cssi/SciSciGPT-SciSciNet huggingface dataset:
Prompting Patients with Poorly Controlled Diabetes to Identify Visit Priorities Before Primary Care Visits: a Pragmatic Cluster Randomized Trial

Most patients with diabetes do not meet all evidence-based goals of care, and many patients report poor communication and lack of involvement in decision-making during primary care visits. To test the hypothesis that a “Pre-Visit Prioritization” secure email message could improve visit communication and glycemic control among patients with type 2 diabetes. We conducted a pragmatic, provider-randomized, multi-site clinical trial from March 2015 to October 2016 across 30 primary care practices within Kaiser Permanente Northern California (KPNC), a large integrated care delivery system. Eligible patients had at least 1 year of KPNC membership, type 2 diabetes with most recently measured hemoglobin A1c (HbA1c) > = 8.0%, and were registered users of the KPNC online patient portal. Patients in the intervention arm, upon booking an appointment, received a secure email through the KPNC online portal with a link to the EHR allowing them to submit their top one or two priorities prior to the visit. Control patients received usual care. Glycemic control; change in HbA1c 6 and 12 months after the initial visit; patient-reported outcomes related to patient-provider communication and patient care experiences. During the study period, 1276 patients had at least one eligible visit. In post-visit surveys (n = 457), more intervention arm patients reported preparing questions for their visit (72% vs 63%, p = 0.048) and being given treatment choices to consider (81% vs 73%, p = 0.041). Patients in both arms had similar reductions in HbA1c over the 12-month study period (0.56% ± 1.45%), with no significant differences between arms. A “light touch” email-based pre-visit intervention resulted in improved measures of visit interaction but did not significantly improve glycemic control relative to usual care. Improving diabetes clinical outcomes through more effective primary care visits may require more intensive approaches to patient visit preparation. NCT02375932
Coronary CT Angiography for Evaluation of Acute Coronary Syndrome in the Emergency Department

There is nearly one death from heart disease every 38 s in the United States (Lloyd-Jones et al. Circulation 121:e46–e215, 2010). Acute chest pain is the single most common complaint of patients older than 15 years of age presenting to the emergency department (ED) (Pitts et al. Natl Health Stat Report 7:1–38, 2008) and accounts for about 4% of ED visits in the United States (McCaig and Burt. Adv Data 340:1–34, 2004). Origins of chest pain include diseases of the heart, aorta, pulmonary system, esophagus, upper abdomen, and chest wall and even psychiatric disorders. Determination of the etiology of the chest pain is often difficult, although different types of chest pain are classically ascribed to different corresponding diseases. Acute coronary syndrome (ACS) is estimated to be responsible for 20% of all clinical encounters for acute chest pain (Pozen et al. N Engl J Med 310:1273–1278, 1984). Patients with ACS present with unstable angina, acute myocardial infarction, or sudden cardiac death (Virmani et al. J Am Coll Cardiol 47:C13–18, 2006); therefore, timely triage of ACS is important as it affects treatment and prognosis. Also timely triage may save significant costs. Using coronary CTA to evaluate patients instead of admitting patients for a rule-out approach with serial troponin has the potential to save significant costs to the health-care system.
Brain Network Analysis

This tutorial reference serves as a coherent overview of various statistical and mathematical approaches used in brain network analysis, where modeling the complex structures and functions of the human brain often poses many unique computational and statistical challenges. This book fills a gap as a textbook for graduate students while simultaneously articulating important and technically challenging topics. Whereas most available books are graph theory-centric, this text introduces techniques arising from graph theory and expands to include other different models in its discussion on network science, regression, and algebraic topology. Links are included to the sample data and codes used in generating the book's results and figures, helping to empower methodological understanding in a manner immediately usable to both researchers and students.
Characteristics of Hospitals That Did and Did Not Join the Bundled Payments for Care Improvement-Advanced Program.

This study describes the characteristics of hospitals participating vs not participating and remaining vs leaving the 2018 CMS Bundled Payments for Care Improvement–Advanced Program (BPCI-A), a payment reform model that reimburses for a 90-day episode of care rather than for individual services.
Designing a Task-Based and Community-Engaged Business Chinese Course

Language for specific purposes courses aim to foster students’ interdisciplinary and intercultural competence in a foreign language through targeted contextualization. However, applied linguists and language professionals are rarely experts in both linguistic and content instruction which may render threat to the LSP course relevance and accountability. This study, based on needs and means analyses, presents a task-based and community-engaged business Chinese course design. The course consisted of three modules: Job Search, Work and Social Life, and International Business and Entrepreneurship. Domain experts (e.g., school career coaches, multinational corporation business professionals, and Chinese international students) from local and virtual communities joined the instructor in conducting a variety of performance-based assessments, including job interview, social gathering, on-site visit, online multimedia competition.
Reproducing spatial inequality? The sustainability fix and barriers to urban mobility in Portland, Oregon

We explore how the language of “just sustainability” may become subsumed into a sustainability fix strategy, depoliticizing the utility of concepts such as justice and/or equity. Building from crit...
Current Concepts on Aqueous Misdirection

To review the current understanding of the pathophysiology and management of aqueous misdirection syndrome. Aqueous misdirection syndrome represents a spectrum of disorders that converge on a common pathway of increasing posterior segment pressure and secondary angle closure glaucoma. Although the etiology of aqueous misdirection remains unclear and is likely multifactorial, recent data supports choroidal expansion as an inciting event in the pathogenesis of the syndrome. As such, the term aqueous misdirection may be a misnomer. Some would argue that the use of terminology such as acute and chronic fluid misdirection may better characterize the full spectrum of the disease process as it is known to occur at varying time points from intraoperatively to years postoperatively. Chronic fluid misdirection most commonly occurs following incisional surgery for primary angle closure glaucoma but has also been associated with numerous laser and invasive ocular surgeries. Regardless of the mechanism, many patients require incisional surgery for complete resolution. Recent literature suggests that variants of anterior vitrectomy with irido-zonulo-hyaloidectomy offer comparable rates of success when compared to pars plana vitrectomy. Aqueous misdirection is a rare, and incompletely understood, form of secondary glaucoma characterized by diffuse shallowing of the anterior chamber in the presence of a patent iridotomy/iridectomy. It represents a spectrum of disorders that result in a cycle of increasing posterior segment pressure and secondary angle closure glaucoma that is notoriously refractory to medical intervention. Regardless of the mechanism, the syndrome can be well managed with incisional procedures that disrupt the anterior hyaloid face, debulk the vitreous, and establish an anterior-posterior communication either by a core or more complete anterior vitrectomy.
Comparison of pediatric sports fracture outcomes based on provider type

Objective: Pediatric primary care sports medicine physicians and pediatric sports medicine orthopedic surgeons, in conjunction with physician assistants (PAs), often manage patients with fractures....
Polymeric nanomaterials in fuel cell applications

Abstract Polymeric nanomaterials are getting increasing attention worldwide in many new-generation applications, among which fuel cells are a new entrance. More specifically, fuel cells based on proton exchange membrane (PEM) electrolytes have seen growing trend of utilization of these nanomaterials, especially in the fabrication of their catalyst systems. Materials having nanodimensions in general and polymeric nanomaterials in particular hold certain unique and tailor-made properties suitable for application as catalyst systems in such fuel cells, as compared to their micro- and macro counterparts. For example, higher surface area, better dispersibility, higher reaction kinetics, and easy synthesis and fabrication are some of the properties which we are taking advantage of. This chapter will provide up-to-date information on the research and development that has taken place in this domain of utilization of polymeric nanomaterials in PEM-based fuel cells.
On the Identity of Gastrisus modestus (Bernhauer), with an Updated Diagnosis and a Key for Dysanellus Bernhauer (Coleoptera: Staphylinidae: Staphylininae: Staphylinini)

Gastrisus modestus (Bernhauer) (Staphylinidae: Staphylininae: Staphylinini) is transferred to the genus Dysanellus Bernhauer as Dysanellus modestus, new combination. An updated diagnosis and key to the species are provided for Dysanellus along with a habitus image and a redescription of D. modestus.
B16-F10 melanoma cells and cell culture supernatant enhance angiogenesis in mouse ischemic limb

Generation of therapeutic angiogenesis to enhance vascularization in the ischemic tissues is a method for treating ischemic tissues in atherosclerotic cardiovascular artery disease.The chemokine stromal cell-derived factor-1(SDF-1) and its receptor(CXC chemokine receptor 4,CXCR4) play a critical role in the process of post-natal neovascularization.The SDF-1-CXCR4 axis is a potential mechanism for the treatment of ischemic limb.Here,we investigated the role of CXCR4 in bone marrow cells(BMCs) in neovascularization induced by tumor cells and the supernatant of culture media in a murine hind-limb ischemia model which was made by resecting femoral artery and vein.After the injection of mouse melanoma cells B16-F10(1×106 cells in 0.1 mL at the operation day,s.c.) into the abdomen or the cell culture supernatant(0.1 mL/d for 21 d after operation,i.m.) into the ischemic abductor muscle,the CXCR4 positive BMCs were analyzed by flow cytometry.The perfusion of the ischemic limb was evaluated by laser Doppler perfusion imaging(LDPI) on 7,14 and 21 d after vascular injury operation.Capillary endothelial alkaline phosphatase(AP) was stained to quantify the presence of capillaries,and histological method was used to evaluate the capillary density as a measure of neovascularization in ischemic tissues.The proportions of CXCR4 positive BMCs were notably higher in ischemic limb injected with tumor cells or the supernatant compared to those in the control group(P0.05).Injection of tumor cells or the supernatant resulted in significantly improved perfusion as measured by LDPI perfusion ratios on 7,14 and 21 d after femoral artery and vein resection in mice,compared to the controls(P0.05).Tissue samples harvested from the lower calf muscle at day 21 demonstrated increased capillary densities in mice receiving tumor cells(0.81±0.13) or the supernatant(0.63±0.05),compared with those in control group(0.44±0.09,P 0.05).In conclusion,the injection of B16-F10 tumor cells or the supernatant induces the increase of CXCR4 positive cells in BMCs and the improvement of in vivo neovasculogenesis in mouse ischemic limb.
Preliminary examination of Coaching in Context with clients with spinal cord injury.

Study design Repeated measures pilot study. Objectives This study examined Coaching in Context when introduced to community-dwelling adults with spinal cord injury (SCI). Setting Urban community. Methods Three volunteers participated in up to ten, 45-60-min Coaching in Context sessions. Number of coaching sessions was recorded. Usefulness of Coaching in Context was examined by the Canadian Occupational Performance Measure (COPM), Goal Attainment Scaling (GAS), and the Moorong Self-efficacy Scale (MSES). Data were examined descriptively. Results Preliminary examination of Coaching in Context revealed successful implementation with adults with SCI living in the community. Mean COPM performance and satisfaction scores increased by 2.55 (SD = 2.25) and 4.27 (SD = 2.41), respectively. With the exception of one, each goal achieved or exceeded GAS expected level. Changed MSES scores ranged from +7 to +16. Conclusions The ability to implement and evaluate Coaching in Context with three adults with SCI was demonstrated. Improvement in goals established for coaching was also documented.
Investigation of Transition Delay on a Wing Section by Dynamic Surface Deformation

Numerical calculations were carried out in order to investigate the delay of transition to turbulence on a wing section by means of local dynamic surface deformation. Physically, the deformation ma...
chapter 5 Stereoscopic Electron Microscopy of Chromosomes

Publisher Summary This chapter discusses the stereoscopic electron microscopy of chromosomes. The studies on the higher order structure of chromosomes suggest that stereomicroscopy at 1MeV is at present the most useful method of obtaining information on the complex three-dimensional structure of chromosomes. The chromatin fibers are suspended in the hypophase from a protein surface film and can be picked up by touching a grid covered with a carbon-coated Formvar film to the surface. They are fixed in 4% aqueous paraformaldehyde. The native 20-nm fiber is a supercoil of the closely packed string of nucleosomes stabilized by Ca 2+ . Polytene chromosomes can be isolated from dipteran larval tissue by squashing in 50% acetic acid between a slide and a coverslip. The supercoil in the 20-nm fibers released from erythrocyte nuclei of the newt Notophthalmus viridescens by spreading on a water surface is shown. It is found that in this nucleus, all chromatin is transcriptionally inactive and is in the form of 20-nm fibers.
Myositis and Pregnancy

The idiopathic inflammatory myopathies (IIM) are rare autoimmune disorders characterized predominantly by autoimmune inflammation within skeletal muscle with resulting clinical weakness. Pregnancy in myositis patients is rare and incompletely understood. Systematic review of myositis pregnancy reports suggests that disease activity during pregnancy (even when subclinical) may be associated with adverse pregnancy outcome. Massive deposition of fibrin in the placenta has been described in several myositis patients. Treatment during pregnancy, usually corticosteroid, appears to be associated with greater likelihood of live birth. IVIG has been used successfully and may be an effective alternative to high-dose corticosteroids.
Spatial and Temporal Variability of Herbaceous Vegetation in an Eastern Deciduous Forest

We examined spatial and temporal variability of understory herbaceousvegetation on opposing north- and south-facing slopes in an eastern deciduousold-growth forest in southeastern Ohio, USA. Secondly, we explored theinfluenceof sampling scale and analytical technique on our assessment of diversitypatterns. The influence of aspect and seasonality were examined at varyingsampling scales using observed richness, evenness, andH′ diversity measures, non-parametric richnessestimators, species-area curves, and SHE analysis. Herb layer composition,abundance, and diversity were strongly influenced by location (north slope vs.south slope), seasonal sampling period (April, June, August), and plot size(micro (2 m2)- vs. meso (70m2)-scale samples). Although north and south plots werecompositionally distinct, they followed similar courses of change through thegrowing season. Richness, evenness, and H′ diversitywere generally greater on the south plot whereas herbaceous abundance wasgreater on the north plot. Species composition and diversity showed markedphenological (temporal) changes, and comparison of diversity measures at micro-and meso-scales produced markedly different results. Minimum sample areas of150–200 m2 were needed to evaluate micro-scalerichness in these species rich communities, suggesting that forest understoriesmay be frequently undersampled in ecological studies. Comparison of observedandestimated meso-scale richness also suggested underestimation of richness in thenorth plot, particularly earlier in the growing season. Thus, sample size,area,and time of sampling appear critical to assessment of diversity in spatiallyandtemporally variable communities such as herbaceous forest understories.
Process Simulation Role in the Development of New Alloys Based on an Integrated Computational Materials Engineering Approach

To accelerate the introduction of new materials and components, the development of metal casting processes requires the teaming between different disciplines, as multi-physical phenomena have to be considered simultaneously for the process design and optimization for mechanical properties. The required models for physical phenomena as well as their validation status for metal casting are reviewed. The data on materials properties, model validation, and relevant microstructure for materials properties are highlighted. One vehicle to accelerate the development of new materials is through combined experimental-computational efforts. Integrated computational/experimental practices are reviewed; strengths and weaknesses are identified with respect to metal casting processes. Specifically, the examples are given for the knowledge base established at Oak Ridge National Laboratory and computer models for predicting casting defects and microstructure distribution in aluminum alloy components.© 2014 ASME
Practical Algorithms on Partial k-Trees with an Application to Domination-like Problems

Many NP-hard problems on graphs have polynomial, in fact usually linear, dynamic programming algorithms when restricted to partial k-trees (graphs of treewidth bounded by k), for fixed values of k. We investigate the practicality of such algorithms, both in terms of their complexity and their derivation, and account for the dependency on the treewidth k. We define a general procedure to derive the details of table updates in the dynamic programming solution algorithms. This procedure is based on a binary parse tree of the input graph. We give a formal description of vertex subset optimization problems in a class that includes several variants of domination, independence, efficiency and packing. We give algorithms for any problem in this class, which take a graph G, integer k and a width k tree-decomposition of G as input, and solve the problem on G in O(n24k) steps.
Effects of Water on the Copper-Catalyzed Conversion of Hydroxymethylfurfural in Tetrahydrofuran.

Reaction kinetics were studied to quantify the effects of water on the conversion of hydroxymethylfurfural (HMF) in THF over Cu/γ-Al2 O3 at 448 K using molecular H2 as the hydrogen source. We show that low concentrations of water (5 wt %) in the THF solvent significantly alter reaction rates and selectivities for the formation of reaction products by hydrogenation and hydrogenolysis processes. In the absence of water, HMF was converted primarily to hydrogenolysis products 2-methyl-5-hydroxymethylfuran (MHMF) and 2,5-dimethylfuran (DMF), whereas reactions carried out in THF-H2 O mixtures (THF/H2 O=95:5 w/w) led to the selective production of the hydrogenation product 2,5-bis(hydroxymethyl)furan (BHMF) and inhibition of HMF hydrogenolysis.
Einstein-Maxwell theory in 2+1 dimensions

Einstein-Maxwell theory in 2+1 dimensions is considered as a toy model for the 3+1 theory and as a means for understanding field theories without a background space-time geometry. Two possible approaches to the quantization of this theory are presented, one based on a Schwinger-Tomonaga time evolution equation and the other on a loop space construction, and the problems arising in both of these are discussed.
Does the cytoskeleton play a significant role in animal virus replication

Abstract Evidence which has accumulated over the past decade implicating various elements of the cytoskeleton in the replication of animal viruses is discussed in this speculative review. In particular, the interactions of adenovirus types 2 and 5 and reovirus type 1 with microtubules are emphasized. Further, a review is presented of associations between poxviruses, polioviruses, papovaviruses and other enveloped viruses with both the 100 A filament and microfilament components of the cytoskeleton. Finally, tentative conclusions are drawn as to the significance of these interactions between viruses and virus subparticles with the cytoskeletons of infected cells.
Quasi-free proton-scattering at 164 MeV☆

Abstract Inclusive proton spectra have been measured over the angular range 25° – 150° for 164 MeV protons on 27 Al, 58 Ni, 62 Ni and 208 Pb. At 25° and 30° a peak attributable to quasi-free scattering, accounting for ≈20% of the total number of fast protons at these angles, is present. No quasi-free peak is evident in the spectra at larger angles. These results are in disagreement with previously published work at this energy but in line with results reported at other energies.
(iv) Soft tissue sarcomas: general features, evaluation, imaging, biopsy and treatment

Abstract Soft tissue sarcomas are uncommon tumors of the musculoskeletal system. These tumors may present in an insidious and non-specific fashion. Many physicians are not familiar with the clinical presentation, pathologic features, biopsy techniques and management of these malignancies. Common features of many sarcomas include: 1) large size (>5 cm); 2) hard or firm texture on palpation; and 3) deep location. Soft tissue sarcomas may also present as small, mobile, and superficial tumors. Plain radiographs in two planes are the first imaging modality to be obtained. Magnetic resonance imaging has evolved as the dominant imaging modality to define the anatomic features and to help characterize the nature of the lesion. Biopsy is a crucial step in management and must be performed carefully. Multi-modality treatment (surgical resection, radiation, and chemotherapy) have dramatically improved local control rates and allows the clinician to offer limb salvage to over 90% of patients with extremity sarcomas.
Solid-phase extraction of sulfamethazine in milk with quantitation at low ppb levels using thin-layer chromatography

Abstract A method for the solid-phase extraction and thin-layer chromatographic (TLC) quantitation of sulfamethazine (SMZ) residues in milk is presented. Sulfabromomethazine was added as an internal standard to homogenized milk samples which were then diluted and passed through C 18 solid-phase extraction columns. The C 18 columns were eluted with methanol, and interfering components in the methanol were removed by passing eluate over an acidic alumina column. The analyte was then concentrated on a small ion-exchange resin. SMZ was eluted and applied to a silica gel TLC plate. Fluorescence detection was induced with fluorescamine and quantitated with a scanning densitometer. Recoveries were 88.36–103.15% in the analysis range [0.51–15.34 ppb (μg/l)]. The average recovery over the analysis range was 96.07%, with a coefficient of variation of 12.52%.
EXCRETION OF AMINO ACIDS IN CHILDHOOD. A RELIABLE METHOD FOR THE DETERMINATION OF AMINO ACID NITROGEN IN URINE.

Abstract A reliable and relatively simple colorimetric determination of amino acid nitrogen in urine is described; urea and ammonia are completely eliminated. The average coefficient of variation calculated from 39 triplicate analyses is ± 3.7%. Colour yields of the main free amino acids occurring in the urine of children are established in relation to the most satisfactory composition of a standard for the determination. Equilibration of urine with ion exchangers for the selective elimination of ammonia from urine is experimentally evaluated. Data for the computation of approximate urea concentration from the pH of urease-buffer treated urine, are given. Averages and standard deviations are given for the ratio of amino acid nitrogen to creatinine nitrogen at different ages in childhood. Detailed statistical analyses are presented which provide conclusive evidence for the enhancement of amino-aciduria with decreasing age, as well as in cases of fever, and collagen diseases.
Superplasticity-Like Behavior, Microstructures and Deformation Mechanism Map in Superlight Mg-6Li-3Zn Alloy

Mg-6Li-3Zn alloy sheets were prepared by melting and casting, and heavy rolling with a total reduction of 94%. The high-temperature mechanical behavior, microstructures and deformation mechanisms were investigated. The maximum elongation to failure of 300% was demonstrated at 623K and an initial strain rate of 1.67×10-3s-1. Observations by optical microscope, transmission electron microscope reveal that significant dynamic recrystallization and grain refinement occurred in banded grains at 573K and an initial strain rate of 1.67×10-3s-1, under which the subgrain contour was ambiguous and dislocation distribution was relatively uniform. It is shown by newly constructed deformation mechanism map that the high-temperature deformation mechanism in Mg-6Li-3Zn alloy sheet with banded grains at 573K and an initial strain rate of 1.67×10-3 s-1 is dislocation viscous glide controlled by lattice diffusion, the stress exponent is 3 (strain rate sensitivity exponent 0.33) and deformation activation energy is 134.8 kJ mol-1, which is the same as the lattice diffusion activation energy of magnesium.
Cyclic AMP-receptor protein activity in rat preputial cells.

Cells from the rat preputial gland — a type of sebaceous gland—exhibited specific responsiveness of cyclic 3',5'-adenosine monophosphate (AMP) dependent protein kinase to stimulation by agents that elevate intracellular cyclic AMP. Electron microscopy shows that the rat preputial gland resembles the human sebaceous gland, not only in terms of containing a sebocyte-like population of cells in an acinar arrangement at different maturational stages, but also in the morphology of its organelles such as abundant and sometimes atypical mitochondria, many perinuclear lysosomes with crystalline inclusions, lipid droplets of various sizes and peroxisomes. Other cell types, among them duct and inflammatory cells, were evident in the tissue sections, but constituted a minor component. Responses to stimulation of the adenylate cyclase-protein kinase pathways were determined using preputial cells that had been both freshly dispersed and grown in monolayer culture. Stimulation with isoproterenol (IPR) or forskolin (FS) resulted in both cases in an increase of cyclic AMP binding of the regulatory (R) subunits of cyclic AMP-dependent protein kinase, as determined by photoaffinity labeling of R subunits with an azido analog of cyclic AMP ([32P]-8-azido cyclic AMP). Cells from the epidermis under comparable conditions responded to a lesser degree and with a different distribution of R subunit isoforms. There are, therefore, differences in receptor activity as well as in the transduction pathways between the two types of epithelial cell populations. These results indicate that the preputial gland contains precursor cells that differentiate in culture to retain specific molecular mechanisms of action mediated via cyclic AMP.
Zebrafish IRX1b in the embryonic cardiac ventricle

The synchronous contraction of the vertebrate heart requires a conduction system. While coordinated contraction of the cardiac chambers is observed in zebrafish larvae, no histological evidence yet has been found for the existence of a cardiac conduction system in this tractable teleost. The homeodomain transcription factor gene IRX1 has been shown in the mouse embryo to be a marker of cells that give rise to the distinctive cardiac ventricular conduction system. Here, I demonstrate that zebrafish IRX1b is expressed in a restricted subset of ventricular myocytes within the embryonic zebrafish heart. IRX1b expression occurs as the electrical maturation of the heart is taking place, in a location analogous to the initial expression domain of mouse IRX1. The gene expression pattern of IRX1b is altered in silent heart genetic mutant embryos and in embryos treated with the endothelin receptor antagonist bosentan. Furthermore, injection of a morpholino oligonucleotide targeted to block IRX1b translation slows the heart rate.
Techniques and results in the management of multiple ventricular septal defects

Abstract Objective: The management of patients with multiple ventricular septal defects remains controversial. Primary closure, interventional catheter techniques, and palliative surgery all may have a role, and specific management guidelines remain undefined. Methods: We reviewed the records of all 33 patients with multiple ventricular septal defects undergoing repair between January 1988 and October 1996. Pulmonary artery hypertension was present in 21 patients (group 1), and pulmonary stenosis was present in the remaining 12 (group 2). Closure was accomplished from a right atriotomy alone in most patients, although an apical left ventriculotomy was used for apical defects. Among group 1 patients, the mean age at repair was 5.9 ± 0.9 months. Major associated anomalies included coarctation ( n = 6), straddling tricuspid valve ( n = l), and critical aortic stenosis ( n = 1). Reoperation was performed in two patients for residual ventricular septal defects. Among group 2 patients, the mean age at repair was 6.6 ± 3.2 years. Major associated anomalies included tetralogy of Fallot ( n = 2), pulmonary stenosis ( n = 4), double-outlet right ventricle with hypoplastic left ventricle ( n = 1), and isolated left ventricular hypoplasia ( n = 1). Three required reoperation for residual ventricular septal defect. Results: There were no early or late deaths, no episodes of heart block, and no significant residual ventricular septal defects among group 1 patients. All group 1 patients remain free of significant residual cardiovascular conditions at a mean of 23.4 ± 5.1 months. Among group 2 patients, there was one early death in a patient with double-outlet right ventricle and left ventricular hypoplasia. Complete heart block occurred in two patients and one required late mitral valve replacement. There were no late deaths, seven remain alive without significant residual defects at a mean of 36.2 ± 8.0 months, and two required transplantation for left ventricular failure. Conclusions: Primary repair for infants with multiple ventricular septal defects is associated with good late outcomes. The right atrial approach is satisfactory for most muscular defects, although limited apical left ventriculotomy was used for apical defects. Pulmonary artery banding should be limited to patients with complex associated defects. (J Thorac Cardiovasc Surg 1998;115:848-56)
Fasting hyperglycemia normalizes oxidative and nonoxidative pathways of insulin-stimulated glucose metabolism in noninsulin-dependent diabetes mellitus

The present studies were undertaken to determine whether fasting hyperglycemia can compensate for decreased insulin-stimulated glucose disposal, oxidation, and storage in noninsulin-dependent diabetes mellitus (NIDDM) as well as to determine whether hyperglycemia normalizes insulin-stimulated skeletal muscle glycogen synthase and pyruvate dehydrogenase (PDH) activities. To accomplish this, we used the glucose clamp technique with isotopic determination of glucose disposal and indirect calorimetry for measuring the pathways of glucose metabolism, and vastus lateralis muscle biopsies to determine the effects of insulin on glycogen synthase and PDH activities. Nine patients with NIDDM and eight matched nondiabetic subjects were infused with insulin (40 mU/m2·min) while plasma glucose was maintained at the prevailing fasting concentration. During insulin infusion, rates of glucose disposal, storage, and oxidation were the same in the two groups. Insulin infusion significantly activated glycogen synthase fract...
Infants' Reaction to Changes in Orientation of Figure and Frame

Five groups of five-month-old infants observed the same horizontal arrangement of a three-element stimulus placed in a rectangular frame during a series of habituating trials. These trials were followed by either (i) additional exposure to the familiarized standard, (ii) a tringular rearrangement of the three stimulus elements, (iii) oblique rotation of the three elements, (iv) oblique rotation of the three elements and the frame, or (v) oblique rotation of the frame alone. The infants were responsive to all changes in the spatial arrangement of the three elements and to the rotation of the frame, but were less responsive to the change in the frame. The two effects were not additive.
Measuring Ocean Currents with HF Radar

HF radar makes it possible to map ocean surface currents from shore without in-situ instruments. Currents are derived from the Doppler shift of echoes from ocean waves a few meters long, whose phase speed is altered by underlying currents. Accuracy of 10 cm/s has been demonstrated with a portable NOAA system called CODAR (Coastal Ocean Dynamics Radar) that illuminates the sea by radio waves that propagate along the ocean surface. With a radar frequency of 25.4 MHz, maps of surface current vectors out to 60 km from shore can be obtained. Longer ranges are possible with lower frequencies, and greater spatial resolution is possible with higher frequencies. Skywave radars, which illuminate the sea by way of ionospheric reflections, have measured ocean currents at much longer ranges (1000-2000 km), but only when very stable ionospheric layers exist, or when nearby stationary targets are available. Current-mapping radars have already proven useful in several oceanographic research exercises, providing new insights with their graphic displays of transport processes, estuarine flows and tidal oscillations. The CODAR system is now in a Transition Engineering Phase, in which this research tool developed by NOAA is being transformed into an operational instrument with broad scientific and commercial applications.
Treatment of brain arteriovenous malformations with high-flow arteriovenous fistulas: risk and complications associated with endovascular embolization in multimodality treatment. Clinical article.

Object High-flow fistulas associated with brain arteriovenous malformations (AVMs) pose a significant challenge to both stereotactic radiosurgery (SRS) and surgical treatment. The purpose of this study was to examine the outcomes of multimodality treatment of AVMs in association with a large arteriovenous fistula (AVF), with a special focus on endovascular embolization and its associated complications. Methods One hundred ninety-two patients harboring cerebral AVMs underwent endovascular treatment in the authors' department between 1997 and 2003. Of these, the authors selected 74 patients presenting with an AVM associated with high-flow AVF(s) for a retrospective analysis based on the findings of superselective angiography. After endovascular embolization, 32 patients underwent resection, 33 underwent either SRS or hypofractionated stereotactic radiotherapy (HSRT), and 3 underwent both surgery and SRS. Six patients underwent embolization only. Immediate and midterm treatment outcomes were analyzed. Result...
Energy-efficient broadband data communications using white LEDs on aircraft powerlines

Broadband powerline communication has advanced through last decade and it is going to be a mature access technique in near future. Meanwhile, optical wireless communication through energy-efficient lighting LEDs has been investigated, recently. In this paper, it is shown that marriage of these two techniques creates an efficient delivery mechanism for fulfilling the promise of broadband access onboard an aircraft, while providing efficient and low-cost lighting. The potential capabilities of these two emerging techniques are examined.
Prognostic value of exercise echocardiography in patients after coronary artery bypass surgery.

To assess the prognostic value of exercise echocardiography in patients with prior coronary artery bypass surgery, follow-up was obtained in 718 patients (591 men [82%] and 127 women [18%], aged 67 ± 9 years) who underwent clinically indicated exercise echocardiography 5.7 ± 4.7 years after coronary bypass surgery. Resting wall motion abnormalities were present in 479 patients (67%). New or worsening wall motion abnormalities developed with exercise in 366 patients (51%). During a median follow-up of 2.9 years, cardiac events included cardiac death in 36 patients and nonfatal myocardial infarction in 40 patients. The addition of the exercise echocardiographic variables, abnormal left ventricular end-systolic volume response and exercise ejection fraction to the clinical, resting echocardiographic and exercise electrocardiographic model provided incremental information in predicting cardiac events (chi-square 37 to chi-square 42, p = 0.02) and cardiac death (chi-square 38 to chi-square 43, p <0.02). Exercise echocardiography provides prognostic information in patients after coronary artery bypass surgery, incremental to clinical, rest echocardiographic, and exercise electrocardiographic variables.
In vitro biosynthesis of cyclooxygenase metabolites in ovalbumin-sensitized and control lungs of guinea pigs☆

Abstract Cyclooxygenase metabolism may regulate mediator release in anaphylaxis. The in vitro biosynthesis of cyclooxygenase metabolites was examined, using isolated microsomal membranes from ovalbumin-sensitized and control guinea pig lungs, under conditions in which the substrate concentration ([ 3 H]arachidonic acid) was varied (5–168 μM). With microsomes from sensitized lungs, there was stimulation of cyclooxygenase activity at substrate concentrations from 20 to 100 μM, with the major increases in activity occurring in the biosynthesis of thromboxane B 2 and prostaglandin D 2 . At substrate concentrations greater than 100 μM, the biosynthesis of thromboxane B 2 and prostaglandin D 2 decreased in microsomes of sensitized lungs to the level of production found in control-lung microsomes. In contrast, prostacyclin production was significantly higher in the control-lung microsomes at the higher substrate concentrations. The ratio of prostacyclin to thromboxane production was lower in sensitized-lung microsomes at all substrate concentrations. No changes in the biosynthesis of prostaglandins F 2α or E 2 were detected between the two groups. Kinetic analysis of the data demonstrated that the cyclooxygenases in control and sensitized-lung microsomes exhibited different apparent K m and V max values. When the enzymes from both the control and the sensitized-lung microsomes were assayed in the presence of indomethacin (1–10 μM), a cyclooxygenase inhibitor, thromboxane synthesis was preferentially inhibited. The microsomal enzymes from control and sensitized lungs showed similar responses to the drug. At the indomethacin concentrations used, no significant inhibition of prostacyclin or prostaglandin production occurred. The results of these in vitro experiments support the hypothesis that net changes in the biosynthesis of cyclooxygenase metabolites may modulate the anaphylactic response of the lungs in sensitized animals.
Infant Response to Rejection of Physical Contact by the Mother

Abstract Previously unexamined consequences of the ethological theory of attachment suggest that if an attachment figure rejects close body contact with an infant, the infant is placed in a conflict situation in which aggression, conflict behavior and avoidance are expected outcomes. In previous studies we have shown that a mother's rejection of contact with her infant is, as expected, highly associated with avoidance of the mother in stress (separation and reunion) situations. Here we report that a mother's aversion to tactual contact with the infant is stable over the first year of life, and that it is positively associated with rough handling of the infant. It is not associated with carly differences in infant cuddliness. In each of the three samples examined, the mother's aversion to contact with the infant is found positively associated with infant conflict behavior. A mother's aversion to contact between one week and three months of age is related positively to infant angry mood and acts of aggression between 9 and 12 months of age. The conflict situation created by the physically rejecting attachment figure is comparable to but distinguished from the well-known “double bind.”
Genetics of atrioventricular conduction disease in humans

Atrioventricular (AV) conduction disease (block) describes impairment of the electrical continuity between the atria and ventricles. Classification of AV block has utilized biophysical characteristics, usually the extent (first, second, or third degree) and site of block (above or below His bundle recording site). The genetic significance of this classification is unknown. In young patients, AV block may result from injury or be the major cardiac manifestation of neuromuscular disease. However, in some cases, AV block has unknown or idiopathic cause. In such cases, familial clustering has been noted and published pedigrees show autosomal dominant inheritance; associated heart disease is common (e.g., congenital heart malformation, cardiomyopathy). The latter finding is not surprising given the common origin of working myocytes and specialized conduction system elements. Using genetic models incorporating reduced penetrance (disease absence in some individuals with disease gene), variable expressivity (individuals with disease gene have different phenotypes), and genetic heterogeneity (similar phenotypes, different genetic cause), molecular genetic causes of AV block are being identified. Mutations identified in genes with diverse functions (transcription, excitability, and energy homeostasis) for the first time provide the means to assess risk and offer insight into the molecular basis of this important clinical condition previously defined only by biophysical characteristics.
Changes of opening angle in hypertensive and hypotensive arteries in 3-day organ culture

Abstract To study the effect of pressure changes on the opening angle of arteries in organ culture, tubular segments of porcine common carotid arteries were cultured with pulsatile flow perfusion under hypertensive (150±20 mmHg), normotensive (100±20 mmHg), or hypotensive (30±10 mmHg) pressure while maintaining the arteris at a physiological wall shear stress of ∼15 dyn/cm 2 for up to 3 days. Arteries were then cut into short ring segments by sections perpendicular to the axis and then cut open radially to observe the opening angle in aerated phosphate buffered saline solution (37 °C). Norepinephrine (NE, 10 μM), carbacol (CCh, 100 μM), and sodium nitroprusside (SNP, 10 μM) were added after the radial cut at 30, 20, and 30 min intervals, the opening angles were measured, respectively. Results show that hypertensive arteries developed a significantly larger opening angle than normotensive and hypotensive arteries, associated with a significant increase in cell proliferation. In addition, with smooth muscle contraction activated by NE, the opening angle decreases significantly in hypertensive arteries but has little change in hypotensive and normotensive arteries, indicating an enhancement of smooth muscle contraction on the lumen side of the hypertensive arterial wall. In comparison, hypotensive pressure has little effect on arterial opening angle and cell proliferation.
Cytokine Receptor-Like Factor 1 (CRLF1) Protects against 6-Hydroxydopamine Toxicity Independent of the gp130/JAK Signaling Pathway

Oxidative stress is an important cause of cellular toxicity in the central nervous system and contributes to the pathology associated with neurodegenerative disorders including Parkinson’s disease. As such, elucidation of cellular mechanisms that enhance neuronal resistance to oxidative stress may provide new avenues for therapy. In this study we employed a simple two-state cellular model to identify genes that are associated with resistance to oxidative stress induced by 6-hydroxydopamine (6-OHDA). In this model, undifferentiated neuroblastoma cells display higher sensitivity to 6-OHDA than differentiated cells. By comparing the gene expression between these two states, we identified several genes whose expression is altered concomitant with changes in 6-OHDA sensitivity. This gene set includes cytokine receptor-like factor 1 (CRLF1), which is up-regulated during the differentiation process and has been previously implicated in neuroprotection. We show that the product of this gene is both necessary and sufficient for increased resistance to 6-OHDA in differentiated neuroblastoma cells, and that CRLF1 serves its protective role by a cell autonomous mechanism that is independent from its known role as a co-ligand for the ciliary neurotrophic factor receptor. These data provide an additional role for CRLF1 that could potentially explain its broad expression pattern and effects on cells lacking expression of this receptor.
Immunogenicity of Haemophilus influenzae type b polysaccharide-tetanus protein conjugate vaccine in children with sickle hemoglobinopathy or malignancies, and after systemic Haemophilus influenzae type b infection

To determine the immunogenicity of Haemophilus influenzae type b polysaccharide-tetanus protein conjugate vaccine in specific populations at risk, we administered vaccine to children with sickle cell anemia (n=19; mean age, 18.3 months, malignancies (n=18; mean age, 43.1 months), or a recent history of systemic H. influenzae type b infection (n=17; mean age, 11.9 months). After one dose of polyribosylribitol phosphate-tetanus toxoid conjugate vaccine the geometric mean titers for polyribosylribitol phosphate antibody were 4.8 μg/ml (14/19 >1 μg/ml), 1.4 μg/ml (9/18 >1 μg/ml), and 5.6 μg/ml (15/17 >1 μg/ml) in these three groups, respectively. Children with sickle cell anemia or a recent history of systemic H. influenzae type b infection had polyribosylribitol phosphate antibody levels comparable to those of normal children of similar age after one or two doses of polyribosylribitol phosphate-tetanus toxoid conjugate vaccine. We conclude that this vaccine is immunogenic in children with underlying conditions associated with an increased risk of H. influenzae type b infection.
ASYMPTOTIC AND LIMITING PROFILES OF BLOWUP SOLUTIONS OF THE NONLINEAR SCHRODINGER EQUATION WITH CRITICAL POWER

This paper is a sequel to previous ones 38, 39, 41. We continue the study of the blowup problem for the nonlinear Schrodinger equation with critical power nonlinearity (NSC). We introduce a new idea to prove the existence of a blowup solution in H1(ℝN) without any weight condition and reduce the problem to a kind of variational problem. Our new method refines the previous results concerning the asymptotic and limiting profiles of blowup solutions: For a certain class of initial data, the blowup solution behaves like a finite superposition of zero-energy, H1-bounded, global-in-time solutions of (NSC); these singularities stay in a bounded region in ℝN, and one can see that the so-called shoulder emerges outside these singularities as suggested by some numerical computations (see, e.g., [26]). We investigate the asymptotic behavior of zero-energy, global-in-time solutions of (NSC) and find that such a solution behaves like a “multisoliton.” However, it is not an assemblage of free “particles”; the “solitons” interact with each other. © 1999 John Wiley & Sons, Inc.