cssi/SciSciGPT-SciSciNet huggingface dataset:
Left Ventricular Assist Device Implantation Site Volume and 30 Day Readmissions

Introduction Readmissions within 30 days of left ventricular assist device (LVAD) implantation are common, contributing to increased morbidity and cost. The relationship between hospital volume and outcomes after LVAD implantation has not been well established. The purpose of this study was to examine 30-day readmission rates after LVAD implantation, stratified by hospital volume, using the Nationwide Readmissions Database (NRD), an all-payer administrative database. Methods Using the 2014 NRD, we examined 1,311 adults discharged following LVAD implantation in January-November 2014. We identified LVAD implantations based on ICD-9-CM procedure code 37.66 and excluded patients with concurrent ICD-9-CM codes of heart transplantation (37.51 and 33.60). LVAD site volume was determined by counting the number of LVAD implantations from January through December 2014 at each hospital. We then classified patients into site volume quartiles (≤ 23, 24-40, 41-49, and ≥ 50). To determine whether LVAD site volume was independently associated with all-cause 30-day readmission, we conducted multivariable logistic regression accounting for the sample design and adjusting for age, sex, payer status, income quartile, Elixhauser weighted comorbidity index, discharge disposition, pre-LVAD mechanical circulatory support, and length of stay. Results Among 1,311 patients discharged following LVAD implantation, 363 (27%) were readmitted within 30 days. Patients who experienced an LVAD implantation at a hospital in the lowest quartile of LVAD volume were more likely to have higher comorbidity burden, longer index hospitalization length of stay, and have had their implantation at a smaller hospital (bed size Conclusion LVAD site volume was not associated with 30-day readmission. This suggests that regulatory processes in place to ensure high quality LVAD care across sites in the United States have been effective independent of volume.
Reduction in Hospitalizations for Esophageal Reflux in a Decade with Minimal Increases in Other Functional and Motor Disorders

Functional and motility disorders (FMDs) are common conditions that cause significant morbidity and economic loss. A comprehensive analysis of these disorders and their impact has not been done in an inpatient setting. We seek to evaluate adult hospitalization trends for FMDs in the USA. The National Inpatient Sample between 2005 and 2014 was analyzed. Poisson regression was used to assess hospitalization trends for FMDs referenced to non-FMD hospitalizations. Linear regression was used to assess cost per hospitalization and length of stay (LOS). All models were adjusted for age, sex, primary insurance, and Charlson comorbidity index. Hospitalizations with FMDs as the primary diagnosis fell by an adjusted 2.46%/year over the study period (p < 0.001). The entirety of this reduction was explained by falling admissions for gastroesophageal reflux (adjusted reduction of 7.04%/year, p < 0.001). The hospitalization rate for all other FMDs (excluding gastroesophageal reflux) minimally increased by 0.75%/year (p = 0.001). Total cost of care for FMD hospitalizations remained relatively stable ($3.17 billion in 2014), while increasing for all other hospitalizations. Mean LOS for FMD hospitalization increased by an adjusted 0.025 days/year, but decreased by 0.038 days/year for all other hospitalizations (p < 0.001). The hospitalization rate for gastroesophageal reflux fell between 2005 and 2014, but remained relatively stable to increase for all other FMDs. These trends may be due to increased proton pump inhibitor use, better patient/provider education, emphasis on outpatient management, and/or coding bias.
Evaluation of low-contrast detectability for iterative reconstruction in pediatric abdominal computed tomography: a phantom study

Iterative reconstruction is offered by all vendors to achieve similar or better CT image quality at lower doses than images reconstructed with filtered back-projection. The purpose of this study was to investigate the dose-reduction potential for pediatric abdominal CT imaging when using either a commercially available hybrid or a commercially available model-based iterative reconstruction algorithm from a single manufacturer. A phantom containing four low-contrast inserts and a uniform background with total attenuation equivalent to the abdomen of an average 8-year-old child was imaged on a CT scanner (IQon; Philips Healthcare, Cleveland, OH). We reconstructed images using both hybrid iterative reconstruction (iDose4) and model-based iterative reconstruction (Iterative Model Reconstruction). The four low-contrast inserts had circular cross-section with diameters of 3 mm, 5 mm, 7 mm and 10 mm and contrasts of 14 Hounsfield units (HU), 7 HU, 5 HU and 3 HU, respectively. Helical scans with identical kilovoltage (kV), pitch, rotation time, and collimation were repeated on the phantom at volume CT dose index (CTDIvol) of 2.0 milligrays (mGy), 3.0 mGy, 4.5 mGy and 6.0 mGy. We measured the contrast-to-noise ratio (CNR) in each rod across scans. Additionally, we collected sub-images containing each rod and sub-images containing the background and used them in two-alternative forced choice observer experiments with four observers (two radiologists and two physicists). We calculated the dose-reduction potential of both iterative reconstruction algorithms relative to a scan performed at 6 mGy and reconstructed with filtered back-projection. We calculated dose-reduction potential by either matching average equal observer performance in the two-alternative forced choice experiments or matching CNR. When matching CNR, the dose-reduction potential was 34% to 45% for hybrid iterative reconstruction and 89% to 95% for model-based iterative reconstruction. When matching average observer performance, the dose-reduction potential was 9% to 30% for hybrid iterative reconstruction and 57% to 74% for model-based iterative reconstruction. The range in dose-reduction potential depended on the rod size and contrast level. Observer performance in this phantom study indicates that the dose-reduction potential indicated by an observer study is less than that of CNR; extrapolating the results to clinical studies suggests that the dose-reduction potential would also be less.
The Lutonix AV Randomized Trial of Paclitaxel-Coated Balloons in Arteriovenous Fistula Stenosis: 2-Year Results and Subgroup Analysis.

Abstract Purpose To present final, 2-year results of a randomized trial comparing paclitaxel-coated vs uncoated balloon angioplasty following vessel preparation with ultra–high-pressure percutaneous transluminal angioplasty (PTA) in hemodialysis arteriovenous fistulae (AVFs). Materials and Methods Twenty-three sites enrolled 285 subjects with dysfunctional AVFs located in the arm. Before 1:1 randomization, successful vessel preparation was achieved (full waist effacement, Results Ninety-six of 141 subjects in the drug-coated balloon (DCB) arm and 111 of 144 in the control arm completed the study. Target lesion primary patency (TLPP) rates for the DCB and control groups were 58% ± 4 vs 46% ± 4 (P = .02) at 9 months, 44% ± 5 vs 36% ± 4 (P = .04) at 12 months, 34% ± 5 vs 28% ± 4 (P = .06) at 18 months, and 27% ± 4 vs 24% ± 4 (P = .09) at 24 months, respectively. Mean time to TLPP event for subjects with an event was longer for DCBs (322 vs 207 d; P Conclusions Two-year results demonstrate long-term safety and variable efficacy of DCB angioplasty in AVFs.
Variability of pelvic axial rotation in patients undergoing total hip arthroplasty

Background:Pelvic axial rotation affects the functional orientation of an acetabular component. Every 1° of axial rotation changes functional acetabular anteversion by 1°. There is limited informat...
Gene-Edited Live Cell Sensor for Free Calcium

A human cell line was gene-edited to provide a visually observable fluorescence response to extracellular free calcium using the CRISPR-Cas9 system. The developed sensor cells have a dynamic range of 0.01-10 µM, and the ability to be reused for multiple signal excitations. We envision using gene-edited cells as responsive elements within tissue engineered constructs that interface with the body for noninvasive semi-continuous monitoring of circulating analytes.
Acute Abdomen in Adult Trauma.

Abstract The radiologist plays a key role in the diagnosis of acute traumatic injuries in the abdomen and pelvis, the acute treatment of a number of these injuries, and the treatment of delayed complications that may arise. CT evaluation of the stable trauma patient is now standard of care and accurately grading injuries is imperative to appropriately triage patients for non-operative, angiographic, or operative treatment.
The Impact of Oil and Gas Job Opportunities on Long Term Human Capital

I exploit the geographic distribution of oil and gas resources to estimate how oil and gas jobs affect college enrollment and later life work outcomes. In the short term, a one standard deviation (equivalent to around 25 percentage points) rise in oil and gas labour share leads to a 1.7-2.8 percentage point decline in enrollment for men but not women, with effects concentrated among part-time enrollees. In the long term, leaving school to work early leads to permanent declines in formal human capital and work-related health. There is some evidence of positive impacts on employment and negative impacts on earnings. This paper contributes to 1) the literature studying how transitory industry shocks influence human capital over the lifecycle and 2) the literature that examines gender differences in college enrollment.
Under Armour, Inc.: will a fallen titan recover?

The case applies corporate analysis and valuation to a firm in a serially competitive industry that is undergoing structural shifts in its revenue model, market segments, and overall branding. The apparel and athletic footwear industry of the consumer discretionary sector has suffered due to the decline in brick-and-mortar garment retailers along with a surge in e-commerce offerings. In evaluating the attractiveness of the Under Armour brand, students will consider key industry and company characteristics and trends, before arriving at a recommendation. In completing this assignment, students should be able to: 1) assess the prospects of an industry in both the short-term and medium-term (i.e., 3-5 years out); 2) evaluate the current prospects of a firm, considering global industry and firm-specific factors; 3) determine the actions that a struggling brand in this industry can take to rejuvenate shareholder value; 4) evaluate a firm's potential to grow its market share in international markets in the face of a shifting geopolitical climate; 5) make recommendations regarding the investment attractiveness of the firm. The case is designed for learners in advanced corporate finance. It can be used in capstone undergraduate and graduate level courses.
A variational characterization of 2-soliton profiles for the KdV equation

We use profile decomposition to characterize 2-soliton solutions of the KdV equation as global minimizers to a constrained variational problem involving three of the polynomial conservation laws for the KdV equation.
20 Years of Radiographic Imaging: Crystalline Deposits Causing Severe Arthropathy and Erosions.

Urate crystal gout arthritis and calcium pyrophosphate deposition disease (CPPD) are crystalline arthropathies seen in middle age to elderly patients, but are also seen in the active duty military population. Flares of either can be identified by acute joint pain, associated swelling, tenderness, and warmth. Definitive diagnosis involves synovial analysis from arthrocentesis. Gout and CPPD are common inflammatory joint diseases. Both arthropathies presenting themselves in the same joint are rather rare. An elderly female with a history of gout presented to the hospital with severe hip pain. She was on urate-lowering therapy at the time, and uric acid levels on admission were not significantly elevated. Radiographic imaging of her hip demonstrated periarticular cartilage calcifications. A review of radiographic imaging over the last 20 years found significant erosive arthropathy in multiple joints and radiographic evidence of chondrocalcinosis, suggesting CPPD. Synovial analysis was not obtained during this admission as the patient declined procedures due to her elderly age. Her condition improved with oral steroids. Few literatures have demonstrated that gout and CPPD are common crystal arthropathies that can occur concomitantly in the same joint. A 20-year review of imaging in an elderly female with known gout arthropathy found that she had radiographic evidence of concomitant CPPD-associated damage to many of her joints. Clinicians should be aware of the different erosive arthropathies, their corresponding imaging findings, evaluation for underlying metabolic disorders if appropriate, and the possibility that they may occur in the same joint. Early prevention can reduce joint destruction later in life.
Honey and Its Antimicrobial Properties: A Function of a Single Component, or the Sum of Its Parts?

Introduction Honey is known for exhibiting antibacterial properties, indicating its use as part of traditional medicine since the early ages. With the advent of antibiotic-resistant bacteria, the need for alternative antimicrobials has outpaced the actual development of novel, broad-spectrum antibiotics. Previous research has revolved around the sugar content of honey because its sweetness makes it an attractive food source. However, research assessing the protein and lipid components of honey is lagging behind that of its sugar counterpart. The goal of this investigation was to examine the antimicrobial properties of honey and to identify any distinct proteins or lipids. Methods In order to isolate individual peptides and lipids, the different samples of local and foreign-sourced honeys were dialyzed, and the resulting dialysate proteins were screened via gel electrophoresis (sodium dodecyl-sulfate polyacrylamide gel electrophoresis [SDS-PAGE]) with Coomassie blue and silver stain, while lipids were examined using thin layer chromatography (TLC). To assess antimicrobial potency, a series of Kirby-Bauer disc diffusion assays was performed on Mueller-Hinton agar using different types of raw honey with Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli, and Bacillus subtilis. The process was then repeated using the peptide extracts from the dialyzed fractions of the honeys. Results The SDS-PAGE trials revealed repetitive promising protein bands across several gels below 75kDa with both Coomassie blue and silver staining. The TLC analysis of varying raw honey samples consistently demonstrated the presence of medium and long-chain fatty acids, likely in the range of C12-C14. In the disc diffusion assays, the greatest amount of inhibition was seen when the honeys were tested as a whole instead of its constituent parts. Conclusion Instead of an individual component acting as the key to honey's action against bacteria, it appears there is a synergistic relationship amongst the sugars, proteins, and lipids that make each honey unique.
Perceived Listening Difficulty in the Classroom, Not Measured Noise Levels, Is Associated With Fatigue in Children With and Without Hearing Loss.

Purpose The purpose of this study was to examine if classroom noise levels and perceived listening difficulty were related to fatigue reported by children with and without hearing loss. Method Meas...
Synchronization of Active Power Filter under Distorted Grid Conditions

Advancement in technology has resulted in increased use of electrical energy. The trend of using energy-saving appliances is also increased considerably. Harmonic currents have been increased in power systems due to the large-scale use of nonlinear loads. Shunt Active Power Filter (SAPF) is the most widely used technique for the compensation of current harmonics. Under adverse grid conditions performance of SAPF is affected badly. In this paper, a modified synchronous reference frame theory is proposed for current reference generation by incorporating an advanced phase-locked loop technique for the estimation of frequency and phase. The proposed approach results in an accurate extraction of reference current in the presence of various grid disturbances. Matlab/Simulink environment is used for evaluating the performance. The results achieved show excellent performance of the proposed technique in terms of reducing harmonics distortion and dynamic response. The total harmonics distortion of the compensated source current is reduced to a value well within the limits of the IEEE-519 standard.
Genetic aspects of the complement system.

Publisher Summary This chapter describes experiments that utilize genetic structural variants or deficiency states in the study of complement function in general. It also discusses the clinical aspects of hereditary angioneurotic edema and its pathogenesis. It also presents the characteristics of the defect and applications of the model in guinea pigs deficient in the “third component of complement,” C5 deficiency in mice, C5 dysfunction in man, and C6 deficiency in rabbits. Structural genetic polymorphisms aid the investigation of structure-function relationships in the complement system. Such polymorphisms may also provide hints about the structure of the complement proteins themselves. From an immunological and complementological point of view, the most important aspect of genetic variation in the complement system has been and will be the use of inherited deficiency and dysfunctional states in defining the role of complement in reactions that play a role in host defense against infection and injury. In this sense, these “natural experiments” provides with superb controls for in vitro systems and the schemata derived there from.
Fine-Grain Access Control Using Shibboleth for the Storage Resource Broker

In this paper, we propose a fine-grain access control system for data resources in the Storage Resource Broker (SRB). The SRB is a Data Grid management system, which can integrate heterogeneous data resources of virtual organizations (VOs). The SRB stores the access control information of individual users in the Metadata Catalog (MCAT) database. However, because of the specific MCAT schema, this information can only be used by the SRB applications. If VOs also have many non-SRB applications, each with its own storage format for user access control information, it creates a scalability problem with regard to administration. To solve this problem, we use Shibboleth, which is an attribute authorization service. By using Shibboleth, the authentication and access control information of the user can be obtained from the user's home institution. Thus, the administration overhead is reduced because the access control information of individual users is now managed by the user's home institution alone, not by MCAT or applications. The use of Shibboleth allows access control decisions to be made based on the user attributes such as role memberships and institutional affiliation, instead of the identity. Thus, our system provides scalable and fine-grain access control and allows privacy protection. Performance analysis shows that our system adds only a small overhead to the existing security infrastructure of the SRB.
Legal liability and highway design and maintenance

The threat of liability arising as a result of highway defects has commanded more respect for legal guidelines and dictums. The general rule of law is that a highway traveler using the highway is entitled to have that highway maintained in a reasonably safe condition. Warning signs must be placed where there are possible dangerous conditions; safety barriers are necessary where safe travel requires them; and lighting is required where a peculiar condition renders it necessary, traffic signals are generally under the rule of governmental capacity. Several recent cases which illustrate the progression of judicial thought to its present day sophistication in the area are thoroughly examined. Especially pertinent are the comments of the court in Martin versus State Highway Commission on the Federally inspired safety program. Language: en
Is there a selective relationship between language functioning and auditory attention in children

This study explores the selectivity of the relationship between auditory attention and language in children. A total of 42 children (16 females) between 7.0 and 10.0 years of age were administered a battery of cognitive, language, and behavioral measures along with 3 auditory and 3 visual continuous performance tests (CPTs). Omission errors on auditory CPTs were related to language skills whereas commission errors on CPTs in both modalities were related to behavioral ratings. The finding of a specific relationship between language functioning and auditory attention indicates that the contribution of auditory attention to language acquisition, processing, and breakdown should be more fully explored.
Basal ppGpp level adjustment shown by new spoT mutants affect steady state growth rates and rrnA ribosomal promoter regulation in Escherichia coli

This work describes an approach towards analyzing the regulatory effects of variation of guanosine 3′,5′-bispyrophosphate (ppGpp) basal levels in Escherichia coli during steady state growth. A series of strains was derived by mutating the spoT gene (which encodes the major cellular ppGppase) so as to obtain systematic increments in ppGpp basal levels. These strains differ genetically at the spoT locus and, in some cases, also at the relA locus because of the severity of spoT mutant alleles. Measurements of ppGpp revealed a ten-fold range of basal levels during growth on minimal medium. The empirical relationship between ppGpp concentration and growth rate is a simple linear inverse correlation. Tandem rrnA ribosomal RNA promoters, present on a multicopy plasmid, are shown to be differentially regulated over this range of basal levels. The upstream P1 promoter activity shows an inverse exponential relation to ppGpp concentration whereas the downstream P2 promoter is only weakly affected. We conclude that there are systematic regulatory consequences associated with small changes in ppGpp basal levels during steady state growth that probably are part of a continuum with more dramatic effects observed during the stringent response to amino acid deprivation.
THE COMPLEMENTARY ROLES OF SURFACE-IMMUNOGLOBULIN CLONALITY AND FLUORESCENCE INTENSITY, MOUSE ROSETTES, AND CD5 IN THE DIAGNOSIS OF B-CHRONIC LYMPHOCYTIC-LEUKEMIA

Peripheral blood from 77 cases of B-CLL was analyzed to evaluate the diagnostic value of SIg clonality and fluorescence intensity, mouse rosettes (MR), and CD5. Monoclonal SIg (L-chain restriction or H-chain restriction or both) was detected in 69 cases (89.61%), with weak fluorescence (mean channel number on flow cytometry <200) in 65 (94.2%); MR was positive in 66 (85.71%); CD5 positive in 64 (83.12%). The association of SIg intensity, MR, and CD5 was as follows: weak SIg/MR+/CD5+, 41 cases (53.25%); weak SIg/MR+/CD5-, 13 (16.88%); weak SIg/MR-/CD5+, 11 (14.29%); strong SIg/MR+/CD5+, 4 (5.19%); and undetected SIg/MR+/CD5+, 8 (10.39%). Thus, by performing the three markers and accepting either two or three positive results (weak SIg, MR+, CD5+) as sufficient for diagnosis, all 77 cases (100%) were diagnosed. The study demonstrated the complementary roles between L- and H- chains, and between SIg intensity, MR, and CD5 in immunophenotyping CLL.
The utility of presurgical CA125 to predict optimal tumor cytoreduction of epithelial ovarian cancer

The objective of this study was to evaluate the ability of a preoperative serum CA125 to predict whether optimal debulking (OD) could be achieved for patients with stage III and IV epithelial ovarian cancer (EOC). The records of consecutive patients who underwent primary surgery for EOC at Indiana University Hospital between January 1997 and January 2003 were reviewed. Eligibility criteria included FIGO stage III/IV disease, surgery by gynecologic oncology faculty, preoperative CA125, and an operative note clearly defining volume of residual disease. The Medcalc software statistical package was used to generate a receiver-operating characteristic (ROC) curve. Two hundred and eighty-nine cases of stage III/IV EOC were identified, of which 164 met the eligibility criteria. Serum CA125 /=75% of the time. Conversely, OD was achieved in /=4500. The area under the ROC curve for CA125 was .670. The OD rate for those with and without ascites was 49% and 79%, respectively (P < 0.001). In a multivariate analysis using CA125, age, and ascites, the area under the curve was 0.686. We conclude that preoperative serum CA125 did not reliably predict OD in patients with stage III-IV EOC.
Collaborative Rehabilitation Goal Setting

(2005). Collaborative Rehabilitation Goal Setting. Topics in Stroke Rehabilitation: Vol. 12, Outcomes in Stroke Rehabilitation, pp. 56-60.
An Examination of Polymorphism in the Hydroid Hydractinia Echinata

Several aspects of polymorphism in Hydractinia echinata (Fleming) have been examined. Polymorphism in Hydractinia appears to be the result of inhibition of the normal developmental sequence and not the result of direct genetic control. The inhibition is mediated by both intrinsic and extrinsic factors. The former are responsible for the formation of reproductive zooids in the colony, but this process may be accelerated by extrinsic factors (crowding, increased pCO 2 ). It is suggested that intrinsic factors consist of an inducer or growth stimulator produced in the hypostomal region of the polyps and an inhibitor of growth and differentiation produced by dividing cells beneath the hypostome. The ratio of these two factors throughout the colony ultimately determines the polyp type which will be formed.
Angiotensin-(1-7) : a bioactive fragment of the renin-angiotensin system

Abstract Accumulating evidence suggests that angiotensin-(1–7) [Ang-(1–7)] is an important component of the renin–angiotensin system. As the most pleiotropic metabolite of angiotensin I (Ang I) it manifest actions which are most often the opposite of those described for angiotensin II (Ang II). Ang-(1–7) is produced from Ang I bypassing the prerequisite formation of Ang II. The generation of Ang-(1–7) is under the control of at least three enzymes, which include neprilysin, thimet oligopeptidase, and prolyl oligopeptidase depending on the tissue compartment. Both neprilysin and thimet oligopeptidase are also involved in the metabolism of bradykinin and the atrial natriuretic peptide. Moreover, recent studies suggest that in addition to Ang I and bradykinin, Ang-(1–7) is an endogenous substrate for angiotensin converting enzyme. This suggests that there is a complex relationship between the enzymatic pathways forming angiotensin II and other various vasodepressor peptides from either the renin–angiotensin system or other peptide systems. The antihypertensive actions of angiotensin-(1–7) are mediated by an angiotensin receptor that is distinct from the pharmacologically characterized AT1 or AT2 receptor subtypes. Ang-(1–7) mediates it antihypertensive effects by stimulating synthesis and release of vasodilator prostaglandins, and nitric oxide and potentiating the hypotensive effects of bradykinin.
Obesity and asthma: cause for concern

Epidemiological data indicate that obesity is a risk factor for incident asthma, and that obesity is also associated with increased asthma severity. Importantly, obesity antedates asthma. The observations that weight loss improves asthma and that obese mice have innate airway hyperresponsiveness and increased responses to asthma triggers also support a relationship between obesity and asthma. The basis for this relationship is unknown, but might be the result of common etiologies, comorbidities, effects of obesity on lung volume or adipokines. Understanding the mechanistic basis for the relationship between obesity and asthma could lead to new therapeutic strategies for treatment of this susceptible population.
EEG profiles of fenfluramine, amobarbital and dextroamphetamine in normal volunteers.

A quantitative EEG study in volunteer adults was undertaken to distinguish single oral administrations of 50 and 100 mg amobarbital, 10 mg dextroamphetamine, 40 mg fenfluramine and placebo. Four hour EEG recordings were monitored by frequent auditory reaction time tasks. The EEG changes were measured by digital computer period analysis.
Granulometric estimation of sizing parameters and proportions for gamma-distributed grain sizes

Granulometric method-of-moment estimation is based on the asymptotic representation of expectations of granulometric moments in terms of grain-sizing model parameters, mixture proportions, and geometric constants. Method-of-moment estimation for sizing parameters and mixture proportions is accomplished by replacing granulometric-moment expectations with moment estimations from image realizations and then solving the resulting system of equations for the model parameters. The present paper considers the special case in which all sizing parameters for the various shapes generating the random image possess a common gamma sizing distribution. In particular, the usually difficult system of nonlinear equations reduces to a more computationally tractable form, which is important when there is more than a single image generator.© (1995) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
Validation of a clinical prediction rule for severe acute lower intestinal bleeding.

OBJECTIVES Acute lower intestinal bleeding is a heterogeneous disorder and identification of high-risk patients is challenging. We previously retrospectively identified predictors of severity in patients with acute lower intestinal bleeding. The aim of this study was to prospectively validate a clinical prediction rule for severe acute lower intestinal bleeding. METHODS This was a prospective, observational cohort study of consecutive patients admitted to an academic, tertiary care or a community-based teaching hospital for management of acute lower intestinal bleeding. Data were collected on seven previously identified predictors of severe bleeding: heart rate > or = 100/min, systolic blood pressure 2 comorbid conditions. Severe bleeding was defined as transfusion of > or =2 units of red blood cells, and/or a decrease in hematocrit of > or =20% in the first 24 h, and/or recurrent rectal bleeding after 24 h of stability (accompanied by a further decrease in hematocrit of > or =20%, and/or additional blood transfusions, and/or readmission for acute lower intestinal bleeding within 1 wk of discharge). Patients were stratified into 3 risk groups according to the previously developed prediction rule: low (no risk factors), moderate (1-3 risk factors), and high (>3 risk factors). RESULTS A total of 275 patients with acute lower intestinal bleeding were identified. The risk of severe bleeding in each risk category was similar in the validation and derivation cohorts (p values >0.05): low risk 6%versus 9%, moderate risk 43%versus 43%, and high risk 79%versus 84%. The area under the receiver operating characteristic curve was 0.754 for the validation cohort and 0.761 for the derivation cohort. The magnitude of the risk score was significantly correlated with major clinical outcomes including surgery, death, blood transfusions, and length of stay. CONCLUSION We have developed and prospectively validated a clinical prediction rule for acute severe lower intestinal bleeding. This prediction rule could improve the triage of patients to appropriate levels of care and interventions, and guide a more standardized approach to acute lower intestinal bleeding.
Capillary gas chromatographic assay of camphor and m-cresol in dermatological creams.

Abstract Camphor and m -cresol mixtures are used in antiseptic and anti-itching creams. No compendial method exists for these preparations. This paper reports a capillary gas chromatographic method using FID detection with 2,6-di- tert -butyl-4-methylphenol as internal standard on a 30 m×0.32 mm Supelcowax®-10 column (0.25 μm film) with helium as carrier gas. Ramped temperature programming was applied. The method allows simultaneous quantitation of camphor and m -cresol in the presence of o - and p -cresols, calamine and zinc oxide. Overall percent recoveries (±SD, n =9) of camphor, o -, p - and m -cresol from spiked placebo creams, at a labeled amount of 10 (w/w)% were 96.9±0.6, 98.2±0.6, 99.2±0.5 and 101.0±0.9%, respectively, and at a labeled amount of 1% were 96.7±0.6, 97.8±0.9, 97.8±0.6, and 100.3±1.0%, respectively. The recovery studies were carried out at ±30% of the labeled amounts. Linear peak area or height ratios were obtained ( r >0.999) for camphor, o -, p - and m -cresol covering a concentration range of 10–200% of the labeled amount. Linearity ( r >0.999) was also obtained for m -cresol when the relative concentration of o - and p -cresol was varied from 5 to 100% of the m -cresol concentration. The resolution between the ‘critical pair’ of p - and m -cresol was ≥1.1. The limit of quantitation was 23 pg for m -cresol and 9.3 pg for camphor using an injection split of 1:50. The repeatability (%RSD) for all compounds were
MRI Appearance of Normal Articular Cartilage

At each joint, the extracellular matrix of cartilage is arranged in a complex and characteristic organization that is specific for that joint. This structure exerts a strong influence on the appearance of magnetic resonance (MR) images through orientation-related alterations in T2 decay. As a result, the MR appearance of cartilage at each joint is predictable and specific for that joint. The diagnostic utility of MR imaging for evaluating cartilage is enhanced when the acquisition and review of the images is informed by an understanding of this relationship between normal structure and the MR appearance of cartilage.
General Strain Theory and Delinquency: Extending a Popular Explanation to American Indian Youth.

Despite evidence that American Indian adolescents are disproportionately involved in crime and delinquent behavior, there exists scant research exploring the correlates of crime among this group. We posit that Agnew's (1992) General Strain Theory (GST) is well suited to explain American Indian delinquent activity. Using the National Longitudinal Study of Adolescent Health, we examined a subsample of American Indian students-a study that represents, to the best of our knowledge, the initial published test of GST principles used to explain AI delinquent behavior. Overall, we find mixed support for the core principles of GST applying to AI delinquent behavior. We also found evidence that some of the personal and social resources identified by Agnew condition the strain-delinquent behavior relationship, albeit, sometimes in ways that are not entirely consistent with GST. Language: en
Size complexity in context-free grammars forms

Grammar forms are compared for their efficiency in representing languages, as measured by the sizes (i.e. total number of symbols, number of variable occurrences, number of productions, and number of distinct variables) of interpretation grammars. For every regular set, right- and left-linear forms are essentially equal in efficiency. Any form for the regular sets provides, at most, polynomial improvement over right-linear form. Moreover, any polynomial improvement is attained by some such form, at least on certain languages. Greater improvement for some languages is possible using forms expressing larger classes of languages than the regular sets. However, there are some languages for which no improvement over right-linear form is possible.While a similar set of results holds for forms expressing exactly the linear languages, only linear improvement can occur for forms expressing all the context-free languages.
Structural and Functional Analysis of the Human Mitotic-specific Ubiquitin-conjugating Enzyme, UbcH10

Cell cycle progression is controlled at several different junctures by the targeted destruction of cell cycle regulatory proteins. These carefully orchestrated events include the destruction of the securin protein to permit entry into anaphase, and the destruction of cyclin B to permit exit from mitosis. These destruction events are mediated by the ubiquitin/proteasome system. The human ubiquitin-conjugating enzyme, UbcH10, is an essential mediator of the mitotic destruction events. We report here the 1.95-A crystal structure of a mutant UbcH10, in which the active site cysteine has been replaced with a serine. Functional analysis indicates that the mutant is active in accepting ubiquitin, although not as efficiently as wild-type. Examination of the crystal structure reveals that the NH2-terminal extension in UbcH10 is disordered and that a conserved 3(10)-helix places a lysine residue near the active site. Analysis of relevant mutants demonstrates that for ubiquitin-adduct formation the presence or absence of the NH2-terminal extension has little effect, whereas the lysine residue near the active site has significant effect. The structure provides additional insight into UbcH10 function including possible sites of interaction with the anaphase promoting complex/cyclosome and the disposition of a putative destruction box motif in the structure.
Information, Skill Building, and the Development of Competence: An Educational Framework for Teaching Business Policy

A developmental approach based on education theory is proposed as a planning model for the business policy course Structured on three levels each of information acquisition, skill building, and the development of competence, the framework integrates a variety of widely accepted pedagogical approaches and techniques—a macro perspective suitable for setting teaching objectives for the policy course.
Determination of the Fe-Ni and Fe-Ni-P phase diagrams at low temperatures (700 to 300 °C)

The α + γ two-phase fields of the Fe-Ni and Fe-Ni (P saturated) phase diagrams have been determined in the composition range 0 to 60 wt pet Ni and in the temperature range 700 to 300 °C. The solubility of Ni in (FeNi)3P was measured in the same temperature range. Homogeneous alloys were austenitized and quenched to form α2, martensite, then heat treated to formα (ferrite) + γ (austenite). The compositions of the α and γ phases were determined with electron microprobe and scanning transmission electron microscope techniques. Retrograde solubility for the α/(α + γ) solvus line was demonstrated exper-imentally. P was shown to significantly decrease the size of the α + γ two-phase field. The maximum solubility of Ni in α is 6.1 ± 0.5 wt pct at 475 °C and 7.8± 0.5 wt pct at 450 °C in the Fe-Ni and Fe-Ni (P saturated) phase diagrams, respectively. The solubility of Ni in α is 4.2 ± 0.5 wt pct Ni and 4.9 ± 0.5 wt pct Ni at 300 °C in the Fe-Ni and Fe-Ni (P saturated) phase diagrams. Ternary Fe-Ni-P isothermal sections were constructed between 700 and 300 °C.
Melt-rich channel observed at the lithosphere-asthenosphere boundary

Sea-floor magnetotelluric data are used to image the electrical conductivity of the lithosphere–asthenosphere boundary offshore of Nicaragua; a high-conductivity layer confined to depths of 45–70 kilometres is found, interpreted to be a partially molten channel of low viscosity. Samer Naif et al. use sea-floor magnetotelluric data to image the electrical conductivity of the boundary between the hard rocky lithosphere and the asthenosphere beneath, where the rock is less rigid. The electromagnetic data, from the Cocos plate off of Nicaragua, indicate a zone of high conductivity confined to depths of 45–70 km. This is interpreted as a 25-km thick partially molten layer separating the sliding tectonic plate from the mantle beneath, and acting as a lubricant to plate motion. The lithosphere–asthenosphere boundary (LAB) separates rigid oceanic plates from the underlying warm ductile asthenosphere. Although a viscosity decrease beneath this boundary is essential for plate tectonics, a consensus on its origin remains elusive. Seismic studies identify a prominent velocity discontinuity at depths thought to coincide with the LAB but disagree on its cause1,2,3,4,5, generally invoking either partial melting6 or a mantle dehydration boundary7 as explanations. Here we use sea-floor magnetotelluric data to image the electrical conductivity of the LAB beneath the edge of the Cocos plate at the Middle America trench offshore of Nicaragua. Underneath the resistive oceanic lithosphere, the magnetotelluric data reveal a high-conductivity layer confined to depths of 45 to 70 kilometres. Because partial melts are stable at these depths in a warm damp mantle8, we interpret the conductor to be a partially molten layer capped by an impermeable frozen lid that is the base of the lithosphere. A conductivity anisotropy parallel to plate motion indicates that this melt has been sheared into flow-aligned tube-like structures9. We infer that the LAB beneath young plates consists of a thin, partially molten, channel of low viscosity that acts to decouple the overlying brittle lithosphere from the deeper convecting mantle. Because this boundary layer has the potential to behave as a lubricant to plate motion, its proximity to the trench may have implications for subduction dynamics.
Oxidative dehydrogenation of isobutane on phosphorous-modified graphitic mesoporous carbon

Abstract Graphitic mesoporous carbon was modified with phosphorous heteroatoms in order to tune the catalytic selectivity and to investigate the roles of different oxygen species for the oxidative dehydrogenation reaction of isobutane to isobutene. Small changes in the isobutane apparent activation energy are consistent with the notion that the phosphorous groups do not change the nature of the active sites but they interfere with the availability of the sites. Our results show that the improvement on selectivity is not proportional to the amount of phosphorous added. Small phosphorous content improved the selectivity by suppressing the combustion of isobutane. However, a higher amount of phosphorous groups lead to coverage of selective quinone sites and/or creation of active sites favorable to total oxidation.
On a simple method for determining the potential strain energy stored in the earth before a large earthquake

This paper describes a technique for determining the potential energy of deformed material around a future earthquake rupture, with this energy being stored during the precursory period. The basic parameters are the following: rupture length on the Earth’s surface after the earthquake has occurred L, rupture depth h, and the relative block movement along the rupture strike line \(\bar u\). We compared the results for 44 large earthquakes with those derived by determining seismic wave energy from earthquake magnitude.
Concerns arising from MSC retrieval from cryostorage and effect on immune suppressive function and pharmaceutical usage in clinical trials

Marrow-derived mesenchymal stromal cells (MSCs) from either autologous or from random donor origin are being investigated in a large number of clinical trials as a cellular pharmaceutical for treatment of immune disorders such as Crohn's disease, systemic lupus erythematous, multiple sclerosis, GvHD and others. Most typically, a polyclonal pool of ex vivo culture expanded cells is cryopreserved after serial passaging and banked for later use. Human subjects subsequently receive an intravenous transfusion of MSCs which were retrieved from cryostorage no more than a few hours beforehand. It is assumed that viable, immediate post-thaw MSCs deploy the same biochemical, homing and immune modulatory features as their pre-freeze counterparts. We here propose that this assumption may be erroneous and may provide, in part, an explanation for discrepancy between pre-clinical models of MSC effectiveness and negative outcome of a large prospective randomized Phase III clinical trial (NCT00366145) of random donor MSCs for treatment of steroid-resistant acute GvHD.
Observation of the Earth and Its Environment—Survey of Missions and Sensors

Observing Earth's surface and atmospheric processes has always posed a challenge to scientists. Ground-based observations are point-based and do not quantify the spatial variability Such measurements are also expensive and difficult to maintain. Space-based observation solves this problem by affording spatial coverage with a specific temporal repeat. Satellite remote sensing in the Earth sciences has come of age in the last 10–20 years with the launch of numerous satellites with Earth-observing sensors. Observations of the Earth and Its Environment is a carefully constructed book with sections emphasizing different aspects of remote sensing in the Earth sciences. It begins with history of Earth observations; this important section helps to put missions and sensors in their proper chronological and scientific perspective. Rather than presenting missions as stand-alone, the book confers an understanding of the scientific and sometimes technological purpose associated with sensors and missions. The interconnections between missions and the physical variables/processes observed in these missions are expressed clearly.
Nondestructive analysis for HeNe lasers

The methods used to measure the gas properties in sealed helium-neon lasers are described. Such parameters as total gas pressure, minor constituent concentration (i.e., He/Ne ratio), and gas purity can be measured using spectral emission methods. How these parameters and measurement techniques relate to the electrical operating characteristics of the laser is described.
Follicular growth and atresia in the mouse

Follicles were classified on the basis of the number of layers of follicle cells, the presence and degree of development of the zona pellucida, and the presence of an antrum. Formation of an antrum in follicles with less than 7 to 8 cell layers and/or presence of necrotic cells was considered indicative of degeneration. When classified in this manner, the data suggest that follicles and their contained oocytes are committed to either normal development or atresia by the time a third layer of granulosa cells is formed.
Hypogammaglobulinemia in children undergoing continuous ambulatory peritoneal dialysis

Humoral immunity was evaluated in seven children undergoing continuous ambulatory peritoneal dialysis (CAPD). Five children (71%) had serum immunoglobulin levels which were more than 2 SD below the mean for age. One mechanism contributing to hypogammaglobulinemia was loss via the peritoneal membrane. Daily losses of IgG into peritoneal dialysis effluents represented 7%–29% of normal daily IgG synthesis, and losses increased with duration of CAPD therapy. Despite the observed hypogammaglobulinemia, all children had protective antibody responses to immunization.
A PHYSIOLOGICAL APPROACH TO MARICULTURE OF RED ALGAE

Algal mariculture research at Hopkins Marine Station (Stanford University) and Marine Bioassay Laboratories (Watsonville, Calif.) led to the development of a critical pathway approach: ecological studies, strain selection, physiological experimentation, and cultivation trials. Initial ecological studies focused on seasonal growth and life history patterns of Gelidium and Gracilaria. The results provided the clues for selection of experimental tolerance ranges for key physical and chemical parameters to be studies. Plant vigor and the algal products of interest were the primary criteria in the strain selection program. The metabolic response patterns for net photosynthesis of the species were then studied to characterize the presumptive environmental optima and tolerance ranges for these red algal cultures. The results from these shortterm physiological experiments are tested in algal cultivation trials. The results from this critical pathway approach were: 1) selected, vigorous strains; 2) basic requirements for cultivation of the species; 3) predictions of how the species will respond in culture; 4) production estimates for use in mariculture feasibility models; and 5) a definition of conditions which must be met by a specific culture technique. This research, which takes place primarily in the laboratory, provides the foundation for development of the capital-intensive, pilot mariculture system for a specific red algal species.