cssi/SciSciGPT-SciSciNet huggingface dataset:
Pediatric Lung Transplantation

Lung and heart–lung transplantation are established therapies for children with end-stage lung or congenital heart disease (CHD)/pulmonary vascular disease (PVD) in which there are no other therapeutic options. The most common indications for transplantation differ by age group. Cystic fibrosis is the most common overall indication of the lung recipients for the 12–17-year age group. In children younger than 1 year, the most common indications are CHD/PVD and diffuse lung disease from surfactant abnormalities. Additional diagnoses include transplant and nontransplant bronchiolitis obliterans and pulmonary fibrosis/interstitial pneumonitis. This chapter reviews pretransplant, donor, and posttransplant imaging evaluation.
The “mother of all bombs” and the forceful force of the greater weapon

In April 2017, the United States military dropped the GBU-43/B Massive Ordinance Air Blast (MOAB), colloquially known as the “Mother of All Bombs,” in Eastern Afghanistan. This essay foregrounds th...
Utilization of Finite Element Analysis for Articular Cartilage Tissue Engineering.

Scaffold design plays an essential role in tissue engineering of articular cartilage by providing the appropriate mechanical and biological environment for chondrocytes to proliferate and function. Optimization of scaffold design to generate tissue-engineered cartilage has traditionally been conducted using in-vitro and in-vivo models. Recent advances in computational analysis allow us to significantly decrease the time and cost of scaffold optimization using finite element analysis (FEA). FEA is an in-silico analysis technique that allows for scaffold design optimization by predicting mechanical responses of cells and scaffolds under applied loads. Finite element analyses can potentially mimic the morphology of cartilage using mesh elements (tetrahedral, hexahedral), material properties (elastic, hyperelastic, poroelastic, composite), physiological loads by applying loading conditions (static, dynamic), and constitutive stress–strain equations (linear, porous–elastic, biphasic). Furthermore, FEA can be applied to the study of the effects of dynamic loading, material properties cell differentiation, cell activity, scaffold structure optimization, and interstitial fluid flow, in isolated or combined multi-scale models. This review covers recent studies and trends in the use of FEA for cartilage tissue engineering and scaffold design.
Erythema Multiforme Major in a Dog Treated with Intravenous Human Immunoglobulin and Immunosuppressive Therapy

An ∼12 yr old castrated mixed-breed dog was evaluated for a 7 wk progressive history of intermittent hyporexia, lethargy, and erosive dermatitis. Initial examination revealed disseminated papules and macules coalescing to irregularly shaped and serpiginous plaques with widespread erosion progressing to ulceration. Skin histopathology revealed transepidermal keratinocyte apoptosis with lymphocyte satellitosis and lymphocytic and histiocytic interface infiltrate. Histopathology combined with clinical signs and history were compatible with the diagnosis of erythema multiforme major. Treatment was initiated with multidrug immunosuppression. Following 36 hr with no improvement, intravenous human immunoglobulin (0.45 mg/kg IV) was administered resulting in notable improvement in the dog's attitude and appetite within 2 hr and the dog's skin lesions within 48 hr. Following discharge, the dog improved daily with near complete resolution of dermatologic disease achieved 1 mo postdischarge. All immunosuppressive medications were ultimately discontinued 5 mo following presentation. This is the first report of a dog with erythema multiforme major that has been successfully treated with a combination of intravenous immunoglobulin and immunosuppression.
Region-specific glial homeostatic signature in prion diseases is replaced by a uniform neuroinflammation signature, common for brain regions and prion strains with different cell tropism

Chronic neuroinflammation is recognized as a major neuropathological hallmark in a broad spectrum of neurodegenerative diseases including Alzheimer's, Parkinson's, Frontal Temporal Dementia, Amyotrophic Lateral Sclerosis, and prion diseases. Both microglia and astrocytes exhibit region-specific homeostatic transcriptional identities, which under chronic neurodegeneration, transform into reactive phenotypes in a region- and disease-specific manner. Little is known about region-specific identity of glia in prion diseases. The current study was designed to determine whether the region-specific homeostatic signature of glia changes with the progression of prion diseases, and whether these changes occur in a region-dependent or universal manner. Also of interest was whether different prion strains give rise to different reactive phenotypes. To answer these questions, we analyzed gene expression in the thalamus, cortex, hypothalamus and hippocampus of mice infected with 22L and ME7 prion strains using a Nanostring Neuroinflammation panel at the subclinical, early clinical and advanced stages of the disease. We found that at the preclinical stage of the disease, the region-specific homeostatic identities were preserved. However, with the appearance of clinical signs, the region-specific signatures were partially lost and replaced with a neuroinflammation signature. While the same sets of genes were activated by both prion strains, the timing of neuroinflammation and the degree of activation in different brain regions was strain-specific. Changes in astrocyte function scored at the top of the activated pathways. Moreover, clustering analysis suggested that the astrocyte function pathway responded to prion infection prior to the Activated Microglia or Neuron and Neurotransmission pathways. The current work established neuroinflammation gene expression signature associated with prion diseases. Our results illustrate that with the disease progression, the region-specific homeostatic transcriptome signatures are replaced by the region-independent neuroinflammation signature, which is common for prion strains with different cell tropism. The prion-associated neuroinflammation signature identified in the current study overlapped only partially with the microglia degenerative phenotype and the disease-associated microglia phenotype reported for animal models of other neurodegenerative diseases.
Enhancing Couple Sexuality: Creating an Intimate and Erotic Bond

They kiss. They touch. He has a predictable and reliable erection. They have intercourse. Both have orgasms and are satisfied. This story of how sexual interactions are “supposed” to happen is exac...
Margin Requirements, Risk Taking, and Multifactor Models

When investors anticipate the Fed increasing margin requirements, they bid up the riskier stocks in the long legs of hedge portfolios associated with the market, HML, and SMB factors relative to the less risky stocks in the short legs. Following such a policy change, the returns on these hedge portfolios decline, implying lower subsequent compensation for bearing the risk associated with these three factors. In contrast, margin requirements are unrelated to returns on the momentum factor. Our evidence suggests that investors adjust their risk exposures to the market, SMB, and HML factors when leverage constraints are changed, but not momentum.
OP58 New US advance care planning billing codes – Who’s using it and for whom?

Background In the US, new reimbursement for advance care planning (ACP) started on January 1, 2016. This study aims to describe patient and practitioner characteristics related to use of the new billing codes, including documentation of the ACP process and advance directives. Methods Retrospective, cross-sectional analysis of the billing code 99497 from January 1, 2016 thru June 30, 2018 in outpatient visits in a large healthcare system. We describe patient-level and practitioner-level characteristics. We reviewed clinical documentation elements from a sample of patient visits from high- and low-utilizing practitioners. Results Seventy-six practitioners used the ACP billing code in 3421 outpatient visits for 2884 patients. Patients were mean age 73 (range 20–104 years), 57% female, and 2% rural residing. 35% of patients had an advance directive on file. Mean number of billing encounters per practitioner was 45 (range 1–704). Visits occurred in primary care settings (family medicine, internal medicine, geriatric medicine) and two subspecialty clinics (neurology, cardiology). ACP was billed multiple times for 150 patients (5.2%), with a range of two to four visits. The average time between unique visits was 330 days. The most commonly documented topics were code status, POLST/MOST form, and surrogate decision maker. 28% of ACP documents on file were completed within seven days of the ACP billing visit. Conclusions This is the first study to describe use of ACP billing codes in outpatient settings. Practitioners are using the ACP billing code mostly in primary care settings, among older adults, and occasionally multiple times.
A saliency-driven video magnifier for people with low vision

Consuming video content poses significant challenges for many screen magnifier users, which is the "go to" assistive technology for people with low vision. While screen magnifier software could be used to achieve a zoom factor that would make the content of the video visible to low-vision users, it is oftentimes a major challenge for these users to navigate through videos. Towards making videos more accessible for low-vision users, we have developed the SViM video magnifier system [6]. Specifically, SViM consists of three different magnifier interfaces with easy-to-use means of interactions. All three interfaces are driven by visual saliency as a guided signal, which provides a quantification of interestingness at the pixel-level. Saliency information, which is provided as a heatmap is then processed to obtain distinct regions of interest. These regions of interests are tracked over time and displayed using an easy-to-use interface. We present a description of our overall design and interfaces.
Material practices of domination: Christian humanism, the built environment, and techniques of Western power

While all human communities must engage the natural world for survival, the degree and kind of legitimate intervention into the landscape has varied enormously historically and culturally even just in the western tradition. Materialist traditions of analysis have suggested that social organization is deeply embedded in patterns of extracting and using natural resources, making what is done with land fundamentally important to social life. Cultural traditions of social explanation have made it clear that even material relations are cultural forms.
The realities of scaling within evidence-based policy

The economic model for scaling described by Al-Ubaydli and colleagues offers recommendations to policymakers who make decisions about whether or not to implement evidence-based programs. The core economic model does not currently acknowledge the broader context of policy decision-making and therefore may fail to achieve its objectives. The model focuses primarily on the generation and use of available research in the decision on whether to scale a program. Research studying the use of evidence in policymaking points to a complex set of factors beyond just the strength of the evidence such as leadership, relationships, timing and financial resources that contribute to decisions to scale a program. Second, there is already a robust evidence-based policy movement at the federal, state and local levels. The economic model should leverage this movement rather than providing recommendations that might stall or redirect the movement. The economic model can push the field to strengthen the available evidence while providing recommendations on selecting models to scale within the currently available evidence. This commentary finishes with suggestions for moving forward.
Germline HOXB13 G84E mutation carriers and risk to twenty common types of cancer: results from the UK Biobank.

Germline HOXB13 G84E mutation has been consistently associated with prostate cancer (PCa) risk, but its association with other cancers is controversial. We systematically tested its association with the 20 most common cancer types in subjects from the UK Biobank. The G84E mutation was found in 1,545 (0.34%) of 460,224 participants of European ancestry. While mutation status did not associate with cancer risk in females, it was significantly associated with increased risk in males; odds ratio (OR) (95% confidence interval) for overall cancer diagnosis was 2.19 (1.89–2.52), P = 2.5E-19. The association remained after excluding PCa; OR = 1.4 (1.16–1.68), P = 0.003, suggesting association with other cancers. Indeed, suggestive novel associations were found for two other cancer types; rectosigmoid cancer, OR = 2.25 (1.05–4.15), P = 0.05 and non-melanoma skin cancer (NMSC), OR = 1.40 (1.12–1.74), P = 0.01. For NMSC, the association was found only in basal cell carcinoma, OR = 1.37 (1.07–1.74), P = 0.03. These findings have potential clinical utility for genetic counselling regarding HOXB13.
Rotating Detonation Rocket Engine Operability Under Varied Pressure Drop Injection

Rotating detonation rocket engine (RDRE) experiments have so far been limited to injectors with high pressure drop to limit injector–plenum coupling. However, this corresponds to a reduction in the...
Total Motion Release® for Restoring Normal Knee Function after Anterior Cruciate Ligament Reconstruction: A Case Study

The objective of this study was to illustrate the case of a community college intercollegiate soccer player who sustained a grade 3 ACL injury and underwent surgical repair at 4 months. The patient engaged in her regular daily activity prior to the surgical procedure. One week prior to surgery the patient produced 140° of active knee flexion and -1° of active knee extension, and scored 69.0 on the International Knee Documentation Committee Subjective Knee Evaluation (SKE). One day post-ACL reconstruction by semitendinosus autograft, the patient’s range of motion was 40° of flexion and 20° of extension and reported a score of 21.8 on the SKE. The patient began rehabilitation immediately following surgery with the goal to increase ROM of the involved limb. A Total Motion Release rehabilitation protocol was implemented in lieu of a traditional ACL reconstruction rehabilitation protocol. Three sessions were completed each week over a four-week period, for a total of 12 sessions. Rehabilitation sessions consisted of 15 minutes of ice massage of the quadriceps with simultaneous quadriceps contraction/relaxation immediately followed by TMR. The patient ended each session with progressive exercise: 5 minutes of half rotations on the bike on day one, progressing to a 20 minute light jog on the treadmill by week four. Patient was re-assessed by the orthopedic surgeon at a one and six month post-op follow-up appointments. Changes in flexion and extension ROM and an SKE was assessed weekly prior to treatment to evaluate knee function. After four weeks, normal knee range of motion was restored demonstrating the effectiveness of Total Motion Release®.
Spinal Cord Injury - Healing from Within

Procuring Oligodendrocytes after Spinal Cord Injury Loss of oligodendrocytes after spinal cord injury results in demyelination and impairs the function of neurons. A recent study shows a potential ...
Medical Nutritional Therapy

This chapter provides an in-depth review of medical nutritional therapy of youth with T1D. Specifically, the types and amounts of carbohydrate, protein, and fat for healthy meal choices in youth with T1D are reviewed. The effects of glycemic index, the importance of accurate carbohydrate counting, and the usefulness of Nutrition Facts labelling are also addressed.
No Other Way Out: States and Revolutionary Movements, 1945–1991

Figures, tables and maps Abbreviations and acronyms Preface and acknowledgments Part I. Introduction: 1. Comparing revolutionary movements 2. The state-centered perspective on revolutions: strengths and limitations Part II. Southeast Asia: Chronology for Southeast Asia 3. The formation of revolutionary movements in Southeast Asia 4. The only domino: the Vietnamese revolution in comparative perspective Part III. Central America: Chronology for Central America 5. The formation of revolutionary movements in Central America 6. Not-so-inevitable revolutions: the political trajectory of revolutionary movements in Central America Part IV. Further Comparisons and Theoretical Elaborations: 7. Between success and failure: persistent insurgencies Chronology for Eastern Europe 8. 'Refolution' and rebellion in Eastern Europe, 1989 9. Conclusion: generalizations and prognostication Annotated bibliography Index.
Selectin' for NETs.

In this issue of Blood , [Etulain et al][1] have added to the knowledge of neutrophil extracellular traps (NETs) by defining the mechanisms involved in platelet-triggered NET formation.[1][2] NETs have been the subject of intense investigation since their description over a decade ago.[2][3]
Community-Level Quality Improvement and the Patient Experience for Chronic Illness Care.

Objective To determine whether chronically ill adults from communities participating in a community-level quality improvement effort reported greater improvement on four domains of patient experience: care coordination, patient satisfaction, provider interaction and support, and receipt of recommended care for diabetes. Study Setting The Robert Wood Johnson Foundation's Aligning Forces for Quality (AF4Q) initiative provides multistakeholder alliances with funding and technical assistance to improve quality in their communities. Study Design This is a quasi-experimental, pre-post study. We used a difference-in-difference approach to detect relative changes over time on 16 survey-based outcome measures representing the four patient experience domains. Data Collection We surveyed adults with chronic illness(es) in 14 AF4Q communities and a national comparison group. Wave 1 was completed in 2008 (8,140 respondents) and wave 2 in 2012 (9,565 respondents). Principal Findings Respondents from AF4Q communities reported modestly greater improvement on patient satisfaction and receipt of recommended care for diabetes. Conclusions Results suggest that community-level QI efforts led by multistakeholder alliances hold the potential to improve patient satisfaction and receipt of recommended care for diabetes, but the magnitude of the effect may be limited. However, there is less evidence that community-level QI can improve patient perceptions of care coordination or provider interaction and support.
Overview on Concepts and Applications of Fab Antibody Fragments

In this overview, the Fab molecule is introduced and discussed as the first generated antibody fragment, which still dominates basic research and clinical applications. The unit contains a concepts section and an applications section. In the concepts section, the two principal methods for producing Fab, as well as the generation and directed evolution of Fab by phage display, are described. The applications section discusses Fab in clinical applications, as well as their increasingly important role in the determination of the three-dimensional structures of transmembrane proteins.
Stability of Singularly Perturbed Systems and Parasitics Bounds for Robust Adaptive Control

In this paper, bounds in the parasitics of an adaptive control problem are obtained through the application of singular perturbation theory, both with uncorrected and corrected models.
Heredity and Alcoholism

The temperance movement (and Prohibition) was based on a 19th century realization that drunkenness was a vice, not only of the wastrel rich and the improvident poor, but also of the middle classes. Alcohol itself was seen as the culprit. However, modern views of alcoholism emphasize that many individuals enjoy drinking without experiencing any alcohol-related difficulties and that one therefore should focus on problem drinkers rather than on alcohol use. In fact, alcoholism is now thought by many to be a disease or a psychiatric disorder rather than a moral weakness. This is reflected in the inclusion of alcohol abuse and of alcohol dependence in the DSM-III. Tables 39 and 40 describe the diagnostic criteria for these two conditions.
Feedback control of triaxial attitude control testbed actuated by two proof mass devices

The triaxial attitude control testbed (TACT) has been developed as part of a research program on spacecraft multibody rotational dynamics and control. In the paper, an attitude control problem for the TACT actuated by two proof mass devices is studied. Under the assumption of uniform gravity, proof masses generate control moments about the roll and pitch axes of the base body. The control objective is to accomplish attitude stabilization about all three axes using only two proof mass actuators. Analysis shows that there do not exist stabilizing continuous time-invariant feedback controllers. For feedback design, we simplify the complex multibody equations of motion and we develop a discontinuous time-invariant feedback controller. The resulting closed loop shows exponentially converging responses for rotational maneuvers about all three axes.
Risky Business: The Decline of Defined Benefit Pensions and Firms' Shifting of Risk

Since the early 1980s, employment in the United States has undergone significant transformation as the large corporations that once safeguarded employees with stable jobs and rewards for loyalty have replaced these employment relationships with ones based on cost containment and flexibility. One important consequence of these developments is that firms have abdicated their role as a critical risk bearer in society. Although evidence suggests that firms have increasingly shifted market risks onto their workforce, to date, there have been few detailed analyses exploring what factors have driven this phenomenon. This study adds to our understanding of why firms have transferred risk to their employees by examining the decline of a highly institutionalized practice wherein large U.S. firms used to bear retirement risk: the defined benefit DB pension plan. Through a detailed analysis, I show that variance in the presence, power, and interests of shareholders and employees at the firm level differentially affect a firm's willingness to shift the risk of retirement onto its workers. Specifically, I demonstrate empirically that different types of shareholders have differential effects on a firm's retirement practices, suggesting that the changing equity ownership structure of large U.S. firms has played a key role in how risk is allocated between workers and firms. Declines in employee power have also played a role because firm levels of unionization positively affect rates of DB participation for both unionized and nonunionized workers.
Multidisciplinary management of spinal lipoma

Spinal lipomas (congenital lipomyelomeningoceles) can cause significant aesthetic deformity of the lower spine in addition to recognised neurological problems. Surgical management consists of untethering the cord in symptomatic cases, and debulking of the lipomatous component to improve the spinal contour. However, management remains controversial. Between May 1998 and November 2002, 23 cases of lumbosacral spinal lipoma were operated on by neurosurgeons at our hospital. Of these, eight (34%) patients were subsequently referred to plastic surgery for aesthetic revision, which was performed by a combined team of plastic surgeons and neurosurgeons. In addition, three new patients had their primary surgery as a planned procedure performed by the same combined team. The purpose of this paper is to present the method and results of combined plastic surgery and neurosurgery technique in these 11 cases of spinal lipoma. Follow up ranged between 12 months and 4 years (mean 20 months). One patient had wound break down and three patients developed seroma. Two patients had cerebrospinal fluid (CSF) leakage which required re-exploration and prolonged hospitalisation. The aesthetic results were very satisfactory in 10 out of the 11 patients. The frequency of secondary referral for aesthetic revision, together with the incidence of CSF leak, underlines the importance of managing spinal lipomas in a multidisciplinary team involving neurosurgeons and plastic surgeons. This series demonstrates that aesthetic results are encouraging but decreasing the CSF leakage rate remains a challenge. Further follow up will determine the role of early combined surgery in the management of spinal lipoma.
Influence of age and environment on the induction of mammary tumours by diethylstilboestrol in C3H/HeN-MTV+ mice.

Abstract C3H/HeN-MTV+ female mice were fed diets containing targeted concentrations of 320 or 640 ppb diethylstilboestrol (DES) starting at 3, 5, 7 or 11 wk
Amplitude-masked photoacoustic wavefront shaping: theory and application in flowmetry

Optical diffusion in scattering media prevents focusing beyond shallow depths, causing optical imaging and sensing to suffer from low optical intensities, resulting in low signal-to-noise ratios (SNR). Here, we demonstrate focusing using a fast binary-amplitude digital micromirror device to characterize the transmission modes of the scattering medium. We then identify and selectively illuminate the transmission modes which contribute constructively to the intensity at the optical focus. Applying this method to photoacoustic flowmetry, we increased the optical intensity at the focus six-fold, and showed that the corresponding increase in SNR allows particle flow to be measured.
Weather and childbirth: a further search for relationships.

Previous attempts to find relationships between weather and parturition (childbirth) and its onset (the beginning of labor pains) have revealed, firstly, limited but statistically significant relationships between weather conditions much colder than the day before, with high winds and low pressure, and increased onsets; and secondly, increased numbers of childbirths during periods of atmospheric pressure rise (highly statistically significant). To test these findings, this study examined weather data coincident childbirth data from a hospital at Bryan-College Station, Texas (for a period of 30 cool months from 1987 to 1992). Tests for (1) days of cold fronts, (2) a day before and a day after the cold front, (3) days with large temperature increases, and (4) decreases from the day before revealed no relationship with mean daily rate of onset. Cold days with high winds and low pressure had significantly fewer onsets, a result that is the opposite of previous findings. The postulated relationship between periods of pressure rise and increased birth frequency was negative, i.e., significantly fewer births occurred at those times--again, the opposite of the apparent occurrence in an earlier study. The coincidence of diurnal variations in both atmospheric pressure and frequency of childbirths, was shown to account for fairly strong negative associations between the two variables.(ABSTRACT TRUNCATED AT 250 WORDS)
Differential H3K4 methylation identifies developmentally poised hematopoietic genes.

Summary Throughout development, cell fate decisions are converted into epigenetic information that determines cellular identity. Covalent histone modifications are heritable epigenetic marks and are hypothesized to play a central role in this process. In this report, we assess the concordance of histone H3 lysine 4 dimethylation (H3K4me2) and trimethylation (H3K4me3) on a genome-wide scale in erythroid development by analyzing pluripotent, multipotent, and unipotent cell types. Although H3K4me2 and H3K4me3 are concordant at most genes, multipotential hematopoietic cells have a subset of genes that are differentially methylated (H3K4me2+/me3−). These genes are transcriptionally silent, highly enriched in lineage-specific hematopoietic genes, and uniquely susceptible to differentiation-induced H3K4 demethylation. Self-renewing embryonic stem cells, which restrict H3K4 methylation to genes that contain CpG islands (CGIs), lack H3K4me2+/me3− genes. These data reveal distinct epigenetic regulation of CGI and non-CGI genes during development and indicate an interactive relationship between DNA sequence and differential H3K4 methylation in lineage-specific differentiation.
Profile of a university computer user community

The data recorded over a one-year period on the permanently mounted system monitor tape at the University of Nebraska is analyzed with a view to determine prominent computer user characteristics. The users are divided into distinct categories according to their patterns of computer resource utilization.
Modeling Protein Conformational Changes by Iterative Fitting of Distance Constraints Using Reoriented Normal Modes

Recently we have developed a normal-modes-based algorithm that predicts the direction of protein conformational changes given the initial state crystal structure together with a small number of pairwise distance constraints for the end state. Here we significantly extend this method to accurately model both the direction and amplitude of protein conformational changes. The new protocol implements a multisteps search in the conformational space that is driven by iteratively minimizing the error of fitting the given distance constraints and simultaneously enforcing the restraint of low elastic energy. At each step, an incremental structural displacement is computed as a linear combination of the lowest 10 normal modes derived from an elastic network model, whose eigenvectors are reorientated to correct for the distortions caused by the structural displacements in the previous steps. We test this method on a list of 16 pairs of protein structures for which relatively large conformational changes are observed (root mean square deviation >3 A), using up to 10 pairwise distance constraints selected by a fluctuation analysis of the initial state structures. This method has achieved a near-optimal performance in almost all cases, and in many cases the final structural models lie within root mean square deviation of 1 ∼ 2 A from the native end state structures.
Local groups of differentiable transformations

Let S be a connected class C (k) Banach manifold, let r be a positive integer with r < k, and let R denote the real number line. By a semi-C ~'~ local transformation group in S, we mean a continuous function T from a connected open subset M of R × S into S such that: (i) (0, p) ~ M and T(0, p) = p for each p ~ S, (ii) if (s, p), (u, p) e M and s < t < u, then (t, p) ~ M, (iii) T(u, T(t, p)) = T(t + u, p) if(t, p), (u, T(t, p)), (t + u, p) ~ M, and (iv) T has continuous second place partial derivatives through the r th order. We prove that such a function T is a class C (r~ function (jointly in both variables) and is a local flow of a vector field on S. We also characterize the vector fields on S which have class C ~') local flows. Even if S is an open subset of a Banach space, it is necessary to consider nontrivial differentiable structures on S in order to characterize these vector fields.
Radial efficiency gradients in Ge(Li) gamma detectors

Counting of radioactive sources in contact with the vacuum container of a Ge(Li) detector may lead to errors because of large efficiency gradients. In order to explore the radial dimension of this problem, several point sources were stepped across in contact with the cap of several detectors, and curves of absolute efficiency against radius were measured. The insensitive core of an open-end coaxial detector reduced the central point-source efficiency at 122 keV at the cap to 20% less than a comparable closed-end detector. In compensation, however, there was a reduction in the radial efficiency gradient. The radial efficiency gradient was approximately proportional to the radius, with the central flattening for the open-end detector superimposed on the trend.
Role of Tc-99m MIBI in the evaluation of single pulmonary nodules: a preliminary report

BACKGROUND Survival in bronchial carcinoma is closely related to the stage of the disease at the time of diagnosis and a single pulmonary nodule represents a potentially curable stage. This study was conducted to assess the feasibility of using Tc-99m labelled 2-methoxy isobutyl isonitrile (MIBI) to differentiate benign from malignant single pulmonary nodules. METHODS A prospective study was conducted in the outpatient pulmonary clinic at the Cleveland Clinic Foundation. Twenty five patients with single pulmonary nodules considered indeterminate by their physicians and undergoing a procedure for tissue diagnosis were evaluated by Tc-99m MIBI SPECT scanning prior to definitive testing. Assessment of MIBI uptake was done qualitatively (subjectively) and quantitatively and correlated with the histopathology and nodule size. RESULTS Of the 21 patients with malignant lesions, 18 had increased uptake of MIBI corresponding to the location of the nodule and were considered positive. The predominant tumour types were large cell (n = 5) and adenocarcinoma (n = 10). All four patients with benign lesions had negative MIBI scans. For malignancy the overall specificity was 100%, sensitivity was 85.7%, positive predictive value was 100%, and negative predictive value was 57%. Quantitative uptake of MIBI correlated with the diameter of the nodule with a correlation coefficient of 0.61 by Spearman9s rank sum test. This relationship was statistically significant (p = 0.02). CONCLUSION This preliminary study suggests that Tc-99m MIBI has a very high specificity and positive predictive value for malignant single pulmonary nodules and might be a useful non-invasive diagnostic modality in their management.
EFFECTS OF QUERCETIN ON ANTIOXIDANT DEFENSE IN STREPTOZOTOCIN-INDUCED DIABETIC RATS

In light of evidence that some complications of diabetes mellitus may be caused or exacerbated by oxidative damage, we investigated the effects of subacute treatment with the antioxidant quercetin on tissue antioxidant defense systems in streptozotocin-induced diabetic Sprague-Dawley rats (30 days after streptozotocin induction). Quercetin, 2-(3,4-dihydroxyphenyl)-3,5,7-trihydroxy-4H-1-benzopyran-4-one, was administered at a dose of 10mg/kg/day, ip for 14 days, after which liver, kidney, brain, and heart were assayed for degree of lipid peroxidation, reduced and oxidized glutathione content, and activities of the free-radical detoxifying enzymes catalase, superoxide dismutase, glutathione peroxidase, and glutathione reductase. Treatment of normal rats with quercetin increased serum AST and increased hepatic concentration of oxidized glutathione. All tissues from diabetic animals exhibited disturbances in antioxidant defense when compared with normal controls. Quercetin treatment of diabetic rats reversed only the diabetic effects on brain oxidized glutathione concentration and on hepatic glutathione peroxidase activity. By contrast, a 20% increase in hepatic lipid peroxidation, a 40% decline in hepatic glutathione concentration, an increase in renal (23%) and cardiac (40%) glutathione peroxidase activities, and a 65% increase in cardiac catalase activity reflect intensified diabetic effects after treatment with quercetin. These results call into question the ability of therapy with the antioxidant quercetin to reverse diabetic oxidative stress in an overall sense.
Cobalamin metabolism in cultured human chorionic villus cells

Cobalamin (Cbl, vitamin B12) metabolism was analyzed in cultures of human chorionic villus (CV) cells obtained at 9–10 weeks of gestation. CV cells were shown to synthesize transcobalamin II (TCII) and to possess a high affinity receptor for that molecule. The cells bound and internalized radioactive cyanocobalamin (CN[57Co]Cbl) complexed to TCII. This internalized CN[57Co]Cbl was found to be converted to both methylCbl and adenosylCbl, the two intracellular coenzyme forms of Cbl, and bound to the two known intracellular Cbl requiring enzymes, methionine synthase (MS) and methylmalonyl-CoA mutase. Both enzyme systems were found to be functional in the intact cell by demonstrating the incorporation of the radioactive label from both [14C]CH3-tetrahydrofolate and [14C]propionate into acid insoluble products. MS activity was also detected in lysed cell material. CV cells were shown not to be auxotrophic for methionine since they were able to utilize homocysteine in place of methionine for cell division. Since CV cells are capable of performing many of the complex events associated with Cbl metabolism, it may be possible to use these cells to diagnose genetic defects of Cbl metabolism. © 1993 Wiley-Liss, Inc.
Fewer medications for in vitro fertilization can be better: thinking outside the box

Minimal stimulation or mild stimulation protocols for in vitro fertilization offer many advantages for all patients, but especially for low and high responders. In the current practice of reducing the number of embryos transfered to a maximum of two for a significant number of patients, using aggressive and high-dose gonadotropins to obtain a large, and sometimes excessive, number of oocytes should be questioned.
Modulation of immunoglobulin production and cytokine mRNA expression in peripheral blood mononuclear cells by intravenous immunoglobulin

Intravenous immunoglobulin (IVIG) has the potential to regulate Ig production, but the mechanism(s) responsible for this effect is unknown. In experiments reported here, we examined the ability of IVIG to regulate Ig production in human peripheral blood mononuclear cells (PBMCs) stimulated with pokeweed mitogen (PWM). IVIG (2–10 mg/ml) showed a potent (80–85%) inhibition of PWM-stimulated IgG, IgM, and IgA production. To determine more precisely how IVIG mediated the inhibition of Ig production, we studied Ig promoting cytokine gene expression after PWM stimulation with or without IVIG (2 and 10 mg/ml) using dot-blot techniques. RNA was isolated from PBMCs at predetermined time points and probed with cDNAs specific for human cytokines (IL-1-β, IL-2, IL-2R, IL-4, IL-5, IL-6, γ-IFN, and TNF-α). IL-6 mRNA accumulation was maximal at 4.5 hr post-PWM stimulation and was inhibited 64–75% when IVIG (10 mg/ml) was present. γ-IFN mRNA levels peaked at 72 hr poststimulation and were also 68–75% inhibited by IVIG. IL-2 mRNA levels peaked at 4.5 hr and were 23–46% inhibited by IVIG. The inhibitory effect of IVIG on production of these cytokines (IL-6 and γ-IFN) was also observed at the protein level in sonicated PBMCs after incubation with PWM and IVIG. The mRNA levels for other cytokines were not or only minimally inhibited by IVIG. Addition of IL-6, γ-IFN, or IL-2 partially restored Ig production in IVIG-treated PWM-stimulated cultures, suggesting that inhibition of other cytokines or another mechanism(s) independent of cytokine inhibition might also be involved, although inhibition of IL-6, γ-IFN, and IL-2 may be one of the critical factors in the suppression of Ig production by IVIG.
The costs and consequences of omalizumab in uncontrolled asthma from a USA payer perspective.

Background: Omalizumab, an anti-immunoglobulin E antibody, reduces exacerbations and symptoms in uncontrolled allergic asthma. The study objective was to estimate the costs and consequences of omalizumab compared to usual care from a US payer perspective. Methods: We estimated payer costs, quality-adjusted survival (QALYs), and the incremental cost-effectiveness ratio (ICER) of omalizumab compared to usual care using a state-transition simulation model that included sensitivity analyses. Every 2 weeks, patients could transition between chronic asthma and exacerbation health states. The best available evidence informed the clinical and cost input estimates. Five years of omalizumab treatment followed by usual care was assumed to estimate a lifetime horizon. Omalizumab responders (60.5% of treated) were modeled as a separate scenario where nonresponders reverted back to usual care after 16 weeks of active treatment. Results: The mean lifetime discounted costs and QALYs were $83 400 and 13.87 for usual care and $174 500 and 14.19 for omalizumab plus usual care resulting in $287 200/QALY (95% interval: $219 300, $557 900). The ICER was $172 300/ QALY when comparing omalizumab to usual care in the responder scenario. Oneway sensitivity analyses indicated that the results were sensitive to the difference in treatment-specific utilities for the chronic state, exacerbation-associated mortality, omalizumab price, exacerbation rates, and response definition. Conclusions: The results suggest that adding omalizumab to usual care improves QALYs at an increase in direct medical costs. The cost-effectiveness of omalizumab is similar to other chronic disease biologics. The value increases when omalizumab response is used to guide long-term treatment.
Surface speciation at solid/liquid interfaces : A vibrational sum-frequency study of acetate adsorption at the fluorite/water interface

Vibrational sum-frequency spectroscopy (VSFS) has been used to investigate the adsorption of acetate at the fluorite/water interface in situ. The bulk pH value was varied to control the composition of the liquid phase in contact with a single crystalline fluorite (CaF2) surface. Spectra were recorded in frequency regions corresponding to vibrational modes of the adsorbate and water. Quantitative information on interfacial water molecules in different states of order was obtained from the present data. Furthermore, the effect of background electrolyte concentration was studied, and it was found that surface hydroxyls play a crucial role for the oriented adsorption of acetate ions at the interface.
Prenatal ethanol exposure alters the post-lesion reorganization (sprouting) of acetylcholinesterase staining in the dentate gyrus of adult rats

Abstract Prenatal exposure of rats to ethanol by feeding pregnant dams a liquid diet containing 35% ethanol-derived calories during days. 1–21 of gestation produced an altered lesion-induced sprouting response in the offspring when they were lesioned as adults. The localization of acetylcholinesterase (AChE) in the molecular layer of the dentate gyrus was determined by histochemical methods and used to monitor sprouting following the unilateral ablation of the entorhinal cortex. Quantitative morphometric techniques, including computer-assisted image analysis, were used to measure the width of bands and the total area of AChE-positive staining. Both measures indicated an expanded commissural/associational (C/A) zone (indicating a more robust sprouting response) in the rats exposed to ethanol prenatally compared to normal and pair-fed control rats that received similar lesions. A comparison of the post-lesion changes in the supra- and infrapyramidal blades revealed a trend towards more C/A sprouting in the infrapyramidal blade, but only in the ethanol-exposed rats. These findings indicate that prenatal ethanol exposure has long-lasting effects on morphological responsiveness such as sprouting in the central nervous system.
Acute Hemolysis Due to Profound Hypo-Osmolality. A Complication of Hemodialysis

Acute hemolysis in maintenance hemodialysis patients is not a rare occurrence. Significant hemolysis is life-threatening and may be unrecognized because of nonspecific symptomatology. This paper reports observation of a severe hemolytic episode in a hemodialysis patient. The hemolysis was associated with a sudden drop in serum osmolality and profound hyponatremia, resulting from accidental dialysis against deionized water. Recognizing the condition and treating it promptly by dialysis with physiological dialysate are essential for patient survival.
Gay Marriage: For Better or for Worse? What We've Learned from the Evidence. By William N. Eskridge Jr. and Darren R. Spedale

Gay Marriage: For Better or for Worse? What We've Learned from the Evidence. By William N. Eskridge Jr. and Darren R. Spedale. New York: Oxford University Press, 2006. Pp. ix+336. $29.95 cloth; $19.95 paper. In May 1989, the Danish Parliament enacted the Registered Partnership Act and thereby made Denmark the first nation officially to recognize same-sex unions and to bestow on lesbian and gay couples most of the rights and duties associated with marriage. In 1993, Norway followed Denmark's lead, as did Sweden in 1995, Iceland in 1996, and Finland in 2002. The Nordic countries thus were trailblazers in granting same-sex pairs what are now termed civil unions or domestic partnerships in the United States. Conservative U.S. commentators such as Stanley Kurtz and Robert Bork have made empirical allegations, based on the Scandinavian experience, that same-sex unions discourage differentsex couples from marrying and result in more children being raised outside of marriage. In 2004 and 2005, these assertions were the principal empirical grounds bolstering the Republican Party's "defense of marriage" argument in support of passage of the Federal Marriage Amendment, which would ban same-sex unions in the United States. In Gay Marriage: For Better or for Worse? What We've Learned from the Evidence, Eskridge and Spedale rebut Kurtz, Bork, and Republicans such as former Pennsylvania senator Rick Santorum. The authors also address questions such as "Has the legal recognition of same-sex partnerships in other countries had positive consequences for citizens in those countries?" (p. 13) The book's most compelling analysis directly confronts the defense-of-marriage contentions of Kurtz, Bork, and Santorum. Eskridge and Spedale convincingly demonstrate that a twogeneration-long Nordic trend of declining marriage rates, rising divorce rates, and soaring rates of nonmarital births pre-dated, by well over a decade, the Scandinavian adoption of registered partnership laws and followed the liberalization of alternatives to marriage (such as cohabitation) and the expansion of exit options (such as no-fault divorce). Every bit as important, the introduction of registered partnerships did not at all accelerate those domesticrelations transformations. In fact, Denmark, Norway, and Sweden had more children raised by their biological parents after those countries adopted partnership laws (p. 172). The volume is chock-full of human interest. The story of Eigil and Axel Axgil, a pioneering male couple who championed gay rights and same-sex unions in Denmark starting in the 1950s, introduces one chapter. Barry Winter and Per Kjaer, depicted as the authors' "bear" couple, begin another ("bear" is slang for gay males who are burly and hairy and thus resemble bears). …
Effects of linear furanocoumarins on the herbivore Spodoptera exigua and the parasitoid Archytas marmoratus: host quality and parasitoid success

We assessed the effects of three photoactivated linear furanocoumarins, secondary plant metabolites present in Apium spp. (Apiaceae) and other taxa, on the larval-pupal parasitoid, Archytas marmoratus (Townsend) (Diptera: Tachinidae) and the host Spodoptera exigua (Hubner) (Lepidoptera: Noctuidae), in the presence and absence of ultraviolet radiation. These results then were compared with previously described responses of Archytas marmoratus and other hosts to different plant allelochemicals. Ultraviolet radiation had no consistent detrimental effects. Increasing concentrations of linear furanocoumarins (from 0 to 0.029% of fresh weight) increased mortality of both the host and parasitoid. Increasing linear furanocoumarin levels also prolonged larval development of surviving S. exigua, but had no effect on pupal developmental time or pupal mass. Consequently, there was no effect of increasing linear furanocoumarin levels on surviving parasitoid development time (from the time of host pupation) or size. These results indicate the effects of linear furanocoumarins are mediated through effects on the host. Because reported responses of Ar. marmoratus to other allelochemicals (e.g., flavones, methyl ketones) are mediated through host effects, these results support the hypothesis that Ar. marmoratus displays a generalized response to plant allelochemicals that are predictable based on host mediated effects.