cssi/SciSciGPT-SciSciNet huggingface dataset:
Bacterial and Fungal Etiology of Sepsis in Children in the United States: Reconsidering Empiric Therapy.

Objectives Timely empiric antimicrobial therapy is associated with improved outcomes in pediatric sepsis, but minimal data exist to guide empiric therapy. We sought to describe the prevalence of four pathogens that are not part of routine empiric coverage (e.g., Staphylococcus aureus, Pseudomonas aeruginosa, Clostridium difficile, and fungal infections) in pediatric sepsis patients in a contemporary nationally representative sample. Design This was a retrospective cohort study using administrative data. Setting We used the Nationwide Readmissions Database from 2014, which is a nationally representative dataset that contains data from nearly half of all discharges from nonfederal hospitals in the United States. Patients Discharges of patients who were less than 19 years old at discharge and were not neonatal with a discharge diagnosis of sepsis. Interventions None. Measurements and main results Of the 19,113 pediatric admissions with sepsis (6,300 [33%] previously healthy and 12,813 [67%] with a chronic disease), 31% received mechanical ventilation, 19% had shock, and 588 (3.1%) died during their hospitalization. Among all admissions, 8,204 (42.9%) had a bacterial or fungal pathogen identified. S. aureus was the most common pathogen identified in previously healthy patients (n = 593, 9.4%) and those with any chronic disease (n = 1,430, 11.1%). Methicillin-resistant S. aureus, P. aeruginosa, C. difficile, and fungal infections all had high prevalence in specific chronic diseases associated with frequent contact with the healthcare system, early surgery, indwelling devices, or immunosuppression. Conclusions In this nationally representative administrative database, the most common identified pathogen was S. aureus in previously healthy and chronically ill children. In addition, a high proportion of children with sepsis and select chronic diseases had infections with methicillin-resistant S. aureus, fungal infections, Pseudomonas infections, and C. difficile. Clinicians caring for pediatric patients should consider coverage of these organisms when administering empiric antimicrobials for sepsis.
Individualization of Exchange Volume

This paper deals with adjustment of instillation volumes to achieve the best efficiency of dialysis in individual patients. Larger volumes may permit fewer daily exchanges which in turn decreases t...
Manufacturing variability drives significant environmental and economic impact: The case of carbon fiber reinforced polymer composites in the aerospace industry

Abstract The link between manufacturing variability and the resulting environmental impact is an understudied topic. We connect manufacturing variability and greenhouse gas emissions impact through the reality of overdesign. Specifically, this study takes the case of manufacturing Carbon Fiber Reinforced Polymers, which has high manufacturing variability relative to conventional manufacturing processes and is of interest due to its light-weighting potential. Through the use of a process-based cost model, including uncertainty , the cost and energy required to fabricate a representative composite part is modeled. The model then connects to a fuel-consumption model of a Boeing 787 which allows the estimation of lifetime fuel savings. Manufacturing variability is taken as an input to the model, which allows the model to estimate the effect of variability on both the cost and energy requirements. We find that manufacturing variability has a significant impact on both part cost and energy requirements, being the fourth most impactful variable in our model for both these performance measures. Under our assumptions, reducing the coefficient of variation of the mechanical properties from 14% to 9% reduces production costs and energy by 12.3 and 11.8%, respectively. In addition, due to the weight savings, we estimate that over the lifetime of a Boeing 787 this drop in variability saves 8.3 kton of fuel, which has a present value of 3.6 million USD and would prevent 21.9 kton carbon dioxide from entering the atmosphere.
Image Augmentation Is All You Need: Regularizing Deep Reinforcement Learning from Pixels

We propose a simple data augmentation technique that can be applied to standard model-free reinforcement learning algorithms, enabling robust learning directly from pixels without the need for auxiliary losses or pre-training. The approach leverages input perturbations commonly used in computer vision tasks to regularize the value function. Existing model-free approaches, such as Soft Actor-Critic (SAC), are not able to train deep networks effectively from image pixels. However, the addition of our augmentation method dramatically improves SAC's performance, enabling it to reach state-of-the-art performance on the DeepMind control suite, surpassing model-based (Dreamer, PlaNet, and SLAC) methods and recently proposed contrastive learning (CURL). Our approach can be combined with any model-free reinforcement learning algorithm, requiring only minor modifications. An implementation can be found at this https URL.
Qualitative Assessment of Unmet Information Management Needs of Informal Cancer Caregivers: Four Themes to Inform Oncology Practice

PURPOSEFamily and friends often provide informal care for patients with cancer, coordinating care and supporting patients at home. Stress, depression, and burnout are increasingly recognized among ...
A social dancing pilot intervention for older adults at high risk for Alzheimer's disease and related dementias.

Close to 6 million older US adults have Alzheimer's disease or related dementias, yet there is currently no cure or effective treatment. This single-blind randomized controlled trial (clinicaltrials.gov: NCT03475316) aims to establish feasibility, and explore the relative efficacy, of a 6-month social ballroom dancing intervention versus a 6-month active control intervention (treadmill walking) for improving executive function in 32 older adults at increased risk for Alzheimer's disease or related dementias. Dementia-at-risk status is determined with cut-scores on the memory impairment screen (≥3 to ≤6) and/or the AD8 Dementia Screening Interview (≥1). The primary outcome is a composite executive function score from digit-symbol substitution, flanker interference and walking-while-talking tasks. The secondary outcome is functional neuroplasticity during fMRI-adapted versions of digit-symbol substitution, flanker interference and walking-while-talking.
Histone PTM Crosstalk Stimulates Dot1 Methyltransferase Activity.

Valencia-Sanchez et al. have demonstrated that two histone post-translational modifications (PTMs) - H4K16 acetylation (H4K16ac) and H2BK120 ubiquitination (H2Bub) - enhance the methylation of H3K79 (H3K79me) by Dot1. This breakthrough indicates crosstalk between H4Kac/H2Bub/H3K79me and may improve our understanding of the role that Dot1/Dot1L plays in developmental processes and disease, including MLL1/KMT2A(MLL-r) leukemia.
Purinergic signaling in peripheral nervous system glial cells

To facilitate analyses of purinergic signaling in peripheral nerve glia, we review recent literature and catalog purinergic receptor mRNA expression in cultured mouse Schwann cells (SCs). Purinergic signaling can decrease developmental SC proliferation, and promote SC differentiation. The purinergic receptors P2RY2 and P2RX7 are implicated in nerve development and in the ratio of Remak SCs to myelinating SCs in differentiated peripheral nerve. P2RY2, P2RX7, and other receptors are also implicated in peripheral neuropathies and SC tumors. In SC tumors lacking the tumor suppressor NF1, the SC pathway that suppresses SC growth through P2RY2-driven β-arrestin-mediated AKT signaling is aberrant. SC-released purinergic agonists acting through SC and/or neuronal purinergic receptors activate pain responses. In all these settings, purinergic receptor activation can result in calcium-independent and calcium-dependent release of SC ATP and UDP, growth factors, and cytokines that may contribute to disease and nerve repair. Thus, current research suggests that purinergic agonists and/or antagonists might have the potential to modulate peripheral glia function in development and in disease.
Stabilin Receptors Clear LPS and Control Systemic Inflammation

Lipopolysaccharides (LPS), remnants of Gram-negative bacterial cell membranes, cause lethal endotoxemia if not rapidly cleared from blood circulation. Liver sinusoidal endothelial cells (LSEC) systemically clear LPS by unknown mechanism(s). We discovered that LPS clearance through LSEC involves endocytosis via Stabilin scavenger receptors (Stab-1 and -2) through lysosomal inactivation. We determined that LPS was lower in the circulation of wild-type (WT) mice than Stab-1 and -2 KO mice, and endocytic uptake was higher in LSEC from WT than in Stab-1 and -2 KO. Stab-1 and -2 KO showed enhanced systemic inflammatory cytokine production and early death compared to WT mice when exposed to LPS. Although LSEC expresses innate immune mediator TLR4, LPS clearance does not use this functional TLR4 system. These data suggest that Stabilin receptors facilitate the proactive clearance of LPS, and control TLR4 mediated inflammation. The findings suggest a means of minimizing endotoxemia by optimizing Stabilin-dependent systemic LPS clearance
Reconstructing the Fingertip: The Moberg, Atasoy, and Kutler Flaps

Fingertip amputations are common injuries that can pose a reconstructive challenge to the plastic surgeon. When evaluating a fingertip amputation, one must take into consideration the geometry of the amputation (transverse, volar oblique, or dorsal oblique), the size of the defect, the level of the amputation, the critical structures exposed, and the importance of each digit. Digital functionality varies. For the middle ring and little finger, length preservation is important. Sensation preservation is most important for the index finger and the thumb and the ulnar border of the little finger.
A "black hole theorem," and its implications

A "black hole theorem" is stated, exhibiting the basic conflict of the information problem. This is formulated in a more general context than that of quantum field theory on a background, and is based on describing a black hole as a quantum subsystem of a larger system, including its environment. As with the Coleman-Mandula theorem, the most important point is probably the loophole in the "theorem," and what this tells us about the fundamental structure of quantum gravity. This "theorem" in particular connects to the general question of how to define quantum subsystems in quantum gravity. If black holes do behave as quantum subsystems, at least to a good approximation, evolve unitarily, and do not leave remnants, the "theorem" implies the presence of interactions between a black hole and its environment that go beyond a description based on local quantum fields. These can be parameterized in a principled way, and with motivated additional assumptions indicate possible observational signatures, which can be investigated by electromagnetic or gravitational wave observations of black holes.
Identification of Key Flavor Compounds in Citrus Fruits: A Flavoromics Approach

In the Huanglongbing (HLB) era, the flavor quality of orange juice has been largely affected by the sensitivity of commercial sweet orange varieties to HLB. Therefore, great interest has been raise...
A sparsity-perspective to quadratic time-frequency distributions

We examine nonstationary signals within the framework of compressive sensing and sparse reconstruction. Most of these signals, which arise in numerous applications, exhibit small relative occupancy in the time-frequency domain, casting them as sparse in a joint-variable representation. We present two general approaches to incorporate sparsity into time-frequency analysis, leading to what we refer to as sparsity-aware quadratic time-frequency distributions. Both approaches exploit time-frequency sparsity under full data and compressed observations. In the first approach, quadratic time-frequency distributions are derived based on optimal multi-task kernel design. In this case, sparseness in the time-frequency domain presents itself as a new design task, adding to the two fundamental tasks of auto-term preservation and cross-term suppression. In the second approach, sparse reconstruction is used, in lieu of the Fourier transform, to obtain quadratic time-frequency distributions from compressed measurements observed in the time domain or the joint-variable domain. It is shown that multiple measurement vector methods and block sparsity techniques play a fundamental role in improving signal local frequency representations. Examples of both approaches are provided. Analysis is supported by results based on simulated data, electromagnetic modeled data, and real Doppler and micro-Doppler data measurements of radar returns associated with human motions.
The Binding Protein as a Modulator of Juvenile Hormone Stability and Uptake

Past data on the corpora allata and juvenile hormone (see Gilbert and King, 1973) suggest a highly intermeshed regulatory system which must allow for rapid and dramatic changes in hormone titer as well as fine tuning. An important compartment in this control system is the hemolymph since it serves as the shuttle system between the corpora allata and peripheral tissues. This compartment represents the central mixing point for those factors determining the juvenile hormone (JH) titer, the latter determining the hormone concentration at the target tissues. The processes responsible for the hemolymph pool of JH are: synthesis and release of the hormone by the corpora allata (e.g. Roller and Dahm, 1970; Judy et al., 1973; Pratt and Tobe, 1974); under certain conditions there may be a reflux from tissues; metabolic inactivation; and tissue uptake with subsequent degradation and/or excretion.
Unbounded cooling force in travelling waves excitation of a four-level system

Summary form only given. In a two-level system under traveling wave excitation, the cooling force is bounded by the spontaneous force, given by the product of the photon momentum and the excited-state decay rate. This because the force in such a scheme originates from absorption of directed photons followed by emission of spontaneous photons in random direction. In the case of a standing wave excitation, this limit no longer holds. The atoms can, in principle, absorb photons from one direction, while emitting coherent photons in the other direction via stimulated emission. This process, known as stimulated cooling, requires symmetry breaking leading to effects such as Doppleron cooling.
Polymeric 16/spl times/16 digital optical switch matrix

We present experimental results on the first integrated optical 16/spl times/16 strictly non-blocking polymeric switch matrix based on 1/spl times/2 digital optical switches. The prototype exhibits an insertion loss around 6 dB and an extinction of better than 30 dB. The polarization dependence is low.
Multiple Plaque Rupture in Acute Coronary Syndrome

To the Editor: Rioufol et al1 recently reported a lower incidence of plaque rupture in culprit arteries than in non-culprit arteries (37.5% versus 79%) in acute coronary syndrome (ACS). The low incidence in culprit arteries was explained by thrombi that masked underlying ulcerations, but findings suggest that plaque rupture/thromboses do not directly induce symptoms in ACS (or ACS/infarction). There are other problems with the plaque rupture/thromboses mechanism. These include low (around 25%) incidences of thromboses in ACS,2,3 failure of thrombolysis to benefit non-ST-segment elevation infarction,3 rising incidence of thromboses over time in infarction,2,3 common occurrence of asymptomatic plaque rupture,3 failure of platelet glycoprotein IIb/IIIa receptor blockade to benefit most cases of ACS,4 and apparent inability of thromboses in very stenotic arteries to explain infarction.2,3 To my knowledge, nobody has seen plaque rupture …
How Non-Ricardian is the Life-Cycle Model?

This paper provides a quantitative analysis of the economic effects of public debt in a pure life-cycle economy. The effects on observable quantities are invariably small in cases where the change in the debt is accompanied by a change in lump-sum taxes and transfers. This is true of both the impact and long-run effects. A permanent increase in the debt can lead to a nontrivial long-run reduction in the welfare, however. A change in the debt accompanied by changes in either government purchases or distorting tax rates can significantly alter economic behavior, but even these effects can be small depending on the exact nature of the tax change. Taken together, the results suggest that if Ricardian Equivalence fails empirically, it does so not because of the finite horizons implied by the life-cycle model but because of more fundamental reasons.
The Autodegradation of Deoxyribonucleic Acid (DNA) in Human Rib Bone and Its Relationship to the Time Interval Since Death

This research explored the feasibility of using the degradation rate of deoxyribonucleic acid (DNA) in human rib bone to determine the time interval since death. Postmortem human rib samples were surface sterilized and incubated under sterile conditions in either high or low humidity conditions at room temperature for a period of weeks. At selected times, portions of the bone were cut away, and the DNA from these samples was extracted and subjected to strand separating gel electrophoresis. The DNAs in the gels were transferred to a nylon membrane, preserving their relative positions as in the gel, and probed with radioactive total genomic human DNA. Autoradiograms produced were scanned and digitized. When the samples were incubated under identical conditions, the degradation rate of DNA in samples from different individuals appeared very similar. The DNA degradation rate may vary with temperature and humidity more than it varies between individuals.
Fish Processing—Sustainability and New Opportunities. Edited by George M. Hall

The volume consists of eleven chapters that address the concept of sustainability applied to the fish-processing industry (FPI) with emphasis on energy and water use, effluents, and by-product reco...
A computational study of feedback effects on signal dynamics in a mitogen-activated protein kinase (MAPK) pathway model.

Exploiting signaling pathways for the purpose of controlling cell function entails identifying and manipulating the information content of intracellular signals. As in the case of the ubiquitously expressed, eukaryotic mitogen-activated protein kinase (MAPK) signaling pathway, this information content partly resides in the signals' dynamical properties. Here, we utilize a mathematical model to examine mechanisms that govern MAPK pathway dynamics, particularly the role of putative negative feedback mechanisms in generating complete signal adaptation, a term referring to the reset of a signal to prestimulation levels. In addition to yielding adaptation of its direct target, feedback mechanisms implemented in our model also indirectly assist in the adaptation of signaling components downstream of the target under certain conditions. In fact, model predictions identify conditions yielding ultra-desensitization of signals in which complete adaptation of target and downstream signals culminates even while stimulus recognition (i.e., receptor-ligand binding) continues to increase. Moreover, the rate at which signal decays can follow first-order kinetics with respect to signal intensity, so that signal adaptation is achieved in the same amount of time regardless of signal intensity or ligand dose. All of these features are consistent with experimental findings recently obtained for the Chinese hamster ovary (CHO) cell lines (Asthagiri et al., J. Biol. Chem. 1999, 274, 27119-27127). Our model further predicts that although downstream effects are independent of whether an enzyme or adaptor protein is targeted by negative feedback, adaptor-targeted feedback can "back-propagate" effects upstream of the target, specifically resulting in increased steady-state upstream signal. Consequently, where these upstream components serve as nodes within a signaling network, feedback can transfer signaling through these nodes into alternate pathways, thereby promoting the sort of signaling cross-talk that is becoming more widely appreciated.
HUMAN GASTRIC ATONY WITH TACHYGASTRIA AND GASTRIC RETENTION

Abstract A 5-month-old white male developed gastric retention unrelieved by either pyloromyotomy or by gastrojejunostomy. The pattern of electrical activity in the wall of the stomach recorded at a third operation was consistent with an ectopic distal antral pacemaker generating electrical cycles (pacesetter potentials, action potentials, or control potentials) at a rapid frequency of 4.7 cycles per min (tachygastria). The gastric pressure increased from 1 cm H 2 O to only 5 cm H 2 O as the stomach was distended to 600 ml, with no further increase after 0.6 mg of urecholine given subcutaneously. Resection of the distal three-fourths of the stomach and gastrojejunostomy when the patient was 1 year old allowed him to resume oral intake without vomiting and with progressive weight gain. The circular smooth muscle cells of the corpus and antrum, when tested in vitro using intracellular electrodes, generated electrical cycles at rapid frequencies of 5 and 20 cycles per min, respectively. The plateau component of the spontaneous electrical cycles which regulates contractile activity, was small or absent in both corporal and antral cells, and the size of the plateau was not increased by pentagastrin or acetylcholine given at doses suprathreshold for healthy gastric smooth muscle. Our conclusion is that the decreased plateau size of the spontaneous electrical cycles generated by the gastric smooth muscle cells and the diminished sensitivity of the cells to appropriate contractile stimuli caused this patient's gastric retention.
Ethanol production and the cost of fermentable sugars from biomass

Abstract The current fermentation alcohol industry in the US is based on utilization of glucose and/or starch derived principally from corn. Biomass materials including wood and agricultural residues, newspaper, and other sources of cellulose could provide a source of fermentable sugars for expanding fuel ethanol production. Prospects for the utilization of biomass for conversion to fermentable hexoses and pentoses are continually improving with advances in enzyme technology, specially engineered microorganisms which can ferment pentoses, and improvement in cellulose pretreatments. Technical and economic factors which affect utilization of sugars from biomass are summarized, and the key steps in wet- and dry-milling of corn are described for purposes of comparison. An approach for estimating fermentable sugar costs is presented to gauge the impact of technical improvements on reducing fermentable sugar costs. An analytical framework resulting from this approach facilitates comparison of effects of feedstock costs, by-product credits, differences in technology, and process costs on the cost of fermentable sugars. A systematic strategy for evaluating differences in cost is presented as a tool for making a first comparison of different technologies and feed stock materials for ethanol production. This analysis suggests that fermentable sugars from enzymatic hydrolysis of cellulose must cost no more than 4–5c lb−1 (8·8–11c kg−1), at current conditions, if they are to be economically competitive with fermentable sugars derived from corn.
Moat: Verifying Confidentiality of Enclave Programs

Security-critical applications constantly face threats from exploits in lower computing layers such as the operating system, virtual machine monitors, or even attacks from malicious administrators. To help protect application secrets from such attacks, there is increasing interest in hardware implementations of primitives for trusted computing, such as Intel's Software Guard Extensions (SGX) instructions. These primitives enable hardware protection of memory regions containing code and data, and provide a root of trust for measurement, remote attestation, and cryptographic sealing. However, vulnerabilities in the application itself, such as the incorrect use of SGX instructions or memory safety errors, can be exploited to divulge secrets. In this paper, we introduce a new approach to formally model these primitives and formally verify properties of so-called enclave programs that use them. More specifically, we create formal models of relevant aspects of SGX, develop several adversary models, and present a sound verification methodology (based on automated theorem proving and information flow analysis) for proving that an enclave program running on SGX does not contain a vulnerability that causes it to reveal secrets to the adversary. We introduce Moat, a tool which formally verifies confidentiality properties of applications running on SGX. We evaluate Moat on several applications, including a one time password scheme, off-the-record messaging, notary service, and secure query processing.
The Fermilab Upgrade

In 1978, Fermilab set out a goal of building a superconducting accelerator (Energy Saver) which would raise the proton energy to close to 1000 GeV for operation in two modes. Tevatron I would provide proton-antiproton collisions at a total CM energy of near 2.0 TeV to study the particle mass domain beyond 100 GeV. Tevatron II would provide extensive facilities for the programmatic study of Standard Model physics in an upgraded fixed-target program. There was of course the realization that with the right mixture of precision and imagination, the collider could add significantly to Standard Model physics (e.g. W and Z physics, W,Z pairs, B-physics) and that the fixed-target program could explore beyond the Standard Model (e.g., rare K-decays, CP violation). In 1988, we are engaged in setting out the future program of the Laboratory based upon the success of the Energy Saver, TeV I and TeV II construction programs. This future program assures that operation of the TEVATRON facility for physics is the overriding priority between now and perhaps 1993 and it also assumes that the Superconducting Super Collider (SSC) will be funded for construction in 1990 and will begin producing physics by 1999.
Aggressive Medical Therapy Alone Is Adequate in Certain Patients With Severe Symptomatic Carotid Stenosis

As clinicians, our responsibility is to be honest with our patients. To achieve the goal of an honest discourse with this patient, we must inform her that it is uncertain whether she would benefit from carotid endarterectomy (CEA). Although the landmark clinical trials that compared CEA plus optimal medical therapy (OMT) with OMT alone showed robust benefit for CEA in symptomatic patients with high-grade stenosis, we should acknowledge that studies such as the North American Symptomatic Carotid Endarterectomy Trial (NASCET) used what now would be regarded as “suboptimal” medical therapy. Furthermore, the 70% to 99% cohort of NASCET was published in 1991. It is shocking that clinicians are still making CEA decisions based on data that are 22 years old! What can we learn from more contemporary stroke prevention studies that have used aggressive medical therapy? A good place to start would be the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) study1 …
A rat histone H4 gene closely associated with the testis-specific H1t gene

A rat histone H4 gene closely associated with the testis-specific H1t gene was isolated by screening the Sargent-Bonner rat genomic library using cloned human histone genes as probes. Both the H4 gene and the H1t gene are located on a 7-kb EcoRI genomic DNA fragment. Although the deduced amino acid sequence of the rat H4 histone is identical to that of the sequence of human histone H4, the nucleotide sequence of the coding region differs significantly from the coding region of the human H4 gene. Moreover, the relative spacing between the 5′-consensus sequence elements is unique for an H4 gene. S1-nuclease protection analyses reveal that both the H4 and H1t mRNA species are present in a fraction of rat testis cells highly enriched in pachytene spermatocytes, while only the H4 mRNA species is present in a rat myeloma cell line (Y3-Ag1.2.3). During a 1-h hydroxyurea treatment of the Y3 cells, which produces a 99% inhibition of DNA synthesis, the level of this H4 mRNA drops by only 50%, indicating that the stability of this mRNA is only partially coupled with DNA synthesis.
Perceived control over anxiety-related events as a predictor of pain behaviors in a cold pressor task.

Abstract The extent to which perceived control over anxiety-related events contributes to the experience of pain was investigated. It was hypothesized that perceived control over anxiety-related events would predict pain behaviors induced via a cold pressor task because perceived control may alter the meaning of a pain-inducing stimulus. Eighty undergraduate students completed the Anxiety Control Questionnaire, Pain Anxiety Symptoms Scale, State-Trait Anxiety Inventory, and Penn State Worry Questionnaire. Heart rate was assessed prior to hand immersion. Participants then immersed their dominant hand in ice water and rated pain intensity at their pain threshold and tolerance times. Results indicate that perceived control over anxiety-related events predicts pain tolerance and endurance (i.e., overt pain response) but not pain intensity, threshold, or heart rate. It appears that the psychological process variable of perceived control over anxiety-related events uniquely influences participants’ ability to cope with the experience of pain by altering the perceived threat of the acute pain induced via a cold pressor task.
Cost-benefit analysis of robotic versus nonrobotic minimally invasive mitral valve surgery.

ObjectiveTo date, a direct comparison of minimally invasive mitral valve repair or replacement (mini-MVR) versus robotic MVR is lacking; therefore, the purpose of this study was to address this def...
Interference screw fixation versus Pulvertaft weave in a simulated early-motion suspensionplasty protocol.

Purpose To compare interference screw fixation to Pulvertaft weave fixation in a cadaveric basal joint abductor pollicis longus (APL) suspensionplasty model with an early range of motion protocol. We asked whether the interference screw fixation would provide comparable initial stability while minimizing the dorsal incision and eliminating the prominent dorsal mass associated with the traditional Pulvertaft weave. Methods Six matched cadaveric forearms underwent suspensionplasty with tendon fixation via an interference screw or a Pulvertaft weave. We then loaded the specimens to 10,000 cycles and used a modification of a previously validated cyclic pinch model. One third of the load required for maximal pinch strength was used. The APL was not loaded because we used the tendon for ligament reconstruction. We obtained measurements of residual trapezial space with feeler gauges after trapeziectomy, after suspensionplasty, and at 1,000-cycle intervals. Results Suspensionplasty with interference screw fixation maintained statistically significantly larger trapezial space heights compared with the Pulvertaft weave. Moreover, after the first 1,000 cycles, none of the specimens fixed with the interference screw lost further height up to the 10,000th cycle. All of the specimens fixed with the Pulvertaft weave continued to lose height with cycling, and 1 specimen showed contact of the first metacarpal with the scaphoid after only 1,000 cycles. With interference screw fixation, the height achieved initially and maintained through 10,000 cycles was an average of 5.5 mm. When the Pulvertaft weave was used, the height achieved was 3.0 mm initially, declining to 2.3 mm after 10,000 cycles. The polylactic acid interference screw was placed through a 5-mm dorsal stab incision and the extra tendon graft was cut flush as it exited the bone tunnel, eliminating the dorsal prominence associated with the Pulvertaft weave. Conclusions Although traditional APL suspensionplasty with a Pulvertaft weave provides good initial stability, it requires a large dorsal incision and leaves a prominent dorsal mass that may be bothersome to some patients. Clinical relevance Fixation of the suspensionplasty with an interference screw appears to offer several advantages.
Psychiatric Disorders in Liver Disease

The frequency of psychiatric illness presenting with liver disease occurs at rates higher than pure chance. This reflects the association between alcohol and drug dependence with acute and chronic liver toxicity and disease. Because mood and anxiety disorders are more common in substance use disorder, the link extends to higher rates of these disorders in patients with liver disease. Finally, liver disease can represent a chronic and painful condition that presents a significant physical and psychological stress for patients.
Heterotrimeric G-protein α-Subunit Adopts a “Preactivated” Conformation When Associated with βγ-Subunits *

Abstract Activation of a heterotrimeric G-protein by an agonist-stimulated G-protein-coupled receptor requires the propagation of structural signals from the receptor binding interface to the guanine nucleotide binding pocket of the G-protein. To probe the molecular basis of this signaling process, we are applying high resolution NMR to track structural changes in an isotope-labeled, full-length G-protein α-subunit (Gα) chimera (ChiT) associated with G-protein βγ-subunit (Gβγ) and activated receptor (R*) interactions. Here, we show that ChiT can be functionally reconstituted with Gβγ as assessed by aluminum fluoride-dependent changes in intrinsic tryptophan fluorescence and light-activated rhodopsin-catalyzed guanine nucleotide exchange. We further show that 15N-ChiT can be titrated with Gβγ to form stable heterotrimers at NMR concentrations. To assess structural changes in ChiT upon heterotrimer formation, HSQC spectra of the 15N-ChiT-reconstituted heterotrimer have been acquired and compared with spectra obtained for GDP/Mg2+-bound 15N-ChiT in the presence and absence of aluminum fluoride and guanosine 5′-3-O-(thio)triphosphate (GTPγS)/Mg2+-bound 15N-ChiT. As anticipated, Gβγ association with 15N-ChiT results in 1HN, 15N chemical shift changes relative to the GDP/Mg2+-bound state. Strikingly, however, most 1HN, 15N chemical shift changes associated with heterotrimer formation are the same as those observed upon formation of the - and GTPγS/Mg2+-bound states. Based on these comparative analyses, assembly of the heterotrimer appears to induce structural changes in the switch II and carboxyl-terminal regions of Gα (“preactivation”) that may facilitate the interaction with R* and subsequent GDP/GTP exchange.
Understanding the Role of Service Convenience in Art Museum Marketing: An Exploratory Study

ABSTRACT Attracting both tourists and local consumers, art museums are an important part of the U.S. hospitality and tourism industry. In light of rapidly increasing operating costs and decreasing funding, U.S. art museums have begun more market-oriented efforts to broaden their appeal and accessibility, thereby increasing awareness and visitation. These nonprofit organizations compete broadly with other leisure activities for consumers' discretionary time. Here, a recently developed model of service convenience is used as the theoretical framework for our exploration of important art museum services and components of service convenience. Four focus group discussions were conducted among art museum visitors. The findings suggest that various factors influence decision, access, and transaction convenience, which, in turn, influence the overall perceptions of service convenience. Hypotheses and a conceptual model are developed and discussed, along with future research directions.
Short-Course Rapamycin Treatment Preserves Airway Epithelium and Protects Against Bronchiolitis Obliterans

Background Damage to airway epithelium is closely related to the development of bronchiolitis obliterans (BO) in pulmonary transplantation. Rapamycin protects against BO development in a murine model, but its use in patients undergoing lung transplantation is limited by its side effects. We hypothesized that short-course rapamycin dosing could be used to prevent airway epithelium loss and protect against BO development in a murine model. Methods A total alloantigenic mismatch, murine, heterotopic tracheal transplant model of BO was used. Animals were treated with either rapamycin or dimethyl sulfoxide (controls) according to one of three treatment regimens: (1) days 1 through 14 after transplantation, (2) days 3 through 7 after transplantation, or (3) days 14 through 28 after transplantation. Epithelial loss was assessed by use of hematoxylin and eosin stains 14 and 28 days after transplantation. Tracheal luminal obliteration was assessed at 28 days. Results Early rapamycin treatment was protective against epithelial loss 14 days after transplantation in comparison with control animals ( p p = 0.002) and reducing luminal obliteration ( p p Conclusions Short-course rapamycin treatment protects against airway epithelium loss and subsequent development of BO in a murine model. Because of its immunosuppressive and antifibrotic effects, rapamycin may prove to be the ideal medication to prevent chronic rejection and BO in patients undergoing lung transplantation.
Infrared Spectral Studies of Peroxyacetyl Nitrate (PAN)

Peroxyacetyl nitrate decomposition products under continued and discontinued irradiations determined by IR spectral analysis
A Direct Hexane Extraction Process for Glanded Cottonseed

A modified filter funnel apparatus was used to determine mass flow velocities for extraction of uncooked glanded cottonseed flakes, and the results were compared with a continuous pilot-plant-scale extractor. A mass velocity of 2,000 lb/hr/ft2 or higher (considered adequate for oilseed extraction) was obtained in all cases. Both the initial meat moisture before flaking and the flake moisture during extraction were found to affect the mass velocity. A meat moisture before flaking of less than 9% decreased the mass velocity, probably as a result of increased fines and thus smaller flake size. A high flake moisture (about 9%) during heated-hexane extraction caused a decrease in mass velocity compared to that of lower-moisture flakes. The correlation of filter-funnel mass velocity data to a continuous pilot-plant extractor confirmed that uncooked flakes can be satisfactorily extracted to yield low residual lipids by using a low solvent-to-flake ratio and ambient-temperature hexane solvent.
Representations of the automorphism groups of free groups

Let @ be the automorphism group of a finitely generated free group F of rank n. The action of @ on the quotient of F by its commutator subgroup gives a homomorphism p from @ onto G&(Z), whose kernel we denote by K. For n = 2, this representation gives much information since Nielsen [6] proved that K is the subgroup of inner automorphisms. For n > 3, however, K is much larger and its structure unknown, so that this representation alone is no longer satisfactory. We therefore attempt to find integral representations of @ whose kernels are smaller than K. In Section 2 we consider integral representations, pc , constructed from the action of Cp on C/C’, where C is a characteristic subgroup of finite index in F. w e prove that such representations “exhaust” @, in the sense that nc kernel (pc) = 1. In fact, we construct in this way an infinite sequence of representations pi , with kernels Ki , such that K = K,, 2 Kl 3 ... r) Ki 3 K.i+l 3 ..., and ni Ki = 1. Each pi contains piPI as a constituent and this leads to a faithful representation of @ in terms of infinite matrices. Since the degrees of the representations pi become quite large, one would like to know their irreducible constituents. This is a difficult problem to solve in general. In Section 3, we limit ourselves to the free group of rank 3 and obtain the reduction for pr . We prove that when pa = p is “split off” from p1 , the remaining constituent is irreducible. This provides an example of an irreducible representation of @ which doesn’t factor through p. Irreducibility is established by a highly computational method. The representation in question is first viewed as a representation of a finite subgroup G of @, G being generated by three of the four known generators for @. Using our knowledge ‘of the irreducible representations of G, we find all proper Ginvariant submodules of our representation space and prove that none of
Organization and development of the brain stem auditory nuclei of the chicken: primary afferent projections.

The pattern of primary auditory projections to the brain stem of young chickens was investigated using terminal degeneration methods and orthograde transport of horseradish peroxidase (HRP) or tritiated amino acid. Of particular interest was the question of whether nucleus laminaris (NL) re- ceives primary afferents. A study of silver-stained degeneration patterns in nu- cleus magnocellularis (NM) and NL at three intervals following unilateral in- terruption of the cochlear nerve revealed that by 48 hours after the lesion, de- generating terminals were found only in the ipsilateral nucleus angularis (NA), NM and lagenar projection areas but not in NL. Five- and eight-day survival times, however, also revealed degeneration bilaterally in NL. The appearance of terminal degeneration in NL at the longer survival times is attributed to the previously-reported severe and rapid transneuronal degeneration of neurons in NM following deafferentation and not to the presence of cochlear nerve termi- nals in NL. Injection of HRP or tritiated proline into the basilar papilla pro- duced patterns of labeling similar to that seen in the 2-day degeneration mate- rial; HRP reaction product or autoradiographic label were seen only in the ipsi- lateral NA and NM and in the ipsilateral projection areas of the macula lagena but not in either NL. The patterns of primary auditory projections revealed by the three methods were quite similar to each other and to that previously re- ported for the pigeon and confirm the conclusion that the laminar nucleus of chickens does not receive primary afferents. The existence of primary cochlear projec- tions to the avian nucleus laminaris (NL) has been disputed for many years. This nucleus, which has been considered homologous to the medial superior olivary nucleus of mammals (Boord, '69; Rubel and Parks, '75) is thought not to receive such direct afferents by a majority of authors (Brandis, 1894; Wallen- berg, 1898, 1900; Holmes, '03; Bok, '15; Levi- Montalcini, '49; Boord and Rasmussen, '63; Winter, '63; Rodriguez and Rebollo, '66). A few investigators, however, have contested this view (Winkler, '07; Sanders, '29; Wold and Hall, '75). Wold and Hall ('75) have revived the issue by reporting that section of the cochlear nerve in adult chickens produces silver-stained degenerating material bilater- ally in NL after 4- to 7-day survival periods. These authors attribute their findings to pri- mary cochlear fibers passing through the ipsi-
Somatosensory response to stimulus trains in patients with multiple sclerosis.

Abstract The train somatosensory evoked response (SERT) was examined in a group of thirty-three MS patients. The filtered SERT and single cycle averaged are described for the patient group, with the single cycle average characterized by peak-to-peak voltage amplitude and phase angle measurements. The differences in the experimental response between patients and normal subjects are examined. The single cycle average amplitudes demonstrated significant differences at all stimulating frequencies between the normal subjects and the MS patients, while phase angles did not. A discriminant function, based on the single cycle average peak-to-peak voltages, was developed to aid in characterizing subjects. Additionally, a posteriori probabilities were obtained to permit probabilistic statements concerning subject classification. These results were verified using a normal and MS subject who were correctly identified in each case. The clinical significance of the above observations is discussed.
Fine root distribution in a young loblolly pine (Pinus taeda L.) stand: Effects of preplant phosphorus fertilization

The effects of preplant phosphorus fertilization on fine root (≤2 mm) distribution were examined in an 11-year-old stand of loblolly pine (Pinus taeda L.) located on the lower Coastal Plain of North Carolina. Root auger cores were collected from the planting bed and interbed areas from two depths (0–10 and 10–20 cm) from fertilized (45 kg P ha−1 at time of planting) and nonfertilized plots. Root samples were collected and aboveground growth measured during the 11th year after fertilization. Despite significant increases in aboveground volume and biomass due to fertilization, fine root biomass was unaffected. No differences in rooting density (root length per volume of soil) due to phosphorus additions were detected. However, the ratio of fine root biomass to aboveground (shoot) biomass (R:S) was significantly smaller on plots receiving phosphorus fertilization.
Six authors in search of a citation: villains or victims of the Vancouver convention?

OBJECTIVES--To analyse trends in the number of authors per article over the past 10 years. DESIGN--Analysis of articles from random volumes of eight biomedical journals. SUBJECTS--Cell, Nature, Proceedings of the National Academy of Sciences USA (PNAS), Journal of Clinical Investigation (JCI), Biochemical and Biophysical Research Communications (BBRC), Journal of Clinical Oncology (JCO), New England Journal of Medicine (NEJM), Lancet. MAIN OUTCOME MEASURES--Median and modal numbers of authors. RESULTS--All journals except Cell and Nature showed a trend towards increasing authorship numbers over the study period. The trend was most noticeable in journals such as JCO which feature clinical research. General medical journals (Lancet, NEJM) with a median of six to seven authors per article published far fewer seven author than six author studies, which suggests that author number may be influenced by the Vancouver convention which precludes citation of more than six authors. CONCLUSIONS--The phenomenon of expanding authorship in biomedical journal articles is not explained by the hypothesis that newer research technologies have necessitated more extensive collaboration. Rather, the data suggest that conferral of authorship may sometimes have a volitional component which contributes to rising author numbers. It is proposed that replacement of the Vancouver convention with a "first author, last author" citation system may help stem this rise in author numbers.
Proactive and Reactive Aggression in a Child Psychiatric Inpatient Population

This study examined relations between proactive and reactive aggression and indicators of antisocial behavior (callous/unemotional traits and behavioral consequences) and negative affect (depressio...
Prediction of early and late re-intubation: is it a crossed or separate line?--Reply.

In Reply : We thank Drs Figueroa-Casas and Esquinas for their important comments regarding the prediction of early and late re-intubation. We agree that there are multiple potential mechanisms and pathways leading to extubation failure. Our data suggest that there are several patient
Outcomes Among Patients Discharged From Busy Intensive Care Units

Intensive care units (ICUs) may have no open beds or inadequate staffing at times; thus, ICU patients may be discharged sooner than desired. This study examined how >3 metrics of ICU capacity strai...