cssi/SciSciGPT-SciSciNet huggingface dataset:
A self-assessment efficacy tool for spermicide contraceptive users

Background Easily accessible contraceptive methods, such as chemical and barrier methods, are used currently by approximately 1 in 6 women who use contraception in the United States. Even in the face of suboptimal effectiveness, coitally dependent methods likely will always have a role in fertility management. Because most contraceptive efficacy stratifications use population-based data, for women to make informed decisions about the individual fit of a contraceptive method, better evidence-based, user-friendly tools are needed. Objectives Spermicides are a readily available, over-the counter, woman-controlled contraceptive method, but their effectiveness is user-dependent. Patient-decision aids for spermicides and other barrier methods are not well-developed, and overall failure rates could be improved by aids that account for individual characteristics. We sought to derive a prediction rule for successful use of spermicides for pregnancy prevention and to convert those data to a point-of-care instrument that women can use when they are considering spermicide use during contraceptive decision-making. Study Design We pooled local data from 3 randomized clinical trials that were published in 2004, 2007, and 2010 that tested spermicide efficacy. We constructed a prediction rule for unintended pregnancy using bootstrap validation and developed a scoring system. Results Data from 621 women showed a mean age of 29 years; 49% of the women were African American, and 43% were white. The overall pregnancy rate was 10.3% (95% confidence interval, 7.9–12.7) over 6 months. In adjusted logistic regression, age >35 years was protective against pregnancy (odds ratio, 0.19; 95% confidence interval, 0.06–0.58; P = .003), and multigravidity was associated with high failure rates (odds ratio, 7.24; 95% confidence interval, 3.04–17.3; P Conclusion Using prospectively collected data, we built a simple risk calculator for contraceptive failure that women can consult when considering spermicide use. This instrument could support patient-centered contraceptive decision-making.
MODELING THE EFFECT OF VACCINES ON CHOLERA TRANSMISSION

Cholera is a diarrhoeal disease that is caused by an intestinal bacterium, Vibrio cholerae. Recently an outbreak of cholera in Haiti brought public attention to this deadly disease. In this work, the goal of our differential equation model is to find an effective optimal vaccination strategy to minimize the disease related mortality and to reduce the associated costs. The effect of seasonality in pathogen transmission on vaccination strategies was investigated under several types of disease scenarios, including an endemic case and a new outbreak case. This model is an extension of a general water-borne pathogen model. This work involves the optimal control problem formulation, analysis and numerical simulations.
Acute on Chronic Ivabradine Overdose: a Case Report

Ivabradine is a newly approved medication which reduces the heart rate by antagonizing the If channel. We report a case of intentional overdose on ivabradine. A 26-year-old female presented after taking 250 mg ivabradine. On arrival, her vital signs and neurologic exam were unremarkable. Within 30 min, her heart rate decreased to 31 bpm, but she remained normotensive with no change in mentation. Her bradycardia resolved after treatment with atropine. She experienced two further bradycardic episodes responsive to atropine; the second episode was associated with hypotension, responsive to a fluid bolus. For the remainder of her hospitalization, she remained hemodynamically stable without further interventions. She was dispositioned to the psychiatry service approximately 36 h post-ingestion with a heart rate of 67 bpm. Laboratory analysis confirmed a serum ivabradine concentration of 525 ng/mL, greater than 50 times the mean level in therapeutic trials. Proposed treatments for ivabradine include activated charcoal, atropine, isoproterenol, and intravenous pacing. Further study is needed to identify ideal treatment modalities.
Stress and glucocorticoid receptor transcriptional programming in time and space: Implications for the brain-gut axis.

Background Chronic psychological stress is associated with enhanced abdominal pain and altered intestinal barrier function that may result from a perturbation in the hypothalamic–pituitary–adrenal (HPA) axis. The glucocorticoid receptor (GR) exploits diverse mechanisms to activate or suppress congeneric gene expression, with regulatory variation associated with stress-related disorders in psychiatry and gastroenterology. Purpose During acute and chronic stress, corticotropin-releasing hormone drives secretion of adrenocorticotropic hormone from the pituitary, ultimately leading to the release of cortisol (human) and corticosterone (rodent) from the adrenal glands. Cortisol binds with the GR in the cytosol, translocates to the nucleus, and activates the NR3C1 (nuclear receptor subfamily 3, group C, member 1 [GR]) gene. This review focuses on the rapidly developing observations that cortisol is responsible for driving circadian and ultradian bursts of transcriptional activity in the CLOCK (clock circadian regulator) and PER (period circadian clock 1) gene families, and this rhythm is disrupted in major depressive disorder, bipolar disorder, and stress-related gastrointestinal and immune disorders. Glucocorticoid receptor regulates different sets of transcripts in a tissue-specific manner, through pulsatile waves of gene expression that includes occupancy of glucocorticoid response elements located within constitutively open spatial domains in chromatin. Emerging evidence supports a potentially pivotal role for epigenetic regulation of how GR interacts with other chromatin regulators to control the expression of its target genes. Dysregulation of the central and peripheral GR regulome has potentially significant consequences for stress-related disorders affecting the brain–gut axis.
A Divergent Synthesis of Polyurethane Dendrimers

Utilizing diphenylphosporyl azide (DPPA) to promote the Curtius reaction, we report a divergent synthesis of several dendrimers. The synthetic scheme involves several diol and triol core molecules. Each generation is propagated through reaction with 3,5-bis(3-acetoxypropyloxy)benzoic acid and DPPA. The generations for each core are characterized by HNMR, CNMR and MALDI-TOF MS.We had previously reported a convergent synthesis of structurally different polyurethane dendrimers and discuss the modification made to facilitate the preparation of these dendrimers.We had previously reported a convergent synthesis of structurally different polyurethane dendrimers. We discuss the modification made to facilitate the preparation of these dendrimers.
A Tec kinase BTK inhibitor ibrutinib promotes maturation and activation of dendritic cells

Ibrutinib, a BTK inhibitor, is currently used to treat various hematological malignancies. We evaluated whether ibrutinib treatment during development of murine bone marrow-derived dendritic cells (DCs) modulates their maturation and activation. Ibrutinib treatment increased the proportion of CD11c(+) DCs, upregulated the expression of MHC-II and CD80 and downregulated Ly6C expression by DCs. Additionally, ibrutinib treatment led to an increase in MHC-II(+), CD80(+) and CCR7(+) DCs but a decrease in CD86(+) DCs upon LPS stimulation. LPS/ibrutinib-treated DCs displayed increased IFNβ and IL-10 synthesis and decreased IL-6, IL-12 and NO production compared to DCs stimulated with LPS alone. Finally, LPS/ibrutinib-treated DCs promoted higher rates of CD4(+) T cell proliferation and cytokine production compared to LPS only stimulated DCs. Taken together, our results indicate that ibrutinib enhances the maturation and activation of DCs to promote CD4(+) T cell activation which could be exploited for the development of DC-based cancer therapies.
Research progress on low-temperature sintering of YIG polycrystalline ferrites

The present situation in research of the low-temperature sintering for YIG(Y3Fe5O12) is summarized. The influences of Cu, Ca, V, Bi etc ion substitutions and TiO2, B2O3 additives on the microstructure and the magnetic properties of YIG are described. Furthermore, the effect of ultrafine YIG powders prepared from sol-gel, co-precipitation and mechanochemical methods on the sintering behavior as well as the application of a new sintering technique are explored. Lastly, the development tendency of low-temperature sintering of YIG polycrystialline ferrite is also mentioned.
Game It Up! Using Gamification to Incentivize Your Library

Gamification in libraries is a hot topic, and this book provides an introduction and many ideas for reaching out to one's patrons and offering services in this area. The first two chapters provide ...
Primary cardiac neoplasms: early and late results of surgical treatment in 42 patients

Forty-two patients underwent resection of primary cardiac neoplasms at Stanford University Medical Center and the Palo Alto Veterans Administration Medical Center between 1961 and 1986. A total of 27 atrial myxomas, seven benign nonmyxomatous tumors, and eight malignant tumors were resected. The mean age was 47 years (range 8 to 79) in 27 female and 15 male patients. The clinical presentations included congestive heart failure in 24 patients, palpitations in nine, neurologic symptoms in six, recurrent cardiac tamponade in three, vasculitis in two, and chest pain in two. Thirty-one of 34 benign lesions were completely resected, although one patient required cardiac transplantation to resect completely an "inoperable" benign tumor. All gross tumor was resected in four of eight patients with malignant lesions. All patients survived operation, but three with malignant disease died within 30 days. Late outcome was known for 41 of 42 (98%) patients. Total follow-up for the series was 200.1 patient-years, for an average of 4.7 years (range 1 month to 18 years). Excellent early and late results were obtained in patients with benign lesions, as there was no known tumor recurrence even if resection was incomplete. Effective palliation and local control of disease is possible with extensive resection of malignant primary tumors, but more effective adjuvant therapy will be necessary to improve long-term prognosis.
Interstitial Cystitis is Associated with Intraukothelial Tamm-Horsfall Protein

AbstractA defective barrier between the urine and urothelium has been suggested as an etiology for interstitial cystitis. With immunohistochemical techniques we assayed the bladder biopsies of 14 interstitial cystitis patients and 10 normal controls for intraurothelial Tamm-Horsfall protein to assess indirectly the in vivo permeability of the urothelium. Eight pathological controls, including bladder biopsies from 3 patients with inflammation owing to infection or catheterization and biopsies of 5 transitional cell carcinomas of the bladder, also were assayed. Superficial intraurothelial Tamm-Horsfall protein was identified in the biopsies from 10 of 14 interstitial cystitis patients (71 per cent) but only 1 of 10 controls (10 per cent) (p <0.01). Tamm-Horsfall protein was not identified in biopsies from the pathological controls. In 6 of 7 cases when more than 1 biopsy was available for analysis the findings were identical in each specimen. There was a direct correlation between the density of detrusor m...
Medical Management of CME Associated with Uveitis

Macular edema is the leading cause of vision loss in patients with uveitis. Chronic edema can lead to permanent retinal damage and atrophy; therefore, treatment should be initiated early and continue until complete resolution. Corticosteroids have been the mainstay of therapy and can be given topically, as a periocular or intravitreal injection, via an implantable depot preparation, or orally. Risks of cataract and glaucoma can limit the ongoing use of steroids, and other agents may be indicated. Alternative treatments including intravitreal anti-VEGF agents, intravitreal methotrexate, subcutaneous interferon alpha, and systemic antitumor necrosis factor agents have also demonstrated efficacy in treating inflammatory macular edema. The decision about which agent is most appropriate can be challenging and should be tailored to the clinical scenario.
Noninvasive Cancer Classification Using Diverse Genomic Features in Circulating Tumor DNA

Circulating tumor DNA (ctDNA) has the potential to revolutionize cancer care, through detection of somatic lesions over time, as relevant for therapy selection, response monitoring, and early detection. Our group previously described cancer personalized profiling with deep sequencing (CAPP-Seq) [2], a ctDNA detection method targeting recurrent point mutations and structural variations within a given tumor. However, two unmet challenges for ctDNA are its utility for noninvasive histology classification and for copy number variation (CNV) at low ctDNA levels. Here, we tackle both challenges as related problems. We describe a simple CNV detection algorithm for ctDNA. To correct for systematic/biological noise, we map depth data into corresponding z-statistics in healthy subjects. Then, we estimate parameters of a multivariate Gaussian governing z-statistics of the contributing regions. Finally, we employ a polished signal to assign a score to each gene. CNVs are then called based on predetermined performance metrics. We benchmarked performance via synthetic and empirical CAPP-Seq data, achieving 95% sensitivity/specificity for ctDNA levels 3-5% in actionable CNVs involving ERBB2, MET, and EGFR. We also successfully detected CNVs for ctDNA level as low as 3% in patients with non-small cell lung cancer or diffuse large B-cell lymphoma (DLBCL). We separately describe a Bayesian tumor histology classifier using prior probabilities from existing knowledge regarding CNVs, single nucleotide variants, and gene fusions in public tumor sequencing data. Prior probabilities were constructed within an optimization framework using maximum entropy. When applied to noninvasive classification of DLBCL subtypes (i.e. germinal center B-cell like (GCB) and activated B-cell like (ABC) [1]) using pretreatment plasma, this method showed ~ 80% concordance with routine clinical classification (Hans Algorithm). We conclude that tumor subtype classification and CNV detection with ctDNA is feasible and robust using CAPP-Seq.
Obesity and Modifiable Cardiovascular Disease Risk Factors Among Chinese Americans in New York City, 2009–2012

We used the Racial and Ethnic Approaches to Community Health Across the US (REACH US) Risk Factor Survey from 2009 through 2012 to examine the association between body mass index (BMI, calculated as kg/m2) and 3 cardiovascular disease risk factors among Chinese Americans in New York City. We used traditional BMI cut points and cut points modified for the Asian population. Compared with normal/underweight Chinese American adults (BMI <23.0), obese Chinese American adults (BMI ≥27.5) had significantly higher odds of having each risk factor in fully adjusted logistic regression models: diabetes (odds ratio [OR], 4.2; 95% confidence interval [CI], 2.8-6.2), high blood pressure (OR, 5.5; 95% CI, 3.9-7.7), and high cholesterol (OR, 1.7; 95% CI, 1.2-2.4). Regression results were similar across BMI definitions, suggesting that both BMI categorizations should be considered in CVD research among Chinese Americans.
Signaling through Galpha12/13 and RGS-RhoGEFs

The transforming heterotrimeric G proteins Gα12 and Gα13 have been implicated in the regulation of various cellular processes, such as gene transcription and rearrangement of the actin-based cytoskeleton. Many of these functions are dependent on the activation of the monomeric GTPase RhoA. The RGS-RhoGEFs, a distinct family of guanine nucleotide exchange factors, which contain RGS-like domains in their N-termini, serve as direct links between Gα12/13 and RhoA. The focus of this chapter is on the molecular mechanisms that underlie and regulate signaling from Gα12/13 to RhoA via the RGS-RhoGEFs. The physiological significance of this signaling pathway is also discussed.
Simplified Solution for Variable Rate Pumping Test

A simple graphical method is presented for the determination of aquifer characteristics from a variable discharge pumping test. The method presented is applicable to throttled or unthrottled pumping tests and requires only a few simple calculations. An example based on synthetic well history is presented.
Counterpoint to Online Teaching with a Focus on Management

Teaching in an online environment is not without its barriers. Time for course preparation, a need to engage students, and the need for near-constant accessibility make teaching online more difficu...
The NSAID allosteric site of human cytosolic sulfotransferases.

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed drugs worldwide—more than 111 million prescriptions were written in the United States in 2014. NSAIDs allosterically inhibit cytosolic sulfotransferases (SULTs) with high specificity and therapeutically relevant affinities. This study focuses on the interactions of SULT1A1 and mefenamic acid (MEF)—a potent, highly specific NSAID inhibitor of 1A1. Here, the first structure of an NSAID allosteric site—the MEF-binding site of SULT1A1—is determined using spin-label triangulation NMR. The structure is confirmed by site-directed mutagenesis and provides a molecular framework for understanding NSAID binding and isoform specificity. The mechanism of NSAID inhibition is explored using molecular dynamics and equilibrium and pre-steady-state ligand-binding studies. MEF inhibits SULT1A1 turnover through an indirect (helix-mediated) stabilization of the closed form of the active-site cap of the enzyme, which traps the nucleotide and slows its release. Using the NSAID-binding site structure of SULT1A1 as a comparative model, it appears that 11 of the 13 human SULT isoforms harbor an NSAID-binding site. We hypothesize that these sites evolved to enable SULT isoforms to respond to metabolites that lie within their metabolic domains. Finally, the NSAID-binding site structure offers a template for developing isozyme-specific allosteric inhibitors that can be used to regulate specific areas of sulfuryl-transfer metabolism.
NRC Committee Review of Using Biosolids and Effluents in Food Crop Production

Potential health effects as well as lack of compliance with existing regulatory requirements are frequently raised as concerns when projects are proposed to recycle biosolids on farmland used for the production of food crops for direct human consumption. These concerns were a primary focus of the report, “Use of Reclaimed Water and Sludge in Food Crop Production”, issued by the National Research Council of the National Academy of Sciences in early 1996 (NRC, 1996).
Hardening Mechanisms in Metals

Introduction The strengths of metals are sensitive to microstructure. Most hardening mechanisms involve making dislocation motion more difficult. These include decreased grain size, strain hardening, solid solution hardening, and dispersion of fine particles. With finer grain sizes, there are more grain boundaries to impede dislocation motion. Metals strain harden because deformation increases the number of dislocations, and each interferes with the movement of others. In solid solutions, solute atoms disrupt the periodicity of the lattice. Fine dispersions of hard particles create obstacles to dislocation motion. Martensite formation and strain aging in steels are sometimes considered separate mechanisms, but these are related to the effects of interstitial solutes on dislocations. Crystal Structure Crystal structure strongly affects hardness and yield strength. Fcc metals tend to have higher strengths than bcc metals and lower strengths than hcp metals. The effect of crystal structure is most apparent in metals that transform from one crystal structure to another. Figure 11.1 shows how the hardness of nearly pure iron changes with temperature. The general decrease of hardness with increasing temperature is interrupted by the α → γ transformation at 910°C. At 910°C, the fcc structure is harder than the bcc structure. The reason the bcc structure is softer is at least partially explained by its greater number of slip systems. Similarly, the hardness of titanium would be expected to undergo a sharp drop as it transforms from hcp because there are fewer slip systems in hcp crystals than bcc ones.
Activity of single-agent PD-1 inhibitor (PD-1i) therapy in advanced sarcoma: A single-center retrospective analysis.

e23541Background: Sarcomas constitute a heterogeneous group of mesenchymal tumors with variable responses to traditional chemotherapies. Recent PD-1i immunotherapy studies show promising results wi...
Transperitoneal Versus Retroperitoneal Laparoscopic Adrenalectomy

Over the last two decades, laparoscopic adrenalectomy (LA) has become the gold standard for the removal of benign adrenal tumors. There are two approaches that are popular. Gagner et al. demonstrated the laparoscopic transperitoneal approach in 1992. A year later, Mercan described the posterior retroperitoneal approach. Laparoscopic transperitoneal adrenalectomy (LTA) was the approach initially adopted by surgeons because of a familiar anatomy, but recently the posterior retroperitoneal adrenalectomy (PRA) has gained widespread acceptance because of avoidance of intra-abdominal organs during resection. Although proponents of each approach claim superiority of one method over other, there is no conclusive data available in the literature that demonstrates the superiority of one over the other. In this article, we will compare the outcomes from published data on the retroperitoneal and transperitoneal approach for adrenalectomy with evidence using the GRADE approach.
Comparison of volume and stand table estimates with alternate methods for selecting measurement trees in point samples.

Point sampling, which does not require measuring plot area, is an efficient sampling approach for forest inventory. However, in order to estimate stand volume and stand tables, it is necessary to take tree measurements, which is the most time-consuming and labour-intensive part of the field work. In this study, we compared three methods for selecting measurement trees, including Big basal-area factor (BAF), measuring every tree on every fourth point, and randomly selecting two trees on every point. Total stand volume and stand tables were estimated in nine 37.63-ha simulated loblolly pine plantations with varying levels of spatial heterogeneity. Results indicated that all three methods performed satisfactorily for estimating stand volume. Using number of trees selected at each sample point as a weight did not show a noticeable improvement for stand volume estimation when measurement trees were randomly selected. For stand tables estimation, number of trees in small-size classes were overestimated across the three tree-selection methods when binned sample data were used. However, if the exact expansion factor computed by dbh values recorded to the nearest 0.25 cm of each sample tree (i.e. unbinned sample data) was utilized in calculation of tree frequency, measurement trees selected by Big BAF or by measuring every tree on every fourth point provided reliable estimates of stand tables.
A culturally grounded biopsychosocial assessment utilizing Indigenous ways of knowing with the Cowichan Tribes

Extant research foregrounds the need for culturally responsive, evidence-based mental health practices when working with Indigenous communities. This study presents an Indigenous biopsychosocial as...
Abstract 4942: Variations in HPV function are associated with patient outcome and identify new candidate therapeutic approaches

Human papilloma virus (HPV) is an oncogenic driver for a subset of head and neck squamous cell carcinomas (HNSCC), primarily from the oropharyngeal tissue subsite (OPSCC). These tumors are increasing in incidence and have recently surpassed cervical cancer as the most common HPV-driven malignancy in the United States. Fortunately, these tumors generally respond well to radiation-based therapy (XRT), and long-term (5 yr) survival is around 85%. However, the XRT treatment can generate significant morbidity, including problems with speech and swallowing. There is a clinical effort to reduce the treatment-related morbidity without compromising survival outcomes, through de-escalation treatment protocols. However, there is a subset of HPV+ OPSCC patients who do not respond to the current therapies and should not be given less intense treatment. This has generated the need to stratify patients based on their risk of recurrence or death, but currently no molecular biomarkers are available for risk assessment in OPSCC. By analyzing genomic data from The Cancer Genome Atlas (TCGA) we have identified a gene expression signature associated with expression of HPV genes. This signature identified 2 groups within the HPV+ tumors that demonstrate different levels of HPV function. One group seems to have reduced HPV function and present with intermediate phenotypes between HPV+ and HPV- tumors. Importantly, this signature is also highly prognostic in HPV+ OPSCC (p Citation Format: Frederico O. Gleber-Netto, Meng Gao, Xiayu Rao, Christopher P. Vellano, Joseph R. Marszalek, Jing Wang, Faye M. Johnson, Curtis R. Pickering. Variations in HPV function are associated with patient outcome and identify new candidate therapeutic approaches [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4942.
A new flavor of entry exclusion in ICE elements provides a selective advantage for the element and its host.

Entry exclusion has been described in many bacterial conjugation systems, but their molecular mechanisms are not well understood. In the current issue, Avello et al. describe a new exclusion system in the conjugative element ICEBs1. They identify the yddJ gene as the functional exclusion gene and its target as the protein product of the conG gene. They provide evidence for a possible mechanism and for the contribution of the system to reduce fitness costs of ICE expression.
Matrices (re)loaded: Durability, viability, and fermentative capacity of yeast encapsulated in beads of different composition during long-term fed-batch culture

Encapsulated microbes have been used for decades to produce commodities ranging from methyl ketone to beer. Encapsulated cells undergo limited replication, which enables them to more efficiently convert substrate to product than planktonic cells and which contributes to their stress resistance. To determine how encapsulated yeast supports long-term, repeated fed-batch ethanologenic fermentation, and whether different matrices influence that process, fermentation and indicators of matrix durability and cell viability were monitored in high-dextrose, fed-batch culture over 7 weeks. At most timepoints, ethanol yield (g/g) in encapsulated cultures exceeded that in planktonic cultures. And frequently, ethanol yield differed among the four matrices tested: sodium alginate crosslinked with Ca2+ and chitosan, sodium alginate crosslinked with Ca2+ , Protanal alginate crosslinked with Ca2+ and chitosan, Protanal alginate crosslinked with Ca2+ , with the last of these consistently demonstrating the highest values. Young's modulus and viscosity were higher for matrices crosslinked with chitosan over the first week; thereafter values for both parameters declined and were indistinguishable among treatments. Encapsulated cells exhibited greater heat shock tolerance at 50°C than planktonic cells in either stationary or exponential phase, with similar thermotolerance observed across all four matrix types. Altogether, these data demonstrate the feasibility of re-using encapsulated yeast to convert dextrose to ethanol over at least 7 weeks.
The Perils of International Capital

Can foreign capital empower dictatorship? This groundbreaking book develops a unified theory that links three prominent forms of international capital to the endurance of dictatorships. International capital empowers governments to finance two key instruments of non-democratic politics: repression and patronage. The Perils of International Capital uses theory, case studies, and cross-national statistical evidence to demonstrate causal effects between foreign capital and authoritarian politics. These finding are crucial to scholars and policymakers alike, as they call for a recalibration of the welfare effects associated with greater financial globalization. Ahmed reveals that, while foreign capital may improve economic development, it can tragically hinder democratic governance in the process.
Cyclic Guanosine Monophosphate and Risk of Incident Heart Failure and Other Cardiovascular Events: the ARIC Study.

Background Cyclic guanosine monophosphate (cGMP) is a second messenger regulated through natriuretic peptide and nitric oxide pathways. Stimulation of cGMP signaling is a potential therapeutic stra...
Dental Management of Patients With Acquired and Congenital Bleeding Disorders

In an age when people are living longer and medical interventions are continually becoming more advanced, clinicians will need to be aware of systemic disorders and treatments that may cause complications in the dental setting. The Office for National Statistics' projections state that 26% of the UK population will be aged over 65 years by 2041.1 Therefore, clinicians may often encounter patients who complain of prolonged bleeding following certain procedures, most commonly dental extractions. In the majority of cases, the cause is often a local one, which can be managed using simple local measures. However, poor management can lead to potentially fatal consequences. The aim of this paper is to update clinicians on the dental management of patients with acquired or congenital bleeding disorders, and on how to decide the most appropriate setting for safe dental care. Patient safety in the NHS is a national priority with ever greater measures being put into place to avoid patient harm. Whilst most patients can be successfully treated in primary care, for the provision of safe dental treatment, the clinician may need to make a decision regarding referral to specialist services for all dental treatment, or share care between primary care and specialist services for selected procedures.
Predicting quantity and quality of life with the Future Elderly Model

The Future Elderly Model (FEM) is a microsimulation model designed to forecast health status, longevity, and a variety of economic outcomes. Compared to traditional actuarial models, microsimulation models provide greater opportunities for policy forecasting and richer detail, but they typically build upon smaller samples of data that may mitigate forecasting accuracy. We perform validation analyses of the FEM's mortality and quality of life forecasts using a version of the FEM estimated exclusively on early waves of data from the Health and Retirement Study. First, we compare FEM mortality and longevity projections to the actual mortality and longevity experience observed over the same period of time. We also compare the FEM results to actuarial forecasts of mortality and longevity during the same time. We find that FEM projections are generally in line with observed mortality rates and closely match longevity. Then, we assess the FEM's performance at predicting quality of life and longitudinal outcomes, two features missing from traditional actuarial models. Our analysis suggests the FEM performs at least as well as actuarial forecasts of mortality, while providing policy simulation features that are not available in actuarial models.
Neurochemical Mechanisms and Neurocircuitry Underlying the Contribution of Stress to Cocaine Seeking

In individuals with substance use disorders, stress is a critical determinant of relapse susceptibility. In some cases, stressors directly trigger cocaine use. In others, stressors interact with other stimuli to promote drug seeking, thereby setting the stage for relapse. Here, we review the mechanisms and neurocircuitry that mediate stress-triggered and stress-potentiated cocaine seeking. Stressors trigger cocaine seeking by activating noradrenergic projections originating in the lateral tegmentum that innervate the bed nucleus of the stria terminalis to produce beta adrenergic receptor-dependent regulation of neurons that release corticotropin releasing factor (CRF) into the ventral tegmental area (VTA). CRF promotes the activation of VTA dopamine neurons that innervate the prelimbic prefrontal cortex resulting in D1 receptor-dependent excitation of a pathway to the nucleus accumbens core that mediates cocaine seeking. The stage-setting effects of stress require glucocorticoids, which exert rapid non-canonical effects at several sites within the mesocorticolimbic system. In the nucleus accumbens, corticosterone attenuates dopamine clearance via the organic cation transporter 3 to promote dopamine signaling. In the prelimbic cortex, corticosterone mobilizes the endocannabinoid, 2-arachidonoylglycerol (2-AG), which produces CB1 receptor-dependent reductions in inhibitory transmission, thereby increasing excitability of neurons which comprise output pathways responsible for cocaine seeking. Factors that influence the role of stress in cocaine seeking, including prior history of drug use, biological sex, chronic stress/co-morbid stress-related disorders, adolescence, social variables, and genetics are discussed. Better understanding when and how stress contributes to drug seeking should guide the development of more effective interventions, particularly for those whose drug use is stress related.
Collapse and Diffusion in Harmonic Activation and Transport

For an $n$-element subset $U$ of $\mathbb{Z}^2$, select $x$ from $U$ according to harmonic measure from infinity, remove $x$ from $U$, and start a random walk from $x$. If the walk leaves from $y$ when it first enters $U$, add $y$ to $U$. Iterating this procedure constitutes the process we call Harmonic Activation and Transport (HAT). HAT exhibits a phenomenon we refer to as collapse: informally, the diameter shrinks to its logarithm over a number of steps which is comparable to this logarithm. Collapse implies the existence of the stationary distribution of HAT, where configurations are viewed up to translation, and the exponential tightness of diameter at stationarity. Additionally, collapse produces a renewal structure with which we establish that the center of mass process, properly rescaled, converges in distribution to two-dimensional Brownian motion. To characterize the phenomenon of collapse, we address fundamental questions about the extremal behavior of harmonic measure and escape probabilities. Among $n$-element subsets of $\mathbb{Z}^2$, what is the least positive value of harmonic measure? What is the probability of escape from the set to a distance of, say, $d$? Concerning the former, examples abound for which the harmonic measure is exponentially small in $n$. We prove that it can be no smaller than exponential in $n \log n$. Regarding the latter, the escape probability is at most the reciprocal of $\log d$, up to a constant factor. We prove it is always at least this much, up to an $n$-dependent factor.
Study on the diet balance index and its relationship with blood uric acid of smoking adults in Tianjin

Objective: Diet balance index (DBI_16) was used to evaluate the dietary status of smoking adults in Tianjin, and the relationship between DBI_16 and serum uric acid was analyzed. Methods: A total of 1 478 inhabitants aged 18 and above were enrolled. The dietary status was obtained with a 3-day dietary recall and condiment weighing method. And their fasting venous blood was collected to detect uric acid. Food intake and DBI_16 scores of smokers and non-smokers were described, and the relationship among smoking, diet quality distance (DQD-DBI), and serum uric acid was analyzed. Results: The intake of vegetables, fruits, and milk of smokers in Tianjin was lower than while the salt, oil, cereals, and aquatic products were higher than that of non-smokers. The DBI_16 scores of vegetables and fruits, food types, milk, and beans of smokers were lower than those of non-smokers in Tianjin, and the scores of pure energy foods and condiments were higher than those of the non-smokers. The DQD-DBI, high bound score and low bound score of smokers in Tianjin were 42.0, 14.0, and 29.0 respectively, which were all higher than those of non-smokers. The main problems appeared as moderately inadequate intake (accounting for 67.0%), low, excessive intake (accounting for 70.9%), and moderate imbalance of intake (accounting for 67.2%). The serum uric acid of smokers was higher than in the non-smokers, and there the same result appeared under the conditions of "not suitable" in DQD-DBI. Conclusions: In Tianjin, the dietary imbalance was more evident in smokers than the non-smokers, and the serum uric acid was significantly higher than the non-smokers. Strategies as strengthening the nutrition education and intervention targeted for smokers were in urgent need.
An apparatus for the evaluation of work capacity and energy expenditure of small animals.

(1968). An Apparatus for the Evaluation of Work Capacity and Energy Expenditure of Small Animals. Research Quarterly. American Association for Health, Physical Education and Recreation: Vol. 39, No. 1, pp. 213-217.
A Minicomputer-Based Perinatal/Neonatal Telecommunications Network

A minicomputer-based telecommunications network has been developed to link all of the state's nine tertiary neonatal intensive care units in order to provide information on availability of neonatal and maternal beds. The information is updated automatically on computer terminals located in each neonatal intensive care unit every two hours by a complete system poll (350 polls per month). This information has been found to be accurate 95% of the time. Through a computer simulation, this network is shown to provide a significant reduction (P less than .0005) in the number of referral telephone calls, and thus the time, required to locate a bed within the state for obstetric or pediatric patients needing transfer. In addition, this network has provided a data base to aid in local, regional, and statewide planning for perinatal facilities. A 6-month summary of the data indicated that for 16% of the system polls, less than two neonatal intensive care units could accept outside referrals, demonstrating frequent severe statewide restrictions for care of high-risk patients. The total operating budget for the most recent fiscal year was less than +25,000, which is far less than that of manual 24-hour central telephone operator systems providing similar services. This telecommunications network is a cost-effective answer to the common problem of limited regional perinatal resources.
Wishing They Were There: Old Postcards and Library History

����� ��� This past winter my husband and I finally finished renovating our home. While we were fixing up our place, so many aspects of our life—intellectual, recreational, and social—were put aside. Then one day I wrestled out another dusty carton that had been relegated to the back of a closet. There it is! My postcard collection! As every researcher knows, putting something aside for a while and then returning to it with fresh eyes can reveal new possibilities. Years ago, when I was aggressively building the collection, it was simply a hobby. I worked in a public library, so it was fun to collect postcards that showed other libraries. Now that I have shifted to an academic job and research is an important aspect of my work, I see my postcards in a different light. It is clear that postcards can be helpful sources for library historians, keeping in mind the medium’s inherent limitations. At the same time, the postcard fad of the early twentieth century serves as a sobering reminder that documentation of library history as well as practitioners’ understanding of that history often have been left to chance.
Multiple genetic variant association testing by collapsing and kernel methods with pedigree or population structured data.

Searching for rare genetic variants associated with complex diseases can be facilitated by enriching for diseased carriers of rare variants by sampling cases from pedigrees enriched for disease, possibly with related or unrelated controls. This strategy, however, complicates analyses because of shared genetic ancestry, as well as linkage disequilibrium among genetic markers. To overcome these problems, we developed broad classes of “burden” statistics and kernel statistics, extending commonly used methods for unrelated case-control data to allow for known pedigree relationships, for autosomes and the X chromosome. Furthermore, by replacing pedigree-based genetic correlation matrices with estimates of genetic relationships based on large-scale genomic data, our methods can be used to account for population-structured data. By simulations, we show that the type I error rates of our developed methods are near the asymptotic nominal levels, allowing rapid computation of P-values. Our simulations also show that a linear weighted kernel statistic is generally more powerful than a weighted “burden” statistic. Because the proposed statistics are rapid to compute, they can be readily used for large-scale screening of the association of genomic sequence data with disease status.
Juvenile Traffic Offenders

KEYWORDS: Juvenile justice; Juvenile delinquency; Traffic safety; Young drivers Language: en
Asymptotic distributions of the likelihood ratio test statistics for covariance structures of the complex multivariate normal distributions

Abstract In this paper, the authors derived asymptotic expressions for the null distributions of the likelihood ratio test statistics for multiple independence and multiple homogeneity of the covariance matrices when the underlying distributions are complex multivariate normal. Also, asymptotic expressions are obtained in the non-null cases for the likelihood ratio test statistics for independence of two sets of variables and the equality of two covariance matrices. The expressions obtained in this paper are in terms of beta series. In the null cases, the accuracy of the first terms alone is sufficient for many practical purposes.
Ingestion of petroleum by breeding mallard ducks: some effects on neonatal progeny.

Breeding female mallard ducks consuming petroleum-contaminated food show significant induced increases in the naphthalene-metabolizing properties of microsomes prepared from their livers. Food contaminated with South Louisiana crude oil was more potent than food contaminated with similar concentrations of Prudhoe Bay crude oil and in each instance food contaminated with 3% (v/w) induced greater increases than food contaminated at the 1% level. These increases in hepatic naphthalene-metabolizing activity may reflect their responses to circulating petroleum contaminants derived from ingested crude oil. When incubated, fertilized eggs laid by the females consuming South Louisiana crude oil yielded ducklings that upon emergence possessed high levels of naphthalene-metabolizing activity associated with hepatic microsomes. In contrast, ducklings derived from eggs laid by females consuming food contaminated with Prudhoe Bay crude oil showed no increases in total hepatic naphthalene-metabolizing activity and only those ducklings hatched from eggs laid by females consuming food contaminated with 3% crude oil showed significantly induced levels of specific naphthalene-metabolizing activity at hatching. During the first week of postnatal life both the uncontaminated ducklings and the ducklings hatched from eggs laid by females consuming food contaminated with South Louisiana crude oil showed initial transient rises in specific and total hepatic naphthalene-metabolizing activity. In each instance, these rises were proportional to the level of contamination in the food consumed by the females. Thereafter, the specific activities of the naphthalene-metabolizing enzyme in all ducklings declined to the level found at hatching in uncontaminated ducklings. Similarly, the total hepatic naphthalene-metabolizing activities in ducklings derived from females consuming food contaminated with 3% crude oil also declined to the level at hatching in uncontaminated ducklings. In contrast, after one week, ducklings hatched from eggs laid by females consuming food contaminated with 1% crude oil showed total hepatic naphthalene-metabolizing activities that were more than twice those found at hatching.
A Comparative and Developmental Analysis of the Midventral Sebaceous Glands in 18 Taxa of Peromyscus, with an Examination of Gonadal Steroid Influences in Peromyscus maniculatus bairdii

Three hundred and thirteen live specimens from 12 species and eight subspecies of Peromyscus were examined for the presence and size of a specialized midventral sebaceous area. External evidence of the area was found primarily in P. maniculatus and P. polionotus . No strong relationship was found between the habitat of the species and glandular presence or size. Glandular areas of males were usually larger than those of females from the same species. In males from a number of taxa examined, size of the glandular area correlated negatively with age. Histological analysis confirmed these general relationships in P. m. bairdii , and revealed that hair follicles were generally absent from the specialized area. In males of P. m. bairdii , androgen dependency of the sebaceous area was determined by castration and subsequent testosterone replacement. The glandular areas of ovariectomized female P. m. bairdii given estrogen and subsequent progesterone were markedly reduced in relation to those of oil-treated controls.
Lift-off effect in high-frequency eddy current conductivity spectroscopy

Abstract Precision eddy current measurements have been shown to be capable of characterizing the near-surface residual stress and cold work profiles in surface-treated components. To capture the peak compressive residual stress in moderately shot-peened (Almen 4–8 A) nickel-base superalloys, the eddy current inspection frequency has to be as high as 50–80 MHz. Unfortunately, spurious self- and stray-capacitance effects render the complex eddy current coil impedance variation with lift-off, the so-called lift-off curve, highly nonlinear, which makes it difficult to achieve accurate eddy current conductivity measurements beyond 25 MHz in the presence of even the slightest lift-off uncertainties. As opposed to the well-known inductive lift-off effect that decreases with increasing probe size, the capacitive lift-off effect increases with probe size. Both effects increase with frequency with the inductive effect being initially stronger, but then taken over at high frequencies by the faster growing capacitive effect. Since the two effects produce opposite curvature in the lift-off curve, in the frequency range where they are approximately equal to the lift-off curve becomes essentially linear and fairly accurate, conductivity measurements can be conducted even in the presence of lift-off variations.
Early response to pulse oximetry alarms with telemetry

Twenty ICU patients were monitored for an average of 45 hr each, with both bedside and nursing station monitors, which were set to alarm audibly if the patient's oxygen saturation dropped below 90%. Bedside alarms alerted caregivers to 51 of the 74 hypoxemic events; central alarms alerted personnel to the other 23 events. The alarms led to a change in treatment in 35 of the 48 (73%) true desaturation episodes. We conclude that central oximetric monitoring may help with detection of arterial desaturation events even in a well-staffed ICU.
American College of Radiology and Society of Nuclear Medicine and Molecular Imaging Joint Credentialing Statement for PET/MR Imaging: Brain

Founded in 1951, the Joint Commission, formerly known as the Joint Commission on Accreditation of Healthcare Organizations and, previous to that, the Joint Commission on Accreditation of Hospitals, is a United States–based nonprofit organization that accredits more than 20,000 health care