cssi/SciSciGPT-SciSciNet huggingface dataset:
High-Resolution CT Scan Findings in Familial Interstitial Pneumonia Do Not Conform to Those of Idiopathic Interstitial Pneumonia

Background The aim of this study was to describe the high-resolution CT (HRCT) scan features that characterize familial interstitial pneumonia (FIP). Methods FIP was defined by the presence of two or more cases of probable or definite idiopathic interstitial pneumonia (IIP) in individuals related within three degrees. The cases were collected consecutively from three centers. We identified 371 individuals with potential FIP from 289 families, including 340 individuals who had HRCT scans. Two chest radiologists independently reviewed the HRCT scans, scoring the extent and distribution of HRCT scan findings, and assessed the overall radiologic diagnosis. Results HRCT scan abnormalities suggestive of IIP were present in 85% (289 of 340 subjects). The most frequent findings were reticular pattern (n = 238, 82%) and ground-glass opacity (GGO) associated with reticular abnormality (n = 231, 80%). Other changes included GGO in 116 (40%), honeycombing in 92 (32%), and micronodules in 65 (22%). In the 289 cases with evidence of IIP, the findings were diffusely distributed in the craniocaudal plane in 186 (64%), and the lower lung zones were predominantly involved in 89 (31%). In the axial plane, 194 (67%) had a subpleural distribution; 88 (30%) were diffuse. The imaging pattern was classified as definite or probable usual interstitial pneumonia (UIP) in only 62 subjects (22%) and definite or probable nonspecific interstitial pneumonia (NSIP) in 35 subjects (12%). In 160 subjects (55%), the imaging findings did not conform to previously described UIP or NSIP patterns. Conclusions Reticulation and a mixed GGO/reticular pattern are the most common HRCT scan findings in FIP. The parenchymal abnormalities are most often diffuse in the craniocaudal dimension and have a predominantly peripheral distribution in the axial dimension. Although a radiologic UIP pattern is not uncommon, most cases do not conform to typical UIP or NSIP patterns.
Radiation Therapy of Carcinoma of the Vagina

Twenty-two patients with invasive primary carcinoma of the vagina were treated with radiation therapy for cure between 1970 and 1980 at Massachusetts General Hospital. Eighteen demonstrated squamous cell carcinoma and six demonstrated adenocarcinoma. the 5-year actuarial survival was 0.38; no difference was noted between the different histologies. For stages I, II, III and IV disease, 5-year actuarial survivals were 0.71, 0.29, 0.48, and 0.52. a dose – response relationship could be demonstrated for both survival and local control. No serious complications were observed. on the basis of these results, increased reliance on implant techniques to increase the radiation dose to subvaginal tissues, is advocated in stage II disease.
Assessment of surface water chloride and conductivity trends in areas of unconventional oil and gas development—Why existing national data sets cannot tell us what we would like to know

Heightened concern regarding the potential effects of unconventional oil and gas development on regional water quality has emerged, but the few studies on this topic are limited in geographic scope. Here we evaluate the potential utility of national and publicly available water-quality data sets for addressing questions regarding unconventional oil and gas development. We used existing U.S. Geological Survey and U.S. Environmental Protection Agency data sets to increase understanding of the spatial distribution of unconventional oil and gas development in the U.S. and broadly assess surface water quality trends in these areas. Based on sample size limitations, we were able to estimate trends in specific conductance (SC) and chloride (Cl−) from 1970 to 2010 in 16% (n = 155) of the watersheds with unconventional oil and gas resources. We assessed these trends relative to spatiotemporal distributions of hydraulically fractured wells. Results from this limited analysis suggest no consistent and widespread trends in surface water quality for SC and Cl− in areas with increasing unconventional oil and gas development and highlight limitations of existing national databases for addressing questions regarding unconventional oil and gas development and water quality.
Ischemic Stroke and Use of Estrogen and Estrogen/Progestogen as Hormone Replacement Therapy

Background and Purpose —Information about the risk of stroke in current postmenopausal hormone users is limited. Methods —In this case-control study, women aged 45 to 74 years hospitalized with a fatal or nonfatal stroke in any of 10 Northern California Kaiser Permanente facilities during the period November 1991 to November 1994 were identified as cases. Controls were selected at random from female Health Plan members. Data regarding use of estrogen plus progestogen or estrogen alone were obtained in interviews. Results —The analysis was based on nonproxy responses from 349 cases of ischemic stroke and 349 matched control subjects. After adjustment for confounders, the odds ratio for ischemic stroke in current hormone users was 1.03 (95% confidence interval, 0.65 to 1.65). The odds ratios for ischemic stroke in current hormone users showed no clear trend of increasing or decreasing risk in relation to duration of hormone use. The odds ratio for ischemic stroke in past hormone users was 0.84 (95% confidence interval, 0.54 to 1.32). Conclusions —In this study postmenopausal hormone use was not associated with an increase or decrease in the risk of ischemic stroke, a finding that is consistent with the body of literature on this topic.
GEOMETRIC FACTORS INFLUENCING STRUCTURAL DUCTILITY IN COMPACT I-SHAPED BEAMS

Local and global instabilities are usually treated as separate phenomena in the design of steel beams in buildings. In the past, such a notional decoupling of these local and global manifestations was necessary in the interest of creating useful and practical design provisions for steel specifications. Currently, great emphasis is being placed on ensuring ductile and predictable member level behavior in the interest of guaranteeing adequate systemwide response. The current practice of decoupling localized and global instabilities when determining member response is inadequate if structural ductility is to be correctly predicted. The research outlined herein uses experimentally verified nonlinear finite-element modeling techniques to identify two distinct inelastic modal manifestations that occur in compact I-shaped beams at failure. The existence of the two modes is supported by experimental evidence obtained from the literature, as well as other corroborating finite-element studies in the literature. A b...
Stringent Controls in Diabetic Nephropathy Associated With Optimization of Pregnancy Outcomes

To evaluate maternal-fetal outcomes in pregnancies complicated by diabetic nephropathy were evaluated. Nephropathy was defined as proteinuria of < 300 mg/24, or albuminuria < 300 mg/24 hr in the absence of infection. Twenty-seven pregnant women with variable degrees of diabetic nephropathy were included in the study. Prenatal care included stringent metabolic control and management of hypertension. Fetal and maternal outcomes were obtained by medical record review. There were no fetal deaths. One neonatal death occurred in a fetus delivered at 29 weeks gestation. IUGR and major congenital malformations were observed in 9% of the neonates; 26% of the infants were delivered preterm. Chronic hypertension (77%) and preeclampsia (53%) were common maternal complications; 63% of women required delivery by cesarean section. Successful pregnancy outcomes were achieved in < 95% of the women in our population. Modem management of the pregnancy complicated by diabetes has substantially improved the outcome of class F...
A different path to internationalization of engineering education

The collaborative team of Engineers in Technical, Humanitarian Opportunities of Service Learning (ETHOS, formed by students and staff at Iowa State University, University of Dayton, and Seattle University), has taken a new path to internationalizing engineering education. ETHOS has helped students gain awareness of the social and cultural fabric of the poorest nations in the world and has allowed them to perform research and design focused on improving the ability of people living in these nations to meet their basic needs. These activities are being implemented via on-campus curricular and immersion service experiences. Collaborations between these universities have been focused on helping two international nongovernmental organizations improve the efficiency and durability of the wood-burning stoves typically used for cooking by the world's poor This paper discusses the initial successes of and lessons learned from this collaboration, as well as its future activities.
Human visual sensitivity-weighted progressive image transmission using the lapped orthogonal transform

Progressive transmission of images based on the lapped orthogonal transform (LOT), adaptive classification, and human visual sensitivity (HVS) weighting is proposed. HVS weighting for LOT basis functions is developed. This technique is quite general and can be applied to any orthogonal transform. The method is compared with discrete cosine transform (DCT)-based progressive image transmission (PIT). It is shown that LOT-based PIT yields subjectively improved images compared to those based on DCT. This is consistent with the reduction in block structure characteristic of LOT image coding.
Pattern- and Network-Based Classification Techniques for Multichannel Medical Data Signals to Improve Brain Diagnosis

There is an urgent need for a quick screening process that could help neurologists diagnose and determine whether a patient is epileptic versus simply demonstrating symptoms linked to epilepsy but actually stemming from a different illness. An inaccurate diagnosis could have fatal consequences, particularly in operating rooms and intensive care units. Electroencephalogram (EEG) has been traditionally used, as a gold standard, to diagnose patients by evaluating those brain functions that might correspond to epilepsy and other brain disorders. This research therefore focuses on developing new classification techniques for multichannel EEG recordings. Two time-series classification techniques, namely, Support Feature Machine (SFM) and Network-Based Support Vector Machine (SVM) (NSVM), are proposed in this paper to predict from EEG readings whether a person is epileptic or nonepileptic. The SFM approach is an optimization model that maximizes classification accuracy by selecting a group of electrodes (features) that has strong class separability based on time-series similarity measures and correctly classifies EEG samples in the training phase. The NSVM approach integrates a new network-based model for multidimensional time-series data with traditional SVMs to exploit both the spatial and temporal characteristics of EEG data. The proposed techniques are tested on two EEG data sets acquired from ten and five patients, respectively. Compared with other commonly used classification techniques such as SVM and decision trees, the proposed SFM and NSVM techniques provide very promising and practical results and require much less time and memory resources than traditional techniques. This study is a necessary application of data mining to advance the diagnosis and treatment of human epilepsy.
Systemic But Not Central Nervous System Nitric Oxide Synthase Inhibition Exacerbates the Hypertensive Effects of Chronic Melanocortin-3/4 Receptor Activation

We examined whether systemic or central nervous system (CNS) inhibition of nitric oxide synthase exacerbates the cardiovascular responses of chronic CNS melanocortin 3/4 receptor activation. Sprague-Dawley rats implanted with telemetry probes, venous catheters, and intracerebroventricular (ICV) cannulae were divided in 3 groups. After control measurements, the NO synthase inhibitor L-NAME was infused (10 μg/kg/min intravenous) for 17 days and, starting on day 7 of L-NAME infusion, the melanocortin 3/4 receptor agonist melanotan II (MTII; 10 ng/hr; group 1) or saline vehicle (group 2) was infused ICV for 10 days. A third group not treated with L-NAME also received MTII ICV. Melanocortin 3/4 receptor activation caused a greater increase in mean arterial pressure (MAP) and heart rate in rats treated with intravenous L-NAME (35 ± 6 mm Hg and 56 ± 8 bpm) than L-NAME plus vehicle or MTII alone (22 ± 5 and 9 ± 2 mm Hg, and 26 ± 14 and 27 ± 5 bpm), despite a 58% and 50% reduction in food intake during the first 6 days of MTII infusion. To test if the amplified pressor response to MTII after L-NAME was attributable to a reduction in nitric oxide availability in the brain, we also infused L-NAME directly into the CNS alone or in combination with MTII. ICV infusion of L-NAME plus MTII caused only ≈ 10 mm Hg increase in MAP with no change in heart rate, similar to the effects of ICV infusion of MTII alone, whereas ICV infusion of L-NAME alone had no effect on MAP. These results suggest that reduction in peripheral, but not CNS, nitric oxide production augments MAP sensitivity to CNS melanocortin 3/4 receptor activation.
Variation and the indexical field 1

This paper argues for a focus on the social meaning of variation, based in a study of stylistic practice. It is common in the study of variation to interpret variables as reflections of speakers’ membership in social categories. Others have argued more recently that variables are associated not with the categories themselves, but with stances and characteristics that constitute those categories. The paper reviews some variation studies that showthatvariablesdonothavestaticmeanings,butrathergeneralmeanings that become more specific in the context of styles. Building on Michael Silverstein’s notion of indexical order, I argue that the meanings of variables are not precise or fixed but rather constitute a field of potential meanings ‐ an indexical field, or constellation of ideologically related meanings, any one of which can be activated in the situated use of the variable. The field is fluid, and each new activation has the potential to change the field by building on ideological connections. Thus variation constitutes an indexical system that embeds ideology in language and that is in turn part and parcel of the construction of ideology.
The Yersinia enterocolitica pYV Virulence Plasmid Contains Multiple Intrinsic DNA Bends Which Melt at 37°C

Temperature has a pleiotropic effect on Yersinia enterocolitica gene expression. Temperature-dependent phenotypes include the switching between two type III protein secretion systems, flagellum biosynthesis (≤30°C) and virulence plasmid-encoded Yop secretion (37°C). The mechanism by which temperature exerts this change in genetic programming is unclear; however, altered gene expression by temperature-dependent changes in DNA topology has been implicated. Here, we present evidence that the Y. enterocolitica virulence plasmid, pYV, undergoes a conformational transition between 30 and 37°C. Using a simplified two-dimensional, single-gel assay, we show that pYV contains multiple regions of intrinsic curvature, including virF, the positive activator of virulence genes. These bends are detectable at 30°C but melt at 37°C, the temperature at which the cells undergo phenotypic switching. We also show that pACYC184, a plasmid used as a reporter of temperature-induced changes in DNA supercoiling, has a single region of intrinsic bending detected by our assay. Topoisomers of pACYC184, with and without this bend, isolated from Y. enterocolitica were resolved by using chloroquine gels. The single bend has a dramatic influence on temperature-dependent DNA supercoiling. These data suggest that the Y. enterocolitica pYV plasmid may undergo a conformational change at the host temperature due to melting of DNA bends followed by compensatory adjustments in superhelical density. Hence, changes in DNA topology may be the temperature-sensing mechanism for virulence gene expression in Y. enterocolitica and other enteric pathogens.
The Assessment of Professional Competence

Valid assessment of professional competence has proven to be an elusive goal. Objective tests, direct observation of performance, overall ratings of competence, and simulations have been tried and found wanting in one way or another. Objective test items are criticized as being unrealistic and therefore invalid. Direct observation tends to be very unreliable and therefore invalid. Simulations and overall ratings of competence share both of these flaws to some extent. Basically, you can't win. This article outlines some of the many ways to lose and some ways to cut these losses. In doing so, it proposes a general framework for evaluating the validity of measures of competence, and it uses this framework to examine the strengths and weaknesses of three approaches to the assessment of professional competence: direct observation, simulation, and objective testing.
Fat Chance for Neural Stem Cells in Alzheimer’s Disease

Identifying factors driving neural stem cell dysfunction in age-related neurodegenerative diseases remains critical for the development of potential regenerative therapies. Now in Cell Stem Cell,Hamilton et al. (2015) find that lipid accumulation observed during early stages of Alzheimer's disease impairs neural stem cell activity in the adult brain.
Evaluation of the highly sensitized transplant recipient

The immune response against alloantigens involves the production of antibodies and development of T-cell immunity. Recipients sensitized to HLA antigens may have antibodies to almost all donors and may not be able to find a suitable kidney transplant donor. Strategies available to enable these patients to obtain a transplant are to give priority to highly sensitized patients, to perform therapy for antibody reduction or to transplant with existing antibodies and to intervene as needed with post-transplant treatment. While sensitization against HLA antigens is the most important cause of immunological transplant failure, other types of alloantigens, many of them expressed selectively in endothelial cells, and autoantigens may also be involved. Molecular typing and solid-phase antibody testing have markedly changed this field in the last few years. Methods for the analysis of HLA antibodies and for the study of T-cell reactivity and sensitization will also be discussed. Virtual cross-matching can now be performed for many patients, resulting in considerable savings in time and effort. Successful application of this approach requires the intervention of highly trained personnel with a good understanding of the limitations of the procedure and with intimate knowledge of the antibody profiles of the patients on the waiting list.
Virtual input devices for 3D systems

The device unified interface is a generalized and easily expandable protocol for the communication between applications and input devices. The key idea is to unify various device data into the parameters of a so-called "virtual input device." The device information-base, which includes device dependent information, is also incorporated into the virtual input device. Using the device unified interface, system builders are able to design their applications independent of the input devices as well as utilize the capabilities of several devices in the same application. >
Tumor proliferation in rectal cancer following preoperative irradiation.

PURPOSEThis study examines the effect of preoperative irradiation on tumor proliferation in rectal cancer.PATIENTS AND METHODSOne hundred twenty-two patients with locally advanced rectal cancer received 45 to 50 Gy of preoperative irradiation followed by surgery. Pretreatment tumor biopsies and postirradiation surgical specimens were scored for proliferative activity by assaying the extent of Ki-67 and proliferating-cell nuclear antigen (PCNA) immunostaining and the number of mitoses per 10 high-power fields (hpf). Preirradiation and postirradiation proliferative activity was determined and correlated to clinical outcome.RESULTSThere was an overall reduction in the tumor proliferative activity of rectal cancer after irradiation compared with its preirradiation state. Decreases in the activity of all three markers of tumor proliferation (Ki-67 and PCNA immunostaining, and mitotic counts) were observed in irradiated tumors compared with pretreatment biopsies. Postirradiation tumor proliferative activity was...
Debt, Discipline and the 99%: Neoliberal Political Economy and the Working Classes

Over the last three decades, neoliberal restructuring of the economy created a symbiosis of debt and discipline. New legal regimes and strategic use of monetary policy displaced Keynesian welfare, facilitated financialization of the economy, broke the power of organized labor, and expanded debt to sustain aggregate demand. Public laws and policies created a field of possibility within which financial markets extended their reach and brought ever-increasing sections of the working classes and the marginalized within the ambit of the credit economy. Reordered public policies and new norms of personal responsibility demarcated the horizon within which the economically vulnerable pursued strategies of economic survival and security. Neoliberalism deployed refashioned concepts of individual responsibility and human capital to facilitate assemblage of subjects who would engage the financialized economy as risk-taking entrepreneurs. Faced with restructured labor markets, wage pressures, and shrinking welfare, working classes found themselves with little choice but to pay for their basic needs through debt. Engulfment in debt, in turn, induced self-discipline and conformity with the logic of the financialized economy and precarious labor markets. This ensemble sutured debt with discipline.
New Risk Factors of Cardiovascular Disease

Cardiovascular (CV) disease is the leading cause of death in the US and worldwide. Primary prevention of CV disease requires identification and treatment of risk factors. Since multiple risk factors coexist and interact leading to overt CVD, use of global risk assessment scores like Framingham risk score is recommended to identify and target high risk individuals. However, scores incorporating traditional risk factors like hypertension, diabetes, dyslipidemia and smoking are imperfect as the majority of cardiac events in the general population occur in low and intermediate risk individuals. This has led to the search for novel risk factors that may provide incremental value over and above the traditional risk models in predicting adverse CV events and reclassify patients to widen the scope of primary prevention. The following chapter aims to provide a comprehensive review of the major emerging risk factors by highlighting their background, evaluating supportive evidence and providing insight into their potential clinical utility. Unresolved or controversial issues will also be addressed.
Las obligaciones internacionales de los Estados miembros de la Organización de Estados Americanos en la lucha contra el terrorismo

En los ultimos anos, el mundo ha sido testigo de acciones atroces que han llevado a la comunidad internacional a incluir en su agenda de trabajo la adopcion de numerosas iniciativas para combatir ataques terroristas. La Organizacion de Estados Americanos (oea), teniendo en cuenta que el terrorismo constituye una amenaza a la seguridad internacional y pone en peligro la proteccion eficaz de los derechos humanos1, ha adoptado una serie de acciones politicas, juridicas y judiciales encaminadas a guiar a los Estados miembros en la lucha contra el terrorismo.
Do All Firms Seek Legitimacy? An Examination of Firms in the Global Garment Industry

Researchers have suggested that firms’ corporate social responsibility (CSR) decisions are based on the desire to gain legitimacy in their institutional environment, which establishes societal norm...
Analysis of the results of IgM antibody detecting in suspected measles cases in Huainan city from 2004 to 2011

Objective To analyze the laboratory test results for measles in huainan from 2004 to 2011,and provide a diagnostic evidence for measles control and elimination.Methods Serological test and descriptive epidemiology method were used in suspected measles cases from measles surveillance system.Results A total of 851 serum samples of suspected measles cases were detected from 2004 to 2011,with 457(53.7%) were measles IgM-positive cases.Suspected measles cases with positive IgM results covered all the counties.The peak incidence was found during the period of March to May.Most cases aged below 8 months and above 15 years.Conclusion Early serological diagnosis of suspected measles by detection of IgM antibodies could provide basis for determination of measles epidemic and taking measures timely.
The effect of the microflora in cattle slurry on the survival of Salmonella dublin.

SUMMARY The survival of Salmonella dublin in cattle slurry is influenced by the presence of other micro-organisms. S. dublin multiplied in sterilized slurry and subsequently survived for more than 370 days, whereas in natural slurry or sterilized slurry to which bacteria originally isolated from slurry were added, no multiplication was observed and S. dublin survived for shorter periods. The survival of S. dublin appears to be influenced by competition with the normal microbial flora of slurry and on the production of acid compounds toxic to S. dublin.
What Difference Does Trade Make

Trade is important, although those of us who have special interests, as scholars or direct participants in exporting and importing, should not be guilty of over-estimating its importance. Achieving free trade in all products, agricultural as well as non-agricultural, will not bring the millennium; poor countries will not immediately, or even in the longer run, become rich as a result; nor will high-income countries realize major gains in national income that can be used to meet the costs of curing their social ills, such as poverty, urban congestion, crime or pollution. Achieving free trade is only one of a number of policy measures that governments can undertake to improve the efficiency with which their economies function and thus increase the national welfare. In saying this I do not imply that the only component of national welfare is more output — more income. But most of the social and economic problems that beset all countries, rich and poor, can be met more easily from a larger rather than a smaller national output.
Ferroelectricity in d 0 double perovskite fluoroscandates

Ferroelectricity in strain-free and strained double perovskite fluorides, ${\mathrm{Na}}_{3}{\mathrm{ScF}}_{6}$ and ${\mathrm{K}}_{2}{\mathrm{NaScF}}_{6}$, is investigated using first-principles density functional theory. Although the experimental room temperature crystal structures of these fluoroscandates are centrosymmetric, i.e., ${\mathrm{Na}}_{3}{\mathrm{ScF}}_{6}$ ($P{2}_{1}/n$) and ${\mathrm{K}}_{2}{\mathrm{NaScF}}_{6}$ ($Fm\overline{3}m$), lattice dynamical calculations reveal that soft polar instabilities exist in each prototypical cubic phase and that the modes harden as the tolerance factor approaches unity. Thus the double fluoroperovskites bear some similarities to $AB{\mathrm{O}}_{3}$ perovskite oxides; however, in contrast, these fluorides exhibit large acentric displacements of alkali metal cations (Na, K) rather than polar displacements of the transition metal cations. Biaxial strain investigations of the centrosymmetric and polar ${\text{Na}}_{3}{\text{ScF}}_{6}$ and ${\text{K}}_{2}{\text{NaScF}}_{6}$ phases reveal that the paraelectric structures are favored under compressive strain, whereas polar structures with in-plane electric polarizations ($\ensuremath{\sim}5--18\phantom{\rule{0.28em}{0ex}}\ensuremath{\mu}\mathrm{C}\phantom{\rule{0.16em}{0ex}}{\mathrm{cm}}^{\ensuremath{-}2}$) are realized at sufficiently large tensile strains. The electric polarization and stability of the polar structures for both chemistries are found to be further enhanced and stabilized by a coexisting single octahedral tilt system. Our results suggest that polar double perovskite fluorides may be realized by suppression of octahedral rotations about more than one Cartesian axis; structures exhibiting in- or out-of-phase octahedral rotations about the $c$ axis are more susceptible to polar symmetries.
Binding of transition metals to S100 proteins.

The S100 proteins are a unique class of EF-hand Ca2+ binding proteins distributed in a cell-specific, tissue-specific, and cell cycle-specific manner in humans and other vertebrates. These proteins are distinguished by their distinctive homodimeric structure, both intracellular and extracellular functions, and the ability to bind transition metals at the dimer interface. Here we summarize current knowledge of S100 protein binding of Zn2+, Cu2+ and Mn2+ ions, focusing on binding affinities, conformational changes that arise from metal binding, and the roles of transition metal binding in S100 protein function.
Differentiation of U.S. Malting Barley Varieties by Electrophoresis of Esterase Enzymes

Some barley varieties that vary widely in malting quality have morphologically identical seeds and thus cannot be readily identified in commerce. A new polyacrylamide gel electrophoretic (PAGE) met...
Effect of starting microstructure on helium plasma-materials interaction in tungsten

Abstract In a magnetic fusion energy (MFE) device, the plasma-facing materials (PFMs) will be subjected to tremendous fluxes of ions, heat, and neutrons. The response of PFMs to the fusion environment is still not well defined. Tungsten metal is the present candidate of choice for PFM applications such as the divertor in ITER. However, tungsten's microstructure will evolve in service, possibly to include recrystallization. How tungsten's response to plasma exposure evolves with changes in microstructure is presently unknown. In this work, we have exposed hot-worked and recrystallized tungsten to an 80 eV helium ion beam at a temperature of 900 °C to fluences of 2 × 1023 or 20 × 1023 He/m2. This resulted in a faceted surface structure at the lower fluence or short but well-developed nanofuzz structure at the higher fluence. There was little difference in the hot-rolled or recrystallized material's near-surface (≤50 nm) bubbles at either fluence. At higher fluence and deeper depth, the bubble populations of the hot-rolled and recrystallized were different, the recrystallized being larger and deeper. This may explain previous high-fluence results showing pronounced differences in recrystallized material. The deeper penetration in recrystallized material also implies that grain boundaries are traps, rather than high-diffusivity paths.
Clinical implications of Paracoccus yeeii bacteremia in a patient with decompensated cirrhosis

Infections in patients with cirrhosis are common among those who develop variceal hemorrhage. Prophylactic antimicrobial treatment with third generation cephalosporins is recommended in patients with advanced cirrhosis and gastrointestinal hemorrhage. However no infectious source is identified in up to 50% of patients with cirrhosis and clinical sepsis. We report the first case of Paracoccus yeeii bacteremia in a patient with decompensated cirrhosis who presented with variceal hemorrhage. This rare gram negative organism that occurs naturally in the soil has been difficult to isolate until recent technological advances and may not be susceptible to third generation cephalosporins. Our case reinforces the challenges in isolating rare infections in patients with cirrhosis, the need to consider uncommon organisms in infected but culture negative patients with cirrhosis, and the importance of optimizing antimicrobials to reduce the incidence of drug resistant organisms.
Impact of tranexamic acid on coagulation and inflammation in murine models of traumatic brain injury and hemorrhage

Abstract Background Posttraumatic coagulopathy and inflammation can exacerbate secondary cerebral damage after traumatic brain injury (TBI). Tranexamic acid (TXA) has been shown clinically to reduce mortality in hemorrhaging and head-injured trauma patients and has the potential to mitigate secondary brain injury with its reported antifibrinolytic and antiinflammatory properties. We hypothesized that TXA would improve posttraumatic coagulation and inflammation in a murine model of TBI alone and in a combined injury model of TBI and hemorrhage (TBI/H). Methods An established murine weight drop model was used to induce a moderate TBI. Mice were administered intraperitoneal injections of 10 mg/kg TXA or equivalent volume of saline 10 min after injury. An additional group of mice was subjected to TBI followed by hemorrhagic shock using a pressure-controlled model. TBI/H mice were given intraperitoneal injections of TXA or saline during resuscitation. Blood was collected at intervals after injury to assess coagulation by rotational thromboelastometry (ROTEM) and inflammation by Multiplex cytokine analysis. Soluble P-selectin, a biomarker of platelet activation, and serum neuron-specific enolase, a biomarker of cerebral injury, were measured at intervals. Brain homogenates were analyzed for inflammatory changes by Multiplex enzyme-linked immunosorbent assay, and splenic tissue was collected for splenic cell population assessment by flow cytometry. Results There were no coagulation, serum or cerebral cytokine, P-selectin, or neuron-specific enolase differences between mice treated with TXA or saline after TBI. After the addition of hemorrhagic shock and resuscitation to TBI, TXA administration still did not affect coagulation parameters, systemic or cerebral inflammation, or platelet activation, as compared with saline alone. At 24 hours after TBI, mice given TXA demonstrated lower splenic total cell counts central memory CD8, effector CD8, B cell, and increased naive CD4 cell populations. By contrast, TXA did not affect splenic leukocyte populations after combined TBI/H. Conclusions Despite clinical data suggesting a mortality benefit, TXA did not modulate coagulation, inflammation, or biomarker generation in either the TBI or TBI/H murine models. Administration of TXA after TBI altered splenic leukocyte populations, which may contribute to a change in posttraumatic immune status. Future studies should be done to investigate the role of TXA in the development of posttraumatic immunosuppression and risk of nosocomial infections.
Can Grammatical Knowledge Predict Chinese Proficiency

This study explored how to assess the explicit and implicit grammatical knowledge of learners of Chinese, and their relationship to learners’ overall Chinese language proficiency. The participants were 85 learners of Chinese as a foreign language (CFL) at universities in the USA. A test battery included three parts: (1) a timed grammaticality judgment test (GJT) and an oral repetition task for implicit grammatical knowledge; (2) an untimed GJT and an error correction task for explicit grammatical knowledge; and (3) a general language proficiency test. A set of correlation coefficients were computed to explore the contributions of implicit and explicit grammatical knowledge to overall proficiency. The results showed that there was no statistically significant correlation between the CFL learners’ implicit grammatical knowledge and their proficiency scores, but there was a strong relationship between their explicit grammatical knowledge and their general proficiency. Further multiple regression analyses demonstrated that explicit knowledge better predicted the CFL learners’ general L2 proficiency. These findings are discussed in light of how the relationship of implicit and explicit grammatical knowledge with general proficiency might be influenced by learners’ actual level of proficiency or learning stage and how general proficiency is tested. Pedagogical implications are also discussed.
Gastrointestinal Complications Following Radical Cystectomy Using Enhanced Recovery Protocol.

Abstract Background The development of enhanced recovery after surgery (ERAS) protocols for patients undergoing radical cystectomy (RC) represents a significant advance in perioperative care. Objective To evaluate gastrointestinal (GI) complications following RC and urinary diversion (UD) using our institutional ERAS protocol. Design, setting, and participants We identified 377 consecutive cases of open RC and UD for which our ERAS protocol was used from May 2012 to December 2015. Exclusion criteria were consent refusal; non-bladder primary disease; palliative, salvage, or additional surgery; and prolonged postoperative intubation. A matched cohort of 144 patients for whom a traditional postoperative protocol (pre-ERAS) was used between 2003 and 2012 was selected for comparison. Results and limitations A total of 292 ERAS patients with median age of 70 yr were included in the study, 65% of whom received an orthotopic neobladder. The median time to first flatus and bowel movement was 2 d. The median length of stay was 4 d. GI complications occurred in 45 patients (15.4%) during the first 30 d following RC, 93% of which were of minor grade. The most common GI complication was postoperative ileus (POI) in 34 cases (11.6%). Some 22 patients (7.5%) required a nasogastric tube, and parenteral nutrition was required in three patients. The rate of 30-d GI complications was significantly lower in the ERAS cohort than in the control group (13% vs 27%; p =0.003), as was the rate of POI (7% vs 23%; p 0.001). This effect was independent of other variables (hazard ratio 0.38, 95% confidence interval 0.18–0.82; p =0.01). Conclusions Our institutional ERAS protocol for RC is associated with significantly improved perioperative GI recovery and lower rates of GI complications. This protocol can be tested in multi-institutional studies to reduce GI morbidity associated with RC. Patient summary In this study, we showed that an enhanced recovery protocol for patients undergoing radical cystectomy for bladder cancer was associated with a significantly shorter length of hospital stay and lower rates of gastrointestinal complications, especially postoperative ileus.
Upper urinary tract washings outperform voided urine specimens to detect upper tract high-grade urothelial carcinoma

Background Cytological examination of voided urine (VU) can reliably diagnose high-grade urothelial carcinoma (HGUC) of the lower urinary tract, but its value in the diagnosis of upper tract HGUC (UTHGUC) is less well-established. To clarify the utility of VU in the setting of UTHGUC, we examined urinary specimens from patients with UTHGUC on follow-up surgical pathology. Methods 52 VU specimens (47 patients) with subsequent biopsy-proven UTHGUC were identified over a 12-year period; 32 had a corresponding upper tract urinary washing (UW) specimen. Patients with concurrent bladder HGUC were excluded. The diagnoses of VU specimens were tabulated and compared to those of UW specimens. Results Three UW specimens had a less severe diagnosis, 8 had the same diagnosis, and 21 had a more severe diagnosis than the corresponding VU specimen from the same patient. Significantly more UW specimens demonstrated high-risk features as compared with VU specimens (P = .003). In specimens with atypia, a definitive diagnosis of HGUC was made significantly more often on UW vs. VU specimens (P = .003). Conclusions Among patients with confirmed UTHGUC, 50% of preceding VU specimens demonstrated high-grade features compared to almost 90% of UW specimens. Though VU cytology shows atypia in the majority of cases, it performs inferiorly to UW for the detection of UTHGUC.
Dietary risk factors and colorectal adenomatous polyps

Source Citation Neugut AI, Garbowski GC, Lee WC, et al. Dietary risk factors for the incidence and recurrence of colorectal adenomatous polyps. A case-control study. Ann Intern Med. 1993 Jan 15:118...
Factors related to black/white disparities in survival among non-elderly women with breast cancer, 2004-2012.

6548Background: The breast cancer mortality gap between black and white women has widened, and as of 2012, the mortality rate was 43% higher in black women. Although disparities in mortality for black women may be partially modifiable with early detection and reducing barriers to treatment, the relative contribution of modifiable factors (MF) to the black-white disparity in breast cancer mortality is unclear. We assessed the individual contributions of MF (stage, tumor size, treatment [surgery, radiation, chemotherapy, hormonal therapy], and stage × treatment interaction) and non-modifiable factors (NMF) (hormone receptor status, histology, grade, and comorbidity) in the excess risk of death among black women with breast cancer. Methods: Our cohort included 573,387 black and white women aged 18-64 with invasive breast cancer diagnosed during 2004−2012 and followed through 2013 from the National Cancer Data Base. Excess relative risk (ERR) of death among black vs white women was measured using multivariate...
Beyond discrimination: A comparison of calibration methods and clinical usefulness of predictive models of readmission risk

Abstract Background Prior to implementing predictive models in novel settings, analyses of calibration and clinical usefulness remain as important as discrimination, but they are not frequently discussed. Calibration is a model’s reflection of actual outcome prevalence in its predictions. Clinical usefulness refers to the utilities, costs, and harms of using a predictive model in practice. A decision analytic approach to calibrating and selecting an optimal intervention threshold may help maximize the impact of readmission risk and other preventive interventions. Objectives To select a pragmatic means of calibrating predictive models that requires a minimum amount of validation data and that performs well in practice. To evaluate the impact of miscalibration on utility and cost via clinical usefulness analyses. Materials and methods Observational, retrospective cohort study with electronic health record data from 120,000 inpatient admissions at an urban, academic center in Manhattan. The primary outcome was thirty-day readmission for three causes: all-cause, congestive heart failure, and chronic coronary atherosclerotic disease. Predictive modeling was performed via L1-regularized logistic regression. Calibration methods were compared including Platt Scaling, Logistic Calibration, and Prevalence Adjustment. Performance of predictive modeling and calibration was assessed via discrimination (c-statistic), calibration (Spiegelhalter Z-statistic, Root Mean Square Error [RMSE] of binned predictions, Sanders and Murphy Resolutions of the Brier Score, Calibration Slope and Intercept), and clinical usefulness (utility terms represented as costs). The amount of validation data necessary to apply each calibration algorithm was also assessed. Results C-statistics by diagnosis ranged from 0.7 for all-cause readmission to 0.86 (0.78–0.93) for congestive heart failure. Logistic Calibration and Platt Scaling performed best and this difference required analyzing multiple metrics of calibration simultaneously, in particular Calibration Slopes and Intercepts. Clinical usefulness analyses provided optimal risk thresholds, which varied by reason for readmission, outcome prevalence, and calibration algorithm. Utility analyses also suggested maximum tolerable intervention costs, e.g., $1720 for all-cause readmissions based on a published cost of readmission of $11,862. Conclusions Choice of calibration method depends on availability of validation data and on performance. Improperly calibrated models may contribute to higher costs of intervention as measured via clinical usefulness. Decision-makers must understand underlying utilities or costs inherent in the use-case at hand to assess usefulness and will obtain the optimal risk threshold to trigger intervention with intervention cost limits as a result.
Clinical benefit and toxicity of nivolumab plus ipilimumab in patients with advanced melanoma previously treated with checkpoint blockade inhibitors.

100Background: The combination of nivolumab and ipilimumab (nivo+ipi) prolongs progression-free survival in treatment-naive patients (pts) with advanced melanoma. However, the efficacy and tolerabi...
Controlling the input impedance of constant power loads

Power electronic circuits often regulate load power and present a constant power load (CPL) to the utility or other electrical source. Because CPLs exhibit a negative incremental input impedance, they pose stability concerns in both DC and AC systems. This paper presents a power converter for a constant power LED lighting load that mitigates these stability concerns by presenting a controllable input impedance to the electrical source. The use of an energy buffer allows the converter to control input power to resemble a resistive load over short times, while still delivering constant output power. Experimental results demonstrate that the converter exhibits a resistive input impedance at frequencies over 0.5 Hz while maintaining constant power to the LED load.
A Mathematician's Look at Foucault's Pendulum

(2005). A Mathematician's Look at Foucault's Pendulum. Math Horizons: Vol. 12, No. 3, pp. 19-32.
A Review of: “The American Faculty: The Restructuring of Academic Work and Careers”

This book provides readers with a 30-year picture on the transformation of academic appointments, work, and careers in higher education. The authors stated, “American higher education and the acade...
Oxygenation of Blood for Clinical Applications

The analytical description of blood oxygenation is of both practical and theoretical importance. The design of clinical oxygenators in the past has been based on experimental trials, whereas the newer generation of such devices rely upon theoretical analysis or implications. Initial clinical use of oxygenators was for short-term open heart surgery, and direct contact of blood with the gas phase was allowed (1). Longer term lung prosthesis or assistance would be possible if the trauma associated with this direct contact could be avoided (2). For this reason, membrane oxygenators have been proposed where the flowing blood and gas phases are separated by a permeable membrane. The interposing of such a membrane results in several problems associated with the additional resistance to the transfer of O2 and CO2 compared with the direct contact oxygenators. Not only Is there a resistance associated with the membrane itself, but the blood adjacent to the membrane approaches stagnant conditions. The zero flow membrane region results in diffusion controlled mass transfer which is generally more significant in dictating oxygenator size (and complexity) than is the membrane resistance. A recent proliferation of membrane oxygenator design innovations reflect attempts to augment diffusion with convection in the direction perpendicular to the flow (3,4,5). Whereas diffusion is an extremely efficient method of transfer over short distances (10−4 cm.) (6), it is ineffective in practical channel dimensions (0.1 cm.). Therefore, an understanding of diffusional processes in a flowing blood stream is of immediate practical importance.