cssi/SciSciGPT-SciSciNet huggingface dataset:
Utility of WT1 as a Reliable Tool for the Detection of Minimal Residual Disease in Children with Leukemia

WT1 encodes a transcription factor involved in the pathogenesis of Wilms' tumor. A high level of expression has been reported in blasts from patients with various hematological malignancies. The study was performed to evaluate the utility of monitoring WT1 expression in children with leukemia at diagnosis, during therapy, and following bone marrow transplant. We tested a total of 204 samples prospectively. These included samples from patients with the following diagnoses: acute lymphoblastic leukemia (ALL) at diagnosis (n = 45), at relapse (n = 14), and in remission (n = 45); acute non-lymphoblastic leukemia (ANLL) at diagnosis (n = 14), at relapse (n = 5), and in remission (n = 12); and chronic myelogenous leukemia (CML) in blast crisis (n = 1) and in chronic phase (n = 1). A total of 33 of these patients were transplanted: 19 ALL, 12 ANLL, and 2 CML. In addition, samples from 5 patients with aplastic anemia and 28 controls were obtained from peripheral blood (n = 17), cord blood (n = 3), and bone marrow (n = 8). Primer pairs were designed to locate specific nucleotide sequences for mRNA of WT1. RT-PCR was performed in all samples and compared with K562 cells from ATCC (defined as 1.0) as positive control. A positive test was arbitrarily defined as WT1/K562 > 0.5. Samples at diagnosis and relapse, including 56 out of 59 ALL (95%), 26 ANLL (100%), and 1 CML in blast crisis, demonstrated high levels of WT1 expression. In contrast, only 5 of 90 samples obtained in remission or post-transplant showed high levels of WT1 expression (P < 0.0001; 95% CI = 0.66–0.94). The five patients with high WT1 expression during follow-up relapsed within 2 to 6 months. In conclusion, we have found that WT1 is consistently elevated in children with leukemia. Significant differences in the level of WT1 expression were noted between these patients during diagnosis and at relapse, and those during remission. More importantly, following bone marrow transplant, a significant high level of WT1 expression preceded clinical relapse by 2 to 6 months. Therefore, WT1 is a reliable marker for monitoring minimal residual disease during therapy as well as in the post-transplant period.
Stimulant drug use in children and adolescents with mental retardation: A review

Stimulant drug use in mentally retarded children and youth has increased consistent with a change in treatment philosophy to the least restrictive alternative. However, empirical documentation supporting increased use of such pharmacological agents is warranted. Studies that have examined this issue over the past 50 years are reviewed, and the adequacy of dependent measures and research methodology are examined. Recommendations are made for the development of a multimodal assessment model. Also, it is suggested that during this initial stage of investigation, single-case design strategies will be useful to document the controlling effects of stimulant medication over observed target behaviors, to be followed by larger-scale controlled group outcome studies.
Gas Chromatograph Injection Liner for Continuous Analyte Admission into a Mass Spectrometer

An inexpensive modification to a gas chromatography injector liner is reported that facilitates continuous admission of analyte into a gas chromatograph/mass spectrometer (GC/MS) for methods development. The MS methods development liner can be made by making simple modifications to commercially available liners and fits into standard injectors in place of the normal liners without any need to break vacuum in the MS. The injector temperature and gas flow rates are adjusted to provide appropriate analyte levels in the MS, which can be admitted under conditions identical with those of real analyses, including co-admission of column bleed. The device is particularly useful for development of tandem MS methods in GC/MS/MS instruments, which are configured with the GC as the sole sample inlet.
A survey of interference problems and applications to geostationary satellite networks

The fundamental limitation in the utilization of the geostationary orbit is the mutual interference generated by satellite networks. A review of the theory of operation of communication systems in an interference environment is provided, with particular attention to those systems of importance in space communications, namely multi-channel FM telephony, frequency-modulated television, and coherent PSK digital signals. Examples are then given to show the limiting effects of interference on orbit utilization.
Do mitochondria participate in general cardiac hypertrophy

Conclusions and summary1. Left ventricular weight:body weight ratio of a group of hypertensive rats was 55% greater than that of similar group of normotensive rats. 2. Ratio of “non-particulate” proteins of left ventricle to total body weight was 53% greater in hypertensive group than in normotensive group. 3. Mitochondria of left ventricle also participated in cardiac hypertrophy of the hypertensive group. Mitochondrial protein:body weight ratio was 25% greater in hypertensive group than in normotensive group. 4. Sub-mitochondrial particles of left ventricle, smaller in size than the mitochondria, also participated in cardiac hypertrophy. Ratio of protein in these particles to total body weight was 37% greater in hypertensive series than in normotensive series. 5. Hypertrophy of mitochondria, however, was not as great proportionately as that of left ventricle as a whole. Ratio of mitochondrial protein to total left ventricular weight was 19% less in hypertensive rats than in normotensive group. When expr...
Location specific summarization of climatic and agricultural trends

Climate change can directly impact agriculture. Failure in different aspects of agriculture due to climate change and other influencing factors, are extremely rampant in several agrarian economies, most of which go unnoticed. In this paper, we describe the design of a system that mines disparate information sources on the Web to automatically summarize important climatic and agricultural trends for any specific location and construct a location-specific climatic and agricultural information portal. We have evaluated the system across 605 different districts in India. The results revealed a pan-India scenario of different problem affected areas. The key findings from this work include, around 64.58% of the districts of India suffer from soil related issues and 76.02% have water related problems. We have also manually validated the authenticity of our information sources and validated our summarized results for specific locations with findings in reputed journals and authoritative sources.
Microring resonators vertically coupled to buried heterostructure bus waveguides

The authors demonstrate all epitaxial semiconductor microring resonators vertically coupled to buried heterostructure (BH) bus waveguides for the first time. Planar vertically stacked waveguides are successfully grown on BH mesas by conducting a two-step regrowth process. This approach is potentially important for any buried waveguide technology where subsequent surface planarity is required. The measured transmission spectra show resonance dips (1.55/spl sim/1.60) /spl mu/m with quality factors, extinction ratios, and free spectral ranges of 2500-3.5 dB, and /spl sim/11 nm, respectively, for 10-/spl mu/m-radii microrings.
Modeling magnetospheric response to synthetic Alfvénic fluctuations in the solar wind: ULF wave fields in the magnetosphere

Several observational studies suggest that small fluctuations in the solar wind can drive magnetospheric dynamics, notably ultralow frequency (ULF) waves, especially during high-speed streams (HSS). ULF fluctuations are believed to be a mechanism for controlling and accelerating radiation belt electrons, and are an important aspect to HSS storms. Previous simulation studies have begun to investigate generation of magnetospheric ULF waves by varying upstream solar wind conditions, such as dynamic pressure or velocity shear. Alfvenic fluctuations, however, which are prevalent within the solar wind, have yet to be incorporated into global MHD simulations of the magnetosphere. To investigate the relationship between Alfvenic fluctuations in the solar wind and magnetospheric ULF waves, we present results from the Lyon-Fedder-Mobarry global, three-dimensional magnetohydrodynamic (MHD) code. These simulations are driven with simulated solar wind plasma parameters from the Wang-Sheeley-Arge-Enlil model with and without Alfven-like fluctuations added. We show that solar wind Alfvenic fluctuations enhance Kelvin-Helmholtz waves along the flanks and drive ULF waves in the dayside magnetosphere. The dayside ULF waves are an enhancement of the compressional component in field-aligned coordinates, due to the varying x component of the velocity (and therefore dynamic pressure) from the Alfvenic fluctuations.
Why a World State is Inevitable

Long dismissed as unscientific, teleological explanation has been undergoing something of a revival as a result of the emergence of self-organization theory, which combines micro-level dynamics with macro-level boundary conditions to explain the tendency of systems to develop toward stable end-states. On that methodological basis this article argues that a global monopoly on the legitimate use of organized violence — a world state — is inevitable. At the micro-level world state formation is driven by the struggle of individuals and groups for recognition of their subjectivity. At the macro-level this struggle is channeled toward a world state by the logic of anarchy, which generates a tendency for military technology and war to become increasingly destructive. The process moves through five stages, each responding to the instabilities of the one before — a system of states, a society of states, world society, collective security, and the world state. Human agency matters all along the way, but is increasi...
Turnover of bone zinc during normal and accelerated bone loss in rats

The ability of the skeleton to serve as a reservoir of available zinc was investigated in weanling and 7-week-old rats. Bone turnover was measured by the loss of previously incorporated 3H-tetracycline (TC), in conditions of normal turnover accompanying growth or accelerated loss produced by calcium deficiency. The 4-week studies involved four experimental groups per age group (all combinations of high and low calcium, high and low zinc). By measuring loss of 3H-TC and whole bone (humerus) contents of Zn and Ca, it was possible to calculate the deposition and resorption of Zn and Ca during the experimental period. Several conclusions emerged from the study: 1) availability of Zn from the skeleton was dependent on the rate of bone resorption, but not on Zn status; 2) redeposition of Zn in the skeleton following resorption was extensive, and independent of the rate of bone mineral deposition; and 3) in Ca deficiency there was an increased deposition of Zn, suggesting a partial substitution of Zn for Ca in bone mineral. The results support the concept that the skeleton does not serve as a reservoir for Zn. Very little Zn is made available by bone resorption, and even then Zn is lost only in a passive manner that is dependent on, but does not influence, bone turnover. The availability of Zn from the skeleton is not mediated by Zn status.
Structure of the cinnamyl-alcohol dehydrogenase gene family in rice and promoter activity of a member associated with lignification.

Analysis of lignification in rice has been facilitated by the availability of the recently completed rice genome sequence, and rice will serve as an important model for understanding the relationship of grass lignin composition to cell wall digestibility. Cinnamyl-alcohol dehydrogenase (CAD) is an enzyme important in lignin biosynthesis. The rice genome contains 12 distinct genes present at nine different loci that encode products with significant similarity to CAD. The rice gene family is diverse with respect to other angiosperm and gymnosperm CAD genes isolated to date and includes one member (OsCAD6) that contains a peroxisomal targeting signal and is substantially diverged relative to other family members. Four closely related family members (OsCAD8A–D) are present at the same locus and represent the product of a localized gene duplication and inversion. Promoter-reporter gene fusions to OsCAD2, an orthologue of the CAD gene present at the bm1 (brown midrib 1) locus of maize, reveal that in rice expression is associated with vascular tissue in aerial parts of the plant and is correlated with the onset of lignification. In root tissue, expression is primarily in the cortical parenchyma adjacent to the exodermis and in vascular tissue.
The Impact of Personality on Cognitive, Behavioral, and Affective Political Processes: The Effects of Need to Evaluate

Need to evaluate (NE) is a personality trait that reflects a person's proclivity to create and hold attitudes; people high in NE are especially likely to form attitudes toward all sorts of objects. Using data from the 1998 National Election Survey Pilot and the 2000 National Election Survey, NE was shown to predict a variety of important attitude-relevant cognitive, behavioral, and affective political processes beyond simply holding attitudes: NE predicted how many evaluative beliefs about candidates a person held, the likelihood that a person would use party identification and issue stances to determine candidate preferences, the extent to which a person engaged in political activism, the likelihood that a person voted or intended to vote, the extent to which a person used the news media for gathering information, and the intensity of emotional reactions a person felt toward political candidates. Thus, NE appears to play a powerful role in shaping important political behavior, emotion, and cognition.
The Roles of LAT in Platelet Signaling Induced by Collagen, TxA2, or ADP☆

The work presented here demonstrates that platelets from mice lacking LAT (linker for the activation of T cells) show reversible aggregation in response to concentrations of collagen that cause TxA2/ADP-dependent irreversible aggregation of control platelets. The aggregation defect of the LAT-deficient platelets was shown to be the result of almost no TxA2 production and significantly diminished ADP secretion. In contrast, the LAT deficiency does not affect aggregation induced by high concentrations of collagen because that aggregation is not dependent on TxA2 and/or ADP. Even though ADP and TxA2 provide amplification signals for platelet activation in response to low concentrations of collagen, LAT-deficient platelets hyperaggregate to low levels of U46619, a TxA2 analog, or ADP. Though the mechanism(s) of costimulatory signals by collagen, ADP, and TxA2 remains unidentified, it is clear that LAT plays a positive role in collagen-induced, TxA2/ADP-dependent aggregation, and a negative role in TxA2 or ADP-induced platelet aggregation.
Optimal frequency separation of cylindrical shells

Abstract : A new and powerful algorithm is applied to the problem of optimal frequency separation of stiffened cylindrical shells. New methodology is introduced which allows the simultaneous separation of several modes of vibration. Results indicate that the procedure can effectively deal with this difficult optimization problem. (Author)
A Longitudinal Study Of Finances At A State Supported University

This study examines information on expenditures at the university and state system levels and identifies trends in the expenditures that support the educational mission of the university. The study period is from fiscal year 95-96 to fiscal year 01-02. This seven- year period encompasses the recovery of state support after the budget reductions of the early 90’s to the beginning of a new round of budgetary constraints. The system-wide data is used to compare trends in the state university expenditures and peer campus expenditures with trends in this university’s financing. The annual campus expenditures are analyzed by division and college or school to identify trends and for comparisons. Significant disparities in the allocation of resources at the state and campus levels are evidenced.
Probabilistic Methods in Differential Geometry

Let M be a Riemannian manifold with metric g. The metric g determines a second order elliptic operator Δ called the Laplace-Beltrami operator. Assume that locally the metric is given by the matrix ds 2 = g ijdxidxj, then the operator Δ has the form $$\Delta = \frac{1}{{\sqrt {\det g} }}\frac{\partial }{{\partial {x^i}}}\left( {\sqrt {\det g{g^{ij}}} \frac{\partial }{{\partial {x^j}}}} \right).$$
Proton Magnetic Resonance Spectroscopy–An Aid in Identification and Chemotaxonomy of Yeasts1

Publisher Summary The chapter discusses the importance of proton magnetic resonance spectroscopy as an aid in identification and chemotaxonomy of yeasts. The term “yeast” refers to ascomycetes of the subclass hemiascomycetidae, order endomycetales, family saccharomycetaceae, which possess a predominantly unicellular thallus. They reproduce asexually by budding, transverse division or both and produce ascospores in a naked ascus, originating either from a zygote or parthenogenetically from a single somatic cell. Forms not known to produce ascospores are not obviously related to other groups of fungi. The chapter describes the chemotaxonomy of yeasts according to their mannose-containing polysaccharides. It discusses the application of the proton magnetic resonance spectroscopic method to yeast polysaccharides, isolation of mannose-containing polysaccharides of yeasts and preparation of pmr spectra, and methods used in determination of chemical structure of yeast mannose-containing poly saccharides. Finally, the chapter presents an overview of the classification of yeasts according to the pmr spectra of their mannose-containing polysaccharides.
Judicial Review, the Long-Run Game: An Exploration of Endogenous Institutional Change at the U.S. Supreme Court

This paper argues that the United States Supreme Court has engaged in a long-run project to expand its political influence by expanding the power associated with constitutional judicial review. The Court has recognized that its standing in the American separation-of-powers system depends critically on the ease with which other political actors can eff ectively nullify its rulings. Accordingly, the Court has sought to increase its authority by increasing the costs over such overrides with a special focus on increasing the public backlash against such eff orts. To do so, the Court has sought public legitimacy by insisting on the existence of a distinction between law and politics, and issuing decisions it describes as "law" and that it hopes will be politically palatable to the general public. I explore the Court's use of such a long-run strategy using three case studies: Chief Justice Marshall's successful e ffort to capture constitutional interpretation for the Court; the Court's abandonment of the Reconstruction Amendments; and the Court's reversal of course regarding its ability (or willingness) to consider redistricting disputes.
Menarche and Menstruation

Menarche, as a rite of passage, and menstruation, as an ongoing fact of a woman’s life, are central to women’s experience. The entry into and exit from reproductive capability seem clearly evident to most women. Until reliable birth control became available in the last century, the menstrual cycle governed women’s lives. The phenomenology of the menstrual cycle deserves the attention of psychoanalysts, because of both its presence during 30 to 40 years of women’s lives, and the possible clues it offers in understanding the complex interplay of psyche and soma in the generation of psychological experience.
Circumferences of 3-connected claw-free graphs

In Li et?al. (2009), proved that a 3-connected claw-free graph of order n with minimum degree ? contains a cycle of length at least min { n , 6 ? - 15 } , and they conjectured that such graphs should have a cycle of length at least min { n , 9 ? - 3 } . We prove that this conjecture is true with ? ? 8 .
Estimating the sustainability returns of recycling construction waste from building projects

Abstract The focus of this study is incorporating construction sectors within the concept of sustainable building, which essentially concerns resource management as well as waste management. It is evident that building construction is one of the largest consuming activities of non-renewable resources and natural materials worldwide. Simultaneously, enormous amounts of construction and demolition waste are generated as construction works expand to meet the increasing demand. This is not only considered an economic loss, but also an accelerating environmental threat. Therefore, it has become crucial for construction waste management to evolve away from the long practiced traditional methodology, which has been proven economically and ecologically inefficient, toward sustainable alternatives that prioritize waste recovery over disposal. Within this context, this study addresses the management of construction waste by selecting case studies of actual construction projects and scrutinizing their waste management data. The study took place at the University of Massachusetts—Amherst, where all selected projects conform to the U.S. Green Building Council standards. Thus, the study works on estimating the financial and environmental returns attained by recycling construction waste from such projects. By utilizing the results from the data analysis, the study eventually sets a statistical paradigm with field-based values for typical construction projects to be followed as a guide, indicating how much cost can be saved, and how much landfill volume can be relieved when material waste is recycled. Thereby, the study serves to enhance the sustainable management of construction waste by maximizing the returns of construction waste recovery.
Gender and self-reported sexual arousal in response to sexual stimuli: A meta-analytic review.

Social constructionist theories and sociobiological perspectives have led to increased interest in gender differences in sexual behavior. This study involved a meta-analysis of gender differences in sexual arousal in response to sexual stimuli. Forty-six studies in which participants were presented with a sexual stimulus depicting males and females and in which participants responded using a self-report measure of arousal were compiled, and 62 independent effect sizes were aggregated. An overall effect size of d = .31 showed a small to moderate-sized gender difference in sexual arousal with men reporting more arousal than women across all studies. There was significant variation in the effect sizes, though, which was only partially explained by variables coded from the studies. It was found that the gender difference was slightly larger for studies using pornographic vs. erotic stimuli, was larger for studies where participants were tested in a private setting or small group compared to a large group, and was much larger for college age participants compared to those who were older than college age. Generally, the pattern of results provided more support for predictions from social influence theories compared to sociobiological theory.
Integrating resuspension with remodeling: Early results with a new valve-sparing aortic root reconstruction technique

Background and aim of the study Currently, two different valve-sparing aortic root reconstruction methods are utilized, namely reimplantation and remodeling. Herein are reported the authors' early results with a new technique that integrates the two procedures. Methods Seven patients (age range: 25-69 years) underwent valve-sparing aortic root replacement with a new technique that integrates the principles of the David and Yacoub operations. The preoperative aortic root sizes were 4.9 to 7.0 cm, and six patients had aortic regurgitation (grade 1+ to 3+). Surgery was divisible into four stages: (i) External subcommissural (downsizing) annuloplasty; (ii) graft sizing and valve competency assessment with saline squirt test; (iii) sewing the individual tongues of a hand-scalloped Hemashield graft to the annular tissue with subvalvular pledgeted mattress sutures; and (iv) running suture lines to the commissural aspects of the aortic wall, followed by coronary reimplantation. Results All patients survived surgery. Intraoperative transesophageal echocardiography showed trace aortic incompetence (AR) in five patients, and mild or moderate AR each in one patient. Over a two-year period the technique was improved to the above-described, four-stage approach, which resulted in only trace AR in the final three patients. Early serial transthoracic echocardiography confirmed stable root dimensions and no progression of AR, except in an early patient. Conclusion In the described technique, graft sizing is strictly tied to early intraoperative valve competency testing after an initial reconstruction within the native aortic root. The operation is then converted into a modified remodeling by suturing the triple-tongued (Yacoub) graft to the true aortic annulus with subannular pledgets (David principle). The operation involves significantly less dissection around the aortic root, and the entire scalloped annulus is stabilized in between the graft material and pledgets.
Dopamine and opioid systems interact within the nucleus accumbens to maintain monogamous pair bonds

Prairie vole breeder pairs form monogamous pair bonds, which are maintained through the expression of selective aggression toward novel conspecifics. Here, we utilize behavioral and anatomical techniques to extend the current understanding of neural mechanisms that mediate pair bond maintenance. For both sexes, we show that pair bonding up-regulates mRNA expression for genes encoding D1-like dopamine (DA) receptors and dynorphin as well as enhances stimulated DA release within the nucleus accumbens (NAc). We next show that D1-like receptor regulation of selective aggression is mediated through downstream activation of kappa-opioid receptors (KORs) and that activation of these receptors mediates social avoidance. Finally, we also identified sex-specific alterations in KOR binding density within the NAc shell of paired males and demonstrate that this alteration contributes to the neuroprotective effect of pair bonding against drug reward. Together, these findings suggest motivational and valence processing systems interact to mediate the maintenance of social bonds.
SENSITIVITY TO SIMULATED DIRECTIONAL SOUND MOTION IN THE RAT PRIMARY AUDITORY CORTEX

Sensitivity to simulated directional sound motion in the rat primary auditory cortex. This paper examines neuron responses in rat primary auditory cortex (AI) during sound stimulation of the two ea...
Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies

Purpose. Drug dose recommendations are not well defined in patients undergoing continuous renal replacement therapy (CRRT) due to limited published data. Several guidelines and pharmacokinetic equations have been proposed as tools for CRRT drug dosing. Dose recommendations derived from these methods have yet to be compared or prospectively evaluated. Methods. A literature search of PubMed, Micromedex, and Embase was conducted for 40 drugs commonly used in the ICU to gather pharmacokinetic data acquired from patients with acute and chronic kidney disease as well as healthy volunteers. These data and that obtained from drug package inserts were gathered for use in three published CRRT drug dosing equations. Doses calculated for a model patient using each method were compared to doses suggested in a commonly used dosing text. Results. Full pharmacokinetic data was available for 18, 31, and 40 agents using acute kidney injury, end stage renal disease, and normal patient data, respectively. On average, calculated doses differed by 30% or more from the doses recommended by the renal dosing text for >50% of the medications. Conclusion. Wide variability in dose recommendations for patients undergoing CRRT exists when these equations are used. Alternate, validated dosing methods need to be developed for this at-risk patient population.
Building Bridges for Student Success: Are Higher Education Articulation Policies Effective?

Background/ContextAlthough the importance of facilitating transfer from community colleges to 4-year institutions is almost universally accepted, there is little consensus on how to measure transfe...
Multitasking simulation: Present application and future directions

The Accreditation Council for Graduate Medical Education lists multi-tasking as a core competency in several medical specialties due to increasing demands on providers to manage the care of multiple patients simultaneously. Trainees often learn multitasking on the job without any formal curriculum, leading to high error rates. Multitasking simulation training has demonstrated success in reducing error rates among trainees. Studies of multitasking simulation demonstrate that this type of simulation is feasible, does not hinder the acquisition of procedural skill, and leads to better performance during subsequent periods of multitasking. Although some healthcare agencies have discouraged multitasking due to higher error rates among multitasking providers, it cannot be eliminated entirely in settings such as the emergency department in which providers care for more than one patient simultaneously. Simulation can help trainees to identify situations in which multitasking is inappropriate, while preparing them for situations in which multitasking is inevitable.
Probing the Conformational Dynamics of Butyrophilin 3A1 using Atomic Force Microscopy and Molecular Dynamics Simulations

In certain types of cancers and pathogenic infections such as Mycobacterium tuberculosis an accumulation of pyrophosphate metabolites, collectively called phosphoantigens (pAgs), in the unhealthy cell can lead to immune recognition and response. Vγ9Vδ2 T-Cells are primarily responsible for this recognition, and Butyrophilin 3A1 (BTN3A1) has been identified as a key mediator in this pAg induced response. Recent progress demonstrates that pAg binds to the intracellular domain of BTN3A1 resulting in stimulation of the T-Cell. The sequence of events that connects pAg binding to this stimulation remain unclear. Previous crystallographic and cell biological studies have provided starting hypotheses, focusing mainly on conformational change and membrane immobilization. To further probe this system and test these hypotheses, atomic force microscopy (AFM) and molecular dynamics (MD) simulations have been employed to elucidate the dynamics of the pAg binding pocket and the subsequent conformational changes associated with this binding. The primary focus of AFM experiments was to survey the topography of the extracellular domains on a supported bilayer with and without phosphoantigen. Molecular Dynamics simulations with explicit solvent focused on the intracellular ligand binding domain in an attempt to characterize both protein-protein and protein-ligand interactions. Together these physical techniques have started to shed light upon this complex biological system.
Serotonergic Antidepressants Are Associated with Increased Blood Loss and Risk for Transfusion in Single-Level Lumbar Fusion Surgery

Study design Retrospective case-control study. Purpose The purpose of this study was to examine the effect of antidepressants on blood loss and transfusion requirements in spinal surgery patients. Overview of literature Several studies have shown an increase in perioperative bleeding in orthopedic surgery patients on antidepressant drug therapy, yet no study has examined the impact of these agents on spinal surgery patients. Methods Charts of patients who underwent single-level spinal fusion (posterior lumbar interbody fusion with posterior instrumentation) performed by five fellowship-trained surgeons at a tertiary spine center between 2008 and 2013, were retrospectively reviewed. Exclusion criteria included select medical comorbidities, select drug therapy, and Amercian Society of Anesthesiologists Physical Status Classification score of greater than 2. Serotonergic antidepressants were examined in multivariate analysis to assess their predictive value on estimated blood loss and risk of transfusion. Results A total of 235 patients, of which 52% were female, were included. Allogeneic blood was transfused in 7% of patients. The average estimated blood loss was 682±463 mL. Selective serotonin reuptake inhibitors were taken by 10% of all patients. Multivariable regression analysis showed that intake of selective serotonin reuptake inhibitors was a significant predictor for blood loss (average increase of 34%, p=0.015) and for the need of allogeneic blood transfusion (odds ratio, 4.550; p=0.029). Conclusions There was a statistically significant association between selective serotonin reuptake inhibitors and both increased blood loss and risk of allogeneic red blood cell transfusion. Surgeons and perioperative providers should take these findings into account when assessing patients' preoperative risk for blood loss and transfusion.
Lipid Emulsion, More Than Reversing Bupivacaine Cardiotoxicity: Potential Organ Protection.

Efforts to develop a treatment for bupivacaine cardiotoxicity led to the discovery that Intralipid, a popular brand of intravenous lipid emulsion, could be used not only as an effective treatment for anesthetic-induced cardiac arrest, but also as a means of reversing many other toxicities. Contradictory data exist regarding the mechanism of action of lipid emulsion, a combination of fatty acids traditionally used in parenteral nutrition. Some researchers attribute the effects to lipophilicity and the individual characteristics of the lipids, while other data demonstrate a direct empowering mechanism through cellular upstream and downstream pathways. Understanding the underlying mechanism of action of this safe source of calories may assist in the development of novel organ protective agents. In this review, some of the direct cardiac effects of lipid emulsion are briefly discussed. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.
Open Problems and New Directions for p -Modulus on Networks

The notion of p-modulus was created, and continues to play a vital role, in complex analysis and geometric function theory. Here we give an overview of the theory of p-modulus on networks that we have been developing in recent years. The hope is not only to develop a flexible tool on networks that can be useful for practical applications, but also that the rich unfolding theory on network will eventually inform the classical theory on metric measure spaces, Euclidean spaces, and the complex plane. We end by offering three open problems that are purely network theory problems. To keep the paper self-contained, we have not included possible applications, both to practical problems and to more theoretic function theoretic problems. We leave those directions for another time.
Framework for quantifying flow and sediment yield to diagnose and solve the aggradation problem of an ungauged catchment

Abstract. Estimating sediment deposition in a stream, a standard procedure for dealing with aggradation problem is complicated in an ungauged catchment due to the absence of necessary flow data. A serious aggradation problem within an ungauged catchment in Alabama, USA, blocked the conveyance of a bridge, reducing the clearance under the bridge from several feet to a couple of inches. A study of historical aerial imageries showed deforestation in the catchment by a significant amount over a period consistent with the first identification of the problem. To further diagnose the aggradation problem, due to the lack of any gauging stations, local rainfall, flow, and sediment measurements were attempted. However, due to the difficulty of installing an area-velocity sensor in an actively aggrading stream, the parameter transfer process for a hydrologic model was adopted to understand/estimate streamflow. Simulated discharge combined with erosion parameters of MUSLE (modified universal soil loss equation) helped in the estimation of sediment yield of the catchment. Sediment yield for the catchment showed a significant increase in recent years. A two-dimensional hydraulic model was developed at the bridge site to examine potential engineering strategies to wash sediments off and mitigate further aggradation. This study is to quantify the increase of sediment yield in an ungauged catchment due to land cover changes and other contributing factors and develop strategies and recommendations for preventing future aggradation in the vicinity of the bridge.
The Radicalization of “Seeing” An Attempt To Go Beyond Reflection

We intend to disclose the original intention of Husserl’s phenomenology as the radicalizing of the act of “seeing.” Why Husserl failed to further radicalize this philosophical knowing is precisely because this radicalization requires to elucidate the nature of and go beyond reflection as philosophical cognition. This reflection is none but the self introspection presupposing the traditional subject-object dichotomy. To overcome limits of the subjectivistic notion of reflection we must achieve phenomenological epoche on the theoretical domain and even on the practical sphere. A parallel is discovered between this radicalized phenomenological approach and that of Zen philosophy for our future philosophical method.
Corruption in Autocracies

Corruption is typically depicted as a result of one of two factors: a lack of political accountability or insufficient state capacity. Nonetheless, substantial variation in corruption levels exists even within the set of politically unaccountable high-capacity regimes. In this paper, we examine a third determinant of corruption ‐ the ideological appeal of the government ‐ and demonstrate that this variable can explain variation in the types and levels of corruption experienced in politically unaccountable regimes. Using a model of both moral hazard and adverse selection, we predict that (1) regimes that inspire the intense ideological loyalty of the populace are likely to enjoy low levels of petty corruption and that (2) autocratic regimes that enjoy such intense support from only a narrow segment of the populace will erect credible anti-corruption institutions. Political corruption, by contrast, need not covary with levels of ideological support. We illustrate the mechanisms of our model through a series of case studies that demonstrate the importance of ideology in driving levels of corruption ‐ with a particular focus on low levels of corruption in ‘developmentalist’ regimes. Finally, we discuss the relevance of our findings to other ‐ democratic ‐ political settings.
Molecular Biology of Cytomegaloviruses

In the human host, infection by cytomegaloviruses (CMVs) induces a variety of syndromes ranging from the classic cytomegalic inclusion disease to intrauterine death, prematurity, congenital defects, infectious mononucleosis, postperfusion syndrome, and interstitial pneumonia in transplantation patients (for reviews, see Weller, 1971; Rapp, 1980; Ho, 1982). These diseases caused by human CMV (HCMV) frequently represent infections after reactivation of latent virus and are usually associated with immuno-suppression due to a variety of situations such as malignant disease and chemotherapy (Weller, 1971; Plummer, 1973). Therefore, the HCMV genome has evolved to remain in human cells in a quiescent state from the time of primary infection. Although the majority of humans carry this virus, overt disease is a rare event. Unfortunately, little is known about the molecular biology of the latent CMV genome; consequently, this chapter will emphasize the events after reactivation of the viral genome. Reactivation is the event that allows for replication of the viral DNA genome and eventual release of infectious virus to cause overt disease. Latency and reactivation of HCMV replication relate directly to the regulation of the viral genome by host- and/or virus-specified genes in the eukaryotic cell.
Interaction of Ethanol with Other Drugs

The interactions between alcohol and other drugs can be categorized into (1) pharmacological interactions, where ethanol and the second drug act on the same biochemical system; (2) physiological interactions, where ethanol and a second drug act on different systems; and (3) metabolic interactions, where the interaction takes place at the level of metabolism of ethanol or the second drug. Of course, more than one mechanism may be operative for any given drug-ethanol combination.
Routine splenic flexure mobilization may increase compliance with pathological quality metrics in patients undergoing low anterior resection.

AIM Mandatory splenic flexure mobilization (SFM) has been debated for rectal cancers. Proponents argue that additional mobilization facilitates a tension-free anastomosis; however, this must be weighed against heightened morbidity. Little is known about the impact of specific techniques on pathology quality metrics. We aim to determine the impact of SFM on pathology quality metrics for patients undergoing rectal resections for colorectal adenocarcinoma. METHOD Patients were selected by querying the University of Kansas electronic medical records and the American College of Surgeons National Surgical Quality Improvement Program database based on Current Procedural Terminology codes. Patients were categorized as SFM or non-SFM. Primary outcomes were node yield less than 12 and margin length. RESULTS There were 146 patients who met the inclusion criteria for chart review and 7369 included from the national database. Splenic flexure mobilization was associated with wider margins (3.52 vs 2.51 cm in low anterior resection, P < 0.01) and a decreased rate of inadequate nodal staging in patients undergoing low anterior resection (3.7% vs 19.3% P < 0.01). CONCLUSIONS SFM may affect surgical quality metrics in patients undergoing resection for distal colon and rectal adenocarcinoma. Further study is warranted to determine whether these differences in quality and pathology translate into differences in oncological outcomes.
VASCULAR ENDOTHELIAL FUNCTION AND ARTERIAL STIFFNESS IN HIV-INFECTED PATIENTS WITH AND WITHOUT ABACAVIR REGIMEN

Although HIV-infected patients on antiretroviral therapy (ART) containing abacavir (ABC) have been reported to have increased cardiovascular disease (CVD) mortality, studies of vascular function have reported inconsistent results. In this study, measures of vascular endothelial function and arterial
Clinical Outcomes of Upfront Stereotactic Radiosurgery Alone for Patients With 5 to 15 Brain Metastases.

Background The role of primary stereotactic radiosurgery (SRS) for patients with >4 brain metastases (BM) remains controversial. Objective To compare the outcomes of patients treated with upfront SRS alone for 1, 2 to 4, and 5 to 15 BM and assess for predictors of clinical outcomes in the 5 to 15 BM group. Methods A total of 478 patients treated with upfront SRS were stratified by number of lesions: 220 had 1 BM, 190 had 2 to 4 BM, and 68 patients had 5 to 15 BM. Overall survival and whole brain radiotherapy-free survival were estimated using the Kaplan-Meier method. The cumulative incidences of local failure and distant brain failure (DBF) were estimated using competing risks methodology. Clinicopathologic and dosimetric parameters were evaluated as predictors of survival and DBF in patients with 5 to 15 BM using Cox proportional hazards. Results Median overall survival was 8.0, 6.3, and 4.7 mo for patients with 1, 2 to 4, and 5 to 15 BM, respectively (P = .14). One-year DBF was 27%, 44%, and 40%, respectively (P = .01). Salvage SRS and whole brain radiotherapy rates did not differ. Progressive extracranial disease and gastrointestinal primary were associated with poor survival while RCC primary was associated with increased risk of DBF. No evaluated dose-volume parameters predicted for death, neurologic death or toxicity. Conclusion SRS for 5 to 15 BM is well tolerated without evidence of an associated increase in toxicity, treatment failure, or salvage therapy. Further prospective, randomized studies are warranted to clarify the role of SRS for these patients.
Ovarian Hyperstimulation Syndrome and Myocardial Infarction: A Systematic Review

Background: Ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication of ovarian stimulation occurring during assisted reproduction technologies (ART). It is characterized by increased vascular permeability and hypercoagulable states resulting in strokes and peripheral ischemia. Acute myocardial infarction and cardiac thrombosis, however, have been rarely reported complications of OHSS. Methods: A literature search was performed for reports on myocardial infarction and cardiac thrombosis associated with ovarian stimulation with a summary of their clinical characteristics. Results: A total of twelve published cases were reviewed with 5 out of 12 (41.67%) of the reported cases were 35 years of age or older. Myocardial infarction was reported in 10 out of the 12 cases (83.3%). Two of the cases were pregnant at presentation (16.67%). The mean duration between starting ovarian stimulation medications and clinical presentation was 23 days. Chest pain was the most common presenting symptom (66.67%), 2 cases presented with stroke (16.67%) and 2 cases presented with abdominal distention (16.67%). A total of 8 patients underwent coronary angiography with 2 of these cases were treated with percutaneous coronary intervention. No mortality reported in any of the twelve cases.
Two-Stage Procedure of Fixed-Width Confidence Intervals for the Risk Ratio

A two-stage procedure is considered for obtaining fixed-width confidence intervals and optimal sample sizes for the risk ratio of two independent binomial proportions. We study desirable properties of the proposed estimator based on a bias-corrected maximum likelihood estimator (MLE). The two-stage procedure provides flexible sampling strategies, thus can be more advantageous in decision-making as well as in inference for the risk ratio. As a result, the proposed procedure can be a remedy not only for asymptotic consistency, but also for drawbacks of coverage to the nominal probability of the purely sequential method. To investigate large-sample properties of the proposed procedure, first-order asymptotic expansions are obtained. Through Monte Carlo experiments, we examine finite sample behavior for various scenarios of samples for illustrations.