cssi/SciSciGPT-SciSciNet huggingface dataset:
Structural Studies of 2,6-Diacetyl- and 2,6-Diformylpyridine Bis(thiosemicarbazones)

Although a large number of crystal structures of heterocyclic thiosemicarbazones have recently appeared in the literature, few structures of heterocyclic bis(thiosemicarbazones) or their metal complexes have been reported. Complexes of iron(II), indium(III), tin(IV), bismuth(III) involve bis(thiosemicarbazones) coordinating as N3S2 pentadentate ligands, often resulting in 7-coordinate complexes. In contrast, complexes with zinc(II) are often binuclear with thiosemicarbazone moieties of a bis(thiosemicarbazone) coordinating to two different zinc centers. Also included in this study is the structure of the first complex with a 2,6-diformylpyridine bis(thiosemicarbazone) ligand, a 4-coordinate nickel(II) complex with unusual coordination.
Effects of ergometrine on airway smooth muscle contractile responses

A 26-year-old asthmatic female developed severe asthma within a few hours of receiving three oral doses of 0.4 mg ergometrine maleate for the control of postpartum haemorrhaging. This experience and two previous reports of bronchospasm in asthmatic subjects following ergometrine suggested that ergometrine altered airway smooth muscle tone. In the present investigation the effect of ergometrine was studied on canine tracheal smooth muscle strips. Ergometrine (10(-9) M-10(-4) M) induced contraction of canine tracheal smooth muscle. The concentration causing 50% of maximal contraction (EC50) was 4.73 X 10(-8) M. The acetylcholine EC50 was not altered by ergometrine (10(-9) M or 10(-8) M); however, acetylcholine (10(-4) M and 10(-3) M) induced contractions were enhanced by ergometrine (10(-8) M). The data suggest that ergometrine maleate may cause broncho-constriction in some patients with asthma.
The development and structure of the choledocho-duodenal junction in Balaenopteran whales†

Three specimens from Balaenopteran whales have been available for study: a 20 mm embryo, a fetus 57 inches long and the ampulla duodeni of a 47-foot adult. By reconstruction, dissections and histological preparations, it has been possible to show that the extrahepatic portion of the bile duct is really an elongated hepato-pancreatic duct receiving ductules draining both rostral and caudal pancreatic lobes. After coursing through the pancreas, this duct pierces the intestinal muscle at the beginning of the pars descendens duodeni, then runs through the whole length of the longitudinal fold before emptying at the bottom of the pars descendens. In the adult, maceration methods have demonstrated that there is no vestige at all of a sphincter of Oddi. Presumably, this is a consequence of the absence of the gall bladder. Contrary to statements in the literature, a complete foramen epiploicum, vestibule and lesser peritoneal sac could be demonstrated as well as a long infracardiac bursa. Most interesting is the presence of a sizable valve in the portal vein at the point where it enters the liver.
Relations between post-mortem alterations and glycolytic metabolism in the brain

Certain post-mortem alterations of brain tissue result from the continuation of anaerobic glycolysis in the presence of abolished tissue oxidation. Experimental incubation of cerebellar tissue from rats in glucose or in glucose-6-phosphate in the presence of cyanide resulted in klasmatodendrosis of astrocytes and marked edematous changes, particularly in the neuroglia of the Purkinje layer. The presence of glycolysis was indicated by a drop in pH of the incubation medium. The tissue changes were indistinguishable from post-mortem alterations in human material. Blocking of glycolysis during the incubation eliminated the experimental tissue changes. The distribution of post-mortem changes depended on the normal cytochemical organization of a given region; regions which normally showed large aggregations of neuroglia cells with weak activity of oxidative enzymes showed strongest glycolytic tissue alterations. There was exidently no sharp border line between normal tissue glycolysis and post-mortem alterations.
The safety and efficacy of day 1 versus day 2 administration of pegfilgrastim in patients receiving myelosuppressive chemotherapy for gynecologic malignancies.

Abstract Objective Pegfilgrastim is indicated to decrease the incidence of febrile neutropenia in patients with gynecologic malignancies who are receiving myelosuppressive chemotherapy. We sought to compare the safety and efficacy of day 1 pegfilgrastim administration to day 2 administration in patients with gynecologic malignancies. Methods We retrospectively evaluated patients receiving both chemotherapy and pegfilgrastim from June 1, 2006 to August 31, 2007 for a gynecologic malignancy. Abstracted data included patient demographics, pathology, blood counts, toxicity, and chemotherapy. After administration of chemotherapy, all patients either received 6 mg of pegfilgrastim subcutaneously on day 1 or day 2. Results 1226 administrations of pegfilgrastim in 230 patients were identified. 490 administrations of pegfilgrastim were given on day 1 compared to 736 on day 2. 70% of patients had ovarian cancer with a median age of 64 years (range 15–88). 79% of patients had stage III, IV, or recurrent disease and 67% were undergoing primary chemotherapy. The most common chemotherapy was docetaxel/carboplatin (53%) followed by paclitaxel/carboplatin (19%). The mean absolute neutrophil count (ANC) nadir was 4810/mm 3 in the day 1 cohort compared to 4212/mm 3 in the day 2 cohort ( p =.004). The incidence of Grade 3/4 neutropenia was similar in both groups (4.9% in day 1 vs. 5.7% in day 2; p =.63). Grade 3/4 febrile neutropenia was uncommon in both cohorts (0 episodes vs. 3 episodes; p =.41). Treatment delays were similar in both cohorts (5.9% vs. 7.5%; p =.35). Dose modifications were also similar in both cohorts (2.8% vs. 5.3%; p =.06). Conclusion Day 1 administration of pegfilgrastim is as effective as day 2 administration in the prevention of neutropenia in patients with gynecologic malignancies. Treatment delays and dose modifications were not increased after day 1 administration of pegfilgrastim. Administering pegfilgrastim on day 1 appears to be safe, effective, and convenient in selected patients receiving myelopsuppressive chemotherapy for gynecologic malignancies.
Deterministic random walk preconditioning for power grid analysis

Iterative linear equation solvers depend on high quality pre-conditioners to achieve fast convergence. For sparse symmetric systems arising from large power grid analysis problems, however, preconditioners generated by traditional incomplete Cholesky factorizations are usually of low quality, resulting in slow convergence. On the other hand, although preconditioners generated by random walks are quite effective to reduce the number of iterations, it takes considerable amount of time to compute them in a stochastic manner. In this paper, we propose a new preconditioning technique for power grid analysis, named deterministic random walk, that combines the advantages of the above two approaches. Our proposed algorithm computes the preconditioners in a deterministic manner to reduce computation time, while achieving similar quality as stochastic random walk preconditioning by modifying fill-ins to compensate dropped entries. We have proved that for such compensation scheme, our algorithm will not fail for certain matrix orderings, which otherwise cannot be guaranteed by traditional incomplete factorizations. We demonstrate that by incorporating our proposed preconditioner, a conjugate gradient solver is able to outperform a state-of-the-art algebraic multigrid preconditioned solver on public IBM power grid benchmarks for DC power grid analysis, while potentially remaining very efficient for transient analysis.
Aids, Empire, and Public Health Behaviorism

Much of the current health approach to designing HIV/AIDS interventions in resource-poor settings involves behavior-change initiatives particularly those adopting education-based and "culturally competent" frameworks for the reduction of HIV-associated "risk behaviors." This article reviews the evidence and social assumptions behind this approach to preventing HIV transmission and argues that these approaches are often inadequate or misguided particularly in their conflation of the concept of "culture" with social circumstances. By analyzing the socioeconomic circumstances that constrain individual agency and by combining data from prevention literature with analyses of international trade agreements and the controversies over antiretroviral drug distribution the author argues that the movement of capital and the maintenance of inequality are central to the problems associated with behavior-change initiatives and must be addressed through new paradigms in order to respond appropriately to the global AIDS pandemic. Hardt and Ncgris paradigm of "Empire”-that is examining the system through which social inequalities are maintained not only between countries but also within them--offers prospects for the design of new interventions and targets for public health workers and social movements. (authors)
Strict Minimality of Alternating Knots in S × I

For prime knots that lie in the plane, it is known that a reduced alternating projection of a knot has fewer crossings than any non-alternating projection of that knot. We show a similar result for knots that lie in S × I, where S is a surface. A combination of polynomial, geometric and topological techniques are used.
Tax Incidence, Macroeconomic Policy, and Absolute Prices

I. Introduction, 254. — II. The model, 255. — III. Relative prices and tax incidence, 257. — IV. The analysis of the model, 259. — V. Concluding remarks, 265.
Global Modernity: Modernity in the Age of Global Capitalism

This article offers the concept of `global modernity' (in the singular) as a way to understand the contemporary world. It suggests that the concept helps overcome the teleology implicit in a term s...
High-level expression of foreign genes in mammalian cells.

Gene expression systems which function in eukaryotic cells are finding an increasing number of applications in modern-day somatic cell genetics and cell biology. For example, as new genes are cloned from a variety of species and cell types, their corresponding gene products can be studied in defined cell lines. For biochemical analysis, it is often necessary to overproduce and purify large amounts of a protein from cells which support appropriate post-translational modification, such as glycosylation or phosphorylation. In addition, specialized cell lines are now being used for production of custom-made proteins, as in the case of myelomas and genetically engineered immunoglobulins (1). Structure-function studies ultimately rely on the analysis of mutated forms of a protein in their appropriate cellular environment.
CSAX: Characterizing Systematic Anomalies in eXpression Data

Methods for translating gene expression signatures into clinically relevant information have typically relied upon having many samples from patients with similar molecular phenotypes. Here, we address the question of what can be done when it is relatively easy to obtain healthy patient samples, but when abnormalities corresponding to disease states may be rare and one-of-a-kind. The associated computational challenge, anomaly detection, is a well-studied machine learning problem. However, due to the dimensionality and variability of expression data, existing methods based on feature space analysis or individual anomalously-expressed genes are insufficient. We present a novel approach, CSAX, that identifies pathways in an individual sample in which the normal expression relationships are disrupted. To evaluate our approach, we have compiled and released a compendium of public microarray data sets, reformulated to create a testbed for anomaly detection. We demonstrate the accuracy of CSAX on the data sets in our compendium, compare it to other leading anomaly-detection methods, and show that CSAX aids both in identifying anomalies and in explaining their underlying biology. We note the potential for the use of such methods in identifying subclasses of disease. We also describe an approach to characterizing the difficulty of specific expression anomaly detection tasks and discuss how one can estimate the feasibility of a specific task. Our approach provides an important step towards identification of individual disease patterns in the era of personalized medicine.
Civic Engagement and Cosmopolitan Leadership

This chapter explores the leadership qualities participants identified as pivotal to the development of civic engagement at a large, suburban community college.
Study on the Persistence of Profit of China's Cross-industry Listed Companies

The persistence of profit is a measure of corporate profit and a reflection of the market competition in eco-nomics.This paper uses time series data with common methodology of persistence of profit to analyze the performance of Chi-nese cross-industry listed companies during 1996-2007.The result is that,compared with Chinese common listed companies,the cross-industry companies have higher long-run profits and faster speed of profit adjustment.The paper presents economic explanation to these phenomena.
Preparing for and Responding to Collapse

This chapter reviews numerous challenges posed by a collapse and explores potential responses to mitigate the problems. Immediate issues include nuclear weapons loss, disorder and chaos, rescuing political camp prisoners, provision of food and basic needs, and mass migration. Medium- to long-term issues include unemployment, elites, poor infrastructure, military integration, social integration, and economic development. How these challenges are handled, and by whom, would affect stability on the peninsula and international relations in the region. It will take concerted effort to manage the aftermath of collapse.
Outcomes of Critical Limb Ischemia in an Urban, Safety Net Hospital Population with High WIfI Amputation Scores.

Background Patients presenting to a public hospital with critical limb ischemia (CLI) typically have advanced disease with significant comorbidities. The purpose of this study was to assess the influence of revascularization on 1-year amputation rate of CLI patients presenting to Los Angeles County USC Medical Center, classified according to the Society for Vascular Surgery Wound, Ischemia and foot Infection (WIfI). Methods A retrospective review of patients who presented to a public hospital with CLI from February 2010 to July 2014 was performed. Patients were classified according to the WIfI system. Only patients with complete data who survived at least 12 months after presentation were included. Results Ninety-three patients with 98 affected limbs were included. The mean age was 62.8 years. Eighty-two patients (84%) had hypertension and 71 (72%) had diabetes. Fifty (57.5%) limbs had Trans-Atlantic Inter-Society Consensus (TASC) C or D femoral–popliteal lesions and 82 (98%) had significant infrapopliteal disease. The majority had moderate or high WIfI amputation and revascularization scores. Eighty-four (86%) limbs underwent open, endovascular, or hybrid revascularization. Overall, one year major amputation (OYMA) rate was 26.5%. In limbs with high WIfI amputation score, the OYMA was 34.5%: 21.4% in those who were revascularized and 57% in those who were not. On univariable analysis, factors associated with increased risk of OYMA were nonrevascularization ( P = 0.005), hyperlipidemia ( P = 0.06), hemodialysis ( P = 0.005), gangrene ( P = 0.02), ulcer classification ( P = 0.05), WIfI amputation score ( P = 0.026), and WIfI wound grade ( P = 0.04). On multivariable analysis, increasing WIfI amputation score (odds ratio [OR] 1.84, 95% confidence interval [CI] 1.0–3.39) was associated with increased risk of OYMA while revascularization (OR 0.24, 95% CI 0.07–0.80) was associated with decreased risk of OYMA. Conclusions The OYMA rates in this population were consistent with those predicted by the WIfI classification system. In this population, revascularization significantly reduced the risk of amputation. Comorbidities including diabetes mellitus and TASC classification did not moderate the association of WIfI amputation score with risk of 1-year major amputation.
Relationship Between Arrhythmogenic Right Ventricular Cardiomyopathy and Brugada Syndrome New Insights From Molecular Biology and Clinical Implications

Both arrhythmogenic right ventricular cardiomyopathy (ARVC) and Brugada syndrome (BS) are inherited conditions, which distinctively affect the RV and predispose to arrhythmic sudden cardiac death (SCD).1,2 Although ARVC is a heart muscle disorder characterized by loss of RV myocardium with fibrofatty substitution which constitute a part of the substrate for malignant ventricular arrhythmias,3–5 BS is a primary electrical heart disease, and the ventricular electrical instability is not directly related to widespread, major structural myocardial changes.6–8 Since the first description of BS in 1992, problems on nosographic definition, pathogenetic relationship, and differential diagnosis with ARVC have emerged on the basis of common phenotypic manifestations mostly related to the predominant RV involvement with right precordial ECG repolarization abnormalities, RV (outflow tract [OT]) conduction disturbances, and RV ventricular arrhythmias degenerating into ventricular fibrillation (VF).9,10 Moreover, because of the concealed nature of structural changes, which may fall under the resolution power of routine imaging techniques, early/minor variants of ARVC may simulate a channelopathy-like primarily electrical disorder mimicking BS.11 Whether ARVC and BS actually have a common pathogenetic denominator remained unsolved by past clinical and pathologic studies. However, recent experimental studies have renewed the interest in identifying the mechanisms responsible for the overlapping disease phenotype by demonstrating a subcellular inter-relationship caused by a cross talk between desmosomal and sodium channel proteins.12–21 This article reviews the available clinical, imaging, electrophysiologic, and pathologic evidence of the overlapping phenotype between ARVC and BS and reweaves the scientific discussion about the possible pathogenetic link between these 2 conditions on the basis of significant insights coming from recent studies of molecular biology. The purpose is to put into perspective the debate on this controversial issue, without claiming to draw definite conclusions. According to traditional …
“Parted Eyes” in Shakespeare's A Midsummer Night's Dream

Shakespeare’s A Midsummer Night’s Dream reflects the complex, even contrary perspectives on dreams prevailing during the Early Modern period. Characters from different worlds—fairies, royalty, and workmen—all discourse on the nature of dreams, and the hilarity of the play is the way these characters and their views collide. But comedy can also put provocative questions to the audience. From one perspective, dreams have an independent, supernatural reality, and from another, they are “vain fantasy.” Likewise, at one moment the audience is caught up in illusion, and at the next, the audience reflects, judges, laughs and applauds from a distance. At the end of the play, after all the conflicts are resolved, the mortal characters leave the stage and the fairies appear and celebrate with music and dance. Then, when they leave, the actor who has played Puck steps out of his role and speaks directly to the audience, breaking the spell of drama to conclude the play. Not only in the epilogue but throughout, the audience has been caught up in illusion and also detached, conscious that the play is a play. Questions about the the phenomenon of “lucid dreams” are part of the comedy of this play and remain unanswered.
Do I Need a Liver Biopsy

Although sensitive and relatively accurate blood tests and imaging studies are available to detect and diagnose liver diseases, the liver biopsy still remains a vital tool. Liver biopsy should be considered in patients in whom the diagnosis is questionable, and for whom obtaining a specific diagnosis likely alters the management plan. The biopsy may also predict prognosis by the staging of a known liver disease. It also helps in developing treatment plans based on histological analysis. However, complications may arise even though the incidence is small. Sampling error and inter-observer variability may result in inaccurate data and limit utility. Physicians and patients may hesitate to undertake liver biopsy for fear of complications. The aim of this chapter is to provide information about the benefits and limitations of liver biopsy for physicians who have to answer questions from patients recommended to undergo liver biopsy.
Tuning the carrier scattering mechanism to effectively improve the thermoelectric properties

A high thermoelectric power factor not only enables a potentially high figure of merit ZT but also leads to a large output power density, and hence it is pivotal to find an effective route to improve the power factor. Previous reports on the manipulation of carrier scattering mechanisms (e.g. ionization scattering) were mainly focused on enhancing the Seebeck coefficient. In contrast, here we demonstrate that by tuning the carrier scattering mechanism in n-type Mg3Sb2-based materials, it is possible to noticeably improve the Hall mobility, from ∼19 to ∼77 cm2 V−1 s−1, and hence substantially increase the power factor by a factor of 3, from ∼5 to ∼15 μW cm−1 K−2. The enhancement in mobility is mainly due to the reason that ionization scattering has been converted into mixed scattering between ionization and acoustic phonon scattering, which less effectively scatters the carriers. The strategy of tuning the carrier scattering mechanism to improve the mobility should be widely applicable to various material systems for achieving better thermoelectric performance.
The sociology of ecologically unequal exchange, foreign investment dependence and environmental load displacement: summary of the literature and implications for sustainability

The article begins by summarizing sociological approaches to (1) ecologically unequal exchange, and (2) foreign investment dependence and environmental load displacement. These areas of sociological inquiry consist of structural theories and cross-national statistical analyses that test hypotheses derived from both approaches. It concludes by briefly describing sociological research on global civil society and the environment, with a focus on the world society approach to environmental change. This area of theory and research provides some insights on ways in which global and transnational civil society groups, such as environmental international nongovernmental organizations, can partially mitigate the environmental harms caused by ecologically unequal exchanges and environmental load displacements. Key words: ecologically unequal exchange, environmental load displacement, foreign investment dependence
A Series Solution to the Nash Strategy for Large Scale Interconnected Systems

Abstract Optimum control of a linear large scale dynamic system is formulated as a game problem using individual subsystem quadratic cost functions and an overall Nash solution strategy. Computational complexities of the exact solution for large systems are overcome by a parametric series solution based on ϵ-coupling. Computational virtues of this approach are noted, and the relation of the approximate and exact solutions is examined.
Two-stage cross-talk mitigation in an orbital-angular-momentum-based free-space optical communication system

We propose and experimentally demonstrate a two-stage cross-talk mitigation method in an orbital-angular-momentum (OAM)-based free-space optical communication system, which is enabled by combining spatial offset and low-density parity-check (LDPC) coded nonuniform signaling. Different from traditional OAM multiplexing, where the OAM modes are centrally aligned for copropagation, the adjacent OAM modes (OAM states 2 and −6 and OAM states −2 and 6) in our proposed scheme are spatially offset to mitigate the mode cross talk. Different from traditional rectangular modulation formats, which transmit equidistant signal points with uniform probability, the 5-quadrature amplitude modulation (5-QAM) and 9-QAM are introduced to relieve cross-talk-induced performance degradation. The 5-QAM and 9-QAM formats are based on the Huffman coding technique, which can potentially achieve great cross-talk tolerance by combining them with corresponding nonbinary LDPC codes. We demonstrate that cross talk can be reduced by 1.6 dB and 1 dB via spatial offset for OAM states ±2 and ±6, respectively. Compared to quadrature phase shift keying and 8-QAM formats, the LDPC-coded 5-QAM and 9-QAM are able to bring 1.1 dB and 5.4 dB performance improvements in the presence of atmospheric turbulence, respectively.
Ultra-wideband electromagnetic detection of biological cells

Traditionally, electromagnetic detection of biological cells was conducted at either radio or microwave frequencies, which was sensitive to either cellular or subcellular properties, respectively. This paper reports for the first time a single sweep from megahertz to gigahertz frequencies so that cell viability, membrane capacitance, cytoplasm resistance, and cytoplasm capacitance could be determined simultaneously. These parameters were determined with the aid of simple cell model and equivalent circuit, despite great challenges in ultra-wideband measurement and analysis. Although the extracted parameter values for Jurkat T-lymphocytes human cells, live or dead, were consistent with that reported in the literature, more careful measurement and analysis are required in the future, especially for electromagnetic detection over an even wider bandwidth. In any case, the present analysis confirmed that it was easier to assess cell viability around 100 MHz but cytoplasm characteristics around 10 GHz.
Propionyl-CoA carboxylase pcca-1 and pccb-1 gene deletions in Caenorhabditis elegans globally impair mitochondrial energy metabolism

Propionic acidemia (PA) is a classical inborn error of metabolism with high morbidity that results from the inability of the propionyl-CoA carboxylase (PCC) enzyme to convert propionyl-CoA to methylmalonyl-CoA. PA is inherited in an autosomal recessive fashion due to functional loss of both alleles of either PCCA or PCCB. These genes are highly conserved across evolutionarily diverse species and share extensive similarity with pcca-1 and pccb-1 in the nematode, Caenorhabditis elegans. Here, we report the global metabolic effects of deletion in a single PCC gene, either pcca-1 or pccb-1, in C. elegans. Animal lifespan was significantly reduced relative to wild-type worms in both mutant strains, although to a greater degree in pcca-1. Mitochondrial oxidative phosphorylation (OXPHOS) capacity and efficiency as determined by direct polarography of isolated mitochondria were also significantly reduced in both mutant strains. While in vivo quantitation of mitochondrial physiology was normal in pccb-1 mutants, pcca-1 deletion mutants had significantly increased mitochondrial matrix oxidant burden as well as significantly decreased mitochondrial membrane potential and mitochondrial content. Whole worm steady-state free amino acid profiling by UPLC revealed reduced levels in both mutant strains of the glutathione precursor cysteine, possibly suggestive of increased oxidative stress. Intermediary metabolic flux analysis by GC/MS with 1,6-13C2-glucose further showed both PCC deletion strains had decreased accumulation of a distal tricarboxylic acid (TCA) cycle metabolic intermediate (+1 malate), isotopic enrichment in a proximal TCA cycle intermediate (+1 citrate), and increased +1 lactate accumulation. GC/MS analysis further revealed accumulation in the PCC mutants of a small amount of 3-hydroxypropionate, which appeared to be metabolized in C. elegans to oxalate through a unique metabolic pathway. Collectively, these detailed metabolic investigations in translational PA model animals with genetic-based PCC deficiency reveal their significantly dysregulated energy metabolism at multiple levels, including reduced mitochondrial OXPHOS capacity, increased oxidative stress, and inhibition of distal TCA cycle flux, culminating in reduced animal lifespan. These findings demonstrate that the pathophysiology of PA extends well beyond what has classically been understood as a single PCC enzyme deficiency with toxic precursor accumulation, and suggest that therapeutically targeting the globally disrupted energy metabolism may offer novel treatment opportunities for PA. Summary: Two C. elegans model animals of propionic acidemia with single-gene pcca-1 or pccb-1 deletions have reduced lifespan with significantly reduced mitochondrial energy metabolism and increased oxidative stress, reflecting the disease’s broader pathophysiology beyond a single enzyme deficiency with toxic precursor accumulation.
Tension pneumothorax and diffuse subcutaneous emphysema as a complication of cardiopulmonary resuscitation.

A 65-year-old man, with a medical history of interstitial lung disease and a recently diagnosed lung adenocarcinoma with known metastases to the bone, was brought to the emergency department after an episode of cardiopulmonary arrest and resuscitation by emergency medical services (EMS). The patient had a recent hospitalisation for bronchoscopic lung biopsy. It was complicated by a pneumothorax, and he was treated with chest tube insertion. The tube was removed 2 weeks prior to the current encounter and no residual leak was found. On the day of arrival, early morning, the patient’s wife found him unresponsive with a temperature of 101 degrees Fahrenheit (38.3 Celsius). EMS was called and the patient was found in pulseless electrical activity. Advanced cardiac life support was initiated and he had a return of spontaneous circulation after two doses of 1 mg epinephrine over approximately 6 min of cardiopulmonary resuscitation (CPR). The patient was intubated in the field and brought to the emergency department. …
The Use of Distal Ulnar Hounsfield Units to Predict Future Fragility Fracture Risk.

Purpose Distal ulnar Hounsfield unit (HU) measurements obtained from computed tomography (CT) scans of the wrist can be used to accurately screen for low bone mineral density. It is unknown whether HU measurements can also predict the risk of future fragility fractures. Therefore, the purpose of this study was to determine if the HU values of the distal ulna correlate to fragility fracture risk. Methods An electronic database of radiographs at a single institution was searched for all wrist CT scans, obtained for any reason, between January 1, 2002, and December 31, 2008, to allow a minimum of 5-year follow-up. Manual measurement of HU on sequential coronal CT slices of the distal ulnar head was taken, and mean values were recorded. Previously determined cutoff values for the diagnosis of low bone mineral density were implemented to stratify patients as at risk or not at risk for future fragility fracture. Medical records were then manually reviewed for the occurrence of any future fragility fracture (hip, spine, proximal humerus, or rib). Results There were 161 CTs in 157 patients and 34 fragility fractures in 21 patients, with a prevalence of 13.4%. The mean HU in the fragility fracture group was significantly lower (134.2 vs 197.1 HU). The percentage of low HU patients with fragility fractures was significantly higher (22.7% vs 3.8%). The odds ratio for fragility fracture in the low HU group was 7.4 (95% confidence interval, 2.1–26.2). Using previously determined cutoff values, the sensitivity and specificity of distal ulna HU values for identifying patients who would sustain at least 1 future fragility fracture were 85.7% and 55.2%, respectively. Conclusions Patients with low distal ulnar HU were significantly more likely to sustain a subsequent fragility fracture. A determination of distal ulnar HUs represents a quick, simple tool to identify patients potentially at risk for fragility fractures. Type of study/level of evidence Prognostic IV.
The Neurophysiological Effects of Amphetamine Upon the Cat Amygdala

Changes in the brain catecholamines (CA), norepinephrine (NE), dopamine (DA) and serotonin, are related to changes in affective behavior. Fluctuation in the synthesis, storage and turnover of these molecules has been demonstrated in different behavioral states and, conversely, different behavioral states have been produced by administering drugs which modify the uptake, metabolism, or degradation of such amines. It is thought that behavioral changes depend upon neural activity and anatomical areas important to affective states were grouped by Paul MacLean into the Limbic System. Understanding the role of CA in the limbic system is crucial to the understanding of the neurochemical basis for affective behavior. To this end, we are studying the influence of amphetamine upon electrophysiological relationships between the amygdala, septal nucleus, and hypothalamic ventromedial nucleus (HVM). The anatomical localization of NE, its effects on behavior thought to be referable to the amygdala, and the neuro-pharmacologic relationship between amphetamine and NE will first be discussed.
Supersensitive Boundary Value Problems

We consider the interesting, but relatively uncommon, situation when the boundary value problem for the steady-state Burgers’ equation has an interior shock layer. An expansion procedure utilizing exponentially small terms shows that a variety of asymptotically exponentially small perturbations can change the shock location by order one when the diffusion coefficient tends to zero. Such supersensitivity is expected for solutions to far more general boundary value problems. This suggests why computation of shocks is so challenging.
Complications from Surgical Treatment of Oral Cancer

Cancer of the oral cavity and oropharynx remains among the top ten most common malignancies in the United States, Europe, and worldwide (Shah et al., Oral cancer, Martin Dunitz an imprint of Taylor and Francis Group, London, 2003). Over the last 30 years the philosophies of treatment of oral cancer have changed very little with regards to primary tumor extirpation, with the exception of marginal mandibular resection. There have been major changes in the approach to cervical lymph nodes at risk for metastasis (Kim and Ord, Oral Maxillofac Surg Clin North Am 15:213–227, 2003). The radical neck dissection, once advocated by Dr. Crile as the only appropriate treatment for the neck, is now rarely performed in most centers (Shah, Cancer of the head and neck – atlas of clinical oncology. In: Management of cervical metastasis. BC Decker Inc, London, 2001). In addition, “organ preservation” protocols involving chemo-radiation therapy, although not without adverse effects, have significantly altered the quality of life for the cancer patient. Also, the ability to offer a variety of reconstruction options with the available hardware, local and regional flaps, as well as free tissue transfer from distant sites, has contributed to the overall significant improvements in functional and esthetic outcomes. The head and neck cancer patient in the new millennium has the opportunity to emerge from an extensive ablative surgical procedure with excellent functional and esthetic results. Despite these surgical advances, the ablative process still results in the sacrifice of several functional and esthetic organs during surgery for cancer of the oral cavity (Shah, Cancer of the head and neck – atlas of clinical oncology. In: Management of cervical metastasis. BC Decker Inc, London, 2001). Early complications from ablative surgery for oral cancer are, for the most part, similar to those from other sites. Long term complications however are quite challenging for the oncologic team as well as the patient who survives oral cancer, primarily due to the highly specialized regional tissues involved in the surgical field.
The Use of Circulatory Support in Cardiac Surgery

The principal goal of mechanical circulatory support is to provide physiologic blood flow to the body’s end organs in the situation where the natural heart fails to do so. The scenarios under which cardiac surgeons will encounter the need for mechanical circulatory support occur in one of two settings, i.e., the post-cardiotomy failure or in patients facing hemodynamic deterioration while awaiting cardiac transplantation. {1,2}
ANISOTROPY AND PATH DEPENDENCE IN FINITE DEFORMATION SHEAR AND SEQUENTIAL COMPRESSION/SHEAR

Many recent theoretical developments concerning deformation-induced anisotropy and/or texturing effects are based on observations from finite strain torsion of tubular specimens. Unfortunately, the behavior in torsion is limited to a narrow range of stress space and only moderately high shear strain levels (e.g. < 2) prior to complications associated with specimen instabilities, for example, which may affect interpretation of results. Consequently, one must consider finite strain torsion as an important but incomplete characterization of the finite strain inelastic response. Largely due to their difficulty, experiments involving stress state sequence effects with multiple finite straining events have not been considered except in a few limited cases. In this work, a phenomenological plasticity framework is introduced which accounts for dislocation substructure effects in both the yield function and hardening rules by using the third invariant of the deviatoric overstress in addition to the plastic spin. Results of large strain compression, finite torsion of thin-walled tubes and sequential compression-torsion tests are reported for 304L stainless steel. The results are discussed in the context of the plasticity framework introduced.
Compiling DNA Strand Displacement Reactions Using a Functional Programming Language

DNA nanotechnology is a rapidly-growing field, with many potential applications in nanoscale manufacturing and autonomous in vivo diagnostic and therapeutic devices. As experimental techniques improve it will become increasingly important to develop software tools and programming abstractions, to enable rapid and correct design of increasingly sophisticated computational circuits. This is analogous to the need for hardware description languages for VLSI. In this paper we discuss our experience implementing a domain-specific language for DNA nanotechnology using a functional programming language. The ability to use abstract data types to describe molecular structures and to recurse over these types to derive the various interactions between structures was a major reason for the use of a functional language in this project.
Phosphorylated SIRT1 as a biomarker of relapse and response to treatment with glatiramer acetate in multiple sclerosis.

Abstract We have previously shown that SIRT1 mRNA expression was significantly lower in relapsing MS patients compared to those in remission. Our goal was to longitudinally investigate the role of active, phosphorylated SIRT1 (p-SIRT1) as a potential biomarker of relapse and predictor for response to glatiramer acetate (GA) treatment in patients with relapsing remitting multiple sclerosis (MS). We also want to investigate the downstream effects of SIRT1 activation by measuring the trimethylation of histone 3 at lysine 9 (H3K9me3). A cohort of 15 GA-treated patients was clinically monitored using the Expanded Disability Status Scale (EDSS) and peripheral blood mononuclear cells (PBMCs) were collected at 0, 3, 6, and 12 months after initiation of the therapy. P-SIRT1 and H3K9me3 levels were assayed by Western blotting using specific antibodies. Statistically significant lower levels of p-SIRT1 protein (p
Effective one-step saccharification of lignocellulosic biomass using magnetite-biocatalysts containing saccharifying enzymes.

Abstract Lignocellulosic biomass, packed with sugars, is one of the most available renewable resources for biofuels and bioproducts production. To release the sugars for the production, enzymatic hydrolysis (saccharification) of pretreated lignocellulosic biomass are required. However, the saccharification process is costly, inefficient, and requires multi-step operations. This is in part due to the high cost and the limited selection of commercial enzymes which commonly have different optimal pH and temperatures. Here we reported a one-step saccharification of pretreated lignocellulosic biomass using immobilized biocatalysts containing five different saccharifying enzymes (SEs) with a similar optimum pH and temperature. The five SEs - endo-1,4-β- d -glucanase (an endoglucanase, eglS), cellobiohydrolase (an exoglucanase, cbhA), and β-glucosidase (bglH), endo-1,4-β-xylanase (an endoxylanase, xynC) and β-xylosidase (bxlB) – were successfully expressed and produced by E. coli BL21. Better saccharification of pretreated corn husks was observed when using the five crude SE enzymes than those using two commonly used SEs, endo-1,4-β- d -glucanase and β-glucosidase. The five SEs were cross-linked in the absence or the presence of magnetic nanoparticles (hereafter referred as SE-CLEAs and M-SE-CLEAs, respectively). By using SE-CLEAs, the highest amount of reduced sugar (250 mg/g biomass) was measured. The activity of immobilized SEs is better than free crude SEs. The M-SE-CLEAs can be reused at least 3 times for effective saccharification of pretreated lignocellulosic biomass.
Neither Time in Therapeutic Range nor Most Recent International Normalized Ratio (INR) Correlate with Adverse Events in Patients Supported by Continuous-Flow Left Ventricular Assist Devices

Introduction Continuous-Flow Left Ventricular Assist Devices (CFLVADs) improve mortality and quality of life in end-stage cardiomyopathy patients. Adverse events however remain high. Hypothesis We hypothesize time in therapeutic range (TTR) correlates with adverse events compared to most recent INR. Methods The study group comprised of patients who suffered suspected/confirmed pump thrombosis, stroke or major bleeding event as defined by INTERMACS after ≥ 1 month at home with ≥ 1 month of INR values. Controls (CON) had at least 3 months of INR values after being home for 1 month from LVAD implant and who did not experience any adverse events (AE). Standard statistical methods were employed as indicated: Chi-square, Fishers Exact test, two-sample t-test, Wilcoxon Rank sum test, One way ANOVA and Kruskal Wallis Analysis. Patients with multiple adverse events were excluded. Results From June 2010 - December 2016, 132 patients underwent CFLVAD implantation at our institution who met entry criteria. Mean age was 57±13 yrs and 106 (80%) were male. Seventy-seven (58%) were implanted as bridge to transplant (BTT). There was no statistically significant difference in TTR (p=0.39, Table 1 ) or most recent INR (p=0.33, Table 2 ) prior to AE. Patients who suffered AEs were older than those who did not (59.3± 12 vs. 54.4±14.3 yrs, p=0.04). There was no association of AEs when stratified by gender, LVAD indication, LVAD device type, race, BMI or hospital length of stay (p=ns). Conclusions Neither time in therapeutic range nor most recent INR correlated with major bleeding, neurological dysfunction or pump thrombosis in CFLVAD patients in this analysis. Further investigation beyond strict INR control and anticoagulation is needed to reduce adverse events in this patient population.
Interpersonal Functioning of Narcissistic Individuals and Implications for Treatment Engagement

The interpersonal problems associated with narcissism reflect patterns of perceiving and relating to others. These patterns have implications for psychotherapy treatment-seeking and engagement, an understudied yet important domain. The surprisingly limited literature available suggests that narcissistic individuals are not only less likely to seek treatment but also to drop out prematurely. This chapter provides an overview of the way that interpersonal functioning can serve as a lens through which to understand psychotherapy treatment engagement for narcissistic individuals and suggestions for how it may be leveraged. Although much of the literature is based on trait grandiose narcissism, where available, findings are presented for vulnerable narcissism as well as clinically assessed narcissistic personality disorder. By considering the interpersonal dynamics of narcissistic individuals, researchers and clinicians may be better able to understand the nature of clinically relevant relational problems and engage these individuals in treatment. The early findings reviewed here highlight the need for additional research in this domain.
External validity is also an ethical consideration in cluster-randomised trials of policy changes

Hemming et al (‘Ethical Implications of Excessive Cluster Sizes in Cluster Randomized Trials’, 20 February 2018) cite the FIRST Trial as an example of a ‘higher risk’ cluster-randomised trial in which large cluster sizes pose unjustifiable excess risk.1 The authors state, ‘[t]he obvious way to reduce the cluster size in this study is to reduce the duration of the trial.’ We believe this to be an inappropriate recommendation stemming from an inaccurate appraisal of the FIRST Trial. The FIRST Trial was designed to inform a potential policy change in …
CORRUPTION AND MISUSE OF PUBLIC OFFICE

CORRUPTION AND MISUSE OF PUBLIC OFFICE Colin Nicholls QC, Tim Daniel, Alan Bacarese, James Maton and Professor John Hatchard, (3rd edn, OUP 2017) lxxviii and 934.
Asynchronous federated optimization

Federated learning enables training on a massive number of edge devices. To improve flexibility and scalability, we propose a new asynchronous federated optimization algorithm. We prove that the proposed approach has near-linear convergence to a global optimum, for both strongly convex and a restricted family of non-convex problems. Empirical results show that the proposed algorithm converges quickly and tolerates staleness in various applications.
Addition of Iodinated Contrast to Rectal Hydrogel Spacer to Facilitate MRI-Independent Target Delineation and Treatment Planning for Prostate Cancer.

Abstract Purpose Hydrogel spacers reduce rectal dose toxicity during prostate cancer radiation therapy. Current products require magnetic resonance imaging (MRI) for visualization during treatment planning, but MRI incompatibility and cost have prompted alternatives using computed tomography (CT). This case series evaluates the addition of iodinated contrast to hydrogel as such an alternative. Methods and materials Three patients underwent rectal hydrogel spacer placement with iodinated contrast modification. CT was performed within 1 hour of injection and again 1 week later. MRI was obtained at the time of the second CT. Hydrogel delineation was compared between CT and MRI and between paired CT scans. Results Spacer enhancement was visible on CT immediately after hydrogel placement (mean Hounsfield units, 122; range, 52-193) but not at the second CT 1 week later (mean Hounsfield units, 8; range, −8 to 29). Delineated spacer volume did not significantly differ between immediate postprocedure CT and MRI ≥1 week later in 2 patients (patient 1: 16.6 vs 15.5 cm3; patient 2: 12.6 vs 14.7 cm3; paired t-test, P = .81). Conclusions CT visualization of rectal hydrogel admixed with contrast is feasible and allows delineation of interface with rectum/prostate.
Abstract 084: Gut Dysbiosis Impairs Serotonergic Gut-Brain Axis and Increases Blood Pressure

Introduction: Fecal microbiota transfer (FMT) from hypertensive to normotensive rats elevates blood pressure (BP). As gut microbiota can affect synthesis of serotonin (5-HT), a major neurotransmitt...