cssi/SciSciGPT-SciSciNet huggingface dataset:
A comparison of misonidazole sensitized radiation therapy to radiation therapy alone for the palliation of hepatic metastases: Results of a radiation therapy oncology group randomized prospective trial

Between May 1980 and July 1983, the RTOG conducted a randomized prospective study comparing external radiation therapy and misonidazole to radiation therapy alone for patients with hepatic metastases. Two hundred fourteen patients were accessioned to this study of whom 187 were evaluable. Radiation therapy was delivered to the whole liver to a dose of 21.0 Gy in 7 fractions. Misonidazole was administered orally, 1.5 gm/m2 daily 4-6 hr before each treatment. Patients in the two treatment groups were evenly distributed with respect to stratification variables including primary site, extent of metastatic disease, and Karnofsky Performance Score (KPS). End points examined included amelioration of hepatic pain, improvement of KPS and alkaline phosphatase, decrease in liver and tumor size, and survival. The addition of misonidazole did not significantly improve the therapeutic response to radiation therapy in any of the parameters studied. Hepatic irradiation was effective in relieving abdominal pain with 80% of the symptomatic patients achieving improvement following therapy. Pain was completely relieved in 54% of these patients. Patients with liver metastases from colon carcinoma improved more frequently than those with metastases from other primary tumor sites (p = 0.02). Relief of pain occurred more frequently in patients treated with radiation therapy and misonidazole (87%) compared with radiation therapy alone (74%) (p = 0.08). Palliation of pain was prompt, occurring within a median of 1.7 weeks from the initiation of treatment, and 94% of patients who improved did so within 6 weeks of treatment. The median duration of response was 13.0 weeks in the symptomatic patients; 52% of those surviving 3 months remained improved. KPS improved in 28% of patients. Serial CT scans revealed a partial response in 7% and a marginal response in 13% of patients. One patient had a complete response to treatment. The median survival of patients treated in this series was 4.2 months with no difference between the two treatment groups. Patients with metastases from colon carcinoma and an initial KPS of 80 or more (48% of the patient population) had a median survival of 5.8 months with radiation therapy alone compared with 6.6 months with radiation therapy and misonidazole (p = 0.36). There was no significant treatment related morbidity. Radiation therapy remains an excellent palliative tool for the management of patients with symptomatic hepatic metastases. Further research must continue to identify new methods of selectivity enhancing the tumor response to radiation therapy.
Aerodynamic Analysis of Simulated Heat Shield Recession for the Orion Command Module

The aerodynamic effects of the recession of the ablative thermal protection system for the Orion Command Module of the Crew Exploration Vehicle are important for the vehicle guidance. At the present time, the aerodynamic effects of recession being handled within the Orion aerodynamic database indirectly with an additional safety factor placed on the uncertainty bounds. This study is an initial attempt to quantify the effects for a particular set of recessed geometry shapes, in order to provide more rigorous analysis for managing recession effects within the aerodynamic database. The aerodynamic forces and moments for the baseline and recessed geometries were computed at several trajectory points using multiple CFD codes, both viscous and inviscid. The resulting aerodynamics for the baseline and recessed geometries were compared. The forces (lift, drag) show negligible differences between baseline and recessed geometries. Generally, the moments show a difference between baseline and recessed geometries that correlates with the maximum amount of recession of the geometry. The difference between the pitching moments for the baseline and recessed geometries increases as Mach number decreases (and the recession is greater), and reach a value of -0.0026 for the lowest Mach number. The change in trim angle of attack increases from approx. 0.5deg at M = 28.7 to approx. 1.3deg at M = 6, and is consistent with a previous analysis with a lower fidelity engineering tool. This correlation of the present results with the engineering tool results supports the continued use of the engineering tool for future work. The present analysis suggests there does not need to be an uncertainty due to recession in the Orion aerodynamic database for the force quantities. The magnitude of the change in pitching moment due to recession is large enough to warrant inclusion in the aerodynamic database. An increment in the uncertainty for pitching moment could be calculated from these results and included in the development of the aerodynamic database uncertainty for pitching moment.
Pareto optimal designs of low sensitivity digital filters: parallel and cascade form structures

Uses the Pareto optimal multi-criterion optimization method to design low sensitivity state-space digital filters for the parallel form and cascade form structures. The designs balance the desire to match a desired filter response with the desire to produce a low sensitivity filter. Some work on direct form II designs which solidifies some previous work is shown. The authors find that pole/zero cancellation pairs added to a desired direct form II filter are Pareto optimal. >
Ethyl (E)‐2,3‐difluoro‐3‐(tributylstannyl)acrylate and Ethyl (Z)‐2,3‐difluoro‐3‐(tributylstannyl)acrylate

Ethyl (Z)-2,3-difluoro-3-(tributylstannyl) acrylate [874203-77-7] C17H32F2O2Sn (MW 425.1416) InChI = 1S/C5H5F2O2.3C4H9.Sn/c1-2-9-5(8)4(7)3-6;3*1-3-4-2;/h2H2,1H3;3*1,3-4H2,2H3; InChIKey = UHAOHINBFTYCMF-UHFFFAOYSA-N Ethyl (E)-2,3-difluoro-3-(tributylstanny)acrylate [500116-28-9] C17H32F2O2Sn (MW 425.1416) InChI = 1S/C5H5F2O2.3C4H9.Sn/c1-2-9-5(8)4(7)3-6;3*1-3-4-2;/h2H2,1H3;3*1,3-4H2,2H3; InChIKey = UHAOHINBFTYCMF-UHFFFAOYSA-N (2,3-difluoroacrylic ester synthons for use in an array of coupling reactions) Physical Data: (Z) yellow oil; (E) colorless oil. Solubility: (Z) and (E), acetonitrile, ethyl acetate, DMF, and hexane. Purification: (Z) and (E) column chromatography on silica gel (hexane/ethyl acetate, 30:1).
Hepatic and pulmonary clearance of exogenous vasoactive intestinal peptide in the rat.

I125-labeled vasoactive intestinal peptide (VIP) has been injected into the portal and systemic circulations of rats in an attempt to identify the distribution and fate of the circulating peptide. When VIP I125 was introduced into the portal circulation radioactivity was concentrated in the liver (415.5% ± 57.2 at 10 min-counts per minute (cpm) per gram of tissue as percentage cpm per milliliter of plasma). Radioactivity in kidney and lung was 346.6% ± 37.4 and 136.4% ± 11.4, respectively. In contrast, if the liver was bypassed by performing a portacaval shunt or by injecting into the inferior vena cava, radioactivity was maximal in the lung (2,454.3% ± 302.3 10 min after IVC injection) with activity in the liver of only 89.3% ± 10.6. Analysis of the pattern of radioactivity in plasma and tissue extracts by gel filtration chromatography showed the presence of a number of fragments of smaller molecular weight than VIP with a progressive diminution of the amount of VIPlike radioactivity. Both liver and lung have the capacity to concentrate VIP from the circulation. Vasoactive intestinal peptide released into the portal circulation is probably taken up initially by the liver, and this may prevent subsequent uptake by pulmonary tissue. There is some evidence to suggest that the liver and the lung may handle VIP in different ways. If this is so, the enhanced pulmonary extraction of VIP when the liver is bypassed may have some significance for the cardiovascular complications of fulminant liver failure.
Vectorcardiographic analysis of T-wave inversion in the right precordial leads

Abstract The transverse plane T loop of 126 subjects with normal QRS complexes and inverted T waves in the right precordial leads were studied and correlated with their clinical diagnoses. The vectorcardiographic analysis included the determination of the direction and magnitude of the maximum T vector, the uniformity of the speed of inscription, and the direction of inscription of the loop. A clockwise and/or a uniformly inscribed T loop were found almost exclusively in patients with clinical evidence of heart disease. It is concluded that the vectorcardiogram may offer additional information permitting separation of patients with or without heart disease whose scalar ECG's show T-wave inversion in the right precordial leads.
Cardiac metastasis in renal cell carcinoma without vena cava or atrial involvement: an unusual presentation of metastatic disease

Cardiac metastasis in renal cell carcinoma is a very rare entity, with only a few previously reported cases. In this series, we report two cases of ventricular metastases from renal cell carcinoma without vena cava or right atrial involvement. The first case involves an initially isolated inoperable metastasis to the left ventricle, which was treated with systemic targeted therapy with favorable local response. Our second case illustrates a patient with an isolated cardiac metastasis in the interventricular septum with extension into the right ventricle, which has also remained stable in size on systemic targeted therapy. Although anti-angiogenic agents such as tyrosine kinase inhibitors have transformed the treatment of metastatic renal cell carcinoma in recent years, their efficacy and safety in treating patients with metastatic disease in highly vascular organs such as the heart are currently unknown, with no prior reports on this topic. We describe our novel management of these unique cases and discuss the current medical and surgical approaches to treating cardiac metastases from renal cell carcinoma.
Force-based needle insertion for medical applications

Needle insertion is pervasive in almost all medical activities. The development of compact, lightweight automated tools for needle insertion with the reliability of an expert needle-inserting nurse could significantly reduce the risk to both civilian and military patients. Such tools could open the door to many advanced concepts for future medicine by being an “enabler” of one of the first actions in almost all procedures. The purpose of this paper is to discuss two force-based devices that address the needle insertion problem: a compliance-sensing system that mimics the nurse palpation to determine the best needle insertion point across a vein, and a needle insertion device that uses force-based profiles during insertion to achieve successful catheterization without puncturing the vein back wall. The methodologies and implementation approaches for the two enabling systems are described. Experimental data obtained with training pads and phantom arms are presented and discussed.
Performance of passive samplers for monitoring estuarine water column concentrations: 2. Emerging contaminants.

Measuring dissolved concentrations of emerging contaminants, such as polybrominated diphenyl ethers (PBDEs) and triclosan, can be challenging due to their physicochemical properties resulting in low aqueous solubilities and association with particles. Passive sampling methods have been applied to assess dissolved concentrations in water and sediments primarily for legacy contaminants. Although the technology is applicable to some emerging contaminants, the use of passive samplers with emerging contaminants is limited. In the present study, the performance of 3 common passive samplers was evaluated for sampling PBDEs and triclosan. Passive sampling polymers included low-density polyethylene (PE) and polyoxymethylene (POM) sheets, and polydimethylsiloxane (PDMS)-coated solid-phase microextraction (SPME) fibers. Dissolved concentrations were calculated using measured sampler concentrations and laboratory-derived partition coefficients. Dissolved tri-, tetra-, and pentabrominated PBDE congeners were detected at several of the study sites at very low pg/L concentrations using PE and POM. Calculated dissolved water concentrations of triclosan ranged from 1.7 ng/L to 18 ng/L for POM and 8.8 ng/L to 13 ng/L for PE using performance reference compound equilibrium adjustments. Concentrations in SPME were not reported due to lack of detectable chemical in the PDMS polymer deployed. Although both PE and POM were found to effectively accumulate emerging contaminants from the water column, further research is needed to determine their utility as passive sampling devices for emerging contaminants. Environ Toxicol Chem 2013;32:2190–2196. © 2013 SETAC
Preventing Youth Violence and Delinquency through a Universal School-Based Prevention Approach

Violence is an important public health problem among adolescents in the United States. Substance use and violence tend to co-occur among adolescents and appear to have similar etiologies. The present study examined the extent to which a comprehensive prevention approach targeting an array of individual-level risk and protective factors and previously found effective in preventing tobacco, alcohol, and illicit drug use is capable of decreasing violence and delinquency. Schools (N=41) were randomly assigned to intervention and control conditions. Participants in the 20 intervention schools received the Life Skills Training prevention program including material focusing on violence and the media, anger management, and conflict resolution skills. Survey data were collected from 4,858 sixth grade students prior to the intervention and three months later after the intervention. Findings showed significant reductions in violence and delinquency for intervention participants relative to controls. Stronger prevention effects were found for students who received at least half of the preventive intervention. These effects include less verbal and physical aggression, fighting, and delinquency. The results of this study indicate that a school-based prevention approach previously found to prevent tobacco, alcohol, and illicit drug use can also prevent violence and delinquency.
Multiparameter continuation methods for tracking desired flow states

Conventional means of continuation and critical point tracking have been adapted for two novel applications: the tracking of onset of separation at a boundary, and of the limiting conditions for pinning of a static contact line at an edge. The method presented applies more generally to tracking flow states under constrained variation of parameters; the only difference from one application to another is the choice of constraints. Because this choice is virtually limitless, it is believed that the method could have wide utility in computational fluid mechanics and other systems modeling, whether for scientific or for technological purposes. >
QUANTIFYING THE IMPACT OF OCCUPANT BEHAVIOR IN MIXED MODE BUILDINGS

As systems in high performance buildings become more complex and manually operable windows and shading devices are incorporated into advanced buildings, it is imperative that building engineers understand and account for the impacts that occupant behavior may have on building performance. By coupling building energy simulation models with stochastic occupant behavior models, the magnitude and distribution of impacts that occupants have on building energy consumption are demonstrated via a simulation study. The results show that occupant actions can increase or decrease energy consumption depending on the HVAC control strategy implemented. For a single month during the cooling season, the range of HVAC electricity consumption predicted by a set of simulations that included stochastic models of occupant window, blind, and lighting use varied by approximately 20% for each of 25 different control scenarios.
Case Study: The USA Paralympic Volleyball Coaching Internship Course

A group of American University Graduate Students participated in a one week internship at the USA Paralympic Volleyball training center in Oklahoma, USA. A primary goal of the internship was to increase the motivation of the students in the program towards their own coaching endeavors as they examined and reflected upon their core values in coaching. The student coaches in the study (n=9) were exposed to Coaching by Master Coaches from the USA Paralympic Volleyball team. These master coaches were skilled in an Athlete Centred Coaching Style that manifested the core values of: 1) an exemplary work ethic, 2) player empowerment, and 3) a prioritization of team cohesion. Upon the completion of the internship, data analysis revealed that there was a signi!cant di"erence on scores for the student coaches on the Sport Motivation Scale II, a reliable and valid instrument designed to measure sport motivation. This increase in coach motivation occurred in large part as a result of the students’ exposure and interaction with the Paralympic Master Coaches and the USA Paralympic Volleyball teams.
Hyperfiltration and uricosuria in adolescents with type 1 diabetes

Urine uric acid (UUA) has been implicated in the pathogenesis of diabetic nephropathy via its effect on tubular cells. We hypothesized that the UUA level would be higher in adolescents with type 1 diabetes (T1D) than in those without T1D. We also hypothesized that UUA and fractional uric acid excretion (FeUA) would be higher in adolescents with T1D and hyperfiltration [estimated glomerular filtration rate (eGFR) ≥141 mL/min/1.73 m2] than in those without hyperfiltration. The UUA concentration was determined and FeUA calculated in adolescents with (n = 239) and without T1D (n = 75). The eGFR was calculated using the Zappitelli equation based on serum creatinine and cystatin C concentrations. Compared to the non-diabetic adolescents enrolled in the study, those with T1D had a higher eGFR (mean ± standard deviation: 120 ± 22 vs. 112 ± 16 mL/min/1.73 m2; p = 0.0006), lower urine pH (6.2 ± 0.8 vs. 6.5 ± 1.0; p = 0.01), and higher UUA (37.7 ± 18.6 vs. 32.8 ± 18.1 mg/dL; p = 0.049) and FeUA (median [interquartile range]: 6.2 [4.3–8.7] vs. 5.2 [3.6–7.0] %; p = 0.02). Among adolescents with T1D, those with hyperfiltration had higher median FeUA (8.6 [5.2–9.9] vs. 6.0 [4.2–8.3] %; p = 0.02) than those without hyperfiltration. The adolescents with T1D enrolled in the study had higher eGFR, higher UUA and more acidic urine than the non-diabetic controls, which may have increased their risk of UUA crystallization. Adolescents with T1D and hyperfiltration had higher FeUA than those without hyperfiltration. These hypothesis-generating observations may suggest a potential pathophysiologic association between uricosuria and hyperfiltration.
Bacterial characterization of Beijing drinking water by flow cytometry and MiSeq sequencing of the 16S rRNA gene

Flow cytometry (FCM) and 16S rRNA gene sequencing data are commonly used to monitor and characterize microbial differences in drinking water distribution systems. In this study, to assess microbial differences in drinking water distribution systems, 12 water samples from different sources water (groundwater, GW; surface water, SW) were analyzed by FCM, heterotrophic plate count (HPC), and 16S rRNA gene sequencing. FCM intact cell concentrations varied from 2.2 × 10(3) cells/mL to 1.6 × 10(4) cells/mL in the network. Characteristics of each water sample were also observed by FCM fluorescence fingerprint analysis. 16S rRNA gene sequencing showed that Proteobacteria (76.9-42.3%) or Cyanobacteria (42.0-3.1%) was most abundant among samples. Proteobacteria were abundant in samples containing chlorine, indicating resistance to disinfection. Interestingly, Mycobacterium, Corynebacterium, and Pseudomonas, were detected in drinking water distribution systems. There was no evidence that these microorganisms represented a health concern through water consumption by the general population. However, they provided a health risk for special crowd, such as the elderly or infants, patients with burns and immune-compromised people exposed by drinking. The combined use of FCM to detect total bacteria concentrations and sequencing to determine the relative abundance of pathogenic bacteria resulted in the quantitative evaluation of drinking water distribution systems. Knowledge regarding the concentration of opportunistic pathogenic bacteria will be particularly useful for epidemiological studies.
New York University Steinhardt Information Technology Group's New Methodologies for Developing Student Worker Skillsets

In light of resource constraints and the strong push for new university technology initiatives, an increasing number of Information Technology (IT) and Academic Technology (AT) teams must create more efficient ways to support staff, faculty, researchers, and students. This demand affects IT/AT professionals and student technicians alike. While hiring student technicians can be a cost effective alternative to retraining and/or hiring more IT/AT professionals, expecting efficient quality work from this population creates its own set of unique managerial challenges. Such challenges demand a new, integrated methodology that both trains and develops student talent. Using his experience as a student leader and Resident Assistant in NYU's Office of Residential Life and Housing Services (ORLHS), the author has fostered his student technicians' skills while creating a pervasive culture of customer service and support. This paper will discuss how student-focused development plans, modular trainings, and goal setting has positively impacted the NYU Steinhardt School of Culture, Education, and Human Development IT group's ability to fulfill its mission: "To empower members of Steinhardt to efficiently and effectively incorporate technology in their academic and professional work". The author will also discuss measures of the training method's effectiveness, as well as future challenges of the student development model at NYU and the higher education community at large.
Upper gastrointestinal tract injury in patients receiving Kayexalate (sodium polystyrene sulfonate) in sorbitol: Clinical, endoscopic, and histopathologic findings

Kayexalate (sodium polystyrene sulfonate) in sorbitol has been demonstrated to cause colonic necrosis in a subset of uremic patients who are administered the cation exchange resin for treatment of hyperkalemia. Upper gastrointestinal damage associated with Kayexalate in sorbitol is reported far less
Regional Land Suitability Framework for Utility-Scale Wind Farm Development

AbstractThis paper presents a replicable framework for geographic information system–(GIS) based land suitability analysis of utility-scale wind farms using publicly available and permissible data. The framework identifies 10 suitability factors accounting for environmental, ecological, cultural, human settlement, physical infrastructure, and wind resource aspects. It uses fuzzy-based nonlinear membership functions for scoring and the analytic hierarchy process (AHP) for weighting by engaging a group of experts. For the case study state, Indiana, suitable lands are identified and compared with existing wind farm developments. A sensitivity analysis shows suitable locations for wind farm development assuming different factors-weighting scenarios, such as suitable locations without considering environmental and ecological aspects. Such state-level analysis can be helpful for permitting agencies, local planners, and engineers engaged in permitting processes, zoning ordinances, and the development of regulati...
Genetic and Environmental Influences on Susceptibility to Acephate in Sweetpotato Whitefly (Homoptera: Aleyrodidae)

The effects of genotype, host plant, and age on susceptibility to acephate in the B biotype of sweetpotato whitefly, Bemisia tabaci (Gennadius) were examined. Offspring of adults collected from a frequently treated site and an infrequently treated site in Hawaii were reared in the laboratory on pole bean, Phaseolus vulgaris L.; tomato, Lycopersicon Esculentum Mill.; and zucchini, Cucurbita pepo L. Seven- and 14-d-old adult offspring from each host plant were tested for susceptibility to acephate in 12 laboratory bioassays (2 colonies × 3 hosts × 2 ages). Twenty-fold differences in LC50 between colonies with environmental conditions held constant indicated a genetically based resistance to acephate. Host plant had no significant effect on susceptibility to acephate. The LC50 of 7-d-old adults was consistently double the LC50 of 14-d-old adults. Although the 95% confidence limits of LC50 overlapped in pairwise comparisons between age classes, ANOVA showed that the effect of age was highly significant. Results suggest that differences in LC50 that are ≥10-fold are likely to be based partly, if not entirely, on genetic differences. Much additional work is needed to determine if the results are broadly applicable. We encourage use of ANOVA in future studies because it provides simple and direct tests for overall effects of genotype, environment, and genotype × environment interaction.
Time-Space Sampling and Respondent-Driven Sampling with Hard-to-Reach Populations

Time-space sampling (TSS; also referred to as time-location sampling, TLS) and respondent-driven sampling (RDS) are strategies that can be used for sampling hard-to-reach populations, for whom it i...
The Positive Role of Sports Economy on China's Economic Development and Research Strategy

Sports economy refers to the sports related economic activities, it is the product of social and economic development to a certain period. Around the world, sports economy has very significant role in promoting social economy, such as: European football, American NBA league, the output of up to tens of billions of dollars every year. Compared with Europe and the United States these sports economy developed countries, our country in the sports concept and theory of economic development is relatively lagging behind. This paper first introduces the concept of sports economy and its positive role in the national economy, then analyzed our country sports economy is now facing the problem, finally gives some Suggestions to solve these problems.
Quantifying mechanical ventilation performance: The connection between transport equations and Markov matrices

Abstract Most people spend approximately 90% of their lives indoors. Thus, designing effective ventilation systems is essential to mitigating problems with indoor air quality. The measures of mechanical ventilation design performance considered in this study are age of air, air residual life time, air residence time, and ventilation effectiveness. This paper presents two different methods to help quantify these measures. The first method is based on transport equations, where a continuous representation of these quantities are calculated. The second method is based on Markov matrices, where a discrete representation of these quantities are calculated. We show 1) how both the continuous and discrete methods are related and 2) that the age of air and residual life time are adjoints. A new transport equation for residual life time along with methods for these quantities using Markov matrices are established. The two approaches are validated and compared using previously established experimental data. The results show that both approaches provide similar results. Using these techniques allows for the quantities of residual life time and residence time to be integrated into the design processes. This paper provides a simple framework that enables designers to get a comprehensive picture of the ventilation systems they design.
The investigation of tuberculosis designated hospitals in Jiangxi Province

Objective To investigate the set of sickbeds of TB inpatients and the proportion of professionals in the TB designated hospitals in Jiangxi Province, so as to provide scientific bases for the comprehensive control capacity of hospitals. Methods Used statistical descriptive methods to analyze the registered staff according to Hospital Classification Management released by the Ministry of Health. Results In all the 107 TB designated hospitals of Jiangxi Province, 63 hospitals(58.88%) made free diagnosis, 70hospitals(65.42%) gave free treatment; 3 hospitals had more than 100 in-patient beds, 1 hospital had more than 50 specified beds for tuberculosis. There were 435(93.15%) permanent staff and 32(6.85%) contracted staff in the hospitals. Among the staff interviewed, doctors in clinic, staff with intermediate title and staff with college degree accounted for the largest proportion that 45.61%,56.10% and 53.53% in the corresponding categories. Conclusion This survey shows that there are some deficiencies and limitations in the tuberculosis designated hospitals. Proper solutions and strategies should be applied to relevant work fields according to local condition of health resources.
The Research on Geological Properties and Prospecting Potentiality of Iron Ore in Chunzhe District in Xietongmen County,Tibet

The Chunzhe iron mine locates in the south of the Gangdisi volcanic-magmatic arc belt,and in the copper、iron、lead、zinc、gold metallogenic belts of Xietongmen-Mozhugongka(Ⅳ5),and also in the gold、silver、copper、lead、zinc mineral resources prospective area of Maire-Konglang,where the metallogenic conditions is superior.When summarizing stratum、structure、magmatic-metallogenical background and minerogenetic conditions、the aerial magnetometer and the geophysical prospecting character,the paper also summarizes predecessor results of the work.Finally,the author analyzes the prospecting potentiality of iron ore in Chunzhe district.The paper emphasizes the prospecting effectiveness based on the aerial magnetometer abnormal、geology and geophysical prospecting method,this method offers certain value for reference to looking for the same type mineral deposit in the region.
Etiologic evaluation and treatment of malabsorption syndrome.

(1984). Etiologic Evaluation and Treatment of Malabsorption Syndrome. Hospital Practice: Vol. 19, No. 4, pp. 88X-88BB.
Extraparotid Warthin's Tumor:

Papillary cystadenoma lymphomatosum (Warthin's tumor) is a benign, slowly growing tumor found almost exclusively in the parotid gland or periparotid lymph nodes. Our experience with 14 cases of extraparotid Warthin's tumor (EPWT) over 22 years is presented. All cases occurred in extraparotid lymph nodes and represented 8.0% of 176 Warthin's tumors accessioned during this time. Fourteen cases of EPWT occurred in 13 patients (seven men and six women) between 41 and 77 years old. Three of the 13 patients (23%) had associated Warthin's tumor of the parotid gland. One of these patients also had a metachronous EPWT presented as a contralateral cervical mass. EPWT was discovered incidentally in six patients (46%) undergoing neck dissections for malignancies of the head and neck. Four patients (31%) presented with clinically evident solitary cervical masses. The embryologic basis for such findings is discussed. EPWT is adequately managed by conservative excision.
Occupational Asthma and Work-Exacerbated Asthma

Occupational asthma (OA) and work-exacerbated asthma (WEA), collectively known as work-related asthma (WRA), have been recognized as the most prevalent work-related lung diseases in the industrialized world. OA is asthma caused by workplace conditions, and is subdivided into sensitizer-induced (allergic) OA and irritant-induced (nonallergic) OA. WEA is asthma that is made worse, but was not initially caused, by workplace conditions. Although WRA is rarely fatal, patients with WRA frequently experience excessive time lost from work, workplace-specific severe disability, loss of income, job loss, and related psychosocial and financial problems. More than 400 workplace environmental agents have been reported to cause WRA, and are classified by molecular weight and allergenic and irritant properties. Diagnosis of WRA requires confirmation of a diagnosis of asthma plus evidence that the asthma was caused or worsened by workplace conditions. Accuracy of diagnosis is important because either overdiagnosis or missed diagnosis of WRA can be problematic for the patient. Self-reported clinical symptoms alone have only fair sensitivity and specificity for OA. If possible, diagnostic assessment should also include objective evidence with functional and immunologic testing. Treatment and prevention of onset or worsening of WRA can be highly effective and typically include both optimal medical management (generally the same as for non-WRA) and, importantly, avoidance of sensitizer or irritant exposures that caused or exacerbate the asthma. In most cases of OA, prognosis is better with cessation rather than reduction of exposure, and this may require substantial changes in the workplace environment or change of job or even profession.
Etiology of Spastic Diplegia

The clinical and etiologic profile of spastic diplegia was studied in a retrospective chart review of 54 patients diagnosed during a 12-year period at Montreal Children’s Hospital, Quebec, Canada.
The association between post-traumatic stress disorder and lifetime DSM-5 psychiatric disorders among veterans: Data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III).

Abstract This study examined the prevalence, correlates and psychiatric comorbidity of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) posttraumatic stress disorder (PTSD) in a nationally representative sample of U.S. veterans using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 3119 veteran respondents). The overall prevalence of lifetime PTSD was 6.9%. Lifetime PTSD prevalence was higher among veterans who were female (13.2%), aged 18–29 years (15.3%), Native American (24.1%) or Black (11.0%), previously or never married (9.6% and 11.2, respectively), had incomes less than $70,000 (7.2%–10.1%) and had >2 traumatic events (5.2%–14.7%). After adjusting for sociodemographic characteristics, comorbidity between lifetime PTSD and other psychiatric disorders was highest for any personality disorder (adjusted odds ratio [AOR] = 11.1, 95% confidence interval [CI], 5.7, 21.5), any mood disorder (AOR = 9.7, 95% CI, 4.6, 20.4) and any anxiety disorder (AOR = 9.6, 95% CI, 5.1, 17.7), followed by nicotine, drug, and alcohol use disorders (AOR = 3.4, 95% CI, 1.8, 6.5; AOR = 3.1, 95% CI, 2.0, 5.9; 2.1, 95% CI, 1.5, 3.1, respectively). Associations remained with any mood, anxiety, and personality disorders after controlling for other psychiatric disorders (AOR = 3.7, 95% CI, 1.2, 10.9; AOR = 3.5, 95% CI, 1.6, 7.4; AOR = 4.5, 95% CI, 2.3, 8.7, respectively). Veterans who sought treatment for PTSD had more comorbid conditions, although treatment was only associated with comorbid drug use disorder (AOR = 2.4, 95% CI, 1.0, 5.7). In U.S. veterans, PTSD is highly comorbid with other psychiatric disorders. Although many veterans remain untreated, comorbidity may influence treatment seeking.
Merit and meritocracy

La meritocratie est une societe fondee sur une certaine theorie de la justice distributive dont les principes sont l'attribution d'un travail, les conditions d'opportunite, et la remuneration de celui-ci en fonction du critere du merite.
Giving Feedback to Students

In a student-centered teaching and learning environment, successful achievement of competencies is strongly dependent on a dynamic exchange of performance-related communication. Students cannot be expected to know what they do or don’t know if they have nothing to measure it against. The use of formative feedback, as it relates to student performance, is no longer an optional exercise but rather an essential element in helping students achieve successful learning outcomes. Formative feedback provides students with meaningful commentary relating to performance for the purpose of improving performance. Literature pertaining to formative feedback is abundant in the field of education and business but only recently introduced in medical education. This chapter distinguishes two types of feedback that may be applied in the anatomy course assessment structure: (i) “directive feedback” used to provide students with information on knowledge deficits that may place them at risk for achieving required grades and (ii) “facilitative feedback” used to provide students with verbal or written commentary on their performance relating to nontraditional discipline-independent skills with the intention of guiding them through their professional development. Anatomy teachers should capitalize on their ability to influence students early in the medical curriculum and incorporate the practice of providing regular formative feedback while teaching anatomy.
Controlling intraoperative hemorrhage during burn surgery: A prospective, randomized trial comparing NuStat® hemostatic dressing to the historic standard of care

Abstract Introduction One of the primary intraoperative challenges during burn surgery is to adequately excise the burn while avoiding massive hemorrhage. This has become increasingly important, as we see more burn patients that are older and with more medical comorbidities. While adequate excision down to healthy tissues for deep burns is essential for skin graft to take, it also leads to active bleeding that can be a challenge to control. Good hemostasis is imperative as a hematoma is the most common cause of graft loss. Several new products have become available to help control intraoperative hemorrhage. A new hemostatic dressing, NuStat®, is available and approved by FDA in United States. Methods A single institution prospective randomized control trial was completed at Regional Burn Center of the University of South Alabama comparing NuStat® with the institutional historic standard of care. Twenty such patients were included in our study. A cost analysis was also completed as part of the study retrospectively. Results For dressings used to treat the burn site, blood loss on the side treated with NuStat® was on average less (27 g/100 cm2) than the side treated with our historic standard of care (31 g/100 cm2), though it was not statistically significant (p = 0.81). Similarly, on the donor site, blood loss on the side treated with NuStat® was on average less (14 g/100 cm2) than the side treated with our historic standard of care (15 g/100 cm2), but it was also not statistically significant (p = 0.92). Average total blood loss from both excision and donor sites was also less with NuStat® (10 g/100 cm2) compared to the historic standard of care (12 g/100 cm2), but it was also not significant (p = 0.77). There was no difference in the number of cycles required to achieve hemostasis for either the burn (1.15 NuStat® vs. 1.1 for historic standard of care, p = 0.70) or the donor site (1 vs. 1, p = 1.0). When comparing the cost of NuStat® versus the historic standard of care, the actual costs incurred for the wounds was less for the portion treated with NuStat® ($148.43) when compared to the historic standard of care ($186.45) (p Conclusions Based on these findings, NuStat® hemostatic action should be comparable to the historic standard of care, and these newer hemostatic agents evaluated further in burn surgery and bleeding during other procedures such as trauma surgery.
Tissue expression of Uridine and Thymidine phosphorylases and NF-κB in breast cancer patients by tissue microarray

4565 Uridine phosphorylase (UPase) and thymidine phosphorylase (TPase) are both upregulated in various human solid tumors and catalyze the reversible phosphorolysis of deoxynucleosides and a wide variety of fluorinated pyrimidine nucleosides. The relative contribution of each of these enzymes varies among different tumor tissues. Uridine phosphorylase activity, in particular, has been reported to be elevated in many tumors, including breast cancers, colorectal cancer, oral squamous carcinomas, melanomas, and lung adenocarcinomas, when compared with adjacent normal tissues. In these studies on small cohorts of patients, the overexpression of UPase was associated with worse long-term survival. Our recent studies have indicated that the NF-κB p65 transcription factor activates UPase expression via sequence-specific binding to the UPase promoter enhancing the sensitivity of murine breast cancer cells (EMT-6) to fluoropyrimidine antimetabolites. We have shown that some cis-acting elements including NF-κB, IFN-regulatory factor-1 (IRF-1) and STAT-1 in the UPase promoter play a critical role in the induction of UPase in combination with TNF-α and IFN-γ. Also, in a small study on fresh frozen human breast cancer specimens, employing Western blot and enzymatic assays, we observed that the UPase activity was higher in the breast cancer tissues and NF-kB p65 expression was associated with the increased UPase activity. >We evaluated the association between UPase, TPase and NF-kB expression and clinical variables on tissue microarrays containing primary specimens from 655 breast cancer patients using a method of automated quantitative analysis (AQUA). Nuclear and cytoplasmic expression of NF-kB was associated with a high nuclear grade (>1/3) (P=0.0070 and P=0.0004, respectively). UPase and TPase expression are associated with tumor size; high expression was seen in tumors >2 cm (P=0.0065 and P=0.0332, respectively). We also observed a direct correlation between UPase and TPase expression (P=0.0004). High TPase expression was associated with decreased survival in the node-positive patient subset by Kaplan-Meier survival analysis (P=0.0478). No association was seen between expression of NF-kB and either phosphorylase. >Given the role of both phosphorylases in the activation and selectivity of fluoropyrimidine antimetabolites, we are in the process of evaluating the association between response to therapy with 5-FU based therapy in early stage breast cancer patients.
Can Decrease in Smoking Incidence Reduce Leukemia Mortality

Smoking is the leading preventable cause of death in the Western world. There is substantial evidence that smokers are approximately 1.5 times more likely to develop acute myeloid leukemia (AML) than non smokers. We were interested to know if there is a relationship between smoking and treatment outcome in AML. We searched the Centers for Disease Control and Prevention (CDC) and Surveillance Epidemiology and End Results (SEER) databases for data about smoking incidence and AML mortality. We collected AML mortality data for the United States (US) from SEER and state leukemia mortality data from CDC. CDC data are lumped for all types of leukemia. Since AML is the most common leukemia, and no significant improvement in AML treatment, as compared to chronic myeloid leukemia, occurred in the last two decades, we used the collective leukemia data. We compared smoking incidence and age-adjusted leukemia mortality between overall US and states with either a high (Alabama, Indiana, Ohio, Oklahoma, Kentucky) or a low (California, Connecticut, New York, Utah, Rhode Island) smoking incidence. SEER data revealed a statistically significant correlation (r=0.88) between smoking incidence and AML mortality for the different US regions (Figure 1). The correlation was significant whether we included a 10-year lag period (r= 0.75) for leukemia mortality or not. The correlation between smoking incidence and mortality rates for individual states was much more variable; data from two representative states, California (CA) with low smoking incidence (r=0.74) and Indiana (IN) with high smoking incidence (r=0.03) are shown (Figure 2). Possible causes for decreased mortality can include less pulmonary infections, less aggressive leukemia [reports of more frequent chromosomal aberrations involving chromosome 5, 7 and 8 in smokers] and better transplant outcome in non-smokers. To date, we did not find any data on association between leukemia incidence and smoking prevalence. These data suggest a possible association between smoking and leukemia mortality, and additional research is needed to determine if smoking cessation can be a tool to decrease leukemia mortality. ![Figure 1][1] Figure 1 ![Figure 2:][1] Figure 2: [1]: pending:yes
Primary Pulmonary Diffuse Large B Cell Non-Hodgkin’s Lymphoma: A Case Report and Literature Review

BACKGROUND Primary pulmonary diffuse large B cell lymphoma (DLBCL) is extremely rare neoplasm representing only 0.5-1% of primary pulmonary malignancies. These patients usually have non-specific clinical presentation and radiological findings. Therefore, it is important to increase awareness of this rare disease, as the correct characterization of the tumors will have therapeutic and prognostic implications. CASE REPORT We present the case of a middle-aged Hispanic woman with chronic cough and an abnormal chest X-ray revealing a lung mass, who was found to have primary pulmonary DLBCL. She underwent 6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) therapy and attained complete remission. CONCLUSIONS With its non-specific presentation, the diagnosis of primary pulmonary DLBCL is very challenging and often leads to misdiagnosis or delayed diagnosis. The pathogenesis of primary pulmonary DLBCL is still poorly understood. The choice of treatment approach should be based on the biological characteristic of the tumor, stage, and performance status.
Law & Neuroscience: What, Why, and Where to Begin

A surprisingly large number of legal issues involve questions about how well a given person’s brain functions - and what that brain was actually doing at some legally relevant moment in the past. The criminal justice system, for instance, must often identify a defendant’s mental state at the time of a prohibited act, or determine whether a brain abnormality suggests diminished responsibility. And civil litigation may raise questions, for example, about a person’s competence to contract, extent of brain injuries, or eligibility for mental disability benefits. Because new neuroscientific technologies that investigate brain structure and function may help to answer these questions, judges, lawyers, and jurors are increasingly encountering neuroscientific evidence in the courtroom. At the same time, the potential benefits come with risks of premature and inappropriate applications. Consequently, the MacArthur Foundation Research Network on Law and Neuroscience has prepared this two-page knowledge brief to help ensure that neuroscientific evidence is properly understood and evaluated so that it in turn may aid, rather than potentially mislead or hinder, the administration of justice. This knowledge brief enables judges, attorneys, policymakers, and students to get a quick grasp on what they need to know about the use - and misuse - of neuroscientific evidence in the courtroom.
Degrowth: culture, power and change

Abstract Harmful environmental consequences of growth have been rigorously documented and widely publicized throughout the past half-century. Yet, the quantity of matter and energy used by human economies continues to increase by the minute, while governments and businesses continue to promise and to prioritize further economic growth. Such a paradox raises questions about how we humans change course. This introduction to a Special Section offers a new theoretical approach to change, together with glimpses of adaptations underway around the world. It directs attention away from individual decision-making and toward systems of culture and power through which socialized humans and socioecological worlds are (re)produced, sustained and adapted. Potential for transformative change is found in habitual practices through which skills, perspectives, denials and desires are viscerally embodied, and in cultural systems (economic, religious, gender and other) that govern those practices and make them meaningful. Case studies reviewed illuminate diverse communities acting to maintain old and to forge new moral and material worlds that prioritize wellbeing, equity and sustainability rather than expansion. This article endeavors to galvanize change by conceptualizing degrowth, by decolonizing worldviews of expansionist myths and values, and by encouraging connections between science and activism, north and south. Key words: degrowth, transition, climate change, socioecological systems