cssi/SciSciGPT-SciSciNet huggingface dataset:
Comparison of endoscopic ultrasonography and multidetector computed tomography for detecting and staging pancreatic cancer.

Background Accurate preoperative detection and staging of pancreatic cancer may identify patients with locoregional disease that is amenable to surgical resection. Objective To compare endoscopic ultrasonography and multidetector computed tomography (CT) for the detection, staging, and resectability of known or suspected locoregional pancreatic cancer. Design Prospective, observational, cohort study. Setting Single, tertiary referral hospital in Indianapolis, Indiana. Patients 120 participants with known or suspected locoregional pancreatic cancer. Interventions Endoscopic ultrasonography followed by multidetector CT was performed in all patients. Patients with known or suspected pancreatic cancer deemed potentially resectable by 1 or both tests were considered for surgery. Measurements Detection, staging, and resectability of pancreatic cancer. Surgically resected pancreatic cancer with negative microscopic histologic margins was considered resectable. Results Of 120 patients enrolled, 104 (87%) underwent endoscopic ultrasonography and CT. Of the 80 patients with pancreatic cancer, 27 (34%) were managed nonoperatively, and 53 (66%) treated surgically had resectable (n = 25) or unresectable (n = 28) cancer. For the 80 patients with cancer, the sensitivity of endoscopic ultrasonography (98% [95% CI, 91% to 100%]) for detecting a pancreatic mass was greater than that of CT (86% [CI, 77% to 93%]; P = 0.012). For the 53 surgical patients, endoscopic ultrasonography was superior to CT for tumor staging accuracy (67% vs. 41%; P 0.2). Of the 25 resectable pancreatic tumors in patients recommended for surgery, endoscopic ultrasonography and CT correctly identified 88% and 92%, respectively, as resectable. Of the 28 unresectable pancreatic tumors in patients recommended for surgery, endoscopic ultrasonography and CT correctly identified 68% and 64%, respectively, as unresectable. Limitations Radiologists who read the scans and endosonographers were not blinded to previous radiographic information. Because of the modest sample size, CIs of the sensitivity estimates were sometimes wide. Conclusion Compared with multidetector CT, endoscopic ultrasonography is superior for tumor detection and staging but similar for nodal staging and resectability of preoperatively suspected nonmetastatic pancreatic cancer.
Subcontinental impacts of an invasive tree disease on forest structure and dynamics

Summary 1. Introduced pests and pathogens are a major source of disturbance to ecosystems world-wide. The famous examples have produced dramatic reductions in host abundance, including virtual extirpation, but most introductions have more subtle impacts that are hard to quantify but are potentially at least as important due to the pathogens’ effects on host reproduction, competitive ability and stress tolerance. A general outcome could be reduced host abundance with concomitant increases in the abundance of competitors. 2. Beech bark disease (BBD) is a widespread, fatal affliction of American beech (Fagus grandifolia), currently present in c. 50% of beech’s distribution in eastern North America. Despite high adult mortality, beech remains a dominant component of the forest community. 3. Employing spatially extensive data from the national Forest Inventory and Analysis program of the United States Forest Service, we show that forests have changed dramatically in the presence of BBD. Within the 2.3 million km 2 range of beech, size-specific mortality was 65% higher in the longest-infected regions, and large beech ( cm diameter at breast height) have declined from c. 79 individuals km )2 to being virtually absent. Small stem beech density was dramatically higher ( such that infested forests contain a roughly equivalent cross-sectional (basal) area of beech as before BBD. 4. There was no evidence for compensation by sugar maple or other co-occurring tree species via increased recruitment or adult survivorship at the landscape scale. Overall, community composition remained roughly unchanged as a result of BBD. 5. Surprisingly, trajectory of stand dynamics (shifts in stem density and mean tree size reflecting normal stand maturation (self-thinning) or retrogression (more abundant, smaller trees over time)) did not differ between affected and unaffected regions. Variance in stand dynamics was greater in afflicted forests, however, indicating that predictability of forest structure has been diminished by BBD. 6. Synthesis. Forests of eastern North America have shifted to increased density and dramatically smaller stature – without notable change in tree species composition – following the invasion of a novel forest disease. Our results reinforce the conclusion that introduced diseases alter fundamental properties of ecosystems, but indicate that the spectrum of potential effects is broader than generally
A treatment of diffusion errors affecting junction depth

An error treatment of the diffusion variables of time t, temperature T, and starting resistivity ρ, has been made in regard to their effects upon junction depth. An analytical equation has been derived for engineering usage in determining the per cent error in junction depth x : Per cent error in junction depth = 100 \sqrt{\frac{\bar{Δt^{2}}{2t}} +\frac{\bar{QΔT}^{2}}{2RT^{2}}+\bar{\frac{\sqrt{\pi DT}}{\microq p^{2}N_{s}x}. \Delta \rho exp (x^{2}/4Dt)}} A sample calculation using the above equation is presented along with a method of estimating errors in junction depth due to heating and cooling in the diffusion cycle.
Historic Assessment of Compatibility

Several properties of compatibility discussed in the previous sections may not be relevant to all the fields of study in which compatibility between objects or concepts is used to analyze information and assist in decision making. An understanding the significance of these properties, however, is necessary for building a general classification framework. In this section we present a brief examination of the measurement and use of compatibility in taxonomy, psychology, and statistics. In these disciplines, the focus has been on the similarity of objects and the assessment has generally been based upon the commonality of crisp sets of attributes possessed by the objects. The analysis of crisp sets has often provided the basis for a generalization to measurement of fuzzy sets and we will focus on crisp techniques that have been subsequently applied to the assessment of the compatibility of objects whose properties are described by fuzzy sets.
Provisioning in wild golden lion tamarins (Leontopithecus rosalia): benefits to omnivorous young

Provisioning may act to cushion weaned young from dietary insufficiency and errors during the period in which they are mastering complex foraging techniques or learning to identify appropriate dietary items. That is, young mammals who receive food from others may gain nutritional and/or informational benefits. I conducted a longitudinal study of 13 wild golden lion tamarins 11--56 weeks of age in six groups to evaluate hypotheses regarding the functions of provisioning. All members belonging to this primate taxonomic family (the Callitrichidae) are cooperative breeders and are known to provision their young more frequently than do other primate species, except humans. My results, together with experimental findings, suggest that juveniles receive both nutritional and informational benefits from being provisioned. My juvenile study subjects received animal prey (invertebrates and small vertebrates) from others more frequently than plant resources (fruits and hardened exudates). Apparently difficult-to-handle fruits were more likely to be transferred than readily processed fruits. These results support the nutritional benefits hypothesis because the young received items, particularly lipid- and protein-rich prey, that they might not otherwise have acquired. That juveniles fed independently on, and were provisioned with, the same fruits on the same day is counterevidence to the nutritional benefits hypothesis, however. The informational benefits hypothesis was supported because juveniles received a large variety of foods (including more than 20% of fruit species eaten) and received uncommon fruits that were easily acquired. Adults emitted food-offering calls to encourage the transfer of prey to juveniles, particularly when the prey was whole and alive. Copyright 2006.
“Nothing Good Ever Came from New Jersey”: Expectations and the Sensory Perception of Wines

The influence of expectations on the sensory perception of wines is investigated in three studies in which New Jersey and California red wines are blind tasted. Studies 1 and 2, in which only the color of the wines is known prior to tasting, demonstrate that neither wine club members nor experienced wine professionals can distinguish between New Jersey and California wines in terms of personal enjoyment. In contrast, Study 3, in which tasters are informed that some (though not which) of the wines are from New Jersey, finds that when a wine is believed to be from New Jersey it receives lower enjoyment ratings than when the identical wine is believed to be from California—regardless of whether the wine is actually from New Jersey or California. The results enhance our understanding of the role of expectations in the interpretation of sub- jective experiences. Implications for wine producers and wine consumers are explored.
“Flowering Walnuts in the Wood” and Other Bases for Seasonal Climate Forecasting

Although it is impossible to forecast the weather more than a few days in advance, the science of seasonal climate forecasting is premised upon an ability to predict the general weather conditions over a prolonged period of time, without trying to predict the precise weather at any specific time during that period. The forecasting is possible only because sometimes, and primarily within tropical latitudes, the atmosphere is sensitive to unusual conditions at the earth’s surface, and especially at the sea surface. El Nino, and its counterpart La Nina, are the primary examples of such forcing conditions: during El Nino events, much of the equatorial Pacific Ocean is unusually hot (cold during La Nina), and the consequent changes to the heat and moisture supplied to the atmosphere can disrupt weather conditions in many parts of the globe. However, all seasonal climate forecasts involve a great deal of uncertainty, and a key aspect of forecasting at such time scales is to estimate the uncertainty in the prediction reliably. There are two sources of uncertainty in seasonal climate forecasting: the atmosphere is nowhere completely forced by conditions at the surface, but is free to vary according to its own internal dynamics; and the models used to predict the climate system are imperfect. These two sources of uncertainty are addressed by producing a set of model predictions: different initial weather conditions are used to represent the uncertainty from the internal dynamics, and different models to account for the uncertainties arising from imperfect model physics.
A compact 5GHz WLAN notched bluetooth/UWB antenna

Among short-range wireless communication systems, Ultra-wideband (UWB) technology, with a frequency allocation of 3.1–10.6 GHz, has gained a lot of popularity from researchers and the wireless industry alike due to the high data transfer rate (110–200 Mb/s) and low power consumption. However, since UWB covers the frequency spectrum of Wireless Local Area Network (WLAN) operating at 5.2 GHz (5150–5350 MHz) and 5.8 GHz (5725–5825MHz), a frequency notched function in the UWB antenna design is greatly desirable to avoid interferences from WLAN. Since 2002, various antenna structures [1, 2] and methods to notch a specific frequency band [1, 3, 4] have been introduced. Moreover, a planar integrated antenna working on both Bluetooth and UWB has been recently introduced for systems operating in those two communication systems [5, 6].
Predictive modeling of piezoelectric wafer active sensors interaction with high-frequency structural waves and vibration

The modeling of the interaction between piezoelectric wafer active sensors (PWAS) and structural waves and vibration is addressed. Three main issues are discussed: (a) modeling of pitch-catch ultrasonic waves between a PWAS transmitter and a PWAS receiver by comparison between exact Lamb wave solutions and various finite element method (FEM) results; (b) analytical modeling of the power and energy transduction between PWAS and ultrasonic guided waves highlighting the tuning opportunities between PWAS and the waves; (c) the use of the transfer matrix method to model the electromechanical (E/M) impedance method for direct reading of high-frequency local structural vibration and comparison with FEM results. The paper ends with a summary and conclusions followed by recommendations for further work.
A study of shape distributions for estimating histologic grade

Breast cancers can be histologically categorized (graded) based upon their architectural patterns and cellular types. Inaccurate histologic grading can result in inappropriate treatment for a given patient. Computational analysis of breast cancers offers an operator-independent method for histologic grading that should enhance grading reliability. We present the initial efforts to develop computational technologies that may be used to automatically and objectively estimate the histologic grade of breast cancer tumors. The approach utilizes image processing and shape analysis of imaged histologic sections. Our work is based on the hypothesis that cellular structures found in breast cancer tumors can be transformed into distinct high-resolution shape distributions using geometric measures from stochastic geometry. The resulting shape distributions define well-populated regions of the associated high-dimensional space. Mapping an unknown breast cancer sample into this high-D space and determining to which region it belongs will allow for the automatic estimation of its histologic grade.
TAKING STOCK OF PHENOMENOLOGY FUTURES

In this paper, I review recent contributions of phenomenology to a variety of disciplines, including the cognitive sciences and psychiatry, and explore (1) controversies about phenomenological methods and naturalization; (2) relations between phenomenology and the enactive and extended mind approaches; and (3) the promise of phenomenology for addressing a number of controversial philosophical issues.
Age Differences in Prefontal Recruitment During Verbal Working Memory Maintenance Depend on Memory Load

Positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) studies have revealed age-related under-activation, where older adults show less regional brain activation compared to younger adults, as well as age-related over-activation, where older adults show greater activation compared to younger adults. These differences have been found across multiple task domains, including verbal working memory (WM). Curiously, both under-activation and over-activation of dorsolateral prefrontal cortex (DLPFC) have been found for older adults in verbal WM tasks. Here, we use event-related fMRI to test the hypothesis that age-related differences in activation depend on memory load (the number of items that must be maintained). Our predictions about the recruitment of prefrontal executive processes are based on the Compensation-Related Utilization of Neural Circuits Hypothesis (CRUNCH; Reuter-Lorenz and Cappell, 2008). According to this hypothesis, more neural resources are engaged by older brains to accomplish computational goals completed with fewer resources by younger brains. Therefore, seniors are more likely than young adults to show over-activations at lower memory loads, and under-activations at higher memory loads. Consistent with these predictions, in right DLPFC, we observed age-related over-activation with lower memory loads despite equivalent performance accuracy across age groups. In contrast, with the highest memory load, older adults were significantly less accurate and showed less DLPFC activation compared to their younger counterparts. These results are considered in relation to previous reports of activation–performance relations using similar tasks, and are found to support the viability of CRUNCH as an account of age-related compensation and its potential costs.
Implementing School-Based Decision Making in Kentucky

In Kentucky, where school-based man agement is legally mandated, schools in various stages of implementation are learning some important lessons.
The inferior emissary vein: a reliable landmark for right adrenal vein sampling.

BACKGROUND: Right adrenal vein (RAV) catheterization can be a very challenging step in adrenal venous sampling (AVS). Visualization of the inferior emissary vein (IEV) may be an indication of successful RAV catheterization. PURPOSE: To compare the rate of successful RAV sampling in the presence of the IEV. MATERIAL AND METHODS: Retrospective review of all consecutive patients with PA who underwent AVS between April 2009 and April 2012 was performed. A total of 30 patients were identified. Procedural images, cortisol, and aldosterone values obtained from sampling of the RAV and inferior vena cava (IVC) were reviewed. Cortisol measurements obtained from RAV samples were divided by measurements from the infra-renal IVC blood samples in order to calculate the selectivity index (SI). An SI >3 was considered indicative of technically successful RAV sampling. RESULTS: RAV sampling was considered technically successful in 29 out of 30 cases (97%). In cases of successful RAV sampling (29 patients), the IEV was identified in 25 patients (86%). The IEV was visualized in isolation in 16 patients (64%), and in conjunction with visualization of the RAV or right adrenal gland stain in nine patients (36%). The IEV was not visualized in the one case of unsuccessful RAV sampling. Visualizing the IEV had a sensitivity of 86.2% for successful RAV sampling. CONCLUSION: The IEV may serve as a reliable landmark for the RAV during RAV sampling.
Acoustic environment profile of the neonatal intensive care unit: High ambient noise and limited language exposure

Abstract Infants in single-patient neonatal intensive care unit (NICU) rooms may experience developmental language delay because of reduced language exposure. We evaluated the acoustic profile of a level IV NICU using Language Environment Analysis (LENA) for 40 singleton infants. Mean and peak sound levels were consistently above 45 dB the recommended standard. NICU patients experienced substantial variability in language exposure (range: 10–2040 words per hour). Neither noise levels nor word counts were associated with illness severity, gestational age, or postmenstrual age at the time of recording. Noise levels were not driven by spoken language, which suggests that interventions to optimize the NICU acoustic environment should focus on minimizing facility noise, and that interventions designed to enrich neonatal language exposure may not significantly raise ambient noise levels.
Rabbit CRP Production After Inulin Injection

SummaryThe effect of intravenous injection of particulate inulin on CRP synthesis and serum C3 levels was studied in 13 rabbits. The rabbits showed a significant increase in serum CRP levels 24 hr after inulin injection, when compared to pretreatment levels and controls. There was a significant reduction in serum C3 levels in the treated animals at 4 hr.The possible role of complement activation in Rabbit CRP production was discussed.
Defining the Lower Limit of a "Critical Bone Defect" in Open Diaphyseal Tibial Fractures.

Objectives:To determine healing outcomes of open diaphyseal tibial shaft fractures treated with reamed intramedullary nailing (IMN) with a bone gap of 10–50 mm on ≥50% of the cortical circumference and to better define a “critical bone defect” based on healing outcome.Design:Retrospective cohort stu
Ancient Polymorphism and the Hypothesis of a Recent Bottleneck in the Malaria Parasite Plasmodium falciparum

RICH et al. ([1998][1]) have recently proposed that the current world population of the human malaria parasite Plasmodium falciparum consists of individuals descended from a single haploid genotype or strain (malarial Eve) that occurred between 24,500 and 57,500 years ago. They base this conclusion
Routes Into Opioid Analgesic Misuse: Emergent Typologies of Initiation

Non-medical use of opioid analgesics (OAs) has increased in the United States over the past decade, yet there has been little in-depth exploration into the circumstances of initiation of OA misuse....
A study on the heavy metal pollution of home-grown vegetables in a city

Objective To know the contents of heavy metal( Pb,Cd,Cr,Ni,Cu,Zn,Hg and As) in home- grown vegetables in a city for providing evidences in vegetable planting. Methods A total of 248 samples from 5 vegetable plantation bases in four seasons were collected and the contents of heavy metal were determined and analyzed. Pb,Cd,Cr,Ni,Cu and Zn were determined by AAS,Hg and As were determined by AFS. The results were evaluated according to the national food sanitation standard limits. Results The exceeding rate of Ni in home- grown vegetables of root leaf and fruit was 48. 48%,9. 29% and 5. 33% respectively,the exceeding rate of Cd was 12. 12%,0. 71% and 8. 00%,the exceeding rate of Pb was 0. 00%,16. 43% and 5. 33%. The exceeding rate of other heavy metal were all below 5% or in line with the standard. The degree of heavy metal pollution decreased with season 's order of autumn,summer,spring and winter. The content of As in leafy- vegetables was in significant association with the contents of AS in soil. Conclusion The heavy metal pollution of Ni,Pb and Cd in vegetables in the city is serious,and more attention should be paid to the heavy metal pollution.
The Reliability Design for Motor Harness Test Table

The failure analysis of motor harness test table is presented. A design is provided to solve the reliability problem for test table.
Pensions and household structure of older persons in Namibia

The purpose of this study is to assess the role of pensions in households in Namibia. The study examines the impact of pensions on household income and household structure, and describes the characteristics of pension households. Namibia is one of two countries in sub-Saharan Africa which have a national non-contributory pension programme. Findings indicate that pensions in general are the main source of income for 11.8% of all households in Namibia and that the national pension is the main source of income for 10% of households. Pension households show evidence of the skip-generation phenomenon, where there is a smaller proportion of young adults and middle-aged persons in the household, particularly males, than in non-pension households. There is also a smaller proportion of children of household heads and a much larger proportion of grandchildren in pension households. Areas with high out-migration are the areas where pensions, particularly the national pension, are the main source of income, suggesting that the security which pensions offer to the extended family enables young adults to migrate for employment, or to extend the employment search, while their children are cared for by elderly parents or other elders in the family network.
Bone morphogenetic proteins, bone marrow stromal cells, and mesenchymal stem cells. Maureen Owen revisited.

In postnatal mammals, there are persistent molecular signals and responding cells in bone to initiate osteogenesis and repair in response to trauma. The responding osteogenic precursor cells are of 2 categories : determined and inducible. The latter can be induced by demineralized bone matrix to form bone. Demineralized bone matrix consists of extracellular matrix and tightly associated bone morphogenetic proteins. The genes for bone morphogenetic proteins have been cloned, the recombinant proteins have been expressed, and currently their mechanism of action is being explored. Bone morphogenetic proteins are pleiotropic initiators of inducible osteogenic precursor cells. Bone morphogenetic proteins govern the 3 key steps in the osteogenic cascade : chemotaxis, mitosis, and differentiation. The receptors for bone morphogenetic proteins have been cloned and expressed and consist of 2 classes, Types I and II, that are membrane bound serine/threonine protein kinases. Bone morphogenetic proteins bind to extracellular matrix and their collaborative action on osteogenic cells culminates in the terminal differentiation of the osteoblast-osteocyte continuum. Bone morphogenetic proteins are currently on the threshold for clinical applications.
“There She Is”: Hispanic Identity, Academic Success, and Class Mobility in a Collegiate Beauty Pageant

Widely accepted definitions of academic success are neither adequate nor meaningful for many ethnic minority students. Using ethnographic research with high-achieving Latina college students in Oklahoma, student experiences in a collegiate Hispanic beauty pageant were analyzed. These successful Latina students negotiated academic achievement through pageant performances of gender and ethnicity. Student understandings of “making it,” shaped by familial approval, adherence to gender norms, and ethnic identity, suggest that a rethinking of “academic success” is necessary.
Suppressive Interactions During Olfactory Bulb Circuit Response to Odor: Computer Simulation

The olfactory bulb response to electrical stimulation is fairly well understood and is determined largely by two laminae of lateral inhibitory interneurons, the periglomerular (PG) and granule (GR) cells. Responses to odor are more complex. Profound suppression, complex responses, and non-monotonic intensity response (I/R) functions occur (both with excitation at low intensity and suppression at high; E-S type; and the opposite S-E type [1]). Studies using 2-deoxyglucose (2DG) or c-fos mRNA mapping [2] suggest that odor input is spatially nonuniform, with isolated foci of activity in different areas for different odors. A computer model, based on the known anatomy and physiology of the bulb was, therefore, constructed to examine output responses to restricted input. It calculates interactions between all cells within a 30 × 30 matrix of glomerular units, re-iterating until excitation, inhibition, and output are in balance [3]. In the latest version, each glomerular unit has one mitral, one middle tufted, and one outer tufted cell with associated interneurons. Relay cell axon collaterals and PG inhibition of PG cells have been added. This more realistic circuit does not qualitatively alter responses compared to earlier models. A two-dimensional normal distribution of input, centered on the matrix, produces a similar output pattern at low intensity, but with an inhibitory surround.
MIS Unicondylar Knee Arthroplasty with the Extramedullary Technique

Minimally invasive surgery (MIS) unicondylar knee arthroplasty has gained popularity over the recent years following the introduction of the limited approach by Repicci and Eberle.1 Their limited approach was essentially a freehand technique that used limited instrumentation. Over the years there have been modifications in the surgical instruments in order to perform the procedure accurately and reproducibly through a MIS approach. The Miller Galante Unicondylar prosthesis (Zimmer, Warsaw, IN) introduced intramedullary instrumentation and most recently extramedullary instrumentation.2 The smaller and reliable modified instruments clearly help in bone preparation and component position producing clinical results that are comparable with a conventional procedure.3,4 Improved instrumentation allows the surgeon to operate through a minimally invasive arthrotomy, without everting the patella, and permits more accurate bone resection. It is the refinements in instrumentation that have contributed to successful clinical results.
Comprehending Competing Spheres of Social Control

My purpose here is to examine the arrangement of both formal and informal norms and how they are utilized to channel children's behavior along certain trajectories. It is argued that three distinct contexts for social action exist within the consumer society. These contexts are described as "spheres of action" which possess moral agents who have vested interests in channeling individual behavior in certain directions. This paper examines this theory in light of the Christmas shopping season, by focusing on the conflictual spheres of social action that exist within the setting of a mall. First, there remain the capitalist entrepreneurs who have a need to sell products both to, and for children. On the other hand, parents often have to control their child's newly created impulsive need for a toy or other product that is directly marketed at them. Unobtrusive observations of children's behaviors were made over a four week period during the Christmas shopping season in order to provide data for an ethnographic analysis of competing methods of social control utilized by the Mall, the toy store, and the parent.
Legislative Independence and Incumbent Electoral Advantage: Evidence from Parliamentary Elections in Kenya

What explains the observed incumbency effects in emerging democracies? Unlike their counterparts in advanced democracies, legislative incumbents in emerging democracies are disadvantaged. Existing research attributes this to “endemic voter discontent,” arguing that the preponderance of venal and low quality incumbents incentivize voters’ preference for high turnovers in legislative elections. This paper provides a different, albeit complementary, explanation. With new data comprising 8,188 candidate-level observations from Kenya, and employing a regression discontinuity design, I show that the electoral impact of a legislator’s incumbency status is conditional on legislative strength. In particular, strong legislatures produce electorally strong incumbents. Therefore, legislative weakness in emerging democracies partially explains the observed incumbency disadvantage in these contexts.
PLCβ Is Critical for T-Cell Chemotaxis In Vivo .

Abstract Chemokines acting through G-protein coupled receptors play an essential role in both the immune and inflammatory responses. Phosphatidylinositol 3-kinase (PI3K) and phospholipase C (PLC) are two distinct signaling molecules that have been proposed as potential candidates in the regulation of this process. Studies with knockout mice have demonstrated a critical role for PI3Kγ, but not PLCβ, in Gαi-coupled receptor-mediated neutrophil chemotaxis. We compared the chemotactic response of peripheral T-cells derived from wild type mice with mice containing loss-of-function mutations of either PI3Kγ, or both of the two predominant lymphocyte PLCβ isoforms (PLCβ2 and PLCβ3). In contrast to neutrophils, loss of PI3Kγ did not significantly impair T-cell migration in vitro, although PI3K pharmacologic inhibitor experiments suggest that another isoform of this enzyme might contribute to T-cell migration. However, loss of PLCβ2β3 decreased chemokine-stimulated T-cell migration in vitro. Chelation of intracellular calcium by BAPTA-AM and Quin-2 AM decreased the chemotactic response of wild type lymphocytes, but pharmacologic inhibition of PKC isoforms by GF109203x did not impair T-cell migration. This suggests that the T-cell migration defect seen in the PLCβ2β3-null T-cells may be due to an impaired ability to increase the cytoplasmic calcium concentration, while there appears to be little requirement for PKC activity. Indeed, SDF-1α-induced calcium efflux was not detected in the PLCβ2β3-null lymphocytes. Compared to fluorescently labeled wild type T-cells, labeled PLCβ2β3 knockout T-cells migrated less efficiently into secondary lymphoid organs of recipient mice. This demonstrates that PLCβ is also required for migration in vivo. PLCβ2β3-null mice develop spontaneous skin ulcers starting around 3 months of age. Histological examination of the lesions revealed a dense inflammatory infiltrate composed of neutrophils, macrophages, and plasma cells, consistent with acute and chronic inflammation. Remarkably, lymphocytes, typical of chronic inflammation, were rare to absent by histology and by paraffin immunohistochemistry for CD3, also consistent with an in vivo migratory defect of T-cells. These results show that phospholipid second messengers generated by PLCβ and isoforms of PI3K, other than PI3Kγ, play a critical role in lymphocyte chemotaxis. Collectively, our data demonstrate that although PLCβ-mediated signaling plays no role in neutrophil chemotaxis, it makes a substantial contribution to this process within T-lymphocytes.
INCIDENCE OF RECURRENT MYOCARDIAL INFARCTION AMONG OLDER ADULTS IN U.S. COMMUNITY PRACTICE

Background: While overall rates of cardiovascular disease are declining in the U.S., we have limited data on the incidence of recurrent myocardial infarction (MI) among patients treated for an acute MI in community practice. Methods: CRUSADE was a national registry of acute coronary syndrome
Residential Camping for Children with End-Stage Renal Disease

Residential camping experiences for children with a chronic illness are primarily designed to provide the children with an outlet to have safe fun. Camping programs for children on dialysis have gradually increased in number over the past 20 years in response to a desire to provide a pleasant camping experience for children who, because of their medical problem, are occasionally considered too sick or too much at risk to attend a normal camp without medical supervision (1–3). This chapter is designed to address issues pertinent to the development and implementation of residential camping programs for children with end-stage renal disease (ESRD). In large part, the information presented is based upon my personal experience as the medical director of Camp Chimer in Excelsior Springs, Missouri. In addition, information will be presented from a number of other camps that are located in the United States and abroad.
Ragweed pollen as an oral vaccine delivery system: Mechanistic insights

We have recently developed pollen grains (PGs) as a unique method to deliver vaccines orally. Extensive chemical processing ensures allergen-free pollen microcapsules that can be loaded with vaccine antigens. Successful oral vaccine delivery has been previously demonstrated by us in a mouse model. However, the underlying mechanisms that help the processed PGs to achieve this goal were not fully understood. In this study, we wanted to understand the effects of chemically processed ragweed pollen (Ambrosia elatior) on the innate immune system. Intestinal epithelial cells, macrophages, and dendritic cells all bridge the innate and adaptive immunity. This study has shown that in response to ragweed pollen all these cells release inflammatory cytokines and chemokines. Scanning electron microscopy imaging revealed that macrophages can engulf ragweed pollen. In addition, in the presence of ragweed, mouse dendritic cells upregulated their activation markers, that is, CD40, CD80, CD86, and MHC class II molecules. Ragweed pollens did not cause significant cell membrane damage as compared to similarly sized poly (lactic-co-glycolic acid) particles. Moreover, ragweed did not affect the integrity of the intestinal epithelial cells. Ragweed pollens were also found in the subepithelial region of the small intestine 24h after pollens were gavaged to mice. Our current findings lead to the conclusion that besides transporting the vaccine cargo, ragweed pollen shells have additional immunomodulatory properties that help the orally delivered antigen to effectively induce an immune response.
Partial CD25 Antagonism Enables Dominance of Antigen-Inducible CD25high FOXP3+ Regulatory T Cells As a Basis for a Regulatory T Cell-Based Adoptive Immunotherapy.

FOXP3+ regulatory T cells (Tregs) represent a promising platform for effective adoptive immunotherapy of chronic inflammatory disease, including autoimmune diseases such as multiple sclerosis. Successful Treg immunotherapy however requires new technologies to enable long-term expansion of stable, antigen-specific FOXP3+ Tregs in cell culture. Antigen-specific activation of naive T cells in the presence of TGF-β elicits the initial differentiation of the FOXP3+ lineage, but these Treg lines lack phenotypic stability and rapidly transition to a conventional T cell (Tcon) phenotype during in vitro propagation. Because Tregs and Tcons differentially express CD25, we hypothesized that anti-CD25 monoclonal antibodies (mAbs) would only partially block IL-2 signaling in CD25high FOXP3+ Tregs while completely blocking IL-2 responses of CD25low-intermediate Tcons to enable preferential outgrowth of Tregs during in vitro propagation. Indeed, murine TGF-β-induced MOG-specific Treg lines from 2D2 transgenic mice that were maintained in IL-2 with the anti-CD25 PC61 mAb rapidly acquired and indefinitely maintained a FOXP3high phenotype during long-term in vitro propagation (>90% FOXP3+ Tregs), whereas parallel cultures lacking PC61 rapidly lost FOXP3. These results pertained to TGF-β-inducible "iTregs" because Tregs from 2D2-FIG Rag1-/- mice, which lack thymic or natural Tregs, were stabilized by continuous culture in IL-2 and PC61. MOG-specific and polyclonal Tregs upregulated the Treg-associated markers Neuropilin-1 (NRP1) and Helios (IKZF2). Just as PC61 stabilized FOXP3+ Tregs during expansion in IL-2, TGF-β fully stabilized FOXP3+ Tregs during cellular activation in the presence of dendritic cells and antigen/mitogen. Adoptive transfer of blastogenic CD25high FOXP3+ Tregs from MOG35-55-specific 2D2 TCR transgenic mice suppressed experimental autoimmune encephalomyelitis in pretreatment and therapeutic protocols. In conclusion, low IL-2 concentrations coupled with high PC61 concentrations constrained IL-2 signaling to a low-intensity range that enabled dominant stable outgrowth of suppressive CD25high FOXP3+ Tregs. The ability to indefinitely expand stable Treg lines will provide insight into FOXP3+ Treg physiology and will be foundational for Treg-based immunotherapy.
Applying research-based multimedia design principles in designing and teaching beginning CFL learners the ba construction online

Teaching grammar online is an increasingly necessary practice, but the process is resource-heavy, requiring online tools such as grammar videos. Studies show that current online grammar modules have mixed effectiveness, and none of the studies have examined the effects of the design of these modules. This study investigated whether an online module, designed according to basic multi-media design principles, is effective in helping learners understand the use of the ba construction. The study also asked how the students respond to the use of the online module. The findings show that the online module improved learners’ understanding and use of the ba construction. It also found that the students enjoyed using the online module and would like to have similar opportunities to learn grammar via multimedia online modules.
Inefficient Ventriculoarterial Coupling in Fontan Patients: A Cardiac Magnetic Resonance Study.

The ventriculoarterial coupling (VAC) ratio, the ratio of arterial elastance (Ea) to ventricular end-systolic elastance (Ees), reflects cardiovascular efficiency. Little is known about this ratio in patients who have undergone the Fontan procedure. Our aim was to assess the VAC ratio in a cohort of Fontan patients using a cardiac magnetic resonance (CMR) method, and to examine its relation to outcomes. We retrospectively assessed VAC from CMR data on 195 Fontan patients (age 19.6 ± 10.7 years) and 42 controls (age 15.2 ± 2.2 years). The VAC ratio was calculated as Ea/Ees (Ea = mean arterial blood pressure (MBP)/ventricular stroke volume; Ees = MBP/end-systolic volume). Compared with controls, Fontan patients had lower body surface area-adjusted median Ees (1.54 vs. 2.4, p < 0.001) and Ea (1.35 vs. 1.48, p = 0.01), and a higher median VAC ratio (0.88 vs. 0.62, p < 0.001). After a median follow-up of 4 years (range 1–10), 20 patients reached a composite endpoint of death or heart transplant listing. On multivariable modeling, being in the lowest tertile of the VAC ratio was independently associated with the composite endpoint (odds ratio 11.39, p = 0.02), and inclusion of the VAC ratio in the model improved prediction compared to traditional risk factors. In patients without ventricular dilation, the VAC ratio was the only factor predictive of the composite endpoint (p = 0.02). In conclusion, we found evidence for inefficient ventriculoarterial coupling in Fontan patients. The VAC ratio improved prediction of outcomes and was especially useful in patients without ventricular dilation. Further investigation into the clinical significance of ventriculoarterial coupling in this patient population is warranted.
Multiple Folded Plate Structures

A computer program is developed for analyzing folded plate structures with more than two plates meeting at a joint known as multiple folded plate structures. The method of analysis is based on the stiffness method developed by DeFries-Skene and Scordelis. Derivation of the stiffness coefficients which are omitted by the previous authors are included. Unlike the method by DeFries-Skene and Scordelis, joint loads are obtained from the fixed-end slab forces. The computer program solves directly the final slab forces and plate forces. Application of the program is shown by three examples. Investigation shows that the plate forces solved can be quite accurate but the slab forces obtained can only be as accurate as the load approximation.
CAOS for Technical Skills Training in Orthopaedic Surgery

accepted as a source of simulated reality which is all pervasive in television, advertising, and entertainment. This same technology has made some in roads into education, however, in the orthopedic context, our primary exposure to the potential of computers has been in Surgical Navigation, which is based on the fundamental premise that computerbased systems should be indispensable components of the process of performing surgery. An alternative approach is based on the belief that the goal of all efforts in surgeon training should be empowerment of the surgeon through development of surgical skills, without long-term dependence on technology to implement a surgical plan. Rationale for this approach can be found in the classic field of motor learning, where it has been long established that, aside from practice, information about performance, in the form of both intrinsic and extrinsic feedback, is the single most important variable affecting outcome [6]. The precise format of this information, how much of it is fed back to the performer, and the timing of its presentation all affect performance and learning. In learning a motor skill, it has been shown that terminal feedback in the form of knowledge of results (feedback on the movement outcome in terms of the environmental goal) and knowledge of performance (feedback on the movement itself ) can be more effective than concurrent feedback, or guidance, presented during the task itself. Guidance feedback has been shown to have the strongest effects on performance during the trials in which it is administered [7–9] as opposed to the more permanent changes attributed to motor learning achieved through post-performance feedback [10]. In fact, it has been suggested that a heavily guiding form of feedback (»enabling«) is actually detrimental to learning [11].  
Adrenal and Pituitary Emergencies

Although loss of normal pituitary function may be silent and asymptomatic, sudden loss of gland function (pituitary apoplexy) typically results in characteristic presentations. Sheehan's syndrome is the development of hypopituitarism after postpartum hemorrhage or shock. Patients with Sheehan's syndrome may have typical or atypical presentations based on the extent of pituitary gland destruction. Patients with typical symptoms fail to lactate after giving birth; subsequently these patients also develop symptoms and signs of hypopituitarism. Measuring the serum prolactin level after giving thyrotropin-releasing hormone is a reasonable first step in the diagnosis of this condition in patients who fail to lactate after giving birth. The diagnosis of hypopituitarism is delayed for up to 7 years in patients with atypical symptoms. Acute symptomatic failure of the pituitary gland (pituitary apoplexy) commonly occurs in patients who have asymptomatic pituitary tumors. Many patients with pituitary tumors do not have signs of abnormal endocrine gland secretion and have a normal appearance. Most patients have the following signs or symptoms: headache; acute disturbances in visual acuity or visual fields; ophthalmoplegia, and changes in the level of consciousness. The syndrome of pituitary apoplexy usually evolves over hours to days. Subarachnoid hemorrhage and acute bacterial meningitis are the two most important mimics of pituitary apoplexy. Intravenous steroids and prompt neurosurgical consultation are mandatory in cases of pituitary apoplexy since both steroids and surgery can improve vision. Testings for acute or chronic hypopituitarism is challenging in the Emergency Department setting; however, carefully chosen tests will aid in the subsequent early correct diagnosis after initial Emergency Department management.
Nonparametric Distribution Models for Predicting and Managing Computational Performance Variability

Performance variability can have a significant impact on many applications of computing. Cloud computing, high performance computing, and computer security communities each exert considerable effort managing and analyzing variability throughout the system stack. This work presents and evaluates a methodology for predicting precise characteristics of the computational performance variability of an input/output (I/O) application over varying system configurations. Results demonstrate that the presented methodology is capable of precisely modeling performance variability, which could allow applications that tighten service level agreements, maximize computational throughput, and obfuscate system configurations against malicious users.
Zur Beurteilung der Dignität intestinaler Carcinoide

Es wird versucht, an Hand von histologischen und cytologischen Merkmalen 66 intestinale Carcinoide (Appendix und Dunndarm) mit bekanntem klinischen Verhalten in bezug auf ihre Malignitat und ihr sekretorisches Verhalten zu charakterisieren. Es zeigt sich, das es nicht sicher gelingt, aus der Morphologie des Primartumors auf die Malignitat zu schliesen. Immerhin finden sich bei metastasierenden Carcinoiden regelmasig ein infiltratives Wachstum und, haufiger als bei nicht metastasierenden, Zellatypien und glandulare Strukturen. Die Metastasierungsrate steigt betrachtlich, wenn der Primartumor die Grose von 5–6 mm uberschreitet. Auch aus der Lokalisation der Primartumoren last sich etwas uber die Prognose und vor allem auch uber die sekretorische Aktivitat aussagen. Im Vergleich zu den Dunndarmcarcinoiden zeigen die Appendixcarcinoide eine viel massivere Lipideinlagerung. Die einzigen zwei Carcinoidtumoren in der Appendix, welche praktisch kein intracellulares Lipid enthielten, entpuppten sich als Metastasen von Ileumcarcinoiden. Fur eine sekretorische Aktivitat sprechen neben der positiven Argentaffinitat Fibrosierungsprozesse an tumorfernen Orten, wahrend Fibrosierungen im Tumor selbst oder in seiner unmittelbaren Nachbarschaft diagnostisch weniger aufschlusreich sind. Ein eindeutiger Beweis fur eine sekretorische Aktivitat gelingt jedoch nur auf biochemischem Weg
Adam Smith's 1759 Rebuke of the Slave Trade

Smith’s two-sentence rebuke of the slave trade was quoted in full four times in early anti-slavery literature. It helps us make sense of Part V of The Theory of Moral Sentiments and understand Smith’s posture toward slavery. Also, it might inform our understanding of the relationship between Smith’s two great works.