cssi/SciSciGPT-SciSciNet huggingface dataset:
Euglycemic diabetic ketoacidosis in a woman with type I diabetes,end-stage renal disease and COVID-19 infection

Case Report: AG is a 33 year-old woman with a history of type I diabetes mellitus (diagnosed at age 8),hypertension and end-stage renal disease on hemodialysis for 8 years who presented to the hospital withworsening nausea, vomiting and abdominal pain of one week's duration, in the setting of COVID-19 infectionwith symptom onset 10 days prior and missed hemodialysis on the day of presentation She was unable totolerate anything oral for the past 5 days and endorsed generalized abdominal pain She denied chest pain,shortness of breath, hematemesis, diarrhea, constipation or bloody stools Home blood sugars ranged from80-140mg/dL Vitals were normal except for blood pressure 154/88 She was fully alert and oriented with mild,diffuse tenderness to palpation over the abdomen Initial workup revealed serum glucose 101mg/dL, sodium137mmol/L, potassium 4 9mmol/L, chloride 85mEq/L, bicarbonate 7mmol/L and anion gap 45mmol/L Serumbeta-hydroxybutyrate (BHB) was elevated at 5 53mmol/L Liver function and lipase were normal Abdominalimaging revealed cholelithiasis but no evidence of cholecystitis, pancreatitis or bowel obstruction AG was dialysed, given bicarbonate and started on a dextrose 10% in water infusion, basal-bolus insulin and low-doseinsulin sliding scale She remained nauseous despite antiemetics, with poor oral intake and uptrending BHB,which was concerning for starvation-induced EDKA Once she was started on peripheral parenteral nutrition,BHB downtrended, anion gap closed and nausea/vomiting resolved She remained stable and was transferredto an outside hospital for further management Discussion: Type I diabetes mellitus (T1DM) is one of the mostcommon chronic medical conditions that originates in childhood The pathophysiology involves autoimmunedestruction of pancreatic beta cells, leading to complete deficiency of insulin Patients with T1DM can sufferfrom glycemic dysregulation during acute illnesses, which can lead to diabetic ketoacidosis (DKA): an elevatedanion gap metabolic acidosis, ketonemia and hyperglycemia often >250mg/dL Less commonly, a patient canpresent with the first two criteria, but have serum glucose levels <200mg/dL - a condition known aseuglycemic DKA (EDKA) High clinical suspicion for EDKA based on the history and initial labs, including bloodpH and ketones, is crucial for proper diagnosis The patient in this case is hemodialysis-dependent, whichfurther complicated diagnosis given the impact of missed dialysis on the anion gap Another potential factorwas her COVID-19 infection, given emerging data that COVID-19 can induce DKA Additionally, thegastrointestinal symptoms worsened to the point of starvation, which likely precipitated the EDKA While fluidresuscitation is typically a key component of DKA management, fluids were avoided in this case given theCOVID-19 infection and hemodialysis-dependence The high anion gap metabolic acidosis was an importantinitial clue that she was in DKA, and ultimately led the team to check her BHB and initiate proper treatment
Welcome and Introduction to SPIE Conference 11743

Introduction to SPIE Defense and Commercial Sensing conference 11743: Thermosense: Thermal Infrared Applications XLIII
GABAA-Receptor Agonists Limit Pneumonitis and Death in Murine Coronavirus-Infected Mice

There is an urgent need for new approaches to limit the severity of coronavirus infections. Many cells of the immune system express receptors for the neurotransmitter γ-aminobutyric acid (GABA), and GABA-receptor (GABA-R) agonists have anti-inflammatory effects. Lung epithelial cells also express GABA-Rs, and GABA-R modulators have been shown to limit acute lung injuries. There is currently, however, no information on whether GABA-R agonists might impact the course of a viral infection. Here, we assessed whether clinically applicable GABA-R agonists could be repurposed for the treatment of a lethal coronavirus (murine hepatitis virus 1, MHV-1) infection in mice. We found that oral GABA administration before, or after the appearance of symptoms, very effectively limited MHV-1-induced pneumonitis, severe illness, and death. GABA treatment also reduced viral load in the lungs, suggesting that GABA-Rs may provide a new druggable target to limit coronavirus replication. Treatment with the GABAA-R-specific agonist homotaurine, but not the GABAB-R-specific agonist baclofen, significantly reduced the severity of pneumonitis and death rates in MHV-1-infected mice, indicating that the therapeutic effects were mediated primarily through GABAA-Rs. Since GABA and homotaurine are safe for human consumption, they are promising candidates to help treat coronavirus infections.
Molding immortality from a plastic germline

Germ cells are uniquely capable of maintaining cellular immortality, allowing them to give rise to new individuals in generation after generation. Recent studies have identified that the germline state is plastic, with frequent interconversion between germline differentiation states and across the germline/soma border. Therefore, features that grant germline immortality must be inducible, with other cells undergoing some form of rejuvenation to a germline state. In this review, we summarize the breadth of our current interpretations of germline plasticity and the ways in which these fate conversion events can aid our understanding of the underlying hallmarks of germline immortality.
On the value of CTIS imagery for neural network based classification : experimental results

The computed tomography imaging spectrometer (CTIS) is a snapshot hyper-spectral imaging system which has recently been demonstrated of value when used in a compressed learning mode. In such a mode, the raw data are not reconstructed in an hyperspectral cube but are directly transmitted to a neural network to perform classification. While the previous investigations on this topic were limited to a simulation perspective, we extend these results to real images and demonstrate the possibility to train the network on simulated data and apply this trained model successfully on real images.
Synthesis of Bench-Stable N-Quaternized Ketene N,O-Acetals and Preliminary Evaluation as Reagents in Organic Synthesis.

N-Quaternized ketene N,O-acetals are typically an unstable, transient class of compounds most commonly observed as reactive intermediates. In this report, we describe a general synthetic approach to a variety of bench-stable N-quaternized ketene N,O-acetals via treatment of pyridine or aniline bases with acetylenic ethers and an appropriate Bronsted or Lewis acid (triflic acid, triflimide, or scandium(III) triflate). The resulting pyridinium and anilinium salts can be used as reagents or synthetic intermediates in multiple reaction types. For example, N-(1-ethoxyvinyl)pyridinium or anilinium salts can thermally release highly reactive O-ethyl ketenium ions for use in acid catalyst-free electrophilic aromatic substitutions. N-(1-Ethoxyvinyl)-2-halopyridinium salts can be employed in peptide couplings as a derivative of Mukaiyama reagents or react with amines in nucleophilic aromatic substitutions under mild conditions. These preliminary reactions illustrate the broad potential of these currently understudied compounds in organic synthesis.
Engineering Properties of Submarine Soils: State-of-the-Art Review

The slope of the application of soil mechanics to ocean engineering is reviewed. Topographic features of the oceans are briefly analyzed and methods of sampling sea-floor deposits as well as in-situ testing procedures are presented. The available data on index properties, shear strength and consolidation characteristics of near shore and deep-sea submarine soils are presented. Comparison is made between engineering properties of submarine soils and terrestrial soils.
Recent Theoretical Adcances in the Terrestrial Propagation of Vlf Electromagnetic Waves

Publisher Summary This chapter presents theoretical advances in the terrestrial propagation of very low frequency (VLF) electromagnetic waves. The VLF band corresponds to frequencies from 3 to 30 kHz, the attenuation of the waves is very low and the phase stability of the waves is very high. These waves find numerous applications in global communications and in long-range navigation systems. A basic preliminary problem concerns the propagation of electromagnetic waves along a homogeneous spherical surface when the external medium is free space with intrinsic properties. In order to illustrate the nature of the slowly varying nonuniform waveguide, the two-dimensional model is considered. It is suggested that although the finite temperature of the plasma does not have a noticeable effect on the waveguide characteristics, it will play an important role when the transmitting antenna is located within the ionosphere. It is emphasized that when considering penetration of the waves well into the ionosphere, the resultant field strength will be critically dependent on the various particle constituents of the plasma.
Simulating combustion in a PCI (premixed compression ignition) engine using DI-SRM and 3 components surrogate model

Abstract A detailed chemistry and pollutant formation model combined with an advanced combustion simulation tool DI-SRM (direct injection stochastic reactor model) and time based mixing model are used to simulate the in-cylinder physico-chemical processes such as compression, heat transfer, charge stratification/mixing and gas phase chemistry in a single cylinder diesel engine run in premixed compression ignition (PCI) mode. These models were used to simulate the combustion of different model fuels (n-heptane, PRF 84 and TRF 82, a toluene isooctane and n-heptane blend) and full boiling range unleaded gasoline (ULG 84 and ULG 91), using the same 3 components (n-heptane, iso-octane and toluene) surrogate model for all five fuels. Soot was simulated using the method of moments, a Probability Density Function (PDF) based model and the other pollutants such as NOx, CO and unburned hydrocarbon (UHC) are estimated through the chemical mechanism model used in this study. The blending of each surrogate fuel was based on the auto-ignition characteristics of the fuel used in the experimental work. The model performed well, in terms of in-cylinder pressure, heat release rate, combustion phasing parameters and pollutant emissions. Phi-T maps were used to gain further insight into both the simulated and experimental data. These maps are used to better understand the processes that take place during the combustion event under PCI combustion mode such as mixing, fuel auto-ignition characteristics and the effect of RON and aromatic content on PM emissions.
Evolutionary Conservation of Splice Sites

The evolution of splice sites (both 5′ and 3′) is constrained. The results of the constraints are observed in conserved signatures exhibited by splice sites across species. Keywords: splice sites; pre-mRNA splicing; evolution; spliceosome; acceptor; donor
Information systems attachment: An empirical exploration of its antecedents and its impact on community participation intention

With the increasing use of information systems (IS) in our everyday lives, people may feel an attachment to their software applications beyond simply perceiving them as a tool for enhancing task performance. However, attachment is still a largely unexplored concept in both IS research and practice. Drawing from the literature on attachment in consumer behavior research and auxiliary theories in IS use and community participation research, this study theoretically identifies and empirically explores the concept of attachment and its antecedents (i.e., relative visual aesthetics, personalization, relative performance) and outcome (i.e., community participation intention) in the IS context. Using web browsers as the target IS, an online survey was conducted. Results show that relative expressive visual aesthetics is the strongest antecedent of IS attachment, and that personalization is the second strongest antecedent of IS attachment, followed by relative performance. Furthermore, this study reveals that IS attachment has a strong positive impact on community participation intention. This study contributes theoretically and empirically to the body of IS use research and has managerial implications, suggesting that although superior performance is a necessary condition for attachment formation, improving users' experience through expressive visual aesthetics and personalization is critical to build strong attachment relationships with users.
Propiedad y hambre

Los argumentos politicos y sociales a menudo recurren a reivindicaciones morales basadas en derechos intrinsecamente valiosos. Hace ya muchisimo tiempo que se invocan los derechos relacionados con la propiedad. Pero existen tambien otrostipos de derechos que han sido considerados como "innatos e inalienables", y la Declaracion de Independencia de los Estados Unidos se refiere a "ciertos derechos inalienables", entre los cuales se cuentan "vida, libertad y la prosecucion de lafelicidad". La Constitucion de la India llega hasta mencionar el "derecho a los medios adecuados de vida". El "derecho a no sufrir hambre" ha sido invocado a menudo en discusiones recientes sobre la obligacion de ayuda a los hambrientos.El derecho a poseer, usar y legar la propiedad que se haya adquirido legalmente es considerado a menudo como valioso intrinsecamente. De hecho, sin embargo, muchas de las defensas que de el se hacen parecen ser realmente de tipo instrumental; searguye, por ejemplo, que los derechos de propiedad hacen que la gente sea mas libre para elegir una clase de vida mas bien que otra.
Whole Body Vibration Levels: A Realistic Baseline for Standards

Statistical measures of whole-body vibration from ambulation are shown to be higher than those from operation of earthmoving machinery and significantly higher than published guidelines for human exposure to whole-body vibration. The inconsistency of human response to low level vibration of technological origin as compared to human imperceptiveness to high level vibration from ambulation is discussed.
The SDM Hand: A Highly Adaptive Compliant Grasper for Unstructured Environments

The inherent uncertainty associated with unstructured grasping tasks makes establishing a successful grasp difficult. Traditional approaches to this problem involve hands that are complex, fragile, require elaborate sensor suites, and are difficult to control. Alternatively, by carefully designing the mechanical structure of the hand to appropriately incorporate features such as compliance and adaptability, the uncertainty inherent in unstructured grasping tasks can be more easily accommodated. These features can reduce the need for complicated sensing and control by passively adapting to the object properties and positioning, making the hand easier to operate and with greater reliability. In this paper, we demonstrate a novel adaptive and compliant grasper that is both simple and robust. The four-fingered hand is driven by a single actuator, yet can grasp objects spanning a wide range of size, shape, and mass. The hand is constructed using polymer-based Shape Deposition Manufacturing (SDM), with joints formed by elastomeric flexures and actuator and sensor components embedded in tough rigid polymers. The hand has superior robustness properties, able to withstand large impacts without damage and capable of grasping objects in the presence of large positioning errors.
Characterization of 3'-Phosphate RNA Ligase Paralogs RtcB1, RtcB2, and RtcB3 from Myxococcus xanthus Highlights DNA and RNA 5'-Phosphate Capping Activity of RtcB3.

ABSTRACT Escherichia coli RtcB exemplifies a family of GTP-dependent RNA repair/splicing enzymes that join 3′-PO4 ends to 5′-OH ends via stable RtcB-(histidinyl-N)-GMP and transient RNA3′pp5′G intermediates. E. coli RtcB also transfers GMP to a DNA 3′-PO4 end to form a stable “capped” product, DNA3′pp5′G. RtcB homologs are found in a multitude of bacterial proteomes, and many bacteria have genes encoding two or more RtcB paralogs; an extreme example is Myxococcus xanthus, which has six RtcBs. In this study, we purified, characterized, and compared the biochemical activities of three M. xanthus RtcB paralogs. We found that M. xanthus RtcB1 resembles E. coli RtcB in its ability to perform intra- and intermolecular sealing of a HORNAp substrate and capping of a DNA 3′-PO4 end. M. xanthus RtcB2 can splice HORNAp but has 5-fold-lower RNA ligase specific activity than RtcB1. In contrast, M. xanthus RtcB3 is distinctively feeble at ligating the HORNAp substrate, although it readily caps a DNA 3′-PO4 end. The novelty of M. xanthus RtcB3 is its capacity to cap DNA and RNA 5′-PO4 ends to form GppDNA and GppRNA products, respectively. As such, RtcB3 joins a growing list of enzymes (including RNA 3′-phosphate cyclase RtcA and thermophilic ATP-dependent RNA ligases) that can cap either end of a polynucleotide substrate. GppDNA formed by RtcB3 can be decapped to pDNA by the DNA repair enzyme aprataxin. IMPORTANCE RtcB enzymes comprise a widely distributed family of RNA 3′-PO4 ligases distinguished by their formation of 3′-GMP-capped RNAppG and/or DNAppG polynucleotides. The mechanism and biochemical repertoire of E. coli RtcB are well studied, but it is unclear whether its properties apply to the many bacteria that have genes encoding multiple RtcB paralogs. A comparison of the biochemical activities of three M. xanthus paralogs, RtcB1, RtcB2, and RtcB3, shows that not all RtcBs are created equal. The standout findings concern RtcB3, which is (i) inactive as an RNA 3′-PO4 ligase but adept at capping a DNA 3′-PO4 end and (ii) able to cap DNA and RNA 5′-PO4 ends to form GppDNA and GppRNA, respectively. The GppDNA and GppRNA capping reactions are novel nucleic acid modifications.
Shared task: crowdsourced accessibility elicitation of Wikipedia articles

Mechanical Turk is useful for generating complex speech resources like conversational speech transcription. In this work, we explore the next step of eliciting narrations of Wikipedia articles to improve accessibility for low-literacy users. This task proves a useful test-bed to implement qualitative vetting of workers based on difficult to define metrics like narrative quality. Working with the Mechanical Turk API, we collected sample narrations, had other Turkers rate these samples and then granted access to full narration HITs depending on aggregate quality. While narrating full articles proved too onerous a task to be viable, using other Turkers to perform vetting was very successful. Elicitation is possible on Mechanical Turk, but it should conform to suggested best practices of simple tasks that can be completed in a streamlined workflow.
Ultrasound-triggered tumor therapy with doxorubicin-liposome-microbubble complexes in a subcutaneous murine colon adenocarcinoma model

Triggered release of drugs from carrier systems in vivo is widely investigated for targeted tumor therapy. During the past several years, an ultrasound-sensitive liposome-microbubble pendant carrier has been developed: microbubbles, decorated with liposomes that carry e.g., doxorubicin, release the drug in response to ultrasound pulse. However, due to low drug load, those particles were not successful for tumor therapy in vivo. In this study, we are able to prepare particles with high doxorubicin load, and achieve successful inhibition of tumor growth in a subcutaneous murine tumor model.
A thermodynamic estimation of the minimum concentration attainable in a flow-through porous electrode reactor

The minimum concentration attainable in a porous flow-through reactor is estimated by applying the thermodynamics of electrochemical cells with a knowledge of the maximum reactor operating potential. This predicted concentration is the equilibrium wall concentration at the back of the reactor and is qualitatively compared to the experimentally measured minimum average bulk values observed by various authors for the deposition of copper, silver, lead, and mercury, and for the oxidation of ferrous ions. It is suggested that a knowledge of the current versus reactor operating potential will elucidate the lower limits observed for any metal system. In particular, the case of antimony removal is discussed.
Determination of fluoroquinolones in serum using an on-line clean-up column coupled to high-performance immunoaffinity-reversed-phase liquid chromatography.

Abstract A simple, rapid and reliable method for the simultaneous analysis of the fluoroquinolones ciprofloxacin, enrofloxacin, sarafloxacin, and difloxacin in bovine serum has been developed. Upon injection of serum samples, an on-line protein G-linked column was employed to automatically remove serum components that otherwise would interfere with analyses. A high-performance immunoaffinity chromatography (HPIAC) column containing covalently bound anti-sarafloxacin antibodies was then used to capture the fluoroquinolones while allowing the remainder of the serum components to elute to waste. After binding to the HPIAC column, the fluoroquinolones were eluted directly onto a reversed-phase (RP) column for final separation of the compounds prior to fluorescence detection at excitation and emission wavelengths of 280 and 444 nm, respectively. Due to use of a clean-up column in tandem with a highly selective HPIAC column, the only off-line sample preparation required was dilution (10-fold) in phosphate buffered saline (PBS) and passage of the samples through a 0.2-μm filter to remove particulate matter prior to injection. No significant interferences from the sample matrix were observed, indicating good selectivity with the HPIAC column. The method yielded high recoveries from fortified bovine serum that were >95% for all four fluoroquinolones with good reproducibility (C.V. values
SU-C-12A-05: Radiation Dose in High-Pitch Pediatric Cardiac CTA: Correlation Between Lung Dose and CTDIvol, DLP, and Size Specific Dose Estimates (SSDE)

Purpose: To investigate the radiation dose for pediatric high pitch cardiac CTA Methods: A total of 14 cases were included in this study, with mean age of 6.2 years (ranges from 2 months to 15 years). Cardiac CTA was performed using a dual-source CT system (Definition Flash, Siemens). Tube voltage (70, 80 and 100kV) was chosen based on patient weight. All patients were scanned using a high-pitch spiral mode (pitch ranges from 2.5 to 3) with tube current modulation technique (CareDose4D, Siemens). For each case, the three dimensional dose distributions were calculated using a Monte Carlo software package (IMPACT-MC, CT Image GmbH). Scanning parameters of each exam, including tube voltage, tube current, beamshaping filters, beam collimation, were defined in the Monte Carlo calculation. Tube current profile along projection angles was obtained from projection data of each tube, which included data within the over-scanning range along z direction. The volume of lungs was segmented out with CT images (3DSlicer). Lung doses of all patients were calculated and compared with CTDIvol, DLP, and SSDE. Results: The average (range) of CTDIvol, DLP and SSDE of all patients was 1.19 mGy (0.58 to 3.12mGy), 31.54 mGy*cm (12.56 to 99 mGy*cm), 2.26 mGy (1.19 to 6.24 mGy), respectively. Radiation dose to the lungs ranged from 0.83 to 4.18 mGy. Lung doses correlated with CTDIvol, DLP and SSDE with correlation coefficients(k) at 0.98, 0.93, and 0.99. However, for the cases with CTDIvol less than 1mGy, only SSDE preserved a strong correlation with lung doses (k=0.83), while much weaker correlations were found for CTDIvol (k=0.29) and DLP (k=-0.47). Conclusion: Lung doses to pediatric patients during Cardiac CTA were estimated. SSDE showed the most robust correlation with lung doses in contrast to CTDIvol and DLP.
The Impact of Nutritional Knowledge on the Quantity and the Quality of Diet Among the Southern Rural Elderly.

Abstract LEARNING OUTCOME: To examine the relationship between diet quality and nutrition knowledge of the rural elderly. Volunteers (n=1555) of elderly residing in counties with 70% or more rural population from 9 Southern states (AL, AK, GA, KY, MD, MO, MS, TN, TX) participated in the study. This study was designed to delineate whether there was a relationship between nutrition knowledge and the quality of diet and nutrient consumption among the rural elderly, one of most neglected segments of our population. The sample consisted of 47.8% Blacks and 51.9% Whites, 15.8% male and 84.2% female. The age ranged from 60 to 102 yrs. (mean ± SD: 72.8 yrs. ± 7.6) and 57.6% lived alone; only 34.9% of the elderly completed high school or higher education. 43% of the elderly had a per capita monthly income less than $450, and 27.5% were Food Stamp Program participants. Information collected from these participants through face-to-face interviews included: socioeconomic factors, health history, 2 non-consecutive days food intakes by 24-hr recall, and nutritional knowledge, practice, and attitudes. The nutrition knowledge and practice questions were adapted from the USDA Diet and Health Knowledge Survey. Nutrient intakes were computed from the 24-hr recall data by using Nutritionist IV (N-Squared, San Bruno, CA). The Diet Quality Index (DQI) was computed based on R. Patterson's method (JADA,. 94: 57-64, 1994). Knowledge scores on dietary fiber and fat/cholesterol were trisected - high, medium and low. One-way factorial ANOVA technique was used to discern the difference in DQI and nutrient consumption as related to their knowledge scores. The DQI increased significantly with the knowledge scores on dietary fiber ((p
A capillary–PDMS hybrid chip for separations-based sensing of neurotransmitters in vivo

A chip fabricated by multilayer soft lithography of poly(dimethylsiloxane) was created for separations-based sensing of neurotransmitters in vivo. The chip incorporated a pneumatically actuated peristaltic pump and valving system to combine low-flow push–pull perfusion sampling, on-line derivatization, and flow-gated injection onto an embedded fused-silica capillary for high speed separation of amine neurotransmitters from the brain of living animals. Six 160 µm wide by 10 µm high control channels, actuated with an overlapping 60° pulse sequence, simultaneously drove sample and buffers through fluidic channels of the same dimensions. Tunable sampling flow rates of 40 to 130 nL min−1 and separation buffer flow rates of 380 to 850 nL min−1 were achieved with actuation frequencies between 3 and 10 Hz. On-line sampling of amine neurotransmitters with separation efficiencies in excess of 250 000 plates, detection limits of ∼40 nM, and relative standard deviations of 4% for glutamate and aspartate were achieved in vitro. Electropherograms with resolution of γ-aminobutyric acid, glutamine, taurine, serine, glycine, o-phosphorylethanolamine, glutamate, and aspartate could be collected every 30 s for over 4 h in vivo. It was also shown that pharmacological agents could be delivered and subsequent changes in neurotransmitter profile could be measured when delivering either 70 mM K+ artificial cerebrospinal fluid or 200 µM L-trans-pyrrolidine-2,4-dicarboxilic acid with the chip. These results demonstrate the ability of this chip to sample and monitor chemicals in the complex environment of the central nervous system with high selectivity and sensitivity over extended periods.
Fracture‐Strength Anisotropy of Sapphire

At 22°C, the bend strength of as-ground sapphire bars with different orientations of tensile surface and tensile axis varies from 4×104 to 12×104 psi as a result of the anisotropies of machining damage and fracture energy. Generally, the strength-controlling surface flaws caused by grinding are of constant size; failure from such flaws is affected by grinding-induced slip and twinning. Surface striations, which occur when there is negligible subsurface slip, can lead to stress concentrations, whereas twins can lead to increases in flaw size; each of these effects reduces strength. In addition, the large anisotropy in fracture strength, which is not predicted by the elastic anisotropy, is controlled by the anisotropic fracture energy. Approximation of the attractive forces across the fracture plane based on elastic moduli and interplanar distance can be used to understand the fracture energy anisotropy.
Formal training in advanced surgical technologies enhances the surgical residency.

Abstract Introduction Surgeons have been consistently instructed to use better tools by which to improve upon a patient’s medical care. Since the first laparoscopic cholecystectomy, the desire for advanced surgical technologies has continued. This surgical breakthrough has been one of many changes in modern surgical and medical therapy that now represents the standard of care. The aim of this article is to examine the changes in surgical technologies that occurred in the past 15 years, evaluate the possible solutions that have been discussed and formally present the results of a formal training rotation in advanced surgical technologies at the University of Louisville, Department of Surgery. Methods Questionnaires were sent to 36 former residents who had completed the residency and the advanced surgical technologies rotation to evaluate the success of their training. Results From its inception in 1998 to 2004, the residents have performed a total of 1097 procedures, or an average of 35 cases per month. Much of the exposure was gained in advanced laparoscopy, including laparoscopic nissen fundoplication, gastric band, gastric bypass, splenectomy, colon resection, small-bowl resection donor nephrectomy, and hepatic ablation. Similarly, an evaluation of the 2 procedures that in the late 1990s were considered advanced surgical procedures—sentinal node biopsy and endovascular procedures—shows that the number of these procedures performed on this rotation has fallen over the past 2 years. The overall impression of the rotation from these former residents was either integral or essential in 70% and was helpful in 20%. Conclusion The number of demands impacting medical education have never been this numerous or complex. The rapid advances in science, systems, and information technology provide numerous advances in surgical training that continue to be the requirement and responsibility of general surgical training. The cultural changes in surgery include the team approach to provide services in surgical technologies, focus on the aging population, and outcomes assessment. The learning curve, for any and all of these procedures, is inevitably steep, and traditional resident training too often focuses on the more conventional procedures done in routine rotations. The need for formal training in advanced surgical technologies continues to be of utmost importance in these rapidly evolving times.
Aurora B Inhibits MCAK Activity through a Phosphoconformational Switch that Reduces Microtubule Association

Summary Background Proper spindle assembly and chromosome segregation rely on precise microtubule dynamics, which are governed in part by the kinesin-13 MCAK. MCAK microtubule depolymerization activity is inhibited by Aurora B-dependent phosphorylation, but the mechanism of this inhibition is not understood. Results Here, we develop the first Forster resonance energy transfer (FRET)-based biosensor for MCAK and show that MCAK in solution exists in a closed conformation mediated by an interaction between the C-terminal domain (CT) and the neck. Using fluorescence lifetime imaging (FLIM) we show that MCAK bound to microtubule ends is closed relative to MCAK associated with the microtubule lattice. Aurora B phosphorylation at S196 in the neck opens MCAK conformation and diminishes the interaction between the CT and the neck. Using FLIM and TIRF imaging, we find that changes in MCAK conformation are associated with a decrease in MCAK affinity for the microtubule. Conclusions Unlike motile kinesins, which are open when doing work, the high-affinity binding state for microtubule-depolymerizing kinesins is in a closed conformation. Phosphorylation switches MCAK conformation, which inhibits its ability to interact with microtubules and reduces its microtubule depolymerization activity. This work shows that the conformational model proposed for regulating kinesin activity is not universal and that microtubule-depolymerizing kinesins utilize a distinct conformational mode to regulate affinity for the microtubule, thus controlling their catalytic efficiency. Furthermore, our work provides a mechanism by which the robust microtubule depolymerization activity of kinesin-13s can be rapidly modulated to control cellular microtubule dynamics.
Religious versus Conventional Psychotherapy for Major Depression in Patients with Chronic Medical Illness: Rationale, Methods, and Preliminary Results

This paper (1) reviews the physical and religious barriers to CBT that disabled medically ill-depressed patients face, (2) discusses research on the relationship between religion and depression-induced physiological changes, (3) describes an ongoing randomized clinical trial of religious versus secular CBT in chronically ill patients with mild-to-moderate major depression designed to (a) overcome physical and religious barriers to CBT and (b) compare the efficacy of religious versus secular CBT in relieving depression and improving immune and endocrine functions, and (4) presents preliminary results that illustrate the technical difficulties that have been encountered in implementing this trial. CBT is being delivered remotely via instant messaging, telephone, or Skype, and Christian, Jewish, Muslim, Buddhist, and Hindu versions of religious CBT are being developed. The preliminary results described here are particular to the technologies employed in this study and are not results from the CBT clinical trial whose findings will be published in the future after the study ends and data are analyzed. The ultimate goal is to determine if a psychotherapy delivered remotely that integrates patients' religious resources improves depression more quickly than a therapy that ignores them, and whether religious CBT is more effective than conventional CBT in reversing depression-induced physiological changes.
A Duplex Quantitative Polymerase Chain Reaction Assay Based on Quantification of α-Methylacyl-CoA Racemase Transcripts and Prostate Cancer Antigen 3 in Urine Sediments Improved Diagnostic Accuracy for Prostate Cancer

Purpose: Most men with increased serum prostate specific antigen and negative biopsy require repeat biopsy because of the lack of a sensitive and specific prostate cancer detection test. In this study we evaluated the diagnostic potential of a duplex assay for prostate cancer by quantifying transcript levels of α-methylacyl-CoA racemase and prostate cancer antigen 3 in urine sediments following prostatic massage.Materials and Methods: Urine sediments from 92 patients, 43 with and 49 without prostate cancer, were collected after digital rectal examination. Transcript levels of AMACR, PCA3 and PSA in total RNA isolated from these samples were determined by absolute quantitative real-time polymerase chain reaction. AMACR and PCA3 scores were obtained by normalizing the transcript level to that of prostate specific antigen for each sample and multiplying by 100.Results: AMACR (p = 0.006) and PCA3 (p = 0.014) scores, but not serum prostate specific antigen (p = 0.306), distinguished specimens from patients wit...
The Effect of Recent Bereavement on Outcomes in a Primary Care Depression Intervention Study

Objectives Although bereavement and depression are both common in older primary care patients, the effect of bereavement on depression intervention outcomes is unknown. We examined whether standard interventions for depression in primary care were as effective for bereaved as for non-bereaved depressed patients. Design Randomized controlled trial. Setting Twenty community-based primary care practices in New York City, greater Philadelphia, and Pittsburgh. Randomization to either intervention or usual care occurred by practice. Participants Patients aged 60 years or older who met criteria for major depression or clinically significant minor depression (N = 599). Patients who did not complete the bereavement measure or who were missing 4-month data were excluded (final N = 417). Intervention Study-trained depression care managers offered guideline-concordant recommendations to primary care physicians at intervention sites and assisted patients with treatment adherence. Patients who did not wish to take antidepressants could receive interpersonal psychotherapy. Measurements Bereavement was captured using the Louisville Older Persons Events Schedule. Depression severity was assessed using the 24-item Hamilton Depression Rating Scale (HDRS). Outcomes at 4 months were remission (HDRS ≤7) and response (HDRS reduction ≥50% from baseline). Results Logistic regressions indicated that, for non-bereaved participants, response and remission were higher in intervention than usual care. However, recently bereaved older adults were less likely to achieve response or remission at 4 months if treated in the intervention condition. Conclusions Standard depression care management appears to be ineffective among recently bereaved older primary care patients. Greater attention should be paid in primary care to emotional distress in the context of bereavement.
Inhibition of telomerase activity by preventing proper assemblage.

Telomerase is a ribonucleoprotein complex that acts as a reverse transcriptase in the maintenance of chromosome ends. Because the vast majority of cancer cells require telomerase activity, telomerase has become a target for anticancer drug discovery. Here, we describe a new approach for targeting telomerase by blocking the association between the telomerase catalytic subunit, hTERT, and key elements of the human telomerase RNA subunit, hTR. By examining the effects of oligonucleotides that hybridize to various regions of hTR, we identified two regions of the RNA subunit that are sensitive to molecular interactions leading to telomerase inhibition. Oligonucleotides that hybridize to either the P3/P1 pairing region or to the CR4−CR5 domain of hTR, hTRas009, and hTRas010, respectively, inhibit telomerase activity when added to recombinant hTERT and hTR prior to assemblage. However, addition of hTRas009 or hTRas010 to preassembled telomerase resulted in little or no inhibition. We also examined the ability of...
Electron-phonon mass enhancement in metal multilayers

A strong electron-phonon interaction in a metal increases the electron density of states in the vicinity of the Fermi energy dramatically. This phenomenon is called electron-phonon mass enhancement. In this paper, the question of whether the mass enhancement can be manipulated in multilayers of two metals with strong and weak electron-phonon interaction is investigated. A rich behavior is observed for different thickness ranges of the layers. For thin layers, one observes a rather homogeneous averaged enhancement. However, for an intermediate thickness range, the mass enhancement is highly anisotropic, i.e., direction dependent as well as position dependent. For large layer thicknesses, one obtains the bulk behavior for each metal.
Floods, Climate Change, and Urban Resilience: One Policy Maker's Perspective

When Hurricane Sandy battered the U.S. Atlantic Seaboard in October 2012, strong winds generated a storm surge that caused waters from the Hudson River to wash across Hoboken, N.J. Those waters flooded about 80% of the city, population 50,000, that lies across the river from Manhattan. The flooding caused more than $100 million in private property damage and more than $10 million in municipal property damage while impairing the region's transportation system.
Cryogenic laser fusion target material design considerations

Abstract Laser fusion target designs exhibit improved performance when the fusion fuel, a deuteriumtritium (DT) mixture, is frozen into a uniform, solid shell. The formation of'such a shell requires rapid isothermal cooling of the target to cryogenic temperatures. The cooling rate must be sufficiently fast to prevent significant, gravitaqtionally driven downward flow of the DT as it passes from the gaseous through the liquid state. Because it is not possible to measure the uniformity of a solid DT layer in opaque, multishell targets, we have modeled such targets to calculate the cooling rate and, hence, the expected thickness uniformity of the DT shell. The presented results provide target designers with practical guidelines for the selection of materials and configurations, which will assist in the fabrication of high-quality cryogenic targets.
Pseudorotaxanes and rotaxanes from macrocyclic rings incorporating acridinone, 9-phenylacridinium and 9-phenyl-9-methoxy-acridane moieties

Abstract Two novel crown ethers incorporating the acridinone and the 9-phenyl-9-methoxy-acridane unit were used to form pseudorotaxanes with the 1,2-bis(4,4′dipyridinium)ethane axle, which are stoppered by the alkylative method to form rotaxanes. The pseudorotaxane formed from the acridane-containing crown was photochemically converted to the corresponding acridinium methoxide thereby releasing the guest. The acridane-containing rotaxane could not be isolated because the preparation conditions formed the acridinium salt.
On the glass present in low-calcium and in high-calcium flyashes

Abstract A suite of 16 American flyashes ranging in analytical CaO content from less than 2% to approximately 27% was subjected to x-ray diffraction and the position of the glass diffraction maximum determined. Flyashes of analytical CaO content of up to about 20% showed maxima indicative of siliceous glass. Within this range the 20 angular position of the maximum was found to increase linearly with CaO content, suggesting progressive modification of the siliceous glass structure with increasing calcium content. Flyashes of analytical CaO content higher than about 20% showed a glass diffraction maximum at a constant and much higher 20 angle, indicative of calcium aluminate glass structural type. The latter glass may be significantly more reactive in concrete.
Constructing a Mind, One Image Schema at a Time.

In The Foundations of Mind, Jean Mandler describes how perceptual analysis provides a mechanism that allows infants to begin their journey into conceptual life, and subsequently to enter the advanced worlds of conceptual systems, memory, language, and consciousness. This review provides an overview of Mandler's theoretical position, celebrates her accomplishments, and supports the claim that The Foundations of Mind is a “must read” for all developmental scientists.
A new method to determine the relation between the particle size and chemical composition of tobacco smoke particles

Abstract A new method was applied to determine whether chemical differences exist among tobacco smoke particles with respect to particle size. The method used was a combination of a screen type diffusion battery and gas chromatography with a trimethylsilylation technique. The results showed that the portion of chemical compounds with higher b.p. in the tobacco smoke increases with particle size.
Emerging concepts of heart failure in tetralogy of Fallot

As our understanding of tetralogy of Fallot (TOF) evolves, so does our approach to treating those born with “la maladie bleu.” Prior to the birth of cardiac surgery, the outlook for children with unrepaired TOF was bleak, with a median age of death of 9 years [1]. Advances in diagnosis, cardiac surgery, and cardiopulmonary bypass led to dramatic improvements in survival, starting with the Blalock–Taussig–Thomas shunt in 1945 [2] and culminating in primary neonatal repair in 1973 [3]. Early mortality after corrective surgery has dropped from 25% to less than 2% in recent decades [4], leading to a growing population of adults with repaired TOF. From early descriptions of cardiac morphology to palliative surgeries to complete repair, the history of TOF is, in essence, the history of congenital heart disease. The latest chapter is the recognition that many patients who benefited from the miraculous evolution of congenital heart surgery harbor the substrate for myocardial dysfunction leading to heart failure (HF). HF is an increasingly common reason for hospitalization in adults with congenital heart disease [5]. Physiologic definitions of heart failure focus on the heart’s inability to meet the requirements of the metabolizing tissues [6]. Overt clinical failure arises due to elevated ventricular filling pressures and inadequate perfusion leading to multi-organ dysfunction. How these definitions apply to ACHD-related HF is unclear, particularly since many younger patients do not exhibit decompensated HF by virtue of compensatory autonomic and renal adjustments. HF symptoms may go unnoticed because many ACHD patients have adapted to lifelong cardiac symptoms and limitations [7]. It could be argued that overt manifestations of HF in ACHD patients represent a
Ultrastructural and Histochemical Studies of Conjunctival Concretions

• Ultrastructural and histochemical studies were performed on conjunctival concretions (yellow spots in the tarsal conjunctiva) from two patients who had associated atopic keratoconjunctivitis and posttrachomatous degeneration. By electron microscopy, these concretions were composed of finely granular material and membranous debris accumulating in the conjunctival subepithelium. Histochemically, concretions stained strongly positive for phospholipid and elastin, weakly positive for neutral polysaccharides and lipid, and were negative for amyloid, collagen, glycogen, iron, mucopolysaccharides, RNA, and DNA. In view of the absence of both calcium and phosphate in the accumulated material, the use of the term "lithiasis" is misleading and should be avoided. These findings support a hypothesis that concretions that follow chronic conjunctivitis represent products of cellular degeneration.
Diagnostic Markers in Human Neurooncology A Progress Report

In this progress report, some of the most commonly used antibodies are discussed in regard to their immunohistochemical application to human neurooncology. The importance of determining the spectrum of antibody immunoreactivity in a wide panel of normal, reactive, and neoplastic tissues is stressed. in atypical and aberrant cases, immunopositivity needs to be interpreted with caution and in the context of all other available data. The demonstration of a well-characterized, cell type-specific marker in a tumor reflects not so much its cytogenesis as its differentiation potential and its capacity for metaplasia. The relation of an abnormal or aberrant expression of antigenic determinants to the process of neoplasia raises a number of intriguing questions to which research in the next few years will likely provide answers.
Caveolin and cholesterol in lipid transport and signaling

Abstract Caveolae are free cholesterol-rich invaginated microdomains of the cell surface characterized by the presence of one or more structural proteins (caveolins). The cholesterol-binding capacity of caveolin plays a key role in the organization of signaling complexes within caveolae. Caveolae are particularly rich in multiprotein signaling complexes containing protein growth factor receptors or integrins. Immunoprecipitation of caveolins from cells labeled with 3H free cholesterol (FC) allows proteins and lipids present in caveolae to be identified at intervals following the initiation of signal transduction. Signaling was found to be associated with transient loss of caveolin-associated FC, stimulation of FC efflux, and phosphorylation of caveolin at a sensitive tyrosine residue. FC within caveolae is labile and responsive to changes in the local composition of signaling complexes. In view of the extended residence of caveolae at the cell surface, these data imply that caveolae take part in an FC cycle initiated by the binding of ligand to its transmembrane kinase. Regulated loss of FC from caveolae is followed by a recovery phase when FC content is restored. These changes form an essential part of signal transduction from the cell surface for caveolae-associated signaling complexes.