cssi/SciSciGPT-SciSciNet huggingface dataset:
Endovascular Repair of Bilateral Iliac Artery Aneurysms in a Patient With Loeys–Dietz Syndrome

Background Loeys–Dietz syndrome (LDS) is a rare congenital connective tissue disorder (CTD) caused by mutations in the gene encoding for transforming growth factor-β receptors I and II. This recently described syndrome is characterized by aortic aneurysms and dissections, arterial tortuosity, and spontaneous organ perforation. The technical feasibility of endovascular interventions, particularly endovascular aneurysm repair (EVAR), in CTDs is relatively unknown. Methods and Results A 38-year-old man presented with asymptomatic bilateral common iliac artery aneurysms measuring 5.3 cm on the right and 4.3 cm on the left. The patient had an extensive surgical and medical history, including a recently repaired Stanford type-A aortic dissection, total colectomy with end ileostomy for a colonic perforation, splenectomy for rupture, and cirrhosis secondary to chronic hepatitis C. The patient’s CTD, multiple abdominal surgeries performed in the past, and ileostomy made him a poor candidate for open repair. We elected to offer him a complex endovascular repair and hoped to preserve his pelvic circulation by using “double-barrel” configuration of stent–grafts in the right iliac artery system. Successful deployment of the devices and repair of femoral access allowed routine discharge on postoperative day 2. At 6-month follow-up, the patient’s pelvic circulation has been maintained, the aneurysms are excluded without endoleak, and sac regression has been shown. Conclusion LDS is a rare connective tissue disorder characterized by vascular aneurysms and arterial tortuosity. When vascular reconstruction is necessary, open techniques are often preferred given the lack of data on endovascular procedures. In the present case, we report the first successful abdominal EVAR in a high-risk patient with LDS, providing excellent short-term results.
Extrinsic flexor muscles generate concurrent flexion of all three finger joints

The role of the forearm (extrinsic) finger flexor muscles in initiating rotation of the metacarpophalangeal (MCP) joint and in coordinating flexion at the MCP, the proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints remains a matter of some debate. To address the biomechanical feasibility of the extrinsic flexors performing these actions, a computer simulation of the index finger was created. The model consisted of a planar open-link chain comprised of three revolute joints and four links, driven by the change in length of the flexor muscles. Passive joint characteristics, included in the model, were obtained from system identification experiments involving the application of angular perturbations to the joint of interest. Simulation results reveal that in the absence of passive joint torque, shortening of the extrinsic flexors results in PIP flexion (80 degrees ), but DIP (8 degrees ) and MCP (7 degrees ) joint extension. The inclusion of normal physiological levels of passive joint torque, however, results in simultaneous flexion of all three joints (63 degrees for DIP, 75 degrees for PIP, and 43 degrees for MCP). Applicability of the simulation results was confirmed by recording finger motion produced by electrical stimulation of the extrinsic flexor muscles for the index finger. These findings support the view that the extrinsic flexor muscles can initiate MCP flexion, and produce simultaneous motion at the MCP, PIP, and DIP joints.
Elevated-temperature stress rupture in interlaminar shear of a Hi-Nic SiC/SiC ceramic matrix composite

Abstract Assessments of stress rupture in a gas-turbine grade, melt-infiltrated Hi-Nicalon TM SiC continuous fiber-reinforced SiC ceramic matrix composite (CMC) were made in interlaminar shear at 1316 °C in air. The composite exhibited appreciable life limiting behavior with a life susceptibility parameter of n s = 22–24, estimated based on a proposed phenomenological life prediction model together with experimental data. The phenomenological life model was in good agreement in prediction between the stress rupture and the constant stress-rate data, validating its appropriateness in describing the life limiting phenomenon of the CMC coupons subjected to interlaminar shear. The results of this work also indicated that the governing mechanism(s) associated with failure in interlaminar shear would have remained almost unchanged, regardless of the type of loading configurations, either in stress rupture or in constant stress rate.
Exploring hybrid memory for GPU energy efficiency through software-hardware co-design

Hybrid memory designs, such as DRAM plus Phase Change Memory (PCM), have shown some promise for alleviating power and density issues faced by traditional memory systems. But previous studies have concentrated on CPU systems with a modest level of parallelism. This work studies the problem in a massively parallel setting. Specifically, it investigates the special implications to hybrid memory imposed by the massive parallelism in GPU. It empirically shows that, contrary to promising results demonstrated for CPU, previous designs of PCM-based hybrid memory result in significant degradation to the energy efficiency of GPU. It reveals that the fundamental reason comes from a multi-facet mismatch between those designs and the massive parallelism in GPU. It presents a solution that centers around a close cooperation between compiler-directed data placement and hardware-assisted runtime adaptation. The co-design approach helps tap into the full potential of hybrid memory for GPU without requiring dramatic hardware changes over previous designs, yielding 6% and 49% energy saving on average compared to pure DRAM and pure PCM respectively, and keeping performance loss less than 2%.
Batch extraction of amines using emulsion liquid membranes: Importance of reaction reversibility

Experimental results for the batch extraction of amines using emulsion liquid membranes with an internal aqueous HCI solution are presented. Four amines and mixtures of one binary pair were studied. Reversibility of the acid-amine reaction within the internal droplets affected extraction rates. The reversible reaction model presented earlier satisfactorily predicts these experimental results.
The Criminology of Downsizing

It is worth pausing a moment to let the enormity and swiftness of today’s changes sink in. A few years ago, around 2011, even as correctional populations had just started their ever-so-slight decli...
Phylogenetic and Ontogenetic Aspects of the Lemniscal Systems and the Pyramidal System

A more comprehensive understanding of encephalization during vertebrate evolution would be uniquely attained if one could compare the actual brains of the ancient common ancestors with those representing a sufficiently complete series of subsequent phyletic stages. Unfortunately, such a panoramic view can never be attained since the former and many of the latter brains are lost in the geological past. Therefore, at present, one can trace the process of the phylogenetic development of the brain only through the evaluation and reconstruction of paleoneurological and comparative neoneurological evidence. The phylogenetic interpretations presented below are made with the full awareness of the pitfalls inherent in evaluating data obtained from living descendents. Often only inferences can be made as to whether apparently similar structures found in modern forms are homologous, or are the products of convergent evolution.
What Millennial Preservice Teachers Want to Learn in Their Training

As teacher educators, we implore teacher candidates to understand the cultures and experiences of their students to engage them in learning. Yet, preservice teachers are seldom asked what they hope to learn in their training to become teachers of young children. In this study, we examined the interests, resources, and expectations of millennial preservice teachers born between 1980 and 2001. We found that millennial preservice teachers saw themselves as accepting of differences, hesitant to learn about assessment, very impressed with their teaching abilities, but not highly skilled in their ability to provide critique and feedback. Suggestions for enhancing the teacher training experience for millennials are discussed, as are the possible implications of training teachers of young children.
Disruption of Circadian Rhythms and Sleep in Critical Illness and its Impact on the Development of Delirium

Purpose This article reviews our current understanding of the relationships between critical illness, circadian disruption, and delirium. Summary Delirium is a common and morbid complication of hospitalization, particularly in the setting of critical illness and intensive care unit (ICU) admission. Critical illness involves a host of acute metabolic, hormonal and inflammatory responses that appear to disrupt normal sleep architecture and precipitate cerebral dysfunction. The intervention-heavy environment of the ICU further disrupts normal circadian rhythms and increases delirium risk. Despite strong evidence for correlation of sleep disruption, critical illness and delirium, causal relationships remain difficult to prove. Delirium is almost certainly a multifactorial condition. This article reviews proposed pathophysiologic mechanisms and potential therapeutic targets. In the absence of definitive pharmacologic therapy, interventions prioritizing maintenance of normal circadian, sleep, and behavioral patterns have shown promise in delirium risk reduction.
New perspective of ClC-Kb/2 Cl− channel physiology in the distal renal tubule

Since its identification as the underlying molecular cause of Bartter's syndrome type 3, ClC-Kb (ClC-K2 in rodents, henceforth it will be referred as ClC-Kb/2) is proposed to play an important role in systemic electrolyte balance and blood pressure regulation by controlling basolateral Cl(-) exit in the distal renal tubular segments from the cortical thick ascending limb to the outer medullary collecting duct. Considerable experimental and clinical effort has been devoted to the identification and characterization of disease-causing mutations as well as control of the channel by its cofactor, barttin. However, we have only begun to unravel the role of ClC-Kb/2 in different tubular segments and to reveal the regulators of its expression and function, e.g., insulin and IGF-1. In this review we discuss recent experimental evidence in this regard and highlight unexplored questions critical to understanding ClC-Kb/2 physiology in the kidney.
Determination of Arsenic and Antimony in Drinking Water by Hydride Generation Atomic Fluorescence Spectrophotometry

[Objective]To establish the determination method of arsenic and antimony in drinking water by hydride generation atomic fluorescence spectrophotometry.[Methods]In the medium of hydrochloric acid,sodium borohydride was adopted as reductant,which caused the ion-state arsenic and antimonium changing into atomic-state arsenic and antimonium steam. The steam was carried into the instrument of atomic fluorescence spectroscopy by argon gas to test. The influencing factors such as instrument condition,acescence,medium,the concentration of sodium borohydride,and others which might affect the determination of arsenic and antimonium were analyzed.[Results]Under optimized condition,the linear relation was fine as the concentration of arsenic and antimonium ranged from 0~100μg/L (r=0.9995). The detection limit of arsenic and antimonium was 0.0587μg/L and 0.0529 μg/L respectively. The standard solution (2.0,4.0,6.0 μ g/L) were used to test the relative standard deviation of the methods,for continuous 11 times;the relative standard deviations were 4.4%,1.8 %,and 0.8 % for arsenic,and 4.1%. 2.8% and 0.9% for antimonium. The recovery rates were from 95.0% ~ 105.5% when the standard addiction walue of 0.8,1.0,and 2.0 μl g/L.[Conclusion]This method is simple,fast,with low detection limit and good reproducibility as well as accurate and reliable results,and applicable for simultaneous determination of arsenic and antimonium in drinking water.
Physician perception of hospital safety and barriers to incident reporting.

Article-at-a-Glance Background Despite increased attention to patient safety in recent years, physician involvement in hospital safety activities appears to have remained limited. Methods An anonymous survey of internal medicine housestaff and faculty physicians at an academic medical center assessed safety reporting behavior and witnessed adverse events or near misses. Results Although 65% of the 120 physicians responding (56% response rate) had not made any adverse event or near miss reports in the prior year, 60% had witnessed at least three adverse events or near misses. Uncertainty about reporting needs and mechanisms, concern about time required, perceived clinical import of the event in question, and lack of physician involvement in the system were all important reasons for failure to report. Concern about being blamed or judged less competent or similar consequences to others were considered less important barriers to reporting. The perceived degree of reporting barriers ( p = .01) and number of witnessed adverse events or near misses ( p = .005) were independently negatively associated with respondents' perception of safety. Most (58%) physicians expressed willingness to participate in the hospital safety process actively if requested. Discussion Physicians' barriers to safety reporting in an academic medical center are negatively associated with their perception of hospital safety. These barriers are remediable, and most physicians appear amenable to increased participation in the hospital safety process.
Content-Aware Master Data Management

Master data management (MDM) provides a means to link data from various structured data sources and to generate a consolidated master record for entities such as customers or products. However, a large amount of valuable information about entities exists as unstructured content in documents. In this paper, we show how MDM can be made aware of information from unstructured content by automatically extracting valuable information from documents. We demonstrate for an example application that it is possible to make MDM content-aware without compromising MDM’s premise to be the one trusted source for all entity-related information.
Discriminative stimulus effects of opioids in pigeons trained to discriminate fentanyl, bremazocine and water: evidence of pharmacological selectivity

The purpose of the present investigation was to examine the discriminative stimulus effects of opioids with activity at mu and kappa opioid receptors, in pigeons trained to discriminate the mu opioid fentanyl, the kappa opioid bremazocine and water in a three-choice discrimination task. The apparent pkB values obtained for naloxone as an antagonist of the stimulus effects of fentanyl were higher than those obtained against the bremazocine stimulus. The mu opioids morphine and l-methadone substituted for the fentanyl stimulus, the kappa opioids U50,488 and U69,593 substituted for the bremazocine stimulus, and the non-opioid pentobarbital failed to substitute for either the fentanyl or bremazocine stimulus. A series of opioids with activity at both the mu and kappa opioid receptor sites, including nalorphine, butorphanol, buprenorphine, nalbuphine, ethylketocyclazocine, (-)-ketocyclazocine, (-)-n-allylnormetazocine (NANM) and levallorphan, produced high levels of substitution for the fentanyl stimulus without producing appreciable levels of substitution for the bremazocine stimulus. At doses that did not substitute for the fentanyl stimulus, (-)-NANM, levallorphan, nalorphine and nalbuphine partially antagonized the bremazocine stimulus (i.e. produced responding on the water key). Butorphanol and buprenorphine also antagonized the bremazocine stimulus, although this effect was evidenced only at doses that substituted for the fentanyl stimulus. In contrast, even when tested up to doses that markedly decreased rates of responding, ethylketocyclazocine and (-)-ketocyclazocine failed to antagonize the bremazocine stimulus. The present findings indicate that in this three-choice task the fentanyl-like substitution patterns produced by opioids with activity at both the mu and kappa opioid receptors are similar to those reported in pigeons trained to discriminate either fentanyl or bremazocine from saline (i.e. two-choice tasks). In this task, however, the level of kappa antagonist activity evidenced by these opioids was considerably less than that obtained in pigeons trained to discriminate bremazocine from saline.
SU-F-I-71: Fetal Protection During Fluoroscopy: To Shield Or Not to Shield?

Purpose: Lead aprons are routinely used to shield the fetus from radiation during fluoroscopically guided interventions (FGI) involving pregnant patients. When placed in the primary beam, lead aprons often reduce image quality and increase fluoroscopic radiation output, which can adversely affect fetal dose. The purpose of this work is to identify an effective and practical method to reduce fetal dose without affecting image quality. Methods: A pregnant patient equivalent abdominal phantom is set on the table along with an image quality test object (CIRS model 903) representing patient anatomy of interest. An ion chamber is positioned at the x-ray beam entrance to the phantom, which is used to estimate the relative fetal dose. For three protective methods, image quality and fetal dose measurements are compared to baseline (no protection):1. Lead apron shielding the entire abdomen2. Lead apron shielding part of the abdomen, including the fetus 3. Narrow collimation such that fetus is excluded from the primary beam Results: With lead shielding the entire abdomen, the dose is reduced by 80% relative to baseline along with a drastic deterioration of image quality. With lead shielding only the fetus, the dose is reduced by 65% along with complete preservation of image quality, since the image quality test object is not shielded. However, narrow collimation results in 90% dose reduction and a slight improvement of image quality relative to baseline. Conclusion: The use of narrow collimation to protect the fetus during FGI is a simple and highly effective method that simultaneously reduces fetal dose and maintains sufficient image quality. Lead aprons are not as effective at fetal dose reduction, and if placed improperly, they can severely degrade image quality. Future work aims to investigate a wider variety of fluoroscopy systems to confirm these results across many different system geometries.
Nanoscale Informal Science Education in the U.S.—NISE Net

The Nanoscale Informal Science Education Network (NISE Net) established with a National Science Foundation award in 2005 created a network of hundreds of informal educators and university research scientists with increased capacity to engage the public in learning about nanotechnology, a wide range of materials to use for that purpose, and new knowledge about engaging the public in learning about emerging technologies. This chapter explores how the challenges were met and thoughts for the future.
Comparison of the AIRS, IASI, and CrIS 900 cm-1 channel for Dome Concordia

We compare AIRS, IASI-A and CrIS under the cold conditions encountered in the daily overpasses of Dome Concordia, located on a high plateau in Antarctica, between May 2012 and March 2016. The mean brightness temperature at DomeC for the 900 cm-1 atmospheric window channel is 218K, but it varies seasonally from 185K to 255K. Averaged over all simultaneous overpass data AIRS is 26±13 mK warmer than IASI-A, AIRS is 116±7 mK colder than CrIS. This is excellent agreement and consistent with SNO analysis in the literature. However, we find that differences for both AIRS/IASI-A and AIRS/CrIS are temperature dependent. AIRS is 120 mK colder at 200K, but 150 mK warmer at 230K than IASI-A. AIRS is 120 mK colder at 200K, 50mK colder at 230K than CrIS. Differences and scene temperature sensitivity of this magnitude have also been reported by other investigators. A scene temperature dependence bias can create a sampling bias which need to be taken into account when comparing data from current instruments, and even more so when analyzing data from vintage instruments with respect to climate change.
Guerilla Warfare on the Pancreas? A Case of Acute Pancreatitis From a Supplement Known to Contain Anabolic-Androgenic Steroids.

ABSTRACTIntroduction: Performance-enhancing drugs (PEDs) are commonly consumed in the United States with high prevalence of use in athlete populations and increased use by deployed service members. Many PEDs may contain anabolic-androgenic steroids (AAS), which are legally restricted and prohibited by many agencies due to their health risk. Case Description: A unique case of acute pancreatitis associated with the use of the PED “Guerilla Warfare,” a labeled AAS-containing supplement, is presented. The patient is a healthy 20-year-old male Marine who presented with multiple episodes of abdominal cramps each day for a month with decreased appetite and nonbilious vomiting. He reported a 6-week history of “Guerilla Warfare” PED use and review of systems identified fatigue and 12 lb reported weight loss. He presented with normal vital signs, tenderness in upper abdominal quadrants, elevated lipase (909 units/L), lactate dehydrogenase (193 units/L), and an enlarged pancreas with surrounding inflammation on comp...
Mining Method Selection and Optimization for Hanging-Wall Ore-Body at Yanqianshan Iron Mine, China

In order to smooth ore production during the transition from open pit to underground mining at Yanqianshan Iron Mine, China, it is necessary to select an appropriate mining method to operate simultaneously open-pit mining and underground mining for inner-slope (hanging-wall) ore-body. Based on practical geologic setting of the hanging-wall ore-body, a comprehensive evaluation model for selecting the underground mining method to extract handing-wall ore-body was proposed, which is constituted by 3 sub-systems of safety factors, production factors and technical–economic factors. This evaluation model could be analyzed by the mutation progression method, which based on catastrophe theory and fuzzy mathematics. In addition, the FLAC3D is employed to simulate the mining process of hanging-wall ore-body, and finally the optimal mining scheme is determined. By using mutation progression analysis and numerical modeling, some useful conclusions for hanging-wall ore-body mining have been drawn, which will be beneficial to mining safety during transitional period from open-pit to underground mining.
Stereolithography-Based 3D Printed “Pillar Plates” that Minimizes Fluid Transfers During Enzyme Linked Immunosorbent Assays

Enzyme linked immunosorbent assay (ELISA) is one of the most popular and indispensable tools in molecular biology. Despite numerous advances in ELISA methods that markedly improve the sensitivity and throughput of detection, a hallmark of all ELISA continues to be repeated pipetting of fluids that is not only cumbersome but can easily introduce errors or contaminations. Robotics, despite obvious advantages, remains expensive. Here, we designed and produced cheap "pillar plates" using stereolithography-based 3D printing that can be readily inserted into conventional 96- and 384- well plates and serve as the substrate for ELISA. We demonstrate that ELISA using these "pillar plates" affords comparable specificity and sensitivity of detection of serum antibodies to traditional sandwich ELISA, while markedly reducing the time and efforts associated with fluid transfer. These results underscore "pillar plates" as an attractive platform for rapid yet robotics-free ELISA.
Stochastic Simulator for Smart Microgrid Planning

Developing world microgrids often balance insufficient supply with growing, unpredictable demand. Deterministic and probabilistic simulators exist to model these microgrids, and each focuses on different technical aspects. With the addition of smart meters into microgrids, monitoring and control is now available at high granularity, which enriches microgrid planning and operation. This research is designing a new simulator that incorporates models of smart meters that allow real-time power clipping for demand side management, effectively smoothing the system load curve as needed to represent inherent uncertainty. Individual supplies and demands are modeled as discrete probability mass functions (PMFs). To compare clipping schemes for grid operation and generation mixes for planning, we aggregate the probabilistic inputs by convolution and then compute expected energy sold and probability of avoiding power cuts. We compare these values for load profiles of different days of the week and test microgrid reliability with different numbers of customers clipped.
Emerging investigators series: highly effective adsorption of organic aromatic molecules from aqueous environments by electronically sorted single-walled carbon nanotubes

The use of electronically sorted (i.e. semiconducting or metallic) single-walled carbon nanotubes (SWCNTs) for the removal of organic compounds from aqueous environments is investigated. Chromatography techniques are used to separate the semiconducting type from the metallic type. Spectroscopy (including UV-visible) is employed to measure the uptake of 1-pyrenebutyric acid, diquat dibromide, and 2,4-dichlorophenoxyacetic acid onto the sorted SWCNTs. Kinetic and equilibrium analysis show that the semiconducting type is capable of adsorbing up to 70.6% more adsorbate compared to the metallic type. This is likely attributed to the favorability of these compounds interacting with the semiconducting type due to a lack of electron density around this type of SWCNT. Moreover, a comparison of the material separated in-house by chromatography to those purchased from a commercial source shows that the in-house material is capable of adsorbing 26.5 to 60% more adsorbate versus the commercial material in which the SWCNTs were separated using density gradient ultracentrifugation methods. This demonstrates that chromatography techniques potentially yield a more effective separation of the semiconducting and metallic SWCNTs. Such opportunities can be influential in the development of new adsorbent systems towards removal of targeted compounds from aqueous environments.
Effects of pectoral fin ray removal on Siberian sturgeon Acipenser baerii swimming performance

Fin ray biopsies are commonly used to age sturgeon, but the effects of fin ray biopsy on Siberian sturgeon Acipenser baerii swimming performance are unknown. Therefore, the effects of two fin ray biopsy methods on swimming performance of hatchery-reared, juvenile Siberian sturgeon were evaluated in this study. Treatment fish were subjected to one of two biopsy methods: removal of a 2- to 4-cm section from a marginal pectoral fin ray, or full removal of a marginal pectoral fin ray. Control fish were only subjected to a sham operation. A modified 2,936-l Brett-type swim tunnel was used to evaluate 10-min critical station-holding speeds (C SHS) and behavioral swimming characteristics of sturgeon immediately after fin ray biopsies were carried out. Fish sizes (range 65- to 84-cm fork length) were comparable among treatments. Mean 10-min C SHS (mean ± SE) were 113 ± 3.4, 109 ± 2.5, and 111 ± 2.8 cm s−1 for the segment removal treatment, full removal treatment, and control treatment, respectively. ANOVA indicated that the two methods had no significant effect on the 10-min C SHS of Siberian sturgeon compared to the control treatment. Results indicate that fin ray removal has no effect on Siberian sturgeon swimming performance.
Step One Towards Science of Security

Science of security necessitates conducting methodologically-defensible research and reporting such research comprehensively to enable replication and future research to build upon the reported study. The comprehensiveness of reporting is as important as the research itself in building a science of security. Key principles of science - replication, meta-analysis, and theory building - are affected by the ability to understand the context and findings of published studies. The goal of this paper is to aid the security research community in understanding the state of scientific communication through the analysis of research published at top security conferences. To analyze scientific communication, we use literature on scientific evaluation to develop a set of rubrics as a guide to check the comprehensiveness of papers published in the IEEE Security and Privacy and ACM Computer and Communications Security conferences. Our review found that papers often omit certain types of information from their reports, including research objectives and threats to validity. Our hope is that this effort sheds some light on one of the essential steps towards advancement of the science of security.
Parathyroid: The Pathology of Hyperparathyroidism

This review focuses on the pathologic entities associated with hyperparathyroidism in humans. A discussion of the lesions, their embryology, and pathologic features is included. Immunohistology, cytopathology, and a brief overview of molecular aspects of the lesion are included.
Fundamentals of Condensation

The fundamentals of condensation heat transfer for a pure vapor are reviewed. Calculational methods for the heat transfer coefficient and the pressure drop are presented for a wide variety of surface geometries and flow configurations, including shell-side condensation, in-tube condensation and direct-contact condensation. Enhancement techniques, including the fundamentals of dropwise condensation, are briefly described.
Biological Function of Vitamin K Antagonists

The role of a dietary factor in the maintenance of normal hemostasis was discovered by Dam in the late 1920’s. He noted a hemorrhagic condition in chicks fed lipid-free diets and demonstrated that the addition of alfalfa meal or a lipid extract of alfalfa would prevent this condition. Continued study of this response in the early 1930’s by the research groups of Dam, Almquist, and Doisy led to the isolation, characterization, and synthesis of the active compound, 2-Me-3-phytyl-l,4-naphthoquinone (phylloquinone). These early studies also demonstrated that in addition to phylloquinone (vitamin K1) in green plants, vitamin K activity was present in many bacteria as a series of menaquinones, 2-Me-1,4-naphthoquinones substituted at the 3-position with an unsaturated polyisoprenoid chain (Fig. 1). The historical aspects of the discovery of vitamin K have been adequately reviewed by Suttie (1985).
Inhibition of Na+ /K+ -ATPase and KIR channels abolishes hypoxic hyperaemia in resting but not contracting skeletal muscle of humans.

KEY POINTS Increasing blood flow (hyperaemia) to exercising muscle helps match oxygen delivery and metabolic demand. During exercise in hypoxia, there is a compensatory increase in muscle hyperaemia that maintains oxygen delivery and tissue oxygen consumption. Nitric oxide (NO) and prostaglandins (PGs) contribute to around half of the augmented hyperaemia during hypoxic exercise, although the contributors to the remaining response are unknown. In the present study, inhibiting NO, PGs, Na+ /K+ -ATPase and inwardly rectifying potassium (KIR ) channels did not blunt augmented hyperaemia during hypoxic exercise beyond previous observations with NO/PG block alone. Furthermore, although inhibition of only Na+ /K+ -ATPase and KIR channels abolished hyperaemia during hypoxia at rest, it had no effect on augmented hyperaemia during hypoxic exercise. This is the first study in humans to demonstrate that Na+ /K+ -ATPase and KIR channel activation is required for augmented muscle hyperaemia during hypoxia at rest but not during hypoxic exercise, thus providing new insight into vascular control. ABSTRACT Exercise hyperaemia in hypoxia is augmented relative to the same exercise intensity in normoxia. During moderate-intensity handgrip exercise, endothelium-derived nitric oxide (NO) and vasodilating prostaglandins (PGs) contribute to ∼50% of the augmented forearm blood flow (FBF) response to hypoxic exercise (HypEx), although the mechanism(s) underlying the remaining response are unclear. We hypothesized that combined inhibition of NO, PGs, Na+ /K+ -ATPase and inwardly rectifying potassium (KIR ) channels would abolish the augmented hyperaemic response in HypEx. In healthy young adults, FBF responses were measured (Doppler ultrasound) and forearm vascular conductance was calculated during 5 min of rhythmic handgrip exercise at 20% maximum voluntary contraction under regional sympathoadrenal inhibition in normoxia and isocapnic HypEx (O2 saturation ∼80%). Compared to control, combined inhibition of NO, PGs, Na+ /K+ -ATPase and KIR channels (l-NMMA + ketorolac + ouabain + BaCl2; Protocol 1; n = 10) blunted the compensatory increase in FBF during HypEx by ∼50% (29 ± 6 mL min-1 vs. 62 ± 8 mL min-1 , respectively, P 0.05). However, the blocked condition in both protocols abolished the hyperaemic response to hypoxia at rest (P < 0.05). We conclude that activation of Na+ /K+ -ATPase and KIR channels is involved in the hyperaemic response to hypoxia at rest, although it does not contribute to the augmented exercise hyperaemia during hypoxia in humans.
Development and Assessment of Intercultural Effectiveness: A Learner-Centered Approach:

Globalization has created an accelerated demand for globally competent managers, yet the gap between this demand and the supply of globally oriented, competent graduates is growing. As a result, th...
Assessment of hospital-level adjusted breast cancer sentinel lymph node positivity rates

BACKGROUND/OBJECTIVES Proficiency of performing sentinel lymph node biopsy (SLNB) for breast cancer varies among hospitals and may be reflected in the hospital's SLNB positivity rate. Our objectives were to examine whether hospital characteristics are associated with variation in SLNB positivity rates and whether hospitals with lower-than-expected SLNB positivity rates have worse patient survival. METHODS Using the National Cancer Data Base, stage I to III breast cancer patients were identified (2004-2012). Hospital-level SLNB positivity rates were adjusted for tumor and patient factors. Hospitals were divided into terciles of SLNB positivity rates (lower-, higher-, as-expected). Hospital characteristics and survival were examined across terciles. RESULTS Of 438 610 SLNB patients (from 1357 hospitals), 78 104 had one or more positive SLN (21.3%). Hospitals in the low and high terciles were more likely to be low volume (low: RRR, 4.40; 95% CI, 2.89-6.57; P < 0.001; and high: RRR, 1.79; 95% CI, 1.21-2.64; P < 0.001) compared to hospitals with as-expected (middle tercile) SLNB positivity rates. Stage I patients at low- and high-tercile hospitals had statistically worse survival. CONCLUSIONS There is a wide variation in hospital SLNB positivity rates. Hospitals with lower- or higher-than-expected SLNB positivity rates were associated with survival differences. Hospital SLNB positivity rates may be a novel 'process measure' to report to hospitals for internal quality assessment.
Development of an Opsonophagocytic Killing Assay Using HL-60 Cells for Detection of Functional Antibodies against Streptococcus pyogenes.

ABSTRACT The clinical development of group A streptococcal (GAS) vaccines will require the implementation of a standardized, high-throughput assay to measure the activity of functional opsonic antibodies in vaccine recipients. In the present study, we adapted and modified the HL-60-based protocol that was developed for the detection of opsonic antibodies against Streptococcus pneumoniae for use with multiple M types of GAS. Modifications of the assay conditions permitted the evaluation of 21 different M types of GAS in the assay. The specificity of the antibody-mediated opsonization was demonstrated by inhibition with homologous, but not heterologous, M proteins. Maximum rates of opsonophagocytic killing (OPK) of 14 different M types promoted by rabbit antiserum against the 30-valent M protein-based vaccine were comparable in whole-blood and HL-60 assays. Data are also presented showing OPK serum titers (opsonic index) of naturally acquired human antibodies present in IVIG [intravenous immune globulin (human)]. Results of the HL-60 assay performed on different days using 21 different M types of GAS and IVIG as the antibody source were significantly concordant. This report indicates that the OPK assay conditions may be optimized for the measurement of opsonic antibodies against a number of epidemiologically important M types of GAS and, once standardized, should facilitate the clinical development of effective vaccines to prevent these infections. IMPORTANCE Measuring functional opsonic antibodies against group A streptococci is an important component of the clinical development path for effective vaccines. Prior studies have used an assay developed over 60 years ago that relied on whole human blood as the source of phagocytes and complement, both of which are critical components of antibody-mediated killing assays. In this study, we adapted an assay that uses the HL-60 human promyelocytic leukemia cell line as phagocytic cells and baby rabbit serum as a source of complement for detection of opsonic antibodies against group A streptococci. On the basis of some of the known biological characteristics of the bacteria, we modified the assay conditions to support the evaluation of 21 epidemiologically important M types and demonstrated the utility and reproducibility of the assay for measurement of functional opsonic antibody levels.
How Consumers Choose Between Equated Alternatives

This research investigates how consumers choose between options when prices offset perceived quality differences. We suggest that consumers choose between equated alternatives by first assessing which option is of higher quality, and then relying on their confidence in this assessment to determine how much weight to give to equating prices: The lower the confidence in their quality assessments, the more weight they give to equating prices, and the more likely they are to choose a lower-priced option against an equally attractive but higher-quality alternative. In five studies, we manipulated consumers’ confidence in their quality assessments and then asked them to choose between equated alternatives. As predicted, consumers were more likely to choose the higher-quality option against an equated alternative when they were more confident in their quality assessments. This occurred even when confidence was manipulated without altering the choice options themselves (e.g., by degrading the font of the questionnaire).
Mammographic architectural distortion caused by cyst aspiration

Improvement in breast cancer screening technology has increased the detection of architectural distortion, which can often indicate underlying malignancy; however, there are also many benign causes...
Applying Machine Learning Models to Identify Forest Cover

This paper presents an application of several classification techniques on forested lands data. More specifically, testing the efficiency of each classifier in its ability to identify a specific forest cover type. Four classifiers were used in the study, and testing was performed with both unscaled data and data scaled via two different methods. The study completes successfully with a stand-out algorithm that easily exceeded its peers in the given task; the Random Forest classifier. It concludes with speculation on how this algorithm, and the study itself, can be built-upon in the future.
Arthroscopic Management of Intra-articular Tophaceous Gout of the Knee: A Case Report and Review of the Literature.

Introduction Surgical management of intra-articular tophaceous gout has been previously described but not widely reported in the literature. Therefore, when faced with clinical decision-making regarding this entity, the surgeon may be unfamiliar with the diagnosis, appropriate management, and outcomes related to treatment. Case report A 42-year-old male oil field worker who presented with the right knee intra-articular tophaceous gout deposits resulting in mechanical symptoms. The pathology was diagnosed intraoperatively while performing knee arthroscopy for what was presumed to be a meniscal tear. The patient underwent arthroscopic debridement of the tophi and partial meniscectomy. The tophaceous gout deposits were debrided with an arthroscopic liberator which allowed for the protection of the underlying articular cartilage. Postoperatively, he was begun with aggressive range of motion exercises and was referred to a rheumatologist for gout medical management. The patient improved significantly in regard to pain and range of motion and was able to return to full duty by 6weeks postoperatively. Conclusions Tophaceous gout of the knee can mimic intra-articular pathology and may be encountered unexpectedly when performing a knee arthroscopy. The treating surgeon should be aware of the potential for this condition and understand that surgical intervention, when combined with appropriate medical management, can yield favorable clinical results.
Fluoroquinolone Versus Nonfluoroquinolone Treatment of Bloodstream Infections Caused by Chromosomally Mediated AmpC-Producing Enterobacteriaceae.

Objectives: Chromosomally mediated AmpC-producing Enterobacteriaceae (CAE) display high susceptibility to fluoroquinolones; minimal clinical data exist supporting comparative clinical outcomes. The objective of this study was to compare treatment outcomes between fluoroquinolone and nonfluoroquinolone definitive therapy of bloodstream infections caused by CAE. Methods: This retrospective cohort assessed adult patients with positive blood cultures for CAE that received inpatient treatment for ≥48 h. The primary outcome was difference in clinical failure between patients who received fluoroquinolone (FQ) versus non-FQ treatment. Secondary endpoints included microbiological cure, infection-related length of stay, 90-day readmission, and all-cause inpatient mortality. Results: 56 patients were included in the study (31 (55%) received a FQ as definitive therapy; 25 (45%) received non-FQ). All non-FQ patients received a beta-lactam (BL). Clinical failure occurred in 10 (18%) patients, with 4 (13%) in the FQ group and 6 (24%) in the BL group (p = 0.315). Microbiological cure occurred in 55 (98%) patients. Median infection-related length of stay was 10 (6–20) days, with a significantly longer stay occurring in the BL group (p = 0.002). There was no statistical difference in 90-day readmissions between groups (7% FQ vs. 17% BL; p = 0.387); one patient expired. Conclusion: These results suggest that fluoroquinolones do not adversely impact clinical outcomes in patients with CAE. When alternatives to beta-lactam therapy are needed, fluoroquinolones may provide an effective option.
Ultra-Widefield Imaging for Evaluation of the Myopic Eye

Topic: Ultra-widefield (UWF) imaging of the myopic eye. Clinical Relevance: Myopes, and particularly high and pathologic myopes, present a unique challenge in fundoscopic imaging. Critical patholog...
NLRP7: From inflammasome regulation to human disease

Nucleotide-binding oligomerization domain (NOD) and leucine-rich repeat (LRR)-containing receptors or NOD-like receptors (NLRs) are cytosolic pattern recognition receptors which sense conserved microbial patterns and host-derived danger signals to elicit innate immune responses. The activation of several prototypic NLRs, including NLR and pyrin domain (PYD) containing (NLRP) 1, NLRP3 and NLR and caspase recruitment domain (CARD) containing (NLRC) 4, results in the assembly of inflammasomes which are large, cytoplasmic multi-protein signaling platforms responsible for the maturation and release of the pro-inflammatory cytokines IL-1β and IL-18, and for the induction of a specialized form of inflammatory cell death called pyroptosis. However, the function of other members of the NLR family, including NLRP7, are less well understood. NLRP7 has been linked to innate immune signaling, but its precise role is still controversial as it has been shown to positively and negatively affect inflammasome responses. Inflammasomes are essential for homeostasis and host defense, but inappropriate inflammasome responses due to hereditary mutations and somatic mosaicism in inflammasome components and defective regulation has been linked to a broad spectrum of human diseases. A compelling connection between NLRP7 mutations and reproductive diseases, and in particular molar pregnancy, has been established. Though, the molecular mechanisms by which NLRP7 mutations contribute to reproductive diseases are largely unknown. In this review, we focus on NLRP7 and discuss the current evidence of its role in inflammasome regulation as well as its implication in human reproductive diseases.
A Novel Activation Maximization-based Approach for Insight into Electrophysiology Classifiers

Abstract Spectral analysis remains a hallmark approach for gaining insight into electrophysiology modalities like electroencephalography (EEG). As the field of deep learning has progressed, more studies have begun to train deep learning classifiers on raw EEG data, which presents unique problems for explainability. A growing number of studies have presented explainability approaches that provide insight into the spectral features learned by deep learning classifiers. However, existing approaches only attribute importance to different frequency bands. Most of the methods cannot provide insight into the actual spectral values or the relationship between spectral features that models have learned. Here, we present a novel adaptation of activation maximization for electrophysiology time-series that generates samples that indicate the features learned by classifiers by optimizing their spectral content. We evaluate our approach within the context of EEG sleep stage classification with a convolutional neural network, and we find that our approach is able to identify spectral patterns known to be associated with each sleep stage. We also find surprising results suggesting that our classifier may have prioritized the use of eye and motion artifact when identifying Awake samples. Our approach is the first adaptation of activation maximization to the domain of raw electrophysiology classification. Additionally, our approach has implications for explaining any classifier trained on highly dynamic, long time-series.