cssi/SciSciGPT-SciSciNet huggingface dataset:
Drip, Ship, and Grip, then Slice and Dice: Comprehensive Stroke Center Management of Cervical and Intracranial Emboli

BACKGROUND AND PURPOSE: Tandem acute thrombotic emboli in the cervical and intracranial arteries are an unusual case of stroke presenting unique management challenges. In regional systems of acute stroke care anchored by Comprehensive Stroke Centers, combined fibrinolytic, endovascular, and open surgical intervention is a new therapeutic option. SUMMARY OF CASE: A 28 year old male underwent retinal surgery, including post-operative neck compression and the next day presented to a primary stroke center with aphasia and right hemiplegia. Intravenous tissue plasminogen activator therapy was initiated and the patient was transferred to a comprehensive stroke center (CSC) for higher level of care (drip and ship). Imaging at the CSC demonstrated tandem thrombi: a near occlusive lesion at the origin of the left cervical internal carotid artery and a total occlusion of the M1 segment of the left middle cerebral artery. Endovascular thrombectomy with the Solitaire stent retriever resulted in intracranial recanalization (grip). Immediately after the endovascular procedure, open carotid thrombectomy was performed to achieve cervical carotid revascularization without systemic heparinization (slice). Both cervical carotid and intracranial thrombi were processed for proteomic analysis via mass spectrometry (dice). CONCLUSION: Combined fibrinolytic, endovascular, and open surgical intervention can yield revascularization and good clinical outcome in cases of tandem lesions.
Development and validation of the General Health Numeracy Test (GHNT).

Abstract Objective Because existing numeracy measures may not optimally assess ‘health numeracy’, we developed and validated the General Health Numeracy Test (GHNT). Methods An iterative pilot testing process produced 21 GHNT items that were administered to 205 patients along with validated measures of health literacy, objective numeracy, subjective numeracy, and medication understanding and medication adherence. We assessed the GHNT's internal consistency reliability, construct validity, and explored its predictive validity. Results On average, participants were 55.0 ± 13.8 years old, 64.9% female, 29.8% non-White, and 51.7% had incomes ≤$39 K with 14.4 ± 2.9 years of education. Psychometric testing produced a 6-item version (GHNT-6). The GHNT-21 and GHNT-6 had acceptable-good internal consistency reliability (KR-20 = 0.87 vs. 0.77, respectively). Both versions were positively associated with income, education, health literacy, objective numeracy, and subjective numeracy (all p Conclusions The GHNT-21 and GHNT-6 are reliable and valid tools for assessing health numeracy. Practice implications Brief, reliable, and valid assessments of health numeracy can assess a patient's numeracy status, and may ultimately help providers and educators tailor education to patients.
A Low Phase Noise Quad-Band CMOS VCO with Minimized Gain Variation for GSM/GPRS/EDGE

A differential LC VCO is presented for commercial quad-band GSM/GPRS/EDGE applications. The VCO is designed in 0.13 mum CMOS process and meets stringent phase noise specifications. A technique to minimize the VCO gain variation is presented which reduces the Kvco variation to plusmn14%; more than three times smaller than the previous solutions. This technique results in reduction of the delay mismatch between the amplitude and phase paths in a polar loop transmitter.
Thermotropic copolyesters. III. Synthesis and characterization of liquid crystal copolyesters containing the bicyclo[2.2.2]octane ring system

The syntheses and characterizations of poly(oxy-trans-1,4-cyclohexyleneoxycarbonyl-1,4-bicyclo[2.2.2]octylenecarbonyl) (I) and poly(oxy-trans-1,4-cyclohexyleneoxycarbonyl-1,4-bicyclo[2.2.2]octylenecarbonyl-co-oxy-trans-1,4-cyclohexyleneoxysebacoyl) (II) are described. The polymer systems were characterized by infrared spectroscopy, proton magnetic resonance spectroscopy, solution viscosity, and differential scanning calorimetry. The random copolyester prepared from 1:0.65:0.35 mol of trans-1,4-cyclohexanediol, bicyclo[2.2.2]octane-1,4-dicarbonyl chloride, and sebacoyl chloride, respectively, formed a birefringent fluid state in the melt.
Health and Social Care for Elderly People in Sweden: Implications for Policy in the United States

Through a descriptive and analytical account of recent trends in the care of elderly people in Sweden, a number of lessons are indicated for America and countries with similar health and social welfare arrangements. Clarity of objectives within a ‘normalising’ framework; sound organisational arrangements based on small local areas; effective knowledge of services by consumers and cost-effective provision are factors identified as significant.
CD19 cytoplasmic tyrosines 482 and 513 mediating binding to PI3K are sufficient to reconstitute the T-dependent humoral immune response (IRM8P.713)

CD19 is a co-stimulatory receptor on B cells that has been shown to play a critical role in regulating B cell differentiation and the humoral immune response. In mice lacking CD19 expression, B1 and marginal zone (MZ) B cell subpopulations are absent and the T-dependent humoral response is severely impaired in association with defective GC B cell generation and GC responses resulting in loss of class switching, affinity maturation and ultimately the failure to generate Ag-specific memory B cells and Ab secreting cells (ASC) that produce class switched, high affinity Abs. Previous studies have demonstrated the selective mutation of tyrosines 482 and 513 (4/5F mice) in the cytoplasmic domain of CD19 is sufficient to recapitulate the phenotype associated with complete loss of CD19 expression. In the present study, mice were generated in which CD19 is expressed containing only Y482 and Y513 in the absence of the other seven cytoplasmic tyrosine residues (4/5Y mice). Analysis of 4/5Y mice revealed that these residues alone are sufficient to restore B1 and MZ B cell development as well as the T-dependent humoral immune response. Studies to examine mice expressing CD19 with a selective mutation to either tyrosine 482 or 513 revealed a preferential requirement for tyrosine 482 to promote a normal humoral response. These data support the conclusion that CD19 predominantly contributes to normal B cell development and the T-dependent humoral response through its recruitment of PI3K.
The Rise of Kink-Unstable Magnetic Flux Tubes in the Solar Convection Zone

We report preliminary results of a three-dimensional simulation of the buoyant rise of a strongly twisted, kink-unstable magnetic flux tube through a gravitationally stratified layer representing the solar convection zone. The numerical calculations employ the well-known anelastic approximation, which is suitable for studying slow, subsonic dynamical processes in the pressure-dominated, high-β plasma of the solar interior. This Letter investigates the case in which the initial twist of the buoyant flux tube is sufficiently high that the e-folding growth times of the unstable kink modes are short in comparison to the rise time of the flux tube. Our simulation shows that the flux tube becomes kinked and that the top portion of the flux tube evolves into a buckled shape with the tube axis being deflected by more than 90° from its original orientation. We suggest that the emergence of this buckled flux tube can give rise to a compact magnetic bipole with polarity order inverted from Hale's polarity law, similar to the configuration often seen in δ spots.
Branch facial nerve trauma after superficial temporal artery biopsy: a case report

Giant cell arteritis is an emergency requiring prompt diagnosis and treatment. Superficial temporal artery biopsy is the gold diagnostic standard. Complications are few and infrequent; however, facial nerve injury has been reported, leaving an untoward cosmetic outcome. This case report is to the best of our knowledge only the fourth one presented in the available literature so far regarding facial nerve injury from superficial temporal artery biopsy. A 73-year-old Caucasian woman presented for neurological evaluation regarding eyebrow and facial asymmetry after a superficial temporal artery biopsy for presumptive giant cell arteritis-induced cephalalgia. Damage to branches of the facial nerve may occur after superficial temporal artery biopsy, resulting in eyebrow droop. Although an uncommon and sparsely reported complication, all clinicians of various specialties involved in the care of these patients should be aware of this given the gravity of giant cell arteritis and the widespread use of temporal artery biopsy.
Relationships with Parents and Peers A Longitudinal Study of Adolescent Intimacy

This study presents a longitudinal account of adolescent-parent and adolescent-friend intimacy from early adolescence to young adulthood. Boys and girls both reported increases in intimacy with fat...
Characterization of Microtubule Binding Domains in the Arabidopsis Kinesin-like Calmodulin Binding Protein

The kinesin-like calmodulin binding protein (KCBP) is a new member of the kinesin superfamily that appears to be present only in plants. The KCBP is unique in its ability to interact with calmodulin in a Ca 2 -dependent manner. To study the interaction of the KCBP with microtubules, we expressed different regions of the Arabidopsis KCBP and used the purified proteins in cosedimentation assays with microtubules. The motor domain with or without the calmodulin binding domain bound to microtubules. The binding of the motor domain containing the calmodulin binding region to microtubules was inhibited by Ca 2 –calmodulin. This Ca 2 –calmodulin regulation of motor domain interactions with microtubules was abolished in the presence of antibodies specific to the calmodulin binding region. In addition, the binding of the motor domain lacking the calmodulin binding region to microtubules was not inhibited in the presence of Ca 2 –calmodulin, suggesting an essential role for the calmodulin binding region in Ca 2 –calmodulin modulation. Results of the cosedimentation assays with the N-terminal tail suggest the presence of a second microtubule binding site on the KCBP. However, the interaction of the N-terminal tail region of the KCBP with microtubules was insensitive to ATP. These data on the interaction of the KCBP with microtubules provide new insights into the functioning of the KCBP in plants.
Decoupling the scholarly journal

Although many observers have advocated the reform of the scholarly publishing system, improvements to functions like peer review have been adopted sluggishly. We argue that this is due to the tight coupling of the journal system: the system's essential functions of archiving, registration, dissemination, and certification are bundled together and siloed into tens of thousands of individual journals. This tight coupling makes it difficult to change any one aspect of the system, choking out innovation. We suggest that the solution is the “decoupled journal (DcJ).” In this system, the functions are unbundled and performed as services, able to compete for patronage and evolve in response to the market. For instance, a scholar might deposit an article in her institutional repository, have it copyedited and typeset by one company, indexed for search by several others, self-marketed over her own social networks, and peer reviewed by one or more stamping agencies that connect her paper to external reviewers. The DcJ brings publishing out of its current seventeenth-century paradigm, and creates a Web-like environment of loosely joined pieces—a marketplace of tools that, like the Web, evolves quickly in response to new technologies and users' needs. Importantly, this system is able to evolve from the current one, requiring only the continued development of bolt-on services external to the journal, particularly for peer review.
The resource conflict methodology for early-stage design space exploration of superscalar RISC processors

In this paper we propose a new execution trace driven simulation technique, called the Resource Conflict Methodology (RCM) for modeling and simulating computer systems early in the design cycle. By using a simplified hardware element model which allows the user to easily add or delete hardware elements in the model, RCM allows the user to readily change the machine design being investigated and to evaluate the resulting machine on a given workload. We describe the RCM model with reference to a family of superscalar processors and develop an RCM-based analysis program (called REAP) for this family of processors. Using REAP, we demonstrate the validity of our method by comparing its RCM performance estimates to those of a traditional early design stage timer model.
Existence and Implications of a Tilted Binocular Disparity Space

The existence of a tilted binocular disparity space was experimentally established. The results of the experiment showed that a texture surface which under binocular viewing appears to be oriented vertically and perpendicular to the line of sight in fact is tilted such that the portions of the texture surface above and below fixation incline toward and away from the observer, respectively. Under monocular viewing such a discrepancy between apparent and objective vertical tilt is not observed. This suggests that under binocular viewing the cortical representations of the upper and lower visual hemifields are biased toward uncrossed and crossed disparities, respectively. The tilted binocular disparity space is explained in terms of an experientially induced disparity gradient effected during development of the binocular system.
Prediction of compression strength of unidirectional polymer matrix composites

An analytical formulation is developed for the prediction of compression strength of unidirectional polymer matrix composites. The exact solution of the problem is simplified into an explicit equation for compression strength. Then, a nondimensional group is identified and used to propose a simple formula for the prediction of compression strength. The final formula can be used in design or to estimate the compression strength of production parts without performing compression testing. No empirical or semi-empirical parameters are used. The formula is validated for a broad class of materials including a variety of polymer matrices reinforced with carbon and glass fibers. Three parameters are required: the shear stiffness and strength of the composite and the standard deviation of fiber misalignment in the composite. All three parameters can be measured by well-established techniques. Data from the literature is used to validate the formula.
Inner-City Contexts, Church Attendance, and African-American Political Participation

Over the years, an undeniable and convincing body of evidence has emphasized the importance of African-American churches as conduits for political skills, resources, and mobilization. In this study, we examine the growing incidence of neighborhood poverty; never-married, parent house-holds; and perceived social isolation to ascertain the extent to which they undermine church attendance and the associated benefits of increased political engagement, organizational membership, and voting. The major finding of this study is that the inner-city contexts in which African-Americans reside matter for overall political behavior. However, these influences occur much more through the perception of social isolation and family structure than through neighborhood poverty. Moreover, while the results indicate that to an extent inner-city contexts do matter, they also reaffirm the continuing importance and durability of the African-American church as a viable and politically relevant institution in beleaguered, inner-cit...
Spontaneous Raman spectra of dipicolinic acid in microcrystalline form

Dipicolinic acid (DPA) is an important component of bacterial spores. The Raman spectrum of DPA in the form of compacted powder was measured in reflection at room temperature with excitation by a nanosecond laser at 532 nm. The spectrum presents a set of characteristic frequency bands in the region 700-3090 cm � 1 that were identified with characteristic vibrational modes of the DPA molecule.
Use of Evidence-Based Practice As a Method for Evaluating the Effects of Secretin on a Child with Autism

Standardized assessment instruments and direct observation data were collected pre-and postadministration (2 weeks after administration) on the effects of secretin on a 4-year-old boy diagnosed wit...
Numerical Survival Rate Estimation for Capture-Recapture Models Using SAS PROC NLIN

This paper discusses and illustrates recent developments in the modeling and analysis of capture-recapture data for open populations. Results are presented using a unified theory of cohort survival processes. The statistical models for survival rate estimation are represented as products of conditionally independent multinomials; this is achieved by always conditioning on the known number of releases initiating the cohorts. This approach facilitates extension of the Jolly-Seber model to control-treatment studies, or other contexts where comparison of population survival rates is of most interest. Numerical computation of maximum likelihood survival and capture rate estimators, under any model, is easily achieved using iteratively-reweighted nonlinear least squares in SAS PROC NLIN. In his classical paper, Jolly (1965) illustrated his methods using summary statistics on female black-kneed capsids (Blepharidopterus angulatus). Here I use the entire data set on males and females to illustrate survival rate estimation and flexible modeling of capture-recapture data.
An automated filter paper dithionite test for the detection of hemoglobin S.

The automated dithionite test for the detection of hemoglobin S has been modified for use with AutoAnalyzers having a filter paper read-out. This method was compared with results of hemoglobin electrophoresis in 425 individuals, of whom 58 were positive for hemoglobin S. The two methods were in complete agreement. The automated filter paper dithionite test is a rapid, economical, accurate method for detection of hemoglobin S and could be easily incorporated into currently available mass screening equipment.
Influence of Wear Particles on Local and Systemic Immune System

Decreasing periprosthetic osteolysis due to wear particles is a current challenge and an on-going research endeavor to prolong the longevity of joint replacements. The aim of this chapter is to provide the reader keys to the understanding of how the immune system interacts with metallic and non metallic wear particles and other byproducts from joint replacements. The local and systemic immune system is involved in a complex network of chemokines, cytokines, and different cell types which in the end leads to inflammation and a foreign body reaction.
Deletion of a gene cluster for [Ni-Fe] hydrogenase maturation in the anaerobic hyperthermophilic bacterium Caldicellulosiruptor bescii identifies its role in hydrogen metabolism

The anaerobic, hyperthermophlic, cellulolytic bacterium Caldicellulosiruptor bescii grows optimally at ∼80 °C and effectively degrades plant biomass without conventional pretreatment. It utilizes a variety of carbohydrate carbon sources, including both C5 and C6 sugars, released from plant biomass and produces lactate, acetate, CO2, and H2 as primary fermentation products. The C. bescii genome encodes two hydrogenases, a bifurcating [Fe-Fe] hydrogenase and a [Ni-Fe] hydrogenase. The [Ni-Fe] hydrogenase is the most widely distributed in nature and is predicted to catalyze hydrogen production and to pump protons across the cellular membrane creating proton motive force. Hydrogenases are the key enzymes in hydrogen metabolism and their crystal structure reveals complexity in the organization of their prosthetic groups suggesting extensive maturation of the primary protein. Here, we report the deletion of a cluster of genes, hypABFCDE, required for maturation of the [Ni-Fe] hydrogenase. These proteins are specific for the hydrogenases they modify and are required for hydrogenase activity. The deletion strain grew more slowly than the wild type or the parent strain and produced slightly less hydrogen overall, but more hydrogen per mole of cellobiose. Acetate yield per mole of cellobiose was increased ∼67 % and ethanol yield per mole of cellobiose was decreased ∼39 %. These data suggest that the primary role of the [Ni-Fe] hydrogenase is to generate a proton gradient in the membrane driving ATP synthesis and is not the primary enzyme for hydrogen catalysis. In its absence, ATP is generated from increased acetate production resulting in more hydrogen produced per mole of cellobiose.
Financial Abuse of the Elderly

As of 2010, more than 10 percent of the population is aged 65 or older. Another 27% of the population falls into the “Baby Boomer” category, aged between 45 and 64. The financial health of the elderly is precarious. Almost half have no housing wealth and rely almost entirely on Social Security benefits for support. In addition, this group is disproportionately in poor health. Based on a replacement rate comparison, many of these households may be deemed to have been well-prepared for retirement, in the sense that their income in their final years was not substantially lower than their income in their late 50s or early 60s. It is important that the regulations and statutes protect the growing group of retirees. In a survey conducted in 2010, 20% of the respondents age 65 and over say they have been taken advantage of or were the victim of fraud. Many gave incorrect answers to basic investor literacy questions. Victims of fraud may be both men and women. A study conducted by MetLife in 2009 found: “Women who have not been in a position to make financial decisions may be more trusting in the advice of others, particularly if they are new at seeking financial advice. Women with cognitive problems may be easily influenced by others, especially if that influence increases in intensity and becomes a ‘hard sell.’” “Men may tend to be more risk-taking in making financial investments than women, so they may be prone to being vulnerable to ‘professionals’ or family members who seek to invest their money by promising unrealistically high returns.” This paper reviews recent FINRA and SEC actions involving older customers. It then summarizes a number of criminal actions taken at the state level against investment professionals. Lastly, it reviews the state statutes that cover fraud specifically against elderly investors.
Influence of probiotics, included in peanut butter, on the fate of selected Salmonella and Listeria strains under simulated gastrointestinal conditions.

AIMS This study observed the behaviour of probiotics and selected bacterial pathogens co-inoculated into peanut butter during gastrointestinal simulation. METHODS AND RESULTS Peanut butter homogenates co-inoculated with Salmonella/Listeria strains (5 log CFU ml(-1) ) and lyophilized or cultured probiotics (9 log CFU ml(-1) ) were exposed to simulated gastrointestinal conditions for 24 h at 37°C. Sample pH, titratable acidity and pathogen populations were determined. Agar diffusion assay was performed to assess the inhibitory effect of probiotic culture supernatants with either natural (3·80 (Lactobacillus), 3·78 (Bifidobacteirum) and 5·17 (Streptococcus/Lactococcus)) or neutralized (6·0) pH. Antibacterial effect of crude bacteriocin extracts were also evaluated against the pathogens. After 24 h, samples with probiotics had lower pH and higher titratable acidity than those without probiotics. The presence of probiotics caused a significant reduction (P < 0·05) in pathogen populations. Supernatants of Bifidobacterium and Lactobacillus cultures inhibited pathogen growth; however, the elevation of pH diminished their antibacterial activities. Crude bacteriocin extracts had a strain-specific inhibitory effect only towards Listeria monocytogenes. CONCLUSION Probiotics in 'peanut butter' survived simulated gastrointestinal conditions and inhibited the growth of Salmonella/Listeria. SIGNIFICANCE AND IMPACT OF THE STUDY Peanut butter is a plausible carrier to deliver probiotics to improve the gastrointestinal health of children in developing countries.
The early responses of frog embryos to tactile stimulation

In the course of some experiments on the regeneration of the spinal cord of frog embryos, it became necessary to establish certain facts in regard to their earfy tactile responses, as has been done for Diemyctylus and Amblystoma by Coghill. The results of this study are briefly summarized here.The frog embryo exhibits a reaction toward the side stimulated as its first response to tactile stimulation with a fine human hair. This occurs so constantly that it must be regarded as normal for the frog, though only an occasional and aberrant reaction in the salamanders. This first response is followed by an avoiding-, a double-coil-, an S-reaction and the swimming movement, in order.In a number of embryos, the cord was cut at different levels to determine the location in the cord where stimuli are transferred from one side of the body to the other. The results are, briefly, as follows: (1) when the cut passes through the brain, the portion anterior to the cut never responds to stimuli, while that posterior to it...
Identification of shiga like toxin Escherichia coli isolated from children with diarrhea disease by polymerase chain reaction

Objective To evaluate the etiology for Shiga like toxin producing Escherichia coli (SLTEC) in children with diarrhea disease Methods We designed and synthesized 3 pairs of primers located in SLT1, SLT2, and eaeA genes of EHEC, while the virulence genes in SLT1, SLT2, and eaeA from E coli species were amplified by PCR Results One strain of EHEC with SLT1, SLT2, and eaeA in 29 reference strains of diarrhea causing E coli (DCEC) and 10 strains of other enterobacteria detected by PCR had positive reaction, while all other DCEC and enterobacteria were negative A total of 474 strains of E coli isolated from 1 032 children with diarrhea disease detected by PCR were 20 strains of SLT1 producing E coli (4 2%) positive, and 7 strains of SLT2 producing E coli (1 5%) positive, while 74 strains of ESIEC were 15 strains of SLT1 (20 3%) and 5 strains of SLT2 (6 8%) positive Conclusion Shiga like toxin E coli has been identified as a major etiologic agent of children with diarrhea disease in Taiyuan
Total body electrical conductivity measurements in the neonate.

Total body electrical conductivity (TOBEC) measurements provide an estimate of the fat-free mass of the body; fat can be calculated by difference from body weight. Although the assessment of the body composition of normal infants using TOBEC measurements is consistent with our current understanding of body composition changes in early postnatal life, the use of these measurements in premature infants and older children (6 months to 2 years) requires further evaluation. TOBEC measurements are precise, safe, rapid, noninva- sive, and comfortable for the subject. These features together with their potential accuracy make TOBEC measurments a useful aid in the assessment of growth and nutritional status of infants and children.
Origins of Allostery and Evolvability in Proteins: A Case Study.

Summary Proteins display the capacity for adaptation to new functions, a property critical for evolvability. But what structural principles underlie the capacity for adaptation? Here, we show that adaptation to a physiologically distinct class of ligand specificity in a PSD95, DLG1, ZO-1 (PDZ) domain preferentially occurs through class-bridging intermediate mutations located distant from the ligand-binding site. These mutations provide a functional link between ligand classes and demonstrate the principle of "conditional neutrality" in mediating evolutionary adaptation. Structures show that class-bridging mutations work allosterically to open up conformational plasticity at the active site, permitting novel functions while retaining existing function. More generally, the class-bridging phenotype arises from mutations in an evolutionarily conserved network of coevolving amino acids in the PDZ family (the sector) that connects the active site to distant surface sites. These findings introduce the concept that allostery in proteins could have its origins not in protein function but in the capacity to adapt.
Effects of dietary modification and fish oil supplementation on dyslipoproteinemia in pediatric systemic lupus erythematosus

Objective. To determine if a program of dietary modification and fish oil supplementation is effective in treating the dyslipoproteinemia in pediatric systemic lupus erythematosus (SLE). Methods. Prospective clinical trial where each patient serves as his/her own control. Twenty-four consecutive adolescents fulfilling SLE classification criteria were screened with fasting lipid profiles. Patients were identified as having dyslipoproteinemia of active disease or of corticosteroid therapy. Patients were treated for 6 weeks with dietary modification and if dyslipoproteinemia did not normalize with another 6 weeks of dietary modification and fish oil supplementation. Results. Seventeen patients (71 %) had dyslipoproteinemia ; 10 of active disease, 4 of steroid therapy ; 3 with a combined pattern. Eleven patients underwent dietary modification. There was a significant decrease in serum triglyceride concentrations (p <0.05). Total cholesterol, low density lipoprotein cholesterol, and high density lipoprotein cholesterol did not change significantly. A further significant decline in serum triglycerides was achieved with fish oil supplementation (p <0.05). Five of the 11 patients who underwent treatment continued to have dyslipoproteinemia. Conclusion. Dyslipoproteinemia is common in pediatric SLE. Dietary modification and fish oil supplementation appear to be effective in improving serum lipid profiles, and blinded studies are warranted. A significant number of patients may require pharmacologic therapy for persistent dyslipoproteinemia to prevent complications of premature atherosclerosis.
Impact of kangaroo care on parental anxiety level and parenting skills for preterm infants in the neonatal intensive care unit

Abstract Objective To assess impact of kangaroo care (KC) on parental anxiety levels, breastfeeding rates and readiness at discharge. Methods Observational, prospective, pre-post interventional study. State–Trait Anxiety Inventory (STAI) surveys pre-post successful KC sessions and parental readiness survey were administered to eligible parents of preterm infants as well as breastfeeding data was collected. Results The mean change in pre- and post-KC STAI scores was significantly different for state anxiety (12.0 ± 10.9, p Conclusions KC is associated with a lower parental anxiety level, greater confidence in parenting skills and higher breastfeeding rates.
Income Approach to Value

This chapter examines the income approach, an approach based on the economic principle of anticipation of future benefits. Under the income approach, valuation of human capital requires analysis of the expected net income stream directly attributable to the workforce. This chapter reviews several techniques for deriving the present value of the anticipated economic benefits of human capital. Economic benefits are measured as the value of worker outputs contributed to the firm, or alternatively, via employee earnings as a proxy of the value employees contribute to the organization, and as the excess earnings remaining after allocating an appropriate amount of earnings to all other assets of the business. Also discussed are the conceptual logic of the income approach and its contrast with the cost approach.
Sugammadex: Clinical Pharmacokinetics and Pharmacodynamics

The purpose of this chapter is to provide an evidence based understanding of the pharmacokinetics and pharmacodynamics of sugammadex. Sugammadex is a c-cyclodextrin that rapidly reverses the effect of aminosteroid nondepolarizing neuromuscular blocking agents (NMBAs) rocuronium and vecuronium by forming an inactive 1:1 complex. It is only available in an intravenous form with a bioavailabilty of 100%. It does not bind to plasma proteins and is eliminated unchanged by the kidneys. The type of NMBA used and the degree of the residual neuromuscular blockade at the time of administration determine the dose of sugammadex needed and the speed of reversal. Plasma levels of exogenous compounds with similar steroidal structure, such as some hormones, hormonal contraceptives, and pheromones may also be reduced following administration of sugammadex. While the package insert does not indicate dosage adjustments in elderly patients, or those with hepatic, cardiac, pulmonary comorbidities (not approved in pediatric patients less than 18 years or patients with a creatinine clearance less than 30 ml/min), sugammadex dosing possibly should be adjusted based upon the patient’s age and comorbidities, including liver or kidney failure and morbid obesity. Sugammadex has been shown to be an effective agent in reversing the effects of NMBAs with an acceptable safety and efficacy profile.
Reading philosophy, writing poetry: intertextual modes of making meaning in early medieval China

The formation of cultural traditions is a central theme for the intellectual history of the pre-modern world as well as reception studies. As scholars often single out China as being ‘the world’s o...
The Judicial Committee of the Privy Council – Contribution to Judicial Review and Public Law

In this article we discuss the influence that decisions of the Judicial Committee of the Privy Council (hereinafter the “Privy Council”) have had on judicial review and on the development of public...
Frequency Dependent Properties of Materials Containing a Distribution of Pores and/or Inclusions

The properties of a material are significantly changed by the presence of pores and/or inclusions. The dynamic behavior of such materials depends on the concentration, type, size and distribution of the pores and inclusions. Such materials behave effectively like lossy materials not only due to geometric dispersion or multiple scattering, but also real losses, if any, associated with the scatterers. A study of wave propagation in such materials is a convenient way to experimentally and theoretically predict the phase velocity and effective dynamic properties such as elastic moduli and dielectric constants.
Synthesis of Layered, Graded Bioscaffolds

Layered, multi-compartment structures are an important class of biomaterials currently under development; their aim is to more accurately recapitulate the heterogeneity of the native extracellular matrix found in many tissues and organs. This chapter describes the synthesis and characterization of two groups of layered, graded collagen-glycosaminoglycan (CG) scaffolds. The first is a multi-compartment material for osteochondral repair. This material contains distinct cartilagenous and osseous compartments joined via a continuous interface that mimics elements of the native articular cartilage-bone interface (tidemark). Techniques to evaluate the chemical composition, mineral phase and distribution, pore size and shape, mechanics, and permeability in spatially selective manners are also introduced. The second class of material discussed in this chapter is a core-shell composite scaffold for tendon and ligament regeneration. Here, the design strategy was inspired by mechanically efficient core-shell structures in nature such as plant stems. Composites were fabricated from a high-density CG membrane integrated into a highly porous (low-density) anisotropic CG core to enhance construct mechanical competence without sacrificing scaffold porosity. Throughout, cellular solids modeling techniques are used as a framework to understand observed trends in scaffold microstructure and mechanics. Overall, the work described here presents two platform technologies for developing heterogeneously structured materials for complex tissue engineering applications.
Medicinal and Cooling Teas of Barbados

Barbados is the most easterly island of the Caribbean archipelago. The tradition of plant use for medicinal remedies has its origins in the self-help practices of the Africans, Amerindians, and Europeans whose lives were intertwined in the early history of the island. A survey conducted in 2007 to assess the current knowledge base in the rural communities on the island unearthed 93 plant species that are still employed in traditional medicine. The survey encompassed 8 of 11 parishes, 35 rural communities, and over 400 participants. Survey results showed that males and females with some knowledge of the use of plants for medicinal purposes represented 28.5 and 35.9%, respectively, of the sample population. The principal custodians of the knowledge base proved to be the females in the communities aged 45 and older. Families sought for therapeutic agents included Apiaceae, Asteraceae, Boraginaceae, Euphorbiaceae, Liliaceae, Papaveraceae, and Piperaceae. The leaf proved to be the best medicine matrix, and extraction invariably involved boiling or steeping in hot water. In the practice of brewing teas for medicine, hypertension and diabetes prove to be two conditions for which a variety of plants are sourced for natural products. In addition, the therapeutic regimen involves a strategy for good health revolving around the minimization of strain on the body by the elimination of toxins and heat stress. This was evident in the number of plants applied in medicinal teas for detoxification (33) and specifically in cooling teas (37). Denuding of the land by the years of sugarcane cultivation and subsequent development has resulted in a shift in medicinal sources from forested areas to roadsides and pastures and from trees to herbs. Phytochemical investigation of a selection of the plants used for cooling teas revealed a high antioxidant profile that is known to offer protection from degenerative diseases. The plants selected for analysis were shown to be high in polyphenolic compounds that possess bioactive properties, including antioxidative, antihypertensive, anti-inflammatory, antiproliferative, and anti-thrombogenic. This protective profile, silently embodied in ethnomedical tradition, may have contributed to Barbados having one of the highest populations of centenarians per capita.
Experimental Evaluation of Vertically Versus Horizontally Split Yokes for SSC Dipole Magnets

The yoke in SSC dipole magnets provides mechanical support to the collared coil as well as serving as a magnetic element. The yoke and skin are used to increase the coil prestress and reduce collar deflections under excitation. Yokes split on the vertical or horizontal mid-plane offer different advantages in meeting these objectives. To evaluate the relative merits of the two configuration a 1.8 m model dipole was assembled and tested first with horizontally split and then with vertically split yoke laminations. The magnet was extensively instrumented to measure azimuthal and axial stresses in the coil and the cold mass skin resulting from cooldown and excitation. Mechanical behavior of this magnet with each configuration is compared with that of other long and short models and with calculations.
An outlook on wireless coexistence with focus on medical devices

The use of shared and unlicensed radio spectrum has been the impetus of innovative and widely used technologies (e.g., Wi-Fi, Bluetooth, and others) — driving the scene of ubiquitous connectivity for devices, sensors, and peripherals in an encompassing Internet of Things (IoT). However, coexisting technologies operating in unlicensed bands need to share limited spectrum resources while attempting to offer desired performance. This could prove challenging as channel access is not guaranteed, which raises concerns for wireless coexistence in sensitive applications like medical devices. In this article, we provide a brief review of topics forming the current stage of wireless coexistence in research, industry, and regulatory circles. We present the standardization activities for the evaluation of wireless coexistence, and recent advancements of unlicensed spectrum technologies such as Wi-Fi, Bluetooth, and Long Term Evolution (LTE) in unlicensed bands, along with proposed evaluation methods.
Physical Therapist Student Readiness for Entrance Into the First Full-Time Clinical Experience: A Delphi Study.

Background To consistently prepare physical therapist students for their first full-time clinical experience, the entry-level curriculum must provide and assess competency in the essential knowledge, skills, attitudes, and professional behaviors. Objective The purpose of this Delphi study was to develop consensus on a core set of elements that should be demonstrated by physical therapist students prior to entry into their first full-time clinical experience. A second aim was to obtain the recommended competency levels and assessment methods. Design The study was conducted using the Delphi method. Methods Purposive selection and snowball sampling techniques were used to recruit clinical instructors, recent graduates, directors or academic coordinators of clinical education, and academic faculty. Four web-based survey rounds were used to achieve consensus, defined as agreement among ≥80% of respondents. The first round gathered demographic information on respondents and identified elements that were deemed essential; the second collected information about clarity and redundancy in the elements provided; the third asked participants to rank their agreement with elements and themes; and the fourth gathered the level of competency that physical therapist students should demonstrate prior to beginning a first full-time clinical experience. Results Consensus revealed 95 elements, categorized under 14 themes, which were deemed essential for readiness for the first clinical experience. Levels of competency for each element were identified. Limitations Participants might not have represented all academic programs, practice settings, and geographic locations. Conclusion This study identified the specific knowledge, skills, attitudes, and professional behaviors in which all physical therapist students in the United States need to demonstrate competency before their first clinical experience, regardless of school or setting, which would allow learning experiences to be tailored appropriately.
The effect of inhalational anaesthesia during deceased donor organ procurement on post-transplantation graft survival

Many deceased by neurologic criteria donors are administered inhalational agents during organ recovery surgery-a process that is characterised by warm and cold ischaemia followed by warm reperfusion. In certain settings, volatile anaesthetics (VA) are known to precondition organs to protect them from subsequent ischaemia-reperfusion injury. As such, we hypothesised that exposure to VA during organ procurement would improve post-graft survival. Lifebanc (organ procurement organisation [OPO] for NE Ohio) provided the investigators with a list of death by neurologic criteria organ donors cared for at three large tertiary hospitals in Cleveland between 2006 and 2016-details about the surgical recovery phase were extracted from the organ donors' medical records. De-identified data on graft survival were obtained from the United Network for Organ Sharing (UNOS). The collated data underwent comparative analysis based on whether or not VA were administered during procurement surgery. Records from 213 donors were obtained for analysis with 138 exposed and 75 not exposed. Demographics, medical histories, and organ procurement rates were similar between the two cohorts. For the primary endpoint, there were no significant differences observed in either early (30-day) or late (five-year) graft survival rates for kidney, liver, lung, or heart transplants. Our findings from this retrospective review of a relatively small cohort do not support the hypothesis that the use of VA during the surgical procurement phase improves graft survival. Reviews of larger datasets and/or a prospective study may be required to provide a definitive answer.
Rapid loss of perihematomal cell viability in the collagenase intracerebral hemorrhage model

Abstract The effective time window of any therapeutic in an experimental stroke model is limited by the rate of injury progression. Intracerebral hemorrhage in rodents is commonly induced by striatal injection of either autologous blood or bacterial collagenase, which digests local blood vessels. During time window studies of the heme oxygenase-1 inducer hemin, which is protective when administered within 1–3 h in both models, the rate of perihematomal injury was directly compared after striatal blood or collagenase injection. Surprisingly, about 80% of the loss of perihematomal cell viability as measured by MTT reduction assay occurred within 6 h of collagenase injection. In contrast, significant viability loss was not observed at this time point after autologous blood injection, but rather it progressed over the subsequent four days to a level similar to that produced by collagenase. Consistent with these observations, systemic hemin therapy reduced blood-brain barrier disruption and perihematomal cell injury when initiated at 6 h after striatal injection of blood but not collagenase. These results indicate that the rate of early cell injury differs markedly in the collagenase and blood injection ICH models, which may contribute to inconsistent results in time window studies. The blood injection model may be more appropriate for prolonged time window studies of a neuroprotective agent.
How Does Pretesting for PubMed Knowledge Spark Student Learning

Predoctoral students enter dental school with varying skill levels for searching biomedical databases and a tendency to overestimate their abilities. Accordingly, PubMed instruction is embedded within a required dental course and includes a graded component. This article describes a pretest/intervention/posttest developed for the PubMed session. The expectation for this new assessment was that motivation to learn PubMed would increase during the intervention if pretesting objectively showed students the difference between their self-perceived versus actual PubMed abilities. The goals were to help students better self-assess their genuine searching abilities, spark learning during the instruction session, and elicit measurable improvement in skills.
A Formation Map of Iron-Containing Intermetallic Phases in Recycled Cast Aluminum Alloys

The cooling rate-dependent modification effect of Mn on the formation of Fe-containing intermetallic phases during solidification of Al-Si-Mg secondary cast aluminum alloys [containing 0.5 to 1 pct Fe (All compositions are in wt pct unless otherwise stated.)] was investigated by CALculation of PHAse Diagrams (CALPHAD) modeling and solidification experiments. The critical Mn concentration required to prevent the formation of detrimental β-Al5FeSi was found to be dependent on both the alloy composition (particularly the Fe/Mn ratio) and the cooling rate. A map of Fe/Mn ratio vs cooling rate was created, to summarize the metallurgical conditions of Fe-rich intermetallic phase formation. By understanding such formation conditions, the microstructure of aluminum castings can be controlled to create low-cost secondary alloys with high Fe content.