cssi/SciSciGPT-SciSciNet huggingface dataset:
Perspectives on a contingency management intervention for alcohol use among consumers with serious mental illness.

Objective This study describes the perspectives of outpatients with serious mental illness (SMI) and alcohol dependence on their participation in a contingency management (CM) intervention for alcohol use. Methods Thirty-five adults with SMI and alcohol dependence participated in a randomized trial of CM for alcohol use, where they were rewarded with prizes contingent on abstinence from alcohol. All participants were interviewed regarding their participation in CM with a consistent structure that included nine open-ended questions. Favored and disliked aspects of CM, perception of alcohol biomarker accuracy, and interest in participating in similar CM interventions provided by treatment centers, rather than researchers, were explored. Results Participants spoke enthusiastically about receiving prizes, as well as how CM increased their awareness of drinking and helped support their abstinence from alcohol. Most participants felt the ethyl glucuronide biomarker urine tests used to measure alcohol use were accurate, and they were interested in enrolling in CM if it was offered as a clinical program. Research staff who implemented the intervention were well regarded by participants, and interactions with research staff were perceived positively. Conclusions and implications for practice Adults with SMI and alcohol dependence participating in a trial of CM for alcohol use reported overall positive perceptions of and experiences with CM. Receiving small tangible prizes and having positive interpersonal interactions with study staff were reported as especially impactful. These findings indicate that CM is well received by consumers, in addition to its empirical and practical benefits as an evidence-based, low-cost intervention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Management and clinical outcomes after lung transplantation in patients with pre-transplant Mycobacterium abscessus infection: A single center experience.

BACKGROUND Preoperative Mycobacterium abscessus infection is often considered a contraindication to lung transplantation because of its association with poor outcomes after transplant. Detailed strategies for bridging to transplant, post-operative management, and data regarding outcomes are lacking. METHODS We reviewed outcomes in subjects with M abscessus infection who underwent lung transplantation between 2010 and 2018 at the University of California San Francisco. M abscessus infection was defined by American Thoracic Society (ATS) criteria. Data collected included age, FEV1 , BMI, LAS, antibiotic regimens, and other management decisions. Time to chronic lung allograft dysfunction (CLAD) and survival were also assessed. RESULTS Of 387 lung transplant recipients, seven were infected with M abscessus at the time of listing. All received multiple antibiotics before transplant. While all subjects converted to smear negative for acid-fast bacilli before listing, five of the seven remained culture-positive at the time of transplant. After transplant, subjects received a median of 6 months of a multi-antibiotic regimen. One subject developed a post-operative M abscessus soft tissue infection that was treated medically. Six of the seven subjects survived the observation period; one died unrelated to M abscessus. Time to CLAD and survival were similar to a contemporary comparator group of CF transplant recipients. CONCLUSION Lung transplant recipients with M abscessus infection have a low incidence of recurrent infection, excellent survival, and freedom from CLAD when an aggressive management and surveillance strategy is utilized. Given these findings, M abscessus infection may not be considered a contraindication to lung transplantation.
17 AN EXTREME EXAMPLE OF DISCORDANT TWINS.

Objective Remind pediatricians of the differential diagnosis of discordant twins. Case A 21-year-old primigravid woman with EGA of 32 weeks by LMP with minimal prenatal care presented with preterm labor fully dilated. Ultrasonography revealed a twin gestation with size discordance and absent fetal heart tones in twin A. Prenatal laboratory tests were unavailable. The twins were delivered by emergent cesarean section, with twin A having Apgar scores of 0, 2, and 6 at 1, 5, and 10 minutes and twin B having Apgar scores of 4, 7, and 9. Physical examination of twin A revealed a 530 g girl with lens vascularization and neurologic evaluation consistent with a less than 28-week gestation and hematocrit of 44.7. Twin B was a 1,570 g girl with lens vascularization, neurologic evaluation, and other parameters consistent with a 32-week gestation and a hematocrit of 38.3. No congenital anomalies were found. The placenta was noted to be dichorionic, diamnionic, late second-trimester twin placenta with a two-vessel cord with a single umbilical artery for twin A and an eccentrically inserted three-vessel cord for twin B. No evidence of chorioamnionitis, funisittis, or villitis was found. Twin A had a complicated hospital course that included the need for HFOV, the development of NEC, hyperbilirubinemia, pulmonary HTN, AOP, and ROP but survived after almost 3 months in the NICU. Twin B required only initial ventilatory support and treatment with indomethacin for a PDA but otherwise had an uneventful 3-week hospital course. The mother denied any use of illicit drugs or alcohol but did admit to tobacco use. Maternal hypertension and DM were not evident at admission. Discussion This case demonstrates extreme twin discordance due to idiopathic IUGR in twin A. Birth discordance occurs in approximately 10% of all twin gestations and is associated with an increased risk of fetal demise and increased neonatal morbidity and mortality. There is a higher rate of IUGR in multiples versus singletons, which is most likely a result of uteroplacental insufficiency related to increased fetal metabolic demands as well as abnormal placental implantation. Other causes of twin discordance, especially in monozygotic twins, include twin-twin transfusion and congenital anomalies. Twin-twin transfusion syndrome (TTTS) has a mortality rate as high as 80% in severe cases. Congenital anomalies associated with discordance include anencephaly, holoprosencephaly, VATER associations, placental vascular shunts, and conjoining. Physicians should be prepared to evaluate discordant twins and identify and treat the associated medical complications of IUGR, TTTS, and/or congenital anomalies.
Behavioral and Psychological Approaches to Weight Management

Since the 1970s, behavioral weight loss approaches have been the preferred treatment for mild to moderate obesity. Patients are taught how to modify eating and exercise behaviors to meet treatment goals. Cognitive elements, such as avoidance of dichotomous thinking, reduction of negative self-talk, and improvement in coping strategies, are also emphasized. Most behavioral weight loss programs achieve a 7–10 % weight loss in 6 months. Losses of this magnitude are often sufficient to prevent or ameliorate obesity-related health concerns; however, long-term maintenance remains a significant challenge. Studies indicate that weight maintenance is associated with the continued application of behavioral modification techniques (Sarwer et al., Curr Opin Endocrinol Diabetes Obes 16(5):347–352, 2009). Initial assessment should screen for behavioral and psychological factors influencing weight control, such as eating frequency, diet quality, portion size, and activity level. Triggers, which cause the patient to eat when not hungry or to overeat, should be assessed and patients taught to avoid or manage them. Likewise, barriers to behavior change should be identified and addressed. Finally, patients should be screened for mood and/or eating disorders. Stepped-care approaches, provisions for increased patient-provider contact, and use of motivational interviewing or acceptance and commitment therapy (ACT) techniques may help improve the efficacy of behavioral interventions (Sarwer et al., Curr Opin Endocrinol Diabetes Obes 16(5):347–352, 2009; Armstrong et al., Obes Rev 12(9):709–723, 2011).
Prebiotics: tools to manipulate the gut microbiome and metabolome

The human gut is an ecosystem comprising trillions of microbes interacting with the host. The composition of the microbiota and their interactions play roles in different biological processes and in the development of human diseases. Close relationships between dietary modifications, microbiota composition and health status have been established. This review focuses on prebiotics, or compounds which selectively encourage the growth of beneficial bacteria, their mechanisms of action and benefits to human hosts. We also review advances in synthesis technology for human milk oligosaccharides, part of one of the most well-characterized prebiotic–probiotic relationships. Current and future research in this area points to greater use of prebiotics as tools to manipulate the microbial and metabolic diversity of the gut for the benefit of human health.
Monotonicity of the Square Root

As explained in the preface, most applications of Loewner’s theorem involve the easy half of the theorem. This chapter is an aside involving the two most significant and common matrix monotone functions: fractional powers and the log.
El escándalo de "La Celestina": magia y acumulación primitiva en la España del holocausto (1486-1507)

This article examines the state of the question on magic and witchcraft in La Celestina. It does so by focusing on a very symptomatic silence: the silence around Silvia Federici’s seminal intervention on the matter in her already classic Caliban and the Witch, which in my view is nothing short of a scandal. I argue that Fernando de Rojas’ masterpiece cannot be properly assessed without paying full and thorough attention to the complex historical processes underlying the dynamics of witch-hunting in late-medieval Europe. Witch-hunting is not a religious or even a political phenomenon, or (to be more precise) it is a religious and a political phenomenon only insofar as it partakes in the broader economic landscape of primitive accumulation during the transition from the feudal to the capitalist mode of production. By obsessively putting all the blame on the Catholic Church and its repressive apparatuses (i.e., the Inquisition), liberal criticism is underscoring this very sim­ple fact. In my critique to this critical trend, originally espoused by Jose Antonio Maravall in the 60s and arguably hegemonic today, I show how La Celestina cannot but be under­stood as a nostalgic testimony for the not-so-distant economy of the medieval commons.
Why Black and Latino Home Ownership Matter to the Color Line and Multiracial Democracy

Recent scholarship across various disciplines since the U.S. housing crisis of 2008 has deepened our understanding of racial wealth gaps, especially as it pertains to housing. This article focuses on two less-developed dimensions of Black and Latino home ownership, voting and immigration, respectively. The Black home ownership rate has fallen to 41% as of 2019, the lowest level since the 1968 Fair Housing Act. I contend that the continued decline of Black home ownership reduces voting turnout. A multivariate fixed effects analysis of state-level Black voter turnout in presidential elections since 2000 lends support to this contention. In contrast, the Latino home ownership rate has rebounded, climbing to nearly 48% in 2019. I argue that this rise is as much a mirage as sign of progress—an artifact of the deportation of millions of Latin Americans and the end of undocumented Mexican migration. Such changes inflate Latino ownership rates by reducing the denominator rather than increasing the numerator of homeowners. Examining state-level data, my multivariate analysis shows that the decline in the undocumented population and, to a lesser extent, the increase of DACA recipients explain the level and change in Latino ownership more than the change in the share of Latino citizens or documented non-citizens. I conclude that the color line has reinforced a new Black/non-Black divide in home ownership that undermines the social mobility and electoral representation of Black Americans. Meanwhile, a tri-racial divide by legal status and race stratifies Latino home ownership. Intra-Latino inequality masquerades as success because of the expulsion of vulnerable Latino immigrants and their US citizen children. The social consequences distort the home ownership rate calculation and pose another threat to multiracial democracy.
Haunting and thinking from the Utopian margins: Conversation with Avery Gordon:

Avery Gordon’s work exceeds the limits of disciplinary boundaries and so does her practice. She uses the term ‘itinerant’ to describe her strategies of inhabiting multidisciplinary spaces and of cr...
Telemedicine After Upper Extremity Surgery: A Prospective Study of Program Implementation.

Purpose Our purpose was to evaluate the implementation of a postoperative hand and upper extremity telemedicine program. We aimed to compare travel burden, visit time, and patient satisfaction between an initial postoperative telemedicine visit and a second conventional in-clinic visit. Methods Telemedicine guidelines established by our hospital system were used as inclusion criteria for this prospective study, which included patients indicated for surgery in the outpatient clinic during a 3-month period. Patients were excluded if they had wounds closed with nonabsorbable suture, remained admitted to the hospital, or required a custom orthosis at their first postoperative visit. Baseline demographics and patient-reported outcome measures were collected prior to surgery. Information pertaining to technology usage was collected for the telemedicine visit and travel information was obtained for the in-clinic visit. Patient satisfaction was recorded for both visits. Results Fifty-seven of 87 patients (66%) who met the inclusion criteria elected to participate in the study. A cell phone was utilized by 89% of patients and 88% of visits were performed from the patient’s home. There were 4 technological complications during the study period (7%). Mean round-trip travel distance for the in-clinic visit was 60 miles with an average drive time of 85 minutes. Visit times were significantly shorter with telemedicine (7 minutes vs 38 minutes). Telemedicine was preferred by 90% of patients for subsequent encounters. All 4 clinical complications were recognized during the telemedicine visit. Conclusions A telemedicine program for postoperative care after hand and upper extremity surgery decreases travel burdens associated with conventional in-clinic appointments. Telemedicine significantly decreases visit times without decreasing patient satisfaction for patients who elect to participate in remote video visits. The ability to recognize early postsurgical complications was not compromised by utilizing this technology, even during our early experience. Clinical relevance Telemedicine after hand and upper extremity surgery results in high levels of patient satisfaction and decreases visit times and the travel burdens associated with conventional in-clinic appointments.
Resonant energy exchange between a moving boundary and radiation modes of a cavity

We discuss the dynamics of a quantum vacuum in a one-dimensional cavity formed by two ideal mirrors: one fixed, the other moving. A nonrelativistic equation of motion is found for the wall that self-consistently determines the wall position and the evolution of the quantum field. This equation is applied to a system with an external potential chosen so that the mirror oscillates at a resonant frequency of the cavity. It is found that this system has an evolutionary cycle during which energy is transferred back and forth between the cavity field and the wall. During the first and third phases of the cycle, energy is transferred from the wall to the cavity; wave packets form in the field as the wall motion decays. During the second and fourth phases, energy is transferred from the field to the wall. The wave packets disperse, providing an impetus for the waxing wall motion.
Mask R-CNN-based tumor localization and segmentation in 4D Lung CT

Motion management is of utmost importance to ensure the effectiveness of radiation treatment for lung cancer patients. The emerging 4D radiotherapy technique aims to actively manage lung tumor motion by providing a time-dependent treatment. This requires the delineation of tumors on all the 3D phase CT images in 4D CT, which is labor intensive and time consuming. In this study, we propose a novel deep learning-based method to automatically localize and segment lung tumor on 4D CT to facilitate the clinical workflow of 4D radiotherapy. The proposed network, named motion Regionbased Convolutional Neural Networks (R-CNN), consists of four stages, i.e., feature extraction, rough tumor location, fine tumor location, and segmentation within tumor region-of-interest (ROI). To aid the network to get rid of unreasonable detected ROIs, different from traditional mask R-CNN, our proposed method first fed 4D CT with consecutive phases into the backbone to extract tumor motion information and then utilized these motion information to estimate global and local deformation vector fields (DVFs), which is useful for measuring the movement of the tumor ROI between each two phases. Our method was tested on 20 patients’ lung 4D CT images in this study. Five metrics were used for quantitative evaluation, i.e., center-of-mass distance (COMD), Dice similarity coefficient (DSC), 95th percentile Hausdorff distance (HD95), mean surface distance (MSD), and volume difference (VD) calculated between the manual tumor contour and the contour obtained by our method. Averaged over the 20 cases, our method yielded 1.14±0.95 mm on COMD, 0.76±0.25 on DSC, 2.29±1.31 mm on HD95, 0.75±0.44 mm on MSD, and 0.51±0.51 cc on VD. These results have demonstrated the feasibility and efficacy of our motion R-CNN method for automatic localization and segmentation of lung tumors on 4D CT images. Our method is also expected to be applicable to in-treatment real-time volumetric imaging to provide 3D markerless tumor tracking during treatment delivery.
CD36-mediated ferroptosis dampens intratumoral CD8+ T cell effector function and impairs their antitumor ability.

Summary Understanding the mechanisms underlying how T cells become dysfunctional in a tumor microenvironment (TME) will greatly benefit cancer immunotherapy. We found that increased CD36 expression in tumor-infiltrating CD8+ T cells, which was induced by TME cholesterol, was associated with tumor progression and poor survival in human and murine cancers. Genetic ablation of Cd36 in effector CD8+ T cells exhibited increased cytotoxic cytokine production and enhanced tumor eradication. CD36 mediated uptake of fatty acids by tumor-infiltrating CD8+ T cells in TME, induced lipid peroxidation and ferroptosis, and led to reduced cytotoxic cytokine production and impaired antitumor ability. Blocking CD36 or inhibiting ferroptosis in CD8+ T cells effectively restored their antitumor activity and, more importantly, possessed greater antitumor efficacy in combination with anti-PD-1 antibodies. This study reveals a new mechanism of CD36 regulating the function of CD8+ effector T cells and therapeutic potential of targeting CD36 or inhibiting ferroptosis to restore T cell function.
Do Alcohol Consequences Serve as Teachable Moments? A Test of Between- and Within-Person Reciprocal Effects From College Age to Adulthood

Objective: Several studies find between-person reciprocal relations between adolescent/college drinking and positive expectancies. However, drinking and expectancies from college into adulthood are...
Effect of uterine manipulation 35 days after parturition on plasma concentrations of 13, 14-dihydro-15-keto prostaglandin F2 alpha in multiparous and primiparous Brahman cows.

Thirteen multiparous (M; 451 kg, 6.1 body condition score) and 11 primiparous (P) Brahman cows (408 kg, 6.3 body condition score) were assigned randomly within parity to receive either 2-min uterine manipulation (UM) per rectum 35 d after calving or no UM (C). This resulted in four groups: MUM (n = 8), MC (n = 5), PUM (n = 5) and PC (n = 6). All animals received a jugular cannula on d 34. Blood samples were collected at 10-min intervals from 30 min prior to UM until 120 min after UM and at 20-min intervals through 300 min after UM. Plasma was harvested immediately and stored at -20 degrees C until RIA for 13, 14-dihydro-15 keto prostaglandin F2 alpha (PGFM). Number of PGFM peaks in 330 min and amplitude of these peaks were similar (P greater than .10) in MC (2.0 peaks, 445.6 pg/ml) and PC (1.8 peaks, 446.9 pg/ml). Response to UM differed (P less than .02) by parity. The PGFM response of UM and C primiparous cows did not differ. Mean PGFM concentrations between 70 and 300 min after UM were greater (P less than .05) in MUM than in MC cows. Area of the PGFM curve did not differ (P greater than .10) in primiparous groups but was greater (P less than .01) in MUM than in MC cows. Uterine manipulation 35 d after parturition increased plasma PGFM in M but not in P cows.
The Disincentive of Salary Increases: Evidence from NFL Quarterback Performances

A first difference econometric method is employed to assess the incentives created by contracts. Data from quarterbacks in the NFL is used to identify whether shirking occurs after significant salary increases. We find that a QB's rating decreases, interceptions become more frequent while touchdowns decrease, and passing yards reduce when salary increases.
Cord blood proteins versus respiratory distress syndrome

Abstract It has been suggested that babies with respiratory distress syndrome have a significantly lower cord blood total protein than nonaffected infants. Total protein was measured in 629 normal term-sized infants, 76 normal premature infants, and 16 with respiratory distress syndrome. Albumin and globulin were measured in 363 normal term infants, 69 normal premature infants, and 15 infants with respiratory distress syndrome. Globulin and total protein were significantly lowered in affected infants. These findings are discussed.
Omics-Based Systems Vaccinology for Vaccine Target Identification

Omics technologies include genomics, transcriptomics, proteomics, metabolomics, and immunomics. These technologies have been used in vaccine research, which can be summarized using the term "vaccinomics." These omics technologies combined with advanced bioinformatics analysis form the core of "systems vaccinology." Omics technologies provide powerful methods in vaccine target identifi- cation. The genomics-based reverse vaccinology starts with predicting vaccine protein candidates through in silico bioinformatics analysis of genome sequences. The VIOLIN Vaxign vaccine design program (http://www.violinet.org/vaxign) is the first web-based vaccine target prediction software based on the reverse vaccinology strategy. Systematic transcriptomics and proteomics analyses facilitate rational vaccine target identification by detesting genome-wide gene expression profiles. Immunomics is the study of the set of antigens recognized by host immune systems and has also been used for efficient vaccine target prediction. With the large amount of omics data available, it is necessary to integrate various vaccine data using ontologies, including the Gene Ontology (GO) and Vaccine Ontology (VO), for more efficient vaccine target prediction and assessment. All these omics technologies combined with advanced bioinformatics analysis methods for a systems biology-based vaccine target prediction strategy. This article reviews the various omics technologies and how they can be used in vaccine target identification. Drug Dev Res 73 : 559-568, 2012. © 2012 Wiley Periodicals, Inc.
Somatostatin pretreatment desensitizes somatostatin receptors linked to adenylate cyclase and facilitates the stimulation of cyclic adenosine 3':5'-monophosphate accumulation in anterior pituitary tumor cells

Somatostatin-14 (SRIF) inhibits both hormone- and forskolin-stimulated cyclic adenosine 3′:5′-monophosphate (cyclic AMP) formation in tumor cells of the mouse anterior pituitary (AtT-20/D16–16). However, long- term pretreatment of cells with SRIF modifies the responsiveness of this system in two ways: The response of adenylate cyclase to stimulatory agents is enhanced, whereas the ability of SRIF to inhibit stimulated cyclic AMP formation is reduced. The supersensitive adenylate cyclase response and the SRIF desensitization were dependent on the concentration and duration of SRIF pretreatment. Enhancement of forskolin-stimulated cyclic AMP formation occurred within 4 hr, whereas that of corticotropin-releasing-factor-, (-)-isoproterenol-, and vasoactive intestinal peptide-induced cyclic AMP accumulation required 16 hr of pretreatment. The elevated responses to each of these stimulants were due to increases in their maximal ability to stimulate cyclic AMP formation. Cycloheximide treatment blocked the enhanced cyclic AMP response induced by SRIF pretreatment, suggesting a requirement for protein synthesis. In membrane preparations, SRIF pretreatment facilitated activation of adenylate cyclase by forskolin, sodium fluoride, and guanosine 5′-(beta,tau-imido)-triphosphate without affecting basal activity. These results suggest that desensitization of an inhibitory input to adenylate cyclase is accompanied by a supersensitivity of adenylate cyclase to stimulatory agents through a process requiring protein synthesis.
Minor Histocompatibility Antigen-Specific MHC-Restricted CD8 T Cell Responses Elicited by Heat Shock Proteins

In mammals, the heat shock proteins (HSP) gp96 and hsp70 elicit potent specific MHC class I-restricted CD8 + T cell (CTL) response to exogenous peptides they chaperone. We show in this study that in the adult frog Xenopus , a species whose common ancestors with mammals date back 300 million years, both hsp70 and gp96 generate an adaptive specific cellular immune response against chaperoned minor histocompatibility antigenic peptides that effects an accelerated rejection of minor histocompatibility-locus disparate skin grafts in vivo and an MHC-specific CD8 + cytotoxic T cell response in vitro. In naturally class I-deficient but immunocompetent Xenopus larvae, gp96 also generates an antitumor immune response that is independent of chaperoned peptides (i.e., gp96 purified from normal tissue also generates a significant antitumor response); this suggests a prominent contribution of an innate type of response in the absence of MHC class I Ags.
Emergence Of New Responders To Treatment And New Adverse Events In Clinical Trials Of Pregabalin In Diabetic Peripheral Neuropathy And Postherpetic Neuralgia (P7.299)

OBJECTIVE: To assess the pattern of first emergence of new responders and new adverse events (AEs) in diabetic peripheral neuropathy (DPN) and postherpetic neuralgia (PHN) patients treated with pregabalin. BACKGROUND: An understanding of when patients first respond to treatment and when AEs emerge or worsen could assist researchers designing proof-of-concept studies and physicians treating patients. DESIGN/METHODS: This was a pooled analysis of 2 randomized, placebo-controlled, double-blind trials (8 and 12 weeks in duration) of flexible-dose pregabalin (150-600mg/day) in DPN and PHN patients (n=514). Dizziness, peripheral edema and somnolence were the most common AEs (incidence of 14.4%, 9.2% and 7.2%, respectfully). New responders were classified as having a 30% and/or 50% reduction in mean pain score from baseline; once a patient responded they were not scored subsequently (and were subsequently excluded from the responder analysis).The most common AEs were recorded weekly for the first 6 weeks; a new AE was scored if it appeared for the first time, or if it increased in severity. RESULTS: Here, responders peaked at week 3 with pregabalin and week 4 with placebo. Proportion of 30% responders by week (from week 1 to 6) was 15.0%, 22.1%, 26.8%, 19.1%, 16.8%, 9.4% with pregabalin, and 5.4%, 15.6%, 19.5%, 24.2%, 10.0%, 3.9% with placebo. Proportion of 50% responders by week was 5.5%, 9.2%, 12.9%, 10.6%, 11.3%, 6.9% with pregabalin, and 0.6%, 4.9%, 8.2%, 12.6%, 9.9%, 4.6% with placebo. The incidence of AEs with pregabalin by week was: dizziness, 6.9%, 4.5%, 3.1%, 1.9%, 0.6%, 0.3%; peripheral edema, 0.3%, 2.4%, 2.1%, 1.6%, 2.6%, 1.0%; and somnolence, 1.4%, 1.8%, 2.4%, 0.6%, 0.3%, 0.0%. CONCLUSIONS: These data suggest that the majority of new responders and new AEs emerge within 3-4 weeks of pregabalin or placebo treatment. These data could advise new proof-of-concept studies and guide clinical management. Study Supported by: Pfizer Inc. Disclosure: Dr. Parson has received personal compensation for activities with Pfizer Inc. as an employee. Dr. Emir has received personal compensation for activities with Pfizer Inc. Dr. Emir holds stock and/or stock options in Pfizer Inc.
Ischemic preconditioning by caspase cleavage of poly(ADP-ribose) polymerase-1.

A transient, sublethal ischemic interval confers resistance to a subsequent, otherwise lethal ischemic insult, in a process termed ischemic preconditioning. Poly(ADP-ribose) polymerase-1 (PARP-1) normally functions in DNA repair, but extensive PARP-1 activation is a major cause of ischemic cell death. Because PARP-1 can be cleaved and inactivated by caspases, we investigated the possibility that caspase cleavage of PARP-1 could contribute to ischemic preconditioning. Murine cortical cultures were treated with glucose deprivation combined with 0.5 mm 2-deoxyglucose and 5 mm azide (“chemical ischemia”) to model the reversible energy failure that occurs during transient ischemia in vivo . Cortical cultures preconditioned with 15 min of chemical ischemia showed increased resistance to subsequent, longer periods of chemical ischemia. These cultures were also more resistant to the PARP-1 activating agent, N -methyl- N ′-nitro- N -nitrosoguanidine, suggesting reduced capacity for PARP-1 activation after preconditioning. Immunostaining for the 89 kDa PARP-1 cleavage fragment and for poly(ADP-ribose) formation confirmed that PARP-1 was cleaved and PARP-1 activity was attenuated in the preconditioned neurons. Preconditioning also produced an increase in activated caspase-3 peptide and an increase in caspase-3 activity in the cortical cultures. A cause-effect relationship between caspase activation, PARP-1 cleavage, and ischemic preconditioning was supported by studies using the caspase inhibitor Ac-Asp-Glu-Val-Asp-aldehyde (DEVD-CHO). Cultures treated with DEVD-CHO after preconditioning showed reduced PARP-1 cleavage and reduced resistance to subsequent ischemia. These findings suggest a novel interaction between the caspase- and PARP-1-mediated cell death pathways in which sublethal caspase activation leads to PARP-1 cleavage, thereby increasing resistance to subsequent ischemic stress.
Damping Subsynchronous Resonance Using Reactive Power Control

The IEEE benchmark system is used to demonstrate a method of damping subsynchronous resonance using a set of phase controlled reactors connected to the machine terminals. It is possible to prevent one mode of instability by modulating the reactive power consumed by the reactors in proportion to the change in generator speed. However, it is shown that this previously Suggested method of control is ineffective in damping all possible modes of instability of the benchmark system due to subsynchronous resonance. Methods of control are established which can be used to damp all critical modes of instability using a set of phase controlled reactors
Reconciling Patients' Wishes with the Public Good

Most recently, a new issue has given rise to such a conflict. This issue is the advisability of permitting patients to select the donors of blood that they may receive in the future. Patients are now requesting the right to select their own donors because of fear that blood otherwise provided may be contaminated with infectious agents that might cause serious disease. This issue has not only occasionally led to an antagonistic relationship between patients and blood service providers, but has also, at times, divided the medical community. The basis for this conflict lies in
Global Health and Primary Care: Increasing Burden of Chronic Diseases and Need for Integrated Training

Noncommunicable diseases, including cardiovascular disease, chronic respiratory disease, diabetes, cancer, and mental illness, are the leading causes of death and disability worldwide. These diseases are chronic and often mediated predominantly by social determinants of health. Currently there exists a global-health workforce crisis and a subsequent disparity in the distribution of providers able to manage chronic noncommunicable diseases. Clinical competency in global health and primary care could provide practitioners with the knowledge and skills needed to address the global rise of noncommunicable diseases through an emphasis on these social determinants. The past decade has seen substantial growth in the number and quality of US global-health and primary-care training programs, in both undergraduate and graduate medical education. Despite their overlapping competencies, these 2 complementary fields are most often presented as distinct disciplines. Furthermore, many global-health training programs suffer from a lack of a formalized curriculum. At present, there are only a few examples of well-integrated US global-health and primary-care training programs. We call for universal acceptance of global health as a core component of medical education and greater integration of global-health and primary-care training programs in order to improve the quality of each and increase a global workforce prepared to manage noncommunicable diseases and their social mediators.
Multilayer thin film cooling devices (non-reviewed)

Solid state thermoelectric cooling devices have been of current interest for hot-spot thermal management. Cooling hot-spots with high heat flux is becoming one of the most important technical challenges facing today's IC industry. The rising temperature limits device minimization and decreases its lifetime. The thermoelectric effect is the appearance of an electric field along a temperature gradient established in a material. The inverse effect, called the Peltier effect, can be used for refrigeration, which uses electricity to pump heat from the cold end to the hot end. In this paper, we report to fabricate an in-plan solid-state thermoelectric cooling device using multilayered Bi2Te3/Sb2Te3 and Bi2Te3/Bi2Te3-xSex thin films. A solid-state in-plan thin film cooling device has been fabricated using multilayered thermoelectric thin films. Bi2Te3/Sb2Te3 and Bi2Te3/Bi2Te3-xSex multilayer thin films were deposited using e-beam evaporation. Solid antimony (III) telluride and bismuth (III) telluride were evaporated to grow the Bi2Te3 and Sb2Te3 layers for the Bi2Te3/Sb2Te3 multilayer films. Bi, Te, and Se powders were mixed with the ratio of 2:2.7:0.3 and were heated at 700degC under nitrogen and melted into solid Bi2Te3-xSex. The thermally-grown solid Bi2Te3-xSex was then evaporated to grow the Bi2Te3-xSex layer for the Bi2Te3/Bi2Te3-xSex multilayer thin film together with the Bi2Te3 layer using e-beam evaporation. The Bi2Te3/Sb2Te3 and Bi2Te3/Bi2Te3-xSex multilayer thin films have a periodic structure consisting of alternating Bi2Te3 and Sb2Te3 layers or Bi2Te3 and Bi2Te3-xSex layers, where each layer is about 10 nm thick. The films were analyzed by XRD, SEM, and AFM. The e-beam-grown Bi2Te3/Sb2Te3 multilayered thin film has a resistivity of 7.1times10-4 Omegaldrcm and an in-plan Seebeck coefficient of 110 muV/K, and the e-beam-grown Bi2Te3/Bi2Te3-xSex multilayered thin film has a resistivity of 1.6times10-4 Omegaldrcm and an in-plan Seebeck coefficient of -95 muV/K. An in-plan cooling device was fabricated with the Bi2Te3/Sb2Te3 and Bi2Te3/Bi2Te3-xSex films using the standard integrated circuit (IC) fabrication process; the cooling device is consisted of 2080 pairs of p-type and n-type elements, where each element is 200 mum long and 50 mum wide; pn junction diodes were fabricated as thermometers for the measurement of temperature difference between the two ends of device. Temperature difference was achieved between the hot and cold ends under an applied DC current. The developed in-plan cooling device can be a good candidate for the application of highly-efficient micro- cooling.
SU-GG-T-67: Objective Approach to Report Planner-Independent Skin and Rib Distance and Maximal Dose in Contura® HDR Breast Brachytherapy Planning

Purpose: To demonstrate an objective approach to determine planner‐independent skin and rib distance and maximal dose in Contura® high dose rate brachytherapy planning. Method and Materials: A virtual skin volume was produced by expanding the skin surface in three dimensions (3D) external to breast with a certain thickness. Therefore, the maximum dose to this volume occurs on the skin surface as with manual selection method. A 3D rib volume was reconstructed from rib contours on axial CTimages. The maximal dose to skin and rib was extracted from their dose volume histograms. Minimum skin and rib distance from the balloon surface was objectively calculated using the inverse square law assuming that the balloon was a sphere and the prescribed dose was located on the surface of a 1‐cm expansion from the balloon. For the calculation, three different plans were ubli single dwell position with single lumen (MDSL)and multiple dwell position with single lumen (MDSL) and multiple dwell position with multi‐lumen (MDML) plans. Those estimated minimum distance of skin and rib were compared for 24 patients with 48 manual measurements taken by a comprehensive review of 3D planning CTimages.Results: The average ± standard deviation (maximum) of estimated skin and rib distance in comparison with manual measurement was 0.4 mm ± 0.4 (1.8) for SDSL, 0.6 mm ± 0.5 (2.5) for MDSL and, 1.3 mm ± 1.2 (5.5) for MDML plans. Agreement within ± 1 mm difference was observed in 46/48 cases for SDSL, 40/48 cases for MDSL, and 25/48 cases for MDML plans. Conclusion: Volumetric information of skin and rib was used to objectively determine their maximal dose. The SDSL plan is better for skin and rib distance measurement because of its spherically symmetric dose distribution. However, asymmetric dose distribution in the MDML plan should be used for treatment.
Health Impact of Jewish Religious Observance in the USA: Findings from the 2000–01 National Jewish Population Survey

Using data from the 2000–01 National Jewish Population Survey (NJPS) (N = 5,148), effects of eight religious measures were investigated in relation to two health outcomes, standard single-item indicators of self-rated health and presence of an activity-limiting health condition. Seven of the religious measures were associated bivariately with one or both health indicators. Through two-step OLS regression of each health indicator onto all of the religious measures, adjusting for age and other sociodemographic correlates, two measures of synagogue involvement remained statistically significant. Follow-up analysis revealed a net health impact of religious observance primarily limited to Orthodox and Conservative Jews.
Response of CD4+T Cells from Myasthenic Patients and Healthy Subjects of Biosynthetic and Synthetic Sequences of the Nicotinic Acetylcholine Receptor

Abstract We investigated the suitability of pools of overlapping synthetic peptides spanning the complete α1subunit sequence of the human muscle acetylcholine receptor (AChR) (α1pool) or the extracellular domain (residues 1-218, α11-218 pool), and of biosynthetic α1 constructs from E. coli, as stimulants of human CD4+cells from myasthenia gravis (MG) patients and healthy subjects. A construct corresponding to residues α11-209 was obtained as solubilized inclusion bodies (ibα11-209), or purified by SDS gel electrophoresis (purα11-209). A second construct included the extracellular, cytoplasmic and carboxylterminal domains plus histidine residues, and was obtained as inclusion bodies (ibα1NoTrans) or purified by gel permeation and histidine tag affinity chromatography (purα1NoTrans). A biosynthetic extracellular domain of the neuronal AChR α7subunit (ibα71-206) isolated fromE. colias inclusion bodies served as control for bacterial contaminants. We usedibα11-209, purα11-209 and peptide pools to propagate CD4+lines from two MG patients. The lines obtained usingpurα11-209 and the peptide pools recognized the peptide pools and α1constructs tested well, but ibα71-206 poorly or not at all. These lines recognized peptides known to form CD4+epitopes in these patients. Theibα11-209 lines recognized ibα11-209 andibα71-206 strongly, but recognized poorly purα11-209 and the α11-218 pool. We propagated T-cell lines from a healthy subject using purα11-209 andibα11-209. The purα11-209 line recognizedpurα11-209 and the α11-218 pool, but not ibα11-209 oribα71-206. The ibα11-209 line recognizedibα11-209 and ibα71-206, but notpurα11-209 or the α11-218 pool. We tested blood CD4+cells from six MG patients and eight healthy subjects withibα11-209, purα11-209, the α11-218 pool and—in the healthy subjects—also ibα71-206,ibα1NoTrans and purα1NoTrans. In both populations, the α11-218 pool elicited low and sporadic responses, while the constructs elicited clear responses that were frequently higher foribα11-209 than purα11-209. The responses toibα71-206 were strong and comparable to those to ibα11-209,ibα1NoTrans, and purα1NoTrans. These results indicate that even purified constructs fromE. colicontain bacterial contaminants recognized by CD4+cells. They should not be used to test unselected blood CD4+cells, because they may evoke strong CD4+responses to the bacterial antigens. Purified recombinant sequences may be suitable for propagation of CD4+cell lines, if the specificity of the lines can be verified using different antigen prepar-ations. Short synthetic peptide sequences can be safely used for propagation of specific CD4+cells. Although they are poor stimulants for unselected blood CD4+cells, the low responses they elicit are probably due to these cells.
Occupational factors and carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is the most commonly reported nerve entrapment syndrome. The prevalence of CTS among 652 active workers in jobs with specific hand force and repetitiveness characteristics was estimated. The prevalence of CTS ranged from 0.6% among workers in low force-low repetitive jobs to 5.6% among workers in high force-high repetitive jobs. When controlling for potential confounders, the odds ratio for the high force-high repetitive jobs was more than 15 (p less than .001) compared to the low force-low repetitive jobs. High repetitiveness appears to be a greater risk factor than high force (odds ratio of 5.5 p less than .05 versus 2.9 and not statistically significant).
Supravalvular aortic stenosis in adults

Abstract Supravalvular aortic stenosis in adults, in contrast to the form seen in infants and children, is usually not associated with mental retardation, peculiar facies or severe peripheral pulmonic stenosis. Subtle clinical findings serve to distinguish it from valvular aortic stenosis, a differentiation of great importance if surgery is a consideration. Diagnosis is made by aortic and left ventricular angiograms. The severity of the clinical disease correlates better with abnormalities of the coronary arteries than with the severity of the obstruction, although both are frequently significant. Once symptoms occur, the prognosis is poor without surgical correction. Surgical mortality rates are high, primarily as a result of incomplete preoperative diagnosis.
Surgical therapy for infective endocarditis.

Unlike infections of the native heart valve, which are often cured by appropriate antibiotic therapy, prosthetic valve endocarditis usually necessitates an operative ap­ proach for adequate treatment. Prosthetic valve endocarditis is associated with a greater mortality and morbidity than is native valve endocarditis, and this relationship is attributable to the increased likelihood of annular destruction and the increased complexity of surgical repair. The risk of pros­ thetic valvular disease is greatest early after operation, and affected patients are also more likely to have hospital-based virulent and destructive organisms, which are less respon­ sive to antibiotic therapy. Fortunately, the frequency of occurrence of prosthetic valvular endocarditis is only ap­ proximately 2 to 4%.4 Although endocarditis remains a devastating and often lethal condition, there have been recent advances in its diag­ nosis and therapy. The evolution of transesophageal echo­ cardiography has led to its increasing application in the assessment of cardiac valvular abnormalities. Operative treatment has improved with a firmer understanding of the need for the complete removal of all devitalized and infected tissue, if necessary in combination with major surgical re­ construction, and an increased use of homograft tissue valves. Echocardiography.-Echocardiography is helpful in de­ tecting various cardiac lesions in endocarditis, including valvular regurgitation, annular ring abscesses, and vegeta­ tions. Transesophageal is better than transthoracic echo­ cardiography in finding evidence of vegetations, quantifying valvular dysfunction, and diagnosing the spread of infec­ tion.' This advantage is especially noted in prosthetic valve endocarditis, in which shielding by the prosthesis may pre­ vent adequate transthoracic diagnosis of vegetations or ab­ scess cavities. What is the significance of finding vegetations on echocardiography? Although seemingly large and loose vegetations may be a daunting phenomenon when discov­ ered echocardiographically, no firm evidence suggests that this appearance, in itself, should trigger surgical interven­ tion. As pointed out in the article by Mullany and associates, although one series showed that mitral vegetations or large vegetations were more likely than others to embolize," this finding did not necessarily prevail in treated patients at the Mayo Clinic," Of interest, antibiotic treatment rather than anticoagulation has been noted to inhibit embolization." Nevertheless, emboli are common (25% of patients in the current series) and usually involve the brain. The frequency of emboli is the same with both native and prosthetic valve endocarditis. Antibiotic treatment should be with bacteri
Active Gate Driver for Crosstalk Suppression of SiC Devices in a Phase-Leg Configuration

In a phase-leg configuration, the high-switching-speed performance of silicon carbide (SiC) devices is limited by the interaction between the upper and lower devices during the switching transient (crosstalk), leading to additional switching losses and overstress of the power devices. To utilize the full potential of fast SiC devices, this paper proposes two gate assist circuits to actively suppress crosstalk on the basis of the intrinsic properties of SiC power devices. One gate assist circuit employs an auxiliary transistor in series with a capacitor to mitigate crosstalk by gate loop impedance reduction. The other gate assist circuit consists of two auxiliary transistors with a diode to actively control the gate voltage for crosstalk elimination. Based on CREE CMF20120D SiC MOSFETs, the experimental results show that both active gate drivers are effective to suppress crosstalk, enabling turn-on switching losses reduction by up to 17%, and negative spurious gate voltage minimization without the penalty of decreasing the switching speed. Furthermore, both gate assist circuits, even without a negative isolated power supply, are more effective in improving the switching behavior of SiC devices in comparison to the conventional gate driver with a -2 V turn-off gate voltage. Accordingly, the proposed active gate assist circuits are simple, efficient, and cost-effective solutions for crosstalk suppression.