cssi/SciSciGPT-SciSciNet huggingface dataset:
Organization and Place in the Anti-U.S. Chinese Student Protests After the 1999 Belgrade Embassy Bombing

*While early studies of participant mobilization in contentious politics stress the roles of organizations and networks in mobilization, more recent scholarship emphasizes the importance of place. This article treats organization-based mobilization and place-based mobilization as two mechanisms of participant mobilization and tries to find a way to understand the relationships between them. By examining different styles of student mobilization during the 1999 anti-U.S. protests at three Beijing universities, each with similarly built environments and spatial student routines, this article shows that the built environment played a crucial role in student mobilizations where there was less organizational involvement, and a small role when mobilization processes were more organized. In short, less-organized protests may be compelled to rely on placed-based mobilization tactics.
RECEPTIVITY AND TRANSIENT GROWTH OF ROUGHNESS-INDUCED DISTURBANCES

Receptivity of transient disturbances to surface roughness is a complicated phenomenon that governs both initial disturbance amplitudes and features of the disturbances’ growth and decay throughout the boundary layer. The experiments described here use hotwire measurements in a Blasius boundary layer to obtain detailed information on the initial disturbances generated by a spanwise-periodic array of roughness elements and the transient growth that follows the initial disturbances. The results indicate that disturbance energy associated with the roughness-induced disturbances scales with the roughness-based Reynolds number, Rek, for values as high as 119. At Rek 162 there is some preliminary evidence for nonlinear amplitude saturation, but this requires more complete verification.
Ancient, Postmodern, and Prophetic: How Haight's Symbol Theory (Almost) Does It All

The achievements of Roger Haight's provocative book Jesus Symbol of God rise and fall according to the strengths—and weaknesses—of Haight's symbol theory as applied to his christological project. While this essay expresses a largely positive view of Haight's overall project, it focuses on two key shortcomings pertaining to Haight's symbol theory as it shapes his Christology: first, that his notion of symbol is too low to serve traditional Christology; second, that Haight strips religious symbols of their prophetic power by conceding too much to his audience. Drawing on the symbol theories of Karl Rahner and Paul Ricoeur, to whom Haight is deeply indebted for his understanding of symbol, a path is indicated by which Haight's model could more adequately wed symbol theory and Christology in yielding a more fruitful understanding of Jesus as symbol of God.
Determination of benzoic acid,sorbicacid,saccharin sodium in soy milk by HPLC

Objective:To establish a method for detecting benzoic acid,sorbicacid,saccharin sodium of food additive in soy milk.Methods:We used sedimentary reagent to remove protein and fat in soy milk.Then,we detect benzoic acid,sorbic acid and saccharin sodium in soy milk with HPLC.Results:The calibration curves for benzoic acid,sorbicacid,saccharin sodium had good linear relations between 0 and 200 mg/L.The clinear correlation coefficient was greater than 0.999.The detection limits of benzoic acid,sorbicacid and saccharin sodium were 0.10,0.10 and 0.08 μg/ml respectively.The recovery of benzoic acid,sorbicacid,saccharin sodium was 89.5%～101.6%,97.5%～103.2%,95.4%～106.7%.The relative standard deviations were 2.45%,2.85%,4.25%.Conclusion:The method is simple,rapid,accurate and easy to operate.It has been applied for actual samples with satisfactory results.
Backward stochastic differential equations driven by continuous local martingale under non-Lipschitz condition

The classical backward stochasticdifferential equations(BSDE) is driven by the Brownian motion,but the Brownmotion is one kind of special stochastic process,which causes the classical BSDE theory to receive certain limit in applications.The backward stochasticdifferential equation is taken continuous local martingale as the noise source isconsidered.The existence and uniqueness theorem under non-Lipschitz condition of Mao on the generator by construction of Picard sequence,Gronwall inequality,It^oformula and Bihari's inequality is obtained.
The Analysis of the Expansion of the Income Distribution Gap of China

AbstrcatThe GDP for average person of China was over 1 000 dollars in the year of 2003. Thus it had come to a very important period for China to develop the economy, so the expansion of income distribution gap became a social focus. This article is divided into three parts:In the first part, the reasons for the expansion of the income distribution gap in our country are analyzed;In the second part, the disadvantages caused by the expansion of the income distribution gap are analyzed;In the third part,some countermeasures to control the expansion of the income distribution gap are proposed.
Evaluation and suggestions for combustion system of a boiler before denitrification retrofit

In order to provide references for adding denitration system and burner transformation and equipment selection,accurate state evaluation on such indices as boiler efficiency,NOx emission,air leakage from preheater and boiler operation performance were conducted for a 330 MW unit before denitration retrofit and burner transformation.Several suggestions for the transformation were presented,like comprehensively considering various factors to find the optimal air volume,regarding the original design coal as one of the check coals,taking effective measures to decrease the air leakage rate of air preheater according to the air preheater's structure,and so on.
Experimental study of phosphorite flotation from magnetic separation tailings of a phosphate-iron ore

In this paper,phosphorite flotation test was carried out to study the magnetic separation tailings of a phosphate-iron ore in China.Because of the complex composition of the ore and the big difference in the phosphorite's flotability between the upper layer and the lower layer,a kind of collector PA-807A that had good selectivity for phosphorite was used in the test.The PA-807A could float the phosphorite in the upper layer ore and the lower layer ore effectively.In open circuit test,when the upper layer ore was ground to the fineness of 50%-200 mesh,a phosphate concentrate with 31.28% P2O5 grade and 96.15% P2O5 recovery could be obtained through one roughing and one cleaning.When the lower layer ore was ground to the fineness of 80%-200 mesh,a phosphate concentrate with 31.76% P2O5 grade and 82.04% P2O5 recovery could be obtained through one roughing and three cleanings.
Neuroendocrine liver metastases: Value of apparent diffusion coefficient and enhancement ratios for characterization of histopathologic grade.

PURPOSE To assess the value of apparent diffusion coefficient (ADC) measured with diffusion-weighted imaging (DWI) and enhancement ratios (ER) measured with contrast-enhanced T1-weighted imaging (CE-T1WI) for the characterization of histopathologic tumor grade of neuroendocrine tumor liver metastases (NETLM). MATERIALS AND METHODS Twenty-two patients with pathology-proven NETLM and pretreatment 1.5 Tesla (T) and 3T MRI including DWI were included in this Institutional Review Board-approved retrospective study. ADC histogram parameters, including mean, minimum (min), skewness, and kurtosis as well as ER, were computed for all lesions. Tumor grading was based on the World Health Organization 2010 classification. Kruskal-Wallis and Mann-Whitney test were used to assess for differences in ADC and ER between different tumor grades. MRI parameters were correlated with pathologic findings using Spearman correlation test. Receiver operating characteristic analysis was performed to determine optimum thresholds for predicting tumor grade. RESULTS Forty-eight NETLM (mean size 3.5 cm) were analyzed with the following grade distribution: G1 (n = 25), G2 (n = 16), and G3 (n = 7). ADC-mean (×10-3 mm2 /s) of G3 tumors (0.87 ± 0.43) was significantly lower than that of G1 (1.47 ± 0.63) and G2 (1.27 ± 0.63; P = 0.042). A weak significant negative correlation was observed between ADC and tumor grade (ADC-mean: r = -0.33, P = 0.02; ADC-min: r = -0.37, P = 0.01) and Ki-67 (ADC-mean: r = -0.31, P = 0.03; ADC-min: r = -0.39, P = 0.007). AUROC, sensitivity and specificity of ADC-mean/ADC-min/ER (measured at the early arterial phase) for differentiation of G3 versus G1-G2 were 0.80/0.76/0.67, 100%/50%/70%, and 68.4%/84.2%/66.6%, respectively. CONCLUSION ADC is a promising marker for characterization of histopathologic grade of NETLM. These results should be confirmed in a prospective study. J. Magn. Reson. Imaging 2016;44:1432-1441.
Introduction: Wonder, Ecocriticism, and Romanticism’s Forgotten Way

This chapter introduces the central project of this book: the recovery of a sense of how wonder’s political and ecological meanings differ from those associated with sublimity. Economides argues that, contrary to most romantic and green scholarship, wonder should not be conflated with sublimity because it is a way of experiencing the more-than-human world that is mobilized by pleasurable awe and open-ended inquiry rather than by fear and violence. After examining the causes of sublimity’s hegemony in recent theory, Economides surveys wonder’s ethical and ecological significance within the works of contemporary philosophers.
Anomalous Feeding of the Left Upper Lobe

We report the case of a 53-year-old woman who presented with massive hemoptysis. Computed tomographic angiography revealed an anomalous vessel arising from the abdominal aorta, coursing anteriorly and through the diaphragm, and feeding the left upper lobe. At operation the vessel was found to anastomose to the left upper lobe lingula, which contained multiple vascular abnormalities and arteriovenous fistulas. The vessel was ligated, and the affected portion of the left upper lobe was resected. Anomalous systemic arterial supply of an upper lobe is an especially rare form of a Pryce type 1 abnormality. Recognition of these unusual anatomic variants is crucial to successful treatment and avoidance of adverse events.
Essays in the Economics of Crime and Punishment

(1977). Essays in the Economics of Crime and Punishment. Journal of Economic Issues: Vol. 11, No. 3, pp. 703-711.
Predicting the Political Alignment of Twitter Users

The widespread adoption of social media for political communication creates unprecedented opportunities to monitor the opinions of large numbers of politically active individuals in real time. However, without a way to distinguish between users of opposing political alignments, conflicting signals at the individual level may, in the aggregate, obscure partisan differences in opinion that are important to political strategy. In this article we describe several methods for predicting the political alignment of Twitter users based on the content and structure of their political communication in the run-up to the 2010 U.S. midterm elections. Using a data set of 1,000 manually-annotated individuals, we find that a support vector machine (SVM) trained on hash tag metadata outperforms an SVM trained on the full text of users' tweets, yielding predictions of political affiliations with 91% accuracy. Applying latent semantic analysis to the content of users' tweets we identify hidden structure in the data strongly associated with political affiliation, but do not find that topic detection improves prediction performance. All of these content-based methods are outperformed by a classifier based on the segregated community structure of political information diffusion networks (95% accuracy). We conclude with a practical application of this machinery to web-based political advertising, and outline several approaches to public opinion monitoring based on the techniques developed herein.
Effects of entrepreneurs’ individual factors and environmental contingencies on venture performance: a case study of African-American women-owned ventures

Few researchers have explored the determinants of venture performance of firms owned by African-American women. In recent years, the growth in the number of these firms have exceeded that of all wo...
Atmospheric boundary layer simulation in a new open-jet facility at LSU: CFD and experimental investigations

Abstract This study focuses on Computational Fluid Dynamics (CFD) investigations of atmospheric boundary layer (ABL) wind generation with proper flow characteristics for an open-jet setup design. The results of two-dimensional and three-dimensional numerical CFD models were later validated experimentally within a newly built open-jet facility at Louisiana State University (LSU). Various turbulence models of k–ɛ, Reynolds Stress Model, and Large Eddy Simulation (LES) are implemented to help selecting appropriate flow management schemes. Based on CFD results, the planks’ configuration that matched open terrain was a set of angles: 15°, 12°, 10°, 5°, 0°, 0° from bottom to top. The LES simulated wind velocity and turbulence intensity profiles were in good agreements with target profiles for open-terrain, because LES uses a spatial filtering operation to separate the larger eddies (which are more anisotropic) and smaller eddies (which are nearly isotropic). Moreover, a comprehensive experimental flow quality check was conducted, and the facility was further calibrated by testing a 1:15 scaled model of a low-rise building. The results were then compared with the National Institute of Standards and Technology, and the University of Western Ontario wind-tunnel database. It was shown that the general patterns of pressure coefficient’s contours are more symmetric for LSU model and the reattachment patterns are identical between the two cases. Eventually, the potential application of CFD was proved when implemented in the design of an open-jet facility to reduce the experimental effort for ABL wind processes.
Systemic SMAD7 Gene Therapy Increases Striated Muscle Mass and Enhances Exercise Capacity in a Dose-Dependent Manner.

Striated muscle wasting occurs with a variety of disease indications, contributing to mortality and compromising life quality. Recent studies indicate that the recombinant adeno-associated virus (serotype 6) Smad7 gene therapeutic, AVGN7, enhances skeletal and cardiac muscle mass and prevents cancer-induced wasting of both tissues. This is accomplished by attenuating ActRIIb intracellular signaling and, as a result, the physiological actions of myostatin and other ActRIIb ligands. AVGN7 also enhances isolated skeletal muscle twitch force, but is unknown to improve systemic muscle function similarly, especially exercise capacity. A 2-month-long dose-escalation study was therefore conducted using 5 × 1011, 1 × 1012, and 5 × 1012 vg/mouse and different tests of systemic muscle function. Body mass, skeletal muscle mass, heart mass, and forelimb grip strength were all increased in a dose-dependent manner, as was the fiber cross-sectional area of tibialis anterior muscles. Maximal oxygen consumption (VO2max), a...
Maize, sweet sorghum, and high biomass sorghum ethanol yield comparison on marginal soils in Midwest USA

Abstract Emerging biofuel feedstock systems are well suited for use on less productive marginal soils in the Midwestern USA. The systems could replace commodity crop agriculture that may not be economically feasible on these soils with current input and output prices, and meet a growing renewable energy demand. Three annual bioenergy crops, maize (Zea mays L.), sweet sorghum (Sorghum bicolor (L.) Moench), and high biomass sorghum (HBS) were grown in rotation with soybean (Glycine max L.) for five years on marginal soils at two locations. Maize aboveground dry matter (DM) yield and grain yield, sweet sorghum aboveground DM yield, and juice yield and Brix, and HBS DM yield were evaluated and used to calculate theoretical ethanol yields. Intermittent drought occurred at both sites during three of the five years notably reducing yield; a terminal drought in 2011 reduced sorghum yields and inhibited maize grain development at both sites. Theoretical ethanol yields averaged across years from sweet sorghum and HBS were greater than from maize at both locations, and indicate that sweet sorghum has the greatest yield potential, but HBS yield was the most stable. The central Missouri site maintained greater dry matter yield, and theoretical ethanol yield than the southwestern Missouri site. Due to the occurrence of drought during the study, the findings have relevance for evaluating marginal land management for annual bioenergy crops in differing rainfall patterns with climate change.
Managers at Work: Real Managers Don't Boss!

(1994). Managers at Work: Real Managers Don't Boss! Research-Technology Management: Vol. 37, No. 6, pp. 12-13.
ECoG high-gamma modulation versus electrical stimulation for presurgical language mapping.

Abstract Objective This meta-analysis compared diagnostic validity of electrocorticographic (ECoG) high-γ modulation (HGM) with electrical stimulation mapping (ESM) for presurgical language localization. Methods From a structured literature search, studies with electrode level data comparing ECoG HGM and ESM for language localization were included in the meta-analysis. Outcomes included global measures of diagnostic validity: area under the summary receiver operating characteristic (SROC) curve (AUC), and diagnostic odds ratio (DOR); as well as pooled estimates of sensitivity and specificity. Clinical and technical determinants of sensitivity/specificity were explored. Results Fifteen studies were included in qualitative synthesis, and 10 studies included in the meta-analysis (number of patients 1–17, mean age 10.3–53.6 years). Overt picture naming was the most commonly used task for language mapping with either method. Electrocorticographic high-γ modulation was analyzed at 50–400 Hz with different bandwidths in individual studies. For ESM, pulse duration, train duration, and maximum current varied greatly among studies. Sensitivity (0.23–0.99), specificity (0.48–0.96), and DOR (1.45–376.28) varied widely across studies. The pooled estimates are: sensitivity 0.61 (95% CI 0.44, 0.76), specificity 0.79 (95% CI 0.68, 0.88), and DOR 6.44 (95% CI 3.47, 11.94). Area under the SROC curve was 0.77. Results of bivariate meta-regression were limited by small samples for individual variables. Conclusion Electrocorticographic high-γ modulation is a specific but not sensitive method for language localization compared with gold-standard ESM. Given the pooled DOR of 6.44 and AUC of 0.77, ECoG HGM can fairly reliably ascertain electrodes overlying ESM cortical language sites.
Spatial heterogeneity and socioeconomic patterns: Identifying the impact of urban center on forest fragmentation

Forest, one of the most important natural resources, has been degraded in both quantity and quality due to the insensive human activities. This research identified the relationship between spatial pattern of forest and socioeconomic drivers in southern New Hampshire. The results indicated that house density was the most important factor in contributing to the forest fragmentation. The area-related fragmentation was influenced largely by the distance and size of nearby cities while the shape-related fragmentation was caused collectively by multiple socioeconomic variables. This research provides a case study to understand the spatial variation of forest and understand the socioeconomic drivers of forest transition.
Cross-correlation method for acoustic detection of small unmanned aerial vehicles

The availability of Unmanned Aerial System (UAS) to consumers has increased in the recent years, with it came the potential for negligent or nefarious misuse of them. Stevens Institute of Technology has built a passive acoustic system for low flying aircraft detection, the application of the developed principles and algorithms for UAS acoustic detection and tracking is presented in this paper. The application of the developed principles and algorithms for UAS acoustic detection and tracking is presented in this paper. Several experiments were conducted aiming to establish the characteristics of the emitted noise of UAVs of various sizes while airborne and demonstrate the processing required to detect and find the direction toward the source. The vehicles tested included popular quadrotors: DJI Phantom 2 Vision + , 3DR Solo, DJI Inspire 1 as well as larger semi-professional vehicles: Freefly Alta 6, DJI S1000. The small array of 16 microphones was used for data collection in the tests near local NJ airport...
Liberating Public Opinion: The Press and a Saint-Dominguan Public Sphere

Philanthropists used the press during the Haitian Revolution to encourage citizens to engage in the public sphere through their daily publications, by printing letters to the editors, responses to the minutes of the legislative and governing bodies, and thought-provoking questions. Philanthropists engaged in this colonial public sphere through the press, a tool for change. They did more than just use Saint-Dominguan revolutionary press to report on the revolution; they used it for cultural development, including philanthropic endeavors to end slavery and establish racial equality.
Neural Network Based Processing of Thermal NDE Data for Corrosion Detection

Subsurface corrosion in aircraft structure is a major concern in lap joints and other joints. Small open gaps in the joints form regions where moisture can be trapped. The trapped water often produces a chemical environment in the regions which accelerates the corrosion process. Corrosion considerably reduces structural strength and load-bearing capacity of the structure. To ensure flight safety, it is imperative to detect subsurface corrosion as early as possible during aircraft maintenance operations. Since long downtimes of commercial aircraft translate to large operating costs for airline industries, it is desirable to develop techniques that can consistently and reliably detect corrosion by rapidly scanning the aircraft. Towards this goal, the thermal technique, which is a nondestructive, noncontacting technique capable of rapidly inspecting aircraft structures for defects such as disbonds, corrosion, and cracks is currently under development [1]. Also under parallel development are techniques such as ultrasonics, magneto-optics, shearography, electromagnetics, and radiography.
S Cone Loss with Aging

Loss of sensitivity to short-wavelength (blue) light and blue-yellow color vision abnormalities are well-known phenomena accompanying normal human aging. Can these losses be completely accounted for by the known yellowing of the crystalline lens with age or is there an additional loss of sensitivity in the short-wavelength-sensitive (SWS) pathways? We addressed this question in 61 subjects in four age groups; a young control group and three older groups (50–60, 60–70, over 70 years). Two color increment threshold techniques were used to isolate the SWS cone pathways and the long-wavelength-sensitive (LWS) cone pathways. Flicker thresholds (25 Hz) on a bright white background were measured as a means to correct the SWS cone increment thresholds for media absorption. No losses in LWS cone sensitivity were found in any of the groups. A loss of SWS cone sensitivity of 0.4–0.5 log units was found in the older age groups, however. About half of the loss could be accounted for by media absorption of blue light, while the other half presumably is caused by loss of sensitivity in the SWS cone pathways with normal aging.
Obsessions, Compulsions, and Repetitive Behavior: Autism and/or OCD

Autism spectrum disorder (ASD) and obsessive–compulsive disorder (OCD) share similar clinical features (e.g., obsessions, compulsions, restricted interests, repetitive behaviors), making accurate differential diagnosis challenging. Fairly high rates of comorbidity between the disorders further complicate the assessment procedures and present additional clinical concerns (e.g., increased psychosocial impairment). Given the clinical implications of their co-occurrence and similar symptom presentations, differentiating obsessive–compulsive symptoms from symptoms of ASD is essential. This chapter provides information on OCD and ASD individually and jointly. Diagnostic criteria for each disorder are reviewed, along with explanations of symptom overlap between OCD and ASD. Clinical examples of overlapping symptoms of OCD and ASD requiring a differential diagnosis are presented, and recommendations for techniques and queries within assessments are included. Commonly utilized measures to aid in the assessment of OCD and ASD symptoms are summarized, though there is still a paucity of measures that have been validated for concurrent use in both populations. A brief overview of treatment in individuals with OCD and ASD is presented, as well as a description of the Diagnostic and Statistical Manual of Mental Disorders—Fifth Edition (DSM-5) changes and associated implications. For each section, clinical implications of the overlap between OCD and ASD are discussed.
Mechanisms Orchestrating Mitochondrial Dynamics for Energy Homeostasis.

Abstract To maintain homeostasis, every cell must constantly monitor its energy level and appropriately adjust energy, in the form of ATP, production rates based on metabolic demand. Continuous fulfillment of this energy demand depends on the ability of cells to sense, metabolize, and convert nutrients into chemical energy. Mitochondria are the main energy conversion sites for many cell types. Cellular metabolic states dictate the mitochondrial size, shape, function, and positioning. Mitochondrial shape varies from singular discrete organelles to interconnected reticular networks within cells. The morphological adaptations of mitochondria to metabolic cues are facilitated by the dynamic events categorized as transport, fusion, fission, and quality control. By changing their dynamics and strategic positioning within the cytoplasm, mitochondria carry out critical functions and also participate actively in inter-organelle cross-talk, assisting metabolite transfer, degradation, and biogenesis. Mitochondrial dynamics has become an active area of research because of its particular importance in cancer, metabolic diseases, and neurological disorders. In this review, we will highlight the molecular pathways involved in the regulation of mitochondrial dynamics and their roles in maintaining energy homeostasis.
A Ligand Protonation Series in Aluminum(III) Complexes of Tridentate Bis(enol)amine Ligand

A series of aluminum(III) complexes supported by the tridentate bis(enol)amine ligand (ONO, 1,1′-azanediylbis(3,3-dimethylbutan-2-one)) in two protonation states have been synthesized and characterized structurally. Reaction of AlCl3 with singly deprotonated H2ONO– afforded pseudo-octahedral [(H2ONO–)2Al][AlCl4] (1). AlCl3 was also reacted with doubly deprotonated HONO2– to afford the five-coordinate, pseudotrigonal bipyramidal complex (HONO2–)AlCl(THF) (2). The reaction of complex 2 with HCl yielded complex 1, which demonstrates reversible protonation of the ligand backbone. Synthesis of an Al(III) complex of ONO3– was not achieved using a variety of Lewis bases. An attempt to deprotonate complex 2 with tBuOK yielded [(HONO2–)Al](μ-tBuO) (3), with no change to the ligand protonation state.
Enhanced endothelial barrier protective and anti-inflammatory effects by synthetic iloprost-conjugated phospholipid.

Products of 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine oxidation bearing cyclopentenone modifications of arachidonoyl moiety exhibit pronounced protective effects on pulmonary endothelial cell (EC) barrier. On the other hand, prostacyclin and its FDA-approved stable synthetic analog, iloprost, also protect lung vascular EC and attenuate lung inflammation caused by bacterial wall lipopolysaccharide (LPS). In this study, we generated phospholipase resistant synthetic phospholipid with arachidonic acid moiety replaced by iloprost (ILO-PC) and investigated its biological effects. In comparison to free ILO, ILO-PC caused sustained EC barrier enhancement. Both, ILO and ILO-PC effects were mediated by activation of Rap1 and Rac1 GTPases and their cytoskeletal effectors PAK1 and cortactin and enhancement of VE-cadherin adherens junctions. ILO and ILO-PC equally efficiently suppressed acute, Rho GTPase-dependent EC hyper-permeability caused by thrombin. However, ILO-PC exhibited more sustained barrier-protective and anti-inflammatory effects in the model of chronic EC dysfunction caused by LPS. ILO-PC also was more potent inhibitor of NFκB signaling and lung vascular leak in the murine model of LPS-induced acute lung injury (ALI). Optical imaging of lungs of LPS-challenged animals monitored over 3 days showed more efficient ALI recovery in animals treated with ILO-PC. In conclusion, this study describes a novel synthetic phospholipid with barrier-enhancing and anti-inflammatory properties superior to existing prostacyclin analogs, which may be used as a prototype for future development of more efficient treatment for ALI and other vascular leak syndromes.
Is the Cost-Effectiveness of Stroke Thrombolysis Affected by Proportion of Stroke Mimics?

Background and Purpose- Differentiating ischemic stroke patients from stroke mimics (SM), nonvascular conditions which simulate stroke, can be challenging in the acute setting. We sought to model the cost-effectiveness of treating suspected acute ischemic stroke patients before a definitive diagnosis could be made. We hypothesized that we would identify threshold proportions of SM among suspected stroke patients arriving to an emergency department above which administration of intravenous thrombolysis was no longer cost-effective. Methods- We constructed a decision-analytic model to examine various emergency department thrombolytic treatment scenarios. The main variables were proportion of SM to true stroke patients, time from symptom onset to treatment, and complication rates. Costs, reimbursement rates, and expected clinical outcomes of ischemic stroke and SM patients were estimated from published data. We report the 90-day incremental cost-effectiveness ratio of administering intravenous thrombolysis compared with no acute treatment from a healthcare sector perspective, as well as the cost-reimbursement ratio from a hospital-level perspective. Cost-effectiveness was defined as a willingness to pay 1.5. Results- There was an increase in incremental cost-effectiveness ratios as the proportion of SM cases increased in the 3-hour time window. The threshold proportion of SM above which the decision to administer thrombolysis was no longer cost-effective was 30%. The threshold proportion of SM above which the decision to administer thrombolysis resulted in high cost-reimbursement ratio was 75%. Results were similar for patients arriving within 0 to 90 minutes of symptom onset as compared with 91 to 180 minutes but were significantly affected by cost of alteplase in sensitivity analyses. Conclusions- We identified thresholds of SM above which thrombolysis was no longer cost-effective from 2 analytic perspectives. Hospitals should monitor SM rates and establish performance metrics to prevent rising acute stroke care costs and avoid potential patient harms.
Abstract 105: Increased Circulating Trimethylamine N-oxide (TMAO) Augments the Incidence of Abdominal Aortic Aneurysm in Low Penetrant C57BL/6J Mice

Background: The gut microbiota is a metabolically active endocrine organ critical to the maintenance of cardiovascular health. Dietary sources of choline are metabolized by microbial enzymes to for...
Esophageal Obstruction and Perforation: Incidence, Etiologies, Presentation, and Management

Esophageal perforation or obstruction is overall a rare but serious entity with mortality rates as high as 30%. Often discussed but rarely encountered, it requires correct and complex decision-making to ensure an optimal outcome for the patient. Throughout the literature, it is difficult to find all-encompassing discussions on esophageal perforation or obstruction and its management. Esophageal obstruction is broadly divided into benign and malignant etiologies. Overall, the most common etiology is for benign causes such as caustic ingestions, foreign body impactions, strictures, dysmotility, and hernias. Perforation is most commonly iatrogenic occurring during instrumentation of the esophagus; however there is typically an underlying associated pathology.
Nonindex Readmission After Ruptured Brain Aneurysm Treatment Is Associated with Higher Morbidity and Repeat Readmission.

Background Aneurysmal subarachnoid hemorrhage (aSAH) requires complex multidisciplinary care. After initial treatment (index hospital), readmission to a different hospital (nonindex) can compromise quality of care, resulting in increased morbidity. We aimed to evaluate factors associated with nonindex readmission and evaluate association of nonindex hospital readmission on outcomes in patients with ruptured aneurysm. Methods Readmissions within 90 days after aSAH treatment were identified in the 2010–2014 Nationwide Readmissions Database. Multivariable logistic regression identified patient and hospital characteristics associated with nonindex readmission. Separate multivariable models determined increased morbidity or risk of second readmission for nonindex readmissions. Results A total of 9254 patients who underwent treatment of ruptured aneurysms from 2010 to 2014 were identified. Of these, 1985 (21.5%) were readmitted within 90 days. Three hundred and fifty-five of these readmissions (17.9%) occurred to nonindex hospitals. Patients that were discharged to a skilled nursing or other facility (odds ratio [OR], 1.70; 95% confidence interval [CI], 1.27–2.28]) had higher odds of nonindex readmission, whereas patients with private insurance were associated with lower odds of nonindex readmission (OR, 0.65; 95% CI, 0.46–0.92). Patients readmitted to a nonindex (vs. index) hospital were associated with increased likelihood of major complications (OR, 1.71; 95% CI, 1.18–2.48) and second readmissions (OR, 1.51; 95% CI, 1.17–1.96). Conclusions After treatment of a ruptured cerebral aneurysm, 17.9% of readmissions occurred at a nonindex hospital. These patients were at increased risk for major complications or subsequent readmissions, which may be because of care fragmentation. Interventions aimed at improving continuity of care may reduce higher morbidity associated with nonindex readmission.
The emerging roles of mTORC1 in macromanaging autophagy

Autophagy is a process of self-degradation that enables the cell to survive when faced with starvation or stressful conditions. The mechanistic target of rapamycin (mTOR), also known as the mammalian target of rapamycin, plays a critical role in maintaining a balance between cellular anabolism and catabolism. mTOR complex 1 (mTORC1) was unveiled as a master regulator of autophagy since inhibition of mTORC1 was required to initiate the autophagy process. Evidence has emerged in recent years to indicate that mTORC1 also directly regulates the subsequent steps of the autophagy process, including the nucleation, autophagosome elongation, autophagosome maturation and termination. By phosphorylating select protein targets of the autophagy core machinery and/or their regulators, mTORC1 can alter their functions, increase their proteasomal degradation or modulate their acetylation status, which is a key switch of the autophagy process. Moreover, it phosphorylates and alters the subcellular localization of transcription factors to suppress the expression of genes needed for autophagosome formation and lysosome biogenesis. The purpose of this review article is to critically analyze current literatures to provide an integrated view of how mTORC1 regulates various steps of the autophagy process.
Current and potential applications of positron emission tomography for multiple myeloma and plasma cell disorders

Fluorine-18 (18F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) allows evaluation of elevated glucose metabolism in malignancies. There has been increasing interest in FDG PET/CT for plasma cell disorders since the International Myeloma Working Group outlined multiple applications of this imaging modality, including distinguishing smoldering myeloma from active multiple myeloma, confirmation of solitary plasmacytoma, and multiple indications in patients with known multiple myeloma, including determining extent of initial disease, monitoring therapy response, and detection of residual disease following therapy. The field of molecular imaging is now shifting focus from evaluation of metabolism to targeted evaluation of specific tumor markers. Targeted PET imaging targeted of CXCR4 and CD38 has advanced into translational clinical trials, bringing us closer to powerful imaging options for myeloma. In this review we discuss the current applications of FDG PET/CT in plasma cell disorders, as well as advances in targeted PET imaging.
Rational design of a high-efficiency, multivariate metal–organic framework phosphor for white LED bulbs

Developing rare-earth element (REE) free yellow phosphors that can be excited by 455 nm blue light will help to decrease the environmental impact of manufacturing energy efficient white light-emitting diodes (WLEDs), decrease their cost of production, and accelerate their adoption across the globe. Luminescent metal–organic frameworks (LMOFs) demonstrate strong potential for use as phosphor materials and have been investigated intensively in recent years. However, the majority are not suitable for the current WLED technology due to their lack of blue excitability. Therefore, designing highly efficient blue-excitable, yellow-emitting, REE free LMOFs is much needed. With an internal quantum yield of 76% at 455 nm excitation, LMOF-231 is the most efficient blue-excitable yellow-emitting LMOF phosphor reported to date. Spectroscopic studies suggest that this quantum yield could be further improved by narrowing the material's bandgap. Based on this information and guided by DFT calculations, we apply a ligand substitution strategy to produce a semi-fluorinated analogue of LMOF-231, LMOF-305. With an internal quantum yield of 88% (λem = 550 nm) under 455 nm excitation, this LMOF sets a new record for luminescent efficiency in yellow-emitting, blue-excitable, REE free LMOF phosphors. Temperature-dependent and polarized photoluminescence (PL) studies have provided insight on the mechanism of emission and origin of the significant PL enhancement.
TREATMENT OF AN UNUSUAL CASE OF PERSISTENT LEFT SUPERIOR VENA CAVA

Persistent left superior vena cava (PLSVC) is a common congenital malformation of the thoracic venous return. Drainage directly into the left atrium (LA) with an intact coronary sinus is rare. A 64-year-old female presented with dyspnea and hypoxia. A bubble study (injection from the left
The Danger of Using Pop-Off Valves for Pediatric Emergency Airway Management.

Abstract Background Most pediatric resuscitator bags are equipped with a positive-pressure relief (“pop-off”) valve meant to prevent delivery of excessive pressure. Pop-off valves, however, can lead to adverse events in emergency situations when providers are unaware of their significance. Case Report A 3-year-old girl with muscular atrophy and a chronic tracheostomy tube was noted to have decreasing oxygen saturations. Paramedics found the patient in cardiac arrest and initiated resuscitative efforts; the patient regained pulses but quickly became pulseless again. There were two more cycles of cardiac arrest followed by return of spontaneous circulation. When she arrived at the emergency department pulses were present. The emergency physician performed bag ventilation and felt no resistance to bag squeezing, but saw no chest rise, and realized the patient was not being ventilated because all of the air was escaping through the pop-off valve. When the valve was closed, it was impossible to perform bag ventilation. She was found to have complete occlusion of her tracheostomy tube; the paramedics had not been ventilating during transport, though were unaware of the occlusion because of the open pop-off valve. Removal of the tracheostomy tube and placement of an endotracheal tube significantly improved ventilation. Why Should an Emergency Physician Be Aware of This? Pop-off valves are common on pediatric resuscitator bags, but often result in insufficient ventilation and oxygenation during emergency airway management. Emergency airway experts recommend that pop-off valves be avoided or deactivated during emergency resuscitation, but this information has not been widely disseminated.
Rod phototransduction and light signal transmission during type 2 diabetes.

INTRODUCTION Diabetic retinopathy is a major complication of diabetes recently associated with compromised photoreceptor function. Multiple stressors in diabetes, such as hyperglycemia, oxidative stress and inflammatory factors, have been identified, but systemic effects of diabetes on outer retina function are incompletely understood. We assessed photoreceptor physiology in vivo and in isolated retinas to better understand how alterations in the cellular environment compared with intrinsic cellular/molecular properties of the photoreceptors, affect light signal transduction and transmission in the retina in chronic type 2 diabetes. RESEARCH DESIGN AND METHODS Photoreceptor function was assessed in BKS.Cs-Dock7m+/+Lepr db/J mice, using homozygotes for Leprdb as a model of type 2 diabetes and heterozygotes as non-diabetic controls. In vivo electroretinogram (ERG) was recorded in dark-adapted mice at both 3 and 6 months of age. For ex vivo ERG, isolated retinas were superfused with oxygenated Ames' media supplemented with 30 mM glucose or mannitol as iso-osmotic control and electrical responses to light stimuli were recorded. RESULTS We found that both transduction and transmission of light signals by rod photoreceptors were compromised in 6-month-old (n=9-10 eyes from 5 animals, ***p<0.001) but not in 3-month-old diabetic mice in vivo (n=4-8 eyes from 2 to 4 animals). In contrast, rod signaling was similar in isolated retinas from 6-month-old control and diabetic mice under normoglycemic conditions (n=11). Acutely elevated glucose ex vivo increased light-evoked rod photoreceptor responses in control mice (n=11, ***p<0.001), but did not affect light responses in diabetic mice (n=11). CONCLUSIONS Our data suggest that long-term diabetes does not irreversibly change the ability of rod photoreceptors to transduce and mediate light signals. However, type 2 diabetes appears to induce adaptational changes in the rods that render them less sensitive to increased availability of glucose.
Observational Studies and Program Evaluation

The principles of experimental design were taught by R. A. Fisher and succeeding generations of statisticians and researchers. First among these principles is the random assignment of experimental material to treatments. This ensures that variables not controlled in the experiment do not introduce spurious effects and permits a measure of error separate from the effects of the treatments. This error is used as the basis for tests and estimates concerning treatment effects.
Conflicts of Obligation

In the preceding chapters of this book, I have introduced a variety of concepts of absolute (nonconditional) obligation. Among these are individual moral obligation, individual prudential obligation, social obligation, and civic obligation. I have also introduced and discussed some forms of “collective” obligation — group moral and prudential obligation, for example. There is also the concept of the ought-to-be. Each of these is a “doing-the-best-we-can” concept of obligation, defined by appeal to some concept of possibility and some concept of value. In addition to all of these, there are also some concepts of obligation that have not been discussed here. Among these are various society- and code-relative forms of obligation, such as legal obligation and etiquettical obligation. Such concepts as these are not doing-the-best-we-can concepts of obligation. They would require a rather different sort of analysis.
Cancer chemosensitivity prediction of drug combinations using single drug responses and microarray profiling data

B46 Currently, the choice of therapy for metastatic cancer remains empiric due to the lack of chemosensitivity prediction for the available combination chemotherapeutic regimens. Here we present a novel approach that identifies chemosensitivity biomarker genes as predictors of tumor growth inhibition for three widely-used chemotherapeutic agents: Cisplatin, Paclitaxel, and Gemcitabine. Measuring cell proliferation responses 72hr after-treatment with each of these three agents on 40 human urothelial cancer cell lines, we obtained dose response curves and GI50 (50% of growth Inhibition) estimates. Based on these single drug response information and genome-wide gene expression profiling data of the 40 cell lines, we applied the MiPP (misclassification penalized posterior) approach, to discover molecular prediction models for these single drug responses. These MiPP-identified prediction models, each with a small number of gene biomarkers, predicted the responses of human bladder cancer cell lines to each of the three agents with a sensitivity of 0.93 to 0.96. Based only on these single-drug prediction models, we developed an in silico approach to predict responses to 3 clinically used two drug combinations of the aforementioned agents. We evaluated these predictions in vitro and found that 80% of 15 randomly-chosen cell lines were correctly predicted for their responsiveness to combination treatment (p=0.0002). Together, our results suggest for the first time that chemosensitivity to drug combinations can be accurately predicted based on gene expression profiling. Furthermore, this study provides the framework for the evaluation of predicted drug sensitivity in patients undergoing combination chemotherapy for cancer, based on gene expression profiles. If validated, this approach will lead to a breakthrough in personalized cancer therapy.
Rhodopsin accumulation at abnormal sites in retinas of mice with a human P23H rhodopsin transgene.

Purpose To investigate the mechanism by which photoreceptors degenerate in transgenic mice carrying a mutant human rhodopsin gene (P23H). Methods The temporal and spatial pattern of the retinal degeneration caused by P23H rhodopsin was mapped using immunocytochemistry with rhodopsin-specific antibodies. The subcellular localizations of rhodopsin, transducin, and rod cGMP phosphodiesterase (PDE) were also determined, and rhodopsin localization was compared among P23H transgenic mice, rd mice, and Royal College of Surgeons (RCS) rats. Results In transgenic mice that express P23H rhodopsin, photoreceptors are lost centrally by postnatal day 10. As the retina degenerates, rhodopsin accumulates in the outer nuclear layer and within the photoreceptor synaptic terminals. The P23H transgenic retinas also show an accumulation of transducin and PDE within the outer plexiform layer. In contrast, other types of hereditary retinal degenerations studied show a similar pattern of rhodopsin accumulation in the outer nuclear layer but not in the outer plexiform layer of the retina. Conclusions The pattern of degeneration in the P23H transgenic retina is consistent with a model in which the centrally located, first-born photoreceptors are the first to die. In contrast to other animal models for hereditary retinal degeneration (rd, RCS), a novel feature of the P23H degeneration is an accumulation of rhodopsin, transducin, and PDE within the outer plexiform layer of the retina. One hypothesis to explain this observation is that P23H rhodopsin is routed intracellularly through a pathway not used by normal rhodopsin. Nonmutant forms of the peripheral transducing proteins normally associated with disk membrane, such as transducin and PDE, may accompany the aberrantly routed rhodopsin.