cssi/SciSciGPT-SciSciNet huggingface dataset:
Tudor-SN–mediated endonucleolytic decay of human cell microRNAs promotes G1/S phase transition

MicroRNAs (miRNAs) are small noncoding RNAs that regulate gene expression. The pathways that mediate mature miRNA decay are less well understood than those that mediate miRNA biogenesis. We found that functional miRNAs are degraded in human cells by the endonuclease Tudor-SN (TSN). In vitro, recombinant TSN initiated the decay of both protein-free and Argonaute 2–loaded miRNAs via endonucleolytic cleavage at CA and UA dinucleotides, preferentially at scissile bonds located more than five nucleotides away from miRNA ends. Cellular targets of TSN-mediated decay defined using microRNA sequencing followed this rule. Inhibiting TSN-mediated miRNA decay by CRISPR-Cas9 knockout of TSN inhibited cell cycle progression by up-regulating a cohort of miRNAs that down-regulates mRNAs that encode proteins critical for the G 1 -to-S phase transition. Our study indicates that targeting TSN nuclease activity could inhibit pathological cell proliferation.
Transparent TiO2 nanotubes on zirconia for biomedical applications

Tissue discoloration in dental implant patients with thin gingival tissue is one of the many causes of dental implants’ revision surgery. Therefore, the purpose of this study is to address this issue by developing a surface that has a “tooth like bright colored” appearance while at the same time enhancing the bone implant integration. A biomimetic surface is fabricated by forming transparent TiO2 nanotubes on zirconia (TTNZ) that can enhance the proliferation and attachment of human mesenchymal stem cells (hMSCs) as compared to roughened ZrO2. This surface treatment was aimed to resolve tissue discoloration and aesthetic appearance problems for dental implant patients, while also enhancing biocompatibility. TiO2 nanotubes (TNTs) were formed using an electrochemical anodization technique in an electrolyte comprised of NH4F, ethylene glycol and water. The presence of TNTs on the ZrO2 substrate was detected by field emission scanning electron microscopy (FESEM). Optical images of longer anodized (20 and 30 min) samples show the white colored appearance characteristic of ZrO2 and FESEM confirmed the presence of TNTs on anodized samples. Surface characteristics of all samples were analyzed using water contact angle analysis, Fourier-transform infrared spectroscopy, white light interferometry and FESEM. Quantitative and qualitative biocompatibility analysis of treated and non-treated ZrO2 surfaces were obtained by performing FESEM, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and fluorescence microscopy. FESEM revealed well-elongated and well-spread cell morphology on the nanotubular surface as compared to roughened ZrO2. Additionally, MTT assay showed a significantly high cell proliferation for anodized Ti–ZrO2 surface as compared to roughened ZrO2 after 7 days of incubation.
Linear combinations come alive in crossover designs

Before learning anything about statistical inference in beginning service courses in biostatistics, students learn how to calculate the mean and variance of linear combinations of random variables. Practical precalculus examples of the importance of these exercises can be helpful for instructors, the target audience of this paper. We shall present applications to the “1-sample” and “2-sample” methods for randomized short-term 2-treatment crossover studies, where patients experience both treatments in random order with a “washout” between the active treatment periods. First, we show that the 2-sample method is preferred as it eliminates “conditional bias” when sample sizes by order differ and produces a smaller variance. We also demonstrate that it is usually advisable to use the differences in posttests (ignoring baseline and post washout values) rather than the differences between the changes in treatment from the start of the period to the end of the period (“delta of delta”). Although the intent is not to provide a definitive discussion of crossover designs, we provide a section and references to excellent alternative methods, where instructors can provide motivation to students to explore the topic in greater detail in future readings or courses.
Isn't belief in God an attitude?

Dans les annees 1949-1951, Wittgenstein affirmait que la croyance en Dieu constituait une Einstellung. Il y parle d'un monde limite du point de vue global et d'un monde possedant un esprit. Pour le croyant, le monde ne peut etre decrit de maniere exhaustive en termes purement scientifiques; on ne peut non plus le concevoir comme un alignement d'atomes et de particules disposes par le hasard. Pour l'A., la foi en l'existence de Dieu constitue une attitude a l'egard du monde. C'est cette attitude qui fait dire que le monde est celui de Dieu et comprendre qu'une vie est au service de sa volonte
Noninfectious Risks of Transfusion

Abstract The goal of blood component therapy is to achieve the desired effect without adverse outcomes. The desired effect may be to increase oxygen carrying capacity, correct coagulation factor deficiencies, or provide cellular components. However, adverse outcomes due to errors, accidents, or transfusion reactions cannot be completely avoided. Despite risk mitigation, the rate of transfusion reactions is 2.4 reactions per 1000 units transfused. Transfusion reactions can be just an annoyance (e.g., urticarial), but more severe reactions can be life threatening (e.g., anaphylaxis). The Transfusion Medicine specialist must be able to recognize, treat, and prevent future reactions by providing a comprehensive consultation for all reported reactions. The blood banking community has been very successful at reducing the risk of transfusion transmitted infections and is continually improving transfusion safety and risk mitigation. The purpose of this chapter on noninfectious risks of transfusion is to enhance the ability of the user to recognize, treat, and prevent these transfusion reactions.
DEVELOPMENT OF MODERN AUDITING STANDARDS: THE STRANGE CASE OF RAYMOND MARIEN AND THE FRAUD AT INTERSTATE HOSIERY MILLS, 1934–1937

In February 1938, the police arrested Raymond Marien, a small, bookish man, for forging checks at Interstate Hosiery Mills, Inc. During the ensuing investigation, the New York Attorney General's office found that Marien had “juggled” the books of the corporation and that these accounting irregularities inflated Interstate Hosiery Mills' assets by $1.9 million or about 40% of the company's assets. In an irony of history, the company's external auditors, as it turned out, employed Marien. The extensive investigation conducted by the SEC into Marien's manipulations found that, save for forged checks amounting to about $2,000, Marien and others were exonerated from any financial gain in the fraud due to the increased value in Interstate's shares. In the end, the fraud and the SEC rulings would serve as a foundation of many modern accounting and auditing principles related to auditor independence, supervision, and management responsibility.
Definition, differentiation, and classification of COPD

The term "COPD" covers a spectrum of diseases with a common denominator, obstruction to airflow on expiration. Chronic asthma, chronic bronchitis, and pulmonary emphysema are the most prevalent conditions. The signs and symptoms of COPD are similar in all entities. Differential diagnosis may be difficult. Early detection of COPD is important, and tests are available for this purpose. For therapeutic and prognostic reasons it is also important to differentiate, wherever possible, which disease entity is predominant in a particular person. This can be done to a high degree by correlating clinical, radiologic, and physiologic findings. The radiologic manifestations of COPD are multiple, varied, and in many instances nonspecific. The primary radiologic feature in COPD is lung hyperinflation. In advanced disease, radiologic changes are diagnostic and correlate well with physiologic and clinical findings. Frequently, however, the chest film is normal even when clinical and physiologic manifestations indicate advanced disease.
Outcomes of Transumbilical Laparoscopic-Assisted Appendectomy and Conventional Laparoscopic Appendectomy for Acute Pediatric Appendicitis in a Single Institution

Background: Single-incision laparoscopic appendectomy (SILA) is a potentially safe and feasible alternative to conventional laparoscopic appendectomy using three ports (CLA). However, the safety and efficacy of SILA for complicated appendicitis (gangrenous and perforated) remain unclear. The aim of this study was to evaluate the outcomes of transumbilical laparoscopic-assisted appendectomy (TULAA) not only for simple appendicitis but also for complicated appendicitis, and to compare them with the outcomes of CLA. Methods: All cases of acute pediatric appendicitis who underwent laparoscopic appendectomies in our hospital from 2007 to 2016 were retrospectively reviewed. CLA was performed between January 2007 and October 2011, and TULAA was performed between November 2011 and December 2016. In this study, patients' demographics and operative outcomes for simple appendicitis (catarrhal and phlegmonous) and complicated appendicitis were analyzed, comparing the results of TULAA and CLA. Results: In total, 262 patients underwent laparoscopic appendectomy: CLA in 103 patients and TULAA in 159 patients. All appendectomies were performed in the acute phase. Complicated appendicitis accounted for 60 CLA cases and 81 TULAA cases. There were no significant differences in patients' demographics. Mean operative time in simple appendicitis was significantly shorter in TULAA than in CLA. In addition, complication rates in complicated appendicitis were significantly lower in TULAA than in CLA. Moreover, in each comparison, the postoperative hospital stay was significantly shorter in TULAA than in CLA. Conclusion: In our institution, TULAA has shown to be a safe and effective alternative for both simple and complicated appendicitis in children compared with CLA.
Intravesical lidocaine decreases autonomic dysreflexia when administered prior to catheter change.

Objective: To evaluate the role of intravesical lidocaine in preventing autonomic dysreflexia (AD) during routine catheter changes in individuals with spinal cord injury (SCI) at T6 or above.Design...
Age and infection history are revealed by different ornaments in a warbler.

Female preference for older or more disease-resistant males are both possible outcomes of parasite-mediated sexual selection, but the extent to which infection alters the development of ornaments to yield signals of male age and health has rarely been explored. In a longitudinal study of 61 male common yellowthroats (Geothlypis trichas), age-related increases in the size of the melanin-based mask and carotenoid-based bib were not correlated among young males, likely owing to differences in how blood parasites affect ornament development. Infection with trypanosomes and hemosporidians in a male’s first breeding season was associated with slower growth of the mask; uninfected males attained large masks in their second breeding season, while infected males attained large masks in their third breeding season. In contrast, the bib size of males increased every year regardless of infection. As a consequence, different populations of males are identified by the largest ornaments—older males in the case of bib and a combination of older males and young, uninfected males in the case of mask. Although mask is thus the more informative trait with respect to male health, females prefer large bibs in our population. If infection is opportunistic, young, uninfected males may not possess good genes for parasite resistance but simply good luck, and it may benefit females to prefer older males who are more likely to have withstood prior episodes of selection. A “pure” signal of age may be a more reliable signal of resistance to parasites than an ornament whose expression is modulated by infection.
Effects of season and interval of prescribed burns on pyrogenic carbon in ponderosa pine stands in the southern Blue Mountains, Oregon, USA.

Abstract In ponderosa pine (Pinus ponderosa) forests of the western United States, prescribed burns are used to reduce fuel loads and restore historical fire regimes. The season of and interval between burns can have complex consequences for the ecosystem, including the production of pyrogenic carbon (PyC). PyC plays a crucial role in soil carbon cycling, displaying turnover times that are orders of magnitude longer than unburned organic matter. This work investigated how the season of and interval between prescribed burns affects soil organic matter, including the formation and retention of PyC, in a ponderosa pine forest of eastern Oregon. In 1997 a prescribed burn study was implemented in Malheur National Forest to examine the ecological effects of burning at 5 and 15-year intervals in either the spring or fall. In October 2015, both O-horizon and mineral soil (0–15 cm) samples were collected and analyzed for PyC concentration, content, and structure using the benzene polycarboxylic acid (BPCA) method. O-horizon depth, carbon and nitrogen concentration and content, pH, and bulk density were also measured. Plots burned in the spring and fall had lower C and N stocks in the O-horizon compared to the unburned controls due to a reduction in O-horizon depth; however, we did not observe any differences in O-horizon concentration of C or N. Moreover, the concentrations and stocks of C and N in the mineral soil of plots burned in the spring or fall were the same as or only very slightly different from the unburned controls, suggesting that the prescribed burns on these sites have not adversely affected SOM quantity in the surface mineral soil carbon pools over the course of this 18-year experiment. Compared to unburned controls, we estimate that fall burns increased the mean PyC concentration of the mineral soil by 8.42 g BPCA/kg C. We did not detect a difference in mean PyC concentration of the mineral soil between the spring burns and the unburned controls; however, the spring burn plots did contain a number of isolated pockets with very high concentrations of PyC, suggesting a patchier burn pattern for these plots. In general, there was no detectable difference in any of the response variables when comparing the various prescribed burn treatments to one another. Reestablishing fire in these forests resulted in minor effects on the PyC concentration and pH, which may have beneficial impacts on soil carbon and available nutrients, while having few effects on other soil characteristics. This suggests that the application of low severity prescribed fires should result in little detrimental change to soils of ponderosa pine forests of the Southern Blue Mountains, while achieving management objectives such as reduction of surface fuels.
A role for reward sensitivity in the serotonergic modulation of impulsivity

Abstract While the neural substrates of impulsive behavior are commonly studied in humans and preclinical models, the behavioral substrates which contribute to impulsivity are still understudied. Understanding the behavioral underpinnings of impulsive behavior will allow us to better model disorders of impulsive behavior in animals, and also help more clearly define the underlying neural circuits. Our goal here was to explore behavioral correlates and effectors of impulsive behavior, using a mouse model for disordered impulsivity, namely mice lacking the serotonin 1B receptor (5-HT1BR). Our past work, along with others’, implicates 5-HT1BR in the regulation of impulsivity, specifically, impulsive action. In mice, the absence of 5-HT1BR expression in adulthood results in a reduced ability to wait or withhold responses. We report here, that in addition to increased impulsive action, mice lacking expression of 5-HT1BR show increased goal-directed responding and motivation, with no differences in extinction, development of habitual behavior, or impulsive choice measured in a delay discounting paradigm. Interestingly, mice lacking 5-HT1BR also show increased hedonic responses to sweet rewards. Finally, using a newly developed paradigm, we report that increasing reward value increases impulsive action on a trial-by-trial basis, showing how changing reward value can directly influence impulsive behavior. Taken together, these data support the hypothesis that the effects of 5-HT1BR on impulsive action reflect enhanced reward sensitivity, and point to potential neural and phenotypic causes for clinically-relevant increases in impulsivity.
Pharmacokinetics of inhaled nanotherapeutics for pulmonary delivery.

Abstract Pulmonary delivery of lipid-based nanotherapeutics by inhalation presents an advantageous alternative to oral and intravenous routes of administration that avoids enzymatic degradation in gastrointestinal tract and hepatic first pass metabolism and also limits off-target adverse side effects upon heathy tissues. For lung-related indications, inhalation provides localized delivery in order to enhance therapeutic efficacy at the site of action. Optimization of physicochemical properties, selected drug and inhalation format can greatly influence the pharmacokinetic behavior of inhaled nanoparticle systems and their payloads. The present review analyzes a wide range of nanoparticle systems, their formulations and consequent effect on pharmacokinetic distribution of delivered active components after inhalation.
Dermoscopic Features of Mycosis Fungoides and Its Variants in Patients with Skin of Color: A Retrospective Analysis.

Background Mycosis fungoides (MF) is a cutaneous T-cell lymphoma that disproportionately affects people with skin of color and is difficult to diagnose. Objective This study characterized the dermoscopic features of MF and its subtypes in patients with skin of color. Methods Dermoscopic images of patients with skin of color seen at the cutaneous T-cell lymphoma clinic at Michigan Medicine Dermatology between 2018 and 2019 were reviewed. Specific dermoscopic features were identified and summarized for each subtype of MF. Results A total of 33 dermoscopic images from 11 patients with skin of color were reviewed. Four patients had classic MF (18 dermoscopic images), 4 had hypopigmented MF (9 dermoscopic images), 1 had folliculotropic MF (4 dermoscopic images), and 2 had verrucous MF (2 dermoscopic images). Classic MF was characterized by striking pigmentary change, thick black lines, white rosettes, and geometric white lines. Hypopigmented MF was characterized by the loss of the patient's natural pigment network. In folliculotropic MF, follicular plugging and hyperpigmented to violaceous perifollicular halos were observed. In verrucous MF, large, yellow-gray amorphous structures with yellow-gray ridges and comedo-like openings were observed within hyperkeratotic areas. Overall, vessel morphology was difficult to discern on dermoscopy. Conclusions Dermoscopic features of MF in patients with skin of color are predominantly characterized by striking pigmentary alteration. Vessel morphology is not a reliable diagnostic feature. As patients with MF and skin of color have a worse prognosis than light-skinned individuals, a better understanding of dermoscopic features may aid in early diagnosis and improve outcomes in this group.
Trends, mechanisms, and racial/ethnic differences of tuberculosis incidence in the US-born population aged 50 years or older in the United States.

Background Older age is a risk factor for TB in low incidence settings. Using data from the U.S. National TB Surveillance System and American Community Survey, we estimated trends and racial/ethnic differences in TB incidence among US-born cohorts aged ≥50 years. Methods 42,000 TB cases among US-born persons ≥50 years were reported during 2001-2019. We used generalized additive regression models to decompose the effects of birth cohort and age on TB incidence rates, stratified by sex and race/ethnicity. Using genotype-based estimates of recent transmission (available 2011-2019), we implemented additional models to decompose incidence trends by estimated recent versus remote infection. Results Estimated incidence rates declined with age, for the overall cohort and most sex and race/ethnicity strata. Average annual percentage declines flattened for older individuals, from 8.80% (95% confidence interval 8.34-9.23) in 51-year-olds to 4.51% (3.87-5.14) in 90-year-olds. Controlling for age, incidence rates were lower for more recent birth cohorts, dropping 8.79% (6.13-11.26) on average between successive cohort years. Incidence rates were substantially higher for racial/ethnic minorities, and these inequalities persisted across all birth cohorts. Rates from recent infection declined at approximately 10% per year as individuals aged. Rates from remote infection declined more slowly with age, and this annual percentage decline approached zero for the oldest individuals. Conclusions TB rates were highest for racial/ethnic minorities and for the earliest birth cohorts and declined with age. For the oldest individuals, annual percentage declines were low, and most cases were attributed to remote infection.
Understanding the link between obesity and severe COVID-19 outcomes: Causal mediation by systemic inflammatory response.

BACKGROUND: Obesity is an established risk factor for severe COVID-19 outcomes. The mechanistic underpinnings of this association are not well-understood. OBJECTIVE: To evaluate the mediating role of systemic inflammation in obesity-associated COVID-19 outcomes. DESIGN: Hospital-based, observational. SETTING: Massachusetts General Hospital (MGH) or Columbia University Irving Medical Center/NewYork-Presbyterian Hospital (CUIMC/NYP). PATIENTS OR OTHER PARTICIPANTS: N=3828 SARS-CoV-2-infected patients hospitalized February to May 2020. MAIN OUTCOME MEASURES: Mediation analysis is used to evaluate whether peak inflammatory biomarkers [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), D-dimer, ferritin, white blood cell count and interleukin-6] are in the causal pathway between obesity (BMI ≥ 30) and mechanical ventilation or death within 28 days of presentation to care. RESULTS: In the MGH cohort (n=1202), obesity was associated with greater likelihood of ventilation or death [OR=1.73, 95% CI=(1.25, 2.41), p=0.001] and higher peak CRP (p<0.001) compared to non-obese patients. The estimated proportion of the association between obesity and ventilation or death mediated by CRP was 0.49 (p<0.001). Evidence of mediation was more pronounced in patients <65 years [proportion mediated=0.52 (p<0.001) versus 0.44 (p=0.180)]. Findings were more moderate but consistent for peak ESR. Mediation by other inflammatory markers was not supported. Results were replicated in CUIMC/NYP cohort (n=2626). CONCLUSIONS: Findings support systemic inflammatory pathways in obesity-associated severe COVID-19 disease, particularly in patients <65 years, captured by CRP and ESR. Contextualized in clinical trials findings, these results reveal therapeutic opportunity to target systemic inflammatory pathways and monitor interventions in high-risk subgroups and particularly obese patients.
Delivering Cognitive Behavioral Therapy for Post-Intensive Care Syndrome-Family via a Mobile Health App.

Background Family members of intensive care unit (ICU) patients are at risk for post-intensive care syndrome- family (PICS-F), including symptoms of anxiety, depression, and posttraumatic stress. Cognitive behavioral therapy is the first-line nonpharmacologic treatment for many psychological symptoms and has been successfully delivered by use of mobile technology for symptom self-management. Objectives To determine the feasibility of delivering cognitive behavioral therapy through a smartphone app to family members of critically ill patients. Methods This was a prospective longitudinal cohort study with a consecutive sample of patients admitted to 2 adult ICUs and their family members. The control group period was followed by the intervention group period. The intervention consisted of a mobile health app preloaded on a smartphone provided to family members. The study time points were enrollment (within 5 days of ICU admission), 30 days after admission, and 60 days after admission. Study measures included demographic data, app use, satisfaction with the app, mental health self-efficacy, and measures of PICS-F symptoms. Results The study sample consisted of 49 predominantly White (92%) and female (82%) family members (24 intervention, 25 control). Smartphone ownership was 88%. Completion rates for study measures were 92% in the control group and 79% in the intervention group. Family members logged in to the app a mean of 18.58 times (range 2-89) and spent a mean of 81.29 minutes (range 4.93-426.63 minutes) using the app. Conclusions The study results confirm the feasibility of implementing app-based delivery of cognitive behavioral therapy to family members of ICU patients.
Testosterone Need Questioned

In Reply.— We thank Dannenhoffer and Crawford for their thoughtful comments on our recent study of testosterone treatment of constitutional delay. We agree that the size of the study population was relatively small, and that subject randomization resulted in a significant difference in mean height at the time of entry into the study. Nevertheless, we believe the data still support the conclusion that short-term testosterone treatment can result in significant growth acceleration in this population. In general, linear growth in children correlates better with bone age than with chronologic age, and the skeletal ages of the two groups in this study were not significantly different.
“Something Wicked This Way Comes”: Constructing the Witch in Contemporary American Popular Culture

Dr. Angela Nelson, Advisor What is a Witch? Traditional mainstream media images of Witches tell us they are evil “devil worshipping baby killers,” green-skinned hags who fly on brooms, or flaky tree huggers who dance naked in the woods. A variety of mainstream media has worked to support these notions as well as develop new ones. Contemporary American popular culture shows us images of Witches on television shows and in films vanquishing demons, traveling back and forth in time and from one reality to another, speaking with dead relatives, and attending private schools, among other things. None of these mainstream images acknowledge the very real beliefs and traditions of modern Witches and Pagans, or speak to the depth and variety of social, cultural, political, and environmental work being undertaken by Pagan and Wiccan groups and individuals around the world. Utilizing social construction theory, this study examines the “historical process” of the construction of stereotypes surrounding Witches in mainstream American society as well as how groups and individuals who call themselves Pagan and/or Wiccan have utilized the only media technology available to them, the internet, to resist and reconstruct these images in order to present more positive images of themselves as well as build community between and among Pagans and nonPagans.
Reactive Collisions Between Gas and Surface Atoms

Publisher Summary This chapter focuses on reactive collision at a gas–solid interface and gaseous atomic species containing unpaired electrons. For chemical interaction between surface and gaseous atoms, an approach of the gaseous atom corresponding to chemisorption is required. Elucidation of the elementary processes associated with reaction requires, therefore, some information on the bond strengths between atoms and surfaces. Desorption of an adatom represents essentially the reverse of the adsorption process. Thus, either an atom or a diatomic molecule may be desorbed depending on the particular conditions. In contrast to the catalytic recombination process, where the over-all chemical change is independent of the nature of the surface, chemical reactions between gaseous atoms and surface lattice atoms can involve an array of chemical processes. Most of the atom detectors that fall into the first category transduce the heat of atom recombination into a temperature rise of a thermocouple or into an enthalpy change at constant temperature in a metal filament calorimeter.
An approach to designing online help for pictorial instruction sets

One approach to designing an online help facility for a pictorial instruction set is to create a text database which contains functional profiles of each object displayed in the instructions. A framework for creating such a database is described along with a method for constructing the individual object profiles. Object profiles are also discussed in terms of how they provide a foundation for evaluating the clarity, consistency, and completeness of pictorial instruction presentations. >
Frequency of complications during EUS‐guided drainage of pancreatic fluid collections in 148 consecutive patients

Background and Aim: The aim of the present study was to evaluate the frequency of complications during endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFC), identify contributing factors, and report on management outcomes. Methods: All patients who underwent EUS-guided PFC drainage over 7 years were enrolled. Indications, demographics, technical details, complications, surgical interventions, and final outcomes were prospectively recorded. Results: Of 148 patients who underwent EUS, PFC was located in the pancreatic body in 84 (56.8%), in the tail in 45 (30.4%), in the head in 15 (10.1%), and in the uncinate region in four patients (2.7%). Perforation was encountered at the site of transmural stenting in two patients (1.3%, 95% confidence interval [CI]: 0.41–4.76) with a pseudocyst in the uncinate region that was drained transgastrically. When compared to other locations, perforation was more common with PFC involving the uncinate region (0% vs 50%, P = 0.0005). Other complications included bleeding in one (0.67%, 95% CI: 0.16, 3.68), stent migration in 1 (0.67%, 95% CI: 0.16, 3.68), and infection in four patients (2.7%, 95% CI: 1.09, 6.73). Bleeding occurred in a patient with underlying acquired factor VIII inhibitors, stent migration in a patient who underwent drainage via the gastric cardia, and infection in two patients with pseudocysts and two with necrosis. While two patients who developed post-procedural infection and one with stent migration were managed endoscopically, both perforations required surgery. Surgical debridement was performed in two patients who developed infection with successful outcomes in one, and death from underlying comorbidity in the other. Conclusions: Complications are rare during EUS-guided drainage of PFC and can be managed successfully in most patients.
Einstein Bed-Load Function at High Sediment Rates

In alluvial channels consisting of fine sand beds, almost all the sediment load moves in suspension with high concentrations near the bed. These high concentrations affect many of the flow characteristics: the roughness is changed, the velocity profiles are altered, the density and viscosity of the fluid are increased, and the particle fall velocity and the von Karman coefficient are reduced. The paper describes how the Einstein bed-load function can be modified in order to better describe flows with high sediment rates of fine grain. Instead of a constant value of von Karman's coefficient of 0.4, both the distributions of velocity and suspended sediment use a variable value of von Karman's coefficient which is a function of a dimensionless parameter but becomes 0.4 when the parameter is larger than 1.
Extrahepatic Biliary Tract

In general, the major blood vessels in the area of the extrahepatic biliary tree are posterior to the ducts, but in a number of cases they may lie anterior. The surgeon must recognize and preserve these arteries. Table 14.1 shows the frequency with which specific arteries are found anterior to segments of the biliary tract.
Ratios of ferrous to ferric iron from nanometre-sized areas in minerals

Minerals with mixed valence states are widespread and form in many different rock types1. They can contain, for example, Fe2+–Fe3+ and Mn2+–Mn3+–Mn4+, with the ratios of oxidation states reflecting the redox conditions under which the host materials crystallized. The distribution of the ratio of iron (III) to total iron content (Fe3+/ΣFe) in minerals reflects the oxidation states of their host rocks and is therefore important for answering fundamental questions about the Earth's evolution and structure2,3,4,5,6,7,8. Iron is the most sensitive and abundant indicator of oxidation state, but many mineral samples are too fine-grained and heterogeneous to be studied by standard methods such as Mossbauer spectroscopy, electron microprobe, and wet chemistry. Here we report on the use of electron energy-loss spectroscopy with a transmission electron microscope to determine Fe3+/ΣFe in minerals at the nanometre scale. This procedure is efficient for determining Fe3+/ΣFe ratios of minor and major amounts of iron on a scale heretofore impossible and allows information to be obtained not only from ultra-fine grains but also, for example, at reaction fronts in minerals.
Aging increases resistance to bacterial infection in the tobacco hornworm, Manduca sexta (1100.4)

Manduca sexta larvae (tobacco hornworm) early in their fifth and final larval stage have been reported to have more robust immune responses to Photorabdus luminscens compared to animals later in that stage. We hypothesized that the robust immune response in early stage caterpillars would result in varying hemolymph bacterial loads and survival to other bacterial infections. Early stage M. sexta injected with non-pathogenic E. coli had 25-fold higher bacterial loads in hemolymph than those injected later. In addition, early stage M. sexta injected with pathogenic Stenotrophomonas maltohphilia died twice as fast as those injected later. These data demonstrate an ineffective immune response in early stage caterpillars. We also hypothesized that the robust immune response in early stage caterpillars would affect other aspects of physiology, such as development and growth. Early stage M. sexta injected with E. coli or S. maltophilia exhibited developmental and growth rates twice as slow as those injected later...
Vitamin E stimulates luteinizing hormone-releasing hormone and ascorbic acid release from medial basal hypothalami of adult male rats.

Vitamin E, a dietary factor, is essential for reproduction in animals. It is an antioxidant present in all mammalian cells. Previously, we showed that ascorbic acid (AA) acted as an inhibitory neur...
Christians Without Christianity: On Being Terminally “Church-Outed”

Old age sometimes brings loss of faith or renewed faith. In the case of three giants of European culture—Milton, Kierkegaard, Tolstoy—it brought both: They turned against institutional religion, but in the name of God and Bible. Brief outlines indicate how they reach this position. They differed crucially on who was Jesus and on what is the Bible. They agree, however, that the Church downplays the difficulty of being a Christian, seeks power, allies itself with the state, splinters easily, and resorts to widespread mendacity, especially on the importance of ritual and on the relevance of a priestly class. Bearing witness to a true piety in a world of allegedly shallow or fake Christianity, these three men are in the line of the Hebrew prophets and of Jesus, and, like them, are engaged in a task that sometimes seems more Sisyphean than Herculean.
Neonatal thyrotoxicosis associated with the hyperviscosity syndrome.

Baby S.M. was the 2,230-gram, 36-week product of a 28-yearold gravida 1 para 0 black woman with a previous history of hyperthyroidism, treated by subtotal thyroidectomy one year prior to her pregnancy. Clinically, she was euthyroid, with a normal T, value and a negative long-acting thyroid stimulator titer. No thyroid or anti-thyroid medications were taken during pregnancy. Labor and delivery were uneventful Shortly after birth, however, the infant developed acrocyanosis, tachypnea (100/ minute), tachycardia (180/minute), and hyperactivity with marked irritability and tremulousness. At 13 hours of age, his blood glucose value, measured by Dextrostix, was 25 mg/dl; 10% dextrose solution was administered intravenously, and he was transferred to St. Louis Children's Hospital. On arrival, he was moderately icteric (total bilirubin 10.4 rng/dl; direct bilirubin 2.52 mg/dl) and was noted to have generalized petechiae, purpura, and hepatosplenomegaly. Diffuse cardiomegaly was noted radiographically; right heart enlargement was shown electrocardiographically. Sixty percent inspired oxygen was required to maintain normal arterial blood gas values. Serum calcium was decreased to 6.8 mg/dl, but the concentrations of the other electrolytes were normal. Venous microhematocrit was 73%. Initial platelet count was 170,000/ mm', but it fell to 56,000/mm :~. Blood smear revealed 2,880 nucleated red blood cells/mrn ~, but was otherwise unremarkable.
Formaldehyde Formation in Large Bore Engines Part 2: Factors Affecting Measured CH2O

Current research shows that the only hazardous air pollutant of significance emitted from large bore natural gas engines is formaldehyde (CH 2 O). A literature review on formaldehyde formation is presented focusing on the interpretation of published test data and its applicability to large bore natural gas engines. The relationship of formaldehyde emissions to that of other pollutants is described. Formaldehyde is seen to have a strong correlation to total hydrocarbon (THC) level in the exhaust. It is observed that the ratio of formaldehyde to THC concentration is roughly 1.0-2.5 percent for a very wide range of large bore engines and operating conditions. The impact of engine operating parameters, load, rpm, spark timing, and equivalence ratio, on formaldehyde emissions is also evaluated.
Ultrastructure of somatic tissues in the ovaries of a chaetognath (Ferosagitta hispida).

Transmission electron microscopy reveals that the ovaries of Ferosagitta hispida contain four somatic tissues. A myoepithelial ovary wall, continuous with a thin layer of peritoneocytes lining the coelomic cavity, encloses a fluid-filled ovarian space in which oocytes develop. Lamellar extensions of a "follicular reticulum" branch throughout the ovarian space and ensheath developing oocytes. This tissue has been overlooked in most previous studies of chaetognath ovaries. A bipartite oviductal complex extends the length of each ovary just within the lateral ovary wall. It consists of a flattened, blindly ending cellular tube, herein referred to as the cellular sheath, and an enclosed syncytium. Sheath cells secrete an electron-dense product into the ovarian space. Those sheath cells directly bordering the syncytium are contractile and are joined to the to the syncytium by gap junctions and microvillar interdigitations. The syncytium contains a complex of membrane-bounded lumina. The latter sometimes enclose sperm received during mating or ovulated eggs. Thus the syncytium serves both as a seminal receptacle and as a duct for passage of eggs to the outside. Contrary to several classical reports, the cellular sheath and syncytium of the oviductal complex do not separate at ovulation to form a temporary oviductal lumen.
Dentists practicing in designated areas of shortage in health personnel.

Those dentists, who have struggled with criteria for designating areas which have a shortage of dentists and might qualify for federal aid, should be interested in Dr. Whiteside's report.
The Deep Self Model and asymmetries in folk judgments about intentional action

Recent studies by experimental philosophers demonstrate puzzling asymmetries in people’s judgments about intentional action, leading many philosophers to propose that normative factors are inappropriately influencing intentionality judgments. In this paper, I present and defend the Deep Self Model of judgments about intentional action that provides a quite different explanation for these judgment asymmetries. The Deep Self Model is based on the idea that people make an intuitive distinction between two parts of an agent’s psychology, an Acting Self that contains the desires, means-end beliefs, and intentions that are the immediate causal source of an agent’s actions, and a Deep Self, which contains an agent’s stable and central psychological attitudes, including the agent’s values, principles, life goals, and other more fundamental attitudes. The Deep Self Model proposes that when people are asked to make judgments about whether an agent brought about an outcome intentionally, in addition to standard criteria proposed in traditional models, people also assess an additional ‘Concordance Criterion’: Does the outcome concord with the psychological attitudes of the agent’s Deep Self? I show that the Deep Self Model can explain a very complex pattern of judgment asymmetries documented in the experimental philosophy literature, and does so in a way that has significant advantages over competing models.
Design, implementation, and evaluation of a thrice-daily cartfill process

Purpose Efficiencies achieved through a redesign of the central pharmacy cartfill process at a large academic medical center are reported. Summary In an initiative to expand clinical pharmacy services in a budget-neutral manner, pharmacists at the University of Wisconsin Hospital and Clinics (UWHC) led the transition from a once-daily to a thrice-daily medication cartfill model designed to better align pharmacy operations with patterns of medication ordering, delivery, and order discontinuation. A pre–post analysis demonstrated several benefits of the shift to thrice-daily cartfill, including a 32.7% decrease in the mean daily number of extemporaneously prepared oral doses. Overall, the new cartfill process resulted in reduction in lead times for three of four peak delivery periods, roughly a 55–65% reduction. During the postimplementation period, the frequency of requests for missing medication doses through the electronic medical record (EMR) system increased from 1.13% to 1.43%; however, this increase may have been the result of improved nurse adherence to EMR protocols for requests for missing medications. Conclusion Implementation of a thrice-daily cartfill process and ancillary changes at UWHC resulted in a 2.1% increase in cartfill doses dispensed, a 44.1% decrease in first doses dispensed, and a 42.9% decrease in the number of medications returned to the central pharmacy. This resulted in a reduction in waste within pharmacy operations and allowed for redeployment of two technician full-time equivalents to expand pharmacy services.
γ-Aminobutyric acidergic and glycinergic inputs shape coding of amplitude modulation in the chinchilla cochlear nucleus

Abstract Amplitude modulation is a prominent acoustic feature of biologically relevant sounds, such as speech and animal vocalizations. Enhanced temporal coding of amplitude modulation signals is found in certain dorsal and posteroventral cochlear nucleus neurons when they are compared to auditory nerve. Although mechanisms underlying this improved temporal selectivity are not known, involvement of inhibition has been suggested. γ-Aminobutyric acid- and glycine-mediated inhibition have been shown to shape the dorsal cochlear nucleus and posteroventral cochlear nucleus response properties to other acoustic stimuli. In the present study, responses to amplitude modulation tones were obtained from chinchilla dorsal cochlear nucleus and posteroventral cochlear nucleus neurons. The amplitude modulation carrier was set to the neuron’s characteristic frequency and the modulating frequency varied from 10 Hz. Rate and temporal modulation transfer functions were compared across neurons. Bandpass temporal modulation transfer functions were observed in 74% of the neurons studied. Most cochlear nucleus neurons (90%) displayed flat or lowpass rate modulation transfer functions to amplitude modulation signals presented at 25–40 dB (re: characteristic frequency threshold). The role of inhibition in shaping responses to amplitude modulation stimuli was examined using iontophoretic application of glycine or γ-aminobutyric acid A receptor agonists and antagonists. Blockade of γ-aminobutyric acid A or glycine receptors increased stimulus-evoked discharge rates for a majority of neurons tested. Synchronization to the envelope was reduced, particularly at low and middle modulating frequencies, with temporal modulation transfer functions becoming flattened and less bandpass in appearance. Application of glycine, γ-aminobutyric acid or muscimol increased the modulation gain over the low- and mid-modulation frequencies and reduced the discharge rate across envelope frequencies for most neurons tested. These findings support the hypothesis that glycinergic and γ-aminobutyric acidergic inputs onto certain dorsal cochlear nucleus and posteroventral cochlear nucleus neurons play a role in shaping responses to amplitude modulation stimuli and may be responsible for the reported preservation of amplitude modulation temporal coding in dorsal cochlear nucleus and posteroventral cochlear nucleus neurons at high stimulus intensities or in background noise.
Effect of O side-chain length and composition on the virulence of Shigella flexneri 2a.

IcsA of Shigella flexneri is required for intercellular spread and is located in the outer membrane at one pole of the bacterium, where it catalyses the polymerization of host-cell actin. The formation of the a tin tail provides the force to move the bacterium in a unidirectional manner through the host-cell cytoplasm. We have previously demonstrated that rough lipopolysaccharide (LPS) mutants of S. flexneri 2a are avirulent and cannot form plaques in tissue-culture monolayers. This inability to form plaques is associated with non-polar localization of IcsA and loss of host-cell membrane-protrusion formation ("fireworks'). To define the minimal LPS structure required for fireworks formation, we constructed a strain of S. flexneri (BS497) that contains a mutation in rfc, encoding the O side-chain polymerase, and a strain, BS520, that possesses a defective O side-chain ligase due to a mutation in rfaL. BS497 produces a LPS that consists of a core with one repeat unit of the O side-chain, while BS520 produces a LPS consisting of a complete core with no O side-chain. BS497 remained invasive but did not form fireworks or plaques in tissue-culture monolayers and was negative in the Sereny test. BS520 was invasive, generated reduced numbers of short fireworks, and made tiny plaques, but it was negative in the Sereny test. Analysis of BS497 with anti-IcsA antibody demonstrated that IcsA was distributed over the entire cell surface. The distribution of IcsA on the surface of BS520 was predominantly unipolar, with some trail-back of IcsA label along the sides of the bacterium. A similar pattern was seen when infected monolayers were stained for polymerized actin. These results suggest that both the presence and the length of the O side-chain are important in the proper localization or maintenance of IcsA at the pole which subsequently affects the ability to form actin tails and produce fireworks. This reduced ability to form actin tails and fireworks results in a decreased ability of Shigella to move into adjacent host cells. To determine if the sugar composition of the O side-chain is important in the ability to form fireworks, the rfb region of S. flexneri 2a was replaced with the rfb region from Escherichia coli serotype O8 or O25. Both hybrids were invasive, formed plaques, and gave positive Sereny reactions. These results suggest that, unlike LPS length, the sugar composition of the O side-chain is not a critical requirement for the proper localization of IcsA and efficient intercellular movement.