cssi/SciSciGPT-SciSciNet huggingface dataset:
Innovative Collaboration between a Medical Clinic and a Community Pharmacy: A Case Report.

As value-based payments become more common in healthcare, providers can develop collaborative relationships to support performance. A medical clinic and community pharmacy worked together to deliver collaborative medication management services to targeted patients in an accountable care organization. The community pharmacy was paid by the clinic to conduct comprehensive medication reviews (CMRs) for 116 patients. The CMRs initially were delivered to patients taking at least 10 medications and to patients rated as high cost/risk by the clinic. The most common medication-related problem types were Needs additional therapy (38.8%) and Suboptimal therapy (19.0%). The most common pharmacist actions were to Change medication (18.1%) and Initiate new therapy (13.8%). Financial analyses showed net savings in annual patient out-of-pocket expenses just over $15,000 for the cohort of patients, and net annual direct cost savings from a payer perspective of about $70,000. This innovative partnership between a medical clinic system and a regional pharmacy chain built upon initial discussions and planning. The partners were able to address problems that arose with their collaboration, changing their approach as needed. The outcomes were positive for the clinic and pharmacy, their patients and the payer(s). Interested providers are encouraged to pursue similar collaborations, which could be key to success in today’s healthcare environment.
Surgical Repair of Thoracoabdominal Aortic Aneurysms

The frequency of paraplegia or paraparesis following aortic surgery is shown in Table 1. In a review of 1509 patients with thoracoabdominal aortic aneurysm (TAAA), the incidence of paraplegia was 15% in extent I aneurysm, 31% in extent II, 7% in extent III, and 4% in extent IV (P < 0.0001).
Social Validity and Treatment Integrity Data: Reporting in Articles Published in the Journal of Developmental and Physical Disabilities, 1991-1995

In general, social validity data reflect the social significance of target behaviors, the appropriateness of procedures, and the perceived importance of results. Intervention integrity data provide evidence that treatments are implemented in the intended fashion. The present paper discusses social validity and intervention integrity data and considers their possible importance. It also reports how often such data were reported in treatment articles published in theJournal of Developmental and Physical Disabilities from 1991 through 1995. Social validity data were presented in 5 of 39 treatment articles (13%). Intervention integrity data were presented in 9 of 39 articles (23%). When social validity data were presented, reliability and validity of the measures were never discussed. Although it is not necessary to assess social validity or intervention integrity to conduct a quality study, or to publish such a study in theJournal of Developmental and Physical Disabilities, doing so is in many cases relatively easy, and may help readers to evaluate the scientific and practical importance of reported findings.
A single or short time repeated arsenic oral exposure in mice impacts mRNA expression for signaling and immunity related genes in the gut.

Arsenic is prevalent in contaminated drinking water and affects more than 140 million people in 50 countries. While the wide-ranging effects of arsenic on neurological development and cancer draw the majority of concern, arsenic's effects on the gut mucosa-associated immune system are often overlooked. In this study, we show that 24 h after a single dose [low dose (50 μg/kg bw), medium dose (100 μg/kg bw) or high dose (200 μg/kg bw)] of arsenic by oral gavage, mice show significantly reduced gut mucosa-associated mRNA expression for the key genes involved in the signaling pathways central to immune responses, such as Nuclear factor κB (NFκB), Extracellular signal-regulated protein kinases 1 and 2 (ERK1/2), p38 and Myeloid differentiation protein 88-dependent (Myd88) pathways. Additionally, mRNA expression of apoptosis, inflammasomes and inflammatory response genes are significantly downregulated in the animals exposed to arsenic. Comparisons of time-dependent effects (24 h vs 48 h) from low dose arsenic exposed animals showed a significant shift in expression of Myd88 alone, suggesting that the down regulation was sustained for the key genes/signaling pathway. An extended eight-day exposure to arsenic showed a decreased state of immune preparedness, though not as diminished as seen in the single dose exposure.
Transvenous management of cardiac implantable electronic device late lead perforation.

INTRODUCTION Late lead perforation (LLP), defined as perforation ≥30 days from cardiac implantable electronic device implant, is a rare diagnosis and little data exist regarding management practices and outcomes. The purpose of this study was to evaluate the occurrence, safety, and efficacy of transvenous management of clinically significant LLP. METHODS The electronic medical records of a single-center tertiary hospital were reviewed for all patients who were referred for LLP or its sequelae. RESULTS Eleven consecutive patients were identified from October 2011 to December 2018 with clinically significant LLP. Patients most often presented with pericardial symptoms with the exception of one asymptomatic patient. The median time from lead implant to intervention for LLP was 246 days. Nine patients were managed with an initial transvenous approach, with one requiring sternotomy (lead 6.3 years old). Two patients had a surgical approach, one performed at an outside hospital with subsequent death and another had a mini-thoracotomy, but the lead was removed percutaneously with no surgical repair. In this small cohort, there was no association between the lead extending beyond the parietal pericardium and surgical repair (P = .99). CONCLUSION Our single-center experience suggests that LLP can be initially managed with a cautious transvenous approach in most patients, but intraprocedural ultrasound for pericardial monitoring and a rescue plan with immediate surgical back up is mandatory.
Recent development of repairable, malleable and recyclable thermosetting polymers through dynamic transesterification

Abstract A fully polymerized (cured) thermoset is no longer capable of flow like a thermoplastic to be recycled and reprocessed into a new object. Developing repairable, malleable and recyclable thermoset is necessary to reduce the ever-increasing polymer waste as well as to extent the service life of the existing polymer materials. As a new class of “recyclable” and/or “reprocessable” crosslinked polymer, “vitrimers” have just emerged in the recent decade. Vitrimers are permanently crosslinked polymers based on dynamic covalent networks. Such networks are stable at the service temperature yet become labile and reprocessable at elevated temperatures due to stimulus activated bond-exchange reactions. Because vitrimers combine the advantages of both thermosets and thermoplastics, they have received extensive attention. There are many vitrimer chemistries that have been reported. In this review, the discussion is focused on the developments of vitrimers based on dynamic transesterification reaction (DTER) between hydroxy groups and ester bonds, which is one of the most representative vitrimer chemistries. This review mainly includes the discussions of synthetic methods, vitrimer behaviors, application developments, and recycling methods. In addition, the challenges and outlook are also provided.
A note on means of entire functions

A result of Singh and Sreenivasulu is proved under less restrictive hypothesis. It is also shown that if a condition on the coefficients is not satisfied, the theorem will not hold.
Focal Therapy: Current Status and Future Directions

Advances in understanding the natural history and molecular characterization of prostate cancer have ushered in an era of expanding treatment options for patients with localized disease. Focal ablative technologies have emerged as innovative, organ-sparing management strategies to eradicate tumors and preserve quality of life by decreasing posttreatment morbidity. Controversy surrounding the use of focal therapy involves the rationale for targeting an index lesion (as opposed to all cancer in the gland) and the possibility of understaging and undertreatment. The accurate assessment of disease risk remains imperfect, as it depends on the known limitations of biopsy and imaging data. Despite improvements in characterizing low-risk disease with the use of confirmatory biopsies or multiparametric MRI, studies are needed that will establish methods for effectively monitoring the disease after focal therapy to identify disease progression. The potential value of focal therapy has shifted from treating very low-risk cancer to treating higher-risk cancers early in their development, with the intent of providing effective local cancer control with negligible impact on quality of life. Coordinated efforts are therefore needed to reclassify localized disease states based on our current biological understanding of prostate cancer and to standardize designs for prospective clinical trials that can define the clinical benefit of focal therapy in men with prostate cancer. In the future, a tailored approach to prostate cancer management will offer a range of effective treatment options in which active surveillance, focal therapy, and radical surgery or radiotherapy form a continuum of complementary therapies.
Developing music streaming as an adjunct digital therapy for depression: A survey study to assess support from key stakeholders

Abstract Background Advancements in digital health technologies, including mobile medical apps and therapeutic video games, have shown clinical benefits in people living with chronic diseases. To improve therapy outcomes of antidepressants or cognitive behavioral therapies, music-based modulation of affective states can be employed in digital therapeutics for depression. This study aimed to evaluate whether key stakeholders support development of music streaming as an adjunct digital therapy for depression. Methods A survey was distributed to individuals who identified as people living with depression and their caregivers, healthcare providers, healthcare insurance companies, pharmaceutical/medical device industry, internet/software/electronic companies, musicians/artists/audio engineers, and regulatory consultants. The online questionnaire included Likert-scale questions assessing the participant's level of support for developing music streaming as an adjunct therapy for depression. Results Out of 81 total responses, 69 responses were complete. Thirty-eight (55%) responders identified as a patient living with depression or their caregiver. The remaining 31 participants (45%) identified as other key stakeholders. There was a significant interest in developing music streaming as adjunct digital therapy for depression; 88% percent of responders selected “strongly agree” or “somewhat agree” on the statement “I support development of music streaming as digital therapy for depression”. Limitations Small sample size and potential selection bias are limitations of this study. Conclusion Among identified key stakeholders, there is an interest in the development of music streaming as an adjunct digital therapy for depression. Our study confirms opportunities for incorporating music as an “active ingredient” in adjunct digital therapies for depression.
The Impact of Dental Insurance and Medical Insurance on Dental Care Utilization During Pregnancy.

To measure the association between dental and medical insurance with the receipt of dental cleaning during pregnancy. We analyzed Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2012 to 2015 on 145,051 women with a recent live birth from 36 states. We used adjusted prevalence ratios [aPR] from multivariable regression to examine the association of dental and medical insurance with receipt of dental cleaning during pregnancy, controlling for selected covariates that influence dental care utilization. Seventy-seven percent (77%) of all women reported having dental insurance during pregnancy. Receipt of dental cleaning before pregnancy was strongly associated with dental cleaning during pregnancy. Among women without pre-pregnancy dental cleaning who had dental insurance, those with Medicaid medical insurance had a significantly higher prevalence of dental cleaning during pregnancy [aPR = 1.42, 95% CI (1.32 − 1.52)], compared to those private medical insurance. Among women without pre-pregnancy dental cleaning, those without dental insurance but with Medicaid medical insurance were about 70% less likely to have dental cleaning during pregnancy compared to those with dental and private medical insurance. With or without dental insurance, pre-pregnancy dental cleaning was strongly associated with dental cleaning during pregnancy. Dental insurance was an important determinant of dental utilization. Medical insurance had an independent and positive effect. This effect varied by private versus Medicaid medical insurance. Programs which provide women with dental insurance both before and during pregnancy could improve the oral health of maternal and infant populations.
Management of Impacted Teeth in Patients with Congenital Clefts

SUMMARY Children born with clefts of the lip and palate present many challenges requiring multidisciplinary interaction. Although not as dramatic as some of the other aspects of overall treatment from birth to adulthood, management of impacted teeth is an integral part of the therapy contributing to successful rehabilitation. Proper application of intercep-tive orthodontics, timing, meticulous surgery, careful reapproximation of tissues, and management of impacted teeth are mandatory to ensure the balanced growth of cleft structures leading to a well-proportioned adult facial profile.
About Power Absolute Integrated of the Solution of Volterra System of Linear Second Kind Integral Equations on Half-axis

Sufficient conditions are established such as the sign of the functions of absolute and quadratic integrability on the half-axis of the components of the solution of a linear system of Volterra-type integral equations of the second kind in the new formulation, namely, without the assumption that the components of the free term possess the properties under study. To achieve the intended goals, the matrix method of weight functions, the matrix method of cutting functions, the matrix method of partial cutting of the author, and the method of integral inequalities of Ya. V. Bykov are developed. The results obtained in this paper are generalizing for linear scalar and vector integral equations previously considered by the author. Note that some matrix cutting functions introduced introduce a quadratic trinomial of some expressions from the terms of the kernel and the free term in such a way that the core actually absorbs the bad properties of the free term (external force). Note that growth, nonsmoothness, alternating terms of the terms of the kernel and the free term are cut off. It should also be emphasized that the kernel and the free term of the considered system of equations consist additively of two kernels, the terms of the first kernel are cut off by both arguments, the terms of the second kernel are cut off by the second argument, i.e. in part, it is shown that the conditions imposed on these two cores are different, i.e. do not intersect. The introduction of a certain matrix weight function helps to establish the absolute integrability on the half-axis of the solution component of the system under consideration, and it plays a decisive role. At the end, the simplest illustrative example is given, which shows that the results of the present article are also new for the scalar linear integral equation of the Volterra type of the second kind on the semiaxis.
Weight loss after Roux-En-Y gastric bypass surgery reveals skeletal muscle DNA methylation changes

The mechanisms of weight loss and metabolic improvements following bariatric surgery in skeletal muscle are not well known; however, epigenetic modifications are likely to contribute. The aim of our study was to investigate skeletal muscle DNA methylation after weight loss induced by Roux-en-Y gastric bypass (RYGB) surgery. Muscle biopsies were obtained basally from seven insulin-resistant obese (BMI > 40 kg/m2) female subjects (45.1 ± 3.6 years) pre- and 3-month post-surgery with euglycemic hyperinsulinemic clamps to assess insulin sensitivity. Four lean (BMI < 25 kg/m2) females (38.5 ± 5.8 years) served as controls. We performed reduced representation bisulfite sequencing next generation methylation on DNA isolated from the vastus lateralis muscle biopsies. Global methylation was significantly higher in the pre- (32.97 ± 0.02%) and post-surgery (33.31 ± 0.02%) compared to the lean (30.46 ± 0.02%), P < 0.05. MethylSig analysis identified 117 differentially methylated cytosines (DMCs) that were significantly altered in the post- versus pre-surgery (Benjamini–Hochberg q < 0.05). In addition, 2978 DMCs were significantly altered in the pre-surgery obese versus the lean controls (Benjamini–Hochberg q < 0.05). For the post-surgery obese versus the lean controls, 2885 DMCs were altered (Benjamini–Hochberg q < 0.05). Seven post-surgery obese DMCs were normalized to levels similar to those observed in lean controls. Of these, 5 were within intergenic regions (chr11.68,968,018, chr16.73,100,688, chr5.174,115,531, chr5.1,831,958 and chr9.98,547,011) and the remaining two DMCs chr17.45,330,989 and chr14.105,353,824 were within in the integrin beta 3 (ITGB3) promoter and KIAA0284 exon, respectively. ITGB3 methylation was significantly decreased in the post-surgery (0.5 ± 0.5%) and lean controls (0 ± 0%) versus pre-surgery (13.6 ± 2.7%, P < 0.05). This decreased methylation post-surgery was associated with an increase in ITGB3 gene expression (fold change + 1.52, P = 0.0087). In addition, we showed that ITGB3 promoter methylation in vitro significantly suppressed transcriptional activity (P < 0.05). Transcription factor binding analysis for ITGB3 chr17.45,330,989 identified three putative transcription factor binding motifs; PAX-5, p53 and AP-2alphaA. These results demonstrate that weight loss after RYGB alters the epigenome through DNA methylation. In particular, this study highlights ITGB3 as a novel gene that may contribute to the metabolic improvements observed post-surgery. Future additional studies are warranted to address the exact mechanism of ITGB3 in skeletal muscle.
Piloting a high-fidelity postpartum hemorrhage simulation with prelicensure nursing students: Evaluating knowledge, confidence, and satisfaction

Abstract Postpartum hemorrhage (PPH) is a medical emergency that is the primary cause of nearly one-quarter of all maternal deaths worldwide. Prelicensure nursing students are often underprepared to respond to obstetrical emergencies, such as PPH, due to a lack of exposure in the clinical setting. Simulation is used to aid students in developing knowledge, skills, and attitudes in clinical learning and emergency scenarios. The purpose of this pilot study was to evaluate student knowledge before and after participation in a high-fidelity simulation of a patient experiencing PPH. Student confidence and satisfaction after the experience was also assessed. Findings demonstrated that high-fidelity simulation significantly increased student knowledge related to PPH nursing care (p = 0.001). Student perceived confidence and satisfaction were also aggregately rated at 95% after the simulation experience. The PPH scenario utilized is described, and implications of implementing simulation in prelicensure nursing programs are discussed.
Is Authoritarian International Law Inevitable? Symposium Introduction

Tom Ginsburg’s powerful article “Authoritarian International Law” warns that as democracy declines within countries, the character of interstate relations changes as well. Six prominent scholars invited to offer critiques also chose to underscore the importance of Ginsburg’s core thesis, by pointing out even darker implications, and proposing modes of resistance. This introductory essay previews some major questions and contributions.
Next-Generation Global And Mesoscale Atmospheric Models

Abstract : The long-term goal of this research is to construct a unified global and mesoscale nonhydrostatic numerical weather prediction (NWP) models for the U.S. Navy using new numerical methods specifically designed for modern computer architectures; this unified model is called the Nonhydrostatic Unified Model of the Atmosphere or NUMA. To take full advantage of distributed-memory computers, the global domains of these new models are partitioned into local sub-domains, or elements, that can then be solved independently on multiple processors and graphical processing units or GPUs. The numerical methods used on these sub-domains are local, high-order accurate, fully conservative, highly efficient, and geometrically flexible. Using these ideas we are developing global and mesoscale nonhydrostatic atmospheric models that will improve the operational models currently used by all U.S. agencies including the U.S. Navy.
Theory of self-assembled smectic-A crenellated disks: Membranes with cusped edges

Smectic-$A$ monolayers self-assembled in aqueous solutions of chiral $\mathit{fd}$ viruses and a polymer depletant have been shown to exhibit a variety of structures, including large, flat disks and twisted ribbons. The virus particles twist near the edge of the structure in a direction determined by the chirality of the viruses. When $\mathit{fd}$ viruses and their mutants of opposite chirality are mixed together in nearly equal amounts, unusual structures referred to as ``crenellated'' disks can appear. These disks are achiral overall but the twist at the edge alternates between left- and right-handedness. To minimize the mismatch where the two regions of opposing twist meet, the crenellated structure exhibits cusps rising out of the plane of the monolayer. We use a phenomenological elastic theory previously applied to flat disks and twisted ribbons to analyze an analytic model proposed to describe the crenellated structure. When compared with flat, circular disks, we find that the model crenellated disks are stable or at least metastable in a wide region of the phase diagram spanned by the Gaussian curvature modulus and the edge energy modulus, with a large energy barrier separating the two structures. The director pattern and geometric parameters of the crenellated disks are found to be in qualitative agreement with experimental observations.
Differences of novice to black belt Aikido practitioners in mindfulness: A longitudinal study

The martial art aikido may be useful in the development of mindfulness (Lothes, Hakan, & Kassab, 2013) and is often philosophically referred to as a meditation in motion, because of the heightened awareness that is ascribed to the training (Dobson & Miller, 1978; Saotome, 1986, 1989). Fuller (1988) argued that martial arts training, especially aikido, has the potential for positive psychological effects such as increased self-control, increased awareness of self and of others and overall increased health and wellbeing. Davidson (2010) argues more longitudinal research needs to be done to examine the changes of mindfulness over time. The current study was a longitudinal assessment of mindfulness in five aikido students of the University of North Carolina Wilmington Aikido Club from their starting through to their obtaining their black belts (a minimum of five years of training). The KIMS/MAAS was administered to these participants at nine intervals over the time course of their advancement in aikido. Results showed a significant increase of self-reported mindfulness from the beginning of training to the achievement of black belt status. Since the length of time from starting to achieve the black belt is approximately five years minimum, this unique longitudinal study affords us the opportunity to see what long-term effects aikido training has on individual’s levels of mindfulness.
Time Trends In The Incidence Of Parkinsonism And Parkinson Disease In Olmsted County, Minnesota Over Thirty Years (S17.007)

Objective: We investigated time trends in the incidence of parkinsonism and Parkinson disease (PD) over a 30-year period from 1976 to 2005. Methods: We used the medical records-linkage system of the Rochester Epidemiology Project to identify all incident cases of parkinsonism in Olmsted County, MN, over 3 decades: 1976-1985, 1986-1995, and 1996-2005. PD and other types of parkinsonism were classified using criteria reported elsewhere. Population denominators were derived from census data and were corrected by removing prevalent cases of parkinsonism. We adjusted incidence rates to the 1990 total U.S. population (midpoint of study period), and we used Poisson rate regression to test for trends. Results: We included 906 incident cases of parkinsonism of any type (464 had PD). The incidence rate of parkinsonism and of PD (per 100,000 person-years) was higher in men than in women at all ages and across all decades. The overall age-adjusted incidence of parkinsonism in men increased from 38.9 in 1976-1985 to 55.9 in 1996-2005 (trend p-value = 0.0002). Similarly, the age-adjusted incidence of PD in men increased from 18.2 in 1976-1985 to 30.4 in 1996-2005 (trend p-value = 0.0005). By contrast, the overall age-adjusted incidence of parkinsonism and PD in women did not change over the 30 years. In analyses stratified by age, the incidence of parkinsonism and PD at ages younger than 70 years remained stable in both men and women. However, incidence rates at ages 70 years or older increased in men for parkinsonism and PD, and increased in women only for PD. Conclusion: Our study suggests that the incidence of parkinsonism and PD are increasing over time in Olmsted County from 1976 to 2005, but only at ages older than 70 years, and particularly in men. Some of these trends may be due to changes in diagnostic practices. Disclosure: Dr. Savica has nothing to disclose. Dr. Grossardt has nothing to disclose. Dr. Bower has nothing to disclose. Dr. Ahlskog has nothing to disclose. Dr. Rocca has nothing to disclose.
Emotional, Sensitive, and Unfit for Office? Gender Stereotype Activation and Support Female Candidates

Women are underrepresented at all levels of elected office. It is suspected that gender stereotypes hinder the electoral success of female candidates, but empirical evidence is inconclusive on whether stereotypes have a direct effect on voting decisions. This empirical conflict stems, in part, from the assumption that voters automatically rely on gender stereotypes when evaluating female candidates. This study explicitly tests the assumption of automatic stereotype activation. I suggest that stereotype reliance depends on whether stereotypes have been activated during a campaign, and it is only when stereotypes are activated that they influence evaluations of female candidates. These hypotheses are tested with a survey experiment and observational analysis. The results show that campaign communication activates stereotypes when they otherwise might not be activated, thereby diminishing support for female candidates.
Defective modulation of noradrenergic neurotransmission by endogenous prostaglandins in aging spontaneously hypertensive rats.

Sympathetic nerve stimulation causes a greater vascular response in spontaneously hypertensive rats (SHR) compared to Wistar-Kyoto normotensive rats (WKY), i.e., noradrenergic neurotransmission is enhanced in SHR. Prejunctional and/or postjunctional defects in the regulation of noradrenergic neurotransmission by endogenous prostaglandins could contribute to the increased responsiveness to sympathetic nerve stimulation in SHR. This hypothesis was tested by comparing the effects in SHR vs. WKY of inhibition of cyclooxygenase on vascular responses to periarterial nerve stimulation (PNS), norepinephrine (NE) and angiotensin II (ang II) in the in situ blood perfused rat mesentery. The cyclooxygenase inhibitor, indomethacin, potentiated vascular responses to PNS and NE similarly in 16-week old SHR vs. age-matched WKY. However, in this age group, indomethacin enhanced responses to ang II more in SHR compared with WKY. To determine whether chronic exposure of the vasculature to high blood pressure might alter the physiological significance of prostaglandin-mediated regulation of noradrenergic neurotransmission in vivo, additional studies were conducted in SHR and WKY that were 25 weeks old. In this age group, neither indomethacin nor ibuprofen, an alternative cyclooxygenase inhibitor, significantly potentiated responses to either PNS or NE in SHR, whereas in WKY both indomethacin and ibuprofen potentiated responses to PNS and NE. Also, in these older animals, indomethacin and ibuprofen enhanced responses to ang II equally in SHR vs. WKY. These findings indicate that in aging SHR prostaglandin-mediated regulation of vascular responses to sympathetic nerve stimulation becomes defective. This defect may contribute to the worsening of high blood pressure with age and may be involved in some of the vascular pathology associated with hypertension.
CO2 wavelengths and the velocity of light

Abstract : New measurements of CO2 laser wavelengths in the 9 micrometer and 10 micrometer bands are reported accurate to about 2X10 to the minus 8th power. These are used in combination with Evenson's recently reported frequency values to derive a new value for the velocity of light and to update Chang's CO2 frequency and wavelength tables. (Author)
The Effect of the Enzymatic Hydrolysis of Phytate on the Available Energy Content of Feed Ingredients for Chicks and Rats

Abstract Experiments were conducted to determine the effect of the enzymatic hydrolysis of phytate in feed ingredients on the metabolizable energy (M.E.) content for chicks and rats and on the digestible energy (D.E.) for rats. The energy assay procedure for both species was the chromic oxide balance method utilizing glucose as the reference ingredient. Chicks and rats responded in a similar manner to the ingredients treated with phytase although rats utilized a greater percentage of the energy from all ingredients than did chicks. The M.E. in phytase treated wheat bran and cottonseed meal for chicks was each greater (P
Do critically ill patients tolerate early intragastric enteral nutrition

Objective: To assess tolerance of intragastric enteral nutrition started within 24 hours of admission to an intensive care unit (ICU). Design: A prospective cohort study. Setting: A medical/surgical university-affiliated ICU. Subjects: We evaluated 73 consecutive eligible patients with an expected length of stay and anticipated intolerance to oral nutrition of more than three days. We enrolled 45 patients (27 [60%] male), aged 55.4±19.0 years with a mean Simplified Acute Physiology Score (SAPS) of 11.0±4.3. Admitting diagnoses included medical (n=16), trauma (n=13), neurosurgical (n=12) and neurological (n=4) conditions. Interventions: We utilised a protocol in which intragastric feedings were initiated at 10 ml/hr within 24 hours of admission, checking gastric residuals every 4 hours. Every 12 hours, the rate was increased by 25 ml/hr if the residual volume was 200 ml and accompanied by nausea, vomiting or abdominal distension, feeds were discontinued for 4 hour...
Cisplatin and 5-Fluorouracil for Metastatic Squamous Cell Carcinoma from Unknown Primary

Chemotherapy for squamous cell carcinoma with unknown primary (SCUP) has not been prospectively studied. To evaluate the efficacy of cis-diaminedichloroplatinum (cisplatin) and 5-fluorouracil (5-FU) in advanced SCUP, we treated 15 patients with measurable disease. A prospective trial was conducted of cisplatin and 5-FU in patients presenting with SCUP. All patients had evaluation in search for primary disease with computed tomographic scan of the head, neck, and chest and endoscopic evaluation of the nasopharynx, larynx, esophagus, and tracheobronchial passages with negative blind biopsies. Chemotherapy consisted of cisplatin 100 mg/m2 on day 1 and 5-FU 1000 mg/m2 continuous infusion over 24 hr for 4 days. The regimen was repeated every 21 days. Responses were seen in 8 of 15 patients [1 complete response (CR) and 7 partial responses (PR)], for an overall response rate of 53%. These results suggest that cisplatin-5-FU combination has efficacy in advanced SCUP and deserves further trials both in advanced disease and in combined modality programs with surgery and radiation therapy.
DNA Damage Response: Multilevel Proteomics Gains Momentum

In this issue of Molecular Cell, Beli et al. (2012) introduce a multilevel proteomics approach for parallel quantification of protein phosphorylation, acetylation, and abundance and apply this to the complex signaling network of the DNA damage response.
Bioeconomic dynamics of a fishery modeled as an S-system

A bioeconomic model of a single species fishery is developed by using a realistic catch-rate function and assuming that a regulatory agency controls exploitation of the fishery by imposing a suitable tax on the catch. The existence of a nontrivial steady state and its stability are examined. The optimal harvesting policy is discussed from the viewpoints of variational calculus and control theory. The fishery is then modeled as an S-system by following the recasting techniques of Savageau and Voit. Numerical examples of the optimal control curves and the yield-effort curves are obtained by executing the ESSYNS algorithm.
A comparison of temporal measures of speech using spectrograms and digital oscillograms.

To determine whether any systematic differences occur as a result of using spectrograms versus digital oscillograms to make durational measurements, a number of temporal features (e.g., voice onset...
The Social Capital of Blacks and Whites: Differing Effects of the Mass Media in the United States

This study relied on telephone survey interviews of adults in two U.S. metropolitan areas to examine whether the relationship between mass media use and social capital varies according to ethnicity. A multigroup approach taken with structural equation modeling validates a four-factor model of social capital for Blacks and Whites and then, with the implementation of a comprehensive model that also includes mass media inputs, tests for structural variance between the ethnic groups. A well-fitting comprehensive model is achieved, with significant differences between Blacks and Whites in terms of the mass media use structures. In support of the two hypotheses, the relationship between news use and social capital is less positive for Blacks than for Whites and the relationship between entertainment TV viewing and social capital is more negative for Blacks than for Whites. These findings are discussed in terms of literature involving mass media effects on social capital, news coverage of ethnic groups, and ethnic differences in self-conceptualization and media responses.
Cyclosporine for the treatment of fulminant ulcerative colitis in children: Immediate response, long-term results, and impact on surgery

PURPOSE: Emergency surgery for fulminant colitis is often complicated by high-dose steroid therapy, poor nutrition, and psychologic maladjustment. Cyclosporine is effective for fulminant ulcerative colitis in adults, resulting in avoidance of immediate surgery in 75 percent of patients and a 55 percent long-term remission rate. Over the last five years, we studied the effectiveness of cyclosporine in children with fulminant colitis. METHODS: Fourteen patients with ulcerative colitis (age, 7–20 years) received cyclosporine after satisfying the following criteria: 1) greater than five bloody diarrheal stools per day; 2) severe abdominal pain; 3) no improvement after ten days of bowel rest, 4) intravenous methylprednisolone (1–2 mg/kg/day); and 5) parenteral nutrition. Treatment was begun with oral cyclosporine (4.6–9.6 mg/kg/day), and the dose was adjusted to achieve whole blood trough levels measured with a monoclonal radioimmunoassay between 150 and 300 ng/ml. If improved, patients were discharged on oral cyclosporine, prednisone, and a regular diet. RESULTS: Eleven of 14 patients (78 percent) responded within two to nine days and were able to consume a normal diet, had three or less soft stools per day, and had no pain. One did not respond after ten days and underwent an ileal pouch-anal anastomosis procedure. Two patients elected surgery after 20 days of therapy and a partial response. Of 11 patients who left the hospital, 4 had recurrent symptoms after 2 to 11 months of taking therapeutic doses of cyclosporine and 3 flare ups while weaning from cyclosporine after 4 to 8 months. Three patients have been weaned from cyclosporine after 8 to 13 months and have remained in remission from six months to five years. One patient is about to complete a six-month course of cyclosporine. Overall ten (72 percent) have undergone surgery, including 7 of 11 who responded initially to cyclosporine and left the hospital. Weight (P<0.001), albumin (P 0.05), and prednisone dose (P<0.001) improved significantly in the seven patients on cyclosporine who responded initially, left the hospital, and subsequently underwent surgery. CONCLUSIONS: Cyclosporine is effective in achieving clinical remission in 80 percent of children with refractory fulminant colitis; however, within one year, most initial responders will require colectomy because of a flare up of the disease. In a majority of patients, the role of cyclosporine therapy is to rapidly ameliorate symptoms and prevent precipitous colectomy, improve nutrition and psychologic adaptation, and reduce the steroid dose leading to surgery in a well-prepared patient.
SRF'ing the actin cytoskeleton with no destrin.

all living cells, including bacteria, require an intricate actin cytoskeleton for normal homeostasis. Once thought to be a static scaffold functioning solely to maintain cell shape, the actin cytoskeleton is now known to be a dynamic menagerie of proteins controlling such processes as migration and
Sustainable economic development and the environment

To maximize society's welfare, economists should be concerned with the efficient use of the stock of natural resources. The stock of natural resources is a gift of nature. The usefulness of this stock comes from its alternative uses, e.g. existence, exploitation and bequest. Therefore, the maintenance of this stock should be part and parcel of economic policymaking, particularly in less developed countries. Otherwise, the latter countries will face scarcity of wealth induced by decline of their environment.
Shock the World (and Then Some)

Book reviewed in this article: T. Ron Paton, Geoff S. Humphreys, and Peter B. Mitchell, On Soils: A New Global View
A Note on the Ideal Compensation of Frequency Modulated Data

The dynamic range of FM tape systems can be increased by using compensation to reduce the effect of tape speed variations. The normai method of compensation, however, requires precise matching of the record-electronics, and fails to compensate large signals. An ideal compensation system is described which, without requiring important modification of existing FM systems, recognizes the multiplicative nature of distortions caused by tape speed variations and removes them algebraically from both large and small signals. Further, it does not require accurate matching of the record-electronics or of the playback demodulators, and it can be applied to existing data.
Polyols induce ATP-independent folding of GroEL-bound bacterial glutamine synthetase.

We have previously assessed the GroE chaperonin requirements for folding of bacterial glutamine synthetase (GS) and established that, at 37 degrees C in 50 mM Tris buffer, ATP binding to the GroEL-GS complex is mandatory for the release and reactivation of dodecameric enzyme. However, we demonstrate here that the addition of 1-4 M glycerol to GroEL-GS complexes resulted in release and reactivation of GS in the absence of nucleotide. Furthermore, the kinetics of refolding and refolding yields of this glycerol-induced refolding were similar to those observed with ATP. Other polyols such as sucrose, 1,2-propanediol, or 1,3-propanediol also facilitated nucleotide-independent refolding of GS from chaperonin complex. The observed phenomenon cannot be attributed to the viscosity or molecular crowding effects because solutions of dextran or Ficoll with the same viscosity as 4 M glycerol failed to reactivate GroEL-bound GS. Like glycerol, other osmolytes such as betaine and sarcosine or high salt (500 mM NaCl) facilitated spontaneous folding of GS. However, no reactivation of GroEL-bound GS was observed with these additives. The presence of glycerol affected binding of fluorescent probe 1,8-anilinonaphthalene to GroEL, suggesting that glycerol may alter the chaperonin structure. Our data suggest that low-molecular-weight polyols affect both GroEL and bound GS monomers to reduce their binding affinity. This results in an increased partitioning of GS toward active, assembly-competent states.
Electric field-induced dipole reorientation in oriented nylon 11 by in situ infrared spectroscopy

Dipole reorientation under the influence of an electric field is investigated in oriented nylon 11 films with polarized infrared spectroscopy for the amide A and amide I bands. Butterfly-shaped hysteresis loops are obtained from peak intensity versus applied electric field strength. Least-squares Gaussian curve fitting of the resolved multiple contributions to the amide I peak show that the components change in either a continuously reducing S-shaped fashion, or in butterfly-shaped curves under ac poling fields. Time-dependent studies of the absorption intensities show that both ordered and disordered species switch towards the electric field direction with the application of electric fields higher than the coercive field. Upon field removal, only the disordered species show orientation relaxation away from the field direction. Below the coercive field, neither species responds orientationally to the field.
A Possible Source for The Coercivity of Ilmenite-Hematite Minerals

Large coercivities of some ilmenohematite minerals are probably due to magnetostrictive effects associated with exsolution.
Fibromuscular Dysplasia: An Update for the Headache Clinician

Background Fibromuscular dysplasia (FMD) is an uncommon vascular disease that presents with stenosis, aneurysm, dissection, beading, and tortuosity of medium-sized arteries. It primarily manifests in the renal and extracranial carotid and vertebral arteries, and is associated with major vascular events such as carotid artery dissection, renal artery dissection, ruptured aneurysm, transient ischemic attack, stroke, and myocardial infarction (due to coronary artery dissection). Discussion There is a wide spectrum of disease severity among FMD patients. Symptoms of FMD are related to the vascular beds involved and the severity of arterial stenoses. Headache is an extremely common and important symptom reported by patients with FMD, although the precise mechanism of headache in this population is not yet known. Conclusion This review summarizes the most recent literature regarding FMD, including epidemiology, clinical manifestations, imaging practices, and treatment. Special attention will be paid to the association of headaches and FMD. Correct diagnosis, optimal medical management, and appropriate referral for vascular intervention are vital elements of the treatment of patients with FMD. There is a great need for more clinical research regarding the epidemiology, pathophysiology, and optimal treatment of headache in the FMD patient population.
A Comparison Between Two Biopolymers Used in Drillings Muds

Abstract The study of biopolymers is increasing considerably in the oil industry because they possess desirable properties such as environmental friendliness. Xanthan gum and scleroglucan are biopolymers used to reduce mud toxicity. These biopolymers are exopolysaccharides added to aid in control of fluid loss to the formation and to increase the viscosity of the drilling mud. In this article, we suggest evaluating the properties of biopolymers used in drilling mud. We constituted a fluid model compliant with the American Petroleum Institute's standards, where the composition differs by the nature of biopolymer. Biopolymer properties were investigated by using two main analytical methods: X-ray diffraction (XRD) and rheology. The substances used in this study are considered to cause little or no risk to the environment. This article describes the characterization of these polymers and the effect of additives such as clay and weighting material on drilling muds.
Bis(mercaptoimidazolyl)borates and the control of nuclearity in cadmium thiolate complexes

Abstract Bis(mercaptoimidazolyl)borate cadmium(II) thiolate complexes of empirical formula (BmMe)CdSR (R=Ph, p-Tol, C6F5) have been readily prepared from the new bromo derivative (BmMe)CdBr and the corresponding thallium(I) thiolates Tl(SR). The new complexes have been characterized analytically and spectroscopically and, in the case of the para-thiocresolate derivative (BmMe)CdS-p-C6H4Me, by X-ray diffraction. While the closely related tris(mercaptoimidazolyl)borate cadmium phenylthiolate complex (Tmp-Tol)CdSPh is mononuclear, (BmMe)CdS-p-C6H4Me exhibits in the solid state a dimeric structure in which each five-coordinate cadmium atom displays a trigonal bipyramidal geometry.
Congenital cholesteatoma of the mastoid temporal bone.

Objective: Congenital mastoid cholesteatomas are rare lesions of the temporal bone. The clinical presentation of these lesions is variable, making them difficult to identify preoperatively. We evaluated our series of mastoid congenital cholesteatomas (CCs) in an effort to better define the clinical presentation, imaging characteristics, and surgical challenges specific to this lesion. Study Design: Retrospective chart and radiologic study review. Methods: The medical records of patients with the diagnosis of mastoid CC on radiologic imaging over a 15-year period were reviewed. All had surgical and pathologic confirmation. Eight patients underwent preoperative computed tomography (CT). Six also underwent magnetic resonance (MR) scanning. Demographic information, clinical presentation, imaging results, and operative findings were recorded. Results: Nine patients with the diagnosis of mastoid CC satisfying the inclusion criteria were found. Clinical findings were variable, with the most common presentation being an incidental finding. Imaging findings were more uniform. All CT scans demonstrated an expansile, well-circumscribed mass centered within the mastoid portion of the temporal bone. All MR scans showed a well-circumscribed mass with high intensity on T2-weighted images with precontrasted T1 sequences showing the lesion to be isointense or slightly hyperintense to cerebrospinal fluid (CSF). Operative findings included lateral mastoid cortex erosion, sigmoid sinus exposure, ossicular destruction, facial nerve exposure, and associated postauricular abscess. Management of these lesions is reviewed. Conclusion: Congenital mastoid cholesteatomas have a variable and nonspecific clinical presentation. Surgical challenges arise from the indolent nature of this clinical entity, which belies the extent of otologic involvement. Imaging with CT and magnetic resonance imaging are diagnostic, defines the extent of these lesions, and facilitates preoperative surgical planning.
Investigations employing high sensitivity spectrometers with particular emphasis on the infrared spectrum of solid hydrogen

Abstract The pure rotational region of the infrared spectrum of hydrogen in the condensed phase appears to be a particularly promising area for obtaining new and valuable information with the help of modern technology.