cssi/SciSciGPT-SciSciNet huggingface dataset:
Cerebral Hemodynamics in Asphyxiated Newborns Undergoing Hypothermia Therapy: Pilot Findings Using a Multiple-Time-Scale Analysis

Abstract Background Improved quantitative assessment of cerebral hemodynamics in newborns might enable us to optimize cerebral perfusion. Our objective was to develop an approach to assess cerebral hemodynamics across multiple time scales during the first 72 hours of life in newborns during hypothermia therapy. Methods Spontaneous oscillations in mean arterial pressure and regional cerebral tissue oxygen saturation were analyzed using a moving window correlation method with time scales ranging from 0.15 to 8 hours in this pilot methodology study. Abnormal neurodevelopmental outcome was defined by Bayley III scores and/or cerebral palsy by age 24 months using receiver operating curve. Results Multiple-time-scale correlations between the mean arterial pressure and regional cerebral tissue oxygen saturation oscillations were tested in 10 asphyxiated newborns undergoing hypothermia therapy. Large noninduced fluctuations in the blood pressure were observed during cooling in all five infants with abnormal outcomes. Notably, these infants had two distinct patterns of correlation: a positive in-phase correlation at the short time scales (15 minutes) and/or a negative antiphase correlations observed at long time scales (4 hours.). Both the in-phase (area under the curve 0.6, [95% confidence interval 0.2-0.95]) and antiphase correlations (area under the curve 0.75, [95% confidence interval 0.4-0.95]) appeared to be related to an abnormal outcome. Conclusions Our observations suggest that the time scale is an important factor that needs to be standardized in the assessment of neonatal cerebral hemodynamics.
An empirical investigation of program spectra

A variety of expensive software maintenance and testing tasks require a comparison of the behaviors of program versions. Program spectra have recently been proposed as a heuristic for use in performing such comparisons. To assess the potential usefulness of spectra in this context, we conducted an experiment that examined the relationship between program spectra and program behavior, and empirically compared several types of spectra. This paper reports the results of that experiment.
Cognitive-Behavioral Therapy for Body Dysmorphic Disorder by Proxy ☆

Body dysmorphic disorder (BDD) is a distressing or impairing preoccupation with a perceived defect in physical appearance. BDD by proxy (BDDBP) is a significant but understudied variant of BDD in which the primary preoccupation involves perceived imperfections of another person. Like BDD, individuals with BDDBP engage in time-consuming rituals to "fix" the other person's appearance or alleviate distress. Avoidance is common and the impact of BDDBP on social functioning is profound. Cognitive-behavioral therapy (CBT) is the best-studied and most promising psychological treatment for BDD, but no studies have examined its generalizability to the BDDBP variant. We tested feasibility, acceptability, and treatment outcome of CBT modified for BDDBP in a sample of 6 adults with primary BDDBP. Treatment was delivered in weekly individual sessions over 12-20weeks. Mean symptom severity (BDDBP-YBOCS) dropped from the moderately severe range at pretreatment to the subclinical range at posttreatment, t(6)=10.7, p<.001, d=3.3. One hundred percent of treatment completers were responders (≥30% reduction in BDDBP-YBOCS). Insight also improved. Treatment gains were maintained at 3-month follow-up. To our knowledge, this represents the first treatment study for BDDBP.
Aminoglycosides for Treatment of Bacteremia Due to Carbapenem-Resistant Klebsiella pneumoniae

Aminoglycoside treatment of carbapenem-resistant (CR) Klebsiella pneumoniae bacteremia was associated with a 70% rate (23/33) of 30-day survival. Successful treatment was associated with sources of bacteremia amenable to reliable aminoglycoside pharmacokinetics (P = 0.037), acute physiology and chronic health evaluation II (APACHE II) scores of <20 (P = 0.16), and nonfatal underlying diseases (P = 0.015). Success rates were 78% and 100% if ≥2 and all 3 factors were present, respectively. Clinicians may consider the use of aminoglycosides against CR K. pneumoniae bacteremia if strains are susceptible and the sources of infection are amenable to reliable pharmacokinetics.
ASIC3 Contributes to the Blunted Muscle Metaboreflex in Heart Failure

Introduction During exercise, the sympathetic nervous system is activated and blood pressure and heart rate increase. In heart failure (HF), the muscle metaboreceptor contribution to sympathetic outflow is attenuated and the mechanoreceptor contribution is accentuated. Previous studies suggest that lactic acid stimulates acid sensing channel subtype 3 (ASIC3), inducing a neurally mediated pressor response. Thus, we hypothesized that the pressor response to ASIC3 stimulation is smaller in HF rats due to attenuation in expression and function of ASIC3 in sensory nerves.
Abstract 1273: Metabolic networks and the role of LDHB in breast cancer

Proceedings: AACR 102nd Annual Meeting 2011‐‐ Apr 2‐6, 2011; Orlando, FL Gene expression data of breast cancer cell lines and patient tumors reveal several distinct subtypes that demonstrate different metabolic phenotypes. Our goal was to determine what metabolism genes contribute to the metabolic phenotypes. We hypothesized that dichotomous expression of metabolism genes would identify key drivers of cell metabolism. To select candidate genes, we completed a bimodal analysis using microarray data from 59 breast cancer cell lines. To generate a metabolic network, dichotomous genes were selected from known or probable metabolic networks including electron transport, TCA cycle, nutrient transport, pentose phosphate shunt, energy requiring pathways, and glycolysis. Two groups of dichotomously expressed genes emerged from this analysis: TCA cycle anaplerotic genes (including PFKP, GLS) and cataplerotic/biosynthetic genes (including FASN, GLUL, and FBP1). The gene with the highest bimodal index was LDHB that encodes lactate dehydrogenase B. For breast cancer cell lines, LDHB mRNA and protein were most highly expressed in ER-, glycolytic cell lines. LDHB is reported by others to be part of a “MYC signature,” and consistent with this hypothesis, for ER- cell lines, LDHB mRNA levels were highly associated with MYC and glutaminase, a metabolic down-stream target of MYC. For patient tumors, LDHB mRNA expression was also bimodal with the highest expression in basal-like cancers. Elevated expression of LDHB mRNA predicted worse clinical outcomes for patients with Her2 positive and triple negative tumors. Compared to normal-like breast tissue from patients, LDHB mRNA expression was elevated in triple negative tumors. We conclude that LDHB may be a target of MYC and contribute to the glycolytic phenotype of triple-negative tumors. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1273. doi:10.1158/1538-7445.AM2011-1273
A New Atom Economic Approach of Introducing Amine Functionality on a Porous Carbon Surface for Application as an Efficient Base Catalyst

Amination of mesoporous carbon nanocage surface has been realized by a novel, atom economic and environment friendly protocol. The aminated mesoporous carbon shows a high activity in the base catalysed synthesis of flavanones.
Good Timing? How One Bank Cut Its Link to a $1.2 Billion Ponzi Scheme

On September 17, 2009, Boston Private Financial Holdings (BPFH) sold its Coral Gables, Florida based Gibraltar Private Bank & Trust subsidiary for $93 million. On October 27, 2009, Scott Rothstein fled to Morocco on a private jet before turning himself in to authorities. Mr. Rothstein has subsequently pled guilty to running a $1.2 billion Ponzi scheme with substantial deposits at Gibraltar Bank. Scott Rothstein had a 5 percent equity stake in the group that bought Gibraltar Bank from BPFH. Investors cheered the news of the sale producing a 27 percent one-day return after the Gibraltar Bank sale was released, adding over $100 million of market value overnight. Using a geometric Brownian motion model of the stock price, we find there was almost no chance that this was a random swing in the stock price. This sale, nevertheless, may not shield BPFH from legal liability from Mr. Rothstein’s four-year Ponzi scheme.
Deliberate Charge Conjugation Symmetry Breaking for π-Conjugated Electron Acceptor Design

Scientific progress in searching for new π-conjugated electron-accepting materials has been greatly limited to the commonly used fullerene-based structures. In this work, a fundamental link is established between frustrated electron–phonon coupling and broken charge conjugation symmetry for π-conjugated systems. This effectively leads to a practical materials design route of using naturally abundant five-membered and six-membered conjugated rings to systematically construct a library of electron-accepting materials beyond fullerenes. Coupled to the recently developed π-conjugated copolymer electron donors of targeted optical bandgaps, a comprehensive list of electron donor and acceptor combinations with the optimal power conversion efficiencies is proposed for the photovoltaic solar cell applications.
A Robotic Lower Limb Prosthesis for Efficient Bicycling

A controller for a powered transfemoral prosthesis is presented, which can coordinate power delivery at the knee with the motion of the crankshaft on a bicycle. The controller continuously estimates the lengths of a four-bar linkage model through the application of a recursive least squares algorithm. The link lengths are used to estimate the angle of the bicycle crankshaft. With this measure, the delivery of knee torque is coordinated with the motion of the user. The controller is implemented on a prosthesis prototype and assessed on a transfemoral amputee subject ( N = 1). The subject exhibited a bilateral work asymmetry of 83.5% when cycling with his daily use prosthesis in a free-swing mode. When 60-N·m peak assistance was provided by the powered prosthesis, the bilateral work asymmetry was reduced to 11.4%. The subject's metabolic energy rate was measured for speed and power-matched cycling while the powered prosthesis provided zero assistance (i.e., turned of f and providing its back-drive resistance) or 30-N·m peak assistance. Subject's metabolic energy rate decreased by 16.5% when receiving powered assistance relative to the zero-assistance condition.
Immunocytochemical studies of the mitochondrial alternative oxidase in the thermogenic appendix of five members of the Araceae family

Summary The distribution of mitochondria in fixed sections of thermogenic appendices of five members of the Araceae family was visualized by using indirect immunofluorescence of the monoclonal antibody against the mitochondrial alternative oxidase. It revealed tissue specific distribution of mitochondria in the different appendices. Clustering of mitochondria at the perinuclear region was observed in the appendix of Amorphophallus konjac, Dracunculus vulgaris , and Arum italicum. In the Sauromatum guttatum appendix, clustering of mitochondria at the perinuclear region was observed only in cells near the vascular elements, and in A. dioscoridis , the distribution was homogenous throughout the cell. A comparative staining with anti-Cyt-actin and anti-β-tubulin subunit revealed a similar but not absolutely identical distribution of these two cytoskeletal proteins. On Western blots of acetone extracts of total appendix proteins of the Sauromatum appendix, anti-AOX recognized three major protein bands. A major protein band with an apparent molecular weight of 37 kDa, and a lower band that consisted of a closely spaced double protein band at an apparent molecular weight of 36 kDa. There was also a new additional band with an apparent molecular weight of 32 kDa. The level of AOX forms increased two-fold from D − 3 to D-day, the day of heat production, and it declined on D + 1. The protein band were also detected in the appendix of A. konjac, D. vulgaris, A. italicum , and A. dioscoridis during their thermogenic activity. When parts of an immature Sauromatum appendix were supplied with one of the three thermogenic inducers: salicylic acid, aspirin, and 2,6-dihydroxybenzoic acid at a 10 μM concentration that is sufficient to trigger heat production, the level of AOX increased twofold in the presence of salicylic acid, 1.5-fold in the presence of aspirin, and only 10% with 2,6-dihydroxybenzoic acid.
Lisa Stevenson, Life Beside Itself: imagining care in the Canadian Arctic (Oakland: University of California Press, 2014)

How does one acknowledge the contradiction of life that is made lifeless and its continuing presence after death? Life Beside Itself is an archival and ethnographic study of how two different forms...
Returns to Operating Room After Colon and Rectal Surgery in a Tertiary Care Academic Medical Center: a Valid Measure of Surgical Quality?

Returns to the operating room (ROR) have been suggested as a marker of surgical quality. Increasingly, quality and value metrics are utilized for reimbursement as well as public reporting to inform health care consumers. We sought to understand the etiology of ROR and assess the validity of simple ROR as a quality metric. This was a single referral center retrospective review of all colon and rectal operations between January 1, 2014 and December 31, 2014. Surgical Systems Nurse + was constructed and validated at our institution for classifying ROR as either an unplanned return to the OR, planned return due to complications, planned staged return, or an unrelated return. The primary outcome was the classification of ROR and total number of ROR within 30 days. Of the 2389 colorectal patients who underwent surgery between January 1, 2014 and December 31, 2014; 214 returned to the operating room within 30 days (9.0%). Among the 214 patients, there were a total of 232 ROR with an average of 1.1 ROR per patient (range 1–4); 90 (38.8%) were unplanned ROR, 49 (21.1%) were planned returns due to complications, 92 (39.7%) were planned staged returns, and 1 (0.4%) were unrelated ROR. The most common reason for an unplanned ROR was an anastomotic leak (n = 21; 9.1%). Overall, unplanned reoperations were rare events (n = 90/2389; 3.8%), largely comprised of patients experiencing an anastomotic abscess or leak (n=21/2389; 0.9%). In a high volume and complexity academic colon and rectal surgery practice, RORs within 30 days occurred after 10.4% of cases. Unplanned ROR were relatively rare and most commonly associated with an anastomotic leak. Since the majority of ROR were planned-staged returns, overall rate of ROR should be questioned as a metric of surgical quality. Perhaps, the anastomotic leak rate may be a better metric to monitor for quality improvement efforts.
Abstract 223: Remodeling of K-ATP Channel Expression and Function in Type-2 Diabetes Mellitus

Diabetes mellitus (DM) is associated with enhanced propensity for ventricular tachyarrhythmias (VT). We found that DM hearts exhibit attenuated APD shortening in response to ischemia (Fig). We hypothesized that altered KATP channel expression & function underlie this impaired electrophysiological (EP) adaptation. Methods: We investigated differential effects of the SUR2a activator Pinacidil (PIN, 100 uM) and the SUR1 activator Diazoxide (DZX, 30 uM) on EP properties in Zucker Diabetic Fatty (ZDF) and control (ctrl) rats at baseline and in response to no flow ischemia. We measured the mRNA expression of KATP channel subunits (Kir6.1, Kir6.2, SUR1a, SUR1b, SUR2a, and SUR2b) in normal and ZDF animals. Results: PIN caused comparable APD shortening in ctrl & ZDF hearts during baseline perfusion and promoted early onset of sustained VT within 6 min of ischemia in ctrl & ZDF hearts. In contrast, DZX did not alter APD (p=NS) or cause arrhythmias in either group during baseline perfusion. However, DZX accelerated APD shortening and promoted VT in all (8/8) ZDF hearts during ischemia (Fig 1). The putative molecular mechanism underlying the differential proarrhythmic sensitivity of ZDF vs ctrl hearts to DZX was investigated. We found marked upregulation of Kir6.1 (by 3.7X p<0.001) and SUR1b (by 2.8X p<0.001) mRNA levels with no changes in Kir6.2, SUR1a, SUR2a, or SUR2b expression in ZDF. Conclusion: Remodeling of KATP channel subunits likely underlies the differential sensitivity of ZDF hearts to DZX. Our findings indicate that this classically cardioprotective agent should be avoided in DM patients at risk of ischemic events. Upregulation of Kir6.1 & SUR1b may be markers of proarrhythmia. ![][1] [1]: /embed/graphic-1.gif
How effective are buffer zones in managing invasive beavers in Patagonia? A simulation study

In an age of invasions, it is critical to design and test management strategies to more efficiently control foreign species. Spatially explicit individual based models (SEIBMs) are a powerful tool to explore different management scenarios to control invaders, but we rarely have enough data to parameterize these models, particularly for relatively long-lived species. Here we take advantage of our previous work estimating demographic rates of invasive beavers in Patagonia, and develop an SEIBM to model the spread of beavers in Patagonia. We used our SEIBM both to estimate dispersal distances by fitting their observed rate of spread and to test how placing a buffer zone (a longitudinal strip of land perpendicular to the direction of spread within which a fraction of beavers are culled) beyond the invasion front would work as a control strategy. Specifically, we explored six different scenarios with two different culling rates and two buffer zone widths. We found that beavers in Patagonia must disperse long distances on average to account for the observed rate of spread, and thus our model predicts that a 100 km buffer zone will be needed to slow (but likely not halt) the spread of beavers. Interestingly, culling a higher proportion of beavers within a 100 km buffer zone (90 vs. 60%) did not improve buffer zone performance. Our study shows that wide buffer zones can slow (but likely not halt) continental spread of beavers in Patagonia and potentially pave the way for beaver eradication.
Correcting Oxidative Stress Measurements using the 8-iso-PGF2α/PGF2α Ratio to Determine Appropriate Interventions

The prevailing viewpoint from decades of research on biomarkers of oxidative stress such as the F2-isoprostanes has been that increased oxidative damage plays an important role in the etiology of many human conditions. However, due to a lack of mechanistic verification of the F2-isoprostane source combined with a sole focus on detecting statistically significant changes, the specificity and utility of these results may have been misinterpreted. F2-isoprostanes have been quantified as biomarkers of oxidative stress in over 50 distinct human conditions ranging from Alzheimer’s to tobacco smoking (223 references). Despite its popularity, the specificity of F2-isoprostanes as biomarkers of oxidative stress is in question. It has been shown that the inflammation-induced prostaglandin-H-synthase enzymes are a major source of the F2-isoprostane, 8-iso-PGF2α. Without accounting for the inflammatory source, F2-isoprostanes cannot be utilized as a specific biomarker of oxidative stress. To distinguish between F2-isoprostanes generated from inflammation vs. oxidative stress, the 8-iso-PGF2α/PGF2α was invented. With this measure, we have verified that exposure to the classic free radical toxicant carbon tetrachloride in rats predominantly causes an increase in chemical lipid peroxidation (86.6 ± 8.0 % of total at 1200 mg/kg). In contrast, exposure to lipopolysaccharide also induces the formation of F2-isoprostanes, however, the predominant mechanism for this exposure is due to increased enzymatic lipid peroxidation (59.5 ± 7.0 % of total at 0.5 mg/kg). Surprisingly, in human tobacco smokers, we also found that enzymatic lipid peroxidation is the primary source of F2-isoprostanes (Hedges’ g = 0.59 for enzymatic vs. 0.35 for chemical). This distribution was independent of sex when accounting for hormonal contraceptive use in females. These results draw into question oxidative stress in human disease etiology. In addition, misidentification of inflammation as oxidative stress may explain the poor responses observed in the over 180 different interventions to reduce F2-isoprostane levels across human conditions (258 references) with various degrees of success. Reexamining the true mechanism of increased F2-isoprostanes should now be a top priority.
A Comparison Between a Panel Data Regression Framework and the Synthetic Control Method: A Case Study of the Effect of Sanctions on Iran's Economy

Synthetic control method has been used in comparative case studies, in which the existence of a counter-factual unit with high level of similarities and comparability is crucial. On the other hand, many studies have been done and many methods have been offered in order to overcome the potential shortages of a traditional regression framework in such case studies. In this paper we compare the synthetic control method with a dynamic panel data regression framework. First, we show that the synthetic control method provides an unbiased estimator if the underlying model of the outcome variable of interest is a dynamic panel data model. Second, we compare the prediction power of these two methods. To apply the idea we use the recent sanctions on Iran as the suitable case of a policy intervention and a comparative case study.
Respiration and the Respiratory System

While the fetus is undergoing development of its own respiratory tract and the intricate neural, muscular, and circulatory structures necessary for initiating respiration at birth, it must entirely depend on its mother for the supply of oxygen and release of carbon dioxide, and for the maintenance of a metabolic environment compatible with its well-being. The dramatic substitution of its own respiratory system for that of the placenta is the primary event that occurs at birth, and the failure to perform this respiratory transition is the major cause of death or morbidity in the perinatal period. To visualize the primary significance of this change at birth, it is essential to understand the respiratory state of the fetus in utero. To aid in this understanding, the development of the placenta and its function as a respiratory organ will be emphasized in this section, as well as the development of the fetus’s own respiratory system.
Loss of Tolerance to Exogenous and Endogenous Factor VIII in a Mild Hemophilia A Patient With an Arg593 to Cys Mutation

A 42-year-old patient with mild hemophilia A developed spontaneous muscle hematomas 1 month after intense therapy with factor VIII concentrates. Factor VIII clotting activity was less than 1% and his factor VIII inhibitor was 10 Bethesda units (BU)/mL. The titer peaked at 128 BU despite daily infusions of factor VIII; 1 year later, the titer was 13 BU with no spontaneous bleeding for 4 months. The plasma inhibitor was 95% neutralized by factor VIII A2 domain but less than 15% neutralized by light-chain or C2 domain. His inhibitor did not cross-react with porcine factor VIII and was at least 10-fold less reactive to a series of hybrid factor VIII proteins in which human residues 484-508 are replaced by the homologous porcine sequence (Healey et al, J Biol Chem 270:14505, 1995). The inhibitor patient's DNA encoding his A2 domain and flanking sequences showed a C-T transition predicting Arg593 to Cys. Thirteen patients from 5 unrelated families with Cys593 have not developed inhibitors. Factor VIII clotting activity from one of them was inhibited similarly to diluted normal plasma by inhibitor patient plasma. In an homologous structure, ceruloplasmin (Zaitseva et al, J Biol Inorgan Chem 1:15,1996), the residue equivalent to Arg593, is in a loop distinct from residues 484-508. On solution phase immunoprecipitation with labeled factor VIII fragments, A2, light chain, and C2 domains bound. In contrast to typical immune responses to factor VIII in patients with severe hemophilia A, this patient's inhibitor was almost entirely reactive with common epitopes within the A2 domain whereas by more sensitive immunoprecipitation testing antibodies to light chain epitopes were also present. Accordingly, immune responsiveness to exogenous factor VIII (antigen burden) appears to be more critical than his endogenous, hemophilic factor VIII to his developing high-titer anti–factor VIII antibodies and loss of tolerance to both native and hemophilic factor VIII proteins.
A Role for Tetrahydroisoquinoline Alkaloids as False Adrenergic Neurotransmitters in Alcoholism

The plant alkaloids comprise a broad grouping of compounds, many of which exhibit drug action in man (Robinson, 1968). A subclassification is the tetrahydroisoquinoline (TIQ) group, which contains compounds that are related structurally to the catecholamines, viz. dopamine (DA), norepinephrine (NE) and epinephrine (E). The main thesis of this paper is that a group of TIQ alkaloids can be biosynthesized in people during alcohol intake, and that these substances can then function as false adrenergic transmitters (Cohen and Collins, 1970). By interfering with adrenergic mechanisms in the brain and in the periphery, biosynthesized TIQ alkaloids may be capable of altering mood and behavior. In this way, they may play a role during alcohol intoxication and in post-intoxication states.
Large Deviations from the Almost Everywhere Central Limit Theorem

We prove large deviation principles for the almost everywhere central limit theorem, assuming that the i.i.d. summands have finite moments of all orders. The level 3 rate function is a specific entropy relative to Wiener measure and the level 2 rate the Donsker-Varadhan entropy of the Ornstein-Uhlenbeck process. In particular, the rate functions are independent of the particular distribution of the i.i.d. process under study. We deduce these results from a large deviation theory for Brownian motion via Skorokhod's representation of random walk as Brownian motion evaluated at random times. The results for Brownian motion come from the well-known large deviation theory of the Ornstein-Uhlenbeck process, by a mapping between the two processes.
The Intermediate Phase and Self-organization in Network Glasses

We have discussed the rigidity of random and self-organized networks. We find that there is a single transition from floppy to rigid in random networks, but an intermediate phase intervenes in the self-organized networks. This intermediate phase is rigid but contains no redundant bonds and so is stress-free.
Regulation of microRNA function in animals

Since their serendipitous discovery in nematodes, microRNAs (miRNAs) have emerged as key regulators of biological processes in animals. These small RNAs form complex networks that regulate cell differentiation, development and homeostasis. Deregulation of miRNA function is associated with an increasing number of human diseases, particularly cancer. Recent discoveries have expanded our understanding of the control of miRNA function. Here, we review the mechanisms that modulate miRNA activity, stability and cellular localization through alternative processing and maturation, sequence editing, post-translational modifications of Argonaute proteins, viral factors, transport from the cytoplasm and regulation of miRNA–target interactions. We conclude by discussing intriguing, unresolved research questions. MicroRNAs (miRNAs) are key regulators of biological processes. Recent discoveries have expanded our understanding of the control of miRNA function in animals, through alternative processing, miRNA-sequence editing, post-translational modifications of Argonaute proteins, subcellular localization and regulation of miRNA–target interactions.
Small organic fulminates as high energy materials. Fulminates of acetylene, ethylene, and allene

ABSTRACTThe minimum-energy structures and thermodynamic properties of small organic fulminate molecules have been explored. The results show that while these compounds have an impressive specific energy of decomposition, other parameters like detonation pressures and velocities are less so.
Who Did Kill Shakespeare

This essay argues that the universally praised opening of the literary canon resulted in problematic effects for professors of literature and especially for professors of early literature, including Shakespeare. These include an attenuated distinctiveness of the field, the slighting of the past in favor of the present, and the undermining of professors’ authority and legitimacy. Opening the canon was done with noble intent, but as a result the academic 99 percent of Shakespeareans today find themselves teaching in departments of “English Studies” dominated by colleagues with no necessary commitment to literature or to literary writing. This essay asks that the academic 99 percent think of ways to rescue themselves and their students from the unintended problematic effects of democratization in higher education.
Reducing Ventilator Associated Pneumonia in the NICU through oral care education: A quality improvement project

Abstract Background Inadequate oral care in the Neonatal Intensive Care Unit (NICU) can lead to Ventilator Associated Pneumonia (VAP). VAP rate was reported at 2.52 per 1000 ventilator days for the 12 months prior to intervention. A root cause analysis of VAPs during this period revealed only 70% compliance with oral care. VAP contributes to higher costs for the hospital, patient pain and suffering, morbidity and mortality, length of time on mechanical ventilation and increased hospital length of stay. This Quality Project aims to reduce VAP in the NICU through multidisciplinary re-education on the importance of oral care, and fostering an interdisciplinary oral care team of Respiratory Therapists and Registered Nurses. Method An IRB approved interventional pre and post intervention review of VAP rate was conducted on intubated neonatal patients from June 1, 2015–May 31, 2017. Intervention consisted of education perform as an interdisciplinary oral care team. Education was coordinated between Respiratory (RT) and Nursing (RN) educators, Lactation, and unit leaders to ensure standardized education to all staff. An oral care poster was created and presented to both RT and NICU RN staff at department meetings. An oral care PowerPoint was created and sent to all NICU RN's and was required as annual mandatory education for all RT's. Encouragement was provided through random chart audits from June 2016–May 2017, praising staff that coordinated care, and reminding staff who did not through friendly face to face interaction and email of the importance of routine, coordinated oral care. Results NICU VAP rates dropped during June, and came back up in July 2016 and dropped again in March 2017. Chart review revealed insufficient oral care (72% and 78%) in the two days prior to VAP events. Oral Care poster and education were re-introduced in August 2016 and April 2017. NICU VAP rates post intervention, June 2016–May 2017, was reported as 0.78 per 1000 ventilator days. Conclusions Identifying the primary factor through VAP root cause analysis made us aware of a VAP bundle component that was not being routinely followed. Having identified oral care as a problem in our unit enabled us to form an educational intervention with a standardized oral care technique that was effective in increasing the frequency and efficacy of oral care. Utilizing a multidisciplinary team for oral care fosters a sense of importance and responsibility to the staff and improved collaboration in care.
Waldenström's macroglobulinemia: incidence patterns in the United States, 1988-1994.

BACKGROUND There are few data describing the epidemiologic aspects of Waldenstrom's macroglobulinemia (WM), a rare lymphoplasmaproliferative disorder. METHODS The authors evaluated the incidence of WM reported in 11 population-based cancer registries in the U.S. RESULTS A total of 624 cases were diagnosed between January 1, 1988 (when WM became reportable) and December 31, 1994. Age-adjusted incidence rates for WM (per 1 million person-years at risk) were 3.4 among males and 1.7 among females. The rates increased sharply with age, from 0.1 at age 0.05). The markedly higher rates for WM among whites than blacks stand in contrast to multiple myeloma, which occurs twice as often among blacks. CONCLUSIONS This survey provides new data regarding the incidence patterns of WM in the U.S. However, further epidemiologic studies with biomarkers are needed to define the environmental, genetic, immunologic, and viral determinants of this rare but distinctive disorder. Cancer 1998;82:1078-81. © 1998 American Cancer Society.
Time Discretization: Some Basic Approaches

The basic concepts of stability, consistency and convergence are introduced. Additional measures of stability, such as A- and L-stability are discussed, along with desirable stability properties for the time integration of partial differential equations. The family of Runge–Kutta methods is reviewed, including both classical schemes and more recently developed strong-stability preserving and diagonally implicit methods. The chapter concludes with a brief discussion of linear multistep methods.
The Cancer Bell: Too Much of a Good Thing?

Purpose Patients around the world often ring a bell on the final day of radiation therapy (RT) to celebrate treatment completion. Patients appear to enjoy ringing the bell, but its psychological impact is unexamined. Applying a psychological principle named the “peak-end rule,” we hypothesized that ringing the bell would improve patients’ perceptions of the overall distress from cancer treatment. Methods and Materials We enrolled 2 cohorts of patients completing definitive RT in a single-center outpatient radiation oncology clinic. Patients in the control arm completed treatment and filled out the survey mentioned below. A bell was then installed in the clinic, and patients in the intervention arm rang the bell on the final day of RT and filled out the same survey. Patients evaluated their overall distress from cancer treatment using a survey composed of an 11-point numerical rating scale in combination with the Verbal Rating Scale. At follow-up, a shorter survey was completed that asked the same questions about distress from cancer treatment. Results Two hundred ten patients were enrolled, 107 in the bell group and 103 in the control group. One hundred sixty-three patients completed follow-up surveys, n = 86 (80%) and n = 77 (75%) in the bell and control groups, respectively. Demographics and treatment characteristics were well balanced. The bell group reported worse overall distress scores than those not ringing the bell (mean [standard deviation] 5.6 [2.8] vs 4.7 [2.7], P = .045). This difference worsened further at follow-up (6.4 [2.9] vs 5.1 [3.0], P = .009; mean 103 vs 130 days, P = .056). Conclusions Counter to our hypothesis, ringing the bell on the final day of RT worsens patients’ evaluation of overall distress from cancer treatment, and this distress persists and even worsens in the months after treatment. Emotional arousal created by ringing the bell may magnify the distress from cancer treatment and subsequently worsen the perception of distress from treatment.
Double resonance Raman study of disorder in CVD-grown single-walled carbon nanotubes

Single-walled carbon nanotubes (SWCNTs) with varying degrees of disorder were investigated using multiple-excitation Raman spectroscopy. The lattice disorder was imparted into the nanotubes by the addition of varying amounts of sulfur to the iron catalyst in a thermal chemical vapor deposition process. Changes in the intensities of peaks occurring due to a double resonance Raman process were studied. The intensity of the disorder-induced D band increased with a decrease in the sulfur content. Upon post-synthesis heat treatment, the double resonance process got quenched due to defect healing. The second order G′ band and iTOLA bands exhibited a two-peak structure, of which one of the peaks is relatively more sensitive to defects and decreased in intensity with heat treatment.
Using Cluster Analysis to Identify Patient Factors Linked to Differential Functional Gains After Total Knee Arthroplasty.

Abstract Background The basis of poor outcomes following total knee arthroplasty (TKA) is multifactorial. Previous research aimed at predicting outcome following TKA focuses largely on outcomes measured between two specific time points (pre-to post-TKA). Analysis of outcomes measured over multiple time points (trajectory) may expose relationships between patients’ characteristics and longitudinal outcome patterns that may otherwise remain obscured. Methods The current study analyzed Short Form 36 Physical Component Score (PCS) trajectories of 656 patients composed of 3 time points over a 1-year period. Clusters were constructed utilizing MultiExperiment Viewer hierarchical clustering algorithm. Statistical significance of these clusters was assessed using MeV’s built-in bootstrapping method. Patient characteristics of the resulting statistically conserved clusters were summarized and compared using Wilcoxon rank-sum test or chi-squared test as appropriate. Results Two distinct clusters of outcome trajectory were identified. Cluster 1 included 550 patients (84%) who demonstrated persistent PCS improvement at 6 and 12 months. Cluster 2 included 106 patients (16%) who demonstrated decline in PCS at 6 months followed by improvement at 12 months. Cluster 1 achieved earlier success, greater absolute mental and physical health scores as compared to Cluster 2 (P Conclusion Cluster analysis identified distinct functional outcome trajectories following TKA. Specific differentiating patient factors were associated with differing trajectories. Future studies should focus on this method’s ability to inform predictive models regarding patient outcomes.
Some Problems with Fractions for the Middle School

The National Assessment of Educational Progress (1980) scores confirm that frac tions, percentages, and decimals are among the topics that middle grade students find difficult. Exploring interesting mathemati cal questions whose solutions require com putations involving these concepts is an ex cellent motivation for improving basic understandings and skills. In this article we will present a series of related questions that involve fractions, percentages, and decimals. The solutions to these questions can be found by paper-and-pencil work, or after the students have gained sufficient un derstanding, the questions can be answered by using a computer or programmable cal culator. Answers appear in Appendix A.
Factors That Impact College Students’ Perceptions of Sexual Pleasure and Satisfaction

It is important to understand how people experience pleasure and sexual satisfaction with a partner, as these phenomena can impact how they view their relationships, themselves, as well as the role...
How Engaged Interdependence Impacts Operating Room Management Metrics

Abstract Objective In this retrospective case study, we examine the impact of an operational coaching-based initiative, Engaged Interdependence, on operating room efficiency. Design Engaged Interdependence is a professional development model that allows surgeons to expand their technical and managerial skills. Engaged Interdependence is composed of three parts and includes 6–8 h of direct operating room surgeon-to-surgeon observation or assistance once every other month, one-hour group discussions every month and 4–6 h of independent reading every month. Surgeon RM began coaching surgeon DL on 2/1/2017. We collected 12 months before and after the start data, splitting the data into a Before and an On/After groups for statistical and graphical comparison. All operating room management data were collected using WiseOR® and OR efficiency was assessed using four metrics: OR workload (patient time in room plus turnover time), operating time, over-utilized (OU) time, and under-utilized (UU) time. OR workload and operating time were analyzed using a Wilcoxon rank sum test, while OU and UU time were analyzed using a two-tailed t-test. Setting Small, academic medical center. Participant A single orthopedic spine surgeon. Results OR workload hours significantly decreased for four of five most common procedures: Procedure 1 “Laminectomy, Part Facetectomy, Foraminotomy, Herniated Disc Lumbar” (Before Mean [M] ± Standard Deviation [SD]=2.09±0.42 h, After M = 1.95±0.42; p = 0.077); Procedure 2 “Laminectomy with Facetectomy + Foraminotomy, Lumbar” (Before M = 2.95±0.77 h, After M = 2.41±0.55; p = 0.022); Procedure 3 “Posterior Non-Segmental Instrumentation” (Before M = 4.11±0.66, After M = 3.52±0.76; p = 0.014); Procedure 4 “Laminectomy, Facetectomy + Foraminotomy Additional Segment” (Before M = 4.05±0.94, After M = 2.80±0.32; p = 0.0018); and Procedure 5 “Posterior Segmental Instrumentation- 3–6 Vertical Segments” (Before M = 6.40±0.83, After M = 4.62±1.1; p = 0.0065). Operating time hours significantly decreased for all five procedures: Procedure 1 (Before M = 1.34±0.38, After M = 1.17±0.32, p = 0.026), Procedure 2 (Before M = 2.15±0.71, After M = 1.61±0.54, p = 0.0058), Procedure 3 (Before M = 3.18±0.67, After M = 2.70±0.63, p = 0.032), Procedure 4 (Before M = 2.92±0.69, After M = 2.09±0.29, p = 0.014), and Procedure 5 (Before M = 5.43±0.83, After M = 3.58±1.0, p = 0.0032). OU time minutes significantly decreased (Before M = 20.5 ± 34.8, After M = 10.1 ± 22.8, p = 0.014), while UU time remained unchanged (Before M = 16.2 ± 22.3, After M = 23.4 ± 28.7, p = 0.063). Conclusion Engaged Interdependence represents a potential high-value intervention that can improve operating room efficiency. Although operational coaching is a subjective process, perioperative health care systems may generate a return on investment by fostering operational and organizational decision-making skills.
Publishing: Double-blind peer review a double risk.

Double-blind peer review of research papers is a worthy idea but has two flaws in practice (Nature 518, 274; 2015).
Lily steroidal glycoalkaloid promotes early inflammatory resolution in wounded human fibroblasts

Abstract Ethnopharmacological relevance The bulbs and flowers of plants from the Lilium genus have historically been used in Asian and Greco-Roman medicine to treat burns and promote skin healing. Aim of the study To evaluate a steroidal glycoalkaloid isolated from Easter lily bulbs for its potential wound healing promoting properties. Materials and methods A lily-derived steroidal glycoalkaloid (LSGA), (22R, 25R)-spirosol-5-en-3β-yl O-α-L-rhamnopyranosyl-(1→2)-β-D-glucopyranosyl-(1→4)-β-D-glucopyranoside, was isolated from Easter lily bulbs, and its structure was confirmed by LC-MS and NMR spectrometry. LSGA effects on wound scratch closure were evaluated in a primary human dermal fibroblast cell culture, and the changes in gene expression profiles were quantitated using an 84 wound-related gene qPCR microarray. Results LSGA promoted migration of dermal fibroblasts into the wounded area. The treatment was associated with a rapid upregulation of early inflammatory (CD40LG, CXCL11, IFNG, IL10, IL2 and IL4), cell growth (CSF3 and TNF) and remodeling (CTSG, F13A1, FGA, MMP and PLG) genes both in the wounded and unwounded cells treated with LSGA. A selective decrease in gene expression profiles associated with inflammatory (CXCL2 and CCL7) and remodeling (MMP7 and PLAT) phases was observed in wounded cells treated with LSGA, in contrast to the wounded cells (control). Conclusion This study demonstrates that a glycoalkaloid present in lilies promoted fibroblast migration in vitro and affected inflammatory, remodeling and growth factor gene expression. The decreases in expression of key genes may impact the wound healing process, possibly contributing to an earlier end of the inflammatory response and shortening the early phases of model tissue reconstitution. The results of this preliminary investigation may provide a basis for the historical use of lily bulbs to promote dermal healing after injury.
Reliability and validity

Abstract Following the previous chapter's presentation of the major risky decision making tasks, the focus of this chapter is on the known evidence in favor of or against reliability and validity of these measures. Test–retest, multiple forms, intermethod, split-half, and internal consistency are examined and concerns are raised about the relative lack of reliability data across tasks. Finally, content, criterion, and construct validity evidence is presented across tasks.
Antegrade Elastic Intramedullary Nailing Insertion Technique Results in Higher Incidence of Symptomatic Implants in Pediatric Ulnar Fractures.

Retrograde and antegrade nailing techniques are the two options available to a surgeon when using elastic stable intramedullary nailing; however, the literature comparing these two nailing techniques is scarce. Thus, we conducted a retrospective review of all pediatric and adolescent ulnar fractures treated with elastic stable intramedullary nailing at our facility. We hypothesize that the clinical outcomes (implant and wound complications) and the time between surgery and radiographic union will be similar for both techniques. Methods A retrospective chart review of pediatric ulnar fracture patients treated at our facility was performed. Demographic and health information associated with the injury were collected, and the clinical outcomes of the two techniques were compared. Results A total of 53 patients with 54 fractures were included in this study. Antegrade nail insertion was used to treat 59.2% fractures. Radiographic union was achieved in all patients. Nail insertion technique was not associated with postoperative wound complications, time to radiographic union or implant removal, or significant deficits in upper extremity rotation (P > 0.05). Antegrade nailing resulted in a symptomatic implantation 3.97 times more frequently than compared with retrograde nailing (P = 0.036). Discussion Antegrade nailing demonstrates a similar healing profile but higher implant complications compared with the retrograde nailing technique in pediatric ulnar fractures.
Hepatic macrophage accumulation with aging: cause for concern?

Aging is associated with chronic, low-grade inflammation that adversely affects physiological function. The liver regulates systemic inflammation; it is a source of cytokine production and also sca...
Towards Understanding How Virtual Human's Verbal Persuasion Strategies Influence User Intentions To Perform Health Behavior

This paper investigates how a virtual human's persuasion attempts influence the user's intentions to perform the recommended behaviors using the Theory of Planned Behavior. The Theory of Planned Behavior suggests that users' attitudes towards the behavior, subjective norms, and perceived behavior control determine user intentions to perform behaviors. Using the Theory of Planned Behavior, we identify the underlying mechanisms of how users' attitudes, subjective norms, and perceived behavior control influence the effectiveness of virtual human's persuasive attempts on user's intentions to perform the behavior. To identify the underlying mechanisms, we conducted an online study with 202 college students. In a between-subjects study, a virtual human persuaded students to use a mental health coping skill using six different persuasion strategies. We present evidence that persuasion strategies influenced the students' perceived behavior control, which further influenced the user intentions to perform the behavior. Additionally, the paper also shows that user personality influenced the effect of persuasion strategies on students' perceived behavior control. This knowledge of underlying mechanisms of how virtual human's persuasion attempts to influence users' intentions to perform the recommended behavior can help in designing effective intelligent virtual humans for persuasion.