cssi/SciSciGPT-SciSciNet huggingface dataset:
Varicocele and Pelvic Congestion Syndrome

Varicocele is a commonly encountered venous disease characterized by varicosities of the pampiniform plexus secondary to gonadal vein reflux. Often found in adolescence, the incidence of varicocele is approximately 16 %, and its prevalence increases with each decade reaching 42 % in the elderly population. While most men with varicocele are asymptomatic, clinical presentations include male infertility, scrotal pain, and/or low serum testosterone level. It is estimated that 19–41 % of the infertile men present with varicocele as the only identifiable cause of infertility, and these individuals frequently manifest with testicular hypotrophy and abnormal semen parameters. The etiology of varicocele is believed to be multifactorial and includes anatomical difference in the venous drainages of the left and right gonadal veins, valvular absence or dysfunction, and venous obstruction from external compression. Varicocele generally occurs on the left side accounting for approximately 80–90 % of the cases although some authors have argued for the bilateral phenomenon of varicocele. The venous drainage of the left gonadal vein into the “high-pressure” left renal vein as well as the longer course and perpendicular insertion of the left gonadal vein may explain the predominance of the left-sided varicocele. It is estimated that up to 40 % of the population presents with congenital valvular absence. Valvular absence or dysfunction is believed to facilitate the venous reflux in the pampiniform plexus leading to the development of varicocele. However, some authors dispute this notion, based on the cadaver data showing the absence of the valves in the spermatic vein in men with and without varicocele. Although rare, compression of the left renal vein by the superior mesenteric artery as in the nutcracker syndrome can cause secondary varicocele. Isolated right varicocele is rare and necessitates further workup for retroperitoneal lymphadenopathy or renal tumors responsible for the venous obstruction.
Characterization and Development Mechanism of Apios americana Tuber Starch

Apios americana is a wild legume-bearing plant with edible tubers. Domestication of Apios is in progress because of the superior nutritional value and health benefits of the tuber. Objectives of this study were to: (1) characterize physicochemical properties of the Apios tuber starch; and (2) understand differences in starch structures and properties between the mother (seed) and child (progeny) tubers and the mechanism of starch development. Granules of the Apios tuber starch displayed ellipsoidal, rod, or kidney shape with diameter ranges of 1-30μm. The mother tuber starches displayed greater percentage crystallinity, larger gelatinization enthalpy-changes, longer branch-chain lengths of amylopectin, and lower pasting viscosity than their counterpart child tuber starches. The mother tuber starch of Apios 2127 displayed distinct two peaks of gelatinization, which were attributed to starch granules located at different regions of the tuber having different structures and properties. The mother tuber displayed more active starch biosynthesis in the periphery than in the center of the tuber.
Photoconvertible Fluorescent Protein-Based Live Imaging of Mitochondrial Fusion

Mitochondria are highly dynamic organelles that undergo fusion and fission on a relatively fast time scale. Here, a straightforward method is described for capturing mitochondrial fusion events in real time using a photoconvertible fluorescent protein and a far-field fluorescence microscope equipped with appropriate image acquisition and analysis software. The Kaede photoconvertible fluorescent protein is tagged with a mitochondrial targeting sequence and delivered to primary neurons by lentiviral transduction, which ensures efficient low copy number transgene insertion, as well as stable transgene expression.
The DNP project: Quandaries for nursing scholars

Abstract Background In the evolving Doctor of Nursing Practice (DNP) movement, there continues to be a lack of agreement about the final scholarly project. Purpose This study identifies and describes the faculty practices and challenges related to the DNP project across the United States. Methods In a descriptive research study, 90 DNP program directors responded to an online survey describing the environment of the DNP program with emphasis on the final scholarly project. Discussion According to the respondents, 87% of faculty are somewhat or very dissatisfied with the DNP project. Elements that may contribute to the dissatisfaction are the reported lack of faculty knowledge of evidence-based practice and quality improvement, lack of consensus on the DNP project, lack of faculty resources for DNP projects, challenges with clinical sites for the DNP project, and students' scholarly writing skills. Conclusion It is imperative to have academic/practice faculty oriented to DNP concepts; achieve consensus on the project title, type, depth, and outcomes; and have an ongoing dialog regarding DNP project design, execution, and challenges. Project implementation models need to be appropriate for the escalating DNP enrollment. Program support related to institutional review board relationships, student writing and statistical skills, and program–practice site partnerships are needed.
Autonomy and Ethnicity: How the Centre Holds: Managing Claims for Regional and Ethnic Autonomy in a Democratic South Africa

This is a pre-publication draft of the chapter published in "Autonomy and Ethnicity" in 2000.
Radon: A Tracer for Atmospheric Studies

Radon is an ideal atmospheric tracer due its mean-life, which is long compared to turbulent timescales, but short enough to constrain 222Rn activities in the free troposphere; the mean-life is comparable to the transit time of air masses across major continents, but much shorter compared to the global mixing time scale of the atmosphere. A well-defined, yet, simple source function (~99 % from continents and ~1 % from oceans) and sink (100 % removal by radioactive decay), as well as large observed gradient in radon concentrations between oceanic and terrestrial air masses aid in identifying and quantifying the sources of air masses, thereby serving as an unambiguous indicator of recent terrestrial influence on the oceanic air mass. Vertical profiles of atmospheric radon in different seasons combined with modeling efforts have provided insights on the inter-seasonal variations of the fractional escape of other trace gases from the planetary boundary layer to the upper atmosphere. Future promising areas of research include investigations on the monsoon dynamics in the Indian subcontinent by combining air trajectory analysis and temporal variations of 222Rn in the upper air and identifying the possible link (if any) between radonic storms observed in the Polar Regions and transport of water vapor by atmospheric rivers from low to high latitudes.
Skin Diseases (Noncancerous)

This article is reproduced from the previous edition, volume 6, pp. 15–21, © 2008, Elsevier Inc.
Risk of Jaw Osteonecrosis After Intravenous Bisphosphonates in Cancer Patients and Patients Without Cancer

Abstract Objective To compare the risk of jaw osteonecrosis after intravenous (IV) bisphosphonate administered to patients with cancer vs patients without cancer. Patients and Methods We conducted a retrospective cohort study of a 5% national sample of Medicare patients administered IV bisphosphonate from January 1, 2008, through December 31, 2013, for cancer vs noncancer indications. Probable jaw osteonecrosis was estimated with an algorithm including diagnoses, surgical procedures, and imaging studies. A non-IV bisphosphonate comparison group included patients prescribed an oral bisphosphonate for 30 days or less. Results During follow-up, 40 (0.42%) out of 9482 patients with cancer developed probable jaw osteonecrosis compared with 8 (0.05%) out of 16,046 patients without cancer. In a Cox multivariable survival analysis controlling for patient characteristics and number of IV zoledronic infusions, patients without cancer had a hazard ratio of 0.17 (95% CI, 0.06-0.46) for developing jaw osteonecrosis compared with those with cancer. The lower rate of jaw osteonecrosis in patients without cancer was also confirmed in a number of sensitivity analyses. Conclusion The low rate of jaw osteonecrosis in patients with osteoporosis who receive IV bisphosphonate should be weighed against the benefit of those agents in preventing hip and other fractures.
Description of Ictal HFO Mapping in Patients with Both Temporal and Extratemporal Seizure Focus.

Objective. Review presurgical use of ictal HFO mapping to detect ictal activation areas with dual seizure focus in both the temporal and extratemporal cortex. Methods. Review of consecutive patients admitted to the University of South Alabama Epilepsy Monitoring Unit (SouthCEP) between January 2014 and October 2015, with suspected temporal lobe epilepsy and intracranial electrode recording. Ictal HFO localization was displayed in 3D reconstructed brain images using the patient’s own coregistered magnetic resonance imaging (MRI) and computed tomography (CT) with the implanted electrodes. Results. Four of fifteen patients showed evidence of extratemporal involvement at the onset of the clinical seizures. Ictal HFO mapping involving both frontal and temporal lobe changed the surgical resection areas in three patients where the initial surgical plan included only the temporal lobe. Resection of the ictal HFO at the onset of the seizure and the initial propagation region was associated with seizure freedom in all patients; follow-up period ranged from 12 to 25 months. Significance. Extratemporal ictal involvement may not have clinical manifestations and may account for surgical failure in temporal lobe epilepsy. Ictal HFO mapping is useful to define the ictal cortical network and may help detect an extratemporal focus.
Authors' response to commentaries on rosuvastatin for delirium and cognitive impairment in sepsis-associated acute respiratory distress syndrome.

We are encouraged by the interest (1,2) in our publication that evaluated the effect of rosuvastatin vs. placebo on delirium in the intensive care unit (ICU) and subsequent cognitive impairment (3). We appreciate the critique of our publication by Pourafkari et al. (2) commented about our study being underpowered for secondary analyses of cognitive impairment at 6- and 12-month follow-up. We reported a 2% absolute reduction in the proportion of patients with cognitive impairment for rosuvastatin vs. placebo at 6-month follow-up (36% vs. 38%). This 2% reduction was not statistically significant (treatment effect 0.93; 95% confidence interval: 0.39–2.22; P=0.87), which may be due to the study being underpowered (i.e., too few patients to detect such a small effect). However, the subsequent comparison of cognitive impairment at 12-months (30% vs. 28% for rosuvastatin vs. placebo, respectively) and the vast majority of the individual standardized tests used to evaluate cognitive impairment favored placebo relative to rosuvastatin. Hence, to be convinced that the lack of statistical significance at 6 months was attributable to the trial’s sample size, we would have expected non-significant results consistently favoring rosuvastatin, which was not the case.
Sub-surface spatial resolution of a near-field scanning microwave microscope

Scanning near-field microwave microscopy (SMM) provides high spatial resolution material and device characterization that is sensitive to complex permittivity and permeability at depth. We analyze spatial resolution at depth for arbitrary SMMs by combining full-wave electromagnetics and image formation theory then demonstrate the method by comparing two standard probe tips.
Evolution in Mind: Evolutionary Dynamics, Cognitive Processes, and Bayesian Inference

Evolutionary theory describes the dynamics of population change in settings affected by reproduction, selection, mutation, and drift. In the context of human cognition, evolutionary theory is most often invoked to explain the origins of capacities such as language, metacognition, and spatial reasoning, framing them as functional adaptations to an ancestral environment. However, evolutionary theory is useful for understanding the mind in a second way: as a mathematical framework for describing evolving populations of thoughts, ideas, and memories within a single mind. In fact, deep correspondences exist between the mathematics of evolution and of learning, with perhaps the deepest being an equivalence between certain evolutionary dynamics and Bayesian inference. This equivalence permits reinterpretation of evolutionary processes as algorithms for Bayesian inference and has relevance for understanding diverse cognitive capacities, including memory and creativity.
Employment Management Work: A Case Study and Theoretical Framework:

Managing employment and labor market experiences is a critical activity for virtually all adults but it is undertheorized in the sociology of work. In this article, we argue for the concept of empl...
A study of thermal destratification for large warehouse energy savings

Abstract Thermal stratification in large warehouses is a common phenomenon in winter, especially for cold climates. Buoyancy-driven warm air tends to move upwards towards ceilings creating vertical temperature gradients with upper higher temperatures, and consequently leading to excessive heat losses through roofs. These warehouses therefore require thermal destratification through certain air mixing strategies, the selection of which often relies on engineering rules of thumb and experiences but can be better determined through combined experimental and numerical approaches. This paper investigated different thermal destratification methods in two industrial warehouses based on field measurements and CFD simulations with the focus on the quantification of thermal stratification, and the suitable methods modeling air mixing devices, e.g. ceiling rotating fans and bucket fans. The numerical models were first validated by field measurements and then used to simulate different destratification strategies and to compare associated energy impacts. The CFD methods for modeling air mixing devices and their performances can be applied to other similar cases.
O-015 Contrast transit time changes on digital subtraction angiography following pipeline flow diversion

Introduction Pipeline embolization devices (PED) are used for endovascular treatment of cerebral aneurysms but can be associated with delayed ipsilateral intraparenchymal hemorrhage (DIPH). Changes in intracranial hemodynamics after PED are poorly understood. Here, we assess hemodynamic changes after PED in patients with and without DIPH. Methods Records of patients with distal internal carotid artery (ICA) aneurysms treated with PED at our institution between 2012–2017 were retrospectively reviewed. Regions of interest were selected proximally to PED over the cavernous ICA and distally over the middle cerebral artery (MCA), and then transit times were determined using syngo iFlow software (Siemens). Ratio of MCA to ICA transit time was compared before and after treatment using Wilcoxon matched-pairs signed-ranks test. Ratios were also compared between patients with and without DIPH using 2-sample Wilcoxon rank-sum test. Results 53 patients were included (mean age 56 years). Ratio of MCA to ICA transit time decreased significantly after PED deployment (1.13 vs. 1.23, p Conclusion Ratio of MCA to ICA transit time decreases more in patients with DIPH following PED treatment. These contrast transit time changes can be detected in real-time in the neuroangiography suite. Disclosures D. Brunozzi: None. S. Shakur: None. F. Charbel: 2; C; Transonic. 4; C; Ownership VasSol Inc. A. Alaraj: 1; C; NIH. 2; C; Cordis-Codman.
Enhanced in vitro activity of tigecycline in the presence of chelating agents.

Abstract The lack of availability of novel antibiotic agents and the rise of resistance to existing therapies has led clinicians to utilise combination therapy to adequately treat bacterial infections. Here we examined how chelators may impact the in vitro activity of tigecycline (TIG) against Pseudomonas aeruginosa , Escherichia coli and Klebsiella pneumoniae . Minimum inhibitory concentrations (MICs) were determined by broth dilution with and without various combinations of chelators (EDTA and other tetracyclines) and metal ions (i.e. calcium, magnesium). Trimethoprim (TMP) was used as a non-chelating control. Addition of metal ions led to increases in MICs, whilst addition of EDTA led to decreases in MICs. The chelating effects of EDTA were reversed by addition of magnesium and most profoundly calcium. Similar effects of EDTA and calcium were observed for tetracycline (TET) and TMP. When other tetracyclines (TET, oxytetracycline (OXY) and chlortetracycline (CHL)) were used as chelators at concentrations below their MICs, TIG MICs decreased for P. aeruginosa but not for E. coli . Some decreases in TIG MICs were observed for K. pneumoniae when TET and CHL were added. A dose-dependent decrease in TIG MIC was observed for TET and was reversed by the addition of calcium. The presence of effects of EDTA and calcium on TMP MICs indicates that mechanisms outside of TIG chelation likely play a role in enhanced activity. Full characterisation of an unexpected interaction such as TIG–TET with different microorganisms could provide valuable insights into the underlying mechanisms and design of physiologically viable chelators as candidates for future combinations regimens.
Inelastic Constitutive Equations and Phenomenological Laws of Damage Accumulation for Structural Metals

During inelastic deformation the mechanical properties of metals can change considerably. Examples of such changes are given. It is argued that these changes are not necessarily a reliable indicator of damage. Residual strength or residual lifetime are proposed as alternate relative measures. For the case of residual lifetime a method of assessing damage is proposed. This method yields the Palmgren-Miner rule as a special case.
Editorial Commentary: Posterolateral Corner Injuries in Elite Athletes Remain a Challenging Diagnostic Problem

Posterolateral corner injuries are rare, and the examination to quantitate these injuries is very challenging. Careful examination comparing the involved and uninvolved knees, considering stress radiographs, and combining this with magnetic resonance imaging findings is currently our most accurate way to grade these injuries.
Conceptualizing addiction through the lens of a learning disorder

Unbroken Brain: A Revolutionary New Way of Understanding Addiction provides the reader with a critical analysis of addiction conveyed through the avenue of personal narrative, theoretical logic, an...
Availability of Records in an Outpatient Preanesthetic Evaluation Clinic

Objective. Despite efforts to develop electronic access to medical records, there are few data on availability of past evaluations. Typical analyses assess only availability of paper charts. We studied the availability of prior internal and external medical documentation in the preanesthetic clinic of our tertiary teaching institution, which has had access to hospital-wide electronic records for five years. Methods. Residents and clerks answered questions on availability of desired pre-existing records either in a physical chart delivered to our clinic by computer terminal, at the start of the physician interview, and on later success in obtaining desired records not available at start of interview. Patient interview lengths were calculated. Results. 397 responses from 19-9-96 through 25-10-96 were available after 718 patient encounters. The surgeon's history & physical was unavailable in 11%. For 114/397 patients (29%) the anesthesiologist desired more pre-existing information than was available in either paper or electronic format. For 32/397 patients (8%), the desired information resided outside the institution (“MISSING EXTERNAL”); for 89/397 (22%), it was within the institution (“MISSING INTERNAL”). Additional information was desired for 41% of ASA 3/4 patients, and for 23% of ASA 1/2 patients. Some or all of desired information was not found for 45% of MISSING INTERNAL, and for 78% (p = 0.12 NS) of MISSING EXTERNAL. MISSING EXTERNAL of any ASA status required significantly longer evaluations (70 ± 39 min) than even ASA 3/4 patients missing no information (51.4 ± 35.7 min, p 0.03). The surgeries of only eight patients (2%) were postponed in the preanesthetic evaluation clinic; half of the postponements were to obtain pre-existing records. Conclusions. Anesthesiologists retrieved, and added to the perioperative evaluation, information from previous encounters for 16% of patients. Despite our hospital-wide electronic records, internal information was missing for 22% of patients. Uneven deployment, and reliance on transcription may contribute to failures. A national electronic medical records system would benefit the 8% (one out of twelve) of outpatients missing external records identified in this study. For many patients, optimal medical understanding was not achieved during the planned preanesthetic evaluation.
Virtual Energy Storage from Flexible Loads: Distributed Control with QoS Constraints

Loads are expected to help the power grid of the future in balancing the highs and lows caused by intermittent renewables such as solar and wind. With appropriate intelligence, loads will be able manipulate demand around a nominal baseline so that the increase and decrease of demand appears like charging and discharging of a battery, thereby creating a virtual energy storage (VES) device. An important question for the control systems community is: how to control these flexible loads so that the apparently conflicting goal of maintaining consumers’ quality of service (QoS) and providing reliable grid support are achieved? We advocate a frequency domain thinking of handling both of these issues, along the lines of a recent paper. In this article, we discuss some of the challenges and opportunities in designing appropriate control algorithms and coordination architectures in obtaining reliable VES from flexible loads.
Blessing of massive scale: spatial graphical model estimation with a total cardinality constraint approach

We consider the problem of estimating high dimensional spatial graphical models with a total cardinality constraint (i.e., the $$\ell _0$$ -constraint). Though this problem is highly nonconvex, we show that its primal-dual gap diminishes linearly with the dimensionality and provide a convex geometry justification of this “blessing of massive scale” phenomenon. Motivated by this result, we propose an efficient algorithm to solve the dual problem (which is concave) and prove that the solution achieves optimal statistical properties. Extensive numerical results are also provided.
Chemotherapy associated myelosuppression and disease-free and overall survival: A systematic review and evidence summary.

6129 Background: Myelosuppression remains the major dose-limiting toxicity of cancer chemotherapy. The risk of myelotoxicity is associated with the specific drugs, doses and schedule utilized along...
Why Do We Want to Know the Future

This chapter explores why we might want to know the future. The reasons span the psychological, the organizational, and other spheres of life. One of these spheres has to do with our (and our organizations’) values. The chapter further explores the relation of values to goals, vision, readiness, flexibility, speed, useful forecasting, and backcasting.
Wearable Technology as a Tool for Sleep-Wake Estimation in Central Disorders of Hypersomnolence

Diagnosing patients with central disorders of hypersomnolence (CDH) can be challenging. The emergence of wearable technology, such as actigraphy and consumer sleep trackers (CSTs), allows for objective characterization of habitual sleep-wake behavior, which can greatly assist the CDH diagnostic process. This review considers the current role and utility of wearable technology as a tool to estimate sleep-wake behavior in CDH. Actigraphy is recommended by the American Academy of Sleep Medicine (AASM) as a diagnostic tool in CDH and has been widely employed in field-based investigations, yet insufficient guidelines have been provided to optimize data collection and analysis. Due to several factors, the AASM does not currently recognize CSTs as a viable diagnostic tool. However, CSTs have demonstrated promising capabilities that may lead to future clinical and research utility in CDH. Actigraphy has an important role for sleep-wake assessment in CDH, but analytic standardization is a key barrier to their use. At present, CSTs are considered experimental, but their unique capabilities suggest they may one day be developed into a powerful tool in the assessment of these disorders.
Lawyers, Politics, and the

The assumption that the occupational identification of "lawyer" is the salient feature in evaluating political motivation is interesting, if questionable, according to the Author. Does occupational identity overwhelm other identities? Are politically active lawyers really a homogeneous group? Are they less affected by competing identities associated with wealth, geography, familial and constituency concerns, political ideology, party considerations, or any of the myriad other sources of public and private motivation of behavior? Surely the hypothesis that politically active lawyers behave differently from nonlawyers is worth investigating. This Article offers some preliminary responses to these questions posed, which are grounded in empirical research. The completed first stage of the project, with which this Article is concerned, entailed the intensive examination of the behavior of lawyers in a self-contained legislative body. The Author chose the state constitutional convention held in Kentucky in 1849. The Author states that whether political lawyers acted together, capturing and shaping the substantive public policy of mid-nineteenth century Kentucky, may seem a small matter. However, the broad question concerning the impact of the legal profession on our institutions and society, addressed here in the Kentucky setting, is not. Given the ubiquity of lawyers in American life and politics, the question surely deserves more serious attention from legal historians than it has hitherto received. A definitive answer to the question whether a "lawyer's interest" has existed-or perhaps still exists-and has seriously influenced our public life in support of particular groups or for its own benefit, must await further research. However, armed with the new tools of the social sciences we are today better able than ever before to undertake the empirical research which is necessary in order to offer a response.
The Hepatitis C Virus NS3 Protein: A Model RNA Helicase and Potential Drug Target

The C-terminal portion of hepatitis C virus (HCV) nonstructural protein 3 (NS3) forms a three domain polypeptide that possesses the ability to travel along RNA or single-stranded DNA (ssDNA) in a 3' to 5' direction. Fueled byATP hydrolysis, this movement allows the protein to displace complementary strands of DNA or RNA and proteins bound to the nucleic acid. HCV helicase shares two domains common to other motor proteins, one of which appears to rotate upon ATP binding. Several models have been proposed to explain how this conformational change leads to protein movement and RNA unwinding, but no model presently explains all existing experimental data. Compounds recently reported to inhibit HCV helicase, which include numerous small molecules, RNA aptamers and antibodies, will be useful for elucidating the role of a helicase in positive-sense single-stranded RNA virus replication and might serve as templates for the design of novel antiviral drugs.
Left Ventricular Assist Device as Bridge to Recovery - Single Center Experience of Successful Device Explantation

Purpose Continuous flow left ventricular assist devices (CF-LVAD) have been shown to enhance reverse remodeling and myocardial recovery in certain patients. We sought to analyze the characteristics of patients who underwent CF-LVAD explantation at a large academic institution. Methods In this study we retrospectively identified all patients who underwent CF-LVAD explants due to recovery from 2006 to 2019 at a single large academic institution. Patient baseline characteristics and data on pre and post-explant evaluation were collected and analyzed. Results Of 421 patients that underwent CF-LVAD implantation, 13 underwent explantation (3.1%). Twelve HeartMate II and one HeartWare LVAD were explanted. Seven patients were male (53.9%) with a mean age of 45.4± 5 years. The etiology of cardiomyopathy was nonischemic in 100% of the patients (4 had peripartum cardiomyopathy). Median time from heart failure (HF) diagnosis to LVAD implant was 12 months (IQR, 2-44 months). Eight patients failed guideline-directed medical therapy and 5 patients presented with acute HF. Median time supported on LVAD was 22 months (IQR, 11-28 months). Mean follow-up time post-explant was 37 ±10.7 months. Two patients died within 30 days from explant due to right HF, one related to severe pulmonary hypertension and the other severe COPD. Three additional patients died during the follow-up period (mean follow up time post-explant of 43.6 months) and all were noted to be non-adherent to medical therapy. Ejection fraction (EF) improved from 12.3 ±3.9% pre-implant to 48.8 ±12.4% pre-explantation (p Conclusion We present a large single center experience of successful CF-LVAD explantation in the setting of myocardial recovery. Of those who died, early death was related to acute right heart failure however, in the long term, medical noncompliance may have been related to heart failure recrudescence. Future studies are needed to determine if recovery strategy can be applied to more patients with end stage heart failure.
G217(P) Improving paediatric asthma long-term management through the emergency department

Aims The UK has one of the worst paediatric asthma mortality rates in Europe. The National Review of Asthma Deaths found that we could prevent many deaths with better basic asthma care and long-term management. We aimed to improve the assessment of children with asthma in the Emergency Department (ED), and their long-term management. Methods We collected data over three months on those >5 presenting to ED with asthma. We subsequently introduced an ED assessment proforma for these children. We re-audited over the same time period the following year and we have made changes to the proforma based on these results, which we will continue to re-assess, and further improve. Results Between 2017 and 2018 we saw a 60% increase in numbers of children attending ED with asthma. We were initially poor at recording patient/carer smoking status with this being done in 23% of patients. Following proforma introduction, this increased to 51%. The objective assessment of chronic severity of asthma also improved, from 67% having this documented in 2017 to 99% in 2018. However, we remained poor at documenting assessment of inhaler technique, recording this in only 23% of patients in 2017 and 13% in 2018. Documentation of follow up plans was also poor and did not improve with proforma introduction. We also saw significant changes in practice; new preventer therapies were introduced in 2% of patients in 2017, but 14% in 2018. Conclusion We found that by designing a proforma with specific prompts we could affect what questions people asked, long-term management and documentation. This worked well for prompts we included such as smoking status and objective assessment of severity, though it did not work for other key points. We have now re-designed the proforma which is rolling out alongside education sessions. This includes a revised discharge checklist highlighting key care standards. We have included information to signpost parents/carers to smoking cessation services and flowcharts to ensure correct follow up is arranged. We have attempted to shift the approach of clinicians from treating just an exacerbation, to thinking about treating asthma as a chronic condition.
Associations between surgical start time (regular vs after hours) and morbidity and mortality during hospitalization in dogs and cats.

OBJECTIVE To examine the relationship between after-hours (ie, nights and weekends) emergency general surgery and morbidity or mortality in dogs and cats during hospitalization. DESIGN Cross-sectional study from September 1, 2013 to May 31, 2017. SETTING University teaching hospital. ANIMALS Four hundred seventy-four dogs and 66 cats that underwent emergency general surgery (gastrointestinal, hepatobiliary, urogenital, soft tissue traumatic injury, splenectomy/excision of bleeding abdominal tumor, surgical revision, and negative exploratory categories) with the emergency surgery service. All patients were required to have complete medical records. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Study animals were grouped as exposed or not exposed to after-hours emergency surgery. They were further classified as either postoperatively dead or suffering morbidity (yes or no). Additional exposure factors (eg, age, sex, American Society of Anesthesiology [ASA] status) were investigated. Multivariable logistic regression was used to identify and quantify any associations with mortality or morbidity. In dogs, exposure to after-hours emergency general surgery was not associated with mortality or morbidity. In dogs, both mortality and morbidity were associated with ASA status. In cats, mortality was not examined because the number of dead cats was small (n = 5). The odds of morbidity were 3.4 times lower (1/0.29) in cats having emergency surgery after hours, compared to cats admitted during regular hours (odds ratio [OR], 0.29; 95% Confidence Interval (CI), 0.09-0.93; P = 0.03). No other investigated exposure factors were associated with morbidity in study cats. CONCLUSIONS After-hours emergency surgery in dogs was not associated with increased risk of mortality and morbidity at the study facility. Feline patients having emergency surgery during regular hospital hours had a higher risk of morbidity; further investigation of modifiable risk factors is warranted.
Early Biomarkers of Hypoxia and Inflammation and Two-Year Neurodevelopmental Outcomes in the Preterm Erythropoietin Neuroprotection (PENUT) Trial.

BACKGROUND In the Preterm Erythropoietin (Epo) NeUroproTection (PENUT) Trial, potential biomarkers of neurological injury were measured to determine their association with outcomes at two years of age and whether Epo treatment decreased markers of inflammation in extremely preterm (<28 weeks' gestation) infants. METHODS Plasma Epo was measured (n=391 Epo, n=384 placebo) within 24h after birth (baseline), 30min after study drug administration (day 7), 30min before study drug (day 9), and on day 14. A subset of infants (n=113 Epo, n=107 placebo) had interferon-gamma (IFN-γ), Interleukin (IL)-6, IL-8, IL-10, Tau, and tumour necrosis factor-α (TNF-α) levels evaluated at baseline, day 7 and 14. Infants were then evaluated at 2 years using the Bayley Scales of Infant and Toddler Development, 3rd Edition (BSID-III). FINDINGS Elevated baseline Epo was associated with increased risk of death or severe disability (BSID-III Motor and Cognitive subscales <70 or severe cerebral palsy). No difference in other biomarkers were seen between treatment groups at any time, though Epo appeared to mitigate the association between elevated baseline IL-6 and lower BSID-III scores in survivors. Elevated baseline, day 7 and 14 Tau concentrations were associated with worse BSID-III Cognitive, Motor, and Language skills at two years. INTERPRETATION Elevated Epo at baseline and elevated Tau in the first two weeks after birth predict poor outcomes in infants born extremely preterm. However, no clear prognostic cut-off values are apparent, and further work is required before these biomarkers can be widely implemented in clinical practice. FUNDING PENUT was funded by the National Institute of Neurological Disorders and Stroke (U01NS077955 and U01NS077953).
Role of salt-bridging interactions in recognition of viral RNA by arginine-rich peptides

Abstract Interactions between RNA molecules and proteins are critical to many cellular processes and are implicated in various diseases. The RNA-peptide complexes are good model systems to probe the recognition mechanism of RNA by proteins. In this work, we report studies on the binding-unbinding process of a helical peptide from a viral RNA element using nonequilibrium molecular dynamics simulations. We explored the existence of various dissociation pathways with distinct free-energy profiles that reveal metastable states and distinct barriers to peptide dissociation. We also report the free-energy differences for each of the four pathways to be 96.47 ± 12.63, 96.1 ± 10.95, 91.83 ± 9.81, and 92 ± 11.32 kcal/mol. Based on the free-energy analysis, we further propose the preferred pathway and the mechanism of peptide dissociation. The preferred pathway is characterized by the formation of sequential hydrogen-bonding and salt-bridging interactions between several key arginine amino acids and the viral RNA nucleotides. Specifically, we identified one arginine amino acid (R8) of the peptide to play a significant role in the recognition mechanism of the peptide by the viral RNA molecule.
Romania: The Unfinished Revolution

The Romanian revolution was motivated by a desire for greater political and intellectual freedom and economic prosperity. It was the bloodiest of the eastern European transitions due to Ceausescu's cult of personality. However, many of the goals of the revolution are still unfulfilled. The lack of civil society, charges of political corruption, the failure to transform the economy, and concerns over the protection of ethnic minority rights are all factors in Romania's failure to become a fully integrated European country. Tracing the country's political history and examining Romania's postcommunist politics, economic transition and foreign policy, this book contemplates the prospects for this country as it enters the twenty first century.
Melanoma In Situ Versus Paget’s Disease

Malignant melanoma in situ (MIS) is characterized by an intraepidermal proliferation of cytologically atypical melanocytes, often disposed as single cells in a haphazard pattern. This “pagetoid” scatter of atypical melanocytes closely resembles Paget’s disease itself. In addition, several other epithelial neoplasms (benign and malignant) are characterized by prominent pagetoid scatter of cells within the epidermis. Histological features that help to distinguish these neoplasms will be discussed.
Instrumentation and Applications of Micro-Liquid Chromatography/Mass Spectrometry

Publisher Summary This chapter discusses the instrumentation and applications of micro-liquid chromatography/mass spectrometry. Micro high performance liquid chromatography (micro HPLC) is finally enjoying increased consideration and applications. Several manufacturers are now marketing either modified conventional HPLC equipment, or entirely new hardware designed to deliver micro LC flow rates ranging usually from 10-100 micro liters per minute. There are a variety of reported benefits or reasons for utilizing micro LC rather than conventional HPLC, but usually the most justifiable reasons for "bothering" with micro LC include HPLC solvent savings and on-line high performance liquid chromatography/mass spectrometry (LC/MS). This chapter reviews on micro LC/MS with emphasis placed upon practical applications which demonstrate the sensitivity gains available when total introduction of micro LC effluent is provided to the mass spectrometer.
An analysis of heavy-atom perturbation of intersystem crossing as a mechanistic tool in photochemistry

Abstract A kinetic analysis of heavy-atom enhanced intersystem crossing is presented, with the object of using this perturbation method for determining whether the majority of a photoproduct originates from an excited singlet or an excited triplet precursor. Expressions are derived which relate the quantum efficiencies of product formation (φr) and S1→T1 intersystem crossing (φisc) with potential quenching or enhancement by the heavy-atom. These allow limits to be placed on the possible quenching or enhancement that may be observed in particular cases (see Fig. 4 and 6) and thereby make an interpretation of the data less ambiguous than has been suggested in recent discussions. A particularly useful observation is that for those molecules (for example, aromatics) having triplets which are relatively unaffected by heavy-atoms, quenching of a product by more than 50% demonstrates that a majority of this product must be derived from the excited singlet state.
A new method for the large scale purification of Escherichia coli deoxyribonucleic acid-dependent ribonucleic acid polymerase.

Abstract This paper describes a method for the purification of Escherichia coli DNA-dependent RNA polymerase which is rapid, reproducible, high in yield, and able to handle preparations using from 1 g to 3 kg of cells. The method involves disruption of the bacterial cells with glass beads in a Waring Blendor, digestion with DNase I, centrifugation to remove ribosomes and debris, fractionation with ammonium sulfate, and chromatography on diethylaminoethyl cellulose, phosphocellulose, and Bio-Gel A-1.5m. Addition of 5% glycerol and 0.1 mm dithiothreitol to all buffers substantially increases the stability of the enzyme throughout the purification. Depending on how cells are grown, 100 to 300 mg of polymerase are obtained from 1 kg of cells. The polymerase is greater than 98% pure and free of contaminating nucleases.
What We Think About When We Think About 'Exile'

This paper will examine the largely under-theorized political phenomenon of exile, specifically as it appears in modern liberal regimes and whether it can be justified. People flee their nations or cities of origin for a number of reasons, but what sets exiles apart from others (refugees, for instance, or economic immigrants) is that their involuntary departure is political in nature.Exile was an accepted feature of the political landscape in ancient Greece and Rome. Early moderns like Machiavelli, as well, accepted exile as a risk associated with political action. When Napoleon Bonaparte came to power, he employed exile not only to weaken his political opponents, but also as a method of making other citizens complicit in the punishment of their dissident peers. Germaine De Stael roundly condemns exile as cruel and barbaric, while her friend Benjamin Constant considers the possibility that given the proper procedures, political expulsion could be a legitimate tool of the sovereign power. In the present-day, political expulsion persists, although its political nature is often cloaked in bureaucratic language.
NCI's provocative questions on cancer: some answers to ignite discussion

Mikhail V. Blagosklonny 1 1 Department of Cell Stress Biology, Roswell Park Cancer Institute, BLSC, L3-312, Elm and Carlton Streets, Buffalo, NY, 14263, USA Received: December 8, 2011; Accepted: December 31, 2011; Published: December 31, 2011; Keywords: NCI, cancer, therapy, prevention, aging, rapamycin, mTOR Correspondence: Mikhail V. Blagosklonny, email: // // Abstract The National Cancer Institute has announced 24 provocative questions on cancer. Why do many cancer cells die when suddenly deprived of a protein encoded by an oncogene? Can we extend patient survival by using approaches that keep tumors static? Why are some disseminated cancers cured by chemotherapy alone? Can we develop methods to rapidly test interventions for cancer treatment or prevention? Can we use our knowledge of aging to enhance prevention or treatment of cancer? What is the mechanism by which some drugs commonly and chronically used for other indications protect against cancer? How does obesity contribute to cancer risk? Here I try to answer these questions by linking the dots of existing knowledge.
A mathematical model for context and word-meaning

Context is vital for deciding which of the possible senses of a word is being used in a particular situation, a taskk nown as disambiguation. Motivated by a survey of disambiguation techniques in natural language processing, this paper presents a mathematical model describing the relationship between words, meanings and contexts, giving examples of how context-groups can be used to distinguish different senses of ambiguous words. Many aspects of this model have interesting similarities with quantum theory.
Government Investigative Reports

This article is a review of New York’s public records exception to the hearsay rule and the concerns that it presented until Cramer v. Kuhns. In Cramer v. Kuhns, 213 A.D.2d 131 (1995), the Third Department held that government investigative reports may be admissible under CPLR 4520 provided that the reports have 'sufficient independent indicia of reliability to justify [their] admission.' In essence, the court adopted a construction of CPLR 4520 that comports with FRE 803(8)(C) as interpreted by the federal courts.The article explains how the law is applied and how a practitioner can enter public records using the Third Department’s decision. It also provides the practitioner a glimpse at what is required of an attorney in a post Cramer landscape.
Effect of soy food intake on mineral status in women of childbearing age

Many health benefits are attributed to soy food intake, but data on mineral balance are limited. Our main objective was to determine the effect of soy foods intake for 10-wk on iron or zinc status in women of childbearing age. We also tested the effect on bone and thyroid hormones. Women (18-28 y) non-smokers without chronic disease, anemia, pregnancy, and/or irregular menstrual cycles were randomly assigned to either a soy (n=31) or an animal food (n=32) group. Blood and urine samples and 3-d dietary records were collected prior to and after intervention. At baseline, iron and zinc status, biochemical markers of bone, and thyroid hormones were not different between two groups. After intervention, no significant changes were observed in hemoglobin, transferrin saturation, serum iron, ferritin, or transferrin receptor concentrations, as well as the transferrin receptor-ferritin index. Funded by Iowa Soybean Association and Soyfoods Council
Review of No Country for Old Men

The title of the movie may be No Country for Old Men, but from a feminist standpoint it may as well be titled No Country for Women of Any Age. There are three women of note within this movie, but t...
Audience in the service of learning: how kids negotiate attention in an online community of interactive media designers

Audience can serve as powerful motivation in learning – and network technologies have the potential to greatly broaden audience for the processes and products of learning. But these new opportunities for audience are accompanied by new challenges. In this paper, we examine and problematize the notion and role of audience in learning by presenting a case study of a large online community of young interactive-media designers. We focus on two key questions: (1) How do young people develop a sense of audience in the online community? (2) How does this sense of audience shape kids' participation as interactive-media designers? Drawing on five years of observation data and interviews with 30 young designers, we share a portrait of how these kids engaged with others as audience, drawing out several major themes: kids' desires for attention in a populous, digitally mediated space, the challenges of getting attention or not getting attention, and how attention-seeking behaviour can be aligned and misaligned with k...
Foucher's and de Mairan's Critiques of Malebranche's Beings of the Third Kind

Etude des critiques adressees par S. Foucher et D. de Mairan a Malebranche concernant la theorie selon laquelle nous voyons toutes les choses en Dieu. Le rejet de la theorie des etres du troisieme genre developpee par Malebranche repose sur le rejet du dualisme cartesien pour l'un (Foucher) et sur le rejet du siponzisme pour l'autre (De Mairan)