cssi/SciSciGPT-SciSciNet huggingface dataset:
Erythropoietin and transferrin metabolism in nephrotic syndrome

Nephrotic syndrome is characterized by marked urinary excretion of albumin and other intermediate-size plasma proteins. This results in a profound alteration of the metabolism of many plasma proteins and protein-bound substances, as well as certain cellular and tissue proteins. This review summarizes available data on the effect of nephrotic syndrome on the metabolism and regulation of erythropoietin (EPO) and transferrin, which are essential for erythropoiesis. Studies of humans and animals have documented significant urinary losses of both EPO and transferrin in nephrotic syndrome. Urinary losses of EPO have been shown to cause EPO-deficiency anemia and prevent the normal increase in plasma EPO level in response to anemia and hypoxia in nephrotic syndrome. Similarly, transferrinuria and increased transferrin catabolism have been shown to cause hypotransferrinemia and, in some cases, iron-deficiency anemia. In addition, dissociation of iron from filtered transferrin, occasioned by a reduction in tubular fluid pH, can promote tubulointerstitial injury through the iron-catalyzed generation of oxygen free radicals. This can account in part for the role of proteinuria as a risk factor for the progression of renal disease. Subcutaneous administration of recombinant EPO has been successfully used in the management of EPO-deficiency anemia in nephrotic syndrome. Similarly, iron supplementation and nutritional support are indicated in nephrotic patients with severe transferrinuria and iron-deficiency anemia. However, correction or amelioration of the underlying proteinuria, when possible, is the ideal approach to reversal of these complications.
Localized-itinerant electronic transitions in oxides and sulfides

Abstract Comparison of the transition-metal oxides and sulfides highlights as a common feature the possibility of finding a displacive crystallographic transition at a cross-over from localized to itinerant electronic behavior. In metastable NiS with the B81 structure, for example, this cross-over manifests itself as a first-order expansion of the c-axis on cooling from a Pauli-paramagnetic metallic phase to an antiferromagnetic phase at a Neel temperature TN= 264 K. A first-order lattice expansion also occurs in the perovskite NdNiO3 on cooling from a metallic to an insulating phase, but in this case the magnetic order below TN indicates a segregation into ferromagnetic Ni-O-Ni (111) sheets containing itinerant electrons that are coupled by ionic bonding across an oxide-ion (111) plane to give a charge-density wave (CDW) with a propagation vector qCDW [111] and a spin-density wave (SDW) with qSDW = 2qCDW. In rhombohedral FeS, itinerant minority-spin electrons co-exist with localized majority-spin electrons into molecular orbitals. A low-spin to intermediate-spin transition in LaCoO3 occurs via short-range ordering of low-spin and high-spin to intermediate-spin trivalent cobalt, localized a electrons at the high-spin cobalt transforming to itinerant σ∗ electrons in the intermediate spin state. As a final example, mixed-valent manganese oxides with perovskite structure are chosen to illustrate strong electron coupling to local Jahn-Teller deformations at a cross-over from localized to itinerant electronic behavior of σ-bonding electrons in the presence of π-bonding electron configurations with localized spins S = 3 2 .
Thermochemistry of (germanium + sulfur): III. Massic energies of combustion in fluorine and the derived standard molar enthalpies of formation of crystalline and vitreous germanium(IV) disulfide GeS2at the temperatureT= 298.15 K. Standard molar enthalpy of the transition GeS2(cr) = GeS2(vit) atT= 298.15 K. Critical assessment of thermodynamic quantities for the high-temperature reaction: GeS2(cr) = GeS(g) + 12S2(g)

Abstract Fluorine-bomb calorimetry was used to determine the massic energies of combustion of high-purity specimens of crystalline and vitreous germanium(IV) disulfide GeS2according to the reaction: GeS2(cr or vit) + 8F2(g) = GeF4(g) + 2SF6(g). Standard massic energies of the combustion atT= 298.15 K andp° = 101.325 kPa were found to be: Δcu°(GeS2, cr) = −(25558.9 ± 3.0) J·g−1and Δcu°(GeS2, vit) = −(25650.2 ± 4.5) J·g−1, where the uncertainties are standard deviations of the mean of the individual experimental results. Standard molar enthalpies of formation ΔfHm°(T= 298.15 K,p° = 101.325 kPa) were derived: −(127.9 ± 1.3) kJ·mol−1for GeS2(cr) and -(115.4 ± 1.6) kJ·mol−1for GeS2(vit). This ΔfHm°(GeS2, cr) is in close agreement with the result from a previous determination (J. Chem. Thermodynamics1984, 16, 335), also by fluorine-combustion calorimetry, and a weighted mean of the two:−(127.8 ± 1.0) kJ·mol−1, is recommended as a “best” value. Third-law treatments of equilibrium vapor pressures as a function of temperature reported in the literature for the high-temperature decomposition reaction: GeS2(cr) = GeS(g) + 1 2 S2(g) and that incorporate the new ΔfHm°(GeS, cr, 298.15 K) obtained in Part II of this study (J. Chem. Thermodynamics1994, 26, 727), yield several derived results for ΔfHm°(GeS2, cr, 298.15 K) that are in reasonable agreement with the calorimetric determinations. The standard molar enthalpy of the transition: GeS2(vit) = GeS2(cr): ΔtrsHm° = −(12.5 ± 1.5)kJ·mol−1atT= 298.15 K, calculated from the difference in the massic energies of combustion, is about the same size as ΔtrsHm° for similar compounds of the Group-14 elements. (Throughout this abstract, uncertainties in all molar quantities are expressed as twice the standard deviation of the mean.)
Donor-Recipient Gender and Size Mismatch Affects Graft Success after Kidney Transplantation

Background Female recipients of male kidneys have an inferior graft survival, and patients receiving larger kidneys relative to their body size may have a graft survival advantage. Thus, graft survival may be affected by both gender and kidney size mismatches. The objective of this study was to analyze the possible confounding effect of body mass mismatch (body mass as proxy for kidney size) between female recipients of male donor kidneys. Study Design A total of 668 kidney transplantations between 1996 and 2005 at our center were studied retrospectively. Graft and patient survival were determined by Kaplan-Meier estimation. Multivariate Cox proportional analyses were performed to determine the hazards of graft loss. Results There were 146 female recipients of male kidneys. Compared with all other gender combinations, this group had the lowest unadjusted graft survival (86%, 79%, and 78% vs 92%, 88%, and 86% at 1, 2, and 3 years, respectively; log-rank p=0.01). Donor body mass index (BMI) correlated with donor kidney size (p Conclusions The inferior graft survival for female recipients of male donor kidneys is mitigated by male donors with a larger BMI.
The role of atypical PKCs in insulin-resistant states

Abstract Insulin-stimulated glucose transport requires IRS1/PI3K, atypical PKCs (aPKCs) and PKB, but mechanisms underlying clinical insulin-resistance in humans are unclear. We and others recently reported that activation of IRS1/PI3K and aPKCs, but not PKB, is defective in muscles of obese/glucose-intolerant and type 2 diabetic humans. Defects in activation of aPKCs, but not IRS1, PI3K or PKB, have also been found in muscles of glucose-tolerant obese women and, to a greater degree, obese women who have polycystic ovary syndrome (PCOS). In each condition, there were defects in aPKC activation by both insulin in vivo and the PI3K lipid product, PIP3, in vitro. Conclusions: (a) insulin resistance in muscle in states of obesity, PCOS, the metabolic syndrome, impaired glucose tolerance and type 2 diabetes is at least partly due to defective activation of aPKCs; and (b) defective aPKC activation is partly due to poor responsiveness to PIP3, which may precede defects in IRS1/PI3K activation.
Race/ethnicity and disparities in mastectomy practice in the Breast Cancer Care in Chicago study.

To examine racial/ethnic disparities in mastectomy practice and explore mediating factors to explain the disparity. Participants included 989 females aged 30–79 years, from a population-based study of newly diagnosed (primary in situ/invasive) breast cancer patients, in Chicago, Illinois, from 2005 to 2008, who completed an interview. Medical records were also abstracted for tumor, diagnostic, and treatment information. Multivariable logistic regression models with model-based standardization were used to estimate risk differences. Differences in rescaled coefficients were used to estimate the proportion of the disparity that could be mediated by patient and tumor characteristics. Mastectomy prevalence overall was 40 %. Factors significantly associated with increased rates of mastectomy (p < 0.05) included the following: non-Hispanic (nH) black and Hispanic race/ethnicity; younger age at diagnosis; lower socioeconomic status (SES); lack of recency of and adherence to screening mammography; and higher tumor pathologic stage and grade. In adjusted models (age, body mass index, comorbidity), compared to nH white patients, mastectomy was increased by 10 % points in both nH black (95 % confidence interval [CI] 0.03, 0.18; p = 0.007) and Hispanic (95 % CI 0.01, 0.19; p = 0.028) patients. After accounting for the proportion of disparity mediated by tumor stage, the disparity was reduced by about a third in nH black (risk difference = 0.07, 95 % CI −0.01, 0.14) and half in Hispanic patients (risk difference = 0.04, 95 % CI −0.05, 0.13). Additional control for mediation by SES and other tumor-related factors almost completely eliminated the nH black:nH white disparity. The best approach to reducing the racial/ethnic disparity in mastectomy rates would be to intervene on factors that could affect stage at diagnosis.
A Family With Autosomal-Dominant Progressive Sensorineural Hearing Loss

The family described in this article provides an unusual opportunity to relate findings from genetic, histological, electrophysiological, psychophysical, and rehabilitative investigation. Although ...
Gastroesophageal reflux disease as an etiology of sleep disturbance in subjects with insomnia and minimal reflux symptoms: a pilot study of prevalence and response to therapy.

Background Gastroesophageal reflux disease (GERD) is a well-recognized cause of impaired sleep in patients with frequent GERD symptoms, as well as those with sleep apnea. GERD’s role in sleep disturbance of minimally symptomatic patients with poor sleep quality is less clear. Aim We aimed to define the prevalence of GERD-related sleep disturbance in minimally-symptomatic subjects with demonstrated insomnia, and to assess the changes in sleep efficiency in these subjects after vigorous acid suppression. Methods We recruited subjects aged 18–75 years reporting at least 6 months of insomnia, and sleep difficulty at least three nights per week. Subjects with a BMI > 30, a history of snoring or ongoing use of proton pump inhibitor or H2 receptor antagonist were excluded. Subjects underwent concurrent sleep study with dual channel 24-h pH study. Sleep efficiency, defined as the percentage of time after sleep initiation that the subject actually slept, and spontaneous arousal index, defined as the number of arousals per hour, were calculated. Those with a sleep study demonstrating poor sleep quality (sleep efficiency of 10 arousals/h for those aged 15 for those who were 45 or older) and no obstructive sleep apnea were treated with rabeprazole 20 mg PO BID × 14 days. After 14 days, the subjects underwent repeat sleep study with pH monitoring. The GERD Symptom Assessment Scale (GSAS), the Epworth Sleepiness Scale (ESS) and the Functional Outcomes of Sleep Questionnaire (FOSQ) were administered to subjects at study inception and after 2 weeks of therapy. Results Twenty-four subjects reporting insomnia were enrolled, and 20 met criteria for disordered sleep and no OSA. Seventeen completed both the first and second studies, and 16 were adequate for analysis. Baseline GSAS demonstrated trivial or no reflux symptoms in the cohort (no subject scored >8 out of 45 on GSAS, corresponding to a median rating of reflux symptoms of “not at all”). Four of 16 subjects (25%) demonstrated abnormal pH studies at baseline. All four had normalization of acid exposures on PPI. After 2 weeks of treatment, three of these four subjects had normalization of sleep efficiency, compared to 4 of 12 of the subjects with normal Johnson-DeMeester scores. Repeated measures analysis showed significant improvement in spontaneous arousal index between the first and second study for the whole group (P < 0.0035). Pre- and post-therapy ESS and FOSQ scores were not significantly different. Conclusions Despite the lack of GERD symptoms, a significant minority of subjects with sleep disturbance have abnormal acid exposures. These preliminary data suggest that aggressive treatment of GERD in such patients may result in improvement in sleep efficiency.
A customer needs motivated conceptual design methodology for product portfolio planning

Platform design strategy is an important topic in modern product development, particularly in the context of global markets that demand customised or region-specific differentiation of products. However, current methods do not fully address platform definition with respect to customer needs. Customer satisfaction is key for survival and it is crucial that the customer is used to plan different variants of a product. This article explores the utility of high-level customer needs as a direct means to define the product's base platform and differentiating modules. Our approach is to outline platform and differentiating modules during the conceptual design stage of product development and to plan a product portfolio before any embodiment design occurs. Modern design tools such as functional modelling and modular heuristics are used in this approach. On the basis of empirical studies, a customer-need-motivated conceptual design method for product portfolio planning is proposed. The developed method is validate...
Stages of autonomy determination

We discuss stages of autonomy determination for software agents that manage and manipulate knowledge in organizations that house other software agents and human knowledge workers. We suggest recognition of potential autonomies in the belief-desire-intention (BDI) paradigm and actual reasoning about autonomy choice decision theoretically. We show how agents might revise their autonomies in light of one another's autonomy and might also experience new, derived autonomies. We discuss the conditions under which an entire group of agents might have a collective autonomy attitude toward agents outside their group. We believe group attitudes are a novel concept and form a strong basis for developing theories of dynamic organizational structure. We briefly sketch an outline of a case study that motivates reasoning about autonomies.
Evaluation of a ten-minute chromogenic substrate test for identification of pathogenic Neisseria species and Branhamella catarrhalis.

A ten-minute chromogenic substrate test was evaluated for its ability to rapidly identify pathogenicNeisseria spp. andBranhamella catarrhalis. Identifications obtained with this system were compared to those obtained using conventional procedures. The test correctly identified 98.9% of 90Neisseria gonorrhoeae, 98.3% of 60Neisseria meningitidis, 96.2% of 26Neisseria lactamica, and 100% of 36Branhamella catarrhalis strains. EightNeisseria subflava strains that grew on modified Thayer-Martin agar were prolyl aminopeptidase positive and were misidentified asNeisseria gonorrhoeae. Other strains of saprophyticNeisseria spp. also reacted with the chromogenic substrates. The system was accurate and reliable for identifying the commonly encountered pathogenic species. In light of recent reports describing new species and atypicalNeisseria strains, however, careful attention to the salient features of both common and atypical organisms is necessary for proper use of rapid enzymatic identification tests.
Drafting New York Civil-Litigation Documents: Part XIX — Motions to Dismiss Continued

This article, which discusses how to draft motions to dismiss, is part of a series on drafting litigation documents under New York law. The series continues next issue with summary judgment motions.
Coherent-feedback quantum control with a dynamic compensator

I present an experimental realization of a coherent-feedback control system that was recently proposed for testing basic principles of linear quantum stochastic control theory [M. R. James, H. I. Nurdin, and I. R. Petersen, e-print arXiv:quant-ph/0703150v2, IEEE Transactions on Automatic Control (to be published)]. For a dynamical plant consisting of an optical ring resonator, I demonstrate $\ensuremath{\sim}7\phantom{\rule{0.3em}{0ex}}\mathrm{dB}$ broadband disturbance rejection of injected laser signals via all-optical feedback with a tailored dynamic compensator. Comparison of the results with a transfer function model pinpoints critical parameters that determine the coherent-feedback control system's performance.
The Indian Elephant

Since the extinction of the dinosaurs, elephants have been the largest land-dwelling animals. Proboscidea evolved as a separate order about 50 MYA, and its many species spread over most of the world. Today only two species survive: the Indian elephant (Elephas maximus) and the large-eared African elephant (Loxodonta africana). Adult elephants may weight up to 5000 kg (5 1/2 tons). Each has a proboscis, or trunk, used for breathing, for drinking by sucking up water and squirting it into the mouth, as a “hand” for tearing off food and conveying it to the mouth, and for carrying heavy loads. They have four enormous, pillarlike legs and feet with plantar surfaces that are thick, flexible, fatty pads that spread the weight evenly over a large area so that they leave only shallow footprints. Two upper incisors grow continuously and form the valuable ivory tusks. Elephants in captivity live 50–65 years. In the wild, their life expectancy is less due to disease and to slaughter by poachers collecting ivory. Elephants are herbivores, eating leaves, grasses, tree bark, and other vegetable matter in huge, often destructive quantities. Female elephants produce one offspring every 3 years. Gestation is about 20 months, followed by an almost equal period of nursing and nurturing during which the mother is not fertile.
Effects of Split Torso Positioning and Laparoscopic Surgery for Donor Nephrectomy on Respiratory Mechanics

Abstract Study Objective: To test whether split torso positioning, abdominal insufflation, and other procedures performed during laparoscopic nephrectomy would affect mechanical impedances to inflation [i.e., elastance (E) and resistance (R) of the total respiratory system (E rs and R rs ), lungs (E L and R L ), and chest wall (E cw and R cw )] differently from previously studied laparoscopic procedures. Design: Unblinded study, each patient serving as own control. Setting: University hospital. Patients: 12 ASA physical status I and II patients scheduled for laparoscopic donor nephrectomy, all without cardiopulmonary disease. Interventions: Patients were anesthetized and paralyzed, tracheally intubated and mechanically ventilated at 10, 20, and 30 breaths/minute and at tidal volumes of 250, 500, and 800 ml. Measurements were made in the following positions: supine, split torso, abdominal insufflation (P ab = 15 mmHg), and supine after deflation. Measurements and Main Results: Airway flow and pressure and esophageal pressure were measured. Discrete Fourier transformation was used to calculate E and R. These were analyzed with repeated measures, linear multiple regression with accepted level of significance at p rs , E cw , and R cw increased (p L decreased (p ab = 15 mmHg, E rs , E cw , and R cw increased further and R rs and R L increased (p cw and E rs remained elevated (p cw caused by laparoscopy and surgery were greater than we have previously measured in other laparoscopic procedures, while the changes in E L were less. Conclusions: Laparoscopic nephrectomy affects lung and chest wall mechanical properties differently from other laparoscopic procedures. This finding could be due to the split torso positioning, and the effects of abdominal swelling on the chest wall caused by administration of more perioperative fluids with laparoscopic nephrectomy.
Structure of Rotavirus Outer-Layer Protein VP7 Bound with a Neutralizing Fab

Rotavirus outer-layer protein VP7 is a principal target of protective antibodies. Removal of free calcium ions (Ca2+) dissociates VP7 trimers into monomers, releasing VP7 from the virion, and initiates penetration-inducing conformational changes in the other outer-layer protein, VP4. We report the crystal structure at 3.4 angstrom resolution of VP7 bound with the Fab fragment of a neutralizing monoclonal antibody. The Fab binds across the outer surface of the intersubunit contact, which contains two Ca2+ sites. Mutations that escape neutralization by other antibodies suggest that the same region bears the epitopes of most neutralizing antibodies. The monovalent Fab is sufficient to neutralize infectivity. We propose that neutralizing antibodies against VP7 act by stabilizing the trimer, thereby inhibiting the uncoating trigger for VP4 rearrangement. A disulfide-linked trimer is a potential subunit immunogen.
Attention improves performance primarily by reducing interneuronal correlations

Previous work has suggested that visual attention improves behavioral performance by increasing the firing rates of individual sensory neurons. Recording from populations of neurons in monkey visual area V4, this study finds that most of the attentional improvement in the population signal results from decreases in interneuronal correlations.
Streptomycin inhibits quorum sensing in Acinetobacter baumannii

Streptomycin at subinhibitory concentrations was found to inhibit quorum sensing in Acinetobacter baumannii. Conditioned medium prepared by growth of A. baumannii in the presence of subinhibitory concentrations of streptomycin exhibited reduced activation of two quorum-sensing-regulated genes, abaI, encoding an autoinducer synthase, and A1S_0112. The reduced expression of AbaI resulted in greatly decreased levels of 3-OH-C(12)-HSL as confirmed by direct analysis using thin-layer chromatography. The effect on acyl-homoserine lactone (AHL) signal production was specific to streptomycin, as gentamicin and myomycin had no significant effect at subinhibitory levels.
Fault-Tolerant Computing

Critical computer applications will grow explosively in the next decade, demanding systems that are reliable and available. Fault tolerance provides the tools to build such systems.
Simulation of gamma-ray current pulse shapes produced in a high purity germanium detector

Results of a simulation of gamma-ray interactions in a high-purity germanium detector (HPGe) are presented. Gamma-ray interactions have been divided into Compton scattering events which leave only part of their energy in the detector and full energy events which leave all their energy in the detector. The current pulse shapes from the detector were examined on a pulse-by-pulse basis. The simulation shows that rejecting all waveforms with trailing edges less than 50 ns reduces the peak to Compton ratio by a factor of two and greatly flattens the remaining Compton edges. >
Cooperative energy management in distributed wireless real-time systems

This work is based on the observation that existing energy management techniques for mobile devices, such as Dynamic Voltage Scaling (DVS), are non-cooperative in the sense that they reduce the energy consumption of a single device, disregarding potential consequences for other constraints (e.g., end-to-end deadlines) and/or other devices (e.g., energy consumption on neighboring devices). This paper argues that energy management in distributed wireless real-time systems has to be end-to-end in nature, requiring a coordinated approach among communicating devices. A cooperative distributed energy management technique (Co-DVS) is proposed that (1) adapts and maintains end-to-end latencies within specified timeliness requirements (deadlines) and (2) enhances energy savings at the devices with the highest pay-off factors that represent the relative benefits or significance of conserving energy at a device. The proposed technique employs a feedback-based approach to dynamically distribute end-to-end slack among the devices based on their pay-off factors.
Derivation of a closed-form approximate expression for the self-capacitance of a printed circuit board trace

The electric fields that couple traces on printed circuit boards to attached cables can generate common-mode currents that result in significant radiated emissions. Previous work has shown that these radiated emissions can be estimated based on the self-capacitances of the microstrip structures on a board . In general, the determination of these self-capacitances must be done numerically using three-dimensional static modeling software. In this paper, an approximate closed-form expression for the self-capacitance of microstrip traces is derived. This expression can be used to estimate the voltage-driven common-mode emissions from boards with various microstrip trace geometries. The expression also provides insight relative to the microstrip parameters that have the greatest effect on radiated emissions.
Breast Mass Classification on Full-Field Digital Mammography and Screen-Film Mammography

Studies have shown that full-field digital mammography (FFDM) has the potential to alleviate some of the limitations of screen-film mammography (SFM). It is therefore important to develop computer-aided diagnosis (CAD) systems for FFDM or adapt CAD systems developed for SFM to FFDM. The purpose of this study was to evaluate the performance of a CAD system, originally developed for characterization of breast masses on SFM, on a data set of masses acquired with FFDM. The performance on the FFDM set was compared to that on the corresponding masses on SFM of the same patients acquired within six months of the FFDM exam. The CAD system was trained on an SFM data set with 397 biopsy-proven masses (187 malignant and 210 benign) in 868 regions of interest (ROIs) (437 malignant and 431 benign). Four computer-extracted mammographic features and the patient age were selected as input predictor variables to two classification methods: linear discriminant analysis (LDA) and C5.0 decision tree (DT). The trained CAD systems were fixed and tested on an independent FFDM data set with 122 biopsy-proven masses (29 malignant and 93 benign) in 238 ROIs (60 malignant and 178 benign) and on the corresponding SFM data set. Receiver operating characteristic (ROC) analysis indicated that the CAD system using the LDA classifier achieved view-based test Az values of 0.81±0.03 and 0.82±0.03 for SFM and FFDM, respectively. The case-based test Az values with the same classifier were 0.82±0.04 for SFM and 0.88±0.03 for FFDM. The difference in the Az values between the two modalities did not achieve statistical significance (p=0.62 and p=0.13 for view-based and case-based evaluation, respectively). The use of the DT classifier resulted in a slight increase in performance for both modalities, with view-based Az values of 0.82±0.03 and 0.83±0.03 for SFM and FFDM, respectively.
Pressure detection and wireless interface for patient bed

A low power, microcontroller based patient bed monitoring system is discussed in this paper. The resistive bend sensor based approach provides an effective low cost alternative for minimizing the harmful effects of bedsores which is prevalent in hospital intensive care units and assisted living environments during rehabilitation. The ZigBee based wireless interface for this pressure detection system is aimed at reducing the hassles of the existing complex wired setup and to provide continuous patient care and monitoring by enabling the patient bed mobility as essentially required for patients in critical condition.
Prevention of Recurrent Vaginal Candidiasis with Weekly Terconazole Cream

OBJECTIVE:To investigate the prophylactic use of weekly terconazole 0.8% cream to prevent recurrent episodes of candidal vaginitis.DESIGN:Women with a documented history of recurrent candidal vaginitis (≥4 recurrences/y) were enrolled into a secondary prevention trial. None of these women were HIV positive, pregnant, diabetic, or immunosuppressed. Patients were initially treated for a symptomatic episode of candidal vaginitis and then started on weekly applications of terconazole 0.8% cream for 26 weeks. These women were then followed for an additional 26 weeks after therapy.SETTING:A university-affiliated medical school.PARTICIPANTS:The study population consisted of 22 healthy women aged 19–41 years.MAIN OUTCOME MEASURES:Patients were interviewed by phone each week concerning symptoms and compliance. They were also reminded to notify the study investigators any time vaginal symptoms of candidiasis occurred. Patients were examined whenever they developed vaginal symptoms and were treated on the basis of m...
Legionnaires disease: historical perspective.

In the summer of 1976, a mysterious epidemic of fatal respiratory disease in Philadelphia launched an intensive investigation that resulted in the definition of a new family of pathogenic bacteria, the Legionellaceae. In retrospect, members of the family had been isolated from clinical specimens as early as 1943. Unsolved epidemics of acute respiratory disease dating to the 1950s were subsequently attributed to the newly described pathogens. In the intervening years, the Legionellaceae have been firmly established as important causes of sporadic and epidemic respiratory disease. The sources of the infecting bacteria are environmental, and geographic variation in the frequency of infection has been documented. Airborne dissemination of bacteria from cooling towers and evaporative condensers has been responsible for some epidemics, but potable water systems are perhaps more important sources. The mode of transmission from drinking water is unclear. The Legionellaceae are gram-negative, facultative, intracellular pathogens. The resident alveolar macrophage, usually an effective antibacterial defense, is the primary site of growth. Cell-mediated immunity appears to be the most important immunological defense; the role of humoral immunity is less clear. Erythromycin remains the antibiotic of choice for therapy of infected patients, but identification and eradication of environmental sources are also essential for the control of infection. Images
Using separable game theory to develop adaptive algorithms for joint codeword optimization and power control in cdma systems

Game theory has emerged as a new mathematical tool in the analysis and design of wireless communication systems, being particularly useful in studying the interactions among adaptive transmitters that attempt to achieve specific objectives without cooperation. In this paper we present application of separable game theory to the development of adaptive algorithms for joint codeword optimization and power control in code division multiple access (CDMA) systems.
Non-planar grain boundary structures in fcc metals and their role in nano-scale deformation mechanisms

This work presents the results of a comparative molecular dynamics study showing that relaxed random grain boundary structures can be significantly non-planar at the nano-scale in fcc metals characterized by low stacking fault values. We studied the relaxed structures of random [1 1 0] tilt boundaries in a polycrystal using interatomic potentials describing Cu and Pd. Grain boundaries presenting non-planar features were observed predominantly for the Cu potential but not for the Pd potential, and we relate these differences to the stacking fault values. We also show that these non-planar structures can have a strong influence on dislocation emission from the grain boundaries as well as on grain boundary strain accommodation processes, such as grain boundary sliding. We studied the loading response in polycrystals of 40 nm grain size to a level of 9% strain and found that the non-planar grain boundaries favour dislocation emission as a deformation mechanism and hinder grain boundary sliding. This has stron...
Surface Texture and the Stress Concentration Factor for FRP Components with Holes

The influence of hole quality on the mechanical behavior of fiber reinforced laminates was studied. Holes were introduced in tensile specimens of a graphite/epoxy (Gr/Ep) laminate using an abrasive waterjet and commercial drills (diamond coated tungsten carbide twist drills or tungsten carbide drill-reamers). The machined surfaces were characterized using contact profilometry and the surface texture was used in estimating the effective stress concentration factor ( Kt). Utilizing the macroscopic stress concentration posed by the hole and Kt, the total stress concentration was estimated using the principle of superposition. The Gr/Ep specimens were then loaded in tension and acoustic emission was used to monitor the failure process. The apparent stress concentration factor (KtðappÞ) of the tensile specimens was determined from the ratio of tensile strengths of coupons without holes to that of specimens with holes. Based on results from tension tests the KtðappÞat first fiber failure ranged from 2.50 to 3.40. The stress concentration factors determined from experiments were within 6% of that predicted using superposition and Kt. Although the hole quality was dependent on the method of machining and drilling, results from this study confirm previous reports that there is no correlation between the surface texture and first fiber failure or ultimate tensile strength of Fiber Reinforced Plastics (FRPs) with open holes. Holes introduced using worn diamond coated twist drills exhibited the lowest surface roughness but resulted in a significant reduction in first fiber failure strength. Results from this study indicate that surface texture and Kt cannot be used for a reliable estimate of hole quality in FRPs, especially for holes produced with worn cutting tools.
Identification of Wild-Derived Inbred Mouse Strains Highly Susceptible to Monkeypox Virus Infection for Use as Small Animal Models

Infection with monkeypox virus (MPXV) causes disease manifestations in humans that are similar, although usually less severe, than those of smallpox. Since routine vaccination for smallpox ceased more than 30 years ago, there is concern that MPXV could be used for bioterrorism. Thus, there is a need to develop animal models to study MPXV infection. Accordingly, we screened 38 inbred mouse strains for susceptibility to MPXV. Three highly susceptible wild-derived inbred strains were identified, of which CAST/EiJ was further developed as a model. Using an intranasal route of infection with an isolate of the Congo Basin clade of MPXV, CAST/EiJ mice exhibited weight loss, morbidity, and death in a dose-dependent manner with a calculated 50% lethal dose (LD50) of 680 PFU, whereas there were no deaths of BALB/c mice at a 10,000-fold higher dose. CAST/EiJ mice exhibited greater MPXV sensitivity when infected via the intraperitoneal route, with an LD50 of 14 PFU. Both routes resulted in MPXV replication in the lung, spleen, and liver. Intranasal infection with an isolate of the less-pathogenic West African clade yielded an LD50 of 7,600 PFU. The immune competence of CAST/EiJ mice was established by immunization with vaccinia virus, which induced antigen-specific T- and B-lymphocyte responses and fully protected mice from lethal doses of MPXV. The new mouse model has the following advantages for studying pathogenesis of MPXV, as well as for evaluation of potential vaccines and therapeutics: relative sensitivity to MPXV through multiple routes, genetic homogeneity, available immunological reagents, and commercial production.
Human Monocytic Ehrlichiosis in Children

Background. Much of what is known about human monocytic ehrlichiosis (HME) is based upon studies with adult patients. Purpose. To review our experience with HME to better understand the epidemiology, clinical manifestations, and outcome of this disease in children. Methods. Demographic, clinical, and laboratory data were gathered after review of the medical records of patients identified with HME. Results. Twelve patients with an median age of 7.4 years (range, 7 months to 13.7 years) were identified with HME; 10 were white, 7 were male, and 10 were from hometowns of Conclusions. More information and long-term follow-up is required to understand the full spectrum of disease and morbidity associated with HME in children.
Motivation and barriers to participation in virtual knowledge‐sharing communities of practice

This paper reports the results of a qualitative study of motivation and barriers to employee participation in virtual knowledge‐sharing communities of practice at Caterpillar Inc., a Fortune 100, multinational corporation. The study indicates that, when employees view knowledge as a public good belonging to the whole organization, knowledge flows easily. However, even when individuals give the highest priority to the interests of the organization and of their community, they tend to shy away from contributing knowledge for a variety of reasons. Specifically, employees hesitate to contribute out of fear of criticism, or of misleading the community members (not being sure that their contributions are important, or completely accurate, or relevant to a specific discussion). To remove the identified barriers, there is a need for developing various types of trust, ranging from the knowledge‐based to the institution‐based trust. Future research directions and implications for KM practitioners are formulated.
The effect of atropine on bile secretion in dogs

Five mongrel dogs weighing 16 to ‘24 kilograms were prepared by cholecystectomy, ligation of the lesser pancreatic duct, insertion of a modified Thomas cannulall into the duodenum opposite the opening of the common bile duct, and insertion of another Thomas cannula into the stomach. Starting no sooner than three weeks postoperatively, experiments were performed no more often than three times weekly. Following a 16 hour fast, the gastric and duodenal cannulas were unstoppered and a polyethylene tube (Intramedic PE-190, O.D. 1.7 mm.) was inserted 4 to 6 cm. into the common bile duct and brought out through a hole in the cork used to occlude the duodenal cannula. Biliary and gastric secretions were collected in 15 minute samples throughout each experiment. Each dog received a continuous intravenous infusion at 66 ml. per hour from a calibrated peristaltic pump (Harvard Ap-
Injection of Xylazine mixed with heroin associated with poor health outcomes and HIV risk behaviors in Puerto Rico

Background and purpose Recent studies of injection drug users (IDUs) in Puerto Rico indicate widespread use of xylazine, also known as horse anesthesia (a veterinary analgesic sedative) mixed with heroin and cocaine. Research shows that xylazine contributes to more severe symptoms of withdrawal. This study explored the association between the use of heroin+xylazine and poor health outcomes, including hepatitis C and HIV risk among Puerto Rican drug users.
Perspectives on: The response to osmotic challenges

The purpose of the Perspectives in General Physiology is to provide a forum where scientific uncertainties or controversies, or important problems, are discussed in an authoritative, yet open manner. The Perspectives are solicited by the editors—often based on recommendations by members of the
Psychotherapy of Depression: Current Status, Future Directions

This article reviews recent studies of psychotherapy for treatment of depression. There is evidence that cognitive behavioral and interpersonal therapies are useful treatments for depressed outpatients, roughly comparable to antidepressant pharmacotherapy. Pharmacotherapy and psychotherapy do not, however, necessarily treat the same patients and there is emerging evidence of a neurobiological "boundary" that may delimit therapy response. Psychotherapy plus pharmacotherapy combinations appear particularly useful for outpatients with more severe, recurrent depressions. Depression-focused psychotherapy may also provide an important alternative to an indefinite course of maintenance pharmacotherapy for patients at high risk for recurrence.
Small Things Considered

As humans we live our lives in 24-hour increments dictated by a deeply rooted circadian rhythm that is also conserved in mammals, plants, fungi, and even cyanobacteria. Interestingly, there are also other temporal rhythm patterns—ranging from years and seasons to minutes and seconds. A curious example of the latter is that of the bacterium Paenibacillus dendritiformis, with its own internal clock of a mere 20 seconds.
Teaching Strategic Management to Nonprofit Students

Strategic management is a multidisciplinary concept with rich theoretical and empirical backgrounds that can inform decision making in organizations. Strategic management is defined as a blend of management practices that entails interpreting environmental conditions and designing systems to foster success (Miles & Snow, 1978). Applying strategic management concepts to the nonprofit sector is not a new idea (Kearns, 1994; Moore, 2000; Oster, 1995), but translating those concepts in a way that is instrumental to students in a nonprofit management class remains a challenge. In this paper, I introduce a framework to inform strategic thinking and suggest how to introduce these ideas to students studying nonprofit management. The four components of the framework are summarized and teaching strategies are reviewed.
Releasing the genomic RNA sequestered in the mumps virus nucleocapsid

In a negative-strand RNA virus, the genomic RNA is sequestered inside the nucleocapsid when the viral RNA-dependent RNA polymerase uses it as the template for viral RNA synthesis. It must require a conformational change in the nucleocapsid protein (N) to make the RNA accessible to the viral polymerase during this process. The structure of an empty mumps virus (MuV) nucleocapsid-like particle was determined to 10.4-A resolution by cryo-electron microscopy (cryo-EM) image reconstruction. By modeling the crystal structure of parainfluenza virus 5 into the density, it was shown that the α-helix close to the RNA became flexible when RNA was removed. Point mutations in this helix resulted in loss of polymerase activities. Since the core of N is rigid in the nucleocapsid, we suggest that interactions between this region of the mumps virus N and its polymerase, instead of large N domain rotations, lead to exposure of the sequestered genomic RNA. IMPORTANCE Mumps virus (MuV) infection may cause serious diseases, including hearing loss, orchitis, oophoritis, mastitis, and pancreatitis. MuV is a negative-strand RNA virus, similar to rabies virus or Ebola virus, that has a unique mechanism of viral RNA synthesis. They all make their own RNA-dependent RNA polymerase (RdRp). The viral RdRp uses the genomic RNA inside the viral nucleocapsid as the template to synthesize viral RNAs. Since the template RNA is always sequestered in the nucleocapsid, the viral RdRp must find a way to open it up in order to gain access to the covered template. Our work reported here shows that a helix structural element in the MuV nucleocapsid protein becomes open when the sequestered RNA is released. The amino acids related to this helix are required for RdRp to synthesize viral RNA. We propose that the viral RdRp pulls this helix open to release the genomic RNA.
Signal analysis for improved timing resolution with scintillation detectors for TOF PET imaging

Clinical TOF PET systems offer significantly degraded timing performance in comparison to that measured with small crystal geometries of the same scintillators. The usage of long, narrow crystal geometries is a major contributor to the degradation in system timing performance. We explore the effect of increased pixel length on timing performance of LaBr 3 [Ce], CeBr 3 and LYSO detectors. Using fast signal digitization we characterize the response of the detector to 511keV photons interacting at different depths. Systematic shift in time pickoff with interaction depth is shown to degrade the timing performance of long crystals. Collected light, signal shape and signal arrival time are shown to correlate with interaction depth. The depth dependence of detector response shows strong dependence on surface treatment, with finer surface treatment corresponding to reduced depth sensitivity. The correlated dependencies of time pickoff, energy and signal shape offer a method for recovering timing information lost due to interaction depth dispersion. An energy-based correction to the time pickoff is shown to improve detector timing resolution. The improvement in timing performance of thick detectors with single sided readout demonstrates the benefit of inclusion of additional signal information attainable by fast signal digitization.
Magnetic Resonance Imaging Provides Added Value to the Prostate Cancer Prevention Trial Risk Calculator for Patients With Estimated Risk of High-grade Prostate Cancer Less Than or Equal to 10.

Objective To determine the added value of prostate magnetic resonance imaging (MRI) to the Prostate Cancer Prevention Trial risk calculator. Methods Between January 2012 and December 2015, 339 patients underwent prostate MRI prior to biopsy at our institution. MRI was considered positive if there was at least 1 Prostate Imaging Reporting and Data System 4 or 5 MRI suspicious region. Logistic regression was used to develop 2 models: biopsy outcome as a function of the (1) Prostate Cancer Prevention Trial risk calculator alone and (2) combined with MRI findings. Results When including all patients, the Prostate Cancer Prevention Trial with and without MRI models performed similarly (area under the curve [AUC] = 0.74 and 0.78, P = .06). When restricting the cohort to patients with estimated risk of high-grade (Gleason ≥7) prostate cancer ≤10%, the model with MRI outperformed the Prostate Cancer Prevention Trial alone model (AUC = 0.69 and 0.60, P = .01). Within this cohort of patients, there was no significant difference in discrimination between models for those with previous negative biopsy (AUC = 0.61 vs 0.63, P = .76), whereas there was a significant improvement in discrimination with the MRI model for biopsy-naive patients (AUC = 0.72 vs 0.60, P = .01). Conclusion The use of prostate MRI in addition to the Prostate Cancer Prevention Trial risk calculator provides a significant improvement in clinical risk discrimination for patients with estimated risk of high-grade (Gleason ≥7) prostate cancer ≤10%. Prebiopsy prostate MRI should be strongly considered for these patients.
Parenting with Cancer I: Developmental Perspective, Communication, and Coping

An estimated 2.85 million children in the United States are living with a parent who has been diagnosed with cancer [1]. One-third of patients with breast cancer have dependent children [2]. For these parents, often their biggest worry is what impact their cancer will have on their children. Unfortunately, it is not common for parents to receive support from clinicians about these concerns. Our aim for this chapter is to familiarize clinicians with the common worries that parents have and empower them with strategies they can use to help support parents in this difficult time. The content discussed in this chapter is derived from the accumulated clinical experience of the team of clinicians comprising the Parenting at a Challenging Time (PACT) Program at the Massachusetts General Hospital (MGH) [3–21]. This chapter will present information that clinicians can use to take a parenting history, and to use a developmental perspective to guide parents at different stages of illness, including new diagnosis, treatment, survivorship, and end-of-life. Practical strategies for parenting challenges such as communication with children about illness, preserving family time, and harnessing support networks will be addressed so that clinicians are equipped with tools they can use to directly impact parents with cancer.