cssi/SciSciGPT-SciSciNet huggingface dataset:
Busulfan and melphalan as consolidation therapy with autologous peripheral blood stem cell transplantation following Children's Oncology Group (COG) induction platform for high‐risk neuroblastoma: Early results from a single institution

Bu-Mel as preparative therapy prior to autologous stem cell rescue was recently shown to be superior to the conventional CEM regimen for HR NBL in Europe. There are no data available on the feasibility and toxicity of Bu-Mel as consolidation therapy following the COG-type induction regimens used in North America. We report early complications and outcomes of patients with HR NBL who received Bu-Mel for consolidation following COG-based induction. Retrospective analysis of all patients who had received Bu-Mel as preparative regimen prior to stem cell rescue for HR NBL was carried out. Toxicity, outcomes, and any delays to receiving radiation or anti-GD2 antibody therapy were analyzed. Six patients undergoing PBSCT had received Bu-Mel. The treatment was well tolerated. Mucositis was the main toxicity; three patients had developed neutropenia fever and none developed pulmonary toxicity. One patient had developed moderate SOS that responded to conservative management. All patients were able to receive and tolerate post-transplant local radiotherapy and ch.14.18 anti-GD2 antibody therapy without any delays. All patients are alive with no disease recurrence. The Bu-Mel regimen is well tolerated and is feasible post-COG-type induction platform.
Coniferyl alcohol, sinapyl alcohol and scopoletin in tobacco callus tissue during growth of a subculture

Coniferyl and sinapyl alcohols were isolated, identified and quantitatively determined as unbound (or weakly bound) phenylpropanoids in neutral hot-water extracts of Nicotiana tabacum L. callus tissue. This is the first identification of these alcohols in cultured tobacco callus. Scopoletin was also detected in these extracts, and it was the most abundant of these three phenylpropanoids with concentrations that ranged from 50–119 μg/g dry wt. Coniferyl alcohol (17–34 μg/g dry wt.) and sinapyl alcohol (23–35 μg/g dry wt.) were present in nearly equimolar concentration ratios and at levels which were about half those determined for unbound (or weakly bound) scopoletin. The amount of scopoletin extracted increased about 10 times when 1 M HCl-50% methanol - 0.3% ascorbic acid was used as the extractant. This indicated that most scopoletin moieties were strongly bound, perhaps by acid-hydrolyzable linkage. Coniferyl alcohol and sinapyl alcohol were not found in the acid extracts, presumably because they were acid-labile. In general, the concentration of each endogenous unbound (or weakly bound) phenylpropanoid appeared to remain relatively constant throughout the growth phase of the subculture. The only exceptions to this were the relatively higher concentrations of scopoletin and coniferyl alcohol present during the initial 0–2 weeks of subculture.
Incidence of the Enterococcal Surface Protein (esp) Gene in Human and Animal Fecal Sources

The occurrence of the enterococcal surface protein (esp) gene in the opportunistic pathogens Enterococcus faecalis and E. faecium is well-documented in clinical research. Recently, the esp gene has been proposed as a marker of human pollution in environmental waters; however, information on its relative incidence in various human and animal fecal sources is limited. We have determined the occurrence of the esp gene in enterococci from human (n = 64) and animal (n = 233) fecal samples by polymerase chain reaction using two primer sets: one presumably specific for E. faecium (espfm) and the other for both E. faecalis and E. faecium (espfs/fm). We believe that this research is the first to explore the use of espfs/fm for the detection of human waste in natural environmental settings. The incidence in human sources was 93.1% espfm and 100% espfs/fm in raw sewage influent; 30% for both espfm and espfs/fm in septic waste; and 0% espfm and 80% espfs/fm in active pit toilets. The overall occurrence of the gene i...
Reflecting on Social Foundations

This essay is a review of Dan W. Butin's edited collection Teaching Social Foundations of Education: Context, Theories, and Issues. I explore how this book helps us to think about the field of social foundations: what it is we do, why, and the challenges we face. I also look at the themes that cut across all ten essays in the collection, including engaging diversity, demonstrating democracy, and reflecting on social foundations as a field.
Design, fabrication and calibration of a cryogenic search-coil array for harmonic analysis of quadrupole magnets

A cryogenic search-coil array was fabricated for harmonic error analysis of Superconducting Super Collider model quadrupoles. The coil consists of three triplet of coils: the center-coil triplet is 10-cm long, and the end coil triplets are 70-cm long. Design objectives are a high bucking ratio for the dipole and quadrupole signals and utility at cryogenic operating currents (-6 kA) with sufficient sensitivity for use at room-temperature currents ( approximately 10 A). Individual coils were measured mechanically to +or-5 mu m, and their magnetic areas measured to 0.05%. A computer program was developed to predict the quadrupole and dipole bucking ratios from the mechanical and magnetic measurements. The calibration procedure and accuracy of the array are specified. Results of measurements of SSC model quadrupoles are also presented. >
Genotoxicity testing with fish hepatic S9 for evaluation of complex mixtures in the aquatic environment: the use of channel catfish as a model

A Salmonella/fish S9 mutagenicity assay, a modification of the traditional rodent Salmonella/musome mutagenicity test of Ames, was evaluated and a working test protocol was established with channel catfish (Ictalurus punctatus) as a model system for monitoring genotoxins in complex mixtures extracted with organic solvents from freshwater sediments. Post-mitochondrial supernatant fractions (S9) from catfish mediated the biotransformation of the arylamines 2-aminoanthracene (2-AA) and 2-aminofluorene (2-AF) as well as polyaromatic hydrocarbon benzo(a)pyrene (BaP) models to Salmonella (strain TA98) mutagens, confirming other freshwater fish studies with bream, carp, pike, and rainbow trout. The enzymatic activity of catfish S9 was cytochrome P-448-450 like: inducible, heat liable, cofactor dependent, and inhibitor sensitive. Bacterial mutagenesis in the Salmonella/catfish S9 test was dose dependent and sensitive to both S9 concentrations and preincubation activation temperature. A liquid-preincubation modification of the standard plate-incorporation method significantly improved the catfish poikilothermic activation system. The hepatic S9 activity of catfish and the traditional Arochlor-1254-induced rat were qualitatively and quantitatively similar in the detection of model arylamines and benzo(a)pyrene genotoxins. The relative sensitivity of the tests, that is the lowest detectable concentration of 2-AA, 2-AF, and BaP, was <1.0 μg/plate with both activation systems. The sensitivity of the Salmonella/fish S9 assay as a screening tool to detect environmental genotoxins was clearly influenced by three test factors: preinduction of the fish, preincubation of the sample, and optimal preincubation temperature of the fish S9. The successful use of a fish activation system to mediate the biotransformation of progenotoxins establishes this Salmonella/fish S9 mutagenicity test as an ecologically relevant assay to monitor the potential aquatic hazards of environmental genotoxins influencing the aquatic resource of concern - the freshwater fisheries.
Illuminated propaganda: the origins of the ‘Ascende calve’ pope prophecies

Abstract The illuminated prophecies depicting fifteen popes from Nicholas III onward (incipit: ‘Ascende calve’) were conceived to advance the cause of southern-French Franciscan Spirituals. They were created between c. 1318 and c. 1340, most likely between 1328 and 1330. The early iconography and commentary by John of Rupescissa are particularly helpful for interpreting the original meaning of the prophecies.
Effect of stressed pre-exposure on the creep strengthening of a 2009 Al-SiCw composite

Clearly the present approach of analyzing the steady state or minimum creep data on the basis on a threshold stress is not likely to produce an unambiguous interpretation of the steady state creep mechanism in aluminum alloy matrix composites. In the authors` opinion it is important to (a) establish the existence of a true steady state creep regime in tension over a large enough strain rate range (e.g. a typical creep rate range for experimental verification would be 10{sup {minus}9}--10{sup {minus}5} s{sup {minus}1}), (b) establish a criterion for the lack of a true steady state creep regime (in at least some composites), and (c) look for some other creep parameter to understand the differences in the creep behavior of composites and unreinforced matrices. In this paper the authors report the creep behavior of a 2009Al-SiC{sub w} composite (w denotes whisker). They note that no steady state creep regime was observed at higher creep rates. Specimens pre-exposed at a prior stress (and only in a critical range) show an unusual creep strengthening. This observation hints at the role of matrix composition on overall creep behavior of composites. The primary creep strain and anelastic strain values are reported to highlight the rolemore » of SiC{sub w} reinforcement on the overall dislocation activities during creep.« less
Are Norms Based on the Original Teller Acuity Cards Appropriate for Use with the New Teller Acuity Cards II

Purpose: We sought to compare visual acuity results obtained with the original Teller Acuity Cards™ (TAC), which are no longer commercially available, and the modified, laminated Teller Acuity Cards™ II (TAC II), which recently became commercially available. Methods: Sixty children were tested, 20 at each of 3 ages: 3.5 months, 11 months, and 30 months. Each subject's binocular grating acuity was measured once with the TAC and once with the TAC II, with the order of testing counterbalanced across subjects. Testers were aware that acuity cards were arranged in ascending order of spatial frequency, but they were masked to the absolute spatial frequencies of the gratings in the subset of cards used. Testers were also masked to acuity results until testing of the child was completed. Results: Repeated-measures analysis of variance with age as a between-subjects variable and card type as a within-subjects variable showed a significant effect of age ( P P P P P Conclusions: These results suggest that normative grating acuity data obtained with the original Teller Acuity Cards™ need to be adjusted toward lower acuity values by approximately 0.5 octave to be appropriate for use with the new Teller Acuity Cards™ II.
B cells as therapeutic targets in SLE

The use of B-cell targeted therapies for the treatment of systemic lupus erythematosus (SLE) has generated great interest owing to the multiple pathogenic roles carried out by B cells in this disease. Strong support for targeting B cells is provided by genetic, immunological and clinical observations that place these cells at the center of SLE pathogenesis, as initiating, amplifying and effector cells. Interest in targeting B cells has also been fostered by the successful use of similar interventions to treat other autoimmune diseases such as rheumatoid arthritis, and by the initial promise shown by B-cell depletion to treat SLE in early studies. Although the initial high enthusiasm has been tempered by negative results from phase III trials of the B-cell-depleting agent rituximab in SLE, renewed vigor should be instilled in the field by the convergence of the latest results using agents that inhibit B-cell-activating factor (BAFF, also known as BLyS and tumor necrosis factor ligand superfamily, member 13b), further analysis of data from trials using rituximab and greatly improved understanding of B-cell biology. Combined, the available information identifies several new avenues for the therapeutic targeting of B cells in SLE.
Percutaneous epicardial ventricular tachycardia ablation after noncoronary cardiac surgery or pericarditis

Background Patients with previous noncoronary cardiac surgery or pericarditis may require epicardial access to facilitate successful ventricular tachycardia (VT) ablation. Percutaneous pericardial access is known to be difficult in these patients owing to the presence of pericardial adhesions. Objective To examine the success and safety of percutaneous pericardial access as well as the ability to map and ablate epicardial VT targets. Methods We studied 10 consecutive patients with prior noncoronary cardiac surgery (8 patients) or prior pericarditis (2 patients) who required epicardial access for VT ablation. Results Percutaneous pericardial access was achieved by experienced operators, and dense adhesions interfering with catheter mapping were encountered in all patients. Using blunt dissection with a deflected ablation catheter, adhesions were divided over the course of 19–125 minutes (mean 57±38 minutes; median 47 minutes). This dissection allowed for sufficient epicardial mapping in 9 of 10 (90%) patients. The clinical targeted VTs were rendered noninducible in 8 (80%) patients. One patient had 70 cm 3 of bleeding with the initial puncture. No other complications occurred. During a long-term follow-up of 24±27 months (median 13 months), 5 patients have remained VT-free. Conclusions Percutaneous pericardial access for epicardial VT ablation in patients with previous noncoronary cardiac surgery or pericarditis can usually be obtained. However, dense pericardial adhesions are often encountered and may limit the ability to map the entire epicardial space. Typically, appropriate targets can be reached and ablated by disrupting the adhesions with the ablation catheter and/or deflectable sheath, facilitating excellent long-term clinical outcome in half of the patients with no major complications.
Validation of an Electronic Surveillance Tool for Identifying Hospital Inpatients With Severe Sepsis

SESSION TITLE: Outcomes/Quality Control Posters SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM 02:30 PM PURPOSE: To assess the value of CareVeillance (CV), an electronic surveillance tool that continuously samples data from the electronic medical record (EMR) for early identification of severe sepsis. METHODS: This is a prospective and retrospective descriptive analysis of CV, developed at the University of Kansas Hospital (KUH). Patients with severe sepsis were identified in 3 ways: 11 day real-time pilot of CV software in 2/12, comparison of hospital discharge (administrative) data with a retrospective application of CV software to all KUH patients discharged in 2/12, and retrospective adjudication of patients in both categories (gold standard). Random number generation was used to determine a statistical sample of the CV-identified severe sepsis patients for adjudication. RESULTS: During the real-time pilot, CV identified 19 patients who were concurrently determined to have severe sepsis by trained CV monitoring personnel; 16 were discharged in 2/12 and were evaluated in the retrospective CV application where all 16 were, likewise, identified. Of this 16, adjudication diagnosis agreed with CV diagnosis 100% of the time. Only 13 of the 16 (81.3%) were diagnosed by their care team with severe sepsis during their hospitalization; 2 of the remaining 3 had severe sepsis on adjudication. Administrative data identified 104 patients with severe sepsis who were discharged in 2/12 (not limited to the pilot period). CV retrospectively identified all 104 of these patients and an additional 110 patients as having severe sepsis. Adjudication of 22 (20%) of these additional patients revealed that 8 (36.4%) had severe sepsis, suggesting that of the 110 patients, 40 had severe sepsis but were not diagnosed during their hospitalization. CV falsely identified 70 patients as having severe sepsis. CONCLUSIONS: CV identified severe sepsis patients when it was applied to EMR data either prospectively or retrospectively; it was more sensitive than hospital care teams. CV identified all patients with severe sepsis according to the administrative data but also identified patients the care team and therefore the administrative data missed. However, CV has relatively low specificity. CLINICAL IMPLICATIONS: CV identifies patients with severe sepsis that may otherwise go unrecognized. Applied prospectively and judiciously, CV can bring this information to the attention of the patient's care team and has the ability to reduce these patients' length of ICU and hospital stay, overall cost of care, and mortality. DISCLOSURE: The following authors have nothing to disclose: Bristol Brandt, Amanda Gartner, Michael Moncure, Chad Cannon, Liz Carlton, Steven Simpson No Product/Research Disclosure Information Copyright © 2014 American College of Chest Physicians
Change in the field

Environmental Magnetism. By Roy Thompson and Frank Oldfield. Allen & Unwin:1986. Pp.227. 35, 50.
Factors Associated with Anxiety and Depression among African American and White Women

Background. We examined factors associated with depression and anxiety in a cohort of low-income Baltimore women. Methods. We used Pathways to Adulthood data, a cohort of adults aged 27 to 33 who were born in Baltimore between 1960 and 1965. Our outcomes were a score of >4 on the General Health Questionnaire (GHQ-28) across the depression or anxiety domains. Linear regression clustered on census tract was used for multivariate analysis. Results. In multivariable analyses, unmarried women, White women, those with lower self-rated health, and younger mothers had higher depression scores. Only lower self-rated health and White race were associated with a higher anxiety score. Neither neighborhood poverty nor racial composition was a predictor for anxiety or depression; however, the significant risk factors cluster in disadvantaged neighborhoods. Conclusion. Our work highlights the importance of universal screening for depression or anxiety with more in-depth surveillance based on risk factors rather than on race.
The impact of heterogeneous transmission on the establishment and spread of antimalarial drug resistance

Abstract Despite the important insights gained by extending the classical models of malaria, other factors, such as immunity, heterogeneous biting, and differential patterns of drug use have not been fully explored due to the complexity of modeling multiple simultaneous malaria infections competing within a host. Understanding these factors is important for understanding how to control the spread of drug resistance to artemisinin which is just emerging in Southeast Asia. The emergence of resistance plays out at the population level, but is the result of competition within individuals for transmission events. Most studies of drug resistance evolution have focused on transmission between hosts and ignored the role of within-host competition due to the inherent complexity of modeling at multiple scales. To embed within-host competition in the model, we used an agent-based framework that was developed to understand how deviations from the classical assumptions of the Ross-MacDonald type models, which have been well-described and analyzed, impact the dynamics of disease. While structured to be a stochastic analog to classical Ross-Macdonald type models, the model is nonetheless based on individuals, and thus aspects of within-host competition can be explored. We use this framework to explore the role of heterogeneous biting and transmission on the establishment and spread of resistance in a population. We find that heterogeneous transmission slows the establishment of resistance in a population, but once resistance is established, it speeds the spread of resistance through the population. These results are due to the skewed distribution of biting which makes onward transmission a low probability and suggests that targeting the “core” group of individuals that provide the vast majority of bites could significantly slow the spread of resistance.
Space Station gas-grain simulation facility - Application to exobiology

The technical issues involved in performing experiments on the behavior and properties of aerosols in a microgravity environment provided by the Space Station are reviewed. The displacement of a particle resulting from g-jitter for ballistic, Knudsen, and Stokes flow regimes is examined in detail, and the radiation, acoustic, electrostatic, and electromagnetic mechanisms for the control of this motion are described. The simulation of organic haze production on Titan has been selected as an example experiment for detailed study. The purpose of this experiment was to simulate the photolysis of methane and the subsequent formation of the organic haze particles in the Titan upper atmosphere.
Superconducting energy gap in Coulomb staircase tunneling structures

A sharp Coulomb staircase /ital I/-/ital V/ characteristic has been observed in tunneling structures formed between a tungsten scanning tunneling microscope (STM) tip and a superconducting lead film. The actual geometry is that of a single isolated particle acting as a common electrode in a series configuration of two low-capacitance tunneling junctions between the bulk of the lead film, the particle, and the STM tip. The voltage width of the step that crossed zero bias was larger than that of other steps in the staircase. This is due to the superconductivity of lead, and is consistent with theory.
Cryonic Life Extension: Scientific Possibility or Stupid Pipe Dream?

This chapter is concerned with cryonics and suspended animation. Like the previous chapter, it contributes substantially to the philosophical debate on where the line between life and death should be drawn. The ultimate aim of cryonics is to achieve nondestructive freezing (cryopreservation) of advanced organisms like humans so that they can be safely thawed in the future, usually with a view to obtaining advanced medical treatment not currently available. In this chapter number of scientific and philosophical questions presented by cryonics are discussed, such as whether cryonics is real science or simply a waste of money, the legal and moral status of cryonically suspended individuals, and how to deal with the possibility that the thawed individual might end up with some organs working but with severe neurological impairment.
Whisker-reinforced bioactive composites containing calcium phosphate cement fillers: effects of filler ratio and surface treatments on mechanical properties.

Calcium phosphate cement (CPC) sets to form microporous solid hydroxyapatite with excellent osteoconductivity, but its brittleness and low strength prohibit use in stress-bearing locations. The aim of this study was to incorporate prehardened CPC particles and ceramic whiskers in a resin matrix to improve the strength and fracture resistance, and to investigate the effects of key microstructural variables on composite mechanical properties. Two types of whiskers were used: silicon nitride, and silicon carbide. The whiskers were surface-treated by fusing with silica and by silanization. The CPC particle fillers were either silanized or not silanized. Seven mass ratios of whisker-silica/CPC were mixed: 0:1 (no whisker-silica), 1:5, 1:2, 1:1, 2:1, 5:1, and 1:0 (no CPC). Each powder was blended with a bisphenol-a-glycidyl methacrylate-based resin to harden in 2 × 2 × 25 mm molds by two-part chemical curing. The specimens were tested in three-point flexure to measure strength, work-of-fracture (toughness), and elastic modulus. Two-way analysis of variance was used to analyze the data, and scanning electron microscopy was used to examine specimen fracture surfaces. The whisker-silica/CPC ratio had significant effects on composite properties (p < 0.001). When this ratio was increased from 0:1 to 1:0, the strength was increased by about three times, work-of-fracture by five times, and modulus by two times. Whisker surface treatments and CPC filler silanization also had significant effects (p < 0.001) on composite properties. Scanning electron microscopy revealed rough fracture surfaces for the whisker composites with steps and whisker pullout. Resin remnants were observed on the surfaces of the pulled-out whiskers, indicating strong whisker-matrix bonding. In conclusion, incorporating highly osteoconductive CPC fillers and ceramic whiskers yielded composites with substantially improved mechanical properties compared with composites filled with CPC particles without whiskers. The composite properties were determined by whisker-to-CPC ratio and filler surface treatments. © 2001 John Wiley & Sons, Inc. J Biomed Mater Res 57: 165–174, 2001
The way ahead: learning cafés in the academic marketplace

Libraries, like the universities they serve, are faced with the daunting task of reconciling the traditional role as repository and provider of information with the increasing demands of a market‐driven society. Learning cafes can provide a place where these two divergent demands are potentially reconciled. By providing sophisticated technologies within a sociable environment, learning cafes seek to enhance the potential for interactive learning among its users. They have the potential to be hosts for an increasingly diverse array of emerging library services. Before incorporating a learning cafe within new or existing libraries, however, planners must keep in mind the types of learning best suited for this type of area and maintain a flexible design model so that the cafe can be adapted to future needs.
Why should the VA continue academic affiliations

Academic affiliations between VA medical centers and medical schools have made an important contribution to the healthcare of veterans and the education of physicians over the last 60 years. The rationale for these affiliations and their establishment following World War II is discussed. The circumstances leading to affiliations and the benefit they afford veterans remain pertinent today.
Relevance feedback for shape-based pathology in spine X-ray image retrieval

Relevance feedback (RF) has become an active research area in Content-based Image Retrieval (CBIR). RF attempts to bridge the gap between low-level image features and high-level human visual perception by analyzing and employing user feedback in an effort to refine the retrieval results to better reflect individual user preference. Need for overcoming this gap is more evident in medical image retrieval due to commonly found characteristics in medical images, viz., (1) images belonging to different pathological categories exhibit subtle differences, and (2) the subjective nature of images often elicits different opinions, even among experts. The National Library of Medicine maintains a collection of digitized spine X-rays from the second National Health and Nutrition Examination Survey (NHANES II). A pathology found frequently in these images is the Anterior Osteophyte (AO), which is of interest to researchers in bone morphometry and osteoarthritis. Since this pathology is manifested as deviation in shape, we have proposed the use of partial shape matching (PSM) methods for pathology-specific spinal X-ray image retrieval. Shape matching tends to suffer from the variability in the pathology expressed by the vertebral shape. This paper describes a novel weight-updating approach to RF. The algorithm was tested and evaluated on a subset of data selected from the image collection. The ground truth was established using Macnab's classification to determine pathology type and a grading system developed by us to express the pathology severity. Experimental results show nearly 20% overall improvement on retrieving the correct pathological category, from 69% without feedback to 88.75% with feedback.
Femoral-infrapopliteal bypass with prosthetic grafts.

Abstract Background: Patients who require prosthetic infrapopliteal of the lower extremity have historically had dismal long-term results. This study examined the outcome of patients undergoing femoral-distal arterial bypass with expanded polytetrafluoroethylene (ePTFE) grafts. Methods: Femoral to infrapopliteal artery bypasses with ePTFE performed between 1990 and 1997 were reviewed. Graft patency, limb salvage, and survival rates were calculated by actuarial analysis. Different anastomotic adjuncts (direct end-to-side anastomosis, vein patch anastomosis, and arteriovenous fistula [AVF] anastomosis) were compared with the log-rank test. Results: Seventy-four femoral-infrapopliteal bypasses with ePTFE were performed in 67 patients for limb salvage. At 24 months the primary patency, assisted primary patency, and secondary patency rates were 40% ± 10% (SEM), 48% ± 11%, and 52% ± 11%, respectively. Limb salvage was successful in 62% ± 10% of the bypasses at 24 months. Forty-six percent of the bypasses were performed with an AVF; 35% were performed with direct end-to-side anastomosis, and 19% were performed with a vein patch anastomosis. Apparent trends in favor of the AVF group did not attain statistical significance with 24-month patency rates of 65% ± 19%, 44% ± 16%, and 35% ± 20%, respectively, in the 3 subgroups. Limb salvage rates were similar (64% ± 17%, 56% ± 15%, and 76% ± 22%, respectively) at 24 months. Conclusions: Patency and limb salvage rates are sufficient to justify the use of ePTFE grafts in infrapopliteal bypass when adequate autogenous material is unavailable. (Surgery 1999;126:759-65.)
Small-duct primary sclerosing cholangitis: A long-term follow-up study

Some patients with inflammatory bowel disease (IBD) have chronic cholestasis and hepatic histology compatible with primary sclerosing cholangitis (PSC) but normal findings on cholangiography. These patients with small-duct PSC have remained largely unstudied. Our aim was to determine the prevalence and long-term outcomes of patients with small-duct PSC. Eighteen patients with small-duct PSC (7 female and 11 male patients; mean age, 39.9 ± 15.3 years [range, 13-68 years]) seen over a 4-year period were matched blindly by age and sex to 36 patients with classic PSC and followed up for 32.5 years. Small-duct PSC represented 5.8% of patients (18 of 309) with sclerosing cholangitis. Subsequent endoscopic retrograde cholangiography (ERC) performed in 5 patients with small-duct PSC showed progression to typical PSC in 3 patients at 4, 5.5, and 21 years of follow-up. None of the patients with small-duct PSC but 4 of the patients with classic PSC developed hepatobiliary malignancy. There were 3 deaths (17%) or liver transplantations in patients with small-duct PSC (2 after progressing to classic PSC) and 15 (42%) in the classic PSC group. Survival free of liver transplantation was significantly greater in the small-duct than in the classic PSC group (P = .04). Compared with the general U.S. population, survival in patients with small-duct PSC was similar (P = .4) but significantly lower in patients with classic PSC (P < .001). In conclusion, small-duct PSC may represent an earlier stage of PSC associated with a significantly better long-term prognosis. Some patients, however, progress to classic PSC and/or end-stage liver disease with the consequent necessity of liver transplantation.
Bounds on the exponent of primitivity which depend on the spectrum and the minimal polynomial

Abstract Suppose A is an n × n nonnegative primitive matrix whose minimal polynomial has degree m . We conjecture that the well-known bound on the exponent of primitivity ( n − 1) 2 + 1, due to Wielandt, can be replaced by ( m − 1) 2 + 1. The only case for which we cannot prove the conjecture is when m ⩾ 5, the number of distinct eigenvalues of A is m − 1 or m , and the directed graph of A has no circuits of length shorter than m − 1, but at least one of its vertices lies on a circuit of length not shorter than m . We show that m ( m − 1) is always a bound on the exponent, this being an improvement on Wielandt's bound when m n . For the case in which A is also symmetric, the bound which we obtain is 2( m − 1). To obtain our results we prove a lemma which shows that for a (general) nonnegative matrix, the number of its distinct eigenvalues is an upper bound on the length of the shortest circuit in its directed graph.
Insignificance of activation pathway on myocardial oxygen consumption

Activation pathway per se is not a prime determinant of myocardial oxygen consumption, as indicated in studies in an isolated empty blood perfused dog heart, a preparation in which changes in end-diastolic volume and pressure are precluded.
Fast localized orthonormal virtual orbitals which depend smoothly on nuclear coordinates

We present here an algorithm for computing stable, well-defined localized orthonormal virtual orbitals which depend smoothly on nuclear coordinates. The algorithm is very fast, limited only by diagonalization of two matrices with dimension the size of the number of virtual orbitals. Furthermore, we require no more than quadratic (in the number of electrons) storage. The basic premise behind our algorithm is that one can decompose any given atomic-orbital (AO) vector space as a minimal basis space (which includes the occupied and valence virtual spaces) and a hard-virtual (HV) space (which includes everything else). The valence virtual space localizes easily with standard methods, while the hard-virtual space is constructed to be atom centered and automatically local. The orbitals presented here may be computed almost as quickly as projecting the AO basis onto the virtual space and are almost as local (according to orbital variance), while our orbitals are orthonormal (rather than redundant and nonorthogonal). We expect this algorithm to find use in local-correlation methods.
The effect of ascorbate and dihydroxyacetone on the 2,3-diphosphoglycerate and ATP levels of stored human red cells.

Fifty ml aliquots of blood were stored in modified CPD-adenine preservative solutions at pH 4.8, 5.6, and 7.0 containing either dihydroxyacetone alone, ascorbic acid alone, or a combination of both. Red blood cell ATP and 2,3-DPG determinations showed that the effect of dihydroxyacetone and ascorbic acid were synergistic at all pH levels, and that even at the lowest pH levels excellent 23-DPG maintenance was observed. A reciprocal relationship existed between 2,3-DPG and ATP maintenance. Studies in 500 ml units of blood containing both dihydroxyacetone and ascorbate gave similar results to those in 50 ml aliquots. There was excellent maintenance of 2,3-DPG levels throughout the 28-day storage period.
Cold acclimation-induced increase of systolic blood pressure in rats is associated with volume expansion

To investigate the mechanisms of cold-induced hypertension, the systolic blood pressure (SBP) and average daily water consumption were measured weekly in 6-month-old male Wistar rats; they were subsequently acclimated to thermoneutrality (26°C for 7 weeks), to cold temperature (6°C for 9 weeks), and then again reacclimated to 26°C for 5 weeks. Circulating plasma volume and whole blood viscosity were measured in subgroups of rats at the end of acclimation to 26°C after 2 days, after 1, 6, and 8 weeks of cold, and after 2 and 5 weeks of rewarming. The control values obtained at the end of thermoneutral period were: SBP = 130.8 ±18.6 mm Hg, plasma volume = 41.9 ± 4.64 mL/kg, whole body viscosity at shear rate of 22.5 per sec = 6.7 ± 0.48 cps, and daily water consumption = 42.25 ± 16.81 mL. After 48 h of cold exposure there was almost a 50% increase in plasma volume that persisted to a lesser degree throughout the whole period of cold exposure (P < .05). After 2 weeks of cold exposure the daily water consumption increased and SBP began to increase. After 6 weeks of cold exposure the SBP was 30 mm Hg above that of the control level (P < .001) and was accompanied by a 25% increase in whole blood viscosity (P < .05). At the end of 8 weeks of cold exposure the plasma volume was 56.8 ± 9.51 mL/kg and the whole blood viscosity was 8.0 ± 1.79 cps at the 22.5 per sec shear rate. During the 5 weeks of rewarming the elevation of SBP and increased whole blood viscosity persisted, whereas the increased daily water consumption and expanded plasma volume returned to normal. Therefore, the acclimation to cold is accompanied by the development of a volume-associated hypertension, which is sustained after rewarming without volume expansion.
ADAPTIVE RIEMANNIAN METRIC FOR ALL-ELECTRON CALCULATIONS

We present two techniques that make feasible the application of the adaptive Riemannian metric technique to all-electron local-density-functional calculations. The first overcomes both the real- (r=0) and Fourier- (G=0) space divergences of the nuclear Coulomb potential by computing the electron-ion energy as the smooth periodic electrostatic potential due to the electrons measured at the positions of the ions. The second overcomes the problem of slow convergence of the extreme metrics which the r=0 Coulomb divergence necessitates by giving an explicit prescription for a suitable metric for arbitrary ionic configurations. All-electron-diamond calculations then serve as a proving ground for these ideas and demonstrate the viability of adaptive Riemannian methods for bypassing the pseudopotential approximation in solid-state calculations.
New results from Bhabha scattering at 29 GeV

Abstract Results are reported on a high statistics study of Bhabha scattering at 29 GeV in the polar angle region, |cos θ | g v 2 = 0.03 ± 0.09 and g a 2 = 0.46±0.14. Limits on the QED-cutoff parameters are Λ + > 154 GeV and Λ - > 220 GeV. Lower limits on scale parameters of composite models are in the range 0.9–2.8 TeV. The partial width of a hypothetical spin-zero boson decaying to e + e − has an upper limit which varies from 6 to 57 MeV corresponding to a boson mass in the range 45–80 GeV/ c 2 .
Chest Physical Therapy for Patients in the Intensive Care Unit

Chest physical therapy is used in the intensive care unit (ICU) to minimize pulmonary secretion retention, to maximize oxygenation, and to reexpand atelectatic lung segments. This article reviews how chest physical therapy is used with patients who are critically ill. A brief historical review of the literature is presented. Chest physical therapy treatments applicable to patients in the ICU are discussed. Postural drainage, percussion, vibration, breathing exercises, cough stimulation techniques, and airway suctioning are described in detail, with current references. The importance of patient mobilization is emphasized. The advantages of chest physical therapy over therapeutic bronchoscopy also are discussed. Two patient examples are used to demonstrate the beneficial effects that may be obtained with chest physical therapy. Following the removal of retained secretions, arterial oxygenation and partial pressure of arterial oxygen/fraction of inspired oxygen concentration ratios improved, and atelectasis resolved without the negative hemodynamic side effects of therapeutic bronchoscopy. Physical therapists trained in the ICU can safely perform chest physical therapy with the majority of patients who are critically ill.
Effects of Acute Ethanol Doses or Dietary Phenobarbitol with Carbon Tetrachloride Exposure on Vitamin A Status of Rats

Hepatotoxins such as ethanol and CCl4 are known to adversely affect vitamin A metabolism, although the effects of acute exposure to these agents have received less evaluation. The purpose of this study was to determine the effects of vitamin A status after a series of acute ethanol doses or a series of CCl4 inhalation challenges with concurrent phenobarbital exposure in the diet of rats. The depressed hepatic vitamin A seen after one ethanol dose was not sustained after repeated dosings. However, the significantly increased urine and liver radiolabeled vitamin A recovery after three acute ethanol exposure periods suggests adaptive physiologic and metabolic changes after the initial dose. The results of repeated CCl4/phenobarbital dosings on vitamin A status paralleled, for the most part, the ethanol results. Thus, the initial acute exposure of hepatotoxic agents causes metabolic changes that are not fully sustained as the animal adapts to these challenges.
Evaluation of Microsatellite Instability and Immunohistochemistry for the Prediction of Germ-Line MSH2 and MLH1 Mutations in Hereditary Nonpolyposis Colon Cancer Families

Forty-eight hereditary nonpolyposis colorectal carcinoma (HNPCC) families for which a tumor sample was available were evaluated for the presence of germ-line mutations in MSH2 and MLH1, tumor microsatellite instability (MSI), and where possible, expression of MSH2 and MLH1 in tumors by immunohistochemistry. Fourteen of 48 of the families had a germ-line mutation in either MSH2 or MLH1 that could be detected by genomic DNA sequencing, and 28 of 48 of the families had MSI-H tumors. Four additional families showed loss of expression of MSH2, and one additional family showed loss of expression of MLH1 but did not have germ-line mutations in MSH2 or MLH1 that could be detected by DNA sequencing. MSI-H, as defined using the National Cancer Institute recommended five-microsatellite panel, had a 100% sensitivity for identifying samples having MSH2 or MLH1 mutations or loss of expression. In contrast, loss of MSH2 and MLH1 expression did not identify all samples having germ-line mutations in MSH2 or MLH1, because in five cases, a mutant protein product was expressed that could be detected by IHC. A combination of the Bethesda criteria for HNPCC and an MSI-H phenotype defined the smallest number of cases having all of the germ-line MSH2 and MLH1 mutations that could be detected by DNA sequencing.
Early origins of inflammation: microbial exposures in infancy predict lower levels of C-reactive protein in adulthood

Ecological factors are important determinants of the development and function of anti-pathogen defences. Inflammation is a central part of innate immunity, but the developmental factors that shape ...
Women’s injection drug practices in their own words: a qualitative study

There are significant gender differences in injection drug practices and relative risks involved for women who inject drug compared with men. This qualitative study aims to explore the social, contextual, and behavioral dimensions of injecting practices among women who inject drugs. Participants were selected by purposive venue-based sampling from a syringe exchange program in 2012–2013. In-depth interviews were conducted with 26 women to elicit detailed perspectives regarding injection drug use practices and women-focused decision-making. All interviews were transcribed verbatim and analyzed with Atlas.ti. Participant’s mean age was 43.2 years, 48% Caucasian, 36% African American, and 16% Latina, poorly educated, mostly single, and heroin self-injectors. Three themes emerged; a) transitioning from non-injection to injection drug use; b) patterns and variations of initiation to injecting; and c) shifting toward autonomy or reliance on others. Women were predominantly influenced to transition to injection drug use by other women with their claims that injecting was a way to curtail their daily drug expenditure. More than half the women received their first injection from another woman in their social network rather than a male sexual partner. Self-injecting women exhibited agency around the circumstances of injection safety and potential risks. Other women revealed that their inability to inject themselves could and did make them dependent on others for unsafe injection practices. The finding that many women were influenced to transition to injection drug use and receive the first injection from a woman is contrary to literature claims that male sexual partners introduce and initiate women to injection drug use. Self-injecting women possessed capacity to act in a way that produced the results they wanted, not sharing prepared drugs or injecting equipment. In stark contrast, women assisted with injections could and did make them vulnerable to unsafe injecting. Findings support early prevention strategies that discourage women’s transition from non-injection to injection and development of female peer-driven experiential interventions to dispel myths for non-injection women and to increase personal capability to self-inject for women who require assistance with injecting, to reduce injection-related harm.
A Demonstration of Neural Programming Applied to Non-Markovian Problems

Genetic programming may be seen as a recent incarnation of a long-held goal in evolutionary computation: to develop actual computational devices through evolutionary search. Genetic programming is particularly attractive because of the generality of its application, but it has rarely been used in environments requiring iteration, recursion, or internal state. In this paper we investigate a version of genetic programming developed originally by Astro Teller called neural programming. Neural programming has a cyclic graph representation which lends itself naturally to implicit internal state and recurrence, but previously has been used primarily for problems which do not need these features. In this paper we show a successful application of neural programming to various partially observable Markov decision processes, originally developed for the learning classifier system community, and which require the use of internal state and iteration.
A developmental time line in a retinal slice from rainbow trout.

The retina in teleost fish continues to grow throughout much of the life of the animal, in part by the continuing differentiation of new tissue at the retinal margin, an area termed the peripheral growth zone (PGZ) (Lyall, Q J Micros Sci, 1957;98:101‐110). We have developed a retinal slice preparation — including the PGZ — from juvenile rainbow trout (Onchorynchus mykiss) ,a species in which retinal growth is rapid and the PGZ is correspondingly pronounced. The PGZ slice preparation contains a time line of retinal development, with cells at different stages of maturation present side by side. We present evidence that the birth sequence of the various retinal cell types in the PGZ recapitulates the sequence during embryonic development. We also report data on the rate of growth of the PGZ in juvenile trout in vivo. Finally, we have used the PGZ slice preparation to make whole-cell voltage clamp recordings from individual retinal GCs at both early and late stages of maturation. We report that the amplitude of delayed rectifier and A-type potassium currents increases during GC maturation. © 1999 Elsevier Science B.V. All rights reserved.
Information Policy, Data Mining, and National Security: False Positives and Unidentified Negatives

Since 9/11, intelligence agencies in the United States have expanded experimentation and use of data mining and analysis techniques to combat terrorism. These efforts have generated significant privacy concerns and discussions about the appropriate balance between civil liberties and technology-aided information integration. This paper argues that while privacy discussions are important, they should be framed within a discussion of the likely ability of data mining systems to meet their stated policy goals. If goal success is not assured, the decision calculus for balancing the use of data integration technology against concerns of privacy abuse will be significantly altered.