cssi/SciSciGPT-SciSciNet huggingface dataset:
Early Magnetic Resonance Imaging Decreases Hospital Length of Stay in Patients with Ischemic Stroke.

Abstract Background Imaging modalities are important part of stroke evaluation. Noncontrast head computed tomography (CT) is the initial imaging modality in acute stroke and although important to rule out acute hemorrhage and making a decision on thrombolytic treatment, ischemic changes may not be visible on CT for up to 24 hours. Magnetic resonance imaging (MRI) brain is an invaluable tool to confirm an ischemic stroke and facilitates stroke evaluation. Objective of this study was to investigate the correlation between time to MRI and length of hospital stay. Methods A total of 432 patients admitted to Hartford Hospital (Comprehensive Stroke Center) with a focal neurological deficit in the year 2014 and got a CT head and MRI brain were enrolled in the study. Data collection was done via stroke database and retrospective chart review. Patients with any hemorrhage or age Results There was a statistically significant difference in hospital length of stay between patients who obtained MRI within 12 hours, as compared with patients who had MRI greater than 12 hours after admission, early MRI group 3 days (1.8, 4.9) versus 4 days (2.6, 7.0), P Conclusions Our study suggests that brain MRI performed within 12 hours of admission facilitates stroke evaluation and decreases hospital length of stay. It provides evidence for cost effectiveness of MRI in ischemic stroke.
CORONARY VASOSPASM AS A CAUSE OF CARDIAC ARREST

Identifying the cause of an out-of-hospital cardiac arrest can be challenging. In a patient with chest pain, documented ventricular tachycardia, a structurally normal heart, and non-obstructive coronary artery disease, what else should be considered? A 48 year old man with Graves' Disease suffered
3-D Implicit–Explicit Hybrid Finite Difference/Spectral Element/Finite Element Time Domain Method Without a Buffer Zone

A nonconformal hybrid finite difference time domain (FDTD)/finite element time domain (FETD) method was previously introduced, which implemented the hybridization through a buffer zone. Although this method has been demonstrated to be accurate and long-time stable, further efforts are still desirable to remove the buffer zone and to implement an implicit–explicit time integration from the perspective of practical applications. In this paper, a novel hybrid method is proposed, which not only successfully eliminates the necessity of the buffer zone without compromising the featured advantage (e.g., nonconformal mesh) but also effectively applies an implicit–explicit time integration scheme to improve the computational efficiency. Furthermore, the new method extends the hybridization to a broader level by incorporating the spectral element time domain (SETD) method based on the discontinuous Galerkin and domain decomposition techniques, resulting in a more general hybrid FDTD/SETD/FETD framework. The framework employs the explicit leapfrog time integration for the FDTD region while it employs the implicit Crank–Nicolson time integration for the FETD region. For the SETD region, either the implicit or explicit time integration can be employed, depending on the mesh sizes in it. When the implicit region becomes large, it can be further split into multiple subdomains to reduce computational complexity. Numerical examples are included to demonstrate the performance of the proposed hybrid method, which is accurate, long-time stable and more efficient than the hybrid method with a buffer zone.
Cognitive Function, Access to Kidney Transplantation, and Waitlist Mortality Among Kidney Transplant Candidates With or Without Diabetes

Rationale & Objective Intact cognition is generally a prerequisite for navigating through and completing evaluation for kidney transplantation. Despite kidney transplantation being contraindicated for those with severe dementia, screening for more mild forms of cognitive impairment before referral is rare. Candidates may have unrecognized cognitive impairment, which may prolong evaluation, elevate mortality risk, and hinder access to kidney transplantation. We estimated the burden of cognitive impairment and its association with access to kidney transplantation and waitlist mortality. Study Design Prospective cohort study. Setting & Participants 3,630 participants (January 2009 to June 2018) with cognitive function measured (by the Modified Mini-Mental State Examination [3MS]) at kidney transplantation evaluation at 1 of 2 transplantation centers. Predictors Cognitive impairment (3MS score Outcomes Listing, waitlist mortality, and kidney transplantation. Analytical Approach We estimated the adjusted chance of listing (Cox regression), risk for waitlist mortality (competing-risks regression), and kidney transplantation rate (Poisson regression) by cognitive impairment. Given potential differences in cause of cognitive impairment among those with and without diabetes, we tested whether these associations differed by diabetes status using a Wald test. Results At evaluation, 6.4% of participants had cognitive impairment, which was independently associated with 25% lower chance of listing (adjusted HR, 0.75; 95% CI, 0.61-0.91); this association did not differ by diabetes status (Pinteraction=0.07). There was a nominal difference by diabetes status for the association between cognitive impairment and kidney transplantation rate (Pinteraction=0.05), while the association between cognitive impairment and waitlist mortality differed by diabetes status kidney transplantation rates (Pinteraction=0.02). Among candidates without diabetes, those with cognitive impairment were at 2.47 (95% CI, 1.31-4.66) times greater risk for waitlist mortality; cognitive impairment was not associated with this outcome among candidates with diabetes. Limitations Single measure of cognitive impairment. Conclusions Cognitive impairment is associated with a lower chance of being placed on the waitlist, and among patients without diabetes, with increased mortality on the waitlist. Future studies should investigate whether implementation of screening for cognitive impairment improves these outcomes.
Impact of Postoperative Opioid Use on 2-Year Patient-Reported Outcomes in Knee Surgery Patients

The objectives of this study are to assess perioperative opioid use in patients undergoing knee surgery and to examine the relationship between preoperative opioid use and 2-year postoperative patient-reported outcomes (PROs). We hypothesized that preoperative opioid use and, more specifically, higher quantities of preoperative opioid use would be associated with worse PROs in knee surgery patients. We studied 192 patients undergoing knee surgery at a single urban institution. Patients completed multiple PRO measures preoperatively and 2-year postoperatively, including six patient-reported outcomes measurement information system (PROMIS) domains; the International Knee Documentation Committee (IKDC) questionnaire, numeric pain scale (NPS) scores for the operative knee and the rest of the body, Marx's knee activity rating scale, Tegner's activity scale, International Physical Activity Questionnaire, as well as measures of met expectations, overall improvement, and overall satisfaction. Total morphine equivalents (TMEs) were calculated from a regional prescription monitoring program. Eighty patients (41.7%) filled an opioid prescription preoperatively, and refill TMEs were significantly higher in this subpopulation. Opioid use was associated with unemployment, government insurance, smoking, depression, history of prior surgery, higher body mass index, greater comorbidities, and lower treatment expectations. Preoperative opioid use was associated with significantly worse 2-year scores on most PROs, including PROMIS physical function, pain interference, fatigue, social satisfaction, IKDC, NPS for the knee and rest of the body, and Marx's and Tegner's scales. There was a significant dose-dependent association between greater preoperative TMEs and worse scores for PROMIS physical function, pain interference, fatigue, social satisfaction, NPS body, and Marx's and Tegner's scales. Multivariable analysis confirmed that any preoperative opioid use, but not quantity of TMEs, was an independent predictor of worse 2-year scores for function, activity, and knee pain. Preoperative opioid use and TMEs were neither independent predictors of met expectations, satisfaction, patient-perceived improvement, nor improvement on any PROs. Our findings demonstrate that preoperative opioid use is associated with clinically relevant worse patient-reported knee function and pain after knee surgery.
Open Budgetary Meetings Amid a Pandemic: Assessing Connecticut’s Various Pathways to Public Engagement During COVID-19

This qualitative analysis of public participation in Connecticut open meetings highlights how Connecticut communities adjusted when the state’s open meeting law was temporarily revised under emergency order during COVID-19. A survey of officials in 95 municipalities found a majority had the same or more participation in budget deliberations during that time. Only about a quarter saw decreased public participation. A closer look at four communities highlights specific challenges and successes during the sudden shift in public meetings. Connecticut’s varied forms of government give multiple perspectives, which can provide insight for other communities looking to expand virtual access to open meetings.
Applied Surgical Anatomy of the Buccal Fat Pad

SUMMARY As discussed in a previous article (Systematic Aesthetic Evaluation of the Cheeks for Cosmetic Surgery), it is not uncommon for individuals seeking cosmetic facial surgery to exhibit fullness or, occasionally, deficiencies of the buccal area. The patient may express concerns either that the cheeks are too full or that there is a lack of definition or relative prominence of the cheek bones. Either of these expressed concerns often is secondary to localized lipomatosis of the buccal fat pads. In these instances, cosmetic surgical revision of the fat pads can, either as an isolated procedure or, more often, in concert with other cosmetic or orthognathic procedures, enhance the cosmetic result.
Fundus motion during mfERG testing

The purpose of this study was to assess eye movements during a multifocal ERG (mfERG) recording. This study evaluated the relationship between bivariate contour ellipse areas (BCEAs), mfERG amplitudes (Amps) and mfERG implicit times (ITs) with repeat testing and experienced subjects. Thirty subjects were selected (15 experienced to ocular procedures and 15 novices). All were confirmed to have healthy retinas and at least 20/25 vision. MfERGs with a stimulus near 100% contrast and 4-min m-sequence were recorded on two different days using our common clinical technique, which did not constrain the head. VERIS with fundus monitoring system was used for recording with a Burian-Allen electrode. An external camera captured the fundus during each mfERG recording. The optic nerve head position was tracked in each video using a custom algorithm in order to determine BCEAs. Each subject performed one mfERG on two different days. MfERGs were analyzed for Amps and ITs for the fovea and whole eye. There was no correlation between the mfERG metrics and BCEAs with repeat testing. There were also no differences between the experienced and novice subjects for mfERG Amps, ITs or BCEAs. Eye movements between visits were highly correlated (multiple r = 0.67). BCEAs were larger during mfERGs (1.04 ± 0.8 deg2) than those observed in previous literature using brief viewing tasks (< 0.3 deg2). The proportion of time spent fixating within 1.0 and 2.0 degrees of the central hexagon was 68 and 93%, respectively. This study is the first to evaluate the stability of the retina while recording a mfERG in healthy subjects and indicates that the center of fixation during a mfERG stays within the central hexagon. Eye stability during an initial recording is the best indicator of stability on the second recording. The amount of movement during these recordings did not seem to affect the mfERG Amps or ITs. These data suggest clinical confidence with mfERGs when recording novice patients.
Abstract P304: A Novel Method for Modeling Flow in Cerebral Vasculature Diagnostics

Introduction: We examined the viability of pairing wire-obtained flow pressure data with computational fluid dynamic (CFD) analysis for accurate patient-specific 3D reconstruction of flow through c...
Mothers as Home DJs: Recorded Music and Young Children's Well-Being During the COVID-19 Pandemic

As the COVID-19 pandemic continues to disrupt our lives in unimagined ways, families are reinventing daily rituals, and this is likely true for musical rituals. This study explored how parents with young children used recorded music in their everyday lives during the pandemic. Mothers (N = 19) of child(ren) aged 18 months to 5 years living in the United States played the role of home DJ over a period of one week by strategically crafting the sonic home environment, based on resources provided by the authors, in response to their children's mood and state. Using a newly developed data collection tool, inspired by the Experience Sampling Method, a total of 197 episodes were collected about children's engagement with recorded music. Findings showed that while mothers utilized music to fulfill various emotional needs, they tended to use it to maintain or reinforce their child's positive mood rather than to improve a negative mood. Also, mothers' reports suggested various ways that young children engaged with music, being aligned with the multimodal nature of their musical experiences. Lastly, mothers reported that their strategic approaches to use recorded music seemed to help their children feel less distressed and happier, and this, in turn, aided in the reduction of some of the burdens associated with parenting.
Transoral Incisionless Fundoplication (TIF)

This chapter will review anti-reflux procedures and the diseases treated along with the goals of treatment. The equipment and supplies needed along with procedure set up will be reviewed and laid out in set by step instructions. Pre, intra and post procedure nursing considerations along with patient discharge instructions and follow up will be reviewed.
Empowerment and Post-Conflict Peacebuilding

This chapter examines the role that empowerment plays in post-conflict peacebuilding processes in Nigeria’s oil region. Based on empirical evidence, the chapter addresses the understudied problem of whether and how DDR programs empower former insurgents and the modalities and forms of empowerment. It powerfully shows the means by which ex-insurgents can be empowered—its various meanings and instruments—and how this is a central plank of post-conflict peacebuilding while at the same time showing the limits of this technocratic model of empowerment. The participants’ differing perceptions of empowerment and disempowerment as reflected in their understanding of the impacts of specific DDR interventions are discussed conceptually and analytically. The emphasis on power and how trust in the peacebuilding program is radically compromised by inefficiencies arising from poor DDR programming highlights some key findings in the author’s analysis that add substantial insight to this book.
Lefthanders Do Just the Opposite

(1976). Lefthanders Do Just the Opposite. Journal of Physical Education and Recreation: Vol. 47, No. 1, pp. 31-31.
In vitro recombination and mutagenesis of DNA. SOEing together tailor-made genes.

Gene Splicing by Overlap Extension (gene SOEing) provides a powerful method of recombining sequences without depending on restriction sites or ligase, and a simple, generally applicable way of using polymerase chain reaction (PCR) to perform site-directed mutagenesis in vitro. This technique allows even those with minimal molecular biology expertise to generate quickly genetic constructs that might otherwise have been impractical using only the older (restriction enzymebased) technology.
Mortality Risk and Pulmonary Function in Adults With Cystic Fibrosis at Time of Wait Listing for Lung Transplantation

Background Lung transplantation (LTx) benefit for survival in cystic fibrosis (CF) patients placed on the wait list is not well studied. Methods To predict the relationship between initial forced expiratory volume in 1 second (FEV 1 ) and forced vital capacity (FVC) and the hazard ratio (HR) associated with LTx in CF patients, the United Network for Organ Sharing database was queried from 2005 to 2006 for adult patients with CF. Survival was assessed from wait list entry time until death on wait list, death after LTx, or censoring. Multivariate Cox proportional hazards models were used to assess the effect of LTx. The first model estimated the HR of LTx with adjustment for FEV 1 or FVC and other covariates, and the second model estimated the HR of LTx conditional on FEV 1 or FVC at listing. Results Two hundred seventy-eight patients with CF were included in the cohort, and 277 were used for survival analysis. Lung transplantation reduced the risk for death controlling for FEV 1 (HR, 0.601; 95% confidence interval, 0.375 to 0.964; p = 0.035) or controlling for FVC (HR, 0.547; 95% confidence interval, 0.336 to 0.889; p = 0.015). Interaction models found that the HR of LTx varied significantly across initial FEV 1 and FVC, with the predicted LTx HR and 95% confidence interval being protective (HR 1 of 25% or less and FVC of 40% or less, respectively. Conclusions The benefit of LTx in adults with CF was significant at a lower baseline FEV 1 than expected. A threshold for baseline FVC was established below which LTx was protective.
Analyzing the CRF Java memory model

The current Java memory model is flawed and has many unintended implications. As multithreaded programming becomes increasingly popular in Java and hardware memory architectures become more aggressively parallel, it is of significant importance to provide a framework for formally analyzing the Java memory model. The Mur/spl phi/ verification system is applied to study the commit/reconcile/fence (CRF) memory model, one of the proposed thread semantics to replace the present Java memory model. The CRF proposal is formally specified using the Mur/spl phi/ description language. A suite of test programs is designed to reveal pivotal properties of the model. The results demonstrate the feasibility of applying model checking techniques to language level memory model specifications. Not only can it help the designers to debug their designs, it also provides a formal mechanism for Java programmers to understand the subtleties of the Java memory model.
Assessing Gaming, Computer and Scientific Inquiry Self-efficacy in a Virtual Environment

“She’s here!” the whispers spread through the room. I had arrived to give my volunteer science lesson to my daughter’s fifth-grade class. These children loved science. For them, this subject was the high point of the day. Yet, as a former veteran secondary science teacher, I know that this is not true of older children. Somewhere between elementary and high school, many students disengage from science, partially because they develop a belief that they can’t succeed in science (Clark, 1999; Farenga & Joyce, 1998).
Celiac Sprue and Crohn's Disease: An Association Causing Severe Growth Retardation

Celiac sprue and Crohn's disease have very rarely been documented in the same patient. We report a case involving an adolescent male with known Crohn's disease who had extreme wasting, growth retardation, intractable diarrhea, and delay in development of secondary sexual characteristics. Peroral jejunal biopsy showed a nonspecific flat mucosal lesion compatible with celiac sprue. An 8.0-kg weight increase occurred within 4 weeks of institution of a gluten-free diet. Jejunal rebiopsy documented significant improvement with a mild to moderate villous abnormality. After 2 years on a gluten-free diet, a rebiopsy of the jejunum documented only a mild villous abnormality.
Expanded Gram-Negative Antimicrobial Prophylaxis Reduces Surgical Site Infections in Hip Arthroplasty

Abstract Background A first-generation cephalosporin is the recommended antibiotic prophylaxis for implants. However, this standard does not address the increasing prevalence and virulence of gram-negative pathogens infecting patients. We found that gram-negative bacilli caused 30% of our surgical site infections (SSIs) following hip procedures, whereas only 10% of knee SSIs were caused by gram-negative bacilli. To address this, we instituted Expanded Gram-Negative Antimicrobial Prophylaxis (EGNAP) for our hip arthroplasty patients. The purpose of this study is to measure the effect of EGNAP on the SSI rates following primary total hip arthroplasty. Methods The study consisted of 10,084 total patients. Before July 2012, all patients were administered 1 g of cefazolin. After July 2012, our protocol was adjusted by adding the EGNAP with either gentamicin or aztreonam to hip patients (group 1) and not to the knee arthroplasty patients (group 2). Results Group 1 consisted of the 5389 primary hip arthroplasty patients. Of these patients, 4122 (before July 2012) did not receive weight-based high-dose gentamicin and 1267 (after July 2012) did. Before the introduction of EGNAP, group 1 SSI rate was 1.19% (49/4122). After July 2012 when EGNAP was added, the overall group 1 SSI rate decreased to 0.55% (7/1267) ( P = .05). During the study period, there was not a significant difference in SSI rate of knee arthroplasty (group 2): 1.08% vs 1.02% ( P = .999). Conclusions The addition of EGNAP for hip arthroplasty is a safe and effective method to decrease SSIs. Level of Evidence: III. Case-control study.
Fatigue in human thenar muscles paralysed by spinal cord injury

Muscle fatigue (force loss) induced by constant frequency stimulation (36 Hz) and variable rate stimulation (36 Hz to 18 Hz over 60 s) were compared in six individuals with thenar muscles which were paralysed by chronic cervical spinal cord injury (SCI), and in six volunteers with no known neurological disorder. The variable stimulation rate pattern represented the general decline in thenar motor unit firing rates recorded during 60 s maximum voluntary contractions performed by the able-bodied (AB) subjects. Constant and variable rate stimulation produced similar resultant force declines, as measured from abduction and flexion force components. However, significant force loss always occurred earlier and was of greater magnitude in SCI subjects, irrespective of the stimulation pattern (all, P < 0.01). Because more force was generally lost in one force component versus the other, the direction of the resultant force could also change with fatigue. The recordings from SCI participants were also contaminated by spontaneous motor unit activity, spasms and F responses. The stimulation frequency needed to produce half-maximum tetanic force increased for SCI subjects after fatigue, so higher, not lower stimulation frequencies were needed to produce any given submaximal force. Therefore, to match stimulation rate to changes in muscle contractile properties, these parameters have to be monitored and controlled on-line. The fatigue during each stimulation protocol, and for each subject population, was attributed primarily to contractile failure because any decrements in M-wave amplitude or area recovered completely within the first minute whereas twitch and tetanic forces remained somewhat depressed.
Shear force/reflection near-field scanning optical microscopy

The spatial resolution afforded by near-field scanning optical microscopy (NSOM) is primarily a function of tip size and tip-sample separation. Combining scanning force microscopy with NSOM allows one to maintain a small tip-sample separation distance and, consequently, optimize NSOM resolution. This provides, simultaneously, a topographic perspective of the sample as well as an NSOM image. We present, in this paper, an instrument that provides simultaneous shear force and reflection NSOM images. We also incorporate a tip deflection detection scheme that allows the force signal to be completely decoupled from the optical signal. In order to accurately analyze the NSOM images, it is important to understand the feedback mechanism so that proper image deconvolution can be performed. Considerations concerning the forces measured are made. A discussion concerning Raman scattering capabilities in this regime is also provided, along with some preliminary Raman data.
Morphological characterization of plastic solar cells using polarized neutron reflectivity

Thermal annealing is known to significantly improve the photovoltaic performance of poly(3-hexylthiophene) and phenyl-C61-butyric acid methyl ester (P3HT:PCBM) bulk heterojunction solar cells. We have used polarized neutron reflectometry to compare the PCBM depth profiles of the same P3HT:PCBM film before and after annealing at conditions know to improve the photovoltaic efficiencies of similarly prepared devices. Contrary to previous findings, annealing is shown to have little effect on the vertical PCBM concentration profile. We attribute the improved efficiency from thermal annealing to increased P3HT crystallinity and/or change in crystal orientation, which inhibits exciton recombination.
Adaptation of Estrogen-regulated Genes in Long-term Estradiol Deprived MCF-7 Breast Cancer Cells

First line treatment of hormone dependent breast cancer initially causes tumor regression but later results in adaptive changes and tumor re-growth. Responses to second line treatments occur but tumors again begin to progress after a period of 12–18 months. In depth understanding of the adaptive process would allow the identification of targets to abrogate the development of hormonal resistance and prolong the efficacy of endocrine therapy. We have developed a model system to examine adaptive changes in human MCF-7 breast cancer cells. Upon deprivation of estradiol for a prolonged period of time, a maneuver analogous to surgical oophorectomy in pre-menopausal women and use of aromatase inhibitors in post-menopausal patients, tumor cells adapt and become hypersensitive to estradiol. We reasoned that the expression pattern of multiple genes would change in response to estradiol deprivation and that cDNA microarrays would provide an efficient means of assessing these changes. Accordingly, we examined the transcriptional responses to estradiol in long-term estradiol deprived (LTED) MCF-7 cells with a cDNA microarray containing 1901 known genes and ESTs. To assess the changes induced by long-term estradiol deprivation, we compared the effects of estradiol administration in LTED cells with those in MCF-7 cells, which we had previously reported, and confirmed with real time PCR using the parental and LTED cells. Seven genes and one EST were induced by estradiol in LTED but not in wild type MCF-7 cells, whereas ten genes were down-regulated by estradiol only in LTED cells. The expression of seven genes increased concurrently and five decreased in response to estradiol in both cell types. From these observations, we generated testable hypotheses regarding several genes including DKFZP, RAP-1, ribosomal protein S6, and TM4SF1. Based upon the known functions of these genes and the patterns of observed changes, we postulate that divergent regulation of these genes may contribute to the different biologic responses to estrogen in these cell lines. These results provide targets for further mechanistic studies in our experimental system. Our findings indicate that long-term estradiol deprivation causes expression changes in multiple genes and emphasizes the complexity of the process of cellular adaptation.
Journal Club: Is the Golden Hour Tarnished? Registries and Multivariable Regression

WHAT IS ALREADY KNOWN ON THIS TOPIC: The "golden hour" concept in trauma is pervasive despite little evidence to support it. WHAT QUESTION THIS STUDY ADDRESSED: Is there an association between various emergency medical services (EMS) intervals and in-hospital mortality in seriously injured adults? WHAT THIS STUDY ADDS TO OUR KNOWLEDGE: In 3,656 injured patients with substantial perturbations of vital signs or mental status, transported by 146 EMS agencies to 51 trauma centers across North America, no association was found among any EMS interval and mortality. HOW THIS MIGHT CHANGE CLINICAL PRACTICE: This study suggests that in our current out-of hospital and emergency care system time may be less crucial than once thought. Routine lights-and-sirens transport for trauma patients, with its inherent risks, may not be warranted.
The Dreamkeepers: Successful Teachers of African American Children

Foreword to the New Edition. Preface. The Author. 1. A Dream Deferred. 2. Does Culture Matter? 3. Seeing Color, Seeing Culture. 4. We Are Family. 5. The Tree of Knowledge. 6. Culturally Relevant Teaching. 7. Making Dreams into Reality. Afterword. Appendix A: Methodology. Appendix B: Context. Notes. Index. Discussion Questions.
Computing optical rotation via an N-body approach

Properties of four chiral compounds—(S)- methyloxirane, (S)-methylthiirane, (S)-2-chloropropionitrile, and (M)-dimethylallene—centered in a solvation shell of six to seven water molecules have been computed using time-dependent density functional theory at several wavelengths using a many-body expansion. Interaction energies, total system dipole moments, and dynamic dipole polarizabilities converge rapidly and smoothly, exhibiting only minor oscillations with higher-body contributions. At three-body truncation of the expansion, errors in such properties as compared to the full cluster typically fall to less than 1 % (and much smaller in most cases). Specific optical rotations, however, are found to converge much more slowly and erratically, requiring five-body contributions to obtain errors less than 5 % in three of four test cases, and six-body terms for (S)-methylthiirane. The source of this behavior is found to be the wide variation of both magnitude and sign of the specific rotation with changes in the configuration of individual solute/solvent clusters. Thus, unlike simpler properties such as energies or dipole moments, where each fragment makes a small, same-sign contribution to the total property, specific rotations typically involve much larger contributions that partly cancel in the many-body expansion. Thus, the computational costs of molecular dynamics simulations of explicit solvation, for example, will be only partially alleviated by such expansions.
Medical Management of Carotid Stenosis

Stroke is a leading cause of morbidity and mortality in the developed world. Although the rates of stroke have decreased in North America, there are significant areas of risk stratification and management that can be improved. Hypertension is the most significant and perhaps most modifiable risk factor for stroke. Carotid atherosclerotic disease is associated with 15% of ischemic strokes. Although carotid endarterectomy (CEA) remains a recommendation for significant symptomatic carotid stenosis, controversy continues in the management of asymptomatic and recurrent carotid stenosis. Medical management options and effectiveness has significantly improved since the early CEA trials were published. Optimal medical management now must incorporate aggressive risk factor reduction measures, particularly with antihyperlipidemic therapy. Improved understanding of the natural history of carotid atherosclerosis is necessary to improve the application of management strategies.
Collagenase from rabbit pulmonary alveolar macrophages

Abstract Rabbit pulmonary alveolar macrophages produce a collagenase which lyses labeled collagen gels, specifically cleaves collagen types I, II and III, is inhibited by ethylenediaminetetraacetate, cysteine, dithiothreitol and serum but is not inhibited by a serine protease inhibitor. Alveolar macrophage collagenase activity can be enhanced by in vivo BCG activation, in vitro latex, silica or mycobacterium activation and by in vitro uncovering of latent enzymatic activity with trypsin treatment. The production of collagenase by unactivated alveolar macrophages and the presence of “latent” collagenase in culture media of alveolar macrophages are examples of significant differences between alveolar and peritoneal macrophages.
An experimental study of mixing and instability development in variable-density systems

Abstract This study presents results of flow-tank experiments on variable-density flow in a layered system. Less dense water displaced more dense water in a system layered with a lower over a higher hydraulic conductivity unit. This configuration created a potentially unstable interface between the displaced water and the displacing water. The displacing water wedge (i.e., less dense water) in the higher hydraulic conductivity layer traveled downgradient faster than the displacing water wedge moving in the layer above. Downward movement of more dense water from the upper layer into the freshwater wedge in the lower layer caused the latter to become more saline. Flow rate and density difference between displacing and displaced water, and hydraulic conductivity difference between layers, were each analyzed for their effect on mixing behavior in this system. Fluid movement and mixing processes were monitored using time sequence photography. Digital processing of black and white negatives provided a large and semi-continuous data base of concentration values to analyze the salinization of the displacing water. In many cases, the unstable stratification and density gradient also promoted the upward growth of finger-shaped instabilities into the less permeable layer. An analytical stability analysis was able to reasonably predict the wavelength of these fingers. Results from the experiments suggest that density variations can promote complex flow and mixing patterns in even the simple layered systems considered herein. This conclusion has important implications for both contaminant transport and fluid displacement processes occurring during remediation.
Copper(II) and Nickel(II) Complexes of Binucleating Macrocyclic Bis(disulfide)tetramine Ligands

Novel macrocyclic bis(disulfide)tetramine ligands and several Cu(II) and Ni(II) complexes of them with additional ligands have been synthesized by the oxidative coupling of linear tetradentate N2S2...
Historical Variation of Water Levels in Lakes Erie and Michigan-Huron

The earliest reliable water level measurements for Lakes Erie and Michigan-Huron are recorded from 1819. These early measurements are reviewed along with the “modern” data set beginning in 1860. Historical and archaeological evidence at European settlements on the Great Lakes from the early 17th century is used to shed light on the water level history of these lakes prior to 1819. Stratigraphic evidence from Lake Michigan-Huron over the past 1,800 years is interpreted to deduce water levels over this time period. When the effects on the lake levels of is ostatic rebound and man-made channel changes are examined, it is concluded that, over at least the last 1,800 years, climate-related variations in maximum mean annual water levels have probably not exceeded those measured on Lakes Erie and Michigan-Huron since A.D. 1819.
Depth of processing and ear differences in memory for sentences

Abstract Sentences were monaurally presented to subjects who were required to perform either a superficial (word-matching) or meaningful (thematic analysis) orienting task during presentation. A right-ear advantage was observed for speed of response under both processing conditions, but only sentences that had been meaningfully processed showed a right-ear advantage on a test of long-term memory. It is suggested that the left hemisphere is specialized for the meaningful use of language as well as for speech perception.
The dnaK protein modulates the heat-shock response of Escherichia coli

Abstract E. coli bacteria respond to a sudden upward shift in temperature by transiently overproducing a small subset of their proteins, one of which is the product of the dnaK gene. Mutations in dnaK have been previously shown to affect both DNA and RNA synthesis in E. coli. Bacteria carrying the dnaK 756 mutation fail to turn off the heat-shock response at 43°C. Instead, they continue to synthesize the heat-shock proteins in large amounts and underproduce other proteins. Both reversion and P1 transduction analyses have shown that the failure to turn off the heat-shock response is the result of the dnaK 756 mutation. In addition, bacteria that overproduce the dnaK protein at all temperatures undergo a drastically reduced heat-shock response at high temperature. We conclude that the dnaK protein is an inhibitor of the heat-shock response in E. coli.
Crossing and looping methods in radical interstitial therapy for lateral and posterior oro-, hypopharyngeal tumors

Abstract 192 Ir looping and crossing methods as a means of megavoltage tumor dose boosting have been applied for Stage II and III lateral and posterior oro-, hypopharyngeal tumors. A megavoltage and interstitial combined dose in excess of 9000 rad resulted in a soft tissue injury in two patients. Nevertheless, all five patients are alive without residual tumor at 8–38 months. We believe that a megavoltage dose of 5200 rad plus interstitial doses of 3000–3500 rad with a four week rest period intervening may improve cure rate at an acceptable injury rate.
Postischemic treatment (2–4 h) with anti-CD11b and anti-CD18 monoclonal antibodies are neuroprotective after transient (2 h) focal cerebral ischemia in the rat

We investigated the effects of F(ab')2 fragments of anti-CD11b and anti-CD18 monoclonal antibodies on ischemic cell damage in the rat when administered upon reperfusion and at 2 h of reperfusion after transient (2 h) middle cerebral artery (MCA) occlusion. 2 h of MCA occlusion was induced by intraluminal insertion of a monofilament. The following groups of animals were investigated. Anti-CD11b groups (n = 15): an intact anti-CD11b antibody (1B6c) and an anti-CD11b F(ab')2 fragment of 1B6c were infused upon reperfusion (4 mg/kg i.v.). Anti-CD18 group (n = 8): an anti-CD18 F(ab')2 fragment of CL26 was infused upon reperfusion (2 mg/kg i.v.), and at 22 h of reperfusion (1 mg/kg i.v.). Anti-CD11b delayed group (n = 9): an anti-CD11b F(ab')2 fragment of 1B6c was infused at 2 h of reperfusion (4 mg/kg i.v.), and at 22 h after reperfusion (2 mg/kg i.v.). Control groups (n = 18): an isotype-matched control antibody (mouse IgG1) was administered: (a) upon reperfusion (n = 13), and (b) at 2 h and 22 h of reperfusion (n = 5). Rats were sacrificed at 7 days of reperfusion. In a separate population of rats subjected to 2 h of MCA occlusion (n = 9), brain myeloperoxidase (MPO) activity was measured at 46 h of reperfusion. The vehicle groups had infarct volumes of 35.21 +/- 2.82% to 41.39 +/- 2.73% of the contralateral hemisphere, respectively. Infarct volume was significantly reduced after treatment with: the intact anti-CD11b antibody upon reperfusion (19.0 +/- 6.6%) (P < 0.05), the fragments of mAbs of anti-CD11b administered upon reperfusion (19.7 +/- 2.7%) (P < 0.05), and at 2 h of reperfusion (22.2 +/- 4.8%) (P < 0.05), and anti-CD18 administered upon reperfusion (20.4 +/- 4.8%) (P < 0.05). Anti-CD11b treatment significantly (P < 0.05) inhibited the increase of MPO activity in the ischemic hemisphere. Our data demonstrate that anti-CD11b and anti-CD18 mAb fragments significantly reduce infarct volume and inhibit the increase of MPO activity in the ischemic lesion; administration of anti-CD11b mAb fragment even at 2 h of reperfusion significantly reduces infarct volume. These data support importance of the beta 2 integrin CD11b/CD18 in ischemia/reperfusion injury and indicate that the therapeutic window for intervention to reduce ischemic cell damage in this model is at least 4 h from the onset of MCA occlusion.
Material force for dynamic crack propagation in multiphase micromorphic materials

Micromorphic theory, which considers material body as a continuous collection of deformable particles of finite size and inner structure; each has nine independent degrees of freedom describing the stretches and rotations of the particle in addition to the three classical translational degrees of freedom of its center, is briefly introduced in this work. The concept of material forces, which may also be referred as Eshelbian mechanics, is extended to micromorphic theory. The balance law of pseudo-momentum is formulated. The detailed expressions of Eshelby stress tensor, pseudo-momentum, and material forces are derived for thermoelastic micromorphic solid. It is found that the material forces are due to (1) body force and body moment, (2) temperature gradient and (3) material inhomogeneities in density, microinertia, and elastic coefficients. The general expression of material forces due to the presence of dynamically propagating crack front has also been derived. It is found that, at the crack front, material force is reduced to the J-integral in a very special and restrictive case.
Long-term effect of trauma splenectomy on blood glucose

Abstract Background Increasing evidence suggests that the spleen harbors stem cells that act as precursors to insulin-producing pancreas cells. Additionally, small studies with short-term follow-up associate splenectomy with increased rates of diabetes mellitus. The purpose of this study was to analyze the long-term effect of trauma splenectomy on blood glucose. Materials and methods Patients were included if a blood glucose level was measured more than 5 y after trauma splenectomy or laparotomy with bowel repair. Mean blood glucose level was then compared between the two groups. Results During the 10-y study period 61 patients underwent trauma splenectomy and 50 survived until discharge. In comparison, 229 patients underwent trauma laparotomy and bowel repair and 207 survived until discharge. Nine splenectomy patients compared with 12 control patients had, blood glucose measured at least 5 y after initial trauma. Mean follow-up period was not significantly different between groups (splenectomy 82.8 ± 17.6 mo versus control 96.0 ± 44.3 mo, P = 0.41). In the splenectomy cohort mean glucose level was significantly higher compared with the control (114 ± 34 mg/dL versus 90 ± 13 mg/dL, P = 0.04), as was the number of patients with recorded blood glucose level greater than 130 mg/dL (4 patient versus 0 patients P = 0.02). One new diagnosis of diabetes mellitus was noted only in the trauma splenectomy cohort. Conclusions This small study suggests that trauma splenectomy may be associated with hyperglycemia at long-term follow-up.
Compact, robust source of cold atoms for efficient loading of a magnetic guide

Abstract We report a compact ( 3 ), robust source for producing a bright flux of cold atoms, which can be loaded efficiently into a magnetic guide. A continuous flux of up to 8 × 10 9 87 Rb atoms/s have been produced from this 2D+ vapor cell MOT. The flux had a divergence of 12.5 mrad and velocity could be controlled in the range 2–15 m/s. This flux was coupled continuously into a magnetic guide with high efficiency.
Continuing Validation of the Teaching Autonomy Scale

Although researchers have demonstrated a link between teacher autonomy and teacher motivation, job satisfaction, stress (burnout), professionalism, and empowerment, the task of identifying the underlying theoretical dimensions of teacher autonomy has met with varied results. The authors verified the existing 2-factor structure of the Teaching Autonomy Scale (TAS) derived from a previous study (Pearson & Hall, 1993) and analyzed the data with confirmatory factor analysis (LISREL). The results of the replication of the earlier study of the TAS supported the internal consistency reliability of the scores and the original factors of general teaching autonomy and curriculum autonomy.
Effects of interleaflet coupling on the morphologies of multicomponent lipid bilayer membranes

We investigate dynamical and stationary compositional and surface morphologies in macroscopically phase-separating multicomponent lipid bilayer membranes using a computational model. We employ a phase-field method for the description of the coexisting phases and treat the two leaflets individually while including interleaflet interactions. The compositional evolution of the two leaflets is coupled to the shape evolution of the membrane via a Helfrich free energy with a composition-dependent spontaneous curvature. We investigate the effects of the interleaflet interaction on the dynamics and stationary states of a system favoring nonzero spontaneous curvatures. Morphological phase diagrams are mapped in composition space using three different interleaflet coupling strengths. We find that characteristics sensitive to the coupling strength include the time required to develop regions of fully separated phases, the prevalence of a stripe morphology, and the shifting of phase compositions to accommodate energetically favorable interactions across leaflets. Characteristics found to be robust with respect to coupling strength include (1) the stripe morphology is favored at nearly equal mixtures and (2) phase separation is prevented in systems where a pair of phases that preferentially interact across leaflets together occupy nearly all or none of the membrane.
Olfaction in Parkinson's Disease

It has become increasingly apparent that Parkinson's disease (PD) can no longer be considered purely a motor disease, as numerous sensory alterations accompany this disorder either before or early in its clinical progression. Most notable among such disturbances are decrements in smell function. Such anomalies have been documented in approximately 90% of patients with early-stage sporadic PD and appear to progress little, if at all, with the development of the more classic PD-related motor symptoms. In this paper, I briefly review the nature of the olfactory dysfunction observed in PD and current theories as to its pathological basis.
Insulin sensitivity in cardiological syndrome X

OBJECTIVES To test whether cardiological syndrome X is an insulin-resistant state. SETTING, DESIGN AND SUBJECTS: The coronary care unit of a referral centre for angina pectoris in Pisa, Italy. A case-control study, involving 10 patients with unequivocal (angiographycally proven) cardiological syndrome X, but normal glucose tolerance, blood pressure and lipid levels, and 13 matched healthy subjects. MAIN OUTCOME MEASURES Insulin sensitivity and pattern of substrate oxidation (assessed by the euglycaemic insulin clamp technique in combination with indirect calorimetry). RESULTS Fasting plasma glucose and insulin levels were 5.05 +/- 0.11 versus 4.88 +/- 0.11 mmol l-1 and 68 +/- 10 versus 56 +/- 6 pmol l-1, respectively (controls versus patients, ns). During the insulin clamp, glucose disposal rate was nearly identical in patients and controls (25.9 +/- 1.8 and 27.2 +/- 1.8 mumol kg-1 min-1, respectively. P = 0.88). Non-oxidative glucose disposal accounted for similar proportions of total glucose uptake (59 versus 53%, patients versus controls, ns). Resting energy expenditure (13.7 +/- 0.6 versus 13.8 +/- 0.8 cal kg-1 min-1, ns) and insulin-induced thermogenesis were similar in the two groups. Fasting plasma NEFA concentrations (0.64 +/- 0.09 and 0.64 +/- 0.06 mmol l-1, patients and controls, ns) fell in a similar time-course and to virtually identical nadirs (0.13 +/- 0.02 and 0.14 +/- 0.02 mmol l-1) after insulin infusion. Fasting plasma potassium was similar in patients and controls (3.99 +/- 0.10 and 4.16 +/- 0.04 mmol l-1, ns), and insulin induced equivalent hypokalaemia (-14 versus -19%). CONCLUSIONS None of the in vivo actions of insulin were impaired in patients with 'pure' syndrome X when compared to matched controls. Therefore, we conclude that cardiological syndrome X is not an insulin resistant state per se, and that any decrease in insulin sensitivity found in this condition is likely to be secondary.