cssi/SciSciGPT-SciSciNet huggingface dataset:
The Choice of Migration Destination: A Longitudinal Approach using Pre-Migration Outcomes

I use longitudinal data to examine the relationship between individual and household outcomes prior to emigration and choice of migration destination. In addition, I have separately pooled data on Nicaraguans in the destination countries. These two types of data together provide a rich description of the determinants of choice of destination for Nicaraguan emigrants. For emigration to both the United States and Costa Rica, patterns of emigration are consistent with individual wage gains. The main finding, though, is that emigrants to Costa Rica have characteristics similar to non-emigrants and that emigration to Costa Rica is based relatively more on the current economic condition of the sender household. In contrast, emigration to the United States is based on the accumulated pre-emigration labor market success of emigrants' households in Nicaragua. These findings suggest that household pre-migration factors may be more important than individual factors as determinants of the location decision.
Myocardial dyssynchrony and resynchronization.

Heart failure is a common cardiovascular condition with more than 500,000 new cases each year and requiring close to 1 billion dollars in health care expenses [1]. During the last decade or so, several publications have noted the prevalence and unfavorable effects of conduction abnormalities in heart failure [2–5]. Conduction delay, most often in the lateral wall, results in early activation and contraction of the septum at a time when the lateral wall is quiescent, and thus in early systole stretches. Subsequent late activation and contraction of the lateral wall occur as the septum is initiating deactivation, resulting in septal bulging. This ventricular dyssynchrony and its associated mechanical abnormalities result in inefficient global contraction and reduced stroke volume [6–8]. Stress is highest in lateactivated myocardial regions because of exaggerated prestretch in early systole (secondary to septal contraction) and late systolic contraction against increased afterload [9]. These mechanical perturbations appear to be associated with significant regional molecular changes. Spragg and colleagues [10] demonstrate the regional expression disparities of key proteins involved with stress response (mitogen-activated kinase), calcium handling (eg, phospholamban), and electrophysiology (connexin 43). Dyssynchrony
Self-Esteem and Identities

While most research examines self-esteem in terms of self-worth, we suggest three dimensions of self-esteem: worth-based, efficacy-based, and authenticity-based esteem. Each of these dimensions is linked to one of the three motives of the self, and each of them primarily emerges through verification of social/group, role, and person identities, respectively. Data are examined to study these three self-esteem dimensions, including measuring the esteem dimensions and assessing their psychometric properties, investigating the effects of identity verification on the different esteem dimensions, and analyzing the causal relationship among the esteem dimensions. Overall, the results support the measurement and validity of these three dimensions as well as the role of identity verification in producing these self-esteem outcomes.
Detection of a Novel Intraneuronal Pool of Insoluble Amyloid β Protein that Accumulates with Time in Culture

The amyloid-β peptide (Aβ) is produced at several sites within cultured human NT2N neurons with Aβ1-42 specifically generated in the endoplasmic reticulum/intermediate compartment. Since Aβ is found as insoluble deposits in senile plaques of the AD brain, and the Aβ peptide can polymerize into insoluble fibrils in vitro, we examined the possibility that Aβ1-40, and particularly the more highly amyloidogenic Aβ1-42, accumulate in an insoluble pool within NT2N neurons. Remarkably, we found that formic acid extraction of the NT2N cells solubilized a pool of previously undetectable Aβ that accounted for over half of the total intracellular Aβ. Aβ1-42 was more abundant than Aβ1-40 in this pool, and most of the insoluble Aβ1-42 was generated in the endoplasmic reticulum/intermediate compartment pathway. High levels of insoluble Aβ were also detected in several nonneuronal cell lines engineered to overexpress the amyloid-β precursor protein. This insoluble intracellular pool of Aβ was exceptionally stable, and accumulated in NT2N neurons in a time-dependent manner, increasing 12-fold over a 7-wk period in culture. These novel findings suggest that Aβ amyloidogenesis may be initiated within living neurons rather than in the extracellular space. Thus, the data presented here require a reexamination of the prevailing view about the pathogenesis of Aβ deposition in the AD brain.
La lógica de Aristóteles en el Departamento de Filosofía de la Universidad de Búfalo

Abstract We begin with an introductory overview of contributions made by more than twenty scholars associated with the Philosophy Department at the University of Buffalo during the last half-century to our understanding and evaluation of Aristotle’s logic. More well-known developments are merely mentioned in order to make room to focus on issues at the center of attention from the beginning: existential import and, more generally, the analysis of categorical propositions. I include a list of the UB scholars, a list of collaborators and supporters from fellow institutions, a bibliography of relevant publications by UB scholars, and a bibliog-raphy of important related works. Keywords: underlying logic, many-sorted logic, range indicator, sortal variable, quantifier-noun-variable, Buffalo-Cambridge interpretation. Resumen Este articulo inicia con una vision introductoria de las contribuciones realizadas durante la segunda mitad del siglo pasado a nuestra comprension y evaluacion de la logica de Aristoteles por mas de veinte academicos asociados al Departamento de Filosofia de la Universidad de Bufalo. Los desarrollos mas conocidos se men-cionan con el objetivo de abrir espacio a temas que desde el principio llamaron nuestra atencion: el importe existencial y, de modo mas general, el analisis de las proposiciones categoricas. Incluyo una lista de los profesores de la UB, una lis-ta de colaboradores y apoyos de instituciones hermanas, una bibliografia de las publicaciones relevantes de los profesores de la UB, y una bibliografia de trabajos relacionados importantes.
Investigation of wave-action on sea-walls by the use of models

Battering seas, high tides, and storm-driven, on-shore winds always cause heavy damage along the seacoast and particularly at many beach communities. The destruction of property is heavy, houses are isolated by the high water, and the need of adequate beach-protection is again vividly brought to the attention of the public. Along the New Jersey shore where the sandy beaches are used as playgrounds by so many people, it is usually the policy to extend the beach ocaanward by constructing jetties to hold the sand. This affords protection to the beach properties, since the wave-energy is dissipated on the sand before any serious damage occurs.
Analysis of Performance Evaluation of Parallel Katsevich Algorithm for 3-D CT Image Reconstruction

The first theoretically exact spiral cone-beam CT reconstruction algorithm developed was by Katsevich [1- 2]. Recently, Yu et al. [3-4] implemented the algorithm numerically. Although the method is very promising, the computation is very intensive. It requires huge amount of computer time. Recently, people [5-6] began to parallelize the algorithm for achieving high performance computation. This paper presents an analysis of data decomposition and data communication in the parallel Katsevich algorithm [5] and develops an analysis expression to evaluate the performance of the algorithm parallelism. The results based on the analytical model and numerical benchmarks compared in a fare agreement. The analytical model provides a great tool to evaluate high performance computing benchmarks in the parallel Katsevich algorithms.
Evaluation of a new endoscopic ultrasound‐guided multi‐fiducial delivery system: A prospective non‐survival study in a live porcine model

Background Endoscopic ultrasound (EUS) is an excellent tool for implanting fiducials for gastrointestinal malignancies, but a dedicated delivery system for EUS-guided fiducial placement is not available. The aim of the present study was to evaluate the performance characteristics of a new dedicated EUS-guided multi-fiducial delivery system. Methods This was a prospective live porcine study using prototype 22-G EUS needles preloaded with four fiducials. Primary outcomes were technical success and accuracy of fiducial placement. Secondary outcomes were ease of passage of delivery system, ease of deployment, EUS visualization of the needle, visual appearance of fiducials on EUS, fluoroscopy and computed tomography (CT) scans, time taken for fiducial placement and adverse events. Outcomes were scored on a predetermined 5-point Likert scale (1 = best, 5 = worst). Results Fiducial deployment was successful in 43 out of 45 needles (95.6%). All 172 fiducials (43 needles, four fiducials each)were successfully deployed on target. Fiducial placement accuracy score was 1.30 ± 0.64. All needles passed with ease (score 1.0 ± 0.0). Ease of fiducial deployment score was 1.85 ± 1.02. Mean scores for EUS visualization of the needle and fiducial were 1.02 ± 0.15 and 2.10 ± 0.91, respectively. Fluoroscopic and CT visualization of fiducials was excellent. Time for placement of four fiducials was <1 min (0.86 ± 0.50 min). No adverse events were seen. Conclusion The new EUS-guided multi-fiducial delivery system provided quick, easy, and accurate fiducial deployment without adverse events.
Service use and health status of persons with severe mental illness in full-risk and no-risk medicaid programs

OBJECTIVE: The service use patterns and health status outcomes of Medicaid recipients with severe mental illness in a system that assigned full financial risk to managed care organizations through capitation and a system that paid for mental health care on a no-risk fee-for-service basis were compared. METHODS: With use of a quasi-experimental design, initial interviews (time 1) and follow-up interviews six months later (time 2) were conducted among 92 clients in the full-risk group and 112 clients in the no-risk group. Regression models were used to compare self-reported service use and health status between the two groups. RESULTS: Service use patterns differed between the two groups. When symptom severity at time 1 was controlled for, clients in the full-risk group were more likely to have received case management but less likely to report contact with a psychiatrist or to have received counseling than clients in the no-risk group. When health status at time 1 was controlled for, clients in the full-ri...
NESTING AND DIET OF LONG-EARED OWLS IN CONIFER FORESTS, OREGON

Long-eared Owls (Asio otus) nested in extensive stands of grand fir (Abies grandis) in northeastern Oregon. Nineteen of 20 nests were in dwarf-mistletoe brooms (Arceuthobium spp.) in Douglas-fir (Pseudotsuga menziesii) trees. Young were raised at 70% of the nests, and brood size averaged 3.0. The northern pocket gopher (Thomomys talpoides) was the primary prey item both in frequency (56%) and biomass (74%). These observations differ from those reported previously for the Long-eared Owl in North America.
Ability of microvolt T-wave alternans to modify risk assessment of ventricular tachyarrhythmic events: a meta-analysis.

Background Prior studies have indicated that the magnitude of risk association of microvolt T-wave alternans (MTWA) testing appears to vary with the population studied. We performed a meta-analysis to determine the ability of MTWA to modify risk assessment of ventricular tachyarrhythmic events (VTEs) and sudden cardiac death (SCD) across a series of patient risk profiles using likelihood ratio (LR) testing, a measure of test performance independent of disease prevalence. Methods We identified original research articles published from January 1990 to January 2011 that investigate spectrally derived MTWA. Ventricular tachyarrhythmic event was defined as the total and arrhythmic mortality and nonfatal sustained or implantable cardioverter-defibrillator–treated ventricular tachyarrhythmias. Summary estimates were created for positive and nonnegative MTWA results using a random-effects model and were expressed as positive (LR+) and negative (LR−) LRs. Results Of 1,534 articles, 20 prospective cohort studies met our inclusion criteria, consisting of 5,945 subjects predominantly with prior myocardial infarction or left ventricular dysfunction. Although there was a modest association between positive MTWA and VTE (relative risk 2.45, 1.58-3.79) and nonnegative MTWA and VTE (3.68, 2.23-6.07), test performance was poor (positive MTWA: LR+ 1.78, LR− 0.43; nonnegative MTWA: LR+ 1.38, LR− 0.56). Subgroup analyses of subjects classified as prior VTE, post–myocardial infarction, SCD-HeFT type, and MADIT-II type had a similar poor test performance. A negative MTWA result would decrease the annualized risk of VTE from 8.85% to 6.37% in MADIT-II–type patients and from 5.91% to 2.60% in SCD-HeFT–type patients. Conclusions Despite a modest association, results of spectrally derived MTWA testing do not sufficiently modify the risk of VTE to change clinical decisions.
Density and diversity of lianas along a chronosequence in a central Panamanian lowland forest.

The abundance and diversity of lianas were examined along a tropical forest chronosequence at the Barro Colorado Nature Monument, Panama. Lianas M 0.5 cm diameter were sampled along transects in two replicated stands in second- ary (20, 40, 70 and 100 y after abandonment) and old-growth (>500 y) forests. Ordination of stands based on relative abundance, but not presence-absence, showed a significant separation of stands by age. Lianas were significantly more abundant and diverse (Fisher's α) in younger forests (20 and 40 y) than in older forests (70 and 100 y, and old-growth). The decline in liana abundance with stand age was offset by increased mean basal area per individual, resulting in a relatively constant total basal area and estimated biomass across stand age. The proportions of tendril climbers decreased and stem twiners increased over stand age. Decline in liana abundance and changes in liana composition may be related to changes in support and light availability. Although lianas are recognized as playing an important role in the early secondary succession of many tropical forests, these results have shown that their important contribution to total basal area and biomass can continue as the forest matures, even as the number of established lianas declines.
ESTIMATING COOKING TIMES AND MEAT YIELDS FROM ROASTED TURKEYS

A total of 160 turkeys equally divided among weights ranging from 3.5-11.0 kg were cooked with or without stuffing in covered Pans or under aluminum foil caps. End-point temperatures were determined in the breast, thigh, body cavity, and just under the skin. Cooking in a 163°C oven was continued until thigh temperature was 82°C. Meat, bone, and skin weights were determined on cooked birds. Either thigh or the breast can be used to determine end-point temperatures. In terms of servings of white meat, no particular advantage was found for any of the sizes studied. Recommended cooking times (min/kilo) for turkeys are:
Effect of excess phenylalanine and of other amino acids on brain development in the infant rat.

Extract: The effects of excess phenylalanine and of a number of other amino acids on brain weight, total brain lipid, and formation of the myelin lipid cerebroside sulfate (sulfatide) have been studied in the newborn rat. Brain weight, amount of brain lipids, and the formation in vivo of sulfatide were reduced as a result of injections of phenylalanine or of certain other amino acids. Total brain cholisterol, cerebroside, and sulfatide were all significantly reduced in phenylalanine-injected animals, although sulfatide was the only lipid that was reduced per gram wet weight of brain. The in vitro activity of the brain enzyme, galactolipid sulfotransferase, which catalyzes the formation of sulfatide from cerebroside and adenosine 3′-phosphate 5′-phosphosulfate (PAPS), was significantly reduced only when exogenous PAPS was not added to the assay medium. This finding suggests that in the brains of animals injected with phenylalanine there was impairement in the formation of PAPS from ATP and sulfate. In both cerebrums and cerebellums of animals injected with phenylalanine for the first 18 days of life, the amount of brain DNA and protein was reduced. Speculation: Increased ambient tissue levels of a number of amino acids, including phenylalanine, may interfere with normal development of the infant rat brain.
Simulating Inbred-Maize Yields with CERES-IM

CERES-Maize, which was designed for simulation of hybrid maize (Zea mays L.), cannot be applied directly to seed-producing inbred maize because of specific field operations and physiological traits of inbred maize plants. We developed CERES-IM, a modified version of CERES-Maize 3.0 that accommodates these inbred-specific operations and traits, using a set of phenological measurements conducted in Nebraska (NE), and further tested this model with a set of field data from Michigan (MI). Detasseling (i.e., removal of the tassels from the female plants) was conducted prior to silking. Male rows were removed approximately 10 d following 75% silking. The thermal time from emergence to the end of the juvenile phase (P1) and the potential number of kernels per plant (G2) were assessed from field data, and were the only two coefficients allowed to vary according to the inbred line. Rate of leaf appearance of the inbreds was accurately simulated using a measured phyllochron interval of 54 degree-days (°Cd). Simulation of detasseling and male-row removal improved grain yield simulation for inbreds. For a set of 35 inbred-site-year simulations, the model simulated grain yield with satisfactory accuracy (RMSE = 429 kg ha -1 ). Average grain yields were 4556 and 4721 kg ha -1 for the measured and simulated values, respectively. CERES-IM simulations suggest that the effect of male-row removal on grain yield is extremely sensitive to the precise date at which this operation is conducted. This would explain the inconsistent effect of male-row removal on female grain yields reported in the literature.
BEC-BCS Crossover of a Trapped Two-Component Fermi Gas with Unequal Masses

Department of Physics and Astronomy, Washington State University, Pullman, Washington 99164-2814(Dated: February 1, 2008)We determine the energetically lowest lying states in the BEC-BCS crossover regime of s-waveinteracting two-component Fermi gases under harmonic conﬁnement by solving the many-bodySchr¨odinger equation using two distinct approaches. Essentially exact basis set expansion techniquesare applied to determine the energy spectrum of systems with N= 4 fermions. Fixed-node diﬀusionMonte Carlo methods are applied to systems with up to N = 20 fermions, and a discussion ofdiﬀerent guiding functions used in the Monte Carlo approach to impose the proper symmetry of thefermionic system is presented. The energies are calculated as a function of the s-wave scatteringlength a
Impact of age on treatment and outcomes in ST-elevation myocardial infarction

Objectives We hypothesized that older patients in a regional ST-elevation myocardial infarction (STEMI) transfer program would attain comparable treatment to younger patients. Background Older patients have been either excluded or underrepresented in STEMI clinical trials. Observational studies suggest that these patients are less likely to receive adjunctive pharmacologies and reperfusion therapy—thrombolysis or percutaneous coronary intervention (PCI)—and therapy is frequently delayed. Methods We identified a consecutive series of 2,262 STEMI patients (March 2003–December 2008) who either presented or were transferred to Abbott Northwestern Hospital for PCI ( Results Overall time-to-reperfusion therapy was similar across age strata—94 minutes ( P Conclusions Older patients receive similar care to younger patients when treated in a regional STEMI transfer program. Although all-cause mortality in the elderly is increased, the absolute rates are lower than previously established. Our data suggest primary PCI (including transfer) can be applied to all appropriate STEMI patients, regardless of age.
Deep intraplate seismicity in the western Sierra Nevada, central California

abstract A microearthquake monitoring program was conducted from 1976 to 1979 in the eastern San Joaquin Valley and Sierran foothills of central California. This program revealed one of the deepest occurrences of intraplate earthquakes observed in the conterminous United States. Earthquakes in the M L range of approximately 0 to 3.2 were confined to the lower crust of the Sierran block at depths from 12 to 38 km. The distribution of epicenters was diffuse and widespread with some clustering in space and time. Two particulary active areas that were consistent with the historical seismicity record were recognized: an area 15 km south of the town of Madera and an area 15 km south of Mariposa. No association of the seismicity with faults or other geologic structures expressed at the surface was apparent. Based on regional seismic monitoring by the U.S. Geological Survey and the detailed monitoring performed in this study, this occurrence of deep seismicity does not appear to extend farther north along the foothills than Jamestown, although two deep events have been observed near Oroville. The southern limit is not as well defined due to the lack of seismographic coverage. Focal mechanisms of these deep crustal earthquakes exhibited: (1) strike-slip faulting combined with some reverse and normal components; and (2) a regional tectonic stress field characterized by a maximum compressive stress generally trending north-south and a minimum compressive stress trending east-west. These observations support the view that (1) the Sierra Nevada represents a transition between a region of primarily shear deformation along the San Andreas fault zone and extensional tectonics of the Basin and Range province; and (2) the orientation of the tectonic stress field is generally uniform throughout the crust of the Sierran block.
Tunnel Vision or Ecological View

The need for a more holistic view of man and his environment in planning man-made alterations in natural eco-systems is cited. Some of the factors that prevent environmental decision-makers from moving toward a more ecological view are analyzed. These include: differences in environmental perception; the position of the decision-maker in the social, political, and economic structure of his community; social values emphasizing progress, economic growth, and the idea of unlimited good. Results of a recent survey indicate that environmentalists are challenging conventional assumptions about such matters as the profit motive, private property rights, the desirability of economic growth, and the capacity of existing economic and political institutions to solve environmental problems. Some of the factors affecting the development of the conservation-ecology movement are analyzed. These include: segmented organizational structure, personal commitment, the effect of opposition, and some of the ideological themes being generated within the movement.
Living at the Edge Disability, Gender, and Neoliberal Debtscapes of Microfinance in India

Based on the philosophy of Yunus—founder of the Grameen Bank model and Nobel Prize laureate—microfinance has been globally upheld as a neoliberal panacea for addressing poverty and income disparities. Despite these advances, microfinance—as a key policy tool for increasing well-being, social mobility, and capital markets in the underserved communities of the Global South—has not yet been evaluated for its effects in empowering women with disabilities. I draw from disability studies, feminist studies, and social work to examine the ethnographic phenomenon of disabled women who, despite dire poverty, take the unexpected strategic step of collectively refusing to accept microfinance loans. I argue that the individualizing, market-oriented logic of microfinance comports standards of compulsory able-bodiedness that are contradicted by disability as a reality that is experienced through relational kinship ties in rural India. This suggests that approaches to social work in microfinance and disability should att...
Clinical Implications of Serum Albumin Levels in Acute Heart Failure: Insights From DOSE-AHF and ROSE-AHF

Abstract Background Hypoalbuminemia is common in patients with chronic heart failure and, as a marker of disease severity, is associated with an adverse prognosis. Whether hypoalbuminemia contributes to (or is associated with) worse outcomes in acute heart failure (AHF) is unclear. We sought to determine the implications of low serum albumin in patients receiving decongestive therapies for AHF. Methods and Results Baseline serum albumin levels were measured in 456 AHF subjects randomized in the DOSE-AHF and ROSE-AHF trials. We assessed the relationship between admission albumin levels (both as a continuous variable and stratified by median albumin [≥3.5 g/dL]) and worsening renal function (WRF), worsening heart failure (WHF), and clinical decongestion by 72 hours; 7-day cardiorenal biomarkers; and post-discharge outcomes. The mean baseline albumin level was 3.5 ± 0.5 g/dL. Albumin was not associated with WRF, WHF, or clinical decongestion by 72 hours. Furthermore, there was no association between continuous albumin levels and symptom change according to visual analog scale or weight change by 72 hours. Albumin was not associated with 60-day mortality, rehospitalization, or unscheduled emergency room visits. Conclusions Baseline serum albumin levels were not associated with short-term clinical outcomes for AHF patients undergoing decongestive therapies. These data suggest that serum albumin may not be a helpful tool to guide decongestion strategies.
Donald Robertson, Mexican Manuscript Painting of the Early Colonial Period: The Metropolitan Schools

(1960). Donald Robertson, Mexican Manuscript Painting of the Early Colonial Period: The Metropolitan Schools. Art Journal: Vol. 20, No. 1, pp. 60-60.
Crystal and Molecular structure ofcyclo-pentamethylene-tert-butylarsanehydroxybromide, C9H20AsBrO

[cyclo-(CH) 5 As-(Bu t ) (OH)] cristallise dans P2 1 2 1 2 1 avec a=6,835, b=11,317 et c=15,641 A, z=4; affinement jusqu'a R=0,059. Le cycle AsC 5 existe en conformation chaise avec les groupes hydroxyde et t-butyl en positions equatoriale et axiale respectivement
A New Intravenous Galactose Clearance Test for Differentiation of Obstructive from Parenchymatous Jaundice.

ConclusionThe intravenous galactose tolerance test offers valuable assistance in the differentiation of the parenchymatous or “medical” type from the obstructive or “surgical” type of jaundice.
Temporary Endovascular Bypass: Rescue Technique During Mechanical Thrombolysis

BACKGROUND: The goal of mechanical thrombolysis is to re-establish blood flow to a completely occluded artery in patients who fail intravenous thrombolytic therapy or who are outside the therapeutic window. OBJECTIVE: We present our single-institution experience with the use of temporary, partial deployment of a self-expanding intracranial stent as a rescue technique for the treatment of acute stroke. The use of the Enterprise stent represents an off-label use of a humanitarian device exemption device. METHODS: We performed a retrospective review of a prospective database of acute stroke patients treated with intra-arterial techniques at the Thomas Jefferson University Comprehensive Stroke Center from July 2009 to July 2010. RESULTS: Seven patients were included, and we obtained a 100% recanalization rate to Thrombolysis in Myocardial Infarction grade 2 and 3 with a 28% asymptomatic hemorrhagic transformation. No device-related complications were encountered. CONCLUSION: Temporary, partial deployment of a self-expanding intracranial stent as a rescue procedure is feasible, effective, and safe in the setting of endovascular intervention for acute stroke, although our experience is limited. This technique was used only as a rescue procedure when more established procedures failed.
Research on Portable General Calibrator Applied in Instrument Transformer

With the rapid development and application of instrument transformer,various instrument transformer calibrators have been widely utilized,but there are still some shortages for those calibrators.Therefore,the study of portable transformer calibrator is urgently required.In this paper,the development of instrument transformer and the performance analysis of different transformer calibrators are presented firstly,and then the concept of portable general transformer calibrator is put forward.After that,the system diagram of calibrator is illustrated,and some key questions are discussed during the design course.At last,the paper presents the research results,and simultaneously discusses the problems and the future direction.
State of Adult Trainee Inflammatory Bowel Disease Education in the United States: A National Survey.

BACKGROUND The fundamentals of inflammatory bowel disease (IBD) education begin during gastroenterology fellowship training. We performed a survey of gastroenterology fellowship program directors (PDs) and trainees with the aim to further examine the current state of IBD training in the United States. METHODS A 15-question PD survey and 19-question trainee survey was performed using an online platform. RESULTS Surveys were completed by 43/161 (27%) PDs and 160 trainees. All trainee years were equally represented. A significant proportion of trainees was unsure or believed that their inpatient (32%) or outpatient (43%) training was inadequate. Only 28% of trainees were satisfied with their current level of IBD exposure during training. Fewer than half the trainees reported comfort in the management of pouch or stoma issues, pregnant patients with IBD, or postoperative management. The proportion of PDs viewing a competency as essential for trainee education strongly correlated with trainee comfort in that area (Pearson's rho = 0.793; P < 0.01). In multivariate logistic regression, monthly IBD didactics was the only variable independently associated with satisfaction with the current level of training (odds ratio, 4.1 95% CI, 1.9-9.0). CONCLUSIONS Over one-third of participating gastroenterology trainees did not feel "confident" or "mostly comfortable" with their level of IBD training, with varying comfort regarding different competencies in IBD management. These findings suggest that specific areas of IBD training may require additional focus during training and can provide the basis for the development of an IBD core competency curriculum.
The Costs of Animal Experiments

Despite our tremendous prevention power, the fact remains that drugs are important tools in the arsenal of modern medical science. To produce new drugs, we need research. This involves applied research, that is, research directly intended to produce a new treatment. Basic, or more exploratory, research is also utilized to help direct applied research. To approve a drug for the market, regulatory requirements usually dictate at least two major stages of safety and efficacy testing. The preclinical stage includes the use of in vitro and/or animal experiments to assess whether a drug is a viable candidate for further clinical investigation based on safety and efficacy evaluations. The clinical stage is broken down into three phases. Phase 1 typically involves a small group of healthy human volunteers to test the safety of a compound. Phases 2 and 3 usually include larger groups of volunteers in controlled clinical trials to test for both safety and efficacy of the potential treatment against the targeted disease or condition. Post-marketing studies are also often required to monitor the safety of a product once in use.
Writing in Earthquake Country

In Woody Allen’s “Sleeper,” our hero, having awakened from a cryogenic sleep many years in the future, comes through a bizarre series of circumstances to try to cook with the utensils of a futuristic kitchen. Needless to say, Allen doesn’t quite have the knack for making futuristic pudding: the pudding swells enormously, surging up out of its huge bowl, overflowing, threatening to roll over him, to fill the entire kitchen, perhaps the house. Allen, daunted but brave, snatches up a nearby broom and whaps at the billowing mound, trying to beat it back into its bowl, trying to contain its pulsating, demanding, overwhelming mass.
Whole gut microbiome composition of damselfish and cardinalfish before and after reef settlement

The Pomacentridae (damselfish) and Apogonidae (cardinalfish) are among the most common fish families on coral reefs and in the aquarium trade. Members of both families undergo a pelagic larvae phase prior to settlement on the reef, where adults play key roles in benthic habitat structuring and trophic interactions. Fish-associated microbial communities (microbiomes) significantly influence fish health and ecology, yet little is known of how microbiomes change with life stage. We quantified the taxonomic (16S rRNA gene) composition of whole gut microbiomes from ten species of damselfish and two species of cardinalfish from Lizard Island, Australia, focusing specifically on comparisons between pelagic larvae prior to settlement on the reef versus post-settlement juvenile and adult individuals. On average, microbiome phylogenetic diversity increased from pre- to post-settlement, and was unrelated to the microbial composition in the surrounding water column. However, this trend varied among species, suggesting stochasticity in fish microbiome assembly. Pre-settlement fish were enriched with bacteria of the Endozoicomonaceae, Shewanellaceae, and Fusobacteriaceae, whereas settled fish harbored higher abundances of Vibrionaceae and Pasteurellaceae. Several individual operational taxonomic units, including ones related to Vibrio harveyi, Shewanella sp., and uncultured Endozoicomonas bacteria, were shared between both pre and post-settlement stages and may be of central importance in the intestinal niche across development. Richness of the core microbiome shared among pre-settlement fish was comparable to that of settled individuals, suggesting that changes in diversity with adulthood are due to the acquisition or loss of host-specific microbes. These results identify a key transition in microbiome structure across host life stage, suggesting changes in the functional contribution of microbiomes over development in two ecologically dominant reef fish families.
Etiology and Prognosis of Neonatal Convulsions

Researchers at Istanbul University, Turkey evaluated etiologic and risk factors affecting long-term neurologic outcome in newborns with neonatal seizures.
The TIGRE prototype results for 511 and 900 keV gamma rays

A small prototype of the Tracking and Imaging Gamma-Ray Experiment (TIGRE) has been assembled and tested at 511 keV and 900 keV. TIGRE uses multi-layers of silicon strip detectors both as a gamma ray converter and to track Compton recoil electrons and positron-electron pairs. Our prototype consists of 7 double sided silicon strip detectors 3.2 cm/spl times/3.2 cm/spl times/300 micron with 1 mm pitch in both the x and y directions. The direction and energy of the Compton scattered gamma ray is measured with small CsI(Tl) photodiode detectors so that an unique direction and energy can be found for each tracked event. In the prototype 36 CsI(Tl) crystals of 1 cm/spl times/1 cm/spl times/1.7 cm were used. Non-tracked events, those interacting in only a single silicon plane, can only be determined to within the Compton scatter ring. The silicon strips were calibrated using the 60 keV photons from Am/sup 241/ and the Landau peak obtained from a Sr/sup 90/ beta source. The energy resolution of the silicon was measured to be 8 keV (1/spl sigma/) at 60 keV and 7.8% FWHM for CsI at 900 keV. Total energy resolutions at 511 and 900 keV were measured to be 11% and 8% FWHM. An important requirement of TIGRE will be its ability to separate atmospheric induced upward gamma rays from downward gamma rays within the field of view. For tracked events this is done by defining a Direction of Motion (DOM) parameter far the electron by its energy deposition and multiple scattering in the silicon layers. Measurements at 511 and 900 keV show that the DOM parameter is correctly predicted at 60% and 65% for tracked events which constitute 5.5% and 11% of the data. Monte Carlo simulations show similar results and shows the percentage increasing to 98% at 6 MeV in which nearly all of the events are tracked. >
Efficacy of ultra short sub-30 minute incubation of 5-aminolevulinic acid photodynamic therapy in vitro

BACKGROUND AND OBJECTIVE The estimated incidence of cutaneous squamous cell carcinoma (SCC) is 700,000 cases per year. In the US, SCC incidence is highest among fair skinned adults older than 50 years of age. Thus, as the population ages, the reported number of SCCs will likely increase in the future. Photodynamic therapy (PDT) is an FDA approved therapy for treatment of actinic keratoses (AKs), a precursor to cutaneous SCC lesions. The FDA approved incubation time of the photosensitizing agent 5-aminolevulinic acid (ALA) is 14-18 hours. Recent studies have investigated short ALA incubation times of 1-3 hours with ALA and PDT demonstrating treatment success. Therefore, the question exists whether ALA incubation periods of less than 30 minutes are efficacious. Herein, we evaluate the efficacy of short ALA incubation periods by measuring apoptosis after 10, 15, and 20 minutes of ALA incubation. STUDY DESIGN/MATERIALS AND METHODS AG13145 normal human dermal fibroblasts HDFs were incubated with 10, 15, or 20 minute of ALA at various concentrations (0, 0.05, 0.075, 0.1, 0.25, 0.375, 0.5, 1, and 2 mM). After ALA incubation, samples were treated with 1,000 seconds (16 minutes 40 seconds) of Blu-U fluorescent blue light (417 ± 5 nm) for a fluence of 10 J/cm2 . Immediately following treatment with blue light, samples were collected and stained for apoptosis and necrosis with annexin-V and 7-aminoactinomycin D (7-AAD), and then analyzed by flow cytometry. RESULTS HDFs incubated with ALA for 10 minute at 36 °C followed by 10 J/cm2 of blue light had no statistically significant changes in apoptosis. HDFs incubated with ALA for 15 or 20 minutes at 36 °C followed by 10 J/cm2 of blue light had statistically significant increases in the percentages of cells positive for apoptosis in the 0.5, 1.0, and 2.0 mM ALA doses (P < 0.05). CONCLUSIONS We found that incubation of ALA for at least 15 minutes followed by 10 J/cm2 of blue light resulted in a statistically significant increase in apoptosis. Lasers Surg. Med. 49:592-598, 2017. © 2017 Wiley Periodicals, Inc.
The Perplexities of Age and Power

The elderly population in the United States is growing dramatically and is expected to reach over seventy-two million, or twenty percent of the citizenry, by 2030. But serious legislative and regulatory gaps leave the surging population of older adults with many unmet needs. Many Americans are aware of the Social Security and Medicare funds’ financial woes. This Article emphasizes that these challenges are only the tip of the iceberg. In addition, the elderly face under-funded Older Americans Act programs, unaffordable long-term care, inadequate driving regulations that fail to identify and protect at-risk drivers, and a significant shortage of geriatricians, among other problems. Neglect of the aging population in the legal and policy arenas makes little sense. Public choice theory, which teaches that all political actors act in their own self-interest, would suggest that support for the elderly should be a high priority because all individuals face the prospect of aging and caring for elderly loved ones. Relying in part on this theory, the Article develops new insights as to why seniors fail to use their potential political strength to advocate forcefully for beneficial policy changes and why aging issues do not resonate with policymakers, voters, and the media. The Article argues that it is human nature to avoid contemplating one’s future decline, and thus we choose to ignore the challenges that lie ahead. Elected officials, in turn, respond to voters’ priorities and conclude that focusing on eldercare matters will not win them votes or yield political pay-offs. The media, for their part, prefer sensational stories to those that engage in in-depth exploration of social problems’ causes and solutions. At its core, the Article is a call to action, as highlighted in its recommendations section. Aging and caregiving for elderly loved ones are not special-interest matters but matters that will affect all of us. Preparing for the swelling older population is not only in everyone’s best interest, but is also a regulatory, social, and political necessity.
Higher defibrillation threshold in methamphetamine cardiomyopathy patients with implantable cardioverter-defibrillator

Abstract Introduction Identification of patients with an increased risk of high defibrillation thresholds (DFTs) is important in planning implantable cardioverter-defibrillator (ICD) procedures. Clinical observations have suggested that patients with methamphetamine cardiomyopathy (MACMP) have significantly elevated defibrillation thresholds. We hypothesized that MACMP patients would have higher DFT thresholds than controls and would require procedural changes during ICD implantation to accommodate higher thresholds. Methods We identified consecutive patients with MACMP undergoing ICD implantation at the academic center from 2003 to 2007. We then compared DFTs against age-and sex-matched controls. Results The MACMP (n = 10) group showed significantly increased DFT thresholds (23.7 ± 6.7 J) compared with age and sex-matched controls (14.5 ± 4.6 J, p Conclusions Planning for ICD implantation should take into consideration a history of methamphetamine abuse, mandating DFT testing and empiric consideration of high output devices for such patients.
Fiscal Management and the Role of the LPN (Working in Long-Term Care)

The LPN is required to be fiscally responsible through cost-effective approaches to the provision of care. While the LPN is not required to know finance or financial aspects of health care, knowledge regarding how payment is received and the role of the LPN in ensuring the appropriate payment is able to be billed and received is important. This chapter will provide an overview of how payment is billed and received and the role of the LPN related to fiscal responsibility especially related to documentation.
The incidental thyroid nodule

Incidental thyroid nodules that are found on an imaging study performed for reasons other than thyroid pathology represent a common scenario encountered by health care providers. The initial workup for these nodules comprises a thorough history and physical examination, thyroid function tests, a dedicated thyroid ultrasound, and fine-needle aspiration of any suspicious lesions. Management ranges from observation and reassurance to surgical resection and depends on the cytologic diagnosis. In cases of cytologically indeterminate or discordant nodules, surgical excision (lobectomy) offers a definitive diagnosis, although molecular testing or a reasonable period of observation may be useful as less invasive adjuncts. CA Cancer J Clin 2018;68:97-105. © 2018 American Cancer Society.
Prophylactic Dextrose Gel Does Not Prevent Neonatal Hypoglycemia: A Quasi-Experimental Pilot Study

Objective To test the hypothesis that prophylactic dextrose gel administered to newborn infants at risk for hypoglycemia will increase the initial blood glucose concentration after the first feeding and decrease neonatal intensive care unit (NICU) admissions for treatment of asymptomatic neonatal hypoglycemia compared with feedings alone. Study design This quasi-experimental study allocated asymptomatic at-risk newborn infants (late preterm, birth weight 4000 g, and infants of mothers with diabetes) to receive prophylactic dextrose gel (Insta-Glucose; Valeant Pharmaceuticals North America LLC, Bridgewater, New Jersey); other at-risk infants formed the control group. After the initial feeding, the prophylactic group received dextrose gel (0.5 mL/kg) rubbed into the buccal mucosa. The blood glucose concentration was checked 30 minutes later. Initial glucose concentrations and rate of NICU admissions were compared between the prophylactic group and controls using bivariate analyses. A multivariable linear regression compared first glucose concentrations between groups, adjusting for at-risk categories and age at first glucose concentration. Results There were 236 subjects (72 prophylactic, 164 controls). The first glucose concentration was not different between the prophylactic and control groups in bivariate analysis (52.1 ± 17.1 vs 50.5 ± 15.3 mg/dL, P = .69) and after adjusting for covariates (P = .18). Rates of NICU admission for treatment of transient neonatal hypoglycemia were 9.7% and 14.6%, respectively (P = .40). Conclusions Prophylactic dextrose gel did not reduce transient neonatal hypoglycemia or NICU admissions for hypoglycemia. The carbohydrate concentration of Insta-Glucose (77%) may have caused a hyperinsulinemic response, or alternatively, exogenous enteral dextrose influences glucose homeostasis minimally during the first few hours when counter-regulatory mechanisms are especially active. Trial registration ClinicalTrials.gov : NCT02523222 .
Trauma- and Stressor-Related Disorders in Late Life

Posttraumatic stress disorder (PTSD) is a disabling psychiatric condition of great public health significance, and older adults are not spared. It can develop after a traumatic experience at any point in life. As we can imagine, difficult experiences are the norm. Trauma is ubiquitous and affects the whole person. But some people go through life with such stressful experiences that they have a sustained impact, which can go unrecognized for many decades. Once the usual coping mechanisms fail, a complex cluster of symptoms (persistent pathological avoidance, intrusions, and negative alterations of cognition, emotions, and arousal) or full spectrum psychiatric disorders may develop. Those manifestations are mediated by disturbances in various systems governing cognitive, affective, and physiological responses to stress (e.g., the limbic system, the HPA axis). Traumatic stress triggers a cascade of physiological catastrophes that impact various major systems in the body. Comorbidities and the overlap with other disorders are very frequent. A new onset of PTSD may occur in old age, even when the trauma was remote. PTSD, which consists of changes in circadian rhythms, mood regulation, perception, cognition, and behavior, is no longer considered an anxiety disorder, and since the publication of the DSM-5, it has its own category. This chapter will review the foundational concepts of trauma, its different types (natural versus interpersonal, including adverse childhood experiences), the general manifestations, and specific symptoms in old age. Treatment approaches that are evidence based and trauma informed will also be discussed.