cssi/SciSciGPT-SciSciNet huggingface dataset:
Indication for Lower Extremity Revascularization and Hospital Profiling of Readmissions

Background Surgical readmissions are common, costly, and the focus of national quality improvement efforts. Given the relatively high readmission rates among vascular patients, pay-for-performance initiatives such as Medicare's Hospital Readmissions Reduction Program (HRRP) have targeted vascular surgery for increased scrutiny in the near future. Yet, the extent to which institutional case mix influences hospital profiling remains unexplored. We sought to evaluate whether higher readmission rates in vascular surgery are a reflection of worse performance or of treating sicker patients. Methods This retrospective observational cohort study of the national Medicare population includes 479,047 beneficiaries undergoing lower extremity revascularization (LER) in 1,701 hospitals from 2005 to 2009. We employed hierarchical logistic regression to mimic Center for Medicare and Medicaid Services methodology accounting for age, gender, preexisting comorbidities, and differences in hospital operative volume. We estimated 30-day risk-standardized readmission rates (RSRR) for each hospital when including (1) all LER patients; (2) claudicants; or (3) high-risk patients (rest pain, ulceration, or tissue loss). We stratified hospitals into quintiles based on overall RSRR for all LERs and examined differences in RSRR for claudicants and high-risk patients between and within quintiles. Next, we evaluated differences in case mix (the proportion of claudicants and high-risk patients treated) across quintiles. Finally, we simulated differences in the receipt of penalties before and after adjusting for hospital case mix. Results Readmission rates varied widely by indication: 7.3% (claudicants) vs. 19.5% (high risk). Even after adjusting for patient demographics, length of stay, and discharge destination, high-risk patients were significantly more likely to be readmitted (odds ratio 1.76, 95% confidence interval 1.71–1.81). The Best hospitals (top quintile) under the HRRP treated a much lower proportion of high-risk patients compared with the Worst hospitals (bottom quintile) (20% vs. 56%, P < 0.001). In the absence of case-mix adjustment, we observed a stepwise increase in the proportion of hospitals penalized as the proportion of high-risk patients treated increased (35–60%, P < 0.001). However, after case-mix adjustment, there were no differences between quintiles in the proportion of hospitalized penalized (50–46%, P = 0.30). Conclusion Our findings suggest that the differences in readmission rates following LER are largely driven by hospital case mix rather than true differences in quality.
Less AND More Are Needed to Assess Primary Care

Significant federal investment is now being directed toward lessening the burden of clinical quality measurement; at the same time, there is growing recognition that current measures are inadequate to capture the domains of primary care that result in improved person and population health at sustainable cost. Our study reveals a significant gap between the universe of what is measured and those elements most critical to good quality primary care, indicating that the important efforts to reduce measurement burden must be accompanied by efforts to increase the relevance of measures to domains of care that affect patient-centered and community health outcomes.
Cilia and Ciliopathies in Congenital Heart Disease

A central role for cilia in congenital heart disease (CHD) was recently identified in a large-scale mouse mutagenesis screen. Although the screen was phenotype-driven, the majority of genes recovered were cilia-related, suggesting that cilia play a central role in CHD pathogenesis. This partly reflects the role of cilia as a hub for cell signaling pathways regulating cardiovascular development. Consistent with this, many cilia-transduced cell signaling genes were also recovered, and genes regulating vesicular trafficking, a pathway essential for ciliogenesis and cell signaling. Interestingly, among CHD-cilia genes recovered, some regulate left-right patterning, indicating cardiac left-right asymmetry disturbance may play significant roles in CHD pathogenesis. Clinically, CHD patients show a high prevalence of ciliary dysfunction and show enrichment for de novo mutations in cilia-related pathways. Combined with the mouse findings, this would suggest CHD may be a new class of ciliopathy.
Human Umbilical Cord Mesenchymal Stromal Cell Isolation, Expansion, Cryopreservation, and Characterization

Revised methods to derive, expand, and characterize mesenchymal stromal cells (MSCs) from the umbilical cord are provided. Several considerations are taken for GMP compliance including using a closed system isolation method and eliminating several xenogenic components. With this method cells are isolated using mechanical and enzymatic digestion and then expanded with high viabilities that retain >90% viability after cryopreservation. Lastly, characterization methods have been optimized to identify these cells as MSCs according to the ISCT minimal criteria. This method standardizes the process for isolating, expanding, cryopreserving, and characterizing MSCs from the umbilical cord. © 2017 by John Wiley & Sons, Inc.
Experimental radar-enabled navigation with UWB system in indoor environments

In this paper, we describe an original multi-functional UWB software-defined radar system's application to dead-reckoning navigation in indoor scenarios. The radar is the only sensor available and no other navigational aids are present, except simple targets of opportunity (TOP), which are then used as references. This work provides the experimental primer on using software-defined sensors for navigational means in, e.g. GPS-denied, uncooperative environments. It can also serve as an educational instrument for undergraduate and early graduate students exploring radar applications.
Models of Electromagnetic Induction in the Earth

In constructing the theory for electromagnetic methods in geophysical exploration, simplified models of electromagnetic field behavior are widely used. Principal among these are the static, quasi-stationary, and wave models. In this chapter, we examine the features of each of these models of fields. We begin with the analysis of the electrostatic fields and potentials and discuss the analogy between constant current fields and electrostatic fields. The direct current flow in isotropic and anisotropic medium and associated magnetic fields are considered as well. Another principal model is that of a quasi-stationary field. We examine the EM field diffusion in conductive media and study the plane and spherical waves propagation. The chapter is concluded with a description of the wave equation and the wave model of the field.
Nanotechnology in Argentina

As it is explained by Gonzalez-Barrientos et al. (2010), Argentina has a long scientific tradition that has led three Argentineans to obtain Nobel Prizes: Bernardo Houssay, in Physiology and Medicine 1947, Luis Federico Leloir, in Chemistry 1970 and Cesar Milstein, in Medicine 1984. Obtaining one Nobel Prize in chemistry and two in medicine cannot possibly be viewed as accidental.
College Sport and Declining Stadium Attendance: Designing Adaptive Strategies

This case study presents the challenge of declining football attendance that a number of NCAA football programs are facing. The case participants (as members of a hypothetically formed advisory board) are asked to develop adaptive strategies and tactics to respond to this challenge by conducting an in-depth examination of fans’ declining stadium attendance and proposing recommendations to the Pac-12 Commissioner’s office. Particularly, students are expected to detail the reasons for fans’ declining stadium attendance, to identify the short-term and long-term implications of declining stadium attendance, and to specify adaptive (corrective) strategies that can be designed based on Arizona State University’s ticket-related marketing initiatives as a template. As a member of the advisory board, students are asked to address a list of questions and provide recommendations to address the challenge.
Emotional, Clinical, and Familial Correlates of Antisocial Personality Disorder and Alcoholism in Men with Unipolar Major Depression

The assessment of the clinical and emotional correlates of alcoholism is important for understanding more about the disease process itself. Investigators have reported at least two factors which predispose to problem drinking; they are: a psychiatric diagnosis of antisocial personality (ASP) (Lewis, Cloninger, & Pais, 1983; Lewis, Rice, and Helzer, 1983b; Lewis, Robins, & Rice, 1985), and a family history of alcoholism (Cotton, 1979). Furthermore, half sibling (Schuckit, Goodwin, & Winokur, 1972) and adoption (Cloninger, Bohman, and Zigvardsson, 1981; Goodwin, Schulsinger, Hermansen, Guze, & Winokur, 1973) studies have demonstrated that this familial disposition may pass from one generation to another in the absence of being raised by alcoholic parents. Our studies (Lewis, et al., 1983b; 1985b) indicate that both a diagnosis of ASP and a positive family history make independent contributions to increase the risk of alcoholism.
Cryptorchidism, Orchiopexy and Infertility: A Critical Long-Term Retrospective Analysis

AbstractWe assessed the fertility of 40 patients who underwent orchiopexy between 1950 and 1960. Testicular biopsies also had been performed at operation, a practice exceptional for the era. Of 23 patients with unilateral undescended testes who attempted to have children 20 (87 per cent) were successful. In contrast, only 3 (33 per cent) of 9 patients with bilateral undescended testes fathered children. Over-all sperm counts in 16 patients were low but they were not predictive of paternity. Testicular biopsy specimens were reviewed and the fertility index was determined. In most cases a good correlation was found between histological status and paternity status.
Pitfalls and Their Avoidance

Almost all patients who sustain a femoral neck fracture should have operative treatment. Nonoperative treatment of an impacted femoral neck fracture, although advocated by some, is not recommended. Peter et al. reported a fracture displacement rate of 42% in older patients treated nonoperatively after sustaining Garden type I impacted femoral neck fractures1; when the fracture resulted in retroversion of the femoral head by more than 40°, loss of reduction occurred in 100% of patients.
Buffers for the physiological pH range : Thermodynamics of the second dissociation of N-(2-hydroxyethyl)piperazine-N'-2-hydroxypropanesulfonic acid from 5 to 55°C

The second acidic dissociation constants pK 2 of the ampholyte N-(2-hydroxyethyl) piperazine-N′-2-hydroxypropanesulfonic acid (HEPPSO) have been determined at seven temperatures from 5 to 55°C from emf measurements utilizing hydrogen and silver–silver chloride cells without liquid junction. The thermodynamic quantities, ΔG°, ΔH°,ΔS°, and Δ C p o have been calculated from the temperature coefficient of pK 2. At 25°C, the pK 2 = 8.042 and at 37°C, pK 2 = 7.876; hence, buffer solutions of HEPPSO and NaHEPPSOate are important for pH control in the region close to that of clinical fluids (blood serum). Conventional pH values from 5 to 55°C as well as those obtained from liquid junction correction at 25 and 37°C have been reported for three buffer solutions with the compositions (molality scale): (1) equimolal mixture of HEPPSO (0.04 m) + NaHEPPSOate (0.04 m) + NaCl (0.12 m); (2) HEPPSO (0.08 m) + NaHEPPSOate (0.08 m); and (3) HEPPSO (0.08 m) + NaHEPPSOate (0.08 m) + NaCl (0.08 m).
The Educational Journeys of Students of Color across the Educational Pipeline: A Pedagogy of Storytelling or A Struggle for Freedom?.

Social inequality as evident through poverty, racism, and irrelevant social and educational policies and practices have created consistent disparities on most educational achievement and attainment...
Relating Coral Skeletal Structures at Different Length Scales to Growth, Light Availability to Symbiodinium, and Thermal Bleaching

Light scattering of coral skeletons and tissues increases light availability to photosynthetic endosymbionts to form one of the most efficient biological collectors of solar radiation. Rapid increases in light availability during thermally-induced symbiont loss (bleaching) impair photosynthetic performance of the remaining Symbiodinium and precipitate a more severe bleaching response (optical feedback-loop hypothesis). Here we focus on light scattering of the skeleton, which is determined by light interaction with skeletal components assembled in a hierarchical fractal-like structure from tens of nanometers (e.g., calcium carbonate nanograins) to micro- and milli-meters (septa, corallites, and coenosteum) to centimeters and higher (colony form). We examined the association between skeletal structures, their role in light scattering, and species-specific bleaching responses for 88 coral species using phylogenetically-corrected analysis. We also explored the effect of growth on light scattering by modeling the fractal-like accretive growth of the skeleton (assuming a diffusion limited process of biomineralization) as a function of skeletal density, size of nanograins, fractal range of biomineralized clusters, and overall mass-fractal dimension, and validated the model with experimental data. Our results show that differences in light scattering from the top ~200µm (micro-μ_s^') of the skeleton, and not from the whole skeleton (bulk-μ_s^'), are related to bleaching susceptibility. We also demonstrate how differences in micro-μ_s^' of corallites and coenosteum could explain, in part, heterogeneous light environment between polyp and coenosarc. The average effective light transport distance of coenosteum measured in 14 coral species indicates that coenosteum could transport light to the corallites, which could then function as ‘light-trapping devices’ where photons are scattered multiple times by septa and corallite walls until absorbed by Symbiodinium. Furthermore, our fractal skeletal growth model suggests that corals that grow faster typically have lower mass-fractal dimension, denser skeletons, lower skeletal micro-μ_s^', and higher bleaching susceptibility. Finally, our results demonstrate that several skeletal structures of varying length scales known to modulate the light microenvironment of Symbiodinium in coral tissue are not associated with bleaching susceptibility. This work provides evidence of the relationship between skeletal growth, light scattering, and bleaching, and further supports the optical feedback-loop hypothesis of coral bleaching.
Dose-Dependent Sorafenib-Induced Immunosuppression Is Associated with Aberrant NFAT Activation and Expression of PD-1 in T Cells

The multikinase inhibitor sorafenib is the only standard first-line therapy for hepatocellular carcinoma (HCC). Here, we report the dose-dependent effects of sorafenib on the immune response, which is related to nuclear factor of activated T cells 1 (NFAT1) activity. In vitro and in vivo experiments were performed with low and high doses of sorafenib using human T cells and spontaneous developed woodchuck HCC models. In vitro studies demonstrated that following exposure to a high dose of sorafenib the baseline activity of NFAT1 in T cells was significantly increased. In a parallel event, high dose sorafenib resulted in a significant decrease in T cell proliferation and increased the proportion of PD-1 expressing CD8+ T cells with NFAT1 activation. In the in vivo model, smaller tumors were detected in the low-dose sorafenib treated group compared to the placebo and high-dose treated groups. The low-dose sorafenib group showed a significant tumor growth delay with significantly more CD3+ cells in tumor. This study demonstrates that sorafenib has immunomodulatory effects in a dose- and time-dependent manner. Higher dose of sorafenib treatment was associated with immunosuppressive action. This observed effect of sorafenib should be taken into consideration in the selection of optimum starting dose for future trials.
Colorectal Cancer Screening in the Older Adult: A Case-Based Approach

This chapter uses a case-based approach to discuss special considerations for colon cancer screening in the geriatric population. Based on current guidelines and prevalence of colon cancer, a framework is provided on decisions to screen, risks and benefits of screening, as well as complications from screening in the older adult. A brief discussion follows on emerging technologies with regards to colon cancer screening.
The Role of Dissolved Organic Matter Composition in Determining Photochemical Reactivity at the Molecular Level

Dissolved organic matter (DOM) composition influences its ability to form photochemically produced reactive intermediates (PPRI). While relationships have been established between bulk DOM properti...
Enhanced electro-optic beam deflection of relaxor ferroelectric KTN crystals by electric-field-induced high permittivity: publisher's note.

This publisher’s note contains corrections to Opt. Lett.44, 5557 (2019)OPLEDP0146-959210.1364/OL.44.005557.
Computational Polyetheylene-Ceramic Composite Plate Design and Optimization

A computational study on the feasibility of increasing the weight-to-protection ratio of polyethylene armored plates by adding local ceramic inserts into the polymer matrix. A computational study was conducted using ANSYS/AUTODYNE software to observe the behavior of the materials under high-velocity impact conditions. Results indicate that efficacy is highly variable based on the geometry and density of the ceramic inserts. Additional studies indicate that the presence of high-density inserts create localizations of high stress and can increase the impact resistance of the by plate by reducing the penetration depth of an impactor by up to 50%.
The Performance of ESEM and BSEM in Structural Equation Models with Ordinal Indicators

Recent developments allow for incorporating exploratory features into structural equation models (SEM). Two approaches, exploratory SEM (ESEM) and Bayesian SEM (BSEM), have been shown flexible of e...
Application of Machine Learning and Spatial Bootstrapping to Image Processing for Predictive Maintenance

Image processing and machine learning have become valuable tools for predictive maintenance applications for a wide variety of industrial and commercial components. We present a novel light transmission image processing methodology utilizing statistical distance algorithms (Wasserstein distance (WD), Kolmogorov-Smirnov statistic (K-S)) for physical attribute correlation combined with Bayesian linear regression to estimate wear level and lifetime prediction for air filters. Robustness of this machine learning algorithm was evaluated using spatial block bootstrapping to generate synthetic training data to estimate the 95% prediction interval for air filter lifetime. Validation of this lifetime prediction was performed using imaging measurements on a test air filter, which showed good agreement with the machine learning model. The proposed machine learning based image analytics framework effectively enables robust predictions of component wear for predictive maintenance.
Detection of Minimal Residual Disease

Complete remission for hematolymphoid neoplasms affecting the bone marrow was traditionally considered to mean absence of morphologically detectable disease in the bone marrow with restoration of normal blood findings. Minimal residual disease (MRD) is the presence of the malignant cells at very low level (typically between 1% and 0.001% of total nucleated cells) in blood and/or bone marrow, detectable only by high sensitivity ancillary technics. MRD detection is clinically used in lymphoblastic leukemia, acute myeloid leukemia, chronic lymphocytic leukemia, and plasma cell myeloma because it offers independent prognostic information, can guide additional therapy, and/or is useful as a surrogate endpoint for novel treatments for these diseases. Multiparameter flow cytometry and molecular methods are currently used, the latter including real-time quantitative PCR and next-generation sequencing assays. While molecular methods can be 1–3 logs more sensitive than flow cytometric methods, they often have technical and practical drawbacks. Flow cytometry methods can be applied more universally but require considerable experience in interpretation of results. Several case studies are presented to familiarize the reader with this testing modality.
The lipid surface of triglyceride-rich particles can modulate (apo)protein binding and tissue uptake.

Plasma lipoproteins are aggregates varying in size from large chylomicrons to small HDL3. They are composed of complex combinations of apoproteins and lipids. The triglyceride-rich lipoproteins, secret ed by the intestine as chylomicrons or by the liver as VLDL, contain a core which is rich in triacylglycerols. Small but varying amounts of cholesterol esters also are contained in the core. The surface lipids are extremely complex and include a variety of phospholipids, including phosphatidylcholines, phosphatidylethanolamines and sphingoelins, as well as glycosphingolipids such as cerebrosides and gangliosides. Also present in the surface is cholesterol and small but significant amounts of triacylglycerols and cholesterol esters. In addition the surface contains insoluble and non-exchangeable apolipoproteins, specifically B100 or B43, and exchangeable soluble apolipoproteins such as A-I, A-II, A-IV, C-I, C-II, C-III, and E. The determinants of triglyceride-rich lipoprotein composition are: 1) the metabolism of the cell that secretes the nascent chylomicron or VLDL, 2) the physical exchanges of lipids and apoproteins that occur in plasma, 3) the transfer proteins mediated exchange between core molecules such as triacylglycerols and cholesterol ester and surface molecules such as phospholipids, and 4) the action of lipolytic enzymes such as lipoprotein lipase, hepatic lipase and lecithin-cholesterol acyltransferase, to produce metabolically important lipid products including fatty acids, monoacylglycerols, diacylglycerols, and lysophosphatides.
Mental Health as a Basic Human Right and the Interference of Commercialized Science

Although there is consensus that a rights-based approach to mental health is needed, there is disagreement about how best to conceptualize and execute it. The dominance of the medical model and industry's influence on psychiatry has led to an over-emphasis on intra-individual solutions, namely increasing individuals' access to biomedical treatments, with a resultant under-appreciation for the social and psychosocial determinants of health and the need for population-based health promotion. This paper argues that a robust rights-based approach to mental health is needed in order to overcome the effects of commercial interests on the mental health field. We show how commercialized science-the use of science primarily to meet industry needs-deflects attention away from the sociopolitical determinants of health, and we offer solutions for reform.
Patient Safety in Primary Care: Conceptual Meanings to the Health Care Team and Patients.

Introduction: Patient safety in primary care is an emerging priority, and experts have highlighted medications, diagnoses, transitions, referrals, and testing as key safety domains. This study aimed to (1) describe how frontline clinicians, administrators, and staff conceptualize patient safety in primary care; and (2) compare and contrast these conceptual meanings from the patient9s perspective. Methods: We conducted interviews with 101 frontline clinicians, administrators and staff, and focus groups with 65 adult patients at 10 patient-centered medical homes. We used thematic analysis to approach coding. Results: Findings indicate that frontline personnel conceptualized patient safety more in terms of work functions, which reflect the grouping of tasks or responsibilities to guide how care is being delivered. Frontline personnel and patients conceptualized patient safety in largely consistent ways. Discussion: Function-based conceptualizations of patient safety in primary care may better reflect frontline personnel and patients9 experiences than domain-based conceptualizations, which are favored by experts.
Regulation of Tyrosine-α-Ketoglutarate Transaminase in Rat Liver REGULATION BY l-LEUCINE IN CULTURED HEPATOMA CELLS

Abstract The level of tyrosine transaminase (l-tyrosine:2-oxoglutarate transaminase, EC 2.6.1.5) in cultured hepatoma cells was markedly elevated by increasing the concentration of amino acids in the medium. The active component of the amino acid mixture was identified as l-leucine. d-Leucine, dl-trifluoroleucine, and the deaminated product of leucine, α-ketoisocaproic acid, were inactive. At the optimum concentration (5 mm) l-leucine elicited an 8- to 10-fold increase in the transaminase level; the response was maximum at 12 to 14 hours and persisted for at least 24 hours. The half-life of the transaminase, estimated both indirectly from kinetics of change in enzyme activity after addition or withdrawal of the amino acid and directly by isotopic-immunochemical methods, was 6 hours in the presence of 5 mm l-leucine and 2 hours after return of the cells to the basal medium (0.2 mm l-leucine). Pulse labeling experiments indicated that l-leucine also increased the rate of tyrosine transaminase synthesis by a factor of 3 to 4. Thus l-leucine increased the level of tyrosine transaminase by a dual effect on both synthesis and degradation of the enzyme. Combinations of l-leucine with the hormonal inducers hydrocortisone and insulin yielded additive effects on the transaminase levels. Hydrocortisone or insulin effectively induced the transaminase in leucine-free medium, and l-leucine further increased, in an additive manner, the enzyme activity of the cells which had been maximally previously induced by hydrocortisone or insulin. These results indicate that induction of the enzyme by either hydrocortisone or insulin is not mediated by l-leucine and imply that the mechanism of the induction by l-leucine is different from that effected by either of these hormones.
MORE INFORMATION IS NOT ALWAYS BETTER: THE CASE OF VOLUNTARY PROVISION OF ENVIRONMENTAL QUALITY

This paper adds to the literature on the voluntary provision of public goods by showing that the warm glow that individuals gain depends on the perceived relative effectiveness of contributions. We use a new survey on pro-environment behaviors, attitudes, and knowledge and find that individuals act in accordance with their beliefs, regardless of whether or not these beliefs are accurate, and engage more frequently in activities that have a higher perceived impact on environmental quality. We find that low provision of the public good is greater among people who believe they cannot do much for the environment and do not consider themselves environmentalists.
Introduction to the Second Edition

This book was to be the first of two volumes whose goal was to establish the systematic relation between modern philosophy and politics. The two volumes were conceived as symmetrical, the one beginning from the emergence of modern philosophy while the other was to start with the birth of modern politics. Their structures were to be isomorphic. Kant, Hegel and Marx can be understood as presenting three distinct formulations of the nature and tasks of philosophy. Kant’s transcendental approach seeks the rational conditions of the possibility of an already given experience; but the result is a dualism because the experience remains external to the reason that explains it. Hegel then attempts to integrate experience and reason in a systematic unity which can account for the rational origin of experience. Marx’s radicalisation of Hegel inverts the procedure by seeking to constitute a world of rational experience. This progression from a transcendental to an originary and then to a constitutive philosophy has an historical echo in the political world. The process by which the Prussian bureaucratic-legal modernisation imposed universal forms on a pre-modern society which it was not strong enough to transform can be called transcendental. At the other extreme, the French Revolution’s need to overcome social resistance led to the adoption of a constitutive politics willing to ‘force them to be free’. Between these poles lies the American Revolution that won more than political independence.
Land Use Change in the Continental United States: Are There Tipping Points?

Land use in US is driven by multiple forces operating at the global level, as income and population growth, yield and productivity improvement, trade policy, climate change, and changing diets. Future land use have implications for biodiversity, run-off, carbon storage, ecosystem values, agriculture, and the broader economy. We investigate those forces in the US and their implications from a multisector, multisystem dynamics (MSD) perspective focused on understanding dynamics and resilience in complex interdependent systems. Historical trends show slightly increased grassland and natural forest areas and decreases in cropland. We project these trends are intensified under higher pressures for agriculture land or reduced under lower pressures, with no evidence of tipping points toward larger agricultural land abandonment or deforestation. However, US sectoral output and trade, fertilizer use, N2O and CH4 emissions from agriculture activities and CO2 emissions from land use changes are substantially impacted under several land use forcing scenarios.
Recurrent Stroke in Giant Cell Arteritis Despite Immunotherapy (P4.3-028)

Objective: To describe the rare but important cerebrovascular complications of Giant Cell Arteritis (GCA) and to report an unfortunate relapse when immunosuppression was switched from cyclophosphamide to tocilizumab. Background: Stroke is a rare but important complication of GCA that occurs in 3–4% of patients and is typically due to stenosis of carotid and/or vertebral or basilar arteries. Despite aggressive steroid and/or immunosuppressive therapy, there is high morbidity and mortality in this patient population. Design/Methods: Case report and literature review. Results: We report a 59-year-old male who initially presented with vasculitis of the lower extremities. While on steroids, he developed strokes in multiple vascular territories. Conventional angiogram showed stenosis of bilateral carotid and vertebral vessels as they entered the dura. Temporal artery biopsy confirmed GCA. He began cyclophosphamide treatment, which stabilized his clinical course; however, this was switched to tocilizumab by a local rheumatologist. Two months later, the patient had progression of vessel stenosis and suffered additional strokes. Imaging revealed expanding infarctions and extensive hypoperfusion. Despite interventions to augment cerebral perfusion, the patient passed away. Conclusions: This case highlights several important features of this rare complication of GCA: the predilection for the dural entry point of cerebral blood vessels, the progression of the disease despite steroids, and the low threshold clinicians should have to escalate treatment in these cases. To our knowledge, this is the first patient with CNS involvement of GCA who was treated with tocilizumab. While this medication has been recently validated as a treatment of GCA, it has not been studied in patients with CNS involvement. The CNS penetration of Tocilizumab is poor and the relapse of our patient following the switch from cyclophosphamide to tocilizumab is suspicious. The clinician should use caution in using this medication in patients with GCA of the CNS until further evidence supports its use. Disclosure: Dr. Cox has nothing to disclose. Dr. Fulgham has nothing to disclose. Dr. Klaas has nothing to disclose.
Basic small ruminant nutrition

The objective of this presentation is to provide an overview of fundamental nutrient requirements and basic feeding practices for sheep and goats in an effort to improve the practitioner's ability to address related concerns from small ruminant clientele. Many principles of ruminant nutrition as applied to dairy or beef cattle can be extrapolated to sheep and goats, but they should not just be considered "little cows”. Feeding behavior of sheep and goats is classified as intermediate browsers compared to the bulk roughage grazing cow. Feed selection and chewing behavior will alter how feeds are processed in the rumen. Additionally, with their smaller size compared to cattle there will be differences in rate of passage influencing rumen dynamics. Equally, sheep and goats are not equivalent, as feeding sheep are more grazers compared to browsing by goats. Sheep and goats also have some significant nutrient requirement differences, especially related to copper, thus products formulated to meet the needs of both species should be scrutinized. The feeding management focus will be on key nutritional principles addressing the role of forage quality on animal health and performance and need for proper mineral and vitamin supplementation. Having an understanding of basic sheep and goat feeding practices can provide an opportunity to offer additional services to new or ongoing small ruminant clients.
Methodology and challenges of fire following earthquake analysis: an urban community study considering water and transportation networks

The Pacific Northwest faces the looming threat of a massive 9.0 earthquake coming from the Cascadia Subduction Zone of the Juan de Fuca plate off the coast of Northern California, Oregon, Washington, and British Columbia. City officials, emergency managers, and researchers are preparing for this event by examining not only the earthquake itself, but also the cascading hazards that will follow it, such as fire and tsunami. Additionally, they must measure the effects of these hazards not just on the infrastructure systems they affect (e.g., water, power, transportation, communication, emergency services, etc.) but also how each system is affected by the failure of one or more of the others, or its “dependency.” The following paper discusses the effects of two cascading hazards—earthquake and fire—and the vulnerability of three infrastructure systems—building stock, water, and transportation—with a special focus on the needs of firefighters and other emergency services in the 12 h following a major seismic event. It then frames these methodologies in the context of a fine-grain case study of Seattle downtown and identifies three critical zones where mitigation measures would provide the most benefit. The discussion includes challenges in approaching such studies—the largest being available data, the uncertainties in making these evaluations, and general best practices for increased resilience in urban communities similar to the case study.
Exercise 15: Enzyme-Linked Immunosorbent Assay (ELISA)

The enzyme-linked immunosorbent assay (ELISA) is a highly sensitive, rapid, relatively cheap solid-phase immunoassay that is used to screen for the presence of, and specificity of a given antibody to an antigen, or to quantitatively determine the concentrations of antibodies and soluble antigens from sources such as patient sera, immunized hosts or antibody secretion by hybridomas. The ELISA can also measure the affinity of an antibody to an antigen. When known amounts of specific antibodies are available, unknown antigens can be detected and their concentrations determined. Protein antigens between 100 pg/mL and 1 ng/mL can be detected. The ELISA is also used to determine the titer of antibodies, most routinely used for antibodies such as monoclonal antibodies.
Clinical Outcomes in Patients Undergoing Coronary Brachytherapy for Restenosis of Coronary Vessels Previously Treated With Drug Eluting Stents.

PURPOSE/OBJECTIVE(S) Coronary brachytherapy has been shown to be a potential option for patients that require reintervention following in-stent restenosis (ISR) of a drug eluting stent (DES). The purpose of this study is to assess long-term clinical outcomes in patients undergoing coronary brachytherapy with high-dose-rate (HDR) beta radiation after ISR of a DES in native and grafted vessels. MATERIALS/METHODS This is a single institution retrospective review of 55 patients that underwent coronary brachytherapy after ISR of a previous DES between January 2015 and June 2017. Each patient underwent cardiac angioplasty with standard percutaneous techniques. A prescribed dose of 23 Gy was delivered to vessels with diameter ≥3.4mm and 18.4Gy in those less < 3.4mm. The primary clinical endpoints were freedom from reintervention and major adverse cardiac events (MACE), defined to be myocardial infarction, progressive congestive heart failure (CHF), or target vessel reintervention. RESULTS A total of 61 treated vessels in 55 patients were eligible for analysis with a median follow up time of 49.7 months. No brachytherapy-related complications were observed during the follow up period. Of the 61 vessels, 20 (33%) were grafted and 41 (67%) were native vessels. Overall, there were 29 (48%) patients with ISR requiring reintervention of the previously treated vessel, and 46 (75%) patients that experienced at least one documented MACE. In the graft vessel subgroup, 10 (50%) required reintervention and 15 (75%) experienced a MACE. In the native vessel subgroup, 19 (46%) required reintervention and 31 (51%) experienced a MACE. The overall median times to reintervention and MACE were 11.1 months and 9.1 months, respectively. The median time to a MACE for grafted vessels was 16.8 months compared to 7.0 months in native vessels. The median time to reintervention for grafted vessels was 13.78 months and 8.13 months for native vessels. CONCLUSION Coronary brachytherapy is a suitable treatment modality for patients with recurrent ISR. The current data demonstrates that it is a safe and effective approach in both native and grafted vessels in patients who have failed multiple prior interventions with DES. We observed the freedom from reintervention was longer for grafted vessels compared to native vessels. A similar result was observed in freedom from a MACE. Further prospective studies are needed to validate and expand on these findings.
The Politics of Apollonius Rhodius' Argonautica

1. Introduction 2. The politics of Alexandrian poetry 3. Strife and restraint among the Argonauts 4. Sexual politics in Lemnos, Colchis, and Drepane 5. Piety, mediation, and the favor of the gods 6. The bones of Apsyrtus 7. Quid denique restat: Apollonius and Virgil.
The mechanism of the rhodanese-catalyzed thiosulfate-cyanide reaction. Thermodynamic and activation parameters.

The spontaneous reaction between thiosulfate and cyanide and the rhodanese catalysis of that same reaction have been studied as a function of temperature and dielectric constant, and the activation parameters for the rate-determining steps of both reactions have been determined. Thermodynamic parameters for the dissociation of the rhodanese-thiosulfate complex have also been obtained. From a comparison of the values for the enzyme-catalyzed reaction with those for the spontaneous process, it has been possible to propose a more detailed mechanism for rhodanese catalysis. This mechanism involves binding of thiosulfate to a metal ion in the enzyme, with complex formation requiring a conformational change in the protein. In the metal ion-thiosulfate complex there is an electronic shift away from the planetary sulfur atom of thiosulfate, with resultant stretching and weakening of the sulfur-sulfur bond. This bond is then more susceptible to the attack by a strong enzymic nucleophil which effects the cleavage. Rupture of the sulfur-sulfur bond appears to be accompanied by a second conformational change.
The Other Side of their Zeal

This article tracks the harsh reality of homophobia in Korea, focusing on the homophobic rhetoric of Korean Christian fundamentalists. I suggest that the fundamentalists’ homophobic rhetoric can be looked at in line with their attempt to build up their bases of support. Facing the loss of their privileged social status in Korea, the fundamentalists have been seeking out a secure road through which they can survive and regain their influence. What they have found was, in addition to literal belief in the Bible, a political alliance with greater powers, namely, Korean right-wing politics and american Christian fundamentalism. Korean fundamentalists’ homophobic rhetoric reveals a crack through which we can observe how they have served as resident ministers of american Christian fundamentalists’ imperialistic vision of the world. This vision couples with the US government’s military deployments and its projects for global domination—whether it is to be proved as an unqualified failure or not.
An energy-dependent partial-wave analysis of πN → KΣ

Abstract We have performed an energy-dependent partial-wave analysis of the isospin-coupled reactions π + p → K + Σ + , π − p → K 0 Σ 0 , and π − p → K + Σ − from threshold to 2310 MeV c.m. energy. We obtained Argand plots of the amplitude and calculated the product of the branching ratios to π N and KΣ for several N ∗ and Δ resonant states. In the best solution there are resonant F 15 and S 31 states between 1900 and 2000 MeV, and a D 13 around 1700 MeV, in addition to other well-known resonant states.
Evaluating indirect and direct classification techniques for network intrusion detection

The network intrusion detection domain has seen increased research that exploit data mining and machine learning techniques and principles. Typically, multi-category classification models are built to classify network traffic instances either as normal or belonging to a specific attack category. While many existing works on data mining in intrusion detection have focused on applying direct classification methods, to our knowledge indirect classification techniques have not been investigated for intrusion detection. In contrast to indirect classification techniques, direct classification techniques generally extend associated binary classifiers to handle multi-category classification problems. An indirect classification technique decomposes (binarization) the original multi-category problem into multiple binary classification problems. The classification technique used to train the set of binary classification problems is called the {base} classifier. Subsequently, a combining strategy is used to merge the results of the binary classifiers. We investigate two binarization techniques and three combining strategies, yielding six indirect classification methods. This study presents a comprehensive comparative study of five direct classification methods with the thirty indirect classification models (six indirect classification models for each of the five base classifiers). To our knowledge, there are no existing works that evaluate as many indirect classification techniques and compare them with direct classification methods, particularly for network intrusion detection. A case study of the DARPA KDD-1999 offline intrusion detection project is used to evaluate the different techniques. It is empirically shown that certain indirect classification techniques yield better network intrusion detection models.
The Paradoxes of Modernity: Scientific Advances, Environmental Problems, and Risks to the Social Fabric?

Recent reviews have contrasted U.S. sociologists' “empirical” work on technological risks with the “theoretical” risk work of Giddens and Beck, but the reality is more complex. Most U.S. sociologists are less likely than Giddens or Beck to see risks as “transcending” socioeconomic and other divisions, but the United States–based work tends to interpret the trustworthiness of scientific–technical expertise in ways that lie between the arguments of Beck and Giddens. An examination of early nuclear technologies indicates that the United States–based perspectives provide a better “fit,” for theoretical as well as empirical reasons. The development of nuclear technologies was mixed, rather than high or low, in its competence and trustworthiness, and it created social and environmental risks that did not so much “transcend” social divisions as to reinforce them.
A parallel processing strategy for computing transitive closure of a database relation

A strategy for parallel computation of transitive closure of a database relation is given. It uses a hashing technique for horizontal data partitioning to achiev high parallelism with a simple scheme of message passing. A performance analysis shows that the strategy may achieve high parallelism with small communication overhead. >
Lectin Analysis of Proteins Blotted onto Filters

Lectins are proteins that bind with great specificity to certain carbohydrate structures. Plant lectins are widely used for investigations of carbohydrate structure and for fractionation and purification of individual oligosaccharides and glycopeptides. This unit describes the use of lectins as sensitive indicators for the presence of certain carbohydrate structures linked to proteins blotted onto filters. A tagged lectin is incubated with a blot containing the target protein and binding of the lectin is detected by one of several different procedures. Direct approaches include using lectins labeled with 125I or conjugated to horseradish peroxidase or alkaline phosphatase, which can be detected by chromogenic or luminescent visualization systems. Indirect approaches involve using lectins conjugated to biotin or digoxigenin followed by a second incubation with alkaline phosphatase-conjugated avidin or antibodies specific for the haptenic digoxigenin group and then by visualization. Several commercial kits are available that provide labeled lectins, control proteins, and developing reagents needed for visualization. These systems can also be adapted for use with lectins other than those supplied with kits. The protocol in this unit is easy to perform with or without a kit. However, the results, while suggestive of carbohydrate structure, are not definitive.
A Brief History of Positron Emission Tomography

Shortly before the time of this writing, Michael Ter-Pogossian, PhD, passed away at the age of 71. He was considered by many to be the father of PET and is best known for experiments beginning in the 1950s, which led to the development of PET as a practical diagnostic tool (Fig. 1). In my research of the literature for this article, Dr. Ter-Pogossian's name appeared frequently on many of the landmark publications and I have drawn heavily from his work as a historian and scientist. His death is a great loss to the nuclear medicine community. It is with his achievements in mind, as well as the achievements of many other outstanding scientists, that I have written this article. I have tried to be as accurate as possible in my documentation of events as well as in my interpretation of their significance. I trust that the reader will gain as much as I have from this endeavor.