cssi/SciSciGPT-SciSciNet huggingface dataset:
Meperidine Misuse in a Patient with Sphincter of Oddi Dysfunction

OBJECTIVE:To report a seizure occurring secondary to meperidine treatment despite normal renal and central nervous system (CNS) function, and to provide a review of meperidine's role in pain management, including its use in pancreatitis and sphincter of Oddi dysfunction.CASE SUMMARY:A 55-year-old white woman with a history of sphincter of Oddi dysfunction presented to the emergency department with severe abdominal pain. On admission to the hospital, the serum creatinine level was 0.6 mg/dL with slightly elevated aspartate aminotransferase of 56 U/L (normal range 0–31) and alanine aminotransferase of 34 U/L (0–31). The patient received repeated and escalating doses of intravenous meperidine, resulting in a generalized seizure on day 4 of hospitalization. The accumulated meperidine dose was 2125 mg. Buprenorphine was substituted in place of meperidine, and the patient had no further reported complications. She was then transferred to a tertiary-care facility for sphincter of Oddi reevaluation. An objective ...
Bankruptcy Prediction In The Textile Industry

This paper extends the use of Altman’s Z-Score bankruptcy predictor to the textile industry. Generally, firms benefited from the North American Free Trade Agreement (NAFTA) but suffered financially after the Asian currency crisis. The study finds that Type I classification errors support prior research while Type II classification errors are much higher than previous literature findings. The results indicate a need for a modified bankruptcy predictor for the textile industry.
Broadband and Gain-Flattened Optical Fiber Amplifiers

Broadband and gain-flattened erbium-doped fiber amplifiers are being widely developed to meet the requirements posed by wavelength-division-multiplexed transmission systems/networks pursuing the ultimate capacity. One approach is the improvement of erbium-doped fiber itself for broader gain bandwidth or better gain flatness. In addition to the well-known aluminum-codoped silica fibers and the fluoride glass fibers, rather new materials, such as tellurite glass, or hybrid configurations which utilize two or more erbium- doped fibers with different glass compositions are being examined. Another approach is the use of gain-equalizing optical filters. One of the most promising gain equalizing techniques is the long-period fiber grating. In order to maintain the gain flatness even under variable operational conditions, control schemes of the optical fiber amplifiers are also a critical issue.
Human Factors and Engineering Design High School Summer Workshop

Enrollment trends and demographics predict that the US will experience a shortfall of over 500,000 engineers within the next twenty years. The engineering community, industry and academia alike, must work together to develop programs that will motivate young men and women to pursue technical careers. The purpose of this paper is to review an annual two week high school summer workshop developed by the University of Idaho College of Engineering. Each summer selected high school students live on campus for two weeks and attend specially developed engineering classes on topics such as Engineering Mechanics, Computer Aided Design, and Human Factors and Engineering Design. Working in teams of 3 to 4, the students utilize these newly developed skills in order to solve a challenging real-world human factors engineering design problem. Student fees for the 1990 workshop were $350 which included room and board as well as university registration for two semester credit hours. Industrial and private donations helped...
Utility of Fresh Frozen Section Analysis in Foot and Ankle Surgery: A Pilot Study

The use of intraoperative fresh frozen section (FFS) analysis to determine the presence of infection has been well reported in orthopedic studies. Specifically, the number of polymorphonuclear leukocytes per high-power field has been used to diagnose total joint arthroplasty-related infection. Less commonly, reconstructive surgeons have extended the use of FFS analysis for intraoperative evaluation when suspicion of deep infection with or without hardware is high. The purpose of the present study was to retrospectively review the data from 11 patients undergoing foot and ankle reconstruction in the setting of possible deep infection and determine the usefulness of FFS analysis. A retrospective review of the medical records of patients who had undergone reconstructive foot and ankle revision surgery with intraoperative FFS analysis and tissue/swab cultures available was performed. A positive FFS was defined as >5 polymorphonuclear leukocytes per high-power field. A positive frozen section was associated with a positive tissue culture 4 of 7 times (57%). The sensitivity and specificity of FFS analysis for infection was 80% and 50%, respectively. The positive and negative predictive value of the FFS result was 57.1% and 75%, respectively. In conclusion, FFS analysis and intraoperative cultures correlated only 57% of the time in the present series. This test had moderate sensitivity for detecting infection at 80%, but the specificity was poor (50%). More research is needed to further evaluate the role of FFS analysis in foot and ankle surgery.
A Numerical Taxonoinic Study of the Genus Psorophora (Diptera: Culicidae)

This study of the phenetic relationships among 29 species of culicine mosquitoes was based on 158 adult characters. These species included 15 in the genus Psorophora (including subgenera Psorophora, Grabhamia, and Janthinosoma) and, for the purposes of comparison, 14 in Aedes. Findings arc reported as phenograms based on correlation and distance coefficients, and as graphs representing the positions of the species in a 3-dimensional factor-space. Although the various subgenera appear distinct, little justification is found for uniting the subgenera Psorophora, Grabhamia, and Janthinosoma into the genus Psorophora as distinct from Aedes. Very low correlations between classifications based on leg characters and those on nonleg characters were found in this study. From the analysis, it is obvious that the classification of these 29 species in the conventional, hierarchic, mutually exclusive manner is unsatisfactory, because it does not represent their phenetic relationships as revealed by this study.
Emergence of Overwintered Boll Weevils from Hibernation Sites Near Waco, Texas

A high percentage of overwintered boll weevils, Anthonomus grandis Boheman, held in hibernation cages emerged by the middle of June each year (1940-58) in the Waco area of central Texas. Also, a high percentage of overwintered weevils collected on flight screens or observed on plants in cotton fields (1959-66) had left their hiberation sites to enter cotton fields by mid-June.
MTRC compensated algorithm based on keystone transform and weighted orientation

The keystone transform and its applications in Inverse Synthetic Aperture Radar(ISAR) are analyzed.The localization character of keystone transform at MTRC(Migration Through Range Cells) is found,and a new method for solving MTRC is proposed.The new method is tested using practice measure data and simulating data.The experimentation results show that the new algorithm is effective.
Application of Non-Linear Extrapolations for the Convergence Acceleration of Source Iteration

ABSTRACTOur paper presents a comparison of the extrapolated-based acceleration of source iteration (SI) techniques against classical acceleration schemes. The basis of the SI method is reviewed before presenting its combination with non-linear extrapolations. Two acceleration strategies are discussed, one based on the extrapolation of the source term for the SIs and the other based on the acceleration of the solution itself. Their performances are compared with classical acceleration techniques (diffusion synthetic acceleration and transport synthetic acceleration, showing the effectiveness of the combination of extrapolation with standard acceleration schemes.
Pre-Existing Peripheral Arterial Disease in Trauma

This article deals with the incidence, diagnosis, treatment, and outcome of injured patients who have pre-existing peripheral arterial disease (PAD), which not only creates problems relative to the effect of trauma on the involved tissues, but also the likelihood that arteries to the heart, brain, kidneys, and other important viscera also may be diseased. Therefore, any hypotension can greatly increase the risk of an acute myocardial infarction, stroke, or other major organ dysfunction. Consequently, preoperative evaluation of patients with PAD should be much more thorough, looking carefully for postoperative complications that are apt to occur in these patients.
Primary Hyperparathyroidism in Pregnancy

The diagnosis of gestational primary hyperparathyroidism (PHPT) is based on elevated serum calcium and PTH levels but is complicated by several physiologic changes including hypoalbuminemia, increased glomerular filtration, transplacental transfer of calcium, and increased estrogen levels which lower maternal serum calcium levels. PHPT during pregnancy is associated with several risks to the mother (hyperemesis, nephrolithiasis, mental status changes, muscle weakness, and rarely pancreatitis) and fetus (neonatal hypoparathyroidism, hypocalcemia, tetany, low birth weight, preterm delivery, and miscarriage), especially when maternal total serum calcium is >11 mg/dL. While clear treatment guidelines for PHPT in pregnancy are lacking, parathyroidectomy (ideally in the second trimester) is often performed to prevent associated risks. If surgery is not performed during pregnancy, neonates should have their serum calcium monitored, with awareness that hypoparathyroidism may not be present in the immediate postpartum period.
Soil invertebrates are concentrated on roots

The density of invertebrates on roots and in soil was determined. This is the first time such observations have been reported; they were made by direct observation through windows of the Soil Biotron at the University of Michigan Biological Station, Pellston, MI. The Soil Biotron is located in a Bigtooth Aspen-mixed hardwood stand on a sandy podzol. Horizontal transects in the top eight cm of soil were censused through a 50 power dissecting microscope mounted on a trolley. Light from the microscope did not affect behavior of the invertebrates. The roots were principally Bigtooth Aspen (Populus grandidentata) and Bracken (Pteridium aqualinum). Total area of soil censused in July was 262 cm2, 3037 cm2 in August, and 446 cm2 in October, 1988.
Salivary stress biomarkers of recent nicotine use and dependence.

ABSTRACTBackground: Although stress plays a critical role in vulnerability to nicotine use and dependence, the stress response factors that contribute to smoking behaviors remain poorly elucidated. To minimize the confounding effects of chronic nicotine use, assessing individuals with relatively short smoking histories is critical for characterizing the neurobiological substrates associated with nicotine dependence early in the course of illness. Objectives: This pilot study examined sympathetic nervous system (alpha-amylase) and hypothalamic–pituitary–adrenal axis (cortisol, dehydroepiandrosterone) responses to the Trier Social Stress Test (TSST) in young adult smokers. Associations among objective indices of recent smoking (salivary cotinine, carbon monoxide in the breath [CO]), behavioral measures of nicotine dependence and withdrawal, and salivary biomarkers in response to the TSST were investigated. Methods: Smokers (N = 64; 28 males, 36 females) provided saliva samples at 30 min intervals for 2 h pr...
Comparison of polystyrene scintillator fiber array and monolithic polystyrene for neutron imaging and radiography

The neutron imaging diagnostic at the National Ignition Facility has been operating since 2011 generating neutron images of deuterium-tritium (DT) implosions at peak compression. The current design features a scintillating fiber array, which allows for high imaging resolution to discern small-scale structure within the implosion. In recent years, it has become clear that additional neutron imaging systems need to be constructed in order to provide 3D reconstructions of the DT source and these additional views need to be on a shorter line of sight. As a result, there has been increased effort to identify new image collection techniques that improve upon imaging resolution for these next generation neutron imaging systems, such as monolithic deuterated scintillators. This work details measurements performed at the Weapons Neutron Research Facility at Los Alamos National Laboratory that compares the radiographic abilities of the fiber scintillator with a monolithic scintillator, which may be featured in a future short line of sight neutron imaging systems.
Churning, power laws, and inequality in a spatial agent-based model of social networks

Amidst many previous network models lacking a spatial dimension, this paper proposes a dynamic agent-based model of social network formation that explicitly considers space. We find that varying the dynamics of agent interaction causes the emergence of differential degree distributions as well as nonlinear dynamics in social and spatial inequalities. The scale-free property of degree connectivity vanishes when tie formation dominates tie dissolution, with power laws re-emerging when tie dissolution is of equal strength or stronger than tie formation. Furthermore, we find a nonlinear relationship between network density and agent inequality in social resources. In particular, multiple phase transitions occur where the relationship is positive in one phase but negative in another. This suggests that, contrary to intuition, higher connectivity can have an adverse distributional impact by benefiting the already privileged. Critically, we find a tradeoff between agent inequality and spatial inequality where the geographic concentration of social resources accompanies a more equal distribution of connectivity. Finally, the disadvantage of agents with limited spatial reach is exacerbated as network density increases. Our results thus highlight the importance of distinguishing between social and spatial inequality in policymaking.
A Surrogate model of gravitational waveforms from numerical relativity simulations of precessing binary black hole mergers

We present the first surrogate model for gravitational waveforms from the coalescence of precessing binary black holes. We call this surrogate model NRSur4d2s. Our methodology significantly extends recently introduced reduced-order and surrogate modeling techniques, and is capable of directly modeling numerical relativity waveforms without introducing phenomenological assumptions or approximations to general relativity. Motivated by GW150914, LIGO’s first detection of gravitational waves from merging black holes, the model is built from a set of 276 numerical relativity (NR) simulations with mass ratios q ≤ 2, dimensionless spin magnitudes up to 0.8, and the restriction that the initial spin of the smaller black hole lies along the axis of orbital angular momentum. It produces waveforms which begin ∼ 30 gravitational wave cycles before merger and continue through ringdown, and which contain the effects of precession as well as all l∈{2,3} spin-weighted spherical-harmonic modes. We perform cross-validation studies to compare the model to NR waveforms not used to build the model and find a better agreement within the parameter range of the model than other, state-of-the-art precessing waveform models, with typical mismatches of 10^(-3). We also construct a frequency domain surrogate model (called NRSur4d2s_FDROM) which can be evaluated in 50 ms and is suitable for performing parameter estimation studies on gravitational wave detections similar to GW150914.
Formation change for robot groups in occluded environments

We study formation change for robot groups in known environments. We are given a team of robots partitioned into groups, where robots in the same group are interchangeable with each other. A formation specifies the locations occupied by each group. The objective is to find collision-free paths that move all robots from a given start formation to a given goal formation. Our algorithm TAPF* has the following features: (a) it incorporates kinematic constraints of robots in form of velocity limits; (b) it maintains a user-specified safety distance between robots; (c) it attempts to minimize the makespan; and (d) it runs efficiently for hundreds of robots and dozens of groups even in dense 3D environments with narrow corridors and other occlusions. We demonstrate the efficiency and effectiveness of TAPF* in simulation and on robots.
Fundamentals Of Dendritic Growth

Dendritic growth is perhaps the most common form of solidification especially in metals and other systems that freeze with relatively low entropies of transformation. Dendritic or branched growth in alloys generates microsegregation as well as other internal defects in castings, ingots, and weldments. More subtle effects introduced by the complex dendritic microstructure in solidified materials include crystallographic texturing, hot cracking, suboptimal toughness, and reduced corrosion resistance. Moreover, the dendritic microstructure and its effects may be modified by subsequent heat treatments, but they are seldom fully “erased”. As such, the understanding and control of dendritic growth in solidification processing is crucial in order to achieve specific material properties in final products.
Coordinate Regulation of Yeast Sterol Regulatory Element-binding Protein (SREBP) and Mga2 Transcription Factors.

The Mga2 and Sre1 transcription factors regulate oxygen-responsive lipid homeostasis in the fission yeast Schizosaccharomyces pombe in a manner analogous to the mammalian sterol regulatory element-binding protein (SREBP)-1 and SREBP-2 transcription factors. Mga2 and SREBP-1 regulate triacylglycerol and glycerophospholipid synthesis, whereas Sre1 and SREBP-2 regulate sterol synthesis. In mammals, a shared activation mechanism allows for coordinate regulation of SREBP-1 and SREBP-2. In contrast, distinct pathways activate fission yeast Mga2 and Sre1. Therefore, it is unclear whether and how these two related pathways are coordinated to maintain lipid balance in fission yeast. Previously, we showed that Sre1 cleavage is defective in the absence of mga2. Here, we report that this defect is due to deficient unsaturated fatty acid synthesis, resulting in aberrant membrane transport. This defect is recapitulated by treatment with the fatty acid synthase inhibitor cerulenin and is rescued by addition of exogenous unsaturated fatty acids. Furthermore, sterol synthesis inhibition blocks Mga2 pathway activation. Together, these data demonstrate that Sre1 and Mga2 are each regulated by the lipid product of the other transcription factor pathway, providing a source of coordination for these two branches of lipid synthesis.
Real-Time In-Pile Acoustic Measurement Infrastructure at the Advanced Test Reactor

AbstractThe core of any nuclear reactor presents a particularly harsh environment for sensors and instrumentation. The reactor core also imposes challenging constraints on signal transmission from inside the reactor core to outside of the reactor vessel. In this letter, an acoustic measurement infrastructure installed at the Advanced Test Reactor (ATR), located at Idaho National Laboratory, is presented. The measurement infrastructure consists of ATR in-pile structural components, coolant, acoustic receivers, primary coolant pumps (PCPs), a data acquisition system, and signal-processing algorithms. Intrinsic and cyclic acoustic signals generated by the operation of the PCPs are collected and processed. The characteristics of the intrinsic signal can indicate the process state of the ATR (such as reactor startup, reactor criticality, reactor attaining maximum power, and reactor shutdown) during operation (i.e., real-time measurement).
Discontinuity Surfaces and Microfacies in a Storm-Dominated Shallow Epeiric Sea, Devonian Cedar Valley Group, Iowa

Discontinuity surfaces develop in carbonate successions in response to a range of environmental changes and represent an integral part of the stratigraphic record. In Paleozoic shallow epeiric basins that are typified by extremely slow subsidence and intermittent sedimentation, discontinuity surfaces may represent the majority of the time-rock record. A depositional and sequence-stratigraphic model was developed through microfacies analysis and discontinuity surface characterization using three cores in a proximal to distal transect across the Middle to Upper Devonian Iowa Basin. Twelve microfacies are recognized, spanning supratidal to deep subtidal facies tracts. A total of 105 discontinuity surfaces were documented and classified as either submarine omission surfaces, subaerial exposure surfaces, or submarine erosional surfaces. Omission surfaces increase in frequency basinward, indicating increased sediment starvation in the offshore direction. Exposure surfaces increase in frequency shoreward, indicating more frequent subaerial exposure in a shallower setting. Erosional surfaces are dominant in the inner and middle ramp and interpreted as the base of storm beds (tempestites); these surfaces are rare in the outer ramp due to its generally deeper setting below storm wave base. Moreover, discontinuity surfaces exhibit systematic groupings stratigraphically (vertically) across the three localities spanning the Devonian carbonate ramp. Zones of either exposure-dominated, erosion-dominated, or omission-dominated surfaces were recognized and correlated with their landward or basinward equivalents (along with shifts in major facies belts) and interpreted in a sequence-stratigraphic context. This study highlights the importance of including a detailed characterization of both depositional facies and non-depositional discontinuity surfaces in order to better understand the stratigraphic history of a basin. The framework of analysis provided here is particularly useful for marine carbonate strata deposited in epeiric basins, which are especially common in the Paleozoic and where non-deposition and erosion occur frequently, but can also be applied to other geologic time periods and settings. This article is protected by copyright. All rights reserved.
A conceptual framework for leveraging team composition decisions to build human capital

Abstract Twenty-first century organizations often rely on teams to enact their strategy and to enhance their flexibility in interacting with their external environment over time. Team composition, or the configuration of team member attributes, can influence team effectiveness and is an important consideration in the management of teams. To date, however, there is limited guidance on how seemingly smaller team composition decisions can contribute to organizational effectiveness and competitive advantage. We draw on strategic human resource management (HRM), HRM, and industrial and organizational psychology literatures to develop a conceptual framework for strategic team composition decisions. We describe how organizations use teams to enact their strategy (i.e., fit), and use adaptive teams and networks of teams to achieve fit in a dynamic environment (i.e., flexibility). Using the concepts of fit and flexibility, we develop four guiding principles for strategic team composition decisions.
Impact of Acoustic Radiation Force Excitation Geometry on Shear Wave Dispersion and Attenuation Estimates.

Abstract Shear wave elasticity imaging (SWEI) characterizes the mechanical properties of human tissues to differentiate healthy from diseased tissue. Commercial scanners tend to reconstruct shear wave speeds for a region of interest using time-of-flight methods reporting a single shear wave speed (or elastic modulus) to the end user under the assumptions that tissue is elastic and shear wave speeds are not dependent on the frequency content of the shear waves. Human tissues, however, are known to be viscoelastic, resulting in dispersion and attenuation. Shear wave spectroscopy and spectral methods have been previously reported in the literature to quantify shear wave dispersion and attenuation, commonly making an assumption that the acoustic radiation force excitation acts as a cylindrical source with a known geometric shear wave amplitude decay. This work quantifies the bias in shear dispersion and attenuation estimates associated with making this cylindrical wave assumption when applied to shear wave sources with finite depth extents, as commonly occurs with realistic focal geometries, in elastic and viscoelastic media. Bias is quantified using analytically derived shear wave data and shear wave data generated using finite-element method models. Shear wave dispersion and attenuation bias (up to 15% for dispersion and 41% for attenuation) is greater for more tightly focused acoustic radiation force sources with smaller depths of field relative to their lateral extent (height-to-width ratios
Metabolic shift from glycogen to trehalose promotes lifespan and healthspan in Caenorhabditis elegans

As Western diets continue to include an ever-increasing amount of sugar, there has been a rise in obesity and type 2 diabetes. To avoid metabolic diseases, the body must maintain proper metabolism, even on a high-sugar diet. In both humans and Caenorhabditis elegans, excess sugar (glucose) is stored as glycogen. Here, we find that animals increased stored glycogen as they aged, whereas even young adult animals had increased stored glycogen on a high-sugar diet. Decreasing the amount of glycogen storage by modulating the C. elegans glycogen synthase, gsy-1, a key enzyme in glycogen synthesis, can extend lifespan, prolong healthspan, and limit the detrimental effects of a high-sugar diet. Importantly, limiting glycogen storage leads to a metabolic shift whereby glucose is now stored as trehalose. Two additional means to increase trehalose show similar longevity extension. Increased trehalose is entirely dependent on a functional FOXO transcription factor DAF-16 and autophagy to promote lifespan and healthspan extension. Our results reveal that when glucose is stored as glycogen, it is detrimental, whereas, when stored as trehalose, animals live a longer, healthier life if DAF-16 is functional. Taken together, these results demonstrate that trehalose modulation may be an avenue for combatting high-sugar-diet pathology.
David Oliver: Will the public use alternatives to emergency departments?

I’ve argued before that we shouldn’t blame the public for using emergency departments,1 as has a joint observational study from the Royal College of Emergency Medicine and the Patients Association.2 The position was that urgent need is defined by service users in real time. The public are intelligent consumers who go where the lights are on, and many are in any case directed to acute hospitals by NHS emergency numbers. But I’m always prepared to reflect and reconsider. A study in January of emergency department attenders at North Middlesex University Hospital has made me wonder.3 Researchers examined 37 000 pieces of data and interviewed 630 patients, seeking to determine what brings patients to emergency departments even for conditions …
Amiodarone induced myxedema coma: Two case reports and literature review

Amiodarone is a benzofuran derivative that contains 37% iodine by weight and is structurally similar to the thyroid hormones. Amiodarone has a complex effect on the thyroid gland, ranging from abnormalities of thyroid function tests to overt thyroid dysfunction, with either thyrotoxicosis or hypothyroidism. Myxedema coma secondary to amiodarone use has been rarely reported in the literature. Our two case reports are an add on to the literature, and illustrate that amiodarone is an important cause of thyroid dysfunction including hypothyroidism and myxedema coma. Hence, healthcare providers should have a high index of suspicion for these conditions while treating patients who are taking amiodarone therapy as early recognition and management are essential to optimize outcomes.
A Systematic Review of Psychosocial Interventions in Treatment of Opioid Addiction

Opioid addiction has become a U.S. epidemic. It is important to determine whether psychosocial interventions help prevent relapse. A total of 14 studies were included in this systematic review. Mos...
Tobacco Smoking Associated With Increased Anastomotic Disruption Following Pancreaticoduodenectomy.

Abstract Background The effect of cigarette smoking on postoperative morbidity following pancreaticoduodenectomy (PD) for cancer is unclear. We hypothesize that smoking is associated with higher morbidity following PD. Methods A retrospective review of patients undergoing PD for cancer from 2010 to 2016 at a single institution was performed. Patients who had never smoked were compared to current or past-smokers with at least 1 pack-year history. Univariate and multivariable analyses were performed. Results Two hundred fifty-two patients met inclusion criteria. On univariate analysis, there was a significant difference between smokers and never-smokers in age at diagnosis (65.5 versus 68.6 y, P = 0.013) and fistula rate (28.5% versus 16.2%, P = 0.024). Male sex was significantly associated with fistula rate compared with female sex (15.5% versus 7.1%, P = 0.023). Comparing males and females separately, smoking correlated with higher fistula development only in the male cohort (22.5% versus 5.8%, P = 0.016 in men and 7.3% versus 9.1%, P = 1.00 in women). On multivariable analysis, current and past smoking was independently predictive of developing a fistula: odds ratio of 2.038 (P = 0.030). For current and past-smokers, male sex was an independent risk factor for developing a fistula: odds ratio 2.817 (P = 0.022). There were no other significant differences between groups in rates of postoperative complications. Conclusions Smoking status is independently predictive of postoperative pancreatic fistula following PD for cancer. Among smokers, male sex is an independent risk factor for fistula. Further studies are needed to determine if smoking cessation before surgery decreases this risk, and if so, the optimal duration of cessation.
Physiology of the Biliary Tree

Anatomically, the biliary tract is composed of intra-and extrahepatic biliary systems. The major function of biliary system is the secretion and delivery of the bile to the intestine. Bile has physiologic functions to promote digestion and absorption of lipids including fat-soluble vitamins and to eliminate cholesterol and bilirubin. The hepatocytes are involved in uptake, synthesis, and secretion, while the bile duct epithelial cells play the major role in the transport of biliary secretions. Distal intestinal uptake of bile acids and transport back to the liver constitutes an enterohepatic circulation to maintain the store of bile acids needed for digestion and absorption of lipids. A deep understanding of the anatomy and physiology of the biliary system and the enterohepatic circulation are necessary to address the impact of specific diseases and surgeries on the system. The chapter is meant to empower the surgeon with the necessary tools needed for optimal provision of care.
Intrahepatic cholestasis of pregnancy: Review of six national and regional guidelines

Intrahepatic cholestasis of pregnancy (ICP) is a poorly understood disease of the late second or third trimester of pregnancy, typically associated with rapid resolution following delivery. It is characterized by pruritis, elevated serum bile acids, and abnormal liver function tests and has been linked to stillbirth, meconium passage, respiratory distress syndrome and fetal asphyxial events. The incidence is highly variable, dependent both on the ethnic makeup of the population as well as the diagnostic criteria being used. Management is challenging for clinicians, as laboratory abnormalities often lag behind clinical symptoms making diagnosis difficult. The American Congress of Gastroenterology, Government of Western Australia Department of Health, the Royal College of Obstetricians and Gynaecologists, Society for Maternal Fetal Medicine, European Association for the Study of the Liver, and South Australia Maternal and Neonatal Community of Practice have all released guidelines to address the risks, diagnosis and management of ICP. We performed a descriptive review of these guidelines along with a literature search to address conflicting recommendations and highlight new evidence. The variations in the guidelines reflect the heterogeneity of the literature and the challenges of diagnosing and managing ICP.
Blends of Renewable Poly(butylene succinate) and Poly(propylene carbonate) Compatibilized with Maleic Anhydride Using Quad Screw Reactive Extrusion

The free radical functionalization of immiscible blends of polybutylene succinate (PBS) and polypropylene carbonate (PPC) was successfully achieved on a novel quad screw extruder. A premade compatibilizer, PPC-grafted-maleic anhydride (gPPC), was added in various amounts to trigger the chemical compatibilization and tailor the properties of the final blend. Titration of acid groups on the functionalized blends showed that the grafting efficiency increases with the addition of gPPC. Proton NMR corroborated the formation of new graft copolymers in the reactive blends. A change in the rheological behavior of the formulations evidenced the grafting reactions occurring at the interphase of the components. Also, gPPC suppressed droplet coalescence as seen in the SEM images. Finally, the addition of compatibilizer increased the tensile strain at break by more than 100%, improved up to 50% the impact resistance, and produced a small increase on flexural and elastic modulus.
Henry G Kunkel and Rheumatoid Factor.

Henry Kunkel was born in Brooklyn, New York in 1916. He died in 1983 at the early age of 67. He was an outstanding clinical scholar who had a deep passion for scientific facts. Almost all his scientific life was involved in biomedical research at the Rockefeller University in New York City. He had a laboratory on the third floor of Founder’s Hall (the first building at what was then Rockefeller Institute for Medical Research). His office was a spare, unpretentious room with a view of the East River in Upper Manhattan. To this room came many scientists the world over as well as many of his former fellows who came back to see the old master. He was especially glad to talk about experimental data and would drop what he was doing to talk about the deeper significance of their observations. His parting words would often be, ‘Come again’ Kunkel has received numerous accolades which could be exemplified in the following story. His research grant application was being reviewed at an NIH Study section meeting and a reviewer pointed out the lack of details concerning techniques and procedures, but …
Novel Bioreactors for Mechanistic Studies of Engineered Heart Valves

Beyond the identification of the most appropriate cells and scaffold materials, translation of cardiovascular tissue engineering structures requires optimization of construct biological and mechanical properties in order to permit their long-term functionality in the native hemodynamic environment. Unfortunately, rudimentary tissue growth technologies such as plate or rotisserie culture do not lead to the generation of functional tissues, thereby limiting their usefulness. Dynamic culture systems or bioreactors with true construct mechanical conditioning capabilities thus form an essential part of the research and development pathway in cardiovascular regenerative medicine. This is because engineered tissues cultured under specific bioreactor mechanical environments enhance their biological properties such as functional stem cell differentiation to complex tissue phenotypes and also augment construct structural properties as a result of accelerated tissue formation. In the heart valve tissue engineering arena, based on at least a decade of scientific results, there is now general acceptance that bioreactor usage is a critical preclinical step. In this book chapter, we describe important considerations in bioreactor design as well as focus on the critical scientific findings in the development of de novo valvular tissues, including our own experience in this area. We subsequently detail scaffold and cell sources that have been used in conjunction with these devices and finally conclude by addressing the key challenges that still remain.
The impact of abnormal BMI on surgical complications after pediatric colorectal surgery.

Abstract Background/Purpose While childhood obesity is a growing problem, the implications of BMI on elective pediatric surgery remains poorly described. This study evaluates the impact of obesity on surgical outcomes after elective colorectal procedures. Methods Children ages 2–18 years undergoing elective colorectal surgery for IBD were identified from the NSQIP-Pediatric database. Patients were classified as underweight (UW), normal weight (NW), overweight (OW) and obese (OB) based on their age- and sex-adjusted BMI. Postoperative complications were compared between cohorts. Results 858 patients (14.8% UW, 64.3% NW, 13.1% OW, 7.8% OB) were identified, with overall complications occurring in 15.3% and SSI in 10.1%. Obese/overweight patients had higher rates of deep incisional SSI (4.5%OB, 4.5%OW, 0%NW, p = 0.002) and superficial wound disruption (5.4%OB, 5.8%OW, 1.6%NW, p = 0.04). Incremental increase in BMI by 1.0kg/m2 was associated with 4.3% increased likelihood of developing deep incisional SSI and 2.3% increase of superficial wound disruption. Obese/overweight children also had increased incidence of septic shock and UTI, as well as longer operative times, days of mechanical ventilation and LOS. Conclusions Increasing BMI was associated with increased wound complications in IBD patients undergoing elective intestinal surgery. Preoperative optimization and weight loss strategies may potentially reduce SSI and other infectious complications. Level of Evidence III
Quantitative analysis of ATM phosphorylation in lymphocytes.

Abstract Since many anticancer therapies target DNA and DNA damage response pathways, biomarkers of DNA damage endpoints may prove valuable in basic and clinical cancer research. Ataxia telangiectasia-mutated (ATM) kinase is the principal regulator of cellular responses to DNA double-strand breaks (DSBs). In humans, ATM autophosphorylation at serine 1981 (p-S1981) is an immediate molecular response to nascent DSBs and ionizing radiation (IR). Here we describe the analytical characteristics and fit-for-purpose validation of a quantitative dual-labeled immunoblot that simultaneously measures p-S1981-ATM and pan-ATM in human peripheral blood mononuclear cells (PBMCs) following ex vivo exposure to 2 Gy IR, facilitating the calculation of %p-ATM. To validate our assay, we isolated PBMCs from 41 volunteers. We report that the median basal level of p-S1981-ATM and pan-ATM was 2.4 and 49.5 ng/107 PBMCs, respectively, resulting in %p-ATM of 4%. Following exposure of PBMCs to 2 Gy IR, p-S1981-ATM levels increased 12-fold to 29.8 ng/107 PBMCs resulting in %p-ATM of 63%. Interestingly, we show that PBMCs from women have a 2.6-fold greater median p-S1981-ATM level following IR exposure than men (44.4 versus 16.9 ng/107 cells; p
Damage Control Vascular Surgery

Exsanguination is one of the most fearsome sequelae of trauma and is responsible for a large portion of both civilian and military mortality. The concept of damage control surgery is a critical development in the field of trauma largely driven by the growing understanding that coagulopathy and physiologic derangements are the primary cause of death in critically ill trauma patients. Damage control vascular surgery focuses on the rapid temporization of vascular injuries. Balloon occlusion can be utilized for rapid hemorrhage control (REBOA, foley catheter, retrohepatic caval balloon, etc.). In the setting of damage control, most veins can and should be ligated. Consideration of shunting should be made regarding the suprarenal inferior vena cava, the portal vein, and the superior mesenteric vein. The named arteries should be shunted and repaired when possible; however, redundant arterial beds can be safely ligated. Vessels of all sizes can be safely shunted with commercially available or improvised devices. Systemic heparinization is not necessary to maintain patency. More recently, the concept of using endovascular stents as long-term shunts has gained attention. These can be deployed traditionally under angiographic guidance or using the novel direct site endovascular repair (DSER) technique. The rapidly evolving field of endovascular trauma management has afforded a host of new management strategies for the physiologically deranged critically ill trauma patient.
Data-Driven Prediction Model of Components Shift during Reflow Process in Surface Mount Technology

Abstract In surface mount technology (SMT), mounted components on soldered pads are subject to move during reflow process. This capability is known as self-alignment and is the result of fluid dynamic behavior of molten solder paste. This capability is critical in SMT because inaccurate self-alignment causes defects such as overhanging, tombstoning, etc. while on the other side, it can enable components to be perfectly self-assembled on or near the desire position. The aim of this study is to develop a machine learning model that predicts the components movement during reflow in x and y-directions as well as rotation. Our study is composed of two steps: (1) experimental data are studied to reveal the relationships between self-alignment and various factors including component geometry, pad geometry, etc. (2) advanced machine learning prediction models are applied to predict the distance and the direction of components shift using support vector regression (SVR), neural network (NN), and random forest regression (RFR). As a result, RFR can predict components shift with the average fitness of %99, %99, and %96 and with average prediction error of 13.47 (µm), 12.02 (µm), and 1.52 (deg.) for component shift in x, y, and rotational directions respectively. This enhancement provides the future capability of the parameters’ optimization in the pick and placement machine to control the best placement location and minimize the intrinsic defects caused by the self-alignment.
Ethanol Inhibits Mesenchymal Stem Cell Osteochondral Lineage Differentiation Due in Part to an Activation of Forkhead Box Protein O-Specific Signaling.

Background During bone fracture repair, resident mesenchymal stem cells (MSCs) differentiate into chondrocytes, to form a cartilaginous fracture callus, and osteoblasts, to ossify the collagen matrix. Our laboratory previously reported that alcohol administration led to decreased cartilage formation within the fracture callus of rodents and this effect was mitigated by postfracture antioxidant treatment. Forkhead box protein O (FoxO) transcription factors are activated in response to intracellular reactive oxygen species (ROS), and alcohol has been shown to increase ROS. Activation of FoxOs has also been shown to inhibit canonical Wnt signaling, a necessary pathway for MSC differentiation. These findings have led to our hypothesis that alcohol exposure decreases osteochondrogenic differentiation of MSCs through the activation of FoxOs. Methods Primary rat MSCs were treated with ethanol (EtOH) and assayed for FoxO expression, FoxO activation, and downstream target expression. Next, MSCs were differentiated toward osteogenic or chondrogenic lineages in the presence of 50 mM EtOH and alterations in osteochondral lineage marker expression were determined. Lastly, osteochondral differentiation experiments were repeated with FoxO1/3 knockdown or with FoxO1/3 inhibitor AS1842856 and osteochondral lineage marker expression was determined. Results EtOH increased the expression of FoxO3a at mRNA and protein levels in primary cultured MSCs. This was accompanied by an increase in FoxO1 nuclear localization, FoxO1 activation, and downstream catalase expression. Moreover, EtOH exposure decreased expression of osteogenic and chondrogenic lineage markers. FoxO1/3 knockdown restored proosteogenic and prochondrogenic lineage marker expression in the presence of 50 mM EtOH. However, FoxO1/3 inhibitor only restored proosteogenic lineage marker expression. Conclusions These data show that EtOH has the ability to inhibit MSC differentiation, and this ability may rely, at least partially, on the activation of FoxO transcription factors.
An Anticolonial Land-Based Approach to Urban Place: Mobile Cartographic Stories by Refugee Youth

This article introduces a mobile Global Positioning System app created by refugee girls in the United States as a social justice- and community-oriented media art project that provides visual and o...
Abstract 12625: Promoting Health Equity in Female San Joaquin South Asian Population

Introduction: South Asians (SA) have a higher death rate than any other population for cardiovascular disease (CVD) and high blood pressure (HBP). 1 out of 4 women die of heart disease in America. ...
أثر السياسات الزراعية على محصول فول الصويا فى مصر

يتناول البحث قياس أثر السيـاسات الزراعية على محصـول فول الصويا فى مصـر خلال الفترة (2000-2018) ، من خلال دراسة إنتاج وإستهلاک وواردات وأسعار المنتج والجملة والتجزئة من فول الصويا ، قياس مصفوفة تحليل السياسات لمحصول فول الصويا . وللتعرف على أثر السياسة الزراعية على محصول فول الصويا فقد تم تقسيم فترة الدراسة (2000-2018) إلى فترتين زمنيتين ، حيث تمثلت الفترة الأولى فى فترة ما قبل الثورة وسياسات تحرير سعر الصرف (2000-2010) ، فى حين تمثلت الفترة الثانية فى فترة ما بعد الثورة وسياسات تحرير سعر الصرف (2011-2018) ، حيث تبين من خلال نتائج تطور أسعار المنتج ، الجملة والمستهلک لمحصول فول الصويا وجود زيادة فى أسعار المنتج ، الجملة والمستهلک لمحصول افول الصويا بلغ حوالى 159,5% ، 184,6% ، 246,8% خلال سياسات الفترة الثانية عن الفترة الأولى من الدراسة. کما تبين من خلال نتائج قياس أثر السياسات الزراعية على أهم العوامل المرتبطة بالأمن الغذائى لمحصول فول الصويا حدوث زيادة فى المساحة المزروعة بفول الصويا وکمية إنتاج فول الصويا بلغت حوالى 36,3% ، 49,7% على الترتيب خلال سياسات الفترة الثانية عن الفترة الأولى من الدراسة ، فى حين تبين زيادة کمية الواردات ، کمية الإستهلاک و الفجوة من فول الصويا بحوالى 112,4% ، 58% ، 58,5% على الترتيب خلال سياسات الفترة الثانية عن الفترة الأولى من الدراسة ، فى حين تبين حدوث زيادة طفيفة في نسبة الإکتفاء الذاتى بلغت حوالى 5,1% ، بينما تبين حدوث زيادة فى فترة کفاية الإنتاج للإستهلاک المحلى وفترة کفاية الواردات للإستهلاک المحلى من فول الصويا بحوالى 16,9% ، 122,8% على الترتيب خلال سياسات الفترة الثانية عن الفترة الأولى من الدراسة . فى حين تبين من خلال نتائج مصفوفة تحليل السياسات لمحصول فول الصويا أن سياسات الدولة ترتب عليها إرتفاع أسعار فول الصويا بالسوق المحلى عن أسعاره العالمية لصالح المنتج على حساب المستهلک خلال خلال الفترة الثانية من الدراسة ، کما تبين أن الدولة إتخذت خلال فترتى الدراسة بعض الإجراءات الحمائيـة لصالح المنتج بوجود دعم ضمنى للمنتجين تمثل في إنخفاض أسعارمستلزمات وموارد الإنتاج أى أن تلک السياسات ترتب عليهـا تحقيق صالح المنتج على حساب المستهلک خلال فترتى الدراسة ، کما تبين زيادة کفاءة استخدام الموارد المحلية لمحصول فول الصويا خاصة خلال سياسات الفترة الثانية من الدراسة ، حيث تبين أن حوالى 0,295 جنيها من تکلفة الموارد المحلية تعطى جنيها واحدا کقيمة مضافة مما يدل على زيادة کفاءة استخدام الموارد المحلية خلال سياسات تلک الفترة. کما تبين من خلال التنبؤ بحجم الفجوة من محصول فول الصويا حتى عام 2025 بإستخدام أربعة نماذج قياسية هى (معدل إزدياد الطلب ، الخط المستقيم للمعادلات الاتجاهية ، براون ذات المعلم الواحد للتنعيم الأسى المزودج ، هولت ذات المعلمتين للتنعيم الأسى المزودج) أن الحد الأدنى للفجوة المحتملة من محصول فول الصويا يقدر بحوالى 750 ألف طن عام 2024 کانت وفقا لنموذج معدل إزدياد الطلب ، بينما بلغ الحد الأقصى للفجوة من محصول فول الصويا المحتملة حوالى 1304 ألف طن عام 2025 وفقا لنموذج براون ذات المعلم الواحد للتنعيم الأسى المزدوج. وقد توصل البحث إلى مجموعة من التوصيات التى تفيد صانعى القرار فى السياسة الاقتصادية الزراعية قي هذا المجال.