cssi/SciSciGPT-SciSciNet huggingface dataset:
Sildenafil Citrate Improves Erectile Function and Lower Urinary Tract Symptoms Independent of Baseline Body Mass Index or LUTS Severity

Objectives To evaluate the body mass index (BMI) and lower urinary tract symptom (LUTS) severity on treatment response to sildenafil in men with erectile dysfunction (ED) and moderate to severe LUTS associated with benign prostatic hyperplasia. Methods A post hoc analysis of data from a 12-week, double-blind, placebo-controlled study of sildenafil (50 mg once daily titrated to 100 mg once daily) was conducted. The BMI categories were obese (≥30 kg/m 2 ), overweight (≥25 to 2 ), and normal weight ( 2 ). ED was defined as a score of ≤25 on the erectile function domain of the International Index of Erectile Function, and LUTS was defined by an International Prostate Symptom Score of ≥12. The maximal urinary flow rate was determined by uroflowmetry. Results Patients receiving sildenafil (n = 189) had a significant improvement in the erectile function domain scores of the International Index of Erectile Function ( P P P = .06). Also, the improvement in LUTS scores was significant ( P ≤ .02) for men taking sildenafil independent of BMI (obese, −8.9 vs −5.4; overweight, −7.3 vs −3.2; normal weight, −7.1 vs −0.84). No difference was found among the treatment groups in the change from baseline maximal urinary flow rate across all LUTS and BMI categories (range 4.5 to −4.2 mL/s). Conclusions The results of our study have shown that daily dosing with sildenafil improved ED and LUTS independent of baseline LUTS severity or BMI.
Performance, diagnostics, controls and plans for the gyrotron system on the DIII-D tokamak

The DIII-D ECH complex is being upgraded with three new depressed collector gyrotrons. The performance of the existing system has been very good. As more gyrotrons having higher power are added to the system, diagnostics of gyrotron operation, optimization of the performance and qualification of components for higher power become more important. A new FPGA-based gyrotron control system is being installed, additional capabilities for rapid real time variation of the rf injection angles by the DIII-D Plasma Control System are being tested and infrastructure enhancements are being completed. Longer term plans continue to include ECH as a major component in the DIII-D heating and current drive capabilities.
Cardiovascular disease in rheumatoid arthritis: Current perspectives on assessing and mitigating risk in clinical practice

That individuals with rheumatoid arthritis (RA) have, on average, higher rates of events related to atherosclerotic vascular disease is now well documented and accepted. However, optimal ways to identify RA patients with atherosclerosis, and treat them to mitigate cardiovascular disease (CVD) risk have not been rigorously established. As such, current guidelines for CVD screening and prevention lack an evidence base. In the context of the current understanding of the determinants of atherosclerosis in RA and the current guidelines that have been published, this review focuses on strategies for identifying RA patients at risk of CVD events, and the possible primary and secondary prevention strategies that may be effective.
Commentary on: The Role of Microfat Grafting in Facial Contouring.

The authors present their use of microfat grafting as an alternative to the advancement of skeletal osteotomies performed for purely aesthetic concerns.1 They appropriately emphasize the not-insignificant complications and morbidity associated with orthognathic procedures to justify their less morbid treatment preference. Although not mentioned by these authors, fat grafting would also avoid the dysaesthetic contour irregularities intrinsic to skeletal osteotomies and advancement. These iatrogenic aesthetic deformities are particularly troubling when orthognathic procedures are performed for purely aesthetic reasons. The authors are complemented on their operative facility and aesthetic results. However, it is important to emphasize that there is a difference in the resultant facial contour when it is altered by expanding the soft tissue envelope as opposed to increasing the projection of the underlying skeleton. Upon review of the patient examples included in this manuscript as well as those presented in the supplement, I find that the bottom …
Professional Quality of Life and Associated Factors Among VHA Chaplains

ABSTRACTChaplains play a unique role in the Veterans Affairs (VA) health care systems and have numerous responsibilities. Compassion satisfaction (CS), compassion fatigue (CF), and burnout (BO) are three major phenomenons that have been documented in other helping professions, but little is known about VA Chaplains' professional quality of life. This study examines a national sample of VA Chaplains and their professional quality of life along with associated factors. Two-hundred and seventeen VA Chaplains completed an anonymous Internet survey, and regression analyses were conducted to determine which variables affect professional quality of life. On average, participants report high levels of CS and low levels of CF and BO. Gender, perceived support from VA administration, and mental health (MH) integration were significant predictors for CS. MH integration and perceived support significantly affected CF. Age, MH integration, and perceived support affected BO. Significant interaction effects were found f...
Targeting Cancer Stem Cells with Phytochemicals: Inhibition of the Rat C6 Glioma Side Population by Curcumin

The phytochemical curcumin, from the Indian spice turmeric, has many biological properties, including anti-inflammatory and anti-carcinogenic activities. We examined the effects of curcumin on the rat C6 glioma cell line. Treated and control cells were analyzed by Hoechst 33342 dye and flow cytometry. Dye exclusion exhibited by cells indicates their activity of drug efflux capacity, a stem cell characteristic, and they are designated as side population (SP), away from the main population of cells that retain the Hoechst dye. With the C6 cells, we observed a decrease in SP after daily treatment of curcumin. Since SP has been associated with stem cell population and C6 glioma is brain tumor derived cell line, curcumin may be active against brain cancer stem cells (CSCs). Isolation and characterization of CSCs, as well as therapeutic potentials of phytochemicals targeting CSCs, are discussed.
Red-winged blackbird aggression but not nest defense success is predicted by exposure to brood parasitism by brown-headed cowbirds

The brown-headed cowbird (Molothrus ater) is an obligate brood parasite known to use over 200 host species. The red-winged blackbird (Agelaius phoeniceus) is a commonly used accepter host that incubates cowbird eggs and cares for cowbird nestlings and fledglings. This host species, however, may reduce the risk of parasitism with a frontloaded antiparasite strategy in which it attacks parasites that approach active host nests. To test this frontloaded parasite-defense hypothesis (FPDH), we presented taxidermic models of a female northern cardinal (Cardinalis cardinalis), which represents no threat to redwings, a male cowbird, which cannot lay a parasitic egg, and a female cowbird, together with species- and sex-specific vocalization playbacks for 5 min. We conducted these presentations at 25 active redwing nests at Newark Road Prairie in southcentral Rock County, Wisconsin, USA, where 18% of redwing nests were parasitized by cowbirds in 2015. As predicted by the FPDH, the female cowbird mount elicited the most aggressive responses and the female cardinal mount the least aggressive, as measured by number of times more than one male redwing responded and number of times the male host attacked the mount, and by Principal Component analyses yielding redwing aggressive behavior and intimidation scores. Contrary to the predictions of FPDH regarding the success of nest defense behaviors, male redwings responding at naturally parasitized nests were significantly more likely to attack the mount than males with nests that were not parasitized. We also compared our results with those of a study using the same methods and conducted in New York State where cowbird parasitism was rare. Wisconsin redwings were more aggressive toward the female cowbird mount than redwings in New York State. Red-winged blackbirds appear to frontload their antiparasite defenses and the aggressiveness, but the apparent success of those defenses depends on individual and population-level experience with parasites.
Rifaximin reduces physiologic intestinal FDG activity on PET/CT

1950 Objectives The utility of FDG-PET for assessment of intestinal disease is limited by localized physiological FDG uptake. We have previously shown that FDG uptake in the colon is located in the intestinal lumen, which contains high concentrations of commensal bacteria. This study aimed to determine whether an oral antibiotic (rifaximin, Salix) taken prior to PET/CT could reduce physiologic FDG uptake in the intestinal tract. Methods Thirty patients scheduled to receive a PET/CT study for re-staging of non-intestinal lymphoma were prospectively enrolled in the study. Patients were administered oral rifaximin 550mg BID for two days prior to their scan. Each enrolled patient’s scan was compared to their prior PET/CT (no rifaximin). In addition, a second group of randomly selected scans from patients also scheduled for lymphoma re-staging during the same time period were used as controls. A total of 30 post-treatment scans, and 90 control scans were analyzed by a nuclear medicine physician blinded to treatment allocation. Quantitative measurements of SUVmax in the cecum and the colon were obtained as well as a qualitative score of colonic uptake (0-4). Results There was a 26% reduction of activity in the cecum of patients treated with rifaximin when compared to their untreated scans (SUVmax, p=0.002, paired t-test). Controls exhibited no significant difference in the same measurements applied to sequential scans (p=0.23). The qualitative score of whole colonic uptake was also reduced in the rifaximin pre-treated group from a mean of 2.3 to 1.8 (p=0.07). No adverse events were reported in the rifaximin-treated group. Conclusions Pre-treatment with rifaximin can reduce physiological F-18 uptake in the intestinal tract. These results support the hypothesis that bacteria may, in part, explain the localization of FDG activity in the normal intestinal lumen. Further study will be required to optimize the antibiotic regimen required to minimize false positive FDG activity. Research Support Salix Pharmaceuticals, Inc.
Midwest Express: A Bright Light in a Cloudy Industry

This case describes the elements, processes, and dynamics that have contributed to Midwest Express's being an outstanding airline service provider of the "best care in the air." The case illustrates the interrelationships among leadership, system, culture, people, and process, and the values of the strategy of dynamics.
A pilot study of cognitive-neuroscience mechanism in product concept evaluation

Novel, functional, and aesthetic products are thought to have a high likelihood of success in the marketplace. While making sound design decisions is a critical ability of good designers, evaluating product concepts for their future successes in the marketplace is a challenging task. In design classes, only about half of product concepts selected by student design teams may be retained and prototyped into final products, i.e., about half of student design teams find that their initial product concepts are difficult to make workable and change to different concepts by the time they create prototypes for testing. This paper investigates if electrophysiological concomitants in product concept evaluation may potentially be used to improve students’ and designers’ product concept evaluation processes. The preliminary data in this pilot study indicate that distinct decision-making processes may occur during evaluations of product concepts on novelty, functionality, and aesthetics, evidenced by brain activation differences among students.Copyright © 2015 by ASME
Customer Impulse Purchasing Behavior: A Reexamination:

A recent article by David T. Kollat and Ronald P. Willett [1] reports a major investigation of impulse in the buying behavior of foods and attempts to identify the degree of such behavior and the economic, demographic, personality, and food shopping behavior factors related to impulse purchasing. Their article explores an important problem in marketing and gives much interesting material but, as presented, it is somewhat unconvincing. Research methodology used to investigate planned versus impulse purchasing is loaded with difficulties, simply because observation of behavior and data collection may significantly change what is being observed. The possibility of experimental effect or guinea pig effect is inherent in all such research and therefore, before data and conclusions can be accepted as valid, it must be shown that the effect is not present. This is probably especially true in the investigation of behavior subject to dramatic changes from small factors such as impulse behavior. Such behavior is impulsive and can be influenced by everything that is going on at the time, and if one of those ongoing events happens to be under observation by researchers, we might well expect behavior to reflect it.
Pharmacotherapy Using Cardiovascular Agents: Focus on the Top 200 Drugs

Objective: To summarize pharmacologic agents available to treat cardiovascular diseases, including heart failure, hypertension, and hyperlipidemia. Data Sources: Drugs used in the management of cardiovascular disease were identified from a list of the top 200 drugs of 2008 by number of prescriptions dispensed. Relevant articles were obtained via a MEDLINE search (2000-March 2010) using the key words pharmacy technician, hypertension, heart failure, hyperlipidemia, β-blocker, ACE inhibitor, angiotensin receptor blocker, diuretic, calcium-channel blocker, clonidine, HMG-CoA reductase inhibitor, ezetimibe, fenofibrate, niacin, clopidogrel, warfarin, isosorbide mononitrate, and digoxin. In addition, evidence-based practice guidelines, monographs, package inserts, and other secondary sources were reviewed. Study Selection and Data Extraction: Relevant information regarding dosages, trade/generic names, pharmacology, and adverse effects associated with common agents to treat cardiovascular disease was included. Data Synthesis: Despite falling mortality rates, cardiovascular disease continues to be the leading cause of death in the US and is a significant cause of morbidity. Pharmacy technicians should be familiar with the basic pharmacology of the most commonly prescribed medications. Selected agents used to treat heart failure and hypertension from the following classes of drugs were reviewed: β-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), diuretics, calcium-channel blockers, and a centrally acting agent. Additionally, common drugs used to treat hyperlipidemia, including hydroxymethylglutaryl coenzyme A reductase inhibitors, cholesterol absorption inhibitors, fibric acids, and niacin, were reviewed. Antiplatelet agents, selected vasodilators, warfarin, and digoxin were also reviewed. Conclusions: Drug therapy is the key to successful management of cardiovascular disease. Health-care providers, including knowledgeable pharmacy technicians, can assist patients in the proper use of agents in the treatment of cardiovascular diseases.
ISP service tier design

Internet Service Provider design of service tiers are modeled and analyzed, based on demand for web browsing and video streaming. A basic model that considers user willingness to pay, network capacity, and application performance is formulated to determine when multiple tiers maximize profit. An extended model that also considers the time that users devote to each application is formulated to determine the optimal network capacity, tier rates, and tier prices. We show that an Internet Service Provider may simplify tier and capacity design by allowing its engineering department to set network capacity, its marketing department to set tier prices, and both to jointly set tier rates. Numerical results are presented to illustrate the magnitude of the decrease in profit compared to the optimal profit resulting from such a simplified design.
Determination of risk factors for recurrent methicillin-resistant Staphylococcus aureus bacteremia in a Veterans Affairs healthcare system population.

OBJECTIVE To identify important risk factors for recurrent methicillin-resistant Staphylococcus aureus (MRSA) to assist clinicians in identifying high-risk patients for continued surveillance and follow-up. METHODS In this retrospective cohort study, we examined patients with MRSA bacteremia at 122 Veterans Affairs medical facilities from January 1, 2003, through December 31, 2010. Recurrent MRSA bacteremia was identified by a positive blood culture result from 2 to 180 days after index hospitalization discharge. Subset analyses were performed to evaluate risk factors for early-onset (2–60 days after discharge) and late-onset (61–180 days after discharge) recurrence. Risk factors were evaluated using Cox proportional hazards regression. RESULTS Of 18,425 patients, 1,159 (6.3%) had recurrent MRSA bacteremia. The median time to recurrence was 63 days. Longer duration of index bacteremia, increased severity of illness, receipt of only vancomycin, community-acquired infection, and several comorbidities were risk factors for recurrence. Congestive heart failure, hypertension, and rheumatoid arthritis/collagen disease were risk factors for early-onset but not late-onset recurrence. Geographic region and cardiac arrhythmias were risk factors for late-onset but not early-onset recurrence. CONCLUSIONS Risk factors for recurrent MRSA bacteremia included comorbidities, severity of illness, duration of bacteremia, and receipt of only vancomycin. Awareness of risk factors may be important at patient discharge for implementation of quality improvement initiatives including surveillance, follow-up, and education for high-risk patients. Infect Control Hosp Epidemiol 2015;00(0): 1–7
SOME NOTES ON PSEUDOTOMENTELLA

The purpose of this communication is to report a heretofore undescribed species of Pseudotomentella from western North America, report the occurrence of chlamydospores in P. vepallidospora M. J. Larsen, and provide a revised key to the known species of Pseudotomentella. The descriptive data presented are based on tissues mounted in 10% aqueous KOH and stained with an aqueous solution of phloxine B. Photomicrographs were prepared with the aid of a Leitz Ortholux microscope and Orthomat camera. Capital letters used to designate herbaria, unless otherwise indicated, are those of Lanjouw and Stafleu (1964), and numerical surface color expressions are those of the Munsell system (1929-1942).
Rare subependymal giant-cell astrocytoma in a neonate with tuberous sclerosis.

Giant-cell astrocytomas associated with tuberous sclerosis in neonates have been reported only once before in the English literature. We report the CT and MR findings in a neonate fwith tuberous sclerosis who had a large giant-cell astrocytoma
Effect of exposure to low concentration of benzene,toluene and xylene on the health of workers

[Objective] To discuss the harm of exposure to low concentration of benzene,toluene and xylene on the health of workers.[Methods]The concentrations of benzene,toluene and xylene in the work places of factory with benzene exposure were detected.The benzene exposure group included 439 workers exposed to benzene,toluene and xylene,and the control group included 338 workers who have not been exposed to benzene.Two groups received the occupational health examination,and the results were investigated by a comparative analysis.[Results]The 8h time weighted average concentration(C-TWA) and short time exposure limit concentration(C-STEL) of benzene,toluene and xylene in all monitoring points of factory were lower than the national standards.The detection rate of leucopenia in the benzene exposure group and the control group was respectively 14.58% and 8.88%,and the difference was statistically significant.The detection rate of lower hemoglobin level in the benzene exposure group and the control group was respectively 19.59% and 8.28%,and the difference was statistically significant.The detection rate of leucopenia of female workers and male workers in the benzene exposure group was respectively 18.07% and 10.53%,and the difference was statistically significant.The detection rate of lower hemoglobin level of female workers and male workers in the benzene exposure group was respectively 32.53% and 2.63%,and the difference was statistically significant.The abnormal rate of serum ALT of male workers and female workers in the benzene exposure group was respectively 7.89% and 0.80%,and the difference was statistically significant.In the benzene exposure group,the detection rate of leucopenia and lower hemoglobin level had a linear relationship with working years.[Conclusion]The long-term exposure to low concentration of benzene,toluene and xylene may harm workers' health,so it is necessary to strengthen the protection measures and health surveillance.
Humanistic Spirit of Confucianism

Confucianism has greatly influenced the formation and development of the Chinese culture. The humanistic spirit in the purpose, the position in running the country, the spirit in beautifying the country and the attitude toward value will play an important part in future.
My Opinion about Strengthening Actual Effect of the High School Enrolment Propaganda Work

As popularization of higher education and very intense competition for student resources among high schools,the quality of student resources would directly affect university's survival and development.The enrolment propaganda becomes one of the central ways for contesting students.The appropriate and effective enrolment propaganda is essential,but then it is necessary to deal with some relation well: between utilizing enrolment message ways effectively that students obtained and the effect of the enrolment propaganda,between deciding extent and object to carry out enrolment propaganda work correctly and improving work effect,between instruction and service and responsibility of the enrolment consultation,between continuance and actual effect of the propaganda work,etc.Dealing with the relations effectively would improve the quality of propaganda,and strengthen actual effect of the propaganda work.
Organic chemistry: Precision pruning of molecules

If organic molecules were trees, then the numerous carbon–hydrogen bonds within them would be leaves. A catalyst that targets one 'leaf' out of many similar other ones looks set to be a huge leap for synthetic chemistry. See Letter p.230 Organic synthesis has traditionally relied heavily on the introduction and manipulation of functional groups, such as carbon–oxygen or carbon–halogen bonds. Much current research is focused on a potentially powerful alternative strategy in which carbon–hydrogen bonds, normally much less reactive and therefore resistant to functionalization, are somehow persuaded to be more easily modified. These authors report that it is possible to selectively functionalize an unactivated C–H bond by the use of well-defined catalysts to control the site selectivity, without the need for a directing or anchoring group present in the molecule. They use dirhodium catalysts to achieve diastereoselective and enantioselective C–H functionalization of n-alkanes and terminally substituted n-alkyl compounds. The reactions proceed in high yield and can be carried out on substrates containing other functional groups such as halides, silanes, and esters.
Stool-based biomarkers of interstitial cystitis/bladder pain syndrome

Interstitial cystitis/bladder pain syndrome (IC) is associated with significant morbidity, yet underlying mechanisms and diagnostic biomarkers remain unknown. Pelvic organs exhibit neural crosstalk by convergence of visceral sensory pathways, and rodent studies demonstrate distinct bacterial pain phenotypes, suggesting that the microbiome modulates pelvic pain in IC. Stool samples were obtained from female IC patients and healthy controls, and symptom severity was determined by questionnaire. Operational taxonomic units (OTUs) were identified by16S rDNA sequence analysis. Machine learning by Extended Random Forest (ERF) identified OTUs associated with symptom scores. Quantitative PCR of stool DNA with species-specific primer pairs demonstrated significantly reduced levels of E. sinensis, C. aerofaciens, F. prausnitzii, O. splanchnicus, and L. longoviformis in microbiota of IC patients. These species, deficient in IC pelvic pain (DIPP), were further evaluated by Receiver-operator characteristic (ROC) analyses, and DIPP species emerged as potential IC biomarkers. Stool metabolomic studies identified glyceraldehyde as significantly elevated in IC. Metabolomic pathway analysis identified lipid pathways, consistent with predicted metagenome functionality. Together, these findings suggest that DIPP species and metabolites may serve as candidates for novel IC biomarkers in stool. Functional changes in the IC microbiome may also serve as therapeutic targets for treating chronic pelvic pain.
Experiences in scaling field studies of software developer behavior: keynote for the software engineering research & industrial practice workshop

Most of our current understanding of how programmers perform various software maintenance and evolution tasks is based on controlled studies or interviews, which are inherently limited in size, scope, and realism. Replicating controlled studies in the field can both explore the findings of these studies in wider contexts and study new factors that have not been previously encountered in the laboratory setting. While replicating controlled studies in the field seems like an obvious next step in scientific progress, it is a step that has rarely been attempted, in part due to its complexity, which requires not only the industrial knowhow to implement a robust, scalable system, but the academic knowledge of how to design rigorous studies. In this talk, I will describe a few examples of successfully scaled studies, contrast them with less successful cases (including our own), and provide lessons learned. I will share the importance of collecting targeted information instead of generic logs, the insight that automated data collection paired with followup surveys is a powerful tool, and the nuances around what researchers can and cannot expect working developers to tolerate for the sake of research.
TUQR: a topology unaware QoS routing protocol for MANETs

The main issue addressed in this paper is the quality of service (QoS) routing protocol for mobile ad hoc networks (MANET). The objective is to improve the packet delivery ratio in QoS constrained communications in comparison to other well-known protocols that use distributed multi-path routing. To accomplish that, a new protocol is developed to reduce the effects of distrustful environment of MANET by keeping the number of suitable paths as high as possible and distributing the decision mechanism among the nodes on the path. The new protocol uses on-demand route discovery. The source node or the intermediate nodes have no knowledge about the path that will be followed by data packets. Instead, starting with the source node, each node just knows which neighbor declared to be capable of forwarding data packets under given delay constraint to the given destination. Simulations are performed to verify the performance improvement of the proposed protocol.
FiSI: Fiberscope sample imaging system for robotic comet surface sample return missions

This paper discusses the Fiberscope Sample Imaging (FiSI) system currently being developed for a potential robotic comet surface sample return mission. In this mission concept, the spacecraft would perform touch-and-go maneuver at a small body to collect a comet surface sample. Immediately after the sample is captured the FiSI would perform in situ verification of the comet sample. Sample volume would be estimated and images of the collected sample acquired and evaluated. If the captured sample volume were deemed insufficient, the sample collection maneuver would be re-attempted, multiple times if necessary, until a baseline sample volume was positively confirmed. This repeatability would improve the potential science outcome of the sample return mission. Our proof-of-concept FiSI hardware consists of nine imaging fiberscopes integrated into a single bundle. The nine fiberscopes are designed to provide wide swath coverage of overlapping fields of view within a sample measurement station. The achieved image resolution is in excess of 4 linepair/mm at 20 mm working distance. Surface color and texture of a comet sample simulant would clearly be discernible at this fidelity. The distal end of these fiberscopes are designed to tolerate harsh temperature and radiation environments near a comet while sensitive electronics and optical components at the proximal end can be placed in a more benign electronics bay of the notional spacecraft. An early FiSI prototype was tested in a −50°C chamber and showed no image degradation. To study the FiSI proof-of-concept system response in a microgravity-like environment, a preliminary experiment was attempted using a neutral buoyancy sample. The test result was consistent with Monte Carlo simulation.
Warfarin-Associated Nonuremic Calciphylaxis.

Importance Classic calciphylaxis associated with renal failure is a life-threatening disease. Warfarin-associated calciphylaxis without renal injury has been described, but whether it is a subset of classic calciphylaxis or a different entity remains unknown. We describe 1 case of warfarin-associated calciphylaxis, present data from 2 others from our institution, and review all cases of warfarin-associated calciphylaxis available in the literature. Our review indicates that warfarin-associated calciphylaxis is clinically and pathophysiologically distinct from classic calciphylaxis. Objective To review warfarin-associated calciphylaxis and determine its relationship to classic calciphylaxis. Design, Setting, and Participants We searched MEDLINE and Ovid without language or date restrictions for case reports of calciphylaxis from the inpatient setting using the terms “calciphylaxis and warfarin,” “non-uremic calciphylaxis,” and “nonuremic calciphylaxis.” We defined nonuremic calciphylaxis as a histopathologic diagnosis of calciphylaxis without severe kidney disease (serum creatinine level >3 mg/dL; glomerular filtration rate Exposures Each patient had been exposed to warfarin before the onset of calciphylaxis. Main Outcomes and Measures Patient data were abstracted from published reports. Original patient medical records were requested and reviewed when possible. Results We identified 18 patients with nonuremic calciphylaxis, 15 from the literature, and 3 from our institution. Patients were predominantly female (15 of 18 [83%]) with ages ranging from 19 to 86 years. Duration of warfarin therapy prior to calciphylaxis onset averaged 32 months. Lesions were usually located below the knees (in 12 of 18 [67%]). No cases reported elevated calcium-phosphate products (0 of 17 [0%]). Calcifications were most often noted in the tunica media (n = 8 [44%]) or in the vessel lumen and tunica intima (n = 7 [39%]). The most common treatments included substitution of heparin or low-molecular weight heparin for warfarin (n = 13 [72%]), intravenous sodium thiosulfate (n = 9 [50%]), and hyperbaric oxygen (n = 3 [17%]). The survival rate on hospital discharge was remarkably high, with 15 cases (83%) reporting full recovery and 3 cases ending in death. Conclusions and Relevance Warfarin-associated calciphylaxis is distinct from classic calciphylaxis in pathogenesis, course, and, particularly, outcome. This finding should influence clinical management of the disease and informs targeted treatment of the disease.
Resisting the Urge to Act: DREADDs Modifying Habits

Recently, Meyer and Bucci used chemogenetic technology - artificial excitatory and inhibitory receptors - to modulate neuronal activity in two connected brain regions in opposite directions simultaneously. This innovative manipulation revealed that the two regions studied, orbitofrontal cortex and nucleus accumbens, are not sequentially dependent during contextual decision-making.
Factors Associated with Abducens Nerve Recovery in Patients Undergoing Surgical Resection of Sixth Nerve Schwannoma: A Systematic Review and Case Illustration.

Background Limited or no literature exists identifying factors associated with functional nerve recovery in patients undergoing resection of sixth cranial nerve (CN VI) schwannomas. Methods A systematic review of literature was performed on CN VI schwannomas that were treated surgically. Synthesizing the findings pooled from the literature, we investigated associations of patient demographics and clinical characteristics with postsurgical CN VI functional recovery in multivariable regression models. In addition, we present the findings of an adolescent woman surgically managed for intracavernous CN VI schwannoma. Complete encasement of the cavernous segment of the internal carotid artery is unique to our case. Results We synthesized data of 32 patients from 29 studies, and our index case. Overall, the mean age of the patients was 44.0 ± 16.5 years, and approximately 52% ( n = 17) were female. Most tumors were left-sided ( n = 18; 54.5%), with an average size of 3.46 ± 1.71 cm. The most common location was cisternal ( n = 11; 33%), followed by cavernous sinus (CS) proper ( n = 9; 27%), cisterocavernous ( n = 8; 24%), orbital ( n = 4; 12%) and caverno-orbital ( n = 1; 3%). CN VI recovery was reported in less than half the cohort ( n = 14; 45%). Tumor extension in the CS was significantly associated with lesser likelihood (odds ratio [OR], 0.07; 95% confidence interval [CI], 0.01–0.98; P = 0.048) of postsurgical CN VI recovery. Although female gender (OR, 0.86; 95% CI, 0.07–10.09; P = 0.906), large tumor size (>2.5 cm) (OR, 0.45; 95% CI, 0.07–2.89; P = 0.397), and solid consistency (OR, 0.37; 95% CI, 0.03–4.19; P = 0.421) were associated with lesser odds for recovery, these were not statistically significant. Likewise, although gross total resection (OR, 6.28; 95% CI, 0.33–118.25; P = 0.220) was associated with higher odds of nerve recovery, the estimates were statistically insignificant. Conclusions CS involvement is associated with lesser odds for functional nerve recovery in patients undergoing surgical resection for CN VI schwannoma.
Effects of apple (Malus × domestica) rootstocks on scion performance and hormone concentration

Abstract New apple rootstocks that are fire blight resistant are rapidly becoming available in recent years. Rootstock effect on vigor, yield, return bloom, branch angle, bud break, and hormone profile was assessed using ‘Honeycrisp’ as the scion cultivar. Three Budagovsky (B.9, B.10 and B.7-20-20), five Geneva (G.814, G.214, G.935, G.41 and G.11) and two Malling (M.9T337 and M.26) rootstocks were used for this trial. G.814 and G.214 were high productive rootstocks, more vigorous than M.9T337 that could be interesting for weak growing cultivars such as ‘Honeycrisp’. B.9. B.10, G.41 and G.214 performed pretty similar to M.9T337, but they had slightly higher cumulative yields. High return bloom values were observed on G.935, M.9T337, and G.814, whereas B.72020 was the rootstock with the lowest values. In addition, B.72020 was the stock with more upright branches, while B.10 and G.11 had the flattest. On average, a few rootstocks had a low biennial bearing index, which included B.10 and G.814. Indole-3-acetic acid was the most abundant auxin in the xylem, being B.72020 and B.9 the stocks with higher content, while G.935 had the least. Regarding cytokinins (CK), the highest content was observed on G.11, and the lowest on G.814 and G.214. The highest ABA/CK ratio was observed on B.9, whereas B.72020 had the lowest value. On the other hand, B.72020 had the highest AUX/CK ratio value; and G.11 and G.935 the lowest. Fruit size was associated with high ABA/CK values. Trunk cross sectional area, branch angle, gas exchange variables, and biennial bearing were correlated with auxins and AUX/CK concentrations in xylem. Yield efficiency, crop load, leaf temperature, return bloom and bud break were correlated with ABA, CK, and ABA/CK in xylem. Since G.814, G.935 and G.11 had a very uniform bud break, these rootstocks could be suitable to test in areas where irregular bud break might be a problem. The high levels of endogenous ABA observed in Honeycrisp grafted on B.9 and G.11 suggests the possibility of these rootstocks tolerating drought stress by slowing evapotranspiration of the scion.
The acid promoted Petasis reaction of organotrifluoroborates with imines and enamines

The acid promoted addition of organotrifluoroborate salts to imine and enamine electrophiles is reported. Use of the pre-activated trifluoroboronate complex bypasses the need for α-hetero substitution on the electrophile component, greatly expanding the scope of the Petasis borono–Mannich reaction. A variety of vinyl, aromatic and heteroaromatic trifluoroborate salts undergo addition with good efficiency under mild reaction conditions. The reaction is amenable for use with a variety of carbamate protected imine and enamine electrophiles, achieving for the first time the effective coupling with aliphatic aldehydes.
MAJOR SECRETORY PROTEINS OF THE PROSTATE AND EPIDIDYMIS

Publisher Summary This chapter discusses major secretory proteins of the prostate and epididymis. The duct system of the male reproductive tract includes the attached accessory glands from a complex functional unit in which transport and maturation of spermatozoa take place and where the components of semen are produced. The prostate secretes a large variety of substances, ranging from ions and small molecules to proteins, into semen. Epididymal protein secretion can be instrumental in sperm maturation. The chapter describes two androgen-dependent proteins—AEG and prostatein—produced by specific cell types in the male reproductive tract. They constitute a significant portion of the soluble protein present in the epididymis and ventral prostate, respectively, and hence are easily purified. The mRNAs coding for AEG and prostatein account for as much as 10–20% of the total poly-A-containing mRNA produced by these tissues. AEG and prostatein bind to the surface membrane of spermatozoa and can promote changes in their motility and fertilizing capacity.
GSTP1-catalyzed PKM2 S-Glutathionylation Regulates Glycolysis in Non-small Cell Lung Cancer and is Attenuated with a Clinically Relevant inhibitor of Glutathione-S-transferase P

Rationale Lung cancer is the most lethal form of any of the common cancers, resulting in over 160,000 deaths in the US every year. Unfortunately, the 5-year survival rate has remained almost unchanged over the past 3 decades. Glutathione S-transferase P1 (GSTP1) is expressed significantly higher in lung tumor tissue from NSCLC compared to matched non-tumorous lung tissue. Originally this was attributed to its role in phase II drug metabolism. However, GSTP1 was recently described as a catalyst of protein S-glutathionylation (PSSG), a reversible cysteine oxidation and post-translational modification pointing towards a different role of GSTP in lung cancer. The goal of this study is to determine whether GSTP1 expression and subsequent enhanced PSSG are important in tumorigenesis. Methods In a tissue micro array of 106 human NSCLC specimens together with adjacent healthy tissue GSTP1 expression and overall PSSG was evaluated. The most common “driver” mutation in NSCLC occurs in the KRAS gene. To study NSCLC in mice we established an inducible KRASG12D-driven lung adenocarcinoma model that enables lung-epithelial specific expression of mutant KRAS. Alternatively, primary Mouse Tracheal Epithelial (MTE) Cells derived from KRASG12D mice were exposed to adeno-Cre to activate mutant KRAS. Results Assessment of 106 NSCLC TMAs revealed that 47% were completely negative and 41% were highly positive for GSTP1, and the lung cancers expressing GSTP1 had high PSSG reactivity. GSTP1 expression and PSSG were associated with a worse prognosis. In a mouse model of NSCLC, activation of mutant KRAS resulted in an increase of GSTP1 protein and PSSG in the lung. Further, lactate content and glycolysis regulators were significantly upregulated in lungs following KRASG12D activation. Following pharmaceutical inhibition of GSTP with TLK117, a phase II tested compound, KRAS-induced increases in PSSG and lactate were strongly decreased in lungs compared to vehicle- treated animals. KRASG12D activation in primary lung epithelial cells by adeno-cre resulted in a strong increase of GSTP1 protein and a striking increase in overall protein S-glutathionylation. More specifically Pyruvate kinase M2 (PKM2), an important enzyme in cancer metabolism, was highly S-glutathionylated in KRASG12D activated mouse lung and in MTE cells and increase in lactate production and expression of glycolysis enzymes was observed. Pharmacological GSTP1 inhibition with TLK117 decreased PKM2-and overall PSSG, glycolysis and tumor migration. Conclusion Together, these data reveal a potential pivotal new role of GSTP1 in regulating lung adenocarcinoma metabolism by promoting glycolysis in part through oxidative inactivation (S-glutathionylation) of PKM2.
Supplementary antimicrobials for patients with HIV and <100 CD4 cells/µL are associated with improved survival

Commentary on : Hakim J, Musiime V, Szubert AJ, et al . Enhanced Prophylaxis plus Antiretroviral Therapy for Advanced HIV Infection in Africa. N Engl J Med 2017;377:233–45. Despite expansion of HIV testing and recommendations to start antiretroviral therapy (ART) immediately, people living with HIV (PLWH) often present late in the disease. In poorer countries, 30%–40% of PLWH starting ART have CD4 counts <200 cells/µL and 20% have a CD4 count <100 cells/µL.1 PLWH with advanced immunosuppression are at greater risk for complications and death, and their care is more complex than those with early disease. The WHO promotes differentiated service delivery2—a strategy that varies the intensity, frequency and location of treatment. To date, this has focused on deintensifying treatment for patients with higher CD4 counts. Hakim and colleagues offer a strategy for PLWH presenting with advanced disease.3 …
Digital image analysis agrees with visual estimates of adult bone marrow trephine biopsy cellularity.

Introduction Evaluation of cellularity is an essential component of bone marrow trephine biopsy examination. The standard practice is to report the results as visual estimates (VE). Digital image analysis (DIA) offers the promise of more objective measurements of cellularity. Methods Adult bone marrow trephine biopsy sections were assessed for cellularity by VE. Sections were scanned using an Aperio AT2 Scanscope and analyzed using a Cytonuclear (version 1.4) algorithm on halo software. Intraclass correlation (ICC) was used to assess relatedness between VE and DIA, and between MRI and DIA for a separate subset of patients. Trephine biopsy sections from a subset of patients with bone marrow biopsies uninvolved by malignancy were assessed for age-related changes. Results Interobserver VE agreement was good to excellent. The ICC value was 0.81 for VE and DIA, and 0.50 for MRI and DIA. Linearity studies showed no statistically significant trend for age-related changes in cellularity in our cohort (r = -.29, P = .06). Conclusions Agreement was good between VE and DIA. It may be possible to use DIA or VE to measure cellularity in the appropriate clinical scenario. The limited sample size precludes similar determinations for MRI calculations. Further studies examining healthy donors are necessary before making definitive conclusions regarding age and cellularity.
Comparison of Tumor Classifications for Cutaneous Squamous Cell Carcinoma of the Head and Neck in the 7th vs 8th Edition of the AJCC Cancer Staging Manual.

Importance Previous studies have shown that theAJCC Cancer Staging Manual, 7th edition (AJCC 7), tumor classification for cutaneous squamous cell carcinoma (CSCC) failed to accurately stratify disease-related outcomes. The recently released 8th edition (AJCC 8) features a revised tumor classification for only head and neck CSCC (HNCSCC). Objective To compareAJCC 7andAJCC 8tumor classifications for HNCSCC and to validateAJCC 8. Design, Setting, and Participants This was a 10-year retrospective cohort study (2000-2009) at an academic tertiary care center reviewing 680 primary HNCSCC tumors in 459 patients. Main Outcomes and Measures Primary HNCSCC tumors were reviewed for disease-related outcomes (DROs): local recurrence (LR), nodal metastasis (NM), and disease-specific death (DSD). Tumors were stratified byAJCC 7andAJCC 8tumor classification. Distinctiveness (outcome differences between categories), homogeneity (outcome similarity within categories), and monotonicity (outcome worsening with increasing categories) were assessed for both classifications. Results Most of the 459 patients were white (451 [98.3%]) and male (312 [68.0%]).AJCC 8high tumor categories (T3/T4) accounted for 121 (17.8%) of total cases but 50 of 71 DROs (70.4%) (22 of 34 of LRs [64.7%], 17 of 24 NMs [70.8%], and 11 of 13 of DSDs [84.6%]). This was a significant improvement overAJCC 7, where only 12 of 71 DROs (16.9%) (4 of 34 LRs [11.8%], 3 of 24 NMs [12.5%], and 5 of 13 DSDs [38.5%]) occurred in T3/T4 categories. However,AJCC 8T2 and T3 were indistinct, with overlapping 95% CIs for 10-year cumulative incidences of LR, NM, and DSD. The 10-year cumulative incidence of DROs in the 119AJCC 8T3 cases were 19.7% (95% CI, 13.0%-29.7%) for LR, 14.1% (95% CI, 9.7%-20.7%) for NM, and 9.3% (95% CI, 6.8%-14.0% for DSD). Conclusions and Relevance AJCC 8demonstrates superior homogeneity and monotonicity compared withAJCC 7. It now may be possible forAJCC 8HNCSCC T2, T3, and T4 cases to be recorded and tracked by tumor registries because they represented a 23.1% subset in this study, which includes nearly all poor outcomes (85.9%). Further work is needed to validateAJCC 8with population-level data and to compareAJCC 8performance against alternative tumor classifications.