cssi/SciSciGPT-SciSciNet huggingface dataset:
An Adolescent With a History of Menorrhagia

Patient: A 15-year-old African-American female presented to the hematology clinic for management of von Willebrand disease (vWD) and a 1-deamino-8-D-arginine vasopressin (DDAVP, or desmopressin) challenge. Chief Complaint: Menorrhagia, requiring as many as 8 to 10 sanitary pads per day during menses lasting up to 1 month at a time. Past Medical History: Previous von Willebrand panel ordered by a gynecologist reported as follows: von Willebrand antigen: 39%; von Willebrand activity: 36%; and factor VIII: 51%. No surgeries or hospitalizations. Family History: Mother with heavy menses lasting 5 to 6 days per month but requiring up to 20 sanitary pads per day. Maternal aunts with history of heavy menses; one aunt and maternal grandmother had hysterectomies due to dysfunctional uterine bleeding. Medications: Recently placed on oral birth control pills by a gynecologist. Physical Exam: Healthy-appearing female in no acute distress. Vital signs within normal limits. Normal physical exam without evidence of abnormal bruising, hepatosplenomegaly, or lymphadenopathy. Laboratory Findings: After great difficulty and multiple unsuccessful attempts, a phlebotomist obtained her blood via venipuncture while the patient turned increasingly anxious. Since it became too late to perform the DDAVP challenge on her first clinic visit, the hematologist decided to place a large bore IV needle overnight and have her return the following day for the DDAVP challenge. Table 1 shows the multiple sets of test results from both days. 1. What is von Willebrand disease (vWD)? 2. How do you test for vWD? What is the most likely diagnosis in this patient? 3. What is the likely explanation for the difference in laboratory values over the 2 days of testing? 4. Which factors can affect von Willebrand factor levels? 5. How does DDAVP work and in which patients is it contraindicated? 1. Von Willebrand disease (vWD) is the most common inherited bleeding disorder with an estimated prevalence of …
The characteristics and design of the conical log-spiral antenna

The balanced conical logarithmic-spiral antenna is considered as a slow-wave locally periodic structure with a slowly varying period. A study of the near fields and their relationship to the far fields has led to the identification of the active region or effective radiating aperture on the antenna and to a clearer understanding of its operating characteristics. Information of the near- and far-field characteristics and on the input impedance for a wide range of parameters is presented in a form suitable for use in the design of practical antennas.
Differential Effects of Glycosylated and Nonglycosylated Prolactin on Islet Cell Division and Insulin Secretion

AbstractA growing body of evidence suggests that prolactin (PRL) is a potent regulator of the structure and function of the islets of Langerhans, but PRL is a polymorphic hormone that exists in several molecular forms. Therefore, it is important to know whether glycosylated PRL, a major structural variant of the hormone in several species, has an effect different from that of the nonglycosylated PRL on islet function. This in vitro study examined the differential effects of glycosylated and nonglycosylated porcine PRL on cell division and insulin secretion from neonatal rat islets, and compared these results with those produced by homologous rat PRL. The nonglycosylated porcine PRL produced modest stimulation of cell division and insulin secretion from rat islets, but glycosylated porcine PRL had no significant effects. The stimulations produced by nonglycosylated porcine PRL were much weaker in comparison to those produced by the homologous rat PRL. The results show differential effects of the two struct...
Surveillance of parapoxvirus among ruminants in Virginia and Connecticut.

Summary In 2008, two deer hunters in Virginia and Connecticut were infected with a unique strain of pseudocowpox virus, a parapoxvirus. To estimate the prevalence of this virus, and in an attempt to define the reservoir, Parapoxvirus surveillance was undertaken between November 2009 and January 2010. 125 samples from four ruminant species (cows, goat, sheep and white-tailed deer) were collected in Virginia, and nine samples from white-tailed deer were collected in Connecticut. We found no evidence that the parapoxvirus species that infected the deer hunters is circulating among domesticated ruminants or white-tailed deer. However, parapoxvirus DNA of a different parapoxvirus species, bovine papular stomatitis virus (BPSV), was detected in 31 samples obtained from asymptomatic cattle in Virginia. Parapoxvirus DNA–positive cattle originated from the same counties indicating probable transmission among animals. Molecular analysis identified BPSV as the parapoxvirus affecting animals. Asymptomatic parapoxvirus infections in livestock, particularly young animals, may be common, and further investigation will inform our knowledge of virus transmission.
Construction Cost Sensitivity of a Lignocellulosic Ethanol Biorefinery

The technology has been developed to convert feedstock with cellulose content into ethanol. However, ethanol produced from cellulosic feedstock is the same as ethanol distilled from grain. The objective of research is to determine the price per gallon of ethanol needed so that producing lignocellulosic based ethanol become economically feasible.
Medicare Readmissions Policies and Racial and Ethnic Health Disparities: A Cautionary Tale

Beginning in 2009, the Centers for Medicare & Medicaid Services started publicly reporting hospital readmission rates as part of the Hospital Compare website. Hospitals will begin having payments reduced if their readmission rates are higher than expected starting in fiscal year 2013. Value-based purchasing initiatives including public reporting and pay-for-performance incentives have the potential to increase quality of care. There is concern, however, that hospitals providing service to minority communities may be disproportionately penalized as a result of these policies due to higher rates of readmissions among racial and ethnic minority groups. Using 2008 Medicare data, we assess the risk for readmission for minorities and discuss implications for minority-serving institutions.
Children who refuse anesthesia or sedation: a survey of anesthesiologists.

Summary Background: Few articles have addressed the issue of the child who refuses anesthesia or sedation for surgery. A survey of members of the Society for Pediatric Anesthesia in the USA was conducted regarding their experience with pediatric refusal and assent for surgery. Methods: Structured response and open-end questions were used in a confidential postal survey to assess the following: details of cancellations, the use of, and attitudes to, physical restraint at induction, premedication, the management of a hypothetical case of child refusal and individual techniques used for uncooperative children. Results: Surveys were received from 453/852 anesthesiologists for a 57% response rate. Nine percent and 45% of respondents had cancelled one or more cases for child refusal in the past year and during their entire career respectively. Forty-four percent of respondents used restraint in the majority of children 11 years. Respondents were more uncomfortable with restraint in older children and less likely to proceed with induction. Twelve years was the median age when respondents would respect the child’s refusal to proceed. Conclusions: Cancellation of planned surgery because of child refusal is not uncommon. It is important to recognize the potentially uncooperative child, particularly older children with developmental delay or a lack of understanding. Discussion with child and parents, selective use of premedication and different induction agents, distraction, play techniques, gentle restraint and the option of cancellation and review should all be considered.
A new aquatic beetle family, Meruidae, from Venezuela (Coleoptera: Adephaga)

An unknown beetle collected in the Territorio Federal Amazonas, Venezuela, and designated as belonging to a new family, is described (as Meru phyllisae gen.n., sp.n.) and illustrated by line drawings and scanning electron micrographs. The new family, Meruidae, is diagnosed and assigned to the suborder Adephaga with a discussion of some characters and likely phylogenetic affinities. With a body length of 0.85-0.9 mm, M. phyllisae is the smallest known member of aquatic Adephaga. Based on the observed skeletal and behavioural characters to date, the taxon appears to represent the sister clade to the remaining families of Dytiscoidea, but also has features suggesting a close relationship among Noteridae and/or Haliplidae. A description and photographs of the habitat are included, with a list of other associated water beetle taxa. Some observations on the behaviour of captive beetles are given. The minute 'comb-clawed cascade beetles' are known only from the type locality, El Tobogan, where streams flow among exposed areas of bedrock in the geologically ancient Guyana Shield region.
HEPATITIS C VIRUS IMPAIRS NATURAL KILLER CELL MEDIATED AUGMENTATION OF COMPLEMENT SYNTHESIS

ABSTRACT Natural killer (NK) cells and the complement system play critical roles in the first line of defense against pathogens. The synthesis of complement components C4 and C3 is transcriptionally downregulated by hepatitis C virus (HCV) core and NS5A proteins, and this negative regulation is apparent in chronically HCV-infected patients. In this study, we have examined the potential contribution of an NK cell line as a model in regulating complement synthesis. Coculture of NK cells (NK3.3) with human hepatoma cells (Huh7.5) expressing HCV core or NS5A protein led to a significant increase in C4 and C3 complement synthesis via enhanced specific transcription factors. Reestablishment of complement protein expression was found to be mediated by direct interaction between NKG2D on NK cells and the hepatocyte protein major histocompatibility complex class I-related chains A and B (MICA/B) and not to be associated with specific cytokine signaling events. On the other hand, C4 and C3 synthesis remained impaired in a coculture of NK cells and Huh7.5 cells infected with cell culture-grown HCV. The association between these two cell types through NKG2D and MICA/B was examined further, with MICA/B expression in HCV-infected hepatocytes found to remain inhibited during coculture. Further experiments revealed that the HCV NS2 and NS5B proteins are responsible for the HCV-associated decrease in MICA/B. These results suggest that HCV disables a key receptor ligand in infected hepatoma cells, thereby inhibiting the ability of infected cells to respond to stimuli from NK cells to positively regulate complement synthesis. IMPORTANCE The complement system contributes to the protection of the host from virus infection. However, the involvement of complement in viral hepatitis has not been well documented. Whether NK cells affect complement component expression in HCV-infected hepatocytes remains unknown. Here, we have shown how HCV subverts the ability of NK cells to positively mediate complement protein expression.
Introduction A General Perspective of Research and Researchers

The purpose of this book is to be encouraging. It is largely addressed to those many clinicians in the field of child mental health who have often been tempted to explore a problem that interested them but have felt some diffidence about doing so because of a lack of research knowledge and training. Now it is true that research, like any other academic pursuit, benefits from training in methodology, but what becomes apparent on the reading of the different contributions to this volume is the self-made quality of the investigators. They have all carried out research not because they were trained to do research but because something within them that one can only nebulously term an attitude of mind compelled them to this activity. Technical proficiency can be acquired on the job and competence tends to increase with experience. The research attitude, however, is more difficult to acquire in its absence since its origins are often lost in the earliest years of life. It undoubtedly begins in wonder at the nature of things and with the wish to discover how they work. Anyone who has watched a year-old infant at work investigating the world around him will appreciate the zest and persistence with which it is done. Piaget (1952) has painted a vivid developmental portrait of the stage-5 baby during the sensorimotor period “discovering new means through active experimentation,” and one can glimpse the once and future researcher in the making if the environment proves to be facilitating: Observation 1 for 2. —At 0; Laurent examines a watch chain hanging from his index finger. At first he touches it very lightly simply “exploring” it without grasping it. He then starts it swinging a little and at once continues this thus rediscovering a “derived secondary reaction.” But instead of stopping there, he grasps the chain with his right hand and swings it with his left while trying some new combinations (here the “tertiary reaction” begins); in particular he slides it along the back of his left hand and sees it fall off when it reaches the end. Then he holds the end of the chain (with his right index finger and thumb) and lets it slide slowly between the fingers of his left hand (the chain is now horizontal and no longer oblique as before). He studies it carefully at the moment when the chain falls from his left hand and repeats this ten times. Afterward, still holding the end of the chain in his right hand, he shakes it violently which makes it describe a series of varied trajectories in the air. He then shows these movements in order to see how the chain slides along the quilt when he merely pulls it. Finally he drops it from different heights and so rediscovers the schema acquired in the preceding observation. From his twelfth month Laurent repeated these kinds of experiments with everything that his hand came upon. He entertains himself either by making them slide or fall or by letting them go in different positions and from different heights in order to study their trajectory [p. 269].
Taming of 3,4-Di(nitramino)furazan.

Highly energetic 3,4-di(nitramino)furazan (1, DNAF) was synthesized and confirmed structurally by using single-crystal X-ray diffraction. Its highly sensitive nature can be attributed to the shortage of hydrogen-bonding interactions and an interactive nitro chain in the crystal structure. In order to stabilize this structure, a series of corresponding nitrogen-rich salts (3–10) has been prepared and fully characterized. Among these energetic materials, dihydrazinium 3,4-dinitraminofurazanate (5) exhibits a very promising detonation performance (νD = 9849 m s–1; P = 40.9 GPa) and is one of the most powerful explosives to date. To ensure the practical applications of 5, rather than preparing the salts of 1 through acid-base reactions, an alternative route through the nitration of N-ethoxycarbonyl-protected 3,4-diaminofurazan and aqueous alkaline workup was developed.
How Competitive are Food Crop Markets in Sub-Saharan Africa?

During the structural adjustment era of the 1980s and 1990s, governments across sub-Saharan Africa generally withdrew from food markets in order to encourage entry by private traders and foster competition. Since that time, the degree to which private crop traders actively compete and pass on price changes to farmers has been a central concern of policymakers, donors, and researchers. In this paper we provide a critical review of the evidence on that topic. We begin by developing an analytical framework to guide the review, and then discuss the empirical evidence from four categories of literature. We have two main findings. First, there is a paucity of empirical evidence on this question, given the importance of the topic. This hinders our ability to draw strong conclusions. Second, that point notwithstanding, the evidence that does exist is broadly supportive of the notion that food markets are competitive. The dominant themes in the literature are that trading profits are highly variable, which is consistent with substantial risk, that trader entry and exit rates are high, and that price co-movements between markets suggest relatively efficient levels of competitive arbitrage. It is possible that the high costs of entry foster non-competitive conditions at the level of large-scale, long-distance subnational trade; but we find no positive evidence to that effect, only the satisfaction of certain necessary conditions.
Rural home health care workers' attitudes toward the elderly: a replication study.

We collected data from 548 rural home health care workers in Southern Illinois in 1990 to replicate a study conducted in 1988 designed to identify and assess the attitudes of those workers toward the elderly and their elderly clients. Subjects were asked to respond to a fifteen item, self-report questionnaire. Reliability of the scale was estimated at .79, using Cronbach's alpha. Readability was estimated at the sixth-grade reading level as measured by the SMOG Readability Formula. Chi-square statistics were used to determine whether there were any differences between the 1988 and 1990 data sets, with a significance level of .003, using the Bonferroni correction procedures. Results were similar for both the 1988 and 1990 data sets. For example, whereas 31.8% of the 1988 respondents agreed with the statement: "most of my clients are pretty much the same," 30.5% of the 1990 respondents agreed. The findings from this study indicate that attitudes toward the elderly among this population of home health care workers have remained relatively consistent over this two year period.
Optimal Reduction of the C1–C3 Combustion Mechanism for the Simulation of Flaring

Flaring is a combustion process designed to relieve pressures and safely dispose of vent gases from chemical and petrochemical plants. An industrial flaring activity typically involves various combustible waste gases and a large number of reactions and species. Because most of the detailed kinetic mechanisms for the speciation study of flaring events are too complicated to use in the computational fluid dynamics simulation of industrial-scale flares, several techniques for reduction of the detailed combustion mechanisms have been developed. In this paper, a new rigorous skeleton mechanism (RSM) based reduction technique, namely, the LU 2.0 algorithm, is proposed. It falls under the category of identification of redundancy. Other techniques in this category try to remove redundant species and reactions based on criteria such as sensitivity and quasi-steady-state analyses. These are highly dependent on the preanalysis of the mechanism and require species concentration sets for the conditions of interest. Th...
Sedimentary Characteristics and Hydrocarbon Accumulation Model of Fuyu Reservoir in Sanzhao Depressiom

Fuyu reservoir of Sanzhao depression in Songliao basin is a typical down-migration accumulation in syncline of large depressions.Applying the high-resolution sequence stratigraphy theory,analyzing different scales of base-level cycles and stacking patterns with sediment dynamics,based on 11 well cores and loggings of 825 wells,Fuyu reservoir were classified into 1 long-term level cycle,4 mid-term level cycles and 35 short-term level cycles,proposed sequence framework that is regression followed by transgression.The sediment characteristic of short-cycle reservoir suggests that Fuyu reservoir is mainly affected by two sources,the northern Baiquan-Qinggang and the southwest Baokang,which meet around Xujiaweizi then flow to the east,Fuyu reservoir develops typical sedimental system of shallow water delta that controlled by rivers,and distributary channels are main microfacies type.Faults analysis shows that T2 has the features of intensive belts in plane and flower-like in section,and the oil-sources faults that petroleum accumulation period successively active are main boundary faults of concentrated ribbons.At the end of Mingshui Formation,hydrocarbon generated by Qingshankou source rocks migrates down along open boundary faults of concentrated ribbons at the force of overpressure,then short lateral-migration along channel sand,finally accumulated on horsts and fault terraces of the uplifted side of both sides,but in the intensive fault zone,most of the units are grabens,so it is not good for accumulation.Based on of the accumulation model,47 hydrocarbon rich target area were depicted,50 million tons of geological reserves are submitted,which gave a clear direction in the exploration and development for the Fuyu Formation in Songliao basin.
Application of occupational health risk assessment in pre-assessment of occupational hazards in construction project of a chemical plant

[Objective]To identify and classify the occupational hazards in construction project of a chemical plant,and put forward suggestions for occupational hazards protection and management of occupational health.[Methods]Qualitative analysis and semi-quantitative analysis were used for risk assessment on types of occupational hazards,exposure,protection and management of this construction project.[Results]The generated occupational hazards such as ammonia,isobutene,tert-butylamine,and nitrogen dioxide were classified as risk levels of medium,low,low,medium respectively.The related protection and management recommendations were put forward.[Conclusion]The control measures against occupational hazards which will be implemented in this plant are effective.
A new method to research the reaction mechanism and the apparent activation energy of the decomposition reaction of calcium carbonate

The thermal decomposition process of calcium carbonate at different heating rates was investigated under pure N2 atmosphere with the thermal analysis techniques.The apparent activation energy has been derived into the rate activation energy(Er)and the mode function activation energy(Ef(α)),based on the differential method.The intrinsic activation energy is determined according to the relation between the Er and the conversion(α),and the reaction mechanism is obtained by the Malek method.It is shown that the reaction mechanism is contracting cylinder.The apparent activation energy is equal to the intrinsic activation energy at0.1≤α≤0.5.However,the apparent activation energy is a function of the conversion at 0.5≤α1.
Significance of Using the PBL Teaching Mode in Engineering Training Teaching

As a new teaching mode,the application of PBL in engineering training teaching is not a pure sense the change of teaching methods,but it is a radical shift of the traditional teaching mode in the teaching concept,teaching process,teaching form,teaching organization,teaching effect and so on. It is standing on the strategic height of talent training,and starting from the needs of social development and use of a teaching practice. Adopting this teaching model in engineering training teaching,which is beneficial to realize the goal of engineering training teaching,to improve teachers quality and ability,to make full use of and develop all kinds of teaching resources,to promote the engineering training teaching reform and development. From the above several aspects,this article elaborated the significance of the PBL teaching mode used in the teaching of engineering training.
Help-Seeking Behaviors Among Active-Duty Military Personnel: Utilization of Chaplains and Other Mental Health Service Providers

Military chaplains not only conduct religious services, but also provide counseling and spiritual support to military service members, operating as liaisons between soldiers and mental health professionals. In this study, active-duty soldiers (N = 889) reported help-seeking behaviors and mental health. Using logistic regressions, we describe the issues for which soldiers reported seeking help, then outline the characteristics of those who are most likely to seek help from a chaplain. Of the soldiers who sought help from a chaplain within the previous year, 29.9% reported high levels of combat exposure, 50.8% screened positive for depression, 39.1% had probable PTSD, and 26.6% screened positive for generalized anxiety disorder. The participant's unit firing on the enemy, personally firing on the enemy, and seeing dead bodies or human remains predicted seeing a chaplain. Future research should examine ways to engage soldiers who have had more combat experiences with the chaplain community to address spiritual issues.
Addressing Scientific Rigor in Data Analytics Using Semantic Workflows

New NIH grants require establishing scientific rigor, i.e. applicants must provide evidence of strict application of the scientific method to ensure robust and unbiased experimental design, methodology, analysis, interpretation and reporting of results. Researchers must transparently report experimental details so others may reproduce and extend findings. Provenance can help accomplish these objectives; analytical workflows can be annotated with sufficient information for peers to understand methods and reproduce the intended results. We aim to produce enhancements to the ontology space including links between existing ontologies, terminology gap analysis and ontology terms to address gaps, and potentially a new ontology aimed at integrating the higher level data analysis planning concepts. We are developing a collection of techniques and tools to enable workflow recipes or plans to be more clearly and consistently shared, improve understanding of all analysis aspects and enable greater reuse and reproduction. We aim to show that semantic workflows can improve scientific rigor in data analysis and to demonstrate their impact in specific research domains.
Calorimetry of Nitrogenase Efficiency in Soybean Nodules

Assessment of the metabolic cost of nitrogenase in intact, detached nodules, was made by a calorimetric technique which we designed for the purpose. This approach avoided some uncertainties of respirometric methods and allowed mathematical treatment to separate the requirement of reduction per se vs. that of enzyme activation.
Responding to Customers’ “Gray” Requests: The Service Employee Dilemma

This research examines how service employees make the decision to comply with customer requests. In this paper, a unique type of customer request is studied: the “gray” request, a request in which the employee is asked to do something that is outside of their job description or outside of what they would normally do to deliver the service (but not something that is fraudulent or illegal). This research develops the gray request concept and provides a conceptual model to explain the circumstances by which gray requests occur and employees comply. Twenty-three qualitative interviews with employees from two different service firms in different industries are conducted. Three main motivational categories relating to why employees respond favorably to gray customer requests emerge: (1) the desire to help others (2) the desire to help the company and (3) the desire to help themselves. The organizational, customer, employee, and situational dimensions that determine when and if employees will respond favorably include: (1) the organization’s culture, the norm of flexibility, and the reward/incentive system (2) the customer demographics (i.e., loyal customer; elderly) (3) the personality factors of the employee (i.e., allocentrism) and (4) the situational factors (ability, ease, legality, safety, time constraints, type of request, and urgency).
Vanishing Springs in Nepalese Mountains: Assessment of Water Sources, Farmers' Perceptions, and Climate Change Adaptation

The Thulokhola watershed of the Nuwakot district in the midhills region of Nepal can be considered typical of climate change-related stresses in the region. To assess the status of water resources and document farmers' perceptions of and adaptation to climate change impacts in this watershed, we invited community groups to monitor water quality and conducted 6 focus group meetings, 3 participatory rural appraisals, and spring and household surveys in 2011 and 2012. Historical precipitation data from a nearby weather station and discharge data for the Tadi Khola, the nearest major river, were also analyzed. The spring survey results confirmed farmers' perceptions and showed that 73.2% of the springs used as water sources had a decreased flow and 12.2% had dried up over the past 10 or more years, as recognized by local residents. In response to the severe decline of precipitation and the drying up of springs, local communities have implemented some climate change adaptation measures, such as constructing water tanks at water sources, using pipes to transport drinking water, diverting water from other springs, digging deeper wells, and traveling farther to wash clothes and fetch drinking water. To enhance drinking water supplies and ensure the agricultural, ecological, and environmental integrity of the watershed, initiatives such as comprehensive research on springs and groundwater hydrology, a spring rejuvenation program, and community capacity building for water sustainability and climate change adaptation are suggested.
Государственное образование: мотор или балласт? Обзор литературы о состоянии и истории государственного образования в США (Public Education and Economic Growth: The Engine or the Burden? Literature Review)

Russian Abstract: Представленные материалы отражают дискуссию о кризисе государственного (public) школьного образования в литературе последних десятилетий. Мнение о том что никакого кризиса нет а есть просто недостаток финансирования школ опровергается статистическими данными: десятки исследователей не смогли привести убедительные данные в пользу гипотезы о способности образования способствовать повышению темпов экономического роста. Собранные нами данные также не подтверждают такой зависимости. История внедрения государственного образования в США по прусскому образцу без сколько-нибудь тщательного изучения вопроса и сравнения заокеанского образца с лучшим отечественным опытом опровергает предположение о том, что сам факт внедрения свидетельствует в пользу государственной системы. Более того, за таковым внедрением легко просматриваются политические мотивы: попытка использовать школу для прививания ценностей традиционной элиты детям недавних иммигрантов. English Abstract: The paper contains review of discussion on crisis in public education in the US. Some authors opine that there are no actual crisis and all shortcomings of the system caused by lack of finances. The opinion contradicts the inability of statistical researches to show the education causes economic growth, not vice versa. The problems to bring evidences of existence positive externality for society caused by education pointed out by some researchers (Acemoglu, Engrist, 2000). Our datasets statistical analysis doesn't show any significant positive correlation between per capita GDP growth and educational attainment (enrollment). History of public education introduction in the US shows, the case can't prove advantages of public education vs. private. Prussian pattern was exploited without robust check and comparison with American best practices because political interest. Traditional elute was interested to shape the world vision and creed of new immigrants' children (to exploit the public school system as a melting pot).
A retrospective external validation study of the HEART score among patients presenting to the emergency department with chest pain.

Emergency physicians must be able to effectively prognosticate outcomes for patients presenting to the Emergency Department (ED) with chest pain. The HEART score offers a prognostication tool, but external validation studies are limited. We conducted an external retrospective validation study of the HEART score among ED patients presenting to our ED with chest pain from 1 January 2014 to 9 June 2014. We utilized chart review methodology to abstract data from each patient’s electronic medical record. We collected data relevant to each of the five elements of the HEART score: history, electrocardiogram (ECG) interpretation, patient age, patient risk factors, and troponin levels. We calculated the diagnostic accuracy of the HEART score (0–10) for predicting the primary outcome of major adverse cardiac events (MACE) over 6 weeks following the ED visit (coronary revascularization, myocardial infarction, or mortality). We randomly selected 10% of patient charts from which a second investigator abstracted all data to assess inter-rater reliability for all study variables. Of 625 charts reviewed, we abstracted data on 417 (66.7%) consecutive patients meeting study inclusion criteria. Thirty-one (7.4%) of these patients experienced 6-week MACE. We observed no instances of MACE within 6 weeks among subjects with a HEART score of 3 or less. The area under the receiver operator curve (AUROC) is 0.885 (95% confidence interval 0.838–0.931). Patients with a HEART score ≤3 are at low risk for 6-week MACE. Hence, these patients may be candidates for outpatient follow-up instead of inpatient admission for cardiac risk stratification.
Toll-like receptor variants and cervical Atopobium vaginae infection in women with pelvic inflammatory disease.

Problem Toll-like (TLR) receptor genetic variants have been implicated in bacterial vaginosis (BV). We determined whether TLR variants are associated with fastidious BV-associated microbes that are linked with infertility following pelvic inflammatory disease (PID). Method of study Sneathia spp., Atopobium vaginae, BVAB1, and Ureaplasma urealyticum were measured in 250 women from the PID Evaluation and Clinical Health (PEACH) study. Relative risk (RR) and 95% confidence intervals (CI) were calculated adjusting for chlamydia and gonorrhea. Principal component analysis was used to adjust for population stratification. A false discovery rate q-value of 0.05 was significant. Results TLR2-1733C>A (P = .003) and TLR2-616A>G (P = .004) were associated with cervical A. vaginae. TLR2-1733C>A and TLR6-438C>T were associated with A. vaginae detection in the endometrium, but this was not significant after adjustment for multiple comparisons (FDR q-value = 0.06). Conclusion Host gene variants in TLR2 signaling pathways were modestly associated with cervical A. vaginae in women with clinical PID.
Additional small dose of prostaglandin F2α at timed artificial insemination failed to improve pregnancy risk of lactating dairy cows.

Abstract Two experiments were performed to test the hypothesis that administering PGF2α concurrent with timed artificial insemination (AI) in lactating dairy cows would enhance pregnancy per AI (P/AI). In experiment 1, lactating Holstein cows (n = 289) in one herd were enrolled after a non-pregnancy diagnosis (30–36 d after AI) to synchronize subsequent ovulation before AI. Cows were assigned randomly to receive (im) 10 mg of PGF2α concurrent with timed AI (Day 0; treatment) or no injection (control). Blood samples were collected on Days −3, 0, and 13 to determine serum concentrations of progesterone. Ovaries were scanned via transrectal ultrasonography to determine follicle diameters (Day −3), subsequent ovulation risk (Day 13), and total volume of luteal tissue (Day 13). Diagnosis of pregnancy occurred on Days 32 and 80 after AI. Ovulation risk post-AI exceeded 90% and did not differ between treatments. In addition, PGF2α treatment only numerically increased progesterone (5.7 ± 0.3 vs. 6.2 ± 0.3 ng/mL) or luteal tissue volume (8.9 ± 0.4 vs. 9.8 ± 0.5 ng/mL) on Day 13 by 8.8% (P = .206) or 10.1% (P = .134) in control and treated cows, respectively. Pregnancy per AI at Days 32 (P = .50) and 80 (P = .33) did not differ between treatments. Cows with progesterone >0.5 ng/mL at timed AI had reduced (P
Retinal guanylyl cyclase activating protein 1 forms a functional dimer.

Retinal guanylyl cyclases (RetGCs) in vertebrate photoreceptors are regulated by the guanylyl cyclase activator proteins (GCAP1 and GCAP2). Here, we report EPR double electron-electron resonance (DEER) studies on the most ubiquitous GCAP isoform, GCAP1 and site-directed mutagenesis analysis to determine an atomic resolution structural model of a GCAP1 dimer. Nitroxide spin-label probes were introduced at individual GCAP1 residues: T29C, E57C, E133C, and E154C. The intermolecular distance of each spin-label probe (measured by DEER) defined restraints for calculating the GCAP1 dimeric structure by molecular docking. The DEER-derived structural model of the GCAP1 dimer was similar within the experimental error for both the Mg2+-bound activator and Ca2+-bound inhibitor states (RMSD < 2.0 A). The GCAP1 dimer possesses intermolecular hydrophobic contacts involving the side chain atoms of H19, Y22, F73 and V77. The structural model of the dimer was validated by GCAP1 mutations (H19R, Y22D, F73E, and V77E) at the dimer interface that each abolished protein dimerization. Previous studies have shown that each of these mutants either diminished or completely suppressed the ability of GCAP1 to activate the cyclase. These results suggest that GCAP1 dimerization may affect compartmentalization of GCAP1 in the photoreceptors and/or affect regulation of the cyclase activity.
Beyond the Human Terrain System: a brief critical history (and a look ahead)

This article provides a brief critical history of the Human Terrain System (HTS), a US Army counterinsurgency programme designed to embed anthropologists and other social scientists with combat bri...
Determination of MiRNA Targets in Skeletal Muscle Cells

MicroRNAs (miRNAs) are a class of small ∼22 nucleotide noncoding RNAs which regulate gene expression at the posttranscriptional level by either destabilizing and consequently degrading their targeted mRNAs or by repressing their translation. Emerging evidence has demonstrated that miRNAs are essential for normal mammalian development, homeostasis, and many other functions. In addition, deleterious changes in miRNA expression were associated with human diseases. Several muscle-specific miRNAs, including miR-1, miR-133, miR-206, and miR-208, have been shown to be important for normal myo-blast differentiation, proliferation, and muscle remodeling in response to stress. They have also been implicated in various cardiac and skeletal muscular diseases. miRNA-based gene therapies hold great potential for the treatment of cardiac and skeletal muscle diseases. Herein, we describe methods commonly applied to study the biological role of miRNAs, as well as techniques utilized to manipulate miRNA expression and to investigate their target regulation.
Modulation of the Stimulation-Evoked Release of 3H-Dopamine Through Activation of Dopamine Autoreceptors of the D-2 Subtype in the Isolated Rabbit Retina

ABSTRACT In the isolated rabbit retina the release of 3H-dopamine elicited by electrical stimulation is regulated through activation of inhibitory dopamine autoreceptors. The relative order of potencies of dopamine receptor agonists to inhibit the stimulation-evoked 3H-dopamine release is: pergolide > apomorphine > bromocryptine > N,N-di-n-propyl-dopamine (DPDA) > dopamine. The relative order of potencies of dopamine receptor antagonists to increase 3H-dopamine release is: S-sulpiride > domperidone > spiroperidol > metoclopramide > fluphenazine > R-sulpiride. Both stereoisomers of flupenthixol and butaclamol were inactive at concentrations up to 10 μM. Our results suggest that the dopamine inhibitory autoreceptor involved in the regulation of dopamine release from the isolated rabbit retina possesses the characteristics of a D-2 receptor since 1) dopamine, apomorphine and dopaminergic ergot compounds are agonists in nanomolar concentrations and 2) the selective D-2 antagonists (S-sulpiride, metoclopramide and domperidone) increase dopaminergic neurotransmission, while the stereoisomers of butaclamol and flupenthixol are inactive in this respect.
Viewing evidence of harm accompanying uses of glyphosate-based herbicides under US legal requirements

Some epidemiological experts feel there is sufficient proof that glyphosate use adversely affects human health, and glyphosate has been labeled as probably carcinogenic by the International Agency for Research on Cancer. Federal law in the United States provides two major options under which health concerns about glyphosate use might be addressed. First, registrations of glyphosate-based herbicides (GBHs) need to be cancelled if the costs are greater that its benefits. Since the cancellation of GBH registrations in the United States would lead to higher maize and soybean prices that would adversely affect food security, further analyses are needed. Second, US law requires consideration of the human dietary risk from pesticide residues, and tolerances of allowable amounts of glyphosate residues allowed to remain in or on food items have been established. Social cost curves depicting three options for regulating GBHs show preferred strategies dependent upon the magnitude of adverse effects on human health and food insecurity. Measures to reduce harm to humans can be identified to ameliorate health damages to allow some uses of GBHs to continue, but only if the evidence supports the conclusion that "no harm will result from aggregate exposure to the pesticide chemical residue."
Staufen1 links RNA stress granules and autophagy in a model of neurodegeneration

Spinocerebellar ataxia type 2 (SCA2) is a neurodegenerative disease caused by expansion of polyglutamine tract in the ATXN2 protein. We identified Staufen1 (STAU1) as an interactor of ATXN2, and showed elevation in cells from SCA2 patients, amyotrophic lateral sclerosis (ALS) patients, and in SCA2 mouse models. We demonstrated recruitment of STAU1 to mutant ATXN2 aggregates in brain tissue from patients with SCA2 human brain and in an SCA2 mouse model, and association of STAU1 elevation with dysregulation of SCA2-related transcript abundances. Targeting STAU1 in vitro by RNAi restored PCP2 transcript levels and lowering mutant ATXN2 also normalized STAU1 levels. Reduction of Stau1 in vivo improved motor behavior in an SCA2 mouse model, normalized the levels of several SCA2-related proteins, and reduced aggregation of polyglutamine-expanded ATXN2. These findings suggest a function for STAU1 in aberrant RNA metabolism associated with ATXN2 mutation, suggesting STAU1 is a possible novel therapeutic target for SCA2.
Analysis of cavopulmonary and cardiac flow characteristics in fontan Patients: Comparison with healthy volunteers.

BACKGROUND Characterizing the flow of the Fontan circuit, and correlating flow characteristics with the development of complications, is an important clinical challenge. Past work has analyzed the flow characteristics of Fontan circulation on a component-by-component basis. 4D flow MRI with radial projections allows for large volumetric coverage, and therefore can be used to analyze the flow through many codependent cardiovascular components in a single imaging session. PURPOSE To describe flow characteristics across the entire Fontan circuit and to compare these with the flow characteristics in healthy volunteers. STUDY TYPE Prospective. SUBJECTS Eleven single ventricle patients with a Fontan connection and 15 healthy controls. SEQUENCE Phase contrast with vastly undersampled isotropic projection reconstruction (PC-VIPR) at a field strength of 3 T. ASSESSMENT Cavopulmonary and ventricular flow distributions, blood flow kinetic energy, vorticities, efficiency indices, and other flow parameters were analyzed using Ensight and MatLab. STATISTICAL TESTS The results were compared across Fontan subjects, between respiratory phases, and between Fontan subjects and healthy volunteers using a Student's t-test for unequal sample sizes and linear regression. RESULTS Cava-specific pulmonary flow distributions of Fontan patients varied significantly between respiratory phases (P < 0.05). Ventricular kinetic energy (KE) was significantly higher in Fontan patients than it was in healthy controls, leading to a lower cardiac efficiency metric in the Fontan group. A significant diastolic KE time-shift was also observed in the Fontan patient group. Peak diastolic KE was significantly higher in the single ventricle of patients with right ventricle morphology than it was in left ventricle morphology patients. DATA CONCLUSION Radial 4D flow MRI can be used for comprehensive analysis of single ventricle Fontan flow characteristics. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019.
Total Syntheses of (+)-Trienomycins A and F via a Unified Strategy

The first total syntheses of (+)-trienomycins A and F, representative members of a new class of cytotoxic ansamycin antibiotics, have been achieved. Key features of the unified synthetic scheme included incorporation of the (E,E,E)-triene unit with concomitant macrocyclization via a novel bis-Wittig olefination and the use of (2,2,2-trichloroethoxy)methyl protecting group for the secondary amide.
CSR-induced emittance growth in achromats: Linear formalism revisited

We review the R-matrix formalism used to describe Coherent Synchrotron Radiation (CSR)-induced projected emittance growth in electron beam transport lines and establish the connection with a description in terms of the dispersion-invariant function.
Chapter 3 – Synaptic Transmission

In this chapter, we will first discuss chemical synapses, which use chemical signaling to convey information between the pre- and postsynaptic neurons, and then we will look at electrical synapses, which are a more basic but important second type of synapse that relies on direct electrical signaling. The previous chapters “Membrane Voltage” and “Dynamics of the Action Potential” provide important background for this chapter.
COVID-19 preparedness in hospice and palliative care

Background: Due to the emergence of COVID-19 and resulting pandemic, there is an increased demand for palliative care and hospice care services However, the impact of COVID-19 on the hospice and palliative agencies is unknown Methods: An electronic survey was disseminated via the Hospice & Palliative Nurses Association newsletter, posted to the Sigma Theta Tau Hospice and Palliative Care Community Group discussion board and advertised through social media from May 7-28, 2020 Summary statistics were computed Results: We collected 36 surveys representing all U S regions Most respondents (78%) reported that their agency has cared for confirmed COVID-19 patients Only half of agencies had access to laboratory facilities for surveillance and detection of the presence of outbreaks in both patients and staff (58%) and the ability to test patients and providers for COVID-19 (55%) Due to COVID-19, participants stated that the agency added new protocols regarding aerosol-generating procedures policies (58%), use of surface barriers (61%) and PPE usage (e g donning and doffing) in patient homes (56%) The majority (76%) reported that their agency required field clinicians to call ahead to ascertain COVID-19 exposure/symptoms before a home visit More than half (58%) reported that their agency lacked supplies, including N95 respirators (45%), cleaning/disinfectant product (23%), alcohol based sanitizer (18%), eye protection (18%), gowns (18%), and surgical masks (14%) Overall, participants shared that field clinicians had to reuse (76%), extend (73%) or ration (30%) PPE supplies Respondents reported that their agency accessed supplemental PPE through state/ local resources (67%), private/community donations (67%), and do-it-yourself efforts (55%) One third (31%) reported that their agency was experiencing staffing shortages due to COVID-19;of these, 60% reported that shortages were due to staff infected with/quarantined due to COVID-19 Conclusion: Our findings suggest that COVID-19 has presented significant challenges for palliative care and hospice agencies as they provide care to patients and families at an unprecedented rate