cssi/SciSciGPT-SciSciNet huggingface dataset:
Workshop report. Circadian rhythm sleep–wake disorders: gaps and opportunities

This White Paper presents the results from a workshop cosponsored by the Sleep Research Society (SRS) and the Society for Research on Biological Rhythms (SRBR) whose goals were to bring together sleep clinicians and sleep and circadian rhythm researchers to identify existing gaps in diagnosis and treatment and areas of high-priority research in circadian rhythm sleep-wake disorders (CRSWD). CRSWD are a distinct class of sleep disorders caused by alterations of the circadian time-keeping system, its entrainment mechanisms, or a misalignment of the endogenous circadian rhythm and the external environment. In these disorders, the timing of the primary sleep episode is either earlier or later than desired, irregular from day-to-day, and/or sleep occurs at the wrong circadian time. While there are incomplete and insufficient prevalence data, CRSWD likely affect at least 800,000 and perhaps as many as 3 million individuals in the United States, and if Shift Work Disorder and Jet Lag are included, then many millions more are impacted. The SRS Advocacy Taskforce has identified CRSWD as a class of sleep disorders for which additional high-quality research could have a significant impact to improve patient care. Participants were selected for their expertise and were assigned to one of three working groups: Phase Disorders, Entrainment Disorders, and Other. Each working group presented a summary of the current state of the science for their specific CRSWD area, followed by discussion from all participants. The outcome of those presentations and discussions are presented here.
Institutional initial experience in establishing Lu-177 Lutathera program for gastroenteropancreatic neuroendocrine tumors (GEP-NETs)

3031 Introduction: Serial post therapy scanning of patients post Lu-177 Lutathera treatments provides early insight into treatment response. Hypothesis: Lu-177 dotatate (Lutathera) is a peptide receptor radionuclide therapy (PRRT) indicated for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Patients receive a total of 4 treatments over a total of 8 months. Traditionally, patients undergo a baseline Ga 68 Dotatate PET scan followed by a repeat PET scan and end of therapy. We hypothesize acquiring post-therapy whole-body scans (WB) and SPECT/CT images on patients after each round of PRRT may provide early insight in differentiating treatment responders from non-responders. Methods: A total of 23 patients with metastatic neuroendocrine tumors received PRRT and subsequently underwent WB and SPECT CT imaging 48-96 hours post treatment on a GE 870 DR SPECT/CT. All patient WB scans were done with a 208 keV energy peak with a 20% window and a scatter window of 112 keV with a 25% window. WB scans were acquired with continuous acquisition at 10 cm/min. The SPECT scan was acquired at 25 sec/stop with 3 degrees of rotation between stops followed by a low dose CT for localization/attenuation correction. All images were processed and reviewed by experienced nuclear medicine physicians. Results: Serial scanning of patients after each round of PRRT demonstrated if the patients were responding to the therapy as determined by interval visual assessment of change in lesion size or intensity as well as increase or decrease in the total number of lesions. This provides the potential for early differentiation of responders from non-responders to treatment. Conclusions: Serial scanning of patients after each round of PRRT with Lu-177 Lutathera provides the potential for early differentiation of responders from non-responders to treatment. This technique could prove an effective method for disease monitoring and evaluating the efficacy of treatment. This could potentially help optimize the patient’s personalized treatment strategy.
Historical View of Intellectual Influences on Regimes in Germany, Italy, and France With a Primary Focus on Germany

This research attempts to discover the intellectual influences that resulted in either successful or unsuccessful regimes in Europe. Germany is a perfect example of intellectual influences as it has been affected by philosophical political thought through its Weimar republic, under Adolf Hitler’s Nazi regime, and after governing systems after World War II. Italy and France also provide excellent examples of having been impacted by philosophical thought under Mussolini and throughout the French Revolution, respectively. The following sections will be addressed to provide an organizational roadmap: The historical background of Germany, the Weimar Republic’s philosophical influence, Influences on Adolf Hitler’s Nazi regime, Germany after World War II and the influence on East Germany and the Basic Law, the historical background of Italy, Mussolini’s influence on Italy, the historical background of France, and the intellectual influences on the French Revolution.
Why do narrow network plans cost less

Narrow network health insurance plans have been shown to have lower premiums and lower costs to insurers. This paper decomposes and quantifies the magnitudes for various mechanisms by which networks may reduce premiums and costs. Using data on the Colorado non-group market, we examine three mechanisms through which a narrow network might achieve lower costs: (1) enroll a population with lower utilization, (2) negotiate lower prices, or (3) steer patients away from high-cost hospitals. We find that all three mechanisms play a role. Narrow plans are partly able to achieve lower costs because they both steer patients to lower cost hospitals and, for a given hospital, negotiate lower prices than broad plans. The lower negotiated prices mechanism accounts for 15% of the cost savings to narrow network plans, and the steering away from higher cost hospitals accounts for about 18%. Both of these mechanisms can be ways to efficiently lower costs. The remaining 67% of the cost savings is due to lower utilization of narrow network plan enrollees. These findings are important for policymakers considering how to balance containing healthcare costs with concern for the appropriate regulation of narrow network plans.
Smart-phone Based Geofencing: A Novel Approach to Monitoring Clinical Work Hours in Surgery Residency.

OBJECTIVE The Accreditation Council for Graduate Medical Education specifies strict requirements for clinical work hours during residency training, with serious consequences for violations. Self-reporting of work hours by trainees can be inaccurate due to recall bias, giving program directors limited data to influence change. We aimed to assess the impact of a smart-phone based geofencing application on submission rates for work hours and reported violations in a general surgery residency program at a university-based medical center. We also examined resident perceptions surrounding implementation and use of the application. METHODS We compared clinical work hours submitted and violations reported during the pilot period (October-November 2019) with the months prior to the launch of the application (July-August 2019). PGY1 and PGY2 residents were eligible to use the application during and after this pilot period. Semi-structured interviews were used to assess resident perceptions. A retrospective review was conducted to compare reporting during the same time period from the prior academic year (2018-2019) for historical reference. Paired t-tests were used to analyze the data. RESULTS Twenty-six residents (15 PGY1, 11 PGY2) were eligible for the intervention and 23 residents (88%) used the application. The mean number of violations reported decreased significantly during the pilot period compared with the months prior to the intervention (4.5 vs. 11, p = 0.04). The total rate of submissions was not significantly different after the intervention (85% vs. 82%, p = 0.42). The PGY1 mean submission rate decreased during the pilot period (91%-75%, p = 0.21) while the PGY2 submission rate increased (77%-91%, p = 0.07). Compared with historical data, there was an increase in overall total submission rates between academic years 2018/2019 and 2019/2020 (74% vs. 79%, p = 0.047) and an associated decrease in the mean number of monthly violations (14 vs. 6.25, p = 0.004). Thirteen (50%) residents (8 PGY1, 5 PGY2) volunteered for semi-structured interviews. Most participants found the application useful for recording and reporting clinical work hours. They noted an ease in the administrative burden as well as more accurate reporting associated with automated logging. Use of the application was not perceived to limit engagement with patient care; however, there were privacy concerns and some technical barriers were identified. The messaging regarding the application's use was identified as critical for implementation. CONCLUSIONS The “real-time” data provided by a geofencing application in our program helped to reduce the number of work-hour violations reported and did not diminish resident engagement with patient care. Decreasing the administrative burden of recording work hours coupled with improving transparency and accuracy of submissions may be important mechanisms.
Assessing the economic viability of pretreatment technologies to make sugars for chemical catalytic upgrading to fuels and chemicals

The monomeric/polymeric sugars derived from cellulose and hemicellulose must be nearly pure (>95%) for chemical catalytic upgrading to chemicals and fuels. This work reports the results of a qualitative screening study of biomass pretreatment and fractionation technologies that can meet this purity requirement. Two technologies, combined autohydrolysis and organosolv (AOF) and formic acid pulping (FAP), were found to be suitable for the effective fractionation of lignocellulose to yield cellulose, hemicellulose, and lignin. The estimated costs of making nearly pure (>95%) polysaccharides from a lignocellulosic feedstock were US$0.66 per kg (AOF) and US$0.36 per kg (FAP). The limiting factor for commercialization was the high ratio of liquid-to-dry-solid required for biomass fractionation using both AOF and FAP technologies.
Holistic Ecosystem Models with Attractor Regions

This section contains the attractor region analogue of the attractor trajectory result in section three of Chapter Six. Our aim is the specification of conditions on the coefficient functions of a very general type of ecosystem model which are sufficient to guarantee the existence of an attractor region.
Crucial and Routine Decisions: A New Explanation of Why Ideology Affects U.S. Supreme Court Decision Making the Way it Does

Models using judicial ideology to explain Supreme Court decision-making remain controversial due to their apparently limited explanatory scope. Civil liberties and civil rights decisions and those concerning economic policy appear to be well explained by the ideological attitudes of the justices. However, decisions in other areas show little relationship to these attitudes. I suggest that this is due to the differing character of the decisions made by the Court in different areas. I hypothesize that decisions made in the civil rights and liberties and economic policy areas are crucial decisions; i.e. decisions by the justices that creatively change their environments through the exercise of judicial review. Long and short term expectations for issues dominated by crucial decisions cannot be generated efficiently since the outcomes are truly uncertain. Instead, each justice’s deliberations in these cases will concentrate on the possibility of highly detrimental or favorable outcomes that might occur. Since reliable probabilistic expectations cannot be generated justices use their ideological preferences to evaluate these “focus outcomes”. Thus, in types of cases where the justices are more likely to make crucial decisions, it is more likely that ideology will affect decision making. In issue areas where more stable environments are present, the justices can make routine decisions, i.e. decisions that follow probabilistic expectations and that stabilize over time. For these issues, ideology is less likely to be a useful explanation. I test this theory with an analysis of Supreme Court cases in different issue areas and end with some observations concerning the consequences of my findings.
Using Aumann-Shapley Values to Allocate Insurance Risk

Abstract The problem of allocating responsibility for risk among members of a portfolio arises in a variety of financial and risk-management contexts. Examples are particularly prominent in the insurance sector, where actuaries have long sought methods for distributing capital (net worth) across a number of distinct exposure units or accounts according to their relative contributions to the total “risk” of an insurer’s portfolio. Although substantial work has been done on this problem, no satisfactory solution has yet been presented for the case of inhomogeneous loss distributions— that is, losses X ∼ F X| λ such that F X|tλ (X) ≠ F tX| λ (X) for some t > 0. The purpose of this article is to show that the value-assignment method of nonatomic cooperative games proposed in 1974 by Aumann and Shapley may be used to solve risk-allocation problems involving losses of this type. This technique is illustrated by providing analytical solutions for a useful class of multivariatenormal loss distributions.
Impact Properties of Three-Dimensional Braided Graphite/Epoxy Composites

An experimental study of the response and damage of three-dimensional braided graphite/epoxy composite due to sub-perforation velocity impact was carried out in this research. Simply supported square plates were impacted with an instrumented impact pendulum and also a projectile fired by a gas gun. Hemispherical nose impactors of two different diameters, 12.7 mm and 25.4 mm, were used in the pendulum tests. In addition, static flexure tests were performed. Impact damage was assessed using X-radiography, and compression after impact tests. Damages involved in impacted braided panel are matrix cracking in resin pockets, separation of fiber tows, and fiber two breakage, mostly in fiber bundle crimp areas. A quasi-isotropic laminate was impact tested with pendulum for comparison of impact tolerance between the two composite systems.
A Food-Grade Silicon Dioxide is Hypocholesterolemic in the Diet of Cholesterol-Fed Rats

Silicon dioxide, commonly referred to as silica, is present in plant cell walls and interstitial spaces, and is often found as a component of dietary fibers that have exhibited hypocholesterolemic activity in animals. The primary objective of this study was to determine the cholesterolemic effects of two different morphological forms of silicon in the diet of cholesterol-fed rats. Male Wistar rats were provided diets containing 1 g cholesterol/100 g diet, and 0.65 g Si/100 g diet as either a sodium salt (silicate group) or silicon dioxide, a synthetic silica polymer (silica group). Cellulose was used as a control (control group). The in vitro bile acid binding capacity of the SiO2 was also measured. After 44 d of diet administration, animals were deprived of food for 24 h and then killed. Plasma total, VLDL, and LDL cholesterol concentrations were 18%, 29%, and 26% lower, respectively, in the silica group than in the control group. However, liver cholesterol concentrations were not different among dietary treatments. During the initial 15 d of the study, average daily total fecal bile acids were 38% higher in the silica group than in the control group, but fecal bile acid outputs were not different for the remainder of the experiment. The silica polymer used in the feeding trial was found to adsorb 5 times more cholate than chenodeoxycholate, at pH 7.5 in vitro. In vivo, the potential for silica to enhance fecal cholic acid excretion, relative to chenodeoxycholic acid during the initial stage of the study, may have contributed to the hypocholesterolemic response to the silica diet.(ABSTRACT TRUNCATED AT 250 WORDS)
Mid‐Ocean Ridges: Dynamics of Processes Associated With Creation of New Ocean Crust

In the study of mid-ocean ridges, the interdisciplinary approach has been embraced for many years. On research expeditions, it is not unusual to see geologists, geophysicists, physical oceanographers, chemists, and biologists working together on their respective experiments. The motivation for this approach is not only to combine efforts; it also allows specialists to appreciate the intellectual value of each other's disciplines.
Patterns of Continuity: A Dynamic Model for Conceptualizing the Stability of Individual Differences in Psychological Constructs Across the Life Course

In contemporary psychology there is debate over whether individual differences in psychological constructs are stable over extended periods of time. The authors argue that it is impossible to resolve such debates unless researchers focus on patterns of stability and the developmental mechanisms that may give rise to them. To facilitate this shift in emphasis, they describe a formal model that integrates 3 developmental processes: stochastic-contextual processes, person-environment transactions, and developmental constancies. The theoretical and mathematical analyses indicate that this model makes novel predictions about the way in which test-retest correlations are structured across a wide range of ages and test-retest intervals. The authors illustrate the utility of the model by comparing its predictions against meta-analytic data on Neuroticism. The discussion emphasizes the value of focusing on patterns of continuity, not only as phenomena to be explained but as data capable of clarifying the developmental processes underlying stability and change for a variety of psychological constructs.
Information-theoretic interpretation of besov spaces

Besov spaces classify signals and images through the Besov norm, which is based on a deterministic smoothness measurement. Recently, we revealed the relationship between the Besov norm and the likelihood of an independent generalized Gaussian wavelet probabilistic model. In this paper, we extend this result by providing an information- theoretical interpretation of the Besov norm as the Shannon codelength for signal compression under this probabilistic mode. This perspective unites several seemingly disparate signal/image processing methods, including denoising by Besov norm regularization, complexity regularized denoising, minimum description length processing, and maximum smoothness interpolation. By extending the wavelet probabilistic model, we broaden the notion of smoothness space to more closely characterize real-world data. The locally Gaussian model leads directly to a powerful wavelet- domain. Wiener filtering algorithm for denoising.© (2000) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
The Impact of New Drugs on US Longevity and Medical Expenditure, 1990–2003: Evidence from Longitudinal, Disease-Level Data

A number of econometric studies (Charles R. Hulten 1992; Byong-Hong Bahk and Michael Gort 1993; Plutarchos Sakellaris and Daniel J. Wilson 2004) have investigated the hypothesis that capital equipment employed by US manufacturing firms embodies technological change, i.e., that each successive vintage of investment is more productive than the last. Equipment is expected to embody significant technical progress due to the relatively high research and development (R&D) intensity of equipment manufacturers. The method that has been used to test the equipment-embodied technical change hypothesis is to estimate manufacturing production functions, including (mean) vintage of equipment as well as quantities of capital and labor. These studies have concluded that technical progress embodied in equipment is a major source of manufacturing productivity growth. Embodied technical progress may also be an important source of economic growth in healthcare. One important input in the production of health—pharmaceuticals—is even more R&D intensive than equipment. According to the National Science Foundation (NSF), the R&D intensity of drugs and medicine manufacturing is 74 percent higher than the R&D intensity of machinery and equipment manufacturing. Therefore, it is quite plausible that there is also a high rate of pharmaceutical-embodied technical progress. This study examines the effect of changes in the vintage distribution of prescription drugs on US longevity and medical expenditure during the 1990–2003 period. We will estimate the following model, using longitudinal disease-level data:
Effects of prefrontal cortex and hippocampal NMDA NR1-subunit deletion on complex cognitive and social behaviors

Glutamate N-methyl-D-aspartate receptors (NMDARs) in the medial prefrontal cortex (mPFC) and hippocampus may play an integral role in complex cognitive and social deficits associated with a number of psychiatric illnesses including autism, mood disorders, and schizophrenia. We used localized infusions of adeno-associated virus Cre-recombinase in adult, targeted knock-in mice with loxP sites flanking exons 11-22 of the NR1 gene to investigate the effects of chronic NMDAR dysfunction in the mPFC and CA3 hippocampus on cognitive and social behavior. A 5-choice serial reaction time task (5-CSRTT) was used to monitor aspects of cognitive function that included attention and response inhibition. Social behavior was assessed using Crowley׳s sociability and preference for social novelty protocol. Chronic NMDAR dysfunction localized to the anterior cingulate/prelimbic mPFC or dorsal CA3 hippocampus differentially affected the response inhibition and social interaction. mPFC NR1-deletion increased perseverative responding in the 5-CSRTT and enhanced preference for social novelty, whereas CA3 NR1-deletion increased premature responding in the 5-CSRTT and decreased social approach behavior. These findings suggest that mPFC and CA3 NMDARs play selective roles in regulating compulsive and impulsive behavior, respectively. Furthermore, these findings are consistent with emerging evidence that these behaviors are mediated by distinct, albeit overlapping, neural circuits. Our data also suggest that NMDARs in these regions uniquely contribute to the expression of normal social behavior. In this case, mPFC and CA3 NMDARs appear to inhibit and facilitate aspects of social interaction, respectively. The latter dissociation raises the possibility that distinct circuits contribute to the expression of social intrusiveness and impoverished social interaction.
Uterine perforation and small bowel incarceration: sonographic and surgical findings

Uterine perforation rarely complicates a first trimester surgical abortion, but perforation resulting in vascular or intraabdominal organ damage may require surgical intervention. The index of suspicion for uterine perforation needs to remain high when a patient presents with abdominal/pelvic pain after an abortion, as the sonographic appearance of the uterus can be variable over time.
Single-vortex structure in a superconductor film and strip

Exact expressions for a normally aligned vortex-structure in an isotropic superconductor film and strip are derived. The ensuing thickness-dependent vortex localization at the surface is analyzed.
Predictive factors for clinically actionable computed tomography findings in inflammatory bowel disease patients seen in the emergency department with acute gastrointestinal symptoms.

Abstract Background The wide use of abdomino-pelvic computed tomography (APCT) in emergency departments (ED) has raised the concern for radiation exposure, costs and potential reactions to contrast agents. The aim of this study was to determine the yield and predictive factors for clinically actionable findings (CAF) in APCTs performed in patients with inflammatory bowel disease (IBD) who visit the ED. Methods We performed a cross-sectional study including patients with IBD who visited the ED. Variables considered were demographics, IBD phenotype, clinical symptoms, IBD medication use prior to ED visit, laboratory values, and imaging results. The primary outcome was a composite of CAF, defined as new, intra-abdominal abscess or tumor, bowel obstruction, fistulae, diverticulitis, choledocholithiasis, or appendicitis. Results 354 patients were included. One or more CAF were reported in 26.6% of the APCTs (32.1% in CD and 12.8% in UC [p Conclusions The yield for CAF with APCT in the ED was high for CD patients but minimal for those with UC and was not improved by the use of contrast. Elevated CRP, low BMI, Black race and previous history of IBD surgery predicted CAF in CD but no variables were predictive of CAF in UC.
A gateway to study protein lysine methylation.

Lysine methyltransferases are well-known regulators of transcription through their methylation of histone lysine residues. Now high-throughput peptide arrays reveal non-histone substrates of G9a/KMT3C, which was previously known as a euchromatic histone H3K9-specific methyltransferase.
Evaluation of irreversible reactions in geochemical processes involving minerals and aqueous solutions—II. Applications

Abstract Equilibrium relations among common rock-forming minerals and aqueous solutions over a range of temperatures and pressures are known experimentally for a number of systems and can be calculated for others. This information permits prediction of the mass transfer involved in chemical reactions characteristic of geochemical processes. Calculations of this kind are used to examine various chemical and geologic implications of irreversibility in idealized models of weathering, evaporative concentration, diagenesis, hydrothermal rock alteration, and ore deposition.
Quantitative determination of antibacterial activity in the rabbit gingival sulcus

Abstract Antibacterial activity against Serratia marcescens was studied in the gingival sulci of the mandibular incisors of rabbits. Utilizing a method involving radiolabelling of viable bacteria, it was possible to study simultaneously both the killing of the bacteria in the sulci and their physical removal from that site. Rapid killing of the bacteria was observed. After 1 min, only 67 per cent of the bacteria in sulcular samples were viable. The proportion of viable organisms declined to 40 per cent at 5 min, 25 per cent at 10 min, 11 per cent at 30 min, and 0 per cent at 60 min. At the same time the bacteria were mechanically eliminated from the sulci. By 10 min, less than 1 per cent of the inoculated bacteria could be recovered, and by 120 min, virtual or complete elimination had occurred. These experiments show that at least two antibacterial mechanisms are present in the rabbit gingival sulcus—one representing mechanical removal, and the other in situ killing.
Controlling inductive cross-talk and power in off-chip buses using CODECs

The parasitic inductances within IC packaging cause supply bounce as well as glitches on the signal pins, significantly limiting the frequency of high-speed inter-chip communication. Also, off-chip communication contributes a large fraction of the total system power. Until recently, the parasitic inductance problem was addressed by aggressive package design, which is expensive. In this work we present a technique to encode the off-chip data transmission to i) limit bounce on the supplies, ii) reduce glitching caused by inductive signal coupling from neighboring signals, iii) limit the edge degradation of signals due to mutually inducted voltages from neighboring switching signals and iv) control the total power consumption of the I/O logic. All these factors are modeled in a unified mathematical framework. Our experimental results show that the proposed encoding based techniques result in reduced supply bounce and signal glitching due to inductive cross-talk, closely matching the theoretical predictions. Also, we show that the bus size overhead is reasonable even after stringent power reduction constraints are imposed. We demonstrate that the overall bandwidth of a bus actually increases by 100% over an unencoded bus, using our technique with inductive constraints only (even after accounting for the encoding overhead). When the power constraints were added (to limit the power to 20% of worst case switching power) in addition to the inductive constraints, the bandwidth was again 100% improved over the unencoded bus. The asymptotic bus size overhead depends on how stringent the user-specified power and inductive cross-talk parameters are. We have validated our approach by simulating it in an ASIC setting as well as prototyping and testing it in an FPGA environment.
School Violence Research from the Middle East

The lead article from the first issue of the Journal of School Violence featured a study from the Middle East (Astor, Benbenishty, Marachi, Haj-Yahia, Zeira, Perkins-Hart, & Pitner, 2002). This stu...
Editorial – Special Issue “Physical Therapy Practice in the 21st Century: A New Evidence-Informed Paradigm and Implications”

The practice of physical therapy is changing as we move forward into the 21st century. Our scope of practice continues to be primarily focused towards rehabilitation of individuals with impairments...
Spatial resolution and noise considerations in determining scalar dissipation rate from passive scalar image data

The effects of photonic shot noise and finite spatial resolution on the scalar dissipation rate were investigated for the analytical profile of a passive scalar layer subjected to a compressive strain, and the results were applied to interpret measured data from spray mixing data from an internal combustion engine. A Monte Carlo approach was employed. The measured scalar dissipation rate is underestimated, and the layer width measured at 20% of the peak height is overestimated by the finite resolution. The ratio of the local scalar spread value to the noise level, the spread-noise ratio, was found to describe the noise effects, which principally results in an overestimation of the scalar dissipation rate, especially at high resolution levels. The Nyquist resolution provides a good compromise between the sampling bias at low resolution and the noise bias at high resolution. Top hat filtering the raw data prior to calculation of the scalar dissipation rate was found to, effectively, reduce spatial resolution, whereas median filtering preserved the resolution. Both filters had a comparable effect on noise reduction. The evaluation of experimental data showed that a significant fraction of data reside at low spread-noise ratio and are biased by noise. The peak scalar dissipation rate is, however, not biased by noise and a method of estimating spatial resolution based on the peak scalar dissipation rate is described.
Endoscopic, Radiographic, and Clinical Response to Prolonged Bowel Rest and Home Parenteral Nutrition in Crohn's Disease

Total parenteral nutrition is widely used as a therapeutic measure is patients with severe, active Crohn's disease unresponsive to conventional medical management. We have reviewed our experience with 10 patients with nonfistulous Crohn's disease treated by home parenteral nutrition (HPN) and bowel rest (nothing-by-mouth) assessing the nutritional, radiologic, endoscopic, and clincial responses. After a mean of 4.1 months of treatment, all patients had a marked improvement in nutritional status and resolution of gastrointestinal symptoms; 90% reduced their corticosteroid dose. Eight of nine patients had endoscopic and/or radiographic evidence of mucosal healing. Although 60% of patients were able to avoid surgery and tolerate refeeding, all six patients continue to require steroids to control symptoms.Our study suggests that HPN and bowel rest is a useful therapeutic approach to selected patients with active Crohn's disease, which permits a reduction in corticosteroid dosage and partial healing of mucosal...
Removal of nickel from aqueous solutions using crab shells

Partially converted crab shell waste, which contains chitosan, was used to remove nickel from water. The chelating ability of chitosan makes it an excellent adsorbent for removing pollutants. Advantages of chitosan in crab shells include availability, low cost, and high biocompatibility. The metal uptake by partially converted crab shell waste was successful and rapid. The sorption occurred primarily within 5 min. The sorption mechanism appears to be quite complicated and cannot be adequately described by either the Langmuir or Freundlich theories. Various anions, including chloride, bromide, fluoride, acetate, sulfate, nitrate, and phosphate, were found to have a very small effect on the capacity of the crab shells for uptake of nickel. The effect of pH was also found not to be prominent.
Protection of mice against tumor growth by immunization with an oncogene-encoded growth factor.

Abstract The K-fgf/hst oncogene encodes a growth factor of the fibroblast growth factor (FGF) family that is secreted and transforms cells through a mechanism of autocrine cell proliferation. K-fgf-transformed cells are highly tumorigenic in immunocompetent allogeneic and syngeneic animals. BALB/c mice were immunized with a bacterial fusion protein consisting of a portion of the MS2 polymerase and of the human K-FGF precursor lacking only the first 4 amino acids or with a recombinant protein corresponding to the mature, secreted form of K-FGF (176 amino acids). They were then challenged with syngeneic K-fgf- or H-ras-transformed cells. Vaccinated animals exhibited a significant degree of protection against tumor induction, which was specific for K-fgf-transformed cells and correlated with the ability of the immunized mice to produce high titers of anti-K-FGF antibodies. Thus immunization with a single oncogene product can protect animals against tumor cells expressing this oncogene.
Shape-preserving quasi-interpolation and interpolation by box spline surfaces

This paper is devoted to the study of shape-preserving approximation and interpolation of functions by box spline surfaces on three and four directional meshes. The properties of positivity, monotonicity, and convexity are considered. A characterization of the grid spacing is given which guarantees the preservation of these properties for functions in certain Lipschitz classes.
IBM toolkit for radical simplification of business processes

Complex global business environments are associated with increasingly interconnected economies, societies, and governments. Moreover, the proliferation of discrete markets, categories of product offerings, and individualized customer segments motivates business leaders to drastically simplify their organizations to become more agile in exploiting this complexity. Incremental changes are no longer sufficient to remain viable in volatile and uncertain environments. Internal business processes must undergo radical simplifications that reduce cycle time (a measure of responsiveness), cost per transaction (a measure of efficiency), and the number of hand-offs (a measure of how often work is transferred to another organization or business process). IBM defines radical simplification as realizing reductions in these measures of 50% or greater. To achieve these goals, IBM executives identified the need for a consistent, carefully matched set of best-practice methods, techniques, and leading-edge software tools, including scenario-based guidance to enable leaders to radically simplify their businesses. This paper describes the resulting IBM Toolkit for Radical Simplification and includes project case studies to demonstrate how the toolkit is being applied to simplify business processes for increased speed, agility, and value.
Ion-exchange preconcentration and group separation of ionic and neutral organic compounds

In many cases sample pretreatment continues to be the most time-consuming and costly step in the analytical process. In the present work it is shown that macroporous ion-exchange resins of low exchange capacity can be used both to preconcentrate organic solutes from aqueous samples and to separate these solutes into groups. Thus, neutral and basic organic compounds are both taken up from aqueous solution by a very short column packed with a special cation-exchange resin. The neutral group of compounds is subsequently eluted with an organic solvent. The bases are then eluted 2 M methylamine in methanol. In a similar manner organic acids are concentrated on a special anion-exchange column. Extensive data are shown to demonstrate the efficiency of the preconcentration and group separation of neutral and basic compounds.
Photodynamic therapy and the evolution of a lung-sparing surgical treatment for mesothelioma

Background Photodynamic therapy (PDT) is a light-based cancer treatment that acts to a depth of several millimeters into tissue. This study reviewed the results of patients who underwent a macroscopic complete resection, by two different surgical techniques, and intraoperative PDT as a treatment for malignant pleural mesothelioma. Methods From 2004 to 2008, 28 patients with malignant pleural mesothelioma underwent macroscopic complete resection, 14 by modified extrapleural pneumonectomy (MEPP) and 14 by radical pleurectomy (RP) and intraoperative PDT. The surgical technique evolved over this period such that 13 of the last 16 patients underwent lung-sparing procedures, even in the setting of large-bulk tumors. Results Demographics in the MEPP and RP cohorts were similar in age, sex, stage, nodal status, histology, and adjuvant treatments. Stage III/IV disease was present in 12 of 14 patients (86%), with 50% or more with +N2 disease. The median overall survival for the MEPP group was 8.4 months, but has not yet been reached for the RP group at a median follow-up of 2.1 years. Conclusions In addition to the inherent advantages of sparing the lung, RP plus PDT yielded a superior overall survival than MEPP plus PDT in this series. The overall survival for the RP plus PDT group was, for unclear reasons, superior to results reported in many surgical series, especially for a cohort with such advanced disease. Given these results, we believe RP plus PDT is a reasonable option for appropriate patients pursuing a surgical treatment for malignant pleural mesothelioma and that this procedure can serve as the backbone of surgically based multimodal treatments.
Inhibitory effects of anti-CD2 monoclonal antibodies on interleukin 2 production and interleukin 2 receptor expression in anti-CD3-induced T cell activation

The effects of anti-CD2 monoclonal antibodies (mAb) on anti-CD3-driven interleukin 2 (IL2) production and IL2 receptor (IL2R) expression were investigated. Two anti-CD2 mAb, which had previously been shown to inhibit in vitro anti-CD3-induced T cell proliferation, also inhibited anti-CD3-induced IL2 production. However, it seemed unlikely that this was the crucial mechanism in the inhibition of anti-CD3-driven proliferation, since anti-CD2 mAb also partially inhibited T cell proliferation induced by the anti-CD3 mAb 446 which does not induce detectable IL2 levels. Anti-CD2 mAb also inhibited anti-CD3-induced surface IL2R expression as measured by immunofluorescence staining with an anti-IL2R mAb against the p55 chain. Inhibition of IL2R expression paralleled inhibition of proliferation. This anti-CD2-mediated inhibition involved a block in the generation of normal numbers of IL2R+ cells rather than a direct inhibitory effect on the IL2R+ cells themselves, since IL2R+ cells isolated from anti-CD2-containing cultures responded normally to IL2. Exogenous IL2 and IL4, singly or in combination, could reverse neither the anti-CD2-mediated inhibition of anti-CD3-induced proliferation nor the anti-CD2-mediated inhibition of anti-CD3-induced IL2R expression. Taken together, these observations suggest that anti-CD2 mAb inhibit anti-CD3-driven proliferation by inhibiting the generation of IL2R+ cells at a maturational stage proximal to their expression of surface IL2R. This inhibition cannot be overcome by exogenous IL2 or IL4, suggesting that the underlying biochemical mechanism involves an IL2- and IL4-independent pathway.
The utility of 12-lead Holter monitoring in patients with permanent atrial fibrillation for the identification of nonresponders after cardiac resynchronization therapy.

Objectives: This study sought to determine the incidence of ineffective capture using 12-lead Holter monitoring and to assess whether this affects response to cardiac resynchronization therapy (CRT...
Comparison of patient-reported outcomes after elective coronary artery bypass grafting in patients aged ≥ and <65 years☆

Older patients represent a growing proportion of patients undergoing coronary artery bypass grafting (CABG). Although functional benefits after CABG have been demonstrated, most assessments of outcomes have involved patients aged less than 65 years. Therefore, little is known concerning the impact of CABG on older patients compared with that on younger ones. A number of postsurgical (6 months) health-related quality-of-life outcomes (e.g., symptoms, cardiac functional class, instrumental activities of daily living, and emotional and social functioning) reported by patients aged less than 65 (n = 169) and greater than or equal to 65 (n = 99) years who underwent elective CABG at 4 major teaching hospitals in Massachusetts and California were compared. The proportion of patients reporting cardiac-related symptoms after surgery did not vary by age, and quality-of-life outcome scores of younger and older patients did not differ even after adjustment for clinical and demographic characteristics. The exception to this was mental health status, an outcome for which older patients reported better functioning than did younger ones. On average, patients in the 2 age groups reported equivalent improvement over preadmission status in instrumental activities of daily living, and emotional and social functioning. The independent relation of clinical and sociodemographic factors to quality-of-life outcomes was also investigated. Patients who functioned better before admission, those with less severe co-morbid disease, and married patients reported better functioning after discharge. In general, older patients who underwent elective CABG reported functional benefits similar to those reported by younger ones, and the factors associated with better functioning did not vary by age group.
Cardiac growth in fetuses of diabetic mothers with good metabolic control.

To evaluate cardiac growth in fetuses of those diabetic mothers with good metabolic control, we examined M-mode echocardiographic measurements obtained from 24 fetuses of diabetic mothers (FODM) and compared these with measurements from 31 normal fetuses of similar gestational age. Fetuses were grouped into three gestational periods: 20 to 26 weeks, 27 to 33 weeks, and 34 to 40 weeks. The mothers were believed to have good metabolic control on the basis of mean daily glucose profiles and glycosylated hemoglobin A (HbA 1c ) values of approximately 110 mg/dl (610 μ mol/L) and 7.5%, respectively, before fetal scanning, and estimated fetal weight similar to that of normal fetuses during all three gestational periods. Both FODM and normal fetuses had significant increases in M-mode measurements from period 1 to period 3, but in FODM, cardiac hypertrophy developed by late gestation (period 3). This involved the interventricular septum (6.1±0.7 vs 4.9±0.3 mm, p p p p p
Toward T Cell Protein–Protein Interaction Activity Relevant to Alopecia Areata

Development of better therapies for the T cell–mediated autoimmune disease alopecia areata (AA) could be expedited by an improved understanding of the immunologic signals underlying its pathogenesis. To approach this, our group is mounting a new technological and analytical platform, multiplex immunoprecipitation detected by flow cytometry (MIF). MIF is designed to allow analysis of collections of protein–protein interactions that participate in T cell signaling webs. Early experiments suggest that MIF can detect the increased protein–protein interaction network activity that occurs under conditions of T cell antigenic stimulation. Future experiments will focus on application of MIF to T cells isolated from AA or control patient samples, to identify critical T cell signaling complexes associated with the disorder.
Evidence that a simpático self-schema accounts for differences in the self-concepts and social behavior of Latinos versus Whites (and Blacks).

On the basis of the assumption that Latino Americans use a simpatico self-schema more than White Americans do, the authors predicted that the effects of this difference would be evident in the participants' self-concepts and social behavior. As predicted, Studies 1 and 2 revealed that Latino participants reported significantly more simpatico-related terms in their spontaneous self-concepts than did White participants. Complementing these findings, Study 3a revealed that the level of interactional involvement and the perceived quality of initial same-sex interactions was significantly enhanced by the presence of Latino dyad members. Study 3b tested the prediction that the content of the dyad members' thoughts and feelings would reveal a greater use of the simpatico self-schema by the Latino participants. This prediction was confirmed, and follow-up analyses indicated that a simpatico self-schema plays an important mediating role in the subjective experience and social behavior of Latino individuals.
Cyclopamine induces digit loss in regenerating axolotl limbs.

Axolotls, with their extensive ability to regenerate as adults, provide a useful model for studying the mechanisms of regeneration in a vertebrate, in hopes of understanding why other vertebrates cannot regenerate. Although the expression of many genes has been described in regeneration, techniques for gain and loss of function analyses have been limited. We demonstrated in a previous study that gain of function for secreted proteins was possible in the axolotl using the vaccinia virus to drive expression of the transgene. In this study, we used a pharmacological approach made possible by the existence of a naturally occurring compound that specifically blocks shh signaling, cyclopamine. The treatment of axolotls with cyclopamine during the process of limb regeneration caused a loss of digits similar to that described for the shh knockout mouse. Our results further demonstrate that shh signaling and function are conserved during limb regeneration in urodeles as in limb development in other vertebrates.
Set-Based Thinking in the Engineering Design Community and Beyond

Since a series of academic case studies had revealed Toyota’s unique product development practices to the world, a flurry of research has been conducted into set-based design, also known as set-based concurrent engineering. In this paper, we review work related to set-based design across academic communities in efforts to find common themes and influences. After a review of this literature, we inductively arrive at two Principles of Set-Based Thinking: considering sets of distinct alternatives concurrently and delaying convergent decision making. These Principles allow us to articulate a working description of set-based design. We then examine these two Principles at work in a case example of a common theoretical construct in design.Copyright © 2014 by ASME
CT-GUIDED TRANSTHORACIC NEEDLE BIOPSY FOLLOWING INDETERMINATE FIBEROPTIC BRONCHOSCOPY IN SOLITARY PULMONARY NODULES

Abstract We evaluated the role of computed tomography (CT)- guided transthoracic needle biopsy (TNB) in patients with solitary pulmonary nodule and indeterminate flexible fiberoptic bronchoscopy (FOB). A review of 112 patients with solitary nodules under 3 cm in size who underwent TNB was carried out. A total of 48 patients had prior FOB with negative or indeterminate results. We reviewed the results of CT-guided TNB of these 48 patients with respect to the cytology results, nodule size and location, and complications of the procedure. Among the 48 patients who had FOB with indeterminate cytology, 32 were found to have malignant cytology on subsequent TNB. Among the remaining 16 patients, eight had diagnostic thoracotomy, which showed that six of the nodules were benign and two were malignant. The remaining eight patients who did not undergo surgery have been followed for more than 2 years, without evidence of growth. Results were not influenced by size or location. TNB offers a high yield for diagnosis in this patient population.