cssi/SciSciGPT-SciSciNet huggingface dataset:
Continuous monitoring of gas exchange and oxygen use with dual oximetry

The utility of integrated pulse and pulmonary artery oximetry, known as dual oximetry, was evaluated by monitoring 10 critically ill surgical patients for a total of 208 patient hours. The ventilation-perfusion index (VQI), an estimate of venous admixture, and the oxygen extraction index (O2EI), an estimate of tissue oxygen utilization coefficient, previously described, were calculated on-line from arterial and mixed venous oxyhemoglobin saturations using a computer. Effective monitoring was accomplished 85% of the total time. The dual oximetry device was nonfunctional owing to equipment failure only 15% of the time, even though no undue attention was given to instructing the staff on operation of the oximeters. Accuracy of VQI and O2EI was reconfirmed by this study. Drift in the saturations, VQI, and O2EI during the 6-h period between calibrations was negligible. The 95% range of random variability was +/- 2% for SaO2, +/- 3% for SvO2, +/- 5% for VQI, and +/- 0.04 for O2EI. Thirty-six episodes of arterial blood desaturation below 90% were detected by continuous oximetry. In contrast, 74 routine arterial blood samples revealed only four such episodes. Dual oximetry appears to be a technically reliable and accurate method of monitoring pulmonary gas exchange and tissue oxygen utilization. The equipment provided stable readings for at least six hours without recalibration. Random variability is sufficiently small to allow early detection of alterations in pulmonary and circulatory function without blood sampling.
Photovoltaic microinverter using single-stage isolated high-frequency link series resonant topology

In this paper, PhotoVoltaic (PV) microinverter using a single-stage high-frequency ac link series resonant topology is proposed. The inverter has two active bridges, one at the front-end of PV module and the other at the output or utility side. The active bridges are interfaced through a series resonant tank and a high frequency transformer. A novel phase-shift modulation technique to regulate the current into utility is proposed. Steady-state analysis using sinusoidal approximation is presented to determine the magnitude of output current into utility. Soft-switching operation is ensured in all switches in the converter due to resonant nature of the circuit. The inverter has advantages of minimal power conversion stages, high-switching frequency operation and low switching losses and hence ideally suited for low power module integrated applications.
Perirolandic cortex in infants : Signal intensity on MR images as a landmark of the sensorimotor cortex

PURPOSE: To correlate the perirolandic low signal intensity seen on T2-weighted magnetic resonance (MR) images in neonates and infants with the anatomically located sensorimotor cortex. MATERIALS AND METHODS: Axial T2-weighted MR images of 146 consecutive patients less than 6 months old were reviewed. The sensorimotor cortex was located by identifying the central sulcus. Two independent readers attempted to identify the central sulcus using two anatomic methods independently and in combination. The location of the central sulcus was compared with that of the perirolandic low signal intensity. RESULTS: Seventy-two normal hemispheres in 36 patients and 91 abnormal hemispheres in 47 patients showed clear perirolandic low signal intensity. The central sulcus was located anatomically in 70 and 72 normal hemispheres (97% and 100%, respectively) and 90 and 91 abnormal hemispheres (99% and 100%, respectively). In all normal hemispheres, the identified central sulcus correlated with the perirolandic low signal int...
A mechanism of chute cutoff along large meandering rivers with uniform floodplain topography

Incidents of chute cutoff are pervasive along many meandering rivers worldwide, but the process is seldom incorporated into theoretical analyses of planform evolution, partly due to the paucity of observations describing its physical controls. Here, we describe a mechanism of chute cutoff that may be prevalent along large meandering rivers with uniform floodplain topography. The mechanism occurs independently of sudden changes in conveyance capacity, such as those caused by natural dams, and instead, it is initiated during a flood by the incision of an embayment. The embayment is typically located almost a channel width upstream of the entrance to the meander that undergoes cutoff, and subsequent floods extend the embayment downstream until a chute is formed. Using sequences of historical aerial photos of the Sacramento River in California, USA, we found that embayments formed where channel curvature was greatest, or where the channel most tightly curved away from the downstream flow path. Embayments formed only within those portions of the floodplain that were lightly vegetated by grasses or crops. We develop a simple physical model that describes the environmental conditions that can lead to embayment formation. The model considers the role of floodplain vegetation in preventing chute incision and in part explains why chute cutoff is prevalent along some meandering rivers but not others.
A Mongol Princess Making hajj : The Biography of El Qutlugh Daughter of Abagha Ilkhan (r. 1265–82)

This study examines in detail the biographical entry of an Ilkhanid (the Mongol state centred in Iran) princess, El Qutlugh Khatun daughter of Abagha Ilkhan (r. 1265–82), in the biographical dictionaries of the Mamluk author Khalīl ibn Aybeg al-Ṣafadī (d. 1363). Al-Ṣafadī‘s biography of the lady provides a rare glance into the life of women of the Mongol royal household during the transitional period which followed the Ilkhanid conversion to Islam. It sheds light on issues such as the relations between the Mamluks and the Ilkhans in light of the latter's conversion to Islam and the influence of the process of Islamization on traditional Mongolian gender related practices. This paper also discusses the motivation of the Mamluk author in including El Qutlugh's unusual story in his biographical dictionaries showing how his choices might have been influenced not only by his own interests but also by what appealed to his readers.
From level set to volume of fluid and back again at second‐order accuracy

Summary We present methods for computing either the level set function or volume fraction field from the other at second-order accuracy. Both algorithms are optimal in that O(N) computations are needed for N total grid points and both algorithms are easily parallelized. This work includes a novel interface reconstruction algorithm in three dimensions that requires a smaller local block of volume fractions than existing algorithms. A compact local solver leads to better algorithm portability and efficiency: for example, fewer restrictions must be imposed on an adaptive mesh, and fewer grid cells must be communicated between processors in a parallel implementation. We also present a fast sweeping method for computing a unique approximation of the signed distance function to a piecewise linear interface. All of the numerical examples confirm second-order accuracy on both uniform and tree-based adaptive grids. Copyright © 2015 John Wiley & Sons, Ltd.
The Cation Selectivity Filter of the Bacterial Sodium Channel, NaChBac

The Bacillus halodurans voltage-gated sodium-selective channel (NaChBac) (Ren, D., B. Navarro, H. Xu, L. Yue, Q. Shi, and D.E. Clapham. 2001b. SCIENCE: 294:2372-2375), is an ideal candidate for high resolution structural studies because it can be expressed in mammalian cells and its functional properties studied in detail. It has the added advantage of being a single six transmembrane (6TM) orthologue of a single repeat of mammalian voltage-gated Ca(2+) (Ca(V)) and Na(+) (Na(V)) channels. Here we report that six amino acids in the pore domain (LESWAS) participate in the selectivity filter. Replacing the amino acid residues adjacent to glutamatic acid (E) by a negatively charged aspartate (D; LEDWAS) converted the Na(+)-selective NaChBac to a Ca(2+)- and Na(+)-permeant channel. When additional aspartates were incorporated (LDDWAD), the mutant channel resulted in a highly expressing voltage-gated Ca(2+)-selective conductance.
Evaluation of bias and logistics in a survey of adults at increased risk for oral health decrements.

Objectives: Designing research to include sufficient respondents in groups at highest risk for oral health decrements can present unique challenges. Our purpose was to evaluate bias and logistics in this survey of adults at increased risk for oral health decrements. Methods: We used a telephone survey methodology that employed both listed numbers and random digit dialing to identify dentate persons 45 years old or older and to oversample blacks, poor persons, and residents of nonmetropolitan counties. At a second stage, a subsample of the respondents to the initial telephone screening was selected for further study, which consisted of a baseline in-person interview and a clinical examination. We assessed bias due to: (1) limiting the sample to households with telephones, (2) using predominantly listed numbers instead of random digit dialing, and (3) nonresponse at two stages of data collection. Results: While this approach apparently created some biases in the sample, they were small in magnitude. Specifically, limiting the sample to households with telephones biased the sample overall toward more females, larger households, and fewer functionally impaired persons. Using predominantly listed numbers led to a modest bias toward selection of persons more likely to be younger, healthier, female, have had a recent dental visit, and reside in smaller households. Blacks who were selected randomly at a second stage were more likely to participate in baseline data gathering than their white counterparts. Comparisons of the data obtained in this survey with those from recent national surveys suggest that this methodology for sampling high-risk groups did not substantively bias the sample with respect to two important dental parameters, prevalence of edentulousness and dental care use, nor were conclusions about multivariate associations with dental care recency substantively affected. Conclusion: This method of sampling persons at high risk for oral health decrements resulted in only modest bias with respect to the population of interest
Topologies of practice

Allen’s (2011) provocative argument on the difference between topographic and topologic ontologies in human geography offers human geographers an important opportunity to re-engage with other similarly spirited arguments about the limitations of the topographic. For example, debate over Marston et al.’s (2005) argument for a ‘site ontology’ has tended to sidestep the question of topological space and has instead dwelled on whether or not their representation of human geography research on scale is accurate. However, if Allen’s research gives human geographers another opportunity to take up the question of sociospatial practice as contingent, site-specific, and self-structuring, it also poses at least two problems. On the one hand, Allen characterizes the topographic and topologic according to a too neat calendar of sociospatial relations. On the other hand, Allen overlooks a long-standing appreciation for the topologic in human geography by drawing a strong distinction between past and newer intellectual ...
Very Late Thrombosis After Bioresorbable Scaffolds: Cause for Concern?

The absence of clinical restenosis in the first major trial of metallic drug-eluting stents (DES) [(1)][1] elicited unbridled enthusiasm among interventional cardiologists. However, it did not take long to realize that, although DES were a marked improvement over bare-metal stents [(2)][2], they
The Multidisciplinary Approach to Breast Cancer Management

The goal of the multidisciplinary treatment of breast cancer is to optimize therapeutic effectiveness while minimizing acute and long-term toxic effects. Correct staging and determination of the breast cancer subtype are critical to the development of appropriate treatment plans. In addition, consideration of the unique aspects of the patient’s history, physical examination, and family history are prerequisites for providing superior care. This chapter describes the multidisciplinary management of ductal carcinoma in situ, early-stage breast cancer, and locally advanced breast cancer. We will discuss the critical steps in formulating a multidisciplinary treatment plan, including how to choose the most appropriate surgical intervention, how to determine if adjuvant radiation therapy is warranted including eligibility for alternative methods of radiation delivery, and how to determine the appropriate sequencing strategies for systemic therapy. Finally, we will describe surveillance for breast cancer patients who have completed curative therapy.
Insight into Speciation From Long-term Research on Darwin’s Finches

Darwin’s finches on the Galapagos Islands are a classical example of adaptive radiation. A total of 13 species have been formed from a single ancestral species that colonized the Galapagos 2–3 million years ago. Each species occupies a distinct and unique feeding niche. For evolutionary biologists, they pose a challenge. What is the explanation for the evolution of such a variety of species in a relatively short space of time? What governs the rate of speciation and the directions of evolution? Answers to these questions are of general significance in the context of understanding why the world is so rich biologically.
Accelerated Publication: Laser-assisted ultrathin die packaging: Insights from a process study

Laser-assisted assembly of ultrathin, ultrasmall bare dice holds promise for enabling a new class of very low cost flexible electronic devices with applications in many areas. But this advanced packaging technology will be of little use if two important parameters are not considered - transfer rate and precision/accuracy of die placement. Both parameters depend on the laser process parameters and the properties of the consumable materials used. Reported are results from a process study designed to investigate the effects of the laser pulse parameters, the adhesive layer properties, and the method of wafer dicing on the transfer rate and placement precision/accuracy when transferring ultrathin ([email protected] thick) silicon dice using the thermo-mechanical selective laser-assisted die transfer (tmSLADT) technique developed by this team and reported in prior publications. It is shown that, when properly controlled, tmSLADT can transfer ultrathin bare dice with precision and accuracy compatible with those achievable by the conventional die placement methods but at a much higher transfer rate.
When 'Yes' May Actually Mean 'No': Rethinking Informed Consent to ADR Processes

It is time for us to rethink how to achieve meaningful party consent to ADR processes such as mediation and arbitration. I, along with my colleagues Professors Jeff Sovern, Paul F. Kirgis and Yuxiang Liu recently contributed to the growing body of research finding that a party’s consent to use an ADR process rather than utilizing a court to resolve their dispute is too often neither informed nor consensual. In our empirical study “‘Whimsy Little Contracts’ With Unexpected Consequences: An Empirical Analysis of Consumer Understanding of Arbitration Agreements,” we found a paucity of consumer awareness and understanding of arbitration clauses in pre-dispute consumer contracts. Although our research was about the degree of a party’s informed consent to arbitration agreements in consumer contracts I believe the findings have broader applicability to our understanding of a party’s informed consent beyond consumer contracts and to ADR processes in general. This research challenges the long-held assumptions and ongoing practices of many ADR professionals, including myself, who believe that a party’s decision to participate in dispute resolution should be a voluntary and informed decision. In this column, I will extrapolate the lessons learned from this research and question how we might make informed consent a more meaningful concept when using and conducting such ADR processes.
Anatomy of the Pedal Skeleton of the Hispaniolan Solenodon, Solenodon paradoxus Brandt, 1833 (Mammalia, Lipotyphla, Solenodontidae)

ABSTRACT The osseous elements of the foot and ankle are described and illustrated in detail for the Hispaniolan solenodon, Solenodon paradoxus Brandt, 1833, one of two extant species of the lipotyphlan family Solenodontidae. Comparisons are made with the same elements in representatives of the three remaining extant families of lipotyphlans, the soricid Crocidura luna Dollman, 1910, the talpid Parascalops breweri (Bachman, 1842), and the erinaceid Erinaceus europaeus Linnaeus, 1758. The muscles attaching to the osseous elements of the foot in lipotyphlans are summarized based on the literature. The solenodon foot is generalized but with a unique modification regarding the entocuneiform: it has an elongate medial spur with a sizeable facet for the astragalar head. The other lipotyphlans studied have a medial spur of the entocuneiform, but it is well separated from the astragalus by the navicular. Crocidura luna also has a remarkable modification; the ectal facets on the astragalus and calcaneus have opposi...
The Human Use of Insects as Food and as Animal Feed

Most Europeans and North Americans are barely, if at all, aware that insects have played an important role in human nutrition. The older literature contains numerous accounts provided by explorers, naturalists, anthropologists, and assorted travelers describing the use of insects as food by the indigenous peoples of most of the world.
Tether and Accretions Fantasy as Form in Videogames

I argue that videogames are structured by conscious fantasy. This project traces two fantasies (tether and accretions) that combine into the genre of the role-playing game, providing a rough timeli...
Hardware–Software Integrated Silicon Photonics for Computing Systems

A wealth of high-bandwidth and energy-efficient silicon photonic devices have been demonstrated in recent years. These represent promising solutions for high-performance computer systems that need to distribute extremely large amounts of data in an energy-efficient manner. Chip-scale optical interconnects that employ novel silicon photonics devices can potentially leapfrog the performance of traditional electronic-interconnected systems. However, the benefits of silicon photonics at a system level have yet to be realized. This chapter reviews methodologies for integrating silicon photonic interconnect technologies with computing systems, including implementation challenges associated with device characteristics. A fully functional co-integrated hardware–software system needs to encompass device functionality, control schema, and software logic seamlessly. Each layer, ranging from individual device characterization, to higher layer control of multiple devices, to arbitration of networks of devices, and ultimately to encapsulation of subsystems to create the entire computing system is explored. Finally, results and implications at each level of the system stack are presented.
Dual-Modality Imaging of Prostate Cancer with a Fluorescent and Radiogallium-Labeled Gastrin-Releasing Peptide Receptor Antagonist

Gastrin-releasing peptide (GRP) receptors (GRPr) are frequently overexpressed in human prostate cancer, and radiolabeled GRPr affinity ligands have shown promise for in vivo imaging of prostate cancer with PET. The goal of this study was to develop a dual-modality imaging probe that can be used for noninvasive PET imaging and optical imaging of prostate cancer. Methods We designed and synthesized an IRDye 650 and DOTA-conjugated GRPr antagonist, HZ220 (DOTA-Lys(IRDye 650)-PEG4-[D-Phe6, Sta13]-BN(6-14)NH2), by reacting DOTA-Lys-PEG4-[D-Phe6, Sta13]-BN(6-14)NH2 (HZ219) with IRDye 650 N-hydroxysuccinimide (NHS) ester. Receptor-specific binding of gallium-labeled HZ220 was characterized in PC-3 prostate cancer cells (PC-3), and tumor uptake in mice was imaged with PET/CT and fluorescence imaging. Receptor binding affinity, in vivo tumor uptake, and biodistribution were compared with the GRPr antagonists HZ219, DOTA-PEG4-[D-Phe6, Sta13]-BN(6-14)NH2 (DOTA-AR), and DOTA-(4-amino-1-carboxymethyl-piperidine)-[D-Phe6, Sta13]-BN(6-14)NH2 (DOTA-RM2). Results After hydrophilic-lipophilic balance cartridge purification, 68Ga-HZ220 was obtained with a radiochemical yield of 56% ± 8% (non-decay-corrected), and the radiochemical purity was greater than 95%. Ga-HZ220 had a lower affinity for GRPr (inhibitory concentration of 50% [IC50], 21.4 ± 7.4 nM) than Ga-DOTA-AR (IC50, 0.48 ± 0.18 nM) or Ga-HZ219 (IC50, 0.69 ± 0.18 nM). Nevertheless, 68Ga-HZ220 had an in vivo tumor accumulation similar to 68Ga-DOTA-AR (4.63 ± 0.31 vs. 4.07 ± 0.29 percentage injected activity per mL [%IA/mL] at 1 h after injection) but lower than that of 68Ga-DOTA-RM2 (10.4 ± 0.4 %IA/mL). The tumor uptake of 68Ga-HZ220 was blocked significantly with an excessive amount of GRP antagonists. IVIS spectrum imaging also visualized PC-3 xenografts in vivo and ex vivo with a high-contrast ratio. Autoradiography and fluorescent-based microscopic imaging with 68Ga-HZ220 consistently colocated the expression of GRPr. 68Ga-HZ220 displayed a higher kidney uptake than both 68Ga-DOTA-AR and 68Ga-DOTA-RM2 (16.9 ± 6.5 vs. 4.48 ± 1.63 vs. 5.01 ± 2.29 %IA/mL). Conclusion 68Ga-HZ220 is a promising bimodal ligand for noninvasive PET imaging and intraoperative optical imaging of GRPr-expressing malignancies. Bimodal nuclear/fluorescence imaging may not only improve cancer detection and guide surgical resections, but also improve our understanding of the uptake of GRPr ligands on the cellular level.
Postgraduate Course ERS Munich 2006 - Paediatric respiratory medicine: allergy for paediatric pulmonologists; Management of paediatric anaphylaxis

Educational aims To understand how to identify those patients at substantial risk of anaphylaxis who are likely to be encountered in everyday practice. To explain how to undertake initial preventive strategies to reduce risk and facilitate specialist care aimed at further risk reduction and treatment. To detail the prescription of an adrenaline self-administration device and provide instructions on its proper use. Summary Anaphylaxis is a severe, systemic allergic reaction. It is also potentially life-threatening. Acute treatment depends on the administration of adrenaline. It is possible to identify those at greatest risk of anaphylaxis and to reduce the danger, by helping them to modify their behaviour and by prescribing them an adrenaline self-administration device. Education and prevention are vital.
Respiratory Diseases in Obesity

While it has long been recognized that obesity is a risk factor for diseases such as type II diabetes and steatohepatitis, it has only recently been appreciated that obesity is a major risk factor for lung diseases such as asthma, sleep apnea and likely also pulmonary hypertension. Obesity also dramatically alters the clinical course of other common lung diseases such as chronic obstructive pulmonary disease and acute lung injury. The purpose of this chapter will be first to review the effects of obesity on lung function, and then to discuss the effect of obesity on the aforementioned pulmonary diseases.
Host Cell Tropism and Adaptation of Blood-Stage Malaria Parasites: Challenges for Malaria Elimination

Plasmodium falciparum and Plasmodium vivax account for most of the mortality and morbidity associated with malaria in humans. Research and control efforts have focused on infections caused by P. falciparum and P. vivax, but have neglected other malaria parasite species that infect humans. Additionally, many related malaria parasite species infect nonhuman primates (NHPs), and have the potential for transmission to humans. For malaria elimination, the varied and specific challenges of all of these Plasmodium species will need to be considered. Recent advances in molecular genetics and genomics have increased our knowledge of the prevalence and existing diversity of the human and NHP Plasmodium species. We are beginning to identify the extent of the reservoirs of each parasite species in humans and NHPs, revealing their origins as well as potential for adaptation in humans. Here, we focus on the red blood cell stage of human infection and the host cell tropism of each human Plasmodium species. Determinants of tropism are unique among malaria parasite species, presenting a complex challenge for malaria elimination.
Investigator-initiated pilot study of bicalutamide and raloxifene in hormone-resistant prostate cancer.

e16065 Background: Estrogens, in addition to androgen may contribute to the progression of prostate cancer.The combination of bicalutamide, a non-steroidal anti-androgen, and raloxifene, a selectiv...
An Innovative Strategy to Increase Patient Hand Hygiene Autonomy of Hospitalized Adults

This dissertation has also been disseminated through Ohio Link: https://etd.ohiolink.edu/pg_10?0::NO:10:P10_ACCESSION_NUM:case1489708859944739. The author retains copyright.
Clinical and Molecular Aspects of Rabies Virus Infections of the Nervous System

Rabies virus produces an acute central nervous system infection in warmblooded animals and humans, causing an illness with overt clinical symptoms that are unlike any other disease. It is not entirely clear how the virus manages to invade the nervous system (both peripheral and central) although there is general agreement about the neural pathways used by the virus. Despite extensive efforts to research the pathogenesis of rabies using state-of-the-art methods of the times for more than a century, there is still much more that needs to be understood about the pathogenetic process of rabies virus. Recent investigations of molecular correlates of rabies pathogenesis have revealed that a significant determinant of viral pathogenicity resides in the glycoprotein of rabies virus. The critical amino acid arginine at position 333 of the glycoprotein sequence of 505 amino acids seems to be essential for the virus to exert its lethal effects on the infected host.
Mood as a Product of Leisure: Causes and Consequences

This paper demonstrates, through a review of the literature, that mood is a significant, prevalent and relevant product of leisure activities. Mood is shown to be an integral part of many leisure t...
Characterization of CD38 in the major cell types of the heart: endothelial cells highly express CD38 with activation by hypoxia-reoxygenation triggering NAD(P)H depletion

The NAD(P)+-hydrolyzing enzyme CD38 is activated in the heart during the process of ischemia and reperfusion, triggering NAD(P)(H) depletion. However, the presence and role of CD38 in the major cel...
A putative causal relationship between genetically determined female body shape and posttraumatic stress disorder.

The nature and underlying mechanisms of the observed increased vulnerability to posttraumatic stress disorder (PTSD) in women are unclear. We investigated the genetic overlap of PTSD with anthropometric traits and reproductive behaviors and functions in women. The analysis was conducted using female-specific summary statistics from large genome-wide association studies (GWAS) and a cohort of 3577 European American women (966 PTSD cases and 2611 trauma-exposed controls). We applied a high-resolution polygenic score approach and Mendelian randomization analysis to investigate genetic correlations and causal relationships. We observed an inverse association of PTSD with genetically determined anthropometric traits related to body shape, independent of body mass index (BMI). The top association was related to BMI-adjusted waist circumference (WCadj; R = –0.079, P < 0.001, Q = 0.011). We estimated a relative decrease of 64.6% (95% confidence interval = 27.5–82.7) in the risk of PTSD per 1-SD increase in WCadj. MR-Egger regression intercept analysis showed no evidence of pleiotropic effects in this association (Ppleiotropy = 0.979). We also observed associations of genetically determined WCadj with age at first sexual intercourse and number of sexual partners (P = 0.013 and P < 0.001, respectively). There is a putative causal relationship between genetically determined female body shape and PTSD, which could be mediated by evolutionary mechanisms involved in human sexual behaviors.
Transposon insertion upstream of a putative sodium/sulphate symporter is associated with hypervirulence in the soft rot bacterium, Pectobacterium carotovorum

Pathogenesis by Pectobacterium carotovorum and the other soft rot bacteria results mostly from the synthesis and secretion of a plethora of exoproteins including plant cell wall‐degrading enzymes and type III effectors. A mini‐Tn5 transposon mutant of P. carotovorum (KD200) was isolated that is highly increased in activity and transcript levels of extracellular cell wall‐degradative enzymes, pectate lyase, polygalacturonase, cellulase and protease. Accordingly, the mutant was more virulent as it macerated more host tissue than its parent. KD200 mutant harbours a Tn5 insertion directly upstream of nssAEcc₇₁, a putative sodium/sulphate symporter gene and member of a family of divalent anion sodium symporters (DASS). The findings reported here suggest that DASS proteins may be involved in soft rot pathogenesis.
Prospective Clinical Trial of Ixazomib, Dexamethasone, and Rituximab as Primary Therapy in Waldenström Macroglobulinemia

Purpose: Proteasome inhibition is of proven efficacy in patients with Waldenstrom macroglobulinemia (WM). However, WM remains incurable with standard treatments. Novel agents, safe and effective, are needed.Patients and Methods: We designed a prospective phase II study evaluating the combination of ixazomib, dexamethasone, and rituximab (IDR) as primary therapy in symptomatic patients with WM. Protocol therapy consisted of oral ixazomib, 4 mg, with intravenous or oral dexamethasone, 20 mg, on days 1, 8, and 15 every 4 weeks for induction cycles 1 and 2, and in combination with intravenous rituximab, 375 mg/m2, on day 1, every 4 weeks for cycles 3 to 6. Maintenance therapy followed 8 weeks later with IDR given every 8 weeks for 6 cycles.Results: Twenty-six patients were enrolled. All patients had the MYD88 L265P mutation, and 15 patients (58%) had a CXCR4 mutation. The median time to response was 8 weeks, which was longer (12 weeks) in WM patients with CXCR4 mutations (P = 0.03). The overall response rate was 96%, and the major response rate was 77%. With a median follow-up of 22 months, the median progression-free survival was not reached. Grade ≥2 adverse events reported in >1 patient included infusion-related reactions (19%), rash (8%), and insomnia (8%).Conclusions: IDR offers a highly effective and well tolerated, neuropathy-sparing regimen for primary therapy in patients with WM. This trial is registered at www.clinicaltrials.gov under ID NCT02400437 Clin Cancer Res; 24(14); 3247-52. ©2018 AACR.
Climate and Fisheries: The Past, The Future, and The Need for Coalescence

In this chapter we review the history of fisheries science with respect to climate impacts on fisheries and prognosticate the future of this type of research. Our review of the development of climate and fisheries research reveals that advances in our discipline emerge from the coalescence of four factors: shifts in fisheries economics and policy; developments in theoretical ecology; innovations in small-scale field and laboratory studies; and progress in large-scale fisheries statistics and modeling. Major advances have occurred when scientists interacted in multidisciplinary forums. We find that efforts to understand the impact of climate on the annual production and distribution of fish have produced a primary level of understanding of the processes underlying stock structure, production, and distribution of fish species. We find that ecosystem-based approaches to management have been advocated to a greater or lesser degree throughout the last century. In the future, we expect that advances in scientific understanding and improved computing power will allow scientists to explore the complex nature of environmental interactions occurring at different spatial and tem- poral scales. New field programs will develop to support the development of spatially explicit models of fish that include complex interactions within and between species, and fish behavior. Field sampling programs will benefit from continuing innovations in technology that improve collection of information on the abundance, distribution of fish, and the environment. New technologies will also be utilized in laboratory studies to rapidly assess the reproductive potential, food habits, and genetic history of fish under different environmental conditions. We expect that interdisciplinary training will continue to serve as a catalyst for new ideas in climate and fisheries. However, as researchers shift their focus from retrospective studies and now-casts to long-term implications of fishing and climate on the ecosystem we expect that training in ocea- nography, ecological theory, and environmental policy will be needed to provide a foundation for the development of models that depict the trade-offs of nature and human use in a realistic manner. Finally, we challenge fisheries scientists to track the accuracy of long- to medium-term forecasts of future states of nature and the potential impact of climate and fisheries on them.
Lifecycle assessment (LCA) and its application to sustainable waste management

Abstract: This chapter deals with quantitative ways to compare waste treatment technologies. It introduces lifecycle analysis and details a lifecycle-based method to evaluate the sustainability of waste treatment systems. It concludes that cities need a mix of waste treatment technologies to manage municipal solid waste flows sustainably.
Klinische Elektroenzephalographie (EEG)

Bei der Elektroenzephalographie (EEG), welche erstmals durch H. Berger 1929 bei Kaninchen angewendet wurde, handelt es sich um die alteste der neurophysiologischen Untersuchungen. Sie verlor nach der Einfuhrung moderner bildgebender Verfahren in vielen Fragestellungen an diagnostischer Bedeutung. Der Stellenwert des EEG in der klinischen Diagnostik zerebraler Funktionsstorungen und deren Verlaufsbeobachtung ist jedoch unumstritten. Das EEG ermoglicht Ruckschlusse auf den Schweregrad einer Funktionsstorung, kann Hinweise auf die Prognose geben und ist die einzige Untersuchungsmethode, die eine erhohte zerebrale Erregbarkeit aufdeckt. So wird das EEG heute v. a. in der Diagnostik der Epilepsien, der Differenzialdiagnose von Enzephalopathien (metabolisch, toxisch, entzundlich, vaskular), der Demenzen sowie im intensivmedizinischen Bereich (Monitoring des Krankheitsverlaufes, des Medikamenteneffektes bei Status epilepticus) und zur Hirntoddiagnostik eingesetzt.
Hot and Dense Nuclear Matter: Summary Talk

I think my first mistake was to sit by the door on Monday of the opening session, taking notes, as Walter Greiner walked past after his introductory remarks. He stopped and asked if I would give the summary talk, and, almost without thinking, r agreed. The realization of what I had done came only seconds later, but it was too late. Since I have been only peripherally involved in the research fields which contribute to the subject of this meeting, my summary will necessarily be from a very narrow, but possibly unbiased point of view. I view this talk not as the traditional conference summary, where the speaker attempts to place into historical perspective the various accomplishments of the dinosaurs and promotes the recent accomplishments of the young turks. Rather I will more closely follow the pattern I remember in elementary school, where on the first day of classes in the fall everyone was expected to stand up III sequence and present an impromptu talk on: ”What I Did on my Summer Holiday”.
A Simulation-based Optimization Approach to Develop Personalized Colorectal Cancer Screening Strategies

Abstract Colorectal cancer (CRC) is the third leading cause of death due to cancer, with survival closely linked to the stage of cancer at diagnosis. This paper presents a simulation-based optimization approach to generate an optimal screening strategy for CRC. We applied our approach to male and female cohorts, and studied the impact of identified strategies on CRC incidence and death rates for the 1975 US population (a population that had little to no screening). The best strategy identified for men was a colonoscopy every 40 years starting at age 32 and ending at age 96 and for women was a FIT every 17 years starting at age 49 and ending at age 100. If those strategies were implemented for the US population of 1975, it would have resulted in a 45 % reduction in CRC cases and a 53 % reduction in CRC related deaths compared to no screening.
The Use of Modern Intramedullary Nailing in Distal Fibula Fracture Fixation

Background. Lateral malleolus (LM) fixation is necessary for unstable ankle fractures. Traditional fixation relies on the use of plates through a lateral incision, wound healing can be an issue for...
Big Bang to Homo Erectus to Multi-Messenger Astronomy

If the title of this chapter doesn’t quite make sense to you it will after you have read the chapter. Now that you have committed to a cruise with an astronomy/astrophotography element it would be to your advantage to learn something about astronomy – the science that studies the universe. By doing so you will gain a deeper appreciation and understanding of the sky sights you will see and photograph. After all, astronomy is recognized as the oldest of the sciences and has a direct lineage from ancient astrology, where practitioners observed the sky to foretell the future. After reading this chapter and the others on specific astronomy and sky-related topics you will have a working knowledge of the concepts and structures of the universe.
Functional Coagulation Differences Between Lobar and Deep Intracerebral Hemorrhage Detected by Rotational Thromboelastometry: A Pilot Study

Lobar intracerebral hemorrhage (ICH) is known to have better clinical outcomes and preliminary evidence of less hematoma expansion compared to deep ICH. No functional coagulation differences between lobar and deep ICH have been identified using traditional plasma-based coagulation tests. We investigated for coagulation differences between lobar and deep ICH using whole-blood coagulation testing (Rotational Thromboelastometry: [ROTEM]). Clinical, radiographic, and laboratory data were prospectively collected for primary ICH patients enrolled in a single-center ICH study. Patients with preceding anticoagulant use or admission coagulopathy on traditional laboratory testing were excluded. Lobar and deep ICH patients receiving admission ROTEM were analyzed. Linear regression was used to assess the association of ICH location with coagulation test results after adjusting for potential confounders. There were 12 lobar and 19 deep ICH patients meeting inclusion criteria. Lobar ICH patients were significantly older and predominantly female. Lobar ICH had faster intrinsic pathway coagulation times (139.8 vs 203.2 s; 95% CI − 179.91 to − 45.96; p = 0.002) on ROTEM testing compared to deep ICH after adjusting for age, sex, and hematoma volume. This revealed functional coagulation differences, specifically quicker clot formation in lobar compared to deep ICH. No differences were noted using traditional coagulation testing (prothrombin time/partial thromboplastin time/platelet count). Our pilot data may suggest that there are functional coagulation differences between lobar and deep ICH identified using ROTEM. Whole-blood coagulation testing may be useful in assessing coagulopathy in ICH patients and in determining reversal treatment paradigms, though further work is needed.
Emergent Neonatal Abdominal Paracentesis: A Step-by-Step Video Simulation

1. Evacuation of ascites with resultant cardiorespiratory compromise. 2. Signs of ascites with resultant cardiorespiratory compromise. 1. There are no absolute contraindications to this procedure in an emergent setting. 2. This is an invasive procedure and should not be performed if the decision has been made for redirection unless approved by the family. 3. Relative contraindications: 4. All relative contraindications, risks, and benefits need to be assessed in the context of an emergent situation. 1. This video provides instruction on how to perform an abdominal paracentesis in an emergency (Video) . …
Soft Tissue Sarcomas of the Extremities

Soft tissue sarcomas are highly diverse mesenchymal malignancies of muscle, peripheral nerves, and adipose or fibrous connective tissues. Sarcoma classification had been entirely based on resemblance to various tissue types. More recently, classifications have been revised to include molecular features and genetic profiles of sarcoma. While our treatment paradigms for soft tissue sarcomas were developed on, what we know now to be oversimplified, histologic classifications, the addition of specific karyotyping and biomarkers has not changed our overall approach to these tumors in the majority. The local therapy paradigms are still based on surgery and radiation for the vast majority of these tumors.
A mixed-methods study of provider perspectives on My Birth Control: a contraceptive decision support tool designed to facilitate shared decision making.

Abstract Objectives Barriers to the provision of patient-centered contraceptive counseling include time limitations, frequent misconceptions and misinformation about methods among patients, and the availability of numerous contraceptive options, which increases the complexity of contraceptive decision making. Decision support tools are interventions designed to facilitate quality decision making in preference-sensitive decisions. We evaluated the impact of a contraceptive decision support tool, My Birth Control, on providers' experience with contraceptive counseling. Study design We interviewed 15 providers who participated in the intervention arm of a cluster randomized controlled trial of My Birth Control to obtain their impressions of their patients' interactions with the tool. We analyzed the interviews using thematic analysis, compared appointment lengths of patients in each arm (n=749) and assessed provider burnout in each arm (n=28). Results Providers reported that incorporating My Birth Control into their practice helped them allocate time more efficiently, enabling them to hone in on patients' areas of interest. They also reported that patients who interacted with the tool appeared more informed about contraception options and features, and took a more active role in method selection. All providers described using the tool as acceptable and feasible, and indicated they would like to incorporate it into their practice. There was no difference in provider burnout scores comparing before and after the trial of My Birth Control. Conclusion Providers had a positive impression of the impact of My Birth Control on contraceptive counseling, including the quality of counseling, and perceived the tool to be a feasible intervention to use in the clinical setting. Implications Family planning clinics should consider incorporating My Birth Control into their clinical services as a means of improving contraceptive care and provider experience of counseling.
Strategies to improve islet yield from chronic pancreatitis pancreases intended for islet autotransplantation

Abstract Over the past four decades, total pancreatectomy (TP) with islet autologous transplantation (IAT) has become the premier treatment option for both children and adults suffering from refractory pain due to chronic pancreatitis (CP). TP followed by IAT as an adjacent therapy was first introduced in 1977 at the University of Minnesota to overcome the resulting “brittle” insulin-dependent pancreatogenic (type 3c) diabetes. After pancreatectomy, the removed pancreas it packed and transported to the specialized clean-room facility for islet isolation. The pancreas is distended with a tissue dissociation enzyme blend (collagenase and protease), that digests the extracellular matrix of the pancreas to liberate the islet and exocrine tissue. If necessary, this tissue is purified using a density gradient, and then the islets are transferred to a transplant bag for the intraportal infusion back into the patient. Overtime, the islets engraft within the liver and some patients are able to wean off insulin therapy. Even if they remain insulin dependent, most patients retain c-peptide levels, indicating some level of islet function, which aids in diabetes management. The most critical determining factor for a positive metabolic outcome from this procedure is the number of islets transplanted, thus making the total isolation yield of particular importance. While the pancreas contains a high number of islets, even the best isolation techniques can only recover a portion of these for transplantation. The standard isolation techniques currently being used still have greatly varying outcomes because they cannot completely account for the variation between patients, which arise from the unique characteristics of each organ, such as the degree of fibrosis and the innate islet mass. The purpose of this review is to describe how the islet isolation procedure for IAT is performed and to explain how it can be modified to accommodate the variation encountered between patients.
Undiagnosed Obstructive Sleep Apnea as Predictor of 90-Day Readmission for Brain Tumor Patients.

Background Previously undiagnosed obstructive sleep apnea (OSA) is a known contributor to negative postoperative outcomes. The STOP-Bang questionnaire is a screening tool for OSA that has been validated in both medical and surgical populations. The authors have previously studied this screening tool in a brain tumor population at 30 days. The present study seeks to investigate the effectiveness of this questionnaire, for predicting 90-day readmissions in a population of brain tumor patients with previously undiagnosed OSA. Methods Included for analysis were all patients undergoing craniotomy for supratentorial neoplasm at a multihospital, single academic medical center. Data were collected from supratentorial craniotomy cases for which the patient was alive at 90 days after surgery (n = 238). Simple logistic regression analyses were used to assess the ability of the STOP-Bang questionnaire and subsequent single variables to accurately predict patient outcomes at 90 days. Results The sample included 238 brain tumor admissions, of which 50% were female (n = 119). The average STOP-Bang score was 1.95 ± 1.24 (range 0–7). A 1-unit higher increase in STOP-Bang score accurately predicted 90-day readmissions (odds ratio [OR] = 1.65, P = 0.001), 30- to 90-day emergency department visits (OR = 1.85, P Conclusions The results of this study suggest that undiagnosed OSA, as evaluated by the STOP-Bang questionnaire, is an effective predictor of readmission risk and health system utilization in a brain tumor craniotomy population with previously undiagnosed OSA.