cssi/SciSciGPT-SciSciNet huggingface dataset:
Effect of antithrombic therapy on bleeding complications in patients receiving emergency cholecystectomy for acute cholecystitis

Background The risk of developing hemorrhagic complications during or after emergency cholecystectomy in patients with antithrombic therapy (ATT) remains uncertain. In this study, we evaluate outcomes in patients with ATT undergoing emergency cholecystectomy and assess the relevance between ATT and perioperative complications including bleeding complications. Methods We retrospectively evaluated 296 patients who were diagnosed as acute cholecystitis and underwent emergency cholecystectomy between 2005 and 2017. One hundred and thirty-three of them (45%) were on ATT. The primary outcome measures were intraoperative blood loss over 500 ml and postoperative complications including bleeding complications. This study was approved by our institutional review board (#13072904). Results There were 23 patients (8%) who experienced intraoperative blood loss over 500 ml and nine postoperative bleeding complications (3%). Multivariable analyses showed that male sex (P = 0.027), Performance Status 2-4 (P = 0.031) and grade II or III acute cholecystitis (P = 0.033) were independent risk factors for intraoperative bleeding over 500 ml, whereas not single antiplatelet therapy (APT) use but multiple APT (P = 0.034) and anticoagulation therapy (ACT) (P = 0.032) were independently associated with postoperative bleeding complications. Additionally, laparoscopic surgery, but not ATT, was a significant prognostic factor for severe postoperative complications. Conclusions Single APT was not remained as an independently associated factor of intraoperative excessive bleeding or severe postoperative complications including bleeding complications. However, patients treated with multiple APT or ACT still represent a challenging group and must be carefully managed to avoid postoperative bleeding complications.
Hysteroscopy and why macroscopic uterine factors matter for fertility

For humans, the uterus is their first home. Accurate evaluation and effective therapy are central to optimizing the conditions for implantation and sustained pregnancy. For macroscopic intracavitary disease, hysteroscopy remains the gold standard for diagnosis and treatment. We review the role of hysteroscopy before fertility therapies. We also address intracavitary pathologies and their relevance to procreative outcomes. Controversies in the literature are noted and clarified, and trends in the field of hysteroscopy are identified regarding how they will influence the future of reproductive care and women's health.
Pteropods in the Hot Brine Sediments of the Red Sea

The distribution of pteropods in four cores from the hot brine area of the Red Sea and from one core 150 miles south of this area shows four stratigraphic zones. These zones can be correlated with eustatic sea level changes.
Treatment of Aggressive Antineutrophil Cytoplasmic Antibody-Associated Vasculitis With Eculizumab.

Antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) is a small vessel necrotizing vasculitis with a predilection for the respiratory tract and kidneys.1,2 Prompt initiation of remission induction immunosuppression is paramount to prevent irreversible organ damage.3 Standard initial therapy for severe AAV consists of cyclophosphamide or rituximab in combination with high-dose glucocorticoids.4,5 In cases of severe pulmonary hemorrhage or rapidly progressive glomerulonephritis, plasma exchange is often added to facilitate rapid removal of ANCA.6 Improved understanding of disease pathogenesis has provided the rationale for targeting the complement pathway in AAV.7 In particular, the anaphylatoxin complement component 5a (C5a) has been identified as a key pathogenic mediator of AAV because of its ability to prime and recruit neutrophils.8 Inhibitors of C5a and the C5a receptor are being evaluated in randomized trials, but are not currently available for clinical use.9 Here, we report the use of eculizumab, a monoclonal antibody against C5, in 2 cases of aggressive AAV with the intention of rapidly inducing remission by inhibiting C5a generation. In both patients, religious beliefs prohibiting the receipt of blood products precluded the use of plasma exchange and cyclophosphamide.
Inherent mitochondrial activity influences specification of the germ line in pluripotent stem cells.

Abstract Herein we investigated whether inherent differences in mitochondrial activity in mouse pluripotent cells could be used to identify populations with an intrinsic ability to differentiate into primordial germ cells (PGCs). Notably, we determined that stem cells sorted based on differences in mitochondrial membrane activity exhibited altered germline differentiation capacity, with low-mitochondrial membrane potential associated with an increase in PGC-like cells. This specification was not further enhanced by hypoxia. We additionally noted differences between these populations in metabolism, transcriptome, and cell-cycle. These data contribute to a growing body of work demonstrating that pluripotent cells exhibit a large range of mitochondrial activity, which impacts cellular function and differentiation potential. Furthermore, pluripotent cells possess a subpopulation of cells with an improved ability to differentiate into the germ lineage that can be identified based on differences in mitochondrial membrane potential.
Rickart ∗-Rings, Baer ∗-Rings, AW *-algebras: Generalities and Examples

All rings considered in this book are associative, and, except in a few of the excercises, they are equipped with an involution in the sense of the following definition:
Spatial Calibration for 3D Freehand Ultrasound via Independent General Motions

The concept of 3D freehand ultrasound has been of great interest to researchers for decades due to many advantages over conventional 2D ultrasound, such as image quality that is less dependent on a sonographer's skills and more intuitive and interactive 3D views of scanned objects. However, obstacles such as the need for spatial calibration remain, which hinder the effective application of this technique in clinical settings. Here we report the feasibility and accuracy of performing spatial calibration based upon a closed-form solution to matrix equations formed by two independent general motions. We achieved millimeter-level accuracy for translational and degree-level accuracy for rotational degrees of freedom. The calibration accuracy may be further improved by optimizing the matrix solution.
Measuring Service Quality at the Mad Boar Restaurant: A SERVQUAL Analysis

Value inconsistencies develop within a business environment where there are gaps between management/leader values, employee values, and customer values. Upon initial investigation of the Mad Boar Restaurant, significant gaps appear between these groups with respect to service quality. In the category of service quality, the differences between four dimensions of service quality - reliability, responsiveness, assurance, and empathy - are notable. At the corporate level, these value inconsistencies represent the misalignment of leader behavior, group members, and task characteristics. Such a misalignment between these factors directly transcends present and future profitability. This paper includes the following: an explanation of the problem with theoretical and practical knowledge, the variables that are relevant to the analysis, and a summary of the data with findings and recommendations.
Ultra-low-dose (boom-boom) radiotherapy for management of recurrent ocular post-transplant lymphoproliferative disorder

Abstract Purpose To report a case of recurrent iris post-transplant lymphoproliferative disorder (PTLD) treated with ultra-low-dose (boom-boom) radiotherapy (RT). Observations A 12-year-old Caucasian male with a history of bilateral, recurrent iris PTLD of the extranodal marginal zone lymphoma (MALT) type presented with persistent bilateral anterior chamber cellular infiltration, which was incompletely controlled on topical corticosteroids, and with elevated intraocular pressure (IOP) in the right eye secondary to steroid response. The patient was diagnosed with PTLD recurrence and was successfully treated with ultra-low-dose RT to both eyes in 2 fractions of 2 Gy. At 15 month follow-up the patient maintained complete disease control with normal IOP off all topical ophthalmic medications. Conclusions and Importance: Ultra-low-dose RT for ocular PTLD of the MALT subtype represents a novel therapeutic approach that may provide a durable treatment response and could be considered as either primary or adjuvant therapy for this rare condition.
Inflammatory myofibroblastic tumor masquerading as an anterior choroidal artery fusiform aneurysm.

Background: Inflammatory myofibroblastic tumor is a rare, poorly understood tumor that has been found to occur in almost every organ tissue. Its location within the central nervous system is uncommon, and patients tend to present with nonspecific symptoms. Case Description: A female in her eighth decade presented to neurosurgery clinic with complaints of headache and dizziness. Initial imaging was consistent with a low-grade, benign brain lesion in the region of the left choroidal fissure. She was recommended for observation but returned 1 month later with progressive symptoms and doubling of the lesion size. She underwent surgical resection and was found to have an IMT arising from the wall of the left anterior choroidal artery. Conclusion: Intracranial IMT remains a rare and poorly understood entity. The present case demonstrates a novel presentation of IMT in an adult patient and exemplifies the heterogeneity of the disease presentation.
Paraganglioma and other tumor detection rates in individuals with SDHx pathogenic variants by age of diagnosis and after the age of 50.

Objective Patients with SDHx germline mutations (SDH A, AF2, B, C, D) are at risk for paragangliomas (PGLs), renal cell carcinoma, and gastrointestinal stromal tumors. The aim of this study was to evaluate age of SDHx tumor diagnosis in those with pathogenic variants (PVs), notably tumor detection after the age of 50 years. Study design Longitudinal retrospective observational analysis PATIENTS: Individuals with SDHx PVs MEASUREMENTS: Demographic, clinical, genetic, screening, and tumor detection and treatment data was abstracted from the electronic medical record. Descriptive analysis was utilized. Results A total of 165 patients with SDHx PVs from 34 families were evaluated. Sixty-eight patients (41.2%) had at least one known SDHx related tumor in their history, identified through symptoms, screening, or incidentally. The average age of SDHx related tumor diagnosis was 32.0 years. Age of diagnosis varied by gene. Nine patients (n=50; 18.0%) were identified with a tumor after the age of 50, identified via baseline screening after PV identification, or due to symptoms prior to molecular SDHx diagnosis. Conclusions Though tumors were identified in individuals above the age of 50, they were all identified on baseline screening or due to symptoms, confirming baseline screening is essential. Given the slow growing nature of PGLs, these tumors might have been discovered prior to age 50 if molecular diagnosis and baseline screening had occurred earlier. Considering discontinuing screening after age 50 may be warranted if baseline screen imaging is negative and the individual does not have a prior tumor history. This article is protected by copyright. All rights reserved.
Design optimization of cylindrical burnable absorber inserted into annular fuel pellets for soluble-boron-free SMR

Abstract This paper presents a high performance burnable absorber named as CIMBA (Cylindrically Inserted and Mechanically Separated Burnable Absorber) for the soluble-boron-free SMR. The CIMBA is the cylindrical gadolinia inserted into the annular fuel pellets. Although the CIMBA utilizes the spatial self-shielding effect of the fuel material, a large reactivity upswing occurs when the gadolinia is depleted. To minimize the reactivity swing of the CIMBA-loaded FA, two approaches were investigated. One is controlling the spatial self-shielding effect of the CIMBA as burnup proceeds by a multi-layered structure of the CIMBA (ML-CIMBA) and the other is the mixed-loading of two different types of CIMBA (MIX-CIMBA). Both approaches show promising performances to minimize the reactivity swing, where the MIX-CIMBA is more preferable due to its simpler fabrication process. In conclusion, the MIX-CIMBA is expected to accelerate the commercialization of the CIMBA and can be used to achieve an optimal soluble-boron-free SMR core design.
Environmental Exposures and Lung Aging: Molecular Mechanisms and Implications for Improving Respiratory Health

Inhaled environmental exposures cause over 12 million deaths per year worldwide. Despite localized efforts to reduce environmental exposures, tobacco smoking and air pollution remain the urgent public health challenges that are contributing to the growing prevalence of respiratory diseases. The purpose of this review is to describe the mechanisms through which inhaled environmental exposures accelerate lung aging and cause overt lung disease. Environmental exposures related to fossil fuel and tobacco combustion and occupational exposures related to silica and coal mining generate oxidative stress and inflammation in the lungs. Sustained oxidative stress causes DNA damage, epigenetic instability, mitochondrial dysfunction, and cell cycle arrest in key progenitor cells in the lung. As a result, critical repair mechanisms are impaired, leading to premature destruction of the lung parenchyma. Inhaled environmental exposures accelerate lung aging by injuring the lungs and damaging the cells responsible for wound healing. Interventions that minimize exposure to noxious antigens are critical to improve lung health, and novel research is required to expand our knowledge of therapies that may slow or prevent premature lung aging.
Linear Models of Impulse Inputs and Linear Basis Functions for Measuring Impulse Responses

Next I undertook systematic exploration of the behavioral correlates of this well defined generator of background and odor-induced EEG and electrically evoked potentials in waking cats by using arrays of permanently placed bipolar electrodes (Freeman 1960a,b), first by presenting different odorants to search for changes in amplitude and frequency distributions of the EEG, then by using different unconditioned stimuli to elicit reactions relating to hunger, thirst, rage and attack, fear and flight, sexual arousal, and stages of drowsiness and sleep. The only significant variations were in the amplitude of the EEG, which increased in the low-frequency range with sleep, and in the higher frequency gamma range (Bressler and Freeman 1980) with the degree of arousal and motivation. There were no patterns that were specific to either the odorant stimuli, or the responses to them, or the type of motivation. An exception was the suppression of bursts in the EEG with sneezing, yawning, sniffing, or other changes peculiar to respiratory patterns. Even in sleep there was only a modest increase in slow wave delta activity. These negative results were not very exciting.
Learning from Queries and Examples with Tree-structured Bias

Incorporating declarative bias or prior knowledge into learning is an active research topic in machine learning. Tree-structured bias specifies the prior knowledge as a tree of “relevance” relationships between attributes. This paper presents a learning algorithm that implements tree-structured bias, i.e., learns any target function probably approximately correctly from random examples and membership queries if it obeys a given tree-structured bias. The theoretical predictions of the paper are empirically validated.
Microdisks with quantum dot active regions lasing near 1300 nm at room-temperature

Lasing near 1300 nm in microdisks with InAs quantum dot active regions is reported for the first time. The microdisks were optically pumped at room temperature, and lasing occurred in devices that are 2.5 /spl mu/m in diameter and larger.
Small and Large Trades Around Earnings Announcements: Does Trading Behavior Explain Post-Earnings-Announcement Drift?

This paper analyzes trade-initiation by small and large traders for one year following earnings announcements and examines the predictive ability of event-time trading for future returns. With earnings surprises based on a seasonal random walk expectations model, small traders react slightly more weakly than large traders, during the event window, to the first surprise in a series of similar surprises, but more strongly than large traders to the later surprises. With earnings surprises based on analyst forecasts, small traders react more weakly than large traders regardless of the past series. Large traders trade in the direction of the earnings surprise for one month after the earnings announcement, while small traders do not. Starting in month two this switches and small traders trade in the direction of the surprise, while large traders do not. The strength of the small trade event-time reaction is a weak positive predictor of returns in the first month after the announcement and a weak negative predictor of drift after the first month. Large trade reaction is generally a negative predictor of future drift. The collection of evidence points to both small and large trader underreaction to earnings announcements, with small trader underreaction more severe in the first month. In month one, large traders capitalize on drift, but after that small traders seem to correct and possibly overreact.
Behavior of the Spin-Flip Amplitude in High-Energy Proton-Proton and Pion-Proton Elastic Scatterings.

Data from recent experiments designed to study high-energy elastic πp and pp cross-sections and polarizations have been analyzed to extract information on the behaviour of the spin-flip amplitudes at smallt. It is found that the reduced spin-flip amplitudes are, to a large degree, independent of the particular elastic interaction at smallt, and have a magnitude comparable to the nonflip amplitudes ast→0.
Nonlinear Systems: Bifurcation Theory

In Chapters 2 and 3 we studied the local and global theory of nonlinear systems of differential equations $$ \dot{x} = f(x) $$ (1) with f ∈ C1(E) where E is an open subset of R n . In this chapter we address the question of how the qualitative behavior of (1) changes as we change the function or vector field f in (1). If the qualitative behavior remains the same for all nearby vector fields, then the system (1) or the vector field f is said to be structurally stable. The idea of structural stability originated with Andronov and Pontryagin in 1937. Their work on planar systems culminated in Peixoto’s Theorem which completely characterizes the structurally stable vector fields on a compact, two-dimensional manifold and establishes that they are generic. Unfortunately, no such complete results are available in higher dimensions (n ≥ 3). If a vector field f ∈ Cl(E) is not structurally stable, it belongs to the bifurcation set in Cl(E). The qualitative structure of the solution set or of the global phase portrait of (1) changes as the vector field f passes through a point in the bifurcation set. In this chapter, we study various types of bifurcations that occur in C1-systems $$ \dot{x}=f\left( {x,\mu} \right) $$ (2) depending on a parameter μ ∈ R (or on several parameters μ ∈ R m ).
Computer literacy: today and tomorrow

Computing and technology departments often offer service courses in Computer Literacy that provide the entire academic community with the opportunity to develop skills in the use of computers. These courses have been around for many years, but all too often they have not been updated to reflect new skills and knowledge that students are now bringing with them. In this paper we chronicle the history of teaching Computer Literacy, and discuss its relationship with the broad topic of Information Literacy. We include the description of a course on the Internet taught at Quinnipiac University that serves as a model for an updated Technology Literacy course incorporating both Computer Literacy and Information Literacy.
A chronological record of environmental chemicals from analysis of stratified vertebrate excretion deposited in a sheltered environment.

Guano deposits of the migratory free-tailed bat Tadarida brasiliensis are stratified into distinguishable annual layers in some caves in the American Southwest. These layers may be dated and analyzed for environmental chemicals thus providing a chronological record of selected chemicals in the food chain of this mammal. It is found that the annual Hg fluctuations observed in the guano correlate with annual production figures of a nearby copper smelter. Analysis of the terms in a mathematical model suggests that the major mechanism by which smelter mercury enters the bat's food chain is dry fallout. A 1-yr delay time between peaks and dips in industrial output and peaks and dips in the mercury present in guano indicate that industrial mercury is ingested by the bat indirectly via the food chain. The preliminary data presented here indicate that analysis of old deposits (preindustrial revolution) will provide baseline data for environmental chemicals.
Building community resilience: what can the United States learn from experiences in other countries?

ObjectivesCommunity resilience (CR) is emerging as a major public policy priority within disaster management and is one of two key pillars of the December 2009 US National Health Security Strategy. However, there is no clear agreement on what key elements constitute CR. We examined exemplary practices from international disaster management to validate the elements of CR, as suggested by Homeland Security Presidential Directive 21 (HSPD-21), to potentially identify new elements and to identify practices that could be emulated or adapted to help build CR.MethodsWe extracted detailed information relevant to CR from unpublished case studies we had developed previously, describing exemplary practices from international natural disasters occurring between 1985 and 2005. We then mapped specific practices against the five elements of CR suggested by HSPD-21.ResultsWe identified 49 relevant exemplary practices from 11 natural disasters in 10 countries (earthquakes in Mexico, India, and Iran; volcanic eruption in Philippines; hurricanes in Honduras and Cuba; floods in Bangladesh, Vietnam, and Mozambique; tsunami in Indian Ocean countries; and typhoon in Vietnam). Of these, 35 mapped well against the five elements of CR: community education, community empowerment, practice, social networks, and familiarity with local services; 15 additional practices were related to physical security and economic security. The five HSPD-21 CR elements and two additional ones we identified were closely related to one another; social networks were especially important to CR.ConclusionsWhile each disaster is unique, the elements of CR appear to be broadly applicable across countries and disaster settings. Our descriptive study provides retrospective empirical evidence that helps validate, and adds to, the elements of CR suggested by HSPD-21. It also generates hypotheses about factors contributing to CR that can be tested in future analytic or experimental research. (Disaster Med Public Health Preparedness. 2013;7:292-301)
Genomic organization and evolution of the soybean SB92 satellite sequence

Repetitive DNA sequences comprise a large percentage of plant genomes, and their characterization provides information about both species and genome evolution. We have isolated a recombinant clone containing a highly repeated DNA element (SB92) that is homologous to ca. 0.9% of the soybean genome or about 10(5) copies. This repeated sequence is tandemly arranged and is found in four or five major genomic locations. FISH analysis of metaphase chromosomes suggests that two of these locations are centromeric. We have determined the sequence of two cloned repeats and performed genomic sequencing to obtain a consensus sequence. The consensus repeat size was 92 bp and exhibited an average of 10% nucleotide substitution relative to the two cloned repeats. This high level of sequence diversity suggests an ancient origin but is inconsistent with the limited phylogenetic distribution of SB92, which is found at high copy number only in the annual soybeans. It therefore seems likely that this sequence is undergoing very rapid evolution.
Ionization of lithium vapor by CW quasiresonant laser light

We report measurements of the excitation and ionization of dense lithium vapor irradiated byCW dye laser light scanning the 22 P−32 D lithium atomic transition at 610.3 nm. Lithium vapor with a density of 8×1016 cm−3 was ionized by a focused beam with as little as 1 mW of single-frequency laser power. The ionization mechanism has been studied and found to consist of a three stage process in which both atomic and molecular absorption of the laser power, two distinct collisional processes, and single-photon ionization of excited lithium atoms all play essential roles.
Steady shear microstructure in dilute colloid–polymer mixtures

The shear-induced microstructure in dilute colloid–polymer mixtures, where the presence of polymer induces a tuneable attractive interaction between the colloids, is investigated using quantitative confocal microscopy, over a wide parameter space including the shear rate, the polymer concentration, and two different polymer molecular weights corresponding to polymer/colloid size ratios of approximately 0.02 and 0.05. Overall, the imposition of low shear rates radically transforms the relatively uniform quiescent structure into one marked by long-range heterogeneities and pronounced segregation of dense clusters and voids. Increasing the rate of deformation effects a consistent decrease in the average cluster size and a gradual transition towards a more homogeneous structure through the redistribution of voids. Interestingly, at high shear rates, the suspension microstructure for the large molecular weight polymer is nearly insensitive to the polymer concentration, and primarily determined by the shear rate alone. The prominent microstructural features of these shear-induced transformations are quantified in detail and discussed in light of the competition between interparticle attraction and microscopic shear forces.
Titanium Elastic Nailing of Pediatric Femur Fractures

In the last 3 decades, there has been a very strong trend for pediatric orthopedic traumatologists to use some form of fixation to mobilize the school-aged child with a femur fracture. Titanium elastic nailing of pediatric femur fractures is a widely adopted technique that has stood the test of time. Perhaps the most attractive features of this technique for pediatric femur fracture management are the low rate of serious complications and the relatively easy and safe learning curve for most surgeons. There are several pitfalls to the titanium elastic nail technique that should be emphasized. In multiple series, the most common problem is irritation caused by the nails at their entry site. To avoid this most common complication, the nail should not be bent away from the distal femur, and only 1 to 2 cm of nail should be left outside the cortex of the bone. It is essential to follow the principles that were outlined years ago by the French developers of elastic nailing. The nail entry site, nail size and nail length should be symmetric. The nails should be prebent so that they have good cortical contact at the fracture site, as this cortical contact is a key factor in stability. The nails should be used cautiously in length-unstable fractures and in patients older than 12 years of age or who are heavier than 50 kg.
A novel low-cost high-conversion-efficiency microwave power detector using GaAs FET

A novel simple microwave power detector using a GaAs MESFET is developed at 5.8 GHz. The FET detector has good noise characteristics, temperature stability, and dynamic range. Since the availability of FET is more flexible and the price is lower, the FET detector can be more cost effective than the GaAs Schottky diode. The detector circuit is self-biased and no external DC bias network is required. The detector converts microwave power to DC power with a conversion efficiency of 62.06% and a DC output voltage of 7.35 V at an input power of 29.4 dBm. This is the highest conversion efficiency and DC output voltage ever reported for a self-biased FET detector. The experimental results agree well with the simulation. © 2004 Wiley Periodicals, Inc. Microwave Opt Technol Lett 44: 29–31, 2005; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.20537
Cell-Mediated Immune Response of the Mammary Gland in Guinea Pigs. I. Effect of Antigen Injection Into the Vaccinated and Unvaccinated Glands*

The leukocytic response of the mammary gland in the locally vaccinated guniea pigs to challenge with specific antigen during lactation was investigated. The response was measured by enumerating cells in milk collected at various times prior to and following antigenic challenge. A significant leukocytosis was observed in milk from vaccinated animals. The maximum cellular response by vaccinated animals was observed at 16 h to 30 h after challenge. The majority of leukocytes collected at that time did not form EA rosettes. Differential cell counts showed that the polymorphonuclear leukocytes were the major cell type until 30 h postchallenge while the mononuclear leukocytes predominated later. The delayed cellular response to challenge and the predominancy of leukocyte type at various times after challenge are discussed. It is proposed that the leukocyte response of the mammary glands in vaccinated animals was a cell-mediated immune reaction.
Interaction of libraries and publishers

Abstract Libraries and publishers have evolved together. Publishers rely on libraries as a minimum market for their scholarly products. Inflationary pressures have caused publishers to increase prices that, in turn, strain library budgets that have not increased as fast, and which, in turn, undermine the minimal demand publishers can count on, adding to inflationary pressure. A simple mathematical model for the dynamics of the interaction between libraries and publishers is analyzed. It derives a function for the supply curve of scholarly publications, and is used to estimate when an institution will have to spend as much per person on library support as on his or her salary if present trends continue. This is used to argue that present trends are unlikely to continue, but that a discontinuous shift in the production of scholarly output is likely to occur within a decade or two. Likely new forms of communication among scholars in “communicating classes” involving nearly simultaneous communication and a new kind of organized cumulative record are discussed. The implication for institutional changes not only in libraries and publishers and their interrelation but of new kinds of institutions are sketched.
The potential roles of 18F-FDG-PET in management of acute stroke patients.

Extensive efforts have recently been devoted to developing noninvasive imaging tools capable of delineating brain tissue viability (penumbra) during acute ischemic stroke. These efforts could have profound clinical implications for identifying patients who may benefit from tPA beyond the currently approved therapeutic time window and/or patients undergoing neuroendovascular treatments. To date, the DWI/PWI MRI and perfusion CT have received the most attention for identifying ischemic penumbra. However, their routine use in clinical settings remains limited. Preclinical and clinical PET studies with [18F]-fluoro-2-deoxy-D-glucose (18F-FDG) have consistently revealed a decreased 18F-FDG uptake in regions of presumed ischemic core. More importantly, an elevated 18F-FDG uptake in the peri-ischemic regions has been reported, potentially reflecting viable tissues. To this end, this paper provides a comprehensive review of the literature on the utilization of 14C-2-DG and 18F-FDG-PET in experimental as well as human stroke studies. Possible cellular mechanisms and physiological underpinnings attributed to the reported temporal and spatial uptake patterns of 18F-FDG are addressed. Given the wide availability of 18F-FDG in routine clinical settings, 18F-FDG PET may serve as an alternative, non-invasive tool to MRI and CT for the management of acute stroke patients.
Dynamic solutions for the non-uniform motion of an edge dislocation

Abstract The fully dynamic analysis for the largely arbitrary motion of an edge dislocation yields exact solutions for the displacements. A study of the dislocation path shear stress shows that the singularity order drops when the disolation moves at the Rayleigh wave speed, or supersonically. Numerical results for the disolation path shear stress are presented for the physically important constant-speed disolation case.
Survival benefit of implantable cardioverter-defibrillators in left ventricular assist device-supported heart failure patients.

Abstract Background Implantable cardioverter-defibrillators (ICDs) reduce mortality in heart failure (HF). In patients requiring a ventricular assist device (VAD), the benefit from ICD therapy is not well established. The aim of this study was to define the impact of ICD on outcomes in VAD-supported patients. Methods and Results We reviewed data for consecutive adult HF patients receiving VAD as a bridge to transplantation from 1996 to 2003. The primary outcome was survival to transplantation. A total of 144 VADs were implanted [85 left ventricular (LVAD), 59 biventricular (BIVAD), mean age 50 ± 12 years, 77% male, left ventricular ejection fraction 18 ± 9%, 54% ischemic]. Mean length of support was 119 days (range 1–670); 103 patients (72%) survived to transplantation. Forty-five patients had an ICD (33 LVAD, 12 BIVAD). More LVAD patients had an appropriate ICD shock before implantation than after (16 vs 7; P = .02). There was a trend toward higher shock frequency before LVAD implant than after (3.3 ± 5.2 vs 1.1 ± 3.8 shocks/y; P = .06). Mean time to first shock after VAD implant was 129 ± 109 days. LVAD-supported patients with an ICD were significantly more likely to survive to transplantation [1-y actuarial survival to transplantation: LVAD: 91% with ICD vs 57% without ICD (log-rank P = .01); BIVAD: 54% vs 47% (log-rank P = NS)]. An ICD was associated with significantly increased survival in a multivariate model controlling for confounding variables (odds ratio 2.54, 95% confidence interval 1.04–6.21; P = .04). Conclusions Shock frequency decreases after VAD implantation, likely owing to ventricular unloading, but appropriate ICD shocks still occur in 21% of patients. An ICD is associated with improved survival in LVAD-supported HF patients.
Experimental Aerothermodynamics In Support Of The Columbia Accident Investigation

The technical foundation for the most probable damage scenario reported in the Columbia Accident Investigation Board's final report was largely derived from synergistic aerodynamic/aerothermodynamic wind tunnel measurements and inviscid predictions made at NASA Langley Research Center and later corroborated with engineering analysis, high fidelity numerical viscous simulations, and foam impact testing near the close of the investigation. This report provides an overview of the hypersonic aerothermodynamic wind tunnel program conducted at NASA Langley and illustrates how the ground-based heating measurements provided early insight that guided the direction and utilization of agency resources in support of the investigation. Global surface heat transfer mappings, surface streamline patterns, and shock shapes were measured on 0.0075 scale models of the Orbiter configuration with and without postulated damage to the thermal protection system. Test parametrics include angle of attack from 38 to 42 degs, sideslip angles of 38 to 42 degs, sideslip angles of plus or minus 1 deg, Reynolds numbers based upon model length from 0.05 x 10(exp 6) to 6.5 x 10(exp 6), and normal shock density ratios of 5 (Mach 6 Air) and 12 (Mach 6 CF4). The primary objective of the testing was to provide surface heating characteristics on scaled Orbiter models with outer mold line perturbations to simulate various forms of localized surface damage to the thermal protection system. Initial experimental testing conducted within two weeks of the accident simulated a broad spectrum of thermal protection system damage to the Orbiter windward surface and was used to refute several hypothesized forms of thermal protection system damage, which included gouges in the windward thermal protection system tiles, breaches through the wing new the main landing gear door, and protuberances along the wing leading edge that produced asymmetric boundary layer transition. As the forensic phase of the investigation developed and the condition of recovered debris was examined, increasing emphasis was placed on identifying wing leading edge damage (partially and fully missing reinforced carbon-carbon panels, and eventually holes in the wing leading edge with venting to the wing upper surface) that produced off-nominal heating trends consistent with extracted Orbiter flight recorder temperature data.
Correlation between the Steric Bulk of the Distal E7 and E11 Residues and the Tilt of the FeCN Unit in Cyanometmyoglobin As Determined by NMR from the Orientation of the Magnetic Axes in Single and Double Point Mutants

The amino acids in the heme pocket of sperm whale myoglobin single E11 and double E7 and E11 point mutants in the metcyano form have been assigned by NMR methods to assess the role of steric bulk in modulating ligand tilt. The five mutants investigated are the single mutants His64(E7)-->Gly (H[E7]G), Val68(E11)-->Ile (V[E11]I), and Val68(E11)-->Ala (V[E11]A) and the double mutants His64-(E7)-->Gly:Val68(E11)-->Ile (H,V[E7,E11]G,I) and His64(E7)-->Gly:Val68(E11)-->Ala (H,V[E7,E11]G,A). The dipolar (NOESY) contacts on the proximal side of the heme confirm a conserved molecular structure for all of the mutants. The proximal residue coordinates, together with the dipolar shifts for proximal side residues, quantitatively yield the orientations of the magnetic susceptibility tensors, whose major axis corresponds to the orientation of the ligand. It is observed that upon reduction of the steric bulk in the V[E11]A mutant, the tilt of the ligand is significantly reduced (approximately 8 degrees) from that in the wild type (WT) (approximately 16 degrees), with little change in the direction of tilt. In the case of increased steric bulk at position 68 in the V[E11]I mutant, it is observed that the extent and direction of the tilt are essentially the same as in WT, and it is shown that this is due to the fact that Ile68 is oriented in the pocket with its C delta H3 directed away from the iron.(ABSTRACT TRUNCATED AT 250 WORDS)
[99mTc]TRODAT-1 : a novel technetium-99m complex as a dopamine transporter imaging agent

Technetium-99m is the most commonly used radionuclide in routine nuclear medicine imaging procedures. Development of99mTc-labeled receptor-specific imaging agents for studying the central nervous system is potentially useful for evaluation of brain function in normal and disease states. A novel99mTc-labeled tropane derivative, [99mTc]TRODAT 1, which is useful as a potential CNS dopamine transporter imaging agent, was evaluated and characterized. After i.v. injection into rats, [99mTc]TRODAT-1 displayed specific brain uptake in the rat striatal region (striatum-cerebellum/cerebellum ratio 1.8 at 60 min), where dopamine neurons are concentrated. The specific striatal uptake could be blocked by pretreating rats with a dose of competing dopamine transporter ligand, s-CIT (or RTI-55, i.v., 1 mg/kg). However, the specific striatal uptake of [99mTc]TRODAT-] was not affected by co-injection of excess free ligand (TRODAT-1, up to 200 μg per rat) or by pretreating the rats with haloperidol (i.v., 1 mg/kg). The specific uptake in striatal regions of rats that had prior 6-hydroxydopamine lesion in the substantia nigra area showed a dramatic reduction. The radioactive material recovered from the rat striatal homogenates at 60 min after i.v. injection of [99mTc]TRODAT-1 showed primarily the original compound (>95%), a good indication of in vivo stability in brain tissue. Similar and comparable organ distribution patterns and brain regional uptakes of [99mTc]TRODAT-1 were obtained for male and female rats. Ex vivo autoradiography results of rat brain sections further confirmed the high uptake and retention of [99mTc]TRODAT-1 in the striatal region. In vitro binding studies measuring the affinity to dopamine transporters for the free ligand, TRODAT-1, and a nonradioactive rhenium derivative, Re-TRODAT-1, showed Ki values of 9.7 nM and 14.1 nM, respectively. Behavioral studies in rats using the free ligand, TRODAT-1 and Re-TRODAT-1 indicated that, unlike other tropane derivatives, they displayed no effect on locomotor activity, suggesting low toxicity. These results strongly support the conclusions that this novel99mTc radioligand binds selectively to dopamine transporters in the brain and that is is potentially useful for in vivo assessment of the loss of dopamine neurons in Parkinson's and other neurodegeneralive diseases.
Phospholipid modulation of low-Km cyclic AMP phosphodiesterase activity on rat adipocyte microsomes☆

The ability of nine phospholipids to alter the activity of low-Km cyclic AMP phosphodiesterase was examined in microsomal fractions of rat adipocytes. The enzyme was activated by phosphatidylserine (21% at 300 microM) and phosphatidylglycerol (36% at 300 microM). The activation was concentration dependent over the range 1-1000 microM. Six other phospholipids were without effect. Phosphatidylinositol 4-phosphate inhibited the activity of the enzyme over the same range of concentrations (26% at 300 microM). Phosphatidylserine also activated a partially purified preparation of the enzyme, whereas phosphatidylinositol 4-phosphate was ineffective. The mechanism of the activation of the enzyme by phosphatidylserine and phosphatidylglycerol involved an increase in the apparent Vmax of the enzyme, while the inhibition by phosphatidylinositol 4-phosphate was associated with an increase in the Km of the enzyme for substrate. The phospholipid modulators of low-Km cyclic AMP phosphodiesterase activity did not alter the activity of high-Km cyclic AMP phosphodiesterase. The ability of phospholipids to alter the activity of low-Km cyclic AMP phosphodiesterase in native membranes suggests a possible role for phospholipids in metabolic regulation.
Perspectives on mixed matrix membranes

This perspective is meant to provide some background and future directions for mixed matrix membranes. It is not meant to be a complete review but an initial description that allows the reader to find appropriate articles on various aspects of this topic and develop a better understanding so that they can pursue this topic with the information needed. A list of references that one can use to gain additional information is provided at the end of the article.
Geriatric Emergency Medicine Educational Module: Abdominal Pain in the Older Adult

The Society for Emergency Medicine (SAEM) Geriatrics Task Force has created an instructional tool to address the complaint of abdominal pain in older adults presenting to the emergency department (ED). This is the first module in a comprehensive, web-based geriatric emergency medicine curriculum that will address common syndromes in older adults presenting to the ED. There is no formal, residency-based curriculum in geriatric emergency medicine and there is a paucity of geriatric Continuing Medical Education (CME) opportunities for practicing emergency physicians. The amount, quality, and convenience of geriatrics training available to emergency physicians is insufficient. This educational gap is particularly concerning given the ever-growing volume of older adult emergency patients. The Task Force chose to focus first on geriatric abdominal pain because a survey of emergency physicians in the mid 1990s found that it is one of the most difficult complaints to evaluate and manage. The module comprises of six clinical cases with a pre- and post-test. Together, these cases encompass the broad differential diagnosis for geriatric abdominal pain and the core medical knowledge pertaining to the subject. The modules will expose the learner, through either content or modeling, to the six Accreditation Council for Graduate Medical Education (ACGME) core competencies and to the Principles of Geriatric Emergency Medicine including rapid evaluation of functional status, communication skills, and consideration of the effect of polypharmacy and co-morbidity on the presenting complaint. This module will be available to residency programs as an “asynchronous educational session” via the Council of Emergency Medicine Residency Directors (CORD) website as well as to practicing emergency physicians via the SAEM and American College of Emergency Physicians (ACEP) websites.
Evaluation of Clinical Outcomes for Gastric Bypass Surgery: Results from a Comprehensive Follow-up Study

Laparoscopic gastric bypass (LGB) surgery markedly increases percent excess weight loss (%EWL) and obesity-related co-morbidities. However, poor study quality and minimal exploration of clinical, behavioral, and psychosocial mechanisms of weight loss have characterized research to date. We conducted a comprehensive assessment of n=100 LGB patients surveyed 2–3 years following surgery using standardized measures. Mean %EWL at follow-up was 59.1±17.2%. This high level of weight loss was associated with a low rate of metabolic syndrome (10.6%), although medications were commonly used to achieve control. Mean adherence to daily vitamin and mineral supplements important to the management of LGB was only 57.6%, and suboptimal blood chemistry levels were found for ferritin (32% of patients), hematocrit (27%), thiamine (25%), and vitamin D (19%). Aerobic exercise level (R 2=0.08) and pre-surgical weight (R 2=0.04) were significantly associated with %EWL, but recommended eating style, fluid intake, clinic follow-up, and support group attendance were not. Psychosocial adjustment results showed an absence of symptomatic depression (0%), common use of antidepressant medications (32.0%), low emotional distress related to the post-surgical lifestyle (19.8±14.0; scale range 0–100), a high level of perceived benefit from weight loss in terms of functioning and emotional well-being (82.7±17.9; scale range 0–100), and a change in marital status for 26% of patients. At 2–3 years following LGB surgery aerobic exercise, but not diet, fluid intake, or attendance at clinic visits or support groups, is associated with %EWL. Depression is symptomatically controlled by medications, lifestyle related distress is low, and marital status is significantly impacted.