cssi/SciSciGPT-SciSciNet huggingface dataset:
Strain Improves Risk Prediction Beyond Ejection Fraction in Chronic Systolic Heart Failure

Background The utility of longitudinal, circumferential, and radial strain and strain rate in determining prognosis in chronic heart failure is not well established. Methods and Results In 416 patients with chronic systolic heart failure, we performed speckle-tracking analyses of left ventricular longitudinal, circumferential, and radial strain and strain rate on archived echocardiography images (30 frames per second). Cox regression models were used to determine the associations between strain and strain rate and risk of all-cause mortality, cardiac transplantation, and ventricular-assist device placement. The area under the time-dependent ROC curve (AUC) was also calculated at 1 year and 5 years. Over a maximum follow-up of 8.9 years, there were 138 events (33.2%). In unadjusted models, all strain and strain rate parameters were associated with adverse outcomes ( P <0.001). In multivariable models, all parameters with the exception of radial strain rate ( P =0.11) remained independently associated, with patients in the lowest tertile of strain or strain rate parameter having a ≈2-fold increased risk of adverse outcomes compared with the reference group ( P <0.05). Addition of strain to ejection fraction (EF) led to a significantly improved AUC at 1 year (0.697 versus 0.633, P =0.032) and 5 years (0.700 versus 0.638, P =0.001). In contrast, strain rate did not provide incremental prognostic value to EF alone. Conclusions Longitudinal and circumferential strain and strain rate, and radial strain are associated with chronic heart failure prognosis. Strain provides incremental value to EF in the prediction of adverse outcomes, and with additional study may be a clinically relevant prognostic tool.
Subtle effects of a managed fire regime: A case study in the longleaf pine ecosystem

a b s t r a c t Land managers often use fire prescriptions to mimic intensity, season, completeness, and return interval of historical fire regimes. However, fire prescriptions based on average historical fire regimes do not consider natural stochastic variability in fire season and frequency. Applying prescribed fire based on averages could alter the relative abundance of important plant species and structure. We evaluated the density and distribution of oak (Quercus spp.) and persimmon (Diospyros virgiana) stems and mast after 22 yr of a historical-based growing-season fire prescription that failed to consider the variability in historical fire regimes. We randomly established 30 25-m transects in each of 5 vegetation types and counted reproductively mature oak and persimmon stems and their fruits. In upland longleaf pine (Pinus palustris) stands, this fire regime killed young hardwood trees, thereby decreasing compositional and structural heterogeneity within the upland pine vegetation type and limiting occurrence of the upland hardwood vegetation type. Acorns and persimmons were disproportionately distributed near firebreaks within low intensity fire transition zones. Mast was maintained, though in an unnatural distribution, as a result of an elaborate firebreak system. Our data indicate managed fire regimes may fail to mimic spatial distribution, frequency, and intensity of historical disturbances even when the fire prescription is based on empirical reference fire regimes. To maximize structural heterogeneity and conserve key ecosystem functionality, fire prescriptions should include variations in frequency, season, application method, and fire weather conditions rather than focusing on an average historical fire regime.
TQM in the Service Sector: A Survey of Small Businesses

This paper reports on a survey of managerial perceptions of the implementation of total quality management (TQM) in small service businesses in the US. The study addresses the employment of TQM, to...
A Review of Drug Interactions With Psychiatric Medicines for the Pharmacy Practitioner

With thousands of potential drug interactions, it is next to impossible to remember them all, especially with many people on multiple prescriptions and over-the-counter medications. With the increasing use of psychiatric medicines in the general population, drug interactions may occur without recognition or warning. Pharmacy computer software programs provide help with identifying the majority of potential drug interactions, but these systems are only as good as the user who develops them. Some drug interactions are negligible, whereas others are quite significant. It is most important to remember drug interactions that may have a significant clinical effect. Approximately half of all medications prescribed today are affected by cytochrome P450 enzymes, but other interactions that involve various mechanisms can also be problematic. This review identifies drug interactions that may occur with the most frequently prescribed psychiatric medications and provides a review of selected interactions that may be c...
Hannah Arendt, National Socialism and the Project of Foundation

Foundation is a crucial concept in Hannah Arendt's work. She was especially interested in modern attempts, successful and unsuccessful, to found new bodies politic. Arendt maintained, however, that totalitarian movements were hostile to the project of foundation. Far from seeking to stabilize the world, totalitarianism set the world in motion and tried to keep it moving. But when we turn to National Socialist ideology itself we discover that foundation was vital to the Nazi project; Hitler understood himself as the founder of his people. Arendt's own interpretation of Nazism is mistaken, but I believe that her general theory of foundation can help us to make sense of the National Socialist experience. This article examines the project of foundation in Hitler's Weltanschauung and redeploys Arendt's concepts to explain his unsuccessful attempt to create a new body politic.
Rate Control for Network-Coded Multipath Relaying with Time-Varying Connectivity

This paper presents techniques for achieving high throughput in delay-constrained, multihop wireless communication networks with time-varying link connectivity. We develop a rate-controlled, multipath strategy using network coding, and compare its performance with that of multipath flooding and with the performance of traditional single-path strategies. These performance comparisons include both theoretical benchmarks and simulation results from cooperative relay scenarios, which incorporate different sets of link connectivity statistics that are drawn from field tests of mobile satellite communication terminals. The results indicate that with appropriate rate-control, network coding can provide throughput performance comparable to multipath flooding of the network while utilizing bandwidth nearly as efficiently as single-path routing.
The impact of the world trade center attack on FDNY firefighter retirement, disabilities, and pension benefits

BACKGROUND: Our goal was to examine the effect of the World Trade Center (WTC) attack and subsequent New York City Fire Department (FDNY) rescue/recovery activities on firefighter retirements. We also analyzed the financial impact associated with the increased number and proportion of service-connected "accidental" disability retirements on the FDNY pension system. METHODS: A total of 7,763 firefighters retired between 9/11/1994 and 9/10/2008. We compared the total number of retirements and the number and proportion of accidental disability retirements 7 years before and 7 years after the WTC attack. We categorized WTC-related accidental disability retirements by medical cause and worked with the New York City Office of the Actuary to approximate the financial impact by cause. RESULTS: In the 7 years before 9/11 there were 3,261 retirements, 48% (1,571) of which were accidental disability retirements. In the 7 years after 9/11, there were 4,502 retirements, 66% (2,970) were accidental disability retirements, of which 47% (1,402) were associated with WTC-related injuries or illnesses. After 9/11, the increase in accidental disability retirements was, for the most part, due to respiratory-related illnesses. Additional increases were attributed to psychological-related illnesses and musculoskeletal injuries incurred at the WTC site. Pension benefits associated with WTC-related accidental disability retirements have produced an increased financial burden of over $826 million on the FDNY pension system. CONCLUSIONS: The WTC attacks affected the health of the FDNY workforce resulting in more post-9/11 retirements than expected, and a larger proportion of these retirees with accidental disability pensions. Am. J. Ind. Med. © 2011 Wiley-Liss, Inc. Language: en
Matching Severance Payments with Worker Losses in the Egyptian Public Sector

Severance pay programs can reduce political opposition and minimize the social costs of labor redundancies. In Egypt, only voluntary programs are feasible because legal limitations preclude layoffs and strong organized labor groups oppose any weakening of job security protections. A common problem with voluntary severance programs, however, is that they tend to overpay workers relative to the welfare losses they experience from displacement. This article estimates the losses that public sector workers would incur if they were displaced from their jobs and simulates several voluntary severance schemes to determine how well the schemes match compensation payments to these estimated losses. It provides a fairly strong argument for looking at the structure of opportunity costs and wage profiles when designing severance programs. It shows that significant overpayment can be avoided by matching compensation payments to the expected losses of workers. It also provides a method for estimating these losses from standard labor force surveys that are available in most countries.
An excitatory amacrine cell detects object motion and provides feature-selective input to ganglion cells in the mouse retina

Retinal circuits detect salient features of the visual world and report them to the brain through spike trains of retinal ganglion cells. The most abundant ganglion cell type in mice, the so-called W3 ganglion cell, selectively responds to movements of small objects. Where and how object motion sensitivity arises in the retina is incompletely understood. In this study, we use 2-photon-guided patch-clamp recordings to characterize responses of vesicular glutamate transporter 3 (VGluT3)-expressing amacrine cells (ACs) to a broad set of visual stimuli. We find that these ACs are object motion sensitive and analyze the synaptic mechanisms underlying this computation. Anatomical circuit reconstructions suggest that VGluT3-expressing ACs form glutamatergic synapses with W3 ganglion cells, and targeted recordings show that the tuning of W3 ganglion cells' excitatory input matches that of VGluT3-expressing ACs' responses. Synaptic excitation of W3 ganglion cells is diminished, and responses to object motion are suppressed in mice lacking VGluT3. Object motion, thus, is first detected by VGluT3-expressing ACs, which provide feature-selective excitatory input to W3 ganglion cells.
A mechanical study of six digital pulley reconstruction techniques: Part II. Strength of individual reconstructions

A laboratory study was done on fresh-frozen human cadaver limbs, using six types of pulley reconstructions about the flexor tendons of the fingers. The reconstructions used were those described by (1) Bunnell, (2) Karev, (3) Weilby, and (4) Lister, and two types developed by us that have not been previously described. The pulleys were tested at constant strain rate to failure with the peak force recorded as the breaking strength. A total of 385 reconstructed pulleys were tested and the results were analyzed statistically. A new "loop and one half" pulley reconstruction was significantly stronger than the other five reconstructions (p less than 0.01) with an average load to failure of 22.5 kilograms-force. The other pulley reconstructions varied in average breaking strength from 2.8 kilograms-force to 18.4 kilograms-force.
Weighted median filters: generation and properties

It is shown, without reference to threshold decomposition or stacking property, that a WM (weighted median) filter of size N, with discrete-time continuous-valued inputs, can be specified by 2/sup N-1/ mutually consistent linear inequalities relating the weights. The filter's relation to binary threshold functions is indicated. For WM filters with symmetric weights, it is shown that the specification is the same as for ternary threshold functions. On the basis of the inequalities specifying a WM filter, some deterministic properties are derived and the generation of the WM filter is discussed. >
Modeling and control of quasi-keyhole arc welding process

Quasi-keyhole is a novel approach proposed to operate the keyhole arc welding process. Because the method's effectiveness depends on the amperage of the peak current used to establish the keyhole, this paper proposes adjusting the amperage based on the duration of the peak current, which equals the keyhole establishment time. A nominal model structure has been selected from those identified using experimental data and been used in the design of an adaptive predictive control system. Closed-loop control experiments have been conducted to verify the effectiveness of the developed system under varying set-points and varying travel speeds.
The Effectiveness of a 9-Month Regimen of Isoniazid Alone versus 3- and 4-Month Regimens of Isoniazid plus Rifampin for Treatment of Latent Tuberculosis Infection in Children: Results of an 11-Year Randomized Study

Background. A 9-month course of isoniazid monotherapy is currently recommended for the treatment of latent tuberculosis infection (LTBI) and has been shown to be effective in both children and adults. Reduced compliance with this regimen has forced physicians to explore shorter regimens. The aim of this study was to compare 3- and 4-month combination regimens of isoniazid plus rifampin with a 9-month regimen of isoniazid monotherapy for the treatment of LTBI in children. Methods. This prospective, randomized, controlled study was conducted over an 11-year period (1995-2005). In period 1 (1995-1998), 232 patients received isoniazid therapy for 9 months (group A), and 238 patients received isoniazid and rifampin for 4 months (group B). In period 2 (1999-2002), 236 patients were treated with isoniazid and rifampin for 4 months (group C), and 220 patients received the same regimen for 3 months (group D). All patients were observed for ≥3 years. Results. Overall compliance with treatment was good, but patients who received isoniazid monotherapy were less compliant than were those who received short-course combination therapy (P =.011, for group A vs. group B; P =.510, for group C vs. group D). No patient in any group developed clinical disease during the follow-up period. New radiographic findings suggestive of possible active disease were more common in patients who received isoniazid monotherapy (24%) than in those treated with shorter regimens (11.8%, 13.6%, and 11% for groups B, C, and D, respectively; P =.001 for group A vs. group B; P =.418 for group C vs. group D). Serious drug-related adverse effects were not detected. Conclusions. Short-course treatment with isoniazid and rifampin for 3-4 months is safe and seems to be superior to a 9-month course of isoniazid monotherapy.
Frame and Metaphor in Political Games

This paper offers an approach to analyzing political rhetoric in videogames intended to carry ideological bias, based on cognitive linguist George Lakoff’s notion of metaphor and frame as the principle organizers or political discourse. I then argue for three ways games function in relation to ideological frames: reinforcement, contestation, and exposition through examples of political games (Tax Invaders), art games (Vigilance 1.0), and commercial games (Grand Theft Auto: San Andreas). Secondarily, I offer thoughts on issues likely to arise from the hypothetical adoption of political frame and metaphor as design principles.
Passive leg motion changes in cerebral palsied children after whole body vertical acceleration

Reports on a pilot study designed to quantify changes in spasticity in children with spastic cerebral palsy following whole body vertical accelerations. Ten subjects, ranging in age from 5 to 18 years, were selected from the Cerebral Palsy Clinic of the Alfred I. duPont Institute. Most of the subjects were independent ambulators, although two used wheelchairs for long distances and one used a wheelchair full time. Passive leg motion changes, as seen in leg drop pendulum tests performed before and after vertical accelerations, are reported here. These changes are based on the comparison of 13 parameters, some of which are derived based on the assumption that normal limbs, when subjected to the leg drop pendulum test, behave as an underdamped second-order system. The vertical acceleration consisted of 15 min of up and down motion on a specially constructed platform capable of rating and lowering both the subject and his or her seating device. Amplitude of oscillation was set at 8.90 cm and the frequency of oscillation was commonly 1.57 Hz. Position of the leg was recorded with an electromagnetic position sensing device. Results of the study showed that 9 of the 10 subjects made a statistically significant improvement in one or more of the 13 attributes, with the highest achiever making improvements in 11 of the 13 attributes. Trends in the data show that the less severely involved clients made the most improvements. >
Illuminating protein interactions in tissue using confocal and two-photon excitation fluorescent resonance energy transfer microscopy

Traumatic brain injury (TBI) remains the most common cause of death in persons under age 45 in the Western world. One of the principal determinants of morbidity and mortality following TBI is traumatic axonal injury (TAI). Current hypotheses on the pathogenesis of TAI involve activation of apoptotic cascades secondary to TBI. While a number of studies have demonstrated direct evidence for the activation of apoptotic cascades in TAI, the precise pathway by which these cascades are initiated remains a subject of intense investigation. As axolemmal disruption with the subsequent intra-axonal influx of large molecular weight species has been demonstrated to occur in relation to local axonal breakdown, attention has focused on cascades that may occur as a result of loss of ionic homeostasis. One proposed pathway by which this has been hypothesized to occur is the Ca(2+)-mediated activation of calmodulin and subsequent activation of the phosphatase calcineurin with dephosphorylation of a protein known as BAD, leading to a proapoptotic interaction between BAD and the mitochondrial protein Bcl-xL. While this pathway is an intriguing route for traumatic axonal pathogenesis, neither conventional immunocytochemical/histochemical nor ultrastructural approaches have had the capacity to shed insight on whether BAD and Bcl-xL interact in TAI in vivo. We describe the implementation of confocal and two-photon excitation fluorescence resonance energy transfer (FRET) microscopy techniques through which we demonstrate interaction between the proapoptotic protein BAD and the prosurvival protein Bcl-xL within TAI following TBI. Further, we report on a method to reliably detect protein interactions within aldehyde fixed tissue sections through conventional immunohistochemical approaches.
Optimal operation of a tubular chemical reactor

A theoretical and experimental study was conducted on the optimal steady state operation of a jacketed, tubular, liquid-phase reactor in which consecutive second-order reactions occurred in turbulent flow. To verify the proposed mathematical model, diethyl adipate was saponified with sodium hydroxide in aqueous solution. The 150 ft. long reactor jacket was divided into 5, 30 ft. sections. Hot water flow rates in the jacket sections were chosen to maximize the concentration of monoethyl adipate ion at the reactor exit. The plug-flow model and a position-dependent heat transfer coefficient accurately described temperature and concentration profiles. The Pontryagin maximum principle was used to choose idealized reactor temperature and wall heat flux profiles which would maximize the exit concentration of monoester. The maximum principle was shown to be an effective tool for this type of reactor optimization. A technique is given for optimizing more complex reaction systems.
TRANSVALUATIONISM: A DIONYSIAN APPROACH TO VAGUENESS

Le propos de l'A. est double: d'une part, il montre que le vague est logiquement incoherent, d'autre part il affirme que le vague est bel et bien une composante du langage et de la pensee des hommes. Cette position paradoxale est appelee par lui-meme «transvaluationnisme» en reference a l'affirmation nietzscheenne qui transcende le nihilisme
The politics of indigenous land rights in Brazil

Brazilian indigenous rights policy has been exclusionary. As a result indigenous people and their supporters have mobilised and politicised indigenous issues. Politicisation led to inclusion of indigenous rights in the 1988 Constitution. Nevertheless, evidence suggests that this process led to a retrenchment of interests opposed to indigenous rights. This analysis compares the asymmetric access to the policy-formation process granted to political and economic interests and indigenous people. The argument is that democratisation has yet to open the policy-making process to disenfranchised groups such as indigenous people. To illustrate the argument evidence of setbacks to indigenous land rights is examined.
The Use of Multifocal Electroretinograms and Visual Evoked Potentials in Diagnosing Optic Nerve Disorders

Electrophysiological tests of vision measure the electrical activity generated by the eye, the optic pathways, and the visual cortex, and thus provide important diagnostic information to the clinical ophthalmologist. Traditionally, these electrophysiological tests involved stimulation of relatively large areas of the retina.1 For example, for the standard electroretinogram (ERG) and the flash visual evoked potential (VEP) tests, the entire retina is illuminated. Other tests, such as the pattern ERG and VEP tests, use a stimulus that typically exceeds 15° in diameter. The size of the stimuli used for these tests presents a problem if the clinician is interested in the local topography of the damage to the retina or optic nerve, as is often the case in neuro-ophthalmology. Although ERG and VEP responses can be elicited to relatively small stimuli using traditional measures, each retinal area had to be be tested separately. Thus, if a clinician wanted a topographical map, the time needed to obtain multiple responses was prohibitive.
To be or not to be exclusive: the sutezolid story

Response from Johns Hopkins University Johns Hopkins University is deeply committed to providing access to essential medicines, and has been working for years to advance the goal of ensuring that promising therapies for tuberculosis reach the market in an expeditious and accessible way. As with other promising drugs in the early stages of development, sutezolid is not yet ready for patients, and will require costly development and approval steps before it can help to address tuberculosis. At this stage, there are scant data on sutezolid’s safety or effi cacy in patients with tuberculosis. A series of clinical trials, which typically cost more than US$50 million, will be required to understand these issues and inform potential benefits versus potential risks to patients. Sutezolid’s early stage of clinical development sets it apart from the in-market or late-stage clinical development HIV medicines targeted by the Medicines Patent Pool. In this case, the story is further complicated by the fact that Johns Hopkins University does not own patent rights for the sutezolid compound; thus, our intellectual property is not necessary for the clinical development and commercialisation of sutezolid itself. Johns Hopkins is part of a jointly assigned patent application with Pfizer Inc entitled “Combination therapy for tuberculosis” (WO2010026526A1), and is limited to the use of sutezolid in combination with other compounds to treat tuberculosis. The development of sutezolid requires a strong outside partner who can take on the costs and risks of the next steps: but such a partner is unlikely to be found without an appropriate set of assurances around their ability to recover their investment. Our challenge is to ensure that we provide the incentives to invest in the development of this compound, while also promoting our interest in the widespread distribution of medicines at an aff ordable price. As researchers and clinicians devoted to human health, Johns Hopkins University aims to ensure the best use of its intellectual property. Indeed, we seek to partner with those organisations who are most willing to pursue development, obtain regulatory approval, and bring this promising combination technology to patients. Furthermore, we aim to respond to the great unmet global need around tuberculosis and the dearth of companies investing in this area.
Clinical modulation of doxorubicin resistance by the calmodulin-inhibitor, trifluoperazine: a phase I/II trial.

Drug resistance to chemotherapy agents such as doxorubicin appears to be an important cause of therapeutic failure in cancer treatment. Based on preclinical information demonstrating that the phenothiazine calmodulin-inhibitor trifluoperazine can enhance retention and cytotoxicity of doxorubicin in resistant cells, a phase I/II trial of the combination was performed to determine the maximally tolerated dose (MTD) of trifluoperazine that could be administered with doxorubicin. Patients with intrinsic (no previous response) and acquired (previous response with relapse) doxorubicin resistance were eligible. Doxorubicin was administered as a 96-hour continuous infusion (60 mg/m2) on days 2 through 5. Trifluoperazine was administered in divided doses orally on days 1 through 6, with dose escalation from 20 to 100 mg/d. Thirty-six patients were evaluable. The MTD of trifluoperazine was 60 mg/d, with dose-limiting toxicity being extrapyramidal side effects. No alteration of doxorubicin toxicity was observed. Sev...
Antarctic MicrobiologyA Study of Antarctic Birds Conducted During the 1957–58 Argentine Antarctic Expedition

at Spitsbergen were free of bacteria. The studies by Gazert on the German expedition, Ekelof on the Swedish expedition, Harvey Pirie on the Scottish expedition and MacLean on the Australasian expedition reported that 50 per cent or more of the birds studied were "bacteriologically sterile". Bunt as recently as 1955 also reported the existence of "bacteriologically sterile" birds. The purpose of this study was to reinvestigate the microflora of antarctic birds to determine if "bacteriologically sterile" birds do exist, if dietary factors influence the microflora and if avian diseases transmissible to man occur in antarctic birds.
Structural refinement in Al-MoO3 nanocomposites prepared by arrested reactive milling

Al-MoO 3 nanocomposites were synthesized based on arrested reactive milling. Altering the milling parameters leads to different scales of refinement in the structure of the reactive nanocomposites. The objective of this work is to determine the range in which the degree of structural refinement can be changed in a controlled manner. The milling intensity was controlled by using different milling media along with varying amounts of process control agent (PCA). XRD, SEM, DSC and wire-ignition tests were performed to analyze the Al-MoO 3 nanocomposites. Results indicate that there is a decrease in the crystallite size with increase in the milling intensity. However increase in milling intensity also stimulates the undesired reaction between Al and MoO 3 . Milling conditions resulting in the highest structural refinement and lowest ignition temperatures were identified.
Periprosthetic Infection: Management of Chronically Infected Total Knee Arthroplasty

Periprosthetic joint infection (PJI) is the most feared and challenging complication after total knee arthroplasty (TKA) due to the difficulty in diagnosis and treatment. The patient is exposed to multiple procedures, increasing the risk of complications, and finally compromising functional outcome. Currently, there is no gold standard test for PJI, and the final diagnosis is accomplished by combining clinical suspicion with inflammatory marker results. Two-stage exchange arthroplasty remains the preferred method of treatment for chronic PJI in TKA, with a high rate of success reported in literature. However, failures and complications in two-stage exchange can occur. There are no clarified guidelines to treat complications or treatment failures. Thus, each case should be individualized to offer options that match the patient’s expectations with what is achievable. The case report in this chapter represents the worst case scenario after a TKA, and is a reminder that the gold standard is far from perfect, while it outlines multiple instances a surgeon could encounter.
Identification of fermented and non-fermented soy sauces based on gel filtration chromatography combined with coomassie brilliant blue staining

A method for identifying fermented and non-fermented soy sauce was developed based on gel filtration chromatography combined with Coomassie brilliant blue staining,in which the content and distribution map of protein molecular weight was used to distinguish fermented and non-fermented soy sauces.The results showed that the map of fermented soy sauce had the characteristics of a complex parabola-trapezoid appearance,in which the content of protein 0.5×104 Da~4.5×104 Da was generally above 60%,however,it was lower than 60% in non-fermented soy sauce.The ratio of the peak height of saturated peak or the highest peak to a sharp peak around 90min in the map of fermented soy sauce was higher than 1.5,whereas it was less than 1.5 in non-fermented soy sauce.This method was accurate and useful to identify fermented and non-fermented soy sauces.
Multiple arterial grafts improve survival with coronary artery bypass graft surgery versus conventional coronary artery bypass grafting compared with percutaneous coronary interventions.

Abstract Objective To compare long-term survival with multiple arterial coronary artery bypass grafting (CABG) (MultArt) versus percutaneous coronary intervention (PCI) in patients with multivessel disease (MVD). Methods We reviewed 12,615 patients with MVD with isolated primary CABG or PCI from 1993 to 2009. Patients with CABG (n = 6667) were grouped according to the number of arterial grafts into left internal thoracic artery (LITA)/saphenous vein (SV) (n = 5712) or MultArt (n = 955); patients with PCI (n = 5948) were grouped into balloon angioplasty (BA) (n = 1020), drug-eluting stent (DES) (n = 1686), and bare metal stent (BMS) (n = 3242). Results Unadjusted long-term survival was lower for CABG than PCI (15-year survival, 34% vs 46%; P P P P = .002), LITA/SV (64% vs 56%; P = .02), and BMS (5-year survival 94% vs 90%; P = .01), and similar to DES at 8 years. In multivariate analysis, compared with MultArt, LITA/SV had worse survival (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.09-1.52; P = .003). BMS (HR, 0.87; 95% CI, 0.80-0.94; P P P = .21, and HR, 0.98; 95% CI, 0.79-1.21; P = .83, respectively). Secondary analyses for treatment crossover indicated lower survival for LITA/SV versus MultArt and PCI. Conclusions In patients with MVD undergoing primary revascularization, MultArt increased survival benefit versus LITA/SV compared with PCI. Use of MultArt must increase.
Psychoanalytic considerations of fertility and sexuality in contraception.

This paper discusses fertility sexuality and creativity from the point of view of the practicing psychiatrist particularly one specializing in psychoanalysis. The wish for fertility has been frequently related to religious rituals and social customs. Although man wishes controlled fertility he seemingly has not dared to entrust this capacity to potentially wrathful or vengeful deities. The author notes that in ancient Egypt many amulets to produce conception have been found but none to prevent it. Instead he tries to control his numbers by various means. As we become increasingly involved with national and international family planning policies and programs it may be important to recognize that societal and individual emotional and psychological factors are involved in the effective use of contraception. Successful contraception depends upon functioning in accordance with the reality principle that includes future oriented and relatively conflict-free behavior. When there is underlying psychopathology symptoms may appear in sexual behavior including the success failure and method of type of contraceptive practice utilized.
Nonlinear space-time information processing

Optical information processing, traditionally employed in the spatial domain, has been experiencing a renaissance with femtosecond laser pulse technology. Temporal optical information can now be manipulated via linear and nonlinear processes, and stored and retrieved, by converting optical signals between the spatial and temporal domains. In this manuscript, we review the state-of-the-art in the spatio-temporal optical signal processing techniques for information data coding, data conversion, signal recording, as well as signal characterization. Applications of these techniques for future computing, communication, storage, and signal processing systems are discussed.
Bicyclic 5-6 Systems: Two Heteroatoms 1:1

This chapter covers bicyclic ring systems that consist of a five- and a six-membered ring with each ring containing one heteroatom that is not situated at a ring junction position. Nine heterocyclic ring systems containing nitrogen, oxygen, and sulfur heteroatoms are covered, including pyrrolopyridines, furopyridines, thienopyridines, pyranopyrroles, thiopyranopyrroles, furopyrans, thienopyrans, thiopyranofurans, and thienothiopyrans. Pyrrolopyridines, furopyridines, thienopyridines, and their pyridinone derivatives have been most widely covered in the chemical literature. For a few of the ring systems, such as thiopyranofurans and thienothiopyrans, there are only scarce references in the literature. In addition to the fully conjugated ring systems, partially and fully reduced derivatives of these compounds are considered. Representative melting point, spectroscopic, and X-ray crystallographic data are presented. Reactivity of the parent and reduced derivatives of the heterocyclic ring systems are provided. Syntheses of the ring systems from acyclic precursors, five- or six-membered ring starting materials, or transformations of other rings are included. A variety of applications of these heterocyclic ring systems are given. A few of the ring systems are found in naturally occuring compounds; however, many of the compounds are only available synthetically.
With Malice Toward Some: Contemporary Information and Political Tolerance Judgments

I n this part , we begin the process of empirically testing the theoretical model of tolerance judgments we laid out in Part I. Since past research has focused almost exclusively on the effects of antecedent considerations on tolerance, we must first establish that contemporary information makes a difference. If tolerance judgments are based solely on the predispositions and standing decisions people hold, then a major part of our theoretical argument – especially the role of threat as contemporary information – would be fallacious. On the other hand, if contemporary information influences tolerance judgments even when we take antecedent considerations into account, then we have taken the first step toward substantiating our theory. We empirically test our basic model in two ways. First, in Chapter 4 we conduct survey-experiments that allow us both to measure the crucial antecedent considerations found to be important in past research and to manipulate the information subjects receive to determine if certain kinds of contemporary information affect tolerance more than others. If our theoretical model is correct, we should find that antecedent considerations play a major role in determining contemporary tolerance judgments, but that contemporary information matters as well. Specifically, as we argued in Chapter 3, it is threatening information, especially about a group's behavior, that should significantly influence people's tolerance judgments. Second, in Appendix 4A we lay out, for interested readers, our checks to validate the studies.
Foreign Economic Policy in Europe: From Rule-Maker to Rule-Breaker in the European Monetary Union

Why did Germany agree to participate in — indeed help instigate the plan for — EMU? Why did it agree to complete monetary union, making unprecedented domestic sacrifices to do so?
Medical Legal Considerations

The increasing frequency and crushing severity of malpractice claims and lawsuits, data bank reporting, Web-based consumer claims data, privacy requirements, increasing clinical demands, greater government regulation and enforcement activity, and increasing malpractice premiums have caused many physicians to leave private practice, retire early, or move to more lawsuit-friendly jurisdictions.
Developmental origins of NAFLD: a womb with a clue

Changes in the maternal environment leading to an altered intrauterine milieu can result in subtle insults to the fetus, promoting increased lifetime disease risk and/or disease acceleration in childhood and later in life. Particularly worrisome is that the prevalence of NAFLD is rapidly increasing among children and adults, and is being diagnosed at increasingly younger ages, pointing towards an early-life origin. A wealth of evidence, in humans and non-human primates, suggests that maternal nutrition affects the placenta and fetal tissues, leading to persistent changes in hepatic metabolism, mitochondrial function, the intestinal microbiota, liver macrophage activation and susceptibility to NASH postnatally. Deleterious exposures in utero include fetal hypoxia, increased nutrient supply, inflammation and altered gut microbiota that might produce metabolic clues, including fatty acids, metabolites, endotoxins, bile acids and cytokines, which prime the infant liver for NAFLD in a persistent manner and increase susceptibility to NASH. Mechanistic links to early disease pathways might involve shifts in lipid metabolism, mitochondrial dysfunction, pioneering gut microorganisms, macrophage programming and epigenetic changes that alter the liver microenvironment, favouring liver injury. In this Review, we discuss how maternal, fetal, neonatal and infant exposures provide developmental clues and mechanisms to help explain NAFLD acceleration and increased disease prevalence. Mechanisms identified in clinical and preclinical models suggest important opportunities for prevention and intervention that could slow down the growing epidemic of NAFLD in the next generation.
Nitrogen Effects on Coastal Marine Ecosystems

Publisher Summary Nitrogen circulation through the global environment has been growing dramatically. This chapter discusses the nitrogen effects on costal marine ecosystems. a rapidly growing human population increased the global circulation of nitrogen. Nitrogen inputs to coastal waters come from the land, from the sea, and from the air; because of these multiple sources and the complexity of the nitrogen cycle, confident estimates of total nitrogen loading to coastal systems are not routine. There is a great diversity in coastal systems and vulnerability to increased nitrogen loading varies greatly. This chapter illustrates that the increasing nitrogen inputs to the coastal zone have been confirmed in more places; symptoms of over-enrichment continue to be reported worldwide and apparently are growing. Fundamental similarities between coastal over-enrichment and lake eutrophication are broadly recognized, although finer details are still debated.
Getting A Leg Up on Cell Therapy for Critical Limb Ischemia.

Critical limb ischemia (CLI) is the most severe form of peripheral arterial disease and is associated with an excessively high risk for death and amputation of the affected extremity.1 The clinical hallmarks of CLI are rest pain and tissue loss because of progressive occlusion of the arteries in the leg as a result of atherosclerosis and, less frequently, autoimmune and inflammatory disorders.2 The estimated annual incidence of CLI in Western society is 500 to 1000 new cases, which is expected to increase as the population ages and obesity and diabetes mellitus become more prevalent.3 Treatment strategies for CLI have traditionally focused on surgical bypass or endovascular interventions that improve limb perfusion to prevent amputation of the affected leg. Unfortunately, 40% of patients with CLI will not have options for these procedures, and as a result, over 53 000 amputations are performed annually in the United States. Patients with diabetes mellitus, Rutherford class 5 or 6 disease (tissue loss), and renal dysfunction are at highest risk for limb loss.3,4 Article, see p 1326 …
A Chinese Inheritance

A society's values may be discernible in its intestacy laws, the laws which govern the distribution of a decedent’s estate when there is no valid will. Upon examination, unique characteristics among competing intestacy schemes emerge. The most startling characteristic of Chinese inheritance law is its willingness to invoke judicial review of an heir’s conduct in settling upon distributions. American succession law also considers an heir’s conduct, but it does so sparingly and formalistically. Chinese conduct-based intestacy is widespread and fluid. This article contrasts American and Chinese approaches to conduct-based intestacy, identifies the underlying competing policies and values in play, and summarizes five recent Chinese judicial opinions as a way of assessing the operation of Chinese conduct-dependent intestacy.
Digital Library Programs for Libraries and Archives: Developing, Managing, and Sustaining Unique Digital Collections, byAaron D. Purcell: Chicago: ALA Neal-Schuman, 2016, 256 pp, ISBN: 978-0-8389-1450-2, $85.00.

Today we have a significant number of libraries that are providing digital access to their rare and special collections online; however, for many of these institutions, questions remain as to how t...
Does Tail-Cuff Plethysmography Provide a Reliable Estimate of Central Blood Pressure in Mice?

Radiotelemetric recording is widely recognized as the best method for establishing a blood pressure phenotype, or evaluating interventions that affect blood pressure, in mice.[1][1] However, the necessary hardware and software is costly, and successful surgical implantation of the transmitters
College Sexual Assault and Campus Climate for Sexual- and Gender-Minority Undergraduate Students

Sexual- and gender-minority (e.g., lesbian, gay, bisexual, and transgender) undergraduate students are at greater risk for sexual assault victimization than their cisgender (i.e., nontransgender) heterosexual peers. However, few studies have examined how social environments affect sexual assault victimization among sexual- and gender-minority undergraduate students. Nevertheless, this research area was identified as a priority by the Institute of Medicine as well as President Barack Obama's White House Task Force to Protect Students From Sexual Assault. Therefore, we tested the association between college campuses' inclusion of sexual- and gender-minority people and experiences of sexual assault victimization. Cross-sectional surveys were completed by sexual- and gender-minority undergraduate students (N = 1,925) from higher education institutions in all 50 U.S. states in 2010. Our dependent variable was experiencing sexual assault victimization at college. Our primary independent variable was campus climate, measured with items assessing perceived inclusion of sexual- and gender-minority people and witnessing sexual- or gender-minority harassment. We used multivariable logistic regression with generalized estimating equations (accounting for the clustering of students within schools) to estimate the association between campus climate and experiencing sexual assault victimization. Overall, 5.2% of the sample reported ever being victims of sexual assault at college. Controlling for sexual orientation, gender identity, race/ethnicity, and year in school, greater perceived inclusion of sexual- and gender-minority people on campus was associated with significantly lower odds of experiencing sexual assault victimization. Our study suggests that improving campus climate for sexual- and gender-minority individuals may reduce their prevalence of college sexual assault, which has potential implications for college practitioners and administrators as well as sexual assault prevention programs and policies.
E-097 Rapidly enlarging mycotic mca bifurcation aneurysm in patient with noonan’s syndrome

Introduction Noonan’s syndrome is an autosomal dominant congenital disorder that often manifests as congenital heart defects including valvular defects and hypertrophic cardiomyopathy. Patients can manifest this syndrome with pterygium colli deformity (webbed neck) and blood clotting disorders. There have been multiple reports in the literature of a possible association with Moya Moya like disease. We discuss a patient who presented with endocarditis and heart failure and was found to have a rapidly enlarging right middle cerebral artery large bifurcation mycotic aneurysm in the setting of a vasculopathy. Case Description: The patient is a 33 year old female with a history of Noonan’s syndrome, pulmonary artery aneurysm, mitral valve prolapse with streptococcus gordonii endocarditis that was complicated by decompensated heart failure. A cerebral angiogram was requested and demonstrated supraclinoid and M1 severe stenosis as well as a 5mm MCA bifurcation aneurysm with severely narrowed M2 branch origins. While the logistics for treatment for both the endocarditis and aneurysm were being planned, the patient developed sudden onset of a severe headache and was found to have subarachnoid blood on CT. A repeat angiogram was performed and the patient’s aneurysm was found to have doubled in size within 4 days with a progressively dysplastic M1 segment becoming evident. Primary coiling was initiated to occlude the aneurysm as open surgery which would require bypass that would delay much needed heart surgery. The patient tolerated the procedure well and underwent heart valve replacement within a few days. Patient was discharged home in stable condition. Conclusion Given the characteristic clinical phenotypes of patients with Noonen’s syndrome, when presented with a patient suffering from endocarditis, a cerebral angiogram may be justified to rule out mycotic aneurysms and Moya Moya like disease. In this case, it is difficult to determine the etiology of the vasculopathy, as Noonen’s syndrome has been associated with moya-moya like changes but an infective vasculopathy is also possible. The rapidly enlarging nature of this aneurysm is likely partially related to flow limitation of the distal vessel origins. Treatment by primary coiling can be considered as a viable treatment option for patient requiring open heart surgery for this situation. Disclosures: N. Moore: None. J. Hardman: None. R. Cerejo: None. D. Wisco: None. M. Bain: 2; C; Stryker Neurovascular. G. Toth: None. M. Hussain: None.