cssi/SciSciGPT-SciSciNet huggingface dataset:
Usefulness of radiofrequency ablation of supraventricular tachycardia to decrease inappropriate shocks from implantable cardioverter-defibrillators.

Inappropriate implantable cardioverter–defibrillator (ICD) therapies can lead to significant adverse events and increased mortality. These therapies are often the result of supraventricular tachycardias (SVTs). The objective of this study was to evaluate the incidence of SVT leading to inappropriate shocks in a large cohort of patients with ICDs and assess the efficacy of radiofrequency ablation (RFA) in decreasing these therapies. Patients with ICDs and recurrent SVTs were identified. A cohort of patients with ICD therapies subsequently underwent electrophysiologic study and RFA. Eighty-four patients (13%) were found to have SVT leading to 122 inappropriate ICD shocks and 130 episodes of antitachycardia pacing therapies. Median time to SVT onset after ICD implantation was 269 days. Electrophysiologic studies were performed in 30 patients. Successful RFA was performed for atrial tachycardia, atrial flutter, or atrioventricular nodal reentrant tachycardia in 22 patients. Ninety-five percent of patients who underwent successful SVT ablation had no further inappropriate ICD therapies compared to 63% of patients in whom ablation was not performed during a mean follow-up of 20.7 ± 11.9 months. In conclusion, SVT is responsible for a significant number of inappropriate ICD therapies. RFA is an effective strategy to substantially decrease subsequent inappropriate ICD therapies.
Supercritical fluid-micronized ipratropium bromide for pulmonary drug delivery

Abstract Ipratropium bromide (IB) was micronized by means of a CO2-based aerosol solvent extraction system (ASES) in order to improve the particle shape and size characteristics for use in inhalation therapy. The particle size parameter most relevant to pulmonary delivery is the aerodynamic diameter. In this study, ASES experiments were conducted using various liquid solvents for IB such as dimethylformamide (DMF), ethanol (EtOH), and mixtures of ethanol and acetone (EtOH/Ac). Several operating parameters were varied including temperature, pressure, IB concentration in the liquid solution, and the solution injection rate. The particles were analyzed by scanning electron microscopy (SEM). The true density of the particles was measured using a pycnometer and the mass median aerodynamic diameter (MMAD) determined. The results indicate that the size and morphology of the microparticles are most sensitive to solvent choice. Optimum results were obtained when IB particles were precipitated from DMF. The particles were more regular in shape, slightly elliptical, not agglomerated, and within the aerodynamic diameter range of 0.6–3.0 μm. Fourier transform infrared (FTIR) studies indicate no structural deformation as result of the ASES process. The regional depositions of inhaled IB particles were estimated using a multiple-path model of particle deposition (MPPD). The results indicate that IB particles with MMAD in the range of 2–3 μm deposited mainly in the respiratory airways in the lung.
Symptomatic histoplasmosis in children.

Abstract Symptomatic histoplasmosis in children is rare and presents difficulties both in differentiation from neoplasm and in the mode of therapy. Thirty-two children with an average age of 8.3 years were studied over a 10-year period for this disease. The most frequent symptoms were chronic fever (25 of the 32 patients), malaise (18 patients), significant weight loss (9 patients), and chest pain (6 patients). While physical evidence of a pneumonic process was present in 11 children, 19 had lymphadenopathy and 10 had hepatic or splenic enlargement or both. Chest roentgenograms demonstrated noncalcified masses and infiltrates in 29 children. Nine patients required operation, primarily for a presumptive diagnosis of neoplasm, including six thoracotomies, one liver abscess drainage, and two pericardiectomies. No operative deaths or morbidity occurred. Six children suffered significant morbidity from the disease. Unlike the chronic process in adults, histoplasmosis in children may strongly mimic neoplasm. Skin and serological testing, while beneficial, are of limited usefulness in endemic regions. Operative intervention is justified when careful patient evaluation cannot confirm the diagnosis.
Convergent and discriminant validity of DSM-IV axis II personality disorder criteria in adult outpatients with binge eating disorder.

The study objective was to evaluate the within-category cohesiveness and between-category overlap of DSM-IV axis II personality disorders (PDs) in outpatients with binge eating disorder (BED). Seventy adult outpatients with BED were reliably administered the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). Within-category interrelatedness of the criteria was evaluated by Cronbach's alpha and mean intercriterion correlations (MICs). Between-category criterion overlap was evaluated by examining intercategory mean intercriterion correlations between all pairs of PDs (ICMICs). Cronbach's alpha was .64 to .93 (mean, .77), the MIC was .17 to .52 (mean, .34), and the ICMIC was .11 to .39 (mean, .28). Our findings indicate that in outpatients with BED, the DSM-IV PD criteria sets have convergent validity (acceptable alpha value and MIC). Some degree of discriminant validity also exists: criteria for most DSM-IV PDs correlate better with each other (MIC) than with criteria for other PDs (ICMIC).
Debonding in foam-core sandwich panels

The strain energy release rate is used to give a criterion for debonding in structural sandwich beams with isotropic faces and a foam core. The critical strain energy release rate of the interface is measured on double-shear specimens and the results of the debonding analysis are compared with experiments on sandwich beams with aluminium faces and foamed polyurethane cores. The analysis describes debonding failure well. Comparison of the load for bebonding with that for other failure modes shows that debonding occurs only if relatively large cracks exist at the interface between the face and the core.
Receptor tyrosine kinases as targets for inhibition of angiogenesis

Anti-angiogenic agents potentially have broad applications in the clinic. Although most agents now in development are intended ultimately for use as anti-cancer drugs, patients with a range of disorders may benefit in the longer term. The signal recognition and transduction processes involved in controlling angiogenesis are complex and are likely to be dependent on the status of the target endothelial cell in a specific organ or tissue. In this review, the authors focus on signaling interactions that affect microvascular endothelium and the role of growth factors and their receptor tyrosine kinases in the regulation of microvessel physiology as they relate to the angiogenic process.
Questions for the Future

In the fall of 1990, the eldest of the surviving internees received the first redress checks. The full impact of the long-awaited payments is unclear and many questions remain. Will redress alleviate the Sansei’s concerns about their rights? And what role will the internment have in the Sansei’s lives as they continue through the life span? Most believe that the internment should never be forgotten, that it should be kept “alive” for future generations. Yet once the Nisei have died, how will the Sansei pass on the legacy of the camps to their own children? Will the fourth generation (Yonsei) also experience cross-generational impacts? How will the increasingly high rates of outmarriage affect this process?.
Spondylolisthesis and Spondylolysis

Spondylolisthesis is a common condition that can be managed both nonsurgically and surgically. More than 80% of children treated nonsurgically have resolution of symptoms. For those patients requiring surgical treatment, fusion in situ may provide adequate treatment for young patients. Patients with neural compression may require decompression to relieve symptoms, and fusion is also usually indicated. High-grade and degenerative spondylolisthesis require care that is unique to those conditions. Spondylolysis is a defect in the pars interarticularis that occurs in approximately 5% of the general population. Approximately 15% of individuals with a pars interarticularis lesion have progression to spondylolisthesis.
Plasmapheresis as an adjunct treatment in toxic epidermal necrolysis

Abstract Background: Toxic epidermal necrolysis (TEN) is a severe, progressive disease characterized by the sudden onset of skin necrosis. It is frequently associated with systemic involvement and has a high rate of morbidity and mortality. Standard therapy includes meticulous wound care, fluid replacement, and nutritional support in an intensive care setting. Objective: We evaluated the outcomes of patients treated in a burn unit for TEN over a 9-year period and compared the outcomes of a subset of patients treated with plasmapheresis with those managed by conventional means. Methods: The records of 16 patients with a diagnosis of TEN obtained from a computerized database were reviewed. Parameters recorded included extent of body surface area involvement and number of mucous membranes involved at admission, complications such as sepsis or need for mechanical ventilation, length of stay, and disposition. Results: Sixteen patients were included in this study. Ten were treated with conventional support measures alone. Six were treated with plasmapheresis. The average age was 42.4 years; the male/female ratio was 1:2.2. Sulfamethoxazole/trimethoprim was implicated in causation in 6 patients. The average extent of involvement on admission in all patients was 51.5% total body surface area. The average length of stay in all patients was 14.8 days. Eight patients (50%) were discharged home, 4 (25%) were discharged to a rehabilitation facility, and 4 (25%) died (2 of sepsis, 2 of cardiopulmonary arrest). None of the plasmapheresis-treated patients died. Conclusion: Plasmapheresis is a safe intervention in extremely ill TEN patients and may reduce the mortality in this severe disease. Prospective studies are needed to further define its usefulness. (J Am Acad Dermatol 1999;40:458-61.)
The optical resonances in carbon nanotubes arise from excitons

Optical transitions in carbon nanotubes are of central importance for nanotube characterization. They also provide insight into the nature of excited states in these one-dimensional systems. Recent work suggests that light absorption produces strongly correlated electron-hole states in the form of excitons. However, it has been difficult to rule out a simpler model in which resonances arise from the van Hove singularities associated with the one-dimensional bond structure of the nanotubes. Here, two-photon excitation spectroscopy bolsters the exciton picture. We found binding energies of ∼400 millielectron volts for semiconducting single-walled nanotubes with 0.8-nanometer diameters. The results demonstrate the dominant role of many-body interactions in the excited-state properties of one-dimensional systems.
Democratic participation in the discursive management of Usenet

Internet voting, sometimes proposed as a means of enhancing democratic participation, is partly inspired by the democratic process of newsgroup creation on Usenet. To better understand how online voting might influence democratic participation more generally, we conducted an empirical investigation into the voting activity on newsgroups in the comp hierarchy of Usenet since 1989. Counter to expectation, participation does not appear to be organized into factions or interest groups, but rather there are distinct, individualized patterns of voting. At a coarser level of analysis, some interest-based patterns do emerge, but these appear to correspond to frequent individual voters instead of coherent groups of voters. Noting that the Usenet voting protocol is designed to function principally as a gauge of participant interest, rather than as a genuine plebiscite, we conclude that the design of the Usenet voting system may not adequately gauge the electorate's will in an electronic democracy where voter turnout and democratic participation are chief concerns.
Stratigraphy and Correlation of the Precambrian Belt Supergroup of the Southern Lewis and Clark Range, Montana

Several well-exposed and little-deformed Belt Supergroup sections have been studied in the southern Lewis and Clark Range. In the area studied, the Belt thins eastward or northeastward due both to primary sedimentation and to pre-Middle Cambrian erosion. These rocks can now be more precisely correlated with the well-known sections near Bonner, Helena, and Glacier National Park. In the western part of the area, the Missoula Group is thickest and lithologically intermediate between the sections at Bonner and Marias Pass. Formation names from these two sections are applied in the southern Lewis and Clark Range. The thin Belt sequence in the eastern part of the area includes the lower part of the Missoula Group and older formations that may be traced southward into the Helena, Empire, and Spokane Formations of the Helena area. Consequently, the Helena Dolomite of the Helena area, the Siyeh Formation of the Marias Pass area, and the “Newland Limestone” of the Bonner area are probably lateral equivalents.
SERS in Salt Wells

We report herein a simple, inexpensive fabrication methodology of salt microwells, and define the utility of the latter as nanoparticle containers for highly sensitive surface-enhanced Raman scattering (SERS) studies. AFM characterization of Ag and Au loaded salt microwells reveal the ability to contain favorable nanostructures such as nanoparticle dimers, which can significantly enhance the Raman intensity of molecules. By performing diffraction-limited confocal Raman microscopy on salt microwells, we show high sensitivity and fidelity in the detection of dyes, peptides, and proteins, as a proof of our concept. The SERS limit of detection (accumulation time of 1 s) for rhodamine B and TAT contained in salt mircowells is 10 pM and 1 nM, respectively. The Raman characterization measurements of salt microwells with three different laser lines (532 nm, 632.81 nm, 785 nm) reveal low background intensity and high signal-to-noise ratio upon nanoparticle loading, which makes them suitable for enhanced Raman detection. SERS mapping of these sub-femtoliter containers show spatial confinement of the relevant analyte to a few microns, which make them potential candidates for microscale bioreactors.
gp78 functions downstream of Hrd1 to promote degradation of misfolded proteins of the endoplasmic reticulum

Eukaryotic cells eliminate misfolded proteins from the endoplasmic reticulum (ER) via a conserved process termed ER-associated degradation (ERAD). Central regulators of the ERAD system are membrane-bound ubiquitin ligases, which are thought to channel misfolded proteins through the ER membrane during retrotranslocation. Hrd1 and gp78 are mammalian ubiquitin ligases homologous to Hrd1p, an ubiquitin ligase essential for ERAD in Saccharomyces cerevisiae. However, the functional relevance of these proteins to Hrd1p is unclear. In this paper, we characterize the gp78-containing ubiquitin ligase complex and define its functional interplay with Hrd1 using biochemical and recently developed CRISPR-based genetic tools. Our data show that transient inactivation of the gp78 complex by short hairpin RNA-mediated gene silencing causes significant stabilization of both luminal and membrane ERAD substrates, but unlike Hrd1, which plays an essential role in retrotranslocation and ubiquitination of these ERAD substrates, knockdown of gp78 does not affect either of these processes. Instead, gp78 appears to act downstream of Hrd1 to promote ERAD via cooperation with the BAG6 chaperone complex. We conclude that the Hrd1 complex forms an essential retrotranslocation module that is evolutionarily conserved, but the mammalian ERAD system uses additional ubiquitin ligases to assist Hrd1 during retrotranslocation.
The Optimal Division of Business Processes Into Subtasks With Specialization and Coordination

This paper analyzes the factors influencing the optimal partition of a business process into subtasks to minimize the process cycle time. The paper develops a single-class open, queueing network model that incorporates the productivity gains due to the division of labor and the server time lost to coordination. An optimization model to minimize the cycle time subject to a maximum number of servers is presented. We derive an upper bound on the number of subtasks and present an algorithm to optimally solve the problem. We conduct an experimental analysis using the model to understand how the coordination time, process technology, and utilization affect the optimal division of labor. The model confirms that as the coordination time increases, the optimal number of subtasks decreases. Moreover, the results show the technology parameter has little effect when coordination is high, and if the utilization increases, then the optimal number of subtasks increases. The model and results provide a means to determine the optimal number of subtasks for a process.
The Program Evaluation of Services in a Primary Care Clinic: Attaining a Medical Home:

A program evaluation of a pediatric primary care training clinic was conducted using the criteria of a “medical home” set forth by the American Academy of Pediatrics (AAP). A total of 107 parents completed questionnaires regarding demographics, satisfaction with care, and questions related to the definition of medical home. Medical providers completed questionnaires regarding demographics, job satisfaction, and community resources. Parents reported acceptable levels of satisfaction with the quality of care provided, and the essential parts of the medical home definition were met. There were several areas that were designated as having room for improvement, including shortening clinic wait times and instructing the medical providers to be more sensitive to cultural differences in beliefs about health and wellness. The concepts of medical home set forth by the AAP are attainable for pediatric primary care clinics, but routine evaluations may be needed to ensure that goals continue to be met.
Regulation of endogenous dopamine release in amphibian retina by gamma-aminobutyric acid and glycine

Endogenous dopamine release in the retina of the African clawed frog (Xenopus laevis) increases in light and decreases in darkness. The roles of the inhibitory amino acid transmitters gamma-aminobutyric acid (GABA) and glycine in regulating this light/dark difference in dopamine release were explored in the present study. Exogenous GABA, the GABA-A receptor agonist muscimol, the GABA-B receptor agonist baclofen, and the GABA-C receptor agonist cis-aminocrotonic acid (CACA) suppressed light-evoked dopamine overflow from eyecups. The effects of GABA-A and -B receptor agonists were selectively reversed by their respective receptor-specific antagonists, whereas the effect of CACA was reversed by the competitive GABA-A receptor antagonist bicuculline. The benzodiazepine diazepam enhanced the effect of muscimol on light-evoked dopamine release. Both GABA-A and -B receptor antagonists stimulated dopamine release in light or darkness. Bicuculline was more potent in light than in darkness. These data suggest that retinal dopaminergic neurons are inhibited by GABA-A and -B receptor activation in both light and darkness but that GABA-mediated inhibitory tone may be greater in darkness than in light. Exogenous glycine inhibited light-stimulated dopamine release in a concentration-dependent and strychnine-sensitive manner. However, strychnine alone did not increase dopamine release in light or darkness, nor did it augment bicuculline-stimulated release in darkness. Additionally, both strychnine and 7-chlorokynurenate, an antagonist of the strychnine-insensitive glycine-binding site of the N-methyl-D-aspartate subtype of glutamate receptor, suppressed light-evoked dopamine release. Thus, the role of endogenous glycine in the regulation of dopamine release remains unclear.
A perspective on electrical energy storage

Electrochemical technologies promise to provide the means for electrical energy storage of electricity generated from wind, solar, or nuclear energies. The challenge is to provide this storage in rechargeable batteries or clean fuels at a cost that is competitive with fossil fuels for replacement: (1) of vehicles powered by the internal combustion engine by electric vehicles and (2) of centralized power plants using intermittent electricity generated by wind and solar energy or constant electricity from a nuclear power plant, all serving a variable demand. This perspective outlines existing and possible lines of materials research for the development of rechargeable batteries or the production of clean fuels within the constraints of electrochemical technology.
Dominant Party Strategy and Democratization

How do incumbent parties strategize against challengers when a new partisan cleavage cuts across the incumbent's electoral coalition? This article argues that a two-dimensional extension of Riker's anticoordination thesis conflicts with Downsian extensions. It shows that when voters coordinate on a single challenger based on their shared preference on a cross-cutting cleavage, a vote-maximizing incumbent party should move away from the challenger on the primary dimension of competition, even at the risk of abandoning the center. The article develops this hypothesis with reference to dominant parties in competitive authoritarian regimes where challenger parties constantly attempt “heresthetical” moves by mobilizing regime issues into the partisan debate, and it tests the predictions with an original sample survey of national leaders of Mexico's Revolutionary Institutional Party (PRI). It also spells out the implications of the findings for dominant party survivability in democratic transitions and, more broadly, for incumbents' spatial strategies in the face of new partisan cleavages.
Immunologic comparison of phospholipases A present in Hymenoptera insect venoms

Abstract A comparative study was made of the effect of anti-bee venom phospholipase A 2 serum and antir-bald face hornet venom serum on the activity of phospholipase A 2 present in yellow hornet, yellow jacket, bald face hornet, and honeybee venoms. Activity of phospholipase A 2 present in the venoms was measured titrimetrically using egg yolk dispersion as the substrate. Antiserum against pure bee venom phospholipase A 2 activity completely suppressed bee venom phospholipase A 2 activity but failed to inhibit phospholipase A 2 activity in yellow jacket, yellow hornet, and bald face hornet venoms. Anti-bald face hornet venom serum suppressed the activity of phospholipase A 2 present in the four insect venoms with the inhibitory effect decreasing in the order: bald face hornet > yellow hornet > yellow jacket > honeybee. A combination of immunoelectrophoresis and immunodiffusion techniques gave indication of common antigenic sites in a component of yellow hornet venom and a component of bald face hornet venom. The results suggest that IgG antibodies against pure bee venom phospholipase A 2 may not give any protection against the reaction(s) due to the phospholipase A 2 in yellow hornet, yellow jacket, and bald face hornet venoms, while antibodies against bald face hornet venom phospholipase A 2 may give some cross-protection.
A wideband multichannel array sensor with a frequency domain adaptive filter structure

A linearly constrained wideband adaptive array sensor is described whose adaptive processor is realized with a multichannel orthogonal filter structure. It was experimentally demonstrated that the transform domain processor utilizing the computationally simple least mean square (LMS) algorithm was capable of convergence speeds which rival the more expensive least squares methods. Furthermore, there is no additional cost in terms of the adaptive coefficient requirements (and only a modest increase in non-adaptive computational requirements) when compared with the standard tapped-delay-line structure array utilizing the LMS algorithm. >
Designing a reliable bio-fuel supply chain network considering link failure probabilities

Presents a pre-disaster planning model to strengthen the links between the multi-modal facilities.Failure probability of links between the multi-modal facilities is estimated using a spatial static model, which developed from real world data.Conduct a case study of biofuel supply chain with data from Mississippi and Alabama.The model saves $0.27/gallon when a disaster happens. This study presents a pre-disaster planning model that seeks to strengthen a bio-fuel supply chain system's multi-modal facility links while accounting for limited budget availability. The model presented here determines which set of facilities and links to select that will maximize post-disaster connectivity and minimize bio-fuel supply chain related costs. The failure probability of the links between the multi-modal facilities is estimated using a spatial statistic model, which is developed from real world data. This paper develops a generalized Benders decomposition algorithm to solve this challenging NP -hard problem. The proposed algorithm is validated via a real-world case study with data from Mississippi and Alabama. Computational results show that the proposed solution approach is capable of solving the problem efficiently. Several experiments are conducted to demonstrate the applicability of this model by testing various model parameters on bio-fuel supply chain network performance, including reliability improvement cost, availability of budget, biomass supply changes, and the risk averseness degree for decision makers. Numerical analysis indicates that, under normal conditions, the minimum cost model determines a unit bio-fuel delivery cost of $3.56/gallon. However, in case of a disaster, the unit bio-fuel delivery cost provided by the minimum cost model increases to $3.96/gallon, compared to $3.69/gallon provided by the reliable model solution.
Effects of Time Horizon on Model Predictive Control for Hybrid Electric Vehicles

Abstract One of the challenges in Model Predictive Control (MPC) for Hybrid Electric Vehicles (HEVs), is real time implementation, Bo-Ah et al. (2012). Computation time can be reduced by limiting the time horizon of the prediction. Limiting the time horizon results in sub optimal control, but may yield nearly optimal control if the time horizon is chosen appropriately. This paper investigates the sensitivity of MPC to predicted horizon length with regard to Fuel Economy (FE). The results show that predicting Driver's Desired Power (DDP) for the next 10 seconds on the highway and 20 seconds in the city, is sufficient for MPC to perform close to the Globally Optimized Controller (GOC). In other words: Regarding fuel economy optimization on the highway, knowing DDP for the next 10 seconds is almost equivalent to knowing the DDP for the whole trip.
A NEW GAUSSIAN PUFF ALGORITHM FOR NON-HOMOGENEOUS, NON-STATIONARY DISPERSION IN COMPLEX TERRAIN

This paper presents a complete algorithm for applying the Gaussian method to the most general and complex dispersion conditions. The plume evolution is described by transport and diffusion of a series of independent puffs, thus allowing the treatment of non-homogeneous, non-stationary conditions which characterize both short-range dispersion in complex terrain and long-range transport of pollutants. Physical and numerical problems related to the application of the puff model are discussed, and a general computer-oriented methodology proposed. This method provides a more numerically-accurate representation of plume characteristics and can handle both transport and calm conditions.
A Comparison of Higher-Order Shock Capturing Schemes Within the LAVA CFD Solver

The efficiency of large-eddy type simulations can be greatly increased by employing higher-order accurate numerical schemes which provide superior accuracy for a given cost. For unsteady turbulent flow simulations including shocks, contacts, and/or material discontinuities, various numerical higher-order shock capturing schemes are available in the literature. The desired numerical scheme should be free of spurious numerical oscillations across discontinuities and obtain higher-order accuracy in smooth flow regions in an efficient manner. Sufficient robustness is absolutely necessary for effectively utilizing these numerical methods in engineering and science applications. Three types of numerical higher-order schemes are discussed in this paper, i.e., central finite-difference schemes with explicit artificial dissipation, a compact centered finite-difference scheme with localized artificial diffusivity and weighted essentially non-oscillatory schemes in explicit and compact finite difference forms. Variations of these numerical schemes were implemented and tested in the Launch Ascent and Vehicle Aerodynamics (LAVA) solver, using a block-structured Cartesian mesh. The current paper provides a detailed discussion and comparison of these numerical schemes. The variety of test cases ranges from 1D shock problems to homogeneous isotropic turbulence at a turbulent Mach number of 0.5 where shocklets form.
Strategic Interactions Among Principal Investigators

Principal investigators (PI’s) face a complex situation that involves multiple projects with multiple PI’s over time. We will focus on a simplied case where we assume projects of dierent PI’s may be complementary. In this paper, we describe the simplied game, prove the existence of Nash equilibria, and analyze in detail a three player example. Parameters represent how each PI values each project including projects of others. We study how equilbirium strategies depend on these parameters. We also consider which equilibria are robust to agreements among coalitions of PI’s.
Total pancreatectomy and islet autotransplantation: A decade nationwide analysis

To investigate outcomes and predictors of in-hospital morbidity and mortality after total pancreatectomy (TP) and islet autotransplantation.The nationwide inpatient sample (NIS) database was used to identify patients who underwent TP and islet autotransplantation (IAT) between 2002-2012 in the United States. Variables of interest were inherent variables of NIS database which included demographic data (age, sex, and race), comorbidities (such as diabetes mellitus, hypertension, and deficiency anemia), and admission type (elective vs non-elective). The primary endpoints were mortality and postoperative complications according to the ICD-9 diagnosis codes which were reported as the second to 25(th) diagnosis of patients in the database. Risk adjusted analysis was performed to investigate morbidity predictors. Multivariate regression analysis was used to identify predictors of in-hospital morbidity.We evaluated a total of 923 patients who underwent IAT after pancreatectomy during 2002-2012. Among them, there were 754 patients who had TP + IAT. The most common indication of surgery was chronic pancreatitis (86%) followed by acute pancreatitis (12%). The number of patients undergoing TP + IAT annually significantly increased during the 11 years of study from 53 cases in 2002 to 155 cases in 2012. Overall mortality and morbidity of patients were 0% and 57.8 %, respectively. Post-surgical hypoinsulinemia was reported in 42.3% of patients, indicating that 57.7% of patients were insulin independent during hospitalization. Predictors of in-hospital morbidity were obesity [adjusted odds ratio (AOR): 3.02, P = 0.01], fluid and electrolyte disorders (AOR: 2.71, P < 0.01), alcohol abuse (AOR: 2.63, P < 0.01), and weight loss (AOR: 2.43, P < 0.01).TP + IAT is a safe procedure with no mortality, acceptable morbidity, and achieved high rate of early insulin independence. Obesity is the most significant predictor of in-hospital morbidity.
Nonobstetric Surgery in Pregnancy

Diagnostic and judgmental uncertainty that results in operative delay, leading to a more severe degree of illness and more complex surgery, is the major factor effecting both maternal and fetal morbidity and mortality in pregnant surgical patients. The acute abdomen is responsible for most errors in diagnosis and therapy. An understanding of anatomic, physiologic, and laboratory changes occurring in pregnancy and a timely interdisciplinary approach will expedite management and optimize outcome.
Abstract 43: Adherence to a Lifestyle Intervention Program Not Improved by Visual Knowledge of Carotid Intima Atherosclerosis

Background: The use of carotid intima media thickness (CIMT) ultrasound to identify subclinical atherosclerosis is widespread, but few studies examine its influence on patient behavior. This randomized, double-blinded clinical trial examined, in participants with ≥ 2 cardiovascular disease (CVD) risk factors and subclinical atherosclerosis, the use of CIMT ultrasound images to motivate adherence to a lifestyle change program. Methods: Participants were randomized into either the intervention group [receive CIMT results weekly (R-CIMT)] or control group [CIMT results withheld (W-CIMT)]. All participants received the 12-week lifestyle program (Mediterranean diet, aerobic exercise, group support). We determined the overall change in program adherence from baseline to week 12 using an ANCOVA model with CIMT group and gender as factors and age as the covariate. Percent adherence was calculated as a composite measure of diet and exercise adherence at baseline and 12 weeks: [Diet adherence = (Mediterranean Diet Score/14) X 100% + Exercise adherence = (weekly exercise time/180) X 100%]/2 where exercise adherence was capped at 100%. The R-CIMT group received a CIMT tutorial explaining results and associated increased CVD risk. Comprehension was assessed by a knowledge test at week 12 in the R-CIMT group only. Baseline motivation was assessed to determine its predictive ability of adherence when added to group assignment in a standard regression model. Results: 142 participants (R-CIMT n=69; W-CIMT n=73) completed the study; mean age = 55 ± 10 yrs; 64% women (n=91); 45% black (n=64). Several demographic differences were seen between groups: R-CIMT group was older (57 vs. 53; p=0.02) and had a higher % female [73 (51 or 79) vs. 55 (40 of 73); p=0.02]. When comparing R-CIMT vs. W-CIMT group assignment, no difference was detected in overall % change in adherence respectively (19.6 ± 24.3 vs. 22.6 ± 24.2; p=0.52). Baseline motivation was similar in both groups and not predictive of change in adherence when added to group assignment (p=0.68). Median knowledge test score = 90% (80,100) in responding completers (80%; 55 of 69). Conclusions: Although the presence of subclinical atherosclerosis increased participant knowledge of their increased CVD risk, it did not act as a motivator in these participants to improve lifestyle change adherence more than those in the control group.
Generation and Cycloaddition Reactions of Phenylthio Nitrile Oxide. A Preparation of 3-(Phenylthio)- and 3-(Phenylsulfonyl)-δ2-isoxazolines.

Phenylthionitromethane (I) and the alkenes (II) or (V) cyclize in the presence of phenyl isocyanate to give the phenylthioisoxazolines (III) or (VI).
DNA replication in Escherichia coli: Replication in absence of protein synthesis after replication inhibition

Abstract In Escherichia coli, DNA replication can occur in the absence of protein synthesis after a period of replication inhibition. Such replication will occur after thymine starvation, nalidixic acid treatment or exposure of a DNA temperature-sensitive mutant to a period at the non-permissive temperature. In all cases, subsequent DNA replication continued in the absemce of protein synthesis for many hours. This DNA synthesis could be observed only under conditions in which the restrictive breakdown of unmethylated cellular DNA is prevented. DNA-DNA hybridization experiments indicated that the entire bacterial genome is replicated. It was also found that DNA is synthesized sequentially and that only a portion of the chromosomes are involved in replication at any time. These appear to be chosen at random from the accumulating chromosome pool. Once acquired, this ability to synthesize DNA in the absence of protein synthesis was stable and could be maintained during growth in a complete medium which allowed synthesis and cell division. The ability to replicate DNA in the absence of protein synthesis appears to involve some normal component of the replication apparatus, since conditional lethal mutants exist which are unable to synthesize DNA at a non-permissive temperature and are altered in the ability to synthesize DNA in chloramphenicol after thymine starvation. The mechanism of stabilization of DNA replication which follows the inhibition of DNA synthesis is discussed in relation to the normal initiation and replication of the E. coli chromosome.
Physician participation in TQM in geriatric medicine.

Article-at-a-Glance Background Quality improvement (QI) approaches such as total quality management (TQM) and continuous quality improvement (CQI) have great potential for improving the care provided to older people. Geriatricians have the necessary experience and skills to initiate and lead these QI efforts. A national sample of practicing geriatricians was surveyed in 1998 regarding involvement in, satisfaction with, and insights regarding TQM processes in four care settings. Results Of 537 questionnaires returned in time for analysis, 497 were included for analysis after omitting questionnares that were undeliverable or unusable (n = 25) and those from respondents who worked fewer than 20hours per week (n = 15). More than one-third of the respondents (37.1%) reported no TQM activity at all. For the remainder, the primary site for TQM activity was the nursing home (33.0%), the hospital (22.5%), the office (11.4%), and the patient's home (3.7%). A majority of the respondents spent two hours per week or less on TQM projects. Planning an intervention and acting to maintain it in practice after its evaluation were the two stages of the improvement cycle these respondents engaged in most frequently. Discussion More geriatricians should be encouraged to participate in TQM training and in specific projects to improve systems of care for older people. Incentives to increase participation should be made available. Rapid-cycle improvement may fit better with physicians' culture of working for outcomes that have relatively short turnaround times.
Framing Robert W. Cox, Framing International Relations

AbstractIn the recent years, R.W. Cox has distanced himself from some genealogical connections made by his followers in regard to what he meant in his famous 1981 article. Was he mischaracterized, framed? This paper focuses on how Cox has been ‘framed’, a concept elaborated and used across social sciences in different contexts. Here, it is used to look at different mechanisms by which ideas, such as those of Cox, can be connected, ‘framed’ to other ideas, not only to advance knowledge but to strengthen individual careers, to strengthen and construct approaches and disciplines. Framing highlights and creates a space but also constrains and obscures. Cox deserves to be seen outside any frames other than the one he creates for himself, one which is changing and developing as does the real world, not captive to any approach, paradigm, discipline, or any other frame.
Sepsis-induced release of interleukin-6 may activate the immediate-early gene program through a hypothalamic-hypophyseal mechanism

Background. The immediate-early gene c-fos has been implicated in transcriptional regulation after sepsis. We test the hypothesis that sepsis-induced central nervous system release of interleukin (IL-6) regulates hepatic c-fos gene expression. Methods. Using a stereotaxically placed intracerebral-ventricular (ICV) catheter in rats with and without hypophysectomy, we measured hepatic c-fos protein accumulation after treatment with either IL-6 or vehicle control. Using a rat cecal ligation and puncture (CLP) model, we studied the following groups: (1) sham-CLP, (2) CLP, (3) hypophysectomyized sham-CLP, and (4) hypophysectomized CLP and measured hepatic c-fos mRNA
Opening and Closing in Tandem.

The rationale and sequencing of opening and closing structures has been well studied in mechanical sciences and disciplines. The report by Attinger-Toller et al. [(1)][1] in this issue of JACC: Cardiovascular Interventions extends this conversation to the specific medical field of aortic stenosis (
The effects of college student smartphone use on academic distraction and dishonesty

The purpose of this study was to determine the effects of college student smartphone use on academic distraction and dishonesty. The subjects consisted of 194 undergraduate students from a small, Midwestern, coeducational, liberal arts college. The results suggest that, for most students, phone use is an academic distraction while studying, phone use is not an academic distraction while studying for quizzes or exams, phone use is not an academic distraction while studying in groups, phone use is not an academic distraction during class time, and phone use does not encourage academic dishonesty. Implications are discussed.
Test-retest reliability and validity of a custom-designed computerized neuropsychological cognitive test battery in young healthy adults.

Objective: Dual-task methodologies are utilized to probe attentional resource sharing between motor and cognitive systems. Computerized neuropsychological testing is an advanced approach for cognitive assessment and its application in dual task testing is evolving. This study aimed to establish the test-retest reliability and concurrent validity of a custom-designed, computerized, cognitive test battery. Methods: Fifteen healthy young adults were tested for the following domains (and tasks): 1) visuomotor function (Spot and Click, SC), 2) phonemic memory (Category Naming, Cat N) and verbal fluency (Word List Generation , WLG), 3) response inhibition (Color Naming, CN), 4) discriminant decision-making (Unveil the Star, US), 5) visual working memory (Triangle and Letter Tracking, TT and LT), 6) problem solving (Peg Game, PG) and 7) information processing speed (Letter-Number, LN). The reaction time, accuracy, time of completion, total number of responses and total number of errors were used as the outcome variables. Results: The intraclass correlation coefficient (ICC) was used to determine reliability for all outcome variables and concurrent validity was established with respect to the Delis Kaplan Executive Function System™ (D-KEFS™). Reliability ranged from good to excellent for all seven tasks (ICC>0.65). The Cat.N, WLG and CN showed good correlation and PG task showed moderate correlation with tests of the D-KEFS. Conclusion: Findings indicate that these computerized cognitive tests were both valid and reproducible and therefore can be easily implemented by clinicians for assessing cognition and incorporated for dual-task testing and training.
Surveillance for Highly Pathogenic Avian Influenza in Wild Turkeys (Meleagris gallopavo) of Minnesota, USA during 2015 Outbreaks in Domestic Poultry

Abstract An outbreak of a novel reassortant of highly pathogenic avian influenza A (H5N2) virus (HPAIV) decimated domestic turkeys (Meleagris gallopavo) from March through mid-June, 2015 in the state of Minnesota, US. In response, as part of broader surveillance efforts in wild birds, we designed a pilot effort to sample and test hunter-harvested Wild Turkeys (Meleagris gallopavo) for HPAIV in Minnesota counties with known infected poultry facilities. We also collected opportunistic samples from dead Wild Turkeys or live Wild Turkeys showing neurologic signs (morbidity and mortality samples) reported by the public or state agency personnel. Cloacal and tracheal samples were collected from each bird and screened for avian influenza virus (AIV) RNA by real-time reverse transcription PCR. From 15 April to 28 May 2015, we sampled 84 hunter-harvested male Wild Turkeys in 11 Minnesota counties. From 7 April 2015 through 11 April 2016, we sampled an additional 23 Wild Turkeys in 17 Minnesota counties. We did not...
Major Hereditary Gastrointestinal Cancer Syndromes: A Narrative Review

Gastrointestinal cancer is one of the major causes of death worldwide. Hereditary gastrointestinal cancer syndromes constitute about 5-10% of all cancers. About 20-25% of undiagnosed cases have a possible hereditary component, which is not yet established. In the last few decades, the advance in genomics has led to the discovery of multiple cancer predisposition genes in gastrointestinal cancer. Physicians should be aware of these syndromes to identify high-risk patients and offer genetic testing to prevent cancer death. In this review, we describe clinical manifestations, genetic testing and its challenges, diagnosis and management of the major hereditary gastrointestinal cancer syndromes.
Fabrication & performance study of a palladium on alumina supported membrane reactor: Natural gas steam reforming, a case study

Abstract In this work, a synthetic mixture of natural gas is considered in a steam reforming process for generating hydrogen by using a membrane reactor housing a composite membrane constituted of a Pd-layer (13 μm) supported on alumina. The Pd/Al2O3 membrane separates part of the produced hydrogen through its selective permeation, although it shows a relatively low H2/N2 ideal selectivity (>200 at 0.5 bar of trans-membrane pressure and T = 425 °C). The steam reforming reaction is performed at 420 °C, by varying the gas hourly space velocity between 4400 h−1 and 6900 h−1 and by using two different mixtures containing some common impurities found within natural gas pipeline. Specifically, the effect of N2 and CO2 as impurities in the feed line is analyzed. The reaction pressure and steam-to-carbon ratio (S/C) are kept constant at 3.0 bar (abs.) and 3.5/1, respectively. The best performance of the Pd-based membrane reactor is obtained at 420 °C, 3.0 bar and 100 mL/min of sweep-gas, yielding a methane conversion of 55% and hydrogen recovery >90%.
Nanopore Measurements of Filamentous Viruses Reveal a Sub-nanometer-Scale Stagnant Fluid Layer.

We report measurements and analyses of nanopore translocations by fd and M13, two related strains of filamentous virus that are identical except for their charge densities. The standard continuum theory of electrokinetics greatly overestimates the translocation speed and the conductance associated with counterions for both viruses. Furthermore, fd and M13 behave differently from one another, even translocating in opposite directions under certain conditions. This cannot be explained by Manning-condensed counterions or a number of other proposed models. Instead, we argue that these anomalous findings are consequences of the breakdown of the validity of continuum hydrodynamics at the scale of a few molecular layers. Next to a polyelectrolyte, there exists an extra-viscous, sub-nanometer-thin boundary layer that has a giant influence on the transport characteristics. We show that a stagnant boundary layer captures the essential hydrodynamics and extends the validity of the electrokinetic theory beyond the co...
A Phase Compensation Technique for B-Mode Echoencephalography

Whereas A-mode echoencephalography has been found diagnostically useful, B-mode displays for similar object volumes have not yet provided the additional information that might be expected from a two-dimensional presentation. Poor image quality results from a number of causes stemming from the presence of skull bone (White, 1967; 1968). Large differences in specific acoustic impedance between skull bone and soft tissue combined with irregularities of skull bone surfaces result in unfavorable reflections and reverberations of acoustic energy. Severe attenuation of ultrasound at diagnostically useful frequencies further reduces system sensitivity and target acquisition. Additionally, significant differences between acoustic velocities in bone and tissue result in beam degradation and registration errors in the B-mode image. With one possible exception (Somer, 1969), the nature and extent of these aberrations have thus far limited practical utilization of B-mode scanners in clinical examinations of head structure.