cssi/SciSciGPT-SciSciNet huggingface dataset:
Endonasal Suturing of Nasoseptal Flap to Nasopharyngeal Fascia Using the V-Loc™ Wound Closure Device: 2-Dimensional Operative Video

We present a case of cerebrospinal fluid (CSF) leak after endoscopic endonasal resection of a large clival chordoma in an obese patient. The leak was at the lower reconstruction at the craniocervical junction and had failed repositioning. Using the V-Loc™ wound closure device (Covidien, New Haven, Connecticut) to suture the nasoseptal flap to the nasopharyngeal fascia, a water-tight seal was created and, along with a lumbar drain, the patient healed successfully.CSF leak after an endoscopic endonasal approach (EEA) to intradural pathologies remains one of the more common complications.1-4 Various closure techniques have been developed5-8 with success in mitigating this risk, but all have their limitations and rely on multiple layers including vascularized flaps like the nasoseptal flap.9-11 Endonasal suturing of graft materials offers the advantage of creating a water-tight seal. We present the use of the V-Loc™ wound closure device (Covidien) to successfully seal a postoperative CSF leak. The absorbable V-Loc™ wound closure device does not require the surgeon to tie knots, which is the most challenging step in a deep, 2-dimensional corridor. The suture is barbed and is anchored by threading the needle through a prefabricated loop at the end of the suture which locks in place. Each throw of the suture through tissue maintains the suture line as the barbs catch the tissue and prevent retraction. After successful closure, the needle can simply be cut off.The V-Loc™ wound closure device (Covidien) is a safe and effective adjunct to reconstruction after endoscopic endonasal skull base surgery as it provides an option for graft/flap suturing.A written release from the patient whose name or likeness is submitted as part of this Work is on file.
Manganese-Catalyzed Kumada Cross-Coupling Reactions of Aliphatic Grignard Reagents with N-Heterocyclic Chlorides

Herein we report the use of manganese(II) chloride for the catalytic generation of C(sp2)–C(sp3) bonds via Kumada cross-coupling. Rapid and selective formation of 2-alkylated N-heterocyclic complexes were observed in high yields with use of 3 mol% MnCl2THF1.6 and under ambient reaction conditions (21 °C, 15 min to 20 h). Manganese-catalyzed cross-coupling is tolerant toward both electron-donating and electron-withdrawing functional groups in the 5-position of the pyridine ring, with the latter resulting in an increased reaction rate and a decrease in the amount of nucleophile required. The use of this biologically and environmentally benign metal salt as a catalyst for C–C bond formation highlights its potential as a catalyst for the late-stage functionalization of pharmaceutically active N-heterocyclic molecules (e.g., pyridine, pyrazine).
Biliary Tree Abnormalities

This part of the book describes a number of biliary tree abnormalities that include Caroli’s disease, cholelithiasis, choledocholithiasis, gallbladder carcinoma, primary sclerosing cholangitis, and hilar cholangiocarcinoma.
Simulation of ductile crack growth in thin aluminum panels using 3-D surface cohesive elements

This work describes the formulation and application of a 3-D, interface-cohesive finite element model to predict quasi-static, ductile crack extension in thin aluminum panels for mode I loading and growth. The fracture model comprises an initially zero thickness, interface element with constitutive response described by a nonlinear traction-separation relationship. Conventional volumetric finite elements model the nonlinear (elastic-plastic) response of background (bulk) material. The interface-cohesive elements undergo gradual decohesion between faces of the volumetric elements to create new traction free crack faces. The paper describes applications of the computational model to simulate crack extension in C(T) and M(T) panels made of a 2.3 mm thick, Al 2024-T3 alloy tested as part of the NASA-Langley Aging Aircraft program. Parameters of the cohesive fracture model (peak opening traction and local work of separation) are calibrated using measured load vs. outside surface crack extensions of high constraint (T-stress > 0) C(T) specimens. Analyses of low constraint M(T) specimens, having widths of 300 and 600 mm and various a/W ratios, demonstrate the capabilities of the calibrated model to predict measured loads and outside surface crack extensions. The models capture accurately the strong 3-D effects leading to various degrees of crack front tunneling in the C(T) and M(T) specimens. The predicted crack growth response shows rapid convergence with through-thickness mesh refinement. Adaptive load increment procedures to control the rate of decohesion in the interface elements leads to stable, rapidly converging iterations in the globally implicit solution procedures.
Motor Impairment–Related Alterations in Biceps and Triceps Brachii Fascicle Lengths in Chronic Hemiparetic Stroke:

Poststroke deficits in upper extremity function occur during activities of daily living due to motor impairments of the paretic arm, including weakness and abnormal synergies, both of which result in altered use of the paretic arm. Over time, chronic disuse and a resultant flexed elbow posture may result in secondary changes in the musculoskeletal system that may limit use of the arm and impact functional mobility. This study utilized extended field-of-view ultrasound to measure fascicle lengths of the biceps (long head) and triceps (distal portion of the lateral head) brachii in order to investigate secondary alterations in muscles of the paretic elbow. Data were collected from both arms in 11 individuals with chronic hemiparetic stroke, with moderate to severe impairment as classified by the Fugl-Meyer assessment score. Across all participants, significantly shorter fascicles were observed in both biceps and triceps brachii ( P < .0005) in the paretic limb under passive conditions. The shortening in paretic fascicle length relative to the nonparetic arm measured under passive conditions remained observable during active muscle contraction for the biceps but not for the triceps brachii. Finally, average fascicle length differences between arms were significantly correlated to impairment level, with more severely impaired participants showing greater shortening of paretic biceps fascicle length relative to changes seen in the triceps across all elbow positions ( r = -0.82, P = .002). Characterization of this secondary adaptation is necessary to facilitate development of interventions designed to reduce or prevent the shortening from occurring in the acute stages of recovery poststroke.
Perceptual Experience in Kant and Merleau-Ponty

I argue that the descriptions of perceptual experience offered by Kant and Merleau-Ponty are, contrary to what many commentators suppose, largely compatible. This is because the two are simply refe...
The Role of Pacing in Elderly Patients with Unexplained Syncope

To discuss the role of pacing in elderly patients with unexplained syncope. In patients with recurrent syncope with suspected reflex mechanism, the decision of pacemaker implantation can be guided by a standardized algorithm which includes carotid sinus massage, tilt-table testing, and implantable loop recorder. Cardiac pacing may reduce recurrent syncope in cardioinhibitory carotid sinus syndrome. In select elderly patients with recurrent cardioinhibitory vasovagal syncope, cardiac pacing may also reduce syncope recurrence. There is no role of cardiac pacing in patients with without a cardioinhibitory response. There is increasing evidence that closed loop stimulation reduces the recurrence of cardioinhibitory vasovagal syncope. In patients with syncope and a positive electrophysiology study consistent with sinoatrial or conduction system disease, cardiac pacing has been shown to reduce recurrent syncope. Cardiac pacing is also effective in reducing recurrent syncope when high-grade atrioventricular block is documented on electrocardiography monitoring. In elderly patients with unexplained syncope and bundle branch block on ECG, diagnostic algorithm should be followed according to guidelines; empirical pacing is generally not recommended. Permanent pacemaker implantation may be effective to reduce recurrent syncope in select groups of elderly patients. It is important to consider additional investigations to evaluate elderly patients with unexplained syncope. The results of these testing would guide the decision on permanent pacemaker implantation.
Cutaneous Ulcerations in Anti-MDA5 Dermatomyositis.

Cutaneous Ulcerations in Anti-MDA5 Dermatomyositis A 48-year-old man presented with painful hand ulcerations and progressively worsening shortness of breath. Chest CT revealed organizing pneumonia,...
Advanced Pericentral Hydroxychloroquine Retinopathy in an Asian Woman

Purpose:This case report describes the unique clinical attributes of pericentral retinopathy associated with hydroxychloroquine (Plaquenil) use in patients of Asian ancestry.Methods:A complete opht...
Operative Versus Nonoperative Management Of Traumatic Arthrotomies from Civilian Gunshot Wounds.

Background Although the rate of non-fatal gunshot wounds (GSW) has increased, few studies have compared the effectiveness of operative and nonoperative treatment with specific focus on infection. We compared the risk of septic arthritis in patients with traumatic arthrotomies caused by GSW treated operatively with irrigation and debridement versus nonoperatively with antibiotics and wound care. Methods From 2009 to 2016, 46 patients at our institution sustained traumatic arthrotomies from low-velocity GSW with at least 90-day follow-up. Medical records were reviewed for demographic information, imaging, type and duration of antibiotics, details of operative and nonoperative interventions, and evidence of infection at follow-up visits. We measured the rate of septic arthritis using a 2-tailed t test. Results The knee was the most commonly affected joint (34 patients; 73.9%). Eight patients (17.4%) were treated nonoperatively and 38 (82.6%) were treated operatively. In the nonoperative group, one patient (12.5%) developed a superficial wound infection that resolved with oral antibiotics. In the operative group, one patient (2.6%) developed a superficial wound infection requiring operative irrigation and debridement. There was no statistically significant difference in risk of infection between the two groups (P = 0.32). No patient developed septic arthritis. Conclusions In select patients, nonoperative treatment with wound care and antibiotics may be sufficient for preventing infection after GSW-related traumatic arthrotomies. Findings of randomized studies and treatment algorithms are needed to further evaluate this relatively common injury.Level of Evidence: IV.
Persistent post-discharge opioid prescribing after traumatic brain injury requiring intensive care unit admission: A cross-sectional study with longitudinal outcome

Traumatic brain injury (TBI) is associated with increased risk for psychological and substance use disorders. The study aim is to determine incidence and risk factors for persistent opioid prescription after hospitalization for TBI. Electronic medical records of patients age ≥ 18 admitted to a neuroscience intensive care unit between January 2013 and February 2017 for an intracranial injury were retrospectively reviewed. Primary outcome was opioid use through 12 months post-hospital discharge. A total of 298 patients with complete data were included in the analysis. The prevalence of opioid use among preadmission opioid users was 48 (87%), 36 (69%) and 22 (56%) at 1, 6 and 12-months post-discharge, respectively. In the opioid naive group, 69 (41%), 24 (23%) and 17 (19%) were prescribed opioids at 1, 6 and 12 months, respectively. Preadmission opioid use (OR 324.8, 95% CI 23.1-16907.5, p = 0.0004) and higher opioid requirements during hospitalization (OR 4.5, 95% CI 1.8-16.3, p = 0.006) were independently associated with an increased risk of being prescribed opioids 12 months post-discharge. These factors may be used to identify and target at-risk patients for intervention.
The critical point of Bootstrap and Lattice QCD

It is shown that the hadronic matter formed at high temperatures, according to the prescription of the statistical bootstrap principle, develops a critical point at nonzero baryon chemical potential. The location of the critical point is evaluated with the use of lattice QCD pressure.
Using The New Yorker Magazine’s Cartoon Caption Contest to Stimulate Creative Group Problem Solving: An In-Class Exercise:

Three staples of management and organizational behavior classes are units on creativity, problem solving, and group decision making. This article presents an experiential exercise in creative probl...
Electrostatic Environment of Proteorhodopsin Affects the pKa of Its Buried Primary Proton Acceptor.

Abstract The protonation state of embedded charged residues in transmembrane proteins (TMPs) can control the onset of protein function. It is understood that interactions between an embedded charged residue and other charged or polar residues in the moiety would influence its pKa, but how the surrounding environment in which the TMP resides affects the pKa of these residues is unclear. Proteorhodopsin (PR), a light-responsive proton pump from marine bacteria, was used as a model to examine externally accessible factors that tune the pKa of its embedded charged residue, specifically its primary proton acceptor D97. The pKa of D97 was compared between PR reconstituted in liposomes with different net headgroup charges and equilibrated in buffer with different ion concentrations. For PR reconstituted in net positively charged compared to net negatively charged liposomes in low-salt buffer solutions, a drop of the apparent pKa from 7.6 to 5.6 was observed, whereas intrinsic pKa modeled with surface pH calculated from Gouy-Chapman predictions found an opposite trend for the pKa change, suggesting that surface pH does not account for the main changes observed in the apparent pKa. This difference in the pKa of D97 observed from PR reconstituted in oppositely charged liposome environments disappeared when the NaCl concentration was increased to 150 mM. We suggest that protein-intrinsic structural properties must play a role in adjusting the local microenvironment around D97 to affect its pKa, as corroborated with observations of changes in protein side-chain and hydration dynamics around the E-F loop of PR. Understanding the effect of externally controllable factors in tuning the pKa of TMP-embedded charged residues is important for bioengineering and biomedical applications relying on TMP systems, in which the onset of functions can be controlled by the protonation state of embedded residues.
Adjacency spectra of random and complete hypergraphs

Abstract We present progress on the problem of asymptotically describing the adjacency eigenvalues of random and complete uniform hypergraphs. There is a natural conjecture arising from analogy with random matrix theory that connects these spectra to that of the all-ones hypermatrix. Several of the ingredients along a possible path to this conjecture are established, and may be of independent interest in spectral hypergraph/hypermatrix theory. In particular, we provide a bound on the spectral radius of the symmetric Bernoulli hyperensemble, and show that the spectrum of the complete k-uniform hypergraph for k = 2 , 3 is close to that of an appropriately scaled all-ones hypermatrix.
Treatment Dilemma in Systemic Lupus Erythematous Related Cardiomiopathy

Background Systemic Lupus Erythematous (SLE) is an autoimmune disease that is known to cause many cardiac complications including lesions of the valves, myocardium, pericardium, and the coronary vessel. However, the management of SLE induced cardiomyopathy remains controversial. Case presentation A 59-year-old African American woman with a medical history of hypertension presented with dyspnea on exertion for a few days. Physical exam revealed distended neck vein, lung crackles, and leg swelling. EKG showed normal sinus rhythm. Transthoracic echocardiogram (TTE) showed a left ventricular ejection fraction of 10% (LVEF). Decision-making The patient was treated with intravenous diuretic and improved symptomatically. She underwent a coronary angiogram, which showed normal coronary arteries and cardiac MRI didn't reveal any signs of myocarditis or infiltrative cardiomyopathy. We started guideline-directed medical therapy (GDMT) including losartan, carvedilol, and spironolactone, and titrated up accordingly. In a follow-up echocardiogram after 3 months, LVEF remained unchanged while on optimal GDMT. She developed a skin rash with fatigue and further investigations showed evidence of SLE. With the presence of heart failure and newly diagnosed SLE, the underlying cause of cardiomyopathy was most likely due to SLE. At this point, we were perplexed on how to approach SLE related cardiomyopathy and decided to treat underlying autoimmune disease with rituximab, hydroxychloroquine, and methylprednisolone. A follow-up TTE in a month disclosed LVEF of 40-45%. Conclusion The role of GDMT is unclear in SLE induced cardiomyopathy and has never been tested in randomized trials. However, treatment of SLE with immunomodulating therapies could ameliorate and even reverse the cardiomyopathy, which was demonstrated in our case. Early recognition of SLE and aggressive intervention is paramount for recovery in SLE related cardiomyopathy.
Obesity and Corticosteroid Dosing Guideline Adherence in Children Hospitalized With Asthma.

OBJECTIVES: Drug dosing recommendations for children with obesity remain limited. This may lead to variability in medication dosing among children with obesity. Therefore, our objective was to determine differences in the prevalence of guideline-nonadherent systemic corticosteroid orders by weight category in children hospitalized for asthma. METHODS: We performed a retrospective cross-sectional study of children aged 2 to 17 years hospitalized with asthma and prescribed systemic corticosteroids between January 1, 2010, and December 31, 2017, using the Cerner Health Facts deidentified database. Weight categories ranging from underweight to class III obesity were defined on the basis of BMI percentiles by using CDC guidelines. Corticosteroid orders were categorized as guideline adherent or nonadherent on the basis of total body weight–based dosing guidelines from the National Heart, Lung, and Blood Institute. χ2 test and multivariable logistic regression models were used to determine differences in guideline adherence between weight categories. RESULTS: We identified 21 488 children prescribed systemic corticosteroids during asthma hospitalizations. Most (54.2%) had a healthy weight, and 23.8% had obesity. Almost one-quarter received guideline-nonadherent orders (22.2%), with increasing prevalence among higher weight categories (19.4% of healthy weight children versus 36.0% of those with class III obesity; P CONCLUSIONS: The prevalence of guideline-nonadherent corticosteroid orders for children hospitalized with asthma increases linearly with weight category, disproportionately affecting children with severe obesity. Standardization of drug dosing guidelines for children with obesity may help reduce variability in drug doses prescribed that may increase risk of harm.
Evaluation of the effects of engineered cementitious composites (ECC) plasticity on concrete pavement performance

Engineered Cementitious Composites (ECC) are considered a promising alternative for the construction of durable pavements. The objective of this study was to evaluate the effects of plasticity and ...
Machine Learning Model Identifies Increased Operative Time and Greater BMI as Predictors for Overnight Admission After Outpatient Hip Arthroscopy

Purpose The purposes of this study were to identify patient characteristics and risk factors for overnight admission following outpatient hip arthroscopy and to develop a machine learning algorithm that can effectively identify patients requiring admission following elective hip arthroscopy. Methods A retrospective review of a prospectively collected national surgical outcomes database was performed to identify patients who underwent elective outpatient hip arthroscopy from 2006 to 2018. Patients admitted overnight postoperatively were identified as those with length of stay of 1 or more days. Models were generated using random forest (RF), extreme gradient boosting (XGBoost), adaptive boosting (AdaBoost), elastic net penalized logistic regression, and an additional model was produced as a weighted ensemble of the four final algorithms. Results Overall, 1,276 patients were included. The median age was 43 years, and 64.2% (819) were female. Of the included patients, 109 (8.5%) required an overnight stay following elective outpatient hip arthroscopy. The most important factors for inpatient admission were increasing operative time, general anesthesia, age extremes, male gender, greater body mass index (BMI), American Society of Anesthesiologists classification >1, and the following preoperative lab values outside of normal ranges: sodium, platelet count, hematocrit, and leukocyte count. The ensemble model achieved the best performance based on discrimination assessed via internal validation (area under the curve = .71), calibration, and decision curve analysis. The model was integrated into a Web-based open-access application able to provide both personalized predictions and explanations. Conclusion A machine learning algorithm developed based on preoperative features identified increasing operative time, age extremes, greater BMI, sodium, hematocrit, platelets, and leukocyte count as the most important variables associated with inpatient admission with fair validity.
Trends in Type of Health Insurance Coverage for US Children and Their Parents, 1998–2011

Abstract Objective To examine trends in health insurance type among US children and their parents. Methods Using the Medical Expenditure Panel Survey (1998–2011), we linked each child (n = 120,521; weighted n ≈ 70 million) with his or her parent or parents and assessed patterns of full-year health insurance type, stratified by income. We examined longitudinal insurance trends using joinpoint regression and further explored these trends with adjusted regression models. Results When comparing 1998 to 2011, the percentage of low-income families with both child and parent or parents privately insured decreased from 29.2% to 19.1%, with an estimated decline of −0.86 (95% confidence interval, −1.10, −0.63) unadjusted percentage points per year; middle-income families experienced a drop from 74.5% to 66.3%, a yearly unadjusted percentage point decrease of −0.73 (95% confidence interval, −0.98, −0.48). The discordant pattern of publicly insured children with uninsured parents increased from 10.4% to 27.2% among low-income families and from 1.4% to 6.7% among middle-income families. Results from adjusted models were similar to joinpoint regression findings. Conclusions During the past decade, low- and middle-income US families experienced a decrease in the percentage of child–parent pairs with private health insurance and pairs without insurance. Concurrently, there was a rise in discordant coverage patterns—mainly publicly insured children with uninsured parents.
An approach to the study of brain damage. The principles of fetal electroencephalography.

Abstract Fetal electroencephalography (EEG) is technically feasible and has been accomplished in more than 300 monitored fetuses. The electrical alterations found are identifiable both in individual fetuses and between different fetuses. These patterns and changes can be differentiated from pre-existing patterns and associated with certain fetal cardiovascular heart rate changes. The preliminary follow-up findings on a small group of infants followed until one year of life are presented. The information presented here should be used as guidelines for the introduction of this technique rather than answers to the problems of clinical monitoring during birth and the relationship of that monitoring to brain damage.
The Patient Problem/Nursing Diagnosis Form: A Computer-Generated Chart Document

In a era of cost constraints, patient-centered computing enhances communication of patient data among disciplines, facilitates efficiency and, most importantly, fosters quality patient care. The patient-centered care approach organizes diagnostic activities and care protocols based upon the particular patient’s needs [1]. Computerized patient records which focus upon patient problems/nursing diagnoses can demonstrate linkages between patient conditions, interventions, and outcomes.
Studies on the oligosaccharide sequence of ribonuclease B.

Abstract α-Mannosidase treatment of the asparaginyl oligosaccharide derivative from ribonuclease B released 5 eq of mannose and yielded a product containing asparagine, N-acetylglucosamine, and mannose in a ratio of 1:2:1. The remaining mannose residue was resistant to hydrolysis by α-mannosidase, but could be removed by a Smith degradation, a procedure which did not affect the N-acetylglucosamine residues. The resultant product chromatographed identically with 2-acetamido-4-O-(2-acetamido-2-deoxy-β-d-glucopyranosyl)-N-(4-l-aspartyl)-2-deoxy-β-d-glucopyranosylamine prepared chemically by Spinola and Jeanloz (J. Biol. Chem., 245, 4158 (1970)). In addition, both synthetic and isolated compounds reacted similarly on treatment with β-N-acetylglucosaminidase and glycosyl asparaginase. Evidence is presented showing the mannose residue in the asparaginyl trisaccharide to be linked to the 3-O position of the terminal nonreducing N-acetylglucosamine and that the N-acetylglucosamines form a disaccharide identical with di-N-acetylchitobiose.
Reliability of scanning laser acoustic microscopy for detecting internal voids in structural ceramics

The reliability of 100 MHz scanning laser acoustic microscopy (SLAM) for detecting internal voids in sintered specimens of silicon nitride and silicon carbide was evaluated. The specimens contained artificially implanted voids and were positioned at depths ranging up to 2 mm below the specimen surface. Detection probability of 0.90 at a 0.95 confidence level was determined as a function of material, void diameter, and void depth. The statistical results presented for void detectability indicate some of the strengths and limitations of SLAM as a nondestructive evaluation technique for structural ceramics.
Enzymatic activities in thylakoid membranes, which form medium [32P]NDP and [32P]ATP from 32Pi. Polynucleotide phosphorylase and adenylate kinase

Soluble chloroplast coupling factor 1 (CF1) and the ATP synthase complex, under uncoupled conditions, can form bound ATP from tightly bound ADP and medium Pi. This partial reaction is a powerful probe of the mechanism of ATP synthesis. During our study of the synthesis of bound ATP by CF1 other enzyme activities, which generate [32P]nucleotides from 32Pi, were characterized and controlled. Two enzymes present at significant levels in the preparations are polynucleotide phosphorylase and adenylate kinase. Polynucleotide phosphorylase (PNPase) was found both in thylakoid and CF1 preparations and catalyzed the formation of [beta-32P]ADP via its Pi----ADP exchange activity. The formation of [beta-32P]ADP during net photophosphorylation is attributable to adenylate kinase action on the [32P]ATP formed since hexokinase and glucose effectively block its production. In addition, PNPase also degraded RNA present in thylakoid preparations yielding all four [32P]nucleoside diphosphates. PNPase was also shown to catalyze a Pi----ATP exchange that is dependent on RNA primers and other cofactors.
Recognition and interpretation of parametric gesture

A new method for the representation, recognition, and interpretation of parameterized gesture is presented. By parameterized gesture. We mean gestures that exhibit a meaningful variation; one example is a point gesture where the important parameter is the 2-dimensional direction. Our approach is to extend the standard hidden Markov model method of gesture recognition by including a global parametric variation in the output probabilities of the states of the HMM. Using a linear model to derive the theory, we formulated an expectation-maximization (EM) method for training the parametric HMM. During testing, the parametric HMM simultaneously recognizes the gesture and estimates the quantifying parameters. Using visually derived and directly measured 3-dimensional hand position measurements as input, we present results on two. Different movements-a size gesture and a point gesture-and show robustness with respect to noise in the input features.
Hybrid reasoning for prognostic learning in CBM systems

Reasoning systems that integrate explicit knowledge with implicit information are essential for high performance decision support in condition-based maintenance and prognostic health management applications. Such reasoning systems must be capable of learning the specific features of each machine during its life cycle. In this paper, a hybrid reasoning approach that is capable of integrating domain knowledge and test and operational data from the machine is described. This approach is illustrated with an industrial gearbox example. In this approach explicit domain knowledge is expressed as a rule-base and used to train a feedforward neural network. The training process results in a parsimonious representation of the explicit knowledge by combining redundant rules. A significant added practical benefit of this process is that it also is able to identify logical inconsistencies in the rule-base. Such inconsistencies are notorious in causing deadlock in large-scale expert systems. The neural network can be periodically updated with test and operational data to adapt the network to each specific machine. The flexibility and efficiency of this hybrid approach make it very suitable for practical health management systems designed to operate in a distributed environment.
How Do You Get Your Water? Structural Violence Pedagogy and Women's Access to Water

In many parts of the less developed world it is women and girls who are expected to provide water for their family. Frequently, young girls are unable to complete school or get jobs because water scarcity means they are forced to walk miles daily to obtain this most basic need. Since the creation of the United Nations Millennium Goals, progress has been made in providing clean water and sanitation to billions of people. Although there are still many regions where water scarcity and gender inequity exclude women from schooling and the workforce. With the new Social Studies C3 Framework students are expected to apply and evaluate civic concepts and take action by engaging in global citizenship. In the “How Do You Get Your Water?” Curriculum students' apply the concepts of structural violence and universal human rights to a case study on the connection between women, social inequity, and water. A writing extension gives students the reflective time to cultivate empathy for families experiencing water insecur...
A Section-Smear Method for Plant Cytology

An improved method for making root tip preparations of plants with medium or small chromosomes is described. Division figures are oriented in polar view by cutting paraffin cross sections of roots; the pectic substance is removed from the middle lamellae and the sections then are smeared. The procedure recommended is as follows: Kill root tips in Navashin or other fluid containing chromic acid. Wash, dehydrate, embed in paraffin, and section transversely. Stain slides bearing the sections by a Feulgen technic following the modification of De Tomasi, except that the hydrolysis is prolonged to 45 minutes, and a 10-minute washing in running water is introduced between the fuchsia and the first bath in sulfite solution. Dehydrate and mount in thin Canada balsam; then apply local pressure to top of cover glass with the tip of a scalpel, while observing the action under low power of a microscope. The prolonged hydrolysis softens the tissue and removes sufficient pectic substance so that cells of the section sep...
Angina pectoris as the initial manifestation of an aortocaval fistula

Spontaneous aortocaval fistula is an unusual disorder associated with abdominal aortic aneurysms and with the onset of high-output heart failure. A novel case of spontaneous aortocaval fistula formation that presented with angina is described. Increased myocardial oxygen demand due to elevated myocardial wall tension, inotropic state, and heart rate is the apparent contributing factor. Clinical evidence of ischemic heart disease and heart failure resolved with surgical correction of the shunt. Spontaneous aortocaval fistula formation can be a precipitating cause of new-onset angina.
Asian Americans and standards of attractiveness: what's in the eye of the beholder?

This article attempts to address standards of physical attractiveness in the United States and the effects these standards have on Asian Americans. In the U.S., attractiveness appears to be defined overwhelmingly by White criteria, and people of color are often neglected or overlooked. There appears to be convergence from a number of fields (i.e., ethnic studies, film studies, and literature, in addition to experts in the field of ethnic minority mental health) that White standards of attractiveness exert a deleterious effect on Asian Americans. This article will discuss the limited mental health research that does exist in this area and make suggestions for further research in this field. Discussion will center around acculturation and ethnic identity as possible mediating factors that may influence reactions to standards of attractiveness.
Care of children with brain and spine tumours - a review of practice.

Aims and method were to assess the current practice in paediatric tumour management by the departments of neurosurgery and oncology, compare these with nationally agreed recommendations and examine for areas of improvement. Patient records were identified from departmental databases – 30 patients treated from October 2004 to May 2006. Factors assessed included reatment timelines (e.g., referral to admission and imaging, admission to surgery, surgery to further treatment), imaging, MDT discussion, and paediatric neurosurgery & neuro-oncology treatments. Of acute referrals, all patients were admitted within 2 days. All surgery was undertaken by a dedicated paediatric neurosurgeon with paediatric anaesthesia. All cases were discussed in a neuro-oncology MDT prior to surgery and 97% after surgery. In the first 6-months 57% received adjuvant treatment within 40 days; in the remaining period this improved to 91%. When measured against recognised benchmark standards, the SCH paediatric neuro-oncology service app...
Development and functional characterization of monoclonal antibodies recognizing chicken lymphocytes with natural killer cell activity.

Abstract We have developed two monoclonal antibodies which detect cell surface antigens present on chicken lymphocytes mediating natural killer (NK) cell activity against the avian tumor cell target. The monoclonal antibodies, K-14 and K-108, stained 17 and 6% of splenic lymphocytes, and 11 and 14% of peripheral blood lymphocytes (PBL), respectively, and fewer than 5% of thymic and bursal lymphocytes. Neither of these monoclonal antibodies stained adherent macrophages or the MC29-virus transformed monocytic cell line. Both monoclonal antibodies significantly inhibited NK cell activity in a standard 4 h 51 Cr-release cytotoxicity assay using the LSCC-RP9 tumor cell line as target cells at an effector to target ratio of 50. Pretreatment of splenocytes with either monoclonal antibody in the presence of rabbit complement (C) resulted in a significant reduction in NK cell activity. However, the monoclonal antibody K-1 which detects normal chicken macrophages did not interfere with NK cell activity. The monoclonal antibody K-108 significantly blocked Fc receptor-mediated rosette formation of sheep red blood cells coated with IgG antibodies (EA) by 56% while the monoclonal antibody K-14 did not show a significant blocking. These results indicate that the monoclonal antibodies K-108 and K-14 identify different epitopes present on the surface of chicken splenic lymphocytes which mediate spontaneous NK cytotoxicity.
A commonsense language for reasoning about causation and rational action

Abstract Commonsense causal discourse requires a language with which to express varying degrees of causal connectedness. This paper presents a commonsense language for reasoning about action and causation whose semantics is expressed by way of counterfactuals. Causal relations are analyzed along several dimensions including notions of resource consumption, degree of responsibility, instrumentality, and degree of causal contribution. Grounding the semantics in a level of counterfactual reasoning is shown to play an important role in constraining the set of allowable event descriptions instantiating reports expressed by any of the relations in the language. These ideas are also applied to a causal analysis of rational action: by adopting an explanatory stance, one can characterize action through descriptions that refer to causal connections between mental states and actions. Such a causal analysis resolves some well-known difficulties in correctly ascribing agency and intentionality. Finally, an implementation is described—used to motivate and refine the theory—in which queries involving causal relations between the activities of agents engaged in purposeful behavior within a microworld can be posed.
Students' Images of Problem Contexts when Solving Applied Problems.

Abstract This article reports findings from an investigation of precalculus students’ approaches to solving novel problems. We characterize the images that students constructed during their solution attempts and describe the degree to which they were successful in imagining how the quantities in a problem's context change together. Our analyses revealed that students who mentally constructed a robust structure of the related quantities were able to produce meaningful and correct solutions. In contrast, students who provided incorrect solutions consistently constructed an image of the problem's context that was misaligned with the intent of the problem. We also observed that students who caught errors in their solutions did so by refining their image of how the quantities in a problem's context are related. These findings suggest that it is critical that students first engage in mental activity to visualize a situation and construct relevant quantitative relationships prior to determining formulas or graphs.
A Technique for the Calculation of the Opening-Shock Forces for Several Types of Solid Cloth Parachutes

Abstract : In 1965, the Naval Ordnance Laboratory was engaged in a project which required the deployment of a 35-foot-diameter extended-skirt parachute (type T- 10) as the second stage of a retardation system at an altitude of 100,000 feet. At that time, there were no available data on the T-10 parachute deployed under similar circumstances. This new parachute opening-shock calculation technique was generated as a solution to this dilemma. A drag area ratio-time ratio signature derived fro infinite mass wind-tunnel parachute deployments is combined with Newton's second law of motion to develop instantaneous velocity ratios and shock factors during the deployment process. Methods of computing the reference time (to) and the inflation time (tf) are presented.
Cellular transformation and the 'morphologic phenotype' of transformed cells.

Expression of the product of the transforming gene (src) of RNA tumour viruses promotes growth and usually alters the adhesion, appearance and surface properties of cultured fibroblasts. The latter group of properties termed the ‘morphologic phenotype’ of transformed cells is largely due to diminished cell-to-substratum adhesion. The role of cyclic AMP, cell surface protein (CSP) and other factors in producing the ‘morphologic phenotype’ are discussed. The effects of src expression bear a striking resemblance to the action of peptide hormones such as insulin on appropriate target cells.
Specificity of behavioral regulation.

Abstract A critical review of some relevant data concerning water deprivation induced drinking, water and food deprivation induced drinking, food associated ad lib drinking, salt arousal of drinking, peripheral modulation of deprivation induced drinking and a discussion of the similarities to adjunctive drinking are presented. The specificity of the physiological basis of drinking is questioned and the role of environmental stimuli and orogastric stimulation in the elicitation and maintenance of licking is emphasized. Some unique properties of a lateral preoptic-lateral hypothalamic-brainstem motor control system are described and suggested as a possible mechanism for adjunctive behavior. The generality and significance of schedule induced polydipsia as a function of this system was demonstrated.
Particulate matter and nutrient distributions in the ice-edge zone of the Weddell Sea: relationship to hydrography during late summer

Previous estimates of the marginal ice zone's quantitative contribution to biogeochemical cycles and annual productivity in the Southern Ocean may be conservative because of assumptions that phytoplankton blooms are associated only with actively retreating ice edges. Observations during March 1986, near an almost stationary ice edge in the northwestern Weddell Sea, revealed very low geostrophic currents, no appreciable horizontal gradients in temperature or salinity and no significant net melting or freezing in the ice-edge region. Vertical stratification within the upper 50 m was evident throughout the study area, and resulted primarily from prior melting of pack ice. In contrast with previous observations in marginal ice zones, the distribution of phytoplankton biomass showed little correlation with the meltwater field; here, significant horizontal biomass gradients occurred in an area where vertical stability was almost uniform laterally and both elevated biomass and diminished nutrient levels extended well below the pycnocline. Absolute levels of chlorophyll were modest (generally 10, 1.5 and 3.5 μmol l−1, respectively) were similar to those found previously during a spring phytoplankton bloom at the Weddell-Scotia Sea ice edge. The mean mole ratio of biogenic silica to organic carbon within the particle assemblage was 0.44, which is very high for surface seawater and about three times higher than that typically found in pure diatom cultures. Therefore, despite relatively low chlorophyll levels, the ice edge remained a localized maximum in biogenic particulate matter at least through March and this material was unusually rich in silica. Combined, these physical and biological data show that elevated phytoplankton biomass in the ice-edge zone can persist well past the time when net melting stops and the ice edge becomes stationary.
Evidence that the methylation state of the monoamine oxidase A (MAOA) gene predicts brain activity of MAO A enzyme in healthy men

Human brain function is mediated by biochemical processes, many of which can be visualized and quantified by positron emission tomography (PET). PET brain imaging of monoamine oxidase A (MAO A)—an enzyme metabolizing neurotransmitters—revealed that MAO A levels vary widely between healthy men and this variability was not explained by the common MAOA genotype (VNTR genotype), suggesting that environmental factors, through epigenetic modifications, may mediate it. Here, we analyzed MAOA methylation in white blood cells (by bisulphite conversion of genomic DNA and subsequent sequencing of cloned DNA products) and measured brain MAO A levels (using PET and [11C]clorgyline, a radiotracer with specificity for MAO A) in 34 healthy non-smoking male volunteers. We found significant interindividual differences in methylation status and methylation patterns of the core MAOA promoter. The VNTR genotype did not influence the methylation status of the gene or brain MAO A activity. In contrast, we found a robust associa...
Apoptosis and white matter injury in preterm infants.

White matter injury in premature infants with or without intraventricular hemorrhage (IVH) remains an important cause of neonatal mortality and neurologic morbidity. The contribution of apoptosis to the cellular death in white matter injury in the preterm infant is unclear. The objective of this study was to determine whether apoptosis contributes to the cellular death in premature infants with cranial ultrasound (US) evidence of IVH and asymmetric periventricular echogenicity (PVE). Brain tissue incorporating frontoparietal white matter was obtained from 21 infants: 6 infants with severe IVH and asymmetric PVE (grade 1V IVH) on US (group 1); 9 infants with minimal IVH or normal US who died within 21 days (group II); and 6 infants with minimal IVH or normal US who died later (group III). The presence of DNA fragmentation, typical of apoptosis, was determined using a terminal deoxytransferase-mediated dUTD nick-end labeling (TUNEL) assay. The TUNEL index for group I infants was significantly greater, i.e., 2.75 +/- 1.94% versus 0.84 +/- 0.70% for group II and 0.42 +/- 0.22 for group III infants (P = 0.004). Most cells showing reactivity had morphologic characteristics consistent with astrocytes and oligodendroglia. The number of white matter cells showing morphologic changes consistent with apoptosis, such as nuclear blebs and karyorrhexis, was also quantitated and was significantly more numerous in group I than in group II infants, i.e., 0.51 +/- 0.64% versus 0.02 +/- 0.05% (P = 0.0005), and group III infants, i.e., 0.10 +/- 0.18% (P = 0.03). These findings implicate apoptosis as a contributing mechanism for the cellular death in infants with IVH and asymmetric PVE. Strategies aimed at preventing the white matter injury will need to incorporate methods of inhibiting the ongoing process of apoptosis.
Patient-Specific iPSCs-Based Liver-On-A-Chip

Successful advent of future medicine (e.g., personalized, preventive, predictive, participating medicine) will be strongly bonded to the availability of human-physiology-describing models. The combination of advanced researches in induced personalized stem cells (iPSCs) and the state-of-the-art microengineering is considered to create in-vitro models of organ functions in a near future; the first can generate patient-specific human cell lines, and the latter enables physiologically relevant microenvironments for recapitulating organ-level functions. Here we present a patient-specific iPSC-derived hepatocytes in an integrated microphysiological analysis platform (iMAP). The iMAP for iPSC-derived hepatocyte model is designed to culture the hepatocytes using endothelial-like physical barriers, which separate cell culture chambers and perfusion channels with Peclet number <<1. The physiological architecture supports enhanced hepatic functions of the iPSCs-derived hepatocytes, especially protein synthesis and drug metabolism. Compared to a conventional sandwich culture method, the liver-on-a-chip supports three-dimensional sinusoidal organization, enhanced junction protein and continuously refreshed media around the hepatic tissue to express higher albumin secretion and specifically enhanced drug metabolism (e.g., phenacetin is more metabolized to acetaminophen and N-acetyl-p-benzoquinone imine). Also, iPSCs-derived hepatocytes, by being matured from hepatoblast in the liver-on-a-chip platform, can increase the structural integrity due to avoiding dissociation of polarized hepatocytes and organogenesis-like tissue development in the microenvironment. The iMAP for iPSC-derived hepatocyte model will be tested for patient-specific pharmacokinetics/pharmacodynamics by involving various patient-derived iPSCs, and also other organ models will be integrated to estimate organ-organ interactions, which will provide various human-physiology-describing in-vitro models.