cssi/SciSciGPT-SciSciNet huggingface dataset:
Pharmacologic evidence for nociception resulting from noncontingent "rewarding" brain stimulation.

Abstract Prolonged noncontingent electrical stimulation to rewarding brain sites will elicit escape behavior in rats. This study was designed to determine if this escape behavior is reinforced by the termination of a nociceptive stimulus or reinforced by the rewarding effects of the onset of the next stimulus. In the present experiment we determined the effects of the hyperalgesic naloxone (NX) and the analgesic ethylketocyclazocine (EKC) on the threshold for escape from electrical brain stimulation to the medial forebrain bundle-lateral hypothalamic area (MFB). Results indicate that EKC (0.5–1.0 mg/kg) raises the escape threshold, whereas NX (8.0–16.0 mg/kg) lowers the escape threshold, suggesting that escape from electrical brain stimulation to the MFB is the result of the nociceptive quality of stimulation and not the result of the rewarding effects of the onset of stimulation.
The electrical conductivity of suspensions of charged particles in ionic solutions: the roles of added counterions and nonspecific adsorption

Abstract Previous theories for the electrical conductivity of dilute suspensions fail to take proper account of the effects of nonspecific adsorption, which alters the concentrations of ions in regions outside the double layers, and counterions derived from the particle charging processes. As a result, agreement with experimental data is poor. These effects are included in the theory developed here and a formula for the conductivity of a dilute suspension of particles with an arbitrarily large charge or ζ-potential is derived, along with an asymptotic expression for situations where the Debye-Huckel approximation is valid. The agreement with extant data is much improved over that obtained with earlier theories.
Scanning Polarization Force Microscopy Study of the Condensation and Wetting Properties of Glycerol on Mica

The condensation of glycerol on mica surfaces in ambient air was studied with scanning polarization force microscopy (SPFM). Two different wetting regimes were found that depend on the state of the surface. On freshly cleaved mica, glycerol condenses, forming flat films. The films expand until a uniform layer is formed. The first molecular layer of glycerol was found to be more strongly bound to the surface than were subsequent layers. On contaminated mica (after 2 h of exposure to air) droplets in the shape of spherical caps form that partially wet the substrate. The droplets grow indefinitely in the saturated vapor. The contact angle of droplets with heights <20 nm was found to deviate from the macroscopic value found in large drops. The results are discussed in the context of the long-range forces in the liquid film.
PSYCHOLOGICAL DISTANCE AS A FUNCTION OF LENGTH OF HOSPITALIZATION

Summary.-21 psychiatric patients hospitalized in a state institution for at least 3 yr. (LH group) were compared in regard to their psychological distance with 38 patients who had been in private hospitals for less than 3 mo. (SH group). Psychological distance was determined by means of a modified version of Kuethe's social schemata technique which calls for replacement of pairs of figures on a field. Although LH patients were significandy older than SH patients, it was demonstrated that age was not significantly related to distance responses. The SH group consistently placed the figures further apart than the LH, suggesting that long-term hospitalized patients have more of a desire for social involvement than patients hospitalized for briefer periods of time. The possible effects of differential severity of symptoms, differences in the social climate of the hospitals, and prolonged relative social isolation were discussed.
Regulation of protein phosphatase 1 by intrinsically disordered proteins.

PP1 (protein phosphatase 1) is an essential serine/threonine phosphatase that plays a critical role in a broad range of biological processes, from muscle contraction to memory formation. PP1 achieves its biological specificity by forming holoenzymes with more than 200 known regulatory proteins. Interestingly, most of these regulatory proteins (≥70%) belong to the class of IDPs (intrinsically disordered proteins). Thus structural studies highlighting the interaction of these IDP regulatory proteins with PP1 are an attractive model system because it allows general parameters for a group of diverse IDPs that interact with the same binding partner to be identified, while also providing fundamental insights into PP1 biology. The present review provides a brief overview of our current understanding of IDP–PP1 interactions, including the importance of pre-formed secondary and tertiary structures for PP1 binding, as well as changes of IDP dynamics upon interacting with PP1.
Self-threading-based approach for branched and/or cross-linked Poly(methacrylate rotaxane)s

Physically branched and cross-linked polymeric structures were produced for the first time by rotaxane formation during reaction of a pendant group of a preformed macromolecule. The rotaxane structure is believed to form from a hydrogen-bonded bimolecular complex of 5-(hydroxymethyl)-1,3-phenylene-1‘,3‘-phenylene-32-crown-10 (16) by esterification of the hydroxy group of one macrocycle through the cavity of the second in its reaction with poly(methacryloyl chloride) (12). For esters formed in model reactions of 12 with methanol and with 5-(hydroxymethyl)-1,3-phenylene-16-crown-5 (14), which is too small to be threaded, the degrees of polymerization were identical; however, the polymer from reaction of 12 and 16 under the same conditions had a significantly higher degree of polymerization and polydispersity, i.e., was highly branched via rotaxane formation. Increasing the concentration in the reaction of 12 with 16 led to the formation of a gel fraction along with a high molecular weight sol fraction; the ...
Calibration of Distance and Size Does Not Calibrate Shape Information: Comparison of Dynamic Monocular and Static and Dynamic Binocular Vision

This study investigated the coupling of distance and size perception as well as the coupling of distance and shape perception. Each was tested in 2 ways using a targeted reaching task that simultaneously yielded measures of distance, size, and shape perception. First, feed-forward reaches were tested without feedback. Errors in size did not covary with errors in distance, but errors in shape did. Second, reaches were tested with visual feedback. Estimated distance and size became more accurate, but shape did not. The evidence indicated that distance and size perception and distance and shape perception are not coupled. These results were replicated 3 times, as we also compared performance using dynamic monocular, static binocular, and dynamic binocular vision. Performance was better with binocular than monocular vision both without and with feedback. The presence of a size gradient did not improve monocular distance perception, yielding additional evidence that distance and size perception are not coupled.
The effect of some additives on the closed bomb burning and ignitability of RDX/TNT (60/40)

Abstract The burning and ignition properties of Composition (Comp) B are studied so that formulation modification could be made that would reduce gun projectile in-bore thermal explosions. Comp B first burns on its surface like a gun propellant; then, at a pressure near 100 MPa, a sudden breakup burning phase develops. New surface area is created at a phenomenal rate, and this is the cause of the catastrophic reaction rates that it can experience. Coating its RDX constituent with a protectant significantly slows this reaction rate. It appears to do this by inhibiting the rate at which the RDX is released from the TNT matrix for burning, probably by infinitesimally delaying the ignition of the RDX in the particle ignition sequence. A new test that evaluates explosive ignitability as a function of pressure and energy indicates that an RDX protective coating may also increase the level of thermal ignition and delay the onset of a thermal explosion. Collectively, these three desirable properties, caused by a ...
INTERNATIONAL EXCHANGE OF SCIENTIFIC INFORMATION DURING CRISIS: A CASE STUDY IN THE RIGHT TO COMMUNICATE

(1980). INTERNATIONAL EXCHANGE OF SCIENTIFIC INFORMATION DURING CRISIS: A CASE STUDY IN THE RIGHT TO COMMUNICATE. Free Speech Yearbook: Vol. 19, No. 1, pp. 58-66.
Simulating indoor concentrations of NO(2) and PM(2.5) in multifamily housing for use in health-based intervention modeling.

UNLABELLED Residents of low-income multifamily housing can have elevated exposures to multiple environmental pollutants known to influence asthma. Simulation models can characterize the health implications of changing indoor concentrations, but quantifying the influence of interventions on concentrations is challenging given complex airflow and source characteristics. In this study, we simulated concentrations in a prototype multifamily building using CONTAM, a multizone airflow and contaminant transport program. Contaminants modeled included PM(2.5) and NO(2) , and parameters included stove use, presence and operability of exhaust fans, smoking, unit level, and building leakiness. We developed regression models to explain variability in CONTAM outputs for individual sources, in a manner that could be utilized in simulation modeling of health outcomes. To evaluate our models, we generated a database of 1000 simulated households with characteristics consistent with Boston public housing developments and residents and compared the predicted levels of NO(2) and PM(2.5) and their correlates with the literature. Our analyses demonstrated that CONTAM outputs could be readily explained by available parameters (R(2) between 0.89 and 0.98 across models), but that one-compartment box models would mischaracterize concentrations and source contributions. Our study quantifies the key drivers for indoor concentrations in multifamily housing and helps to identify opportunities for interventions. PRACTICAL IMPLICATIONS Many low-income urban asthmatics live in multifamily housing that may be amenable to ventilation-related interventions such as weatherization or air sealing, wall and ceiling hole repairs, and exhaust fan installation or repair, but such interventions must be designed carefully given their cost and their offsetting effects on energy savings as well as indoor and outdoor pollutants. We developed models to take into account the complex behavior of airflow patterns in multifamily buildings, which can be used to identify and evaluate environmental and non-environmental interventions targeting indoor air pollutants which can trigger asthma exacerbations.
Experience with a graph-based propagation programming tool

A graph-based tool for object-oriented programming, referred to as propagation patterns, has been developed as part of the Demeter system. The Demeter system consists of the programming language independent Demeter method and a suite of platform-specific Demeter tools. Propagation patterns use a technique based on propagation within a graph to specify groups of collaborating classes. Experience has shown that the propagation pattern tool reduces development effort and makes software easier to engineer and reuse. The Demeter system is introduced, the propagation pattern technique for software engineering is described within the context of the Demeter system, and experience in the use of propagation patterns is summarized. >
Elevated Lactate Dehydrogenase Values in Patients with Pneumocystis carinii Pneumonia

We investigated the source of elevated serum lactate dehydrogenase (LDH) levels in seven patients with Pneumocystis carinii pneumonia (PCP) by analyzing blood and bronchoalveolar lavage (BAL) albumin (ALB) and LDH, with isoenzyme fractionation. Four patients with non-PCP lung disease served as control subjects. In PCP patients, BAL LDH was sixfold higher, and BAL ALB, fourfold higher than in the non-PCP patients. The increased LDH/ALB in BAL as compared to serum, in addition to a BAL isoenzyme pattern characteristic of lung, suggest that BAL LDH arises from a pulmonary source. We postulate that the high correlation observed between BAL and serum LDH (r=0.93, p
Human-robot interactions during the robot-assisted urban search and rescue response at the World Trade Center

The World Trade Center (WTC) rescue response provided an unfortunate opportunity to study the human-robot interactions (HRI) during a real unstaged rescue for the first time. A post-hoc analysis was performed on the data collected during the response, which resulted in 17 findings on the impact of the environment and conditions on the HRI: the skills displayed and needed by robots and humans, the details of the Urban Search and Rescue (USAR) task, the social informatics in the USAR domain, and what information is communicated at what time. The results of this work impact the field of robotics by providing a case study for HRI in USAR drawn from an unstaged USAR effort. Eleven recommendations are made based on the findings that impact the robotics, computer science, engineering, psychology, and rescue fields. These recommendations call for group organization and user confidence studies, more research into perceptual and assistive interfaces, and formal models of the state of the robot, state of the world, and information as to what has been observed.
Epstein-Barr Virus Latent Membrane Protein 1 (LMP-1) Half-Life in Epithelial Cells Is Down-Regulated by Lytic LMP-1

This study examined the effect of naturally occurring Epstein-Barr virus (EBV) latent membrane protein 1 (LMP-1) gene sequence variation on the LMP-1 half-life in epithelial cells. The LMP-1 half-life was not influenced by sequence variation in amino acids 250 to 307 or amino acids 343 to 352. The LMP-1 half-life was short when the amino acid encoded at position 129 was methionine, the initiation codon product of lytic LMP-1 (lyLMP-1). The mutation of amino acid 129 to isoleucine greatly increased the LMP-1 half-life. Expression of lyLMP-1 in trans down-regulated the LMP-1 half-life in a dose-dependent manner and restored a short-half-life phenotype to the mutated LMP-1 construct lacking the cis ability to express lyLMP-1. This observed dominant negative effect of lyLMP-1 expression on the LMP-1 half-life in epithelial cells in vitro may have implications for EBV epithelial oncogenesis in vivo.
High-gain holographic screens

A high-gain screen can be made as a sandwich of a hologram and a retroreflective screen material. When a hologram is used in front of the screen instead of the screen material alone, the position of high-brightness viewing can be moved to any desired angle rather than being directed back along the projection beam.
Rate constant for the reaction Cl+HO2NO2→products

The total rate constant for the reaction of Cl atoms with HO2NO2 was found to be less than 1.0 × 10−13 cm3 s−1 at 296 K by the discharge flow/resonance fluorescence technique. The reaction was also studied by the discharge flow/mass spectrometric technique. k1a + k1b was measured to be (3.4 ± 1.4) × 10−14 cm3 s−1 at 296 K. The reaction is too slow to be of any importance in stratospheric chemistry.
W-Meson Production in π - +p-->W - +p Interactions

The cross section for production of $W$ bosons in the reaction ${\ensuremath{\pi}}^{\ensuremath{-}}+p\ensuremath{\rightarrow}{W}^{\ensuremath{-}}+p$ is calculated on the basis of single-particle exchange for $W$ masses in the region 2-5 BeV. Corrections for absorption in the initial channel are included. Pion exchange is found to dominate rho exchange and gives (4-12) ${|{F}_{\ensuremath{\pi}}({{m}_{W}}^{2})|}^{2}\ifmmode\times\else\texttimes\fi{}{10}^{\ensuremath{-}34}$ ${\mathrm{cm}}^{2}$ as an estimate of the total production cross section. Here ${F}_{\ensuremath{\pi}}({{m}_{W}}^{2})$ is the pion electromagnetic form factor evaluated at the $W$-meson mass.
Performance Analysis of Thermocline Energy Storage Proposed for the 1 MW Saguaro Solar Trough Plant

The 1 MW Saguaro solar parabolic trough power plant began operation in December 2005. The plant will initially operate without an energy storage system. However, recent studies predict a thermocline-type storage should be the most cost-effective storage concept for solar parabolic troughs power plants. If such a system can be successfully demonstrated at Saguaro, future trough plants will likely adopt this storage technology. A thermocline storage system for Saguaro has been proposed by Department of Energy (DOE) laboratories and the solar industry. In this paper, the time-dependent performance of the proposed storage system was evaluated with a new model of the plant based on the TRNSYS simulation system. Results indicate that the proposed system should work well at Saguaro. The paper describes the TRNSYS model and the engineering insights gleaned from annual performance simulations of the plant.
From Breaking Down Barriers to Breaking Up Communities The Expanding Spatial Strategies of Fair Housing Advocacy

This article offers a critique of developments within fair housing thought in the United States that have brought it into conflict with community development approaches to high-poverty, segregated urban neighborhoods. I argue that the spatial strategies of Fair Housing have expanded from an initial orientation toward opening up the suburbs to nonwhite occupancy to efforts aimed at breaking up communities of color in central areas. The shifting gaze of Fair Housing toward neighborhoods of concentrated poverty has manifest itself in both a criticism of and opposition to affordable housing programs in central areas and support for what Chicago Fair Housing Attorney Alexander Polikoff calls the “radical surgery” of displacement and demolition of existing communities of color.
geomorph: an r package for the collection and analysis of geometric morphometric shape data

Summary 1. Many ecological and evolutionary studies seek to explain patterns of shape variation and its covariation with other variables. Geometric morphometrics is often used for this purpose, where a set of shape variables are obtained from landmark coordinates following a Procrustes superimposition. 2. We introduce geomorph: a software package for performing geometric morphometric shape analysis in the R statistical computing environment. 3. Geomorph provides routines for all stages of landmark-based geometric morphometric analyses in two and three-dimensions. It is an open source package to read, manipulate, and digitize landmark data, generate shape variables via Procrustes analysis for points, curves and surfaces, perform statistical analyses of shape variation and covariation, and to provide graphical depictions of shapes and patterns of shape variation. An important contribution of geomorph is the ability to perform Procrustes superimposition on landmark points, as well as semilandmarks from curves and surfaces. 4. A wide range of statistical methods germane to testing ecological and evolutionary hypotheses of shape variation are provided. These include standard multivariate methods such as principal components analysis, and approaches for multivariate regression and group comparison. Methods for more specialized analyses, such as for assessing shape allometry, comparing shape trajectories, examining morphological integration, and for assessing phylogenetic signal, are also included. 5. Several functions are provided to graphically visualize results, including routines for examining variation in shape space, visualizing allometric trajectories, comparing specific shapes to one another and for plotting phylogenetic changes in morphospace. 6. Finally, geomorph participates to make available advanced geometric morphometric analyses through the R statistical computing platform.
Functional Status Determines Postoperative Outcomes in Elderly Patients Undergoing Hepatic Resections

Background With the aging population and increasing incidence of hepatic malignancies in elderly patients, establishing the safety of hepatic resections is crucial. The present study investigates early postoperative morbidity and mortality in elderly patients undergoing hepatic resection using a nationally validated database. Methods The National Surgical Quality Improvement Program Participant User Files (NSQIP-PUF) for 2005–2009 were used for the retrospective analysis of all patients undergoing hepatic resection. The primary outcome measures were 30-day postoperative mortality, overall complication rate, and serious complication rate. The primary predictor variable was patient age, which was treated as a dichotomous variable (age ≤70 years, age ≥70 years). Results Five thousand seven hundred six patients were included in the final analysis, 1,280 of which were ≥70 years of age. Thirty-day postoperative mortality (≤70 years 1.9% vs. ≥70 years 4.5%, P < 0.0001), serious complications (≤70 years 15.2% vs. ≥ 70 years 18.4%, P < 0.006) and overall complications (≤70 years 23.1% vs. ≥70 years 26.6%, P < 0.01) were more common in the elderly group. Elderly patients had significantly more wound infections, pneumonia, prolonged ventilator support, unplanned re-intubations, renal failure, strokes, myocardial infarction, cardiac arrests, and septic shock. The median length of hospitalization was also significantly longer in the elderly. Conclusions This study shows significantly higher complication rates and mortality following hepatic resections in elderly patients. These findings should be taken into account when considering hepatectomy in this population. J. Surg. Oncol. 2013;107:865–870. © 2013 Wiley Periodicals, Inc.
A method for determining energy gap narrowing in highly doped semiconductors

A general experimental method for the determination of the phenomenological energy gap narrowing \DeltaE_{G} in regions of semiconductor devices that have high concentrations of donor or acceptor impurity atoms is presented. The theoretical grounds for the method are discussed in detail, including the strong influence of Fermi-Dirac statistics on minority-carrier recombination in heavily doped regions. The method requires measurements only of the temperature dependence of de current; therefore it is very accurate. The values of \DeltaE_{G} deduced from the method are insensitive to the mechanisms controlling recombination and to the value of minority-carrier mobility in the heavily doped region; they are also independent of the value of n i the intrinsic carrier density, at a specific temperature. The values for the Si:As emitters of transistors and diodes were measured in the majority-carrier concentration range from 4 × 1018cm-3to 2 × 1020cm-3.
The President as Chief Administrator

"The spirit of American institutions is opposed to reposing arbitrary power anywhere. We have no place in our polity for an omnipotent leader or body of superman administrators with infallible hunches, guided by a super, super-" man at the head of an absolute hierarchy." ROSCOE POUND. "It (administration) may contribute admirably to the transient greatness of a man, but it cannot insure the durable prosperity of a people." DE TO(CQUEViLLE. "The Judiciary are the sole protection against a tyrannical execution of the laws." PATRICK HENRY.
Protocols and system capacity of relay-enhanced HSDPA systems

In this paper we examine the impact of using relays on the throughput and coverage of the High-Speed Packet Downlink Access (HSDPA) cellular system.We consider two cooperation schemes that can be incorporated into the existing HSPDA system with relative ease. Using a system-level simulation approach we demonstrate that relaying, when properly designed and deployed, can have a significant positive impact on the throughput and coverage of cellular systems.
Monoterpenes, fatty and resin acids of Pinus lambertiana and Pinus monticola☆

Abstract The sapwood and heartwood of sugar pine ( Pinus lambertiana ) and western white pine ( Pinus monticola ) have been examined for monoterpenes, fatty and resin acids. The principal qualitative differences between the terpene composition are the presence of Δ 3 -carene in significant amounts in sugar pine and its apparent absence in western white pine and the presence of n -decane in western white pine and its absence in sugar pine. While the seldom reported trans -cinnamic acid was found in each of these pines, the recently reported sugar pine resin acid, lambertianic, was not found in western white pine.
Efficient Supply Contracts for Fashion Goods with Forecast Updating and Two Production Modes

We examine the problem of developing supply contracts that encourage proper coordination of forecast information and production decisions between a manufacturer and distributor of high fashion, seasonal products operating in a two-mode production environment. The first production mode is relatively cheap but requires a long lead time while the second is expensive but offers quick turnaround. We focus on contracts of the form ( w1,w2,b) wherewi is the wholesale price offered for production modei andb is a return price offered for items left over at the end of the season. We find that such a contract can coordinate the manufacturer and distributor to act in the best interest of the channel. The pricing conditions needed to ensure an efficient solution vary depending on the degree of demand forecast improvement between periods and the manufacturer's access to forecast information. We also examine whether these conditions ensure a Pareto optimal solution with respect to two traditional production settings.
Multiple‐scale Homogenization for Weakly Nonlinear Conservation Laws with Rapid Spatial Fluctuations

We consider hyperbolic conservation laws with rapid periodic spatial fluctuations and study initial value problems that correspond to small perturbations about a steady state. Weakly nonlinear solutions are computed asymptotically using multiple spatial and temporal scales to capture the homogenized solution as well as its long-term behavior. We show that the linear problem may be destabilized through interactions between two solution modes and the periodic structure. We also show that a discontinuity, either in the initial data or due to shock formation, introduces rapid spatial and temporal fluctuations to leading order in its zone of influence. The evolution equations we derive for the homogenized leading-order solution are more general than their counterparts for conservation laws having no rapid spatial variations. In particular, these equations may be diffusive for certain general flux vectors. Selected examples are solved numerically to substantiate the asymptotic results.
The Modified Cam-Clay Model and Its Integration

In Chap. 11, the details of two models based on the von Mises yield and failure surfaces have been presented. One of the models simulates the isotropic hardening behavior and the other simulates the kinematic hardening behavior. The latter has the potential for simulating the plastic behavior of materials during a cyclic loading. These von Mises models may be used to model the total stress-based constitutive behavior of soil. However, the effective stress-based constitutive behavior of soil involves two other aspects that the von Mises models presented in Chap. 11 are incapable of simulating. These aspects are (1) the dependence of elastic and plastic stress–strain relations on mean normal pressure (“pressure-dependency”) and (2) the development of plastic volumetric strain during deviatoric stress loading (plastic dilatancy). The Cam-clay model (Schofield and Wroth 1968) is intended to fill this gap.
Unterkühlung durch die Kälteflüssigkeit

Von der im Kondensator K (Abb. 34) niedergeschlagenen Flussigkeit stromt der groste Teil in die Kuhlschlange des Unterkuhlers U und von da wie gewohnt durch das Regulierventil R in den Verdampfer V; der dort entstandene Dampf wird vom ND-Zylinder angesaugt und durch den Zwischenkuhler Z in den HD-Zylinder geleitet.
Vocational Skills Interventions for Adults with Autism Spectrum Disorder: A Review of the Literature

With a disproportionately high unemployment rate, obtaining and maintaining employment is exceptionally difficult for individuals with autism spectrum disorders (ASD). Further, few individuals with ASD have been trained in the vocational skills needed to obtain gainful employment. The need to evaluate not only our current knowledge about the employment needs of individuals with ASD, but also to inquire about interventions, strategies, and supports in the workplace is pressing. The harsh reality of high unemployment rates for adults with ASD, and the consequently high cost of services, can be aided by examining the best practices for supporting employment. This review of the literature focuses on vocational training interventions targeted specifically to adolescents and adults with ASD. Twenty studies evaluating pre-employment, specific vocational skill training, and job retention interventions are discussed, trends in intervention characteristics are highlighted, and recommendations for future research are suggested.
Copulatory behavior of male rats following reserpine administration

Two experiments were conducted further to specify the effects of reserpine on copulatory behavior in male rats. In Experiment 1, multiple doses of 0.5 mg/kg reserpine produced significant reductions in the number of intromissions required to attain ejaculation, as well as changes in two other measures. In Experiment 2, intromission frequency in the second series was reduced following a single injection of 1.0 mg/kg reserpine. Data from experiments on reserpine reveal a specific facilitatory effect on intromission frequency, which is consistent with the hypothesis that high brain monoamine level inhibits ejaculation.
Response to "Comments on 'Lateral Subcutaneous Brow Lift: Updated Technique'".

No screw fixation is used in our technique,1 nor is it in the original article by Miller.2 Only a single layer closure of 4-0 nylon is utilized. Dr Tjong Joe Wai states that there is a possibility of rupture in this static solution, resulting in recurrence of eyebrow ptosis.3 In well over 100 consecutive patients utilizing our technique,1 and in the …
EMS and Acute Stroke Care: Evidence for Policies to Reduce Delays to Definitive Treatments

Tremendous advances have altered the management of stroke over the past two decades. In a landmark paper in 1995, intravenous tissue plasminogen activator (TPA) was shown to improve outcomes in stroke patients when compared with the standard treatment at the time. Municipalities around the country created destination plans for their EMS systems to direct stroke patients to an appropriate stroke center and therefore prevent the costly time delays associated with interfacility transports. When properly identified as a stroke by EMS, studies show that EMS prenotification to the hospital leads to faster in-hospital times and in some cases faster treatment times. With such an important role of EMS in stroke care, the importance of proper recognition by EMS became paramount. Stroke identification tools were developed to aid in stroke recognition with varying results. Some systems developed mobile stroke units to bring the emergency department to the patient to expedite TPA administration. Recently, five studies published in 2015 demonstrated the benefit of intra-arterial thrombolysis (IAT) for patients with large-vessel occlusions (LVO). While primary stroke centers are able to provide TPA management, comprehensive stroke centers are the only centers capable of providing intra-arterial interventions. Should IAT become the standard of care, EMS will have a responsibility to adjust its stroke recognition systems to differentiate patients with LVOs who might benefit from intervention at a comprehensive stroke center (CSC) and appropriately bypass a primary stroke center (PSC) for a CSC to provide them the best opportunity to receive this time-sensitive therapy and prevent the significant interfacility transport delays.
Chronic rhinosinusitis endotyping: Sharpening the focus on inflammation

The heterogeneity of allergic diseases, such as asthma, has been pondered since the 1940s-1950s. The late Dr Richard Farr described the heterogeneity of asthma in terms of a 3-dimensional structure akin to a Rubik’s Cube, with each of the small components of the cube representing a different phenotype. He and his longtime colleague, Dr Sheldon L. Spector, wrote about the heterogeneity of asthma as far back as 1976. It was believed by Drs Spector and Farr that each of the different asthma phenotypes would have a different underlying pathophysiologic basis, even though the components of this were far from clear at the time. Over the ensuing years, much has been learned to validate their belief. The term endotype was proposed by Lotvall et al in 2011 to describe the link between the underlying pathophysiologic mechanism or mechanisms and subtypes of asthma and, by extrapolation, other diseases. There is nothing unique about asthma or allergic disease in this regard, but the term endotype has been applied mainly to studies of allergic and respiratory diseases, including chronic rhinosinusitis (CRS). The conceptual framework of endotyping dovetails with interest in personalized medicine and has its analogy in other fields based on a similar conceptual framework, such as molecular oncology, which is based on characterizing tumors based on mutation status of key oncogenes and growth factors. In each instance the hope is that endotyping will facilitate the design of more targeted and appropriate treatments for disease. There is an ever-growing array of technologies that has expanded our capacity to endotype diseases far beyond traditional pathologic methods, including gene expression profiling; measurement of cytokines, profibrotic factors, and other key regulatory or signaling molecules at the level of translated proteins; and measurement of mediators or metabolic products in tissues or exhaled air and metabolomics. In addition, related technologies, such as delineation of tissue microbiomes and broad-based platforms that examine genetic polymorphisms, gene mutations, and abnormalities of gene copy number, can all be applied to endotyping.
Investigation on the epidemiological and etiological characteristics in severe and death cases of hand-foot-mouth disease in Hebei province in 2010

Objective:To analyze the epidemiological and etiological characteristics of severe and death cases of hand-foot-mouth diseases(HFMD) in Hebei province in 2010.Methods: The 1586 specimens of patients with severe HFMD and 65 specimens of death cases were detected by RT-PCR,and the data of all the patients were input Epidata software and statistically analyzed,then the epidemiological and etiological characteristics in severe HFMD cases and death cases were dynamically analyzed.Results: EV71 was the main pathogen which resulted in severe and death cases of HFMD,and the severe cases and death cases concentrated on the young age group,especially in 1-year age group,and invalid population was mainly scattered habitation rural children,which accounted for 82.63% of all the cases.The cause of death was closely related with non timely diagnosis and longer time of transfer treatment.Conclusion: The pathogen that cause severe cases and death cases of HFMD is mainly EV71 in Hebei province in 2010,and the main invalid population is in 1 year age group,and severe cases and death cases of HFMD are mainly the scattered habitation rural children.
Near-optimal convolutionally coded asynchronous CDMA with iterative multiuser detection/decoding

We consider in this paper a convolutionally coded asynchronous CDMA system with iterative multiuser detection and decoding. Each user's bits are convolutionally encoded, interleaved, and differentially encoded before being transmitted over the multiuser CDMA channel. In contrast to previous work in this area, a differential encoder is inserted to effect an interleaver gain. We view the asynchronous CDMA channel as a periodically time-varying ISI channel. The receiver jointly decodes the differential encoders and the CDMA channel with a combined trellis, and shares soft output information with the convolutional decoders in an iterative (turbo) fashion. Dramatic gains over conventional convolutionally coded systems are demonstrated via simulation. Near single-user turbo performance is obtained with a moderate number of users. We also show that there exists an optimal code rate under a bandwidth constraint. The performance and optimal code rates are also demonstrated via density evolution analyses.
Remedial Processes in Embarrassing Predicaments

Embarrassing predicaments are a routine pari of social interaction arising from the display of untoward or inappropriate behavior. Such events create feelings of chagrin, engender negative attributions about the embarrassed person, and disrupt social interaction. Consequently, both embarrassed acton and observers employ remedial face work in response to embarrassing predicaments in order to repair damaged identities, maintain face, and restore interactional equilibrium. This chapter summarizes the relevant literature in four areas related to embarrassment: (a) the nature of embarrassing predicaments, (b) remedial strategies employed by embarrassed acton, (c) responses of observers to an embarrassing predicament, and (d) factors influencing the use and effectiveness of remedial strategies. While prior research has offered some useful knowledge about general remedial processes, it fails to capture some of the unique and subtle aspects of coping with embarrassment. To promote greater understanding of the inh...
Sociodemographic Disparities in Proximity of Schools to Tobacco Outlets and Fast-Food Restaurants

Objectives. To examine the association of school sociodemographic characteristics with tobacco outlet and fast-food restaurant availability near schools in a national study.Methods. Business lists and data from the National Center for Education Statistics were used to calculate the numbers of tobacco outlets and fast-food restaurants within 800 meters of public schools in 97 US counties.Results. More than 50% of schools with a majority of Hispanic students had both a fast-food restaurant and tobacco outlet nearby, compared with 21% of schools with a majority of White students. In adjusted models, each 10% increase in the number of low-income and Hispanic students enrolled in a school led to a 3% to 5% increase in the odds of the school having both a fast-food restaurant and a tobacco outlet nearby.Conclusions. Low-income and Hispanic students are disproportionately exposed to both tobacco outlets and fast-food restaurants near their schools. Easy access to tobacco products and fast food may influence yout...
Clinical Trials: The Validation of Theory and Therapy

In recent years there has developed an increased general interest in the methods by which the efficacy of clinical therapies may be judged. The biomedical literature both in this country and abroad has contained many sophisticated essays on the methodology of the classical randomized controlled clinical trial and various alternatives to it.1Curiously, one specific clinical discipline, psychoanalysis with its extensive schools and variant forms of therapy, has until very recently been most reluctant to mount a clinical trial to determine the effectiveness of its modalities, though it has been criticized for not doing so by a number of philosophers, psychologists, and psychiatrists. It is not irrevelant on the more practical side to note that health insurance companies and the Federal government have become intensely interested in the question whether psychotherapy has any efficacy.2
Transforming Chaos into Beauty: Intentionally Developing Unity in Church Plants

This paper describes how unity can be developed in young church planting contexts. Two dimensions of unity are explored: Task cohesiveness and Relational cohesiveness. Empirically verified approaches to increasing both dimensions of unity in organizations are presented along with applications for church planting.
Quantification of suvorexant in urine using gas chromatography/mass spectrometry

Abstract Suvorexant (Belsomra ® ) is a novel sedative hypnotic drug that is prescribed to promote sleep in patients with insomnia. It is the first of a new class of drugs classified as dual orexin receptor antagonists (DORAs). Sedative hypnotics with central nervous system depressant effects feature prominently in forensic toxicology investigations. For this reason, a new analytical method was developed to identify suvorexant in urine using liquid-liquid extraction (LLE) and gas chromatography/mass spectrometry (GC/MS). Due to the absence of a commercially available isotopically labeled internal standard, estazolam-D5 was used due to its azepine, triazole and chlorinated functionality. The limit of detection and limit of quantitation was 10 ng/mL and the linear range of the assay was 10–1000 ng/mL. Accuracy and precision (%CV) were 98–101% and
The Human Being, a Person of Substance: A Response to Dean Stretton

Over the past decade or so several challenges to the prolife understanding of fetal personhood have been published. Two of the authors who have contributed much to this critique are Jeff McMahon and Dean Stretton. The purpose of this chapter is to respond to some of their arguments. My point of departure will be Stretton’s 2008 Journal of Medical Ethics review (Stretton, 2008, pp. 793–797) of my 2007 book, Defending Life: A Moral and Legal Case Against Abortion Choice (Beckwith, 2007). In his critique of my defense of fetal personhood Stretton relies heavily on McMahon’s work. I will first summarize the case I make for fetal personhood in Defending Life, and then respond to the challenges to my case offered in Stretton’s review.
The Relationship Between Safety Culture and Voluntary Event Reporting in a Large Regional Ambulatory Care Group.

ObjectivesThe safety culture in the workplace may affect event reporting. We evaluated the relationship of safety culture and voluntary event reporting within a large network of ambulatory practices, most of which provided primary care.MethodsThis study was an observational, retrospective cohort stu
Abstract NTOC-113: TGF–β SIGNALING INHIBITION AS A POTENTIAL APPROACH TO TARGET SUBOPTIMALLY DEBULKED OVARIAN TUMORS

The current standard of care for all patients with high-grade, advanced-stage serous ovarian cancer is surgery followed by adjuvant chemotherapy. Resection of all visible residual disease to less than 1 cm is associated with a favorable prognosis, but this optimal debulking can only be achieved in ~70% of patients. Patients with suboptimal cytoreduction are presumed to have lower response rates to subsequent chemotherapy and are known to have a poor prognosis. Recently, we performed a meta-analysis of 1,525 publicly available expression profiling assays and identified a 200-gene expression signature of primary ovarian tumors to predict the outcome of debulking surgery. The signature was validated using two independent sets of tumors. This debulking signature consists of transcripts positively regulated by TGF-β, indicating that hyperactivation of TGF-β signaling may be responsible of the aggressive biological and clinical behavior of suboptimally debulked tumors. In this study, we evaluated the potential anti-tumor effect of TGF-β signaling blockade in ovarian cancer cells in vitro and in vivo . Integrated TGF-β signaling was observed in 8 of 10 ovarian cancer cell lines tested by a SMAD-binding element based luciferase assay. The potential anti-tumor effect of a small molecular TGFBR1 kinase inhibitor LY2157299 was further investigated in SKOV3 cell line, which presents both endogenous and inducible TGF-β signaling and is highly disseminative when inoculated into immunodeficient mice. Although imposing minimal effect on in vitro cellular proliferation, LY2157299 significantly inhibited tumor-dissemination related biological processes in SKOV3 cells including migration, invasion and mesothelial cell adhesion. In an interperitoneal SKOV3 xenograft model, administration of LY2157299 significantly increased cisplatin related cytotoxicity and tumor burden reduction. Taken together, our study has provided evidence for the potential clinical use of LY2157299 to improve the treatment and survival of women with suboptimal surgery. Citation Format: Wei Wei and Michael J. Birrer. TGF–β SIGNALING INHIBITION AS A POTENTIAL APPROACH TO TARGET SUBOPTIMALLY DEBULKED OVARIAN TUMORS [abstract]. In: Proceedings of the 11th Biennial Ovarian Cancer Research Symposium; Sep 12-13, 2016; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2017;23(11 Suppl):Abstract nr NTOC-113.
Site-Specific Considerations in the Surgical Management of Skull Base Chondrosarcomas

BACKGROUND Numerous approaches have been reported in the management of skull base chondrosarcomas. Data are lacking for surgical outcomes by the tumor site of origin. OBJECTIVE To provide insight into outcomes by site of origin and factors affecting resection in order to aid in surgical approach selection. METHODS A retrospective review was conducted of 49 patients with chondrosarcoma treated at our institution. Charts were reviewed for tumor- and treatment-related factors. Extent of resection was the primary outcome, while neurological function and surgical complications were secondary outcomes. Statistical analyses were performed assessing variables for their impact on the primary outcome. RESULTS The gross total resection rate for the overall cohort was 67.3%, and 97.8% of patients were either neurologically stable or improved postoperatively. A petroclival site of origin had lower rates of resection vs all other sites (P .05), while previous radiotherapy and cavernous sinus invasion correlated with a subtotal resection (P < .05). In the petroclival cohort, clival, jugular tubercle, and soft tissue involvement correlated with a subtotal resection (P < .05). An endoscopic endonasal transpterygoid approach alone or combined with a transcranial approach yielded the highest resection rates for petroclival tumors (P < .05). CONCLUSION Chondrosarcomas pose unique challenges based on the site of origin and pattern of extension. While current surgical strategies appear to yield adequate results at a majority of skull base sites, petroclival tumors represent a particular cohort in which improvement is needed. Based on our analysis, strategies incorporating both endoscopic and transcranial skull base approaches are likely necessary to achieve optimal outcomes.
Single-Incision Rectopexy (With and Without Resection)

Rectal prolapse affects up to 0.5% of the population in the United States, but its prevalence rises with age. Single-incision minimally invasive rectopexy with or without resection is an excellent treatment option to both minimize recurrence and expedite recovery. The two keys to technical success in this surgery involve carrying the dissection completely down to the pelvic floor and successful suturing of the rectum to the sacral periosteum. To facilitate successful surgery, it is often beneficial to employ a robotic surgical platform. Herein we describe the most effective ways to complete this surgery from a single-incision technique both robotically and laparoscopically.
Relative Contributions of the Cerebellar Cortex and Cerebellar Nucleus to Eyelid Conditioning

We have presented data addressing the relative contributions of the cerebellar cortex and nuclei in the acquisition and expression of conditioned eyelid responses. Data from a series of studies support the notion that while plasticity occurs in both the cerebellar cortex and nucleus, the cerebellar cortex is essential for acquisition, extinction, and for the proper expression of conditioned eyelid responses. We have presented arguments that the experiments that support this position were designed in ways to preclude confounds that were present in other attempts to identify the role of the cerebellar cortex in eyelid conditioning. We have also presented evidence that suggests plasticity in both the cerebellar cortex and nucleus is required for the expression of a conditioned response, and that reversing this plasticity only in the cerebellar cortex may be sufficient to produce extinction of conditioned responses. Computer simulations based on the connectivity of the cerebellum and on the sites and rules