need for cardiac catheterization or revascularization. The mean age of our patients was 57.5 years. The age, diabetes, hypertension, smoking and history of coronary artery disease was not significantly different between patients who reached an endpoint at 6 months versus those who did not. Overall 19% reached an endpoint at 6 months. The endpoint was largely driven by the need for cardiac catheterization due to positive stress test results. Results: On univariate analysis, patients who reached an endpoint at 6 months had higher levels of PMPIIb/IIIa than those who did not (geometric means 2059.6 vs. 924.4 counts/μL; p=0.04; medians 2157.5 vs 1764.0 counts/μL; p=0.009). When adjusted for age, diabetes, hypertension, dyslipidemia, aspirin use and current smoking by analysis of covariance, the difference persisted (adjusted geometric means: 2484.9 vs. 829.5 counts/μL; p=0.01). In contrast, PMP31 levels were not significantly different between patients who reached an endpoint at 6 months versus those who did not (5908 ±7990 vs. 3812 ±3109 counts/μL; p=0.26). Conclusions: Our findings suggest that different subspecies of PMPs may reflect different pathophysiological phenomena. PMP31 levels did not correlate with the risk of adverse outcomes in this population. In contrast, GpIIb/IIIa-positive PMP appear to be promising prognostic indicators in chest pain patients with negative troponins and nondiagnostic EKGs. Our results are consistent with prior studies showing association between PMP and thrombosis, but suggest that not all PMP are equal. Further research is needed to investigate a possible role of PMP in the pathogenesis of ACS, and as prognostic markers in current stratification strategies. Assay of different species of MP is likely to provide more discriminating diagnostic and prognostic information.
Optimizing surgical resection of the bleeding Meckel diverticulum in children

Abstract Purpose Meckel diverticula containing gastric heterotopia predispose to local hyperacidity, mucosal ulceration, and gastrointestinal bleeding in children. Eradication of acid-producing oxyntic cells is performed by either of two surgical methods: segmental enterectomy including the diverticulum or diverticulectomy only. Methods Retrospective review of all children having surgical resection of a Meckel diverticulum at a tertiary-referral children's hospital from 2002 to 2016 was performed. Demographic data, surgical method, pathological specimens, and outcomes were evaluated. Results 102 children underwent surgical resection of a Meckel diverticulum during the study period. 27 (26.5%) children presented with bleeding, of which 16 (59%) had diverticulectomy only, and 11 (41%) had segmental ileal resection. All Meckel diverticula in children presenting with bleeding contained gastric heterotopia, and resection margins were free of gastric mucosa. Histologically, 19 specimens showed microscopic features of ulceration, on average 2.95mm (SD 4.49) from the nearest gastric mucosa (range: 0–16mm). Mean length of hospitalization after ileal resection was 4.0days (SD 1.2) compared to 1.6days (SD 0.9) for diverticulectomy only (p Conclusion In the operative management of children having a bleeding Meckel diverticulum, diverticulectomy-only completely eradicates gastric heterotopia without increased risk of continued bleeding or complications and significantly shortens hospitalization. Level of evidence Treatment Study: Level III.
A Persistent Rash on the Back, Chest, and Abdomen.

A 62-year-old breast cancer survivor presented with an erythematous, pruritic, expanding rash on her back, chest, and left lower abdomen.
The production of narrative through static imagery: examples from a peculiar medieval illustration:

Certain images perform upon and with their readers. Among the performative capabilities of imagery is narrative function, where the reader actively constructs a sense of time from an otherwise stat...
The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system predicts wound healing better than direct angiosome perfusion in diabetic foot wounds

Abstract Objective Previous studies show conflicting results in wound healing outcomes based on angiosome direct perfusion (DP), but few have adjusted for wound characteristics in their analyses. We have previously shown that the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification correlates with wound healing in diabetic foot ulcers (DFUs) treated by a multidisciplinary team. The aim of this study was to compare WIfI classification vs DP and pedal arch patency as predictors of wound healing in patients presenting with DFU and peripheral arterial disease. Methods We performed a retrospective review of a prospectively maintained database of all patients with peripheral arterial disease presenting to our multidisciplinary DFU clinic who underwent angiography. An angiosome was considered directly perfused if the artery feeding the angiosome was revascularized or was completely patent. Wound healing time at 1 year was compared on the basis of DP vs indirect perfusion, Rutherford pedal arch grade, and WIfI classification using univariable statistics and Cox proportional hazards models. Results Angiography was performed on 225 wounds in 99 patients (mean age, 63.3 ± 1.2 years; 62.6% male; 53.5% black) during the entire study period. There were 33 WIfI stage 1, 33 stage 2, 51 stage 3, and 108 stage 4 wounds. DP was achieved in 154 wounds (68.4%) and indirect perfusion in 71 wounds (31.6%). On univariable analysis, WIfI classification was significantly associated with improved wound healing (57.2% for WIfI 3/4 vs 77.3% for WIfI 1/2; P = .02), whereas DP and pedal arch patency were not (both, P ≥ .08). After adjusting for baseline patient and wound characteristics, WIfI stage remained independently predictive of wound healing (WIfI 3/4: hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.67-0.88), whereas DP (HR, 0.82; 95% CI, 0.55-1.21) and pedal arch grade (HR, 0.85; 95% CI, 0.70-1.03) were not. Conclusions In our population of patients treated by a multidisciplinary diabetic foot service, the Society for Vascular Surgery WIfI classification system was a stronger predictor of diabetic foot wound healing than DP or pedal arch patency. Our results suggest that a measure of wound severity should be included in all future studies assessing wound healing as an outcome, as differences in patients' wound characteristics may be a strong contributor to the variation of angiosome-directed perfusion results previously observed.
Taming Radical Pairs in Nanocrystalline Ketones: Photochemical Synthesis of Compounds with Vicinal Stereogenic All-Carbon Quaternary Centers

Here we describe the use of crystalline ketones to control the fate of the radical pair intermediates generated in the Norrish type I photodecarbonylation reaction to render it a powerful tool in the challenging synthesis of sterically congested carbon–carbon bonds. This methodology makes the synthetically more accessible hexasubstituted ketones ideal synthons for the construction of adjacent, all-carbon substituted, stereogenic quaternary stereocenters. We describe here the structural and thermochemical parameters required of the starting ketone in order to react in the solid state. Finally, the scope and scalability of the reaction and its application in the total synthesis of two natural products is described.
Enhancing preparation for large Nipah outbreaks beyond Bangladesh: Preventing a tragedy like Ebola in West Africa

The Nipah virus has been transmitted from person-to-person via close contact in non-urban parts of India (including Kerala May 2018), Bangladesh, and the Philippines. It can cause encephalitis and pneumonia, and has a high case fatality rate. Nipah is a One Health zoonotic infectious disease linked to fruit bats, and sometimes pigs or horses. We advocate anticipating and preparing for urban and larger rural outbreaks of Nipah. Immediate enhanced preparations would include standardized guidance on infection prevention and control, and personal protective equipment, from the World Health Organization (WHO) on their OpenWHO website and 2018 "Managing Epidemics" handbook, along with adding best clinical practices by experts in countries with multiple outbreaks such as Bangladesh and India. Longer-term enhanced preparations include accelerating development of field diagnostics, antiviral drugs, immune-based therapies, and vaccines. WHO-coordinated multi-partner protocols to test investigational treatments, diagnostics, and vaccines are needed, by analogy to such protocols for Ebola during the unanticipated pan-epidemic in Guinea, Liberia, and Sierra Leone. Anticipating and preparing now for urban and rural Nipah outbreaks in nations with no experience with Nipah will help avoid the potential for what the United Nations 2016 report on Ebola in West Africa called a "preventable tragedy".
Slightly Generalized Contagion: Unifying Simple Models of Biological and Social Spreading

We motivate and explore the basic features of generalized contagion, a model mechanism that unifies fundamental models of biological and social contagion. Generalized contagion builds on the elementary observation that spreading and contagion of all kinds involve some form of system memory. We discuss the three main classes of systems that generalized contagion affords, resembling: simple biological contagion; critical mass contagion of social phenomena; and an intermediate, and explosive, vanishing critical mass contagion. We also present a simple explanation of the global spreading condition in the context of a small seed of infected individuals.
Middle class identification: The influence of interclass context on middle class evaluations of morality and success

This study explored the influence of interclass context on how people identify themselves as middle class. Data were collected from 676 employees of Iowa State University who categorized themselves as being in the middle class. Using an online survey design, all participants were randomly selected into an experimental condition in which they were asked to compare their own social class (i.e., the middle class) with either the working class or the upper class. In agreement with social identity theory, participants evaluated members of the upper class to be more successful, but less moral, than members of the middle class. On the other hand, while members of the working class were seen as less successful than members of the middle class, they were rated higher on morality. Results also show that participants perceived the relations between the middle class and the working class to be more permeable and less legitimate than the relations between the middle class and the upper class. Thus, results indicate that the middle class participants found themselves to be more similar to, and less distinct from, the working class in comparison to the upper class.
The Influence of Grain Boundaries on Creep of KBr

Most creep experiments on alkali halides have used single crystal specimens, and only relatively little information is available on the creep characteristics of polycrystalline materials (primarily LiF and NaCl). In addition, there is the possibility of marked differences in impurity content between the single and polycrystalline samples, which make it difficult to compare the limited data at present available. Accordingly, this paper describes a series of experiments conducted on KBr with the objective of overcoming these difficulties.
Learning a Dynamic-Based Representation for Multivariate Biomarker Time Series Classifications

Time series in healthcare practices and biomedical research are typically multivariate, i.e. multiple biomarkers are observed simultaneously at a time. However, they tend to be short, noisy, unaligned, irregularly sampled, partially observed, and with only limited samples. These imperfections pose a challenge for mining information from data. In this work, we propose to use dynamic-based representations to present such imperfect multivariate time series. Specifically, we propose an approach to learn a corresponding Linear Dynamical System (LDS) for a multivariate time series example and use the set of system parameters as a representation for that example. Such a representation is able to capture interactions of different variables and provide a unified view of multivariate time series with different lengths, different missingness mechanisms, and different starting points. Other techniques are then used to mine useful information and perform learning tasks based on the new representation. For example, we use support vector machine classification models with LDS kernels in time series classification tasks. To evaluate the effectiveness of the proposed approach, we conducted experiments on both synthetic data sets and real-life datasets. The results in synthetic datasets demonstrated that the proposed approach could correctly learn the similarities of underlying linear dynamical systems. Our real-life data sets included human influenza A (H3N2), Rhinovirus (HRV), and respiratory syncytial virus (RSV) gene expression time series. The accuracies in the leave-one-out symptomatic/asymptomatic diagnostic tasks showed that our approach outperformed three baseline algorithms. Moreover, in experiments where various levels of imperfections were imposed on the H3N2 dataset, the accuracies of other baseline methods degraded significantly, but the accuracy of our approach remained high.
Credit Risk Transfer: A Fork in the Road

The Fannie Mae and Freddie Mac credit risk transfer (CRT) programs have been a huge success. Starting in 2013, the government-sponsored enterprises (GSEs) have transferred the risk on increasing amounts of reference collateral. But rising interest rates and declining origination volumes suggest that, over the next few years, the GSEs will struggle to keep CRT volumes flat. This will require the GSEs to choose between increasing their capital markets transactions and increasing CRT at the point of acquisition. Moreover, although the GSEs may continue to broaden their offerings, the growth in the market is likely to come from outside the GSE space. There has already been a notable expansion in CRT by the mortgage insurance companies and we could eventually see trading in CRT indexes and the emergence of CRT issuance by banks, should they get capital relief. This article examines the landscape for CRT with that in mind.
Why dictators hold semi-competitive elections and encourage the use of semi-independent courts: a comment on Thornhill and Smirnova’s “litigation and political transformation”

In this comment, I highlight similarities between Russia’s contemporary political system and other post-Cold War dictatorships. Most modern dictatorships hold semi-competitive elections. That is, regime officials face competition in elections, but playing fields are tilted so as to leave little suspense about who will win. I suggest that semi-competitive elections and the encouragement of litigation by citizens against local and regional officials, as described by Thornhill and Smirnova (Accepted/In press), have similar functions from the dictator’s point of view. They help the ruling elite with monitoring and controlling local officials whose behavior might otherwise alienate citizens enough to threaten the dictatorial elite with overthrow. Thus the real benefits citizens receive from the increased use of the courts to resolve disputes and electoral competition among politicians are counterbalanced by the contribution these institutions make to the prolongation of dictatorship.
Effects of Time-Varying Changes in Tobacco and Alcohol Use on Depressive Symptoms Following Pharmaco-Behavioral Treatment for Smoking and Heavy Drinking

Abstract Background Complete abstinence from alcohol as well as smoking cessation have been shown to predict reductions in depressive symptoms over time. However, whether reducing alcohol use or smoking positively affect depressive symptoms has yet to be examined. The current study examined depressive symptoms as a function of time-varying changes in alcohol use and smoking status following a pharmaco-behavioral treatment addressing smoking cessation and alcohol reduction. Methods Participants were heavy-drinking smokers (n = 150) followed for 26 weeks after their quit smoking date, with assessments of smoking, alcohol use, and depressive symptoms at baseline and 2, 8, 16, and 26 weeks. Results Abstinence from smoking was associated with significantly lower depressive symptoms, as compared to little to no reduction in smoking (B = −6.1) as well as significant reductions in smoking (B = 4.01). Exploratory analyses, which excluded observations in which a participant was abstinent, revealed a significant effect of percent change in cigarettes smoked, modeled continuously, on depressive symptoms, (B = 4.39). By contrast, no differences were observed in depressive symptoms in relation to changes in alcohol use. Conclusion It appears that smoking abstinence is associated with improvements in depression as compared to any level of sustained or reduced use and that the magnitude of smoking reduction may be associated with lower depressive symptoms among those who did not quit successfully. If replicated, these findings may inform treatment for individuals for whom depression is a major barrier to cessation and who have been unable or are unwilling to be completely abstinent from smoking.
Using the National Surgical Quality Improvement Project (NSQIP) to Perform Clinical Research in Colon and Rectal Surgery

The American College of Surgeons' National Surgical Quality Improvement Project (ACS-NSQIP) is probably the most well-known surgical database in North American and worldwide. This clinical database was first proposed by Dr. Clifford Ko, a colorectal surgeon, to the ACS, and NSQIP first started collecting data ca. 2005 with the intent of comparing hospitals (benchmarking) and for hospital-level quality improvement projects. Since then, its popularity has grown from just a few participating hospitals in the United States to more than 708 participating hospitals worldwide, and collaboration allows regional or disease-specific data sharing. Importantly, from a methodological perspective, as the number of hospitals has grown so has the hospital heterogeneity and thus generalizability of the results and conclusions of the individual studies. In this article, we will first briefly present the structure of the database (aka the Participant User File) and other important methodological considerations specific to performing clinical research. We will then briefly review and summarize the approximately 60 published colectomy articles and 30 published articles on proctectomy. We will conclude with future directions relevant to colorectal clinical research.
Role of imaging in low-grade cutaneous B-cell lymphoma presenting in the skin

Background Whole-body imaging is the current standard of care for staging all patients presenting with skin lesions of B-cell lymphomas (BCLs), regardless of skin disease extent; however, supporting data are lacking. Objective To determine the clinical utility of imaging in the detection of systemic involvement in low-grade cutaneous BCLs in the skin. Methods Retrospective cohort analysis of patients presenting with cutaneous lesions of BCLs at Memorial Sloan Kettering Cancer Center and Stanford University during 1997-2016. Results At initial staging, of the 522 patients, extracutaneous disease was noted in 3.6% and 8.8% of patients with marginal zone lymphoma (MZL, n = 306) and follicle center lymphoma (FCL, n = 216) histology, respectively. In patients with systemic involvement, imaging alone identified 81.8% (9/11) of MZL cases and 89.4% of follicular lymphoma cases. In primary cutaneous MZL, 1.7% of patients subsequently had extracutaneous involvement (median follow-up 45 months), and in primary cutaneous FCL. 3.0% subsequently had extracutaneous involvement (median follow-up 47 months). Limitations This was a retrospective study. Conclusion Imaging is effective at identifying patients with systemic involvement in indolent BCLs present in the skin; however, incidence is low. After negative initial staging, primary cutaneous MZL patients may be followed clinically without routine imaging.
Congenital Cystic Diaphragm with Diaphragmatic Eventration in a Fetus: A Case Presentation.

AbstractIntroduction: Congenital diaphragmatic eventration (CDE) is defined as the abnormal elevation of the diaphragm, due to incomplete muscularization of the diaphragm with a thin membranous she...
Bounded reflexivity of kernels of elementary operators

Abstract Kernels of elementary operators of length two give rise to many interesting classes of operators. In this paper we study bounded reflexivity of these kernels. For general Banach spaces, a sufficient condition is given for the kernels to be boundedly reflexive, in particular this assures that the commutant of any Banach space operator is boundedly reflexive. We also show that the bounded reflexive cover of the set of all Toeplitz matrices in M m × n is the entire M m × n . For finite-dimensional Banach spaces, using Kronecker canonical form for matrix pencils, we obtain some necessary and sufficient conditions for the kernels to be boundedly reflexive. These conditions enable us to easily determine bounded reflexivity by simply computing rank or nullity of matrices.
Synovial fluid biomarkers associated with osteoarthritis severity reflect macrophage and neutrophil related inflammation

To identify a synovial fluid (SF) biomarker profile characteristic of individuals with an inflammatory osteoarthritis (OA) endotype. A total of 48 knees (of 25 participants) were characterized for an extensive array of SF biomarkers quantified by Rules Based Medicine using the high-sensitivity multiplex immunoassay, Myriad Human InflammationMAP® 1.0, which included 47 different cytokines, chemokines, and growth factors related to inflammation. Multivariable regression with generalized estimating equations (GEE) and false discovery rate (FDR) correction was used to assess associations of SF RBM biomarkers with etarfolatide imaging scores reflecting synovial inflammation; radiographic knee OA severity (based on Kellgren-Lawrence (KL) grade, joint space narrowing, and osteophyte scores); knee joint symptoms; and SF biomarkers associated with activated macrophages and knee OA progression including CD14 and CD163 (shed by activated macrophages) and elastase (shed by activated neutrophils). Significant associations of SF biomarkers meeting FDR < 0.05 included soluble (s)VCAM-1 and MMP-3 with synovial inflammation (FDR-adjusted p = 0.025 and 1.06 × 10−7); sVCAM-1, sICAM-1, TIMP-1, and VEGF with radiographic OA severity (p = 1.85 × 10−5 to 3.97 × 10−4); and VEGF, MMP-3, TIMP-1, sICAM-1, sVCAM-1, and MCP-1 with OA symptoms (p = 2.72 × 10−5 to 0.050). All these SF biomarkers were highly correlated with macrophage markers CD163 and CD14 in SF (r = 0.43 to 0.90, FDR < 0.05); all but MCP-1 were also highly correlated with neutrophil elastase in SF (r = 0.62 to 0.89, FDR < 0.05). A subset of six SF biomarkers was related to synovial inflammation in OA, as well as radiographic and symptom severity. These six OA-related SF biomarkers were specifically linked to indicators of activated macrophages and neutrophils. These results attest to an inflammatory OA endotype that may serve as the basis for therapeutic targeting of a subset of individuals at high risk for knee OA progression. Written informed consent was received from participants prior to inclusion in the study; the study was registered at ClinicalTrials.gov ( NCT01237405 ) on November 9, 2010, prior to enrollment of the first participant.
Perceived Self-Efficacy in Psychiatry

This study examined medical students’ perceptions of self-efficacy in psychiatry-based skills. Significant deficiencies in students’ perceptions of their ability to acquire proficiency in key psychiatric skills were observed, and were found to relate to negative attitudes towards the treatment of patients with psychiatric symptomatology. A model of psychiatric competency development is proposed in which perceptions of self-efficacy are hypothesized to mediate attitude and competency change. Class year variations in the pattern of correlations among variable sets provide support for this model, and suggest the importance of early training in psychiatry-based skills to undercut possible avoidance behaviors.
Characterization of a transgenic mouse model of chronic conditional platelet depletion

Background Platelets are widely recognized for their role in maintaining hemostasis. Recently, platelets have become appreciated for their varying roles in immunity, neuroprotection, and other physiological processes. While there are currently excellent methods to transiently deplete platelets and models of thrombocytopenia, studying the roles of platelets in chronic processes can be challenging. Objective Phenotypic characterization of the PF4-DTR mouse model of conditional platelet depletion compared to antibody depletion. Methods We describe the ability of the PF4-DTR mouse to maintain chronic platelet depletion, along with examining the bleeding phenotype compared to antibody-mediated platelet depletion. Results Systemic administration of diphtheria toxin resulted in >99% platelet depletion that can be maintained for >2 weeks. When compared to an antibody depletion model, PF4-DTR mice showed similar phenotypes when challenged with tail bleed and saphenous vein measurements of hemostasis. Mice depleted with diphtheria toxin were also able to undergo adoptive transfer of platelets. If the frequency and amount of diphtheria toxin is reduced, mice can be maintained at >40% depletion for >28 days, showing that this model is tunable. Conclusions When compared to the gold standard of antibody-mediated depletion, PF4-DTR mice showed similar phenotypes and should be considered an important tool for examining the impact of thrombocytopenia over longer periods of time.
Needle Point Cloud

Needle Point Cloud is a series of framed, computationally embroidered architectural drawings that explore the aesthetics of computerized needlepoint and its power in the production of architectural...
Design and Experimental Evaluation of an Active Underwater Inflatable Co-prime Sonar Array (UICSA)

We consider underwater target detection by using a novel active, self-contained and rapidly deployable underwater inflatable co-prime sonar array (UICSA). In particular, we measure the received signal strength (RSS) and angle-of-arrival (AoA) of acoustic signals reflected by an underwater target. Measurements from different positions of the transmitter with respect to the UICSA are organized in a three mode real-valued tensor. Then, the conformity of each entry with respect to all other data points in the tensor is calculated based on recursively refined calculations of $L_{1}$ -norm tensor subspaces. Conformity values are then used for the detection of an underwater target. We evaluate the data conformity of RSS and AoA recordings acquired from the testbed deployment of a seven-element UICSA prototype and three underwater acoustic transmitters at Florida Atlantic University. We show for the first time that conformity evaluation over multi-modal data measurements can accurately detect the presence of an underwater target.
Clinical factors associated with outcome in metastatic renal cell carcinoma patients treated with VEGF-targeted therapy

5046 Background: Therapy targeted against the vascular endothelial growth factor (VEGF) pathway is a standard of care in metastatic renal cell carcinoma (RCC). Identification of clinical features o...
Medical and nutritional management of cholestasis in infants and children

Introduction When first encountering an infant or child with cholestatic liver disease, it is essential that diagnostic evaluation be conducted promptly in order to (1) recognize disorders amenable either to specific medical therapy (e.g. galactosemia, tyrosinemia, hypothyroidism, urinary tract infection) or to early surgical intervention (e.g. biliary atresia, choledochal cyst); (2) institute treatment directed toward enhancing bile flow; and (3) prevent and treat the varied medical, nutritional, and emotional consequences of chronic liver disease. Because many of the treatable causes require early diagnosis and prompt institution of therapy, the evaluation of the cholestatic infant should never be delayed. Although “physiologic cholestasis” (hypercholemia or elevated bile acids) may be present in the infant, there is no state of “physiologic conjugated hyperbilirubinemia”. For the jaundiced infant, historical and clinical information such as color of the stools, birth weight, and presence of hepatomegaly may provide important clues as to the etiology of cholestasis. Consanguinity or liver disease in siblings suggests the possibility of metabolic, familial, or genetic disease. Review of the prenatal and postnatal course may reveal intrauterine infection, occurrence of hypoglycemia or seizures, and exposure to toxins/drugs (i.e. total parenteral nutrition (TPN)). Careful physical examination may reveal features of typical disorders or syndromes. For the older child and adolescent, a history of exposure to drugs/toxins (e.g. acetaminophen), the presence of vascular insufficiency, and the presence of underlying disease (e.g. inflammatory bowel disease) provide helpful clues. The diagnostic evaluation of the infant with cholestasis is detailed in Chapter 8.
Pathologic findings in fallopian tubes of women with chronic pelvic pain after Essure placement.

Abstract Background: Pelvic pain has been associated with Essure, a permanent contraceptive implant. Here we describe histopathologic findings in long-term Essure users with chronic pelvic pain. Methods: We descriptively evaluated and compared histopathologic features of hysterectomy specimens removed for a primary diagnosis of chronic pelvic pain from women with (n = 3) and without (n = 3) prior placement of Essure coils (mean of 8.6 years prior). Results: Interstitial fallopian tubes of Essure patients demonstrated fibrosis. Two cases had flattening of ampullary epithelial folds. Tubes of Essure users showed no acute inflammation, but 2/3 showed focal chronic inflammation. All patients had additional findings, such as endometriosis, adenomyosis or leiomyomas, that could be associated with pain. Conclusions: Given the minimal and bland inflammation in Essure cases, symptoms may more plausibly be ascribed to confounding gynecologic conditions or other mechanisms.