cssi/SciSciGPT-SciSciNet huggingface dataset:
Cyclometalated gold(III) trioxadiborrin complexes: studies of the bonding and excited states.

Trioxadiborrins are chelating ligands that assemble in dehydration reactions of boronic acids. They are structurally related to β-diketonate ligands, but have a 2-charge. Little is known of the bonding properties of trioxadiborrin ligands. Presented here are density-functional theory (DFT) studies of cyclometalated gold(III) trioxadiborrins. Substituent effects are evaluated, and comparison is made to the cyclometalating 2-(4-tolyl)pyridine (tpy) ligand on gold. The tpy ligand binds more strongly than any trioxadiborrin ligand considered here, and the two ligands bind competitively to gold. The 1,3-diphenyl trioxadiborrin ligand of 1 has a larger absolute binding enthalpy to gold than its β-diketonate analogue. Conjugation between boron and aryl substituents delocalizes charge and attenuates the trioxadiborrin's binding capacity. Steric effects that disrupt conjugation between boron and aryl substituents cause the trioxadiborrin to chelate more tightly. Fragment bond orders are divided into in-plane and out-of-plane contributions for square planar 1. In-plane bonding accounts for 88% of bond order between (tpy)Au2+ and the trioxadiborrin ligand. Cyclometalated gold(III) trioxadiborrin complexes were previously shown to be phosphorescent. Spin-unrestricted triplet-state geometry optimizations find that the ten largest excited-state distortions all occur on the tpy ligand. A plot of spin density in triplet 1 shows spin to reside predominantly on tpy. The 77 K luminescence spectrum of 1 is reported here. Time-dependent DFT and configuration interaction singles calculations (corrected for doubles excitations) overestimate the emission energy by ∼0.12 eV.
Fatigue of cord-rubber composites : III. Minimum stress effect

Abstract The dependence of fatigue lifetime on the minimum cyclic stress was assessed for the rubber matrix composite of bias aircraft tire carcass reinforced by nylon cords as well as two model rubber composites reinforced by steel wire cables. At a given stress range, the use of higher minimum stress up to a certain level led to longer fatigue life of the composite laminate. When the minimum stress exceeded this critical level, an opposite trend of shorter fatigue life occurred with a higher level of minimum stress. The initial trend of longer fatigue life of angle-plied, cord—rubber composite laminates with a higher level of minimum stress stems from a nonlinear stress—strain relationship with a tendency of strain stiffening. Under stress-controlled fatigue loading, a shorter strain range was experienced for the same stress range when the level of minimum stress was raised. However, the increase of minimum stress raises the potential for damage initiation and accumulation. This effect of increased dama...
Multi-security Scheme Combining Chaotic Modulation and Masking Using Acousto-optic Feedback Devices

An input signal is encrypted onto a chaotic carrier in a hybrid Bragg cell and added to a separately generated chaotic mask with independent encryption keys. Simulations indicate considerable enhancement in system performance vis-a-vis security.
Sex Determination of Pupae of Vogtia malloi (Lepidoptera: Phycitidae)

The phycitid stem borer V. malloi Pastrana is a phytophagous parasite of alligatorweed, Alternanthera phylloxeroides (Mart.) Griseb., an introduced aquatic weed pest in the southeastern United States. This moth and its host plant, alligatorweed, are native to South America. The moth is at present being considered for introduction into the United States as a biotic agent for control of this pest plant.
A Study on System Value in Building a Service-oriented Local Government

The service-oriented government in China today has become the leading government reform goals.Compared with the central government,the execution and ministrant of local authority function are more remarkable,which has the service cost and the system innovation superiority.This paper explores the path of building a service-oriented local government,reshaping public service idea and innovating public service competition mechanism.From the cost of service and system innovation,it also analyzed the value of the local government system,and pointed out that the local government should actively explore the characteristics model of service-oriented government.
Medical Therapy in Patients Managed in a Chest Pain Observation Unit

There are no randomized controlled trials that demonstrate that any medical therapy reduces adverse events in patients with undifferentiated chest pain evaluated in chest pain units (CPUs). Many of the millions of patients that present to the emergency departments (EDs) in the United States with chest pain are managed in CPUs, but the vast majority of these patients do not suffer an acute coronary syndrome (ACS). Studies have shown that only ˜2% of patients evaluated in CPUs are diagnosed with myocardial infarction (MI) (Newby et al. Am J Cardiol 85(7):801–5, 2000; Farkouh et al. N Eng J Med 339(26):1882–8, 1998). This chapter will address the role of aspirin (ASA), nitrates, heparin, and beta blockers in the patients with undifferentiated chest pain in the CPU.
Teratogenic Constituents of Potatoes

Solanum tuberosum L, the potato, ranks third in world production behind wheat and rice. The per capita consumption in the United States is estimated at 55 kg (120 lbs) per year. The potato also makes an important contribution to the diet in northern, central and eastern Europe, and portions of South America, and it provides a source of high quality protein in addition to carbohydrate. Any question concerning the safety of the potato as a food, therefore, presents a serious threat to the health of a large segment of the world’s population. The potato and a serious disease of potato, late blight, incited by Phytophthora infestons* have already had a pronounced influence on history. In the middle of the nineteenth century the Irish had become highly dependent on the potato as a food, and in 1845 and 1846 the crop was almost totally destroyed by the disease. Ireland lost almost a third of its population between 1845 and 1860 as a direct result of the outbreak of late blight. A million people died from starvation or from disease following malnutrition. A million and a half more emigrated.
Feature Extraction for Bearing Diagnostics Based on the Characterization of Orbit Plots With Orthogonal Functions

This paper introduces a new feature extraction method based on the topology of the phase space of the dynamical systems. The method is based on transforming the phase space into the density space and approximating the density with orthogonal functions. The proposed method has been applied to vibration data of a rotating machine measured by proximity probes in order to identify and diagnose bearing defects. As will be shown, the proposed feature extraction method has outstanding capability in characterizing the system response and diagnosing the system, is robust to noise, does not depend on expert knowledge about the system, requires no feature ranking or selection and can easily be applied in an automated process.Copyright © 2016 by ASME
Cellular Senescence and Lung Function during Aging. Yin and Yang

Cellular senescence is a cell fate decision and stress response that entails a permanent arrest of cell proliferation coupled to a complex secretory phenotype. Senescent cells increase in number with age in most, if not all, mammalian tissues, including the airways and lungs. They also increase at greater than expected numbers, compared with age-matched controls, at sites of age-related pathologies such as chronic obstructive pulmonary disorder and emphysema. The senescence response is a double-edged sword. The proliferative arrest suppresses the development of cancer by preventing the propagation of stressed or damaged cells that are at risk for neoplastic transformation. However, this arrest can also curtail the proliferation of stem or progenitor cells and thus hamper tissue repair and regeneration. Similarly, the secretory phenotype can promote wound healing by transiently providing growth factors and the initial inflammatory stimulus that is required for tissue repair. However, when chronically present, the secretory phenotype of senescent cells can drive pathological inflammation, which contributes to a host of age-related pathologies, including cancer. There are now transgenes and prototype small molecules that can clear senescent cells, at least in mouse models, and thus improve health span and median life span. The next challenge will be to develop interventions and supplements that can abrogate the deleterious effects of senescent cells while preserving their beneficial effects.
Rapid bactericidal activity of an amphiphilic polyacrylate terpolymer system comprised of same-centered comonomers with 2-carbon and 6-carbon spacer arms and an uncharged repeat unit

The global health threat of antimicrobial resistance has created a pressing need to develop practical alternatives to conventional antibiotic agents. Peptide mimetic synthetic amphiphilic polymers are known to non-specifically disrupt the bacterial cell surface thus leading to highly hindered bacterial resistance development. We investigated the antibacterial activities of a terpolymer macromolecular architecture with a combination of 6-carbon and 2-carbon spacer arms (distance from polymer backbone to pendent cationic center) interspersed with counits with hydrophobic side groups. A random copolymer with a combination of 6-carbon spacer arm repeat units (60 mol%) and 2-carbon spacer arm (40 mol%) units is moderately active against bacteria and shows very low hemolytic activity. Incorporation of comonomer units with alkyl side groups, by replacing different levels of 2-carbon spacer arm counit, led to substantial increments in antibacterial activities without detrimental effects on hemolytic activities leading to highly selective (bacteria over red blood cells) antibacterial activity. Time-kill studies revealed rapid bactericidal activity of the terpolymer against both Staphylococcus aureus and Escherichia coli with 100% killing efficiency achieved within 1 h of polymer treatment, corresponding to a 5-log reduction of bacterial colony forming units. These results indicate the high potential of this amphiphilic terpolymer architecture in the development of alternatives to antibiotics.
Effectiveness of an Online Educational Module in Improving Evidence‐Based Practice Skills of Practicing Registered Nurses

Background Implementation of evidence-based practice (EBP) at the bedside has been difficult to achieve. Significant gaps between current research and actual practice have been identified and must be addressed in effort to increase utilization of EBP. Aims The purpose of this study was to evaluate the efficacy of an online EBP educational intervention and to examine the relationship between educational preparation and years of nursing experience on nurses’ practice, attitudes, and knowledge and skills of EBP. Methods An experimental pretest-posttest design study with three randomized groups utilizing the EBPQ instrument was conducted. Results No significant differences were noted in EBPQ subscale scores of practice, attitude, or knowledge and skills from pre- to posttest. In addition, no statistical difference in EBPQ subscale scores regarding educational preparation or years of experience were noted. Linking Evidence to Practice While nurses report positive attitudes toward EBP, their perceptions of practice and knowledge and skills score much lower. Educational interventions are needed for practicing nurses to overcome this knowledge deficit to successfully implement EBP. However, the use of online, independent, computer-based learning modules, while cost-efficient and offer several benefits when educating nurses, may not necessarily be the most effective method for teaching EBP knowledge and skills to practicing nurses.
The use of mouse class II MHC peptides to produce site-specific monoclonal antibodies.

We have attempted to produce site-specific monoclonal antibodies against defined regions on mouse class II (Ia) molecules. These studies were designed to produce monoclonal antibodies against defined sequences of Ia molecules which may have applications in the design of novel experimental , functional and therapeutic investigations into the biochemical role of Ia molecules in immunity and disease states (Rothbard and Taylor , 1988) . We describe here our initial results using peptides derived from the polymorphic regions 43–61 of the alpha chain subunit and polymorphic regions 57–74/78 of beta chain subunit of I-A molecules from three alleles .
Remarks on non decays of the ϒ(4S)

Abstract We consider the recent experimental observation of non B B decays of ϒ(4S) into final states containing J/ψ mesons in the context of a model which assumes an admixture of gluons and/or light quark pairs in the ϒ(4S). We emphasize the necessity of a normalization-independent measurement of the B meson semileptonic branching ratio as a means of finding the total fraction of the non B B decays of ϒ(4S). We also propose a search for an enchancement in the spectrum of inclusive photons from ϒ(4S) in the energy range 4–5 GeV at a level of a few tenths of a percent of the total width as an indicator of the presence of a colored b b heavy quark pair in the ϒ(4S).
Phosphorus-functionalized multi-wall carbon nanotubes as flame-retardant additives for polystyrene and poly (methyl methacrylate)

In the present work, we have studied the flame-retardant properties of phosphorus-functionalized multi-walled carbon nanotubes (MWCNTs) created by treating oxidized MWCNTs (O-MWCNTs) with phosphoric acid. These phosphorus MWCNTs (P-MWCNTs), along with pristine MWCNTs and O-MWCNTs, were incorporated into polystyrene (PS) and poly (methyl methacrylate) (PMMA) by solution blending at lower concentrations (0.5–10 mass%) than conventional organophosphorus flame retardants (5–30 mass%). Thermal properties of the PS and PMMA polymer nanocomposites were subsequently investigated through thermogravimetric (TG) analysis and microcombustion calorimetry. Scanning electron microscopy was used to evaluate P-MWCNT dispersion in each polymer matrix. P-MWCNTs were well-dispersed in PS, improved PS thermal stability during nitrogen pyrolysis in proportion to the phosphorus loading, and led to an improvement in PS flammability properties. In contrast, the P-MWCNTs were more aggregated in PMMA and only moderately improved PMMA thermal stability during pyrolysis. In both PS and PMMA, P-MWCNTs were more effective than either MWCNTs or O-MWCNTs at improving each polymer’s thermal oxidative stability during combustion in air. Characterization of the P-MWCNT nanoparticles, the PS and PMMA nanocomposites, and TG residues indicated that P-MWCNT flame retardants primarily act in the condensed phase, encouraging char formation of the dispersed MWCNT network as a route to protecting the polymer. By comparing results of polymer composites containing MWCNTs, O-MWCNTs or P-MWCNTs at comparable loadings, data from the current study indicate that phosphorus incorporation can improve the fire-retardant properties of MWCNTs, although optimizing P-MWCNT dispersion in different polymers remains critical to optimizing the flame-retardant effect.
DESCRY: reproducing system-level concurrency failures

Concurrent systems may fail in the field due to various elusive faults such as race conditions. Reproducing such failures is hard because (1) concurrency failures at the system level often involve multiple processes or event handlers (e.g., software signals), which cannot be handled by existing tools for reproducing intra-process (thread-level) failures; (2) detailed field data, such as user input, file content and interleaving schedule, may not be available to developers; and (3) the debugging environment may differ from the deployed environment, which further complicates failure reproduction. To address these problems, we present DESCRY, the first fully automated tool for reproducing system-level concurrency failures based only on default log messages collected from the field. DESCRY uses a combination of static and dynamic analysis techniques, together with symbolic execution, to synthesize both the failure-inducing data input and the interleaving schedule, and leverages them to deterministically replay the failed execution using existing virtual platforms. We have evaluated DESCRY on 22 real-world multi-process Linux applications with a total of 236,875 lines of code to demonstrate both its effectiveness and its efficiency in reproducing failures that no other tool can reproduce.
Quasi-static pulmonary P-V curves of patients with ARDS, Part I: Characterization.

Abstract Quasi-static, pulmonary pressure–volume (P–V) curves are combined with a respiratory system model to analyze characteristics of patients with acute respiratory distress syndrome (ARDS). It is shown that there exist distinct differences between healthy- and injured-respiratory system in the order of magnitudes of parameters of their P–V model equation. Four stages of ARDS (Early ARDS, Deep knee, Advanced ARDS and Baby lung) are defined quantitatively in terms of these parameters.
Primary Closure of Animal Bites.

Dog bites can have a primary closure at the time of injury. Primary closure of dog bites does not increase the rate of wound infections compared with nonclosure.
Using a Single-Switch Voice Output Communication Aid to Increase Social Access for Children with Severe Disabilities in Inclusive Classrooms.

Three young children with severe, multiple disabilities were taught to utilize a voice output communication aid (VOCA) to request access to preferred items and/or peers during play activities. Acquisition of VOCA use resulted from a naturalistic intervention strategy that consisted of creating communication opportunities, prompting the participant to engage in the target behavior via a full physical prompt, and facilitating access to natural consequences for appropriate participant responses. Intervention occurred in the context of naturally occurring free-choice activities in inclusive classrooms. Results showed that the intervention strategy was effective in teaching all three participants to use a VOCA to request access to items and/or peers. The peers generally responded to the participants with either positive or neutral responses. Survey data on the acceptability of the intervention to classroom staff are also discussed.
Kenneth David Jackson. Adverse Genres in Fernando Pessoa. New York: Oxford University Press, 2010.

In Adverse Genres in Fernando Pessoa, Kenneth David Jackson proposes a new understanding of Pessoa’s approach to literary genres. The study highlights the centrality of the figure of paradox in Pessoa’s works, which, as demonstrated, has also permeated the criticism of his texts. Jackson revisits influential conceptualizations of Pessoa and his heteronyms, such as Octavio Paz’s “the man who didn’t know himself,” Jorge de Sena’s “the man who never was,” or George Monteiro’s “empty labyrinth” of his inner-being.
Characterization of transport limitations in SAPO-34 adsorbent coatings for adsorption heat pumps

Abstract Adsorption heat pumps have become an increasingly viable technology to use waste heat or renewable thermal energy for heating and cooling. The power density of this emerging technology is limited by the rate of heat and/or mass transfer in the adsorption heat exchanger (AdHEX) which drives investment costs. This work presents an experimental analysis of the mass and heat transfer during water sorption on SAPO-34 coatings to determine the limiting transport mechanism in state-of-the-art AdHEX. Isochoric temperature swings were carried out and evaluated using a recently introduced method to determine the relative importance of heat and mass transport impedances. Coatings with thicknesses between 60 and 460 µm were investigated and in all cases the sorption dynamics were limited by mass transport. Ragone plots were used to characterize the power and energy trade-off during thermal cycling of SAPO-34 in water vapor to identify the pareto-optimal cycle time for a specific coating thickness. With the knowledge of the rate-limiting mechanism, the overall transport rates of adsorbent coatings can systematically be improved to enhance transport rates in next-generation AdHEX.
Protamine sulfate for the reversal of enoxaparin associated hemorrhage beyond 12 h.

Abstract Clinical practice guidelines recommend protamine sulfate for reversal of enoxaparin associated bleeds dependent on the time from last administration and dose of enoxaparin. We present a case of a hemodynamically unstable patient with an enoxaparin induced abdominal wall hematoma/hemorrhage and the previous enoxaparin administration 21.5 h prior to presentation with a therapeutic anti-Xa assay (0.8 IU/mL) upon assessment in the emergency department. Along with resuscitative efforts, an interdisciplinary team collaborated to administer protamine sulfate 50 mg intravenous once (0.5 mg per 1 mg of enoxaparin) to reverse the therapeutic anticoagulation. Our case demonstrates the importance of monitoring renal function and the potential for accumulation of enoxaparin in patients with renal dysfunction leading to prolonged therapeutic anti-Xa assays. With the availability of anti-Xa assays, future reversal recommendations of enoxaparin associated bleeds using protamine sulfate should include the initial anti-Xa assay as a guide for the dosing regimen.
Virtual Reality, Visual Cliffs, and Movement Disorders

We outline an experimental setup designed to dynamically understand neural responses to visual cliffs while walking. The goal of our work is understanding and mitigating fear of falling, particularly among the elderly. In our setup, an EEG cap monitors a subject’s neural activity while the subject is immersed in a virtual world and walking on an instrumented treadmill. The subject’s response to visual stimuli is measured by both the EEG cap and by speed and pressure data from the treadmill. Based on this data, we can dynamically alter the landscape in the virtual world. We hope that our setup may be useful in helping subjects develop mechanisms to compensate for significant fear of falling while walking.
The Psychology of Sexual Harassment

Sexual harassment (SH) occurs when people are targets of unwanted sexual comments, sexual gestures, or sexual actions because of their actual or perceived gender, gender expression, or sexual orien...
Notizen: Two New Phloroglucinol Derivatives with Phosphodiesterase Inhibitory Activity from the Leaves of Eucalyptus robusta

Two simple, new phloroglucinol derivatives have been isolated from the leaves of Eucalyptus robusta Smith, used in the Chinese traditional medicine Da Ye An. These phenolic compounds were purified using a phosphodiesterase inhibition bioassay to guide the isolation. Both compounds had moderate activity in this bioassay.
Association of Smoking and Other Factors With the Outcome of Mohs Reconstruction Using Flaps or Grafts.

ImportanceSmoking, a common lifestyle trait, is considered by many surgeons to be a major risk factor for postoperative complications. However, in the literature on local reconstruction, the associ...
A preliminary report of an in vivo investigation of amphetamine-induced dopamine release in schizophrenia.

1630 Objectives To characterize the effects of amphetamine on dopaminergic neurotransmission in schizophrenia. Methods Participants with schizophrenia (N=17) (5F, 12M) and [healthy participants (N=21) (8F, 13M)], aged in years, mean = 32.94 [31.33], range = (18, 48) [(18,53)], underwent two 90-min PET scans after intravenous (IV) injections of 740 Mbq (20 mCi) high-specific-activity [11C]raclopride. Five min before the first scan, they received 10 mL 0.9% NaCl intravenously (IV) (inert), and five min before the second scan, they received 0.3 mg/kg amphetamine IV (challenge). Dopamine release was calculated by means of true equilibrium bolus estimation (TREMBLE) (Wong, et al, 1998) utilizing regions of interest (ROIs) manually drawn on coregistered images of PET and MRI as follows: caudate nucleus (CN), putamen (P), and ventral striatum (VS). Dopamine release (DAR) = [BPsaline - BPamphetamine]/[BPsaline] where BP = binding potential Results DAR in CN, P, and VS did not differentiate people with established schizophrenia (N=9) (1F, 8M) from [healthy participants (N=9) (5F, 4M)]. In contrast, a never-medicated subject suffering a first psychotic episode (a 29-year-old man, see Table) demonstrated substantial dopamine release of 0.29 CN, 0.31 P, and 0.32 VS, values far exceeding those for participants with the syndrome of Gilles de la Tourette and healthy participants (Wong, et al, 2008). Conclusions People with initial psychotic symptoms of schizophrenia without medication may exhibit marked phasic elevations of both psychotic symptoms and striatal DAR. Research Support PHS Grants RO1 MH078175, NS38927, K24 DA00412, RO1 AA12839, the Johns Hopkins Institute for Clinical and Translational Research (ICTR) Grant Number UL1 TR 001079 from the Center for Advancing Translational Sciences (NCATS), a component of NIH and NIH roadmap for Medical Research, and the Brain and Behavior Research Foundation (NARSAD)
The role of changing temperature in microbial metabolic processes during permafrost thaw

Approximately one fourth of the Earth's Northern Hemisphere is underlain by permafrost, earth materials (soil, organic matter, or bedrock), that has been continuously frozen for at least two consecutive years. Numerous studies point to evidence of accelerated climate warming in the Arctic and sub-Arctic where permafrost is located. Changes to permafrost biochemical processes may critically impact ecosystem processes at the landscape scale. Here, we sought to understand how the permafrost metabolome responds to thaw and how this response differs based on location (i.e. chronosequence of permafrost formation constituting diverse permafrost types). We analyzed metabolites from microbial cells originating from Alaskan permafrost. Overall, permafrost thaw induced a shift in microbial metabolic processes. Of note were the dissimilarities in biochemical structure between frozen and thawed samples. The thawed permafrost metabolomes from different locations were highly similar. In the intact permafrost, several metabolites with antagonist properties were identified, illustrating the competitive survival strategy required to survive a frozen state. Interestingly, the intensity of these antagonistic metabolites decreased with warmer temperature, indicating a shift in ecological strategies in thawed permafrost. These findings illustrate the impact of change in temperature and spatial variability as permafrost undergoes thaw, knowledge that will become crucial for predicting permafrost biogeochemical dynamics as the Arctic and Antarctic landscapes continue to warm.
A random small molecule library screen identifies novel antagonists of the kinin receptor from the cattle fever tick, Rhipicephalus microplus (Acari: Ixodidae).

BACKGROUND The southern cattle tick, Rhipicephalus microplus, is a primary vector of the deadly bovine disease babesiosis. Worldwide populations of ticks have developed resistance to acaricides, underscoring the need for novel target discovery for tick control. The arthropod-specific R. microplus kinin receptor is such a target, previously validated by silencing, which resulted in female reproductive fitness costs, including a reduced percentage of eggs hatching. RESULTS In order to identify potent small molecules that bind and activate or inhibit the kinin receptor, a high-throughput screening (HTS) assay was developed using a CHO-K1 cell line expressing the recombinant tick kinin receptor (BMLK3 ). A total of ~20 000 molecules from a random in-house small molecule library were screened in a 'dual-addition' calcium fluorescence assay. This was followed by dose-response validation of the hit molecules identified both from HTS and an in silico screen of ~390 000 molecules. We validated 29 antagonists, 11 of them were full antagonists with IC50 values between 0.67 and 8 μmol L-1 . To explore the structure-activity relationships (SAR) of the small molecules, we tested the activities of seven analogs of the most potent identified antagonist, additionally discovering three full antagonists and four partial antagonists. These three potent antagonists (IC50 < 3.2 μmol L-1 ) were validated in vitro using the recombinant mosquito kinin receptor and showed similar antagonistic activities. In vivo, these three compounds also inhibited the mosquito hindgut contraction rate induced by a myotropic kinin agonist analog 1728. CONCLUSION Antagonists identified in this study could become pesticide leads and are reagents for probing the kinin signaling system. © 2021 Society of Chemical Industry.
The value of formal planning for strategic decisions: reply

In Armstrong (1982a), I examined alternative explanations to the empirical findings that supported the use of formal planning. In considering the possibility that researcher bias might lead to such results, I used Terpstra's (1981) evaluation scheme. Based on this test, poor methodology did not seem responsible for the conclusions on the value of formal planning.
Exploring treatment needs among women who prostitute

Women engaged in street-level prostitution (SLP) report high treatment recidivism rates and worse substance use treatment outcomes compared to other treatment-seeking women. Even so, few efforts ha...
Perioperative care of adults with Down syndrome: a narrative review

Because of enhanced life expectancy due to medical and surgical therapeutic advances, it is estimated that there are more adults than children living with Down syndrome (DS), or trisomy 21, in the United States. Therefore, DS can no longer be considered a syndrome limited to the pediatric population. These patients are presenting for surgery and anesthesia in adult care settings, where anesthesiologists will encounter these patients more frequently. As these patients age, their commonly associated co-morbidities not only progress, but they also develop other cardiac, respiratory, gastrointestinal, and neurologic conditions. The manifestations and consequences of chronic disease can present new challenges for the anesthesiologist and require expertise and judgement to minimize patient risk. The purpose of this narrative review is to describe the common pediatric co-morbidities associated with DS and discuss the age-acquired manifestations. Additionally, considerations for anesthetic care of the adult with DS will be presented, including the preoperative assessment, intraoperative management, and postoperative care.
Engaging in Health Activism through Neighbor-to-Neighbor Communication.

Given the importance of local organizing to environmental health advocacy and activism, we need more understanding of how neighbors communicate about health risks. Individual residents in a neighbo...
Examining Factors that Impact Intentions to Use Pre-Exposure Prophylaxis Among African-American Young Adults

Pre-exposure prophylaxis (PrEP) is a biomedical HIV prevention strategy with potential to reduce racial HIV disparities. However, African-Americans have not received the benefits of PrEP to the same extent as other groups. The theory of planned behavior (TPB) was employed to explain intentions to use PrEP among a sample of African-Americans (age 18–29) in Louisville, Kentucky. Data were derived from the Afya Project, a study examining PrEP-focused HIV prevention for African-American young adults. The sample was developed through respondent-driven sampling and participants (N = 181) completed audio computer-assisted self-interviews assessing demographics and TPB variables. Analysis of variance was used to examine relationships between demographics and PrEP intentions. Linear regressions determined associations between control beliefs, attitudes, norms, and PrEP use intentions. Confidence in using PrEP (p ≤ .0001), perceived HIV risk (p ≤ 0.05), perceived likelihood of acquiring HIV (p ≤ 0.05), and positive norms around PrEP (p ≤ 0.05) were significantly associated with PrEP use intentions. Findings can inform interventions to advance PrEP as a HIV prevention option for African-American populations at higher risk of contracting HIV.
Like Mother, Like Daughter: Feeding Intolerance in the NICU.

A female infant is born at 35 weeks, 4 days of gestation to a 29-year-old gravida 1, para 1 mother via cesarean section because of a footling breech presentation. The mother had received adequate prenatal care and had normal ultrasonography scans except for the finding of a 2-vessel cord and an infant who was small for gestational age. Maternal infectious laboratory findings are negative. Delivery is uneventful and Apgar scores at 1 minute and 5 minutes are 7 and 9, respectively. The infant’s birthweight is 1,920 g (0.35%, Z −2.69), birth length is 44.5 cm (1.46%, Z −2.18), and head circumference is 29.8 cm. (0.02%, Z −3.6) Around 85 minutes after birth, because of jitteriness, the infant’s blood glucose (BG) is measured and found to be 21 mg/dL (1.17 mmol/L). She is offered preterm infant formula 22 kcal/oz, of which, she took around 10 mL, and repeat BG is found to be 27 mg/dL (1.5 mmol/L). A peripheral intravenous catheter is placed and a 2 mL/kg bolus of 10% dextrose (D10) given, and an infusion of D10 in water at the rate of 80 mL/kg per day is started. Repeat BG is 88 mg/dL (4.9 mmol/L). On day 2 after birth, she starts having choking episodes and nonbilious emesis with feeding. Abdominal radiography shows a nonobstructive bowel gas pattern. She is transferred to the NICU and a nasogastric (NG) tube placed for feeding. Her BG levels remain stable with NG feedings, and she continues to be in room air with no evidence of respiratory distress. A sepsis evaluation is completed, with rule-out antibiotics (ampicillin and gentamycin) for 48 hours, with negative findings noted on culture. Echocardiography and head ultrasonography findings are normal, renal ultrasonography shows normal kidneys and a questionable bicornuate uterus. Physical examination findings are otherwise normal except for …
Basic Data on Hydrogen-Deficient Stars

The current state of our knowledge on the distribution and motions of various types of hydrogen-deficient stars, and of their positions in the H-R diagram,, is reviewed. It is concluded that the extreme helium stars (with the exception of the H-deficient binaries) and cool hydrogen-deficient stars belong to the population of the Galactic nuclear bulge, whereas the intermediate helium stars are young stars of Population I. The helium-rich sdO stars appear to be a local sample which is predominantly Population I.
Cost-Effectiveness Analysis of Morcellation Hysterectomy for Myomas.

Abstract Study Objective To estimate the cost-effectiveness of eliminating morcellation in the surgical treatment of leiomyomas from a societal perspective. Design Cost-effectiveness analysis. Design Classification Not applicable. Setting A theoretical cohort of women undergoing hysterectomy for myoma disease large enough to require morcellation. Patients None. Interventions None. Measurements A decision analysis model was constructed using probabilities, costs, and utility data from published sources. A cost-effectiveness analysis analyzing both quality-adjusted life years (QALYs) and cases of disseminated cancer was performed to determine the incremental cost-effectiveness ratio (ICER) of eliminating morcellation as a tool in the surgical treatment of leiomyomas. Costs and utilities were discounted using standard methodology. The base case included health care system costs and costs incurred by the patient for surgery-related disability. One-way sensitivity analyses were performed to assess the effect of various assumptions. Main Results The cost to prevent 1 case of disseminated cancer was $10 540 832. A strategy of nonmorcellation hysterectomy via laparotomy costed more ($30 359.92 vs $20 853.15) and yielded more QALYs (21.284 vs 21.280) relative to morcellation hysterectomy. The ICER for nonmorcellation hysterectomy compared with morcellation hysterectomy was $2 184 172 per QALY. Health care costs (prolonged hospitalizations) and costs to patients of prolonged time away from work were the primary drivers of cost differential between the 2 strategies. Even when the incidence of occult sarcoma in leiomyoma surgery was ranged to twice that reported in the literature (.98%), the ICER for nonmorcellation hysterectomy was $644 393.30. Conclusions Eliminating morcellation hysterectomy as a treatment for myomas is not cost-effective under a wide variety of probability and cost assumptions. Performing laparotomy for all patients who might otherwise be candidates for morcellation hysterectomy is a costly policy from a societal perspective.
Characteristics and outcome of children with Beckwith-Wiedemann syndrome and Wilms' tumor: a report from the National Wilms Tumor Study Group

PURPOSE: Children with Beckwith-Wiedemann syndrome (BWS) are at increased risk for developing Wilms’ tumor (WT). We reviewed the National Wilms Tumor Study Group (NWTSG) records to assess clinical characteristics and outcome of patients with WT and BWS. METHODS: In the NWTSG, treating clinicians were asked to report, for each enrolled patient, whether the patient had BWS. Between 1980 and 1995, 4,669 patients were treated on two consecutive NWTSG protocols (NWTS 3 and NWTS 4). We retrospectively reviewed the clinical characteristics and treatment outcomes of BWS patients compared with patients with WT without BWS. RESULTS: Fifty-three children enrolled onto NWTS 3 and 4 were reported to have BWS. BWS patients were more likely to present with lower-stage tumors (P = .0001), with more than half (27 of 53) presenting with stage I disease. The overall treatment outcomes for the BWS patients were nearly identical to those without BWS, with overall survival at 4 years from diagnosis at 89% and 90%, respectively...
HipBA-promoter structures reveal the basis of heritable multidrug tolerance

Multidrug tolerance is largely responsible for chronic infections and caused by a small population of dormant cells called persisters. Selection for survival in the presence of antibiotics produced the first genetic link to multidrug tolerance: a mutant in the Escherichia coli hipA locus. HipA encodes a serine-protein kinase, the multidrug tolerance activity of which is neutralized by binding to the transcriptional regulator HipB and hipBA promoter. The physiological role of HipA in multidrug tolerance, however, has been unclear. Here we show that wild-type HipA contributes to persister formation and that high-persister hipA mutants cause multidrug tolerance in urinary tract infections. Perplexingly, high-persister mutations map to the N-subdomain-1 of HipA far from its active site. Structures of higher-order HipA–HipB–promoter complexes reveal HipA forms dimers in these assemblies via N-subdomain-1 interactions that occlude their active sites. High-persistence mutations, therefore, diminish HipA–HipA dimerization, thereby unleashing HipA to effect multidrug tolerance. Thus, our studies reveal the mechanistic basis of heritable, clinically relevant antibiotic tolerance. The molecular basis of multidrug tolerance in chronic urinary tract infections is mediated by mutations in the N-subdomain-1 of the Escherichia coli HipA protein kinase. The spread of multidrug tolerance among bacterial pathogens is mainly due to the existence of 'persisters', phenotypic variants that lie dormant and so are not susceptible to antibiotics that are effective only against actively growing cells. Maria Schumacher et al. show here that wild-type HipA, a serine protein kinase that inhibits protein synthesis and drives cells into dormancy, contributes to persister formation in Escherichia coli, and that hipA7 high-persister mutants are present in patients with urinary tract infections. The authors determine the structures of transcription autorepression complexes consisting of promoter DNA and HipA–HipB complexes. These structures reveal that high-persistence mutations function by interfering with HipA–HipA interactions, releasing HipA from the higher-order complex and triggering multidrug tolerance.
Using XHMM software to detect copy number variation in whole-exome sequencing data

Copy number variation (CNV) has emerged as an important genetic component in human diseases, which are increasingly being studied for large numbers of samples by sequencing the coding regions of the genome, i.e., exome sequencing. Nonetheless, detecting this variation from such targeted sequencing data is a difficult task, involving sorting out signal from noise, for which we have recently developed a set of statistical and computational tools called XHMM. In this unit, we give detailed instructions on how to run XHMM and how to use the resulting CNV calls in biological analyses.
Effect of type 1 piliation on in vitro killing of Escherichia coli by mouse peritoneal macrophages.

Abstract Escherichia coli K-12 mutants possessing defined lesions affecting type 1 pilus production, receptor binding, or length were examined for their ability to resist killing by mouse peritoneal macrophages in vitro. Mutants were mixed pairwise at known ratios in wells containing macrophages, and after incubation, the ratio of the survivors was assayed. The difference in phagocytic killing between type 1 piliated cells and isogenic nonpiliated cells was significant, the piliated cells being approximately threefold more resistant. Pilus length had little effect upon survival, as the long-piliated mutants were no more resistant to killing than the normal-length parents. Interestingly, the receptor-binding function of type 1 pili was most important in effecting resistance, as mutants lacking the ability to bind receptor were killed as effectively as nonpiliated mutants. These data are consistent with the notion that pili actually impede killing by macrophages rather than serve as passive physical barriers to uptake.
Influence of self-management and self-management support on chronic low back pain patients in primary care.

AbstractPurpose:This study utilized a nonexperimental, cross-sectional, descriptive design to examine self-management (SM), self-management support (SMS), and other pain-related variables in chronic low back pain (CLBP), and described participants’ perceptions of their SM, SMS, and functional ableme
Development of an in vitro dissolution method using microdialysis sampling technique for implantable drug delivery systems

The major challenge faced during the development of implantable dosage forms for site-specific delivery is monitoring the local concentration of the drug at or around the site of action. The tissue concentration at the site is generally measured by either sacrificing the animal at different points in time or by determining the amount of drug left in the implants at various time intervals. Unfortunately, there are no official in vitro dissolution methods available to study the release characteristics of drugs from this drug delivery system. The objective of this investigation was to develop a simple method using microdialysis sampling technique to serve as an in vitro dissolution method for implantable drug delivery systems. Ciprofloxacin implants were prepared by compressing ciprofloxacin microcapsules in poly(lactic acid) (PLA) and poly(lactic-glycolic acid) (PLGA). A sensitive HPLC method was developed and validated for the assay of Ciprofloxacin. An in vitro dissolution method was developed to study the release characteristics of drug from these implants. The method used a microdialysis sampling technique and a small sample volume of release medium. The various advantages and disadvantages of this method over other USP methods are discussed.
Behavioral and experiential avoidance in patients with hoarding disorder.

Abstract Background and objectives This study examined the relationship between experiential and behavioral avoidance and hoarding symptom severity, controlling for anxiety and depression symptoms, in 66 adult individuals (M age = 61.41; SD = 9.03) with HD. Methods Hierarchical regression was used to test the associations between hoarding severity, as defined by the Savings Inventory-Revised (SI-R) total and its three subscales, and avoidance, as defined by the Acceptance and Action Questionnaire II (AAQ-II) and two scales from the Brief COPE (Self-Distraction and Behavioral Disengagement) when controlling for anxiety and depression symptoms. Results Experiential avoidance (AAQ-II) and behavioral avoidance (Brief COPE subscales Self-Distraction and Behavioral Disengagement) uniquely accounted for aspects of hoarding severity (SI-R) in regression models. Behavioral avoidance contributed significant additional variance to the SI-R Clutter subscale, whereas experiential avoidance was uniquely predictive of additional variance in the SI-R Difficulty Discarding and the SI-R Acquisition subscales. Limitations Future research should examine the effect of experiential avoidance on hoarding behaviors experimentally. Conclusions Given that the AAQ-II and Self-Distraction and Behavioral Disengagement subscales were not correlated, these findings suggest that experiential and behavioral avoidance are two distinct processes contributing to the severity of specific HD. Results support the utility of avoidance in the cognitive-behavioral model for HD.
Epstein-Barr Virus Latent Membrane Protein LMP-2A Is Sufficient for Transactivation of the Human Endogenous Retrovirus HERV-K18 Superantigen

Superantigens are microbial proteins that strongly stimulate T cells. We described previously that the Epstein-Barr virus (EBV) transactivates a superantigen encoded by the human endogenous retrovirus, HERV-K18. We now report that the transactivation is dependent upon the EBV latent cycle proteins. Moreover, LMP-2A is sufficient for induction of HERV-K18 superantigen activity.
Magneto-absorption resonances in superconducting Al at 35 GHz

Abstract Multiple, narrow resonances in the microwave magneto-absorption are observed in a highly polished (110)-plane sample of superconducting Al. The dependence of the resonances on field orientation suggests that the resonant quasiparticles correspond to spherical portions of the Fermi surface. A doublet structure indicates transitions belonging to a single quantum well. The temperature dependence of the resonance positions appears to follow the simple scaling with magnetic field penetration observed in other metals.
Flexural properties and dynamic mechanical properties of glass fibre-epoxy composites

The viscoelastic behaviour of glass fibre (GF)-epoxy composites was studied by flexural tests and dynamic mechanical measurements. In relation, the influence of surface treatment of GF on viscoelastic behaviour was also examined. Using the results of flexural tests under a variety of constant temperature and strain rate, master curves of flexural strength (σ) and flexural strain (ɛ) were obtained for matrix epoxy and GF composites. The magnitudes of the master curves were different between matrix epoxy and GF composites. The fracture mode was influenced by temperature, strain rate, and G F surface treatment. The magnitude of storage modulus and effectiveness of adhesion at the GF-matrix interface were also influenced by GF surface treatment. Relationship between the results of flexural strain and loss modulus were considered for GF composites.