cssi/SciSciGPT-SciSciNet huggingface dataset:
Considerations of Fractionated Stereotactic Radiotherapy in Patients with Dentures

Stereotactic radiotherapy (SRT) using the Gill–Thomas–Cosman (GTC) repeat localizer allows for accurate and reproducible daily setup. The formation of a custom dental plate presents a challenge. We present the problems of utilizing this technique in patients with dentures. Twenty-seven patients were referred for fractionated SRT:15 patients had natural teeth and 12 patients had dentures. The comfort and accuracy of daily setup were compared in patients with and without dentures. All patients with natural teeth experienced no discomfort during the treatment and no interruptions were needed. The patients with dentures were categorized into four grades (I–IV), according to the need for medical intervention and necessity for treatment interruption. Two were Grade IV and SRT could not be delivered; alternate treatments were used (one had SRS and one had external RT). Three patients were Grade I, where there was minimal discomfort. Grade II discomfort was encountered in three patients helped by gingival anesthetic cream with no treatment interruption and Grade III was encountered in the remaining four where the treatment was interrupted for variable periods. The mean inaccuracy of daily setup was 2.1 ± 3.0 mm in patients with dentures and 0.48 ± 0.57 mm in patients with natural teeth. The use of the GTC frame is well tolerated and reproducible in patients with natural teeth. Variable degrees of discomfort are noted in patients with dentures and is well correlated to the degree of accuracy and reproducibility. Using other fixation devices, avoiding the oral cavity may be an alternative in patients with Grade III and IV discomfort.
Using Neurofeedback and Mindfulness Pedagogies to Teach Open Listening

Abstract Neurofeedback is a technology that allows users to observe, reflect, and learn from their brain wave activity. It is often used in conjunction with mindfulness to help people obtain a more open state of mind. While both neurofeedback and mindfulness have been employed in support of neoliberal goals, they can be used for more socially responsible ones. Specifically, when integrated with scholarship on listening, mindfulness and neurofeedback can enrich an open listening pedagogy. Open listening can be understood as a narrative fusion of horizons (Ivor Goodson & Scherto Gill, 2011). This fusion occurs when two people’s narrative horizons, consisting of a set of narratives and standpoints, come together while preserving the multiplicity, fluidity, complexity, and intersectionality of each. Interdisciplinary scholarship, including neurological and biological perspectives, shows that a listener’s embodied dynamics, specifically fear and attachment, contribute to closed listening, in which the listener tries to preserve the stability and fixity of their own narratives. An open listening pedagogy that incorporates mindfulness and neurofeedback responds to the need for interdisciplinary understandings of the body-social relationships that are part of closed listening. Neurofeedback and mindfulness further help students practice ways of relating to their bodies that are conducive to open listening.
Cost comparison of surveillance for HPV-positive versus HPV-negative oropharyngeal cancer.

e18908Background: The rise of human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma (OPSCC) is changing current treatment paradigms. While significant efforts have been direct...
Gluten and Functional Abdominal Pain Disorders in Children

In children, functional gastrointestinal disorders (FGIDs) are common at all ages. Consumption of certain foods, particularly gluten, is frequently associated with the development and persistence of FGIDs and functional abdominal pain disorders (FAPDs) in adults and children. However, this association is not well defined. Even without a diagnosis of celiac disease (CD), some people avoid gluten or wheat in their diet since it has been shown to trigger mostly gastrointestinal symptoms in certain individuals, especially in children. The incidence of conditions such as non-celiac gluten sensitivity (NCGS) is increasing, particularly in children. On the other hand, CD is a chronic, autoimmune small intestinal enteropathy with symptoms that can sometimes be mimicked by FAPD. It is still unclear if pediatric patients with irritable bowel syndrome (IBS) are more likely to have CD. Abdominal, pain-associated FGID in children with CD does not seem to improve on a gluten-free diet. The threshold for gluten tolerance in patients with NCGS is unknown and varies among subjects. Thus, it is challenging to clearly distinguish between gluten exclusion and improvement of symptoms related solely to functional disorders.
Paper Origami‐Inspired Design and Actuation of DNA Nanomachines with Complex Motions

Significant progress in DNA nanotechnology has accelerated the development of molecular machines with functions like macroscale machines. However, the mobility of DNA self-assembled nanorobots is still dramatically limited due to challenges with designing and controlling nanoscale systems with many degrees of freedom. Here, an origami-inspired method to design transformable DNA nanomachines is presented. This approach integrates stiff panels formed by bundles of double-stranded DNA connected with foldable creases formed by single-stranded DNA. To demonstrate the method, a DNA version of the paper origami mechanism called a waterbomb base (WBB) consisting of six panels connected by six joints is constructed. This nanoscale WBB can follow four distinct motion paths to transform between five distinct configurations including a flat square, two triangles, a rectangle, and a fully compacted trapezoidal shape. To achieve this, the sequence specificity of DNA base-pairing is leveraged for the selective actuation of joints and the ion-sensitivity of base-stacking interactions is employed for the flattening of joints. In addition, higher-order assembly of DNA WBBs into reconfigurable arrays is achieved. This work establishes a foundation for origami-inspired design for next generation synthetic molecular robots and reconfigurable nanomaterials enabling more complex and controllable motion.
Propagating patterns of activity across motor cortex facilitate movement initiation

Abstract Voluntary movement initiation involves the modulation of neurons in the primary motor cortex (M1) around movement onset. Yet, similar modulations of M1 activity occur during movement planning when no movement occurs. Here, we show that a sequential spatio-temporal pattern of excitability based on beta oscillation amplitude attenuation propagates across M1 prior to the initiation of reaching movements in one of two oppositely oriented directions along the rostro-caudal axis. Using spatiotemporal patterns of intracortical microstimulation, we find that reaction time increases significantly when stimulation is delivered against but not with the natural propagation orientation suggesting that movement initiation requires a precise recruitment pattern in M1. Functional connections among M1 units emerge at movement onset that are oriented along the same rostro-caudal axis but not during movement planning. Finally, we show that beta amplitude profiles can more accurately decode muscle activity when these patterns conform to the natural propagating patterns. These findings provide the first causal evidence that large-scale, spatially organized propagating patterns of cortical excitability and activity are behaviorally relevant and may be a necessary component of movement initiation.
TREATMENT WITH BIOLOGIC THERAPY IN PSORIASIS IS ASSOCIATED WITH A REDUCTION IN CORONARY ARTERY INFLAMMATION, ASSESSED BY PERIVASCULAR FAT ATTENUATION INDEX

Perivascular fat attenuation index (FAI) is a novel imaging biomarker that assesses coronary inflammation by mapping spatial changes of perivascular fat composition on computed tomography angiography (CCTA). Psoriasis is a chronic inflammatory skin disease associated with increased vascular
ISOLATED SYSTOLIC HYPERTENSION IS MORE PREVALENT IN PERSONS WITH DIABETES

Prior studies have demonstrated that the prevalence of isolated systolic hypertension (ISH) increases with age. We examined whether the presence of diabetes mellitus (DM) relates to an earlier increased prevalence of ISH. We studied adults with untreated hypertension (HTN), defined as a systolic
Perceptions of Panethnicity among Asian American High School Students

(1996). Perceptions of Panethnicity among Asian American High School Students. Amerasia Journal: Vol. 22, No. 2, pp. 109-126.
Size Matters: Toward a Contingency Theory of Diversity Effects on Performance

This study examines the diversity-performance link by focusing on two types of diversity—gender and functional—in the context of governing boards of 24 quasi-government agencies in Korea over 16 ye...
The Stupid as Narrative Dissonance

Different from a surprising plot twist, narrative dissonance pertains to narrative syntax. Like music, where dissonance is evident even to the completely untrained ear, narrative dissonance marks a narrative encounter that “feels off,” and in that sense stupid. The authors take Cartoon Network’s Adventure Time as their primary example. Episodes might end abruptly, feeling incomplete. The program also draws from Bakhtinian principles, including what is termed, “adventure time”—internal-diegetic moments where characters embark on various quests, but these individuated episodes have no bearing on the overarching narrative. And these quests, because they have no bearing on the narrative writ-large, might be considered stupid. The chapter also reviews the videogame Gone Home, and its reliance on spatialized storytelling, which strike some as dissonant—stupid.
Reply to: Beta-blockade for the treatment of cardiac arrest due to ventricular fibrillation or pulseless ventricular tachycardia: A systematic review and meta-analysis

Abstract Background Refractory ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) refers to cases that do not respond to traditional Advanced Cardiac Life Support measures and are associated with significantly lower survival rates. Beta-blockade may improve outcomes by protecting against the deleterious effects associated with epinephrine’s beta-receptor effect. Objective This systematic review and meta-analysis aimed to evaluate whether beta-blockade compared with control improved outcomes among patients in cardiac arrest due to refractory VF/VT. Methods PubMed, Scopus, CINAHL, LILACS, the Cochrane databases, Google Scholar, and bibliographies of selected articles were assessed on September 2nd, 2019 for all studies evaluating beta-blockade versus control groups in patients with cardiac arrest due to refractory VF/VT. PRISMA guidelines were followed. Data were dual extracted into a predefined worksheet and quality analysis was performed with the Cochrane Risk of Bias in Non-randomised Studies of Interventions tool. Data were summarized and a meta-analysis was performed assessing temporary and sustained return of spontaneous circulation (ROSC), survival-to-admission, survival-to-discharge, and survival with a favorable neurologic outcome. Results Three studies (n = 115 patients) were selected for final inclusion. Beta-blockade was associated with an increased rate of temporary ROSC (OR 14.46; 95% CI 3.63–57.57), sustained ROSC (OR 5.76; 95% CI 1.79–18.52), survival-to-admission (OR 5.76; 95% CI 1.79–18.52), survival-to-discharge (OR 7.92; 95% CI 1.85–33.89), and survival with a favorable neurologic outcome (OR 4.42; 95% CI 1.05–18.56). Overall risk of bias ranged from moderate-to-severe, which was primarily influenced by selection of participants and potential confounding. This study was registered with PROSPERO (CRD42019126902). Conclusions The data suggest that beta-blockade may be associated with improved outcomes ranging from ROSC to survival with a favorable neurologic outcome. Future randomized controlled trials are needed to further evaluate this intervention in refractory VF/VT.
Phase I dose-escalation study of PSMA-targeted alpha emitter 225Ac-J591 in men with metastatic castration-resistant prostate cancer (mCRPC).

5560Background: Antibodies (Abs) or small molecules can target PSMA with different biodistribution. Certain sites of PSMA expression (e.g. salivary/lacrimal glands, kidneys, small bowel) are not ac...
Association of habits, triggers, glycaemic control, routines, stress and impulse control among emerging adults with type 1 diabetes.

Aim Glycaemic control is known to be poor among emerging adults with type 1 diabetes, but the reasons for this are poorly understood. Examination of diabetes self-management-related habits, triggers and daily routines within the context of impulse control and perceived daily stress may provide increased understanding of glycaemic control during this transitional period. This study examined associations among checking blood glucose (CBG) habits, eating a meal (EAM) habits and glycaemic control within the context of CBG triggers, daily routines, impulse control and perceived daily stress, in emerging adults with type 1 diabetes. Methods A cross-sectional convenience sample of 100 emerging adults with type 1 diabetes was recruited from an outpatient diabetes care clinic for this age group. Participants self-reported frequency of CBG and EAM habits, CBG triggers, daily routines, perceived daily stress and impulse control. Glycaemic control values were obtained from medical records. Path analysis was performed. Results Better glycaemic control was positively and significantly associated with greater frequency of CBG and EAM habits. CBG habits were positively and significantly associated with CBG triggers and EAM habits. EAM habits were positively and significantly associated with daily routines. Conclusions We suggest interventional research targeting CBG and EAM habits and daily routines to examine the impact on diabetes self-management and glycaemic control.
In vitro and in vivo activity of topotecan against human B-lineage acute lymphoblastic leukemia cells

Topotecan [(S)-9-dimethylaminomethyl-10-hydroxycamptothecin hydrochloride; SK&F 104864-A, NSC 609699], a water soluble semisynthetic analogue of the alkaloid camptothecin, is a potent topoisomerase I inhibitor. Here we show that topotecan stabilizes topoisomerase I/DNA cleavable complexes in radiation-resistant human B-lineage acute lymphoblastic leukemia (ALL) cells, causes rapid apoptotic cell death despite high-level expression of bcl-2 protein, and inhibits ALL cell in vitro clonogenic growth in a dose-dependent fashion. Furthermore, topotecan elicited potent antileukemic activity in three different severe combined immunodeficiency (SCID) mouse models of human poor prognosis ALL and markedly improved event-free survival of SCID mice challenged with otherwise fatal doses of human leukemia cells at systemic drug exposure levels that can be easily achieved in children with leukemia.
Black and White Differences in Colorectal Cancer Screening and Screening Outcomes: A Narrative Review

Racial disparities in colorectal cancer incidence are widely documented. There are two potential mechanisms for these disparities: differences in access to screening, including screening follow-up, and differences in underlying risk of colorectal cancer. We reviewed the literature for evidence of these two mechanisms. We show that higher colorectal cancer incidence in blacks relative to whites emerged only after the dissemination of screening and describe evidence of racial disparities in screening rates. In contrast to the strong evidence for differences in colorectal cancer screening utilization, there is limited evidence for racial differences in adenoma prevalence. In general, black and white patients who are screened have similar adenoma prevalence, though there is some evidence that advanced adenomas and adenomas in the proximal colon are somewhat more likely in black than white patients. We conclude that higher rates of colorectal cancer incidence among black patients are primarily driven by lower rates of colorectal cancer screening. Our findings highlight the need to increase black patients' access to quality screening to reduce colorectal cancer incidence and mortality.
Perioperative Pain Control

SUMMARY Pain control is one of the cornerstones upon which the specialty of oral and maxillofacial surgery has built its reputation. Our patients expect us to exhibit a high level of expertise in the management of all phases of pain associated with commonly performed procedures. A review of the pain response and most common modalities of pain control has been presented, along with the indications for specific methods of treatment. With increased technology, as well concerted effort by clinicians and basic scientists, it may be possible to devise drug combinations capable of producing significant analgesia while minimizing toxicity and untoward effects. As new agents and technologies are identified, their application to this surgical specialty should be determined.
Biophysical characterization of local field potential recordings from directional deep brain stimulation electrodes.

Abstract Objective Two major advances in clinical deep brain stimulation (DBS) technology have been the introduction of local field potential (LFP) recording capabilities, and the deployment of directional DBS electrodes. However, these two technologies are not operationally integrated within current clinical DBS devices. Therefore, we evaluated the theoretical advantages of using directional DBS electrodes for LFP recordings, with a focus on measuring beta-band activity in the subthalamic nucleus (STN). Methods We used a computational model of human STN neural activity to simulate LFP recordings. The model consisted of 235,280 anatomically and electrically detailed STN neurons surrounding the DBS electrode, which was previously optimized to mimic beta-band synchrony in the dorsolateral STN. We then used that model system to compare LFP recordings from cylindrical and directional DBS contacts, and evaluate how the selection of different contacts for bipolar recording affected the LFP measurements. Results The model predicted two advantages of directional DBS electrodes over cylindrical DBS electrodes for STN LFP recording. First, recording from directional contacts could provide additional insight on the location of a synchronous volume of neurons within the STN. Second, directional contacts could detect a smaller volume of synchronous neurons than cylindrical contacts, which our simulations predicted to be a ~0.5 mm minimum radius. Conclusions STN LFP recordings from 8-contact directional DBS electrodes (28 possible bipolar pairs) can provide more information than 4-contact cylindrical DBS electrodes (6 possible bipolar pairs), but they also introduce additional complexity in analyzing the signals. Significance Integration of directional electrodes with DBS systems that are capable of LFP recordings could improve localization of targeted volumes of synchronous neurons in PD patients.
Frequency domain filtering for phase fringe patterns of digital speckle pattern interferometry

In order to solve the problem of serious influence of much noise in the phase fringe patterns of digital speckle pattern interferometry on the result and accuracy of phase unwrapping,an effective method of stripe sine / cosine decomposition combined with frequency domain low-pass filtering is introduced in this paper,and the high precision filter of phase fringe patterns of digital speckle pattern interferometry is realized. Basic idea of this method is that phase fringe patterns is mapped into two patterns by the sine / cosine function before the phase image filter processing,and then is synthesized into phase fringe patterns through frequency domain filter. This decomposition frequency domain filtering method can retention phase jump information effectively when filtering. Experimental results show that compared with the traditional image noise reduction method,this method can filter out the speckle noise in images better on the basis of reserving "rush"image information,and it is simple and effective,which solves the problem of loss from 10% to 40% for phase fringe patterns gray level information when traditional filtering methods are used in stripe phase fringe patterns.
Functional brain response to painful mechanical stimulation and painful stimulation in areas of secondary mechanical hyperalgesia: A meta-analysis

This study evaluated brain activity in response to painful and nonpainful mechanical stimuli within an area of secondary mechanical hyperalgesia (SMH) compared to non-sensitized areas. We performed a meta-analysis summarizing responses to three different types of stimuli. Furthermore, we summarize reported results of contrast maps comparing brain responses to mechanical stimuli in SMH that in non-sensitized regions. We investigated 3 categories of brain responses to 1) nonpainful mechanical stimuli in 226 participants across 16 studies, 2) painful mechanical stimuli in 164 participants across 11 studies, 3) mechanical stimuli in SMH in 84 participants across 7 studies, and 4) contrast maps of brain responses to mechanical stimuli in SMH versus painful mechanical stimuli in 107 participants across 7 studies. We used GingerALE 3.0.2 to create meta-analytic statistical parametric maps. We generated summary Z-maps by subtracting negative maps from positive maps. Maps were Z-value thresholded at 3.29 and a cluster size of 272 mm3. Nonpainful mechanical stimuli activated bilateral parietal operculum (PO), right inferior frontal gyrus (IFG) and inferior parietal lobule. Painful mechanical stimuli activated bilateral PO, bilateral IFG pars opercularis, and deactivation in bilateral superior occipital gyri. Mechanical stimuli in SMH activated bilateral PO, bilateral dorsal anterior insula, left postcentral gyrus and supragenual anterior cingulate cortex. The contrast of mechanical stimuli in SMH versus painful mechanical stimuli included greater activation in right thalamus, left lateral periaqueductal gray, right dorsolateral prefrontal (DLPFC), right Rolandic opercular, bilateral primary somatosensory, anterior midcingulate, and right middle insular cortices. Contrast results revealed greater activation during SMH compared to painful mechanical stimulation in right thalamus, right DLPFC, and left lateral periaqueductal gray. These areas are involved in pain modulation (hyperalgesic and analgesic), while responses in mid insula and mid cingulate cortices are prominent in processing salient and painful stimuli. Neurosurgery Pain Research Institute, Postdoctoral Scholarship (TJM).
Nonclinical Safety Profile of Sotorasib, a KRASG12C-Specific Covalent Inhibitor for the Treatment of KRAS p.G12C-Mutated Cancer:

Sotorasib is a first-in-class KRASG12C covalent inhibitor in clinical development for the treatment of tumors with the KRAS p.G12C mutation. A comprehensive nonclinical safety assessment package, including secondary/safety pharmacology and toxicology studies, was conducted to support the marketing application for sotorasib. Sotorasib was negative in a battery of genotoxicity assays and negative in an in vitro phototoxicity assay. Based on in vitro assays, sotorasib had no off-target effects against various receptors, enzymes (including numerous kinases), ion channels, or transporters. Consistent with the tumor-specific target distribution (ie, KRASG12C), there were no primary pharmacology-related on-target effects identified. The kidney was identified as a target organ in the rat but not the dog. Renal toxicity in the rat was characterized by tubular degeneration and necrosis restricted to a specific region suggesting that the toxicity was attributed to the local formation of a putative toxic reactive metabolite. In the 3-month dog study, adaptive changes of hepatocellular hypertrophy due to drug metabolizing enzyme induction were observed in the liver that was associated with secondary effects in the pituitary and thyroid gland. Sotorasib was not teratogenic and had no direct effect on embryo-fetal development in the rat or rabbit. Human, dog, and rat circulating metabolites, M24, M10, and M18, raised no clinically relevant safety concerns based on the general toxicology studies, primary/secondary pharmacology screening, an in vitro human ether-a-go-go-related gene assay, or mutagenicity assessment. Overall, the results of the nonclinical safety program support a high benefit/risk ratio of sotorasib for the treatment of patients with KRAS p.G12C-mutated tumors.
Cardiac Electrophysiology in Stroke Investigation

This chapter evaluates the cardiac chronotropic etiologies of syncope or decreased cerebral blood flow of cardiac origin. The proposed evaluation may be indicated for patients with syncope or symptoms of global or focal cerebral ischemia who are at risk for, or who have documented cerebrovascular or cardiac disease. Formal electrophysiologic testing may be useful for patients who have structural heart disease, particularly those who have previous remote myocardial infarction and present with syncope, or patients with syncope for whom all noninvasive workup is entirely negative, and there is strong suspicion of a cardiovascular cause. In this particular test, three electrodecatheters are inserted through the venous system, one near the high right atrium, one at the atrioventricular junction, and one in the right ventricular apex. A series of tests are performed to assess sinus node function, carotid sinus hypersensitivity, and integrity of AV nodal conduction. The His-Purkinje system is evaluated and attempts to assess its performance and the tendency to block are performed. In some cases, drugs such as procainamide are added to challenge the conducting system. Occasionally, total autonomic blockade is performed to assess intrinsic sinus node function, i.e., total adrenergic blockade with propranolol and atropine is used to determine the intrinsic sinus rate. Accessory pathways are sought, as well as mechanisms of supraventricular tachycardia which can cause syncope in some patients if it is extremely fast.
A Consideration of the Role of the Reticuloendothelial System (RES) in Endotoxin Shock

A recent hypothesis concerning host susceptibility to shock postulates that the basic etiology of shock phenomena centers on vascular smooth muscle injuries (Palmerio and Fine, 1969). Palmerio and Fine (1969) presented evidence that resistance to shock is dependent upon the antibacterial and detoxification potential of the RES. A shock model in which the critical nature of the RES has been implicated is endotoxin-induced shock (Beeson, 1947 a, b). Beeson in 1947 first demonstrated the importance of RES function in host defense against endotoxin-induced pathology (Beeson, 1947 a, b). Rabbits, previously tolerant to the febrile effects of endotoxin and subsequently treated with a large dose of colloidal materials which were known to temporarily depress RES activity, responded to the pyrogenic effects of endotoxin (Beeson, 1947a). In addition, an RES “blockading” dose of colloidal material resensitized tolerant rabbits to the Shwartzman reaction and enhanced lethality when endotoxin was subsequently administered (Beeson, 1947b). Passive plasma transfer studies indicated that RES blockade retarded the clearance of circulating endotoxin (Beeson, 1947a). Beeson speculated that diminution in phagocytosis of endotoxin enabled the endotoxin to injure various tissues as reflected by fever (Beeson, 1947a).
Carne de cuarta para consumidores de cuarta

is a study of beef retailing in Bogota (Colombia), and especially about the persistence of informal networks of sale and consump- tion. In my view, informality is responsible for two concomitant and seemingly opposite phenomena: high meat prices (the result of a long, unproductive, and ineffi cient supply chain), and the distribution of poor quality meat, slaughtered under questionable hygienic conditions, which in fact allows the poorest people to gain access to it. I begin this article by examining the importance of beef in Colombia. I then explore why it is so expensive, and describe the structure of its retailing and consumption chain. I end by discussing the implications of informal retailing and the impact of new, "modernizing" regulations that are being imposed.
Regulation of Enzymes Associated with C-1 Metabolism in Three Facultative Methylotrophs

The levels of the oxidation enzyme methanol dehydrogenase and the serine pathway enzymes, hydroxypyruvate reductase, glycerate kinase, serine transhydroxymethylase, serine-glyoxylate aminotransferase, phosphoenolpyruvate carboxylase, and malyl-coenzyme A lyase, were studied in cells of the facultative methylotrophs Pseudomonas AM1, Pseudomonas 3A2 and Hyphomicrobium X grown on different substrates. Induction and dilution curves for these enzymes suggest they may be regulated coordinately in Hyphomicrobium X, but not in Pseudomonas AM1 or 3A2. Glyoxylate stimulated the serine transhydroxymethylase activity in methanol-grown cells of all three organisms. A secondary alcohol dehydrogenase activity was detected at low levels in Pseudomonas AM1 and Hyphomicrobium X, but not in Pseudomonas 3A2.
Hidden risks: early discharge and bilirubin toxicity due to glucose 6-phosphate dehydrogenase deficiency.

In the United States today it is common for a mother motherand her term newborn to leave the hospital at 12 to 48 hours postnatally. Current opinion varies widely regarding the desirability of this practice. Proponents of early discharge claim that it is safe and may be advantageous; opponents argue that detection of significant illness may be missed or delayed. Economic considerations often limit the choice of families and their physicians; as they fund progressively shorter hospital stays, managed care and health insurance companies constitute a major driving force toward earlier postpartum discharge. The American Academy of Pediatrics (AAP)1,2 and the American College of Obstetricians and Gynecologists (ACOG) have published criteria to be met by early discharge candidates.2 These basic criteria include attendance at prenatal classes, instruction regarding common neonatal problems, uncomplicated term delivery, normal physical examination, thermal homeostasis, a negative Coombs test, demonstration of basic maternal skills, including successful infant feeding, and "physician-directed" follow-up within 48 to 72 hours after discharge. NEONATAL MORBIDITY AND MORTALITY: RELATIONSHIP TO TIME OF DISCHARGE Many neonatal problems do not become apparent for several days. However, the risks of early discharge remain poorly defined. Among published series of infants discharged early, mortality rates are low and not significantly different from those of control infants.3-6 Most studies have compared morbidity (rates of hospital readmission) between infants discharged early and late and have found similar rates of readmission between groups.7-9 There are few prospective, randomized studies; those that have been published have significant methodological flaws.3,10-16 For example, length of hospital stay varies, and length of stay and timing of follow-up overlap with control infants; study sample sizes are small, usually less than 100 per study.
Imaging metalloproteinase activity in vivo.

Better clinical endpoints are needed to monitor the efficacy of drugs designed to block enzymatic function, such as matrix metalloproteinase inhibitors. A new imaging technique allows researchers to monitor native enzymatic activity in vivo, and more effectively evaluate the therapeutic potential of these drugs ( pages 743–748 ).
Role of aromatic structure in pathways of hydrogen transfer and bond cleavage in coal liquefaction: Theoretical studies

The mechanisms by which strong carbon-carbon bonds between aromatic rings and side chains are cleaved under hydropyrolysis conditions remain a subject of wide interest to fuel science. Recently, the authors have studied in detail an alternate pathway for hydrogen atom transfer to {pi}-systems, radical hydrogen transfer (RHT). RHT is the direct, bimolecular transfer of hydrogen from the {beta}-position of an organic radical to the target {pi}-system. In the initial theoretical study, they examined the reaction ethyl radical + ethylene = ethylene + ethyl at the spin-projected UMP2/6-31G** level of theory. Recently, they have used a calibrated ROHF-MNDO-PM3 method to predict thermoneutral RHT barriers for hydrogen transfer between hydroaryl radicals and the corresponding arene. Because of the inherent limitations of semiempirical methods such as ROHF-MNDO-PM3, they have extended the initial work with the ethyl + ethylene study to examine this reaction at the ROHF-MBPT[2]-6-31G** and ROHF-CCSD[T]-6-31G** levels of ab initio theory. The primary objective was to determine how intrinsic RHT barriers change with conjugative stabilization of the radicals. The spin-restricted ROHF approach has been applied to study several RHT reactions, and they present completed ROHF results for the ethyl + ethylene system and preliminary results for the methallyl + butadiene system. The methallyl + butadiene system serves as a model for highly stabilized hydroaryl radicals: the methallyl radical exhibits a C-H bond strength of 46.5 kcal/mol compared to 9-hydroanthracenyl, 43.1 kcal/mol.
A Bigot by Any Other Name...: Are you an Open Source Bigot?

I’ve been responsible for hiring many software engineers. I tend to ask lots of elaborate technical questions so I can really get to know how the candidate thinks and works with me while solving hard problems. QA engineers will appreciate this one (it’s a “negative test” for intellectual honesty): “Explain the relative strengths and weaknesses of FreeBSD, Windows NT, Solaris, and Linux.”
Constant Speed Control Theory

The general theory of the constant speed control is reviewed for an "error" and "rate-of-change of error" control applied to a system possessing inertia but no damping or inherent speed stability. I t is shown that the most satisfactory control is one which has a high natural frequency, small inertia, and little or no Coulomb friction. Viscous damping is shown to have a less detrimental effect on the response of the control than control inertia, and the general conclusion is drawn that stability of the motion is secured by viscous damping in the control, while good performance is obtained by keeping the inertia of the control small.
Closing the Loops on Energy Balance: Energy Output Side

While failure to attain desired levels of weight loss is a common disappointment for many dieters, what to many is even more discouraging is the difficulty of maintaining those subpar weight losses. The record shows that a majority of dieters who succeed in losing weight eventually regain it, typically regaining one third to two thirds of lost weight within a year and almost all of it within 5 years.108,109,110 So, it is not surprising that the growing consensus in the field is that the real challenge in obesity treatment is not losing the weight, but keeping it off.111
Malignant papillary glioneuronal tumor of the pineal gland: Case presentation and literature review of a distinct entity.

Patient Male, 58. Final diagnosis Papillary glioneuronal tumor of the pineal gland. Symptoms Headache • loss of memory • hydrocephalus. Medication - Clinical procedure - Specialty Oncology • neurology • neurosurgery. Objective Rare disease. Background The authors report the third case of a rare papillary glioneuronal tumor of the pineal gland and only the second case reported with anaplastic features in this particular location. The authors also review the literature of papillary glioneuronal tumors. Case report Our patient is a 58-year-old Caucasian male who presented with diffuse headaches and loss of short-term memory. There were no deficits on physical exam. MRI Brain was performed demonstrating a large heterogeneously enhancing mass within the pineal gland causing obstructive hydrocephalus. He was taken to the operating room for supracerebellar-infratentorial approach for biopsy of the mass using neuronavigation. He required an endoscopic third ventriculostomy post-operatively for worsening hydrocephalus. Pathology demonstrated a rare malignant papillary glioneuronal tumor. It was recommended that patient undergo chemotherapy and radiation, however he refused treatment. He died six months after his initial diagnosis due to a condition unrelated to his intracranial tumor. Conclusions This is an unusually rare tumor of the pineal gland, with only one other malignant case noted in this location. We review the literature of this rare entity that should be considered on the differential diagnosis of a pineal gland mass.
Patient Demands and Requests for Cancer Tests and Treatments.

Importance Surveyed physicians tend to place responsibility for high medical costs more on “demanding patients” than themselves. However, there are few data about the frequency of demanding patients, clinical appropriateness of their demands, and clinicians’ compliance with them. Objective To assess how frequently patients demand or request medical tests or treatments, what types they demand, the clinical appropriateness of their demands, and how frequently clinicians comply. Design, Setting, and Participants Immediately after visits, clinicians—physicians, fellows, nurse practitioners, and physician assistants—were interviewed about whether the patient made a demand or request and their type and appropriateness. Interviews occurred in oncology outpatient facilities at 3 Philadelphia-area hospitals between October 2013 and June 2014. Main Outcomes and Measures The 4 main outcomes were (1) frequency of patient demands for medical tests or treatments, (2) the types of tests or treatments demanded, (3) clinicians’ assessment of the clinical appropriateness of the demands, and (4) how frequently clinicians complied. Results There were 5050 patient-clinician encounters involving 3624 patients and 60 clinicians. Overall, of the 5050 encounters, 440 (8.7%) included a patient demand or request for a medical intervention. Clinicians complied with 365 of the clinically appropriate demands (83.0%). In only 50 of the 440 encounters with demands (11.4%) did the patient demand or request clinically inappropriate interventions. Clinicians complied with 7 of these inappropriate demands or requests (14%). Clinicians complied with inappropriate demands or requests in only 0.14% (7 of 5050) of encounters. Of the 440 patient demands, 216 (49.1%) were for imaging studies; 68 (15.5%) were for palliative treatments, excluding chemotherapy or radiation; and 60 (13.6%) were for laboratory tests. In a multivariable model, having lung/head and neck cancer (odds ratio [OR], 1.74; 95% CI, 1.26-2.41), receiving active treatments (OR, 1.40; 95% CI, 1.11-1.77), and a fair- or poor-quality patient-clinician relationship (OR, 2.82; 95% CI, 1.13-7.07) were associated with patients making demands or requests (all P Conclusions and Relevance Patient demands occur in 8.7% of patient-clinician encounters in the outpatient oncology setting. Clinicians deem most demands or requests as clinically appropriate. Clinically inappropriate demands occur in 1% of encounters, and clinicians comply with very few. At least in oncology, “demanding patients” seem infrequent and may not account for a significant proportion of costs.
Mechanism and Application of a Microcapsule Enabled Multicatalyst Reaction

In this paper, we describe the development and application of a multistep one-pot reaction that is made possible by the site isolation of two otherwise incompatible catalysts. We prepared a microencapsulated amine catalyst by interfacial polymerization and used it in conjunction with a nickel-based catalyst for the transformation of an aldehyde to a Michael adduct via a nitroalkene intermediate. The amine-catalyzed conversion of an aldehyde to a nitroalkene was found to proceed through an imine rather than a nitroalcohol. Kinetic studies indicated that the reaction is first order in both the nickel catalyst and the shell of the encapsulated amine catalyst. Furthermore, we provide evidence against interaction between amine and nickel catalysts and present kinetic data that demonstrates that there is a rate enhancement of the Michael addition due to the urea groups on the surface of the microencapsulated catalyst. We applied our one-pot reaction to the development of a new synthetic route for pregabalin that proceeds with an overall yield of 74%.
Diastolic function predicts survival after renal revascularization

Purpose The purpose of this study was to define the relationship between left ventricular diastolic function and survival after renal revascularization. Methods Seventy-six adult patients (49 women, 27 men; mean age: 63 ± 13 years) with preoperative echocardiography who underwent renal revascularization for atherosclerotic disease were identified. Diastolic function was estimated from the early diastolic transmitral flow velocity (E), the atrial transmitral flow velocity (A), and the mitral annular tissue doppler velocity (e′). Patients were divided into two groups of diastolic dysfunction as either none/mild (E/A ≤0.75, E/e′ 0.75, E/e′ ≥10). Perioperative and follow-up mortality were determined from a prospective vascular database and the National Death Index. Descriptive statistics were calculated and postoperative survival was estimated by product-limit methods. Associations between preoperative factors, perioperative factors, and follow-up survival were examined using proportional hazards regression models. A forward stepwise variable selection procedure was used to select a "best" model to predict follow-up survival. Results Seventy-six patients were followed for an average of 41.9 months after renal revascularization. Within this group, 47 of 76 patients (61.8%) were identified as having moderate or severe diastolic dysfunction. Diastolic dysfunction had no apparent association with abnormal systolic function. The mean ejection fraction for those with moderate/severe diastolic dysfunction was 57.7% ± 11.5%. When comparing the moderate/severe and none/mild groupings of diastolic dysfunction, there was a significant difference in left ventricular mass index (151.9 ± 48.9 vs 125.3 ± 31.7; P = .0087). There were five deaths in the perioperative period and 20 deaths on follow-up. Among perioperative survivors, hypertension was cured or improved in 82% of the none/mild group and 53% of the moderate/severe group ( P = .012). In multivariable analysis, none/mild diastolic dysfunction was significantly and independently associated with an improvement in blood pressure after revascularization (odds ratio [OR], 6.2; 95% confidence interval [CI], 1.4-28.6; P = .018). Ejection fraction was not associated with survival. After forward variable selection, moderate/severe diastolic dysfunction (hazard ratio [HR], 5.8; 95% CI 1.4-25; P = .018) was the only variable to demonstrate a significant and independent association with follow-up survival. Conclusion Diastolic dysfunction, but not systolic dysfunction, was frequent in patients with renovascular disease. Blood pressure response and follow-up survival after renal revascularization demonstrated significant and independent associations with diastolic function. Consideration of diastolic function should be included in the management of patients with atherosclerotic renovascular disease.
Using Rights to Counter “Gender-Specific” Wrongs

One popular strategy of opposition to practices of female genital cutting (FCG) is rooted in the global feminist movement. Arguing that women’s rights are human rights, global feminists contend that practices of FGC are a culturally specific manifestation of gender-based oppression that violates a number of rights. Many African feminists resist a women’s rights approach. They argue that by focusing on gender as the primary axis of oppression affecting the African communities where FGC occurs, a women’s rights approach has misrepresented African women as passive victims who need to be rescued from African men and has obscured the role of certain international institutions that have perpetuated the oppression of African women. In this paper, I defend these critiques by arguing that the use of a women’s rights framework to combat practices of female genital cutting among African communities has often been practically ineffective and morally inappropriate.
Prymnesium parvum bloom termination: role of hydraulic dilution

The toxic haptophyte Prymnesium parvum is an alga that causes fish-killing blooms worldwide. In Texas (USA), P. parvum blooms occur in inland brackish waters and have recently increased in frequency and magnitude. Here, we document the development and termination of a localized bloom in Lake Whitney during spring. Initially, water conditions were non-toxic, and then became toxic to cladocerans and fish. As the bloom peaked, P.parvum populations reached ∼38 million cells L ―1 and prymnesiophytes dominated the phytoplankton assemblage, comprising ∼92% of the biomass. In April, a sizeable inflow event terminated this bloom, completely removed toxicity and decreased P. parvum densities by 52%, under a 30% hydraulic dilution. The lake level rose, but no substantial outflow occurred. This demonstrated that flushing losses, previously shown to be important for P. parvum bloom termination elsewhere, did not contribute to the termination of this bloom. Following the inflow event, P. parvum might have lost its competitive edge due to the cessation of toxin production as a result of nutrient loading. Despite positive specific growth rates for P. parvum, population density did not increase. During the non-toxic, post-inflow conditions, zooplankton biomass increased ∼225-fold, suggesting that grazing losses contributed to the offset of P. parvum reproductive growth. Our findings emphasize the importance of inflows to P. parvum bloom dynamics, while demonstrating the impact of hydraulic dilution on bloom termination.
Boundary extraction in thermal images by edge map

Extracting object boundaries in thermal images is a challenging task because of the amorphous nature of the images and the lack of sharp boundaries. Classical edge-based segmentation methods have the drawback of not connecting edge segments to form a distinct and meaningful boundary. Many level set approaches, which can deal with changes of topology and the presence of corners, have been developed to extract object boundaries. Previous researchers have used image gradient, edge strength, area minimization and region intensity to define the speed function. Our approach uses edge direction and magnitude, called an edge map, as the main component of the speed function. The edge map points toward the nearest boundary; its magnitude represents the total gradient energy in the half plane. The experimental results are significantly superior to those obtained using edge magnitude alone.