cssi/SciSciGPT-SciSciNet huggingface dataset:
Shape fidelity of native and engineered human nasal septal cartilage.

ObjectiveTo test engineered and native septal cartilage for resistance to deformation and remodeling under sustained bending loads and to determine the effect of bending loads on the biochemical properties of constructs.Study DesignProspective, basic science.SettingLaboratory.Subjects and MethodsHuman septal chondrocytes from 6 donors were used to create 12-mm constructs. These were cultured for 10 weeks and subjected to bending for 6 days. Free-swelling controls and native tissue from 6 donors were used for comparison. Shape retention, photo documentation, live-dead staining, and biochemical properties were measured.ResultsLive-dead staining showed no difference in cell survival between loaded constructs and free-swelling controls. The immediate shape retention of the constructs was 39.0% versus 24.4% for native tissue (P = .13). After 2 and 24 hours of relaxation, the constructs possessed similar shape retention to native tissue (26.9% and 16.4%; P = .126; 21.7% and 14.4%; P = .153). There was no signif...
Cytokinins: biosynthesis, metabolism and perception.

Cytokinins are essential hormones for plant growth and development. They are also of vital importance for in vitro manipulations of plant cells and tissues. The biological activities and chemistry of cytokinins are well defined but very little is known about their mode of action and it is only recently that cytokinin genes have been identified in plants. This review summarizes the current status of knowledge on cytokinin biosynthesis, metabolism and signal transduction, with an emphasis on genes encoding metabolic enzymes and putative receptors, and genes rapidly induced by cytokinins.
Stable adaptive reference trajectory modification for saturated control applications

This paper will address the issue of reference trajectory modification in the presence of actuator saturation constraints. A stable adaptive trajectory modification scheme is proposed that ensures the stability of the closed loop system under actuator constraints. Also, the specific issues of the effects of actuator constraints on controller performance and stability is studied in detail. In particular, the performance of the control law is evaluated by considering the spacecraft rendezvous problem with realistic actuator constraints. The essential ideas and results from computer simulations are presented to illustrate the algorithm developed in paper.
Inhibition of HIV-1 Replication in Human Lymphoid Tissues Ex Vivo by Measles Virus

Human immunodeficiency virus (HIV) type 1 replication and disease progression are enhanced by various pathogens in coinfected individuals. However, acute infection with measles virus (MV) has been found to suppress HIV-1 replication in coinfected children. We investigated the mechanisms of this phenomenon using human lymphoid tissues coinfected ex vivo with HIV-1 and MV. MV inhibited both CXCR4-tropic (X4) and CCR5-tropic (R5) HIV-1, but the inhibitory effect was particularly profound for R5 virus, which transmits infection and dominates the early stages of HIV-1 disease. MV inhibits the replication of R5 HIV-1 in coinfected tissues by up-regulation of the CC chemokine RANTES, a well-known inhibitor of R5 HIV-1 infection, and this up-regulation is augmented in tissues coinfected with R5 HIV-1. Deciphering the molecular mechanisms by which MV and other pathogens alter local cytokine/chemokine networks and cause tissue microenvironments to become detrimental to HIV-1 may significantly contribute to the development of effective anti-HIV therapies.
Opportunities and challenges of multiscale modeling and simulation in polymer composite processing

Composite processing, due to their heterogeneous nature, complex chemistry of the resin, its interaction with fibres and fillers and simultaneous transport of mass, momentum and energy at the nano, micro, meso and macro levels eludes formulation of process models from first principles. Hence most researchers have resorted to the use of constitutive equations along with conservation laws at the macro level to describe the relationship between various process parameters. Constitutive equations are empirical relations that endeavour to incorporate the physics observed from the experiments or studied and analyzed at the micron and molecular level into the equations at the macro scale. Almost all constitutive equations require the researchers to characterize constants needed in the equation that are specific to the material and its state. This paper will provide examples of various approaches used in our research to introduce the phenomenon observed at the micron and molecular level in process models to predict the influence of various material, geometric and process parameters on the resulting microstructure in composite manufacturing. The various pitfalls and short comings in modelling will be identified and the opportunities and challenges in integrating the physics occurring at the multi scale level into a coherent process models will be discussed. The role of numerical modelling and simulation in furthering our understanding at the micro and molecular levels and presenting the results in the form of interest to the process engineer will be accentuated with pedagogic examples. Some thoughts on how process models and their simulations can be integrated on the manufacturing floor to improve product reliability and repeatability will be provided.
Conservation genetics of freshwater fish

Genetic markers have helped to resolve many diYcult taxonomic problems and map patterns of diversity within and among remnant populations of threatened and endangered species. Knowledge of historical patterns of gene flow can help to manage dispersal among anthropogenically fragmented populations. Genetic considerations are used in the design of captive breeding programmes that avoid inbreeding depression and artificial selection that may impact on Darwinian fitness. Case studies from endangered populations of topminnows from North American deserts are used to illustrate a variety of methods used in conservation genetic studies. Several merits of studying putatively neutral, molecular markers v. adaptive phenotypic traits are discussed. ? 1998 The Fisheries Society of the British Isles
Characterization of multiaxial constitutive properties of rubbery polymers

Rubbery response of polyurea is examined under monotonic loading in the confined compression, composite compression, and Arcan shear configurations. For polyurea prepared by a casting process, it is shown that while the bulk response is significantly nonlinear, and well fitted by the Tait equation, the shear resistance is extremely small. In contrast, polyurea formed by a spray process shows significant compressibility, inelastic volumetric deformation, and significantly enhanced shear resistance.
Synovial tissue-infiltrating natural killer cells in osteoarthritis and periprosthetic inflammation.

Objective Infiltrating immune cells play a central role in degenerative joint disease associated with osteoarthritis (OA) and particle-mediated periprosthetic osteolysis. The goal of this study was to characterize a newly identified population of synovial tissue–infiltrating natural killer (NK) cells obtained from patients with OA or patients with periprosthetic joint inflammation. Methods Synovial and interfacial tissue samples were collected from patients with OA who were undergoing primary or revision total joint replacement (TJR) surgery. The histologic features of OA synovium obtained from patients undergoing primary surgery and interfacial tissue obtained from patients undergoing revision surgery were determined by immunohistochemistry and immunofluorescence. Synovial tissue–infiltrating NK cells were evaluated for the expression of surface receptors, using flow cytometry. Chemoattractant and cytokine protein and RNA levels in synovial and interfacial tissue and fluid were assessed by Luminex assay and real-time quantitative polymerase chain reaction. Cytokine production and degranulation by stimulated synovial tissue versus normal blood NK cells were evaluated by intracellular cytokine staining. Results NK cells comprised nearly 30% of the CD45+ mononuclear cell infiltrate in synovial tissue obtained from patients undergoing primary TJR and from patients undergoing revision TJR. NK cells from both groups expressed CXCR3, CCR5, L-selectin, α4 integrins, and cutaneous lymphocyte antigen. Synovial fluid from patients undergoing revision surgery contained elevated concentrations of the NK cell attractants CCL4, CCL5, CXCL9, and CXCL10; all levels in synovial fluid obtained from patients undergoing revision surgery were higher than those in synovial fluid from patients undergoing primary surgery. Cytokine-stimulated interferon-γ production was significantly impaired in NK cells derived from primary and revision TJRs compared with blood NK cells. Conclusion NK cells are a principal tissue-infiltrating lymphocyte subset in patients with OA and patients with periprosthetic inflammation and display a quiescent phenotype that is consistent with postactivation exhaustion.
Mode of Communication, Perceived Level of Understanding, and Perceived Quality of Life in Youth Who Are Deaf or Hard of Hearing

Given the important role of parent–youth communication in adolescent well-being and quality of life, we sought to examine the relationship between specific communication variables and youth perceived quality of life in general and as a deaf or hard-of-hearing (DHH) individual. A convenience sample of 230 youth (mean age = 14.1, standard deviation = 2.2; 24% used sign only, 40% speech only, and 36% sign + speech) was surveyed on communication-related issues, generic and DHH-specific quality of life, and depression symptoms. Higher youth perception of their ability to understand parents’ communication was significantly correlated with perceived quality of life as well as lower reported depressive symptoms and lower perceived stigma. Youth who use speech as their single mode of communication were more likely to report greater stigma associated with being DHH than youth who used both speech and sign. These findings demonstrate the importance of youths’ perceptions of communication with their parents on generic and DHH-specific youth quality of life.
Pattern of trauma determines the threshold for epileptic activity in a model of cortical deafferentation

Epileptic activity often occurs in the cortex after a latent period after head trauma; this delay has been attributed to the destabilizing influence of homeostatic synaptic scaling and changes in intrinsic properties. However, the impact of the spatial organization of cortical trauma on epileptogenesis is poorly understood. We addressed this question by analyzing the dynamics of a large-scale biophysically realistic cortical network model subjected to different patterns of trauma. Our results suggest that the spatial pattern of trauma can greatly affect the propensity for developing posttraumatic epileptic activity. For the same fraction of lesioned neurons, spatially compact trauma resulted in stronger posttraumatic elevation of paroxysmal activity than spatially diffuse trauma. In the case of very severe trauma, diffuse distribution of a small number of surviving intact neurons alleviated posttraumatic epileptogenesis. We suggest that clinical evaluation of the severity of brain trauma should take into account the spatial pattern of the injured cortex.
Studies on the relationship of the adrenal cortex to the experimental production of hypoferremia in rats.

IN A previous paper (Cartwright, Hamilton, Gubler, Fellows, Ashenbrucker and Wintrobe, to be published) in this series the results of experiments in dogs were reported which were designed to elucidate the mechanism by which hypoferremia is produced. It was found that a variety of agents was capable of producing an acute hypoferremia in dogs. These included bacterial abscesses, sterile turpentine abscesses, histamine, epinephrine, fracture, anaphylactic shock and occasionally the stress of taking blood samples. Adrenal cortical extract and the adrenocorticotrophic hormone (ACTH) were found to produce hypoferremia to a similar degree. In the adrenalectomized dog the hypoferremia caused by mild stress and by ACTH was abolished; the hypoferremic effect of epinephrine was significantly decreased but was not abolished. Intravenously administered saccharated oxide of iron was found to be cleared most rapidly from the plasma of intact dogs given ACTH and most slowly from the plasma of adrenalectomized dogs, the r...
Measuring medical students' sense of community and satisfaction with a structured advising program

Objectives: The purpose of this study was to assess changes in students’ perceptions of the medical school sense of community and their satisfaction with advising following the initiation of a structured advising program at the Johns Hopkins University School of Medicine. Methods: Participants included School of Medicine graduates from 2006 to 2009. Total sample size was 471. The response rate was 367/471 (81%). A cross-sectional survey design was utilized to assess students’ perceived differences in advising and sense of community. Scales were developed to assess these constructs. Scale scores and responses to individual items were compared by graduation year. Results: Statistically significant increases over time were noted on the Advising Satisfaction (F (3,363) = 6.54; p≤0.001) and the Relational Community (F(3,363) = 2.76; p=0.042) scales. Using simple logistic regression, unadjusted Odds Ratios show that students graduating in 2009 report higher quality of advising during their clinical years (OR 2.87, 95% CI=1.56-5.28), around academics (OR 2.54, 95% CI=1.414.60), career planning (OR 1.87, 95% CI=1.03-3.38), stress management (OR 2.88, 95% CI=1.56-5.30), and an enhanced sense of community (OR 2.55, 95% CI=1.40-4.64), and social integration (OR 2.07, 95% CI=1.15-3.71) compared to 2006 graduates. Conclusions: We found, that students were more satisfied with advising and the medical school environment over the four years of maturation of the Program. A structured advising program that fosters meaningful, longitudinal relationships between students and advisors may enhance students’ experiences during medical school.
Mass spectrometry imaging as a tool for surgical decision-making.

Despite significant advances in image-guided therapy, surgeons are still too often left with uncertainty when deciding to remove tissue. This binary decision between removing and leaving tissue during surgery implies that the surgeon should be able to distinguish tumor from healthy tissue. In neurosurgery, current image-guidance approaches such as magnetic resonance imaging (MRI) combined with neuro-navigation offer a map as to where the tumor should be, but the only definitive method to characterize the tissue at stake is histopathology. While extremely valuable information is derived from this gold standard approach, it is limited to very few samples during surgery and is not practically used for the delineation of tumor margins. The development and implementation of faster, comprehensive and complementary approaches for tissue characterization are required to support surgical decision-making – an incremental and iterative process with tumor removed in multiple and often minute biopsies. The development of atmospheric pressure ionization sources makes it possible to analyze tissue specimens with little to no sample preparation. Here, we highlight the value of desorption electrospray ionization (DESI) as one of many available approaches for the analysis of surgical tissue. Twelve surgical samples resected from a patient during surgery were analyzed and diagnosed as glioblastoma (GBM) tumor or necrotic tissue by standard histopathology, and mass spectrometry results were further correlated to histopathology for critical validation of the approach. The use of a robust statistical approach reiterated results from the qualitative detection of potential biomarkers of these tissue types. The correlation of the MS and histopathology results to magnetic resonance images brings significant insight into tumor presentation that could not only serve to guide tumor resection, but that is worthy of more detailed studies on our understanding of tumor presentation on MRI.
A Delve Into The Deployment Of eCommerce And Higher Educational Learning

Higher Educational Institutions (HEIs) and organisations have made significant investments in eCommerce/eBusiness in efforts to keep up with heightened technology penetration in organisational and institutional fabrics. These efforts have been incorporated in their strategic mission partly, to bolster their reputation. HEIs reputation depends much on their delivery of education to their clientele (students); thus, their endeavours to invest in eCommerce solutions. In reconnoitring the impact of eCommerce/eBusiness at HEIs, higher level administrators at randomly selected cluster sample of historically black colleges and universities in America were surveyed. A mixed method analysis showed positive impact between eCommerce/eBusiness and student learning, student satisfaction, student conflict resolution.
Public Accountants’ Perceptions Of The Acceptability Of Earnings Management Practices Through The Employment Of GAAP In The Post-Sox Period

Over fifteen years ago, Martens and McEnroe (1992) conducted a behavioral study involving earnings management through the use of Generally Accepted Accounting Principles (GAAP). Their findings indicated that auditors issued unqualified audit opinions on those financial statements and perceived little risk to litigation as a result. A decade later they conducted a similar study (Martens and McEnroe 2002) with the expectation that increased attention to earnings management by then chairman of the Securities and Exchange Commission (SEC), Arthur Levitt, would reduce auditors’ perceptions that the letter of GAAP is in itself an aegis or “safe harbor” against litigation. Although the authors found that auditors had become more conservative, they still issued unqualified opinions on financial statements in which transactions were reported in their form rather than their substance. Given the accounting scandals of Enron and WorldCom, among others, and the enactment of the Sarbanes-Oxley Act (SOX) in 2002, especially with its officers’ certification requirements, it was posited that auditors would exhibit a much more conservative approach than in either of the two previous studies. The results indicate that although auditors are more conservative than in the 1992 study, they still allow clients to engage in earnings management practices through the use of GAAP by issuing unqualified audit opinions on their financial statements.
Suntrust Acquisition of National Commerce

This case presents an interesting acquisition opportunity that SunTrust considered in 2004: National Commerce Financial, a large commercial bank, based in Memphis, Tennessee, with a strong footprint in North and South Carolina. The case shows how capital ratios are often a key component in the bank-merger process, and it allows for the evaluation of whether Phil Humann (SunTrust’s CEO) could justify a multi-billion-dollar acquisition that had the potential to deplete capital, even if the deal were accretive to earnings.
Gall Bladder Versus Sphincter Papillae.

An analysis of the contraction curves of the human gall bladder, constructed from cholecystograms taken at short intervals after a meal of egg yolk and cream, indicates that the average gall bladder discharges approximately ¾ of its volume in the first half hour after each meal. The first phase of contraction in which this is accomplished, is usually divided into three parts: the “initial response” (usually of 2 minutes duration), the “2-minute pause”, and the “principal period of discharge”. On the basis of Elman and McMaster's work on the sphincter of the dog,1 the sudden discharge of the first 2 minutes is interpreted as being due to the opening of the sphincter; the interruption of emptying during the next 2 minutes to the initial increase in resistance offered by the sphincter to the flow of bile (as described by these authors); and the subsequent “principal discharge” to the contractile force of the gall bladder which, after slowly getting under way, is able for a time to overcome the growing resist...
Teacher Educators' and Student Teachers' Beliefs about Preparation for Working with Families Including Those from Diverse Socioeconomic and Cultural Backgrounds.

This mixed-methods study examined teacher preparation for developing family partnerships. The attitudes and practices of teacher educators and the attitudes and experiences of student teachers were...
Reperfusion-induced modulation of cardiac mitochondrial function by free radicals and calcium.

Reperfusion of an ischemic myocardium is associated with a number of deleterious events that are thought to contribute to myocardial dysfunction. Cellular events that predominate during reperfusion include calcium overload, mitochondrial dysfunction and enhanced production of free radicals. Cardiac mitochondria are believed to play an important role in the pathophysiology of reperfusion by contributing to calcium overload as well as free radical production. In an initial in vivo study, the effect of in vivo ischemia/reperfusion on mitochondrial function was investigated. The LAD coronary artery of male SD rats was ligated to induce ischemia, and reperfusion was initiated by removal of the ligature. Cardiac mitochondria were isolated from the affected area of the left ventricular free wall and were utilized for assays of ADP linked respiration as well as individual mitochondrial enzyme activities and western blot analysis of mitochondrial proteins. We were able to demonstrate that reperfusion was associated with a significant decline in ADP linked respiration. The mechanism of decline in overall mitochondrial respiration was due to selective inactivation of the redox sensitive Krebs cycle enzymes KGDH and aconitase. Reperfusion was also associated with a significant decline in activity of complex I of the electron transport chain. The mechanism of inactivation of complex I was further investigated in an in vitro setting by simulating conditions that predominate during ischemia and reperfusion such as pH changes and calcium overload. Results indicate that mitochondrial calcium regulates complex I activity by inducing an endogenous superoxide burst. This leads to a sulfhydryl modification of complex I resulting in its inactivation. In the presence of NADH, and after chelation of calcium, complex I is capable of self-reactivation. The findings of our in vivo and in vitro studies suggest a scenario in which calcium overload during reperfusion results in an endogenous superoxide burst at the complex I site. This radical burst potentially contributes to inactivation of redox sensitive enzymes during reperfusion. The inhibitory effect of calcium on complex I activity also suggest a regulatory effect of calcium on mitochondrial proton gradient, which in turn regulates mitochondrial calcium uptake
Promoting polyarchy: Nicaragua: From low-intensity warfare to low-intensity democracy

Preventive diplomacy and preemptive reform can reduce the risks of extremist political infection and radical contamination. When confronted with such situations, the United States must define its interests early on and then develop strategies in cooperation with regional friends that will promote the likelihood of peaceful change and successor governments compatible with our own. Henry Kissinger and Cyrus Vance Washington believes that Nicaragua must serve as a warning to the rest of Central America to never again challenge US hegemony, because of the enormous economic and political costs. It's too bad that the [Nicaraguan] poor must suffer, but historically the poor have always suffered. Nicaragua must be a lesson to others. Richard John Neuhaus Preventative diplomacy and preemptive reform In May 1989, on the eve of the opening of the Nicaraguan electoral process, one of President Bush's national security advisors observed: “Since Manila, the United States has gotten into this; we have been brandishing this new tool of giving support to electoral processes. The Plebiscite in Chile was analogous, where we saw we could shake an entrenched regime by [getting involved in] elections… We are learning these techniques, and they should be applied to Nicaragua.” In the Philippines and Chile, the United States applied “preventive diplomacy and preemptive reform” as part of shifts in policy to “democracy promotion.” The shift and the concomitant introduction of new forms of political intervention came precisely when society-wide anti-dictatorial movements were reaching a critical mass under the leadership of popular forces.
A survey of health care needs of physicians.

The healthcare needs of physician are not well studied. We surveyed physicians attending a large primary care conference about their access and perceived barriers to receiving healthcare services. Response rate was 46 % (270/592). The majority were trained in family medicine. The age category of above 60 years was the most common (39 %) and 46 % were women. Important difficulty in accessing healthcare services was reported by 39 % of physicians and the majority (61 %) reported reverting to self-diagnosis and self-treatment. Female physicians reported more difficulties than male physicians (p < 0.001 for difficulty in securing access and p = 0.02 for self-diagnosis and treatment). The barriers cited were finding time for healthcare, concern about confidentiality, and lack of encouragement by employer. Respondents reported experiencing a career threatening illness themselves (20 %) or in a colleague (81 %). Forty-two percent experienced being concerned about a colleague being able to safely practice due to illness. Participants ranked substance abuse as the most common illnesses affecting a physician’s ability to practice followed by psychiatric disorders, heart disease, neurological disorders and cancer. Physicians face important barriers to accessing healthcare services. Female physicians report worse access. The identified barriers are modifiable. This survey calls for efforts to improve physicians’ health that require collaboration among physicians, employers and policymakers.
Disturbance‐mediated Cyanobacterial Harmful Algal Bloom (CHAB) formation in a small Ohio reservoir

Cyanobacterial Harmful Algal Blooms (CHABs) in lentic waterbodies are becoming increasingly common because of climate change, changes in water usage and eutrophication. This study provides observational evidence that CHAB formation in a small Ohio reservoir (Lake Hope) is associated with metalimnetic disturbance during the summer months. Disturbance via lotic interflow may result in the appearance of CHABs in lentic habitats, with cyanobacterial maxima in the metalimnion.
Machine Learning Force Field Parameters from Ab Initio Data

Machine learning (ML) techniques with the genetic algorithm (GA) have been applied to determine a polarizable force field parameters using only ab initio data from quantum mechanics (QM) calculations of molecular clusters at the MP2/6-31G(d,p), DFMP2(fc)/jul-cc-pVDZ, and DFMP2(fc)/jul-cc-pVTZ levels to predict experimental condensed phase properties (i.e., density and heat of vaporization). The performance of this ML/GA approach is demonstrated on 4943 dimer electrostatic potentials and 1250 cluster interaction energies for methanol. Excellent agreement between the training data set from QM calculations and the optimized force field model was achieved. The results were further improved by introducing an offset factor during the machine learning process to compensate for the discrepancy between the QM calculated energy and the energy reproduced by optimized force field, while maintaining the local “shape” of the QM energy surface. Throughout the machine learning process, experimental observables were not i...
Integrated Structural Optimization System

This article describes a three-phase process for generating optimal structural designs: starting with boundary and packaging conditions a fully detailed design is derived that may include manufacturing considerations. The first phase is based on the homogenization approach, the second on a variety of image processing and artificial intelligence techniques, and the third on more traditional size and shape optimization. The article focuses on two-dimensional problems for which full automation has been achieved.
Percutaneous Left Atrial Appendage Closure Devices

Atrial fibrillation (AF) is the most common arrhythmia in humans. It is a major cause of morbidity and mortality as it impairs cardiac function and is a major risk of embolic stroke. Traditionally, thromboembolic risk of AF has been treated with system anticoagulation with intravenous, intramuscular, or oral anticoagulants. Although the novel oral anticoagulants (NOACs) have revolutionized stroke risk reduction in AF patients, they are associated with a significant risk of bleeding and may be contraindicated in certain patients. Embolic events in AF typically originate from thrombi that form within the left atrial appendage (LAA), especially in nonvalvular AF. Both surgical and percutaneous LAA closure techniques have been devised as alternatives to systemic anticoagulation. As surgical LAA closure is typically performed as an adjunct to other cardiac surgeries, the amount of eligible patients for this type of therapy may be limited. Excluding the LAA from the systemic circulation may reduce the risk of thromboembolism in AF. Recent technologic advances have led to the development of several percutaneously delivered devices that can occlude or exclude the LAA from systemic circulation. These devices may be purely endocardially delivered such as the Watchman (Boston Scientific, Maple Grove, MN) and Amulet (St. Jude Medical, Minneapolis, MN), or both endocardially and pericardially delivered such as the Lariat (Sentre-HEART, Palo Alto, CA). During Amulet and Watchman procedures, a transseptally delivered device composed of nitinol is placed in the LAA orifice, subsequently excluding the LAA from the systemic circulation. In the Lariat procedure, a magnet link is created between a transseptally delivered endocardial wire and epicardially delivered pericardial wire, followed by epicardial suture ligation of the LAA. Their use is steadily increasing in worldwide either through routine clinical use of approved devices or within clinical trials. In this review, we describe the various devices available for percutaneous LAA closure, and the indispensable role of real-time transesophageal echocardiography in the periprocedural assessment and intraprocedural guidance of percutaneous LAA occlusion procedures.
A History of Flexible Gastrointestinal Endoscopy.

For millennia, physicians have endeavored to view the interior of the gastrointestinal tract in order to diagnose and treat disease. Greek, Roman, and Egyptian scholars are all known to have created specula with which body orifices were viewed. Early endoscopes of the nineteenth century were rigid instruments with large lumens that lacked lens systems and depended upon light provided by candle or flame. Later rigid instruments employed lens assemblies and small bulbs at the tip of the instrument which generated intense heat. Early in the twentieth century, instruments with semiflexible rubber tips were developed to facilitate passage of the endoscope into the esophagus. In the mid-twentieth century, the development of fiberoptic technology permitted the evolution of flexible endoscopes that transmitted “cold light” from an outside source. Light was carried by a fiberoptic bundle from the external source, through the endoscope, to the interior of the viscus being viewed. As light returned through the endoscope, each fiber carried a parcel of the image.
Electrocardiogram Changes with Acute Alcohol Intoxication: A Systematic Review

Background Acute alcohol intoxication has been associated with cardiac arrhythmias but the electrocardiogram (ECG) changes associated with acute alcohol intoxication are not well defined in the literature. Objective Highlight the best evidence regarding the ECG changes associated with acute alcohol intoxication in otherwise healthy patients and the pathophysiology of the changes. Methods A literature search was carried out; 4 studies relating to ECG changes with acute alcohol intoxication were included in this review. Results Of the total 141 patients included in the review, 90 (63.8%) patients had P-wave prolongation, 80 (56%) patients had QTc prolongation, 19 (13.5%) patients developed T-wave abnormalities, 10 (7%) patients had QRS complex prolongation, 3 (2.12%) patients developed ST-segment depressions. Conclusion The most common ECG changes associated with acute alcohol intoxication are (in decreasing order of frequency) P-wave and QTc prolongation, followed by T-wave abnormalities and QRS complex prolongation. Mostly, these changes are completely reversible.
Optimal Assignment of Sensors to Analysts in a Cybersecurity Operations Center

A cybersecurity operations center (CSOC) analyzes a large volume of alerts generated by intrusion detection systems, which process data from a number of sensors. Sensors are assigned to analysts, and the number of sensors is much larger than the number of analysts at the CSOC. Hence, sensors are grouped into clusters, which are allocated to analysts for investigation. There are two essential properties that must be met in the above grouping and allocation process: 1) meeting the cluster's requirement for specific analyst expertise mix, complete tool coverage that allows the analysts to handle the type of alerts generated, and analyst credentials such as security clearances; and 2) minimizing and balancing the number of unanalyzed alerts among clusters at the end of the daily work shift because an imbalance or a large number of unanalyzed alerts among clusters due to factors such as lack of analyst credentials or tooling expertise in a cluster would pose a security risk to the organization. Current practice at CSOCs is to group and then to allocate, which may not meet the above properties because grouping and allocation steps are done independently that remain static for a long time despite uncertainties such as day-to-day changes in alert generation rates and analyst absenteeism. This paper meets both properties by presenting an optimization model, in which grouping of sensors to clusters and analyst allocation to clusters is achieved simultaneously . The integrated methodology produces optimal sensor grouping and analyst allocation that is adaptable to changing shift conditions.
Transforaminal Endoscopic Decompression of the Lumbar Spine for Stable Isthmic Spondylolisthesis as the Least Invasive Surgical Treatment Using the YESS Surgery Technique

The first author's series has reported and published his 5- to 10-year results in a preliminary review of endoscopic transforaminal decompression for degenerative and isthmic spondylolisthesis causing sciatica and back pain. This study was initiated due to favorable results in relieving both back and leg pain after a spine surgeon with isthmic spondylolisthesis who wanted to avoid fusion requested consideration for an endoscopic procedure for his own isthmic spondylolisthesis condition. After listening to the first author's podium presentation on selective endoscopic discectomy and foraminal decompression under local anesthesia in 1995, he requested consideration for transforaminal endoscopic decompression for recent onset of progressive sciatica from his isthmic spondylolisthesis. He was the first patient to undergo endoscopic decompression in our series of 55 patients from January 2002 to December 2012 that served as the database for a clinical case series review of selective endoscopic discectomy and foraminoplasty in patients with degenerative spondylolisthesis who specifically chose to stage the author's endoscopic transforaminal decompressive trademarked procedure over fusion. The patients were evaluated and considered for the endoscopic procedure specifically at their request, even though they were informed about the traditional "gold standard" fusion for surgical intervention. At that time the medical field did not have the database to study outcomes other than the favorable clinical results found in patients who underwent selective endoscopic discectomy and foraminoplasty for degenerative spondylolisthesis. These patients were accepted for endoscopic spine surgery in a shared clinical decision after full disclosure. The patients opted specifically for the Yeung Endoscopic Spine Surgery (YESS) technique that included foraminoplasty and dorsal endoscopic rhizotomy from the author's evolving clinical experience of 10,000 cases over 27 years.
Real-time heuristic search: new results

We present new results from applying the assumptions of two-player game searches, namely limited search horizon and commitment to moves in constant time, to single-agent problem-solving searches. We show that the search depth achievable with alpha pruning for a given amount of computation actually increases with increasing branching factor. We prove that real-time-A* (RTA*) makes locally optimal decisions given the heuristic information available to it on a tree. We then modify RTA* to perform optimally on a graph as well. We also prove that RTA* is guaranteed to find a solution to any solvable problem regardless of the initial heuristic values. In addition, we develop a learning version of RTA* that improves its performance over multiple problem-solving trials, and prove convergence of the learned heuristic values to the exact values. Finally, we demonstrate that these algorithms effectively solve larger problems than have previously been solvable with heuristic search techniques.
Return of bowel sounds indicating an end of postoperative ileus: is it time to cease this long-standing nursing tradition?

UNLABELLED Evidence and rationale supporting return of bowel sounds as an unreliable indicator of the end of postoperative ileus after abdominal surgery are provided. INTRODUCTION A loss of gastrointestinal motility, commonly known as postoperative ileus (POI), occurs after abdominal surgery. Since the 1900s, nurses and other clinicians have been taught to listen for return of bowel sounds to indicate the end of POI. Evidence-based nursing literature has challenged this long-standing traditional nursing practice. PURPOSE The purpose of this study was to provide evidence from a randomized clinical trial and rationale supporting evidence-based inquiry concerning return of bowel sounds as an unreliable indicator of the end of POI after abdominal surgery. METHOD Time (days) of return of bowel sounds after abdominal surgery was compared to the time (days) of first postoperative flatus, an indicator of the end of POI, in 66 patients recovering from abdominal surgery randomized to receive standard care compared to those who received standard care plus a rocking chair intervention. FINDINGS Pearson's correlation between time to first flatus and return of bowel sounds for combined groups was not significant (r = 0.231, p = 0.062, p < 0.05) indicating that time to return of bowel sounds and time to first flatus were not associated. CONCLUSIONS The results of this study provide support to evidence-based inquiry that questions the relevance of traditional nursing practice activities such as listening to bowel sounds as an indicator of the end of POI.
Robust Collective Action in Healthcare: Mobilizing to Address a Grand Challenge

This research analyzes how a healthcare social enterprise convened other stakeholders to create a health information exchange. Three robust action mechanisms- participatory architecture, multivocal...
RACIAL DIFFERENCES IN WORK ATTITUDES: WHAT YOU SEE DEPENDS ON WHAT YOU STUDY

Differences in a constellation of work attitudes were studied with respect to black and white employees using a sample of healthcare workers. Preliminary analyses using MANOVA indicated that blacks had more positive work attitudes than did whites. However, systematic analyses of set of covariates including personal, lifestyle, and organizational variables eliminated all racial differences in work attitudes. Implications of these findings and directions for future research were discussed.
Cryo-EM structure of the benzodiazepine-sensitive α1β1γ2S tri-heteromeric GABAA receptor in complex with GABA

Fast inhibitory neurotransmission in the mammalian nervous system is largely mediated by GABAA receptors, chloride-selective members of the superfamily of pentameric Cys-loop receptors. Native GABAA receptors are heteromeric assemblies sensitive to many important drugs, from sedatives to anesthetics and anticonvulsant agents, with mutant forms of GABAA receptors implicated in multiple neurological diseases. Despite the profound importance of heteromeric GABAA receptors in neuroscience and medicine, they have proven recalcitrant to structure determination. Here we present the structure of a tri-heteromeric α1β1γ2SEM GABAA receptor in complex with GABA, determined by single particle cryo-EM at 3.1-3.8 A resolution, elucidating molecular principles of receptor assembly and agonist binding. Remarkable N-linked glycosylation on the α1 subunit occludes the extracellular vestibule of the ion channel and is poised to modulate receptor assembly and perhaps ion channel gating. Our work provides a pathway to structural studies of heteromeric GABAA receptors and a framework for rational design of novel therapeutic agents.
On preconditioning the treecode-accelerated boundary integral (TABI) Poisson–Boltzmann solver

Abstract We recently developed a treecode-accelerated boundary integral (TABI) solver for solving Poisson–Boltzmann (PB) equation [1] . The solver has combined advantages in accuracy, efficiency, memory, and parallelization as it applies a well-posed boundary integral formulation to circumvent many numerical difficulties associated with the PB equation and uses an O ( N log ⁡ N ) treecode to accelerate the GMRES iterative solver. However, as observed in our previous work [2] , occasionally when the mesh generator produces low quality triangles, the number of GMRES iterations required to solve the discretized boundary integral equations A x = b could be large. To address this issue, we design a preconditioning scheme using preconditioner matrix M such that M − 1 A has much improved condition while M − 1 z can be rapidly computed for any vector z. In this scheme, the matrix M carries the interactions between boundary elements on the same leaf only in the tree structure thus is block diagonal with many computational advantages. The sizes of the blocks in M are conveniently controlled by the treecode parameter N 0 , the maximum number of particles per leaf. The numerical results show that this new preconditioning scheme improves the TABI solver with significantly reduced iteration numbers and better accuracy, particularly for protein sets on which TABI solver previously converges slowly. In addition, this preconditioning scheme potentially can improve the condition number of various multipole method accelerated boundary elements solvers in scattering, fluids, elasticity, etc.
Interleukin 4 is inactivated via selective disulfide-bond reduction by extracellular thioredoxin.

Thioredoxin 1 (TRX), an essential intracellular redox regulator, is also secreted by mammalian cells. Recently, we showed that TRX activates extracellular transglutaminase 2 via reduction of an allosteric disulfide bond. In an effort to identify other extracellular substrates of TRX, macrophages derived from THP-1 cells were treated with NP161, a small-molecule inhibitor of secreted TRX. NP161 enhanced cytokine outputs of alternatively activated macrophages, suggesting that extracellular TRX regulated the activity of interleukin 4 (IL-4) and/or interleukin 13 (IL-13). To test this hypothesis, the C35S mutant of human TRX was shown to form a mixed disulfide bond with recombinant IL-4 but not IL-13. Kinetic analysis revealed a k cat / K M value of 8.1 μM −1 ⋅min −1 for TRX-mediated recognition of IL-4, which established this cytokine as the most selective partner of extracellular TRX to date. Mass spectrometry identified the C46–C99 bond of IL-4 as the target of TRX, consistent with the essential role of this disulfide bond in IL-4 activity. To demonstrate the physiological relevance of our biochemical findings, recombinant TRX was shown to attenuate IL-4–dependent proliferation of cultured TF-1 erythroleukemia cells and also to inhibit the progression of chronic pancreatitis in an IL-4–driven mouse model of this disease. By establishing that IL-4 is posttranslationally regulated by TRX-promoted reduction of a disulfide bond, our findings highlight a novel regulatory mechanism of the type 2 immune response that is specific to IL-4 over IL-13.
Case 36: Bilateral Open Globe Injury Stemming from an Assault

A 53 year-old male was assaulted resulting in bilateral open globe ruptures. Post-operatively the left eye remained no light perception and the right eye remained light perception only; at 4 weeks after the initial injury, vitrectomy was attempted to reattach the retina but it was found intraoperatively to be inoperable. The patient expired 3 months later due to unrelated causes.
Estrogen Receptor β and Breast Cancer

Despite the primary role of estrogen receptor α (ERα) in mediating the effects of estrogen in malignant breast and as therapeutic target, the development of endocrine-resistant and metastatic phenotypes indicates the complexity of the mechanisms that regulate hormone signaling in the disease. The discovery of ERβ and its functional characterization has improved our understanding about the mechanism of estrogen receptor action, the regulation of estrogen signaling in breast tumors, and their response to therapy. The progressive decline of ERβ in pro-invasive lesions and invasive tumors points toward a role as suppressor of both tumorigenesis and progression in breast cancer. The antiproliferative and anti-invasive effects of the receptor and its agonists in preclinical models of breast cancer support these roles and delineate the mechanisms of action. The association of ERβ with clinical outcome proposes the potential use of the receptor as prognostic marker and its agonists in chemoprevention and therapeutic strategies for resistant and metastatic disease.
Shape Analysis of Carpal Bones Using Spectral Graph Wavelets

Graph signal processing is an emerging field that provides powerful tools for analyzing signals defined on graphs. In this chapter, we present a graph signal processing approach to shape analysis of carpal bones of the human wrist by exploiting local structure information among shape features for the purpose of quantitative shape comparison. We represent the cortical surface of a carpal bone in the spectral geometric setting using the Laplace-Beltrami operator and spectral graph wavelets. We propose a global spectral graph wavelet (GSGW) descriptor that is isometric invariant, efficient to compute, and combines the advantages of both low-pass and band-pass filters. We perform experiments on shapes of the carpal bones of ten women and ten men from a publicly-available database of wrist bones. Using one-way multivatiate analysis of variance (MANOVA) and permutation testing, our extensive results that the proposed GSGW framework gives a much better performance compared to the graph spectral signature (GPS) embedding approach for comparing shapes of the carpal bones across populations.