cssi/SciSciGPT-SciSciNet huggingface dataset:
Transoral rigid 70-degree laryngoscopy in a pediatric voice clinic.

OBJECTIVE Complaints of dysphonia and dysphagia frequently require rigid or flexible laryngoscopy in the office to aid in diagnosis. For young children, flexible laryngoscopy can be uncomfortable and often requires multiple adults to restrain the child. Rigid laryngoscopy does not result in crying but does require patient cooperation; thus, it is used primarily in adults. This project describes our experience using rigid laryngoscopy in a pediatric cohort. METHODS This was a retrospective chart review of patients at a pediatric voice clinic who underwent laryngoscopy from December 2011 through March 2017. Data analysis is via Student t test and descriptive analysis. RESULTS Three hundred and eleven patients were identified with 423 unique laryngoscopy exams. Of those, 212 of the exams were flexible and 210 were rigid. One patient did not tolerate either rigid or flexible exam. There was a statistically significant difference in age between children diagnosed via rigid mean 10.92 years (range 2.39-19.14 years) versus flexible mean 6.51 years (range 0.41-19.29 years), P ≤ 0.01. Of the 44 children under 3 years of age, flexible laryngoscopy was used almost exclusively, with 43 of 44 (97.7%) flexible scope exams. Rigid laryngoscopy was performed on 24 of 115 (20.9%) children aged 3 to 5 years, 26 of 40 (65%) aged 6 years, and 159 of 223 (71.3%) aged 7 and older. CONCLUSION Transoral 70o rigid laryngoscopy can be used in select children as young as 3 years of age. This modality allows for improved visualization of lesions with greater comfort for patients. Laryngoscope, 129:1657-1659, 2019.
A Simple ZVT Auxiliary Circuit for Totem-Pole Bridgeless PFC Rectifier

The utilization of wide band gap devices has enabled high frequency operation of totem pole bridgeless PFC rectifier. However, most of the designs reported in the literature with frequency higher than 100 kHz operate under discontinuous conduction mode or critical mode to reduce the switching loss. This paper proposes a zero-voltage-transition (ZVT) technique for totem-pole PFC rectifier under continuous conduction mode operation which enables efficient operation at switching frequencies well above 100 kHz. A simple auxiliary circuit consisting of a small auxiliary inductor and two active switches is placed in parallel with the main input filter inductor to achieve zero-voltage-switching of the main switches. The auxiliary switches operate with zero-current-switching (ZCS) and conduct current as short resonant pulses only during the critical turn- on transition which results in very low losses in the auxiliary circuit. The timing of the auxiliary switches is adaptively controlled with respect to the grid voltage angle for optimized overall efficiency. The effectiveness of the proposed ZVT scheme has been validated through experiments based on a 2.4 kW 400 kHz hardware prototype with 98.35% peak efficiency.
Robot-assisted laparoscopic sacrocolpopexy with autologous fascia lata: technique and initial outcomes.

Pelvic reconstructive surgery is increasingly being performed with autologous grafts to avoid complications of synthetic mesh and improve the durability of a native tissue repair. Autologous fascia lata (AFL) provides a reliable source of robust connective tissue to improve surgical outcomes. We present our technique and initial experience with performing robotic sacrocolpopexy (RSC) augmented with AFL. A retrospective review was conducted of patients who underwent RSC with AFL between January 2015 and November 2017. Outcomes evaluated include recurrence of prolapse on physical examination, prolapse symptoms, urinary incontinence, patient satisfaction based on the Patient Global Impression of Improvement (PGI-I) and complications. Twelve patients were identified with a median age of 68 years (range, 46–77 years) at the time of RSC with AFL. Eleven patients had a history of prior sling and/or vaginal mesh. The median operative time was 225 min (177–302 min). There were no intra- or postoperative complications. After a median follow-up of 14.7 months (5.7 to 39 months), the median PGI-I response was 2 (range, 1–3, very much to a little better). No recurrent or persistent apical prolapse was observed. Three patients (25%) reported recurrence of sensation of a vaginal bulge, which were all due to anterior vaginal wall prolapse. RSC can be performed with AFL and should be considered in patients with a history of mesh complications. Overall patient satisfaction was high. While these short-term outcomes are encouraging, further studies are needed to assess long-term durability of anatomic results.
Potential health risks of long-term e-cigarette use

E-cigarettes are becoming increasingly popular in recent years, especially among adolescents. Many healthcare professionals are unsure of what health consequences can be expected after long-term use of e-cigarettes. This review focuses on the currently published data of long-term e-cigarette vapor exposure in cells, animals, and humans. Most research suggests that e-cigarettes are not harmless. Increased oxidative stress from free radicals and systemic inflammation occur after weeks or months of exposure. E-cigarette vapor contains multiple known human carcinogens which are found in the serum of users, and DNA damage is seen in exposed animals. Pulmonary changes seen after months of exposure in mice are reminiscent of chronic obstructive pulmonary disease (COPD), and human users report increased respiratory symptoms. Cardiovascular disease risk is also likely, with e-cigarette use leading to multiple pathophysiological changes and possibly associated with an increased risk of myocardial infarction. Limitations of the current research are discussed, including the retrospective nature of most human data to date. A call for large, longitudinal prospective studies is deemed necessary to better understand the causal role of long-term e-cigarette use in chronic disease formation.
Pharmacological Assessment of Sepiapterin Reductase Inhibition on Tactile Response in the Rat

There is an unmet medical need for nonopioid pain therapies in human populations; several pathways are under investigation for possible therapeutic intervention. Tetrahydrobiopterin (BH4) has received attention recently as a mediator of neuropathic pain. Recent reports have implicated sepiapterin reductase (SPR) in this pain pathway as a regulator of BH4 production. To evaluate the role of SPR inhibition on BH4 reduction, we developed analytical methods to monitor the relationship between the plasma concentration of test article and endogenous pterins and applied these in the rat spinal nerve ligation pain model. Sepiapterin is an endogenous substrate, which accumulates upon inhibition of SPR. In response to a potent inhibitor of SPR, plasma concentrations of sepiapterin increased proportionally with exposure. An indirect-effect pharmacokinetic/pharmacodynamic model was developed to describe the relationship between the plasma pharmacokinetics of test article and plasma sepiapterin levels in the rat, which was used to determine an in vivo SPR IC50 value. SPR inhibition and mechanical allodynia were assessed coordinately with pterin biomarkers in plasma and at the site of neuronal injury (i.e., dorsal root ganglion). Upon daily oral administration for 3 consecutive days, unbound plasma concentrations of test article exceeded the unbound in vivo rat SPR IC90 throughout the dose intervals, leading to a 60% reduction in BH4 in the dorsal root ganglion. Despite evidence for pharmacological modulation of the BH4 pathway, there was no significant effect on the tactile paw withdrawal threshold relative to vehicle-treated controls.
Assessment of the Benefits of Anesthesia Patient Risk Reduction Measures

This chapter presents an analytical framework based on Bayesian analysis that was used to evaluate human and management risk factors for patients undergoing anesthesia, and the effects of a variety of proposed measures for mitigating those risks. More specifically, the analysis considers the frequency and the effects of various risk factors, the extent to which safety measures based on management improvements can decrease the chances that they occur, and the effects of these safety measures on patient risk. The analysis demonstrates that the accident sequences that had received the most attention because they had made the headlines were not the largest contributors to the overall patient risk. The analysis finds that most of the problems are not caused by rare events, but by more mundane factors such as fatigue and poor supervision of residents. Closer supervision of residents, periodic re-certification and simulator training appeared to be among the most potentially effective measures for reducing patient risk. A similar model can be applied to other medical problems involving risk, such as assessing the performance of surgeons or early assessment of medical devices (before comprehensive testing on large populations).
Mitigating roadside noise pollution: A comparison between rounded and sinusoidal milled rumble strips

Abstract Shoulder or centerline rumble strips (RS) generate noise and vibration to alert drivers when they are departing the travel lane. Although inexpensive to install, easy to maintain, and have documented safety benefits, RS are not installed on many roadway segments primarily due to noise concerns of nearby property owners. This study evaluated the feasibility of using sinusoidal RS as a substitute for rounded milled RS on roadway segments in Oregon (U.S.A.) with lane-departure crash problems. Exterior sound levels generated by rounded and sinusoidal RS strikes were compared to baseline sound levels for three vehicle types (passenger car, van, and heavy vehicle) to establish sound generation and alerts of the two designs. A total of 39 vehicle strikes of RS were recorded in a controlled field experiment. Rumble strip strikes by the passenger car and van generated less exterior noise with the sinusoidal (3.1 dBA) than with the rounded (passenger car: 5.4 dBA, van: 4.6 dBA) design. Results for the heavy vehicle were complicated due to bridging of the narrower rounded rumble strip by the tires. The wider cut of the sinusoidal RS generated a clearly detectable increase in exterior roadside noise for the heavy vehicle.
An automated approach for parallel adjoint-based error estimation and mesh adaptation

In finite element simulations, not all of the data are of equal importance. In fact, the primary purpose of a numerical study is often to accurately assess only one or two engineering output quantities that can be expressed as functionals. Adjoint-based error estimation provides a means to approximate the discretization error in functional quantities and mesh adaptation provides the ability to control this discretization error by locally modifying the finite element mesh. In the past, adjoint-based error estimation has only been accessible to expert practitioners in the field of solid mechanics. In this work, we present an approach to automate the process of adjoint-based error estimation and mesh adaptation on parallel machines. This process is intended to lower the barrier of entry to adjoint-based error estimation and mesh adaptation for solid mechanics practitioners. We demonstrate that this approach is effective for example problems in Poisson’s equation, nonlinear elasticity, and thermomechanical elastoplasticity.
Systematic Analysis of Efflux Pump-Mediated Antiseptic Resistance in Staphylococcus aureus Suggests a Need for Greater Antiseptic Stewardship

ABSTRACT Staphylococcus aureus-associated infections can be difficult to treat due to multidrug resistance. Thus, infection prevention is critical. Cationic antiseptics, such as chlorhexidine (CHX) and benzalkonium chloride (BKC), are liberally used in health care and community settings to prevent infection. However, increased administration of antiseptics has selected for S. aureus strains that show reduced susceptibilities to cationic antiseptics. This increased resistance has been associated with carriage of specific efflux pumps (QacA, QacC, and NorA). Since prior published studies focused on different strains and on strains carrying only a single efflux gene, the relative importance of these various systems to antiseptic resistance is difficult to ascertain. To overcome this, we engineered a collection of isogenic S. aureus strains that harbored norA, qacA, and qacC, individually or in combination. MIC assays showed that qacA was associated with increased resistance to CHX, cetrimide (CT), and BKC, qacC was associated with resistance to CT and BKC, and norA was necessary for basal-level resistance to the majority of tested antiseptics. When all three pumps were present in a single strain, an additive effect was observed in the MIC for CT. Transcriptional analysis revealed that expression of qacA and norA was significantly induced following exposure to BKC. Alarmingly, in a strain carrying qacA and norA, preexposure to BKC increased CHX tolerance. Overall, our results reveal increased antiseptic resistance in strains carrying multiple efflux pumps and indicate that preexposure to BKC, which is found in numerous daily-use products, can increase CHX tolerance. IMPORTANCES. aureus remains a significant cause of disease within hospitals and communities. To reduce the burden of S. aureus infections, antiseptics are ubiquitously used in our daily lives. Furthermore, many antiseptic compounds are dual purpose and are found in household products. The increased abundance of antiseptic compounds has selected for S. aureus strains that carry efflux pumps that increase resistance to antiseptic compounds; however, the effect of carrying multiple pumps within S. aureus is unclear. We demonstrated that an isogenic strain carrying multiple efflux pumps had an additive resistance phenotype to cetrimide. Moreover, in a strain carrying qacA and norA, increased chlorhexidine tolerance was observed after the strain was preexposed to subinhibitory concentrations of a different common-use antiseptic. Taken together, our findings demonstrate cooperation between antiseptic resistance efflux pumps and suggest that their protective phenotype may be exacerbated by priming with subinhibitory concentrations of household antiseptics.
In Search of Order: Portrayal of Communists in Cold War Italy

This article analyzes the battle between Italian Communists and anti-Communists during the early Cold War. Without denying the critical role of high politics or the rivalry between Washington and M...
Evaluation in the age of evidence-based policymaking: Promises, pitfalls and paths forward:

Evaluators have long sought a world in which our work makes a tangible difference to society, but that goal has often seemed out of reach. However, in recent years, advocates have proclaimed an era...
Pharmacogenetic factors affecting β-blocker metabolism and response.

β-blockers are among the most widely prescribed of all drugs, used for treatment of a large number of cardiovascular diseases. Herein we evaluate literature pertaining to pharmacogenetics of β-bloc...
Usual Dietary Intake of Resistant Starch in US Adults from NHANES 2015-2016.

Background Resistant starch (RS) confers many health benefits, mostly due to nonenzymatic human digestion and gut microbiota fermentation capacity. The usual intake of naturally occurring dietary RS in US adults is unclear. Objectives This study estimated usual daily RS intake in grams per 1000 kcal in US adults by sex, age, and ethnic group, as well as the most frequent food category contributing to RS intake using data from the NHANES 2015-2016. Methods RS content of foods consumed was matched with Food and Nutrient Database for Dietary Studies food codes. The National Cancer Institute method was used to estimate adults' usual RS intake from 2 24-h dietary recalls. Day 1 RS contribution from food groups to overall RS intake was ranked for the total sample, across age-sex categories, and across ethnic groups. Results In total, 5139 US adults (48.4% male) had a mean daily usual intake of RS of 1.9 ± 0.0 g/(1000 kcal⋅d). Males and females had a similar intake of RS [2.0 ± 0.0 g compared with 1.9 ± 0.0 g/(1000 kcal⋅d)] with no differences between sexes within the same age category. When comparing ethnic groups within each age category, the non-Hispanic white males and females had significantly lower RS intake than all other ethnic groups [range: 1.7-1.8 compared with 2.1-2.3 g RS/(1000 kcal⋅d), respectively], with no differences among the other ethnic groups. French fries and other fried white potatoes, rice, and beans, peas, and legumes were the most frequently consumed food categories contributing to RS intake in all adults. Conclusions US adults should improve the intake of natural RS food sources. Increasing RS intake will improve gastrointestinal health as a prebiotic and potentially increase insulin sensitivity with adequate consumption (e.g., ∼15 g/d).
New self-consistent homogenization for thermo-elastic polycrystals with imperfect interfaces

Abstract This paper presents a new thermo-elastic self-consistent formulation to calculate the thermo-mechanical response of polycrystalline aggregates with imperfect interfaces. The new model is based on an improved treatment of the effect of imperfect interfaces on the micromechanical response of the grains compared to pre-existing models. New expressions/algorithms are derived for the effective elastic and thermal properties, localization relations, and calculation of intragranular field fluctuations. In addition, derivation of a novel integral equation for the strain field in a heterogeneous elastic medium subjected to arbitrary thermal strain field and displacement jumps is presented. The new model is applied to study the effective thermo-elastic properties and average field fluctuations as a function of the interface properties for imperfectly-bonded triaminotrinitrobenzene (TATB) polycrystalline granular aggregates. The proposed formulation is general in the sense that it can be extended to other material systems and deformation regimes that require a proper consideration of the effect of imperfect interface properties on the material's thermo-mechanical response.
The Relationship Between Inclusion, Absenteeism, and Disciplinary Outcomes for Students With Disabilities:

Students with disabilities (SWDs) are more likely to be suspended or expelled than their general education peers and more likely to be chronically absent. This study uses 5 years of student-level d...
Impact of a division-wide bundle on hospital-acquired Clostridioides difficile cases, antibiotic days of therapy, testing appropriateness, and associated financial costs.

Introduction: Updated international guidelines recommend the use of a two-step algorithm (glutamate dehydrogenase [GDH] or nucleic-acid amplification test [NAAT] plus toxin) rather than NAAT alone for the diagnosis of Clostridioides difficile (formerly Clostridium difficile) infections. The goal of our project was to evaluate the impact of a new bundle on the rate of hospital-acquired C. difficile infections (CDIs), hospital-acquired CDI standardized infection ratio (SIR), antibiotic days of therapy (DOT), and financial cost. Materials and Methods: The new bundle was implemented in April 2018. This bundle was implemented across five hospitals in Catholic Health Initiatives (CHI) Texas Division. The bundle included a switch from NAAT to a two-step process (GDH and toxin). We placed the new test in an order panel which included enteric isolation and required indications for C. difficile testing. We used quarterly data pre- and post-intervention to calculate SIR and DOT. Results: In the pre-intervention period, 15.5% of the total 3513 C. difficile NAAT was positive. In the post-intervention period, 5.7% of a total of 2845 GDH and toxin assays was positive for both GDH and toxin (P < 0.0001). SIR, which adjusts for denominator and change in testing methodology, also dropped from 1.02 to 0.43. The estimated cost associated with positive C. difficile cases dropped from 1,932,150 USD to 1,113,800 USD with an estimated yearly cost saving of 794,150 USD. Compliance with enteric isolation improved from 73.1% to 92.5% (P = 0.008). Conclusion: The new testing bundle led to a marked reduction in hospital-acquired CDI and unnecessary treatment, reduction in C. difficile testing, an increase in compliance with enteric isolation, and significant cost savings.
Relationships between patterns of technology-based weight-related self-monitoring and eating disorder behaviors among first year university students.

Abstract Objective To identify patterns of technology-based weight-related self-monitoring (WRSM) and assess associations between identified patterns and eating disorder behaviors among first year university students. Methods First year university students (n = 647) completed a web-based survey to assess their use of technology-based WRSM and eating disorder behaviors. The cross-sectional data were analyzed using gender-stratified latent class analysis to identify patterns of WRSM, followed by logistic regression to calculate the predicted probability of eating disorder behaviors for each pattern of WRSM. Results Technology-based WRSM is common among first year university students, with patterns of WRSM differing by student gender. Further, unique patterns of WRSM were associated with differing probability of engaging in eating disorder behaviors. For example, compared to the 67.0% of females who did not use technology-based WRSM, females engaging in high amounts of technology-based WRSM (33.0%) were more likely to report fasting, skipping meals, excessively exercising, and using supplements. Among males, those who reported all forms of WRSM (9.5%) were more likely to report fasting, skipping meals, purging, and using supplements but those who only used exercise self-monitoring (11.9%) did not have increased likelihood of eating disorder behaviors. Conclusions Using multiple forms of technology-based WRSM is associated with increased likelihood of engaging in eating disorder behaviors among both female and male, first year university students. Assessing technology-based WRSM may be a simple method to screen for elevated eating disorder risk among first year students.
Cooperative Model-Based Reinforcement Learning for Approximate Optimal Tracking

This paper provides an approximate online adaptive solution to the infinite-horizon optimal tracking problem for a set of agents with homogeneous dynamics and common tracking objectives. Model-based reinforcement learning is implemented by simultaneously evaluating the Bellman error (BE) at the state of each agent and on nearby off-trajectory points, as needed, throughout the state space. Each agent will calculate and share their respective on and off-trajectory BE information with a centralized estimator, which computes updates for the approximate solution to the infinite-horizon optimal tracking problem and shares the estimate with the agents. In doing so, the computational burden associated with BE extrapolation is shared between the agents and a centralized updating resource. Edge computing is leveraged to share the computational load between the agents and a centralized resource. Uniformly ultimately bounded tracking of each agent's state to the desired state and convergence of the control policy to the neighborhood of the optimal policy is proven via a Lyapunov-like stability analysis.
Cognitive bias in decision making about development permits for living shorelines: The case of wetlands boards in Virginia localities

Abstract This paper explores the factors impacting permit decisions of citizen wetlands boards in Virginia's localities, specifically identifying any potential sources of cognitive bias in decision making stemming from the use of heuristics and social influences. Semi-structured interviews were conducted of wetlands board chairs and board staff to understand the factors influencing decision making. While technical guidelines are found to affect the decisions of these shoreline regulators, their decisions are not free of heuristics and social influences. Past experiences and processes of compromise and negotiation with property owners are highly valued as part of the permit-approval process. The paper highlights the opportunity for effective citizen engagement in environmental management decisions and the challenges involved.
Commensal Cryptosporidium colonization elicits a cDC1-dependent Th1 response that promotes intestinal homeostasis and limits other infections.

Summary Cryptosporidium can cause severe diarrhea and morbidity, but many infections are asymptomatic. Here, we studied the immune response to a commensal strain of Cryptosporidium tyzzeri (Ct-STL) serendipitously discovered when conventional type 1 dendritic cell (cDC1)-deficient mice developed cryptosporidiosis. Ct-STL was vertically transmitted without negative health effects in wild-type mice. Yet, Ct-STL provoked profound changes in the intestinal immune system, including induction of an IFN-γ-producing Th1 response. TCR sequencing coupled with in vitro and in vivo analysis of common Th1 TCRs revealed that Ct-STL elicited a dominant antigen-specific Th1 response. In contrast, deficiency in cDC1s skewed the Ct-STL CD4 T cell response toward Th17 and regulatory T cells. Although Ct-STL predominantly colonized the small intestine, colon Th1 responses were enhanced and associated with protection against Citrobacter rodentium infection and exacerbation of dextran sodium sulfate and anti-IL10R-triggered colitis. Thus, Ct-STL represents a commensal pathobiont that elicits Th1-mediated intestinal homeostasis that may reflect asymptomatic human Cryptosporidium infection.
Characterizing comprehensiveness of urban forest management plans in Washington State

Abstract Urban forest management plans serve as a municipality's guiding document for management of its urban trees and urban forest. This paper presents results of a content analysis and evaluation of the comprehensiveness of 39 urban forest management plans in Washington State. Comprehensiveness is the degree to which a plan includes a review of the current state of the resource, a vision for the future state, goals and objectives, an action plan for implementation, and a plan for monitoring progress. We also explored whether municipality size, community involvement, plan author, or funding source influence plan comprehensiveness. Plan comprehensiveness varies, and although most plans included the results of a tree inventory, very few conducted a full assessment of the current state of the urban forest. Tree maintenance, tree establishment, and tree protection were addressed most frequently, and many of the plans included a vision statement. The majority of plans included detailed action steps for implementing goals related to tree maintenance and tree establishment, and about a quarter of the plans included an implementation plan. Very few plans addressed monitoring and adaptive management, and no plan included a detailed strategy for monitoring the implementation of the plan. Larger municipalities tend to have more comprehensive plans, and community involvement in the plan development process appears to positively influence the overall comprehensiveness score. No relationship was found between plan author or receipt of grant funding and plan comprehensiveness. Our approach for evaluating plan comprehensiveness suggests a useful framework for future plan development, revision, and evaluation.
Concrete Hilbert Spaces

In this chapter we consider an infinite-dimensional generalization of Euclidean space introduced by the mathematician David Hilbert. This generalization preserves two fundamental geometric notions of Euclidean space— namely, distance and perpendicularity. Both of these geometric properties depend on the existence of an inner product. In the infinite-dimensional case, however, we take the inner product of functions rather than of vectors. Our emphasis here will be on concrete examples of Hilbert spaces relevant to statistics. To keep our discussion within bounds, some theoretical facts are stated without proof. Relevant proofs can be found in almost any book on real or functional analysis [6, 12]. Applications of our examples to numerical integration, wavelets, and other topics appear in later chapters.
An Examination of Demographic Variables Associated with Ethical Behaviors and Perceptions of Retailers

This study investigates the association of certain demographic variables with measures of ethical behavior and perceptions. Retailers from two states were asked to respond to ethical dilemmas posed in three scenarios. To these responses, demographic variables of sex, age, education, religious attendance, and two measures of business size (sales and square footage) were examined. Results indicate a consistent association for all questions in all scenarios between age and ethical behaviors/perceptions.
A Feminist Examination of Studies into Student Evaluations of Teaching: Moving Our Voices to the Center

This paper will explore the impact of gender on student evaluations of teaching and their study. Feminist studies into student evaluations of teaching have shown that there are biases at work in the evaluation process, which, though inevitable, if not acknowledged or accounted for can have a negative impact on women in the academy. In spite of this important feminist research, many other, more traditional researchers claim that there are no biases affecting the evaluations. Thus, feminist researchers must not only continue their investigation of the ways gender-based biases affect evaluations, but they must be rhetorical in making themselves heard by administrators and educators, so that postsecondary institutions can take the lead in illuminating potentially hegemonic practices and fight the oppression that results from them.
Impaired vascular-mediated clearance of brain amyloid beta in Alzheimer's disease: The role, regulation and restoration of LRP1

Amyloid beta (Aβ) homeostasis in the brain is governed by its production and clearance mechanisms. An imbalance in this homeostasis results in pathological accumulations of cerebral Aβ, a characteristic of Alzheimer’s disease (AD). While Aβ may be cleared by several physiological mechanisms, a major route of Aβ clearance is the vascular-mediated removal of Aβ from the brain across the blood-brain barrier (BBB). Here, we discuss the role of the predominant Aβ clearance protein—low-density lipoprotein receptor-related protein 1 (LRP1)—in the efflux of Aβ from the brain. We also outline the multiple factors that influence the function of LRP1-mediated Aβ clearance, such as its expression, shedding, structural modification and transcriptional regulation by other genes. Finally, we summarize approaches aimed at restoring LRP1-mediated Aβ clearance from the brain.
Nicotine withdrawal and stress-induced changes in pain sensitivity: a cross-sectional investigation between abstinent smokers and nonsmokers.

Chronic smoking has been linked with alterations in endogenous pain regulation. These alterations may be pronounced when individuals quit smoking because nicotine withdrawal produces a variety of psychological and physiological symptoms. Smokers interested in quitting (n = 98) and nonsmokers (n = 37) completed a laboratory session including cold pressor test (CPT) and heat thermal pain. Smokers set a quit date and completed the session after 48 h of abstinence. Participants completed the pain assessments once after rest and once after stress. Cardiovascular and nicotine withdrawal measures were collected. Smokers showed blunted cardiovascular responses to stress relative to nonsmokers. Only nonsmokers had greater pain tolerance to CPT after stress than after rest. Lower systolic blood pressure was related to lower pain tolerance. These findings suggest that smoking withdrawal is associated with blunted stress response and increased pain sensitivity.
Binding of 3H-labeled benzo(a)pyrene to DNA in hamster tracheal epithelial cells.

Summary Isolated tracheas were incubated in vitro in the presence of tritiated benzo[ a ]pyrene. Highly purified DNA was isolated from the epithelial cells of these tracheas and was found to contain bound BP- 3 H. If tracheas were obtained from hamsters previously treated intratracheally with benzo[α]pyrene plus Fe 2 O 3 , this binding was enhanced. Incubation of tracheas in the presence of 7, 8-benzoflavone or at a temperature of 0° resulted in inhibition of this enhanced binding. These results suggest that the tracheal epithelium is able to metabolize benzo[α]pyrene and that this metabolism is necessary for the inducible binding of benzo[α]pyrene to DNA in this tissue.
Preventing dengue and chikungunya fever among international travelers

Purpose To describe the vulnerability of U.S. travelers in tropical and subtropical regions of the world to dengue and chikungunya fever, to provide practical recommendations to avoid these mosquito-borne diseases, and to offer a communication tool as an aid for pretravel health consultations. Data sources Medical, epidemiological, and entomological research articles and reviews, and reports from government agencies. Conclusions Dengue and chikungunya fever have growing public health impact around the world. International travelers return to the United States infected with these diseases. Mosquito bite avoidance is the only way to prevent dengue and chikungunya fever. Informed travelers have many options for simple and practical measures to lessen the risk of mosquito bites. A message map can be used as a communication tool for pretravel counseling on the prevention of dengue and chikungunya fever within the time frame of an office visit. Implications for practice In a pretravel health consultation, a nurse practitioner can promote travelers’ health and prevent dengue, chikungunya fever, and other mosquito-borne diseases by counseling on the risk of these diseases and giving practical recommendations for prevention using a message map.
Default α -Logic for Modeling Customizable Failure Semantics in Workflow Systems Using Dynamic Reconfiguration Constraints

In this paper, we propose a logic based framework to handle failures that occur during the execution of workflows by encoding the failures in formalism of a default normal modal logic. Default logic provides a set of rules for adding premises to logical arguments. Since the specifications of services are encoded in α-logic, defaults can be added to this logic to accommodate the failure semantics for the predicates. We encode predicate failures as predicates and provide a dynamic proof system that handles failures at the execution time. Workflow adaptations are re-synthesized from proofs in our logic using a Curry-Howard style correspondence.
Anomalous diffusion in the presence of external forces: Exact time-dependent solutions and their thermostatistical basis

Driven anomalous diffusions (such as those occurring in some surface growths) are currently described through the nonlinear Fokker-Planck-like equation $(\frac{\ensuremath{\partial}}{\ensuremath{\partial}t}){p}^{\ensuremath{\mu}}=\ensuremath{-}(\frac{\ensuremath{\partial}}{\ensuremath{\partial}x})[F(x){p}^{\ensuremath{\mu}}]+D(\frac{{\ensuremath{\partial}}^{2}}{\ensuremath{\partial}{x}^{2}}){p}^{\ensuremath{\nu}}$ [$(\ensuremath{\mu}, \ensuremath{\nu})\ensuremath{\in}{\mathcal{R}}^{2}$; $F(x)={k}_{1}\ensuremath{-}{k}_{2}x$ is the external force; ${k}_{2}g~0$]. We exhibit here the (physically relevant) exact solution for all $(x, t)$. This solution was found through an ansatz based on the generalized entropic form ${S}_{q}[p]=\frac{{1\ensuremath{-}\ensuremath{\int}\mathrm{du}{[p(u)]}^{q}}}{(q\ensuremath{-}1)}$ (with $q\ensuremath{\in}\mathcal{R}$), in a completely analogous manner through which the usual entropy ${S}_{1}[p]=\ensuremath{-}\ensuremath{\int}\mathrm{dup}(u)\mathrm{ln}p(u)$ is known to provide the correct ansatz for exactly solving the standard Fokker-Planck equation ($\ensuremath{\mu}=\ensuremath{\nu}=1$). This remarkably simple unification of normal diffusion ($q=1$), superdiffusion ($qg1$) and subdiffusion ($ql1$) occurs with $q=1+\ensuremath{\mu}\ensuremath{-}\ensuremath{\nu}$.
Mechanical Esophageal Displacement During Catheter Ablation for Atrial Fibrillation

Esophageal Deviation in AF Ablation. Objective: To determine the feasibility and safety of esophageal displacement during atrial fibrillation (AF) ablation, to prevent thermal injury. Background: Patients undergoing AF ablation are at risk of esophageal thermal injury, which ranges from superficial ulceration, to gastroparesis, to the rare but catastrophic atrioesophageal fistula. A common approach to avoid damage is luminal esophageal temperature (LET) monitoring; however, (1) temperature rises mandate interruptions in energy delivery that interrupt workflow and potentially decrease procedural efficacy, and (2) esophageal fistulas have been reported even with LET monitoring. Methods: A cohort of 20 consecutive patients undergoing radiofrequency (RF) (16 patients) or laser balloon (4 patients) ablation of AF under general anesthesia. After barium instillation, the esophagus was deviated using an endotracheal stylet placed within a thoracic chest tube. LET monitoring was used during catheter ablation. Upper GI endoscopy was performed prior to discharge. Results: At the pulmonary vein level, leftward deviation measured 2.8 ± 1.6 cm (range: 0.4–5.7) and rightward deviation 2.8 ± 1.8 cm (range: 0.5–4.9). The temperature rose to >38.5 °C in 3/20 (15%) patients. In these 3 patients, there was an average of 2 applications/patient that recorded temperatures >38.5 °C. No patient had a temperature rise > 40 °C. Endoscopy revealed no esophageal ulceration from thermal injury in 18/19 (95%) patients; the sole patient with a thermally mediated ulceration had an unusual esophageal diverticulum fully across the posterior left atrium. Twelve patients (63%) exhibited trauma related to instrumentation with no clinical sequelae. Conclusions: Mechanical esophageal deviation is feasible and allows for uninterrupted energy delivery along the posterior wall during catheter ablation of AF. J Cardiovasc Electrophysiol, Vol. 23, pp. 147-154, February 2012)
Effect of the metal on metal/polymer contacts

Thermally stimulated currents (TSC) of ionomer/polyethylene blends were investigated. Experimental results obtained for aluminum, indium, lead, pressed gold, and evaporated gold electrodes are reported. The peak temperature and peak current observed for the high-temperature alpha peak was found to vary approximately linearly with the literature value of the work function of the metal. This is ascribed to differences in the ease of electron injection and its microscopic reverse. The lower temperature beta peaks showed differences with different electrode metals. Positive beta peaks were observed using lead electrodes whereas the gold electrodes always produced negative beta peaks. With aluminum electrodes, homopolymers showed negative beta peaks. Variables such as the partial oxidation of the metal and possible morphologic changes of the polymeric sample during the electrode evaporation were considered. After examining the effect on TSC of the various metal electrodes, evaporated gold was chosen as the best electrode for material TSC studies. >
TIP47: A Cargo Selection Device for Mannose 6-Phosphate Receptor Trafficking

Mannose 6-phosphate receptors (MPRs) transport newly synthesized lysosomal hydrolases from the Golgi to prelysosomes and then return to the Golgi for another round of transport. We have identified a 47 kDa protein (TIP47) that binds selectively to the cytoplasmic domains of cation-independent and cation-dependent MPRs. TIP47 is present in cytosol and on endosomes and is required for MPR transport from endosomes to the trans-Golgi network in vitro and in vivo. TIP47 recognizes a phenylalanine/tryptophan signal in the tail of the cation-dependent MPR that is essential for its proper sorting within the endosomal pathway. These data suggest that TIP47 binds MPR cytoplasmic domains and facilitates their collection into transport vesicles destined for the Golgi.
Pyridine nucleotides in the thyroid. V. An artifactual effect of thyroid stimulating hormone in thyroid homogenate.

The factors which influence the oxidation of 6-phosphogluconate-I-14C by thyroid homogenate have been investigated. In a system in which 14CO2 production was not increased by addition of 6-phosphogluconic dehydrogenase, augmented oxidation was observed when ATP and DPN were added, consistent with the presence of DPN kinase activity and generation of TPN. With constant amounts of ATP and DPN, the addition of increasing quantities of partially purified liver DPN kinase was associated with greater 14CO2 production. Two “crude” preparations of TSH increased decarboxylation of 6-phosphogluconate- 1-14C in thyroid homogenate both with and without added ATP and DPN, but this effect could not be reproduced using more purified preparations of TSH. Furthermore, it was not specific, since the “crude” TSH also stimulated 14CO2 production using rat testis homogenate. Despite this difference between the “crude” and more purified TSH using thyroid homogenates, both hormones equally increased glucose oxidation and TPN le...
Cause and consequence in public policy theory: Ethnic policy and system transformation in Malaysia

Considering public policy as both a dependent and an independent variable, this article undertakes a systematic assessment of the sources and systemic consequences of policy. It begins with a statement of contrasting theories of the sources of policy. One strand of comparative theory emphasizes national cultures and elite beliefs as the main sources of policy; another stresses the cross-national imperatives of particular policy programs, of international diffusion, and of common policy processes. Drawing on longitudinal data on an array of ethnic policies in Malaysia, the study highlights the limits of cultural-determinist theories of policy. It shows that elite beliefs change over time, often creating layers of policy based on varying premises; that one set of beliefs can overcome another, inconsistent set; that critical events can alter the balance of authoritative beliefs; and that, where beliefs are in conflict, organized interests have room for maneuver. Moreover, the interaction of a mix of operative beliefs can produce outcomes very much at variance with what policymakers wish or anticipate. Finally, on the systemic effects of policy, the study shows that interests created by earlier policy can be decisive actors in the shaping of later policy. Policy itself can change the entire structure of the political system - an outcome rather clearly demonstrated in the case of Malaysia.
A Comparison of Pulmonary Function Tests for Postthoracotomy Pain Using Cryoanalgesia and Transcutaneous Nerve Stimulation

The beneficial effects of transcutaneous nerve stimulation (TNS) and cryoanalgesia for post-thoracotomy pain were compared against each other and against a control group through pulmonary function testing in the immediate and delayed postoperative period. Patients receiving cryoanalgesia did not perform well in the first 24 hours after operation. However, by the fifth postoperative day, they did as well as or even better than the TNS patients. Both cryoanalgesia and TNS were significantly effective in the management of postoperative pain as compared with controls.
High Sensitivity Silicon Slit Detectors for 1 nm Powder XRD Size Detection Limit

The limit of conventional X-ray powder diffraction for the detection of supported nanoparticles is usually taken to be 2–2.5 nm, at which size low signal to noise ratios make detection of particles of low weight loading and small particle size difficult. State of the art silicon strip detectors, however, are 2 orders of magnitude more sensitive than scintillation counters, and the greatly improved signal to noise ratio obtained in typical powder XRD scan times (tens of minutes to several hours) allows for the detection of much smaller nanoparticles than was previously possible. In this paper we demonstrate the use of a Si slit detector to characterize Au particles supported on carbon at sizes as small as 1.2 nm and weight loading as low as 0.33 %. At elevated scan speeds good corroboration between STEM and XRD is maintained. Thus, the latest generation XRD detector allows quick and simple access to the behaviorally rich 1–2 nm particle size range.
Conformational energy gaps and scaling of conformer density in chain molecules

Abstract We propose three reasons for the simplicity of vibrationally resolved electronic spectra of complex chain molecules: vibr(onic) state localization, insensitivity of chromophores to conformational changes outside the chromophore, and an ‘energy gap law’ for low-lying conformers. Here we use alkanals as simple models of chain molecules to study the third proposal. A disconnectivity tree and scaling analysis reveals an energy gap creating just two ‘special’ conformational minima in the torsional energy landscape of alkanals. We also derive a simple scaling formula to connect the energy spanned by all torsional minima in the alkanal energy landscape with molecular size.
Regionalism: Old and New

This review of recent literature on political, economic, and cultural regionalism shows that this area of inquiry has become increasingly fragmented not only as a result of debates between the protagonists of methodological approaches but also because of underlying changes in international relations. Traditional views concerning the state-centric regional system are being challenged by the concentration of political and military power at the top as well as by transnational networks built around economic ties and cultural identities. Early post-Cold War expectations that regions and regional concerts would form the foundation for a new international order have proven untenable. Instead, regions appear to arise either through the dissemination of various transactions and externalities or as protection against the hegemony of capitalist globalization and great-power politics. Older conceptions of regionalism need to be redefined and reintegrated into current international relations theories.
The effect of anoxemia and oxygen therapy upon the flow of bile and urine in the nembutalized dog: II. Its possible relationship to the hepatorenal syndrome

1. Inhalation of 15 per cent oxygen in nitrogen for 30 to 45 minutes resulted in a 16 to 50 per cent decrease in the flow of bile below normal and a 13 to 69 per cent decrease in the flow of urine below normal in 10 nembutalized dogs. 2. Inhalation of mixtures of 10 and 5 per cent oxygen with nitrogen caused a further decrease in the flow of bile and urine. Acholia developed in 2 dogs and anuria in 5 dogs. 3. The inhalation of 100 per cent oxygen for 30 to 45 minutes after the anoxemia resulted in an increase in the flow of bile and urine above that observed during the anoxemia. In 3 dogs the flow was increased above the normal control level. 4. Mild anoxemia may be a predisposing factor in the hepatorenal syndrome of intestinal obstruction, hyperthyroidism and burns. The moderate inhibition of liver and kidney function may make these organs more susceptible to other injurious agents. 5. Severe anoxemia may be a direct causative factor because it produces a severe impairment of liver and kidney function and in some instances it may produce an acholia and anuria.
12. Brachial neuritis presenting as median thenar branch palsy

Brachial neuritis typically involves proximal upper limb muscles but can affect any part of the brachial plexus or its branches. We present a case of isolated median thenar branch palsy due to brachial neuritis. The patient presented with painless thumb weakness without sensory loss. Nerve conduction studies showed severe distal median nerve motor dysfunction with active and chronic denervation of abductor pollicis brevis and opponens pollicis on electromyography. The remainder of the study was normal. Motor and somatosensory evoked potentials ruled out a proximal lesion. Magnetic resonance imaging did not reveal a compressive aetiology. Clinical and electrophysiologic improvement occurred over the next year with no intervention.