cssi/SciSciGPT-SciSciNet huggingface dataset:
Minimal clinically important differences of 3 patient-rated outcomes instruments.

Purpose Patient-rated instruments are increasingly used to measure orthopedic outcomes. However, the clinical relevance of modest score changes on such instruments is often unclear. This study was designed to define the minimal clinically important differences (MCIDs) of the Disabilities of the Arm, Shoulder, and Hand (DASH), QuickDASH (subset of DASH), and Patient-Rated Wrist Evaluation (PRWE) questionnaires for atraumatic conditions of the hand, wrist, and forearm. Methods We prospectively analyzed 102 patients undergoing nonoperative treatment for isolated tendinitis, arthritis, or nerve compression syndromes from the forearm to the hand. By phone, patients completed the DASH, QuickDASH, and PRWE at enrollment and at 2 weeks (n = 78 used in the analysis) and 4 weeks (n = 24 used in the analysis) after initiating treatment. Patients reporting clinical improvement each contributed a single data point categorized as no change (n = 41), minimal improvement (n = 30), or marked improvement (n = 31) via a validated anchor-based approach. We calculated the MCID as the mean change score for each outcome measure in the minimal improvement group. Results The MCID (95% confidence interval) for the DASH was 10 (5–15). The MCID for the QuickDASH was 14 (9–20). The MCID was 14 (8–20) for the PRWE. The MCID values were significantly different from changes in these outcome measures at times of either no change or marked improvement. The MCID values positively correlated with baseline outcome measure scores to a greater degree than final outcome measure scores. Conclusions Longitudinal changes on the DASH of 10 points, on the QuickDASH of 14 points, and on the PRWE of 14 points represent minimal clinically important changes. We recommend application of these MCID values for group-level analysis when conducting research and interpreting data examining groups of patients as opposed to assessing individual patients. These MCID values may provide a basis for sample size calculations for future investigation using these common patient-rated outcome measures. Type of study/level of evidence Diagnostic III.
SEDIMENTATION RATE OF CELLS IN METAPHASE AS COMPARED WITH CELLS IN INTERPHASE.

IN recent years there has been considerable interest in the study of the chromosome complement of malignant tumours. In most of these investigations culture techniques have been utilized. Direct methods of study have an advantage in that there can be no questions of selection of particular clones that happen to proliferate better in in vitro conditions. Direct methods have worked well in examination of bone marrow and neoplastic effusions. However, study of solid neoplasms has been hampered by the fact that usually only a few metaphases suitable for karyotyping can be obtained from any given tumour.
Going beyond the kidney disease outcomes quality initiative: hemodialysis access experience at Kaiser Permanente Southern California.

In 1996, as part of Kaiser Permanente Southern California's participation in the Medicare End-Stage Renal Disease Managed Care Demonstration Project, a multidisciplinary continuous quality improvement (CQI) committee was formed, which included nephrologists, vascular surgeons, interventional radiologists, care managers, a renal quality-improvement nursing director, and renal program administrators. The goal of this report was to analyze the impact of this CQI program on hemodialysis outcomes within the organization. Kaiser Permanente is a national, integrated, nonprofit, staff model health maintenance organization with 8 million members. The southern California region has 3.1 million members and currently manages the health care of 3,700 hemodialysis patients, 300 peritoneal dialysis patients, and 1,000 kidney transplant patients. Thirty-one vascular surgeons and 29 interventional radiologists provide for their hemodialysis access needs. The Kidney Disease Dialysis Outcomes Quality Initiative (K/DOQI) guidelines were adopted, as well as measures to perform more venous transpositions and less common arteriovenous fistulas (AVFs) before graft placement. The outcomes assessed included incidence and prevalence of AVFs, grafts, and catheters; replacement access with AVFs; and combined AVF and graft thrombosis episodes per patient per year. Primary AVF incidence rates increased from 27% in 1997 to 88% in 2003. AVF prevalence rates increased from 30% in 1997 to 62% in 2003. Replacement access which is an AVF increased from 26% in 1998 to 58% in 2003. Yearly thrombosis episodes/patient decreased from 0.62 in 1998 to 0.34 in 2003. Catheter usage as of 2003 comprised an incidence of 65% and prevalence (≥90 days) of 13%, which was essentially unchanged from 1999, despite improvements in fistula usage and thrombosis rate. The rate of AVF prevalence can be increased dramatically, exceeding the 40% K/DOQI recommendation, by using the CQI process. Increased prevalence of AVF is associated with a lower yearly incidence of thrombosis episodes/patient. Reducing excessive catheter usage appears to be a more difficult problem.
Effect of exotic S=+1 resonances on K 0 L p scattering data

We consider the effect of an exotic $S=+1$ ${\ensuremath{\Theta}}^{+}$ resonance on the scattering of neutral kaons off protons. Explicit results are presented for the ${K}_{L}^{0}p$ total cross sections.
Cardinal interpolation and spline functions VII. The behavior of cardinal spline interpolants as their degree tends to infinity

Let F(x) be a function from ℝ to ℂ and let $$S_m \left( x \right)\, = \,\sum\limits_{ - \infty }^\infty {F\left( \nu \right)L_m \left( {x - \nu } \right)}$$ (1) be the spline function of degree 2m−1, with knots at the integers, that interpolates F(x) at all the integers. We know that S m (x), as defined by (1), exists if F(x) grows at most like a power | x |γ as x → ± ∞ (see [7]). Here we investigate conditions which will insure that S m (x) will converge to F(x) as m → ∞.
Cellulase gene expression in ripening avocado fruit: the accumulation of cellulase mRNA and protein as demonstrated by cDNA hybridization and immunodetection

A cDNA library was constructed from poly(A)(+)RNA of ripe avocado fruit. Colony hybridization identified a number of ripening specific clones of which one, pAV5, was shown to be specific for cellulase. Hybrid selection with pAV5 provided a message from ripe fruit that on in vitro translation yielded a polypeptide of 53kD, comigrating with purified avocado cellulase on SDS polyacrylamide gel electrophoresis. The translation product was selectively immunoprecipitated by antiserum to purified avocado cellulase. Immunoblotting of unripe and ripe avocado fruit extracts following SDS-PAGE showed a plentiful immunoreactive polypeptide in ripe fruit, and essentially none in unripe fruit. Hybridization of pAV5 to poly(A)(+)-RNA from unripe and ripe avocado fruit demonstrated that there is at least a 50-fold increase in the cellulase message concentration during ripening. Thus, the expression of cellulase enzyme activity during ripening is regulated by the appearance of mRNA coding for cellulase rather than by either translational or post-translational control mechanisms.
The Non-Diagnostic Sherd Problem: Lessons from Jeddito Yellow Ware Typology

Although ceramic types are applied most commonly to sherds (simply because of their abundance), most typologies have been derived at least in part from patterns of attribute covariation on whole vessels. As a result, one typological concern is the “non-diagnostic sherd problem,” where only a fraction of the sherds deriving from a whole vessel share all of the attributes of that vessel. This paper assesses the severity of the non-diagnostic sherd problem for Jeddito Yellow Ware polychrome sherds, demonstrating that it may cause up to half of the sherds from some polychrome vessels to be incorrectly typed. Implications for chronology and social dynamics are discussed, and a preliminary correction for the non-diagnostic sherd problem is offered.
Partial life tables for the red pine shoot moth, Dioryctria resinosella (Lepidoptera: Pyralidae), in Wisconsin red-pine plantations

Partial life tables were prepared for the red pine shoot moth, Dioryctria resinosella Mutuura, in three red-pine, Pinus resinosa Aiton, plantations in central Wisconsin during a period of shoot-moth population decline. Survivorship in the early instars ranged from 72–78% in 1982 and from 22–75% in 1983. In the fifth instar, survivorship ranged from 0–4% in 1982 and 0–31% in 1983. Pupal numbers were very low both years and survivorship was variable; it ranged from 0–100%. Phrynofrontina sp., Exeristes comstockii (Cresson), Bracon rhyacioniae (Muesebeck), Hyssopus rhyacioniae (Gahan), and Elachertus sp. were parasitoids present in high numbers. B. rhyacioniae caused the greatest impact on shoot-moth populations, particularly in the fifth instar. Heavy fifth-instar mortality appeared related to shoot-moth population declines. However, mortality in other life stages not included in the partial life tables, such as dispersing early instar larvae, possibly were involved.
Performance prediction of dynamic component substitutions

The Web-based Environment for Systems Engineering (wese) is a Web-based modeling and simulation environment in which the level of abstraction of a model can be configured statically (prior to simulation) or dynamically (during simulation) by substituting a module (set of components) with an equivalent component or vice versa through a process called dynamic component substitution (DCS). DCS can considerably improve the overall efficiency of simulations by enabling dynamic tradeoffs between several modeling and simulation related parameters. However, identifying ideal sequence of DCS is a complicated task. This paper proposes a novel methodology called DCS performance prediction methodology (DCSPPM) to identify ideal sequences of DCS. DCSPPM utilizes estimates of the changes induced by each atomic DCS along with model characteristics to predict the changes induced by a combination of substitutions. Our studies indicate that the proposed methodology provides good estimates (maximum error <8%) of the changes induced by DCS.
College Students' Perceptions About the Plausibility of Human-Induced Climate Change

Overcoming students’ misconceptions may be a challenge when teaching about phenomena such as climate change. Students tend to cite short-term weather effects as evidence to support or refute long-term climate transformations, which displays a fundamental misunderstanding about weather and climate distinctions. Confusion about weather and climate may also reflect student misunderstanding about deep time, a concept that spans several scientific content areas. This study examines the relationships between students’ understanding of deep time and their understandings of the distinctions between weather and climate, as well as how these understandings influence students’ perceptions about the plausibility of human-induced global climate change. Undergraduate students enrolled in an introductory science class on global climate change completed measures of their (a) understanding of distinctions between weather and climate, (b) knowledge of deep time, and (c) plausibility perceptions of human-induced climate change, both at the beginning and end of the course. The study includes comparison groups of similar students enrolled in introductory physical geography classes. Results revealed that greater knowledge of deep time and increased plausibility perceptions of human-induced climate change provide significant explanation of variance in students’ understanding of weather and climate distinctions. Furthermore, students achieve significantly increased understanding of weather and climate, even with brief instruction.
Cancer prevention: epigenetics steps up to the plate.

The fields both of cancer prevention and epigenetics have matured to a point where their intersection deserves sustained attention. There now is strong evidence for an epigenetic component of early neoplasia, and data on the cancer preventive properties of epigenetic modulation are emerging. With
Two-Phase Transients of Polymer Electrolyte Fuel Cells

A three-dimensional transient model fully coupling the two-phase flow, species transport, heat transfer, and electrochemical processes was developed to study the dynamics of gas-diffusion layer GDL dewetting and its impact on polymer electrolyte fuel cell performance. It was found that the dewetting of fuel cells by dry gas is characterized by several regimes of different time constants. These regimes can be classified by through-plane drying vs in-plane drying as well as by the differing water diffusivity in the anode and cathode. The water diffusivity in the anode GDL is several times larger than that in the cathode, therefore the anode side undergoes faster water loss to the dry gas stream. In addition, the land hampers the diffusive transport of water, therefore the liquid water tends to be trapped under the land and the water loss there starts only after through-plane drying of the GDL under the channel is completed. The different time constants of various dewetting regimes also affect the evolution of cell voltage due to the ohmic loss in the membrane. In addition, theoretical solutions are developed for the in-plane and through-plane drying regimes, and show good agreement with the numerically predicted time scales. © 2007 The Electrochemical Society. DOI: 10.1149/1.2734076 All rights reserved.
Melt immiscibility in crosslinked polyethylene

Low density polyethylene crosslinked by decomposition of dicumyl peroxide shows evidence for two thases being present in the melt in a narrow temperature range just above the melting point. The effect has been studied in detail using differential scanning calorimetry, transmitted light intensity, and wide angle X-ray diffraction studies at 107 o C. It is believed that the effect is caused by the presence of relatively low molecular weight molecules which remain as an extractable fraction after crosslinking
NF-kappaB activation mediates the response of a subpopulation of basal uroepithelial cells to a cell wall component of Enterococcus faecalis.

Earlier in vitro studies revealed that treatment of basal urothelial cells (UT) with lipoteichoic acid, a cell wall component of Enterococcus faecalis (LT-2), stimulated a subpopulation of quiescent cells with high proliferative potential to divide (Elgavish et al., 1996b, J Cell Physiol 169:42-51). Studies were consistent with the possibility that NO-mediated mechanisms were involved (Elgavish et al., 1996c, J Cell Physiol 169:66-77). We postulated that LT-2 may upregulate expression of iNOS. Promoters of the gene encoding iNOS, as well as genes encoding many cytokines, contain elements homologous to consensus sequences for the binding of the transcription factor NF-kappaB. Based on this, we postulated that: (1) NF-kappaB activation is an early event following exposure of basal UT to LT-2 and (2) NF-kappaB activation mediates basal UT proliferation triggered by LT-2. To test these hypotheses, UT maintained for 3 days under growth-restricting conditions, were treated with or without 25 microg/ml LT-2. Nuclear distribution of NF-kappaB, that is, activated NF-kappaB, was detected by immunofluorescence microscopy in a subpopulation of basal UT as early as 5-10 min after the beginning of the treatment. In contrast, LT-2 had no effect on cultures containing more differentiated UT. NF-kappaB activation preceded production of NO, since treatment with 25 microM hemoglobin, a potent inactivator of NO, did not prevent LT-2-triggered NF-kappaB activation. Treatment with 10 microM pyrrolidine dithiocarbamate (PDTC) inhibited LT-2-triggered activation of NF-kappaB and prevented the stimulatory effect of LT-2 on proliferation of basal UT. These findings support the possibility that NF-kappaB activation mediates basal UT proliferation triggered by LT-2.
Hierarchical Multialgorithm Parallel Circuit Simulation

The emergence of multicore and many-core processors has introduced new opportunities and challenges to electronic design automation research and development. While the availability of increasing parallel computing power holds new promise to address many challenges in computer-aided design (CAD), the leverage of hardware parallelism can only be possible with a new generation of parallel CAD applications. In this paper, we propose a novel hierarchical multialgorithm (MA) parallel circuit simulation approach and its multicore implementation to expedite one of the most fundamental CAD applications: transistor-level transient circuit simulation. In our parallel circuit simulation approach, we create two levels of parallelism. At the higher level of parallelism, we start multiple simulation algorithms in parallel for a given simulation task. Interalgorithm communication is established to enable simulation algorithms to exchange useful information so that they could advance faster than without doing so. At the lower level of parallelism, each algorithm within the MA framework utilizes fine-grained parallel techniques such as parallel device evaluation and parallel matrix solve to fully harness the available hardware resources. By combining the two levels of parallelism, the computing power of the multicore or many-core processor platforms can be fully utilized to achieve superlinear speedup in circuit simulation.
The Prevention of Dental Caries: Ten Years Later

The program of the National Caries Program of the National Institute of Dental Research toward finding ways to prevent caries on a widespread basis is assessed.
Primate evolution — in and out of Africa

A synthetic analysis of molecular, fossil and biogeographical data gives a remarkably consistent scenario for the evolution of the catarrhine primates - the hominoids and Old World monkeys. This analysis supports the African location of the common ancestor of the Old World monkeys, and suggests that the Asian colobine monkeys and macaques dispersed out of Africa into Eurasia within the past ten million years. More interestingly and controversially, this analysis further suggests that the lineage leading to the living hominoids dispersed out of Africa about twenty million years ago, and that the common ancestor of the living African apes, including humans, migrated back into Africa from Eurasia within about the past ten million years.
Isolation and Properties of Aromatic α-Keto Acid Reductase

Abstract An enzyme which catalyzes the reduction of aromatic α-keto acids to phenyllactic acids has been isolated from beef and dog heart. This enzyme has been designated aromatic α-keto acid reductase. Reduced diphosphopyridine nucleotide is a required cofactor for aromatic α-keto acid reductase activity. Substrates for aromatic α-keto acid reductase include 3,5-diiodo-p-hydroxyphenylpyruvic acid, p-hydroxyphenylpyruvic acid, and phenylpyruvic acid. 3,5-Diiodo-p-hydroxyphenylpyruvic acid has a high affinity for the enzyme (Km of 4.3 x 10-5 m). The enzyme is present in many mammalian tissues. These include heart, skeletal muscle, kidney, adrenal, liver, thyroid, and blood.
Compact Energy Absorbing Structure: A Finite Element Study

Energy absorption is becoming a challenging issue in various applications. Progressively increasing demand of crash protection systems in the arena of public safety is advocating the need for more superior energy absorbing materials and structures to meet the stringent design requirements for alleviating the impact damages. In this paper, a novel structure is presented that absorbs the impact energy by undergoing a systematic stepwise crushing process that results in the mitigation of the impact damages. The structure's geometry is observed in a banana peel that contains a graded cellular packing that allows the peel to protect the internal soft core from the external impacts. The structure is reproduced in a solid section and the energy absorbing characteristics of the section with and without the graded structure are studied by means of finite element simulations using ABAQUS. The graded section exhibits better energy absorbing characteristics over a solid section.
Strain Rate and Temperature Effects on Tensile Properties and Their Representation in Deformation Modeling of Vinyl Ester Polymer

This paper discusses the effects of strain rate and temperature on tensile properties and stress-strain behavior of vinyl ester polymer. Tensile strength and modulus were found to increase linearly with the log of strain rate, and decrease linearly with increasing temperature. Ramberg-Osgood and Menges models were used and extended to describe the strain rate and temperature dependency of the stress-strain behavior. The extended Menges model provided better representation of the observed behavior compared to the Ramberg-Osgood model for a wide range of temperatures and strain rates. Mechanical properties obtained from flexure tests are also presented and compared to tensile data.
Lessons from the lysozyme of phage T4

An overview is presented of some of the major insights that have come from studies of the structure, stability, and folding of T4 phage lysozyme. A major purpose of this review is to provide the reader with a complete tabulation of all of the variants that have been characterized, including melting temperatures, crystallographic data, Protein Data Bank access codes, and references to the original literature. The greatest increase in melting temperature (Tm) for any point mutant is 5.1°C for the mutant Ser 117 → Val. This is achieved in part not only by hydrophobic stabilization but also by eliminating an unusually short hydrogen bond of 2.48 A that apparently has an unfavorable van der Waals contact. Increases in Tm of more than 3–4°C for point mutants are rare, whereas several different types of destabilizing substitutions decrease Tm by 20°C or thereabouts. The energetic cost of cavity creation and its relation to the hydrophobic effect, derived from early studies of “large-to-small” mutants in the core of T4 lysozyme, has recently been strongly supported by related studies of the intrinsic membrane protein bacteriorhodopsin. The L99A cavity in the C-terminal domain of the protein, which readily binds benzene and many other ligands, has been the subject of extensive study. Crystallographic evidence, together with recent NMR analysis, suggest that these ligands are admitted by a conformational change involving Helix F and its neighbors. A total of 43 nonisomorphous crystal forms of different monomeric lysozyme mutants were obtained plus three more for synthetically-engineered dimers. Among the 43 space groups, P212121 and P21 were observed most frequently, consistent with the prediction of Wukovitz and Yeates.
Experimental study of a diffraction reflector

A microwave antenna has been designed and constructed on the principles of parageometric optics formulated by Toraldo di Francia and on principles similar to those of Fresnel rings and the diffraction grating. Its surfaces are all zones of cones and are simple to construct. The chosen design parameters were incorporated in two K -band ( \lambda = 1.24 cm, \lambda = 1.22 cm) models. Experimental results show good agreement with theory. Scanning characteristics are superior to those of the paraboloidal or spherical reflector, and spherical aberration and coma are minimized, and the effects of astigmatism are minimized by using a "compromise focus."
Some approaches and paradigms for verifying and validating simulation models

In this paper we discuss verification and validation of simulation models. The different approaches to deciding model validity are described, two different paradigms that relate verification and validation to the model development process are presented, the use of graphical data statistical references for operational validity is discussed, and a recommended procedure for model validation is given.
A trade-investment model for distribution of wealth

Econophysics provides a strategy for understanding the potential mechanisms underlying the anomalous distribution of wealth found in real societies. We present a computational nonlinear stochastic model for the distribution of wealth that depends upon three parameters and two mechanisms: trade and investment. To avoid economic paradoxes, the trade mechanism is assumed to be related to the poorer trader’s wealth and to statistically advantage the poorer of the two traders. The two mechanisms together are shown to generate a distribution that reproduces the full range of the empirical wealth distribution, and not only the inverse power-law tail that Pareto found in western societies at the end of the 19th century.
Aerobic Fitness and Cognitive Development: Event-Related Brain Potential and Task Performance Indices of Executive Control in Preadolescent Children

The relationship between aerobic fitness and executive control was assessed in 38 higher- and lower-fit children (M-sub(age) = 9.4 years), grouped according to their performance on a field test of aerobic capacity. Participants performed a flanker task requiring variable amounts of executive control while event-related brain potential responses and task performance were assessed. Results indicated that higher-fit children performed more accurately across conditions of the flanker task and following commission errors when compared to lower-fit children, whereas no group differences were observed for reaction time. Neuroelectric data indicated that P3 amplitude was larger for higher- compared to lower-fit children across conditions of the flanker task, and higher-fit children exhibited reduced error-related negativity amplitude and increased error positivity amplitude compared to lower-fit children. The data suggest that fitness is associated with better cognitive performance on an executive control task through increased cognitive control, resulting in greater allocation of attentional resources during stimulus encoding and a subsequent reduction in conflict during response selection. The findings differ from those observed in adult populations by indicating a general rather than a selective relationship between aerobic fitness and cognition.
Reducing compensatory motions in video games for stroke rehabilitation

Stroke is the leading cause of long-term disability among adults in industrialized nations; approximately 80% of people who survive a stroke experience motor disabilities. Recovery requires hundreds of daily repetitions of therapeutic exercises, often without therapist supervision. When performing therapy alone, people with limited motion often compensate for the lack of motion in one joint by moving another one. This compensation can impede the recovery progress and create new health problems. In this work we contribute (1) a methodology to reliably sense compensatory torso motion in the context of shoulder exercises done by persons with stroke and (2) the design and experimental evaluation of operant-conditioning-based strategies for games that aim to reduce compensatory torso motion. Our results show that these strategies significantly reduce compensatory motions compared to alternatives.
Building a culture of health: challenges for the public health workforce.

Health and health care have reached a pivotal point in the U.S. For generations, Americans’ health has been unequally influenced by income, education, ethnicity, and where people live. Healthcare systems have operated largely apart from each other and from community life. The definition of health has been “not needing to seek health care,” rather than the broader public health view that all aspects of our lives—in our work, families, and communities—should support active and healthy living. Today, however, the world is changing and the education, training, and practice strategies of the public health workforce must adapt to these changes. This requires new skills and perspectives, some of which are presented in papers in this special issue. A growing number of communities, regions, and states are working to redefine what it means to get and stay healthy by addressing social and physical spaces and conditions in which people live, learn, work, and play—the social, environmental, and economic determinants of health. Demographics are shifting, especially in terms of the U.S. population’s age, ethnic diversity, and education levels. Workforce constraints and financial pressures, along with the requirements of federal healthcare reform, are changing who has access to care, how care is paid for and delivered, and how patients and providers interact. Coordinated efforts to promote wellness and prevent disease are proliferating among a diverse set of stakeholders, including organizations that are traditionally “non-health” focused. Providers of personal health services are connecting with their public health colleagues and multiple levels, and “big data”—large, varied data sets that are available in real or almost-real time—make it possible to analyze health patterns in unprecedented ways to gain a clearer picture of the actionable determinants, trends, and outcomes of societal health and well-being. These developments in health and society present a window of opportunity for real societal transformation and an imperative for public health professionals to
A Review of Entrepreneur.com and Inc.com

A popular topic in entrepreneurial research is the identifying the characteristics and traits of entrepreneurs. Entrepreneurship research focuses a considerable amount of energy on uncovering and u...
Consumers preferences by choice of retail store

Working of new rising bigsquare stores of domestic and foreign distribution descriptors evocate through its expressively diverse quality of foodstuff distribution the rise of new shopping consumers manners. How is consumers behavior developing in selected region in the Czech Republic? It was a main subject of marketing researches in years 1997·2001. Among the factors, which influence consumers choice of supermarkets is price, assortment, comfortable shopping and opening hours. At the local stores the consumer appreciate its accessibility from view of time as well as a distance, first he buys here the fresh goods of daily consumption and he appreciate good relations with stuff. The marketing research about meaningful factors influencing decision of store choice evidenced, that on the consumers foodstuff market in the South bohemian region henceforth will have their own place both bigsquare stores involved in big distribution descriptors and local stores under assumption of fitting diversity of services and assortment.
Bacterial allergy increases susceptibility to influenza virus in mice.

SummaryExperiments with mice indicate that hypersensitivity induced by the H. pertussis antigen can increase susceptibility to influenza virus influenza virus.
Benign Infantile Convulsions

The clinical features of 58 patients with benign infantile convulsions (BIC), seen at the Department of Pediatrics, University of Bologna, Italy, over a 20 year-period (1983-2003), are reviewed retrospectively, with reference to both familial and nonfamilial cases.
Pediatric Lifestyle Medicine

Pediatric lifestyle medicine encompasses key aspects of preventive medicine, which is at the heart of pediatric care. Lifestyle choices are important determinants of health outcomes. Key components of preventive health care include optimal nutrition, maintaining an appropriate weight, developing an active lifestyle, and avoidance of tobacco, alcohol, and other substances of abuse. In addition, reduction of risk behaviors through incorporation of safe health habits is important. Incorporation of the tenets of pediatric lifestyle medicine by pediatricians and other primary care providers of infants, children, and adolescents will promote a healthier population, prevent disease and disability, and ultimately decrease health care costs and use of health care resources. Communities, including school systems, must also embrace concepts of pediatric lifestyle medicine.
Outgrowth of Clostridium botulinum in Shredded Cabbage at Room Temperature Under a Modified Atmosphere

The ability of Clostridium botulinum types A and B spores to grow and produce toxin in shredded cabbage at room temperature under a modified atmosphere was investigated. Seven type A and seven type B strains of C. botulinum , mostly of vegetable origin, were used as inocula. Shredded cabbage in high barrier bags, 250 g/bag, was inoculated with various numbers of spores, sealed under a modified atmosphere of 70% CO2 and 30% N2 and incubated at room temperature. Duplicate bags were examined for organoleptic acceptability and the presence of toxin from day 3 by blending the entire contents of each bag and injecting mice with dilutions of the extracts. Toxic extracts were typed with appropriate antitoxins. Only type A spores grew and produced toxin in the cabbage. An inoculum of approximately 100-200 type A spores/g of cabbage, whether in single strains or in various combinations, produced toxin on days 4, 5, and 6, while the cabbage was still organoleptically acceptable, as determined by appearance, odor, and texture.
Environment and Social Psychology: A Good Nexus

On the cusp of growth and development, humanity confronts a crisis of confidence. Dualities of success and catastrophes abound. A deadly drought in Texas, followed by devastating floods in Austin and Dallas, Texas is not a freaky natural calamity. Human complicity is both hidden and underrated. Paradox of boom and gloom characterize the crisis of biodiversity compounded by environmental injustice.
Treatment of hypertension with orthostatic hypotension confusion

The prevalence of hypertension has increased greatly worldwide.Blood pressure controlling has been confirmed to be the effective measure for decreasing cardiovascular disease.Orthostatic hypotension(OH) has been associated with hypertension as well as antihypertensive drugs.The combination of hypertension and OH has been recognized as a common phenomenon in aged people.OH can cause fall,syncope and other low-perfusion symptoms.Asympomatic OH has predicted independently increased risk of cardiovascular disease.For hypertensive patients,how could the clinicians control the older people's blood pressure to target level but at the same time refrain from the associated adverse events OH? For patients with combined hypertension and OH,what is the optimal or ideal level of blood pressure? These problems are common dilemma faced by clinicians in clinical practice.
On Being "Just" a Follower: Rejecting the Pejorative and Pursuing a Higher Calling

The world has many more followers than leaders, but most of the attention is focused on the leaders, with followers considered passive, easily manipulated, and in need of both direction and motivation. Scripture, however, reassures us that being a follower is a worthy and even honored position. Despite this assurance, a follower is not excused from becoming a virtuous person, even if the leader is not virtuous. Using the writings of both Aristotle and the Apostle Paul, this article discusses the necessary virtues and actions a follower should consider, whether currently a follower or a developing leader.
THE PREDICTIVE MEANS OF GAS INJECTING DISPLACEMENT FRONT LOCATION AND APPLICATION

When the gas reservoir adopts commingling production,production compartment is the key.How to make use of geologic parameter and production data is important to carve up production and then to study the dynamics of gas reservoir.Conventional method always makes use of some geologic parameters such as net pay thickness,effective permeability,etc.to analyze,and seldom consider the pressure.Based on the bi-layer model without inter-flow between layers,using numerical simulation,according to thepressure and physical property of gas reservoirs,the equation is derived for multiple-zone(selective zone) production of multi-layered gas reservoir.Real case indicates that this new method can be used to production dividing of multi-layered gas reservoirs.
0134 Reviewing the impact of a one-day fully immersive simulation faculty development course

Background/context Faculty development is critical to the success of any simulation program. 1 The Centre for Simulation and Patient Safety (CSPS) has designed a one-day course for participants interested in developing teaching and facilitation skills in high fidelity simulation. This involved ‘hands on’ workshops on mannequin set up, control, scenario facilitation and design. This formed the start of a ‘hub-and-spoke’ model for supporting faculty development. Methodology To review the impact of the course on the participants, we devised a questionnaire. This was emailed to 60 participants who attended 4 courses between July 2013 and October 2014. Questions reviewed motivation to attend and their simulation experience after the course. We also investigated why participants hadn’t pursued their interest. Results/outcomes 24/60 participants replied to the questionnaire. 13/24 were Anaesthetists, 9/24 were Consultants. 15/24 attended the course with the intention of teaching simulation at CSPS. 9/24 intended to develop skills and teaching of simulation within their own hospital. Since attending the course only 15/24 have taught on simulation courses, 10/15 have taught at CSPS. Those who have taught at CSPS have taught 3 times or less. 78% stated difficulties due to work commitments and would be encouraged to develop their skills if they had ‘greater support’, ‘further exposure to simulation’ and ‘regular updates’. Conclusions and recommendations Despite attending a one-day faculty development course many have found it difficult to continue their interest due to work/time restrictions and requirements to attend other courses. This could be overcome by allowing fully immersive simulation instruction sessions to be included in clinician’s job plans. Participants developing simulation within their own hospital have taken advantage of the ‘hub-and-spoke’ model offered by CSPS as part of their faculty development program. Reference Waxman KT, Telles CL. The use of Benner’s framework in high-fidelity simulation faculty development: The Bay Area Simulation Collaborative model. Clin Simulat Nurs. 2009;5:e231–e235
Surgical Correction of Peyronie’s Disease: The Nesbit Procedure

AbstractSurgical therapy for the correction of Peyronie’s disease is indicated in patients with severe and chronic penile curvature that does not respond to conservative therapy and that is severe enough to prevent sexual intercourse. The penile prosthesis has been shown to be an effective treatment in patients with associated erectile impotence. However, there is disagreement regarding the procedure of choice in patients with Peyronie’s disease and adequate erectile function. Because of the inconsistent results reported for grafting techniques, we used the Nesbit procedure in 12 patients with adequate erectile capacity distal to the plaque. Eleven patients reported satisfactory intercourse postoperatively with excellent anatomical results.
Compulsory treatment of substance use disorders

Substance use disorders are the cause of significant suffering for individuals and impose a tremendous burden on society in terms of related social costs. Current drug policy in the USA has failed to have a significant impact on the prevalence or the deleterious effects of this group of illnesses. Crime, violence, family disruption and economic displacement are felt most acutely by already impoverished and disadvantaged communities. The need for a public health approach to these problems rather than a law enforcement solution, is discussed with special attention to compulsory drug use treatment approaches. These approaches are considered in the context of their history and effectiveness through a review of current literature. The positive and negative aspects of compulsory treatment approaches are summarised and recommendations for expanded use of treatment options for clients involved with the criminal justice system are elaborated.
The Quality/Cost/Value Relationship

The cost of healthcare in the United States is growing at a rate that is non-sustainable given its percentage of the gross domestic product. This is in the setting of poor quality as defined by preventable mortality, access to care and equitable and efficient care delivery measured relative to other nations. Given the potential significant growth in individuals requiring healthcare, emphasis must be placed on the improvement in the value of care delivery. In order to improve the value, quality must be improved, or cost/or volume must be reduced in order to effect the value = quality/cost equation. The cost of quality theoretical model will be reviewed to understand how this has evolved as we move through the quality improvement era. Mechanisms to improve quality and cost including value stream analysis, value on investment and the use of interdisciplinary teams to improve the value of healthcare delivery will be examined.
Dialectics and the Megamachine: A Critique of Ersatz Education

ABSTRACTThis article proposes that the learning environment matters, and that there are qualitative differences in online versus face-to-face classes. While online education provides some benefits, they also narrow the opportunities for dialectical conflict that thoroughly challenge student thinking, an interaction more likely to be found in real-time conversations. In person, there is more opportunity for an instructor to challenge the reasoning of students in real time, and for students to ask probing and follow-up questions. The article considers the structure of educational dialectic suggested by important thinkers including Galtung, Habermas, and Buber. Online education is then situated as a technology that interferes with human relations and dialectical reasoning and fits within the notion of technics and the megamachine advanced by Lewis Mumford, which dehumanizes personal interactions with instrumental processes for growth and efficiency. Students follow suit by focusing more on the instrumental a...
RCT utilizing acupuncture for management of insomnia associated with cancer.

e20572 Background: Acupuncture is widely used by cancer patients and survivors for management of side effects. However, the empirical evidence supporting the efficacy of acupuncture for these sympt...
Evolution of ribozymes in the presence of a mineral surface

Mineral surfaces are often proposed as the sites of critical processes in the emergence of life. Clay minerals in particular are thought to play significant roles in the origin of life including polymerizing, concentrating, organizing, and protecting biopolymers. In these scenarios, the impact of minerals on biopolymer folding is expected to influence evolutionary processes. These processes include both the initial emergence of functional structures in the presence of the mineral and the subsequent transition away from the mineral-associated niche. The initial evolution of function depends upon the number and distribution of sequences capable of functioning in the presence of the mineral, and the transition to new environments depends upon the overlap between sequences that evolve on the mineral surface and sequences that can perform the same functions in the mineral's absence. To examine these processes, we evolved self-cleaving ribozymes in vitro in the presence or absence of Na-saturated montmorillonite clay mineral particles. Starting from a shared population of random sequences, RNA populations were evolved in parallel, along separate evolutionary trajectories. Comparative sequence analysis and activity assays show that the impact of this clay mineral on functional structure selection was minimal; it neither prevented common structures from emerging, nor did it promote the emergence of new structures. This suggests that montmorillonite does not improve RNA's ability to evolve functional structures; however, it also suggests that RNAs that do evolve in contact with montmorillonite retain the same structures in mineral-free environments, potentially facilitating an evolutionary transition away from a mineral-associated niche.
Cancer Stem Cells: An Innovative Therapeutic Approach

Cancer stem cells (CSCs) are gaining prominence in oncology. The characterization of the molecular phenotype of CSCs or “cancer cell-like stem cells” can clarify several intriguing and obscure aspects of cancer pathophysiology (e.g., cancer cell dormancy, chemoresistance, and metastasis) and could represent a fundamental advance in terms of early diagnosis and selective therapy for cancer. Moreover, understanding the underlying pathogenetic mechanisms of CSCs can expand the therapeutic applications of normal adult stem cells by reducing the risk of disordered uncontrolled and potentially tumorigenic stem cell differentiation. An explosion of emerging therapeutic and diagnostic options for cancer treatment that selectively target CSCs has occurred in recent years. These include the targeting of cell surface proteins, various activated signaling pathways, different molecules of the stem cell niche, and various drug resistance mechanisms. Importantly, approaching cancer research by investigating the pathogenesis of these intriguing cancer cells is increasing the knowledge of the pathophysiology of the disease, emphasizing certain concepts and molecular mechanisms that have been partially neglected and facilitating the understanding of a global vision of complex cancer cell biology.
Right and left ventricular 24-segment sphericity index is abnormal in small-for-gestational-age fetuses.

OBJECTIVE Fetuses with growth restriction have been reported to have an abnormal sphericity index (SI), which is indicative of the shape of the ventricular chambers of the heart. Our aim was to evaluate the SI for 24 transverse segments distributed from base to apex of the right (RV) and left (LV) ventricles to determine whether, in small-for-gestational-age (SGA) fetuses, the SI is abnormal at locations other than the basal segment. METHODS We evaluated 30 SGA fetuses between 25 and 37 weeks of gestation. SI was computed for both ventricles by dividing the end-diastolic mid-basal-apical length by each of 24 end-diastolic transverse segmental widths, from base (Segment 1) to apex (Segment 24). For each ventricle, the Z-score and centile for the SI from each of the 24 segments were computed using the mean and SD from published equations. The 24-segment method, defining abnormal SI as values 90th centile, was compared with that of using only the basal segment by chi-square analysis to determine the number of fetuses identified with an abnormal SI. RESULTS In 23 of the 30 (77%) SGA fetuses, at least one of the 24 transverse segments in one or both ventricles had an abnormal SI; in 17% of cases, both ventricles were affected, in 23% of cases only the RV was involved and in 37% of cases only the LV was involved. Compared with the 24-segment model, significantly fewer fetuses with an abnormal SI were identified using only basal Segment 1, from the RV base (58%, 7/12; P < 0.01) or only Segment 12, in the mid portion of the RV (50%, 6/12; P < 0.005). Combining measurements of Segment 1 and Segment 12 from the RV identified 83% of fetuses with at least one abnormal SI and was not significantly different from using the 24-segment model. Similarly, significantly fewer fetuses with an abnormal SI were identified using only LV basal Segment 1 (63%, 10/16; P < 0.006) or only Segment 12, in the mid portion of the LV (75%, 12/16; P < 0.03), when compared with the 24-segment model. Combining measurements of both LV Segment 1 and Segment 12 identified 81% (13/16) of fetuses with an abnormal SI and was not significantly different from using the 24-segment model. CONCLUSION The 24-segment SI of RV and LV provides a comprehensive method with which to examine the shape of the ventricular chambers and identifies more SGA fetuses with an abnormal SI than are identified using only the basal segment SI. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
Case Report: An Unusual Presentation of Kawasaki Disease

This disease is typically seen as a systemic vasculitis in children. Characteristics include sore throat, fever of unknown etiology, upper body rash, and may have more serious involvement of the ao...