cssi/SciSciGPT-SciSciNet huggingface dataset:
Endoscopic sphincterotomy-induced hemorrhage: treatment with multipolar electrocoagulation

Multipolar electrocoagulation is an effective therapy for patients with endoscopic evidence of active upper gastrointestinal hemorrhage or a non-bleeding visible vessel in an ulcer crater. The use of this therapy for endoscopic sphincterotomy-induced hemorrhage has not been reported previously. This prospective study attempted to assess the efficacy of multipolar electrocoagulation in patients with endoscopic sphincterotomy-induced hemorrhage not responding to conservative and/or other endoscopic measures. Nine patients with moderate or severe bleeding following endoscopic sphincterotomy (one, immediate; eight, delayed 12 to 144 hours) were treated by multipolar electrocoagulation. Prior to endoscopic therapy with multipolar electrocoagulation, the mean hematocrit drop was 14.5% and the mean number of packed red blood cells transfused was 4.8 units. Complete hemostasis was achieved in eight (89%) patients. Re-bleeding occurred in two (25%) and was controlled by a second course of multipolar electrocoagulation in one in whom it was attempted. There were no complications or deaths from multipolar electrocoagulation and surgical therapy was avoided in all nine patients. We recommend proceeding with multipolar electrocoagulation (if possible) after injection therapy and/or balloon tamponade fail to control the hemorrhage and before considering angiographic or surgical intervention.
Ion source modeling and design at PRIME Lab

Abstract The design and ion optics of a new high intensity cesium ion source and sample changer being built at PRIME Lab will be discussed. The ion source is based on the Center for Accelerator Mass Spectrometry (CAMS) at Lawrence Livermore National Laboratory design and the sample changer is based on a sample changer developed at Chalk River Nuclear Laboratories in Canada. The ion optics are being modeled using Simion 7.0, which iteratively solves Laplaces' equation. Simion 7.0 does not require cylindrical symmetry so the effects of non-symmetric components, in particular the sample insertion rod and immersion lens can be explored. Other aspects that are being modeled are small shifts in the position of the ionizer as it is heated; shape of the immersion lens; distance from the cathode to the immersion lens; distance from the ionizer to the cathode; the effect of voltage (relative to the cathode) on the immersion lens; the shape of the cathode; and space charge.
The Effects of Listeners' Control of Speech Rate on Second Language Comprehension

Speech rate has been identified as a major factor affecting listening comprehension. Despite the common-sense belief that slower rates facilitate listening comprehension, empirical studies have yielded contradictory findings. A review of previous studies of speech rate and listening comprehension revealed methodological problems. Using a novel approach and recent developments in computer technology, this study examined the issue of speech rate and listening comprehension from a different perspective. By giving the control of speech rate to the students and by attending to individuals instead of groups, this study concluded that (a) when given control, students' listening comprehension improved and (b) improved listening comprehension was achieved by slowing down the speech rate.
Cellular lithium uptake as a probe of sodium channels in the rat heart: Modulation of lithium uptake by tetrodotoxin, verapamil, anthopleurin-A, isoproterenol and external stimulation

Since the initial rate of sodium influx by the perfused rat heart is too rapid to measure accurately, lithium was used as an analogue for sodium. 10 mM lithium was added to the perfusate, and the rate of cellular lithium uptake was found to be linear for 5 min and was equal to 1.29 +/- 0.26 mumol/5 min/g wet wt heart. The cell took up lithium ions 36% as fast as sodium ions, but after 30 min the cellular/perfusate ratio of lithium reached nine times the cellular/perfusate ratio of sodium. Lithium uptake was inhibited 43% by 1 microM tetrodotoxin (TTX) (P greater than 0.05) and 47% by 1.4 microM verapamil (P less than 0.05). External stimulation abolished the inhibition by TTX. Anthopleurin-A (60 nM) stimulated TTX-sensitive lithium uptake by 118% (P less than 0.01) and stimulated verapamil-sensitive lithium uptake by 213% (P less than 0.01) but did not stimulate verapamil-sensitive manganese uptake. Anthopleurin-A also increased dP/dt by 164% (P less than 0.01). Isoproterenol (150 nM) stimulated both verapamil-sensitive lithium uptake (72%, P less than 0.01) and verapamil-sensitive manganese uptake (128%, P less than 0.01). This suggests that there are both TTX-sensitive and verapamil-sensitive sodium channels in the rat heart.
Immediate-Early Genes and Chronic Pain

T he hypothesis presented by Zimmerman and Herdegen is an intriguing one. Both clinical and experimental evidence suggest that prolonged nociceptive input or neural injury may produce chronic foci of hyperactivity within the central nervous system (CNS). These foci may be responsible for the development of chronic pain. If this is indeed the case, such long-term changes must be related to changes in the production of proteins and the expression of genes. Immediate-early genes (lEGs) make an excellent theoretical bridge between the initial inciting event and the production of longterm changes in the CNS. Zimmerman and Herdegen propose seven lines of evidence to support the hypothesis that lEG induction is related to long-term changes within the CNS and to the development of chronic pain:
Endomyocardial biopsy and selective coronary angiography are low-risk procedures in pediatric heart transplant recipients: results of a multicenter experience.

Background No prior reports documenting the safety and diagnostic yield of cardiac catheterization and endomyocardial biopsy (EMB) in heart transplant recipients include multicenter data. Methods Data on the safety and diagnostic yield of EMB procedures performed in heart transplant recipients were recorded in the Congenital Cardiac Catheterization Outcomes Project database at 8 pediatric centers during a 3-year period. Adverse events (AEs) were classified according to a 5-level severity scale. Generalized estimating equation models identified risk factors for high-severity AEs (HSAEs; Levels 3–5) and non-diagnostic biopsy samples. Results A total of 2,665 EMB cases were performed in 744 pediatric heart transplant recipients (median age, 12 years [interquartile range, 4.8, 16.7]; 54% male). AEs occurred in 88 cases (3.3%), of which 28 (1.1%) were HSAEs. AEs attributable to EMB included tricuspid valve injury, transient complete heart block, and right bundle branch block. Amongst 822 cases involving coronary angiography, 10 (1.2%) resulted in a coronary-related AE. There were no myocardial perforations or deaths. Multivariable risk factors for HSAEs included fewer prior catheterizations ( p = 0.006) and longer case length ( p p Conclusions In the current era, cardiac catheterizations involving EMB can be performed in pediatric heart transplant recipients with a low AE rate and high diagnostic yield. Risk of HSAEs is increased in early post-transplant biopsies and with longer case length. Longer time since heart transplant is associated with non-diagnostic EMB samples.
Jet Noise Source Distribution from Far-Field Cross Correlations

HIS paper contains the development of a technique to determine the relationship between the unknown source correlation function and the correlation of the far-field acoustic pressure. Based on LighthilPs equivalent source model, a Fredholm integral equation relating the unknown source-correlation function to the far-field pressure correlation is derived. Analytically, this is a statistically inverse radiation problem. It is assumed that the source is distributed over an axisymmetric region, that is, a cylindrical region in an axisymmetric jet. This technique was developed for an application in the study of the installation effects for static and moving jets, since the spatial and temporal distribution of the source relative to the jet were required.l In the literature, several techniques are available, for example, Refs. 2 through 5, which provide information of the spatial distribution only or suitable to reproduce far-field intensity without body effects. In addition, further information can be extracted from the source field if obtained from the far-field two-point correlation.6'7 Contents Consider the propagation of an acoustic wave generated by turbulence in the jet confined in a region D in space, Fig. 1; the sound pressure in the spectral or frequency domain satisfies
InAs-GaSb superlattices — synthesized narrow-gap semiconductors and semimetals

The salient features of InAs-GaSb and In1-xGaxAs-GaSb1-yAsy superlattices are summarized, including theoretical treatments, MBE growth, characterization of materials and heterojunctions, optical absorption, Shubnikov-de Haas measurements, and observation of semiconductor-semimetal transitions.
Reflections of occupational therapists working as members of a research team

Aim: This qualitative study explored the effects of clinician participation in a randomised clinical trial on subsequent practice. Method: Eight occupational therapists responded to open-ended questions delivered by email about their reflections on participating in clinical research and its impact on their practice. Qualitative analysis uncovered therapists’ motivation to participate in research, what they felt that they gained, and if and how research participation influenced practice. Results: Clinicians learned about research, practice, and their own clinical biases through their participation in clinical research. Conclusion: Our findings suggest that participation in research may contribute to shrinking the research-practice gap.
Soybean oil-isosorbide-based waterborne polyurethane-urea dispersions.

A series of soybean oil-based amide diol-isosorbide waterborne polyurethane-urea (PUU) dispersions have been successfully prepared, with amounts of isosorbide ranging from 0 to 20 wt % of the total diol content. The thermal and mechanical properties of the resulting PUU films have been characterized by dynamic mechanical analysis, differential scanning calorimetry, thermogravimetric analysis, and mechanical testing. The results reveal that the glass transition temperature is increased with increased amounts of isosorbide, and the mechanical properties are improved significantly with the incorporation of isosorbide. For example, the Young's modulus increases from 2.3 to 63 MPa and the ultimate tensile strength increases from 0.7 to 8.2 MPa when the isosorbide amount is increased from 0 to 20 wt %. The thermal stability decreases slightly with the incorporation of isosorbide. This work provides a new way of utilizing biorenewable materials, such as isosorbide and a soybean oil-based amide diol, for the preparation of high-performance polyurethane-urea coatings.
Modifying the risk of atypical antipsychotics in the treatment of juvenile-onset schizophrenia.

Importance to the field: This review summarizes the evidence for use of typical and atypical antipsychotic medications for the treatment of juvenile-onset schizophrenia. We highlight the risks and benefits of antipsychotic agents for youth with this disorder, paying special attention to weight gain and metabolic effects, an area of specific concern within child and adolescent psychiatry.Areas covered in this review: We describe the seriousness of juvenile-onset schizophrenia and its impact on long-term functioning, noting that pharmacological treatment remains the standard of care for this disorder. We focus on weight gain and metabolic effects associated with atypical agents and review strategies to modify risks associated with these agents.What the reader will gain: We summarize strategies for attenuating the risk of weight gain for youth on atypical antipsychotics, including what is known about nutritional counseling and exercise programs as well as pharmacotherapy with adjunctive weight loss agents.Ta...
Perceptions of Parental Awareness of Emotional Responses to Stressful Life Events

There is a need to better understand family processes related to recovery from past stressful life events. The present study aimed to investigate links between perceptions of parental awareness regarding stressful life events, continued event-related rumination, and current symptoms of depression. Students at a diverse, urban university completed a life events checklist and a semi-structured interview regarding family processing of stressful life events, as well as self-report measures of event-related rumination and depression. Results indicated that perceptions of mothers' and fathers' awareness of sadness regarding stressful life events as well as mothers' and fathers' verbal event processing predicted symptoms of event-related rumination and depression. Results support the inclusion of perceptions of parental awareness in the understanding of how emerging adults continue to cope with past stressful life events.
Quadratic programming with quadratic constraints

A program with a quadratic objective function and quadratic constraints is considered. Two duals to such programs are provided, and an algorithm is presented based upon approximations to the duals. The algorithm consists of a sequence of linear programs and programs involving the optimization of a quadratic function either unconstrained or constrained to the nonnegative orthant. An example involving production planning is presented.
The study of oliguric and polyuric acute renal failure

Abstract A simple laboratory model for acute renal failure (ARF) induced by warm ischemia was studied in an attempt to elucidate the mechanisms for oliguria. It was observed that unilateral warm ischemic injury with contralateral nephrectomy or bilateral warm ischemic injury resulted in a high output (polyuric) form of ARF. In contrast, when unilateral warm ischemic injury was induced and the contracolateral kidney was left intact, low output (oliguric) ARF was observed in the injured kidney. Ligation of the ureter of the normal contralateral kidney reversed the oliguric state. Replacement of the urine output by the normal kidney with Ringer's lactate solution failed to reverse the low output state in the injured kidney. Reinfusion of the urine itself from the intact contralateral kidney, while increasing urine output, did not entirely alleviate the oliguric phenomenon in the injured kidney during a 24-hr period during which the animals underwent volume expansion. Although the basis for the oliguria in the injured kidney when functioning renal tissue remains is unclear, indirect evidence suggests that the excretion of a diuretic factor in urine by the normal kidney contributes to the oliguria observed in the injured kidney.
Research standards for promotion and tenure in information systems

What constitutes excellence in information systems research for promotion and tenure? This is a question that is regularly addressed by members of promotion and tenure committees and those called upon to write external letters. While there are many elements to this question, one major element is the quality and quantity of an individual's research publications. An informal survey of senior Information Systems faculty members at 49 leading U.S. and Canadian universities found 86 percent to expect three or more articles in elite journals. In contrast, an analysis of publication performance of Ph.D. graduates between the years of 1992 and 2004 found that approximately three individuals in each graduating year of Ph.D.s (about 2 percent) published 3 or more articles in a set of 20 elite journals within 6 years of graduation. Only 15 individuals from each graduating year (11 percent) published one or more articles. As a discipline, we publish elite journal articles at a lower rate than Accounting, yet our promotion and tenure standards are higher, similar to those of Management, Marketing, and Finance. Thus, there is a growing divergence between research performance and research standards within the Information Systems discipline. As such, unless we make major changes, these differences will perpetuate a vicious cycle of increasing faculty turnover, declining influence on university affairs, and lower research productivity. We believe that we must act now to create a new future, and offer recommendations that focus on the use of more appropriate standards for promotion and tenure and ways to increase the number of articles published.
The Purification and Properties of the A Protein of Lactose Synthetase

Abstract The A protein of lactose synthetase has been purified from bovine skim milk. After chromatography on DEAE-Sephadex and cellulose phosphate, the active fractions were purified to constant specific activity by chromatography on columns of α-lactalbumin attached covalently to Sepharose. The A protein was bound specifically to this column in buffers containing glucose and was eluted by omitting glucose from the developing buffer. These highly purified preparations are inactivated easily but can be stabilized by N-acetylglucosamine or by bovine serum albumin. The final preparation was shown to be homogeneous by gel electrophoresis in sodium dodecyl sulfate, by ultracentrifugal analysis, and by gel filtration on 4% Agarose in the presence of 6 m guanidine hydrochloride. The fully denatured enzyme was found to have a molecular weight between 40,000 and 44,000, values in good agreement with a molecular weight of 42,900, which was estimated for the native enzyme by sedimentation in sucrose density gradients. These molecular weight measurements suggest that the enzyme is not composed of subunits. Amino acid and carbohydrate analyses indicate that the enzyme is a glycoprotein with about 12% by weight carbohydrate.
Cross-Topic Learning for Work Prioritization in Systematic Review Creation and Update

Abstract Objective Machine learning systems can be an aid to experts performing systematic reviews (SRs) by automatically ranking journal articles for work-prioritization. This work investigates whether a topic-specific automated document ranking system for SRs can be improved using a hybrid approach, combining topic-specific training data with data from other SR topics. Design A test collection was built using annotated reference files from 24 systematic drug class reviews. A support vector machine learning algorithm was evaluated with cross-validation, using seven different fractions of topic-specific training data in combination with samples from the other 23 topics. This approach was compared to both a baseline system, which used only topic-specific training data, and to a system using only the nontopic data sampled from the remaining topics. Measurements Mean area under the receiver-operating curve (AUC) was used as the measure of comparison. Results On average, the hybrid system improved mean AUC over the baseline system by 20%, when topic-specific training data were scarce. The system performed significantly better than the baseline system at all levels of topic-specific training data. In addition, the system performed better than the nontopic system at all but the two smallest fractions of topic specific training data, and no worse than the nontopic system with these smallest amounts of topic specific training data. Conclusions Automated literature prioritization could be helpful in assisting experts to organize their time when performing systematic reviews. Future work will focus on extending the algorithm to use additional sources of topic-specific data, and on embedding the algorithm in an interactive system available to systematic reviewers during the literature review process.
Evaluating the statistical significance of biclusters

Biclustering (also known as submatrix localization) is a problem of high practical relevance in exploratory analysis of high-dimensional data. We develop a framework for performing statistical inference on biclusters found by score-based algorithms. Since the bicluster was selected in a data dependent manner by a biclustering or localization algorithm, this is a form of selective inference. Our framework gives exact (non-asymptotic) confidence intervals and p-values for the significance of the selected biclusters.
The Challenges of High-Confidence Medical Device Software

Bringing new safety-critical medical devices to market faces several major challenges, but modeling and formal methods can facilitate this process from early system requirements verification to platform-level testing to late-stage clinical trials.
Galactose elimination as a liver function test in goats.

Summary Two hundred to 230 mg./kg. body weight of galactose was injected into the jugular vein of goats and the disappearance of galactose from the blood was measured over a 30 min. period. The mean half-times for elimination were 16·4 min. in female goats and 17·9 mitt, in castrated male goats. Although reproducibility of the disappearance curves in the same goat and between goats is good, at least 20% of the dose is excreted in the urine during the test. Up to 35% is excreted within 90 min. of injection. Thus the validity of the procedure as a test of liver function where water homeostasis and/or renal function may fluctuate is very doubtful. The liver may play a quantitatively smaller part in the removal of galactose from the blood in the goat, than in man. If a renal threshold for galactose exists in the goat it is a very low one.
Change in Angina Symptom Status After Acute Myocardial Infarction and Its Association With Readmission Risk: An Analysis of the Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (TRIUMPH) Registry.

Background Angina is common both before and after myocardial infarction (MI). Whether the change in angina status within the first 30 days after MI is associated with subsequent readmission and angina persistence is unknown. Methods and Results We studied 2915 MI patients enrolled at 24 hospitals in the Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients’ Health Status (TRIUMPH) registry. Angina before and 30 days after MI was assessed with the Seattle Angina Questionnaire. Patients were divided into angina‐free pre‐ and post‐MI (−/−), resolved angina (+/−), new angina (−/+), and persistent angina (+/+) groups. Multivariable proportional hazards and hierarchical modified Poisson models were performed to assess the association of each group with all‐cause readmission, readmission for MI or unplanned revascularization, and angina persistence at 1 year. Overall, 1293 patients (44%) had angina before their MI and 849 (29%) reported angina within 30 days of discharge. Patients with post‐MI angina were more likely to be younger, nonwhite, and uninsured. Compared with patients who were angina‐free pre‐ and post‐MI, 1‐year all‐cause readmission risks were significantly higher for patients with persistent angina (hazard ratio [HR], 1.35; 95% CI 1.06–1.71) or new angina (HR, 1.40; 95% CI, 1.08–1.82). At 1 year, angina was present in 22% of patients and was more likely if angina was persistent (HR, 3.55; 95% CI, 3.05–4.13) or new (HR, 3.38; 95% CI, 2.59–4.42) at 30 days compared with patients who were angina‐free pre‐ and post‐MI. Conclusions Post‐MI angina, whether new or persistent, is associated with higher likelihood of readmission. Prioritizing post‐MI angina management is a potential means of improving 1‐year outcomes.
Introduction and Acknowledgments

Among the common rock-forming minerals, perhaps no major group is as poorly understood as the amphibole group. This is because doublechain silicates are very complicated with regard to crystal structure, chemical variation and natural occurrence. Consequently, although many amphibole species have been distinguished, mostly on a chemical basis, it is difficult to relate the geologic occurrences to physical and chemical principles.
Handbook of Mobile Communications: 30. Mobile Games and Entertainment

Mobile communication has become mainstream and even omnipresent. It is arguably the most successful and certainly the most rapidly adopted new technology in the world: more than one of every three people worldwide possesses a mobile phone. This volume offers a comprehensive view of the cultural, family, and interpersonal consequences of mobile communication across the globe. Leading scholars analyze the effect of mobile communication on all parts of life, from the relationship between literacy and the textual features of mobile phones to the use of ringtones as a form of social exchange, from the "aspirational consumption" of middle class families in India to the belief in parts of Africa and Asia that mobile phones can communicate with the dead. The contributors explore the ways mobile communication profoundly affects the tempo, structure, and process of daily life around the world. They discuss the impact of mobile communication on social networks, other communication strategies, traditional forms of social organization, and political activities. They consider how quickly miraculous technologies come to seem ordinary and even necessary--and how ordinary technology comes to seem mysterious and even miraculous. The chapters cut across social issues and geographical regions; they highlight use by the elite and the masses, utilitarian and expressive functions, and political and operational consequences. Taken together, the chapters demonstrate how mobile communication has affected the quality of life in both exotic and humdrum settings, and how it increasingly occupies center stage in people's lives around the world.
Chapter 2 Making Sense: Stein’s Radical Epistemology

This chapter compares two texts that reveal Stein’s model of explanation. Voris treats the lecture “Composition As Explanation” (1926) as a cautionary text for critics because, in place of the equivalence of terms her title suggests, the lecture reproduces conventions of explanation including analogy and example. By contrast, “An Elucidation” (1923) expresses Stein’s findings in landscape writing and expresses her radical epistemology. Voris demonstrates that Stein is making sense of explanation itself and offers critics an innovative model. Her alternative is a dynamic compositional event that results when language is not limited to the logic of predication. A curious time sense emerges, combining the contradictory depictions of this period: landscape as duration and as ceaseless flux. Consistent with the radical empiricism of William James and Gilles Deleuze, Stein’s radical epistemology is a useful framework for interpretation.
Electrochemical Characterization of Galvanic Couples Under Saline Droplets in a Simulated Atmospheric Environment

This work investigates galvanic corrosion of titanium and martensitic stainless steel alloys coupled with UNS A92024 and UNS A97075 in a simulated atmospheric environment under electrolyte droplets. Alloys were evaluated electrochemically in bulk electrolytes of varied chemistries relevant to atmospheric electrolytes. Microelectrodes and micro-salt bridges were utilized to probe droplet chloride concentration under various humidity levels. Droplets were monitored during polarization scans to track electrochemical behavior and disentangle the events occurring during cathodic polarization in small drops with microelectrodes. Predicted galvanic corrosion rates from polarization scans for bulk and droplet electrolytes were compared.
Online Shaping of a Drug’s Periodic Administration Trajectory for Efficacy Maximization

This paper addresses the problem of shaping nicotine’s administration trajectory for maximization of its cardio-accelerating effects. Pharmacologists explain the interaction of this drug with the human body using a two-compartment model. One compartment, in the model, describes the concentration dynamics of nicotine in the plasma, while the other captures buildup of resistance to the drug’s effects. Researchers have employed this model and shown that a periodic delivery trajectory results in an average efficacy level superior to the best achievable steady-state performance. The literature has also studied finding the optimal shape of this periodic drug delivery trajectory and offers different solution methods. While the existing methods depend on the exact knowledge of the drug’s model, the human body’s metabolism varies from one patient to another, affecting the shape of the maximum efficacy trajectory. This creates a need for online solution methods. This paper addresses this issue by developing two online solution algorithms for the problem: 1) a model-reference, gradient-descent-based regulator that considers parameter uncertainty and 2) a model-free extremum seeking control scheme. The latter controller is shown to converge very slowly. Still, it is included in this paper as a completely model-free option and as a benchmark. In contrast, the first controller converges more quickly, and its convergence to the optimal solution is proved using Floquet theory. Finally, this paper demonstrates the performance of the two methods in a simulation study, and also compares them against the deterministic solutions from the literature.
Perspective on Continuum Modeling of Mesoscale/ Macroscale Phenomena

The attempt to model or predict the inelastic response or permanent deformation and failure observed in metals dates back over 180 years. Various descriptions of the post elastic response of metals have been proposed from the fields of physics, materials science (metallurgy), engineering, mechanics, and applied mathematics. The communication between these fields has improved and many of the modeling efforts today involve concepts from most or all of these fields. Early engineering description of post yield response treated the material as perfectly plastic — the material continues to deform with zero additional increase in load. These models became the basis of the mathematical theory of plasticity and were extended to account for hardening, unloading, and directional hardening. In contradistinction, rheological models treated the finite deformation of a solid similar to the deformation of a viscous fluid. In many cases of large deformation, rheological models have provided both adequate and accurate information about the deformed shape of a metal during many manufacturing processes. The treatment of geometric defects in solid bodies initiated within the mathematical theory of elasticity, the dislocation, introduced as an incompatible “cut” in a continuum body. This resulted in a very large body of literature devoted to the linear elastic study of dislocations, dislocation structures, and their interactions, and has provided essential information in the understanding of the “state” of a deformed material.
Failure of efforts to contain costs of care after colorectal procedures: Nationwide trends in length of stay, costs and post-acute care utilization

Abstract Background This study aims to report trends in healthcare resource utilization and costs after colorectal surgery in the US. Methods From all-payer inpatient data, patients who were discharged after elective colorectal procedures (2002–2011) were identified. Trends in postoperative hospital stay, costs and post-acute care were evaluated. Results Of 251,583 included patients, median length of stay was 6 days. Trends over time suggested a progressive reduction in hospital stay after surgery until 2008 after which there was an increase (6.6 days in 2002, 5.9 days in 2008 and 6.1 days in 2010). Costs (peak:2011, $51,731) and post-acute care (peak:2011, 19.4%) continued to increase throughout. Conclusions While length of stay over the last decade reduced, a further reduction may not be feasible. Meanwhile, inpatient costs as well as the use of post-acute care programs have continued to rise. Healthcare planning needs to focus on patients who cannot be discharged early, and more comprehensively evaluate the interplay between length of stay, readmissions, inpatient and post-acute care utilization if we are to contain overall healthcare costs.
Transcriptomic analysis of gene signatures associated with sickle pain

Pain is a hallmark feature of sickle cell disease (SCD). Recurrent and unpredictable acute pain due to vaso-oclussive crises (VOC) is unique to SCD; and can be superimposed on chronic pain. To examine the mechanisms underlying pain in SCD, we performed RNA sequencing of dorsal root ganglion (DRG) of transgenic sickle mice and their age-matched control mice expressing normal human hemoglobin A, at 2 and 5 months of age. Sickle and control mice of both ages were equally divided into hypoxia/reoxygenation (to simulate VOC) and normoxia treatment, resulting in eight groups of mice. Each group had at least six mice. RNA isolated from the DRG was sequenced and paired-end 50 bp sequencing data were generated using Illumina's HiSeq 2000. This large dataset can serve as a resource for examining transcriptional changes in the DRG that are associated with age and hypoxia/reoxygenation associated signatures of nociceptive mechanisms underlying chronic and acute pain, respectively.
Alternatives for Dynamic Web Development Projects

Dennis provides a starting point for developers seeking solutions for their web application development requirements.
Towards the plant metabolome and beyond

Plant metabolomics — the high-throughput analysis of plant compounds — is an invaluable tool for understanding plant metabolism. Recent innovations in mass-spectrometry-based analyses are shedding light on the structure and regulation of biosynthetic pathways and the temporal and spatial dynamics of the plant metabolome. Methods for network-wide analysis are increasingly showing that the textbook view of the regulation of plant metabolism is often incomplete and misleading. Recent innovations in small-molecule analysis have created the ability to rapidly identify and quantify numerous compounds, and these data are creating new opportunities for understanding plant metabolism and for plant metabolic engineering.
Intelligibility, Oral Communication, and the Teaching of Pronunciation

A proper understanding of intelligibility is at the heart of effective pronunciation teaching, and with it, successful teaching of speaking and listening. Far from being an optional 'add-it-on-if-we-have-time' language feature, pronunciation is essential because of its tremendous impact on speech intelligibility. Pronunciation dramatically affects the ability of language learners to make themselves understood and to understand the speech of others. But not all elements of pronunciation are equally important. Some affect intelligibility a great deal, while others do not. With a strong emphasis on classroom practice and how pronunciation teaching can be more effectively approached in different teaching contexts, this book provides an important resource for pronunciation researchers, with a distinctly practical focus. It shows how intelligibility research informs pronunciation teaching within communicative classrooms, enabling language teachers to incorporate intelligibility findings into their teaching. Professionals interested in oral communication, pronunciation, and speech perception will find the book fascinating.
Weaponizing Twitter Litter: Abuse-Forming Networks and Social Media

Instead of liberating us from the biases of the educated among us, the Internet has saddled us with the biases of the unreasoned among us.
Integrated electronics for control of large-area piezoelectric arrays for adjustable optics

Abstract Direct integration of electronics on piezoelectrics is attractive for large array transducers and adjustable optics systems; it allows for the possibility of reconfigurability as well as active surfaces with a greatly reduced number of electrical connections. In this work, lead zirconate titanate (PZT) piezoelectric films were co-processed with ZnO thin film transistors to explore the possibility of direct integration. The sputter deposited PZT on glass had good electrical properties on large area (cm2) electrodes, with a dielectric constant of >1200 with a loss of approximately 2% and an average remanent polarization of greater than >23 μC/cm2. Fabrication of arrays of thin film transistors (TFTs) processed directly on top of PZT pixels for use in an adaptive optics system was demonstrated. Photoreactive benzocyclobutene (BCB) electrically isolated the ZnO TFTs, deposited using plasma enhanced atomic layer deposition, from the electrodes on the piezoelectric cell. Flex cables were bonded to the wafer using anisotropic conductive film (ACF) to connect the gates (row control) and the drains (column control) in the TFT array to a control box. It was found that when actuating the PZT cells through the TFT array with 5–10 V, the glass mirror experienced approximately 700–1000 nm of deflection, adequate for figure control in future X-ray mirrors.
Inhibition of the Transsulfuration Pathway Affects Growth and Feather Follicle Development in Meat-Type Chickens.

Cysteine is a nonessential amino acid in poultry nutrition. Poultry diets are deficient in cysteine, but the bird’s cysteine need is met through the transsulfuration pathway (TSP) where homocysteine is converted to cysteine: a process catalyzed by cystathionine β-synthase (CBS) and cystathionine γ-lyase (CTH). Cysteine is also a major component of keratinized protein found in feathers, but the extent to which cysteine is involved in feather and skin development in poultry is unknown. We randomly assigned chicks to control and treatment (control diet plus 100 mg/kg body weight of propargylglycine which is an inhibitor of CTH) diets. The thickness of skin layers, primary feather follicle parameters, growth, and mRNA expression of CBS and CTH were measured. Inhibition of TSP corresponded with the upregulation of liver mRNA of both CBS and CTH and reduction in growth from 35 to 40 days of age. The epidermis thickness, feather follicle length, and diameter were reduced from 10 to 40 days of age. Incorporation of cysteine into keratinized protein may be more sensitive to the level of available cysteine than into nonkeratinized proteins. Thus, disruption of the TSP could affect the thermoregulatory ability of the bird.
The Association of Aspirin Use with Survival Following Radical Cystectomy

Purpose: Aspirin may have antineoplastic properties through the inhibition of inflammatory cytokines that regulate cell proliferation, angiogenesis and apoptosis. In patients with nonmuscle invasive bladder cancer aspirin use has been linked to a reduced risk of recurrence. We evaluated the association of aspirin with survival following radical cystectomy.Materials and Methods: A total of 1,061 patients underwent radical cystectomy at our institution between 2007 and 2016, of whom 461 (43%) were aspirin users at the time of surgery. Survival estimates were assessed by the Kaplan-Meier method. The Cox proportional hazards model was applied to evaluate associations between patient features and survival.Results: Median followup after radical cystectomy among survivors was 4.2 years (IQR 2–6.2). During this time 442 patients died, including 331 of bladder cancer. Aspirin users were significantly older, more likely to have a history of cardiovascular disease and diabetes, and more likely to use metformin or st...
Implementing Advanced Internet Search Engines

Current Internet search tools, e.g., Yahoo! and AltaVista, are relatively simple. Their reliance on indexed files containing keyword-to-IP-address mappings limits them to handling low-level keyword queries. Future Internet search tools will be much more sophisticated (see, e.g., Arens et al., 1993; Iuaba et al., 1995; Liu and Pu, 1997). They will employ metadata repositories to support content-based querying and distributed, persistent agents performing a variety of functions, including data gathering, metadata extraction, data mining and information fusion. Users could create swarms of persistent search agents that would range the Internet in response to sophisticated queries, keeping them informed about updates and terminating only on explicit user directives. Clearly, such search engines will pose serious threats to security and privacy.
Using Video Feedback to Improve Horseback-Riding Skills.

This study used video feedback to improve the horseback-riding skills of advanced beginning riders. We focused on 3 skill sets: those used in jumping over obstacles, dressage riding on the flat, and jumping position riding on the flat. Baseline consisted of standard lesson procedures. Intervention consisted of video feedback in which a recorded attempt at the target behavior was immediately shown to the rider and the instructor. The rider and instructor reviewed the video while the instructor delivered feedback. After the lesson, experimenters scored riding position according to checklists that corresponded to each skill. For all participants, video feedback increased their correct riding skills.
Nueve adivinanzas de Estambul. (Colección Milwitzky)

From the extensive collection of Eastern Judeo-Spanish oral literature, brought together by William Milwitzky, in Yugoslavia, Rumania, Bulgaria, Greece, and Turkey, in 1898-1899, nine previously unedited riddles from Istanbul are edited and studied in detail. Their solutions refer to the bolt (of a door) (1); the burro (2); the horse (and its harness) (3-4); the bucket (of a well) (5); the ear (6a-6b); the writing pen (7); the radish (8); the sun (9). In regard to their possible origins, four of these riddles have close peninsular analogues (1, 5, 9; possibly also 3); two others obviously originated in the Balkans (6, 8); while the origin of the other three cannot be determined (2, 4, 7). Despite the limited number of riddles collected by Milwitzky, they would seem to confirm the tradition's culturally eclectic character, already noted in Rabbi Menahem Azuz's small collection (see note 6).
Barriers to cancer clinical trial participation among Native elders.

Objectives American Indians/Alaska Natives are underrepresented in clinical trials. Therefore, they must participate in large-scale cancer clinical trials to ensure the generalizability of trial results and improve their access to high-quality treatment. Our goal was to identify factors that influenced participation in cancer clinical trials among American Indians/Alaska Natives. Methods An anonymous survey that assessed willingness to participate in a hypothetical cancer clinical trial and how 37 factors influenced their willingness to participate was administered to 112 older American Indian/Alaska Native adults at an annual social event honoring elders. Responses ranged from one (definitely would not participate) to five (definitely would participate). Data were analyzed with ordinal logistic regression. Results Factors that most strongly increased willingness to participate were having a lead researcher of Native descent, having a study physician with experience treating American Indians/Alaska Natives, personal experience with the cancer being studied, family support for participation, and belief/hope that the study would result in new treatments. Factors that decreased willingness to participate most strongly were living far from the study site and a high risk that confidentiality could be breached. Conclusions Our results identify conventional and culturally unique barriers to research participation among older American Indians/Alaska Natives. These data emphasize the need to establish partnerships with Native communities and include American Indian/Alaska Native and culturally competent professionals in research efforts. Of equal importance are disseminating information about clinical trials and recognizing the role of family in decisionmaking in this group.
Quantitation of 17-OH-Progesterone (OHPG) for Diagnosis of Congenital Adrenal Hyperplasia (CAH)

Most (90%) cases of congenital adrenal hyperplasia (CAH) are due to mutations in the steroid 21-hydroxylase gene (Cyp21). CAH due to 21-hydroxylase deficiency is diagnosed by confirming elevations of 17-hydroxyprogesterone (OHPG) and androstenedione (ANST) with decreased cortisol. By contrast, in two less common forms of CAH, due to 17-hydroxylase or 11-hydroxylase deficiency, OHPG and ANST levels are not significantly elevated and measurement of progesterone (PGSN) and deoxycorticosterone (DOC), respectively are necessary for diagnosis. Since 21-hydroxylase deficiency is more common and results in remarkable increase in OHPG, this test is most commonly ordered compared to other steroid intermediates. Various methods are used in clinical laboratories for the analysis of OHPG in serum or plasma but mass spectrometric methods are considered gold standard method.
Evaluation of the Lower Eyelids and Midface

The scenarios under which patients are evaluated for lower eyelid and midface surgery vary based on the specialty of the surgeon.
Special Orientation Methods

This chapter deals briefly with the universal stage and the spindle stage. As noted in Chapter 2, both these instruments have specialized applications that go far beyond routine crystal identification. Detailed discussions of their use may be found in the various books and papers referenced, particularly Muir (1981) for the universal stage and Bloss (1981) for the spindle stage. This chapter will also serve to suggest the pertinence of these instruments to problems of crystal identification, and to describe their manipulation for a few routine procedures.
Post-Mortem Evaluation of Potentially Survivable Hemorrhagic Death in a Civilian Population.

Background Although the survivability of military extremity hemorrhage is well documented, equivalent civilian data are limited. We analyzed statewide autopsy records in Maryland to determine the number of hemorrhagic deaths that might have been potentially survivable with prompt hemorrhage control. Similar analyses of battlefield deaths led to life-saving changes in military medical practice. Study Design This is a retrospective study of decedent records. The objective is to estimate the number of hemorrhagic deaths that might have been prevented by prompt placement of an extremity tourniquet. Maryland autopsy records from 2002 to 2016 were selected using the following search terms: amputation, arm/arms, avulsion, exsanguination, extremity/extremities, leg/legs. The records were analyzed by applying a checklist of previously developed military criteria to characterize deaths as potentially survivable or nonsurvivable with prompt use of a tourniquet. Suicides and decedents less than 18 years old were excluded. The study did not use information about living participants. Two expert reviewers independently evaluated and scored the death records. Deaths were classified as either potentially survivable or nonsurvivable. A third reviewer broke any ties. Results There were 288 full autopsy records included in the final analysis. Of the eligible decedents reviewed during the 14-year period, 124 of 288 had potentially survivable wounds; 164 had nonsurvivable wounds. Conclusions Over the 14-year study interval, 124 Maryland decedents—an average of 9 per year—might have been saved with prompt placement of a tourniquet. If extrapolated, approximately 480 people in the US might be saved per year. These results provide evidence to support educating and equipping the public to provide bleeding control.
Young Hispanic and Non-Hispanic Children’s Fundamental Motor Competence and Physical Activity Behaviors

The purpose of this study was to examine the associations between fundamental motor skills (FMS; including locomotor and object-control skills), moderate-to-vigorous physical activity (MVPA), and s...