cssi/SciSciGPT-SciSciNet huggingface dataset:
PHENIX Level-1 Trigger systems for RHIC run-3

The PHENIX detector at the Relativistic Heavy Ion Collider (RHIC) will study the dynamics of ultra-relativistic heavy ion collisions and search for exotic states of matter, most notably the Quark Gluon Plasma (QGP). Substantial event selectivity is needed at RHIC to enhance interesting events relative to more common ones and to satisfy the requirements of the data acquisition system. The first on-line screening is achieved by the Level-1 Trigger. The Level-1 Trigger is a beam-clock parallel-pipeline system that uses Local Level-1 (LL1) algorithms pertaining to the fastest PHENIX subdetectors, followed by a Global Level-1 (GL1) system that processes encoded LL1 reduced-bit data to issue up to 32 triggers. In this paper we discuss a new set of LL1 trigger systems that will be deployed for the third RHIC run. These new trigger systems utilize the same basic hardware designed around commercial FPGA logic in order to provide a common platform for a wide variety of physics triggers.
Influence of Light and Agitation on Bovine Spermatozoa Stored with Protective Agents

Abstract Bovine spermatozoa were stored at 5C in the Cornell University Extender (CUE) consisting of 20% egg yolk medium and exposed to 2,150 lux of illumination. Viability of spermatozoa following agitation and exposure to light was determined in a series of factorially arranged experiments combining the effects of catalase, N 2 gassing, spectral filtering of the light, and the radiation-protective agent, β-mercaptoethylamine (MEA). Both light and agitation were spermicidal (P 2 in sealed glass ampules was highly effective and catalase was partially effective in negating this harmful effect on motility of spermatozoa (P 2 with MEA were thwarted by toxicity of MEA to spermatozoa. These results indicate that only part of the amaging effect of O 2 is catalase specific (H 2 O 2 formation), and that other harmful mechanisms may be inhibited by replacement of air with N 2 . Spectral filtering of white light revealed that the blue region was particularly damaging to spermatozoa and to catalase. The spectral characteristics of the cytochromes suggest that these heme proteins, like catalase, may be particularly sensitive to the blue light and serve as photon acceptors, thus initiating a series of photochemical reactions damaging to the cell.
Scalable Reasoning Techniques for Semantic Enterprise Data

Semantic Reasoners are the set of applications that can provide inferences over semantic data sets. As the types of data ontologies, the amount of instance data based on those ontologies, and the type of required inferences grow, the problem of reasoning becomes increasingly difficult. Linking of the Data within the enterprise as with the case of external data explodes the scaling problem. In this chapter, we look at various reasoning techniques and how to assure that they can scale properly so that Linking Data results in additional knowledge.
Values and Beliefs About Obesity and Weight Reduction Among African American and Caucasian Women

Designing culturally relevant weight-reduction programs requires understanding of ethnic variations and illness beliefs. Preliminary data on the values and beliefs about obesity and weight reduction were obtained from women of different ethnic/racial backgrounds. Purposive sampling was used to recruit African American (AA) and Caucasian (C) women with a body mass index (BMI)>or= 30 from the general internal medicine clinics of a large tertiary care facility. Four focus groups (2 with AA women and 2 with C women) consisting of a total of 20 subjects were conducted in a 2-month period. AA women cited culture specific barriers to weight loss more so than did C women. AA women and C women also differed on how health care professionals could help them with weight loss. These findings have implications for nursing's role in the design of culturally relevant weight-loss programs.
Mutual authentication and key exchange for low power wireless communications

We propose two efficient mutual authentication and key exchange protocols (MAKEPs) namely (1) server-specific and (2) linear MAKEPs. They are suitable for establishing secure communications between a low-power wireless device (client) and a powerful base station (server) under different system requirements. These protocols reduce the computational burden of the client while still maintaining a required level of security and a good amount of scalability for most wireless communications applications. We discuss their security and also demonstrate that they can be implemented efficiently.
Normal metaphyseal radiologic variants not to be confused with findings of infant abuse

Postmortem high-detail skeletal radiography of 78 infants who died of the sudden infant death syndrome was performed during a 3-year period. Review of the studies reveals a variety of distinct radiologic variants that should not be confused with the metaphyseal injuries caused by infant abuse.
Implicit motor sequence learning is not represented purely in response locations.

This study employed a novel variant of the serial reaction time task, focused on sequencing one element of movement—direction. During the task a repeated pattern of alternating directions (right–left–right, etc.) was embedded in the stimuli, and there was no series of response locations. Responses were made via two effector systems: single-finger responding (necessitates lateral arm movements between response keys), and four-fingered responding (4 individual fingers on 4 individual keys; requires no lateral arm movement). The sequence of directions was only learned by participants who performed lateral movements during training, indicating that learning was contingent on the particular motor effector used. Participants with low levels of sequence awareness displayed the same pattern of results.
Modeling the delays of successively-transmitted Internet packets

We introduce an Internet packet delay and loss model for use in rate-distortion optimized media streaming. Our scheme uses feedback to learn the delay over the channel in the recent past and then finds probability mass functions for delays at later times by using chains of approximated conditional delay distributions. With an Internet delay trace we have collected and a performance metric that we introduce, we show that our scheme is far more accurate than the commonly-used model, which assumes packet delays to be i.i.d. /spl Gamma/-distributed, at predicting arrival outcomes for groups of successively-transmitted Internet packets. In addition, we outline our Linux-based one-way delay trace collection techniques and we show the suitability of the shifted /spl Gamma/ distribution for modeling conditional packet delays over Internet links that include a cable modem last hop.
THE FIRST MAN AND THE COMPANY MAN: THE COMMON GOOD, TRANSCENDENCE, AND MEDIATING INSTITUTIONS

An enormous oblivion spread over them, and actually that was what this land gave out, what fell from the sky with the night over the three men returning to the village, their hearts made anxious by the approach of night, filled with that dread that seizes all men in Africa when the sudden evening descends on the sea, on the rough mountains and the high plateaus, the same holy dread that has the same effect on the slopes of Delphi's mountain, where it makes temples and altars emerge. But on the land of Africa the temples have been destroyed, and all that is leR is this soft unbearable burden of the heart.
Self-oscillation in BaTiO(3) using a multimode laser.

The effect of temporal coherence on the phenomena of self-oscillation in photorefractive materials is analyzed using multilongitudinal-mode argon-ion and helium–neon lasers. Observations demonstrate that self-oscillation is possible when the mirror–crystal separation is large compared to the laser coherence length. The observations are shown to agree with predictions based on the recurrence in the temporal coherence of a multilongitudinal-mode laser.
RAD9 deficiency enhances radiation induced bystander DNA damage and transcriptomal response

Radiation induced bystander effects are an important component of the overall response of cells to irradiation and are associated with human health risks. The mechanism responsible includes intra-cellular and inter-cellular signaling by which the bystander response is propagated. However, details of the signaling mechanism are not well defined. We measured the bystander response of Mrad9 +/+ and Mrad9 −/− mouse embryonic stem cells, as well as human H1299 cells with inherent or RNA interference-mediated reduced RAD9 levels after exposure to 1 Gy α particles, by scoring chromosomal aberrations and micronuclei formation, respectively. In addition, we used microarray gene expression analyses to profile the transcriptome of directly irradiated and bystander H1299 cells. We demonstrated that Mrad9 null enhances chromatid aberration frequency induced by radiation in bystander mouse embryonic stem cells. In addition, we found that H1299 cells with reduced RAD9 protein levels showed a higher frequency of radiation induced bystander micronuclei formation, compared with parental cells containing inherent levels of RAD9. The enhanced bystander response in human cells was associated with a unique transcriptomic profile. In unirradiated cells, RAD9 reduction broadly affected stress response pathways at the mRNA level; there was reduction in transcript levels corresponding to genes encoding multiple members of the UVA-MAPK and p38MAPK families, such as STAT1 and PARP1, suggesting that these signaling mechanisms may not function optimally when RAD9 is reduced. Using network analysis, we found that differential activation of the SP1 and NUPR1 transcriptional regulators was predicted in directly irradiated and bystander H1299 cells. Transcription factor prediction analysis also implied that HIF1α (Hypoxia induced factor 1 alpha) activation by protein stabilization in irradiated cells could be a negative predictor of the bystander response, suggesting that local hypoxic stress experienced by cells directly exposed to radiation may influence whether or not they will elicit a bystander response in neighboring cells.
Comparative Performance of Different Plastic Films for Soil Solarization and Weed Suppression

ADDITIONAL INDEX WORDS. Cyperus rotundus, durability, nutsedges, plastic mulch SUMMARY. Soil solarization is an important practice for small-acreage farmers and home gardeners and is used commercially in areas with high solar radiation and air temperature during the summer. In this technique, clear plastic films are used to increase soil temperature to manage soil-borne plant pests such as insects, diseases, nematodes, fungi, and weeds. Several different kinds of plastic films were evaluated in 2007 and 2008 for durability, weather tolerance, and weed suppression. Treatments were arranged in a randomized complete block design with five replications. In 2007, treatments were four clear plastic films including: ISO, VeriPack, Poly Pak, Bromostop, and a white plastic control. In 2008, treatments were Polydak, Poly Pak, Bromostop, and white plastic. Films were evaluated for weed suppression based on the population density of weeds that emerged through breaks in the plastic, for durability in terms of number and size of breaks in the films, and for the total exposed soil area resulting from breaks. Purple nutsedge (Cyperus rotundus) was the major weed problem throughout both years. In both years, total exposed area was greater with white plastic and Bromostop (81.5 ft 2 / bed) compared with other plastic films (<21.5 ft 2 /bed). Due to their durability, Poly Pak, ISO, and VeriPack suppressed nutsedge more than Bromostop and white plastic. Although a number of very small (<0.75 inch long) breaks were observed in Polydak plastic film, they never increased in size, and this plastic film remained intact throughout the experiment and provided excellent weed control.
Use of Spatiotemporal Constraints to Quantify Transit Accessibility Case Study of Potential Transit-Oriented Development in West Valley City, Utah

Accessibility emerges as the transportation performance measure that emphasizes the benefits to transportation system users and captures more than the speed of travel. Transit accessibility shows how easy it is for an individual to travel to a desired destination by using public transit. However, for transit to be considered as an option in mode choice at all, there has to be a feasible transit route leading from a given origin to a desirable destination within the available time frame. This study used spatial and temporal constraints and a set of transit features that affected access to transit to develop a conceptual framework for transit accessibility measurements in a potential transit-oriented development (TOD) location in West Valley City, Utah. As this network develops more transit-friendly features, temporal and spatial accessibility indicators will provide useful information on the opportunities that users can reach by using transit. The proposed methodology was based on traffic and transit data ...
On the Threshold of Law: Dictatorship and Exception in Machiavelli and Schmitt

IN PALLAS AND THE CENTAUR , a well-known painting probably commissioned by Lorenzo de’ Medici around 1482, Botticelli depicted an iconic image of power, where unruliness and restraint symbolically coexist projecting a sense of wondrous tension. While expressing the integration of mythological themes within the Neoplatonic gist of Florence’s esthetic canons, Botticelli’s work captures the political mood of the city in the aftermath of the Pazzi conspiracy, when rampant violence indelibly marked Lorenzo’s de facto rule over the Florentine republic. Botticelli portrayed Pallas, traditionally considered an epitome of reason and wisdom, as ruling over the centaur, usually associated with physical strength and intemperance. Despite the contrast between the two, at least one detail characterizes them both: they are armed, although with their weapons at rest. Pallas wields a magnificently chiseled halberd, the centaur a simple bow. The spectacle of tamed violence dramatizes a vision of power that sets the sovereign of a state on the threshold between a divinely inspired humanity and unbridled bestiality. About thirty years after the completion of this painting, the same vision would find its most compelling correction in chapter 18 of Il principe. Leaving no room for Pallas, Niccolo Machiavelli famously retrieves the myth of the centaur to assert that, when necessary, a prince should be able to operate outside the boundaries of the law, which is proper to man, and use fraud or force, qualities that are proper to the beast: “a uno principe e necessario sapere bene usare la bestia e lo
Barriers to the Use of Psychosocial Support Services Among Adolescent and Young Adult Survivors of Pediatric Cancer

Purpose: Adolescent and young adult (AYA) survivors of pediatric cancer commonly report both functional and emotional difficulties, yet many of their mental health needs are not met. Given the unique needs of these survivors, this study examined barriers to psychosocial support service utilization in this population, including accessibility, personal preferences, and practical barriers such as insurance and transportation. Methods: Thirty-six adolescent and young adult survivors of pediatric cancer (aged 15-29) with mental health difficulties (i.e., anxiety or depression) completed surveys assessing access and utilization of services and barriers to utilization. Services assessed included the use of mental health professionals, a pastor or someone in a place of worship, and support groups. Results: Half of the participants utilized a mental health professional, but other forms of support were used less frequently. Utilization of services was related to insurance status and use of prescription medication. Greater time since completion of treatment was a barrier to utilizing psychosocial support services. Conclusion: Use of psychosocial support services is linked closely with use of other healthcare services, including taking prescription medication for mood difficulties. Results have implications for how primary care and oncology providers address barriers to these services among AYA survivors of pediatric cancer.
O-030 Headache following intracranial endovascular coiling

Objectives To predict which patients with intracranial endovascular coiling develop headaches (HA), the utility of neuroimaging in these patients and to investigate whether triptans and ergots can be safely used for migraine in the setting of pre- and post-coiled aneurysms. Background Excessive diagnostic testing is often obtained in patients with prior intracranial endovascular coiling who present with HA. Results are frequently low yield with unnecessary risks and costs. The ability to predict those most likely to develop post-coiling HA would help decrease these risks and costs. Lastly, pre- and post-coiled aneurysms are often considered a contraindication for triptan and ergot use, although supporting data are lacking. Methods Retrospective chart review. Inclusions: men/women >18 years with intracranial endovascular coiling at the Cleveland Clinic from July 2006 to June 2009. Exclusions: age Results 264 patient were reviewed (202 females, 62 males). Post-coiling HA 72%; 190/264 (155F: 82% of HA, 77% of F) (35M: 18% of HA, 57% of M). Anterior circulation: 146/190, posterior circulation: 46/190. HA pre-emergent coiling: 73%; 43/59 (38F, 5M). HA pre-emergent coiling with no HA post-coiling: 16/59 (9F, 7M). HA HA HA >1 year pre-coiling: 89%; 46/52 (38F, 8M). HA >1 year pre-coiling with no HA post-coiling: 6/52 (6F, 0M). No HA pre-elective coiling: 48%; 37/77 (32F, 5M). Urgent procedures: 118; non-contrast CT 69; CTA 7; MRI/A/V 29; cerebral angiogram five; LP eight (one required blood patch); all negative except one with small acute finding. Triptans used safely in 10 pre-coiling and 10 post-coiling patients, and DHE in one post-coiling patient. Post-coiling HA comorbidities Smokers: 57%; 108/190. (87F: 81% total smokers with HA, 56% total women with HA, 46% total HA). (21M: 19% total smokers with HA, 60% total men with HA, 11% total HA). Depression/anxiety: 48%; 92/190. (78F: 85% total anxiety/depression with HA, 50% total women with HA, 41% total HA). (14M: 15% total anxiety/depression with HA, 40% total men with HA, 0.07% total HA). Smokers and/or anxiety/depression: 75%; 142/190. (115F: 81% total smokers and/or anxiety/depression with HA, 74% total women with HA, 61% total HA). (27M: 19% total smokers and/or anxiety/depression with HA, 77% total men with HA, 14% total HA). Conclusions HA frequently follows intracranial endovascular coiling. Post-coiling HA occurs more commonly in women, and this risk is magnified in patients who smoke or have comorbid psychiatric disease. These findings may help predict those most likely to develop post-coiling HA. Diagnostic testing for acute post-coiling HA is low yield and may pose unnecessary costs and risks. Triptans and DHE (an ergot) were used safely in a small number of patients pre- and post-coiling. Many pre-coiling HAs resolved post-coiling, suggesting that aneurysmal coiling may resolve HAs in select patients. More data are needed to further prospectively evaluate these trends.
Activation of the p53 DNA damage response pathway after inhibition of DNA methyltransferase by 5-Aza-2′-deoxycytidine

Transcriptional silencing of tumor suppressor genes by DNA methylation occurs in cancer cell lines and in human tumors. This has led to the pursuit of DNA methyltransferase inhibition as a drug target. 5-Aza-2'-deoxycytidine [5-aza-CdR (decitabine)], a potent inhibitor of DNA methyltransferase, is a drug currently in clinical trials for the treatment of solid tumors and leukemia. The efficacy of 5-aza-CdR may be related to the induction of methylation-silenced tumor suppressor genes, genomic hypomethylation, and/or enzyme-DNA adduct formation. Here, we test the hypothesis that 5-aza-CdR treatment is perceived as DNA damage, as assessed by the activation of the tumor suppressor p53. We show that 1) colon tumor cell lines expressing wild-type p53 are more sensitive to 5-aza-CdR mediated growth arrest and cytotoxicity; 2) the response to 5-aza-CdR treatment includes the induction and activation of wild-type but not mutant p53 protein; and 3) the induction of the downstream p53 target gene p21 is partially p53-dependent. The induction of p53 protein after 5-aza-CdR treatment did not correlate with an increase in p53 transcripts, indicating that hypomethylation at the p53 promoter does not account for the p53 response. It is relevant that 5-aza-CdR has shown the greatest promise in clinical trials for the treatment of chronic myelogenous leukemia, a malignancy in which functional p53 is often retained. Our data raise the hypothesis that p53 activation may contribute to the clinical efficacy and/or toxicity of 5-aza-CdR.
A revision of Rhapis (Arecaceae)

A revision of the Asian palm genus Rhapis is given based on study of 167 herbarium specimens of wild origin from A, AAU, BH, BK, BKF, GH, HN, HNU, HPNP, IBSC, K, KUN, L, MO, NY, P, SYS, US and application of the Phylogenetic Species Concept to a database comprising 13 qualitative and 16 quantitative variables. Eleven species are recognized, including two new ones. Two species are divided into subspecies.
Sellar Region Epidermoid and Dermoid Cysts

Epidermoid and dermoid cysts are developmental anomalies that can occur anywhere in the cranial cavity.
Analysis on Malaria Surveillance in Sichuan Province from 1999 to 2003

Objective To master the dynamic malaria situation in Sichuan so as to make out suitable control measures. Method Based on malaria surveillance program,routine techniques on malaria incidence and vector were adopted. Results The malaria situation in surveillance sites revealed decline tendency year by year.In recent 2 years,the confirmed malaria cases by blood examination amounted to over 90% of the information report on epidemic situation.The confirmed malaria cases of two-type fever cases(fever cases diagnosed as malaria in first visit examination and suspected malaria cases)amounted to over 90% of the total positives in blood ex- amination.The anopheles density in human rooms varied slightly but it revealed decline tendency in cow- sheds. Conclusion Based on the results,the authors suggested that the control and surveillance activities,the treatment of cases with clinical symptoms,the professional quality of malaria health workers,the blood exami- nation of fever cases,the management of floating population,and the report system of information on epidemic situation should be strengthened.
Role Modeling and Regional Health Care Intensity: U.S. Medical Student Attitudes Toward and Experiences With Cost-Conscious Care.

PurposeTo examine medical student attitudes toward cost-conscious care and whether regional health care intensity is associated with reported exposure to physician role-modeling behaviors related to cost-conscious care.MethodStudents at 10 U.S. medical schools were surveyed in 2015. Thirty-five item
Development of a Self-Assessment Tool to Facilitate Decision-Making in Choosing a Long Term Care Administration Major.

ABSTRACTLong term care administrators need a broad base of knowledge, skills, and interests to provide leadership and be successful in managing a fiscally responsible, quality long term care organization. Researchers developed a tool to help students assess whether a long term care administration major is a compatible fit. With input from professionals in the field and in context with the literature, a multi-phase research process, utilizing undergraduates as research assistants, led to development of the Long Term Care Administrator (LTCA) Self-Assessment Tool which focuses on assessing interest, ability, and experience of prospective students across the following 10 characteristics deemed necessary for effective leadership of long term care communities: organization, critical thinking, people skills, attitude, confidence, communication, visionary leadership, sense of caring, change agent, and business sense. Internal consistency measures and factor analysis suggest the LTCA Tool is reasonably reliable a...
Comparison of the Cost of Drug-Eluting Stents versus Bare Metal Stents in the Treatment of Critical Limb Ischemia in the United States.

Background Despite significant technical advancement in the last decade, the durability of endovascular management of critical limb ischemia (CLI) remains highly debatable. Drug-eluting stents (DESs) are being popularized for the management of CLI after its precedent success in coronary intervention. Initial reports on the durability of DES are promising. However, little is known on the additional cost of this relatively newer technology. The aim of this study is to compare the cost of the traditional bare metal stents (BMSs) to the newly introduced DES in a large cohort of CLI patients. Methods Using the Premier database (2009-2015), we identified all patients with CLI undergoing DES and BMS. A multivariable generalized linear model was implemented to examine in-hospital cost adjusting for patients' characteristics, comorbidities, and regional characteristics. Results A total of 20,702 patients with CLI underwent peripheral artery revascularization using BMS (18,924 [91.41%]) or DES (1,778 [8.6%]). Majority of patients were males (53%) and whites (71%). Patients undergoing BMS were slightly younger (median age [interquartile range]: 70 [62-79] versus 71 [63-80]) and were more likely to be smokers (46% vs. 39%) and have a history of cerebrovascular disease (10% vs. 8%) and chronic pulmonary disease (24.5% vs. 20.9%) as compared with those undergoing DES (all P Conclusions In this large cohort of CLI patients, after controlling for potential confounders, we demonstrated that the cost of endovascular revascularization is significantly higher in patients undergoing DES than those undergoing BMS. Regional disparities in cost were also observed. Further studies looking at the long-term durability and costs of DES versus BMS are needed.
Injury Prevention and Trauma Mortality

Injury is a global health problem, and in the United States, it is the leading cause of death for persons aged 1 to 44 years. In 2014, unintentional injuries were responsible for 136,053 deaths in the United States and an additional 29 million injuries involved an ED visit.1 The 2 most frequently seen causes of unintentional injury death are head injury and hemorrhage. These types of injuries result in death at the scene in approximately 60% of all unintentional injury cases. The remainder of unintentional injury deaths occur once the patient has reached the hospital. Language: en
Using TCAD Modeling to Compare Heavy-Ion and Laser-Induced Single Event Transients in SiGe HBTs

Silicon-germanium heterojunction bipolar transistor (SiGe HBT) models are used in technology computer aided design (TCAD) to investigate single event transients induced by heavy-ion broadbeam and pulsed-laser two-photon absorption sources. A comparison between transient waveforms is provided, the proper extraction of heavy-ion broadbeam transients is discussed (along with circuit implications), and basic laser strike profiles are implemented in TCAD to provide insight into future design practices for simulation software to be used to describe laser-induced upsets in terms of an effective linear energy transfer (LET).
Diuretics reduced cardiovascular disease events in diabetic and nondiabetic patients

Source Citation Curb JD, Pressel SL, Cutler JA, et al., for the Systolic Hypertension in the Elderly Program Cooperative Research Group. Effect of diuretic-based antihypertensive treatment on cardi...
STUDIES ON TYPHUS FEVER : VII. ACTIVE IMMUNIZATION AGAINST MEXICAN TYPHUS FEVER WITH DEAD VIRUS

Guinea pigs can be immunized against Mexican typhus virus by peritoneal injections of formalinized Rickettsia material, provided sufficient amounts of the organisms are used. Our results in this respect are analogous to those of Spencer and Parker with carbolized virus of Rocky Mountain spotted fever. The Rickettsia suspensions appear to possess considerable toxicity. We do not wish to be misunderstood as implying that the results in guinea pigs offer anything more than a demonstration of the principle of active immunization with killed Rickettsiae. Application to man will have to be worked out, and preliminary to this, we are now attempting to apply the methods to a limited number of monkeys.
Geographies of Local Government Stress after the Great Recession

Local governments in the USA are facing increased levels of fiscal stress after the Great Recession. We conducted a national survey in 2012 to assess differences in sources of stress and service delivery responses (privatization, inter-municipal co-operation, and public delivery) across places. Our discriminant analysis on 1,889 US cities and counties contributes to the literature on state rescaling. We differentiate three types of stress: fiscal, housing market decline and demographic. Fiscal stress and demographic stress are linked and highest in metro core and rural places, while housing market decline is associated with population density and revenue diversification. Diverse revenue sources can ameliorate some of the fiscal challenges brought on by housing market decline. Regarding service delivery, we find privatization and co-operation are higher in suburbs. State aid dependence is highest in rural and metro core areas with greater need, but decrease in state aid is highest in the South and West, where fiscal stress is also highest. Decentralization has exacerbated spatial inequality in the wake of the Great Recession challenging the efficiency claims of fiscal federalism. More redistributive state policies are needed.
Normal Anal Examination After Penetration: A Case Report

Abstract Background Physical findings are rare after anal penetration. Furthermore, children delay in disclosing or are reticent to discuss penetration. Case Report A 12-year-old boy presented to medical care multiple times over a several-week period complaining of abdominal pain, bloody diarrhea, and poor appetite. On colonoscopy, he was found to have a cylindrical foreign body (measuring 7 cm tall and 7 cm in diameter) in his rectum, which had been present for at least 2 weeks. He initially denied knowing how the object got into his rectum and later stated that he inserted it himself out of curiosity. One week after the object was removed, follow-up examination using video colposcopy revealed a completely normal anal examination; the patient had a normal anal examination despite known anal penetration and removal of the object. Why Should an Emergency Physician Be Aware of This? Children can have a normal anal examination despite anal penetration, and do not always disclose anal penetration. The aforementioned concepts can be applied to situations related to child sexual abuse in the emergency department, where physical examinations are frequently normal and children delay in disclosing the abuse. When there is concern for sexual abuse, even in the absence of a disclosure or examination findings, patients should be referred for a child abuse pediatrics evaluation if available.
Is there still a role for alveolar recruitment maneuvers in acute respiratory distress syndrome

An alveolar recruitment maneuver (ARM) involves the transient application of high transpulmonary pressures to achieve threshold opening pressures in collapsed peripheral airways and alveoli. The expectation of ARMs is to improve oxygenation, lung compliance and potentially facilitate alveolar fluid clearance (1,2). Although the origins of ARM as a clinical tool were for treating intra- or post-operative atelectasis (3), beginning in the 1990’s ARM became a central feature of “open-lung ventilation” (OLV), a lungprotective ventilation strategy for managing patients with acute respiratory distress syndrome (ARDS) (4).
Creatine-electrolyte supplementation improves repeated sprint cycling performance: A double blind randomized control study

Creatine supplementation is recommended as an ergogenic aid to improve repeated sprint cycling performance. Furthermore, creatine uptake is increased in the presence of electrolytes. Prior research examining the effect of a creatine-electrolyte (CE) supplement on repeated sprint cycling performance, however, did not show post-supplementation improvement. The purpose of this double blind randomized control study was to investigate the effect of a six-week CE supplementation intervention on overall and repeated peak and mean power output during repeated cycling sprints with recovery periods of 2 min between sprints. Peak and mean power generated by 23 male recreational cyclists (CE group: n = 12; 24.0 ± 4.2 years; placebo (P) group: n = 11; 23.3 ± 3.1 years) were measured on a Velotron ergometer as they completed five 15-s cycling sprints, with 2 min of recovery between sprints, pre- and post-supplementation. Mixed-model ANOVAs were used for statistical analyses. A supplement-time interaction showed a 4% increase in overall peak power (pre: 734 ± 75 W; post: 765 ± 71 W; p = 0.040; ηp2 = 0.187) and a 5% increase in overall mean power (pre: 586 ± 72 W; post: 615 ± 74 W; p = 0.019; ηp2 = 0.234) from pre- to post-supplementation for the CE group. For the P group, no differences were observed in overall peak (pre: 768 ± 95 W; post: 772 ± 108 W; p = 0.735) and overall mean power (pre: 638 ± 77 W; post: 643 ± 92 W; p = 0.435) from pre- to post-testing. For repeated sprint analysis, peak (pre: 737 ± 88 W; post: 767 ± 92 W; p = 0.002; ηp2 = 0.380) and mean (pre: 650 ± 92 W; post: 694 ± 87 W; p < 0.001; ηp2 = 0.578) power output were significantly increased only in the first sprint effort in CE group from pre- to post-supplementation testing. For the P group, no differences were observed for repeated sprint performance. A CE supplement improves overall and repeated short duration sprint cycling performance when sprints are interspersed with adequate recovery periods.
29. Laparoscopic Placement of Jejunostomy Tube

Feeding jejunostomy is indicated for patients who require enteral access for nutritional support and are best served with a jejunal rather than a gastric site of such access. Placement of a jejunal feeding tube via a laparoscopic approach is described, as are the indications and potential pitfalls of the procedure.
Basement membrane modulation of stimulated secretion by lacrimal acinar cells.

Lacrimal acinar cells rest basally on a basement membrane and have a secretory granule-filled apical cytoplasm adjacent to a lumen into which tear proteins are released. An important array of proteins are produced. In man, tear proteins are estimated to number as many as sixty (Gachon et al, 1979) and include: lysozyme, which plays a prominent bacteriocidal role on the corneal surface; lactoferrin, which functions as both a bacteriocidal agent and as a potential inhibitor of complement activation; secretory component, which regulates the transcellular movement of IgA into acini lumen where it acts on the corneal surface to inhibit bacterial adhesion; tear-specific prealbumin, whose function is not known. In rats, peroxidase is a tear component which has served as a convenient marker in experimental studies. Tears not only have an important bacteriocidal role, they also keep the cornea clean and lubricated, and are important for the well-being of the corneal epithelium.
Publisher Correction: Structural and chemical biology of deacetylases for carbohydrates, proteins, small molecules and histones.

In the original published version of the article, the protein name for the carbohydrate deacetylase in Geobacillus stearothermophilus was missing from Table 1. The protein name, Axe2 (corresponding to PDB code 3W7V), should have appeared immediately following the species name. In addition, a space was inadvertently omitted between Xanthomonas campestris and ACDase in Table 1. The errors have been corrected in the HTML and PDF versions.
An Evaluation of Spin in Lower Extremity Joint Trials.

Abstract Background Spin is a specific type of reporting bias that misrepresents data and results within randomized controlled trials (RCTs). Because spin may provide a surgeon with an inaccurate representation of trial results, thus misconstruing the surgeons' interpretation thereof and possibly negatively affecting patient care, it is important that spin is identified within publications. The primary goal of our study was to determine the prevalence of spin found within the abstracts of lower extremity joint trials. Methods Using Google Scholar’s H-5 index, we selected the top 20 journals in the orthopedic surgery category. We then conducted a PubMed search on July 2nd, 2018 using the advanced search feature, encompassing all RCTs published in these journals from January 1, 2016 to January 1, 2017. Spin was evaluated using a standardized protocol, using a previously published protocol on the Open Science Network. Results Our final sample consisted of 46 trials published in 9 of the top 20 orthopedic surgery journals. Spin was found in 27 (58.7%) of the 46 abstracts. Evidence of spin in the abstract results was found in 19 (41.3%) of the 46 articles, and spin in abstract conclusions was found in 15 (32.6%) of the 46 articles. Conclusions Our study found that a significant number of lower extremity joint RCTs contain one or more form of spin in either their abstract results, conclusions, or both. In addition, our investigation revealed that a sizable portion of these lower extremity orthopedic joint RCTs are not registered or do not report their registration, and funding sources are also underreported.
Abstract 129: Brain-Heart Interaction After Stroke: Therapeutic Effects of Exosomes in Type 2 Diabetic Mice Subjected to Stroke

Aim: Diabetes exacerbates post-stroke cardiac injury. We tested whether treatment with exosomes harvested from human umbilical cord blood derived CD133+/KDR+ cells (CD133+Exo) improves neurological...
IL-35 Suppresses Lipopolysaccharide-Induced Endothelial Cell Activation Through Downregulation of MAPK Signaling-Mediated Upregulation of Adhesion Molecule VCAM-1

Abstract 3310 Our previous reports showed that survival/apoptosis of CD4+CD25+Foxp3+ regulatory T cells (Tregs) modulates vascular inflammation even though the mode of Tregs inhibition was unknown. Interleukin-35 (IL-35), consisting of two subunits Epstein-Barr virus–induced gene 3 (EBI3) and p35, is a novel anti-inflammatory cytokine, which is a member of the interleukin-12 (IL-12) cytokine family. IL-35 is produced by Tregs. It has been shown that IL-35 suppresses chronic inflammatory diseases such as asthma and inflammatory bowel diseases. However, an important question of whether IL-35 can carry out Tregs suppression and inhibit endothelial cell (EC) activation in acute inflammation remained unknown. Here we found that IL-35 significantly inhibits lung neutrophil infiltration into the surrounding areas of bronchioles and alveolar space when induced by intraperitoneal injection of lipopolysaccharide (LPS) in wild type mice and EBI3-deficient mice. Furthermore, cremaster microvasculature study using intravital microscopy showed IL-35 significantly suppresses leukocyte adhesion to the vascular wall as well, suggesting IL-35 inhibition of endothelial activation. Mechanistically, IL-35 inhibited LPS-induced upregulation of adhesion molecules on human aortic endothelial cells, a marker of endothelial activation, including vascular cell adhesion molecule 1 (VCAM-1). IL-35 acted through new IL-35 dimeric receptors gp130 and IL-12Rβ2, and inhibited VCAM-1 promoter transcription in mitogen-activated protein kinase (MAPK)-mediated pathway. These results provide a novel insight on Tregs and IL-35 inhibition of vascular inflammation. Disclosures: No relevant conflicts of interest to declare.
Occipital nerve stimulation: trial and permanent

Abstract A 45-year-old woman presented in referral from a headache center with a long history of complex migraines and focal occipitoparietal head pain as well. The head pains seemed to be present all the time, or nearly so, while the more “typical” migraine, which was how she described it, came on every few days and lasted about a day or two. She had been prescribed numerous medications over the years, some of which may have helped at times but generally did not. Currently, she is taking a combination of tramadol and gabapentin. She had also had several injections to block the occipital nerve or trigger points in the back of her head. These had lasted for up to a few days at times. With further questioning about these injections, she did admit that they typically eliminated a significant amount of the pain for hours or a few days, but it always came back.
Devising Efficient Red-Shifting Strategies for Bioimaging: A Generalizable Donor-Acceptor Fluorophore Prototype.

Long emission wavelengths, high fluorescence quantum yields (FQYs), and large Stokes shifts are highly desirable features for fluorescent probes in biological imaging. However, the current development of many fluorescent probes remains largely trial-and-error and lacks efficiency. Moreover, to achieve far-red/near-infrared emission, a significant extension in the π -conjugation is usually adopted but accompanied by other drawbacks such as fluorescence loss. In this review, we discuss an effective red-shifting strategy built upon the green fluorescent protein chromophore, which enables a synergistic tuning of both the electronic ground and excited states. This approach could shorten the path toward redder emission in comparison to the conventional intramolecular charge transfer (ICT) strategy. We envision that this spectroscopy and computation-aided strategy may advance the noncanonical fluorescent protein design and be generalized to various fluorophore scaffolds for redder emission while preserving other superior properties such as high FQYs.
6 – Model One

Publisher Summary The chapter discusses Model One as a mathematical representation. The chapter describes five ingredients of the model: the current endowment and the endowment at time t, driver, and utility, feasible set, and motion law. The chapter explains that endowments are points x in a point set X. Actions are vectors a in a vector space A. The connection between the two is that the difference of two endowments is an action. Utility is a real-valued differentiable function defined over X. The endowment owes its velocity in part to what the agent does and in part to the exogenous influences. Vector da, the action at time t, belongs to the feasible set. More precisely, da is a constant multiple of the vector in F that is closest to H-lu. One can say that da is the vector in F that is closest to yH-Nudt.
Massive Pulmonary Embolism in a Recent Intracranial Hemorrhage: A Case Report of Inhaled Nitric Oxide to Improve Outcomes.

Acute massive pulmonary embolism (PE) has a high mortality if left untreated. The mainstay of treatment is systemic thrombolysis which has some absolute contraindications like intracranial hemorrhage (ICH). Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator that decreases pulmonary artery pressure (PAP) and allows the right ventricle of the heart to pump against less resistance. We present a case of iNO use to improve hemodynamics in a patient with a recent ICH. We believe this to be the first such case reported. A 70-year-old female with a history of PE on Eliquis initially presented for weakness and was found to have right-sided ICH. She was discharged with instructions to hold Eliquis given ICH but was readmitted eight days later in florid cardiogenic shock requiring vasopressors and hypoxic respiratory failure refractory to intubation. CT showed bilateral PE with evidence of right heart strain and IV heparin was started. Due to her history of a recent ICH, she had an absolute contraindication prohibiting the use of systemic tissue plasminogen activator (tPA). Interventional radiology (IR) consult determined that the patient was not a candidate for catheter-directed tPA due to the recent ICH, mechanical ventilation, and hemodynamic instability based on pressor requirement. Vascular surgery and extracorporeal membrane oxygenation (ECMO) consults deemed the patient not operable. The patient was then started on iNO with immediate improvement in her blood pressure. Once vitally stable, IR consult performed pulmonary angiogram and completed a thrombectomy. The patient was eventually extubated and she restarted her Eliquis. She continues to do well 16 months after discharge. In patients with massive PE with contraindications to systemic thrombolytics, providers are left with very few therapeutic interventions. A handful of case reports show that iNO improves systemic hemodynamics in postoperative patients with massive PE. This case highlights the potential for iNO to be a potential adjuvant in patients with absolute contraindications to systemic thrombolysis.
Effects of aquatic conditioning on cartilage and bone metabolism in young horses.

While beneficial in rehabilitation, aquatic exercise effects on cartilage and bone metabolism in young, healthy horses has not been well described. Therefore, 30 Quarter Horse yearlings (343 ± 28 kg; 496 ± 12 d of age) were stratified by age, body weight (BW), and sex and randomly assigned to 1 of 3 treatments for 140-d to evaluate effects of aquatic, dry, or no exercise on bone and cartilage metabolism in young horses transitioning to an advanced workload. Treatments included nonexercise control (CON; n = 10), dry treadmill (DRY; n = 10), or aquatic treadmill exercise (H2O; n = 10; water: 60% wither height, WH). Horses were housed individually (3.6 × 3.6 m) from 0600 to 1800 hours, allowed turnout (74 × 70 m) from 1800 to 0600 hours, and fed to meet or exceed requirements. During phase I (days 0 to 112), DRY and H2O walked on treadmills 30 min/d, 5 d/wk. Phase II (days 113 to 140) transitioned to an advanced workload 5 d/wk. Every 14-d, WH, hip height (HH), and BW were recorded. Left third metacarpal radiographs on days 0, 112, and 140 were analyzed for radiographic bone aluminum equivalence (RBAE). Every 28-d, serum samples were analyzed for osteocalcin and C-telopeptide crosslaps of type I collagen (CTX-1), and synovial fluid samples were analyzed for prostaglandin E2, collagenase cleavage neopeptide (C2C), collagenase of type I and type II collagen, and carboxypeptide of type II collagen using ELISAs. All data were analyzed using PROC MIXED of SAS, including random effect of horse within treatment, and repeated effect of day. Baseline treatment differences were accounted for using a covariate. There were treatment × day interactions (P 0.30) in RBAE, BW, or HH, but all increased over time (P < 0.01). There were no treatment × day interactions of synovial inflammation or markers of cartilage metabolism; however, there was an effect of day for each marker (P<0.03). Changes in biomarkers of cartilage turnover in horses exercised at the walk, whether dry or aquatic, could not be distinguished from horses with access to turnout alone. This study indicates that early forced exercise supports consistent bone metabolism necessary for uniform growth and bone development, and that there are no negative effects of buoyancy on cartilage metabolism in yearlings transitioned from aquatic exercise to a 28-d advanced workload.