cssi/SciSciGPT-SciSciNet huggingface dataset:
Usefulness of the American College of Surgeons' Fundamentals of Surgery Curriculum as a knowledge preparatory tool for incoming surgery interns

BACKGROUND: The Fundamentals of Surgery Curriculum (FSC) is an interactive system that engages interns in case-based scenarios that involve identifying symptoms, ordering tests, and formulating treatment plans. In this study, we examined the usefulness of the FSC as a knowledge preparatory tool for incoming interns. METHODS: Twenty incoming interns participated in this study. Half were asked to complete 96 FSC cases before internship orientation (ie, the experimental group). The other half did not receive FSC accounts (ie, the control group). During orientation, all interns completed an examination that was representative of the FSC cases. Interns completed a survey to assess the usefulness of the FSC cases. American Board of Surgery In-Training Examination (ABSITE) scores were also examined. RESULTS: Interns in the experimental group completed an average of 71.1 cases before taking the examination and had higher median examination percent correct scores (P , .011). Interns rated the FSC cases as ‘‘extremely helpful.’’ There were no differences in terms of ABSITE percentile rank or the basic science and clinical management sections of the ABSITE. CONCLUSIONS: The FSC is a useful preparatory tool for interns when administered before starting internship; however, this benefit may not extend to the ABSITE.
Mg2+ facilitates leader peptide translation to induce riboswitch‐mediated transcription termination

We have characterized a 17-residue peptide, MgtL, which is translated specifically in high Mg2+ from an open reading frame (ORF) embedded in the Mg2+ riboswitch domain, previously identified in the 5′ leader region of Mg2+ transporter gene mgtA in Salmonella. We demonstrate that mgtL translation is required to prematurely terminate mgtA transcription. Abrogation of mgtL translation by mutation of its start codon results in transcription of the mgtA-coding region in high Mg2+, suggesting that ribosome stalling is not required for preventing premature transcription termination. Consistently, the Mg2+ riboswitch responds to cytoplasmic Mg2+, but not to proline or arginine, both repeatedly present in the MgtL sequence, to mediate mgtL translation-coupled regulation. RNA structural probing and nucleotide substitution analysis show that the riboswitch loop A region alters base pairing in response to Mg2+, and favours stem-loop A1 in high Mg2+, subsequently opening the ribosome-binding sequence for mgtL translation. Presumably, mgtL ORF directs translation to localize a ribosome in cis to act on downstream RNA in a manner similar to some upstream ORFs in prokaryotes and eukaryotes.
Stark–Heegner points on modular jacobians

Abstract We present a construction which lifts Darmon's Stark–Heegner points from elliptic curves to certain modular Jacobians. Let N be a positive integer and let p be a prime not dividing N. Our essential idea is to replace the modular symbol attached to an elliptic curve E of conductor Np with the universal modular symbol for Γ 0 ( N p ) . We then construct a certain torus T over Q p and lattice L ⊂ T , and prove that the quotient T / L is isogenous to the maximal toric quotient J 0 ( N p ) p - new of the Jacobian of X 0 ( N p ) . This theorem generalizes a conjecture of Mazur, Tate, and Teitelbaum on the p-adic periods of elliptic curves, which was proven by Greenberg and Stevens. As a by-product of our theorem, we obtain an efficient method of calculating the p-adic periods of J 0 ( N p ) p - new .
Efficacy and tolerability of glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes mellitus

Glucagon-like peptide-1 (GLP-1) has been evaluated for use in the treatment of type 2 diabetes mellitus (T2DM) due to its role in glucose regulation. Four GLP-1 receptor agonists (RAs) are currently indicated for T2DM in the USA. Exenatide and liraglutide are short-acting and require twice-daily and daily dosing, respectively. Two longer acting agents, exenatide long-acting release (LAR) and albiglutide, were formulated to allow for once-weekly dosing. All four GLP-1 RAs have demonstrated reductions in hemoglobin A1c, fasting blood glucose, and body weight both as monotherapy and in combination with first- and second-line diabetes agents including metformin, sulfonylureas, thiazolidinediones, and insulin. Greater glycemic control was seen with liraglutide compared with the other GLP-1 treatment options; however, the two long-acting agents were superior to exenatide twice daily. All agents were well tolerated with most adverse events being mild or moderate in nature. The most common adverse event was transient nausea which typically resolved 4–8 weeks after treatment initiation. Long-acting agents had lower rates of nausea but an increased incidence of injection site reactions. Trials have suggested GLP-1 RAs may improve cardiovascular risk factors including blood pressure, lipid parameters and inflammatory markers. Future trials are needed to confirm the clinical outcomes of these agents. Overall, GLP-1 RAs will provide benefit for patients with T2DM intolerable to or not reaching glycemic goals with first-line agents, especially in patients in need of weight loss.
ALLOXAN ADMINISTRATION IN THE GUINEA PIG: A STUDY OF THE HISTOLOGICAL CHANGES IN THE ISLANDS OF LANGERHANS, THE BLOOD SUGAR FLUCTUATIONS, AND CHANGES IN THE GLUCOSE TOLERANCE1

Since the discovery in 1943 by Dunn, Sheehan and McLetchie that the injection of the drug alloxan results in specific injury to the B cells in the islands of Langerhans of the rabbit, alloxan diabetes has been produced in several species of experimental animals: rabbits, rats, dogs, cats, mice and monkeys. Although there are both species and individual differences in the degree of the response to the administration of alloxan, the qualitative effect is constant. Histologically, there is a selective necrosis of the B cells of the islets of Langerhans, with either complete disappearance of these cells (dog) or their replacement by agranular cells (rat, rabbit, monkey). In either case, there is a resultant lack of insulin-producing tissue. The A cells apparently remain unharmed by the alloxan (Goldner and Gomori, 1943, 1944 c; Hard and Carr, 1944; Duffy, 1945; Ruben and Yardumian, 1945; Duff, 1947).
Skin pretreatment with microneedles prior to pilocarpine iontophoresis increases sweat production.

Collection of sweat via pilocarpine iontophoresis is commonly used to diagnose cystic fibrosis (CF), with thousands of tests performed each day. The main source of resistance to the passage of pilocarpine ions to the sweat glands is the electrical resistance of the stratum corneum. It was hypothesized that pretreating the skin with 0·5 mm-long microneedles would significantly decrease this resistance, thus increasing pilocarpine's permeation into the skin. Improved permeation should result in significantly reduced time to sweat initiation, time to collection of a clinically meaningful amount of sweat, and increased total amount of sweat produced in 15 min. Subjects (n = 12) had two 5 cm(2) areas on the forearm measured, marked and randomized to experimental (microneedles + iontophoresis) or control (iontophoresis alone). Microneedle pretreatment was conducted using a 35-needle microneedle stamp in a manner that 20 applications completely covered the 5 cm(2) treatment area. This was repeated five times for a total of 100 applications. Both experimental and control sites were placed under iontophoresis (1·5 mA) for 5 min. Microneedle pretreatment significantly decreased mean skin resistance (260 ± 27 kΩ versus 160 ± 19 kΩ, P = 0·006), while significantly increasing mean sweat rate (0·76 ± 0·35 versus 0·54 ± 0·19 μl cm(2) min(-1) , P = 0·007). No significant difference was found concerning pain (P = 0·059), number of active sweat glands (P = 0·627) or the osmolality of the collected sweat (P = 0·636). The results of this study suggest that microneedle pretreatment prior to pilocarpine iontophoresis significantly increases sweat production. Such results have the potential to improve the methodology currently used to diagnose cystic fibrosis and, more broadly, to administer drugs via the skin.
Inferred relatedness and heritability in malaria parasites

Malaria parasites vary in phenotypic traits of biomedical or biological interest such as growth rate, virulence, sex ratio and drug resistance, and there is considerable interest in identifying the...
Watchful eyes: implicit observability cues and voting

Abstract Explicit social pressure has been shown to be a powerful motivator of prosocial behavior like voting in elections. In this study, I replicate and extend the findings of a randomized field experiment designed to study the impact of more subtle, implicit social pressure treatments on voting. The results of the original experiment, conducted in the October 2011 municipal elections in Key West, Florida, demonstrated that even subtle, implicit observability cues, like a pair of stylized eyes facing subjects, effectively mobilized citizens to vote, by about as much as explicit surveillance cues. The replication study, conducted in Lexington, KY, during the November 2011 gubernatorial election, corroborates these findings and suggests that eyes effect on average does not likely depend on the gender of eyespots used. Taken together, the two field experiments provide strong support for the notion studies that humans are evolutionarily programmed to respond to certain stimuli and that exposure to images that implicitly signal observability is sufficient to stimulate prosocial behavior.
The Effect of Proton Irradiation on the Critical Current of Commercially Produced YBCO Conductors

Samples of YBCO superconductor from two manufacturers were irradiated with protons at the BLIP facility at BNL. Two specimens of each type of conductor were irradiated to five fluences covering the range from 1016 to 4 times1017 protons/cm2. The beam parameters for the irradiations were 42 muA and 142 MeV. The critical current (zero field, 1 muV/cm) for all twenty samples was measured in liquid nitrogen before and after irradiation to quantify the effects of high-dose proton-induced radiation damage on the performance of the conductor, and thus evaluate its suitability for service in high-radiation environments. All of the specimens had a pre-irradiation current of about 100 A. This current decreased linearly with fluence, with a slope of about 20% per 1017 protons/cm2. The agreement between the two samples of each brand of conductor was exceptional.
Foley balloon occlusion of the atheromatous ascending aorta: the role of transesophageal echocardiography.

CASE 1 A 76-year-old woman was referred for corona~y artery bypass grafting (CABG). Past medical history was s:Lgnificant for hypertension, paroxysmal atrial tachycardia, and smoking. Cardiac catheterization showed significant stenosis of the left anterior descending mad circumflex arteries, 3 + mitra[ regurgitation, 1 + aortic insufficiency, moderately decreased left ventricular function, and calcification of the ascending aorta. After uneventful anesthetic induction and endotracheal intubation, the thoracic aorta was evaluated by TEE and EAE. Severity of atheromatous disease was graded as described by Katz et al. 6 Patients with grades I and II had mild disease witia intimal thickening, patients with grade III had sessile atheroma 5 mm into the aortic lumen, and patients with grade V had a mobile component to protruding atheroma of any size. In the patient in case 1, TEE showed severe atheromatous disease of the aortic arch and descending thoracic aorta (grade IV). EAE showed a severely calcified ascending aorta (grade III) and aortic arch (grade III). The proximal 4 cm of the ascending aorta appeared disease-free by EAE, and was "soft" by digital palpation. A decision was made to minimally manipulate the aorta. The left common femoral artery and the right atrium were cannulated. After the initiation of CPB, an 18F Foley catheter was carefully placed into the ascending aorta just distal to the aortic valve and just proximal to the innominate artery. The balloon was inflated with 30 mL of saline; cardioplegia was administered through a needle placed in the proximal ascending aorta. Pressure in the aortic root was noted to be low. Two-dimensional TEE with Doppler reconfirmed the absence of significant aortic insufficiency, but showed inadequate aortic balloon occlusion. When an additional 10 mL of saline was added to the balloon, aortic root pressure increased, the leak resolved, and cardiac arrest was achieved (Fig 2). Reversed saphenous vein grafts were anastomosed end-to-side to the left anterior descending and ramus arteries. The left anterior descending vein graft was anastomosed to the ascending aorta at the cardioplegia needle Fig 1. Diagram of a Foley balloon catheter obstructing the ascending aorta.
Sequence and conformational effects on imino proton exchange in A.T- and A.U-containing DNA and RNA duplexes.

1H-nmr relaxation has been used to study the effect of sequence and conformation on imino proton exchange in adenine–thymine (A · T) and adenine–uracil (A · U) containing DNA and RNA duplexes. At low temperature, relaxation is caused by dipolar interactions between the imino and the adenine amino and AH2 protons, and at higher temperature, by exchange with the solvent protons. Although room temperature exchange rates vary between 3 and 12s−1, the exchange activation energies (Eα) are insensitive to changes in the duplex sequence (alternating vs homopolymer duplexes), the conformation (B-form DNA vs A-form RNA), and the identity of the pyrimidine base (thymine vs uracil). The average value of the activation energy for the five duplexes studied, poly[d(A-T)], poly[d(A) · d(T)], poly[d(A-U)], Poly[d(A) · d(U)], and poly[r(A) · r(U)], was 16.8 ± 1.3 kcal/mol. In addition, we find that the average Eα for the A.T base pairs in a 43-base-pair restriction fragment is 16.4 ± 1.0 kcal/mol. This result is to be contrasted with the observation that the Eα of cytosine-containing duplexes depends on the sequence, conformation, and substituent groups on the purine and pyrimidine bases. Taken together, the data indicate that there is a common low-energy pathway for the escape of the thymine (uracil) imino protons from the double helix. The absolute values of the exchange rates in the simple sequence polymers are typically 3–10 times faster than in DNAs containing both A · T and G · C base pairs.
Competency in Child Care Settings The Role of the Physical Environment

A rating scale is developed for preschool classrooms to assess the physical environment’s role in children’s development of cognitive and social competency. The scale is tested in 98 classrooms, and children are assessed on two measures of competency in a subsample of these classrooms. Findings indicate that the physical environment is related to measures of competency, one of which is a self-perception measure. Younger children’s competency, those in the 3-year-olds’ classrooms as opposed to the 4-year-olds’ classrooms, is most affected by the physical environment. Assessment of quality child care must include thorough assessment of the physical environment.
Continuous glucose monitoring: the experience of women with type 2 diabetes.

PurposeThe purpose of this descriptive study was to document the experience of wearing a continuous glucose monitoring (CGM) device in women with type 2 diabetes (T2DM). The availability of CGM has provided patients and clinicians with the opportunity to describe the immediate effects of diet, exercise, and medications on blood glucose levels; however, there are few data examining patients’ experiences and acceptability of using CGM.MethodsThirty-five women with T2DM wore a CGM for 3 days. Semistructured interviews were conducted to capture the self-described experience of wearing a CGM. Three open-ended questions were used to guide the participants’ self-reflection. Interviews were transcribed and analyzed.ResultsThe women verbalized both positive and negative aspects of needing to check their blood glucose more frequently and wearing the monitor. After viewing the results, most women were surprised by the magnitude and frequency of blood glucose excursions. They immediately examined their behaviors duri...
Assessing Jet-Induced Spatial Mixing in a Rich, Reacting Crossflow

In many advanced low NOx gas turbine combustion techniques, such as rich-burn/quick-mix/lean-burn (RQL), jet mixing in a reacting, hot, fuel-rich crossflow plays an important role in minimizing all pollutant emissions and maximizing combustion efficiency. Assessing the degree of mixing and predicting jet penetration is critical to the optimization of the jet injection design strategy. Different passive scalar quantities, including carbon, oxygen, and helium are compared to quantify mixing in an atmospheric RQL combustion rig under reacting conditions. The results show that the O2-based jet mixture fraction underpredicts the C-based mixture fraction due to jet dilution and combustion, whereas the He tracer overpredicts it possibly due to differences in density and diffusivity. The He-method also exhibits significant scatter in the mixture fraction data that can most likely be attributed to differences in gas density and turbulent diffusivity. The jet mixture fraction data were used to evaluate planar spatial unmixedness, which showed good agreement for all three scalars. This investigation suggests that, with further technique refinement, O2 or a He tracer could be used instead of C to determine the extent of reaction and mixing in an RQL combustor.
Lysine methylation: Beyond histones

Posttranslational modifications (PTMs) of histone proteins, such as acetylation, methylation, phosphorylation, and ubiquitylation, play essential roles in regulating chromatin dynamics. Combinations of different modifications on the histone proteins, termed 'histone code' in many cases, extend the information potential of the genetic code by regulating DNA at the epigenetic level. Many PTMs occur on non-histone proteins as well as histones, regulating protein-protein interactions, stability, localization, and/or enzymatic activities of proteins involved in diverse cellular processes. Although protein phosphorylation, ubiquitylation, and acetylation have been extensively studied, only a few proteins other than histones have been reported that can be modified by lysine methylation. This review summarizes the current progress on lysine methylation of non-histone proteins, and we propose that lysine methylation, like phosphorylation and acetylation, is a common PTM that regulates proteins in diverse cellular processes.
A Control-Theoretic Aid to Managing the Construction Phase in Incremental Software Development (Extended Abstract)

We propose to adapt the techniques of state-modeling and feedback control from the discipline of control engineering to the tasks of software process modeling and software process control as they appear in software engineering. The scope of our investigation is focused on the construction phase (as per the rational unified process) as it occurs in industrial incremental software development
Electron Irradiation of Gold Below 2 K

Gold (99.9999% purity) was irradiated by 2.5-MeV electrons below 2 K. Damage production was monitored by measuring the dc resistivity of the gold. The production rate $\frac{d\ensuremath{\rho}}{d\ensuremath{\Phi}}$ (change in resistivity per integrated electron flux) was found to (a) be enhanced by the presence of quenched vacancies at extremely low values of integrated flux, (b) be attenuated by the presence of quenched vacancies at higher values of integrated flux, (c) decrease with increasing $\ensuremath{\Phi}$ particularly at the lowest values of $\ensuremath{\Phi}$, and (d) increase with increasing $\frac{d\ensuremath{\Phi}}{\mathrm{dt}}$ (beam flux). Thermal recovery of resistivity was observed as low as 2.3 K. The recovery in the range 2.3-30 K was found to (a) be enhanced by the presence of quenched vacancies, (b) be attenuated by the presence of silver impurities, and (c) increase with increasing $\ensuremath{\Phi}$. These observations are consistent with the hypothesis that the interstitial in gold undergoes long-range migration either during electron irradiation at 1.7 K or during annealing at 1.95 K.
Relation of pace mapping QRS configuration and conduction delay to ventricular tachycardia reentry circuits in human infarct scars.

Abstract Objectives . This study sought to determine the relation of the paced QRS configuration and conduction delay during pace mapping to reentry circuit sites in patients with ventricular tachycardia late after myocardial infarction. Background . The QRS configuration produced by ventricular pacing during sinus rhythm (pace mapping) can locate focal idiopathic ventricular tachycardias during catheter mapping, but postinfarction reentry circuits may be relatively large and contain regions of slow conduction. We hypothesized that for postinfarction ventricular tachycardia, 1) pacing during sinus rhythm at reentry circuit sites distant from the exit from the scar would produce a QRS configuration different from the tachycardia; and 2) a stimulus to QRS delay during pace mapping may be a useful guide to reentry circuit slow conduction zones. Methods . Catheter mapping and ablation were performed in 18 consecutive patients with ventricular tachycardia after myocardial infarction. At 85 endocardial sites in 13 patients, 12-lead electrocardiograms (ECGs) were recorded during pace mapping, and participation of each site in a reentry circuit was then evaluated by entrainment techniques during induced ventricular tachycardia or by application of radiofrequency current. Results . Pace maps resembled tachycardia at 40 ms was observed at ≥70% of reentry circuit sites. Conclusions . At many sites in postinfarction ventricular reentry circuits, the QRS configuration during pace mapping does not resemble the ventricular tachycardia QRS complex, consistent with relatively large reentry circuits or regions of functional conduction block during ventricular tachycardia. A stimulus to QRS delay during pace mapping is consistent with slow conduction and may aid in targeting endocardial sites for further evaluation during tachycardia.
Domestic and International Integration of the London Money Market, 1731–1789

The purpose of this study is to provide a quantitatively-based description of the main trends in the domestic structure and international position of the London money market during the eighteenth century. Using monthly data for the years 1731 to 1789, the findings supported the general hypothesis of the existence of a trend toward increased association between the money markets during the course of the century, but at the same time indicated variation in the inter-market relationships between sub-periods.
Applications of Behavior to Poultry Management

Abstract The application of poultry behavior to management is discussed with examples of behavior-management interactions relating to commercial poultry husbandry practices. Behaviors that are important for the adaptation of poultry to husbandry include: social behavior, aggression, sexual behavior, feeding, broodiness, cannibalism, nest site selection, and comfort behaviors.
Ultrawideband noise radar tomography: Principles, simulation, and experimental validation

The paper introduces the principles, simulation results, and hardware implementation of ultrawideband (UWB) noise radar for obtaining tomographic images of various scenarios of rotating cylindrical objects using independent and identically distributed UWB noise waveforms. A UWB noise radar was designed to transmit multiple UWB random noise waveforms over the 3–5 GHz frequency range and to measure the backward scattering data for the validation of the theoretical analysis and numerical simulation results. The reconstructed tomographic images of the rotating cylindrical objects based on experimental results are seen to be in good agreement with the simulation results, which demonstrates the capability of UWB noise radar for complete two-dimensional tomographic image reconstruction of various shaped metallic and dielectric target objects.
Nest-defense behavior in the red-winged blackbird

We examined various aspects of nest-defense behavior in marsh-nesting Redwinged Blackbirds (Agelaius phoeniceus) in Madison, Wisconsin. Blackbirds used seven types of calls in nest defense. The female scream elicited the strongest response of any call type; attracting more birds, and eliciting the highest rate of hovers. Additionally, the scream caused begging nestlings to stop begging and crouch low in the nest. Female blackbirds had higher call rates to predator models than did male blackbirds; however, males were the more aggressive sex in defense of the nest. Although there were no differences in call rates to different predator models, there were differences in more overt nest-defense behavior. The ability to drive off a predator best explained the variation in aggressiveness to the predator models. Male blackbirds, when faced with a choice, defended nests of primary females more aggressively than nests of secondary females; the differences were due to neither the nests' contents nor to the stage of the nests. Call rates, but not rates of dives and strikes, were correlated with successful nests. Finally, the most aggressive males had the largest harems.
Progress in optimization of transition metal cation chromatography and its application to analysis of silicon

Abstract Methods are reported which yield sensitive semi-quantitative analysis of transition metal contaminants on silicon wafers. An effective extracting solution is proposed with compatible concentration and two eluent (column and post-column) chemistry combinations to measure ppt (1012) concentrations and surface densities extending into the 1010 atoms per cm2 range. Possible applications include numerous steps in wafer and integrated circuit manufacture as well as other solid-surface analysis.
Registration of Temperate Quality Protein Maize (QPM) Lines BQPM9, BQPM10, BQPM11, BQPM12, BQPM13, BQPM14, BQPM15, BQPM16, and BQPM17

The discovery of the opaque2 (o2) mutation and o2 modifier genes in maize (Zea mays L.) has resulted in the development of Quality Protein Maize (QPM) lines with increased lysine and tryptophan content. The QPM lines BQPM9 (Reg. No. GP-584, PI 671795), BQPM10 (Reg. No. GP-585, PI 671796), BQPM11 (Reg. No. GP-586, PI 671797), BQPM12 (Reg. No. GP587, PI 671798), BQPM13 (Reg. No. GP-588, PI 671799), BQPM14 (Reg. No. GP-589, PI 671800), BQPM15 (Reg. No. GP-592, PI 673348), BQPM16 (Reg. No. GP-590, PI 671801), and BQPM17 (Reg. No. GP-591, PI 671802) were developed jointly by Iowa State University and the USDA-ARS to address the lack of QPM lines adapted to the US Corn Belt. These lines originated from crosses made between two QPM lines from the International Maize and Wheat Improvement Center (CIMMYT) (CLQ06901 and CLRQ00502) and six inbred lines released by Iowa State University (B91, B97, B98, B99, B100, and B113). Increased lysine and tryptophan content, characteristics associated with the presence of the o2 mutation, and agronomic performance were used as selection criteria in the development of the nine BQPM lines released herein.
Theoretical and Experimental Single-Phonon Data

From the dynamical matrix constructed according to the arguments in Section 5 we can calculate the normal-mode eigen-frequencies and also the eigenvectors; that is, the eigenvalues and eigenvectors of the matrix given by Eqs. (2.9) and (5.20). We employ periodic boundary conditions, which means that we are restricting ourselves to a crystal supercell whose symmetry is the same as that of the primitive unit cell, but whose sides are some many powers of 10 larger than those of the primitive unit cell. We impose periodic boundary conditions to the surfaces of the supercell. In practice, the calculations are done numerically by computer, which requires that we restrict ourselves to a finite sample of wave vectors. We thus have t odecide how fine this sample has to be before the frequency distribution; that is, the function $$N\left( \Omega \right) = \mathop {\lim }\limits_{\mathop {\Delta \Omega \to 0}\limits_{N \to \infty } } {\left( {6N\Delta \Omega } \right)^{ - 1}}\mathop \Sigma \limits_{qi} \int_\Omega ^{\Omega + \Delta \Omega } \delta \left[ {\Omega ' - \omega \left( {_i^q} \right)} \right]d\Omega $$ (7.1) is an adequate representation of the true distribution function for an infinite crystal, since the enchancement of the sample density is equivalent to treatiing a larger and larger supercell [note that ≀ 0 ∞ N(Ω)dΩ = 1].
Multiples in Core Biopsy Samples

This chapter is intended to provide practical instruction in further assessing core biopsy material in occasionally encountered but important diagnostic scenarios. Further evaluating cases with inherent pitfalls including those with seemingly nondiagnostic findings, instances of excluding concomitant microinvasive carcinoma, and recognizing tangential sections that mimic atypical epithelial proliferations will be discussed. Attention will also be drawn to examples of core biopsies containing multiple diagnoses as well as the use of multiplex immunohistochemistry in these specimens.
Closest Substring Problem - Results from an Evolutionary Algorithm

The closest substring problem is a formal description of how to find a pattern such that from a given set of strings a subregion of each string is highly similar to that pattern. This problem appears frequently in computational biology and in coding theory. Experimental results suggest that this NP-hard optimization problem can be approached very well with a custom-built evolutionary algorithm using a fixed-length string representation, as in the typical genetic algorithm (GA) concept. Part of this success can be attributed to a novel mutation operator introduced in this paper. For practical purposes, the GA used here seems to be an improvement compared to traditional approximation algorithms. While the time complexity of traditional approximation algorithms can be analyzed precisely, they suffer from poor run-time efficiency or poor accuracy, or both.
Error tolerant DNA self-assembly by link-fracturing

This paper proposes and evaluates link fracturing as an approach for error tolerance in self-assembly by utilizing a DNA chain as a link between two blocks of molecules. Through the use of restriction enzymes, link fracturing breaks the connecting DNA chain between two blocks if an incorrect assembly has occurred due to the erroneous growth of tiles. Two error tolerant techniques are proposed by fracturing of the DNA chain links, namely 1-link and 2-link. Using the tool Xgrow, simulations under the Kinetic Tile Assembly Model (KTAM) are performed. Results show that 2-link fracturing achieves an improvement in error rate as compared to a normal assembly; moreover this is accomplished with little overhead in assembly size and execution complexity. The 1-link method shows 100% error free growth with moderate overhead as compared to normal growth and other existing error tolerant methods.
Reconciling Systems for Acute Myocardial Infarction Definition and Coding Classification

According to the Third Universal Definition of Myocardial Infarction (3rd UDMI),2 a consensus document from the European Society of Cardiology/American College of Cardiology Foundation/American Heart Association/World Heart Federation, the term “acute myocardial infarction” can be used when there is “evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia” (1). Although the 3rd UDMI document specified 5 categories, or “types,” of acute myocardial infarction, the categories most relevant in general practice are “Type 1” (acute myocardial infarction resulting from coronary artery plaque rupture with thrombosis) and “Type 2” (acute myocardial infarction resulting from a mismatch of myocardial oxygen supply and demand). For both Type 1 and Type 2 acute myocardial infarction, there must be a characteristic rise and/or fall in levels of biomarkers of myocardial necrosis (cardiac troponin preferred), and at least 1 value must be above the 99th percentile for the assay used. Further, biomarker evidence of acute myocardial infarction must be associated with at least one of the following: symptoms of acute coronary ischemia, new or presumed new ST-segment changes or left bundle branch block acutely on the electrocardiogram, development of new pathologic Q waves on serial electrocardiograms obtained after presentation, new regional wall motion abnormalities or loss of viable myocardium by cardiac imaging studies, or presence of coronary thrombus at angiography or autopsy. For regions of the world that have no resource constraints, including the US, the WHO has adopted the key principles of the UDMI (2). Although the WHO owns and publishes the International Classification of Diseases (ICD) coding system, it has not incorporated specific codes for the system of acute myocardial infarction types identified in the 3rd UDMI. The adoption of the 3rd UDMI in clinical practice has been met with some confusion and uncertainty among clinicians and coders alike particularly …
Allene Oxide Biosynthesis and Metabolism

Allene oxides are reactive epoxides with a versatile chemistry.1 The name allene oxide comes from the chemical literature — the first chemical syntheses of this type of epoxide involved the oxidation of an allene, Figure 1. In biochemical systems, allene oxides are synthesized by the enzymic dehydration of hydroperoxides (lipoxygenase products), (Figure 1). Allene oxides are extremely unstable and are prone to hydrolysis and unique intramolecular rearrangements.2 While these reactions can occur in the absence of an enzymic catalyst, the naturally occurring allene oxides are substrates for enzymatic/metabolic transformations to end-products that are thought to include prostaglandins or prostaglandin-like molecules,3–5 Fig. 2.
A Proposal to Redefine Close Surgical Margins in Squamous Cell Carcinoma of the Oral Tongue.

Importance Resection of the primary tumor with negative margins is the gold standard treatment for squamous cell carcinoma of the oral tongue (SCCOT). A microscopically positive surgical margin is clearly associated with a higher risk for local recurrence, whereas a negative margin has traditionally been defined as greater than 5.0 mm clearance from the tumor, with lesser margins arbitrarily designated as close. The precise cutoff at which the risk for local recurrence with a close margin approximates that of a microscopically positive margin remains unclear. Objective To determine whether the arbitrarily defined close margin ( Design, Setting, and Participants In this retrospective study, head and neck pathologists reviewed archived tumor specimens from 381 patients with SCCOT who underwent primary surgical resection at a tertiary care center from January 1, 2000, through December 31, 2012. Data were analyzed from November 15, 2015, to January 5, 2016. Time-dependent receiver operating characteristic curve analysis was used in patients who did not have a microscopically positive margin to determine an optimal margin cutoff for local recurrence-free survival (LRFS). Pathologic factors were assessed for LRFS in a multivariate Cox proportional hazards regression model. Main Outcomes and Measures The primary end point was evaluation of the margin distance associated with LRFS. Results Among the 381 patients included in the analysis (222 men [58.3%] and 159 women [41.7%]; mean [SD] age, 58 [14.7] years), the optimal cutoff associated with LRFS was determined to be 2.2 mm. This cutoff was compared with the traditionally accepted cutoff of 5.0 mm. Patients with a margin of 2.3 to 5.0 mm had similar LRFS as patients with a margin of greater than 5.0 mm (hazard ratio [HR], 1.31; 95% CI, 0.58-2.96), and all other comparisons were significantly different (HR for positive margin, 9.03; 95% CI, 3.45-23.67; HR for 0.01- to 2.2-mm margin, 2.83; 95% CI, 1.32-6.07). Based on this result, negative margins were redefined as those with a clearance of greater than 2.2 mm. In a multivariate model adjusting for pathologic factors, positive margins (adjusted HR, 5.73; 95% CI, 2.45-13.41) and margins of 0.01 to 2.2 mm (adjusted HR, 2.00; 95% CI, 1.13-3.55) were the variables most significantly associated with LRFS. Conclusions and Relevance In this study, local recurrence-free survival was significantly affected only with surgical margins of less than or equal to 2.2 mm in patients with SCCOT. This new definition of close margins stratifies the risk for local recurrence better than the arbitrary 5.0-mm cutoff that has been used.
Dementia beyond disease: Enhancing well-being (Revised edition), by G. Allen Power

Dementia beyond disease: Enhancing well-being, Revised edition, explores how to improve the lives of people with dementia and those who care for them. Internationally acknowledged author G. Allen P...
Medicaid insurance as primary payer predicts increased mortality after total hip replacement in the state inpatient databases of California, Florida and New York

Abstract Study objective To confirm the relationship between primary payer status as a predictor of increased perioperative risks and post-operative outcomes after total hip replacements. Design Retrospective cohort study. Setting Administrative database study using 2007–2011 data from California, Florida, and New York from the State Inpatient Databases (SID), Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. Patients 295,572 patients age≥18years old who underwent total hip replacement with non-missing insurance data were collected, using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnoses and procedures code (ICD-9-CM code 81.51). Interventions Patients underwent total hip replacement. Measurements Patients were cohorted by insurance type as either Medicare, Medicaid, Uninsured, Other, and Private Insurance. Demographic characteristics and comorbidities were compared. Unadjusted rates of in-hospital mortality, postoperative complications, LOS, 30-day, and 90-day readmission status were compared. Adjusted odds ratios were calculated for our outcomes using multivariate linear and logistic regression models fitted to our data. Main results Medicaid patients incurred a 125% increase in the odds of in-hospital mortality compared to those with Private Insurance (OR 2.25, 99% CI 1.01–5.01). Medicaid payer status was associated with the highest statistically significant adjusted odds of mortality, any complication (OR, 1.26), cardiovascular complications (OR, 1.37), and infectious complications (OR, 1.66) when compared with Private Insurance. Medicaid patients had the highest statistically significant adjusted odds of 30-day (OR, 1.63) and 90-day readmission (OR, 1.58) and the longest adjusted LOS. Conclusions We found higher unadjusted rates and risk adjusted odds ratios of postoperative mortality, morbidity, LOS, and readmissions for patients with Medicaid insurance as compared to patients with Private Insurance. Our study shows that primary payer status serves as a predictor of perioperative risks and that primary payer status should be viewed as a peri-operative risk factor.
Physical Intimate Partner Violence and Contraceptive Behaviors Among Young Women.

Abstract Background: Understanding the link between physical intimate partner violence (IPV) and contraception is key to preventing unintended pregnancy and sexually transmitted infections. Materials and Methods: Data from the Relationship Dynamics and Social Life study, a longitudinal study of a racially and socioeconomically diverse population-representative random sample of 18- to 19-year-old women residing in a Michigan county in 2008–2009 and followed weekly through 2011–2012, were used. Logistic regression models of contraceptive behaviors on temporally specific measures of physical violence victimization: recent, history in the current relationship, and history in prior relationships were conducted among 711 women. Results: Women who experienced physical IPV in their current relationship had lower odds of using contraception (odds ratio [OR], 0.47; 95% confidence interval [CI], 0.28, 0.76 for recent; OR, 0.53; 95% CI, 0.33, 0.83 for past). Condom use was lower among women who experienced past physi...
Does Fiat-to-Bitcoin Exchange Activity Lead to Increased User-to-User Bitcoin Transaction Activity?

I exploit the "perfect ledger" feature of Bitcoin to find the degree to which Bitcoin-to-fiat exchange activity is associated with increased user-to-user transactions on the Bitcoin network with two distinct but complementary methodologies. First, I use an instrumental variable strategy to estimate the elasticity of user-to-user Bitcoin transaction activity with respect to fiat-to-Bitcoin exchange activity. Secondly, I use vector autoregression to determine the dynamic effects of fiat-to-Bitcoin exchange innovations in user-to-user Bitcoin transactions. In both approaches I find strong evidence of speculative hoarding of Bitcoin via the weak transmission of fiat-to-Bitcoin exchange activity to user-to-user Bitcoin network transactions.
An optimization approach for team coordination through information sharing

Team coordination and information sharing are important in concurrent engineering (CE), where multiple design teams execute their tasks simultaneously and then share information to update their designs, e.g., through integrated tests. The process then iterates until the global design objective is optimized. When properly controlled and executed, CE can be an effective method to speed up the design process for complex and large-scale projects thanks to its parallel nature. Recently, a coordinate optimization framework is proposed in [1] to model and control the information sharing in CE. It can be shown that under a convexity assumption, CE converges to a globally optimal design. In this paper, we study how the coordinate optimization framework can be applied to CE in a general environment where the objective function is non-convex. We propose a simulation optimization method using a domain space cutting and optimal computing budget allocation to efficiently select the initial points from which the coordinate optimization can be applied under a mild local convexity condition. The proposed approach has broad potentials in decentralized control and optimization of complex and large-scale systems in automation. Numerical experiments show that the optimal selection of the initial points allow coordination optimization to efficiently find the global optimum.
Duration of Spontaneous Active Labor and Perinatal Outcomes Using Contemporary Labor Curves.

Objective Evaluate the association between spontaneous active labor duration utilizing contemporary labor curves and risk of adverse outcomes. Materials and Methods This is a retrospective cohort study from January 2012 to January 2015. Subjects were nulliparous, 18 to 44 years, with a cephalic, singleton ≥37 weeks in spontaneous labor. Subjects were placed into three subgroups, defined by active labor duration from 6 to 10 cm as less than the median, the median-95th, and >95th percentile based on contemporary labor curves published by Zhang et al. We evaluated the association between subgroups and cesarean delivery, chorioamnionitis, estimated blood loss, Apgar score Results Six-hundred forty two women met the inclusion criteria. Compared with women whose active labor was less than the median, the risk of cesarean was higher in the median-95th percentile ([adjusted OR, aOR] 3.1, 95% CI 1.8–5.5) and the >95th percentile ([aOR] 6.8, 95% CI 3.9–11.7) subgroups. There was an increased odds of chorioamnionitis in the median-95th percentile subgroup ([aOR] 2.5, 95% CI 1.1–5.9). Conclusion Chorioamnionitis and cesarean delivery increased significantly as labor duration exceeded the median. This study provides a better understanding regarding the potential risk of cesarean and chorioamnionitis using contemporary labor curves.
A virtual training system based on computer sensing and football kicking dynamics using real-time wireless feedback

Most football simulators available use computer simulation to mimic football motion in a virtual environment. These kinds of simulations, while fun and interactive, are primarily for entertainment rather than as a training tool. In this paper, we present a virtual training system for football kicking based on computer sensing and football impact dynamics using real-time wireless feedback. It is designed as a computer-assisted training system that will give a kicker the ability to practice off the field and receive the detailed feedback comparable yet more quantitative than they would experience at a training camp. In addition, it enables football coaches with quantitative data to design player-specific training program for kickers in order to achieve a goal with more precision. The system includes a force-sensing panel to determine the position and velocity as initial data, real-time wireless feedback to calibrate the football kicking dynamics model, and an advanced visualization environment designed to recreate the realistic atmosphere of all major football stadiums. The system has been designed and tested in a lab environment. The preliminary results show that the wireless signal is sensitive enough to detect football positions on the fly. The data collected in real-time can be used to calibrate the football dynamics model in predicting the final position of the football with respect to the field goal, which is visualized using 3D stereoscopic technology.
Recently Infiltrating MAC387+ Monocytes/Macrophages: A Third Macrophage Population Involved in SIV and HIV Encephalitic Lesion Formation

Monocytes/macrophages are critical components of HIV and SIV encephalitic lesions. We used in vivo BrdU labeling and markers specific to stages of macrophage differentiation or inflammation to define macrophage heterogeneity and to better define the role of macrophage populations in lesion formation and productive infection. Lesions were heterogeneously composed of resident macrophages (CD68 + HAM56 + ), perivascular macrophages (CD163 + CD68 + MAC387 − ), and recently infiltrated MAC387 + CD68 − CD163 − monocytes/macrophages. At 24 and 48 hours after BrdU inoculation, 30% of MAC387 + monocytes/macrophages were BrdU + , consistent with their being recently infiltrated. In perivascular cuffs with low-level SIV replication, MAC387 + monocytes/macrophages outnumbered CD68 + macrophages. Conversely, lesions with numerous SIV-p28 + macrophages and multinucleated giant cells had fewer MAC387 + monocytes/macrophages. The MAC387 + cells were not productively infected nor did they express detectable CCR2, unlike perivascular macrophages. Overall, we found that the proportion of MAC387 + cells tends to be higher than the proportion of CD68 + macrophages in the brain of animals with mild encephalitis; the ratio was reversed with more severe encephalitis. These results suggest that development of SIV and HIV encephalitis is an active and ongoing process that involves the recruitment and accumulation of: i) nonproductively infected MAC387 + monocytes/macrophages that are present with inflammation (potentially M1-like macrophages), ii) CD163 + perivascular macrophages (consistent with M2-like macrophages), and iii) CD68 + or HAM56 + resident macrophages. The latter two populations are cellular reservoirs for productive infection.