cssi/SciSciGPT-SciSciNet huggingface dataset:
Emergency Department patients with suicide risk: Differences in care by acute alcohol use

Abstract Objective To compare Emergency Department (ED) care of suicidal patients with and without documented acute alcohol use. Methods Retrospective chart review of randomly sampled patient visits (n = 800; January 2014 to December 2015) at an urban ED with universal screening for suicide risk. Eligible visits were by adults (18+ years) who screened positive for suicide risk at the ED visit (i.e., suicidal ideation in past two weeks or suicide attempt in past six months). Analyses compared those with and without documentation of acute alcohol use. Results Among these patients with suicide risk, 19% had documented acute alcohol use (versus 43% with no use and 38% without documentation); individuals with acute alcohol use were more often male and aged 35–59 years. Overall, 62% were evaluated by a mental health professional in the ED. Individuals with acute alcohol use were significantly less likely (vs those without use) to be evaluated by a mental health professional in the ED (odds ratio 0.49, 95%CI 0.28–0.87) after adjustment for age, recent suicide ideation, current suicide plan, self-harm as a chief complaint, contact with family, and ED disposition. Conclusions Although alcohol use can increase suicide risk, ED patients with acute use appear to receive less thorough suicide risk assessments.
Notches in sentence spectra bias subsequent phoneme categorization

Spectral differences across earlier (context) and later (target) sounds are perceptually magnified, resulting in spectral contrast effects (SCEs) that bias categorization of later sounds. Most studies added spectral peaks to context sounds in order to produce SCEs, but noise contexts with spectral notches at speech frequencies biased phoneme categorization in a complementary manner (Coady et al., 2003 JASA). We tested whether this approach generalized to speech contexts with spectral notches. On each trial, a context sentence preceded the target phoneme (Experiment 1: /ɪ/-/ɛ/; Experiment 2: /d/-/g/). Sentences were processed by notch filters that attenuated energy in the same frequency regions that, when amplified to add spectral peaks, produced SCEs (Experiment 1: 100–400/550–850 Hz, as in Stilp et al., 2015 JASA; Experiment 2: 1700–2700/2700–3700 Hz, as in Stilp & Assgari, 2017 JASA). Notch depths ranged from −5 to −20 dB in 5-dB steps. In both experiments, notch-filtered sentences biased phoneme categorization in complementary directions to SCEs, with bias magnitudes increasing at larger notch depths. Whether earlier sounds have spectral peaks or notches, speech categorization is highly sensitive to the magnitudes of spectral differences across context and target sounds.Spectral differences across earlier (context) and later (target) sounds are perceptually magnified, resulting in spectral contrast effects (SCEs) that bias categorization of later sounds. Most studies added spectral peaks to context sounds in order to produce SCEs, but noise contexts with spectral notches at speech frequencies biased phoneme categorization in a complementary manner (Coady et al., 2003 JASA). We tested whether this approach generalized to speech contexts with spectral notches. On each trial, a context sentence preceded the target phoneme (Experiment 1: /ɪ/-/ɛ/; Experiment 2: /d/-/g/). Sentences were processed by notch filters that attenuated energy in the same frequency regions that, when amplified to add spectral peaks, produced SCEs (Experiment 1: 100–400/550–850 Hz, as in Stilp et al., 2015 JASA; Experiment 2: 1700–2700/2700–3700 Hz, as in Stilp & Assgari, 2017 JASA). Notch depths ranged from −5 to −20 dB in 5-dB steps. In both experiments, notch-filtered sentences biased phoneme catego...
Elevated arterial shear rate increases indexes of endothelial cell autophagy and nitric oxide synthase activation in humans

Previously, our group reported in bovine arterial and human arterial endothelial cells (ECs) that shear stress initiates trafficking of the autophagosome to the lysosome and increases endothelial n...
Engineering identity and communication outcomes: comparing integrated engineering and traditional public-speaking courses

ABSTRACTWe assessed the effectiveness of an integrated engineering public-speaking class relative to a traditionally taught public-speaking class. The integrated class was designed to meet the grow...
Quantitating bedside diagnosis: clinical evaluation of ascites.

The authors prospectively evaluated the operating characteristics of the history and physical examination for ascites in a broad spectrum of hospitalized patients. The overall clinical evaluation produced a positive likelihood ratio = 37.7−83.3 when suggestive of ascites, a likelihood ratio = 2.23−3.42 when intermediate, and a negative likelihood ratio = 0.77 − 0.90 when not suggestive of ascites. Patients’ perceptions of increased abdominal girth (positive likelihood ratio = 4.16) or recent weight gain (positive likelihood ratio = 3.20) increased the likelihood of ascites. The absence of subjective ankle swelling (negative likelihood ratio = 0.10) or increased abdominal girth (negative likelihood ratio = 0.17) decreased the likelihood of ascites. The positive likelihood ratios for a fluid wave = 9.6 and shifting dullness = 5.76 favored ascites, while the absence of bulging flanks (negative likelihood ratio = 0.12) or peripheral edema (negative likelihood ratio = 0.17) favored ascites the least. Thus, a routine history and physical examination are quantitatively useful in the clinical evaluation of ascites.
Anatomy of the Homicide Rise

After declining for over two decades, homicides in the United States rose sharply in 2015 and 2016. We dissect the homicide rise by characteristics of the victims, offenders, and incidents and devo...
Pharmacological characterization of a homomeric nicotinic acetylcholine receptor formed by Ancylostoma caninum ACR-16

Parasitic nematode infections are treated using anthelmintic drugs, some of which target nicotinic acetylcholine receptors (nAChRs) located in different parasite tissues. The limited arsenal of anthelmintic agents and the prevalence of drug resistance imply that future defense against parasitic infections will depend on the discovery of novel targets and therapeutics. Previous studies have suggested that Ascaris suum ACR-16 nAChRs are a suitable target for the development of antinematodal drugs. In this study, we characterized the pharmacology of the Ancylostoma caninum ACR-16 receptor using two-electrode voltage-clamp electrophysiology. This technique allowed us to study the effects of cholinergic agonists and antagonists on the nematode nAChRs expressed in Xenopus laevis oocytes. Aca-ACR-16 was not sensitive to many of the existing cholinomimetic anthelmintics (levamisole, oxantel, pyrantel, and tribendimidine). 3-Bromocytisine was the most potent agonist (> 130% of the control acetylcholine current) on the Aca-ACR-16 nAChR but, unlike Asu-ACR-16, oxantel did not activate the receptor. The mean time constants of desensitization for agonists on Aca-ACR-16 were longer than the rates observed in Asu-ACR-16. In contrast to Asu-ACR-16, the A. caninum receptor was completely inhibited by DHβE and moderately inhibited by α-BTX. In conclusion, we have successfully reconstituted a fully functional homomeric nAChR, ACR-16, from A. caninum, a model for human hookworm infections. The pharmacology of the receptor is distinct from levamisole-sensitive nematode receptors. The ACR-16 homologue also displayed some pharmacological differences from Asu-ACR-16. Hence, A. caninum ACR-16 may be a valid target site for the development of anthelmintics against hookworm infections.
Journalists in the 21st Century: Conclusions

Comparing journalists across national boundaries and cultures is no easier now than it was in the late 1990s when the ﬁ rst Global Journalist book was written. In fact, it is more complicated, given the dramatic changes in journalism during the past decade. In addition to the many characteristics, attitudes, and behaviors that could be said to depend on the speciﬁ c situation, there has been a blurring of the boundaries between journalism and other forms of public communication, and between journalists and those formerly known as media audiences. This makes it even more difﬁ cult, though not impossible, to look for general patterns and trends. There are still similarities that seem to cut across the boundaries of geography, culture, language, society, religion, race, and ethnicity, as well as diff erences that are not easily explained.
Pediatric leg ulcers: going out on a limb for the diagnosis

This article exhibits the most common differential diagnoses for pediatric leg ulcers and contrasts the etiologies with the adult population. The diagnoses are further categorized into hematologic, infectious, genodermatoses, and autoimmune etiologies to help the dermatologist deduce the accurate diagnosis in this unique patient population.
Swipe right for surgical residency: Exploring the unconscious bias in resident selection.

Abstract Background Applicants provide a photo with their application through the Electronic Residency Application Service, which may introduce appearance-based bias. We evaluated whether an unconscious appearance bias exists in surgical resident selection. Methods After the match, applicant data from the 2018 to 2019 and 2019 to 2020 application cycles were examined. Reviewers were not provided the applicant photo or self-identified race during the second cycle. Photos provided by candidates were then rated by 4 surgical subspecialty residents who had no prior exposure to applications or interview status. Photos were rated on perceived fitness level, visual appearance, and photo professionalism. An overall photo score was then calculated. Results In the study, 422 applications were reviewed and 164 received interview invitations during the 2018 to 2019 cycle. Alpha Omega Alpha membership (odds ratio, 2.31; 95% confidence interval, 1.18–4.51), overall photo score (odds ratio, 2.29, 95% confidence interval, 1.43–3.66), research (odds ratio, 5.61, 95% confidence interval, 2.84–11.20), age (odds ratio, 0.86, 95% confidence interval, 0.76–0.99), and step 2 (odds ratio, 1.06, 95% confidence interval, 1.03–1.09) were predictors for receiving an interview. For the 2019 to 2020 cycle, 398 applications were reviewed, and 75 applicants received an invitation. Step 2 (odds ratio, 1.07, 95% confidence interval, 1.02–1.12), research (odds ratio, 2.78, 95% confidence interval, 1.40–5.55), age (odds ratio, 0.82, 95% confidence interval, 0.71–0.95), and overall photo score (odds ratio, 2.27; 95% confidence interval, 1.14–4.52) remained predictors despite reviewers being blinded to the photo during this cycle. Conclusion Although objective metrics remain critical in determining interview invitations, overall perceived applicant appearance may influence the selection process. Although visual appearance was associated with receiving an interview, the Electronic Residency Application Service photo does not ultimately affect selection. This may suggest that appearance may influence other objective and subjective aspects of the application.
Predictions of adsorption energies of methane-related species on Cu-based alloys through machine learning

Abstract Recent studies show that the adsorption energy can be used as a descriptor of the catalytic activity in methane direct conversion. We develop Gaussian process regression models to predict DFT-calculated adsorption energies of CH4 related species – CH3 , CH2, CH, C, and H – on Cu-based alloys from elements’ readily available physical properties. As compared to conventional first-principle-based methods, the models are simple and fast to implement. They produce predictions with root mean squared errors of below 0.15 eV. The models also present numerical and statistical relationships between fundamental physiochemical parameters of doped elements and adsorption energies. Hence, they might be considered as efficient alternatives to the DFT approach for adsorption energy calculations, which allow for further assessments of certain solid catalysts’ catalytic performance.
Na+/H+ Exchangers in Epithelia

Cation/proton antiporters (CPAs), which include Na+/H+ exchangers, are evolutionarily ancient transporters present in most species from prokaryotes to higher eukaryotes. Many of them are expressed in epithelial cells or various organs, where they utilize the electrochemical gradient of one ion to transport another ion against its electrochemical gradient. In the intestinal and renal epithelia, NHEs are critical for vectorial transport of Na+, HCO3− and water, and consequently for the systemic volume and acid–base homeostasis. They also contribute to nutrient absorption, cellular proliferation, migration, and apoptosis, and modulate extracellular milieu, e.g., to regulate the intestinal microbial microenvironment. Their dysregulation, or in some instances, mutations, contributes to the human disease pathogenesis and some of the well-characterized Na+/H+ exchangers have been considered as attractive targets for pharmacological inhibition. In this chapter, we provide an overview of the members of the CPA superfamily of cation/proton antiporters, with particular focus on their roles in epithelial cells, their expression patterns, intracellular localization, regulation, and function, primarily as determined by gene targeting studies.
Astrocyte-Derived Thrombospondin Induces Cortical Synaptogenesis in a Sex-Specific Manner.

The regulation of synaptic connectivity in the brain is vital to proper functioning and development of the central nervous system (CNS). Formation of neural networks in the CNS has been shown to be heavily influenced by astrocytes, which secrete factors, including thrombospondin (TSP) family proteins, that promote synaptogenesis. However, whether this process is different between males and females has not been thoroughly investigated. In this study, we found that cortical neurons purified from newborn male rats showed a significantly more robust synaptogenic response compared to female-derived cells when exposed to factors secreted from astrocytes. This difference was driven largely by the neuronal response to thrombospondin-2 (TSP2), which increased synapses in male neurons while showing no effect on female neurons. Blockade of endogenous 17β-estradiol production with letrozole normalized the TSP response between male and female cells, indicating a level of regulation by estrogen signaling. Our results suggest that male and female neurons show a divergent response to TSP synaptogenic signaling, contributing to sex differences in astrocyte-mediated synaptic connectivity. Significance Statement The regulation of synaptic connectivity by astrocytes has been a focus of both the neurodevelopmental and glial biology fields for nearly two decades, but many key findings did not take into account the possibility of sex differences. For the first time, we show that a prominent astrocyte signaling factor, thrombospondin-2, strongly promotes synapse formation in male but not female neurons. Furthermore, this sex difference can be abolished by inhibiting production of 17β-estradiol, revealing that this astrocyte synaptogenic pathway is regulated by estrogen. Our findings should prompt serious consideration into the ramifications of sex and sex hormones on astrocyte synaptic signaling as well as encourage and inform future studies, including potential implications for neurodevelopmental disorders that present with strong sex biases.
In Older Adults, Aspirin Increases the Risk of Metastatic or Stage 4 Cancers and Cancer Mortality

In this large trial, older adults who received aspirin had higher rates of metastatic cancer, stage 4 cancer, and cancer mortality than those who received placebo.
Sharing and Commenting Facilitate Political Learning on Facebook: Evidence From a Two-Wave Panel Study

Social media, as sources of political news and sites of political discussion, may be novel environments for political learning. Many early reports, however, failed to find that social media use pro...
Implantable cardioverter-defibrillators with end stage renal disease: nationwide inpatient sample database results.

BACKGROUND When compared to patients with normal renal function, patients with chronic kidney disease develop higher in-hospital complications post implantable cardioverter-defibrillator (ICD) therapy. However, real world data on in-hospital complications post ICD therapy in patients with end stage renal disease (ESRD) is limited. In this study, we aim to explore the procedure-related complications of ICD therapy in patients with ESRD. METHODS Using the nationwide inpatient sample database, we conducted a retrospective analysis on ESRD patients who underwent inpatient ICD placement from 2010 to 2016. Using 1:2 propensity score matching, we compared ESRD patients to those with normal renal function. Outcomes of interest were postoperative hemorrhage and hematoma formation, blood transfusion, pericardial complications, mechanical complications requiring lead revision, vascular injury, in-hospital mortality, and length of stay. RESULTS Our sample included 40,075 cases with subsequent propensity score matching between ESRD and normal renal function. Comparatively, patients with ESRD had higher odds of postoperative hemorrhage (Odds ratio (OR) = 1.67, 95% confidence interval (CI) 1.4-1.99, P = <0.0001), blood transfusion (OR, 3.88; CI 3.29-4.56; P = <0.0001), mechanical complications requiring lead revision (OR, 1.24; CI 1.01-1.51; P = 0.035), vascular injury (OR, 2.02; CI 1.27-3.24; P = 0.0027), in-hospital mortality (OR, 4.56; CI 3.08-6.76; P = <0.0001), and longer hospitalization (11 days VS 7 days, P = <0.0001), but without significant difference in pericardial complications (OR, 1.9; CI 0.92-1.54; P = <0.18). CONCLUSION In this large contemporary cohort, patients with ESRD undergoing inpatient ICD therapy are at higher risk of developing post-procedural complications including hemorrhage and hematoma, blood transfusion, mechanical complications requiring lead revision, and in hospital mortality, without increased risk of pericardial complications. This article is protected by copyright. All rights reserved.
Nuclear and Cytoplasmic Functions of Abl Tyrosine Kinase

Publisher Summary This chapter focuses on the signaling functions of the mammalian Abl tyrosine kinase, with an emphasis on the role of nuclear Abl in cellular response to genotoxic stress. The Abl gene encodes a non-receptor tyrosine kinase that is conserved through evolution. The mammalian Abl contains three nuclear localization signals (NLSs). Disruption of all three NLSs is required to prevent Abl from entering the nucleus. Functional interactions between the N- and the C-terminal regions of Abl are suggested by the following observations: F-actin binding to the Abl C-terminus exerts a negative effect on its kinase activity only when the Abl SH2 domain is intact, and the three NLSs in the C-terminal region are subjected to regulation by the conformation of the kinase domain such that the constitutively active BCR-ABL does not undergo nuclear import but its NLSs can be reactivated by imatinib, which binds to the kinase N-lobe. The multiple functional domains of Abl direct its interaction with a large number of proteins, such as SH3 binding proteins, SH2 binding proteins, kinase domain binding proteins, and proline-rich motif binding proteins. In the cytoplasmic signaling function, Abl transduces a variety of extracellular signals to regulate F-actin dynamics.
Supervisor-Worker Relationship Affects Injury Rate

Two research studies on construction safety are presented in this paper. The primary focus is on how managerial styles and company policies can have a direct impact on safety performances. Results show that safer performances exist in those situations where the supervisor respects and acknowledges the worker's viewpoint in job-related conflicts. Situations where a dogmatic approach to conflict resolution was cited to prevail were associated with higher incidences of injuries. Greater assurance of job security exists, along with better safety performance, when the foremen do not have full authority in the firing of workers. In one study it was shown that managerial practices play a more vital role in reducing injuries in an open shop environment than in a union environment.
Hilbert modules over a class of semicrossed products

Given the disk algebra A(ID) and an automorphism ae, there is associated a non-self-adjoint operator algebra 2+ x ( A(ID) called the semicrossed product of A(ID) with ae. Buske and Peters showed that there is a one-to-one correspondence between the contractive Hilbert modules XH over Z+ x, A(ID) and pairs of contractions S and T on XH satisfying TS = Sa(T). In this paper, we show that the orthogonally projective and Shilov Hilbert modules Xover 2+ x A(ID) correspond to pairs of isometries on XH satisfying TS = Sa(T). The problem of commutant lifting for 2+ x ( A(ID) is left open, but some related results are presented.
Towards a better measure of protein 3D model quality

Advances in protein three-dimensional structure prediction depend strongly on the ability to measure the quality of a protein model. One of the best single measures of the model quality is the area under the graph of the so-called “GDT function” that assigns to each distance cutoff θ the percentage of residues in the model structure that can be superimposed at distance ≤ θ from the corresponding residues in the experimental structure. In lieu of a method capable of computing this measure, researchers often resort to its approximation GDTTS. In this short paper we present the first theoretical framework for the development of an algorithm capable of computing near-optimal estimates of the area under the GDT curve of a protein model in polynomial time.
A novel characterization of saddle-node bifurcation points for general nonlinear systems with decoupled parameters

The authors develop a new characterization for saddle-node bifurcations for a specific class of nonlinear dynamical systems. These particular dynamical systems depend on a parameter which is mathematically decoupled from the system states. The new characteristic equation is (n + 1)-dimensional and therefore computationally more efficient than the standard (2n + 1)-dimensional formulation generally utilized for n-dimensional general nonlinear systems. A new test function is proposed and shown to be monotonical in the vicinity of a saddle-node bifurcation point and therefore it is possible to monitor the approach to the saddle-node bifurcation point during the solution process, offering in this manner a definite advantage over the conventional approach in terms of control over the solution process. Some simulation results on a 234-bus power system are presented. >
Toward Automatic Tolerancing of Mechanical Assemblies: First-Order GD&T Schema Development and Tolerance Allocation

Geometric and dimensional tolerances must be determined not only to ensure proper achievement of design function but also for manufacturability and assemblability of mechanical assemblies. We are investigating the degree to which it is possible to automate tolerance assignment on mechanical assemblies received only as STEP AP 203 (nominal) geometry files. In a previous paper, we reported on the preprocessing steps required: assembly feature recognition, pattern recognition, and extraction of both constraints and directions of control (DoC) for assembly. In this paper, we discuss first-order tolerance schema development, based purely on assemblability conditions. This includes selecting features to be toleranced, tolerance types, datums, and datum reference frames (DRFs), and tolerance value allocation. The approach described here is a combination of geometric analysis and heuristics. The assumption is that this initial geometric dimensioning and tolerancing (GD&T) specification will be sent to a stack analysis module and iterated upon until satisfactory results, such as desired acceptance rates, are reached. The paper also touches upon issues related to second-order schema development, one that takes intended design function into account.
Fructose 6‐Phosphate 2‐Kinase:Fructose 2,6‐Bisphosphatase

This article has no abstract. Keywords: fructose 6-phosphate 2-kinase:fructose 2,6-bisphosphatase
On the use of the push-pull cannula as a means of measuring biochemical changes during ongoing behavior

Chronic indwelling push-pull cannulae (Gaddum, 1961) were implanted in the right lateral ventricles of two adult male and two adult female rats. Perfusion with artifical cerebrospinal fluid containing trace amounts of tritiated norepinephrine (H3-7-NE) was performed, under pentobarbital anesthesia, at rates of 20, 40, and 70 microl/min with two male rats and 40 and 70 microl/min with the female rats. Aliquots of perfusate were counted in order to determine if H3, from H3-7-NE varied as a function of perfusion rate, and volume loss, if any, was monitored by weighing tared collection vials. Perfusion of the male rats at 20 microl/min while they were working for food under fixed-ratio schedules of reinforcment indicated that this method might be used to study central biochemical-behavioral interactions using operant-conditioning procedures.
Challenges to adaptation: a fundamental concept for the shared socio-economic pathways and beyond

The framework for the new scenarios being developed for climate research calls for the development of a set of Shared Socioeconomic Pathways (SSPs), which are meant to differ in terms of their challenges to mitigation and challenges to adaptation. In order for the scenario process to fulfill its goals, the research and policy communities need to develop a shared understanding of these concepts. This paper focuses on challenges to adaptation .W e begin by situating this new concept in the context of the rich literatures related to inter alia adaptation, vulnerability, and resilience. We argue that a proper characterization of chal- lenges to adaptation requires a rich, exploration of the concept, which goes beyond mere description. This has a number of implications for the operationalization of the concept in the basic and extended versions of the SSPs. First, the elements comprising challenges to adaptation must include a wide range of socioeconomic and even some (non-climatic) biophysical factors. Second, careful consideration must be given to differences in these factors across scales, as well as cross-scale interactions. Third, any representation of the concept will require both quantitative and qualitative elements. The scenario framework offers the opportunity for the SSPs and full scenarios to be of greater value than has been the case in past exercises to both Integrated Assessment Modeling (IAM) and Impacts,
Parallelism and algorithms for algebraic manipulation: current work

We outline recent results relating to the use of parallelism for solving problems in algebraic manipulation. Practical issues are discussed.
Balloon Closure of Ventricular Septal Defect

A prototype double-lumen cardiac catheter with an inflatable disc balloon for interim closure of left-to-right shunts through the ventricular septum is described. Five clinical fatalities following ventricular septal rupture in the early postmyocardial infarction period were seen at New York University Medical Center from October, 1968 to March, 1970. Ventricular septal defects were made in nine acute dog experiments. Shunt sizes ranged from 2.2:1 to 4.8:1. Absence of shunting after balloon occlusion was confirmed by oxygen saturations, phonocardiography, and the hydrogen electrode method. Left ventricular angiography confirmed cardiac catheter positions. The feasibility of ventricular shunt occlusion in patients who are deteriorating from early postinfarction septal rupture is discussed.
Tritiation of the nitroxide spin labeled fatty acid 14‐proxylstearic acid

The nitroxide spin labeled fatty acid 14-proxylstearic acid (1) was tritium labeled (likely at the 2-position) by a platinum black catalyzed exchange reaction in tritiated hot aqueous potassium hydroxide. The recovery of pure tritiated 1 was 565, with a specific activity of 260 mCi/mM.
A ROLE FOR LAPAROSCOPY IN THE MANAGEMENT OF ADOLESCENTS WITH CHRONIC SALPINGITIS

The prevalence of venereal disease among adolescents has resulted in a rise in chronic salpingitis. Laparoscopy was evaluated as an aid in the diagnosis and treatment of chronic salpingitis in 21 adolescents over a 3 year period. Indications for laparoscopy included: failure to respond to a standard antibiotic regimen, persistence of adnexal mass, or preference in basing therapy on laparoscopic findings. The patients had a mean age of 17½ years and a mean duration of symptoms of 5½ months. Half of the patients had a recent history of vaginal discharge and/or bilateral pelvic pain and/or a history of previous treatment with penicillin. On examination, 55% had pain on motion of the cervix, 75% had adnexal tenderness, half had a palpable adnexal mass and 1 had a positive cervical culture for N.gonorrhoeae. Anatomic findings at laparoscopy included normal pelvic structures in 7, acute salpingitis in 7 and chronic adhesions or scarring in 7. Anaerobic, aerobic and viral peritoneal cultures obtained at laparoscopy from 14 patients resulted in no growth in 10. The 4 with positive cultures had 1 organism identified in each case. Since a definitive diagnosis was made in 21 patients undergoing laparoscopy, treatment could be individualized and consisted of observation in 5, initiation of antibiotic treatment in 12, cessation of antibiotics in 3 and salpingooophorectomy in 1. Anatomic findings were more helpful than the bacteriologic analysis. This experience suggests that laparoscopy increases diagnostic accuracy in management of chronic salpingitis.
Differential expression of chemokines and chemokine receptors during microglial activation and inhibition

Intrauterine infection produces an inflammatory response in the fetus characterized by increased inflammatory cytokines in the fetal brain and activation of brain microglial cells. Intrauterine infection can release bacterial cell wall products into the fetal circulation. Lipopolysaccharides (LPS) are derived from the cell walls of gram negative organisms. The degree of microglial cell activation may influence the extent of brain injury following an inflammatory stimulus. Chemokines, which are released by activated microglia, regulate the influx of inflammatory cells to the brain. Accordingly, therapeutic strategies that reduce the extent of chemokine expression in microglial cells may prove neuroprotective. Minocycline (MN), a semisynthetic tetracycline derivative, protects brain against global and focal ischemia in rodents and inhibits microglial cell activation. To determine if minocycline can reduce the production of chemokines and chemokine receptors in response to LPS, microglial-like BV-2 and HAPI cells were cultured in the presence or absence of 100 ng/ml of LPS. Enzyme-linked immunosorbent assay (ELISA) and semi-quantitative RT-PCR were used to examine changes in inflammatory chemokines (macrophage inflammatory protein-1 (MIP-1alpha), regulated upon activation, normal T cell expressed and secreted (RANTES), and inducible protein-10 (IP-10)) and chemokine receptor (C-C chemokine receptor 5 (CCR5) and C-X-C chemokine receptor 3 (CXCR3)) production, respectively. We found that in both cell lines chemokine release after 4-, 8-, and 16-h exposure to LPS was significantly higher compared to non-exposed cells for all the chemokines measured, P<0.001. Minocycline inhibited chemokine release of LPS-stimulated BV-2 cells. There was even greater inhibition (up to 50%) of mRNA expression after exposure to LPS (P<0.001). We conclude that endotoxin enhanced the expression of chemokines and chemokine receptors in microglial-like cell lines. Modulation of this expression was achieved with minocycline. Recognition of the mechanisms whereby minocycline exerts its anti-inflammatory effect on microglia may uncover specific targets for pharmacologic intervention.
Outbreak of adenovirus type 30 in a neonatal intensive care unit.

Objectives To describe an outbreak of adenovirus, type 30, in a neonatal intensive care unit (NICU). Study design This was a retrospective, observational study. Results An outbreak of adenovirus infection occurred in an NICU. It lasted 6 months and involved 21 of 333 (6.3%) infants. The introduction of infection control measures controlled the outbreak; however, premature discontinuation of the measures resulted in a second wave of cases. The virus caused pneumonia in 7 infants, conjunctivitis in 7 infants, pneumonia and conjunctivitis in 1 infant, and upper respiratory tract illness in 1 infant. Infection was asymptomatic in 5 infants. Six infants died. Death was associated with the presence of pneumonia ( P =.0001), administration of steroids ( P =.003), and mechanical ventilation ( P =.02). Investigation into the origin of the outbreak suggested that the virus may have been introduced and spread during ophthalmologic procedures. Conclusions Adenovirus type 30 can cause severe disease among premature infants in an NICU. Infants with severe bronchopulmonary dysplasia requiring mechanical ventilation are more likely to have development of adenovirus pneumonia and die. Standard infection control measures are effective in controlling an outbreak. Ophthalmologic procedures continue to be a potential source of adenovirus outbreaks.
Genetics: new HLA variants could predict T1DM risk in African Americans.

A recent study has identified novel African-derived haplotypes, previously unreported in white people, which predispose to or are protective against type 1 diabetes mellitus (T1DM) in African Americans. These findings could have important implications for T1DM disease risk and prognosis assessment in African Americans.
Temperature Dependence and Gas-Sensing Response of Conduction for Mixed Conducting SrFe y Co z O x Thin Films

A series of SrFeyCozOx thin films on sapphire substrates was prepared by laser deposition and the conductance responses to both temperature and gas composition in O2 /N 2 mixtures were examined. All films exhibited p-type semiconductor behavior with film conductivities at 500°C between 20 and 200 S/cm for films exposed to 100% O 2 atm and 0.4-25 S/cm for films exposed to 0.2% O2 . At 500°C, thin films of compositions SrFe yCo12yOx , 0.25 < y < 0.75, were found to be the most conductive for oxygen partial pressures between 0.002 , pO2 , 1.0 atm. SrFeOx and SrFe1.3Co0.2Ox films were found to be the least conductive under these conditions. SrFe0.25Co0.75Ox and SrFe0.5Co0.5Ox films were found to exhibit regions where conductivity exhibited temperature independence between 200 < T < 500°C for oxygen concentrations between 0.2 and 100% O 2 . The temperature independence was interpreted as the result of a balancing of two opposing thermal effects: thermal activation of charge carriers and thermal-induced oxygen stoichiometry changes. For some films, enhanced oxygen sensitivity was observed over narrow pO2 regions, and is attributed to cubic perovskite to brownmillerite phase transitions. CO and H 2 gases could be detected in background air for conditions where there is negligible temperature dependence of conduction. © 2002 The Electrochemical Society. @DOI: 10.1149/1.1470661# All rights reserved.
“Selling the store” to the HMO: A life insurance contract for optimal provision of care

Abstract Health care is a credence good: consumers must consult an expert who diagnoses and repairs a problem. Since effort is difficult to monitor, fraud or low effort are possible. This paper proposes “selling the store” to an HMO via a life insurance contract. The HMO becomes a residual claimant, avoiding payment as long as the patient is alive. This contract forces the HMO to provide a specified level of care, even when a patient does not know his initial level of health. This contract solves several problems associated with fraudulent diagnosis and low effort, but is not a panacea.
Peripheral and central administration of cocaine produce conditioned odor preferences in the infant rat

Abstract To assess the development of the reinforcing properties of cocaine, 3- to 4-day-old rat pups were administered cocaine s.c (3.0–30.0 mg/kg), intracerebroventricularly (3.0–10.0 μg/injection), or directly to the nucleus accumbens (1–25 μg/injection) in the presence of a distinctive odor. Six to 8 h later, pups were allowed a choice between the paired odor and a non-paired odor. Compared to saline treated controls, pups demonstrated a preference for the odor paired with cocained for each route of administration. Taken together with previous work demonstrating that cocaine increases responding for electrical self-stimulation of the basal forebrain, these results suggest that cocaine is rewarding in the infant animal and that mesolimbic structures may mediate, at least in part, those reinforcing properties.
Stabilization of the reduced halocarbon-cytochrome P-450 complex of halothane by N-alkanes

Under anaerobic conditions, various halogenated compounds, when metabolized by cytochrome P-450, form complexes which are spectrally detectable. Previous studies have shown that halothane forms such a complex with cytochrome P-450, and the result is a strong absorption at 470 nm. Stabilization of this proposed intermediate carbanion complex has never been demonstrated in a biological system. Data are presented which show that several organic solvents (C5-C7N-alkanes) will stabilize the complex formed between halothane and cytochrome P-450. Stabilization allowed the decay of the complex to be studied, and it is demonstrated that the product of decay was chlorodifluoroethylene, which substantiates the hypothesis that the complex is a two electron-reduced carbanion. Carbon tetrachloride and benzyl bromide, which also produce spectrally visible intermediate complexes, were not stabilized by this treatment. Stabilization of the halothane complex in a biological system may facilitate studies to identify precisely the halothane-cytochrome P-450 complex and to clarify the mechanisms of halothane reduction by cytochrome P-450.
Antiplatelet drug 'resistance'. Part 2: laboratory resistance to antiplatelet drugs—fact or artifact?

Many patients experience recurrent ischemic events despite optimal antiplatelet therapy. This has generated much interest in finding a laboratory test of platelet function to identify such patients, who have been termed 'nonresponders' or antiplatelet 'resistant'. Laboratory tests of platelet function have identified 'resistance' in 5-60% of patients taking aspirin and 4-30% of those taking clopidogrel. However, these tests of 'resistance' have not correlated closely with subsequent recurrent events, and have not reliably identified nonresponders to antiplatelet therapy. Here, we identify and discuss three major limitations common to all these tests. Firstly, they are performed on citrate-anticoagulated blood, secondly, blood is stored for a variable period of time, and thirdly, the assessment of thrombotic status on the basis of platelet response to only one or two agonists ignores the complexity of the mechanism of platelet thrombus formation in vivo. In this Review we discuss the significance of these important limitations, and the applicability of such in vitro platelet function tests to the prediction of in vivo events. We conclude that such tests are so unphysiological that they cannot reliably predict the true thrombotic status of patients. Identification of 'resistance' on the basis of these tests lacks sensitivity and specificity for identifying thrombotic risk, and is likely to be artifactual.
Sensitivity of dielectric resonators to environmental conditions

The effects of the variation of different physical parameters in a simple, shielded dielectric resonator structure is studied. The study uses an approximate analytical expression for the resonance frequency stability of dielectric resonators. The results are of special importance in applications where the dielectric resonators are subjected to varying environmental conditions.
Digital optical switch based on amorphous silicon waveguide

In this paper, the performance of a digital optical switch, operating at the infrared communications wavelength of 1550 nm and based on the thermo-optic effect in amorphous silicon, are investigated. We prove that the strong thermo-optic effect of amorphous silicon, combined with the possibility of realising micrometric integrated structures, allow the design of promising integrated switches. The device, designed for low-cost photonic applications, could be easily integrated in silicon optoelectronic circuits.
Preserving the Multi‐service Concept in the Change from Entrepreneurial to Professional Management

Close inspection of many services reveals them to be multiple services (multi‐services). Many others, such as ski resorts, entertainment centres, motorway service complexes and restaurant/hotel developments, are more obviously of a multi‐service type. The inter‐relationship of the component services of a multi‐service is often closely held by the entrepreneur during the early stages of the venture, and may still be the subject of experimentation. Moving from entrepreneurial to professional management requires definition of these service inter‐relationships. Division of the concept into its components to simplify control, and the use of separate performance maximising incentives are hazardous approaches. The first objective of new control systems should be to replicate the entrepreneurial multi‐concept service. Experimentation should be left until later.
Clefts and microtubules of photoreceptor outer segments in the retina of the domestic cat

Transverse sections of cat photoreceptor outer segments, at several levels, were examined in the electron microscope. Rod disks usually had three shallow clefts. Single ciliary microtubules faced individual clefts and were observed close to the outer segment tip. Cone disks had a single cleft that deepened sclerally and subdivided the outer segment tip into two lobules. Ciliary microtubules also were positioned opposite the cleft in cone disks as far as the outer segment tip. The edge membrane of the clefts may be a preferred route for metabolic exchange between outer segment disks and cytoplasm.
CO2 recycling using microalgae for the production of fuels

CO2 capture and recycle using microalgae was demonstrated at a coal-fired power plant (Duke Energy’s East Bend Station, Kentucky). Using an in-house designed closed loop, vertical tube photobioreactor, Scenedesmus acutus was cultured using flue gas as the CO2 source. Algae productivity of 39 g/(m2 day) in June–July was achieved at significant scale (18,000 L), while average daily productivity slightly in excess of 10 g/(m2 day) was demonstrated in the month of December. A protocol for low-cost algae harvesting and dewatering was developed, and the conversion of algal lipids—extracted from the harvested biomass—to diesel-range hydrocarbons via catalytic deoxygenation was demonstrated. Assuming an amortization period of 10 years, calculations suggest that the current cost of capturing and recycling CO2 using this approach will fall close to $1,600/ton CO2, the main expense corresponding to the capital cost of the photobioreactor system and the associated installation cost. From this it follows that future cost reduction measures should focus on the design of a culturing system which is less expensive to build and install. In even the most optimistic scenario, the cost of algae-based CO2 capture is unlikely to fall below $225/ton, corresponding to a production cost of ~$400/ton biomass. Hence, the value of the algal biomass produced will be critical in determining the overall economics of CO2 capture and recycle.
Fine-needle aspiration of supraclavicular lymph nodes

Malignancies from many primary sites may metastasize to supraclavicular lymph nodes (SCLN). We reviewed 100 fine-needle aspirations (FNAs) of SCLNs. There were three major types of malignancy detected by this method: adenocarcinoma (n=40), squamous cell carcinoma (n=14), and other malignancies (n=29). Adenocarcinomas and other malignancies from all sites tended to metastasize to the left SCLN. Squamous cell carcinomas from all sites, however, tended to appear on the right side. For 61 patients, a previous diagnosis of malignancy had been made within 1 yr of the clinical appearance of the abnormal SCLN. For 20 patients, the primary diagnosis antedated SCLN metastasis by more than 1 yr, particularly patients with adenocarcinoma of the breast. prostate, or thyroid papillary carcinoma. Diagn Cytopathol 1996 14:216-220. © 1996 Wiley-Liss, Inc.
Production of tumor necrosis factor α and interferon γ in interleukin-2-treated melanoma patients: Correlation with clinical toxicity

Interleukin-2 (IL-2)-based immunotherapy regimens are accompanied by dose-limiting toxicity consisting of fever, tachycardia, chills and capillary leak syndrome. We hypothesized that the toxicity was caused by the induction and release of endogenous cytokines such as tumor necrosis factor α (TNFα) and interferon γ (IFNγ). We measured the serum levels of TNFα and IFNγ in IL-2-treated melanoma patients and attempted a correlation with clinical toxicity. A total of 23 patients received either 6 × 106 IU or 12 × 106 IU Cetus IL-2/m2 by i. v. bolus daily for 5 consecutive days on weeks 1, 3 and 5. Serum TNFα and IFNγ levels were measured by enzyme-linked immunosorbent assay. Clinical toxicity was scored each day by objective measurements of hypotension, tachycardia, fever and chills/rigors. Clinical toxicity and IFNγ levels correlated nicely, peaking on the 5th day of each treatment cycle. The kinetics and magnitude of TNFα production, however, were not predictable and did not correlate with either IFNγ or toxicity. Some patients had modest increases in TNFα production while others had markedly increased levels during the second and third treatment weeks. Remarkably, these high levels persisted during nontreatment weeks and after completion of therapy. This clinical study demonstrates novel kinetics for immunoreactive TNFα in IL-2 cancer patients, which do not correlate well with toxicity.
Epinephrine versus Vasopressin in Adult Cardiac Arrest: Role of Agonal Respirations and Patient Age

A review of the literature regarding the use of vasopressin versus epinephrine in the treatment of out-of-hospital cardiac arrest recommends initially administering 1 mg of epinephrine, followed by alternating doses of vasopressin 40 IU and epinephrine 1 mg every 3 minutes in adults, regardless of the initial electrocardiographic rhythm. The American Heart Association-Emergency Cardiac Care Committee (AHA-ECCC) adopted this position in its recent recommendations. However, further research is required to determine whether epinephrine should always be the initial agent regardless of the initial cardiac rhythm or whether other factors need to be considered. A review of evidence that may have been overlooked by the AHA-ECCC argues for the need to consider the presence of spontaneous agonal ("gasping") respirations and patient age before determining which vasopressor to use first.
Hemorrhagic Complications of Pancreatitis: Radiologic Evaluation with Emphasis on CT Imaging

Objective: To analyze and describe the incidence, pathophysiology, radiographic diagnosis and the initial management of hemorrhagic complications associated with pancreatitis. <i
Gap junction channel gating and permselectivity: their roles in co-ordinated tissue function.

SUMMARY 1. The gating and permselective properties of gap junction channels are important parameters to determine in delineating their role in co-ordinated tissue function. This is of particular relevance in non-excitable tissues. 2. In the present study gating characteristics of rCx43 are demonstrated. The mean open times are of the order of 0.45-1.1 s. These values are extraordinarily large. 3. The permselectivity of a variety of gap junction channels is also illustrated to show the poor selectivity properties of gap junctions and, hence, their potential to allow the permeation of second messenger molecules. 4. Gating and permselectivity, along with diffusion modelling, produce a picture for gap junction channels that is consistent with physiologically relevant modulation or regulation of gap junction channel patency.