cssi/SciSciGPT-SciSciNet huggingface dataset:
The Effects of Delays in Diagnosis and Surgical Reconstruction of ACL Tears in Skeletally Immature Individuals on Subsequent Meniscal and Chondral Injury.

Background Although studies have shown increased rates of chondral injury with delayed surgical treatment of pediatric anterior cruciate ligament (ACL) injuries, it is unknown if this is related to a delay in diagnosis and appropriate activity restrictions. The purpose of this study was to determine if the time from injury to diagnosis, time from diagnosis to reconstruction, and preoperative activity level correlate with the degree of cartilage injury seen intraoperatively. Methods A retrospective review of skeletally immature patients who underwent ACL reconstruction was performed. Patients were stratified based on the time from injury to diagnosis (≤6 vs. >6 wk), diagnosis to surgery (≤6 vs. >6 wk), and injury to surgery (≤12 vs. >12 wk). Weight-bearing status, brace usage, athletic participation, and meniscus tears were characterized as binary variables. Articular cartilage injury was graded on a scale of 0 to 3. Differences between groups were analyzed using the χ test. Results In total, 91 subjects with mean age of 13 years (range, 9 to 16 y) were included. In total, 71% were diagnosed within 6 weeks of injury and 40% underwent surgery within 6 weeks of diagnosis. No differences were found in the presence of medial or lateral meniscus tears or the grade of articular cartilage damage when groups were analyzed by time from injury to diagnosis, diagnosis to surgery, and injury to surgery (P>0.05 in all cases). When stratified by weight-bearing status, brace status, and athletic activity, there were no significant differences between groups for meniscal tears or cartilage injury in any compartment (P>0.05). Conclusions Diagnosis of ACL rupture within 6 weeks of injury and surgical reconstruction within 6 weeks of diagnosis or 12 weeks of injury do not appear to affect the rate of cartilage injury in skeletally immature patients. Weight-bearing status, brace use, and participation in athletic activities between the time of injury and diagnosis also did not impact the rate of intra-articular injury following ACL tear. Level of evidence Level IV.
Disparities in patient portal messaging by hematology and oncology patients.

e17608 Background: Patient portals are online applications that patients utilize to interact with their healthcare information and organizations. Patient portal adoption is increasing, and secure p...
TRAINING OF VERNACULAR TEACHERS IN PRE-INDEPENDENT INDIA IN THE FIRST HALF OF TWENTIETH CENTURY

The development of teacher education had been a continuous process since the beginning of the nineteenth century in British India. The teachers’ training programme of pre-independence period in general could be classified into three categories: training of primary and middle school teachers, training of Anglo-Vernacular teachers for Secondary English schools and training of vernacular teachers. Existence of separate types of training institutions had been found for these three types of training. The development of vernacular teachers’ training in the various provinces of British India during the first half of twentieth century (1900-19470 is discussed in the present paper from a historical point of view.
Streamlined EDSS for use in multiple sclerosis clinical practice: Development and cross-sectional comparison to EDSS:

Background:The Expanded Disability Status Scale (EDSS) is the standard measure of disability in multiple sclerosis clinical trials. The EDSS has limited application in the clinical setting due to r...
Methodological Transactionalism and the Sociology of Education

The development and spread of research methods in sociology can be understood as a story about the increasing sophistication of tools in order to better answer fundamental disciplinary questions. In this chapter, we argue that recent developments, related to both increased computing power and data collection ability along with broader cultural shifts emphasizing interdependencies, have positioned Social Network Analysis (SNA) as a powerful tool for empirically studying the dynamic and processual view of schooling that is at the heart of educational theory. More specifically, we explore how SNA can help us both better understand as well as reconceptualize two central topics in the sociology of education: classroom interaction and status attainment. We conclude with a brief discussion about possible future directions network analysis may take in educational research, positing that it will become an increasingly valuable research approach because our ability to collect streaming behavioral and transactional data is growing rapidly.
Judaism, Philosophy, and the Idea of the West

In contemporary social and political discourse, the concept of “the West” plays a role that is both centrally important and difficult to define. It is most frequently used to designate an entire civilization, in a way that does not quite map onto what is suggested by its first dictionary meaning as a cardinal direction. Deciding what exactly is and is not included under the umbrella of the West, or whether the term usefully describes anything at all, is a daunting normative task involving a series of discrete historical and definitional judgments. For example, is the West defined more by medieval Christendom, or by the subsequent intellectual and spiritual movements that attacked it, such as the Renaissance, Reformation, and Enlightenment? Is it possible or coherent to include all these conflicting movements under the same designation? Geographically, how important is the ancient split between the Latin and Orthodox churches, and does the Cold War-era exclusion of Russia from the West still hold today? Champions of the concept see defending it and the values it stands for as the foremost ideological task of our time, while critics suspect it of being little more than a portentous tribal designation for societies whose heritage happens to be both majority-Christian and majority-white.
Occurrence of right angles in vector spaces over finite fields

Abstract Here we examine some Erdős–Falconer-type problems in vector spaces over finite fields involving right angles. Our main goals are to show that (a) a subset A ⊂ F q d of size ≥ c q d + 2 3 contains three points which generate a right angle, and (b) a subset A ⊂ F q d of size ≥ C q d + 2 2 contains two points which generate a right angle with the vertex at the origin. We will also prove that (b) is sharp up to constants and provide some partial results for similar problems related to spread and collinear triples.
Action Research Experiences for Scholarly Practitioners in an Online Education Doctorate Program: Design, Reality, and Lessons Learned

The purpose of this paper is to present the design and techniques used by the Educational Technology program at the University of South Carolina to prepare scholarly practitioners with action research methods in an online doctoral program. With an emphasis on students’ local contexts, we will describe the design of experiences and our lessons learned. This paper could aid higher education faculty, administrators, and educators that train scholarly practitioners who engage in scholarship to improve practice.
Probiotics and the Ageing Gut

Probiotic food and supplements are very popular particularly in an ageing population. There usage has principally been confined to gastrointestinal (GI) related conditions. However, ‘‘live probiotics’’ are now being used to alleviate infection and diseases in many areas of the human body. It is well acknowledged that there is a growing body of evidence to support the fact that the complex and vast microflora inside our gastrointestinal tract (GIT) contributes to health and disease. For this micoflora to function optimally in the adult gut, the ‘‘balance’’ of the microflora must be maintained and this appears to be increasingly difficult because of lifestyle changes and the problems associated with human ageing. Various factors (e.g. diet, antibiotic treatment, stress, age) may ‘‘shift’’ the balance of the gut microflora away from potentially beneficial or health-promoting bacteria (e.g. Lactobacilli and Bifidobacteria) towards a predominance of potentially harmful or pathogenic bacteria such as Clostridia, sulfate-reducers, and certain Bacteroides species. Predominance of these latter populations are known to predispose an individual to a number of clinical conditions such as cancer and inflammatory disorders while making the host more susceptible to infections by transient enteropathogens such as Salmonella, Escherichia coli, and Listeria. Consequently, people are seeking healthier lifestyles, and evidence is mounting that supports the idea that our health can be affected by the daily consumption of specific bacteria such as ‘‘probiotics.’’ Probiotic is derived from Greek and means ‘‘for life.’’ Fuller defined probiotics as ‘‘live microbial feed supplements which beneficially affect the host by improving the intestinal microbial balance.’’ However, a later definition by the Food and Agricultural Organization of the United Nations and the World Health Organization to provide health benefits proposed probiotics as ‘‘live microorganisms which when administered in adequate amounts confer a health benefit on the host.’’ A probiotic is considered as a food or supplement containing viable microorganisms that on
Exploring the psychometric properties of the mind-map scoring rubric

Educational practitioners have used mind mapping as an instructional strategy for decades. Recently, researchers have explored the use of mind mapping in classroom settings, and observed that using this tool may benefit students’ conceptual understanding, as well as improve their creativity. Despite their widespread use, there is a lack of psychometrically sound assessment rubrics that researchers and practitioners can use to evaluate the quality of mind maps. To address this issue, we developed and evaluated a new scoring rubric, namely, mind-map-scoring rubric (MMSR) using a sample of 120 mind maps. By applying many-facet Rasch modeling, we observed that the MMSR demonstrated acceptable psychometric properties. We also observed that the level of difficulty of the aspect of the mind maps was not consistent across different educational levels. We discuss implications for research and practice in relation with the use of visual-learning tools.
Vaccinations for Older Adults

Vaccinations are a preventative health priority for older adults. The purpose of this paper is to review recent publications on this topic and to provide updates on current research involving recommended vaccines. In the USA, older adults receive vaccinations at less than optimal rates. Vaccine-preventable illnesses, particularly influenza and pneumococcal disease, continue to cause high morbidity and mortality in this population. A recently introduced herpes zoster vaccine has increased efficacy against varicella-zoster virus reactivation and its sequelae. Older adults can benefit from receiving appropriate vaccinations. Interventions to increase rates of vaccination have the potential to improve the overall health of older adults in the USA. Challenges exist in creating and disseminating effective vaccines in this population.
A kernel smoothing algorithm for ablation visualization in ultrasound elastography.

Three-dimensional visualization of tumor ablation procedures have significant clinical value because the ability to accurately visualize ablated volumes can help clinicians gauge the extent of ablated tissue necrosis and plan future treatment steps. Better control over ablation volume can prevent recurrence of tumors treated using ablative procedures. This paper presents a kernel based smoothing algorithm called MaternSmooth to reconstruct shear wave velocity maps from data acquired through ultrasound electrode vibration elastography. Shear wave velocity estimates are acquired on several intersecting imaging planes that share a common axis of intersection collinear with the ablation needle. An objective method of choosing smoothing parameters from underlying data is outlined through simulations. Experimental validation was performed on data acquired from a tissue mimicking phantom. Volume estimates were found to be within 20% of the true value.
The re-emerging association between tuberculosis and diabetes: lessons from past centuries

The association between tuberculosis (TB) and diabetes mellitus (DM) had a common place in the literature up to the first half of the 20th century, but virtually disappeared with the discovery of insulin to treat DM and antibiotics to cure TB. In the late 1990s the literature began to re-emerge with the worldwide increase in type 2 DM, particularly in TB-endemic countries. Today, type 2 DM is the most prevalent comorbidity among TB patients and the World Health Organization considers it a threat to TB control. We summarize the literature on TB and DM up to the 1960s. Then we evaluate unique aspects of this comorbidity in older times, such as the frequent diabetic comas that suggest challenges for proper DM management as insulin was being implemented, or the absence of antibiotics to cure TB. Despite the unique aspects of each study period, the literature across times is consistent in key aspects of the association. Namely, a higher TB prevalence among DM (versus non-DM patients), the importance of glucose control and chronic DM on TB susceptibility and the higher risk of death among patients with the co-morbidity. From the older literature, we can infer the likely contribution of type 1 DM to TB (in addition to type 2), regardless of their differing autoimmune or metabolic pathophysiology, respectively. Furthermore, in the older literature there was a notable reporting of DM development among TB patients, even though DM usually preceded TB. This observation deserves further epidemiological and basic studies to elucidate this intriguing aspect of the relationship between TB and DM.
In Vitro Pharmacodynamics of a Novel Ceftibuten-Clavulanate Combination Antibiotic against Enterobacteriaceae.

A novel antibiotic combination of the oral cephalosporin ceftibuten (CTB) and the β-lactamase inhibitor clavulanate (CLA) is currently in development for urinary tract infections, including those caused by extended-spectrum-β-lactamase (ESBL)-producing organisms. This study aimed to identify the pharmacodynamic index and magnitude of this index for CLA, when combined with a fixed CTB exposure (∼59% free time above the CTB-CLA MIC) against ESBL-producing Escherichia coli and Klebsiella pneumoniae (CTB-CLA MICs of 0.25/0.125 to 1/0.5 μg/ml) using the in vitro chemostat model. Dose fractionation studies identified the time that free CLA concentrations remained above a threshold concentration (fT>threshold) to be the best pharmacodynamic index (R2 = 0.85) compared with the free area under the curve (AUC)/threshold ratio (R2 = 0.62) and free maximum concentration/threshold ratio (R2 = 0.37). For E. coli isolates, stasis and 1-log10 CFU reductions were achieved at 30.9 and 47.9% fT>CTB concentrations of the 2:1 CTB-CLA MIC (fT>MIC here), respectively. For K. pneumoniae isolates, stasis and 1-log10 CFU reductions were achieved at 51.9 and 92.0% fT>MIC, respectively. These data inform exposure requirements for CLA combined with CTB for optimizing pharmacodynamics against Enterobacteriaceae and should be useful in designing dosage regimens for this combination antibiotic.
INDICE DE AUTORES 2017

Reconocimiento a los autores que participaron en los numeros de la revista Lux Medica 2017. Muchas gracias a todos ellos.
NT5E expression and the immune landscape of prostate cancer (PC): An analysis from The Cancer Genome Atlas database.

e16591Background: Immune checkpoint inhibitors targeting PD-1/L1 and CTLA-4 pathway have shown modest activity in patients with advanced PC. Additional immunosuppressive mechanisms in the PC tumor ...
Comparison of Accuracy of Patient and Physician Scar Length Estimates Before Mohs Micrographic Surgery for Facial Skin Cancers.

Importance Patients are satisfied when surgical outcomes meet their expectations. Dissatisfaction with surgical scars is one of the most common reasons that patients sue surgeons who perform Mohs micrographic surgery (MMS). Objective To measure the accuracy of patient and physician estimations of scar length prior to skin cancer removal with MMS. Design, Setting, and Participants This cross-sectional study was conducted between December 1, 2017, and February 28, 2018, at the MMS clinic of a single tertiary referral center health system. A total of 101 adults presenting for MMS for treatment of facial skin cancers volunteered for this study, and 86 surgeons who performed the MMS procedure participated. Main Outcomes and Measures Patients and physicians independently drew the anticipated scar length on the patients’ skin prior to surgery. Preoperative estimates by patients and surgeons were compared with actual postoperative scar length. Results Of the 101 patients who participated, 57 patients (56.4%) were men and 57 patients (56.4%) were aged 65 years or older. Eighty-four patients (83.2%) underestimated scar length, whereas 67 of the 86 surgeons (77.9%) correctly estimated the scar length (P Conclusions and Relevance This study’s findings suggest that patients with facial skin cancers have unrealistic expectations regarding scars that measure, on average, less than half the length of the actual postoperative scars. Surgeons appear to accurately estimate the length of most surgical scars and have an opportunity to set realistic patient expectations about scar length before surgery.
Cost-Efficient Worker Trajectory Planning Optimization in Spatial Crowdsourcing Platforms

With the progress of mobile devices and the successful usage of the wisdom of crowds, spatial crowdsourcing has attracted much attention from the research community. This paper addresses the efficient worker recruitment problem under the task coverage constraint. The efficiency of worker recruitment is measured by the total quality collected by a set of workers and the corresponding cost, e.g., proportional to the overall trajectory length of workers. Specifically, we consider two different scenarios, 1-D line topology and general 2-D topology, in which workers may have either homogeneous or heterogeneous crowdsourcing quality (e.g., the quality of videos or photos for an object at a particular location). In the 1-D scenario, we propose two dynamic programming approaches to find the optimal solution in both homogeneous and heterogeneous cases. In the general 2-D scenario, the proposed problem turns out to be NP-hard even in the homogeneous case. We first prove that the simple nearest assignment has an approximation ratio of 1/(2n), where n is the number of the workers. Therefore, the nearest assignment cannot be scalable. We further propose a novel assignment approach based on the minimum spanning tree. The proposed approach is proved to be close to the optimal solution in the homogeneous case and 1/ρ in the heterogeneous case, where ρ is the maximum quality ratio between two workers. The effectiveness of the proposed algorithm is verified using a real mobility trace: Uber pick-up trace in the New York City.
Negotiating human engagement and the fixity of computational design: Toward a performative design space for the differently-abled bodymind:

Computational design affords agency: the ability to orchestrate the material, spatial, and technical architectural system. In this specific case, it occurs through enhanced, authored means to facil...
Pregnancy in women with rheumatic valve disease: how to improve the outcome?

Rheumatic valvular disease (RHD) which has almost been eliminated in high-income countries is still common in low-income and middle-income countries. The presence of valvular heart disease in pregnant patients increases the risk to both the mother and the fetus.1 In this issue of the journal, Baghel et al present an observational study describing the outcome of a large group of pregnant women with RHD managed in one medical centre in India. Fifteen per cent of the patients had severe adverse cardiac outcome defined as death, heart failure, cerebrovascular accident and arrhythmias. Fetal outcome was also severely affected with a shortened gestational age at delivery and almost 40% newborns with low birth weight. These results confirm the potential risks associated with pregnancy in this patient population and emphasises the need for specific care to avoid or at least minimise maternal morbidity and mortality and assure fetal well-being. How can the outcome of pregnancy in women with RHD be improved? In this study, 26% of the patients were diagnosed during pregnancy and several of the cases resulting in maternal death presented late. These findings support the notion that management of women with RHD should ideally begin before conception or very early in pregnancy with a careful assessment and risk stratification as shown in table 1. The value of obtaining a careful history has been shown in this study and others,2 who found prior cardiovascular events to be a powerful predictor of pregnancy-associated complications. A 12-lead …
Off-Pump Explant of a Left Ventricular Assist Device Using a Recovery Plug in a Pediatric Patient.

Though the numbers remain small, the use of continuous-flow left ventricular assist devices as a bridge to recovery in pediatric patients has been increasing. Select patients may have sufficient myocardial recovery to allow for device removal. Here, we describe a 13-year old requiring left ventricular assist device implantation for myocarditis who was referred for explant of the device after recovery. This was performed via thoracotomy, without cardiopulmonary bypass, using a newly developed titanium recovery plug that is custom designed to fit the HeartMate 3.
Introducing EL-FIT (Exercise and Liver FITness): A Smartphone App to Prehabilitate and Monitor Liver Transplant Candidates

Preserved physical function is key for successful liver transplantation (LT); however, prehabilitation strategies are underdeveloped. We created a smartphone application (app), EL-FIT (Exercise and Liver FITness), to facilitate exercise training in end-stage liver disease (ESLD). In this feasibility study, we tested EL-FIT app usage and the accuracy of physical activity data transfer and obtained feedback from initial users. A total of 28 participants used the EL-FIT app and wore a physical activity tracker for 38 ± 12 days (age, 60 ± 8 years; 57% males; Model for End-Stage Liver Disease-sodium, 19 ± 5). There was fidelity in data transfer from the tracker to the EL-FIT app. Participants were sedentary (1957 [interquartile range, 873-4643] steps/day) at baseline. Level of training assigned by the EL-FIT app agreed with that from a physical therapist in 89% of cases. Participants interacted with all app features (videos, perceived exertion, and gamification/motivational features). We rearranged training data to generate heart rate-validated steps as a marker of performance and showed that 35% of the participants had significant increases in their physical performance. Participants emphasized their interest in having choices to better engage in exercise, and they appreciated the sense of community the EL-FIT app generated. We showed that patients with ESLD are able to use and interact with the EL-FIT app. This novel smartphone app has the potential of becoming an invaluable tool for home-based prehabilitation in LT candidates.
FC gamma receptor mediated phagocytosis by human neutrophil cytoplasts.

Neutrophils utilize Fcγ Receptors (FcγR) to bind and internalize antibody coated cells or immune complexes. We have compared ultrastructurally FcγR-mediated phagocytosis by neutrophil cytoplasts (enucleated and granule-free neutrophils) prepared either by treatment with cytochalasin B (CB-cytoplasts) followed by ultracentrifugation or by brief heating at 45°C in suspension followed by ultracentrifugation. The phagocytosis of antibody-coated erythrocytes (EIgG) or the internalization of crosslinked IgG complexes by cytoplasts prepared by brief heating was comparable to that of untreated neutrophils. In contrast, CB-cytoplasts bound but failed to internalize EIgG or crosslinked IgG complexes. Comparison of these two methods for the preparation of neutrophil cytoplasts may assist in clarifying the signal transduction requirements involved following ligand binding to FcγR which initiate phagocytosis.
Abstract TP487: Comprehensive Profiling of Secreted Factors in the Cerebrospinal Fluid of Moyamoya Disease Patients

Background: Moyamoya disease (MMD) is a chronic cerebrovascular disease characterized by progressive occlusion of the internal carotid arteries leading to ischemic and hemorrhagic events. The under...
Investor sentiment and sovereign bonds

Abstract Investor sentiment is an important driver of sovereign bond returns in emerging markets. Using local sovereign debt and external sovereign debt, this paper finds that sentiment is negatively related to future bond returns on average across emerging market countries. This negative sentiment effect suggests that investors treat emerging market sovereign bonds as risky assets rather than as safe assets. This paper further finds that this sentiment effect is relatively stronger when liquidity frictions are higher, which is consistent with illiquid bonds being generally harder to arbitrage.
The Antifascist Roots of Presidential Administration

This Article uncovers the intellectual foundations of presidential administration and, on the basis of original archival research and new contextualization, grounds its legitimacy in the fight against fascism. It shows how the architects of presidential control of the administrative state reconciled a strong executive with democratic norms by embracing separation of powers in order to make the government responsible and antifascist. It then draws out the consequences of these overlooked developments for presidential administration today. The Article takes inspiration from the turn to history in Article II scholarship and jurisprudence. In search of legitimating foundations, champions of presidential administration have embraced the work of the New Deal-era President’s Committee on Administrative Management. While they have been right to focus on the Committee, they have misunderstood its program. This Article uses untapped sources and overlooked historical context to advance a new reading of the Committee’s report. It demonstrates that presidential administration was the culmination of a longstanding project to make democracy efficacious and accountable, showing how the New Dealers on the President’s Committee drew from and adapted an older Progressive Era tradition. At the heart of this story is a remarkable reversal: where Progressive Era reformers reject-ed formal constitutionalism and the principle of separation of powers, the New Dealers embraced both. This volte-face was connected to the need to empower the president while guarding against fascism. Anti-fascism thus became a core component of presidential administration, realized through checks on the executive and internal and external separation of powers. This revisionist history has three immediate consequences for contemporary law and legal scholarship. First, it raises a pair of challenges to the unitary theory of the executive. Second, it provides a historical and doctrinal foundation for the competing “internal separation of powers” school of Article II jurisprudence. And finally, it motivates an antifascist litmus test, which offers a new perspective on current debates about the fascism of the Trump presidency and can help assess recent proposals for executive branch reform.
Review: Closing nutrient cycles for animal production - Current and future agroecological and socio-economic issues.

Abstract We face an urgent and complex challenge to produce large amounts of healthful animal and plant foods for an estimated 10 billion people by 2050 while maintaining essential ecosystem services. To compound this challenge, we must do so while not further degrading our environment and conserving essential nutrients such as copper, magnesium, phosphorus, selenium, and zinc that are in short supply for fertilization. Much good research has been done, but to meet this challenge, we need to greatly increase on-farm and watershed-scale research including on-farm evaluations and demonstrations of the putative best combinations of stewardship techniques over multiple years in real-world settings, which are backed by data on nutrient inputs, soil, air, and water chemistry (fluxes) and water discharge. We also need to work with farmers, specialists, and generalists in highly creative interdisciplinary teams that resist forming silos and that use combinations of techniques linked to agroecology and industrial ecology in combination with state-of-the-art engineering. Some of these research and demonstration farms need to be in catchments prone to pollution of aquatic and terrestrial ecosystems with nitrogen, phosphorus, and other nutrients. Some promising approaches include mixed crop-livestock systems, although these alone may not be productive enough without updating to meet the dietary needs of an estimated 10 billion people by 2050. Other approaches could be state-of-the-art multi-trophic production systems, which include several species of plants integrated into production with vertebrates (e.g., ruminants, pigs, poultry), invertebrates (e.g., insects, earthworms) and fish, shrimp, or crayfish to utilize wasted feed and excreta, and recycle nutrients back to the animals (via plants or invertebrates) in the systems. To cut costs and increase desirable outputs, we must recycle nutrients much better within our food production systems and produce both animal and plant foods more efficiently as nutrients cycle through systems.
Transfusion guidelines in adult spine surgery: a systematic review and critical summary of currently available evidence.

Abstract Background Context Red blood cell transfusion can be associated with complications in medical and surgical patients. Acute anemia in ambulatory patients undergoing surgery can also impede wound healing and independent self-care. Current transfusion threshold guidelines are still based on evidence derived from critically-ill intensive care unit medical patients and may not apply to spine surgery candidates. Purpose We aimed to provide the reader with a synthesis of the best available evidence to recommend transfusion trigger thresholds and guidelines in adult patients undergoing spine surgery. Study Design/Setting This is a systematic review. Outcome measures Physiological measure: Blood transfusion thresholds and associated posttransfusion complications (morbidity, mortality, length of stay, infections, etc…) of the published articles. Patient Sample Adult spine surgery patients. Methods A systematic review of the literature using the PubMed, Google Scholar, and Web of Science electronic databases was made according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Focus was set on papers discussing thresholds for blood transfusion in adult surgical spine patients, as well as complications associated with transfusion after acute surgical blood loss in the operating room or postoperative period. Publications discussing pediatric cases, blood type analyses, blood loss prevention strategies and protocols, systematic reviews and letters to the editor were excluded. Results A total of 22 articles fitting our search criteria were reviewed. Patients who received blood transfusion in these studies were older, of female gender, had more severe comorbidities except for smoking, and had prolonged surgical time. Blood transfusion was associated with multiple adverse postoperative complications, including a higher rate of superficial or deep surgical site infections, sepsis, urinary and pulmonary infections, cardiovascular complications, return to the operating room, and increased postoperative length of stay and 30 day readmission. Analysis of transfusion thresholds from these studies showed that a pre-operative hemoglobin (Hb) of > 13 g/dL, and an intraoperative and post-operative Hb nadir above 9 and 8 g/dL, respectively, were associated with better outcomes and fewer wound infections than lower thresholds (Level B Class III). Additionally, it was generally recommended to transfuse autologous blood that was Conclusions Blood transfusion thresholds in surgical patients may be specialty-specific and different than those used for critically-ill medical patients. For adult spine surgery patients, red blood cell transfusion should be avoided if Hb numbers remain > 9 and 8 g/dL in the intraoperative and direct post-operative periods, respectively.
Sexual Script Theory: Past, Present, and Future

Since its formal introduction in the early 1970s, sexual script theory has been a popular conceptual framework among social scientists examining human sexuality. In this chapter the basic tenants, history, and foundational sources of sexual script theory are presented. Next, sexual script theory is compared to several other theoretical approaches in psychology and sociology that entail script concepts implicitly or explicitly. Researchers employing sexual script theory have tended to take two primary approaches to data collection and analysis: critical examination of cultural artifacts or previously published research results versus analysis of self-report data from respondents. These methods are examined and illustrative examples described, thereby highlighting research topics and questions to which sexual script theory has been applied. Last, the status of sexual script theory is critically examined, and future research directions proposed. Sexual script theory has played an important role in sex research, but resolution of key criticisms and unanswered questions is necessary for the advancement of sexual script theory beyond its frequent use as a convenient metaphor.
Patient and clinical characteristics associated with gout flares in an integrated healthcare system.

Gout flares have been challenging to identify in retrospective databases due to gout flares not being well documented by diagnosis codes, making it difficult to conduct accurate database studies. Previous studies have used different algorithms, and in this study, we used a computer-based method to identify gout flares. The objectives of this study were to identify gout flares in gout patients newly initiated on urate-lowering therapy and evaluate factors associated with a patient experiencing gout flares after starting drug treatment. This was a retrospective cohort study identifying gout patients newly initiated on a urate-lowering therapy (ULT) during the study time period of January 1, 2007–December 31, 2010. The index date was the first dispensed ULT prescription during the study time period. Patients had to be ≥18 years of age on index date, have no history of prior ULT prescription during 12 months before index date, and were required to have 12 months of continuous membership with drug benefit during pre-/post-index. Electronic chart notes were reviewed to identify gout flares; these reviews helped create a validated computer-based method to further identify patients with gout flares and were categorized into 0 gout flares, 1–2 gout flares, and ≥3 gout flares during the 12 months post-index period. Multivariable logistic regression was used to examine patient and clinical factors associated with gout flares during the 12-month follow-up period. There were 8905 patients identified as the final cohort and 68 % of these patients had one or more gout flares during the 12-month follow-up: 2797 patients (31 %) had 0 gout flares, 4836 (54 %) had 1–2 gout flares, and 1272 patients (14 %) had ≥3 gout flares. Using a multivariate regression analyses, factors independently associated with 1–2 gout flares and ≥3 gout flares versus no gout flares were similar, however, with slight differences, such as younger patients were more likely to have 1–2 gout flares and patients ≥65 years of age had ≥3 gout flares. Factors such as male gender, not attaining sUA goal, having ≥3 comorbidities, diuretics use, no changes in initial ULT dose, and not adhering to ULT all were associated with gout flares versus no gout flares. Using a new method to identify gout flares, we had the opportunity to compare our findings with the previous studies. Our study findings echo other previous studies where older patients, male, diuretics, having a greater number of comorbidities, and non-adherence are more likely to have more gout flares during the first year of newly initiating ULT. There is an unmet need for patients with gout to be educated and managed more closely, especially during the first year.
Leukocyte histidine decarboxylase: properties and activity in myeloproliferative disorders.

1. Histidine decarboxylase was assayed in extracts from human leukocytes and the properties of the enzyme studied. 2. Leukocyte histidine decarboxylase was found to be substrate-specific, to require pyridoxal phosphate as co-enzyme, and to be inhibited by alpha-hydrazino analog of histidine (MK 785), a selective inhibitor of the specific histidine decarboxylase occuring in rat tissue. A non-specific L-aromatic amino acid decarboxylase was also demonstrated in leukocyte extracts, which possessed little activity toward histidine. 3. Cellular localization studies revealed that mature neutrophils and basophils possessed most of the histidine decarboxylase activity exhibited by mixed leukocyte preparations. Mature eosinophils, small lymphocytes, and immature myeloid cells (myeloblasts and promyelocytes) showed little histidine decarboxylase activity. 4. In the clinical studies, patients with uncontrolled polycythemia vera, "spent" polycythemia, myelofibrosis with myeloid metaplasia, and chronic myelocytic leukemia, showed increased leukocyte enzyme activity when compared to a control group composed of normal subjects and patients with relative polycythemia. This increased activity appears to represent a true increase in enzyme activity per granulocyte, and is believed to account for the elevated leukocyte histamine content demonstrated in patients with myeloproliferative disorders.
Fouling of HVAC fin and tube heat exchangers

Fin and tube heat exchangers are used widely in residential, commercial and industrial HVAC applications. Invariably, indoor and outdoor air contaminants foul these heat exchangers. This fouling can cause decreased capacity and efficiency of the HVAC equipment as well as indoor air quality problems related to microbiological growth. This paper describes laboratory studies to investigate the mechanisms that cause fouling. The laboratory experiments involve subjecting a 4.7 fins/cm (12 fins/inch) fin and tube heat exchanger to an air stream that contains monodisperse particles. Air velocities ranging from 1.5-5.2 m/s (295 ft/min-1024 ft/min) and particle sizes from 1--8.6 {micro}m are used. The measured fraction of particles that deposit as well as information about the location of the deposited material indicate that particles greater than about 1 {micro}m contribute to fouling. These experimental results are used to validate a scaling analysis that describes the relative importance of several deposition mechanisms including impaction, Brownian diffusion, turbophoresis, thermophoresis, diffusiophoresis, and gravitational settling. The analysis is extended to apply to different fin spacings and particle sizes typical of those found in indoor air.
Algorithms and performance analysis for estimation of low-rank matrices with Kronecker structured singular vectors

We consider the problem of estimating the singular vectors of low-rank signal matrices buried in noise in the setting where the singular vectors are assumed to be Kronecker products of unknown vectors. We propose four algorithms for estimating such singular vectors, analyze their performance and show that they asymptotically fail to estimate to latent singular vector below the same critical SNR. We corroborate our theoretical findings with numerical simulations and illustrate the improved performance on a STAP beamforming application.
Citizens’ Communication and the 2009 G8 Summit in L’Aquila, Italy

In this article, I explore the emerging communication tactics that citizen committees and movements in L’Aquila, Italy, implemented during the Group of Eight (G8) summit in July 2009 – three months after a devastating earthquake left 80,000 residents homeless. I describe these tactics as 360-Degree Communication, an illuminating case study in citizen media and post-disaster political machinations. The focus is on how three main forms of communication (interpersonal, movements’ relationships with mainstream media, and citizens’ use of information and communication technologies) weaved together to support citizens’ needs to organize and claim a more active role in the rebuilding process. This article also questions dominant views according to which political and civic life in Italy’s south is based on a subservient relationship between power elites and residents, and that only rooted traditions of involvement with organized political parties and civil society can be a strong predictor of an active citizenry.
Investigation of metal coatings for the free electron laser

We are investigating the deposition and characteristics of metal coatings for use in environments such as the Free Electron Laser where the radiation resistance of metal coatings could prove to be of great benefit. We have concentrated our initial efforts on silver laminate coatings due to the high reflectance of silver at 1 micron wavelength. Our initial laminate coatings have utilized thin layers of titanium oxide to break up the columnar structure of the silver during electron-beam deposition on fused silica substrates. Our initial results on equal coating thickness samples indicate an improvement in damage threshold that ranges from 1.07 to 1.71 at 351 nm.
Abstract 102: Acute Mechanical Unloading of the Left Ventricle Promotes Cardioprotective Signaling and Limits Myocardial Infarct Size

Management of an acute myocardial infarction (AMI) focuses on restoring oxygen supply to limit myocardial damage, however ischemia-reperfusion injury (IRI) remains a major determinant of mortality in AMI. No studies have targeted initially reducing left ventricular stroke work (LVSW) to limit IRI in AMI. The Impella CP axial-flow pump reduces LVSW. We tested the hypothesis that first reducing myocardial work and delaying coronary reperfusion reduces infarct size by activating cardioprotective signaling pathways. Methods: AMI was induced by occlusion of the left anterior descending artery (LAD) via angioplasty for 90 minutes in 50kg male Yorkshire swine (n=5/group). In Group 1, the LAD was reperfused for 120 minutes. In Group 2, after 90 minutes of ischemia the Impella CP device was activated and the LAD left occluded for an additional 60 minutes (150 minutes of LAD occlusion total), followed by 120 minutes of reperfusion. The Impella CP was active throughout reperfusion. Western blot analysis quantified myocardial kinase activity. Results: Compared to Group 1, Group 2 had a reduced LVSW, LV end-diastolic volume and end-diastolic pressure after reperfusion [Fig A]. Group 2 showed increased myocardial phosphorylation of cardioprotective kinases: AKT, ERK, GSK3β and STAT-3 [Fig B]. Compared to Group 1, the percent myocardial infarct size normalized to the area at risk (AAR) was reduced in Group 2 (73+13% vs 42+15%, p=0.02). Conclusion: We report the potential benefit of primarily unloading the heart and delaying coronary reperfusion to salvage myocardium in AMI. This is the first report to examine the impact of the Impella CP on cardioprotective signaling in the heart. ![][1] [1]: /embed/graphic-1.gif
Physician uncertainty and the art of persuasion

Abstract Incomplete information is a chronic feature of medical markets. Much attention has focused on information asymmetries between physicians and their patients. In contrast, physician uncertainty has received far less attention. This is a significant omission. Physician uncertainty may be an even more important reason than consumer uncertainty for the high cost of health care. This paper reviews and evaluates major approaches for managing physician uncertainty. We argue that quantitative approaches alone, such as scientific advancement and the application of decision analysis to clinical reasoning, are insufficient for dealing with uncertainty. Qualitative approaches, such as forging consensus through expert panels, and teaching physicians to accept and cope with uncertainty, will play a valuable role in promoting more effective clinical decision-making under conditions of uncertainty. The current tensions between those who would eradicate physician uncertainty through quantitative approaches and those who favor qualitative methods has parallels in many other fields, including economics and mathematics. These tensions are unfortunate, since the most promising initiative to promote better clinical decision-making will likely need to draw upon both approaches. The recent initiative to implement medical practice guidelines is one example of a broad-based approach to improve clinical decision-making. Guidelines draw upon available scientific evidence, but typically involve consensus-building as well. They seek to persuade and educate physicians about appropriate treatments, without mandating changes in physician treatment patterns.Given the persistent uncertainties physicians will undoubtedly confront regarding appropriate clinical decision-making, this flexible approach may be the best way to mitigate market failures resulting from inappropriate clinical decisions. Whatever initiatives are chosen, physicians must learn to live with uncertainty rather than live in hope of its eventual extinction.
How a nested framework illuminates the challenges of comparative environmental analysis

Stratospheric ozone loss is on course to become a solved environmental problem, with all significant producing countries (including China and India) undertaking complete phase-outs of ozone-depleting substances. The universal concurrence and speed with which ozone loss has been addressed are sometimes heralded as signs that effective international agreements on other problems of the global commons are just around the corner. However, progress on many other issues has been strikingly limited. Is ozone the exception, rather than the rule, and if so why? Here we present one way to illuminate why some environmental problems are more tractable than others by consideration of a “nested” (vs. nonnested) framework. [Nested governance schemes are an established part of the common pool of resource literature (e.g., refs. 1 and 2), where use of the term “nesting” or “polycentricity” generally refers to the spatial scale of governance (e.g., grassroots to national); our focus here is broader.] We will refer to nesting as having three components: intellectual, societal, and institutional. Intellectual nesting refers to the academic communities that study the roots …