cssi/SciSciGPT-SciSciNet huggingface dataset:
Protocol-based medical management of post-ERCP pancreatitis.

Background and Aims: Although numerous studies have evaluated outcomes pertaining to endoscopic retrograde cholangio-pancreatography (ERCP) complications, studies evaluating outcomes of management of post-ERCP pancreatitis are scant. This study evaluated the effectiveness of a standard treatment protocol in management of post-ERCP pancreatitis. Methods: This is a retrospective study of consecutive patients managed for post-ERCP pancreatitis, using a standard treatment protocol over a 3-year period. By protocol, patients received only intravenous fluids, narcotics, and analgesics for the first 24–72 h after admission. Oral intake was attempted when white cell count was normal or followed a downward trend, abdominal pain was absent or minimal without need for narcotics over a 12-h period, and serum lipase was less than three times normal range. For patients hospitalized beyond 72 h, an abdomen CT was obtained at days 4 and 10 to guide management. Intravenous antibiotics were administered only for patients with pancreatic necrosis. Jejunal feeding and a meperidine pump for pain control were initiated in symptomatic patients at day 4. Data on ERCP complications were collected prospectively and graded per consensus criteria. Effectiveness of the treatment protocol was evaluated by comparing clinical outcomes of patients managed by protocol versus those managed outside protocol. Results: 45 of 1976 patients (2.3%) who underwent ERCP developed post-ERCP pancreatitis. Of the 45 (female 31; mean age 43 years) patients, 32 were managed by protocol and 13 outside protocol. Protocol based management was associated with less severe disease as compared with those managed outside protocol (crude odds ratio (OR) = 11.2; 95% confidence interval (CI) = 1.9–68.7; P = 0.002). One patient managed outside protocol died of severe pancreatitis. When compared with those managed outside protocol, the median duration of hospital stay (7 vs 3 days; P = 0.01), the use of CT (100% vs 15.6%; P < 0.001), and the use of antibiotics (50% vs 3.1%; P = 0.01) were significantly lower in those managed by protocol. By multiple logistic regression, protocol-based management was associated with less severe disease (adjusted OR = 18.7; 95% CI = 2.6–132.1; P = 0.003) when adjusted for age, comorbidity, endotherapy and pancreatic stenting. Conclusions: A protocol-based management strategy was associated with less severe pancreatitis, shorter length of hospital stay, need for fewer imaging studies, and use of antibiotics. Prospective validation of these findings is justified.
Antiphase domains and {011} twins in TiAl

Abstract Titanium aluminides with a TiAl/Ti3Al two-phase microstructure exhibit mechanical properties which are superior to those for either single-phase TiAl or Ti3Al. The TiAl lamella in the two-phase microstructures show differently oriented TiAl regions which are frequently observed to coexist within the same TiAl lamella. The atomic arrangements of these regions are similar to antiphase domains/{011} twins of TiAl. However, the mechanism by which these regions are formed cannot be derived from the TiAl phase alone. This study suggests that, for two-phase titanium aluminides, Ti3Al has a strong influence on the development of the TiAl microstructure.
Structural Analysis of a Two-dimensional Braided Fabric

Two-dimensional-braid geometry is analyzed. The cover factor of a fabric braided on a particular braider depends on three variables: braid angle, helical length, and braid diameter; however, only two of the three are independent because of an equation of constraint. The cover factor of an existing braid is a function of braid angle and diameter and maintains a constant helical length between its tensile and compressive jammed states. A stable jammed state with maximum crimp is found to exist when the braid angle is 45° and the helical length is a minimum. When the braid diameter is held constant by braiding on a constant-diameter mandrel, the cover factor is increased by decreasing the helical length or increasing the braid angle. The cover factor is directly related to the fabric width as a single independent variable. When the yarn cannot be considered as a flat strip but must instead be considered to have a circular cross-section, the maximum cover factor in the jammed state is shown to be 0.82.
Recurrence Rate, Clinical Outcome, and Cellular Proliferation: Indices as Prognostic Indicators after Incomplete Surgical Excision of Cutaneous Grade II Mast Cell Tumors: 28 Dogs (1994–2002)

The objectives of this study were to determine local recurrence rate, clinical outcome, and prognostic value of the number of argyrophylic nucleolar organizer regions (AgNORs), presence of proliferating cell nuclear antigen (PCNA), and number of Ki-67-positive nuclei after incomplete surgical excision of canine cutaneous grade II mast cell tumors (MCTs). This retrospective study included 30 MCTs in 28 dogs. Medical records were examined and follow-up information was obtained from owners and referring veterinarians. Only cases in which excision was incomplete and no anvcillary therapy (other than prednisone) for MCT was given were included. Paraffin-embedded tumor tissues were retrieved for AgNORs, PCNA, and Ki-67 staining. Median follow-up time was 811.5 days. Seven (23.3%) tumors recurred locally. Median time to local recurrence was not reached with a mean of 1,713 days. The estimated proportions of tumors that recurred locally at 1, 2, and 5 years were 17.3, 22.1, and 33.3%, respectively. Eleven (39.3%) dogs developed MCTs at other cutaneous locations. Median progression-free survival was 1,044 days. Median overall survival was 1,426 days. The combination of Ki-67 and PCNA scores was prognostic for local recurrence (P = .03) and development of local recurrence was prognostic for decreased overall survival (P = .04). Results suggest that a minority of incompletely excised MCTs recur. Therefore, ancillary local therapies may not always be necessary. However, local recurrence can negatively affect survival of the affected dogs. Cellular proliferation indices may indicate the likelihood of MCT recurrence after incomplete excision.
Nuclear RNA synthesis in sea urchin embryos

Abstract Nuclei have been prepared from sea urchin embryos at several stages of development, and the RNA isolated and characterized. Up to the swimming blastula stage, nuclear RNA labeled with 3H-uridine is dispersed throughout the nucleus and is not localized on any particular structure. It has a DNA-like base composition and is heterogeneous in size, most of it being larger than 26S. At stages in which large amounts of the 9S histone mRNA complex are synthesized and found on cytoplasmic polyribosomes, molecules of the same size and electrophoretic mobility cannot be detected in the nuclei. Nuclei from gastrulae contain easily identifiable 36S and 28S RNAs that precursors to mature ribosoml RNA (26S and 18S). Also present in these nuclei are homodisperse low molecular weight species of unknown function, previously observed only in the cells of warm-blooded animals.
The Bill-snap Reflex : a Feeding Mechanism in the American Wood Stork

IN the course of field observations of the American wood stork (Mycteria americana) in Florida, the birds were seen to capture fish habitually from water so turbid or choked with vegetation that the use of visual cues was improbable. In such feeding behaviour, a stork typically inserts its partially open bill into the water, moves the bill slowly from side to side, and walks forward. Submerged vegetation is sometimes stirred with one foot and the wing on the same side is flashed open, presumably to startle concealed fish into the open bill. When a fish makes contact with the bill, the mandibles are quickly closed with considerable force. These feeding techniques have been previously described1–3.
Hydrodynamic description of collective modes in heavy-fermion superconductors.

We present a hydrodynamical theory for the collective modes of a p-wave superconductor that is described by an order parameter d which transforms as a vector under rotations generated by the spin angular-momentum operator J = L+S. Such superconducting order is possible in metals with cubic, hexagonal, or tetragonal crystal symmetry whose pairing electrons experience strong spin-orbit coupling. This is true of the known heavy-fermion superconductors. The variables J and d follow a Hamiltonian dynamics that results in an internal Josephson effect between the populations of spin-up and spin-down Cooper pairs. The effect is similar to the longitudinal spin-resonance behavior observed in the superfluid phases of /sup 3/He. Viscous corrections to the spin angular-momentum conservation of the pairs and to the momentum conservation of the bulk are introduced, serving to couple this Josephson mode to sound propagation. The coupling, which exists for both longitudinal and transverse sound, results in a resonant absorption contribution to the sound attenuation constant with a Lorentzian shape centered at the longitudinal spin-orbit resonance frequency. The height of this Lorentzian varies as ..omega../sup 2/ with frequency, characteristic of hydrodynamics, and its width depends upon frequency and the amount of quasiparticle scattering. It is suggested that thismore » mechanism accounts for the sound absorption peak recently observed in the heavy-fermion superconductor UBe/sub 13/.« less
Consumers’ Responses to Negative Word-of-Mouth Communication: An Attribution Theory Perspective

Research on negative word-of-mouth communication (WOMC) in general, and the process by which negative WOMC affects consumers’ brand evaluations in particular, has been limited. This study uses attribution theory to explain consumers’ responses to negative WOMC. Experimental results suggest that (a) causal attributions mediate the negative WOMC-brand evaluation relation, (b) receivers’ attributions depend on the manner in which the negative WOMC is conveyed, and (c) brand name affects attributions. Results also suggest that when receivers attribute the negativity of the WOMC message to the brand, brand evaluations decrease; however, if receivers attribute the negativity to the communicator, brand evaluations increase.
Total charge screening

Abstract Solutions of classical massless scalar electrodynamics with a large external charge which exhibit total charge screening, that is, in which the charge in the field exactly neutralizes the external charge, are found. These solutions have lower energy than the unscreened Coulomb potential. The relation to the color screening problem in QCD is discussed.
Antibody class and complement requirement of neutralizing antibodies in the primary and secondary antibody response of cattle to infectious bovine rhinotracheitis virus vaccine

Calves responded to a single intramuscular injection of an attenuated strain of infectious bovine rhinotracheitis virus by producing IgM followed by IgG antibody. Both IgM and IgG antibody produced during the first month were primarily complement-requiring neutralizing antibody (CRNAb), especially IgM antibody. After a month, IgG had replaced IgM as the predominant immunoglobulin, and titers with and without complement (C') decreased in both IgG and IgM fractions. The largest decrease was in the IgM CRNAb fraction. Seven days after a second injection given on day 196, calves responded with an anamnestic IgG response in which CRNAb titers were 1 or 2 two-fold dilutions higher than non-CRNAb titers. One calf developed an IgM response similar to its primary response, whereas inhibition of the IgM response occurred in the other 3 calves which had much lower IgM antibody titers than those attained in the primary response. Twenty-eight days after the second injection the titers of IgG were the same or only a 2-fold dilution less than their 7-day secondary titers, whereas IgM titers generally decreased considerably more than this. Guinea pig and rabbit sera were equally effective as C' sources in potentiating CRNAb, whereas bovine serum was a poor C' source.
Cytochemical demonstration of DNAse in pollen

Pollen DNAse of Chlorophytum comosum was demonstrated cytochemically by coupling the breakdown of DNA (due to the endogenous DNAse) with acid phosphatase supplied to the reaction mixture. Precipitation of the free phosphate groups (from acid phosphatase reaction on the freed nucleotides) as lead phosphate results in a electron dense deposit, visible with the electron microscope. Enzyme activity using this technique was localized in vesicles along the intine (principally along the aperture region) and around the generative cell.
Fact-based question decomposition for candidate answer re-ranking

Factoid questions often contain one or more assertions (facts) about their answers. However, existing question-answering (QA) systems have not investigated how the multiple facts may be leveraged to enhance system performance. We argue that decomposing complex factoid questions can benefit QA, as an answer candidate is more likely to be correct if multiple independent facts support it. We categorize decomposable questions as parallel or nested, depending on processing strategy required. We present a novel decomposition framework---for parallel and nested questions---which can be overlaid on top of traditional QA systems. It contains decomposition rules for identifying fact sub-questions, a question-rewriting component and a candidate re-ranker. In a particularly challenging domain for our baseline QA system, our framework shows a statistically significant improvement in end-to-end QA performance.
NMR study of the interaction of retinoids with phospholipid bilayers

Abstract The interaction of three vitamin A derivatives or retinoids: all-trans-retinoic acid, 13-cis-retinoic acid and retinol with multilamellar phospholipid bilayers was studied using a combination of 2H- and 31P-NMR measurements. The following model membrane systems were used: (1) dipalmitolyphosphatidylcholine (DPPC) bilayers; (2) bilayers composed of a mixture of DPPC and bovine heart phosphatidylcholine (PC); (3) mixed PC/phosphatidylethanolamine (PE) bilayers. Only a weak interaction was observed between 13-cis-retinoic acid and DPPC membranes. Addition of all-trans-retinoic acid at a molar ratio of 1:2 to the lipid causes a small decrease (5 C°) in the gel to liquid crystalline phase-transition temperature of DPPC, a small increase in the order parameters of the lipid side-chains of single component bilayers and no measurable effect in the other lipid systems studied. Considerably larger perturbation in the lipid bilayer structure is introduced by addition of retinol which, at a molar ratio of 1:2 to the lipid, lowered the gel to liquid crystalline phase-transition temperature of DPPC by 21 C° and caused a decrease of order parameters of the lipid side-chains in all three lipid bilayer systems. These effects are consistent with intercalation of retinol molecules into the bilayer interior. The results for the mixed PC/PE bilayers indicate that the presence of retinol caused lateral separation of PE- and retinol-enriched regions.
Linking Physical Geography Education and Research Through the Development of an Environmental Sensing Network and Project-Based Learning

Geographic education is more effective when students actively participate by developing hypotheses, designing experiments, collecting and analyzing data, and discussing results. We describe an innovative pedagogical approach, in which students learn physical geography concepts by analyzing environmental data collected in contrasting environments in Santa Barbara County, CA. The major components of this approach include a local network of micrometeorology stations (the Innovative Datasets for Environmental Analysis by Students (IDEAS network)), student field trips, a web portal (www.geog.ucsb.edu/ideas) and analysis tools which support student education and research. Examples of student work, graded rubrics, course evaluation scores, and instructor observations demonstrate the effectiveness of this approach. The most serious limitation is the high cost of equipment given the low number of students initially involved, a weakness that can be addressed through expanded use of this facility by other physical g...
Contributory factors in coronary occlusion

Abstract Possible contributory factors in coronary thrombosis are: (a) those which change the blood and (b) those which lessen coronary flow. Diminution of coronary flow follows lowering of diastolic blood pressure, decrease in systolic output and constriction of coronary arteries. There is little evidence that change in the blood is often important in causing occlusion. Most instances of occlusion occur under circumstances associated with lowering of diastolic pressure and lessening of systolic output. Evidence suggests that coronary constriction induced by gastrointestinal reflexes may upon occasion play a part in thrombosis. It appears possible that the ingestion of cold fluid into the stomach may at times induce occlusion either by such a reflex or by the direct effect of cold upon the inferior part of the apex of the heart.
Kinematic differences between optical motion capture and biplanar videoradiography during a jump–cut maneuver

Jumping and cutting activities are investigated in many laboratories attempting to better understand the biomechanics associated with non-contact ACL injury. Optical motion capture is widely used; however, it is subject to soft tissue artifact (STA). Biplanar videoradiography offers a unique approach to collecting skeletal motion without STA. The goal of this study was to compare how STA affects the six-degrees-of-freedom motion of the femur and tibia during a jump-cut maneuver associated with non-contact ACL injury. Ten volunteers performed a jump-cut maneuver while their landing leg was imaged using optical motion capture (OMC) and biplanar videoradiography. The within-bone motion differences were compared using anatomical coordinate systems for the femur and tibia, respectively. The knee joint kinematic measurements were compared during two periods: before and after ground contact. Over the entire activity, the within-bone motion differences between the two motion capture techniques were significantly lower for the tibia than the femur for two of the rotational axes (flexion/extension, internal/external) and the origin. The OMC and biplanar videoradiography knee joint kinematics were in best agreement before landing. Kinematic deviations between the two techniques increased significantly after contact. This study provides information on the kinematic discrepancies between OMC and biplanar videoradiography that can be used to optimize methods employing both technologies for studying dynamic in vivo knee kinematics and kinetics during a jump-cut maneuver.
The kinetic properties of the galactic cosmic- ray gas.

Pressure and sound velocity determined for statistically isotropic homogeneous cosmic ray gas
Are physician estimates of asthma severity less accurate in black than in white patients

Background Racial differences in asthma care are not fully explained by socioeconomic status, care access, and insurance status. Appropriate care requires accurate physician estimates of severity. It is unknown if accuracy of physician estimates differs between black and white patients, and how this relates to asthma care disparities.
Copper vanadates as candidate materials for phase change optical memory

Several copper vanadium oxide melts were tested for possible application as the active medium in phase-change optical data storage devices. These materials were melted in the bulk and then quenched. Their phase development was characterized to help determine their applicability to optical data storage. It was found that they satisfy many of the criteria necessary for successful phase-change data storage; further studies of their behavior in thin film geometry would be warranted.
Hamilton-Jacobi equations in the Wasserstein space

We introduce a concept of viscosity solutions for Hamilton-Jacobi equations (HJE) in the Wasserstein space. We prove existence of solutions for the Cauchy problem for certain Hamil- tonians defined on the Wasserstein space over the real line. In order to illustrate the link between HJE in the Wasserstein space and Fluid Mechanics, in the last part of the paper we focus on a special Hamiltonian. The characteristics for these HJE are solutions of physical systems in finite dimensional spaces.
Reconstructing trees from two cards

Let T be the class of unlabeled trees. An unlabeled vertex-deleted subgraph of a tree T is called a card. A collection of cards is called a deck. We say that the tree T has a deck D if each card in D can be obtained by deleting distinct vertices of T. If T is the only unlabeled tree that has the deck D, we say that T is T-reconstructible from D. We want to know how large of a deck D is necessary for T to be T-reconstructible. We define Trn(T) as the minimum number of cards in a deck D such that T is T-reconstructible from D. It is known that Trn(T)≤3, but it is conjectured that Trn(T)≤2 for all trees T. We prove that the conjecture holds for all homeomorphically irreducible trees. © 2009 Wiley Periodicals, Inc. J Graph Theory 63: 243–257, 2010
Las políticas reparativas del movimiento LGBT peruano: narrativas de afectos queer

This article explores the production of reparative politics in the lesbian, gay, bisexual and transgender movement in Peru. Paying close attention to the often ignored site of affections, it argues the necessity of reparative politics for the survival of both LGBT activists and activisms. Furthermore, it argues that reparative politics hold open the possibility for creating alliances previously unimaginable by hegemonic norms, thus radicalizing the LGBT movement's collective commitment to social justice.
Hall instabilities in dusty plasmas

Abstract A unified treatment is presented of Hall instabilities in collisional dusty plasmas, using fluid equations for all charged components. Two modes are generally possible: one with frequencies in the ion-acoustic range (the Farley–Buneman mode), and the other with frequencies in the dust-acoustic range. The real and imaginary parts of the mode frequencies are obtained as functions of the electric field, E 0 , perpendicular to the magnetic field, B, permeating the plasma. Calculations are performed for laboratory-type plasmas, and for ionospheric-type plasmas.
Endorectal MRI and MR spectroscopic imaging of prostate cancer: developing selection criteria for MR-guided focal therapy.

Purpose To investigate criteria that can identify dominant treatable prostate cancer foci with high certainty at endorectal magnetic resonance imaging (MRI) and MR spectroscopic (MRS) imaging, and thus facilitate selection of patients who are radiological candidates for MR-guided focal therapy. Materials and Methods We retrospectively identified 88 patients with biopsy-proven prostate cancer who underwent endorectal MRI and MRS imaging prior to radical prostatectomy with creation of histopathological tumor maps. Two independent readers noted the largest tumor foci at MRI, if visible, and the volume of concordant abnormal tissue at MRS imaging, if present. A logistic random intercept model was used to determine the association between clinical and MR findings and correct identification of treatable (over 0.5 cm3) dominant intraprostatic tumor foci. Results Readers 1 and 2 identified dominant tumor foci in 50 (57%) and 58 (65%) of 88 patients; 42 (84%) and 48 (83%) of these were dominant treatable lesions at histopathology, respectively. Within the statistical model, the volume of concordant spectroscopic abnormality was the only factor that predicted correct identification of a dominant treatable lesion on T2-weighted images (odds ratio = 1.75; 95% confidence interval = 1.08 to 2.82; P value = 0.02). In particular, all visible lesions on T2-weighted imaging associated with at least 0.54 cm3 of concordant spectroscopic abnormality were correctly identified dominant treatable tumor foci. Conclusion Patients with dominant intraprostatic tumor foci seen on T2-weighted MRI and associated with at least 0.54 cm3 of concordant MRS imaging abnormality may be radiological candidates for MR-guided focal therapy. J. Magn. Reson. Imaging 2014;39:519–525. © 2013 Wiley Periodicals, Inc.
Text processing of domain-related information for individuals with high and low domain knowledge

This paper is concerned with how previously acquired knowledge affects the processing of new domain-related information. Text processing was studied in two groups differing in knowledge of a particular domain (baseball). A knowledge structure for the domain was constructed, and the text propositions were classified in terms of the knowledge structure. After hearing the text of a half-inning account of a fictitious baseball game, subjects summarized its contents. A completion test followed. Analyses indicated quantitative and qualitative differences in recall for high- and low-knowledge individuals. The results were explained primarily in terms of the greater ability of high-knowledge individuals to relate the actions of the game to the goal structure and to maintain the most important information in a working memory system. Application of the Kintsch and van Dijk ( Psychological Review , 1978, 85 , 363–394) model supported this interpretation and suggested the operation of a complex working memory mechanism which processes both macrostructure and microstructure information. Such a mechanism, it was concluded, is difficult to explain in terms of a typical limited-capacity, working memory buffer. Instead, the results suggest the possible existence of two interacting working memory systems, each of which is concerned with the one type of information, or the operation of a more traditional working memory system combined with an “active” list of macrostructure information that is maintained in long-term memory.
Perceptions of contribution in multi-cultural groups in non-GDSS and GDSS environments

Abstract This study examined multi-cultural team decision making within a Group Decision Support System (GDSS) environment and within a non-GDSS face-to-face (FtF) environment. One hundred and eleven undergraduate students of varying ethnicities participated in the study. The perceptions of contribution of ethnic minority group members were compared to non-minorities. Results showed that in terms of overall perceptions of contributions involving rating of self, rating of others, and rating by others, the non-GDSS environment achieved higher ratings over the GDSS environment. Although, ethnic minorities' rating of self was significantly lower than the ethnic minorities' rating of others in the non-GDSS environment. In comparison, there were no significant differences between these ratings in the GDSS environment. Furthermore, consistent with previous research on GDSS the average number of ideas generated in the GDSS environment was significantly higher than in the non-GDSS environment.
Functional analysis of the two alternative translation initiation sites of foot-and-mouth disease virus.

The effect of deletion of each of the two authentic polyprotein translation initiation sites of foot-and-mouth disease virus on viral protein synthesis and replication was analyzed. Deletion of either thefirst or the second initiation site led to the expression of only one form of the leader protein, L or L*, respectively, but in vitro processing of the viral polyprotein and cleavage of eIF-4gwere not affected by either deletion. Whereas RNA in which the first translation initiation site had been deleted led to the production of viruses in transfected BHK cells, deletion of the second translation initiation site abolished virus replication.
Clonal and Spontaneous Origins of Fluconazole Resistance in Candida albicans

The genotypes and susceptibilities to fluconazole of 78 strains of the human pathogenic yeast Candida albicans were compared. The strains comprised two sets of samples from Durham, N.C.: one from patients infected with the human immunodeficiency virus (HIV) and the other from healthy volunteers. For each strain, the MIC of fluconazole was determined by the standard National Committee for Clinical Laboratory Standards protocol. Genotypes were determined by PCR fingerprinting with five separate primers. The analysis revealed little evidence for genotypic clustering according to HIV status or body site. However, a small group of fluconazole-resistant strains isolated from patients infected with HIV formed a distinct cluster. In addition, two fluconazole-resistant strains were isolated from individuals who never took fluconazole, one from a patient infected with HIV and the other from a healthy person. The results suggest both clonal and spontaneous origins of fluconazole resistance in C. albicans.
Steerable augmented reality with the beamatron

Steerable displays use a motorized platform to orient a projector to display graphics at any point in the room. Often a camera is included to recognize markers and other objects, as well as user gestures in the display volume. Such systems can be used to superimpose graphics onto the real world, and so are useful in a number of augmented reality and ubiquitous computing scenarios. We contribute the Beamatron, which advances steerable displays by drawing on recent progress in depth camera-based interactions. The Beamatron consists of a computer-controlled pan and tilt platform on which is mounted a projector and Microsoft Kinect sensor. While much previous work with steerable displays deals primarily with projecting corrected graphics onto a discrete set of static planes, we describe computational techniques that enable reasoning in 3D using live depth data. We show two example applications that are enabled by the unique capabilities of the Beamatron: an augmented reality game in which a player can drive a virtual toy car around a room, and a ubiquitous computing demo that uses speech and gesture to move projected graphics throughout the room.
Comparative microbial character of consumed food and drinking water.

Humans ingest large numbers of microbes daily. Food provides distinctly different physical and physiological conditions from drinking water. With high concentrations of carbohydrate, protein, and ionic strength, food is much closer to the human physiological state than drinking water, which is essentially devoid of nutrients and ionic strength. Accordingly, microbes that can multiply in humans and cause disease can grow in food, but do not multiply in drinking water. Virtually all food sources contain many thousand times more bacteria than drinking water. Therefore, based on both observed microbial content and the presence of large numbers of pathogens or their indicators in food, in this country food is more of a health risk to humans than drinking water. Compounding this disparity is the fact that much food is imported with limited control over the means of production. Naturally occurring bacteria (HPC or autochthonous flora) do not have virulence factors, making their numbers irrelevant to health risk except in the case of the most severely immunocompromised--a very defined population group. Consequently, public health regulations should not be directed to eliminating naturally occurring HPC, but should be focused toward controlling pathogens through measures such as sanitary crop systems in the steps from production (e.g., quality of irrigation and fertilization, animal feed lot sanitation) through storage to consumer preparation. Food possesses a far greater risk than drinking water, and government agencies should take this fact into account when writing regulations.
Minoxidil‐Associated Anorexia in an Infant with Refractory Hypertension

Minoxidil is a potent antihypertensive used as an adjunctive agent in refractory hypertension. It exerts an antihypertensive effect through two mechanisms: selective arterial vasodilation by activation of potassium channels in the vascular smooth muscle and stimulation of carotid and aortic baroreceptors, leading to downstream release of renin and norepinephrine. Although frequently cited in reviews of antihypertensive agents, limited data about the use of minoxidil in neonates are available. We describe an infant girl, born at 35 weeks of gestation, who was diagnosed with idiopathic hypertension after extensive diagnostic evaluation. Adequate blood pressure control was not achieved with captopril, amlodipine, and clonidine. Oliguria secondary to captopril and rapid-onset congestive heart failure due to persistent hypertension led to the introduction of intravenous agents labetalol and nitroprusside. Although adequate blood pressure control was achieved, attempts to transition back to oral agents were unsuccessful, prompting the use of minoxidil as an alternative agent. Although good blood pressure control was achieved, the infant's oral intake plummeted from 210 to 63 ml/kg/day. The anorexia quickly resolved after stopping minoxidil, and she was discharged home at 5 months of age receiving propranolol, amlodipine, and doxazosin. Use of the Naranjo adverse drug reaction probability scale indicated a definite relationship (score of 10) between the patient's development of anorexia and minoxidil therapy. To our knowledge, there have been no previous reports of minoxidil-associated anorexia in preterm or term infants. Clinicians should be aware that anorexia is a possible adverse effect of minoxidil in this patient population when initiating the drug in similar patients.
HIV Treatment as Prevention: Issues in Economic Evaluation

Meyer-Rath and Over assert in another article in the July 2012 PLoS Medicine Collection, “Investigating the Impact of Treatment on New HIV Infections”, that economic evaluations of antiretroviral therapy (ART) in currently existing programs and in HIV treatment as prevention (TasP) programs should use cost functions that capture cost dependence on a number of factors, such as scale and scope of delivery, health states, ART regimens, health workers' experience, patients' time on treatment, and the distribution of delivery across public and private sectors. We argue that for particular evaluation purposes (e.g., to establish the social value of TasP) and from particular perspectives (e.g., national health policy makers) less detailed cost functions may be sufficient. We then extend the discussion of economic evaluation of TasP, describing why ART outcomes and costs assessed in currently existing programs are unlikely to be generalizable to TasP programs for several fundamental reasons. First, to achieve frequent, widespread HIV testing and high uptake of ART immediately following an HIV diagnosis, TasP programs will require components that are not present in current ART programs and whose costs are not included in current estimates. Second, the early initiation of ART under TasP will change not only patients' disease courses and treatment experiences—which can affect behaviors that determine clinical treatment success, such as ART adherence and retention—but also quality of life and economic outcomes for HIV-infected individuals. Third, the preventive effects of TasP are likely to alter the composition of the HIV-infected population over time, changing its biological and behavioral characteristics and leading to different costs and outcomes for ART.
Effects of Team-Based Learning on short-term and long-term retention of factual knowledge.

AbstractPurpose: We investigated the effect of Team-Based Learning (TBL) on long-term retention of knowledge in comparison to a traditional curriculum.Methods: As TBL was incorporated into our curriculum in the 2008–2009 academic year, students were compared with those who received the traditional curriculum the year prior. Students in both the groups completed multiple-choice knowledge test at four time points spanning two years. Test performance was compared at each time point to assess changes in knowledge retention as a function of time.Results: Baseline knowledge did not differ significantly between the TBL and control groups [51% versus 46%; t(84) = 0.91, p = 0.37, d = 0.20]. Performance improved after the course for both the groups, but was significantly higher in the TBL group [79% versus 59%; t(84) = 4.96, p = 0.000004, d = 0.95]. However, when assessed prior to the pediatrics clerkship, learning gains from TBL had largely disappeared and the small difference in performance was not significant [5...
The role of the attending physician.

The role of the attending physician is crucial to the education of house staff and students. Nevertheless, certain aspects of this role have not been the subject of serious discussion or scrutiny.1What are the attending physician's expectations as a teacher? Are they compatible with the needs of students and house staff? We will examine these questions as they relate to the attending physician's effectiveness as an educator. Several principles and behaviors that we describe, if implemented, should make the attending physician's experience more gratifying. These ideas developed from our personal observations as attending physicians and from the comments of fellow faculty members in the Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, at scheduled evening conferences related to patient care and teaching. The department is comprised of a full-time hospital-based faculty, the majority of whom spend 20% to 30% of their time in patient
Exchange anisotropy — a review

Abstract Exchange anisotropy refers to the magnetic manifestations of an exchange coupling at the interface between two different magnetically ordered systems. Of particular current technological interest is the unidirectional anisotropy, or `exchange-bias’ field produced in a ferromagnetic film that is coupled to an appropriate antiferromagnetic film. Experimental characterization and theoretical models are discussed for these types of bilayers for a variety of metallic and oxide film couples.
Genetically modified plants for law enforcement applications

Plants are ubiquitous in the environment and have the unique ability to respond to their environment physiologically and through altered gene expression profiles (they cannot walk away). In addition, plant genetic transformation techniques and genomic information in plants are becoming increasingly advanced. We have been performing research to express the jellyfish green fluorescent protein (GFP) in plants. GFP emits green light when excited by blue or UV light. In addition, my group and collaborators have developed methods to detect GFP in plants by contact instruments and at a standoff. There are several law enforcement applications for this technology. One involves using tagging and perhaps modifying drug plants genetically. In one instance, we could tag them for destruction. In another, we could adulterate them directly. Another application is one that falls into the chemical terrorism and bioterrorism countermeasures category. We are developing plants to sense toxins and whole organisms covertly. Plants are well adapted to monitor large geographic areas; biosurveillance. Some examples of research being performed focus on plants with plant pathogen inducible promoters fused to GFP for disease sensing, and algae biosensors for chemicals.
Tracking lithium transport and electrochemical reactions in nanoparticles

Expectations for the next generation of lithium batteries include greater energy and power densities along with a substantial increase in both calendar and cycle life. Developing new materials to meet these goals requires a better understanding of how electrodes function by tracking physical and chemical changes of active components in a working electrode. Here we develop a new, simple in-situ electrochemical cell for the transmission electron microscope and use it to track lithium transport and conversion in FeF2 nanoparticles by nanoscale imaging, diffraction and spectroscopy. In this system, lithium conversion is initiated at the surface, sweeping rapidly across the FeF2 particles, followed by a gradual phase transformation in the bulk, resulting in 1–3 nm iron crystallites mixed with amorphous LiF. The real-time imaging reveals a surprisingly fast conversion process in individual particles (complete in a few minutes), with a morphological evolution resembling spinodal decomposition. This work provides new insights into the inter- and intra-particle lithium transport and kinetics of lithium conversion reactions, and may help to pave the way to develop highenergy conversion electrodes for lithium-ion batteries.
Second nature and spirit: Hegel on the role of habit in the appearance of perceptual consciousness

Hegel's discussion of the concept of “habit” appears at a crucial point in his Encyclopedia system, namely, in the transition from the topic of “nature” to the topic of “spirit” (Geist): it is through habit that the subject both distinguishes itself from its various sensory states as an absolute unity (the I) and, at the same time, preserves those sensory states as the content of sensory consciousness. By calling habit a “second nature,” Hegel highlights the fact that incipient spirit retains a “moment” of the natural that marks a limitation compared to “pure thought” but that also makes perceptual consciousness possible. This makes Hegel's account analogous in important respects to John McDowell's “naturalism of second nature.” But Hegel's account of habit can be seen as a version of a Kantian synthesis of the productive imagination—and hence presupposes a given material that can become one's own by means of habit. This does not mean that Hegel falls into the Myth of the Given, but it does suggest that an appropriate account of second nature might be committed to something McDowell wants to deny: that nonconceptual states of consciousness play a role (even if not a justificatory role) in perception.
Strategies towards a longer acting factor VIII

The reduced mortality, improved joint outcomes and enhanced quality of life, which have been witnessed in the developed world for patients with haemophilia, have been an outstanding achievement. Advancements in biotechnology contributed significantly through the development of improved pathogen screening, viral inactivation techniques and the development of recombinant clotting factors. These were partnered with enhanced delivery of care through comprehensive haemophilia centres, adoption of home therapy and most recently effective prophylaxis. This came at great costs to governments, medical insurers and patients' families. In addition, barriers persist limiting the adoption and adherence of effective prophylactic therapy. Biotechnology has been successful at overcoming similar barriers in other disease states. Long-acting biological therapeutics are an incremental advance towards overcoming some of these barriers. Strategies that have been successful for other therapeutic proteins are now being applied to factor VIII (FVIII) and include modifications such as the addition of polyethylene glycol (PEG) polymers and polysialic acids and alternative formulation with PEG-modified liposomes. In addition, insight into FVIII structure and function has allowed targeted modifications of the protein to increase the duration of its cofactor activity and reduce its clearance in vivo. The potential advantages and disadvantages of these approaches will be discussed.
Approximate distributed Kalman filtering in sensor networks with quantifiable performance

We analyze the performance of an approximate distributed Kalman filter proposed in recent work on distributed coordination. This approach to distributed estimation is novel in that it admits a systematic analysis of its performance as various network quantities such as connection density, topology, and bandwidth are varied. Our main contribution is a frequency-domain characterization of the distributed estimator's steady-state performance; this is quantified in terms of a special matrix associated with the connection topology called the graph Laplacian, and also the rate of message exchange between immediate neighbors in the communication network.
US physicians' treatment of smoking in outpatients with psychiatric diagnoses

A 1996 American Psychiatric Association (APA) guideline recommends the routine treatment of smoking for patients with psychiatric diagnoses. This study evaluates how often US physicians identified and treated smoking among these patients in the ambulatory setting just prior to publication of this guideline, by analysis of 1991-1996 data from the National Ambulatory Medical Care Survey, an annual survey of a random sample of US office-based physicians. Physicians were more likely to identify the smoking status of patients with psychiatric diagnoses compared to patients without these diagnoses (76% vs. 64% of visits, p<0.0001). Smokers with psychiatric diagnoses were more likely to be counseled about smoking than were smokers with non-psychiatric diagnoses (23% vs. 18% of visits, p<0.0001), although the absolute difference was small. Primary care physicians counseled smokers with psychiatric diagnoses more often than did psychiatrists, but both groups of physicians counseled at less than half of smokers' visits. All physicians were more likely to counsel smokers with the diagnosis of anxiety but less likely to counsel smokers with the diagnosis of an affective disorder compared to smokers without these diagnoses. Physicians usually identified the smoking status of patients with psychiatric diagnoses but infrequently acted on this information by counseling smokers to quit. Physicians are missing an important opportunity to prevent tobacco-related morbidity and mortality among this group of patients.
Neuroprotective and neurorestorative signal transduction mechanisms in brain aging: Modification by genes, diet and behavior

Cells in the brain deploy multiple mechanisms to maintain the integrity of nerve cell circuits, and to facilitate responses to environmental demands and promote recovery of function after injury. The mechanisms include production of neurotrophic factors and cytokines, expression of various cell survival-promoting proteins (e.g. protein chaperones, antioxidant enzymes, Bcl-2 and inhibitor of apoptosis proteins), protection of the genome by telomerase and DNA repair proteins, and mobilization of neural stem cells to replace damaged neurons and glia. The aging process challenges such neuroprotective and neurorestorative mechanisms, often with devastating consequences as in Alzheimer's disease (AD), Parkinson's and Huntington's diseases and stroke. Genetic and environmental factors superimposed upon the aging process can determine whether brain aging is successful or unsuccessful. Mutations in genes that cause inherited forms of AD (amyloid precursor protein (APP) and presenilins), Parkinson's disease (alpha-synuclein and parkin) and trinucleotide repeat disorders (e.g. huntingtin and the androgen receptor) overwhelm endogenous neuroprotective mechanisms. On the other hand, neuroprotective mechanisms can be bolstered by dietary (caloric restriction, and folate and antioxidant supplementation) and behavioral (cognitive and physical activities) modifications. At the cellular and molecular levels, successful brain aging can be facilitated by activating a hormesis response to which neurons respond by upregulating the expression of neurotrophic factors and stress proteins. Neural stem cells that reside in the adult brain are also responsive to environmental demands, and appear capable of replacing lost or dysfunctional neurons and glial cells, perhaps even in the aging brain. The recent application of modem methods of molecular and cellular biology to the problem of brain aging is revealing a remarkable capacity within brain cells for adaptation to aging and resistance to disease.