cssi/SciSciGPT-SciSciNet huggingface dataset:
Efficacy of Chlorhexidine for the Prevention and Treatment of Oral Mucositis in Cancer Patients: A Systematic Review with Meta-analyses

Background Oral mucositis occurs in patients undergoing chemoradiation for cancer treatment. It is believed that colonization of ulcerated mucosa by bacteria, fungi and virus results in secondary infections. The effect of chlorhexidine (CHX) on the incidence and severity of oral mucositis in cancer patients was evaluated in this review. Methods Studies were limited to randomized placebo-controlled trials. Three databases were searched: MEDLINE (via PubMed), Web of Science and the Cochrane Library up to May 25, 2016. Results Ninety-eight abstracts were evaluated by three independent reviewers. Twelve studies met the criteria for inclusion. Four of these studies were assessed at unclear risk of bias and eight of them at high risk. Of the 12 studies, 9 were included in two meta-analyses. Pooled results showed that chlorhexidine did not significantly reduce incidence of mucositis compared to placebo (p=0.129), nor chlorhexidine did significantly reduce the severity of mucositis (p=0.127), though subgroup analysis in the chemotherapy group showed a trend toward significance (p=0.054). Side-effects reported in the included studies were teeth staining and altered taste perception. Conclusions This systematic review found that chlorhexidine is not significantly effective in reducing the severity of mucositis (moderate quality of evidence) nor in preventing the incidence of mucositis (low quality of evidence). However, more studies are needed in patients receiving chemotherapy only, as a positive trend toward significance was found (p=.054). This article is protected by copyright. All rights reserved.
Association between Mycobacterium tuberculosis lineage and site of disease in Florida, 2009-2015.

Abstract Background Mycobacterium tuberculosis is characterized into four global lineages with strong geographical restriction. To date one study in the United States has investigated M. tuberculosis lineage association with tuberculosis (TB) disease presentation (extra-pulmonary versus pulmonary). We update this analysis using recent (2009–2015) data from the State of Florida to measure lineage association with pulmonary TB, the infectious form of the disease. Methods M. tuberculosis lineage was assigned based on the spacer oligonucleotide typing (spoligotyping) patterns. TB disease site was defined as exclusively pulmonary or extra-pulmonary. We used ORs to measure the association between M. tuberculosis lineages and pulmonary compared to extra-pulmonary TB. The final multivariable model was adjusted for patient socio-demographics, HIV and diabetes status. Results We analyzed 3061 cases, 83.4% were infected with a Euro-American lineage, 8.4% Indo-Oceanic and 8.2% East-Asian lineage. The majority of the cases (86.0%) were exclusively pulmonary. Compared to the Indo-Oceanic lineage, infection with a Euro-American (AOR = 1.87, 95% CI: 1.21, 2.91) or an East-Asian (AOR = 2.11, 95% CI: 1.27, 3.50) lineage favored pulmonary disease compared to extra-pulmonary. In a sub-analysis among pulmonary cases, strain lineage was not associated with sputum smear positive status, indicating that the observed association with pulmonary disease is independent of host contagiousness. Conclusion As an obligate pathogen, M. tuberculosis' fitness is directly correlated to its transmission potential. In this analysis, we show that M. tuberculosis lineage is associated with pulmonary disease presentation. This association may explain the predominance in a region of certain lineages compared to others.
Optimality of an affine intensity policy for maximizing the probability of an arrival count in point-process intensity control

Abstract This paper considers the problem of maximizing the probability of attaining a prescribed count of arrivals generated by a point process, by controlling its intensity. Our analysis shows the existence of optimal intensity switching times that are affine in the arrival count, thereby contributing to the literature on the optimality of affine policies. The optimal intensity control law is established, along with closed-form expressions for its numerical parameters. Several properties of the value function are listed as well.
Deployment of a Wireless Ultrasonic Sensor Array for Psychological Monitoring

The deployment of a wireless sensor network to monitor subjects’ locations and relative distances during psychological experiments is discussed. As its primary function, an overhead array of ultrasound sensors automatically tracks a parent, child and stranger over a \(4.45~\text{m} \times 4.23~\text{m}\) observation area. The array of ultrasonic-equipped motes can resolve two point targets separated by at least 73 cm. Each sensor can detect the range to the nearest object with 20 cm resolution. Challenges with setting up the 6 x 6 ultrasonic imaging array and with establishing a Kalman tracking filter are also detailed. This WiPsy (Wireless sensors for Psychology research) system provides accurate, real-time quantitative metrics for psychological evaluation in lieu of traditional qualitative manual coding. Moreover, tracking subjects using ultrasound sensors is less error-prone than existing methods that track based on human coding of video. Overall, WiPsy strives to streamline data acquisition, processing, and analysis by providing previously unavailable assessment parameters.
PREBIOLOGICAL CHEMISTRY AND THE ORIGIN OF LIFE. A PERSONAL ACCOUNT

Publisher Summary This chapter reviews a personal account of J. Oro on pre-biological chemistry and the origin of life. By having the insight and wisdom to follow the thread of the biochemistry of high energy phosphate and working with vigor and imagination, Severo Ochoa has been a pioneer or major contributor in many of the above discoveries. These major advances together with the contributions of Mendelian and molecular genetics have provided a clear understanding of the basic principles that govern all living organisms and have demonstrated the fundamental unity of terrestrial life, as required by Darwin's theory of biological evolution. As pointed out by Miller, the similar experiment performed earlier by W. Loeb was done in an entirely different context in an unsuccessful attempt to provide a chemical model for the mechanisms of nitrogen fixation and amino acid biosynthesis in plants. Besides hydroxy acids, urea and other organic compounds, some of the most abundant biological amino acids obtained by Miller in these experiments were glycine, alanine, and aspartic acid.
Propofol inhibits prokaryotic voltage-gated Na+ channels by promoting activation-coupled inactivation

Propofol is widely used in the clinic for the induction and maintenance of general anesthesia. As with most general anesthetics, however, our understanding of its mechanism of action remains incomplete. Local and general anesthetics largely inhibit voltage-gated Na+ channels (Navs) by inducing an apparent stabilization of the inactivated state, associated in some instances with pore block. To determine the biophysical and molecular basis of propofol action in Navs, we investigated NaChBac and NavMs, two prokaryotic Navs with distinct voltage dependencies and gating kinetics, by whole-cell patch clamp electrophysiology in the absence and presence of propofol at clinically relevant concentrations (2-10 µM). In both Navs, propofol induced a hyperpolarizing shift of the pre-pulse inactivation curve without any significant effects on recovery from inactivation at strongly hyperpolarized voltages, demonstrating that propofol does not stabilize the inactivated state. Moreover, there was no evidence of fast or slow pore block by propofol in a non-inactivating NaChBac mutant (T220A). Propofol also induced hyperpolarizing shifts of the conductance-voltage relationships with negligible effects on the time constants of deactivation at hyperpolarized voltages, indicating that propofol does not stabilize the open state. Instead, propofol decreases the time constants of macroscopic activation and inactivation. Adopting a kinetic scheme of Nav gating that assumes preferential closed-state recovery from inactivation, a 1.7-fold acceleration of the rate constant of activation and a 1.4-fold acceleration of the rate constant of inactivation were sufficient to reproduce experimental observations with computer simulations. In addition, molecular dynamics simulations and molecular docking suggest that propofol binding involves interactions with gating machinery in the S4-S5 linker and external pore regions. Our findings show that propofol is primarily a positive gating modulator of prokaryotic Navs, which ultimately inhibits the channels by promoting activation-coupled inactivation.
Postoperative outcomes with neuraxial versus general anesthesia in bilateral total hip arthroplasty

Abstract Study objective Current evidence remains limited on the postoperative outcomes of neuraxial (NA) versus general anesthesia (GA) as primary anesthesia type in patients receiving simultaneous bilateral total hip arthroplasty (BTHA). We aimed to evaluate the rates of postoperative outcomes among patients receiving NA versus GA for BTHA. Design Retrospective cohort study. Setting Multi-institutional. Patients A total of 798 patients undergoing BTHA with 519 and 279 who received GA and NA, respectively. We used the American College of Surgeons – National Surgical Quality Improvement Program database for years 2007 to 2016. Interventions Patients undergoing BTHA. Measurements We propensity-score matched on demographic factors and comorbid conditions to compare rates of postoperative outcomes among cohorts (NA versus GA). We performed Pearson chi-square and Wilcoxon rank sum test to compare NA versus GA cohorts. Main results The final analysis included 798 BTHA patients, of which 35% received NA as the primary anesthetic. The median age was 58 years old and 50.8% were female. The rate of perioperative transfusion in the NA and GA group were 20.1% and 29.0%, respectively (p = 0.02). There were no significant differences in the rate of postoperative outcomes between patients receiving NA versus GA as their primary anesthesia type (Bonferroni corrected p Conclusion Our study showed no significant differences in postoperative outcomes between NA versus GA following BTHA. Further studies are needed to investigate outcomes among this surgical population.
Neuromodulation targets pathological not physiological beta bursts during gait in Parkinson's disease

Abstract Freezing of gait (FOG) is a devastating axial motor symptom in Parkinson's disease (PD) leading to falls, institutionalization, and even death. The response of FOG to dopaminergic medication and deep brain stimulation (DBS) is complex, variable, and yet to be optimized. Fundamental gaps in the knowledge of the underlying neurobiomechanical mechanisms of FOG render this symptom one of the unsolved challenges in the treatment of PD. Subcortical neural mechanisms of gait impairment and FOG in PD are largely unknown due to the challenge of accessing deep brain circuitry and measuring neural signals in real time in freely-moving subjects. Additionally, there is a lack of gait tasks that reliably elicit FOG. Since FOG is episodic, we hypothesized that dynamic features of subthalamic (STN) beta oscillations, or beta bursts, may contribute to the Freezer phenotype in PD during gait tasks that elicit FOG. We also investigated whether STN DBS at 60 Hz or 140 Hz affected beta burst dynamics and gait impairment differently in Freezers and Non-Freezers. Synchronized STN local field potentials, from an implanted, sensing neurostimulator (Activa® PC + S, Medtronic, Inc.), and gait kinematics were recorded in 12 PD subjects, off-medication during forward walking and stepping-in-place tasks under the following randomly presented conditions: NO, 60 Hz, and 140 Hz DBS. Prolonged movement band beta burst durations differentiated Freezers from Non-Freezers, were a pathological neural feature of FOG and were shortened during DBS which improved gait. Normal gait parameters, accompanied by shorter bursts in Non-Freezers, were unchanged during DBS. The difference between the mean burst duration between hemispheres (STNs) of all individuals strongly correlated with the difference in stride time between their legs but there was no correlation between mean burst duration of each STN and stride time of the contralateral leg, suggesting an interaction between hemispheres influences gait. These results suggest that prolonged STN beta burst durations measured during gait is an important biomarker for FOG and that STN DBS modulated long not short burst durations, thereby acting to restore physiological sensorimotor information processing, while improving gait.
Reported obstructive sleep apnea does not diminish the cardiometabolic health benefits from a comprehensive lifestyle intervention program.

Obstructive sleep apnea (OSA) commonly coexists with the metabolic syndrome, a condition for which behavioral changes are often prescribed. Whether OSA diminishes the cardiometabolic health benefits from lifestyle interventions remains unclear. We evaluated 278 consecutive metabolic syndrome participants enrolled in a 12-week comprehensive lifestyle intervention program. The changes in blood pressure (BP), along with other metabolic health parameters, from baseline to follow-up were compared between those with and without OSA. Mean age was 52.4 ± 10.9 years and 37% were male. At enrollment, mean body mass index (BMI) was 38.2 ± 7.7 kg/m2 . OSA was reported in 126 of 269 final participants (47%). At baseline, participants with reported OSA were more likely to be male, older, have a higher BMI, waist and neck size (all P < 0.05). At program completion, participants with (-5.8 ± 16.1/-3.0 ± 10.0 mm Hg) and without OSA (-4.7 ± 13.1/-3.3 ± 8.2 mm Hg) had significant reductions in systolic and diastolic BP as well as BMI, fasting glucose, and triglyceride levels. There were no significant differences in the absolute or percentage changes in BP or other metabolic parameters between groups. Our findings support that patients with the metabolic syndrome can derive substantial health benefits, including reductions in BP, by a lifestyle intervention program regardless of the presence of OSA.
Multi-modal Educational Curriculum to Improve Richmond Agitation-sedation Scale Inter-rater Reliability in Pediatric Patients.

Introduction The Richmond Agitation-sedation Scale (RASS) is a reliable and valid scale for assessing sedation in critically ill pediatric patients. This investigation evaluates the inter-rater reliability of the RASS in mechanically ventilated pediatric patients before and after an educational intervention. Methods This prospective, interventional quality improvement study was completed in a 20-bed pediatric intensive care unit from July 2013 to July 2014. Children 0-18 years of age requiring mechanical ventilation and receiving sedative or analgesic medications were eligible. Staff completed simultaneous paired RASS assessments in 3 phases: baseline, after educational intervention, and maintenance. Results Staff completed 347 paired assessments on 45 pediatric intensive care unit patients: 49 in the baseline phase, 228 in the postintervention phase, and 70 in the maintenance phase. There was a significant increase in the weighted κ after the intervention, from 0.56 (95% CI, 0.39-0.72) to 0.86 (95% CI, 0.77-0.95; P < 0.001). The improvement was maintained months later with weighted κ 0.78 (95% CI, 0.61-0.94). In subgroup analysis, there was an increase in weighted κ in patients less than 1 year of age (0.41-0.87) and those with developmental delay (0.49-0.84). Conclusions The RASS is a reliable tool for sedation assessment in mechanically ventilated, sedated pediatric patients after implementation of an educational intervention. It is also reliable in patients less than 12 months of age and patients with developmental delay. The ability to easily educate providers to utilize a valid, reliable sedation tool is an important step toward using it to provide consistent care to optimize sedation.
A new approach for software correctness and reliability (keynote)

Software correctness and security have been a central issue in the field for decades. Researchers have developed a wide range of approaches to these problems, none of which has solved these problems to date. In this talk I consider two very different approaches to solving correctness and security problems, failure-oblivious computing and domain-specific languages. I will discuss how these approaches (as well as others) interact with the cognitive limitations and available technical skills of the human population of software developers that currently must be part of any solution for it to be successful. I’ll conclude by outlining a new approach that, by deploying automated programming language technology in an appropriately targeted way, may interact more productively with the characteristics of the developer population as a whole.
Consensus Building and Its Epistemic Conditions

Most of the epistemological debate on disagreement tries to develop standards that describe which actions or beliefs would be rational under specific circumstances in a controversy. To build things on a firm foundation, much work starts from certain idealizations—for example the assumption that parties in a disagreement share all the evidence that is relevant and are equal with regard to their abilities and dispositions. This contribution, by contrast, focuses on a different question and takes a different route. The question is: What should people actually do who find themselves in deep disagreement with others? And instead of building theory on some “firm foundation,” the paper starts from a specific goal—building consensus by creating new proposals—and asks, first, which actions are suitable to achieve this goal and, second, what are the epistemic conditions of these actions. With regard to the latter, the paper focuses on what has been called framing and reframing in conflict research, and argues that both metaphors need and deserve a suitable epistemological conceptualization.
Simultaneous and precise generation of Zebra3 and Wsl5 mutations in rice using CRISPR/Cas9-mediated adenine base editors

Abstract The CRISPR/Cas9-mediated base editing technology can efficiently generate point mutations in the genome without introducing double-strand break (DSB) or supplying a DNA donor template for homology-dependent repair (HDR). In this study, adenine base editors (ABEs) were used for rapid generation of precise point mutations in two distinct genes, OsWsl5, and OsZebra3 (Z3), in rice protoplasts and regenerated plants. The precisely engineered point mutations were stably inherited to subsequent generations. These single nucleotide alterations resulted in single amino acid changes and associated wsl5 and z3 phenotypes as evidenced by white stripe leaf and light green/dark green leaf pattern, respectively. Through selfing and segregation, transgene-free, base edited wsl5 and z3 mutants were readily obtained in a short period of time. We noticed a novel mutation (V540A) in Z3 locus could mimic the phenotype of Z3 mutation (S542P). Furthermore, we observed unexpected non-A/G or T/C mutations in the ABE editing window in a few of the edited plants. The ABE vectors and the method from in this study could be used to simultaneously generate point mutations in multiple genes in a single transformation and serve as a useful base editing tool for crop improvement as well as basic studies in plant biology. Highlights Adenine base editors were adapted for plant base editing that can generate precise and heritable point mutations in rice genome without indel formation. The base editing approach allows rapid generation of transgene-free rice mutants with expected phenotypic changes.
Late Thermal Pulse Models and the Rapid Evolution of V839 Ara

We present evolution calculations from the Asymptotic Giant Branch (AGB) to the Planetary Nebula (PNe) phase for models of mass 1.0 to 2.0 M⊙ over a range of metallicities. The understanding of these objects plays an important role in galactic evolution and composition. Here, we particularly focus on Late Thermal Pulse (LTP) models, which are models that experience an intense helium-shell pulse that occurs just following AGB departure and causes a rapid looping evolution between the AGB and PN phases. The transient phases only last decades and centuries while increasing and decreasing in temperature dramatically. We use our models to make comparisons to V839 Ara (SAO 244567). This star has been observed rapidly heating over more than 50 years. Observations have proven difficult to model because the central star has a small radius, high surface gravity, and low temperature compared to our models.
Temporal rise in the proportion of younger adults and older adolescents among COVID-19 cases in Germany: evidence of lesser adherence to social distancing practices?

Background: There is uncertainty about the role of different age groups in propagating the SARS-CoV-2 epidemics in different countries. Methods: We used the Koch Institute data on COVID-19 cases in Germany. To minimize the effect of changes in healthcare seeking behavior and testing practices, we included the following 5-year age groups in the analyses: 10-14y through 45-49y. For each age group g, we considered the proportion PL(g) of individuals in age group g among all detected cases aged 10-49y during weeks 13-14, 2020 (later period), as well as corresponding proportion PE(g) for weeks 10-11, 2020 (early period), and the relative risk RR(g)=PL(g)/PE(g). For each pair of age groups g1,g2, a higher value of RR(g1) compared to RR(g2) is interpreted as the relative increase in the population incidence of SARS-Cov-2 for g1 compared to g2 for the later vs. early period. Results: The relative risk was highest for individuals aged 20-24y (RR=1.4(95% CI (1.27,1.55))), followed by individuals aged 15-19y (RR=1.14(0.99,1.32)), aged 30-34y (RR= 1.07(0.99,1.16)), aged 25-29y (RR= 1.06(0.98,1.15)), aged 35-39y (RR=0.95(0.87,1.03)), aged 40-44y (RR=0.9(0.83,0.98)), aged 45-49y (RR=0.83(0.77,0.89)) and aged 10-14y (RR=0.78(0.64,0.95)). Conclusions: The observed relative increase with time in the prevalence of individuals aged 15-34y (particularly those aged 20-24y) among COVID-19 cases is unlikely to be explained by increases in the likelihood of seeking medical care/being tested for individuals in those age groups compared to individuals aged 35-49y or 10-14y, suggesting an actual increase in the prevalence of individuals aged 15-34y among SARS-CoV-2 infections in the German population. That increase likely reflects elevated mixing among individuals aged 15-34y (particularly those aged 20-24y) compared to other age groups, possibly due to lesser adherence to social distancing practices.
46 – Acoustic Transduction

Publisher Summary This chapter discusses acoustic transduction. The chapter focuses on cellular aspects of acoustic transduction in the auditory periphery. It is mentioned that information on the function of the mammalian cochlea is derived from experiments performed on preparations from the vestibular labyrinth of mammals, birds, and amphibians, and from the cochlea of birds. The chapter discusses several concepts, including inner ear structure of mammals, cell physiology of endolymph homeostasis and cell physiology of acoustic transduction. Cell physiology of endolymph homeostasis further discusses composition, stria vascularis, and outer sulcus epithelium. The cellular bases of hearing in the auditory periphery were described with emphasis on the sensory hair cells and on cells of the stria vascularis. The latter is a complex structure responsible both for the generation of a lumen-positive electrical potential and for the secretion of potassium to an unusually high level in the cochlear lumen. Transduction of sound waves into neural impulses by the hair cells relies on modulation of an electric current carried by potassium flowing through the hair cells. The ion channels, carriers, and pumps in the marginal cell membranes, which accounts for constitutive potassium secretion are described in the chapter. A wide variety of extracellular and cytosolic signaling pathways that regulate the rate of potassium secretion are also described. The specializations of hair cell physiology are discussed, including the transduction channel in the sensory cilia and the highly unusual lateral membrane motors of OHCs. The description of the physiological mechanisms employed by inner ear epithelial cells is related in the chapter to the function of the organ as a whole.
Abstract IA17: Patient-derived organoid models of bladder cancer

The molecular mechanisms of bladder tumorigenesis are poorly understood, in part due to the lack of suitable model systems that reflect the biology of human bladder cancer. In our studies, we have used three-dimensional culture approaches to establish a novel biobank of human patient-derived organoids from primary bladder tumors. These organoid lines recapitulate the histopathologic and molecular diversity of non-muscle invasive bladder cancer as well as muscle-invasive bladder cancer, and can be readily converted into xenografts by orthotopic transplantation. These organoid lines can be propagated by serial passaging in culture while maintaining their tumor properties and display mutational profiles that are highly concordant with their parental tumors. Notably, organoid lines often retain parental tumor heterogeneity and exhibit a spectrum of genomic changes that are consistent with tumor evolution in culture. Furthermore, we have shown that these organoid lines are highly amenable for analyses of drug response, which can be validated in vivo using orthotopic xenografts. I will discuss our recent findings using patient-derived tumor organoid lines to investigate bladder cancer biology and drug response, including ongoing analyses of tumor plasticity and the basis for tumor recurrence. Citation Format: Michael M. Shen. Patient-derived organoid models of bladder cancer [abstract]. In: Proceedings of the AACR Special Conference on Bladder Cancer: Transforming the Field; 2019 May 18-21; Denver, CO. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(15_Suppl):Abstract nr IA17.
Is it all in my neck? ‐ Bipolar disorder with mixed features and suicidal ideation related to thyrotoxicosis: A case report

Thyroid dysfunctions must be suspected in patients with mood episodes. Thyrotoxicosis may manifest as manic episodes with mixed features, with a severe presentation, including suicidality. Patients with affective disorders should be screened for thyroidopathy. A strategy combining thionamides, betablockers and psychotropics may lead to an efficient stabilization of mood symptoms.
Daten-Software ist noch lange keine CRM-Lösung: Customer Relationship Management

Der Erfolg des Kunden-Beziehungs-Managements hangt von der Qualitat des Modells ab. Data Warehouse und Data Mining sind umfassende CRM-Systeme, die auf Database-Marketing aufbauen und variable Kundendaten analysieren und zusammen fuhren.
Efficacy and safety of mycophenolate mofetil in the treatment for IgA nephropathy: a meta-analysis of randomized controlled trials

IgA nephropathy is virtually known as the most common glomerulopathy to end-stage renal failure in the world. Mycophenolate mofetil is a selective immunosuppressant widely used in organ transplantation, yet its tolerance and effectiveness in IgAN is controversial. This is a systematic review and random-effects meta-analysis, searching PubMed, Embase, Te Cochrane Library, Science Citation Index, Ovid evidence-based medicine, Chinese Biomedical Literature and Chinese Science and Technology Periodicals. Screen out randomized controlled trials on patients with biopsy-proven IgA nephropathy and analysis mycophenolate mofetil treatment regimens used for therapy of IgA nephropathy. Complete remission and partial remission, doubling of creatinine level, proteinuria, incidence of end-stage kidney disease, infection, Cushing syndrome, diabetes, hepatic dysfunction or gastrointestinal symptoms, neurologic or visual ambiguity, acne, and alopecia were observed. Nine relevant trials were conducted with 587 patients enrolled. In Mycophenolate mofetil or plus medium/low-dose steroid comparing full-dose steroid alone or placebo, there was no significant difference. The risk of Cushing syndrome and diabetes had been significantly lowered with Mycophenolate mofetil-treated patients, while the risk of infection had been increased. Mycophenolate mofetil therapy did not differ in reducing proteinuria and Scr in patients with IgAN who had persistent proteinuria, while having fewer Cushing syndrome and diabetes risk and more infection risk. However, larger randomized studies are needed to reveal these results.
Ultrasonographic Assessment of Extravascular Lung Water in Hospitalized Patients Requiring Hemodialysis: A Prospective Observational Study.

INTRODUCTION Sonographic technologies can estimate extravascular lung water (EVLW) in hemodialysis (HD) patients. This study investigated the suitability of a handheld scanner in contrast to a portable scanner for quantifying EVLW in hospitalized patients requiring HD. METHODS In this prospective study, 54 hospitalized HD patients were enrolled. Bedside lung ultrasound was performed within 30 min before and after dialysis using handheld (phased array transducer, 1.7-3.8 MHz) and portable (curved probe, 5-2 MHz) ultrasound devices. Eight lung zones were scanned for total B-lines number (TBLN). The maximum diameter of inferior vena cava (IVC) was measured. We performed Passing-Bablok regression, Deming regression, Bland-Altman, and logistic regression analysis. RESULTS The 2 devices did not differ in measuring TBLN and IVC (p > 0.05), showing a high correlation (r = 0.92 and r = 0.51, respectively). Passing-Bablok regression had a slope of 1.11 and an intercept of 0 for TBLN, and the slope of Deming regression was 1.02 within the CI bands of 0.94 and 1.11 in the full cohort. TBLN was logarithmically transformed for Bland-Altman analysis, showing a bias of 0.06 (TBLN = 1.2) between devices. The slope and intercept of the Deming regression in IVC measurements were 0.77 and 0.46, respectively; Bland-Altman plot showed a bias of -0.07. Compared with predialysis, TBLN significantly (p < 0.001) decreased after dialysis, while IVC was unchanged (p = 0.16). Univariate analysis showed that cardiovascular disease (odds ratio [OR] 8.94 [2.13-61.96], p = 0.002), smoking history (OR 5.75 [1.8-20.46], p = 0.003), and right pleural effusion (OR 5.0 [1.2-25.99], p = 0.03) were strong predictors of EVLW indicated by TBLN ≥ 4. CONCLUSION The lung and IVC findings obtained from handheld and portable ultrasound scanners are comparable and concordant. Cardiovascular disease and smoking history were strong predictors of EVLW. The use of TBLN to assess EVLW in hospitalized HD patients is feasible. Further studies are needed to determine if TBLN can help guide volume removal in HD patients.
Diagnosis and antimicrobial susceptibility of Campylobacter species.

Patients with Campylobacter infection may manifest signs and symptoms of acute appendicitis and result in unnecessary surgery. Bacteremia, endocarditis, meningitis, urinary tract infection, and other extraintestinal diseases may result from Campylobacter infections. Fecal samples should routinely be submitted to the laboratory for isolation of Campylobacter species from patients with diarrheal illness. Commercial blood culture systems such as the BACTEC system (aerobic bottles) and Septi-Chek system support the growth of the common Campylobacter species. Advantages of molecular approaches over culture include same-day detection, additional data regarding mixed infections, and uncommonCampylobacter species that are often missed when routine culture and procedures that are amenable to automation and high-throughput capabilities are used. A microaerobic atmosphere containing approximately 5% O2, 10% CO2, and 85% N2 is required for optimal recovery of most Campylobacter species. Campylobacter species are difficult to identify phenotypically because of relative biochemical inactivity, special growth requirements, and complex taxonomy. The 16S rRNA gene and 23S rRNA gene are two widely used targets for the design of species-specific tests; PCR assays based on these targets have been described for 12 different Campylobacter species. Fluoroquinolones had good in vitro activity for all Campylobacter species as well as for members of the family of Enterobacteriaceae. Little information is available on the antimicrobial susceptibility of C. concisus. Multidrug resistance in Campylobacter appears to be occurring more frequently and poses the risk that an effective antimicrobial regimen to treat infection may be lacking.
Stress waves measured and calculated for in situ explosive rubblization experiments in oil shale

A three-part ''bore-springing'' experiment to rubblize Green River formation oil shale was conducted near Rock Springs, Wyoming. The experiment involved the detonation of a cylindrical explosive charge at the bottom of a 60 m deep well, the detonation of a second charge in the now expanded cavity of this same well, and the detonation of a third charge at the bottom of a similar well 5 m away. Transient stress in the oil shale was monitored with lithium niobate (piezoelectric) and ytterbium (piezoresistive) gages in wells 5 and 10 m from the explosive wells. The stress fields were also calculated using a two-dimensional wave code, CSQ. The paper correlates measurements and calculations, with emphasis given to borehole expansion, stress wave propagation, and fracture distribution. Realistic prediction of the stress field is demonstrated.
Risk Assessment and Life Prediction of Complex Engineering Systems

Many complex engineering systems will exceed their design life expectancy within the next 10 to 15 years. It is also expected that these systems must be maintained and operated beyond their design life. This paper presents a integrated approach for managing the risks associated with aging effects and predicting the residual-life expectancy these systems. The approach unifies risk assessment, enhanced surveillance and testing, and robust computational models to assess the risk, predict age, and develop a life-extension management procedure. It also relies on the state of the art in life-extension and risk assessment methods from the nuclear power industry. Borrowing from the developments in decision analysis, this approach should systematically identify the options available for managing the existing aging systems beyond their intended design life.
An Agent Framework for Intranet Document Management

Document management inside an organization is a complex and broadly scoped problem. This paper approaches the technical and social issues of Intranet document management by developing a straightforward document lifecycle model consisting of five phases: creation, publication, organization, access, and destruction. A document management system (DMS) which encompasses these areas should also have an evaluation component so its effectiveness can be measured. The document lifecycle is visualized as a waterfall model to help explore the discrete phases of an idealized Intranet DMS. The discussion of this model pinpoints where traditional DMS have fallen short, most notably in the areas of user-to-user and user-to-evaluator communication and coordination. From the document lifecycle, we derive an agent framework to integrate technical and social considerations and guide the design, implementation, and evaluation of a flexible and efficient DMS. The lifecycle model and agent framework are useful to organize both technical and social perspectives in this area.
Using ultrasound and amniotic fluid determinations to diagnose intrauterine growth retardation before birth: a clinical model

Intrauterine growth retardation, a major source of fetal/infant morbidity and mortality, remains difficult to detect reliably before birth. In a previous study from our laboratory, determination of the presence of phosphatidylglycerol (PG) in amniotic fluid was found to be potentially useful for separating the growth-retarded fetus from the appropriately grown fetus of similar size. In the current study, this finding was confirmed and a clinical model for applying this method of detecting the small-for-gestational age (SGA) fetus was developed. Among 249 pregnancies in which ultrasound examination and amniocenteses were performed at or beyond 34 weeks' gestation and within a week of delivery, a fetal biparietal diameter of less than or equal to 87 mm and the presence of PG in amniotic fluid were found to be capable of detecting 80% of all SGA fetuses. Moreover, one half of the predictions of the birth of an SGA infant would have been correct. A positive screen with the use of this model was associated with a fifteen fold increase in risk for the birth of an SGA infant. These findings suggest a series of diagnostic steps to improve the antenatal detection of the growth-retarded fetus. (1) The clinician should assess risks and have a high index of suspicion. (2) When the at-risk pregnancy is thought to be at least 34 weeks, ultrasound examination may be helpful in confirming that the fetus is small. (3) Carefully amniocentesis, with the determination of PG, may then be useful in diagnosing intrauterine growth retardation.
The Use of Motor Evoked Potentials in the Diagnosis of Psychogenic Quadriparesis

We present a case illustrating the usefulness of motor evoked potentials (MEPs) in differentiating psychogenic from organic postoperative paralysis. Discussed is a 12-year-old girl who underwent surge
Responses of Blueback Herring Eggs and Larvae to Pulses of Acid and Aluminum

Abstract We measured the sensitivity of eggs and yolk-sac larvae of blueback herring Alosa aestivalis to acid and aluminum pulses in moderately soft fresh water (23–25 mg/L, hardness as CaCO3) during 96-h experiments in the laboratory. Over a 3-h period, pH was reduced from 7.4–7.7 to 5.5–5.6, coincident with an increase in aluminum from 0 to 0.10, 0.15, 0.20, or 0.25 mg/L. These pH-aluminum conditions were maintained for five single-pulse durations (0.5, 4, 8, 12, 24 h) and then gradually returned to control conditions within 8–10 h. Relatively mature embryos (20–24 h postfertilization, early tail-bud stage) were more tolerant than larvae to all treatments. Eggs exposed to a 24-h pulse of pH 5.5–5.6 and 0.20 mg/L total aluminum (predicted total monomeric aluminum, 0.09 mg/L) experienced the highest mortality observed for this life stage, 48%. Larvae tolerated single pulses of pH 5.5–5.6 (without aluminum) for up to 12 h, but mortality doubled (25% to 49%) when pulse duration doubled (12 h to 24 h). Pulse...
Weak estrogenic activity from continuous-release pellets

In the process of evaluating a proprietary compound for weak estrogenic activity, two different types of dosing regimens were used, repeated daily dosing (three times/d) and continuous-release pellets. In studies using the proprietary compound, rats that were dosed via intraperitoneal injection showed no estrogenic responses, while those receiving the test compound via continuous-release pellets displayed several estrogenic responses. Because of the conflicting results, the control pellets were evaluated for estrogenic activity in the same battery of tests using the same number of pellets. In studies using only the control pellets, several estrogenic responses were observed including increased uterine weight, uterine stromal cell proliferation, estrous conversion, uterine progesterone receptor content, and decreased uterine estrogen receptor content. Animals receiving no pellet implant showed no estrogenic responses. In addition, a methylene chloride/DMSO extract of the control pellets promoted expression of a reporter gene controlled by the estrogen receptor and demonstrated competition with 17 beta-estradiol for binding to the human estrogen receptor. It is concluded that component(s) of the control pellets possess weak estrogenic activity.
Fetal-specific forms of alpha 1-protease inhibitors in mouse plasma.

ABSTRACT: Adult mouse plasma contains two distinct al-protease inhibitors (α1-PIs), which we have called α1-PI(E) and α1-PI(T) because of their differing specificities for elastase and trypsin. Plasma levels of the two mouse inhibitors, determined either functionally or immunologically, are lower in fetal animals than in adults. Western blotting after sodium dodecyl sulfate-polyacrylamide gel electrophoresis, using specific, polyclonal antibodies raised to the inhibitors in adult plasma shows new immunoreactive species of both α1-PI(T) and α1-PI(E) in fetal mouse plasma with apparent molecular weights approximately 1 kDa less than the corresponding proteins in adult plasma. In both cases the fetal α1-PI is replaced by the adult protein between 2 and 6 days after birth. After chemical deglycosylation, the molecular weight difference between the adult and fetal forms of α1-PI(E) and α1-PI(T) is retained, suggesting that the adult and fetal mouse α1-PIs have different amino acid sequences. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the protease inhibitors, cleaved specifically at the protease binding site, indicated that the difference in sequence between the adult and fetal proteins resided in the 50–60 kDa N-terminal fragment.
The problem of automated theorem finding

This article is the twenty-fifth of a series of articles discussing various open research problems in automated reasoning. The problem proposed for research asks one to identify appropriate properties to permit an automated reasoning program tofind new and interesting theorems, in contrast toproving conjectured theorems. Such programs are now functioning in many domains as valuable reasoning assistants. A sharp increase in their value would occur if they could also be used as colleagues to (so to speak) produce research on their own.
Methods for graft size selection in aortic valve-sparing operations

Simple and reproducible methods for accurate restoration of aortic root dimensions during aortic valve-sparing operations are described. The methods are based on choice of an appropriate size vascular graft based on the measured or desired diameter of the aortic annulus.
Knowing Jazz: Community, Pedagogy, and Canon in the Information Age

How are we to learn about jazz and teach it, and what can we know about it? From whose perspective are we to “know,” and who holds the definitions of the jazz canon, traditions, or the best keys to...
SU‐E‐T‐23: A Novel Two‐Step Optimization Scheme for Tandem and Ovoid (T&O) HDR Brachytherapy Treatment for Locally Advanced Cervical Cancer

Purpose: To present a novel method allowing fast, true volumetric optimization of T and O HDR treatments and to quantify its benefits. Materials and Methods: 27 CT planning datasets and treatment plans from six consecutive cervical cancer patients treated with 4–5 intracavitary T and O insertions were used. Initial treatment plans were created with a goal of covering high risk (HR)-CTV with D90 > 90% and minimizing D2cc to rectum, bladder and sigmoid with manual optimization, approved and delivered. For the second step, each case was re-planned adding a new structure, created from the 100% prescription isodose line of the manually optimized plan to the existent physician delineated HR-CTV, rectum, bladder and sigmoid. New, more rigorous DVH constraints for the critical OARs were used for the optimization. D90 for the HR-CTV and D2cc for OARs were evaluated in both plans. Results: Two-step optimized plans had consistently smaller D2cc's for all three OARs while preserving good D90s for HR-CTV. On plans with “excellent” CTV coverage, average D90 of 96% (range 91–102), sigmoid D2cc was reduced on average by 37% (range 16–73), bladder by 28% (range 20–47) and rectum by 27% (range 15–45). Similar reductions were obtained on plans with “good” coverage,more » with an average D90 of 93% (range 90–99). For plans with inferior coverage, average D90 of 81%, an increase in coverage to 87% was achieved concurrently with D2cc reductions of 31%, 18% and 11% for sigmoid, bladder and rectum. Conclusions: A two-step DVH-based optimization can be added with minimal planning time increase, but with the potential of dramatic and systematic reductions of D2cc for OARs and in some cases with concurrent increases in target dose coverage. These single-fraction modifications would be magnified over the course of 4–5 intracavitary insertions and may have real clinical implications in terms of decreasing both acute and late toxicity.« less
Assessing impact of urban impervious surface on watershed hydrology using distributed object-oriented simulation and spatial regression

In this study, we investigated the relation- ship between watershed characteristics and hydrology using high spatial resolution impervious surface area (ISA), hydrologic simulations and spatial regression. We selected 20 watersheds at HUC 12 level with different degrees of urbanization and performed hydro- logic simulation using a distributed object-oriented rainfall and runoff simulation model. We extracted the discharge per area and ratio of runoff to base flow from simulation results and used them as indicators of hydrology pattern. We derived percentage of ISA, distance from ISA to streams, and stream density as the watershed characteristics to evaluate the relationship with hydrology pattern in watersheds using ordinary least square, spatial error and spatial lag regression models. The comparison indicates that spatial lag regression model can achieve better performance for the evaluation of relationship between ratio of runoff to base flow and watershed characteristics, and that three models provide similar performance for the evaluation of relationship between discharge per area and watershed characteristics. The results from regression analyses demonstrate that ISA plays an important role in watershed hydrology. Ignorance of spatial dependence in analyses will likely cause inaccurate evaluation for relationship between ISA and watershed hydrology. The hydrologic model, regression methods and relationships between watershed characteristics and hydrology pat- tern provide important tools and information for deci- sion makers to evaluate the effect of different scenarios in land management.
Improving accuracy in binding site comparison with homology modeling

Conformational changes make the comparison of protein structures difficult. Algorithms that identify small differences in protein structures to identify influences on specificity are particularly affected by molecular flexibility. However, such algorithms typically compare proteins with identical function and varying specificity, causing them to focus on closely related proteins rather than the remote evolutionary homologs sought by most comparison algorithms. This focus inspired us to ask if structure prediction algorithms, which more accurately predict the structures of close evolutionary neighbors, can be used to "remodel" existing structures with the same template, to make the comparison of their binding sites more accurate. Our results, on the enolase superfamily and the tyrosine kinases, reveal that this approach to error reduction is indeed possible, enabling our methods to identify influences on specificity in protein structures that originally could not be compared.
Hydrogen ion speciation in the acid precipitation of the northeastern United States

The acidity of precipitation in rural, forested areas of the northeastern United States is dominated by the strong mineral acids: H2SO4 and HN03. Weak acids have a negligible effect on the measured acidity (pH) of precipitation. These conclusions are based on total acidity titrations and detailed analysis of organic and inorganic components in precipitation.