cssi/SciSciGPT-SciSciNet huggingface dataset:
Cardiogenic shock complicating acute myocardial infarction in elderly patients: does admission to a tertiary center improve survival?

Abstract Background The role of early revascularization among patients with acute myocardial infarction complicated by cardiogenic shock remains controversial. Angioplasty registries, while suggesting a benefit, are subject to selection bias, and clinical trials have been underpowered to detect early benefits. If an invasive strategy is beneficial in this population, patients admitted to hospitals with onsite coronary revascularization might be expected to have a better prognosis. We sought to determine whether access to cardiovascular resources at the admitting hospital influenced the prognosis of patients with acute myocardial infarction complicated by cardiogenic shock. Methods By use of the Cooperative Cardiovascular Project database (a retrospective medical record review of Medicare patients discharged with acute myocardial infarction), we identified patients aged ≥65 years whose myocardial infarction was complicated by cardiogenic shock. Results Of the 601 patients with cardiogenic shock, 287 (47.8%) were admitted to hospitals without revascularization services and 314 (52.2%) were admitted to hospitals with coronary angioplasty and coronary artery bypass surgery facilities. Clinical characteristics were similar across the subgroups. Patients admitted to hospitals with revascularization services were more likely to undergo coronary revascularization during the index hospitalization and during the first month after acute myocardial infarction. After adjustment for demographic, clinical, hospital, and treatment strategies, the presence of onsite revascularization services was not associated with a significantly lower 30-day (odds ratio 0.83, 95% CI 0.47, 1.45) or 1-year mortality (odds ratio 0.91, 95% CI 0.49, 1.72). Conclusions In a community-based cohort, patients with acute myocardial infarction complicated by cardiogenic shock did not have significantly different adjusted 30-day and 1-year mortality, irrespective of the revascularization capabilities of the admitting hospital. (Am Heart J 2002;143:768-76.)
Prostaglandin E2-Induced Release of LHRH into Hypophysial Portal Blood

Prostaglandin E2 (PGE2) was infused into a lateral ventricle of adult male rats or infused into a hypophysial portal vessel. Intraventricularly administered PGE2 stimulated the release of LH, FSH, and prolactin but not TSH. Intraventricular infusion of the control solution did not alter the basal release of any of these hormones. PGE2 was found to be a potent stimulator of LH release, but larger quantities were needed to stimulate the release of FSH or prolactin. In addition, lateral ventricle infusion of 5 μg or 20 μg of PGE2 stimulated a 2- to 3-fold increase in the concentration of LHRH in hypophysial portal plasma but did not affect LHRH levels in arterial plasma. PGE2 infused into a hypophysial portal vessel at a rate of 0.167 μg⁄min for 30 min, or infusion of the control solution, resulted in similar changes in the concentration of FSH, LH, and prolactin in arterial plasma. The results of this investigation suggest that PGE2 stimulates the release of gonadotropins in vivo by enhancing the release of...
Poststructuralist ethics: subjectivity, responsibility and the space of community

The theoretical tenets of poststructuralism pose significant challenges to traditional ethical thinking, suggesting the need for an ethics sensitive to openness and difference. Drawing upon the work of Levinas, Derrida and Nancy, I discuss three dimensions of such an ethics: a theory of subjectivity based in a responsibility to the other; a politics of deconstruction within which this responsibility is foregrounded; and a theory of spatiality articulated in the sharing of community. This points toward an ethics of hospitality, in which the space of community is offered as a gift, and in the context of an irrecusable responsibility toward others.
The role of threshold limit values in U.S. air pollution policy.

This paper analyzes the role of threshold limit values (TLVs) in national air pollution policy during the 1980s, a period in which the Environmental Protection Agency (EPA) sought to delegate to individual states the authority to evaluate and regulate airborne toxic substances. We focus on 20 carcinogens and 11 substances with non-genotoxic health effects that were regulated by local air toxics programs using TLVs. Data from EPA's National Air Toxics Information Clearinghouse indicate that maximum TLV-based Ambient Air Level guidelines (AALs) frequently exceed minimum TLV-based AALs by a factor of greater than 1,000. Cancer potency data from EPA's Integrated Risk Information System suggest significant risks remain at TLV-based AALs. Cancer risks at the median TLV-based AAL exceed 1,000 cases per million exposed persons for cadmium (1,040), nickel and its compounds (1,420), propylene oxide (1,550), coke oven emissions (1,860), benzene (2,500), arsenic and its compounds (7,300), N-nitrosodimethylamine (21,000), asbestos (21,500), and ethylene dibromide (55,000). We also summarize published studies that report non-genotoxic health effects in workers exposed at levels near the TLV for 11 substances whose AALs were based on TLVs. Contrary to the assumption frequently made by state air toxics program, TLVs cannot be taken to represent no observed effect levels (NOELs) for regulatory purposes.
Vertical incision intraoral silicone chin augmentation.

Objective. Solid silicone augmentation mentoplasty is a common procedure with consistent aesthetic results in properly selected patients. While many plastic surgeons employ the external approach, t...
Northwestern’s new Maeda bookplate: Capturing continuity and change in an image for the 21st century

Pour la creation d'un nouvel ex-libris celebrant la generosite et la vision des principaux donateurs en meme temps que la place de la bibliotheque dans l'environnement academique du 21eme siecle, l'equipe des bibliothecaires de la Northwestern University (Illinois) a fait appel a l'artiste John Maeda. L'oeuvre de Maeda, cascade typographique aleatoire autour du texte Northwestern University Library: Imagination-Tranformation-Synthesis admet plusieurs differentes lectures.
Why noise is useful in functional and neural mechanisms of interval timing

The ability to estimate durations in the seconds-to-minutes range - interval timing - is essential for survival, adaptation and its impairment leads to severe cognitive and/or motor dysfunctions. The response rate near a memorized duration has a Gaussian shape centered on the to-be-timed interval (criterion time). The width of the Gaussian-like distribution of responses increases linearly with the criterion time, i.e., interval timing obeys the scalar property. We presented analytical and numerical results based on the striatal beat frequency (SBF) model showing that parameter variability (noise) mimics behavioral data. A key functional block of the SBF model is the set of oscillators that provide the time base for the entire timing network. The implementation of the oscillators block as simplified phase (cosine) oscillators has the additional advantage that is analytically tractable. We also checked numerically that the scalar property emerges in the presence of memory variability by using biophysically realistic Morris-Lecar oscillators. First, we predicted analytically and tested numerically that in a noise-free SBF model the output function could be approximated by a Gaussian. However, in a noise-free SBF model the width of the Gaussian envelope is independent of the criterion time, which violates the scalar property. We showed analytically and verified numerically that small fluctuations of the memorized criterion time leads to scalar property of interval timing. Noise is ubiquitous in the form of small fluctuations of intrinsic frequencies of the neural oscillators, the errors in recording/retrieving stored information related to criterion time, fluctuation in neurotransmitters’ concentration, etc. Our model suggests that the biological noise plays an essential functional role in the SBF interval timing.
Is administration of the HPV vaccine during pregnancy feasible in the future

Despite the strong evidence supporting the efficacy of the HPV vaccine, the uptake rate remains low. One reason for this is that young females do not interact frequently with the healthcare system. In fact, pregnancy is often the first time young women experience multiple scheduled visits to a health provider. We review the data regarding safety of administering the HPV vaccine during pregnancy and consider the possibility of incorporating vaccination into prenatal care. Although the optimal time for vaccination is prior to sexual debut, this does not always occur, and as such, a broader approach to HPV vaccination may be necessary. Increasing the vaccine uptake rate among young women who did not initiate or complete the series earlier may significantly contribute to the decline in HPV-associated diseases.
FPGA architecture for 2D Discrete Fourier Transform based on 2D decomposition for large-sized data

Applications based on Discrete Fourier Transforms (DFT) are extensively used in various areas of signal and digital image processing. Of particular interest is the two-dimensional (2D) DFT which is more computation- and bandwidth-intensive than the one-dimensional (1D) DFT. Traditionally, a 2D DFT is computed using Row-Column (RC) decomposition, where 1D DFTs are computed along the rows followed by 1D DFTs along the columns. Both application specific and reconfigurable hardware have been used for high-performance implementations of 2D DFT. However, architectures based on RC decomposition are not efficient for large input size data due to memory bandwidth constraints. In this paper, we propose an efficient architecture to implement the 2D DFT for large-sized input data based on a novel 2D decomposition algorithm. This architecture achieves very high throughput by exploiting the inherent parallelism due to the algorithm decomposition and by utilizing the row-wise burst access pattern of the external memory. A high throughput memory interface has been designed to enable maximum utilization of the memory bandwidth. In addition, an automatic system generator is provided for mapping this architecture onto a reconfigurable platform of Xilinx Virtex5 devices. For a 2K×2K input size, the proposed architecture is 1.96x times faster than RC decomposition based implementation under the same memory constraints, and also outperforms other existing implementations.
Processes Determining the Rapid Reestablishment of the Equatorial Pacific Cold Tongue/ITCZ Complex

Abstract The annual reestablishment of the equatorial cold tongue (ECT) in the Pacific is signified by a remarkably rapid reversal of the warming trend from March to May. The processes responsible for this dramatic turnabout are investigated using the outputs generated by a coupled ocean–atmosphere model, which simulates realistic tropical Pacific climate. A new diagnostic equation is put forward for a budget study of the temperature tendency in a mixed layer (ML) with a variable depth. The budget study reveals that the rapid boreal spring cooling in the ML of the ECT (4°S–2°N, 120°–90°W) is primarily attributed to turbulent entrainment (54%), surface evaporation (21%), and meridional advection (14%). The spring shallowness of the ML is also a significant“implicit” contributor. Annually, the ML depth in the ECT varies nearly 180° out of phase with the SST while in phase with the ML heat content. The annual variation of the ML depth is determined by competing effects of the Ekman transport and turbulent en...
Key contributors to variations in fish mercury within and among freshwater reservoirs in Oklahoma, USA.

Elevated fish mercury (Hg) concentrations in freshwater ecosystems worldwide are a significant human and ecological health concern. Mercury bioaccumulation and biomagnification in lakes and reservoirs are controlled by numerous biogeochemical and ecological factors, contributing to variability in fish Hg concentrations both within and among systems. We measured total mercury concentrations ([THg]) and stable isotopes (δ15N, δ13C) in over 30 fish species in two connected subtropical freshwater reservoirs (Grand Lake and Lake Hudson, Oklahoma, USA), their tributaries, and local farm ponds, all of which are potentially impacted by nearby atmospheric Hg sources. We also conducted an inter-system analysis among 61 reservoirs in Oklahoma to explore biological, chemical and physical factors associated with fish [THg] across systems. We found that [THg] for most species in Grand Lake and Lake Hudson were relatively low compared to other reservoirs in Oklahoma. There were significant spatial variations in many species within and between Grand Lake and Lake Hudson, even after accounting for length and/or trophic position (based on δ15N). Fish in local farm ponds, commonly used in agricultural regions for raising game fish, had 2–17 times higher [THg] than fish of a similar length in nearby reservoirs. The inter-system analysis revealed that pH, water color, rainfall, and nutrients are the best predictors of fish [THg] across systems. Our results provide insight into the key factors associated with fish [THg] variations both within and across systems, and may be useful for exposure assessment and for identifying sites and water bodies prone to high fish [THg] as monitoring priorities.
Strategies for reducing cardiovascular risk in women.

Women experience higher morbidity and mortality from coronary heart disease (CHD) than men and as major providers of health care to women obstetricians-gynecologists can play a crucial role in counseling their patients about CHD prevention. The major risk factors for CHD have been identified as elevated cholesterol hypertension cigarette smoking low high density lipoprotein (HDL) cholesterol levels severe obesity diabetes mellitus a history of stroke and/or thromboembolic disease and a family history of premature CHD. Screening for these risk factors is one way obstetricians-gynecologists can contribute to improving womens cardiovascular health. Once risk factors are identified the physicians can counsel patients about reducing the intake of sodium fats and cholesterol; maintaining an appropriate weight; initiating a physical activity program comprised of aerobic exercises that contribute to cardiovascular fitness; and providing smokers with both encouragement to quit and referral to a specific smoking cessation program. the prescription of hormonal therapy is another area where obstetricians- gynecologists can help prevent CHD risk given the impact of oral contraceptives (OCs) and other hormonal preparations on lipids and lipoproteins. Estrogens exert a generally positive effect through elevated HDl and reduced low density lipoproteins (LDL) while progestins lower HDL and raise HDL. In general clinical studies have suggested that OCs containing progestins with the weakest androgenic potency and the lowest possible dose (e.g. norethindrone and ethinyl diacetate) are preferable in terms of their minimal impact on lipids and lipoproteins. The elevation in HDl conferred by estrogen replacement therapy also appears to have a protective value against CHD. If obstetricians-gynecologists come to view themselves as participants in the fight against CHD in women the long-term public health gains will be substantial.
Zoning and Diversity in Historical Perspective

The notion of urban diversity is a key component of successful urbanism. It is ironic that the rules of citymaking—in particular, zoning—came to be associated with the near antithesis of diversity....
G protein G alpha i-2 inhibits outwardly rectifying chloride channels in human airway epithelial cells

Previously we demonstrated that the heterotrimeric G protein, G alpha i-2, inhibits cystic fibrosis transmembrane conductance regulator (CFTR) chloride (Cl-) channels in human airway epithelial cells (E. M. Schwiebert, F. Gesek, L. Ercolani, C. Wjasow, D. C. Gruenert, and B. A. Stanton. Am. J. Physiol. 267 (Cell Physiol. 36): C272-C281, 1994, and E. M. Schwiebert, N. L. Kizer, D. C. Gruenert, and B. A. Stanton. Proc. Natl. Acad. Sci. USA 89: 10623-10627, 1992). The goal of the present study was to determine if G proteins also regulate outwardly rectifying Cl- channels (ORCC), a distinct class of Cl- channels regulated defectively by protein kinase A (PKA) in cystic fibrosis (CF). To this end, we used the patch-clamp technique to study ORCC in a normal human airway epithelial cell line (9HTEo-) that expresses CFTR and ORCC. Stimulation of G proteins with GTP and GTP gamma S decreased the single-channel open probability (Po) of ORCC, whereas inhibition of G proteins by GDP beta S increased the Po. Moreover, pertussis toxin (PTX), an uncoupler of Gi and G(o) subclasses of heterotrimeric G proteins, also increased the Po. Purified G alpha i-2 decreased the Po. In contrast, other PTX-sensitive G proteins, G alpha i-1, G alpha i-3, and G alpha o, had no effect on Po. We propose that G alpha i-2 couples to a receptor whose agonist negatively regulates ORCC in human airway epithelial cells.
Spatial and Temporal Factors Controlling Overtopping of Coastal Ridges

On low coasts there may be one of three basic sand or gravel ridge types: swash-built ridge, dune ridge or storm surge ridge. The first of these commonly occurs in beach ridge plains, with up to 200 or more ridges, more-or-less parallel with each other.
Infant Mortality: Development of a Proposed Update to the Dollfus Classification of Infant Deaths:

Objective Identifying infant deaths with common underlying causes and potential intervention points is critical to infant mortality surveillance and the development of prevention strategies. We constructed an International Classification of Diseases 10th Revision (ICD-10) parallel to the Dollfus cause-of-death classification scheme first published in 1990, which organized infant deaths by etiology and their amenability to prevention efforts. Methods Infant death records for 1996, dual-coded to the ICD Ninth Revision (ICD-9) and ICD-10, were obtained from the CDC public-use multiple-cause-of-death file on comparability between ICD-9 and ICD-10. We used the underlying cause of death to group 27,821 infant deaths into the nine categories of the ICD-9-based update to Dollfus' original coding scheme, published by Sowards in 1999. Comparability ratios were computed to measure concordance between ICD versions. Results The Dollfus classification system updated with ICD-10 codes had limited agreement with the 1999 modified classification system. Although prematurity, congenital malformations, Sudden Infant Death Syndrome, and obstetric conditions were the first through fourth most common causes of infant death under both systems, most comparability ratios were significantly different from one system to the other. Conclusion The Dollfus classification system can be adapted for use with ICD-10 codes to create a comprehensive, etiology-based profile of infant deaths. The potential benefits of using Dollfus logic to guide perinatal mortality reduction strategies, particularly to maternal and child health programs and other initiatives focused on improving infant health, warrant further examination of this method's use in perinatal mortality surveillance.
Gauging the Material Magnitude, Public Perception, and Governance of Roadside Litter in a Rural Mexican Municipio

Roadside litter is an ever-present human-environmental issue in Mexico, yet material estimates do not exist for rural places. This study estimates roadside litter, by abundance, weight, and class, and examines public perceptions of litter in the rural municipio of Coxcatlan, Puebla, Mexico. During fieldwork, ten study sites were selected, cleaned, and sampled periodically to estimate the generation rate of garbage. A household survey was conducted using participatory risk mapping in 433 households across the study area to gauge concern over litter. Litter and dumping are substantial concerns for households while generation rates along Coxcatlan’s roadsides are lower than most estimates for U.S. roadsides, highlighting the importance of perception of an environmental issue amid its empirically-derived reality. Results are contextualized within the broader framework of current and potential governance and management in the study area.
The Biocompatibility of Implant Materials

Biocompatibility is a key concept in understanding the host response to implants and biomaterials. Biocompatibility is also essential to developing medical implants and improving the performance of those implants. A short history of biocompatible materials is presented. Central ideas reviewed in this chapter include toxicology, mechanical effects, issues related to colonizing organisms, cell–biomaterial interactions, and in vivo assessment including the foreign body reaction (FBR). Finally, examples of implants that show vascularized, reconstructive integration in contrast to fibrosis are presented. Based on these examples of implants that heal in a manner different from that seen with the classical FBR, a new definition of the word biocompatibility is proposed.
Technical Note: When is Just–In–Time inventory management appropriate

This article introduces Just–in–Time inventory management as a method designed to eliminate costs that do not add value to the final product. It affects primarily the purchasing and production operations. However, it also requires support and commitment from workers as well as management to be appropriate for a company striving towards manufacturing excellence.
Case 2: Shoulder Pain in 7-year-old Girl.

1. Ashley L. Scheffer, MD* 2. Palka R. Patel, MD† 3. John J. Manaloor, MD‡ 1. *Department of Child Health, University of Arizona College of Medicine-Phoenix; Department of Pediatric Critical Care, Phoenix Children's Hospital, Phoenix, AZ 2. †Uganda Site Director, Global Primary Care Program, MGH Global Health, Massachusetts General Hospital, Boston, MA 3. ‡Clinical Pediatrics; Pediatric Antimicrobial Stewardship Program, Ryan White Center for Pediatric Infectious Diseases and Global Health, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN A previously healthy, fully vaccinated 7-year-old girl presents with a 3-day history of pain in her right shoulder, refusal to move her right arm, and temperature to 39.4°C (103°F). She complains of pain at the superior and posterior areas of her right shoulder, over her right scapula, and at the right lateral chest in the mid-axillary area. She maintains her neck in a slightly flexed and laterally rotated position. The review of systems is otherwise negative. She is eating and drinking well and denies sweats, chills, malaise, or antecedent viral respiratory tract infection. She was evaluated 2 days earlier for the same symptoms. At that time, the right shoulder and arm had no abnormalities and she had full range of motion of the right shoulder. The radiograph of the right shoulder was read as normal. She was discharged from the urgent care facility with a diagnosis of muscle strain and a recommendation to use ibuprofen as needed for pain. On physical examination today, her temperature is 39.4°C (102.9° F), heart rate is 130 beats per minute, and respiratory rate is 14 breaths per minute. She appears anxious and remains very still on the examination table. She maintains a rigid posture when sitting up, keeping her neck slightly flexed and rotated to the right. She refuses to move her shoulder. One hour after provision of acetaminophen, clinicians elicit full passive range of motion of her right shoulder but she continues to refuse active range of motion. Upon examination of the neck, 5 to 10 degrees of active motion in any direction is elicited. Her gait is normal. Aside from tachycardia, …
Spectroscopy and New Particles from BaBar

Results on charmonium states and searches for pentaquark states at the BABAR experiment are presented.
Competing loyalties in electoral reform: An analysis of the U.S. electoral college

A central tenet in the electoral systems subfield is that parties, when in power and motivated by partisan interest, seek desired outcomes via the strategic adoption of electoral rules. Such a focus, however, omits a key point: electoral rules also distribute power among geographic units. If, within a party, the partisan and geographic interests of some members conflict, then the canonical relationship between partisanship and rule choice may be conditional. The U.S. electoral college provides an opportunity to test for such intra-party variation, because it advantages some states over others and thus makes salient geographic allegiances. Using an original dataset on one reform proposal—the National Popular Vote Interstate Compact (NPVIC)—I find evidence of competing loyalties. Although NPVIC advances furthest when Democrats control state lawmaking, a state's status as a swing—but not as an overrepresented—state weakens the relationship to the point where even Democrats are unlikely to aid NPVIC.
Myeloid cell plasticity in the evolution of central nervous system autoimmunity

OBJECTIVE Myeloid cells, including macrophages and dendritic cells, are a prominent component of central nervous system (CNS) infiltrates during multiple sclerosis (MS) and the animal model experimental autoimmune encephalomyelitis (EAE). Although myeloid cells are generally thought to be proinflammatory, alternatively polarized subsets can serve noninflammatory and/or reparative functions. Here we investigate the heterogeneity and biological properties of myeloid cells during central nervous system autoimmunity. METHODS Myeloid cell phenotypes in chronic active MS lesions were analyzed by immunohistochemistry. In addition, immune cells were isolated from the CNS during exacerbations and remissions of EAE and characterized by flow cytometric, genetic, and functional assays. RESULTS Myeloid cells expressing inducible nitric oxide synthase (iNOS), indicative of a proinflammatory phenotype, were detected in the actively demyelinating rim of chronic active MS lesions, whereas macrophages expressing mannose receptor (CD206), a marker of alternatively polarized human myeloid cells, were enriched in the quiescent lesion core. During EAE, CNS-infiltrating myeloid cells, as well as microglia, shifted from expression of proinflammatory markers to expression of noninflammatory markers immediately prior to clinical remissions. Murine CNS myeloid cells expressing the alternative lineage marker arginase-1 (Arg1) were partially derived from iNOS+ precursors and were deficient in activating encephalitogenic T cells compared with their Arg1- counterparts. INTERPRETATION These observations demonstrate the heterogeneity of CNS myeloid cells, their evolution during the course of autoimmune demyelinating disease, and their plasticity on the single cell level. Future therapeutic strategies for disease modification in individuals with MS may be focused on accelerating the transition of CNS myeloid cells from a proinflammatory to a noninflammatory phenotype. Ann Neurol 2018;83:131-141.
A Kinematic Model for the Evolution of the Eastern California Shear Zone and Garlock Fault, Mojave Desert, California

Abstract The Eastern California shear zone in the Mojave Desert, California, accommodates nearly a quarter of Pacific–North America plate motion. In south-central Mojave, the shear zone consists of six active faults, with the central Calico fault having the fastest slip rate. However, faults to the east of the Calico fault have larger total offsets. We explain this pattern of slip rate and total offset with a model involving a crustal block (the Mojave Block) that migrates eastward relative to a shear zone at depth whose position and orientation is fixed by the Coachella segment of the San Andreas fault (SAF), southwest of the transpressive “big bend” in the SAF. Both the shear zone and the Garlock fault are assumed to be a direct result of this restraining bend, and consequent strain redistribution. The model explains several aspects of local and regional tectonics, may apply to other transpressive continental plate boundary zones, and may improve seismic hazard estimates in these zones.
Where “Sex” Is Born(e): Intersexed Births and the Social Urgency of Heterosexuality

Our beloved “genders” of the present moment are neither universal nor trans-historical presences in the world. The specific gender order which we employ today is the legacy of a particular cultural and political history, and there is still a great deal at stake in preserving it. As a graduate student I stumbled upon the topic of intersexuality a few years ago and found myself enthralled with its implications. Continuing to present itself inspite of all our scientific knowledge about the supposed immutability of “female” and “male,” intersexuality disrupts the gender order. The response to this disruption has been swift and terrible: from the intersexed infants who enter “our” world everyday are carved (literally and figuratively) supposedly “normal” boys and girls (mostly girls). The following exposition represents a pre-fieldwork (theoretical) stage in my current research and attempts to demonstrate that medical authorities manage intersex “cases” as they do in order to stabilize the always precarious institution of heterosexuality.
A Method for Optimizing Human Performance in Detecting and Diagnosing Mission Avionics Faults

Mission avionic systems have realized, and will continue to realize, significant advances in the application of automated maintenance test programs and on-line readiness testing. This is primarily due to the extensive use of digital computers, digital interfaces, and operational/diagnostic software. Dramatic advances have been made in the reliability of hardware in the quest for increased operational availability. Fault tolerance, parallel data busing, on-line diagnostics, and reconfiguration offer additional promises toward meeting the ideal “mission failure-free” avionics system.
Evaluation and Management of Childhood Obesity in Primary Care Settings

Publisher Summary The well-publicized epidemic of obesity affects both adults and children. In the United States, 31.9% of children are either overweight or obese, 16.3% are obese. Many other developed countries are similarly affected. The combined prevalence of overweight and obesity is higher than 15% in Canada, the United Kingdom, and several Mediterranean countries. Childhood obesity is now a significant problem in many developing countries as well. Roughly 11% of middle-class Indian children, for example, are obese. Among adults, obesity is strongly associated with type 2 diabetes, hypertension, dyslipidemia, cardiovascular disease, biliary tract disease, and asthma. There is also a strong association between obesity and cancer of the colon, breast in postmenopausal women, endometrium, esophagus, and kidney. Disturbingly, childhood obesity has become so serious that some of these problems are now emerging in children. A generation ago, type 2 diabetes was rare among children. Today, in some settings, it constitutes nearly half of all new cases of diabetes diagnosed among children. This chapter aims to provide practical recommendations for busy primary care physicians for the evaluation and management of common obesity-related illnesses among overweight and obese children and to offer strategies for helping children achieve or maintain a healthy weight. The chapter makes use of a case study to describe a stepwise approach to the problem.
Industrial Meat Production

This review surveys the past 30 years of the anthropology of corporate animal agribusiness, analyzing how various themes embedded in the words of the article's title—industrial, meat, and productio...
Sleep hygiene in adolescents with asthma.

AbstractObjective: Youth with asthma are at-risk for sleep difficulties due to nocturnal asthma symptoms. Sleep hygiene, or the ability to practice consistent sleep behaviors and habits, impacts yo...
Infrainguinal bypass surgery outcomes are worse in hemodialysis patients compared with patients with renal transplants.

Abstract Objective Studies of infrainguinal bypass surgery (IBS) in patients with end-stage renal disease have focused on hemodialysis (HD) patients. Little is known of the applicability of their outcomes to patients with renal transplants (RTs). In this study, we sought to compare perioperative and long-term outcomes of IBS in a large population-based cohort of HD and RT patients. Methods A retrospective review of all HD and RT patients who underwent IBS between January 2007 and December 2011 in the U.S. Renal Data System was performed. Univariable, Kaplan-Meier, multivariable logistic, and Cox regression analyses were employed to evaluate 30-day postoperative (graft failure, limb loss, conduit infection, death) and long-term (primary patency [PP], primary assisted patency [PAP], secondary patency [SP], limb salvage, mortality) outcomes. Results There were 10,787 IBSs performed in 9739 (90%) HD patients and 1048 (10%) RT patients who presented predominantly with critical limb ischemia (72%). Bypass configurations were femoral-popliteal (48%), femoral-tibial (34%), and popliteal-tibial (18%). Comparing HD vs RT patients, PP, PAP, and SP were 18% vs 33%, 23% vs 38%, and 30% vs 48%, respectively, at 5 years among autogenous conduit recipients (all P Conclusions The HD-dependent state is associated with elevated bypass and patient-level risks after IBS compared with patients with RTs. These results show that the benefits of renal transplantation likely extend to infrainguinal bypass-specific outcomes. The estimates of risk reported herein should inform the patient's and provider's expectations at the point of care.
Friction: Male Identity and Representation in Umfundalai

This study employs an autoethnographic lens to illuminate men’s constructions of gender in the Umfundalai tradition of African dance. Specifically, the research explores gender agency among eight male practitioners, including the researcher. The study’s qualitative methodology is informed by Max van Manen’s hermeneutic phenomenology and Anselm Strauss’s applied grounded theory. Sources of data include in-depth interviews as well as a research journal recording the author’s own lived experience descriptions and memories of dancing Umfundalai. The study is in dialogue with the literature of masculine studies, highlighting the social function of masculinities as scripted and learned ideals. Analysis of data revealed that performing Umfundalai choreography affords men an opportunity to dance a self-determined construction of gender performance and that Umfundalai studio practice can be a site for men’s affirmation of their `dancer’ identities as well as friction with gender performance. Umfundalai choreography can house multiple masculinities, potentially dismantling the hegemony that erodes the community in which it exists.
OVER-THE-TOP VERSUS ALL-EPIPHYSEAL TECHNIQUE FOR PHYSEAL SPARING ACL RECONSTRUCTION:

BACKGROUNDA variety of techniques are utilized for physeal sparing ACL reconstruction, however, no clear consensus exists on the ideal surgical technique, the frequency of complications, and how to...
Association Between Pet Ownership and the Risk of Dying From Colorectal Cancer: An 18-year Follow-up of a National Cohort

Despite the popularity of pets, research on the relationship between pet ownership and the risk of cancer remains minimal and inconclusive. To longitudinally examine the association between pet ownership and the risk of dying from colorectal cancer. We analyzed the data of a nationally representative cohort of 13,929 adults aged ≥ 19 years who answered the question about pet ownership in the Third National Health and Nutrition Examination Survey (NHANES), 1988–1994. The vital status was followed through 31 December 2010. Approximately, 43% of the participants had pets, 26% with dogs, 20% with cats and 5% with birds. By the end of an 18-year follow-up (mean = 15 years), 70 colorectal cancer deaths were recorded. After adjustment for socio-demographic factors, cigarette smoking, alcohol drinking, body mass index, physical activity, history of atopic conditions and serum cotinine measured at the baseline survey, the hazard ratio (HR) of dying from colorectal cancer associated with having any pets was 2.83 (95% CI = 1.51–5.30) compared with non-pet owners. This association was largely attributed to owning a cat. The HR of dying from colorectal cancer for owning a cat was 2.67 (1.22–5.86). The HR for owning a dog was 0.89 (0.37–2.12). Having a cat was significantly associated with an elevated risk of dying from colorectal cancer among the general population. The observed detrimental effects the cats conferred may not be explained by confounding effects from socio-demographics, cigarette smoking, sedentary life or atopic conditions.
A History of the Peoples of the British Isles: From Prehistoric Times to 1688

The three volumes of A History of the Peoples of the British Isles weave together the histories of England, Ireland, Scotland, and Wales and their peoples. The authors trace the course of social, economic, cultural and political history from prehistoric times to the present, analyzing the relationships, differences and similarities of the four areas. Covering British history from prehistoric times to 1688, Volume I's main themes include: * the development of prehistoric, Roman and Anglo-Saxon Britain* discussions of family and class structures* Medieval British history* the Stuart and Tudor leaderships* the arts and intellectual developments from 1485 to 1688. Presenting a wealth of material on themes such as women's history, the family, religion, intellectual history, society, politics, and the arts, these volumes are an important resource for all students of the political and cultural heritage of the British Isles.
Scholar-Administrators as Change Agents.

Flexibility and readiness to change are not necessarily valued or recognized traits in higher education. Yet higher education is in a period of dramatic change, because of rapid change in scholarship and society. With this change in mind, I reflect here on the role and effect of scholar-administrators as agents of change.
Probabilistic Aging Pipe Strength Estimation Using Multimodality Information Fusion

Accurate pipe material strength estimation is critical for the integrity and risk assessment of aging pipeline infrastructure systems. To predict the strength without interrupting the serviceability of the pipeline, inference methods are used through the relationship between the bulk yield tensile strength and surface material properties from nondestructive testing, such as chemical composition, microstructure images, and hardness testing. In order to make the best of information provided by multimodality surface measurements, Bayesian model averaging (BMA) method is used in this paper to integrate the information from various types of surface measurements for a more accurate bulk strength estimation. The models being considered are constructed by randomly combining the multimodality surface measurements and each case of linear combinations is included. The models considered are assessed by assigning different weights based on the posterior model probability. Markov Chain Monte Carlo sampling provides an effective way for numerically computing the marginal likelihoods, which are essential for obtaining the posterior model probabilities. To avoid the risk of overfitting, BMA is implemented to account for model uncertainty. The predictive performance of single model and BMA are compared by logarithmic scoring rule. The data collected from industry are used for demonstration and model predictive performance assessment. It is shown that the Bayesian model averaging approach can provide more reliable results in predicting the strength of the aging pipelines.
Groundwater recharge from an oxbow lake-wetland system in the Mississippi Alluvial Plain

The Mississippi River Valley Alluvial Aquifer ranks among the most overdrafted aquifers in the United States due to intensive irrigation. Concern over declining water levels has increased focus on understanding the sources of recharge. Numerous oxbow lakes overlie the aquifer that are often considered hydraulically disconnected from the groundwater system due to fine‐grained bottom sediments. In the current study, groundwater levels in and around a 445‐ha oxbow lake‐wetland in Mississippi were monitored for a 2‐year period that included an unusually long low‐water condition in the lake (>17 months), followed by a high‐water event lasting over 4 months before returning to earlier low‐water levels. The high‐water pulse (>4 m rise) provided a unique opportunity to track the impact in the underlying alluvial aquifer. During low‐water conditions, groundwater flowed westward beneath the lake. Following the lake rise, groundwater beneath and near the perimeter responded as quickly as the same day, with more delayed responses moving away from the lake. Within 2 months, a groundwater mound formed near the centre of the oxbow (>3 m increase), with a reversal in the local hydraulic gradient towards the east. Flow returned to a westward gradient when the lake level dropped back below 0.3 m. Analysis of precipitation and nearby river stage could not account for the observed behavior. Recharge to the aquifer is attributed to rising water levels spreading over point bar deposits and into the surrounding forested wetlands where preferential flow pathways are likely to exist due to buried and decomposing tree remains. An earlier study in the wetland demonstrated an increasing redox potential in isolated zones, consistent with the existence of preferential flow pathways through the bottom sediments (Lahiri & Davidson, 2020). Retaining high‐water levels in oxbow lakes could be a relatively low‐cost water management practice for enhancing aquifer recharge.
Prevalence, screening, treatment, and complications of osteoporosis and osteopenia in Medicare patients with chronic lymphocytic leukemia (CLL).

e24050Background: Despite treatment advances, patients (pts) with CLL, a common chronic cancer affecting the elderly, often experience adverse outcomes due to their comorbidities and frequent lack ...
Development of a small-scale rotary lobe-pump cell culture model for examining cell damage in large-scale N-1 seed perfusion process.

Perfusion technology has been identified as a process improvement capable of eliminating some of the constraints in cell culture and allows for high cell densities and viabilities. However, when implementing this N-1 seed perfusion platform in large-scale manufacturing, unexpected cell damage was observed as early as day one. Given shear rate within recirculation hollow fibers was normalized and aligned correctly across bench, pilot and manufacture scale, the primary mitigation was placed on the rotary lobe pump. Lowering the pump rate in manufacture scale successfully alleviated the cell damage. To understand the source of cell damage within the pump, a small-scale rotary lobe pump robustness model was developed. Testing different pump flow rates and back pressures, it was concluded that high back pressure can cause cell damage. The back pressure within the system can cause back flow and high shear within small clearances inside the pump, which lead to the primary cell damage observed at large-scale. This shear level can be significantly higher than the shear in the hollow fiber. This pump robustness model can be utilized to aid the perfusion skid design, including pump operation efficiency and cell shear sensitivity. Methods to reduce the back pressure and cell shearing were determined to better predict manufacturing performance in the future. This article is protected by copyright. All rights reserved.
Low body mass and high-quality sleep maximize the ability of aerobic fitness to promote improved cognitive function in older African Americans

Objectives: Because African Americans are at elevated risk for cognitive decline and Alzheimer’s disease, it is important to understand which health and lifestyle factors are most important for red...
Vibrational Signatures of Sarin Adsorption on Anatase Surfaces

Abstract Herein we report a theoretical study of the adsorption of the organophosphate nerve agent sarin (GB) on anatase titanium dioxide. From the results of density functional theory (DFT) calculations, we explore changes in the GB vibrational spectrum upon adsorption to the anatase (101) and (001) surfaces. Two vibrational modes with strong signatures in the infrared (IR) spectrum of GB are of interest, the P=O and P-O-C stretches. The frequency of the IR band corresponding to the P=O stretch red-shifts upon adsorption, consistent with published experimental data. Moreover, we find that the frequency of the less well-characterized P-O-C stretch blue-shifts upon adsorption. We show that the magnitudes of both IR band frequency shifts correlate with the strength of GB adsorption to anatase, and offer new considerations for the interpretation of experimental spectra.
Residual Shunt After Patent Foramen Ovale Closure and Long-Term Stroke Recurrence: A Prospective Cohort Study.

BACKGROUND Residual shunt is observed in up to 25% of patients after patent foramen ovale (PFO) closure, but its long-term influence on stroke recurrence currently is unknown. OBJECTIVE To investigate the association of residual shunt after PFO closure with the incidence of recurrent stroke and transient ischemic attack (TIA). DESIGN Prospective cohort study comparing stroke or TIA recurrence in patients with and without residual shunt after PFO closure. SETTING Single hospital center. PARTICIPANTS 1078 consecutive patients (mean age, 49.3 years) with PFO-attributable cryptogenic stroke who were undergoing percutaneous PFO closure were followed for up to 11 years. MEASUREMENTS Residual shunt was evaluated by transthoracic echocardiography with saline contrast. Primary outcome was a composite of the first recurrent ischemic stroke or TIA after PFO closure. RESULTS Compared with complete closure, the presence of residual shunt after PFO closure was associated with an increased incidence of recurrent stroke or TIA: 2.32 versus 0.75 events per 100 patient-years (hazard ratio [HR], 3.05 [95% CI, 1.65 to 5.62]; P < 0.001). This result remained robust after adjustment for important covariates, namely age; study period; device; presence of atrial septal aneurysm, hypertension, hyperlipidemia, diabetes, hypercoagulability, or hypermobile septum; and medication use (HR, 3.01 [CI, 1.59 to 5.69]; P < 0.001). Further stratification based on shunt size revealed that moderate or large residual shunts were associated with a higher risk for stroke or TIA recurrence (HR, 4.50 [CI, 2.20 to 9.20]; P < 0.001); the result for small residual shunts was indeterminate (HR, 2.02 [CI, 0.87 to 4.69]; P = 0.102). LIMITATION Nonrandomized study with potential unmeasured confounding. CONCLUSION Among patients undergoing PFO closure to prevent future stroke, the presence of residual shunt, particularly a moderate or large residual shunt, was associated with an increased risk for stroke or TIA recurrence. PRIMARY FUNDING SOURCE National Institutes of Health.
The Domestic Politics of US Treaty Ratification: Bilateral Treaties from 1949 to 2012

Treaties represent an important policy mechanism in US foreign policy. There are good reasons to expect that the political process underlying treaty ratification in the United States is structured by the partisan political context, the policy context including the policy agenda, and, in the case of bilateral agreements, the relationship between the treaty partners. I analyze the duration of the ratification process for all bilateral treaties transmitted by the president to the Senate from 1949 to 2012. I focus the analysis on two key stages where delay is most common: the presidential transmittal stage and the Senate Foreign Relations committee stage. Analysis indicates that presidential resources, partisan polarization, the broader policy agenda, and the value of the treaty structure presidential decisions on treaty transmittal. I find less support for these factors at the committee stage; however, the committee processes treaties with democracies more quickly than treaties with other states. The results have important implications for US foreign policy.