cssi/SciSciGPT-SciSciNet huggingface dataset:
Effectiveness and safety of EUS-guided choledochoduodenostomy using lumen-apposing metal stents (LAMS): a systematic review and meta-analysis

Endoscopic ultrasound-guided choledochoduodenostomy (CDD) is emerging as an alternative technique for biliary drainage in patients who fail conventional endoscopic retrograde cholangiopancreatography (ERCP). The lumen-apposing metal stents (LAMS) are being increasingly used for CDD. We performed a systematic review and meta-analysis to evaluate the effectiveness and safety of CDD using LAMS. We performed a systematic search of multiple databases through May 2019 to identify studies on CDD using covered self-expanding metal stents. Pooled rates of technical success, clinical success, adverse events, and recurrent jaundice associated with CDD using LAMS were estimated. A subgroup analysis was performed based on use of LAMS with electrocautery-enhanced delivery system (EC-LAMS). Seven studies on CDD using LAMS (with 284 patients) were included in the meta-analysis. Pooled rates of technical and clinical success (per-protocol analysis) were 95.7% (95% CI 93.2–98.1) and 95.9% (95% CI 92.8–98.9), respectively. Pooled rate of post-procedure adverse events was 5.2% (95% CI 2.6–7.9). Pooled rate of recurrent jaundice was 8.7% (95% CI 4.5–12.8). On subgroup analysis of CDD using EC-LAMS (5 studies with 201 patients), the pooled rates of technical and clinical success (per-protocol analysis) were 93.8% (95% CI 90.4–97.1) and 95.9% (95% CI 91.9–99.9), respectively. Pooled rate of post-procedure adverse events was 5.6% (95% CI 1.7–9.5). Pooled rate of recurrent jaundice was 11.3% (95% CI 6.9–15.7). Heterogeneity (I2) was low to moderate in the analyses. CDD using LAMS/EC-LAMS is an effective and safe technique for biliary decompression in patients who failed ERCP. Further studies are needed to assess CDD using LAMS as primary treatment modality for biliary obstruction.
‘International law in ancient China’: Eurocentrism and the rethinking of case studies in Chinese intellectual history

The opening of the twentieth-first century has been a time of uncertainty. Despite many visions of the future, a Eurocentric bias is still at heart of the discourse about world order. For instance,...
Rates of Subsequent Shoulder Surgery Within Three Years for Patients Undergoing SLAP Repair Versus Biceps Tenodesis.

Purpose To investigate the demographics of patients for whom SLAP repair or biceps tenodesis was performed, as well as to compare rates of additional shoulder surgery for these 2 procedures within 3 years postoperatively. Methods Using the MarketScan Commercial Database, we examined all patients with SLAP tear who underwent arthroscopic SLAP repair or open or arthroscopic biceps tenodesis within the encompassed time period (2003-2014). Rates of repeat shoulder surgery within 3 years were evaluated, as were comparative demographics. Results In total, 25,142 patients initially underwent SLAP repair, of whom 11.5% had subsequent shoulder surgery within 3 years. A total of 840 patients initially underwent biceps tenodesis as treatment for a SLAP tear, of whom 13.0% underwent additional shoulder surgery within 3 years. Rates of subsequent shoulder surgery between the 2 procedural groups did not statistically differ (P = .19). Patients who underwent SLAP repair were younger than those who underwent tenodesis (mean age 38.3 vs 49.3 years, P Conclusions The rates of additional shoulder surgery for patients undergoing SLAP repair and biceps tenodesis were similar within 3 years of the index procedure. Patients who underwent SLAP repair were younger than those who underwent tenodesis. Of those requiring additional surgery, patients initially treated with SLAP repair were older (≥35 years) and those treated with tenodesis were younger ( Level of Evidence III, retrospective comparative study.
Eastern dobsonfly (adult), hellgrammite (larva) Corydalus cornutus (Linnaeus) (Insecta: Megaloptera: Corydalidae: Corydalinae)

The eastern dobsonfly is one of our largest non-lepidopteran insects. Its larvae, known as hellgrammites, are the top invertebrate predators in rocky streams where they occur. Adult male dobsonflies are particularly spectacular because of their large sickle-shaped mandibles (jaws). This 4-page fact sheet was written by Donald W. Hall and published by the UF Department of Entomology and Nematology, April 2013. http://edis.ifas.ufl.edu/in987
How Does a Math Review Impact a Student’s Arithmetic Skills and Performance in First-Semester General Chemistry?

Arithmetic skills are without a doubt integral to a student’s success or failure in first-semester general chemistry. The MUST (Math-Up Skills Test) is a powerful tool for assessing a student’s arithmetic logic and therefore serves as a great predictor for at-risk students. Early math reviews at the start of the semester are thought to help students develop or refresh the necessary skills needed for success in general chemistry. However, the improvement that students gain from such math reviews is yet to be quantitatively assessed. In this study, a math intervention was given to students in the second week of the fall semester. The MUST was administered to the students before and after the 1-week intervention to determine if the students have indeed improved their arithmetic skills. A control group had a similar design except their intervention which was a general chemistry review. The math intervention group had a significant gain in the MUST scores over the gain for students whose intervention was the chemistry review. Students were grouped by their reasoning ability, as measured by the Test of Logical Thinking (TOLT). Students with high or low reasoning abilities did not differ in their MUST gain by intervention; however, students of average logic abilities who also had the math intervention had significantly higher gains than those in the chemistry intervention. Although 33% of a student’s final course average could be accounted for by his/her score on the second administration of the MUST, it was not possible to expect any significant difference in final course averages by intervention, since all subjects were allowed to do both reviews after the study data was collected.
Hysteroscopic Resection of an Interstitial Ectopic Pregnancy

Study Objective We demonstrate a novel approach for treatment of an interstitial ectopic pregnancy via hysteroscopic resection under laparoscopic guidance. Design N/A Setting The patient was a 29 year old G2P0010 with an enlarging interstitial pregnancy despite treatment with methotrexate. The surgery was performed in an ambulatory center affiliated with a tertiary teaching hospital. Patients or Participants N/A Interventions We performed a resection of an interstitial ectopic pregnancy hysteroscopically with the aid of laparoscopic visualization. This surgical approach was undertaken after both hysteroscopic and laparoscopic evaluation determined its feasibility. Measurements and Main Results N/A Conclusion Interstitial ectopic pregnancies are rare, and factors such as hemodynamic stability, gestational age, and surgeon expertise must be considered in surgical planning. Hysteroscopic resection of an interstitial pregnancy under laparoscopic guidance can be employed safely in select cases. When appropriate, this technique allows treatment of an ectopic pregnancy with avoidance of more morbid, traditional treatments such as a cornuostomy or cornual wedge resection.
Association between pica and gastrointestinal symptoms in preschoolers with and without autism spectrum disorder, Study to Explore Early Development

Abstract Background Pica, the repeated ingestion of nonfood items, can result in gastrointestinal (GI) outcomes. Children with autism spectrum disorder (ASD) and other developmental disabilities (DDs) are disproportionately affected by both pica and GI symptoms. Study of the inter-relationship between pica, GI symptoms, and ASD/DD is limited. Objective/Hypothesis We assessed associations between pica and GI symptoms in preschool-aged children with and without ASD and other (non-ASD) DDs in the Study to Explore Early Development. Methods Our sample included children with ASD (n = 1244), other DDs (n = 1593), and population (POP) controls (n = 1487). Data to define final case-control status, pica, and GI symptoms were from standardized developmental assessments/questionnaires. Prevalence ratios, adjusted for sociodemographic factors (aPRs), and 95% confidence intervals were derived from modified Poisson regression. Results Within each group (ASD, DD, POP) and for the total sample, pica was associated with vomiting (aPR for total sample 2.6 [1.7, 4.0]), diarrhea (1.8 [1.4, 2.2]), and loose stools (1.8 [1.4, 2.2]). In the DD group, pica was associated with constipation (1.4 [1.03, 1.9]) and pain on stooling (1.8 [1.2, 2.6]). In analyses of the subgroup without pica, increases in GI symptoms were still evident in the ASD and DD groups compared to POP group. Conclusion These findings highlight an important adverse effect of pica, GI symptoms, in children with and without ASD and DDs; nonetheless, pica does not fully explain the increased risk for GI symptoms among children with ASD and DDs. These findings inform the specialized healthcare needs of children with ASD and other DDs.
Omega-3 polyunsaturated fatty acids modify the inverse association between systemic inflammation and cardiovascular fitness.

Summary Background and objective Exercise increases quality of life and lowers all-cause mortality, likely by preventing cardiovascular disease. Although the beneficial effects of exercise are linked with reductions in chronic inflammation, individual responses vary and factors that contribute to the anti-inflammatory effects of cardiovascular fitness remain largely undefined. We sought to investigate the role of fatty acids in the inverse relationship between inflammation and cardiovascular fitness. Approach and results In this cross-sectional study using data from 435 participants in NHANES and linear regression models with CRP as the outcome, we observed significant negative interactions between VO2max and omega-3 polyunsaturated fatty acids (PUFAs) but not saturated, monounsaturated, or omega-6 PUFAs. When stratified by omega-3 PUFA tertiles, participants in the medium tertile, but not low tertile, show an enhanced negative association between VO2max and CRP, with a −32.0% difference (95% CI: −44.95, −15.9%) per 10 mL/kg/min of VO2max. Exploratory factor analysis identified five unique dietary fatty acid (FA) profiles. The FA profile consisting predominantly of omega-3 PUFA had the strongest negative association for VO2max and CRP, with a −28.2% difference in CRP (95% CI: −43.4, −8.9) per 10 mL/kg/min of VO2max. We also found that alpha-linolenic acid (ALA) and docosahexaenoic acid (DHA) enhanced the negative association between VO2max and CRP, suggesting that the anti-inflammatory response to VO2max capacity is associated with ALA and DHA levels. Males, Whites, and individuals with lower BMI were more sensitive to the effects of omega-3 PUFAs, while having high SFA levels attenuated the benefit. Conclusions This study suggests that omega-3 PUFAs are effect modifiers for VO2max and CRP and that the anti-inflammatory benefits of increasing cardiovascular fitness are associated with omega-3 PUFAs.
3131 – THE ROLE OF VASCULAR ENDOTHELIAL GROWTH FACTOR - C IN DEVELOPMENTAL HEMATOPOIESIS

Hematopoietic stem and progenitor cells (HSPCs) are multipotent cells that self-renew or differentiate to establish and replenish the entire blood hierarchy. HSPCs arise from the hemogenic endothelium of the dorsal aorta (DA) in the embryo. We use zebrafish to study endothelial-to-hematopoietic transition (EHT) because the embryos are transparent and develop externally, allowing direct observation of in vivo cellular events. My long-term goal is to identify factors that impact HSPC differentiation during EHT. One candidate, VEGFC, is expressed in the DA and specifically in long-term HSPCs of both mouse and zebrafish. VEGFC has been shown to play a role in fetal liver erythropoiesis, but its developmental role in definitive hematopoiesis has not been explored. I hypothesize that VEGFC maintains HSPC identity by negatively regulating alternative hemogenic endothelium fates. Preliminarily, we have shown in zebrafish that morpholino knock-down of vegfc results in decreased HSPC emergence and altered cell behavior during EHT. During the peak of HSPC emergence from the DA, vegfc knock-down embryos show decreased HSPC emergence, this lack of HSPCs persists into lymphoid development in the thymus. HSPCs in vegfc knock-down embryos also display altered cell behavior, they crawl similar to myeloid cells, instead of the typical and well described budding from the DA. vegfc knock-down embryos and genetic mutants also show an increase in myeloid cells in the caudal hematopoietic tissue (CHT), the zebrafish equivalent of the mammalian fetal liver. We plan to further investigate the role of VEGFC in a mammalian system using human pluripotent stem cell differentiation protocols and aorta-gonad mesonephros explants. We hope to use the results of this research to improve our ability to create HSPCs in vitro to be used in clinical stem cell transplants.
Simplifying Hyperbilirubinemia Risk Estimation

* Abbreviations: AAP — : American Academy of Pediatrics TSB — : total serum bilirubin Δ-TSB — : difference between the predischarge total serum bilirubin and the corresponding AAP phototherapy threshold (in milligrams/deciliter) Jaundice impacts more than half of term and late preterm newborns in the first week of life. Although in most cases, jaundice is benign, the consequences of severe hyperbilirubinemia are debilitating; thus, identification of newborns likely to exceed bilirubin treatment thresholds is needed. The American Academy of Pediatrics (AAP) recommends stratification of predischarge total serum bilirubin (TSB) levels by using the Bhutani Nomogram to help determine the appropriate timing of newborn follow-up. A separate nomogram is then used to determine if an infant meets criteria for phototherapy.1 Kuzniewicz et al2 aim to simplify the process and more precisely determine when a newborn requires outpatient follow-up for jaundice with a simple equation. Starting with a retrospective cohort study of a diverse sample of 148 162 newborns born at ≥35 weeks’ gestation at 11 Kaiser Permanente Northern California facilities from 2012 to 2017, the researchers identified newborns whose TSB measurements did not exceed phototherapy levels and did not receive phototherapy during the birth hospitalization. Using the newborn’s last TSB value before hospital discharge (predischarge TSB), the authors calculated the difference between the predischarge total serum bilirubin and the corresponding American Academy of … Address correspondence to Laura R. Kair, MD, MAS, Department of Pediatrics, University of California, Davis, 2516 Stockton Blvd, Ticon II, Room 341, Sacramento, CA 95817. E-mail: lrkair{at}ucdavis.edu
Dose-dependent Pharmacological Response to Rituximab in the Treatment of Antineutrophil Cytoplasmic Antibody-associated Vasculitis.

Objective Rituximab (RTX) is effective in the induction and maintenance of remission in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). However, uncertainty remains regarding the optimal maintenance dosing regimen. This work evaluates the relationship between variability in RTX dosing and pharmacological response in AAV. Methods A prospective cohort of patients with AAV (n = 28) with either granulomatosis with polyangiitis (n = 23) or microscopic polyangiitis (n = 5) receiving maintenance RTX therapy were followed in a single tertiary care academic medical center over a 2-year period. Patient demographics, RTX dosing information, and trough plasma RTX levels were collected along with laboratory measures of pharmacologic response, including B cell counts and ANCA titers. Results RTX dosing information from 94 infusions with 59 trough samples were collected with a mean ± SD dose of 640 ± 221 mg, dosing interval of 210 ± 88 days, and trough plasma RTX concentration of 622 ± 548 ng/mL. RTX trough concentrations were associated with RTX dose (ρ = 0.60, P 3.3 mg/d; P Conclusion RTX maintenance dosing of 500 mg every 6 months may be inadequate to maintain B cell depletion in the treatment of AAV.
Blocking Blockage

The Blockage Argument is designed to improve upon Harry Frankfurt’s famous argument against the Principle of Alternative Possibilities (PAP) by removing the counterfactual intervener altogether. If the argument worked, then it would prove in a way that Frankfurt’s argument does not that moral responsibility does not require any alternative possibilities whatsoever, not even the weakest “flicker of freedom” (such as the possibility of avoiding voluntary action). Some philosophers have rejected the Blockage Argument solely on the basis of their intuition that the inability to do otherwise is incompatible with moral responsibility. I will argue, however, that it is not merely the inability to do otherwise by itself but rather the inability to do otherwise in combination with the absence of a counterfactual intervener that is incompatible with moral responsibility. If I cannot do otherwise and it is not because of a counterfactual intervener, then it must be the case that I am being forced to choose and therefore act as I do, in which case I cannot be morally responsible for this action. Because the Blockage Argument fails, and because it was really the only way to establish that moral responsibility does not require any alternative possibilities whatsoever, it follows that moral responsibility does indeed require at least one alternative possibility in any given situation. But it turns out that this conclusion does not tip the balance in favor of incompatibilism over compatibilism. It would have if blockage and determinism were equivalent. But they are not. Unlike blockage, determinism is compatible with certain counterfactuals that compatibilists traditionally believed the ability to do otherwise reduces to. So even though moral responsibility is incompatible with blockage, it does not necessarily follow that moral responsibility is incompatible with determinism.
Research Approaches for Building Enclosure Studies

Research in building enclosure studies aims primarily to answer questions about the characteristics and behavior of roofs, walls, and foundations. Its ultimate goal is to ensure that the designs proposed by architects and other building design professionals are realized in ways that will prove beautiful, useful, and sustainable. The focus is often on the multifaceted performance of building assemblies; this performance can be considered in terms articulated in The Building Systems Integration Handbook in a chapter by Hartkopf et al. (Chapter 6: integration for performance. In: Rush RD (ed) The building systems integration handbook. Wiley, New York, 1986), namely, “spatial performance, thermal performance, air quality performance, acoustical performance, visual performance, and building integrity” (p. 232).
SPARTA: An Integrated Stability, Discriminability, and Sparsity Based Radiomic Feature Selection Approach

In order to ensure that a radiomics-based machine learning model will robustly generalize to new, unseen data (which may harbor significant variations compared to the discovery cohort), radiomic features are often screened for stability via test/retest or cross-site evaluation. However, as stability screening is often conducted independent of the feature selection process, the resulting feature set may not be simultaneously optimized for discriminability, stability, as well as sparsity. In this work, we present a novel radiomic feature selection approach termed SPARse sTable lAsso (SPARTA), uniquely developed to identify a highly discriminative and sparse set of features which are also stable to acquisition or institution variations. The primary contribution of this work is the integration of feature stability as a generalizable regularization term into a least absolute shrinkage and selection operator (LASSO)-based optimization function. Secondly, we utilize a unique non-convex sparse relaxation approach inspired by proximal algorithms to provide a computationally efficient convergence guarantee for our novel algorithm. SPARTA was evaluated on three different multi-institutional imaging cohorts to identify the most relevant radiomic features for distinguishing: (a) healthy from diseased lesions in 147 prostate cancer patients via T2-weighted MRI, (b) healthy subjects from Crohn’s disease patients via 170 CT enterography scans, and (c) responders and non-responders to chemoradiation in 82 rectal cancer patients via T2w MRI. When compared to 3 state-of-the-art feature selection schemes, features selected via SPARTA yielded significantly higher classifier performance on unseen data in multi-institutional validation (hold-out AUCs of 0.91, 0.91, and 0.93 in the 3 cohorts).
Purification of Escherichia coli heat-stable enterotoxin

Publisher Summary The chapter describes the purification of enterotoxigenic Escherichia coli (ETEC) enterotoxin ST a , which is the heat-stable mouse-active enterotoxin. ETEC may induce clinically significant intestinal fluid secretion (i.e., diarrhea) in humans and animals by production of enterotoxins. Several types of ETEC enterotoxins are recognized, each with a unique structure and mechanism of action. ST a activates particulate guanylate cyclase in intestinal epithelial cells. A modification suckling mouse assay (SMA) is used for detection and quantitation of ST a throughout the purification steps. Sequence analysis of ST a peptides is performed by the manual microsequencing technique of Chang using the double-coupling method with dimethylaminoazobenze isothiocyanate/phenyl isothiocyanate. After each cycle of derivatization, the labeled amino-terminal amino acid is cleaved. For preparative purposes the described scheme can be scaled upward to produce larger amounts of ST a . The derivatized amino acids are identified by their retention times in comparison with amino acid standards derivatized and chromatographed under the same conditions.
Dynamics and Stability of Acoustic Wavefronts in the Ocean

Abstract : Long-term goals: To develop a method of modeling sound propagation in an environment with multi-scale inhomogeneities, which preserves the efficiency and intuitive qualities of the ray theory but is free from spurious environmental sensitivity and strong perturbations associated with ray trajectories. To investigate and quantify effects on underwater acoustic wavefronts of internal gravity waves, sea swell, spice, and other small-scale processes in the water column.
Beyond the Fragments: Feminism and the Making of Socialism

Beyond the Fragments: Feminism and the Making of Socialism has a notable history. Its authors, Sheila Rowbotham, Lynne Segal, and Hilary Wainwright are well-established figures of British Second Wa...
The Production of Jets from Magnetized Accretion Disks: Simulation of the Blandford-Payne Mechanism

We have used massively parallel supercomputer simulations to perform an extensive study of a plausible mechanism for producing the jets seen in extragalactic radio sources - acceleration and collimation by coronal magnetic fields in an accretion disk orbiting a central black hole. We find that such disks can propel jets for a wide range of coronal conditions. The terminal jet velocity is a strong function of the magnetic field equatorial component. Acceleration and collimation are produced by a tight azimuthal field coil generated in the corona, rather than by a stiff poloidal field extending to large distances. The jets are pressure-confined when the external medium pressure is high, but magnetically-confined when it is low.
Percutaneous versus Surgical Insertion of PD Catheters in Dialysis Patients: A Meta-Analysis:

PurposeSeveral small studies have suggested that the percutaneous method of peritoneal dialysis (PD) catheter insertion is effective and has a lower complication rate than surgical techniques (open...
Diffusion of m-sulfobenzoic acid in nylon 6

Diffusion of m-sulfobenzoic acid in nylon 6 was measured by using the S-35 labelled acid as a tracer. A multimodal mechanism, identical to that in a preceding paper on sorption, was assumed, according to which the protonated acid diffused by dissolution, and the two dissociated acids diffused by competitive interaction with the charged sites in nylon 6. The concentration dependence of the diffusion coefficients was explained by the chemical potential gradient model. The monobasically dissociated species was found to be dominant in the diffusion process. Diffusion coefficients and the activation energies of diffusion did not vary significantly with pH. Die Diffusion von m-Sulfobenzoesaure in Nylon 6 wurde mit S-35 als Tracer untersucht. Der gleiche Mechanisms, der zur Erklarung der Sorptionsdaten benutzt worden war, wurde vorausgesetzt. Die Konzentrationsabhangigkeit der Diffusionskoeffizienten wurde mit dem Gradienten des chemischen Potentials erklart. Im Diffusionsprozes herrschen monobasische Spezies vor. Der Diffusionskoeffizient und die Aktivierungsenergie sind nicht stark abhangig vom pH-Wert.
Estrogen deficiency induced intestinal inflammation and permeability is linked with osteoporosis (488.8)

One out of two post-menopausal women will experience an osteoporotic fracture. Osteoporosis is characterized by decreased bone density and increased fracture risk, over 2 million annually. We and others previously demonstrated an association between intestinal inflammation and bone loss. Given that menopause is associated with bone inflammation, we hypothesized that intestinal inflammation contributes to bone inflammation and loss associated with estrogen depletion. We performed ovariectomy surgeries to induce an estrogen deficient state in female mice. As expected, micro-computed tomography demonstrated that distal femur trabecular bone volume was decreased by 26% as compared to sham control mice. Gene expression analysis of the small intestine demonstrated increased levels of pro-inflammatory cytokines (tumor necrosis factor (TNF) and interferon gamma (IFNg)) and decreased anti-inflammatory cytokines (interleukin-10 (IL-10)). Consistent with increased inflammation, estrogen depletion increased intestina...
Supporting procedural constructs in existing SQL compilers

The draft of the SQL/PSM standard denes a procedural extension to the existing SQL2 language. An essential part of this extension is the support of procedural constructs such as BEGIN/END blocks, local variables, assignment statements, conditional statements, and various forms of loops.Such an extension introduces new challenges to existing SQL compilers. Most SQL compilers exiting in the marketplace today were built based on the declarativeness of SQL. The question is how these procedural extensions can be best implemented in a relational DBMS without losing the power of existing query optimization mechanisms. So far, most implementations of the SQL procedural extensions rely on the use of a separate interpreter to handle the procedural statements so that the existing SQL compiler can be left untouched. Although this approach is quite easy to implement (as it follows the paradigm currently used between SQL and host languages), it does not provide the best possible performance.In this paper, we propose an integrated approach to extend existing query compilers to support SQL/PSM-like procedural extensions. We show how the existing SQL compiler infrastructure can be generalized to accommodate the new procedural constructs, and we describe how this approach can be implemented as part of an existing DBMS. The work presented in this paper has been prototyped on the code base of IBM DB2 for Common Server Version 2 product.
A Humoral Immune Defect Distinguishes the Response to Staphylococcus aureus Infections in Mice with Obesity and Type 2 Diabetes from That in Mice with Type 1 Diabetes

ABSTRACT Obesity and diabetes are among the greatest risk factors for infection following total joint arthroplasty. However, the underlying mechanism of susceptibility is unclear. We compared orthopedic implant-associated Staphylococcus aureus infections in type 1 (T1D) versus type 2 (T2D) diabetic mouse models and in patients with S. aureus infections, focusing on the adaptive immune response. Mice were fed a high-fat diet to initiate obesity and T2D. T1D was initiated with streptozotocin. Mice were then given a trans-tibial implant that was precoated with bioluminescent Xen36 S. aureus. Although both mouse models of diabetes demonstrated worse infection severity than controls, infection in T2D mice was more severe, as indicated by increases in bioluminescence, S. aureus CFU in tissue, and death within the first 7 days. Furthermore, T2D mice had an impaired humoral immune response at day 14 with reduced total IgG, decreased S. aureus-specific IgG, and increased IgM. These changes were not present in T1D mice. Similarly, T2D patients and obese nondiabetics with active S. aureus infections had a blunted IgG response to S. aureus. In conclusion, we report the first evidence of a humoral immune deficit, possibly due to an immunoglobulin class switch defect, in obesity and T2D during exacerbated S. aureus infection which may contribute to the increased infection risk following arthroplasty in patients with T2D and obesity.
Molluscicide Acute and Sub-Chronic Toxicity to the Three Non-Target Organisms Hexagenia limbata, Ceriodaphnia dubia, and Pimephelas promelas, and Neutralization of That Toxicity by Bentonite Clay

Three non-target organisms were used in this study to investigate H-130 toxicity; Hexagenia limbata (larval mayfly nymphs), Ceriodaphnia dubia, and larval Pimephelas promelas. Hexagenia limbata was chosen as a representative benthic organism likely to come into contact with and ingest adsorbed molluscicide. Ceriodaphnia dubia and Pimephelas promelas were chosen as representativ e pelagic organisms. Both the toxicity of H-130 and the effectiveness of bentonite clay in neutralizing H-130 toxicity were investigated in acute and sub-chronic toxicity tests (Horning and Weber 1985). MATERIALS AND METHODS Both C. dubia and P. promelas were taken from cultures maintained at the Ohio Environmental Protection Agency (EPA) bioassay laboratory. Less than 24H old P. promelas and C. dubia neonates were used in both acute and sub-chronic tests. Reproductive performance of the C. dubia population was assessed by subjecting them to quality assurance tests (Horning and Weber 1985) prior to use of neonates in the toxicity tests. H. limbata nymphs were collected from wild populations. The length of the nymphs used in the acute tests was between 12 and 33 mm. The components used in these tests were the molluscicide H-130 and bentonite clay. The quaternary ammonium compound H-130 is positively charged. When in the presence of bentonite clay, the cationic molluscicide is attracted to the anionic charge on the surface of the clay which is the basis for use of the clay as a sorbent medium. Most
An ethical tax dilemma: Support of hobby versus trade or business in the presence of competing incentives and client pressure

The tax law treats hobbies and businesses in a significantly different manner. The ability to discern when an activity is a business and when it is a hobby is critically important. Unfortunately, tax practitioners face an additional challenge when making judgment decisions: competing incentives and pressure from the client. Practitioners not only have obligations to their clients but are also obligated to uphold the tax system. Balancing professional responsibilities with other incentives and pressures introduces an ethical dimension to the issue. In this case, you will have the opportunity to explore the hobby versus business question in the presence of client pressure and competing incentives. You will be required to research the technical tax issues and make appropriate recommendations. Rather than this being a mere tax law analysis, however, you also need to look deeper into the decision making process and examine the ethical issues involved. At the conclusion of the case, you will have demonstrated an understanding of both the technical tax issues and the ethical issues involved.
Educating medical students in pain medicine and palliative care.

Since 1997, the Institute of Medicine of the National Academy of Sciences has released two reports regarding the need to provide more educational programs that stress the importance of end-of-life care and that train clinicians to provide such care [1,2]. The Summary and Recommendations for Improving Palliative Care for Cancer, released by the Institute of Medicine in 2001, listed “inadequate training of health care personnel in symptom management and other palliative care skills” as a barrier to ensure excellent palliative and end-of-life care [2]. Pain is a common symptom of patients with cancer, and pain control is an important clinical goal for this patient group as well as for patients with nonmalignant diseases. All patients expect reliable skillful care from their physicians when experiencing pain and approaching death. The Joint Commission on Accreditation of Healthcare Organizations ( JCAHO) first established pain management standards for all hospitals in 2001. These standards require all physicians to assess and manage pain for all patients. However, pain medicine and palliative care are not a part of the required curriculum at most of the United State's medical schools. Billings et al. [3] reviewed articles, and Barzansky et al. [4] reviewed the Liaison Committee on Medical Education (LCME) and Association of American Medical Colleges (AAMC) Annual Medical School Questionnaires regarding medical education … Reprint requests to: Hui-Ming Chang, MD, MPH, Department of Palliative Care and Rehabilitation, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard Box 8, Houston, TX 77030. Tel: (713) 500-3559; Fax: (713) 500-0336; E-mail: Hui-Ming.Chang{at}uth.tmc.edu.
Worlding Miss World, Bangalore, 1996

This essay revisits the much-discussed swarm of protests surrounding the 1996 Miss World pageant in Bangalore, India. It suggests that behind the clamour of clashing opinions regarding the content of the pageant lay a deeper crisis, uninterrogated yet constantly palpable: the absence of a performative dispensation within which the then-nascent project of liberalisation could, paradoxically, be experienced as self-grounding. By organising its discussion around interviews with some of the people most directly involved in trying to manage the meaning of the event – through sponsorship, public relations, policing, and protest – the essay shows how a reconsideration of the pageant can help us understand the delicate relation between commercial publicity and sovereign authority in a globalising age.
The effects of antioxidants on radiation-induced apoptosis pathways in TK6 cells.

Abstract This study was designed to determine if radiation-mediated activation of the apoptotic pathways would be influenced by antioxidants and if a correlation would be found between radioprotection and changes in transduction pathways. Human lymphoblastoid TK6 cells, known to undergo apoptosis as a result of radiation, were irradiated (6 Gy) with and without antioxidants, and then whole-cell lysates were collected. Parallel studies were conducted to assess the survival (clonogenic assay) and apoptotic index. The impacts of two nitroxide antioxidants, tempol and CAT-1, differing in cell permeability, as well as the sulfhydryl antioxidant N-acetyl- l -cysteine (L-NAC), were estimated. Changes in apoptotic pathway proteins and p53 were assessed by Western blotting. Fraction of apoptotic cells was determined by flow cytometry. Tempol (10 mM), which readily enters cells, partially radioprotected TK6 cells against clonogenic killing, but had no effect on radiation-induced apoptotic parameters such as cleaved caspase 3 or cleaved PARP. Tempol alone did not induce cytotoxicity, yet did increase cleaved PARP levels. The radiation-induced increase in p53 protein was partly inhibited by tempol, but was unaffected by CAT-1 and L-NAC. Both CAT-1 (10 mM), which does not enter cells, and L-NAC (10 mM) had no radioprotective effect on cell survival. Although L-NAC did not protect against radiation-induced cytotoxicity, it completely inhibited radiation-induced increase in cleaved caspase 3 and cleaved PARP. Collectively, the results question the validity of using selected apoptosis pathway members as sole indicators of cytotoxicity.
Peripheral odontogenic tumors

Peripheral odontogenic tumors, also referred to as Peripheral ameloblastoma extraosseous or soft tissue odontogenic tumors, manifest the histopathologic characteristics of their central or intraosseous counterparts but arise in the soft tissues of the maxilla or mandible, usually in gingival tooth-bearing areas. Peripheral odontogenic lesions are considered rare within the odontogenic tumors classification. Clinical differential diagnosis of these lesions infrequently includes a peripheral odontogenic tumor, but usually favors gingival fibroma, pyogenic granuloma, peripheral giant cell granuloma, or other reactive hyperplasia. For the most part, it is not until the tumor has been excised and examined histologically that the true nature of the lesion is known. Many odontogenic tumors have been reported in the soft tissues, including ameloblastoma, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, odontogenic fibroma, squamous odontogenic tumor, odontogenic myxoma odontoma, and epithelial odontogenic ghost cell tumor. The most commonly reported peripheral odontogenic tumor is the ameloblastoma. The paucity of reports in the literature on tumors, other than peripheral ameloblastoma, makes it difficult to state with certainty the biologic behavior of these lesions; therefore, one only can suggest the most common clinical features. The following is a summary of the most pertinent information on the clinical and histopathologic features of peripheral odontogenic tumors.
Community Sustainability and Land Use

Books reviewed: Timothy Beatley, Green Urbanism: Learning from European Cities Amer El-Ahraf, Mohammad Qayoumi and Ron Dowd, The Impact of Public Policy on Environmental Quality and Health: The Case of Land Use Management and Planning Daniel A. Mazmanian and Michael E. Kraft, (eds.) Toward Sustainable Communities: Transition and Transformations in Environmental Policy Kee Warner and Harvey Molotch, Building Rules: How Local Rules Shape Community Environments and Economies
The discursive construction of knowledge and equity in classroom interactions

Abstract Given the established relationship between student participation and learning, an equitable distribution of turns at talk is critically important. This paper examines the discursive strategies teachers use in allocating such turns during teacher-fronted lessons, demonstrating that the predominant strategy in many classrooms—one in which teachers avoid dispreferred (incorrect or inappropriate) responses by soliciting volunteers and nominating only those students who actively seek the floor—is inconducive to the goal of equity insofar as it allocates fewer turns to students who (due to culture, personality, etc.) volunteer less often. It is shown that the advantage of this strategy stems from teachers’ use of monologic recitation scripts. Consequently, abandoning such scripts in favor of more dialogic classroom discourse—as has long been recommended—would reduce the desirability of volunteer-based turn allocation, thus freeing teachers to promote an equitable distribution of opportunities for student participation by nominating students regardless of whether they seek the floor.
Luxatio erecta of the hip: a critical retrospective

The term "luxatio erecta" has been borrowed from the shoulder to identify rare traumatic hip dislocations in which there is inferior dislocation of the femoral head and inversion of the femoral shaft. A review of the literature is presented along with an additional illustrative case. The mechanism of injury, and the radiological and physical appearance of the patient, indicate that there are two subtypes of dislocation hitherto lumped together under the single term.
Completely automatic weight-minimization method for high-speed digital computers

This paper presents a step-by-step procedure, related to the method of steepest descent, for the weight minimization of an arbitrary structure and, as an example, applies it to optimizing the weight of a simple cantilevered box. The procedure presented is capable of handling limiting conditions placed upon the stresses or deflections at selected points and is, in general, applicable to any single-extrema type of continuous function. It is assumed that a procedure or program exists—'the stiffness-matrix method being ideal for this purpose—-for calculating stresses and deflections, etc., at specific points under various load conditions, once the defining structural parameters are known. Hence, only auxiliary calculations needed to interpret output from and prepare new input for such a program are discussed. Furthermore, the input is assumed to vary continuously, and the subject of discretely varying arguments, as well as multiple extrema, is considered to be outside the scope of the present paper.
The hierarchical structure of graph searches

Abstract Given a graph B , we show the existenee of a universal automaton U which “searches” B. U is universal in the sense that any automaton which searches B behaves as a subautomaton of U . Further, U is naturally filtered in a manner suggestive of hierarchical search depth: level 1 corresponds to simple rules for moving on B , level 2 to “meta-rules,” and so on. We show that if M is any finite state automaton which searches B , then M can in fact be embedded in some finite level U n of U . This leads naturally to a definition of “depth” of an arbitrary automaton which searches B , and we give several examples of such automata with varying depth. This notion of depth is independent of the state space structure of M . We further describe a resulting strategy for the construction of evolutionary learning systems which learn structural control hierarchies, based on our model of the universal automaton.
Surgery for the herniated lumbar disk with nerve root entrapment: Are alternative treatments to surgical intervention effective?

The concept that compressive lesions of the nerve root, as with a herniated disk, is the mechanism by which pain is produced may not be tenable. Overlooked and untreated are the myofascial syndromes that produce symptoms and signs that mimic the traditional description of nerve-root syndromes. Because the two entities may coexist, which is causative? Alternative treatments that focus on pain management, myofascial syndromes, and behavioral modification —especially when carried out in a multidisciplinary center—do produce functional restoration and control or relief of pain. Such treatment may not only yield superior outcome results as opposed to surgery, but also be cost effective while saving human suffering.
Disaster-Relief Anesthesia — Notes on Coming Home

Anesthesiologists have a unique view of humanitarian disasters, as I discovered when I spent 21 days volunteering on the U.S.N.S. Comfort after the January earthquake in Haiti. Based in operating rooms, anesthesiologists see close up the entire grotesque flood of distorted bodies. Under pressure, we tend to cope by focusing on the mechanics of the body and the technicalities of procedures — to think not of dying or shattered people, but of damaged anatomy and the techniques of repair. After our team had done several days of intense work with patients with complicated limb wounds, broken pelvises, skull factures, and . . .
Thermogravimetric characteristics of barbituric acid and some of its derivatives

Abstract The thermolysis curves of barbituric acid and some of its derivatives have been determined. Barbituric acid, violuric acid and dilituric acid form hydrates while 1,3-dimethylvioluric acid and barbital are anhydrous. Barbital and 1,3-dimethylvioluric acid sublime before decomposition. The differential thermal analysis for dilituric acid showed a sharp exotherm at 190° indicating a violent explosion.
Beaver populations and their relation to wetland habitat and breeding waterfowl in Maine

The influence of beaver (Castor canadensis) trapping on beaver and waterfowl densities and wetland habitat is not well understood, and this information is needed by managers trying to balance beaver densities and harvest and complaints of nuisance beaver with the abundance of wetlands and waterfowl. During 1988–92 in south-central Maine, we determined the density of beaver colonies and beaver harvest, wetland characteristics, and density of breeding pairs of waterfowl on a 111-km2 site recently closed to beaver trapping and a similar site open to trapping. Density of beaver colonies increased from 0.15 to 0.32/km2 (113%) on the untrapped site but changed little (0.19–0.20/km2) on the trapped site. The number of beaver dams maintained by beaver and the density of beaver colonies were correlated on the untrapped site (r=0.99, n=4,P=0.009) but not on the trapped site (r=−0.18, n=4,P=0.820). Number of wetlands was correlated with the density of beaver colonies during 1989–92 on the untrapped site (r=0.92, n=4,P=0.081) but not on the trapped site (r=−0.13, n=4,P=0.875). Total surface area of water on the untrapped site increased from 115 to 158 ha (36%); surface area of water remained stable on the trapped area. Species of waterfowl that increased on the untrapped site included Canada geese (Branta canadensis) (4–9/100 km2), hooded mergansers (Lophodytes cucullatus) (23–29/100 km2), and mallards (Anas platyrhynchos) (7–12/100 km2). Numbers of wetlands used by pairs of each species of waterfowl increased on the untrapped site. Overall, a ≥1-year closure of beaver trapping is sufficient to increase the density of beaver colonies, whereas a 2–3 year closure is necessary to increase wetland habitat. More than 3–4 years may be required to begin influencing the density of waterfowl and number of wetlands used by waterfowl.
Inverse halftoning via robust nonlinear filtering

A new blind inverse halftoning algorithm based on a nonlinear filtering technique of low computational complexity and low memory requirement is proposed in this research. It is called blind since we do not require the knowledge of the halftone kernel. The proposed scheme performs nonlinear filtering in conjunction with edge enhancement to improve the quality of an inverse halftoned image. Distinct features of the proposed approach include: efficiently smoothing halftone patterns in large homogeneous areas, additional edge enhancement capability to recover the edge quality and an excellent PSNR performance with only local integer operations and a small memory buffer.