cssi/SciSciGPT-SciSciNet huggingface dataset:
Delay of sexual senescence

The article analyzes and discusses"sexual senescence"from the perspectives of sexual medicine,sexual psychology,sexual sociology,gerontics,genetics and nutriology. The factors causing sexual senescence are firstly dealt with in order to find out the ways of delaying senescence. Then the article suggests delayed senescence can be achieved by correct sexual concept,proper sexual life in senility,healthy life style,careful treatment on menopause,and new"genetic therapy". By doing so, senile couples can prolong their life and enjoy their sexual life.
Average Waiting Time Model for Transfer from Rail Transit to Buses

The modeling of average waiting time for passengers has an important role in several fields of studies,such as the public transport network coordination optimization,the benefit analysis of the public transportation system,and so on.This paper first categorizes passengers transferring from rail transit to buses into two groups,namely,scheduled passengers and random passengers,and conducts the curve-fitting for the arrival time distribution accordingly.It is shown that the lognormal distribution has the best fitting performance for scheduled passengers,and the gamma distribution has the best performance for random passengers.Then,it develops a peak-hour average waiting time model for transferring passengers based on the passenger classification.Finally,it applies the proposed model to the bus line 519 at Longze station of Beijing to examine the accuracy of the model.The examination results demonstrate that the developed model can accurately estimate the peak-hour average waiting time of transferring passengers with a relative error less than 2.05%.
Trajectories of Diabetes Medication Adherence and Hospitalization Risk: A Retrospective Cohort Study in a Large State Medicaid Program

Numerous interventions are available to boost medication adherence, but the targeting of these interventions often relies on crude measures of poor adherence. Group-based trajectory models identify individuals with similar longitudinal prescription filling patterns. Identifying distinct adherence trajectories may be more useful for targeting interventions, although the association between adherence trajectories and clinical outcomes is unknown. To examine the association between adherence trajectories for oral hypoglycemics and subsequent hospitalizations among diabetes patients. Retrospective cohort study. A total of 16,256 Pennsylvania Medicaid enrollees, non-dually eligible for Medicare, initiating oral hypoglycemics between 2007 and 2009. We used group-based trajectory models to identify trajectories of oral hypoglycemics in the 12 months post-treatment initiation, using monthly proportion of days covered (PDC) as the adherence measure. Multivariable Cox proportional hazard models were used to examine the association between trajectories and time to first diabetes-related hospitalization/emergency department (ED) visits in the following year. We used the C-index to compare prediction performance between adherence trajectories and dichotomous cutpoints (annual PDC <80 vs. ≥80 %). The mean annual PDC was 0.58 (SD 0.32). Seven trajectories were identified: perfect adherers (9 % of the cohort), nearly perfect adherers (31.4 %), moderate adherers (21.0 %), low adherers (11.0 %), late discontinuers (6.8 %), early discontinuers (9.7 %), and non-adherers with only one fill (11.1 %). Compared to perfect adherers, trajectories of moderate adherers (HR = 1.48, 95 % CI 1.25, 1.75), low adherers (HR = 1.51, 95 % CI 1.25, 1.83), and non-adherers with only one fill (HR = 1.35, 95 % CI 1.09, 1.67) had greater risk of diabetes-related hospitalizations/ED visits. Predictive accuracy was improved using trajectories compared to dichotomized cutpoints (C-index = 0.714 vs. 0.652). Oral hypoglycemic treatment trajectories were highly variable in this large Medicaid cohort. Low and moderate adherers and those filling only one prescription had a modestly higher risk of hospitalizations/ED visits compared to perfect adherers. Trajectory models may be valuable in identifying specific non-adherence patterns for targeting interventions.
Using Human Induced Pluripotent Stem Cells to Model Skeletal Diseases.

Abstract Musculoskeletal disorders affecting the bones and joints are major health problems among children and adults. Major challenges such as the genetic origins or poor diagnostics of severe skeletal disease hinder our understanding of human skeletal diseases. The recent advent of human induced pluripotent stem cells (human iPS cells) provides an unparalleled opportunity to create human-specific models of human skeletal diseases. iPS cells have the ability to self-renew, allowing us to obtain large amounts of starting material, and have the potential to differentiate into any cell types in the body. In addition, they can carry one or more mutations responsible for the disease of interest or be genetically corrected to create isogenic controls. Our work has focused on modeling rare musculoskeletal disorders including fibrodysplasia ossificans progressive (FOP), a congenital disease of increased heterotopic ossification. In this review, we will discuss our experiences and protocols differentiating human iPS cells toward the osteogenic lineage and their application to model skeletal diseases. A number of critical challenges and exciting new approaches are also discussed, which will allow the skeletal biology field to harness the potential of human iPS cells as a critical model system for understanding diseases of abnormal skeletal formation and bone regeneration.
Bile acid inhibition of the intestinal microflora--a function for simple bile acids?

The predominant groups of intestinal bacteria were tested in vitro for sensitivity to concentrations of bile acids that occur in the intestine. Strains of anaerobic Bacteroides and lactobacilli were easily inhibited by the simple bile acids, cholic and deoxycholic acid, whereas aerobic organisms were less sensitive. Inhibition of streptococci varied with the strain tested but coliforms were not inhibited by simple bile acids. Anaerobic and aerobic organisms alike were rarely inhibited by the conjugated bile acids, taurocholic or glycocholic acid. Growth of common anaerobic intestinal bacteria in vitro is apparently inhibited by simple bile acids but not by conjugated bile acids, a phenomenon in which the possibility that unconjugated bile acids may play a role in controlling bacterial populations within the small and large intestinal lumen is raised.
Brief vagal bursts can induce Wenckebach arrhythmia.

We hypothesized that a brief burst of vagal stimulation applied in each cardiac cycle could elicit an atrioventricular (AV) nodal Wenckebach arrhythmia. Twenty-six dogs were anesthetized with pento...
Pancreas transplant outcomes for United States (US) cases reported to the United Network for Organ Sharing (UNOS) and non-US cases reported to the International Pancreas Transplant Registry (IPTR) as of October, 2000.

As of October 2000, > 15,000 pancreas transplant had been reported to the IPTR, > 11,000 in the US and > 4,000 outside the US. An era analysis of US cases from 1987-2000 showed a progressive improvement in outcome (p 45 years old increased from 5% to 25%, and the improved outcomes encompassed the older patients as well. In patients > 45 years old, SPK pancreas GSRs at one year increased from 62% to 78% (p or = 94% in each recipient category, with one-year pancreas GSRs of 84% for SPK (n = 3,697), 76% for PAK (n = 696), and 71% for PTA (n = 300) (p = 0.0001). The immunological graft failure rates for 1996-2000 US SPK, PAK and PTA cases were 2%, 6%, and 8% at one year (p = 0.001). There was a progressive increase in the use of ED (as opposed to BD) for duct management, to > 50% for 1996-2000 US SPK transplants. Approximately 20% of US SPK ED transplants had venous drainage via the portal system. Pancreas GSRs were not significantly different for 1996-2000 ED (n = 1,940) and BD (n = 1,541) US SPK transplants (83% and 84%, respectively, at one year), nor was there a difference in pancreas GSRs for systemic (n = 1,509) versus portal (n = 411) venous drained ED SPK transplants (83% for both at one year). Kidney GSRs were also not significantly different for ED versus BD US SPK cases, 93% versus 91% at one year (p = 0.13). Duct management did matter for solitary (PAK and PTA) pancreas transplants (P 0.08). In regard to non-US cases, the overwhelming majority were in the SPK category (n = 676 for 1996-2000), with a one-year pancreas GSR of 84%, not significantly different than for US cases. In summary, pancreas transplant graft survival rates were > 70% in the solitary (PAK and PTA) and > 80% in SPK recipients during the last 4 years of the 20th century. These outcomes culminate a third of a century of application for the treatment of diabetes mellitus.
Third World and “Illegal” in the City of Angels

A1979 Pentagon-commissioned report described one of the three basic roles of the U.S. Army in low-intensity conflict (LIC) as being “the federal exercise of police power within the United States.” Such operations, stated the report, could take place “in response to civil disorder and terrorism.” According to sociologist Timothy Dunn, one possible scenario was entitled “A U.S. City in Revolt” and envisioned “an armed uprising based in Los Angeles, led by ‘a combination of poor and minority activist elements,’ to which the White House responds by sending in ‘regular Army units to restore order, disarm dissidents, and close all border traffic.’”1
Improvement of rheological, thermal and functional properties of tapioca starch by using gum arabic ☆

Abstract Gum arabic (GA) is a fairly inexpensive gum and is well known for its stabilizing, emulsifying, and thickening properties. The effects of adding GA (0.1–1.0%) on solubility, pasting, and rheological properties of 5% native tapioca starch (TS) were analyzed. Dynamic viscoelasticity measurements showed that the elastic modulus (G′) and the viscous modulus (G″) increased in the presence of GA, suggesting a strong interaction between GA-TS in the composite system. All concentrations of GA resulted in higher elasticity (G′ > G″). Pasting properties revealed that the peak viscosity and setback of the TS-GA dispersion decreased with increasing concentration of GA, suggesting the importance of GA in controlling overall viscosity. The flow behavior index (n) decreased from 0.99 to 0.23 as the concentration of GA in the dispersion increased, indicating pseudoplastic behavior (n
Model order reduction using sparse coding exemplified for the lid-driven cavity

Basis identification is a critical step in the construction of accurate reduced-order models using Galerkin projection. This is particularly challenging in unsteady flow fields due to the presence of multi-scale phenomena that cannot be ignored and may not be captured using a small set of modes extracted using the ubiquitous proper orthogonal decomposition. This study focuses on this issue by exploring an approach known as sparse coding for the basis identification problem. Compared with proper orthogonal decomposition, which seeks to truncate the basis spanning an observed data set into a small set of dominant modes, sparse coding is used to identify a compact representation that spans all scales of the observed data. As such, the inherently multi-scale bases may improve reduced-order modelling of unsteady flow fields. The approach is examined for a canonical problem of an incompressible flow inside a two-dimensional lid-driven cavity. The results demonstrate that Galerkin reduction of the governing equations using sparse modes yields a significantly improved predictive model of the fluid dynamics.
Acoustic modulation of contrast agents for hepatic flow differentiation

Current methods of liver metastasis diagnosis involve an intravenous (IV) bolus injection of CT contrast agent, with detection in the liver parenchyma using a time differential in enhancement. Recent studies have shown that ultrasound measurements of time to initial enhancement and time to and level of peak enhancements with an IV bolus of contrast agent can be diagnostic. Research presented here demonstrates a technique in which arterial modulation of contrast can be realized with leading and trailing edge characteristics similar to an IA injection, using an externally applied acoustic field and continuous IV infusion. In vivo experiments with New Zealand White rabbits were performed using a perfluorocarbon-based ultrasound contrast agent infused into an ear vein at 10 /spl mu/L/kg/min. An acoustic field applied to the abdominal aorta was used to control the flow of the contrast agent. Spectral Doppler images of the abdominal aorta and hepatic vein and grayscale harmonic images of the aorta and liver parenchyma were collected.
A model of electric breakdown in solids

When a solid dielectric is subjected to a sufficiently high electrical stress, breakdown occurs with an abrupt increase in conductance. The signature of the breakdown includes a rapid transition from nonlocalized to localized conduction at a field of about 106 V/cm, a high breakdown current density, creation of hollow channels through the dielectric, and intense light emission from the damage channels.
Acute coronary syndromes in 2016: Assessing strategies to improve patient management

The leading studies in 2016 on acute coronary syndromes focused on strategies of acute coronary management, from the influence of revascularization timing on outcomes, to selection of second-generation antiplatelet therapy and the utility of monitoring platelet function in patients at high risk of coronary artery disease.
Using spectral acoustic features to identify abnormal heart sounds

Using the Physionet challenge database we aim to determine whether a heart sound recording, a phonocardio-gram (PCG), corresponds to a “normal” or “abnormal” physiological state. Our goal is to augment the information available to a physician during auscultation of a patient's heart, ultimately assisting with clinical decision making. To that end, we first produce spectral features of the PCG, for varying windows and frequency bands. We use the resulting spectral information to identify a variety of features based on means, variance, and activity at different frequency bands. We find that much of the information corresponding to abnormalities is captured in these features, with particular good performance on murmurs. Finally, we build a discriminative model, specifically a random forest regressor, to classify new samples based on the aforementioned features. Our final performance on the challenge data received a combined score of 81%.
Single Photon Emission Computed Tomography (SPECT): Technique

Single-photon emission computed tomography (SPECT) is a widely available and flexible imaging technique that is capable of visualizing and quantifying changes in cerebral blood flow and neurotransmitter systems. SPECT is an important tool in the differential diagnosis of both neurological and psychiatric diseases, and it may have sufficient sensitivity to detect neuronal changes before the onset of clinical symptoms. SPECT imaging can also be performed in a longitudinal manner to assess the efficacy and mode of action of therapeutic interventions such as psychotropic drugs and surgery. This review summarizes recent applications of SPECT imaging with particular reference to the development of new radiopharmaceuticals and the increasing role SPECT plays in the understanding, diagnosis, and management of neuropsychiatric diseases.
Delta Opioid Receptor Expression and Function in Primary Afferent Somatosensory Neurons

The functional diversity of primary afferent neurons of the dorsal root ganglia (DRG) generates a variety of qualitatively and quantitatively distinct somatosensory experiences, from shooting pain to pleasant touch. In recent years, the identification of dozens of genetic markers specifically expressed by subpopulations of DRG neurons has dramatically improved our understanding of this diversity and provided the tools to manipulate their activity and uncover their molecular identity and function. Opioid receptors have long been known to be expressed by discrete populations of DRG neurons, in which they regulate cell excitability and neurotransmitter release. We review recent insights into the identity of the DRG neurons that express the delta opioid receptor (DOR) and the ion channel mechanisms that DOR engages in these cells to regulate sensory input. We highlight recent findings derived from DORGFP reporter mice and from in situ hybridization and RNA sequencing studies in wild-type mice that revealed DOR presence in cutaneous mechanosensory afferents eliciting touch and implicated in tactile allodynia. Mechanistically, we describe how DOR modulates opening of voltage-gated calcium channels (VGCCs) to control glutamatergic neurotransmission between somatosensory neurons and postsynaptic neurons in the spinal cord dorsal horn. We additionally discuss other potential signaling mechanisms, including those involving potassium channels, which DOR may engage to fine tune somatosensation. We conclude by discussing how this knowledge may explain the analgesic properties of DOR agonists against mechanical pain and uncovers an unanticipated specialized function for DOR in cutaneous mechanosensation.
Planning for the Balance of Danger and Delight

As a species, we are drawn to water and to marine edges and we gain many benefits from the blue, including wonder, enjoyment, stress reduction and greater meaning in life. Yet there are corresponding dangers associated with proximity to water, and climate change and sea level rise represent serious physical (and social and economic) design and planning challenges. The vision and practice of blue biophilic cities understands the need to balance the danger and delight: not only to provide new connections to water, but also creatively seek to adapt in ways that will make a city more resilient in the face of these physical forces.
A Structured Instructional System for Developing the School Survival Skills of Adolescents with Behavioral Disorders.

School survival skills are behaviors which enhance the likelihood of academic success. In general, academically successful students have a greater knowledge of school survival skills and actively a...
Fiber and Colon Cancer

The human evidence that dietary fiber prevents the development of colon cancer has been reviewed. The correlational studies are consistent with a protective effect in 61.9 per cent of reports. However, these studies are all retrospective and largely uncontrolled. The case-control studies provide evidence of a protective effect in only 48 per cent of reports. It is of additional concern that some human studies have found an association between tumor enhancement and some fiber-containing foods. Whereas this is not sufficient evidence to implicate dietary fiber as a promoter of human colon cancer, it does perhaps argue for a more conservative approach to recommending high-fiber diets as a means of cancer prevention. The animal data show that different sources of dietary fiber produce markedly different effects on colon carcinogenesis. Although some fibers exhibit protective properties, others clearly promote tumor development. The mechanisms behind these opposing actions require further investigation. However, one thing is clear and that is that dietary fibers do modulate the carcinogenic process and as such provide a valuable tool for probing the mechanisms and stages of colon tumor development. Dietary fiber appears to play a major role in the regulation of normal intestinal function and in the maintenance of a healthy intestinal mucosa. Although there is some evidence that a fiber-deficient diet predisposes to colon carcinogenesis, it is still not known whether an increase in fiber consumption will prevent the development of colon cancer. This is further complicated by not knowing what constitutes a normal level of fiber intake. In the interim, physicians should perhaps advise their patients to consume a moderate diet that contains vegetables, fruits, and whole grains. This will provide a varied source of fiber-containing foods and if consumed in sufficient quantity will optimize intestinal transit and bulk according to individual needs. Isolated fiber supplements have not been shown to be effective in colon cancer prevention. Further attempts to be more specific about what type of fiber to recommend seem premature at this time. However, an intake in the range of 20 to 35 gm per day of dietary fiber from foods has recently been recommended by an Expert Panel.
Development of Full Space System Model Modes from Expansion of Reduced Order Component Modal Information

Model reduction is a technique commonly used to reduce the computation time of structural dynamic models. The results of the reduced model can then be expanded to full space using the transformation matrix developed in the reduction process. This work focuses on expanding the mode shapes of system models that are comprised of reduced component models. Typically, this expansion requires the full space system model to be computed in order to obtain the system model transformation matrix needed to perform the expansion. Computing the full space system model to determine the expansion matrix does not save computation time and therefore defeats the purpose of using model reduction. This paper proposes using the expansion matrices of the individual components to expand the assembled system model modes. In this work, System Equivalent Reduction Expansion Process (SEREP) is used for reduction and expansion. The accuracy of the expanded system model is shown to be dependent on the modes retained in the reduced component models. Recent work on Variability Improvement of Key Inaccurate Node Groups (VIKING) has shown that over specifying the number of modes used in the reduction/expansion process that span the space of the system model modes significantly improves the results. The VIKING technique is the basis for the expansion process developed in this work. Multiple analytical cases are presented to show how the selection of component modes affects the expansion results. The analytical cases demonstrate that accurate system model expansion results can be obtained when a sufficient set of component modes that span the space of the system model modes are used.
Uniform particle beam distributions produced by octupole focusing

The transverse intensity distribution of a beam emerging from a linear accelerator can be described well by a two-dimensional Gaussian function with elliptical contours. A method is presented that utilizes third-order optics to modify this Gaussian beam distribution and to produce at a given location along the beam direction a more uniform beam, which also is confined within a prescribed rectangular area.
Density estimation using ocean-bottom seismometers in Cascadia

The Cascadia Initiative placed a large number of ocean-bottom seismic sensors off the coast of the US Pacific Northwest. These sensors recorded pulsed sounds from fin whales, recorded in conditions that in many cases make it impossible to resolve the sounds from individual whales. The sounds from multiple whales, however, combine to make a distinct rise in spectral energy in the 15–30 Hz band. This received energy can be used to estimate the population density of fin whales in the vicinity of each sensor over the 4-year duration of the project. Difficulties addressed include the variable rate and intensity of fin whale vocalizations, acoustic properties of the seafloor, and differences between seismic and acoustic sensors. [Funding from ONR.]
Resiliency and robustness of complex systems and networks

The burgeoning field of network science has started to examine the fundamentals of multi-genre networks, which include traditional communication networks but also encompass information flow networks, social networks, and potentially other networks as well. The dependencies between these different genres (or types) of networks introduce additional complexities that must be addressed. However, the existence of these different genres can also be a benefit to resilience. In this chapter, Alexander Kott and Tarek Abdelzaher first introduce the notion of complex networks or multi-genre networks, followed by definitions of robustness and resiliencyContents 5.1 Introduction to Complex Networks 68 5.2 Resiliency and Robustness 70 5.3 Fundamental Tradeoffs 72 5.4 Robustness to Topology Modifications 73 5.5 Robustness to Cascaded Resource Failures 75 5.6 Buffering and Resiliency to Function Loss 78 5.7 Resiliency to Input Corruption 80 5.8 Resiliency of Inference 81 References 83in complex networks. The core part of the chapter examines several types of failures and approaches to make complex networks robust and/or resilient to these failures.
Electrospun nanofiber mats from aqueous starch-pullulan dispersions: Optimizing dispersion properties for electrospinning.

Abstract A green method to fabricate starch-based nanofibers is provided. High-temperature (≈162 °C) was used to destructure high-amylose starch in water. Sodium palmitate was added to enhance the stability of high-amylose starch in water at room temperature and increase the conductivity of the electrospinning dope. Flow properties and zeta potential of starch-palmitate dispersions were characterized by rheometer and dynamic light scattering, respectively. Pullulan was mixed in as a minor component of the starch-palmitate complex (starch:pullulan at a ca. 2:1 ratio) and the mixture electrospun. Pullulan hindered starch association and modified the dispersion properties, promoting molecular entanglement without gelation. The presence of sodium palmitate-starch inclusion complexes in the fiber was confirmed by differential scanning calorimetry and X-ray diffraction. Tensile strength of the nanofiber composite was found to be weaker than that of micro-sized pure starch fiber mats. This method provides future industry with lower cost by eliminating the use of organic chemicals.
Airline schedule padding and consumer choice behavior

Abstract Disclosure programs are quality assurance instruments when consumers are imperfectly informed about product quality. This study examines the On-Time Disclosure Rule for airline on-time performance which ranks airlines based on how well their flights arrive/depart on time. The program creates incentives for airlines to pad their flight schedules and artificially improve their reported on-time performance. Using a discrete choice demand model for air travel, we investigate how schedule padding affects consumer preferences. We find that schedule padding is associated with negative consumer welfare effects, reinforcing the notion of an unanticipated gaming behavior by firms that ends up harming consumer welfare.
Magnetically controlled growing rods in early onset scoliosis : Indications, timing and treatment.

Early onset scoliosis (EOS) remains one of the most challenging aspects of pediatric spine deformity care. The management is often complex, and options are non-operative care with casting or bracing and operative interventions. Surgical treatment includes distraction-based, compression-based and growth-guided techniques. The decision making should focus on preservation of growth, control of curve progression, minimizing complications, but most importantly improvement of the quality of life. Distraction-based techniques are the most commonly used growth-friendly surgery and the magnetically controlled growing rods (MCGR) technique is being utilized increasingly more in the USA over the past 10 years. The MCGR technique was cleared by the Food and Drug Administration (FDA) and available in the USA since 2014. It is indicated for the treatment of progressive EOS in immature patients and those at risk for thoracic insufficiency syndrome (TIS) with the goal of reducing the number of planned open surgical procedures for lengthening and minimizing the complications of more conventional techniques, such as traditional growing rods (TGR). The advent of MCGR has been a game changer for patients with EOS where the distractions are non-invasive and can be performed in outpatient clinics. Long-term follow-up is essential in understanding the outcome of any new treatment method especially in a very young and growing child. Multicenter registries with prospective data collection of pediatric spine deformity patients is imperative for understanding the outcomes of different methods of treatment, minimizing the complications and improving the quality of life of these children.
Study of Delta — Log Interaction

It is found that small values of σ in zero range Skyrme interaction -tOδ(r1-r2) + t3δσ(R)δ(r1-r2) lead to smaller values for the compression modulus. It would therefore be of interest to study the limiting case σ → 0; this leads to a delta — log interaction for binding energy, effective two body interaction for single particle energies and the effective particle-hole interaction. This interaction is used to study the isotope shift.
Incentives to Form Research Joint Ventures II: Virtual Diversification

This Chapter takes a different approach to explaining the incentives of firms to cooperate in RD Lewis, 1990). Partner characteristics are of critical importance in determining the extent to which complementary resources can be combined and research synergies can be exploited. As mentioned in various occasions in this book, RJVs are considered exceptionally appropriate for exploiting synergies in research, combining complementary resources, and creating otherwise unattainable “technology options” for their members.
Familial severe psychiatric history in bipolar disorder and correlation with disease severity and treatment response

Abstract Background Bipolar disorder is a heritable disorder, and we aimed to assess the impact of family history of mental disorders in first-degree relatives on the severity and course of bipolar disorder. Methods The Bipolar CHOICE (lithium versus quetiapine) and LiTMUS (optimized treatment with versus without lithium) comparative effectiveness studies were similar trials among bipolar disorder outpatients studying four different randomized treatment arms for 24 weeks. Patients self-reported on six severe mental disorders among first-degree relatives. We performed ANOVA and linear regression regarding disease severity measures, sociodemographic and cardiometabolic markers and mixed effects linear regression to evaluate treatment response. Results Among 757 patients, 644 (85.1%) reported at least one first-degree relative with a severe mental disorder (mean=2.8; standard deviation=2.2; range=0-13). Depression (67.1%), alcohol abuse (51.0%) and bipolar disorder (47.0%) were the most frequently reported disorders. Familial psychiatric history correlated with several disease severity measures (hospitalizations, suicide attempts, and earlier onset) and sociodemographic markers (lower education and household income) but not with cardiometabolic markers (e.g. cholesterol or waist circumference) or cardiovascular risk scores, e.g. the Framingham risk score. Patients with familial psychiatric history tended to require more psychopharmacological treatment (p=0.054) but responded similarly (all p>0.1) to all four treatment arms. Conclusions Our findings indicate that familial psychiatric history is common among outpatients with bipolar disorder and correlates with disease severity and sociodemographic measures. Patients with a greater familial psychiatric load required more intense treatment but achieved similar treatment responses compared to patients without familial psychiatric history.
Increased Health Care Costs and Opioid Use in Patients with Anxiety and Depression Undergoing Rotator Cuff Repair.

Purpose To (1) quantify the prevalence of mood disorders in patients undergoing arthroscopic rotator cuff repair (RCR) by use of a large claims database and (2) compare opioid use and medical costs in the year before and the year after RCR between patients with and without comorbid mood disorders. Methods A large claims database was queried to identify patients who underwent arthroscopic RCR (Current Procedural Terminology code 29827) between October 2010 and December 2015. All patients were then screened for insurance claims relating to either anxiety or depression. We compared net costs and opioid use both 1 year preoperatively and 1 year postoperatively between patients with and without mood disorders by use of an analysis of covariance. Results A total of 170,329 patients (97,427 male patients [57.2%] and 72,902 female patients [42.8%]) undergoing arthroscopic RCR were identified. Of the 170,329 patients, 46,737 (27.4%) had comorbid anxiety or depression, and after adjustment for preoperative cost, sex, age, and both preoperative and postoperative opioid use, the 1-year postoperative cost was 7.05% higher for those with a preoperative mood disorder than for those without a mood disorder. In addition, opioid use both in the 180 days prior to surgery (36.7% vs 26.9%) and more than 90 days after surgery (33.0% vs 27.2%) was substantially greater in the group with comorbid depression or anxiety. Conclusions In patients with comorbid mood disorders, opioid use and health care costs were increased both preoperatively and postoperatively. The increased cost in this patient population is estimated at $62.3 million annually. In an effort to provide high-quality, value-based care, treatment strategies should be developed to identify these patients preoperatively and provide the appropriate resources needed to improve the probability of a successful surgical outcome. Level of Evidence Level III, retrospective, comparative therapeutic study.
Black Box Warning: Cardiovascular Complications Make Motherhood Unsafe for African American Women

Background In the United States, cardiovascular disease and its complications in pregnancy is the leading killer in mothers. The black maternal mortality rate is quadruple the rate among white women. Main body The reasons for this staggering discrepancy hinge on two central issues: First, black women are more likely to have pre-existing cardiovascular morbidity that increase the risk of maternal mortality. Second, black women are more likely to experience adverse pregnancy outcomes including small for gestational age, gestational diabetes and preeclampsia. These perinatal complications put them at risk for developing long-term cardiovascular disease. Conclusions This article is a call to action to recognize that adverse pregnancy outcomes represent an opportunity to intervene in order to change the long-term cardiovascular health of black women.
Impact of Clinical Decision Support on Antibiotic Prescribing for Acute Respiratory Infections: a Cluster Randomized Implementation Trial

Clinical decision support (CDS) is a promising tool for reducing antibiotic prescribing for acute respiratory infections (ARIs). To assess the impact of previously effective CDS on antibiotic-prescribing rates for ARIs when adapted and implemented in diverse primary care settings. Cluster randomized clinical trial (RCT) implementing a CDS tool designed to guide evidence-based evaluation and treatment of streptococcal pharyngitis and pneumonia. Two large academic health system primary care networks with a mix of providers. All primary care practices within each health system were invited. All providers within participating clinic were considered a participant. Practices were randomized selection to a control or intervention group. Intervention practice providers had access to an integrated clinical prediction rule (iCPR) system designed to determine the risk of bacterial infection from reason for visit of sore throat, cough, or upper respiratory infection and guide evidence-based evaluation and treatment. Change in overall antibiotic prescription rates. Frequency, rates, and type of antibiotics prescribed in intervention and controls groups. 33 primary care practices participated with 541 providers and 100,573 patient visits. Intervention providers completed the tool in 6.9% of eligible visits. Antibiotics were prescribed in 35% and 36% of intervention and control visits, respectively, showing no statistically significant difference. There were also no differences in rates of orders for rapid streptococcal tests (RR, 0.94; P = 0.11) or chest X-rays (RR, 1.01; P = 0.999) between groups. The iCPR tool was not effective in reducing antibiotic prescription rates for upper respiratory infections in diverse primary care settings. This has implications for the generalizability of CDS tools as they are adapted to heterogeneous clinical contexts. Clinicaltrials.gov (NCT02534987). Registered August 26, 2015 at https://clinicaltrials.gov
An Ethical Paradox

If asked for fundamental principles of ethics, most theorists would unhesitatingly include the following two:
Statistical Probes of Reionization With 21 cm Tomography

We consider the degree to which "21 cm tomography" of the high-redshift Universe can distinguish different ionization histories. Using a new analytic model for the size distribution of HII regions that associates these ionized bubbles with large-scale galaxy overdensities, we compute the angular power spectrum and other statistical properties of the 21 cm brightness temperature during reionization. We show that the HII regions imprint features on the power spectrum that allow us to separate histories with discrete bubbles from those with partial uniform ionization (by, for example, X-rays). We also show that "double reionization" scenarios will modify the morphology of the bubbles in ways that depend on the mechanism through which the first generation of sources shuts off. If, for example, the transition occurs globally at a fixed redshift, the first generation imprints a persistent feature on the 21 cm power spectrum. Finally, we compare our model to one in which voids are ionized first. While the power spectra of these two models are qualitatively similar, we show that the underlying distributions of neutral hydrogen differ dramatically and suggest that other statistical tests can distinguish them. The next generation of low-frequency radio telescopes will have the sensitivity to distinguish all of these models and strongly constrain the history and morphology of reionization.
Short- and Long-Term Outcomes of Hematologic Malignancy Patients After Cardiopulmonary Resuscitation: Experience of a Large Oncology Center.

Purpose The objective of this study is to describe characteristics and short- and long-term outcomes of patients with hematologic malignancies who received cardiopulmonary resuscitation (CPR). Methods A retrospective review was conducted of all Code Blues at a large comprehensive cancer center. Demographic, clinical, and outcome variables were analyzed for patients with a hematologic malignancy who underwent CPR. Results Of 258 patients, 60.1% had leukemia. Outcomes included return of spontaneous circulation (70.2%), hospital survival (12%), and 90-day, 6-month, and 1-year survival rates of 9.8%, 8.2%, and 5.9%, respectively. Factors associated with hospital mortality included establishing a do not resuscitate order after CPR (p < .0001), location of CPR (p = .0004), cause of arrest (p = .0019), requiring vasopressors (p = .0130), mechanical ventilation (p = .0423), and acute renal failure post CPR (p = .0006). Although no difference in hospital survival between leukemia and non-leukemia patients was found, more non-leukemia patients were alive at 90 days (p = .0099), 6 months (p = .0023), and 1 year (p = .0119). Conclusions Factors including organ dysfunction, location of CPR, and cause of arrest are associated with hospital mortality post CPR. However, immediate survival post CPR does not seem to be affected by a diagnosis of leukemia. These data should assist health care providers with discussions regarding advance care planning and goals of care after cardiac arrest.
Streptococcus pneumoniae bacteremia in Southern California hospitalized children after implementation of pneumococcal conjugate vaccine

The introduction of Streptococcus pneumoniae 7-valent conjugate vaccine has decreased pneumococcal infections in children. Recently a resurgence of invasive pneumococcal infections has been reported. Delineating populations at risk and microbiological changes responsible for this is important to develop new preventive strategies. We conducted a retrospective review of medical records of children hospitalized with pneumococcal bacteremia from July 1st 2005 through February 28th 2010 in a large tertiary care center in Southern California. We identified 74 subjects (mean age 5 yr; range 32 days to 21 yr and 2 mo) of which the majority (58.1%) had underlying medical conditions associated with increased risk for pneumococcal infections for whom pneumococcal polysaccharide vaccine is recommended after 2 yr of age. Seventy-seven isolates were recovered from 76 positive blood cultures; serotype was available for 57 isolates, 5 (6B, 14, 23F and two were 19F) were 7-valent conjugate vaccine isolates. Forty were included in the 23-valent polysaccharide vaccine. Nineteen (35.2%) were 19A. Pneumonia was common particularly among previously healthy children (74%). New vaccines, targeted against serotypes that have emerged following the introduction of the 7-valent conjugate vaccine and better utilization of existing vaccines in patients at risk should further decrease invasive pneumococcal disease.
Getting past appearances: the many-fold consequences of remote homology

In the absence of other biological information, the detection of remote homology is a prerequisite step toward understanding the function of a new protein. A novel method based on structure comparison improves our ability to do this automatically and systematically.
Genotyping Escherichia coli O157:H7 for Its Ability to Cause Disease in Humans

Escherichia coli are ubiquitous in the world, and for the most part are non-pathogenic and part of the normal lower gastrointestinal tract in mammals. However, some pathogenic isolates can cause severe disease that range from meningitis to hemorrhagic colitis (HC). In recent years, Shiga toxin-containing E. coli (STEC) have been a major cause of food borne and environmental cases of HC and hemolytic uremic syndrome. One STEC serotype, O157:H7, has been responsible for numerous food-associated outbreaks and recalls worldwide. The protocols in this unit will allow the reader to use real-time polymerase chain reaction genotyping to identify isolates that are more likely to cause disease in humans. The genotyping assay targets a single-nucleotide polymorphism (SNP) in the tir gene. The tir gene is located in a virulence operon called the locus for enterocyte effacement and functions as a receptor for the tight adherence of E. coli O157:H7 to epithelial cells. As more genomes are sequenced, informative SNPs that associate with phenotypes will be identified. Identifying isolates not only by their genus and species, but also by using other informative genomic traits will increase the general knowledge about their genetic diversity.
Axo-axonic structures in the medial prefrontal cortex of the rat: reduction by prenatal exposure to cocaine.

The cognitive deficits associated with prenatal exposure to cocaine have been hypothesized to be the results of changes in the anatomy and function of the frontal cortex. In this study, pregnant dams were treated with cocaine (3 mg/kg i.v. twice a day) and the resulting adolescent (postnatal day, approximately 45) male offspring were killed for immunocytochemical determination of the total linear measure, number, location, and lengths of inhibitory GABA transporter-1 immunoreactive axo-axonic structures commonly called "candles" or "cartridges" in the medial prefrontal cortex. These inhibitory structures are the axon terminals of GABAergic cells that impinge on the initial axon segments of excitatory pyramidal neurons. We report that prenatal cocaine exposure decreased the number of these inhibitory candles. The greatest reduction of candles was observed in the ventral prelimbic cortex. Additionally, there was a subtle difference in the pattern of distribution of candles, namely the depth of the initial candle in the ventral portions of the prefrontal cortex was greater in rats exposed to prenatal cocaine. However, there was no overt change in the number of cells that were immunoreactive for the calcium-binding protein parvalbumin, an indicator of a subset of GABAergic interneurons that includes axo-axonic chandelier cells. We conclude that exposure to cocaine in utero disrupts the development of the axo-axonic cells in the prefrontal cortex and this disruption could contribute to the cognitive deficits reported with prenatal cocaine exposure.
Alternative theories of the rate of interest

In this paper I shall develop a framework which may be used to examine several alternative theories of the rate of interest. The four most widely accepted approaches are the Neo classical Loanable Funds, Keynes's Liquidity Preference, Neoclassical Synthesis ISLM, and Basil Moore's Horizontalist (or endogenous money). I will use the framework developed here to present a fifth: an integration of liquidity preference theory with an endogenous money approach. I first briefly set forth the primary alternative approaches, then develop an analytical framework based on an asset or stock approach and use it to discuss several theories of the interest rate: those advanced by Keynes, by Moore, by neoclassical theory and the monetarists, by Kregel, and by Tobin. Finally, I shall use the framework to reconcile liquidity preference theory with an endogenous money approach.
Giant cell arteritis and Crohn's disease: An unreported association

This report describes a 16-yr-old patient with coexistant Crohn's disease and giant cell arteritis. The unusual features of the case include presence of giant cell arteritis of temporal arteritis type in the bowel wall, the young age of the patient, and the previously unreported association of these two pathologic processes.
The Necessity of Cofactors in the Pathogenesis of AIDS: a Mathematical Model

Abstract Current arguments for the role of cofactors in the initiation of a chronic HIV infection and progression of AIDS are given. The natural history of an HIV infection as affected by cofactors which provide additional stimulatory signals is explored through a mathematical model. The model demonstrates that “antigen load” plays a role in determining susceptibility to an HIV infection. It also suggests that certain individuals may not be able to be infected by small doses of HIV and that the identification and treatment of existing cofactors may be useful in treating early stages of HIV infection. Prevention of cofactor exposures may also protect against HIV infection.
The Continuing Quest for New Measures

L'article resume les activites de l'ARL (Association of Research Libraries) dans sa recherche de nouvelles mesures de performances pour les bibliotheques de recherche.
Corrigendum to “Retrieval interference in sentence comprehension” [Journal of Memory and Language 55 (2006) 157–166]

On page 165, left column, second paragraph, lines 20–27 should read: ‘‘Hence, the Gordon et al. (2001, 2004) findings can be explained with a simple assumption that the match of the target to a pronoun or to a proper name is lower than that to a common noun phrase, perhaps because the referential properties associated with the former make it more distinctive than those associated with the later.’’ www.elsevier.com/locate/jml