cssi/SciSciGPT-SciSciNet huggingface dataset:
Se definirá la controversia de publicar en español o en inglés por los méritos académicos

RESUMEN Este articulo debate la poca atencion dada en libros de texto de anestesiologia a las contribuciones originales que han hecho colegas de America Latina a esta disciplina medica; se mencionan los factores que probablemente hayan promovido este tipo de olvido inusitado. La posibilidad de que esas innovaciones hayan aparecido en publicaciones poco leidas en el exterior probablemente sea una de las causas, aunque hubo articulos que aparecieron en revistas reconocidas y publicadas en ingles, pero no fueron citadas apropiadamente, lo cual tiene poca justificacion. Los nuevos parametros que buscan evaluar los articulos usando conceptos de la medicina basada en la evidencia han presentado una perspectiva diferente, ya que deben planear los protocolos por adelantado y hacer comparaciones entre diversos grupos o con otros sujetos. En tales casos solo se puede tener exito si hay un analisis estadistico y comparativo mas rigido. Tambien surgio el metodo basado en el numero de citas bibliograficas que se refieren al articulo, lo cual definiria el interes que los lectores tuvieron por el material, el planeamiento, el metodo y los resultados. Si hay interes por la publicacion, se determina el "grado de impacto" que tuvo el articulo entre el grupo de lectores. Las probabilidades de exito y la dinamica que puedan atraer la atencion de mas lectores, sobre todo de otros paises, dependera de los temas presentados, la calidad de la investigacion de los trabajos publicados en la Revista Colombiana de Anestesiologia y el grado de interes que originen en esos potenciales lectores.
Iterative reweighted least-squares design of FIR filters

Develops a new iterative reweighted least squares algorithm for the design of optimal L/sub p/ approximation FIR filters. The algorithm combines a variable p technique with a Newton's method to give excellent robust initial convergence and quadratic final convergence. Details of the convergence properties when applied to the L/sub p/ optimization problem are given. The primary purpose of L/sub p/ approximation for filter design is to allow design with different error criteria in pass and stopband and to design constrained L/sub 2/ approximation filters. The new method can also be applied to the complex Chebyshev approximation problem and to the design of 2D FIR filters. >
A2B Adenosine Receptor Expression by Myeloid Cells Is Proinflammatory in Murine Allergic-Airway Inflammation

Asthma is a chronic condition with high morbidity and healthcare costs, and cockroach allergens are an established cause of urban pediatric asthma. A better understanding of cell types involved in promoting lung inflammation could provide new targets for the treatment of chronic pulmonary disease. Because of its role in regulating myeloid cell-dependent inflammatory processes, we examined A(2B) R expression by myeloid cells in a cockroach allergen model of murine asthma-like pulmonary inflammation. Both systemic and myeloid tissue-specific A(2B) R deletion significantly decreased pulmonary inflammatory cell recruitment, airway mucin production, and proinflammatory cytokine secretion after final allergen challenge in sensitized mice. A(2B) R deficiency resulted in a dramatic reduction on Th2-type airways responses with decreased pulmonary eosinophilia without augmenting neutrophilia, and decreased lung IL-4, IL-5, and IL-13 production. Chemokine analysis demonstrated that eotaxin 1 and 2 secretion in response to repeated allergen challenge is myeloid cell A(2B) R dependent. In contrast, there were no differences in the levels of the CXC chemokines keratinocyte-derived chemokine and MIP-2 in the myeloid cell A(2B) R-deficient mice, strengthening A(2B) R involvement in the development of Th2-type airways inflammation. Proinflammatory TNF-α, IFN-γ, and IL-17 secretion were also reduced in systemic and myeloid tissue-specific A(2B) R deletion mouse lines. Our results demonstrate Th2-type predominance for A(2B) R expression by myeloid cells as a mechanism of development of asthma-like pulmonary inflammation.
Biochemical characterization of the major peanut‐agglutinin‐binding glycoproteins in vertebrate retinae

Peanut agglutinin (PNA), a lectin that binds D-galactose-beta (1----3) N-acetyl-D-galactosamine disaccharide linkages, selectively labels cone photoreceptors in the retinae of a variety of species. PNA binds consistently to domains of the interphotoreceptor matrix associated with cone, but not rod, inner and outer segments, to cone cell body and axonal membranes, to cone synaptic pedicles, and to portions of the inner plexiform layer. In order to begin the characterization of the molecular species responsible for cone-specific PNA binding, chick, turkey, rat, dog, pig, monkey, and human retinal extracts were separated by SDS-polyacrylamide gel electrophoresis and probed with peroxidase-conjugated PNA. The results reveal the presence of six major groups of PNA-binding glycoproteins ranging from 30 to 88 kilodaltons. Most of these are shared by the seven species examined; however, some interspecies variation is present. Three groups, designated GP39/40, GP42/45, and GP60, are the most intensely labeled by PNA and are common to all species analyzed, while groups GP29/31 and GP88 are less intensely labeled and are present in most but not all of the species investigated. Labeling of the GP54 group is variable but is most consistently associated with extracts of rat and pig retinae. Trypsin treatment, which results in the loss of cone-associated PNA binding in the interphotoreceptor matrix, causes a visually detectable reduction in three of the six groups of PNA-binding glycoproteins in porcine retinal extracts. Of these, GP54 is the most sensitive, being undetectable on PNA-stained blots after only 5 minutes of enzyme exposure; GP88 and GP45 are less sensitive but both are markedly reduced after 15 minutes of trypsinization. Trypsin-sensitive molecules thus may be involved in the establishment of the cone-specific domains of interphotoreceptor matrix identified by PNA binding. These, as well as the other groups of PNA-binding molecules, are being utilized to develop more specific immunologic probes with which to further study of their distribution and function.
A gas chromatographic method for ethanol determination in vapors of biological fluids

Rapid identification and quantitation of blood ethanol by gas chromatography (GC) has been especially useful to the clinical and forensic chemist, particularly as court evidence in prosecuting drunken drivers. Certain identification can be made and concentration determined rapidly by GC. A number of GC methods are available for ethanol determination in biological liquid samples. Currently, advances are being made in the area of vapor phase analysis [1–4]. Direct vapor injections overcome several disadvantages of liquid sample injection. Liquid samples containing sodium fluoride as a preservative tend to etch the syringe. Clotted samples are no longer a problem with vapor injections and frequent cleaning of the syringe is not required. With direct injection of blood or diluted blood samples, special inlets are necessary and must be changed periodically to remove protein and other nonvolatile deposits. In addition, the life of the columns is increased with vapor samples. According to Henry's law, at a given temperature there is a definite ratio between the concentration of ethanol in the blood phase and the air in direct equilibrium with it. Investigators have verified Henry's law [5–10] for both aqueous and blood ethanol solutions. The method described here consists of equilibrating blood with n-propanol as internal standard and injecting the vapors. Because of the internal standard, the volume of the injected sample is no longer a critical quantity.
On-the-fly programming: using code as an expressive musical instrument

On-the-fly programming is a style of programming in which the programmer/performer/composer augments and modifies the program while it is running, without stopping or restarting, in order to assert expressive, programmable control at runtime. Because of the fundamental powers of programming languages, we believe the technical and aesthetic aspects of on-the-fly programming are worth exploring.In this paper, we present a formalized framework for on-the-fly programming, based on the ChucK synthesis language, which supports a truly concurrent audio programming model with sample-synchronous timing, and a highly on-the-fly style of programming. We first provide a well-defined notion of on-the-fly programming. We then address four fundamental issues that confront the on-the-fly programmer: timing, modularity, conciseness, and flexibility. Using the features and properties of ChucK, we show how it solves many of these issues. In this new model, we show that (1) concurrency provides natural modularity for on-the-fly programming, (2) the timing mechanism in ChucK guarantees on-the-fly precision and consistency, (3) the Chuck syntax improves conciseness, and (4) the overall system is a useful framework for exploring on-the-fly programming. Finally, we discuss the aesthetics of on-the-fly performance.
Improving Usability of FPGA-Based Reconfigurable Computers Through Operating System Support

Advances in FPGA-based reconfigurable computers have made them a viable computing platform for a vast variety of computation demanding areas such as bioinformatics, speech recognition, and high-end digital signal processing. The lack of common, intuitive operating system support, however, hinders their wide deployment. This paper presents BORPH, an operating system frame-work for FPGA-based reconfigurable computers with a goal to ease and accelerate development of high-level applications to run on these computers. It provides kernel support for FPGA resources by extending a standard Linux operating system. Users therefore compile and execute hardware processes on FPGA resources the same way they run software processes on conventional processor-based systems. The operating system offers run-time general file system support to hardware processes as if they were software. Furthermore, a virtual file system is built to allow access to memories and registers defined in the FPGA, which provides communication links with running hardware processes. Increased productivities have been observed for high-level application developers, who have few previous experiences in hardware design, to implement complex mixed software/hardware designs on a FPGA-based reconfigurable computer running BORPH.
Novel Mechanisms of Depolarizing Inhibition in the Escape Circuit of Crayfish

Tonic depolarization has an inhibitory effect on excitatory synaptic responses of the lateral giant (LG) command neuron and the motor giant (MoG) motoneuron in the tailflip escape circuit of crayfish. In both cells, tonic depolarization reduces excitatory postsynaptic potentials (EPSPs) and currents (EPSCs). While the mechanism underlying these effects in LG is not yet clear, it appears to be similar to a novel inhibitory process in MoG. In that cell, slow depolarization reverse biases the rectifying electrical synapses from LG and MG and so decreases their transsynaptic conductances.
Information Literacy and Student Engagement: What the National Survey of Student Engagement Reveals about Your Campus

The annual National Survey of Student Engagement (NSSE) measures undergraduate “participation in programs and activities that institutions provide for their learning and personal development.”1 Each item on the survey correlates to one of five benchmarks of “empirically confirmed ‘good practices’ in undergraduate education.”2 The NSSE is an excellent diagnostic fit with the Information Literacy Competency Standards for Higher Education because learning outcomes can be correlated with student engagement. This article presents case studies from the University of Mississippi and Indiana University-Purdue University Indianapolis to demonstrate how librarians can apply NSSE results for the purpose of assessment.3
Competency Assessment in the Clinical Microbiology Laboratory

The laboratory comprises an invaluable part of the total health care provided to patients. Competency assessment is one method by which we can verify that our employees are competent to perform laboratory testing and report accurate and timely results. To derive the greatest benefit from the inclusion of competency assessment in the laboratory, we must be sure that we are addressing areas where our efforts can be best utilized to optimize patient care. To be competent, an employee must know how to perform a test, must have the ability to perform the test, must be able to perform the test properly without supervision, and know when there is a problem with the test that must be solved. In some cases, competency assessment protocols may demonstrate areas of competence but can fail to disclose incompetence. For example, challenges of low-complexity tasks (such as reading the technical procedure manual) are inferior to challenges that measure understanding and execution of a protocol, and poorly designed competency challenges will probably not detect substandard laboratory performance. Thus, if we are to receive the greatest benefit from our competency assessment programs, which may be time-consuming for the supervisors and the staff as well, we must not only meet the letter of the law but also find a way to make these assessments meaningful, instructive, and able to detect areas of concern. As we address competency assessment in our laboratories, we must understand that when done properly, competency assessment will reward our organizations and assist us in providing the best possible care to our patients.
Comparison of Precuffed and Vein-Cuffed Expanded Polytetrafluoroethylene Grafts for Infragenicular Arterial Reconstructions: A Case-Matched Study

Distal vein cuff interposition is often added to prosthetic infragenicular arterial reconstruction in an attempt to improve hemodynamics and patency rates. The purpose of this study was to compare the outcome of a precuffed expanded polytetrafluroethylene (ePTFE) graft with a vein-cuffed ePTFE graft for infragenicular bypass. We reviewed the clinical outcome of 77 patients with critical limb ischemia without available autologous vein conduits who underwent arterial reconstruction of 80 limbs to below-knee popliteal or tibioperoneal vessels using either ePTFE precuffed graft (precuffed group, 38 patients 40 limbs) or ePTFE vein-cuffed graft (vein-cuffed group, 39 patient, 40 limbs). Precuffed group patients were enrolled in a prospective cohort study. Vein-cuffed group patients consisted of consecutive case-matched patients operated on during the same study period. End points were primary graft patency and limb salvage rates. There were 42 males and 35 females with a mean age of 73.4 years (range, 44-92 years). Both groups were matched to demographics, risk factors for atherosclerosis, previous ipsilateral reconstruction, and location of the distal anastomosis. Proximal anastomosis was to the common (n = 68) or superficial (n = 12) femoral arteries. Distal anastomosis was to the below-knee popliteal (n = 28), anterior tibial (n = 12), posterior tibial (n = 15) and peroneal (n = 25) arteries. Operative mortality was 1.3%. Graft patency at dismissal was 90% and 95% in the precuffed and vein-cuffed groups, respectively. The mean follow-up was 25.7 months (range, 2.4-61 months). Primary patency rates at 1 and 3 years were 70% and 57% in the precuffed group, and 78% and 54% in the vein-cuffed group (p = 0.32). Limb salvage rates at 1 and 3 years were 97% and 70% in the precuffed group, and 95% and 81 % in the vein-cuffed group (p = 0.49). Overall patient survival at 1 and 3 years was 81 % and 57%, respectively. In this case-control study, results of precuffed ePTFE graft were similar to those obtained with vein-cuffed ePTFE grafts. The precuffed ePTFE graft is an adequate alternative conduit for infragenicular arterial reconstruction in patients with critical limb ischemia and no available autologous veins.
Treatment-Seeking Barriers for Veterans of the Iraq and Afghanistan Conflicts Who Screen Positive for PTSD

Objectives:Barriers associated with the decision not to seek treatment for symptoms of combat-related posttraumatic stress disorder (PTSD) were examined.Methods:Participants were 143 military men and women who served in Operation Enduring Freedom or Operation Iraqi Freedom (OEF/OIF) and who screened positive for posttraumatic stress disorder (PTSD), as assessed by the PTSD Checklist–Military Version, and who had not sought treatment for PTSD. During a cognitive-behavioral telephone intervention, participants were asked about their beliefs concerning seeking PTSD treatment.Results:Four categories of beliefs were associated with the decision to seek treatment, including concerns about treatment (40%), emotional readiness for treatment (35%), stigma (16%), and logistical issues (8%).Conclusions:This work suggests areas for intervention efforts to minimize barriers to treatment for PTSD for OEF/OIF veterans.
Playing, Shopping, and Working as Rock Musicians: Masculinities in “De-Skilled” and “Re-Skilled” Organizations

Masculinities vary by organizational context, demonstrating that organizational culture shapes the gendering of work even within the same occupation. The author draws on comparative and ethnographic data collected in two retail environments (large and small musical instrument stores) to understand how a common organizational culture is differently gendered by the organization of work. In these music stores, organizational culture is driven by masculinist fantasies of the rock musician lifestyle. As the products and knowledge of the rock musician lifestyle are made popularly accessible and retail work is deskilled, a style of masculinity based on fraternization and competition takes the place of formal knowledge and experience—reaffirming rock musician as a populist, but exclusively male identity. The article concludes with a consideration of how the de-skilling of retail work reproduces gendered interactions that affirm men’s control over work and its products, even as retail work is presumed to be femini...
Content-based filtering for efficient online materialized view maintenance

Real-time materialized view maintenance has become increasingly popular, especially in real-time data warehousing and data streaming environments. Upon updates to base relations, maintaining the corresponding materialized views can bring a heavy burden to the RDBMS. A traditional method to mitigate this problem is to use the where clause condition in the materialized view definition to detect whether an update to a base relation is relevant and can affect the materialized view. However, this detection method does not consider the content in the base relations and hence misses a large number of filtering opportunities. In this paper, we propose a content-based method for detecting irrelevant updates to base relations of a materialized view. At the cost of using more space, this method increases the probability of catching irrelevant updates by judiciously designing filtering relations to capture the content in the base relations. Based on the content-based method, a prototype real-time data warehouse has been implemented on top of IBM's System S using IBM DB2. Using an analytical model and our prototype, we show that the content-based method can catch most (or all) irrelevant updates to base relations that are missed by the traditional method. Thus, when the fraction of irrelevant updates is non-negligible, the load on the RDBMS due to materialized view maintenance can be significantly reduced.
Is memory organized by temporal contiguity

The hypotheses that memories are ordered according to time and that contiguity is central to learning have recently reemerged in the human memory literature. This article reviews some of the key empirical findings behind this revival and some of the evidence against it, and finds the evidence for temporal organization unconvincing. A central problem is that, as many memory experiments are done, they have a prospective, as well as a retrospective, component. That is, if subjects can anticipate how they will be tested, they encode the to-be-remembered material in a way that they believe will facilitate performance on the anticipated test. Experiments that avoid this confounding factor have shown little or no evidence of organization by contiguity.
The Influence Of Pension Obligations And Other Postretirement Benefits On Primary Bond Pricing

This paper investigates alternative measures of pension obligations and other postretirement benefits in an effort to assess their incremental value in determining risk premia of primary market corporate bonds. The results indicate that the information pertaining to pension liabilities (SFAS 87), and presented on the balance sheet, have not observable impact upon the firms primary market bond yields beyond that impounded in the firms bond rating. However, the information pertaining to other postretirement benefits (SFAS 81), and required in the footnotes to the financial statements, is found to be related to higher risk premia.
The Influence of Residency Status on Agonistic Behavior of Male and Female Ozark Zigzag Salamanders Plethodon angusticlavius

Abstract Once territories become established residents often have a high probability of successfully defending their territories against intruders. This advantage often can be explained by intrinsic qualities (e.g., size, body condition, experience) that make residents superior competitors. In addition, residency status can confer an advantage that is independent of fighting ability. We used a laboratory experiment to examine the effect of residency status on aggressive behavior by adults of the Ozark zigzag salamander (Plethodon angusticlavius), a small terrestrial salamander found under rocks and logs on the forest floor. We controlled for intrinsic effects by testing each individual as both a resident and an intruder in random order. Males and females were tested in same-sex contests in separate experiments. Based on an index that incorporated the frequency of aggressive and submissive postures, both males and females were significantly more aggressive as residents than as intruders. Bites were perform...
The Boards of Contract Appeals: A Historical Perspective

This article - introducing the journal's special issue discussing the U.S. Court of Appeals for the Federal Circuit - traces the historical evolution of the agency boards of contract appeals to meet the changing dispute resolution needs of the Government in its procurement activities. It discusses the boards of contract appeals and their relationship to the Federal Circuit, focusing more on the factual background rather than the theoretical.
Apologies of the Rich and Famous: Cultural, Cognitive, and Social Explanations of Why We Care and Why We Forgive

In recent years, U.S. and other Western media have inundated the public with celebrity apologies. The public (measured via representative opinion polls) then expresses clear ideas about who deserve...
Crystal structures of N (6)-methyladenine hydrochloride and N (6), N (9)-dimethyladenine

The crystal structures ofN (6)-methyladenine hydrochloride (6-MA·HCl) and ofN (6),N (9)-dimethyladenine (6,9-DMA) were determined by the use of X-ray diffractometer data. Crystals of 6-MA·HCl are monoclinic, space groupP21/m, witha = 9.3450(6),b = 6.5838(4),c = 7.3142(3) A, β = 114.837(4) °, andZ = 2. Crystals of 6,9-DMA are monoclinic, space groupP21/c, witha = 12.045(3),b = 6.135(2),c = 23.27(1) A, β = 111.79(3), andZ = 8. The crystal structures were refined by least-squares toR = 0.053 for 6-MA·HCl andR = 0.071 for 6,9-DMA. The N(1)-protonated adenine derivative in the 6-MA·HCl crystal structure and the two crystallographically independent adenine derivatives in the 6,9-DMA structure all assume conformations in which the methyl substituent at N(6) is in or near the purine plane, and is pointing away from the imidazole moiety.
NANOMETRIC MICRODYNAMICS OF A BORON/GRAPHITE HYBRID FIBER COMPOSITE STRUT

~ _ The microdynatiic stability of a boron/graphite hybrid fiber composite strut in extension and thermally actuated bending is experimentally assessed. The strut is a boron/graphite hybrid fiber.composite strut with a high modulus and very low coefficient of thermal expansion that was intended for use on an optically precise space structure. Nanometer level strains were measured under load from DC to 1000 Hz to assess the existence of acoustic emissions in the composite material. For strains from 1 to 250 nanostrain, there were no observed microdynamic instabilities; however, a picostrain dynamic measurement revealed a change in the vibration due to the small but resolvable, ambient vibration. In contrast, the free I Doctoral Research Assistant Student Member AIAA hardaway@colorado.edu (303) 492-3576 ?. Associate Professor, Senior Member AIAA Associate Member ASME Lee.Peterson@colorado.edu (303) 492-1743 3 roy.ikegami@boeing.com (253) 773-5876 Copyright
EXPERIMENTAL STUDY ON DYNAMIC MECHANICAL PROPERTIES OF AMPHIBOLITES UNDER IMPACT COMPRESSIVE LOADING

In order to investigate rock dynamic compression mechanical properties with strain rate varying from 40 s-1 to 150 s-1 on amphibolites,the specimens are subjected to axial impact with different projectile speeds by using the split Hopkinson pressure bar(SHPB) of 100 mm in diameter and a thin red copper circular plate as pulse shaper;and the consistence of experiment is discussed to consider the effect on experimental result of size of the samples. The wavy curves of samples,dynamic compressive strength,dynamic strength increase factor,and the relationship between specific energy absorption and strain rate are also analyzed. Experimental results show that the dynamic compressive strength and specific energy absorption of amphibolites are strain rate dependent,and the strain rate effect can be expressed by linear approximations. The failure strain of rock increases with the strain rate;and the relationship between dynamic strength increase factor and logarithm of average strain rate is approximately linear,but no relations can be seen for the initial elastic modulus of amphibolites with strain rate. Testing and consistence of case verification experiment show that the SHPB test results of amphibolites are acceptable. The experimental method and conclusions can be used to analyze the dynamic capabilities of other brittle materials.
Acquired neurocutaneous disorders.

Abstract A variety of neurologic diseases have cutaneous manifestations. These may precede, coincide with, or follow the neurologic findings. An array of autoimmune, genetic, and environmental factors play a role in expression and severity of the neurologic burden in these conditions. This chapter emphasizes congenital and genetic disorders, but we also discuss the pathophysiology and manifestation of various acquired neurocutaneous disorders with an emphasis Behcet’s disease, dermatomyositis, Sjogren’s syndrome, systemic lupus erythematosus, scleroderma, Parry-Romberg syndrome and Degos disease.
Positron Emission Tomography: Clinical Status in the United States in 1987

PET studies are now being used to provide unique clinical information in several conditions. PET is an accurate, noninvasive method of identifying patients with coronary artery disease. Furthermore, PET studies can accurately differentiate patients who will or will not benefit from revascularization procedures. In patients with partial epilepsy being considered for surgery, PET studies provide spatial localization of the focus that complements other tests in improving the surgical management of these patients. PET studies give important diagnostic and prognostic information in the management of patients with gliomas and can direct recurrence of tumor and distinguish it from radiation necrosis. These uses of PET are well documented, and their utility has been independently confirmed in several institutions. Several other areas of research are being pursued with PET, and these will probably develop into clinically useful procedures in the future.
The effect of BCG intravesical therapy and recurrence on PDL1 expression in non-invasive bladder cancers.

e15504 Background: Treatment of metastatic bladder cancers that express PDL1 with an anti-PDL1 antibody (MPDL3280) resulted in response rates of 40-50%. Approximately 30% of metastatic bladder canc...
Seri Ironwood Carving

ABSTRACTThe Seri Indians of Sonora, Mexico in the last seven years have developed a revolutionary craft enterprise in a bid for tourist trade. Discovery of this latent talent and the extent of their involvement are the subjects of this paper.
Systemic Racism and the Rhetoric of Recognition

This chapter investigates the status dynamics of racial inequality within abolitionism and the strategic dilemmas faced by black abolitionists. Black protest rhetoric developed distinctive indexical properties of frame-busting out of closer personal, familial, and historical experience with slavery as well as from a greater vulnerability to the violence and disrespects of systemic racism. In response to racializing civil-society binaries, black abolitionists also formulated a more logos-oriented rhetoric that consisted of arguments for social recognition to counter the bias and discrimination internal to white antislavery organizations. The chapter discusses how Frederick Douglass and others took a more direct approach in appealing to the moral emotions through rational arguments about the nature of human flourishing than did status rhetoric, though the two overlap quite a bit.
Discriminatory performance of positive urine hemoglobin for detection of significant hemolysis in patients with continuous-flow left ventricular assist devices

Background Serum lactate dehydrogenase (LDH) is the standard measure for detection of hemolysis and thus surveillance for device thrombosis in patients on continuous-flow left ventricular assist device (CF-LVAD) support. Significant hemolysis has been defined as LDH ≥600 IU/L. However, LDH testing requires phlebotomy, precluding frequent home monitoring. Simple dipstick urinalysis (UA) for urine hemoglobin (U-Hb) overcomes this limitation. This study correlated U-Hb and LDH levels and evaluated the performance of UA for detection of significant hemolysis in patients with CF-LVADs. Methods U-Hb and LDH were measured concurrently 956 times in 221 patients with CF-LVADs. Statistics were computed to determine accuracy of UA in detecting LDH ≥600 IU/L, with a positive result being any detected U-Hb. All analyses were performed with and without excluding for 1) conditions associated with tissue damage, which are known to increase LDH, and 2) suspected or confirmed urinary tract infections or hematuria, which are known to cause hemoglobinuria for reasons other than hemolysis. Results Mean LDH for absent/mild/severe U-Hb was 360 IU/L/467 IU/L IU/L/777 IU/L without exclusions, 354 IU/L/444 IU/L IU/L/651 IU/L after excluding non-hemolytic LDH elevations, 370 IU/L/513 IU/L IU/L/1,357 IU/L after excluding urinary tract infections and hematuria, and 367 IU/L/470 IU/L IU/L/1,217 IU/L when both exclusions applied (all p 90% for all analyses. Conclusions Serum LDH is significantly associated with U-Hb levels. Absence of U-Hb appears to efficiently exclude significant hemolysis in patients with CF-LVADs. Because it can be performed by patients at home, hemoglobinuria monitoring may enable more intense surveillance and earlier diagnosis of device thrombosis.
Imaging serotonin reuptake in the living brain

Traditional functional magnetic resonance imaging (fMRI) measures brain activity by detecting changes associated with blood flow in specific regions of the brain. Due to the noninvasive nature of this technique, fMRI has been employed to elucidate the neural substrates of behaviors in healthy volunteers and patients with various neuropsychiatric disorders. However, traditional fMRI does not detect changes in neurotransmitters, which are key chemical messengers that signal neurons to communicate with each other. In a recent publication, Hai et al. reported their success in developing a molecular fMRI method that maps the neurotransmitter serotonin (5HT) as it is transported into neurons. These researchers designed and synthesized an imaging sensor, which is a protein that carries 5HT and releases the neurotransmitter at the moment of reuptake to neurons. Reuptake of 5HT is the reabsorption of a secreted 5HT by the neuron that originally produced and secreted it. Reuptake of 5HT is necessary for the neurotransmitter to be dissociated from the sensor and recycled. By exploiting the reuptake process, this imaging method allows for an unprecedented opportunity to map 5HT transport three-dimensionally in the living brain. Using this novel molecular imaging technique, the authors demonstrated that 5HT removal from the imaging sensor varied spatially in different parts of the basal ganglia and anatomical regions nearby in rats, which suggested that there were multiple mechanisms of 5HT clearance. Furthermore, administration of fluoxetine, a selective 5HT reuptake inhibitor (SSRI), suppressed 5HT removal in septal subregions, whereas fluoxetine decreased reuptake in striatum. The region-specific effects of modulators of 5HT physiology provide tremendous insights into the mechanisms of actions of medications such as SSRIs. This new molecular fMRI method is clearly an important neuroimaging tool for advancing the understanding of the mechanisms of actions of psychiatric medications modulating the 5HT system. Because of the presence of the blood-brain barrier, currently the sensor needs to be directly injected into the brain. Although this molecular imaging method has great promise in animal models, researchers will need to be able to deliver the sensor noninvasively to the brain to be useful in humans. A. Hai et al. , Molecular fMRI of serotonin transport. Neuron 92 , 754–756 (2016). [[Abstract]][1] [1]: http://www.cell.com/neuron/abstract/S0896-6273(16)30653-5
Human Pregnancy Resources

ABSTRACTThe Interactive Web column reviews freely available Internet resources that are interactive in some form and/or provide helpful videos and animations. The websites are used for assignments, lectures, and self-study purposes and are available for viewing within The Interactive Web blog at https://thewebisinteractive.wordpress.com/. For information on how to search the blog, please see the About, How to Search, Writing Opportunity, and Disclaimer webpage within the blog. Each of the favorite websites of users is labeled with a star. This issue will highlight pregnancy websites.
Predictors of Improved Walking after a Supervised Walking Exercise Program in Men and Women with Peripheral Artery Disease.

We compared the changes in ambulatory outcomes between men and women with symptomatic peripheral arterial disease (PAD) following completion of a supervised, on-site, treadmill exercise program, and we determined whether exercise training variables and baseline clinical characteristics were predictive of changes in ambulatory outcomes in men and women. Twenty-three men and 25 women completed the supervised exercise program, consisting of intermittent walking to mild-to-moderate claudication pain for three months. Men and women significantly increased claudication onset time (COT) ( and , resp.) and peak walking time (PWT) ( for each group). However, change in PWT was less in women (54%) than in men (77%) (). Neither group significantly changed 6-minute walk distance (6MWD). In women, baseline COT was the only predictor for the change in COT () and the change in PWT (). In men, baseline COT () and obesity () were predictors for the change in COT, and obesity was the only predictor for the change in PWT (). Following a supervised, on-site, treadmill exercise program, women had less improvement in PWT than men, and neither men nor women improved submaximal, overground 6MWD. Furthermore, obese men and patients with lower baseline COT were least responsive to supervised exercise. This trial is registered with ClinicalTrial.gov, unique identifier: NCT00618670.
Homeobox-Containing Genes and GAP Junctional Communication in Pattern Formation during Chick Limb Development

Elucidating the mechanisms involved in eliciting the formation of the various skeletal elements of the limb in their appropriate position and sequence along the anterior-posterior (A-P) axis is fundamental to understanding normal and abnormal vertebrate limb development. The zone of polarizing activity (ZPA) at the posterior margin of the developing limb bud appears to be the source of a diffusible morphogen, possibly retinoic acid, that becomes distributed in a graded fashion across the A-P axis of the limb, and specifies the A-P positional values of the skeletal elements of the limb according to its local concentration (Brickell and Tickle, 1989; Eichele, 1989). Homeobox-containing genes have been implicated in the regulation of pattern formation during development, and several homeobox genes exhibit spatially-restricted and temporally-regulated patterns of expression during vertebrate limb development (Oliver et al., 1988, 1989; Dolle et al., 1989; Hill et al., 1989; Robert et al., 1989; Wedden et al., 1989). In the present manuscript we describe some of our current studies on the isolation and characterization of several homeobox genes expressed during embryonic chick limb development, and present evidence indicating that some of these genes are expressed in a graded fashion along the A-P axis of the chick limb bud as positional values along the A-P axis are being specified. We also report on studies indicating that intercellular signalling via gap junctions may be involved in specification of pattern along the A-P axis of the chick limb bud.
Chromosomal and Inherited Syndromes

Chromosomal and inherited syndromes with orthopedic manifestations vary in their presentation, severity, and treatments. With respect to orthopedic manifestations, Marfan’s syndrome is an autosomal dominant mutation in the fibrillin-1 gene that can lead to scoliosis and ligamentous laxity. Ligamentous laxity is also a sign of Ehlers-Danlos, a group of collagen disorders, marked also by hyperelastic skin and chronic pain. Within the forms of neurofibromatosis, NF1 is the most common exhibiting dystrophic and non-dystrophic scoliosis as well as anterolateral bowing of the tibia. Mucopolysacharide (MPS) disorders lead to glycosaminoglycan aggregation and can lead to cervical instability, carpal tunnel syndrome, and scoliosis. Down’s syndrome is a result of trisomy 21 and also can manifest cervical instability in addition to instability of the hips and patella. Prader-Willi and Turner syndrome are also chromosomal disorders with orthopedic manifestations.
The long-term effect of maternal dietary protein restriction on 5-HT1A receptor function and behavioral responses to stress in adulthood

Maternal nutrition impacts fetal development, and may play a role in determining resilience to stress and vulnerability to stress-precipitated psychiatric disorders, such as anxiety and depression. In this study, we examined the effect of a reduction in maternal dietary protein during pregnancy on the brain neurochemistry and behavior of offspring. We focused specifically on the serotonin system, the 5-HT1A receptor and the responsivity of offspring as adults to stress. Dams were fed either a low protein diet (10% protein by weight) or isocaloric control diet (20% protein by weight). The low protein diet did not alter maternal food intake and body weight, or litter size and the average birth weight of male or female littermates. 5-HT1A receptor function, as measured by quantitative autoradiography of 8-OH-DPAT (1 μM)-stimulated [35S]GTPγS binding, was markedly reduced in hippocampus of weanling female, but not male offspring (postnatal day, PND 21) of dams fed the low protein diet. The number of serotonergic cell bodies in the rostral raphe, and 5-HT metabolism in the limbic system of weanling offspring was not altered by maternal low protein diet. The deficit in hippocampal 5-HT1A receptor function observed in weanling female offspring persisted into adulthood (PND 112), and was accompanied by an increased sensitivity to stress, specifically increased immobility during a 15-minute forced swim challenge and increased anorexia following 30-minute restraint (PND 97-100). The present work begins to uncover important future directions for understanding the early developmental origins of resilience to stress, and factors that may put individuals at greater risk for stress-related psychiatric disorders.
Subclassifying atypical squamous cells in Thin-Prep cervical cytology correlates with detection of high-risk human papillomavirus DNA.

Recent studies have proposed subclassifying ASCUS into "favor reactive" (ASFR), "not otherwise specified" (ASNOS), and "favor squamous intraepithelial lesion (SIL)" (ASFS). This study explored the reproducibility of these diagnoses with Thin-Prep cytology and their association with high-risk human papillomavirus DNA (HRHPV). Three pathologists and 1 cytotechnologist with 2 to 25 years of experience reviewed 144 Thin-Prep (Cytyc, Boxborough, MA) specimens previously diagnosed as normal, ASFR, ASNOS, ASFS, and SIL. Interobserver reproducibility was computed with the kappa statistic. The original laboratory diagnosis was compared with the presence of HRHPV types. Interobserver reproducibility for a normal or SIL diagnosis was very good (kappa = .68 and .63). Reproducibility for ASFR, ASNOS, and ASFS ranged from poor to fair (kappa = .21, .19, and .32). In a weighted analysis, kappa values for ASFR/ASNOS and ASFS/SIL were .36 and .62, respectively. HRHPV-positivity for preparations originally diagnosed as N, ASFR, ASNOS, ASFS, and SIL were 5.7%, 8.8%, 17.4%, 47.8%, and 54.5%, respectively. The difference in index of HRHPV for either N or ASFR and ASFS or SIL was significant (P < .001). Reproducibility for ASCUS is generally poor, but better reproducibility is obtained by combining ASFS with SIL and, to a lesser degree, ASNOS with ASFR. ASFS and SIL confer a similar index of HRHPV and merit similar management. ASFR may be managed with cytologic follow-up; but this may depend upon the individual laboratory. HPV testing, in conjunction with cytologic and biopsy follow-up, appears useful for estimating the significance of ASCUS subgroups in laboratory practice.
Issues in E-commerce and E-government service delivery

This chapter examines three issues emerging in the fields of e-government service delivery and e-commerce -- the need for and a potential structure for performance measures, the heightened need for security awareness around e-government and e-commerce, and the need for e-government web design centered around usability. Beginning these discussions are some basic definitions, a review of the current literature on e-government and a discussion of the stages of e-government development. The chapter concludes with a discussion of a future research agenda in e-service delivery and e-commerce.Electronic government, or e-government, can be defined as the "use of technology, particularly web-based Internet applications, to enhance the access to and delivery of government information and service to citizens, business partners, employees, other agencies, and government entities" (McClure, 2000). As will be discussed later, e-commerce applications are a subset of e-government applications, and can be easily defined as "Business transactions conducted by electronic means other than conventional telephone service, e.g., facsimile or electronic mail (e-mail)" (National Telecommunications and Information Administration, 2002).
Context probabilism

We investigate a basic probabilistic dynamic semantics for a fragment containing conditionals, probability operators, modals, and attitude verbs, with the aim of shedding light on the prospects for adding probabilistic structure to models of the conversational common ground.
Operationalizing Telehealth for Home Dialysis Patients in the United States

Until January 2019, Medicare beneficiaries requiring maintenance dialysis therapy were eligible for telehealth services only if the originating site was located in a rural area and the patient was situated in an authorized facility. Free-standing dialysis facilities and the patient's home were clearly restricted sites. Beginning in 2019, new opportunities are available for home dialysis patients in the United States to engage in telehealth; these include existing waivers within End-Stage Renal Disease (ESRD) Seamless Care Organizations (ESCOs) participating in the Comprehensive ESRD Care demonstration project and, more broadly, for most prevalent home dialysis patients based on legislation within the 2018 Bipartisan Budget Act. Under this act, Medicare will pay for a monthly comprehensive telehealth encounter with the patient that originates from his or her home or a dialysis unit without geographic restrictions. The home dialysis patient has the sole power to choose the telehealth option, which may occur twice over a 3-month cycle and cannot occur during the first 3 months of home dialysis therapy. With studies suggesting that effective use of remote monitoring and telehealth encounters may improve patient satisfaction and outcomes while reducing the cost of care, increased use of telehealth has the potential to improve patient-centered care for home dialysis patients. In this perspective, we review the legislative changes, regulatory requirements, and technical and operational challenges for conducting telehealth encounters for home dialysis patients.
Chapter 31 Health care and the public sector

Abstract This chapter summarizes the many aspects of public policy for health care. I first consider government policy affecting individual behaviors. Government intervention to change individual actions such as smoking and drinking is frequently justified on externality grounds. External costs of smoking in particular are not very high relative to current taxes, however. More important quantitatively are the internal costs of smoking to the smoker. A recent literature has debated whether such internalities justify government action. I then turn to markets for medical care and health insurance. Virtually all governments provide health insurance for some part of the population. Governments face several fundamental choices in this provision. The first choice is between operating the medical system publicly or contracting for care from private providers. The make-or-buy decision is difficult in medical care because medical quality is not fully observable. Thus, private sector efficiency may come at the expense of quality. A second choice is in the degree of cost sharing. More generous insurance reduces the utility cost of illness but also leads to overconsumption of care when sick. Optimal insurance balances the marginal costs of risk bearing and moral hazard. In the USA, government policy has historically tilted towards more generous insurance, by excluding employer payments for health insurance from income taxation. The welfare loss from this subsidy has been a theme of much research. Finally, governments face issues of competition and selection. Sick people prefer more generous insurance than do healthy people. If insurers know who is sick and who is healthy, they will charge the sick more than the healthy. This differential pricing is a welfare loss, since it denies sick people the benefits of ex ante pooling of risk type. Even if insurers cannot separate sick from healthy, there are still losses: high costs of generous plans discourage people from enrolling in those plans. Generous plans also have incentives to reduce their generosity, to induce sick people to enroll elsewhere. Adverse selection is empirically very important. To date, public policies have not been able to offset it. Finally, I turn to the distributional aspects of medical care. Longstanding norms support at least basic medical care for everyone in society. But the generosity of health programs for the poor runs up against the possibility of crowding out private insurance coverage. Analysis from Medicaid program expansions shows that crowd-out does occur. Still, coverage expansions are worth the cost, given the health benefits they bring.