cssi/SciSciGPT-SciSciNet huggingface dataset:
Impact of consensus guidelines for breast-conserving surgery in patients with ductal carcinoma in situ

Background Consensus guidelines published in 2016 recommended a 2 mm free margin as the standard for negative margins in patients undergoing breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS). The goal of the guideline recommendation was standardization of re-excision practices. Aims To evaluate the impact of this consensus guideline on our institutional practices. Methods We identified all patients at our institution with pure DCIS who were initially treated with BCS from September 2014 to August 2018 using a prospectively-maintained institutional database. A retrospective chart review was performed to determine margin status and re-excision rates during the 2 years before and the 2 years after the guideline was published in order to determine the effect on our re-excision rates. Close margins were defined as Results In the 2 years before the consensus guideline was published, 184 patients with DCIS underwent BCS. Twenty-six patients had positive margins and 24 underwent re-excision, including three who had completion mastectomy. Of the remaining 159 patients, 76 had ≥2 mm (negative) margins. The remaining 82 patients had close margins and 48 of these patients (58.5%) underwent re-excision, including one who had a completion mastectomy. Excluding the patients with positive margins, our re-excision rate was 30.4% prior to the guideline. In the 2 years after the consensus guideline was published, 192 patients with DCIS underwent initial BCS. Twenty-four patients had positive margins and 22 underwent re-excision, including three who had completion mastectomy. Of the remaining 168 patients, 95 patients had ≥2 mm (negative) margins. The remaining 73 patients had close margins and 45 of those patients (61.6%) underwent re-excision, including six who had completion mastectomy. Excluding the patients with positive margins, our re-excision rate was 26.8% after the guideline. Conclusions Our institution's re-excision rate did not change significantly during the 2 years before and after the publication of the consensus guideline on adequate margins for patients undergoing BCT for DCIS. Our overall re-excision rate decreased slightly. However, of the patients who had close margins, a larger proportion underwent re-excision after the guideline was published. The guideline publication appears to have affected our institutional practices slightly, but not dramatically as many of our surgeons' practices were comparable to the guideline recommendations prior to 2016. We continue to use clinical judgment based on patient and tumor characteristics in deciding which patients will benefit from margin re-excision.
Percutaneous coronary intervention of totally occluded coronary venous bypass grafts: An exercise in futility?

BACKGROUND Percutaneous coronary intervention (PCI) of diseased saphenous vein grafts (SVG) continues to pose a clinical challenge. Current PCI guidelines give a class III recommendation against performing PCI on chronically occluded SVG. However, contemporary outcomes after SVG intervention have incrementally improved with distal protection devices, intracoronary vasodilators, drug-eluting stents, and prolonged dual antiplatelet therapy. AIM To reassess the procedural and long-term outcomes of PCI for totally occluded SVG with contemporary techniques. METHODS This was a retrospective observational study conducted at a single university hospital. The study population consisted of 35 consecutive patients undergoing PCI of totally occluded SVG. Post-procedure dual antiplatelet therapy was continued for a minimum of one year and aspirin was continued indefinitely. Clinical outcomes were assessed at a mean follow-up of 1221 ± 1038 d. The primary outcome was freedom from a major adverse cardiac event (MACE) defined as the occurrence of any of the following: death, myocardial infarction, stroke, repeat bypass surgery, repeat PCI, or graft reocclusion. RESULTS The study group included 29 men and 6 women with a mean age of 69 ± 12 years. Diabetes was present in 14 (40%) patients. All patients had Canadian Heart Classification class III or IV angina. Clinical presentation was an acute coronary syndrome in 34 (97%) patients. Mean SVG age was 12 ± 5 years. Estimated duration of occlusion was acute ( 24 h to 30 d) in 26%, and late (> 30 d) in 40%. PCI was initially successful in 29/35 SVG occlusions (83%). Total stent length was 52 ± 35 mm. Intraprocedural complications of distal embolization or no-reflow occurred in 6 (17%) patients. During longer term follow-up, MACE-free survival was only 30% at 3 years and 17% at 5 years. CONCLUSION PCI of totally occluded SVG can be performed with a high procedural success rate. However, its clinical utility remains limited by poor follow-up outcomes.
Working to Increase Stability through Exercise (WISE): screening, recruitment, and baseline characteristics

The aim of this paper is to describe the utility of various recruitment modalities utilized in the Working to Increase Stability through Exercise (WISE) study. WISE is a pragmatic randomized trial that is testing the impact of a 3-year, multicomponent (strength, balance, aerobic) physical activity program led by trained volunteers or delivered via DVD on the rate of serious fall-related injuries among adults 65 and older with a past history of fragility fractures (e.g., vertebral, fall-related). The modified goal was to recruit 1130 participants over 2 years in three regions of Pennsylvania. The at-risk population was identified primarily using letters mailed to patients of three health systems and those over 65 in each region, as well as using provider alerts in the health record, proactive recruitment phone calls, radio advertisements, and presentations at community meetings. Over 24 months of recruitment, 209,301 recruitment letters were mailed, resulting in 6818 telephone interviews. The two most productive recruitment methods were letters (72% of randomized participants) and the research registries at the University of Pittsburgh (11%). An average of 211 letters were required to be mailed for each participant enrolled. Of those interviewed, 2854 were ineligible, 2,825 declined to enroll and 1139 were enrolled and randomized. Most participants were female (84.4%), under age 75 (64.2%), and 50% took an osteoporosis medication. Not having a prior fragility fracture was the most common reason for not being eligible (87.5%). The most common reason provided for declining enrollment was not feeling healthy enough to participate (12.6%). The WISE study achieved its overall recruitment goal. Bulk mailing was the most productive method for recruiting community-dwelling older adults at risk of serious fall-related injury into this long-term physical activity intervention trial, and electronic registries are important sources and should be considered.
Up, down, and out

I've appreciated my work and my colleagues in the past year. And yet I've decided that my interests lie elsewhere. I've decided to leave science research.
The Valuation and Exercise of Executive Stock Options

Much has been made of the potential for hedging restrictions to reduce the value of executive stock options. We investigate this issue by comparing a rational utility-maximizing model that incorporates both hedging restrictions and an endogenous departure decision and a naive value-maximizing model with an exogenous departure rate. While researchers mainly use these kinds of models to compute option values, we also use the models to generate forecasts of observable variables, the size and the timing of the payoffs of exercised options, and the annual rate at which options are canceled. We show that the naive model provides just as good a description of actual exercise patterns of executives as the rational model in a sample of NYSE and AMEX firms. The more parsimonious naive model may, there, be better for the purpose of valuation. The naive incorporation of the exogenous departure rate in the standard America option model not only aligns predicted exercise and cancellation patterns with actual patterns, but also reduces option value by about a quarter.
Feasibility of Predicting Ease of Peeling of Tomato Fruits by Using a Handheld Infrared Spectrometer

The potential of infrared (IR) handheld spectrometers, paired with chemometrics, to predict peelability of processing tomatoes was examined. A pilot plant scale study was carried out where tomato fruits underwent lye treatment and peeled with rotating rubber disks. The degree of peeling was regressed on the infrared spectral data collected from various regions on the fruits using partial least squares regression procedure. Peelability was best explained by spectra collected from areas adjacent to the blossom and stem ends. The regression model exhibited residuals with nonhomogeneous variance and was accurate only in predicting “very hard to peel” values, using IR frequencies associated with phenolics in the cuticular domain. The use of a handheld infrared spectrometer paired with chemometrics showed promise for predicting ease of peel of processing tomatoes. There is a need to improve spectral quality through better sample contact with the attenuated total reflectance accessory for predicting intermediate-peeling tomatoes. Practical Applications The tomato industry incurs in significant losses during the peeling stage, accounting for up to 28% of the waste generated in commercial canneries. Current technology used to assess tomato maturity (color, soluble solids, titratable acidity) has not correlated to tomato-peeling losses. The use of a handheld IR spectrometer paired with chemometrics has shown potential as a tool for predicting peelability of processing tomatoes. We have shown that infrared spectra reflect the peel's chemical state, which in turn could be related to the fruit's developmental stage.
Narcotic administration and fall-related injury in the hospital: implications for patient safety programs and providers.

OBJECTIVE: Identify factors that predict fall-related injury in hospitalized adults. DESIGN: Retrospective records review. SETTING: 435-bed university hospital. PARTICIPANTS: Inpatients with reported falls in 2010. RESULTS: Medical records were available for 286/293 (98%) of reported falls in 251 patients. 25% (63/286) of falls were associated with injury, 4% (11/286) with serious injury. Compared to all fallers, patients with injury did not differ by gender or age. In univariate analysis, patients who reported hitting their head, had pre-fall confusion, or who received narcotics within 24 hours before falling were more likely to suffer injury (estimated odds ratios 6.04, 2.00 and 5.1, respectfully). In multivariate analysis, receiving a narcotic prior to falling was the strongest predictor of injury (estimated odds ratio 5.38; 95% confidence intervals 2.07-13.98, p < 0.001). CONCLUSIONS: In this single-institution study, 25% of patients who fell suffered injury and 4% serious injury. Neither age nor gender predicted fall-related injury. Recent narcotic administration was the strongest predictor of injury. Strategies to prevent fall-related injury in the hospital should target patients receiving narcotics. When evaluating inpatients who have fallen, providers should be especially vigilant about injury in patients who have pre-fall confusion, hit their head, or have received recent narcotics.
Gratian's Decretum and the Changing Historiographical Landscape

Gratian's Concordia discordantium canonum (i.e., Decretum) organized the canonical tradition into a comprehensive survey and laid a new foundation for canon law. Scholarship on the Decretum in the decades preceding the late 1990s focused on the later additions to the Decretum. The importance of which suggested that the Decretum was not compiled in one fell swoop, but rather experienced some sort of development. Since the late 1990s, scholars have made tremendous advances in our understanding of the Decretum. This essay centers on the controversial debate regarding the number of recensions (i.e., versions) in which the work circulated. This debate has changed how scholars understand the dating of the work and Gratian's use of Roman law, all of which shape our understanding of the Decretum's purpose.
Providing assisted reproductive care to male haemophiliacs infected with human immunodeficiency virus: preliminary experience.

Summary. Outlined is our experience with couples in whom the male was both human immunodeficiency virus (HIV) seropositive and a haemophiliac who underwent assisted reproductive technologies (ART) in order to attain family goals while minimizing the risk of HIV transmission. We report their demographics, attitudes towards assisted reproduction, and ART performance and outcomes. The study included HIV serodiscordant couples (n = 11) who underwent ART at a university-based infertility practice from August 1997 to May 2002. Prior to treatment, couples prospectively completed a survey regarding their demographics and attitudes towards assisted reproduction. All couples underwent ART and pregnancy outcomes were analysed. The majority of the patients were fully employed, college-educated, in good health, married and motivated to have a child while minimizing the risk of HIV transmission. Eleven couples underwent 25 cycles of ART [19 in vitro fertilization (IVF) cycles; five frozen embryo transfer cycles; and one oocyte donation cycle] resulting in nine successful pregnancies. The ongoing/delivered pregnancy rate per initiated IVF cycle was 42.1% per embryo transfer. Eight of 11 (72.7%) couples achieved a successful pregnancy. More than half (six of 11; 54.5%) the couples conceived during their initial attempt. Four of nine (44.4%) pregnancies were multiple gestations, including three sets of triplets. All female recipients tested seronegative for HIV at 3 and 6 months post-embryo transfer. All delivered babies (n = 8) tested seronegative for HIV at birth and 3 months postpartum. Four pregnancies are currently ongoing. ART should be considered for HIV serodiscordant couples with haemophilia who desire to have children in order to minimize the risk of viral infection.
Do depressive symptoms predict declines in physical performance in an elderly, biracial population?

OBJECTIVE We investigated whether depressive symptoms, assessed by the 10-item Center for Epidemiological Studies Depression Scale (CES-D), predicted change in physical function in elderly adults. METHODS Participants were from a biracial, population-based sample of adults aged 65 and older (N: 4069; 61% black; 61% female). Physical function was assessed as a summary performance measure of tandem stand, measured walk, and repeated chair stand (mean [standard deviation], 10.3 [3.5]; range, 0-15), commonly used measures of overall physical health in older adults. Generalized estimating equation models estimated physical function across 3 assessments over 5.4 years of follow up as a function of CES-D scores at baseline. RESULTS Adjusting for age, sex, race, and education, each 1-point higher CES-D score was associated with a 0.34-point lower absolute level of physical performance (p or =4) showed no significant physical decline over time (p = .89). CONCLUSION We observed a strong cross-sectional association between depressive symptoms and overall physical performance. Physical function declined over time, yet depressive symptoms did not consistently contribute to greater decline over an average of 5.4 years of follow up among older adults. Findings highlight the importance of longitudinal models in understanding the relation between depressive symptomatology and physical health.
Pattern of pulmonary venous blood flow in the hypoplastic left heart syndrome in the fetus

OBJECTIVE—To determine whether restriction at the atrial septum in the newborn with hypoplastic left heart syndrome can be predicted accurately by examining the pattern of pulmonary venous flow in the fetus. A restrictive atrial septum can contribute to haemodynamic instability before surgery for this lesion and has been associated with an increased mortality. DESIGN—Pulmonary venous pulsed Doppler tracings were compared between fetuses with hypoplastic left heart syndrome and controls. The size of the atrial septal defect on the postnatal echocardiogram was graded according to the degree of restriction. Pulsed Doppler tracings of pulmonary venous blood flow were obtained in 18 fetuses with left atrial outflow atresia and compared with 77 controls, adjusted for gestational age. Postnatal echocardiograms were available for analysis in 13 of 18 neonates. SETTING—A tertiary referral centre for fetal cardiology and paediatric cardiac surgery. RESULTS—Fetuses with hypoplastic left heart syndrome were different from controls in all pulmonary vein indices measured. As assessed from the postnatal echocardiogram, there were seven fetuses with a restrictive atrial septum. In these fetuses, the systolic flow velocity (p < 0.01), S/D ratio (p < 0.01), and peak reversal wave (p < 0.001) in the pulmonary vein tracing showed a good correlation with the degree of restriction. CONCLUSIONS—The Doppler pattern of pulmonary venous flow in the fetus with hypoplastic left heart syndrome appears to be a reliable predictor of restriction of the atrial septum in the neonate. This may help in the immediate post-delivery management of these infants before surgery. Keywords: fetus; congenital heart defects; echocardiography; risk factors
Specificity of delayed responses to hapten-protein conjugates in rats☆

Abstract Rats actively immunized with p-azobenzenearsonate conjugates of polytyrosine, acetyltyrosine and acetyl-bovine serum albumin or dinitrophenylated bovine serum albumin and bovine gamma globulin showed, upon challenge with homologous hapten-heterologous carrier conjugates, a hypersensitivity reaction of delayed type. The significance of hapten and carrier specificity is discussed in terms of cooperating cells in the induction of delayed hypersensitivity.
Pediatric infectious disease emergencies

Infectious disease emergencies are those in which delays in diagnosis or treatment may lead to untoward harm. Recent developments in the field offer few new therapies, but rather emphasize familiar infections in new guises or clarify approaches to troublesome entities. An enduring concern for the legal risks implicit in the care of infected children has recently received new attention.
Lifetimes of Imidinium Ions in Aqueous Solution

Imidinium ions, ArNCNR2+, were generated in aqueous solution from the solvolysis of fluoro and chloro formamidines at pH 9.3 and 25 °C. Rate constants for the hydration of five imidinium ions were determined from a kinetic analysis of their trapping by thiolacetate anion, CH3COS-, in the presence of a pool of competing fluoride anion, and a rate constant of kAcS− = 5 × 109 M-1 s-1 for diffusion-controlled trapping of the carbocations with thiolacetate anion. The rate constants, ks, for hydration of the imidinium ions, XArNCNC4H8O+ are 3.6 × 105, 5.8 × 105, 1.5 × 106, 1.6 × 106, and 1.8 × 106 s-1 for X = H, 4-Cl, 3-CN, 4-CN, and 3-NO2, respectively. In a similar experiment a rate constant of ks = 3.3 × 107 s-1 was obtained for hydration of the imidinium ion 4-NO2ArNCNCH3(OCH3)+, by using azide anion to trap the cation and a rate constant of kaz = 5 × 109 M-1 s-1 for diffusion-controlled trapping of the imidinium ion with azide ion. The partitioning rate constant ratio kAcS−/ks for 4-ClArNCNC4H8O+ decreases...
Engineering-scale distillation of cadmium for actinide recovery

During the recovery of actinide products from spent nuclear fuel, cadmium is separated from the actinide products by a distillation process. Distillation occurs in an induction-heated furnace called a cathode processor capable of processing kilogram quantities of cadmium. Operating parameters have been established for sufficient recovery of the cadmium based on mass balance and product purity. A cadmium distillation rate similar to previous investigators has also been determined. The development of cadmium distillation for spent fuel treatment enhances the capabilities for actinide recovery processes.
Plautus on the Palatine

It was probably in the agora at Athens and possibly in the seventieth Olympiad (i.e. 499–496 B.C.) that a wooden grandstand collapsed while a play by Pratinas was being performed. The Athenians responded quite sensibly to this disaster by moving their dramatic performances to the precinct of Dionysus Eleuthereus, where the audience could be more safely accommodated on the south slope of the acropolis. Or so it appears: no fact of this early period in ancient theatre history is ever entirely secure. By the time of Aeschylus, however, what we call the Theatre of Dionysus was certainly the place where Athenian tragedies and comedies were performed, and the facility grew in size and grandeur along with the festivals it served. One result of this continuity has been a great boon to the performance-based criticism of Greek drama.
Computational modeling of metal matrix composite materials—II. Isothermal stress-strain behavior

Abstract The mechanical behavior of particulate reinforced metal matrix composites, in particular an SiC reinforced Al-3 wt% Cu model system, was analyzed numerically using the computational micromechanics approach. In this, the second in a series of four articles, the isothermal overall stress-strain behavior and its relation to microstructural deformation is examined in detail. The macroscopic strengthening effect of the reinforcement is quantified in terms of a hardness increment . As seen in the first article for microscale deformation, inhomogeneous and localized stress patterns develop in the microstructures. These are predominantly controlled by the positions of the reinforcing particles. Within the particles stress levels are high, indicating a load transfer from matrix to reinforcement. The higher straining that develops in the matrix grains, relative to the unreinforced polycrystal, causes matrix hardness advancement . Hydrostatic stress levels in the composite are enhanced by constraints on plastic flow imposed by the particles. Constrained plastic flow and matrix hardness advancement are seen as major composite strengthening mechanisms. The latter is sensitive to the strain hardening nature in the matrix alloy. To assess the effects of constraint more fully, simulations using external confining loads were performed. Both strengthening mechanisms depend strongly on reinforcement volume fraction and morphology. In addition, texture development and grain interaction influence the overall composite behavior. Failure mechanisms can be inferred from the microscale deformation and stress patterns. Intense strain localization and development of high stresses within particles and in the matrix close to the particle vertices indicate possible sites for fracture.
A comparison of the toxicity of nickel to the developing eggs and larvae of carp (Cyprinus carpio).

SAUTER, et al., (1976) reported that fish eggs appeared to be more resistant than fry to Cd, Cu, Cr, and Pb. However, their comparison can be questioned because the exposure times varied for the fry and the eggs. The objectives of this study were (1) to determine the toxicity of Ni to developing carp eggs and newly hatched carp larvae and (2) to compare the resistance of these two life stages to Ni toxicity.
Staphylococcus aureus Endocarditis and Pericarditis in an Infant with a Central Venous Catheter

Chez un premature dans une unite de soins intensifs pour detresse respiratoire. 2 catheters ont ete utilises dans la phase d'hyperalimentation, l'un a ete repere a la radiographie thoracique dans l'oreillette droite. Signes de septicemie avec pericardite et endocardite a Staphylococcus aureus. Deces malgre l'antibiotherapie
The most-cited works in Geomorphology

Abstract We conducted a review and analysis of the references cited in articles published (1995–2004) in the journal Geomorphology and also solicited comments from the authors of the most-cited works on their major influences. Of the 31,696 unique works cited in the journal, only 22 were referenced at least 20 times, with the vast majority (92%) cited only once or twice. We divided the citations into the 10 most-cited books (i.e., complete volumes) and 10 most-cited papers (i.e., journal articles, book chapters, reports). A total of 23 different researchers were responsible for the 20 works, with one (Wolman) being an author or co-author of a quarter of them. Seven of the ten most-cited papers were based on work in the USGS in the mid-twentieth century, indicating a particularly fruitful time of geomorphic research and a particularly important cohort of scientists. Based on our citation analysis and author commentaries, we suggest that classic works in geomorphology are most likely to be those that provide useful knowledge and those that incorporate interdisciplinary perspectives.
Helium Diffusion Through Glass

Using the mass spectrometer as an analytical tool and as a means of rate measurement, the rates of helium diffusion through nine types of glass were measured. The temperature range covered was from –80° to 600°C. The highest rates were for fused silica and Vycor brand glass; the lowest were for the lead glasses. The rate at 100°C. decreased by a factor of one million as the percentage of glassformers (SiO2, B2O3, P2O5) decreased in the glass composition. A few measurements are also given for hydrogen, deuterium, and neon rates through fused silica and estimates are made of the upper limit for argon, oxygen, and nitrogen at 700°C.
An Urban Secondary School Case Study of Disciplinary Writing in Tracked Classrooms

This yearlong ethnographic case study investigated higher and lower track adolescents’ experiences with core content-area (social studies, science, and math) writing in one urban working-class district. Teacher, student, and administrator interviews; field notes; and students’ written work comprised the data set. The findings from this study, framed by sociocultural theory and Bourdieu’s theory of practice, suggest that higher and lower track students experienced disciplinary writing in distinct ways in terms of the expectations for the kinds and complexity of writing and the importance placed on writing in content learning. These contrasting experiences affected the quality of students’ preparation to engage in advanced disciplinary discourse as they progressed through secondary school. The findings from this study are discussed in light of the increasing emphasis on disciplinary writing at the secondary level.
The contributions of A. W. Hofmann.

Atracurium and cisatracurium call attention to August Wilhelm von Hofmann (Figs. 1 and 2) (1). Actually, all of the neuromuscular blocking drugs should do so.Hofmann (1818–1892) was the first chemist to synthesize quaternary amines (2,3). He wanted to convince chemists that so-called organic bases s
Schooling, Sexuality, and Rights: An Investigation of Heterosexual Students' Social Cognition Regarding Sexual Orientation and the Rights of Gay and Lesbian Peers in School

Within the United States, protecting the rights of lesbian, gay, bisexual, and transgender (LGBT) students in school elicits much controversy and debate. On one side is the argument that all students should be able to receive an education free from discrimination, harassment, and harm. On the other side is the argument that by protecting LGBT students' rights, schools are infringing on the rights of others to their individual beliefs about homosexuality. To investigate these competing arguments, we surveyed high school-aged heterosexual adolescents (N = 1,076) regarding their beliefs and attitudes about sexual orientation and the rights of gay and lesbian peers. Results suggest that adolescents differentiate between their individual beliefs about homosexuality and the rights of others to be safe in school. Further, the results provide additional support for the idea that attitudes and beliefs about sexual orientation and the rights of gay and lesbian peers are multifaceted and draw from multiple domains of social knowledge. The implications of these findings will be discussed in relation to the rights of LGBT students and the obligations that schools have to create safe and supportive learning environments for all students regardless of sexual orientation or gender identity.
Using weather derivatives to hedge precipitation exposure

Purpose – The purpose of this study is to demonstrate the use of weather derivatives to hedge firm exposure to previously unmanageable risk events caused by natural phenomenon such as excessive rainfall.Design/methodology/approach – The paper adopts a case study approach to meet the objectives above, focusing on golf courses in the Midwest USA, which provide perfect examples of businesses with seasonal cash flows.Findings – It is shown that a firm can reduce its revenue volatility by up to 80 per cent. Weather derivatives are important additions to firm portfolios of risk management tools. Purchasing weather derivatives will improve the owner's ability to forecast revenues and assure expenditure coverage, both important goals for a small business owner.Practical implications – Many firms find the uneven revenue streams associated with their industry to be difficult to manage. One of the primary risks faced by firms is exposure to weather phenomena. With the introduction of weather derivatives, firms can n...
Treatment with beta-hydroxybutyrate and melatonin is associated with improved survival in a porcine model of hemorrhagic shock

Abstract Introduction The neuroprotective ketone β-hydroxybutyrate (BHB) and the antioxidant melatonin have been found at elevated levels in hibernating mammals. Previous studies in rat models of hemorrhagic shock have suggested a benefit. We compared infusion of 4 M BHB and 43 mM melatonin (BHB/M) to 4 M sodium chloride and 20% DMSO (control solution) to evaluate for potential benefits in porcine hemorrhagic shock. Methods Hemorrhagic shock was induced to obtain systolic blood pressures n = 9) or control solution ( n = 8) followed by 4-h infusion of the either BHB/M or control solution. All animals were then resuscitated for 20 h after shock. Physiological data were continually recorded, and blood samples were taken at intervals throughout the experiment. Serum samples were analyzed via high resolution NMR for metabolomic response. Results BHB/M treatment significantly increased 24-h survival time when compared to treatment with control solution (100% versus 62%; p = 0.050), with a trend toward decreased volume of resuscitative fluid administered to animals receiving BHB/M. BHB/M-treated animals had lower base deficit and higher oxygen consumption when compared to animals receiving control solution. Serum metabolite profiles revealed increases in β-hydroxybutyrate (BHB), succinate, 2-oxovalerate and adipate with BHB/M treatment as compared with animals treated with control infusion. Conclusion Infusion of BHB/M conferred a survival benefit over infusion of control solution in hemorrhagic shock. BHB and its products of metabolism are identified in serum of animals subjected to shock and treated with BHB/M. Further preclinical studies are needed to clarify the mechanisms of action of this promising treatment strategy.
Elemental mercury vapor interaction with individual gold nanorods

We show that single gold nanorods can act as highly sensitive mercury vapor sensors with attogram resolution. We exposed assorted gold nanorods, with aspect ratios ranging from 2.8–4.1, to μg m−3 concentrations of mercury vapor in air for 1 hour. Pre- and post-exposure, the nanorods were examined with a combination of dark field spectroscopy and transmission electron microscopy. Because we isolated individual particles, we can describe the shape and size effects distinctly rather than statistically (a constraint of studying heterogeneous nanoparticle films). No measurable changes occurred to the shape and size of the nanorods due to their saturation with mercury vapor. The localized surface plasmon resonance (LSPR) of the mercury-saturated nanorods blue shifted 2.6–3.8 nm; the magnitude of the shift depended on the initial shape and size of the nanorod. Larger aspect ratios and surface-area-to-volume ratios both enhance the LSPR shift seen in saturated nanoparticles. The predictions of a core–shell model mirrors the shape and size effects observed experimentally. These results increase our understanding of mercury-adsorption by gold surfaces, and help to optimize nanoparticle-based plasmonic mercury sensing.
Malnutrition in a UK children's hospital

A survey of the nutritional status of a multi-racial group of children in a UK regional referral centre revealed a high prevalence of both acute and chronic protein-energy malnutrition; 16% were severely stunted and 14% severely wasted, with a further 20% at risk of severe malnutrition if nutritionally stressed. Severe stunting was particularly common in patients with chronic cardiac or gastrointestinal disorders. No racial differences in stunting were found. These findings indicate that formal nutritional surveillance of children in hospital is important, and will identify a large reservoir of patients with secondary malnutrition requiring nutritional support.
Adenoviral mediated delivery of FAS ligand to arthritic joints causes extensive apoptosis in the synovial lining.

Background Rheumatoid arthritis (RA) is an autoimmune disease where the synovial lining layer of the joint becomes thickened, hypercellular, and highly aggressive. Invading synovial tissue erodes cartilage and subchondral bone and leads to loss of joint function. FasL, a cell-surface molecule on activated T-cells interacts with its receptor, Fas, to induce apoptosis in target cells. We addressed the feasibility of using adenoviral gene transfer of FasL therapeutically to mediate apoptosis in arthritic joints similar in size to the small joints of the hands and feet that are the primary sites of RA in humans. Methods Adenoviral vectors were used to transfer FasL and LacZ cDNAs into human RA and rabbit synovial fibroblasts in culture where apoptosis was evaluated using MTT and TUNEL analyses. The ability of Ad.FasL to mediate synovial apoptosis in vivo was then addressed in an IL-1-induced arthritis model in the rabbit knee. Results In culture, delivery of FasL was found to efficiently induce apoptosis in both human RA and rabbit synovial fibroblasts. The ability of Ad.FasL to induce synovial apoptosis was then evaluated in rabbit knee joints. 24 h after intra-articular injection of 1011 Ad.FasL particles, large regions of synovial tissue were observed histologically consisting primarily of fibrous matrix and cellular debris. TUNEL staining of corresponding sections was highly positive for fragmented DNA. Glycosaminoglycan (GAG) synthesis from cartilage shavings from treated joints suggests that Ad.FasL does not induce significant apoptosis in resident articular chondrocytes. Conclusions Infection of human and rabbit synovial fibroblasts with Ad.FasL results in significant apoptotic cell death in vitro. Direct intra-articular injection of Ad.FasL in the arthritic rabbit knee results in extensive apoptosis in the synovium without affecting chondrocyte viability. Copyright © 2000 John Wiley & Sons, Ltd.
Patient values and preferences for end-of-life treatments: are values better predictors than a living will?

Abstract Background: Advance care planning is widely considered important for good treatment decision making. Patient values have been proposed as superior to standard living wills as guides to end-of-life (EOL) care decisions on behalf of decisionally incapacitated patients. Little research has examined whether values outperform living wills as predictors of treatment preferences. Objective: The study aimed to test whether patient values are associated with treatment preferences, compare values and preferences to responses from a standard living will, and determine whether some values are better predictors than others. Design: Community-dwelling elderly men and women (n=304) were interviewed in their homes by telephone. The interview consisted of an eight-item EOL values scale, a standard living will question, preferences for four life-prolonging treatments in each of six scenarios, and sociodemographic questions. Results: Principal components analysis of the EOL values revealed two factors: (1) dignity,...
Structure Evolution and Kinetics of Thermoreversible Gelation in a Rigid-Rod Polyimide/m-Cresol System

Biphenyltetracarborylic dianhydride-(perfluoromethyl)benzidine (BPDA-PFMB) polyimide/m-cresol solutions showed thermoreversible gelation associated with thermally induced phase separation and subsequent liquid crystal formation. Phase equilibria and structure evolution in a BPDA-PFMB/m-cresol solution were investigated. A temperature-composition phase diagram of BPDA-PEMB/m-cresol was established by a cloud point method. Kinetic aspects of the phase transition were studied in the framework of a nucleation and growth theory
Literacy and Language Development Within Microcomputer-Videodisc-Assisted Interactive Contexts

During the past decade developmental psycholinguists focused primary attention on the social and interpersonal aspects of children's language. This line of research parallels the recent emphasis on pragmatics and discourse analysis. Some preliminary studies have been conducted on the interactive contexts in which language is learned and on the role of adult input language in the child's communicative development. This article addresses the effects of one type of discourse adjustment —"recasting"— within the context of microcomputer-videodisc-assisted interaention for deaf children acquiring spoken, written, and/or signed language. Theoretical and applied issues related to language, literacy, and discourse development are discussed.
Linear C3 Deposits on the Tubular Basement Membrane in Renal Allograft Biopsies

Linear and granular tubular basement membrane (TBM) deposits of C3 occur in renal allograft biopsies, but their significance is unknown. We retrospectively analyzed the predictive importance of C3 deposits in 88 biopsied transplant patients with allograft dysfunction. All patients were followed for ≥ 2 years from biopsy. Patients were divided into three groups: group I: no C3 deposits, 47 patients; group II: granular deposits of C3, 28 patients; and group III: linear TBM deposits, 13 patients. The incidence of acute and chronic rejection was not different. In group III, 12 grafts were lost by 5 years (92%), and the remaining patient has chronic rejection. Group III survival was significantly less than groups I and II (Kaplan-Meier curves), P = 0.02, but graft survival in groups I and II were similar. There was no association of anti-TBM antibody deposits with C3, and the mechanism of deposition is unknown. We conclude that the presence of linear C3 deposits along the TBM in the setting of allograft dysfunction is associated with decreased allograft survival.
The Interprofessional Team as a Small Group

Conflicts in interprofessional teamwork may be as much explained by group process considerations as by the interaction of professional roles and statuses. This paper examines the interprofessional team as a small group, using a synthesis of sources from social psychology, social group work, T-group literature, management theory, and health team research. Eight issues are considered in relation to the team as a small group, namely, (a) the individual in the group, (b) team size, (c) group norms, (d) democracy, (e) decision making and conflict resolution, (f) communication and structure, (g) leadership, and (h) group harmony and its relationship to group productivity.
GCN5-mediated Transcriptional Control of the Metabolic Coactivator PGC-1β through Lysine Acetylation

Changes in expression levels of genes encoding for proteins that control metabolic pathways are essential to maintain nutrient and energy homeostasis in individual cells as well as in or ga nisms. An important regulated step in this process is accomplished through covalent chemical modifications of proteins that form complexes with the chromatin of gene promoters. The peroxisome proliferators γ co-activator 1 (PGC-1) family of transcriptional co-activators comprises important components of a number of these complexes and participates in a large array of glucose and lipid metabolic adaptations. Here, we show that PGC-1β is acetylated on at least 10 lysine residues distributed along the length of the protein by the acetyl transferase general control of amino-acid synthesis (GCN5) and that this acetylation reaction is reversed by the deacetylase sirtuin 1 (SIRT1). GCN5 strongly interacts with PGC-1β and represses its transcriptional activity associated with transcription factors such as ERRα, NRF-1, and HNF4α, however acetylation and transcriptional repression do not occur when a catalytically inactive GCN5 is co-expressed. Transcriptional repression coincides with PGC-1β redistribution to nuclear foci where it co-localizes with GCN5. Furthermore, knockdown of GCN5 ablates PGC-1β acetylation and increases transcriptional activity. In primary skeletal muscle cells, PGC-1β induction of endogenous target genes, including MCAD and GLUT4, is largely repressed by GCN5. Functionally, this translates to a blunted response to PGC-1β-induced insulin-mediated glucose transport. These results suggest that PGC-1β acetylation by GCN5 might be an important step in the control of glucose and lipid pathways and its dysregulation could contribute to metabolic diseases.
Cyclical Generation and Degeneration of Organs in a Colonial Urochordate Involves Crosstalk between Old and New: A Model for Development and Regeneration

Botryllus schlosseri is a colonial marine urochordate in which all adult organisms (called zooids) in a colony die synchronously by apoptosis (programmed cell death) in cyclical fashion. During this death phase called takeover, cell corpses within the dying organism are engulfed by circulating phagocytic cells. The "old" zooids and their organs are resorbed within 24-36 h (programmed cell removal). This process coincides temporally with the growth of asexually derived primary buds, that harbor a small number of undifferentiated cells, into mature zooids containing functional organs and tissues with the same body plan as adult zooids from which they budded. Within these colonies, all zooids share a ramifying network of extracorporeal blood vessels embedded in a gelatinous tunic. The underlying mechanisms regulating programmed cell death and programmed cell removal in this organism are unknown. In this study, we extirpated buds or zooids from B. schlosseri colonies in order to investigate the interplay that exists between buds, zooids, and the vascular system during takeover. Our findings indicate that, in the complete absence of buds (budectomy), organs from adult zooids underwent programmed cell death but were markedly impaired in their ability to be resorbed despite engulfment of zooid-derived cell corpses by phagocytes. However, when buds were removed from only half of the flower-shaped systems of zooids in a colony (hemibudectomy), the budectomized zooids were completely resorbed within 36-48 h following onset of programmed cell death. Furthermore, if hemibudectomies were carried out by using small colonies, leaving only a single functional bud, zooids from the old generation were also resorbed, albeit delayed to 48-60 h following onset of programmed cell death. This bud eventually reached functional maturity, but grew significantly larger in size than any control zooid, and exhibited hyperplasia. This finding strongly suggested that components of the dying zooid viscera could be reutilized by the developing buds, possibly as part of a colony-wide recycling mechanism. In order to test this hypothesis, zooids were surgically removed (zooidectomy) at the onset of takeover, and bud growth was quantitatively determined. In these zooidectomized colonies, bud growth was severely curtailed. In most solitary, long-lived animals, organs and tissues are maintained by processes of continual death and removal of aging cells counterbalanced by regeneration with stem and progenitor cells. In the colonial tunicate B. schlosseri, the same kinds of processes ensure the longevity of the colony (an animal) by cycles of death and regeneration of its constituent zooids (also animals).
Impact fracture behavior of clay–reinforced polypropylene nanocomposites

Abstract The micromechanism of plastic deformation during impact loading of polypropylene–clay nanocomposites is examined and compared with the unreinforced polypropylene under identical conditions of processing to underscore the determining role of clay. The addition of clay to polypropylene increases the impact strength in the temperature range of 0 to +70 °C. Differential scanning calorimetry (DSC), dynamic mechanical analysis (DMA) and transmission electron microscopy (TEM), wide-angle X-ray diffraction (WAXD) and scanning electron microscopy (SEM) techniques provided an understanding of the micromechanism of plastic deformation in terms of the response of the polymer matrix, nucleating capability of the reinforcement, crystal structure, percentage crystallinity, lamellae thickness, and particle–matrix interface. The enhancement of toughness on reinforcement of polypropylene with nanoclay is associated with change in the primary mechanism of plastic deformation from crazing and vein-type in neat polypropylene to microvoid-coalescence-fibrillation process in the nanocomposite.
The synthesis of high-energy phosphate in the citrulline ureidase reaction by soluble enzymes of Pseudomonas.

Abstract A Pseudomonas species has been isolated from soil which utilized l -citrulline as sole source of carbon and nitrogen for growth. Cell-free extracts converted citrulline to ornithine, carbon dioxide, and ammonia. No breakdown of ornithine or urea occurred. The requirements of the reaction were found to be inorganic phosphate, ADP (or AMP-5), and bivalent ions. In contrast to findings with streptococcal extracts possessing a similar enzyme system, no myokinase was present and ATPase activity was low. Also, the activity of Pseudomonas extracts was approximately twice that reported for Streptococcus faecalis . Adenosine triphosphate was formed from either AMP-5 or ADP during the breakdown of citrulline by dialyzed extracts. In the presence of excess orthophosphate, the quantity of ATP which accumulated was equivalent to the esterification of 0.7 μmole phosphate/μmole citrulline metabolized. In the presence of minimal orthophosphate, the phosphate esterified was equivalent to 0.3–0.4 μmole. The phosphate taken up under the latter conditions was in excess of the phosphate esterified in ATP. Arsenate will substitute for inorganic phosphate, phosphate acceptor, and bivalent ions. The products of the arsenolysis of citrulline were the same as when the adenylic acid system was employed. The reaction proceeded to completion and was linear until 65% of the substrate had been decomposed. Inorganic phosphate inhibited the arsenolysis in a competitive manner. The results indicate the formation of a phosphorylated intermediate belonging to the energy-rich series. The metabolism of citrulline as presented here appears to be a phosphorolysis.