cssi/SciSciGPT-SciSciNet huggingface dataset:
Surgeon case volume, not institution case volume, is the primary determinant of in-hospital mortality after elective open abdominal aortic aneurysm repair

Objective Studies analyzing the effects of volume on outcomes after abdominal aortic aneurysm (AAA) repair have primarily centered on institutional volume and not on individual surgeon volume. We sought to determine the relative effects of both surgeon and institution volume on mortality after open and endovascular aneurysm repair (EVAR) for intact AAAs. Methods The Nationwide Inpatient Sample (2003-2007) was queried to identify all patients undergoing open repair and EVAR for nonruptured AAAs. To calculate surgeon and institution volume, 11 participating states that record a unique physician identifier for each procedure were included. Surgeon and institution volume were defined as low (first quintile), medium (second, third, or fourth quintile), and high (fifth quintile). Stratification by institution volume and then by surgeon volume was performed to analyze the primary endpoint: in-hospital mortality. Multivariable models were used to evaluate the association of institution and surgeon volume with mortality for open repair and EVAR, controlling for potential confounders. Results During the study period, 5972 open repairs and 8121 EVARs were performed. For open AAA repair, a significant mortality reduction was associated with both annual institution volume (low 30) and surgeon volume (low ≤2, medium 3-9, and high >9). High surgeon volume conferred a greater mortality reduction than did high institution volume. When low and medium volume institutions were stratified by surgeon volume, mortality after open AAA repair was inversely proportional to surgeon volume (8.7%, 3.6%, and 0%; P P = .02, for low, medium, and high-volume surgeons at medium-volume institutions). High-volume institutions stratified by surgeon volume demonstrated the same trend (5.1%, 3.4%, and 2.8%), but this finding was not statistically significant ( P = .57). Multivariable analysis was confirmatory: low surgeon volume independently predicted mortality (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.3-3.1; P P = .1). For EVAR, neither institution volume nor surgeon volume influenced mortality (univariate or multivariable). Conclusion The primary factor driving the mortality reduction associated with case volume after open AAA repair is surgeon volume, not institution volume. Regionalization of AAAs should focus on open repair, as EVAR outcomes are equivalent across volume levels. Payers may need to re-evaluate strategies that encourage open AAA repair at high-volume institutions if specific surgeon volume is not considered.
Glycine-Serine Requirement for Chicks

Abstract The requirement of glycine or serine was established for optimum growth in chicks. Equimolar quantities of serine completely replaced glycine for maximum chick gains. Chicks fed a chick starter diet for the first five days had a requirement of 0.25% glycine for optimum weight gain for the feeding period of 6-15 days. Chicks fed experimental diets from one day of age required a minimum level of glycine between 0.50 and 1.0%. The 1.40% level of serine did not produce results which were significantly different than those obtained with lower levels of glycine or serine. There was no significant difference in weight gain of chicks fed various proportions of glycine for days 6–10 if the chick diets were supplemented with glycine from 1–5 days inclusive. The possibility exists that glycine is needed in high amounts in early growth for uric acid formation, purine synthesis and metabolic regulation.
Biotransport Education: Thermal Therapies

Thermal therapies are important clinical modalities in patient treatment that range from long term lower temperature heating for physical therapy and tumor hyperthermia therapy to very high temperature extremely short term heating for surgery. Heat sources that are typically applied include surface contact conduction heat transfer devices, lasers, and electromagnetic field sources from 500 kHz to 2.45 GHz. Their analysis using the classical bioheat equation has proven to be an effective and useful approach to treatment planning, experiment modeling, and new device development efforts.Copyright © 2011 by ASME
GAA Trinucleotide Repeat Region Regulates M9/pMGA Gene Expression in Mycoplasma gallisepticum

Mycoplasma gallisepticum, the cause of chronic respiratory infections in the avian host, possesses a family of M9/pMGA genes encoding an adhesin(s) associated with hemagglutination. Nucleotide sequences of M9/pMGA gene family members indicate extensive sequence similarity in the promoter regions of both the transcribed and silent genes. The mechanism that regulates M9/pMGA gene expression is unknown, but studies have revealed an apparent correlation between gene expression and the number of tandem GAA repeat motifs located upstream of the putative promoter. In this study, transposon Tn4001 was used as a vector with the Escherichia coli lacZ gene as the reporter system to examine the role of the GAA repeats in M9/pMGA gene expression in M. gallisepticum. A 336-bp M9 gene fragment (containing the GAA repeat region, the promoter, and the translation start codon) was amplified by PCR, ligated with a lacZ gene from E. coli, and inserted into the Tn4001-containing plasmid pISM2062. This construct was transformed into M. gallisepticum PG31. Transformants were filter cloned on agar supplemented with 5-bromo-4-chloro-3-indolyl-β-d-galactopyranoside (X-Gal) to monitor lacZ gene expression on the basis of blue/white color selection. Several cycles of filter cloning resulted in cell lineages in which lacZ gene expression alternated between the On and Off states in successive generations of progeny clones. The promoter regions of the M9-lacZ hybrid genes of individual progeny clones were amplified by PCR and sequenced. The only differences between the promoter regions of the blue and white colonies were in the number of GAA repeats. Clones that expressed lacZ had exactly 12 tandem copies of the GAA repeat. Clones that did not express lacZ invariably had either more than 12 (14 to 16) or fewer than 12 (5 to 11) GAA repeats. Southern analysis of M. gallisepticum chromosomal DNA confirmed that the phase-variable expression of the lacZ reporter gene was not caused by Tn4001 transposition. These data strongly indicate that changes in the length of the GAA repeat region are responsible for regulating M9/pMGA gene expression.
Assessing potentially gifted students from lower socioeconomic status with nonverbal measures of intelligence.

Summary The screening and identification of gifted students has historically been conducted using verbal measures of intelligence. However, the underrepresentation in gifted programs of culturally diverse children, who may have limited English proficiency or cultural values different from those measured in traditional intelligence tests, has prompted researchers to consider other measures. Nonverbal measures of intelligence have been utilized to increase the number of gifted children from diverse backgrounds. Researchers in the current study sought to increase the number of culturally diverse gifted students at a rural public school enrolling predominantly African-American students from low socioeconomic homes. 169 students in Grades 2 through 6 were assessed using three nonverbal measures of intelligence: the Culture-Fair Intelligence Test, the Naglieri Nonverbal Abilities Test, and the Raven Standard Progressive Matrices. The scores on these nonverbal measures indicated that the Culture-Fair Intelligenc...
Cesarean delivery: background, trends, and epidemiology.

Objective To examine trends in cesarean delivery for the overall population and for women with "no indicated risk" for cesarean section, and to summarize the available literature on "maternal request" cesarean deliveries. Findings Nearly 3 in 10 births were delivered by cesarean section in 2004 (29.1%), the highest rate ever reported in the United States. The overall rate has increased by over 40% since 1996, reflecting two concurrent trends: an increase in the primary rate (14.6% to 20.6%), and a steep decline in the rate of vaginal birth after cesarean (28.3% to 9.2%). There has been a clear increase in primary cesarean delivery without a medical or obstetrical indication, and studies using hospital discharge data or birth certificate data estimate the rate of primary cesarean deliveries with no reported medical or obstetrical indication to be between 3% and 7% of all deliveries to women who had not had a previous cesarean delivery. However, these studies contain no direct information on whether these cesareans were the result of maternal request or because of physician recommendation. There was little data to support the contention that the rise in the cesarean rate was the result of maternal request. Conclusion There are no systematic data available on cesarean delivery by "maternal request." However, the rate of primary cesarean delivery is increasing rapidly for women of all ages, races, and medical conditions, as well as for births at all gestational ages. Since a first cesarean section virtually guarantees that subsequent pregnancies will be cesarean deliveries (the repeat cesarean delivery rate is now almost 91%), research is needed on physician practice patterns, maternal attitudes, clinical outcomes for mother and infant (harms, benefits), and clinical and nonclinical factors (institutional, legal, economic) that affect the decision to have a cesarean delivery.
A Review of: “Adam Dolnik. Understanding Terrorist Innovation: Technology, Tactics and Global Trends.”

Previously, terrorists were believed to be conservative in their methods, favoring less lethal tried-and-true tactics, viz., conventional explosives and guns. During much of the 1970s and 1980s, se...
A polarity dependent fluorescence “switch” in live cells

The spectroscopic properties, ultrafast kinetics and utilization of a photochromic molecule as a bi-stable fluorescing sensor of polarity in live cells are described. This molecule is a photochromic fulgimide, 2,3-dialkylidenesuccinimide, which emits fluorescence that can be switched optically on and off. The fluorescence intensity is a function of the polarity of the molecular environment, namely it fluoresces strongly when the molecule is in its polar isomeric structure form. We demonstrate that this molecule enters live cells without inducing damage, it binds primarily to internal membranous organelles (mitochondria) and its fluorescence can be switched optically "on" and "off" repeatedly while inside the living cell. A possible use as a bi-stable, on/off sensor is discussed.
Multiscale, Statistical Anomaly Detection Analysis andAlgorithms for Linearized Inverse Scattering Problems

In this paper we explore the utility of multiscale and statistical techniques for detecting and characterizing the structure of localized anomalies in a medium based upon observations of scattered energy obtained at the boundaries of the region of interest. Wavelet transform techniques are used to provide an efficient and physically meaningful method for modeling the non-anomalous structure of the medium under investigation. We employ decision-theoretic methods both to analyze a variety of difficulties associated with the anomaly detection problem and as the basis for an algorithm to perform anomaly detection and estimation. These methods allow for a quantitative evaluation of the manner in which the performance of the algorithms is impacted by the amplitudes, spatial sizes, and positions of anomalous areas in the overall region of interest. Given the insight provided by this work, we formulate and analyze an algorithm for determining the number, location, and magnitudes associated with a set of anomaly structures. This approach is based upon the use of a Generalized, M-ary Likelihood Ratio Test to successively subdivide the region as a means of localizing anomalous areas in both space and scale. Examples of our multiscale inversion algorithm are presented using the Born approximation of an electrical conductivity problem formulated so as to illustrate many of the features associated with similar detection problems arising in fields such as geophysical prospecting, ultrasonic imaging, and medical imaging.
Direct observation of a preinactivated, open state in BK channels with β2 subunits

Proteins arising from the Slo family assemble into homotetramers to form functional large-conductance, Ca2+- and voltage-activated K+ channels, or BK channels. These channels are also found in association with accessory β subunits, which modulate several aspects of channel gating and expression. Coexpression with either of two such subunits, β2 or β3b, confers time-dependent inactivation onto BK currents. mSlo1+β3b channels display inactivation that is very rapid but incomplete. Previous studies involving macroscopic recordings from these channels have argued for the existence of a second, short-lived conducting state in rapid equilibrium with the nonconducting, inactivated conformation. This state has been termed “pre-inactivated,” or O*. β2-mediated inactivation, in contrast, occurs more slowly but is virtually complete at steady state. Here we demonstrate, using both macroscopic and single channel current recordings, that a preinactivated state is also a property of mSlo1+β2 channels. Detection of this state is enhanced by a mutation (W4E) within the initial β2 NH2-terminal segment critical for inactivation. This mutation increases the rate of recovery to the preinactivated open state, yielding macroscopic inactivation properties qualitatively more similar to those of β3b. Furthermore, short-lived openings corresponding to entry into the preinactivated state can be observed directly with single-channel recording. By examining the initial openings after depolarization of a channel containing β2-W4E, we show that channels can arrive directly at the preinactivated state without passing through the usual long-lived open conformation. This final result suggests that channel opening and inactivation are at least partly separable in this channel. Mechanistically, the preinactivated and inactivated conformations may correspond to binding of the β subunit NH2 terminus in the vicinity of the cytoplasmic pore mouth, followed by definitive movement of the NH2 terminus into a position of occlusion within the ion-conducting pathway.
Corruption and Capital Flight: An Empirical Assessment

Abstract This paper considers the role of corruption in impelling capital flight. Identifying corruption as one dimension of poor governance, the empirical analysis explores direct linkages between corruption and capital flight in a broad sample of countries. The novelty of this investigation is that it is based on a portfolio choice model of asset allocation that explicitly recognizes corruption as contributing to the variance of domestic investment risk. The main testable proposition emerging from our theoretical specification is stated thus: does corruption impel capital flight by raising the risk of domestic investment, ceteris paribus? An econometric analysis suggests that, holding other determinants of capital flight constant, corruption does have a positive and significant impact on capital flight. Based on these results, the paper concludes that advocating good governance by combating corruption makes a great deal of sense for countries aiming to staunch capital flight. Capital flight and corrupti...
Latent Semantic Analysis.

L'Analyse Semantique Latente est une approche statistique introduite pour ameliorer la recherche d'information. Elle consiste a reduire la dimensionalite du probleme de la recherche d'information pour surmonter les difficultes liees a la synonymie et la polysemie. Au-dela de ses applications en recherche d'information (filtrage, multilinguisme), elle a egalement ete utilisee en sciences cognitives pour la modelisation de la memoire humaine. Un certain nombre de developpements ont concerne les modeles probabilistes et les aspects computationnels.
Decentralized authorization for distributed database system

A mechanism for decentralized authorization in a distributed database system is presented. This mechanism is an extension of a previously presented concept of the decentralized authorization for a non-distributed database. Three configuration models for the information necessary to perform the validation of an authorization request are proposed. An algorithm for the implementation of the validation process is presented. >
Why Are Total Knee Arthroplasties Failing Today—Has Anything Changed After 10 Years?

article i nfo The purpose of this study was to determine the frequency and cause of failure after total knee arthroplasty and compare the results with those reported by our similar investigation conducted 10 years ago. A total of 781 revision TKAs performed at our institution over the past 10 years were identified. The most common failure mechanisms were: loosening (39.9%), infection (27.4%), instability (7.5%), periprosthetic fracture (4.7%), and arthrofibrosis (4.5%). Infection was the most common failure mechanism for early revision (b2 years from primary) and aseptic loosening was the most common reason for late revision. Polyethylene (PE) wear was no longer the major cause of failure. Compared to our previous report, the percentage of revisions performed for polyethylene wear, instability, arthrofibrosis, malalignment and extensor mechanism deficiency has decreased. © 2014 Published by Elsevier Inc.
Integrating Project ASSERT: a screening, intervention, and referral to treatment program for unhealthy alcohol and drug use into an urban emergency department.

Objectives: The objective was to evaluate the effects of Project Alcohol and Substance Abuse Services Education and Referral to Treatment (ASSERT), an emergency department (ED)-based screening, brief intervention, and referral to treatment program for unhealthy alcohol and other drug use. Methods: Health promotion advocates (HPAs) screened ED patients for alcohol and ⁄ or drug problems 7 days a week using questions embedded in a general health questionnaire. Patients with unhealthy drinking and ⁄ or drug use received a brief negotiation interview (BNI), with the goal of reducing alcohol ⁄ drug use and ⁄ or accepting a referral to a specialized treatment facility (STF), depending on severity of use. Patients referred to an STF were followed up at 1 month by phone or contact with the STF to determine referral completion and enrollment into the treatment program. Results: Over a 5-year period (December 1999 through December 2004), 22,534 adult ED patients were screened. A total of 10,246 (45.5%) reported alcohol consumption in the past 30 days, of whom 5,533 (54%) exceeded the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines for low-risk drinking. Use of at least one illicit drug was reported by 3,530 patients (15.7%). Over one-fourth of screened patients received BNIs (6,266, or 27.8%). Of these, 3,968 (63%) were referred to an STF. Eightythree percent of patients were followed at 1 month, and 2,159 (65%) had enrolled in a program. Patients who received a direct admission to an STF were 30 times more likely to enroll than those who were indirectly referred (odds ratio = 30.71; 95% confidence interval = 18.48 to 51.04). After 3 years, funding for Project ASSERT was fully incorporated into the ED budget.
Visual Imagery in Haptic Shape Perception

Many studies now suggest that the brain is not organized around discrete parallel processing of modality-specific inputs, but rather has a multisensory task-based organization. For example, many areas previously thought to be specialized for various visual tasks, such as motion detection or face processing, have been shown to be active during analogous tactile or haptic tasks. Here, we focus on the involvement of visual cortex in haptic shape perception and review the extent to which this reflects visual imagery. We discuss a model of visuo-haptic object representation in which the lateral occipital complex houses object representations that are flexibly accessible via top-down pathways involving object imagery for familiar objects or bottom-up pathways for unfamiliar objects.
The impact of product line extensions and consumer goals on the formation of price image

Abstract How do vertical product line extensions influence a retailer's price image? Conventional wisdom suggests that adding an upscale or downscale item to a product line has a directionally consistent impact on price image, such that upscale extensions increase price image and downscale extensions decrease price image. In contrast, this research argues that vertical extensions can have the opposite effect, such that upscale extensions can decrease rather than increase price image, and vice versa for downscale extensions. The authors further propose that the impact of vertical extensions on price image is a function of consumer goals and, in particular, whether consumers have the intent of browsing or buying. The authors test these predictions in a series of five empirical studies that offer converging evidence in support of the proposed theory.
ERK MAP kinases regulate smooth muscle contraction in ovine uterine artery: effect of pregnancy.

The present study investigated the potential role of extracellular signal-regulated kinase (ERK) in uterine artery contraction and tested the hypothesis that pregnancy upregulated ERK-mediated func...
Patterns of Intimate Partner Violence and Sexual Risk Behavior among Young Heterosexually Active Men

Intimate partner violence (IPV) victimization is linked to sexual risk exposure among women. However, less is known about the intersection of IPV perpetration and sexual risk behavior among men. This study used data from a diverse, community sample of 334 heterosexually active young men, aged 18 to 25, across the United States to examine whether and how men with distinct IPV-related behavior patterns differed in sexual risk–related behavior and attitudes. Participants were recruited and surveyed online, and grouped conceptually based on the types of IPV perpetration behavior(s) used in a current or recent romantic relationship. Groups were then compared on relevant sexual risk variables. Men reporting both physical abuse and sexual coercion against intimate partners reported significantly higher numbers of lifetime partners, higher rates of nonmonogamy, greater endorsement of nonmonogamy, and less frequent condom use relative to nonabusive men or those reporting controlling behavior only. This group also ...
Sequential Combination Therapy of CDK Inhibition and Doxorubicin Is Synthetically Lethal in p53-Mutant Triple-Negative Breast Cancer

Triple-negative breast cancer (TNBC) is an aggressive malignancy in which the tumors lack expression of estrogen receptor, progesterone receptor, and HER2. Hence, TNBC patients cannot benefit from clinically available targeted therapies and rely on chemotherapy and surgery for treatment. While initially responding to chemotherapy, TNBC patients are at increased risk of developing distant metastasis and have decreased overall survival compared with non-TNBC patients. A majority of TNBC tumors carry p53 mutations, enabling them to bypass the G1 checkpoint and complete the cell cycle even in the presence of DNA damage. Therefore, we hypothesized that TNBC cells are sensitive to cell-cycle-targeted combination therapy, which leaves nontransformed cells unharmed. Our findings demonstrate that sequential administration of the pan-CDK inhibitor roscovitine before doxorubicin treatment is synthetically lethal explicitly in TNBC cells. Roscovitine treatment arrests TNBC cells in the G2-M cell-cycle phase, priming them for DNA damage. Combination treatment increased frequency of DNA double-strand breaks, while simultaneously reducing recruitment of homologous recombination proteins compared with doxorubicin treatment alone. Furthermore, this combination therapy significantly reduced tumor volume and increased overall survival compared with single drug or concomitant treatment in xenograft studies. Examination of isogenic immortalized human mammary epithelial cells and isogenic tumor cell lines found that abolishment of the p53 pathway is required for combination-induced cytotoxicity, making p53 a putative predictor of response to therapy. By exploiting the specific biologic and molecular characteristics of TNBC tumors, this innovative therapy can greatly impact the treatment and care of TNBC patients. Mol Cancer Ther; 15(4); 593-607. ©2016 AACR.
Management of infection about total elbow prostheses.

Deep infection was a complication after twelve (7.3 per cent) of 164 primary total elbow replacements. Two additional patients who had an infection about an elbow prosthesis were referred for treatment after total elbow replacement elsewhere. A statistical analysis of all of these primary total elbow arthroplasties, including the two in patients who were referred from outside institutions, identified preoperative factors that placed a patient at significant risk for subsequent infection. The risk factors included a previous operation on the elbow, a previous infection in the region of the elbow, psychiatric illness, class-IV rheumatoid arthritis, drainage from the wound after operation, spontaneous drainage after ten days, and reoperation for any reason. Three modes of treatment were used for patients who had an established infection: debridement and salvage of the implant, resection arthroplasty, and arthrodesis. After early operative debridement and suppression of the infection with long-term antibiotic therapy, three patients were able to retain the prosthesis, with restoration of range of motion and function of the upper extremity. One prosthesis was reimplanted after a six-week course of intravenous administration of antibiotics.
A change has come: The Obamas and the culture of black marriage in America

Given the historical nature of the Obama presidency, this paper qualitatively examines whether black men and women believe the Obamas can change low marriage rates among blacks in America. By using a marital–political–cultural change framework as our foundation, this exploratory study examined the written responses of 17 blacks between the ages of 23 and 61 years to two questions. (1) “Do you believe that President Barack Obama and Michelle Obama have the ability to change low marriage rates among blacks in the United States?” (2) “In what ways can President Barack Obama and Michelle Obama change low marriage rates among blacks in the United States?” Qualitative analyses of the data resulted in four delineated themes: (1) the inability of the Obamas to change the importance of marriage; (2) the inability of the Obamas to change marital motivations and stability; (3) the ability of the Obamas to change low marriage rates among blacks through positive interactions; and (4) the ability of the Obamas to chang...
IMPROVING OUTCOMES OF PATIENTS PRESENTING WITH ANTERIOR ST ELEVATION MYOCARDIAL INFARCTION WHO UNDERGO PRIMARY PERCUTANEOUS PRIMARY INTERVENTION OVER 20 YEARS IN A TERTIARY CENTER

Cardiovascular disease remains the most common cause of mortality. We studied the change in outcomes for anterior ST elevation myocardial infarction (STEMI) over twenty years in a tertiary-care center. Over the past twenty years, 1658 patients presented with anterior STEMI to our center and
Exploring the Brachistochrone Problem

(1995). Exploring the Brachistochrone Problem. The American Mathematical Monthly: Vol. 102, No. 4, pp. 328-336.
Synthesis, spectroscopic characterization, and reactivity of water-tolerant Eu3+-based precatalysts.

We report the synthesis, spectroscopic characterization, and reactivity of Eu3+ in the presence of a new set of chiral ligands designed for the aqueous, enantioselective Mukaiyama aldol reaction. Luminescence and NMR measurements were used to characterize the coordination environments of the Eu3+-based precatalysts, and this data is compared with yields and stereoselectivities. In addition to structure–function relationships, we found that, in the presence of excess hexadentate ligands, Eu3+ is coordinatively saturated, and subsequently, the reactivity of the precatalysts is reduced. These findings are helpful for the design of new ligands that bind Eu3+ without saturating the Eu3+ coordination sphere.
POEM Procedure: What the Radiologist Needs to Know for This New Surgical Intervention for Achalasia

Achalasia is a debilitating condition resulting from the failure of appropriate lower esophageal sphincter relaxation. Traditionally, the treatment of choice for achalasia has been a Heller myotomy, performed either via laparotomy or laparoscopically. The latter method has gained wide popularity in its documented lower postoperative morbidity. Recently, however, a new technique has been developed that can be performed by both thoracic surgeons and endoscopists-Per-Oral Endoscopic Myotomy. This procedure offers an alternative to invasive surgery and provides excellent outcomes with minimal recovery time.1 This article would help familiarize radiologists with this new technique, as well as both normal and abnormal postoperative appearances.
Investigation on comprehensive properties of clean operating department in 27 hospitals of Anhui Province

Objective To investigate the comprehensive properties of clean operating department in different level hospitals of Anhui province.Methods Static surveillance was used to detect dust particles,sedimentated bacteria and related technical indexes of 191 clean operating rooms and 391 ancillary rooms in 27 hospitals,according to "Architectural technical code for hospital clean operating department"GB 50333-2002.Results The qualified rates of dust particle count,settling bacteria,differential pressure,temperature,relative humidity,noise,illumination and wind speed of the first-grade operating rooms were 96.4%,100.0%,92.9%,96.4%,89.3%,75.0%,64.3% and 92.9%,respectively.The qualified rates of dust particle count,settling bacteria,differential pressure,temperature,relative humidity,noise,illumination,wind speed and ventilation frequency of all the operating rooms were 98.4%,100.0%,94.2%,96.9%,93.7%,83.2%,72.5%,92.9% and 82.2%,respectively.Conclusion The qualified rates of main clean indices of clean operation rooms in some hospitals of Anhui Province were relative high.However,the qualified rates of noise and illumination of the first-grade operation rooms,and illumination and ventilation frequency of the other operating rooms and ancillary rooms were low.
CHAPTER 44 – Vascular endothelial growth factor

Vascular endothelial growth factor (VEGF) made the long journey from obscurity to the frontline of research. It is considered as the major factors responsible for physiological and pathological angiogenesis. Increasing evidence indicates a prominent role for VEGF in the regulation of hematopoiesis and immune response. The knowledge of signal transduction pathways for VEGF-R1 and VEGF-R3 are very sketchy and require more studies, as well as the molecular mechanisms of VEGF effects on hematopoietic cells. Angiogenic potential of VEGF stimulated the use of growth factor in the treatment of ischemic diseases. In preclinical experiments, VEGF was delivered either as a protein or DNA in a model of rabbit hind limb ischemia. Significant increase in collateral vessel formation has been detected. Animal studies encouraged clinical trials. Expression of VEGF165 DNA after intramascular gene transfer promoted collateral vessel formation in patients with critical limb ischemia. In several clinical trials, the positive effect of recombinant VEGF was detected in patients with myocardial ischemia. However, a placebo-controlled phase II study has not revealed any clinical benefit. VEGF's role in tumor angiogenesis stimulated attempts to neutralize its effect in cancer. Several clinical trials are under way with neutralizing humanized monoclonal antibody, and various small molecules inhibiting signal transduction. First results of these trials are encouraging. However, much more information is needed to clarify the possible therapeutic utility of VEGF-based therapy.
Low incidence of pneumocystis pneumonia utilizing PCR‐based diagnosis in patients with B‐cell lymphoma receiving rituximab‐containing combination chemotherapy

Recent literature has demonstrated concern over the risk of Pneumocystis jirovecii pneumonia (PJP) when administering rituximab with combination chemotherapy such as in R-CHOP; however, the exact risk and potential need for prophylaxis is unknown. We sought to determine the incidence of PJP infection following R-CHOP administration in patients with B-cell lymphoma. Consecutive patients diagnosed with B-cell lymphoma receiving R-CHOP were evaluated from chemotherapy initiation until 180 days after the last administration. The primary outcome was cumulative incidence of PJP infection. Secondary endpoints included the association of rituximab, prednisone and subsequent chemotherapy with PJP infection risk. A total of 689 patients (53% male, median age 66 years) were included. Seventy-three percent of patients completed at least 6 cycles of R-CHOP treatment. Median rituximab and prednisone cumulative doses were 3950 mg and 5325 mg, respectively. Median daily prednisone dose through end of treatment was 45 mg (range 7.6 mg to 119 mg). The cumulative incidence of PJP was 1.51% (95% CI 0.57-2.43, at maximum follow-up of 330 days), below 3.5%, the conventional threshold for prophylaxis. Univariate analysis did not detect a statistically significant association between PJP and rituximab, steroids, or receipt of additional chemotherapy in this patient population. Our results demonstrate a low occurrence of Pneumocystis pneumonia during R-CHOP treatment of B-cell lymphoma and argue against universal anti-Pneumocystis prophylaxis in this setting. Further investigations should focus on targeted anti-Pneumocystis prophylaxis for patients presenting with high-risk baseline characteristics or when receiving rituximab-inclusive intensive combination chemotherapy regimens as treatment for other aggressive lymphoma subtypes. Am. J. Hematol. 91:1113-1117, 2016. © 2016 Wiley Periodicals, Inc.
Bitcoin as Currency and Catalyst

The past five years have seen the rise of the Bitcoin digital currency and, as a result, increased discussion of the idea of a digital currency. This paper seeks to address Bitcoin in several contexts, viewing it as representative of the broader state of the digital currency debate. Through an analysis of several of the most important factors shaping Bitcoin’s existence, this essay develops and defends the assertion that Bitcoin will not achieve widespread adoption in the United States, and in all likelihood will fail to do so throughout the rest of the world as well. In light of this hypothesized downfall, this paper discusses the considerably more viable potential for Bitcoin (and its underlying blockchain technology) to drive innovation in the financial sector and other industries.
Can Game-Based Learning Enhance Engineering Communication Skills?

Research problem: The enhancement of communication skills among engineering students has been a focus within the engineering curriculum for many years. Despite this emphasis, continual published reports document that engineering graduates are not well versed in the areas of written and oral communication when they graduate and transition into industrial-based positions. This study focuses on examining whether game-based pedagogy could serve as a potential tool for enhancing the written and oral communication skills of engineering undergraduates. Research questions: (1) What is the relationship between communication game exposure and oral and written communication skills achievement in engineering students? (2) Do engineering students' perceptions of their oral and written communication skills development associated with participation in communication games align with their achievement in these areas? Literature review: This study examines the ability of games to enhance engineering student communication skills by using the lens of activity theory. This communication theory was chosen because it describes how the creation of a piece of communication goes beyond traditional features such as grammar and syntax to include grappling with the objective or goal of the work, the system within which the product must be completed, and the methods selected to subdivide the work. These same constraints were imposed on the students within this study, in which they were assigned a technical design report and infomercial (or elevator pitch) to assess their oral and written communication skills. Methodology: Three groups of a sophomore-level Introduction to Chemical Product Design course compared non-games, games, and games-plus instructional methods. Student design reports and infomercials were scored by two analysts using reliable and validated rubrics. Team-based performance scores for each of the three sections were compared to determine whether any resulting differences in communication achievement were associated with the incorporation of game-based activities within the classroom. Students' perceptions of their communication skill development were measured through survey instruments and focus groups. The focus group data were content-analyzed by the same two analysts using a coding scheme developed from an emergent qualitative analysis of the focus group data. Results and conclusion: We found that the use of game-based pedagogy within engineering classes can enhance oral and written communication skills even though this method of instruction is not always perceived by students as relevant to their achievement in these areas.
Weebles Only Wobble But Eggs Fall Down

SummaryWhy does a roly-poly toy tend to stand upright on its less pointed end while an egg does not? The answer lies in a simple principle that governs the nature of the mechanical equilibrium of a...
Breast cancer survivorship: State of the science.

45Background: Only in the past decade has breast cancer survivorship earned formal recognition as a research discipline. Complicating survivorship research is the overlap between aging and treatment sequelae (Pan et al., Breast Cancer Res Treat 2016). The ACS/ASCO 2015 Breast Cancer Survivorship Care Guideline and the jointly sponsored 2016 Cancer Survivorship Symposium afforded an opportunity to review the “state of the science.” Methods: All 236 citations from the Guideline and all 250 abstracts from the Symposium were reviewed independently by two authors and prospectively categorized as follows: randomized trial; non-randomized study with controls; study without controls; review; and guideline. Additional categories were generated during the review process. Results: The Guideline most commonly cited reviews (n = 88, 37%), followed by 51 (22%) non-randomized, non-controlled studies and 37 (16%) randomized trials, which mostly addressed interventions for therapy sequelae such as lymphedema. Symposium ab...
Abstract TP377: Advancing Comprehensive Stroke Outcomes Through Concurrent Data Abstraction

Background: An opportunity existed to improve the chart abstraction process to include concurrent review of stroke patients and allow the application of current evidence based practices in real-tim...
From ‘Separation’ to a ‘Turned on’ Model of Services:

During a two-year evolutionary process, administration and staff moved into the mainstream of controversies current in public welfare and social work practice
Cell Fusion and Stem Cells

Differentiation, self-renewal and the ability to readily undergo cell fusion are properties of adult and embryonic stem cells. Spontaneous fusion between stem cells, and fusion of stem cells with various differentiated cell types, has been observed in many in vitro and in vivo contexts. Stem cell fusion is implicated in many crucial functions during normal development and is increasingly being harnessed as a tool for regenerative therapies. Experimentally induced fusion between somatic and stem cells forms the basis for our current understanding of nuclear reprogramming. Additionally, the potential fusion of stem cells with cancer cells may have physiologic contributions to aspects of tumor progression and metastasis. Understanding the mechanisms of stem cell fusion might allow manipulation of these processes to affect tissue regeneration, nuclear reprogramming and cancer chemotherapy. In this chapter we consider the functional consequences of stem cell fusion in development, regeneration and disease and postulate how cell fusion might contribute to the advancement of stem cell therapies in regenerative medicine.
TRPM7, the Mg 2+ Inhibited Channel and Kinase

TRPM7 is a ubiquitously expressed nonselective cation channel fused to a C-terminal alpha kinase. TRPM7 current is typically small at physiological magnesium concentrations, but large outwardly rectifying currents develop in low-magnesium extracellular solution when cells are dialyzed with magnesium free solutions during whole-cell patch clamp recordings. In addition to regulation by magnesium, TRPM7 current is potentiated by low extracellular pH and inhibited by depletion of phosphatidylinositol 4,5-bisphosphate (PIP2) during phospholipase C mediated signaling events. A diverse body of literature has implicated TRPM7 in fundamental cellular processes including death, survival, proliferation, cell cycle progression, magnesium homeostasis and responses to shear stress and oxidative stress. Global deletion of TRPM7 in mouse results in embryonic lethality and a thymocyte-restricted conditional knockout exhibits defective thymopoeisis, suggesting a role for TRPM7 in development and organogenesis. In disease states, TRPM7 has been linked to Guamanian amyotrophic lateral sclerosis and parkinsonian dementia (ALS/PD), various forms of neoplasia, hypertension and delayed neuronal death following cerebral ischemia.
Power Series and the Exponential Function

As with integrals, power series (though fascinating) are a tool here and are not pursued extensively. (However, some special kinds of power series, those with many zero coefficients or with integer coefficients, are examined in some detail in Chapters XVI and XVII.) For in-depth treatises on power series the reader should consult Knopp [1951] or Bromwich [1926]. To make our definitions and get started only one simple result is needed: $${{\lim }_{{n \to \infty }}}{{n}^{{1/n}}} = 1 \leqslant and \leqslant for \leqslant any \leqslant a > 0,{{\lim }_{{n \to \infty }}}{{n}^{{1/n}}} = 1.$$ .
Review of the Panama City Metro Project

The Metro rail transit system now under construction in Panama City, and planned extensions to that system, are poor investments for Panama. Depending on ridership, the US$1.88 billion construction cost of the first 13.7-kilometer line of the system could cost as much as $15 per rider. The costs of operating the line are likely to be greater than fare revenues, and maintenance costs for the system will grow until, after about 30 years, much of the infrastructure will need to be replaced at a probable cost of more than $1 billion.The government says Panama City needs a rail system because buses do not have the capacity to move the large numbers of people who enter and leave the center city each day. But the government has designed and is building a low-capacity rail system that will not be able to move more than about 6,400 people per hour. By comparison, transit buses can move more than 10,000 people per hour on city streets and double-decker buses can move at least 17,000 people per hour.The Panama City Metro will use three-car trains that the manufacturer says have a capacity of 600 people per train. But this is what transit experts call “crush capacity” in which everyone on board is pressed up against other people and/or car walls. Few people are willing to accept such crowding, so the actual capacity of each train is likely to be closer to about 375 people. At peak operation, the wait between trains will be about3.5 minutes, which means the system can move about 6,400 people per hour in each direction.A single train can hold more people than a transit bus, but buses can safely operate far more frequently than trains. Studies have found that a single bus stop can serve 42 buses per hour. If bus stops are staggered, with four stops every 400 feet, they can serve 168 buses per hour.Double-decker buses can easily hold more than 100 people, so they can move more 2.5 times as many people per hour as the Panama City Metro.The one thing rail transit does is create winners and losers. The winners include the companies that design and build the expensive rail lines, owners of property near rail stations, and the few people who will find it convenient to take a train from where most people don’t live to where most people don’t want to go. The losers include the taxpayers who have to support the train, owners of property away from the rail stations, and anyone who wants to travel to the many places the trains don’t go who suffers congestion and poor quality transportation because money that could have helped the entire city was spent on the rail line for an elite few.
Thrombospondin-1 Mediates Axon Regeneration in Retinal Ganglion Cells

Neuronal subtypes show diverse injury responses, but the molecular underpinnings remain elusive. Using transgenic mice that allow reliable visualization of axonal fate, we demonstrate that intrinsically photosensitive retinal ganglion cells (ipRGCs) are both resilient to cell death and highly regenerative. Using RNA sequencing (RNA-seq), we show genes that are differentially expressed in ipRGCs and that associate with their survival and axon regeneration. Strikingly, thrombospondin-1 (Thbs1) ranked as the most differentially expressed gene, along with the well-documented injury-response genes Atf3 and Jun. THBS1 knockdown in RGCs eliminated axon regeneration. Conversely, RGC overexpression of THBS1 enhanced regeneration in both ipRGCs and non-ipRGCs, an effect that was dependent on syndecan-1, a known THBS1-binding protein. All structural domains of the THBS1 were not equally effective; the trimerization and C-terminal domains promoted regeneration, while the THBS type-1 repeats were dispensable. Our results identify cell-type-specific induction of Thbs1 as a novel gene conferring high regenerative capacity.
The Effect of Socioeconomic Status on Treatment and Mortality in Non-Small Cell Lung Cancer Patients.

Background Treatment decisions for patients with non-small cell lung cancer (NSCLC) are based on patient and tumor characteristics, including socioeconomic status (SES) factors. The objective was to assess the contribution of SES factors to treatment and outcomes among patients with stage I NSCLC. Methods The National Cancer Database was queried for operable patients with stage I NSCLC. Patients were divided into three treatment groups: primary resection (ie, surgery only); nonstandard treatments consisting of chemotherapy with or without radiation; and no therapy. The SES of patients who made up the treatment groups was assessed, and the 5-year survival of all groups was analyzed. Results The cohort included 69,168 patients with stage I NSCLC. Each of these patients had between zero and five SES risk factors. The factors associated with no surgery were low income, nonwhite race, low high school graduation rate, Medicaid or no insurance, rural residence, and distance less than 12.5 miles from treatment facility. Patients with several SES risk factors have linearly increasing odds of undergoing nonstandard treatments and quadratically increasing odds of having no therapy (for patients with five factors, to odds ratio 4.7; 95% confidence interval, 3.44 to 6.30). Surgery alone was associated with significantly longer 5-year survival (71.8%) compared with nonstandard treatments (22.7%) and no therapy (21.8%; P Conclusions Socioeconomic status factors increase the risk of undergoing guideline discordant therapy for stage I NSCLC. As the number of SES factors increases, the odds of no therapy rises quadratically whereas the odds of nonstandard treatments rises constantly. The surgery only group had significantly longer survival than the nonstandard treatment and no therapy groups.