cssi/SciSciGPT-SciSciNet huggingface dataset:
Influence of ventricular contractility on non-work-related myocardial oxygen consumption

The relationship between myocardial oxygen consumption (MVO2) and the total pressure-volume area (PVA), which represents the total mechanical work performed during a cardiac cycle, has been shown to be linear and independent of loading conditions: MVO2=aPVA+b. When inotropic state is enhanced, the MVO2-PVA relation shifts upward (increase inb), and when inotropic state is depressed the relation shifts downward (decrease inb). However, thequantitative relationship between contractility andb (the non-work-related myocardial oxygen consumption) determined over a wide range of contractilities is not known. In seven isolated blood perfused canine hearts, left ventricular (LV) contractility was increased by dobutamine and decreased with nifedipine or reduction of coronary blood flow. At each level of contractility, the end-systolic pressure-volume relationship (ESPVR) and the MVO2-PVA relation were determined. For each heart, the resulting values ofb (ml O2/beat) were plotted as a function of Emax (mmHg/ml), an index of contractility defined as the slope of the ESPVR. There was a linear relation between Emax andb over a wide range of contractilities; on average,b (ml O2/beat)=0.0036 Emax (mmHg/ml) + 0.0101 [r=0.929–0.978 (95% confidence interval)], when Emax was varied over an average range of 2.8–9.6 mmHg/ml. These results suggest a common underlying determinant of contractility and non-work-related oxygen consumption.
Physical Therapy to Improve Functioning of Older People in Residential Care Facilities

Background and Purpose. The purpose of this study was to determine the effectiveness of an individualized physical therapy mobility training program on the gait, balance, and functional performance of elderly individuals living in residential care facilities. Subjects. Twenty-seven elderly individuals with impaired balance and difficulty performing at least one functional activity participated in the study. The subjects ranged in age from 71 to 97 years (X=87.1, SD=6.7). Methods. Balance and gait speed were assessed at baseline and following physical therapy that consisted of exercises to improve specific functional limitations. Outcomes were reassessed 1 month following completion of the physical therapy. Results. Gait and balance outcomes were analyzed using a one-way repeated measures analysis of variance. Improvement was obtained in balance, which was maintained at 1 month follow-up. Gait speed did not improve to a level of statistical significance. Conclusion and Discussion. After physical therapy, subjects improved in balance and functional performance. An improvement in gait speed may require a longer duration of treatment.
Using virtual machines to improve learning and save resources in an introductory IT course

Information technology courses often require the use of software and hardware to support classroom learning. These systems can assist in achieving the learning objectives for a course through classroom problems and laboratory exercises. The procurement and maintenance of these systems can be a challenge even for well resourced organizations. In this paper we discuss how virtual machines can relieve organizations of some of their resource burdens while effectively achieving course learning objectives and provide examples of how that is currently done at the United States Military Academy.
VISCOSITY‐TIME‐TEMPERATURE RELATIONS IN GLASS AT ANNEALING TEMPERATURES*

Viscosity data published by the author in 1931 are discussed with reference to their limitations. New experiments on fiber elongation in a redesigned apparatus are described in which one of the glasses previously used is tested. The results show that the viscosity of a newly drawn fiber increases with time of heat treatment according to a definite law which may be explained on the basis of a change in the state of aggregation in the glass. A finite equilibrium viscosity is indicated a t each temperature, this limit being approachable from either side depending on previous heat treatment of the sample. This is taken to indicate an equilibrium average size of aggregate for any temperature, the groups starting to break up again if the temperature is increased after a long treatment. The expression of Sheppard and Houck is used for estimating effective molecular or aggregate weights in equilibrium at various temperatures, an example being 112,000 at about 500°C. The variation of viscosity with time is at least one reason why glasses fail to conform to Adams' and Williamson's annealing equation at low temperatures.
Advances in wafer level and chip scale packaging

Wafer-level packaging (WLP) is becoming more prevalent in the semiconductor packaging industry, fuelled by the increasing prominence of area array devices employed in electronics manufacturing. With feature size requirements in the range of 10-15 /spl mu/m, the current thinking is that the bumping process should be accomplished by either a stepper or proximity mask aligner. A key factor in this decision is the financial investment of the manufacturer and the relative process benefits of photolithography. This paper presents the benefits of utilizing projection stepper technology in the wafer bumping process. In particular, the paper discusses an innovative system design that significantly improves stepper yields while enabling the imaging of thick resists on wafers. Considered are the relative performance capabilities and process flexibility of the system design versus conventional steppers and projection aligners. Described are key subsystems incorporated in the advanced stepper platform, including dual wafer handling, optimized lens field projection optics, and broadband illumination. The paper concludes that the resulting increase in throughput and process latitude can be expected to reduce cost of ownership (COO) when process and maintenance costs are considered as well as the initial capital expense of the equipment.
The Predictive Ability of Geographic Segment Information at the Country, Continent, and Consolidated Levels

This study examines whether geographic information disclosed at an increasingly disaggregated level (specifically, consolidated vs. continent vs. country) results in increased predictive ability of company operations (specifically, sales, gross profit, and earnings). Multinational corporations (MNCs) are formed using a simulated merger approach by combining the annual operating results of six individual firms, one from each of six countries. This approach makes it possible to compare the forecasting accuracy of data disclosed at the country, continent, and consolidated levels, not possible using current geographic segment disclosures. Previous studies using year-ahead forecast models implicitly assume the predictive factors included in the models are significant in forecasting operating results. Using regression forecast models, this study tests whether the predictive factors included in the models are effective in forecasting operating results by examining the direction, size, and significance of the regression coefficient estimates. The coefficients provide evidence that exchange rate changes, inflation, and real GNP growth are useful in forecasting annual sales and gross profit. Whereas, at least for this sample and this time period, exchange rate changes, inflation, and real GNP growth are not significant variables in forecasting annual earnings. The results indicate that the accuracy of forecasts increase as sales and gross profit are disclosed at a more disaggregated geographic level. The hypothesized relationship between consolidated, continent, and country levels, while holding strongly under perfect foresight, holds to a lesser extent using forecasts of exchange rates, inflation, and real GNP.
Flavor and Nutrient Composition of a Sausage Ball Snack-type Food Made From Pork or Catfish

Ground catfish flavored with pork sausage seasoning was used in a sausage ball snack-type food and the product was compared to pork sausage balls for sensory and nutrient differences. Triangle tests were not significant (P > 0.05). Protein (p ≦ 0.01), fat (p ≦ 0.01), and nitrogen free extract (p ≦ 0.05) were significantly different between the two products. Moisture, crude fiber, ash, sodium, and potassium content were not significantly different (P > 0.05). In the proportions used in this study, catfish sausage is useful as a substitute for pork sausage.
LDD MOSFETs using disposable sidewall spacer technology

A technology for fabricating lightly doped drain (LDD) MOSFET devices based on disposable sidewall spacers is presented. Using a thin polysilicon buffer layer between the low-temperature oxide (LTO) sidewall spacers and the oxidized polysilicon gate, a single masking step can be used to form the n/sup -/ and n/sup +/ or p/sup -/ and p/sup +/ source/drain implants for the NMOS and PMOS devices, respectively. In addition, the LTO sidewall spacers may be removed by a wet HF strip, thus minimizing additional damage to the gate oxide that may be caused by reactive ion etch removal. The disposable sidewall spacer technology is easily adaptable to a CMOS process as demonstrated by the fabrication of a 4 K*4 SRAM circuit using a conventional 1.5- mu CMOS technology. >
Lipotropic Effects of Liver Extract, Vitamin B12 and Choline.

SummaryWith the diet employed, one cc of crude liver extract administered subcutaneously 3 times a week represents the approximate minimal effective dose of this material for lipotropic activity. The same dose of liver extract administered orally also has lipotropic activity but slightly less than that obtained on subcutaneous administration. The lipotropic effect of crude liver extract or vitamin B12 concentrate is not due to the small amounts of choline, inositol and folic acid present in these materials. Crystalline vitamin B12 alone is without lipotropic effect. Small amounts of choline, alone or in combination with crystalline vitamin B12, also failed to prevent fatty changes in the liver.
The effects of premolar-extraction: A long-term comparison of outcomes in “clear-cut” extraction and nonextraction Class II patients

Discriminant analysis was used to assess the anatomical basis of the extraction/nonextraction decision in 238 former Saint Louis University Class II edgewise patients. The resulting discriminant scores (based on six measures of protrusion and crowding) were used to divide this parent sample into three prognostic subgroups: clear-cut extraction, clear-cut nonextraction, and a borderline stratum containing both extraction and nonextraction patients. The "clear-cut" patients--those at the tails of the distribution--were then contacted and asked to return for follow-up records (cephalograms, models, clinical examination); in the end, 62 (33 extraction and 29 nonextraction) were recalled. The average post-treatment interval was about 15 years. Premolar extraction produced a significantly greater reduction in hard- and soft-tissue protrusion. During the post-treatment period, however, both groups underwent essentially the same change: decreased profile convexity and a pattern of dental change/relapse that was correlated with antero-posterior mandibular displacement. Because of their greater initial crowding and protrusion, the various effects summed to make the extraction patients significantly more protrusive at recall. Both treatments produced mesial mandibular displacement, extraction significantly more than nonextraction; however, at recall the two groups did not differ with respect to the signs and symptoms of dysfunction. The present findings, therefore, fail to support the common, influential belief that premolar extraction frequently causes "dished in" profiles, "distalized" mandibles, and, ultimately, craniomandibular dysfunction.
Terrestrial passive integrated transponder antennae for tracking small animal movements

Abstract Measuring terrestrial movements of small animals poses a substantial technological challenge. We developed very long (up to 130 m) passive integrated transponder (PIT) detectors with which we tracked salamanders (Caudata) migrating from breeding ponds to their upland habitat >200 m away. In all 60 trials, salamanders were detected when released near the antennae. In a second test, we tracked 7 of 14 tagged marbled salamanders (Ambystoma opacum) migrating >65 m, well beyond the area protected by existing wetland buffer regulations in Massachusetts, USA. The mean rate of movement for these salamanders (x ¯ = 0.9 m/min; SE = 0.1 m/min) was substantially higher than rates of movement reported for related salamanders with radio-implants. These PIT antennae offer researchers a means to study small animal movements with less disruption of the animals' natural movement patterns than is caused by other available techniques.
Basic science of anterior cruciate ligament injury and repair

Injury to the anterior cruciate ligament (ACL) is one of the most devastating and frequent injuries of the knee. Surgical reconstruction is the current standard of care for treatment of ACL injuries in active patients. The widespread adoption of ACL reconstruction over primary repair was based on early perception of the limited healing capacity of the ACL. Although the majority of ACL reconstruction surgeries successfully restore gross joint stability, post-traumatic osteoarthritis is commonplace following these injuries, even with ACL reconstruction. The development of new techniques to limit the long-term clinical sequelae associated with ACL reconstruction has been the main focus of research over the past decades. The improved knowledge of healing, along with recent advances in tissue engineering and regenerative medicine, has resulted in the discovery of novel biologically augmented ACL-repair techniques that have satisfactory outcomes in preclinical studies. This instructional review provides a summary of the latest advances made in ACL repair. Cite this article: Bone Joint Res 2014;3:20–31.
Overview of the treatment of rumination disorder for adults in a residential setting

Rumination, or the chewing and re-swallowing of regurgitated stomach contents, can be found in up to 10% of institutionalized individuals with severe or profound mental retardation. Serious physical consequences, including death, can result from the disorder. Unfortunately, rumination can be subtle and difficult to observe and often continues untreated. Additionally, the research literature has provided divergent results without clear treatment guidance for clinicians. We present an overview of the history of rumination, a review of the literature on its etiology and treatment, and recommendations for future research.
Adapting wave-front algorithms to efficiently utilize systems with deep communication hierarchies

Large-scale systems increasingly exhibit a differential between intra-chip and inter-chip communication performance especially in hybrid systems using accelerators. Processor-cores on the same socket are able to communicate at lower latencies, and with higher bandwidths, than cores on different sockets either within the same node or between nodes. A key challenge is to efficiently use this communication hierarchy and hence optimize performance. We consider here the class of applications that contains wave-front processing. In these applications data can only be processed after their upstream neighbors have been processed. Similar dependencies result between processors in which communication is required to pass boundary data downstream and whose cost is typically impacted by the slowest communication channel in use. In this work we develop a novel hierarchical wave-front approach that reduces the use of slower communications in the hierarchy but at the cost of additional steps in the parallel computation and higher use of on-chip communications. This tradeoff is explored using a performance model. An implementation using the reverse-acceleration programming model on the petascale Roadrunner system demonstrates a 27% performance improvement at full system-scale on a kernel application. The approach is generally applicable to large-scale multi-core and accelerated systems where a differential in communication performance exists.
Modelling Broadband fan Noise and Comparison with Experiments

The interaction of upstream turbulence with an annular cascade is investigated. The model uses a spectral representation of the impinging upstream turbulence and a multiple scale analysis for the evolution of turbulence in a nonuniform swirling flow. The aerodynamic‐acoustic response of the annular cascade in a nonuniform swirling flow is calculated for upstream Fourier disturbances. The broadband sectional lift and the noise power radiated are then calculated by summing the spectral density weighted contributions of all Fourier components of a turbulence realization and averaging the turbulence stochastic variables. Broadband noise spectra are calculated for four dierent cases to examine the eects of swirl, blade loading and nonuniform inflow angle distribution. Comparison of the results indicate that the eects of these parameters on the acoustic power density spectra is about 3 to 4 dB and that these eects strongly vary with the frequency, being stronger at low frequencies and moderately high frequencies. At very high frequency the results tend toward the two-dimensional model results with 1 to 2 dB dierence. The eect of dierent turbulence spectral representation is examined since they have dierent turbulent energy distribution. A high frequency asymptotic analysis shows that the acoustic response of the cascade will be dominated by the local blade geometry. This suggests that a simplified two-dimensional cascade model may be adequate for calculating the fan acoustic response at high frequency. This conclusion is confirmed for unloaded blades by a comparison of the numerical results of the radiated noise spectra of a 3D annular cascade and a 2D linear cascade. The model is validated by comparison with BFAN and NASA 22-in fan Source Diagnostic Test data.
Accommodations for Test Anxiety Under ADA

Test anxiety prevents students from demonstrating their knowledge on examinations. To be covered by the Americans with Disabilities Act, test anxiety must pass two legal tests. First, it must be a "mental impairment." As a form of Social Phobia, a mental disorder included in the Diagnostic and Statistical Manual of Mental Disorders, it meets this first test. Second, it must "substantially limit one or more of the major life activities." Individuals for whom test anxiety is one manifestation of Social Phobia-Generalized are substantially limited in the major life activities of interacting with others and working. Individuals for whom test anxiety is the only manifestation of their Social Phobia are substantially limited in the major life activities of thinking and working, the latter because they are excluded from any career requiring a test for application, credentialing, licensure, or training. Accommodations may include taking the test in a separate room or taking an untimed examination. Documentation supporting a diagnosis of test anxiety should include evidence of significant impairment in test performance.
Personality and Situational Influences upon Verbal Slips: A Laboratory Test of Freudian and Prearticulatory Editing Hypotheses

Earlier studies of laboratory-induced verbal slips have demonstrated the existence of a “prearticulatory editing” phase of speech/language production, the supposed function of which is to evaluate the linguistic integrity of phoneme sequences destined for articulation, allowing articulation of linguistically legitimate sequences, and preventing articulation of linguistically anomalous sequences. Freud's view of verbal slips as a manifestation of speakers' private internal states, these internal states resulting from interactions of personality and situational influences, may be viewed as a prediction that prearticulatory editing involves personality/situation-based semantic criteria. The prediction was tested and supported. Implications are discussed.
An application of ridge regression analysis in the study of syphilis data

We provide a brief summary of the theory of ridge regression, regress reported rates of congenital syphilis on three stages of adult syphilis using both ridge regression and least squares techniques, and discuss the results. We also develop a principal components regression model for the same example and compare the results. The example demonstrates the usefulness of ridge regression to handle multicollinearity in data. Problems of overestimation and instability associated with ordinary least squares estimates of these non-orthogonal data diminish with use of the ridge regression techniques.
Prospects for Small Business in Poland's Future

Poland has undergone a dramatic shift in its economy during the 1980s and early 1990s by essentially moving from a command to a free market orientation. To realize the full benefit of this shift, however, Poland will need to do everything possible to exploit its current national competitive advantages. In this paper, we focus on the role small business development can play in this effort in light of the current social, legal, and financial conditions in the country. The paper concludes with a discussion of several intriguing strategic options that could be profitably pursued.
Accuracy of Caregivers' Recollections of Caregiving Hassles

Despite their common use in clinical settings, caregivers' recollections of the hassles they face in caregiving have not been examined in previous research. Ninety-seven spousal caregivers of persons with dementia were assessed for 6 consecutive months concerning caregiving hassles and numerous other issues. A multi-pass rank order assessment identified the most stressful event in caregiving over each month-long interval. Each month via telephone interview, caregivers' recollections of the most stressful event in the previous month were assessed; no retrieval cues were provided. Of a total of 582 retrieval events examined, 378 (65%) were correct, 84 (14%) were incorrect, and 120 (21%) were not remembered. These data indicate that a majority of caregivers are capable of accurate recollection of caregiving hassles after a delay of one month following very careful ranking procedures, but also that individual differences in accuracy are present.
Global Market Conditions and Systemic Risk

This paper examines several key global market conditions, such as a proxy for market uncertainty and measures of interbank funding stress, to assess financial volatility and the likelihood of crisis. Using Markov regime-switching techniques, it shows that the Lehman Brothers failure was a watershed event in the crisis, although signs of heightened systemic risk could be detected as early as February 2007. In addition, we analyze the role of global market conditions to help determine when governments should begin to exit their extraordinary public support measures.
The Movement Society in Comparative Perspective

Recent scholarship argues that citizens in advanced democracies are turning to protests as a means of voicing political preferences. Advocates of this perspective claim that individuals now live in a "movement society," where protest activity stands alongside more traditional forms of political participation. However, despite the theoretical advances associated with the movement society approach, comprehensive evaluations of the underlying claims are lacking. This study remedies the empirical gaps by assessing three arguments. First, are more individuals participating in protest activities? Second, are protest activities expanding to more democratic countries? Third, have protest activities become "institutionalized," as indicated by a shift to nonconfrontational tactics? Analyses based on cross-national data provide mixed support for the movement society thesis. More individuals are becoming involved in protests, and this trend is observed in a large number of advanced democracies. Yet, there has not bee...
Glioblastoma Induces Vascular Dysregulation in Nonenhancing Peritumoral Regions in Humans.

OBJECTIVE. Glioblastoma is an invasive primary brain malignancy that typically infiltrates the surrounding tissue with malignant cells. It disrupts cerebral blood flow through a variety of biomechanical and biochemical mechanisms. Thus, neuroimaging focused on identifying regions of vascular dysregulation may reveal a marker of tumor spread. The purpose of this study was to use blood oxygenation level–dependent (BOLD) functional MRI (fMRI) to compare the temporal dynamics of the enhancing portion of a tumor with those of brain regions without apparent tumors. MATERIALS AND METHODS. Patients with pathologically proven glioblastoma underwent preoperative resting-state BOLD fMRI, T1-weighted contrast-enhanced MRI, and FLAIR MRI. The contralesional control hemisphere, contrast-enhancing tumor, and peritu-moral edema were segmented by use of structural images and were used to extract the time series of these respective regions. The parameter estimates (beta values) for the two regressors and resulting z-statis...
SFCP P-021 - Microgastrie : chirurgie néonatale et revue de la littérature

Introduction Nous rapportons le cas d’un nouveau-ne presentant une microgastrie. Il s’agit d’une malformation tres rare, souvent associee a d’autres malformations. Case report Garcon ne a terme (2 Kg 870), sans anomalie cardiaque. Suivi antenatal pour suspicion d’atresie de l’œsophage : estomac non vu sans hydramnios. Test a la sonde naso-gastrique positif. L’opacification ne retrouve pas de poche gastrique malgre une continuite digestive vraie entre un megaoesophage et l’intestin. Opere a J1 de vie : microgastrie et asplenie, augmentation du volume gastrique selon Hunt-Lawrence (anse montee en Y). Reprise rapide de l’alimentation orale. Discussion On retrouve 60 cas dans la litterature, de diagnostic plus ou moins precoce, traites initialement par une jejunostosmie d’alimentation. La plupart presentaient d’autres malformations. Dans notre cas, nous avons realise d’emblee l’agrandissement gastrique. Ceci a permis une alimentation orale rapide et favorise le developpement de l’oralite. Le suivi nous permettra d’evaluer l’interet a long terme de cette intervention neonatale. Conclusion La non visualisation de l’estomac en antenatal sans hydramnios doit faire penser a cette pathologie. Le traitement chirurgical neonatal est faisable et nous semble efficace.
Using Redesign to Compete in a Dynamic Manufacturing Environment

ABSTRACTChange and the need to respond rapidly to it generate the need for new thinking in how manufacturing is performed. The transition from mass production manufacturing to flexible, agile manufacturing will require a major overhaul that can be accomplished only through redesigning and integrating resources including people, systems, and technology. This article examines three different types of redesign: process, organization, and factory. Also described is how one company, Texas Instruments Defense Systems & Electronics Group (DSEG), has employed a redesign methodology in its Harpoon missile program to remain competitive.
Geometric nonlinearity analysis of A-shaped drilling derrick with ANSYS6.0

This paper analyses the geometric nonlinearity of JJ315/43-A derrick under the permissible loading and presents the conception of nonlinear influence degree, with which we can determine what degree geometric nonlinearity influences on the parameters of derrick loading. As a result, the influence on X and Y directional displacement is greater, the influence on axial stress of derrick elements is small. So we can conclude that measuring Z directional displacement on derrick top or testing the main elements stress by exerting a small load on derrick hook and using the linear extrapolation method to evaluate the safety resisting capacity of derrick is practicable.
Continuous Subarachnoid Analgesia in Two Adolescents with Severe Scoliosis and Impaired Pulmonary Function

We report postoperative pain management of two adolescents after upper abdominal procedures, one with Hurler-Scheie syndrome and a second with Duchenne muscular dystrophy, and both had progressive spinal scoliosis with poor pulmonary function. A combined technique of subarachnoid and general anesthesia was used during surgery. Postoperative administration of small intermittent doses of subarachnoid morphine produced profound analgesia, which eliminated the need for systemic opioids, restored preoperative arterial oxygenation within 48 hours after the operation, and expedited postoperative recovery.
Flying spot studies of brain flavoproteins in the gerbil.

AbstractThe flying spot fluorometer/reflectometer for flavo-protein (Fp) was used in the present study in order to evaluate energy metabolism in the anesthetized gerbil brain. This model was exposed to various conditions, such as anoxia, spreading depression, and ischemia. The fluorescence and reflected light were analyzed in terms of intensities of histograms, and the fractional changes were calculated and compared between the metabolic states.The results show that under various conditions, the fluorescence of Fp changed together with the reflectance change, and the net mitochondrial change was not always clear. The results presented in the study are in good agreement with the previously-published results.
Preputial Calculus: A Case Report

A preputial calculus developed postoperatively in a child with epispadias. Analysis of the pathophysiological development of this lesion and a review of the literature are presented. The inert subpreputial space may become calculogenic in the presence of phimosis and urinary stasis.
Contours of American National Identity

All nationalist doctrines insist that allegiance to the nation should override affiliations to less inclusive groups, such as those based on race, religion, language, or class. Writing about the aftermath of colonialism in From Empire to Nation , Rupert Emerson wrote that the nation is “the largest community which, when the chips are down, effectively commands men’s loyalty, overriding the claims both of the lesser communities within it and those which cut across it or potentially enfold it within a still greater society.” Whether this claim about the strength and pervasiveness of identification with the nation and the unique importance of this identity still holds in the United States is the subject of this chapter. Has the conflation of demographic change, due largely to immigration, and identity politics prompted an overall weakening of Americans’ national identity and a widening of ethnic fault lines in patriotic sentiment? Pessimistic observers highlight distinctive threats to national attachment in all the country’s main ethnic groups. Samuel Huntington singles out Hispanic immigration, arguing that the mass entry and geographic concentration of these newcomers close to their countries of origin may short-circuit the development of loyalty to the United States that occurred among earlier immigrant waves. If Huntington is correct about the future attitudes of American Latinos, then the fact that they are the fastest growing segment of a projected majority-minority society is a significant challenge to the traditional meaning of e pluribus unum .
Cbl-b Deficiency Mediates Resistance to Programmed Death-Ligand 1/Programmed Death-1 Regulation

Cbl-b is an E3 ubiquitin ligase that negatively regulates T cell activation. Cbl-b-/- T cells are hyper-reactive and co-stimulation independent, and Cbl-b-/- mice demonstrate robust T cell and NK cell-mediated anti-tumor immunity. As a result of these murine studies, Cbl-b is considered a potential target for therapeutic manipulation in human cancer immunotherapy. The PD-L1/PD-1 pathway of immune regulation is presently an important therapeutic focus in tumor immunotherapy and although Cbl-b-/- mice have been shown to be resistant to several immuno-regulatory mechanisms, the sensitivity of Cbl-b-/- mice to PD-L1-mediated suppression has not been reported. We now document that Cbl-b-/- T cells and NK cells are resistant to PD-L1/PD-1-mediated suppression. Using a PD-L1 Ig fusion protein, this resistance is shown for both in vitro proliferative responses and IFN-γ production and is not associated with decreased PD-1 expression on Cbl-b-/- cells. In co-culture studies, Cbl-b-/- CD8+, but not CD4+ T cells diminish the PD-L1 Ig-mediated suppression of bystander naive WT CD8+ T cells. Using an in vivo model of B16 melanoma in which numerous liver metastases develop in WT mice in a PD-1 dependent manner, Cbl-b-/- mice develop significantly fewer liver metastases without the administration of anti-PD-1 antibody. Overall, our findings identify a new mode of immuno-regulatory resistance associated with Cbl-b deficiency and suggest that resistance to PD-L1/PD-1-mediated suppression is a novel mechanism by which Cbl-b deficiency leads to enhanced anti-tumor immunity. Our results suggest that targeting Cbl-b in cancer immunotherapy offers the opportunity to simultaneously override numerous relevant “checkpoints” including sensitivity to regulatory T cells, suppression by TGF-β, and immune-regulation by both CTLA-4, and as we now report, by the PD-L1/PD-1 pathway.
Commentary on Symptom Management of the Patient with CKD: The Role of Dialysis

This evidence-based review by Cabrera et al. ([1][1]) examines the effect of timing of dialysis initiation on control of uremic symptoms in patients with advanced CKD. The authors consider the effects of dialysis initiation and its timing on health-related quality of life (HRQoL), malnutrition,
Improved Overall Survival with Aggressive Primary Tumor Radiotherapy for Patients with Metastatic Esophageal Cancer

Abstract Objectives The aim of this study was to characterize utilization and survival outcomes associated with primary tumor–directed radiotherapy (PTDRT) in patients with newly diagnosed metastatic esophageal cancer. Methods We conducted an observational cohort study using the National Cancer Data Base to evaluate patients with newly diagnosed metastatic esophageal cancer between 2004 and 2012. Overall survival outcomes after treatment with chemotherapy plus conventional palliative dose radiotherapy ( Results The final cohort consisted of 12,683 patients: 57% were treated with chemotherapy alone, 24% were treated with chemotherapy plus palliative dose radiotherapy, and 19% were treated with chemotherapy plus definitive dose radiotherapy. Compared with chemotherapy alone, chemotherapy plus definitive dose radiotherapy was associated with improved survival (median overall survival of 8.3 versus 11.3 months [hazard ratio = 0.72, 95% confidence interval: 0.70–0.74, p ≤ 0.001]), whereas chemotherapy plus palliative dose radiotherapy was associated with slightly inferior outcomes (median overall survival of 8.3 months versus 7.5 months (hazard ratio = 1.10, 95% confidence interval 1.07–1.13, p ≤ 0.001). These findings were robust to potential unmeasured confounding in sensitivity analyses. Additionally, landmark analyses confirmed these findings in patients surviving 12 months or longer. Conclusions Definitive dose, but not conventional palliative dose, PTDRT is associated with improved overall survival in metastatic esophageal cancer, suggesting that local control may be important to prognosis. These findings support integrating PTDRT into future clinical trials aimed at refining personalized treatment for patients with metastatic esophageal cancer.
Control of Morphology in Polymer Blends through Light Self-Trapping: An in Situ Study of Structure Evolution, Reaction Kinetics, and Phase Separation

We report on how polymer morphology is controlled through the self-trapping of transmitted optical beams in photoreactive polymer blends. Self-trapped optical beams, characterized by divergence-free propagation, drives the growth of a congruent arrangement of polymer filaments in the blends. With suitable component weight fractions and exposure intensity, binary phase morphologies form in precisely the same pattern as the beams’ arrangement, thereby producing 2D structures in polymer blend volumes of large depth and area. Morphology evolution and the formation processes were observed by in situ microscopy. In situ confocal Raman measurements of polymer conversion and molecular weight increase along the filament regions reveal that polymerization undergoes autoacceleration, followed by the onset of mixing instability which leads to phase separation. These phenomena begin at the front end of the filament and propagate along its length over the depth of the blend. Control over morphology is discussed with re...
A Bastard and a Changeling? England’s Edward of Westminster and Delayed Childbirth

When Margaret of Anjou married England’s Henry VI in 1445, people expected an heir to quickly follow. Unfortunately, their son and heir Edward of Westminster was not born until 1453, after eight years of marriage. The royal couple’s prolonged period of infertility provided ammunition for their Yorkist opponents, who used it and slanders to the queen’s sexual morality to cast doubt on Edward’s legitimacy, claiming he was the product of adultery or even a random boy the queen was attempting to pass off as a prince. Despite Margaret’s best efforts, Edward was disinherited and lived with her in exile on the continent. There he was educated as befit a prince, schooled in law, politics, and war until his untimely death in battle at age seventeen.
Conclusion: A Clinical Bone Perspective

This text has reviewed adolescent bone pathophysiology and provided evidence to support strategies to optimize bone mass accrual during this critical developmental period. In this concluding chapter, we attempt to bring these concepts together to illustrate how they play out in day-to-day practice.
Molecular characterization of antibiotic resistant and potentially virulent enterococci isolated from swine farms and feed mills

Abstract A total of 108 swine feed samples were collected from six feed mills and two farms and tested for enterococcal contamination. Nearly 43% of these samples were positive for enterococci. The mean ± SE concentration of enterococci in feed samples ranged from 2.0 × 101 to 7.3 × 103 CFU/g of feed. About 38% of processed feed mill samples were contaminated with enterococci compared to 59% of swine farm samples. A total of 208 enterococcal isolates were represented by Enterococcus casseliflavus (54.8% of total isolates), E. gallinarum (17.8%), E. faecium (17.8%), E. hirae (5.8%), and E. faecalis (3.8%). These isolates were phenotypically resistant to tetracycline (48.5%), erythromycin (14.4%), streptomycin (13.4%), kanamycin (11.5%), ciprofloxacin (10.0%), ampicillin (2.8%), and chloramphenicol (1.4%). All isolates were susceptible to vancomycin and gentamicin. Tetracycline resistance was encoded by tetM gene (52.8%), tetO (14.4%), tetK (1.0%), and tetS (0.5%), whereas ermB conferred erythromycin resistance in 10.6% of all isolates. Several isolates carried genes coding for virulence factors, including gelatinase (gelE; 18.2%), an enterococcal surface protein (esp; 2.4%), and cytolysin (cylA; 2.4%). Only E. faecalis was β-hemolytic (2.9%) and gelatinolytic (3.4%). The aggregation substance gene asa1 was detected in 5 out of 8 E. faecalis isolates, of which four were phenotypically positive. The transposon Tn916/1545 was detected in 11.5% of all isolates. Mating assays revealed that 7 out of 8 E. faecalis could transfer tetM gene, and rate of transfer ranged from 2.0 × 10−3 to 1.6 × 10−5. The presence of antibiotic resistant and potentially virulent enterococci in swine farm samples and feed mill samples, though in low prevalence, raises concern and emphasizes the need for improved hygiene and quality standards on farms and in feed mills.
Normal Forms and Invariant Manifolds

In the previous chapter, we began the discussion of the bifurcations that occur in nonautonomous perturbations of autonomous equations. To understand more about these bifurcations, we need several general results and methods from the theory of differential equations—in particular, the theory of transformation to normal form and the method of integral manifolds. This material is also an important ingredient in the discussion in the next chapter on the behavior near an equilibrium point in dimension greater than two for which the linear variational equation has several eigenvalues on the imaginary axis.
Intestinal CD36 and Other Key Proteins of Lipid Utilization: Role in Absorption and Gut Homeostasis

Several proteins have been implicated in fatty acid (FA) transport by enterocytes including the scavenger receptor CD36 (SR-B2), the scavenger receptor B1 (SR-B1) a member of the CD36 family and the FA transport protein 4 (FATP4). Here, we review the regulation of enterocyte FA uptake and its function in lipid absorption including prechylomicron formation, assembly and transport. Emphasis is given to CD36, which is abundantly expressed along the digestive tract of rodents and humans and has been the most studied. We also address the pleiotropic functions of CD36 that go beyond lipid absorption and metabolism to include recent evidence of its impact on intestinal homeostasis and barrier maintenance. Areas of progress involving contribution of membrane phospholipid remodeling and of cytosolic FA-binding proteins, FABP1 and FABP2 to fat absorption will be covered. © 2018 American Physiological Society. Compr Physiol 8:493-507, 2018.
The relationship between Americans’ spiritual/religious beliefs and behaviors and mental health: New evidence from the 2016 General Social Survey

This study uses 2016 General Social Survey (GSS) data to examine the relationship between Americans’ religious and spiritual beliefs and behaviors and their mental health. Mental health is measured...
Room to move: Physical activity and exercise barriers in the cancer clinic.

e21601Background: Exercise can improve outcomes and quality of life following cancer diagnosis. The American College of Sports Medicine (ACSM) recommends 150 minutes of moderate aerobic activity fo...
No Facebook for Me: Examining the Reasons People Choose Not to be on Facebook

For several years, research has investigated a number of variable associated with behavior on social networking and the proclivity toward its use. the present study explores some of the reasons people choose not to join one social networking site, Facebook (FB). A convenience sample consisting of 91 women and 58 men, none of whome were on FB, responded to a 13-item survey offering possible reasons for their not participating. Responses disclosed four core concerns: privacy, preference for personal interactions, superficiality of FB, and time constraints. For these reasons subjects chose either to leave or not to join FB. Age and gender were analyzed as well, illustrating minimal differences.
The Tool Box

In functional programming, we adapt and combine functions in a variety of ways. Sometimes a pattern of adaptation and combination appears again and again, in different contexts, expressing the same underlying programming idea and design. Scheme provides names for only a few of these patterns, but we can define and name the others ourselves, using the notations that we learned in Chapter 1.
Seasonality of nitrate sources and isotopic composition in the Upper Illinois River

Abstract To improve understanding of spatial, seasonal, and inter-annual variations in nitrate sources and in-stream processes in the Illinois River system, nitrate concentrations and isotopic compositions were measured in 445 water samples collected over a four-year period (2004–2008) from the Upper Illinois River Basin (UIRB). Samples included surface water in the river and major tributaries, effluent samples from Chicago’s largest wastewater treatment plant (WTP), and representative groundwater from shallow wells in agricultural land. Two principal nitrate endmember sources within the UIRB had distinctive isotopic compositions: WTP effluent with δ15N = 8.6 ± 1.7‰ and δ18O = 0.8 ± 1.4‰ and agricultural groundwater with δ15N-NO3 = 3.4 ± 0.6‰ and δ18O = 3.7 ± 0.5‰ (when minimally affected by nitrate reduction). Isotopic data indicated that the large pulse of nitrate exported from the river basin during the spring was mostly derived from agricultural land drainage, while nitrate from large WTP effluent point sources was predominant in the upper reaches of the river near Chicago. During low base-flow conditions in late-summer and fall, the agricultural nitrate source was greatly diminished and the headwater WTP source was predominant in the river basin export. Our results indicated biogeochemical nitrate reduction and isotopic fractionation occurred within the river network, affecting both agricultural and urban sources during surface-water transport. In addition, diminished agricultural nitrate export was attributable to preferential discharge of biogeochemically reduced groundwater during low base flow. Isotopic indicators of spatial and seasonal variations in the relative importance of different nitrate sources, and their relative susceptibility to natural attenuation, might be useful for guiding monitoring and management practices to reduce nitrate export from complex watersheds with mixed land uses.
Distributed Generator Sizing for Joint Optimization of Resilience and Voltage Regulation

The vulnerability of electric power distribution systems to extreme weather events calls for added resilience to help withstand and recover from the high impact low probability (HILP) events. The ongoing push to integrate distributed generators (DGs) in power distribution systems can be leveraged to provide resilience to extreme weather events. Optimally located DGs can help recover the critical services in the event of a major disaster by actively forming self-sustained islanded grids (SSIGs). Unfortunately, the increased DG penetration during normal operation can cause power flow reversal and potential over-voltage concerns at the customer locations. In this paper, a novel approach for the optimal sizing of distribution generators is formulated for resilient restoration in a disaster condition and improving the voltage profile in normal operation. Specifically, a mixed-integer linear problem (MILP) is formulated to maximize the critical loads to be picked up while satisfying the operational and connectivity constraints for SSIG formation problem and minimize the voltage deviations during normal operation of the distribution network. Numerical results based on IEEE 123-node test case validates the effectiveness of the proposed approach.
Highly Functionalized Cyclohexenes Derived from Benzene: Sequential Tandem Addition Reactions Promoted by Tungsten.

The dihapto-coordination of benzene to the π-basic fragment {TpW(NO)(PMe3)} (Tp = hydridotris(pyrazolyl)-borate) enhances the basicity of the arene ligand to the point that it can be protonated with a mild Bronsted acid (diphenylammonium triflate; p Ka ∼ 1). The resulting η2-benzenium complex reacts with a wide range of nucleophiles including protected enolates, cyanide, amines, methoxide, and aromatic nucleophiles to form 5-substituted 3,4-η2-1,3-cyclohexadiene complexes in good yield (42-70%). These coordinated dienes were successfully taken through a second protonation and nucleophilic addition with a similar scope of nucleophiles (54-80%). The resulting cis-3,4- and cis-3,6-disubstituted η2-cyclohexene complexes were prepared with high regio- and stereocontrol, as governed by the asymmetric nature of π-allyl intermediates. In some cases, a diene linkage isomerization from 3,4-η2 to 1,2-η2 could be effected with a redox catalyst, and reactions of the latter species led to cis-3,5-disubstituted cyclohexene products exclusively. Oxidative decomplexation afforded the free cyclohexene products in moderate yield (37-68%). Additionally, when a single enantiomer of the chiral dearomatization agent was used, the elaborated cyclohexenes were able to be synthesized in enantioenriched forms (86-90% enantiomeric excess). Full characterization of 40 new compounds is provided that includes two-dimensional NMR, IR, electrochemical and in some cases crystallographic data.