cssi/SciSciGPT-SciSciNet huggingface dataset:
Neuroimmunomodulation: neural anatomical basis for impairment and facilitation.

Rats with bilateral electrolytic lesions of specific limbic nuclei show alterations in lymphoid cell number and in lymphocyte activation induced in vitro by concanavalin A (Con A). The number of splenocytes decreases after lesioning in the anterior hypothalamus (p less than 0.001), ventromedial hypothalamus (p less than .0.2), and mamillary bodies (p less than. 0.001). The number of thymocytes decreases after lesioning of the anterior hypothalamus (p less than 0.001) and increases after hippocampal lesioning (p less than 0.001). Spleen cell responsiveness to con A decreases subsequent to lesioning of the anterior hypothalamus, whereas reactivity was enhanced after lesion placement in the mamillary bodies (p less than 0.002), hippocampus (p less than 0.001), and amygdaloid complex (p less than 0.001). Thymocyte mitogen reactivity is increased by lesions of the hippocampus (p less than 0.001) and amygdaloid complex (p less than 0.001). These effects manifest themselves maximally 4 days after lesioning, with a return to normal by day 14. These preliminary data indicated that quantitative and qualitative lymphocyte functions are altered by ablation of selected brain nuclei, thereby suggesting the presence of neural modulation of immune function.
Effect of prostaglandins on the velocity of the reaction between human renin and homologous renin substrate.

ABSTRACT The present study was undertaken to evaluate the effects of several prostaglandins (PG) on the in vitro velocity of the reaction between human renin and homologous renin substrate. In the presence of high renin concentrations, 1.4 × 10−6 moles PGA1 and PGA2 each significantly inhibited the rate of angiotensin I production (p 0.05). At lower enzyme concentrations, PGA2 was a more potent inhibitor than PGA1. In the presence of physiologic renin concentrations, 1.4 × 10−9 moles PGA2 but not 1.4 × 10−10 moles PGA2 inhibited renin reactivity. Unrelated to differences of endogenous renin substrate concentration, renin reactivity in plasma of uremic patients was greater than that of normotensive control subjects, even after the addition of 1.4 × 10−9 moles PGA (p < 0.025). Renin inhibition was demonstrated by concentrations of PGA within the renal medulla, but not at the lower concentrations in peripheral venous plasma. Consequently, if PGA induced renin inhi...
Dependence of Sheet Hole Concentrations on Growth Kinetics of a Carbon Doped Electron Beam Heated Graphite Source in GaAs and Al0.3GaD0.7As Films Grown by Solid Source MBE

A series of carbon delta- and uniformly- doped GaAs and Al0.3Ga0.7As films have been grown by solid source Molecular Beam Epitaxy using an electron-beam heated graphite rod as the dopant source. In contrast to heated filament carbon sources, this electron-beam source produces atomic carbon C1, rather than C3 as the predominant species. The purpose of these experiments was to compare measured sheet carrier concentration of delta-doped GaAs and Al0.3Ga0.7As films under fixed growth conditions and with similar carbon beam fluxes using this electron-beam source. The films were characterized by Hall-effect measurements. The Al0.3Ga0.7As films have consistently higher hole sheet carrier concentrations than GaAs films with similar carbon fluxes. Delta-doped Al0.3Ga0.7 As sheet carrier concentrations of up to 2.2×1013 cm−2 were measured, and thin uniformly-doped Al0.3Ga0.7 As carrier densities were measured up to 5.7×1020 cm−3. The uniformly doped Al0.3Ga0.7As films appear to have higher atomic carbon activation than this delta-doped Al0.3Ga0.7As films. These results can be possibly explained in terms of several concurrent processes involving C-C pairing, stronger Al-C bonding, and dopant surface segregation taking place on the growth surface of the delta-doped layer. Photoluminescence intensity measurements of uniformly-doped GaAs shows degradation at hole concentrations greater then 1018 cm−3 and bandgap contraction at hole densities greater than mid 1018 cm−3.
High percentage of CD8+, Leu-7+ cells in rheumatoid arthritis synovial fluid.

Objective. While analyzing the phenotype of the synovial fluid mononuclear cells (SFMC) clustered about dendritic cells in rheumatoid arthritis (RA) joint effusions, it was noted that most of the clustering cells were CD8+ and coexpressed Leu-7. Therefore, the present study was conducted to investigate the frequency of CD8+, Leu-7+ cells in RA SF. Methods. SFMC from 13 patients with RA and from 12 patients with non-RA inflammatory arthritides were examined for CD8 and Leu-7 expression using 2-color immunofluorescence flow cytometry. Results. RA SFMC had statistically significantly greater percentages of total CD8+ cells, total Leu-7+ cells, and CD8+, Leu-7+ cells, compared with SFMC from the non-RA patients. These RA CD8+, Leu-7+ SFMC had a distinctive electron microscopic appearance compared with CD8+, Leu-7– SFMC. When peripheral blood mononuclear cells (PBMC) from 31 RA patients (including 7 from the SFMC group) were compared with PBMC from 15 normal controls, the percentage of CD8+, Leu-7+ cells was not significantly greater in the RA patients. However, the combination of a modest increase in CD8+, Leu-7+ cells and a decrease in total CD8 cells in RA PBMC altered the composition of the RA CD8 population compared with normal PBMC, such that over 40% of RA peripheral blood CD8 cells coexpressed Leu-7. Conclusion. The increased frequency of CD8+, Leu-7+ cells in RA SFMC may arise from the fact that a high percentage of the CD8+ PBMC in RA patients are also Leu-7+. This altered composition of CD8 cells in RA SF may have a role in the pathogenesis of the disease.
A Dynamic Programming Algorithm for Cluster Analysis

This paper considers the problem of partitioning N entities into M disjoint and nonempty subsets clusters. Except when both N and N-M are very small, a search for the optimal solution by total enumeration of all clustering alternatives is quite impractical. The paper presents a dynamic programming approach that reduces the amount of redundant transitional calculations implicit in a total enumeration approach. A comparison of the number of calculations required under each approach is presented in Appendix A. Unlike most clustering approaches used in practice, the dynamic programming algorithm will always converge on the best clustering solution. The efficiency of the dynamic programming approach depends upon the rapid-access computer memory available. A numerical example is given in Appendix B.
Scheduling manufacturing systems with work-in-process inventory control: multiple-part-type systems

Abstract We have studied here the real-time production scheduling problem for multiple-part-type flow shops. The system under consideration consists of many machines and produces many product types. Each part goes through the system following a pre-defined routeing and may visit each machine at most once. We consider three classes of activities: operations, failures or repairs and starvation or blockage. The scheduling objectives are to keep the actual production close to the demand and to reduce the work-in-process inventory and cycle time. A three-level hierarchical production control model is developed to regulate production for the manufacturing systems. The control policy specifies how to react to machine failures. It also tells how to allocate limited system capacity among all the part types. It utilizes the material and the space in the storage buffers to alleviate the propagation of a failure to other machines in the system.
Thyroid dysfunction after radiation therapy in head and neck cancer patients

Introduction: The reported incidence of hypothyroidism following surgery and/or radiation therapy for head and neck cancer varies widely. Most patients undergo thyroid lobectomy during laryngectomy. Standard radiation treatment portals often include the thyroid gland. The insidious development of hypothyroidism may be misdiagnosed. This study examines the incidence of thyroid dysfunction in the setting of head and neck cancer therapy. Materials and Methods: Thyroid function tests were performed on 100 consecutive patients treated in the head and neck tumor clinic. Statistical inferences on proportions were made using chi-square analysis. Results: Therapy included surgery only (10 patients), radiation therapy only (28 patients), and combined therapy (62 patients). These patients experienced thyroid dysfunction in 0%, 29%, and 45% of individuals respectively. These differences were statistically signicant (P < .05). The highest rate of dysfunction (69%) was associated with patients undergoing laryngectomy and radiation therapy. When laryngectomy was not performed, thyroid dysfunction occurred in 28%. Conclusion: The likelihood of thyroid dysfunction after radiation therapy is high particularly when combined with surgery in which thyroid lobectomy is performed and the contralateral lobe is potentially devascularized. These results suggest that radiation therapy is a primary factor in alteration of thyroid function. We recommend that routine thyroid function testing be part of follow-up of all head and neck cancer patients.
"Proper Subjects for Medical Treatment?" Addiction, Prison-Based Drug Treatment, and the Eighth Amendment

The Supreme Court has held that deliberate indiference to prisoners' serious medical needs violates the Eighth Amendment's prohibition on cruel and unusual punishment. This article argues that, because both courts and the medical community have consistently acknowledged that addiction is a disease, there may well be a basis in constitutional law for people in prison to claim a constitutional right to prison-based drug
HYDROLOGY, FLOODS AND DROUGHTS | Deserts and Desertification

This article is a revision of the previous edition article by G Wang, G S Jenkins, volume 2, pp 633–640, © 2003, Elsevier Ltd.
Complications Related to the Treatment of Slipped Capital Femoral Epiphysis

Slipped capital femoral epiphysis (SCFE) is a condition of the immature hip in which mechanical overload of the proximal femoral physis results in anterior and superior displacement of the femoral metaphysis relative to the epiphysis. The treatment of SCFE is surgical, as the natural history of nonsurgical treatment is slip progression and early arthritis. Despite advances in treatment, much controversy exists regarding the best treatment, and complication rates remain high. Complications include osteonecrosis, chondrolysis, SCFE-induced impingement, and related articular degeneration, fixation failure and deformity progression, growth disturbance of the proximal femur, and development of bilateral disease.
Impact of predictors upon the reduction of lipid parameters in family medicine practice

CONTEXT AND OBJECTIVE: To evaluate predictors of changes in lipid parameters consisting of LDL-C (low-density lipoprotein cholesterol), TC (total cholesterol) and non-HDL-C (non-high density lipoprotein cholesterol) among primary care patients. DESIGN AND SETTING: Retrospective study conducted on family medicine patients. METHODS: Demographic features and other clinically relevant information were abstracted from medical records. The primary outcome was the difference in LDL-C level from initial testing to the index test. Secondary outcomes were the changes in TC and non-HDL-C levels between two measurements. RESULTS: Three hundred and eleven participants were included in the final secondary analysis. Multiple linear regression revealed that male patients (β = 4.97, P = 0.040), diabetes (β = 9.75, P = 0.003) and higher LDL-C levels at baseline (β = 0.35, P < 0.001) were positively associated with LDL variance, whereas longer time period (β = -0.15, P = 0.045) and familial hypercholesterolemia history (β = -7.56, P = 0.033) were negatively associated. Male patients (β = 8.45, P = 0.002), DM (β = 9.26, P = 0.011), higher TC levels at baseline (β = 0.35, P < 0.001) and taking statins (β = 7.31, P = 0.023) were positively associated with TC variance, whilst longer time period (β = -0.183, P = 0.031) and familial hypercholesterolemia (β = -10.70, P = 0.008) were negatively associated. CONCLUSION: In the present study, patients who were male, on statin treatment, diagnosed with diabetes and had higher baseline lipid values were more likely associated with better lipid outcomes at future testing.
Muscle-specific and inducible expression of 293-base pair beta-myosin heavy chain promoter in transgenic mice

The DNA regulatory element(s) involved in beta-myosin heavy chain (beta-MHC) induction by the physiological stimulus of mechanical overload have not been identified as yet. To delineate regulatory sequences that are required for mechanical overload induction of the beta-MHC gene, transgenic mouse lines were generated that harbor transgenes containing serial deletions of the human beta-MHC promoter to nucleotides -293 (beta 293), -201 (beta 201), and -141 (beta 141) from the transcription start site (+1). Mechanically overloaded adult plantaris and soleus muscles contained 11- and 1.9-fold increases, respectively, in endogenous beta-MHC-specific mRNA transcripts (Northern blot) compared with sham-operated controls. Expression assays (chloramphenicol acetyltransferase specific activity) revealed that only transgene beta 293 expression was muscle specific in both fetal and adult mice and was induced in the plantaris (10- to 27-fold) and soleus (2- to 2.5-fold) muscles by mechanical overload. Histochemical staining for myosin adenosinetriphosphatase activity revealed a fiber-type transition of type II to type I in the overloaded plantaris and soleus muscles. These transgenic data suggest that sequences located between nucleotides -293 and +120 may be sufficient to regulate the endogenous beta-MHC gene in response to developmental signals and to the physiological signals generated by mechanical overload in fast- and slow-twitch muscles.
P1-S6.20 Perinatal Screening for STIs in the USA: adherence to preventive screening recommendations for HIV and syphilis among the commercially insured (2008)

Background Perinatal transmission of sexually transmitted infections is a preventable source of morbidity. In the USA, the incidence of congenital syphilis has increased by 23% since 2005 and, in 2008, 141 infants were infected with HIV, despite the fact that the CDC recommends routine prenatal syphilis and HIV screening. To encourage compliance with guidelines, many payers rely on claims data to track utilisation. In this study, the percentage of women screened for syphilis or HIV during their pregnancy was estimated using MarketScan claims data, as a measure of compliance and of the feasibility of using these data for assessment of prenatal screening. Methods We analysed data from the MarketScan database, that allows linkage of de-identified patient and utilisation data from varying sites of care. The analysis was restricted to women who delivered a live birth in 2008, and who were continuously enrolled in one health plan for at least 293 days prior to delivery. The eligible population was identified using the coding algorithm for a live birth defined by HEDIS. Results Among the 220 571 women with a live birth in 2008, 87.0% received a syphilis test during their pregnancy, 74.1% received an HIV test and 73.3% received both. The test rate for syphilis was highest for those 31–35 yrs (88.2%) and lowest for those 15–20 yrs (78.3%). The test rate for HIV was highest among those 21–25 yrs (75.2%) and lowest among those 15–20 yrs (70%). Both prenatal syphilis and HIV test rates were highest among those insured by a preferred provider plan. Regionally, testing rates were highest in the South (89.8% for syphilis and 82.1% for HIV) and lowest in the Northeast for syphilis (82.8%) and in the West for HIV (62.9%). Conclusions The results suggest fairly good compliance with guidelines for prenatal HIV and syphilis screening, although utilisation still varies by age, insurance type and geographic region. The MarketScan database represents individuals covered by employment-based health plans, which is how most Americans are insured. These data provide a unique opportunity to assess utilisation among the insured, at a time when the USA is poised to move a larger proportion of the population into this group. Tracking of year-to-year changes could help public health and healthcare organizations partner to improve care and target interventions to ensure equal access to these critical services.
Realizable Unied RANS-LES and Dynamic LES Methods for Turbulent Flow Simulations

Existing LES methods face three basic problems: a huge variety of LES models are currently applied, dynamic LES methods are either very expensive or have to be combined with ow-dependent empirical stabilization techniques, and the cost of LES for wall-bounded ow simulations are way too high for most applications. Solutions for these three problems can be developed by deriving non-dynamic, dynamic, and uni ed LES methods on the basis of a consistent stochastic theory. This approach results in a hierarchy of realizable LES models, corresponding dynamic LES methods that overcome the stability problems of existing dynamic LES methods, and uni ed RANS-LES methods that provide a reduction of LES cost by a factor of 0:07 Re, which is huge for a high Reynolds number Re. The paper explains the theoretical background of the novel dynamic and uni ed LES methods based on stochastic analysis. Applications to several ows reveal the signi cant advantages of these methods in comparison to usually applied LES methods.
ENDOTOXIC PROPERTIES OF AN EXTRACT OF S. AUREUS.

SummaryComparative dose-response studies on the pharmacologic effectiveness of an S. aureus extract and E. coli endotoxin have been performed with regard to 1) lethal effect in intact and adrenalectomized mice, 2) tumor-necrotizing activity, and 3) lethal and hemorrhagic effects in chick embryo. Results indicate that properties of S. aureus extract are distinctive but similar to those of gram negative endotoxin. It is suggested that this material may be an important virulence factor in certain strains of S. aureus and that its effectiveness in this regard is inversely related to adrenal function of the host.
Patient preferences for route of allergy immunotherapy: a comparison of four delivery methods.

Background Allergen-specific immunotherapy (IT) is a disease-modifying treatment for allergic rhinitis, and adherence to the treatment schedule is important for a successful outcome. Several methods for delivering IT are now available, but little information is known concerning patient preference for these options. Methods Over a 12-month period, 228 adults scheduled to undergo outpatient allergy testing were offered a survey to rank 4 different IT delivery methods: subcutaneous IT (SCIT), sublingual IT using liquid extracts (SLIT), sublingual allergy immunotherapy tablets (AIT), and oral mucosal immunotherapy (OMIT) using a toothpaste delivery vehicle. Results Of the participants who completed the survey, ranking scores (mean ± SD) for SCIT, SLIT, AIT, and OMIT, with 1 being the highest rank, were 3.36 ± 1.02, 2.03 ± 0.92, 2.30 ± 1.02, and 2.32 ± 1.05, respectively. The number of participants who ranked SCIT, SLIT, AIT, or OMIT as their number 1 choice was 24 (10.5%), 79 (34.6%), 61 (26.8%), and 64 (28.1%), respectively. When comparing first choice rankings, there were no statistically significant differences between SLIT, AIT, or OMIT, yet all 3 groups ranked higher than SCIT (p < 0.0001). Conclusion SCIT earned the lowest mean rank and had the least number of participants rank it as the most preferred method. Among the other 3 choices, by mean scores, SLIT was preferred most compared to either AIT or OMIT; but when considering first choices only, there were no significant differences in preference. Most of the study participants identified the convenience of home IT administration as the most important factor in their ranking.
IMPS-29REFUTING BRAIN IMMUNE PRIVILEGE: LONGITUDINAL MULTIPHOTON IMAGING THROUGH SKULL WINDOWS REVEALS THE IMMUNE SURVEILLANCE OF BRAIN METASTASES AND ITS REGULATION BY FRACTALKINE

INTRODUCTION: The brain has conventionally been considered to be immune-privileged, which has detracted from the pursuit of immunotherapies for brain tumors. However, whether brain malignancies remain insulated from the immune system is unclear. T cell migration in tissues is regulated in part by chemokines often in an organ-specific manner. We hypothesized that brain tumors are accessible to T cell surveillance, and that this process is regulated by a chemokine called fractalkine, which is highly expressed in the brain. METHODS: Cranial windows for intravital multiphoton microscopy were established in novel transgenic murine models in which T cells, macrophages, microglia, and dendritic cells were distinctly gene-labeled with fluorescent tags. For comparison, multicolor reporter mice deficient in fractalkine receptor (CX3CR1gfp/gfp-KO) were used. Brain metastases (BM) were induced via carotid artery injection of fluorescent MCA fibrosarcoma cells and the immune dynamics at brain tumor lesions was imaged longitudinally. RESULTS: BM regressed after initial progression in wild-type (WT) mice, but were lethal in Rag1-KO mice, and importantly also lethal in CX3CR1-KO mice. Intravital microscopy in WT reporter mice revealed hotspots of T cell migration at BM foci followed by tumor fragmentation. In striking contrast, T cells were reduced in BM in CX3CR1-KO reporter mice and exhibited increased meandering and decreased engagement with cancer cells. CONCLUSION: With live imaging, we directly show the existence of robust and effective immune surveillance within the brain contrary to the concept of "brain immune privilege". Furthermore, we identify the fractalkine/CX3CR1 chemokine-receptor axis as a key regulator of T cell immune surveillance in the malignant brain.
Facial nerve dissection by use of acoustic (loudspeaker) facial EMG monitoring.

The development of the surgical microscope in 1953, and the subsequent development of microsurgical instrumentation, signaled the beginning of modern-day acoustic neuroma surgery. Preservation of f...
Psoriasis as an Independent Risk Factor for Cardiovascular Disease: An Epidemiologic Analysis Using a National Database

Background:Psoriasis is known to be associated with metabolic syndrome, a well-established risk factor for ischemic heart disease and stroke. Emerging evidence indicates that psoriasis is an indepe...
Communication and the Service Exchange: Confirming The Dimensions of Provider Relational Messages and Exploring their Impact on Client Satisfaction

The relationship marketing concept has received much attention in the services marketing literature. Much of this literature has focused on the role of communication in building and maintaining relationships between a service firm, its personnel, and its clients. While some of this research links relational outcomes such as trust (Berry, 1995) to service outcomes such as satisfaction and quality, no research to date has tested a valid classification of relational messages and their impact on service outcomes.
High Brightness Lasers using an In-Phase, Coherently Coupled, Output Waveguide Array

We have developed a novel diode laser coupled waveguide array which achieves strong in-phase coupling. Far-field measurements show an interference pattern with a strong, narrow, stable, on-axis central lobe ideal for high-brightness applications.
Use of a continual sweep motion to compare air polishing devices, powders and exposure time on unexposed root cementum.

Low abrasive air polishing powders are a viable method for subgingival biofilm removal. This in vitro study evaluated the effects of air polishing using a standard tip on cementum following clinically recommended protocols. Forty-eight teeth were randomly divided into eight groups with six teeth per group. Teeth were treated using either a Hu-Friedy EMS or DENTSPLY Cavitron® air polishing device. One of three glycine powders (Air-flow 25 µm, Clinpro 45 μm, Clinpro+TCP 45 μm) or a sodium bicarbonate powder (NaHCO3 85 μm) was sprayed on cementum using a clinically relevant sweeping motion. Volume and depth of cementum removed after 5 and 90 s exposures were calculated. Surface texture was evaluated using SEMs taken following the last exposure. After 5 s exposures, neither unit nor powder had a substantial effect on volume loss or defect depth. After 90 s exposures, differences between powders existed only for the DENTSPLY unit (p < 0.0001). Pairwise comparisons for this unit revealed mean volume loss and maximum defect depth were greater for NaHCO3 85 μm than the glycine powders (p < 0.0001). The 90 s exposure produced greater mean volume loss and defect depth for all powders (p < 0.0001). SEM images revealed dentinal tubule exposure with all powders; however, exposed tubules were larger and more prevalent for NaHCO3 85 μm. Root surface loss was similar for glycine powders evaluated in this study. Differences in powder performance between units may be related to tip apertures and spray patterns. Additional research is needed to determine if cementum loss is greater than what occurs with conventional biofilm removal methods, such as curets and ultrasonic scalers.
Abstract 559: Augmented Renal Levels of PDGFß And PDGFß Receptors in Cyp1a1-Ren2 Transgenic Rats With Angiotensin II-Dependent Malignant Hypertension

PDGF receptor antagonism with imatinib mesylate prevents the renal injury, proteinuria and augmented urinary ANG II excretion independent of changes in blood pressure that occur in Cyp1a1-Ren2 rats with ANG II-dependent malignant hypertension. These findings suggest that arterial pressure-dependent increases in PDGFβ protein levels and PDGFβ receptor activation contribute importantly to the marked renal functional and morphological derangements that occur in ANG II-dependent malignant hypertension. To address this issue, the present study was performed to determine the protein levels of PDGFβ and PDGFβ receptors in renal cortical and medullary tissue from kidneys of hypertensive Cyp1a1-Ren2 transgenic rats. Male Cyp1a1-Ren2 rats were fed a diet containing indole-3-carbinol (I3C; 0.3%) for 10 days to induce malignant hypertension (n=5) or a non-I3C containing diet (controls, n=6). Rats induced with I3C developed malignant hypertension and exhibited increases in PDGFβ protein levels in both the renal cortex (0.046±0.002 vs.0.026±0.003 AU, P
Long-Term Comparative Outcomes of Patients With Peripheral Artery Disease With and Without Concomitant Coronary Artery Disease.

There are limited contemporary data on guideline-directed medical therapy (GDMT) utilization and long-term clinical outcomes in patients with peripheral artery disease (PAD) with and without concomitant coronary artery disease (CAD). From 2006 to 2013, 879 patients with claudication or critical limb ischemia (CLI) underwent diagnostic angiography or therapeutic endovascular intervention at our multidisciplinary vascular center. GDMT use was assessed at the time of angiography, and major adverse cardiovascular and cerebrovascular events (MACCE) and all-cause mortality were determined during 5 years of follow-up. Cox proportional hazard modeling was used to adjust for baseline differences between patients with and without concomitant CAD. Despite a higher adherence to GDMT (all p ≤0.002) for the use of aspirin, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, and statins, patients with PAD and concomitant CAD had higher unadjusted 5-year rates of MACCE (hazard ratio [HR] 1.7, 95% CI 1.3 to 2.1, p = 0.0001) and all-cause mortality (HR 1.86, 95% CI 1.4 to 2.4, p = 0.0001). After adjustment for baseline co-morbidities, the presence of CAD remained an independent risk factor for mortality (adjusted HR 1.35, 95% CI 1.02 to 1.80, p = 0.04) but not for MACCE (adjusted HR 1.24, 95% CI 0.96 to 1.60, p = 0.10) in patients with PAD. A sensitivity analysis limited to patients with CLI demonstrated that concomitant CAD was associated with significantly higher adjusted rates of both MACCE (adjusted HR 1.52, 95% CI 1.14 to 2.03, p = 0.01) and mortality (adjusted HR 1.64, 95% CI 1.12 to 2.20, p = 0.006). In conclusion, despite higher rates of GDMT use, PAD patients with concomitant CAD had significantly increased risk of all-cause mortality during a 5-year postprocedural follow-up. The subgroup of CLI patients with concomitant CAD was at particularly high risk for both MACCE and all-cause mortality.
Impact of Compton scatter on material decomposition using a photon counting spectral detector

Photon counting spectral detectors are being investigated to allow better discrimination of multiple materials by collecting spectral data for every detector pixel. The process of material decomposition or discrimination starts with an accurate estimation of energy dependent attenuation of the composite object. Photoelectric effect and Compton scattering are two important constituents of the attenuation. Compton scattering while results in a loss of primary photon, also results in an increase in photon counts in the lower ene 1 rgy bins via multiple orders of scatter. This contribution to each energy bin may change with material properties, thickness and x-ray energies. There has been little investigation into the effect of this increase in counts at lower energies due to presence of these Compton scattered photons using photon counting detectors. Our investigations show that it is important to account for this effect in spectral decomposition problems.
Nationwide disparities in testicular cancer care delivery: Racial, ethnic, and economic markers of patient vulnerability.

421Background: Testis cancer is often curable, yet early presentation is a key determinant of survival and treatment morbidity. Testis cancer affects the young, who have less consistent primary care access. This may impede timely mobilization of complex healthcare resources needed for cancer care. We analyze the National Cancer Database (NCDB) for disparity in disease-specific outcomes. Methods: The NCDB identified adult males with testicular tumors (2004-2013). Four outcomes were selected as markers of care delays: higher stage presentation (defined as stage III+), large primary lesion at diagnosis, time to orchiectomy and overall mortality. Key exposures included race/ethnicity, socioeconomic factors and insurance status. Outcomes were assessed with multivariable hazards regression (survival) or logistic regression (others). Results: 31,964 men were eligible. Seventeen percent had higher stage presentation, 29% had a large primary, and 9.9% had delayed orchiectomy and 4.8% died during follow up. All out...
Evaluation of an Acid–Base Disorder

In Chap. 26, we stated that a change in plasma [HCO3 −] results in a metabolic acid–base disturbance, whereas a change in arterial pCO2 results in a respiratory acid–base disorder. Clinically, four primary acid–base disorders can be recognized: (1) metabolic acidosis; (2) metabolic alkalosis; (3) respiratory acidosis; and (4) respiratory alkalosis. Values for an arterial blood gas (ABG) for each primary acid–base disorder are shown in Table 27.1.
Review of Snowpack Chemistry Studies

The chemistry of snowpacks in eastern North America and other parts of the world are compared to illustrate the influence of maritime air masses, pollution sources, organic debris from vegetation, dry deposition and melting. Snowpacks integrate the effects of both wet and dry deposition and as such can be used to monitor spatial and temporal patterns of atmospheric deposition.
White LEDs for lighting applications

Abstract Definitions of “White” light are provided, associated with certain types of application. The importance of white LED light, related to visual tasks, is underlined with requirements of occupational organizations. An outlook on market needs is presented, compared to manufacturers' “abilities” and regulators' “restrictions” on applications. Some of today's LED illumination tasks in the field are visualized as exemplary. Examples and ideas where white LED when connected are beneficial or will be an important part of a bigger network are given, including comfort and efficiency, for example, by human centric lighting, wireless operation, and information transfer by superimposed radiation. The role of standards serving the market with well-defined LED species is indicated and the set of published IEC LED standards (components, light source, controlgear, luminaire) is listed. A choice of consortia/alliances, together with their aims and output, is compiled. Concepts for worldwide LED lighting conditions are outlined.
Return to Work or Sport After Multiligament Knee Injury: A Systematic Review of 21 Studies and 524 Patients.

Purpose To systematically review multiligament knee injury (MLKI) outcome studies to determine overall rates of return to work or sport after MLKI and risk factors for lack of return to work or sport after MLKI. Methods A search was performed of MLKI outcome studies from 1950 to March 1, 2017. Ninety-two studies were identified. All included reported return to work, return to sport, or Tegner activity scores. Rates of return to work or sport were determined for overall population and by obesity status, injury severity, and presence of peroneal nerve or vascular injury. Results A total of 524 patients (21 studies) were included. Return to high-level sport was low (22%-33%). Return to any level of sport was 53.6% overall (178/332), with a higher rate reported in studies with all surgical patients (59.1%, 114/193 patients) versus studies with mixed surgical and nonoperative treatment (46.0%, 64/139 patients) ( P = .02). Rate of return to work with little or no modifications was 62.1% (146/200) and return to any work was 88.4% (190/215). Obese patients had lower postoperative Tegner scores than a general population (obese: mean 1.7 ± 1.2; nonobese: mean 4.5 ± 1.0; P P = .017). Return to any work was higher in studies without vascular injuries (96.3%, 105/109) versus those including them (80.2%, 85/106) ( P Conclusions Return to sport after MLKI occurs in approximately 60% of surgically treated patients, though return to high-level sport is lower. Return to work is frequently possible after MLKI though it may require workplace or job duty modifications. Obesity, nonoperative treatment, higher injury severity, and vascular injury are associated with poorer functional outcomes. Level of evidence Level IV, systematic review of level III and IV studies.
Targeted Antimicrobial Prophylaxis Does Not Always Prevent Sepsis after Transrectal Prostate Biopsy

Purpose: We compared the effectiveness of targeted prophylaxis to augmented empirical prophylaxis and single agent empirical prophylaxis to prevent sepsis after transrectal prostate biopsy.Materials and Methods: We retrospectively reviewed the records of transrectal prostate biopsies performed during 3 years at 13 Southern California Kaiser Permanente® departments of urology. Targeted prophylaxis was guided by rectal culture bacterial susceptibility for use of a single prophylactic antibiotic while for empirical prophylaxis 1 antibiotic (single agent empirical prophylaxis) or multiple antibiotics (augmented empirical prophylaxis) were given according to the usual practice of the urologist. Sepsis was the primary outcome analyzed.Results: We reviewed 15,236 transrectal prostate biopsy cases. Targeted prophylaxis, single agent empirical prophylaxis and augmented empirical prophylaxis were administered in 26%, 58% and 16% of cases, respectively. The overall incidence of post-biopsy sepsis was 0.64%. On multi...
Non-Competition Clauses

In Germany the law in relation to non-competition clauses is contained in the German Commercial Code (Handelsgesetzbuch, HGB) and applies both during the term of the employment relationship and after its termination (where there is a contractual post-employment non-competition provision). The relevant provisions of the Commercial Code are mandatory and must be observed.
Subunit Arrangement in Bovine Mitochondrial H+-ATPASE

The ATP-synthase or H+-ATPase of mitochondria is a multisubunit enzyme that couples the energy of a transmembrane proton gradient to the reversible synthesis of ATP (Pedersen, 1983; Hatefi, 1985). The enzyme is comprised of two sectors: the extrinsic sector F1 carries the catalytic centers and the membrane-intercalated sector F0 constitutes the proton conduction pathway through the membrane. These two sectors are believed to be connected by another morphologically distinct entity known as the stalk (Soper et al., 1979), The F1-ATPase from all known sources contains five nonidentical subunits termed α, β, γ, δ and e in a stoichiometry of 3:3:1:1:1 respectively (Wakabayashi et al., 1977). The composition of F0 is species-dependent. The E. coli F0 (the simplest so far defined) contains three subunits designated a, b and c (Senior and Wise, 1983). Mitohondrial F0 is considerably more complex and contains at least thirteen subunits. Two of these, namely oligomycin-sensitivity-conferring protein (OSCP) and coupling factor 6 (F6), are considered to constitute the stalk segment that separates F1 from the membrane segment (Hatefi, 1985). The organization of the stalk subunits, and how they interact with other F0 subunits or subunits of F1 is not clear. However, to understand the functional roles of the polypeptides which comprise a multisubunit complex, a knowledge of their subunit arrangement is essential. A plausible arrangement of subunits in F1 has been deduced from cross-linking experiments and from X-Ray diffraction studies, but little is known about the organization of subunits belonging to the F0 region.
Toward a Systematic Method for the Generalization of Fermentation Data

A common problem encountered in many research and development laboratories is the management and better utilization of large volumes of fermentation data collected in the course of basic fermentation research and product development programs. Besides rudimentary evaluation of fermentation performance, it would be highly desirable if the same data could be further utilized in order to extract and retain important features which are generic to the biological system and of essential value for fermentor control and optimization. In this context, the problem is defined as one of identifying a set of key culture variables and biological parameters which best represent the state of the organism as well as the fermentor. The approach discussed in this paper builds upon prior research on data reconciliation and fermentor identification and monitoring of intracellular metabolism, and extends the methods of generalization and pattern recognition to the problem of key feature identification and correlation in fermentation processes. Such a method, holds the promise of significantly enhancing the value of primary fermentation data as well as contributing to the development of supervisory control systems for fermentation processes.
Dental Student to Patient Communication Analysis: A Pilot Study.

It is very crucial that dental students who comprise our future dental workforce are adequately trained in communication skills. This training is especially important because of the increasing popu...
Psychological Distress, Formal Help-Seeking Behavior, and the Role of Victim Services Among Violent Crime Victims

Using data from the 2015 National Crime Victimization Survey, this research explores the characteristics related to psychological distress and formal help-seeking behavior among victims of violent ...
Fabrication and characterization of ZnS:Ag-based ultrafiltration membrane scintillator

Abstract This contribution describes the fabrication of an ultrafiltration membrane scintillator based on ZnS:Ag. A solid state reaction method was used for the synthesis of ZnS:Ag, with particular emphasis on investigating the effects of the reaction temperature on the ZnS host, and of the Ag concentration on the radioluminescence (RL) output. The reaction temperature was found to control the crystallite size between 3 and 10 nm for temperatures between 75 and 500 °C, while the RL output was maximized for an Ag concentration of 0.2 mol%. Modified membranes were coated with ZnS:Ag powders via ultrafiltration and their response to ionizing radiation was characterized by means of RL measurements.
An integrated assessment of the potential impacts of climate change on Indiana forests

Forests provide myriad ecosystem services, many of which are vital to local and regional economies. Consequently, there is a need to better understand how predicted changes in climate will impact forest dynamics and the implications of such changes for society as a whole. Here we focus on the impacts of climate change on Indiana forests, which are representative of many secondary growth broadleaved forests in the greater Midwest region in terms of their land use history and current composition. We found that predicted changes in climate for the state—warmer and wetter winters/springs and hotter and potentially drier summers—will dramatically shape forest communities, resulting in new assemblages of trees and wildlife that differ from forest communities of the past or present. Overall, suitable habitat is expected to decline for 17–29% of tree species and increase for 43–52% of tree species in the state, depending on the region and climate scenario. Such changes have important consequences for wildlife that depend on certain tree species or have ranges with strong sensitivities to climate. Additionally, these changes will have potential economic impacts on Indiana industries that depend on forest resources and products (both timber and non-timber). Finally, we offer some practical suggestions on how management may minimize the extent of climate-induced ecological impacts and highlight a case study from a tree planting initiative currently underway in the Patoka River National Wildlife Refuge and Management Area.
Applying behavioral theory to understand fertility consultation uptake after cancer.

Objective The objective of this study was to examine the association between theoretical constructs from the Health Belief Model and fertility consultation status after cancer. Methods Reproductive-aged female cancer survivors self-reported their use of fertility consultation, perceived severity of and susceptibility to infertility, perceived barriers to and effectiveness of fertility consultation, and cues to action from family/peers and doctors, as well as demographics and cancer characteristics. Logistic regression was used to analyze the association between theoretical constructs and fertility consultation status. Results Fertility consultation uptake was more prevalent among survivors with higher incomes, those without children, those who wanted a (another) child, and those who were diagnosed more recently. In the final multivariate model, higher perceived severity of infertility, fewer perceived barriers to fertility consultation, and more cues to action from family/peers and doctors were significantly associated with fertility consultation uptake, controlling for income. Exploratory bivariate analyses of barriers to fertility consultation revealed that cost and trouble accessing services were significantly associated with not having a fertility consultation. Conclusions The Health Belief Model is useful for understanding factors associated with fertility consultation uptake. Efforts should be made to reduce financial barriers and improve patient-centered assessment of family-building goals.
Tongue- and Jaw-Specific Articulatory Underpinnings of Reduced and Enhanced Acoustic Vowel Contrast in Talkers With Parkinson's Disease

Purpose This study sought to identify the articulator-specific mechanisms that underlie reduced and enhanced acoustic vowel contrast in talkers with dysarthria due to Parkinson's disease (PD). Meth...
TEE for Lung Transplantation: A Case Series and Discussion of Vascular Complications.

Summary Stenosis at either the pulmonary artery (PA) or pulmonary vein (PV) anastomosis during lung transplantation (LTx) is a serious complication that requires an accurate and timely diagnosis for optimal clinical management. Transesophageal echocardiography (TEE) can play an essential role in making these diagnoses, both intraoperatively and postoperatively. However, it is important to recognize the limitations of TEE in this setting, including the lack of official guidelines to diagnose PA or PV stenosis. In this series, we describe four cases of vascular complications associated with LTx. We highlight the utility of TEE in the perioperative management of these patients, and discuss the diagnostic considerations when using this tool to assess the PA and PV anastomoses. As experts in perioperative echocardiography, anesthesiologists can employ TEE to enhance surgical success and improve patient outcomes after LTx. We therefore advocate the use of TEE during all cases of LTx, and encourage further efforts into the development of official echocardiographic guidelines specific to this patient population.
Positive Meaningful Events and Coping in the Context of HIV/AIDS

Most research on coping with chronic stress tends to focus inquiry on strategies that help the person manage stressor-related demands. In the case of coping with a debilitating illness, for example, the search often focuses on strategies that are related to managing the primary consequences of the illness, including disease-related limited mobility, pain, or dysphoria, and the secondary consequences of the illness, including disrupted family relationships or changes in role functioning. However, the lives of people with a debilitating illness consist of more than just their illness. They may have warm family relationships, friends with whom they talk, or work or other activities that interest them. These other aspects of people’s lives may play an important role in sustaining their well-being while they are coping with their illness. Thus, a full understanding of the coping process in the context of chronic stress may need to take into account aspects of people’s lives that at first blush do not seem to be related directly to how they cope with the chronic stress per se.
National Public Health Burden Estimates of Endocarditis and Skin and Soft-Tissue Infections Related to Injection Drug Use: A Review.

Background Despite concerns about the burden of the bacterial and fungal infection syndromes related to injection drug use (IDU), robust estimates of the public health burden of these conditions are lacking. The current article reviews and compares data sources and national burden estimates for infective endocarditis (IE) and skin and soft-tissue infections related to IDU in the United States. Methods A literature review was conducted for estimates of skin and soft-tissue infection and endocarditis disease burden with related IDU or substance use disorder terms since 2011. A range of the burden is presented, based on different methods of obtaining national projections from available data sources or published data. Results Estimates using available data suggest the number of hospital admissions for IE related to IDU ranged from 2900 admissions in 2013 to more than 20 000 in 2017. The only source of data available to estimate the annual number of hospitalizations and emergency department visits for skin and soft-tissue infections related to IDU yielded a crude estimate of 98 000 such visits. Including people who are not hospitalized, a crude calculation suggests that 155 000-540 000 skin infections related to IDU occur annually. Discussion These estimates carry significant limitations. However, regardless of the source or method, the burden of disease appears substantial, with estimates of thousands of episodes of IE among persons with IDU and at least 100 000 persons who inject drugs (PWID) with skin and soft-tissue infections annually in the United States. Given the importance of these types of infections, more robust and reliable estimates are needed to better quantitate the occurrence and understand the impact of interventions.