cssi/SciSciGPT-SciSciNet huggingface dataset:
Modeling of Flow Through a Sandwiched Monolith Filter

The flow field and filtration efficiency was modeled and analyzed for a novel monolith filter, comprised of a series of layers of microchannels. In our simulations, we considered two scenarios: the fluid flowing tangentially across the filter face (cross flow) and fluid flowing normal to the filter face (normal flow). The aim of this article is to study the effect of having two or more layers of filters in series on particle capture efficiency. This will help in understanding the mechanisms of particle capture and provide inputs for studying particle segregation or selective filtration using monolith filters. The influences of particle size, number of filter layers and pressure drop on particle capture efficiency were also investigated.
Conceptual Development of a Personalised Whiplash Protection System

Modern automobiles are safer than their predecessors owing to the installation of new, more effective vehicular restraint systems. Unfortunately, crash-induced fatality and injury rates remain high because certain data related to human injury responses and tolerances are not available to aid in the design of more effective occupant protection. A one-size-fits-all approach is not always the best way to protect occupants of different ages, sizes and weights. We believe that personalised protection systems will become the future trend in designing restraint systems. In this study, combined post mortem human subject testing, medical imaging segmentation and explicit finite element analyses were used to exemplify the use of patient-specific data in injury analysis. Rear-end impact simulations were run with the FE models to depict the head and neck kinematics during the so-called 'whiplash' event. Simulations of an active head restraint system were conducted to investigate the risk of neck injury.
Valve-in-Valve Implantation Using a Novel Supravalvular Transcatheter Aortic Valve: Proof of Concept

Background Transcatheter valve implantation within degenerated bioprostheses is a potentially promising treatment for high-risk surgical patients. Clinical experience is limited; however, we have shown in vitro that currently available transcatheter aortic valve sizes did not provide acceptable hemodynamics in small bioprostheses. The objective of this study was to develop a new transcatheter valve that would provide good hemodynamics within degenerated bioprostheses. Methods Supravalvular transcatheter valves were created using a Dacron covered stainless steel stent at the base and trileaflet pericardial leaflets in an open stent above the bioprosthesis. The transcatheter valves were implanted within 19-, 21-, and 23-mm Carpentier-Edwards Perimount bioprostheses with simulated degeneration using BioGlue to achieve a mean pressure gradient of 50 mm Hg. Hemodynamics of valve-in-valve implantation were studied in a pulse duplicator. Results Supravalvular transcatheter valves successfully relieved bioprosthetic stenosis. Acceptable hemodynamics were achieved with a significant reduction in mean pressure gradient of 54.0 ± 3.5 to 9.2 ± 6.3 mm Hg in 23-mm bioprostheses ( p p p = 0.013) in 19-mm bioprostheses. Effective orifice area after valve-in-valve implantation increased significantly and was comparable to rereplacement with the same size bioprosthesis. Conclusions Valve-in-valve implantation was performed using a novel supravalvular transcatheter valve, which successfully relieved bioprosthetic stenosis. The hemodynamics were comparable with standard surgical valve replacement. Further studies are required to assess device safety and efficacy in patients.
A Serine12Stop mutation in PB1-F2 of the 2009 pandemic (H1N1) influenza A: a possible reason for its enhanced transmission and pathogenicity to humans.

As the scientific community scrambles to define the ancestry and lineages of the eight segments of new pandemic H1N1 strain, we looked for unique genetic events in this virus’s genome to explain the newly found enhanced virulence and transmissibility among humans. Genome annotations of this virus identified a stop mutation replacing serine at codon 12 (S12Stop) of the PB1-F2 protein, a virulence factor in influenza A viruses. Here, we discuss the significance of this finding and how it may contribute to host specialization, explaining the virtual absence of the H1N1 influenza A virus strain in pig populations. This finding is expected to lead to a better understanding of the transmission and pathogenesis of the 2009 pandemic strain.
On low rank classical groups in string theory, gauge theory and matrix models

Abstract We consider N =1 supersymmetric U ( N ), SO ( N ), and Sp ( N ) gauge theories, with two-index tensor matter and added tree-level superpotential, for general breaking patterns of the gauge group. By considering the string theory realization and geometric transitions, we clarify when glueball superfields should be included and extremized, or rather set to zero; this issue arises for unbroken group factors of low rank. The string theory results, which are equivalent to those of the matrix model, refer to a particular UV completion of the gauge theory, which could differ from conventional gauge theory results by residual instanton effects. Often, however, these effects exhibit miraculous cancellations, and the string theory or matrix model results end up agreeing with standard gauge theory. In particular, these string theory considerations explain and remove some apparent discrepancies between gauge theories and matrix models in the literature.
Distinguishing Caregiver Strain from Psychological Distress: Modeling the Relationships Among Child, Family, and Caregiver Variables

Although both have been used in studies of the impact of mental illness on the family, the constructs of caregiver strain (often referred to as “burden of care”) and psychological distress have not been clearly distinguished. The vagueness surrounding these constructs, and the lack of a cohesive conceptual framework for understanding how they relate, leads to contradictory interpretations of results. This compromises the building of the knowledge base needed to develop and evaluate interventions to support families as they struggle to meet the needs of their children with emotional and behavioral challenges. We utilized the ABCX Model as a framework for understanding caregiver strain and its relationship to psychological distress. Structural equations modeling was used to test the hypothesized relationship between caregiver strain and psychological distress, as well as the role of key child and family variables. These included child symptoms, stressful life events, social support, family functioning, and material resources. Our findings indicated that caregiver strain and psychological distress, although related, have distinct correlates and different implications in the family context.
A Deep-Sea Differential Pressure Gauge

Abstract A pressure gauge configured to respond to the difference between the ocean pressure and the pressure within a confined volume of compressible oil is found to be especially useful for detecting pressure fluctuations in the frequency range from a few millihertz to a few hertz. In the middle of the range its noise level is lower than any other known gauge. The limitation of the gauge at the lower frequency limit is caused by unpredictable thermal expansion in the confined oil and at the upper limit by thermal agitation noise in the resistance of the strain gauge transducer. The gauge is insensitive to acceleration and tilting. Measurements with this gauge on the deep seafloor show two principal features in the spectrum of pressure fluctuations. At frequencies below 0.03 Hz there is evidence of pressures generated directly by long surface gravity waves. Above 0.11 Hz the pressures associated with microseisms are predominant. Between 0.03 and 0.11 Hz there is a spectral gap where the pressure level dr...
Next generation public safety networks: A spectrum sharing approach

Wireless communications play a critical role in national security and disaster relief and are extensively utilized by first responder teams, such as police officers, firefighters, and ambulances. The first responders in emergency situations need to always be connected with one another and with the remote service centers for effective cooperation and coordination. However, the existing public safety (PS) services fail to satisfy the PS user requirements in many emergency scenarios, which usually leads to exceptionally high traffic loads. As a result, increasing the network capacity is one of the primary concerns, and spectrum sharing has been deemed the key solution. With appropriate spectrum sharing partnerships among PS agencies and commercial networks, PS users can access licensed PS spectrum, shared spectrum, as well as commercial networks when the need arises. In this article we present different initiatives undertaken by Wireless @ Virginia Tech toward the next generation PS network. We also discuss our vision of a flexible, rapidly deployable, and reconfigurable PS system to meet imminent and future demands on critical communications infrastructure and discuss the value of spectrum sharing for supporting this long-term vision.
The "coal tar" odor of Tricholoma inamoenum.

The odor of Tricholoma inamoenum (Fr.) Quel. (Agaricales, Tricholomataceae) has been described as a coal tar odor (Benedict and Stuntz, 1975; Smith, 1979), or smelling of illuminating gas (Moser, 1983) and can often be used as an aid in identification of the species. Using paper and silica gel chromatography, Hilber (1968) reported that indole and/or skatole were responsible for the odor in this species. In an on-going attempt to identify the major chemical constituents of numerous species of mushrooms with unusual odors, the coal tar odor of Tricholoma inamoenum was re-evaluated
New Fiber Lasers based on Nonlinear Optics

Nonlinear optics (NLO) including Raman and optical parametric processes allow generation of new frequencies. Our recent effort in generation of new fiber laser sources in near IR and mid IR will be summarized. Article not available.
Isolation of hydromorphone and dihydromorphine glucuronides from urine of the rabbit after hydromorphone administration.

SummaryTwo metabolites of hydromorphone were isolated from the urine of the rabbit. By infrared analyses, thin layer chromatography, β-glucuronidase hydrolysis and ultraviolet spectroscopy, the crystalline metabolites were found to be hydromorphone-3-glucuronide and dihydromorphine-3-glucuronide.The authors acknowledge the excellent technical assistance of Mrs. Sandra Huse. The hydromorphone (Dilaudid) hydrochloride was generously provided by Dr. A. Bavley, Knoll Pharmaceutical Co., Orange, NJ. Dihydromorphine was provided by Dr. John P. Long of the University of Iowa, Iowa City, IA.
Structural diversity in metal complexes with a dinucleating ligand containing carboxyamidopyridyl groups.

The synthesis of a (carboxyamido)pyridinepyrazolate (H5bppap) dinucleating ligand is described. Bimetallic iron and cobalt complexes of H5bppap ([MII2H2bppap]+) showed structural differences in bot...
Review of Methods to Determine VA Health Care Costs

BACKGROUND Estimates of health care cost are needed to conduct cost-effectiveness research at the facilities operated by the US Department of Veterans Affairs. METHODS The medical literature was searched for VA studies to characterize different cost methods and identify their advantages and disadvantages. RESULTS Different methods are appropriate for different studies. Analysts who wish to capture the effect of an intervention on resources used in a health care encounter may wish to create a detailed pseudo-bill by combining VA utilization data with unit costs from the non-VA sector. If a cost function can be estimated from non-VA data, VA costs may be determined more economically from a reduced list of utilization items. If the analysis involves a new intervention or a program that is unique to VA, direct measurement of staff time and supplies may be needed. It is often sufficient to estimate the average cost of similar encounters, for example, the average of all hospital stays with the same diagnosis and same length of stay. Such estimates may be made by combining VA cost and utilization data bases and by applying judicious assumptions. CONCLUSIONS Assumptions used to estimate costs need to be documented and tested. VA cost-effectiveness research could be facilitated by the creation of a universal cost data base; however, it will not supplant the detailed estimates that are needed to determine the effect of clinical interventions on cost.
Fluorination in the Design of Membrane Protein Assemblies

Protein design approaches based on the binary patterning of nonpolar and polar amino acids have been successful in generating native-like protein structures of amphiphilic α-helices or idealized amphiphilic β-strands in aqueous solution. Such patterning is not possible in the nonpolar environment of biological membranes, precluding the application of conventional approaches to the design of membrane proteins that assemble into discrete aggregates. This review surveys a promising, new strategy for membrane protein design that exploits the unique properties of fluorocarbons-in particular, their ability to phase separate from both water (due to their hydrophobicity) and hydrocarbons (due to their lipophobicity)-to generate membrane protein assemblies. The ability to design such discrete assemblies should enable the disruption of protein-protein interactions and provide templates for novel biomaterials and therapeutics.
Hand Injuries in Children

Hand injuries in children are seen frequently in the office and the emergency room. Basic principles determine which fractures, tendon injuries, dislocations, nerve injuries, fingertip injuries, infections, and amputations can be treated by the primary physician and which should be referred to a specialist.
Chronic Renal Failure and Bladder Augmentation: Stomach Versus Sigmoid Colon in the Canine Model

Abstract A canine model for chronic renal failure and bladder augmentation with a segment of stomach or sigmoid colon (or control) was developed to evaluate the possible benefit of net chloride ion excretion noted in an earlier canine model for gastrocystoplasty. Gastrocystoplasty animals behaved similar to control animals relative to the sigmoid cystoplasty animals, tolerated significantly greater acid loading, did not have hyperchloremia with acidosis and had less weight loss with acidosis. Gastrocystoplasty seems to be superior to sigmoid cystoplasty in the azotemic canine. (J. Urol, part 2, 140:1138-1140, 1988)
Making Heritage: The Case of Black Beluga Agriculture on the Northern Great Plains

This article considers the perils and potential of an increasingly popular alternative food commodity: heritage and heirloom foods. Drawing on ethnographic research with Black Beluga lentil farmers in Montana, I develop a process-based means of conceptualizing heritage agriculture, to avoid the pitfalls of simply reifying old crop varieties. This article makes three contributions to scholarship on alternative food commodities: (1) modeling a method of generative critique of alternative food movements that are in danger of being undermined by their articulation as commodity markets, (2) demonstrating how feminist ethnography of situated knowledge production can provide insight into processes of cross-species learning through which alternative food systems are created and sustained, and (3) suggesting that a reflexive approach to alternative food movement praxis is the best means of fostering environmental sustainability and social justice.
Dynamic spectral mask construction for radar transmission based on communication receiver locations

Dynamic spectrum allocation is becoming a means of allocating spectrum based on users and available frequencies in surrounding geographic regions. Presently, spectral masks are applied to radar transmission based on specifications from governmental regulatory agencies. This paper describes a concept for dynamic spectral mask determination based on the location and acceptable interference power levels at frequencies used by nearby communication receivers. This concept will be applied going forward to allow information from wireless networks about surrounding users to be applied in dynamically constraining radar transmitter spectra.
Intramural outflow tract ventricular tachycardia: anatomy, mapping, and ablation.

Idiopathic ventricular tachycardia (VT) originating from the outflow tract has been treated with a relatively high success rate by radiofrequency catheter ablation. However, a small percentage of failure in these patients may be because of an inaccessible site of origin from an intramural location. The region of the interventricular septum between the right (RVOT) and left ventricular outflow tracts (LVOT) can be mapped by using thinner multielectrode catheters advanced via the septal perforating venous tributaries of the great cardiac vein (GCV).1,2 The following case series is a description of these intramural VTs and the anatomic analysis in this region. See Editor’s Perspective p 982 ### Case 1 A 56-year-old man with a history of high-burden premature ventricular contractions (PVCs) that were refractory to medical therapy underwent catheter ablation. The morphology of the PVC by ECG showed a rS wave with S wave notch at lead I and a rS wave in V1 (Figure 1A). The earliest ventricular activation timing at the RVOT was −19 ms. Mapping of the GCV and vein tributaries was then performed using a 3.5-mm irrigated ablation catheter guided by venography (Figure 1B). The GCV and lateral veins of the GCV were mapped with no optimal early ventricular activation located. However, the earliest activation was located at a septal perforating branch (SPB) vein of the GCV with a timing of −39 ms. Pace mapping at the target area completely matched with the clinical PVC. Ablation was performed at the earliest SPB vein site using an irrigated catheter with 15 W and an infusion rate of 17 mL/min with impedance …
Early death after discharge from emergency departments: analysis of national US insurance claims data

Objective To measure incidence of early death after discharge from emergency departments, and explore potential sources of variation in risk by measurable aspects of hospitals and patients. Design Retrospective cohort study. Setting Claims data from the US Medicare program, covering visits to an emergency department, 2007-12. Participants Nationally representative 20% sample of Medicare fee for service beneficiaries. As the focus was on generally healthy people living in the community, patients in nursing facilities, aged ≥90, receiving palliative or hospice care, or with a diagnosis of a life limiting illnesses, either during emergency department visits (for example, myocardial infarction) or in the year before (for example, malignancy) were excluded. Main outcome measure Death within seven days after discharge from the emergency department, excluding patients transferred or admitted as inpatients. Results Among discharged patients, 0.12% (12 375/10 093 678, in the 20% sample over 2007-12) died within seven days, or 10 093 per year nationally. Mean age at death was 69. Leading causes of death on death certificates were atherosclerotic heart disease (13.6%), myocardial infarction (10.3%), and chronic obstructive pulmonary disease (9.6%). Some 2.3% died of narcotic overdose, largely after visits for musculoskeletal problems. Hospitals in the lowest fifth of rates of inpatient admission from the emergency department had the highest rates of early death (0.27%)—3.4 times higher than hospitals in the highest fifth (0.08%)—despite the fact that hospitals with low admission rates served healthier populations, as measured by overall seven day mortality among all comers to the emergency department. Small increases in admission rate were linked to large decreases in risk. In multivariate analysis, emergency departments that saw higher volumes of patients (odds ratio 0.84, 95% confidence interval 0.81 to 0.86) and those with higher charges for visits (0.75, 0.74 to 0.77) had significantly fewer deaths. Certain diagnoses were more common among early deaths compared with other emergency department visits: altered mental status (risk ratio 4.4, 95% confidence interval 3.8 to 5.1), dyspnea (3.1, 2.9 to 3.4), and malaise/fatigue (3.0, 2.9 to 3.7). Conclusions Every year, a substantial number of Medicare beneficiaries die soon after discharge from emergency departments, despite no diagnosis of a life limiting illnesses recorded in their claims. Further research is needed to explore whether these deaths were preventable.
Nontraditional Exports in Costa Rica: An Exploration of Public Policy Issues

As LDC’s turn from inward focused to export oriented development, nontraditional exports have taken on added significance. This chapter examines LDC export marketing problems and practices from a policy point of view. Costa Rican exporters regard marketing problems as their most serious concerns. However, exporters’ means of gathering information about target markets, and their own choice of marketing strategies, raise serious concerns. Moreover, distinct approaches to export marketing are not evolving as firms become more experienced. It is suggested that export promotion organizations must become more involved in “marketing” marketing, if export-led development strategies are to succeed.
Sex differences in fitness and cardiac function during exercise in adolescents with chronic fatigue.

Females demonstrate less robust Frank-Starling mechanism with respect to cardiac preload than males at rest. We asked whether this phenomenon would also affect cardiac performance during exercise. We hypothesized that stroke volume (SV) response to exercise would be more limited in deconditioned females such that cardiac output would be mainly rate dependent, compared with males. We conducted a chart audit of clinical exercise tests performed by adolescents with chronic fatigue. Oxygen uptake (V˙O2) was measured breath-by-breath at rest and during cycle ergometry, while cardiac output was measured by acetylene rebreathing at rest plus 2-3 subthreshold workloads. SV response was analyzed in two ways: after normalization for body surface area (SV index, SVI) and as percentage change from resting values. Among 304 adolescents (78% females) with chronic fatigue, 189 (80%) of 236 females and 52 (76%) of 68 males were deconditioned (peakV˙O2 <90% predicted). Heart rate trajectory during exercise was steeper for unfit than fit females, 70 vs 61 beat·min-1 per L·min-1 V˙O2, (P=.003); but not for males, 47 vs 42 beat·min-1 per L·min-1 V˙O2 (P=.23). The highest measured SVI did not differ between unfit vs fit females (42.8 vs 41.5 mL·m-2 , P=.39) while fit males showed larger SV during exercise than their unfit peers (highest SVI 55.9 vs 48.0 mL·m-2 , P=.014). Both qualitative and quantitative sex differences exist in SV responses to exercise among chronically fatigued adolescents, suggesting volume loading may be more efficacious in girls.
Experiential learning in physical therapy education.

BACKGROUND AND PURPOSE Experiential learning can provide students in entry-level physical therapy (PT) education programs the opportunity to practice skills and techniques, learned in the classroom, in a real-world setting. Experiential learning is currently being utilized in all entry-level PT programs in the form of professional practice experiences but may be integrated throughout the curriculum to enhance student engagement and knowledge application and retention. The purpose of this paper is to express the need for increased integration of experiential learning into entry-level PT education curricula. POSITION AND RATIONALE Experiential learning can effectively replace a portion of in-class laboratory time in entry-level PT education programs. Several methods of experiential learning exist, including simulation, integrated clinical experiences, service learning, community patient resource groups, and professional practice opportunities. Students benefit from the ability to practice hands-on skills in a safe, nonjudgmental environment. Students can still experience consequences of poor decisions but can have multiple opportunities to master the skill without the fear of negative outcomes. Incorporation of high-risk age ranges and diagnoses can be achieved through simulation. DISCUSSION AND CONCLUSION Experiential learning can be integrated into any PT curriculum if faculties are committed and flexible. Experiential learning may be particularly useful in specialty practice areas where there are fewer opportunities for students to practice skills. The practice of reflection upon experiences that is commonly performed in conjunction with experiential learning will help prepare students for the type of reflective practice that is essential to transition from novice to expert practitioners.
Endovascular stent graft repair of an abdominal gunshot with liver and aortic injuries

After being shot in the abdomen with a small caliber gun, a 16-year-old boy was transported to the emergency department (ED) in a private vehicle. On arrival to the ED, he was pale, tachycardic, and hypotensive. Intravenous access was obtained, and 1 L of saline and 2 units of packed red blood cells were given to stabilize the patient. Abdominal examination showed a subxiphoid entrance wound with no signs of peritonitis. No exit wound or other significant physical examination findings were noted. Focused Assessment with Sonography for Trauma (FAST) examination was negative for pericardial fluid but positive for minimal intra-abdominal fluid. Chest radiograph was negative for hemothorax and pneumothorax. His vital signs remained stable so he was taken for CT imaging. CT scan (figure 1) showed a linear laceration of the left hepatic lobe with the bullet trajectory passing through the supraceliac aorta. Irregularity of the aortic wall and extensive retroperitoneal hemorrhage surrounding the aorta were concerning for aortic injury, but no contrast extravasation was noted. A L1 vertebral …
Phenomena in rotating fluids

The hydrodynamic phenomena which occur in rotating systems display such a variety of subtleties, they are important in so many contexts, and they manifest themselves over so vast a range of scales (including such extremes as the flow in the biochemist’s centrifuge, and the motions of the atmosphere and ocean) that one cannot begin to give a comprehensive outline of the field in a single lecture such as this. Accordingly, I shall choose a few specific questions whose analysis and whose answers may give some rudimentary view of the fascinating flow regimes and the challenges inherent in the study of rotating fluids. In particular, I will confine my attention to flows of a fluid whose viscosities, thermal conductivity and specific heats are constant. In fact, whenever I can assign a property or a geometry which simplifies the analysis while retaining the character of the phenomenon under study, I shall do so. Since the objective here is to characterize flows rather than to compute them accurately, no understanding will be lost by such arbitrary decisions.
A Just-Identified Nonrecursive Model

This chapter discusses the concept of nonrecursive model. In contrast to the case of a fully recursive model, in the nonrecursive model, the specification of zero covariances between disturbances and exogenous variables does not lead to either zero covariance between the two disturbances or zero covariance between the disturbance and each explanatory variable in an equation. The chapter discusses the model x 3 = b 31 x 1 + b 34 x 4 + u, x 4 = b 42 x 2 + b 43 x 3 + v, where E(x j ) = 0, j = 1, …, 4, and E(u) = E(v) = 0. However, one does not put the variables in standard form. Variables x l and x 2 are exogenous; their variances and their covariance are not explained within the model. Variables x 3 and x 4 are jointly dependent or endogenous; the purpose of the model is to explain the behavior of these variables. Variables u and v are, respectively, the disturbances in the x 3 -equation and the x 4 -equation. Their presence accounts for the fact that x 3 and x 4 are not fully explained by their explicit determining factors. The model will be operational only if we can assume that disturbances are uncorrelated with exogenous variables; hence, the specification E(x 1 u) = E(x l v) = E(x 2 u) = E(x 2 v) = 0.
Copyright Reform in the 21st Century: Adding Privacy Considerations into the Normative Mix

The new technology of the ‘Digital Age’ has led to the creation of potentially new copyrightable forms of works and new methods of distribution that do not automatically fit within existing paradigms based on a hard-goods world. As a result, copyright reform efforts are underway in jurisdictions as diverse as Australia, China, New Zealand, Singapore, South Korea, the European Union (EU), Hong Kong, Japan, Canada and the United States. To avoid the mistakes of the past, and create reforms whose effectiveness survives more than a few years, we must consider a broader array of normative inputs, including, critically the inter-relationship between copyright and personal and data privacy. In the 21st Century such privacy concerns are no longer adjuncts to issues of copyright protection but instead increasingly impact the scope and effectiveness of such protection. Using examples from the United States, Canada, the European Union and the Asia Pacific, I explore the impact of privacy considerations on such diverse issues as the author/subject dichotomy, fair use/fair dealing, digital enforcement mechanisms, including notice and takedown regimes, anticircumvention protections, database and other data collections, and distributional relief, including injunctions and suggest the shape that such reforms might take. Adding privacy concerns to copyright reformation considerations will not simplify the process. But the resulting normative framework could provide a copyright regime that not only provides a balance more in concert with the social justice and access to information/culture concerns but also remains viable regardless of what the next technological revolution may bring.
Underwater spirits and sacred places: artesian springs in southwestern Missouri

Indigenous people throughout Native America often bestowed special meaning and veneration upon certain landscape features. This is the case for a series of artesian springs in the upper Osage River...
Safety and efficacy of methenamine hippurate for the prevention of recurrent urinary tract infections in adult renal transplant recipients: A single center, retrospective study.

Background Recurrent urinary tract infections (UTI) are an important cause of morbidity and mortality in renal transplant recipients (RTR). Methods In this retrospective study we gathered clinical data from patients prescribed methenamine hippurate to prevent recurrent UTI pre- and post-intervention. Thirty-eight RTR ≥18 years old at Northwestern Memorial Hospital from 2006-2017 were included in the final analysis. Results The median and range for follow-up days were 365 (299-365) pre- vs 314 (105-365) post-methenamine. Total UTI frequency (9.16 vs 5.01/1000 patient follow-up days), days of antibiotic therapy to treat UTI (215 vs 132/1000 patient follow-up days), and hospitalization due to UTI (2.64 vs 1.07/1000 patient follow-up days) decreased while patients took methenamine. Escherichia coli and Klebsiella pneumoniae were the most commonly identified cause of UTI both pre- and post-intervention. Drug resistant bacteria (ESBL-producing or VRE) affected 3 patients pre- and recurred in 1 of those patients plus 3 new patients post-methenamine. Methenamine had few adverse side effects for patients. One patient had nausea and 1 was intolerant. Conclusion We found that methenamine is well tolerated and is useful in reducing UTI, antibiotic prescriptions, and hospitalization in RTR with recurrent UTI. Larger prospective studies are needed to confirm these findings.
Electrophoresis and Immunoelectrophoresis in the Evaluation of Homogeneous Immunoglobulin Components

Publisher Summary This chapter discusses the techniques for characterization and quantitation of homogeneous immunoglobulin components. The precise identification of the immunoglobulin fraction is carried out by immunoelectrophoretic analysis and quantitation of individual components can be carried out by a variety of techniques, most commonly radial immunodiffusion. Electrophoresis, immunoelectrophoresis, and immunoglobulin quantitation are useful in the situations where a single clone of plasma cells or lymphocytes proliferates to produce large amounts of a homogeneous immunoglobulin or immunoglobulin fragment, which is readily detectable as a narrow band on ordinary serum electrophoresis. Such homogeneous immunoglobulin components are generally encountered in the malignant diseases of plasma cells or lymphocytes. The disorders where monoclonal proteins are encountered include multiple myeloma, macroglobulinemia, H-chain diseases, and benign monoclonal gammopathy. Electrophoresis does not allow the precise characterization and quantitation of the homogeneous component; therefore, immunoelectrophoresis is performed as the next step to clearly identify individual immunoglobulin fractions and a variety of techniques, the simplest of which is radial immunodiffusion, can be used for the quantitation of individual immunoglobulins.
24R,25-dihydroxyvitamin D3 modulates tumorigenicity in breast cancer in an estrogen receptor-dependent manner.

Abstract Vitamin D has long been prescribed as a supplement to breast cancer patients. This is partially motivated by data indicating that low serum vitamin D, measured as 25-hydroxyvitamin D3 [25(OH)D3], is associated with worsened cancer prognosis and decreased survival rates in cancer patients. However, clinical studies investigating the role of vitamin D supplementation in breast cancer treatment are largely inconclusive. One reason for this may be that many of these studies ignore the complexity of the vitamin D metabolome and the effects of these metabolites at the cellular level. Once ingested, vitamin D is metabolized into 37 different metabolites, including 25(OH)D3, which is the metabolite actually measured clinically, as well as 1,25(OH)2D3 and 24,25(OH)2D3. Recent work by our lab and others has demonstrated a role for 24R,25(OH)2D3, in the modulation of breast cancer tumors via an estrogen receptor α-dependent mechanism. This review highlights the importance of considering estrogen receptor status in vitamin d -associated prognostic studies of breast cancer and proposes a potential mechanism for 24R,25(OH)2D3 signaling in breast cancer cells.
Building Data Talent and Workforce

Hiring data talent is desirable and challenging. Due to a global talent shortage, there are hundreds of thousands of Data Science jobs that go unfilled each year. There are, however, a few traits that differentiate the best hiring managers from the rest. Managers that take full advantage of their resources and build a culture of recruiting tend to consistently get the top candidates. In this section, we talk about why hiring for Data Science and analytics talent is different, the flaws in the traditional ways Human Resources departments are used, the strategies for building an updated culture of recruiting and the direct benefits to hiring managers. We also talk about reasonable expectations and the missing links in the hiring process, how to assess skills, talent sourcing and continuing education for current employees. Finally, we discuss considerations for senior-level data scientists and the new Data C-suite.
Archiving federally, writing regionally: archival practices and princely state histories in postcolonial India

This article examines the paucity of pre-1947 Indian princely state records, especially those regarding their federalist advocacies from the 1920s through 1940s, in the various provincial archives ...
Supporting Local Health Departments to Lead Multisectoral Youth Violence Prevention Efforts

This article examines organizational-level outcomes achieved during a technical assistance (TA) initiative designed to increase the capacity of local health departments (LHDs) to prevent youth viol...
Clavicle fractures: Associated trauma and morbidity.

Abstract Background Clavicle fractures are frequently associated with trauma to regions beyond the immediate zone of injury. In order to provide surgeons with information on injury prevalence to prevent delays in diagnosis and management, we describe the epidemiology of concomitant injuries in patients with clavicle fractures and identify differences between those with open and closed fractures. Methods: The Nationwide Inpatient Sample (NIS) 2001–2013 database was queried for adult patients discharged with a diagnosis of a clavicle fracture using ICD-9 codes. A “common” injury was defined as prevalence ≥4.0% in our study population. We analyzed data for injury locations associated with open vs. closed clavicle fractures with chi square and independent samples t-tests. Results A total of 41,1612 patients were included in our study population. The majority of patients had closed clavicle fractures (98.2%). The most common concomitant fracture was that of the rib, followed by the spine. The most common non-vascular, non-nervous injury was a hemo/pneumothorax followed by a lung, bronchus, or diaphragm injury. Fractures of the humerus, rib, scapula, pelvis, tibia or fibula, and facial bones as well as concussion, pneumo/hemothorax, other pulmonary, and splenic injuries were more common in patients with open clavicle fractures. Patients with open clavicle fractures were, on average, 11.8 years younger than those with closed fractures. Conclusion There is a significant association between clavicle fractures and concussion, splenic, and thoracic injuries, as well as increased rate of complications with open fractures. Clinicians may use this information to perform risk assessments prevent delays in diagnosis.
Health Information Sources and the Influenza Vaccination: The Mediating Roles of Perceived Vaccine Efficacy and Safety.

Although the influenza vaccine is widely recognized as an effective preventive measure, influenza vaccination rates among U.S. adults remain low. Moreover, influenza-related respiratory illnesses may increase the risk of adverse outcomes of COVID-19. Thus, this study examines the mechanisms involved in influenza vaccination uptake. Specifically, this study investigates how health information sources are associated with perceived vaccine efficacy and safety, which, in turn, associated with influenza vaccine uptake. Analyzing cross-sectional survey data from a national U.S. adult sample (N = 19,420), mediation analyses were conducted. Results revealed that considering vaccine efficacy, health information seekers who assigned more value to medical professionals, medical journals, and newspaper articles were more likely to perceive a vaccine as effective, thus being more likely to receive the influenza vaccine. By contrast, individuals who placed more value in social media were less likely to perceive vaccine efficacy, and, in turn, were less likely to get the influenza vaccine. Turning to vaccine safety, the value ascribed to medical professionals was positively associated with vaccine safety, which, in turn, related to influenza vaccine uptake. By contrast, social media, family or friends, and promotions were negatively associated with vaccine safety, and then influenza vaccine uptake.
Contribution of donor- and recipient-associated factors to allergic transfusion reactions to platelets.

BACKGROUND Pediatric hematology-oncology patients require frequent platelet transfusions to manage chemotherapy-induced thrombocytopenia, and allergic transfusion reactions (ATRs) are common. Risk for platelet-associated ATRs can result from recipient- or donor-specific factors. STUDY DESIGN AND METHODS We report a rare case in which an individual platelet donor caused repeated ATRs in multiple recipients. This observation led us to conduct a retrospective study at a pediatric hematology-oncology center to identify donor- and recipient-associated risk factors for ATRs. RESULTS Single-donor platelets from an individual donor precipitated ATRs in 78.6% (n = 11/14) of recipients and 66.7% (n = 12/18) of platelet transfusions. We found in a cohort of pediatric hematology-oncology patients that 12.6% of recipients and 1.0% of platelet transfusions were associated with ATRs. Recipients who were aged 4 to 18 years, male, and those with central nervous system or solid tumors and with a history of ATRs to platelets were more likely to experience ATRs. Donor-associated risk factors were not identified, and we did not implicate additional donors in our single-center cohort with a frequency of ATRs comparable to the index donor. Based on our findings, we developed a novel statistical model to identify recipients and donors prone to experiencing or mediating ATRs. CONCLUSIONS Both donors and recipients contribute to ATRs. Identification of high-risk donors and recipients for further scrutiny and potential interventions can improve the safety of platelet transfusions.
Fixing the Senate: A User's Guide

The Senate is the most undemocratic part of the U.S. Constitution – worse even than the Electoral College, although the two are related, and some versions of fixing the Senate would ameliorate the Electoral College also. Unfortunately, each state's “equal Suffrage” in the Senate is protected by a unique constitutional entrenchment clause. The Entrenchment Clause creates a genuine bar to reform, but that bar is not insurmountable. We argue first that the constitutional proscription on abolishing the Senate has been overstated, but that in any case there are constitutional reform options that range from abolishing the Senate to various degrees of disempowering it. We then argue that there are several promising reforms that could move in the direction of democratizing the Senate without constitutional amendment. In particular: admitting new states, breaking up the largest states, and a new Constitutional Convention. This paper canvasses benefits, costs, effectiveness, and likely feasibility of each of these methods by which one might seek to make the Senate more representative despite the entrenchment clause. Several of the proposals create an opportunity for Supreme Court review and perhaps obstruction, raising questions about the relationship between Senate reform and Supreme Court reform.
Nicotine Exposure Via Electronic Cigarettes Significantly Impedes Biomechanical Healing Properties of Tendon Healing in a Rat Model.

Purpose To evaluate the biomechanical and histologic effects on Achilles tendon repair of inhaled combusted tobacco versus nicotine exposure via electronic cigarette versus a control group in a small-animal model (Sprague-Dawley rat). Methods Fifty-four Sprague-Dawley rats were randomized into 3 groups: combusted tobacco, e-cigarettes, or control. Experimental rats were exposed to research cigarettes or e-cigarette vapor in a smoking chamber for 4 weeks. Surgical transection and repair of the Achilles tendon were then completed, followed by 2 additional weeks of exposure. Achilles tendons were harvested, and biomechanical tensile testing was performed. Histologic evaluation was completed, including hematoxylin-eosin staining, trichrome staining, and immunohistochemistry analysis for type I and type III collagen. Results The control group showed the highest mean tensile load to failure, at 41.0 ± 10.4 N (range, 18.3-55.1 N); the cigarette cohort had the second highest mean, at 37.3 ± 11.1 N (range, 14.0-54.7 N); and finally, the vaping group had the lowest mean, at 32.3 ± 8.4 N (range, 17.8-45.1 N). One-way analysis of variance showed a significant difference in load to failure when comparing the control group with the e-cigarette group (P = .026). No statistical difference was detected between the control group and cigarette group (P = .35) or between the e-cigarette group and cigarette group (P = .23). Stiffness and qualitative histologic analysis showed no difference among groups. Conclusions This investigation shows that in a rat model, nicotine exposure via e-cigarette significantly impedes the biomechanical healing properties of Achilles tendon surgical repair. Clinical Relevance The results indicate that although e-cigarettes are often used as a perceived “safer” alternative to smoking, their use may have a detrimental effect on tendon load to failure.
Disordered Eating, Development of Menstrual Irregularity, and Reduced Bone Mass Change After a 3-Year Follow-Up In Female Adolescent Endurance Runners.

This prospective study evaluated the 3-year change in menstrual function and bone mass among 40 female adolescent endurance runners (age 15.9 ± 1.0 years) according to baseline disordered eating status. Three years after initial data collection, runners underwent follow-up measures including the Eating Disorder Examination Questionnaire and a survey evaluating menstrual function, running training, injury history, and prior sports participation. Dual-energy X-ray absorptiometry was used to measure bone mineral density and body composition. Runners with a weight concern, shape concern, or global score ≥4.0 or reporting >1 pathologic behavior in the past 28 days were classified with disordered eating. Compared with runners with normal Eating Disorder Examination Questionnaire scores at baseline, runners with disordered eating at baseline reported fewer menstrual cycles/year (6.4 ± 4.5 vs. 10.5 ± 2.8, p = .005), more years of amenorrhea (1.6 ± 1.4 vs. 0.3 ± 0.5, p = .03), and a higher proportion of menstrual irregularity (75.0% vs. 31.3%, p = .02) and failed to increase lumbar spine or total hip bone mineral density at the 3-year follow-up. In a multivariate model including body mass index and menstrual cycles in the past year at baseline, baseline shape concern score (B = -0.57, p value = .001) was inversely related to the annual number of menstrual cycles between assessments. Weight concern score (B = -0.40, p value = .005) was inversely associated with lumbar spine bone mineral density Z-score change between assessments according to a multivariate model adjusting for age and body mass index. These finding support associations between disordered eating at baseline and future menstrual irregularities or reduced accrual of lumbar spine bone mass in female adolescent endurance runners.
Novel Roles of Necroptosis Mediator Receptor-Interacting Protein Kinase 3 in Kidney Injury

Necroptosis is a programmed cell death that is characterized by regulated necrosis resulting in plasma membrane rupture and subsequent release of damage-associated molecular patterns (DAMPs). Receptor-interacting protein kinase 3 (RIPK3) is a key mediator of this pathway. Accumulating evidence supports a critical role of RIPK3 and the necroptosis pathway in various human diseases. In this review, we discuss recent investigations that have uncovered pathogenic roles of RIPK3 in both acute kidney injury (AKI) and kidney fibrosis. RIPK3 promotes kidney tubular injury via a mechanism involving mitochondrial dysfunction. Additionally, extracellular mitochondrial DNA, which is one of the necroptotic DAMPs, released from damaged mitochondria correlates with kidney tubular injury and represents a potential novel biomarker. RIPK3 also induces kidney fibrogenesis through AKT-dependent activation of the metabolic enzyme ATP citrate lyase. Thus, the RIPK3-mediated necroptosis pathway may serve as a promising new therapeutic target in AKI and kidney fibrosis.