cssi/SciSciGPT-SciSciNet huggingface dataset:
Utility of preoperative scores for predicting morbidity after cholecystectomy in patients with cirrhosis

Background & Aims: Patients with cirrhosis have an increased risk for cholelithiasis but also have an increased risk for morbidity and mortality after cholecystectomy. Current preoperative assessment of surgical risk is imprecise. Our aims were to identify preoperative factors that would accurately predict the risk for cholecystectomy in patients with cirrhosis. Methods: Preoperative clinical or biochemical parameters were determined for 33 patients with cirrhosis and 31 age- and sex-matched patients without cirrhosis. The use of these parameters and of the Child-Pugh and model for end-stage liver disease (MELD) scores as preoperative predictors of outcome after surgery were assessed. Results: There were 2 deaths, both in cirrhotic patients. The overall risk for morbidity or mortality was increased in cirrhotic patients compared with controls. Postoperative morbidity was significantly associated with preoperative increases of international normalized ratio >1.2, bilirubin >1.0 mg/dL, creatinine >1.4 mg/dL, and a decreased platelet count 3 /mL. The MELD and Child-Pugh scores accurately predicted postoperative morbidity, with an area under the curve of 0.938 and 0.839, respectively. A preoperative MELD score of ≥8 had a sensitivity of 91% and a specificity of 77% for predicting postoperative morbidity. Persons with a MELD score of ≥8 had increased 30- and 90-day global charges and increased blood product usage. Conclusions: Preoperative biochemical parameters, international normalized ratio, bilirubin, platelets, and creatinine can predict increased morbidity in cirrhotic patients. A MELD score of ≥8 identifies a group at high risk for postoperative morbidity after cholecystectomy.
Detection of Residual Leukemia with Immunologic Methods: Technical Developments and Clinical Implications

The identification of immunophenotypes expressed on leukemic cells but rare or absent during normal hematopoiesis allows close monitoring of residual leukemia after treatment. Phenotypes that afford a detection level of 1 leukemic cell among 10,000 normal bone marrow cells have been identified in 90% of cases of T-lineage acute lymphoblastic leukemia (T-ALL), 25% of B lineage ALL and 40% of acute myeloid leukemia (AML). Residual disease detected with immunologic techniques in patients with acute leukemia during continuation therapy or off treatment usually anticipates overt relapse. While these data indicate the reliability of these techniques, further studies with homogeneously treated cohorts of patients, currently underway, are needed to precisely define the clinical significance of detecting occult leukemia at different points during treatment. The proportion of patients that can be studied with immunologic methods may increase through the definition of new leukemia-associated phenotypes using existin...
Rotational vertebrobasilar ischemia due to vertebral artery dynamic stenoses complicated by an ostial atherosclerotic stenosis

We describe a patient with rotational vertebrobasilar ischemia (RVBI) due to vertebral artery (VA) compressive stenoses during neck rotation, complicated by an ostial atherosclerotic stenosis (OAS). Referred for 'near-syncopal spells', inquiry revealed a symptom-complex consistent with vertebrobasilar transient ischemic attacks (TIAs) provoked by head rotation. VA dynamic angiography with imaging via prevertebral subclavian injections in neck-rotated positions while reproducing symptoms, demonstrated two compressive stenoses not present in the neck-neutral position, establishing the diagnosis of RVBI due to CT-demonstrated cervical spondylosis. There was an occluded contralateral VA, isolated posterior circulation, and absent vertebral collateral flow. Disabling symptoms persisted despite using a cervical collar. Surgical decompression of the dynamic stenoses would not address the OAS, was considered high risk, and absence of a suitable donor artery precluded distal VA reconstruction. RVBI resolved with ostial stent placement by improving perfusion pressure across the compressive stenoses. To our knowledge, this is the first report of RVBI in which the affected VA had an obstructive atherosclerotic stenosis in addition to the characteristic rotation-induced dynamic stenoses, and the first report of stent placement in the culprit artery to treat this disorder. Diagnosis depends on recognizing the association of symptoms with positional neck changes and VA dynamic angiography demonstrating the compressive stenosis while reproducing symptoms. This case illustrates the management complexities when there are coexisting abnormalities, emphasizing the need to individualize treatment. RVBI is a potentially correctable cause of TIAs and particularly relevant due to the aging population which has a significant incidence of both degenerative cervical and atherosclerotic cerebrovascular disease.
What's in a Name: Is “Evolutionary Psychology” Eclipsing “Sociobiology” in the Scientific Literature?

Is the term “evolutionary psychology” supplanting “sociobiology” in the scientific literature? How influential was E. O. Wilson's (1975) book, Sociobiology, in establishing the discipline of the sa...
An insider threat activity in a software security course

Software development teams face a critical threat to the security of their systems: insiders. A malicious insider is a person who violates an authorized level of access in a software system. Unfortunately, when creating software, developers do not typically account for insider threat. Students learning software development are unaware of the impacts of malicious actors and are far too often untrained in prevention methods against them. A few of the defensive mechanisms to protect against insider threats include eliminating system access once an employee leaves an organization, enforcing principle of least privilege, code reviews, and constant monitoring for suspicious activity. At the Department of Software Engineering at the Rochester Institute of Technology, we require a course titled Engineering of Secure Software and have created an activity designed to prepare students for the problem of insider threats. At the beginning of this activity, student teams are given the task of designing a moderately sized secure software system. The goal of this insider is to manipulate the team into creating a flawed system design that would allow attackers to perform malicious activities once the system has been created. When the insider is revealed at the conclusion of the project, students discuss countermeasures regarding the malicious actions the insiders were able to plan or complete, along with methods of prevention that may have been employed by the team to detect the malicious developer. In this paper, we describe the activity along with the results of a survey. We discuss the benefits and challenges of the activity with the goal of giving other instructors the tools they need to conduct this activity at their institution. While many institutions do not offer courses in computer security, this self-contained activity may be used in any computing course to enforce the importance of protecting against insider threats.
Land for welfare in China

Drawing on firsthand observations, Party and government documents, and survey data, this study examines the causes and processes of the land for welfare policy in China. The implementation of the land for welfare program cannot be understood in isolation from the profound urban–rural gap in the land property rights regime and social welfare provision in China. The dual land tenure system allows local officials to generate revenue by expropriating rural land, which, to rural households, functions as a social insurance as well as an income-generating property. In the process of land requisition, land-losing villagers are provided with social welfare benefits to compensate for their loss of their land's insurance function. Such provision, however, is not developed out of the local governments’ benign intention, but their strategic reaction to the central government's development program that combines rural social welfare provision with a land rewarding system, which provides an opportunity for local officials to gain more land, a valuable asset for local governments. The provision of social welfare benefits is selective: affected rural households are provided with welfare benefits that are less costly to the local government, typically in the form of a pension insurance.
Control of Morphogenesis in Myxobacteria

The myxobacteria are Gram-negative soil bacteria that live in large communities known as swarms. The most remarkable characteristic of myxobacteria is their ability to form fruiting bodies that have a species-specific shape and color. Fruiting body formation requires the concerted effort of hundreds of thousands of cells. Development is initiated only when two conditions are satisfied. The cells must be nutritionally deprived (environmental signal) and there must be many other cells in the vicinity (intercellular signal). The development of one species, Myxococcus xanthus, has been studied in the most detail. M. xanthus uses amino acids as its primary carbon, nitrogen, and energy source. Starvation for a single amino acid, or for inorganic phosphate, serves as the environmental signal. A variety of intercellular signals appear to control the initiation of development and the timing of subsequent developmental events.
An Analysis of the New York Charter School Auditing Cases

This article explains how New York’s charter schools have, thus far, relied upon their private characteristics to avoid audits by the state comptroller. In each instance, the charter schools prevailed by demonstrating that they were more “private” than the institutions that the state constitution authorized the comptroller to audit. As context for the private characteristics argument of these charter schools, Part I of this article provides an overview of the hybrid nature of charter schools. This part also explains how charter schools have used their public characteristics to qualify for public funding under state constitutional law, while highlighting their private characteristics to exempt themselves from other laws that apply to public schools. Parts II and III of this article discuss the litigation pertaining to the first two legislative attempts to place New York’s charter schools under the state comptroller. Part IV discusses how other state legislatures can learn from the New York cases to design charter school laws that provide greater protection to the public.
Sewage Treatment by Raw Sewage Stabilization Ponds

U. S. Public Health Service conducted cooperative field studies on sewage ponds to develop information on design, operation, and applicability of such facilities for treating raw sewage; limited ev...
Historical role of alpha-1-antitrypsin deficiency in respiratory and hepatic complications

Alpha-1-antitrypsin (AAT) deficiency is a heritable disease that is commonly associated with complications in the respiratory and hepatic systems. AAT acts as a regulatory enzyme that primarily inhibits neutrophil elastase activity thus protecting tissues from proteolytic damage after inflammation. This paper provides a historical review of the discovery, classification, phenotypic expression, and treatment of AAT deficiency. While its pattern of inheritance has been long understood, the underlying mechanism between AAT deficiency and related diseases remains to be elucidated. Most commonly, AAT deficiency is associated with the development of emphysema in the lungs as well as various liver injuries. Cigarette smoke has been shown to be particularly detrimental in AAT deficient individuals during the development of lung disease. Therefore, understanding familial history may be beneficial when educating patients regarding lifestyle choices. While numerous AAT deficient phenotypes exist in the human populations, only specific variants have been proven to markedly predispose individuals to lung and liver disorders. The exact relationship between AAT levels and the aforementioned diseases is an essential area of further research. It is imperative that clinicians and researchers alike strive to standardize diagnostic criteria and develop safe and effective therapies for this genetic disease.
The Neonatal Transition of the Right Ventricle

The pulmonary circulation undergoes a dramatic transition at birth, which includes a marked fall in pulmonary vascular resistance (PVR) to accommodate an eight- to tenfold increase in pulmonary blood flow. Failure to achieve or sustain this normal drop in PVR leads to the syndrome of persistent pulmonary hypertension of the newborn (PPHN), which is characterized by profound hypoxemia due to extra-pulmonary shunt, poor cardiac output, and significant morbidity and mortality. The fetal myocardium must also adapt rapidly during the transition, and the right ventricle (RV) undergoes striking functional and structural changes after birth. The RV serves as the “systemic ventricle” in utero, as most of the RV output crosses the widely patent DA and provides 2/3 of combined ventricular output in the normal fetus. Increased systemic vascular resistance, the marked fall in PVR, and functional closure of the “fetal channels” account for the progressive decrease in RV wall thickness and increase in LV mass after birth. Unlike changes in the RV during the normal transition, RV hypertrophy persists in the setting of sustained elevations of PVR due to birth at altitude, PPHN, congenital heart disease, and other cardiopulmonary disorders. In addition to these striking physiologic changes, the neonatal transition of the RV is further characterized by remarkable cellular, molecular, and metabolic adaptations. The fetal heart grows and develops during normal intrauterine life at low oxygen tensions that would induce severe hypoxic stress during postnatal life, yet the fetus thrives and is well-prepared for the normal transition at birth. Insights into mechanisms underlying the normal metabolic and functional transition from fetal to neonatal life are not only important for better understanding of neonatal cardiopulmonary diseases, but will also provide insights into adaptive and maladaptive responses in the adult RV.
Theory and Practice of Intergovernmental Transfers

This paper provides a selective survey of the theory and practice of intergovernmental transfers with a view to developing a broad agenda for reform. It discusses the economic rationale for intergovernmental transfers and its implications for the design of transfers. Issues and options in the design of equalization programs to reduce regional fiscal disparities are also presented. Existing mechanisms for fiscal transfers in developing countries are also reviewed.
Performance Measures to Characterize Corridor Travel Time Delay Based on Probe Vehicle Data

Anonymous probe vehicle data are being collected on roadways throughout the United States. These data are incorporated into local and statewide mobility reports to measure the performance of highways and arterial systems. Predefined spatially located segments, known as traffic message channels (TMCs), are spatially and temporally joined with probe vehicle speed data. Through the analysis of these data, transportation agencies have been developing agencywide travel time performance measures. One widely accepted performance measure is travel time reliability, which is calculated along a series of TMCs. When reliable travel times are not achieved because of incidents and recurring congestion, it is desirable to understand the time and the location of these occurrences so that the corridor can be proactively managed. This research emphasizes a visually intuitive methodology that aggregates a series of TMC segments based on a cursory review of congestion hotspots within a corridor. Instead of a fixed congestio...
Experimental assessment of the susceptibility of Aedes mosquitoes (Diptera: Culicidae) to infection with Jamestown Canyon virus.

The susceptibility of the principal Aedes species mosquitoes of the Delmarva Peninsula to infection with Jamestown Canyon (JC) virus was assessed in a series of laboratory experiments. Data revealed that infection rates were 60% or greater for Aedes sollicitans and Aedes taeniorhynchus following ingestion of blood that contained 104.5 and/or 105.0 suckling mouse intracerebral lethal dose (SMICLD)50/ml of JC virus. Infection rates for Aedes canadensis were 8% and 48% following ingestion of blood meals that contained 104.5 and 106.0 SMICLD50 of virus, respectively. After ingesting blood with comparable amounts of virus, only 8% of Aedes cantator and 12% of Aedes atlanticus became infected. JC virus was transmitted to mice by a low percentage of infected Ae. canadensis.
Aerodynamic Analysis of a Spinning Missile with Dithering Canards using a High Order Unstructured Grid Scheme

Time-accurate viscous flow simulations are carried out for a canard-controlled missile in which the body spins at a constant roll rate while the canards are dithering. A Reynolds-averaged Navier-Stokes arbitrary Mach number flow solver based on unstructured grid topology and embedded dynamic moving grid technique is employed to solve the spinning missile with canard control surfaces. Both second and third-order spatial discretization schemes are investigated for analyzing the unsteady aerodynamic characteristics of forces and moments, which are compared with the benchmark solution obtained by NASA OVERFLOW code. The computed solutions revealed the formation of strong vortices induced by canards which interact with the tail fin shocks and boundary layers on the body. The use of third-order discretization scheme noticeably improved the prediction of vortical flows by reducing the excessive numerical dissipation, and thus improves the accuracy of computed forces and moments.
Speech Outcomes After Clinically Indicated Posterior Pharyngeal Flap Takedown.

BACKGROUND Velopharyngeal insufficiency affects as many as one in three patients after cleft palate repair. Correction using a posterior pharyngeal flap (PPF) has been shown to improve clinical speech symptomatology; however, PPFs can be complicated by hyponasality and obstructive sleep apnea. The goal of this study was to assess if speech outcomes revert after clinically indicated PPF takedown. METHODS The cleft-craniofacial database of the Children's Hospital of Pittsburgh at the University of Pittsburgh Medical Center was retrospectively queried to identify patients with a diagnosis of velopharyngeal insufficiency treated with PPF who ultimately required takedown. Using the Pittsburgh Weighted Speech Score (PWSS), preoperative scores were compared to those after PPF takedown. Outcomes after 2 different methods of PPF takedown (PPF takedown alone or PPF takedown with conversion to Furlow palatoplasty) were stratified and cross-compared. RESULTS A total of 64 patients underwent takedown of their PPF. Of these, 18 patients underwent PPF takedown alone, and 46 patients underwent PPF takedown with conversion to Furlow Palatoplasty. Patients averaged 12.43 (range, 3.0-22.0)(SD: 3.93) years of age at the time of PPF takedown, and 58% were men. Demographics between groups were not statistically different. The mean duration of follow-up after surgery was 38.09 (range, 1-104) (SD, 27.81) months. For patients undergoing PPF takedown alone, the mean preoperative and postoperative PWSS was 3.83 (range, 0.0-23.0) (SD, 6.13) and 4.11 (range, 0.0-23.0) (SD, 5.31), respectively (P = 0.89). The mean change in PWSS was 0.28 (range, -9.0 to 7.0) (SD, 4.3). For patients undergoing takedown of PPF with conversion to Furlow palatoplasty, the mean preoperative and postoperative PWSS was 6.37 (range, 0-26) (SD, 6.70) and 3.11 (range, 0.0-27.0) (SD, 4.14), respectively (P < 0.01). The mean change in PWSS was -3.26 (range, -23.0 to 4.0) (SD, 4.3). For all patients, the mean preoperative PWSS was 5.66 (range, 0.0-26) (SD, 6.60) and 3.39 (range, 0.0-27) (SD, 4.48), respectively (P < 0.05). The mean change in PWSS was -2.26 (range, -23.0 to 7) (SD, 5.7). There was no statistically significant regression in PWSS for either surgical intervention. Two patients in the PPF takedown alone cohort demonstrated deterioration in PWSS that warranted delayed conversion to Furlow palatoplasty. Approximately 90% of patients, who undergo clinically indicated PPF takedown alone, without conversion to Furlow Palatoplasty, will show no clinically significant reduction in speech. CONCLUSIONS Although there is concern that PPF takedown may degrade speech, this study finds that surgical takedown of PPF, when clinically indicated, does not result in a clinically significant regression of speech.
Self-Monitoring for High School Students With Disabilities A Cross-Categorical Investigation of I-Connect

Self-monitoring interventions are well supported within the empirical literature as improving classroom engagement for students with disabilities. However, studies implementing self-monitoring inte...
Evading invasives: how Eurasian watermilfoil affects the development of lake properties.

Eurasian watermilfoil is an aquatic invasive plant that has spread rapidly through freshwater lakes across the United States. Along with being a hazard to local ecosystems, milfoil is a nuisance to those who use lakes for recreation, and its presence has been shown to lower lakefront property values. This study presents the first evidence of the effects of Eurasian watermilfoil on the probability that undeveloped properties near lakes are developed into single-family housing units. Using a comprehensive dataset from the Twin Cities, Minnesota region, a duration model of land conversion is estimated using data on new home construction from 1990 through 2005. We find that undeveloped parcels of land on and near lakes invaded by Eurasian watermilfoil are less likely to be developed than their counterparts on non-invaded lakes. In counterfactual simulations, we show that absent spread after 1990, total development would increase in 112 of the region’s 650 census tracts by an average of 19 houses per tract.
In Vitro Antioxidant-Activity Evaluation of Gallic-Acid-Grafted Chitosan Conjugate Synthesized by Free-Radical-Induced Grafting Method.

The major objective of this work was to develop a green and facile process to prepare gallic acid–chitosan conjugate and comprehensively evaluate the physicochemical properties and biological activities of an as-prepared water-soluble chitosan derivative. A free-radical-induced grafting approach using an ascorbic acid–hydrogen peroxide redox pair was adopted. The obtained conjugate was characterized by Fourier transform infrared spectroscopy, UV–vis, X-ray diffraction, and pKa analysis. The antioxidant activities were evaluated by 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzothiazoline-6)-sulphonic acid (ABTS), reducing power, and oxygen-radical antioxidant-capacity assays. The results showed that the mass ratio of gallic acid to chitosan played a vital role in determining the grafting degree and ζ potential of the conjugates, with the ratio of 0.5:1 being the optimal ratio that resulted in the highest grafting degree. The antioxidant assays demonstrated that conjugation significantly ...
How Much Are the Firm’s Interorganizational Relationships Worth? A Social Network Perspective

One major issue in mergers and acquisitions (M&A) is information asymmetry, which may reduce the value of both acquirer and target. Drawing from social network and signaling theories, we examine wh...
Policy Issues Related to Worst Case Risk Analyses and the Establishment of Acceptable Standards of De Minimis Risk

Worst case analyses of risks become important whenever there are wide ranges of uncertainty surrounding estimated risks of technological applications, especially if environmental and societal impacts can reach catastrophic proportions. Risk may be defined as the possible consequences of a decision option times the probability of consequences materializing and special circumstances that may be involved.Increasingly severe magnitudes of consequences resulting from a technological option are sometimes accompanied by increasingly small probabilities that can reach de minimis, or insignificant, levels. Thus, a dilemma exists for policy development as to what the de minimislevel of probability is for those rare combinations of circumstances that can produce worst case consequences. One possible guide is the probability level of fatal accidents individuals routinely accept in their personal activities. Another is the establishment of safety-cost trade-off criteria that take into account equity considerations of the diverse opportunities for saving lives by the allocation of finite financial resources. On November 29, 1978, the Council on Environmental Quality issued implementing regulations for environmental impact statements (40 CFR 1502.22) requiring a worst case analysis, under certain conditions, and an indication of the probability of its occurrence. Difficulties and controversies in implementing the concept of worst case analysis have led the CEQ to reconsider this requirement (48 FR 36486, August 11, 1983). This paper explores a number of policy issues related to worst case analyses within a spectrum of high-consequence/low-probability events and the establishment of acceptable standards of de minimisrisk. Case material is used comparing the catastrophic risk of nuclear power plants with the chronic and accidental risks of using coal to generate electricity.
DNA ploidy, cell cycle kinetics, and low versus high grade atypia in endometrial hyperplasia

There have been few studies of DNA ploidy and cell cycle kinetics in endometrial hyperplasia. The authors studied archival cases of proliferative endometrium, simple, complex and atypical endometrial hyperplasia and well, moderately, and poorly differentiated endometrial adenocarcinoma by flow cytometry and also evaluated the significance of the degree of cytologic atypia (low versus high) in endometrial hyperplasia relative to the occurrence of carcinoma. All proliferative endometria, all types of hyperplasia and well and moderately differentiated carcinomas were diploid. Two-thirds of poorly differentiated adenocarcinomas were aneuploid. Neither S-phase fractions or proliferative fractions (S+G2M) could distinguish among the different types of hyperplasia or predict which hyperplasias were associated with carcinomas. The degree of cytologic atypia in atypical hyperplasia was not predictive of the occurrence of carcinoma. Poorly differentiated carcinomas showed significant differences in DNA ploidy, S-phase, and proliferative fractions from endometrial hyperplasia and lower grade carcinoma. These results support the concept that there are two fundamentally different types of endometrial carcinoma.
Achievement Goal Theory: Definitions, Correlates, and Unresolved Questions

The achievement goal framework and theory has emerged as one of the most prominent and heavily researched area within motivation research. Achievement goals refer to the cognitive representations of desired, competence-related outcomes in achievement contexts and have generally been divided into mastery and performance goals. This article begins with a brief review of the history of the achievement goal construct. Then, a summary of the research on the correlates and effects of mastery and performance goal pursuit is reviewed. The article concludes with a consideration of some of the potential avenues for future research using the achievement goal framework.
The phylogenetic relationship and cross-infection of nucleopolyhedroviruses between the invasive winter moth (Operophtera brumata) and its native congener, Bruce spanworm (O. bruceata)

Disease can affect biological invasions by acting as either a synergist or antagonist. Disease-mediated invasions have important implications for understanding the spread of invasive insects, which cost billions of dollars in damages annually. One such non-native, destructive insect is the winter moth, Operophtera brumata L. (Lepidoptera: Geometridae), which causes defoliation and mortality of deciduous trees in its introduced range. In the northeastern United States, winter moth populations overlap with a native congener, Bruce spanworm, Operophtera bruceata Hulst. Nucleopolyhedrovirus (NPV), appears to be an important natural enemy in Bruce spanworm and there is some evidence that the NPV infection found in winter moth in the northeastern U.S. may originate from Bruce spanworm. By sequencing two viral genes (the polyhedrin and p74 genes) from field-collected larvae of both species, we found that the winter moth virus (OpbuNPV) is distinct from the virus from Bruce spanworm (OpbrNPV). However, the two viruses do constitute a clade within the Alphabaculovirus Group 2 NPVs, indicating that they are more similar to each other than they are to other lepidopteran viruses, even other geometrid-derived NPVs. As far as we know, this is the first report of sequences from an NPV from Bruce spanworm. Results from cross infection trials suggest that cross infection is uncommon if it occurs at all. Our results show that these two closely related species have distinct viruses and, unlike previous suggestions, Bruce spanworm virus is not mediating the winter moth invasion.
Effective Transfer via Demonstrations in Reinforcement Learning: A Preliminary Study

There are many successful methods for transferring information from one agent to another. One approach, taken in this work, is to have one (source) agent demonstrate a policy to a second (target) agent, and then have that second agent improve upon the policy. By allowing the target agent to observe the source agent's demonstrations, rather than relying on other types of direct knowledge transfer like Q-values, rules, or shared representations, we remove the need for the agents to know anything about each other's internal representation or have a shared language. In this work, we introduce a refinement to HAT, an existing transfer learning method, by integrating the target agent's confidence in its representation of the source agent's policy. Results show that a target agent can effectively 1) improve its initial performance relative to learning without transfer (jumpstart) and 2) improve its performance relative to the source agent (total reward). Furthermore, both the jumpstart and total reward are improved with this new refinement, relative to learning without transfer and relative to learning with HAT.
Improved Cell Viability, Viable Cell Recovery and Faster Engraftment of Products Thawed Using a Premixed Solution of Human Serum Albumin and Dextran 40 Compared to Sequential Addition During the Thawing Procedure

Abstract 2248 HPC, Apheresis products collected for autologous use must be cryopreserved prior to hematopoietic progenitor cell transplantation. Improved recovery of cryopreserved cord blood cells was demonstrated by Rubinstein et al. (PNAS:92, 10119, 1995) when the thawed cells were diluted with an equal volume of a solution containing 2.5% (wt/vol) of human serum albumin (HSA) and 5% (wt/vol) Dextran 40, the cells centrifuged, the supernatant removed, and the cells restored to their original volume with the same Dextran/Albumin solution as compared to thawing the product without dilution or washing. This method has the additional advantage of allowing cells to be thawed under controlled conditions within the laboratory and greatly reduces reactions to DMSO. Several variations in this procedure have been published including one employed at our center that has been used to thaw all cryopreserved products since 1996 in which 5% HSA and 10% Dextran 40 was added sequentially to the thawed cells each at 1/2 the frozen volume. The cells and solution were mixed and after 10 minutes of incubation the bag was filled to capacity (300 mL total) with Dextran 40 prior to centrifugation. Reconstitution to the original volume for infusion was also by sequential addition of HSA and Dextran 40 (Method 1). A variation of this method is to use a premixed solution of 2.5% HSA and 5% Dextran 40 both before and after centrifugation (Method 2). A third method, which is currently recommended by the Blood and Marrow Transplantation Clinical Trials Network (BMT-CTN) for thawing HPC, Cord Blood is similar to method 2 but uses a higher concentration of HSA resulting in 4.2% HSA in the premixed Dextran/Albumin solution (Method 3). We directly compared the three methods using autologous products (n=3) that were no longer needed for infusion and that were each frozen in multiple bags to assess viability (7-AAD method), along with recovery of viable total nucleated cells (TNC), CD3+ T-cells, and CD34+ cells. No significant differences were seen for any of the outcomes between method 2 and method 3. However, both method 2 and method 3 resulted in better overall viability, viable TNC recovery and viable recovery of CD34+ cells and CD3+ T-cells than method 1. Starting in January 2010 we modified our standard thawing procedure to method 3 (to conform to CTN requirements) and have compared the results of 96 bags thawed using this method with 173 bags thawed using method 1. Thaw viability (Trypan blue method) using method 1 was 72.7%±11.8% compared to 77.5%±9.1% for method 3, p=0.0005 and viable cell recovery was 62.1%±12.6% versus 68.5%±10.2%, p= Disclosures: No relevant conflicts of interest to declare.
Antecedents and early correlates of high and low concentrations of angiogenic proteins in extremely preterm newborns

Abstract Background To identify the antecedents and very early correlates of low concentrations of angiogenic proteins in the blood of extremely preterm newborns during the first postnatal month. Methods Using multiplex immunoassays we measured the concentrations of vascular endothelial growth factor A (VEGF), VEGF receptor-1 (VEGFR-1), VEGF receptor-2 (VEGFR-2), placenta growth factor (PIGF), and angiopoietins 1 and 2 (Ang-1, Ang-2), as well as 21 other proteins in blood spots collected on postnatal days 1 ( N = 1062), 7 ( N = 1087), 14 ( N = 989), 21 ( N = 940) and 28 ( N = 880) from infants born before the 28th week of gestation. We then sought the protein-concentration correlates of concentrations in the top and bottom quartile for gestational age and day the specimen was collected. Results Children who were delivered for medical indications and those who were severely growth restricted were more likely than others to have low day-1 blood concentrations of VEGF, VEGF-R2, Ang-1, and PIGF. Systemic inflammation accompanied top quartile concentrations of every one of the 6 angiogenic proteins. Conclusions Low day-1 concentrations of most angiogenic proteins are associated with disorders linked to placenta insufficiency/dysfunction. High concentrations, on the other hand, are associated with systemic inflammation throughout the first postnatal month.
High-Spatial-Resolution OH PLIF Visualization in a Cavity-Stabilized Ethylene-Air Turbulent Flame

High-spatial-resolution OH planar laser-induced fluorescence was measured for a premixed ethylene-air turbulent flame in an electrically-heated Mach 2 continuous-flow facility (University of Virginia Supersonic Combustion Facility, Configuration E.) The facility comprised a Mach 2 nozzle, an isolator with flush-wall fuel injectors, a combustor with optical access, and an extender. The flame was anchored at a cavity flameholder with a backward-facing step of height 9 mm. The temperature-insensitive Q1(8) transition of OH was excited using laser light of wavelength 283.55 nm. A spatial filter was used to create a laser sheet approximately 25 microns thick based on full-width at half maximum (FWHM). Extension tubes increased the magnification of an intensified camera system, achieving in-plane resolution of 40 microns based on a 50% modulation transfer function (MTF). The facility was tested with total temperature 1200 K, total pressure 300 kPa, local fuel/air equivalence ratios of approximately 0.4, and local Mach number of approximately 0.73 in the combustor. A test case with reduced total temperature and another with reduced equivalence ratio were also tested. PLIF images were acquired along a streamwise plane bisecting the cavity flameholder, from the backward facing step to 120 mm downstream of the step. The smallest observed features in the flow had width of approximately 110 microns. Flame surface density was calculated for OH PLIF images.
Characteristics of Adults Who Switched From Cigarette Smoking to E-cigarettes.

Introduction Because of the rapidly increasing use of electronic cigarettes (e-cigarettes), this study aimed to investigate the individual characteristics and state-level prevalence of U.S. adults who have switched to e-cigarettes from traditional cigarettes. Methods Data from the 2012–2013 and 2013–2014 National Adult Tobacco Surveys were analyzed in 2016. Relative percent change in switching was estimated, and the state-specific prevalence of adults who switched to e-cigarettes from traditional cigarettes was calculated and mapped. Multivariate logistic regression was conducted to examine how switching varied by sociodemographic subgroups and region. Results Overall, the number of individuals who switched from traditional cigarettes to e-cigarettes increased by approximately 100% over the 1-year interval. Significant increases were found among a number of sociodemographics and regions. Multivariate logistic regression analyses showed that young adults and those living in the South and West were more likely to switch to e-cigarettes, compared to former smokers who did not switch. Compared with current dual users, those with higher education and those who were not single were more likely to switch to e-cigarettes. The state with the highest prevalence of switching was New Mexico (7.3%), whereas Connecticut had the lowest prevalence (0.8 %) among former smokers. Conclusions There is an increase in the progression from traditional cigarette use to e-cigarette use. Further research is warranted to determine whether this change continues and facilitates cigarette smoking cessation as a possible public health benefit and opportunity to save lives rather than constitutes a potential threat to public health.
Letter to the Editor: Mobile Technology Can Improve Adherence and Lessen Tacrolimus Variability in Patients Receiving Kidney Transplants.

Medication adherence is of paramount importance in transplant recipients. Studies have demonstrated that variability in tacrolimus blood concentrations is associated with de novo formation of donor-specific antibodies and an increased incidence of rejection following renal transplantation.[1][1]-[3
Hydrogen sulfide as a regulatory factor in kidney health and disease

Hydrogen sulfide (H2S) is synthesized in nearly all organ systems including the kidney. Recent findings have revealed that H2S functions as a gasotransmitter affecting a wide range of physiologic functions similar to other gasotransmitters nitric oxide (NO) and carbon monoxide (CO). Research on H2S regulation of kidney function is still in early stages. H2S increases glomerular filtration rate (GFR) and inhibits sodium absorption by the tubules. There is burgeoning evidence that H2S generation by kidney cells is reduced in acute and chronic disease states and that H2S donors ameliorate injury. However, there are hints that the gas could also mediate kidney injury in specific models suggesting that its participation in kidney pathology is context-dependent. Expanding investigation of H2S in kidney physiology and disease will not only help us understand its regulatory role but it may also give us a potential new target for therapeutic intervention.
COL1A1 Mutations Presenting as Descending Perineum Syndrome in a Young Patient With Hypermobility Syndrome

A 22-year-old woman presented with 12 years of progressive constipation; she had increased joint flexibility, hyperextensible skin, and excessive perineal descent on examination. Radiological studies confirmed evidence of rectal evacuation disorder due to descending perineum syndrome, enterocele, and rectocele. In a wide genetic screen (∼611,000 single nucleotide polymorphisms), 4 variations were identified in COL1A1 gene ([rs72656352, Chr17: 50,185,535-50,185,539, deletion], [rs72654794, Chr17: 50,188,575, deletion], [rs72667023, Chr17: 50,198,170, deletion], [rs67828806, Chr17: 50,198,177 G→C]). These mutations result in an increase in the number of base pairs in the C' end, as well as replacement of the glycine amino acid in the N' end, leading to incomplete cleavage of procollagen by proteases and resulting in collagen weakness. Our observations suggest that COL1A1 gene mutations are plausible biological factors predisposing to descending perineum syndrome in association with joint hypermobility in this patient.
Radiolytic gas generation in concrete made with incinerator ash containing transuranium nuclides

The effects of various factors on H2 generation by alpha radiolysis of concrete containing TRU incinerator ash were studied. Methods for reducing H2 generation were investigated. Samples of portland and high-alumina cement containing up to 30% calcined ash (dry basis) were doped with 238PuO2. Gas pressures were measured as a function of radiation dose; gas compositions were determined. Gas yields were calculated in terms of G values (molecules produced per 100 eV of alpha energy absorbed). These yields were used to estimate pressures in containers of radioactive concrete waste during storage.
Using Learning Style Information to Improve the Core Financial Management Course

This study presents learning styles as a technique that can help teachers of the core financial management course see how students learn and, simultaneously, improve their teaching performance and enhance student learning. A brief overview of the learning style literature is presented with a focus on Gregorc's learning styles. The empirical segment of the study is based on the learning styles of 483 undergraduate students in core financial management courses at three universities. A hierarchical loglinear model is used to test various hypotheses concerning the relationship among students' sex, race, academic major and learning styles. The analysis shows that within the sample there is no difference in the leaning styles of African American and Caucasian students. Also the learning styles of female student s in the sample are significantly different from male students. A user-friendly example provides suggested strategies for teaching present value to the four learning styles. Finally, specific recommendations and strategies are presented show how learning style information can improve teaching performance and student learning.
Adjunctive visceral artery chimney in patients undergoing Zenith Fenestrated aortic repair

Abstract Objective Visceral artery chimneys have been employed as an adjunct to endovascular aneurysm repair (EVAR) to treat short-neck infrarenal and juxtarenal aortic aneurysms for more than two decades. With the widespread introduction of fenestrated endovascular aneurysm repair by the Food and Drug Administration-approved Zenith Fenestrated endograft (ZFEN; Cook Medical, Bloomington, Ind) to the United States in 2012, clinicians gained the ability to apply the chimney technique to these custom devices for difficult anatomy. The purpose of this report was to demonstrate feasibility and to provide evidence on the performance of chimneys for the treatment of complex juxtarenal aneurysms that could not be adequately treated with ZFEN alone. Methods A retrospective analysis was performed of a prospectively maintained institutional ZFEN database capturing 110 fenestrated endovascular aneurysm repairs from October 2012 to January 2018 to identify patients undergoing a concomitant visceral artery chimney. All patients with Results Six patients met criteria and were included in this investigation. They were universally male with a mean age of 76.2 years at the time of ZFEN/chimney. Chimneys were placed in a total of six visceral arteries (n = 1 per patient) consisting of three renal arteries, two celiac arteries, and one accessory renal artery. Mean estimated blood loss and operative time were 283 mL and 298 minutes, respectively. Technical success was achieved in all cases. Two small type IA "gutter" endoleaks were detected early; both spontaneously resolved on follow-up. We observed no instances of chimney migration, stenosis, or thrombosis perioperatively or on follow-up. Two reinterventions were performed in these six patients; these consisted of a repeated renal stent for ostial stenosis at a main body fenestration and a common femoral artery endarterectomy and patch angioplasty for an access-related common femoral artery occlusion. Conclusions Use of ZFEN in conjunction with a singular chimney is safe, feasible, and durable in patients with difficult anatomy who do not meet instructions for use as demonstrated in this limited series.
Mapping and Quantitating Penetrating Vessels in Cortical Brain Using Eigen-Decomposition of OCT Signals and Subsequent Principal Component Analysis

Penetrating vessels bridge the mesh of communicating vessels on the surface of the cortex with the subsurface microvascular beds that feed the underlying neural tissue. Their accurate identification in vivo is important in the investigations of neural degenerative diseases, e.g., Alzheimer's disease and stroke. Here, we propose an efficient method to automatically map cortical penetrating vessels based on an eigen decompensation analysis of the optical coherence tomography (OCT) and OCT angiographic signals. We first project the ensemble of repeated OCT signals into a feature space that represents the power spectral components of eigenvectors through a well-known eigen-decomposition method. A principal component analysis is then applied to the spectral components to identify penetrating vessels. We find that the spectral components of OCT signals captured from a cortical brain tissue follow a subtle logistic distribution, which is, however, broken down if there are penetrating vessels. Such feature allows for an automatic mapping of penetrating arterioles and ascending venules from large volume OCT-scan datasets, accordingly contributing to the topological and morphological analyses of cortical microvasculature in the functioning brains. To demonstrate the utility of the proposed method, an OCT angiography imaging platform is used to show the functional behavior of penetrating blood flows before and after an ischemic insult in an established middle cerebral artery occlusion (MCAO) model of rodent, where an average of 41% reduction in penetrating vessel density ( n = 5 animals) was observed in the ischemic region post-MCAO.