cssi/SciSciGPT-SciSciNet huggingface dataset:
Honored guest's address. The inverse relationship between cost and prognosis

While doctors get the blame for increasing medical costs, studies show that societal, political factors, and medicine's limitations are the culprit. Clinicians (I use the term to distinguish between those M.D.s who work at the bedside and others who are in nonpatient direct care) are well aware of the huge costs associated with serious illness, but it is only recently that many papers are appearing in the medical literature discussing this problem in relation to medical care. In a study published in JAMA (April 10,1981), Steven A. Schroeder, el at., found that high cost illness is really terminal illness in a random sample of 776 adult high-cost patients. Two years after discharge at least 34% of high-cost patients had died and these patients accounted for 39% of the hospital charges incurred by the total group studied. Francis Moore and colleagues pointed out in the New England Journal of Medicine (March 12,1981) that this very group of patients also had the highest incidence of complications in the surgical field. In one year they identified 36 such cases at the Peter Bent Brigham Hospital in Boston; the total cost of their care was nearly $2,000,000. While there were unnecessary complications, in this group of patients it is very likely inevitable that the complication rate will be high. Since many authors seem to imply that it is the clinicians who are at fault to a large extent in generating these costs, I would like to point out that the physician-clinician actually has control over a relatively small percent of the total cost.
Autobiographies of Violence: The SA in its Own Words

What was the moral horizon of ordinary SA men? What did they think, what did they believe, and what were their ideals? These are hard questions to answer even when they concern people still alive and events still going on. To pose them some eighty years after the fact is to admit that no answer can be definitive. Yet a fresh look at some well-known contemporary sources can at least allow some tentative, suggestive answers. They demonstrate, above all, an emphasis on frenetic activism, combined with a sense of personal suffering and sacrifice. They stress key National Socialist values, such as antisemitism, criticism of the bourgeoisie, and a commitment to an idealized national community, or Volksgemeinschaft. And yet, they also reflect, to a certain extent, pre-Nazi middle-class values. Beyond this, they show men trying desperately to rewrite themselves as ideal SA men and Nazis.
Anaphylaxis to insect stings

Anaphylaxis to insect stings has occurred in 3% of adults and can be fatal even on the first reaction. Large local reactions are more frequent but rarely dangerous. The chance of a systemic reaction to a sting is 5% to 10% in large local reactors and in children with mild (cutaneous) systemic reactions, and varies between 30% and 65% in adults with previous systemic reactions, depending on the severity of previous sting reactions. Baseline serum tryptase level is increased in many patients with sting anaphylaxis. Venom immunotherapy is 75% to 98% effective in preventing sting anaphylaxis.
Diagnosis and Management of Dengue Fever in Children

1. Ashlesha Kaushik, MD* 2. Carol Pineda, MD* 3. Helen Kest, MD, MPH, CPH† 1. *Department of Pediatrics, St Joseph's Children's Hospital, Patterson, NJ. 2. †Division of Pediatric Infectious Disease, Department of Pediatrics, St. Joseph's Children's Hospital, Patterson, NJ. After completing this article, readers should be able to: 1. Describe the epidemiology and clinical spectrum of dengue viral infections. 2. Recognize when to consider dengue in the differential diagnosis of acute fever. 3. Discuss the diagnosis and management of this common tropical illness. 4. Identify other diseases that can mimic dengue viral infections. A 17-year-old Hispanic girl presents with a 5-day history of temperature of 39.4°C to 40.5°C and a 4-day history of severe bifrontal and intermittent headaches. She also has a 3-day history of malaise, generalized body aches, and mild epigastric pain. On the day of admission, she develops a dark reddish-purple, nonpruritic, and nonblanching rash over her arms and thighs and is brought to the emergency department. There is no cough, sore throat, vomiting, or diarrhea. She denies illicit drug use, tick exposure, sexual activity, or allergies. On physical examination, the girl appears alert, oriented, and in no acute distress. Her temperature is 38.5°C, heart rate is 119 beats/min, respiratory rate is 18 breaths/min, and blood pressure is 130/68 mm Hg (90th to 95th percentile). Capillary refill time is less than 2 seconds. A petechial rash is present over her arms and anterior thighs. She has mild epigastric tenderness, with no rebound tenderness, guarding, hepatosplenomegaly, or masses. Tourniquet test is positive. Kernig and Brudzinski signs are negative. The remainder of the physical examination findings are normal. Her white blood cell count is 3.5×103/mcL (3.5×10 9/L) with 59% neutrophils, 33% lymphocytes, 6% monocytes, and 1% eosinophils; hemoglobin is 13.4 g/dL (134 g/L); hematocrit is 39.6% (0.396); platelet count is 126×103/mcL (126×10 9/L); and erythrocyte sedimentation …
Induction of Acute Pleural Inflammation by Staphylococcus aureus. I. CD4+ T Cells Play a Critical Role in Experimental Empyema

Bacterial empyema is a frequent complication of pneumonia in patients with acquired immunodeficiency syndrome (AIDS). A model of Staphylococcus aureus empyema was developed that closely resembles bacterial empyema in patients infected with human immunodeficiency virus (HIV). Results show a compartmentalized chemokine response in bacterial empyema. The chemokine levels were higher in the pleural compartment than in the peripheral circulation. Polymorphonuclear leukocyte counts, murine GRO-alpha (KC), and macrophage inflammatory protein-2 levels were significantly (P<.001) lower in CD4+ knockout (CD4 KO) mice pleural fluid than in CD4+ wild-type (CD4 WT) mice. The CD4 KO mice had poorer bacterial clearance than CD4 WT mice. During S. aureus infection, interleukin-10 levels increased in the CD4 KO mice, whereas interferon-gamma levels were increased in CD4 WT mice. CD4+ T cell depletion results in a decreased pleural chemokine response, decreased neutrophil influx into pleural space, and impaired bacterial clearance in empyema.
Short time dynamics in the isotropic phase of liquid crystals: the aspect ratio and the power law decay

Optical heterodyne detected optical Kerr effect (OHD-OKE) experiments are used to study the orientational dynamics of the liquid crystal 4 0 -octyl-4-biphenylcarbonitrile (8CB) in the isotropic phase near the isotropic to nematic phase transition. The results are compared to those for three other liquid crystals. The 8CB data display a short time scale temperature independent power law decay and a long time scale exponential decay with a temperature dependence described by Landau–de Gennes theory. The power law exponent is )0.56. Combining this result with previous results for three other liquid crystals [J. Chem. Phys. 116 (2002) 6339; J. Chem. Phys. 116 (2002) 360], it is found that the power law exponent depends linearly on the aspect ratio of the liquid crystal. 2002 Elsevier Science B.V. All rights reserved.
The Replication of Yeast Chromosomes

Eukaryotic chromosomes consist of linear DNA molecules that are complexed with proteins to form chromatin. Early analysis of replicating chromosomal DNA by fiber autoradiography revealed that replication initiates at multiple sites along each DNA molecule and that replication forks move bidirectionally away from the initiation sites (Huberman and Riggs 1968). Important questions raised by these observation are whether replication initiation sites (origins of replication) are specified by cis-acting elements (replicators) present in the primary DNA sequence and how the multiple initiation events along a chromosome are coordinated and regulated. An additional important question is how the ends of the linear DNA molecules of eukaryotic chromosomes are replicated completely. All known DNA polymerases synthesize DNA in the 5′ to 3′ direction and are unable to begin DNA synthesis de novo. They require a primer, which is usually RNA, carrying a free 3′-OH that can be extended. Removal of the primers at the 5′ ends of newly replicated chromosomal DNA molecules would result in the gradual loss of genetic information from the ends of chromosomes with each replication, a problem which is circumvented somehow by telomeres.
Klebsiella Pulmonary Infections: Occurrence at One Medical Center and Review

Klebsiella pneumoniae is the species of aerobic gram-negative bacteria most commonly recognized as a cause of community-acquired pneumonia. The vast majority of articles concerning the epidemiology, frequency, and clinical and radiographic features of community-acquired pneumonias caused by this organism are over 20 years old. Experience with community-acquired pneumonias due to K. pneumoniae at one medical center over the last 20 years is reported and compared with the previously published literature. The recent experience at Parkland Memorial is quite similar to that in the literature. Salient features include the infrequency of K. pneumoniae as a cause of community-acquired pneumonia, the lack of specificity and sensitivity of most clinical and radiographic findings, and the similarity to and potential confusion with anaerobic pneumonitis and cavitary lung disease if only expectorated sputums are utilized for diagnosis in certain population groups such as alcoholics.
ADDITIONS TO THE FLORA OF CONNECTICUT

Since the publication of the Connecticut checklist by Dowhan (1979), new state records have continued to appear. These were summarized by Mehrhoff (1995), including some made by Tucker (1987,1991). Although geographically distant, the flora of Connecti cut has continued to hold my attention since the publication of a flora of the southeastern part of the state (Tucker 1995). Over the past decade, I have made several collections that are new records for the state flora. These new records are reported in this paper, as well as a 1970 collection of Coronilla scorpioides that was never added to the state's flora. All are non-native, either persisting or possibly naturalized species, and are enumerated below by family.
Recovery of pituitary function following treatment of an unruptured giant cavernous carotid aneurysm using Surpass flow-diverting stents

Giant aneurysms arising from the cavernous internal carotid artery (ICA) can mimic pituitary adenomas and may cause pituitary dysfunction due to their mass effect on the pituitary gland. We report a case of a 56-year-old man presenting with impotence, fatigue and panhypopituitarism who was found to have a giant unruptured aneurysm arising from the right cavernous ICA with severe mass effect on the pituitary gland. The patient underwent endovascular treatment of the giant aneurysm using two telescoping Surpass flow-diverting stents. At 6-month follow-up, repeat cerebral angiography showed Raymond grade II occlusion of the aneurysm with a small neck remnant. At the 10-month follow-up the patient showed full recovery of his pituitary function and clinical resolution of impotence and fatigue. This is the first report of occlusion of a giant cavernous carotid aneurysm using next generation Surpass flow-diverting stents leading to complete recovery of pituitary function.
Decreased formation of porstaglandins derived from arachidonic acid by dietary linolenate in rats.

Accumulated evidence now suggests that availability of precursor acid is an important factor controlling the biosynthesis of prostaglandins (P0's). Since linolenic acid inhibits the conversion of linoleic acid to arachidonic acid (POE2, PG F2,, and thromboxane Aprecursor), rats receiving more linolenic acid are expected to have less arachidonic acid and thus less PG's synthesized from arachidonic acid than those receiving linoleic acid alone. Essential fatty acid- deficient rats, induced by feeding hydrogenated coconut oil diet for 15 weeks, were divided into six groups and fed graded amounts of purified methyl linolenate for 6 weeks. Each group of rats except essential fatty acid-deficient group received the same amount of linoleate. The results showed that the level of anachidonic acid in serum lipids and serum concentrations of PG's synthesized from anachidonic acid by platelets decreased as the amount of dietary linolenate increased. This indicated that biosynthesis of PG's in platelets can be influenced by the availability of precursors, and thus it can be modified by the manipulation of dietary fatty acids. Am. J. Clin. Nutr. 33: 590-597, 1980.
Automated Load Balancing of a Missile Defense Simulation Using Domain Knowledge

For discrete-event simulations with a large number of objects, parallelization provides an opportunity for improved performance. However, if simulation objects are not placed carefully, the additional communication costs can outweigh the performance gain from adding CPUs. For many simulations, the large number of objects makes manual placement of objects impractical. We present two new algorithms for static load balancing that, using a small amount of domain knowledge and run-time measurements, automatically discover objects of different classes that communicate frequently and place these objects on the same processor. We compare results obtained from a missile defense simulation implemented in SPEEDES using our algorithms to those obtained with previously published load-balancing algorithms.
Spectral graphs for quasi-cyclic LDPC codes

Quasi-cyclic codes are described in terms of code equations on the spectral components of constituent cyclic codes. These define a constraint graph in the spectral domain. Here spectral graphs define low density parity check codes (LDPC) codes for which minimum distance can be bounded with algebraic and graph-based arguments. Examples include [42,22,8] and [155,64,20] regular LPDC codes.
Riemannian Manifolds with Positive Sectional Curvature

Of special interest in the history of Riemannian geometry have been manifolds with positive sectional curvature. In these notes we give a survey of this subject and recent developments.
Risk of Stroke After the International Classification of Diseases-Ninth Revision Discharge Code Diagnosis of Hypertensive Encephalopathy

Background and Purpose—Although chronic hypertension is a well-established risk factor for stroke, little is known about stroke risk after hypertensive encephalopathy (HE), when neurologic sequelae of hypertension become evident. Therefore, we evaluated the risk of stroke after a diagnosis of HE. Methods—We identified all patients discharged from California, New York, and Florida emergency departments and acute care hospitals between 2005 and 2012 with a primary International Classification of Diseases, Ninth Edition, Clinical Modification discharge diagnosis of HE (437.2). Patients discharged with a primary diagnosis of seizure (345.x) served as negative controls, whereas patients with a primary diagnosis of transient ischemic attack (435.x) were positive controls. Our primary outcome was the composite of subsequent ischemic stroke or intracerebral hemorrhage. Kaplan–Meier survival statistics were used to calculate cumulative outcome rates, and Cox proportional hazard analysis was used to examine the ass...
A pioneer country? A history of Norwegian climate politics

The shift away from ecology towards climatology in Norwegian environmental policy in the late 1980s and 1990s was not accidental. A main mover was the Labor Party politician Gro Harlem Brundtland who did not want to deal with unruly and highly vocal Deep Ecologists. Better then to start afresh with a different set of environmental scholars appealing to the technocratic tradition within the Labor Party. Instead of changing the ethical and social ways of dealing with environmental problems as the Deep Ecologists were advocating, she was looking for technological and economic solutions. And she mobilized an international regime of carbon capture storage (CCS), tradable carbon emissions quota (TEQs), and clean development mechanisms (CDMs), all of which eventually were approved in Kyoto in 1997. This move towards technocracy and cost-benefit economics reflects a post-Cold War turn towards utilitarian capitalism, but also a longing to showcase Norway as an environmental pioneer country to the world. The underlying question was how to reconcile the nation’s booming petroleum industry with reduction in climate gas emissions. Should the oil and gas stay underground and the country strive towards the ecologically informed zerogrowth society the Deep Ecologists were envisioning? Or could growth in the petroleum industry take place without harming the environment as the Labor Party environmentalists argued?
Chondroid chordoma. A hyalinized chordoma without cartilaginous differentiation.

"Chondroid chordoma" is a controversial and confusing entity that was originally described by Heffelfinger and colleagues as a biphasic malignant neoplasm possessing elements of both chordoma and cartilaginous tissue. Because the premise for this distinction was based strictly on histomorphologic criteria, the light microscopic, immunohistochemical, and electron microscopic features of the chondroid and chordoid areas of five chondroid chordomas of the skull base were evaluated separately, and compared to five typical chordomas and six low grade chondrosarcomas. Using light microscopy, chondroid chordoma revealed areas that resembled typical chordoma (chordoid areas) and areas that resembled low grade chondrosarcoma (chondroid areas). However, both the chordoid and chondroid areas had an epithelial phenotype and stained strongly for cytokeratin and EMA as well as S-100. 5'-nucleotidase, an enzyme that has been described in chordoma but not in chondrosarcoma, was found in both the chordoid and chondroid areas of one chondroid chordoma. Electron microscopic studies of both the chordoid and chondroid areas in four of the tumors demonstrated both tonofibrils and desmosomes. Chordoma demonstrated immunohistochemical and electron microscopic features that were nearly identical to chondroid chordoma. Chordoma was cytokeratin, EMA, S-100, and 5'-nucleotidase positive. Ultrastructurally, chordoma exhibited variably-sized vacuoles, abundant rough endoplasmic reticulum (RER), and desmosomes with tonofilaments. In contrast to chondroid chordoma, chondrosarcoma consistently stained for only S-100 protein and was cytokeratin, EMA and 5'-nucleotidase negative. Ultrastructurally, chondrosarcoma demonstrated a flocculogranular matrix, glycogen, abundant RER, and scalloped cellular outlines, but lacked desmosomes with tonofilaments. These findings indicate that "chondroid chordoma" is a variant of chordoma with histologic features that may mimic chondrosarcoma. Despite the resemblance of these hyalinized areas to cartilaginous tissue, these tumors retain their epithelial phenotype. Biphasic differentiation is not present. These findings undermine the original premise for distinguishing "chondroid chordoma" from typical chordoma. The authors propose that these tumors be classified as "hyalinized chordomas," rather than "chondroid chordoma," to clarify their histogenesis and avoid confusion with chondrosarcomas of the base of the skull.
Will Value-Based Purchasing Increase Disparities in Care?

U.S. hospitals caring for more disadvantaged patients fared worse in the first year of Medicare's Hospital Value-Based Purchasing program. Over time, such resource reductions may cause the quality of care to deteriorate in hospitals serving more disadvantaged patients.
Phocoenoides dalli Washed Ashore in California

On January 28, 1956, at Long Beach, California, the body of a Dall porpoise was found among the debris caused by recent rain storms. The animal had washed ashore during the night and had only been dead for a short time. It could not be determined whether the …
CBIO-23THE TEAD4-DRIVEN TRANSPORTOME MEDIATES ACTIVATION OF THE OSMOTIC ENGINE TO POTENTIATE GLIOBLASTOMA INVASION

Cancer cell migration is a critical process that underlies invasion, treatment evasion, and tumor recurrence. In the complex 3D-confined microenvironments of the body, a diverse molecular machinery drives migratory behavior. In particular, the recently discovered osmotic engine plays a pivotal role in promoting cell dispersal through directed water permeation. This osmotic engine machinery is driven by solute transporters and aquaporins, collectively named the transportome. Hence, it is imperative to determine the role of this transportome and its implications for invasive gliomas. Using novel in vitro microfluidic technology, we demonstrate for the first time that human glioblastoma (GBM) cells rely on the osmotic engine to migrate in confined microenvironments. In particular, using microchannel microfluidic devices, we characterize the migratory capacity of GBM cells in 3D-confined microenvironments using real-time imaging and assess their migratory behavior upon osmotic shock treatment. Our results show that GBM cells readily migrate in high degrees of confinement (3uM). In addition, when exposed to either a hypotonic shock at the leading edge or hypertonic shock at the lagging edge, these primary GBM cells reverse their directional migration, signifying the role of the osmotic engine model in brain cancer (p < 0.05). Furthermore, we uncover the transcription factor TEAD4 as a master regulator of the transportome gene signature and the osmotic engine collectively. Genetic inhibition of TEAD4 results in reduced migratory potential through confined microchannels as well as decreased speed within these confined spaces in vitro (p < 0.05). Using TCGA (n = 528) and REMBRANDT (n = 228) GBM patient datasets, we found that the TEAD4-controlled transportome machinery is overrepresented in glioblastomas and correlates with its poor prognosis. Taken together, our results show that the osmotic engine is a crucial mechanism for GBM cell migration driven by the TEAD4-dependent transportome machinery. Targeting this TEAD4-driven osmotic engine may hold a promising alternative for management of invasive gliomas.
Gram-negative bacterial sepsis and sepsis syndrome.

Gram-negative bacterial sepsis and septic shock remain significant causes of morbidity and mortality in hospitalized patients. Recent investigation in this area has served to better define the host response to these and other types of infections; a constellation of signs and symptoms that has been termed sepsis syndrome. Recent studies indicate that the mortality rate associated with this latter disease is approximately 40%, despite administration of antimicrobial agents, hemodynamic monitoring and fluid resuscitation, and metabolic support. For this reason, the pathophysiology of this process is undergoing intensive examination, and attempts are being made to use several new types of treatment modalities as adjunctive therapy.
Flame structure and ignition limit of partially premixed cool flames in a counterflow burner

Abstract Due to their natural coupling of low-temperature chemistry and transport, cool flames are a valuable platform for drawing fundamental understandings of complicated phenomena relevant to real engines. In this study, self-sustaining partially premixed cool flames of dimethyl ether are investigated in detail through the use of an ozone-assisted counterflow burner. A double cool flame with distinct diffusion flame and premixed flames sides is visibly observed at increased fuel loading and equivalence ratio. The examination of double cool flames and double hot flames through planar laser-induced fluorescence measurements reveals the stark differences in the role of CH 2 O in each. The results show that while CH 2 O is one of the main product species of the cool flame via low-temperature chemistry, for the hot flame it is only a short-lived intermediate produced in the preheat zone. Comparisons of experimental results with numerical calculations based upon detailed chemical kinetic models show fair agreement on the double cool flame structure but a noticeable discrepancy in the prediction of the second-stage ignition limit, which triggers the transition from cool flames to hot flames. The critical strain rate for second-stage ignition is shown to be much more sensitive to fuel addition on the premixed side of the double flame than on the diffusion side. A mechanism for second-stage ignition in partially premixed cool flames is proposed based upon numerical modeling and experimental observations: H 2 O 2 is primarily formed in the premixed cool flame, diffuses toward the stagnation plane, and then finally decomposes into OH radicals upon approaching the cool diffusion flame.
Clinical Psychology Since 1917: Science, Practice, and Organization

Chronological Narrative: Introduction. The American Association of Clinical Psychologists. The Clinical Section of the American Psychological Association. The Clinical Section of the American Association for Applied Psychology. The Division of Clinical and Abnormal Psychology/Division of Clinical Psychology. Growth of Division 12 and the Origins of the Section on Clinical Child Psychology. Psychologists Interested in the Advancement of Psychotherapy. The Corresponding Committee of Fifty and the Section on Continuing Professional Education. The Section for Clinical Psychology as an ExperimentalBehavioral Science/Society for a Science of Clinical Psychology. The Section on the Clinical Psychology of Women. Issues and Personalities: Research and Scholarly Activities: Basic Science and Psychopathology. Education and Training: The Vail Model. The Economics of Psychological Services: The Public Sector. Summing Up: Conclusion. 9 additional articles. Index.
Pharmacokinetics and analgesic effects of methadone in children and adults with sickle cell disease

Background Vaso-occlusive episodes (VOEs) are a significant source of morbidity among children and adults with sickle cell disease (SCD). There is little information on methadone use for SCD pain. This investigation evaluated methadone pharmacokinetics in children and adults with SCD, with a secondary aim to assess pain relief and opioid consumption. Procedure Participants included children (<18 years) and adults with a VOE requiring hospitalization. Patients were randomly assigned to receive standard care (opioid patient-controlled analgesia; control group) or one dose of intravenous methadone (0.1–0.125 mg/kg) in addition to standard care (methadone group). Venous methadone and metabolite concentrations were measured. Pain scores, pain relief scores, and opioid consumption were recorded. Results Twenty-four children (12 methadone, 12 controls) and 23 adults (11 methadone, 12 controls) were studied. In children, the half-life of R- and S-methadone enantiomers was 34 ± 16 and 24 ± 9 hr, respectively. In adults, R- and S-methadone half-lives were 52 ± 17 and 38 ± 12 hr, respectively. Pain scores were lower (P = 0.002) and pain relief scores were higher (P = 0.0396) in children receiving methadone versus controls. There was no difference in pain scores and pain relief in adults receiving methadone versus controls. There was no difference in opioid consumption between methadone and control groups, in both adults and children. Conclusions Intravenous methadone disposition in children and adults with SCD was comparable to that in subjects without SCD from prior studies. Methadone produced more pain relief than standard care in children with SCD. Higher methadone doses may be more effective and should be evaluated in both children and adults with SCD.
Macrophage alterations within the mesenteric lymphatic tissue are associated with impairment of lymphatic pump in metabolic syndrome.

Objective The intrinsic lymphatic pump is critical to proper lymph transport and is impaired in models of the MetSyn. Lymphatic contractile inhibition under inflammatory conditions has been linked with elevated NO production by activated myeloid–derived cells. Hence we hypothesized that inhibition of the MLV pump function in MetSyn animals was dependent on NO and was associated with altered macrophage recruitment and polarization within the MLV. Methods We used a high fructose-fed rat model of MetSyn. Macrophage polarization was determined by whole mount immunofluorescence in mesenteric neurovascular bundles based on expression of CD163, CD206, and MHCII. We also utilized isolated vessel isobaric preparations to determine the role for elevated NO production in the inhibition of MLV contractility. Both LECs and LMCs were used to assess the cytokines and chemokines to test how the lymphatic cells response to inflammatory conditions. Results Data demonstrated a greater accumulation of M1-skewed (CD163+MHCII+) macrophages that were observed both within the perivascular adipose tissue and invested along the lymphatic vessels in MetSyn rats when compared to control rats. LECs and LMCs basally express the macrophage maturation polarization cytokines monocyte colony-stimulating factor and dramatically up regulate the M1 promoting cytokine granulocyte/monocyte colony-stimulating factor in response to lipopolysaccharide stimulation. MetSyn MLVs exhibited altered phasic contraction frequency. Incubation of MetSyn MLVs with LNAME or Glib had a partial restoration of lymphatic contraction frequency. Conclusion The data presented here provide the first evidence for a correlation between alterations in macrophage status and lymphatic dysfunction that is partially mediated by NO and KATP channel in MetSyn rats.
Comparison of potential-based analysis methods for simple and complex media

A comparison of vector and scalar potential formulations for simple and complex media is presented. Boundary conditions for the various formulations are provided, including new scalar potential boundary conditions valid for layered bianisotropic gyrotropic media. Advantages and limitations of each technique are discussed in order to identify the most suitable method of analysis for a given class of material.
Cannabis Smoking and the Lung

Abstract Habitual cannabis smoking is associated with symptoms of acute and chronic bronchitis, and evidence of microscopic injury to the cells lining the central airways. However, evidence is inconsistent regarding an association with airflow obstruction involving peripheral airways (the major site of chronic obstructive pulmonary disease, COPD), suggesting that cannabis is unlikely to predispose to clinically significant COPD. Several cases of pneumothorax, pneumomediastinum, and bullous lung disease have been reported in cannabis smokers (often with tobacco), but a causal relationship to cannabis has not been established. A large prospective cohort study and a large population-based case-control study have both failed to find a significant association with lung cancer, while a smaller case-control study has suggested a positive association in heavy cannabis users. While case series and older observational studies suggest a possible association between cannabis and pneumonia, including tuberculosis, large-scale epidemiologic studies testing for a significant association are lacking.
Paternal nicotine exposure alters hepatic xenobiotic metabolism in offspring

Paternal environmental conditions can influence phenotypes in future generations, but it is unclear whether offspring phenotypes represent specific responses to particular aspects of the paternal exposure history, or a generic response to paternal 'quality of life'. Here, we establish a paternal effect model based on nicotine exposure in mice, enabling pharmacological interrogation of the specificity of the offspring response. Paternal exposure to nicotine prior to reproduction induced a broad protective response to multiple xenobiotics in male offspring. This effect manifested as increased survival following injection of toxic levels of either nicotine or cocaine, accompanied by hepatic upregulation of xenobiotic processing genes, and enhanced drug clearance. Surprisingly, this protective effect could also be induced by a nicotinic receptor antagonist, suggesting that xenobiotic exposure, rather than nicotinic receptor signaling, is responsible for programming offspring drug resistance. Thus, paternal drug exposure induces a protective phenotype in offspring by enhancing metabolic tolerance to xenobiotics.
What is cocoa sustainability? Mapping stakeholders’ socio-economic, environmental, and commercial constellations of priorities

Given growing concerns regarding the chocolate sector’s long-term future, more private-sector, public-sector, and civil-society stakeholders have become involved in initiatives seeking to make cocoa more ‘sustainable’. However, the commercial, socio-economic, and environmental priorities they associate with the omnipresent, yet polysemic term diverge considerably: while transforming the crop into a more viable livelihood for growers is essential for some, others prioritize the crop’s links to global environmental challenges through agroforestry. A third dimension encompasses commercial concerns related to securing supply. The article explores how tensions and synergies manifest in these divergent understandings of what cocoa sustainability is and is to entail, which diverse civil-society, public-sector, and private-sector stakeholders bring to the table. It argues that priorities associated with ‘cocoa sustainability’ diverge, yielding synergies, tensions, and trade-offs. This article draws on the author’s in-depth doctoral fieldwork in cocoa sustainability initiatives incorporating environmental measures, which encompassed semi-structured interviews, focus-group discussions, documentary analysis, and participant observation in Latin America and Europe. It proposes the ‘constellations of priorities’ model as an instrument to capture how the priorities driving cocoa stakeholders variously dovetail, intersect, and collide. Particularly against the backdrop of the sector’s brewing crisis, the paper suggests that stakeholders systematically assess their and other actors’ socio-economic, environmental, and commercial priorities as part of the equitable engagement required to transform the sector and attain genuine cocoa sustainability.
Advocating for the DREAM Act: Why Pediatricians Should Care and What They Can Do.

* Abbreviations: DACA — : Deferred Action for Childhood Arrivals DREAM — : Development, Relief, and Education for Alien Minors Deferred Action for Childhood Arrivals (DACA) recipients are undocumented immigrants who were brought to the United States before the age of 16, lived in the United States for at least 5 years, have no significant criminal history, and were <31 years of age on June 15, 2012. They are sometimes termed “Dreamers” after the never-passed legislation known as the Development, Relief, and Education for Alien Minors (DREAM) Act. The DREAM Act would provide a path to citizenship for this population. DACA does not. President Trump recently rescinded the executive memorandum that created the DACA program.1 Although his action does not take effect immediately, it leaves nearly a million Dreamers in limbo. Unless Congress acts by March 5, 2018, Dreamers’ legal status will expire. Starting on that date, more than 1000 DACA recipients will lose their legal status every day. If that happens, they will lose their ability to work lawfully and to take out educational loans. They will face potential deportation by Immigration and Customs Enforcement. This will have both a personal impact and a societal one. One DACA recipient (and a coauthor of this article) described the personal impact: > In the past few months, I have felt the return of that crippling fear. I feel it in my … Address correspondence to John D. Lantos, MD, Children’s Mercy Hospital Bioethics Center, Kansas City, 2401 Gillham Rd, Kansas City, MO 64108. E-mail: jlantos{at}cmh.edu
Incidental Finding of Traumatic Arteriovenous Fistula in the Tibial Peroneal Trunk during Venous Duplex Ultrasound to Rule Out Deep Vein Thrombosis

Traumatic arteriovenous (AV) fistulas are caused by injury to an adjacent artery and vein and can be potentially limb threatening. AV fistulas occurring at the level of the popliteal artery result ...
Reachability analysis of linear dynamic systems with constant, arbitrary, and Lipschitz continuous inputs

Abstract This paper sets forth a method for reachability analysis of linear dynamic systems in continuous time that can be used to compute time-domain bounds of states and outputs with floating-point precision. The focus is on the particular initial conditions and inputs that cause state or output trajectories to attain their extreme values in time. Inputs can be constant, arbitrary, or Lipschitz continuous waveforms. Uncertainties in initial conditions and inputs are modeled using zonotopes. The calculations exploit the definition of zonotopes and the modal information of the linear system dynamics.
Circulation: Cardiovascular Interventions: The First 10 Years.

> Success is the journey, not a destination . > > —Arthur Ash Circulation: Cardiovascular Interventions published its first issue in August of 2008. It was 1 of 6 new journals started by the American Heart Association to address the needs of the major subspecialty areas in Cardiology. It joined the established journals of the American Heart Association: Circulation ; Circulation Research ; Arteriosclerosis, Thrombosis, and Vascular Biology; Hypertension ; and Stroke . The 6 daughter journals were initially under the umbrella of Circulation , and there was a natural close relationship between the subspecialty journals and Circulation because nearly all the initial subspecialty editors were members of the Editorial Board of Circulation . Under the guidance of Circulation , this remarkable experiment exceeded expectations and quieted skeptics. All the daughter journals have grown to be among the top 25 Cardiology journals in the world as measured by impact factor. Before 2008, there were only 4 dedicated interventional cardiology journals: Catheterization and Cardiovascular Intervention (formerly Catheterization and Cardiovascular Diagnosis published from 1975 to 1998), Journal of Invasive Cardiology (1990–), Journal of Interventional Cardiology (1991–), and EuroIntervention (2005–). Today, there are a total of 9 interventional journals listed on PubMed and many others online. Circulation: Cardiovascular Interventions and JACC: Cardiovascular Interventions are leading in metrics, and both rank within the top 10 Cardiovascular Journals overall. We set out to publish original experimental …
Delivery of Multiple IMRT Fields Using a Single Physical Attenuator

Intensity modulated radiotherapy (IMRT) can deliver improved dose distributions compared to conventional radiotherapy. IMRT treatments are delivered using either a multileaf collimator (MLC) or a physical attenuator, the more general case of a missing tissue compensator. There are two important issues that must be addressed when choosing an IMRT delivery method, delivery efficiency and quality assurance.
Puckered hexagonal nets in 2∞[Sn33As−33] and 2∞[Sn33Sb−33]

Abstract The new compounds KSnAs and KSnSb have been prepared and their crystal structures have been determined from X-ray powder diffraction patterns. Both compounds crystallize in hexagonal systems (space group P6 3 mc; a = 4.1032(5) A , c = 12.845(2)A for KSnAs and a = 4.359(1) A , c = 13.150(3) A for KSnSb). The structures contain puckered sheets, with the Sn and As (or Sb) segregated on opposite sides of each sheet and with the potassium cations between the sheets.
Design and Optimization of Forced Convection Heat Sinks for Sustainable Development

The development of forced convection heat sinks for microelectronic applications, which are compatible with sustainable development, involves the achievement of a subtle balance between a superior thermal design, minimum material consumption, and minimum pumping power. Due to the rapid proliferation of electronic systems, substantial material streams and energy consumption rates are associated with the cooling of computers, as well as other categories of electronic equipment. The study reported herein explores the potential for the least-energy optimization of forced convection cooled rectangular plate heat sinks. Analytical models are used to determine the thermal performance of such heat sinks, for pressure drops in the range of 20 to 80Pa and flow rates between 0.01 and 0.04 m3/s. The results are evaluated in terms of a heat sink Coefficient of Performance, relating the cooling capability to the energy invested. Guidelines for "sustainable" heat sink designs are suggested.
Race/Ethnicity and Use of Elective Joint Replacement in the Management of End-Stage Knee/Hip Osteoarthritis:: A Review of the Literature

Although much research has documented disparities exist for utilization of TJA, additional studies have shown that we have not narrowed the gap. Because multiple studies have shown that insurance and access to care are not necessarily underlying causes for these disparities, other studies have shown that there are real and significant differences between racial/ethnic groups in preferences for and expectations of joint arthroplasty. Additional research has established there are racial differences in certain postoperative processes and outcomes. Reasons have not been elucidated, but highlight the need for more research to understand these differences, their causes, and then to design interventions to minimize these inequalities.
An Exploration of Timing of Online Surveys on Response Characteristics

REQUIRED) This paper conducts a study of responses of a web-based survey of opinion contributors to Amazon.com to explore contextual characteristics of the responses. These include the early versus cumulative response rates, best times to receive a survey request, best times to broadcast a survey request, coordination of the delays before response for different broadcast times. The survey is broadcasted every hour over a 24 hour period to account for respondents differing time zones. This research therefore purports to answer the questions that are often significant to quantitative researchers who need to optimize their data collection based on their needs. For instance: When do most respondents respond? How long do they wait before doing so? What would be the best time to send out a survey so that the email does not get deprioritized for later? Does this time differ for the highest cumulative response rate?
Perceptions of the frequency and importance of social support by students classified as victims, bullies, and bully/victims in an urban middle school

The present study examined the perceptions of the frequency and importance of social support for students classified as bullies, victims, bully-victims, and comparison students (nonbully/nonvictim)...
Time-to-Detection Occupancy Modeling: An Efficient Method for Analyzing the Occurrence of Amphibians and Reptiles

Abstract Occupancy models provide a reliable method of estimating species distributions while accounting for imperfect detectability. The cost of accounting for false absences is that detection and nondetection surveys typically require repeated visits to a site or multiple-observer techniques. More efficient methods of collecting data to estimate detection probabilities would allow additional sites to be surveyed for the same amount of effort, which would support more precise estimation of covariate effects to improve inference about underlying ecological processes. Time-to-detection surveys allow the estimation of detection probability based on a single site visit by one observer, and therefore might be an efficient technique for herpetological occupancy studies. We evaluated the use of time-to-detection surveys to estimate the occupancy of pond-breeding amphibians at Point Reyes National Seashore, California, USA, including variables that affected detection rates and the probability of occurrence. We f...
An exploratory investigation of the impact of ramp metering on driver acceleration behavior

Abstract Ramp metering has been proven as an effective freeway management strategy; however, the impact of ramp metering on drivers' acceleration behavior has not been fully investigated. A better understanding of acceleration behavior changes with ramp metering is critical to the adequate design of ramp metering facilities. In this study, drivers' speed and acceleration data were collected at two representative metered ramps in Los Angeles, California. The speed and acceleration profiles under meter-on and meter-off scenarios were compared. Statistical results demonstrated that ramp metering affects drivers' acceleration behavior at ramp acceleration lane. It was found that at the metered ramp with short existing acceleration length, the average acceleration rate from ramp meter stop bar to 500 ft downstream under meter-on scenario (4.72 ft./s2) is approximately 40% higher than when meter-off (3.18 ft./s2). The design of acceleration lane length for metered on-ramps should therefore take into account the potential impacts of ramp metering on driver acceleration behavior.
Programmed Cell Death Ligand-1 (PD-L1) and CD8 Expression Profiling Identify an Immunologic Subtype of Pancreatic Ductal Adenocarcinomas with Favorable Survival

Immune-checkpoint therapy has failed to demonstrate meaningful clinical benefit in unselected cases of pancreatic adenocarcinoma (PDAC), but a subset of PDACs are known to upregulate pathways involved in acquired immune suppression. Further delineation of immunologic subtypes of PDAC is necessary to improve clinical trial designs and identify patients who might benefit from immune-checkpoint therapy. We used clinical survival and RNA expression data from The Cancer Genome Atlas (TCGA) to investigate the relationship between immune-modulating pathways and immune subset markers and their impact on survival in PDAC patients. Of the adaptive immune-resistance pathways, expression of PD-L1 and IDO1 was individually associated with poor survival. Although CD8 expression alone was not correlated with survival, the combination of PD-L1- and high CD8 expression identified a subtype with favorable survival. We further extended these observations using an independent PDAC cohort from our institution via IHC, again observing that the PD-L1-/CD8high subtype was associated with positive prognosis. Although PDAC is regarded as a poorly immunogenic cancer type, these findings infer that T-cell infiltration in the absence of adaptive immune-resistance pathways is a feature of long-term survival in PDAC and imply the importance of developing future immunotherapeutic strategies based on data-supported biomarkers to refine patient selection.