cssi/SciSciGPT-SciSciNet huggingface dataset:
Clinical application of deoxyribonucleic acid markers in a Utah family with hypercholesterolemia.

The manifestation of coronary artery disease (CAD) depends on the interplay of genetic and environmental factors.1 Deoxyribonucleic acid (DNA) markers should become practical clinical tools for examining the genetic components of CAD. With this in mind, we assessed the use of DNA markers in familial hypercholesterolemia. Many different DNA mutations of the low density lipoprotein receptor gene on chromosome 19 cause familial hypercholesterolemia.2 Familial hypercholesterolemia is a prevalent autosomal trait characterized by elevated levels of plasma low density lipoprotein cholesterol and early CAD. Heterozygotes have serum cholesterol levels >300 mg/dl and affected men often develop CAD by the fifth decade of life.2 Restriction fragment length polymorphisms are DNA variations that are detected by Southern blotting.3 DNA differences between people show up as different sized allelic bands on autoradiograms of Southern blots. Investigators can follow a gene's inheritance by studying the pattern of allelic bands within families of interest.3 If a DNA marker appears consistently with the disease in affected family members, then DNA variation at the marker locus is said to be linked with the disease.3 Once linkage with a genetic locus is established, secondary influences on the disease such as diet or exercise can be examined. In this study, we report an 8-generation Utah kindred with many members affected with familial hypercholesterolemia. We found that the familial hypercholesterolemia phenotype was due to a mutation at the low density lipoprotein receptor gene locus. A wide discrepancy in the age of coronary deaths among gene carriers suggested the influence of other genetic or environmental factors. The DNA markers also helped to diagnose as normal a child with borderline high cholesterol levels clinically suspected to have familial hypercholesterolemia.
Real time track finding in a drift chamber with a VLSI neural network

Abstract In a test setup, a hardware neural network determined track parameters of charged particles traversing a drift chamber. Voltages proportional to the drift times in 6 cells of the 3-layer chamber were inputs to the Intel ETANN neural network chip which had been trained to give the slope and intercept of tracks. We compare network track parameters to those obtained from off-line track fits. To our knowledge this is the first on-line application of a VLSI neural network to a high energy physics detector. This test explored the potential of the chip and the practical problems of using it in a real world setting. We compare the chip performance to a neural network simulation on a conventional computer. We discuss possible applications of the chip in high energy physics detector triggers.
The infrared microspectroscopic and energy dispersive X-ray analysis of paints removed from a painted, medieval sculpture of Saint Wolfgang

A spectroscopic study of paints removed from a 15th century sculpture depicting Saint Wolfgang, which is housed in the Ball State Museum of Art, was performed. Infrared spectra on the minute paint samples were obtained using a microscope accessory in the transmission mode, and the spectra were compared to reference spectra of known art pigments and materials. In addition, energy dispersive X-ray spectra were obtained using a scanning electron microscope source. Although many of the pigments found are relatively modern pigments, the first application of paint is composed of materials consistent with the sculpture's medieval date. Pigments identified include brass gilding, calcium carbonate, China clay, lac dye, orpiment, Prussian blue, satin ochre, ultramarine blue and red, and zinc chromate. A zinc tungate finish was also identified.
Basic fibroblast growth factor and epidermal growth factor downmodulate the growth of hematopoietic cells in long‐term stromal cultures

The bone marrow microenvironment consists of stromal cells and extracellular matrix components which act in concert to regulate the growth and differentiation of hematopoietic stem cells. There is little understanding of the mechanisms which modulate the regulatory role of stromal cells. This study examined the hypothesis that mesenchymal growth factors such as basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF) modulate stromal cell activities and thereby influence the course of hematopoiesis. Both bFGF and EGF were potent mitogens for marrow stroma. However, both factors proved to be inhibitory to hematopoiesis in primary log-term marrow cultures. Inhibition was also observed when hematopoietic cells and bFGF or EGF were added to subconfluent irradiated stromal layers, demonstrating that the decline of hematopoiesis was not due to overgrowth of the stromal layer. Loss of hematopoietic support in bFGF and EGF was dose-dependent. Removal of bFGF and EGF permitted stromal layers to regain their normal capacity to support hematopoiesis. In stroma-free long-term cultures, neither factor affected CFU-GM expansion. Basic FGF slightly enhanced granulocyte-macrophage colony forming unit (CFU-GM) cloning efficiency in short-term agarose culture. Basic FGF did not reduce the levels of interleukin-6 (IL-6), GM-CSF, or G-CSF released by steady state or IL-1-stimulated stroma. Similarly, the constitutive levels of steel factor (SF) mRNA and protein were not affected by bFGF. Basic FGF did not alter the level of TGF-β1 in stromal cultures. We conclude that bFGF and EGF can act as indirect negative modulators of hematopoietic growth in stromal cultures. The actual mediators of regulation, whether bound or soluble, remain to be identified. © 1995 Wiley-Liss, Inc.
Recreation and Park Congress

Lombolou, Edouard 1981 Current professional training needs--special ized training for civil-aviation careers in Africa. Impact of Science on Society 31 (July-September):323333. Lucas, Henry C. 1982 Information Systems Concepts for Management. New York: McGraw Hill Book Company. Malumo, Siyanga 1979 African Airlines: In unity lies strength. Africa 91 (March 1979:85-89). Schwartz, Adele C. 1981 Airports in developing nations: World Bank helps with financing, expert guidance. Impact of Science on Society 31 (JulySeptember 1981):313321. Vivian, Jack 1981 ICAO assistance to civil aviation in the developing world. Impact of Science on Society 31 (JulySeptember):305 312.
Social psychological correlates of health behavior: knowledge of breast self-examination techniques among black women.

Abstract This paper examines the relationship between fear, perceived susceptibility and belief in the efficacy of early detection of breast cancer as correlates of the likelihood that a procedure for early detection, self-examination (BSE), will actually be known. The data were obtained via personal interviews as part of a study of practices and beliefs related to cancer detection and prevention among black females in Buffalo, New York. Belief in the efficacy of early detection of the disease to reduce the danger from the disease was found to be the strongest correlate of the ability to perform BSE. However, independent effects of fear as reflected in perceived threat and feelings of personal susceptibility were also apparent.
Preferences in the management of osteoarthritis of the hip and knee: results of a survey of community-based rheumatologists in the United States.

Objective. To determine rheumatologists' preferences in the medical management of osteoarthritis (OA) of the hip and knee, and examine possible variations in these preferences. Methods. A stratified random sample of 1,001 rheumatologists in community-based practice in the United States was surveyed by mail. Results. Responses were obtained from 594 subjects (529 white, 499 male, mean ± SD age 47.4 ± 8.1 years). Over 80% used acetaminophen or nonaspirin, nonsteroidal antiinflammatory drugs (NSAIDs) either always or frequently for the management of OA of the hip and knee. A majority used the following nonpharmacologic methods either always or frequently: weight loss, cane or crutch, physical and/or occupational therapy referral, and exercise. Variation in practice preferences was noted by age (<47 versus ≧47 years), sex, board certification in rheumatology, and number of patients seen per month. Respondents felt that severe pain and limitation of function were the most important factors in recommending total join arthroplasty for patients. Conclusion. These data demonstrate that practicing rheumatologists most often use either acetaminophen and/or NSAIDs in combination with nonpharmacologic methods in the medical management of OA of the hip and knee. The existence of variation in practice preferences has policy implications.
Characterization of pattern reconfigurable antenna arrays for MIMO systems

In this paper, we focus on the characterization of a pattern reconfigurable antenna design for mobile terminals and application in next generation technologies. We use a simple and efficient approach to measure and analyze the envelope correlation of the antenna diversity system. Specifically, we provide an analysis of the effects of mutual coupling and input match on the diversity performance of the antenna system using its scattering parameters. This evaluation is performed for a two antenna element array with multiple radiation patterns.
Salvage chemotherapy for recurrent primary brain tumors in children.

Sixty consecutive evaluable children with recurrent primary tumors of the central nervous system were treated with a regimen of vincristine, nitrogen mustard, procarbazine, and prednisone over a 12-year period. Tumor types included medulloblastoma (19), brain-stem glioma (16), astrocytoma (13), and a miscellaneous glioma (12). Responses and sustained survivals were achieved. Responses were highly dependent on tumor type. Disease progression was halted in 73% of the children with medulioblastoma, and three have survived in complete remission for more than 10 years from the start of therapy with vincristine, nitrogen mustard, procarbazine, and prednisone. Two of four patients with anaplastic glioma, are long-term survivors. In contrast, less than one third of children with brain-stem gliomas responded. Toxicity consisted mainly of neutropenia, thrombocytopenia, infections, and rarely a procarbazine rash.
Improving the Precision of Dependence-Based Defect Mining by Supervised Learning of Rule and Violation Graphs

Previous work has shown that application of graph mining techniques to system dependence graphs improves the precision of automatic defect discovery by revealing subgraphs corresponding to implicit programming rules and to rule violations. However, developers must still confirm, edit, or discard reported rules and violations, which is both costly and error-prone. In order to reduce developer effort and further improve precision, we investigate the use of supervised learning models for classifying and ranking rule and violation subgraphs. In particular, we present and evaluate logistic regression models for rules and violations, respectively, which are based on general dependence-graph features. Our empirical results indicate that (i) use of these models can significantly improve the precision and recall of defect discovery, and (ii) our approach is superior to existing heuristic approaches to rule and violation ranking and to an existing static-warning classifier, and (iii) accurate models can be learned using only a few labeled examples.
Study of the excited states in 30Si by means of the 30Si(α, α'γ)30Si reaction

Abstract The method II of Litherland and Ferguson was applied to study states in 30 Si by the 30 Si(α, α'γ) 30 Si reaction. An annular Si detector placed at 180° to the incident beam and 25 and 30 cm 3 Ge(Li) detectors were used for particle and gamma-ray detection, respectively. The results for the first two excited states agree well with previous measurements. The spin assignments 1 + and 0 + are suggested for the 3.767 and 3.786 MeV levels, respectively. The 4.808 MeV state has spin and parity 2 + , the 4.826 MeV state is most likely 2 + and the 5.948 MeV state is 4 + . Gamma-ray decay schemes for many states were obtained. No spin 3 − state was strongly excited in the present reaction, and no strong transitions from the 3 − states to the ground state were observed.
Dual-surface-coil MR imaging of bilateral temporomandibular joints: improvements in the imaging protocol.

Surface-coil MR imaging is considered to be an efficacious technique for evaluating temporomandibular joint (TMJ) dys­ function [1-4]. However, several problems are associated with the clinical implementation of MR imaging for TMJ ex­ amination. These include (1) the long procedure time required to image both joints with surface coils (this is necessary because of the large number of bilateral abnormalities in patients with internal derangements [5, 6]); (2) the inability or failure to obtain images in standardized perpendicular and parallel planes relative to the long axis of the condylar head (this is difficult to accomplish by using conventional positioning techniques and external landmarks because the angulation of the joint is highly variable [7, 8]); and (3) the lack of diagnostic information concerning motion of the TMJ. Although there have been attempts to address some of these issues [5, 6, 8, 9], not all of the solutions have been entirely satisfactory nor have the various techniques been used together to opti­ mize the imaging protocol. Therefore, in this report we de­ scribe the application of recent technological advances that were combined to provide answers to the above-mentioned problems in order to improve the MR imaging technique for examination of the TMJ. Materials and Methods MR imaging was performed with a 1.5-T MR Signa scanner* using a quadrature body coi l as the transmitter and two 6.5-cm receive­ on ly surface coils. The dual surface coils were factory-tuned to 50 ohm and combined with a special RF matching network that matched the output in phase to a 50-ohm impedance. This resulted in a configuration that did not require additional tuning or modification of the surface coils. The dual surface coils were positioned over the right and left TMJs by means of a commercially available surface-coil positioning device* that all owed the coils to be placed firmly again st
Atherosclerosis and Infection Due to Chlamydia pneumoniae or Cytomegalovirus: Weighing the Evidence

A link between infectious agents and atherosclerosis has been postulated for decades. This review describes the epidemiological and biological evidence linking cytomegalovirus and Chlamydia pneumoniae to atherosclerotic disease. Case-control studies and histologic evidence from atheromatous specimens support an association between atherosclerosis and infection with these two microorganisms, and small interventional trials appear to confirm the link with C. pneumoniae, but these findings require confirmation in larger studies. A lack of clinically relevant animal models has hampered investigations regarding biological mechanisms, particularly for C. pneumoniae.
Sinus Node Reentry An In Vivo Demonstration In The Dog

The phenomenon of sinus node reentry was investigated in 20 dogs by programed atrial stimulation during sinus rhythm and atrial pacing. Recordings were made simultaneously at multiple atrial sites. In 18 dogs, a closely coupled premature atrial beat (A2) introduced into the region of the coronary sinus, the right or the left atrial appendage, or the Bachmann bundle was followed 100-300 msec later by an accelerated beat (A3) consistent with sinus node reentry. The atrial activation sequence and the P-wave morphology of A3 and of the spontaneous sinus beats were similar. The occurrence of A3 during sinus rhythm and atrial pacing was dependent on the coupling interval of A2 and the arrival time of excitation in the region of the sinus node but was independent of the atrial site at which A2 was introduced; A3 could be clearly distinguished from local or atrioventricular node reentry and sinus node entrance block. Moreover, crushing of the sinus node (10 dogs) or vagal stimulation (7 dogs) prevented the appear...
Organized F-Actin Is Essential for Normal Trichome Morphogenesis in Arabidopsis

Actin microfilaments form a three-dimensional cytoskeletal network throughout the cell and constitute an essential throughway for organelle and vesicle transport. Development of Arabidopsis trichomes, unicellular structures derived from the epidermis, is being used as a genetic system in which to study actin-dependent growth in plant cells. The present study indicates that filamentous actin (F-actin) plays an important role during Arabidopsis trichome morphogenesis. For example, immunolocalization of actin filaments during trichome morphogenesis identified rearrangements of the cytoskeletal structure during the development of the mature cell. Moreover, pharmacological experiments indicate that there are distinct requirements for actin- and microtubule-dependent function during trichome morphogenesis. The F-actin–disrupting drug cytochalasin D does not affect the establishment of polarity during trichome development; however, maintenance and coordination of the normal pattern of cell growth are very sensitive to this drug. In contrast, oryzalin, an agent that depolymerizes microtubules, severely inhibits cell polarization. Furthermore, cytochalasin D treatment phenocopies a known class of mutations that cause distorted trichome morphology. Results of an analysis of cell shape and microfilament structure in wild-type, mutant, and drug-treated trichomes are consistent with a role for actin in the maintenance and coordination of an established growth pattern.
Bivariate statistical modeling of color and range in natural scenes

The statistical properties embedded in visual stimuli from the surrounding environment guide and affect the evolutionary processes of human vision systems. There are strong statistical relationships between co-located luminance/chrominance and disparity bandpass coefficients in natural scenes. However, these statistical rela- tionships have only been deeply developed to create point-wise statistical models, although there exist spatial dependencies between adjacent pixels in both 2D color images and range maps. Here we study the bivariate statistics of the joint and conditional distributions of spatially adjacent bandpass responses on both luminance/chrominance and range data of naturalistic scenes. We deploy bivariate generalized Gaussian distributions to model the underlying statistics. The analysis and modeling results show that there exist important and useful statistical properties of both joint and conditional distributions, which can be reliably described by the corresponding bivariate generalized Gaussian models. Furthermore, by utilizing these robust bivariate models, we are able to incorporate measurements of bivariate statistics between spatially adjacent luminance/chrominance and range information into various 3D image/video and computer vision applications, e.g., quality assessment, 2D-to-3D conversion, etc.
Long-term behavior of the atlantic interhemispheric sst gradient in the cmip5 historical simulations

AbstractMultidecadal and longer changes to the Atlantic interhemispheric sea surface temperature gradient (AITG) in phase 5 of the Coupled Model Intercomparison Project (CMIP5) historical simulations are investigated. Observations show a secular trend to this gradient over most of the twentieth century, with the southern lobe warming faster relative to its northern counterpart. A previous study of phase 3 of the CMIP (CMIP3) suggests that this trend is partially forced by anthropogenic sulfate aerosols. This analysis collectively confirms the partially forced trend for the CMIP5 and by anthropogenic aerosols. Like the CMIP3, the CMIP5 also simulates a reversal in the AITG trend in the late 1970s, which was attributed to a leveling off of the anthropogenic aerosol influence and increased influence of greenhouse gases in the late twentieth century. Two (of 25) CMIP5 models, however, systematically simulate a twentieth-century trend opposite to observed, leading to some uncertainty regarding the forced natur...
Local equilibrium phase diagrams: SiC deposition in a hot wall LPCVD reactor

Traditional CVD phase diagrams, which neglect the depletion effects in a hot wall reactor and assume the gaseous species concentrations at the substrate are the same as input concentrations, are at best valid for a cold wall reactor. Due to the constant change of gaseous species concentration along the length of the reactor, traditional CVD phase diagrams do not accurately predict the phases in the deposit on the substrate in a hot wall CVD system. In this paper, a new approach to calculate the local equilibrium CVD phase diagrams at the substrate is presented by coupling the depletion effects in a hot wall reactor to the equilibrium thermodynamic computer codes solgasmix-pv. The deposition of SiC using the gas system of methyltrichlorosilane (MTS)-hydrogen (H2) under low pressure was chosen for this study. Differences between the new CVD phase diagrams and the traditional phase diagrams for this gas system are discussed. The calculated CVD phase diagrams are also compared with the experimental data both from our own experiment and from the literature. The local equilibrium phase diagrams predicted the deposition of a single phase of SiC much better than those without the consideration of the depletion effects. The experimental regions for depositing single phase SiC are larger than the calculated local phase diagrams. This is attributed to the higher linear velocity of the gas flux under low pressure and the polarity of the Si carrying intermediate species.
A combinatorial algorithm for the Maximum Lifetime Data Gathering And Aggregation problem in sensor networks

The maximum lifetime data gathering and aggregation (MLDA) problem is concerned with maximizing the system lifetime T so that we can perform T rounds of data gathering with in-network aggregation, given the initial available energy of the sensors. A solution of value T to the MLDA problem consists of a collection of aggregation trees together with the number of rounds each such tree should be used in order to achieve lifetime T. We describe a combinatorial iterative algorithm for finding an optimal continuous solution to the MLDA problem that consists of up to n-1 aggregation trees and achieves lifetime To, which depends on the network topology and initial energy available at the sensors. We obtain an alpha-approximate optimal integral solution by simply rounding down the optimal continuous solution, where alpha = (To-n+1)/To. Since in practice To Gt n, alpha ap 1. We get asymptotically optimal integral solutions to the MLDA problem whenever the optimal continuous solution is omega(n). Furthermore, we demonstrate the efficiency and effectiveness of the proposed algorithm via extensive experimental results.
Advanced wound care therapies in non-healing lower extremity ulcers: high expectations, low evidence

Commentary on: Greer N, Foman NA, Macdonald R, et al. Advanced wound care therapies for nonhealing diabetic, venous, and arterial ulcers: a systematic review. Ann Intern Med 2013;159:532–42.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Chronic lower extremity (LE) ulcers represent a major challenge to healthcare systems worldwide. In the USA, they affect an estimated 2.5–4.5 million people. The most common chronic LE wounds are venous leg ulcers (VLU), diabetic foot ulcers (DFU) and arterial ulcers (AU).1 Since standard care (SC) heals only between 30% and 75% of VLUs and between 24% and 31% of DFUs,2 ,3 additional therapies for non-healing ulcers are needed. This was a systematic review of randomized controlled trials (RCTs) of approved advanced care therapies in healing of DFUs, VLUs and AUs. … [1]: {openurl}?query=rft.jtitle%253DAnn%2BIntern%2BMed%26rft.volume%253D159%26rft.spage%253D532%26rft_id%253Dinfo%253Adoi%252F10.7326%252F0003-4819-159-8-201310150-00006%26rft_id%253Dinfo%253Apmid%252F24126647%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.7326/0003-4819-159-8-201310150-00006&link_type=DOI [3]: /lookup/external-ref?access_num=24126647&link_type=MED&atom=%2Febmed%2Fearly%2F2013%2F12%2F17%2Feb-2013-101650.atom [4]: /lookup/external-ref?access_num=000326751200016&link_type=ISI
Human brain hemorrhage: quantification of perihematoma edema by use of diffusion-weighted MR imaging.

BACKGROUND AND PURPOSE: Animal models have clearly shown a critical role for extravascular blood in the initiation of the vasogenic edema associated with intracerebral hemorrhage (ICH). Nevertheless, the relevance of these observations to the human disease process has not been evaluated. With a prospectively collected cohort of nine patients, we report the relation between intraparenchymal blood clot volume and elevation of perihematoma brain tissue (and homologous contralateral brain tissue) apparent diffusion coefficient (ADC). METHODS: Patients with acute and subacute supratentorial ICH were prospectively evaluated by using diffusion-weighted imaging. ADC was measured in perihematoma tissue and in homologous contralateral regions. The relationship between ADC and volume of hematoma was determined by using linear regression analysis. RESULTS: Nine patients were enrolled in the study. The mean hematoma volume was 30.8 cc (range, 2.6–74 cc). The ADC in the perihematoma regions was 172.5 × 10−5 mm2/s (range, 120.1–302.5 × 10−5 mm2/s) and in the contralateral corresponding regions of interest was 87.6 × 10−5 mm2/s (range, 76.5–102.1 × 10−5 mm2/s) (P=.02). The Pearson correlation coefficient for the ADC in surrounding edema and hematoma volume was 0.7 (P=.04). The correlation coefficient between hematoma volume and contralateral hemisphere ADC was 0.8 (P=.02). CONCLUSION: We report a significant direct correlation between ICH volume and degree of ADC elevation in perihematoma and ADC values in contralateral corresponding brain tissue. These findings suggest a dose-effect interaction between volume and concentration of blood products and intensity of response that brain tissue exhibits in blood-mediated edema. Prospective natural history and interventional studies are required to confirm this biologically meaningful correlation in patients with ICH.
Biometric-rich gestures: a novel approach to authentication on multi-touch devices

In this paper, we present a novel multi-touch gesture-based authentication technique. We take advantage of the multi-touch surface to combine biometric techniques with gestural input. We defined a comprehensive set of five-finger touch gestures, based upon classifying movement characteristics of the center of the palm and fingertips, and tested them in a user study combining biometric data collection with usability questions. Using pattern recognition techniques, we built a classifier to recognize unique biometric gesture characteristics of an individual. We achieved a 90% accuracy rate with single gestures, and saw significant improvement when multiple gestures were performed in sequence. We found user ratings of a gestures desirable characteristics (ease, pleasure, excitement) correlated with a gestures actual biometric recognition rate - that is to say, user ratings aligned well with gestural security, in contrast to typical text-based passwords. Based on these results, we conclude that multi-touch gestures show great promise as an authentication mechanism.
Supraventricular Tachycardia and Sinus Rhythm with Contralateral Bundle Branch Block Patterns

A contralateral bundle branch block (BBB) aberration during tachycardia with a preexisting BBB strongly suggests the presence of ventricular tachycardia. We report on a middle-aged, female patient presented with wide QRS tachycardia. The patient had orthodromic atrioventricular tachycardia with a left BBB aberration in the presence of a preexisting right BBB due to an abnormal His-Purkinje system. We learned that the contralateral BBB aberration with supraventricular tachycardia could be seen when the His-Purkinje system was abnormal.
Priority windows: A device independent, vector oriented approach

Priority windows are a basic tool for interactive graphics, underlying such techniques as pop-up menus and single screen viewing and control of multiple contexts. Most implementations of priority windows are raster oriented, frequently relying on special hardware capabilities such as high speed rasterops. This paper discusses an alternative approach, based on vector clipping, that works with any display device capable of drawing and erasing vectors. It has been used to implement a general purpose windowing package that supports application programs using a vector graphics model. It is device independent, running without change on a desktop computer with integral graphics and on a timesharing system with a peripheral display. In purely device independent form, windowing performance depends on host processing speed and communications bandwidth. Techniques are described for improving responsiveness by overlapping some windowing computations with the user's think time. Performance improvements based on extended device capabilities such as rectangular fill, hardware characters, and local display lists with clipping are also suggested.Presentation of this paper included a videotape showing the dynamics of one application on an HP-9000 desktop computer and on a VAX 11/780 plus Ramtek Marquis configuration.
Hypothermic Circulatory Arrest in Cardiac Transplantation

Abstract Purpose Infrequently, hypothermic circulatory arrest (HCA) must be used during cardiac transplantation. Such cases may include concomitant aortic arch surgery, explantation of ventricular assist devices with outflow grafts or pseudoaneurysms closely abutting the sternum, and other scenarios for which dense mediastinal adhesions preclude exposure and anatomic dissection by conventional methods of adhesiolysis. Outcomes of heart transplantations performed with HCA have not been previously catalogued in the literature and are presented in the current case series. Methods Between November 2012 and December 2014, 193 patients underwent heart transplantation at a single institution. Of these, 7 cases (3.6%) required implementation of HCA. Postoperative outcomes in these patients were analyzed using a prospectively maintained clinical database. Results The HCA patients included 28% females, with mean age of 46 years, and 71% had nonischemic cardiomyopathies. The majority (N = 5, 71%) had prior ventricular assist device implantation, including 1 patient with a paracorporeal biventricular assist device. One of the remaining 2 patients had three previous surgeries for repair of tetralogy of Fallot, with a completely calcified right ventricular outflow tract and pulmonary arterial system. Mean HCA and cold ischemic times were 25 minutes (range, 9–34 minutes) and 285 minutes (range, 181–425 minutes), respectively. Mean postoperative length of stay was 31 days, and six of seven patients (86%) survived to hospital discharge. One patient expired as an outpatient 2 months following transplant. Rates of postoperative renal failure, respiratory failure, and stroke were 43%, 43%, and 29%, respectively. Conclusion On rare occasions, HCA must be instituted to safely conduct a complex heart transplantation procedure. Based on this small case series, these patients can be salvaged and discharged from the hospital, but may experience prolonged lengths of stay with moderate rates of other end-organ complications.
Insulin Receptor Substrate 1: The Hub Linking Follicle-stimulating Hormone to Phosphatidylinositol-3 Kinase Activation

The ubiquitous phosphatidylinositol 3-kinase (PI3K) signaling pathway regulates many cellular functions. However, the mechanism by which G protein-coupled receptors (GPCRs) signal to activate PI3K is poorly understood. We have used ovarian granulosa cells as a model to investigate this pathway, based on evidence that the GPCR agonist follicle-stimulating hormone (FSH) promotes the protein kinase A (PKA)-dependent phosphorylation of insulin receptor substrate 1 (IRS1) on tyrosine residues that activate PI3K. We report that in the absence of FSH, granulosa cells secrete a subthreshold concentration of insulin-like growth factor-1 (IGF-1) that primes the IGF-1 receptor (IGF-1R) but fails to promote tyrosine phosphorylation of IRS1. FSH via PKA acts to sensitize IRS1 to the tyrosine kinase activity of the IGF-1R by activating protein phosphatase 1 (PP1) to promote dephosphorylation of inhibitory Ser/Thr residues on IRS1, including Ser(789). Knockdown of PP1β blocks the ability of FSH to activate PI3K in the presence of endogenous IGF-1. Activation of PI3K thus requires both PKA-mediated relief of IRS1 inhibition and IGF-1R-dependent tyrosine phosphorylation of IRS1. Treatment with FSH and increasing concentrations of exogenous IGF-1 triggers synergistic IRS1 tyrosine phosphorylation at PI3K-activating residues that persists downstream through protein kinase B (AKT) and FOXO1 (forkhead box protein O1) to drive synergistic expression of genes that underlies follicle maturation. Based on the ability of GPCR agonists to synergize with IGFs to enhance gene expression in other cell types, PP1 activation to relieve IRS1 inhibition may be a more general mechanism by which GPCRs act with the IGF-1R to activate PI3K/AKT.
Spinoreticular cell responses to intrarenal injections of bradykinin

Thirty cats were anesthetized with alpha-chloralose, paralyzed, and artificially ventilated. Extracellular unit activity was recorded from 63 spinoreticular tract (SRT) neurons in the T12-L2 segments. All cells were excited by renal nerve stimulation and had somatic receptive fields. Intrarenal injection of bradykinin (4 micrograms/kg) increased activity of 36 cells from 7 +/- 1 to 23 +/- 5 spikes/s. Latency to onset of responses averaged 11 +/- 2 s and latencies to peak were 26 +/- 5 s. Intrarenal injection of isotonic saline vehicle or intravenous injection of the same dose of bradykinin failed to alter activity. Responses increased as dosage increased from 2 to 12 micrograms/kg. Seventeen cells exhibited tachyphylaxis to repeated injections. Cells most likely to respond to bradykinin received both A delta- and C-fiber renal inputs and/or were located in lamina V of the spinal gray matter. Mechanical pressure applied to the renal capsule excited eight of the cells that responded to bradykinin. These results show that activation of renal afferent fibers with bradykinin leads to activation of T12-L2 SRT neurons. These cells may participate in the ascending limb of supraspinal reflexes initiated by renal receptors.
Integrated genomic analysis of pancreatic ductal adenocarcinomas reveals genomic rearrangement events as significant drivers of disease.

Many somatic mutations have been detected in pancreatic ductal adenocarcinoma (PDAC), leading to the identification of some key drivers of disease progression, but the involvement of large genomic rearrangements has often been overlooked. In this study, we performed mate pair sequencing (MPseq) on genomic DNA from 24 PDAC tumors, including 15 laser-captured microdissected PDAC and 9 patient-derived xenografts, to identify genome-wide rearrangements. Large genomic rearrangements with intragenic breakpoints altering key regulatory genes involved in PDAC progression were detected in all tumors. SMAD4, ZNF521, and FHIT were among the most frequently hit genes. Conversely, commonly reported genes with copy number gains, including MYC and GATA6, were frequently observed in the absence of direct intragenic breakpoints, suggesting a requirement for sustaining oncogenic function during PDAC progression. Integration of data from MPseq, exome sequencing, and transcriptome analysis of primary PDAC cases identified limited overlap in genes affected by both rearrangements and point mutations. However, significant overlap was observed in major PDAC-associated signaling pathways, with all PDAC exhibiting reduced SMAD4 expression, reduced SMAD-dependent TGFβ signaling, and increased WNT and Hedgehog signaling. The frequent loss of SMAD4 and FHIT due to genomic rearrangements strongly implicates these genes as key drivers of PDAC, thus highlighting the strengths of an integrated genomic and transcriptomic approach for identifying mechanisms underlying disease initiation and progression.
Epistemic Democracy in Classical Athens: Sophistication, Diversity, and Innovation

Analysis of democracy in Athens as an “epistemic” (knowledge-based) form of political and social organization. Adapted from Ober, Democracy and Knowledge, chapters 1-4. Jon Elster (ed.), volume on “Collective Wisdom” (to be published in English and French).
Pediatric appendicitis and need for antibiotics at time of discharge: Does route of administration matter?

Abstract Introduction Following complicated appendicitis, there are limited data available to guide the surgeon regarding antibiotic selection, specifically in regards to route of administration. We hypothesized that among children with appendicitis who are discharged home with antibiotic therapy, the post-discharge readmission and complication rates do not differ between those children who receive IV antibiotics and those who receive PO antibiotics. Methods We performed a retrospective review of all children discharged home on antibiotics following appendectomy at a single institution between 11/10–10/14. We compared outcomes including ED and hospital readmission rates, and development of postoperative complications, between those children who were discharged on IV antibiotics and those discharged on PO antibiotics. Results 325 children were discharged with antibiotics following appendectomy ( n =291 PO antibiotics group; n =34 IV group). On both univariate and multivariate analysis, rate of each complication did not differ between the two groups including inpatient readmission (5% PO vs. 6% IV; p =0.8), ED readmission (10% vs. 11%; p =0.8), postdischarge complications related to the operation (10% vs. 15%; p =0.4), or abscess development post-discharge (4% vs. 3%; p =1). Conclusions Among children with complicated appendicitis who are discharged home with ongoing antibiotic therapy, our data demonstrate no differences in outcomes between those children who receive IV and PO antibiotics. Further data, collected in a prospective fashion, are needed to clarify the role of IV and PO antibiotics among children with perforated appendicitis.
Enhanced Ambient Stability of Efficient Perovskite Solar Cells by Employing a Modified Fullerene Cathode Interlayer

A novel fullerene cathode interlayer is employed to facilitate the fabrication of stable and efficient perovskite solar cells. This modified fullerene surfactant significantly increases air stability of the derived devices due to its hydrophobic characteristics to enable 80% of the initial PCE to be retained after being exposed in ambient condition with 20% relative humidity for 14 days.
Preparation of Antienic Material Inducing Leucopenia from Eberthella typhosa Cultured in a Synthetic Medium

SummaryAn antigenic substance has been isolated from cultures of E. typhosa grown in a synthetic medium. Appropriate amounts kill mice and rabbits and smaller quantities induce a leucopenia and fever in rabbits.The author wishes to acknowledge with gratitude the advice of Drs. J. F. Enders, J. H. Mueller, Y. Subbarow and M. A. Logan of the Harvard University Medical School.
Perforated hollow-core optical waveguides for on-chip atomic spectroscopy and gas sensing

A hollow-core waveguide structure for on-chip atomic spectroscopy is presented. The devices are based on Anti-Resonant Reflecting Optical Waveguides and may be used for a wide variety of applications which rely on the interaction of light with gases and vapors. The designs presented here feature short delivery paths of the atomic vapor into the hollow waveguide. They also have excellent environmental stability by incorporating buried solid-core waveguides to deliver light to the hollow cores. Completed chips were packaged with an Rb source and the F = 3 ≥ F′ = 2, 3, 4 transitions of the D2 line in 85Rb were monitored for optical absorption. Maximum absorption peak depths of 9% were measured.
Victory in War: Toward a General Theory of Victory

In contemporary politics, no term is more central to debates about military intervention than victory . When President Barack Obama's administration conducted a strategic review of U.S. policy toward Afghanistan in 2009, policymakers and scholars actively debated the strategy. Missing from their public deliberations, however, was the term victory . When General Stanley McChrystal addressed his goals for Afghanistan in the August 2009 Commander's Initial Assessment , he used the word victory only three times – one of which was to quote the Afghan Defense Minister Abdul Rahim Wardak who said that “Victory is within our grasp.” McChrystal used victory to describe the insurgency's strategy (i.e., “the inevitability of their strategy”) and to “avoid winning tactical victories while suffering strategic defeats,” but he did not define the overall strategy as victory. By contrast, his strategy was based on success , which appeared in the report numerous times, most significantly in the section entitled “A Strategy for Success.” The overall strategy was “to defeat the insurgency,” which held that “Success will be achieved when the [Government of Afghanistan] has earned the support of the powerful Afghan people and effectively controls its own territory.” This observation applies to President Obama's speech on December 1, 2009, at West Point that outlined his strategy for Afghanistan. The word victory did not appear in Obama's speech although it was designed to “bring this war to a successful conclusion.
Acute cocaine administration alters posttraumatic blood pressure and cerebral blood flow in rats

Cocaine abuse is widespread, and it is possible that its two main pharmacological actions, sympathomimetic and local anesthetic, could influence the blood pressure and cerebral blood flow response to brain injury, which occurs with increased frequency in drug abusers. We tested this hypothesis in ventilated barbiturate-anesthetized rats. Brain injury was induced using the fluid-percussion method, and cortical blood flow was measured using laser-Doppler flowmetry. Saline, cocaine, methamphetamine, or lidocaine was administered 10 min before injury. Upon injury, both cocaine- and saline-pretreated rats showed a similar acute hypertensive phase, which was followed by a period of more pronounced hypotension in the cocaine group (68 ± 4 vs. 100 ± 6 mmHg). Cortical blood flow increased dramatically 3−15 s following injury-induced hypertension in both the cocaine and saline groups (∼ 230−260%), but then fell below preinjury values within minutes. At 1 h postinjury, the blood flow in the saline group was 53 ± 6% of the preinjury value, while in the cocaine group, flow was 74 ± 7% of preinjury baseline. Similar to the cocaine-treated animals, methamphetamine also caused a more pronounced hypotensive event, but blood flow was not significantly different from saline controls. Lidocaine did not alter posttraumatic blood pressure but did significantly elevate blood flow throughout the 1-h postinjury period. At 60 min posttrauma, blood flow in the lidocaine group was 80 ± 10% of the preinjury value. The mechanism by which cocaine alters blood pressure and blood flow after injury is not entirely certain. In general, it appears that the sympathomimetic action of cocaine mediates the greater posttraumatic hypotension, while the local anesthetic action of cocaine may reduce the hypoperfusion produced by experimental brain injury
Carcinoma of the lung. Who will benefit from surgery

PreviewAlthough many people automatically think lung cancer patients are headed toward an early death, surgery can be curative for many with stage I and II disease and for some with certain types of stage IIIA disease. Besides the clinical stage of the disease, the extent of pulmonary resection required and the functional reserve of the patient determine whether surgical intervention should be attempted. Dr Landreneau describes staging by size, location, and changes on x-ray film and also discusses when adjuvant irradiation and chemotherapy should be considered to control recurrence.
Compliance with the 24-hour, in-house attending coverage requirement : a survey

Fifty-six residency training programs in Region I Council on Resident Education in Obstetrics and Gynecology/Association of Professors in Gynecology and Obstetrics were surveyed for compliance with the 24-hour, in-house attending coverage requirement, which took effect July 1991. Forty-six program directors responded to a questionnaire, for a response rate of 82.1%. Each had plans to implement this coverage in the 1991-1992 academic year. Two programs were unable to implement coverage because of inadequate financing or insufficient staffing. There were no differences in the types of programs (community, university, public or private university, or New York State program) in respondents as compared to non respondents. All the programs had overnight staff coverage for an average of 13 hours (range, 12-15) and had 24-hour, continuous coverage on the weekend. There was a wide variation in the attending/resident ratio. Twenty-eight programs (60.8%) reported that they compensated their attendings. Revenue for this compensation came from the hospitals (14), direct billing (8), faculty practice plans (6) or New York State (3). Of the 28 programs that offered compensation, 20 were private community hospitals, 6 were private university programs, 1 was a public university program and 1 was a public community hospital. Of the 28 programs compensating faculty, 17 were able to cite figures that had been approved by their respective institutions or practice plans. The annual cost ranged from $130,300 to $901,887 per program for institutions that compensated their attendings (mean, $340,402).
Examining Secondary Special Education Teachers’ Literacy Instructional Practices

ABSTRACTThis study presents findings from a survey of secondary special education teachers who teach reading. Respondents were 577 special education teachers from a large Midwestern state who completed an online or mail survey. Results based on quantitative and qualitative analyses indicate predominant foci of secondary special education teachers’ reading instructional practices were teaching vocabulary and comprehension, engaging in ongoing formative assessment, and incorporating technology into instruction. Major themes included the widespread use of commercial reading programs and a bifurcation of instructional roles. These findings are discussed in relation to the national discourse on adolescent literacy and current schooling initiatives including the Common Core State Standards and Multi-tiered Systems of Support.