cssi/SciSciGPT-SciSciNet huggingface dataset:
The role of the community teaching hospital in surgical undergraduate education.

Background: Significant changes in surgical practice have resulted in a reexamination of surgical undergraduate education. The increasing emphasis toward ambulatory procedures positions the community hospital as an excellent alternative site for surgical education. This study compares the quality of one medical school’s surgical education at a principal teaching hospital to that of affiliated teaching hospitals. Methods: Surgical undergraduate education offered through four programs was evaluated for 1993 to 1997. Students’ performance was objectively rated by the National Board Examination in surgery, an oral examination, and a clinical appraisal. A subjective appraisal was determined via students’ clerkship evaluation. Results: There was a significant difference (P <0.01) in National Board Examination scores and clerkship evaluations that favored some affiliated teaching hospitals over the principal teaching hospital. Conclusion: The quality of surgical undergraduate education, documented by objective testing and subjective perception, indicated that the education obtained at the affiliated hospitals was at least equivalent to the principal teaching hospital.
On the Asymptotic Validity of Fully Sequential Selection Procedures for Steady-State Simulation

We present fully sequential procedures for steady-state simulation that are designed to select the best of a finite number of simulated systems when best is defined by the largest or smallest long-run average performance. We also provide a framework for establishing the asymptotic validity of such procedures and prove the validity of our procedures. An example based on the M/M/1 queue is given.
Influence of invasive Spartina growth stages on associated macrofaunal communities

In coastal wetlands, invasive plants often act as ecosystem engineers altering flow, light and sediments which, in turn, can affect benthic animal communities. However, the degree of influence of the engineer will vary significantly as it grows, matures and senesces, and surprisingly little is known about how the influence of an ecosystem engineer varies with ontogeny. We address this issue on the tidal flats of San Francisco Bay where hybrid Spartina (foliosa × alterniflora) invaded 30 years ago. The invasion has altered the physico-chemical properties of the sediment habitat, which we predicted should cause changes in macrofaunal community structure and function. Through mensurative and manipulative approaches we investigated the influence of different growth stages of hybrid Spartina on macrobenthos and the underlying mechanisms. Cross-elevation sampling transects were established covering 5 zones (or stages) of the invasion, running from the tidal flat (pre-invasion) to an unvegetated dieback zone. Additionally, we experimentally removed aboveground plant structure in the mature (inner) marsh to mimic the ’unvegetated areas’. Our results revealed four distinct faunal assemblages, which reflected Spartina-induced changes in the corresponding habitat properties along an elevation gradient: a pre-invaded tidal flat, a leading edge of immature invasion, a center of mature invasion, and a senescing dieback area. These stages of hybrid Spartina invasion were accompanied by a substantial reduction in macrofaunal species richness and an increase in dominance, as well as a strong shift in feeding modes, from surface microalgal feeders to subsurface detritus/Spartina feeders (mainly tubificid oligochaetes and capitellid polychaetes). Knowledge of the varying influence of plant invaders on the sediment ecosystem during different phases of invasion is critical for management of coastal wetlands.
Homoclinic orbits and chaos in discretized perturbed NLS systems: Part I. Homoclinic orbits

The existence of homocliic orbits, for a finite-difference discretized form of a damped and driven perturbation of the focusing nonlinear Schroedinger equation under even periodic boundary conditions, is established. More specifically, for external parameters on a codimension 1 submanifold, the existence of homoclinic orbits is established through an argument which combines Melnikov analysis with a geometric singular perturbation theory and a purely geometric argument (called the “second measurement” in the paper). The geometric singular perturbation theory deals with persistence of invariant manifolds and fibration of the persistent invariant manifolds. The approximate location of the codimension 1 submanifold of parameters is calculated. (This is the material in Part I.) Then, in a neighborhood of these homoclinic orbits, the existence of “Smale horseshoes” and the corresponding symbolic dynamics are established in Part II [21].
Fitzpatrick skin phototype is an independent predictor of squamous cell carcinoma risk after solid organ transplantation

Background Solid organ transplant recipients (OTR) are at an increased risk of developing squamous cell carcinoma (SCC) of the skin after transplantation. In predominantly white cohorts, Fitzpatrick skin type (FST) has been reported to be a risk factor for developing posttransplantation skin cancers. Objective Our goal was to determine if FST is a statistically significant risk factor for the development of SCC after solid organ transplantation in a diverse US population of OTR. Methods A cohort of OTR completed a questionnaire of demographic factors, transplant type, FST, and skin cancer history. Univariate and multivariate analyses were performed to determine the risk factors for development of SCC after transplantation. Results As expected, male subjects had an increased risk for SCC compared with female subjects ( P = .02), and those aged 50 years and older at the time of transplantation were more likely to develop SCC compared with those younger than 50 years ( P P Limitations Our questionnaire did not ask specifically about immunosuppressive medications; instead, organ transplant category was used as a proxy for level of immunosuppression. Conclusions FST, a patient-reported variable, is an independent risk factor for the development of SCC in OTR, and should be elicited from patients who have gone or will undergo organ transplantation.
Phase-based cell imaging techniques for microbeam irradiations

The microbeam facility at Columbia University is expanding current protocols for single-particle, single-cell irradiations, so experimenters can locate and irradiate nuclei and cytoplasm of unstained cells. The ion beamline is located directly under the dish, therefore, any new techniques must use reflection microscopy. Two approaches are being integrated and neither require the removal of the cell growth medium prior to irradiation. (1) A novel immersion-based Mirau interferometry lens which uses low-coherence light sources to inhibit unwanted fringing is under design. The process requires tens of nanometers or better precision of vertical stage motion, which will be accomplished with our custom high-precision z-stage. (2) Quantitative Phase microscopy is under testing, also using the z-stage. Future plans include optimization of software routines to decrease time between irradiations. Both methods will be compared further with the automated location routines which use nuclear and cytoplasm stains.
Putting the science into computer science: treating introductory computer science as the study of algorithms

This paper describes why the study of algorithms should be a fundamental component of the standard introductory computer science (CS) curriculum. By shifting the focus of basic CS classes from implementation to concept, educators can greatly enhance student understanding and course relevance despite rapidly-changing paradigms, technologies, and programming languages. Teaching algorithms also encourages the development of other more generalized skills, including the scientific method, problem-solving, modeling, and technical communication.
Side fringing of thin film heads with pole trimming

A technique for measuring write and erase widths using a narrow-track MR (magnetoresistive) probe to acquire the dual-track profiles of write/overwrite tracks has been developed. This technique was used to reveal the distinct features of shoulder effects on the side-writing and side-erasing behavior of pole-tip trimmed heads. Another technique, using the microtrack profile, was utilized to demonstrate the impact of the low shoulder on the side reading of trimmed heads. Trimmed heads which have a shoulder within 5 mu m of the air-bearing surface exhibit modified side-fringing characteristics for the heads and disks studied. The trimmed heads with a shoulder height exceeding 6 mu m show substantially smaller erase and read widths, and a weaker dependence of write width on transition density when compared with an untrimmed head having unequal pole widths. >
Antiorthostatic suspension as a model for the effects of spaceflight on the immune system

We describe the use and appropriateness of antiorthostatic suspension in immunological investigations. This manuscript describes the model and discusses how well data obtained by using the model correlate with spaceflight data. This review concludes with some suggestions for future experiments using antiorthostatic suspension.
Summertime impact of convective transport and lightning NO x production over North America: modeling dependence on meteorological simulations

Abstract. Global-scale chemical transport model simulations indicate lightning NOx dominates upper tropospheric O3 production above Eastern North America during summertime but vary in their estimates. To improve our understanding, a regional-scale model (REAM) with higher resolution is applied. To examine the uncertainties in modeling the impact of convective transport and lightning NOx production on upper tropospheric chemical tracer distributions, REAM simulations of chemical tracers are driven by two meteorological models, WRF and MM5, with different cumulus convective parameterizations. The model simulations are evaluated using INTEX-A aircraft measurements and satellite measurements of NO2 columns and cloud top pressure, and we find that mid and upper tropospheric trace gas concentrations are affected strongly by convection and lightning NOx production. WRF with the KF-eta convection scheme simulates larger convective updraft mass fluxes below 150 hPa than MM5 with the Grell scheme. The inclusion of the entrainment and detrainment processes leads to more outflow in the mid troposphere in WRF than MM5. The ratio of C2H6/C3H8 is found to be a sensitive parameter to convective outflow; the simulation by WRF-REAM is in closer agreement with INTEX-A measurements than MM5-REAM, implying that convective mass fluxes by WRF are more realistic. WRF also simulates lower cloud top heights (10–12 km) than MM5 (up to 16 km), and hence smaller amounts of estimated (intra-cloud) lightning NOx and lower emission altitudes. WRF simulated cloud top heights are in better agreement with GOES satellite measurements than MM5. Simulated lightning NOx production difference (due primarily to cloud top height difference) is mostly above 12 km. At 8–12 km, the models simulate a contribution of 60–75% of NOx and up to 20 ppbv of O3 from lightning, although the decrease of lightning NOx effect from the Southeast to Northeast and eastern Canada is overestimated. The model differences and biases found in this study reflect some major uncertainties of upper tropospheric NOx and O3 simulations driven by those in meteorological simulations and lightning parameterizations.
Collegiate purpose orientations and well-being in early and middle adulthood

Two studies evaluated whether different purpose orientations, defined by the content of one's life-goals, would differentially predict personal well-being in the short- and long-term. Four types of purpose orientations (creative, prosocial, financial, and personal recognition) were examined using a sample of 416 (57% male) college undergraduates tested as seniors and again thirteen years after graduation. At senior year, all four purpose orientations were correlated with perceived personal development during college, measured using Higher Education Research Institute surveys. However, at middle adulthood, only the prosocial purpose orientation was predictive of greater generativity, personal growth, and integrity. These studies point to the benefits of having goals focused on helping others rather than helping oneself.
Does knowledge of connectives play a unique role in the reading comprehension of English learners and English‐only students?

Connectives (e.g., although, meanwhile) carry abstract meanings and often signal key relationships between text ideas. This study explored whether understanding of connectives represents a unique domain of vocabulary knowledge that provides special leverage for reading comprehension, and whether the contribution of knowledge of connectives to reading comprehension differs for students from distinct language backgrounds. Understanding of connectives, word reading efficiency and breadth of vocabulary knowledge of 75 English language learners (ELLs) and 75 English-only (EO) fifth graders were assessed. Hierarchical multiple regression techniques revealed that understanding of connectives explained a sizeable and significant portion of unique variance in comprehension beyond that explained by breadth of vocabulary knowledge when controlling for word reading efficiency. The magnitude of this relationship was larger for EO students than for ELLs. Findings indicate that connectives play an important role in comprehension, but that the strength of their influence varies by readers’ linguistic background.
The role of response and reward in spatial memory

Abstract Two experiments were conducted to determine the role of the response and of reward in spatial working memory. Rats were initially trained on a four-arm maze to run to the end of each arm for a single pellet of food. On subsequent tests, rats were first placed at the end of one, two, or three arms. In Experiment 1, the arms on which the rat was placed (“placed arms”) had food which the rat was allowed to eat, whereas in Experiment 2 these placed arms did not have food. Following the placements the rat was allowed to choose among the four arms; only unplaced arms contained food. Two measures indicated that the response made a slight but reliable contribution to spatial memory. (a) When a rewarded arm was still available, choice accuracy after placements was less than choice accuracy on tests in which no placements had occurred; this difference diminished over test days. (b) When all four arms had been chosen once, the rats were more likely to go back to a placed arm rather than an unplaced arm. No influence of the presence or absence of food on the placed arms was found. These data demonstrate that the response of running down an arm, but not the reward outcome at the end, had a small influence on the memorability of a visit. Overall, above chance performance in the spatial working memory task was maintained without either running to the arm or obtaining food on it.
Exploring the Canadian-U.S. Unemployment and Nonemployment Rate Gaps: Are There Lessons for Both Countries?

The Canadian and U.S. economies are very similar. Yet, beginning in the 1980s, Canada experienced much greater relative unemployment rates followed in the 1990s by a declining share of population employed. Using state- and provincial-level data this study assesses why U.S. labor markets have recently performed relatively better than their Canadian counterparts. The empirical results indicate that more rapid U.S. employment growth explains a relatively small proportion of its lower joblessness. Structural causes including lower U.S. unionization and less generous unemployment insurance appear to be more important, at least in the long run. The Canadian labor market also appears to be less flexible to regional economic shocks.
The Cross-sectional Association Between Blood Pressure and Alzheimer's Disease in a Biracial Community Population of Older Persons

Background. The relation of blood pressure to Alzheimer’s disease (AD) is complex because both an association of high blood pressure with increased risk of the disease and lower blood pressure as a consequence of the disease are possible. Methods. We examined the cross-sectional association of blood pressure and AD in the Chicago Health and Aging Project (CHAP), a study of a geographically defined, biracial community. After in-home interviews with 6,162 residents $ 65 years, a stratified random sample of 729 participants was clinically evaluated; 709 had blood pressures measured, and 243 were diagnosed with AD. Results. In logistic regression models adjusted for age, sex, education, and race there was no association between blood pressure measured as a continuous variable and Alzheimer’s disease. In categorical analyses, however, prevalence of Alzheimer’s disease was significantly higher among persons with low systolic pressure ( , 130 mmHg) compared with the referent group of 130‐139 mmHg (odds ratio [OR] 5 2.2, 95% confidence interval [CI]: 1.2,4.1), and with low diastolic pressure ( , 70 mmHg) compared to the referent of 70‐79 mmHg (OR 5 1.8, 95% CI: 1.1,3.1). High systolic and diastolic categories were not statistically different from the referent group, although there was some evidence that the associations differed by race. The odds ratios changed little with further adjustment for apolipoprotein E genotype, antihypertensive medications, body mass, stroke, diabetes, and heart disease. Conclusion. These findings are consistent with previous studies showing associations between low blood pressure and AD, but longitudinal studies are needed to characterize cause-and-effect associations.
The Admissibility of Evidence in ICSID Arbitration: Considering the Validity of WikiLeaks Cables as Evidence

This article examines the admissibility of WikiLeaks diplomatic cables as evidence in international arbitral tribunals. Following the ICSID Tribunal's recent Decision in ConocoPhillips v Venezuela, Venezuela challenged the Decision utilizing WikiLeaks diplomatic cables containing confidential communications between ConocoPhillips' counsel and representatives from the US Embassy. This raises significant questions regarding what types of evidence are admissible in arbitral proceedings. Traditional international legal principles would point to such diplomatic communications being clearly inadmissible. However, the question is far less clear in a transnational arbitration, where the tribunal has the final authority over admitting evidence without being bound by international law. This article begins by considering the treatment of such evidence under international legal concepts and cases. It will then examine how such evidence has been treated by tribunals thus far within the developing transnational legal order. It will conclude by postulating how future ICSID tribunals might treat the admissibility and authenticity of WikiLeaks diplomatic cables.
One-dimensional closure models for three-dimensional incompressible viscoelastic free jets: von Karman flow geometry and elliptical cross-section

In this paper we derive one-space-dimensional, reduced systems of equations (one-dimensional closure models) for viscoelastic free jets. We begin with the three-dimensional system of conservation laws and a Maxwell-Jeffreys constitutive law for an incompressible viscoelastic fluid. First, we exhibit exact truncations to a finite, closed system of one-dimensional equations based on classical velocity assumptions of von Karman (1921). Next, we demonstrate that the three-dimensional free-surface boundary conditions overconstrain these truncated systems, so that only a very limited class of solutions exist. We then proceed to derive approximate one-dimensional closure theories through a slender-jet asymptotic scaling, combined with appropriate definitions of velocity, pressure and stress unknowns. Our non-axisymmetric one-dimensional slender-jet models incorporate the physical effects of inertia, viscoelasticity (viscosity, relaxation and retardation), gravity, surface tension, and properties of the ambient fluid, and include shear stresses and time dependence. Previous special one-dimensional slender-jet models correspond to the lowest-order equations in the present asymptotic theory by an a posteriori suppression to leading order of some of these effects, and a reduction to axisymmetry. We thereby: (i) derive existing one-dimensional models from the three-dimensional free surface boundary-value problem; (ii) clarify the sense of the one-dimensional approximation; (iii) deduce new one-dimensional closure models for non-axisymmetric viscoelastic free jets.
Propagation characteristics of single and coupled microstrip antenna feed-lines on anisotropic substrates

Both biaxial permittivity and permeability tensors are considered for the analysis of open single and coupled microstrip lines by using the spectral-domain approach. Based on Maxwell's equations in the spectral domain and the appropriate boundary conditions, the dyadic Green's function is obtained, and the propagation characteristics of these transmission lines are numerically examined. To verify the formulation, both sapphire and boron nitride substrates were used for single and coupled microstrip lines. The computed data indicate very good agreement with independent results from previous research. >
Use of routine histologic evaluation of carpal ganglions.

Purpose Although histologic evaluation is performed routinely on tissue removed during the excision of carpal ganglions, the necessity of this evaluation is uncertain. We evaluated the use of routine histologic evaluation of excised carpal ganglions and performed a cost-benefit analysis. Methods A retrospective review identified 160 consecutive carpal ganglion (102 dorsal, 58 volar) excisions performed over the past 7 years by 2 surgeons. The preoperative evaluation, surgical findings, and results of the pathologic assessment were evaluated for patients treated with a typical carpal ganglion excision. Results In 156 of 160 patients the preoperative and intraoperative data were highly suggestive of a carpal ganglion; the pathology reports confirmed the diagnosis in all of these patients. No new information was provided by pathologic assessment. In 4 patients the preoperative and intraoperative assessments were less certain; the pathologic assessments in these patients also were equivocal. No malignancy or condition requiring additional treatment was identified. At our institution the total cost of pathologic evaluation for a carpal ganglion including processing and interpretation fees is $352. Conclusions Routine histologic examination of excised dorsal and volar carpal ganglions may be unnecessary if the preoperative and intraoperative evaluations are consistent with a diagnosis of carpal ganglion. Type of study/level of evidence Therapeutic, Level IV.
The management of rectal cancer in the elderly

Abstract Introduction : The majority of patients with rectal cancer are elderly. Due to the increasingly aging population the number of people with colorectal cancer is increasing. As medical advances in the areas of local therapy, radiation therapy, and surgical technique, such as, laparoscopy are made more elderly patients are offered various types of treatment for rectal cancer. As the number of treatment options increase, the debate on how to treat elderly patients' with rectal cancer intensifies. Methods : A Medline search using "rectal cancer," "elderly," "local therapy," "radical surgery," and "radiation therapy" as key words was performed for English-language articles. Further references were obtained through cross-referencing the bibliography cited in each work. Discussion : Numerous treatment options exists for elderly patients with rectal cancer. These range from transanal local excision to radical surgery. The best treatment option for a certain elderly patient is multifactorial and includes tumor stage, operative curability, preoperative functioning of the patient, patient comorbidities, quality of life goals, and patient preference. Conclusion : Age, taken as an independent variable, is not a contraindication to any specific type of therapy, including radical surgery with primary anastomsis. Patients' who meet the criteria for local resection should undergo this procedure. However, for tumors which are not amenable to local resection, these patients should be considered for radical surgery if this provides the best chance for cure. Elderly patients who can tolerate a major operation, and have good preoperative sphincter function should undergo a resection with primary anastomosis.
The Examination of the Mentoring Relationship between the Head Coach and Assistant Coaches of Women’s Basketball Teams

A number of studies have examined the decreasing number of female head coaches of women’s teams. Researchers have consistently demonstrated the mentoring relationship has provided substantial benefits in helping women advance within leadership positions within the sport industry. The purpose of this study was to examine the mentoring relationship between the head coach and female assistant coach of women’s basketball teams who aspire to become a head coach. More specifically, the mentoring characteristics and advancement techniques were two areas of focus. Findings suggested mentoring characteristics and advancement techniques may provide recommendations on mentoring women who aspire to become head coaches.
Gender Discrimination and the Thirteenth Amendment

Although the Thirteenth Amendment was ratified more than a century and a half ago, courts have yet to delve into its relevance to gender discrimination. This oversight is unfortunate given the extent to which jurisprudence about another Reconstruction Amendment, the Fourteenth Amendment, has evolved beyond its original racial confines to include gender, disability, sexual orientation, and other forms of group-specific inequalities. A progressive interpretation of the Thirteenth Amendment should likewise expand congressional enforcement authority beyond race. As was the case with its Fourteenth Amendment counterpart, the Thirteenth Amendment was initially ratified to prevent racial discrimination, but its antisubordination principles are also relevant to policies for abolishing gender discrimination. This underexplored area of law offers tremendous potential for providing redress against a variety private, state, and institutional forms of gender discrimination that are not actionable under current civil rights statutes.This Essay demonstrates how broad concepts of liberty, which abolitionists, feminists, and Congress developed before and after the ratification of the Thirteenth Amendment, seamlessly lend themselves to the enforcement of gender equality norms. Over the last forty years, the Supreme Court has recognized the existence of federal authority to prevent state gender discrimination. The Thirteenth Amendment is a source of legislative authority that can be used to address private acts of discrimination.
Asynchronous adaptive conditioning for visual-inertial SLAM

This paper is concerned with real-time monocular visual-inertial simultaneous localization and mapping SLAM. In particular a tightly coupled nonlinear-optimization-based solution that can match the global optimal result in real time is proposed. The methodology is motivated by the requirement to produce a scale-correct visual map, in an optimization framework that is able to incorporate relocalization and loop closure constraints. Special attention is paid to achieve robustness to many real world difficulties, including degenerate motions and unobservablity. A variety of helpful techniques are used, including: a relative manifold representation, a minimal-state inverse depth parameterization, and robust non-metric initialization and tracking. Importantly, to enable real-time operation and robustness, a novel numerical dog-leg solver is presented that employs multi-threaded, asynchronous, adaptive conditioning. In this approach, the conditioning edges of the SLAM graph are adaptively identified and solved for both synchronously and asynchronously. In this way one thread focuses on a small number of temporally immediate parameters and hence constitute a natural ?front-end?; the other thread adaptively focuses on larger portions of the SLAM problem, and hence is able to re-estimate past parameters in the presence of new information: an ability that is useful for self-calibration, during degenerate motions, or when bias and the direction of gravity are poorly observed. Experiments with real and simulated data for both indoor and outdoor scenarios demonstrate that asynchronous adaptive conditioning is accurate, and able to closely track the batch SLAM maximum likelihood solution in real time.
Combined Laboratory and Greenhouse Techniques for Year-Round Rearing of the Mimosa Webworm, Homadaula anisocentra

A method is described for year-round rearing of Homadaula anisocentra Meyrick. During summer months, field-collected larvae are reared to the pupal stage on a semisynthetic artificial diet. The pupae, in cocoons, obtained by this method are held at 5°C until required. During winter months, larvae are reared in the greenhouse on potted honey locust seedlings.
695: Low PAPP-A levels and placental pathology: is there an association with adverse pregnancy outcome?

an association with adverse pregnancy outcome? Karen Florio, Natan Haratz, Carolyn Salafia, Samantha VanHorn, Kajal Pruthi, Andrew Smith New York Methodist Hospital Cornell/Presbyterian, OB/GYN, Brooklyn, NY, New York Methodist Hospital Cornell Presbyterian, OB/GYN, Brooklyn, NY, New York Methodist Hospital Cornell Presbyterian, OB/GYN, Pathology, Pediatrics, Brooklyn, NY, New York Methodist Hospital Cornell Presbyterian, Pediatrics, Brooklyn, NY OBJECTIVE: To evaluate perinatal outcomes in patients with low PAPP-A ( 5th percentile) between 11 and 13 6/7 weeks and the possible association with adverse placental findings. STUDY DESIGN: 150 women with singleton pregnancies who attended New York Methodist Hospital Imaging Center from 6/2007 5/2011 were included. Maternal age, gestational age, serum PAPP-A levels, serum free-BHCG levels, Nuchal translucency and CRL were recorded. Medical records were reviewed and the following parameters evaluated: 1) Maternal age, 2) BMI, 3) Race, 4) Cigarette smoking, 5) Medical history including DM, hypertension, thrombophilia, autoimmune disorders, 6) Previous obstetrical history, 7) Neonatal APGAR score, 8) Diagnosis of Pre-Eclampsia, 9) Fetal weight, 10) Fetal outcome (live vs. IUFD), 11) Fetal cord blood gases, and 12) Placental pathology. Linear regression analysis was used to compare the obstetrical outcome of these patients with age-matched controls (80) and PAPP-A above the 5th percentile. The Mann-Whitney test for nonnormally distributed variables was also utilized. RESULTS: The composite perinatal outcome (IUGR, IUFD, pre-eclampsia, spontaneous AB and pre-term labor) in our study population was significantly poorer (P 0.047) than our controls. When analyzed separately, only pre-eclampsia seemed significantly more prevalent (p 0.047) in patients with PAPP-A below the 5th percentile. Preliminary analysis of placental pathology shows a stastically significant difference in women with low PAPP-A levels and fetal thrombotic lesions (p 0.05). CONCLUSION: In this study, patients with PAPP-A levels below the 5th percentile between 11 and 13 6/7 weeks had a significantly poorer composite perinatal outcome (p 0.047). In addition, these women also had more fetal vascular lesions than the contols. We are currently analyzing various placental parameters and we speculate that other placental lesions, including inflammation, will be more prevalent in women with low PAPP-A who also experience adverse outcomes.
Granulocyte-macrophage colony-stimulating factor (GM-CSF) secreted by cDNA-transfected tumor cells induces a more potent antitumor response than exogenous GM-CSF

Clinical cancer gene therapy trials have generally focused on the transfer of cytokine cDNA to tumor cells ex vivo and with the subsequent vaccination of the patient with these genetically altered tumor cells. This approach results in high local cytokine concentrations that may account for the efficacy of this technique in animal models. We hypothesized that the expression of certain cytokines by tumor cells would be a superior immune stimulant when compared with local delivery of exogenous cytokines. Granulocyte-macrophage colony-stimulating factor (GM-CSF) cDNA in a nonviral expression vector was inserted into MDA-MB-231 (human breast cancer), M21 (human melanoma), B16 (murine melanoma), and P815 (mastocytoma) cells by particle-mediated gene transfer. The ability of transfected tumor cells to generate a tumor-specific immune response was evaluated in an in vitro mixed lymphocyte-tumor cell assay and in an in vivo murine tumor protection model. Peripheral blood lymphocytes cocultured with human GM-CSF-transfected tumor cells were 3- to 5-fold more effective at lysis of the parental tumor cells than were peripheral blood lymphocytes incubated with irradiated tumor cells and exogenous human GM-CSF. Mice immunized with murine GM-CSF-transfected irradiated B16 murine melanoma cells or P815 mastocytoma cells were protected from subsequent tumor challenge, whereas mice immunized with the nontransfected tumors and cutaneous transfection of murine GM-CSF cDNA at the vaccination site developed tumors more frequently. The results indicate that GM-CSF protein expressed in human and murine tumor cells is a superior antitumor immune stimulant compared with exogenous GM-CSF in the tumor microenvironment.
SHED: Four Important Sub-theories That Help Us to “Bracket”

The concepts of simple, complicated, and complex adaptive systems helped us to understand some difficulties that our team was experiencing. However, for some problems, this perspective seemed too broad, and a more fine-grained approach was desirable.
Key references: Antiphospholipid antibody syndrome.

Conley CL, Hartmann RC. A hemorrhagic disorder caused by circulating anticoagulant in patients with disseminated lupus erythematosus. J Clin Invest 1952;31:621‐622. Angeles-Cano E, Sultan Y, Clauvel JP. Predisposing factors to thrombosis in systemic lupus erythematosus. Possible relationships to endothelial cell damage. J Lab Clin Med 1979;94:
Ruptured pseudoaneurysm of the middle meningeal artery presenting with a temporal lobe hematoma and a contralateral subdural hematoma.

BACKGROUND Traumatic pseudoaneurysms of the middle meningeal artery (MMA) are rare, associated with skull fractures, and have a high mortality rate. When they rupture, MMA pseudoaneurysms frequently cause epidural hematomas and occasionally ipsilateral subdural or subarachnoid hemorrhage. Isolated intraparenchymal hemorrhage has also been reported. CASE DESCRIPTION A 54-year-old female who suffered a loss of consciousness resulting in a fall presented with a Glasgow Coma Scale of 7t. Imaging demonstrated a right subdural hematoma (SDH) with midline shift, left skull fracture overlying the left MMA, and left temporal lobe intraparenchymal hematoma extending to the surface. The patient underwent a right craniectomy with evacuation of the SDH, and the preoperative computed tomographic angiography revealed abnormal dilation of the left MMA consistent with a pseudoaneurysm. The pseudoaneurysm was treated with endovascular treatment, and the intraparenchymal hematoma was treated conservatively. Her recovery was uneventful, and she received a cranioplasty 3 months after the decompression. CONCLUSIONS The presence of a fracture over the MMA and intraparenchymal hematoma should prompt suspicion for a traumatic pseudoaneurysm. Pseudoaneurysms of the MMA can cause catastrophic bleeding, and prompt treatment is necessary. Endovascular embolization is an effective method that decreases the hemorrhage risk of MMA pseudoaneurysms.
High Resolution Phonon-assisted Quasi-resonance Fluorescence Spectroscopy

High resolution optical spectroscopy methods are demanding in terms of either technology, equipment, complexity, time or a combination of these. Here we demonstrate an optical spectroscopy method that is capable of resolving spectral features beyond that of the spin fine structure and homogeneous linewidth of single quantum dots (QDs) using a standard, easy-to-use spectrometer setup. This method incorporates both laser and photoluminescence spectroscopy, combining the advantage of laser line-width limited resolution with multi-channel photoluminescence detection. Such a scheme allows for considerable improvement of resolution over that of a common single-stage spectrometer. The method uses phonons to assist in the measurement of the photoluminescence of a single quantum dot after resonant excitation of its ground state transition. The phonon's energy difference allows one to separate and filter out the laser light exciting the quantum dot. An advantageous feature of this method is its straight forward integration into standard spectroscopy setups, which are accessible to most researchers.
6. Phylogenetic Hypotheses and the Utility of Multiple Sequence Alignment

The role of Multiple Sequence Alignment in phylogenetic analysis is discussed in the context of data and hypothesis. Alignments cannot be observed in nature, hence are neither data nor “real” in the scientific sense. Observers gather sequence data as strings of nucleotides and phylogenetic hypotheses (= topologies) are tested with them on the basis of quantitative optimality criteria. This optimization problem, the Tree-Alignment problem, is known to be NP-Hard, hence extremely unlikely to have an exact solution in polynomial time. Multiple sequence alignment can play a role, however, as a tool in identifying heuristic solutions to this problem. As such, it must be evaluated against other such tools. Real data sets and recent simulations offer tests of the performance of multiple sequence alignment as a heuristic approach to the tree-alignment problem.
Chapter 36 – Skeletal Heterogeneity and the Purposes of Bone Remodeling: Implications for the Understanding of Osteoporosis

The cells of bone influence its structure by means of four processes: growth, repair, modeling, and remodeling, the last being the basis of bone tissue turnover in the adult skeleton. The purposes of growth and repair are obvious. Modeling serves to adapt bones to changes in mechanical loading [1], and remodeling serves to thicken trabeculae in the growing skeleton [2], processes that are most effective during adolescence [3]. But why does a tissue that can survive for thousands of years after death need to be maintained by periodic replacement during life? Most of those interested in bone, whether as physicians, as clinical investigators, or as basic scientists, show remarkably little interest in this fundamental question. Many articles and book chapters discuss the regulation of bone remodeling, but regulation, at least in the physiologic sense, implies a target [4]. The target value of any regulatory process in biology has been optimized by natural selection. Mechanisms have evolved which ensure that deviations from the target are detected and that corrective measures to restore the target value are carried out. In this sense, body temperature, extracellular fluid osmolality, tissue oxygen tension, and countless other physiologic quantities are regulated, but the mechanisms of regulation could not be determined until the existence of the target had been recognized and its precise nature defined. Is there a target for bone remodeling or for some characteristic of bone that is influenced by remodeling?
The significance of snow to surface water supply: an empirical case study from the southwestern United States

AbstractCool season runoff is central to water management strategies within the southwestern United States, yet the historical impact of precipitation type is not fully understood. This study quantifies the significance of snow to surface water supply from the Salt River basin in Arizona using runoff data for the basin and historical climate station data for 64 years within the 82-year period 1933–1934 through 2014–2015. Seasonal values for precipitation, snowfall, fraction of precipitation as snow, and air temperature were examined for statistical relationships with seasonal values of fraction of precipitation as runoff and timing of runoff. The runoff-to-precipitation ratio is predominantly a function of seasonal precipitation, explaining 60% of the variance. Only the fraction of precipitation falling as snowfall adds instructive value, explaining an additional 3% of the variance. The timing of runoff within the season is primarily a function of daily mean air temperature, explaining 25% of the variance...
EFFECTS OF A HEALTH PROMOTION PROGRAM ON SUSTAINING HEALTH BEHAVIORS IN OLDER ADULTS

Background Controversy exists regarding the optimal way to provide health promotion education to the elderly. This prospective randomized study evaluated the effectiveness of individualized assessment and counseling coupled with the receipt of a written health plan on client adherence to health behavior recommendations. Methods Two hundred thirty-seven ethnically diverse and predominantly low-income adults 60 and older, participating for the first time in an established statewide public health prevention program delivered in both rural and urban clinics, were recruited and randomly assigned to treatment and control groups. All participants received a standardized assessment that included a health history, nutrition assessment, and limited physical exam from a public health nurse. The treatment group additionally received a written personal health plan and individualized counseling to support implementation of the plan. Both groups were interviewed after one year to determine their adherence to the original recommendations. Results Seventeen preventive services and health behaviors were evaluated. There were no statistically significant differences between the groups on health care use and previous health behaviors at baseline. Using logistic regression and controlling for socioeconomic and demographic variables, we found that the treatment group that received a personal health plan and counseling completed significantly more preventive referrals and health behavior changes (P Conclusions A client-centered planning process with supportive counseling by public health nurses, combined with health plans provided to clients, can significantly increase the prevention measures taken by older adults.
At the Mind’s Limits and German-Jewish Symbiosis: Or, Améry on Guilt and the Possibility of Redemption

At the 50 th anniversary of the Jean Amery’s Jenseits von Schuld und Suhne: Bewaltigungsversuche eines Uberwaltigten , published in English as At the Mind’s Limits: Contemplations By a Survivor on Auschwitz and its Realities , this work is garnering increased attention in the Anglophone world. Perhaps it should not be surprising that there is increased interest in this book at this moment when our attention is repeatedly drawn to the plight of immigrants and exiles, state sanctioned use of torture, and police violence — all themes At the Mi nd’s Limits deals with at length. While this recent attention is certainly appropriate, it nevertheless tends to blur the specific and particular socio-political and cultural contours of the work. Amery becomes a writer about the plight of the victim in general, such that specificity of his Jewishness is lost and the already submerged theological dimensions of his work remain obscure.
Does change in readiness influence retention among African American women and men in substance abuse treatment

ABSTRACTAfrican Americans are less likely than other racial groups to engage in and complete outpatient substance abuse treatment. The current study, conducted as a secondary analysis of a multisite randomized clinical trial, examined whether readiness to change (RTC) over time influences retention and whether gender moderates the relationship between changes in RTC and retention among 194 African American women and men. Participants completed the University of Rhode Island Change Assessment at baseline and at the end of the 16-week study. Findings revealed a significant relationship between RTC over time and retention. Specifically, the more RTC increased throughout the 16-week study, the longer participants remained in treatment. In addition, gender moderated the relationship between changes in RTC and retention, with a stronger association between changes in RTC and retention among men relative to women. One approach to improving substance abuse treatment retention rates is to focus on increasing RTC d...
Prevention of Surgical Site Infections and Biofilms: Pharmacokinetics of Subcutaneous Cefazolin and Metronidazole in a Tumescent Lidocaine Solution.

Background: Tumescent anesthesia antibiotic delivery (TAAD) consists of subcutaneous infiltration of antibiotic(s) dissolved tumescent lidocaine anesthesia. Tumescent lidocaine anesthesia contains lidocaine (≤ 1 g/L), epinephrine (≤ 1 mg/L), sodium bicarbonate (10 mEq/L) in 0.9% saline. Our aim was to measure cefazolin and metronidazole concentrations over time in subcutaneous tumescent interstitial fluid (TISF) after TAAD, in serum after TAAD and after intravenous antibiotic delivery (IVAD). We hypothesize that the pharmacokinetic/pharmacodynamic profiles of TAAD + IVAD are superior to IVAD alone for the prevention of surgical site infections and biofilms. Methods: Concentrations of cefazolin and metronidazole in TISF and serum following TAAD and in serum following IVAD were compared in 5 female volunteers. Subjects received cefazolin or cefazolin plus metronidazole by IVAD alone and by TAAD alone. One subject also received concomitant IVAD and TAAD of these 2 antibiotics. Sequential samples of serum or subcutaneous TISF were assayed for antibiotic concentration. Results: Cefazolin (1 g) by TAAD resulted in an area under the curve of the concentration–time profile and a maximum concentration (Cmax) in subcutaneous tissue that were 16.5 and 5.6 times greater than in serum following 1 g by IVAD. Metronidazole (500 mg) by TAAD resulted in an area under the curve and Cmax that were 8.1 and 24.7 times greater in TISF, than in serum after 500 mg by intravenous delivery. IVAD + TAAD resulted in superior antibiotic concentrations to IVAD alone. Conclusions: TAAD + IVAD produced superior antibiotic bioavailability in both subcutaneous interstitial fluid and serum compared with IVAD alone. There was no evidence that TAAD of cefazolin and metronidazole poses a significant risk of harm to patients.
Chronic Electrophysiological and Behavioral Response in Rats due to Cerebral Ischemic Stroke in the Motor Cortex

This work is the beginning of a study investigating dynamic changes of electrophysiological and correlative behavioral response in rats before, during and after stroke in the motor cortex. The animals need training sessions to regularly perform the behavioral tests. The standard deviation of total paw touches in the cylinder test (n=4) and the time required to eat a single strand of pasta (n=3) decreased by a factor of 1.7 and 3.6 respectively after 5 days of training. Behaviorally, post-stroke, average cylinder touches decreased by a factor of 5.6, and pasta adjustments increased by a factor of 3.6 suggesting impairments due to stroke. The pre-stroke mean neural firing rate was 94 spikes per second (spk/s), this increased to 146 spk/s during the 20 minute stroke induction, and was only 4 spk/s 20 min post-stroke. The firing rate has increased to near pre-stroke levels in the 2 nd and 3 rd days following stroke.