cssi/SciSciGPT-SciSciNet huggingface dataset:
Red cell aplasia and autoimmune hemolytic anemia following immunosuppression with alemtuzumab, mycophenolate, and daclizumab in pancreas transplant recipients

Background and Objectives Acquired red cell aplasia (RCA) is a rare disorder and can be either idiopathic or associated with certain diseases, pregnancy, or drugs. In exceptionally rare cases, it has been reported to co-exist with other autoimmune cytopenias. We report a high incidence of RCA and autoimmune hemolytic anemia (AIHA) in pancreas transplant recipients on alemtuzumab-based maintenance therapy. Design and Methods Between February 2003 and July 2005, 357 pancreas transplant recipients were treated with immunosuppressive regimens containing the lymphocyte-depleting antibody alemtuzumab, the T-cell activation inhibitor daclizumab, and the anti-metabolite mycophenolate mofetil (MMF). We retrospectively reviewed medical records, blood bank data and bone marrow biopsy specimens of patients with a Transplant Information Services database diagnosis of RCA and AIHA from February 2003 to November 2005. Results Severe RCA, AIHA, and idiopathic thrombocytopenic purpura (ITP) occurred independently or in combination, in 20 out of 357 (5.6%) pancreas transplant recipients, 12 to 24 months following the initiation of the aforementioned immunosuppressive regimens. Severe opportunistic infections developed late in 14/20 (70%) of these patients. Atypical morphologic features, including variable dysgranulopoiesis, variable megakaryocytic hyperplasia with normal or low peripheral platelet counts, and atypical lymphoid aggregates were found in bone marrow trephine sections of 11 patients in whom the diagnosis of RCA was made. Interpretation and Conclusions We hypothesize that the combination of alemtuzumab, daclizumab and MMF can result in immune dysregulation thereby permitting autoantibody formation. Because the use of these three immune suppressants is becoming increasingly common, it is important to recognize the severe hematologic complications that can arise.
Quantifying and Improving the Availability of High-Performance Cluster-Based Internet Services

Cluster-based servers can substantially increase performance when nodes cooperate to globally manage resources. However, in this paper we show that cooperation results in a substantial availability loss, in the absence of high-availability mechanisms. Specifically, we show that a sophisticated cluster-based Web server, which gains a factor of 3 in performance through cooperation, increases service unavailability by a factor of 10 over a non-cooperative version. We then show how to augment this Web server with software components embodying a small set of high-availability techniques to regain the lost availability. Among other interesting observations, we show that the application of multiple high-availability techniques, each implemented independently in its own subsystem, can lead to inconsistent recovery actions. We also show that a novel technique called Fault Model Enforcement can be used to resolve such inconsistencies. Augmenting the server with these techniques led to a final expected availability of close to 99.99%.
Fatness and fat distribution in Mexican-American children and youths from the Hispanic health and nutrition examination survey.

Mexican-American children are shorter but relatively heavier than non-Hispanic white children. The excess relative weight is probably due to increased fat rather than lean body mass and, more specifically, to increased fat deposition on the upper trunk sites. The objective of this paper is to describe the level of fatness and fat distribution in a large, representative sample of Mexican- American children and adolescents from the recently completed Hispanic Health and Nutrition Examination Survey (HHANES). As expected, Mexican-American children are generally fatter than white children measured in previous national surveys (National Health and Nutrition Examination Survey [NHANES] II, Health Examination Survey [HES]). Differences are particularly evident for trunk skinfold thicknesses and generally increase with age. Indices of fat distribution clearly show a centralized, upper body adiposity pattern among Mexican-Americans, a cause for concern since greater fat deposition on the trunk has been associated with increased risk of certain chronic disease.
Affect and the Functional Bases of Behavior: On the Dimensional Structure of Affective Experience:

Discussions of the dimensional structure of affect usually are based on results of factor analyses. Disagreements focus largely on issues of measurement and measurement error. I argue that the structure of affect is not discussed meaningfully without considering functional implications of affects. A functional analysis is outlined in which approach and incentive-related affects (both positive and negative) are managed by 1 self-regulatory system, and avoidance and threat-related affects (positive and negative) are managed by another self-regulatory system. In both cases, positive and negative affects are posited to convey information about whether the behavior being engaged in is going well or poorly. This view argues for the existence of 2 bipolar affective dimensions, the properties of which are informed by an understanding of both behavior and feelings.
A phase 1 study of vorinostat maintenance after autologous transplant in high-risk lymphoma.

AbstractOnly a minority of patients with high risk lymphoma will be cured with autologous transplant, so maintenance with vorinostat, an oral agent with activity in relapsed lymphoma, was studied starting day + 60 for 21 consecutive days followed by a week off for up to 11 cycles. Twenty-three patients with lymphoma were treated. Ten patients completed the full 11-cycle treatment plan per protocol, four patients were removed due to progressive disease and seven withdrew or were removed from the study due to toxicities. Despite Prevnar vaccine administration every 2 months for three injections, the mean antibody concentration never reached protective levels (> 0.35 μg/mL). Fatigue and functional well-being measured by Brief Fatigue Inventory and Functional Assessment of Cancer Therapy-General improved significantly from cycle 1 to cycle 7, but depression scores from the Center for Epidemiologic Studies Depression scale did not change. Given the toxicities observed, this broad-spectrum deacetylase inhibitor...
The role of heat-shock proteins as molecular chaperones.

Abstract Recent studies have revealed that protein folding and assembly events in vivo require the participation of accessory components, now being referred to as ‘molecular chaperones’. A number of chaperones have been identified as members of the heat-shock (or stress) protein family. This review discusses the roles of two classes of chaperones, the heat-shock protein 70 and groEL/ES families, in facilitating protein maturation, and describes how such events are perturbed in the cell subjected to metabolic stress.
An analysis of facilitated-diffusion problems

Abstract This paper develops the mathematical analysis of nonlinear boundary-value problems that model the facilitated diffusion of a substrate across a membrane. The analysis includes bounds for solutions, global existence results, local uniqueness and continuity results, and estimates for parameter ranges for uniqueness of solutions.
DISCOUNTING AND RISK NEUTRALITY

Consider a binary relation on a real vector space of vector-valued discrete-time stochastic processes. If the binary relation satisfies four axioms, then there are unique discount factors such that preferences regarding stochastic processes induce prefences among present value random vectors. Three of the axioms are familiar: weak ordering, continuity, and non-triviality. The fourth axiom is decomposition. Also, if preferences satisfy the four axioms then the following properties are equivalent: the converse of decomposition, the existence of a felicity function on the set of random vectors, and risk neutrality. In this limited sense, discounting implies risk neutrality.
Self-Care Management for the Patient with Normomagnesemia Magnesium Deficiency

A comprehensive review of the magnesium literature failed to disclose any articles describing self-care or self-management of normomagnesemia magnesium (Mg) deficiency (NMgD) requiring oral dosing with Mg supplication (MgS). A review of eleven books on Mg, mostly research conference proceedings, likewise showed a lack of interest in this essential modality of clinical medical care. Yet physician guidelines are available that recommend, that at every opportunity the patient should be exposed to self-management education for a partnership in comprehensive asthma care, including self-medication1. Many books exist on this subject for asthmatics, as well for diabetics2.
Platinum-RNA modifications following drug treatment in S. cerevisiae identified by click chemistry and enzymatic mapping.

With the importance of RNA-based regulatory pathways, the potential for targeting noncoding and coding RNAs by small molecule therapeutics is of great interest. Platinum(II) complexes including cisplatin (cis-diamminedichloroplatinum(II)) are widely prescribed anticancer compounds that form stable adducts on nucleic acids. In tumors, DNA damage from Pt(II) initiates apoptotic signaling, but this activity is not necessary for cytotoxicity (e.g., Yu et al., 2008), suggesting accumulation and consequences of Pt(II) lesions on non-DNA targets. We previously reported an azide-functionalized compound, picazoplatin, designed for post-treatment click labeling that enables detection of Pt complexes (White et al., 2013). Here, we report in-gel fluorescent detection of Pt-bound rRNA and tRNA extracted from picazoplatin-treated S. cerevisiae and labeled using Cu-free click chemistry. These data provide the first evidence that cellular tRNA is a platinum drug substrate. We assess Pt(II) binding sites within rRNA from ...
Six-month follow observation about the treatment of panic disorder with sertraline and clomipramine

OBJECTIVE To evaluate the efficacy and safety of the treatment of panic disorders with sertraline.METHODS A 24 weeks single-blind randomized study was designed.The efficacy was evaluated by clinical judgement,PASS and HAMA.The side-effect was assessed in terms of TESS.RESULTS 68 cases of panic disorder were enrolled(36 cases were in the treatment of sertraline,32 cases were in clomipramine group).According the judgement of clinicians,the marked improved rate was 77.75% for sertraline and 65.6% for clomipramine in the end of fourth week,By the end of this study,the effective rate was 100% for sertraline and 96.9% for clomipramine.There was no significant difference.The therapeutic effect was shown from the end of second week in the group of sertraline.but from the end of third or fourth week in that of clomipramine.The sertraline group had much lower incidence of side effect(13.61%) than that of clomipramine(24.68%).CONCLUSION Sertraline is one of efficient and safe drug in treatment of panic disorder.
Progress of the Research on Intein-mediated Protein Cyclization

Intein-mediated backbone cyclization of proteins is an attractive approach for stabilization of proteins against unfolding.The stabilization achieved is presumably the result of reduced conformational entropy of the unfolded state by formation of a native peptide bond between the N and C termini of a protein of interest.This approach offers a considerable promise for stabilization of pharmaceutical proteins and industrial enzymes.
The New Zealand Labour Party

In this chapter, I analyse the New Zealand Labour Party’s (NZLP) embrace of neoliberal policies during its 1984–1990 government. I argue that this government provides the prime example of a working-class party which so repudiated its historic base and constituency that it effectively changed its class character. The failure of the New Zealand labour movement to remain engaged with the party’s internal politics made possible a change in the leadership of the party, which sought to implement policies of ‘a distinctly Hayekian flavour’.1 While other factors may be relevant in explaining how the government was able to implement such radical measures once it had obtained power, only a focus upon the change in the internal life of the NZLP can explain why the government was so open to New Right economic ideas and came to have such a firm ideological commitment to them. All other accounts ultimately centre on how the party in power could be so successful in its project and therefore miss what is truly important—that the project itself was initiated by an ostensible labour party.
Evolution at the Speed of Thought: A New Chapter in the History of Evolution

This discussion proposes a solution to the agency-determinism debate by defining humans as “super-adaptable agents.” Humans super-adapt by developing, testing and deploying cognitive solutions to evolutionary survival challenges. As a result, Homo sapiens has succeeded in transforming the evolutionary process into an intellectual exercise that proceeds at the speed of thought. Stephen Jay Gould acknowledges this transformation by asserting that evolution for humans adheres to a Lamarckian rather than a Darwinian logic. Cognitive super-adaptation enables humans to significantly accelerate the adaptation process, while it also transforms adaptation from a random to a highly specific problem solving process. Finally, cognitive super-adaptation offers perhaps the clearest and most definitive expression of “agency,” i.e., cognitive innovation that transcends otherwise deterministic constraints.
Clinical and Laboratory Predictors for Renal Damage in Sickle Cell Disease

Abstract 3252 Renal failure is an independent marker for developing other forms of chronic organ damage and for early mortality in sickle cell disease (SCD). We conducted a retrospective, cross-sectional chart review of 292 adults with SCD (type SS or S-beta thal) treated at the University of Illinois Medical Center to assess the prevalence and factors related to kidney damage. Data was recorded from a clinic visit at least four weeks from a vaso-occlusive pain episode or red blood cell transfusion. The glomerular filtration rate (GFR) was calculated using the modification of diet in renal disease formula. Hemoglobinuria was defined by dipstick urinalysis showing trace, small, or moderate blood and 300 mg/g were categorized as microalbuminuria and macroalbuminuria, respectively. The median age was 33 years and 46% of patients were on hydroxyurea. We observed microalbuminuria in 41%, macroalbuminuria in 20%, hemoglobinuria in 41% and GFR Disclosures: No relevant conflicts of interest to declare.
Cauda Equina Syndrome

There are very few true orthopedic emergencies. Several conditions such as open fractures, once thought to be emergent, have been shown in the literature to be urgencies that should be tended to in prompt rather than emergent fashion. Some notable emergencies are hemodynamically unstable pelvis fractures, necrotizing fasciitis, and compartment syndrome.
Mimetic Peptide to CDK Inhibitor p16 INK4a Induces Cell Death In Mantle Cell Lymphoma Cells: A New Strategy to Eradicate Minimal Residual Disease

Abstract Abstract 3921 Autologous stem cell transplantation (ASCT) is an effective treatment strategy for Mantle Cell Lymphoma (MCL) that has been shown to improve disease free survival. However, data from recent trials suggest that the presence of minimal residual disease (MRD) contributes to relapse following current intensive treatment strategies, including ASCT. Thus, we sought to test a highly selective approach to eradication of MRD in stem cell collections from MCL patients using targeted small peptides that disrupt the aberrant cyclin/CDKs interactions that are involved in the pathogenesis of MCL. In the current study, the efficacy of a mimetic peptide to the CDK inhibitor p16INK4a to eliminate MRD was tested. Using (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) (MTS) cell viability assays, we demonstrated that a transducible TAT-p16 mimetic peptide was able to induce cell death in the MCL cell line, Jeko-1, in a dose and time-dependent fashion (see Figure). A TAT-p16 mimetic was able to induce cell death in approximately 60% of Jeko-1 cells after 4 hours of incubation, and approximately 80% of Jeko-1 cells at 24 hours. In contrast, the same dose of TAT-p16 mimetic had no effect on cell survival when it was incubated with CD34+ rich apheresis samples from healthy donors. Furthermore, CFU-GM, BFU-E colony assays showed that there was no toxicity of the TAT-p16 mimetic when compared to untreated cells or cells treated with a control, scrambled TAT-p16 peptide. TAT-p16 mimetic did not impair erythroblast differentiation but induced mild apoptotic cell death in the erythroblast cells. The strategy was further tested using a CD34+ enriched apheresis sample collected from a patient with MCL with documented MRD who had been treated on a clinical trial of ASCT for MCL. Using Real-time quantitative PCR for IgH and BCL1 gene rearrangements, we demonstrated that the TAT-p16 mimetic was able to reduce MRD level by 40% compared with the scrambled TAT-p16 peptide. These data suggest that the use of a peptide-mimetic to p16 selectively and effectively can reduce MRD in MCL cells and in an apheresis (stem cell) sample from a patient with MCL. Treatment with the peptide allowed differentiation of CD34+ progenitor cells. A combinational approach using additional targeted cell cycle regulatory peptides that block p21CIP1/WAF1 and cyclin D2 is being explored to optimize the efficacy of this purging technique. Thus, this novel strategy may be an effective, selective and non-toxic method for eradication of MRD in MCL. Download : Download high-res image (118KB) Download : Download full-size image Disclosures: No relevant conflicts of interest to declare.
Enhancing the cultural competence of women's health nurses via online continuing education

By 2050, current minority groups will comprise almost half of the US population further challenging healthcare providers and nurses to deliver culturally competent care. Numerous organizations have published documents supporting cultural competence and its incorporation into nursing curricula has been encouraged since 1986. However, practicing nurses, specifically those providing care to childbearing women and families, continue to acknowledge their lack of cultural competence. This is concerning as large health disparities exist between culturally diverse women and cultural competence can lead to greater health equality and better client care. Studies have shown face-to-face education increases the cultural competence of healthcare providers; few studies have explored the impact of online education on cultural competence levels and no studies of online socially interactive continuing education (CE) have been conducted with nurses. Therefore, the purpose of this study was to evaluate the effect of two different online CE interventions on the cultural competence level of nurses who care for childbearing women and newborns in the US. The study also explored: the relationship between social desirability and self-reported level of cultural competence, the relationship between level of educational attainment and cultural competence level, and the relationship between having previous cultural diversity training and level of cultural competence. The framework for the study included two existing models: the 3-dimensional puzzle model of culturally congruent care and the instructional strategy framework for online learning environments. The study had an experimental pre- and post-test design using the Cultural Competence Assessment instrument. Three groups of RNs who care for childbearing women and newborns in the US were used: (a) control, (b) socially interactive online CE intervention, and (c) socially isolated online CE intervention. The study began with 249 registered participants, 190 completed the informed consent process, 132 completed the pre-test, and 93 completed the study. Data was analyzed with a RM-ANOVA with a between-groups variable, ANCOVA, and correlation statistics. Major findings indicated socially isolated online cultural competence CE is significantly more effective than not having online cultural competence CE. However, socially interactive online cultural competence CE is not more effective than socially isolated, nor is it significantly more effective than not having online cultural competence CE. Findings also indicated MCSDS scores and the number of previous types of cultural diversity training are positively correlated with CCA scores.
Medication organizers (pill minders) increase the risk for unintentional pediatric ingestions.

AbstractObjective: Medication organizers may help improve medication compliance; however, they may increase the risk of having an unintentional pediatric exposure. The objective of this study was to measure the association between a pediatric emergency department (ED) visit for an unintentional pharmaceutical ingestion and the use of a medication organizer in the household.Methods: This was a cross-sectional case control study at a tertiary care children’s hospital ED. Cases included subjects <6 years of age who were evaluated in the ED for an unintentional pharmaceutical ingestion. The control group presented to the ED for a non-injury complaint and was matched using age and sex.Results: The unadjusted odds ratio (OR) of risk for unintentional pharmaceutical ingestion with use of a medication organizer was 2.0 (95% CI, 1.3, 2.9). After adjusting for the presence of prescription medications in the home, the OR of risk for ingestion remained statistically significant at 1.8 (95% CI, 1.1, 2.7). The child ob...
Cytoskeletal Abnormalities in Parkinson’s Disease

Alterations in the neuronal cytoskeleton are major features of many neurodegenerative diseases. In Parkinson’s Disease, a characteristic pathological change is the Lewy body. Lewy bodies are intraneuronal, cytoplasmic inclusions. They were first described in large neurons of the substantia innominata and dorsal motor nucleus of the vagus (1). We now consider the catecholaminergic nuclei, the substantia nigra and locus ceruleus, to be the typical sites of Lewy body formation in Parkinson’s disease. Nevertheless, careful neuropathological studies have demonstrated Lewy bodies in a large number of CNS areas, including many brain stem nuclei, hypothalamus, neocortex, and peripheral ganglia (2–5). Lewy bodies in these different areas show many similarities, but some morphological differences (see below).
Kilohertz VLIF (volumetric laser induced fluorescence) measurements in a seeded free gas-phase jet in the transitionally turbulent flow regime

Abstract This paper reports the demonstration of instantaneous three-dimension (3D) measurements in turbulent flows at repetition rates up to 10 kHz using VLIF (volumetric laser induced fluorescence). The measurements were performed based on the LIF signal of iodine (I2) vapor seeded in the flow. The LIF signals of I2 vapor were generated volumetrically by a thick laser slab and then simultaneously captured by a total of seven cameras from different perspectives, based on which a 3D tomographic reconstruction was performed to obtain the 3D distribution of I2 vapor concentration. Single-shot measurements obtained in a duration of hundreds of nanoseconds (limited by the pulse duration of the excitation laser) were demonstrated in a 50 × 50 × 50 mm3 at a repetition rate up to 10 kHz. These measurements demonstrated the feasibility and potential of VLIF for resolving the 4D spatiotemporal dynamics of turbulent flows. Based on the experimental results obtained, this work also studied the VLIF signal level and its effects on the reconstruction accuracy under different the measurement conditions, illustrating the capabilities and limitations of performing high speed VLIF measurements.
Outcomes associated with resident involvement in ventral hernia repair: A population based study using the NSQIP database.

Abstract Introduction This study evaluated the effect of resident involvement on patient outcomes following major ventral hernia repair (VHR). Methods National Surgical Quality Improvement Program database was queried to identify patients with major VHR between 2007 and 2010. Patient outcomes were compared based on presence or absence of resident in the operating room. Results Residents participated in 57% of the 27,773 identified cases. There was no significant difference in return to operating room or 30-day mortality. A higher incidence of superficial surgical site infection (SSI) (4.9% vs 3.9%, P = 0.013) and longer operative time (129.2 vs 99.1 min, P Conclusion Resident involvement in VHR has little impact on morbidity, and patients can be reassured that resident participation in their care is safe.
High spatiotemporal resolution bSSFP imaging of hyperpolarized [1‐13C]pyruvate and [1‐13C]lactate with spectral suppression of alanine and pyruvate‐hydrate

Purpose The bSSFP acquisition enables high spatiotemporal resolution for hyperpolarized 13C MRI at 3T, but is limited by spectral contamination from adjacent resonances. The purpose of this study was to develop a framework for in vivo dynamic high resolution imaging of hyperpolarized [1-13C]pyruvate and [1-13C]lactate generated in vivo at 3T by simplifying the spectrum through the use of selective suppression pulses. Methods Spectral suppression pulses were incorporated into the bSSFP sequence for suppression of [1-13C]alanine and [1-13C]pyruvate-hydrate signals, leaving only the pyruvate and lactate resonances. Subsequently, the bSSFP pulse width, time-bandwidth, and repetition time were optimized for imaging these dual resonances. Results The spectral suppression reduced both the alanine and pyruvate-hydrate signals by 85.5 ± 4.9% and had no significant effect on quantitation of pyruvate to lactate conversion (liver: P = 0.400, kidney: P = 0.499). High resolution (2 × 2 mm2 and 3 × 3 mm2) sub-second 2D coronal projections and 3D 2.5 mm isotropic images were obtained in rats and tumor-bearing mice with 1.8-5 s temporal resolution, allowing for calculation of lactate-to-pyruvate ratios and kPL. Conclusion The developed framework presented here shows the capability for dynamic high resolution volumetric hyperpolarized bSSFP imaging of pyruvate-to-lactate conversion on a clinical 3T MR scanner.
The Relationship between Consumer Characteristics and Online Co-design Involvement

Co-design process allows consumers to take an active role to co-create the product (Bolton & Saxena-Iyer, 2009). In the process, consumers’ individual characteristics and their design ability play a central part (Fiore, Lee, & Kunz, 2004). Thus, consumers’ expectations and future involvement in the co-design process are expected to be different based on his or her individual characteristics. Furthermore, consumers may want to involve in codesign process in different ways depending on the product categories. In this regard, we explored various consumer characteristics as influential factors determining consumers’ co-design expectations and their desired involvement. The findings will provide insightful perspectives to online co-design service providers who want to develop products satisfying consumers’ expectations as well as to encourage consumer involvement.
Assessment of Coronal Spinal Alignment for Adult Spine Deformity Cases After Intraoperative T Square Shaped Use

Abstract Study Design Retrospectively reviewed surgeries between 2011 and 2015 of patients who underwent posterior spinal deformity instrumentation with constructs involving fusions to pelvis and encompassing at least five levels. Objective Measure the radiographic outcomes of coronal malalignment (CM) after use of an intraoperative T square shaped instrument in posterior spinal deformity surgeries with at least five levels of fusion and extension to pelvis. Background Neuromuscular children found to benefit from intraoperative T square technique to help achieve proper coronal spinal balance with extensive fusions. This intraoperative technique used in our posterior spine deformity instrumentation surgeries with the aforementioned parameters. Methods There were 50 patients: n = 16 with intraoperative T square and n = 34 no–T square shaped device. Subgroups divided based on greater than 20 mm displacement and greater than 40 mm displacement of the C7 plumb line to the central sacral vertical line on either side in preoperative radiographs. We analyzed the demographics and the pre- and postoperative radiographic parameters of standing films: standing CM (displacement of C7 plumb line to central sacral vertical line), and major coronal Cobb angles in total sample and subgroups and compared T square shaped device with no–T square shaped device use by analysis of variance. A p value ≤.05 is statistically significant. Results In the total sample, though postoperative CM mean was not statistically different, we observed greater CM corrections in patients where a T square shaped device was used (70%) versus no–T square shaped device used (18%). In >20 mm and >40 mm subgroups, the postoperative mean CM values were statistically lower for the patients where a T square shaped device was used, p = .016 and p = .003, respectively. Cobb corrections were statistically higher for T square shaped device use in both >20 mm and >40 mm subgroups, 68%, respectively. Conclusion The intraoperative T square shaped device technique had a positive effect on the amount of spine coronal malalignment correction after its use and for lumbar and thoracic coronal Cobb angles. Level of Evidence Level III.
Simultaneous exploration and harvesting in multi-robot foraging

We study the multi-robot foraging problem in an unknown environment with risks. Robots have to explore entire unknown environment without stepping into risk areas and simultaneously collect all discovered targets. We present a novel algorithm that integrates the frontier-based exploration algorithm with auction-based task-allocation. Extensive simulation studies demonstrate that our algorithm can balance the tasks of environment exploration and target collection efficiently.
An Exploration of Potential Gender Differences in the Discipline of Nurse Anesthetists

Great diversity exists in the US population, therefore the US Department of Health and Human Services [HHS] has called for increased diversity among healthcare professionals as a means of improving public health outcomes. Males are consistently a minority group within the nursing profession and are disproportionately disciplined. The disproportionate discipline of male nurses and the loss of licensure often resulting from censure may have an impact on efforts to diversify the nursing sector of healthcare. Among certified registered nurse anesthetists [CRNAs], the ratio of males to females is more equal and little data exists examining the characteristics of disciplined CRNAs. The purpose of this study was to describe formal licensure discipline against CRNAs practicing in select states during a 33-year period (1983-2017). This descriptive study is a retrospective cohort study involving secondary data analysis of public records information. Disciplinary list data was generated via the database tools accessible on the government websites provided by each state department of health and/or BON. The disciplinary list data was then cross-referenced against the Nursys database maintained by the National Council of State Boards of Nursing (NCSBN) for greater detail and analysis. Of the CRNA licenses in the sample (n=4401), the rate of sanction was 1.20% (n=53). Males (n=26) were disciplined more often than women (n=27) at a ratio of 1.6:1. CRNAs in this study were six times more likely to commit an infraction related to substance abuse than any other single infraction type at 66% (n=35). Loss of licensure in some form resulted in approximately 51% (n=27) of cases.
Are children more accurate than adults? Spontaneous use of metaphor by children and adults.

This study examined an observation in which children outscored adults on a series of test questions, which included unusual items such as, “Do you see with your ears?” We assumed that the adults were treating the questions metaphorically because the literally correct answer was so obvious, an assumption consistent with Grice's theory. In Study 1, we tested this assumption by manipulating pretest and test items so as to suggest, or not suggest, a metaphorical or factual response. In Study 2, we used a similar manipulation involving the order of questions of various sorts and we more directly tested the Gricean hypothesis by giving college students a reason to treat the question literally. The results replicated the previous finding in which college students' scores were lower than those of children, and the condition effects suggested that the college students' performance was due to their responding metaphorically.
Association of Transthoracic Echocardiography Findings and Long-Term Outcomes in Patients Undergoing Workup of Stroke

Abstract Background Transthoracic echocardiography (TTE) has become routine as part of initial stroke workup to assess for sources of emboli. Few studies have looked at other TTE findings such as ejection fraction, wall motion abnormalities, valve disease, pulmonary hypertension and left ventricular hypertrophy and their association with various subtypes of stroke, long-term outcomes of recurrent stroke, and all-cause mortality. Methods and Results Computed tomography and magnetic resonance imaging brain imaging and TTE reports were reviewed for 2464 consecutive patients referred for TTE as part of a workup for acute stroke between 1/1/01 and 9/30/07. Study patients were 67 ± 15years, 60% female, 75% minorities and had hypertension (76%), diabetes (41%), chronic kidney disease (27%) and atrial fibrillation (18%). On TTE, a mass, thrombus, or vegetation was identified in only 4 cases (0.2%), whereas a clinically significant abnormality (ejection fraction Conclusions TTE performed as part of an initial workup for stroke had minimal yield for identifying sources of embolism. Clinically important abnormalities found on TTE were independently associated with increased long-term mortality, but not recurrent stroke.
Identification of NFAT5 as a transcriptional regulator of the EDN1 gene in collecting duct.

The inner medullary collecting duct (IMCD) produces very high levels of endothelin-1 (ET-1) that acts as an autocrine inhibitor of IMCD Na+ and water reabsorption. Recent studies suggest that IMCD ...
Nitration of cyclopentenecarboxaldehyde: Studies toward 1-amino-2-nitrocyclopentanecarboxylic acid

Abstract The formation of 2,2-dinitrocyclopentanone oxime is described during an attempted nitroacetamidation of cyclopentenecarboxaldehyde using ceric ammonium nitrate and sodium nitrite in acetonitrile. Progress towards the total synthesis of 1-amino-2-nitrocyclopentanecarboxylic acid is also discussed.
The Assumptions of Direction Dependence Analysis.

AbstractDirection dependence analysis attempts to discern the direction of a causal effect, using statistical features of the data, such as skew and kurtosis of variables, and their residuals in re...
Minimally Invasive Neurosurgery: Anesthetic Implications

late to new anesthettc challen~,es could be restated as "New surgical procedures demand new anesthetic techniques." Neurosurgery has come a long way from the days of Harvey Cushing and Walter Dandy. Cushing was the pioneer of modern neurosurgery and, in the words of Sir William Osler, ° he opened a new chapter in the field of surgery. Cushing followed the principles of brain imaging, but it was based on his knowledge of neurophysiology and the patient's clinical features. Today, the scope of the available techniques in neuroimaging is vast. Apart from computed tomography (CT) and magnetic resonance imaging (MRI), there are other imaging modalities, such as magnetic resonance spectroscopy, magnetic resonance angiography, single photon emission contrast tomography, and positron emission tomography, to name a few. These techniques, besides providing precise neuroanatomical visualization of intracranial lesions, also have functional imaging capabilities, which give us physiological information about cerebral blood flow/metabolism, outline functional areas like the speech center and motor center and, in chronic pain patients, make it possible to visualize hyperactivity of the pain center in the thalamus, thus differentiating the psychological component from the somatic component of pain. Simultaneously, the field of endoscopy has come a long way, with the availability of video endoscopes and miniature cameras. Tools for endoscopic surgery have permitted surgical access to lesions previously considered inaccessible because of their location. Therefore, minimally invasive neurosurgery is the fulfillment of a long-felt need to develop surgical techniques with minimum potential for damage to the normal brain and a sequel to various technological innovations. The principle of "primum nor nocire" (do no harm), although important in medicine as a whole, has always been the guiding philosophy in neurosurgery. Preserving the integrity of normal tissue while maximizing the resection of a brain tumor is more effectively possible with the combination of available imaging techniques and a minimally invasive approach (endoscopic surgery). The availability of open MRI systems 2 allows real-time imaging intraoperatively, adding more precision to tumor localization and resection. Besides this, modern imaging technology is also being used for nonsurgical approaches to some of the central nervous system disease states, such as Parkinsonism, chronic pain, acoustic neurinoma, and arteriovenous malformation (AVM). This discussion will focus on 3 aspects of minimally invasive neurosurgery--endoscopic neurosurgery, brain imaging, and gamma knife surgery. NEUROENDOSCOPY History
Race Structure of Cowpea Witchweed (Striga gesnerioides) in West Africa and Its Implications for Striga Resistance Breeding of Cowpea

Cowpea witchweed [Striga gesnerioides (Willd.) Vatke] is a primary constraint of cowpea [Vigna unguiculata (L.) Walp.] production in West Africa. Previously, seven S. gesnerioides races were classified based upon host specificity and genotypic profiling. Because race number and distribution are dynamic systems influenced by gene flow, genetic drift, and natural selection, a thorough investigation of S. gesnerioides diversity and the effectiveness of known sources of resistance in cowpea is needed to develop varieties with durable and broad-spectrum Striga resistance. In this study, we screened seven cowpea lines against 58 unique S. gesnerioides populations collected from across nine West African countries. Individuals from 10 S. gesnerioides populations were genotyped with simple sequence repeat (SSR) markers. We identified six races of S. gesnerioides based on their parasitism of the seven cowpea lines with known differential resistance genotypes. No cowpea line was resistant to all 58 Striga populations and none of the Striga populations were able to overcome the resistance of all seven lines. A novel race, SG6, of the parasite collected from Kudu, Nigeria, was found to overcome more cowpea resistance genes than any previously reported race. SSR analysis indicates that Striga populations are highly differentiated and genetic relatedness generally corresponds with geographic proximity rather than their host compatibility. Due to the dearth of broad-spectrum resistance found among Striga-resistant cowpea lines, there exists a need to stack multiple Striga resistance genes in order to confer broad-spectrum and durable resistance.
Aging Response and Cryogenic Mechanical Properties of an In-Sn Eutectic Solder Alloy for Josephson Packaging

Josephson computing technology entails the use of superconducting Josephson junction devices which combine high speeds and low power dissipation compared to conventional semiconductor devices.1–3 A low melting point (390K) In (52 weight %) Sn (48 weight %) eutectic alloy which is superconducting at 4.2K is used as an interconnection solder in Josephson packaging to enable chip and package part replacements to be done at reasonably low temperatures. For a typical contact application, about 25µm thick film of the alloy is usually evaporated onto 200 µm diameter contact pads of 100 nm each of Pd and Au and 230 nm of Nb situated on a Si substrate and subjected to reflow prior to use4,5. In the anticipated service cycle, the alloy undergoes rapid solidification after the reflow operation and could experience aging at room temperature (298K) during storage and/or at 348K where a reflow operation is carried out for interconnections using a second lower melting solder in the package. Subsequently, the whole package is cooled down to near 4.2K at which the superconducting junction devices operate. In such a service cycle, stresses can arise due to thermal contraction mismatch between the substrate and the solder and due to joining of parts made of dissimilar materials. Further, since 298K and 348K are significant fractions of the alloy melting point, one would expect significant changes in the as quenched microstructure and, as a result, in the mechanical properties of the alloy. Accordingly, it is necessary to study the low temperature mechanical behavior of the alloy and its dependence on aging at 298K and 348K and correlate them with the attendant changes in the microstructure. Recently, Yeh 6 reported on the shear and tensile properties of this alloy in the overaged condition, tested between room temperature and 77K. In this paper we extend this data base to 4.2K and document the microstructual and mechanical property changes caused by 298K and 348K aging treatments.
Finally, a Successful Randomized Trial for GVHD

For the past half century, we have been attempting to understand graft-versus-host disease (GVHD), at times randomly and more recently in a methodical manner. It became clear early on that GVHD, es...
Improvements in Cleft Lip Aesthetics with the Fisher Repair Compared to the Mohler Repair.

Background The extended Mohler rotation-advancement repair and the Fisher anatomic subunit repair are commonly used for the surgical correction of unilateral cleft lip. The rotation-advancement repair was the initial technique of choice by the senior surgeon. However, due to recurring suboptimal aesthetic results, the senior surgeon transitioned to the anatomic subunit repair. This study was performed to compare the outcomes of the rotation-advancement repair and the anatomic subunit repair. Methods A retrospective study of all consecutive patients undergoing unilateral cleft lip repair by the senior author between 2009 and 2016 was conducted. Demographic data, the presence of scar shortening/contraction, hypertrophy, widening, and revision rates were recorded. Results There were 68 patients identified for inclusion. Thirty-four patients had a rotation-advancement repair and 35 had an anatomic subunit repair. Twelve patients (36%) with the rotation-advancement repair and 1 patient (2.9%) with the subunit repair required anterior lip revision (P < 0.001). Conversely, 2 patients (6.1%) with the rotation-advancement repair and 13 patients (37.1%) with the subunit repair required minor debulking of excess red vermilion fullness (P < 0.005). Conclusions Transitioning from the rotation-advancement repair to the anatomic subunit repair has resulted in improved lip aesthetics with decreased incidence of scar contracture, hypertrophy, and widening as evidenced by a decrease in the revision rate for these suboptimal scars. However, the rate of debulking procedures of the red vermilion did increase early in the adoption of the anatomic subunit repair, requiring minor modifications in the technique.
Accommodation and nonaccommodation as predictors of instrumental caregiving intentions and expectations in grandparent-grandchild relationships:

This dyadic study examined how grandparents’ and grandchildren’s perceptions of receiving accommodation, overaccommodation, and underaccommodation were indirectly associated with grandchildren’s in...
The innate immune system and cell death in autoinflammatory and autoimmune disease

The innate immune system, the first line of defense against pathogens and host tissue damage, initiates pro-inflammatory responses which, when dysregulated, promote inflammation to drive a broad range of autoimmune diseases. Immunomodulatory therapies have been developed to successfully treat several autoimmune diseases, but still many others lack effective treatments. Here, we explore recent advances in how the innate immune system contributes to autoinflammation, from the innate immune sensors that initiate immune responses to how this system regulates the activation of programmed cell death pathways including pyroptosis, apoptosis, necroptosis, and PANoptosis, which involves machinery from the pyroptotic, apoptotic, and necroptotic pathways. Recent advances in our understanding of innate immunity raise important considerations for developing new inflammatory disease treatments that target innate immune signaling and programmed cell death pathways.
Comparison of big cat food habits in the Amazon piedmont forest in two Bolivian protected areas

The feeding habits of jaguar (Panthera onca) and puma (Puma concolor) were studied in the lower Tuichi, Hondo (PNANMI Madidi) and Quiquibey (RB Pilon Lajas) river valleys. A total of 122 large felid scats were collected and identified by an experienced local guide, with identifications later confirmed by morphometry. Of this total, 54 were also identified using associated tracks. For jaguar, prey species richness was 25 species considering all scats and 20 species only considering those scats associated with tracks. For puma, 28 and 22 prey species were obtained, respectively. The results indicate that there is low trophic niche overlap between both cats (0.46 and 0.44 respectively). The breadth of the trophic niche indicates that the jaguar is more specialized in its diet (0.28 and 0.42 respectively), mainly due to the high consumption of the white-lipped peccary (Tayassu pecari), which contributes significantly to jaguar prey biomass. The puma has a more generalist tendency (0.56 and 0.58 respectively), with the spotted paca (Cuniculus paca) the most frequently consumed prey and also contributing the most biomass. Despite the fact that both felines share most of their prey, jaguar and puma differ in the frequency of prey consumption.
Boundary Conditions for Thermal Load on Concrete Structures

Whereas the boundary conditions for vector field problems are straightforward, this is not the case for thermal (diffusion) problems. Those are particularly important in the thermal analysis of concrete dams, and the proper investigation of chloride diffusion.