cssi/SciSciGPT-SciSciNet huggingface dataset:
Predictors and outcomes of restenosis following tibial artery endovascular interventions for critical limb ischemia

Objective Restenosis following tibial artery endovascular interventions (TAEIs) is thought to be benign but is not well characterized. This study examines the consequences and predictors of recurrent stenosis of TAEIs for critical limb ischemia. Methods All TAEIs for critical limb ischemia performed between 2004 and 2010 were retrospectively reviewed. Restenosis was detected by noninvasive imaging and angiography when indicated. Restenoses were identified and the limb outcomes recorded. Tibial reinterventions were performed only for persistent, worsening, or recurrent tissue loss or rest pain with evidence of recurrence on duplex ultrasound or hemodynamic imaging. The χ 2 test and logistic regression were applied as indicated. One-year patency rates were calculated using the Kaplan-Meier method. Results A total of 235 limbs in 210 patients were treated for critical limb ischemia (70% tissue loss, 30% rest pain). Tissue loss included gangrene (49%) and ulcers (51%), and involved the forefoot (80%), the heel (14%), or both (6%). Seventy-eight percent of limbs had Trans-Atlantic InterSociety Consensus C/D lesions, with mean preoperative runoff score of 12. Interventions were isolated tibial (45%) or multilevel (55%) (including tibial). Mean postoperative runoff score improved to 6.6, but restenosis occurred in 96 limbs (41%) at a mean of 4 months. The 1-year primary patency was 59% with a mean follow-up of 9 months. Restenosis presented with a persistent wound (32%), worsened wound (42%), rest pain (16%), or no symptoms (10%). A repeat TAEI was performed in 42 (44%), major amputation in 26 (27%), open bypass in 20 (21%), and observation in eight (8%). The overall amputation rate was 13%, but limb loss was significantly higher in patients with restenosis (n = 26 [27%]) than in patients with no restenosis (n = 5 [4%]; P P = .0003) but had comparable wound distribution ( P = NS). There was a trend toward a higher restenosis rate in patients with renal insufficiency (odds ratio, 5.57; P = .08), but this was unaffected by diabetes, statin therapy, or smoking ( P = NS). The rate of repeat intervention after the first reintervention was 36%, with an 87% overall limb salvage rate. Conclusions TAEIs can be used successfully to treat patients with critical limb ischemia with acceptable limb salvage rates. Special attention should be given to patients with extensive tissue loss or gangrene because they are at risk for early restenosis and subsequent limb loss. Strict wound and hemodynamic surveillance, wound care, and timely reinterventions are crucial to achieve successful outcomes in this patient population. Amputation or alternative revascularization options, when feasible, should be considered in patients with restenosis and tissue loss given the high rate of limb loss with tibial reinterventions.
A comprehensive analysis of transient stability enhancement methods of electric power system

Dynamic braking resistor (BR), bridge type fault current limiter (BFCL), thyristor controlled series capacitor (TCSC), static var compensator (SVC) and unified power flow controller (UPFC) are well-known transient stability enhancement methods for electric power systems. Although individual technologies are well documented, so far no comparison among these methods is reported. This paper fills in the gap, and presents a detailed analysis and comparison among these five methods. The comparison is done in terms of transient stability enhancement, control structure and cost. The total kinetic energy (TKE) of the generators in the system is used to determine the transient stability enhancement index. The Critical Clearing Time (CCT) is also presented as a stability limit. Simulations are performed considering both permanent and temporary faults at different points of the IEEE 30 bus power system. Simulation analyses reveal that the series connected devices perform better than the parallel connected devices. The BR has simplest control structure and its application cost is also less than the other considered auxiliary devices. Thus, this study provides a guideline to select an appropriate transient stability enhancement technique for electric power systems.
Using electric vehicles to mitigate imbalance requirements associated with an increased penetration of wind generation

The integration of variable renewable generation sources continues to be a significant area of focus for power system planning. Renewable portfolio standards and initiatives to reduce the dependency on foreign energy sources drive much of the deployment. Unfortunately, renewable energy generation sources like wind and solar tend to be highly variable in nature. To counter the energy imbalance caused by this variability, wind generation often requires additional balancing resources to compensate for the variability in the electricity production. With the expected electrification of transportation, electric vehicles may offer a new load resource for meeting all, or part, of the imbalance created by the renewable generation. This paper investigates a regulation-services-based battery charging method on a population of plug-in hybrid electric vehicles to meet the power imbalance requirements associated with the introduction of 11 GW of additional wind generation into the Northwest Power Pool. It quantifies the number of vehicles required to meet the imbalance requirements under various charging assumptions.
Computer Support for a Neighborhood Health Clinic: Design and Implementation

Neighborhood comprehensive health care centers have become an important model of health care delivery in large metropolitan areas. Constraints in manpower resources dictate the need to explore ways and means by which computer technology can support the activity of health professionals in these centers. The Department of Community Medicine at Baylor has designed and is in the process of implementing a computer support system for a neighborhood health clinic, Casa de Amigos, of the Harris County Hospital District.
A general model for kinetics of heavy metal adsorption and desorption on soils.

In this study, we propose a general kinetics model for heavy metal adsorption and desorption reactions in soils when soil organic matter (SOM) is the dominant adsorbent. The kinetics model, integrated with the equilibrium speciation model WHAM VI, specifically considers metal reactions with SOM and dissolved organic matter (DOM) and accounts for the variations of solution chemistry. Metal reactions with SOM are associated with two groups of sites, one from the monodentate sites and another one from the bidentate and tridentate sites. There are three model parameters, desorption rate coefficients of the two groups of SOM sites for each metal and reactive organic carbon (ROC) for each soil. The applicability of the kinetics model was mainly examined with three elements, Cu, Pb, and Zn, which demonstrate different binding ability with organic matter. The kinetic data were collected with a stirred-flow reactor covering a wide range of experimental conditions, including varying SOM, DOM, Ca, and metal concentr...
Women with knee osteoarthritis have more pain and poorer function than men, but similar physical activity prior to total knee replacement

Osteoarthritis of the knee is a major clinical problem affecting a greater proportion of women than men. Women generally report higher pain intensity at rest and greater perceived functional deficits than men. Women also perform worse than men on function measures such as the 6-minute walk and timed up and go tests. Differences in pain sensitivity, pain during function, psychosocial variables, and physical activity levels are unclear. Further the ability of various biopsychosocial variables to explain physical activity, function and pain is unknown. This study examined differences in pain, pain sensitivity, function, psychosocial variables, and physical activity between women and men with knee osteoarthritis (N = 208) immediately prior to total knee arthroplasty. We assessed: (1) pain using self-report measures and a numerical rating scale at rest and during functional tasks, (2) pain sensitivity using quantitative sensory measures, (3) function with self-report measures and specific function tasks (timed walk, maximal active flexion and extension), (4) psychosocial measures (depression, anxiety, catastrophizing, and social support), and (5) physical activity using accelerometry. The ability of these mixed variables to explain physical activity, function and pain was assessed using regression analysis. Our findings showed significant differences on pain intensity, pain sensitivity, and function tasks, but not on psychosocial measures or physical activity. Women had significantly worse pain and more impaired function than men. Their levels of depression, anxiety, pain catastrophizing, social support, and physical activity, however, did not differ significantly. Factors explaining differences in (1) pain during movement (during gait speed test) were pain at rest, knee extension, state anxiety, and pressure pain threshold; (2) function (gait speed test) were sex, age, knee extension, knee flexion opioid medications, pain duration, pain catastrophizing, body mass index (BMI), and heat pain threshold; and (3) physical activity (average metabolic equivalent tasks (METS)/day) were BMI, age, Short-Form 36 (SF-36) Physical Function, Kellgren-Lawrence osteoarthritis grade, depression, and Knee Injury and Osteoarthritis Outcome Score (KOOS) pain subscale. Women continue to be as physically active as men prior to total knee replacement even though they have significantly more pain, greater pain sensitivity, poorer perceived function, and more impairment on specific functional tasks.
Morbid Obesity: Obscuring the Diagnosis of Aortic Stenosis in a Patient with Cardiogenic Wheezing

We report the case of a morbidly obese 65-year-old female who presented with repeated hypotensive episodes following dialysis. She was misdiagnosed as suffering from asthma, and eventually was found to have severe aortic stenosis. Obesity has become a common and formidable obstacle to gathering important diagnostic information in patients. Modern diagnostic lab tests and imaging modalities such as transthoracic echocardiography (TTE) can provide spurious data in the morbidly obese population, which can ultimately lead to misdiagnosis. In this clinical vignette, we discuss the relationship between the basic pathophysiologic mechanisms underlying aortic stenosis and patient clinical presentation. We also review the relevant literature and discuss the impact of obesity on the diagnosis of this condition.
Hotel loyalty programs: how valuable is valuable enough?

Purpose – This study attempts to examine customers' perceived value of hotel loyalty programs, to identify the relationship between perceived program value and active loyalty, and to examine the effect of perceived program value in determining customers' active loyalty. Design/methodology/approach – An extensive sample of 15,000 respondents was randomly selected from a pool of US domestic tourists who previously requested tourism information from the Convention and Visitor's Bureau (CVB) websites across the country. The data for this study were collected using online survey questionnaires. The researchers sent out e-mails, embedding a link to a brief questionnaire and consent form to potential respondents. Findings – This study substantiates the impact of perceived program value, particularly the psychological value, on active loyalty. In addition, the study identifies significant differences in perceived financial value and externality value of the loyalty programs. Originality/value – This study breaks ...
A Sensitive Spinner Magnetometer Using a Coil Detector

Summary A rock spinner magnetometer using a coil as a detector has been designed and constructed, incorporating several fundamental improvements. A detailed study of pick-up coil design has led to an instrument which can take fast measurements on weakly-magnetized rocks. The reference signals for demodulation of the signal induced in the pick-up coil are obtained from a reference oscillator rather than from the shaft by optical or magnetic means. This allows the instrument to be calibrated directly for magnetic moment and simplifies angular calibration. It also permits the electronics to be serviced and the system to be calibrated without the motor running. A phase-locked loop has been used to lock a dc motor onto one of the reference signals provided by the reference oscillator. A dc type motor was chosen in preference to an ac type in order to reduce interference from stray fields. A careful study has been made of offset drifts and several features have been introduced to minimize these undesirable effects. Amongst these are bearings designed to absorb vibrations, and a belt drive between the motor and shaft. The performance of the magnetometer compares favourably with that of two commercially produced magnetometers, the ten degree confidence limit of the instrument being 2.2 x lo-'' A m2 (1 -8 x lo-* gauss) for a six-spin operating sequence.
Wobble and nutation of the Earth

ummary Elastic-gravitational normal mode theory is used to study theoretically the free wobble and free nutation of a suite of geophysically plausible rotating slightly elliptical earth models. We principally find that observations of wobble eigenfrequencies are not likely to constrain strongly the structure of the Earth's fluid core, that the results of our calculations, together with Dahlen's estimate of the ocean correction, yield the observed Chandler wobble period within its observational uncertainty and that estimates of wobble excitation by earthquakes based on quasi-static calculations of the Earth's response are correctly computed. Also we summarize several analytical treatments of both wobble and internal core modes of rotating Earth models and use that information to assess analytically and numerically the approximate theory exploited here. We show that the approximation we use is valid for the Earth's major free wobbles but not for studying internal modes in the fluid core. summary By exploiting the existence of analytic solutions to certain members of the general class of problems of interest to us here, we have been able to explore the range over which the numerical theory used here is valid. In particular, the theory is adequate to describe the major mantle wobbles of the Earth – namely the Chandler wobble and the nearly diurnal free wobble. It is also adequate to describe the response of the Earth to tidal potentials, at least to the extent that ‘internal’ modes in the fluid core do not participate in the Earth's response. The theory has been demonstrated to be sorely inadequate for two other classes of normal modes: internal core modes and the Chandler Wobble of the solid inner-core. In both cases the failure of the theory is associated with the inability of our finite representation to adequately represent motion in the fluid. These failures are not evident from inspection of the numerical results alone; their detection was only made possible by the availability of analytic solutions. A corollary of these results is that recent published calculations of internal core modes for rotating geophysically plausible earth models by Crossley (1975) and Shen & Mansinha (1976) are almost surely invalid. The theoretical basis for those studies, like the one exploited here, is wholly inadequate to describe internal core modes.
Competitive Incentives and the Education Market: How Charter Schools Define Themselves in Metropolitan Detroit

Policymakers often advance charter schools as an education reform model that can offer more diverse educational alternatives for families. Yet, as these schools compete for students, questions arise about how they respond to the competitive incentives in differentiating themselves through marketing distinct options for learners. The way these schools promote themselves to their anticipated clientele—as opposed to how they are defined by their competitors—speaks to how schools engage and thus arrange themselves in the local education market. In that regard, school mission statements can offer critical information on the intended organizational purposes that differentiate each organization. Yet there is little empirical research on what these statements contain, and thus how schools respond to incentives in engaging local markets. This study looks at the content of mission statements—which are largely consistent with the schools’ charters themselves—developed by each charter school in one of the most compet...
The luteal phase defect: the relative frequency of and encouraging response to treatment with vaginal progesterone.

Three hundred and ninety-six patients were evaluated for primary and secondary infertility between December 1976 and May 1979 at a large referral center. Timed late luteal endometrial biopsies were routinely obtained as part of the work-up and were repeated for confirmation if subsequent menses did not occur within 2 days of the expected date. If both biopsies were abnormal, a diagnosis of luteal phase defect (LPD) was made and patients were treated with vaginal progesterone suppositories for a minimum of 6 months. LPD was discovered in 32 of 396 patients (8.1%); among those patients whose infertility was not complicated by other abnormalities, 9 of 13 conceived (70%) and 7 of 13 carried to term (54%). These data suggest an incidence higher than generally recognized and a very encouraging response to replacement therapy.
Undocumented migration in response to climate change

In the face of climate change-induced economic uncertainties, households may employ migration as an adaptation strategy to diversify their livelihood portfolio through remittances. However, it is unclear whether such climate-related migration will be documented or undocumented. In this study we combined detailed migration histories with daily temperature and precipitation information from 214 weather stations to investigate whether climate change more strongly impacted undocumented or documented migrations from 68 rural Mexican municipalities to the U.S. from 1986−1999. We employed two measures of climate change, the warm spell duration index (WSDI) and precipitation during extremely wet days (R99PTOT).Results from multi-level event-history models demonstrated that climate-related international migration from rural Mexico was predominantly undocumented. We conclude that programs to facilitate climate change adaptations in rural Mexico may be more effective in reducing undocumented border crossings than increasing border fortification.
Perisigmoid Abscess Leading to a Diagnosis of Ehlers-Danlos Syndrome Type IV

The Ehlers-Danlos syndromes (EDS) are a group of connective tissue disorders characterized by triad of joint hypermobility, skin extensibility, and tissue fragility. Ehlers-Danlos syndrome type IV places patients at risk for life-threatening, spontaneous, vascular or visceral rupture due to reduced or abnormal secretion of type III collagen. We present an adolescent male who was found to have a perisigmoid abscess with a fistula connecting to adjacent sigmoid colon secondary to undiagnosed EDS type IV. Conservative management with antibiotics and bowel rest was pursued to allow for elective resection for his acute complicated diverticulitis at a safer time.
Rapid Simultaneous Capillary Electrophoretic Determination of (R)- and (S)-Secobarbital from Serum and Prediction of Hydroxypropyl-γ-cyclodextrin—Secobarbital Stereoselective interaction Using Molecular Mechanics Simulation

Secobarbital is a hypnotic sedative that is used in the treatment of preoperative anxiety and to manage elevated intracranial pressures and cerebral ischemia due to neurosurgical procedures. Stereoselective resolution is first predicted using hydroxypropyl-gamma-cyclodextrin (HPGCD)-(R)- and (S)-secobarbital transient complex energy calculations using SYBYL 6.01 molecular modeling software. Separation is accomplished as predicted using 40 mM HPGCD in 50 mM phosphate buffer (pH 9.0), resulting in a rapid, sensitive method for the determination of (S)- and (R)-enantiomers of secobarbital from serum using solid-phase extraction, capillary electrophoresis (CE), and ultraviolet detection. The method involves extraction of both enantiomers and the internal standard, aprobarbital, from serum using C18 Bond-Elut solid-phase cartridges. The CE system consists of fused-silica capillary (52 cm x 75-microns i.d.) maintained at a run voltage of 15 kV with detection performed at a wavelength of 254 nm. The detection and quantitation limits from serum for (S)- and (R)-secobarbital are 1 microgram/mL. Linear calibration curves from 1 to 60 micrograms of both (S)- and (R)-secobarbital show a coefficient of determination of more than 0.999. The precision and accuracy of the method, calculated as relative standard deviation (%) and percent error, are 0.35-4.48% and 0.71-8.67%, respectively, for (R)-secobarbital and 0.39-4.08% and 2.16-3.70%, respectively, for (S)-secobarbital.
Risk factors and management of oligometastatic non-small cell lung cancer

Non-small cell lung cancer (NSCLC) is an aggressive malignancy with close to half of all patients presenting with metastatic disease. A proportion of these patients with limited metastatic disease, termed oligometastatic disease, have been shown to benefit from a definitive treatment approach. Synchronous and metachronous presentation of oligometastatic disease have prognostic significance, with current belief that metachronous disease is more favorable. Surgical excision of intracranial and extracranial oligometastatic disease has been shown to improve survival, especially in patients with lymph node-negative disease, adenocarcinoma histology and smaller thoracic tumors. Definitive radiation to sites of oligometastatic disease and initial thoracic disease has also been shown to have a similar impact on survival for both intracranial and extracranial disease. Recent studies have reported on the use of targeted agents combined with ablative doses of radiation in the oligometastatic setting with promising outcomes. In this review, we present the historical and current literature describing surgical and radiation treatment options for patients with oligometastatic NSCLC.
Altered epithelial lining fluid parameters in old normal individuals

Pneumonia is a leading cause of morbidity and death in older patients, and immunosenescence is believed to contribute to their susceptibility. In order to investigate whether age-related changes occur on the epithelial surfaces of the lung, bronchoscopy and bronchoalveolar lavage (BAL) were performed without complication in 19 young (27.7 +/- 4.2 yrs), 6 middle-aged (49.8 +/- 3.5 yrs), and 8 old (74.1 +/- 4.3 yrs) normal, nonsmoking subjects. BAL was performed by instilling and retrieving five 20 ml aliquots of normal saline into three sites. The returns from the first aliquots (the bronchial sample) were analyzed separately from the returns from the subsequent aliquots (the distal sample). Lavage fluid cellularity was characterized and IgA, IgG, and albumin were measured by ELISA. Lavage fluid returns were lower in the elderly group and correlated with spirometric parameters. Significantly elevated numbers of neutrophils were recovered by the bronchial sample fluid from the old group. In contrast, no consistent difference in macrophage recovery by either the bronchial or distal sample was noted. In both the bronchial and distal samples, IgG, but not IgA or albumin, was elevated in the group of old subjects. Alterations occurring in BAL fluid with aging may reflect changes in local host defenses.
Nanocrystal grain growth and device architectures for high-efficiency CdTe ink-based photovoltaics.

We study the use of cadmium telluride (CdTe) nanocrystal colloids as a solution-processable “ink” for large-grain CdTe absorber layers in solar cells. The resulting grain structure and solar cell performance depend on the initial nanocrystal size, shape, and crystal structure. We find that inks of predominantly wurtzite tetrapod-shaped nanocrystals with arms ∼5.6 nm in diameter exhibit better device performance compared to inks composed of smaller tetrapods, irregular faceted nanocrystals, or spherical zincblende nanocrystals despite the fact that the final sintered film has a zincblende crystal structure. Five different working device architectures were investigated. The indium tin oxide (ITO)/CdTe/zinc oxide structure leads to our best performing device architecture (with efficiency >11%) compared to others including two structures with a cadmium sulfide (CdS) n-type layer typically used in high efficiency sublimation-grown CdTe solar cells. Moreover, devices without CdS have improved response at short ...
216 LIPOPOLYSACCHARIDE INHIBITS Fibroblast Growth Factor-10 EXPRESSION IN FETAL MOUSE LUNG MESENCHYME.

Purpose of Study Prenatal exposure to inflammation increases the risk of bronchopulmonary dysplasia (BPD) in preterm infants. In a fetal mouse lung model, lipopolysaccharide (LPS) decreased distal airway branching, which may contribute to BPD pathology. In a candidate gene approach, we tested if LPS decreased expression of FGF-10, a master regulator of branching morphogenesis. We hypothesized that decreased FGF-10 expression could lead to defective distal airway branching. Methods E16 fetal mouse lung explants were cultured for up to 72 hours. Distal airway branching was measured by counting the number of distal airways per explant area. Fetal mouse lung mesenchymal cells were also isolated and cultured. Gene expression was measured by real time PCR. Results We measured decreased FGF-10 gene expression in LPS-treated fetal lung explants (55% of control, p Conclusion LPS decreased FGF-10 expression and altered gene expression along the FGF-10 signaling pathway. Decreased FGF-10 expression may identify a mechanism by which innate immunity can contribute to BPD.
Factors Associated with Unmet Needs among African-American Dementia Care Providers.

Racial and ethnic minorities currently comprise 20% of the U.S. population; in 2050, this figure is expected to rise to 42%. As a result, Alzheimer’s disease (AD), the 5th leading cause of death for people aged 65 and older, is likely to increase in these groups. Most dementia caregiving for these populations comes from family and friends, especially among families with lower socioeconomic status. A convenience sample of 30 African-American dementia caregivers was interviewed to determine unmet needs. Participants expressed a limited desire for formal services, such as support groups, legal advice, case management, and homemaker services. Instead, commonly expressed needs were daytime respite care and especially a desire for family and social support. Many caregivers expressed a need for other family members to share responsibility in the process; therefore, methods for caregiver support that address multiple family members in care provision may be beneficial for this group.
Assessing Resident Cataract Surgery Outcomes Using Medicare Physician Quality Reporting System Measures

Objectives To assess resident cataract surgery outcomes at an academic teaching institution using 2 Physician Quality Reporting System (PQRS) cataract measures, which are intended to serve as a proxy for quality of surgical care. Design A retrospective review comparing cataract surgery outcomes of resident and attending surgeries using 2 PQRS measures: (1) 20/40 or better best-corrected visual acuity following cataract surgery and (2) complications within 30 days following cataract surgery requiring additional surgical procedures. Setting An academic ophthalmology center. Participants A total of 2487 surgeries performed at the Massachusetts Eye and Ear Infirmary from January 1, 2011 to December 31, 2012 were included in this study. Results Of all 2487 cataract surgeries, 98.95% achieved a vision of at least 20/40 at or before 90 days, and only 0.64% required a return to the operating room for postoperative complications. Of resident surgeries, 98.9% (1370 of 1385) achieved 20/40 vision at or before 90 days follow-up. Of attending surgeries, 99.0% (1091 of 1102) achieved 20/40 vision at or before 90 days (p = 1.00). There were no statistically significant differences between resident and attending cases regarding postoperative complications needing a return to the operating room (i.e., 0.65%, or 9 of 1385 resident cases vs 0.64%, or 7 of 1102 attending cases; p = 1.00). Conclusions Using PQRS Medicare cataract surgery criteria, this study establishes new benchmarks for cataract surgery outcomes at a teaching institution and supplemental measure for assessing resident surgical performance. Excellent cataract outcomes were achieved at an academic teaching institution, with results exceeding Medicare thresholds of 50%. There appears to be no significant difference in supervised trainee and attending cataract surgeon outcomes using 2 PQRS measures currently used by Medicare to determine physician reimbursement and quality of care.
Analysis of MDM2 Amplification in 43 Endometrial Stromal Tumors: A Potential Diagnostic Pitfall

MDM2 amplification is known to occur in a variety of neoplasms and its detection by fluorescence in situ hybridization is helpful in distinguishing well-differentiated and dedifferentated liposarcoma from classic lipoma. We recently evaluated a mesenteric mass initially diagnosed as dedifferentiated liposarcoma, largely due to the neoplasm's myxoid morphology and MDM2 expression by immunohistochemistry, from a 46-yr-old woman with a history of uterine low-grade endometrial stromal sarcoma (LG-ESS) with a JAZF1 rearrangement. Our workup of the mesenteric mass revealed a JAZF1 rearrangement and a revised diagnosis of metastatic LG-ESS with myxoid change was rendered. Retrospective testing of the mesenteric mass was negative for MDM2 amplification, an uncommon, but known diagnostic pitfall in MDM2 expression by immunohistochemistry. As MDM2 amplification is not specific for the diagnosis of liposarcoma, we investigated its occurrence in 43 cases of endometrial stromal tumors: 14 uterine LG-ESS, 11 metastatic or recurrent uterine LG-ESS, 8 undifferentiated uterine sarcomas, 5 endometrial stromal nodules, and 4 high-grade ESS with YHWAE rearrangement. In addition, 40 of the 43 cases had previously undergone fluorescence in situ hybridization analysis of JAZF1, PHF1, and YHWAE. Two of the 43 cases (5%) had MDM2 amplification: one was a uterine LG-ESS (JAZF1 rearrangement) and the other was a undifferentiated uterine sarcoma (polysomy intact JAZF1, PHF1, and YHWAE), both metastatic to the lung. Both cases positive for MDM2 amplification showed MDM2 expression by immunohistochemistry. At last follow-up, both patients had died of disease (19 and 60 mo). Our study is the first to demonstrate MDM2 amplification in endometrial stromal tumor. Awareness of MDM2 amplification in endometrial stromal tumor is critical; particularly in locations more common to liposarcoma, to avoid diagnostic errors.
Marrow-Derived Mesenchymal Stromal Cells in the Treatment of Stroke

Mesenchymal stromal cells (MSC) are a multipotent stem cell that can be derived from several different tissues, including bone marrow. In preclinical studies, MSC have been found to improve outcome after stroke with a time window measured in days–weeks, in a manner robust across species, delivery route, allogenicity, and dose. These effects are achieved via multiple mechanisms in parallel, including paracrine elaboration of neurotrophins and remote immunomodulation. Human studies support the safety of MSC administration after stroke. Future trials can be designed with attention to key issues reviewed herein, including choices during MSC manufacture, and principles of brain repair.
Epidermal growth factor, transforming growth factor-alpha, and epidermal growth factor receptor localization in the baboon (Papio anubis) uterus during the menstrual cycle and early pregnancy.

OBJECTIVE Marked alterations occur in the synthesis of endometrium-specific proteins during the first third of pregnancy in the baboon. Because epidermal growth factor (EGF) expression has been associated with proliferation in the human and mouse endometrium, we hypothesized that EGF, transforming growth factor-alpha (TGF alpha), and EGF receptor (EGF-R) expression in baboon endometrium may be modulated by the early invasive trophoblast and play a role in decidualization of the endometrial stroma. METHODS Endometrial tissue was obtained from cycling baboons (n = 4-5 per time point), ovariectomized steroid-treated baboons (n = 4 per group), or from pregnant baboons on days 18-60 of pregnancy (n = 2-4 per group). The tissue was fixed in Bouin's solution and embedded in paraffin for immunocytochemistry using polyclonal antibodies against EGF and EGF-R and a monoclonal antibody to TGF alpha. RESULTS Endometrial staining was located almost entirely in the glandular epithelium for TGF alpha and EGF-R in the follicular phase animals, whereas EGF staining was strongest in the periglandular stroma. In the luteal phase, specific staining for EGF also was detected in the glands as well as the periglandular stroma. There appeared to be little difference in endometrial staining between the late follicular and mid-luteal phase for TGF alpha and EGF-R. A similar pattern was observed in the steroid-treated animals. In the endometrium from pregnant animals, EGF, TGF alpha, and EGF-R intensely stained the glandular epithelium on days 18, 25, and 32. Both EGF and EGF-R showed light stromal staining on days 18 and 25. Light stromal TGF alpha staining was present on day 25 and became moderately intense by day 32. By day 60, the most intense staining for EGF and EGF-R was stromal. Staining of TGF alpha continued to be strong in the remaining epithelium through day 60. In placenta, EGF and EGF-R intensely stained the syncytiotrophoblast, but not the cytotrophoblast, whereas TGF alpha stained only the villous cytotrophoblast and intermediate cytotrophoblast within maternal blood vessels. There appeared to be no change in this staining pattern or intensity in the placenta throughout early pregnancy. CONCLUSIONS This study demonstrates the presence of EGF, TGF alpha, and EGF-R in the endometrium during the cycle and early pregnancy. The detection of EGF, TGF alpha, and EGF-R in the stromal cells during pregnancy correlated with the onset of decidualization. We propose that EGF, TGF alpha, and EGF-R may play a role in glandular development during the cycle and in decidualization and implantation during early pregnancy.
SIGCSE 2017 Chairs Roundtable

What are the challenges that Department Chairs face? How would you design the ideal Department Chair? What are the features of a great Department Chair? What are the issues in having a poor Department Chair? The summary at the end of this article demonstrates the challenges that face anyone that takes on this critical role.
FANCD2 Purification and Identification of a Functionally Important Phosphorylation Event at Serine 331.

Abstract Fanconi anemia (FA) is an inherited hematological disorder characterized by birth defects, bone marrow failure, and cancer susceptibility. FA cells are characterized by spontaneous chromosomal instability and hypersensitivity to cross linking reagents such as mitomycin C (MMC). Cloned FA genes cooperate in a signaling pathway activated by DNA damage during replication, and monoubiquitination of FANCD2 is the critical downstream event. The check point kinase ATR is required for the efficient monoubiquitination of FANCD2. Inducible ATR-dependent phosphorylation of threonine 691 and serine 717 are reported to enhance the monoubiquitination of FANCD2 and resistance to MMC. In the present study, we have devised means to purify the FANCD2 protein into multiple subcomplexes. In doing so, we have identified at least 3 distinct subcomplexes: a pure multimeric precursor form comprised of FANCD2 polypeptides, a 1 MD form that is chromatin bound, and a 2 MD form that is in the nucleosol. Electron microscopic analysis of the precursor form reveals homogenous appearing complexes. Mass spectroscopic analysis of the 1MD FANCD2 complex has identified the FANCI protein, among others, which confirms recent reports of FANCD2-FANCI interaction. Further mass spectroscopic analysis of FANCD2 has identified a novel phosphorylation site on FANCD2, serine 331, which is further confirmed by immunoblot using phosphospecific antibody against phospho-serine 331. This phosphorylation site is conserved in other species, including mouse, rat, xenopus, and tetraodon nigroviridis. Single amino acid mutation by alanine at this site results in a complete loss of monoubquitination of FANCD2 and resistance to MMC, suggesting that the phosphorylation of S331 is a functionally significant event. Moreover, this site fits the consensus sequence for a CHK1 substrate, which in turn is a substrate of target for CHK1, a substrate of ATR, which is also required for monoubiquitination of FANCD2. These findings further support the correlation between phosphorylation and monoubiquitination of FANCD2 in the DNA damage response with the intervention of CHK1 as a mediator of ATR and suggest dynamic regulation of FANCD2 subcomplexes within the FA pathway.
Nipple-Sparing Mastectomy in the Community Setting

The majority of the surgical literature describing institutional experience with nipple-sparing mastectomy (NSM) has come from academic institutions. Little has been published by community-based surgeons who are responsible for more than 80 % of breast cancer surgical treatment in the United States. This chapter describes the experience of a single breast surgeon (JKH) over the past 11 years in the community setting as a member of a comprehensive multidisciplinary breast program. Early on, a more assertive approach was taken to include patients that others felt were not candidates for NSM. Overall, 374 areolar or nipple-areolar sparing mastectomies were performed in 237 patients. The loco-regional recurrence rates and complication profile were comparable to what is reported in the peer-reviewed literature. We hope that this will inspire other community programs to publish their experiences as a means of reinforcing the safety of NSM in the community setting.
Cell–biomaterial interactions for blood vessel formation

Abstract: Our knowledge of human vascular development and growth has been considerably augmented by biomaterial-based approaches. This chapter first discusses the architecture of the vasculature, from its cellular to extracellular matrix components. In the following sections, engineering of biomaterials to study the mechanisms of vascular morphogenesis and angiogenesis, including cancer-associated angiogenesis, are explored. The final section focuses on materials designed with defined spatial arrangements of molecules or complex topographical features to recapitulate aspects within the native vascular microenvironment.
Planning for Adaptation to Climate Change:Landmark Cases from Australia

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Comparative evaluation of physical characteristics of different inflatable penile prostheses

AbstractObjective: The aim of this study was to describe and evaluate existing inflatable penile prostheses (IPPs) in an independent laboratory setting.Materials and methods: New IPPs were obtained from two manufacturers: American Medical Systems (AMS) and Coloplast. The AMS 700™ LGX (18 cm), CX (18 cm) and CXR (14 cm), and the Coloplast Titan® Touch (18 cm) and Titan Narrow (14 cm) were investigated. Internal pressure, length and girth of the cylinders were measured at 2 ml increments. A urodynamic individual transducer connected to an analogue amplifier and recording system was used to measure pressure. Rigidity and axial loading of the different IPPs were evaluated with a compression system.Results: Regular-size prostheses were inflated to 22 ml and narrow prostheses to 16 ml. The Titan Touch had a girth of 17.8 mm at 22 ml compared to 15.6 mm for the AMS 700 LGX and 16.5 mm for CX. The AMS 700 LGX increased in length by 13 mm from baseline, a feature that was unique among all the tested prostheses. Ri...
Control Dependencies in Interpretive Systems

Interpreters and just-in-time (JIT) compilers are ubiquitous in modern computer systems, making it important to have good program analyses for reasoning about such systems. Control dependence, which plays a fundamental role in a number of program analyses, is an important contender in this regard. Existing algorithms for (dynamic) control dependence analysis do not take into account some important runtime characteristics of interpretive computations, and as a result produce results that may be imprecise and/or unsound. This paper describes a new notion of control dependence and an analysis algorithm for interpretive systems. This significantly improves dynamic control dependence information, with corresponding improvements in client analyses such as dynamic program slicing and reverse engineering. To the best of our knowledge, this is the first proposal to reason about low-level dynamic control dependencies in interpretive systems in the presence of dynamic code generation and optimization.
How Important Is Connectivity for Surface Water Fluxes? A Generalized Expression for Flow Through Heterogeneous Landscapes

How important is hydrologic connectivity for surface-water fluxes though heterogeneous floodplains, deltas, and wetlands? While significant for management, this question remains poorly addressed. Here we adopt spatial resistance averaging, based on channel and patch configuration metrics quantifiable from aerial imagery, to produce an upscaled rate law for discharge. Our model suggests that patch coverage largely controls discharge sensitivity, with smaller effects from channel connectivity and vegetation patch fractal dimension. However, connectivity and patch configuration become increasingly important near the percolation threshold and at low water levels. These effects can establish positive feedbacks responsible for substantial flow change in evolving landscapes (14-36%, in our Everglades case study). Connectivity also interacts with other drivers; flow through poorly connected hydroscapes is less resilient to perturbations in other drivers. Finally, we found that flow through heterogeneous patches is alone sufficient to produce non-Manning flow-depth relationships commonly observed in wetlands but previously attributed to depth-varying roughness.
Establishing the Hemodynamic Determinants of Human Plaque Configuration, Composition and Complication

We now have sound information concerning the distribution of intimai thickenings and atherosclerotic plaques at clinically important sites in humans. Low and/or oscillatory wall shear stress are the associated hemodynamic conditions at these locations. It is also evident that artery walls may compensate for hemodynamic changes and for the development of atherosclerotic disease and maintain lumen diameters and configurations consistent with adequate flow. Obstruction occurs when the adaptive processes do not keep pace with plaque enlargement or when plaques are disrupted. Future investigations must therefore include studies of plaque growth and composition in relation to variations in geometric configuration, pulse rate and flow velocity. Until the disease can be prevented it is necessary to identify those features of plaque composition and configuration which underlie susceptibility to instability and to characterize the hemodynamic and other mechanical circumstances which may induce plaque disruption and those which favor the maintenance of an adequate and stable channel. Such studies place renewed emphasis on the fact that the artery wall and the atherosclerotic plaque are living tissues, capable of healing and adaptive restructuring as well as degeneration and disruption.
Chaperones in Sterile Inflammation and Injury

Heat shock proteins (Hsp) are highly conserved proteins and their expression increases in response to stress stimuli for the maintenance of cellular homeostasis. Cellular stress conditions like hypoxia, change in pH, and metabolic changes are typically associated with upregulation of HSP. In addition to their traditional role of protein refolding or degradation during maintenance of homeostasis, Hsp also acts as key modulators of innate and adaptive immune pathways and play an important role in inflammation and host defense mechanisms. Several pathological conditions such as chronic inflammatory diseases and cancer are typically marked with an elevated expression of HSP. Increasing evidence demonstrates that Hsp can be secreted in the extracellular milieu during disease conditions. These proteins are released into the extracellular spaces either by necrotic cell death or by active secretion via exosomes. Exosomes containing Hsp can communicate and release exosomal contents to elicit immune cell activation. Thus, increased levels of Hsp can be considered as a danger signal both intracellularly, for its ability to chaperone inflammatory signaling molecules as well as extracellularly, for eliciting the activation of immune cells via exosomal communications. This chapter summarizes the chaperone role of HSP in serving as regulators of the immune response in chronic disease conditions.
Ocular fundus imaging with transmitted light (Conference Presentation)

Widefield ocular fundus imaging is conventionally performed in a reflection geometry. In this configuration, back-reflections from inner retinal layers, such as the nerve fiber layer, the inner limiting membrane, or even the anterior walls of large blood vessels, are often encountered, and may obscure the visibility of deeper features. Moreover, spectroscopic quantification of endogenous chromophores is complicated since the final image is a summation of reflections from several fundus layers (i.e. no single absorption pathlength can safely be assumed). Researchers have sought to model the fundus reflections, however the models are sensitive to the populations used and particular imaging platform. In theory, unwanted superficial reflections could be avoided and light path modeling could be simplified by adopting a transmission imaging geometry. We present an alternative transillumination fundus imaging strategy based on deeply penetrating near-infrared (NIR) light delivered transcranial near the subject’s temple. A portion of this light diffuses through bone and illuminates the posterior eye not from the front, as with conventional methods, but rather mostly from behind. As such, we image light transmitted through the fundus rather than back-reflected off multiple fundus layers. This single-pass measurement geometry simplifies absorption pathlength considerations and provides complementary information to fundus reflectometry. The use of NIR light enables imaging as deep as the choroid. Importantly, the technique is compatible with reflection-based techniques and we have shown that it works well with a commercial non-mydriatic fundus camera. Combining information from these two illumination approaches should improve spectroscopic analysis of the fundus.