cssi/SciSciGPT-SciSciNet huggingface dataset:
Relationship between perceived cognitive dysfunction and objective neuropsychological performance in persons with rheumatoid arthritis.

Objective Research shows a gap between perceived cognitive dysfunction and objective neuropsychological performance in persons with chronic diseases. We explored this relationship in persons with rheumatoid arthritis (RA). Methods Individuals from a longitudinal cohort study of RA participated in a study visit that included physical, psychosocial, cognitive, and biologic metrics. Subjective cognitive dysfunction was assessed using the Perceived Deficits Questionnaire (PDQ; range 0–20, where higher scores = greater perceived impairment). Objective cognitive impairment was assessed using a battery of 12 standardized neuropsychological measures yielding 16 indices. On each test, subjects were classified as impaired if they performed 1 SD below the age-based population norms. Total cognitive function scores were calculated by summing the transformed scores (range 0–16, where higher scores = greater impairment). Multiple linear regression analyses determined the relationship of the total cognitive function score with the PDQ score, controlling for sex, race, marital status, income, education, disease duration, disease severity, depression, and fatigue. Results One hundred twenty subjects (mean ± SD age 58.5 ± 11.0 years) were included. Mean ± SD scores of total cognitive function and the PDQ were 2.5 ± 2.2 (range 0–10) and 5.8 ± 3.8 (range 0–16), respectively. In multivariate analysis, there was no significant relationship between the total cognitive function score and the PDQ score. However, depression and fatigue (β = 0.32, P < 0.001 and β = 0.31, P = 0.001, respectively) were significantly associated with the PDQ score. Conclusion The findings emphasize the gap between subjective and objective measures of cognitive impairment and the importance of considering psychological factors within the context of cognitive symptoms in clinical settings.
Applying Transdisciplinary Research Strategies to Understanding and Eliminating Health Disparities

This overview for the special issue of Health Education & Behavior on "Health Disparities and Social Inequities" briefly outlines the transdisciplinary (TD) approach to research and examines the scope of TD science. The need to embrace basic science as well as several domains of applied research is discussed along the TD "pipeline" from discovery to development to delivery to policy. The overview concludes with selected examples of the emerging TD science of disparities. One central challenge for a TD approach is the need to strengthen what is being called "the science of dissemination" along with improving the "dissemination of evidence-based science."
Calibrated Peer Review for Interpreting Linear Regression Parameters: Results from a Graduate Course

Biostatistics is traditionally a difficult subject for students to learn. While the mathematical aspects are challenging, it can also be demanding for students to learn the exact language to use to correctly interpret statistical results. In particular, correctly interpreting the parameters from linear regression is both a vital tool and a potentially taxing topic. We have developed a Calibrated Peer Review (CPR) module to aid in learning the intricacies of correct interpretation for continuous, binary, and categorical predictors. Student results in interpreting regression parameters for a continuous predictor on midterm exams were compared between students who had used CPR and historical controls from the prior course offering. The risk of mistakenly interpreting a regression parameter was 6.2 times greater before the introduction of the CPR module (p=0.04). We also assessed when learning took place for a specific item for three students of differing capabilities at the start of the assignment. All three demonstrated achievement of the goal of this assignment; that they learn to correctly evaluate their written work to identify mistakes, though one did so without understanding the concept. For each student, we were able to qualitatively identify a time during their CPR assignment in which they demonstrated this understanding.
Treatment of concurrent metastatic renal cell carcinoma and chronic myelogenous leukemia--easier said than done? A case report

Treating two active malignancies concurrently can be exceedingly difficult. Complications can occur from the different treatment regimens, especially if they share common targets, and the progressing diseases can make managing treatment side-effects even more challenging. We report a case of a patient with coexisting CML and mRCC who progressed on multiple lines of mRCC therapy while experiencing significant dose limiting side-effects.
Multifocal Tracheal Chondromata

Chondromata of the trachea occur rarely. There are only 10 prior case reports in the literature, all of which have been of unifocal chondromata. We present the first case report, to our knowledge, of multifocal tracheal chondromata in a patient with laryngopharyngeal reflux. Evaluation, diagnosis, and management are discussed.
Integrated development environments: technological and behavioral productivity perceptions

An empirical study of computer-aided software-engineering (CASE) technology productivity perceptions of information systems professionals. In a PC-based survey, fifteen CASE technological functions were compared along with two behavioral functions using the method of paired comparison. A rank ordering of the results revealed that data-flow diagramming and the data dictionary maintenance technological functions were perceived to most improve the respondent's productivity over comparable manual methods. Two behavioral functions, communication with other team members and adherence to the enterprise's information systems development standards, were regarded as providing significantly less productivity improvement compared to 47.75% of the other stimuli or significantly more productivity improvement compared to 47.75% of the other stimuli, respectively is described. >
Delayed skin grafting in head and neck surgery

Summary Today, surgery for carcinoma of the head and neck frequently requires the use of large rotation flaps that leave a defect that must be covered by a split-thickness skin graft. The graft can be performed immediately, or delayed for several days. The chief disadvantage to immediate grafting is the biological differential or readiness for take between the recipient site and the graft, a factor that can jeopardize the take. The rationale for delayed grafting is related to the use of the optimal biological readiness of recipient site and graft to take. The author outlines his technique for deliberately delayed grafting, cutting the split-thickness skin graft at the time of initial surgery, but leaving it on the donor site. The grafting is performed in from 48 to 72 hours later on the patient in his hospital room, without anesthesia. Among the numerous advantages of this technique are a saving of time, cost, and suturing, avoidance of bulky dressing and hematoma formation, and extremely good results, far superior to those of immediate grafing.
Microwave superconductivity part 1: History, properties and early applications

The 100th anniversary of superconductivity will be celebrated during 2011. As part of this celebration, a Special Session has been scheduled for IMS 2011 to commemorate this event and highlight the potential impact of superconductivity on electronic technologies, especially in the microwave and terahertz frequencies regimes. In this paper, Part 1, the history, properties and some early high frequency applications of superconductivity will be reviewed, while in Part 2, current and future applications will be discussed.
On Complemented Lattices

In a paper on the foundation of quantum mechanics, Kodi Husimi(1) conjectured that a lattice with a negation is modular if the chain law holds for every sublattice closed with respect to relative negation. Although the theorem in this form does not hold, as we show by an example, we prove a theorem of a similar nature for relatively complemented lattices.
Interest in health behavior intervention delivery modalities among cancer survivors: A cross-sectional study

Background: Effective, broad-reaching channels are important for the delivery of health behavior interventions in order to meet the needs of the growing population of cancer survivors in the United States. New technology presents opportunities to increase the reach of health behavior change interventions and therefore their overall impact. However, evidence suggests that older adults may be slower in their adoption of these technologies than the general population. Survivors’ interest for more traditional channels of delivery (eg, clinic) versus new technology-based channels (eg, smartphones) may depend on a variety of factors, including demographics, current health status, and the behavior requiring intervention. Objective: The aim of this study was to determine the factors that predict cancer survivors’ interest in new technology-based health behavior intervention modalities versus traditional modalities. Methods: Surveys were mailed to 1871 survivors of breast, prostate, and colorectal cancer. Participants’ demographics, diet and physical activity behaviors, interest in health behavior interventions, and interest in intervention delivery modalities were collected. Using path analysis, we explored the relationship between four intervention modality variables (ie, clinic, telephone, computer, and smartphone) and potential predictors of modality interest. Results: In total, 1053 respondents to the survey (56.3% response rate); 847 provided complete data for this analysis. Delivery channel interest was highest for computer-based interventions (236/847, 27.9% very/extremely interested) and lowest for smartphone–based interventions (73/847, 8.6%), with interest in clinic-based (147/847, 17.3%) and telephone-delivered (143/847, 16.9%) falling in between. Use of other technology platforms, such as Web cameras and social networking sites, was positively predictive of interest in technology-based delivery channels. Older survivors were less likely to report interest in smartphone–based diet interventions. Physical activity, fruit and vegetable consumption, weight status, and age moderated relationships between interest in targeted intervention behavior and modality. Conclusions: This study identified several predictors of survivor interest in various health behavior intervention delivery modalities. Overall, computer-based interventions were found to be most acceptable, while smartphones were the least. Factors related to survivors’ current technology use and health status play a role in their interest for technology-based intervention versus more traditional delivery channels. Future health behavior change research in this population should consider participants’ demographic, clinical, and lifestyle characteristics when selecting a delivery channel. Furthermore, current health behavior interventions for older cancer survivors may be best delivered over the Internet. Smartphone interventions may be feasible in the future following further adoption and familiarization by this particular population.
A comparison of the physical behavior of normal articular cartilage and the arthroplasty surface.

A study of the rabbit metatarsophalangeal joints with arthroplasty surface and normal articular cartilage was done by using compression testing to compare the elastic and viscoelastic behaviors of these two surfaces. Consistent differences were observed. Articular cartilage exhibited less instantaneous deformation than the arthroplasty surface, that is, the cartilage was stiffer. Both the rate and magnitude of time-dependent deformation under constant load (creep) of the articular cartilage were less than that of the arthroplasty surface. These differences increased significantly as a function of load. However, within the range of three to twelve-month-old anthroplasties, the viscoelastic behavior remained approximately constant. Mechanical analogues were constructed in an attempt to characterize the physical behaviors of these tissues, and mathematical relations of the experimental data to the analogues were developed. The loading range used in this study was not felt to exceed physiological limits as no plastic or permanent deformation was observed. Our findings show that cartilage is superior to the anthroplasty surface for resistance to and for recovery from the repetitive and rapid deformations which might be experienced in normal joint function Clinical experience supports this finding. The difference in elastic and viscoelastic behaviors was related to histological and biochemical differences of the two surfaces.
Should human milk for premature children be fortified after discharge to improve neurodevelopmental outcomes

reported a paradox between preterm infantsfed with human milk that grew less during hospitalizationcompared to formula fed infants, but had better neurode-velopment in the ﬁrst few years of life; however, the groupthat was breastfed had higher birth weight, although theauthors controlled for growth restriction and socioeconomicstatus.Use of fortiﬁed human milk during the NICU stay hasdemonstrated improvement in growth in preterm infants
Iterative Deblending of Simultaneous-Source Seismic Data Using Shaping Regularization

We introduce a new iterative estimation scheme for separation of blended seismic data from simultaneous sources. We first construct an augmented estimation problem, then use shaping regularization to constrain the model when iteratively solving the problem. Both model and data in the estimation problem correspond to different seismic sources. In the case of two sources, the forward operator is a block operator composed of two identity operators, one blending operator and one inverse blending operator. The shaping operator used in our method is soft thresholding in the seislet domain, where useful seismic signals stand compact and sparse. Numerically-blended synthetic and field datasets demonstrate an excellent performance of the proposed algorithm.
Minimally Invasive Delivery of a Novel Direct Epicardial Assist Device in a Porcine Heart Failure Model

ObjectiveDespite advances in design, modern ventricular assist device placement involves median sternotomy and cardiopulmonary bypass and is associated with infectious/embolic complications. In thi...
Stallings island revisited : New evidence for occupational history, community pattern, and subsistence technology

For nearly 150 years Stallings Island, Georgia has figured prominently in the conceptualization of Late Archaic culture in the American Southeast, most notably in its namesake pottery series, the oldest in North America, and more recently, in models of economic change among hunter-gatherer societies broadly classified as the Shell Mound Archaic. Recent field-work resulting in new radiocarbon assays from secure contexts pushes back the onset of intensive shellfish gathering at Stallings Island several centuries; enables recognition of a hiatus in occupation that coincides with the regional advent of pottery making; and places abandonment at ca. 3500 B.P. Analysis of collections and unpublished field records from a 1929 Peabody expedition suggests that the final phase of occupation involved the construction of a circular village and plaza complex with household storage and a formalized cemetery, as well as technological innovations to meet the demands of increased settlement permanence. Although there are too few data to assess the degree to which more permanent settlement led to population-resource imbalance, several lines of evidence suggest that economic changes were stimulated by ritual intensification.
Abstract 48: Directing glutamine and glucose metabolism with troglitazone and EGCG limits MCF-7 cell growth

Proceedings: AACR 101st Annual Meeting 2010‐‐ Apr 17‐21, 2010; Washington, DC Tumor cell growth requires balanced glutaminolysis and glycolysis which in turn subserve mitochondrial membrane potential (Ψm) and cell growth (DNA synthesis). Troglitazone (TRO) reduces Ψm by 72% (p 40% reduction in cellular proliferation consistent with a shift of glucose from glycolysis (5,261± 512 to 3,635±478 nmol/mg, p<0.05) supporting proliferation (lac/glc=0.60 to 0.46) to maintaining Ψm in place of glutamate. These results point to an interrelationship of glutamine and glucose metabolism in supporting Ψm in cancer cells and suggest that shifting Ψm dependency to GDH flux with TRO while blocking this flux with EGCG may limit tumor growth. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 48.
GIS and the A'i of Colombia: Reserves, Resguardos and the Future

This paper presents the work of the WCS with the A'i Indigenous people in Colombia as part of a USAID-funded project between 2009 and 2011. The project had several dimensions that make it unusual. Unlike conventional "counter-mapping" attempts to represent Indigenous land claims as a counter to government representations, the project sought to create maps and analyses that represent prior land assignments to the A'i by the Colombian government itself. These land assignments were not supported by geo-referenced maps and, in the case of Indigenous "reserves" the original boundary markers were only known to the oldest of the A'i people. Analysis of forest cover in lands controlled by the A'i reveal that they are highly protective of forests; indeed their collective identity is strongly related to forest cover. The process described also illustrates the difficult position many Indigenous Amazonians face in an era of drug wars, uncontrolled colonization, and in the case of Colombia, the lack of follow-up to the political and social measures envisioned in the 1991 Constitution.
Models, Measurement, and Strategies in Developing Critical-Thinking Skills

Health care professionals must use critical-thinking skills to solve increasingly complex problems. Educators need to help nurses develop their critical-thinking skills to maintain and enhance their competence. This article reviews various models of critical thinking, as well as methods used to evaluate critical thinking. Specific educational strategies to develop nurses' critical-thinking skills are discussed. Additional research studies are needed to determine how the process of nursing practice can nurture and develop critical-thinking skills, and which strategies are most effective in developing and evaluating critical thinking.
Corticosteroids prevented atrial fibrillation after cardiac surgery.

Source Citation Halonen J, Halonen P, Jarvinen O, et al. Corticosteroids for the prevention of atrial fibrillation after cardiac surgery: a randomized controlled trial. JAMA. 2007;297:1562-7. 17426275
A burst in a wind bubble and the impact on baryonic ejecta: high-energy gamma-ray flashes and afterglows from fast radio bursts and pulsar-driven supernova remnants

Tenuous wind bubbles, which are formed by the spin-down activity of central compact remnants, are relevant in some models of fast radio bursts (FRBs) and super-luminous supernovae. We study their high-energy signatures, focusing on the role of pair-enriched bubbles produced by young magnetars, rapidly-rotating neutron stars, and magnetized white dwarfs. (i) First, we study the nebular properties and the conditions allowing for escape of high-energy gamma-rays and radio waves, showing that their escape is possible for nebulae with ages of >10-100 yr. In the rapidly-rotating neutron star scenario, we find that radio emission from the quasi-steady nebula itself may be bright enough to be detected especially at sub-mm frequencies, which is relevant as a possible counterpart of pulsar-driven SNe and FRBs. (ii) Second, we consider the fate of bursting emission in the nebulae. We suggest that an impulsive burst may lead to a highly relativistic flow, which would interact with the nebula. If the shocked nebula is still relativistic, pre-existing non-thermal particles in the nebula can be significantly boosted by the forward shock, leading to short-duration (maybe millisecond or longer) high-energy gamma-ray flashes. Possible dissipation at the reverse shock may also lead to gamma-ray emission. (iii) After such flares, interactions with the baryonic ejecta may lead to afterglow emission with a duration of days to weeks. In the magnetar scenario, this burst-in-bubble model leads to the expectation that nearby (<10-100 Mpc) high-energy gamma-ray flashes may be detected by HAWC and CTA, and the subsequent afterglow emission may be seen by radio telescopes such as VLA. (iv) Finally, we discuss several implications specific to FRBs, including constraints on the emission regions and limits on soft gamma-ray counterparts.
Training for Transfer: Guidelines for Promoting Flexible Use of Trained Skills

Preparation of this manuscript was supported in part by Grants HD-05951 and HD-15808 from the National Institute of Child Health and Human Development and by Fellowship funds from the Spencer Foundation awarded to the first author during her tenure at the Center for Advanced Study in the Behavioral Sciences, Stanford.
Local Structure of Bulk and Nanocrystalline Semiconductors Using Total Scattering Methods

We describe the use of total scattering atomic pair distribution function (PDF) methods to study the nanoscale structure of semiconductors. We give a broad introduction to the method and illustrate the kind of information that can be obtained by using a number of examples where the method has been applied to semiconductors. In particular, the approach yields valuable information beyond crystallography about the local structure, defects and atomic disorder, nanoscale substructures in bulk materials, and the atomic structure, size, defects, and strain of tiny nanoparticles (NPs).
Educational Attainment Of Language Minorities In The United States

Language minority adults in the United States who usually speak their native languages are less than half as likely to have completed high school or to have attended college as people with English language backgrounds. They are more than ten times as likely to be among the five million people in the United States with fewer than five years of schooling. However, foreign-born people with the same language characteristics have generally higher rates of high school completion and attendance in college than their cousins who were bom here, in Puerto Rico or in other outlying areas of the United States. These are some of the findings in the continuing study of the 1976 Survey of Income and Education in which the National Center for Education Statistics (NCES) collaborated with the U.S. Bureau of the Census to obtain information about the characteristics and educational status of the approximately 28 million people in this country who have language backgrounds other than English.
Targeting the Gut Microbiota–FXR Signaling Axis for Glycemic Control: Does a Dietary Supplement Work Magic?

Glucose-dependent organs such as the brain are sustained through periods of fasting by glucose production in the liver, called hepatic gluconeogenesis. Normally, rising blood glucose levels homeostatically suppress gluconeogenesis. In obesity-related type 2 diabetes, however, insulin resistance and elevated glucagon inhibit the suppression of gluconeogenesis, contributing to hyperglycemia. Therapeutic intervention to suppress hepatic gluconeogenesis is therefore clinically important for controlling glucose in type 2 diabetes. Recent studies have suggested that the bile acid−farnesoid X receptor (FXR) signaling axis is a potential therapeutic target for metabolic disorders, including hyperglycemia caused by elevated hepatic gluconeogenesis (1,2). Bile acids are synthesized in the liver from cholesterol as conjugates of taurine (in mice) or glycine (in humans) and delivered to the gut to facilitate solubilization of dietary lipids and vitamins. Bile acids and their metabolites also function as endogenous ligands of FXR, a ligand-activated transcription factor highly expressed in the liver and the intestine. Bile acid−FXR signaling provides negative feedback control of bile acid production and transport to maintain bile acid homeostasis (3). Moreover, the bile acid−FXR signaling axis has been shown to regulate fat and glucose metabolism (4–7). Comparative analysis of global, liver-specific, and intestine-specific FXR knockout mice revealed a complex signaling network, wherein activation of the liver FXR and intestinal FXR result in distinct metabolic outcomes in diet-induced or genetic obesity models (6,8–12). In particular, several recent studies indicate that selective inhibition of intestinal FXR improves metabolic phenotypes in obese animals (9 …
Decision Making on the Labor and Delivery Unit: An Investigation of Influencing Factors:

Objective The aim of this study was to describe the relationship between negative affect (NA), decision-making style, time stress, and decision quality in health care. Background Health care providers must often make swift, high-stakes decisions. Influencing factors of the decision-making process in this context have been understudied. Method Within a sample of labor and delivery nurses, physicians, and allied personnel, we used self-report measures to examine the impact of trait factors, including NA, decision-making style, and perceived time stress, on decision quality in a situational judgment test (Study 1). In Study 2, we observed the influence of state NA, state decision-making style, state time stress, and their relationship with decision quality on real clinical decisions. Results In Study 1, we found that trait NA significantly predicted avoidant decision-making style. Furthermore, those who were higher on trait time stress and trait avoidant decision-making style exhibited poorer decisions. In Study 2, we observed associations between state NA with state avoidant and analytical decision-making styles. We also observed that these decision-making styles, when considered in tandem with time stress, were influential in predicting clinical decision quality. Conclusion NA predicts some decision-making styles, and decision-making style can affect decision quality under time stress. This is particularly true for state factors. Application Individual differences, such as affect and decision-making style, should be considered during selection. Training to reduce time stress perceptions should be provided.
Factors affecting bee communities in forest openings and adjacent mature forest

Anthropogenic disturbance of habitat is considered a contributing factor of pollinator declines, but some disturbances such as silviculture, may have positive implications for pollinator communities. Silviculture is a key source of disturbance in the eastern USA and thus, developing a better understanding of its ramifications for these keystone species is important for effective ecosystem conservation. We sampled bees in 30 forest openings created by group selection harvest as well as 30 sites in adjacent mature forest to examine the extent to which small forest openings support bees, to identify environmental variables influencing bee abundance and diversity, and to gauge their potential to augment bee populations in adjacent unmanaged forest. Bees were significantly more abundant and diverse in forest openings than in mature forest, but species composition did not differ. There was no relationship between opening size and abundance or diversity of bees in openings or adjacent mature forest. Both abundance and diversity were generally positively related to the amount of early-successional habitat on the landscape. Within openings, overall abundance and diversity decreased with vegetation height and increased with a metric representing floral richness and abundance. Notably, social, soft-wood-nesting, and small bees exhibited the opposite pattern in adjacent forest, increasing with vegetation height in openings and decreasing with greater floral richness and abundance within openings. Our results suggest that the creation of small forest openings helps to promote bees both in openings and adjacent mature forest, but this pattern is not consistent for all guilds.
Packaging Reliability Effect of ENIG and ENEPIG Surface Finishes in Board Level Thermal Test under Long-Term Aging and Cycling.

This study illustrates test results and comparative literature data on the influence of isothermal aging and thermal cycling associated with Sn-1.0Ag-0.5Cu (SAC105) and Sn-3.0Ag-0.5Cu (SAC305) ball grid array (BGA) solder joints finished with ENIG and ENEPIG on the board side and ENIG on the package side compared with ImAg plating on both sides. The resulting degradation data suggests that the main concern for 0.4 mm pitch 10 mm package size BGA is package side surface finish, not board side. That is, ENIG performs better than immersion Ag for applications involving long-term isothermal aging. SAC305, with a higher relative fraction of Ag3Sn IMC within the solder, performs better than SAC105. SEM and polarized light microscope analysis show cracks propagated from the corners to the center or even to solder bulk, which eventually causes fatigue failure. Three factors are discussed: IMC, grain structure, and Ag3Sn particle. The continuous growth of Cu-Sn intermetallic compounds (IMC) and grains increase the risk of failure, while Ag3Sn particles seem helpful in blocking the crack propagation.
Book Review: András Fejérdy, Editor, the Vatican “Ostpolitik” 1958–1978: Responsibility and Witness During John XXIII and Paul VI

A review of the book: The Vatican “Ostpolitik” 1958-1978: Responsibility and Witness during John XXIII and Paul VI.
Mechanism of HIV-1 Entry into CD4+ T Cells

Although the mechanism responsible for HIV-1 entry into susceptible CD4+ T cells is incompletely understood, a number of key components are now known. For example, the tropism of HIV-1 for cells expressing the CD4 membrane glycoprotein reflects the use of this protein as a specific viral receptor to which the HIV-1 gp120 envelope protein binds with high affinity. This binding apparently results in the exposure of hydrophobic domains of the gp41 transmembrane protein to apposing plasma membrane components, resulting in the fusion of viral and plasma membranes to one another which, in turn, releases HIV-1 RNA into the cytosol. This fusion event, which is requisite for viral entry as well as HIV-1 associated syncytia formation, occurs in a pH-independent fashion, but requires antecedent T cell activation. In the absence of T cell stimuli, resting CD4+ cells are resistant to HIV-1 entry, which may explain the observation that at any given time the vast majority of CD4+ T cells in HIV-1 seropositive patients are not infected despite the presence of relatively large quantities of free virus in the blood of such patients. The mechanism of HIV-1 entry into other CD4+ cell types, such as macrophages and dendritic cells, remains to be determined.
Oral anticoagulation may not be necessary for patients discharged in sinus rhythm after the Cox Maze IV procedure.

Abstract Objectives Oral anticoagulants have inherent risks. In the absence of clear evidence, anticoagulant use after surgical ablation for atrial fibrillation remains variable. This study examined patient outcomes with and without oral anticoagulants after successful surgical ablation. Methods From October 2011 to April 2016, 239 consecutive patients underwent biatrial Cox Maze IV operations for persistent atrial fibrillation. All patients received endocardial left atrial appendage obliteration. All patients discharged in sinus rhythm not requiring anticoagulation for preexisting or mechanical prosthetic reasons received antiplatelet therapy only. Neurologic end points were defined as any deficit of abrupt onset not resolving within 24 hours. Results Of 233 patients discharged, 57 received oral anticoagulants and 176 did not. Thirty-day mortality was 2.9%. Follow-up was 2.2 ± 1.3 years. During follow-up, 46 of 176 patients received anticoagulation, and 130 of 176 patients did not. In patients without mechanical valves, 87% were off anticoagulation at 1 year, 77% were off anticoagulation at 2 years, and 81% were off anticoagulation at 3 years. Return to sinus rhythm off antiarrhythmic drugs at 1, 2, and 3 years was 81%, 77%, and 68%, respectively. Of patients receiving anticoagulation during follow-up, 11 of 103 (11%) had major bleeds (1 fatal) and 2 (1.9%) developed stroke. In patients without anticoagulation for the entirety of follow-up, 1 stroke occurred at 21 months and 1 stroke occurred at 23 months postoperatively. Cumulative 4-year freedom from stroke in patients without anticoagulation was 97.5%. Conclusions Discharging patients who underwent Cox Maze IV in sinus rhythm without oral anticoagulants seems to be safe with a stroke rate of less than 1% per year. This management strategy will need further validation by prospective investigation.
Cradle-to-gate CO2e emissions vs. in situ CO2 sequestration of structural concrete elements

Abstract Life cycle assessment (LCA) is an emerging methodological tool used in building design and construction to quantify the environmental impacts of materials, components, and whole buildings. While calculation of embodied cradle-to-gate greenhouse gas (GHG) emissions is commonplace for ordinary portland cement (OPC) structural concrete elements in building-related LCAs, the carbon dioxide (CO2) sequestered by in situ carbonation of exposed OPC concrete is often neglected because the quantity of sequesterable CO2 is assumed trivial compared to the initial GHG emissions (kg CO2e) associated with their manufacture. Using a screening cradle-to-gate LCA and a previously developed and validated CO2 sequestration model for OPC concrete, this paper quantifies and compares estimates of the initial CO2e emissions to the CO2 sequestration potential of several OPC concrete elements at both finite (25 years) and infinite time intervals. The results demonstrate that, depending on cement type, compressive strength, structural geometry, and time, approximately 19%—a non-trivial sum—of initial CO2e emissions could be recoverable via CO2 sequestration for the concrete elements considered herein. Notably, however, concrete elements that sequester the most CO2 do not always result in the lowest net CO2e emissions.
Water nebulization in a non-rebreathing system during anaesthesia.

Humidity protects the integrity of the tracheobronchial mucociliary system during anaesthesia.1 This study compares humidification by heat versus nebulization.
Impact of the Presence of Select Cardiovascular Risk Factors on Cognitive Changes among Dementia Subtypes.

Background Studies have shown select associations between cardiovascular risk factors and dementia, but mostly focused on Alzheimer's Disease (AD). Objective We enhance these works by evaluating the relationship between the presence of cardiovascular risk factors and the rate of cognitive decline, measured using the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SUM) on four common dementia subtypes (AD, dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and vascular dementia (VaD), as well as non-demented elderly individuals (normal)). Method We used generalized linear mixed models with random intercepts to account for correlation at the patient and center levels for each dementia subtype adjusting for time since initial visit, baseline cognitive score, age, and demographic factors. The cardiovascular risk factors evaluated included body mass index, diabetes, years of smoking, atrial fibrillation, hypertension, and hypercholesterolemia. Results Patients diagnosed with AD (n=1899), DLB (n=65), FTD (n=168), or VaD (n=13); or lacked cognitive impairment (normal) (n=3583) were evaluated using data from the National Alzheimer's Coordinating Centers. Cardiovascular risk factors were associated with select dementia subtypes including AD and FTD. Using MMSE and CDR-SUM, recent or active hypertension and hypercholesterolemia were associated with a slower cognitive decline for AD patients, while higher body mass index and years of smoking were associated with a slower cognitive decline for FTD patients. However, several cardiovascular factors demonstrated associations with more rapid cognitive decline. Conclusion These results demonstrate disease specific associations and can provide clinicians guidance on predicted cognitive changes at the group level using information about cardiovascular risk factors.
Mapping semantic widgets to web-based, domain-specific collections

Domain-specific, online collections and digital libraries are often composed of richly structured content and modern content management systems make it easy to define multiple heterogeneous structures with similar semantics. But developers typically write code for each structure, a repetitive perhaps difficult process. In this paper, we present canonical structures, small schema fragments, consisting of unnamed entities, relationships, and attributes that can be instantiated into domain structures by providing names for all structural elements. Domain structures represent commonly occurring patterns within a given application domain that can be mapped repeatedly, as appropriate, to local structures. We formally define canonical and domain structures, mappings to local structures, and functionality. We have implemented several, generic semantic widgets using our approach in an operational educational web repository.
Assessment of the interaction between urokinase and reactive site mutants of protein C inhibitor.

Urokinase-type plasminogen activator (uPA) is a serine protease involved in pericellular proteolysis and tumor cell metastasis via plasmin-mediated degradation of extracellular matrix proteins. Plasma uPA is inhibited by the serine protease inhibitor protein C inhibitor (PCI) by the insertion of PCI's reactive site loop into the active site of the protease. To better understand the structural aspects of this inhibition, 15 reactive-site mutants of recombinant PCI (rPCI) were assayed for differences in uPA inhibition. These assays revealed that substitutions at the P1 Arg354 and P3 Thr352 sites of rPCI were detrimental to inhibitory activity, while P3′ Arg357 mutations had little effect upon the inhibition rate. However, replacement of the P2 Phe353 with small residues like Ala and Gly increased the effectiveness of rPCI three- to four fold. To explain these altered rates of inhibition, a computer-derived molecular model of uPA was generated and docked to a model of PCI to simulate complex formation. The changes made by mutagenesis were then recreated in the model of uPA–PCI. In accordance with the kinetic data, the poor performance of P3 variants is primarily attributable to charge repulsion, while alleviation of steric hindrance at P2 produces the observed increase in uPA inhibition. In the model, residues at P3′ interact with PCI rather than uPA, consistent with P3′ variants demonstrating that little variation from wild-type activity. Ultimately, this combination of mutagenesis and molecular modeling will further refine our understanding of the interaction between PCI and uPA.
Features of the structure, development, and activity of the zebrafish noradrenergic system explored in new CRISPR transgenic lines

The noradrenergic (NA) system of vertebrates is implicated in learning, memory, arousal, and neuroinflammatory responses, but is difficult to access experimentally. Small and optically transparent, larval zebrafish offer the prospect of exploration of NA structure and function in an intact animal. We made multiple transgenic zebrafish lines using the CRISPR/Cas9 system to insert fluorescent reporters upstream of slc6a2, the norepinephrine transporter gene. These lines faithfully express reporters in NA cell populations, including the locus coeruleus (LC), which contains only about 14 total neurons. We used the lines in combination with two-photon microscopy to explore the structure and projections of the NA system in the context of the columnar organization of cell types in the zebrafish hindbrain. We found robust alignment of NA projections with glutamatergic neurotransmitter stripes in some hindbrain segments, suggesting orderly relations to neuronal cell types early in life. We also quantified neurite density in the rostral spinal cord in individual larvae with as much as 100% difference in the number of LC neurons, and found no correlation between neuronal number in the LC and projection density in the rostral spinal cord. Finally, using light sheet microscopy, we performed bilateral calcium imaging of the entire LC. We found that large-amplitude calcium responses were evident in all LC neurons and showed bilateral synchrony, whereas small-amplitude events were more likely to show interhemispheric asynchrony, supporting the potential for targeted LC neuromodulation. Our observations and new transgenic lines set the stage for a deeper understanding of the NA system.
Abundance matching for low-mass galaxies in the CDM and FDM models

Abundance matching between galaxies and halos has proven to be an informative technique, less dependent on detailed physical approximations than some other methods. We extend the discussion to the dwarf galaxies realm and to the study of the alternative hypothesis that the dark matter is composed of ultra--light particles: Fuzzy Dark Matter. We find that, given current observations, both CDM and FDM have difficulties with dwarf systems in the local group, but that, if mechanisms are proposed to alleviate these difficulties, they make radically different predictions for FDM and CDM at high redshift. These differences should allow clear observational tests with currently planned experiments, with the number of galaxies per unit volume with stellar mass over $10^6$ M$_{\odot}$ lower in FDM by factors of ($10^{-2.7},10^{-2.0},10^{-1.7},10^{-0.7},10^{-0.1}$) at $z=(10,8,6,4,2)$.
Sociophysiology as the basic science of psychiatry.

The medical specialty of psychiatry should possess a basic science in which pathologies are considered deviations from normal brain physiology. Historically, psychoanalytic pathogenesis was considered separately from brain physiology. It was not scientific because observations could not be refuted. Countering this, Eli Robins's legacy stemmed partly from his having been damaged by a psychoanalyst. It eschewed pathogenesis. Attempting to integrate psychiatry with medicine more generally, Robins and colleagues refocused on empiricism, although they acknowledged the brain's centrality. Here I hold that the term biology used in the context of psychiatry should broadly encompass social facets of organismal function. The term “sociophysiology” may best describe the central basic science of psychiatry because it alludes to brain functions used for the person's social realm. Disruptions of such functions result in deviant behaviors and unpleasant feelings which psychiatrists diagnose and treat. Future study encompassing top-down and bottom-up research should include genome-neural-behavioral analyses.
Loyalty, longevity and a community of influence: Playmaking with urban youth

This article explores the factors influencing extended commitment by urban young people to a community playmaking group. EmersonTHEATRE is a project in its fifth year of creating devised theatre wi...
Rabies-like neuronal inclusions in a dog with meningoencephalomyelitis and neuritis of unknown origin

A four-year-old intact female pointer dog from a hunting plantation in South Georgia, USA, developed acute neurological signs. The referring veterinarian suspected rabies or pseudorabies; the dog was euthanased and submitted to the Tifton Veterinary Diagnostic and Investigational Laboratory for necropsy. No gross anatomical changes were present. Portions of brain were submitted for rabies virus fluorescent antibody test with a negative result. Histopathology revealed a marked lymphoplasmacytic meningoencephalitis with numerous intracytoplasmic eosinophilic inclusions within neurons, still raising concerns for rabies meningoencephalitis. Rabies immunohistochemistry was then performed on the brain, yielding a negative result. Brain samples were also negative for canine distemper virus and herpesvirus (pan-herpesvirus primers) PCR. Electron microscopy did not reveal viral particles within the inclusions. Similar intraneuronal pseudoinclusions have been previously reported in non-rabid dogs and cats. Such inclusions are a diagnostic challenge, especially in animals with central neurological signs and/or meningoencephalitis.
Preoperative Sleep Questionnaires Identify Medical Emergency Team Activation in Older Adults

Abstract Patients with obstructive sleep apnea (OSA) have increased postoperative complications that are important for patient safety and healthcare utilization. Questionnaires help identify patients at risk for OSA; however, among older adults who preoperatively self-administered OSA questionnaires, the frequency of postoperative Medical Emergency Team Activation (META), rapid response, code blue, code stroke, is unknown. Objectives Identify whether having OSA questionnaires completed by patients is feasible in the preoperative clinic. Determine the frequency of META among older patients at risk for OSA. Design and intervention Cohort of prospective patients independently completed 2 OSA questionnaires in a preoperative clinic, STOP-Bang (SB) and ISNORED (IS). Observers blinded to questionnaire responses recorded incidence of META. setting and participants Of the 898 consecutive patients approached in the preoperative assessment clinic and surgical navigation center, 575 (64%) consented and completed the questionnaires in Measures Sleep questionnaire responses and frequency of inpatient postoperative META. Results With an affirmative response to ≥3 questions on either questionnaire, 65% of patients enrolled were at risk for OSA. Of these, 3.1% sustained an META. In patients at risk for OSA, META occurred in 7.6% (SB+) and 7.2% (IS+) vs 2.5% (SB+) and 1.7% (IS+) for low risk. METAs were disproportionately higher among patients aged ≥65 years (6.3% vs 1.7%; P Conclusions/Implications Preoperative, self-administration of SB and IS questionnaires is feasible. Overall, 65% of those with affirmative responses to ≥3 questions were at risk for OSA and associated with a disproportionate number of postoperative META in older patients. Additionally, risk of OSA identified by preoperative sleep questionnaires was associated with postoperative META among older adults. Use of clinical tools and OSA questionnaires may improve preoperative identification of META in this population.
Application of system thinking to frame the problem in a subsea development projects with high-level business requirements

The oil and gas industry are continuously performing development projects to improve their offerings. In this industry the typical input to the development project is high-level business requirement mixed with specific solutions. The stakeholders setting the requirements and dictating the solutions are often more concerned with the business needs and are lacking a holistic view of how this affect the technical systems solution through its life cycle. In this paper, we apply systems thinking to understand the impact of the high-level business requirements and gain a deeper insight in how to tackle them to meet the target of the project. We apply systematic analysis to an actual development project in a supplier company to understand the problem and the forces acting on it. Using a systemigram we model the problem and then apply the system principle of openness to understand what parts of the problem we can affect. Based on the analysis we propose three focus areas for the project development to move forward and meet the project target