cssi/SciSciGPT-SciSciNet huggingface dataset:
Role of laparoscopy in the evaluation of the adnexa in patients with stage IV breast cancer

Abstract Objective . To describe the utility of laparoscopic evaluation of adnexal masses in women with stage IV breast cancer. Methods . A retrospective review of gynecologic and breast surgery databases at our institution was performed to identify patients with stage IV breast cancer who underwent surgical evaluation for an adnexal mass or bilateral salpingo-oophorectomy (BSO) between January 1986 and August 2002. Patient demographics and operative and pathologic findings were reviewed. Results . Thirty-one patients were identified. Median age was 47 years (range, 25–79 years). Pathology of the primary breast tumor was infiltrating ductal carcinoma in 58%, invasive lobular carcinoma in 29%, and unspecified in 13%. Median time from diagnosis of stage IV breast cancer to surgical evaluation of the adnexa was 15 months (range, 0–106 months). Surgery consisted of planned laparotomy in four patients and laparoscopic evaluation in 27 patients. Six patients had laparoscopic BSO for hormonal ablation. The remaining 21 patients had laparoscopic evaluation of an adnexal mass. Conversion to laparotomy occurred in three patients based on intraoperative findings of suspected primary ovarian cancer and for technical reasons in one patient. Overall, metastatic breast cancer was diagnosed in 21 (68%) of 31 patients, including two patients with occult metastases undergoing BSO for hormonal ablation. Primary ovarian cancer was found in 3 (10%) of 31 patients, and 7 (22%) of 31 patients had benign findings. Pathologic intraoperative frozen section was obtained in 21 (84%) of 25 patients undergoing laparoscopic evaluation for an adnexal mass. Intraoperative frozen section was concordant with final pathology in 20 (95%) of 21 patients (18 on laparoscopic evaluation, two on laparotomy). Conclusions . The majority of patients with stage IV breast cancer who present with an adnexal mass will be diagnosed with metastatic breast cancer. A small subset of patients will be diagnosed with primary ovarian cancer; thus, the evaluation of an adnexal mass even in this stage IV setting is warranted. Accurate diagnosis of metastatic breast cancer versus ovarian cancer can be made laparoscopically, thereby avoiding laparotomy in the metastatic breast cancer setting.
Carcinogenic response of hamster buccal pouch epithelium to 4 polycyclic aromatic hydrocarbons.

In order to assess the relative carcinogenic potency of polycyclic aromatic hydrocarbons in hamster buccal pouch, groups of male Syrian golden hamsters were treated by painting the buccal pouch surfaces for up to 20 weeks with equimolar concentrations of 7, 12-dimelhylbenzanthracenc; benzanthracene, 3,4-bcnzpyrene; or 20-methylcholanthrenc dissolved in paraffin oil. Control hamsters were simarily treated with paraffin oil. Whereas 100% of the 7, 12-dimethylbenzanthraccne treated hamsters developed buccal pouch carcinomas within the 20-week treatment period, no cancers were observed in the control hamsters or in those treated with the other polycyclic aromatic hydrocarbons. Simarily, of the various treatment groups, only 7,12-dimethylbenzanthraccnc treated hamsters displayed the efficient induction of foci of intense gamma glutamyltranspeptidase (GGT) histochemical activity within the buccal pouch epithelium. These results support the working hypothesis that induction of GGT foci is an early indicator of developing carcinoma in this experimental model.
Selective killing of Kaposi's sarcoma-associated herpesvirus lytically infected cells with a recombinant immunotoxin targeting the viral gpK8.1A envelope glycoprotein.

Kaposi sarcoma-associated herpesvirus (KSHV, human herpesvirus 8) is etiologically associated with three neoplastic syndromes: Kaposi sarcoma and the uncommon HIV-associated B-cell lymphoproliferative disorders primary effusion lymphoma and multicentric Castleman disease. The incidence of the latter B-cell pathology has been increasing in spite of antiretroviral therapy; its association with lytic virus replication has prompted interest in therapeutic strategies aimed at this phase of the virus life cycle. We designed and expressed a recombinant immunotoxin (2014-PE38) targeting the gpK8.1A viral glycoprotein expressed on the surface of the virion and infected cells. We show that this immunotoxin selectively kills KSHV-infected cells in dose-dependent fashion, resulting in major reductions of infectious virus release. The immunotoxin and ganciclovir, an inhibitor of viral DNA replication, showed marked reciprocal potentiation of antiviral activities. These results suggest that the immunotoxin, alone or in...
The effects of prior aversive stimulation on the behavioral and physiological responses to intense acoustic stimuli in the rat

Abstract Two experiments were conducted to assess the effects of intense, inescapable electric shock (preshock, PS) on the behavioral and physiological responses of rats to intense acoustic stimuli. In Experiment 1 startle amplitude, interstimulus activity and plasma corticosterone levels were compared in control and animals previously subjected to the PS treatment. In Experiment 2 heart rate (HR) responses were similarly compared. Results indicated that (1) startle amplitude was not affected by PS treatment (2) interstimulus activity was markedly suppressed and the plasma corticosterone response to startle testing elevated by the PS treatment, and (3) the initial presentations of startle stimuli elicited a dramatic HR deceleration in animals subjected to the PS treatment. These results were discussed in terms of (1) the relationship between arousal and startle and (2) the nature of the PS effect as revealed by the unusual HR response to the initial stimulus presentations.
Relations between daytime pre-ejection period reactivity and sleep in late childhood.

Summary The sympathetic nervous system and children's sleep serve critical arousal regulation functions. Shortened pre-ejection period, a reliable indirect index of greater sympathetic nervous system activity, has been associated with reduced sleep duration and quality in adults, but limited evidence exists in children regarding associations between pre-ejection period and sleep. We examined relations between pre-ejection period reactivity in response to a laboratory-based stressor and multiple parameters of actigraphy-based sleep duration and quality in children. The sample included 123 boys and 112 girls [mean age = 11.31 years, standard deviation (SD) = 0.63 years]. Controlling for body mass index, sex and pre-ejection period baseline, increased sympathetic nervous system reactivity, indexed by a lower level of pre-ejection period during the challenge than the baseline, was associated with worse sleep quality indicated by lower sleep efficiency, greater sleep activity and greater long wake episodes. The findings add to a small literature on relations between sympathetic nervous system functioning and children's sleep, suggesting that poor sleep quality is related to dysregulation of this stress response system.
Feature sensitivity, bias, and interdependencies as a function of energy and payoffs

In our previous research on human perception of simple patterns (Townsend, Hu, & Evans, 1984), positive dependencies in the sampling of features were interpreted in terms of underlying sensory and decisional processes. Those findings suggested a model, called Blobloc here, which is further tested in the present study under various conditions of stimulus duration in Experiment 1 and feature-specific payoff ◊ stimulus duration in Experiment 2. Signal detection microanalyses generally supported Blobloc by discovering estimated d’ greater on a given feature when another feature was a "hit" or a "correct rejection." The bias, as estimated by ~, was less consistent in the microanalyses. The macroanalyses found that d’ and ~ on individual features behaved as predicted as functions of the experimental conditions. However, in contrast to previous results, the variation in number of features in a pattern was apparently too small to yield consistent d’ and ~ changes. In addition, increasing stimulus duration produced tendencies toward linear increases in/~ (significant in Experiment 2), a finding consistent with Blobloc. A plausible alternative medel (Correlated Noise model) is rejected by the results of the present and previous studies. Recent studies have begun to clarify how psychological and contextual variables influence the way we perceive simple patterns made up of elementary sets of lines and curves (e.g., Keren & Baggen, 1981; Loomis, 1982;
Optimum Catalyst Size for Slurry Bubble Column Reactors

A mathematical model to describe the hydrodynamics of the slurry bubble-column reactor (SBCR) for converting synthesis gas into liquid fuels has been developed. This model includes the complete granular temperature balance based on the kinetic theory of granular flow. The kinetic theory model and the computer code1 were extended to include the effect of the mass-transfer coefficient between the liquid and gas and the water gas shift reaction in the Air Products/DOE LaPorte SBCR. In this model, the mass-transfer coefficient is an input. It was estimated from a relationship between the fundamental equations of the boundary layers and the turbulent kinetic energy of particles (granular temperature) computed by the hydrodynamic model with no reaction. We have varied the particle size from 20 to 100 μm and discovered a maximum in the granular temperature. For the particles over this range, the mass-transfer coefficient has the highest values. With reaction, this model was used to predict the slurry height, gas...
Reconstructing parameters of the FitzHugh–Nagumo system from boundary potential measurements

We consider distributed parameter identification problems for the FitzHugh–Nagumo model of electrocardiology. The model describes the evolution of electrical potentials in heart tissues. The mathematical problem is to reconstruct physical parameters of the system through partial knowledge of its solutions on the boundary of the domain. We present a parallel algorithm of Newton–Krylov type that combines Newton’s method for numerical optimization with Krylov subspace solvers for the resulting Karush–Kuhn–Tucker system. We show by numerical simulations that parameter reconstruction can be performed from measurements taken on the boundary of the domain only. We discuss the effects of various model parameters on the quality of reconstructions.
Clinical effects of using stannous fluoride mouthrinses during a five day study in the absence of oral hygiene

The purpose of this investigation was to determine the effects of stannous fluoride mouthrinses containing 250 or 1000 ppmF on plaque accumulation, gingivitis, microbial composition of plaque, and the ability of saliva to produce acid, in 48 subjects who abstained from oral hygiene for 5 days. Plaque formation was significantly lower in both SnF2 groups. Clinical gingivitis and gingival fluid measurements did not differ. Significant reductions in viable plaque organisms were provided by the fluoride rinses. No change was noted in the proportions of aerobic, anaerobic, gram-positive, or streptococcal bacterial populations. Both fluoride rinses inhibited the ability of saliva to lower the pH of a sugar solution.
Modeling of a dilute vaporizing multicomponent fuel spray

Abstract A simplified spray environment is used to represent the multicomponent nature of liquid fuels and to examine the sensitivity of their vaporization behavior to the various liquid- and gas-phase models. Liquid-phase models are the diffusion limit, the infinite diffusion, and the vortex. Gas-phase models are the Ranz-Marshall correlation and the axisymmetric model. Three subsets of equations are solved by a hybrid Eulerian-Lagrangian, explicit-implicit scheme. Results demonstrate that the fuel vapor distributions are extremely sensitive to the models considered, that the internal circulation is less important for the multicomponent case as compared to the single component, that the multicomponent results are in complete contrast to those for the single component, and that an acceptable spray model should realistically consider the diffusive-convective processes inside and outside the droplet. For most spray situations, the diffusion-limit model is recommended.
Synthesis of the facteur thymique serique and an analog also related to thymopoietin

Abstract The known 9-amino-acid sequence of the facteur thymique serique (FTS) and the known 49-amino-acid sequence of thymopoietin, in conjunction with background peptide chemistry, raised the possibility that Gln 1 of FTS might be linked to Arg 49 of thymopoietin in a new 58-amino-acid peptide in tissue. A presumed cleavage between Gln 50 and Arg 49 adjacent to the Lys 48 -Arg 49 moiety would liberate [H-Gln 1 ]-FTS and thymopoietin; the former fragment would cyclize to FTS by known chemistry. To study this possibility, FTS, and a new dodecapeptide consisting of Val-Lys-Arg linked to the N-terminal of [H-Gln 1 ]-FTS were synthesized on a new solid-phase resin and were found to show comparable immune stimulating activity, in vivo . These data do not negate, but support, the concept of the 58-aminoacid peptide.
Calculus of fuzzy if-then rules and its applications

In contrast to classical logical systems, fuzzy logic is aimed at a formalization of modes of reasoning which are approximate rather than exact. Basically, a fuzzy logical system may be viewed as a result of fuzzifying a standard logical system. Thus, one may speak of fuzzy predicate logic, fuzzy modal logic, fuzzy default logic, fuzzy multivalued logic, fuzzy epistemic logic, etc. In this perspective, fuzzy logic is essentially a union of fuzzified logical systems, and precise reasoning may be viewed as a special case of approximate reasoning.
Intimin types alpha, beta, and gamma bind to nucleolin with equivalent affinity but lower avidity than to the translocated intimin receptor.

Abstract The outer membrane adhesins of enteropathogenic Escherichia coli, Citrobacter rodentium, and enterohemorrhagic E. coli (EHEC) O157:H7 that mediate attach and efface intestinal lesions are classified as intimin α, β, and γ, respectively. Each of these intimin types binds to its cognate, bacterially encoded receptor (called Tir for translocated intimin receptor) to promote tight adherence of the organism to the host-cell plasma membrane. We previously reported that γ intimin of EHEC O157:H7 also bound to a eucaryotic receptor that we determined was nucleolin. The objective of this study was to investigate in vitro and in vivo the interactions of intimins α, β, and γ with nucleolin in the presence of Tir from EHEC O157:H7. Protein binding experiments demonstrated that intimin of types α, β, and γ bound nucleolin with similar affinity. Moreover, all three intimin types co-localized with regions of nucleolin expressed on the surface of HEp-2 cells. When intimin α, β, or γ bound to Tir in vitro, the intimin interaction with nucleolin was blocked. Both Tir and nucleolin accumulated beneath intimin-presenting bacteria that had attached to the surface of HEp-2 cells. Taken together, these findings suggest that nucleolin is involved in bacterial adherence promoted by all intimin types and that Tir and nucleolin compete for intimin during adherence.
C5aR Expression in a Novel GFP Reporter Gene Knockin Mouse: Implications for the Mechanism of Action of C5aR Signaling in T Cell Immunity

C5aR is a G protein-coupled receptor for the anaphylatoxin C5a and mediates many proinflammatory reactions. C5aR signaling also has been shown to regulate T cell immunity, but its sites and mechanism of action in this process remain uncertain. In this study, we created a GFP knockin mouse and used GFP as a surrogate marker to examine C5aR expression. GFP was knocked into the 3'-untranslated region of C5ar1 by gene targeting. We show that GFP is expressed highly on Gr-1(+)CD11b(+) cells in the blood, spleen, and bone marrow and moderately on CD11b(+)F4/80(+) circulating leukocytes and elicited peritoneal macrophages. No GFP is detected on resting or activated T lymphocytes or on splenic myeloid or plasmacytoid dendritic cells. In contrast, 5-25% cultured bone marrow-derived dendritic cells expressed GFP. Interestingly, GFP knockin prevented cell surface but not intracellular C5aR expression. We conclude that C5aR is unlikely to play an intrinsic role on murine T cells and primary dendritic cells. Instead, its effect on T cell immunity in vivo may involve CD11b(+)F4/80(+) or other C5aR-expressing leukocytes. Further, our data reveal a surprising role for the 3'-untranslated region of C5aR mRNA in regulating C5aR protein targeting to the plasma membrane.
Effects of Resection of Pig Needle Teeth on Pig and Sow Injuries and Pre-Weaning Pig Performance

Abstract The objective was to determine the effects of pig needle teeth resection (teeth cut off flat) on sow underline injuries, pig facial injuries, and pre-weaning performance. Pigs in litters on a university and commercial farm had needle teeth resected (18 litters; 170 pigs) or left intact (17 litters; 172 pigs). On d 7, sows nursing pigs with intact teeth had a greater (P 0.96) by treatment. For the intact and resected groups, pig BW on d 7 (3.1 ± 0.1 vs. 3.1 ± 0.1 kg; P=0.57) and d 21 (7.2 ± 0.2 vs. 7.2 ± 0.2 kg; P=0.96) and death loss (8.6 ± 2.3 vs. 13.1 ± 2.3; P=0.20) were similar. Pig performance was not affected by resecting needle teeth. The practice may be warranted, however, to prevent injuries to pigs and sows.
Meiotic drive and sex determination: molecular and cytological mechanisms of sex ratio adjustment in birds

Differences in relative fitness of male and female offspring across ecological and social environments should favour the evolution of sex-determining mechanisms that enable adjustment of brood sex ratio to the context of breeding. Despite the expectation that genetic sex determination should not produce consistent bias in primary sex ratios, extensive and adaptive modifications of offspring sex ratio in relation to social and physiological conditions during reproduction are often documented. Such discordance emphasizes the need for empirical investigation of the proximate mechanisms for modifying primary sex ratios, and suggests epigenetic effects on sex-determining mechanisms as the most likely candidates. Birds, in particular, are thought to have an unusually direct opportunity to modify offspring sex ratio because avian females are heterogametic and because the sex-determining division in avian meiosis occurs prior to ovulation and fertilization. However, despite evidence of strong epigenetic effects on sex determination in pre-ovulatory avian oocytes, the mechanisms behind such effects remain elusive. Our review of molecular and cytological mechanisms of avian meiosis uncovers a multitude of potential targets for selection on biased segregation of sex chromosomes, which may reflect the diversity of mechanisms and levels on which such selection operates in birds. Our findings indicate that pronounced differences between sex chromosomes in size, shape, size of protein bodies, alignment at the meiotic plate, microtubule attachment and epigenetic markings should commonly produce biased segregation of sex chromosomes as the default state, with secondary evolution of compensatory mechanisms necessary to maintain unbiased meiosis. We suggest that it is the epigenetic effects that modify such compensatory mechanisms that enable context-dependent and precise adjustment of primary sex ratio in birds. Furthermore, we highlight the features of avian meiosis that can be influenced by maternal hormones in response to environmental stimuli and may account for the precise and adaptive patterns of offspring sex ratio adjustment observed in some species.
A case of ‘sign blindness’ following left occipital damage in a deaf signer

Abstract We report on a right-handed, deaf, life long signer who suffered a left posterior cerebral artery (PCA) stroke. The patient presented with right homonymous hemianopia, alexia and a severe sign comprehension deficit. Her production of sign language was, however, virtually normal. We suggest that her syndrome can be characterized as a case of ‘sign blindness’, a disconnection of the intact right hemisphere visual areas from intact left hemisphere language areas. This case provides strong evidence that the neural systems supporting sign language processing are predominantly in the left hemisphere, but also suggests that there are some differences in the neural organization of signed vs spoken language within the left hemisphere.
Correlations of Enthalpies of Food Systems

Correlations of enthalpies of food systems containing water fraction from 0.74–0.94 are presented for a temperature range 230–310°K (–50 to 95°F). with these correlations, energy requirement in freezing and thawing foods within the limits of data base used for this work may be computed by providing the identity of food group (meat, juice or vegetable/fruits), water content, initial, and final temperatures.
Treating Men Like Boys Pedagogy at a Job Corps Center

Instructional methods that may be appropriate for small children are manifestly inappropriate for adults.
Plasma ion heating produces L10 FePt nanoclusters

In this study, cubic and spherical FePt clusters were created by inert gas condensation in an argon-helium dc sputter discharge under different flow and target power conditions. The plasma recipes for spherical and cubic clusters called for high He:Ar ratio, low target power and low He:Ar ratio, high target power, respectively. As expected, Langmuir probe measurements show the recipes led to larger ion density for the cubic case (2 × 108 cm−3 versus 6 × 106 cm−3 for spherical). We conclude that the larger density of argon ions increased the cluster-ion collision probability, heating the clusters in situ to promote atomic rearrangements and the formation of the ordered L10 crystal structure rather than the disordered fcc structure.
A STRUCTURAL APPROACH TO ESTIMATING RATE OF RETURN EXPECTATIONS OF FARMERS

A dual cost function approach is developed as an alternative to time series and simplistic approaches for estimating farmers’ expected operating rates of return on assets. A translog restricted cost function is estimated using data provided by 152 North Carolina damy farmers over the period 1976 through 1986. The predicted costs from the fitted restricted cost function are used to construct estimates of farmers’ expected operating rates of return on assets. The estimates from this structural approach explain more of the variation in observed rates than do time series estimates or sample mean observed rates.
Probabilistic Sufficient Conditions on Optimality for Reliability Based Decoding of Linear Block Codes

In this work, an efficient approach is introduced for reliability-based list decoding of a linear block code. This method terminates the decoding if a local optimal candidate satisfies a probabilistic sufficient condition. The average computation complexity is greatly reduced with this method. The false alarm probability associated with the use of the probabilistic sufficient condition is also derived. Simulation results confirm the analysis with no performance degradation and important computation savings on average for soft decision decoding of the (255,239) RS code (reduction by a factor between 2 and 20).
In vitro estimation of iron availability from a range of plant foods: influence of phytate, ascorbate and citrate.

1. Plant foods were digested in vitro and the proportion of iron which diffused across a ssemi-permeable membrane was used as an index of Fe availability.2. The mean (with SEM) Fe diffusibility from a group of eighteen cereals, legumes and nuts was very low, 2.1 (0.25)%, whereas from a group of sixteen fruits and vegetables it was high, 13.7 (1.09)%. The difference between the two food groups was highly significant (P < 0.001).3. The results for Fe diffusibility correlated well with literature values for the in vivo absorption of Fe from similar foods (r0.84, P < 0.01).4. When phytate, citrate and ascorbate were added to selected foods in amounts corresponding to endogenous levels, only phytate and citrate gave the expected effects on Fe diffusibility. Ascorbate only enhanced Fe diffusibility to the expected extent when it was added in much larger amounts, not normally found in foods.5. When added to cereal foods, orange juice was found to enhance greatly Fe diffusibility even when its content of ascorbate was completely destroyed by boiling followed by prolonged storage. When citrate and ascorbate were added to cereal foods in amounts equivalent to those found in fresh orange juice, both enhanced Fe diffusibility but citrate was far more effective.6. It is concluded that phytate is a major inhibitor of Fe diffusibility in cereals, legumes and nuts. However, citrate rather than ascorbate would appear to be the major enhancer of Fe diffusibility from many fruits and vegetables.7. The implications of the present results are discussed in relation to the relative influence of phytate, citrate and ascorbate on dietary Fe availability.
Apoptosis of limb innervating motor neurons and erosion of motor pool identity upon lineage specific dicer inactivation.

Diversification of mammalian spinal motor neurons into hundreds of subtypes is critical for the maintenance of body posture and coordination of complex movements. Motor neuron differentiation is controlled by extrinsic signals that regulate intrinsic genetic programs specifying and consolidating motor neuron subtype identity. While transcription factors (TFs) have been recognized as principal regulators of the intrinsic program, the role of posttranscriptional regulations has not been systematically tested. MicroRNAs produced by Dicer mediated cleavage of RNA hairpins contribute to gene regulation by posttranscriptional silencing. Here we used Olig2-cre conditional deletion of Dicer gene in motor neuron progenitors to examine effects of miRNA biogenesis disruption on postmitotic spinal motor neurons. We report that despite the initial increase in the number of motor neuron progenitors, disruption of Dicer function results in a loss of many limb- and sympathetic ganglia- innervating spinal motor neurons. Furthermore, it leads to defects in motor pool identity specification. Thus, our results indicate that miRNAs are an integral part of the genetic program controlling motor neuron survival and acquisition of subtype specific properties.
Development of functional organization of the pallid bat auditory cortex

The primary auditory cortex is characterized by a tonotopic map and a clustered organization of binaural properties. The factors involved in the development of overlain representation of these two properties are unclear. We addressed this issue in the auditory cortex of the pallid bat. The adult pallid bat cortex contains a systematic relationship between best frequency (BF) and binaural properties. Most neurons with BF 30 kHz are monaural (EO). As in other species, binaural properties are clustered. The EO/I cluster contains a systematic map of interaural intensity difference (IID) sensitivity. We asked if these properties are present at the time the bat acquires its full audible range (postnatal day [P] 15). Tonotopy, relationship between BF and binaural properties, and the map of IID sensitivity are adult-like at P15. However, binaural facilitation is only observed in pups older than P25. Frequency selectivity shows a BF-dependent sharpening during development. Thus, overlain representation of binaural properties and tonotopy in the pallid bat cortex is remarkably adult-like at an age when the full audible range is first present, suggesting an experience-independent development of overlapping feature maps.
Accuracy of combined endocardial and epicardial electroanatomic mapping of a reperfused porcine infarct model: a comparison of electrofield and magnetic systems with histopathologic correlation.

Background Contact mapping of the ventricle with NAVX has not been validated. Objective This study sought to compare the accuracy of infarct mapping between NAVX and CARTO using a histopathologic gold standard. Methods A closed-chest porcine infarction model was created by circumflex artery occlusion. After 4 to 12 weeks, 7 subjects underwent high-density endocardial and epicardial mapping using CARTO (Biosense Webster, Diamond Bar, California) and NAVX (St. Jude Medical, St. Paul, Minnesota) mapping systems. After mapping, animals were euthanized and histopathologic examination was used to quantify areas of scar at depths of 1 to 4 mm. Results Using a single-point acquisition approach with CARTO and a multipoint acquisition approach with the NAVX, endocardial and epicardial maps created using CARTO consisted of 360 ± 121 points performed in 54 ± 23 minutes/361 ± 90 points in 41 ± 13 minutes compared with 697 ± 132 points in 35 ± 8 minutes/1,303 ± 207 points in 30 ± 11 minutes using NAVX. At a 2-mm depth from the endocardial and epicardial surface, the mean scar area quantified by histopathology was 9.5 ± 8.7 cm 2 and 6.2 ± 4.8 cm 2 , respectively. Correlation between histopathology and electroanatomic maps was excellent (r = 0.88, CARTO and 0.92, NAVX). Correlation between scar area determined by CARTO and NAVX was good (r = 0.88, P Conclusion Balloon occlusion-reperfusion of the circumflex artery creates a localized patchy infarction in the inferolateral wall. Multipolar mapping achieves higher density in a shorter period of time and increases the detection of late potentials. A strong correlation between CARTO and NAVX exists, and both systems demonstrate good correlation with histopathologic quantification of scar.
Intravenous acetylcysteine for indications other than acetaminophen overdose

Purpose The use of intravenous acetylcysteine for off-label indications, specifically non-acetaminophen-induced acute liver failure (NAI-ALF), severe alcoholic hepatitis, and contrast-induced nephropathy (CIN), is reviewed. Summary I.V. acetylcysteine is most often used as an antidote for acetaminophen overdose due to its ability to increase levels of glutathione; however, it is also used to treat NAI-ALF and severe alcoholic hepatitis and to prevent CIN. Although the i.v. and oral formulations of acetylcysteine have been evaluated for these indications, most studies have examined the i.v. form. I.V. acetylcysteine is used in the treatment of NAI-ALF to improve oxygenation to the liver. One large randomized trial of 173 adults with NAI-ALF from any etiology and of any grade encephalopathy demonstrated overall improvement in transplant-free survival, particularly for patients with low-grade encephalopathy, though overall survival was not improved. When used to treat severe alcoholic hepatitis, i.v. acetylcysteine serves as an antioxidant and glutathione source. A trial of 174 patients with severe alcoholic hepatitis revealed that patients had 28-day survival benefit when treated with acetylcysteine; improvement in patients with hepatorenal syndrome was also noted. When used for the prevention of CIN, i.v. acetylcysteine provides antioxidants and vasodilation. The benefit for this indication is limited to surrogate markers such as serum creatinine and in patients with multiple risk factors for the development of CIN. Conclusion Data regarding the use of i.v. acetylcysteine for the treatment of NAI-ALF and severe alcoholic hepatitis and in the prevention of CIN are inconclusive, though some evidence supports its use in certain populations.
Aortic Intimal Dehiscence: A Complication of Percutaneous Balloon Fenestration for Aortic Dissection

A patient with acute type B dissection and a tube configuration of the intimal flap presented with signs of advanced mesenteric and renal ischemia as well as decreased pulses in the lower extremities. The patient was referred for emergency percutaneous fenestration of the abdominal aorta as a salvage procedure and a possible bridge to later surgery. After fenestration, femoral pulses became transiently stronger and then disappeared. The patient died after exploratory laparotomy. Postmortem examination demonstrated dehiscence of the infrarenal abdominal aortic intima with occlusion of the aortic bifurcation.
Effect of pharmaceuticals on radiographic appearance of selected examinations of the abdomen and thorax.

Come of radiographic interpretation in small animal imaging. Alterations in the abdomen and thorax may represent artifactual or transient changes or changes reflecting cytotoxicity. Examples of agents that may influence the appearance of radiographs include anticonvulsants, sedatives, anesthetics, analgesics, antiinflammatories, gastrointestinal prokinetic drugs, antineoplastics, and hormones such as megestrol acetate. Radiographic studies may be part of a disease-monitoring process. It is important to understand how pharmaceuticals (e.g., chemotherapeutics or therapy for an underlying medical condition) affect the radiographic appearance. Caution should be exercised in the interpretation of radiographic studies because the findings may relate to the drug therapy rather than the underlying condition.
Bitopological and topological ordered k-spaces

Abstract Domain theory, in theoretical computer science, needs to be able to handle function spaces easily. It also requires asymmetric spaces, and these are necessarily not T 1 . At the same time, techniques used with the higher separation axioms are useful there (see [Topology Appl. 199 (2002) 241]). In order to handle all these requirements, we develop a theory of k-bispaces using bitopological spaces, which results in a Cartesian closed category. The other well-known way to combine asymmetry and separation is ordered topological spaces [Nachbin, Topology and Order, Van Nostrand, 1965]; we define the category of ordered k-spaces, which is isomorphic to that found among bitopological spaces.
SYNTHESIS OF GLYCOPROTEIN, GLYCOLIPID, PROTEIN, AND LIPID IN SYNCHRONIZED L5178Y CELLS

Synthesis of four macromolecular classes found in membranes—glycoprotein, glycolipid, protein, and lipid—was measured as a function of time of the cell cycle in synchronized L5178Y cells. Incorporation of leucine, choline, fucose, glucosamine, or thymidine into the cells, protein, nucleic acid, or lipid was measured by pulse-labeling for ½ hr at ½ hr intervals after release from the mitotic block. The amount of protein, lipid, glycoprotein, or glycolipid released or secreted into the medium by the L5178Y cells was also measured as a function of time of the cell cycle. Cellular protein was found to be synthesized throughout the cell cycle, with the highest synthesis occurring in the S period; synthesis was depressed in the M period. Cellular glycoprotein was synthesized at approximately the same times as protein, except that the rates of glycoprotein synthesis in the S period relative to other periods were much greater than for protein. Secreted protein was synthesized throughout the cell cycle without any general pattern, except that secretion was elevated in the late S and G2 periods. Secreted glycoprotein was similar to secreted protein. Cellular lipid and cellular glycolipid were synthesized almost exclusively in the G2 and M periods; there was no synthesis in the G1 and S periods. Release or secretion of glycolipid and lipid also occurred in the G2 and M periods.
Competing through Standards: DOS/V and Japan's PC Market

Strategic Management Society 16th Annual International Conference Phoenix, Arizona November 12, 1996 Competing through Standards: DOS/V and Japan’ PC Market s Joel West and Jason Dedrick Center for Research on Information Technologies and Organizations (CRITO) University of California, Irvine 3200 Berkeley Place Irvine, CA 92697-4650 +1-714-824-5449; fax: +1-714-824-8091 http://www.crito.uci.edu November 30, 1996 Working Paper: #PAC-111
Let it Be a Treasure Hunt

(1937). Let it Be a Treasure Hunt. The Journal of Health and Physical Education: Vol. 8, No. 5, pp. 298-338.
NFAT restricts osteochondroma formation from entheseal progenitors

Osteochondromas are common benign osteocartilaginous tumors in children and adolescents characterized by cartilage-capped bony projections on the surface of bones. These tumors often cause pain, deformity, fracture, and musculoskeletal dysfunction, and they occasionally undergo malignant transformation. The pathogenesis of osteochondromas remains poorly understood. Here, we demonstrate that nuclear factor of activated T cells c1 and c2 (NFATc1 and NFATc2) suppress osteochondromagenesis through individual and combinatorial mechanisms. In mice, conditional deletion of NFATc1 in mesenchymal limb progenitors, Scleraxis-expressing (Scx-expressing) tendoligamentous cells, or postnatally in Aggrecan-expressing cells resulted in osteochondroma formation at entheses, the insertion sites of ligaments and tendons onto bone. Combinatorial deletion of NFATc1 and NFATc2 gave rise to larger and more numerous osteochondromas in inverse proportion to gene dosage. A population of entheseal NFATc1- and Aggrecan-expressing cells was identified as the osteochondroma precursor, previously believed to be growth plate derived or perichondrium derived. Mechanistically, we show that NFATc1 restricts the proliferation and chondrogenesis of osteochondroma precursors. In contrast, NFATc2 preferentially inhibits chondrocyte hypertrophy and osteogenesis. Together, our findings identify and characterize a mechanism of osteochondroma formation and suggest that regulating NFAT activity is a new therapeutic approach for skeletal diseases characterized by defective or exaggerated osteochondral growth.
American College of Surgeons Resident Objective Structured Clinical Examination: a national program to assess clinical readiness of entering postgraduate year 1 surgery residents.

Objective This report describes the development, initial implementation, and reliability of American College of Surgeons Resident Objective Structured Clinical Examination (ACS OSCE). Background Variability in clinical knowledge and skills of entering surgery residents has been demonstrated. The ACS OSCE was developed to evaluate and help remediate residents' knowledge and skills in managing patients with life-threatening conditions. Methods A task force of surgeons and professional educators developed 10 standardized clinical case stations, evaluation checklists, and rating scales. Standardized patients (SPs) evaluated each resident's clinical skills (history taking, physical examination, communication, and SP-global scores). Residents completed checklists on diagnosis and management. Coefficient alpha and item-total correlations were used, respectively, to assess internal consistency of metrics and station validity. The resident's overall performance for each station was calculated by combining scores of the individual skills. Analysis of variance compared performance across different institutions. Results A total of 103 postgraduate year 1 residents from 7 institutions completed the OSCE. Reliability coefficients of skills ranged from 0.38 for diagnosis to 0.68 for global scores. For overall performance on individual stations, the reliability coefficients ranged from 0.51 to 0.82. Using total percent correct scores from highly reliable stations (α > 0.8), wide variability in resident performance was demonstrated within and between the 7 institutions. Conclusions The ACS OSCE was successfully implemented across diverse institutions. It had moderate reliability and demonstrated variability among entering surgery residents. The ACS OSCE is now available for broader implementation. It should help reduce resident variability and address the requirements of Accreditation Council for Graduate Medical Education for resident supervision.
Effects of Regulation and Payment Policies on Nurse Practitioners' Clinical Practices

Increasing patient demand following health care reform has led to concerns about provider shortages, particularly in primary care and for Medicaid patients. Nurse practitioners (NPs) represent a potential solution to meeting demand. However, varying state scope of practice regulations and Medicaid reimbursement rates may limit efficient distribution of NPs. Using a national sample of 252,657 ambulatory practices, we examined the effect of state policies on NP employment in primary care and practice Medicaid acceptance. NPs had 13% higher odds of working in primary care in states with full scope of practice; those odds increased to 20% if the state also reimbursed NPs at 100% of the physician Medicaid fee-for-service rate. Furthermore, in states with 100% Medicaid reimbursement, practices with NPs had 23% higher odds of accepting Medicaid than practices without NPs. Removing scope of practice restrictions and increasing Medicaid reimbursement may increase NP participation in primary care and practice Medicaid acceptance.
Non-aqueous Synthesis of Water-Dispersible La_(0.88)Sr_(0.12)MnO_3 Nanoparticles

Water-dispersible La0.88Sr0.12MnO3 nanoparticles were successfully synthesized via non-aqueous nanoemulsion method using the triblock copolymer poly(ethylene oxide)-poly(propylene oxide)-poly(ethylene oxide)(PEO-PPO-PEO)as the surfactant,lanthanum(III)acetylacetonate(La(acac)3),manganese(III)acetylacetonate(Mn(acac)3)and strontium(II)acetylacetonate(Sr(acac)2)as precursors,1,2-hexadecanediol as the reducing agent.The Fourier transform infrared spectroscopy(FTIR)study confirms the PEO-PPO-PEO molecules on the surface of the resulting nanoparticles.The X-ray powder diffraction(XRD)and transmission electron microscopy(TEM)analyses confirm the formation,morphology and particle size of the nanoparticles.The vibrating sample magnetometry(VSM)measurement displays soft ferromagnetic properties of the La0.88Sr0.12MnO3 nanoparticles at room temperature.In addition,a rapid,efficient and reversible dispersion-collection process of the nanoparticles in water visually demonstrates their good magnetic properties and water dispersity.Such nanoparticles have potential application prospect in biomedical fields.
Safety and Early Oncologic Effectiveness of Primary Robotic Retroperitoneal Lymph Node Dissection for Nonseminomatous Germ Cell Testicular Cancer

Abstract Background Primary robot-assisted retroperitoneal lymph node dissection (R-RPLND) has been studied as an alternative to open RPLND in single-institution series for patients with low-stage nonseminomatous germ cell tumors (NSGCT). Objective To evaluate a multicenter series of primary R-RPLND for low-stage NSGCT. Design, setting, and participants Between 2011 and 2015, 47 patients underwent primary R-RPLND at four centers for Clinical Stage (CS) I-IIA NSGCT. Surgical procedure R-RPLND was performed using the da Vinci surgical system (Intuitive Surgical Inc., Sunnyvale, CA, USA). Outcome measurements and statistical analysis Data were collected regarding patient demographics, primary tumor characteristics, pathologic findings, and clinical outcomes. Results and limitations Forty-two patients (89%) were CS I and five (11%) were CS IIA. The median operative time was 235min (interquartile range [IQR]: 214–258min), estimated blood loss was 50ml (IQR: 50–100ml), node count was 26 (IQR: 18–32), and length of stay was 1 d. There were two intraoperative complications (4%), four early postoperative complications (9%), no late complications, and the rate of antegrade ejaculation was 100%. Of the eight patients (17%) with positive nodes (seven pN1and one pN2), five (62%) received adjuvant chemotherapy. The one recurrence was out of template in the pelvis after adjuvant chemotherapy (resected teratoma). The median follow-up was 16 mo and the 2-yr recurrence-free survival rate was 97% (95% confidence interval: 82–100%). Limitations include retrospective design and limited follow-up. Conclusions Our multicenter experience supports R-RPLND as a potential option at experienced centers in select patients with low-stage NSGCT. Informal comparison to open and laparoscopic series suggests R-RPLND has an acceptably low morbidity profile, but oncologic efficacy evaluation requires further evaluation. Patient summary We examined outcomes after robot-assisted retroperitoneal lymph node dissection for patients with low-stage nonseminomatous testicular cancer with our data suggesting the robotic approach has acceptable morbidity and early oncologic outcomes.
A Double-blind Comparison of the Abdominal Wall Relaxation Produced by Epidural 0.75% Ropivacaine and 0.75% Bupivacaine in Gynecologic Surgery

Background and Objectives. Ropivacaine is a long-acting local anesthetic agent with similar potency to that of bupivacaine when administered for epidural anesthesia. Ropivacaine, however, may be less cardiotoxic than bupivacaine. Epidural bupivacaine and ropivacaine have been shown to be equally effective in providing sensory block for lower extremity surgery, but they have not been compared for their ability to produce abdominal wall relaxation. Methods. Sixty-six American Society of Anesthesiologists I-III women, 18-70 years old undergoing elective gynecologic surgery were studied in a randomized, double-blind manner after giving informed consent in an institutionally approved protocol. Thirty-four patients received a single epidural injection of 20 mL 0.75% bupivacaine at the L2-L3 or L3-L4 interspace and 32 patients received 20 mL 0.75% ropivacaine in a similar manner. Sensory block was tested with pinprick; motor block with a modified Bromage scale, rectus abdominis muscle (RAM) test and surgeon satisfaction. Statistical analysis was performed using the SigmaStat for Windows computer software. Parametric data were analyzed with Student9s t-test, while nonparametric data was analyzed using the Mann-Whitney rank sum test. Results. Results are expressed as mean ± SD. Times to maximal sensory block and peak sensory level achieved were similar in both groups. However, time to complete sensory regression was significantly longer with bupivacaine than ropivacaine (457 ± 77 vs. 404 ± 62 minutes, P Conclusions. Both 0.75% ropivacaine and 0.75% bupivacaine provide adequate surgical anesthesia for lower abdominal surgery when administered epidurally. However, lower extremity motor block with ropivacaine is significantly shorter and of slower onset and sensory block shorter at these concentrations.
Metabolic risk factors in nondiabetic adolescents with glomerular hyperfiltration

Background. In adults, glomerular hyperfiltration is associated with abnormalities related to metabolic syndrome (MetS). We investigated if glomerular hyperfiltration was associated with metabolic abnormalities in US adolescents without diabetes. Methods. We analyzed data from the National Health and Nutrition Examination Survey, a nationally representative sample of US adolescents ages 12–17 years. Estimated glomerular filtration rate (eGFR) was determined using the bedside Schwartz equation; adolescents with hyperfiltration (eGFR >120 mL/min/1.73 m2) were compared to those with normal eGFR (90–120 mL/min/1.73 m2). We calculated mean levels of factors related to MetS, insulin resistance and diabetes risk, adjusting for age, race/ethnicity, sex, socioeconomic status, and BMI z-score. Results. Overall, 11.8% of US adolescents had hyperfiltration [95% confidence interval (CI) 10.6–13.0]. Hyperfiltration prevalence varied by race (20.2% in Hispanics versus 9.8% non-Hispanic whites and 7.4% non-Hispanic blacks; P< 0.001). Compared to those with normal eGFR, adolescents with hyperfiltration had higher adjusted mean levels of triglyceride (83 versus 77 mg/dL; P = 0.05), fasting insulin (15.1 versus 12.9; P< 0.001) and homeostatic model assessment of insulin resistance (3.52 versus 3.01; P = 0.001). These differences persisted after adjusting for BMI z-score. Adolescents with hyperfiltration had increased odds for hypertriglyceridemia [odds ratio 1.58 (95% CI 1.11–2.23)]. These relationships varied by racial/ethnic group. Conclusions. Glomerular hyperfiltration is associated with hypertriglyceridemia and increased insulin resistance independent of BMI z-score in a nationally representative sample of US adolescents. Hispanic adolescents are more likely to have hyperfiltration than other racial/ethnic groups. These findings could have significance in evaluations of renal function and MetS in adolescents to identify related risks and target interventions.