cssi/SciSciGPT-SciSciNet huggingface dataset:
Assessment of health literacy in adolescents with spina bifida and their caregivers: a multi-institutional study

Summary Introduction and Objective: Health literacy is defined as the ability to obtain, integrate, and appraise health-related knowledge. It is known to correlate with disparities in clinical outcomes in adults with chronic disease. Patients with spina bifida represent a potentially vulnerable cohort as they often have multiple comorbidities. The authors aimed to characterize health literacy in adolescent patients with spina bifida and their caregivers. Study design The Newest Vital Sign (NVS), a validated assessment of health literacy and numeracy, was administered to patients (aged ≥10 years) and caregivers in outpatient pediatric urology and multidisciplinary spina bifida clinics. Subjects not fluent in English or Spanish and those with cognitive delay were excluded. Survey responses and demographic information were analyzed and compared between the spina bifida and control groups. Results Three hundred eleven caregivers (caregivers for patients with spina bifida: 185, caregivers for the controls: 126) and 84 adolescents (those with spina bifida: 46, controls: 38) completed the NVS. Although there was no difference in health literacy between caregivers (p = 0.98), adolescents with spina bifida demonstrated lower NVS scores (spina bifida 1 [0–3] vs. control 2 [2–4]; p = 0.02) (Figure). Health literacy of patients with spina bifida and controls increased with age (p = 0.002). Adjusting for age and gender, the odds of having limited literacy were 5.5 times higher in patients with spina bifida than in the controls (p = 0.004). Inadequate caregiver health literacy was associated with a lower education level (p Discussion Spina bifida is among the most complex birth defects compatible with life and affects a multitude of systems. Although it is well established that limited health literacy in adults with chronic disease is associated with adverse outcomes, there are considerably fewer data in the pediatric population. The authors found that caregivers of patients with spina bifida exhibited health literacy and numeracy comparable with parents in the control group, despite lower education levels. In contrast, adolescents with spina bifida demonstrated poorer health literacy than the controls. Multidisciplinary care is necessary, given the medical complexity of spina bifida; therefore, impaired understanding of adults’ own needs may pose a barrier to successful transition to their care and subsequent outcomes. Conclusions The majority of surveyed caregivers for patients with spina bifida exhibited adequate health literacy, especially those with some college education; however inadequate health literacy was more likely among adolescents with spina bifida when compared with the controls. Screening for health literacy may be useful to assess readiness for transition to more independent self-care among patients with spina bifida. Download : Download high-res image (106KB) Download : Download full-size image Summary Figure . Comparison of health literacy between adolescents (P = 0.02).
Religion in Civil Society: The Influence of Black Religious Ecology on Crime in the South

The civil society perspective predicts that civic and voluntary organizations promote the welfare of communities by enhancing social capital and cohesion. Here, I examine whether black Protestant churches, because of their dual emphasis on personal piety and social justice, function as agents of civil society in the southern United States by reducing crime, and whether structural context moderates the relationship between black religious ecology and crime. With data from the 2010 Religious Congregations and Membership Survey, I used spatial regression analyses to estimate models of arrest rates in 799 southern counties. I examined indices representing both property and violent crime provided in the FBI Uniform Crime Reports. In main effects models, black Protestant density related inversely to county-level property crime arrest rates, but it was unrelated to violent crime arrest rates. Interactive models revealed that black Protestant affiliation was particularly protective of property crime in counties with the highest levels of resource disadvantage. While black Protestant affiliation was protective of both property and violent crime in low-income counties, it had a positive association with arrest rates in high-income counties. Net of total religious adherence, the Black Church has a uniquely protective effect against crime in the most disadvantaged southern communities. Findings were largely consistent with ecological theories related to social capital, social organization, and collective efficacy. They also highlight limits to the moral communities thesis. Results suggest that more scholarship should examine racialized law enforcement practices in high-income counties.
Analysis of the Development Potential of the Food Industry in the EU28

Building on the idea that the available balance of economic enterprises allows financing of investments as a source of innovation and development, the paper provides the main results of investigation upon the development potential of the food industry in the EU28 countries, in terms of the dynamics and structural comparisons, aiming to highlight the changes in performance and the gaps that determine the hierarchy of countries, in view of increasing their economic convergence as a basic factor for a sustainable Single Market. The research used the comparison of the selected relevant economic and financial indicators for the activity of enterprises in the agri-food manufacturing industry of the countries and groups of states by their current membership to the Eurozone, against the EU28 average, using the most recent available statistical material provided by Eurostat for the last decade.
Monitoring results of drinking water quality in Jianhe County of Guizhou Province from 2009 to 2011

Objective To find out the hygienic status of rural drinking water in Jianhe County of Guizhou Province.Methods Forty-eight source water and tap water samples from small centralized water supply stations in 12 townships of Jianhe County in dry season and wet period were tested from 2009-2011.The water samples were examined in accordance with the relevant provision of "Standard Examination Methods for Drinking Water" (B/T5750-2006).The contents included:①sensory indicators:standard color,turbidity,smell and taste and visible objects; ②general chemical indicators:pH,iron,manganese,chloride,sulfate,total dissolved solids,total hardness,oxygen consumption and ammonia; ③toxicological indicators:fluoride,arsenic and nitrate; ④microbial indicators:total number of colonies,with a total population of Escherichia coli and heat-resistant Escherichia coli Outcome evaluation was carried out in accordance with the "Drinking Water Health Standards" (B/T 5.749-2006).Results A total of 192 rural water samples were collected in 2009-2011,and 18 samples were qualified,accounting for 9.38％.The differences of water passing rate between groups of years were statistically significant (x2 =14.74,P＜ 0.01).Rural drinking water quality in dry season (18.75％,18/96) was better than that in wet season (0.00％,0/96; x2 =19.76,P ＜ 0.01).Passing rate of source water quality (16.67％,16/96) was higher than that of tap water(2.08％,2/96; x2 =11.95,P ＜ 0.01).Sensory indicators and toxicological indicators of 192 water samples were qualified.General chemical indicators:in addition to four water samples with pH exceeded the standard(two copies in 2009 and two copies in 2010),other test indicators were qualified.Microbiological indicators:passing rates of the total number of colonies,Escherichia coli group and heat-resistant Escherichia coli group were 77.08％ (148/192),9.90％ (19/192) and 20.31％ (39/192),respectively.Passing rate of microbes was 18.75％ (18/96) in dry season and 0.00％ (0/96) in wet period,and microbes passing rate was significantly higher in dry season than that of the wet period(x2 =19.76,P ＜ 0.01).Passing rate of microbes was 16.67％(16/96) in source water and 2.08％(2/96) in tap water,and passing rate of the source water was significantly higher than that of the tap water(x2 =11.95,P ＜ 0.01).Conclusions The hygienic status of rural drinking water in rural areas of Jianhe County of Guizhou Province is poor.Microbial pollution is the main reason. Key words: Rural area; Drinking; Water quality detection; Qualified rate
Sustainability efforts of denim brands Mud Jeans and Levi Strauss & Co.

The textile and apparel production processes make use of scarce resources and many chemicals resulting in products with high environmental impact. The social and environmental factors that disrupt textile and apparel businesses and their performance are often multidimensional in nature. The sheer number of chemicals used in the textile and apparel supply chain presents obvious opportunities for companies to reduce use of toxic chemicals and materials to improve their environmental sustainability quotient. At the same time, the social sustainability measures focus on improving the lives of various stakeholders that are in its supply chain. This study assess the sustainable practices of two denim brands – Levi Strauss & Co. (U.S.A) and Mud Jeans (Netherlands). Levis’ current sustainability goals are to accomplish zero discharge of hazardous chemical by 2020 and to produce more than 80 % of its product volume in Worker Wellbeing factories by 2025. However, Mud Jeans is making efforts to adopt circular model in the category of denim products.
Association of Prehospital Step 1 Vital Sign Criteria and Vital Sign Decline with Increased Emergency Department and Hospital Death.

Background This study analyzed data from the 2017 American College of Surgeons National Trauma Data Bank to examine the effects of pre-hospital Field Triage Decision Scheme Step 1 vital sign criteria (S1C) and vital sign decline on subsequent emergency department (ED) and hospital death in emergency medical services (EMS) transported trauma victims. Study design Patient and injury characteristics, transport time, and ED and hospital disposition were collected. S1C (respiratory rate [RR] 29 breaths/min, systolic blood pressure [SBP] Results Of 333,213 included patients, 54,849 (16.5%) met Step 1 criteria at the scene, and 21,566 (6.9%) declined en route. The ED death rate was 0.4% (n = 1,188), and the hospital death/hospice rate was 4.0% (11,624 of 287,675). Patients who met S1C at the scene or who declined were more likely to require longer hospital lengths of stay, ICU admission, and surgical intervention. S1C and decline patients had higher odds of death in both the ED (S1C odds ratio [OR] 15.1, decline OR 2.4, p values Conclusions This study quantifies the mortality risks associated with individual S1C and validates their use as an indicator for injury severity and pre-hospital triage tool.
Did people's behavior after receiving negative COVID-19 tests contribute to the spread?

Background Testing on demand for coronavirus disease (COVID-19) is hypothesized to increase spread of the virus as some persons who test negative falsely assume that they can engage in activities that increase spread. Methods Daily new COVID-19 hospitalization counts through 2020 from 25 countries that reported testing and hospitalizations were studied by regression of logarithms of new hospitalizations 14 days out against log(new hospitalizations on a given day), log(negative tests), log(positivity rate) and days since the first hospitalizations were reported. The regression coefficients were examined separately for periods in countries that were following three different testing policies. Results Corrected for the other factors, negative test numbers when tested on demand and tested if symptomatic only are associated with an increase in hospitalizations 14 days after the tests. When only the symptomatic and more vulnerable are tested, negative tests are associated with fewer hospitalizations 2 weeks out. Conclusions A policy of testing only vulnerable populations, whether symptomatic or not, appears to avoid spreading the virus as a result of testing policy. False confidence of reduced risk among those who test negative may have contributed to the spread in countries that allowed testing on demand or testing only those who claimed to have symptoms.
Can Financial Economics Cure Cancer

Funding for early-stage biomedical innovation has become more difficult to secure at the same time that medical breakthroughs seem to be occurring at ever increasing rates. One explanation for this counterintuitive trend is that increasing scientific knowledge can actually lead to greater economic risk for investors in the life sciences. While the Human Genome Project, high-throughput screening, genetic biomarkers, immunotherapies, and gene therapies have made a tremendously positive impact on biomedical research and, consequently, patient lives, they have also increased the cost and complexity of the drug development process, causing many investors to shift their assets to more attractive investment opportunities. This suggests that new business models and financing strategies can be used to reduce the risk and increase the attractiveness of biomedical innovation so as to bring new and better therapies to patients faster.
Cardiorenal Systems Modeling: Left Ventricular Hypertrophy and Differential Effects of Antihypertensive Therapies on Hypertrophy Regression

Cardiac and renal function are inextricably connected through both hemodynamic and neurohormonal mechanisms, and the interaction between these organ systems plays an important role in adaptive and pathophysiologic remodeling of the heart, as well as in the response to renally acting therapies. Insufficient understanding of the integrative function or dysfunction of these physiological systems has led to many examples of unexpected or incompletely understood clinical trial results. Mathematical models of heart and kidney physiology have long been used to better understand the function of these organs, but an integrated model of renal function and cardiac function and cardiac remodeling has not yet been published. Here we describe an integrated cardiorenal model that couples existing cardiac and renal models, and expands them to simulate cardiac remodeling in response to pressure and volume overload, as well as hypertrophy regression in response to angiotensin receptor blockers and beta-blockers. The model is able to reproduce different patterns of hypertrophy in response to pressure and volume overload. We show that increases in myocyte diameter are adaptive in pressure overload not only because it normalizes wall shear stress, as others have shown before, but also because it limits excess volume accumulation and further elevation of cardiac stresses by maintaining cardiac output and renal sodium and water balance. The model also reproduces the clinically observed larger LV mass reduction with angiotensin receptor blockers than with beta blockers. We further provide a mechanistic explanation for this difference by showing that heart rate lowering with beta blockers limits the reduction in peak systolic wall stress (a key signal for myocyte hypertrophy) relative to ARBs.
Pediatric palliative care pharmacy pearls—a focus on pain and sedation

Determining the optimal dosing regimen for pediatric patients is a challenge due to the lack of dosing guidelines and studies. In addition, many developmental pharmacology changes that occur throughout childhood that have profound impacts on the absorption, distribution, metabolism, and elimination of medications are commonly used in palliative care. Adding to that complexity, certain medications have different effects in the pediatric patient compared to the adult patient. Being aware of the pharmacokinetic changes, impact on neurodevelopment and unique medication factors that are present in pediatric patients helps clinicians treat the pediatric palliative care patient in the best and safest way possible.
Land Rush in Las Vegas

Excerpt] Introduction For decades, Las Vegas has been a favorite destination for fun-seekers who yearn for the glitz and glamour that personifies ‘The Strip’. While visitors came by the millions, few took the step of making Sin City their permanent residence. Oh, how times have changed! Best known as the gambling center of the world, Las Vegas has grown from a desert way-station situated in one of the harshest climates in the United States to a desert oasis that draws over 70,000 immigrants a year. The rapid expansion of the population in Las Vegas has created one of the hottest real estate markets in the country. Between the second quarter of 2003 and 2004, the price of single-family residences in Las Vegas increased by more than 52%, the greatest 12-month increase ever for any metropolitan area2.
Abstract #4400: Cdk3-mediated c-Jun phosphorylation at Ser63 and Ser73 enhances cell transformation

c-Jun is a component of the activator protein-1 (AP-1) complex, which plays a crucial role in the regulation of gene expression, cell proliferation and transformation, as well as cancer development. Herein, we found that Cdk3, but not Cdk2 or JNK, is a novel kinase of c-Jun induced by stimulation with growth factors such as epidermal growth factor (EGF). Cdk3 was shown to phosphorylate c-Jun at Ser63 and Ser73 in vitro and ex vivo. EGF-induced Cdk3 activation caused c-Jun phosphorylation at Ser63 and Ser73, resulting in increased AP-1 transactivation. Ectopic expression of Cdk3 resulted in anchorage-independent cell transformation of JB6 Cl41 cells induced by EGF and foci formation stimulated by constitutively active Ras (RasG12V), which was mediated by AP-1 in NIH3T3 cells. These results demonstrated that the Cdk3/c-Jun signaling axis plays an important role in EGF-stimulated cell proliferation and cell transformation. Citation Information: In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 4400.
Emissivity and Its Effect on the Current-Carrying Capacity of Stranded Aluminum Conductors [includes discussion]

An apparatus for the measurement of the total hemispherical emissivity of stranded conductor is described. A measurement is made by suspending the specimen in the center of an evacuated chamber, heating the specimen, and taking a cooling curve. New stranded aluminum conductors have emissivity values of about 20 to 25%; old, weathered conductors may have emissivities of 90% or higher. Data tending to confirm the values of emissivity obtained are presented in the form of actual temperature rises of several sizes of stranded conductor under controlled conditions. It is shown that the values of convected heat loss obtained by subtracting calculated radiated heat loss from the measured I2R input to the conductor check very closely for both new and blackened conductors.
Composite indices of physical quality of life, basic needs fulfilment, and income: A ‘principal component’ representation

Abstract In the context of international comparisons, the multivariate method of ’principal components’ is suggested for computing composite indices of economic development that capture per capita income, basic needs fulfilment, and other possible indicators of well-being. The method is conceptually appealing, easy to apply, and seems promising in several directions. Two illustrative applications are given. One develops a composite index based on the three PQLI constituents and per capita GNP for 147 countries. In the other, a composite index of basic needs fulfilment is first computed for 82 countries, and then a more inclusive measure, that also takes account of per capita GNP, is derived.
Does route of administration affect the outcome of TNF antagonist therapy

The tumor necrosis factor (TNF) antagonists are parenterally administered biologic response modifiers indicated for the management of rheumatoid arthritis. Although infliximab, etanercept, and adalimumab are all members of this class, they differ in route of administration and dosing regimen. In the USA and in Europe, infliximab, in combination with oral methotrexate, is administered intravenously, initially at a dose of 3 mg/kg at weeks 0, 2, and 6, then every 8 weeks thereafter. The US Food and Drug Administration (FDA) has further approved that the dosage can be increased to 10 mg/kg and the doses can be given as often as every 4 weeks to optimize patient outcome (information based on the US package insert dated June 2002). Etanercept and adalimumab are given subcutaneously and can be self-injected. The FDA-approved dose of etanercept is 25 mg twice weekly, and of adalimumab is 40 mg every 2 weeks with methotrexate, or 40 mg alone. Medication adherence, possibly the most important factor in maintaining the benefits of anti-TNF therapy, is influenced by the interaction between the patient and his or her healthcare team, the patient's attitude toward the disease and medication regimen, and the choice of therapy.
Discovery of the Reverse Transcriptase

1995 is the 20th anniversity of the award of the Nobel Prize in Physiology or Medicine to David Baltimore and Howard Temin for the discovery of the reverse transcriptase. The prize was shared with Renato Dulbecco.
The importance of gold‐electrode‐adjacent stationary high‐field Böer domains for the photoconductivity of CdS

When the electron density decreases stronger than linearly with the electric field in photoconductive CdS due to field quenching, high-field domains must occur that remain attached to either the cathode or anode in slit electrode geometry with blocking cathodes. These Boer domains1 are easily seen by their shift in optical absorption due to the Franz-Keldysh effect and offer unique opportunities to analyze field dependent parameters within the range of constant electron density and electric field, such as the carrier density or mobility as a function of the field, and give information of the light dependent work function. They also provide insight why a 200 A thick cover layer of CdS on top of a CdTe solar cell increases its efficiency from 8 to 16% . The behavior of these Boer domains escapes conventional current voltage analyses except for their visual observation, while other high-field domains with their current fluctuations or oscillations are easily observed and are the subjects of thousands of publications and many books. In this review we will exclude detailed discussion of dynamic domains, but include some new specifics that help to understand the mechanisms of the Boer domains and their applications. Only properties at low optical excitation intensities are discussed that exclude Joules heating. Within the p-type regime of the anode-adjacent domain extremely steep electronic quenching signal becomes visible that could signalize an intrinsic donor level slightly above the middle of the band gap that may be responsible for not allowing CdS to ever become p-type by doping.
Aggregate corporate liquidity and stock returns

Aggregate investment in cash and liquid assets as a share of total corporate investment negatively predicts U.S. stock market returns between 1947 and 2003. The share of cash in total investment is a more stable predictor of returns than scaled price variables and performs well in out-of-sample predictability tests. Increases in cash are uncorrelated with planned increases in investment and current or lagged changes in profitability, but are negatively related to other known predictors that are positively related to subsequent returns. Cash investment is a stronger predictor of market returns in years in which external financing is also high. The results support a theory of active market timing, in which cash accumulation is the consequence of overvalued firms issuing external finance that cannot be spent productively and which they do not immediately return to investors.
The effect of sleep deprivation on cerebral glucose metabolic rate in normal humans assessed with positron emission tomography

This study is the first report on the effects of total sleep deprivation (about 32 h) on regional cerebral glucose metabolism during wakefulness in man, using positron emission tomography (PET) with F-18 deoxyglucose (FDG). Sleep deprivation leads to a significant reorganization of regional cerebral metabolic activity, with relative decreases in the temporal lobes and increases in visual cortex. Absolute glucose metabolic measurements indicate a decrease in thalamus, basal ganglia, white matter, and cerebellum. No overall decrease in whole brain metabolism was noted after sleep deprivation. As expected, sleep deprivation significantly reduced visual vigilance as assessed by the continuous performance test and this decrease was correlated significantly with reduced metabolic rate in thalamic, basal ganglia, and limbic regions.
A Review of “Infant research & neuroscience at work in psychotherapy: Expanding the clinical repertoire”

Judith Rustin, a highly accomplished and seasoned psychoanalyst-clinician, has made a valuable contribution to the ever-expanding and rapidly growing literature that demonstrates how infant researc...
On the Plastic Behavior of Polycrystalline Aggregates

The complete understanding of the physical origin and nature of the plastic behavior of polycrystalline aggregates constitutes one of the major problems in materials science. It has as its major objective the predictions of the plastic behavior of polycrystals from the known behavior of single crystals. The possibility of making such a prediction rests on the tacit assumption that the mechanisms of plastic deformation in aggregates are substantially identical with those observed in single crystals. The steps involved in the solution are: (a) mechanisms of deformation in single crystals; (b) interactions at grain boundary; (c) statistical averaging; and (d) contained plasticity.
Optimization of maintenance planning for water distribution networks under random failures

AbstractCost-effective and preventive maintenance for water distribution networks (WDN) is essential for the sustainable and reliable use of water resources. In this work, mathematical models were developed and optimization procedures were used for optimal WDN maintenance planning under random failures. A conditional probabilistic measure known as conditional expected supply impact (CESI) was derived, which took into account both WDN infrastructure conditions and dynamic customer demands. To seek an optimal WDN maintenance plan, an integer programming problem was formulated to minimize the CESI measure with binary decision variables and budget constraints. The mathematical models and optimization approach were demonstrated using a regional WDN in a large United States city. Genetics algorithms (GA) were applied to solve the optimization problem and find the optimum maintenance plan for the WDN. The optimum plan averaged a reduction of CESI by 60%.
Glutamine and Asparagine Transaminases

At least 2 types of glutamine transaminase are present in rat tissues—glutamine transaminase L (predominantly located in liver) and glutamine transaminase K (widespread but most active in kidney). Both exhibit wide specificity. The L-enzyme is a fully reversible glutamine: methionine transaminase and the K-enzyme is a fully reversible glutamine (phenylalanine): methionine transaminase. Because 1) the concentration of glutamine in tissues is much higher than that of phenylalanine or methionine, and 2) α-ketoglutaramate cyclizes to a lactam or is deamidated, it is probable that the glutamine transaminases predominantly utilize glutaminein vivo. Possible metabolic roles for the glutamine transaminases include 1) salvage of phenylpyruvate, p-hydroxyphenylpyruvate, 3-mercaptopyruvate, α-keto-γ-mercaptobutyrate and α-keto-γ-methiolbutyrate, 2) salvage of methionine during polyamine biosynthesis, 3) metabolism of aromatic amino acids in brain, 4) ammonia production in kidney and liver, 5) regulation of phenylpyruvate (an insulin secretagogue) in pancreas, 6) amino acid transport across mitochondria and 7) incorporation of ammonia nitrogen into various amino acids (in some microorganisms). In the rat, asparagine transaminase is most active in liver with smaller amounts in kidney and brain. The enzyme has broad specificity; several investigators have unknowingly purified the same enzyme. The enzyme has a high affinity for glyoxylate, suggesting that it may act normally to detoxify glyoxylate; patients with hyperoxaluria type I lack activity, α-Ketosuccinamate is present in rat liver and kidney, suggesting that this enzyme acts on asparaginein vivo.
A Flash Kinetic Spectrophotometer Employing Photodiode Array Sensors

We are describing a method for rapid spectroscopic measurement of phototransients obtained in a flash photolysis apparatus. A linear photodiode array is employed as a detector to sense changes in light absorption across the visible spectrum. A microcomputer handles sampling, analysis, and plotting the data, and controls a xenon flash photolysis unit. This approach provides simultaneous wavelength acquisition compatible with millisecond time scales. The implementation described here monitors 22 wavelengths over a 300 nm range with up to 50 consecutive spectral scans spaced a minimum of 0.5 ms. Wavelength and temporal resolution, set by spectrograph and detector exposure period, are 1.5 nm and 0.5 ms. The main advantages of this method are collection of multiwavelength data for determining complex transient spectral changes with little sample, and convenience of both data acquisition and analysis. Application to measurements of bacterial rhodopsin photochemistry is described.
Predictors of discrepancies between informants’ ratings of preschool-aged children's behavior: An examination of ethnicity, child characteristics, and family functioning

The present study examined predictors of discrepancies between mothers', fathers', and teachers' ratings of 3-year-old children's hyperactivity, attention problems, and aggression. Participants were families of 196 3-year-old children who took part in child and family assessments. Ethnicity was one of the most consistent predictors of discrepancies. African American mothers and fathers were more likely to rate their children's hyperactivity, attention problems, and aggression lower than teachers. In contrast, Latina mothers were more likely to rate their children as more hyperactive and inattentive than teachers. ADHD/ODD diagnoses, parental depression, number of children, and children's pre-academic skills were also predictive of discrepancies for some measures for some informants. These findings provide insight into factors that may contribute to informant discrepancies in ratings of preschool children.
Curriculum Evaluation and Modification: An Effective Teaching Perspective.

Literature on effective teaching provides a basis for curriculum evaluation and modification for children with mild handicaps.
Metabolic consequences of patients with gastrointestinal fistulas.

The historical highlights of the management of fistulas of the gastrointestinal tract during the past century are presented briefly, together with the significant lessons learned from the studies published in the literature. The evolution from predominantly operative or technical approaches to comprehensive multidisciplinary management of metabolic and nutritional support, which are essential to optimal fistula closure, and morbidity and mortality outcomes are discussed. The importance of achieving hemodynamic stability, fluid and electrolyte homeostasis, fistula effluent control, protection of the skin, control of infection and sepsis, and cardiopulmonary and major organ support, preferably by specially trained and motivated teams in critical care units of institutions with the interest, resources, and skills in managing the metabolic consequences of gastrointestinal fistula patients, is emphasized. The current status of the nutritional and metabolic support of patients with gastrointestinal tract fistulas is outlined and discussed briefly. The optimal metabolic and nutritional management of patients with gastrointestinal tract fistulas is an extraordinary and daunting challenge which has yet to be perfected, demonstrated, and applied universally. Much education, research, motivation, proficiency, and concerted conscientious effort will be required in order to achieve this elusive but noble goal. Some suggestions for achieving success in this endeavor are proffered, consistent with the senior author’s philosophy, which has evolved during a half-century of experience and endeavor in this vital area.
On the nature of intelligence

Our concept of intelligence has been heavily influenced by the development of intelligence tests as screening devices in education and personnel selection. An alternative approach is to begin with a theory of the process of cognition and identify those aspects of individual mental performance that should be important on theoretical grounds. Three classes of performance have been identified. These deal with a person's choice of an internal representation for a problem, strategies for manipulating the representation, and abilities to execute elementary information processing steps required by the strategy.
Method for kinematic calibration of stewart platforms

A Stewart platform is a six degrees of freedom parallel manipulator composed of six variable-length legs connecting a fixed base to a movable plate. Like all parallel manipulators, Stewart platforms offer high force/torque capability and high structural rigidity in exchange for small workspace and reduced dexterity. Because the solution for parallel manipulators' forward kinematics is in general much harder than their inverse kinematics, a typical control strategy for such manipulators is to specify the plate's pose in world coordinates and then solve the individual leg lengths. The accuracy of the robot critically depends on accurate knowledge of the device's kinematic parameters. This article focuses on the accuracy improvement of Stewart platforms by means of calibration. Calibration of Stewart platforms consists of construction of a kinematic model, measurement of the position and orientation of the platform in a reference coordinate frame, identification of the kinematic parameters, and accuracy compensation. A measurement procedure proposed in this article allows a great simplification of the kinematic identification. The idea is to keep the length of the particular leg, whose parameters are to be identified, fixed while the other legs change their lengths during the measurement phase. By that, redundant parameters can be eliminated systematically in the identification phase. The method also shows the estimation of each leg's parameters separately because the measurement equations are fully decoupled, which results in a drastical reduction of the computational effort in the parameter identification. Simulation results assess the performance of the proposed approach. © 1993 John Wiley & Sons, Inc.
Thermal stimulation of the hypothalamus does not evoke the acute-phase reaction.

Abstract Interleukin-1 (IL1) injected into the preoptic-anterior hypothalamus (POAH) induces, besides fever, the hepatic synthesis of acute-phase glycoproteins. Since the febrigenic action of IL1 may involve thermosensitive neurons in the POAH, this study examined whether such neurons also might mediate the acute-phase response (APR). The POAH of six adult NZW rabbits was cooled (Tpo)=34.4±0.4°C [means±SD]) or heated (40.6±0.2°C) continuously for 2.5 hr (so as to mimic the mean febrile course following a bolus microinjection of IL1 into the POAH). The ambient temperature (Ta) was 23.5± 1.0°C. Expectedly, core temperature fell and skin temperature rose on POAH heating and the opposite occurred on POAH cooling. However, no statistically significant changes in the plasma levels of Fe, Zn, Cu and N-acetylneuraminic acid, as indices of the APR, were induced by these treatments. These results indicate, therefore, that the central actions of IL1 in inducing fever and the APR are separate and that the APR is not mediated through stimulation of thermosensitive units in the POAH.
FYI: TMI: Toward a holistic social theory of information overload

Research into information overload has been extensive and cross-disciplinary, producing a multitude of suggested causes and posed solutions. I argue that many of the conclusions arrived at by existing research, while laudable in their inventiveness and/or practicality, miss the mark by viewing information overload as a problem that can be understood (or even solved) by purely rational means. Such a perspective lacks a critical understanding in human information usage: much in the same way that economic models dependent on rationality for their explanations or projections fail (often spectacularly, as recent history attests), models that rely too heavily upon the same rational behavior, and not heavily enough upon the interplay of actual social dynamics—power, reputation, norms, and others—in their attempts to explain, project, or address information overload prove bankrupt as well. Furthermore, even research that displays greater awareness of the social context in which overload exists often reveals a similar rationality in its conceptualization. That is, often the same “social” approaches that offer potential advantages (in mitigating information overload) over their “non-social” counterparts paradoxically raise new problems, requiring a reappraisal of overload that takes social issues into account holistically.
Effects of Computer-Assisted Instruction on Students' Knowledge of Postschool Options

Enhancing students’ ability to make informed choices is an important precursor to successful choice-making, decision-making, and goal-setting. This study used a multiple-baseline design across behaviors replicated across participants to examine the effects of computer-assisted instruction on acquisition of students’ knowledge of postschool options (i.e., employment, education, independent living). Results demonstrated a functional relationship between baseline and intervention for all four students. Implications for practice and future research are discussed.
Endothelial Lipase Promotes the Catabolism of ApoB-Containing Lipoproteins

Endothelial lipase (EL) has been found to be a key enzyme in high-density lipoprotein (HDL) metabolism in mice, leading to the concept that inhibition of EL could be a novel strategy for raising HDL cholesterol levels. However, mice are “HDL animals” and the effect of EL on atherogenic apoB-containing lipoproteins has not been elucidated. We previously found that EL is capable of hydrolyzing very low-density lipoprotein (VLDL) and LDL lipids ex vivo. To investigate the role of EL in the metabolism of apoB-containing lipoproteins in vivo, we expressed human EL in three mouse models of elevated apoB-containing lipoproteins: apoE-deficient, LDL receptor–deficient, and human apoB transgenic mice. Unexpectedly, hepatic expression of EL resulted in markedly decreased levels of VLDL/LDL cholesterol, phospholipid, and apoB accompanied by significantly increased LDL apolipoprotein and phospholipid catabolism. To determine whether lipolytic activity is required for this effect, we also expressed a catalytically inactive form of human EL (EL S149A ); unexpectedly, expression of EL S149A did not lower and in fact increased plasma lipids. Coexpression and coimmunoprecipitation studies suggested that catalytically inactive EL S149A inhibits endogenous mouse EL, accounting for the increased lipid levels. We conclude that (1) in addition to its known effects on HDL metabolism, EL influences the metabolism of apoB-containing particles; (2) catalytic activity of EL is required for its effects on apoB-containing lipoproteins; and (3) overexpressed catalytically inactive EL inhibits endogenous mouse EL, resulting in increased levels of plasma lipids. In light of these results, inhibition of EL has the potential to raise levels of atherogenic lipoproteins in addition to HDL-C levels.
Toward an authentic knowing of god: the differentiation-of-self construct in relational spirituality

Differentiation-of-self (DoS), a concept of Murray Bowen's family systems theory, is proposed as a conceptualization tool toward an increasingly authentic relational spirituality in Christianity. By considering neuroscience implications for relationship with embodied others and the Divine Other (i.e., God), the complexity of forces toward individuality and togetherness will be explored in the context of embodied relationship and embodied spirituality. DoS is explored as a clinical construct for conceptualizing a “both-and” experience of these polarities with the result of greater authenticity in relationship with the other/Other. Finally, a Trinitarian grounding will provide a theological-spiritual view of the potential wholeness of a self-in-relationship that is the goal of DoS.
Is there a link between Arctic amplification and midlatitude weather

As the Earth's climate warms, the Arctic has been warming more rapidly than the rest of the globe. Some previous studies have suggested that this Arctic amplification of warming is causing an increase in extreme weather events in the midlatitudes. They proposed that this occurs because Arctic warming induces changes in atmospheric circulation, including changes in atmospheric planetary waves that tend to promote persistent extreme weather conditions, such as heat waves, cold spells, droughts, and floods.
Spontaneous Formation of Periodically Patterned Deposits by Chemical Vapor Deposition

Patterns of colloidal origin that are formed in ionic precipitation-diffusion systems and are known as Liesegang Rings (LR) have fascinated researchers since the beginning of the century and have been the subject of numerous theoretical, numerical, and experimental studies. The terms recurrent, rhythmic, or periodic precipitation are often used to describe the temporal pattern evolution in such systems. Pattern formation in the vapor phase reaction of NH_3 and HCl has also been reported since 1930. It has been suggested that any reaction giving an insoluble product is capable of LR pattern formation. However, the potential of such self-organized deposition for the fabrication of materials (other than NH_4Cl) from vapor precursors has not been demonstrated. Moreover, reproducible LR patterns are usually characterized by uneven spacing (Matalon-Packter law) and band thickness, although nearly periodic patterns have been reported as well. Here we propose, for the first time, a connection of LR phenomena, with the spontaneous (i.e., involving no external concentration, temperature, or other parameter forcing) formation of micrometer size periodic stripes of nanocrystalline titania deposited in mesoporous glass by counter diffusion chemical vapor deposition (CVD) using titanium chloride and water.
MINIMAL ELECTROMAGNETIC CURRENTS AND COMMUTATION RELATIONS.

It is pointed out that within the quark model the equal-time commutation relations of currents provide us with a test of minimal electromagnetic interaction of the hadrons. When compared with experiment, the modifications of the Cabibbo-Radicati and Drell-Hearn sum rules resulting from nonminimal interactions may possibly fix the magnitudes of the isoscalar and the isovector Pauli interactions.
On the tertiary structure of tropomyosin tactoids

Abstract Correlation of tropomyosin amino acid sequence with uranyl acetate stained magnesium salt tactoids has been carried out by a computer graphic technique. Contrary to some previous suggestions, the results seem to indicate that there is no chain stagger within the molecule and the molecules are aligned with 178 ± 2 residue overlap in antiparallel array. In addition, the molecules for one particular tactoid appear to have an end overlap of approximately 21 residues.
Electronic eyes for the allies: Anglo‐American cooperation on radar development during World War II

Abstract During World War II, the American and British governments sponsored collaborative research in radar technology. Beginning in September 1940, scientists from the two countries increasingly shared information and worked together to develop radar systems. The radar technology developed through this cooperation had a significant impact on the outcome of the war. There is more to the story, however, than white‐coated scientists joining forces in the name of the common good. The process of wartime radar development influenced and was influenced by the ever‐changing character and priorities of the Anglo‐American diplomatic and military alliance. Social and political factors also played an important role within the research and development process itself. This article will examine radar research during World War II in the context of the collaborative efforts of the British and Americans to develop the technology, and will attempt to uncover the relationships between radar development efforts and the poli...
A Phase I Study of CPX-351 in Combination with Busulfan and Fludarabine Conditioning and Allogeneic Stem Cell Transplantation in Adult Patients with Refractory Acute Leukemia

Abstract This phase I study evaluated the maximal tolerated dose of CPX-351 when administered sequentially with allogeneic hematopoietic stem cell transplantation (HSCT) in patients with refractory acute leukemia. CPX-351 is a novel liposomal formulation that combines cytosine arabinoside (ara-c) and daunorubicin in a fixed molar ratio of 5:1. Patients in cohorts of 3 were treated with CPX-351 followed by fludarabine and busulfan (Bu/Flu) conditioning at 4-week (schedule A) or 3-week (schedule B) intervals. CPX-351 doses were escalated in 20-U/m2 increments starting at 60 U/m2 for 3 doses. Of the 36 patients enrolled, 29 were able to undergo HSCT, and the other 7 (the majority on schedule A) did not proceed to HSCT because of rapid disease progression. The maximal tolerated dose of CPX-351 was not reached at the 120 U/m2 × 3 dose level. All 29 patients who proceeded to HSCT demonstrated adequate neutrophil and platelet engraftment. The median follow-up on the study for all 36 patients was 205 days (range, 20 to 996 days). The 1-year cumulative incidence of relapse for the 36 patients was 60.1% (95% confidence interval [CI], 43.4% to 77.3%), and that of nonrelapse mortality was 23.8% (95% CI, 10.9% to 47.4%). The 1-year overall survival and leukemia-free survival were 37% (95% CI, 21% to 53%) and 27% (95% CI, 13% to 43%), respectively. Our data suggest that a phase II trial should incorporate CPX-351 120 U/m2 × 3 dosing on schedule B. Patients with good performance status and those who achieve effective cytoreduction from CPX-351 derived the greatest benefit.
Not all aromatic nitro compounds form free radicals.

Abstract One-electron reduction of the aromatic nitro-containing drug, clonazepam, by rat hepatic microsomes was found to produce a nitro anion radical which was observable by electron paramagnetic resonance (EPR) spectrometry under anaerobic conditions. It was determined that NADPH-cytochrome P-450 reductase may be the enzyme responsible for this reduction and that this free radical reacts rapidly with oxygen to produce Superoxide. The vasodilator nifedipine, another aromatic nitro-containing drug, was found not to be reduced by rat hepatic microsomes to a free radical nor to stimulate Superoxide production. Based on a series of experiments, we propose that the inability of nifedipine to be bioreduced to its nitro anion free radical is the result of geometric restrictions which prevent the transfer of an electron from cytochrome P-450 reductase to nifedipine.