cssi/SciSciGPT-SciSciNet huggingface dataset:
Red Cell Mass: The Sleeping Beauty

Objective: One of the more neglected procedures in nuclear medicine is the radioisotopic determination of red cell mass (RCM) which is a valuable, cost-effective and easily performed procedure that helps establish the diagnosis of true polycythemia and distinguish it from relative erythrocytosis. Early diagnosis of polycythemia is important since a delay in treatment may be associated with serious complications. Methods: Whole blood (15–25 ml) was withdrawn and added to a small volume of ACD solution. Chromate-51 (1.48–1.85 MBq) was added to the blood with continuous mixing at 37°–39°C. After incubation, ascorbic acid (50–100 mg) was added to reduce the 51Cr to the trivalent state and stop it from binding to the red cells. The blood was reinjected into the patient and a whole-blood sample was drawn from a different vein at 45 min postinjection. The aliquots from the sample were washed three times in saline and then counted. Results: If the RCM exceeds the predicted mean normal value by more than 12.5%, the patient is thought to have a high-normal RCM, which may be a physiologic variable, transient anomoly or an early stage of an absolute polycythemia. Conclusions: Although many labaratories express the results of RCM in terms of ml/kg body weight, this approach may be inaccurate for the individual patient. Based on the literature, a more accurate and practical method of predicting and interpreting RCM is presented.
Contesting ideologies and the struggle for equality: Reconsidering the politics of education in South Africa

As international standards are continually publicized, countries across the globe have adapted educational policies to meet the demands of the global market, which has led to much emphasis on speci...
4.19 – Obesity and Appetite: Central Control Mechanisms

Societies all around the world are experiencing an increased prevalence of obesity. While increased fat mass alone is not an illness or disorder, in vulnerable individuals it can contribute to serious comorbidities. These include late-onset chronic diseases, such as diabetes, dementias, Alzheimer's disease, Parkinson's disease, cardiovascular disorders, and tissue malignancies. As the size of the aging population increases, obesity-driven late-onset chronic diseases are predicted to further dominate the attention of biomedicine and society at large. Guided by the notion that late-onset chronic diseases are the consequence of prolonged overworking of various tissues with genetic and epigenetic vulnerabilities, we assert that it is the cellular energy metabolism of different tissues that determines their health and longevity and, consequently, that of the entire organism. A major role in this process is played by central controllers of appetite and satiety, which determine the type and amount of fuels the cells utilize, including glucose, lipids, and amino acids.
Prevalence of Autonomic Dysfunction in Hospitalized Patients with Guillain‐ Barre Syndrome

Introduction There is a paucity of data regarding autonomic dysfunction (AD) in Guillain-Barre Syndrome (GBS). Concern exists regarding inpatient mortality risk in GBS. We sought to identify the prevalence of AD in GBS inpatients. Methods We used the Health Cost and Utilization Project Nationwide Inpatient Sample (NIS). GBS hospitalizations were identified by International Classification of Diseases, Ninth Revision, Clinical Modification code-357.0. Non-GBS hospitalizations were matched to these cases 4:1 by age and gender. Results We identified 2,587 GBS patients and a control population of 10,348 patients during 2010–2011. The most common manifestations of AD were: diarrhea/constipation (15.5%), hyponatremia (14.9%), syndrome of inappropriate antidiuretic hormone secretion (SIADH) (4.8%), bradycardia (4.7%), and urinary retention (3.9%). GBS patients had higher rates of reversible cardiomyopathy, syncope, tachycardia, and Horner syndrome (P < 0.0001). Conclusions AD most commonly manifests as diarrhea/constipation, SIADH/hyponatremia, and cardiac dysfunction. This report can help increase awareness of AD in GBS and aid in early identification, treatment, and mortality reduction. Muscle Nerve 56: 331–333, 2017
Application of microgrids in providing ancillary services to the utility grid

A microgrid optimal scheduling model is developed in this paper to demonstrate microgrid's capability in offering ancillary services to the utility grid. The application of localized ancillary services is of significant importance to grid operators as the growing proliferation of distributed renewable energy resources, mainly solar generation, is causing major technical challenges in supply-load balance. The proposed microgrid optimal scheduling model coordinates the microgrid net load with the aggregated consumers/prosumers net load in its connected distribution feeder to capture both inter-hour and intra-hour net load variations. In particular, net load variations for three various time resolutions are considered, including hourly ramping, 10-min based load following, and 1-min based frequency regulation. Numerical simulations on a test distribution feeder with one microgrid and several consumers/prosumers indicate the effectiveness of the proposed model and the viability of the microgrid application in supporting grid operation.
Abstract 245: Cardiac Stem Cells and Myocyte Regeneration in Diabetic Cardiomyopathy

The mammalian heart contains a pool of resident c-kit-positive cardiac stem cells (CSCs), raising questions concerning their role in the etiology of the diabetic myopathy. The objective of the current study was to determine whether the negative effects of diabetes on the adult heart are dictated by defects in CSC growth and lineage commitment. Type I insulin-dependent diabetes mellitus was induced in mice by streptozotocin administration. The kinetics of CSCs and cardiomyocytes was measured 3, 7, 10, 20, and 30 days after the onset of diabetes, by implementing a hierarchically structured cell system, which allows the quantitative analysis of the rate of cell turnover. The multiple variables required to apply this mathematical model were measured by confocal microscopy. They included first the number of CSCs, LCCs (lineage committed cells: myocyte progenitors-precursors), transit amplifying myocytes, and post-mitotic myocytes in the left ventricular (LV) myocardium. Additionally, the fraction of cycling CSCs and the length of their cell cycle were measured, together with the number of cardiomyocytes dying by apoptosis and necrosis. The specificity of labeling was documented by spectral analysis. The diabetic heart was characterized by a severe time-dependent loss in LV post-mitotic myocytes, dictated primarily by a defect in cell renewal. Under control conditions, 20% of myocytes were replaced per month in the adult mouse heart through activation, cell cycle reentry, and differentiation of CSCs. This value decreased sharply to 6%, 1.4%, 0.5%, 0.07%, and 0.05% at 3, 7, 10, 20 and 30 days after the administration of streptozotocin. The myocardium showed a progressive increase in old cardiomyocytes expressing the senescence-associated protein p16INK4a and p53. Importantly, the severe impairment in myocyte regeneration was coupled with an increase in LV end-diastolic pressure, and a decrease in LV systolic pressure, LV developed pressure, positive and negative dP/dt. Thus, our data indicate that the diabetic myopathy has to be viewed as a stem cell disease in which the decrease in the number of myocytes is a secondary event, resulting from defects in replication and lineage specification of cardiac stem cells.
Homework: Toward a critical ethnography of the university

Anthropologists have not systematically studied universities, and ethnographies of the university focus too much on student life. The literature on the Cold War university, broadly concerned with the relationship between power and knowledge, could serve as a model for a critical anthropology of the neoliberal university. Such an anthropology would investigate various important issues—including the changing character of public and private universities, the rise of casual labor and corporate employment practices on campus, the student-debt crisis, the university's role in increasing socioeconomic inequality and class immobility, and the relationship that such disciplines as economics and political science maintain with the state and capital. [university, neoliberalism, Cold War, class, debt, adjunct, United States] Los antropologos no han estudiado la universidad sistematicamente, y las etnografias de la universidad se enfocan demasiado en la vida estudiantil. La literatura sobre la universidad durante la Guerra Fria, generalmente centrada en la relacion entre el poder y el conocimiento, puede servir de modelo para una antropologia critica de la universidad neoliberal. Tal antropologia investigaria diferentes temas importantes —incluyendo la transformacion de las universidades publicas y privadas, el aumento del trabajo temporal y de las practicas corporativas de empleo en el campus universitario, la crisis de endeudamiento estudiantil, el rol de la universidad en el agravamiento de la desigualdad social y economica y la relacion que mantienen disciplinas como la economia y la ciencia politica con el estado y el capital—. [universidad, neoliberalismo, Guerra Fria, clase, deuda, profesores adjuntos, Estados Unidos]
Nutrition in the Peri-HSCT Period

Nutrition is an integral part of the supportive care of hematopoietic stem cell transplantation (HSCT) patients, and good nutritional status has been shown to improve outcomes in HSCT. However, providing proper nutritional support over the course of HSCT can prove to be challenging because many side effects associated with HSCT transplant negatively impact nutrition. This chapter details the factors that can lead to inadequate intake, poor GI absorption, and metabolic alterations. It also describes how the use of anthropometric assessments and energy need estimations play a key role in monitoring nutritional status and determining when further interventions are needed. Specific nutritional considerations in SOS/VOD and GvHD are discussed herein. Enteral and parenteral nutrition are compared: While enteral nutrition offers several advantages over total parenteral nutrition, there are situations in which full enteral nutrition is not feasible and parenteral nutrition is required to fulfill the patient’s caloric demands.
1674 Wikipedia workshop for health professionals: a hands-on course for extending the reach. engagement and impact of your occupational safety and health information

Aim of Workshop This workshop has been designed as an interactive session with 40 min of overview followed by a 2 hour hands on period of exercises that assist participants to design, manage, and track the use of edits to Wikipedia for increasing the engagement of wider audiences and extending the reach of OSH information including research findings, and guidance documents. Participants will gain practical skills concerning security protection, tracking of edits, evaluation, ROI, the culture of Wikipedia and become familiar with easy to use digital tools through online hands-on tutorials. Take away self-learning information will be provided to assist future reference. 1 Max Lum, 2 Thais Morata, 2 Garrett Burnett 1 National Institute for Occupational Safety and Health, Washington, D.C. USA 2 National Institute for Occupational Safety and Health, Cincinnati, Ohio. USA
'On Psilorhynchus sucatio and P. nudithoracicus', the sequel: Unnecessary and unscientific names lead to rapid synonymization and taxonomic time wasting-A response to Arunachalam et al. (2018).

The Torrent minnows Psilorhynchus sucatio (Hamilton, 1822) and P. nudithoracicus Tilak & Husain, 1980 are widespread throughout the Ganges-Brahmaputra drainage of India, Bangladesh and Nepal (Conway et al ., 2013). Like many widespread species, P. sucatio and P. nudithoracicus exhibit high levels of variation in morphological traits (particularly colour pattern) across their respective ranges and both have been described on more than one occasion by different authors examining material obtained from different parts of their range and/or unaware of earlier works. The distinctive, long-snouted torrent minnow Psilorhynchus sucatio was described by Hamilton (1822: 347) based on material from “Northern Bengal” (no types known). David (1953) introduced the name P. sucatio damodarai for a “variety” (=subspecies; ICZN, 1999; art. 45.6.4) of P. sucatio from the Damodar River (Jharkhand and West Bengal) and Tilak & Husain (1980) described the subspecies P. sucatio nudithoracicus based on material from Uttar Pradesh. In 1983, Rainboth described Psilorhynchus gracilis based on a smaller, more slender series of Psilorhynchus with a shorter snout than P. sucatio , collected in the tributaries of the Ganges and Brahmaptura rivers in northern Bangladesh. In 2013, Conway et al . argued that the names P. s. nudithoracicus and P. gracilis referred to the same species, placed the latter in the synonymy of the former, and elevated P. nudithoracicus to species status. As part of their redescription of P. sucatio and P. nudithoracicus , Conway et al . (2013) examined large series of specimens representing a range of body sizes (462 specimens of P. sucatio [13–67 mm SL] and 97 of P. nudithoracicus = [10–68 mm SL]), and encompassing almost the entire range of both species, provided multiple figures illustrating the important anatomical features of both species and, most importantly, provided clear diagnoses.
EPG waveform library for Graphocephala atropunctata (Hemiptera: Cicadellidae): Effect of adhesive, input resistor, and voltage levels on waveform appearance and stylet probing behaviors

Blue-green sharpshooter, Graphocephala atropunctata, is a native California vector of Xylella fastidiosa (Xf), a foregut-borne bacterium that is the causal agent of Pierce's disease in grapevines. A 3rd-generation, AC-DC electropenetrograph (EPG monitor) was used to record stylet probing and ingestion behaviors of adult G. atropunctata on healthy grapevines. This study presents for the first time a complete, updated waveform library for this species, as well as effects of different electropenetrograph settings and adhesives on waveform appearances. Both AC and DC applied signals were used with input resistor (Ri) levels (amplifier sensitivities) of 106, 107, 108 and 109 Ohms, as well as two type of adhesives, conducting silver paint and handmade silver glue. Waveform description, characterization of electrical origins (R versus emf components), and proposed biological meanings of waveforms are reported, as well as qualitative differences in waveform appearances observed with different electropenetrograph settings and adhesives. In addition, a quantitative study with AC signal, using two applied voltage levels (50 and 200 mV) and two Ri levels (107 and 109 Ohms) was performed. Intermediate Ri levels 107 and 108 Ohms provided EPG waveforms with the greatest amount of information, because both levels captured similar proportions of R and emf components, as supported by appearance, clarity, and definition of waveforms. Similarly, use of a gold wire loop plus handmade silver glue provided more definition of waveforms than a gold wire loop plus commercial conducting silver paint. Qualitative/observational evidence suggested that AC applied signal caused fewer aberrant behaviors/waveforms than DC applied signal. In the quantitative study, behavioral components of the sharpshooter X wave were the most affected by changes in Ri and voltage level. Because the X wave probably represents X. fastidiosa inoculation behavior, future studies of X. fastidiosa inoculation via EPG will require carefully determined instrument settings. An intermediate Ri level such as 108 Ohms with low voltage, AC applied signal, and gold wire loop plus silver glue is recommended as the best electropenetrograph methods to conduct future EPG studies of sharpshooter inoculation behaviors on Xf-resistant and -susceptible grapevine.
Repair of a Proximal Hamstring Rupture in a 14-Year-Old Patient: A Case Report:

Proximal hamstring tendon ruptures are rare in children and adolescents. The typical pediatric hamstring injury pattern involves an apophyseal avulsion fracture. We present the case of a 14-year-old male with a widely displaced ischial avulsion fracture and a bony fragment that was too small to allow for bony fixation. The patient presented with left-buttock pain and ecchymosis, as well as tenderness at the ischial tuberosity, following an injury sustained while running 2 weeks prior. Imaging demonstrated an avulsion of the proximal hamstrings with a 4-mm bony fragment, too small to allow for repair. The patient underwent primary repair using two 3-mm suture anchors. The bony fragment was not excised but incorporated into the repair. Although most proximal hamstring injuries in children and adolescents are treated non-operatively, operative treatment may confer a small but clinically important difference in rates of healing and return to play in adolescent athletes. This case demonstrates successful treatment of a proximal hamstring rupture with suture anchor fixation, which may be considered for pediatric and adolescent displaced avulsion fractures when the bony fragment is too small to allow for bony fixation.
Pricing Exotic Options

In this chapter we review some exotic optioins and show how they can be priced by Monte Carlo methods. Pricing options that depend on the price history of the underlying is a major theoretical challenge for analytical methods. In many cases Monte Carlo is the only practical solution.
FULL FIELD MAPPING OF TRANSIENT SURFACE ACOUSTIC WAVES USING HETERODYNE HOLOGRAPHIC INTERFEROMETRY

Heterodyne techniques applied to holographic interferometry provide an increase in sensitivity of nearly three orders of magnitude over classical holographic interferometry. Consequently, surface displacements on the order of Angstroms may be mapped with great precision using these techniques. When combined with pulsed holographic recording, it is possible to measure and map surface displacements associated with high speed transient phenomena such as acoustic waves.
Life from an RNA World

DNA may get most of the press, but in Life from an RNA World, Michael Yarus wants us to develop an appreciation for RNA. Yarus begins by introducing Darwin’s theory of natural selection while countering some of its more frequent critiques (i.e., the complexity of life cannot be adequately explained by natural selection). Importantly, he emphasizes that any mutation that does not adversely affect an organism’s fitness will not be selected against – this includes both overtly advantageous mutations as well as those that do not change anything. In this way, Yarus effectively lays the necessary groundwork for the relevance of the term “RNA world.”
Design and Implementation of a Low Cost Multi-Fingered Robotic Hand Using a Method of Blocks

The control of a mechanical robotic hand is plagued by an inability to derive accurate dynamic models of such a mechanism. The aspects of static and kinetic friction are major obstacles in the control of a mechanical hand. This paper presents a fuzzy-like based controller and its implementation for a low cost robotic hand. The controller has the ability to automatically regenerate the member set during the translation of any arbitrary joint in a robotic hand. A series of simulations has been conducted that illustrate the effectiveness of this controller for providing smooth translation independent of frictional forces. The implementation of the controller used here is based on an IBM compatible computer using a custom designed acquisition/conversion interface and a mechanical hand assembly. A hand with a progressively linked finger structure has been used for simplicity. The acquisition system used here allows bidirectional communication with the sensors and actuators of the hand. A series of experiments have been conducted which verify that the method of blocks was successful for controlling joint position. The simulation results include both fine movements, needed for dexterity, and gross movements that can be used for grasping. This robotic hand produces good results in a low cost implementation.
Mars: Formation and fate of a frozen Hesperian ocean

Abstract Late Hesperian-aged, circum-Tharsis floods interpreted to have formed by catastrophic release of groundwater cut large channels and debouched significant quantities of water into the northern lowlands of Mars. The floods are thought by many to have formed an ocean of significant volume and depth, encircled by contacts that have been interpreted as shorelines. Models of catastrophic groundwater release require a thick and continuous cryosphere with mean annual temperatures well below freezing much like those today. In this environment, the bodies of liquid formed by individual outflow events would have been very short lived, undergoing rapid freezing. We investigate the case where floods repeatedly flowed into the northern lowlands under climatic conditions that resemble those of the present day; the water from each flood froze in a geologically short period of time to form an ice layer. Successive ice layers accumulated to form an ocean-sized body of ice that filled the basin up to the -3650 contour, thereby enclosing a 110 m global equivalent layer (GEL) of water. Subsequent to the filling of the basin the ice slowly sublimated into the atmosphere to be lost to space or to accumulate in various surface and near-surface cold traps, such as the polar layered deposits. Where is this excess water today? The presence of the thick global cryosphere meant that only minor amounts of water were lost from the surface back into the global groundwater system. Approximately 20-30 m GEL of water is estimated to be at or near the surface today and exchanging with the atmosphere on geologic time scales (this includes the polar layered deposits and deposits elsewhere at depths less than approximately 80 m). Below the exchangeable reservoir is a non-exchangeable reservoir of unknown capacity. Present day loss rates to space fall far short of those needed to eliminate the mid-Hesperian ice ocean and those needed to cause the observed doubling of the D/H of the exchangeable reservoir since the mid-Hesperian. The discrepancy implies earlier loss rates must have been higher. Assuming a linear increase in loss rates because of the higher early EUV output of the Sun, we estimate that for a present inventory of 30 m GEL, 42 m GEL remains to be accounted for. Possibilities include greater dependence of losses of EUV than assumed, and enhanced losses during periods of high obliquity. In addition, large volumes of ice may be present near the surface at high latitudes outside the polar layered deposits as indicated by recent discoveries of ice layers in cliffs.
The United States Federal Energy Management Program lighting energy efficiency 2017 update and impacts

Abstract Lighting consumes a great deal of electrical energy in buildings, and the U.S. federal government is the largest single energy consumer in the United States. Therefore, the way that the U.S. federal government manages its lighting energy use is of great importance. One important way that energy use is managed is through Federal Energy Management Program (FEMP) energy efficiency requirements. However, there is not much literature on how these requirements are set and how to value the resulting savings. This paper documents the methodology used to develop these for the 2017 FEMP lighting update. A methodology for calculating the total benefits is presented that goes beyond site energy saved, and includes full fuel cycle energy savings, energy cost savings, emissions offset and monetized emissions costs. The results show total benefits of $33 million USD including 475 kilotons of carbon dioxide (CO2) offset under the low compliance scenario, $104 million USD including 1494 kilotons of CO2 offset under the medium compliance scenario, and $217 million USD including 3124 kilotons of CO2 offset under the high compliance scenario.
Phase II trial of sunitinib in patients with thymic epithelial tumors (TET).

7525 Background: There are no standard treatments for patients with advanced TETs after failure of platinum-based chemotherapy. In thymic carcinoma, KIT over-expression and mutations are found in a...
Karl Rahner’s Theological Logic, Phenomenology, and Anticipation:

This article provides an update on the logic undergirding Karl Rahner’s theology of mystery through a dialogue between Rahner and Jean-Luc Marion. It focuses on Rahner’s account of truth in Aquinas...
Utility of Blood Cultures in Pneumonia

Abstract Introduction Blood cultures are of limited utility in nonsevere community-acquired pneumonia, though routinely recommended for severe community-acquired pneumonia or health care-associated pneumonia due to perceived greater bacteremia risk, particularly with multidrug-resistant organisms. The utility of this practice is unknown. Methods In this observational cohort study, we abstracted data from medical records for consecutive hospitalizations for pneumonia by adults to an academic medical center from 2014-2015. The primary outcomes included bacteremia, multidrug-resistant organism bacteremia, and appropriate management changes attributed to culture results, stratified by pneumonia classification (nonsevere community-acquired pneumonia, severe community-acquired pneumonia, or health care-associated pneumonia) and likelihood the bacteremia was due to pneumonia vs another infection. We assessed the diagnostic test performance of one or more guideline-defined risk factors for bacteremia in nonsevere community-acquired pneumonia, for whom cultures are routinely recommended. Results Of 456 pneumonia hospitalizations, 30 (6.6%) had bacteremia, with a greater incidence in severe community-acquired pneumonia (14.7%) than nonsevere community-acquired pneumonia (7.8%) and health care-associated pneumonia (6.6%; P = .12). Seventeen bacteremia cases were likely due to pneumonia (3.7%). Only 2 (0.4%) had multidrug-resistant organisms (both health care-associated pneumonia), one of whom was due to pneumonia. Appropriate management changes occurred in 8 cases (1.8%; 7 de-escalation and 1 escalation of antibiotics); only 1 with bacteremia likely due to pneumonia (de-escalation). The one case of appropriate antibiotic escalation occurred in a patient with vancomycin-resistant Enterococcus unrelated to pneumonia. Having one or more guideline-defined risk factors did not identify bacteremia in nonsevere community-acquired pneumonia (positive likelihood ratio, 1.10; 95% confidence interval, 0.61-1.99). Conclusion Routine blood cultures in pneumonia have extremely low yield and utility irrespective of severity and risk.
Real World Objects: Conceptual Framework and University Library Consortium Study

Abstract Expanding libraries' repertoire of relevant materials is one of the most important areas of concern for librarians. Incorporation of objects into library collections is an ongoing practice for which librarians remain under-equipped. Having a common language to discuss less conventional library materials across specialization areas helps libraries provide patrons with access to valuable informational objects. In order to provide access and preservation for objects, libraries need a conceptual framework, which is developed here. An observational case study was conducted to inform the reader of the current landscape of objects in libraries by sampling the websites and catalogs of a university consortium utilizing definitions established in the framework. The qualitative data from this study will be presented in a table after the framework is explored. This paper has implications for informational objects in every academic subject area, as well as for ongoing services in makerspaces and media centers.
Feasibility of text-based symptom monitoring of ovarian and endometrial patients during treatment.

e18299Background: Unreported symptoms during cancer treatment can lead to poorer patient care and quality of life. Newer technology enables effective means to track patients’ health in real time. W...
The Role of a Mitochondrial Progesterone Receptor in the Growth of Breast Epithelial Cells

Abstract : This proposal proves a new molecular mechanism whereby progesterone via a mitochondrial receptor, named PR-M, influences the growth of breast cancer cells by enhancing cellular respiration. For this purpose we developed an RNAi assay to silence expression of PR-M in T47D breast cancer cells. We have demonstrated with this assay a decrease in PR-M transcript levels by qRT-PCR and a decrease in protein levels with western blot analysis. Functionally, we then demonstrated a decrease in progesterone/progestin induced mitochondrial membrane potential with silencing of PR-M expression. We then sought to determine the influence of PR-M silencing on the metabolomic pathway of these cells. These studies are still ongoing but initially suggest an increase in lipid catabolism with increased levels of acylcarnitines. These results suggest that progesterone increases cellular energy production by influencing fatty acid oxidation via a unique mitochondrial progesterone receptor. This provides a new mechanism whereby progesterone influences the growth and survival of breast cancer cells.
Education and Its Impact on Post-Heart Transplant Survival

Purpose The purpose of this study was to evaluate the effect of education on survival after orthotopic heart transplantation. Few studies have explored the impact of education from quality of life and adherence to medication and follow-up, thus a paucity of literature exists in understanding education and its impact on survival. Methods We evaluated the United Network for Organ Sharing (UNOS) registry for all adult heart transplant recipients (HTR) from 1999 to 2018. Recipients were grouped based upon their education level. We had two groups in our analysis: group 1 = education level > high school and group 2 = education level Results 30,999 heart transplant recipients (HTR) in our analysis, 29,877 in group 1 and 1,122 in group 2. Kaplan-Meier survival analysis of the patient survival time showed a higher survival in HTRs with education level above high school (Figure). Group 2 had 17% increased risk of death (p=0.0024). On adjusting for confounding variables including age, gender, status of HF, ethnicity, etc., education level continued to have a positive impact on survival. Lower episodes of rejection and better follow-up were also seen in HTR with an education level higher than high school. (data not shown) Conclusion Higher level of education has a positive impact on survival. This relationship can be explained by the notion that HTRs with higher education status may be better informed, more adherent to medication, and more likely to follow-up. All of these factors contribute to earlier identification of complications and fewer rejection episodes, ultimately leading to greater outcomes of survival. Further studies are required to further understand this complex relationship.
Resuscitative endovascular balloon occlusion of the aorta-Interest is widespread but need for training persists.

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) was first described in the 1950s, but early attempts at REBOA faced several technical challenges. Subsequent advances in endovascular technologies led to renewed interest in employing REBOA for management of hemorrhagic shock. However, REBOA usage remains infrequent, and indications for REBOA implementation remain unclear. We evaluated current opinions of trauma surgeons toward the use of REBOA for control of trauma-related hemorrhage and other causes of hemorrhagic shock. We hypothesize, that despite heightened interest in REBOA, implementation remains limited. A 25-question survey was thus created to query institutional and surgeon-specific training and practice patterns related to REBOA usage. The anonymized survey was distributed via email to a national trauma surgeon database and responses were recorded online. 992 subjects were invited to participate, of whom 31% (n=311) responded. Of these, 89% reported to be a trauma or acute care surgeon at a Level I trauma center, 50% reported practicing for ≥20 years. Two-thirds (68%) reported REBOA use at their institution, and the majority (59%) employed REBOA at least once. However, most (78%) performed ≤5 REBOA placements last year. Respondents supported REBOA usage in non-trauma causes of shock including gastrointestinal bleeding (60%), post-partum hemorrhage (83%), and ruptured abdominal aortic aneurysm (69%). A significant minority (20.3%) reported either only slight confidence or no confidence in their ability to deploy REBOA, and thus 21% reported being 'very interested' in attending a REBOA skills course.We thus conclude that REBOA has gained wide interest among trauma surgeons. However, placement remains infrequent with most providers placing a few annually. Educational courses are needed to disseminate the necessary skills for REBOA utilization.
Human hypertrophic cardiomyopathy mutation R712L suppresses the working stroke of cardiac myosin and can be rescued by omecamtiv mecarbil

Abstract Hypertrophic cardiomyopathies (HCMs) are the leading cause of acute cardiac failure in young individuals. Over 300 mutations throughout β-cardiac myosin, including in the motor domain, are associated with HCM. A β-cardiac myosin motor mutation (R712L) leads to a severe form of HCM. Actin-gliding motility of R712L-myosin is inhibited, despite near normal ATPase kinetics. By optical trapping, the working stroke of R712L-myosin was decreased 4-fold, but actin-attachment durations were normal. A prevalent hypothesis that HCM mutants are hypercontractile is thus not universal. R712 is adjacent to the binding site of the heart failure drug omecamtiv mecarbil (OM). OM suppresses the working stroke of normal β-cardiac myosin, but remarkably, OM rescues the R712L-myosin working stroke. Using a flow chamber to interrogate a single molecule during buffer exchange, we found OM rescue to be reversible. Thus, the R712L mutation uncouples lever arm rotation from ATPase activity and this inhibition is rescued by OM.
The Stellar Halos of Massive Elliptical Galaxies. III. Kinematics at Large Radius

We present a two-dimensional kinematic analysis out to ∼2-5 effective radii (R{sub e} ) of 33 massive elliptical galaxies with stellar velocity dispersions σ > 150 km s{sup –1}. Our observations were taken using the Mitchell Spectrograph (formerly VIRUS-P), a spectrograph with a large 107 × 107 arcsec{sup 2} field of view that allows us to construct robust, spatially resolved kinematic maps of V and σ for each galaxy extending to at least 2 R{sub e} . Using these maps, we study the radial dependence of the stellar angular momentum and other kinematic properties. We see the familiar division between slow and fast rotators persisting out to a large radius in our sample. Centrally slow rotating galaxies, which are almost universally characterized by some form of kinematic decoupling or misalignment, remain slowly rotating in their halos. The majority of fast-rotating galaxies show either increases in specific angular momentum outward or no change beyond R{sub e} . The generally triaxial nature of the slow rotators suggests that they formed through mergers, consistent with a 'two-phase' picture of elliptical galaxy formation. However, we do not observe the sharp transitions in kinematics proposed in the literature as a signpost of moving from centralmore » dissipationally formed components to outer accretion-dominated halos.« less
Successful postoperative analgesia with ilio-inguinal nerve block following sclerotherapy for a labial venous malformation.

Though ilio-inguinal nerve block has been commonly utilised in male urologic surgery, a single injection ilio-inguinal nerve block alone has not previously been reported for analgesia of the vulva. In this report, we describe the case of a 14-year-old girl undergoing sclerotherapy of a venous malformation affecting the labia majora and minora. After induction of anaesthesia, we performed an ultrasound-guided ilio-inguinal nerve block using a total volume of 15 ml of ropivacaine 0.2% with 1 μg.ml-1 dexmedetomidine which provided effective postoperative analgesia. Though the patient received intravenous analgesia intra-operatively and had an inpatient bed reserved in anticipation of severe postoperative pain, she required no further analgesia and was discharged home following 2 hours in the postoperative anaesthesia care unit. With the additional use of dexmedetomidine resulting in prolonged efficacy of the block, the patient reported effective postoperative relief for approximately 30 hours, solely using ibuprofen for pain relief. This case reminds clinicians that the ilio-inguinal nerve block may provide benefit not only for male urologic surgery but also for procedures involving the external female genitalia, with extended analgesia with the use of dexmedetomidine.
Racial Residential Segregation and Colorectal Cancer Mortality in the Mississippi Delta Region.

INTRODUCTION Few studies have examined the effects of racial segregation on colorectal cancer (CRC) outcomes, and none has determined whether rurality moderates the effect of racial segregation on CRC mortality. We examined whether the effect of segregation on CRC mortality varied by rurality in the Mississippi Delta Region, an economically distressed and historically segregated region of the United States. METHODS We used data from the US Census Bureau and the 1999-2018 Surveillance, Epidemiology, and End Results (SEER) program to estimate mixed linear regression models in which CRC mortality rates among Black and White residents in Delta Region counties (N = 252) were stratified by rurality and regressed on White-Black residential segregation indices and 4 socioeconomic control variables. RESULTS Among Black residents, CRC mortality rates in urban counties were a function of a squared segregation term (b = 162.78, P = .01), indicating that the relationship between segregation and CRC mortality was U-shaped. Among White residents, main effects of annual household income (b = 29.01, P = .04) and educational attainment (b = 34.58, P = .03) were associated with CRC mortality rates in urban counties, whereas only annual household income (b = 19.44, P = .04) was associated with CRC mortality rates in rural counties. Racial segregation was not associated with CRC mortality rates among White residents. CONCLUSION Our county-level analysis suggests that health outcomes related to racial segregation vary by racial, contextual, and community factors. Segregated rural Black communities may feature stronger social bonds among residents than urban communities, thus increasing interpersonal support for cancer prevention and control. Future research should explore the effect of individual-level factors on colorectal cancer mortality.
Three-Dimensional Echocardiographic Left Atrial Appendage Volumetric Analysis.

Background Left atrial appendage (LAA) echocardiographic assessment is difficult because of the complex shape and relatively small size of the LAA. Three-dimensional (3D) echocardiographic imaging can overcome the limitations of two-dimensional imaging. Pulsed-wave Doppler is the only currently standard LAA functional parameter. The aim of this study was to test a new approach for 3D echocardiographic volumetric analysis to obtain LAA ejection fraction (EF), its size and shape. Methods Transesophageal two-dimensional and 3D LAA images were prospectively obtained in 159 consecutive patients. LAA volumes were measured from 3D echocardiographic images using available software. Pulsed-wave Doppler was considered the reference value for LAA function and was used for comparison with LAA EF. Comparison with cardiac computed tomography was performed in a subgroup of 32 patients. Comparisons included linear regression and Bland-Altman analyses. Repeated measurements were performed to assess measurement variability. Results Nine patients were excluded because of suboptimal image quality (94% feasibility). Three-dimensional LAA calculated EF was in good agreement with LAA pulsed-wave measurements. Three-dimensional morphologic evaluation showed that 43% of the patients had “chicken wing,” 33% “cactus,” 19% “windsock,” and 5% cauliflower shapes. At the time of data acquisition, patients with atrial fibrillation had nonsignificantly larger LAA end-systolic and end-diastolic volumes, leading to lower calculated EFs. Three-dimensional echocardiographic LAA end-systolic volumes were in good agreement with cardiac computed tomography (r = 0.75), with small biases (mean, −2.5 ± 3.9 ml). Reproducibility was better for larger LAA volumes. Conclusions A novel 3D echocardiographic approach can determine the geometry, size, and function of the LAA. A new parameter, LAA EF, provides functional quantitation.
Markov Renewal Model of Linked Trip Travel Behavior

Previous models have been used in attempts to examine the linkages among activities in an urban area. Focusing upon linked trips made among the activities, these models have used Markov chain theory. However, the lack of time-dependence in such models has necessitated a nontemporal view of such trips. A Markov renewal model, however, includes this time dimension and, thus, can represent the time spent at each destination of a linked trip. This model is mathematically developed, and its application to urban travel modeling is reviewed.
Molecular Genetics of Chloroplast Ribosomes in Chlamydomonas Reinhardtii

The green alga Chlamydomonas reinhardtii is an ideal model in which to study the cooperation of nuclear and chloroplast genes in chloroplast ribosome biogenesis. At least six of the 33 r-proteins identified in the large subunit and 14 of the 31 r-proteins of the small subunit appear to be made in the chloroplast of C. reinhardtii, with the remainder being synthesized in the cytoplasm (Schmidt et al, 1983). Antibodies to 16 chloroplast r-proteins from C. reinhardtii have been examined for cross reactivity with specific r-proteins from Anabaena, E. coli and the chloroplast of spinach (Randolph-Anderson et al, 1989; Schmidt et al, 1984). To date 11 chloroplast-encoded r-protein genes have been identified in C. reinhardtii (Harris, 1992). The completely sequenced chloroplast genomes of tobacco, rice and the liverwort Marchantia have revealed an additional 12 r-protein genes which have not yet been located in Chlamydomonas (Shimada and Sugiura, 1991). With a few exceptions, the same set of r-protein genes is found in all chloroplast genomes examined in green algae and land plants (Palmer, 1991). The exceptions include the location of the rpl5 gene in the chloroplast genome of Chlamydomonas and certain other algae, the rpl21 gene in the chloroplast genome of Marchantia, and the rpsl6 gene in the chloroplast genome of higher plants but not in Marchantia.
Epidermal keratin messenger RNAs: a heterogeneous family.

Abstract A messenger RNA fraction from guinea-pig skin sediments on sucrose gradients at approx. 19 S and codes for keratin polypeptides in a messenger-dependent reticulocyte lysate system. Partial purification of this fraction was achieved by two cycles of chromatography on oligo(dT)-cellulose, followed by two cycles of sucrose gradient centrifugation. The identities of the protein products as keratins were established by co-electrophoresis on sodium dodecyl sulfate-polyacrylamide gels, by peptide mapping, and by co-electrophoresis on two-dimensional polyacrylamide gels. All of the epidermal keratin polypeptides which are present in vivo are synthesized in vitro under the direction of this messenger. Fractionation of the messenger indicates that each different polypeptide is the product of a single mRNA species, and that no keratin is formed by proteolytic processing of higher molecular weight species or by polymerization of smaller precursors. Post-translational changes such as phosphorylation, which are known to occur in vivo, cannot be identified in the reticulocyte lysate system. Translation of these keratin messenger species is strongly inhibited by 7-methylguanosine 5′-triphosphate, indicating that the molecules have a ‘capped’ 5′-terminus.
Systems analysis of the tricarboxylic acid cycle in Dictyostelium discoideum. I. The basis for model construction.

A steady-state model of the tricarboxylic acid cycle was constructed using a dynamic systems analysis computer program, METASIM. The model was based on radioactive tracer analyses which provided flux relationships and compartmented metabolite concentrations. Ten of the enzymes modeled were purified and characterized from Dictyostelium discoideum. Although experimentally determined enzyme mechanisms and constants were used in the model, Vmax values were found to be unreliable, i.e. they did not reflect enzyme activity in vivo. This value was therefore calculated as the only unknown in each enzyme kinetic equation and called Vvivo, to distinguish it from Vmax determined in vitro.
Treatment of Acute Relapses of Multiple Sclerosis

The evaluation and treatment of acute MS relapses has several aspects: Evaluation of the patient to determine whether the change in neurologic status represents a bona fide relapse and whether an intercurrent medical condition (eg, infection) may have triggered the relapse. MS relapses must be distinguished from transient day-to-day fluctuations in neurologic symptoms common in patients with MS, pseudo-relapses (worsening of pre-existing neurologic manifestations in association with a febrile illness or metabolic derangement), or progression (gradual worsening over months). Treatment of underlying infection or metabolic derangement if one is identified. Symptomatic therapy (eg, for vertigo from a brainstem relapse). A short course of corticosteroids to accelerate recovery and, in theory, improve degree of recovery. Rehabilitation to develop compensatory strategies (eg. for gait impairment and promote functional recovery). Reconsideration of long-term disease therapy: the occurrence of a relapse may indicate the need to initiate or alter disease-modifying therapy. MRI on a case-by-case basis: typically it is not necessary to perform MRI to diagnose an acute relapse. MRI is sometimes obtained in the setting of a suspected acute relapse to rule-out an alternative explanation for the change in neurologic status. It also may be useful to assess the level of disease activity to guide the decision to initiate or alter disease therapy.
Revising and Reviewing Documents

Chances are that you’ll create some documents on your own, but for other documents, you’ll need to work with other people—either sharing the documents on a network or via the Internet or using e-mail to send the documents back and forth.
You're Fired! The C ause and Effec t of Managerial Turnover on Team Performance: A Study of Major League Baseball

This study aims at answering two questions: Why does a manager get fired and what impact does dismissing the field manager of a baseball team have on subsequent team performance? It is hypothesized that a manager will be fired when a team is performing poorly. If this is the case, a new manager should improve performance; however, the fans and chief executives do not recognize the other potential factors that lead to meager performance. Is it realistic to believe that getting rid of a manager will automatically lead to increased winning percentages in a team? The decision to focus on management within sports was made based on the fact that sports foster an environment in which there is a huge cultural, social and economic impact on today‘s society (Audas et al., 1999). In one-way or another, a majority of the population can relate to the sporting world. In addition, team performance is easily measured in baseball making the data needed for this study accessible. This article is available in The Park Place Economist: http://digitalcommons.iwu.edu/parkplace/vol18/iss1/14