cssi/SciSciGPT-SciSciNet huggingface dataset:
Evaluation of Antimicrobial Stewardship–Related Alerts Using a Clinical Decision Support System

Background: Information technology, including clinical decision support systems (CDSS), have an increasingly important and growing role in identifying opportunities for antimicrobial stewardship-related interventions. Objective: The aim of this study was to describe and compare types and outcomes of CDSS-built antimicrobial stewardship alerts. Methods: Fifteen alerts were evaluated in the initial antimicrobial stewardship program (ASP) review. Preimplementation, alerts were reviewed retrospectively. Postimplementation, alerts were reviewed in real-time. Data collection included total number of actionable alerts, recommendation acceptance rates, and time spent on each alert. Time to de-escalation to narrower spectrum agents was collected. Results: In total, 749 alerts were evaluated. Overall, 306 (41%) alerts were actionable (173 preimplementation, 133 postimplementation). Rates of actionable alerts were similar for custom-built and prebuilt alert types (39% [53 of 135] vs 41% [253 of 614], P = .68]. In the postimplementation group, an intervention was attempted in 97% of actionable alerts and 70% of interventions were accepted. The median time spent per alert was 7 minutes (interquartile range [IQR], 5-13 minutes; 15 [12-17] minutes for actionable alerts vs 6 [5-7] minutes for nonactionable alerts, P < .001). In cases where the antimicrobial was eventually de-escalated, the median time to de-escalation was 28.8 hours (95% confidence interval [CI], 10.0-69.1 hours) preimplementation vs 4.7 hours (95% CI, 2.4-22.1 hours) postimplementation, P < .001. Conclusions: CDSS have played an important role in ASPs to help identify opportunities to optimize antimicrobial use through prebuilt and custom-built alerts. As ASP roles continue to expand, focusing time on customizing institution specific alerts will be of vital importance to help redistribute time needed to manage other ASP tasks and opportunities.
Superstorms: Comments on Bahamian Fenestrae and Boulder Evidence from the Last Interglacial

ABSTRACT Mylroie, J.E., 2018. Superstorms: Comments on Bahamian fenestrae and boulder evidence from the Last Interglacial. Sea level during the last interglacial (Marine Isotope Substage 5e [MIS 5e]) was ∼6 m above present, interpreted to represent a warmer climate, with increased storm intensity and storm frequency. Two hypotheses have been advanced to demonstrate an increase in storm intensity during MIS 5e. The first considers fenestrae in eolian calcarenites at elevations up to 43 m in the Bahama Archipelago to be evidence of superstorm washover. Additional observations include rip-up clasts and loss of bedform and root structures as a result of wave scour. Such an event should produce a tempestite with a wide-ranging footprint, but none exists above 10 m. This paper argues that the fenestrae are rainfall slurries, rip-up clasts are weathering products of calcarenite protosol development, and bed-form and root structure absence or presence reflects transgressive-phase vs. regressive-phase eolian forma...
The relationship between repetitive finger movement and quality of life in Parkinson's disease.

Background: Repetitive finger movement significantly impacts daily living activities, but there have been limited studies determining how repetitive finger movement impacts quality of life (QOL) in...
Robotic gastric bypass is getting better: first results from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.

Abstract Background The use of robotic platforms in performing laparoscopic Roux-en-Y gastric bypass (LRYGB) is increasing, though their safety compared with the conventional laparoscopic approach remains unclear. Objective The objective of this study was to evaluate perioperative data and 30-day outcomes of conventional and robot-assisted LRYGB using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry. Setting University health network, United States. Methods We reviewed all conventional and robot-assisted LRYGB cases entered between January 1 and December 31, 2016 in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry. Demographic characteristics and 30-day outcomes were analyzed based on separate Mann-Whitney rank sums tests, χ2, or Fisher's exact tests as appropriate, with P ≤ .05 denoting statistical significance with no adjustment for multiple testing. Results Of the 39,425 patients who underwent LRYGB, 2822 were robot-assisted. The robot-assisted approach required significantly more time (138 versus 108 min, P Conclusions Robot-assisted LRYGB is an increasingly popular alternative to the conventional laparoscopic approach. According to the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database, the early safety of these 2 techniques is equal, although the robotic approach requires more operative time.
Obesity and Response to Infliximab in Patients with Inflammatory Bowel Diseases: Pooled Analysis of Individual Participant Data from Clinical Trials

To assess whether obesity may affect response to infliximab, we conducted an individual participant data pooled analysis using data from clinical trials of infliximab in inflammatory bowel diseases (IBD), using the Yale Open Data Access (YODA) Project. We analyzed individual participant data from four clinical trials of infliximab in adults with IBD (ACCENT-I, SONIC, ACT-1, and -2). Patients were categorized as obese (body mass index [BMI] ≥ 30 kg/m2) vs. non-obese, and by quartiles based on BMI or weight at time of trial entry. Primary outcome was clinical remission (Crohn’s disease activity index [CDAI] < 150 or pediatric CDAI <10, Mayo Clinic Score <3); secondary outcomes were clinical response and mucosal healing. Multivariable logistic regression analysis was performed, after adjusting for sex, smoking, disease activity, and concomitant prednisone and/or immunomodulators. We included 1205 infliximab-treated patients (mean age 37 years, 51.6% males, 14% obese). Obesity was not associated with odds of achieving clinical remission (obese vs. non-obese: adjusted OR, 0.93 [95% CI, 0.47–1.46]; Q4 vs. Q1: aOR, 0.94 [0.61–1.47], p-value for trend = 0.97), clinical response (Q4 vs. Q1: aOR, 0.84 [0.52–1.35], p = 0.45) or mucosal healing (Q4 vs. Q1: aOR, 1.13 [0.55–2.34], p = 0.95). These results were consistent across strata based on disease type (Crohn’s disease and ulcerative colitis) and trial design (induction and maintenance therapy). Based on individual participant data pooled analysis, obesity is not associated with inferior response to infliximab in patients with IBD. Future studies examining the association between obesity and fixed-dose therapies are warranted.
Control of Neovascularization and Cell Survival in the Eye by PEDF

Pathological angiogenesis is by far the most common aspect of eye diseases. Corneal lesions and inflammatory ocular diseases have a strong angiogenesis component and are the most common causes of visits to ophthalmologists. Proliferative diabetic retinopathy (PDR) and age-related macular degeneration (AMD) affect more than 7 million people in the United States alone. As described elsewhere in this volume, pathological angiogenesis is also an important component of many other diseases of the eye. Controlling blood vessel growth, therefore, offers a unique opportunity to affect a wide spectrum of physiological and pathological functions.
Clinical features and outcomes in young adults with oral tongue cancer.

Abstract Objective To evaluate outcomes and survival in young patients with oral tongue cancer (OTC). Methods Retrospective chart review of patients aged 18–40 with OTC treated between 2000 and 2016. Tumor characteristics of p16 expression, perineural invasion (PNI), and lymph-vascular invasion (LVI) were evaluated. Recurrence-free (RFS) and overall survival (OS) data were analyzed according to Kaplan-Meier method with univariate analysis. Results A total of 23 patients were identified: 12 with early stage disease (ESD, stage I), and 11 with advanced stage disease (ASD, stage III or IV), (17 men and 6 women). Mean age at presentation was 34.5 years (±5 months) and mean follow-up was 46.6 months. For all patients, 5-year RFS was 62% and OS 66%. RFS for ESD was 73% and ASD 25% (log rank p = 0.011). OS for ESD was 100% and ASD 55% (log rank p = 0.012). 22% indicated tobacco use >5 pack-years and 9% heavy alcohol use. Factors associated with worse OS were neck disease (log rank p = 0.073), positive margins (log rank p = 0.001), and LVI (log rank p = 0.002). Factors associated with worse RFS were chemotherapy or radiation therapy prior to surgery (log rank p = 0.002), neck disease (log rank p = 0.047), positive margins (log rank p = 0.039), and PNI (log rank p = 0.001). Expression of p16 was observed in five cases and was not significantly associated with OS or RFS. Conclusion In young patients with OTC, factors associated with worse outcomes are similar to known predictors in older patients. Expression of p16 was not statistically associated with improved OS. OS in patients with ESD was excellent (100%), and significantly worse for ASD.
Late Adolescent User Experiences with Online Sexual Health Resources: A Qualitative Study.

Adolescents rely on the internet as a primary source for sexual health information. Understanding users’ assessments of trust and credibility in online materials may help inform interventions. Cogn...
Implementing Colon Cancer Screening Guidelines Into the Primary Care Setting

Colon cancer is the second leading cause of all cancers deaths. Despite public awareness, many healthcare providers and patients remain uninformed about colon cancer screening options alternative to colonoscopy. Research supports the lack of providers' education and patient knowledge. At a clinic for veterans in Central Florida, 2 educational presentations were delivered to primary care providers (N = 46) on the clinical pathway for colon cancer screening options. A pilot study with a quantitative pretest-post-test design was used to evaluate differences between screening orders 3 months before and after the presentations. A 10-item survey on the usefulness of the educational information was also administered to providers. Results of a 1-way analysis of variance indicated no significant differences between the two 3-month periods. However, with exclusion of the lowest month, a significance level resulted of .087, 91.3% confidence level. Survey responses indicated a positive impact, with most answers ranging from agree to strongly agree. The study revealed that the educational clinical pathway contributed to providers' increased recommendations of screening options and the educational information was useful. Additional research is recommended on the effectiveness of education and providers' use of screening options for colon cancer for average-risk veterans in healthcare institutions.
The glycocalyx: a novel diagnostic and therapeutic target in sepsis

The glycocalyx is a gel-like layer covering the luminal surface of vascular endothelial cells. It is comprised of membrane-attached proteoglycans, glycosaminoglycan chains, glycoproteins, and adherent plasma proteins. The glycocalyx maintains homeostasis of the vasculature, including controlling vascular permeability and microvascular tone, preventing microvascular thrombosis, and regulating leukocyte adhesion. During sepsis, the glycocalyx is degraded via inflammatory mechanisms such as metalloproteinases, heparanase, and hyaluronidase. These sheddases are activated by reactive oxygen species and pro-inflammatory cytokines such as tumor necrosis factor alpha and interleukin-1beta. Inflammation-mediated glycocalyx degradation leads to vascular hyper-permeability, unregulated vasodilation, microvessel thrombosis, and augmented leukocyte adhesion. Clinical studies have demonstrated the correlation between blood levels of glycocalyx components with organ dysfunction, severity, and mortality in sepsis. Fluid resuscitation therapy is an essential part of sepsis treatment, but overaggressive fluid therapy practices (leading to hypervolemia) may augment glycocalyx degradation. Conversely, fresh frozen plasma and albumin administration may attenuate glycocalyx degradation. The beneficial and harmful effects of fluid and plasma infusion on glycocalyx integrity in sepsis are not well understood; future studies are warranted. In this review, we first analyze the underlying mechanisms of glycocalyx degradation in sepsis. Second, we demonstrate how the blood and urine levels of glycocalyx components are associated with patient outcomes. Third, we show beneficial and harmful effects of fluid therapy on the glycocalyx status during sepsis. Finally, we address the concept of glycocalyx degradation as a therapeutic target.
Machine learning assisted plasmonics and quantum optics

Within this work, we will discuss our recent and promising advances in the development of machine learning assisted optimization schemes for plasmonic/photonic meta-structures design development. We will showcase that by coupling adversarial autoencoding network with topology optimization, it is possible to expand conventional meta-device design methodology to a global optimization space. In the second part of the talk, we will cover our recent effort on coupling machine learning classification/regression algorithms with quantum measurements. Particularly, we will show that the synergy between advanced machine learning assisted data analysis with quantum optical measurements dramatically reduces data collection time as well as increases the accuracy of the measurements.
Effects of cattle breed and corn processing on ruminal pH and volatile fatty acid concentrations, and apparent digestibility

Abstract Objectives were to evaluate the effects of cattle breed, Holstein or Angus, and corn processing methods on total tract digestibility, and ruminal pH and volatile fatty acid concentrations (VFA). Six Holstein (BW = 548 ± 6.3 kg) and 6 Angus steers (BW = 596 ± 7.6 kg) previously fitted with rumen cannulae, were assigned to a 2 × 3 factorial arrangement of treatments. Factors included breed, Holstein or Angus, and corn processing method, whole shelled corn (WSC), dry rolled corn (DRC), or finely ground corn (FGC). Steers were fed diets containing 815 g/kg corn grain, 100 g/kg grass hay, 65 g/kg soybean, and 20 g/kg supplement. Steers were fed in a replicated 3 × 3 Latin square split-plot design. Each period consisted of 14 d diet adaptation followed by 7 d of sample collection. On d 1, rumen contents were collected. Ruminal pH was recorded at 0, 3, 6, 12, and 18 h after feeding and a portion of the strained ruminal fluid was subsampled at 0 and 3 h for VFA analysis. From d 2–7, feces, feed, and refusals samples were collected and analyzed for DM, NDF, and starch. Data were analyzed using the MIXED procedures in SAS (v9.4 SAS Inst. Inc., Cary, NC). Repeated measures were used to analyze changes in ruminal pH and VFA over time. There was no interaction of breed × diet (P ≥ 0.16) on diet intake and digestibility. Holstein steers had a greater (P ≤ 0.05) intake than Angus steers, regardless of diet. There was no effect (P ≥ 0.81) of breed on diet digestibility. Digestibility of DM, OM, and starch were reduced (P ≤ 0.03) when corn grain was fed whole, regardless of breed. There was an interaction of breed × diet (P = 0.02) on ruminal pH. Angus steers fed FGC had the most acidic ruminal pH, while ruminal pH in Holstein steers fed FGC was similar to ruminal pH Holstein steers fed WSC or DRC. There was no interaction of breed × diet (P = 0.28), nor were there main effects of breed (P = 0.21) or diet (P = 0.92), on total VFA concentrations. Although Holstein steers ate 22 % more DM than Angus steers, they were able to sustain a greater (P = 0.04) ruminal pH. Compared to feeding WSC, starch digestibility improved by 5% when processed corn grain was fed, regardless processing method.
Accurate operation delay prediction for FPGA HLS using graph neural networks

Modern heterogeneous FPGA architectures incorporate a variety of hardened blocks for boosting the performance of arithmetic-intensive designs, such as DSP blocks and carry blocks. Since hardened blocks can be configured in different ways, a variety of datapath patterns can be mapped into these blocks. We observe that existing high-level synthesis (HLS) tools often fail to capture some of the operation mapping patterns, leading to limited estimation accuracy in terms of resource usage and delay. To address this deficiency, we propose to exploit graph neural networks (GNN) to automatically learn operation mapping patterns. We apply GNN models that are trained on microbenchmarks directly to realistic designs through inductive learning. Experimental results show that our approach can effectively infer various valid mapping patterns on both microbenchmarks and realistic designs. Furthermore, the proposed framework is exploited to improve the accuracy of delay estimation in HLS.
Dynamic Double Auctions: Toward First Best

We study the problem of designing dynamic double auctions for two-sided markets in which a platform intermediates the trade between one seller offering independent items to multiple buyers, repeatedly over a finite horizon, when agents have private values. Motivated by online platforms for advertising, ride-sharing, and freelancing markets, we seek to design mechanisms satisfying the following properties: no positive transfers, i.e., the platform never asks the seller to make payments nor are buyers ever paid and periodic individual rationality, i.e., every agent derives a non-negative utility from every trade opportunity. We provide mechanisms satisfying these requirements that are asymptotically efficient and budget-balanced with high probability as the number of trading opportunities grows. Moreover, we show that the average expected profit obtained by the platform under these mechanisms asymptotically approaches first best (the maximum possible welfare generated by the market). We also extend our approach to general environments with complex, combinatorial preferences.
Abstract P754: Prothrombotic and Proinflammatory Milieu in Diabetic and Non-Diabetic Stroke Cohort - Using Coated-Platelets and Peripheral Blood Indices

Introduction: Elevated levels of coated-platelets (a subset of procoagulant platelets) are often associated with acute ischemic stroke (AIS). In addition, diabetes mellitus (DM) and chronic inflamm...
Familial Adenomatous Polyposis

Familial adenomatous polyposis (FAP) is an autosomal dominant disease with a prevalence of about one in 10,000 live births. It is classically characterized by the development of hundreds to thousands of adenomas in the colon and rectum that progress to colorectal cancer (CRC) in almost all individuals if left untreated. It typically presents in early adolescence and without any intervention, 95 % of patients will develop CRC by age 50. Adequate colonoscopy surveillance and prophylactic colectomy have reduced the incidence of CRC cases in FAP. This article examines the epidemiology, clinical presentation, genetic basis, differential diagnosis, endoscopic and surgical management of FAP.
Evaluation of screening strategies for pulmonary tuberculosis among hospitalized patients in a low-burden setting: cost-effectiveness of GeneXpert MTB/RIF compared to smear microscopy.

OBJECTIVE Hospitalized patients undergoing evaluation for pulmonary tuberculosis (TB) require airborne isolation while testing for Mycobacterium tuberculosis (MTB) to reduce risk of nosocomial transmission. GeneXpert MTB/RIF (Xpert) is more rapid and accurate than sputum smear microscopy, but it is not routinely used to 'rule out' infectious pulmonary TB among hospitalized patients in the United States. We sought to evaluate the diagnostic performance and cost-effectiveness of Xpert-based TB evaluation. METHODS We conducted a retrospective cohort study of hospitalized adults evaluated for pulmonary TB at a large academic medical center in New York from 2010 to 2017. Using propensity score matching, we compared hospital length-of-stay among patients undergoing conventional smear-based TB evaluation to a control group with non-TB pneumonia. We performed a probabilistic cost-effectiveness analysis to compare Xpert-based versus conventional TB evaluation. RESULTS In total 1,421 patients were evaluated for TB with airborne isolation and sputum testing; mycobacterial culture was positive for MTB in 49 (3.4%). Conventional TB evaluation was associated with an increase of 4.4 hospital days compared to propensity-matched controls. Xpert-based testing strategies dominated conventional TB evaluation with a cost savings of $5,947 (95% CI, $1,156-$12,540) and $4,445 (95% CI, $696-$9,526) per patient depending on the number of Xpert tests performed (1 vs 2, respectively) and assumptions about the reduction of length of stay achieved. CONCLUSIONS In the evaluation of hospitalized patients for pulmonary TB, Xpert-based testing has superior diagnostic performance and is likely cost-effective compared to smear microscopy due to reduced hospital length-of-stay associated with more rapid test results.
The effect of increased straight leg raise on work production in subjects with tight hamstrings

This study examined the effect of a 20% increase in straight leg raise (SLR) on concentric isokinetic measures of work in subjects with tight hamstrings. Subjects were deemed eligible if passive SLR of the dominate limb was < 70° and if subjects had no documented problems with the tested limb. Thirty-two volunteer subjects were randomly assigned to experimental and control groups (n = 16 each) and baseline measures were completed. Experimental group subjects then participated in supervised stretching and a home program with SLR re-assessment prior to each supervised session. Within 24 hours of an experimental subject reaching the 20% targeted increase in SLR range, that subject and a control subject were re-tested. The results showed no significant change in work production despite a 20% increase in SLR. This study suggests that a modest increase in SLR does not adversely affect the strength of tight hamstring muscles. Clinical implications are that an increase in flexibility of a tight muscle may not adversely effect a subject's ability to maximize muscular potential.
Kinetic Timing: A Novel Mechanism That Improves the Accuracy of GTPase Timers in Endosome Fusion and Other Biological Processes

The GTPase superfamily contains a large number of proteins that function as molecular switches by binding and hydrolyzing GTP molecules. They are localized at various intracellular organelles and control diverse cellular processes. For many GTPases, the lifetime of the activated, GTP-bound state is believed to serve as a timer in determining the activation time of a biological event such as membrane fusion and signal transduction. However, such a timer is intrinsically stochastic due to thermal noise at the level of single GTPase molecules. Here, we describe a mathematical model that shows how a directional GTPase cycle, in a nonequilibrium steady-state driven by GTP hydrolysis, can significantly reduce the variance in the lifetime of an activated GTPase molecule and thereby increase the accuracy and efficiency of the timer. This mechanism, termed kinetic timing, articulates a clear function for the energy consumption in GTPase-controlled biological processes. It provides a rationale for why biological timers utilize a GTP hydrolysis cycle rather than a simple GTP binding–dissociation equilibrium, and why the GTP-bound state is a better timer than the GDP-bound state. It also explains the necessity for the existence of multiple GTP-bound intermediates identified by fluorescence spectroscopy and nuclear magnetic resonance studies.
Effects of Strong Binding of Anionic Adsorbates on Adsorption of Trace Metals on Amorphous Iron Oxyhydroxide

Adsorption of three metal ions (Cd2+, Co2+, Zn2+) onto amorphous iron oxyhydroxide has been studied in the presence of several strongly binding anionic adsorbates (SeO 4 2- , SeO 3 2- , AsO 4 3- , AsO 3 3- , CrO 4 2- , PO 4 -3 ). The anions either increase or have no effect on trace metal adsorption, indicating that competition between the anions and cations for surface sites is relatively minor. The results cannot be explained by electrostatic interactions unless the relative acidities of the anions are very different at the surface than in solution. The most likely cause of the enhanced metal adsorption in some systems is that a secondary surface phase forms, and the metals bind more strongly to the new phase than they do to the original substrate. The secondary phase appears to be an iron-anion solid rather than a trace metal-anion solid. In systems where a new surface does not form, electrostatic and competitive interactions are somehow suppressed, which may indicate that anion adsorption sites are physically and electrically isolated from cation adsorption sites.
Visualization of automated trust negotiation

We have designed an interactive visualization framework for the automated trust negotiation (ATN) protocol and we have implemented a prototype of the visualizer in Java. This framework provides capabilities to perform the interactive visualization of an ATN session, display credentials and policies, analyze the relations of negotiated components, and refine access control policies and negotiation strategies. We give examples of the visualization of ATN sessions and demonstrate the interactive features of the visualizer for the incremental construction of a trust target graph (TTG). Our prototype, which implements most components of the visualization framework, has played a key role in a research project that has developed working trust negotiation systems in an industrial environment.
Realizing the benefits of structural test for Intel microprocessors

This paper traces the evolution of the distributed test strategy at Intel, covering both the tester platform, which is now on the 2nd generation, as well as the parallel evolution of the test content, which is optimized for this platform. We describe the distribution of Pentium/spl reg/ 4 processor test content between structural and functional platforms, associated fallout, and key issues encountered with content migration. Finally, we discuss future test content and platform trends as shaped by increasing device complexity and defect types.
Undiscovered role of endogenous thromboxane A2 in activation of cardiac sympathetic afferents during ischaemia

Myocardial ischaemia activates blood platelets, which in turn stimulate cardiac sympathetic afferents, leading to chest pain and sympathoexcitatory reflex cardiovascular responses. Previous studies have shown that activated platelets stimulate ischaemically sensitive cardiac sympathetic afferents, and that thromboxane A(2) (TxA(2)) is one of the mediators released from activated platelets during myocardial ischaemia. The present study tested the hypothesis that endogenous TxA(2) stimulates cardiac afferents during ischaemia through direct activation of TxA(2) (TP) receptors coupled with the phospholipase C-protein kinase C (PLC-PKC) cellular pathway. Nerve activity of single unit cardiac sympathetic afferents was recorded from the left sympathetic chain or rami communicantes (T(2)-T(5)) in anaesthetized cats. Single fields of 39 afferents (conduction velocity = 0.27-3.65 m s(-1)) were identified in the left or right ventricle initially with mechanical stimulation and confirmed with a stimulating electrode. Five minutes of myocardial ischaemia stimulated all 39 cardiac afferents (8 Adelta-, 31 C-fibres) and the responses of these 39 afferents to chemical stimuli were further studied in the following four protocols. In the first protocol, 2.5, 5 and 10 microg of the TxA(2) mimetic, U46619, injected into the left atrium (LA), stimulated seven ischaemically sensitive cardiac afferents in a dose-dependent manner. Second, BM13,177, a selective TxA(2) receptor antagonist, abolished the responses of six afferents to 5 microg of U46619 injected into the left atrium and attenuated the ischaemia-related increase in activity of seven other afferents by 44%. In contrast, cardiac afferents, in the absence of TP receptor blockade responded consistently to repeated administration of U46619 (n = 6) and to recurrent myocardial ischaemia (n = 7). In the fourth protocol, administration of PKC-(19-36), a selective PKC inhibitor, attenuated the responses of six other cardiac afferents to U46619 by 38%. Finally, using an immunohistochemical staining approach, we observed that TP receptors were expressed in cardiac sensory neurons in thoracic dorsal root ganglia. Taken together, these data indicate that endogenous TxA(2) contributes to the activation of cardiac afferents during myocardial ischaemia through direct stimulation of TP receptors probably located in the cardiac sensory nervous system and that the stimulating effect of TxA(2) on cardiac afferents is dependent, at least in part, upon the PLC-PKC cellular pathway.
Grandientless reactors and transient methods in heterogeneous catalysis

Abstract A general review of catalytic laboratory reactors is presented which emphasizes gradient-less reactors. Details are given on a new gradientless reactor system which is well designed for transient experiments. This reactor has a low ratio of gas volume to catalyst volume. Experimental results verify that the reactor is well-mixed and free from undesirable mass and heat transfer effects under reactions conditions. The desirability and utilization of such a reactor is discussed.
Review: A posteriori error estimation techniques in practical finite element analysis

In this paper we review the basic concepts to obtain a posteriori error estimates for the finite element solution of an elliptic linear model problem. We give the basic ideas to establish global error estimates for the energy norm as well as goal-oriented error estimates. While we show how these error estimation techniques are employed for our simple model problem, the emphasis of the paper is on assessing whether these procedures are ready for use in practical linear finite element analysis. We conclude that the actually practical error estimation techniques do not provide mathematically proven bounds on the error and need to be used with care. The more accurate estimation procedures also do not provide proven bounds that, in general, can be computed efficiently. We also briefly comment upon the state of error estimations in nonlinear and transient analyses and when mixed methods are used.
The role of refrigerants in climate change

Abstract The primary chemicals used as refrigerants, chlorofluorocarbons (CFCs), and the compounds being considered as their replacements (HCHCs and HFCs) have been intensely studied because of concerns about chlorine chemistry effects on stratospheric ozone. Increasing attention is being given to the potential contributions of these compounds to global warming. CFCs, HCFCs and HFCs absorb infra-red radiation and thus are greenhouse gases that can exert an additional radiative forcing that tends to warm the climate. The purpose of this paper is to describe the current understanding of the role of refrigerants in affecting climate. Increasing atmospheric concentrations of CFCs have accounted for about 24% of the direct increase in radiative forcing from greenhouse gases over the last decade. However, an observed decrease in stratospheric ozone, thought to be connected to increasing stratospheric chlorine from CFCs (and, to a lesser extent, from other man-made compounds containing chlorine and bromine), suggests a negative radiative forcing or cooling tendency over the last decade. This cooling tendency has strong latitudinal gradients, but is, when globally averaged, about comparable in magnitude and opposite in sign to the radiative forcing from CFCs over this period. On the other hand, the radiative influence on climate from the compounds being considered as replacements, because of their shorter atmospheric lifetimes, should generally be much smaller than the CFCs. However, the effects on ozone should also be much smaller from the replacement compounds and there should be less cancellation in the overall globally averaged influence on climate.
Relief from a heavy heart: redox-sensitive NF-κB as a therapeutic target in managing cardiac hypertrophy

cardiac hypertrophy is both an adaptive response to chronic pressure overload and a key risk factor in patients with hypertension ([6][1]). On one hand, cardiac hypertrophy may normalize wall tension, whereas on the other it may progress to a decompensated state causing overt heart failure, a common
Capturing every patron interaction: the move from paper statistics to an electronic system to track the whole library.

Reference departments track patron interactions to illustrate the type and number of services provided as well as to tailor librarians’ time and expertise to the interest and needs of their patrons. Until 2010 the Reference, Education, and Community Engagement Department at the Calder Memorial Library tracked statistics using a complicated system of paper tic sheets and two Excel™ spreadsheets. After considering different electronic systems, the department decided to employ an electronic form created with SurveyMonkey™ to track patron interactions. After the system had been in place for three months, the authors administered a satisfaction and use survey to collect faculty and staff feedback on the new system. Seven months later the authors undertook usability testing to collect further evaluative data on the electronic form. The patron interaction form continues to be used to collect statistics, provide data for annual reviews, and recognize the contributions of all faculty and staff at the library.
Post-conceptional induction of menses with a single vaginal suppository of (15S)-15-methyl prostaglandin F2α methyl ester

The induction of post-conceptional menses needs a technically simple method which would avoid instrumentation of the uterus. One possible method investigated in this study is the abortifacient effect of a single dose long-acting vaginal suppository containing 3.0 mg of (15S)-15-methyl prostaglandin F2 alpha methyl ester. Pregnancy was terminated successfully in 13 of the 14 subjects. Two successful patients required curettage for prolonged bleeding and retained products of conception. Prolonged vaginal bleeding and the uncertainty of endpoints with particular reference to human chorionic gonadotropin (HCG) constitute the major problem with this non-invasive method, and are discussed in the light of the data obtained.
Scaling procedures for specifying color appearance

Colors of objects are often specified by color matches in some standard colorimetric system. While color-matching allows a color to be reproduced accurately, it does not specify what the color actually looks like. Color appearance (i.e., hue, saturation, brightness) can be measured by direct psychophysical scaling techniques; however, these methods have not been standardized and have been confined mostly to the laboratory. We have examined several variants of continuous, numerical scaling of hue and saturation to find a procedure that is usable, even by untrained observers. Appearances of monochromatic, equal-luminance light flashes were scaled along the dimensions of the unique hue sensations (red, yellow, green, blue) and apparent saturation. These functions were obtained for various stimulus conditions, including changes in stimulus luminance, size, and eccentricity. Multidimensional scaling methods were used to derive metrically uniform color appearance diagrams from the hue and saturation scaling data. Validity of the scaling procedures was assessed by deriving well-known visual functions, such as wavelength discrimination, from the color appearance diagrams. The direct scaling method was shown to be generally useful, and both trained and untrained observers readily and reliably used the technique.
Using selective, short-term memory to improve resilience against DDoS exhaustion attacks

Summary Distributed denial of service (DDoS) attacks originating from botnets can quickly bring normally effective web services to a screeching halt. This paper presents SESRAA (selective short-term randomized acceptance algorithms), an adaptive scheme for maintaining web service despite the presence of multifaceted attacks in a noisy environment. In contrast to existing solutions that rely upon ‘clean’ training data, we presume that a live web service environment makes finding such training data difficult if not impossible. SESRAA functions much like a battlefield surgeon’s triage: focusing on quickly and efficiently salvaging good connections with the realization that the chaotic nature of the live environment implicitly limits the accuracy of such detections. SESRAA employs an adaptive k-means clustering approach using short-term extraction and limited centroid evolution to defend the legitimate connections in a mixed attack environment. We present the SESRAA approach and evaluate its performance through experimental studies in a diverse attack environment. The results show significant improvements against a wide variety of DDoS configurations and input traffic patterns. Copyright © 2008 John Wiley & Sons, Ltd.
Tracer-grade rhodamine WT : Structure of constituent isomers and their sorption behavior

Rhodamine WT (RWT), a fluorescent xanthene dye, is often used as a conservative tracer in aquifer characterization and as a surrogate or sorbing tracer for contaminant fate and transport. Quantitative tracing employing RWT is confounded by the presence of two major fluorescent constituents in the tracer-grade mixture. Here, we have confirmed that the two constituents are isomers of RWT, elucidated their molecular structures and their percent mass distribution in the tracer-grade mixture, and examined their individual sorption behavior onto soil solids. The energy-minimized geometry of the meta isomer indicates that it possesses a greater potential for (i) hydrophobic exclusion from bulk solution, (ii) electrostatic attraction to the solid phase, and (iii) surface complexation with surface-bound Al and Fe ions as compared with the para isomer. Hence, the meta isomer consistently sorbs to a higher extent onto the mineral phases examined. The para isomer has the potential to be a nearly conservative tracer, and the meta isomer has the potential to be a nonconservative tracer. To facilitate RWT use as a conservative tracer and comparison of tracer tests at different locations, we recommend modification of the RWT manufacturing process toward production of 100% of the para isomer. Alternatively, appropriately designed tests with tracer-grade RWT have the potential for simultaneous estimation of hydraulic parameters and contaminant fate and transport.
Hepatitis G virus co-infection does not alter the course of recurrent hepatitis C virus infection in liver transplantation recipients

Although hepatitis G virus infection (HGV) is usually asymptomatic, it has been associated with mild hepatic injury. Whether hepatitis G co-infection alters the natural history of other viral hepatitis infections remains to be determined. In the present study, we investigated whether hepatitis G impacts on the time to recurrent hepatitis or on the time to progression to fibrosis in hepatitis C-infected patients who undergo liver transplantation. Forty-five liver transplantation recipients with persistent hepatitis C viremia by polymerase chain reaction (PCR) were evaluated. Stored sera obtained before and after liver transplantation was tested for HGV RNA by reverse transcriptase (RT)-PCR using primers to the 5' region of the HGV genome. A median of eight serial liver biopsy specimens were reviewed per patient. The prevalence of HGV co-infection was 21% before transplantation and 22% following transplantation. During a median follow-up of 29 months, 78% (35/45) of patients with hepatitis C viremia developed histological features of recurrent hepatitis. Fifty-one percent (23/45) progressed to fibrous portal expansion and 16% (7/45) developed bridging fibrosis. Comparisons of patients with and without hepatitis G co-infection following transplantation showed no significant difference in time to recurrent hepatitis, fibrous portal expansion, bridging fibrosis, or of allograft or patient survival. In conclusion, hepatitis G co-infection does not seem to impact on the time to recurrent hepatitis C or progression of hepatitis C-related histological injury after liver transplantation.
In-line reference cell for real-time calibration of laser absorption spectrometers

We discuss a novel method of tunable diode laser sensor calibration using an in-line reference gas cell. The technique employs wavelength modulation spectroscopy at higher harmonics to simultaneously probe the sample and reference spectra.
Injectable In Situ Forming Biodegradable Chitosan-Hyaluronic acid Based Hydrogels for Cartilage Tissue Engineering

Injectable, biodegradable scaffolds are important biomaterials for tissue engineering and drug delivery. Hydrogels derived from natural polysaccharides are ideal scaffolds as they resemble the extracellular matrices of tissues comprised of various glycosaminoglycans (GAGs). Here, we report a new class of biocompatible and biodegradable composite hydrogels derived from water-soluble chitosan and oxidized hyaluronic acid upon mixing, without the addition of a chemical crosslinking agent. The gelation is attributed to the Schiff base reaction between amino and aldehyde groups of polysaccharide derivatives. In the current work, N-succinyl-chitosan (S-CS) and aldehyde hyaluronic acid (A-HA) were synthesized for preparation of the composite hydrogels. The polysaccharide derivatives and composite hydrogels were characterized by FTIR spectroscopy. The effect of the ratio of S-CS and A-HA on the gelation time, microstructure, surface morphology, equilibrium swelling, compressive modulus, and in vitro degradation of composite hydrogels was examined. The potential of the composite hydrogel as an injectable scaffold was demonstrated by the encapsulation of bovine articular chondrocytes within the composite hydrogel matrix in vitro. The results demonstrated that the composite hydrogel supported cell survival and the cells retained chondrocytic morphology. These characteristics provide a potential opportunity to use the injectable, composite hydrogels in tissue engineering applications.
Limb sparing surgery for pediatric musculoskeletal tumors.

There has been an unprecedented improvement in the survival outcome of children with extremity sarcoma as well as a corresponding increase in percentage of limb-sparing surgeries being performed over the past many decades. This has been, in part, due to the improved imaging modalities, newer surgical techniques, and advences in neoadjuvant chemotherapy. Limb-sparing surgery for primary bone and soft-tissue malignancies in children is becoming an acceptable option of surgical treatment in most cases today. This article outlines the demographics, classification, clinical presentation, imaging, and molecular genetics of pediatric mosculoskeletal tumors and discusses the current treatment principles with emphasis on the state-of-the-art surgical management and limb-sparing techniques for children with extremity sarcoma. © 2004 Wiley-Liss, Inc.
Epidemiology and etiology of bladder cancer

The incidence of bladder cancer continues to increase, with an estimated 53,000 new cases diagnosed in the United States in 1996-90% of which are transitional cell carcinomas. The male-to-female ratio is 3:1. A number of etiological factors are associated with the development of bladder cancer, but in industrialized countries, cigarette smoking is the most important. Specific chemicals have also been identified as causing bladder cancer, as have a number of occupational exposures to less well-defined specific agents. Treatment with cytostatic drugs, especially cyclophosphamide, is associated with increased risk of bladder cancer, as is treatment with radiotherapy for uterine cancer. In developing countries, especially in the Middle East and parts of Africa, infections with members of the genus Schistosoma are responsible for a high incidence of bladder cancer-75% of which are squamous cell carcinomas. Arsenic has been indicated as a bladder carcinogen in Argentina, Chile, and Taiwan. The reason for the high incidence of urinary tract cancer in individuals suffering from Balkan nephropathy has yet to be determined. A careful history of patients with bladder cancer is an important and useful process in helping to identify causal factor and, in more than one-half the cases, a known relationship is found. Bladder cancer is a potentially preventable disease, with a significant morbidity and mortality in many parts of the world.
Thomson scattering and ponderomotive intermodulation within standing laser beat waves in plasma

Electrons in a standing electromagnetic wave--an optical lattice--tend to oscillate due to the quiver and ponderomotive potentials. For sufficiently intense laser fields (Ilamda2 approximately < or = 5 x 10(17) W cm(-2) microm2) and in plasmas with sufficiently low electron densities (n approximately < or = 10(18) cm(-3)), these oscillations can occur faster than the plasma can respond. This paper shows that these oscillations result in Thomson scattering of light at both the laser and ponderomotive bounce frequencies and their harmonics as well as at mixtures of these frequencies. We term this mixing ponderomotive intermodulation. Here, the case of counterpropagating laser beams creating a one-dimensional (1D) optical lattice is analyzed. The near-equilibrium electron orbits and subsequent Thomson scattering patterns are computed in the single-particle limit. Scaling laws are derived to quantify the range of validity of this approach. Finally, collective plasma and laser focusing effects are included by using particle-in-cell (PIC) techniques. This effect resulting in light-frequency conversion has applications both as an infrared light source and as a means to diagnose high laser intensities inside dense plasmas.
Response of container-grown photinia to moisture stress

Abstract Two experiments were conducted to determine the effect of Vapor Gard (VG), an antitranspirant, and moisture stress on shoot water potential of container-grown photinia. In Experiment 1, plants sprayed with VG has less moisture stress than plants with no VG when 24.0 and 27.5 mm of net evaporation occurred prior to watering. Recovery periods for shoot water potential were within 4, 8 and 24 h for photinia stressed to 21.5, 24.0 and 27.5 mm of net evaporation, respectively. Photinia with and without VG were compared in Experiment 2. Shoot water potential and stomatal opening were measured pre-dawn daily (for 9 days) on photinia stressed to −25 and −35 bars pre-dawn shoot water potential before watering. Plants watered daily had a maximum pre-dawn shoot water potential of −3 bars, and watered plants had a higher shoot water potential than stressed plants. Within 8 h after watering, plants with a pre-dawn stress of −25 bars recovered to shoot water potentials of plants watered daily, and stomates closed regardless of VG treatment. Pre-dawn stress to −35 bars resulted in a longer recovery period of shoot water potential (about 36 h). Stomates were closed on plants treated with VG and open on plants not treated with VG. Defoliation (25–75%) occurred on plants stressed to −35 bars and not treated with VG.