cssi/SciSciGPT-SciSciNet huggingface dataset:
Effect of Naproxen on Gastroesophageal Reflux and Esophageal Function: A Randomized, Double‐Blind, Placebo‐Controlled Study

Objectives: Gastrointestinal symptoms, particularly pyrosis, complicate nonsteroidal anti-inflammatory drug (NSAID) use. NSAIDs cause esophageal injury, and H, blockers are often prescribed for, and successfully control, NSAID-related .symptoms. To determine whether NSAIDs can induce gastroesophageal reflux, we studied the effect of a commonly used NSAID. naproxen, on relltix parameters and esophageal function. Methods: Nine healthy volunteers (five males, four females, age 2.V-34 yr) were studied. After basal measurements were taken, (he subjects randomly received naproxen 500 mg p.o. b.Ld. or placebo for 1 wk. On day 6, the subjects underwent esophageal manometry with a water-perfu.sed system and Dent sleeve. Body pressures, contraction velocity, and duration of contraction were recorded in the distal 7 cm of the esophagus. The lower esophageal sphincter pressure (I.KSP) and nuniher of transient relaxations (TLESRs) were monitored. This was followed by 24-h pH monitoring. The subjects then crossed over to the other drug after a minimum 14-day wash-out period. Results: No subject experienced any GI symptoms during the study. One subject developed refluxinduced symptoms a few months after completing the study and was excluded from the analysis. The total fraction of time (pH < 4) was 4.9 ± 1.0% in the basal state, 5.5 ± 1.4% on placebo, and 5.4 ± 1.5% on naproxen. These differences were not significant. The number of reflux episodes and the e.sophageal clearance time were not aflected by naproxen. The LESP in the basal state was 32.1 ± 5.6 mm Hg, 32.3 ± 4.2 mm Hg on placebo, and 29.9 ± 3.3 mm Hg on naproxen {p = NS). Tbe number of TLESRs per 30 minutes in tbe basal state was 3.5 ± 0.9, 4.6 ± 1.2 on placebo, and 5.8 ± 1.0 on naproxen {p = NS). Tbe speed and duration of contractions were not alTected by naproxen. The excluded subject had marked basal retlux (total fraction of time pH < 4 = 10.7%), low LESP {8 mm Hg), and a marked increase in reflux on naproxen (total fraction of time pH < 4 = 53%). Conclusions: Naproxen did not induce reflux in normal subjects, althougb reflux did increase in some subjects. Naproxen had no significant effect on motility parameters. Our data suggest that NSAIDs do not impair the anti-reflux barrier or induce reflux. Pyrosis experienced during NSAID use may not arise from the esophagus or may reflect altered e.sophageal sensitivity. A single suhject with decreased LESP and asympUmiatic increased acid exposure in the basal state had a marked increase in reflux on naproxen. This person subsequently developed symptomatic gastroesophageal retlux. The effect of NSAIDs on individuals with a propensity to reflux deserves further study.
Abstract 18971: Heart Transplantation for Adult Patients With Congenital Heart Disease: Are the Outcomes Still Worse Than in the General Population in 2015?

Introduction: Short and medium term outcome after heart transplantation has steadily improved over the last few decades. Outcomes for adult patients with congenital heart disease (ACHD) who undergo transplantation are generally considered to be less favorable. Hypothesis: We hypothesized that the development of heart teams that specialize in ACHD would lead to improved outcomes after transplantation in this population. Methods: We reviewed the records of all patients undergoing first heart transplant at a university center with a dedicated ACHD team over the last 10 years. Patients undergoing re-transplantation were excluded. We looked at short (30 days) and medium term (1 year) survival after heart transplantation in ACHD patients. Results: Between 1/1/05 and 6/10/15, 258 patients underwent heart transplantation. Of the 258 patients, 17 were re-transplants and were excluded. Of the remaining 241 patients, 12 were ACHD patients and 229 were transplanted for other diagnosis (general group). In the general group 184 of 212 (86.8%) patients were alive at 1 year (the remaining 17 did not have sufficient follow up to be included in the 1-year survival analysis). In the ACHD group 9 of 9 patients (100%) were alive at 1 year. The remaining 3 ACHD patients with insufficient follow up to be included in the 1-year survival analysis were still alive 2.5-9.5 months after transplant, such that all 12 ACHD patients survived at least 30 days and were discharged home after heart transplant. At the end of the study period 160 of 229 (70%) patients were still alive in the general group, compared to 8 of 12 (66.7%) in the ACHD group. Conclusions: Short and medium term survival after heart transplantation appears to be no worse for selected ACHD patients compared to the general population. Larger studies with longer follow up are needed to confirm our findings and clarify the intermediate and long-term outcomes of ACHD patients undergoing heart transplantation in the modern era.
Malignant yet Benign: The Political Economy of a Skin Cancer Diagnosis in Colombia:

This paper is about the ontology of a cancer diagnosis at high-end hospitals in Colombia. Drawing on a seventeen-month ethnographic fieldwork study in this country, it pays attention to how dermato...
Trauma-Informed Behavioral Parenting for Early Intervention

Training in trauma-informed early intervention programs is greatly needed for Part C early intervention providers (EIs). This study evaluated the feasibility, acceptability, and initial outcomes of Trauma-Informed Behavioral Parenting (TIBP; subsequently renamed Smart Start), an early intervention program designed to meet the social–emotional needs of toddlers enrolled in Part C services. This pilot study consisted of training and supervising 5 EIs to implement TIBP with 8 parent–child dyads as part of their Part C services. Preliminary changes in child behavior problems, trauma exposures, parenting stress, and parenting skills were evaluated quantitively. EIs completed treatment integrity measures. Focus groups provided data regarding the feasibility of implementation and caregiver attitudes about TIBP. Significant reductions in child trauma symptoms on both the YCPC-PTSD (S = 11.5, p = 0.0586, rMPRB = 0.64) and YCPC-FI (S = 11.5, p = 0.0586, rMPRB = 0.53) were indicated. No significant changes in externalizing behaviors were observed. Caregivers demonstrated improved use of positive verbal reinforcement and verbal reflections, and reported improvements on parent–child dysfunctional interactions on the PSI-SF (S = 16, p = 0.0117, rMPRB = 0.89). All focus group participants reported benefits from participating in TIBP. EIs demonstrated high adherence to treatment protocol and identified TIBP as a feasible program to implement within Part C services. This study showed promising results as a means to disseminate evidence-based practices into a community-level program to address the social–emotional needs of toddlers. The need for additional, large sample research was highlighted.
Age-Dependent Impact of Pre-Transplant Intensive Care Unit Stay on Mortality in Heart Transplant Recipients.

Background: Heart transplantation (HTx) is a treatment option for refractory end-stage heart failure. Severe illness requiring pre-transplant intensive care unit (ICU) stay may be a risk factor for diminished post-transplant survival, but this association is surprisingly inconsistent in recent studies. To clarify the significance of ICU stay as a risk factor for heart transplant outcomes, we aimed to define if patient age was a factor in which ICU stay was predictive of survival after HTx. Methods: De-identified data were obtained on isolated first-time HTx performed during the years 2006 - 2015 from the UNOS Registry. Nine age groups were defined. The primary outcome was 1-year post-transplant mortality. Cox proportional hazard regression estimated unadjusted and adjusted hazard ratio (HR) associated with pre-transplant ICU stay in each age group. Results: The analysis included 19,508 patients (9% deceased within 1 year). In the overall cohort, pre-transplant ICU stay was associated with increased hazard of 1-year mortality (HR = 1.3; 95% confidence interval (CI): 1.2 - 1.4; P < 0.001); but further univariate analysis showed a greater hazard of 1-year mortality associated with ICU stay in infants (HR = 2.2; 95% CI: 1.5 - 3.2; P < 0.001). However, the adjusted analysis found that adults ages 40 - 49 had the highest statistically significant hazard of 1-year mortality (HR = 1.5; 95% CI: 1.1 - 2.1; P = 0.011). Conclusions: Our study established age variation in the association between ICU stay and survival after HTx, with this association being strongest among adults, 40 to 49 years of age, undergoing HTx. Previous data suggesting decreased survival in infants may be related to the increased use of extracorporeal membrane oxygenation as a mechanical cardiac assist rather than ventricular assist devices. Cardiol Res. 2019;10(3):157-164 doi: https://doi.org/10.14740/cr870
Effect of feeding reduced protein, amino acid-supplemented diets on nitrogen and energy balance in grower pigs

Two experiments were conducted to determine the effect of feeding reduced CP, amino acid (AA)-supplemented diets on the nitrogen (N) and energy (E) balance of grower pigs. In Exp. 1, 24 barrows (22.2 kg BW) were fed corn-soybean meal (C-SBM) diets containing either 16% CP, 12% CP, or 12% CP supplemented with lysine (LYS), tryptophan (TRP), and threonine (THR). After 6 d of adaptation to the diets and feeding frequency, a 5-d N and E balance trial was conducted. Supplementation of the 12% CP diet with LYS, TRP, and THR improved N retention ( P .10). Energy retention was increased by AA-supplementation of the 12% CP diet ( P .10) to pigs fed the 12% CP diet with IDAA and DAAN supplementation. Pigs fed the 12% CP diet with LYS, TRP, and THR supplementation exhibited the highest efficiency of N retention (P < .01). Pigs fed the 12% CP diet supplemented with LYS, TRP, THR, and DAAN retained more (P < .01) E than pigs fed the 12% CP diet supplemented with IDAA and DAAN and more (P < .07) E than pigs fed either the 12% CP diet supplemented with LYS, TRP, and THR or the unsupplemented 12% CP diet. Pigs fed the 16% CP diet retained more (P < .06) E than pigs fed the 12% CP diet with IDAA and DAAN supplementation. Although the data show that the efficiency of N retention is greatest when LYS, TRP, and THR are supplemented to the 12% CP diet, maximal N retention is achieved only when the 12% CP diets are supplemented with both the deficient AA and a source of N for dispensable AA synthesis.
Ending the abuse: the human rights implications of obstetric violence and the promise of rights-based policy to realise respectful maternity care

In September 2019, Dubravka Simonovic, the United Nations (UN) Special Rapporteur on violence against women (VAW), submitted her report to the UN General Assembly on “mistreatment and VAW during re...
Detection of after-discharges during intraoperative functional brain mapping in awake brain tumor surgery using a novel high-density circular grid.

Abstract Objective To evaluate intraoperative use of a novel high-density circular grid in detecting after-discharges (AD) on electrocorticography (ECoG) during functional brain mapping (FBM). Methods FBM during glioma surgery (10/2016 to 5/2019) recorded ADs using a 22-channel circular grid compared to conventional strip electrodes. ADs were analyzed for detection, duration, amplitude, morphology, histology, direction, and clinical signs. Results Thirty-two patients (mean age 54.2 years; r = 30–75) with glioma (WHO grade II-IV; 20 grade IV) had surgery. ADs during FBM were more likely in patients with wild-type as opposed to IDH-1 mutants (p Conclusions High-density circular grids detect ADs in 360 degrees during FBM for glioma resection. Provocation of ADs was more likely in patients with wild-type than IDH-1 mutation. Significance Circular grids offer high-resolution ECoG during intraoperative FBM for detection of ADs.
Efficacy observation of intradermal continuous suture of perineal incision

Objective To observe the efficacy and clinical value of intradermal continuous suture of perineal incision.Methods 300 natural delivery and eligible women were divided into experimental group and control group according to different suture methods.In the experimental group,continuous suture with absorbable thread was adopted and in controls the conventional methods was used.Induration,swelling,ache,wound healing and hospitalization time were recoded of both methods.Their advantages and disadvantages were compared.Results In the experimental group,there were 2 cases of local induration,1 case of swelling,3 cases of painless,136 cases of light pain,11 cases of moderate pain and 0 case of severe pain,142 cases with grade A healing,3 cases with grade B healing and 0 with grade C healing,which the differences was statistical significance(P ＜ 0.05).Conclusions Compared with the traditional perineorrhaphy,the method of intradermal continuous suture could reduce the infection rate,relieve the pain,shorten the hospitalization time,promote healing,physical and mental health of parturient and it also enhance the social efficiency of hospital. Key words: Perineal incision; Intradermal continuous suture; Perineorrhaphy
Testimony Before the Subcommittee on the Constitution, Civil Rights and Civil Liberties, of the U.S. House Committee on the Judiciary: Congressional Authority to Protect Voting Rights After Shelby County v. Holder

The Voting Rights Act has been widely hailed as one of the most successful pieces of civil rights legislation in the country’s history. It is our most significant shared national commitment to equal electoral participation and equitable political diversity, based in part on history that allows us to recognize that we all suffer when such a commitment is absent. In 2006, Congress voted overwhelmingly, and in bipartisan fashion, to reauthorize and update the Voting Rights Act. There had been undeniable and positive progress since 1965, but that progress existed in part due to the very protections that the Voting Rights Act offered, which were necessary to preserve equal opportunity. Those protections have since been degraded by the courts – particularly, but not exclusively, by Shelby County v. Holder. That same Court also issued Congress an express invitation to rectify the matter. The continued update of effective measures to prevent discrimination in the franchise are regrettably, and no less undeniably, necessary today. This testimony reviews the continuing need to restore the Voting Rights Act, explaining why election harms are distinct from other civil rights harms, and require distinct treatment. It analyzes the aftermath of the Shelby County decision, and the particular ways in which Shelby County, and a few follow-on cases in Texas, have left the electoral system dangerously vulnerable to discrimination. And it canvasses the legal authority delineating Congress’s constitutional ability to pass restorative legislation responding to this threat.
Cancer models: A nonhomogeneous two-stage model of carcinogenesis

In this paper we extend the Moolgavkar-Venzon-Knudson two-stage model into nonhomogeneous cases. The probability generating functions (PGF) of initiated cells and tumors are derived under very general conditions. Using these PGF's we then obtain expected incidence functions of tumor and provide an iterative procedure for computing probability distributions of tumors. These results can be used to take account of time-varying exposures to help identify etiologic agents and to assess their mechanisms of action in epidemiologic studies.
Probabilistic bilinear models for appearance-based vision

We present a probabilistic approach to learning object representations based on the "content and style" bilinear generative model of Tenenbaum and Freeman. In contrast to their earlier SVD-based approach, our approach models images using particle filters. We maintain separate particle filters to represent the content and style spaces, allowing us to define arbitrary weighting functions over the particles to help estimate the content/style densities. We combine this approach with a new EM-based method for learning basis vectors that describe content-style mixing. Using a particle-based representation permits good reconstruction despite reduced dimensionality, and increases storage capacity and computational efficiency. We describe how learning the distributions using particle filters allows us to efficiently compute a probabilistic "novelty" term. Our example application considers a dataset of faces under different lighting conditions. The system classifies faces of people it has seen before, and can identify previously unseen faces as new content. Using a probabilistic definition of novelty in conjunction with learning content-style separability provides a crucial building block for designing real-world, real-time object recognition systems.
Estimation of cancer cell fractions and clone trees from multi-region sequencing of tumors

AO_SCPLOWBSTRACTC_SCPLOWMulti-region sequencing of one or multiple biopsies of solid tumors from a patient can be used to improve our understanding of the diversity of subclones in the patients tumor and shed light on the evolutionary history of the disease. Due to the large number of possible evolutionary relationships between clones and the fundamental uncertainty of the mutational composition of subclones, elucidating the most probable evolutionary relationships poses statistical and computational challenges. We developed a Bayesian hierarchical model called PICTograph to model uncertainty in the assignment of mutations to subclones and an approach to reduce the space of possible graphical models that postulate their evolutionary origin. Compared to available methods, our approach provided more consistent and accurate estimates of cancer cell fractions and better tree topology reconstruction over a range of simulated clonal diversity. Application of PICTograph to whole exome sequencing data of individuals with pancreatic cancer precursor lesions confirmed known early occurring mutations and indicated substantial molecular diversity, including multiple distinct subclones (range 6 - 12) and intra-sample mixing of subclones. As the complete evolutionary history for some patients was not identifiable, we used ensemble-based visualizations to distinguish between highly probable evolutionary relationships recovered in multiple models from uncertain relationships occurring in a small subset of models. These analyses indicate that PICTograph provides a useful approximation to evolutionary inference, particularly when the evolutionary course of a patients cancer is complex.
Real-time pixelwise phasor analysis for video-rate two-photon fluorescence lifetime imaging microscopy.

Two-photon fluorescence lifetime imaging microscopy (FLIM) is a widely used technique in biomedical optical imaging. Presently, many two-photon time-domain FLIM setups are limited by long acquisition and postprocessing times that decrease data throughput and inhibit the ability to image fast sub-second processes. Here, we present a versatile two-photon FLIM setup capable of video-rate (up to 25 fps) imaging with graphics processing unit (GPU)-accelerated pixelwise phasor analysis displayed and saved simultaneously with acquisition. The system uses an analog output photomultiplier tube in conjunction with 12-bit digitization at 3.2 GHz to overcome the limited maximum acceptable photon rate associated with the photon counting electronics in many FLIM systems. This allows for higher throughput FLIM acquisition and analysis, and additionally enables the user to assess sample fluorescence lifetime in real-time. We further explore the capabilities of the system to examine the kinetics of Rhodamine B uptake by human breast cancer cells and characterize the effect of pixel dwell time on the reduced nicotinamide adenine dinucleotide and reduced nicotinamide adenine dinucleotide phosphate (NAD(P)H) autofluorescence lifetime estimation accuracy.
Choked: Life and Breath in the Age of Air Pollution

It can be difficult for health information professionals to provide accurate, evidence-based consumer health information on the effects of air pollution. Despite studies on the negative health effe...
“Migration Is Not a Crime”: Migrant Justice and the Creative Uses of Paddington Bear

Created in 1957, the well-known English children’s book character Paddington Bear is the product of a dizzying number of displacements. Author Michael Bond (1926–2017) was inspired to make Paddingt...
Computational Modeling Reinforces that Proprioceptive Cues May Augment Compliance Discrimination When Elasticity Is Decoupled from Radius of Curvature

Our capability to discriminate object compliance is based on cues both tactile and proprioceptive, in addition to visual. To understand how the mechanics of the fingertip skin and bone might encode such information, we used finite element models to simulate the task of differentiating spherical indenters of radii (4, 6 and 8 mm) and elasticity (initial shear modulus of 10, 50 and 90 kPa). In particular, we considered two response variables, the strain energy density (SED) at the epidermal-dermal interface where Merkel cell end-organs of slowly adapting type I afferents reside, and the displacement of the fingertip bone necessary to achieve certain surface contact force. The former variable ties to tactile cues while the latter ties to proprioceptive cues. The results indicate that distributions of SED are clearly distinct for most combinations of object radii and elasticity. However, for certain combinations – e.g., between 4 mm spheres of 10 kPa and 8 mm of 90 kPa – spatial distributions of SED are nearly identical. In such cases where tactile-only cues are non-differentiable, we may rely on proprioceptive cues to discriminate compliance.
Estrogen replacement therapy by transdermal estradiol administration

To determine whether the nonoral administration of estradiol (E2) might provide physiologic replacement without alteration of hepatic function, 20 postmenopausal women were studied before and after 3 weeks of treatment with either E2-containing transdermal therapeutic systems or placebo. Twenty premenopausal women were also studied. With E2-containing systems, serum E2 and estrone levels were restored to the premenopausal range. Variable responses of the different biochemical and biologic markers of the actions of E2 were observed. The most sensitive marker was vaginal cytology, with the E2 dosage reverting the maturation index to premenopausal values. Hot flashes, measured objectively, were reduced in frequency but not abolished. Serum levels of follicle-stimulating hormone and luteinizing hormone were lowered but remained higher than the premenopausal range. No significant changes were noted in urinary calcium/creatinine and hydroxyproline/creatinine ratios, which were used as markers of bone resorption. With active systems, no significant changes were noted in the concentrations of the hepatic proteins renin substrate and thyroxine-binding globulin or in the binding capacities of cortisol-binding globulin and sex hormone-binding globulin. These results indicate that transdermal E2 administration may be used to provide estrogen replacement while exerting limited effects on hepatic function.
Emergency department presentation of children with tuberculosis.

ACADEMIC EMERGENCY MEDICINE 2011; 18:726–732 © 2011 by the Society for Academic Emergency Medicine Abstract Objectives: The objectives were to describe emergency department (ED) presentations of children with tuberculosis (TB) disease and assess the utility in children of TB screening tools developed for adults. Methods: Children at most 18 years old with confirmed or probable TB seen at the Children’s TB Clinic from 2005 to 2009 who were initially evaluated in the ED for symptoms compatible with TB in the preceding month were included. TB was classified as microbiologically confirmed disease or probable TB disease, as defined by the World Health Organization. Results: Sixty children (29 with confirmed TB and 31 with probable TB) were identified after presentation to the ED, representing 35% of all children diagnosed with TB at the two hospitals during this interval. Eighty-eight percent were previously healthy. Fifty-five percent were Hispanic, 30% were black or African American, 12% were Asian, and 3% were white. Forty-four (73%) had intrathoracic disease (37 pulmonary parenchymal or pleural disease, four miliary disease, two endobronchial, one pericarditis). Sixteen (27%) had extrathoracic disease (eight meningitis, five cervical lymphadenopathy, two gastrointestinal, one interstitial keratitis), 11 of whom also had abnormal chest radiographs, including all eight children with TB meningitis. Most (76.7%) were diagnosed at the time of their first ED visit or during their first hospital admission, 12% after their second ED visit, 10% after their third ED visit, and one patient after six ED visits to various facilities. In 33 case (55%), the diagnosis was suspected in the ED because of epidemiologic risk factors (15), radiographic evaluation (11), or symptoms (7). Hemoptysis (12%) and night sweats (10%) were uncommon. Neither cavitary lesions (seen in two children) nor apical lesions (seen in 42%) predominated. The five screening tools validated for adults with pulmonary disease were 77% to 98% sensitive in identifying children with intrathoracic TB and 50% to 100% sensitive for extrathoracic TB. Conclusions: The point of entry to health care for many children with TB is the ED. The more protean manifestations of TB in children can decrease the utility of screening tools developed to identify adults with TB. While TB in adults often is a microbiologic diagnosis, childhood TB often is an epidemiologic diagnosis. Therefore, questioning caregivers about TB risk factors in the family may identify a higher percentage of children with possible TB.
Decomposing document images by heuristic search

Document decomposition is a basic but crucial step for many document related applications. This paper proposes a novel approach to decompose document images into zones. It first generates overlapping zone hypotheses based on generic visual features. Then, each candidate zone is evaluated quantitatively by a learned generative zone model. We infer the optimal set of non-overlapping zones that covers a given document image by a heuristic search algorithm. The experimental results demonstrate that the proposed method is very robust to document structure variation and noise.
The Challenges of Teaching the Introductory LIS Management Course

ABSTRACTTeaching the introductory LIS management course may be the most challenging assignment for LIS professors because of the breadth of the subject, the probabilistic nature of management principles, and the differing management environments of LIS organizations. The best teaching strategy is to describe honestly to students the benefits and limitations of the course and to focus on the achievable objectives of introducing students to core management concepts, providing skill enhancement, and encouraging them to evaluate their management potential. The article discusses the difficulties of teaching leadership skills, the limits imposed by student competencies, and the impact of the professor's background on course content.
REM sleep twitches rouse nascent cerebellar circuits: Implications for sensorimotor development

The cerebellum is critical for sensorimotor integration and undergoes extensive postnatal development. During the first postnatal week in rats, climbing fibers polyinnervate Purkinje cells and, before granule cell migration, mossy fibers make transient, direct connections with Purkinje cells. Activity-dependent processes are assumed to play a critical role in the development and refinement of these and other aspects of cerebellar circuitry. However, the sources and patterning of activity have not been described. We hypothesize that sensory feedback (i.e., reafference) from myoclonic twitches in sleeping newborn rats is a prominent driver of activity for the developing cerebellum. Here, in 6-day-old rats, we show that Purkinje cells exhibit substantial state-dependent changes in complex and simple spike activity-primarily during active sleep. In addition, this activity increases significantly during bouts of twitching. Moreover, the surprising observation of twitch-dependent increases in simple spike activity at this age suggests a functional engagement of mossy fibers before the parallel fiber system has developed. Based on these and other results, we propose that twitching comprises a unique class of self-produced movement that drives critical aspects of activity-dependent development in the cerebellum and other sensorimotor systems.
Inheritance: from code reuse to reasoning reuse

In the object-oriented approach, a designer can, given an existing base class, use inheritance to build a derived class that extends, or that slightly differs from the base class, but in order to exploit the full potential of inheritance to build systems incrementally, the designer must also be able to reason about the derived class incrementally. This paper presents a specification notation and verification procedure that allows such incremental reasoning out; the approach makes important use of the concrete specification of a class, in addition to the usual abstract specification. The reasoning reuse that the approach enables is illustrated by applying it to a simple example.
Consumer Evaluations of Corporate Brand Redeployments

There has been little attention paid to the management of corporate brand names as part of the merger and acquisition process. As an initial step towards developing a better understanding of this brand redeployment decision the authors consider the reactions of one important stakeholder group—consumers—to alternative strategies. Specifically, the authors discuss the importance of the corporate branding decision in the M&A process and present a typology of alternative redeployment strategies as well as an exploratory study examining reactions to different postmerger branding strategies. The authors find evidence that the brand equity related to corporate brands is often decreased as a result of M&A activities and that individuals react differently to mergers employing different redeployment strategies. These results emphasize the need for firms to evaluate the corporate branding component of M&A activities as part of the process of managing corporate brands and should generate interest and research in this managerially relevant area.
Laparoscopic Heller myotomy provides durable relief from achalasia and salvages failures after botox or dilation.

Initial care for achalasia is often provided by nonsurgeons and, thereby, many patients have been initially treated with botulinum toxin (Botox) or have undergone balloon dilation prior to considerations for myotomy. Over the last decade, however, laparoscopic approaches to achalasia have become widely available and experience has grown, as documented by favorable results from many centers.1–8 Laparoscopic Heller myotomy is evolving into a “first-line” therapy for patients with achalasia, as well as a definitive therapy for salvage of patients failing endoscopic therapy for achalasia. Laparoscopic myotomy has now been undertaken at enough centers and for long enough that the full picture of the experience of laparoscopic Heller myotomy should be coming into focus. We undertook our first laparoscopic Heller myotomy in 1992. We have prospectively followed patients since then, building upon our earlier experience with myotomy via celiotomy or thoracotomy. While our initial videoscopic myotomies were undertaken through thoracoscopy, after our initial experience of less than 20 patients, we converted our approach to involve laparoscopy because of perceived simplicity and superior outcomes. Our initial results with thoracoscopy have been documented,9 and we believed they were inadequate to justify continuing that approach. Many questions over the past decade have arisen regarding outcomes after laparoscopic Heller myotomy, including the frequency and severity of gastroesophageal reflux, the need for an antireflux fundoplication, the need for intraoperative endoscopy, the extent of myotomy, the need for robotics, and long-term relief of dysphagia. As well, rates of success and failure have been sought, as well as the need for interventions and revisions after myotomy. This report documents our experience with videoscopic Heller myotomy since we began undertaking laparoscopic Heller myotomies. This report encompasses our journey with laparoscopic Heller myotomy over the last decade, documents our results, and delineates our current approach. In undertaking this review of our experience, we have sought to address several key issues, specifically, rates of complications associated with laparoscopic Heller myotomy, rates of success as determined by patient judgment, and rates of reinterventions. We hypothesized prior to reviewing our cumulative experience that success following laparoscopic Heller myotomy (as judged by patients) would be very high, complications would be relatively infrequent, and interventions after laparoscopic Heller myotomy would be infrequent, though late recurrence of symptoms of achalasia and consequences of reflux would occur.
Lipopolysaccharide Induces Expression of Genes Encoding Pro-Inflammatory Cytokines and the Elastin-Degrading Enzyme, Cathepsin S, in Human Cervical Smooth-Muscle Cells

Vaginal and amniotic infection with gram-negative bacteria is associated with preterm birth. We previously reported that human cervical smooth-muscle cells (CSMC) respond to pro-inflammatory cytokines by expressing enzymes that degrade the extracellular matrix. Our objective was to characterize the effects of lipopolysaccharide (LPS) from Escherichia coli (E coli), Bacteroides fragilis, (B frag) and Fusobacterium nucleatum (F nac) on the expression of pro-inflammatory cytokines and the elastindegrading enzyme, cathepsin S, in human CSMC. Human CSMC were exposed to LPS and the expression of mRNAs encoding pro-inflammatory cytokines and cathepsin S, and selected matrix metalloproteinases (MMPs) was analyzed by Northern blotting. The effect of cytokine-neutralizing antibodies on LPS-induced cathepsin S mRNA expression also was determined. E coli LPS increased expression of cathepsin S 12.5-fold after 12 hours; MMP-1 and MMP-3 mRNAs also were increased 2.9- and 3.5-fold, respectively. Tumor necrosis factor (TNF)-α, interleukin (IL-1)α, and IL-1β mRNAs were markedly up-regulated after 3 hours of LPS treatment. B frag and F nuc LPS also induced TNF-α and cathepsin S mRNAs. E coli LPS caused a sevenfold increase in TNF-α secretion after 5 to 8 hours. Antihuman TNF-α monoclonal antibody, but not a monoclonal antibody to the low-density lipoprotein receptor,r educed the LPS-induced increase in cathepsin S mRNA by 27%, whereas neutralizing antibodies against IL-1α and IL-1β did not suppress the response. Human CSMC were shown to express the toll-like receptor (TLR-2) and TLR-4 genes, which mediate the action of LPS. TLR-2 mRNA was up-regulated by TNF-α. CSMC respond to LPS with increased expression of pro-inflammatory cytokines and cathepsin S. Increases in catehpsin S mRNA result only in part from the rapid induction of TNF-α gene expression. TNF-α may also augment the CSMC response to LPS by increasing expression of the LPS signaling receptor, TLR-2, which probably directly mediates LPS action. These observations provide a mechanism by which gram-negative bacteria can precipitate cervical changes associated with pretenn birth.
Flexible penalty functions for nonlinear constrained optimization

We propose a globalization strategy for nonlinear constrained optimization. The method employs a ‘flexible’ penalty function to promote convergence, where during each iteration the penalty parameter can be chosen as any number within a prescribed interval, rather than a fixed value. This increased flexibility in the step acceptance procedure is designed to promote long productive steps for fast convergence. An analysis of the global convergence properties of the approach in the context of a line search sequential quadratic programming method and numerical results for the KNITRO software package are presented.
Transcatheter Aortic Valve Replacement: Focus on Sex-Related Differences in Outcomes

Transcatheter aortic valve replacement (TAVR) has transformed the management of severe aortic stenosis for high-risk and inoperable patients. The 10-year experience in Europe has proven the technology to be safe and effective in select populations. The PARTNER trial, the first prospective, randomized, controlled trial for TAVR, showed the technology to be superior to medical management for inoperable patients and equivalent to surgical aortic valve replacement for high-risk patients. Research in cardiovascular medicine has been dominated by studies on the male sex, due to the incidence of the disease process and partly due to historic predominance of male subjects in research studies. Alternatively, TAVR studies focused on high-risk and inoperable patients who are equally distributed by sex. Although sex-related differences are apparent in their baseline characteristics, outcomes have been mixed, with evidence suggesting that female patients may have a mortality advantage with TAVR. Herein we review the TAVR procedure and devices currently available and focus our discussion on outcomes after transcatheter or surgical aortic valve replacement in patients with severe aortic stenosis.
Simple model of flow-injection sample transport for prediction of peak heights

Abstract A model of the flow characteristics of a simple single-line flow-injection manifold is described and evaluated for the effects of various operating conditions on peak parameters, in particular peak height. The model is based on the mechanism for dispersion of diffusion across concentration gradients generated by laminar flow in a closed circular pipe. The flow conduit is considered to be divided into a number of segments both radially and longitudinally. The number of the segments in both dimensions is calculated from an empirically derived relationship from the initial input parameters of length, internal diameter, sample volume, detector volume and flow-rate. An iterative procedure assigns whole number values to the number of segments. Both normal and reverse procedures can be modelled. Diffusion is modelled by averaging the concentration of any one segment over those with which it has a common boundary and flow by transport of a proportion of the contents of a segment according to a parabolic velocity profile. The performance of the model was evaluated from the predicted peak heights for manifolds in which injector volume, flow-rate and tube length were varied. The predicted effect of changing the volume of the detector was examined. The model indicates that detector volume has little effect on peak shape unless the injected volume is less than the detector volume.
The Experiential Group: An Ethical and Professional Dilemma.

Abstract This article examines the ethical dilemma surrounding the use of experiential groups in the preparation of group counselors and makes recommendations for resolving it.
MO‐C‐BRCD‐01: Towards Personalized Medicine: Integration of Imaging into Therapy

A significant advance in cancer therapy is currently underway with the evolution from a population‐based to a personalized patient‐based prescription. Rapid developments in imaging, particularly adoption of molecular imaging, offer unprecedented opportunities for accurate characterization of tumor biology, as well as early assessment of treatment response. Accurate characterization of tumor biology enables effective selection of appropriate therapy or even a design of purposefully non‐uniform tumor‐specific treatment plans, tailored to the spatial distribution of biological properties of each patient's tumor. Early assessment of treatment response enables treatment adaptation, potentially intensifying or reducing the treatment dose to provide more efficacious and less toxic therapies. However, integration of imaging into therapeutic applications requires a high level of image quantification, well beyond what is currently required in diagnosticimaging applications. This lecture will provide an overview of imaging applications in therapy, ranging from target selection totreatment response assessment. Potential roadblocks, as well as research opportunities on the path to personalization of cancer therapy, will be highlighted. Learning Objectives: 1. Understand the role of imaging in target definition and treatment response assessment 2. Understand the requirements for establishing imaging as a biomarker 3. Learn about research opportunities on the interface between imaging and therapy
Opioid Receptor Blockade During Prenatal Life Modifies Postnatal Behavioral Development

The ontogeny of physical characteristics, spontaneous motor, and sensorimotor behaviors of preweaning rats, as well as ambulation and emotionality at weaning (day 21) were studied in rats exposed to 50 mg/kg naltrexone (NTX) or saline (controls) daily throughout gestation by maternal administration; all animals were cross-fostered to untreated mothers at birth. Morphine challenge tests and nociceptive measures revealed that this dosage of opioid antagonist blocked opioid receptors for 24 h. At birth and weaning, animals in the NTX group weighed 12 and 20%, respectively, more than control offspring. The age at which a specific physical characteristic, spontaneous motor behavior, or reflex initially appeared and the age at which 100% of the animals demonstrated a particular characteristic/behavior often were accelerated in animals prenatally exposed to NTX. The frequency of ambulation was subnormal in the NTX group, and the frequency and/or incidence of rearing, grooming, wet-dog shakes, and defecation were reduced from normal levels in these opioid antagonist-exposed rats. These results imply that interactions of endogenous opioid systems during embryogenesis are determinants of somatic, physical, and behavioral development in postnatal life.
An XML experiment description language for ns-3

While the ns-3 tool has been shown to be an excellent tool for researchers and network designers to analyze and evaluate network performance, the use of ns-3 in educational classroom environments has less success. The use of ns-3 to illustrate network design principles to lower--level undergraduate students requires considerable skill in the C++ programming language, and appears to be beyond the ability of first or second year undergraduate students. Further, teaching faculty at the university level are also unlikely to have these skills, or the desire to obtain them to use ns-3. In order to allow novices to use ns-3 to construct simple experiments and observe results, we have created the ns3xml front--end processor for ns-3, that reads a flat text file in the well--known XML format and then constructs and executes an ns-3 experiment based on the XML description of the experiment.
The Internet, intranets, and the AI renaissance

Virtually cost-free publication on the World Wide Web has led to information overload. Artificial intelligence (AI), with its roots in knowledge representation, is experiencing a renaissance as new tools emerge to make the Web more tractable. Why do these Internet-based applications herald an AI renaissance? AI has come to play a crucial role in Information Age retrieval strategies. Internet-based applications can exploit a wide range of AI developments. In this survey, we look at examples of the following AI technologies: natural language processing (concept-based Internet searching); machine-learning (WebWatcher); heuristic rules for establishing preference (Letizia); rule-based/heuristic natural language processing (ContactFinder, FAQFinder, Globenet); and neural networks (Autonomy). This isn't AI for AI's sake-this renaissance is not one of stand-alone AI applications. Unlike first-generation AI applications, AI can now be embedded in heterogeneous networked computing environments and used for searching, retrieval and analysis of previously unimaginable quantities of data. Because the wealth of data makes direct human analysis impossible, AI-based support has become necessary to help users fully exploit that information. Our increasingly competitive and technology-driven world has reduced the time available to us for decision-making. To survive in this environment, we are increasingly turning to advanced computer technologies, such as intelligent agents, and delegating some of that decision-making to these electronic surrogates.
Using public health data systems to understand and eliminate cancer disparities

Identifying and eliminating social disparities in cancer depend upon the availability and ready use of public health surveillance data at the national, state and local levels. As an example of advancing a statewide research agenda in cancer disparities, we present descriptive statistics from major public health surveillance data systems in Massachusetts. Disparities highlighted include higher breast cancer mortality rates among African-American women than women of other racial groups, lower rates of colorectal and cervical cancer screening among Asian-American residents, and striking gradients in cancer risk factor prevalence and screening by income and education. Challenges in utilizing public health surveillance data include lack of information in many domains of social inequity beyond race/ethnicity, uneven quality, and lack of stable, reportable data for smaller populations. Opportunities to maximize the usefulness of cancer registry data include application of geographic information systems and linkage with other data systems tracking information on health services outcomes and clinical trial participation. Analyses of surveillance data can spark advances not only in community-based participatory research but also in programs and policies that may ultimately eliminate disparities along the cancer continuum.
Structure of the Hybrid-2 type intramolecular human telomeric G-quadruplex in K+ solution: insights into structure polymorphism of the human telomeric sequence

Formation of the G-quadruplex in the human telomeric sequence can inhibit the activity of telomerase, thus the intramolecular telomeric G-quadruplexes have been considered as an attractive anticancer target. Information of intramolecular telomeric G-quadruplex structures formed under physiological conditions is important for structure-based drug design. Here, we report the first structure of the major intramolecular G-quadruplex formed in a native, non-modified human telomeric sequence in K(+) solution. This is a hybrid-type mixed parallel/antiparallel-G-stranded G-quadruplex, one end of which is covered by a novel T:A:T triple capping structure. This structure (Hybrid-2) and the previously reported Hybrid-1 structure differ in their loop arrangements, strand orientations and capping structures. The distinct capping structures appear to be crucial for the favored formation of the specific hybrid-type intramolecular telomeric G-quadruplexes, and may provide specific binding sites for drug targeting. Our study also shows that while the hybrid-type G-quadruplexes appear to be the major conformations in K(+) solution, human telomeric sequences are always in equilibrium between Hybrid-1 and Hybrid-2 structures, which is largely determined by the 3'-flanking sequence. Furthermore, both hybrid-type G-quadruplexes suggest a straightforward means for multimer formation with effective packing in the human telomeric sequence and provide important implications for drug targeting of G-quadruplexes in human telomeres.
Upper extremity deep vein thrombosis with tourniquet use.

INTRODUCTION Upper extremity deep vein thrombosis is an increasingly important clinical finding with significant morbidity and mortality. The condition may be under-diagnosed in trauma and surgery settings.