cssi/SciSciGPT-SciSciNet huggingface dataset:
Respiratory syncytial virus outbreak on an adult stem cell transplant unit.

Background An increase in respiratory syncytial virus type B (RSV-B) infections was detected on an adult hematology/oncology and stem cell transplant unit during March 2015. This prompted an outbreak investigation. Methods Nosocomial cases were defined as RSV-B–positive patients who developed respiratory virus symptoms ≥ 7 days after admission to the unit or were readmitted with symptoms ≤ 7 days since last discharge from the unit. Strict outbreak control measures were implemented to stop the outbreak. Results During the outbreak, 19 cases of RSV-B were detected, 14 among patients and 5 among health care workers (HCWs). Additionally, 2 HCWs tested positive for respiratory syncytial virus type A and 1 tested positive for influenza B among the 27 symptomatic HCWs evaluated. No specific antiviral therapy was given and all cases recovered without progression to lower respiratory tract infection. After no new cases were identified for 2 weeks, the outbreak was declared over. Conclusions High vigilance for respiratory viruses on high-risk inpatient units is required for detection and prevention of potential outbreaks. Multiple respiratory viruses with outbreak potential were identified among HCWs. HCWs with respiratory virus symptoms should not provide direct patient care. Absence of lower respiratory tract infection suggests lower virulence of RSV-B, compared with respiratory syncytial virus type A, among immunocompromised adults.
E‐cigarette Policymaking by Local and State Governments: 2009‐2014

Policy Points: E-cigarettes are new products that are generating policy issues, including youth access and smokefree laws, for local and state governments. Unlike with analogous debates on conventional cigarettes, initial opposition came from e-cigarette users and retailers independent of the multinational cigarette companies. After the cigarette companies entered the e-cigarette market, the opposition changed to resemble long-standing industry resistance to tobacco control policies, including campaign contributions, lobbying, and working through third parties and front groups. As with earlier efforts to restrict tobacco products, health advocates have had the most success at the local rather than the state level. Context E-cigarettes entered the US market in 2007 without federal regulation. In 2009, local and state policymakers began identifying ways to regulate their sale, public usage, taxation, and marketing, often by integrating them into existing tobacco control laws. Methods We reviewed legislative hearings, newspaper articles, financial disclosure reports, NewsBank, Google, Twitter, and Facebook and conducted interviews to analyze e-cigarette policy debates between 2009 and 2014 in 4 cities and the corresponding states. Findings Initial opposition to local and state legislation came from e-cigarette users and retailers independent of the large multinational cigarette companies. After cigarette companies entered the e-cigarette market, e-cigarette policy debates increasingly resembled comparable tobacco control debates from the 1970s through the 1990s, including pushing pro-industry legislation, working through third parties and front groups, mobilizing “grassroots” networks, lobbying and using campaign contributions, and claiming that policy was unnecessary due to “imminent” federal regulation. Similar to the 1980s, when the voluntary health organizations were slow to enter tobacco control debates, because they saw smoking restrictions as controversial, these organizations were reluctant to enter e-cigarette debates. Strong legislation passed at the local level because of the committed efforts of local health departments and leadership from experienced politicians but failed at the state level due to intense cigarette company lobbying without countervailing pressure from the voluntary health organizations. Conclusions Passing e-cigarette regulations at the state level has become more difficult since cigarette companies have entered the market. While state legislation is possible, as with earlier tobacco control policymaking, local governments remain a viable option for overcoming cigarette company interference in the policymaking process.
Expanding anchored hybrid enrichment to resolve both deep and shallow relationships within the spider tree of life

Despite considerable effort, progress in spider molecular systematics has lagged behind many other comparable arthropod groups, thereby hindering family-level resolution, classification, and testing of important macroevolutionary hypotheses. Recently, alternative targeted sequence capture techniques have provided molecular systematics a powerful tool for resolving relationships across the Tree of Life. One of these approaches, Anchored Hybrid Enrichment (AHE), is designed to recover hundreds of unique orthologous loci from across the genome, for resolving both shallow and deep-scale evolutionary relationships within non-model systems. Herein we present a modification of the AHE approach that expands its use for application in spiders, with a particular emphasis on the infraorder Mygalomorphae. Our aim was to design a set of probes that effectively capture loci informative at a diversity of phylogenetic timescales. Following identification of putative arthropod-wide loci, we utilized homologous transcriptome sequences from 17 species across all spiders to identify exon boundaries. Conserved regions with variable flanking regions were then sought across the tick genome, three published araneomorph spider genomes, and raw genomic reads of two mygalomorph taxa. Following development of the 585 target loci in the Spider Probe Kit, we applied AHE across three taxonomic depths to evaluate performance: deep-level spider family relationships (33 taxa, 327 loci); family and generic relationships within the mygalomorph family Euctenizidae (25 taxa, 403 loci); and species relationships in the North American tarantula genus Aphonopelma (83 taxa, 581 loci). At the deepest level, all three major spider lineages (the Mesothelae, Mygalomorphae, and Araneomorphae) were supported with high bootstrap support. Strong support was also found throughout the Euctenizidae, including generic relationships within the family and species relationships within the genus Aptostichus. As in the Euctenizidae, virtually identical topologies were inferred with high support throughout Aphonopelma. The Spider Probe Kit, the first implementation of AHE methodology in Class Arachnida, holds great promise for gathering the types and quantities of molecular data needed to accelerate an understanding of the spider Tree of Life by providing a mechanism whereby different researchers can confidently and effectively use the same loci for independent projects, yet allowing synthesis of data across independent research groups.
Impact of value based breast cancer care pathway implementation on pre-operative breast magnetic resonance imaging utilization.

Background: Bilateral breast magnetic resonance imaging (MRI) is commonly used in the diagnostic workup of breast cancer (BC) to assess extent of disease and identify occult foci of disease. However, evidence for routine use of pre-operative MRI is lacking. Breast MRI is costly and can lead to unnecessary tests and treatment delays. Clinical care pathways (care paths) are value-based guidelines, which define management recommendations derived by expert consensus and available evidence based data. At Cleveland Clinic, care paths created for newly diagnosed BC patients recommend selective use of pre-operative MRI. We evaluated the number of pre-operative MRIs ordered before and after implementing an institution wide BC care paths in April 2014. Methods: A retrospective review was conducted of BC cases during the years 2012, 2014, and part of 2015. Patient, tumor and treatment characteristics were collected. Pre-operative MRI utilization was compared before and after care path implementation. Results: We identified 1,515 BC patients during the study period. Patients were more likely to undergo pre-operative MRI in 2012 than 2014 (OR: 2.77; P Conclusions: Implementation of online BC care paths at our institution was associated with a decreased use of pre-operative MRI overall and in patients without a BC care path indication, driving value based care through the reduction of pre-operative breast MRIs.
Zika Virus and Transgenic Mosquitoes: Potentials of a Public Health Tool

With transgenic mosquitoes now being deployed as a major solution to the pandemic Zika virus disease, more curious questions have arisen about this public health technology. This essay reviews the philosophical considerations that presaged the development, by WHO, of the genetically modified mosquitoes. It focuses more specifically on the inter-disciplinary approach in formulating the clinical trials process. While it is still early to determine the full merits of this health intervention tool, it is nonetheless timely to examine the rich vein of form that constitutes the clinical trial protocol. I argue that the steps it suggests should be a gold standard for all clinical trial procedures including those that use human subjects and those with both direct and indirect environmental implications. Also, the early signs portend that its application could indeed be widespread. For instance, malaria and dengue fever were the original targets, but now the development of transgenic mosquito technology is deemed a potent option in the fight against Zika virus disease. In addition, this clinical trial protocol has remarkably gone beyond the four pillars of principlism to recognize the possibility that a new technology (such as GMM), can have the potential to simultaneously impact human individuals, the community and the ecosystem in tandem. In “Guidance framework for testing of genetically modified mosquito,” the WHO has set an example that calls for emulation. With the right awareness, biomedical researchers, scholars, policy makers, and students stand to benefit immensely from this reformulated approach.
Semi-Supervised Biomedical Translation With Cycle Wasserstein Regression GANs.

The biomedical field offers many learning tasks that share unique challenges: large amounts of unpaired data, and a high cost to generate labels. In this work, we develop a method to address these issues with semi-supervised learning in regression tasks (e.g., translation from source to target). Our model uses adversarial signals to learn from unpaired datapoints, and imposes a cycle-loss reconstruction error penalty to regularize mappings in either direction against one another. We first evaluate our method on synthetic experiments, demonstrating two primary advantages of the system: 1) distribution matching via the adversarial loss and 2) regularization towards invertible mappings via the cycle loss. We then show a regularization effect and improved performance when paired data is supplemented by additional unpaired data on two real biomedical regression tasks: estimating the physiological effect of medical treatments, and extrapolating gene expression (transcriptomics) signals. Our proposed technique is a promising initial step towards more robust use of adversarial signals in semi-supervised regression, and could be useful for other tasks (e.g., causal inference or modality translation) in the biomedical field.
Staying True in Nepal: Understanding Community Mediation Through Action Research

This chapter focuses on a community mediation initiative in Nepal that employed participatory action research as the mode for understanding practice and the development of relevant training materials for local use. The approach permitted a better understanding of mediation at local levels that helped improve program strategies and mediator preparation.
Gender Identity, Leisure Identity, and Leisure Participation

We adapted identity theory to explore relationships between gender identity, leisure identity, and leisure participation. Based upon the premise of identity theory, we hypothesized that the intensity of participation in recreational golf would be predicted by their gender identity (masculine/feminine) and leisure-related identity of “golfer.” Our analyses explored these relationships among men and women golfers. Our data offered partial support for our hypothesized model. For men, masculine identity had both direct and indirect effects on golf participationpartially mediated by “golfer” identity. Alternately, for women, masculine identity indirectly influenced leisure participation, also mediated by “golfer” identity. These findings provide insight on the utility of identity theory for understanding leisure behavior, in general, and the influence of gender on leisure, in particular.
Pomegranate-Derived Constituents as Inducers of Cell Death: Implications in Cancer Prevention and Therapy

Cancer chemoprevention, the process of administrating agents which inhibit, delay or reverse the process of carcinogenesis, represents one of the most novel and promising approaches in cancer research. Significant epidemiological evidence suggests an association between increased consumption of fruits, vegetables and spices with a reduced risk of cancer. Bioactive components present in fruits and vegetables, especially polyphenolic flavonoids such as anthocyanins and catechins, show antioxidant, anti-inflammatory and pro-apoptotic effects which afford chemopreventive properties. Pomegranate, obtained from the tree Punica granatum has been suggested as an excellent chemopreventive dietary agent. The pomegranate tree, especially the fruit has been a part of medical and religious folklore for centuries. Pomegranates are an extremely rich source of several complex polyphenolic flavonoids such as anthocyanins, hydrolyzable tannins such as punicalin and ellagic acid as well as fatty acids such as punicic acid. Pomegranate phytochemicals have been shown to demonstrate potent anti-tumor promoting effects due to its antioxidant, anti-inflammatory and apoptosis-inducing properties. Apoptosis, programmed cell death, is one of the most important cancer arresting mechanisms and an important target for chemopreventive strategy. Several studies provide evidence highlighting the pro-apoptotic effects of both the polyphenolic and non-polyphenolic bioactive components of pomegranate. This chapter reviews, in detail, the pro-apoptotic and anti-tumor effects of pomegranate-derived constituents in both in vivo as well as in vitro studies in pre-clinical models of breast, colon, hematological, skin and prostate cancer. The role of synergy, highlighting the importance of poly-constituent pomegranate extracts, bioavailability studies as well as the critical need for clinical studies are discussed.
SELENIUM, IODINE, AND THE THYROID

The demonstration that selenium is an integral component of the enzyme glutathione peroxidase led to the understanding of many of the effects of this trace element as an antioxidant. Although glutathione peroxidase was the first selenoprotein described in mammals, in vivo labeling with 75selenium demonstrated that most rat tissues have 11 to 13 selenium-containing proteins2. The relationship between selenium and thyroid hormones remained quite anecdotal until 1987, when two independent investigators reported an association between selenium deficiency and impaired thyroid hormone metabolism. In rats fed a selenium-deficient diet for 5 weeks, Beckett et al3 found a 38% increase in serum T4 concentrations and a marked decrease in liver T3 production from T4. In humans, in an iodine-deficient area in the Eastern part of Zaire, Goyens et al4 observed that decreased serum selenium concentrations were associated with an increased incidence of the myxedematous form of cretinism, characteristic of the African endemia. We will review how selenium deficiency influences thyroid hormone metabolism and what is the proposed role of selenium deficiency in the pathogenesis of endemic goiter and cretinism. The geographical distribution of serum selenium concentrations in European populations will also be described.
Growth and characterization of detector-grade CdMnTe by the vertical Bridgman technique

We grew Cd1-xMnxTe crystals with a nominal Mn concentration of 5% by the vertical Bridgman growth technique. The compositional variation along the length of the grown ingot was studied by powder X-ray diffraction. The composition was found to be uniform along the growth direction. The achieved resistivity was 1-2.5 x1010 ohm-cm with a mobility-lifetime (μτ) product value for electrons of ∼1.7x10-3 cm2/V. An energy resolution of ∼7.5% at 662 keV was achieved for a 9-mm long Frisch grid detector fabricated from an ingot grown using as-received starting materials.
Open Access Colonoscopy for Colorectal Cancer Prevention: An Evaluation of Appropriateness and Quality.

Open access colonoscopy (OAC) has gained widespread acceptance and has the potential to increase colorectal cancer (CRC) screening. However, there is little data evaluating its appropriateness for CRC prevention. The aim of this study is to evaluate the appropriateness of OAC in CRC screening and polyp surveillance by comparing to procedures ordered by gastroenterologists (NOAC). As secondary outcomes, we compared the quality of bowel preparation and adenoma detection rate (ADR) between OAC and NOAC. It is retrospective single-center study. Inclusion criteria included patients > 50 years of age undergoing a colonoscopy for CRC screening and surveillance. Appropriateness was defined as those colonoscopies performed within 12 months of the recommended 2012 consensus guidelines. Secondary outcomes included the quality of bowel preparation and ADR. 5211 colonoscopies met inclusion criteria, and 64.9% were OAC. Screening OAC was appropriately 91.6% and NOAC 92.9% of the time (p = 0.179). Surveillance NOAC were inappropriate in 26.4% of cases, and surveillance OAC was 32.6% (p = 0.008). Multivariate analysis demonstrated that OAC did not influence ADR (OR for NOAC 0.97; 95% CI 0.86–1.1; p = 0.644) or an adequate bowel preparation (OR for NOAC 1.11; 95% CI 0.91–1.36; p = 0.306). OAC performed similarly to NOAC for screening indications, quality of bowel preparation, and ADR. However, more surveillance procedures were inappropriate in the OAC group although both groups had a high number of inappropriate indications. Although OAC can be efficiently performed for screening indications, measures to decrease inappropriate surveillance colonoscopies are needed.
Oral flora meningoencephalitis diagnosis by next-generation DNA sequencing.

Introduction Standard culture methods may fail to detect the causative agents of bacterial infection for various reasons including specimen collection after antibiotic administration, or when standard techniques or environmental conditions are not appropriate for growth of the microorganisms. Conventional 16S rRNA gene sequencing is sometimes a useful alternative technique for identification of bacteria, but is confounded by polymicrobial infection. We present a case of a patient who developed a serious neurological infection for which causative oral flora organisms were observed by microscopy, failed to culture but were identified by next-generation DNA sequencing. Case presentation A male in his forties developed sinus pain and congestion, followed by facial and eye pain, and several weeks later acute-onset confusion and neck stiffness. Cerebrospinal fluid examination revealed pleocytosis and several bacterial morphologies, which were subsequently identified by next-generation sequencing as oral flora constituents Porphyromonas endodontalis , Fusobacterium nucleatum , Streptococcus constellatus , Prevotella species and Parvimonas micra . Conclusion Oral flora can cause meningoencephalitis and brain abscess formation if translocation occurs by injury or surgical procedures. Next-generation sequencing is often not available at healthcare facilities, or when available may not have been validated for a wide spectrum of specimen sources, but is available at reference laboratories and should be considered when routine methods fail to provide a diagnosis for serious infections.
Control of Salmonella in chicken meat using a combination of a commercial bacteriophage and plant-based essential oils

Abstract Salmonella contamination in broiler carcasses poses significant health concerns. The objectives of this study were to evaluate the antimicrobial activity of 10 essential oil compounds and to determine the combined effects with a commercial bacteriophage (SALMONELEX) against Salmonella. Thymol and carvacrol were the most active compounds tested, with a minimum inhibitory concentration (MIC) of 0.25–1 mg/ml and a minimum bactericidal concentration (MBC) of 0.5–1 mg/ml against three Salmonella strains. Multiplicity of infection (MOI), or bacteriophage/pathogen ratio (PFU/CFU), significantly affected bacteriophage efficacy in media and in chicken products. The bacteriophage decreased Salmonella Typhimurium JWC-3001 by 5 log CFU/ml at low MOI (≥1.7) in tryptic soy broth, but a higher bacteriophage concentration was needed to exhibit bactericidal effect in chicken products. Dipping of inoculated chicken in 1.6% (w/v) thymol and carvacrol emulsions for 3 min inactivated 1.3 and 1.6 log CFU/g, respectively, of a cocktail of three Salmonella strains. A sequential dipping treatment of inoculated chicken in bacteriophage (1.1 × 108 PFU/ml) for 3 min and in 1.6% (w/v) thymol or carvacrol for 3 min resulted in reductions of 1.9–2.0 log CFU/g of the cocktail. The combined treatments resulted in significantly greater reduction of Salmonella than individual bacteriophage or essential oil treatments.
Emergency Department Stopping Elderly Accidents, Deaths and Injuries (ED STEADI) Program.

Abstract Background Falls are among the leading cause of emergency department (ED) visits. Objective We set out to determine whether using a bedside decision aid could decrease falls. Methods This randomized controlled trial was conducted on those aged ≥ 65 years who were being discharged home and screened positive for a Centers for Disease Control and Prevention (CDC) fall risk factor. Control-arm subjects were given a CDC brochure about falls. The active-arm subjects received a personalized decision aid intervention. Both groups were followed up via telephone. Results A total of 200 subjects were enrolled and, after exclusions, 184 patients were analyzed. There were 76 male (41.3%) and 108 female (58.7%) subjects; 14% of the subjects chose to have their medications reviewed, 13.6% chose to have an eye examination, 22.8% chose to begin an exercise program, and the majority (44.6%) chose to have a home safety evaluation. Patients in the intervention arm chose more interventions to complete compared to control-arm subjects (p Conclusions Overall, in this study, subjects who had their fall-risk interventions facilitated by a decision tool chose to participate in interventions more than control subjects. However, they did not complete the interventions or fall less often than their counterparts in the control arm. Future study is needed to determine the effect of CDC screening guidelines and interventions facilitated by a decision aid on fall outcomes and their application in the ED population.
Components of normal human sleep

Abstract Sleep, a modifiable health behavior and an essential physiologic state, is a fundamental human need for overall health and survival. Sleep health has emerged as a broad concept to refer to healthy sleep. Sleep health involves several measurable dimensions including satisfaction, alertness, timing, efficiency, and duration. Sleep disorders and sleep deficiency (short sleep duration or poor sleep quality) are highly prevalent. Sleep disorders are often undiagnosed and untreated, which creates a public health burden. Epidemiologic research has shown that insufficient sleep and sleep disorders are associated with a host of adverse physical and mental health outcomes as well as mortality. Also, sleep deficiency can result in excessive daytime sleepiness, which can cause occupational as well as motor vehicle injuries. There are serious consequences of sleep deficiency; thus there is an immediate public health need to advance the field of sleep health and safety and train public health professionals in sleep health promotion. In this chapter we will discuss the components of normal human sleep. We begin the chapter with a brief discussion of the public health importance of sleep, followed by a description of sleep architecture and wake–sleep regulation.
Some Elastic Moduli of Three Thick Composites

Thick composites are in use in critical applications and are proposed for still others. It is important to measure the elastic moduli of thick composites for two reasons: (1) design data on stiffness, and (2) prediction of feasible wave paths for ultrasonic waves for NDE. Except for one earlier report, (1) only relatively thin composites of relatively simple symmetries have been measured for their elastic moduli (2–6), Now, it is becoming necessary to measure thick composites of feasible engineering lay-ups. These often provide the complexity of orthorhombic symmetry locally in a specimen combined with curvature in the gross structure. In this work, specimens cut from thick structures will be treated in the same way as crystals to measure the elastic moduli by means of ultrasonic wave velocities. Results on three structures will be presented.
The targeted assessment coaching interview: Adapting the assessment process to different coaching requirements.

Purpose – The purpose of this article is to provide readers with an understanding of how the assessment protocol for executive coaching can be adapted to more effectively meet the different needs of clients who are seeking developmental, transitional, or remedial coaching.Design/methodology/approach – This article is based on the author's 20 years of experience as both an internal executive coach and external consultant. Organizational examples are provided to illustrate key concepts.Findings – The assessment interview can be customized to meet the unique requirements of transitional, developmental, and remedial coaching.Practical implications – The article provides readers with clear guidelines for adapting the assessment process to meet three different coaching requirements. By following these guidelines, coaches will be able to obtain more detailed and relevant background information on the client's history, organizational setting, goals, and development issues, and in so doing establish a more effecti...
Science Requirements and Required Future Measurements

The role of solar variability in climate variability and change has been debated for a long time. Now, new results from various space experiments monitoring the radiative and particle emissions from the Sun together with detailed studies of their terrestrial impacts have opened an exciting new era in both solar and atmospheric physics. Being so close, the Sun is the only star where we have a chance to identify and study in detail the processes responsible for changes in irradiance on time scales from minutes to decades-the longest time scale over which high precision data are available. High-resolution spatial and temporal observations conducted in various space and ground-based experiments demonstrate that the surface of the Sun and its outer atmosphere are highly variable on almost all spatial scales, and that many of the observed changes are linked to interior processes taking place in the Sun's convective zone or below. The broad collection of the material in this Monograph clearly shows that the variable solar energy output affects the Earth's atmosphere and climate in many fundamental ways. However, a quantitative understanding of all the involved processes and their relationship to the climate system and its response remains elusive. Based on the current database and knowledge, it remains to be seen what role solar forcing will play in future climate.
A Review of: “Keep it Real: Working with Today's Black Youth”

Anne E. Streaty Wimberly has edited an inspiring book about realistic ministry with black youth that is steeped in a powerful, practical theology. This framework insists on open, authentic, and cri...
Folate Coenzymes in Amethopterin-sensitive and -resistant Strains of Streptococcus faecalis ENZYMATIC FORMATION AND METABOLIC FUNCTION

Abstract Formyltetrahydrofolate synthetase was partially purified from extracts of two amethopterin-resistant mutant strains of Streptococcus faecalis, SF/A and SF/Ak. The concentrations of formate, tetrahydrofolate, adenosine triphosphate, and MgCl2 giving half-maximal reaction velocity were determined. The purified enzyme requires Mg++ for maximal activity and is specific for formate. The product of the enzymatic reaction is 10-formyltetrahydrofolate. Tetrahydropteroyltriglutamate can replace tetrahydrofolate; its Km value is 10 times larger than that of tetrahydrofolate. The pH optimum is 6.4 and is ascorbate dependent; the temperature coefficient (35–45°) is 1.9. Inorganic phosphate and ADP inhibit the reaction. Purines, which repress synthesis of the enzyme, are not strong inhibitors of formate activation. Formyltetrahydrofolate synthetase was not found in the amethopterin-sensitive strain, SF/O. The presence of serine hydroxymethyltransferase, 5,10-methylenetetrahydrofolate dehydrogenase, and 5,10-methenyltetrahydrofolate cyclohydrolase suggest the preferential utilization of exogenous serine as source of active 1 carbon moieties. Why serine synthesis de novo is independent of a formate-activating enzyme in SF/O is not yet clear.
Magnetic properties of SiO2-coated Fe nanoparticles

SiO2-coated Fe nanoparticles were synthesized using a wet chemical method, and their structural and magnetic properties were studied. The SiO2 material was in an amorphous state. The Fe nanoparticles were in a bcc state and contained an inner ferrihydrite core whose size decreased with increasing calcination temperature. The nanoparticles were basically in the ferromagnetic state. Their saturation magnetization increased with increasing calcination temperature, whereas their coercivity decreased with increasing calcination temperature. Different from bulk Fe, the nanoparticles exhibited strong temperature-dependent magnetic behaviors. The Bloch exponent fell from 1.5 to smaller values and decreased with increasing ferrihydrite content, while the Bloch constants were much bigger than that for bulk and increased significantly with ferrihydrite content. The value of coercivity decreased notably with increasing temperature. The exchange anisotropy arising from the exchange coupling across the Fe/ferrihydrite ...
A double-blind, randomized comparison of clindamycin-gentamicin versus cefamandole for treatment of post-cesarean section endomyometritis

Abstract Among patients with endomyometritis after cesarean section, a double-blind comparison of clindamycin-gentamicin versus cefamandole-placebo therapy was performed. Study criteria were: exclusion—use of prophylactic antibiotics or allergy to the drugs used; entry—uterine tenderness, oral temperature ≥101° F, and leukocytosis. Uterine specimens for culture were obtained via a single-lumen transcervical catheter. Most common isolates were Bacteroides bivius, Escherichia coli, and anaerobic cocci. Bacteremia occurred in 9.0%. Therapy results were: Clindamycingentamicin Cefamandoleplacebo Total Cure 93 76 169 Therapeutic failure 6 13 19 Side-effect failure 7 3 10 Total 106 92 198 Therapeutic failures were defined as persistent fever despite 3 or more days of treatment. Among the six clindamycin-gentamicin therapeutic failures, one patient had a resistant organism, and one had a pelvic mass. Among the 13 cefamandole-placebo therapeutic failures, three patients had resistant organisms, and one had a pelvic mass. Cause of persistent fever was not evident in the other patients. Side effects that necessitated discontinuation of therapy were: clindamycin-gentamicin group—diarrhea (six), allergic response (one); cefamandole-placebo group—diarrhea (two), allergic response (one). If the common practice of excluding side-effect failures is followed there were more cures in the clindamycin-gentamicin group (P = 0.06).
Single neurons in CA1 hippocampus encode trace interval duration during trace heart rate (fear) conditioning in rabbit.

This study sought to determine whether CA1 hippocampal neurons encode the duration of the trace interval during trace fear conditioning. Single neurons were recorded extracellularly in the CA1 of rabbits during and after a single trace fear classical conditioning session. Trace fear conditioning trials consisted of an auditory conditioned stimulus (CS; 3 sec) and a fear-producing shock unconditioned stimulus (US; 0.5 sec) separated by a silent trace interval. One group of rabbits was trained using a 10 sec trace interval ( n = 5), and another group was trained using a 20 sec trace interval ( n = 4). These groups were compared with pseudoconditioning control rabbits ( n = 5 and n = 4, respectively) that received unpaired CSs and USs. One day after trace and pseudo fear conditioning rabbits received a CS-alone retention session in which no USs were presented. The trace conditioned groups showed larger bradycardiac-fear responses on CS-alone trials compared with the pseudoconditioning groups. A significant percentage of CA1 neurons from the 10 and 20 sec trace groups (24 and 28%, respectively) showed maximal firing on CS-alone retention trials timed to 10 sec (±1.5 sec) and 20 sec (±2.0 sec) after CS offset, respectively. These latencies were similar to the duration of the trace interval used on previous CS–trace–US trials. Timed CA1 firing was not seen in pseudoconditioning control animals, suggesting that a subset of CA1 neurons encoded the trace interval duration. The percentage of neurons encoding trace duration was largest when rabbits exhibited significant fear responses to the CS, suggesting that trace encoding was related to the strength of the CS and US association.
Review: DOACs do not differ from standard anticoagulants for recurrent VTE; factor Xa inhibitors reduce bleeding

Source Citation Robertson L, Kesteven P, McCaslin JE.Oral direct thrombin inhibitors or oral factor Xa inhibitors for the treatment of deep vein thrombosis. Cochrane Database Syst Rev. 2015;6:CD010...
Breakdown mechanisms in a pulse-charged spark gap

The breakdown strength of a highly overvoltaged gas spark gap operating in air has been extensively investigated. The switch, which operated in a self-breakdown mode, was used to discharge a water Blumlein charged to peak voltages of 250 kV. At a charging rate of 20 kV/ mu s, overvoltages greater than a factor of three were measured at a pressure of 1 atmosphere. With UV preionization, the overvoltage was substantially reduced. A comprehensive model has been developed that precisely relates the DC and pulse-charge breakdown voltage in terms of the statistical delay and the streamer transit time. The dependence of these contributions over a pressure range of 1 to 5.5 atmospheres was considered. The statistical delay, which was eliminated with preionization, was inversely proportional to pressure and could be related to an effective surface roughness. >
Diet of the Nonnative Greenhouse Frog (Eleutherodactylus planirostris) in Maui, Hawaii

Abstract The Greenhouse Frog (Eleutherodactylus planirostris) is one of the most widespread frog species in the world. Because of its high population densities, widespread distribution, and consumption of native invertebrates in some invaded sites, understanding its impacts in Hawaii is important. We analyzed stomach contents of 397 frogs from 10 study sites in Maui. Results suggest Greenhouse Frogs are active, ant-specialist predators in the leaf litter. Ants (Formicidae) were the dominant prey found in stomachs in both number and volume. Furthermore, only ants were consumed in a higher proportion than they were sampled in the environment. Because ants dominated their diets, and because all ants are nonnative to Hawaii, this means Greenhouse Frogs consumed primarily nonnative invertebrates (>80%) in the areas sampled. Although results suggest that most native taxa are not at risk from Greenhouse Frog predation, the only locations where we could currently find Greenhouse Frogs were in human-dominated lowl...
Using Ada on microcomputers in the undergraduate curriculum

Currently, many Computer Science Departments are considering the use of a language other than Pascal either for an entire Computer Science curriculum, or at least for some courses, such as data structures. At Georgia State University, where our program is primarily based on IBM PC compatible microcomputers, we have converted our data structures course from Pascal to Ada, and use Ada in several other courses. In this paper I will discuss the rationale behind our choice and our experience with using Ada on microcomputers.
Integration of immigrant mothers in Germany: policy issues and empirical outcomes

This article examines the integration experiences of immigrant women in Germany in the period immediately before and after the birth of a child. It uses data from the German Socio-Economic Panel to analyze and compare the labor force behavior of women from different immigrant groups in Germany with the labor force behavior of German women during the period before and following childbirth. It also investigates whether differences exist between immigrant and native-born German women in subjective well-being in the years immediately before and after the birth of a child. The results indicate that immigrant women differ substantially in their labor market behavior and in their levels of life satisfaction compared with women who are both German citizens and who were born in Germany.
Complementary & Alternative Management of Parkinson’s Disease: An Evidence-Based Review of Eastern Influenced Practices

The prevalence of Parkinson’s disease (PD) appears to be lower in Asia compared to the Western world. It is unclear if this is related to the ubiquitous use of traditional medicine in Eastern healthcare, but the use of complementary and alternative medicine (CAM) modalities in countries like Korea may be as high as 76%. Among patients with PD, herbal medicines, health supplement foods, and acupuncture are interventions which are increasingly used throughout the world. Countries like Korea, China, India, and Japan have long embraced and incorporated traditional medicine into modern management of conditions such as PD, but research into various CAM modalities remains in its infancy limiting evidence-based recommendations for many treatments. We reviewed the literature on CAM treatments for PD, focusing on mind-body interventions and natural products. Based on evidence limited to randomized-controlled trials we found that mind-body interventions are generally effective forms of physical activity that are likely to foster good adherence and may reduce disability associated with PD. Based on the current data, modalities like Tai Chi and dance are safe and beneficial in PD, but better studies are needed to assess the effects of other frequently used modalities such as yoga and acupuncture. Furthermore, despite centuries of experience using medicinal herbs and plants in Eastern countries, and despite substantial preclinical data on the beneficial effects of nutritional antioxidants as neuroprotective agents in PD, there is insufficient clinical evidence that any vitamin, food additive, or supplement, can improve motor function or delay disease progression in PD.
Response to: Do initial tidal volumes impact acute respiratory distress syndrome development in patients intubated in the emergency department?

tion for patients intubated in the ED. We believe the editorial misstates our main conclusion. We primarily found that, in the subset of patients in whom the ARDS developed, initial tidal volumes were higher than the recommended tidal volume of 6 mL/kg of ideal body weight (IBW) [1]. Our study was not designed to show causality between higher initial ventilator settings and the subsequent development of ARDS. Rather, we selected the subset of patients in whom ARDS later developed because they are the patients in whom tidal volumes are felt to be most important. Lung-protective ventilation with a recommended tidal volume of 6 mL/kg has been commonly adopted for all comers since the And Respiratory Management in ARDS (ARMA) trial from the ARDS Network [1] .I n that prospective, randomized trial, the patients seeing a mortality benefit from lung-protective tidal volume ventilation were those who had ARDS. We therefore chose to look at this specific population by including only patients who developed ARDS within 48 hours after intubation. We sought to determine if the ED-initiated ventilator settings in this subset adhered to the goal of 6 mL/kg IBW and found that the volumes were set higher by approximately 1.5 mL/kg of IBW. Importantly, the assertion that the ARMA trial protocol called for an initial tidal volume of 8 mL/kg IBW is somewhat misleading. The protocol does call for an “initial” tidal volume of 8 mL/kg IBW but then states that this tidal volume “will be reduced by 1 mL/kg IBW at intervals of less than or equal to 2 hours until tidal volume equals to 6 mL/kg IBW,” at which point further adjustments would be made for acidosis, hypoxia, and plateau pressures. We did not findthat this titration occurredin our cohort. For patientswho were eventually ventilated at 6 mL/kg IBW, an average of 14 hours passed before they reached this goal. Furthermore, the same protocol states that the tidal volume could be increased above 6 mL/kg only in the setting of severe acidosis (pH b7.15) that persisted despite a respiratory rate of 35
From Pathfinders to Subject Guides: One Library's Experience with LibGuides

Subject specialists create pathfinders, toolkits, and subject guides to help patrons find information. These guides have evolved from colorful paper handouts to detailed, Web-based tools. Web-based subject guides work best when librarians are able to create their own Web content. Many tools, such as blogs, wikis, and content management systems, allow nonprogrammers to update Web content on their own. Software designed specifically for creating subject guides further simplifies the task by making it easy to create and maintain interactive, multimedia pathfinders incorporating Web 2.0 features. Web-based and locally hosted options are available. LibGuides, a Web-based tool, has a strong user base and encourages collaboration among libraries.
Barriers and Facilitators to Maternal Communication with Preadolescents about Age-Relevant Sexual Topics

The present study examined factors that promote parent-child discussions about sex topics. A sample of 1,066 dyads of African American mothers and their 9-12-year-old children participated completing computer-administered surveys. After controlling for all other covariates, mother's sexual communication responsiveness (i.e., knowledge, comfort, skills, and confidence) was the most consistent predictor of discussions. Mothers with higher responsiveness had significantly increased odds of discussions about abstinence, puberty, and reproduction, based on both mother and child reports. In addition, child's age, pubertal development, readiness to learn about sex, and being female were positively associated with an increase in the odds of discussions in most models. Findings indicate that encouraging parents to talk with their children early may not be sufficient to promote parent-child sex discussions. Parents also need the knowledge, comfort, skills, and confidence to communicate effectively and keep them from avoiding these often difficult and emotional conversations with their children.
Global analysis of Navier–Stokes and Boussinesq stochastic flows using dynamical orthogonality

We provide a new framework for the study of fluid flows presenting complex uncertain behaviour. Our approach is based on the stochastic reduction and analysis of the governing equations using the dynamically orthogonal field equations. By numerically solving these equations, we evolve in a fully coupled way the mean flow and the statistical and spatial characteristics of the stochastic fluctuations. This set of equations is formulated for the general case of stochastic boundary conditions and allows for the application of projection methods that considerably reduce the computational cost. We analyse the transformation of energy from stochastic modes to mean dynamics, and vice versa, by deriving exact expressions that quantify the interaction among different components of the flow. The developed framework is illustrated through specific flows in unstable regimes. In particular, we consider the flow behind a disk and the Rayleigh–Benard convection, for which we construct bifurcation diagrams that describe the variation of the response as well as the energy transfers for different parameters associated with the considered flows. We reveal the low dimensionality of the underlying stochastic attractor.
Development of HgCdTe for LWIR Imagers

This paper provides a historical perspective on the emergency of HgCdTe as the material of choice for long wavelength infrared (LWIR) imagers. The need for devices which see room temperature objects through the atmospheric window actually drove the development of this material. The lack of elemental or compound semiconductors having the desired wavelength response forced the choice of the alloy semiconductor, HgCdTe. The development of this material in several countries and companies beginning in the late 1950’s is traced. The crystal growth methods used to grow HgCdTe have included melt growth techniques such as Bridgman, zone-melting, quench-anneal and slushgrowth. The solution growth techniques include growth from HgTe-rich, Te-rich and Hg-rich solutions. Vapor phase growth has included evaporation, sputtering, molecular beam epitaxy (MBE) and metalorganic chemical vapor deposition (MOCVD). No perfect method has yet been developed, but several have provided material for the large area arrays needed for modern imagers.
Healthy aging among inner-city men.

Objective: Until now, prospective studies of aging have begun with 50- to 60-year olds, not adolescents. Premature deaths, childhood variables, and alcohol abuse have been often ignored. So has positive aging. As people live longer, gerontology needs to understand the determinants of health as well as illness in the later years. Method: The present study follows a cohort of adolescent boys (332 inner-city youths) for 60 years or until death. Complete physical exams were obtained every 5 years and psychosocial data every 2 years. Predictor variables assessed prior to age 50 include six variables reflecting uncontrollable factors—parental social class, environmental strengths, number of family problems, major depression, ancestral longevity, and premorbid physical health at age 50—and six variables reflecting (at least some) personal control: alcohol abuse, smoking, marital stability, body mass index, coping mechanisms, and education. The four outcome variables chosen to assess healthy aging at 70 reflected both “mind” and “body”. They included objectively assessed variables (death and/or disability prior to 70, and objectives mental health) and two subjectively assessed variables (perceived instrumental activities of daily living and life enjoyment). Results: Multivariate analysis suggested that positive aging at 70 could be predicted by variables assessed prior to age 50. More hopeful still, if the six variables under some personal control were controlled, depression was the only uncontrollable variable that affected the quality of subjective and objective aging. Conclusions: First, we may have greater personal control over our biopsychosocial health after retirement than previously recognized. Second, in this cohort, psychiatric rather than sociological predictors appeared more important.