cssi/SciSciGPT-SciSciNet huggingface dataset:
Use of hyaluronic acid filler for enhancement of nipple projection following breast reconstruction: An easy and effective technique

Summary Background Breast reconstruction improves the psychological well-being of patients with breast cancer. Patients who complete nipple-areolar reconstruction are even more satisfied with their final reconstructive result. Nipple flattening is a common complication. We hypothesized that injectable soft-tissue filler can be used to augment nipple projection in patients who underwent breast reconstruction. Methods This is a retrospective study of patients who underwent breast reconstruction and desired an enhanced postoperative nipple projection. The patients underwent a single session of injection with a hyaluronic acid filler as an outpatient. The filler was injected intradermally at the base of the nipple until the desired nipple projection was obtained. Results Twelve patients and 22 breasts were included in this study. Enhanced nipple projection was observed in all cases, with an average increase of 3.0 mm in nipple height (range 2.5–4.5 mm). All injected nipples remained soft to the touch. All results were stable at a median of 7.5 months follow-up. No complications were observed. Conclusions The use of injectable fillers for enhanced nipple projection is a useful adjunct treatment in patients undergoing breast reconstruction. Advantages include the ability to obtain nipple projection in patients who opt to forgo nipple-areola reconstruction with local flaps, to augment reconstructed nipples in patients with thin mastectomy skin flaps especially following implant-based reconstruction, and to improve projection of the native nipple following nipple-sparing mastectomy. Another benefit of this adjunct treatment is that the injection is reversible. Filler injection is a safe and simple solution to the problem of insufficient nipple projection.
Optimizing Interprofessional Education with In Situ Simulation

There are many barriers and logistical burdens for implementing off-site simulation programs (i.e., in a simulation center) for healthcare teams in practice, including team availability, travel time to and from locations, and limited realism. In situ simulation, which utilizes a functional clinical environment with real staff, equipment, and systems to provide rehearsal and training for clinical teams, has been touted as one possible solution to ensure that healthcare providers can train together on simulated patients to develop and examine core team competencies.
Prediction of pregnancy loss by early first trimester ultrasound characteristics.

Background Pregnancy loss prediction based on routinely measured ultrasound characteristics is generally aimed toward distinguishing nonviability. Physicians also use ultrasound indicators for patient counseling, and in some cases to decide upon the frequency of follow-up sonograms. To improve clinical utility, allocation of cut-points should be based on clinical data for multiple sonographic characteristics, be specific to gestational week, and be determined by methods that optimize prediction. Objectives To identify routinely measured features of the early first trimester ultrasound and the gestational age−specific cut-points that are most predictive of pregnancy loss. Materials and Methods This was a secondary analysis of 617 pregnant women enrolled in the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial; all women had 1−2 previous pregnancy losses and no documented infertility. Each participant had a single ultrasound with a detectable fetal heartbeat between 6 weeks 0 days and 8 weeks 6 days. Cut-points for low fetal heart rate and small crown–rump length were separately defined for gestational weeks 6, 7, and 8 to optimize prediction. Identity and log-binomial regression models were used to estimate absolute and relative risks, respectively, and 95% confidence intervals between jointly categorized low fetal heart rate, small crown–rump length, and clinical pregnancy loss. Adjusted models accounted for gestational age at ultrasound in weeks. Missing data were addressed using multiple imputation. Results A total of 64 women experienced a clinical pregnancy loss following the first ultrasound (10.4%), 7 were lost to follow-up (1.1%), and 546 women (88.5%) had a live birth. Low fetal heart rate and small crown–rump length (≤122, 123, and 158 bpm; ≤6.0, 8.5, and 10.9 mm for gestational weeks 6, 7, and 8, respectively) were independent predictors of clinical pregnancy loss, with greatest risks observed for pregnancies having both characteristics (relative risk, 2.08; 95% confidence interval, 1.24−2.91). The combination of low fetal heart rate and small crown–rump length was linked to a 16% (95% confidence interval, 9.1−23%) adjusted absolute increase in risk of subsequent loss, from 5.0% (95% confidence interval, 1.5−8.5%) to 21% (95% confidence interval, 15−27%). Abnormal yolk sac diameter or the presence of a subchorionic hemmhorage did not improve prediction of clinical pregnancy loss. Conclusion Identified cut-points can be used by physicians for patient counseling, and in some cases to decide upon the frequency of follow-up sonograms. The specified criteria should not be used to diagnose nonviability.
An Overview of Rising CO2 and Climatic Change on Aeroallergens and Allergic Diseases

There are a number of implications of climate change in regard to human health. Among these, the role of rising carbon dioxide (CO₂) and temperature in aeroallergen exposure and associated changes in the start, duration and intensity of the pollen season, and associated consequences in aeroallergens and allergic disease are a primary concern. This review is intended to provide a synopsis of CO₂ and climate factors associated with likely changes in aeroallergen biology (indoor and outdoor), including changes in the demography of flowering plants, pollen seasonality, aeroallergen production, and potential biotic and abiotic interactions. These factors, in turn, are compared to clinical trials that have linked aeroallergens to allergic disease and associated health impacts. Finally, suggestions to address unmet needs and critical knowledge gaps are offered. Such recommendations are not meant to be inclusive, but to serve as a spur for the additional research and resources that will be necessary to acquire a better understanding of climate change, CO₂, aeroallergens and associated allergic diseases. Such resources will be critical to derive time-relevant scientific and policy solutions that will minimize public health consequences in a changing climate.
GSP expiration and declining exports from developing countries

This paper investigates whether the 2011 expiration of the most comprehensive trade preference program (Generalized System of Preferences or GSP) offered by the US had a detrimental impact on the exports from developing countries. The effect of GSP expiration is examined with a triple difference‐in‐differences estimation that controls for both country‐ and product‐level export changes. Even though the duties collected during the period of expiration are ultimately refunded after GSP is reauthorized, the findings of this paper suggest that the expiration of GSP had a considerable impact on the level of exports to the US. On average exports dropped by 3% in 2011, with exports of agricultural products and textiles and clothing declining as much as 5% and 9%, respectively. The decline is increasing in the tariff rates and rates of utilization. The effect appears to be persistent over time as exports do not fully recover by 2012. The 2011 expiration is also found to be similar in magnitude to the 1995–1996 and 2013–2015 expirations, the longest episodes of expiration in the history of the GSP. Resume. Suspension du SGP et baisse des exportations en provenance des pays en voie de developpement. Cet article cherche a determiner si la suspension en 2011 du Systeme Generalise de Preferences (SGP) propose par les Etats‐Unis eut des consequences negatives sur les exportations en provenance des pays en voie de developpement. Nous etudions l’effet de la suspension du SGP grâce a une estimation basee sur la methode des triples differences tenant compte des changements en matiere d’exportation, a la fois au niveau des produits mais aussi des pays. Meme si les droits percus au cours de la periode d’interruption du SGP furent finalement restitues au moment de sa reintroduction, les conclusions de cet article suggerent que la suspension du SGP engendra des repercussions considerables quant au niveau des exportations vers les Etats‐Unis. En moyenne, les exportations chuterent de 3% en 2011; les exportations de produits agricoles et les exportations de textiles et de vetements chuterent quant a elles de 5% et 9% respectivement. Cette baisse entraina une hausse des droits de douane et des taux d’utilisation. Ces effets semblent persister dans le temps puisque les exportations en 2012 ne retrouverent pas totalement les niveaux anterieurs. Il apparait que la suspension du SGP en 2011 fut de meme ampleur que les interruptions de 1995–1996 et de 2013–2015, les plus longues de l’histoire du SGP.
Hit or miss: the use of melatonin supplements.

Citation:Goldstein CA, Burgess HJ. Hit or miss: the use of melatonin supplements. J Clin Sleep Med. 2020;16(suppl_1):29S–30S.
Surface-Normal Active Flow Control for Lift Enhancement and Separation Mitigation for High-Lift Common Research Model

This study explores the feasibility of using small surface-normal jets near the flap trailing edge as active aerodynamic load control on the high-lift Common Research Model wing/-body configuration. Chimera Grid Tools are utilized to generate structured curvilinear overset grids, and the Reynolds-averaged Navier-Stokes solver OVERFLOW is employed to solve for the flow-field around the geometry. The so-called microjet is initially employed across both the inboard and the outboard flaps on the pressure-side near the trailing edge. It is shown that implementing the microjet on the inboard flap is more effective compared to implementing it on the outboard flap. This is because, prior to microjet implementation, the flow on the outboard flap exhibits extensive separation, while the flow on the inboard flap exhibits moderate separation. For microjet implementation across the inboard flap only, the relationship between momentum coefficient of the microjet and lift-enhancement is found to be∆CL'1.66√Cμfor the rangeCμ= 0.00−0.012. We show that implementing a microjet with a jet velocity ratio of one, which corresponds toCμ= 0.003, can shift the linear region of the lift curve by ∆CL= 0.08. The linear shift in the lift curve is significant for enhancing airplane performance such as increasing its payload. Microjet implementation effects on the drag coefficient are also investigated through a drag decomposition analysis. Further, we employ an induced drag analysis based on the spanwise load distribution and show that the microjet-related increase in pressure drag coefficient is dominated by the increase in the induced drag while microjet implementation reduces the form drag. These preliminary results show that favorable changes in aerodynamic performance can be achieved by using the surface-normal jets presented in this study.
Fiscal Buffers for Natural Disasters in Pacific Island Countries

Pacific island countries (PICs) are vulnerable severe natural disasters, especially cyclones, inflicting large losses on their economies. In the aftermath of disasters, PIC governments face revenue losses and spending pressures to address post-disaster relief and recovery efforts. This paper estimates the effects of severe natural disasters on fiscal revenues and expenditure in PICs. These are combined with information on the frequency of large disasters to calculate the rate of budgetary savings needed to build appropriate fiscal buffers. Fiscal buffers provide self-insurance against natural disaster shocks and facilitate quick disbursement for recovery and relief efforts, and protection of spending on essential services and infrastructure. The estimates can provide a benchmark for policymakers, and should be adjusted to take into account other sources of financing, as well as budget risks from less severe as well as more frequent disasters.
Improving Memory Reliability by Bounding DRAM Faults: DDR5 improved reliability features

DRAM reliability is an increasingly difficult to address as error correction code (ECC) overhead increases and process nodes shrink, driving up DRAM cell errors. As single bit errors increase, failures of larger hardware structures within the memory are also an ever-present threat to data integrity. This paper presents a set of methods aimed at reducing the required ECC overhead for correcting many DRAM failures types or fault types. This enables more reliable ECC protection of DIMMs that have traditionally been lower reliability, for example x8 DIMMs that have only one device allocated to ECC check-bits. Reducing the ECC overhead required to correct failures is done by limiting or bounding the area of a cache line that is impacted by those failure types. Individually these methods are all reliability features that a DDR5 memory vendor may choose to implement in their design; collectively this paper refers to these features as DDR5 – Bounded Fault or DDR5-BF. This paper will give an overview of the features needed to bound failures. Specifically, failure pattern requirements for common fault types and on-die ECC modifications to contain miscorrections in the event of multi-bit errors.
Abstract 17065: Performance of Cardiovascular Disease Risk Scores to Identify Coronary Artery Calcium Burden in Retired National Football League Players

Introduction: Coronary artery calcium (CAC) is a robust predictor of coronary events in asymptomatic individuals with latent atherosclerotic cardiovascular disease (CVD). While evidence suggests CA...
Motivation (Constructs) Made Simpler: Adapting Self-Determination Theory for Community-Based Youth Development Programs

Motivation is a key factor for enhancing psychological engagement among underserved youth. However, the abundance of motivational constructs complicates the translation of theory into practice by community-based youth development programs. This paper simplifies the translation process, presenting an actionable motivation model derived from Ryan and Deci’s (2000) self-determination theory (SDT) and its sub-construct, organismic integration theory (OIT). This model was developed by Youth Enrichment Services (YES), a Pittsburgh-based nonprofit that cultivates long-term relationships, academic and professional success, and community engagement among low-income, adolescent students of color. Although intrinsic motivation to learn is more positively associated with psychological engagement than extrinsic motivation, contemporary institutions are built around extrinsic incentives. Therefore, guided by OIT, this model cultivates the gradual internalization of motivational regulation by supporting youth’s psychological needs of relatedness, competences, and autonomy. As a practical application of self-determination theory, this model holds promise for adoption by other youth development programs.
A Review of Percutaneous Deep Vein Arterialization for the Treatment of Non-Reconstructable Chronic Limb Threatening Ischemia

Abstract Peripheral arterial disease is estimated to affect over 200 million people worldwide with some patients progressing to chronic limb threatening ischemia (CLTI). Patients with CLTI have extremely high rates of amputation and associated increases in morbidity and mortality. There is a subset of patients with CLTI that have no available options for revascularization due to factors such as the absence of distal target vessels or adequate conduit for surgical revascularization. Percutaneous deep vein arterialization can be utilized in patients with non-reconstructable CLTI. In this review article, we discuss patient selection, methods and techniques of deep vein arterialization. Additionally, results from studies evaluating the use of percutaneous deep vein arterialization, such as the Alkmaar (Netherlands), Leipzig (Germany), Paris (France) and Singapore (ALPS) multicenter center study and the prospective, multicenter, single-arm, early feasibility (PROMISE I) trial, are highlighted. These results have been encouraging with improved rates of limb salvage and wound healing reported, suggesting percutaneous deep vein arterialization may be beneficial in treating patients with CLTI.
Disparities in COVID-19 Outcomes by Race, Ethnicity, and Socioeconomic Status: A Systematic-Review and Meta-analysis.

Importance COVID-19 has disproportionately affected racial and ethnic minority groups, and race and ethnicity have been associated with disease severity. However, the association of socioeconomic determinants with racial disparities in COVID-19 outcomes remains unclear. Objective To evaluate the association of race and ethnicity with COVID-19 outcomes and to examine the association between race, ethnicity, COVID-19 outcomes, and socioeconomic determinants. Data sources A systematic search of PubMed, medRxiv, bioRxiv, Embase, and the World Health Organization COVID-19 databases was performed for studies published from January 1, 2020, to January 6, 2021. Study selection Studies that reported data on associations between race and ethnicity and COVID-19 positivity, disease severity, and socioeconomic status were included and screened by 2 independent reviewers. Studies that did not have a satisfactory quality score were excluded. Overall, less than 1% (0.47%) of initially identified studies met selection criteria. Data extraction and synthesis Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Associations were assessed using adjusted and unadjusted risk ratios (RRs) and odds ratios (ORs), combined prevalence, and metaregression. Data were pooled using a random-effects model. Main outcomes and measures The main measures were RRs, ORs, and combined prevalence values. Results A total of 4 318 929 patients from 68 studies were included in this meta-analysis. Overall, 370 933 patients (8.6%) were African American, 9082 (0.2%) were American Indian or Alaska Native, 101 793 (2.4%) were Asian American, 851 392 identified as Hispanic/Latino (19.7%), 7417 (0.2%) were Pacific Islander, 1 037 996 (24.0%) were White, and 269 040 (6.2%) identified as multiracial and another race or ethnicity. In age- and sex-adjusted analyses, African American individuals (RR, 3.54; 95% CI, 1.38-9.07; P = .008) and Hispanic individuals (RR, 4.68; 95% CI, 1.28-17.20; P = .02) were the most likely to test positive for COVID-19. Asian American individuals had the highest risk of intensive care unit admission (RR, 1.93; 95% CI, 1.60-2.34, P Conclusions and relevance In this study, members of racial and ethnic minority groups had higher risks of COVID-19 positivity and disease severity. Furthermore, socioeconomic determinants were strongly associated with COVID-19 outcomes in racial and ethnic minority populations.
Microcrystalloscopic Differentiation of 3,4-Methylenedioxyamphetamine and Related Amphetamine Derivatives

Commonly used gold chloride and its diluted forms are compared with gold bromide for potential microcrystalloscopic differentiation of 3,4-methylenedioxyamphetamine (MDA) and related amphetamine derivatives. The crystal formation characteristics of MDA, mescaline, and 2,5-dimethoxy-4-ethylamphetamine (DOET) with diluted and undiluted gold chloride allow differentiation of these drugs, while 3,4-methylenedioxymethamphetamine (MDMA) and 3,4-methylenedioxy-N-ethylamphetamine (MDEA) form similar crystals and are not easily differentiated. The compounds 2,5-dimethoxy-4-methylamphetamine (DOM) and N-hydroxy-MDA were soluble in the gold chloride reagents, and no crystals were formed.
Coronary artery dilation and left ventricular hypertrophy do not predict morbidity in children with sickle cell disease

Background Little is known about the clinical significance of coronary artery dilation (CAD) and left ventricular hypertrophy (LVH) in patients with sickle cell disease (SCD). Procedure In a retrospective cohort, we studied the prevalence of CAD and LVH in 101 children with SCD in comparison to 93 healthy African–American patients without SCD. Hospital days, number of admissions, and intensive care unit admission after the echocardiogram were assessed as measures of morbidity. Results Multivariable analysis of echocardiographic measures of LVH and CAD did not predict subsequent intensive care unit admission, hospital days/year or number of hospital admissions/year during a median follow-up time of 6.1 years. LVH as measured by left ventricular mass index was present in 46% of children with SCD and was inversely related to age (P = 0.0004). Height-indexed dimensions in children with SCD demonstrated that the prevalence of dilation was 49% for the left main coronary artery (LMCA), 29% for the left anterior descending (LAD), and 6% for the right coronary artery (RCA). LMCA dilation was related to relative wall thickness (P = 0.006), inversely to age (P < 0.0006) and weakly to disease severity as determined by hemoglobin (P = 0.03). CAD and LVH were not related to a clinical history of vaso-occlusive pain episode, acute chest syndrome, or cerebrovascular accident. Conclusion LVH and CAD are common findings in children with SCD; however, they are not associated with need for subsequent hospital or intensive care unit admission. Pediatr Blood Cancer 2015;62:115–119. © 2014 Wiley Periodicals, Inc.
Mössbauer study of CO dehydrogenase from Clostridium thermoaceticum.

We have studied with Mossbauer spectroscopy the metal clusters of CO dehydrogenase from Clostridium thermoaceticum. At potentials greater than -200 mV, all of the approximately 12 irons reside in diamagnetic environments and contribute a quadrupole doublet characteristic of [Fe4S4]2+ clusters. At lower potentials a variety of components are observed. About 40% of the Fe appears to belong to one [Fe4S4]1+ cluster. We have also observed the Mossbauer spectrum (approximately 18% of Fe) of the complex which yields EPR with g = 2.01, 1.81, and 1.65. Also present is a doublet (9% of Fe) with delta EQ = 2.90 mm/s and delta = 0.70 mm/s, values typical of a ferrous FeS4 complex. This component seems to interact with a nickel site to form an EPR-silent complex with half-integral electronic spin. We have also characterized the iron environments of the S = 1/2 NiFeC complex. This complex contributes approximately 20% of the total Mossbauer absorption when the EPR signal has approximately 0.35 spins/12 Fe. From isomer shift comparisons in the oxidized and CO-reacted states of this center, we speculate that the NiFeC complex may consist of a nickel site exchange-coupled to a [Fe4S4]2+ cluster. Finally, the Mossbauer and EPR data, taken together, force us to conclude that current preparations, while homogeneous according to purifications standards, are spectroscopically heterogeneous, thus rendering the development of a model of the cluster types and compositions in this enzyme premature.
The Proper Scope of the Copyright and Patent Power

As an increasing amount of society's wealth is tied up in intangible assets, strong, clear property rights can make a good deal of sense. But it is also possible to have too much of a good thing, and our society is in danger of reaching that point. Recent scholarship suggests as much: a growing body of literature details the expansion of particular doctrines, the rising burden of IP-related transaction costs, or the pressing need for collective *46 institutions to mediate between individual firms and the mushrooming pile of IP rights they must traverse to do business. In this Essay, we approach one part of this problem at the source. We argue that there are limits on Congress's power to create and extend intellectual property interests. Such limits are "internal" in the sense that they are the result of the very same constitutional provision giving rise to Congress's power in the first place, the Copyright and Patent Clause of the Constitution which grants the power "To promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries." We argue that the language of the Copyright and Patent Clause may restrict some of Congress's more far-reaching efforts at promoting intellectual property in recent years, particularly in passing ad hoc extensions of copyrights and patents for the benefit of individual companies. We then suggest some approaches that courts might take in evaluating, and perhaps striking down, congressional actions in this area.
The Politics of Income Inequality in the United States

1. Explaining income inequality 2. The distributional force of government 3. Political conflict over 'who gets what?' 4. Party dynamics and income inequality 5. Macro policy and distributional processes 6. Who gets what and how 7. Distribution, redistribution, and the future of American politics.
A diagnostic for denitrification in the winter polar stratospheres

The pairwise correlation of NO(y) and N2O data from the Southern and Northern Hemispheres is presented. Both data sets show a linear correlation region, defined as a reference state, and regions of denitrification where the correlation breaks down. Using two-dimensional photochemical model simulations of the atmosphere, a similar linear correlation is found between NO(y) and N2O, thereby establishing a theoretical framework for the reference state. This general approach, which can be extended to other pairs of molecules, should prove to be powerful in further comparisons of aircraft data with numerical models.
Laser Flash Photolysis and Computational Study of Singlet Phenylnitrene

Laser flash photolysis (LFP, Nd:YAG laser, 35 ps, 266 nm, 10 mJ) of phenyl azide (PA) releases open-shell singlet phenylnitrene (1PN). 1PN has a sharp absorption band at 350 nm and a very weak absorption band at 540 nm. These bands are assigned as nz−ny and a mixture of 52% π−nx and 28% nx−π* transitions, respectively, on the basis of CASSCF and CASPT2 calculations. A CASPT2 calculation of the spectrum of triplet phenylnitrene (3PN) is in very good agreement with the experimental spectrum. A sharp absorption band of 3PN at 308 nm and a broad, structured band at 370 nm are assigned as nz−ny and π−π transitions on the basis of CASSCF and CASPT2 calculations. The low intensity, long wavelength band of 3PN tailing to 500 nm is assigned as a mixture of π−nx, nx−π* transitions. The decay of 1PN in pentane was measured as a function of temperature to obtain observed rate constants of disappearance, kobs. The rate constant kobs is equal to kR + kISC, where kR is the absolute rate constant of rearrangement of 1PN ...
SLEEP PATTERNS IN YOUNG ADULTS: AN EEG STUDY.

Abstract 1. 1. EEG sleep stages do not appear in any consistent temporal sequence from night to night in a given subject nor in a group of subjects. 2. 2. The typical young adult in our study spent an individually characteristics relative amount of time in each sleep stage each night. 3. 3. The length of stages was short, usually less than 10 min, with the exception of stage 1-REM which ranged up to 39 min in length. Our subjects characteristically changed stages fewer times on successive nights. The number of sleep stage changes differed among subjects. 4. 4. The stage change was usually smooth, moving from one stage to the next when sleep was deepening, but less smooth, often “jumping”.
Quality and Microbial Population of Cornish Game Hen Carcasses as Affected by Electron Beam Irradiation

We evaluated the chemical and microbiological quality of Cornish game hen carcasses irradiated up to 7 kGy with a 10 MeV linear accelerator (dual beam configuration). Eighty frozen and vacuum packaged (approximately 0.45 kg) Cornish game hens (Gallus domesticus) were irradiated and stored in low-density polyethylene bags at 4 ± 1 °C for 21 d; nonirradiated chickens served as controls. Fat oxidation (in terms of malonaldehyde content) increased with storage time and dose for all chicken parts analyzed (breast, thigh, and skin). As expected, the skin had the highest level of fat oxidation while the breast samples had the lowest. Oxidation level in all samples exposed to 2 kGy reached a maximum on day 14. Sensory evaluation showed that irradiation caused significant textural toughening, and increased the redness of raw chicken meat. In terms of overall quality and aroma, lipid oxidation was not a major problem since it was not detected by the panelists. Irradiation significantly reduced the total viable microbial counts (TVC) in the breast and thigh samples. Exposure to 3-kGy dose decreased the TVC by 0.3-log cycles on the surface of the skin. In less than 14 d, the nonirradiated chicken carcasses had counts greater than 6 log CFU/50 cm2, while the 2 and 3 kGy irradiated samples reached these numbers only after 21 d of storage. Samples irradiated at 7 kGy had consistently the lowest counts (2.5 log CFU/50 cm2) throughout storage time.This study shows that irradiation up to 7 kGy and refrigerated storage (4 °C) inhibits microbial growth and extends shelf life of Cornish game hens without affecting consumers' acceptability.
The drug aloes of commerce, with special reference to the cape species

The laxative property in the juice of aloe leaves has been recognized since ancient times. The Union of South Africa is the principal producer today, but 90% of American imports come from the Dutch West Indies— Aruba and Bonaire.
One Building, Many Histories: Historical Inquiry on a New York City Street

This article provides a discussion in which a building in New York City is used as a resource to access diverse historical concepts and ideas. Rather than usee a noteworthy, famous, or significant structure, the focus here is on a simple, nondescript tenement apartment. The article begins with a discussion of the building and the neighborhood that surrounds it. Subsequent sections use the building as an entry point to understand different historical themes through analysis of its construction date, its architectural style, and people who have lived there in the past. A concluding section discusses approaches that teachers can use to incorporate buildings in their own communities as instructional resources.
Heavy and light chain utilization in autoantibodies of elderly patients with systemic lupus erythematosus.

Abstract To determine whether age-related changes in immune function affect patterns of autoantibody production, we have examined the isotype and light chain utilization in autoantibodies of elderly patients with systemic lupus erythematosus (SLE). Enzyme-linked immunosorbent assays (ELISA) were used to determine the frequencies of IgG and IgM antibodies to single-stranded DNA (ssDNA), Sm, and the 70K protein component of RNP in the sera of 53 patients with SLE older than age 60. The IgG subclass distributions and κ λ ratios for each of these autoantibodies were also determined and compared to measurements performed on the sera of 53 young adult patients with SLE. The frequencies of autoantibodies of each specificity, except IgM anti-ss DNA antibodies, were higher among the young adult patients, although the magnitudes of the responses were similar in both age groups. IgG anti-Sm antibodies were composed of both IgG1 and IgG2 subclasses, while IgG anti-70K RNP and IgG anti-ssDNA were predominantly of the IgGl subclass. There were no differences in the IgG subclass distributions of any of the three autoantibodies between the elderly and young adult patient sera. The κ λ ratios for each of the three autoantibodies were similar to that present in total serum immunoglobulins, and κ λ ratios of autoantibodies, standardized to the κ λ ratios of serum, were not different between elderly and young adult groups. Few patient sera of either age group (9 elderly, 7 young adult) demonstrated even midly skewed light chain ratios in their autoantibody responses. Thus, despite developing in an immunological environment that may have altered the clonality and isotype distribution of their responses, the autoantibodies produced by elderly patients with SLE were qualitatively similar to autoantibodies of younger patients.
Improving tactical biometric systems through the application of systems engineering

To date, the impact of tactical biometric systems has been limited by designs driven by subsystem performance metrics and little consideration for the operational environment in which they are deployed. The design of these systems may be significantly improved by the application of systems engineering practices that consider these and other factors. This study discusses limitations of the current system design approach and proposes a methodology to improve designs. These improvements in design have the potential to dramatically increase the effectiveness and acceptance of biometric technologies in operational environments.
Genetic vaccines for anthrax based on recombinant adeno-associated virus vectors.

Bacillus anthracis represents a formidable bioterrorism and biowarfare threat for which new vaccines are needed with improved safety and efficacy over current options. Toward this end, we created recombinant adeno-associated virus type 1 (rAAV1) vectors containing synthetic genes derived from the protective antigen (PA) or lethal factor (LF) of anthrax lethal toxin (LeTx) and tested them for immunogenicity and induction of toxin-neutralizing antibodies in rabbits. Codon-optimized segments encoding activated PA (PA63), or LF, were synthesized and cloned into optimized rAAV1 vectors containing a human cytomegalovirus (hCMV) promoter and synthetic optimized leader. Serum from rabbits immunized intramuscularly with rAAV1/PA (monovalent), rAAV1/LF (monovalent), rAAV1/PA + rAAV1/LF (bivalent), or rAAV1/enhanced green fluorescent protein (control) exhibited substantial PA- and LF-specific antibody responses at 4 weeks by both western blot (> 1:10,000 dilution) and enzyme-linked immunosorbent assay (ELISA) (mean end-point titer: 32,000–260,000), and contained anthrax LeTx–neutralizing activity in vitro, with peak titers approximating those of a rabbit hyperimmune antisera raised against soluble PA and LF. Compared to the monovalent groups (rAAV1/PA or rAAV1/LF), the bivalent group (rAAV1/PA + rAAV1/LF) exhibited marginally higher ELISA and neutralization activity with dual specificity for both PA and LF. The finding of robust neutralizing antibody responses after a single injection of these rAAV1-based vectors supports their further development as candidate anthrax vaccines.
Fundamental studies of the sampling process in an inductively coupled plasma-mass spectrometer Part IV.-Replacement of the inductively coupled plasma with a helium microwave-induced plasma

Abstract A fundamental investigation was performed to assess the feasibility of replacing the argon source in an inductively coupled plasma mass spectrometer (ICP-MS) with a helium plasma source. For this study an argon ICP-MS interface was modified to sample a helium plasma. However, despite efforts to increase pumping efficiency in the mass spectrometer first stage, the conventional ICP-MS interface could not be reconfigured for optimal skimming of the first-stage free-jet expansion as gas dynamic theory advocates. Moreover, coulombic forces produced by ion-beam space charge after the skimmer cone were found to influence ion movement more strongly than gas-kinetic forces. These conclusions were based on kinetic energies measured across the mass range for ions as they exited the first vacuum stage of the interface. Because of the importance of these coulombic forces on ion movement, gas-kinetic factors need not be a primary consideration in skimming a helium free-jet expansion.
Cupreous metal corrosion at a Bronze Age coastal marine archaeological site: a study of site processes at Tel Nami, Israel

L'analyse des artefacts de bronze de Tel Nami a permis de distinguer les traces de corrosion dues a l'eau de la mer au micro environnement
Temporary balloon occlusion of the cavernous carotid artery for removal of an orbital and intracranial foreign body: case report

Objective and importance We describe the first reported use of temporary balloon occlusion of the cavernous internal carotid artery for controlled removal of a foreign object from the cavernous sinus. This endovascular approach may be an alternative to craniotomy in highly selected cases. Clinical presentation A 34-year-old incarcerated male attempted suicide by stabbing the earpiece of his glasses through his right orbit into the intracranial compartment. He presented with complete ophthalmoplegia. The earpiece traversed the cavernous sinus, penetrating its posterior wall to enter the perimesencephalic cistern and cerebellum. Angiography demonstrated a small direct carotid-cavernous fistula. Intervention Removal of the foreign body was performed under general anesthesia in the angiography suite with the operating room on standby. Nondetachable and detachable balloons were inflated in the cavernous carotid artery to provide vascular control while the foreign body was withdrawn from the cranium at the orbit. Follow-up angiographic runs with the balloons deflated revealed minimal arteriovenous shunting, which disappeared on subsequent studies. The balloons were removed. The patient remained neurologically stable with his baseline right ophthalmoplegia and V1-V2 hemianesthesia. At the 6-week follow-up, the patient remained clinically stable with no evidence of carotid-cavernous fistula or interval abscess formation. Conclusion Endovascular temporary balloon occlusion of the cavernous carotid artery provides immediate control of the vessel (with an option of permanent carotid sacrifice), allowing removal of a foreign body without craniotomy in appropriate cases.
A Tight Spot

a 0 PRESENTATION On occasion, patients are surprised to discover that they have lived for decades with a congenital anomaly. This was the case for a 48-year-old woman who had progressively increasing dysphagia over a period of several years. Significant worsening over 3-4 weeks spurred her to again seek medical attention for this condition. She reported difficulty swallowing solid food and a feeling of retrosternal obstruction upon swallowing. Results of an upper endoscopy and biopsies performed a few months earlier had been normal. The patient had a history of breast cancer. A left-sided mastectomy and reconstructive surgery were followed by chemotherapy. Her physical examination and laboratory data were unremarkable.
Impact of transitioning to antibiotic-impregnated PICCs on blood stream infection rate at a large tertiary institution

Purpose Catheter-related blood stream infections (CRBSIs) are associated with high morbidity and mortality as well as significant economic burden. These infections increase the length of hospitalization 7-21 days while costing an extra $23, 424 ± 5,184. 1 Consequently, to reduce the risk of CRBSIs, our institution transitioned to minocycline/rifampin-impregnated PICCs in April 2012. The aim of this study is to compare the rate of BSIs associated with antibiotic-impregnated versus non-impregnated PICCs. Materials and Methods A retrospective analysis of BSIs associated with minocycline/rifampin-impregnated versus non-impregnated PICCs was performed in conjunction with our infectious disease department. The rate of BSIs associated with the new antibiotic-impregnated PICCs placed from 4/1/2012 through 8/31/2012 was compared to the rate of BSIs associated with non-impregnated PICCs placed from 1/1/2011 through 12/31/2011. Results A total of 1,515 minocycline/rifampin-impregnated PICCs were placed at our institution from 4/1/2012 through 8/31/2012. There were 12 documented BSIs associated with these PICCs (6 patients had multiple catheters). A total of 4,516 non-impregnated PICCs were placed from 1/1/2011 through 12/31/2011. There were 31 documented BSIs associated with these PICCs (7 patients had multiple catheters). Approximately 1 out of every 126 antibiotic-impregnated PICCs was associated with a BSI while approximately 1 out of every 146 non-impregnated PICCs was associated with a BSI. Conclusion The transition from non-impregnated to minocycline/rifampin-impregnated PICCs has not decreased the rate of CRBSIs at our institution. However, the cohort size is limited as this has been a recent change. This study is also limited by the high proportion of patients with multiple catheters in the antibiotic-impregnated group. Further analysis will be performed as more PICCs are placed. References 1. Weber DJ, Rutala WA. Central line-associated bloodstream infections: prevention and management. Infect Dis Clin North Am. 2011;25:77-102.
Use of the Rhomboid Major Muscle Flap for Esophageal Repair

Abstract A 16-year-old boy sustained vehicular blunt trauma with delayed esophageal rupture that resulted in empyema and an esophagopleurocutaneous fistula. Diverting esophagostomy, gastrostomy, and transpyloric jejunostomy were performed, and these procedures permitted satisfactory nutritional support of the patient. Staged direct closure of the esophagus buttressed by a rhomboid muscle flap preserved normal esophageal function. Both clinical application and cadaver dissections have demonstrated that the rhomboid flap has an excellent blood supply and that it can be used to repair lesions on either side in the upper half of the esophagus. Because this flap is extrathoracic, it is not usually distorted by intrathoracic sepsis or previous thoracic incisions. The rhomboid major muscle flap is an excellent alternative to conventional autogenous grafts for esophageal repair.
Functionalized Silk Biomaterials for Wound Healing

Silk protein-biomaterial wound dressings with epidermal growth factor (EGF) and silver sulfadiazine were studied with a cutaneous excisional mouse wound model. Three different material designs and two different drug incorporation techniques were studied to compare wound healing responses. Material formats included silk films, lamellar porous silk films and electrospun silk nanofibers, each studied with the silk matrix alone and with drug loading or drug coatings on the silk matrices. Changes in wound size and histological assessments of wound tissues showed that the functionalized silk biomaterial wound dressings increased wound healing rate, including reepithelialization, dermis proliferation, collagen synthesis and reduced scar formation, when compared to air-permeable Tegaderm tape (3M) (- control) and a commercial wound dressing, Tegaderm Hydrocolloid dressing (3M) (+ control). All silk biomaterials were effective for wound healing, while the lamellar porous films and electrospun nanofibers and the incorporation of EGF/silver sulfadiazine, via drug loading or coating, provided the most rapid wound healing responses. This systematic approach to evaluating functionalized silk biomaterial wound dressings demonstrates a useful strategy to select formulations for further study towards new treatment options for chronic wounds.
bis-Pyridinium cyclophanes: Novel ligands with high affinity for the blood–brain barrier choline transporter

Abstract A series of bis- pyridinium cyclophane analogs designed as conformationally restricted bis -quaternary ammonium compounds were evaluated for their affinity for the blood–brain barrier (BBB) choline transporter. All the cyclophanes investigated exhibited high affinity compared to choline. Of these compounds, N , N ′-(1,10-decanediyl)3,3′-(1,9-decadiyn-1,10-diyl)- bis- pyridinium diiodide ( 5c ) and N , N ′-(1,9-nonanediyl)3,3′-(1,9-decadiyn-1,10-diyl)- bis- pyridinium dibromide ( 5b ) exhibited highest affinity with K i values of 0.8 μM and 1.4 μM, respectively, and constitute some of the most potent BBB choline transporter ligands reported.
History of brain death as death: 1968 to the present

The concept of brain death was formulated in 1968 in the landmark report A Definition of Irreversible Coma. While brain death has been widely accepted as a determination of death throughout the world, many of the controversies that surround it have not been settled. Some may be rooted in a misconstruction about the history of brain death. The concept evolved as a result of the convergence of several parallel developments in the second half of the 20th century including advances in resuscitation and critical care, research into the underlying physiology of consciousness, and growing concerns about technology, medical futility, and the ethics of end of life care. Organ transplantation also developed in parallel, and though it clearly benefited from a new definition of death, it was not a principal driving force in its creation. Since 1968, the concept of brain death has been extensively analyzed, debated, and reworked. Still there remains much misunderstanding and confusion, especially in the general public. In this comprehensive review, I will trace the evolution of the definition of brain death as death from 1968 to the present, providing background, history and context.
Ages of Pacific Deep-Sea Basalts, and Spreading of the Sea Floor

Potassium-argon determinations of age from whole-rock samples of tholeiitic basalts, dredged from the crest of the East Pacific Rise and from the flanks of three seamounts at varying distances from the crest, show that the crest is younger than 1 million years and that age does not correlate with distance from the crest. Our data, however, do not necessarily oppose the general concept of spreading of the ocean floor.
Malignant fibrous histiocytoma of the soft tissues of the mandible

Abstract This article presents, insofar as we know, the sixth report of a case of malignant fibrous histiocytoma occurring in the paramandibular tissues. The biologic behavior and the gross and microscopic pathologic features of this lesion are discussed with reference to the recent literature on malignant fibrous histiocytoma.
Isostasy and Overthrusting in Western Wyoming: ABSTRACT

Coinciding with the frontal zone of the overthrust belt in western Wyoming is the axis of a former narrow trough along which a maximum of 25,000 ft of Cretaceous sediment accumulated. Marine and brackish-water fossils in the Adaville Formation indicate that intermittent marine deposition persisted to near the top of the system. During subsidence in this zone, the former miogeosyncline in southeast Idaho was rising. Overthrusting progressed eastward in time, and the Adaville and Evanston Formations were overridden by the easternmost Hogsback thrust soon after final deposition, while the top of the system was near sea level. Cretaceous Hilliard Shale, approximately 3,000 ft stratigraphically below the top of the Adaville, occurs at the surface at an elevation of 7,500 ft 5 mi west of La Barge, Wyoming. This locality is cratonward from the easternmost major thrust; therefore, the restored elevation of about 2 mi for the top of the Cretaceous is not attributable to thrusting, but to vertical uplift that is post-thrusting. Block faulting in southeast Idaho since late Eocene may represent subsidence in the area behind the western Wyoming salient of the overthrust belt. These data indicate that the pre-Cretaceous surface in the miogeosyncline-shelf boundary zone subsided 25,000 ft during the Cretaceous time of sedimentation whereas the former miogeosyncline was uplifted an unknown amount. Subsequent to overthrusting, the Cretaceous frontal trough has risen 10,000+ ft and there has been possible subsidence in southeast Idaho. This oscillatory motion appears to be of sufficient magnitude to reverse dips on major thrust surfaces from down-to-the-east at the end of Cretaceous to down-to-the-west at the present time. Thus, present attitudes do not preclude gravitational gliding as the mechanism of overthrusting. The average of 100 Bouguer gravity measurements in southeast Idaho plots 20 mgal on the positive side of Woollard's mean world curve, whereas the average of 32 Bouguer measurements over the former Cretaceous trough in Wyoming plots 32 mgal on the negative side. In terms of isostasy, the vertical movements tending to reverse the dips on overthrust faults appear to be active at present. End_of_Article - Last_Page 1900------------